Nuclear medicine imaging

Abstract

Until the 1990s, the role of nuclear medicine procedures in the workup of soft tissue tumors had been quite modest, for various reasons. Firstly, soft tissue tumors are not a common type of tumor; they only account for about 1% of all malignancies [91]. Secondly, nuclear medicine procedures attempted in the past for this type of tumor yielded rather disappointing results, among other reasons due to technical limitations and a limited choice of appropriate radiopharmaceuticals [59]. Clinicians then gradually abandoned nuclear medicine examinations for this application and relied more and more upon the increasing armamentarium of nonradioactive imaging modalities: ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) However, a comeback of nuclear medicine procedures in the study of soft tissue tumors has been observed. This is mainly due to the introduction of positron emission tomography (PET) into clinical diagnosis, resulting in a sensitivity and a specificity that are unattained by other imaging modalities. There are two main reasons to perform scintigraphic procedures in the management of soft tissue tumors: 1. If the tumor takes up the radiopharmaceutical, metastases and recurrences will generally also do so. This, combined with the possibility of performing total body imaging and as many additional spot views as may appear necessary without increasing the radiation burden leads naturally to the use of radiotracer techniques in staging procedures and in follow-up. 2. Some radiopharmaceuticals appear to be taken up only by viable tumor cells,which makes it possible to distinguish between scar tissue and residual tumor in post-therapeutic follow-up. © 2006 Springer-Verlag Berlin Heidelberg.