Blood pool images of soft tissue tumors

From January 1986 through August 1992, three-phase bone scintigraphy with Tc-99m methylene diphosphonate (MDP) or Tc-99m hydroxy methylene diphosphonate (HMDP) was performed on consecutive 152 patients with pathologically proven soft tissue tumors. The ability of blood pool scintigraphy to delineate tumors was examined in evaluable 149 patients. According to tumor histology, it showed hot spots in 28/29 for malignant fibrous histiocytoma, 16/16 for liposarcoma, 8/8 for periosteal sarcoma, 42/43 for other sarcomas, 10/11 for neurilemoma, 12/14 for desmoid, 1/4 for myxoma, 5/5 for pigmented villonodullar synovitis or giant cell tumor of tendon sheath, 7/7 for angiomas, and 9/12 for other benign tumors. Malignant tumors were shown as hot spots in 98% (94/96) and the entire tumors, including benign ones, in 93% (138/149). Blood pool scintigraphy was inferior in detecting mucous tumors and small nodules. It could not differentiate between degeneration or necrosis and cytoma that were detectable on MRI. Blood pool scintigraphy was superior in determining the outcome of preoperative chemotherapy and/or radiotherapy. In conclusion, blood pool scintigraphy is an essential preoperative method for providing useful information on soft tissue tumors. (N.K.)