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March 13, 1967

Brain Scan Artifact From Saliva Contamination

JAMA. 1967;199(11):861. doi:10.1001/jama.1967.03120110133035

To the Editor:—  The ready availability of technetium 99m for brain scanning recently has promoted its wider use in clinical medicine. The advantages of using this isotope are well known; however, certain disadvantages may not be appreciated. One of these disadvantages has been pointed out by Witcofski et al1 and bears emphasis since it is a potential source of confusion or misdiagnosis. This is the artifact observed when there is extracranial contamination with saliva.

Report of a Case:  A 75-year-old woman who was comatose and hemiplegic because of a presumed cerebrovascular accident was referred for brain scan. She was given 7.7 mc of technetium 99m in the pertechnetate form (obtained from a sterile generator) intravenously. Scanning was begun one hour later and progressed from anterior to left lateral to right lateral views (Fig 1). Although there were no apparent abnormalities on the first two views, an area of intense