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Sample records for 99mtc scintigraphy application

  1. 99mtc-Ubiquicidin [29–41], a Promising Radiopharmaceutical to Differentiate Orthopedic Implant Infections from Sterile Inflammation

    PubMed Central

    Beiki, Davood; Yousefi, Gholamali; Fallahi, Babak; Tahmasebi, Mohammad Naghi; Gholamrezanezhad, Ali; Fard-Esfahani, Armaghan; Erfani, Mostafa; Eftekhari, Mohammad

    2013-01-01

    Ubiquicidin (UBI) [29-41] is a synthetic cationic antimicrobial peptide that preferentially binds to bacterial cell membrane at the site of infection. We aimed to assess diagnostic value of 99mTc-UBI [29-41] as a radiopharmaceutical in differentiation of bacterial infection from sterile inflammation in suspected orthopedic implants. Nine patients suspected for orthopedic implant infection, all males with the mean age of 41.6 ± 20.9 years, were studied. A dose of 10 MBq/Kg (range : 555-740 MBq) 99mTc-UBI [29-41] was injected intravenously. A dynamic study followed by static whole body imaging at 30, 60 and 120 min post-radiotracer injection was acquired. Periprosthetic tissue culture was considered the closest test to a gold standard for diagnosing infections and scintigraphic scans were categorized as true- or false-positive and true- or false-negative, considering the bacterial culture as the gold standard. No adverse reaction was observed during or after the radiotracer injection days. There were five true positive, four true negative and no false positive and false negative scans. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were all calculated as 100%. We found a high diagnostic accuracy for 99mTc-UBI [29-41] scintigraphy in differentiation of bacterial infection from sterile inflammation in suspected orthopedic implants. Therefore, 99mTc-UBI [29-41] scintigraphy might be potentially recommended as a safe and promising imaging modality in these settings. However, further studies on a larger number of patients and different pathologies are still needed. PMID:24250609

  2. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy.

    PubMed

    Oliveira, Anderson de; Rezende, Maria Fernanda; Corrêa, Renato; Mousinho, Rodrigo; Azevedo, Jader Cunha; Miranda, Sandra Marina; Oliveira, Aline Ribeiro; Gutterres, Ricardo Fraga; Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco

    2014-11-01

    Background: Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective: To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. Methods: We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Results: Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. Conclusions: We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  3. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    PubMed Central

    de Oliveira, Anderson; Rezende, Maria Fernanda; Corrêa, Renato; Mousinho, Rodrigo; Azevedo, Jader Cunha; Miranda, Sandra Marina; Oliveira, Aline Ribeiro; Gutterres, Ricardo Fraga; Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco

    2014-01-01

    Background Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. Methods We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Results Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. Conclusions We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results. PMID:25252163

  4. 99MTc-Hexamethylpropyleneamine Oxime Imaging for Early Detection of Acute Lung Injury in Rats Exposed to Hyperoxia or Lipopolysaccharide Treatment.

    PubMed

    Audi, Said H; Clough, Anne V; Haworth, Steven T; Medhora, Meetha; Ranji, Mahsa; Densmore, John C; Jacobs, Elizabeth R

    2016-10-01

    Tc-Hexamethylpropyleneamine oxime (HMPAO) is a clinical single-photon emission computed tomography biomarker of tissue oxidoreductive state. Our objective was to investigate whether HMPAO lung uptake can serve as a preclinical marker of lung injury in two well-established rat models of human acute lung injury (ALI).Rats were exposed to >95% O2 (hyperoxia) or treated with intratracheal lipopolysaccharide (LPS), with first endpoints obtained 24 h later. HMPAO was administered intravenously before and after treatment with the glutathione-depleting agent diethyl maleate (DEM), scintigraphy images were acquired, and HMPAO lung uptake was quantified from the images. We also measured breathing rates, heart rates, oxygen saturation, bronchoalveolar lavage (BAL) cell counts and protein, lung homogenate glutathione (GSH) content, and pulmonary vascular endothelial filtration coefficient (Kf).For hyperoxia rats, HMPAO lung uptake increased after 24 h (134%) and 48 h (172%) of exposure. For LPS-treated rats, HMPAO lung uptake increased (188%) 24 h after injury and fell with resolution of injury. DEM reduced HMPAO uptake in hyperoxia and LPS rats by a greater fraction than in normoxia rats. Both hyperoxia exposure (18%) and LPS treatment (26%) increased lung homogenate GSH content, which correlated strongly with HMPAO uptake. Neither of the treatments had an effect on Kf at 24 h. LPS-treated rats appeared healthy but exhibited mild tachypnea, BAL, and histological evidence of inflammation, and increased wet and dry lung weights. These results suggest the potential utility of HMPAO as a tool for detecting ALI at a phase likely to exhibit minimal clinical evidence of injury.

  5. Liver scintigraphy in veterinary medicine.

    PubMed

    Morandi, Federica

    2014-01-01

    The most common veterinary application of liver scintigraphy is for the diagnosis of portosystemic shunts (PSSs). There has been a continual evolution of nuclear medicine techniques for diagnosis of PSS, starting in the early 1980s. Currently, transplenic portal scintigraphy using pertechnetate or (99m)Tc-mebrofenin is the technique of choice. This technique provides both anatomical and functional information about the nature of the PSS, with high sensitivity and specificity. Hepatobiliary scintigraphy has also been used in veterinary medicine for the evaluation of liver function and biliary patency. Hepatobiliary scintigraphy provides information about biliary patency that complements finding in ultrasound, which may not be able to differentiate between biliary ductal dilation from previous obstruction vs current obstruction. Hepatocellular function can also be determined by deconvolutional analysis of hepatic uptake or by measuring the clearance of the radiopharmaceutical from the plasma. Plasma clearance of the radiopharmaceutical can be directly measured from serial plasma samples, as in the horse, or by measuring changes in cardiac blood pool activity by region of interest analysis of images. The objective of this paper is to present a summary of the reported applications of hepatobiliary scintigraphy in veterinary medicine.

  6. Dipyridamole perfusion scintigraphy: The experience with its application in one hundred seventy patients with known or suspected unstable angina

    SciTech Connect

    Zhu, Y.Y.; Chung, W.S.; Botvinick, E.H.; Dae, M.W.; Lim, A.D.; Ports, T.A.; Danforth, J.W.; Wolfe, C.L.; Goldschlager, N.; Chatterjee, K. )

    1991-01-01

    We evaluated the safety, accuracy, and potential clinical utility of intravenous dipyridamole perfusion scintigraphy with thallium-201 in 170 patients, 78 with suspected and 92 with known unstable angina. All had coronary angiography. Noncardiac side effects (26%), induced chest discomfort (44%), and ST segment changes (12%) were similar in the two groups. No significant arrhythmias occurred. Two patients had prolonged chest pain, both with extensive reversible image abnormalities and associated creatinine kinase-MB release. Both had elective bypass surgery. Twenty-eight patients had normal coronary arteries, and 35 had single-vessel disease. Scintigraphic per patient sensitivity and specificity were 91% and 79% with a per vessel sensitivity of 74% and a per vessel specificity of 78% without between-group differences. During a brief follow-up period, 62 patients with image abnormalities had coronary revascularization, and there were seven deaths without intergroup differences. In a similar patient group that did not have angiography, scintigraphic defects were less frequent and less extensive, revascularization was not performed, and subsequent deaths occurred less often. Dipyridamole perfusion scintigraphy is an accurate alternative to exercise testing in the evaluation of patients with unstable angina pectoris. Although not without risk, the method appears relatively safe and should be considered as a guide to diagnosis, and probably to prognosis and management.

  7. Renal scintigraphy in veterinary medicine.

    PubMed

    Tyson, Reid; Daniel, Gregory B

    2014-01-01

    Renal scintigraphy is performed commonly in dogs and cats and has been used in a variety of other species. In a 2012 survey of the members of the Society of Veterinary Nuclear Medicine, 95% of the respondents indicated they perform renal scintigraphy in their practice. Renal scintigraphy is primarily used to assess renal function and to evaluate postrenal obstruction. This article reviews how renal scintigraphy is used in veterinary medicine and describes the methods of analysis. Species variation is also discussed.

  8. Thallium 201 Scintigraphy

    PubMed Central

    McKillop, James H.

    1980-01-01

    The radioactive isotope thallium 201 behaves physiologically as a potassium analog, and when injected intravenously accumulates rapidly within the cells of many organs. Uptake of the isotope reflects both regional perfusion and sodium-potassium pump activity. The radionuclide emits 80 keV x-rays which are suitable for scintillation camera imaging. The main clinical application of 201TI scintigraphy has been in myocardial imaging. Abnormal uptake of the isotope results in a cold spot on the myocardial image. In patients with coronary artery disease, the differentiation of ischemic and infarcted myocardium is made by comparing images obtained after injecting the radionuclide at the peak of a maximal exercise test with those obtained after injection at rest. Abnormalities due to ischemia usually are seen only on the stress image whereas fixed defects in both rest and stress studies usually indicate areas of infarction or scarring. Some investigators believe that redistribution images obtained four to six hours after stress injection (without administering further 201TI) give the same information as a separate rest study. The sensitivity of stress imaging for detecting significant coronary disease is of the order of 80 percent to 95 percent, though computer processing of the images may be necessary to achieve the higher figure. The prediction of the extent of coronary disease from 201TI images is less reliable. An abnormal 201TI image is not entirely specific for coronary artery disease and the likelihood of an abnormal image being due to this diagnosis varies according to the clinical circumstances. The main clinical value of 201TI myocardial imaging is likely to be in the noninvasive screening of patients with atypical chest pain or with ambiguous findings on stress electrocardiographic tests. It has also proved useful in studying patients with variant angina or following a coronary bypass operation. It is doubtful whether the technique is clinically helpful in most

  9. Liver scintigraphy in ponies

    SciTech Connect

    Theodorakis, M.C.; Bermudez, A.J.; Manning, J.P.; Koritz, G.D.; Hillidge, C.J.

    1982-09-01

    Six derivatives of ethylenediamine-N,N'-bis (alpha-2-hydroxy phenyl) acetic acid labeled with /sup 99m/Tc were prepared and their imaging qualities evaluated in ponies. The 6 agents produced good scintigraphic images of certain structures of the liver in the pony. For each agent, 13 different scans were taken. Dorsal views of the left lateral, right lateral, and quadrate lobe were obtained with dorsal scans. Left lateral and left lateral oblique (45 degrees) scans provided a left lateral view of the left lobe and a medial view of the right lateral lobe. Right lateral scans revealed the right lateral and quadrate lobes. Administration of /sup 99m/Tc-labeled colloids which are commonly used in other species for liver scintigraphy resulted in extensive lung uptake in the pony.

  10. Endocrine scintigraphy with hybrid SPECT/CT.

    PubMed

    Wong, Ka Kit; Fig, Lorraine M; Youssef, Ehab; Ferretti, Alice; Rubello, Domenico; Gross, Milton D

    2014-10-01

    Nuclear medicine imaging of endocrine disorders takes advantage of unique cellular properties of endocrine organs and tissues that can be depicted by targeted radiopharmaceuticals. Detailed functional maps of biodistributions of radiopharmaceutical uptake can be displayed in three-dimensional tomographic formats, using single photon emission computed tomography (CT) that can now be directly combined with simultaneously acquired cross-sectional anatomic maps derived from CT. The integration of function depicted by scintigraphy and anatomy with CT has synergistically improved the efficacy of nuclear medicine imaging across a broad spectrum of clinical applications, which include some of the oldest imaging studies of endocrine dysfunction.

  11. A significant diagnostic method in torture investigation: bone scintigraphy.

    PubMed

    Ozkalipci, Onder; Unuvar, Umit; Sahin, Umit; Irencin, Sukran; Fincanci, Sebnem Korur

    2013-03-10

    Torture appears to be a permanent feature in countries, which have experienced military coups or ruled by oppressive governments in the past, such as Turkey. The Human Rights Foundation of Turkey (HRFT) was established in 1990 to serve torture victims, mainly those who were the victims of the 1980 military regime. Since then the HRFT has been providing rehabilitation and documentation for torture survivors. Bone scintigraphy can be one of the diagnostic methods to reveal trauma, particularly after several years when it is challenging to find any physical or radiological evidence. The HRFT's Istanbul Branch referred 97 of their applicants for bone scintigraphy between 1992 and 2010. In this retrospective survey of 97 cases, 17 of them were female and 80 of them were male. Several aspects were evaluated, including working conditions, change of torture methods practiced in certain time periods, time since torture and duration of exposure to torture in comparison with findings of bone scintigraphies. The torture methods varied from beating to falanga, electric shock, suspension and several other types of torture within the period of practice, although beating was a common denominator among all. The findings were classified according to time since torture and duration of exposure to torture. More than half of the cases (59%) had a detectable bone lesion on bone scintigraphy, and the detectable bone lesion on scintigraphy increased significantly with the duration of exposure to torture, particularly among cases who had been subjected to torture for a longer period (8 days and more). Bone scintigraphy should be considered as a valuable non-invasive diagnostic method to assess and document long term torture practices and/or cases with no detectable marks upon physical examination.

  12. Thyroid scintigraphy in veterinary medicine.

    PubMed

    Daniel, Gregory B; Neelis, Dana A

    2014-01-01

    Thyroid scintigraphy is performed in cats and dogs and has been used to a limited degree in other species such as the horse. Thyroid scintigraphy is most commonly used to aid in the diagnosis and treatment management of feline hyperthyroidism but is also used in the evaluation of canine hypothyroidism and canine thyroid carcinoma. This article reviews the normal scintigraphic appearance of the thyroid in the cat, the dog, and the horse and the principles of interpretation of abnormal scan results in the cat and the dog. Radioiodine is the treatment of choice for feline hyperthyroidism, and the principles of its use in the cat are reviewed.

  13. 123I-Metaiodobenzylguanidine Myocardial Scintigraphy in Lewy Body-Related Disorders: A Literature Review

    PubMed Central

    Chung, Eun Joo; Kim, Sang Jin

    2015-01-01

    Lewy body-related disorders are characterized by the presence of Lewy bodies and Lewy neurites, which have abnormal aggregations of α-synuclein in the nigral and extranigral areas, including in the heart. 123I-metaiodobenzylguanidine (MIBG) scintigraphy is a well-known tool to evaluate cardiac sympathetic denervation in the Lewy body-related disorders. MIBG scintigraphy showed low uptake of MIBG in the Lewy body-related disorders, including Parkinson’s disease, dementia with Lewy bodies, pure autonomic failure and rapid eye movement sleep behavior disorder. This review summarizes previous results on the diagnostic applications of MIBG scintigraphy in Lewy body-related disorders. PMID:26090077

  14. Gallium scintigraphy in acute panniculitis

    SciTech Connect

    Choy, D.; Murray, I.P.C.; Ford, J.C.

    1981-11-01

    Gallium scintigraphy was performed in a 27-yr-old female in search of a possible occult focus of infection; it showed an unusual diffuse superficial accumulation in the thighs and buttocks. Biopsy of an area of abnormal uptake showed lobular panniculitis which, in the clinical context, led to the diagnosis of Weber-Christian syndrome.

  15. Nuclear cardiograph and scintigraphy

    NASA Technical Reports Server (NTRS)

    Mclaughlin, P.

    1975-01-01

    Extensive advances in the technology of detectors, data analysis systems, and tracers used have resulted in greatly expanded applications of radioisotopes to the assessment of cardiac function and disease. The development of nuclear cardiology has proceeded along four lines: (1) radionuclide angiography, (2) myocardial perfusion imaging, (3) intracoronary microsphere imaging, and (4) regional myocardial blood flow determination using inert gases.

  16. Radionuclide scintigraphy of bacterial nephritis

    SciTech Connect

    Conway, J.J.; Weiss, S.C.; Shkolnik, A.; Yogev, R.; Firlit, C.; Traisman, E.S.

    1984-01-01

    Pyelonephritis is a leading cause of renal failure and is expected to cost as much as three billion dollars in 1984. The diagnosis of urinary tract infection is usually not difficult. However, localization of the infection within the renal parenchyma as opposed to the collecting system is much more difficult. Flank pain, fever, bacteiuria and evidence of parenchymal involvement by intravenous urography may be absent or unrecognized particularly in the infant. Ultrasound and Nuclear Medicine are advocated as better methods to define parenchymal involvement. Such definition is important in the consideration of treatment since parenchymal involvement of the kidney carries a much more ominous potential outcome than infection restricted to within the collecting system. 38 children with a clinical diagnosis of urinary tract infection were studied. 26 of the patients demonstrated abnormal renal parenchymal findings with Gallium-67 Citrate or Tc-99m Glucoheptonate scintigraphy. Intravenous urography was notably ineffective with only 5 of the 20 interpreted as abnormal due to parenchymal disease or decreased function. 11 were entirely normal while only 5 demonstrated scars or hydronephrosis. Only 10 of 17 patients demonstrated intranvesicoureteral reflux on x-ray or nuclear cystography. Ultrasound depicted 6 of 20 patients as having parenchymal abnormalities. Seven were normal. Nonspecific findings such as dilitation of the renal pelvis or renal enlargement was noted in 11 of the 20 patients. Radionuclide Scintigraphy is the most efficacious modality to detect since acute bacterial nephritis.

  17. Thallium-201 myocardial scintigraphy in acute myocardial infarction and ischemia

    SciTech Connect

    Wackers, F.J.

    1982-04-01

    Thallium-201 scintigraphy provides a sensitive and reliable method of detecting acute myocardial infarction and ischemia when imaging is performed with understanding of the temporal characteristics and accuracy of the technique. The results of scintigraphy are related to the time interval between onset of symptoms and time of imaging. During the first 6 hr after chest pain almost all patients with acute myocardial infarction and approximately 50% of the patients with unstable angina will demonstrate /sup 201/TI pefusion defects. Delayed imaging at 2-4 hr will permit distinction between ischemia and infarction. In patients with acute myocardial infarction, the size of the perfusion defect accurately reflects the extent of the infarcted and/or jeopardized myocardium, which may be used for prognostic stratification. In view of the characteristics of /sup 201/TI scintigraphy, the most practical application of this technique is in patients in whom myocardial infarction has to be ruled out, and for early recognition of patients at high risk for complications.

  18. Radionuclide bone scintigraphy in pediatric orthopedics

    SciTech Connect

    Conway, J.J.

    1986-12-01

    Radionuclide bone scintigraphy is highly sensitive and specific for diagnosing the musculoskeletal disorders of childhood. Conditions such as neonatal osteomyelitis, septic arthritis, diskitis of childhood, Legg-Calve-Perthes disease, the osteochondroses, the toddler's fracture, sports injuries, spondylolysis, myositis ossificians, and reflex sympathetic dystrophy are readily defined. High-quality state-of-the-art scintigraphy is essential in infants and young children. 64 references.

  19. Normal gallbladder scintigraphy in acute cholecystitis

    SciTech Connect

    Ohrt, H.J.; Posalaky, I.P.; Shafer, R.B.

    1983-03-01

    Normal gallbladder scintigraphy occurs in 2 to 5% of reported patients with acute cholecystitis. Gallbladder visualization is found in patients with acalculous cholecystitis and in those with recent relief of cystic duct obstruction but persistence of inflammation. A patient is reported who had clinical and pathologic findings of acute cholecystitis but normal gallbladder visualization. This reemphasizes that the diagnosis of acute cholecystitis cannot be excluded by normal gallbladder scintigraphy.

  20. Biliary scintigraphy in acute pancreatitis

    SciTech Connect

    Serafini, A.N.; Al-Sheikh, W.; Barkin, J.S.; Hourani, M.; Sfakiankis, G.; Clarke, L.P.; Ashkar, F.S.

    1982-08-01

    A prospective study was carried out in 60 patients to determine the efficacy of /sup 99m/Tc-PIPIDA scintigraphy in differentiating biliary pancreatitis from nonbiliary pancreatitis. Forty patients were classified as having biliary pancreatitis and 20 patients as having the nonbiliary type. Scintigraphic scans were divided into five main types according to the time to visualization of the gallbladder and the time to excretion of /sup 99m/Tc-PIPIDA into the intestinal tract. Normal scans were obtained on 95% of patients (19/20) with nonbiliary pancreatitis; 22.5% of patients (9/40) with biliary pancreatitis had normal scans. It is concluded that elevated amylase levels together with an abnormal biliary scan, as defined by the criteria presented here, indicate biliary pancreatitis, while a normal scan largely excludes such diagnosis.

  1. Biliary scintigraphy in acute pancreatitis

    SciTech Connect

    Serafini, A.N.; Al-Sheikh, W.; Barkin, J.S.; Hourani, M.; Sfakiankis, G.; Clarke, L.P.; Ashkar, F.S.

    1982-08-01

    A prospective study was carried out in 60 patients to determine the efficacy of /sup 99//sup m/Tc-PIPIDA scintigraphy in differentiating biliary pancreatitis from nonbiliary pancreatitis. Forty patients were classified as having biliary pancreatitis and 20 patients as having the nonbiliary type. Scintigraphic scans were divided into five main types according to the time to visualization of the gallbladder and the time to excretion of /sup 99//sup m/Tc-PIPIDA into the intestinal tract. Normal scans were obtained in 95% of patients (19/20) with nonbiliary pancreatitis; 22.5% of patients (9/40) with biliary pancreatitis had normal scans. It is concluded that elevated amylase levels together with an abnormal biliary scan, as defined by the criteria presented here, indicate biliary pancreatitis, while a normal scan largely excludes such diagnosis.

  2. A large renal pelvic diverticulum, presenting incomplete excretion during tc-99m MAG-3 scintigraphy and tracer accumulation on tc-99m DMSA scintigraphy; a case report.

    PubMed

    Turgut, Bulent; Erselcan, Taner; Ozdemir, Semra; Hasbek, Zekiye; Tosun, H Bayram; Topaktas, Seher

    2004-12-01

    This case report illustrates the dynamic and static renal scintigraphic images of a patient with an unusual large diverticulum of the renal pelvis. The initial diagnosis by intravenous pyelography (IVP) and ultrasonographic (US) examination was a renal pelvic diverticulum of the left kidney, and the patient was referred to the nuclear medicine department for exploration of the effect of the pelvic diverticulum on renal functions. We performed dynamic renal scintigraphy with technetium-99m (Tc-99m) labeled mercaptoacetyl triglycine (MAG-3) and static renal scintigraphy with Tc-99m labeled dimercaptosuccinic acid (DMSA). In dynamic renal scintigraphy, bilaterally normal concentration function was observed. While right kidney excretion function was normal, an incomplete excretion pattern was seen on the left side. Complete urinary flow obstruction occurred approximately at the 10th minute of the acquisition, which did not seem to respond to the i.v. furosemide application. However, when only the renal cortex was included in the region of interest, the obstructive pattern disappeared. In static renal scintigraphy, a large renal pelvic diverticulum localized antero-medially was clearly visualized in the left-anterior oblique projection, most probably due to accumulation of radiopharmaceutical inside it. This case showed that a renal pelvic diverticulum should be thought of when an incomplete excretion pattern is seen on dynamic renal scintigraphy. Using only a cortical region of interest may also help to distinguish other types of obstructive pattern from diverticulum. Additionally, Tc-99m DMSA scintigraphy may show diverticulum localization with antero-oblique projections in addition to routine projections.

  3. Evaluating disease activity in patients with ankylosing spondylitis and rheumatoid arthritis using 99mtc-glucosamine

    PubMed Central

    Manolios, Nicholas; Ali, Marina; Camden, Bradley; Aflaky, Elham; Pavic, Katrina; Markewycz, Andrew; De Costa, Robert; Angelides, Socrates

    2016-01-01

    Objective To evaluate the clinical utility of a novel radiotracer, 99mTc-glucosamine, in assessing disease activity of both rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Material and Methods: Twenty-five patients with RA (nine males and 16 females) and 12 patients with AS (all male) at various stages of disease were recruited for the study. A clinical history and examination was performed, followed by the measurement of hematological, biochemical, and autoimmune serological parameters to assess disease activity. 99mTc-glucosamine was intravenously administered and scans were compared with other imaging modalities, including plain X-ray, magnetic resonance imaging (MRI), and bone scans. Results In patients with AS, 99mTc-glucosamine scans were more capable of identifying active disease and differentiating between inflammatory and non-inflammatory causes. In patients with RA, 99mTc-glucosamine accumulated at all known sites of disease involvement. Uptake was most pronounced in patients with active untreated disease. The relative tracer activity in the involved joints increased with time compared with that in the adjoining soft tissue, liver, and cardiac blood pool. Using Spearman’s correlation coefficient, there was a positive correlation among glucosamine scan scores, C-reactive protein (p=0.048), and clinical assessment (p=0.003), which was not noted with bone scans. Conclusion The radiotracer was well tolerated by all patients, with no adverse reactions. 99mTc-glucosamine imaging could detect spinal inflammation in AS. With respect to RA, 99mTc-glucosamine was a viable alternative to 99mTc-labeled methylene diphosphonate nuclear bone scans for imaging inflamed joints and had the added advantage of demonstrating a significant clinical correlation between disease activity and scan findings. PMID:27708974

  4. Hepatic anomalous lobulation demonstrated by liver and hepatobiliary scintigraphy

    SciTech Connect

    Arakawa, K.; Hoshi, H.; Jinnouchi, S.; Ono, S.; Kihara, Y.; Takeuchi, M.; Wakuta, Y.; Kakitsubata, Y.; Watanabe, K.

    1984-10-01

    The use of liver and hepatobiliary scintigraphy for evaluation of the hepatobiliary system in patients with hepatic disease is now widespread. In the present case, the usefulness of liver and hepatobiliary scintigraphy for the diagnosis of liver malformation is described.

  5. Combined gated cardiac blood pool scintigraphy and /sup 67/Ga-citrate scintigraphy for detection of cardiac lymphoproliferative disorders

    SciTech Connect

    Winzelberg, G.G.; Rapoport, F.; Boucher, C.A.

    1981-10-01

    Two cases are reported in which combined radionuclide imaging using gated cardiac blood pool scintigraphy and /sup 67/Ga-citrate scintigraphy aided in evaluating lymphomatous involvement of the heart and distinguishing tumor involvement from other cardiac disorders.

  6. Hysterosalpingo-radionuclide scintigraphy (HERS)

    SciTech Connect

    Iturralde, M.; Venter, P.F.

    1981-10-01

    A radionuclide procedure, hysterosalpingo-radionuclide scintigraphy (HERS), was designed to evaluate the migration of a particulate radioactive tracer from the vagina to the peritoneal cavity and ovaries as well as to image and functionally outline the patency of the pathways between these two extremes of the female reproductive system. Technetium-99m human albumin microspheres (99mTc-HAM) were deposited in the posterior fornices of patients who were divided into two specific groups. Group I consisted of patients who were to undergo different elective gynecologic operations, in which besides obtaining sequential images, radioactivity levels were measured in the removed organs and tissues. Group II consisted of patients referred by the Infertility Clinic for evaluation of their reproductive system pathways patency. In this latter group, HERS was compared with contrast hysterosalpingography (HSG) and peritoneoscopy (PCP). The results obtained from measurements of radioactivity levels on the removed surgical specimens and comparison with other conventional gynecologic diagnostic procedures provide accurate evidence of the migration of 99mTc-HAM from the vagina, through the uterus and tubes, to the peritoneal cavity and ovaries, and show that HERS is a simple noninvasive method for functionally imaging and assessing the patency of the female reproductive system pathways.

  7. Findings of Bone Scintigraphy After Leech Theraphy

    PubMed Central

    Özyurt, Sinem; Koca, Gökhan; Demirel, Koray; Baskın, Aylin; Korkmaz, Meliha

    2014-01-01

    In this case report, we present a 70 year old female patient who had recieved Leech therapy (hirudotherapy) on her leg without informing referring physician. In dynamic bone scintigraphy there was increased perfusion and hyperemia in her left ankle and leg, also in late static images moderate increased uptake was seen in soft tissue region and at the fracture site of ankle. We learned that she had Leech therapy applied on her leg, which could explain the increased perfusion and hyperemia in dynamic and blood pool phases of bone scintigraphy because of Leech therapy’s dilatory effects on superficial veins. Leech therapy may lead to an increase in perfusion and hyperemia in blood pool phase of bone scintigraphy, which may cause confusion in differential diagnosis. To our best knowledge this report is the first case that shows the scintigraphic findigs after Leech therapy. Conflict of interest:None declared. PMID:24653932

  8. Incidental Warthin Tumor on Pertechnetate Scintigraphy.

    PubMed

    Kulkarni, Mukta; Shetkar, Shubhangi; Joshi, Prathamesh; Kasaliwal, Sanket; Chaudhari, Shrikant

    2016-09-01

    A 30-year-old woman underwent Tc-pertechnetate scintigraphy for evaluation of thyrotoxicosis. The scintigraphy revealed hypervascular thyroid gland with markedly increased trapping function in both the lobes suggesting diagnosis of Graves disease. Incidentally, a hypervascular and pertechnetate avid focus was seen along the lateral margin of the right parotid gland. Pertechnetate avidity and site of uptake suggested possibility of Warthin tumor. Clinical examination and ultrasonography revealed a well-defined lesion in the superficial lobe of the right parotid gland favoring diagnosis of benign lesion. Postsurgery specimen confirmed diagnosis of Warthin tumor. PMID:27405035

  9. Guidelines for radioiodinated MIBG scintigraphy in children.

    PubMed

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations. PMID:12658506

  10. Guidelines for radioiodinated MIBG scintigraphy in children.

    PubMed

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations.

  11. Radioiodine therapy of hyperthyroidism precludes thallium-201 myocardial scintigraphy

    SciTech Connect

    Orzel, J.A.; Kruyer, W.B.; Borchert, R.D.

    1987-02-01

    The authors attempted to perform Tl-201 myocardial perfusion scintigraphy in a 42-year-old man 23 and 35 days after he received 9.8 mCi of oral I-131 for documented Graves' disease. Interference from primary and scattered photons from residual thyroid I-131 made Tl-201 myocardial scintigraphy technically impossible. A series of phantom and patient studies using I-131 and Tl-201 were performed, yielding guidelines for planning Tl-201 myocardial scintigraphy following radioiodine therapy.

  12. Musculoskeletal scintigraphy of the equine athlete.

    PubMed

    Dyson, Sue

    2014-01-01

    Nuclear scintigraphic examination of equine athletes has a potentially important role in the diagnosis of lameness or poor performance, but increased radiopharmaceutical uptake (IRU) is not necessarily synonymous with pain causing lameness. Nuclear scintigraphy is highly sensitive to changes in bone turnover that may be induced by loading and knowledge of normal patterns of RU is crucial for accurate diagnosis. Blood pool images can be useful for identification of some soft tissue injuries, although acute bone injuries may also have intense IRU in blood pool images. Some muscle injuries may be associated with IRU in bone phase images. The use of scintigraphy together with other diagnostic imaging modalities has helped us to better understand the mechanisms of some musculoskeletal injuries. In immature racehorses, stress-related bone injury is a common finding and may be multifocal, whereas in mature sport horses, a very different spectrum of injuries may be identified. False-negative results are common with some injuries.

  13. Role of scintigraphy in urinary tract infection

    SciTech Connect

    Conway, J.J.

    1988-10-01

    There is controversy regarding the role of radiological imaging for urinary tract infection (UTI). The gold standard has been the intravenous pyelogram (IVP). Yet, the IVP has a very limited value with only about 25% of children with pyelonephritis demonstrating abnormalities. Ultrasound (US) has recently been advocated as a replacement for the poorly sensitive and poorly specific IVP. However, comparative studies between US and IVP indicate only an equivalent sensitivity and specificity. Cortical scintigraphy with Technetium-99m glucoheptonate (99mTc GH) or 99mTc dimercaptosuccinic acid (99mTc DMSA) has also been advocated as a means of differentiating parenchymal (pyelonephritis) from nonparenchymal (lower UTI) involvement in UTI. The clinical presentation may be misleading especially in the infant and child in whom an elevated temperature, flank pain, shaking chills, or an elevated sedimentation rate are often lacking. The clinician attempts to localize the site of infection for it has a direct bearing upon the therapy. A collecting system infection can often be eradicated with a single oral dose of an appropriate antibiotic, whereas renal parenchymal involvement requires IV therapy for an extended interval. Cortical scintigraphy can localize the site of infection with a high degree of accuracy. Recent studies report a sensitivity of 86% and specificity of 81% of pyelonephritis. This is in contrast to the IVP with a sensitivity of only 24% and US with a sensitivity of only 42%. The scintigraphic appearance of parenchymal infection of the kidney is a spectrum of minimal to gross defects reflecting the degree of histologic involvement that spans from a mild infection to frank abscess. Cortical scintigraphy can be used to monitor the evolution of scarring following infection. Cortical scintigraphy with 99mTc DMSA or 99mTc GH is the method of choice for the initial evaluation of UTI. 37 references.

  14. Bone scintigraphy in fluoride treated osteoporosis

    SciTech Connect

    Froelich, J.W.; Kleerekoper, M.; Parker, D.A.

    1985-05-01

    Quantitative bone scintigraphy was performed on 23 white females with post-menopausal osteoporosis and vertebral compression fractures. These patients were then entered into a randomized, double-blind clinical trial or sodium fluoride therapy (NaF=14, placebo=9) which included repeat bone scintigraphy every six months. Scintigraphic images were acquired for 500K counts per image over the total body with computer acquisition over the posterior thoracic and lumbar spine. Images were obtained on a wide field-of-view gamma camera two hours after injecting 15 mCi of Tc-99m MDP. Data analysis showed a significant reduction in the activity ratio of abnormal vertebral body to normal vertebral body in those patients treated with sodium fluoride (paired t-test p=0.0095). No significant change was observed in the control group of (p=0.142). These results suggest that sodium fluoride therapy promotes more rapid healing of osteoporotic vertebral fractures. They also demonstrate the utility of serial quantitative bone scintigraphy in assessing osteoporotic patients with vertebral compression fractures.

  15. Positive indium-111 leukocyte scintigraphy in a skeletal metastasis

    SciTech Connect

    Sfakianakis, G.N.; Mnaymneh, W.; Ghandur-Mnaymneh, L.; Al-Sheikh, W.; Hourani, M.; Heal, A.

    1982-09-01

    Indium-111 scintigraphy is a method proposed for specific diagnosis and localization of focal infection. It has been found that, in general, cancers did not visualize with leukocyte scintigraphy. In this article, a case of positive indium-111 leukocyte scintigrams of a foot metstasis from a mucoepidermoid carcinoma of the lung is reported. (JMT)

  16. Pancreas transplants: Evaluation using perfusion scintigraphy

    SciTech Connect

    Kuni, C.C.; du Cret, R.P.; Boudreau, R.J.

    1989-07-01

    To determine the value of scintigraphic perfusion studies in evaluating pancreas transplant patients, we reviewed 56 of these studies in 22 patients who had 27 transplants. Seventeen patients underwent two or more studies. The perfusion studies were performed with 20 mCi (740 MBq) of 99mTc-DTPA injected as a bolus followed by eight to 16 serial 2-sec images and a 500,000-count immediate static image. Images were evaluated for (1) the time and intensity of pancreatic peak radioactivity relative to the time and intensity of the iliac arterial peak; (2) relative pancreatic to iliac arterial intensity on the static image; and (3) size, homogeneity, and definition of the pancreas. Clinical diagnoses at the time of scintigraphy of normal function (n = 36), rejection (n = 13), pancreatitis (n = 6), or arterial thrombosis (n = 1) were based on insulin requirement, urine amylase, serum glucose, serum amylase, response to therapy, cultures, CT, MR, sonography, scintigraphy with 67Ga or 111In-WBCs, percutaneous drainage results, angiography, surgery, and pathologic examination of resected transplants. Three 99mTc-DTPA perfusion studies showed no pancreatic perfusion, four showed decreasing perfusion on serial studies, and five showed progressive loss of definition of the pancreas on serial studies. Of the three patients with no detectable perfusion, one had a normally functioning transplant, one had arterial thrombosis with transplant infarction, and one had severe rejection with minimal function. Decreasing perfusion was associated with rejection in three patients and pancreatitis in one. Decreasing definition was seen in four patients with rejection and one with pancreatitis. We conclude that perfusion scintigraphy is useful, primarily when performed serially, although nonspecific for evaluating pancreas transplants.

  17. Detection of deep venous thrombophlebitis by gallium 67 scintigraphy

    SciTech Connect

    Miller, J.H.

    1981-07-01

    Deep venous thrombophlebitis may escape clinical detection. Three cases are reported in which whole-body gallium 67 scintigraphy was used to detect unsuspected deep venous thrombophlebitis related to indwelling catheters in three children who were being evaluated for fevers of unknown origin. Two of these children had septicemia from Candida organisms secondary to these venous lines. Gallium 67 scintigraphy may be useful in the detection of complications of indwelling venous catheters.

  18. Gallium 67 scintigraphy in glomerular disease

    SciTech Connect

    Bakir, A.A.; Lopez-Majano, V.; Levy, P.S.; Rhee, H.L.; Dunea, G.

    1988-12-01

    To evaluate the diagnostic usefulness of gallium 67 scintigraphy in glomerular disease, 45 patients with various glomerulopathies, excluding lupus nephritis and renal vasculitis, were studied. Persistent renal visualization 48 hours after the gallium injection, a positive scintigram, was graded as + (less than), ++ (equal to), and +++ (greater than) the hepatic uptake. Positive scintigrams were seen in ten of 16 cases of focal segmental glomerulosclerosis, six of 11 cases of proliferative glomerulonephritis, and one case of minimal change, and one of two cases of membranous nephropathy; also in three of six cases of sickle glomerulopathy, two cases of diabetic neuropathy, one of two cases of amyloidosis, and one case of mild chronic allograft rejection. The 25 patients with positive scans were younger than the 20 with negative scans (31 +/- 12 v 42 +/- 17 years; P less than 0.01), and exhibited greater proteinuria (8.19 +/- 7.96 v 2.9 +/- 2.3 S/d; P less than 0.01) and lower serum creatinine values (2 +/- 2 v 4.1 +/- 2.8 mg/dL; P less than 0.01). The amount of proteinuria correlated directly with the intensity grade of the gallium image (P less than 0.02), but there was no correlation between the biopsy diagnosis and the outcome of the gallium scan. It was concluded that gallium scintigraphy is not useful in the differential diagnosis of the glomerular diseases under discussion. Younger patients with good renal function and heavy proteinuria are likely to have a positive renal scintigram regardless of the underlying glomerulopathy.

  19. Renal scintigraphy following angiotensin converting enzyme inhibition in the diagnosis of renovascular hypertension (captopril scintigraphy)

    SciTech Connect

    Sfakianakis, G.N. )

    1989-09-01

    This article describes the pathophysiology and primary causes of renovascular hypertension (RVH). No historical or physical finding is specific in the diagnosis of RVH, although onset of hypertension before the age of 30 years may suggest the possible presence of RVH. The physiology of the kidney is described along with the biochemistry of angiotensin converting enzyme inhibitors. The main thrust of the article is nuclear medicine techniques useful in the diagnosis of this disease. Several diagnositic methods are described but captopril scintigraphy is presented as a method that may give more optimal results in the diagnosis of RVH.

  20. Testis Scintigraphy in a Patient with Acute Lymphoblastic Leukemia

    PubMed Central

    Şencan Eren, Mine; Koç, Murat; Ören, Hale; Özkal, Şermin; Durak, Hatice

    2014-01-01

    Acute lymphoblastic leukemia (ALL) is a pediatric malignancy associated with remissions and relapses. Common relapsing sitesare meninges, testis and ovary. Testicular scintigraphy is a highly specific modality used mainly in the differential diagnosis of testicular torsion and epidydimitis/epidydimo-orchitis. There is only one interesting image on leukemic infiltration with scrotal scintigraphy in the literature. The aim of this case presentation is to report that although the scintigraphic appearance of testicular torsion was observed in a patient with the diagnosis of ALL, testicular ALL infiltration was revealed in pathologic examination. Conflict of interest:None declared. PMID:24653935

  1. Endocrine radionuclide scintigraphy with fusion single photon emission computed tomography/computed tomography

    PubMed Central

    Wong, Ka-Kit; Gandhi, Arpit; Viglianti, Benjamin L; Fig, Lorraine M; Rubello, Domenico; Gross, Milton D

    2016-01-01

    AIM: To review the benefits of single photon emission computed tomography (SPECT)/computed tomography (CT) hybrid imaging for diagnosis of various endocrine disorders. METHODS: We performed MEDLINE and PubMed searches using the terms: “SPECT/CT”; “functional anatomic mapping”; “transmission emission tomography”; “parathyroid adenoma”; “thyroid cancer”; “neuroendocrine tumor”; “adrenal”; “pheochromocytoma”; “paraganglioma”; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts (case reports, reviews, meta-analyses and abstracts) concerning the application of SPECT/CT to endocrine imaging were analyzed to provide a descriptive synthesis of the utility of this technology. RESULTS: The emergence of hybrid SPECT/CT camera technology now allows simultaneous acquisition of combined multi-modality imaging, with seamless fusion of three-dimensional volume datasets. The usefulness of combining functional information to depict the bio-distribution of radiotracers that map cellular processes of the endocrine system and tumors of endocrine origin, with anatomy derived from CT, has improved the diagnostic capability of scintigraphy for a range of disorders of endocrine gland function. The literature describes benefits of SPECT/CT for 99mTc-sestamibi parathyroid scintigraphy and 99mTc-pertechnetate thyroid scintigraphy, 123I- or 131I-radioiodine for staging of differentiated thyroid carcinoma, 111In- and 99mTc- labeled somatostatin receptor analogues for detection of neuroendocrine tumors, 131I-norcholesterol (NP-59) scans for assessment of adrenal cortical hyperfunction, and 123I- or 131I-metaiodobenzylguanidine imaging for evaluation of pheochromocytoma and paraganglioma. CONCLUSION: SPECT/CT exploits the synergism between the functional information from radiopharmaceutical imaging and anatomy

  2. Cavernous hemangioma. Why is peripheral filling at scintigraphy so rare

    SciTech Connect

    Drane, W.E.; Weatherby, E. III

    1987-10-01

    Peripheral filling at dynamic CT occurs frequently with cavernous hemangiomas, yet this phenomenon is a rare finding on Tc-99m RBC imaging. A case of peripheral filling of a cavernous hemangioma with scintigraphy is reported and the rationale for its infrequent occurrence is discussed.

  3. /sup 123/I-metaiodobenzylguanidine scintigraphy of ectopic intracranial retinoblastoma

    SciTech Connect

    Bomanji, J.; Kingston, J.E.; Hungerford, J.L.; Britton, K.E.

    1989-01-01

    Radioiodinated metaiodobenzylguanidine (MIBG) has been used for diagnostic purposes to image neural crest tumors. We report the uptake of /sup 123/I MIBG in a child with ectopic intracranial retinoblastoma. It is felt that /sup 123/I MIBG scintigraphy may have a role in detecting occult metastatic disease in these patients.

  4. Accuracy of Hepatobiliary Scintigraphy after Liver Transplantation and Liver Resection

    PubMed Central

    Ackermann, Hanns; Bechstein, Wolf O.; Grünwald, Frank

    2016-01-01

    Background and Aims. Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS) and impact of hyperbilirubinemia were evaluated. Methods. Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (n = 13) or hepatic resection (n = 26) were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin. The results were compared to ERCP as gold standard performed within one month after HBS. We calculated sensitivity, specificity, PPV, and NPV. We compared LTX patients to patients with other liver surgeries. Furthermore the influence of hyperbilirubinemia on HBS scans was evaluated. Results. HBS always provided the correct diagnosis in cases of bile leak in the liver-resected group (14/14). Overall diagnostic accuracy was 76% (19/25) in this group and 54% (7/13) in the LTX group. False negative (FN) diagnoses occurred more often among LTX patients (p = 0.011). Hyperbilirubinemia (>5 mg/dL) significantly influenced the excretion function of the liver, prolonging HBS's time-activity-curve (p = 0.001). Conclusions. Hepatobiliary scintigraphy is a reliable tool to detect biliary complications, but reduced accuracy must be considered after LTX. PMID:27563464

  5. Accuracy of Hepatobiliary Scintigraphy after Liver Transplantation and Liver Resection.

    PubMed

    Eckenschwiller, Manuel; Ackermann, Hanns; Bechstein, Wolf O; Grünwald, Frank

    2016-01-01

    Background and Aims. Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS) and impact of hyperbilirubinemia were evaluated. Methods. Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (n = 13) or hepatic resection (n = 26) were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin. The results were compared to ERCP as gold standard performed within one month after HBS. We calculated sensitivity, specificity, PPV, and NPV. We compared LTX patients to patients with other liver surgeries. Furthermore the influence of hyperbilirubinemia on HBS scans was evaluated. Results. HBS always provided the correct diagnosis in cases of bile leak in the liver-resected group (14/14). Overall diagnostic accuracy was 76% (19/25) in this group and 54% (7/13) in the LTX group. False negative (FN) diagnoses occurred more often among LTX patients (p = 0.011). Hyperbilirubinemia (>5 mg/dL) significantly influenced the excretion function of the liver, prolonging HBS's time-activity-curve (p = 0.001). Conclusions. Hepatobiliary scintigraphy is a reliable tool to detect biliary complications, but reduced accuracy must be considered after LTX. PMID:27563464

  6. Noninvasive external cardiac pacing for thallium-201 scintigraphy

    SciTech Connect

    Feldman, M.D.; Warren, S.E.; Gervino, E.V.; Aroesty, J.M.; Royal, H.D.; Parker, J.A.; Silverman, K.J.; Kolodny, G.M.; Zoll, P.M.; McKay, R.G.

    1988-01-01

    Improvements in noninvasive external cardiac pacing have led to a technique with reliable electrical capture and tolerable patient discomfort. To assess the use of this modality of pacing in combination with thallium scintigraphy as a noninvasive pacing stress test, we applied simultaneous noninvasive cardiac pacing, hemodynamic monitoring, and thallium-201 scintigraphy in 14 patients undergoing cardiac catheterization for chest pain syndromes. Two patients had normal coronary arteries, while the remaining 12 had significant coronary artery disease. Thallium scintigraphic responses to pacing were compared to routine exercise thallium stress testing in nine of these 14 patients. All patients were noninvasively paced to more than 85% of the age-predicted maximum heart rate. Twelve patients demonstrated reversible thallium defects, which corresponded in 11 cases to significant lesions seen on coronary angiography. Of nine patients who underwent both pacing and exercise thallium stress tests, comparable maximal rate-pressure products were achieved. Moreover, thallium imaging at peak pacing and during delayed views did not differ significantly from exercise thallium scintigraphy. A limiting factor associated with the technique was local patient discomfort, which occurred to some degree in all patients. We conclude that noninvasive external cardiac pacing together with thallium scintigraphy is capable of detecting significant coronary artery disease and may be comparable to routine exercise thallium stress testing. This new modality of stress testing could be useful in patients unable to undergo the exercise required for standard exercise tolerance testing, particularly if improvements in the technology can be found to reduce further the local discomfort.

  7. Iodine-123-metaiodobenzylguanidine scintigraphy in risk stratification of sudden death in heart failure.

    PubMed

    Martins da Silva, Marta Inês; Vidigal Ferreira, Maria João; Morão Moreira, Ana Paula

    2013-06-01

    Metaiodobenzylguanidine (MIBG) is a false neurotransmitter noradrenaline analogue that is taken up by the 'uptake 1' transporter mechanism in the cell membrane of presynaptic adrenergic neurons and accumulates in catecholamine storage vesicles. Since it is practically unmetabolized, it can be labeled with a radioisotope (iodine-123) in scintigraphic exams to noninvasively assess the functional status of the sympathetic innervation of organs with a significant adrenergic component, including the heart. Studies of its application in nuclear cardiology appear to confirm its value in the assessment of conditions such as coronary artery disease, heart failure, arrhythmias and sudden death. Heart failure is a global problem, with an estimated prevalence of 2% in developed countries. Sudden cardiac death is the main cause of its high mortality. The autonomic nervous system dysfunction, including sympathetic hyperactivity, that accompanies chronic heart failure is associated with progressive myocardial remodeling, declining left ventricular function and worsening symptoms, and contributes to the development of ventricular arrhythmias and sudden death. Since 123I-MIBG cardiac scintigraphy can detect changes in the cardiac adrenergic system, there is considerable interest in its role in obtaining diagnostic and prognostic information in patients with heart failure. In this article we present a literature review on the use of 123I-MIBG scintigraphy for risk stratification of sudden death in patients with heart failure.

  8. The clinical value of bone and gallium scintigraphy for soft-tissue sarcomas of the extremities

    SciTech Connect

    Kirchner, P.T.; Simon, M.A.

    1984-03-01

    In a prospective study of forty-five patients, we evaluated the usefulness of bone and gallium scintigraphy prior to definitive surgery for a soft-tissue sarcoma in an extremity. Bone scintigraphy provides a baseline for staging and often reveals periosteal invasion that is not detected by routine radiographs. Blood-pool scintigraphy with bone tracers is very sensitive for a diagnosis of malignant disease. Gallium scintigraphy appeared to be a reliable preoperative indicator of malignant disease of soft tissue (sensitivity, 85 per cent; specificity, 92 per cent) and was useful for detecting the infrequent occult, non-pulmonary metastasis. Combined gallium and bone scintigraphy with blood-pool imaging provided a reliable prediction of the presence or absence of a malignant lesion in patients with a soft-tissue mass in an extremity. We recommend that bone and gallium scintigraphy be routinely used in the initial clinical staging of soft-tissue sarcomas.

  9. 123I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson's disease

    PubMed Central

    Orimo, S; Ozawa, E; Nakade, S; Sugimoto, T; Mizusawa, H

    1999-01-01

    OBJECTIVES—123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is clinically used to estimate local myocardial sympathetic nerve damage in some forms of heart disease, autonomic nerve disturbance in diabetic neuropathy, and disturbance of the autonomic nervous system in neurodegenerative disease. In the present study, examinations were performed to clarify (1) the proportion of cardiac sympathetic nerve disturbance in Parkinson's disease, (2) the usefulness of 123I-MIBG myocardial scintigraphy to detect sympathetic nerve disturbances compared with autonomic function tests, (3) cardiac function in patients who have a decreased MIBG uptake in 123I-MIBG myocardial scintigraphy, (4) the usefulness of 123I-MIBG myocardial scintigraphy to differentiate Parkinson's disease from the other neurological diseases mimicking it.
METHODS—123I-MIBG myocardial scintigraphy was performed, together with autonomic function tests and cardiac examinations in 46 patients with Parkinson's disease and 25 patients with vascular parkinsonism, essential tremor, or multiple system atrophy.
RESULTS—In an anterior image study, the average count per pixel in heart to mediastinum (H/M) ratio decreased in 80% of the patients with Parkinson's disease in the early phase and 84% in the late phase. The mean H/M ratio in Parkinson's disease was significantly lower than that in controls and the other diseases. The H/M ratio tended to decrease with the disease progression. In almost half of the patients in Hoehn and Yahr stage I, the H/M ratio was already decreased. The sympathetic skin response in upper and lower limbs, head up tilt test, and coefficient of variation of R-R interval were abnormal in 17%, 31%, 30%, and 17% of the patients, respectively. All the patients with abnormal autonomic functions were in Hoehn and Yahr stage III, IV, or V. Echocardiography showed normal left ventricular function. Twenty four hour Holter electrocardiography detected no serious arrhythmias except

  10. Bone scintigraphy of hip joint effusions in children

    SciTech Connect

    Kloiber, R.; Pavlosky, W.; Portner, O.; Gartke, K.

    1983-05-01

    Thirty-eight children with hip pain of acute onset were studied by bone scintigraphy. Nine patients had diminished radiotracer deposition involving the entire proximal femoral ossification center. This could be related to infarction or compression of blood supply by a tense joint effusion. Eight of these patients had joint aspiration confirming the presence of an effusion. Five patients had follow-up studies after aspiration, and femoral-head uptake reverted to normal in all but one which subsequently proved to be infarcted. A photopenic zone was seen on blood pool images in 10 patients, many of whom were also aspirated of fluid. Bone scintigraphy is useful in the diagnosis of joint effusions and can give information as to the state of perfusion of the femoral head. Follow-up studies after aspiration can differentiate infarction from reversible ischemia.

  11. Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy.

    PubMed

    Moralidis, Efstratios; Gerasimou, Georgios; Theodoridou, Athina; Hilidis, Ilias; Mylonaki, Efrosyni; Gotzamani-Psarrakou, Anna

    2010-05-01

    Hypertrophic osteoarthropathy (HOA) is an incompletely understood syndrome characterized by digital clubbing and periosteal proliferation of long bones and it is commonly associated with primary lung tumors. Bone scintigraphy is a sensitive method in detecting HOA and characteristic findings have been reported. We present the case of a man with newly diagnosed non-small cell lung cancer, unremarkable clinical examination and blood tests and no digital clubbing. During disease staging, however, bone scintigraphy showed intense calcaneal cortical proliferation bilaterally without involvement of other parts of the skeleton. Cortical reaction of both calcanei resolved significantly after chemotherapy. This case indicates that HOA may manifest with isolated calcaneal periostitis bilaterally, which is a new addition to the literature.

  12. Indium-111 leukocyte scintigraphy in Wegener's granulomatosis involving the spleen

    SciTech Connect

    Morayati, S.J.; Fink-Bennett, D.

    1986-12-01

    Indium-111-labeled leukocyte scintigraphy was performed on a 44-yr-old man to exclude an occult abscess. Four- and twenty-four-hour images of the abdomen revealed splenic photopenia except for a rim of activity medially. A subsequent computed tomography (CT) study demonstrated necrosis or hemorrhage of the spleen except for a medial rim. Exploratory laparotomy demonstrated necrotizing vasculitis with granuloma formation consistent with Wegener's granulomatosis and a rim of viable splenic tissue corresponding to the radionuclide and CT studies.

  13. Tc-99m polyclonal human immunoglobulin scintigraphy in brucellosis.

    PubMed

    Kadanali, A; Varoglu, E; Kerek, M; Tasyaran, M A

    2005-06-01

    The aim of this study was to evaluate the accuracy of Tc-99m polyclonal human immunoglobulin (HIG) scintigraphy for the diagnosis of brucellosis, and to compare its effectiveness in the diagnosis of osteoarticular involvement in comparison with bone scanning. Of 30 patients with brucellosis, Tc-99m HIG detected osteoarticular involvement in 18 (60%) patients, in whom the sacroiliac joints were affected most commonly (n = 13; 72.2%), with statistically predominant bilateral involvement (p < 0.05). By bone scanning, the rate of osteoarticular involvement was 70% (21 of 30 patients), and the joints affected most commonly were sacroiliac (15 of 21 patients; 71.4%). Although bilateral involvement was observed mostly by bone scanning, there was no significant difference between the rate of bilateral and unilateral involvement. The anatomical distribution of osteoarticular complications, as detected by Tc-99m HIG and bone scintigraphy, did not differ significantly. With Tc-99m HIG, orchitis was detected in two patients and paravertebral abscess in one patient. Since bone scanning did not detect these soft tissue complications, Tc-99m HIG scintigraphy might be useful for the detection of both osteoarticular and soft tissue complications resulting from brucellosis.

  14. Current role of lung scintigraphy in pulmonary embolism.

    PubMed

    Giordano, A; Angiolillo, D J

    2001-12-01

    The pivotal role of lung scintigraphy in the diagnosis of pulmonary embolism (PE) has been questioned in recent years due to the introduction of spiral computed tomography. However, the scintigraphic results used for comparisons are often those of the authoritative PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) study, carried out in the 1980s. Pulmonary scintigraphy has progressed from those years both in the methodological and interpretative fields, although perhaps too slowly. Results better than those of PIOPED's have been presented by study groups who used: 1) perfusion-only approach, 2) SPET imaging; 3) new interpretative criteria; 4) different prediction rules to integrate clinical and scintigraphic probabilities of PE. These advances are still insufficiently recognised by the nuclear medicine community, possibly due to a sort of PIOPED-based "cultural globalisation". This paper reviews the actual advantages and limitations of nuclear medicine techniques, the diagnostic role of scintigraphy within the diagnostic algorithms proposed by international working groups and scientific societies and the results obtained from SPET imaging in the diagnosis of PE.

  15. Thallium-201 scintigraphy of the suppressed thyroid: an alternative for iodine-123 scanning after TSH stimulation

    SciTech Connect

    Corstens, F.; Huysmans, D.; Kloppenborg, P.

    1988-08-01

    Thallium-201 scintigraphy of the thyroid gland suppressed by autonomous nodule was compared with /sup 123/I scintigraphy after TSH stimulation. In all patients, similar images were obtained by both methods. In 20 patients, the contralateral lobe was visualized on both scans and in 14 of these, the upper pole of the ipsilateral lobe was also visualized. In one patient, neither /sup 123/I scanning after TSH nor /sup 201/TI scintigraphy showed any extranodular tissue. This study suggests that /sup 201/TI scintigraphy is a reliable alternative for scanning after TSH. It is a relatively simple method, not inducing any TSH-related allergic reactions. Iodine uptake in extranodular tissue is not stimulated and therefore, /sup 201/TI scintigraphy and radioiodine therapy can be combined on one day, without increasing the risk of radiation damage to the normal thyroid tissue with a resultant post-treatment hypothyroidism.

  16. Perfusion Scintigraphy and Patient Selection for Lung Volume Reduction Surgery

    PubMed Central

    Chandra, Divay; Lipson, David A.; Hoffman, Eric A.; Hansen-Flaschen, John; Sciurba, Frank C.; DeCamp, Malcolm M.; Reilly, John J.; Washko, George R.

    2010-01-01

    Rationale: It is unclear if lung perfusion can predict response to lung volume reduction surgery (LVRS). Objectives: To study the role of perfusion scintigraphy in patient selection for LVRS. Methods: We performed an intention-to-treat analysis of 1,045 of 1,218 patients enrolled in the National Emphysema Treatment Trial who were non–high risk for LVRS and had complete perfusion scintigraphy results at baseline. The median follow-up was 6.0 years. Patients were classified as having upper or non–upper lobe–predominant emphysema on visual examination of the chest computed tomography and high or low exercise capacity on cardiopulmonary exercise testing at baseline. Low upper zone perfusion was defined as less than 20% of total lung perfusion distributed to the upper third of both lungs as measured on perfusion scintigraphy. Measurements and Main Results: Among 284 of 1,045 patients with upper lobe–predominant emphysema and low exercise capacity at baseline, the 202 with low upper zone perfusion had lower mortality with LVRS versus medical management (risk ratio [RR], 0.56; P = 0.008) unlike the remaining 82 with high perfusion where mortality was unchanged (RR, 0.97; P = 0.62). Similarly, among 404 of 1,045 patients with upper lobe–predominant emphysema and high exercise capacity, the 278 with low upper zone perfusion had lower mortality with LVRS (RR, 0.70; P = 0.02) unlike the remaining 126 with high perfusion (RR, 1.05; P = 1.00). Among the 357 patients with non–upper lobe–predominant emphysema (75 with low and 282 with high exercise capacity) there was no improvement in survival with LVRS and measurement of upper zone perfusion did not contribute new prognostic information. Conclusions: Compared with optimal medical management, LVRS reduces mortality in patients with upper lobe–predominant emphysema when there is low rather than high perfusion to the upper lung. PMID:20538961

  17. Detection of deep venous thrombosis by indium-111 leukocyte scintigraphy

    SciTech Connect

    D'Alonzo, W.A. Jr.; Alavi, A.

    1986-05-01

    Indium-111-labeled leukocyte ((/sup 111/In)WBC) scintigraphy has been used successfully for detection of inflammation. Occasionally, noninflammatory collections of white blood cells such as hematomas or hemorrhage have been localized. We report a case in which unsuspected femoral deep venous thrombosis was diagnosed on an (/sup 111/In)WBC leukocyte scan performed for detection of osteomyelitis. Readers are advised to avoid interpreting all vascular (/sup 111/In)WBC localization as necessarily infectious. This may be of particular significance in patients with vascular grafts.

  18. Dynamic ventilation scintigraphy: a comparison of parameter estimation gating models.

    PubMed

    Hack, S N; Paoni, R A; Stratton, H; Valvano, M; Line, B R; Cooper, J A

    1988-11-01

    Two procedures for providing the synchronization of ventilation scintigraphic data to create dynamic displays of the pulmonary cycle are described and compared. These techniques are based on estimating instantaneous lung volume by pneumotachometry and by scintigraphy. Twenty-three patients were studied by these two techniques. The results indicate that the estimation of the times of end-inspiration and end-expiration are equivalent by the two techniques but the morphologies of the two estimated time-volume waveforms are not equivalent. Ventilation cinescintigraphy based on time division gating but not on isovolume division gating can be equivalently generated from list mode acquired data by employing either technique described.

  19. Rare case of thoracic kidney detected by renal scintigraphy

    PubMed Central

    Natarajan, Aravintho; Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2016-01-01

    Intrathoracic kidney is a rare congenital abnormality with lowest frequency among all renal ectopias. Patients with thoracic kidneys are usually asymptomatic, and the condition is usually discovered incidentally during radiological evaluation for other conditions or during thoracic surgery. We report a case of a 62-year-old male who was referred to our department for renal scintigraphy for a nonvisualized left kidney on ultrasonography report. Both Tc-99m dimercaptosuccinic acid and diethylenetriaminepentaacetic acid scans revealed a left thoracic kidney which was confirmed by CT scan of the thorax and abdomen. PMID:27385896

  20. Femoroacetabular impingement mimicking avascular osteonecrosis on bone scintigraphy

    PubMed Central

    Suarez, Juan Pablo; Domínguez, María Luz; Nogareda, Zulema; Gómez, María Asunción; Muñoz, Jose

    2016-01-01

    Femoroacetabular impingement (FAI) is a structural abnormality of proximal femur and/or acetabulum. It has been recently described, and there are limited reports in nuclear medicine literature because bone scintigraphy is not listed in its diagnostic protocol, but it should be included on differential diagnosis when evaluating patients, with hip-related symptoms because it may be misinterpreted as degenerative changes or avascular necrosis, and its early treatment avoid progression to osteoarthritis. We describe the case of a male who suffered from hip pain. Bone planar scintigraphic appearance mimicked avascular necrosis, but single photon emission computed tomography (CT) imaging and CT examination confirmed the diagnosis of FAI. PMID:27095871

  1. Technetium-99m bone scintigraphy and mandibular condylar hyperplasia.

    PubMed

    Henderson, M J; Wastie, M L; Bromige, M; Selwyn, P; Smith, A

    1990-06-01

    Radionuclide skeletal scintigraphy has been successfully used in the assessment of mandibular condylar hyperplasia (condylar hyperplasia) causing mandibular asymmetry to identify the presence of continued active growth in the condylar region. This study reviews 14 cases of mandibular asymmetry and concludes that symmetrical radionuclide uptake in the condylar regions on the bone scintigram excludes a continuing asymmetrical growth focus. Unilateral increased radionuclide uptake may often indicate an abnormally active condylar growth focus but false positive results may be encountered in patients with associated temporo-mandibular joint disease. PMID:2383957

  2. Malignant external otitis: The diagnostic value of bone scintigraphy

    SciTech Connect

    Ostfeld, E.; Aviel, A.; Pelet, D.

    1981-06-01

    Technetium99m Methylene Diphosphate bone scintigraphy (BS) of the skull was performed in three patients with malignant external otitis (MEO). Pathological uptake of the radioisotope in the mastoid region was found during the early stages of MEO updating radiologic findings. The extent of the radioisotope accumulation during the early stages of MEO indicates that the actual tissue damage exceeds the clinical estimation. The follow-up BS findings correlate well with the clinical course of MEO indicating either healing or extension to the base of skull.

  3. Bone Scintigraphy in the Diagnosis of Rheumatoid Arthritis: Is There Additional Value of Bone Scintigraphy with Blood Pool Phase over Conventional Bone Scintigraphy?

    PubMed Central

    2016-01-01

    We aimed to investigate the value of bone scintigraphy with additional blood pool phase (BSBP), compared with conventional bone scintigraphy (CBS), in the assessment of rheumatoid arthritis (RA). A total of 242 patients (43 males, 199 females; 14–78 years) with arthralgia, and underwent BSBP were retrospectively analyzed. On the first physical examination, active arthritis was found in 128 of the 242 patients. Clinical diagnosis was made by a rheumatologist on the basis of the 1987 American College of Rheumatology (ACR) criteria, which are considered to be the gold standard. The diagnostic performances and prognostic value of BSBP and CBS were analyzed in the total patients with arthralgia and in the patients with arthritis. The sensitivity of BSBP (84.2%, 80/95) were significantly higher than that of CBS (74.8%, 72/95) in the patients with arthralgia (P = 0.039). When BSBP was interpreted with the results of elevated/positive anti-CCP antibody, its accuracy over CBS also became significantly higher (86.0%, 208/242 vs. 83.1%, 201/242 respectively, P = 0.021). The diagnostic odds ratio of BSBP positivity was higher than CBS positivity in the patients with arthralgia (26.0, 12.9-52.4 vs. 21.1, 10.8-41.3) and with arthritis (12.0, 4.9-29.4 vs. 10.0, 4.2-23.4). Both BSBP and CBS appear to provide acceptable accuracy and comparable diagnostic performance for diagnosis of RA. However, in the patients with arthralgia, BSBP was found to be more sensitive than CBS and more accurate when interpreted with the result of anti-CCP antibody. This could help physicians diagnose RA in daily clinical practice. PMID:27051232

  4. Indium-111-labeled platelet scintigraphy in carotid atherosclerosis

    SciTech Connect

    Minar, E.; Ehringer, H.; Dudczak, R.; Schoefl, R.J.; Jung, M.; Koppensteiner, R.; Ahmadi, R.; Kretschmer, G.

    1989-01-01

    We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index.

  5. Laxative Related Primary Hyperphosphatemic Tumoral Calcinosis Identified by Bone Scintigraphy.

    PubMed

    Asokendaran, Marcus; Lenzo, Nat Patrick

    2016-09-01

    We describe a case of a 40-year-old female patient presenting with tumor calcinosis where hypertrophic pulmonary osteoarthropathy (HPOA) was suspected given her extensive history of malignancy. Plain X-rays did not show reveal the typical periarticular calcification but did show appearances consistent with HPOA. Bone scintigraphy with (99m)Tc-methylene diphosphonate (MDP) is a sensitive investigation in the detection of hypertrophic osteoarthopathy but did not show findings characteristics of HPOA like bilateral symmetrical increased uptake of the radiopharmaceutical along the cortical margins of the long bones. The final diagnosis of tumor calcinosis was only made after low dose computerized tomography chest showed a moderated sized amorphous calcified cluster in the apical segment of the right upper lobe consistent. In conclusion, bone scintigraphy continues to be a useful investigation for both common and rare conditions like tumor calcinosis. The unusual three phase bone scan finding of diffuse activity throughout both lung fields, which turned to out to be tumoral calcinosis is highlighted in this case. PMID:27651742

  6. Current imaging techniques in rheumatology: MRI, scintigraphy and PET

    PubMed Central

    Sudoł-Szopińska, Iwona; Ćwikła, Jarosław B.

    2013-01-01

    Summary The first-line imaging technique for diagnosis inflammation in musculo-skeletal organs in rheumatoid arthritis (RA) is planar X-ray examination, which was for many years the first and the only single tool for RA diagnostics and response evaluation. Today, in the era of more aggressive RA treatment, ultrasound examination (US) and magnetic resonance imaging (MRI) are also frequently used. US is used to detect early signs of inflammation within the soft tissue. MRI allows to assess the soft tissue and bone marrow involvement in case of inflammation and/or infection. MRI is capable of detecting more inflammatory lesions and erosions than US, X-ray, or CT. Standard scintigraphy plays a crucial role, and data from positron emission tomography (PET) are also promising. These functional imaging techniques are used in detection of inflammation and/or infection in case of ambiguous results being obtained by other techniques or at other clinics. In patients with RA, scintigraphy plays a key role in the differential diagnosis of hip, knee, etc. endoprosthesis disorders, including mechanical or septic loosening. PMID:24115960

  7. A sign of symptomatic chronic cholecystitis on biliary scintigraphy

    SciTech Connect

    Al-Sheikh, W.; Hourani, M.; Barkin, J.S.; Clarke, L.P.; Ashkar, F.S.; Serafini, A.N.

    1983-02-01

    Five hundred patients with acute right-upper-quadrant pain underwent biliary scintigraphy with /sup 99m/Tc paraisopropyliminodiacetic acid. One hundred and thirty-four studies were reported normal (both gallbladder and activity in bowel are noted in 1 hr). Of the 134 studies reported as normal, 32 showed intestinal activity before gallbladder visualization during the first hour of the study. Sonography and/or oral cholecystography revealed that 24 patients had gallstones, and eight patients had no demonstrable pathology in the biliary system. Of the 134 studies, 102 showed visualization of the gallbladder before intestinal activity during the first hour of the study. Sonography and/or oral cholecystography showed that 73 patients had normal biliary system. The remaining 29 patients had gallstones. The overall sensitivity of this finding is 45%, the specificity is 90%, and the accuracy is 73%. In this group of symptomatic patients, the appearance of intestinal activity before gallbladder activity on biliary scintigraphy warrants further evaluation of these patients by sonography and/or oral cholecystography.

  8. Laxative Related Primary Hyperphosphatemic Tumoral Calcinosis Identified by Bone Scintigraphy

    PubMed Central

    Asokendaran, Marcus; Lenzo, Nat Patrick

    2016-01-01

    We describe a case of a 40-year-old female patient presenting with tumor calcinosis where hypertrophic pulmonary osteoarthropathy (HPOA) was suspected given her extensive history of malignancy. Plain X-rays did not show reveal the typical periarticular calcification but did show appearances consistent with HPOA. Bone scintigraphy with 99mTc-methylene diphosphonate (MDP) is a sensitive investigation in the detection of hypertrophic osteoarthopathy but did not show findings characteristics of HPOA like bilateral symmetrical increased uptake of the radiopharmaceutical along the cortical margins of the long bones. The final diagnosis of tumor calcinosis was only made after low dose computerized tomography chest showed a moderated sized amorphous calcified cluster in the apical segment of the right upper lobe consistent. In conclusion, bone scintigraphy continues to be a useful investigation for both common and rare conditions like tumor calcinosis. The unusual three phase bone scan finding of diffuse activity throughout both lung fields, which turned to out to be tumoral calcinosis is highlighted in this case. PMID:27651742

  9. 131I-19-iodocholesterol scintigraphy of the adrenal cortex.

    PubMed

    Dige-Petersen, H; Munkner, T; Fogh, J; Blichert-Toft, M; Lund, J O

    1975-09-01

    131-I-19-iodocholesterol scintigraphy of the adrenal cortex has been carried out in 26 patients. In 4 patients with normal adrenocortical function the tracer was equally accumulated on the two sides. In 7 patients with untreated Cushing's syndrome, bilateral uptake was found in 4 patients with bilateral hyperplasia whereas unilateral visualization was obtained in three cases of cortisol producing adenomas. The side localization was confirmed at operation. Eight patients had been operated for Cushings syndrome prior to the scintigraphy. Remnant adrenocortical tissue with negligible or subnormal function (4 patients) could not be visualized. Normo- or hyperfunctioning remnant tissue was visualized in 3 patients. One patient had recurrent hypercorticism due to metastases from a previously removed adrenocortical carcinoma; a single pelvic accumulation was seen, whereas several metastases in the abdomen and thorax were not visualized. Four patients with aldosteronism were investigated. Three had primary aldosteronism due to an adrenocortical adenoma. In two of these, the site of the adrenal lesion was localized pre-operatively. In the third patient, equal bilateral accumulation of iodocholesterol was seen even after suppression with dexamethasone. At operation a small tumour was found. In 1 patient with indeterminate aldosteronism both glands were visualized and at a second examination the uptake was equally suppressed by dexamethasone.

  10. Hepatobiliary scintigraphy in patients receiving hepatic artery infusion chemotherapy

    SciTech Connect

    Housholder, D.F.; Hynes, H.E.; Dakhil, S.R.; Marymont, J.H. Jr.

    1984-01-01

    Two patients receiving hepatic artery infusion chemotherapy (HAIC) required cholecystectomy for both acute and chronic cholecystitis with cholelithiasis suggesting chemical cholecystitis. To evaluate the incidence of gall bladder dysfunction in patients receiving HAIC, the authors performed hepatobiliary scintigraphy using Tc-99m DISIDA or PIPIDA on eight patients receiving HAIC through an indwelling hepatic artery catheter and Infusaid (trademark) pump. In 7 of 8 patients, there was non-visualization of the gall bladder throughout the hepatobiliary study. In the eighth patient, the gall bladder visualized at 2 hr. One patient with non-visualization of the gall bladder at 4 hr developed acute symptoms requiring cholecystectomy which showed acute and chronic cholecystitis with cholethiasis. There was prominent sclerosis which was thought to be due to chemical cholecystitis as well as cholelithiasis. In all 10 patients, no evidence of cholecystitis had been observed during the surgical placement of the hepatic artery catheter and Infusaid pump. The hepatobiliary scintigraphic finding of gall bladder dysfunction in all eight patients studied is most likely due to chemical cholecystitis from HAIC. This series suggests that chemical cholecystitis is common during HAIC and can be identified by hepatobiliary scintigraphy. The authors consider elective cholecystectomy during the operative placement of the hepatic artery catheter and Infusaid pump.

  11. Laxative Related Primary Hyperphosphatemic Tumoral Calcinosis Identified by Bone Scintigraphy

    PubMed Central

    Asokendaran, Marcus; Lenzo, Nat Patrick

    2016-01-01

    We describe a case of a 40-year-old female patient presenting with tumor calcinosis where hypertrophic pulmonary osteoarthropathy (HPOA) was suspected given her extensive history of malignancy. Plain X-rays did not show reveal the typical periarticular calcification but did show appearances consistent with HPOA. Bone scintigraphy with 99mTc-methylene diphosphonate (MDP) is a sensitive investigation in the detection of hypertrophic osteoarthopathy but did not show findings characteristics of HPOA like bilateral symmetrical increased uptake of the radiopharmaceutical along the cortical margins of the long bones. The final diagnosis of tumor calcinosis was only made after low dose computerized tomography chest showed a moderated sized amorphous calcified cluster in the apical segment of the right upper lobe consistent. In conclusion, bone scintigraphy continues to be a useful investigation for both common and rare conditions like tumor calcinosis. The unusual three phase bone scan finding of diffuse activity throughout both lung fields, which turned to out to be tumoral calcinosis is highlighted in this case.

  12. (99m)Tc-methylene diphosphonate bone scintigraphy findings in posttransplant distal limb syndrome.

    PubMed

    Derlin, Thorsten; Busch, Jasmin D; Bannas, Peter

    2014-07-01

    We report a case of posttransplant distal limb syndrome (PTDLS) representing a rare complication in kidney transplant recipients characterized by a pain syndrome of the distal extremities. A 68-year-old man with a history of kidney transplantation presented with symmetrical and incapacitating pain in the feet and knees and underwent whole-body Tc-methylene diphosphonate (MDP) scintigraphy for further evaluation. Planar scintigraphy demonstrated marked tracer uptake in the distal femoral and tibial epiphyses, and magnetic resonance imaging showed corresponding osteoedema. Tc-MDP scintigraphy is a valuable tool for evaluation of the etiology of musculoskeletal pain and may demonstrate typical findings in case of PTDLS.

  13. Uremic Leontiasis Ossea in a Patient With Chronic Renal Insufficiency Demonstrated on Bone Scintigraphy.

    PubMed

    Han, Yeon-Hee; Jeong, Hwan-Jeong; Lim, Seok Tae; Sohn, Myung-Hee

    2016-08-01

    A 37-year-old woman with chronic renal insufficiency underwent bone scintigraphy to evaluate renal osteodystrophy (ROD). Markedly increased uptakes were shown in the maxilla and the mandible, which suggested extensive maxillary and mandibular hypertrophy. CT image revealed that diffuse bony thickening and ground-glass appearance in the skull, maxilla, and mandible with poor distinction of the corticomedullary junction. Whole-body bone scintigraphy images also demonstrated various skeletal characteristics of ROD. This case emphasizes the utility of bone scintigraphy for the surveillance of the whole body in ROD. PMID:27276201

  14. Congenital renal anomaly: evaluation with 99mTc-dimercaptosuccinic acid renal scintigraphy

    SciTech Connect

    Hosokawa, S.; Kawamura, J.; Tomoyoshi, T.; Yoshida, O.

    1983-05-01

    Technetium 99m-2,3, dimercaptosuccinic acid (99mTc-DMSA) preferentially accumulates in the renal cortex, demonstrating functioning cortical mass. We used 99mTc-DMSA renal scintigraphy in ten patients with horseshoe kidneys and five patients with unilateral fused kidneys. The results show that 99mTc-DMSA renal scintigraphy reliably establishes the diagnosis of horseshoe kidney and clearly shows the isthmus, which is very essential for proper management. The technique also aids in the definitive assessment of separate kidney function and of total radionuclide uptake is possible using 99mTc-DMSA scintigraphy.

  15. Techniques for technetium scintigraphy in plants.

    PubMed

    Currie, Geoffrey; Clarke, Simon; Rogiers, Suzy; Wheat, Janelle

    2010-06-01

    The accumulation of technetium by plants has been widely studied and reported in the literature from the perspective of the incorporation of environmental (99)Tc into the food chain. Pertechnetate (TcO(4)(-)) is the most stable surface chemical form of technetium and is known to be extracted by plant roots, transported by the xylem, and reduced in the leaves; however, the mechanism of action is not entirely clear. Measuring the distribution of technetium in plants has been challenging, many questions remaining unanswered. To date, tracer studies for plant physiology (radionuclide and color dye) have relied on destructive sampling, prohibiting repeat-design experimentation. This article explores the technical issues relating to the application of scintigraphic imaging to plant physiology. The benefits and limitations of methods for introducing radiotracers to plants are outlined. Strategies for the successful labeling of various plant organs with (99m)Tc and several unanticipated artifacts are described. The relevance of these labeling experiments to the study of plant vascular transport is explained, and strategies for optimizing the scintigraphic imaging of plants are outlined. Assessing plant physiology is an emerging frontier, especially given the growing importance of water management and the increased competing demand for crops as biofuels.

  16. In-111 labeled leukocyte scintigraphy in a case of multifocal candidiasis

    SciTech Connect

    Palestro, C.J.; Vega, A.; Kim, C.K.; Goldsmith, S.J. )

    1990-06-01

    The value of indium-111 labeled leukocyte scintigraphy for the diagnosis of infection in the general population is well documented; there is less information available on its role in the evaluation of the immunocompromised patient. In this study, leukocyte scintigraphy was performed on a 31-year-old immunocompromised woman who had a possible intra-abdominal abscess. No abscess was detected, but intense oral, esophageal, gastric, and vaginal uptake was observed. Candida infection was histologically confirmed at all four sites.

  17. A case of synovial sarcoma with bone metastasis identified by bone marrow scintigraphy

    SciTech Connect

    Otsuka, N.; Morita, R.; Yamamoto, T.; Muranaka, A.; Tomomitsu, T.; Yanagimoto, S.; Sone, T.; Fukunaga, M.

    1985-04-01

    In a patient with synovial sarcoma, routine bone survey showed no abnormality, while bone marrow scintigraphy with Tc-99m sulfur colloid revealed a defect in the fifth lumbar vertebra. At surgery, tumorous invasion was noted in the fifth lumbar vertebra and the surrounding tissues. It was suggested that the bone marrow scintigraphy was particularly useful in the detection of tumorous invasion into the bone marrow at the early stage before the destruction of skeletal tissue.

  18. Scintigraphy for the diagnosis of testicular torsion and differential diagnosis of acute intrascrotal processes.

    PubMed

    Romics, I; Wesseler, T; Bach, D

    1988-01-01

    Twenty-five patients suffering from acute painful testicular processes were subjected to scintigraphy. Testicular torsion in the early and delayed phases were diagnosed with 100% accuracy, but one out of 7 cases of epididymitis was wrongly recognized as negative. Interoperative diagnosis in two cases of hydatid torsion proved the foregoing scintigraphic finding to have been wrong. Nevertheless, scintigraphy was found to be reliable in testicular torsion diagnosis.

  19. The role of bone scintigraphy in the evaluation of the suspected abused child

    SciTech Connect

    Sty, J.R.; Starshak, R.J.

    1983-02-01

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children who were suspected victims of abuse. Radiography was positive in 105 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused.

  20. Abnormal thallium 201 scintigraphy during low-dose vasopressin infusions

    SciTech Connect

    Davison, R.; Kaplan, K.; Bines, A.; Spies, S.; Reed, M.T.; Lesch, M.

    1986-12-01

    Thallium 201 (/sup 201/Tl) myocardial scans were obtained in 16 patients just prior to the discontinuation of a vasopressin infusion (.1 to .2 units/min) administered for the treatment of upper gastrointestinal bleeding. Repeat scintigraphy was performed two to three hours after the vasopressin was stopped. Eleven of the 16 patients (69 percent) demonstrated areas of decreased myocardial /sup 201/Tl uptake that resolved after the infusion was stopped. Heart rate-blood pressure product was significantly lower at the time of the second scan. Autopsies were secured in three of 11 scan-positive patients: one had severe coronary artery obstruction, one nonsignificant disease, and another had normal coronary arteries. Vasopressin, even at low doses, can induce abnormalities in myocardial perfusion that are probably mediated by a direct effect on the coronary circulation. They are usually not detectable by routine monitoring techniques and conceivably form the basis for the cardiovascular morbidity associated with the use of this agent.

  1. Suspected acute cholecystitis. Comparison of hepatobiliary scintigraphy versus ultrasonography

    SciTech Connect

    Freitas, J.E.; Mirkes, S.H.; Fink-Bennett, D.M.; Bree, R.L.

    1982-08-01

    One hundred ninety-five patients with suspected acute cholecystitis (AC) underwent both hepatobiliary scintigraphy (HBS) and static gray-scale ultrasonography (US) to assess the relative value of each imaging modality in this clinical setting. HBS was performed after the intravenous injection of 5 mCi /sup 99m/Tc iprofenin. Abnormal HBS indicative of AC visualized the common bile duct, but not the gallbladder, within 1 to 4 hours after tracer administration. Abnormal US indicative of AC demonstrated cholelithiasis and/or gallbladder wall edema. In this series, HBS surpassed US in sensitivity (98.3% versus 81.4%), specificity (90.2% versus 60.2%), predictive value of an abnormal test (91.4% versus 51.6%), and predictive value of a normal test (100% versus 92%), HBS should be the procedure of choice for the rapid detection of AC.

  2. Nurse exposure doses resulted from bone scintigraphy patient

    NASA Astrophysics Data System (ADS)

    Tunçman, Duygu; Kovan, Bilal; Poyraz, Leyla; ćapali, Veli; Demir, Bayram; Türkmen, Cüneyt

    2016-03-01

    Bone scintigraphy is used for displaying the radiologic undiagnosed bone lesions in nuclear medicine. It's general indications are researching bone metastases, detection of radiographically occult fractures, staging and follow-up in primary bone tumors, diagnosis of paget's disease, investigation of loosening and infection in orthopedic implants. It is applied with using 99mTc labeled radiopharmaceuticals (e.g 99m Tc MDP,99mTc HEDP and 99mTc HMDP). 20 -25 mCi IV radiotracer was injected into vein and radiotracer emits gamma radiation. Patient waits in isolated room for about 3 hours then a gamma camera scans radiation area and creates an image. When some patient's situation is not good, patients are hospitalized until the scanning because of patients' close contact care need. In this study, measurements were taken from ten patients using Geiger Muller counter. After these measurements, we calculated nurse's exposure radiations from patient's routine treatment, examination and emergency station.

  3. Spontaneous retroperitoneal hemorrhage localized by blood pool scintigraphy.

    PubMed

    Lerer, Daniel B; Rozenblit, Alla M; Cynamon, Jacob; Tubman, Gary; Freeman, Leonard M

    2004-02-01

    A healthy 17-year-old girl presented to the emergency department with a 1-day history of left upper quadrant abdominal pain associated with nausea and vomiting. Her hematocrit was 22. On physical examination, she had left upper quadrant fullness and tenderness. Initial computed tomography revealed a large, loculated, left-sided retroperitoneal hematoma. Blood pool scintigraphy with labeled red cells revealed a very large photon-deficient area with 3 areas of active bleeding in the upper margin of the cold area. An angiogram showed active extravasation from the left inferior phrenic artery. The patient was felt to have had spontaneous adrenal hemorrhage, likely within a preexisting, large adrenal cyst. Spontaneous hemorrhage into an adrenal cyst is a rare entity that can be life-threatening if not treated early in its course.

  4. Technetium-99m human immunoglobulin scintigraphy in patients with adhesive capsulitis: a correlative study with bone scintigraphy.

    PubMed

    Senocak, Ozlem; Degirmenci, Berna; Ozdogan, Ozhan; Akalin, Elif; Arslan, Gülhan; Kaner, Burcu; Taşci, Cengiz; Peker, Ozlen

    2002-06-01

    Adhesive capsulitis (AC) is a disorder that is characterized by shoulder pain and progressive limitation of both active and passive shoulder motion. Although the underlying pathological mechanisms of the disease are not well understood, the inflammatory reactions depending on the stage have been demonstrated histologically. The purpose of the study is to investigate the inflammatory changes that can be demonstrated with Tc-99m HIG in AC, and to determine the presence of correlations between scintigraphic findings and the clinical assessment. Twenty-one patients (12 females and 9 males) with a mean age of 50.57+/-8.49 were included in the study. AC was diagnosed according to recognized criteria. The planar X-ray images of the affected shoulders of all patients were normal. The patients were evaluated with the Constant Scoring System, and the functional and pain assessment parts of the American Shoulder and Elbow Surgeons' Form (ASES). Three phase bone scans and Tc-99m HIG scintigraphy were performed at least two days apart. Bone scan and Tc-99m HIG scintigraphy were evaluated visually and HIG uptake was evaluated in comparison with the contralateral normal shoulder. Bone scan demonstrated hypervascularity in 9 of the 21 patients (43%), whereas increased osteoblastic activity was detected in 19 (90%) in the affected shoulder. Tc-99m HIG uptake was positive in 12 (57%), and negative in 9 (43%) patients. All patients with increased Tc-99m HIG accumulation in the affected shoulder, also had increased osteoblastic activity on Tc-99m bone scintigraphy. A significant correlation was found between HIG uptake and constant, functional and pain scores. The difference between these scores was also statistically significant in patients with HIG positive and negative uptake. This study indicates that there is a good correlation between Tc-99m HIG scan findings and clinical scores. Tc-99m HIG accumulation in the affected shoulder may be related to continuing inflammatory reaction

  5. Renal anomalies in patients with turner syndrome: Is scintigraphy superior to ultrasound?

    PubMed

    Hamza, Rasha T; Shalaby, Mennatallah H; Hamed, Laith S; Abdulla, Dunya B A; Elfekky, Sahar M; Sultan, Omar M

    2016-02-01

    Renal anomalies are present in up to 30% of patients with Turner syndrome (TS). Renal ultrasound (U/S) detects anatomical renal anomalies only while renal scintigraphy detects anomalies, detects early renal malfunction, and estimates glomerular filtration rate (GFR). Thus, we aimed to assess frequency of renal abnormalities detected by scintigraphy in comparison to renal U/S in TS patients. Ninety TS patients were subjected to auxological assessment, measurement of serum creatinine; and renal U/S and scintigraphy. Renal U/S detected renal anomalies in 22.22% of patients versus 17.78 % detected by scintigraphy (P = 0.035). Scintigraphy detected renal functional abnormalities in 44.44% of patients in the form of subnormal total GFR, abnormal renogram curve pattern, improper tracer handling and perfusion; and difference in split renal function >10% between both kidneys. Patients with a 45,X karyotype had more renal functional abnormalities (56%) than those with mosaic karyotype (33.33%), P = 0.04. In conclusion, renal scintigraphy is not superior to U/S in detection of renal anomalies but is a reliable method for early detection of renal malfunction in TS patients especially those with 45,X to ensure early management to offer a better quality of life.

  6. Quantitative bone and 67Ga scintigraphy in the differentiation of necrotizing external otitis from severe external otitis

    SciTech Connect

    Uri, N.; Gips, S.; Front, A.; Meyer, S.W.; Hardoff, R. )

    1991-06-01

    Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 {plus minus} 0.16 in patients with NEO and 1.08 {plus minus} 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 {plus minus} 0.24 in NEO patients and 1.05 {plus minus} 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO.

  7. ["Technetium crisis" -  causes, possible solutions and consequences for planar scintigraphy and SPECT diagnostics].

    PubMed

    Adam, J; Kadeřávek, J; Kužel, F; Vašina, J; Rehák, Z

    2014-01-01

    Nuclear medicine is an important field of nuclear medicine, especially thanks to its role in in vivo imaging of important processes in human organism. An overwhelming majority of nuclear medicine examinations comprises of planar scintigraphy and single photon emission computed tomography, for decades relying on the labeling by metastable technetium nuclide (99mTc), used with a great diversity of ligands for various applications. Nuclear medicine departments utilize commercially available molybdenum technetium generators, being able to elute the nuclide at any time and prepare the radiopharmaceutical. The mother nuclide, molybdenum-99 (99Mo), is produced in just a handful of places around the world. The production places are without exception research nuclear reactors working far past their life expectancy. A concurrent temporary shutdown of two of them in the year 2009 caused a critical worldwide shortage of 99mTc. An unavoidable permanent shutdown of part of these capacities in the second decade of the 21st century will cause the second, and this time rather permanent "technetium crisis". The article focuses on history, present, potential future and possible solutions in regard to SPECT diagnostics.

  8. Radiotherapy and technetium-99m-labeled red blood cell scintigraphy for hemoptysis from chronic MRSA infection

    PubMed Central

    Lapuz, Carminia; Gupta, Sandeep K.; Bennett, Elizabeth A.; Tang, Colin I.

    2013-01-01

    Aim To discuss the application of external beam radiotherapy (EBRT) and technetium-99m-labeled red blood cell scintigraphy (LRBCS) in life-threatening hemoptysis from a non-malignant condition. Materials and methods This case report presents a patient with persistent hemoptysis secondary to chronic Methicillin-resistant Staphylococcus aureus (MRSA) infection in whom conventional management failed to localize the site of pulmonary bleeding or to provide effective therapy. Results EBRT was successfully given for life-threatening hemoptysis with improvement in quality of life for nearly 1 year. LRBCS was used to localize the source of further bleeding and facilitate targeted therapy. Conclusion EBRT can be an effective and well-tolerated modality in treating life-threatening hemoptysis refractory to conventional methods. LRBCS is a non-invasive diagnostic tool that can be used to detect the source of pulmonary bleeding. PMID:24416570

  9. Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function

    PubMed Central

    Manevska, Nevena; Stojanoski, Sinisa; Majstorov, Venjamin; Pop-Gjorcheva, Daniela; Zdraveska, Nikolina; Kuzmanovska, Dafina

    2016-01-01

    BACKGROUND: Radionuclide techniques, as direct radionuclide cystography and 99mTc-DMSA scintigraphy, have been used in evaluation of vesicoureteral reflux (VUR) and reflux nephropathy (RN) in children. Dynamic 99mTc-DTPA scintigraphy is reserved for evaluation of differential renal function and obstruction in children, where hydronephrosis is detected by ultrasonography (US) pre- or postnatally. CASE REPORT: Six year old boy was prenatally diagnosed with bilateral hydronephrosis. Postnatal, severe bilateral VUR was detected by voiding urethrocytography. US and 99mTc-DTPA scintigraphy performed in the first month of life showed small left kidney that participated with 2% in the global renal function. Bilateral cutaneous ureterostomy has been performed in order to obtain good renal drainage and promote optimal renal growth. Twelve months later, classic antireflux procedure was done. Control 99mTc-DTPA scintigraphy, 5 ys after antireflux surgery, revealed persisting radioactivity during the diuretic phase, in the left kidney that indicated antireflux procedure failure with VUR reappearance. CONCLUSION: 99mTc-DTPA scintigraphy is the first method of choice for long-term monitoring of individual kidney function in children with VUR and other congenital urinary tract anomalies. Additionally, it can be used as indirect radionuclide cystography when rising of radioactivity in the kidney region, during the diuretic phase can indicate presence of VUR. PMID:27275347

  10. Prognostic significance of normal quantitative planar thallium-201 stress scintigraphy in patients with chest pain

    SciTech Connect

    Wackers, F.J.; Russo, D.J.; Russo, D.; Clements, J.P.

    1985-07-01

    The prognostic significance of normal quantitative planar thallium-201 stress scintigraphy was evaluated in patients with a chest pain syndrome. The prevalence of cardiac events during follow-up was related to the pretest (that is, before stress scintigraphy) likelihood of coronary artery disease determined on the basis of symptoms, age, sex and stress electrocardiography. In a consecutive series of 344 patients who had adequate thallium-201 stress scintigrams, 95 had unequivocally normal studies by quantitative analysis. The pretest likelihood of coronary artery disease in the 95 patients had a bimodal distribution. During a mean follow-up period of 22 +/- 3 months, no patient died. Three patients (3%) had a cardiac event: two of these patients (pretest likelihood of coronary artery disease 54 and 94%) had a nonfatal myocardial infarction 8 and 22 months, respectively, after stress scintigraphy, and one patient (pretest likelihood 98%) underwent percutaneous transluminal coronary angioplasty 16 months after stress scintigraphy for persisting anginal complaints. Three patients were lost to follow-up; all three had a low pretest likelihood of coronary artery disease. It is concluded that patients with chest pain and normal findings on quantitative thallium-201 scintigraphy have an excellent prognosis. Cardiac events are rare (infarction rate 1% per year) and occur in patients with a moderate to high pretest likelihood of coronary artery disease.

  11. Thallium scintigraphy during dobutamine infusion: nonexercise-dependent screening test for coronary disease

    SciTech Connect

    Mason, J.R.; Palac, R.T.; Freeman, M.L.; Virupannavar, S.; Loeb, H.S.; Kaplan, E.; Gunnar, R.M.

    1984-03-01

    Exercise thallium scintigraphy has proven to be a sensitive method for detecting coronary artery disease (CAD). However, early redistribution of thallium and inadequate exercise can reduce its sensitivity. In this study, dobutamine was infused in incremental doses (5, 10, 15, and 20 micrograms/kg/min) in 24 patients being evaluated for chest pain. Thallium scintigraphy was completed during the maximum dose of dobutamine tolerated and repeated 4 hours later. Significant CAD was present in 16 patients; the remaining eight had normal coronaries. Exercise ECG was obtained in 23 patients. During dobutamine thallium scintigraphy, reversible perfusion defects occurred in 15 of 16 CAD and in one of eight non-CAD patients, resulting in a sensitivity of 94% and a specificity of 87%. Exercise ECG had a sensitivity of 60% and a specificity of 63%. We conclude that: (1) dobutamine thallium scintigraphy appears to be a sensitive method for detecting significant CAD and provided a more sensitive screening test than exercise ECG; (2) dobutamine thallium scintigraphy is especially useful in patients who cannot exercise; and (3) because imaging occurs during dobutamine infusion, the problem of early redistribution may be mitigated.

  12. Clinical utility of bone scintigraphy in patients with limb pain of suspected musculoskeletal origin

    PubMed Central

    Ferrari, Robert

    2015-01-01

    Objective To determine the clinical utility of bone scintigraphy in patients with limb pain of suspected musculoskeletal origin. Material and Methods All patients aged ≥18 years who were referred for diagnosis and management of limb pain were diagnosed on the basis of history, physical examination, and investigations excluding bone scintigraphy. After the presumptive diagnosis was made (the pre-test diagnosis), all subjects underwent bone scintigraphy, or if they had a previous bone scintigram for their pain condition, the results of that scintigram were reviewed. Then, the pre-test diagnosis was reviewed in light of the bone scintigraphy findings and repeat clinical assessment as needed. The post-test diagnosis was considered either as unchanged diagnosis or changed diagnosis for the region or regions of interest. Results There were 118 females (54.8%) and 97 males (45.2%). The mean age of the entire group was 36±8.1 years (range: 18–87 years). The mean duration of the symptoms was 17.4±11.2 months (range: 1–264 months). Of the 215 subjects, 212 had a bone scintigram. Of these 212 subjects, none had a changed diagnosis. Conclusion In the evaluation of limb pain of suspected musculoskeletal origin, scintigraphy is unlikely to alter the pre-test diagnosis or affect treatment decisions after history, physical examination, and non-scintigraphic investigations. The clinical utility of scinitigraphy in this setting is low. PMID:27708914

  13. Dexamethasone-suppression adrenal scintigraphy in hyperandrogenism: concise communication

    SciTech Connect

    Gross, M.D.; Freitas, J.E.; Swanson, D.P.; Woodbury, M.C.; Schteingart, D.E.; Beierwaltes, W.H.

    1981-01-01

    To assess the contribution of adrenal-derived androgens in women with hirsutism, adrenal scintigrams under dexamethasone suppression (DS) were performed on 35 women with increasing facial or body hair and irregular or absent menses. Based upon the DS regimen chosen (8 mg/d for 2 days or 4 md/d for 7 days before the injection of 6..beta..-(/sup 131/I)iodomethylnorcholesterol), three imaging patterns were identified. The first was the absence of uptake before 3 days (8-mg DS) or before 5 days (4-mg DS) after injection. This imaging pattern was seen in 17 of the 35 patients studied and was considered normal. The second pattern was bilateral uptake earlier than 3 days (8-mg DS regimen) or 5 days (4-mg DS) after injection. This was seen in 13 of the 35 patients and was interpreted as bilateral early visualization. Adrenal-vein catheterization performed on six patients with this pattern showed increased adrenal-vein testosterone. The third pattern, observed in five patients, was unilateral early visualization, which in four cases investigated to date was the result of an adrenocortical adenoma. This study confirms the adrenal cortex as a source of androgens in women with hirsutism and hyperandrogenism and demonstrates that DS adrenal scintigraphy can be utilized to identify those women in whom adrenal-derived androgens contribute to their hyperandrogenism.

  14. Preoperative localization of parathyroid adenomas: ultrasonography, sestamibi scintigraphy, or both?

    PubMed

    Hajioff, D; Iyngkaran, T; Panagamuwa, C; Hill, D; Stearns, M P

    2004-10-01

    Minimal access techniques are increasingly used to remove parathyroid adenomas. Such surgery depends on accurate preoperative localization but the selection of imaging modality remains controversial. We have reviewed the accuracy of ultrasonography, sestamibi scintigraphy and their combination in 48 cases of primary hyperparathyroidism. Ultrasound had a sensitivity of 64.3% (95% confidence interval 44.1-81.4) and positive predictive value (PPV) of 100% (81.5-100) for correct lateralization. Sestamibi had a sensitivity of 83.3% (69.8-92.5) and PPV of 87.1% (73.7-95.1). The simple combination of ultrasound with sestamibi had a sensitivity of 82.1% (63.1-93.9) and a PPV of 92.0% (74.0-99.0): little different from sestamibi alone. However, if the sestamibi result was disregarded in favour of ultrasonography in discordant cases, the sensitivity reached 96.4% (81.7-99.9) and the PPV was 100% (87.2-100). These results were not dependant on a learning curve or the size of adenoma.

  15. Human pancreas scintigraphy using iodine-123-labeled HIPDM and SPECT

    SciTech Connect

    Yamamoto, K.; Shibata, T.; Saji, H.; Kubo, S.; Aoki, E.; Fujita, T.; Yonekura, Y.; Konishi, J.; Yokoyama, A. )

    1990-06-01

    The pancreatic affinity of iodine-123-labeled HIPDM (N,N,N'-trimethyl-N'-(2-hydroxy-3-methyl-5-iodobenzyl)-1,3-propane diamine) (({sup 123}I)HIPDM) was studied in 18 cases (5 normal volunteers, 7 cases with pancreas cancer, and 6 with chronic pancreatitis). In the normal cases, the pancreas was visualized in the planar images as early as 3 hr, and again at 20 hr postinjection. Single-photon emission computed tomography (SPECT) performed following 3-hr planar scintigraphy, provided excellent pancreas images without an overlap of activity in the liver or spleen. The mean pancreas-to-liver (P/L) ratio was 1.26 +/- 0.22 in normal controls. With the exception of one case of massive calcification in the pancreas, the entire pancreas could be observed in the cases with chronic pancreatitis, but the P/L ratio was 0.74 +/- 0.15, significantly lower than that of normal cases. Defective areas of the distal portion of the pancreas were clearly seen in those with cancer of the pancreas. The results of our study indicate that ({sup 123}I) HIPDM may have clinical potential as a human pancreas imaging agent.

  16. Bone marrow scintigraphy and computed tomography in myloproliferative disease

    SciTech Connect

    Goldsmith, S.J.; Gilbert, H.S.; Hermann, G.

    1985-05-01

    Peripheral bone marrow (BM) expansion in myeloproliferative disease (MPD) is demonstrated by scintigraphy (scint) with Technetium 99m sulfur colloid (TSC) or Indium III chloride (In). Computed tomography (CT) of the normal adult medullary cavity yields negative attenuation coefficients (AC) which become positive when BM fat is replaced. BM scint and CT of the medullary cavity are obtained in 23 studies in 21 pts: 6 polycythemia vera (PCV), 6 post PCV myeloid metaplasis (MyM), 4 agnogenic MyM, 3 myelodysplasia with refractory anemia, 1 acute myelocytic leukemia and 1 chronic myelocytic with acute leukemic transformation. AC were measured for BM cavity of lower extremities at each third of the femur and tibia. Values ranged from -89 to +289 Hounsfield units. The results are presented in this paper. There was agreement between SCINT and CT in 83% pts and segments. 80% of MB segments with + AC had scint identified BM. BM biopsy of the iliac crest demonstrated fibrosis or blast proliferation in pts with +AC rather than hypercellularity or osteosclerosis. The highest AC values (>200) were seen in pts with blast proliferation and fibrosis. Decreased BM scint visualization and +CT AC correlated with BM fibrosis and may reflect replacement of BM elements or decreased RES function. BM scint and CT are useful to monitor MPD and select BM sites for biopsy.

  17. Subacute and chronic bone infections: Diagnosis using In-111, Ga-67 and Tc-99m MDP bone scintigraphy and radiography

    SciTech Connect

    Al-Sheikh, W.; Sfakianakis, G.N.; Mnaymneh, W.; Hourani, M.; Heal, A.; Duncan, R.C.; Burnett, A.; Ashkar, F.S.; Serafini, A.N.

    1985-05-01

    The usefulness of indium-111 white blood cell scintigraphy in the diagnosis of subacute or chronic bone infection was examined in 21 orthopedic patients. In-111 WBC imaging was compared with gallium-67 and technetium-99m methylene diphosphonate skeletal scintigraphy and bone radiography, all studies being performed within 1 week. In-111 WBC scintigraphy showed no definite advantage over Ga-67 scintigraphy in the identification of chronic bone infection. The two tests had the same sensitivity and similar specificity. Bone radiography had a sensitivity of 60% and a specificity of 67%. A negative Tc-99m MDP bone scintigram ruled out infection, but because of low specific, final evaluation required performance of Ga-67 or In-111 WBC scintigraphy.

  18. Bone scintigraphy in plasma-cell myeloma: a prospective study of 70 patients

    SciTech Connect

    Bataille, R.; Chevalier, J.; Rossi, M.; Sany, J.

    1982-12-01

    Radiography and scintigraphy were correlated in 70 patients with recently diagnosed, untreated multiple myeloma, including 59 with and 11 without primary lytic bone lesions. A site-by-site comparison showed that scintigraphy was more sensitive than radiography in only 18% of cases, whereas radiography was more sensitive in 38% (p<0.001). Patients whose bone scan was as sensitive or more so than the radiograph (''hot'' myeloma) had more active disease than those with the ''cold'' form. Remission was indicated by significant regression or disappearance of scintigraphic abnormalities in 90% of cases. The authors conclude that scintigraphy is not helpful in detecting myelomatous bone lesions, but does have prognastic value for diagnosis and chemotherapy: a positive bone scan indicates initial or residual activity.

  19. Bone scintigraphy in plasma-cell myeloma. A prospective study of 70 patients

    SciTech Connect

    Bataille, R.; Chevalier, J.; Rossi, M.; Sany, J.

    1982-12-01

    Radiography and scintigraphy were correlated in 70 patients with recently diagnosed, untreated multiple myeloma, including 59 with and 11 without primary lytic bone lesions. A site-by-site comparison showed that scintigraphy was more sensitive than radiography in only 18% of cases, whereas radiography was more sensitive in 38% (p less than 0.001). Patients whose bone scan was as sensitive or more so than the radiograph (hot myeloma) had more active disease than those with the cold form. Remission was indicated by significant regression or disappearance of scintigraphic abnormalities in 90% of cases. The authors conclude that scintigraphy is not helpful in detecting myelomatous bone lesions, but does have prognostic value for diagnosis and chemotherapy: a positive bone scan indicates initial or residual activity.

  20. Scintigraphy of the salivary glands in Sjögen's syndrome.

    PubMed Central

    Arrago, J P; Rain, J D; Brocheriou, C; Rocher, F

    1987-01-01

    Scintigraphy of the salivary glands with technetium-sodium pertechnetate (99mTc) was undertaken on 320 patients with oral dryness or connective tissue disease using a computer assisted method that gave quantitative results about the major salivary gland function. Compared with clinical and histological data, scintigraphy provides a sensitive method, even though it is not specific, for detecting minimal injuries to salivary glands in patients suspected of having Sjögen's syndrome. Moreover, it might differentiate between the Sjögen-like syndrome and the sequelae of radiotherapy in patients with bone marrow graft. Scintigraphy of the major salivary glands could therefore form part of the routine investigation of patients with Sjögen's syndrome. PMID:2828435

  1. Liver/spleen scintigraphy for diagnosis of splenic infarction in cirrhotic patients.

    PubMed Central

    Chin, J. K.; McCormick, P. A.; Hilson, A. J.; Burroughs, A. K.; McIntyre, N.

    1993-01-01

    Splenic infarction is rare in cirrhotic patients. The diagnosis of the condition is based on clinical findings and splenic imaging. In recent years, ultrasonography and computed tomographic scan have gained popularity over the more classical scintigraphy as the preferred investigations for the diagnosis of splenic infarction. We report three cases of splenic infarction in patients with cirrhosis and portal hypertension. Computed tomographic scan, angiography and ultrasonography failed to identify the lesions and the diagnoses were finally made with the aid of liver--spleen scintigraphy. We suggest that scintigraphy is the investigation of choice if splenic infarction is suspected in patients with congestive splenomegaly secondary to liver cirrhosis. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:8255838

  2. Indium-111-labeled leukocyte scintigraphy in hemodialysis access-site infection

    SciTech Connect

    Palestro, C.J.; Vega, A.; Kim, C.K.; Vallabhajosula, S.; Goldsmith, S.J. )

    1990-03-01

    Bacterial sepsis, a significant complication of chronic hemodialysis, is generally the result of infection at the vascular access site. We retrospectively reviewed the utility of indium-111-(111In) labeled autologous leukocyte scintigraphy in 26 patients (30 scans) with synthetic vascular grafts, on chronic hemodialysis, in whom hemodialysis access site infection was a diagnostic consideration. Leukocyte scintigraphy correctly identified all fifteen access-site infections; there was one false-positive study, for an overall sensitivity and specificity of 100% and 93%, respectively. Of particular significance is the fact that in nine (60%) of the fifteen access-site infections, physical examination was normal. Our data indicate that 111In-labeled leukocyte scintigraphy is a useful procedure for the diagnosis of hemodialysis access-site infection, and it is especially valuable when physical examination of the access site is normal.

  3. Limitations and pitfalls of 99mTc-EDDA/HYNIC-TOC (Tektrotyd) scintigraphy.

    PubMed

    Garai, Ildikó; Barna, Sandor; Nagy, Gabor; Forgacs, Attila

    2016-01-01

    Tektrotyd kit was developed by Polatom company for 99mTc labeling to make an alternative tracer of somatostatin receptor scintigraphy available. Since 2005, 99mTc-EDDA/HYNIC-Tyr3-Octreotide has been used in clinical imaging and achieved high impact in management of patients with neuroendocrine tumors. Knowing the limitations and pitfalls is essential to provide ac-curate diagnosis. Therefore, the potential pitfalls associated with the use of 99mTc-EDDA/HYNIC-TOC are reviewed on the basis of own experience. Data were analyzed of 310 patients who underwent somatostatin receptor scintigraphy with 99mTc-Tektrotyd. Pitfalls during radiolabeling process or acquisition can worsen the sensitivity of SRS (somatostatin receptor scintigraphy). Recognizing physi-ological and clinical pitfalls, the diagnostic accuracy will improve.

  4. [67Ga scintigraphy as a therapeutic marker for spinal cord and muscular sarcoidosis: A case report].

    PubMed

    Yamada, Shinichiro; Nakanishi, Hirotaka; Hirayama, Masaaki; Katsuno, Masahisa; Sobue, Gen

    2015-01-01

    A 70-year-old woman was admitted to our hospital because of the right limb pain and gait disturbance. (67)Ga scintigraphy showed an increased uptake in the spinal cord, mediastinal lymph node and right tibialis anterior muscle. Based on the histopathological findings of epithelioid cell granuloma in endobronchial ultrasound-guided transbronchial needle aspiration of lymph node, she was diagnosed as having probable spinal cord/muscular sarcoidosis. After she was treated with oral prednisolone, her limb pain and gait disturbance improved. Furthermore, uptake in (67)Ga scintigraphy was reduced after the treatment. In conclusion, (67)Ga scintigraphy is useful not only for diagnosis, but also for estimating the efficiency of the treatment for sarcoidosis involving multiple organs such as the spinal cord and skeletal muscle.

  5. Scintigraphy with 99mTc(V)-DMSA in monitoring patients with inflammatory bowel disease.

    PubMed

    Javadi, Hamid; Amiriani, Taghi; Mirkarimi, HoneySadat; Besharat, Sima; Semnani, Shahriar; Abedi, Jamshid; Seyedabadi, Mohammad; Assadi, Majid

    2013-01-01

    The clinical significance of pentavalent technetium-99m dimercaptosuccinic acid (99mTc(V)-DMSA) scintigraphy in diagnosing inflammatory bowel disease (IBD) has not yet been fully elucidated. The aim of this prospective paper was to study the above. This study included 54 patients, 22 females and 32 males (mean age: 36.68±11.49; range: 18-63 years) with IBD who came to our clinics for follow-up and were examined clinically by colonoscopy and 99mTc(V)-DMSA scintigraphy. On the follow-up studies, five patients (9.25%) relapsed, and 49 (90.74%) remained at a steady condition. There was a good correlation between the scintigraphic results and the clinical and colonoscopy data of the patients (P<0.05). In conclusion, our results indicated that 99mTc(V)DMSA scintigraphy can be complementary to colonoscopy for the diagnostic evaluation of IBD.

  6. Limitations and pitfalls of 99mTc-EDDA/HYNIC-TOC (Tektrotyd) scintigraphy.

    PubMed

    Garai, Ildikó; Barna, Sandor; Nagy, Gabor; Forgacs, Attila

    2016-01-01

    Tektrotyd kit was developed by Polatom company for 99mTc labeling to make an alternative tracer of somatostatin receptor scintigraphy available. Since 2005, 99mTc-EDDA/HYNIC-Tyr3-Octreotide has been used in clinical imaging and achieved high impact in management of patients with neuroendocrine tumors. Knowing the limitations and pitfalls is essential to provide ac-curate diagnosis. Therefore, the potential pitfalls associated with the use of 99mTc-EDDA/HYNIC-TOC are reviewed on the basis of own experience. Data were analyzed of 310 patients who underwent somatostatin receptor scintigraphy with 99mTc-Tektrotyd. Pitfalls during radiolabeling process or acquisition can worsen the sensitivity of SRS (somatostatin receptor scintigraphy). Recognizing physi-ological and clinical pitfalls, the diagnostic accuracy will improve. PMID:27479887

  7. Thallium-201 scintigraphy in the diagnosis and management of myocardial sarcoidosis

    SciTech Connect

    Fields, C.L.; Ossorio, M.A.; Roy, T.M.; Denny, D.M.; Varga, D.W. )

    1990-03-01

    We have described three patients with clinical evidence of myocardial sarcoidosis to illustrate the utility of thallium-201 scintigraphy in demonstrating the myocardial lesions. Both the symptomatic and asymptomatic individuals studied showed the characteristic reverse redistribution phenomenon. No abnormalities were seen during the exercise phase of the thallium study, but myocardial defects were detected in each patient when repeat studies were obtained at rest six hours later. Steroid therapy resolved the defects in each case. We propose thallium-201 scintigraphy of the heart as a safe and useful tool for documenting myocardial involvement in sarcoidosis and following the effects of therapy.

  8. Sestamibi scintigraphy for parathyroid localisation: a reminder of the dangers of false positives.

    PubMed

    Whitcroft, Katherine Lisa; Sharma, Anup

    2014-03-11

    Surgical parathyroidectomy is the only curative treatment for primary hyperparathyroidism. As minimally invasive parathyroidectomy increases in popularity, so does reliance on preoperative parathyroid localisation techniques. One such technique is sestamibi scintigraphy. We report a case of false-positive sestamibi scintigraphy caused by follicular variant of papillary thyroid carcinoma. Subsequent completion thyroidectomy was not possible due to widespread postoperative fibrosis. This case, therefore, highlights the potential dangers of false-positive results due to thyroid carcinoma and encourages surgeons to consider this possibility when faced with intrathyroidal or otherwise ambiguous parathyroid localisation results.

  9. Unusual appearance for urinary bladder obstruction detected with 99mTc-MDP bone scintigraphy.

    PubMed

    Wright, Chadwick L; Sharma, Akash

    2015-12-01

    Unanticipated but clinically significant nonosseous findings can be detected during routine bone scintigraphy. We present a case of an 83-year-old man who presented with a pathologic fracture of the right femur. Whole-body bone scintigraphy for osseous staging revealed intense radiotracer accumulation in the kidneys and ureters but no activity within the urinary bladder. The patient had not voided for 14 hours. A Foley catheter was inserted, and more than 2000 mL of urine was drained, most consistent with urinary bladder obstruction. Subsequent repeat images demonstrated marked reduction of the renal and ureteral activity with trace activity in the urinary bladder.

  10. /sup 57/Co-bleomycin scintigraphy for the staging of lung cancer

    SciTech Connect

    Nieweg, O.E.; Piers, D.A.; Beekhuis, H.; Sluiter, H.J.; van der Wal, A.M.; Woldring, M.G.

    1989-03-15

    The value of Cobalt-57 bleomycin (/sup 57/Co-BLM) scintigraphy in the detection of lymph node metastases in the hilum and mediastinum was investigated in 132 patients with peripherally located lung cancer. In one half of the patients with metastases, these were visualized. Specificity was 98%. These results were better than those obtained with chest radiography and conventional roentgen tomography. /sup 57/Co-BLM scintigraphy is routinely used in the staging of patients with lung cancer, obviating the need for mediastinoscopy.

  11. Functional fecal retention visualized by (111)In-DTPA colon transit scintigraphy.

    PubMed

    Infante, Jose Rafael; Rayo, Juan I; Serrano, Justo; Dominguez, Maria L; Garcia, Lucia; Moreno, Manuel

    2015-06-01

    Constipation is an extremely common problem in children, varying from mild and short-lived to severe and chronic. Chronic constipation is a serious childhood condition and requires further investigation, including blood test, colonoscopy, radio-opaque marker study, and/or scintigraphy. We present small bowel and colon transit scintigraphy of a 14-year-old girl with history of chronic constipation, abdominal pain, weight loss, and poor response to medical treatment. After oral administration of In-DTPA in water, planar and SPECT/CT images showed normal small bowel transit time and functional fecal retention in colon transit study. PMID:25706788

  12. Complementary roles of brain scintigraphy and computed tomography in multiple sclerosis

    SciTech Connect

    Moreno, A.J.; Brown, J.M.; Waller, S.F.; Lundy, M.M.; Brown, T.J.

    1983-12-01

    Cerebral computed tomography, with and without iodinated contrast, revealed the appearance and evolution of lesions in a 32-year-old man with multiple sclerosis. Two areas were enhanced with contrast, with one showing a mild mass effect and rim of enhancement. Serial brain scintigraphy using technetium-/sub 99m/ glucoheptonate, following the computed tomography, showed the appearance and regression of corresponding regions of increased uptake. Computed tomography one day prior to brain scintigraphy failed to demonstrate a region of increased accumulation of radiotracer. One week later, however, evidence of a corresponding unenhanced defect was noted on computed tomography. Clinical correlation is given additionally.

  13. Technetium labelled red blood cell scintigraphy in the diagnosis of intestinal haemorrhage.

    PubMed Central

    Harvey, M. H.; Neoptolemos, J. P.; Watkin, E. M.; Cosgriff, P.; Barrie, W. W.

    1985-01-01

    99m-Technetium labelled red blood cell scintigraphy was used in the investigation of 15 adult patients with suspected small or large bowel bleeding requiring at least five units of blood (mean 14.3 units) and one neonate with rectal bleeding. Scintigraphy was found to be an accurate method of detecting the site of haemorrhage and was superior to angiography. This technique may be of particular value in patients with profuse colonic haemorrhage when the view at colonoscopy is poor. Images Fig. 1 Fig. 2 Fig. 3 PMID:3872094

  14. Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

    PubMed Central

    Smanio, Paola Emanuela Poggio; Silva, Juliana Horie; Holtz, João Vitor; Ueda, Leandro; Abreu, Marilia; Marques, Carlindo; Machado, Leonardo

    2015-01-01

    Background Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined. Objective To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea) that underwent myocardial scintigraphy (MS), over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group. Methods This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05. Results Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5%) had non-fatal myocardial infarction and six individuals (0.7%) died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036) and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0.043). Conclusion The

  15. Sodium 18F-Fluoride Bone Scintigraphy in Deep Ocean Diver.

    PubMed

    Lim, Jin T E; Moncayo, Valeria M; Alazraki, Naomi

    2015-07-01

    Sodium ¹⁸F-fluoride (NaF) is a diagnostic marker for new bone formation in bone scintigraphy that was approved by US FDA in 1972 but discontinued in 1984. We report a case of a US naval officer who spent time living and working in an oceanic lab, 205 feet below the surface. Plain skeletal films of femurs 4 years later demonstrate bilateral bone infarcts. Corresponding sodium ¹⁸F-fluoride bone scintigraphy demonstrates low-normal to decreased tracer activity. This rectilinear scan image is of historical interest. Other bone scintigraphic radiotracers used in the past and present will be briefly discussed.

  16. Pulmonary evaluation of patients with osteosarcoma: roles of standard radiography, tomography, CT, scintigraphy, and tomoscintigraphy

    SciTech Connect

    Vanel, D.; Henry-Amar, M.; Lumbroso, J.; Lemalet, E.; Couanet, D.; Piekarski, J.D.; Masselot, J.; Boddaert, A.; Kalifa, C.; Le Chevalier, T.

    1984-09-01

    Sixty-one radiologic evaluations were performed on 32 patients with possible pulmonary metastases from osteosarcoma. CT scanning was performed 61 times; standard chest radiography, 58; tomography, 36; scintigraphy, 40; and tomoscintigraphy, 33. Using CT as a reference, the sensitivities of the other examinations were 57% (32% of total metastases) for standard radiography, 88% (48%) for tomography, 21% (5%) for scintigraphy, and 41% (8%) for tomoscintigraphy. Of the 193 metastases, 98 were subpleural and 95 were parenchymatous. The authors' current evaluation of patients with metastases from osteosarcoma includes chest radiography and CT; the other three examinations are performed only before surgery.

  17. Determination of the gastric emptying of solid dosage forms using gamma-scintigraphy: a problem of image timing and mathematical analysis.

    PubMed

    Podczeck, F; Course, N J; Newton, J M

    1999-04-01

    This work was designed to identify the maximum time interval of image acquisition by gamma-scintigraphy for monitoring the emptying of a dosage form such as a tablet. Appropriate statistical parameters to describe this process were sought, including a statistical procedure for group comparisons of such data. Gamma-scintigraphy was employed in seven healthy male volunteers, who swallowed a light and a dense tablet, each 12 mm in diameter, formulated to contain different isotopes to allow identification. Images were taken sequentially at 30-s intervals to provide images of each tablet in 1-min spacing until emptying of both tablets was reported. In selecting images, it was also possible to simulate image acquisition intervals of 2, 3, 5, 10, 15, 20 and 30 min. The values derived are discrete random variables. The maximum time interval between image acquisitions that permitted reliable results to be obtained was found to be 3 min for light and 2 min for dense tablets. Consideration of the emptying of a tablet as a Bernoulli random event provided a suitable statistical approach to the analysis of such data, giving a median and an interquartile range. While the commonly applied method, which is based on parametric procedures deriving arithmetic means and standard deviations, failed to detect a difference in the emptying times of the two types of tablets, the use of non-parametric statistics (Wilcoxon test) provided a clear distinction between them in this respect. The assessment of gastric emptying by gamma-scintigraphy studies can be improved by using short image intervals and application of appropriate statistical analysis.

  18. Thallium-201 scintigraphy in complete left bundle branch block.

    PubMed

    Hirzel, H O; Senn, M; Nuesch, K; Buettner, C; Pfeiffer, A; Hess, O M; Krayenbuehl, H P

    1984-03-01

    Nineteen symptomatic patients with left bundle branch block (LBBB) were examined by thallium-201 (TI-201) exercise scintigraphy and selective coronary arteriography. All elicited significant anteroseptal perfusion defects in the exercise scintigrams, but in only 4 was coronary artery disease (CAD) involving the left anterior descending coronary artery present. To further elucidate the effect of LBBB on septal TI-201 uptake in the absence of CAD, TI-201 scintigrams combined with regional myocardial blood flow measurements using radioactive microspheres were carried out in 7 dogs during right atrial and right ventricular pacing (LBBB in the ECG) at similar heart rates. During right atrial pacing, TI-201 uptake was homogeneous in the entire left ventricle, as were tissue flows. During right ventricular pacing, TI-201 activity was reduced to 69% of maximal TI-201 activity within the septum, whereas it averaged 90% in the lateral wall (p less than 0.05) in 6 dogs. Correspondingly, regional myocardial blood flow was lower within the septum as compared with that in the lateral wall, averaging 89 and 120 ml/min/100 g, respectively (p less than 0.005). In 1 dog, normal TI-201 distribution and tissue flows were found in both studies. Thus, symptomatic patients with LBBB may elicit abnormal TI-201 exercise scintigrams, suggesting anteroseptal ischemia despite normal coronary arteries. The electrical induction of LBBB in dogs results, in most instances, in a comparable reduction in septal TI-201 uptake associated with diminished septal blood flow. Therefore, exercise-induced septal perfusion defects in the presence of LBBB do not necessarily indicate CAD even in symptomatic patients, but may reflect functional ischemia due to asynchronous septal contraction. PMID:6702625

  19. Gated thallium scintigraphy in the assessment of coronary artery disease

    SciTech Connect

    Martin, W.; Tweddel, A.C.; McGhie, A.I.; McKillop, J.H.; Hutton, I.

    1984-01-01

    This study was aimed at assessing ECG gated images to provide both perfusion and ventricular function information. 18 patients with acute myocardial infarction were studied at rest, and 12 male volunteers and 55 male patients undergoing routine coronary angiography were studied following the injection of 2 mCi (80 MBq) of thallous chloride 30s prior to termination of a symptom limited maximal exercise. Listmode data gated to the ECG were obtained in 3 projections for 6 minutes using a mobile gamma camera with a high sensitivity collimator. Three independent observers, on separate occasions analysed firstly standard reconstructed thallium scintigrams and secondly cine display of the gated image for perfusion defects and regional wall motion (RWM) using a 4 point scoring system. In addition ejection fraction (EF) was calculated from the 45/sup 0/ LAO projection. The gated thallium EF ranged from 52-65% in the volunteers, from 24-65% in the angiography patients and from 13-61% in the acute infarcts, and correlated well against the gated blood pool (r=.84) and contrast angiography (r=.78). RWM assessed for 850 segments gave interobserver disagreement of 0.9% and when compared to gated blood pool scans, disagreement occurred in 2 of 77 segments (2.8%). In the detection of significant coronary disease static thallium images provided a sensitivity of 71% and overall predictive accuracy of 75%. If the perfusion and wall motion from the gated image were considered the sensitivity was 93% at a predictive accuracy of 90%. The authors conclude that multiple view gated thallium scintigraphy gives accurate information as to ventricular function and enhances the detection of perfusion defects.

  20. NEN - the role of somatostatin receptor scintigraphy in clinical setting.

    PubMed

    Opalińska, Marta; Hubalewska-Dydejczyk, Alicja; Sowa-Staszczak, Anna; Stefańska, Agnieszka

    2016-01-01

    Detection of neuroendocrine neoplasms (NENs) and monitoring of their response to therapy is still challenging due to huge heterogeneity of that group of tumors. Actually, NENs visualization is mainly based on molecular imaging while in the past it was relied on less effective structural imaging including CT and MRI. Molecular imaging techniques in combination with structural imaging (hybrid imaging), especially in patients with well-differentiated NENs, in addition to morphological provide the functional information about tumor which benefits in a more accurate patient management, including more sensitive visualization of primary tumors, more precise staging and better therapy follow-up. Overexpression of somatostatin receptors (SSTR) on NENs' cell membrane was a basis for development of somatostatin receptor scintigraphy (SRS) using single photon emission tomography SPECT, which is today a well-established standard in molecular imaging of NENs, and further imaging improvement in the field of positron emission tomography (PET). Use of hybrid imaging (SPECT/CT, PET/CT) increased sensitivity of examination, mainly resulting in better detection of small lesions. Generally, somatostatin receptor imaging with PET/CT is an emerging technique, although still with limited access, but due to several advantages over SSTR SPECT/CT, should be used if available. It is worth mentioning, that both SSTR PET/CT and SSTR SPECT/CT have some limitations, such as relatively low detection rate of benign insulinomas, poorly differentiated GEP-NETs and liver metastases. For that reason further improvement of NETs imaging is necessary. The most promising new tracers' families are based on SSTR antagonists, 64Cu-radiolabeled ligands and glucagon-like peptide-1 receptor (GLP-1R) imaging. Finally, in case of poor-differentiated neuroendocrine cancers 18F-FDG PET/CT may be beneficial in comparison with molecular imaging based on somatostatin receptor modalities. PMID:27479789

  1. Leg arteritis exploration by quantitative muscle scintigraphy with 201Tl

    SciTech Connect

    Robert, J.; Thouvenot, P.; Schmidt, C.; Escanye, J.M.; Schmitt, J.

    1984-10-01

    Detection and localization of peripheral arterial disease was evaluated by an intravenous injection of 201Tl at peak exercise in 18 subjects and at rest in 6 patients. Images of the skull (S), thighs (T), knees (K), calves (C) and feet (F) were obtained at rest or after exercise and stored in a computer. Intraleg (T/K, T/C, T/F), and left to right interleg (TL/TR,...) count ratios were calculated. In addition, all patients were submitted to routine functional tests (walk perimeter, serial local arterial blood pressure measurement, Strandness test, venous occlusion plethysmography). Correlations between functional tests and the intra and interleg ratios were calculated. After exercise, there is a medium correlation between the tissular blood flow under hyperemia at the calf level and the T/C and C/K ratios. At the calf level a good correlation is obtained for CL/CR and the flux under hyperemia (r = 0.81, P 0.001). A ratio between the counting rates of limb segments after exercise and those of skull was established. The ratios T/S and C/S compared with the systolic pressure index of the most affected limb after a Strandness test give a correlation of 0.72 (P 0.02) for the thigh and of 0.86 (P 0.001) for the calf. For hyperemic flux, the correlation are 0.58 (P 0.005) with T/S and 0.75 (P 0.001) with C/S. In order to find the best quantitative scintigraphic index of the arterial illness, we compared the different ratio values with the distance walked. For T/S we found a relationship very close to a linear one and for C/S a less significant exponential one. Thus, quantitative scintigraphy using 201Tl appears as an accurate method to measure local muscular perfusion deficit in the cases of lower limb arterial disease.

  2. Use of Marrow Scintigraphy to Confirm Compensatory Marrow Rather than Active Myeloma.

    PubMed

    Bartel, Twyla B; Yarbrough, Tracy L; De Blanche, Lorraine E

    2016-09-01

    We present the case of a 40-year-old male with multiple myeloma for whom bone marrow scintigraphy was utilized to help differentiate between active bony myelomatous disease versus treated lesions with compensatory marrow uptake. This case demonstrates technetium (Tc-99m) sulfur colloid imaging as an inexpensive technique to quickly distinguish between active focal bone disease and reactive marrow. PMID:27651743

  3. Nasal visualization on radioiodine whole-body scintigraphy due to benign abnormality.

    PubMed

    Jiang, Xue; Wang, Qiao; Huang, Rui

    2015-04-01

    Nasal iodine activity can be observed on 123Iodine (123I) or 131I whole-body scintigraphy (WBS) commonly as a normal variant caused by nasal or salivary secretion of the tracer. We encountered 2 patients whose increased accumulation of 131I activity was associated with underlying abnormalities. One patient had a nasal polyp, whereas the other had an abscess.

  4. Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary artery disease

    SciTech Connect

    Kotler, T.S.; Diamond, G.A. )

    1990-11-01

    The objective of this study is to determine the discriminant accuracy of exercise thallium-201 myocardial perfusion scintigraphy for the diagnosis and prognosis of patients with known or suspected coronary artery disease. This is a survey of the National Library of Medicine MEDLINE database. The key medical subject headings used were coronary disease, myocardial infarction, radionuclide imaging, and thallium. A total of 122 retrieved studies were considered relevant and were reviewed in depth. Only studies reporting both the sensitivity and specificity of thallium scintigraphy were analyzed. Discriminant accuracy for diagnosis and prognosis was summarized in terms of pooled sensitivity and specificity. Exercise thallium scintigraphy is useful in the noninvasive diagnosis of coronary artery disease, especially in patients with abnormal resting electrocardiograms, restricted exercise tolerance, and intermediate probability of having disease at the time of testing as well as of defining the prognosis of patients with known or suspected coronary artery disease, especially in those with previous myocardial infarction. Because of various shortcomings in the published record, however, the marginal discriminant accuracy and cost effectiveness of thallium scintigraphy compared with conventional clinical assessment and exercise electrocardiography remain controversial. 193 references.

  5. Gastric emptying scintigraphy results in children are affected by age, anthropometric factors, and study duration

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A standardized 4-hour adult-based gastric emptying scintigraphy (GES) protocol is increasingly being used in children to evaluate for gastroparesis. We sought to determine the effect of age, anthropometrics, and study duration on GES results using this protocol in children. Retrospective review of c...

  6. Use of Marrow Scintigraphy to Confirm Compensatory Marrow Rather than Active Myeloma

    PubMed Central

    Bartel, Twyla B.; Yarbrough, Tracy L.; De Blanche, Lorraine E.

    2016-01-01

    We present the case of a 40-year-old male with multiple myeloma for whom bone marrow scintigraphy was utilized to help differentiate between active bony myelomatous disease versus treated lesions with compensatory marrow uptake. This case demonstrates technetium (Tc-99m) sulfur colloid imaging as an inexpensive technique to quickly distinguish between active focal bone disease and reactive marrow. PMID:27651743

  7. Use of Marrow Scintigraphy to Confirm Compensatory Marrow Rather than Active Myeloma

    PubMed Central

    Bartel, Twyla B.; Yarbrough, Tracy L.; De Blanche, Lorraine E.

    2016-01-01

    We present the case of a 40-year-old male with multiple myeloma for whom bone marrow scintigraphy was utilized to help differentiate between active bony myelomatous disease versus treated lesions with compensatory marrow uptake. This case demonstrates technetium (Tc-99m) sulfur colloid imaging as an inexpensive technique to quickly distinguish between active focal bone disease and reactive marrow.

  8. Acute lymphocytic leukemia presented as back pain and revealed by bone scintigraphy.

    PubMed

    Liu, Bin; Gwal, Kriti; Servaes, Sabah; Zhuang, Hongming

    2013-08-01

    A previously healthy 8-year-old girl underwent MDP bone scintigraphy to evaluate possible spondylolysis due to worsening back pain. Unexpectedly, the bone scan images revealed intense activity in several thoracic and lumbar vertebrae, which was not consistent with spondylolysis. Further examinations proved that the patient had acute lymphocytic leukemia.

  9. Evaluation of Feline Renal Perfusion with Contrast-Enhanced Ultrasonography and Scintigraphy

    PubMed Central

    Vanderperren, Katrien; Bosmans, Tim; Dobbeleir, André; Duchateau, Luc; Hesta, Myriam; Lybaert, Lien; Peremans, Kathelijne; Vandermeulen, Eva; Saunders, Jimmy

    2016-01-01

    Contrast-enhanced ultrasound (CEUS) is an emerging technique to evaluate tissue perfusion. Promising results have been obtained in the evaluation of renal perfusion in health and disease, both in human and veterinary medicine. Renal scintigraphy using 99mTc-Mercaptoacetyltriglycine (MAG3) is another non-invasive technique that can be used to evaluate renal perfusion. However, no data are available on the ability of CEUS or 99mTc- MAG3 scintigraphy to detect small changes in renal perfusion in cats. Therefore, both techniques were applied in a normal feline population to evaluate detection possibilities of perfusion changes by angiotensin II (AT II). Contrast-enhanced ultrasound using a bolus injection of commercially available contrast agent and renal scintigraphy using 99mTc-MAG3 were performed in 11 healthy cats after infusion of 0,9% NaCl (control) and AT II. Angiotensin II induced changes were noticed on several CEUS parameters. Mean peak enhancement, wash-in perfusion index and wash-out rate for the entire kidney decreased significantly after AT II infusion. Moreover, a tendency towards a lower wash-in area-under-the curve was present. Renal scintigraphy could not detect perfusion changes induced by AT II. This study shows that CEUS is able to detect changes in feline renal perfusion induced by AT II infusion. PMID:27736928

  10. [Thermo- and scintigraphy with 67Ga citrate in the diagnosis of oro- and parapharyngeal tumors].

    PubMed

    Gabunov, R I; Kurbandurdyev, A G; Lenskaia, O P; Bogdasarov, Iu V

    1988-07-01

    The authors analyzed the results of thermographic and scintigraphic (using 67Ga-citrate produced in the USSR) investigations in 41 patients: 10 with tumors of the oral cavity, 12 with oropharyngeal tumors, and 19 with parapharyngeal tumors. Of the latter 10 had morphologically verified benign tumors, 5--mixed type tumors, and 4--malignant tumors (sarcoma in 2 patients, a thyroid cancer metastasis to the parapharyngeal lymph nodes in 1, malignant chemodectoma in 1). Thermography and scintigraphy positive results (the absence of hyperthermia and RP hyperfixation in a tumor) were obtained in 7 of 10 patients with benign parapharyngeal tumors. Thermography false-positive results were obtained in 3 patients, however 67Ga-citrate accumulation was undetectable in these patients' tumors making the diagnosis more accurate. Thermography and scintigraphy results were positive in all 22 patients with malignant oropharyngeal (the oral cavity and oropharynx) tumors. Thermography and scintigraphy positive results were also noted in all 5 patients with parapharyngeal mixed tumors which could be associated with raised tumor tissue biological activity. The data obtained suggested a possibility of the use of thermography and scintigraphy in the diagnosis of oro-and parapharyngeal tumors. PMID:3294558

  11. Bone and Gallium scintigraphy in primary malignant and benign bone tumors of the extremities

    SciTech Connect

    Sepahdari, S.; Martin, W.B.; Ryan, J.; Simon, M.; Kirchner, P.

    1985-05-01

    A six yer prospective evaluation of 129 patients suspected of having a primary bone tumor included Tc-99m MDP bone scintigraphy followed by Ga-67 imaging at 48-72 hours. Blood pool images were part of bone scintigraphy in nearly half of the patients. Extent and intensity of tracer uptake in tumor and adjacent bone and joints were recorded for each tracer by two observers blind to the diagnosis. Tissue samples obtained in every patient by biopsy or tumor excision after scintigraphy, revealed 72 malignant and 57 benign bone tumors. The bone scan was positive in 95% (69/72) of malignancies. The scintigraphic intensity of benign and malignant lesions was comparable with both Tc-99m MDP and Ga-67. On the other hand, bone scintigraphy showed 72% (52/72) of bone malignancies to have abnormal proximal and distal bone/joint uptake whereas the Ga-67 images revealed this in only 6% (4/65) of malignancies. Benign lesions manifested this enhanced contiguous bone/joint uptake on only 8% (5/55) of bone and 0% of Ga-67 scans. This study concludes positive bone, blood pool, or Ga-67 images have less specificity for malignancy than the presence of increased Tc-99m MDP deposition in a contiguous bone/joint, but negative scintigraphic results strongly favor a benign lesion. Ga-67 was more accurate than Tc-99m MDP in portraying intraosseous extent of malignant tumors; however, this is now preferably done with C.T.

  12. Evaluation of soft tissue injury by Tc-99m bone agent scintigraphy

    SciTech Connect

    Delpassand, E.S.; Dhekne, R.D.; Barron, B.J.; Moore, W.H. )

    1991-05-01

    Six patients with soft tissue injury secondary to different etiologic factors are presented. The degree and extent of tissue necrosis was precisely identified by scintigraphy. In two of these, radionuclide imaging helped to establish accurately the level of amputation that resulted in appropriate wound healing.

  13. Tc-99m macro aggregated albumin scintigraphy – indications other than pulmonary embolism: A pictorial essay

    PubMed Central

    Gandhi, Sunny J; Babu, Sanjay; Subramanyam, Padma; Shanmuga Sundaram, Palaniswamy

    2013-01-01

    Introduction: Tc-99m macro aggregated albumin (MAA) is synonymous for lung perfusion scintigraphy and is part of the study in the evaluation of pulmonary thromboembolism. We wanted to highlight the utilities of Tc-99m MAA other than pulmonary embolism as a pictorial assay. Materials and Methods: Patients referred for Tc-99m MAA scintigraphy under various indications were included in this pictorial essay. Commercially available TechneScan LyoMAA cold kit from Mallinckrodt Medical B.V., Holland was used. Acquisition protocols for different indications are described in this article. Different clinical indications (e.g., pulmonary artery stenosis, hepatopulmonary syndrome, FEV1 calculation in lung surgery planning, selective internal radiation therapy planning, venography for deep venous thrombosis, left to right cardiac shunts, etc.) where Tc-99m MAA scintigraphy was asked for; how it helped in different clinical scenarios and how it can be used clinically is explained with unique and interesting case examples and images. We also reviewed the literature to look for certain remote indications of MAA imaging for the sake of completion like – (shunt scintigraphy, peritoneopleural communication, etc.) Conclusion: Tc-99m MAA is a very useful radiopharmaceutical, which can be used for many other indications apart from the commonly used indication of lung perfusion scan in pulmonary embolism. It can provide useful clinical information in other indications, which we try to highlight in this article. PMID:24250023

  14. Early detection of restenosis after successful percutaneous transluminal coronary angioplasty by exercise-redistribution thallium scintigraphy

    SciTech Connect

    Wijns, W.; Serruys, P.W.; Reiber, J.H.; de Feyter, P.J.; van den Brand, M.; Simoons, M.L.; Hugenholtz, P.G.

    1985-02-01

    The value of exercise testing and thallium scintigraphy in predicting recurrence of angina pectoris and restenosis after a primary successful transluminal coronary angioplasty (PTCA) was prospectively evaluated. In 89 patients, a symptom-limited exercise electrocardiogram (ECG) and thallium scintigraphy were performed 4 weeks after they had undergone successful PTCA. Thereafter, the patients were followed for 6.4 +/- 2.5 months (mean +/- standard deviation) or until recurrence of angina. They all underwent a repeat coronary angiography at 6 months or earlier if symptoms recurred. PTCA was considered successful if the patients had no symptoms and if the stenosis was reduced to less than 50% of the luminal diameter. Restenosis was defined as an increase of the stenosis to more than 50% luminal diameter. The ability of the thallium scintigram (presence of a reversible defect) to predict recurrence of angina was 66%, vs 38% for the exercise ECG (ST-segment depression or angina at peak workload). Restenosis was predicted in 74% of patients by thallium scintigraphy, but only in 50% of patients by the exercise ECG. Thus, thallium scintigraphy was highly predictive but the exercise ECG was not (p less than 0.005). These results suggest that restenosis had occurred to some extent already at 4 weeks after the PTCA in most patients in whom it was going to occur.

  15. Myocardial perfusion scintigraphy and coronary disease risk factors in systemic lupus erythematosus

    PubMed Central

    Sella, E; Sato, E; Leite, W; Filho, J; Barbieri, A

    2003-01-01

    Objective: To evaluate the prevalence of myocardial perfusion abnormalities and the possible association between myocardial perfusion defects and traditional coronary artery disease (CAD) risk factors as well as systemic lupus erythematosus (SLE) related risk factors. Patients and methods: Female patients with SLE, disease duration >5 years, age 18–55 years, who had used steroids for at least one year were enrolled. Traditional CAD risk factors evaluated were arterial hypertension, diabetes mellitus, dyslipidaemia, postmenopausal status, smoking, obesity, and premature family CAD profile. Myocardial perfusion scintigraphy was evaluated by single photon emission computed tomography with technetium 99m-sestamibi at rest and after dipyridamole induced stress. Results: Eight two female patients with SLE without angina pectoris with mean (SD) age 37 (10) years, disease duration 127 (57) months, SLE Disease Activity Index (SLEDAI) score 6 (5), and SLICC/ACR-DI score 2 (2) were evaluated. Myocardial perfusion abnormalities were found in 23 patients (28%). The mean (SD) number of CAD risk factors was 2.2 (1.6). There was a significant positive correlation between age and number of CAD risk factors. Lower high density lipoprotein (HDL) cholesterol level showed a significant association with abnormal scintigraphy. Logistic regression analysis showed that lower HDL cholesterol level and diabetes mellitus were associated with myocardial perfusion abnormalities. Current vasculitis was also associated with abnormal scintigraphy. Conclusions: Lower HDL cholesterol level and diabetes mellitus have a significant influence on abnormal myocardial perfusion results found in asymptomatic patients with SLE. Current vasculitis was associated with abnormal myocardial scintigraphy. These data suggest that abnormal myocardial scintigraphy may be related to subclinical atherosclerosis. PMID:14583569

  16. Is thyroid scintigraphy necessary before I-131 therapy for hyperthyroidism. Concise Communication

    SciTech Connect

    Ripley, S.D.; Freitas, J.E.; Nagle, C.E.

    1984-06-01

    To assess the value of routine thyroid scintigraphy in the differential diagnosis of hyperthyroidism and as a guide to I-131 therapy, the authors prospectively examined 100 consecutive hyperthyroid patients referred for a 24-hr radioiodine uptake and I-131 therapy. The nuclear medicine physician recorded his preimaging diagnostic impression and therapeutic plan for each patient. After the (/sup 99m/Tc) pertechnetate image, the patient was reassessed to determine whether the image induced any change in the diagnosis or therapeutic plan. Seventy-nine of 80 patients with diffuse goiter to palpation, had scintigrams demonstrating no discrete focal defects and were diagnosed as Graves' disease; thus the scintigram did not contribute useful information. In 17 of 20 patients with uninodular or multinodular goiters, the image was necessary to clarify the final diagnosis and therapeutic plan. Thus, selective use of thyroid scintigraphy should decrease the number of scintigrams performed before I-131 therapy for hyperthyroidism, without compromising diagnostic accuracy or therapeutic success.

  17. Detection of bladder hemangioma in a child by blood-pool scintigraphy.

    PubMed

    Ishikawa, Ken; Saitoh, Masahiko; Chida, Shoichi

    2003-06-01

    Bladder hemangioma is a rare cause of gross hematuria. A 5-year-old boy was investigated for recurrent episodes of asymptomatic gross hematuria, but no abnormalities were found. Blood-pool scintigraphy using (99m)technetium-human serum albumin combined with diethylene triamine penta-acetic acid (DTPA) revealed an area of increased activity in the right side of the bladder, which was confirmed by cystoscopy as a bladder hemangioma. Endoscopic laser therapy was used to remove two lesions successfully that were diagnosed histologically as cavernous hemangioma. The patient had no further episodes of hematuria in the 2-year period after this treatment. This case study indicates blood-pool scintigraphy may be a useful technique for detecting bladder hemangiomas.

  18. [Usefulness of top-hat transform processing in whole body bone scintigraphy].

    PubMed

    Kita, Akinobu; Sugimoto, Katsuya; Tsuchida, Tatsurou; Kishimoto, Takahiro; Toi, Akiko; Shimada, Masato; Adachi, Toshiki

    2013-01-01

    To assess the usefulness of top-hat transform processing in whole body bone scintigraphy, five radiological technicians interpreted both original and top-hat processed images to determine the improvement of lesion detectability and interpretation time. For the evaluation of detectability, receiver operating characteristic (ROC) analysis was performed. The area under the curve (AUC) calculated from the ROC curve was improved in all observers (from 0.786 to 0.864 in average), although no significant difference was observed. However, the interpretation time was improved significantly (from 24.5 to 16.2 s in average). Top-hat transform processing in whole body bone scintigraphy is thought to be useful for the improvement of lesion detectability and interpretation time.

  19. Comparison between scintigraphy with polyclonal immunoglobulin (99Tcm-HIG) and physical examination in polyarthritic disease.

    PubMed

    Vesterskiöld, L; Schnell, P O; Jacobsson, H

    1996-01-01

    99Tcm-labelled polyclonal human immunoglobulin 99Tcm-HIG scintigraphy has been suggested as a technique to detect joint inflammation in arthritic disorders. Scintigraphy was performed in fifteen patients with active polyarthritis. All joints except the hips were scored clinically for swelling and pain by a rheumatologist and scintigraphic images were obtained at 30 minutes and four hours after injection of 350MBq 99Tcm-HIG. The images were assessed by a nuclear medicine physician according to a four grade scale. The images were easy to assess. There was a highly significant correlation between swelling and scan score, but no correlation between pain and scan score. The mechanism for the accumulation of activity to inflamed synovial tissue remains unclear. The mean values of the scan score however increased significantly between 30 minutes and 4 hours, indicating an active binding mechanism. The method has a potential as an objective tool in monitoring rheumatic diseases.

  20. Atypical appearance of an hepatic hemangioma with technetium-99m red blood cell scintigraphy

    SciTech Connect

    Larcos, G.; Farlow, D.C.; Gruenewald, S.M.; Antico, V.F. )

    1989-11-01

    Three-phase 99mTc red blood cell scintigraphy is an established technique for distinguishing hemangiomas from other focal liver lesions. The most widely recognized feature is the perfusion to blood-pool mismatch characterized by decreased or normal arterial perfusion, with lesion activity which progressively increases over 1-2 hr. Although increased arterial vascularity of hemangiomas has been described, such cases either involved small portions of the lesion only or occurred in lesions not conclusively proven to be hemangiomas. We report a case of an angiography proven hemangioma with increased arterial vascularity involving a significant portion of the lesion as well as intense early blood-pool activity similar to that seen on delayed imaging. This case emphasizes the diverse appearance of hepatic hemangiomas using 99mTc blood cell scintigraphy.

  1. (123)I-meta-iodobenzylguanidine (MIBG) cardiac scintigraphy in α-synucleinopathies.

    PubMed

    Orimo, Satoshi; Yogo, Makiko; Nakamura, Tomohiko; Suzuki, Masahiko; Watanabe, Hirohisa

    2016-09-01

    Cardiac meta-iodobenzylguanidine (MIBG) uptake on (123)I-MIBG cardiac scintigraphy is reduced in patients with Lewy body disease such as Parkinson's disease (PD), dementia with Lewy bodies (DLB), and pure autonomic failure, and has been reported to be useful for differentiating PD from other parkinsonian syndromes, as well as DLB from Alzheimer disease (AD). Postmortem studies have shown that the number of tyrosine hydroxylase (TH)-immunoreactive nerve fibers of the heart was decreased in pathologically-confirmed Lewy body disease, supporting the findings of reduced cardiac MIBG uptake in Lewy body diseases. Now, reduced cardiac MIBG uptake can be a potential biomarker for the presence of Lewy bodies in the nervous system. (123)I-MIBG cardiac scintigraphy can allow us to determine the presence of Lewy bodies. PMID:26835846

  2. Right ventricular visualization by thallium 201 myocardial scintigraphy in chronic obstructive pulmonary disease

    SciTech Connect

    Shuck, J.W.; Walder, J.; Oetgen, W.J.; Thomas, H.M.

    1985-12-01

    The right ventricle is not normally displayed by studies with thallium 201 in patients at rest, but it can be shown by thallium 201 myocardial scintigraphy with pressure or volume overload of the right ventricle and with right ventricular hypertrophy. We sought to determine the frequency of right ventricular demonstration by thallium 201 in 20 patients at rest, who had chronic obstructive pulmonary disease of varying severity studied at baseline. The ventricle was viewed in 11 of 20 patients (55%); these patients had significantly lower values for forced expiratory volume in one second (FEV1) and PO/sub 2/. Eight patients had catheterization of the right side of the heart; mean pulmonary artery pressure and pulmonary vascular resistance were significantly higher in patients with right ventricular visualization. We conclude that thallium 201 scintigraphy frequently shows the right ventricle in patients with chronic obstructive pulmonary disease and that such visualization correlates with the severity of the ventilatory defect and with pulmonary hypertension.

  3. [Dynamic renal scintigraphy in assessing kidney function in patients with nonspecific colitis].

    PubMed

    Topchiĭ, T V; Moskalenko, N I; Man'kovskaia, O L; Morozova, N L

    1990-11-01

    Research into the morphofunctional status of the kidneys was conducted in patients with nonspecific colitis-NC (nonspecific ulcerative colitis-NUC and Crohn's disease). Urodynamics and partial function of the kidneys were assessed in 74 NC patients (51 NUC patients and 23 patients with Crohn's disease) on the basis of the findings of two-nuclide dynamic renal scintigraphy with 131I-hippuran and 99mTc-pentatech. Despite the absence of clinical symptomatology of urinary tract lesions, marked dysfunction of the kidneys of various degree (depending on severity of disease, tactics of its treatment and a type of surgical intervention) was noted in NC patients. In most cases changes of renal function were without visible clinical manifestations and were frequently undetectable by routine laboratory tests. Therefore dynamic renal scintigraphy was found necessary for investigation on NC patients. PMID:2259285

  4. Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia

    NASA Astrophysics Data System (ADS)

    Krivonogov, Nikolay G.; Efimova, Nataliya Y.; Zavadovsky, Konstantin W.; Lishmanov, Yuri B.

    2016-08-01

    Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

  5. Myocardial contusion in patients with blunt chest trauma as evaluated by thallium 201 myocardial scintigraphy

    SciTech Connect

    Bodin, L.; Rouby, J.J.; Viars, P.

    1988-07-01

    Fifty five patients suffering from blunt chest trauma were studied to assess the diagnosis of myocardial contusion using thallium 201 myocardial scintigraphy. Thirty-eight patients had consistent scintigraphic defects and were considered to have a myocardial contusion. All patients with scintigraphic defects had paroxysmal arrhythmias and/or ECG abnormalities. Of 38 patients, 32 had localized ST-T segment abnormalities; 29, ST-T segment abnormalities suggesting involvement of the same cardiac area as scintigraphic defects; 21, echocardiographic abnormalities. Sixteen patients had segmental hypokinesia involving the same cardiac area as the scintigraphic defects. Fifteen patients had clinical signs suggestive of myocardial contusion and scintigraphic defects. Almost 70 percent of patients with blunt chest trauma had scintigraphic defects related to areas of myocardial contusion. When thallium 201 myocardial scintigraphy directly showed myocardial lesion, two-dimensional echocardiography and standard ECG detected related functional consequences of cardiac trauma.

  6. Osteomyelitis and infarction in sickle cell hemoglobinopathies: differentiation by combined technetium and gallium scintigraphy

    SciTech Connect

    Amundsen, T.R.; Siegel, M.J.; Siegel, B.A.

    1984-12-01

    Clinical records and scintigrams were reviewed of 18 patients with sickle cell hemoglobinophaties who had undergone combined technetium and gallium scintigraphy during 22 separate episodes of suspected osseous infection. The combined scintigrams were correctly interpreted as indicating osteomyelitis in four studies. Of 18 studies in patients with infarction, the combined scintigrams were correctly interpreted in 16 and showed either no local accumulation of Ga-67 or less accumulation than that of Tc-99m MDP at symptomatic sites. In the other two studies, the scintigrams were falsely interpreted as indicating osteomyelitis and showed congruent, increased accumulation of both Tc-99, MDP and Ga-67. This pattern must be considered indeterminate. Overall, the results indicate that the combination of technetium and gallium scintigraphy is an effective means to distinguish osteomyelitis from infarction in patients with sickle cell hemoglobinopathies.

  7. Sensitivity of scintigraphy for detection of pulmonary capillary albumin leak in canine oleic acid ARDS

    SciTech Connect

    Sugerman, H.J.; Strash, A.M.; Hirsch, J.I.; Glauser, F.L.; Shirazi, K.K.; Sharp, D.E.; Greenfield, L.J.

    1981-07-01

    Computerized gamma scintigraphy was shown in this study to be a sensitive technique for the detection and kinetic analysis of a pulmonary capillary protein leak. A rising lung:heart radioactivity of slope of injury was found at each dose of intravenous oleic acid in dogs from 0.01 to 0.20 ml/kg (p less than 0.01). This slope of injury was proportional to the dose of oleic acid (r . +0.97; p less than 0.004) and was more sensitive than changes in arterial oxygen tension, standard chest radiography, bloodless wet:dry lung weight, or alveolar epithelial membrane permeability. Only standard light microscopy and right lymphatic duct flow were able to document the leakage of protein detected by gamma scintigraphy at 0.01 ml/kg oleic acid.

  8. Osteoid osteoma simulating osteomyelitis: differentiation with Tc-99m HIG scintigraphy.

    PubMed

    Türkölmez, Seyda; Cayir, Derya; Korkmaz, Meliha

    2006-04-01

    We present a case of osteoid osteoma with a history of mild pain, local swelling and point tenderness on the right lower leg. The diagnosis of osteoid osteoma was difficult due to the atypical clinical history and misleading radiological and bone scan findings. When it is difficult to differentiate an osteoid osteoma from osteomyelitis using CT, MRI or bone scan; HIG scintigraphy can be used to exclude an infection.

  9. Biliary scintigraphy: comparison with other modern techniques for evaluation of biliary tract disease

    SciTech Connect

    Serafini, A.N.

    1982-10-01

    The recent availability of iminodiacetic acid analogues labeled with technetium Tc 99m provides a safe and accurate noninvasive test of biliary function. Biliary scintigraphy is a simple and rapid method of detecting acute cholecystitis in particular but also of distinguishing acute biliary pancreatitis from nonbiliary pancreatitis, of evaluating the patency of the common duct in early obstruction, of assessing possible postcholecystectomy syndrome, of evaluating the patency of a biliary enteric bypass, and of detecting postoperative biliary leaks.

  10. Scintigraphic Evaluation of the Stump Region After Extremity Amputation and the Effect of Scintigraphy on Treatment

    PubMed Central

    Sadic, Murat; Atilgan, Hasan Ikbal; Baskin, Aylin; Cinar, Alev; Koca, Gokhan; Demirel, Koray; Comak, Aylin; Ozyurt, Sinem; Yildirim, Sule; Korkmaz, Meliha

    2016-01-01

    Background We evaluated the stump region with scintigraphy and compared the correlation of treatment modalities and scintigraphic results. Methods Sixty-eight cases with extremity amputation were included in the study. Amputation applied cases underwent four-phase Tc-99m hydroxymethylene diphosphonate scintigraphy. Groups were performed according to the scanning time after amputation and amputation regions. After scintigraphic evaluation, results were recorded into five groups: osteomyelitis, soft-tissue infection, reactive changes secondary to surgery, chronic osteomyelitis, and normal. Post-surgical treatment modalities of the patients were determined and compared with scintigraphic results. Results In the scintigraphic evaluation of stump regions of the 68 amputated cases, 34 patients had acute osteomyelitis, one had chronic osteomyelitis, 16 had soft-tissue infection, and eight had changes secondary to the surgery. Nine of 68 cases had normal scintigraphic features. In the scintigraphic evaluation, 43 patients took antibiotic treatment and 16 had surgery. There was a strong correlation between scintigraphic results and treatment approach (P < 0.0001, r = 0.803) by means of preferred therapy and effectiveness of the therapy according to the scintigraphic results. Scintigraphy need increases with age after amputation and a negative correlation between patient age and scintigraphic need was found (P < 0.02, r = -0.339). There was no pathology in the follow-up in the cases that were scintigraphically normal. Conclusion Bone scintigraphy is a cost-effective, non-invasive, and efficient method that directs treatment in the evaluation of the stump region after amputation. PMID:26858796

  11. Potential diagnostic role of renal scintigraphy in the management of patients with high anorectal malformation.

    PubMed

    Harisankar, Chidambaram Natrajan Balasubramanian; Mittal, Bhagwant Rai; Bhattacharya, Anish; Sunil, Hejjaji Venkataramarao; Singh, Baljinder; Rao, Katragadda Lakshmi Narasimha

    2009-01-01

    Urological problems are the leading associated anomalies in patients with anorectal malformation (ARM). In this study, we evaluated the role of scintigraphy in managing patients with high ARM. The records of infants with urologic anomalies on abdominal ultrasound and referred for scintigraphic evaluation were retrospectively analyzed. Diuretic renography in these patients was performed using (99m)Tc-diethyl triamine penta-acetic acid ((99m)Tc-DTPA) or (99m)Tc-ethylene cysteine ((99m)Tc-EC) while cortical scintigraphy was performed with (99m)Tc-dimercaptosuccinate (DMSA). Whenever available, EC was preferred in children of age less than 1 year. Forty patients (38 males, 2 females) were analyzed. The mean age of the population was 25 months (range 15 days-21 years). Eighteen of the forty patients were less than 3 months of age. Twenty seven of the patients were less than one year of age. The most common renal anomaly was unilaterally non-visualized kidney affecting 15 out of the 40 patients. The visualised kidney was abnormal in 8/15 patients. Hydronephrotic changes were noticed in 12 of 40 patients of whom 2 had pelvi ureteric junction obstruction that was confirmed and treated surgically. Horse shoe kidney was present in 1 patient while 2 had an ectopic kidney. Scarring/ pyelonephritic changes were found in 7/40 patients. Five patients had already progressed to chronic renal failure at the time of scintigraphy. Only 8 patients of the 40 had bilaterally normal kidneys. In conclusion, this study suggests that urologic abnormalities often found in infants with high ARM may remain clinically silent and eventually lead to chronic renal failure. Proper evaluation by diuretic renography and cortical scintigraphy can lead to early identification of potentially treatable conditions hence reducing the likelihood of developing severe renal damage.

  12. Cholelithiasis demonstrated on hepatobiliary scintigraphy as a photopenic defect within the inferior portion of the liver

    SciTech Connect

    Moreno, A.J.; Yedinak, M.A.; Turnbull, G.L.; Spicer, M.J.; Brown, T.J.

    1984-11-01

    A 47-year-old man presented with the clinical findings of acute cholecystitis. During hepatobiliary scintigraphy using Tc-99m DISIDA, a persistent photopenic defect was noted within the inferior portion of the liver in the region of the gallbladder. Abdominal ultrasonography revealed large gallstones with acoustic shadowing within a normal-sized gallbladder. Eleven large gallstones were found within a normal-sized intrahepatic gallbladder at surgery.

  13. Dual ectopic thyroid gland: sonography and scintigraphy of lingual and sublingual thyroid.

    PubMed

    Marković, Vinko; Glavina, Gordana; Eterović, Davor; Punda, Ante; Brdar, Dubravka

    2014-06-01

    Dual ectopic lingual and sublingual thyroid gland is an extraordinarily rare condition. We present 1 patient with subclinical hypothyroidism. The clinical examination revealed that the thyroid gland was not palpable in its usual cervical location, whereas ultrasonography confirmed an empty thyroid bed without any ectopic thyroid tissue in the rest of the neck. The final diagnosis of dual ectopic lingual and sublingual thyroid was established by ultrasound examination through the mouth floor and confirmed by scintigraphy and CT thereafter.

  14. Gallium-67 scintigraphy as an aid in the detection of spinal epidural abscess.

    PubMed

    Klein, M; Ahn, C S; Drum, D E; Tow, D E

    1994-09-01

    Gadolinium-enhanced MRI is considered the study of choice for diagnosing spinal epidural abscess (SEA). Most of such cases, however, are not suspected initially, and thus do not benefit from the procedure. A case of SEA is described in which positive Ga-67 scintigraphy shortly before onset of lower extremity dysfunction was instrumental in obtaining an emergency gadolinium-enhanced MRI and establishing the diagnosis.

  15. Radionuclides in detecting active granuloma formation. Gallium-67 scintigraphy and histopathology with autoradiographic findings

    SciTech Connect

    van Maarsseveen, A.; Alberts, C.; van der Schoot, J.; van Royen, E.; Hens, C.; Mullink, H.; de Groot, J.

    1986-01-01

    Granuloma formation studies were performed on lungs of guinea pigs sensitized with FCA over 2 to 17 months. Prolonged time of sensitization revealed more granulomatous pulmonary tissue. An intravenous booster of FCA in the animals that had been sensitized for 3 months yielded enhanced granuloma formation within 5 days. The histopathology of these lungs was comparable with that seen in lungs of animals after 17 months of sensitization without booster. Enhanced local proliferation of macrophages, measured by (/sup 3/H)thymidine incorporation and autoradiography, was seen in the lungs of the animals that had received boosters. Moreover, /sup 67/Ga scintigraphy was strongly positive in these animals. Scintigraphy of cell suspensions of pulmonary tissue from these animals showed that /sup 67/Ga was predominantly taken up (quantitatively as well as qualitatively) by the alveolar macrophages. Cell suspensions of sarcoidosis patients, prepared in the same way, showed only a low level of /sup 67/Ga uptake, one comparable to that of the pulmonary cell suspensions of the sensitized animals that had not received boosters. It is suggested that a negative scintigraphy in patients with chronic pulmonary granulomatous disorders could be (partly) explained by the absence of activated macrophages.

  16. Transformation of a Nonfunctional Paraganglioma With I-123 MIBG Scintigraphy Correlation

    PubMed Central

    Davalos, Eric A; Cho, John; Dave, Hiren; Shen, Hong; Barank, David; Shim, John

    2016-01-01

    Abstract A 35-year-old woman presenting with abdominal pain was found to have mildly elevated catecholamine levels and a retroperitoneal mass. The patient underwent a negative I-123 MIBG scintigraphy scan and a nondiagnostic fine needle aspiration. Eleven years later the patient presented with a hypertensive emergency and markedly elevated catecholamine levels. A subsequent I-123 MIBG scintigraphy scan showed intense uptake corresponding to the previously seen retroperitoneal mass. The patient underwent surgical resection and pathology confirmed the presence of a paraganglioma A paraganglioma is an extra-adrenal pheochromocytoma that contains chromaffin cells and is thus capable of producing catecholamines. I-123 metaiodobenzylguanidine (MIBG) scintigraphy has become the imaging study of choice for paragangliomas and has a sensitivity of ∼77% to 100% in detecting functional paragangliomas.1 This case demonstrates scintigraphic correlation of the functional transformation of a nonfunctional paraganglioma in a time span of ∼10 years. Although there are previously published case reports of scintigraphic positive, nonfunctional paragangliomas2,3 and scintigraphic negative chromaffin cell tumors,4,5 there has been no prior documented case of scintigraphic transformation on MIBG. PMID:26765464

  17. Diagnostic impact of thallium scintigraphy and cardiac fluoroscopy when the exercise ECG is strongly positive

    SciTech Connect

    Chaitman, B.R.; Brevers, G.; Dupras, G.; Lesperance, J.; Bourassa, M.G.

    1984-08-01

    We studied 83 men, who had a chest pain syndrome, no prior history of myocardial infarction, and exercise-induced horizontal or downsloping ST segment depression greater than or equal to 0.2 mV. The 38 patients unable to complete Bruce stage II had a significant increased risk of coronary (0.97 vs 0.71) and multivessel (0.88 vs 0.61) disease (p less than 0.01) compared to the pretest risk; data obtained from exercise-reperfusion thallium scintigraphy and cardiac fluoroscopy did not alter the risk of coronary or multivessel disease. The 45 patients who had ST depression greater than or equal to 0.2 mV and a peak work capacity greater than or equal to Bruce stage III did not have a significant increased risk of coronary (0.76) or multivessel disease (0.44). When both exercise-reperfusion thallium scintigraphy and cardiac fluoroscopy were abnormal in this latter patient subgroup, the post-test risk of multivessel disease was increased from 0.44 to 0.82 (p less than 0.03); when both tests were normal, none of the patients had multivessel disease (p less than 0.03) and only 0.18 had coronary artery disease. Thus, cardiac fluoroscopy and exercise thallium scintigraphy increase the diagnostic content of the strongly positive exercise ECG, particularly in men who have a peak work capacity greater than or equal to Bruce stage III.

  18. Is radiolabelled sucralphate scintigraphy of any use in the diagnosis of inflammatory bowel disease?

    PubMed

    Crama-Bohbouth, G E; Arndt, J W; Peña, A S; Blok, D; Verspaget, H W; Weterman, I T; Lamers, C B; Pauwels, E K

    1988-08-01

    Previous optimistic reports led us to undertake a study to determine the value of 99Tcm-sucralphate scintigraphy in the assessment of localization and extent of active inflammatory bowel disease. Eight patients were studied; four had Crohn's disease (three small bowel and one colon localization) and four patients had ulcerative colitis. The results obtained by scintigraphy were compared with those obtained by diagnostic radiology and/or endoscopy. In five patients indium-111 granulocyte scintigraphy was also performed. 99Tcm-sucralphate scans showed total discrepancy with standard investigations in four patients and partial discrepancy in the other four. Furthermore, it was difficult from the images to decide whether the radiolabelled sucralphate indicated true inflammation or normal distribution of the radiopharmaceutical. Patient acceptability was very low due to frequent scanning times and the recommended purgation which was not well tolerated and is contraindicated in severely ill patients. We conclude that this technique is not a good screening test for diagnosing inflammatory bowel disease and we have, therefore, discontinued the study.

  19. Atrial pacing and thallium 201 scintigraphy: combined use for diagnosis of coronary artery disease

    SciTech Connect

    Stratmann, H.G.; Mark, A.L.; Walter, K.E.; Fletcher, J.W.; Williams, G.A.

    1987-11-01

    To evaluate the presence of coronary artery disease (CAD), atrial pacing and thallium 201 scintigraphy were performed in 36 patients with stable angina pectoris who were unable to perform an adequate exercise stress test. All patients underwent cardiac catheterization. Nine patients had previously undergone coronary artery bypass surgery. Significant CAD (one or more lesions greater than or equal to 50%) was present in 33 patients. Atrial pacing produced ischemic ST segment depression (greater than or equal to 1 mm) in 18 (55%) patients with CAD, and angina in 20 patients (61%). As the number of vessels with CAD increased, there was no significant change in the sensitivities of pacing-induced angina or ST segment depression for detecting CAD. In the 3 patients without CAD, ST segment depression occurred in 1 patient and angina in none. Thallium 201 scintigraphy demonstrated perfusion defects in 27 (82%) patients with CAD, with fixed defects seen in 13 studies (39%) and reversible defects in 15 (45%). In the 3 patients without CAD, no perfusion defects were seen. The thallium 201 scan successfully predicted the presence of CAD in patients with single-vessel disease but usually underestimated the number of vessels involved in patients with multivessel disease. Combined sensitivity of pacing-induced ST segment depression and an abnormal thallium 201 scan finding for detecting CAD was 91%. The authors conclude that combined atrial pacing and thallium 201 scintigraphy is a useful test for detecting CAD in patients unable to perform an adequate exercise stress test.

  20. Myocardial scintigraphy with 201thallium in pediatric cardiology: A review of 52 cases

    SciTech Connect

    Bjoerkhem, G.E.; Evander, E.; White, T.; Lundstroem, N.R. )

    1990-01-01

    We report our experience of myocardial scintigraphy with 201thallium (201Tl) in 52 children, aged 4 days to 18 years, in which 80 studies were made primarily to demonstrate or exclude impaired myocardial perfusion. For analysis, the patients were divided into the following eight groups: group I, coronary artery malformations (five patients); group II, Kawasaki's syndrome (six patients); group III, arterial switch operation (seven patients); group IV, dilated cardiomyopathy (18 patients); group V, hypertrophic cardiomyopathy (four patients); group VI, myocardial dysfunction after surgery for congenital heart disease (five patients); group VII, pulmonary atresia (three patients); and group VIII, miscellaneous (four patients). Myocardial scintigraphy was performed with a planar or tomographic technique at rest or after exercise (four patients). Isotope-uptake defects, indicating impaired myocardial perfusion, were present in 14 patients, including small infants. Defects were seen in all groups except those with hypertrophic cardiomyopathy and pulmonary atresia. The absence of such defects in several of the patients with Kawasaki's syndrome was particularly valuable as it made coronary angiography unnecessary. In the other groups of patients myocardial scintigraphy was a valuable adjunct to other investigations.

  1. Arm exercise testing with myocardial scintigraphy in asymptomatic patients with peripheral vascular disease

    SciTech Connect

    Goodman, S.; Rubler, S.; Bryk, H.; Sklar, B.; Glasser, L.

    1989-04-01

    Arm exercise with myocardial scintigraphy and oxygen consumption determinations was performed by 33 men with peripheral vascular disease, 40 to 74 years of age (group 2). None had evidence of coronary disease. Nineteen age-matched male control subjects (group 1) were also tested to determine the normal endurance and oxygen consumption during arm exercise in their age group and to compare the results with those obtained during a standard treadmill performance. The maximal heart rate, systolic blood pressure, pressure rate product, and oxygen consumption were all significantly lower for arm than for leg exercise. However, there was good correlation between all these parameters for both types of exertion. The maximal heart rate, work load and oxygen consumption were greater for group 1 subjects than in patients with peripheral vascular disease despite similar activity status. None of the group 1 subjects had abnormal arm exercise ECGs, while six members of group 2 had ST segment changes. Thallium-201 scintigraphy performed in the latter group demonstrated perfusion defects in 25 patients. After nine to 29 months of follow-up, three patients who had abnormal tests developed angina and one of them required coronary bypass surgery. Arm exercise with myocardial scintigraphy may be an effective method of detecting occult ischemia in patients with peripheral vascular disease. Those with good exercise tolerance and no electrocardiographic changes or /sup 201/T1 defects are probably at lower risk for the development of cardiac complications, while those who develop abnormalities at low exercise levels may be candidates for invasive studies.

  2. Importance of Heparin Provocation and SPECT/CT in Detecting Obscure Gastrointestinal Bleeding on 99mTc-RBC Scintigraphy

    PubMed Central

    Haghighatafshar, Mahdi; Gheisari, Farshid; Ghaedian, Tahereh

    2015-01-01

    Abstract We presented a pediatric case with a history of intermittent melena for 3 years because of angiodyplasia of small intestine. The results of frequent upper gastrointestinal endoscopies and colonoscopies as well as both 99mTc-red blood cell (RBC) and Meckel's scintigraphies for several times were negative in detection of bleeding site. However, 99mTc-RBC scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) after heparin augmentation detected a site of bleeding in the distal ileum which later was confirmed during surgery with final diagnosis of angiodysplasia. It could be stated that heparin provocation of bleeding before 99mTc-RBC scintigraphy accompanied by fused SPECT/CT images should be kept in mind for management of intestinal bleeding especially in difficult cases. PMID:26313771

  3. Role of 123I-Iobenguane Myocardial Scintigraphy in Predicting Short-term Left Ventricular Functional Recovery: An Interesting Image

    PubMed Central

    Feola, Mauro; Chauvie, Stephane; Biggi, Alberto; Testa, Marzia

    2015-01-01

    123I-iobenguane myocardial scintigraphy (MIBG) has been shown to be a predictor of sudden cardiac mortality in patients with heart failure. One patient with recent anterior myocardial infarction (MI) treated with coronary angioplasty and having left ventricular ejection fraction (LVEF) of 30% underwent early MIBG myocardial scintigraphy/tetrofosmin single-photon emission computed tomography (SPECT) in order to help evaluate his eligibility for implantable cardioverter defibrillator (ICD). The late heart/mediastinum (H/M) ratio was calculated to be 1.32% and the washout rate was 1%. At 40-day follow-up after angioplasty, LVEF proved to be 32%, New York Heart Association (NYHA) class was still II–III, and an ICD was placed in order to reduce mortality from ventricular arrhythmias. MIBG myocardial scintigraphy might be a promising method for evaluating left ventricular recovery in post-MI patients. PMID:26664773

  4. Conversion to Paradoxical Finding on Technetium-99m-labeled RBC Scintigraphy after Treatment for Secondary Raynaud's Phenomenon.

    PubMed

    Chong, Ari; Ha, Jung-Min; Song, Ho-Chun; Kim, Jahae; Choi, Soo Jin Na

    2013-12-01

    An 18-year-old woman reported that after exposure to cold temperatures her fingers appeared blue and her hands and feet felt cold. Secondary Raynaud's phenomenon (RP) associated with peripheral vascular disease was suspected. Technetium (Tc)-99m-labeled RBC hand scintigraphy after cold change showed decreased blood pool activity in her fingers. The patient's symptoms improved after she received sarpogrelate HCL (200 mg/day) and nifedifine (40 mg/day). Follow-up scintigraphy performed 7 months after the patient started treatment showed paradoxically increased blood pool activity in her fingers after cold challenge. To the best of our knowledge, this is the first case report of a patient with secondary RP showing paradoxical change on scintigraphy after she received medication that improved her symptoms.

  5. Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography

    SciTech Connect

    Gibson, R.S.; Watson, D.D.; Craddock, G.B.; Crampton, R.S.; Kaiser, D.L.; Denny, M.J.; Beller, G.A.

    1983-08-01

    The ability of predischarge quantitative exercise thallium-201 (/sup 201/T1) scintigraphy to predict future cardiac events was evaluated prospectively in 140 consecutive patients with uncomplicated acute myocardial infarction; the results were compared with those of submaximal exercise treadmill testing and coronary angiography. High risk was assigned if scintigraphy detected /sup 201/T1 defects in more than one discrete vascular region, redistribution, or increased lung uptake, if exercise testing caused ST segment depression greater than or equal to 1 mm or angina or if angiography revealed multivessel disease. Low risk was designated if scintigraphy detected a single-region defect, no redistribution, or no increase in lung uptake, if exercise testing caused no ST segment depression or angina, or if angiography revealed single-vessel disease or no disease. By 15 +/- 12 months, 50 patients had experienced a cardiac event; seven died (five suddenly), nine suffered recurrent myocardial infarction, and 34 developed severe class III or IV angina pectoris. Compared with that of patients at low risk, the cumulative probability of a cardiac event was greater in high-risk patients identified by scintigraphy, exercise testing, or angiography. Scintigraphy predicted low-risk status better than exercise testing or angiography. Each predicted mortality with equal accuracy. These results indicate that (1) submaximal exercise /sup 201/T1 scintigraphy can distinguish high- and low-risk groups after uncomplicated acute myocardial infarction before hospital discharge; (2) /sup 201/T1 defects in more than one discrete vascular region, presence of delayed redistribution, or increased lung thallium uptake are more sensitive predictors of subsequent cardiac events than ST segment depression, angina, or extent of angiographic disease; and (3) low-risk patients are best identified by a single-region /sup 201/T1 defect without redistribution and no increased lung uptake.

  6. PREOPERATIVE PREDICTION OF LUNG FUNCTION IN PNEUMONECTOMY BY SPIROMETRY AND LUNG PERFUSION SCINTIGRAPHY

    PubMed Central

    Cukic, Vesna

    2012-01-01

    Introduction: Nowadays an increasing number of lung resections are being done because of the rising prevalence of lung cancer that occurs mainly in patients with limited lung function, what is caused by common etiologic factor - smoking cigarettes. Loss of lung tissue in such patients can worsen much the postoperative pulmonary function. So it is necessary to asses the postoperative pulmonary function especially after maximal resection, i.e. pneumonectomy. Objective: To check over the accuracy of preoperative prognosis of postoperative lung function after pneumonectomy using spirometry and lung perfusion scinigraphy. Material and methods: The study was done on 17 patients operated at the Clinic for thoracic surgery, who were treated previously at the Clinic for Pulmonary Diseases “Podhrastovi” in the period from 01. 12. 2008. to 01. 06. 2011. Postoperative pulmonary function expressed as ppoFEV1 (predicted postoperative forced expiratory volume in one second) was prognosticated preoperatively using spirometry, i.e.. simple calculation according to the number of the pulmonary segments to be removed and perfusion lung scintigraphy. Results: There is no significant deviation of postoperative achieved values of FEV1 from predicted ones obtained by both methods, and there is no significant differences between predicted values (ppoFEV1) obtained by spirometry and perfusion scintigraphy. Conclusion: It is necessary to asses the postoperative pulmonary function before lung resection to avoid postoperative respiratory failure and other cardiopulmonary complications. It is absolutely necessary for pneumonectomy, i.e.. maximal pulmonary resection. It can be done with great possibility using spirometry or perfusion lung scintigraphy. PMID:23378687

  7. [Diagnostic value of bone scintigraphy with technetium pyrophosphate. Study of 250 patients].

    PubMed

    Kuntz, D; Rain, J D; Lemaire, V; Sainte-Croix, A; Ryckewaert, A

    1975-01-01

    The authors report the results they obtained by bone scintigraphy using technetium pyrophosphate. In a study of 142 patients with cancer, the authors show, as others have done, that bone scintigraphy makes it possible to find bone metastases that are radiologically undetectable and they emphasize the importance of this discovery. In 7 patients with spondylodiscitis, of whom 1 was without radiological signs at the time the scintigraphy was carried out, the authors always observed localized vertebral hyperfixation and they noted that this examination can be valuable for distinguishing spondylodiscitis from pseudo-Pott's discarthroses and from the lesions of vertebral epiphysitis, which in their experience do not result in isotopic hyperfixation. In 7 patients with epiphyseal osteonecrosis, the authors observed isotopic hyperfixation before the appearance of radiological signs. In 12 patients with osteoporosis, the authors observed hyperfixation in bone in certain compressed vertebrae, whereas other vertebrae that had probably been compressed some considerable time earlier did not fix the isotope excessively. They never observed hyperfixation in vertebrae that were not compressed. Among 5 patients with ankylosing spondylitis with radiological signs of sacro-iliac arthritis, the authors observed sacro-iliac hyperfixation in only 3 cases. Two other patients who had signs indicating ankylosing spondylarthritis, but were without radiological signs of sacro-iliac arthritis did not show sacro-iliac hyperfixation of the isotope. Among 7 patients with Paget's disease, the authors observed hyperfixation in all the bones with radiological signs of disease; in addition, in 3 patients, there was also hyperfixation in certain bones that were radiologically clear.

  8. Visualization of a prosthetic vascular graft due to platelet contamination during /sup 111/Indium-labeled leukocyte scintigraphy

    SciTech Connect

    Oates, E.; Ramberg, K.

    1988-09-01

    A prosthetic axillo-femoral bypass graft was visualized during /sup 111/In-labeled leukocyte scintigraphy in a patient referred for possible abdominal abscess. The presence of significant cardiac blood-pool activity raised the possibility that this uptake was due to deposition of contaminating labeled platelets rather than labeled leukocytes. An analysis of a small sample of the patient's blood confirmed that the circulating activity was due to labeled platelets. Increased activity along prosthetic vascular grafts in patients undergoing /sup 111/In-labeled leukocyte scintigraphy may be due to adherent platelet, and not indicative of infection.

  9. Whole-body (99m)Tc-octreotide scintigraphy with SPECT/CT to detect occult tumor inducing paraneoplastic osteomalacia.

    PubMed

    Rodrigues, Napoleão Ramalho; Calich, Ana Luisa; Etchebehere, Mauricio; Ichiki, Wilson Andre; Pereira, Fabio Payao; Amstalden, Elaine Maria Ingrid; de Sa Etchebehere, Elba Cristina

    2015-01-01

    A 32-year-old woman presented with progressive myalgia, bone pain, fatigue, insufficiency hip fractures, high urine phosphate, and low serum phosphate and vitamin D levels. These findings were suggestive of oncogenic osteomalacia. A whole-body Tc-octreotide scintigraphy with SPECT/CT showed uptake on a sclerotic intramedullary lesion in the left medial tibia plateau. MRI depicted a solid lesion. The lesion was surgically removed; the patient became asymptomatic, and follow-up laboratory results normalized. Histopathologic examination revealed a vascular hemangiopericytoma-like tumor, positive for somatostatin receptor (SSR-2). Whole-body Tc-octreotide scintigraphy with SPECT/CT may detect occult oncogenic osteomalacia tumors.

  10. Multifocal hot spots demonstrated by whole-body 131I scintigraphy and SPECT/CT after transaxillary endoscopic thyroidectomy.

    PubMed

    Kim, Ho Seong; Kim, Seok Hwi; Kim, Jung Han; Kim, Byung-Tae; Lee, Kyung-Han

    2015-03-01

    A 35-year-old woman received open thyroidectomy for a thyroid nodule that was confirmed as papillary carcinoma. Whole-body 131I scintigraphy during thyroid ablation demonstrated high uptake in the thyroid bed and multiple focal hot spots in the thorax. SPECT/CT localized the hot spots to the right chest wall and axilla, as well as to the left chest wall. The surgeon recognized these sites to concur with the transaxillary tract used during endoscopic thyroidectomy for nodular hyperplasia 8 years previously. Thus, this case illustrates how thyroidal tissue fragments seeded during endoscopic thyroidectomy can be mistaken for thyroid cancer metastasis on 131I scintigraphy.

  11. Ventilation-perfusion scintigraphy in an adult with congenital unilateral hyperlucent lung

    SciTech Connect

    Wegener, W.A.; Velchik, M.G. )

    1990-10-01

    A variety of congenital and acquired etiologies can give rise to the radiographic finding of a unilateral hyperlucent lung. An unusual case of congenital lobar emphysema diagnosed in a young adult following the initial discovery of a hyperexpanded, hyperlucent lung is reported. Although subsequent bronchoscopy and radiologic studies detailed extensive anatomic abnormalities, functional imaging also played an important role in arriving at this rare diagnosis. In particular, ventilation-perfusion scintigraphy identified the small contralateral lung as the functional lung and helped narrow the differential diagnosis to etiologies involving obstructive airway disorders.

  12. Critical evaluation of lung scintigraphy in cystic fibrosis: study of 113 patients

    SciTech Connect

    Piepsz, A.; Wetzburger, C.; Spehl, M.; Machin, D.; Dab, I.; Ham, H.R.; Vandevivere, J.; Baran, D.

    1980-10-01

    A long-term study has been performed on 285 lung perfusion scintigrams obtained from 113 patients with cystic fibrosis. Transverse and longitudinal comparisons with clinical and radiological scores, as well as retrospective analysis of the deceased patients, were the methods used in order to evaluate the importance of the scintigraphic images. It appears that lung scintigraphy is the best index of the regional lung impairment, and contributes, as does a chest radiograph, to the early detection of lung lesions, the two methods being complementary.

  13. Radiocolloid scintigraphy as an aid to the diagnosis of congenital portacaval anomalies in the dog

    SciTech Connect

    Hornof, W.J.; Koblik, P.D.; Breznock, E.M.

    1983-01-01

    Five clinically normal dogs and 5 dogs in which portacaval anomalies were diagnosed angiographically were utilized to evaluate differences in the appearance of the radiocolloid liver scan between the 2 groups. The liver was clearly visualized in all dogs, allowing subjective evaluation of size. In the dogs with portacaval shunts, scintigraphy revealed an obviously small liver as well as pulmonary uptake of radiocolloid. The utility of this technique was then tested in a group of dogs with liver disease and was shown to be of value in differentiating dogs with primary portacaval shunts from other types of liver disease.

  14. Post-traumatic changes of the temporo-mandibular joint by bone scintigraphy.

    PubMed

    Harris, S A; Rood, J P; Testa, H J

    1988-06-01

    13 patients who sustained mandibular trauma were investigated with radiographs and scintiscans. The scintiscans showed abnormal uptake of radiopharmaceutical in the temporomandibular joint (TMJ). In patients with a long history of traumatic arthrosis, there was more positive correlation between the scintiscans, and clinical symptoms and histology than between radiographs, and symptoms and histology. In patients with mandibular body fractures and no TMJ symptoms, the scans showed abnormal uptake in the TMJ in 7/8 joints, in the absence of radiographic abnormality. The significance of the abnormal uptake and the value of scintigraphy is discussed.

  15. Aspirin inhibition of platelet deposition at angioplasty sites: demonstration by platelet scintigraphy

    SciTech Connect

    Cuningham, D.A.; Kumar, B.; Siegel, B.A.; Gilula, L.A.; Totty, W.G.; Welch, M.J.

    1984-05-01

    In-111 platelet scintigraphy was used to evaluate the effects of prior aspirin administration on the accumulation of In-111-labeled autologous platelets at sites of arterial injury resulting from iliac, femoral, or popliteal transluminal angioplasty in a nonrandomized study of 17 men. The degree of platelet localization at angioplasty sites was significantly less in nine men who had received aspirin in varying doses within the 4 days before angioplasty than in eight men who had not received aspirin for at least two weeks. The results suggest that aspirin treatment before angioplasty limits the early platelet deposition at the angioplasty site in men.

  16. Chronic recurrent multifocal osteomyelitis: typical patterns of bone involvement in whole-body bone scintigraphy.

    PubMed

    Acikgoz, Gunsel; Averill, Lauren W

    2014-08-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease of unknown etiology. It affects children and adolescents predominantly and occurs mostly in the female population. It is characterized by the insidious onset of pain and swelling, with a fluctuating clinical course of relapses and remissions. Typically, several bones are affected, either synchronously or metachronously, and bilateral involvement is common. CRMO most commonly affects the metaphysis of long bones, especially the tibia, femur, and clavicle. The spine, pelvis, ribs, sternum, and mandible may also be affected. Although lesions are mostly multiple, patients may present with a single symptomatic focus. Radiographic findings may be negative early in the course of the disease. Bone scintigraphy is useful in determining the presence of abnormality and the extent of disease. The imaging and clinical features of CRMO overlap with those of infectious osteomyelitis, bone malignancy, and inflammatory arthritis. Nonetheless, CRMO can be confidently diagnosed with the recognition of typical imaging patterns in the appropriate clinical setting. This article reviews imaging findings with special emphasis on bone scintigraphy and specific disease sites.

  17. Indium-111-chloride and three-phase bone scintigraphy: A comparison for imaging experimental osteomyelitis

    SciTech Connect

    Hoskinson, J.J.; Daniel, G.B.; Patton, C.S. )

    1991-01-01

    To investigate the utility of indium-111-chloride ({sup 111}In-Cl) imaging in detecting osteomyelitis complicating surgical or fracture sites, the proximal tibia of 11 dogs were experimentally infected with Staphylococcus aureus after creation of a cortical defect. The contralateral limb served as a sham-operated control. Animals were serially imaged by radiography, three-phase technetium-99m-methylene diphosphonate (99mTc-MDP) scintigraphy, and {sup 111}In-Cl scintigraphy. There was a significant difference between infected (1.93) and noninfected (1.32) limb's tibia/femur count density ratios on 24-hr (p = 0.0001) and 72-hr (p = 0.0001) {sup 111}In-Cl images. A smaller difference was found for 99mTc-MDP bone-phase tibia/femur ratios (p = 0.0199). Using receiver operator characteristic analysis of tibia/femur ratios, a sensitivity of 61%, specificity of 88%, and positive (75%) and negative (79%) predictive values were determined for the 24-hr {sup 111}In-Cl images. Indium-111-chloride was superior to 99mTc-MDP in differentiating infected and noninfected operative sites.

  18. Prediction of death, myocardial infarction, and worsening chest pain using thallium scintigraphy and exercise electrocardiography

    SciTech Connect

    Staniloff, H.M.; Forrester, J.S.; Berman, D.S.; Swan, H.J.

    1986-12-01

    Although used extensively, there is little published information on the prognostic ability of exercise /sup 201/Tl scintigraphy. Accordingly, 1 yr after testing we contacted 819 patients without previous MI or CABG seen in our laboratory during a 2-yr period. Events were defined as death from a cardiovascular cause, nonfatal MI, or worsening clinical state requiring CABG. The event rate was 3.9 events per 100 patients per year. There was univariate prognostic information when comparing the highest and lowest categories as risk ratios for chest pain characteristics (2.7), sex (2.3), exercise duration (3.1), ST slope (2.5), and thallium pattern (11.6), intensity of perfusion defect (17.2), and number of abnormal regions (8.7). However, the strongest predictors were also the least common. Prognostic ability was improved by combining the results categorically, as the number of abnormal tests (13.9). The highest risk ratio, 20.5:1, was obtained by combining results through discriminant function analysis. We conclude that exercise thallium scintigraphy provides prognostic information, although the most predictive patterns are uncommon. Combining the results of multiple test results improves the prognostic ability.

  19. Exercise thallium-201 scintigraphy and prognosis in typical angina pectoris and negative exercise electrocardiography

    SciTech Connect

    Bairey, C.N.; Rozanski, A.; Maddahi, J.; Resser, K.J.; Berman, D.S. )

    1989-08-01

    Patients with a history of typical angina but negative exercise electrocardiography represent a subgroup with an intermediate likelihood of having coronary artery disease and future cardiac events. A retrospective study of the prognostic utility of stress-redistribution thallium-201 scintigraphy was performed in 190 such patients. A second group of 203 patients with typical angina and a positive exercise electrocardiogram were analyzed for comparative scintigraphic purposes. The cardiac event rate for the 144 negative exercise electrocardiogram patients with normal thallium results was 5 vs 15% in the 46 patients with abnormal thallium results (p = 0.01). These patients were further stratified into high (14 to 18%), intermediate (9%) and low (less than 2%) risk groups for future cardiac events based on combining the thallium results with the percentage of maximal predicted heart rate achieved. A multivariate analysis revealed that an abnormal thallium result was the only significant correlate of future cardiac events. Mechanisms responsible for the discordant finding of a negative exercise electrocardiogram in patients with typical angina include (1) false-positive angina symptomatology in low prevalence coronary artery disease groups in whom the thallium test is negative, and (2) electrocardiographically silent ischemia in patients in whom the thallium test is positive. These findings reveal that thallium stress-redistribution scintigraphy can be used to stratify 1-year prognosis in this subgroup of patients with typical angina and negative exercise electrocardiograms.

  20. Image-based retrieval system and computer-aided diagnosis system for renal cortical scintigraphy images

    NASA Astrophysics Data System (ADS)

    Mumcuoğlu, Erkan; Nar, Fatih; Uğur, Omer; Bozkurt, M. Fani; Aslan, Mehmet

    2008-03-01

    Cortical renal (kidney) scintigraphy images are 2D images (256x256) acquired in three projection angles (posterior, right-posterior-oblique and left-posterior-oblique). These images are used by nuclear medicine specialists to examine the functional morphology of kidney parenchyma. The main visual features examined in reading the images are: size, location, shape and activity distribution (pixel intensity distribution within the boundary of each kidney). Among the above features, activity distribution (in finding scars if any) was found to have the least interobserver reproducibility. Therefore, in this study, we developed an image-based retrieval (IBR) and a computer-based diagnosis (CAD) system, focused on this feature in particular. The developed IBR and CAD algorithms start with automatic segmentation, boundary and landmark detection. Then, shape and activity distribution features are computed. Activity distribution feature is obtained using the acquired image and image set statistics of the normal patients. Active Shape Model (ASM) technique is used for more accurate kidney segmentation. In the training step of ASM, normal patient images are used. Retrieval performance is evaluated by calculating precision and recall. CAD performance is evaluated by specificity and sensitivity. To our knowledge, this paper is the first IBR or CAD system reported in the literature on renal cortical scintigraphy images.

  1. Potential Role of Lung Ventilation Scintigraphy in the Assessment of COPD

    PubMed Central

    Cukic, Vesna; Begic, Amela

    2014-01-01

    Objective: To highlight the importance of the lung ventilation scintigraphy (LVS) to study the regional distribution of lung ventilation and to describe most frequent abnormal patterns of lung ventilation distribution obtained by this technique in COPD and to compare the information obtained by LVS with the that obtained by traditional lung function tests. Material and methods: The research was done in 20 patients with previously diagnosed COPD who were treated in Intensive care unit of Clinic for pulmonary diseases and TB “Podhrastovi” Clinical Center, University of Sarajevo in exacerbation of COPD during first three months of 2014. Each patient was undergone to testing of pulmonary function by body plethysmography and ventilation/perfusion lung scintigraphy with radio pharmaceutics Technegas, 111 MBq Tc -99m-MAA. We compared the results obtained by these two methods. Results: All patients with COPD have a damaged lung function tests examined by body plethysmography implying airflow obstruction, but LVS indicates not only airflow obstruction and reduced ventilation, but also indicates the disorders in distribution in lung ventilation. Conclusion: LVS may add further information to the functional evaluation of COPD to that provided by traditional lung function tests and may contribute to characterizing the different phenotypes of COPD. PMID:25132709

  2. Distinction of infected and non-infected post-surgical incisions with In-111-WBC scintigraphy

    SciTech Connect

    Abdel-Nabi, H.; Hinkle, G.H.; Olsen, J.O.

    1985-05-01

    To determine if In-111-WBCs scintigraphy can distinguish between healing and infection in post-surgical wounds, a prospective study was performed in patients with 3-14 day old surgical incisions. Eighteen patients (11 males and 7 females) were scanned 24 hrs after injection of 0.5 mCi of In-111 labeled autologous leukocytes. The scan findings were correlated with blood and/wound cultures results and diagnosis at time of discharge. Incisional uptake of In-111-WBCs was noted in 9 patients with infected surgical wounds and was absent in those 9 patients with non-infected surgical wounds. The results of the authors' study show that In-111-WBCs do not accumulate in non-infected surgical incisions. This confirms their previous findings in rats. The high specificity of In-111 leukocytes imaging makes it a valuable study in the evaluation of post-operative patients with suspected surgical wound infections. In-111 WBCs scintigraphy can distinguish between normal healing and infection at the site of recent (3-14 days) surgical incisions.

  3. Prognostic value of dipyridamole thallium scintigraphy for evaluation of ischemic heart disease

    SciTech Connect

    Hendel, R.C.; Layden, J.J.; Leppo, J.A. )

    1990-01-01

    Exercise testing alone or in combination with thallium scintigraphy has significant prognostic value. In contrast, dipyridamole thallium imaging is not dependent on patients achieving adequate levels of exercise, but no long-term prognostic studies have been reported. Accordingly, imaging results of 516 consecutive patients referred for dipyridamole thallium studies were correlated with subsequent cardiac events, death (n = 23) and myocardial infarction (n = 43) over a mean follow-up period of 21 months. Patients with a history of congestive heart failure, prior myocardial infarction, diabetes mellitus or abnormal scans were significantly more likely to have a cardiac event (p less than 0.03). With use of logistic regression analysis, an abnormal scan was an independent and significant predictor of subsequent myocardial infarction or cardiac death and increased the relative risk of any event more than threefold. The presence of redistribution on thallium scanning further increased the risk of a cardiac event. Survival analysis demonstrated a significant difference between patients with an abnormal or normal thallium scan over a 30 month period. In conclusion, dipyridamole thallium scintigraphy demonstrates prognostic value in a large unselected population and may be an adequate clinical alternative to physiologic exercise testing in the evaluation of coronary heart disease.

  4. Studies of GI bleeding with scintigraphy and the influence of vasopressin

    SciTech Connect

    Alavi, A.; McLean, G.K.

    1981-07-01

    The management of patients with gastrointestinal (GI) bleeding depends on accurate localization of the site of hemorrhage. Endoscopy and arteriography, although successful in achieving this goal in the majority of patients, are invasive and have other shortcomings. The introduction of the 99mTc-sulfur colloid technique has greatly simplified the evaluation and management of these patients. This test is useful in detecting and localizing the bleeding site in the lower GI tract. Scintigraphy is now used as the initial study of choice in patients with rectal bleeding. Advances made in angiography and nuclear medicine techniques also have resulted in improved management of patients. Conservative approaches succeed in controlling hemorrhage in most patients. Vasopressin is the most widely tested agent and has been adopted by many as the preferred preparation for this purpose. Before the introduction of the 99mTc-sulfur colloid technique, angiography was used to monitor the effectiveness of this drug, whether administered intravenously or intraarterially. With the use of scintigraphy and intravenous administration of vasopressin, these patients now can be managed noninvasively. Only when the intravenous Pitressin infusion fails to stop hemorrhage, is the intraarterial approach considered. Surgery is used as a last resort when these measures fail to stop the bleeding.

  5. Limitations of /sup 131/I-MIBG scintigraphy in locating pheochromocytomas

    SciTech Connect

    Gough, I.R.; Thompson, N.W.; Shapiro, B.; Sisson, J.C.

    1985-07-01

    /sup 131/I-metaiodobenzylguanidine (/sup 131/I-MIBG) scintigraphy for the location of pheochromocytomas has proved to be a major advance in patient management. In combination with computerized tomographic scanning, nearly all pheochromocytomas can be located before surgery and invasive investigations are now indicated only in exceptional cases. However, there are still lessons to be learned concerning the optimal administration and interpretation of /sup 131/I-MIBG scintigraphy. With careful attention to detail and an awareness of isotope distribution, false positive studies should be extremely rare. While the incidence of false negative studies is uncommon, these certainly occur. A patient with sporadic bilateral adrenal medullary hyperplasia, bilateral pheochromocytomas, and additional benign pheochromocytomas arising in paraganglia tissue anterior to the abdominal aorta is presented. The right adrenal pheochromocytoma was not identified on /sup 131/I-MIBG imaging. The authors conclude that even with current locating techniques, the traditional surgical approach to pheochromocytoma should not be abandoned. This involves transabdominal exploration of both adrenal glands and careful examination of all possible sites of extra-adrenal pheochromocytomas.

  6. Detection of abnormalities in febrile AIDS patients with In-111-labeled leukocyte and Ga-67 scintigraphy

    SciTech Connect

    Fineman, D.S.; Palestro, C.J.; Kim, C.K.; Needle, L.B.; Vallabhajosula, S.; Solomon, R.W.; Goldsmith, S.J.

    1989-03-01

    Thirty-six patients with acquired immunodeficiency syndrome (AIDS), who were febrile but without localizing signs, underwent indium-111 leukocyte scintigraphy 24 hours after injection of labeled white blood cells (WBCs) and were restudied 48 hours after injection of gallium-67 citrate. Fifty-six abnormalities were identified as possible sources of the fever; 27 were confirmed with biopsy. Of these 27, 15 were identified only on In-111 WBC scans (including colitis, sinusitis, and focal bacterial pneumonia); six, only on Ga-67 scans (predominantly Pneumocystis carinii pneumonia and lymphadenopathy); and six, on both studies (predominantly pulmonary lesions). In-111 WBC scanning revealed 21 of 27 abnormalities (78%) and gallium scanning, 12 of 27 (44%). If only one scintigraphic study has been performed, particularly with Ga-67, a significant number of lesions would not have been detected. The authors believe radionuclide evaluation of the febrile AIDS patient without localizing signs should begin with In-111 WBC scintigraphy. Gallium scanning may be used depending on results of In-111 WBC scans or if there is a high index of suspicion for P carinii pneumonia.

  7. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction

    PubMed Central

    Schuepbach, Jonas; Dassonville, Olivier; Poissonnet, Gilles; Demard, Francois

    2007-01-01

    Background Bone scintigraphy was performed to monitor anastomotic patency and bone viability. Methods In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla. Results In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p < 10-6) and a sensitivity that was superior to the sensitivity of clinical monitoring (92% and 75% respectively). Conclusion When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure. PMID:17448223

  8. Stress scintigraphy using single-photon emission computed tomography in the evaluation of coronary artery disease

    SciTech Connect

    Nohara, R.; Kambara, H.; Suzuki, Y.; Tamaki, S.; Kadota, K.; Kawai, C.; Tamaki, N.; Torizuka, K.

    1984-05-01

    Twenty-seven patients with angina pectoris, 24 with postmyocardial infarction angina and 7 with normal coronary arteries were examined by exercise thallium-201 emission computed tomography (SPECT) and planar scintigraphy. Exercise SPECT was compared with the reperfusion imaging obtained approximately 2 to 3 hours after exercise. The sensitivity and specificity of demonstrating involved coronary arteries by identifying the locations of myocardial perfusion defects were 96 and 87% for right coronary artery, 88 and 89% for left anterior descending artery (LAD) and 78 and 100% for left circumflex artery (LC). These figures are higher than those for planar scintigraphy (85 and 87% for right coronary artery, 73 and 89% for LAD and 39 and 100% for LC arteries). In patients with 3-vessel disease, sensitivity of SPECT (100, 88 and 75% for right coronary artery, LAD and LC, respectively) was higher than planar imaging (88, 63 and 31%, respectively), with a significant difference for LC (p less than 0.05). In 1, 2 and 0-vessel disease the sensitivity and specificity of the 2 techniques were comparable. Multivessel disease was more easily identified as multiple coronary involvement than planar imaging with a significant difference in 3-vessel disease (p less than 0.05). In conclusion, stress SPECT provides useful information for the identification of LC lesions in coronary heart disease, including 3-vessel involvement.

  9. Prognostic value of intravenous dipyridamole thallium scintigraphy after an acute myocardial ischemic event

    SciTech Connect

    Younis, L.T.; Byers, S.; Shaw, L.; Barth, G.; Goodgold, H.; Chaitman, B.R.

    1989-07-15

    Seventy-seven patients recovering from an acute coronary event were studied by intravenous dipyridamole thallium scintigraphy to evaluate the prognostic value and safety of the test in this patient subset. Forty-four patients (58%) had unstable angina and 33 (42%) had an acute myocardial infarction. One death occurred within 24 hours of testing. Sixty-eight patients were followed for an average of 12 months; 25, 31 and 23% had a fixed, reversible or combined thallium defect on their predischarge thallium scan. During follow-up, 10 patients died or had a nonfatal myocardial infarction; in each case, a reversible or combined myocardial thallium defect was present. Univariate analysis of 17 clinical, scintigraphic and angiographic variables showed that a reversible thallium defect and the angiographically determined extent of coronary artery disease were predictors of future cardiac events. The extent of coronary disease and global left ventricular ejection fraction were predictors of subsequent reinfarction or death. Logistic regression analyses revealed that a reversible thallium defect (p less than 0.001) and the extent of coronary disease (p less than 0.009) were the only significant predictors of a cardiac event. When death or reinfarction were the outcome variables, the extent of coronary disease (p less than 0.02) and left ventricular ejection fraction (p less than 0.06) were the only variables selected. Thus, intravenous dipyridamole thallium scintigraphy after an acute coronary ischemic syndrome is a useful and relatively safe noninvasive test to predict subsequent cardiac events.

  10. Two-phase whole-body skeletal scintigraphy in children--revisiting the usefulness of the early blood pool phase.

    PubMed

    Kwatra, Neha; Shalaby-Rana, Eglal; Majd, Massoud

    2013-10-01

    The usefulness of whole-body blood pool imaging as part of Tc-99m methylene diphosphonate (MDP) skeletal scintigraphy in detection of marrow infiltrative processes and unexpected soft-tissue and visceral abnormalities is demonstrated via illustrative case examples. Technical aspects of this simple and fast scanning technique are also highlighted.

  11. THE BONE SCINTIGRAPHY AS A COMPLEMENTARY EXAM IN THE DIAGNOSIS OF THE AVASCULAR NECROSIS OF THE SESAMOID

    PubMed Central

    Barral, Carlyle Marques; Félix, Arnóbio Moreira; Magalhães, Leonardo Neuenschwander; Carvalho, Luciana Araújo; Machado, Fernando Santana

    2015-01-01

    Objective: This study aimed to present seven cases of avascular necrosis of the sesamoid and report the role of bone scintigraphy in the diagnosis of these patients. Methods: Seven patients with clinical suspicion of avascular necrosis of the sesamoid underwent three-phase bone scintigraphy with 30 mCi of 99mTc-MDP. Results: Most of the patients were young female adults with complaints of limiting pain in the forefoot, who were making use of inappropriate footwear and/or had a history of injury with or without fracture. There was no predominance of either of the feet or between the femoral or tibial sesamoid. Two patients (28.57%) had a bipartite tibial sesamoid and one (14.29%) had splitting of the tibial and fibular sesamoids. In 100% of the patients, three-phase bone scintigraphy, combined with other propaedeutic methods, proved to be crucial for the diagnosis. The initial procedure in all cases was conservative. In four cases (57.14%), there was no remission of symptoms, and surgical excision of the necrotized sesamoid tissue was performed. In all the patients, the therapy used was effective, with complete remission of symptoms, without complications or deformities of the forefoot. Conclusions: Three-phase bone scintigraphy becomes a cornerstone of the propaedeutics when avascular necrosis of the sesamoid is suspected, through contributing towards early and accurate diagnosis and enabling allowing appropriate specialized treatment. PMID:27042628

  12. Sister Mary Joseph Nodules on 99mTc HYNIC-TOC scintigraphy in patients with neuroendocrine tumors.

    PubMed

    Jing, Hongli; Zhang, Yingqiang; Li, Fang

    2015-02-01

    A Sister Mary Joseph nodule represents an umbilical metastasis, which is more commonly caused by a primary malignancy in gastrointestinal tract or from reproductive system. We report Sister Mary Joseph nodules caused by neuroendocrine tumor and revealed on Tc HYNIC-TOC scintigraphy.

  13. Dipyridamole thallium-201 scintigraphy for early risk stratification of patients after uncomplicated myocardial infarction

    PubMed Central

    Hung, J.; Moshiri, M.; Groom, G.; Van der Schaaf, A. A; Parsons, R.; Hands, M.

    1997-01-01

    Objective—To determine the safety and prognostic value of dipyridamole thallium-201 scintigraphy performed in patients within three to five days of acute myocardial infarction, including those receiving thrombolytic treatment.
Design—A prospective study of dipyridamole thallium-201 scintigraphy in patients early after acute myocardial infarction.
Setting—University hospital.
Patients—200 patients who were clinically uncomplicated at day 3 after infarction, 92 (46%) of whom had received thrombolysis.
Main outcome measures—Incidence of cardiac death, non-fatal reinfarction, readmission to hospital for unstable angina, or non-elective revascularisation procedure within six months' follow up. 
Results—No patient had a serious complication from the dipyridamole study. At six month follow up, 55 patients (28%) had suffered a defined cardiac event. Patients who received thrombolysis had the same extent of thallium-201 redistribution and the same occurrence of subsequent cardiac events as those not receiving thrombolysis. Patients who subsequently had an event had more myocardial segments showing thallium-201 redistribution than event free patients: 2.7 (SD 1.9) v 1.2 (1.4), respectively (p < 0.001). Among all clinical and scintigraphic variables, multivariate analysis identified the extent of thallium-201 redistribution as the only independent predictor of outcome (p < 0.001). Among 63 patients (32%) of the study cohort who showed more than two myocardial segments with thallium-201 redistribution, the adjusted risk ratio for a cardiac event was 7.5 (95% confidence interval 2.9 to 19.1) compared with patients without any redistribution.
Conclusions—Dipyridamole thallium-201 scintigraphy can be performed safely within a few days of the event in patients with uncomplicated myocardial infarction, including those who received thrombolysis, and can identify a subgroup of patients at high risk of future ischaemic events.

 Keywords

  14. Insufficiency of Bone Scintigraphy in Vertebral Lesions of Langerhans Cell Histiocytosis Compared to F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Diagnostic Computed Tomography

    PubMed Central

    Koç, Zehra Pınar; Şimşek, Selçuk; Akarsu, Saadet; Balcı, Tansel Ansal; Onur, Mehmet Ruhi; Kepenek, Ferat

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a benign disorder related to the histiocytes which can infiltrate bone tissue. The most effective method for demonstrating severity of this disease is PET/CT and bone scintigraphy might show bone lesions. We present a seventeen year old male patient with disseminated LCH presented with exophtalmos and having multiple vertebral lesions which were identified by F-18 FDG PET/CT scan and diagnostic CT but not in the bone scintigraphy. PMID:25800594

  15. Insufficiency of bone scintigraphy in vertebral lesions of langerhans cell histiocytosis compared to f-18 fluorodeoxyglucose positron emission tomography/computed tomography and diagnostic computed tomography.

    PubMed

    Koç, Zehra Pınar; Şimşek, Selçuk; Akarsu, Saadet; Balcı, Tansel Ansal; Onur, Mehmet Ruhi; Kepenek, Ferat

    2015-02-01

    Langerhans cell histiocytosis (LCH) is a benign disorder related to the histiocytes which can infiltrate bone tissue. The most effective method for demonstrating severity of this disease is PET/CT and bone scintigraphy might show bone lesions. We present a seventeen year old male patient with disseminated LCH presented with exophtalmos and having multiple vertebral lesions which were identified by F-18 FDG PET/CT scan and diagnostic CT but not in the bone scintigraphy.

  16. Comparison of bone scintigraphy and radiography in multiple myeloma. [/sup 99m/Tc-phosphate complexes

    SciTech Connect

    Woolfenden, J.M.; Pitt, M.J.; Durie, B.G.M.; Moon, T.E.

    1980-03-01

    Radionuclide images and skeletal radiographs of 51 patients with multiple myeloma were compared to assess the sensitivity of scintigraphy in detecting radiographically evident disease. Comparable studies were available for 562 sites. The radionuclide image was relatively insensitive in detecting myeloma; it failed to show radiographically evident disease or underestimated its extent at 27% of the sites. On a limited number of serial images there were 7 sites at which a scintigraphic abnormality preceded the radiographic abnormality. No definite correlation was found between scintigraphic findings and hematologic parameters of myeloma activity. Although the radionuclide image may demonstrate a few sites of myeloma before the radiograph, radiography remains the primary method of evaluating skeletal involvement by myeloma.

  17. Appearance of acute gouty arthritis on indium-111-labeled leukocyte scintigraphy

    SciTech Connect

    Palestro, C.J.; Vega, A.; Kim, C.K.; Swyer, A.J.; Goldsmith, S.J. )

    1990-05-01

    Indium-111-labeled leukocyte scintigraphy was performed on a 66-yr-old male with polyarticular acute gouty arthritis. Images revealed intense labeled leukocyte accumulation in a pattern indistinguishable from septic arthritis, in both knees and ankles, and the metatarsophalangeal joint of both great toes, all of which were involved in the acute gouty attack. Joint aspirate as well as blood cultures were reported as no growth; the patient was treated with intravenous colchicine and ACTH for 10 days with dramatic improvement noted. Labeled leukocyte imaging, repeated 12 days after the initial study, revealed near total resolution of joint abnormalities, concordant with the patient's clinical improvement. This case demonstrates that while acute gouty arthritis is a potential pitfall in labeled leukocyte imaging, in the presence of known gout, it may provide a simple, objective, noninvasive method of evaluating patient response to therapy.

  18. Cardiac emission tomography in patients using 201thallium. A new technique for perfusion scintigraphy.

    PubMed

    Dymond, D S; Stone, D L; Elliott, A T; Britton, K E; Spurrell, R A

    1979-06-01

    The distribution of 201thallium (Tl) in the myocardium has been studied by the new technique of emission tomography, and compared with standard gamma camera images in 5 patients. Tomographic imaging was carried out using a dual-detector scanner operated under the single-photon technique. Initial results have been promising, with visualisation of resting perfusion defects in patients with recent infarction and those with ventricular aneurysms. Emission tomography has also been performed at exercise, and has shown tracer deficits in the distribution of significant coronary stenoses. This new approach to myocardial perfusion scintigraphy may lead to improved sensitivity for detecting apical and inferior wall abnormalities by providing depth information not available from a conventional two-dimensional image. PMID:315854

  19. Pulmonary sequestration: a (131)I whole body scintigraphy false-positive result.

    PubMed

    Spinapolice, Elena Giulia; Chytiris, S; Fuccio, C; Leporati, P; Volpato, G; Villani, L; Trifirò, G; Chiovato, L

    2014-08-01

    A 35-year-old woman affected by a well-differentiated papillary thyroid carcinoma was referred to our hospital to perform a (131)Iodine ((131)I) whole body scintigraphy for restaging purpose. The patient had been previously treated with total thyroidectomy and three subsequent doses of (131)I for the ablation of a remnant jugular tissue and a suspected metastatic focus at the superior left hemi-thorax. In spite of the previous treatments with (131)I, planar and tomographic images showed the persistence of an area of increased uptake at the superior left hemi-thorax. This finding prompted the surgical resection of the lesion. Histological examination of the surgical specimen showed the presence of a pulmonary tissue consistent with pulmonary sequestration. Even though rare, pulmonary sequestration should be included in the potential causes of false-positive results of radioiodine scans.

  20. Extensive gastric varices demonstrated by technetium-99m red blood cell scintigraphy

    SciTech Connect

    Shih, W.J.; Domstad, P.A.; Loh, F.G.; Pulmano, C.

    1987-04-01

    An alcohol abuse patient complicated by chronic pancreatitis had splenic vein thrombosis leading to gastric varices and underwent abdominal Tc-99m red blood cell scintigraphy. First pass study, sequential images up to 1 hour, and a 2.5 hour image showed abnormal radioactivity in the left side of the abdomen and midabdomen. In 24 hour images, the high level of activity in the left side persisted; in addition, there was accumulation of radioactivity in the cecum, ascending, transverse colon, the splenic flexure, and descending colon. A splenectomy was performed and during the surgical procedure, a large dilated vein in the greater omentum was noted. It is reemphasized that delayed imaging up to 24 hours is important when the results of earlier images are equivocal or negative.

  1. Comparative evaluation of intragastric bile acids and hepatobiliary scintigraphy in the diagnosis of duodenogastric reflux

    PubMed Central

    Chen, Teng-Fei; Yadav, Praveen K; Wu, Rui-Jin; Yu, Wei-Hua; Liu, Chang-Qin; Lin, Hui; Liu, Zhan-Ju

    2013-01-01

    AIM: To assess the diagnostic value of a combination of intragastric bile acids and hepatobiliary scintigraphy in the detection of duodenogastric reflux (DGR). METHODS: The study contained 99 patients with DGR and 70 healthy volunteers who made up the control group. The diagnosis was based on the combination of several objective arguments: a long history of gastric symptoms (i.e., nausea, epigastric pain, and/or bilious vomiting) poorly responsive to medical treatment, gastroesophageal reflux symptoms unresponsive to proton-pump inhibitors, gastritis on upper gastrointestinal (GI) endoscopy and/or at histology, presence of a bilious gastric lake at > 1 upper GI endoscopy, pathologic 24-h intragastric bile monitoring with the Bilitec device. Gastric juice was aspirated in the GI endoscopy and total bile acid (TBA), total bilirubin (TBIL) and direct bilirubin (DBIL) were tested in the clinical laboratory. Continuous data of gastric juice were compared between each group using the independent-samples Mann-Whitney U-test and their relationship was analysed by Spearman’s rank correlation test and Fisher’s linear discriminant analysis. Histopathology of DGR patients and 23 patients with chronic atrophic gastritis was compared by clinical pathologists. Using the Independent-samples Mann-Whitney U-test, DGR index (DGRi) was calculated in 28 patients of DGR group and 19 persons of control group who were subjected to hepatobiliary scintigraphy. Receiver operating characteristic curve was made to determine the sensitivity and specificity of these two methods in the diagnosis of DGR. RESULTS: The group of patients with DGR showed a statistically higher prevalence of epigastric pain in comparison with control group. There was no significant difference between the histology of gastric mucosa with atrophic gastritis and duodenogastric reflux. The bile acid levels of DGR patients were significantly higher than the control values (Z: TBA: -8.916, DBIL: -3.914, TBIL: -6.197, all

  2. Myocardial stunning in hypertrophic cardiomyopathy: recovery predicted by single photon emission computed tomographic thallium-201 scintigraphy

    SciTech Connect

    Fine, D.G.; Clements, I.P.; Callahan, M.J.

    1989-05-01

    A young woman with hypertrophic cardiomyopathy confirmed by echocardiography and cardiac catheterization presented with chest pain and features of a large left ventricular aneurysm. The initial diagnosis was myocardial ischemia with either an evolving or an ancient myocardial infarction. Subsequently, verapamil therapy was associated with complete resolution of the extensive left ventricular wall motion abnormalities, normalization of left ventricular ejection fraction and a minimal myocardial infarction. Normal thallium uptake on single photon emission computed tomographic scintigraphy early in the hospital course predicted myocardial viability in the region of the aneurysm. Thus, orally administered verapamil may reverse spontaneous extensive myocardial ischemia in hypertrophic cardiomyopathy and possibly limit the extent of myocardial infarction in such circumstances.

  3. Strip sign: a new sign for diagnosis of nonembolic defects on pulmonary perfusion scintigraphy

    SciTech Connect

    Sostman, H.D.; Gottschalk, A.

    1982-03-01

    A total of 47 patients who underwent both lung ventilation-perfusion scintigraphy and pulmonary arteriography were evaluated for presence on the scintigram of perfusion defects that did not extend to the lung edge, leaving a peripheral parenchymal stripe (PPS) of perfused lung between the defect and the adjacent pleural surface. Scans were scored both with and without regard for the PPS according to probability of pulmonary embolism; these predictions were then compared with the official lung scan report given initially to the referring physician. Predictions were then verified by pulmonary arteriography. Of the 13 patients who showed one or more PPSs, four reports would have been more accurate using the revised criteria that included the stripe sign. In this study, visualization of a PPS in an area of defect on a perfusion lung scan was extremely accurate for predicting absence of pulmonary emboli in the specific area of the stripe. Further studies that would be needed to confirm this finding are discussed.

  4. Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy

    SciTech Connect

    Nesto, R.W.; Phillips, R.T.; Kett, K.G.; Hill, T.; Perper, E.; Young, E.; Leland, O.S. Jr.

    1988-02-01

    Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 7 patients with diabetes compared with 17 patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted.

  5. PIPIDA scintigraphy for cholecystitis: false positives in alcoholism and total parenteral nutrition

    SciTech Connect

    Shuman, W.P.; Gibbs, P.; Rudd, T.G.; Mack, L.A.

    1982-01-01

    A review of gallbladder scintigraphy in patients with potentially compromised hepatobiliary function revealed two groups in whom cholecystitis might be mistakenly diagnosed. In 200 consecutive hospitalized patients studied with technetium-99m-PIPIDA for acute cholecystitis or cholestasis, there were 41 alcoholics and 17 patients on total parenteral nutrition. In 60% of the alcoholics and 92% of those on parenteral nutrition, absent or delayed visualization of the gallbladder occurred without physical or clinical evidence of cholecystitis. A cholecystagogue, sincalide, did not prevent the false-positive features which presumably are due to altered bile flow kinetics related to alcoholism and parenteral nutrition. Four patients on parenteral nutrition undergoing cholecystectomy for suspected cholecystitis had normal gallbladders filled with jellylike viscous thick bile. A positive (nonvisualized or delayed visualized) gallbladder PIPIDA scintigram in these two populations should not be interpreted as indicating a need for cholecystectomy.

  6. [Thyroid scintigraphy and body scanning with 67 Ga in a case of primary thyroid lymphoma].

    PubMed

    Hervás Benito, I; Vera Espallardo, F; Saura Quiles, A; González Cabezas, P; Bello Arques, P; Rivas Sánchez, A; Alonso Monfort, J; Pérez Velasco, R; Mateo Navarro, A

    2001-10-01

    The case of a 60-year old woman first presented a rapidly growing left cervical mass is presented. The fine needle aspiration-puncture (FNAP) lead to a diagnosis of thyroiditis. Due to the persistence of the symptoms, the FNAP was repeated again but was not conclusive, so that a surgical biopsy was performed. The pathological diagnosis was diffuse large cell primary thyroid lymphoma (PTL). The PTL is a rare entity that accounts for less than 1% of all the Non-Hodgkin's lymphomas. The thyroid scintigraphy showed the existence of a cold nodule in the left thyroid lobule and the 67Ga scan revealed a large abnormal lesion in the mediastinum that extended to the right latero-cervical region. After two chemotherapy courses, the 67Ga scan was normal.

  7. Is Brown Adipose Tissue Visualization Reliable on 99mTc-Methoxyisobutylisonitrile Diagnostic SPECT Scintigraphy?

    PubMed Central

    Haghighatafshar, Mahdi; Farhoudi, Farinaz

    2016-01-01

    Abstract The 99mTc-MIBI has been used with great value as a diagnostic technique in patients with primary hyperparathyroidism. False-positive scans may occur due to misinterpretation of the physiologic distribution of the 99mTc-MIBI. Reviewing consecutive SPECT scans, we evaluated this possibility and assessed how frequently brown adipose tissue (BAT) is seen on 99mTc-MIBI scintigraphy. Here, we retrospectively reviewed scans of consecutive patients who were evaluated for parathyroid adenomas from March 2015 to June 2015, using dual-phase (early and delayed) planar imaging and SPECT. We identified 60 patients (48 female and 12 male; mean age, 52.25 ± 15.20 years; range, 22–86 years). We detected the presence of 99mTc-MIBI uptake in BAT in 20 of 60 patients (33.33%) in the neck. Although the patients with 99mTc-MIBI uptake in BAT were younger (mean age, 48.85 ± 15.27 years, range, 26–73 years) than the patients with no 99mTc-MIBI uptake (mean age, 53.95 ± 15.07 years, range, 22–86 years), this difference was not statistically significant (P = 0.224). The percentage of female patients with BAT detection was higher (17/48 patients; 37.5%) than that of the male population (3/12 patients; 25%), this difference was not also statistically significant (P = 0.85). In patient population referred to 99mTc MIBI scintigraphy of the parathyroid glands, uptake of 99mTc-MIBI in BAT should not be misinterpreted with 99mTc-MIBI-avid-tumors. Fused SPECT/CT images (not SPECT-only) are necessary to distinguish BAT from bone, muscle, thyroid, myocardium, parathyroids, and other structures in the neck and chest. PMID:26765463

  8. Significance of positive or negative thallium-201 scintigraphy in hypertrophic cardiomyopathy

    SciTech Connect

    von Dohlen, T.W.; Prisant, L.M.; Frank, M.J. )

    1989-09-01

    Myocardial ischemia, fibrosis and infarction may occur in patients with hypertrophic cardiomyopathy (HC) in the absence of epicardial coronary artery disease. To determine their prevalence and relation with common characteristics, stress thallium-201 scintigraphy was performed in 28 patients. Eleven (39%) had positive scans despite normal epicardial coronary arteries (7 patients) or a pretest risk of coronary disease less than or equal to 5% (4 patients). There was no relation between thallium defects and age, sex, chest pain or outflow tract gradients at rest. However, the mean left ventricular ejection fraction was significantly lower in those with perfusion abnormalities compared with those without (64 +/- 15 vs 75 +/- 11%, respectively, p less than 0.05). Also, the mean ventricular septal thickness was greater in patients with positive scans (27 +/- 7 vs 21 +/- 6 mm, p less than 0.05), and there was a nonparametric relation between increasing septal thickness and the frequency of positive scans (p less than 0.025). Seven of 11 patients with positive scans had ventricular tachycardia compared with none among those who had negative scans (p less than 0.001), and 5 of these 11 patients had conduction system disease requiring permanent pacemaker insertion compared with 1 of 17 with negative scans (p less than 0.025). It is concluded that thallium perfusion abnormalities are common in patients with HC in the absence of epicardial coronary disease, and are strongly associated with potentially lethal arrhythmias. Thallium scintigraphy appears to identify a subset of patients with HC at increased risk for sudden death, who therefore require closer follow-up.

  9. Efficacy of (99m)Tc-EDDA/HYNIC-TOC SPECT/CT scintigraphy in Graves' ophthalmopathy.

    PubMed

    Zhao, Rong; Wang, Jiang; Deng, Jinglan; Yang, Weidong; Wang, Jing

    2012-01-01

    The aim of this study was to investigate the predictive role of the orbital somatostatin receptor scintigraphy with (99m)Tc-EDDA/HYNIC-TOC ((99m)Tc-TOC) to detect clinical stage of Graves' ophthalmopathy and the response to corticosteroid therapy. The subjects of the experiment were 46 patients with Graves' ophthalmopathy (GO) and four volunteers without eye disease or GO as the normal group (NG). Single photon emission computed tomography (SPECT), computed tomography (CT) and the left and right lateral position planar imaging of the heads of the all subjects were obtained 4 h after the intravenous injection of 555 MBq of (99m)Tc-TOC. The (99m)Tc-TOC SPECT/CT was repeated 3 months later. 35 (35/46) patients were received corticosteroid therapy (prednisolone, 10 mg po tid ) for 3 months, however, the other 11 patients as control groups did not receive any treatment. The treatment effect was evaluated both by the orbital (99m)Tc-TOC uptake and NOSPECS. A significant decrease in the O/OC ratio was observed in 22 GO patients between pre- and post-treatment (1.64 ± 0.13 vs. 1.21 ± 0.09, P < 0.05). There were neither significant difference of the O/OC ratio in 13 GO patients between pre- and post-treatment periods, nor significant difference in the 9 (9/11) patients before and after three months. Orbital (99m)Tc-TOC scintigraphy is a feasible technique to estimate the Graves' ophthalmopathy activity and predict the response to subsequent corticosteroid therapy in GO patients. The technique could be a useful tool for physicians not familiar with CAS determination.

  10. Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

    PubMed Central

    Kraft, Otakar; Havel, Martin

    2012-01-01

    Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) detection in patients with gynecologic tumours. Material and Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years): 36 pts with cervical cancer (Group A), 21 pts with endometrial cancer (Group B), 7 pts with vulvar carcinoma (Group C). Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared. Results: Planar scintigraphy did not image SLN in 7 patients (10.9%), SPECT/CT was negative in 4 patients (6.3%). In 35 (54.7%) patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05). Three foci of uptake (1.7% from totally visible 177 foci on planar images) in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. Conclusion: In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs. Conflict of interest:None declared. PMID:23486989

  11. Is Brown Adipose Tissue Visualization Reliable on 99mTc-Methoxyisobutylisonitrile Diagnostic SPECT Scintigraphy?

    PubMed

    Haghighatafshar, Mahdi; Farhoudi, Farinaz

    2016-01-01

    The 99mTc-MIBI has been used with great value as a diagnostic technique in patients with primary hyperparathyroidism. False-positive scans may occur due to misinterpretation of the physiologic distribution of the 99mTc-MIBI. Reviewing consecutive SPECT scans, we evaluated this possibility and assessed how frequently brown adipose tissue (BAT) is seen on 99mTc-MIBI scintigraphy. Here, we retrospectively reviewed scans of consecutive patients who were evaluated for parathyroid adenomas from March 2015 to June 2015, using dual-phase (early and delayed) planar imaging and SPECT. We identified 60 patients (48 female and 12 male; mean age, 52.25 ± 15.20 years; range, 22-86 years).We detected the presence of 99mTc-MIBI uptake in BAT in 20 of 60 patients (33.33%) in the neck. Although the patients with T99mc-MIBI uptake in BAT were younger (mean age, 48.85 ± 15.27 years, range, 26-73 years) than the patients with no 99mTc-MIBI uptake (mean age, 53.95 ± 15.07 years, range, 22-86 years), this difference was not statistically significant (P = 0.224). The percentage of female patients with BAT detection was higher (17/48 patients; 37.5%) than that of the male population (3/12 patients; 25%), this difference was not also statistically significant (P = 0.85).In patient population referred to 99mTc MIBI scintigraphy of the parathyroid glands, uptake of 99mTc-MIBI in BAT should not be misinterpreted with 99mTc-MIBI-avid-tumors. Fused SPECT/CT images (not SPECT-only) are necessary to distinguish BAT from bone, muscle, thyroid, myocardium, parathyroids, and other structures in the neck and chest. PMID:26765463

  12. The limitations of gallium scintigraphy in the differentiation between benign and malignant salivary gland mass lesions.

    PubMed

    Yoshikai, T; Ishimaru, J; Satoh, T; Inokuchi, A; Kudo, S

    2003-06-01

    The aim of this study was to evaluate the ability of gallium scintigraphy to differentiate between benign and malignant salivary gland mass lesions and to identify what types of lesions surpass its diagnostic utility. By considering the uptake of 67Ga, 193 salivary gland masses were graded visually as negative, weakly positive, moderately positive or strongly positive in comparison to the uptake in the nasal cavity and the liver. The uptake was compared with histopathological findings. Among 39 malignant tumours, uptake was positive in 31 (79%) (strongly positive in 18, moderately positive in seven and weakly positive in six) and uptake was negative in eight (21%). Adenoid cystic carcinoma was the most common malignant tumour in our study (11/39), and uptake was negative in five (45%) of these tumours. Malignant tumours did not differ significantly in size despite differences in uptake. Among 154 benign lesions, uptake was negative in 101 (66%) and positive in 53 (34%) (strongly positive in 12, moderately positive in 19 and weakly positive in 22). Out of 88 pleomorphic adenomas, 41 (47%) showed positive uptake. Sensitivity, specificity and accuracy for gallium study were 80%, 66% and 68%, respectively, when the malignancy criterion was weakly positive uptake. Accuracy was greatest (83%) when the criterion was strongly positive uptake, but this criterion failed to detect more than a half of malignant tumours (46% sensitivity). In conclusion, gallium scintigraphy had limitations in differentiating between benign and malignant salivary gland mass lesions. Adenoid cystic carcinomas and pleomorphic adenomas were the principal sources of false negative and false positive results, respectively.

  13. [Dual isotope myocardial scintigraphy (201thallium at rest/99 M technetium tetrofosmin with exercise) in the detection of reversible hypoperfusion].

    PubMed

    Peix González, A; López Díaz, A; Ponce Vicente, F; Maltas Pineda, A M; García Fernández, R; Barrera Sarduy, J D; García Barreto, D

    2000-02-01

    The dual-isotope technique (rest 201Tl and stress 99mTc-sestamibi) is useful to assess myocardial perfusion in coronary disease patients. 99mTc-labeled tetrofosmin is a radiopharmaceutical whose characteristics are similar to sestamibi. Thus, we decided to use it to detect reversible myocardial hypoperfusion in patients with a background of myocardial infarction and ischemia. A sequential dual-isotope scintigraphy (3 mCi rest 201Tl and 25 mCi stress 99mTc-tetrofosmin) with 24-hour 201Tl redistribution (RD) was performed in 20 patients with previously confirmed myocardial infarction and clinical and ergometric signs of ischemia. Each patient also underwent a stress-redistribution protocol with redistribution at 4 and 24 hours post injection with 201Tl scintigraphy within two weeks of the first study. The qualitative uptake analysis showed no significant differences in the number of myocardial segments with severe reduction of tracer uptake on stress that improved at rest or in RD images, even if 24-hour RD images were considered. The quantitative global uptake analysis showed a similar defect reversibility with both protocols; however if 24-hour RD images were considered the uptake improvement was significant only when compared with the rest 201Tl images in dual-isotope scintigraphy protocol (75+/-8% vs. 81+/-9% of peak activity, rest vs. 24-hour RD; p<0.01) and not when compared with the 4-hour RD in the 201Tl scintigraphy. On the other hand, when only the segments with severely reduced uptake (<50% of peak activity) were analyzed, the 24-hour RD improved myocardial uptake significantly (p<0.001 vs. rest and vs 4-hour RD) in both protocols. We conclude that a sequential dual-isotope rest 201Tl/stress 99mTc-tetrofosmin scintigraphy is comparable with stress-redistribution 201Tl scintigraphy to detect reversible myocardial hypoperfusion; however in both cases, the addition of 24-hour images increases its usefulness in severely hypoperfused segments, if the uptake of

  14. Renal Scintigraphy

    MedlinePlus

    ... the examination table which slides in between the parallel gamma camera heads which are suspended over the ... this energy, and with the help of a computer, create pictures offering details on both the structure ...

  15. 123I-Mibg scintigraphy and 18F-Fdg-Pet imaging for diagnosing neuroblastoma

    PubMed Central

    Bleeker, Gitta; Tytgat, Godelieve Am; Adam, Judit A; Caron, Huib N; Kremer, Leontien Cm; Hooft, Lotty; van Dalen, Elvira C

    2015-01-01

    Background Neuroblastoma is an embryonic tumour of childhood that originates in the neural crest. It is the second most common extracranial malignant solid tumour of childhood. Neuroblastoma cells have the unique capacity to accumulate Iodine-123-metaiodobenzylguanidine (123I-MIBG), which can be used for imaging the tumour. Moreover, 123I-MIBG scintigraphy is not only important for the diagnosis of neuroblastoma, but also for staging and localization of skeletal lesions. If these are present, MIBG follow-up scans are used to assess the patient's response to therapy. However, the sensitivity and specificity of 123I-MIBG scintigraphy to detect neuroblastoma varies according to the literature. Prognosis, treatment and response to therapy of patients with neuroblastoma are currently based on extension scoring of 123I-MIBG scans. Due to its clinical use and importance, it is necessary to determine the exact diagnostic accuracy of 123I-MIBG scintigraphy. In case the tumour is not MIBG avid, fluorine-18-fluorodeoxy-glucose (18F-FDG) positron emission tomography (PET) is often used and the diagnostic accuracy of this test should also be assessed. Objectives Primary objectives: 1.1 To determine the diagnostic accuracy of 123I-MIBG (single photon emission computed tomography (SPECT), with or without computed tomography (CT)) scintigraphy for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old. 1.2 To determine the diagnostic accuracy of negative 123I-MIBG scintigraphy in combination with 18F-FDG-PET(-CT) imaging for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old, i.e. an add-on test. Secondary objectives: 2.1 To determine the diagnostic accuracy of 18F-FDG-PET(-CT) imaging for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old. 2.2 To compare the diagnostic accuracy of 123I

  16. Thallium-201 scintigraphy for diagnosis of old myocardial infarction: comparison with electrocardiographic, ventriculographic, and coronary arteriographic findings.

    PubMed Central

    Uthurralt, N; Parodi, O; Severi, S; Davies, G; Maseri, A

    1980-01-01

    Myocardial scintigraphy with 201Tl was performed at rest in a selected group of 36 patients with unequivocal clinical and electrocardiographic evidence of old myocardial infarction. The scintigraphic findings were correlated with electrocardiographic pattern, and with regional left ventricular wall motion and the severity of coronary artery disease defined by contrast angiography. Detection was dependent on the extent of the infarct but was independent of QRS morphology and of the severity of coronary disease. When positive, 201Tl scintigraphy was often a more precise method than the electrocardiogram for localising and delineating the extent of the infarct. Furthermore, the perfusion defect corresponded in location and extent to abnormalities of left ventricular wall motion. The site or severity of coronary artery disease could not be determined from the 201Tl scintigram. Images PMID:7378212

  17. (99m)Tc-DMSA scintigraphy diagnosing crossed renal ectopia with fusion in a three years old boy.

    PubMed

    Tsalkidis, Aggelos; Gardikis, Stefanos; Kambouri, Katerina; Zissimopoulos, Athanassios; Boussios, Nikos; Deftereos, Savas; Vaos, George; Chatzimichael, Athanassios

    2011-01-01

    A 3 years old boy with a history of surgery for orchidopexy was admitted to our hospital with fever and abdominal pain. Clinical examination and laboratory investigations revealed urinary tract infection with renal involvement. Ultrasonography demonstrated a solitary left kidney and raised the suspicion of a fusion anomaly. Voiding cystography disclosed grade III vesicoureteral reflux and technetium-99m dimercaptosuccinic acid scintigraphy revealed right to left crossed renal ectopia with fusion (L-shaped kidney). The patient is undergoing standard follow-up for the early detection of possible renal complications. In conclusion, L-shaped kidney is a rare entity and the (99m)Tc-DMSA scintigraphy played an important role on timely diagnosis.

  18. Scintigraphy of hepatic hemangiomas: the value of Tc-99m-labeled red blood cells - concise communication

    SciTech Connect

    Front, D.; Royal, H.D.; Israel, O; Parker, J.A.; Kolodny, G.M.

    1981-08-01

    Fourteen patients with hepatic hemangiomas were evaluated by Tc-99m colloid scintigraphy and Tc-99m RBC angiography, including flow studies and early and delayed static studies. On colloid scintigraphy, the liver appeared enlarged, with single or multiple focal defects. During the flow and early static Tc-99m RBC studies, the lesions showed poor perfusion and were filled only partially or not at all. Delayed Tc-99m RBC studies demonstrated the whole extent of the lesion and all the lesions when multiple hemangiomas were present. A flow study showing decreased perfusion and a late blood-pool study showing increased local blood volume appear characteristic of hemangiomas. Liver biopsy should not be attempted in such cases.

  19. Scintigraphy of hepatic hemangiomas: the value of Tc-99m-labeled red blood cells: concise communication

    SciTech Connect

    Royal, H.D.; Israel, O.; Parker, J.A.; Kolodny, G.M.

    1981-08-01

    Fourteen patients with hepatic hemangiomas were evaluated by Tc-99m colloid scintigraphy and Tc-99m RBC angiography, including flow studies and early and delayed static studies. On colloid scintigraphy, the liver appeared enlarged, with single or multiple focal defects. During the flow and early static Tc-99m RBC studies, the lesions showed poor perfusion and were filled only partially or not at all. Delayed Tc-99m RBC studies demonstrated the whole extent of the lesion and all the lesions when multiple hemangiomas were present. A flow study showing decreased perfusion and a late blood-pool study showing increased local blood volume appear characteristic of hemangiomas. Liver biopsy should not be attempted in such cases.

  20. Splenic scintigraphy using Tc-99m-labeled heat-denatured red blood cells in pediatric patients: concise communication

    SciTech Connect

    Ehrlich, C.P.; Papanicolaou, N.; Treves, S.; Hurwitz, R.A.; Richards, P.

    1982-03-01

    Ten children underwent splenic imaging with heat-denatured red blood cells labeled with technetium-99m (Tc-99m DRBC). The presenting problems included the heterotaxia syndrome, recurrent idiopathic thrombocytopenic purpura following splenectomy, mass in the left posterior hemithorax, and blunt abdominal trauma. In nine patients, the presence or absence of splenic tissue was established. A splenic hematoma was identified in the tenth patient. All patients were initially scanned with Tc-99m sulfur colloid (Tc-99m SC), and were selected for Tc-99m DRBC scintigraphy only after the results of the SC scans failed to establish the clinical problem beyond doubt. The availability of kits containing stannous ions, essential for efficient and stable labeling of red blood cells with Tc-99m and requiring only a small volume of blood, make splenic scintigraphy in children a relatively simple and definitive diagnostic procedure, when identification of splenic tissue is of clinical importance.

  1. Comparisons of scintigraphy with /sup 111/In leukocytes and /sup 67/Ga in the diagnosis of occult sepsis

    SciTech Connect

    Sfakianakis, G.N.; Al-Sheikh, W.; Heal, A.; Rodman, G.; Zeppa, R.; Serafini, A.

    1982-07-01

    In a prospective study involving 32 patients with clinical suspicion of focal infection, the sensitivity and specificity of /sup 111/In-labeled leukocyte (In-WBC) scintigraphy were compared with those of /sup 67/Ga scintigraphy performed 24-48 hr later. Of a total of 192 body sites studied, 26 foci of infection were diagnosed by aspiration, cultures, or chest radiographs. Indium-WBC indicated 19 (73%) true-positive (TP) and four (2.5%) false-positive (FP) foci of abnormal accretion; /sup 67/Ga had 21 (81%) TP and 15 (9%) FP. The 7/26 (27%) false-negative (FN) In-WBC scintigrams involved infection foci of more than 2-wk duration; the 5/26 (19%) FN /sup 67/Ga studies were in patients with infections manifested for less than 1 wk. The results of this study are useful in considering the indications of the two tracers.

  2. (18)F-FDG PET/CT versus bone scintigraphy in the follow-up of gastric cancer.

    PubMed

    Sollini, M; Calabrese, L; Zangheri, B; Erba, P A; Gramaglia, A; Gasparini, M

    2016-01-01

    A 53-year-old patient underwent a positron emission tomography/computed tomography with 2-fluoro-2-deoxy-d-glucose ((18)F-FDG PET/CT) in the suspicious of gastric tumor recurrence (mediastinal and abdominal lymph nodes). PET/CT identified only an area of (18)F-FDGuptake in the twelfth thoracic vertebrae. Unexpectedly, a bone scintigraphy revealed many "hot" spots changing the diagnosis (single metastasis versus plurimetastatic disease) and impacting on patient's management. PMID:26653282

  3. Evaluation of primary lung cancer with indium 111 anti-carcinoembryonic antigen (type ZCE-025) monoclonal antibody scintigraphy

    SciTech Connect

    Krishnamurthy, S.; Morris, J.F.; Antonovic, R.; Ahmed, A.; Galey, W.T.; Duncan, C.; Krishnamurthy, G.T. )

    1990-02-01

    A study was undertaken to test whether indium 111 (111In)-labeled anti-carcinoembryonic antigen (CEA) (type ZCE 025) monoclonal intact antibody (MoAb) would concentrate in primary lung cancer enabling its detection and localization by scintigraphy. The scintigraphic results were correlated with chest radiograph, computed tomograph (CT), bronchoscopy, surgical resection, and tumor CEA analysis. Twenty adult male patients with clinical suspicion of primary lung cancer were studied. Each subject was infused with 4 to 5 mCi of 111In anti-CEA ZCE 025 MoAb, and planar and tomographic scintiphotos were obtained on days 3 and 6 or 7 postinfusion. The scintigraphy was true-positive in 12 of 16 patients with primary lung cancer, eight of nine patients with squamous cell carcinoma, and four of seven with adenocarcinoma; it was true-negative in three of four patients with benign lung disease with an overall accuracy of 75%. In seven patients with confirmed primary lung cancer, but with negative bronchoscopic findings, the scintigraphy was true-positive in four. In 11 patients with definitely positive or suspicious malignancy by bronchoscopy the monoclonal scintigraphy was positive in eight. In true-positive cases, the location and size of the lesion by 111In anti-CEA ZCE 025 MoAb imaging correlated well with CT findings and also tumor mass at surgery. Only one of 12 tumors stained positive for CEA had serum CEA levels greater than 10 ng/ml, indicating nonleakage of the tumor antigen into general circulation in early lung cancer. It is concluded that 111In anti-CEA ZCE 025 MoAb planar and tomographic imaging shows potential to serve as a noninvasive diagnostic test in the evaluation of primary lung cancer. The lung lesion is likely to be malignant if it concentrates 111In anti-CEA ZCE 025 MoAb and benign if it does not.

  4. (18)F-FDG PET/CT versus bone scintigraphy in the follow-up of gastric cancer.

    PubMed

    Sollini, M; Calabrese, L; Zangheri, B; Erba, P A; Gramaglia, A; Gasparini, M

    2016-01-01

    A 53-year-old patient underwent a positron emission tomography/computed tomography with 2-fluoro-2-deoxy-d-glucose ((18)F-FDG PET/CT) in the suspicious of gastric tumor recurrence (mediastinal and abdominal lymph nodes). PET/CT identified only an area of (18)F-FDGuptake in the twelfth thoracic vertebrae. Unexpectedly, a bone scintigraphy revealed many "hot" spots changing the diagnosis (single metastasis versus plurimetastatic disease) and impacting on patient's management.

  5. Rosai Dorfman disease of the parotid and submandibular glands: salivary gland scintigraphy and oral findings in two siblings.

    PubMed

    Güven, G; Ilgan, S; Altun, C; Gerek, M; Gunhan, O

    2007-10-01

    Rosai-Dorfman disease (RDD) is an unusual clinical entity characterized by benign pseudolymphomatous proliferation with significant histiocytic infiltration. In the present paper, extranodal RDD of the major salivary glands causing salivary hypofunction and the results of salivary gland scintigraphy and ultrasound are presented in two siblings. Case 1: a 10-year-old boy with bilateral painless masses around the parotid and submandibular glands was referred. Ultrasound examination showed bilateral, well-defined, hypoechoic solid mass lesions within both parotid glands with minimal normal parenchyma in the upper poles. Both submandibular glands were markedly hypoechoic and heterogeneous. Mass lesions within the parotid glands appeared as cold lesions with regular contours on scintigraphy. Dynamic images showed normal uptake and normal response to secretion in the upper poles of the parotid glands, corresponding with ultrasonographically normal parenchyma. Both submandibular glands showed markedly diminished uptake and secretion. Case 2: a 9-year-old boy presented with mass lesions around the submandibular glands. Ultrasound examination showed normal parotid glands and markedly hypoechoic and heterogeneous submandibular glands. Salivary gland scintigraphy showed normal uptake and secretion of parotid glands with markedly diminished uptake and secretion in both submandibular glands. There were severe carious lesions in both patients due to salivary hypofunction. Treatments of the two patients' teeth were performed. Major salivary gland involvement of RDD is important for dentists as it may cause xerostomia and can mimic dental abscess. Functional evaluation of salivary glands with scintigraphy, besides radiological and pathological techniques, will help to explain whether salivary glands are affected or not and improve the diagnostic effectiveness.

  6. Distribution of lung blood on modified bilateral Glenn shunt evaluated by Tc-99m-MAA lung perfusion scintigraphy

    PubMed Central

    Si, Biao; Luan, Zhao-sheng; Wang, Tong-jian; Ning, Yan-song; Li, Na; Zhu, Meng; Liu, Zhong-min; Ding, Guang-hong; Qiao, Bin

    2016-01-01

    Abstract The aim of the present study was to determine the distribution of lung blood in a modified bilateral Glenn procedure designed in our institute with lung perfusion scintigraphy. Sixteen consecutive patients who underwent modified bilateral Glenn operation from 2011 to 2014 were enrolled in the study. The control group consisted of 7 patients who underwent bidirectional Glenn shunt. Radionuclide lung perfusion scintigraphy was performed using Tc-99m-macro aggregated albumin (MAA) in all patients. For the patients in modified bilateral Glenn group, the time at which the radioactivity accumulation peaked did not differ significantly between the right and left lung field (t = 0.608, P = 0.554). The incidence of perfusion abnormality in each lung lobe also did not differ significantly (P = 0.426 by Fisher exact test). The radioactive counts were higher in the right lung than in the left lung, but the difference was not statistically significant (t = 1.502, P = 0.157). Radioactive perfusion in the lower lung field was significantly greater than that in the upper field (t = 4.368, P < 0.001). Compared with that in the bidirectional Glenn group, the ratio of radioactivity in the right lung to that in left lung was significantly lower in the modified bilateral Glenn group (t = 3.686, P = 0.002). Lung perfusion scintigraphy confirmed the benefit of the modified bilateral Glenn shunt with regard to more balanced blood perfusion in both lungs. PMID:27661042

  7. Determination of inflammation of reflex sympathetic dystrophy at early stages with Tc-99m HIG scintigraphy: preliminary results.

    PubMed

    Okudan, Berna; Celik, Canan

    2006-03-01

    The pathogenesis of reflex sympathetic dystrophy (RSD) is not completely understood. However, an excessive regional inflammation, sensitization of primary somatosensory afferents, and sensitization of spinal neurons are considered to have a role in the pathogenesis of RSD. The underlying pathophysiology relating the clinical picture may help to determine the pharmacotherapeutic approach for an individual patient. Scintigraphy using radiolabelled human polyclonal non-specific immunoglobulin (HIG) has been recognized as a useful tool for the localization of inflammatory disorders. Thirty-six consecutive RSD patients associated with hemiplegia were included in this study. All the patients in this study had three phases bone scan and Tc-99m HIG scintigraphy. On admission, of 36 patients with positive bone scan, 30 had positive Tc-99m HIG scan. All the patients were symptomatic at the time of bone scanning. On the contrary, 24 out of 36 patients subsequently became asymptomatic at an 8-month re-evaluation period. Tc-99m HIG scintigraphy is a non-invasive complementary method for the determination of ongoing inflammatory reactions which also aids the clinicians to predict the response to anti-inflammatory therapy at the very early phase of RSD associated with hemiplegia. This preliminary study may be a source of inspiration for further studies with larger series and longer follow-up .

  8. 99mTc-HMPAO leucocyte scintigraphy fails to detect Crohn's disease in the proximal gastrointestinal tract

    PubMed Central

    Davison, S; Chapman, S; Murphy, M

    2001-01-01

    OBJECTIVE—To investigate the use of 99mTc-HMPAO (hexamethyl propylene amine oxime) leucocyte scintigraphy as a non-invasive screening test for inflammatory bowel disease.
PATIENTS—10 children with suspected Crohn's disease, in whom routine investigation using barium contrast radiology, upper gastrointestinal endoscopy, colonoscopy, and mucosal biopsies had identified severe gastroduodenal and/or jejunal involvement.
DESIGN—99mTc-HMPAO leucocyte scintigraphic studies performed in each of these cases were assessed by a radiologist who was blinded to the disease distribution.
RESULTS—In nine cases there was no scintigraphic evidence of inflammation in the proximal gastrointestinal tract. The 10th child had both gastroduodenal and jejunal involvement, but scintigraphy only revealed faint jejunal positivity.
CONCLUSIONS—99mTc-HMPAO leucocyte scintigraphy should not be depended upon as a screening test for Crohn's disease. False negative results are likely in cases with Crohn's disease confined to the proximal gastrointestinal tract.

 PMID:11420197

  9. High protracted (99m)Tc-HDP uptake in synthetic bone implants - a potentially misleading incidental finding on bone scintigraphy.

    PubMed

    Tabouret-Viaud, Claire; Mainta, Ismini; Boudabbous, Sana; Amzalag, Gaël; Ratib, Osman; Rager, Olivier; Paycha, Frédéric

    2014-12-01

    We report the case of a 56-year-old male with bilateral total knee prostheses suffering from bilateral knee pain mainly on the right side and referred for bone scintigraphy. The medical history of the patient revealed an opening wedge high tibial osteotomy performed nine years earlier, with insertion of two blocks of ceramic made of hydroxyapatite and tricalcium phosphate in a wedge configuration as synthetic bone substitutes. The porous structure of these implants is analogous to the architecture of cancellous bone and permits fibrovascular and bone ingrowth, promoting the healing process. Planar scintigraphy and SPECT/CT showed an intense uptake within those implants in the early phase as well as in the late phase of the bone scan. It also showed bilateral patellofemoral arthritis. A (99m)Tc-labeled antigranulocyte antibody scintigraphy was negative for infection or inflammation. Bilateral patellar resurfacing led to complete symptom regression, confirmed at 10 months follow-up. To the best of our knowledge, this scintigraphic pattern with such a high tracer uptake reflecting bone substitute osteointegration has not yet been published. This should be considered in patients with such bone replacement materials that are increasingly used, in order to avoid false diagnosis of inflammation or infection.

  10. Potential Pitfalls on the (99m)Tc-Mebrofenin Hepatobiliary Scintigraphy in a Patient with Biliary Atresia Splenic Malformation Syndrome.

    PubMed

    Maestri Brittain, Jane; Borgwardt, Lise

    2016-01-01

    Biliary atresia (BA) is an obliterative cholangiopathy affecting 1:10.000-14.000 of newborns. Infants with Biliary Atresia Splenic Malformation syndrome (BASM) are a subgroup of BA patients with additional congenital anomalies. Untreated the disease will result in fatal liver failure within the first years of life. Kasai portoenterostomy restores bile flow and delay the progressive liver damage thereby postponing liver transplantation. An early diagnosis is of most importance to ensure the effectiveness of the operation. The (99m)Tc-Mebrofenin hepatobiliary scintigraphy is part of the diagnostic strategy when an infant presents jaundice due to conjugated hyperbilirubinemia (>20 µmol/L total bilirubin of which 20% is conjugated) with its high sensitivity of 97%-100% in refuting BA. Rapid extraction of tracer by the liver and no visible tracer in the small bowl after 24 h is indicative of BA. Laparotomy with antegrade cholangiography is then performed giving the final diagnosis when the remains of the obliterated biliary tree are revealed in the case of BA. We present a case demonstrating some of the challenges of interpreting the (99m)Tc-Mebrofenin hepatobiliary scintigraphy in an infant with BASM and stress the importance that the (99m)Tc-Mebrofenin hepatobiliary scintigraphy is part of a spectrum of imaging modalities in diagnosing BA. PMID:26838802

  11. Predictive value of quantitative dipyridamole-thallium scintigraphy in assessing cardiovascular risk after vascular surgery in diabetes mellitus

    SciTech Connect

    Lane, S.E.; Lewis, S.M.; Pippin, J.J.; Kosinski, E.J.; Campbell, D.; Nesto, R.W.; Hill, T. )

    1989-12-01

    Cardiac complications represent a major risk to patients undergoing vascular surgery. Diabetic patients may be particularly prone to such complications due to the high incidence of concomitant coronary artery disease, the severity of which may be clinically unrecognized. Attempts to stratify groups by clinical criteria have been useful but lack the predictive value of currently used noninvasive techniques such as dipyridamole-thallium scintigraphy. One hundred one diabetic patients were evaluated with dipyridamole-thallium scintigraphy before undergoing vascular surgery. The incidence of thallium abnormalities was high (80%) and did not correlate with clinical markers of coronary disease. Even in a subgroup of patients with no overt clinical evidence of underlying heart disease, thallium abnormalities were present in 59%. Cardiovascular complications, however, occurred in only 11% of all patients. Statistically significant prediction of risk was not achieved with simple assessment of thallium results as normal or abnormal. Quantification of total number of reversible defects, as well as assessment of ischemia in the distribution of the left anterior descending coronary artery was required for optimum predictive accuracy. The prevalence of dipyridamole-thallium abnormalities in a diabetic population is much higher than that reported in nondiabetic patients and cannot be predicted by usual clinical indicators of heart disease. In addition, cardiovascular risk of vascular surgery can be optimally assessed by quantitative analysis of dipyridamole-thallium scintigraphy and identification of high- and low-risk subgroups.

  12. Parathyroid imaging with pertechnetate plus perchlorate/MIBI subtraction scintigraphy: a fast and effective technique.

    PubMed

    Rubello, D; Saladini, G; Casara, D; Borsato, N; Toniato, A; Piotto, A; Bernante, P; Pelizzo, M R

    2000-07-01

    We set up a modified technetium-99m (Tc-99m) pertechnetate/Tc-99m MIBI (Tc-MIBI) subtraction scintigraphy for parathyroid imaging by introducing the use of potassium perchlorate (KCLO4). Initially, the effect of KCLO4 on technetium thyroid wash-out was evaluated in five healthy volunteers: 40-minute dynamic studies of the thyroid were obtained 20 minutes after the injection of technetium 150 MBq (4 mCi), both in baseline conditions and after the oral administration of 400 mg KCLO4. After an average latency time of 10.5 minutes, KCLO4 administration resulted in fast and relevant technetium thyroid wash-out with a mean half-time of 16.2 minutes (the half-time was 142.8 minutes in baseline conditions), and a 40-minute reduction of thyroid activity of 78% (it was 14% in baseline conditions). Based on these findings, a new Tc-MIBI subtraction procedure was established as follows: 1) 150 MBq technetium (4 mCi) injection; 2) 400 mg KCLO4 administered orally; 3) patient neck immobilization; 4) acquisition of a 5-minute technetium thyroid scan; 5) 500 MBq MIBI (13.5 mCi) injection; 6) acquisition of a sequence of seven MIBI images, each lasting 5 minutes; and 7) processing (image realignment when necessary, background subtraction, normalization of MIBI images to the maximum pixel count of the technetium image, and subtraction of the technetium image from the MIBI images). In addition, high-resolution neck ultrasound (US) was performed in all cases on the same day as the scintigraphic evaluation. Eighteen consecutive patients with primary hyperparathyroidism were enrolled in the study. Tc-MIBI scintigraphy revealed a single adenoma in all cases and US showed this finding in 15 of 18 cases (83.3%). Furthermore, in three patients, a thyroid nodule associated with hyperparathyroidism was detected by technetium thyroid scans and neck US. In all patients, the parathyroid adenoma was easily identified on both the 20- to 40-minute MIBI and subtracted (MIBI-Tc) images. Regarding the

  13. An Experimental Comparison of Two Different Technetium Source Activities Which Can Imitate Thyroid Scintigraphy in Case of Thyroid Toxic Nodule

    PubMed Central

    Miftari, Ramë; Fejza, Ferki; Bicaj, Xhavit; Nura, Adem; Topciu, Valdete; Bajrami, Ismet

    2014-01-01

    Purpose: In cases of thyroid toxic autonomous nodule, anterior projection of Tc-99m pertechnetate image shows a hot nodule that occupies most, or the entire thyroid lobe with near-total or total suppression of the contra lateral lobe. In this case is very difficult to distinguish toxic nodule from lobe agenesis. Our interest was to estimate and determinate the rate of radioactivity when the source with high activity can make total suppression of the second source with low activity in same conditions with thyroid scintigraphy procedures. Material and methodology: Thyroid scintigraphy was performed with Technetium 99 meta stable pertechnetate. A parallel high resolution low energy collimator was used as an energy setting of 140 KeV photo peak for T-99m. Images are acquired at 200 Kilo Counts in the anterior projection with the collimator positioned as close as the patient’s extended neck (approximately in distance of 18 cm). The scintigraphy of thyroid gland was performed 15 minutes after intravenous administration of 1.5 mCi Tc-99m pertechnetate. Technetium 99 meta stable radioactive sources with different activity were used for two scintigraphies studies, performed in same thyroid scintigraphy acquisition procedures. In the first study, were compared the standard source with high activity A=11.2 mCi with sources with variable activities B=1.33 mCi; 1.03 mCi; 0.7 mCi; 0.36 mCi; and 0.16mCi) in distance of 1.5cm from each other sources, which is approximately same with distance between two thyroid lobes. In the second study were compared the sources with low activity in proportion 70:1(source A = 1.5 mCi and source B=0.021mCi). As clinical studies we preferred two different patents with different thyroid disorders. There were one patient with thyroid toxic nodule in the right lobe, therefore the second patient was with left thyroid nodule agenesis. Results: During our examination, we accurately determined that two radioactive sources in proportion 70:1 will be

  14. [Planar scintigraphy versus PET in measuring fatty acid metabolism of the heart].

    PubMed

    Kaiser, K P; Feinendegen, L E

    1987-02-01

    In addition to radionuclide ventriculography and thallium scintigraphy, already well established in nuclear medicine, assessment of myocardial metabolism is also of interest for diagnosis and follow-up observations in heart disease. Under aerobic conditions and in the fasting state, the heart muscle primarily oxidizes fatty acids; during ischemia, in contrast, there is slowing of fatty acid turnover and increased anaerobic glycolysis. With 11C-palmitic acid, in humans, reduced fatty acid uptake has been documented in infarcted myocardial regions. The analysis of 11C-palmitic acid in dogs showed a three-phased elimination curve in normal myocardium. In ischemic myocardium, there was diminished utilization of free fatty acids and the glucose utilization was concomitantly increased. After insulin-glucose infusion, as well, there was increased glucose utilization and a reduction in fatty acid utilization. Studies with 11C-palmitic acid require the equipment for positron emission tomography (PET); because of the short half-life of 20.3 minutes, the nuclide must be generated by a cyclotron in the immediate vicinity. In the search for well-suited isotopes for use in planar scintigraphy employing a gamma camera, the uptake and elimination of a variety of isotopically-marked fatty acids were measured and compared with the characteristics of 14C-palmitic acid. For 17-123I-heptadecanic acid (IHA) the elimination curve was similar to that of 14C-palmitate: disadvantage, however, was the relatively high percentage of water soluble marked catabolites which required dual parameter analysis by means of 99-m-technetium pertechnetate or 123I sodium iodide to quantify the amount of myocardial fatty acid utilization through subtraction of the externally measured water soluble catabolite from the externally measured total activity. In studies with the gamma camera in fasting patients in whom 2 to 3 mCi IHA was injected intravenously after symptom limited bicycle ergometry, in healthy

  15. Whole body MR imaging: applications in oncology.

    PubMed

    Johnston, C; Brennan, S; Ford, S; Eustace, S

    2006-04-01

    This article reviews technique and clinical applications of whole body MR imaging as a diagnostic tool in cancer staging. In particular the article reviews its role as an alternative to scintigraphy (bone scan and PET) in staging skeletal spread of disease, its role in assessing total tumour burden, its role in multiple myeloma and finally its evolving non oncologic role predominantly assessing total body composition.

  16. Diagnosis of osteomyelitis of the foot in diabetic patients: Value of 111In-leukocyte scintigraphy

    SciTech Connect

    Larcos, G.; Brown, M.L.; Sutton, R.T. )

    1991-09-01

    The noninvasive diagnosis of osteomyelitis of the foot in diabetic patients with currently available radiologic and radionuclide imaging techniques is often difficult. Recently, 111In-labeled leukocyte scintigraphy has been proposed as an attractive alternative. Accordingly, the authors retrospectively reviewed 51 111In-labeled leukocyte scans, 49 technetium-99m bone scans, and 49 plain radiographs obtained in 51 adults with diabetes in whom osteomyelitis of the foot was suspected. The sensitivity and specificity of these techniques were evaluated in all patients, as well as in a subgroup of 11 patients with neuroarthropathy. Results with 111In-labeled leukocyte scans were also examined in subsets of patients with soft-tissue ulcers (n = 35) and those receiving antibiotics during investigation (n = 20). Confirmation or exclusion of osteomyelitis was made surgically in 28 patients and clinically in 23. Fourteen patients had osteomyelitis. Bone scans were most sensitive (93%) but least specific (43%); plain radiographs were most specific (83%) but least sensitive (43%). 111In-labeled leukocyte scans were both sensitive (79%) and specific (78%), and remained useful in patients with neuroarthropathy, soft-tissue ulcers, and antibiotic treatment. Poor spatial resolution contributed to the false-negative and false-positive 111In-labeled leukocyte scans, suggesting that this technique should not be interpreted independent of other tests. 111In-labeled leukocyte scans are a valuable diagnostic tool for the diagnosis of pedal osteomyelitis in diabetic patients.

  17. Indium-111-granulocyte scintigraphy in brain abscess diagnosis: Limitations and pitfalls

    SciTech Connect

    Schmidt, K.G.; Rasmussen, J.W.; Frederiksen, P.B.; Kock-Jensen, C.; Pedersen, N.T. )

    1990-07-01

    The scintigrams and records of 28 patients referred for indium-111-granulocyte scintigraphy (111In-GS) because of a suspected brain abscess were studied retrospectively. The final diagnosis was brain abscess in 8 patients, brain tumor in 18 patients, and infarct and hematoma in 1 patient each. Five patients not on corticosteroid treatment showed intense focal 111In accumulation in abscesses, whereas an abscess patient receiving a high steroid dose showed no uptake. Two patients studied twice showed intense uptake in abscesses when not on steroid therapy or on a low dose, whereas no uptake was seen when they received high or medium doses. Weak or moderate 111In uptake was observed in nine tumors. Microscopically assessed degree of tumor granulocyte infiltration, vessel proliferation, and hemorrhage did not correlate with the outcome of 111In GS. Our results suggest that intense focal cerebral 111In uptake favors the abscess diagnosis. Abscesses may go undetected, however, in patients on high- or medium-dose steroid therapy.

  18. [3-phase scintigraphy in the Sudeck syndrome. Comparison with the results of roentgenologic and clinical studies].

    PubMed

    Koppers, B

    1982-11-01

    37 patients with clinically and radiologically proved reflex sympathetic dystrophy syndrome were scintigraphed by 99mTc-MDP (three-phase-scintigraphy). In 87% of the examinations (all three-phases) an increased tracer accumulation in the region of the affected limb could be seen scintigraphically. The majority of the positive results (92% resp. 87%) were found in the interval phase (phase II) and the late phase (phase III) of the scintigraphic examinations.--We recommend a staging of the increase of the tracer accumulation when examining the reflex sympathetic dystrophy syndrome. This staging doesn't significantly correlate with the familiar clinical and radiological stagings. However it may be useful when assessing the course of the syndrome.--Increased tracer accumulations could be observed in the case of clinically, radiologically and scintigraphically manifest reflex sympathetic dystrophy syndrome in the region of the foot, frequently in the ipsilateral knee region, rarely in the ipsilateral hip joint region, although clinically the syndrome could not be observed in these regions. PMID:6184293

  19. The use of indium-111 oxine platelet scintigraphy and survival studies in pediatric patients with thrombocytopenia

    SciTech Connect

    Castle, V.P.; Shulkin, B.L.; Coates, G.; Andrew, M. )

    1989-11-01

    We have utilized {sup 111}In-labeled heterologous platelets to investigate the mechanism of thrombocytopenia in ten children. From the scintigraphic findings, platelet survival times, and clinical information, thrombocytopenia was ascribed to decreased production or to increased destruction. Two patients were found to have bone marrow production defects. Two patients with hemangiomas were studied. In one, the hemangioma was shown not to be the cause of thrombocytopenia. In the second, the hemangioma was proven the source of platelet destruction, but was much more extensive than clinically evident. In both, surgical manipulation of the hemangioma was avoided. Six additional patients had thrombocytopenia due to accelerated destruction. In four, the spleen was shown responsible. In two, however, the spleen was shown not to be responsible for the low platelet counts, and splenectomy was avoided. Thus, {sup 111}In-platelet scintigraphy and survival studies are valuable in the classification and management of childhood thrombocytopenia. We believe that this study should be performed, when possible, in any child with thrombocytopenia where the mechanism is unclear or the therapeutic intervention involves splenectomy or resection of a hemangioma.

  20. Pinhole collimator scintigraphy in differential diagnosis of metastasis, fracture, and infections of the spine

    SciTech Connect

    Bahk, Y.W.; Kim, O.H.; Chung, S.K.

    1987-04-01

    The informational gains obtained by the use of pinhole collimator scintigraphy (PCS) have been well documented. The present study has been undertaken to prospectively investigate its efficacy in diagnosing several commonly occurring spinal diseases. Patient material consisted of metastatic cancer (39 vertebrae), compression fractures (33 vertebrae), tuberculous spondylitis (17 vertebrae), and pyogenic spondylitis (six vertebrae). PCS findings were characterized in terms of localization, appearance, and homogeneity of abnormal radionuclide accumulation. Thus, metastatic cancer manifested as diffusely or focally homogeneous accumulation within the vertebral body or as a typical short-segmental accumulation along the end-plate, whereas compression fracture manifested as characteristic board-like accumulation along the entire length of end-plates. Tuberculous spondylitis, on the other hand, revealed homogeneous accumulation throughout the vertebral body, and pyogenic spondylitis revealed accumulation at the end-zone of opposing vertebral bodies giving sandwich-like appearance. The disk space at the affected level was not narrowed in the former two diseases but it was narrowed in the latter two. It was concluded that PCS may be useful in differentiating metastatic cancer, compression fracture, tuberculous spondylitis, and pyogenic spondylitis.

  1. Scintigraphy and Doppler ultrasonography for the evaluation of obstructive urinary calculi.

    PubMed

    Gandolpho, L; Sevillano, M; Barbieri, A; Ajzen, S; Schor, N; Ortiz, V; Heilberg, I P

    2001-06-01

    Forty-seven patients with unilateral obstructive calculi (12 males and 35 females) were submitted to 99mTc-diethylene triamine pentaacetic acid (DTPA) or 99mTc-dimercaptosuccinic acid (DMSA) scans for assessment of renal function. The scans revealed unilateral functional deficit in 68 and 66% of the patients, respectively. A calculus size of 1.1 to 2.0 cm was significantly associated with deficit detected by DTPA, but duration of obstruction and calculus localization were not. After relief of the obstruction, the mean percent renal function of the affected kidney was found to be significantly increased from 25 +/- 12% to 29 +/- 12% in DTPA and from 21 +/- 15% to 24 +/- 12% in DMSA. Initial Doppler ultrasonography performed in 35 patients detected an increased resistive index in 10 (29%). In the remaining patients with a normal resistive index, ureteral urinary jet was observed, indicating partial obstruction. The high frequency of renal function impairment detected by DTPA and of tubulointerstitial damage detected by DMSA as well as the slight amelioration of unilateral renal function after relief of obstruction suggest that scintigraphy assessment may help evaluate the unilateral percentage of renal function and monitor renal function recovery when it occurs. The presence of a urinary jet detected by Doppler ultrasonography further indicates the severity of obstruction and the recovery prognosis. PMID:11378662

  2. Diagnosis of pulmonary embolism: ventilation perfusion scintigraphy versus helical computed tomography pulmonary angiography.

    PubMed

    Macdonald, W B G; Patrikeos, A P; Thompson, R I; Adler, B D; van der Schaaf, A A

    2005-02-01

    The present study compared the accuracy of ventilation perfusion scintigraphy (VQS) and CT pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism. This was a prospective observational study of 112 patients with suspected pulmonary embolism (PE) who could be studied with both investigations within 24 h. Results were compared to final diagnosis at completion of 6-month follow up, using receiver operating characteristic (ROC) analysis. Pulmonary embolism was diagnosed in 27 referred patients (24%). The sensitivity and specificity of VQS and CTPA were similar to that reported from the literature. A normal VQ scan had the highest negative predictive value (100%), while a high-probability VQ scan had the highest positive predictive value (92%). There was no overall difference (area under the ROC curve (AUC)) between VQS (AUC (95% CI) = 0.82 (0.75,0.89)) and CTPA (AUC = 0.88 (0.81,0.94)) for the diagnosis of PE. Among patients with abnormal chest X-rays, CTPA (AUC 0.90 (0.83,0.97)) appeared somewhat better than VQS (AUC 0.78 (0.68,0.88)) but this difference did not reach statistical significance. In this instance, CTPA is at least as accurate as VQS and may provide an opportunity to make alternative diagnoses.

  3. Clinical studies on diabetic myocardial disease using exercise testing with myocardial scintigraphy and endomyocardial biopsy

    SciTech Connect

    Genda, A.; Mizuno, S.; Nunoda, S.; Nakayama, A.; Igarashi, Y.; Sugihara, N.; Namura, M.; Takeda, R.; Bunko, H.; Hisada, K.

    1986-08-01

    Nine diabetics without significant coronary stenosis participated in an exercise testing protocol with thallium-201 myocardial scintigraphy. Endomyocardial biopsy of right ventricle was also obtained. There were 4 patients with abnormal perfusion (positive group) and 5 patients with normal perfusion (negative group). All cases of the positive group were familial diabetics and there was only one case of dietary treatment, whereas in the negative group, there were only 2 cases of familial diabetics and 3 cases receiving dietary treatment. No statistical differences between the positive and negative groups were observed for the data of exercise performance and hemodynamic parameters in cardiac catheterization at rest. However, the mean ejection fraction in the positive group (62 +/- 13%) was significantly lower than in the negative group (77 +/- 4%). In both groups, the mean diameter of myocardial cells and the mean percent fibrosis of biopsy specimens showed significant increases compared with the control group. The mean percent fibrosis in the positive group (24.1 +/- 8.5%) compared with that in the negative group (16.5 +/- 5.9%) showed a tendency to increase. It is suggested that the abnormal perfusion of thallium-201 in the positive group indicates subclinically a pathological change of microcirculation caused by diabetes mellitus.

  4. The potential of myocardial perfusion scintigraphy for risk stratification of asymptomatic patients with type 2 diabetes.

    PubMed

    Bax, Jeroen J; Bonow, Robert O; Tschöpe, Diethelm; Inzucchi, Silvio E; Barrett, Eugene

    2006-08-15

    Patients with diabetes, in particular patients with type 2 diabetes, are at a 2- to 4-fold higher risk of cardiovascular mortality compared with their nondiabetic peers. Patients with diabetes are also more likely to have silent ischemia and less likely to survive a myocardial infarction than nondiabetic patients. Recent studies with electron beam computed tomography (EBCT) have shown that subclinical atherosclerosis is common in patients with diabetes, and studies with myocardial perfusion scintigraphy (with single-photon emission computed tomography) or stress echocardiography have demonstrated that between 25% and 50% of asymptomatic diabetic patients have ischemia during exercise or pharmacological stress and that a substantial proportion of these patients go on to develop major cardiovascular events within several years. Clearly, asymptomatic diabetic patients include a subset of individuals at high risk of cardiovascular disease who would benefit from improved risk stratification beyond that possible with risk factor scoring systems alone. Single-photon emission computed tomography, stress echocardiography, and possibly EBCT or multi-slice computed tomography, are emerging as valuable diagnostic tools for identifying asymptomatic diabetic patients who might require early and aggressive intervention to manage their cardiovascular risk. PMID:16904545

  5. Regional distribution of ventilation assessed by Kr-81m scintigraphy employing temporal Fourier transform

    SciTech Connect

    Slosman, D.; Susskind, H.; Cinotti, L.; van Giessen, J.W.; Brill, A.B.

    1986-01-01

    Temporal Fourier analysis was applied to Kr-81m ventilation scintigraphy to determine the amplitude (AMP1) and phase (PHA1) of the first harmonic of a single composite respiratory cycle and to compare regional patterns in subjects with obstructive pulmonary disease (COPD) and nonobstructed subjects. Six nonobstructed subjects, three subjects with small airway disease, six subjects with COPD, and one subject with restrictive disease were investigated. The mean value of the functional PHA1 image (PHA1m) correlated negatively with 1-second forced expiratory volume (FEV1) (r = -0.801, P less than .001), with %FEV1/FVC (r = -0.636, P less than .01) and maximum midexpiratory flow rate (FEF25-75%) (r = -0.723, P less than .002), and correlated positively with residual volume (r = 0.640, P less than .01). PHA1m values for the six subjects with COPD were significantly higher (t = 2.359, P less than .05) than for the ten nonobstructed subjects. Display of phase and amplitude functional images permits a visual evaluation of the regional distribution of ventilation to be made. Regional abnormalities of air flow were detected in obstructed subjects, and the presence of airway obstruction could be predicted. Dynamic ventilation imaging, therefore, appears to be a potentially useful noninvasive technique to assess lung impairment on a localized level.

  6. Sensitivity of technetium-99m-pyrophosphate scintigraphy in diagnosing cardiac amyloidosis

    SciTech Connect

    Falk, R.H.; Lee, V.W.; Rubinow, A.; Hood, W.B. Jr.; Cohen, A.S.

    1983-03-01

    To determine the value of technetium-99m-pyrophosphate myocardial scintigraphy in the diagnosis of amyloid heart disease this procedure was prospectively performed in 20 consecutive patients with biopsy-proven primary amyloidosis. Eleven patients had echocardiographic abnormalities compatible with amyloid cardiomyopathy, 9 of whom had congestive heart failure. Diffuse myocardial pyrophosphate uptake was of equal or greater intensity than that of the ribs in 9 of the 11 patients with echocardiograms suggestive of amyloidosis, but in only 2 of the 9 with normal echocardiograms, despite abnormal electrocardiograms (p less than 0.01). Increased wall thickness measured by M-mode echocardiography correlated with myocardial pyrophosphate uptake (r . 0.68, p less than 0.01). None of 10 control patients with nonamyloid, nonischemic heart disease had a strongly positive myocardial pyrophosphate uptake. Thus, myocardial technetium-99m-pyrophosphate scanning is a sensitive and specific test for the diagnosis of cardiac amyloidosis in patients with congestive heart failure of obscure origin. It does not appear to be of value for the early detection of cardiac involvement in patients with known primary amyloidosis without echocardiographic abnormalities.

  7. Portosystemic shunting in portal hypertension: evaluation with portal scintigraphy with transrectally administered I-123 IMP

    SciTech Connect

    Kashiwagi, T.; Azuma, M.; Ikawa, T.; Takehara, T.; Matsuda, H.; Yoshioka, H.; Mitsutani, N.; Koizumi, T.; Kimura, K.

    1988-10-01

    Portosystemic shunting was evaluated with rectal administration of iodine-123 iodoamphetamine (IMP) in seven patients without liver disease and 53 patients with liver cirrhosis. IMP (2-3 mCi (74-111 MBq)) was administered to the rectum through a catheter. Images of the chest and abdomen were obtained for up to 60 minutes with a scintillation camera interfaced with a computer. In all patients, images of the liver and/or lungs were observed within 5-10 minutes and became clear with time. In patients without liver disease, only liver images could be obtained, whereas the lung was visualized with or without the liver in all patients with liver cirrhosis. The portosystemic shunt index was calculated by dividing counts of lungs by counts of liver and lung. These values were significantly higher in liver cirrhosis, especially in the decompensated stage. Transrectal portal scintigraphy with IMP appears to be a useful method for noninvasive and quantitative evaluation of portosystemic shunting in portal hypertension.

  8. Gastrointestinal behavior of orally administered radiolabeled erythromycin pellets in man as determined by gamma scintigraphy

    SciTech Connect

    Digenis, G.A.; Sandefer, E.P.; Parr, A.F.; Beihn, R.; McClain, C.; Scheinthal, B.M.; Ghebre-Sellassie, I.; Iyer, U.; Nesbitt, R.U.; Randinitis, E. )

    1990-07-01

    The behavior of single 250-mg doses of a multiparticulate form of erythromycin base (ERYC(R)), each including five pellets radiolabeled with neutron-activated samarium-153, was observed by gamma scintigraphy in seven male subjects under fasting and nonfasting conditions. The residence time and locus of radiolabeled pellets within regions of the gastrointestinal tract were determined and were correlated with plasma concentrations of erythromycin at coincident time points. Administration of food 30 minutes postdosing reduced fasting plasma erythromycin Cmax and area under the plasma erythromycin versus time curve (AUC) values by 43% and 54%, respectively. Mean peak plasma concentration of erythromycin (Cmax) in the fasting state was 1.64 micrograms/mL versus 0.94 micrograms/mL in the nonfasting state. Total oral bioavailability, as determined by mean AUC (0-infinity) of the plasma erythromycin concentration versus time curve, was 7.6 hr/micrograms/mL in the fasted state, versus 3.5 hr/micrograms/mL in the nonfasting state. Mean time to peak plasma erythromycin concentration (tmax) in the fasting state was 3.3 hours, versus 2.3 hours in the nonfasting state. Plasma concentrations of erythromycin in both fasting and nonfasting states were within acceptable therapeutic ranges.

  9. Dipyridamole-thallium-201 scintigraphy in the prediction of future cardiac events after acute myocardial infarction

    SciTech Connect

    Leppo, J.A.; O'Brien, J.; Rothendler, J.A.; Getchell, J.D.; Lee, V.W.

    1984-04-19

    To evaluate the safety and usefulness of serial thallium scanning immediately after intravenous dipyridamole, we studied 51 patients recovering from acute myocardial infarction. Eight patients experienced angina during the procedure, but there were no serious complications. Patients were followed for a mean period of 19 months after hospital discharge. Eleven of 12 patients who died during follow-up or had another infarction had shown transient defects (redistribution) on their predischarge scan, as had 22 of the 24 patients who needed readmission for management of angina. Among all the other clinical or scintigraphic criteria tested, the presence of redistribution on the dipyridamole-thallium scan was the only significant predictor of these serious cardiac events. Twenty-six patients were also given a submaximal exercise test before discharge, of whom 13 subsequently had serious cardiac events. The exercise test had been positive in only 6 of these 13 patients, whereas the dipyridamole-thallium scan had shown a redistribution pattern in 12 (P less than 0.001). We conclude from this preliminary study that dipyridamole-thallium scintigraphy after myocardial infraction is relatively safe. It appears to be a more sensitive predictor of subsequent cardiac events than a submaximal exercise test and may therefore prove useful in evaluating patients after recovery from a myocardial infarction.

  10. Radiographic and radionuclide imaging in multiple myeloma: the role of gallium scintigraphy: concise communication

    SciTech Connect

    Waxman, A.D.; Siemsen, J.K.; Levine, A.M.; Holdorf, D.; Suzuki, R.; Singer, F.R.; Bateman, J.

    1981-03-01

    Eighteen patients with multiple myeloma were studied using radiographs of the skeletal system, technetium phosphate bone scans, and gallium-67 scintigraphy. A total of 94 sites were used as the basis for comparison in these 18 patients. Radiographic sensitivity on a patient basis was 94%, and was 82% on a site basis. Bone scans were positive in 78% of patients and in 46% of sites. Gallium scans were positive in 56% of patients and in 40% of sites. In five of the 18 patients, gallium scans showed activity in abnormal sites wth a greater lesion-to-nonlesion ratio than did the bone scan. In this subgroup of patients, the disease was fulminant, and all died within 3 mo of their study. The finding of high gallium uptake in osseous sites that are normal or only slightly abnormal on bone scan has served to identify a subgroup of patients with rapidly progressive disease who may benefit from alternative treatment modalities such as radiation therapy.

  11. Bone scintigraphy in the management of X-ray-negative potential scaphoid fractures.

    PubMed Central

    Wilson, A W; Kurer, M H; Peggington, J L; Grant, D S; Kirk, C C

    1986-01-01

    One hundred and eleven patients with signs and symptoms of carpal scaphoid injury, but with no fracture visible on X-ray, underwent bone scintigraphy of the wrists. The first 42 patients were re-X-rayed 10 days after injury: bone scanning had identified all fractures confirmed on this X-ray; there were no false negative bone scans. Sixty-seven patients (60%) did not have increased focal uptake over the scaphoid or distal radius, and were mobilised immediately. None of these had a fracture at follow up. Twenty-nine patients with increased uptake over the scaphoid area (26%) remained in plaster of Paris for 6 weeks. All of these had clinical signs of a scaphoid injury. Bone scanning is a practical investigation for all X-ray-negative potential scaphoid injuries, and is acceptable to patient and clinician. In the presence of a normal scan, the practice of re-X-raying patients 10 days after injury may be abandoned. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:3801112

  12. A pilot study evaluating 99mTc-anti-TNF-alpha scintigraphy in graves' ophtalmopathy patients with different clinical activity score.

    PubMed

    Rebelo Pinto, E dos S; Lopes, F P P L; de Souza, S A L; da Fonseca, L M B; Vaisman, M; Gutfilen, B; dos Santos Teixeira, P de F

    2013-09-01

    The present study describes the preliminary results of the use of 99mTc-anti-TNF-α scintigraphy as a new diagnostic approach to evaluate patients presenting with Graves' ophthalmopathy (GO). Patients (n=25) presenting at different inflammatory stages of GO and 10 healthy volunteers underwent 99mTc-anti-TNF-α scintigraphy. Images were obtained 15 min after the intravenous injection of 370 MBq (10 mCi) 99mTc-anti-TNF-α. Planar images were obtained in a 256×256 matrix (each lasting 5 min) and single photon emission computed tomography (SPECT) scan lasting 13 min. Regions of interest (ROI) were drawn on the orbit and cerebral hemispheres. The uptake of 99m Tc-anti-TNF-α in these regions was compared and positive scintigraphy established when the ROI was >2.5. In addition, uptake for each positive exam was scored as either slight (2.6-5.1), moderate (5.2-7.6), or high (>7.6). In this pilot study, 69 orbits were evaluated (1 patient had only 1 eye), and 27 had a positive CAS (≥3/7). Scintigraphies were positive in 38 orbits. Comparing the results of the exams with CAS, a high sensitivity and negative predictive values were determined for scintigraphy (96.3% and 96.7%, respectively). However, the specificity and the positive predictive values were 71.4% and 68.4%, respectively, with an accuracy of 81.2%. The exclusion of examinations that were slightly positive from the analysis resulted in an improvement in test accuracy (95.5%). The preliminary results suggest that 99mTc-anti-TNF-α scintigraphy is a promising procedure for the evaluation of active orbital inflammation in GO. PMID:23918686

  13. Diagnosis of sclerosing cholangitis with technetium 99m-labeled iminodiacetic acid planar and single photon emission computed tomographic scintigraphy

    SciTech Connect

    Rodman, C.A.; Keeffe, E.B.; Lieberman, D.A.; Krishnamurthy, S.; Krishnamurthy, G.T.; Gilbert, S.; Eklem, M.J.

    1987-03-01

    The purpose of this study was to determine whether /sup 99m/Tc-iminodiacetic acid planar biliary scintigraphy combined with single photon emission computed tomography could detect sclerosing cholangitis and provide additional information regarding the extent and severity of disease. Thirteen patients with sclerosing cholangitis and 13 normal control subjects were studied. Scintigraphic results were also compared with previously reported studies of patients with isolated common bile duct obstruction and with primary biliary cirrhosis. The planar scintigraphy in patients with sclerosing cholangitis showed beading or bandlike constrictions of the biliary tract corresponding to lesions seen on cholangiography, and the image pattern was distinctly different from images obtained from patients with isolated common bile duct obstruction or primary biliary cirrhosis. The single photon emission computed tomography images of the liver in patients with sclerosing cholangitis demonstrated multiple focal areas of /sup 99m/Tc-iminodiacetic acid retention, representing bile stasis in intrahepatic bile ducts. Compared to controls, the mean hepatic clearance half-time of /sup 99m/Tc-iminodiacetic acid was markedly delayed in patients with sclerosing cholangitis (6-10 times normal). Individual patients with sclerosing cholangitis had wider variation in isotope clearance half-time from three regions of the liver than patients with isolated common bile duct obstruction, consistent with regional difference in disease severity and variable impairment of bile flow. In 4 patients with sclerosing cholangitis with incomplete filling of the right and left hepatic ducts at cholangiography, planar and single photon emission computed tomographic scintigraphy provided evidence of significant intrahepatic sclerosing cholangitis.

  14. Iodomethylnorcholesterol uptake in an aldosteronoma shown by dexamethasone-suppression scintigraphy: Relationship to adenoma size and functional activity

    SciTech Connect

    Nomura, K.; Kusakabe, K.; Maki, M.; Ito, Y.; Aiba, M.; Demura, H. )

    1990-10-01

    Dexamethasone-suppression (DS) adrenal scintigraphy localizes an aldosteronoma, but with false-negative results, i.e. 2 of 19 cases in our study. Our aim was to clarify the clinical meaningfulness of this test. Adrenal iodomethyl-norcholesterol (NP-59) uptake on the adenoma side correlated with the estimated adenoma volume (n = 15, r = 0.843, P less than 0.001). Accordingly, the uptake ratio on the adenoma side to that on the opposite side depended on the adenoma volume (r = 0.683, P less than 0.01). This explains the false-negative results (uptake ratio less than 2) in two cases with small adenomas. The NP-59 uptake correlated weakly with the plasma aldosterone level (r = 0.516, P less than 0.05). This result indicates the low correlation between NP-59 uptake and the ability to secrete aldosterone. NP-59 accumulation in the surgically removed gland was analyzed by autoradiography in six cases where DS scintigraphy was done just before surgery. The density was higher in the adenoma cells than in the adjacent cortical cells in five cases, but the difference was rather small, i.e., within a 2-fold difference in four cases. In one case, almost the same density was observed in both types of cells. Thus, the laterality of NP-59 uptake primarily depends on the adenoma volume although NP-59 uptake somewhat reflects the adenoma's ability to secrete aldosterone or the adenoma cell's activity in accumulating NP-59. Care must be taken in interpreting the findings from DS scintigraphy where the adenoma is small or adrenal uptake is low.

  15. Incidentally Visualization of the Thymus on Whole-Body Iodine Scintigraphy: Report of 2 Cases and Review of the Latest Insights.

    PubMed

    Haghighatafshar, Mahdi; Farhoudi, Farinaz

    2015-07-01

    Radioiodine uptake is not commonly seen by the thymus gland. On the contrary, the gland is slowly replaced by fat after puberty. Herein, we present 2 patients with papillary thyroid carcinoma, follicular variant, and cervical lymph node involvement. After total/near-total thyroidectomy, the patients received I for ablation therapy. On posttreatment radioiodine scintigraphy, mediastinal I uptake was noted that finally was histologically/anatomically diagnosed as thymus gland uptake. It should be borne in mind as a potential cause of false-positive whole-body I scintigraphy.

  16. Hypertrophic pulmonary osteoarthropathy on bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography in a patient with lung adenocarcinoma

    PubMed Central

    Cengiz, Arzu; Eren, Mine Şencan; Polatli, Mehmet; Yürekli, Yakup

    2015-01-01

    Hypertrophic pulmonary osteoarthropathy (HPOA) is not an uncommon paraneoplastic syndrome that is frequently associated with lung cancer. A 54-year-old male patient with lung adenocarcinoma underwent bone scintigraphy and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scanning for initial staging. Bone scintigraphy revealed increased periosteal activity in lower extremities. FDG PET/CT revealed hypermetabolic right lung mass, mediastinal lymph nodes, and mildly increased periosteal FDG uptake in both femurs and tibias. The findings in lower extremities on bone scan and FDG PET/CT were interpreted as HPOA. PMID:26170569

  17. Exercise electrocardiography and myocardial scintigraphy in the serial evaluation of the results of percutaneous transluminal coronary angioplasty

    SciTech Connect

    Schall, J.M.; Chaitman, B.R.; David, P.R.; Dupras, G.; Brevers, G; Val, P.G.; Crepeau, J.; Lesperance, J.; Bourassa, M.G.

    1982-08-01

    The diagnostic value of exercise electrocardiography using 14 leads and thallium-201 scintigraphy were evaluated in 54 of 70 patients who underwent percutaneous transluminal coronary angioplasty (PTCA), both in the initial assessment and serial follow-up of patients after PTCA. Of the 45 patients who had successful PTCA, 36 had complete noninvasive studies performed before and 1 month after PTCA. The use of clinical symptoms in conjunction with the physiologic data, ECG and myocardial scintigram acquired during exercise provide important short-term data on the angiographic evolution of PTCA results. The noninvasive tests may be useful in determining guidelines for repeat angiography in patients who have had PTCA. (JMT)

  18. Functionally active ganglioneuroma with increased plasma and urinary catecholamines and positive iodine 131-meta-iodobenzylguanidine scintigraphy

    SciTech Connect

    Clerico, A.; Jenkner, A.; Castello, M.A.; Ciofetta, G.; Lucarelli, C.; Codini, M. )

    1991-01-01

    Ganglioneuromas are usually considered not to be functionally active. Studies of their catecholamine excretory pattern and of their imaging by means of the adrenergic tracing agent 131-I-MIBG have been therefore sparse. We report on a case of secretory ganglioneuroma, as demonstrated by the increased urinary excretion of the catecholamine metabolites HVA and VMA, increased plasma dopamine and epinephrine levels, and positive 131-I-MIBG scintigraphy. We must therefore be aware that a functionally active tumor is not necessarily a neuroblastoma, and that the diagnosis should be biopsy proven.

  19. Silent myocardial ischemia and infarction in diabetics with peripheral vascular disease: Assessment by dipyridamole thallium-201 scintigraphy

    SciTech Connect

    Nesto, R.W.; Watson, F.S.; Kowalchuk, G.J.; Zarich, S.W.; Hill, T.; Lewis, S.M.; Lane, S.E. )

    1990-11-01

    We investigated the incidence of silent myocardial ischemia and infarction as assessed by dipyridamole thallium scintigraphy in 30 diabetic patients with peripheral vascular disease and without clinical suspicion of coronary artery disease. Seventeen patients (57%) had thallium abnormalities, with reversible thallium defects compatible with ischemia in 14 patients (47%) and evidence of prior, clinically silent myocardial infarction in 11 patients (37%). Thallium abnormalities were most frequent in patients with concomitant hypertension and cigarette smoking (p = 0.001). These results suggest that unsuspected coronary artery disease is common in this particular group of patients with diabetes mellitus.

  20. Hepatic arterial perfusion scintigraphy with Tc-99m-MAA: use of a totally implanted drug delivery system

    SciTech Connect

    Ziessman, H.A.; Thrall, J.H.; Yang, P.J.; Walker, S.C.; Cozzi, E.A.; Niederhuber, J.E.; Gyves, J.W.; Ensminger, W.D.; Tuscan, M.C.

    1984-07-01

    Tc-99m-MAA hepatic arterial perfusion scintigraphy (HAPS) using a totally implanted drug delivery system was employed for hepatic arterial chemotherapy in 147 patients (335 studies). Complete perfusion of the involved liver was seen in 88% of patients initially and remained good on follow-up. A significant decrease in hepatic and/or extrahepatic perfusion associated with a hot spot at the tip of the catheter indicated hepatic arterial thrombosis. Extrahepatic perfusion was seen in 14% of cases, usually in the distribution of the stomach, small bowel, and spleen. Significant symptoms of drug toxicity were seen in 70% of patients with extrahepatic perfusion, compared to 19% of those without it.

  1. Comparison Between Postprocessing Software and Repeated Scanning to Eliminate Subdiaphragmatic Activity in Myocardial Perfusion Scintigraphy

    PubMed Central

    Theerakulpisut, Daris; Chotipanich, Chanisa

    2016-01-01

    Myocardial perfusion single photon emission computed tomography (SPECT) is a powerful test of evaluation for coronary artery disease, but subdiaphragmatic radiotracer activity often interferes with the interpretation of inferior wall findings. This study aims to evaluate the effectiveness of using software elimination of the subdiaphragmatic activity for the assessment of its efficacy in the correctness of image interpretation and the overall image quality of myocardial perfusion scintigraphy (MPS). MPS studies from January 2010 to October 2012 at our institution were reviewed. Thirty-two SPECT studies were included, all of which had significant subdiaphragmatic activity in the first scan and needed to be delayed to let the activity clear. Each scan was interpreted by using semiquantitative scoring in 17 segments according to the degree of radiotracer uptake. The first scan, which had interfering activity, was manipulated by masking out the unwanted activity with software native to our image processing software suite. The manipulated images were then compared with delayed images of the same patient, of which the subdiaphragmatic activity was spontaneously cleared with time. The first scan masked by software correlated with the delayed scan for myocardial regions supplied by the left circumflex (LCx) and right coronary artery (RCA), but not the left anterior descending (LAD). However, the quality of the masked scans was perceived by the observer to be better in terms of quality and ease of interpretation. Using software to mask out unwanted subdiaphragmatic activity has no detrimental effect on the interpretation of MPS images when compared with delayed scanning, but it can improve subjective scan quality and ease of interpretation. PMID:27134559

  2. [Renal function study assessed by 99mTc-DMSA renal scintigraphy before and after PNL].

    PubMed

    Sakurai, M; Hioki, T; Okuno, T; Sugimura, Y; Yamakawa, K; Yanagawa, M; Tajima, K; Tochigi, H; Kawamura, J

    1990-01-01

    99mTc-DMSA renal scintigraphy was carried out in 54 patients with unilateral renal stones before and after PNL. Four to 8 weeks after PNL the DMSA renal uptake significantly decreased to 17.2 +/- 6.0% from 18.2 +/- 6.7% before PNL. DMSA renal uptake did not change in the contralateral side. Since in some patients changes in the DMSA renal uptake of 5-7% were observed after PNL not only in the PNL side but also in the contralateral side, the renal function was assessed by the formula: DMSA renal uptake in the PNL side/DMSA renal uptake in the contralateral side, and the change of this ratio was evaluated in 44 patients, in whom the renal DMSA uptake in the PNL side was less than two times that in the contralateral side. The DMSA renal uptake ratio decreased to 95.6 +/- 8.7% from the base line 4-8 weeks after PNL. This change was statistically significant. Some functional risks such as massive bleeding with PNL, the fever after PNL and the number of nephrostomy tract did not affect the decrease in the renal function. In 29 patients in whom renal function was reevaluated one year after PNL, the DMSA renal uptake ratio significantly decreased to 94.2 +/- 9.6% from the base line 4-8 weeks after PNL. But the ratio significantly improved to 99.6 +/- 11.6% about one year after PNL. In two patients with a cold area on the renal image, the renal function of the operated side still remained at about 80% levels from the base line even one year after PNL.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Are chitosan formulations mucoadhesive in the human small intestine? An evaluation based on gamma scintigraphy.

    PubMed

    Säkkinen, Mia; Marvola, Janne; Kanerva, Hanna; Lindevall, Kai; Ahonen, Aapo; Marvola, Martti

    2006-01-13

    Rapid passage through the proximal intestine can result in the low bioavailability of a drug substance with site-specific absorption characteristics in the upper gastrointestinal tract. To overcome this, there is increasing interest in developing gastro-retentive formulations and/or formulations that linger in the proximal parts of the small intestine, e.g. by using mucoadhesive polymers as excipients in formulations. In our recent study, we used neutron activation-based gamma scintigraphy to evaluate the gastro-retentive properties of formulations containing chitosan (Mw 150 kDa) in man. At the same time, we had an opportunity to monitor the transit of the formulations (40 or 95% of chitosan) in the small intestine. Gamma scintigraphic investigations revealed that although the chitosan studied had exhibited marked mucoadhesive capacities in vitro, retention of the chitosan formulations in the upper gastrointestinal tract was not sufficiently reproducible and the duration of retention was relatively short. In 3 volunteers out of 10, the formulation adhered to the gastric mucosa (retention times varied from 1.25 to 2.5 h) and in two volunteers to the upper small intestine (approximate retention time 45 min). In one case, the formulation adhered to the oesophagus. The system failed to increase the bioavailability of furosemide, a drug site-specifically absorbed in the upper gastrointestinal tract. As far as the kind of formulation studied is concerned, preparation of a system that is site-specific to the stomach and/or the upper small intestine seems difficult if the proposed mechanism of action is mucoadhesion. The results suggest that other mechanisms of action should also be studied. PMID:16310992

  4. Intracoronary thallium 201 scintigraphy as an immediate predictor of salvaged myocardium following intracoronary lysis

    SciTech Connect

    Krebber, H.J.; Schofer, J.; Mathey, D.; Montz, R.; Kalmar, P.; Rodewald, G.

    1984-01-01

    Since February of 1980, 157 patients who had had symptoms of acute myocardial infarction for less than 3 hours underwent intracoronary lysis. Forty-six patients required early aorta-coronary revascularization. However, operation was believed to be indicated only when intracoronary lysis was successful and myocardium was salvaged. Since left ventricular angiography proved unreliable in assessing the viability of the myocardium in the acute stage, starting in March of 1981 intracoronary thallium 201 scintiscans were obtained in 23 patients before and after intracoronary lysis. Patients in whom there was a significant reduction in the initial /sup 201/Th defect were considered ideal candidates for operation (Group 3). Patients with poor or unimproved /sup 201/Th uptake after successful intracoronary lysis were treated medically (Group 2), as were patients in whom intracoronary lysis was unsuccessful (Group 1). In order to validate this new approach, a comparison was made of the change in the regional wall motion of the ''infarcted area,'' as shown in the early and follow-up left ventricular angiograms in all three groups. In the acute stage, the mean regional ejection fraction was 19.9% in Group 1, 19.1% in Group 2, and 20.1% in Group 3. Only in Group 3 was there a significant increase in regional ejection fraction to a mean of 51%. The mean ejection fraction obtained at follow-up in Groups 1 and 2 was 16.5% and 17.3%, respectively. From these findings, it was concluded that /sup 201/Th scintigraphy is a valuable predictor of the salvageability of myocardium immediately following intracoronary lysis. To date, it has been the most valuable tool in assessing those patients suitable for early coronary revascularization.

  5. Localization of obscure gastrointestinal bleeding by technetium 99m-labeled red blood cell scintigraphy.

    PubMed

    Wang, C S; Tzen, K Y; Huang, M J; Wang, J Y; Chen, M F

    1992-01-01

    When a bleeding source from the gastrointestinal (GI) tract cannot be identified with conventional diagnostic studies, it is known as GI bleeding of an obscure origin. In the past three years, in vivo Technetium 99m-labeled red blood cell scintigraphy (RBC scan) has been added to our armamentarium for the diagnosis of obscure GI bleeding. Out of a total of 26 cases, the bleeders could be detected in 12 or 46.2% by RBC scan. The time required ranged from 15 minutes to 24 hours (median, one hour). In 14 patients with active bleeding during the scan period, 11 had positive scans (sensitivity, 78.6%). In 12 patients with inactive bleeding, 11 had negative scans (specificity, 91.7%). Angiography was conducted in nine cases, with all showing negative findings; however, six of them had a positive focus by RBC scan. Laparotomy was performed in seven scan-positive patients, and in three scan-negative patients because of a positive Meckel's scan (two cases) or recurrent bleeding (one case). Of the 12 scan-positive patients, incorrect localization was noted in two patients due to rapid transit of the labeled RBC in the small bowel. False localization could be prevented by shortening the sequential imaging interval. It is concluded that an RBC scan is a very sensitive and safe tool for detection of GI bleeding of an intermittent nature, because the bleeder can be monitored for 24 hours after a single injection. It can be used as a preangiographic screening test and to guide the surgeon in surgical planning or decision-making.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1352337

  6. Prognostic value of atrial pacing and thallium-201 scintigraphy in patients with stable chest pain

    SciTech Connect

    Stratmann, H.G.; Mark, A.L.; Walter, K.E.; Williams, G.A. )

    1989-11-01

    The value of atrial pacing and thallium-201 scintigraphy for assessing risk of subsequent cardiac events was examined in 210 patients with stable chest pain. Follow-up information was complete in 195 patients (mean age 61 years). Over an average follow-up of 19 months, cardiac events occurred in 38 patients--unstable angina in 20, nonfatal acute myocardial infarction in 6 and death from cardiac causes in 12. A history of previous myocardial infarction, diabetes mellitus, systemic hypertension or peripheral vascular disease at the time of pacing was not associated with an increased frequency of subsequent cardiac events. Six of 38 patients with later cardiac events had a history of congestive heart failure, compared with 8 of 157 without cardiac events (p less than 0.05). Neither pacing-induced angina, ST depression, nor the presence of a fixed perfusion defect was significantly more frequent in patients with cardiac events as a whole compared with patients without such events. Reversible defects and abnormal scans (reversible or fixed defects) were present, respectively, in 19 and 31 of 38 patients with cardiac events, compared with 42 and 79 patients, respectively, of the 157 patients without cardiac events (both p less than 0.01). In patients who developed unstable angina, a reversible defect was seen in 13 and an abnormal scan in 16 (both p less than 0.01 compared with patients without cardiac events). In 12 patients who died from a primary cardiac event, fixed defects were present in 8 and an abnormal scan in 11 (p less than 0.05 and p less than 0.01, respectively, compared with patients without cardiac events).

  7. The continuing importance of thyroid scintigraphy in the era of high-resolution ultrasound.

    PubMed

    Meller, J; Becker, W

    2002-08-01

    At the molecular level, the uptake of radioiodine and pertechnetate is proportional to the expression of the thyroidal sodium/iodine symporter (NIS). Qualitative and quantitative scintigraphic evaluation of the thyroid is performed with a gamma camera fitted with an on-line computer system and enables determination of the iodine uptake or the technetium uptake (TCTU) as an iodine clearance equivalent. Despite new molecular genetic insights into congenital hypothyroidism, the iodine-123 or pertechnetate scan remains the most accurate test for the detection of ectopic thyroid tissue. Following the identification of specific mutations of the genes coding for the NIS, thyroid peroxidase and pendrin, the discharge test has lost its role in establishing the diagnosis of inherited dyshormonogenesis, but it is still of value in the assessment of defect severity. In PDS mutations the test can be used to establish the diagnosis of syndromic disease. Quantitative pertechnetate scintigraphy is the most sensitive and specific technique for the diagnosis and quantification of thyroid autonomy. The method has proved to be valuable in risk stratification of spontaneous or iodine-induced hyperthyroidism, in the estimation of the target volume prior to radioiodine therapy and in the evaluation of therapeutic success after definitive treatment. In iodine deficiency areas the thyroid scan remains indispensable for the functional characterisation of a thyroid nodule and is still a first-line diagnostic procedure in cases of suspected thyroid malignancy. This is especially of importance in patients with Graves' disease, among whom a relatively high prevalence of cancer has been found in cold thyroid nodules. While determination of the TCTU is without any value in the differentiation between autoimmune thyroiditis and Graves' disease in most cases, it is of substantial importance in the differentiation between hyperthyroid autoimmune thyroiditis and Graves' disease.

  8. Functional aspects of silent ureteral stones investigated with MAG-3 renal scintigraphy

    PubMed Central

    2014-01-01

    Background To investigate functional aspects of silent ureteral stones with special focus on obstruction and its relationship to renal anatomy. The present study is the first investigation of renal excretory function in patients with silent ureteral stones. Methods Patients with primarily asymptomatic ureteral stones underwent a mercapto-acetyltriglycine (MAG-3) renal scintigraphy prior to treatment, in addition to anatomic evaluation of renal units and serum creatinine levels. The primary outcome measure was the presence or absence of obstruction. Secondary outcome measures were kidney anatomy, grade of hydronephrosis, location of stones, stone size, and serum creatinine levels. Results During a ten-year period, 14 patients (median age 52.6 years; range 37.3 to 80.7 years) were included in the study. The relative frequency of primarily asymptomatic ureteral stones among all patients treated for ureteral stones in the study period was 0.7%. Eleven renal units showed some degree of hydronephrosis while 3 kidneys were not dilated. On the MAG-3 scan, 7 patients had an obstruction of the ureter, 5 had no obstruction, and 2 had dysfunction of the kidney. A statistically significant correlation was established between the grade of obstruction and stone size (p = 0.02). Conclusions At the time of presentation, only 64.3% of the patients revealed an obstruction in the stone-bearing renal unit. The degree of hydronephrosis and renal function were very diverse in this subgroup of patients with ureteral stones. The onset of ureterolithiasis and the chronological sequence of obstruction remain unclear in patients who have never experienced symptoms due to their stones. PMID:24397735

  9. Differentiation between meningiomas and other CNS tumors by simultaneous somatostatin receptor and brain scintigraphy

    SciTech Connect

    Haldemann, A.R.; Luescher, D.; Sulzer, M.

    1994-05-01

    Since the differentiation between meningiomas and some other CNS tumors may be difficult in certain localizations, biopsy is mandatory, even in patients with meningiomas who are to be treated with percutaneous radiotherapy alone. The high density of somatostatin receptors (SSR) in meningiomas has led us to compare patients with meningiomas and other CNS tumors by simultaneous SSR and brain scintigraphy (BS) using 74 MBq 111In octreotide and 740 MBq 99mTc DTPA injected two hours later. SPECT was performed on a 3-head gamma camera 4 hours after 111In octreotide injection in multiple peak acquisition mode in 35 patients with radiologically documented CNS tumors. In positive scans, a tumor ROI was defined manually in the transverse 111In slice with highest tumor contrast and the identical tumor ROI was transferred to the corresponding 99mTc slice. A SSR to BS index was then calculated from the ratio of 111In to 99mTc counts after normalizing for identical total counts in the slices. in negative scans, the SSR to BS index was set to be 1.0. In 7 meningiomas, the SSR to BS index was 2.64{plus_minus}0.76. In 28 other CNS tumors (7 gliomas I-111, 4 neurinomas, 3 glial reactions, 3 metastases, 3 gliomas IV, 2 ependymomas, 1 chordoma, 1 NHL; plus 4 inoperable, radiologically diagnosed glioblastomas) 1.06{plus_minus}0.13. Thus, a highly significant difference was found between these two groups (p<0.0001). It is concluded that combined SSR and BS allows excellent discrimination between meningiomas and other CNS tumors and may become a non-invasive alternative to biopsy in selected clinical situations.

  10. Bedside tomographic scintigraphy: a diagnostic tool in intensive care and the emergency room

    NASA Astrophysics Data System (ADS)

    Bone, Dianna; Persson, Mikael; Ribbe, Tommy; Dale, Susanne

    2001-09-01

    Scintigraphic tomography (SPECT) with a gamma camera is an established tool for the diagnosis of disturbances in perfusion of the myocardium. The technique has been shown to be useful in the management of patients with acute myocardial infarction. However, SPECT is not widely used for seriously ill patients due to the need to transport the patient to the gamma camera system. In order to make tomography available by the bedside, a form of limited view angle tomography, Ectomography, has been implemented on a mobile gamma camera system. Projection data are acquired by rotating a slant hole collimator in front of the stationary detector and therefore, the head gantry is simple and easily transported. The mobile system is completely self-contained providing acquisition, reconstruction and bedside display. System sensitivity can be increased by using a segmented collimator, making it possible to present reconstructed sections for diagnosis less than 10 min after the start of acquisition. At present, reconstruction is performed with 2D filtered back projection. A comparative study of patients with suspected coronary artery disease has shown that Ectomography and SPECT yield similar diagnostic information. In an experimental study, in which a coronary artery was occluded, it has been possible to use Ectomography to define myocardial area at risk and final infarct size. Myocardial imaging has been performed in the intensive care unit and a pilot study has demonstrated that brain scans can also be performed. Bedside tomographic scintigraphy has been shown to be feasible and studies can be performed without moving the patient. The method should provide, therefore, an alternative to SPECT in intensive care and the emergency room.

  11. T1-201 chloride scintigraphy for bone tumors and soft part sarcomas

    SciTech Connect

    Terui, S.; Oyamada, H.; Nishikawa, K.; Beppu, Y.; Fukuma, H.

    1984-01-01

    The author investigated T1-201 chloride as a tumor scanning agent of both tumors and soft part sarcomas. Six bone tumors (2 with Ewing sarcoma, 3 with osteosarcoma and 1 with giant cell tumor) and 3 soft part sarcoma (1 with liposarcoma and 2 with malignant fibrous histiocytoma (MFH)) were examined. All but one MFH were untreated primary cases. The diagnosis was determined from biopsy specimen. One patient with Ewing sarcoma had bone metastases. All cases were subsequently received chemotherpeutic agents. Surgery or local irradiation were also used in treatment. T1-201 scintigraphy were performed with intravenous administration of 2 mCi of T1-201 chloride before initiation of therapy. In addition, follow-up examinations were done in 4 patients (2 with Ewing sarcoma and 2 with osteosarcoma) to study the effect of chemotherapy on T1-201 uptake by the tumor. Tc-99m bone scans were available for comparison in 6 tumor. Ga-67 citrate scans were also examined for the 3 soft part sarcomas. The untreated tumors even in the metastatic lesions of Ewing sarcoma were distinctly visualized with T1-201 in all cases. The distribution of T1-201 in the tumors was sometimes different from that of Tc-99m and similar to that of Ga-67. Of 3 out of the 4 follow-up patients, the post-therapy scan showed reduction in T1-201 uptake more markedly than Tc-99m uptake during effective chemotherapy. The other one patient had not responded to the treatment so that the scan showed no changes in T1-201 uptake. These findings indicate that the tumor imaging with T1-201 is useful in the diagnosis of these malignant tumors and may be of value in assessing the response of bone tumors to chemotherapy.

  12. Preoperative evaluation of cardiac risk by means of atrial pacing and thallium 201 scintigraphy

    SciTech Connect

    Stratmann, H.G.; Mark, A.L.; Walter, K.E.; Williams, G.A. )

    1989-10-01

    Atrial pacing and thallium 201 scintigraphy were done in 61 patients with known or suspected coronary artery disease referred for evaluation of cardiac risk before elective vascular surgery. All patients had noncardiac limitations precluding performance of an adequate exercise stress test. Before atrial pacing all were considered to be at low risk of a postoperative cardiac event based on assessment of clinical parameters. Vascular surgery was subsequently performed in 47 patients. In these patients, pacing-induced ST segment depression greater than or equal to 1 mm occurred in 18, a fixed perfusion defect occurred in 11, and a reversible defect occurred in six. Two of the six patients with reversible perfusion defects had preoperative coronary angiography; both had significant coronary artery disease (one or more lesions greater than or equal to 50%). Two patients (one of whom had a reversible perfusion defect) underwent preoperative coronary revascularization and tolerated subsequent vascular surgery well. All other patients received only medical therapy. None of the 47 patients undergoing vascular surgery had a postoperative cardiac event (unstable angina, congestive heart failure, myocardial infarction, or cardiac death). Of the 14 patients in whom vascular surgery was deferred or canceled, surgery was canceled for noncardiac reasons in seven. Six of these seven patients had a normal perfusion scan; none had a reversible perfusion defect or marked (greater than or equal to 2 mm) ST segment depression. No cardiac event occurred during a 3-month period after atrial pacing in any of these patients. Six of the remaining seven patients had reversible perfusion defects.

  13. Quantitative comparison of thallium-201 scintigraphy after exercise and dipyridamole in coronary artery disease

    SciTech Connect

    Varma, S.K.; Watson, D.D.; Beller, G.A. )

    1989-10-15

    Data comparing myocardial thallium-201 imaging after exercise and intravenous dipyridamole infusion in the same patients are scarce. Accordingly, this study is a segment-by-segment quantitative analysis of regional uptake and washout of thallium-201 after dipyridamole (0.56 mg/kg) and symptom-limited exercise testing in 21 patients (ages 58 +/- 9.2 years) with chest pain studied 2.5 +/- 1.0 weeks apart. Thallium-201 activity in 9 myocardial segments was measured in initial and delayed anterior and 45 degree left anterior oblique views, producing 184 pairs of segments in the distribution of 63 coronary supply regions for direct comparison. The number of segments with normal thallium-201 uptake and the number of numerically significant defects were similar with exercise and dipyridamole (76 vs 73%, 24 vs 27%, respectively, difference not significant). A slightly higher proportion of redistribution defects was found after dipyridamole infusion compared to exercise (17 vs 10%, p less than 0.05). Agreement between 87% (165 of 189) of segment pairs was found when each was classified as either normal or abnormal. Although 24 of 189 segments were discordant, agreement was observed in 92% (61 of 63) of coronary supply regions determined to be normal (41 of 41) or abnormal (20 of 22). In 15 patients who underwent cardiac catheterization, exercise and dipyridamole-thallium-201 scintigraphy detected 61% (16 of 26) vs 61% (16 of 26) of stenoses greater than 50% (difference not significant) and 100% (19 of 19) vs 100% (19 of 19) (difference not significant) normal vessels, respectively.

  14. Renal scintigraphy in insulin-dependent diabetes mellitus: Early glomerular and urologic dysfunction

    SciTech Connect

    Poirier, J.Y.; Moisan, A.; Le Cloirec, J.; Siemen, C.; Yaouanq, J.; Edan, G.; Herry, J.Y. )

    1990-07-01

    Glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured by intravenous injection of 99mTc-diethylenetriaminepentaacetic acid (DTPA) and 131I-Hippuran in 115 insulin-dependent diabetic patients with albumin excretion rates (AER) less than 200 micrograms/min, and in 45 normal subjects. Separate kidney function and urinary elimination were estimated by renography. GFR was increased in the diabetic patients (152 +/- 24 ml/min/1.73 m2 vs. 128 +/- 15) and correlated significantly with RPF (r = 0.5; p less than 10(-9)). No relationship was found between GFR and the duration of diabetes, blood glucose, HbA1c, or AER. Fifty patients were hyperfiltering with RPF and filtration fraction higher than those in the normofiltering group. Slow intrarenal or pyeloureteral elimination, either unilateral or bilateral, was observed in 3 controls and 60 diabetic subjects (24 hyperfiltering; 36 normofiltering) and did not disappear with the patient in the standing position. In these 60 patients, mean age, duration of diabetes, blood glucose, HbA1c, 24 h albumin excretion rate, and frequency of peripheral or autonomic neuropathy did not differ from patients with normal scintigraphy; GFR was lower in the group with slow elimination, but not significantly so. 99mTc-DTPA renal uptake was symmetric in all the controls; asymmetric renal uptake with asymmetric GFR was observed in 13 patients (7 hyperfiltering; 6 normofiltering) and often associated with slower elimination. No evidence for renal stenotic atheroma or parenchymatous disease was found on the angiopyleoureterography. The results suggest that incipient uropathy is a very common phenomenon that occurs irrespective of glomerular dysfunction.

  15. Diagnostic value of technetium-99m methoxyisobutyl isonitrile (99mTc-MIBI) scintigraphy in detecting thyroid cancer metastases: a critical evaluation.

    PubMed

    Alam, M S; Kasagi, K; Misaki, T; Miyamoto, S; Iwata, M; Iida, Y; Konishi, J

    1998-12-01

    Technetium-99m methoxyisobutyl isonitrile (99mTc-MIBI) scintigraphy has recently been used in clinical application for detecting thyroid cancer metastases, its role being considered supplementary to serum thyroglobulin (Tg) measurements and radioactive iodine (131I) whole-body scans (WBS). The present retrospective study was designed to elucidate the role of 99mTc-MIBI scans in localizing metastatic lesions by assessing sensitivity and specificity of the scan results obtained in a group of 68 thyroidectomized thyroid cancer patients. Presence or absence of thyroid cancer was judged with other diagnostic modes including serum Tg measurements, 131I WBS, bone scans, chest x-rays, computed tomography (CT), ultrasonography, histopathology, and evolution of disease during follow-up. All scans were read on lesion basis for detecting neck, lung, and bone metastases and also on region basis, namely head-neck, chest, and abdomen-pelvis-extremities (ab-p-ex) areas. The sensitivity of detection was 94.4% (17/18) for neck, 78.4% (40/51) for lung, and 92.8% (64/69) for skeletal lesions. Positive predictive value (PPV) and negative predictive value (NPV) were 96.3% (26/27) and 97.7% (43/44) for head-neck; 94.7% (71/75) and 50.0% (12/24) for chest; 100.0% (25/25) and 93.1% (54/58) for ab-p-ex regions, respectively. For all scan sites taken together, PPV and NPV were 96.1% (122/127) and 86.5% (109/126), respectively. In conclusion, the present study reveals that 99mTc-MIBI can be proposed as a first-line diagnostic agent for the follow-up protocol of thyroid cancer patients, although the ability to detect small lung metastases is somewhat limited.

  16. (111)In-trastuzumab scintigraphy in HER2-positive metastatic breast cancer patients remains feasible during trastuzumab treatment.

    PubMed

    Gaykema, Sietske B M; de Jong, Johan R; Perik, Patrick J; Brouwers, Adrienne H; Schröder, Carolien P; Oude Munnink, Thijs H; Bongaerts, Alphons H H; de Vries, Elisabeth G E; Lub-de Hooge, Marjolijn N

    2014-01-01

    Human epidermal growth factor receptor (HER)2 imaging with radiolabeled trastuzumab might support HER2-targeted therapy. It is, however, frequently questioned whether HER2 imaging is also possible during trastuzumab treatment as the receptor might be saturated. We studied the effect of trastuzumab treatment on 111In-trastuzumab uptake. Patients received trastuzumab weekly and paclitaxel once every 3 weeks. 111In-trastuzumab was injected on day 1 of cycle 1 and day 15 of cycle 4. Whole-body planar scintigraphy was acquired at different time points postinjection. Tumor uptake and organ distribution between the first and repeated scan series were calculated via residence times. Twenty-five tumor lesions in 12 patients were visualized on both scintigraphy series. Tumor uptake decreased (19.6%; p  =  .03). The residence times of normal organs remained similar except for the cardiac blood pool (+ 16.3%; p  =  .014). Trastuzumab treatment decreases tumor 111In-trastuzumab uptake around 20%. HER2 imaging is feasible during trastuzumab treatment.

  17. Myocardial perfusion as assessed by thallium-201 scintigraphy during the discontinuation of mechanical ventilation in ventilator-dependent patients

    SciTech Connect

    Hurford, W.E.; Lynch, K.E.; Strauss, H.W.; Lowenstein, E.; Zapol, W.M. )

    1991-06-01

    Patients who cannot be separated from mechanical ventilation (MV) after an episode of acute respiratory failure often have coexisting coronary artery disease. The authors hypothesized that increased left ventricular (LV) wall stress during periods of spontaneous ventilation (SV) could alter myocardial perfusion in these patients. Using thallium-201 (201TI) myocardial scintigraphy, the authors studied the occurrence of myocardial perfusion abnormalities during periods of SV in 15 MV-dependent patients (nine women, six men; aged 71 {plus minus} 7 yr, mean {plus minus} SD). Fourteen of these patients were studied once with 201TI myocardial scintigraphy during intermittent mechanical ventilation (IMV) and again on another day, after at least 10 min of SV through a T-piece. One patient was studied during SV only. Thirteen of 14 of the patients (93%) studied during MV had abnormal patterns of initial myocardial 201TI uptake, but only 1 patient demonstrated redistribution of 201TI on delayed images. The remainder of the abnormalities observed during MV were fixed defects. SV produced significant alterations of myocardial 201TI distribution or transient LV dilation, or both, in 7 of the 15 patients (47%). Four patients demonstrated new regional decreases of LV myocardial thallium concentration with redistribution of the isotope on delayed images. The patient studied only during SV also had myocardial 201TI defects with redistribution. Five patients (3 also having areas of 201TI redistribution) had transient LV dilation during SV.

  18. Dipyridamole thallium-201 scintigraphy as a preoperative screening test. A reexamination of its predictive potential. Study of Perioperative Ischemia Research Group

    SciTech Connect

    Mangano, D.T.; London, M.J.; Tubau, J.F.; Browner, W.S.; Hollenberg, M.; Krupski, W.; Layug, E.L.; Massie, B. )

    1991-08-01

    The authors examined the value of dipyridamole thallium-201 (201Tl) scintigraphy as a preoperative screening test for perioperative myocardial ischemia and infarction. They prospectively studied 60 patients undergoing elective vascular surgery. They performed 201Tl scintigraphy preoperatively and blinded all treating physicians to the results. Historical, clinical, laboratory, and physiological data were gathered throughout hospitalization. Myocardial ischemia was assessed during the intraoperative period using continuous 12-lead electrocardiography (ECG) and transesophageal echocardiography (TEE) and during the postoperative period using continuous two-lead ambulatory ECG. Adverse cardiac outcomes (cardiac death, myocardial infarction, unstable angina, severe ischemia, or congestive heart failure) were assessed daily throughout hospitalization. Twenty-two patients (37%) had defects that improved or reversed on delayed scintigrams (redistribution defects), 18 (30%) had persistent defects, and 20 (33%) had no defects on 201Tl scintigraphy. There was no association between redistribution defects and adverse cardiac outcomes: 54% (seven of 13) of adverse outcomes occurred in patients without redistribution defects, and the risk of an adverse outcome was not significantly increased in patients with redistribution defects. Consistent with these findings, there was also no association between redistribution defects and perioperative ischemia: 54% (19 of all 35) of perioperative ECG and TEE ischemic episodes and 58% (14 of 24) of severe ischemic episodes occurred in patients without redistribution defects. The sensitivity of 201Tl scintigraphy for perioperative ischemia and adverse outcomes ranged from 40% to 54%, specificity from 65% to 71%, positive predictive value from 27% to 47% and negative predictive value from 61% to 82%.

  19. [Acute effects of transdermal administration of nitroglycerin on effort tolerance and myocardial perfusion, evaluated by Tl-201 scintigraphy, in patients with stable effort angina].

    PubMed

    Novo, S; Liquori, M; Abrignani, M G; Giuliano, F; Panno, V; Fazio, M; Adamo, L; Corda, M; Indovina, A; di Maria, G

    1991-09-01

    The aim of this study was to evaluate the effects of the transdermal application of nitroglycerin (NGT) on exercise tolerated and regional myocardial perfusion, as evaluated by 201 thallium stress scintigraphy, in patients with stable effort angina. We studied 20 patients, 15 men and 5 women, aged between 43 and 68 years, with average age of 55 +/- 8 years, suffering from effort angina, whose angina threshold was stable in 3 stress testing performed in the week before the study started. The patients, after a pharmacological washout of 1 week, underwent 2 exercise testing 20 hours after the application of a patch containing placebo or 10 mg NGT, with an interval of 7 days. 60-90 s before stress testing was interrupted, 2 mCi of thallium 201 were injected in an antecubital vein of the arm. The scintigraphic images were obtained soon in the 0, 45 and 90 degree views and after 4 hours reperfusion. Under placebo patch all patients interrupted ergometer test for angina, while under the patch containing active NGT angina was present in 11/20 patients and 9 patients stopped the test because of muscular exhaustion. NGT induced an increase of the ergometer test duration (+26%); this difference was statistically significant. The ST segment downsloping decreased significantly both at maximal common work and at exercise peak after NGT application in comparison with placebo. The perfusional defects observed on the scintigraphic images obtained soon after the exercise (and reversible after 4 hours of reperfusion) on placebo patch, diminished significantly after NGT and the captation index lung/heart decreased also significantly (from 49 to 41%), showing so an improvement of cardiac performance. In conclusion the transdermal application of NGT, in patients with effort angina, demonstrated to have antianginal and antiischemic effect, reducing the number of patients interrupting the stress testing for angina, increasing the exercise tolerated and diminishing the ST segment

  20. 99mTc Labeled Glucagon-Like Peptide-1-Analogue (99mTc-GLP1) Scintigraphy in the Management of Patients with Occult Insulinoma

    PubMed Central

    Sowa-Staszczak, Anna; Trofimiuk-Müldner, Małgorzata; Stefańska, Agnieszka; Tomaszuk, Monika; Buziak-Bereza, Monika; Gilis-Januszewska, Aleksandra; Jabrocka-Hybel, Agata; Głowa, Bogusław; Małecki, Maciej; Bednarczuk, Tomasz; Kamiński, Grzegorz; Kowalska, Aldona; Mikołajczak, Renata; Janota, Barbara; Hubalewska-Dydejczyk, Alicja

    2016-01-01

    Introduction The aim of this study was to assess the utility of [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 scintigraphy in the management of patients with hypoglycemia, particularly in the detection of occult insulinoma. Materials and Methods Forty patients with hypoglycemia and increased/confusing results of serum insulin and C-peptide concentration and negative/inconclusive results of other imaging examinations were enrolled in the study. In all patients GLP-1 receptor imaging was performed to localise potential pancreatic lesions. Results Positive results of GLP-1 scintigraphy were observed in 28 patients. In 18 patients postsurgical histopathological examination confirmed diagnosis of insulinoma. Two patients had contraindications to the surgery, one patient did not want to be operated. One patient, who presented with postprandial hypoglycemia, with positive result of GLP-1 imaging was not qualified for surgery and is in the observational group. Eight patients were lost for follow up, among them 6 patients with positive GLP-1 scintigraphy result. One patient with negative scintigraphy was diagnosed with malignant insulinoma. In two patients with negative scintigraphy Munchausen syndrome was diagnosed (patients were taking insulin). Other seven patients with negative results of 99mTcGLP-1 scintigraphy and postprandial hypoglycemia with C-peptide and insulin levels within the limits of normal ranges are in the observational group. We would like to mention that 99mTc-GLP1-SPECT/CT was also performed in 3 pts with nesidioblastosis (revealing diffuse tracer uptake in two and a focal lesion in one case) and in two patients with malignant insulinoma (with the a focal uptake in the localization of a removed pancreatic headin one case and negative GLP-1 1 scintigraphy in the other patient). Conclusions 99mTc-GLP1-SPECT/CT could be helpful examination in the management of patients with hypoglycemia enabling proper localization of the pancreatic lesion and effective

  1. Subsequent investigation and management of patients with intermediate-category and -probability ventilation-perfusion scintigraphy.

    PubMed

    Walsh, G; Jones, D N

    2000-11-01

    The authors wished to determine the proportion of patients with intermediate-category and intermediate-probability ventilation-perfusion scintigraphy (IVQS) who proceed to further imaging for investigation of thromboembolism, to identify the defining clinical parameters and to determine the proportion of patients who have a definite imaging diagnosis of thromboembolism prior to discharge from hospital on anticoagulation therapy. One hundred and twelve VQS studies performed at the Flinders Medical Centre over a 9-month period were reported as having intermediate category and probability for pulmonary embolism. Medical case notes were available for review in 99 of these patients and from these the pretest clinical probability, subsequent patient progress and treatment were recorded. Eight cases were excluded because they were already receiving anticoagulation therapy. In the remaining 91 patients the pretest clinical probability was considered to be low in 25; intermediate in 30; and high in 36 cases. In total, 51.6% (n = 47) of these patients (8% (n = 2) with low, 66% (n = 20) with intermediate, and 69.4% (n = 25) with high pretest probability) proceeded to CT pulmonary angiography (CTPA) and/or lower limb duplex Doppler ultrasound (DUS) evaluation. Of the patients with IVQS results, 30.7% (n = 28) were evaluated with CTPA. No patient with a low, all patients with a high and 46% of patients with an intermediate pretest probability initially received anticoagulation therapy. This was discontinued in three patients with high and in 12 patients with intermediate clinical probability prior to discharge from hospital. Overall, 40% of patients discharged on anticoagulation therapy (including 39% of those with a high pretest probability) had a positive imaging diagnosis of thromboembolism The results suggest that, although the majority of patients with intermediate-to-high pretest probability and IVQS proceed to further imaging investigation, CTPA is relatively underused

  2. Efficacy of /sup 67/Ga-scintigraphy in predicting the diagnostic yield of transbronchial lung biopsy in pulmonary sarcoidosis

    SciTech Connect

    Ackart, R.S.; Munzel, T.L.; Rodriguez, J.J.; Donlan, C.J.; Klayton, R.J.; Foreman, D.R.

    1982-07-01

    Nineteen consecutive patients with clinically suspected sarcoidosis underwent /sup 67/Ga-scintigraphy prior to transbronchial lung biopsy (TBLB) to determine if /sup 67/Ga uptake in lung parenchyma would increase the diagnostic yield of the biopsy procedure. Biopsies were obtained from the areas showing parenchymal uptake on the /sup 67/Ga scan in 13 of the 19 patients. In the six patients not demonstrating uptake of /sup 67/Ga in the lung parenchyma, biopsies were obtained at random from the right lower lobe. There was no correlation between /sup 67/Ga uptake in hilar nodes or pulmonary parenchyma tissue and the diagnostic yield from TBLB. Researchers conclude that /sup 67/Ga scanning is neither efficacious nor cost-effective in predicting the diagnostic yield of TBLB in sarcoidosis.

  3. Tc-99m MAA lung perfusion scintigraphy performed before and after pulmonary embolectomy for saddle-type pulmonary embolism.

    PubMed

    Shih, W J; Robinson, M C; Huber, C; Pulmano, C

    1995-02-01

    A 58-year-old man had shortness of breath, hypotension, and decreased partial pressure of oxygen (PO2) on the eighteenth day after undergoing craniotomy for a meningioma. Tc-99m MAA pulmonary perfusion scintigraphy showed little perfusion to the right lung and left lower lung and multiple perfusion defects in the left upper lung. Although the results of concurrent chest radiography were negative for pulmonary infiltrates, pulmonary angiography demonstrated a saddle-type embolism. The patient underwent emergency pulmonary artery embolectomy to remove blood clots and organized thromboemboli from the main pulmonary artery and the right and left pulmonary arteries. The patient's postoperative course was uneventful, and a second Tc-99m MAA lung perfusion scan demonstrated marked improvement in lung perfusion.

  4. Can areas of myocardial ischemia be localized by the exercise electrocardiogram. A correlative study with thallium-201 scintigraphy

    SciTech Connect

    Abouantoun, S.; Ahnve, S.; Savvides, M.; Witztum, K.; Jensen, D.; Froelicher, V.

    1984-10-01

    In order to determine whether areas of ischemia identified by thallium-201 scintigraphy could be localized by exercise ECG, we studied 54 patients with stable coronary heart disease. All 54 patients had exercise-induced thallium-201 scintigraphic defects. Their exercise ECG test results were compared to their thallium-201 images and also to 14 low-risk normal subjects. Exercise data were analyzed for spatial ST vector shifts, using a computer program in order to most accurately classify ST segment depression and elevation. Thallium-201 ischemic defects detected in our patients included areas in the septum and the inferior, lateral, and anterior walls. Twenty-six of these 54 patients also had coronary angiography for classification and comparison as having either localized or generalized disease. None of the scintigraphic ischemic sites or angiographic diseased areas could be specifically identified by exercise-induced ST vector shifts. Therefore, the surface exercise ECG has limitations in localizing ischemia to specific areas of the myocardium.

  5. Gastroesophageal scintigraphy to assess the severity of gastroesophageal reflux disease. [/sup 99m/Tc-sulfur colloid

    SciTech Connect

    Menin, R.A.; Malmud, L.S.; Petersen, R.P.; Maier, W.P.; Fisher, R.S.

    1980-01-01

    Thirty-six (36) patients with symptomatic gastroesophageal reflux were studied. Symptoms of heartburn, regurgitation, and dysphagia were scored as to their severity and compared to quantitative tests of gastroesophageal reflux. Patients were studied with the acid reflux test, fiberoptic endoscopy, exophageal mucosal biopsy with a pinch forceps, esophageal manometry, and radioisotopic gastroesophgeal scintigraphy. Symptoms were scored according to an arbitrary grading system as mild, moderate, or severe. There were significant correlations between symptoms scores and both the degree of endoscopic esophagitis and the gastroesophageal reflux indices as measured by the radioisotopic scintiscan, but not with the degree of histologic esophagitis or lower esophageal sphincter pressure. Review of the findings suggest the following profile for patients who might require antireflux surgery: severe symptoms; presence of endoscopic esophagitis; resting lower esophageal sphincter pressure below 10 mmHg; and gastroesophageal reflux index above 10%.

  6. Prognostic significance of normal quantitative Tl-201 stress scintigraphy in relation to pretest likelihood of coronary artery disease

    SciTech Connect

    Russo, D.J.; Russo, D.; Clements, J.; Wackers, F.

    1984-01-01

    A previous study reported an excellent prognosis and low cardiac event rate in patients(pts) with chest pain and normal quantitative T1-201 scintigraphy(SC). Such result would not be unexpected if the population under study had a predominance of pts with low pre-T1-201 likelihood(L) of significant coronary artery disease (CAD). Hence, the authors undertook telephone follow-up in pts with chest pain syndrome and normal quantitative T1-201 exercise SC, and related outcome to pretest L of CAD. Pretest L was determined by serial L analysis on the basis of: symptoms, age, sex, and exercise ECG. All pts had T1-201 SC immediately post exercise and 2 hrs later. After interpolative background correction, circumferential count and washout profiles were generated. All pts had unequivocally normal studies. Of a total of 96 pts studied in 1981-82, 20 pts were lost to follow-up. Of the remaining 76 pts, 45 were males and 31 females. The pretest L of CAD had an inverted Gaussian distribution: thirty-four pts(47%) had <33% L of CAD, 3 pts (5%) had 33-66% L of CAD, and 35 pts(48%) had >66% L of CAD. Mean follow-up was 22+- 3 months. No deaths occurred. Two pts(3%) (with pretest L of 54% and 94%) had myocardial infarctions, 8 and 22 months respectively after T1-201 stress SC. One pt underwent percutaneous transluminal coronary angioplasty (PTCA) 16 months after T1-201 stress SC. These findings confirm excellent prognostic significance of normal quantitative T1-201 stress scintigraphy.

  7. Prevalence and prognostic significance of exercise-induced silent myocardial ischemia detected by thallium scintigraphy and electrocardiography in asymptomatic volunteers

    SciTech Connect

    Fleg, J.L.; Gerstenblith, G.; Zonderman, A.B.; Becker, L.C.; Weisfeldt, M.L.; Costa, P.T. Jr.; Lakatta, E.G. )

    1990-02-01

    Although a silent ischemic electrocardiographic response to treadmill exercise in clinically healthy populations is associated with an increased likelihood of future coronary events (i.e., angina pectoris, myocardial infarction, or cardiac death), such a response has a low predictive value for future events because of the low prevalence of disease in asymptomatic populations. To examine whether detection of reduced regional perfusion by thallium scintigraphy improved the predictive value of exercise-induced ST segment depression, we performed maximal treadmill exercise electrocardiography (ECG) and thallium scintigraphy (201Tl) in 407 asymptomatic volunteers 40-96 years of age (mean = 60) from the Baltimore Longitudinal Study on Aging. The prevalence of exercise-induced silent ischemia, defined by concordant ST segment depression and a thallium perfusion defect, increased more than sevenfold from 2% in the fifth and sixth decades to 15% in the ninth decade. Over a mean follow-up period of 4.6 years, cardiac events developed in 9.8% of subjects and consisted of 20 cases of new angina pectoris, 13 myocardial infarctions, and seven deaths. Events occurred in 7% of individuals with both negative 201Tl and ECG, 8% of those with either test positive, and 48% of those in whom both tests were positive (p less than 0.001). By proportional hazards analysis, age, hypertension, exercise duration, and a concordant positive ECG and 201Tl result were independent predictors of coronary events. Furthermore, those with positive ECG and 201Tl had a 3.6-fold relative risk for subsequent coronary events, independent of conventional risk factors.

  8. Cardiac Sympathetic Hyperactivity in a Patient with Guillain-Barré Syndrome: An Analysis Using Cardiac [(123)I] Metaiodobenzylguanidine (MIBG) Scintigraphy.

    PubMed

    Tanaka, Yuji; Satomi, Kazuo

    2016-01-01

    A 31-year-old woman gradually developed weakness in the lower extremities and gait disturbance. Subsequently, the patient developed severe constipation and hypertension with tachycardia. Nerve conduction studies revealed demyelinating polyneuropathy. Serum anti-GQ1b IgG antibody was detected. The levels of plasma noradrenaline and dopamine and urinary noradrenaline were elevated. Cardiac [(123)I] metaiodobenzylguanidine (MIBG) scintigraphy showed a normal H/M rate at the early phase and an elevated washout rate. According to these findings, the patient was diagnosed with Guillain-Barré syndrome with cardiac sympathetic hyperactivity. During convalescence, the plasma and urine catecholamine levels fell within the reference ranges, and MIBG scintigraphy showed a decreased washout rate.

  9. Hybrid Single-Photon Emission Computed Tomography/Computed Tomography Imaging Features of Tumoral Calcinosis in Technetium-99m Methylene Diphosphonate Bone Scintigraphy

    PubMed Central

    Kamaleshwaran, Koramadai Karuppusamy; Asokumar, Premkumar; Malaikkal, Anjali; Mohanan, Vyshakh; Shinto, Ajit Sugunan

    2015-01-01

    Tumoral calcinosis (TC) is an uncommon ectopic calcification syndrome. TC is a benign condition characterized by the presence of large calcific soft tissue deposits occurring predominantly in a periarticular location. It generally occurs as a complication of renal dialysis or trauma, and is rarely seen in familial and sporadic cases. Bone scintigraphy is a sensitive method for diagnosing TC. We report a case of year old female with. She underwent bone scintigraphy to see the sites of involvement, which showed intense foci of tracer activity in soft tissue in bilateral thigh and gluteal region. Hybrid single-photon emission computed tomography/computed tomography of the pelvis and thigh localized tracer uptake to the calcification in the gluteal and thigh region. PMID:26097427

  10. Hybrid Single-Photon Emission Computed Tomography/Computed Tomography Imaging Features of Tumoral Calcinosis in Technetium-99m Methylene Diphosphonate Bone Scintigraphy.

    PubMed

    Kamaleshwaran, Koramadai Karuppusamy; Asokumar, Premkumar; Malaikkal, Anjali; Mohanan, Vyshakh; Shinto, Ajit Sugunan

    2015-01-01

    Tumoral calcinosis (TC) is an uncommon ectopic calcification syndrome. TC is a benign condition characterized by the presence of large calcific soft tissue deposits occurring predominantly in a periarticular location. It generally occurs as a complication of renal dialysis or trauma, and is rarely seen in familial and sporadic cases. Bone scintigraphy is a sensitive method for diagnosing TC. We report a case of year old female with. She underwent bone scintigraphy to see the sites of involvement, which showed intense foci of tracer activity in soft tissue in bilateral thigh and gluteal region. Hybrid single-photon emission computed tomography/computed tomography of the pelvis and thigh localized tracer uptake to the calcification in the gluteal and thigh region.

  11. Accuracy of 99mTc (V)-Dimercaptosuccinic Acid Scintigraphy and Fecal Calprotectin Compared with Colonoscopy in Localizing Active Lesions in Inflammatory Bowel Disease

    PubMed Central

    Basirat, Vahid; Azizi, Zahra; Javid Anbardan, Sanam; Taghizadeh Asl, Mina; Farbod, Yasaman; Teimouri, Azam; Ebrahimi Daryani, Nasser

    2016-01-01

    INTRODUCTION Due to limitation of colonoscopy in assessing the entire bowel and patients’ intolerance in inflammatory bowel disease (IBD), in the current study, we aimed to prospectively compare the accuracy of 99mTc(V)-dimercaptosuccinic acid (DMSA) and fecal calprotectin with ileocolonoscopy as new methods for localizing inflammations. METHODS Current prospective study conducted between 2012 and 2014 on 30 patients with IBD attending Gastroenterology Clinic of Tehran University of Medical Sciences. Fecal calprotectin and disease activity were measured for all participants and all of them underwent 99mTc (V)-DMSA scintigraphy and colonoscopy. The accuracy of 99mTc (V)-DMSA scintigraphy and calprotectin in localizing bowel lesions were calculated. RESULTS A total of 22 patients with ulcerative colitis (UC) and 8 patients with Crohn’s disease (CD) were evaluated in our study. Sensitivity, positive likelihood ratio (PLR), and positive predictive value (PPV) of scintigraphy and calprotectin over colonoscopy in localization of UC lesions were 86.36%, 0.86%, 100.00% and 90.91%, 0.91, and 100.00%, respectively. Meanwhile, it showed 66.67% sensitivity and 81.25% specificity with PLR=3.56, negative likelihood ratio (NLR)=0.41, PPV=84.21%, and negative predictive value (NPV)= 61.90% in localizing lesions in patients with CD. The calprotectin level had sensitivity, PLR, and PPV of 90.00%, 0.90, and 100.00% in detecting active disease over colonoscopy, respectively. CONCLUSION The 99mTc (V)-DMSA scintigraphy would be an accurate method for detecting active inflammation in follow-up of patients with IBD and assessing response to treatment as a non-invasive and complementary method beside colonoscopy for more accurate diagnosis of CD or UC. PMID:27698971

  12. Unusual False Positive Radioiodine Uptake on (131)I Whole Body Scintigraphy in Three Unrelated Organs with Different Pathologies in Patients of Differentiated Thyroid Carcinoma: A Case Series.

    PubMed

    Ranade, Rohit; Pawar, Shwetal; Mahajan, Abhishek; Basu, Sandip

    2016-01-01

    Three cases with unusual false positive radioiodine uptake in three different organs and pathologies (infective old fibrotic lesion in the lung, simple liver cyst, and benign breast lesion) on iodine-131 ((131)I) whole body scintigraphy. Clinicoradiological correlation was undertaken in all three cases and the pathologies were ascertained. In all the three cases, single-photon emission computerized tomography-computed tomography (SPECT-CT) and ancillary imaging modalities were employed and were helpful in arriving at the final diagnosis.

  13. Accuracy of 99mTc (V)-Dimercaptosuccinic Acid Scintigraphy and Fecal Calprotectin Compared with Colonoscopy in Localizing Active Lesions in Inflammatory Bowel Disease

    PubMed Central

    Basirat, Vahid; Azizi, Zahra; Javid Anbardan, Sanam; Taghizadeh Asl, Mina; Farbod, Yasaman; Teimouri, Azam; Ebrahimi Daryani, Nasser

    2016-01-01

    INTRODUCTION Due to limitation of colonoscopy in assessing the entire bowel and patients’ intolerance in inflammatory bowel disease (IBD), in the current study, we aimed to prospectively compare the accuracy of 99mTc(V)-dimercaptosuccinic acid (DMSA) and fecal calprotectin with ileocolonoscopy as new methods for localizing inflammations. METHODS Current prospective study conducted between 2012 and 2014 on 30 patients with IBD attending Gastroenterology Clinic of Tehran University of Medical Sciences. Fecal calprotectin and disease activity were measured for all participants and all of them underwent 99mTc (V)-DMSA scintigraphy and colonoscopy. The accuracy of 99mTc (V)-DMSA scintigraphy and calprotectin in localizing bowel lesions were calculated. RESULTS A total of 22 patients with ulcerative colitis (UC) and 8 patients with Crohn’s disease (CD) were evaluated in our study. Sensitivity, positive likelihood ratio (PLR), and positive predictive value (PPV) of scintigraphy and calprotectin over colonoscopy in localization of UC lesions were 86.36%, 0.86%, 100.00% and 90.91%, 0.91, and 100.00%, respectively. Meanwhile, it showed 66.67% sensitivity and 81.25% specificity with PLR=3.56, negative likelihood ratio (NLR)=0.41, PPV=84.21%, and negative predictive value (NPV)= 61.90% in localizing lesions in patients with CD. The calprotectin level had sensitivity, PLR, and PPV of 90.00%, 0.90, and 100.00% in detecting active disease over colonoscopy, respectively. CONCLUSION The 99mTc (V)-DMSA scintigraphy would be an accurate method for detecting active inflammation in follow-up of patients with IBD and assessing response to treatment as a non-invasive and complementary method beside colonoscopy for more accurate diagnosis of CD or UC.

  14. Unusual False Positive Radioiodine Uptake on 131I Whole Body Scintigraphy in Three Unrelated Organs with Different Pathologies in Patients of Differentiated Thyroid Carcinoma: A Case Series

    PubMed Central

    Ranade, Rohit; Pawar, Shwetal; Mahajan, Abhishek; Basu, Sandip

    2016-01-01

    Three cases with unusual false positive radioiodine uptake in three different organs and pathologies (infective old fibrotic lesion in the lung, simple liver cyst, and benign breast lesion) on iodine-131 (131I) whole body scintigraphy. Clinicoradiological correlation was undertaken in all three cases and the pathologies were ascertained. In all the three cases, single-photon emission computerized tomography-computed tomography (SPECT-CT) and ancillary imaging modalities were employed and were helpful in arriving at the final diagnosis. PMID:27134566

  15. Massive Pelvic Lymphadenopathy Due to Recurrent Non-Hodgkin Lymphoma Incidentally Revealed on a 99mTc-MDP Bone Scintigraphy.

    PubMed

    Huang, Jianmin; Xie, Peng

    2016-06-01

    A 58-year-old man underwent Tc-MDP bone scintigraphy to evaluate the cause of diffuse bone pain. The images did not identify the exact cause of his symptoms. However, a "light bulb"-shaped urinary bladder and diffused increased activity in the scrotal region and left thigh were noted, which suggest a mass effect in the pelvis. A CT scan of the pelvis revealed soft tissue compressing the urinary bladder. A diagnosis of recurrent lymphoma was made. PMID:26828142

  16. Reduced uncertainty as a diagnostic benefit: an initial assessment of somatostatic receptor scintigraphy's value in detecting distant metastases of carcinoid liver tumours.

    PubMed

    Woodward, R S; Schnitzler, M A; Kvols, L K

    1998-03-01

    This paper employs classical concepts of diminishing marginal utility to demonstrate that risk-aversion can increase the perceived value of diagnostic procedures and thus raise optimum diagnostic expenditures. The theory is applied to a model in the spirit of Phelps and Mushlin's initial technology assessments. The specific evaluation is the cost-effectiveness of somatostatin receptor scintigraphy used to detect distant metastases of carcinoid liver tumours in a patient otherwise eligible for surgical resection of the liver. Data for the model are taken from published sources and financial databases, when available, and otherwise from a senior clinician's experience (LKK). The quantitative results indicate that receptor scintigraphy may have two beneficial impacts to risk-neutral individuals. First, it may reduce the combined costs of therapy and treatment because the diagnostic procedure costs less than the expected savings generated by avoiding inappropriate surgeries. Second, it may improve the patient's expected health-status-adjusted life years (HSALY) because the information allows physicians to better match treatment to the cancer's stage. Finally the paper demonstrates that risk aversion, as embodied in classical diminishing marginal utility applied to health status, can increase the value of the diagnostic tests and can lead the patient to choose a less beneficial treatment. An illustrative risk-averse utility function changed the optimum treatment from surgery to chemotherapy and increased scintigraphy's benefit by 500%. PMID:9565171

  17. The correlation between effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) with renal scintigraphy 99mTc-DTPA study

    NASA Astrophysics Data System (ADS)

    Ratnasari, D.; Nazir, F.; Toresano, L. O. H. Z.; Pawiro, S. A.; Soejoko, D. S.

    2016-03-01

    The prevalence of chronic renal diseases in Indonesia has an increasing annual trend, because it is frequently unrecognized and often co-exists with other disease. GFR and ERPF are parameters currently utilized to estimate renal function at routine renal scintigraphy 99m-Tc DTPA study. This study used 99m-Tc DTPA to measure GFR and ERPF. The purpose of this study was to find the correlation between ERPF and GFR, for ERPF analysis with Schlegel's method, and GFR analysis with Gate's method, as well as to find correction factor between both variables. Analysis of renal scintigraphy has been performed at Department of Nuclear Medicine Pertamina Center Hospital to thirty patient images acquired from 2014 to 2015 which were analyzed retrospectively data, using gamma camera dual head with counting method from renal scintigraphy 99m-Tc DTPA study. The calculation was executed by means of both display and manual calculation. Pearson's statistical analysis resulted on Positive Correlation for all data, with ERPF and GFR (display) showing Strongly Positive Correlation (r = 0.82; p- value < 0.05). Standard deviation was found to be 27.58 and 107.64 for GFR and ERPF (display), respectively. Our result indicated that the use of 99mTc-DTPA measure ERPF was not recommended.

  18. Detection of occult infection following total joint arthroplasty using sequential technetium-99m HDP bone scintigraphy and indium-111 WBC imaging

    SciTech Connect

    Johnson, J.A.; Christie, M.J.; Sandler, M.P.; Parks, P.F. Jr.; Homra, L.; Kaye, J.J.

    1988-08-01

    Preoperative exclusion or confirmation of periprosthetic infection is essential for correct surgical management of patients with suspected infected joint prostheses. The sensitivity and specificity of (/sup 111/In)WBC imaging in the diagnosis of infected total joint prostheses was examined in 28 patients and compared with sequential (/sup 99m/Tc)HDP/(/sup 111/In)WBC scintigraphy and aspiration arthrography. The sensitivity of preoperative aspiration cultures was 12%, with a specificity of 81% and an accuracy of 58%. The sensitivity of (/sup 111/In)WBC imaging alone was 100%, with a specificity of 50% and an accuracy of 65%. When correlated with the bone scintigraphy and read as sequential (/sup 99m/Tc)HDP/(/sup 111/In)WBC imaging, the sensitivity was 88%, specificity 95%, and accuracy 93%. This study demonstrates that (/sup 111/In)WBC imaging is an extremely sensitive imaging modality for the detection of occult infection of joint prostheses. It also demonstrates the necessity of correlating (/sup 111/In)WBC images with (/sup 99m/Tc)HDP skeletal scintigraphy in the detection of occult periprosthetic infection.

  19. Distribution of lung blood on modified bilateral Glenn shunt evaluated by Tc-99m-MAA lung perfusion scintigraphy: A retrospective study.

    PubMed

    Si, Biao; Luan, Zhao-Sheng; Wang, Tong-Jian; Ning, Yan-Song; Li, Na; Zhu, Meng; Liu, Zhong-Min; Ding, Guang-Hong; Qiao, Bin

    2016-09-01

    The aim of the present study was to determine the distribution of lung blood in a modified bilateral Glenn procedure designed in our institute with lung perfusion scintigraphy. Sixteen consecutive patients who underwent modified bilateral Glenn operation from 2011 to 2014 were enrolled in the study. The control group consisted of 7 patients who underwent bidirectional Glenn shunt. Radionuclide lung perfusion scintigraphy was performed using Tc-99m-macro aggregated albumin (MAA) in all patients. For the patients in modified bilateral Glenn group, the time at which the radioactivity accumulation peaked did not differ significantly between the right and left lung field (t = 0.608, P = 0.554). The incidence of perfusion abnormality in each lung lobe also did not differ significantly (P = 0.426 by Fisher exact test). The radioactive counts were higher in the right lung than in the left lung, but the difference was not statistically significant (t = 1.502, P = 0.157). Radioactive perfusion in the lower lung field was significantly greater than that in the upper field (t = 4.368, P < 0.001). Compared with that in the bidirectional Glenn group, the ratio of radioactivity in the right lung to that in left lung was significantly lower in the modified bilateral Glenn group (t = 3.686, P = 0.002). Lung perfusion scintigraphy confirmed the benefit of the modified bilateral Glenn shunt with regard to more balanced blood perfusion in both lungs. PMID:27661042

  20. Comparison of N-isopropyl (/sup 123/I) p-iodoamphetamine brain scans using Anger camera scintigraphy and single-photon emission tomography

    SciTech Connect

    Lee, R.G.; Hill, T.C.; Holman, B.L.; Uren, R.; Clouse, M.E.

    1982-12-01

    N-isopropyl (/sup 123/I) p-iodoamphetamine (IMP), which is extracted by the brain in proportion to regional blood flow, has been shown to be useful with single-photon emission tomography (SPECT) in the assessment of pathologic states related to blood flow. Because emission tomographic equipment is not yet available at most hospitals, the authors compared IMP brain images obtained with an Anger camera with those obtained by SPECT to determine the usefulness of IMP scintigraphy. Thirty-nine pairs of studies were performed on 12 control patients, 14 patients with stroke, three patients with tumors, and a miscellaneous group of eight patients. Planar scintigraphy showed good correlation with SPECT in determining the presence or absence of abnormality in all patients except one with a very small brain stem infarction that was not detected by planar imaging. Anger images showed poor contrast resolution compared with SPECT images. It is thus expected that SPECT will result in better lesion detection when smaller lesions are studied. Planar scintigraphy is not capable of providing quantitative measurement of regional cerebral blood flow.

  1. Comparison of N-isopropyl (I-123) p-iodoamphetamine brain scans using Anger camera scintigraphy and single-photon emission tomography

    SciTech Connect

    Lee, R.G.; Hill, T.C.; Holman, B.L.; Uren, R.; Clouse, M.E.

    1982-12-01

    N-isopropyl (I-123) p-iodoamphetamine (IMP), which is extracted by the brain in proportion to regional blood flow, has been shown to be useful with single-photon emission tomography (SPECT) in the assessment of pathologic states related to blood flow. Because emission tomographic equipment is not yet available at most hospitals, the authors compared IMP brain images obtained with an Anger camera with those obtained by SPECT to determine the usefulness of IMP scintigraphy. Thirty-nine pairs of studies were performed on 12 control patients, 14 patients with stroke, three patients with tumors, and a miscellaneous group of eight patients. Planar scintigraphy showed good correlation with SPECT in determining the presence or absence of abnormality in all patients except one with a very small brain stem infarction that was not detected by planar imaging. Anger images showed poor contrast resolution compared with SPECT images. It is thus expected that SPECT will result in better lesion detection when smaller lesions are studied. Planar scintigraphy is not capable of providing quantitative measurement of regional cerebral blood flow.

  2. Detection of multivessel disease in patients with sustained myocardial infarction by thallium 201 myocardial scintigraphy: No additional value of quantitative analysis

    SciTech Connect

    Niemeyer, M.G.; Pauwels, E.K.; van der Wall, E.E.; Cramer, M.J.; Verzijlbergen, J.F.; Zwinderman, A.H.; Ascoop, C.A. )

    1989-01-01

    This study was performed to determine the value of visual and quantitative thallium 201 scintigraphy for the detection of multivessel disease in 67 patients with a sustained transmural myocardial infarction. Also the viability of the myocardial regions corresponding to pathologic Q-waves was evaluated. Of the 67 patients, 51 patients had multivessel coronary artery disease (76%). The sensitivity of the exercise test was 53%, of thallium scintigraphy 69%, when interpreted visually, and 67%, when analysed quantitatively. The specificity of these methods was 69%, 56%, and 50%, respectively. Sixty-two infarct-related flow regions were detected by visual analysis of the thallium scans, total redistribution was observed in 11/62 (18%) of patients, partial redistribution in 26/62 (42%), and no redistribution in 25/62 (40%) of patients. The infarct-related areas with total redistribution on the thallium scintigrams were more likely to be associated with normal or hypokinetic wall motion (7/11: 64%) than the areas with a persistent defect (7/25:28%) (P = 0.05), which were more related with akinetic or dyskinetic wall motion. Based on our results, it is concluded that (1) both visual and quantitative analysis of thallium exercise scintigraphy have limited value to predict the presence or absence of multivessel coronary artery disease in patients with sustained myocardial infarction, and (2) exercise-induced thallium redistribution may occur within the infarct zone, suggesting the presence of viable but jeopardized myocardium in presumed fibrotic myocardial areas.

  3. Stress thallium-201 myocardial scintigraphy for the detection of individual coronary arterial lesions in patients with and without previous myocardial infarction

    SciTech Connect

    Rigo, P.; Bailey, I.K.; Griffith, L.S.; Pitt, B.; Wagner, H.N. Jr.; Becker, L.C.

    1981-08-01

    The value of stress thallium-201 scintigraphy for detecting individual coronary arterial stenoses was analyzed in 141 patients with angiographically proved coronary artery disease, 101 with and 40 without a previous myocardial infarction. In patients without infarction, the sensitivity for detecting greater than 50 percent narrowing in the left anterior descending, the right and the left circumflex coronary artery was 66, 53 and 24 percent, respectively. In those with a previous infarction, the sensitivity for demonstrating disease in the artery corresponding to the site of infarction was 100 percent for the left anterior descending, 79 percent for the right and 63 percent for the left circumflex coronary artery. In patients with a prior anterior infarction, concomitant right or left circumflex coronary arterial lesions were detected in only 1 of 12 cases, whereas in those with previous inferior or inferolateral infarction, the sensitivity for left anterior descending coronary artery disease was 69 percent. Because of the reasonably high sensitivity for detecting left anterior descending arterial disease, irrespective of the presence and location of previous infarction, myocardial scintigraphy was useful in identifying multivessel disease in patients with a previous inferior infarction. However, because of its relative insensitivity for right or left circumflex coronary artery disease, scintigraphy proved to be a poor predictor of multivessel disease in patients with a prior anterior infarction and in patients without previous myocardial infarction.

  4. Comparison of gamma scintigraphy and a pharmacokinetic technique for assessing pulmonary deposition of terbutaline sulphate delivered by pressurized metered dose inhaler.

    PubMed

    Newman, S; Steed, K; Hooper, G; Källén, A; Borgström, L

    1995-02-01

    A comparison has been made of pulmonary deposition of terbutaline sulphate from a pressurized metered dose inhaler (pMDI), measured in 8 healthy male subjects by gamma scintigraphy and by a pharmacokinetic (charcoal-block) method, involving drug recovery in urine. Measurements were carried out with a pMDI at slow (27 l/min) and fast (151 l/min) inhaled flows and with Nebuhaler large volume spacer device (average inhaled flow 17 l/min). Overall, the two methods did not differ significantly in their estimates of whole lung deposition, although values obtained by gamma scintigraphy exceeded those from the charcoal-block method for the pMDI with fast inhalation. The regional distribution of drug within the lungs and deposition in the oropharynx could be assessed by gamma scintigraphy, but not by the charcoal-block method. It is concluded that either method may be used to assess whole lung deposition of terbutaline sulphate from pMDIs, both with and without a spacer, although each method has its own inherent advantages and disadvantages. PMID:7784338

  5. [Study of the muscular perfusion of the lower limbs using thallium 201 scintigraphy before and after lumbar sympathectomy in 13 patients].

    PubMed

    Serise, J M; Basse-Cathalinat, B; Medina, M; Aguilar, P; Le Héron, D; Boissieras, P

    1985-01-01

    Scintigraphy with 201-Thallium is a useful method for exploring muscle circulation in lower limbs of patients with arteritis. Comparative values with time can be obtained by studying respective isotopic activity ratios of the thigh, calf and foot. Unilateral isolated lumbar sympathectomy was performed in 13 patients for arteriopathy of the lower limbs (7 claudications, 4 isolated trophic disorders, 1 thrash-foot and 1 juvenile arteriopathy). Investigations included clinical and arteriographic explorations and functional tests (Doppler, distal pressure, digital plethysmography and 201-Thallium muscle scintigraphy) before and after operation. Pathology of the sympathetic chain was determined in each case. Short-term (2 weeks) follow up examinations gave data showing absence of correlation between the operative procedure and scintigraphy results. Muscle perfusion was improved in only 3 cases: one presented paradoxical improvement contralateral to the sympathectomy, while no change from the pre-operative values was recorded in 9 patients. The findings raise questions concerning the reproducibility of the scintigraphic method, and also confirm the pathogenic hypothesis by which lumbar sympathectomy has only a limited effect on muscle circulation.

  6. Distribution of lung blood on modified bilateral Glenn shunt evaluated by Tc-99m-MAA lung perfusion scintigraphy: A retrospective study.

    PubMed

    Si, Biao; Luan, Zhao-Sheng; Wang, Tong-Jian; Ning, Yan-Song; Li, Na; Zhu, Meng; Liu, Zhong-Min; Ding, Guang-Hong; Qiao, Bin

    2016-09-01

    The aim of the present study was to determine the distribution of lung blood in a modified bilateral Glenn procedure designed in our institute with lung perfusion scintigraphy. Sixteen consecutive patients who underwent modified bilateral Glenn operation from 2011 to 2014 were enrolled in the study. The control group consisted of 7 patients who underwent bidirectional Glenn shunt. Radionuclide lung perfusion scintigraphy was performed using Tc-99m-macro aggregated albumin (MAA) in all patients. For the patients in modified bilateral Glenn group, the time at which the radioactivity accumulation peaked did not differ significantly between the right and left lung field (t = 0.608, P = 0.554). The incidence of perfusion abnormality in each lung lobe also did not differ significantly (P = 0.426 by Fisher exact test). The radioactive counts were higher in the right lung than in the left lung, but the difference was not statistically significant (t = 1.502, P = 0.157). Radioactive perfusion in the lower lung field was significantly greater than that in the upper field (t = 4.368, P < 0.001). Compared with that in the bidirectional Glenn group, the ratio of radioactivity in the right lung to that in left lung was significantly lower in the modified bilateral Glenn group (t = 3.686, P = 0.002). Lung perfusion scintigraphy confirmed the benefit of the modified bilateral Glenn shunt with regard to more balanced blood perfusion in both lungs.

  7. Applications

    NASA Astrophysics Data System (ADS)

    Stern, Arthur M.

    1986-07-01

    Economic incentives have spurred numerous applications of genetically engineered organisms in manufacture of pharmaceuticals and industrial chemicals. These successes, involving a variety of methods of genetic manipulation, have dispelled early fears that genetic engineering could not be handled safely, even in the laboratory. Consequently, the potential for applications in the wider environment without physical containment is being considered for agriculture, mining, pollution control, and pest control. These proposed applications range from modest extensions of current plant breeding techniques for new disease-resistant species to radical combinations of organisms (for example, nitrogen-fixing corn plants). These applications raise concerns about potential ecological impacts (see chapter 5), largely because of adverse experiences with both deliberate and inadvertent introductions of nonindigenous species.

  8. Simplified method of selective spleen scintigraphy with Tc-99m-labeled erythrocytes: clinical applications. Concise communication

    SciTech Connect

    Armas, R.R.; Thakur, M.L.; Gottschalk, A.

    1980-05-01

    We report our initial clinical experience with a simplified spleen-imaging technique that requires no red cell washing or special kits. Thirty minutes after an injection of ''cold'' pyrophosphate containing 0.5 mg of stannous chloride or fluoride, a blood sample is drawn, 2 mCi of pertechnetate (Tc-99m) are added, the sample is incubated at 49 to 50/sup 0/ for 35 min, and then reinjected into the patient. We have studied 13 patients with this technique, and have found it useful in the clarification of various questionable splenic abnormalities found on the sulfur colloid scan, as well as in the detection of splenosis.

  9. Normal Solid Gastric Emptying Values Measured by Scintigraphy Using Asian-style Meal:A Multicenter Study in Healthy Volunteers

    PubMed Central

    Vasavid, Pataramon; Chaiwatanarat, Tawatchai; Pusuwan, Pawana; Sritara, Chanika; Roysri, Krisana; Namwongprom, Sirianong; Kuanrakcharoen, Pichit; Premprabha, Teerapon; Chunlertrith, Kitti; Thongsawat, Satawat; Sirinthornpunya, Siam; Ovartlarnporn, Bancha; Kachintorn, Udom; Leelakusolvong, Somchai; Kositchaiwat, Chomsri; Chakkaphak, Suriya; Gonlachanvit, Sutep

    2014-01-01

    Background/Aims To report gastric emptying scintigraphy, normal values should be established for a specific protocol. The aim of this study was to provide normal gastric emptying values and determine factors affecting gastric emptying using Asian rice-based meal in healthy volunteers. Methods One hundred and ninety-two healthy volunteers were included at 7 tertiary care centers across Thailand. Gastric emptying scintigraphy was acquired in 45 degree left anterior oblique view immediately after ingestion of a 267 kcal steamed-rice with technetium-99m labeled-microwaved egg meal with 100 mL water for up to 4 hours. Results One hundred and eighty-nine volunteers (99 females, age 43 ± 14 years) completed the study. The medians (5–95th percentiles) of lag time, gastric emptying half time (GE T1/2) and percent gastric retentions at 2 and 4 hours for all volunteers were 18.6 (0.5–39.1) minutes, 68.7 (45.1–107.8) minutes, 16.3% (2.7–49.8%) and 1.1% (0.2–8.8%), respectively. Female volunteers had significantly slower gastric emptying compared to male (GE T1/2, 74 [48–115] minutes vs. 63 (41–96) minutes; P < 0.05). Female volunteers who were in luteal phase of menstrual cycle had significantly slower gastric emptying compared to those in follicular phase or menopausal status (GE T1/2, 85 [66–102] mintes vs. 69 [50–120] minutes or 72 [47–109] minutes, P < 0.05). All of smoking volunteers were male. Smoker male volunteers had significantly faster gastric emptying compared to non-smoker males (GE T1/2, 56 [44–80] minutes vs. 67 [44–100] minutes, P < 0.05). Age, body mass index and alcohol consumption habits did not affect gastric emptying values. Conclusions A steamed-rice with microwaved egg meal was well tolerated by healthy volunteers. Gender, menstrual status and smoking status were found to affect solid gastric emptying. PMID:24948129

  10. Tibial stress reaction in runners. Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system.

    PubMed

    Fredericson, M; Bergman, A G; Hoffman, K L; Dillingham, M S

    1995-01-01

    Medial tibial pain in runners has traditionally been diagnosed as either a shin splint syndrome or as a stress fracture. Our work using magnetic resonance imaging suggests that a progression of injury can be identified, starting with periosteal edema, then progressive marrow involvement, and ultimately frank cortical stress fracture. Fourteen runners, with a total of 18 symptomatic legs, were evaluated and, within 10 days, referred for radiographs, a technetium bone scan, and a magnetic resonance imaging scan. In 14 of the 18 symptomatic legs, magnetic resonance imaging findings correlated with an established technetium bone scan grading system and more precisely defined the anatomic location and extent of injury. We identified clinical symptoms, such as pain with daily ambulation and physical examination findings, including localized tibial tenderness and pain with direct or indirect percussion, that correlated with more severe tibial stress injuries. When clinically warranted, we recommend magnetic resonance imaging over bone scan for grading of tibial stress lesions in runners. Magnetic resonance imaging is more accurate in correlating the degree of bone involvement with clinical symptoms, allowing for more accurate recommendations for rehabilitation and return to impact activity. Additional advantages of magnetic resonance imaging include lack of exposure to ionizing radiation and significantly less imaging time than three-phase bone scintigraphy.

  11. High-risk angina patient. Identification by clinical features, hospital course, electrocardiography and technetium-99m stannous pyrophosphate scintigraphy

    SciTech Connect

    Olson, H.G.; Lyons, K.P.; Aronow, W.S.; Stinson, P.J.; Kuperus, J.; Waters, H.J.

    1981-10-01

    We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +/- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p less than 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p less than 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients.

  12. High-risk angina patient: identification by clinical features, hospital course, electrocardiography, and technetium-99m stannous pyrophosphate scintigraphy

    SciTech Connect

    Olson, H.G.; Lyons, K.P.; Aronow, W.S.; Stinson, P.J.; Kuperus, J.; Waters, H.J.

    1981-10-01

    We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p < 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p < 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup, with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients.

  13. Myocardial infarction size and location: a comparative study of epicardial isopotential mapping, thallium-201 scintigraphy, electrocardiography and vectorcardiography

    SciTech Connect

    Toyama, S.; Suzuki, K.; Takahashi, T.; Yamashita, Y.

    1987-07-01

    Based on epicardial isopotential mapping (the Ep Map), which was calculated from body surface isopotential mapping (the Body Map) with Yamashita's method, using the finite element technique, we predicted the location and size of the abnormal depolarized area (the infarcted area) in 19 clinical cases of anterior and 18 cases of inferoposterior infarction. The prediction was done using Toyama's diagnostic method, previously reported. The accuracy of the prediction by the Ep Map was assessed by comparing it with findings from thallium-201 scintigraphy (SCG), electrocardiography (ECG) and vectorcardiography (VCG). In all cases of anterior infarction, the location of the abnormal depolarized areas determined on the Ep Map, which was localized at the anterior wall along the anterior intraventricular septum, agreed with the location of the abnormal findings obtained by SCG, ECG and VCG. For all inferoposterior infarction cases, the abnormal depolarized areas were localized at the posterior wall and the location also coincided with that of the abnormal findings obtained by SCG, ECG and VCG. Furthermore, we ranked and ordered the size of the abnormal depolarized areas, which were predicted by the Ep Map for both anterior and inferoposterior infarction cases. In the cases of anterior infarction, the order of the size of the abnormal depolarized area by the Ep Map was correlated to the size of the abnormal findings by SCG, as well as to the results from Selvester's QRS scoring system in ECG and to the angle of the maximum QRS vector in the horizontal plane in VCG.

  14. Platelet aggregability and in vivo platelet deposition in patients with ischemic cerebrovascular disease--evaluation by indium-111-platelet scintigraphy

    SciTech Connect

    Isaka, Y.; Kimura, K.; Uehara, A.; Hashikawa, K.; Mieno, M.; Matsumoto, M.; Handa, N.; Nakabayashi, S.; Imaizumi, M.; Kamada, T. )

    1989-12-15

    In ischemic cerebrovascular disease, it is not clear whether platelet function in vitro actually reflects the situation in vivo. Using indium-111 platelet scintigraphy as a method for detecting platelet activation in vivo, we tried to elucidate this problem. Twenty eight patients with chronic stage of ischemic cerebrovascular disease (CVD) and 17 control subjects were examined. Platelet scintigrams were positive in 9 of 28 patients in CVD, while all were negative in control. A comparison of the results obtained from qualitative platelet imaging and platelet aggregability was performed to evaluate whether threshold aggregation concentration (TAC) grade differed across the three groups (control, CVD patients without platelet deposition and CVD patients with platelet deposition). CVD patients with platelet deposition showed a higher TAC than those patients who did not show platelet deposition (P less than 0.05) or control subjects without platelet deposition (P less than 0.05). These results suggest that some patients in chronic stages of CVD may have active platelet deposition on carotid atheromatous lesions, and presence of platelet deposition in vivo could contribute to reduce platelet reactivity in peripheral blood.

  15. Relationship between redistribution on exercise thallium-201 scintigraphy and repetitive ventricular premature beats in patients with recent myocardial infarction

    SciTech Connect

    Tsuji, H.; Iwasaka, T.; Sugiura, T.; Shimada, T.; Nakamori, H.; Kimura, Y.; Inada, M. )

    1991-06-01

    The relationship between myocardial ischemia detected by exercise thallium-201 scintigraphy and repetitive ventricular premature beats (VPBs) during ambulatory monitoring was evaluated in 57 patients with recent myocardial infarction. Multivariate analysis was performed to obtain the relatively important factor related to repetitive VPBs with the use of the following variables: age, redistribution, left ventricular ejection fraction, serum potassium and magnesium concentration, QRS score, left ventricular aneurysm, and the number of diseased vessels. Thirty-five patients had redistribution, but only three of them had repetitive VPBs during exercise testing. The average heart rate before 79% of 398 episodes of repetitive VPBs during ambulatory monitoring was in the range of 56 to 70/min. These data indicate that most of repetitive VPBs during ambulatory monitoring were not provoked by exercise-induced acute myocardial ischemia. However, redistribution was found to be an important factor associated with repetitive VPBs. The electrical abnormality relating to a substrate characterized by chronic reversible ischemia may explain the association between redistribution and repetitive VPBs.

  16. Electrocardiographic diagnosis of posterior myocardial infarction revisited: a new approach using a multivariate discriminant analysis and thallium-201 myocardial scintigraphy

    SciTech Connect

    Nestico, P.F.; Hakki, A.H.; Iskandrian, A.S.; Anderson, G.J.

    1986-01-01

    This study examined the feasibility of using a multivariate discriminant analysis to design a useful electrocardiographic (ECG) model to diagnose posterior myocardial infarction (MI). Thallium-20) scintigraphy was used as a reference standard to identify posterior scar (fixed perfusion defects). The model was derived from 111 patients of whom 37 had fixed posterior defects and 74 had normal images, and its validity was subsequently tested in a separate group of 180 patients. In the initial group of patients, the fixed perfusion defects involved the posterior left ventricular wall alone in 15 patients, and the posterior and inferior walls in 22 patients. Stepwise multivariate discriminant analysis of 26 ECG variables produced a model of two variables (Q-wave duration in a VF and T-wave amplitude in V1) which provided a sensitivity of 78%, a specificity of 89%, and a predictive accuracy of 86% for the diagnosis of posterior MI. This model, when tested in the second group of 180 patients, yielded an overall prediction accuracy of 82% (sensitivity 65%, specificity 85%). Thus, the combination of Q-wave in a VF and upright T wave in V1 is the best ECG predictor of posterior MI. These two variables reflect the frequent association of posterior MI with inferior MI, and the reciprocal repolarization changes in the right precordial leads.

  17. Early Indium-111 antimyosin scintigraphy for assessment of regional wall motion asynergy on discharge after myocardial infarction

    SciTech Connect

    van Vlies, B.; Baas, J.; Visser, C.A.; van Royen, E.; Delemarre, B.J.; Bot, H.; Dunning, A.J. )

    1990-01-01

    To assess the relation between early Indium-111 monoclonal antimyosin antibody scintigraphy and degree of regional asynergy on discharge, 38 patients with a first acute myocardial infarct were studied (18 anterior, 20 inferoposterior infarctions). In 21 patients thrombolytic therapy was administered. On the first day of myocardial infarction, 80 MBq Indium-111 Antimyosin was injected. Planar images, anterior, lateral and left anterior oblique, were made 24 hours later. Localized myocardial uptake was present in 37/38 patients, and was evaluated for Count Density Index (count density of infarct zone/left lung count density) in the left anterior oblique images, which displayed the infarct zone well. Regional asynergy on discharge was evaluated by cross-sectional echocardiography and defined mild (hypokinesia) or severe (akinesia or dyskinesia). Count density index was significantly lower in 15 patients with mild asynergy, compared with 22 patients with severe asynergy (1.61 +/- 0.25 vs. 2.42 +/- 0.40, p less than 0.001). This difference was present in both patient groups treated with or without thrombolysis. We conclude that early count density index, reflecting the amount of local necrosis, is highly correlated to the ultimate degree of wall motion impairment.

  18. The effects of lidoflazine on exercise performance and thallium stress scintigraphy in patients with stable angina pectoris

    SciTech Connect

    Shapiro, W.; Narahara, K.A.; Park, J.

    1982-01-01

    Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a 7-month study, 36 patients with stable angina pectoris were tested during a 3-month single-blind placebo phase. Nineteen were then randomized by double-blind methods to lidoflazine and 17 to placebo therapy. The lidoflazine group had a significant (p < 0.01) reduction in anginal attacks; the placebo group did not. Exercise testing demonstrated that lidoflazine therapy was associated with a 34% increase in total work performance and a 15.6% increase in peak calculated oxygen uptake during double-blind treatment (both p < 0.004 compared with the placebo group). Heart rate was significantly reduced at submaximal levels of exercise during lidoflazine therapy (p < 0.04). Nitroglycerin consumption and electrocardiographic changes at the end of exercise did not change during the double-blind phase. In a second study of six similar patients, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise.

  19. The effects of lidoflazine on exercise performance and thallium stress scintigraphy in patients with stable angina pectoris

    SciTech Connect

    Shapiro, W.; Narahara, K.A.; Park, J.

    1982-01-01

    Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a 7-month study, 36 patients with stable angina pectoris were tested during a 3-month single-blind placebo phase. Nineteen were then randomized by double-blind methods to lidoflazine and 17 to placebo therapy. The lidoflazine group had a significant (p less than 0.01) reduction in anginal attacks; the placebo group did not. Exercise testing demonstrated that lidoflazine therapy was associated with a 34% increase in total work performance and a 15.6% increase in peak calculated oxygen uptake during double-blind treatment (both p less than 0.004 compared with the placebo group). Heart rate was significantly reduced at submaximal levels of exercise during lidoflazine therapy (p less than 0.04). Nitroglycerin consumption and electrocardiographic changes at the end of exercise did not change during the double-blind phase. In a second study of six similar patients, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise.

  20. The role of tumour markers in predicting skeletal metastases in breast cancer patients with equivocal bone scintigraphy

    PubMed Central

    Nicolini, A; Ferrari, P; Sagripanti, A; Carpi, A

    1999-01-01

    Bone scintigraphy (BS) is commonly performed in the staging and postoperative monitoring of breast cancer. Nevertheless, due to low specificity it often demonstrates hot spots with equivocal interpretation, which may be misleading in the management of these patients. The aim of this study was to assess the value of a serum tumour marker panel in selecting among the patients with equivocal BS those with bone metastases. Between January 1986 and December 1995, 297 breast cancer patients were followed-up after mastectomy with serial determinations of a CEA-TPA-CA15.3 tumour marker panel, BS and liver echography. The tumour marker panel was used to select patients with equivocal BS for examination of suspicious bone areas by further imaging techniques. Up to December 1995, 158 (53%) patients showed an equivocal BS and 47 patients developed bone metastases. In the 158 patients with equivocal BS, prolonged clinical and imaging follow-up over 45 months (mean; range 12–120) was used to ascertain the presence or absence of bone metastases. In these 158 patients the negative predictive value and positive predictive value of the tumour marker panel to predict bone metastases was 97% and 75% respectively. This study shows that in breast cancer patients the CEA-TPA-CA15.3 tumour marker panel has a high value in selecting those patients with bone metastases, or at high risk of developing clinically-evident bone metastases, among the large number of subjects with equivocal BS. © 1999 Cancer Research Campaign PMID:10188888

  1. Comparison of Diagnostic Performance Between Visual and Quantitative Assessment of Bone Scintigraphy Results in Patients With Painful Temporomandibular Disorder

    PubMed Central

    Choi, Bong-Hoi; Yoon, Seok-Ho; Song, Seung-Il; Yoon, Joon-Kee; Lee, Su Jin; An, Young-Sil

    2016-01-01

    Abstract This retrospective clinical study was performed to evaluate whether a visual or quantitative method is more valuable for assessing painful temporomandibular disorder (TMD) using bone scintigraphy results. In total, 230 patients (172 women and 58 men) with TMD were enrolled. All patients were questioned about their temporomandibular joint (TMJ) pain. Bone scintigraphic data were acquired in all patients, and images were analyzed by visual and quantitative methods using the TMJ-to-skull uptake ratio. The diagnostic performances of both bone scintigraphic assessment methods for painful TMD were compared. In total, 241 of 460 TMJs (52.4%) were finally diagnosed with painful TMD. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the visual analysis for diagnosing painful TMD were 62.8%, 59.6%, 58.6%, 63.8%, and 61.1%, respectively. The quantitative assessment showed the ability to diagnose painful TMD with a sensitivity of 58.8% and specificity of 69.3%. The diagnostic ability of the visual analysis for diagnosing painful TMD was not significantly different from that of the quantitative analysis. Visual bone scintigraphic analysis showed a diagnostic utility similar to that of quantitative assessment for the diagnosis of painful TMD. PMID:26765456

  2. (99m)Technetium Sestamibi-(123)Iodine Scintigraphy Is More Accurate Than (99m)Technetium Sestamibi Alone before Surgery for Primary Hyperparathyroidism.

    PubMed

    Ryhänen, Eeva M; Schildt, Jukka; Heiskanen, Ilkka; Väisänen, Mika; Ahonen, Aapo; Löyttyniemi, Eliisa; Schalin-Jäntti, Camilla; Välimäki, Matti J

    2015-01-01

    Objectives. Studies comparing outcome of single-(99m)Tc-methoxyisobutylisonitrile ((99m)Tc-sestamibi) and dual-tracer (99m)Tc-sestamibi scintigraphy in combination with (123)I before primary surgery of primary hyperparathyroidism (PHPT) are scarce. Methods. We compared (99m)Tc-sestamibi/(123)I and (99m)Tc-sestamibi in a single-centre retrospective series of 269 PHPT patients. The results were related to laboratory, surgical and histological findings. Results. (99m)Tc-sestamibi/(123)I and (99m)Tc-sestamibi were positive in 206 (76.6%) and 111 (41.3%) of 269 patients, respectively (P < 0.001). Accuracies for (99m)Tc-sestamibi/(123)I and (99m)Tc-sestamibi were 63.4% and 34.9%, respectively (96% CI, P < 0.001). Prevalence of multiglandular disease was 15.2%. In multiglandular disease, (99m)Tc-sestamibi/(123)I and (99m)Tc-sestamibi revealed 43.8 and 22.1% of pathological glands, respectively (P < 0.001). Cure rate was similar for patients with (191/206; 92.7%) and without (59 of 63; 93.7%) a positive (99m)Tc-sestamibi/(123)I finding. Duration of targeted surgery (one or two quadrants) was 21 and 15 minutes shorter than bilateral neck exploration, respectively (both P < 0.001). Higher serum calcium (P = 0.014) and PTH (P = 0.055) concentrations and larger tumours (P < 0.001) characterized the 206 patients with a positive preoperative scan who were cured by removal of a single adenoma. Conclusions. (99m)Tc-sestamibi/(123)I scintigraphy is more accurate than (99m)Tc-sestamibi before surgery of PHPT. However, outcome of surgery is not determined by scintigraphy alone.

  3. Prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia: study by 99mTc-sestamibi radionuclide scintigraphy.

    PubMed

    Ismail, Ahmed M; Rayan, Mona; Adel, Amr; Demerdash, Salah; Atef, Mohamed; Abdallah, Mohamed; Nammas, Wail

    2014-02-01

    We explored the prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia (CAE), as demonstrated by (99m)Tc-sestamibi scintigraphy. Prospectively, we enrolled 35 patients with angiographically documented CAE and no significant coronary obstruction, who underwent elective coronary angiography. Patients underwent Stress-rest (99m)Tc-sestamibi scintigraphy within 4 days of coronary angiography. They were divided into 2 groups: group I: with normal perfusion scan; and group II: with reversible perfusion defects. The mean age was 49.6 ± 6.9 years; 34 (97.1 %) were males. Seventy-nine (75.2 %) arteries were affected by CAE. Among 79 arteries affected by CAE, affection was diffuse in 37 (46.8 %). Thirteen (37.1 %) patients had normal perfusion scan (group I), whereas 22 (62.9 %) had reversible perfusion defects (group II). Among 22 patients with reversible perfusion defects, 20 (90.9 %) had mild and 2 (9.1 %) had moderate ischemia. Among 49 myocardial segments with reversible perfusion defects, 22 (44.9 %) were basal, 18 (36.7 %) mid-, and 9 (18.4 %) apical segments. Diffuse CAE was significantly more prevalent in group II versus group I, in all 3 major coronary arteries (p < 0.05 for all). In patients with isolated CAE who underwent elective coronary angiography, reversible perfusion defects demonstrated by (99m)Tc-sestamibi scintigraphy were rather prevalent, mostly mild, more likely to affect the basal and mid-segments of the myocardium, and more frequently associated with diffuse ectasia.

  4. The effect of an iodine restricted including no sea foods diet, on technetium-99m thyroid scintigraphy: a neglected issue in nuclear medicine practice.

    PubMed

    Javadi, Hamid; Neshandarasli, Isa; Mogharrabi, Mehdi; Jalallat, Sara; Nabipour, Iraj; Assadi, Majid

    2012-01-01

    Although it is recommended to patients to avoid sea food and iodine-containing medications prior to iodine-131 (¹³¹I) scanning, the efficacy of this diet as for technetium-99m pertechnetate ((99m)Tc-P) thyroid scintigraphy is not well addressed in the literature. We evaluated a self-managed, outpatients, iodine restricted diet (IRD) designed to reduce total body iodine in preparation for such a scan. We have studied 39 patients who referred to our Department for multinodular goiter, 30 females and 9 males, aged:14-54 years and their (99m)Tc-P thyroid scintigraphy showed poor visualization of the thyroid gland. These patiens were living in regions with high consumption of sea foods went underwent a two-weeks iodine restriction including restriction of sea food diet for the reduction of iodine body content. These patients were called for a repeated scan after going on a IRD for at least two weeks. The two scans were compared visually, and by semiquantitative analysis. Semiquantitative analysis was applied in 8 regions of interest (ROI) by using Wilcoxon signed rank test. Thirty-six subjects had better quality scintigraphy images in the post IRD thyroid scan, as was visually assessed by two nuclear medicine physicians. Semiquantitatetively, there was a significant difference in the mean counts of ROI of the right and the left thyroid lobes in favor of the post IRD scans (P<0.05). In conclusion, this study suggests that in patients with multinodular goiter, living in regions with high consumption of sea foods a two-weeks diet for the reduction of iodine body content induces in most of the cases a slightly better diagnostic thyroid (99m)Tc-P scan.

  5. [Influence of extracorporeal shock wave lithotripsy (ESWL) on renal function assessed by 99mTc-DMSA scintigraphy: comparative analysis between ESWL and percutaneous nephroureterolithotripsy (PNL)].

    PubMed

    Matsuura, H; Hioki, T; Sakurai, M; Arima, K; Yanagawa, M; Sugimura, Y; Tochigi, H; Kawamura, J; Kinoshita, N; Katoh, H

    1994-12-01

    99mTc-DMSA renal scintigraphy was utilized to investigate the influence of ESWL on renal function in comparison with that of PNL. In the beginning, the reproducibility of renal uptake rate by the scintigraphy was examined in eleven healthy volunteers under both non-diuretic and diuretic states. The renal uptake rate was shown to be sufficiently reproducible in the same person in the two different trials. However, the differences and the standard deviations were shown to be a few percentages, which were not statistically significant. Changes in the repeated renal uptake rate seem to indicate not only changes of renal function with the treatment but also some technical errors. Herein, to investigate changes in renal function of the therapeutic side, the uptake ratio rate (rate of uptake rate in the therapeutic side/uptake rate in the contral lateral side) was utilized instead of uptake rate. Renal scintigraphy was carried out in 48 patients with unilateral renal stones before and after ESWL or PNL monotherapy or the combined ESWL and PNL therapies. Within one week of treatment, the uptake ratio rate significantly decreased in patients with PNL or the combined ESWL and PNL, although DMSA uptake rate in the therapeutic side did not significantly changes. Neither renal uptake rate nor uptake ratio rate significantly changed after ESWL treatment. There was no significant difference in changes of uptake ratio rate between Siemens Lithostars Plus and the improved Dornier HM-3 lithotriptors. This study indicated that ESWL monotherapy did not affect the uptake ratio rate, although PNL monotherapy and the combined ESWL and PNL therapies may affect the uptake ratio rate to some extent.

  6. The effect of an iodine restricted including no sea foods diet, on technetium-99m thyroid scintigraphy: a neglected issue in nuclear medicine practice.

    PubMed

    Javadi, Hamid; Neshandarasli, Isa; Mogharrabi, Mehdi; Jalallat, Sara; Nabipour, Iraj; Assadi, Majid

    2012-01-01

    Although it is recommended to patients to avoid sea food and iodine-containing medications prior to iodine-131 (¹³¹I) scanning, the efficacy of this diet as for technetium-99m pertechnetate ((99m)Tc-P) thyroid scintigraphy is not well addressed in the literature. We evaluated a self-managed, outpatients, iodine restricted diet (IRD) designed to reduce total body iodine in preparation for such a scan. We have studied 39 patients who referred to our Department for multinodular goiter, 30 females and 9 males, aged:14-54 years and their (99m)Tc-P thyroid scintigraphy showed poor visualization of the thyroid gland. These patiens were living in regions with high consumption of sea foods went underwent a two-weeks iodine restriction including restriction of sea food diet for the reduction of iodine body content. These patients were called for a repeated scan after going on a IRD for at least two weeks. The two scans were compared visually, and by semiquantitative analysis. Semiquantitative analysis was applied in 8 regions of interest (ROI) by using Wilcoxon signed rank test. Thirty-six subjects had better quality scintigraphy images in the post IRD thyroid scan, as was visually assessed by two nuclear medicine physicians. Semiquantitatetively, there was a significant difference in the mean counts of ROI of the right and the left thyroid lobes in favor of the post IRD scans (P<0.05). In conclusion, this study suggests that in patients with multinodular goiter, living in regions with high consumption of sea foods a two-weeks diet for the reduction of iodine body content induces in most of the cases a slightly better diagnostic thyroid (99m)Tc-P scan. PMID:22413111

  7. Unusual mediastinal lymph node uptake and peritoneopleural fistula demonstrated on Technetium-99m macro-aggregated human serum albumin (Tc-99m MAA) peritoneal scintigraphy in a patient with portal hypertension.

    PubMed

    Tan, C J; Thang, S P; Lam, W W

    2016-04-01

    Peritoneal radionuclide scan is an established imaging modality for evaluating peritoneopleural communications. In this case report, unusual mediastinal lymph node radiotracer uptake is seen in a patient with portal hypertension on peritoneal scintigraphy. This was suspected to be due to marked lymphatic enlargement from longstanding portal hypertension since childhood, permitting passage of the large Tc-99m MAA particle. The nodes were morphologically benign on CT. Mediastinal lymph node uptake on peritoneal scintigraphy is rare but should not raise undue clinical concern, particularly in a patient with chronic portal hypertension. Anatomic correlation with SPECT-CT can provide reassurance. PMID:27326945

  8. Follow-up (99m)Tc EC renal dynamic scintigraphy and DMSA-III SPECT/CT in unmasking a masqueraded case of Horseshoe kidney.

    PubMed

    Jain, T K; Basher, R K; Mittal, B R; Bhatia, A; Rao, K L N

    2015-01-01

    Hydronephrosis is a common finding in urinary tract outflow obstruction. Chronically obstructed hydronephrotic system may be associated with parenchymal changes. Ultrasound, intravenous urography, micturating cysto-urethrogram and scintigraphy are commonly performed to evaluate the cause of obstruction. In childhood, pelviureteric junction obstruction is a common cause of the hydronephrosis. Hydronephrosis can also be present in horseshoe kidneys due to poor drainage. However, a large sized hydronephrotic cavity may obscure the finding of horseshoe kidney. A case was reported, and it was diagnosed as horseshoe kidney on follow-up renal dynamic scan and confirmed with the help of dimercaptosuccinic acid SPECT/CT.

  9. 99m-Tc-ubiquicidin scintigraphy in diagnosis of knee prosthesis infection and comparison with F-18 fluorodeoxy-glucose positron emission tomography/computed tomography.

    PubMed

    Kamaleshwaran, Koramadai Karuppusamy; Rajkumar, N; Mohanan, Vyshak; Kalarikal, Radhakrishnan; Shinto, Ajit Sugunan

    2015-01-01

    Total knee arthroplasty has witnessed a significant increase in recent years. Despite the advantages of this surgical procedure, it has some complications, the most serious of which is prosthetic infection. The discrimination of bacterial infections from sterile inflammatory processes is of great importance in the management of periprosthetic infection (PPI). Ubiquicidin (UBI) is a synthetic antimicrobial peptide fragment reported to be highly infection-specific. Tc99m-UBI has recently been reported to be a promising radiotracer for infection imaging. We report a case of left knee PPI diagnosed using 99mTc-UBI scintigraphy and compared with F-18 fluorodeoxy-glucose positron emission tomography.

  10. 99m-Tc-ubiquicidin scintigraphy in diagnosis of knee prosthesis infection and comparison with F-18 fluorodeoxy-glucose positron emission tomography/computed tomography

    PubMed Central

    Kamaleshwaran, Koramadai Karuppusamy; Rajkumar, N; Mohanan, Vyshak; Kalarikal, Radhakrishnan; Shinto, Ajit Sugunan

    2015-01-01

    Total knee arthroplasty has witnessed a significant increase in recent years. Despite the advantages of this surgical procedure, it has some complications, the most serious of which is prosthetic infection. The discrimination of bacterial infections from sterile inflammatory processes is of great importance in the management of periprosthetic infection (PPI). Ubiquicidin (UBI) is a synthetic antimicrobial peptide fragment reported to be highly infection-specific. Tc99m-UBI has recently been reported to be a promising radiotracer for infection imaging. We report a case of left knee PPI diagnosed using 99mTc-UBI scintigraphy and compared with F-18 fluorodeoxy-glucose positron emission tomography. PMID:26170572

  11. Unusual case of hepatic metastasis in follicular thyroid carcinoma detected using I-131 whole body scintigraphy and single-photon emission computerized tomography/computerized tomography

    PubMed Central

    Kamaleshwaran, Koramadai Karuppusamy; Natarajan, Sudhakar; Mohanan, Vyshak; Shinto, Ajit Sugunan

    2015-01-01

    Papillary and follicular thyroid carcinomas, together known as differentiated thyroid carcinomas (DTC), are among the most curable of cancers. Distant metastases are rare events at the onset of DTC. Among these presentations, metastasis to the liver is even more unusual. Only 11 cases of DTC with liver metastasis were previously reported in the literature. We present a 55-year-old male on Iodine-131 whole body scintigraphy showed intense uptake in thyroid bed, metastasis in both lungs and right lobe of the liver. Radioiodine concentration in liver metastases made him amenable to high-dose radioiodine therapy patient. PMID:26430327

  12. Mediastinal ectopic benign colloid goitre detected using iodine-131 whole body scintigraphy and single-photon emission computed tomography-computed tomography.

    PubMed

    Kamaleshwaran, Koramadai Karuppusamy; Rajan, Firoz; Asokumar, Premkumar; Mohanan, Vyshak; Shinto, Ajit Sugunan

    2015-01-01

    Ectopic thyroid tissue primarily occurs along the course of the embryologic migration of the thyroid gland. Mediastinal thyroid may be differentiated into primary and secondary form. Primary mediastinal goiters are quite rare, occurring in <1% of all goiters. We present findings of 29-year-old female, case of papillary carcinoma of the thyroid who underwent iodine-131 whole body scintigraphy after total thyroidectomy showed a primary mediastinal mass lesion along with residual thyroid. She underwent mediastinal mass excision through sternotomy and biopsy confirmed as ectopic nodular colloid goiter with no malignancy.

  13. Mediastinal ectopic benign colloid goitre detected using iodine-131 whole body scintigraphy and single-photon emission computed tomography-computed tomography

    PubMed Central

    Kamaleshwaran, Koramadai Karuppusamy; Rajan, Firoz; Asokumar, Premkumar; Mohanan, Vyshak; Shinto, Ajit Sugunan

    2015-01-01

    Ectopic thyroid tissue primarily occurs along the course of the embryologic migration of the thyroid gland. Mediastinal thyroid may be differentiated into primary and secondary form. Primary mediastinal goiters are quite rare, occurring in <1% of all goiters. We present findings of 29-year-old female, case of papillary carcinoma of the thyroid who underwent iodine-131 whole body scintigraphy after total thyroidectomy showed a primary mediastinal mass lesion along with residual thyroid. She underwent mediastinal mass excision through sternotomy and biopsy confirmed as ectopic nodular colloid goiter with no malignancy. PMID:25829745

  14. Unusual case of hepatic metastasis in follicular thyroid carcinoma detected using I-131 whole body scintigraphy and single-photon emission computerized tomography/computerized tomography.

    PubMed

    Kamaleshwaran, Koramadai Karuppusamy; Natarajan, Sudhakar; Mohanan, Vyshak; Shinto, Ajit Sugunan

    2015-01-01

    Papillary and follicular thyroid carcinomas, together known as differentiated thyroid carcinomas (DTC), are among the most curable of cancers. Distant metastases are rare events at the onset of DTC. Among these presentations, metastasis to the liver is even more unusual. Only 11 cases of DTC with liver metastasis were previously reported in the literature. We present a 55-year-old male on Iodine-131 whole body scintigraphy showed intense uptake in thyroid bed, metastasis in both lungs and right lobe of the liver. Radioiodine concentration in liver metastases made him amenable to high-dose radioiodine therapy patient.

  15. Osteomalacia-inducing renal clear cell carcinoma uncovered by 99mTc-Hydrazinonicotinyl-Tyr3-octreotide (99mTc-HYNIC-TOC) scintigraphy.

    PubMed

    Jin, Xiaona; Jing, Hongli; Li, Fang; Zhuang, Hongming

    2013-11-01

    Most osteomalacia-causing tumors are small, benign mesenchymal neoplasms, which are commonly located in the extremities or craniofacial regions. An 18-year-old male patient with suspicion of tumor-induced osteomalacia underwent (99m)Tc-HYNIC-TOC scintigraphy to search potential culprit tumor. The images showed a large activity in the region of the left kidney. The lesion was resected and a clear cell renal cell carcinoma was found. One year after the left nephrectomy, the patient was tumor-free without symptoms of osteomalacia.

  16. Is there still a role for thyroid scintigraphy in the workup of a thyroid nodule in the era of fine needle aspiration cytology and molecular testing?

    PubMed Central

    Moreno-Reyes, Rodrigo; Kyrilli, Aglaia; Lytrivi, Maria; Bourmorck, Carole; Chami, Rayan; Corvilain, Bernard

    2016-01-01

    Thyroid scintigraphy is now rarely used in the work-up of a thyroid nodule except in the presence of a low TSH value. Therefore, autonomously functioning thyroid nodules (AFTNs) with a normal TSH value are diagnosed only in the rare medical centers that continue to use thyroid scan systematically in the presence of a thyroid nodule. In this review, we discuss the prevalence of AFTN with a normal TSH level and the possible consequences of performing fine needle aspiration cytology (FNAC) in an undiagnosed AFTN. We also discuss the risk of malignant AFTN which may be higher than previously stated. PMID:27158470

  17. Detection of ectopic gastric mucosa in Meckel's diverticulum and in other aberrations by scintigraphy: ii. indications and methods--a 10-year experience.

    PubMed

    Sfakianakis, G N; Conway, J J

    1981-08-01

    Ten years' experience with pertechnetate (Tc-99m) abdominal scintigraphy has shown that the method is specifically indicated for the diagnosis and location of ectopic gastric mucosa in a Meckel's diverticulum, in enteric or gastric duplications and cysts, and in Barrett's esophagus. Careful patient preparation is essential, and sequential gamma camera imaging for 1 hr in the anterior projection is advisable, with complementary lateral, upright, and postvoiding views. Nonspecific accumulations of the tracer within tumours, intestinal obstructions, arteriovenous malformations, and the urinary tract can be recognized with the help of the clinical history and can be investigated by other tests. This approach has raised the accuracy of the method above 90%.

  18. Expectoration in the gastrointestinal tract. A diagnostic problem in In-111 granulocyte scintigraphy

    SciTech Connect

    Schifter, S.; Madsen, J.L. )

    1990-09-01

    Scintigraphic detection of infectious foci with In-111 labeled granulocytes or leukocytes is a well-established technique in nuclear medicine. The technique is commonly used to demonstrate inflammatory activity in Crohn's disease and ulcerative colitis. Its application, however, may be influenced by infectious expectoration located within the gastrointestinal tract. In performing this technique, it is important to have this differential diagnostic possibility in mind; it can be clarified by repeated imaging.

  19. Bromocriptine loaded chitosan nanoparticles intended for direct nose to brain delivery: pharmacodynamic, pharmacokinetic and scintigraphy study in mice model.

    PubMed

    Md, Shadab; Khan, Rashid A; Mustafa, Gulam; Chuttani, Krishna; Baboota, Sanjula; Sahni, Jasjeet K; Ali, Javed

    2013-02-14

    The primary aim of this study was to investigate the potential use of chitosan nanoparticles as a delivery system to enhance the brain targeting efficiency of bromocriptine (BRC) following intranasal (i.n.) administration. The BRC loaded chitosan nanoparticles (CS NPs) were prepared by ionic gelation of CS with tripolyphosphate anions. These NPs had a mean size (161.3 ± 4. 7 nm), zeta potential (+40.3 ± 2.7 mV), loading capacity (37.8% ± 1.8%) and entrapment efficiency (84.2% ± 3.5%). The oral administration of haloperidol (2mg/kg) to mice produced typical Parkinson (PD) symptoms. Catalepsy and akinesia outcomes in animals receiving BRC either in solution or within CS NPs showed a reversal in catalepsy and akinesia behavior when compared to haloperidol treated mice, this reversal being specially pronounced in mice receiving BRC loaded CS NPs. Biodistribution of BRC formulations in the brain and blood of mice following i.n. and intravenous (i.v.) administration was performed using optimized technetium labeled (99mTc-labeled) BRC formulations. The brain/blood ratio of 0.47 ± 0.04, 0.69 ± 0.031, and 0.05 ± 0.01 for BRC solution (i.n.), BRC loaded CS NPs (i.n.) and (i.v.) respectively, at 0.5h are suggestive of direct nose to brain transport bypassing the blood-brain barrier. Gamma scintigraphy imaging of mice brain following i.v. and i.n. administrations were performed to determine the localization of drug in brain. The drug targeting index and direct transport percentage for BRC loaded CS NPs following i.n. route were 6.3 ± 0.8 and 84.2% ± 1.9%. These encouraging results confirmed the development of a novel non-invasive nose to brain delivery system of BRC for the treatment of PD.

  20. The significance of faint visualization of the superior sagittal sinus in brain scintigraphy for the diagnosis of brain death

    SciTech Connect

    Bisset, R.; Sfakianakis, G.; Ihmedian, I.; Holzman, B.; Curless, R.; Serafini, A.

    1985-05-01

    Brain death is associated with cessation of blood flow to the brain. Tc-99m brain flow studies are used as a laboratory confirmatory test for the establishment of the diagnosis of brain death. Criteria for the diagnosis of cessation of blood flow to the brain are 1) visualization of carotid artery activity in the neck of the patient and 2) no visualization of activity in the distribution of the anterior and middle cerebral arteries. The authors noticed that in a significant number of patients, although there was no visualization of arterial blood flow to the brain the static images demonstrated faint accumulation of activity in the region of the superior sagittal sinus (SSS). In a four year period 212 brain flow studies were performed in 154 patients for diagnosis of brain death; of them 137 studies (65%) showed no evidence of arterial flow. In 103 out of the 137 studies (75%) there was no visualization of the SSS; in the remaining 34 studies (3l patients) however three patterns of faint activity attributed to partial and or faint visualization of the SSS could be recognized at the midline of the immediate anterior static view: a) linear from the cranial vault floor up b) disk shaped at the apex of the vault and c) disk shaped at the apex tailing caudad. All of the 3l patients in this group satisfied brain death criteria within four days of the last study which showed faint visualization of the superior sagittal sinus. The authors conclude that even in the presence of a faint visualization of the superior sagittal sinus on static post brain flow scintigraphy, the diagnosis of cessation of blood flow to the brain can be made if there is no evidence of arterial blood flow.

  1. Usefulness of thallium-201 scintigraphy in predicting the development of angina pectoris in hypertensive patients with left ventricular hypertrophy

    SciTech Connect

    Tubau, J.F.; Szlachcic, J.; Hollenberg, M.; Massie, B.M.

    1989-07-01

    Hypertension and left ventricular (LV) hypertrophy are independent risk factors for the development of coronary artery disease. To determine whether patients at higher risk for coronary artery disease can be identified, 40 asymptomatic hypertensive men with LV hypertrophy were prospectively studied using exercise thallium-201 scintigraphy and exercise radionuclide angiography. Endpoints indicative of coronary artery disease were defined as the subsequent development of typical angina pectoris, which occurred in 8 patients during a median follow-up of 38 months, or myocardial infarction, which did not occur. The exercise electrocardiogram was interpreted by standard ST-segment criteria and by a computerized treadmill exercise score. Abnormal ST-segment responses were present in 16 of the 40 hypertensives (40%), whereas the treadmill score was positive in 8 of those same 40 patients (20%). Scintigraphic perfusion defects assessed both visually and semiquantitatively were observed in 8 of 40 (20%) patients. An abnormal ejection fraction response to exercise was present in 40% (16 of 40) of patients, and 3 of 40 (7.5%) developed new wall motion abnormalities during exercise. Six of 8 patients with either perfusion defects or abnormal treadmill score developed typical angina during follow-up. All 5 patients with concordant positive exercise scintigrams and treadmill score developed chest pain during follow-up and had coronary artery disease confirmed by coronary angiography. However, only 7 of 16 (44%) patients with positive ST changes or abnormal ejection fraction responses during exercise developed chest pain during follow-up. In contrast, of 32 patients with negative scintigrams only 2 developed atypical chest pain syndromes, and significant coronary artery disease was excluded by angiography in 1 patient.

  2. Alterations in myocardial perfusion during exercise after isosorbide dinitrate infusion in patients with coronary disease: assessment by thallium-201 scintigraphy

    SciTech Connect

    Tono, I.; Satoh, S.; Kanaya, T.; Komatani, A.; Takahashi, K.; Tsuiki, K.; Yasui, S.

    1986-03-01

    We studied the effect of intravenous isosorbide dinitrate (ISDN) on myocardial perfusion of patients with coronary artery disease, by using exercise thallium-201 (TI-201) myocardial scintigraphy. A control study was conducted initially to assess regional myocardial perfusion rate. Left ventricular myocardium was divided into six parts: anterior, lateral, apical, inferior, posterior, and septal segments. The segmental myocardial perfusion was characterized according to TI-201 initial uptake index (IUI) of relative distribution and redistribution index (RDI) of TI-201 washout. The normal limit of IUI and RDI was established from the data of 17 persons with normal coronary arteries, and then the IUI less than or equal to 84% and the RDI greater than or equal to 1.12 was defined as abnormal. Based on IUI and RDI, each segment was characterized into three types: A type = IUI less than or equal to 84%, RDI greater than or equal to 1.12; B type = IUI less than or equal to 84%, RDI less than 1.12; and C type = IUI greater than 84%, RDI less than 1.12. ISDN was given as a dose of 0.1 mg/kg/hr, and then treadmill testing was repeated for the same duration of exercise time using the same protocol as in the control period. The segments of A type showed a significant improvement in IUI and RDI after receiving ISDN infusion, while the B and C type segments showed no change. It was also shown that the improvement of IUI and RDI of the A type segments was not as marked in multivessel disease as in cases of single-vessel disease.

  3. Myocardial viability in patients with chronic coronary artery disease and previous myocardial infarction: comparison of myocardial contrast echocardiography and myocardial perfusion scintigraphy.

    PubMed

    Vernon, S; Kaul, S; Powers, E R; Camarano, G; Gimple, L W; Ragosta, M

    1997-11-01

    The aim of this study was to compare perfusion patterns on myocardial contrast echocardiography with those on myocardial perfusion scintigraphy for the assessment of myocardial viability in patients with previous myocardial infarction. Accordingly, perfusion scores with the two techniques were compared in 91 ventricular regions in 21 patients with previous (>6 weeks old) myocardial infarction. Complete concordance between the two techniques was found in 63 (69%) regions; 25 (27%) regions were discordant by only 1 grade, and complete discordance (2 grades) was found in only 3 (3%) regions. A kappa statistic of 0.65 indicated good concordance between the two techniques. Although the scores on both techniques demonstrated a relation with the wall motion score, the correlation between the myocardial contrast echocardiography and wall motion scores was closer (r = -0.63 vs r = -0.50, p = 0.05). It is concluded that myocardial contrast echocardiography provides similar information regarding myocardial viability as myocardial perfusion scintigraphy in patients with coronary artery disease and previous myocardial infarction.

  4. Bone scintigraphy in evaluating the viability of composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and free non-revascularized periosteal grafts

    SciTech Connect

    Berggren, A.; Weiland, A.J.; Ostrup, L.T.

    1982-07-01

    Researchers studied the value of bone scintigraphy in the assessment of anastomotic patency and bone-cell viability in free bone grafts revascularized by microvascular anastomoses in twenty-seven dogs. The dogs were divided into three different groups, and scintigraphy was carried out using technetium-labeled methylene diphosphonate in composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and periosteal grafts placed in different recipient beds. The viability of the grafts were evaluated by histological examination and fluorescence microscopy after triple labeling with oxytetracycline on the first postoperative day, alizarin complexone on the fourth postoperative day, and DCAF on the eleventh postoperative day. A positive scintiscan within the first week following surgery indicated patent microvascular anastomoses, and histological study and fluorescence microscopy confirmed that bone throughout the graft was viable. A positive scintiscan one week after surgery or later does not necessarily indicate microvascular patency or bone-cell survival, because new bone formed by creeping substitution on the surface of a dead bone graft can result in this finding.

  5. Noninvasive diagnostic test choices for the evaluation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography and exercise thallium myocardial perfusion scintigraphy

    SciTech Connect

    Hung, J.; Chaitman, B.R.; Lam, J.; Lesperance, J.; Dupras, G.; Fines, P.; Bourassa, M.G.

    1984-07-01

    Several diagnostic noninvasive tests to detect coronary and multivessel coronary disease are available for women. However, all are imperfect and it is not yet clear whether one particular test provides substantially more information than others. The aim of this study was to evaluate clinical findings, exercise electrocardiography, exercise thallium myocardial scintigraphy and cardiac fluoroscopy in 92 symptomatic women without previous infarction and determine which tests were most useful in determining the presence of coronary disease and its severity. Univariate analysis revealed two clinical, eight exercise electrocardiographic, seven myocardial scintigraphic and seven fluoroscopic variables predictive of coronary or multivessel disease with 70% or greater stenosis. The multivariate discriminant function analysis selected a reversible thallium defect, coronary calcification and character of chest pain syndrome as the variables most predictive of presence or absence of coronary disease. The ranked order of variables most predictive of multivessel disease were cardiac fluoroscopy score, thallium score and extent of ST segment depression in 14 electrocardiographic leads. Each provided statistically significant information to the model. The estimate of predictive accuracy was 89% for coronary disease and 97% for multivessel coronary disease. The results suggest that cardiac fluoroscopy or thallium scintigraphy provide significantly more diagnostic information than exercise electrocardiography in women over a wide range of clinical patient subsets.

  6. Intracoronary Infusion of Autologous CD133+ Cells in Myocardial Infarction and Tracing by Tc99m MIBI Scintigraphy of the Heart Areas Involved in Cell Homing

    PubMed Central

    Kurbonov, Ubaidullo; Dustov, Abdusamad; Barotov, Alisher; Khidirov, Murtazokul; Mirojov, Giesidin; Rahimov, Zikrie; Navjuvonov, Navjuvon; Rizoev, Eraj; Olimov, Nasim; Goibov, Alijon; Karim-Zade, Bakhtovar; Rakhmatov, Mukim; Muminjonov, Suhayli; Didari, Azadeh; Irgasheva, Jamila; Bobokhojaev, Oktam; Gulmuradov, Tashpulat; Therwath, Amu; Rakhmonov, Sohibnazar; Mirshahi, Massoud

    2013-01-01

    CD133 mesenchymal cells were enriched using magnetic microbead anti-CD133 antibody from bone marrow mononuclear cells (BMMNCs). Flow cytometry and immunocytochemistry analysis using specific antibodies revealed that these cells were essentially 89 ± 4% CD133+ and 8 ± 5% CD34+. CD133+/CD34+ BMMNCs secrete important bioactive proteins such as cardiotrophin-1, angiogenic and neurogenic factors, morphogenetic proteins, and proinflammatory and remodeling factors in vitro. Single intracoronary infusions of autologous CD133+/CD34+ BMMNCs are effective and reduce infarct size in patients as analyzed by Tc99m MIBI myocardial scintigraphy. The majority of patients were treated via left coronary artery. Nine months after cell therapy, 5 out of 8 patients showed a net positive response to therapy in different regions of the heart. Uptake of Tc99 isotope and revitalization of the heart area in inferoseptal region are more pronounced (P = 0.016) as compared to apex and anterosptal regions after intracoronary injection of the stem cells. The cells chosen here have the properties essential for their potential use in cell therapy and their homing can be followed without major difficulty by the scintigraphy. The cell therapy proposed here is safe and should be practiced, as we found, in conjunction with scintigraphic observation of areas of heart which respond optimally to the infusion of autologous CD133+/CD34+ BMMNCs. PMID:23983717

  7. Value of noninvasive assessment of patients with atypical chest pain and suspected coronary spasm using ergonovine infusion and thallium-201 scintigraphy

    SciTech Connect

    DiCarlo, L.A. Jr.; Botvinick, E.H.; Canhasi, B.S.; Schwartz, A.S.; Chatterjee, K.

    1984-10-01

    Twenty-six patients with known benign coronary anatomic characteristics and atypical chest pain syndromes were evaluated for the possibility of coronary spasm. Incremental intravenous ergonovine maleate infusions were administered, and thallium-201 scintigraphy was performed at the peak dosage and during recovery in the coronary care unit. With ergonovine therapy, 4 patients (16%) had chest pain associated with electrocardiographic (ECG) or scintigraphic changes. Nine patients (35%) had chest pain without associated ECG or scintigraphic changes, and 13 patients did not have chest pain in response to ergonovine administration, although 2 (8%) had ergonovine-induced scintigraphic defects. All 4 patients with ergonovine-induced chest pain and associated ECG or scintigraphic abnormalities had resolution or reduction of chest pain after medical treatment. However, 7 of the 9 patients with ergonovine-induced chest pain in the absence of ECG or scintigraphic abnormalities continued to have symptoms despite medical treatment a mean of 18 months later. In this limited study of a select group, bedside ergonovine provocation appeared safe. Many patients had chest pain, but few showed ECG or scintigraphic evidence of ischemia. Perfusion scintigraphy appears to have potential complementary value for the identification of an ischemic cardiac cause of atypical chest pain and provides a rationale for appropriate therapy.

  8. The acetabulum: A prospective study of three-phase bone and indium white blood cell scintigraphy following porous-coated hip arthroplasty

    SciTech Connect

    Oswald, S.G.; Van Nostrand, D.; Savory, C.G.; Anderson, J.H.; Callaghan, J.J. )

    1990-03-01

    Although few studies address the use of three-phase bone scanning (TPBS) and indium-111-labeled white blood cell scintigraphy ({sup 111}In-WBC) in hip arthroplasty utilizing a porous-coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ from that seen with the cemented prosthesis. In an attempt to determine the scintigraphic natural history, 25 uncomplicated porous-coated hip arthroplasties in 21 patients were prospectively studied with serial TPBS and {sup 111I}n-WBC at approximately 7 days, and 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the acetabulum. All 25 prostheses (144 of 144 scans) demonstrated increased uptake on the bone-phase images. Although this activity decreased with time, 76% had persistent uptake at 24 mo. Twenty-three of 25 prostheses (126 of 140 scans) showed increased uptake on {sup 111}In-WBC scintigraphy, invariably decreasing with time, but with 37% having significant uptake at 24 mo. Scintigraphic patterns in the uncomplicated porous-coated hip arthroplasty patient appear to differ from patterns described in cemented prostheses.

  9. Differential diagnosis between secondary hyperparathyroidism and aluminum intoxication in uremic patients: Usefulness of /sup 99m/Tc-pyrophosphate bone scintigraphy

    SciTech Connect

    Kinnaert, P.; Van Hooff, I.; Schoutens, A.; Bergmann, P.; Fuss, M.; Dratwa, M.; Vienne, A.; Pasteels, J.L.; van Geertruyden, J.; Vanherweghem, J.L.

    1989-03-01

    Forty-one patients in chronic end-stage renal failure and 4 patients with a functioning kidney transplant presented with spontaneous hypercalcemia or intolerance to vitamin D3 sterols and/or oral calcium supplements. Bone iliac crest biopsy with aluminum staining and Tc-pyrophosphate bone scintigraphy with determination of Fogelman score were performed in all cases. Two patients had aluminum-induced osteomalacia (AL O). Thirty-eight biopsies showed renal osteodystrophy (secondary hyperparathyroidism or various combinations of osteitis fibrosa and osteomalacia): 19 with positive staining for aluminum (RO + AL) and 19 without aluminum deposits (RO). The series also comprised 2 cases of pure osteomalacia (OM), 2 cases of osteoporosis (OP), and 1 case of osteoporosis with aluminum accumulation (OP + AL). Mean Fogelman score in RO patients (9.1 +/- 0.3) was significantly higher than in all other categories (5.9 +/- 0.5 for RO + AL, and scores ranging from 0 to 8 in the last 7 patients, p less than 0.01). Patients with massive aluminum accumulation in bone (greater than 75% of the total trabecular surface) showed no or very low uptake of the isotope by the skeleton. Fogelman scores of 9 or higher were always associated with histological secondary hyperparathyroidism. /sup 99m/Tc-pyrophosphate bone scintigraphy is helpful to distinguish aluminum intoxication from secondary hyperparathyroidism in uremic patients.

  10. [The accuracy and side effects of pharmacologic stress thallium myocardial scintigraphy with adenosine triphosphate disodium (ATP) infusion in the diagnosis of coronary artery disease].

    PubMed

    Kinoshita, S; Suzuki, S; Shindou, A; Watanabe, K; Muramatsu, T; Ide, M; Dohi, Y; Yamashita, S; Suzuki, T; Nishimura, K

    1994-08-01

    The diagnostic accuracy and side effects of pharmacologic stress thallium myocardial scintigraphy with ATP infusion were studied in 172 patients with or without coronary artery disease. ATP was infused for five minutes at a rate of 0.16 mg/kg/min (group A) or 0.18 mg/kg/min (group B) via antecubital vein. One hundred and eleven (67 of group A, 44 of group B) of 172 patients underwent coronary arteriography (CAG). In 111 patients received CAG, overall sensitivity, specificity and accuracy of this method were 88%, 84% and 87%, respectively. In 67 patients of group A, these were 92%, 81% and 90%. In 44 patients of group B, 79%, 87% and 82% were documented (NS, between group A and B). Chest pain, flushing, bradycardia and ST depression were included in side effects caused by ATP infusion. At least one of these side effects were observed in 84% of the all 172 patients, 89% of group A and 75% of group B (NS). But, all of the side effects were spontaneously alleviated within two minutes without any therapy. In conclusion, pharmacologic stress myocardial scintigraphy with ATP infusion is very accurate and safe, and infusion rate of 0.16 mg/kg/min is optimal for this purpose. PMID:7933682

  11. Utility of /sup 67/Ga scintigraphy and bronchial washings in the diagnosis and treatment of Pneumocystis carinii pneumonia in patients with the acquired immune deficiency syndrome

    SciTech Connect

    Tuazon, C.U.; Delaney, M.D.; Simon, G.L.; Witorsch, P.; Varma, V.M.

    1985-11-01

    Twenty patients with the acquired immune deficiency syndrome (AIDS) and suspected Pneumocystis carinii pneumonia were evaluated by /sup 67/Ga scintigraphy and fiberoptic bronchoscopy for initial diagnosis and response to therapy. Lung uptake of /sup 67/Ga was demonstrated in 100% of AIDS patients with P. carinii pneumonia, including those with subclinical infection. Fiberoptic bronchoscopy identified P. carinii in the bronchial washings of 100% of cases (19 patients), whereas only 13 of 16 (81%) patients had P. carinii in lung tissue obtained by transbronchial biopsy. Repeat fiberoptic bronchoscopy was performed in 16 of 20 patients. After 2 to 4 wk of therapy, P. carinii was identified in bronchial washings in 8 of 16 (50%) patients and in transbronchial biopsy in 1 of 10 (10%) patients examined. Bronchial washing has a higher yield than transbronchial biopsy in demonstrating P. carinii in patients with AIDS and may evolve as the procedure of choice in such patients. Based on the clinical course and results of /sup 67/Ga scintigraphy and fiberoptic bronchoscopy in AIDS patients with P. carinii pneumonia, optimal therapy may require at least 3 wk of treatment.

  12. ICG fluorescence imaging and its medical applications

    NASA Astrophysics Data System (ADS)

    Miwa, Mitsuharu; Shikayama, Takahiro

    2008-12-01

    This paper presents a novel optical angiography system, and introduces its medical applications. We developed the optical enhanced imaging system which can observe the blood and lymphatic vessels as the Indocyanine green (ICG) fluorescence image. The imaging system consists of 760nm light emitted diode (LED) as excite light, CCD camera as a detector, a high-pass optical filter in front of the CCD and video processing system. The advantage of ICG fluorescence method is safe (radiation free), high sensitive, real time monitoring of blood and/or lymphatic flow, small size, easy to operate and cost effective compared to conventional X-ray angiography or scintigraphy. We have applied this method to several clinical applications such as breast cancer sentinel lymph node (SLN) navigation, lymph edema diagnostic and identification of liver segmentation. In each application, ICG fluorescence method shows useful result. It's indicated that this method is promising technique as optical angiography.

  13. Functional imaging of kinetic parameters from the time dependent linear response function by dynamic scintigraphy

    SciTech Connect

    Stritzke, P.; Knop, J.; Spielmann, R.P.; Montz, R.; Schneider, C.

    1984-01-01

    A new method is proposed to determine the locally differing time dependent linear response function h(r,t) of a radioactive tracer injected into a patients blood pool B(t) by mathematical analysis of a dynamic scintigraphic study A(r,t). Transit times, uptake rates and clearance rates of different tracers are calculated from the linear response function at every matrix point by one computer program. The parameters are presented in functional images on a standard computer display. Thus the whole information from a dynamic study can be condensed within a few images. The integral equation A=h+B +c(r)*B (+ means convolution, c(r)*B(t)=nontarget activity) derived from tracer theory is deconvoluted by mathematical methods, which are unsensitive against noise contamination of the input data. The numerical technique is successfully applied in Iodide-123-Hippuran and Tc-99m-DMSA kidney studies, in Tc-99m-MDP and -DPD bone studies, in Tl-201 myocardial studies and in Iodide-123 thyroid studies. Because the regional blood pool-or nontarget activity is calculated and subtracted, the kinetic parameters are considered to be free from nontarget contributions in all dynamic scintigraphic studies. Examples are demonstrated and the usefulness for clinical application is discussed.

  14. Significance of technetium-99m human serum albumin diethylenetriamine pentaacetic acid scintigraphy in patients with nephrotic syndrome.

    PubMed

    Takashima, Tsuyoshi; Kishi, Tomoya; Onozawa, Koji; Rikitake, Shuichi; Miyazono, Motoaki; Otsuka, Takateru; Irie, Hiroyuki; Iwakiri, Ryuichi; Fujimoto, Kazuma; Ikeda, Yuji

    2015-01-01

    It is thought that a large amount of albumin leaking from the glomerulus in nephrotic syndrome (NS) is reabsorbed at the proximal tubule and catabolized. Therefore, it is possible the final quantity of urinary protein does not always reflect the amount of leakage of protein from the glomerulus. We experienced two cases without nephrotic range proteinuria thought to involve hypoproteinemia due to the same pathophysiology as NS. On these patients, we performed protein leakage scintigraphy with technetium-99m human serum albumin diethylenetriamine pentaacetic acid (99mTc-HSAD) to exclude a diagnosis of protein-losing gastroenteropathy and observed diffuse positive accumulation in the kidneys with more intense uptake in the kidney than the liver on the anterior view 24 hours after 99mTc-HSAD administration. In healthy adults intravenously given 99mTc-HSAD, the same dynamics are observed as in albumin metabolism, and the organ radioactivity of the liver and kidneys after 24 hours is equal. Therefore, we thought it was possible that the renal uptake 24 hours after 99mTc-HSAD administration was a characteristic finding of NS. In order to confirm it, the subjects were divided into two groups: the NS group (n = 10) and the non-NS group (n = 7). We defined more intense uptake in the kidney than the liver on the anterior view 24 hours after 99mTc-HSAD administration as Dense Kidney (+). Furthermore, we designed regions of interest in the right and left kidneys and liver on anterior and posterior images, then calculated the kidney-liver ratio. Nine of the ten patients had Dense Kidney (+) in the NS group, compared to none in the non-NS group. And the kidney-liver ratio was significantly higher in the NS group than in the non-NS group on each view in the bilateral kidneys. In conclusion, our results suggest that the renal uptake 24 hours after 99mTc-HSAD administration is a characteristic finding of NS.

  15. Significance of Technetium-99m Human Serum Albumin Diethylenetriamine Pentaacetic Acid Scintigraphy in Patients with Nephrotic Syndrome

    PubMed Central

    Takashima, Tsuyoshi; Kishi, Tomoya; Onozawa, Koji; Rikitake, Shuichi; Miyazono, Motoaki; Otsuka, Takateru; Irie, Hiroyuki; Iwakiri, Ryuichi; Fujimoto, Kazuma; Ikeda, Yuji

    2015-01-01

    It is thought that a large amount of albumin leaking from the glomerulus in nephrotic syndrome (NS) is reabsorbed at the proximal tubule and catabolized. Therefore, it is possible the final quantity of urinary protein does not always reflect the amount of leakage of protein from the glomerulus. We experienced two cases without nephrotic range proteinuria thought to involve hypoproteinemia due to the same pathophysiology as NS. On these patients, we performed protein leakage scintigraphy with technetium-99m human serum albumin diethylenetriamine pentaacetic acid (99mTc-HSAD) to exclude a diagnosis of protein-losing gastroenteropathy and observed diffuse positive accumulation in the kidneys with more intense uptake in the kidney than the liver on the anterior view 24 hours after 99mTc-HSAD administration. In healthy adults intravenously given 99mTc-HSAD, the same dynamics are observed as in albumin metabolism, and the organ radioactivity of the liver and kidneys after 24 hours is equal. Therefore, we thought it was possible that the renal uptake 24 hours after 99mTc-HSAD administration was a characteristic finding of NS. In order to confirm it, the subjects were divided into two groups: the NS group (n = 10) and the non-NS group (n = 7). We defined more intense uptake in the kidney than the liver on the anterior view 24 hours after 99mTc-HSAD administration as Dense Kidney (+). Furthermore, we designed regions of interest in the right and left kidneys and liver on anterior and posterior images, then calculated the kidney-liver ratio. Nine of the ten patients had Dense Kidney (+) in the NS group, compared to none in the non-NS group. And the kidney-liver ratio was significantly higher in the NS group than in the non-NS group on each view in the bilateral kidneys. In conclusion, our results suggest that the renal uptake 24 hours after 99mTc-HSAD administration is a characteristic finding of NS. PMID:25859658

  16. Initial Experience with Renal Denervation for the Treatment of Resistant Hypertension - The Utility of Novel Anesthetics and Metaiodobenzylguanidine Scintigraphy (MIBG)

    PubMed Central

    Ziakas, Antonios; Petroglou, Dimitrios; Moralidis, Efstratios; Tsioufis, Konstantinos; Doumas, Mihalis; Argiriadou, Elena; Savopoulos, Christos; Hadjimiltiades, Stavros; Stiliadis, Ioannis; Kouparanis, Antonios; Katranas, Sotirios; Lillis, Leonidas; Koutsakis, Athanasios; Karvounis, Haralambos

    2016-01-01

    Background: The Symplicity-HTN 3 trial failed to show significant difference in blood pressure (BP) lowering between patients undergoing catheter-based renal denervation (RDN) and the sham-procedure arm of the study. However, there is still optimism about the role of RDN in the treatment of resistant hypertension, because identification of patients with increased sympathetic activity thus being good RDN responders, improvements in the RDN procedure and new technology RDN catheters are all expected to lead to better RDN results. We present our initial experience with RDN for the treatment of resistant hypertension, and the utility of novel anesthetics and cardiac 123I-metaiodobenzylguanidine scintigraphy (123I-MIBG). Methods and Results: Seven patients with resistant hypertension underwent RDN and were followed up for 6 months. MIBG was performed before RDN, in order to estimate sympathetic activity and predict the response to RDN. All patients were sedated with dexmedetomidine and remifentanil during RDN. All patients tolerated the procedure well, were hemodynamically stable and their peri-procedural pain was effectively controlled. A median of 7.6 ± 2.1 and 6 ± 1.4 ablations were delivered in the right and left renal artery respectively, making an average of 6.8 burns per artery. No peri-procedural or late complications - adverse events (local or systematic) occurred. At 6 months, mean reduction in office BP was -26.0/-16.3 mmHg (p=0.004/p=0.02), while mean reduction in ambulatory BP was -12.3/-9.2 mmHg (p=0.118/p=0.045). One patient (14.3%) was a non-responder. None of the cardiac 123I-MIBG imaging indexes(early and late heart-to-mediastinum (H/M) count density ratio, washout rate (WR) of the tracer from the myocardium) were different between responders and non-responders. Conclusion: Patients with resistant hypertension who underwent RDN in our department had a significant reduction in BP 6 months after the intervention. 123I-MIBG was not useful in predicting

  17. The potential role of pretransplant MIBG diagnostic scintigraphy in targeted administration of 131I-MIBG accompanied by ASCT for high-risk and relapsed neuroblastoma: a pilot study.

    PubMed

    Hamidieh, Amir Ali; Beiki, Davood; Paragomi, Pedram; Fallahi, Babak; Behfar, Maryam; Fard-Esfahani, Armaghan; Hosseini, Ashraf Sadat; Shamshiri, Ahmadreza; Eftekhari, Mohammad; Ghavamzadeh, Ardeshir

    2014-08-01

    MIBG is an effective component in treatment of neuroblastoma. Furthermore, MIBG scintigraphy is an imaging modality in primary assessments. None of the previous studies have evaluated the role of pretransplant MIBG scintigraphy in decision making for neuroblastoma treatment. We selected therapeutic regimen based on pretransplant (131) I-MIBG scintigraphy. Twenty high-risk patients were enrolled. On day -30, patients underwent diagnostic MIBG scintigraphy. Patients were then subdivided into two groups (10 cases in each arm). MIBG-avid subgroup received MIBG (12 mCi/kg), etoposide (1200 mg/m2), carboplatin (1500 mg/m2), and melphalan (210 mg/m2). Non-MIBG-avid subgroup received etoposide (600 mg/m2), carboplatin (1200 mg/m2), and melphalan (150 mg/m2). Patients received CRA after ASCT. Mean age at diagnosis was 42.5 months (range, 17-65) in MIBG-avid and 38.9 months (range, 18-65) in non-MIBG-avid patients. Mean age at diagnosis and transplantation did not reveal significant difference between two subgroups. In MIBG-avid patients, the three-yr OS was 66 ± 21%. In MIBG-non-avid subgroup, the three-yr OS was 53 ± 20%. In MIBG-avid and non-MIBG-avid subgroups, the three-yr EFS were 66 ± 21% and 47 ± 19%, respectively. These findings may suggest an effective role in selecting the therapeutic strategy for pre-ASCT MIBG scintigraphy in high-risk neuroblastoma. MIBG-avid subset may benefit from the combination of therapeutic MIBG and high dose of chemotherapy.

  18. What role for radiobiphosphonates bone scintigraphy in the monitoring of an unusual bone giant cell tumor: a case report and literature review

    PubMed Central

    Oueriagli, Salah Nabih; Ghfir, Imad; Guerrouj, Hassna El; Raïs, Nouzha Ben

    2016-01-01

    We report the case of 24 years old female patient, followed since ten years ago for bone giant cell tumor (GCT) of the right knee, which was complicated by pulmonary metastases. Surgical treatment and pulmonary metastasectomies have not allowed definitive cure of this disease with the appearance of metachronous bone lesions after eight years of evolution. The literature review confirms the originality of this observation: the age of the patient, the initial and metastasis locations and the occurrence of lung metastases with unfavorable prognosis. Through this clinical case, the authors highlight the role of radiobiphosphonates bone scintigraphy in detecting synchronous or metachronous bone lesions, and in monitoring of these locations under medical treatment. PMID:27186440

  19. Is there an advantage in performing a combined examination: diuretic renal scintigraphy and low dose computed tomography compared to the separate use of these methods in urolithiasis.

    PubMed

    Hadzhiyska, Valeriya; Kostadinova, Irena; Demirev, Anastas

    2015-01-01

    Ultrasonography (US), radiography of the kidneys, ureters and bladder (RKUB), intravenous urography (IVU) and especially non-enchanced CT are well established diagnostic modalities in screening patients with urolithiasis, while not always fully diagnostic especially when obstructive uropathy or calculous pyelonephritis are present . Diuretic renal scintigraphy (DRS) can determine obstruction, may differentiate between complete or partial, acute or chronic obstruction, but can not specify the cause and often the location of obstruction. The imaging protocol, including DRS with technetium-99m-mercaptylacetyltriglycine ((99m)Tc-MAG3) and single photon emission tomography/computed tomography (SPET/CT) of the kidneys, ureters, and urinary bladder allows for both functional and morphological information, visualization of renal stones and possible renal complications. The main advantages and limitations of this combined examination are discussed and the test is compared to the separate use of DRS and low dose of CT, in urolithiasis.

  20. Preparation and biokinetic evaluation of various halogenated iminodiacetic acid-type compounds labeled with technetium-99m for hepatobiliary scintigraphy in the baboon (Papio ursinus) model.

    PubMed

    Dormehl, I C; Grobbelaar, C; van Wyk, A; Jacobs, L; Maree, M; Oliver, D

    1990-01-01

    In an evaluation of various 99mTc-labeled halogenated (F, Cl, Br, I) iminodiacetic acid (IDA) derivatives for hepatobiliary scintigraphy, it was found that, in the baboon model, none of these compounds performed as well as did disida. F-IDA was least effective, with the lowest biliary excretion and highest renal participation, but multihalogen substitution as in penta-F-IDA increased the biliary specificity and reduced urinary excretion to the extent that penta-F-IDA scored second to disida and even above I-IDA, with its high molecular weight. Surprising also was the relatively good performance of Cl-IDA compared to Br-IDA and I-IDA.

  1. What role for radiobiphosphonates bone scintigraphy in the monitoring of an unusual bone giant cell tumor: a case report and literature review.

    PubMed

    Oueriagli, Salah Nabih; Ghfir, Imad; Guerrouj, Hassna El; Raïs, Nouzha Ben

    2016-01-01

    We report the case of 24 years old female patient, followed since ten years ago for bone giant cell tumor (GCT) of the right knee, which was complicated by pulmonary metastases. Surgical treatment and pulmonary metastasectomies have not allowed definitive cure of this disease with the appearance of metachronous bone lesions after eight years of evolution. The literature review confirms the originality of this observation: the age of the patient, the initial and metastasis locations and the occurrence of lung metastases with unfavorable prognosis. Through this clinical case, the authors highlight the role of radiobiphosphonates bone scintigraphy in detecting synchronous or metachronous bone lesions, and in monitoring of these locations under medical treatment. PMID:27186440

  2. The Value of Oro-Pharyngo-Esophageal Scintigraphy in the Management of Patients with Aspiration into the Tracheo-bronchial Tree and Consequent Dysphagia

    PubMed Central

    Grosso, Mariano; Duce, Valerio; Fattori, Bruno; Bruschini, Luca; Meniconi, Martina; Raschillà, Rosanna; Cocco, Fabiola; Locantore, Luisa; Guidoccio, Federica; Orsini, Federica; Massri, Katrin; Volterrani, Duccio; Rubello, Domenico

    2015-01-01

    Context: Tracheo-bronchial aspiration is the most invalidating condition which can happen to patients affected by dysphagia, especially when caused by central neurologic disorders; the associated pneumonia episodes represent the most frequent cause of death in these patients. Oro-pharyngo-esophageal scintigraphy (OPES) allows both functional imaging and semiquantitative evaluation of the subsequent phases of swallowing. Case Report: We evaluated by means of OPES a woman who had previously undergone high-dose external beam radiation therapy for a nasopharyngeal carcinoma, which determined tissue fibrosis and progressive dysphagia. Conclusion: In this patient with dysphagia, OPES was a simple, inexpensive, noninvasive, and reliable technique that allowed to show the presence of bolus aspiration and quantified tracheobronchial aspirate. PMID:26713303

  3. Usefulness of Cardiac Sympathetic Nerve Imaging Using (123)Iodine-Metaiodobenzylguanidine Scintigraphy for Predicting Sudden Cardiac Death in Patients With Heart Failure.

    PubMed

    Kasama, Shu; Toyama, Takuji; Kurabayashi, Masahiko

    2016-01-01

    The autonomic nervous system plays an important role in the human heart. Activation of the cardiac sympathetic nervous system is a cardinal pathophysiological abnormality associated with the failing human heart. Myocardial imaging using (123)I-metaiodobenzylguanidine (MIBG), an analog of norepinephrine, can be used to investigate the activity of norepinephrine, the predominant neurotransmitter of the sympathetic nervous system. Many clinical trials have demonstrated that (123)I-MIBG scintigraphic parameters predict cardiac adverse events, especially sudden cardiac death, in patients with heart failure. In this review, we summarize results from published studies that have focused on the use of cardiac sympathetic nerve imaging using (123)I-MIBG scintigraphy for risk stratification of sudden cardiac death in patients with heart failure.

  4. Dobutamine 99Tcm-MIBI SPET myocardial perfusion scintigraphy in the prediction of restenosis after percutaneous transluminal coronary angioplasty in patients unable to perform an exercise stress test.

    PubMed

    Elhendy, A; Geleijnse, M L; Roelandt, J R; van Domburg, R T; Nierop, P R; Bax, J J; Kasprzak, J D; el-Said, G M; Ibrahim, M M; Fioretti, P M

    1997-02-01

    After successful percutaneous transluminal coronary angioplasty (PTCA), restenosis occurs in a relatively high proportion of patients. Exercise thallium scintigraphy is a useful method for the detection of restenosis. In patients unable to exercise, dobutamine perfusion scintigraphy may represent a feasible alternative. However, its diagnostic accuracy in this clinical setting has not been evaluated. We studied 40 patients (29 males, 11 females) aged 57 +/- 9 years, at a mean of 185 +/- 80 days after successful PTCA with a high-dose dobutamine (up to 40 micrograms kg-1 min-1) stress test, in conjunction with 99Tcm-methoxyisobutyl isonitrile (99Tcm-MIBI) single photon emission tomography (SPET). Significant restenosis was defined as > or = 50% luminal diameter stenosis of a coronary segment with previous PTCA and was predicted on the basis of the occurrence of reversible perfusion defects in the corresponding territories. Reversible perfusion defects occurred in 20 of 29 arteries with and in 4 of 17 arteries without restenosis. The sensitivity of dobutamine MIBI for the detection of restenosis in arteries with previous PTCA was 69% (CI = 56-82), the specificity 76% (CI = 64-89), the positive predictive value 83% (CI = 73-94), the negative predictive value 59% (CI = 45-73) and accuracy 72% (CI = 59-85). The overall sensitivity of 99Tcm-MIBI SPET for the diagnosis of significant coronary stenosis (including arteries without previous PTCA) on a patient basis was 79% (CI = 67-92), the specificity 82% (CI = 70-94) and accuracy 80% (CI = 68-92). The sensitivity of 99Tcm-MIBI SPET was significantly higher than that of electrocardiography (79 vs 38%, P < 0.005). It is concluded that dobutamine 99Tcm-MIBI SPET is a useful method for the detection of restenosis after PTCA in patients unable to perform an exercise stress test.

  5. Assessment of systolic wall thickening using technetium-99m methoxyisobutylisonitrile in patients with coronary artery disease: relation to thallium-201 scintigraphy with re-injection.

    PubMed

    Nicolai, E; Cuocolo, A; Pace, L; Maurea, S; Nappi, A; Imbriaco, M; Morisco, C; Argenziano, L; Salvatore, M

    1995-09-01

    The results of resting planar ECG-gated technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) imaging were compared with those of thallium-201 (Tl) re-injection after exercise-redistribution scintigraphy in 20 patients (19 men, 1 woman, mean age 53 +/- 10 years) with angiographically proven coronary artery disease. Eight normal subjects (seven men, one woman, mean age 50 +/- 8 years) constituted the control group. In these subjects, only resting 99mTc-MIBI imaging was performed. The standardized percent count increase from end-diastole to end-systole was calculated as an index of wall thickening in 13 segments for each study. Regional wall thickening index (WTI) and 99mTc-MIBI uptake were significantly different (P < 0.05) among segments classified as normal, reversible defects, irreversible defects with increased tracer uptake after re-injection (Re+) or irreversible defects with unchanged tracer uptake after re-injection (Re-) on Tl imaging. Furthermore, WTI and 99mTc-MIBI uptake were significantly higher (P < 0.05) in Re- segments with moderate reduction of Tl uptake (> or = 50% of peak activity) than in Re- segments with severe reduction of Tl uptake (< 50% of peak activity). A significant relationship between WTI and the results of Tl scintigraphy was observed (rho = 0.71, P < 0.0001). The percentage of Re- segments with severe reduction of WTI was significantly higher compared to Re+ segments (64% vs 3%, P < 0.01). Furthermore, compared with moderate Re- segments, a significantly higher percentage of severe Re- segments showed a severe reduction of WTI (86% vs 48%, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Comparative value of maximal treadmill testing, exercise thallium myocardial perfusion scintigraphy and exercise radionuclide ventriculography for distinguishing high- and low-risk patients soon after acute myocardial infarction

    SciTech Connect

    Hung, J.; Goris, M.L.; Nash, E.; Kraemer, H.C.; DeBusk, R.F.; Berger, W.E.; Lew, H.

    1984-05-01

    The prognostic value of symptom-limited treadmill exercise electrocardiography, exercise thallium myocardial perfusion scintigraphy and rest and exercise radionuclide ventriculography was compared in 117 men, aged 54 +/- 9 years, tested 3 weeks after a clinically uncomplicated acute myocardial infarction (MI). During a mean follow-up period of 11.6 months, 8 men experienced ''hard'' medical events (cardiac death, nonfatal ventricular fibrillation or recurrent MI) and 14 were hospitalized for unstable angina pectoris, congestive heart failure or coronary bypass surgery (total of 22 combined events). By multivariate analysis (Cox proportional hazards model), peak treadmill work load and the change in left ventricular ejection fraction (EF) during exercise were significant (p less than 0.01) predictors of hard medical events; these 2 risk factors and recurrent ischemic chest pain in the coronary care unit were also significantly predictive (p less than 0.001) for combined events. A peak treadmill work load of 4 METs or less or a decrease in EF of 5% or more below the value at rest during submaximal effort distinguished 22 high-risk patients (20% of the study population) from 89 low-risk patients. The rate of hard medical events within 12 months was 23% (5 of 22 patients), vs 2% (2 of 89 patients) in the high- and low-risk patient subsets, respectively (p less than 0.001). Thus, in patients who underwent evaluation 3 weeks after a clinically uncomplicated MI, exercise radionuclide ventriculography contributed independent prognostic information to that provided by symptom-limited treadmill testing and was superior to exercise thallium scintigraphy for this purpose.

  7. Use of thallium-201 myocardial scintigraphy for the prediction of the response to beta-blocker therapy in patients with dilated cardiomyopathy.

    PubMed

    Hara, Yuji; Hamada, Mareomi; Ohtsuka, Tomoaki; Ogimoto, Akiyoshi; Saeki, Hideyuki; Suzuki, Jun; Matsunaka, Tsuyoshi; Nakata, Shigeru; Shigematsu, Yuji

    2002-12-01

    This study was performed to evaluate whether thallium-201 myocardial scintigraphy (Tl-201) and iodine-123-metaiodobenzylguanidine (MIBG) myocardial scintigraphy could predict the usefulness of beta-blocker therapy in patients with dilated cardiomyopathy (DCM). Tl-201 and MIBG were performed in 47 patients before beta-blocker therapy. Patients were classified into group A, if their cardiac function improved, and group B, whose function remained unchanged. Two types of extent score (ES) by Tl-201 were proposed to quantitate myocardial damage, mean-2SD (ES-2) and mean-3SD (ES-3). The ES difference between ES-2 and ES-3 was calculated, and according to ES and ES difference, DCM cases were classified into 3 groups: mild-defect type (mild-type), moderate-defect type (moderate-type) and severe-defect type (severe-type). The heart-to-mediastinum (H/M) MIBG uptake ratio was evaluated, and the percent washout ratio of myocardial MIBG was obtained from these data. Group A comprised 18 mild-type, 14 moderate-type and 1 severe-type cases, and group B comprised 5 mild-type, 4 moderate-type and 5 severe-type cases. A significant relation was observed between the defect type on Tl-201 and the response to beta-blocker therapy (p=0.0090). Both H/M MIBG uptake ratios and washout ratio were not significantly different in the 2 groups. Tl-201 may be useful for predicting the response to beta-blocker therapy in patients with DCM.

  8. Value of post-therapeutic ¹³¹I scintigraphy in stimulated serum thyroglobulin-negative patients with metastatic differentiated thyroid carcinoma.

    PubMed

    Shen, Chen-Tian; Wei, Wei-Jun; Qiu, Zhong-Ling; Song, Hong-Jun; Luo, Quan-Yong

    2016-02-01

    Metastatic differentiated thyroid carcinoma (DTC) with positive (131)I scintigraphy, but negative stimulated Tg (sTg) is relatively rare in clinical practice. The clinical characteristics of these patients were analyzed in the current study. A total of 3367 consecutive histologically proven DTC patients were analyzed retrospectively from January 2007 to June 2013. Tg negativity was defined as a sTg level of <2 ng/mL without positive anti-Tg antibody (TgAb level of <100 IU/mL) under thyroid-stimulating hormone stimulation (TSH level of ≥30 mIU/L). Analyses were performed using the Statistical Package for the Social Sciences, version 20.0 (SPSS, Chicago, IL, USA). Seventy-one patients (median age 45 years, range 17-68 years) were post-therapeutic (131)I-SPECT/CT positive and sTg negative (PTP-TN) constituting 2.1 % of all patients. Of these 71 patients, 2 (2.8 %) had bone metastasis, 11 (15.5 %) had lung metastasis, and 59 (83.1 %) had lymph node metastasis. Fifty-six patients had cervical lymph node metastasis (cLNM), and US was positive in 15 patients (26.8 %), while negative in 41 patients (73.2 %). When compared to patients with concordant positive results for sTg and (131)I scintigraphy, US showed a relatively lower positive rate in the detection of cLNM in PTP-TN patients (28.8 vs. 53.8 %; χ (2) = 6.70; P = 0.01). In conclusion, even with sTg <2 ng/mL, there is a low risk of metastatic DTC. US had limitations in PTP-TN patients, while post-therapy (131)I-SPECT/CT demonstrated an advantage in the detection of functioning metastasis despite low sTg levels in patients with metastatic DTC.

  9. Biodistribution of an anti-interleukin 2 receptor monoclonal antibody in rat recipients of a heart allograft, and its use as a rejection marker in gamma scintigraphy

    SciTech Connect

    Thedrez, P.; Paineau, J.; Jacques, Y.; Chatal, J.F.; Pelegrin, A.; Bouchaud, C.; Soulillou, J.P. )

    1989-09-01

    Anti-interleukin-2 receptor monoclonal antibodies have been shown to prevent allograft rejection. This paper reports on the biodistribution of a mouse MoAb directed at the 55 Kd alpha chain of rat interleukin-2 receptor (IL2-R) during allograft rejection. Only a low percentage (approximately 1%) of intact 125I-labeled MoAb was detected in the rejected graft, and irrelevant control IgG1 was found at a similar level. This suggests that most of the injected intact MoAb bound to graft tissue via its monomorphic Fc segment. In contrast, OX39 F(ab')2 fragments showed a preferential localization in the rejected allograft and did not bind to the LEW-to-LEW syngeneic heart graft. Irrelevant F(ab')2 did not concentrate in the allogeneic graft. Accordingly, F(ab')2 fragments from OX39 or irrelevant MoAb were used for gamma-scintigraphy on allograft recipients together with biodistribution studies. Results show that scintigraphy was able to detect allograft accumulation of 131I OX39 F(ab')2, whereas no imaging was obtained when OX39 F(ab')2 was used in the syngeneic combination or when irrelevant 131-IgG1 F(ab')2 was given to allograft recipients. This method, applied to the clinical situation, could be of interest for detection of early graft rejection episodes by immunoscintigraphy using reagents specific for activation determinants on lymphocyte membranes, such as anti-interleukin-2 receptor MoAb.

  10. Clinical relationship of myocardial sympathetic nervous activity to cardiovascular functions in chronic heart failure: assessment by myocardial scintigraphy with 123I-metaiodobenzylguanidine.

    PubMed

    Wada, Yukoh; Miura, Masaetsu; Fujiwara, Satomi; Mori, Shunpei; Seiji, Kazumasa; Kimura, Tokihisa

    2003-12-01

    The aim of this study was to clarify the relationship between cardiac sympathetic nervous activity (SNA) assessed by radioiodinated metaiodobenzylguanidine (123I-MIBG), an analogue of norepinephrine and cardiovascular functions in patients with chronic heart failure (CHF). Subjects were 17 patients with CHF. A dose of 111 MBq of 123I-MIBG was administered intravenously, and 5-minute anterior planar images were obtained 15 minutes (early image) and 3 hours (delayed image) after the injection. The heart/mediastinum (H/M) count ratio was defined to quantify cardiac 123I-MIBG uptake. The washout ratio (WR) of 123I-MIBG from the heart was calculated as follows: (early counts-delayed counts)/early counts x 100 (%). Echocardiography was performed on all patients within 1 week of 123I-MIBG scintigraphy to measure stroke volume index (SVI). Blood pressure and heart rate (HR) in the resting state were also recorded to calculate cardiovascular functions including cardiac output, pulse pressure (PP), and mean blood pressure. Significant linear correlations were found between the early H/M ratio of 123I-MIBG and SVI, and between the delayed H/M ratio of 123I-MIBG and SVI, respectively. WR of 123I-MIBG was correlated with HR, and was inversely correlated with SVI and with PP, respectively. It is likely that a decrease in SVI is associated with enhanced cardiac SNA in severe CHF. 123I-MIBG scintigraphy is effective in assessing the cardiac functional status and SNA in patients with CHF in vivo. Moreover, changes in PP and HR indicate well alteration in SNA. PMID:14690018

  11. Prospective study of somatostatin receptor scintigraphy and its effect on operative outcome in patients with Zollinger-Ellison syndrome.

    PubMed Central

    Alexander, H R; Fraker, D L; Norton, J A; Bartlett, D L; Tio, L; Benjamin, S B; Doppman, J L; Goebel, S U; Serrano, J; Gibril, F; Jensen, R T

    1998-01-01

    OBJECTIVE: To determine the relative abilities of somatostatin receptor scintigraphy (SRS) and conventional imaging studies (computed tomography, magnetic resonance imaging, ultrasound, angiography) to localize gastrinomas before surgery in patients with Zollinger-Ellison syndrome (ZES) subsequently found at surgery, and to determine the effect of SRS on the disease-free rate. SUMMARY BACKGROUND DATA: Recent studies demonstrate that SRS is the most sensitive imaging modality for localizing neuroendocrine tumors such as gastrinomas. Because of conflicting results in small series, it is unclear in ZES whether SRS will alter the disease-free rate, which gastrinomas are not detected, what factors contribute to failure to detect a gastrinoma, or whether the SRS result should be used to determine operability in patients without hepatic metastases, as recently recommended by some investigators. METHODS: Thirty-five consecutive patients with ZES undergoing 37 exploratory laparotomies for possible cure were prospectively studied. All had SRS and conventional imaging studies before surgery. Imaging results were determined by an independent investigator depending on surgical findings. All patients underwent an identical surgical protocol (palpation after an extensive Kocher maneuver, ultrasound during surgery, duodenal transillumination, and 3 cm duodenotomy) and postoperative assessment of disease status (fasting gastrin, secretin test imaging within 2 weeks, at 3 to 6 months, and yearly), as used in pre-SRS studies previously. RESULTS: Gastrinomas were detected in all patients at each surgery. Seventy-four gastrinomas were found: 22 duodenal, 8 pancreatic, 3 primaries in other sites, and 41 lymph node metastases. The relative detection order on a per-patient or per-lesion basis was SRS > angiography, magnetic resonance imaging, computed tomography > ultrasound. On a per-lesion basis, SRS had greater sensitivity than all conventional studies combined. SRS missed one third of

  12. Clinical pretreatment risk factors and prediction of outcome using gallium 67 scintigraphy in patients with Hodgkin's lymphoma

    PubMed Central

    ESCOBAR, IGNACIO GARCÍA; LÓPEZ, ANA; RUBIO, JUDIT; PÉREZ-CALLEJO, DAVID; BARRIGÓN, DOLORES CABALLERO; ALONSO, PILAR TAMAYO; CASADO, ELENA ALMAGRO; PULLA, MARIANO PROVENCIO

    2016-01-01

    This study was conducted to investigate the prognostic effect and implications of gallium 67 scintigraphy (gallium scan) at mid-treatment and at the end of first-line treatment in patients with early- and advanced-stage Hodgkin's lymphoma (HL). A total of 216 HL patients were included in the study. Gallium scan was performed at mid-treatment and at the end of first-line treatment. The overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier method. The log-rank test was used to identify univariate predictors of EFS and OS. For early-stage disease, bulky mediastinal involvement (yes vs. no, 98 vs. 79%, respectively; P=0.01), erythrocyte sedimentation rate (good vs. adverse, 98 vs. 88%, respectively; P=0.03), presence of B symptoms (no vs. yes, 94 vs. 78%, respectively; P=0.006), post-chemotherapy disease status [complete response (CR) vs. unconfirmed CR (uCR) vs. partial response (PR) vs. progressive disease (PGR), 95 vs. 90 vs. 87 vs. 0%, respectively; P<0.01] and gallium scan at mid-treatment and at the end of treatment (negative vs. positive, 88 vs. 20%, P<0.001; and 85 vs. 10%, P<0.001, respectively) significantly affected the EFS. In addition, age (<50 vs. ≥50 years, 96 vs. 78%, respectively; P=0.01), presence of B symptoms (no vs. yes, 97 vs. 87%, respectively; P=0.03), post-chemotherapy disease status (CR vs. uCR vs. PR vs. PGR, 95 vs. 90 vs. 90 vs. 0%, respectively; P<0.01) and gallium scan results at mid-treatment and at the end of treatment (negative vs. positive, 87 vs. 60%, P<0.001; and 95 vs. 0%, P<0.001, respectively) significantly affected the OS. For advanced-stage disease, Hassenclever index (1–3 vs. 4–6, 80 vs. 57%, respectively; P=0.05) and gallium scan results at mid-treatment and at the end of treatment (negative vs. positive, 84 vs. 18%, P<0.001; and 84 vs. 0%, P<0.001, respectively) significantly affected the EFS, whereas age at diagnosis (<50 vs. ≥50 years, 92 vs. 78%, respectively; P=0

  13. Skeletal Scintigraphy (Bone Scan)

    MedlinePlus

    ... young patients, sedation is seldom necessary. Risks Allergic reactions to radiopharmaceuticals may occur but are extremely rare and are usually mild. Nevertheless, you should inform the nuclear medicine personnel of any allergies you may have ...

  14. Hepatobiliary scintigraphy in 2014.

    PubMed

    Ziessman, Harvey A

    2014-06-01

    Cholescintigraphy with (99m)Tc-hepatobiliary radiopharmaceuticals has been an important, clinically useful diagnostic imaging study for almost 4 decades. It continues to be in much clinical demand; however, the indications, methodology, and interpretative criteria have evolved over the years. This review will emphasize state-of-the-art methodology and diagnostic criteria for various clinical indications, including acute cholecystitis, chronic acalculous gallbladder disease, high-grade and partial biliary obstruction, and the postcholecystectomy pain syndrome, including sphincter-of-Oddi dysfunction and biliary atresia. The review will also emphasize the use of diagnostic pharmacologic interventions, particularly sincalide. PMID:24744445

  15. Hepatobiliary scintigraphy in 2014.

    PubMed

    Ziessman, Harvey A

    2014-12-01

    Cholescintigraphy with (99m)Tc-hepatobiliary radiopharmaceuticals has been an important, clinically useful diagnostic imaging study for almost 4 decades. It continues to be in much clinical demand; however, the indications, methodology, and interpretative criteria have evolved over the years. This review will emphasize state-of-the-art methodology and diagnostic criteria for various clinical indications, including acute cholecystitis, chronic acalculous gallbladder disease, high-grade and partial biliary obstruction, and the postcholecystectomy pain syndrome, including sphincter-of-Oddi dysfunction and biliary atresia. The review will also emphasize the use of diagnostic pharmacologic interventions, particularly sincalide. PMID:25472513

  16. Preoperative Diagnostic Strategy for Parotid Gland Tumors Using Diffusion-Weighted MRI and Technetium-99m Pertechnetate Scintigraphy: A Prospective Study

    PubMed Central

    Kikuchi, Masahiro; Koyasu, Sho; Shinohara, Shogo; Imai, Yukihiro; Hino, Megumu; Naito, Yasushi

    2016-01-01

    Objective Fine needle aspiration cytology (FNAC) for diagnosis of a parotid gland tumor is widely used but its sensitivity is low and non-diagnostic rate is relatively high. In contrast, core needle biopsy (CNB) has a higher sensitivity and lower rate of sampling errors but has a higher risk of injury to adjacent organs such as facial nerve than FNAC. Screening of patients with parotid gland tumors to identify cases of pleomorphic adenoma (PA) and Warthin tumor (WT) may allow CNB to be confined to patients without PA and WT. We established an algorithm for preoperative diagnosis and management of parotid gland tumor using diffusion-weighted MRI and 99mTc pertechnetate scintigraphy. This algorithm was developed with the goal of maximal reduction of the number of patients in whom CNB is required. The purpose of the study is to validate our algorithm prospectively. Methods A prospective study was conducted in 71 cases who were newly diagnosed with parotid gland tumor and 53 cases were enrolled in the study. In the algorithm, PA (high apparent diffusion coefficient (ADC) mean≥1.5×10−3 mm2/s) and non-PA (low ADCmean<1.5×10−3 mm2/s) cases are first distinguished based on the ADCmean on diffusion-weighed MRI. Second, among suspected non-PA cases, WT and non-WT are distinguished using technetium-99m pertechnetate scintigraphy. CNB is then performed only in probable non-PA and non-WT cases. Results Although CNB was only required in 40% (21/53) of all cases, we made a preoperative histopathological diagnosis with an accuracy of 87% (46/53) and we correctly diagnosed whether a tumor was benign or malignant with an accuracy of 96% (51/53). Preoperative surgical planning had to be changed during surgery in only one case (2%) Conclusions Our algorithm is valuable in terms of clinical practice with highly potential for preoperative diagnosis and with less risk of CNB procedure. PMID:26849569

  17. Normal tissue complication probability model parameter estimation for xerostomia in head and neck cancer patients based on scintigraphy and quality of life assessments

    PubMed Central

    2012-01-01

    Background With advances in modern radiotherapy (RT), many patients with head and neck (HN) cancer can be effectively cured. However, xerostomia is a common complication in patients after RT for HN cancer. The purpose of this study was to use the Lyman–Kutcher–Burman (LKB) model to derive parameters for the normal tissue complication probability (NTCP) for xerostomia based on scintigraphy assessments and quality of life (QoL) questionnaires. We performed validation tests of the Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) guidelines against prospectively collected QoL and salivary scintigraphic data. Methods Thirty-one patients with HN cancer were enrolled. Salivary excretion factors (SEFs) measured by scintigraphy and QoL data from self-reported questionnaires were used for NTCP modeling to describe the incidence of grade 3+ xerostomia. The NTCP parameters estimated from the QoL and SEF datasets were compared. Model performance was assessed using Pearson’s chi-squared test, Nagelkerke’s R2, the area under the receiver operating characteristic curve, and the Hosmer–Lemeshow test. The negative predictive value (NPV) was checked for the rate of correctly predicting the lack of incidence. Pearson’s chi-squared test was used to test the goodness of fit and association. Results Using the LKB NTCP model and assuming n=1, the dose for uniform irradiation of the whole or partial volume of the parotid gland that results in 50% probability of a complication (TD50) and the slope of the dose–response curve (m) were determined from the QoL and SEF datasets, respectively. The NTCP-fitted parameters for local disease were TD50=43.6 Gy and m=0.18 with the SEF data, and TD50=44.1 Gy and m=0.11 with the QoL data. The rate of grade 3+ xerostomia for treatment plans meeting the QUANTEC guidelines was specifically predicted, with a NPV of 100%, using either the QoL or SEF dataset. Conclusions Our study shows the agreement between the NTCP

  18. Comparison of Renal Function between Robot-Assisted and Open Partial Nephrectomy as Determined by Tc 99m-DTPA Renal Scintigraphy

    PubMed Central

    2016-01-01

    We compared postoperative renal function impairment between patients undergoing robot-assisted partial nephrectomy (RAPN) and those undergoing open partial nephrectomy (OPN) by using Tc-99m diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy. Patients who underwent partial nephrectomy by a single surgeon between 2007 and 2013 were eligible and were matched by propensity score, based on age, tumor size, exophytic properties of tumor, and location relative to the polar lines. Of the 403 patients who underwent partial nephrectomy, 114 (28%) underwent RAPN and 289 (72%) underwent OPN. Mean follow-up duration was 35.2 months. Following propensity matching, there were no significant differences between the two groups in tumor exophytic properties (P = 0.818) or nephrometry score (P = 0.527). Renal ischemic time (24.4 minutes vs. 17.8 minutes, P < 0.001) was significantly longer in the RAPN group than in the OPN group, while the other characteristics were similar. Multivariate analysis showed that greater preoperative renal unit function (P = 0.011) and nephrometry score (P = 0.041) were independently correlated with a reduction in glomerular filtration rate. The operative method did not correlate with renal function impairment (P = 0.704). Postoperative renal function impairment was similar between patients who underwent OPN and those who underwent RAPN, despite RAPN having a longer ischemic time. PMID:27134496

  19. Use of pre-operative Tc99m-Sestamibi scintigraphy and intraoperative parathyroid hormone monitoring to eliminate neck exploration in mediastinal parathyroid adenocarcinoma.

    PubMed

    Damadi, Amir; Harkema, James; Kareti, Rao; Saxe, Andrew

    2007-01-01

    A 66-year-old white woman was found to have an elevated serum calcium and parathyroid hormone (PTH) on routine health evaluation. Physical examination was unremarkable as was ultrasonography of the neck. A sestamibi parathyroid scan revealed abnormal uptake in the anterior mediastinum. Computed tomography of the chest demonstrated an anterior mediastinal mass compatible with a parathyroid adenoma but no neck masses. The patient underwent mediastinoscopy that was converted to a median sternotomy to fully access the mass. The mass was completely resected with surrounding thymus gland. Frozen section confirmed that excised tissue was parathyroid gland in origin. An intraoperative PTH obtained 20 minutes after specimen removal showed a decrease of more than 50% from preoperative levels. The strategy for initial surgery for hyperparathyroidism when a sestamibi scan is "positive" in the mediastinum (only) is a point of some controversy. Traditional recommendations have been to "clear the neck" of abnormal parathyroid tissue before undertaking a more morbid sternotomy. Mediastinoscopy was attempted to remove the mediastinal lesion and to avoid a sternotomy. Preoperative Tc99m sestamibi scintigraphy, frozen section histology, and intraoperative PTH monitoring permitted the authors to conclude that neck exploration was unnecessary.

  20. An investigation into the floating behaviour of a pectin-containing anti-reflux formulation (FF5005) by means of gamma scintigraphy.

    PubMed

    Washington, N; Wilson, C G; Greaves, J L; Danneskiold-Samsøe, P

    1988-10-01

    The gastric distribution and residence time of a new pectin-containing formulation, FF5005 (Farma Food A/S, Denmark), was investigated by using the technique of gamma scintigraphy in six healthy volunteers after administration with a radiolabelled meal. The formulation and test meal were radiolabelled with indium-113m and technetium-99m, respectively, and the formulation was administered to the subjects 30 min after the labelled meal. FF5005 was shown to float and form a discrete phase on top of the stomach contents and emptied from the stomach more slowly than the food (p less than 0.05, Wilcoxon signed rank test). The times taken for the formulation and test meal to half-empty from the stomach (T50) were 4.13 +/- 0.69 h (mean +/- SD) and 2.17 +/- 0.15 h (mean +/- SD), respectively. Greater than 50% of the formulation remained in the fundal region of the stomach for 3 h. FF5005 produced in vivo behaviour similar to that of established alginate-containing anti-reflux agents, and the pectin content of the formulation was shown to decrease the rate of emptying of the meal.

  1. Tissue-Muscle Perfusion Scintigraphy of the Lower Limbs in a Patient with Type 2 Diabetes Mellitus and Peripheral Arterial Disease.

    PubMed

    Manevska, Nevena; Gjorceva, Daniela Pop; Ahmeti, Irfan; Todorovska, Lidija; Stojanoski, Sinisa; Kocovska, Marina Zdraveska

    2016-02-01

    The estimation of tissue perfusion as a hemodynamic consequence of peripheral arterial disease (PAD) in diabetic patients is of great importance in the management of these patients.We present a noninvasive, functional method of 99mTc-MIBI (methoxy-isobutyl-isonitrile) tissue-muscle perfusion scintigraphy (TMPS) of the lower limbs, which assesses tissue perfusion in basal conditions ("rest" study) and exercise conditions ("stress" study). Emphasis is given on perfusion reserve (PR) as an important indicator of preservation of microcirculation and its local autoregulatory mechanisms in PAD. We present a case of a 71-year-old male diabetic patient with skin ulcers of the right foot and an ankle-brachial index >1.2 (0.9-1.1). Dynamic phase TMPS of the lower limbs showed decreased and late arterial vascularization of the right calf (RC) with lower percentage of radioactivity in the 1st minute: RC 66%, left calf (LC) 84%. PR was borderline with a value of 57% for LC and decreased for RC (42%). Functional assessment of hemodynamic consequences of PAD is important in evaluating both advanced and early PAD, especially the asymptomatic form. The method used to determine the TMPS of the lower limbs, can differentiate subtle changes in microcirculation and tissue perfusion. PMID:27299288

  2. The Role of 99mTc-Annexin V Apoptosis Scintigraphy in Visualizing Early Stage Glucocorticoid-Induced Femoral Head Osteonecrosis in the Rabbit

    PubMed Central

    Wang, Xiaolong; Liu, Yu; Wang, Xuemei; Liu, Rui; Li, Jianbo; Zhang, Guoliang; Li, Qiang; Wang, Lei; Bai, Zhigang; Zhao, Jianmin

    2016-01-01

    Objective. To validate the ability of 99mTc-Annexin V to visualize early stage of glucocorticoid-induced femoral head necrosis by comparing with 99mTc-MDP bone scanning. Methods. Femoral head necrosis was induced in adult New Zealand white rabbits by intramuscular injection of methylprednisolone. 99mTc-Annexin scintigraphy and 99mTc-MDP scans were performed before and 5, 6, and 8 weeks after methylprednisolone administration. Rabbits were sacrificed at various time points and conducted for TUNEL and H&E staining. Results. All methylprednisolone treated animals developed femoral head necrosis; at 8 weeks postinjection, destruction of bone structure was evident in H&E staining, and apoptosis was confirmed by the TUNEL assay. This was matched by 99mTc-Annexin V images, which showed a significant increase in signal over baseline. Serial 99mTc-Annexin V scans revealed that increased 99mTc-Annexin V uptake could be observed in 5 weeks. In contrast, there was no effect on 99mTc-MDP signal until 8 weeks. The TUNEL assay revealed that bone cell apoptosis occurred at 5 weeks. Conclusion. 99mTc-Annexin V is superior to 99mTc-MDP for the early detection of glucocorticoid-induced femoral head necrosis in the rabbit and may be a better strategy for the early detection of glucocorticoid-induced femoral head necrosis in patients. PMID:26989689

  3. Effects of propranolol and nifedipine on exercise-induced attack in patients variant angina: assessment by exercise thallium-201 myocardial scintigraphy with quantitative rotational tomography

    SciTech Connect

    Kugiyama, K.; Yasue, H.; Horio, Y.; Morikami, Y.; Fujii, H.; Koga, Y.; Kojima, A.; Takahashi, M.

    1986-08-01

    To examine the effects of propranolol and nifedipine on exercise-induced attack in patients with variant angina, exercise /sup 201/Tl myocardial scintigraphy with quantitative analysis by emission-computed tomography was performed in 20 patients with variant angina after oral propranolol (80 mg), nifedipine (20 mg), and placebo. Exercise-induced attack occurred in 11 patients on placebo, in 14 on propranolol, and in none on nifedipine. The exercise duration was significantly shorter in those on propranolol (p less than .05), but significantly longer in patients on nifedipine (p less than .05) than in those on placebo. The peak rate-pressure product was significantly lower in patients on propranolol (p less than .01), but did not change in those on nifedipine, as compared with that in patients on placebo. The size of the perfusion defect as measured by /sup 201/Tl tomography was significantly greater in patients on propranolol (p less than .05), but significantly less in those on nifedipine (p less than .01) than in those on placebo. In conclusion, propranolol does not suppress but rather may aggravate exercise-induced attack in patients with variant angina, while nifedipine suppresses it. This unfavorable effect of propranolol on exercise-induced attack in patients with variant angina is likely to be due to a reduction of regional myocardial blood flow.

  4. New approach to quantitation of exercise thallium-201 scintigraphy before and after an intervention: application to define the impact of coronary angioplasty on regional myocardial perfusion

    SciTech Connect

    Lim, Y.L.; Okada, R.D.; Chesler, D.A.; Block, P.C.; Boucher, C.A.; Pohost, G.M.

    1984-10-01

    We have developed a new computer method designed to quantitate regional myocardial thallium-201 (TI-201) initial distribution, redistribution, and clearance rate. In addition, this computer method permits the generation of functional images to compare two thallium images in the same projection to one another. These functional images can be used to demonstrate the extent of redistribution and the extent of change in regional perfusion before and after an intervention. To validate and apply this new computer technique, exercise TI-201 myocardial images obtained before and 1 week after percutaneous transluminal coronary angioplasty (PTCA) were analyzed in 20 patients with isolated left anterior descending coronary artery disease. Significant improvement in initial TI-201 activity, expressed as a percentage of maximal myocardial activity, was present in the anterior (71.9 +/- 12.0 to 84.1 +/- 11.5%, p less than 0.001) and septal (66.7 +/- 15.4 to 75.2 +/- 11.0%, p less than 0.05) regions of the left ventricle 1 week after PTCA. This increase in relative anterior wall TI-201 uptake was associated with a significant reduction in the amount of TI-201 redistribution between initial and delayed postexercise images (14.7 +/- 14.6 to 3.0 +/- 13.2%, p less than 0.05) as well as an increase in TI-201 clearance rate (t 1/2 from 8.8 +/- 4.4 to 4.3 +/- 2.5 hours, p less than 0.001). Quantitative analysis of TI-201 scans demonstrated improvement in 14 of 20 patients following PTCA. Computer-derived functional difference images depicted diminution in the extent of ischemia as manifested by redistribution of TI-201.

  5. Rare case of axillary lymph node metastasis in papillary thyroid carcinoma detected using Iodine-131 whole-body scintigraphy and single-photon emission computed tomography/computed tomography

    PubMed Central

    Kamaleshwaran, Koramadai Karuppusamy; Rajan, Firoz; Mohanan, Vyshak; Shinto, Ajit Sugunan

    2015-01-01

    Differentiated thyroid cancer is, usually, associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual. Only few cases of papillary carcinoma with axillary nodal metastasis were previously reported in the literature. We present a 38-year-old female who underwent Iodine-131 whole-body scintigraphy, after total thyroidectomy and bilateral neck lymph node dissection for papillary carcinoma of thyroid, showed intense uptake in the remnant thyroid, lung metastasis, left cervical and left axillary lymph nodes. Excision of left axillary lymph nodes confirmed metastatic papillary carcinoma. PMID:25829741

  6. Rare case of axillary lymph node metastasis in papillary thyroid carcinoma detected using Iodine-131 whole-body scintigraphy and single-photon emission computed tomography/computed tomography.

    PubMed

    Kamaleshwaran, Koramadai Karuppusamy; Rajan, Firoz; Mohanan, Vyshak; Shinto, Ajit Sugunan

    2015-01-01

    Differentiated thyroid cancer is, usually, associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual. Only few cases of papillary carcinoma with axillary nodal metastasis were previously reported in the literature. We present a 38-year-old female who underwent Iodine-131 whole-body scintigraphy, after total thyroidectomy and bilateral neck lymph node dissection for papillary carcinoma of thyroid, showed intense uptake in the remnant thyroid, lung metastasis, left cervical and left axillary lymph nodes. Excision of left axillary lymph nodes confirmed metastatic papillary carcinoma.

  7. [Identification of viable myocardium in ischemic heart disease with severe left ventricular contractile dysfunction: comparison of myocardial scintigraphy with 99mTc-sestamabi and with 201-thallium].

    PubMed

    Brandao, S; Cagnac, R; Roncalli, J; Lotterie, J A; Elbaz, M; Richez, F; Galinier, M; Carrie, D; Alibelli-Chemarin, M J

    2005-06-01

    The aim of this study was to compare quantitatively uptake of 99mTc-Sestamibi at rest and that of late redistribution of 201Tl in the same patients with severe ischaemic left ventricular dysfunction, and to correlate the uptake of the tracer to regional ventricular dysfunction studied by ECG grated 99Tc-Sestamini. A double isotope myocardial scintigraphy, 201 Thallium at rest/redistribution and 99Tc-Sestamibi at rest and on exercise, was performed in 28 patients with severe postinfarction ischaemic cardiomyopathy (EF= 29 +/- 4%). Quantitative analysis for each patient and each isotope were performed with respect to the number of hits expressed in percentage of the activity of a normal zone in 17 circumferential profiles distributed in 4 zones, that is to say in 476 segments. A score allowed counting of viable and non-viable segments and evaluation of contractile function of the 17 segments with respect to wall motion and systolic thickening. Total concordance of global uptake of the two isotopes was observed in 430 of the 476 segments (90.3%) (r= 0.814, p< 0.0001), but the 99mTc-Sestamibi uptake was less than 201 Th (71 +/- 23% vs 73 +/- 21%, p= 0.0001). With respect to left ventricular wall motion, uptake of 99mTc-Sestamibi was greater than that of 201Tl in normal or hypokinetic segments but less in akinetic and dyskinetic segments. The difference between the two isotopes was most marked in segments with very severe contractile dysfunction. The authors conclude that the uptake of 99mTc-Sestamibi is correlated with that of late distribution of 201Tl when left ventricular contraction is not too poor and should no longer be considered as only a marker of perfusion but can also be useful in the investigation of myocardial viability.

  8. Diagnosis of osteomyelitis in the presence of soft-tissue infection and radiologic evidence of osseous abnormalities: Value of leukocyte scintigraphy

    SciTech Connect

    Jacobson, A.F.; Harley, J.D.; Lipsky, B.A.; Pecoraro, R.E. )

    1991-10-01

    To evaluate the usefulness of 111In-leukocyte scintigraphy for identifying osteomyelitis in the presence of soft-tissue infection, the author prospectively studied 45 bone sites adjacent to soft-tissue infection in patients with abnormal findings on radiographs and 99mTc bone scans that were suggestive of osteomyelitis. 111In-leukocyte scans were analyzed in terms of the intensity of abnormal uptake and its location relative to bone. The diagnosis of osteomyelitis was established from results of percutaneous bone biopsy culture (n = 35), histologic examination of surgical specimens (n = 8), and clinical follow-up (n = 2). Osteomyelitis was present at 22 sites, including 16 of 18 sites with increased leukocyte uptake in bone, resulting in a sensitivity of 73%, specificity of 91%, and positive predictive value of 89% for this finding. Osteomyelitis was present at four of 17 sites with predominantly soft-tissue localization of leukocyte activity in the region of bone, none of seven sites with normal leukocyte scans, and two of three sites with diminished leukocyte uptake in bone. Although not helpful in distinguishing infectious from noninfectious bone abnormalities, 3- and especially 24-hr bone scans viewed in conjunction with leukocyte studies provided important correlation to aid in estimating the location of focal abnormal leukocyte uptake. The finding of soft-tissue infection with increased uptake of labeled leukocytes that extends to involve adjacent bone strongly suggests concurrent osteomyelitis. When the presence of abnormal leukocyte uptake in bone is uncertain, additional imaging and possibly biopsy may be required to establish or exclude the diagnosis of osteomyelitis.

  9. Tolerance and safety of pharmacologic coronary vasodilation with adenosine in association with thallium-201 scintigraphy in patients with suspected coronary artery disease

    SciTech Connect

    Abreu, A.; Mahmarian, J.J.; Nishimura, S.; Boyce, T.M.; Verani, M.S. )

    1991-09-01

    Adenosine thallium-201 myocardial scintigraphy is a promising test for coronary artery disease detection, but its safety has not been reported in large patient cohorts. Accordingly, the tolerance and safety profile of adenosine infusion were analyzed in 607 patients (351 men, 256 women, mean age 63 {plus minus} 11 years) undergoing this test either because of suspected coronary artery disease (Group I, n = 482) or for risk stratification early (5.2 {plus minus} 2.8 days) after myocardial infarction (Group II, n = 125). Adenosine increased the heart rate from 74.5 {plus minus} 14.0 to 91.8 {plus minus} 15.9 beats/min (p less than 0.001) and decreased systolic blood pressure from 137.8 {plus minus} 26.8 to 120.7 {plus minus} 26.1 mm Hg (p less than 0.001). Side effects were frequent and similar in both groups. Flushing occurred in 35%, chest pain in 34%, headache in 21% and dyspnea in 19% of patients. Only 35.6% of Group I patients with chest pain during adenosine infusion had concomitant transient perfusion abnormalities, compared with 60.7% of Group II patients (p less than 0.05). First- and second-degree AV block occurred in 9.6% and 3.6% of patients, respectively, and ischemic ST changes in 12.5% of cases. Concomitance of chest pain and ischemic ST depression was uncommon (6%) but, when present, predicted perfusion abnormalities in 73% of patients. Most side effects ceased rapidly after stopping the adenosine infusion. The side effects were severe in only 1.6% of patients and in only six patients (1%) was it necessary to discontinue the infusion. No serious adverse reactions such as acute myocardial infarction or death occurred.

  10. Quantitative stress-redistribution planar T1-201 scintigraphy: Assessment of the extent of hypoperfused myocardium by relationship to angiographic findings

    SciTech Connect

    Bassir, R.; Maddahi, J.; Garcia, E.; Van Train, K.; Bughi, S.; Becerra, A.; Weiss, T.; Brown, D.; Shaw, C.; Berman, D.

    1984-01-01

    The size of hypoperfused myocardium (HM) in coronary artery (CA) disease (D) potentially provides a prognostic index that may not be accurately assess by conventional angiographic classification. The authors studied 62 consecutive patients (pts) with planar stress-redistribution T1-201 scintigraphy (T1-201) and coronary arteriography who did not have prior myocardial infarction and achieved 85% predicted maximum heart rate on exercise. Of 62 pts, 42 had CAD (>50% stenosis). For T1-201 quantification of the size of HM, maximum count circumferential profiles of initial distribution and % washout were obtained and compared to previously established normal limits. The area enclosed between the normal limits and the abnormal portion of the pt's profiles represented a quantitative T1-201 jeopardy score (JS). Despite increasing T1-201 JS from 1 to 3 vessel (V) and left-main (LM) D, significant overlap between the different angiographic groups was observed; of 45 pts with mild JS (<300), 14 (31%) had 3VD and/or LMD. The angiographic extent of CAD was also analyzed using a method (CLASS) proposed by Gensini et al based on the CA territory, location and severity of stenosis, and collateral circulation. T1-201 JS correlated significantly with CLASS (r=.78, p<.01). Of the 45 pts with mild JS, only 5 (11%) had severe CLASS score. Thus, the size of the hypoperfused myocardium by quantitative stress- and redistribution T1-201 correlates better with a more complex angiographic estimate of myocardium at risk than conventional 1, 2, and 3 vessel disease classification.

  11. Usefulness of exercise electrocardiography and thallium scintigraphy in unstable angina pectoris in predicting the extent and severity of coronary artery disease

    SciTech Connect

    Freeman, M.R.; Chisholm, R.J.; Armstrong, P.W.

    1988-12-01

    The safety and efficacy of exercise electrocardiography and thallium scintigraphy early in the course of unstable angina pectoris were assessed 4.6 +/- 1.6 days after admission in 67 patients with unstable angina that stabilized after medical therapy. Coronary arteriography was performed in all patients 5.4 +/- 2.4 days after admission. There was no difference in clinical, exercise or scintigraphic variables between patients with stenoses less than 50% and patients with 1-vessel coronary artery disease (CAD) defined as a diameter stenosis greater than or equal to 50%. Patients with 3-vessel CAD had a significantly shorter exercise duration than patients with less than 50%-diameter narrowing (5.5 +/- 2.2 vs 8.3 +/- 3.3 minutes, respectively), lower exercise heart rate (119 +/- 20 vs 149 +/- 22 beats/min) and systolic blood pressure (156 +/- 29 vs 166 +/- 33 mm Hg), more frequent chest pain (76 vs 20%) and more pronounced ST depression (-1.48 +/- 1.37 vs -0.33 +/- 0.72 mm). In addition, thallium defect size on exercise was greater in the patients with 2-vessel CAD (159 +/- 132 degrees) and 3-vessel CAD (255 +/- 132 degrees) than in patients with no CAD (28 +/- 319 degrees) or 1-vessel CAD (73 +/- 78 degrees), p greater than or equal to 0.05. Multiple regression analysis demonstrated that thallium defect size was the best predictor of extent of CAD, with exercise heart rate and presence of chest pain during exercise also predictive of extent of CAD.

  12. Octreotide scintigraphy and Chromogranin A do not predict clinical response in patients with octreotide acetate-treated hormone-refractory prostate cancer.

    PubMed

    Kalkner, K M; Acosta, S; Thorsson, O; Frederiksen, H; Nilsson, A; Gustavsson, B; Elingsbo, M; Stridsberg, M; Abrahamsson, P-A

    2006-01-01

    In this pilot study, the predictive value of Octreotide scintigraphy (Octreoscan) and/or Chromogranin-A (CgA) was investigated in patients with hormone-refractory prostate cancer treated with Octreotide acetate. In total, 20 patients with progressive disease and bone metastases entered the trial. At baseline Octreoscan, CgA, PSA, alkaline phosphates (ALP) and two self-administered questionnaires (EORTC QLQ C-30 (v3) and brief pain index) were performed and a diary of the pharmaceutical was started. The treatment consisted of Octreotide (Sandostatin LAR) acetate 30 mg intramuscular injection every month. The blood samples and questionnaires were repeated every month until 3 months. Clinical responder was defined as a patient with increased global health score more than 10 units and stable or decreased pain score without an increase in analgesic. In all, 17 patients were treated per protocol, and four were assessed as clinical responders. Six patients developed a reduction in ALP (median -26%, range -5 to -78%). All patients increased in PSA. At baseline, three patients had a negative Octreoscan and the patients with positive lesions, demonstrated uptake of low intensity. At baseline the CgA was elevated above the normal range in 15 of the patients, and during treatment five patients decreased their CgA to the normal range. Neither baseline Octreoscan nor CgA could identify the clinical reponders. A minority of patients improves their health-related quality of life. The decrease and normalization of CgA levels in five patients during therapy indicates therapeutic activity but Octreoscan and CgA could not identify clinical responders.

  13. The role of 18FDG, 18FDOPA PET/CT and 99mTc bone scintigraphy imaging in Erdheim-Chester disease.

    PubMed

    García-Gómez, F J; Acevedo-Báñez, I; Martínez-Castillo, R; Tirado-Hospital, J L; Cuenca-Cuenca, J I; Pachón-Garrudo, V M; Álvarez-Pérez, R M; García-Jiménez, R; Rivas-Infante, E; García-Morillo, J S; Borrego-Dorado, I

    2015-08-01

    Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different presentations of the disease were observed in our casuistic: most indolent form was a cutaneous confined disease, presented in only one patient. Multifocal involvement with central nervous system (CNS) preservation was observed in two patients. Most aggressive form consisted in a systemic involvement with CNS infiltration, presented in three patients. In our experience neurological involvement, among one case with isolate pituitary infiltration, was associated with mortality in all cases. 18FDG-PET/CT and BS were particularly useful in despite systemic involvement; locate the site for biopsy and the treatment response evaluation. By our knowledge, 18FDOPA-PET/CT not seems useful in the initial staging of ECD. A baseline 18FDG-PET/CT and BS may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically 18FDG-PET/CT must be performed in the follow up to evaluate treatment response.

  14. [Thallium-201 myocardial scintigraphy after intravenous infusion of adenosine triphosphate disodium: a preliminary study in the diagnosis of coronary artery disease].

    PubMed

    Kinoshita, S; Yamashita, S; Suzuki, T; Muramatsu, T; Ide, M; Dohi, Y; Nishimura, K; Miyamae, T

    1991-12-01

    The feasibility and safety of thallium-201 myocardial scintigraphy after the intravenous infusion of adenosine triphosphate disodium (ATP) (Adetphos, Kowa) were studied in eight patients with angina pectoris and/or old myocardial infarction. Coronary arteriography (CAG) was performed by the conventional method in all patients. ATP was infused for 5 min and thallium was injected at 3 min after the start of ATP infusion. ATP was given at 0.12 mg/min/kg in two patients (group A), 0.16 mg/min/kg in three patients (group B), 0.20 mg/min/kg in one patient (group C) and 0.28 mg/min/kg in two patients (group D). SPECT images were obtained at 10 min and 180 min after thallium injection. No significant hemodynamic changes were observed in group A and B. Severe hypotension was observed in group C and one member of group D. Chest pain was experienced by one patient in group A, two in group B, one in group C, and both of the two in group D. ST depression on the electrocardiogram (ECG) was documented in one patient each of groups B and C. In one group D patient, the study was discontinued because of complete atrioventricular block persistent for 5 beats. The correlation between thallium imaging and CAG was unclear in group A, reasonable in groups B and C, and obscure in group D because of side effects. None of the patients who developed side effects of ATP were administered sublingual nitroglycerin or intravenous aminophylline. Their symptoms or ECG changes improved spontaneously within 2 min and disappeared within 5 min after termination of infusion. In conclusion, the optimal ATP regimen for this purpose was considered to be a 5 min infusion at 0.16 mg/kg/min and this method was found to be feasible and safe. PMID:1784093

  15. Right ventricular ejection fraction during exercise in normal subjects and in coronary artery disease patients: assessment by multiple-gated equilibrium scintigraphy

    SciTech Connect

    Maddahi, J.; Berman, D.S.; Matsuoka, D.T.; Waxman, A.D.; Forrester, J.S.; Swan, H.J.C.

    1980-07-01

    The response of right ventricular ejection fraction (RVEF) during exercise and its relationship to the location and extent of coronary artery disease are not fully understood. We have recently developed and validated a new method for scintigraphic evaluation of RVEF using rapid multiple-gated equilibrium scintigraphy and multiple right ventricular regions of interest. The technique has been applied during upright bicycle exercise in 10 normal subjects and 20 patients with coronary artery disease. Resting RVEF was not significantly different between the groups (0.49 +- 0.04 vs 0.47 +- 0.09, respectively, mean +- SD). In all 10 normal subjects RVEF rose (0.49 +- 0.04 to 0.66 +- 0.08, p < 0.01) at peak exercise. At peak exercise in coronary artery disease patients, the group RVEF remained unchanged (0.47 +- 0.09 to 0.50 +- 0.11, p = NS), but the individual responses varied. In the coronary artery disease patients, the relationship between RVEF response to exercise and exercise left ventricular function, septal motion and right coronary artery stenosis were studied. Significant statistical association was found only between exercise RVEF and right coronary artery stenosis. RVEF rose during exercise in seven of seven patients without right coronary artery stenosis (0.42 +- 0.06 to 0.58 +- 0.08, p = 0.001) and was unchanged or fell in 12 of 13 patients with right coronary artery stenosis (0.50 +- 0.09 to 0.45 +- 0.10, p = NS). We conclude that (1) in normal subjects RVEF increases during upright exercise and (2) although RVEF at rest is not necessarily affected by coronary artery disease, failure of RVEF to increase during exercise, in the absence of chronic obstructive pulmonary disease or valvular heart disease, may be related to the presence of significant right coronary artery stenosis.

  16. Bayesian meta-analysis of test accuracy in the absence of a perfect reference test applied to bone scintigraphy for the diagnosis of complex regional pain syndrome.

    PubMed

    Held, Ulrike; Brunner, Florian; Steurer, Johann; Wertli, Maria M

    2015-11-01

    There is conflicting evidence about the accuracy of bone scintigraphy (BS) for the diagnosis of complex regional pain syndrome 1 (CRPS 1). In a meta-analysis of diagnostic studies, the evaluation of test accuracy is impeded by the use of different imperfect reference tests. The aim of our study is to summarize sensitivity and specificity of BS for CRPS 1 and to identify factors to explain heterogeneity. We use a hierarchical Bayesian approach to model test accuracy and threshold, and we present different models accounting for the imperfect nature of the reference tests, and assuming conditional dependence between BS and the reference test results. Further, we include disease duration as explanatory variable in the model. The models are compared using summary ROC curves and the deviance information criterion (DIC). Our results show that those models which account for different imperfect reference tests with conditional dependence and inclusion of the covariate are the ones with the smallest DIC. The sensitivity of BS was 0.87 (95% credible interval 0.73-0.97) and the overall specificity was 0.87 (0.73-0.95) in the model with the smallest DIC, in which missing values of the covariate are imputed within the Bayesian framework. The estimated effect of duration of symptoms on the threshold parameter was 0.17 (-0.25 to 0.57). We demonstrate that the Bayesian models presented in this paper are useful to address typical problems occurring in meta-analysis of diagnostic studies, including conditional dependence between index test and reference test, as well as missing values in the study-specific covariates. PMID:26479506

  17. Evaluation of diagnostic parameters from parotid and submandibular dynamic salivary glands scintigraphy and unstimulated sialometry in Sjögren's syndrome.

    PubMed

    Dugonjić, Sanja; Stefanović, Dušan; Ethurović, Branka; Spasić-Jokić, Vesna; Ajdinović, Boris

    2014-01-01

    Our aim was to validate eight scintigraphic salivary gland (SG) parameters, as diagnostic parameters in patients with Sjögren's syndrome (SS). We used the standardized stimulated dynamic salivary gland scintigraphy (DSGS) protocol and correlated this with the unstimulated whole sialometry (UWS) functions. The DSGS and UWS tests meeting the European and the USA diagnostic classification criteria for SS were applied in twenty patients and in ten normal controls. The DSGS tests were performed 60min after the intravenous (i.v.) injection of 370MBq of technetium-99m-pertechnetate ((99m)TcO(-)4) and after per os stimulation with a 0.5g tablet of ascorbic acid administered 40min after the injection. Using time-activity curves, eight different parameters were calculated for each parotid gland (PG) and each submandibular salivary gland (SMG): a) time at maximum counts (Tmax), b) time at minimum counts (Tmin), c) maximum accumulation (MA), d) accumulation velocity (AV), e) maximum secretion (MS), f) maximum stimulated secretion (MSS), g) stimulated secretion velocity (SSV), and h) uptake ratio (UR). Values of UWS below 2.5mL/15min, were considered abnormal. All these parameters, as for the PG, showed significant abnormality in SS patients (P<0.001), especially of the secretion function. All SMG parameters also showed a significant abnormality (P<0.001), but especially of the accumulation function. There was a greater impairment of the above parameters in SMG than in PG in the SS patients. Sensitivity of the standardized DSGS was 100%, specificity 80%, negative prognostic value 100%, and positive prognostic value 91%. Sensitivity of UWS was 75%. In conclusion, this paper suggested that the best diagnostic parameters for the SS patients were those of: a) the maximum secretion, b) the maximum stimulated secretion for both the parotid and the submandibular glands, c) maximum accumulation and d) accumulation velocity of submandibular glands. The times at maximum and at minimum

  18. MR urography in children and adolescents: techniques and clinical applications.

    PubMed

    Dillman, Jonathan R; Trout, Andrew T; Smith, Ethan A

    2016-06-01

    Renal and urinary tract imaging is commonly performed in the pediatric population, particularly in the setting of suspected or known congenital anomalies. In most cases, adequate anatomic assessment can be achieved using ultrasound and fluoroscopic techniques, and evaluation of differential renal function and urinary tract drainage can be accomplished with renal scintigraphy. However, in a subset of children, anatomic or functional questions may remain after this routine evaluation. In this setting, magnetic resonance imaging (MRI) tailored to evaluate the kidneys and urinary tract, known as MR urography (MRU), can be used to depict the kidneys, ureters, and urinary bladder in detail and to determine differential renal function and assess urinary tract drainage. The objectives of this review article are to (1) describe pediatric-specific MRI techniques for assessment of the kidneys and urinary tract and (2) present common clinical applications for pediatric MRU where imaging can "add value" in terms of diagnosis and patient management. PMID:26915088

  19. A Pilot Comparison of 18F-fluorocholine PET/CT, Ultrasonography and 123I/99mTc-sestaMIBI Dual-Phase Dual-Isotope Scintigraphy in the Preoperative Localization of Hyperfunctioning Parathyroid Glands in Primary or Secondary Hyperparathyroidism: Influence of Thyroid Anomalies.

    PubMed

    Michaud, Laure; Balogova, Sona; Burgess, Alice; Ohnona, Jessica; Huchet, Virginie; Kerrou, Khaldoun; Lefèvre, Marine; Tassart, Marc; Montravers, Françoise; Périé, Sophie; Talbot, Jean-Noël

    2015-10-01

    We compared (18)F-fluorocholine hybrid positron emission tomography/X-ray computed tomography (FCH-PET/CT) with ultrasonography (US) and scintigraphy in patients with hyperparathyroidism and discordant, or equivocal results of US and (123)I/(99m)Tc-sesta-methoxyisobutylisonitrile (sestaMIBI) dual-phase parathyroid scintigraphy. FCH-PET/CT was performed in 17 patients with primary (n = 11) lithium induced (n = 1) or secondary hyperparathyroidism (1 dialyzed, 4 renal-transplanted).The reference standard was based on results of surgical exploration and histopathological examination. The results of imaging modalities were evaluated, on site and by masked reading, on per-patient and per-lesion bases.In a first approach, equivocal images/foci were considered as negative. On a per-patient level, the sensitivity was for US 38%, for scintigraphy 69% by open and 94% by masked reading, and for FCH-PET/CT 88% by open and 94% by masked reading. On a per-lesion level, sensitivity was for US 42%, for scintigraphy 58% by open and 83% by masked reading, and for FCH-PET/CT 88% by open and 96% by masked reading. One ectopic adenoma was missed by the 3 imaging modalities. Considering equivocal images/foci as positive increased the accuracy of the open reading of scintigraphy or of FCH-PET/CT, but not of US. FCH-PET/CT was significantly superior to US in all approaches, whereas it was more sensitive than scintigraphy only for open reading considering equivocal images/foci as negative (P = 0.04). FCH uptake was more intense in adenomas than in hyperplastic parathyroid glands. Thyroid lesions were suspected in 9 patients. They may induce false-positive results as in one case of oncocytic thyroid adenoma, or false-negative results as in one case of intrathyroidal parathyroid adenoma. Thyroid cancer (4 cases) can be visualized with FCH as with (99m)Tc-sestaMIBI, but the intensity of uptake was moderate, similar to that of parathyroid hyperplasia.This pilot study confirmed that

  20. A Pilot Comparison of 18F-fluorocholine PET/CT, Ultrasonography and 123I/99mTc-sestaMIBI Dual-Phase Dual-Isotope Scintigraphy in the Preoperative Localization of Hyperfunctioning Parathyroid Glands in Primary or Secondary Hyperparathyroidism

    PubMed Central

    Michaud, Laure; Balogova, Sona; Burgess, Alice; Ohnona, Jessica; Huchet, Virginie; Kerrou, Khaldoun; Lefèvre, Marine; Tassart, Marc; Montravers, Françoise; Périé, Sophie; Talbot, Jean-Noël

    2015-01-01

    Abstract We compared 18F-fluorocholine hybrid positron emission tomography/X-ray computed tomography (FCH-PET/CT) with ultrasonography (US) and scintigraphy in patients with hyperparathyroidism and discordant, or equivocal results of US and 123I/99mTc-sesta-methoxyisobutylisonitrile (sestaMIBI) dual-phase parathyroid scintigraphy. FCH-PET/CT was performed in 17 patients with primary (n = 11) lithium induced (n = 1) or secondary hyperparathyroidism (1 dialyzed, 4 renal-transplanted). The reference standard was based on results of surgical exploration and histopathological examination. The results of imaging modalities were evaluated, on site and by masked reading, on per-patient and per-lesion bases. In a first approach, equivocal images/foci were considered as negative. On a per-patient level, the sensitivity was for US 38%, for scintigraphy 69% by open and 94% by masked reading, and for FCH-PET/CT 88% by open and 94% by masked reading. On a per-lesion level, sensitivity was for US 42%, for scintigraphy 58% by open and 83% by masked reading, and for FCH-PET/CT 88% by open and 96% by masked reading. One ectopic adenoma was missed by the 3 imaging modalities. Considering equivocal images/foci as positive increased the accuracy of the open reading of scintigraphy or of FCH-PET/CT, but not of US. FCH-PET/CT was significantly superior to US in all approaches, whereas it was more sensitive than scintigraphy only for open reading considering equivocal images/foci as negative (P = 0.04). FCH uptake was more intense in adenomas than in hyperplastic parathyroid glands. Thyroid lesions were suspected in 9 patients. They may induce false-positive results as in one case of oncocytic thyroid adenoma, or false-negative results as in one case of intrathyroidal parathyroid adenoma. Thyroid cancer (4 cases) can be visualized with FCH as with 99mTc-sestaMIBI, but the intensity of uptake was moderate, similar to that of parathyroid hyperplasia. This pilot study confirmed

  1. Comparison of chest pain, electrocardiographic changes and thallium-201 scintigraphy during varying exercise intensities in men with stable angina pectoris

    SciTech Connect

    Heller, G.V.; Ahmed, I.; Tilkemeier, P.L.; Barbour, M.M.; Garber, C.E. )

    1991-09-01

    This study was performed to evaluate the presence of angina pectoris, electrocardiographic changes and reversible thallium-201 defects resulting from 2 different levels of exercise in 19 patients with known coronary artery disease and evidence of exercise-induced ischemia. The exercise protocols consisted of a symptom-limited incremental exercise test (Bruce protocol) followed within 3 to 14 days by a submaximal, steady-state exercise test performed at 70% of the maximal heart rate achieved during the Bruce protocol. The presence and time of onset of angina and electrocardiographic changes (greater than or equal to 0.1 mV ST-segment depression) as well as oxygen uptake, exercise duration and pressure-rate product were recorded. Thallium-201 (2.5 to 3.0 mCi) was injected during the last minute of exercise during both protocols, and the images were analyzed using both computer-assisted quantitation and visual interpretations. Incremental exercise resulted in anginal symptoms in 84% of patients, and electrocardiographic changes and reversible thallium-201 defects in all patients. In contrast, submaximal exercise produced anginal symptoms in only 26% (p less than 0.01) and electrocardiographic changes in only 47% (p less than 0.05), but resulted in thallium-201 defects in 89% of patients (p = not significant). The locations of the thallium-201 defects, when present, were not different between the 2 exercise protocols. These findings confirm the sequence of the ischemic cascade using 2 levels of exercise and demonstrate that the cascade theory is applicable during varying ischemic intensities in the same patient.

  2. Diagnostics différentiels d'images d'hypofixations sur une scintigraphie du squelette: à propos d'un cas de leucémie aigue lymphoblastique

    PubMed Central

    Bahadi, Nisrine; Biyi, Abdelhamid; Oueriagli, Salah Nabih; Doudouh, Abderrahim

    2016-01-01

    Si les hyperfixations sont la traduction scintigraphique habituelle de nombreuses pathologies osseuses, les hypofixations sont un événement rare et suscitent souvent analyse minutieuse afin d’éviter des interprétations erronés. Nous rapportons ici l'observation d'un adolescent de 17 ans admis pour douleurs osseuses diffuses, une hypercalcémie et une thrombopénie. La scintigraphie du squelette a montré des foyers d'hypofixations. L’étude de la moelle osseuse a conclu au diagnostic de leucémie aigue lymphoblastique. A travers ce cas clinique, nous discutons les principaux diagnostics différentiels soulevés par de telles anomalies scintigraphiques. PMID:27642484

  3. Evaluation of Alpha-Therapy with Radium-223-Dichloride in Castration Resistant Metastatic Prostate Cancer-the Role of Gamma Scintigraphy in Dosimetry and Pharmacokinetics.

    PubMed

    Kairemo, Kalevi; Joensuu, Timo; Rasulova, Nigora; Kiljunen, Timo; Kangasmäki, Aki

    2015-01-01

    Radium-223-dichloride ((223)RaCl₂) is a new bone-seeking calcium analogue alpha-emitter, which has obtained marketing authorization for the treatment skeletal metastases of hormone-refractory prostate cancer. The current treatment regimen is based on six consecutive doses of (223)RaCl₂ at 4 week intervals and the administered activity dose, 50 kBq/kg per cycle is based on patient weight. We analyzed two patients using quantitative serial gamma imaging to estimate dosimetry in tumors and see possible pharmacokinetic differences in the treatment cycles. The lesions were rather well visualized in gamma scintigraphy in spite of low gamma activity (<1.1% gamma radiation) at 0, 7 and 28 days using 30-60 min acquisition times. Both our patients analyzed in serial gamma imagings, had two lesions in the gamma imaging field, the mean counts of the relative intensity varied from 27.8 to 36.5 (patient 1), and from 37.4 to 82.2 (patient 2). The half-lives varied from 1.8 days to 4.5 days during the six cycles (patient 1), and from 1.5 days to 3.6 days (patient 2), respectively. In the lesion half-lives calculated from the imaging the maximum difference between the treatment cycles in the same lesion was 2.0-fold (1.8 vs. 3.6). Of these patients, patient 1 demonstrated a serum PSA response, whereas there was no PSA response in patient 2. From our data, there were maximally up to 4.0-fold differences (62.1 vs. 246.6 ) between the relative absorbed radiation doses between patients as calculated from the quantitative standardized imaging to be delivered in only two lesions, and in the same lesion the maximum difference in the cycles was up to 2.3-fold (107.4 vs. 246.6). Our recommendation based on statistical simulation analysis, is serial measurement at days 0-8 at least 3 times, this improve the accuracy significantly to study the lesion activities, half-lives or calculated relative absorbed radiation doses as calculated from the imaging. Both our patients had originally two

  4. Solubilized xenon 133 lung scintigraphy

    SciTech Connect

    Oates, E.; Sarno, R.C.

    1988-11-01

    Lung scanning using solubilized xenon 133 can provide important information concerning both pulmonary perfusion and ventilation. This technique proved valuable in establishing the diagnosis of congenital lobar emphysema in a 7-month-old baby.

  5. Unsuspected pregnancy during bone scintigraphy

    SciTech Connect

    Oates, E.; Ramberg, K.; Becker, J.L. )

    1990-06-01

    Despite careful screening efforts to avoid it, nuclear medicine studies are unintentionally performed on pregnant patients. Three-phase bone scanning is a common procedure performed in women of child-bearing age. Unsuspected pregnancies have been discovered on the flow and early view of the pelvis. The authors present a case of a pregnant girl, aged 15, who had a bone scan. They explain how this occurred and how they plan to prevent a recurrence. Dosimetry for the fetus also is considered.

  6. Genitourinary imaging: current and emerging applications.

    PubMed

    O' Donoghue, P M; McSweeney, S E; Jhaveri, K

    2010-01-01

    This review discusses the current and emerging techniques in urinary tract imaging. Recent technical advances and novel discoveries make this an exciting but challenging time for urinary tract imaging. The first section describes the imaging of the adrenal gland which has made great strides in the last decade, the current major adrenal imaging modalities as well as new applications are discussed with particular attention to the role of imaging in the incidentally detected adrenal lesion. In the second section the role of ultrasound, computed tomography (CT) and magnetic resonance (MR) in evaluation of the renal tract are discussed with the new technical advances leading to earlier detection and characterization of renal lesions. Complementary to this is the emerging role of CT and MR urography in assessment of the urinary tract and bladder in contrast to the demise of plain film studies/intravenous urography. The role of CT angiography in assessment of the renal vasculature is also discussed. The third section discusses the role of prostate imaging in the diagnosis, staging and management of prostate cancer. Transrectal ultrasonography, can be used to guide biopsy, CT is frequently used in staging, with bone scintigraphy and positron emission tomography having roles in advanced disease. Currently, all imaging modalities, especially MR are evolving to improve disease detection and staging. The final section discusses the recently encountered adverse reaction of nephrogenic systemic fibrosis in patients post gadolinium-enhanced MRI and how to help prevent this adverse reaction.

  7. Validation of technetium-99m stannous pyrophosphate myocardial scintigraphy for diagnosing acute myocardial infarction more than 48 hours old when serum creatine kinase-MB has returned to normal

    SciTech Connect

    Olson, H.G.; Lyons, K.P.; Butman, S.; Piters, K.M.

    1983-08-01

    Determination of lactic dehydrogenase (LDH) isoenzymes is the current method of choice for diagnosing acute myocardial infarction (AMI) greater than 48 hours old. However, other causes of enzyme elevation make the availability of an alternate method of diagnosis worthwhile. Accordingly, serial technetium-99m pyrophosphate scintigrams were obtained in 61 patients with transmural AMI and in 46 patients with subendocardial AMI. Imaging was performed in all 107 patients at the time creatine kinase isoenzyme (CK-MB) was present 37 +/- 18 hours (range 12 to 72) after the onset of AMI, and at the time CK-MB was absent 106 +/- 34 hours (range 48 to 168) after the onset of AMI. At the time CK-MB was absent, the sensitivity using either a regional or a diffuse positive scintigram was 95% (58 of 61 patients) for transmural AMI and 65% (30 of 46 patients) for subendocardial AMI. The sensitivity using a regional positive scintigram was 82% (50 of 61 patients) for transmural AMI and 37% (17 of 46 patients) for subendocardial AMI. The sensitivity using a high-grade regional positive scintigram was 36% (22 of 61 patients) for transmural AMI and 11% (5 of 46 patients) for subendocardial AMI. The specificity was 70% (143 of 204 patients) for either a regional or a diffuse abnormality, 92% (187 of 204 patients) for a regional abnormality, and 100% (204 of 204 patients) for a high-grade regional abnormality. Thus, pyrophosphate scintigraphy is useful in confirming the diagnosis of AMI, particularly transmural, greater than 48 hours old and when CK-MB has returned to normal. A positive scintigram with a high-grade regional abnormality is specific for a recent AMI and may be contributory in establishing the diagnoses when LDH isoenzymes are inconclusive.

  8. Nuclear molecular imaging with nanoparticles: radiochemistry, applications and translation

    PubMed Central

    Abou, D S; Pickett, J E

    2015-01-01

    Molecular imaging provides considerable insight into biological processes for greater understanding of health and disease. Numerous advances in medical physics, chemistry and biology have driven the growth of this field in the past two decades. With exquisite sensitivity, depth of detection and potential for theranostics, radioactive imaging approaches have played a major role in the emergence of molecular imaging. At the same time, developments in materials science, characterization and synthesis have led to explosive progress in the nanoparticle (NP) sciences. NPs are generally defined as particles with a diameter in the nanometre size range. Unique physical, chemical and biological properties arise at this scale, stimulating interest for applications as diverse as energy production and storage, chemical catalysis and electronics. In biomedicine, NPs have generated perhaps the greatest attention. These materials directly interface with life at the subcellular scale of nucleic acids, membranes and proteins. In this review, we will detail the advances made in combining radioactive imaging and NPs. First, we provide an overview of the NP platforms and their properties. This is followed by a look at methods for radiolabelling NPs with gamma-emitting radionuclides for use in single photon emission CT and planar scintigraphy. Next, utilization of positron-emitting radionuclides for positron emission tomography is considered. Finally, recent advances for multimodal nuclear imaging with NPs and efforts for clinical translation and ongoing trials are discussed. PMID:26133075

  9. Changes in salivary gland function after radiotherapy of head and neck tumors measured by quantitative pertechnetate scintigraphy: Comparison of intensity-modulated radiotherapy and conventional radiation therapy with and without Amifostine

    SciTech Connect

    Muenter, Marc W. . E-mail: m.muenter@dkfz.de; Hoffner, Simone; Hof, Holger; Herfarth, Klaus K.; Haberkorn, Uwe; Rudat, Volker; Huber, Peter; Debus, Juergen; Karger, Christian P.

    2007-03-01

    Purpose: The aim of this study was to compare changes in salivary gland function after intensity-modulated radiotherapy (IMRT) and conventional radiotherapy (RT), with or without Amifostine, for tumors of the head-and-neck region using quantitative salivary gland scintigraphy (QSGS). Methods and Materials: A total of 75 patients received pre- and post-therapeutic QSGS to quantify the salivary gland function. In all, 251 salivary glands were independently evaluated. Changes in the maximum uptake ({delta}U) and relative excretion rate ({delta}F) both pre- and post-RT were determined to characterize radiation-induced changes in the salivary gland function. In addition, dose-response curves were calculated. Results: In all groups, maximum uptake and relative excretion rate were reduced after RT ({delta}U {<=}0 and {delta}F {<=}0). The reduction was significantly lower for IMRT than for conventional RT. For the parotid glands, the reduction was smaller for the IMRT-low than for the IMRT-high group. For the Amifostine-high and the conventional group the difference was significant only for one parameter ({delta}U, parotid and submandibular glands, p < 0.05). In contrast to this, the difference between the Amifostine-low and the conventional group was always significant or at least showed a clear trend for both changes in U and F. In regard to the endpoint 'reduction of the salivary gland excretion rate of more than 50%,' the dose-response curves yielded D{sub 50}-values of 34.2 {+-} 12.2 Gy for the conventionally treated group and 36.8 {+-} 2.9 Gy for the IMRT group. For the Amifostine group, an increased D{sub 50}-values of 46.3 {+-} 2.3 Gy was obtained. Conclusion: Intensity-modulated RT can significantly reduce the loss of parotid gland function when respecting a certain dose threshold. Conventional RT plus Amifostine prevents reduced salivary gland function only in the patient group treated with <40.6 Gy.

  10. Role of scintigraphy in inflammatory bowel disease

    PubMed Central

    Stathaki, Maria I; Koukouraki, Sophia I; Karkavitsas, Nikolaos S; Koutroubakis, Ioannis E

    2009-01-01

    The diagnosis of inflammatory bowel disease (IBD) depends on direct endoscopic visualization of the colonic and ileal mucosa and the histological study of the obtained samples. Radiological and scintigraphic methods are mainly used as an adjunct to endoscopy. In this review, we focus on the diagnostic potential of nuclear medicine procedures. The value of all radiotracers is described with special reference to those with greater experience and more satisfactory results. Tc-99m hexamethylpropylene amine oxime white blood cells remain a widely acceptable scintigraphic method for the diagnosis of IBD, as well as for the evaluation of disease extension and severity. Recently, pentavalent Tc-99m dimercaptosuccinic acid has been recommended as an accurate variant and a complementary technique to endoscopy for the follow-up and assessment of disease activity. Positron emission tomography alone or with computed tomography using fluorine-18 fluorodeoxyglucose appears to be a promising method of measuring inflammation in IBD patients. PMID:19522018

  11. Commercial applications

    NASA Technical Reports Server (NTRS)

    Togai, Masaki

    1990-01-01

    Viewgraphs on commercial applications of fuzzy logic in Japan are presented. Topics covered include: suitable application area of fuzzy theory; characteristics of fuzzy control; fuzzy closed-loop controller; Mitsubishi heavy air conditioner; predictive fuzzy control; the Sendai subway system; automatic transmission; fuzzy logic-based command system for antilock braking system; fuzzy feed-forward controller; and fuzzy auto-tuning system.

  12. Land Application.

    ERIC Educational Resources Information Center

    Reynolds, James H.

    1978-01-01

    Presents a literature review of wastewater land application, covering publications of 1976-77. This review covers areas such as the history, development, philosophy, design, models, and case studies of land application. A list of 41 references is also presented. (HM)

  13. Plasma Applications

    NASA Astrophysics Data System (ADS)

    Kristiansen, M.; Guenther, A. H.

    Plasmas have numerous applications for civilian as well as defense purposes. However, technical development is still in its infancy. Many new important applications depend only upon the imagination of engineers and scientists. In contrast to other develping technologies, applications from the fields of plasma science and engineering can only evolve through a multidisciplinary synergism. Research in plasma chemistry and physics together with gaseous electronics, fluid dynamics and thermodynamics, particularly mass and heat transfer, must be coupled with electro-chemistry and material science research particularly those aspects dealing with surfaces. In this paper we attempt to evaluate the importance of plasma applications. Obviously, it is impossible to do justice to all the important areas. The selection of topics is, therefore, influenced by the authors' interests and background. We will outline most of the applications rather briefly and concentrate in some detail on those areas in which we are interested.

  14. Rejected applications

    PubMed Central

    2014-01-01

    Objective: To review membership application materials (especially rejected applications) to the American Academy of Neurology (AAN) during its formative years (1947–1953). Methods: Detailed study of materials in the AAN Historical Collection. Results: The author identified 73 rejected applications. Rejected applicants (71 male, 2 female) lived in 25 states. The largest number was for the Associate membership category (49). These were individuals “in related fields who have made and are making contributions to the field of neurology.” By contrast, few applicants to Active membership or Fellowship status were rejected. The largest numbers of rejectees were neuropsychiatrists (19), neurosurgeons (16), and psychiatrists (14). Conclusion: The AAN, established in the late 1940s, was a small and politically vulnerable organization. A defining feature of the fledgling society was its inclusiveness; its membership was less restrictive than that of the older American Neurological Association. At the same time, the society needed to preserve its core as a neurologic society rather than one of psychiatry or neurosurgery. Hence, the balance between inclusiveness and exclusive identity was a difficult one to maintain. The Associate membership category, more than any other, was at the heart of this issue of self-definition. Associate members were largely practitioners of psychiatry or neurosurgery. Their membership was a source of consternation and was to be carefully been held in check during these critical formative years. PMID:24944256

  15. ASCI applications

    SciTech Connect

    Nowak, D.A.; Christensen, R.C.

    1997-11-11

    ASCI applications codes are key elements of the Department of Energy`s Stockpile Stewardship and Management Program (SSMP). They will provide the simulation capabilities needed to predict the performance, safety, reliability, and manufacturability of the U.S. nuclear deterrent.

  16. Application note :

    SciTech Connect

    Russo, Thomas V.

    2013-08-01

    The development of the XyceTM Parallel Electronic Simulator has focused entirely on the creation of a fast, scalable simulation tool, and has not included any schematic capture or data visualization tools. This application note will describe how to use the open source schematic capture tool gschem and its associated netlist creation tool gnetlist to create basic circuit designs for Xyce, and how to access advanced features of Xyce that are not directly supported by either gschem or gnetlist.

  17. Photography applications

    USGS Publications Warehouse

    Cochran, Susan A.; Goodman, James A.; Purkis, Samuel J.; Phinn, Stuart R.

    2013-01-01

    Photographic imaging is the oldest form of remote sensing used in coral reef studies. This chapter briefly explores the history of photography from the 1850s to the present, and delves into its application for coral reef research. The investigation focuses on both photographs collected from low-altitude fixed-wing and rotary aircraft, and those collected from space by astronauts. Different types of classification and analysis techniques are discussed, and several case studies are presented as examples of the broad use of photographs as a tool in coral reef research.

  18. Medical Applications

    NASA Astrophysics Data System (ADS)

    Boccara, A. Claude; Mordon, Serge

    2015-10-01

    In re-listening to the lectures of Charles Townes shortly after the invention of the laser (e.g., in the Boston Science Museum), one can already have a realistic vision of the potentialities of this new tool in the field of medical therapy, as evidenced by the use of the laser in ophthalmology to cure retinal detachment in the 1960's. Since then, applications have flourished in the domain of therapy. We will thus illustrate here only some of the main fields of application of medical lasers. On the opposite, the use of lasers in medical imaging is, with one exception in ophthalmology, still at the development level. It is becoming a diagnostic tool in addition to high performance imaging facilities that are often very expensive (such as CT scan, Magnetic Resonance Imaging (MRI) and nuclear imaging). Even if progress is sometimes slow, one can now image with light inside the human body, in spite of the strong scattering of light by tissues, in the same way as a pathologist sees surgical specimens.

  19. In vivo application of ( sup 111 In-DTPA-D-Phe sup 1 )-octreotide for detection of somatostatin receptor-positive tumors in rats

    SciTech Connect

    Bakker, W.H.; Krenning, E.P.; Reubi, J.C.; Breeman, W.A.P.; Setyono-Han, B.; de Jong, M.; Kooij, P.P.M.; Bruns, C.; van Hagen, P.M.; Marbach, P.; Visser, T.J.; Pless, J.; Lamberts, S.W.J. Sandoz Research Inst., Berne Dr. Daniel den Hoed Cancer Centre, Rotterdam Sandoz Pharma AG, Basel )

    1991-01-01

    In this study the authors investigated its in vivo application in the visualization of somatostatin receptor-positive tumors in rats. The distribution of the radiopharmaceutical was investigated after intravenous injection in normal rats and in rats bearing the somatostatin receptor-positive rat pancreatic carcinoma CA 20948. Ex vivo autoradiographic studies showed that specific accumulation of radioactivity occurred in somatostatin receptor-containing tissue (anterior pituitary gland). However, in contrast to the adrenals and pituitary, the tracer accumulation in the kidneys was not mediated by somatostatin receptors. Increasing radioactivity over the somatostatin receptor-positive tumors was measured rapidly after injection and the tumors were clearly visualized by gamma camera scintigraphy. In rats pretreated with 1 mg octreotide accumulation of ({sup 111}In-DPTA-D-Phe{sup 1})-octreotide in the tumors was prevented. Because of its relatively long effective half-life, ({sup 111}In-DTPA-D-Phe{sup 1})-octreotide is a radionuclide-coupled somatostatin analogue which can be used to visualize somatostatin receptor-bearing tumors efficiently after 24 hr, when interfering background radioactivity is minimized by renal clearance.

  20. Contrast-enhanced CT- and MRI-based perfusion assessment for pulmonary diseases: basics and clinical applications

    PubMed Central

    Ohno, Yoshiharu; Koyama, Hisanobu; Lee, Ho Yun; Miura, Sachiko; Yoshikawa, Takeshi; Sugimura, Kazuro

    2016-01-01

    Assessment of regional pulmonary perfusion as well as nodule and tumor perfusions in various pulmonary diseases are currently performed by means of nuclear medicine studies requiring radioactive macroaggregates, dual-energy computed tomography (CT), and dynamic first-pass contrast-enhanced perfusion CT techniques and unenhanced and dynamic first-pass contrast enhanced perfusion magnetic resonance imaging (MRI), as well as time-resolved three-dimensional or four-dimensional contrast-enhanced magnetic resonance angiography (MRA). Perfusion scintigraphy, single-photon emission tomography (SPECT) and SPECT fused with CT have been established as clinically available scintigraphic methods; however, they are limited by perfusion information with poor spatial resolution and other shortcomings. Although positron emission tomography with 15O water can measure absolute pulmonary perfusion, it requires a cyclotron for generation of a tracer with an extremely short half-life (2 min), and can only be performed for academic purposes. Therefore, clinicians are concentrating their efforts on the application of CT-based and MRI-based quantitative and qualitative perfusion assessment to various pulmonary diseases. This review article covers 1) the basics of dual-energy CT and dynamic first-pass contrast-enhanced perfusion CT techniques, 2) the basics of time-resolved contrast-enhanced MRA and dynamic first-pass contrast-enhanced perfusion MRI, and 3) clinical applications of contrast-enhanced CT- and MRI-based perfusion assessment for patients with pulmonary nodule, lung cancer, and pulmonary vascular diseases. We believe that these new techniques can be useful in routine clinical practice for not only thoracic oncology patients, but also patients with different pulmonary vascular diseases. PMID:27523813

  1. Contrast-enhanced CT- and MRI-based perfusion assessment for pulmonary diseases: basics and clinical applications.

    PubMed

    Ohno, Yoshiharu; Koyama, Hisanobu; Lee, Ho Yun; Miura, Sachiko; Yoshikawa, Takeshi; Sugimura, Kazuro

    2016-01-01

    Assessment of regional pulmonary perfusion as well as nodule and tumor perfusions in various pulmonary diseases are currently performed by means of nuclear medicine studies requiring radioactive macroaggregates, dual-energy computed tomography (CT), and dynamic first-pass contrast-enhanced perfusion CT techniques and unenhanced and dynamic first-pass contrast enhanced perfusion magnetic resonance imaging (MRI), as well as time-resolved three-dimensional or four-dimensional contrast-enhanced magnetic resonance angiography (MRA). Perfusion scintigraphy, single-photon emission tomography (SPECT) and SPECT fused with CT have been established as clinically available scintigraphic methods; however, they are limited by perfusion information with poor spatial resolution and other shortcomings. Although positron emission tomography with 15O water can measure absolute pulmonary perfusion, it requires a cyclotron for generation of a tracer with an extremely short half-life (2 min), and can only be performed for academic purposes. Therefore, clinicians are concentrating their efforts on the application of CT-based and MRI-based quantitative and qualitative perfusion assessment to various pulmonary diseases. This review article covers 1) the basics of dual-energy CT and dynamic first-pass contrast-enhanced perfusion CT techniques, 2) the basics of time-resolved contrast-enhanced MRA and dynamic first-pass contrast-enhanced perfusion MRI, and 3) clinical applications of contrast-enhanced CT- and MRI-based perfusion assessment for patients with pulmonary nodule, lung cancer, and pulmonary vascular diseases. We believe that these new techniques can be useful in routine clinical practice for not only thoracic oncology patients, but also patients with different pulmonary vascular diseases.

  2. Contrast-enhanced CT- and MRI-based perfusion assessment for pulmonary diseases: basics and clinical applications.

    PubMed

    Ohno, Yoshiharu; Koyama, Hisanobu; Lee, Ho Yun; Miura, Sachiko; Yoshikawa, Takeshi; Sugimura, Kazuro

    2016-01-01

    Assessment of regional pulmonary perfusion as well as nodule and tumor perfusions in various pulmonary diseases are currently performed by means of nuclear medicine studies requiring radioactive macroaggregates, dual-energy computed tomography (CT), and dynamic first-pass contrast-enhanced perfusion CT techniques and unenhanced and dynamic first-pass contrast enhanced perfusion magnetic resonance imaging (MRI), as well as time-resolved three-dimensional or four-dimensional contrast-enhanced magnetic resonance angiography (MRA). Perfusion scintigraphy, single-photon emission tomography (SPECT) and SPECT fused with CT have been established as clinically available scintigraphic methods; however, they are limited by perfusion information with poor spatial resolution and other shortcomings. Although positron emission tomography with 15O water can measure absolute pulmonary perfusion, it requires a cyclotron for generation of a tracer with an extremely short half-life (2 min), and can only be performed for academic purposes. Therefore, clinicians are concentrating their efforts on the application of CT-based and MRI-based quantitative and qualitative perfusion assessment to various pulmonary diseases. This review article covers 1) the basics of dual-energy CT and dynamic first-pass contrast-enhanced perfusion CT techniques, 2) the basics of time-resolved contrast-enhanced MRA and dynamic first-pass contrast-enhanced perfusion MRI, and 3) clinical applications of contrast-enhanced CT- and MRI-based perfusion assessment for patients with pulmonary nodule, lung cancer, and pulmonary vascular diseases. We believe that these new techniques can be useful in routine clinical practice for not only thoracic oncology patients, but also patients with different pulmonary vascular diseases. PMID:27523813

  3. Aerospace Applications of Microprocessors

    NASA Technical Reports Server (NTRS)

    1980-01-01

    An assessment of the state of microprocessor applications is presented. Current and future requirements and associated technological advances which allow effective exploitation in aerospace applications are discussed.

  4. Sight Application Analysis Tool

    SciTech Connect

    Bronevetsky, G.

    2014-09-17

    The scale and complexity of scientific applications makes it very difficult to optimize, debug and extend them to support new capabilities. We have developed a tool that supports developers’ efforts to understand the logical flow of their applications and interactions between application components and hardware in a way that scales with application complexity and parallelism.

  5. Small Molecule Sequential Dual-Targeting Theragnostic Strategy (SMSDTTS): from Preclinical Experiments towards Possible Clinical Anticancer Applications

    PubMed Central

    Li, Junjie; Oyen, Raymond; Verbruggen, Alfons; Ni, Yicheng

    2013-01-01

    Hitting the evasive tumor cells proves challenging in targeted cancer therapies. A general and unconventional anticancer approach namely small molecule sequential dual-targeting theragnostic strategy (SMSDTTS) has recently been introduced with the aims to target and debulk the tumor mass, wipe out the residual tumor cells, and meanwhile enable cancer detectability. This dual targeting approach works in two steps for systemic delivery of two naturally derived drugs. First, an anti-tubulin vascular disrupting agent, e.g., combretastatin A4 phosphate (CA4P), is injected to selectively cut off tumor blood supply and to cause massive necrosis, which nevertheless always leaves peripheral tumor residues. Secondly, a necrosis-avid radiopharmaceutical, namely 131I-hypericin (131I-Hyp), is administered the next day, which accumulates in intratumoral necrosis and irradiates the residual cancer cells with beta particles. Theoretically, this complementary targeted approach may biologically and radioactively ablate solid tumors and reduce the risk of local recurrence, remote metastases, and thus cancer mortality. Meanwhile, the emitted gamma rays facilitate radio-scintigraphy to detect tumors and follow up the therapy, hence a simultaneous theragnostic approach. SMSDTTS has now shown promise from multicenter animal experiments and may demonstrate unique anticancer efficacy in upcoming preliminary clinical trials. In this short review article, information about the two involved agents, the rationale of SMSDTTS, its preclinical antitumor efficacy, multifocal targetability, simultaneous theragnostic property, and toxicities of the dose regimens are summarized. Meanwhile, possible drawbacks, practical challenges and future improvement with SMSDTTS are discussed, which hopefully may help to push forward this strategy from preclinical experiments towards possible clinical applications. PMID:23412554

  6. Ruby on Rails Applications

    NASA Technical Reports Server (NTRS)

    Hochstadt, Jake

    2011-01-01

    Ruby on Rails is an open source web application framework for the Ruby programming language. The first application I built was a web application to manage and authenticate other applications. One of the main requirements for this application was a single sign-on service. This allowed authentication to be built in one location and be implemented in many different applications. For example, users would be able to login using their existing credentials, and be able to access other NASA applications without authenticating again. The second application I worked on was an internal qualification plan app. Previously, the viewing of employee qualifications was managed through Excel spread sheets. I built a database driven application to streamline the process of managing qualifications. Employees would be able to login securely to view, edit and update their personal qualifications.

  7. Intravenous dipyridamole thallium-201 SPECT imaging methodology, applications, and interpretations

    SciTech Connect

    Rockett, J.F.; Magill, H.L.; Loveless, V.S.; Murray, G.L. )

    1990-10-01

    Dipyridamole TI-201 imaging is an ideal alternative to exercise TI-201 scintigraphy in patients who are unwilling or unable to perform maximum exercise stress. The use of intravenous dipyridamole, alone or in combination with exercise, has not been approved for clinical practice by the Food and Drug Administration. Once approval is granted, the test will become a widely used and important component of the cardiac work-up. The indications, methodology, side effects, and utility of dipyridamole cardiac imaging in the clinical setting are discussed and a variety of examples presented.59 references.

  8. CYBER 200 Applications Seminar

    NASA Technical Reports Server (NTRS)

    Gary, J. P. (Compiler)

    1984-01-01

    Applications suited for the CYBER 200 digital computer are discussed. Various areas of application including meteorology, algorithms, fluid dynamics, monte carlo methods, petroleum, electronic circuit simulation, biochemistry, lattice gauge theory, economics and ray tracing are discussed.

  9. Industrial storage applications overview

    NASA Technical Reports Server (NTRS)

    Duscha, R. A.

    1980-01-01

    The implementation of a technology demonstration for the food processing industry, development and technology demonstrations for selected near-term, in-plant applications and advanced industrial applications of thermal energy storage are overviewed.

  10. Entomopathogenic nematode application technology

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Biocontrol success when using entomopathogenic nematodes (EPNs) in the genera Heterorhabditis and Steinernema relies on a variety of factors including components of the application event itself. Successful application encompasses both abiotic and biotic influences. For example, adverse array of equi...

  11. Effect of fasting and parenteral alimentation on PIPIDA scintigraphy.

    PubMed

    Potter, T; McClain, C J; Shafer, R B

    1983-08-01

    Ten patients were prospectively studied using 99mTc-PIPIDA imaging to evaluate the effects of fasting and parenteral alimentation on gallbladder function. Three of ten patients had initial nonvisualization of the gallbladder for up to 2 hr, yet had normal visualization on repeat imaging performed after resumption of oral intake or after parenteral alimentation was discontinued. 99mTc-PIPIDA imaging should be interpreted with caution in patients fitting into either of these groups.

  12. Hodgkin's disease with hypercalcemia detected by thallium-201 scintigraphy

    SciTech Connect

    Linde, R.; Basso, L.

    1987-01-01

    A 53-yr-old man with hypercalcemia was referred after an unsuccessful operative attempt to find a parathyroid adenoma. Metabolic evaluation showed relatively suppressed levels of parathyroid hormone with an elevation of serum 1,25-dihydroxyvitamin D. Thallium-technetium dual isotope imaging revealed localized mediastinal thallium uptake. A vascular mediastinal lesion was then demonstrated by arteriography, with subsequent surgical removal of a mass that proved to be lymphocyte predominant Hodgkin's disease. This case is noteworthy for the finding of isolated lymphocyte predominant Hodgkin's disease in the chest, the association of elevated serum 1,25-dihydroxyvitamin D with hypercalcemia that resolved postoperatively, and the uptake of thallium by the tumor.

  13. Space/time quantitation of thallium-201 myocardial scintigraphy.

    PubMed

    Garcia, E; Maddahi, J; Berman, D; Waxman, A

    1981-04-01

    A comprehensive method is described for quantitation of the spatial distribution of TI-201 in the myocardium and its changes with time. The method, applied here to 51 patients, uses bilinear interpolative background subtraction to compensate for tissue crosstalk, and circumferential profiles to quantitate the relative radionuclide activity in the myocardium as an angular function with origin at the center of the left-ventricular cavity. In addition, washout circumferential profiles are calculated as percent washout from the stress circumferential profiles. Abnormal thallium distribution or washout is identified by automatic computer comparison of each patient's profiles with the corresponding limits of normal profiles, determined from the pooled profiles of 31 normal patients. In these 31, the computer output was normal in all cases. In 20 patients with angiographically documented coronary artery disease, 19 were determined to be abnormal by this method. This new computerized treatment provides accurate objective assessment of the presence of coronary artery disease.

  14. Gallium scintigraphy in bone infarction. Correlation with bone imaging

    SciTech Connect

    Armas, R.R.; Goldsmith, S.J.

    1984-01-01

    The appearance of gallium-67 images in bone infarction was studied in nine patients with sickle cell disease and correlated with the bone scan findings. Gallium uptake in acute infarction was decreased or absent with a variable bone scan uptake, and normal in healing infarcts, which showed increased uptake on bone scan. The significance of these findings is discussed.

  15. Ancillary diagnostic imaging. Angiography, ultrasonography, scintigraphy, and xeroradiography

    SciTech Connect

    Pharr, J.W.

    1985-03-01

    Veterinary medical imaging is now accepted as including a number of imaging modalities other than conventional radiography. Although the wide availability and relatively low cost of conventional radiography will keep it in the forefront of veterinary medical imaging, other imaging modalities or techniques such as those discussed in this article will, where available, be of significant value in selected cases of bovine lameness.

  16. Gallium scintigraphy in a case of septic cavernous sinus thrombosis

    SciTech Connect

    Palestro, C.J.; Malat, J.; Gladstone, A.G.; Richman, A.H.

    1986-09-01

    Septic cavernous sinus thrombosis, a relatively uncommon disease entity, frequently can be fatal. Early diagnosis is imperative in order that appropriate treatment be instituted. A 59-year-old woman who was admitted to our institution with complaints of diplopia, blurred vision and fevers that developed following a tooth extraction is presented. Initial CT and lumbar puncture on the day of admission were totally normal. A repeat CT performed 48 hours after admission, on the same day as gallium imaging, demonstrated findings consistent with cavernous sinus thrombosis. Gallium imaging demonstrated intense uptake in the left cavernous sinus and left orbit as well as moderately increased activity in the right cavernous sinus and orbit, confirming infection. The patient was treated with antibiotics, and repeat CT and gallium imaging were performed ten days later, both of which demonstrated near total resolution of the disease process. Conceivably, if gallium imaging had been initiated on the day of admission it may have been the first study to demonstrate an infectious process in the cavernous sinus. Gallium imaging should be considered as a diagnostic tool in the noninvasive workup of this entity.

  17. Lymphatic imaging: Lymphography, computed tomography and scintigraphy, 2nd ed

    SciTech Connect

    Close, M.E.; Wallace, S.

    1985-01-01

    The latest addition to the Golden's Diagnostic Radiology series deals not only with imaging of the lymphatic system but also with lymphatic anatomy, its pathophysiology, and treatment of disorders. The first two chapters deal with the history of the discovery of the lymphatic system and its normal anatomy. The section on technique contains practical information and discussion of lymphatic physiology and the pathology of lymphomas. Half of the book's 16 chapters are devoted to problems encountered in clinical imaging. The approach is both by anatomy (thorax, neck, abdomen) and pathology (benign disease, lymphoma, solid tumors).

  18. Colonic varices demonstrated by technetium-99m red cell scintigraphy

    SciTech Connect

    Brill, D.R.

    1987-03-01

    Colonic varices is a rare condition, generally associated with portal hypertension, which normally presents as acute, severe, gastrointestinal blood loss. A case is presented in which the varicosities were observed serendipitously in a patient with a pancreatic tumor, in whom the bleeding was not variceal but due to two small unrelated gastric hemangiomas. The literature is reviewed and scintigraphic features described.

  19. Myocardial Perfusion Scintigraphy: Techniques, Interpretation, Indications and Reporting

    PubMed Central

    Fathala, Ahmed

    2011-01-01

    Myocardial perfusion single photon emission-computed tomography (MPS) has been one of the most important and common non-invasive diagnostic cardiac test. Gated MPS provides simultaneous assessment of myocardial perfusion and function with only one study. With appropriate attention to the MPS techniques, appropriate clinical utilization and effective reporting, gated MPS will remain a useful diagnostic test for many years to come. The aim of this article is to review the basic techniques of MPS, a simplified systematic approach for study interpretation, current clinical indications and reporting. After reading this article the reader should develop an understanding of the techniques, interpretation, current clinical indications and reporting of MPS studies. PMID:22048510

  20. New observations in scintigraphy of subdural and extradural hematomas

    SciTech Connect

    Smoak, W.M.; Gilson, A.J.; Janowitz, W.; Zusmer, N.; Maturo, V.

    1980-11-01

    Static radionuclide images of subacute subdural hematomas demonstrate significant variations in findings over a 3-hr period in the same patient. The lesion can appear, disappear, and reconstitute in an entirely different pattern. This transformation has not appeared in extradural hematomas, and may provide a differential diagnostic sign. In patients with a clinical history or physical findings suspicious for these intracranial hematomas, immediate and sequential delayed static imaging is recommended.

  1. Bone Scintigraphy SPECT/CT Evaluation of Mandibular Condylar Hyperplasia.

    PubMed

    Yang, Zhiyun; Reed, Tameron; Longino, Becky H

    2016-03-01

    Mandibular condylar hyperplasia (CH) is a complex developmental deformity resulting in asymmetries of the hyperplastic condyle. Bone scan SPECT is a sensitive and accurate method of detecting the growth activity of this disorder. This method can be used to quantitate the radionuclide uptake differences between the left and right condyles. Uptake differences of 10% or more between the left and right condyles, with increased uptake ipsilateral to the CH, are considered to be evidence of active growing CH. Quantitative assessment of CH is important to select an appropriate treatment course. Degenerative arthropathies of the temporomandibular joints may result in altered uptake, but this is mostly associated with the side contralateral to the CH. The CT portion of SPECT/CT is useful to assess the condylar dimensions and underlying bony changes. PMID:26111714

  2. Hybrid imaging in planar scintigraphy: new implementations and historical precedents.

    PubMed

    Zuckier, Lionel S

    2012-01-01

    Fusion of tomographic radionuclide studies with anatomical examinations has become standard practice in positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging. Nonetheless, fusion of planar scintigraphic images with an anatomical modality remains distinctly uncommon, although methods to do so have appeared sporadically in the literature during the past 2 decades. In this article we review several techniques that have been used to combine planar scintigraphic images with radiographs and visual (photographic) images. Rigid or affine transformations have been performed to co-register the planar images with each other using custom, commercial, or public domain software. Display of the hybrid images has been achieved primarily with nonselective color-fusion methods. Promising efforts are underway to develop a technique of fusing planar lymphoscintigraphic images with CT topograms (scout images) obtained on the SPECT-CT camera in a manner that compensates for position-dependent variation in magnification that affects the CT scout. An advantage of this approach is that both of the component images are acquired on the same gantry, without need for repositioning of the patient. It is instructive to note that techniques of fusing rectilinear scans with radiographic and visual images were first developed more than 50 years ago. The revisiting of these methods after many decades reflects a fundamental need for spatial orientation in nuclear medicine that fusion imaging can also bring to planar scintigraphic studies.

  3. The clinical impact of perfusion scintigraphy with dipyridamole

    SciTech Connect

    Schechtmann, N.; Dae, M.; Lanzer, P.; Sajardo, L.; Faulkner, D.; Botvinick, E.

    1984-01-01

    In order to assess their clinical impact, the authors analyzed perfusion scintigrams (PS) with dipyridamole (D) and the resultant clinical management in 41 consecutive patients (PTS). Population mean age was 67, with 22 males and represented 14% of those having PS. Fifteen PTS had rest chest pain of unknown cause and 26 PTS had pain typical or suggestive of angina but couldn't undergo dynamic stress due to claudication, arthritis, amputation, stroke, recent surgery or other disability. Four PTS were studies for surgical clearance, 3 following angiography to assess coronary pathophysiology and 9 had prior negative or equivocal stress PS at suboptimal levels. Among 18 PTS with reversible scintigraphic abnormalities, 10 underwent subsequent catheterization, with successful CABG in 7, PTCA in 1, aggressive medical treatment of ischemia in 11, and 2 had noncoronary surgery delayed. One PT with associated extensive fixed abnormalities underwent CABG and died late in heart failure. Among 23 PTS without significant scintigraphic reversibility, 8 with normal studies were discharged, 3 went on to uncomplicated noncardiac surgery and 11 PTS, 9 with dilated cardiomyopathy, were managed without therapeutic change. D infusion was uncomplicated and related findings on PS correlated well with coronary angiography, where available in 19 of 20 PTS. PS with D: 1) is safe; 2) correlates closely with coronary anatomy; and 3) adds unique, important pathophysiologic information to clinical evaluation and impacts strongly on the management of a large number of PTS with known or suspected coronary disease.

  4. PIPIDA excretory scintigraphy in the diagnosis of hepatobiliary disorders

    SciTech Connect

    Pelot, D.; Berk, J.E.; Wistow, B.W.; Morton, M.E.

    1981-01-01

    The diagnostic accuracy of hepatobiliary radionuclide imaging using /sup 99/mTC-labeled para-isopropyl acetanilido-iminodiacetic acid (/sup 99/mTc-PIPIDA) in patients with hepatobiliary disorders was assessed in 50 patients. Thirty of the study group were jaundiced; the remaining 20 had other clinical features suggestive of some hepatobiliary disorder. The findings using PIPIDA proved to be correct in 22 (73%) of the 30 jaundiced patients and in 18 (90%) of 20 patients without jaundice. There appears to be a close relationship between the diagnostic accuracy of the test and the level of serum bilirubin. Thus, the diagnosis indicated by the PIPIDA test was correct in 30 (88%) of 34 patients in whom the serum bilirubin was less than 5 mg./dl. but only in 10 (62%) of 16 patients whose serum bilirubin exceeded 5 mg./dl. It is concluded from these observations that: 1. PIPIDA is diagnostically useful in the evaluation of hepatobiliary disorders, especially when the serum bilirubin is less than 5 mg./dl. and 2. the accuracy of this test is not absolute and the findings are not always definitive.

  5. Potential pitfall of DMSA scintigraphy in patients with ureteral duplication

    SciTech Connect

    Wu, F.; Snow, B.; Taylor, A. Jr.

    1986-07-01

    A 5-wk-old male presented with radiographic findings of a duplicated collecting system. A (/sup 99m/Tc)DMSA scan was requested to evaluate cortical function. Images obtained immediately. postinjection showed activity restricted to the upper poles; in contrast, delayed images at 4 hr showed activity in the bladder and throughout both kidneys. Catheterizing the patient drained the activity from the bladder but had little effect on the refluxed renal activity. The early (/sup 99m/Tc)DMSA images were critical in making the proper interpretation. Technetium-99m DMSA is excreted into the urine and this fact needs to be considered when interpreting scans of patients with possible reflux or obstruction. When DMSA scans are obtained in pediatric patients with possible reflux, catheterization prior to the study and early images prior to the appearance of DMSA in the collecting system are recommended.

  6. Bone scintigraphy in the reflex sympathetic dystrophy syndrome

    SciTech Connect

    Kozin, F.; Soin, J.S.; Ryan, L.M.; Carrera, G.F.; Wortmann, R.L.

    1981-02-01

    Sixty-four consecutive patients were studied for possible reflex sympathetic dystrophy syndrome (RSDS). They were divided into five groups, based upon specific clinical criteria, and the radiographic and scintigraphic findings in each group were examined. Osteoporosis was the most common radiographic abnormality. Scintigraphic abnormalities were noted in 60% of RSDS patients but in only 7% of the others. These findings included increased blood flow and enhanced periarticular radionuclide activity in the affected extremity. The scan may reflect an active, potentially reversible disorder of local blood flow in RSDS. Furthermore, the scintigraphic patterns may be useful in the diagnosis and in predicting which patients are likely to respond to systemic steroid therapy.

  7. Deep Vein Thrombosis Presenting on Pulmonary Ventilation and Perfusion Scintigraphy.

    PubMed

    Itani, Malak; Fair, Joanna; Hillman, Zachary; Behnia, Fatemeh; Elojeimy, Saeed

    2016-10-01

    A 52-year-old woman presenting with dyspnea was referred for a ventilation and perfusion scan (VQ). VQ images (with Tc-DTPA [diethylene triamine pentaacetic acid aerosol] and Tc-MAA [macroaggregated albumin]) initially appeared normal; however, count rates on perfusion images were similar to ventilation images, implying little Tc-MAA had reached the lungs. Spot images of the injected extremity demonstrated focal Tc-MAA accumulation worrisome for a venous thrombus, subsequently confirmed by Doppler ultrasound. Careful attention to relative radiotracer count rates on VQ scans is crucial to ensure diagnostic utility. In addition, abnormal low perfusion radiotracer counts may unveil other pathology with important clinical implications. PMID:27556796

  8. Osteomyelitis complicating fracture: pitfalls of /sup 111/In leukocyte scintigraphy

    SciTech Connect

    Kim, E.E.; Pjura, G.A.; Lowry, P.A.; Gobuty, A.H.; Traina, J.F.

    1987-05-01

    /sup 111/In-labeled leukocyte imaging has shown greater accuracy and specificity than alternative noninvasive methods in the detection of uncomplicated osteomyelitis. Forty patients with suspected osteomyelitis complicating fractures (with and without surgical intervention) were evaluated with /sup 111/In-labeled leukocytes. All five patients with intense focal uptake, but only one of 13 with no uptake, had active osteomyelitis. However, mild to moderate /sup 111/In leukocyte uptake, observed in 22 cases, indicated the presence of osteomyelitis in only four of these; the other false-positive results were observed in noninfected callus formation, heterotopic bone formation, myositis ossificans, and sickle-cell disease. These results suggest that /sup 111/In-labeled leukocyte imaging is useful for the evaluation of suspected osteomyelitis complicating fracture but must be used in conjunction with clinical and radiographic correlation to avoid false-positive results.

  9. Visualization of the liver, gallbladder, and intestine on bone scintigraphy

    SciTech Connect

    Sherkow, L.; Ryo, U.Y.; Fabich, D.; Patel, G.C.; Pinsky, S.M.

    1984-08-01

    Images of the liver, gallbladder, and/or intestine were visualized on bone scans on several occasions. Radiopharmaceutical quality control data, including molybdenum-99 and aluminum ion content in the Tc-99m eluate, free unbound Tc-99m, and hydrolyzed reduced Tc-99m in the labeled MDP, were all satisfactory. A minor defect in the quality of the Tc-99m generator was considered to be the probable cause of the unusual localization of the bone imaging agent.

  10. Cholecystokinin cholecystography, sonography, and scintigraphy: detection of chronic acalculous cholecystitis

    SciTech Connect

    Davis, G.B.; Berk, R.N.; Sheible, F.W.; Witztum, K.F.; Gilmore, I.T.; Strong, R.M.; Hofmann, A.F.

    1982-12-01

    Because the efficacy of cholecystokinin cholecystography in the detection of chronic acalculous cholecystitis remains in doubt, the procedure is rarely used in clinical practice. However, the ability to observe gallbladder contraction with sonography and /sup 99m/Tc-para-isopropylacetanilido-iminodiacetic acid cholescintigraphy (PIPIDA) offers a possibility to improve the sensitivity of the test. To determine if the degree of gallbladder contraction after cholecystokinin is the same as measured by the three techniques and if it differs in symptomatic patients compared to the normal population, cholecystokinin cholecystography, cholecystokinin sonography, and cholecystokinin PIPIDA were performed in 10 symptomatic patients and 10 normal volunteers. The mean maximum contraction of the gallbladder during the three studies was 63%, 61%, and 68%, respectively, for the volunteers, and 72%, 63%, and 73%, respectively, for the patients. The mean maximum gallbladder contraction during all three procedues was 64% +/- 26% SD in the volunteers and 74% +/- 17% SD in the patients. The differences were not statistically significant. Although there was good correlation in the degree of maximum gallbladder contraction among cholecystokinin PIPIDA, marked variation in both the volunteers and the patients makes it unlikely that the degree of contraction as observed by any of these techniques can be used to indicate the presence of chronic acalculous cholecystitis.

  11. Phrygian cap simulating mass lesion in hepatobiliary scintigraphy

    SciTech Connect

    Smergel, E.M.; Maurer, A.H.

    1984-03-01

    Hepatobiliary imaging has been used to demonstrate that defects in the region of the gallbladder fossa in sulfur colloid studies correspond to normal gallbladder and not tumor. We report a case of delayed filling of a portion of the gallbladder due to a Phrygian cap anomaly. The case demonstrates that without delayed images incomplete filling of the gallbladder can be confused with a mass lesion in the liver.

  12. Cholecystokinin cholecystography, sonography, and scintigraphy: detection of chronic acalculous cholecystitis

    SciTech Connect

    Davis, G.B.; Berk, R.N.; Scheible, F.W.; Witztum, K.F.; Gilmore, I.T.; Strong, R.M.; Hofmann, A.F.

    1982-12-01

    Because the efficacy of cholecystokinin cholecystography in the detection of chronic acalculous cholecystitis remains in doubt, the procedure is rarely used in clinical practice. However, the ability to observe gallbladder contraction with sonography and /sup 99m/Tc-para-isopropylacetanilido-iminodiacetic acid cholescintigraphy (PIPIDA) offers a possibility to improve the sensitivity of the test. To determine if the degree of gallbladder contraction after cholecystokinin is the same as measured by the three techniques and if it differs in symptomatic patients compared to the normal population, cholecystokinin cholecystography, cholecystokinin sonography, and cholecystokinin PIPIDA were performed in 10 symptomatic patients and 10 normal volunteers. The mean maximum contraction of the gallbladder during the three studies was 63%, 61%, and 68%, respectively, for the volunteers, and 72%, 63%, and 73%, respectively, for the patients. The mean maximum gallbladder contraction during all three procedures was 64% +/- 26% SD in the volunteers and 74% +/- 17% SD in the patients. The differences were not statistically significant. Although there was good correlation in the degree of maximum gallbladder contraction among cholecystokinin cholecystography, cholecystokinin sonography, and cholecystokinin PIPIDA, marked variation in both the volunteers and the patients makes it unlikely that the degree of contraction as observed by any of these techniques can be used to indicate the presence of chronic acalculous cholecystitis.

  13. Effect of fasting and parenteral alimentation on PIPIDA scintigraphy

    SciTech Connect

    Potter, T.; McClain, C.J.; Shafer, R.B.

    1983-08-01

    Ten patients were prospectively studied using 99mTc-PIPIDA imaging to evaluate the effects of fasting and parenteral alimentation on gallbladder function. Three of ten patients had initial nonvisualization of the gallbladder for up to 2 hr, yet had normal visualization on repeat imaging performed after resumption of oral intake or after parenteral alimentation was discontinued. 99mTc-PIPIDA imaging should be interpreted with caution in patients fitting into either of these groups.

  14. Changing indications for bone scintigraphy in patients with osteosarcoma

    SciTech Connect

    Goldstein, H.; McNeil, B.J.; Zufall, E.; Jaffe, N.; Treves, S.

    1980-04-01

    Fifty-six patients with osteosarcoma were studied to determine the onset of pulmonary and bone metastases. While pulmonary metastases were always detected prior to bone metastases in the era before adjuvant chemotherapy, in this study of patients on adjuvant therapy 16% of patients with metastases showed osseous metastases prior to or without pulmonary metastases.

  15. AFRL POSS Applications Research

    NASA Astrophysics Data System (ADS)

    Phillips, Shawn

    2002-09-01

    The Air Force is heavily invested in POSS Applications Research and Development. Currently one application is being 'flight-tested' for a technology transition. New applications are being investigated (e.g. batteries, capacitors, radomes). The technology transfer to Hybrid Plastics is a success story with significant volume increase and price reduction. POSS Nanotechnology Offers Versatility.

  16. Teaching Computer Applications.

    ERIC Educational Resources Information Center

    Lundgren, Carol A.; And Others

    This document, which is designed to provide classroom teachers at all levels with practical ideas for a computer applications course, examines curricular considerations, teaching strategies, delivery techniques, and assessment methods applicable to a course focusing on applications of computers in business. The guide is divided into three…

  17. Parts application handbook study

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The requirements for a NASA application handbook for standard electronic parts are determined and defined. This study concentrated on identifying in detail the type of information that designers and parts engineers need and expect in a parts application handbook for the effective application of standard parts on NASA projects.

  18. Engineering electrochemical capacitor applications

    NASA Astrophysics Data System (ADS)

    Miller, John R.

    2016-09-01

    Electrochemical capacitor (EC) applications have broadened tremendously since EC energy storage devices were introduced in 1978. Then typical applications operated below 10 V at power levels below 1 W. Today many EC applications operate at voltages approaching 1000 V at power levels above 100 kW. This paper briefly reviews EC energy storage technology, shows representative applications using EC storage, and describes engineering approaches to design EC storage systems. Comparisons are made among storage systems designed to meet the same application power requirement but using different commercial electrochemical capacitor products.

  19. Biopharmaceutical applications of nanogold.

    PubMed

    Alanazi, Fars K; Radwan, Awwad A; Alsarra, Ibrahim A

    2010-10-01

    The application of nanogold in biopharmaceutical field is reviewed in this work. The properties of nanogold including nanogold surface Plasmon absorption and nanogold surface Plasmon light scattering are illustrated. The physical, chemical, biosynthesis methods of nanogold preparation are presented. Catalytic properties as well as biomedical applications are highlighted as one of the most important applications of nanogold. Biosensing, and diagnostic and therapeutic applications of gold nanoparticles are evaluated. Moreover, gold nanoparticles in drugs, biomolecules and proteins' delivery are analyzed. Gold nanoparticles for the site-directed photothermal applications are reviewed as the most fruitful research area in the future.

  20. ERIP application instructions

    SciTech Connect

    Watt, D.M.

    1992-01-02

    This report provides background information and instructions to assist applicants in writing Energy-Related Inventions Program (ERIP) applications. Initial feedback fro usage for the new instructions shows that the best instructions would not be read and followed by all applicants. Applications from more than thirty applicants who have received the new instructions indicated that few had read the instructions. Based on this feedback, the instructions have been further revised to include a title page and table of contents. A warning was also added to advise applicants of the potential penalty of delayed review if these instructions are not followed. This revision was intended to address the possibility that some applicants did not see or bother to follow the instructions which followed the background information about ERIP. Included are two examples of ERIP applications which have been prepared for handout at workshops or mailing to applicants. Writing of example applications was time consuming and more difficult than expected for several reasons: (1) Full disclosures can be lengthy, very detailed, and technical. This contrasts with the desire to prepare examples which are comparatively short and easy for the non-technical person to read. (2) Disclosures contain confidential information which should not be published. (3) It is difficult to imagine that applicants will study examples when they do not bother to read the basic instructions.

  1. Technical applications of aerogels

    SciTech Connect

    Hrubesh, L.W.

    1997-08-18

    Aerogel materials posses such a wide variety of exceptional properties that a striking number of applications have developed for them. Many of the commercial applications of aerogels such as catalysts, thermal insulation, windows, and particle detectors are still under development and new application as have been publicized since the ISA4 Conference in 1994: e.g.; supercapacitors, insulation for heat storage in automobiles, electrodes for capacitive deionization, etc. More applications are evolving as the scientific and engineering community becomes familiar with the unusual and exceptional physical properties of aerogels, there are also scientific and technical application, as well. This paper discusses a variety of applications under development at Lawrence Livermore National Laboratory for which several types of aerogels are formed in custom sizes and shapes. Particular discussions will focus on the uses of aerogels for physics experiments which rely on the exceptional, sometimes unique, properties of aerogels.

  2. Applications of MST radars: Meteorological applications

    NASA Technical Reports Server (NTRS)

    Larsen, M. F.

    1989-01-01

    Applications of mesosphere stratosphere troposphere radar to mesoscale meteorology are discussed. The applications include using the radar either as a research tool to improve our understanding of certain dynamical systems or as part of a network used to provide input data for weather forecasting. The workhorse of the operational observing network is the radiosonde balloon which provides measurements of pressure, temperature, humidity, and winds up to heights of 16 to 20 km. Horizontal and vertical measurement capabilities, reflectivity data, derivable quantities and parameters, and special operational requirements are surveyed.

  3. Application Layer Multicast

    NASA Astrophysics Data System (ADS)

    Allani, Mouna; Garbinato, Benoît; Pedone, Fernando

    An increasing number of Peer-to-Peer (P2P) Internet applications rely today on data dissemination as their cornerstone, e.g., audio or video streaming, multi-party games. These applications typically depend on some support for multicast communication, where peers interested in a given data stream can join a corresponding multicast group. As a consequence, the efficiency, scalability, and reliability guarantees of these applications are tightly coupled with that of the underlying multicast mechanism.

  4. Exploiting chaos for applications

    SciTech Connect

    Ditto, William L.; Sinha, Sudeshna

    2015-09-15

    We discuss how understanding the nature of chaotic dynamics allows us to control these systems. A controlled chaotic system can then serve as a versatile pattern generator that can be used for a range of application. Specifically, we will discuss the application of controlled chaos to the design of novel computational paradigms. Thus, we present an illustrative research arc, starting with ideas of control, based on the general understanding of chaos, moving over to applications that influence the course of building better devices.

  5. LANL application communication patterns

    SciTech Connect

    Pakiin, Scott

    2011-01-10

    This brief presentation describes the communication patterns used by a set of unclassified applications developed at Los Alamos National Laboratory: XNobel/XRAGE/RAGE/SAGE, Krak, Sweep3D, and Partisn. It mentions which processes communicate with which other processes, whether the application is typically run in a strong-scaling mode or a weak-scaling mode, what message sizes are commonly used, and how the application's performance changes at scale.

  6. Applications and Experiences

    NASA Astrophysics Data System (ADS)

    Sacco, Giovanni Maria; Ferré, Sébastien

    This chapter discusses a number of real-world applications of dynamic taxonomies. Most current applications are object-seeking or knowledge-seeking exploratory tasks, and address important areas such as e-commerce, multimedia infobases, diagnostic systems, digital libraries and news systems, e-government, file systems, and geographical information systems. Applications in these areas are discussed in detail in the following, and applications in cultural heritage, art and architecture, e-recruitment, e-hrm, e-matchmaking, e-health, and e-learning are briefly reviewed.

  7. Application Power Signature Analysis

    SciTech Connect

    Hsu, Chung-Hsing; Combs, Jacob; Nazor, Jolie; Santiago, Fabian; Thysell, Rachelle; Rivoire, Suzanne; Poole, Stephen W

    2014-01-01

    The high-performance computing (HPC) community has been greatly concerned about energy efficiency. To address this concern, it is essential to understand and characterize the electrical loads of HPC applications. In this work, we study whether HPC applications can be distinguished by their power-consumption patterns using quantitative measures in an automatic manner. Using a collection of 88 power traces from 4 different systems, we find that basic statistical measures do a surprisingly good job of summarizing applications' distinctive power behavior. Moreover, this study opens up a new area of research in power-aware HPC that has a multitude of potential applications.

  8. Nanomaterials for Defense Applications

    NASA Astrophysics Data System (ADS)

    Turaga, Uday; Singh, Vinitkumar; Lalagiri, Muralidhar; Kiekens, Paul; Ramkumar, Seshadri S.

    Nanotechnology has found a number of applications in electronics and healthcare. Within the textile field, applications of nanotechnology have been limited to filters, protective liners for chemical and biological clothing and nanocoatings. This chapter presents an overview of the applications of nanomaterials such as nanofibers and nanoparticles that are of use to military and industrial sectors. An effort has been made to categorize nanofibers based on the method of production. This chapter particularly focuses on a few latest developments that have taken place with regard to the application of nanomaterials such as metal oxides in the defense arena.

  9. Flat conductor cable applications

    NASA Technical Reports Server (NTRS)

    Angele, W.

    1972-01-01

    Some of the numerous applications of flat conductor cable (FCC) systems are briefly described. Both government and commercial uses were considered, with applications designated as either aerospace, military, or commercial. The number and variety of ways in which FCC is being applied and considered for future designs are illustrated.

  10. Automatic multiple applicator electrophoresis

    NASA Technical Reports Server (NTRS)

    Grunbaum, B. W.

    1977-01-01

    Easy-to-use, economical device permits electrophoresis on all known supporting media. System includes automatic multiple-sample applicator, sample holder, and electrophoresis apparatus. System has potential applicability to fields of taxonomy, immunology, and genetics. Apparatus is also used for electrofocusing.

  11. Application Statistics 1987.

    ERIC Educational Resources Information Center

    Council of Ontario Universities, Toronto.

    Summary statistics on application and registration patterns of applicants wishing to pursue full-time study in first-year places in Ontario universities (for the fall of 1987) are given. Data on registrations were received indirectly from the universities as part of their annual submission of USIS/UAR enrollment data to Statistics Canada and MCU.…

  12. Microcomputer Applications in Agriculture.

    ERIC Educational Resources Information Center

    Hilgenberg, Gene; And Others

    This curriculum guide is intended to assist persons teaching a course in microcomputer applications in agriculture. (These applications are designed to be used on Apple IIe or TRS-80 microcomputers.) Addressed in the individual units of instruction are the following topics: microcomputer operating procedures; procedures for evaluating and…

  13. Application Security Automation

    ERIC Educational Resources Information Center

    Malaika, Majid A.

    2011-01-01

    With today's high demand for online applications and services running on the Internet, software has become a vital component in our lives. With every revolutionary technology comes challenges unique to its characteristics; for online applications, security is one huge concern and challenge. Currently, there are several schemes that address…

  14. Applications of Solubility Data

    ERIC Educational Resources Information Center

    Tomkins, Reginald P. T.

    2008-01-01

    This article describes several applications of the use of solubility data. It is not meant to be exhaustive but rather to show that knowledge of solubility data is required in a variety of technical applications that assist in the design of chemical processes. (Contains 3 figures and 1 table.)

  15. Applications of Carbon Nanotubes

    NASA Astrophysics Data System (ADS)

    Ajayan, Pulickel M.; Zhou, Otto Z.

    Carbon nanotubes have attracted the fancy of many scientists worldwide. The small dimensions, strength and the remarkable physical properties of these structures make them a very unique material with a whole range of promising applications. In this review we describe some of the important materials science applications of carbon nanotubes. Specifically we discuss the electronic and electrochemical applications of nanotubes, nanotubes as mechanical reinforcements in high performance composites, nanotube-based field emitters, and their use as nanoprobes in metrology and biological and chemical investigations, and as templates for the creation of other nanostructures. Electronic properties and device applications of nanotubes are treated elsewhere in the book. The challenges that ensue in realizing some of these applications are also discussed from the point of view of manufacturing, processing, and cost considerations.

  16. Stirling engine application study

    NASA Technical Reports Server (NTRS)

    Teagan, W. P.; Cunningham, D.

    1983-01-01

    A range of potential applications for Stirling engines in the power range from 0.5 to 5000 hp is surveyed. Over one hundred such engine applications are grouped into a small number of classes (10), with the application in each class having a high degree of commonality in technical performance and cost requirements. A review of conventional engines (usually spark ignition or Diesel) was then undertaken to determine the degree to which commercial engine practice now serves the needs of the application classes and to detemine the nature of the competition faced by a new engine system. In each application class the Stirling engine was compared to the conventional engines, assuming that objectives of ongoing Stirling engine development programs are met. This ranking process indicated that Stirling engines showed potential for use in all application classes except very light duty applications (lawn mowers, etc.). However, this potential is contingent on demonstrating much greater operating life and reliability than has been demonstrated to date by developmental Stirling engine systems. This implies that future program initiatives in developing Stirling engine systems should give more emphasis to life and reliability issues than has been the case in ongoing programs.

  17. Wind energy applications guide

    SciTech Connect

    anon.

    2001-01-01

    The brochure is an introduction to various wind power applications for locations with underdeveloped transmission systems, from remote water pumping to village electrification. It includes an introductory section on wind energy, including wind power basics and system components and then provides examples of applications, including water pumping, stand-alone systems for home and business, systems for community centers, schools, and health clinics, and examples in the industrial area. There is also a page of contacts, plus two specific example applications for a wind-diesel system for a remote station in Antarctica and one on wind-diesel village electrification in Russia.

  18. Application trends for photovoltaics

    NASA Astrophysics Data System (ADS)

    Macomber, H. L.

    This paper presents the results of studies by MONEGON to develop forecasts of PV system application markets. These forecasts consider economic factors such as conventional energy costs now and in the future, the relationship between world economic conditions, as represented by each country's Gross National Product, and energy demand; the cost potential for PV systems technologies; and the application trends in the past and future. The application sectors analyzed are: remote, stand-alone systems; residential systems; service/commercial/industrial/institutional; and central utility systems. An overall market forecast is developed and this forecast is segmented into the four market sectors.

  19. Biomaterials and therapeutic applications

    NASA Astrophysics Data System (ADS)

    Ferraro, Angelo

    2016-03-01

    A number of organic and inorganic, synthetic or natural derived materials have been classified as not harmful for the human body and are appropriate for medical applications. These materials are usually named biomaterials since they are suitable for introduction into living human tissues of prosthesis, as well as for drug delivery, diagnosis, therapies, tissue regeneration and many other clinical applications. Recently, nanomaterials and bioabsorbable polymers have greatly enlarged the fields of application of biomaterials attracting much more the attention of the biomedical community. In this review paper I am going to discuss the most recent advances in the use of magnetic nanoparticles and biodegradable materials as new biomedical tools.

  20. Industrial applications of nanoparticles.

    PubMed

    Stark, W J; Stoessel, P R; Wohlleben, W; Hafner, A

    2015-08-21

    Research efforts in the past two decades have resulted in thousands of potential application areas for nanoparticles - which materials have become industrially relevant? Where are sustainable applications of nanoparticles replacing traditional processing and materials? This tutorial review starts with a brief analysis on what makes nanoparticles attractive to chemical product design. The article highlights established industrial applications of nanoparticles and then moves to rapidly emerging applications in the chemical industry and discusses future research directions. Contributions from large companies, academia and high-tech start-ups are used to elucidate where academic nanoparticle research has revolutionized industry practice. A nanomaterial-focused analysis discusses new trends, such as particles with an identity, and the influence of modern instrument advances in the development of novel industrial products.

  1. Neutron sources and applications

    SciTech Connect

    Price, D.L.; Rush, J.J.

    1994-01-01

    Review of Neutron Sources and Applications was held at Oak Brook, Illinois, during September 8--10, 1992. This review involved some 70 national and international experts in different areas of neutron research, sources, and applications. Separate working groups were asked to (1) review the current status of advanced research reactors and spallation sources; and (2) provide an update on scientific, technological, and medical applications, including neutron scattering research in a number of disciplines, isotope production, materials irradiation, and other important uses of neutron sources such as materials analysis and fundamental neutron physics. This report summarizes the findings and conclusions of the different working groups involved in the review, and contains some of the best current expertise on neutron sources and applications.

  2. Food Applications and Regulation

    NASA Astrophysics Data System (ADS)

    Gálvez, Antonio; Abriouel, Hikmate; Omar, Nabil Ben; Lucas, Rosario

    This chapter deals with food applications of bacteriocins. Regulatory issues on the different possibilities for incorporating bacteriocins as bioprotectants are discussed. Specific applications of bacteriocins or bacteriocin-producing strains are described for main food categories, including milk and dairy products, raw meats, ready-to-eat meat and poultry products, fermented meats, fish and fish products or fermented fish. The last section of the chapter deals with applications in foods and beverages derived from plant materials, such as raw vegetable foods, fruits and fruit juices, cooked food products, fermented vegetable foods and ­fermented beverages. Results obtained for application of bacteriocins in combination with other hurdles are also discussed for each specific case, with a special emphasis on novel food packaging and food-processing technologies, such as irradiation, pulsed electric field treatments or high hydrostatic pressure treatment.

  3. Applications of decelerated ions

    SciTech Connect

    Johnson, B.M.

    1985-03-01

    Many facilities whose sole purpose had been to accelerate ion beams are now becoming decelerators as well. The development and current status of accel-decel operations is reviewed here. Applications of decelerated ions in atomic physics experiments are discussed.

  4. Space applications of superconductivity

    NASA Technical Reports Server (NTRS)

    Sullivan, D. B.; Vorreiter, J. W.

    1979-01-01

    Some potential applications of superconductivity in space are summarized, e.g., the use of high field magnets for cosmic ray analysis or energy storage and generation, space applications of digital superconducting devices, such as the Josephson switch and, in the future, a superconducting computer. Other superconducting instrumentation which could be used in space includes: low frequency superconducting sensors, microwave and infrared detectors, instruments for gravitational studies, and high-Q cavities for use as stabilizing elements in clocks and oscillators.

  5. Photovoltaic systems and applications

    SciTech Connect

    Not Available

    1982-01-01

    Abstracts are given of presentations given at a project review meeting held at Albuquerque, NM. The proceedings cover the past accomplishments and current activities of the Photovoltaic Systems Research, Balance-of-System Technology Development and System Application Experiments Projects at Sandia National Laboratories. The status of intermediate system application experiments and residential system analysis is emphasized. Some discussion of the future of the Photovoltaic Program in general, and the Sandia projects in particular is also presented.

  6. Programmable Logic Application Notes

    NASA Technical Reports Server (NTRS)

    Katz, Richard

    1998-01-01

    This column will be provided each quarter as a source for reliability, radiation results, NASA capabilities, and other information on programmable logic devices and related applications. This quarter's column will include some announcements and some recent radiation test results and evaluations of interest. Specifically, the following topics will be covered: the Military and Aerospace Applications of Programmable Devices and Technologies Conference to be held at GSFC in September, 1998, proton test results, heavy ion test results, and some total dose results.

  7. Applications of cavity optomechanics

    SciTech Connect

    Metcalfe, Michael

    2014-09-15

    “Cavity-optomechanics” aims to study the quantum properties of mechanical systems. A common strategy implemented in order to achieve this goal couples a high finesse photonic cavity to a high quality factor mechanical resonator. Then, using feedback forces such as radiation pressure, one can cool the mechanical mode of interest into the quantum ground state and create non-classical states of mechanical motion. On the path towards achieving these goals, many near-term applications of this field have emerged. After briefly introducing optomechanical systems and describing the current state-of-the-art experimental results, this article summarizes some of the more exciting practical applications such as ultra-sensitive, high bandwidth accelerometers and force sensors, low phase noise x-band integrated microwave oscillators and optical signal processing such as optical delay-lines, wavelength converters, and tunable optical filters. In this rapidly evolving field, new applications are emerging at a fast pace, but this article concentrates on the aforementioned lab-based applications as these are the most promising avenues for near-term real-world applications. New basic science applications are also becoming apparent such as the generation of squeezed light, testing gravitational theories and for providing a link between disparate quantum systems.

  8. LCS Content Document Application

    NASA Technical Reports Server (NTRS)

    Hochstadt, Jake

    2011-01-01

    My project at KSC during my spring 2011 internship was to develop a Ruby on Rails application to manage Content Documents..A Content Document is a collection of documents and information that describes what software is installed on a Launch Control System Computer. It's important for us to make sure the tools we use everyday are secure, up-to-date, and properly licensed. Previously, keeping track of the information was done by Excel and Word files between different personnel. The goal of the new application is to be able to manage and access the Content Documents through a single database backed web application. Our LCS team will benefit greatly with this app. Admin's will be able to login securely to keep track and update the software installed on each computer in a timely manner. We also included exportability such as attaching additional documents that can be downloaded from the web application. The finished application will ease the process of managing Content Documents while streamlining the procedure. Ruby on Rails is a very powerful programming language and I am grateful to have the opportunity to build this application.

  9. Computer Applications in Educational Audiology.

    ERIC Educational Resources Information Center

    Mendel, Lisa Lucks; And Others

    1995-01-01

    This article provides an overview of how computer technologies can be used by educational audiologists. Computer technologies are classified into three categories: (1) information systems applications; (2) screening and diagnostic applications; and (3) intervention applications. (Author/DB)

  10. Technology Applications Team: Applications of aerospace technology

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Highlights of the Research Triangle Institute (RTI) Applications Team activities over the past quarter are presented in Section 1.0. The Team's progress in fulfilling the requirements of the contract is summarized in Section 2.0. In addition to our market-driven approach to applications project development, RTI has placed increased effort on activities to commercialize technologies developed at NASA Centers. These Technology Commercialization efforts are summarized in Section 3.0. New problem statements prepared by the Team in the reporting period are presented in Section 4.0. The Team's transfer activities for ongoing projects with the NASA Centers are presented in Section 5.0. Section 6.0 summarizes the status of four add-on tasks. Travel for the reporting period is described in Section 7.0. The RTI Team staff and consultants and their project responsibilities are listed in Appendix A. The authors gratefully acknowledge the contributions of many individuals to the RTI Technology Applications Team program. The time and effort contributed by managers, engineers, and scientists throughout NASA were essential to program success. Most important to the program has been a productive working relationship with the NASA Field Center Technology Utilization (TU) Offices. The RTI Team continues to strive for improved effectiveness as a resource to these offices. Industry managers, technical staff, medical researchers, and clinicians have been cooperative and open in their participation. The RTI Team looks forward to continuing expansion of its interaction with U.S. industry to facilitate the transfer of aerospace technology to the private sector.

  11. Application of radionuclide ventriculography to cardiac screening

    SciTech Connect

    Lindsay, J. Jr.; Milner, M.R.; Chandeysson, P.L.; Rodman, D.J.; Okin, P.M.; Goldstein, S.A.

    1989-05-01

    Screening asymptomatic individuals for latent coronary disease often requires sequential testing because exercise electrocardiography typically produces more false positive than true positive results in a population with a low prevalence of coronary disease. Cardiac scintigraphy is a technique that may be employed as a confirmatory test in lieu of coronary arteriography to further evaluate the significance of a positive exercise electrocardiogram. Radionuclide ventriculography was employed in 98 asymptomatic individuals who were considered to be at moderate risk of heart disease after risk factor analysis and exercise electrocardiography. Seventeen (17%) patients had an abnormal study and underwent cardiac catheterization. Seven had coronary artery disease, two had cardiomyopathy, and eight were normal. Eighty-one (83%) patients had a normal study. Because the sensitivity of radionuclide ventriculography is 63-80%, it was postulated that 2 to 5 individuals with disease were missed. Thus, from a population with an 11-14% prevalence of disease, two subsets were identified. A large subset in which a prevalence of 2-6% could be estimated was separated from a much smaller one in which a prevalence of approximately 50% was demonstrated.

  12. 37 CFR 1.421 - Applicant for international application.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Applicant for international..., DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES International Processing Provisions Who May File An International Application § 1.421 Applicant for international application. (a) Only...

  13. 37 CFR 1.421 - Applicant for international application.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Applicant for international..., DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES International Processing Provisions Who May File An International Application § 1.421 Applicant for international application. (a) Only...

  14. 37 CFR 1.421 - Applicant for international application.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Applicant for international..., DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES International Processing Provisions Who May File An International Application § 1.421 Applicant for international application. (a) Only...

  15. Nonlinear Optics and Applications

    NASA Technical Reports Server (NTRS)

    Abdeldayem, Hossin A. (Editor); Frazier, Donald O. (Editor)

    2007-01-01

    Nonlinear optics is the result of laser beam interaction with materials and started with the advent of lasers in the early 1960s. The field is growing daily and plays a major role in emerging photonic technology. Nonlinear optics play a major role in many of the optical applications such as optical signal processing, optical computers, ultrafast switches, ultra-short pulsed lasers, sensors, laser amplifiers, and many others. This special review volume on Nonlinear Optics and Applications is intended for those who want to be aware of the most recent technology. This book presents a survey of the recent advances of nonlinear optical applications. Emphasis will be on novel devices and materials, switching technology, optical computing, and important experimental results. Recent developments in topics which are of historical interest to researchers, and in the same time of potential use in the fields of all-optical communication and computing technologies, are also included. Additionally, a few new related topics which might provoke discussion are presented. The book includes chapters on nonlinear optics and applications; the nonlinear Schrodinger and associated equations that model spatio-temporal propagation; the supercontinuum light source; wideband ultrashort pulse fiber laser sources; lattice fabrication as well as their linear and nonlinear light guiding properties; the second-order EO effect (Pockels), the third-order (Kerr) and thermo-optical effects in optical waveguides and their applications in optical communication; and, the effect of magnetic field and its role in nonlinear optics, among other chapters.

  16. Multiphysics Application Coupling Toolkit

    SciTech Connect

    Campbell, Michael T.

    2013-12-02

    This particular consortium implementation of the software integration infrastructure will, in large part, refactor portions of the Rocstar multiphysics infrastructure. Development of this infrastructure originated at the University of Illinois DOE ASCI Center for Simulation of Advanced Rockets (CSAR) to support the center's massively parallel multiphysics simulation application, Rocstar, and has continued at IllinoisRocstar, a small company formed near the end of the University-based program. IllinoisRocstar is now licensing these new developments as free, open source, in hopes to help improve their own and others' access to infrastructure which can be readily utilized in developing coupled or composite software systems; with particular attention to more rapid production and utilization of multiphysics applications in the HPC environment. There are two major pieces to the consortium implementation, the Application Component Toolkit (ACT), and the Multiphysics Application Coupling Toolkit (MPACT). The current development focus is the ACT, which is (will be) the substrate for MPACT. The ACT itself is built up from the components described in the technical approach. In particular, the ACT has the following major components: 1.The Component Object Manager (COM): The COM package provides encapsulation of user applications, and their data. COM also provides the inter-component function call mechanism. 2.The System Integration Manager (SIM): The SIM package provides constructs and mechanisms for orchestrating composite systems of multiply integrated pieces.

  17. Multiphysics Application Coupling Toolkit

    2013-12-02

    This particular consortium implementation of the software integration infrastructure will, in large part, refactor portions of the Rocstar multiphysics infrastructure. Development of this infrastructure originated at the University of Illinois DOE ASCI Center for Simulation of Advanced Rockets (CSAR) to support the center's massively parallel multiphysics simulation application, Rocstar, and has continued at IllinoisRocstar, a small company formed near the end of the University-based program. IllinoisRocstar is now licensing these new developments as free, openmore » source, in hopes to help improve their own and others' access to infrastructure which can be readily utilized in developing coupled or composite software systems; with particular attention to more rapid production and utilization of multiphysics applications in the HPC environment. There are two major pieces to the consortium implementation, the Application Component Toolkit (ACT), and the Multiphysics Application Coupling Toolkit (MPACT). The current development focus is the ACT, which is (will be) the substrate for MPACT. The ACT itself is built up from the components described in the technical approach. In particular, the ACT has the following major components: 1.The Component Object Manager (COM): The COM package provides encapsulation of user applications, and their data. COM also provides the inter-component function call mechanism. 2.The System Integration Manager (SIM): The SIM package provides constructs and mechanisms for orchestrating composite systems of multiply integrated pieces.« less

  18. An overview of translational (radio)pharmaceutical research related to certain oncological and non-oncological applications

    PubMed Central

    Cona, Marlein Miranda; de Witte, Peter; Verbruggen, Alfons; Ni, Yicheng

    2013-01-01

    Translational medicine pursues the conversion of scientific discovery into human health improvement. It aims to establish strategies for diagnosis and treatment of diseases. Cancer treatment is difficult. Radio-pharmaceutical research has played an important role in multiple disciplines, particularly in translational oncology. Based on the natural phenomenon of necrosis avidity, OncoCiDia has emerged as a novel generic approach for treating solid malignancies. Under this systemic dual targeting strategy, a vascular disrupting agent first selectively causes massive tumor necrosis that is followed by iodine-131 labeled-hypericin (123I-Hyp), a necrosis-avid compound that kills the residual cancer cells by crossfire effect of beta radiation. In this review, by emphasizing the potential clinical applicability of OncoCiDia, we summarize our research activities including optimization of radioiodinated hypericin Hyp preparations and recent studies on the biodistribution, dosimetry, pharmacokinetic and, chemical and radiochemical toxicities of the preparations. Myocardial infarction is a global health problem. Although cardiac scintigraphy using radioactive perfusion tracers is used in the assessment of myocardial viability, searching for diagnostic imaging agents with authentic necrosis avidity is pursued. Therefore, a comparative study on the biological profiles of the necrosis avid 123I-Hyp and the commercially available 99mTc-Sestamibi was conducted and the results are demonstrated. Cholelithiasis or gallstone disease may cause gallbladder inflammation, infection and other severe complications. While studying the mechanisms underlying the necrosis avidity of Hyp and derivatives, their naturally occurring fluorophore property was exploited for targeting cholesterol as a main component of gallstones. The usefulness of Hyp as an optical imaging agent for cholelithiasis was studied and the results are presented. Multiple uses of automatic contrast injectors may reduce costs

  19. APTASENSORS FOR BIOSECURITY APPLICATIONS

    SciTech Connect

    Fischer, N; Tarasow, T; Tok, J

    2007-01-03

    Nucleic acid aptamers have found steadily increased utility and application steadily over the last decade. In particular, aptamers have been touted as a valuable complement to and in some cases replacement for antibodies due to their structural and functional robustness as well as their ease in generation and synthesis. They are thus attractive for biosecurity applications, e.g. pathogen detection, and are especially well suited since their in vitro generation process does not require infection of any host systems. Herein we provide a brief overview of the aptamers generated against biopathogens over the last few years. In addition, a few recently described detection platforms using aptamers (aptasensors) and potentially suitable for biosecurity applications will be discussed.

  20. Data management applications

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Kennedy Space Center's primary institutional computer is a 4 megabyte IBM 4341 with 3.175 billion characters of IBM 3350 disc storage. This system utilizes the Software AG product known as ADABAS with the on line user oriented features of NATURAL and COMPLETE as a Data Base Management System (DBMS). It is operational under the OS/VSI and is currently supporting batch/on line applications such as Personnel, Training, Physical Space Management, Procurement, Office Equipment Maintenance, and Equipment Visibility. A third and by far the largest DBMS application is known as the Shuttle Inventory Management System (SIMS) which is operational on a Honeywell 6660 (dedicated) computer system utilizing Honeywell Integrated Data Storage I (IDSI) as the DBMS. The SIMS application is designed to provide central supply system acquisition, inventory control, receipt, storage, and issue of spares, supplies, and materials.