Brain Tumour Scintigraphy with 99mTc-Pertechnetate, 99mTc-Fe(II) Complex and 131I-Labelled Macroaggregated Albumin - Comparison of Results

99mTc, in the form of pertechnetate, has now gained its place in brain scintigraphy. The present authors and many others have found its diagnostic value equal to that of substances labelled with mercury or iodine. Using 99mTc-pertechnetate as the basis of their work, the authors attempted to extend isotopic diagnosis by two methods, namely: intra-arterial introduction of macroaggregated albumin; and intravenous injection of a new substance, the 99mTc-Fe(II) complex. Following their publication in 1966 of the results obtained with the first method, the authors now present an account of their experiments carried out on over 100 patients with brain tumours. Compared with scintigraphy involving intravenous injection of 99mTc-pertechnetate, this new method gives supplementary information which is often of considerable help in clinical neuroradiological diagnosis of these patients. The findings in a majority of cases were confirmed by operation or by autopsy. The method made it possible for the first time to use scintigraphy to visualize the arterial network of the brain. In view of the ease with which brain scintigraphy can be performed after intravenous injection, and also of our experience with the 99mTc-Fe(II) complex in kidney scintigraphy and the evidence of a brief report in the United States literature, the authors decided to try out this substance in the detection of brain tumours. Their first results showed it to be incontestably superior to all others previously applied intravenously. It has the indubitable advantages of 99mTc as regards the irradiation dose to the patient and gives an exceptionally precise delineation of the invasive cerebral processes due to a rapid fall in blood concentration. A combination of these two new scintigraphic methods would thus seem to open up new possibilities and greatly enhance the field of application of radioisotopes in the clinical study of brain diseases. The paper contains material from a wide selection of case studies. (author)