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Primary Ewing sarcoma: follow-up with Ga-67 scintigraphy
D N Estes1, H L Magill, E I Thompson
1Department of Radiology, University of Tennessee, Memphis 38163.
Radiology
|November 1, 1990
Summary
Gallium-67 citrate and technetium-99m methylene diphosphonate (MDP) uptake decreases after Ewing sarcoma treatment. Gallium-67 scintigraphy is more sensitive for detecting relapse, especially when bone scintigraphy remains abnormal.
Area of Science:
- Nuclear medicine
- Oncology
- Pediatric oncology
Background:
- Ewing sarcoma is a rare bone cancer primarily affecting children and young adults.
- Gallium-67 citrate and technetium-99m methylene diphosphonate (MDP) scintigraphy are used to diagnose and monitor Ewing sarcoma.
- The behavior of these imaging agents after therapy requires further definition.
Purpose of the Study:
- To evaluate changes in Gallium-67 (Ga-67) and Technetium-99m methylene diphosphonate (Tc-99m MDP) uptake in patients with Ewing sarcoma after therapy.
- To compare the utility of Ga-67 and Tc-99m MDP scintigraphy in detecting disease relapse.
Main Methods:
- Retrospective analysis of 30 patients with Ewing sarcoma.
- Comparison of Ga-67 and Tc-99m MDP scintigraphy findings at diagnosis, post-therapy, and relapse.
- Evaluation of tracer uptake intensity and changes over time.
Main Results:
- All patients showed decreased Ga-67 uptake at the primary site post-therapy.
- Most patients (23/28) also showed decreased Tc-99m MDP uptake, but residual activity was often more intense than with Ga-67.
- Ga-67 reaccumulation was noted in four of five patients with primary site relapse, while Tc-99m MDP showed less change.
Conclusions:
- Successful Ewing sarcoma treatment often leads to a greater decrease in Ga-67 uptake compared to Tc-99m MDP uptake.
- Ga-67 scintigraphy provides valuable information for detecting relapse, particularly when Tc-99m MDP scans remain abnormal or occult relapse is suspected.