The role of Thallium-201 scintigraphy and Tc-99m pentavalent dimercaptosuccinic acid in diagnosis and grading of chondrosarcoma.

Title The role of Thallium-201 scintigraphy and Tc-99m pentavalent dimercaptosuccinic acid in diagnosis and grading of chondrosarcoma.
Authors O. Jo; S. Schlicht; J. Slavin; C. Di Bella; G. Pang; G. Powell; T. Spelman; P.Fm Choong
Journal Eur J Radiol
DOI 10.1016/j.ejrad.2020.108846
Abstract

PURPOSE: Distinguishing between enchondromas and low-grade (grade 1) chondrosarcomas can be challenging. The aim of this study was to investigate the role of Thallium-201 scintigraphy and Technetium-99 m pentavalent dimercaptosuccinic acid (Tc-99 m DMSA (V)) in the diagnosis and grading of chondrosarcomas.

METHODS: 232 consecutive patients with pathologically proven cartilaginous tumours between the years 2000 and 2018 were evaluated. We included 197 patients (101 males and 96 females; median age 50 years; range 15-86 years) who underwent Thallium-201(n = 193) and/or Tc-99 m DMSA (V) scanning (n = 67). Increased uptake was defined as uptake greater than background. The reference standard was the histopathological assessment based on a grading system (grade 1-3). Data was analysed using multivariate modelling.

RESULTS: There were 46 patients with enchondromas and 151 with chondrosarcomas. Of those, 64 (enchondroma n = 21, chondrosarcoma n = 43) underwent both Thallium-201 and Tc-99 m DMSA (V). Thallium-201 uptake had 7.92 times greater odds of grade 1 chondrosarcomas than enchondromas. Thallium-201 uptake was significantly associated with the odds of a higher grade chondrosarcoma (grade 2-3). DMSA (V) positivity was associated with 4.75 times the odds of a chondrosarcoma diagnosis over enchondroma (p = 0.024). DMSA (V) uptake revealed no association with chondrosarcoma grading.

CONCLUSION: Low-grade chondrosarcomas continue to pose a diagnostic dilemma. Thallium-201 scans may identify malignancy in benign appearing tumours as well as differentiate between low-grade and high-grade chondrosarcomas in said malignancies. DMSA (V) may be useful in distinguishing between benign and malignant entities as a whole.

Citation O. Jo; S. Schlicht; J. Slavin; C. Di Bella; G. Pang; G. Powell; T. Spelman; P.Fm Choong.The role of Thallium-201 scintigraphy and Tc-99m pentavalent dimercaptosuccinic acid in diagnosis and grading of chondrosarcoma.. Eur J Radiol. 2020;125:108846. doi:10.1016/j.ejrad.2020.108846

Related Elements

Thallium

81 Tl 204.383300000 Thallium

See more Thallium products. Thallium (atomic symbol: Tl, atomic number: 81) is a Block P, Group 13, Period 6 element with an atomic weight of 204.38. Thallium Bohr ModelThe number of electrons in each of thallium's shells is 2, 8, 18, 32, 18, 3 and its electron configuration is [Xe] 4f14 5d10 6s2 6p1. The thallium atom has a radius of 170 pm and a Van der Waals radius of 196 pm. Thallium was discovered by Sir William Crookes in 1861 and first isolated by Claude-Auguste Lamy in 1862. Thallium is a post-transition metal that is not found free in nature. Thallium is primarily used for its electrical conductivity as thallium sulfide, which changes with exposure to infrared light. This ability makes the compound useful in photocells. Elemental ThalliumThallium bromide-iodide crystals have been used as infrared optical materials. Thallium has also been used with sulfur, selenium or arsenic to produce low melting glasses which become fluid between 125 and 150 °C, while thallium oxide has been used to produce glasses with a high index of refraction, and is also used in the manufacture of photo cells. Its name is derived from the Greek word thallos, which means twig or green shoot.

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Isotopes
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