Histologic and Hydrodynamic Evaluation of Blood Flow for Scintigraphic Detection of Malignant Tumor of the Head and Neck.

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In the experiment with animals, Japan white rabbits transplanted with VX2 carcinoma in the right femoral regionwere examined histologically, angiographically and hydrodynamically. The tumor blood vessel became rich in accordance with tumor growth and the blood flow rate and the volume of the blood flow of the right femoral artery in the tumor side was approximately twice or three times as much as that in the control side (left femoral artery) by means of the ultrasonic blood flow meter (5 MHz). In the clinical examination, 117 patients with oral cancer were examined scintigraphically and histopathologically. Tumor blood flow was estimated scintigraphically immediately after administration of <@D199m@>D1Tc-HMDP.Radioactivity of venous phase (30 to 40 seconds after administration) and blood pool phase (1 to 3 minutes) were observed. Radioactive ratios of tumor to the control region in both phases were calculated ; venous ratio (VR), blood pool ratio (BPR). Early image with <@D199m@>D1Tc-HMDP (early image) was obtained 5 minutes after administration and the image with <@D167@>D1Ga-citrate (Ga-image) was obtained 3 days after administration. Tumor vascular patterns were classified histopathologically into three groups ; rich, intermediate and poor. VR,BPR,early image, Ga-image, vascular pattern and tumor size were compared each other. Poor vascular pattern showed small VR (M(]SY.+-。[)SD=0.97(]SY.+-。[)0.08) and BPR (1.02(]SY.+-。[)0.04). Rich vascular pattern showed large VR (1.39(]SY.+-。[)0.01) and BPR (1.31(]SY.+-。[)0.16). Positive early image was predominant among large VR (78%) and BPR (100%). Tumors of under 3 cm in size showed that 65% of them belonged to intermediate or rich vascular pattern and positive early image reflected tumor blood flow. These results intimated the improvement of detecting ratio by combining early image (blood flow image) with delayd image.