It is preferred because of its short half-life and because the emitted photon has an appropriate energy for normal imaging techniques. The "m" indicates that this radionuclide is metastable. It is generated on site from a molybdenum source.
Selection of therapeutic strategy e. Aetna considers I labeled MIBG radiotherapy medically necessasry for treatment recurrent high-risk neuroblastoma. AndreView Aetna considers iobenguane I injection AdreView, GE Healthcare medically necessary for the detection of primary or metastatic pheochromocytoma or neuroblastoma as an adjunct to other diagnostic tests.
Aetna considers iobenguane I injection experimental and investigational for all other indications because its effectiveness for indications other than the ones listed above has not been established.
Scintimammography and Breast Specific Gamma Imaging BSGI Aetna considers scintimammography, including breast-specific gamma imaging BSGI; also known as molecular breast imagingexperimental and investigational as an adjunct to mammography for imaging of breast tissue, for Tc 99m detection of axillary metastases, staging the axillary lymph nodes in members with breast cancer, and to assess response to adjuvant chemotherapy in members with breast cancer, and for all other indications because its effectiveness has not been established.
Technetium-Tc 99m Tilmanocept Lymphoseek Aetna considers technetium Tc 99m tilmanocept Lymphoseek injection medically necessary for location of lymph nodes in persons with breast cancer or melanoma who are undergoing surgery to remove tumor-draining lymph nodes.
Tumor scintigraphy involves the intravenous administration of a radio-pharmaceutical, defined as an isotope attached to a carrier molecule, which localizes in certain tumor tissues and the subsequent imaging and computer acquisition of data. The goal of tumor scintigraphy is to enable the interpreting physician to detect and evaluate primary, metastatic, or recurrent tumor tissue by producing images of diagnostic quality.
In general, Tc 99m scintigraphy may be used for, but is not limited to, detection of certain primary, metastatic, and recurrent tumors, evaluation of abnormal imaging Tc 99m non-imaging findings in patients with a history of certain tumors, and reassessment of patients for residual tumor burden after therapy.
Specific clinical applications differ depending upon the specific radiopharmaceutical that is used. Traditional imaging modalities CT, MRI for prostate cancer perform very poorly and bone scanning, although having a high positive predictive value, is insensitive for metastasis and is used only in those patients with a reasonable probability of metastatic disease e.
The ProstaScint scan uses a monoclonal antibody-based imaging agent InCapromab Pendetide and was approved by the U. Food and Drug Administration FDA for use in patients with biopsy proven prostate cancer in whom there is a high clinical suspicion of occult metastatic disease and who have had a negative or equivocal standard staging evaluation.
Patients with primary colorectal carcinoma undergo an extensive pre-operative staging work-up.
In regards to ovarian cancer, serum CA levels have been shown to be useful in predicting the presence of ovarian cancer, but negative titers do not preclude malignancy. Oncoscint is an IgG murine monoclonal antibody that specifically targets the cell surface mucin-like glycoprotein antigen TAG, which is commonly found on colorectal and ovarian carcinomas.
According to the available literature, a major advantage of Oncoscint is that it allows one to survey the entire body, thus permitting the detection of occult metastases that can have a major impact on tumor staging. Clinical studies have documented only minimal cross reactivity with other tumors or normal tissues i.
Oncoscint can also be used to confirm the absence of other sites of disease prior to surgery. This is important for the patient about to undergo a potentially curative resection of an isolated recurrence of colorectal carcinoma located in a single site, i.
CEA-Scan is a nuclear imaging test which uses a monoclonal antibody fragment arcitumomab labeled with technetium 99 that reacts with CEA, a tumor marker for cancer of the colon and rectum.
CEA-Scan can be used to detect recurrent or metastatic colorectal carcinoma in conjunction with standard imaging modalities.
The agent is not indicated as a screening tool for colorectal cancer. Since its introduction, technetiumm-sestamibi also known as technetiumm-MIBI has been shown to be of value in assessing malignant bone and soft tissue tumor response to therapy.
Technetiumm-sestamibi Miraluma has also been proposed as the radio-pharmaceutical agent for use during scintimammography in the evaluation of women with dense breast tissue and possibly for women who have had partial mastectomy, previous biopsies, radiation therapy or silicone implants.
Although Miraluma may be more sensitive than thallium in the evaluation of breast lesions greater than 1. There is a lack of evidence in the medical literature demonstrating an acceptable level of sensitivity and specificity in detecting small, non-palpable breast lesions less than 1.
False-positive examinations have been described with fibroadenomas, papillomas, epithelial hyperplasia, and fibrocystic breast disease. Patients with fibrocystic disease are more likely to have false-positive examinations even though the Miraluma exam has been reported to be unaffected by the density of the breast.
Most false-negative examinations occur with lesions smaller than 1 cm in size or in lesions not palpable. And lastly, the available literature shows that Miraluma is not competitive with mammography on either a cost-effective or sensitivity basis in the screening of patients for breast cancer.
This suggests a selection bias and sensitivity of the examination is likely over-estimated; and the mean lesion size is generally over 1. Other drawbacks include the lack of an adequately high negative predictive value, which means malignant lesions may be missed, and false positive exams occur in benign lesions such as fibroadenomas.
Since the implications of a missed diagnosis of breast cancer can be disastrous to patient outcome, the available literature states that Miraluma has no role in breast cancer screening to confirm the presence or absence of malignancy particularly clinically occult abnormalitiesand it is not an alternative to biopsy.
Stereotactic and ultrasound guided biopsies of breast lesions are minimally invasive and can provide a definitive diagnosis.
Despite optimism in the nuclear medicine literature, the literature on balance states that this examination probably has no role in the evaluation of patients with suspected breast malignancy. Determining a subset of women that would benefit from this procedure will be difficult until larger prospective studies have been performed.
Mammography remains the generally accepted standard for screening. Continued evaluation with diagnostic mammography, ultrasound and surgical biopsy remains the diagnostic work-up that is most frequently recommended.
Although it has FDA approval, the current data do not justify its implementation on a standard basis. Technological improvements and novel radioactive compounds could potentially improve its utility, but at the moment its future is uncertain.
The method also has potential for use in functional imaging applications, but further study and development are needed. The report found that, for every 1, women with negative scintimammogram results, about women would avoid an unnecessary biopsy but 93 women would have missed cancers.Technetium m is produced by bombarding molybdenum 98 Mo with neutrons.
The resultant 99 Mo decays with a half-life of 66 hours to the metastable state of Tc. This process permits the production of 99m Tc for medical purposes. Since 99 Mo is a fission product of U fission, it can be separated.
Technetium TCM | Tc | CID - structure, chemical names, physical and chemical properties, classification, patents, literature, biological activities, safety.
A technetiumm generator, or colloquially a technetium cow or moly cow, is a device used to extract the metastable isotope 99m Tc of technetium from a source of decaying molybdenum 99 Mo has a half-life of 66 hours and can be easily transported over long distances to hospitals where its decay product technetiumm (with a half-life of only 6 hours, inconvenient for transport) is.
Aetna considers iobenguane I injection (Azedra) medically necessary for the treatment of adults and adolescents aged 12 years and older with pheochromocytoma or paraganglioma that is unresectable, have spread beyond the original tumor site and require systemic anti-cancer therapy.
Ibudilast as a Nootropic. Ibudilast (MN or AV) is on my short list of the best nootropics I’ve tried (along with LLLT, intranasal insulin, concentrated oxygen, etc.).
Ontario Power Generation's (OPG) Darlington nuclear power plant is to produce molybdenum (Mo) for use in new technetiumm (Tcm) generators designed by BWX Technologies Inc. The Candu plant will be the first large-scale commercial nuclear power plant in .