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99m Tc‐MIBI imaging of cutaneous AIDS‐associated Kaposi's sarcoma
Author(s) -
Peer Fawzia I.,
Pui Margaret H.,
Mosam Anisa,
Rae William I. D.
Publication year - 2007
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2006.03001.x
Subject(s) - medicine , lymph , lymph node , sarcoma , lymphedema , scintigraphy , thyroid , lymphoma , pathology , radiology , nuclear medicine , breast cancer , cancer
Background Kapoksi's sarcoma (KS) is a common neoplasm complicating acquired immunodeficiency syndrome (AIDS). Skin, mucus membranes, lymph nodes, gastrointestinal tract and lungs may be involved. Kaposi's sarcoma has been demonstrated by scintigraphy, and a 99m Tc‐hexakis‐2‐methoxy isobutyl isonitrile (MIBI) scan can demonstrate lymphoma and tumors of the brain, nasopharynx, thyroid, parathyroid, lung, breast and kidney. It may also be useful for detecting and delineating the extent of KS. The objective of this study was to determine the efficacy of 99m Tc‐MIBI scanning to demonstrate cutaneous AIDS‐associated KS, lymphedema and lymphadenopathy in the extremities. Methods Whole body 99m Tc‐MIBI scans were obtained on 40 patients with AIDS‐associated KS. Abnormal uptake of 99m Tc‐MIBI in the skin, subcutaneous soft tissues and lymph nodes was compared with the clinical assessment. Results The 99m Tc‐MIBI uptake was noted in the cutaneous/subcutaneous KS of the extremities with a sensitivity of 73.53%, a specificity of 96.91% and an accuracy of 91.31%. Abnormal lymph nodes and lymphedema were detected in more patients on 99m Tc‐MIBI scans (33 and 18 patients) than clinical assessment (10 and 12 patients), respectively. Lymphedema of the lower extremity was found in four of 17 patients without any palpable or abnormal lymph node uptake of 99m Tc‐MIBI in the inguinal regions. Follow‐up 99m Tc‐MIBI scans after treatment showed no uptake in the skin lesions and decreased uptake in the lymph nodes corresponding to complete clearing on clinical assessment. Conclusions 99m Tc‐MIBI imaging provides additional information on the extent of lymph node involvement and more precise staging and therapeutic planning. It may be useful as a predictive test or follow up of response of cutaneous KS to treatment.