Radionuclide Ommayagrams in 25 patients with leptomeningeal carcinomatosis were performed after injection of 0.5 mCl of In-111 DTPA into Ommaya shunt reservoirs to evaluate cerebrospinal fluid-shunt communication, detect the blockage of the cerebrospinal fluid pathway, evaluate the cerebrospinal fluid flow pattern, and predict the distribution of the chemotherapeutics. All results were correlated with MRI evaluations of the brain and spine, as well as clinical findings. Radionuclide Ommayagrams were found to be 73% sensitive and 100% specific in the evaluation of cerebrospinal fluid space disease. MRI of the spine and head was found to be 100% sensitive, but 86% specific for obstructive cerebrospinal fluid space disease.