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One hundred consecutive patients with findings suggestive of resectable bronchogenic carcinoma were studied prospectively to determine if routine liver, brain, and bone scans (multiorgan scans) detected metastases which were not suggested by a history, physical examination, and serum chemistries. Multiorgan scans were compared with clinical evaluations in 52 patients found to have operable bronchogenic carcinoma. There was a discordance between scans and clinical evaluations in 25/153 scans (16 per cent). Two of the 22 negative scans in patients with abnormal clinical findings were false negative. Sixteen of the 17 positive scans in patients with normal clinical findings were false positive. One of the 131 scans done in patients with no evidence of metastases on clinical evaluation was true positive. These data indicate that the routine use of multiorgan scans in the initial staging of potentially resectable bronchogenic carcinoma is not justified.

When the solid fraction of a standardized meal is labeled with technetium 99m-sulfur colloid-labeled chicken liver and fed to human subjects, linear regions of decreased radioactivity that have the appearance of a band are identified on the scintillation camera images of the stomach. The band is not a peristaltic contraction because it persists in individual subjects after 4 h of imaging. The band has also been identified in the dog, pig, and monkey. It is transverse and midgastric in location. William Beaumont noted a similar band in his observations on Alexis St. Martin in 1833, and a transverse band was noted in autopsy specimens of food-filled human stomachs in 1919. However, the finding has been ignored in current gastrointestinal or radiologic textbooks because the band cannot be identified with conventional barium sulfate meals. The anatomic basis for the band and its role in regulating gastric emptying remain unclear.

Morton KA, Alazraki NP, Datz FL, Taylor AT, Winge D, Lynch RE. Uptake of cadmiuum-109, a metallothionein-binding radiometal, by tumors in mice as a function of the transformed phenotype. Invest Radiol 1988;23:200–204.

To differentiate upper from lower-tract urinary infections, 73 patients were imaged with 67Ga citrate. Renal uptake of the radioisotope occurred in pyelonephritis (documented in 47 patients by ureteral catheterization, bladder washout, or histology) with an accuracy of 86 per cent. There were 15 per cent false-positives and 13 per cent false-negatives. 67Ga may prove to be a clinically valuable test in the diagnosis of pyelonephritis. Results are promptly available 24 hours after injection, and it is a non-invasive test that can safely be repeated to follow recurrent infections.

99mTc-mercaptoacetyltriglycine (MAG3) is a new renal radiopharmaceutical which has been shown to have biological properties similar to131I-hippurate (OIH) in animals and volunteers.99mTc-MAG3 has now been compared with131I-orthoiodohippurate (OIH) in a group of patients with varying degrees of renal impairment. In all cases, the99mTc-MAG3 images were superior regardless of serum creatinine. Selected examples are illustrated including scans and renogram curves in a normal volunteer, transplant patients with creatinines of 9.8 mg/dl and 2.6 mg/dl respectively, and a furosemide study in a patient with questionable obstruction. Our preliminary results suggest that99mTc-MAG3 performs well in patients with impaired renal function and may well provide an acceptable replacement for OIH. A kit formulation has been developed and will soon be undergoing clinical evaluation.

The size of the liver and spleen was determined by scintiphotography in 214 patients and the results correlated with the physical findings concerning these two organs. False-positive interpretations of liver size and false-negative interpretations of spleen size were very common as determined by physical examination. The findings of a palpable spleen by physical examination correlated to a very high degree with anatomical enlargement of that organ.