n SA Journal of Radiology - Can ulceration in carcinoma of the oesophagus be detected by 99mTc- sucralfate scan? : original article




&lt;I&gt;Objective.&lt;/I&gt; To test: (i) the sensitivity and positive predictive value of tagged material in delineating ulcerations of the oesophagus in the pre- and post-treatment periods and at follow-up; and (ii) whether tagging could reduce the need for invasive endoscopic procedures in patients with carcinoma of the oesophagus. <br><I>Materials and methods.&lt;/I&gt; Twenty-nine patients with carcinoma of the oesophagus selected for radiation therapy underwent the <sup>99m</sup>Tc sucralfate scintimaging prior to radiation therapy. Patients were asked to drink 10 ml suspension of 10 mci <sup>99m</sup>Tc sucralfate. The sequential images of the oesophagus were acquired at 2 minutes, 2 hours, 4 hours and 6 hours following ingestion. In some patients images were also acquired at 24 hours and at follow-up. The comparison was done with endoscopy as the gold standard. <br><I>Results and observations.&lt;/I&gt; The overall positivity of the test was 83% at 4 hours (24 of 29 patients), 34% at 6 hours (10 of 29 patients) and 24% at 24 hours (7 of 29 patients). The sensitivity of the test was 85%, and the positive predictive value 50%. &lt;br&gt;&lt;I&gt;Conclusion.&lt;/I&gt; Due to low positive predictive value, this investigation cannot replace endoscopy to diagnose ulcerative disease in patients with carcinoma of the oesophagus.


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