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Sample records for 99mtechnetium blood-pool scintigraphy

  1. Preoperative and postoperative cortical function of the kidney with staghorn calculi assessed by 99mtechnetium-dimercaptosuccinic acid renal scintigraphy.

    PubMed

    Kawamura, J; Itoh, H; Okada, Y; Higashi, Y; Yoshida, O; Fujita, T; Torizuka, K

    1983-09-01

    99mTechnetium dimercaptosuccinic acid renal scintigraphy, consisting of the cortical image and dimercaptosuccinic acid renal uptake rate, was used to assess preoperative and postoperative renal function in 55 patients with staghorn calculi. In 14 of 20 patients who had undergone extended pyelolithotomy and in 4 of 22 who had undergone nephrolithotomy there was an increase or no change in the postoperative dimercaptosuccinic acid renal uptake in the surgically treated kidney. However, there was no increase in the postoperative dimercaptosuccinic acid renal uptake in the patients who had undergone pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight per cent of the preoperative dimercaptosuccinic acid renal uptake rate in the diseased kidney seems to be the absolute level for predicting the postoperative recovery of renal function. Dimercaptosuccinic acid renal images provide evidence of morphological changes in the cortex of the kidney with stones and the dimercaptosuccinic acid uptake rate is a useful adjunct for quantitative assessments of preoperative and postoperative residual cortical function.

  2. Exposure of veterinary personnel to ionising radiation during bone scanning of horses by nuclear scintigraphy with 99mtechnetium methylene diphosphonate.

    PubMed

    Gatherer, M E; Faulkner, J; Voûte, L C

    2007-06-16

    The aim of this study was to compare the radiation doses received by the personnel drawing up and injecting the radiopharmaceutical and operating the nuclear scintigraphy equipment, and those restraining nine horses while they were being scanned during scintigraphic investigations of lameness. Sensitive electronic dosimeters were worn by the personnel and the doses they received during the administration of the radiopharmaceutical and during the period of image acquisition were recorded at intervals. On average, 90 per cent of the total doses were received during the period of image acquisition. There was no significant difference between the total dose received by the person who drew up and injected the radiopharmaceutical, and the person restraining the horse during its administration. However, the person holding the horse received approximately twice the dose received by the person operating the equipment during the period of image acquisition.

  3. Optimal use of 99mtechnetium-glucoheptonate scintigraphy in the detection of pyelonephritic scarring in children: a preliminary report

    SciTech Connect

    Shapiro, E.; Slovis, T.L.; Perlmutter, A.D.; Kuhns, L.R.

    1988-11-01

    Renal scintigraphy represents the optimal modality for the detection of renal scars. 99mTechnetium-glucoheptonate is rapidly accumulated by the kidney through glomerular filtration and active transport by renal tubular cells. This permits rapid visualization of the renal parenchyma in the early phase (1 to 3-minute images) and subsequent imaging of the collecting system and ureters. About 10 to 15 per cent of the injected activity remains in the kidney, labeling the cells of the proximal convoluted tubules (late phase or 1 to 2-hour images). The late phase has been used more commonly to assess renal parenchymal damage. Early and late phase glucoheptonate scanning was performed in 42 children as part of the evaluation of recurrent febrile urinary tract infections with or without a history of vesicoureteral reflux. Inter-observer reliability to interpret glucoheptonate scans was good (early, 83 per cent agreement and late, 93 per cent agreement). The ability of glucoheptonate scanning to detect renal scarring in children with febrile urinary tract infections was equivalent with the early or late phase of the study. In 6 patients renal scarring was detected on only the early phase scan and in 7 scarring was detected only in the late phase. Although the detection rates are equivalent the over-all detection of scarring is improved by using both phases. Therefore, the early phase of the glucoheptonate scan may be a valuable adjunct to conventional glucoheptonate scan methodology used for the detection of renal scarring in children with recurrent urinary tract infections.

  4. Left ventricular platelet deposition after acute myocardial infarction. An attempt at quantification using blood pool subtracted indium-111 platelet scintigraphy.

    PubMed Central

    Verheugt, F W; Lindenfeld, J; Kirch, D L; Steele, P P

    1984-01-01

    Since indium-111 platelet scintigraphy for the detection of left ventricular thrombosis often shows considerable non-specific blood pool activity a subtraction method using simultaneous technetium-99m blood pool scintigraphy was undertaken in 11 subjects with well documented remote myocardial infarction, who served as positive or negative controls, and in 18 consecutive patients with acute myocardial infarction. The results were compared with those of cross sectional echocardiography. Thirteen patients had transmural myocardial infarction and the calculated count per pixel in the left ventricle of the subtracted indium-111 platelet scintigram was (mean (SD)) 0.28(0.35), but five patients with subendocardial myocardial infarction had a mean count of 0.04(0.06). In seven patients with transmural myocardial infarction (two anterior and five inferior) left ventricular thrombosis was detected by indium-111 platelet scintigraphy but in only one of these by cross sectional echocardiography. None of the patients with subendocardial myocardial infarction had left ventricular thrombosis. Subtracted left ventricular counts correlated well with the visual results. It is concluded that left ventricular platelet sequestration after acute myocardial infarction may be quantified and precisely located and that quantitative longitudinal studies of the natural history and drug intervention are now possible. Images PMID:6437421

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

    PubMed

    Kim, Ji Young; Choi, Yun Young; Kim, Chan Woo; Sung, Yoon-Kyoung; Yoo, Dae-Hyun

    2016-04-01

    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.

  6. Prospective evaluation of renal allograft dysfunction with 99mtechnetium-diethylenetriaminepentaacetic acid renal scans

    SciTech Connect

    McConnell, J.D.; Sagalowsky, A.I.; Lewis, S.E.; Gailiunas, P.; Helderman, J.H.; Dawidson, I.; Peters, P.C.

    1984-05-01

    A prospective, single-blinded study was done to determine the ability of serial 99mtechnetium-diethylenetriaminepentaacetic acid scans to diagnose renal allograft rejection. Among 28 transplant recipients 111 renal scans were obtained 1 day postoperatively and every 3 to 4 days thereafter for 3 weeks in all patients retaining an allograft. Computer-generated time-activity blood flow curves were analyzed semiquantitatively for the 1) interval between curve peaks of the allograft and iliac artery, 2) renal transit time and 3) renal washout of radionuclide. Excretory function was assessed by degree and interval to appearance of radionuclide in the calices and bladder. Deterioration of renal blood flow and excretion compared to the initial scan was considered rejection. Of 52 scans performed during clinical rejection 47 (90.4 per cent) were interpreted as showing rejection (sensitivity). Of 53 scans interpreted as showing rejection 47 (88.7 per cent) were positive for clinical rejection. The remaining 6 patients (initial false positive results) suffered clinical rejection within 24 to 72 hours. We conclude that 99mtechnetium-diethylenetriaminepentaacetic acid renal scans are useful in the differential diagnosis of renal allograft dysfunction.

  7. Importance of SPECT/CT in detecting multiple hemangiomas on 99mTc-labeled RBC blood pool scintigraphy.

    PubMed

    Roy, Shambo Guha; Karunanithi, Sellam; Agarwal, Krishan Kant; Bal, Chandrasekhar; Kumar, Rakesh

    2015-04-01

    Vascular malformations and hemangiomas are common in children, but gastric hemangioma is extremely rare with less than 15 reported cases in the pediatric age group. Gastric hemangioma accounts for only 0.05% of all gastrointestinal neoplasms, and intra-abdominal hemangiomas are rarely found outside of the liver. We present a unique case of gastric hemangioma, and multiple hemangiomas were detected in a single scan by 99mTc-labeled RBC blood pool imaging. This case also depicts the incremental role of SPECT/CT over planar acquisition for detecting multiple hemangiomas, especially for those lesions located adjacent to physiological blood pool activity.

  8. Alendronate-coated long-circulating liposomes containing 99mtechnetium-ceftizoxime used to identify osteomyelitis

    PubMed Central

    Ferreira, Diego dos Santos; Boratto, Fernanda Alves; Cardoso, Valbert Nascimento; Serakides, Rogéria; Fernandes, Simone Odília; Ferreira, Lucas Antônio Miranda; Oliveira, Mônica Cristina

    2015-01-01

    Osteomyelitis is a progressive destruction of bones caused by microorganisms. Inadequate or absent treatment increases the risk of bone growth inhibition, fractures, and sepsis. Among the diagnostic techniques, functional images are the most sensitive in detecting osteomyelitis in its early stages. However, these techniques do not have adequate specificity. By contrast, radiolabeled antibiotics could improve selectivity, since they are specifically recognized by the bacteria. The incorporation of these radiopharmaceuticals in drug-delivery systems with high affinity for bones could improve the overall uptake. In this work, long-circulating and alendronate-coated liposomes containing 99mtechnetium-radiolabeled ceftizoxime were prepared and their ability to identify infectious foci (osteomyelitis) in animal models was evaluated. The effect of the presence of PEGylated lipids and surface-attached alendronate was evaluated. The bone-targeted long-circulating liposomal 99mtechnetium–ceftizoxime showed higher uptake in regions of septic inflammation than did the non-long-circulating and/or alendronate-non-coated liposomes, showing that both the presence of PEGylated lipids and alendronate coating are important to optimize the bone targeting. Scintigraphic images of septic or aseptic inflammation-bearing Wistar rats, as well as healthy rats, were acquired at different time intervals after the intravenous administration of these liposomes. The target-to-non-target ratio proved to be significantly higher in the osteomyelitis-bearing animals for all investigated time intervals. Biodistribution studies were also performed after the intravenous administration of the formulation in osteomyelitis-bearing animals. A significant amount of liposomes were taken up by the organs of the mononuclear phagocyte system (liver and spleen). Intense renal excretion was also observed during the entire experiment period. Moreover, the liposome uptake by the infectious focus was significantly

  9. Cardiac blood-pool scintigraphy in rats and hamsters: comparison of five radiopharmaceuticals and three pinhole collimator apertures

    SciTech Connect

    Pieri, P.; Fischman, A.J.; Ahmad, M.; Moore, R.H.; Callahan, R.J.; Strauss, H.W. )

    1991-05-01

    Preclinical evaluation of cardiac drugs may require evaluation of cardiac function in intact animals. To optimize the quality of radionuclide measurements of ventricular function in small animals, a comparison was made of gated blood-pool scans recorded with five blood-pool radiopharmaceuticals ({sup 99}mTc-labeled human polyclonal IgG, {sup 99}mTc-human serum albumin labeled by two methods, and red blood cells radiolabeled with {sup 99}mTc via in vivo and in vitro methods) in rats and three pinhole apertures in hamsters. The quality of the radiopharmaceuticals was evaluated by comparing count density ratios (LV/BACKGROUND and LV/LIVER) and ejection fractions recorded with each agent. The edge definition of the left ventricle and count rate performance of the 1-, 2-, and 3-mm apertures was evaluated in hamsters. In general, the images obtained with the radiolabeled cells were superior to those obtained with the labeled proteins and no significant differences between the protein preparations were detected. Left ventricular ejection fractions calculated with all five radiopharmaceuticals were not significantly different. The best quality images were obtained with the 1-mm pinhole collimator. Ejection fraction and acquisition time were inversely related to aperture size. A good compromise between resolution and sensitivity was obtained with the 2-mm pinhole collimator.

  10. 99mtechnetium-dimercapto-succinic acid renal scanning and excretory urography in diagnosis of renal scars in children

    SciTech Connect

    McLorie, G.A.; Aliabadi, H.; Churchill, B.M.; Ash, J.M.; Gilday, D.L. )

    1989-09-01

    We compared the ability of excretory urography (without tomography) and 99mtechnetium-dimercapto-succinic acid renal scanning to detect renal scars in 32 children with primary vesicoureteral reflux. These children did not have hydronephrosis, renal failure or urinary tract obstruction. In all cases both studies were conducted within a 10-month period. The findings from both modalities were in agreement for 51 of the 64 renal units evaluated (80%). Evaluation of the excretory urogram indicated 6 cases of diffuse and 2 of focal scarring that were not detected by evaluation of the renal scan. The sensitivity of excretory urography to detect renal scars was 84% and the specificity was 83%. The 99mtechnetium-dimercapto-succinic acid renal scan showed 5 cases of focal renal scarring not detected by excretory urography. The sensitivity of the renal scan to detect renal scars was 77% and the specificity was 75%. We conclude that neither study alone could effectively replace the other for the detection of renal scars, and recommend that both be included in the initial evaluation and followup of patients with renal scars.

  11. Comparison of technetium-99m IgG with technetium-99m red blood cells labeling in cardiac blood-pool scintigraphy: a preliminary study.

    PubMed

    Javadi, Hamid; Asli, Isa Neshandar; Semnani, Shahriar; Jallalat, Sara; Ansari, Mojtaba; Amini, Abdullatif; Barekat, Maryam; Assadi, Majid

    2011-01-01

    This first clinical prospective study was conducted to use of technetium-99m immunoglobulin G ((99m)Tc-IgG) as compared with autologous (99m)Tc-red blood cells (RBC) in gated blood pool ventriculography. We studied 12 patients who referred to us for a possible diagnosis of liver hemangioma or infection. Six patients underwent gated planar blood pool (GPBP) acquisition using (99m)Tc-RBC and 6 GPBP acquisition using (99m)Tc-IgG. The use of (99m)Tc-IgG in cardiac blood pool studies provided comparable images to (99m)Tc-RBC. In conclusion, (99m)Tc-IgG, which is readily available and needs only a single injection, may be an attractive alternative to (99m)Tc-RBC for the estimation of various cardiac function parameters like left ventricular function.

  12. Combined use of 99mtechnetium-labelled macroaggregates of albumin and 75selenium-selenomethionine in the diagnosis of lung cancer

    PubMed Central

    Critchley, Mair; Testa, H. J.; Stretton, T. B.

    1974-01-01

    Critchley, M., Testa, H. J., and Stretton, T. B. (1974).Thorax, 29, 421-424. Combined use of 99mtechnetium-labelled macroaggregates of albumin and 75selenium-selenomethionine in the diagnosis of lung cancer. A two-stage isotope technique has been used in 30 patients with radiographic evidence of circumscribed pulmonary lesions in an attempt to establish the nature of the underlying pathological process. The test was carried out as a `blind' procedure without knowledge of the findings of investigations other than the plain chest radiograph. An initial scan was performed with 99mtechnetium-labelled macroaggregated albumin. The view showing the lesion most clearly was selected and a second scan was obtained after an intravenous injection of 75Se-selenomethionine. Scans were interpreted by comparison of the `cold area' on the technetium scan with the corresponding area on the selenomethionine scan. Accumulation of 75Se-selenomethionine at the site corresponding to the lesion is described as a positive result and absence of accumulation as negative. The findings suggest that there is selective uptake of 75Se-selenomethionine by primary bronchogenic carcinoma; in the few patients with secondary carcinomas and non-malignant disease investigated so far, the lesion has failed to concentrate 75Se-selenomethionine. Images PMID:4368517

  13. Morphology of drying blood pools

    NASA Astrophysics Data System (ADS)

    Laan, Nick; Smith, Fiona; Nicloux, Celine; Brutin, David; D-Blood project Collaboration

    2016-11-01

    Often blood pools are found on crime scenes providing information concerning the events and sequence of events that took place on the scene. However, there is a lack of knowledge concerning the drying dynamics of blood pools. This study focuses on the drying process of blood pools to determine what relevant information can be obtained for the forensic application. We recorded the drying process of blood pools with a camera and measured the weight. We found that the drying process can be separated into five different: coagulation, gelation, rim desiccation, centre desiccation, and final desiccation. Moreover, we found that the weight of the blood pool diminishes similarly and in a reproducible way for blood pools created in various conditions. In addition, we verify that the size of the blood pools is directly related to its volume and the wettability of the surface. Our study clearly shows that blood pools dry in a reproducible fashion. This preliminary work highlights the difficult task that represents blood pool analysis in forensic investigations, and how internal and external parameters influence its dynamics. We conclude that understanding the drying process dynamics would be advancement in timeline reconstitution of events. ANR funded project: D-Blood Project.

  14. Evaluation of hemangiomas with technetium 99m-labeled RBCs: the perfusion-blood pool mismatch

    SciTech Connect

    Front, D.; Israel, O.; Joachims, H.; Brown, Y.; Eliachar, I.

    1983-03-18

    A case report is presented of a woman with a tumor mass in the nasopharynx. Early and delayed scintigraphy with Technetium 99m-labeled RBCs showed a large area of increased uptake which was later shown to be a hemangioma by contrast angiography. The perfusion-blood pool mismatch observed in hemangiomas is characteristic of these lesions and has not been described in any other abnormalities. The Tc-RBC using both early and delayed scintigraphy is a simple, noninvasive method for assessing the vascular characteristics of these tumors. (JMT)

  15. Hemangioma of the tongue demonstrating a perfusion blood pool mismatch

    SciTech Connect

    Front, D.; Groshar, D.; Israel, O.; Robinson, E.

    1986-02-01

    Perfusion blood pool mismatch using Tc-99m labeled red blood cells (RBCs) in a hemangioma of the tongue is described. The method is useful in the evaluation of size of the residual blood pool after irradiation of the tumor.

  16. Detection of varicocele by radionuclide blood-pool scanning

    SciTech Connect

    Freund, J.; Handelsman, D.J.; Bautovich, G.J.; Conway, A.J.; Morris, J.G.

    1980-10-01

    Varicocele is a common and treatable cause of male subfertility. The authors describe a new technique for varicocele detection using radionuclide blood-pool imaging of the scrotum. The results indicate that this technique detects unilateral varicoceles with high sensitivity, including some which are subclinical. There may be significant implications for treatment of infertility.

  17. 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.

  18. Synthetic copolymer kit for radionuclide blood-pool imaging

    SciTech Connect

    Bogdanov, A.A. Jr.; Callahan, R.J.; Wilkinson, R.A.

    1994-11-01

    A synthetic blood pool imaging agent labeled with {sup 99m}Tc is reported. The agent, methoxypolyethylene glycolpoly-L-Iysyl-diethylenetriaminepentaacetate monoamide was synthesized from a covalent graft copolymer of methoxypolyethylene glycol succinate (molecular weight 5.1 kD) with subsequent modification of the product with diethylenetriamineacetyl residues. The polymer was formulated into a kit that contained Sn(II) and sodium acetate for radiolabeling with {sup 99m}Tc. Biodistribution studies were performed in rats. Blood-pool imaging and blood clearance determination was carried out in rabbits and in a rhesus monkey. The {sup 99m}Tc-labeled agent [specific activity greater than 3.7 GBq/mg; radiochemical purity more than 98% by thin-layer and high-performance liquid chromatography (HPLC)] demonstrated remarkable stability in solution (pH 5.5-6.5) with no radioactive products of degradation detectable by HPLC even at 24 hr postlabeling. The agent exhibited prolonged circulation in the blood with a half-life of 31.5 hr in rabbits. Bio-distribution in rats showed a lack of substantial accumulation of the agent in the reticuloendothelial system. Sequential acquisitions were performed in a rhesus monkey. The {sup 99m}Tc-labeled polymer kit was compared with the {sup 99m}Tc-red blood cells (RBCs) labeled in vitro. Both methods produced similar heart-to-lung ratios. The ratios remained essentially unchanged for up to 15 hr postinjection. The {sup 99m}Tc-labeled methaxypolyethylene glycol-poly-L-lysyl-diethylenetriamine pentaacetate monoamide is an attractive alternative to radiolabeled RBCs for blood pool imaging applications. 33 refs., 7 figs.

  19. 99mtechnetium penicillamine: a renal cortical scanning agent.

    PubMed

    Taylor, A; Davis, G; Halpern, S; Ashburn, W

    1977-04-01

    99mTechnetium penicillamine, a renal cortical imaging agent, can be used to provide a rapid, safe and non-invasive assessment of renal morphology and the renal vascular supply. Since this agent is not excreted significantly during the imaging procedure cortical scans of high quality can be obtained without image deterioration owing to a superimposed collecting system. These scans, which are clearly superior in anatomical detail to earlier scans using 131I hippuran, can be obtained along with the 131I hippuran renogram when the patient comes to the nuclear medicine department. Herein we demonstrate the anatomical detail it is now possible to achieve by presenting the cortical renal scans and accompanying radiograms from 5 patients with different renal pathology.

  20. 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.

  1. Blood pool contrast agents for venous magnetic resonance imaging

    PubMed Central

    Oliveira, Irai S.; Li, Weier; Ganguli, Suvranu; Prabhakar, Anand M.

    2016-01-01

    Imaging of the venous system plays a vital role in the diagnosis and management of a wide range of clinically significant disorders. There have been great advances in venous imaging techniques, culminating in the use of magnetic resonance venography (MRV). Although MRV has distinct advantages in anatomic and quantitative cross sectional imaging without ionizing radiation, there are well-known challenges in acquisition timing and contrast administration in patients with renal impairment. The latest advancement involves the addition of new contrast media agents, which have emerged as valuable alternatives in these difficult scenarios. In this review, we will focus on a group of specific contrast agents called blood pool agents and discuss their salient features and clinical applications. PMID:28123972

  2. Nonstationary temporal Wiener filtering of gated blood pool studies

    SciTech Connect

    King, M.A.; Miller, T.R.; Doherty, P.W.; Bianco, J.A.

    1985-05-01

    Temporal filtering of dynamic images can significantly improve the image quality of gated blood pool (GBP) studies and serves as a necessary preprocessing step in the formation of cardiac functional images based on derivatives of pixel time activity curves. Generally, either linear combination of the frames, or a simple frequency domain low pass filter have been employed. The work described in this paper introduces the Wiener temporal filter which adjusts to match the temporal characteristic of the image at each pixel. For temporal data degraded by signal-dependent Poisson noise, the frequency domain form of the filter is presented. Use of nonstationary temporal Wiener filtering was found to improve the quality of cines formed from GBP studies and yielded better separation of cardiac from non-cardiac regions in functional images the peak ejection and filling rates.

  3. Renal Scintigraphy

    MedlinePlus

    ... size with caption Related Articles and Media General Nuclear Medicine Radiation Dose in X-Ray and CT Exams X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Renal Scintigraphy Sponsored by ...

  4. An improved method of right ventricular gated equilibrium blood pool radionuclide ventriculography

    SciTech Connect

    Morrison, D.; Marshall, J.; Wright, A.L.; Daly, M.; Henry, R.

    1982-11-01

    Gated blood pool radionuclide ventriculography provides a means for obtaining repeated studies of both cardiac ventricles with a single dose of radionuclide. Quantitative assessment of right ventricular (RV) function using this technique has been complicated by several technical problems. We describe a new method of RV blood pool analysis which attempts to solve these problems using well-established concepts for left ventricular (LV) blood pool analysis: (1) variable regions of interest; (2) computer edge detection with operator intervention; and (3) computer selected background. Results showed a strong linear correlation between gated first pass RV ejection fraction (RVEF) and the gated blood pool RVEF (n . 22; r . 0.93; blood pool RVEF . 0.03 + 0.89 X first pass RVEF; Sy.x . 0.04). There was also a strong linear correlation between LV and RV stroke counts in patients without valvular regurgitation, intracardiac shunts, or ventricular aneurysms (n . 19; r .0.86; RV counts . 72 + 0.94 X LV counts; Sy.x . 116). In terms of both of these validation standards this method proved superior to three published methods of RV blood pool analysis that used hand-drawn regions, and is suitable for analysis of rest, exercise, and intervention studies of RV function.

  5. Value of blood-pool subtraction in cardiac indium-111-labeled platelet imaging

    SciTech Connect

    Machac, J.; Vallabhajosula, S.; Goldman, M.E.; Goldsmith, S.J.; Palestro, C.; Strashun, A.; Vaquer, R.; Phillips, R.A.; Fuster, V. )

    1989-09-01

    Blood-pool subtraction has been proposed to enhance {sup 111}In-labeled platelet imaging of intracardiac thrombi. We tested the accuracy of labeled platelet imaging, with and without blood-pool subtraction, in ten subjects with cardiac thrombi of varying age, eight with endocarditis being treated with antimicrobial therapy and ten normal controls. Imaging was performed early after labeled platelet injection (24 hr or less) and late (48 hr or more). Blood-pool subtraction was carried out. All images were graded subjectively by four experienced, blinded readers. Detection accuracy was measured by the sensitivity at three fixed levels of specificity estimated from receiver operator characteristic curve analysis and tested by three-way analysis of variance. Detection accuracy was generally improved on delayed images. Blood-pool subtraction did not improve accuracy. Although blood-pool subtraction increased detection sensitivity, this was offset by decreased specificity. For this population studied, blood-pool subtraction did not improve subjective detection of abnormal platelet deposition by 111In platelet imaging.

  6. Utility of three-phase skeletal scintigraphy in suspected osteomyelitis: concise communication.

    PubMed

    Maurer, A H; Chen, D C; Camargo, E E; Wong, D F; Wagner, H N; Alderson, P O

    1981-11-01

    Three-phase skeletal scintigraphy, consisting of a radionuclide angiogram, an immediate postinjection "blood-pool" image, and 2--3 hr delayed images, was performed on 98 patients with suspected osteomyelitis. This procedure was evaluated by first interpreting only the delayed images, next the combination of "blood-pool" and delayed images, and finally the three-phase study. There was no change in the sensitivity (12/13 = 0.92) for detecting osteomyelitis, but the false-positive rate for osteomyelitis decreased from 0.25 (21/85) to 0.06 (5/85). In 21 of 64 patients (33%) with abnormal studies, the "blood-pool" image and/or the radionuclide angiogram led to a more accurate scintigraphic diagnosis. In 12 patients (19%) the "blood pool" alone was enough to achieve the correct final diagnosis and was used most often to identify noninfectious skeletal disease. In 9 patients (14%) the radionuclide angiogram was required for an accurate interpretation and was considered essential most often in cases of soft-tissue infection. Both radionuclide angiography and "blood-pool" imaging appear to augment the specificity of skeletal scintigraphy in patients with suspected osteomyelitis.

  7. Assessment of the site of ventricular activation by Fourier analysis of gated blood-pool studies

    SciTech Connect

    Links, J.M.; Raichlen, J.S.; Wagner, H.N. Jr.; Reid, P.R.

    1985-01-01

    The authors studied the use of first-harmonic Fourier analysis of gated blood-pool images to assess the site of ventricular activation in a group of 12 patients undergoing electrophysiologic pacing studies. They acquired gated blood-pool studies during pacing at up to four sites at each of two different rates. A total of 50 studies were made. At a pacing rate of 100 beats/min, when the pacing electrode was the right-ventricular outflow tract, 7/8; at the anterolateral left-ventricular wall, 4/4. When the Fourier activation site was at the right-ventricular apex, 9/9 times the pacing electrode was there; at the right-ventricular outflow tract, 7/10; in the left ventricle, 4/4. Fourier analysis of gated blood-pool studies can help identify the site of ventricular activation but is not sufficiently accurate to fully replace endocardial mapping.

  8. Slower lower limb blood pooling in young women with orthostatic intolerance.

    PubMed

    Lindenberger, Marcus; Länne, Toste

    2015-01-01

    What is the central question of this study? Orthostatic stress is mostly caused by venous blood pooling in the lower limbs. Venous distension elicits sympathetic responses, and increased distension speed enhances the cardiovascular response. We examine whether lower limb blood pooling rate during lower body negative pressure is linked to orthostatic intolerance. What is the main finding and its importance? A similar amount of blood was pooled in the lower limb, but at a slower rate in women who developed signs of orthostatic intolerance. The difference in blood pooling rate increased with orthostatic stress and was most prominent at a presyncope-inducing level of lower body negative pressure. The findings have implications for the pathophysiology as well as treatment of orthostatic intolerance. Vasovagal syncope is common in young women, but its aetiology remains elusive. Orthostatic stress-induced lower limb blood pooling is linked with central hypovolaemia and baroreceptor unloading. Venous distension in the arm elicits a sympathetic response, which is enhanced with more rapid distension. Our aim was to study both the amount and the speed of lower limb pooling during orthostatic stress and its effects on compensatory mechanisms to maintain cardiovascular homeostasis in women with orthostatic intolerance. Twenty-seven healthy women, aged 20-27 years, were subjected to a lower body negative pressure (LBNP) of 11-44 mmHg. Five women developed symptoms of vasovagal syncope (orthostatic intolerant) and were compared with the remaining women, who tolerated LBNP well (orthostatic tolerant). Lower limb blood pooling, blood flow and compensatory mobilization of venous capacitance blood were measured. Lower body negative pressure induced equal lower limb blood pooling in both groups, but at a slower rate in orthostatic intolerant women (e.g. time to 50% of total blood pooling, orthostatic intolerant 44 ± 7 s and orthostatic tolerant 26 ± 2 s; P < 0.001). At presyncope

  9. Skeletal Scintigraphy.

    PubMed

    Montilla-Soler, Jaime L; Makanji, Rikesh

    2017-04-01

    Skeletal scintigraphy remains a valuable tool in the initial and subsequent evaluation of the skeletal system in patients with a diagnosis of primary or metastatic neoplasms. We discuss radiopharmaceuticals, nuclear medicine imaging techniques, and current as well as future oncological applications in the adult population. Pertinent literature was reviewed to describe the advantages and limitations of available technologies for the evaluation of skeletal metastatic disease. Evaluation of primary and metastatic skeletal disease using nuclear medicine and positron emission tomography techniques is discussed. Skeletal scintigraphy provides valuable information in the initial evaluation for the presence of osteoblastic skeletal metastases. Incremental advances on available radiopharmaceuticals (fludeoxyglucose F 18, sodium fluoride F 18), coupled with advances in imaging techniques and imaging devices (single photon emission computed tomography/computed tomography, positron emission tomography/computed tomography, positron emission tomography/magnetic resonance imaging), have had a significant impact on sensitivity, specificity, and accuracy rates for the detection of skeletal metastases. Skeletal scintigraphy has a significant role in the initial diagnosis, staging, restaging, and treatment monitoring of patients with cancer and primary skeletal or metastatic disease. The coupling of diagnostic and therapeutic nuclear medicine agents in the setting of osteoblastic skeletal metastases is a valuable tool for the treatment for certain cancer types, including prostate cancer, and may become more widely used to treat other histologies as more data on other tumor types (eg, breast cancer, osteosarcoma) become available.

  10. Slower Lower Limb Blood Pooling Increases Orthostatic Tolerance in Women with Vasovagal Syncope.

    PubMed

    Skoog, Johan; Zachrisson, Helene; Länne, Toste; Lindenberger, Marcus

    2016-01-01

    Slower lower limb blood pooling and associated blunted sympathetic activation has been detected in healthy women prone to orthostatic syncope. Whether these findings are true also for patients with vasovagal syncope (VVS) is unknown. The aim was to investigate initial blood pooling time (poolingtime, time to 50% of total blood pooling) together with hemodynamic responses and orthostatic tolerance during lower body negative pressure (LBNP) in VVS and healthy controls. Fourteen VVS women (25.7 ± 1.3 years) and 15 healthy women (22.8 ± 0.8 years) were subjected to single-step and graded LBNP to pre-syncope. Lower limb blood pooling (ml · 100 ml(-1)), poolingtime (s), hemodynamic responses and LBNP-tolerance were evaluated. LBNP induced comparable lower limb blood pooling in both groups (controls, 3.1 ± 0.3; VVS, 2.9 ± 0.3 ml · 100 ml(-1), P = 0.70). In controls, shorter poolingtime correlated to higher LBNP-tolerance (r = -0.550, P < 0.05) as well as better maintained stroke volume (r = -0.698, P < 0.01) and cardiac output (r = -0.563, P < 0.05). In contrast, shorter poolingtime correlated to lower LBNP-tolerance in VVS (r = 0.821, P < 0.001) and larger decline in stroke volume (r = 0.611, P < 0.05). Furthermore, in controls, shorter poolingtime correlated to baroreflex-mediated hemodynamic changes during LBNP, e.g., increased vasoconstriction (P < 0.001). In VVS, poolingtime was not correlated with LBNP-induced baroreceptor unloading, but rather highly correlated to resting calf blood flow (P < 0.001). Shorter poolingtime seems to elicit greater sympathetic activation with a concomitant higher orthostatic tolerance in healthy women. The contrasting findings in VVS indicate a deteriorated vascular sympathetic control suggesting well-defined differences already in the initial responses during orthostatic stress.

  11. Scintigraphic diagnosis of gastrointestinal bleeding with /sup 99/. mu. Tc-labeled blood-pool agents

    SciTech Connect

    Miskowiak, J.; Nielsen, S.; Munck, O.

    1981-11-01

    Abdominal scintigraphy with /sup 99/..mu..Tc-labeled albumin or red blood cells was used in 68 patients to localize gastrointestinal bleeding or confirm that it had stopped. Acute, active bleeding was identified in 33 patients; characteristic patterns of bleeding from the stomach, biliary passages, small intestine, and colon are shown. Sensitivity was 0.86 (95% confidence limits, 0.57-0.98) and specificity was 1.0 (95% confidence limits, 0.82-1.0) in 33 patients who had scintigraphy and endoscopy performed in succession. Abdominal scintigraphy appears to be a valuable supplement to conventional diagnostic methods. In upper gastrointestinal bleeding, scintigraphy should be considered when endoscopy fails. In lower intestinal bleeding, scintigraphy should be the method of choice.

  12. Scintigraphic diagnosis of gastrointestinal bleeding with /sup 99/mTc-labeled blood-pool agents

    SciTech Connect

    Miskowiak, J.; Nielsen, S.L.; Munck, O.

    1981-01-01

    Abdominal scintigraphy with /sup 99/mTc-labeled albumin or red blood cells was used in 68 patients to localize gastrointestinal bleeding or confirm that it had stopped. Acute, active bleeding was identified in 33 patients; characteristic patterns of bleeding from the stomach, biliary passages, small intestine, and colon are shown. Sensitivity was 0.86 (95% confidence limits, 0.57-0.98) and specificity was 1.0 (95% confidence limits, 0.82-1.0) in 33 patients who had scintigraphy and endoscopy performed in succession. Abdominal scintigraphy appears to be a valuable supplement to conventional diagnostic methods. In upper gastrointestinal bleeding, scintigraphy should be considered when endoscopy fails. In lower intestinal bleeding, scintigraphy should be the method of choice.

  13. 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.

  14. Diagnosis of Popliteal Venous Entrapment Syndrome by Magnetic Resonance Imaging Using Blood-Pool Contrast Agents

    SciTech Connect

    Beitzke, Dietrich Wolf, Florian; Juelg, Gregor; Lammer, Johannes; Loewe, Christian

    2011-02-15

    Popliteal vascular entrapment syndrome is caused by aberrations or hypertrophy of the gastrocnemius muscles, which compress the neurovascular structures of the popliteal fossa, leading to symptoms of vascular and degeneration as well as aneurysm formation. Imaging of popliteal vascular entrapment may be performed with ultrasound, magnetic resonance imaging (MRI), computed tomography angiography, and conventional angiography. The use of blood-pool contrast agents in MRI when popliteal vascular entrapment is suspected offers the possibility to perform vascular imaging with first-pass magnetic resonance angiographic, high-resolution, steady-state imaging and allows functional tests all within one examination with a single dose of contrast agent. We present imaging findings in a case of symptomatic popliteal vein entrapment diagnosed by the use of blood pool contrast-enhanced MRI.

  15. Accuracy and precision of regional multiharmonic Fourier analysis of gated blood-pool images.

    PubMed

    Machac, J; Horowitz, S F; Broder, D; Goldsmith, S J

    1984-12-01

    In order to estimate the precision and accuracy of parameters derived from segmental multiharmonic Fourier analysis of gated blood-pool images, a Monte Carlo computer noise simulation was tested on five sample regional time-activity curves. The first three Fourier harmonics were retained and the precision and accuracy of parameters of ventricular function were calculated, varying the ejection fraction, segment size, and framing rate. Precision improved with higher ejection fraction, higher counts per frame, or higher framing rate. There was no change in precision as the framing rate changed at fixed total counts. Accuracy changed little with changing framing rate. Thus, for segmental analysis there is no advantage to using a higher framing rate. Regions five or more pixels in size are recommended for reliable results. This study provides useful information for the optimization of acquisition and processing conditions for regional gated blood-pool analysis.

  16. Combined blood pool and extracellular contrast agents for pediatric and young adult cardiovascular magnetic resonance imaging.

    PubMed

    Johnson, Joyce T; Robinson, Joshua D; Deng, Jie; Rigsby, Cynthia K

    2016-12-01

    A comprehensive cardiac magnetic resonance (cardiac MR) study including both late gadolinium enhancement (LGE) and MR angiography may be indicated for patients with a history of acquired or congenital heart disease. To study the novel use of an extracellular agent for assessment of LGE combined with a blood pool contrast agent for detailed MR angiography evaluation to yield a comprehensive cardiac MR study in these patients. We reviewed clinical cardiac MR studies utilizing extracellular and blood pool contrast agents and noted demographics, clinical data and adverse events. We rated LGE image quality and MR angiography image quality for each vascular segment and calculated inter-rater variability. We also quantified contrast-to-noise ratio (CNR). Thirty-three patients (mean age 13.9 ± 3 years) received an extracellular contrast agent (10 gadobenate dimeglumine, 23 gadopentetate dimeglumine) and blood pool contrast agent (33 gadofosveset trisodium). No adverse events were reported. MRI indications included Kawasaki disease (8), cardiomyopathy and coronary anatomy (15), repaired congenital heart disease (8), and other (2). Mean LGE quality was 2.6 ± 0.6 with 97% diagnostic imaging. LGE quality did not vary by type of contrast agent given (P = 0.07). Mean MR angiography quality score was 4.7 ± 0.6, with high inter-rater agreement (k = 0.6-0.8, P < 0.002). MR angiography quality did not vary by type of contrast agent used (P = 0.6). Cardiac MR studies utilizing both extracellular and blood pool contrast agents are feasible and safe and provide excellent-quality LGE and MR angiography images. The use of two contrast agents allows for a comprehensive assessment of both myocardial viability and vascular anatomy during the same exam.

  17. 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.

  18. Cinematic three-dimensional surface display of cardiac blood pool tomography

    SciTech Connect

    Honda, N.; Machida, K.; Takishima, T.; Mamiya, T.; Takahashi, T.; Kamano, T.; Tamaki, S.; Ban, R. )

    1991-02-01

    A method of three-dimensional cinematic display (3D cine) of cardiac blood pool tomography is described. ECG-gated transaxial blood pool imaging was obtained from a set of projection images that were collected from 32 images with 10 ECG-gated images per projection during a 180 degrees arc of a rotating gamma camera. A surface contour of the blood pool was determined by a set of isocount lines (40-55% of the maximum pixel counts) of the transaxial images. 3D cine was made by a depth-shading method, in which brightness of a given point on the contour was set proportional to the distance between the viewing plane and the point and to the incident angle formed by the viewing line and the surface of the point. In 15 patients, 3D cine showed hypokinesia, akinesia, dyskinesia, ventricular aneurysm, and opposite motions of the atria and ventricles. Diagnoses of left ventricular motion by 3D cine agreed well with those by echocardiography and contrast left ventriculography.

  19. Blood-pool contrast agent for pre-clinical computed tomography

    NASA Astrophysics Data System (ADS)

    Cruje, Charmainne; Tse, Justin J.; Holdsworth, David W.; Gillies, Elizabeth R.; Drangova, Maria

    2017-03-01

    Advances in nanotechnology have led to the development of blood-pool contrast agents for micro-computed tomography (micro-CT). Although long-circulating nanoparticle-based agents exist for micro-CT, they are predominantly based on iodine, which has a low atomic number. Micro-CT contrast increases when using elements with higher atomic numbers (i.e. lanthanides), particularly at higher energies. The purpose of our work was to develop and evaluate a lanthanide-based blood-pool contrast agent that is suitable for in vivo micro-CT. We synthesized a contrast agent in the form of polymer-encapsulated Gd nanoparticles and evaluated its stability in vitro. The synthesized nanoparticles were shown to have an average diameter of 127 +/- 6 nm, with good size dispersity. Particle size distribution - evaluated by dynamic light scattering over the period of two days - demonstrated no change in size of the contrast agent in water and saline. Additionally, our contrast agent was stable in a mouse serum mimic for up to 30 minutes. CT images of the synthesized contrast agent (containing 27 mg/mL of Gd) demonstrated an attenuation of over 1000 Hounsfield Units. This approach to synthesizing a Gd-based blood-pool contrast agent promises to enhance the capabilities of micro-CT imaging.

  20. Diagnostic yield of blood flow and blood pool studies of the liver

    SciTech Connect

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

    1984-01-01

    The accuracy of Tc-99m RBC studies of the liver to diagnose cavernous hemangiomas has been previously reported. The authors have reviewed 82 of these studies performed in the last four years to determine the prevalence of this benign lesion when it is suspected. Studies were performed in patients with focal solid abnormalities of the liver if the patient had no known primary or if there were no definitive clinical or laboratory findings to support the diagnosis of metastatic disease. Blood flow, immediate blood pool and one hour delayed blood pool images were obtained in all patients. The combination of decreased or normal blood flow and markedly increased blood pool is pathognomonic for patients having cavernous hemangiomas. Seventeen percent (14/82) of patients were found to have cavernous hemangiomas of the liver. The remaining patients had metastatic disease (38), abscess (6), hepatomas (6), and miscellaneous diagnosis (11). All patients diagnosed as having cavernous hemangioma have been followed for at least one year. Seven of the remaining patients were lost to medical follow-up. In the series no false positive or false negative results have been obtained; however, false negative cases are anticipated for small or thrombosed hemangiomas. RBC liver studies should be encouraged since 1) the diagnostic yield is high; 2) it is the diagnostic procedure of choice; 3) biopsy of these lesions can be catastrophic; and 4) therapy and prognosis is greatly altered if the liver lesions are proven to be benign.

  1. Slower Lower Limb Blood Pooling Increases Orthostatic Tolerance in Women with Vasovagal Syncope

    PubMed Central

    Skoog, Johan; Zachrisson, Helene; Länne, Toste; Lindenberger, Marcus

    2016-01-01

    Background and Aim: Slower lower limb blood pooling and associated blunted sympathetic activation has been detected in healthy women prone to orthostatic syncope. Whether these findings are true also for patients with vasovagal syncope (VVS) is unknown. The aim was to investigate initial blood pooling time (poolingtime, time to 50% of total blood pooling) together with hemodynamic responses and orthostatic tolerance during lower body negative pressure (LBNP) in VVS and healthy controls. Methods and Results: Fourteen VVS women (25.7 ± 1.3 years) and 15 healthy women (22.8 ± 0.8 years) were subjected to single-step and graded LBNP to pre-syncope. Lower limb blood pooling (ml · 100 ml−1), poolingtime (s), hemodynamic responses and LBNP-tolerance were evaluated. LBNP induced comparable lower limb blood pooling in both groups (controls, 3.1 ± 0.3; VVS, 2.9 ± 0.3 ml · 100 ml−1, P = 0.70). In controls, shorter poolingtime correlated to higher LBNP-tolerance (r = –0.550, P < 0.05) as well as better maintained stroke volume (r = –0.698, P < 0.01) and cardiac output (r = –0.563, P < 0.05). In contrast, shorter poolingtime correlated to lower LBNP-tolerance in VVS (r = 0.821, P < 0.001) and larger decline in stroke volume (r = 0.611, P < 0.05). Furthermore, in controls, shorter poolingtime correlated to baroreflex-mediated hemodynamic changes during LBNP, e.g., increased vasoconstriction (P < 0.001). In VVS, poolingtime was not correlated with LBNP-induced baroreceptor unloading, but rather highly correlated to resting calf blood flow (P < 0.001). Conclusions: Shorter poolingtime seems to elicit greater sympathetic activation with a concomitant higher orthostatic tolerance in healthy women. The contrasting findings in VVS indicate a deteriorated vascular sympathetic control suggesting well-defined differences already in the initial responses during orthostatic stress. PMID:27378941

  2. Skeletal Scintigraphy

    PubMed Central

    McDougall, I. Ross

    1979-01-01

    Skeletal scintigraphy, using phosphates or diphosphonates labeled with technetium 99m, is a sensitive method of detecting bone abnormalities. The most important and most frequent role of bone scanning is evaluating the skeletal areas in patients who have a primary cancer, especially a malignant condition that has a tendency to spread to bone areas. The bone scan is superior to bone radiographs in diagnosing these abnormalities; 15 percent to 25 percent of patients with breast, prostate or lung cancer, who have normal roentgenograms, also have abnormal scintigrams due to metastases. The majority of bone metastases appear as hot spots on the scan and are easily recognized. The incidence of abnormal bone scans in patients with early stages (I and II) of breast cancer varies from 6 percent to 26 percent, but almost invariably those patients with scan abnormalities have a poor prognosis and should be considered for additional therapies. Progression or regression of bony lesions can be defined through scanning, and abnormal areas can be identified for biopsy. The incidence of metastases in solitary scan lesions in patients with known primary tumors varies from 20 percent to 64 percent. Bone scintigraphy shows positive uptake in 95 percent of cases with acute osteomyelitis. Stress fractures and trauma suspected in battered babies can be diagnosed by scanning before there is radiological evidence. The procedure is free from acute or long-term side effects and, except in cases of very young patients, sedation is seldom necessary. Although the test is sensitive, it is not specific and therefore it is difficult to overemphasize the importance of clinical, radiographic, biochemical and scanning correlation in each patient. ImagesFigure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8.Figure 9.Figure 10. PMID:390886

  3. 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.

  4. Gallium-68-DOTA-albumin as a PET blood-pool marker: experimental evaluation in vivo.

    PubMed

    Hoffend, Johannes; Mier, Walter; Schuhmacher, Jochen; Schmidt, Kerstin; Dimitrakopoulou-Strauss, Antonia; Strauss, Ludwig G; Eisenhut, Michael; Kinscherf, Ralf; Haberkorn, Uwe

    2005-04-01

    Investigations into tumor angiogenesis and antiangiogenic treatment have renewed interest in tumor perfusion. To image tumor blood-pool by PET, suitable tracers are not generally available. In this experimental study, we characterized a 68Ga-labeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) conjugate of rat serum albumin (68Ga-DOTA-RSA) in vivo using a generator-produced isotope. Biodistribution was determined in ACI rats after intravenous administration of 3-6 MBq of 68Ga-DOTA-RSA. Three ACI rats were imaged over 1 h by dynamic PET after intravenous administration of 15-25 MBq of 68Ga-DOTA-RSA while the blood-pool activity was recorded simultaneously in a closed extracorporeal loop (ECL) between the carotid artery and the jugular vein. Time-activity curves (TACs) were obtained from volume of interest (VOI) analysis and from the ECL data. Stability and metabolites in plasma and urine were analyzed by size exclusion HPLC (SE-HPLC) 1 h after intravenous injection of 67Ga-DOTA-RSA. Blood radioactivity decreased by 10% and 18% from 10 to 60 min p.i. by biodistribution and PET or ECL, respectively. Tissue sampling between 10 and 60 min p.i. showed slight increases in the uptake of spleen, myocardium, kidney and skeletal muscle while hepatic accretion remained unchanged. Total urinary excretion after 60 min amounted to 9% of the injected dose. HPLC demonstrated a single urinary metabolite corresponding in size to gallium-labeled DOTA. 68Ga-DOTA-RSA is a blood-pool tracer whose physical and biological half-life is well suited for PET. Our findings support clinical imaging using 68Ga-DOTA-labeled human serum albumin (HSA). The generator-produced label makes 68Ga-DOTA-labeled albumin continuously available even to centers lacking an in-house cyclotron.

  5. Fourier analysis of a gated blood-pool study during atrial flutter

    SciTech Connect

    Makler, P.T. Jr.; McCarthy, D.M.; London, J.W.; Sandler, M.S.; Alavi, A.

    1983-08-01

    First-harmonic Fourier analysis of a gated blood-pool study is based on the assumption that the cardiac chambers contract once per cardiac cycle. In atrial arrhythmias this condition may not exist for the atria. We recently studied a patient with atrial flutter and 2:1 artioventricular conduction. There were predictable alterations in the first-harmonic Fourier phase and amplitude images. The observed changes from first-harmonic Fourier analysis were: (a) very low atrial amplitude values, and (b) absence of identifiable atrial regions on the phase image.

  6. Gallbladder visualization during technetium-99m RBC blood pool imaging. Case report and literature review

    SciTech Connect

    Kotlyarov, E.V.; Mattay, V.S.; Reba, R.C.

    1988-07-01

    Gallbladder visualization occurred after a Tc-99m red blood cell (RBC) cardiac gated blood pool scan. To date, seven cases of gallbladder visualization after the intravenous injection of Tc-99m RBCs have been reported. In the previous six patients the gallbladder was visualized incidentally during a search for gastrointestinal (GI) bleeding. All of the patients were anemic, six of seven had chronic renal failure, and five of seven had received multiple blood transfusions. When interpreting GI bleeding scans in patients with anemia and renal failure, awareness of the possibility of gallbladder visualization in the delayed images is important to avoid false-positive results. 3 references.

  7. 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.

  8. Blood pool agent contrast-enhanced MRA: level-set-based artery-vein separation

    NASA Astrophysics Data System (ADS)

    van Bemmel, Cornelis M.; Spreeuwers, Luuk J.; Verdonck, Bert; Viergever, Max A.; Niessen, Wiro J.

    2002-05-01

    Blood pool agents (BPAs) for contrast-enhanced magnetic resonance angiography (CE-MRA) allow prolonged imaging times for higher contrast and resolution by imaging during the steady-state when the contrast agent is distributed through the complete vascular system. However, simultaneous venous and arterial enhancement hampers interpretation. It is shown that arterial and venous segmentation in this equilibrium phase can be achieved if the central arterial axis (CAA) and central venous axis (CVA) are known. Since the CAA can not straightforwardly be obtained from the steady-state data, images acquired during the first-pass of the contrast agent can be utilized to determine the CAA with minimal user initialization. Utilizing the CAA to provide a rough arterial segmentation, the CVA can subsequently be determined from the steady-state dataset. The final segmentations of the arteries and veins are achieved by simultaneously evolving two level-sets in the steady-state dataset starting from the CAA and CVA.

  9. A method for measuring mean circumferential fiber shortening rate from gated blood pool scans.

    PubMed

    Bhargava, V; Costello, D; Slutsky, R; Verba, J

    1982-01-01

    Ejection fraction and ejection rate are easily obtained from gated cardiac images, but no method is available for calculating mean circumferential fiber shortening rate. We assumed that the cube root of left ventricular end-diastolic volume or counts is proportional to the minor axis of the left ventricle at end-diastole or end-systole. Mean circumferential fiber shortening rate is then equal to the [cube root of the end-diastolic volume (count) minus cube root of end-systolic volume (count)] divided by [cube root of end-diastolic volume (count) multiplied by the ejection time]. In 250 contrast ventriculograms, the standard mean circumferential fiber shortening rate (MCFSR) and that derived by the cube root method correlated well (r = 0.94). The mean value of MCFSR (0.85 +/- 0.35) was greater than the cube root value (0.75 +/- 0.35) (P less than 0.001). The regression equation was y = 0.86x + 0.02. Similar correlations were obtained from gated radionuclide images using a semiautomated program (r = 0.93) in 24 subjects or completely automated program (r = 0.85) in 28 patients. The regression equation between MCFSR and that derived from the cube root of counts for the semiautomated program was y = 0.82x + 0.04 and for the automated program was y = 0.84x + 0.004. Similar correlations, slopes, and intercepts were seen using circumferential fractional shortening for angiographic data when correlated with both the semiautomated and automated gated blood pool scan programs. These data indicate that MCFSR and circumferential fractional shortening may be obtained from gated blood pool images using cube root estimates of end-diastolic and end-systolic radii with a high degree of correlation with the standard contrast ventriculographic technique.

  10. Synthesis of fluorine-18 radio-labeled serum albumins for PET blood pool imaging.

    PubMed

    Basuli, Falguni; Li, Changhui; Xu, Biying; Williams, Mark; Wong, Karen; Coble, Vincent L; Vasalatiy, Olga; Seidel, Jurgen; Green, Michael V; Griffiths, Gary L; Choyke, Peter L; Jagoda, Elaine M

    2015-03-01

    We sought to develop a practical, reproducible and clinically translatable method of radiolabeling serum albumins with fluorine-18 for use as a PET blood pool imaging agent in animals and man. Fluorine-18 radiolabeled fluoronicotinic acid-2,3,5,6-tetrafluorophenyl ester, [(18)F]F-Py-TFP was prepared first by the reaction of its quaternary ammonium triflate precursor with [(18)F]tetrabutylammonium fluoride ([(18)F]TBAF) according to a previously published method for peptides, with minor modifications. The incubation of [(18)F]F-Py-TFP with rat serum albumin (RSA) in phosphate buffer (pH9) for 15 min at 37-40 °C produced fluorine-18-radiolabeled RSA and the product was purified using a mini-PD MiniTrap G-25 column. The overall radiochemical yield of the reaction was 18-35% (n=30, uncorrected) in a 90-min synthesis. This procedure, repeated with human serum albumin (HSA), yielded similar results. Fluorine-18-radiolabeled RSA demonstrated prolonged blood retention (biological half-life of 4.8 hours) in healthy awake rats. The distribution of major organ radioactivity remained relatively unchanged during the 4 hour observation periods either by direct tissue counting or by dynamic PET whole-body imaging except for a gradual accumulation of labeled metabolic products in the bladder. This manual method for synthesizing radiolabeled serum albumins uses fluorine-18, a widely available PET radionuclide, and natural protein available in both pure and recombinant forms which could be scaled up for widespread clinical applications. These preclinical biodistribution and PET imaging results indicate that [(18)F]RSA is an effective blood pool imaging agent in rats and might, as [(18)F]HSA, prove similarly useful as a clinical imaging agent.

  11. A novel blood-pooling MR contrast agent: Carboxymethyl-diethylaminoethyl dextran magnetite.

    PubMed

    Sonoda, Akinaga; Nitta, Norihisa; Tsuchiya, Keiko; Nitta-Seko, Ayumi; Ohta, Shinichi; Otani, Hideji; Murata, Kiyoshi

    2016-12-01

    Gadofosveset trisodium is available as a prolonged pooling vascular contrast agent for magnetic resonance imaging. As gadolinium (Gd)-based agents may increase the risk for nephrogenic systemic fibrosis in patients with severe renal insufficiency, the present study synthesized carboxymethyl-diethylaminoethyl dextran magnetite (CMEADM) particles as a blood-pooling, non-Gd‑based contrast agent. CMEADM particles carry a negative or positive charge due to the binding of amino and carboxyl groups to the hydroxyl group of dextran. The present study evaluated whether the degree of charge alters the blood‑pooling time. The evaluation was performed by injecting four groups of three Japanese white rabbits each with CMEADM‑, CMEADM2‑, CMEADM+ (surface charges: ‑10.4, ‑41.0 and +9.6 mV, respectively) or with ultrasmall superparamagnetic iron oxide (USPIO; ‑11.5 mV). The relative signal intensity (SIrel) of each was calculated using the following formula: SIrel = (SI post‑contrast ‑ SI pre‑contrast / SI pre‑contrast) x 100. Following injection with the CMEADMs, but not with USPIO, the in vivo pooling time was prolonged to >300 min. No significant differences were attributable to the electric charge among the CMEADM‑, CMEADM2‑ or and CMEADM+ particles when analyzed with analysis of variance and Tukey's HSD test. Taken together, all three differently‑charged CMEADM2 particles exhibited prolonged vascular enhancing effects, compared with the USPIO. The degree of charge of the contrast agents used in the present study did not result in alteration of the prolonged blood pooling time.

  12. Alendronate-coated long-circulating liposomes containing 99mtechnetium-ceftizoxime used to identify osteomyelitis.

    PubMed

    Ferreira, Diego dos Santos; Boratto, Fernanda Alves; Cardoso, Valbert Nascimento; Serakides, Rogéria; Fernandes, Simone Odília; Ferreira, Lucas Antônio Miranda; Oliveira, Mônica Cristina

    2015-01-01

    Osteomyelitis is a progressive destruction of bones caused by microorganisms. Inadequate or absent treatment increases the risk of bone growth inhibition, fractures, and sepsis. Among the diagnostic techniques, functional images are the most sensitive in detecting osteomyelitis in its early stages. However, these techniques do not have adequate specificity. By contrast, radiolabeled antibiotics could improve selectivity, since they are specifically recognized by the bacteria. The incorporation of these radiopharmaceuticals in drug-delivery systems with high affinity for bones could improve the overall uptake. In this work, long-circulating and alendronate-coated liposomes containing (99m)technetium-radiolabeled ceftizoxime were prepared and their ability to identify infectious foci (osteomyelitis) in animal models was evaluated. The effect of the presence of PEGylated lipids and surface-attached alendronate was evaluated. The bone-targeted long-circulating liposomal (99m)technetium-ceftizoxime showed higher uptake in regions of septic inflammation than did the non-long-circulating and/or alendronate-non-coated liposomes, showing that both the presence of PEGylated lipids and alendronate coating are important to optimize the bone targeting. Scintigraphic images of septic or aseptic inflammation-bearing Wistar rats, as well as healthy rats, were acquired at different time intervals after the intravenous administration of these liposomes. The target-to-non-target ratio proved to be significantly higher in the osteomyelitis-bearing animals for all investigated time intervals. Biodistribution studies were also performed after the intravenous administration of the formulation in osteomyelitis-bearing animals. A significant amount of liposomes were taken up by the organs of the mononuclear phagocyte system (liver and spleen). Intense renal excretion was also observed during the entire experiment period. Moreover, the liposome uptake by the infectious focus was significantly high. These results show that long-circulating and alendronate-coated liposomes containing (99m)technetium-radiolabeled ceftizoxime have a tropism for infectious foci.

  13. Utility of the SPECT Tc-99m labeled RBC blood pool scan in the detection of hepatic hemangiomas

    SciTech Connect

    Guze, B.H.; Hawkins, R.A.

    1989-11-01

    The sensitivity of SPECT imaging of hepatic blood pool activity using Tc-99m labeled RBCs was contrasted with magnetic resonance and CT imaging in 22 cases. SPECT is a noninvasive technique with a high sensitivity for the diagnosis of hepatic hemangiomas. It is helpful for clarifying equivocal magnetic resonance imaging results.

  14. Imaging the whole body atherosclerosis: high resolution magnetic resonance angiography using blood-pool agent. Initial clinical experience.

    PubMed

    Napoli, A; Catalano, C; Anzidei, M; Lanciotti, K; Calabrese, F A; Cavallo Marincola, B; Zini, C; Di Paolo, P L; Kyventidis, T; Passariello, R

    2007-06-01

    Recently whole-body 3D MR angiography (MRA) with blood-pool contrast agent has become available. The purpose of this study was to introduce and evaluate this technique to demonstrate arterial steno-occlusive involvement in systemic atherosclerosis and to compare blood-pool enhanced MRA results with those of CT angiography (CTA) as reference modality. Twenty patients with clinically and US documented carotid occlusive disease underwent whole-body MRA on a 1.5 T scanner and CTA on a 64-MDCT unit. Ten milliliters of a blood-pool agent (MS-235 Gadofosveset Trisodium, VASOVIST, Schering, Berlin, Germany) were administered intravenously and four 3-D MRA stations were acquired successively through automatic table moving. Images were reviewed by two observers. Overall image quality of each arterial segment was assessed and rated for both MRA and CTA examinations; MRA sensitivity, MRA specificity interobserver and intermodality agreement were calculated. Whole-body MRA with blood-pool contrast agent was well tolerated by all patients. It yielded a detailed display of the arterial system with a short examination time. In 14 out of 20 patients there was extensive involvement of the arterial bed by steno-occlusive atherosclerotic disease; for the identification and characterization of vessel damage in the various vascular districts MRA sensitivity was 92-100%, MRA specificity was 95-100%; in 2 cases MRA underestimated the degree of peripheral vessel stenosis. Interobserver agreement calculated with K value was 0.63, intermodality agreement with CTA was 93% (P<0.01). The whole-body MRA technique is a valuable tool for comprehensive evaluation of arterial steno-occlusive involvement in systemic arterial atherosclerosis; there is a good agreement between blood-pool enhanced MRA results and CTA, used as modality of reference.

  15. Nanoparticle encapsulation in red blood cells enables blood-pool magnetic particle imaging hours after injection

    NASA Astrophysics Data System (ADS)

    Rahmer, J.; Antonelli, A.; Sfara, C.; Tiemann, B.; Gleich, B.; Magnani, M.; Weizenecker, J.; Borgert, J.

    2013-06-01

    Magnetic particle imaging (MPI) is a new medical imaging approach that is based on the nonlinear magnetization response of super-paramagnetic iron oxide nanoparticles (SPIOs) injected into the blood stream. To date, real-time MPI of the bolus passage of an approved MRI SPIO contrast agent injected into the tail vein of living mice has been demonstrated. However, nanoparticles are rapidly removed from the blood stream by the mononuclear phagocyte system. Therefore, imaging applications for long-term monitoring require the repeated administration of bolus injections, which complicates quantitative comparisons due to the temporal variations in concentration. Encapsulation of SPIOs into red blood cells (RBCs) has been suggested to increase the blood circulation time of nanoparticles. This work presents first evidence that SPIO-loaded RBCs can be imaged in the blood pool of mice several hours after injection using MPI. This finding is supported by magnetic particle spectroscopy performed to quantify the iron concentration in blood samples extracted from the mice 3 and 24 h after injection of SPIO-loaded RBCs. Based on these results, new MPI applications can be envisioned, such as permanent 3D real-time visualization of the vessel tree during interventional procedures, bleeding monitoring after stroke, or long-term monitoring and treatment control of cardiovascular diseases.

  16. Coronary MR angiography: experimental results with a monomer-stabilized blood pool contrast medium.

    PubMed

    Taupitz, Matthias; Schnorr, Jörg; Wagner, Susanne; Abramjuk, Claudia; Pilgrimm, Herbert; Kivelitz, Dietmar; Schink, Tania; Hansel, Jörg; Laub, Gerhard; Hünigen, Hanna; Hamm, Bernd

    2002-01-01

    To evaluate the signal-enhancing characteristics of monomer-coated very small superparamagnetic iron oxide (SPIO) particles used as a blood pool contrast medium for magnetic resonance (MR) angiography in the coronary arteries. The particles used in this study were coated with citrate as the monomer (VSOP-C91). The particles have a total diameter of 7 nm and show the following relaxivities at 0.47 T: T1, 19 L/mmol. sec(-1); T2, 29 L/mmol. sec(-1). Fifteen cardiac MR examinations were performed at 1.5 T in five pigs. Images were acquired from immediately to 35 minutes (equilibrium phase) after intravenous injection of gadopentetate dimeglumine, gadobenate dimeglumine, and the very small SPIO particles (n = 5 for each substance). Immediately after administration of gadopentetate dimeglumine, gadobenate dimeglumine, and the very small SPIO particles, respectively, increases in the signal-to-noise ratio in blood were 94%, 103%, and 102% and in myocardium were 83%, 83%, and 29% (P <.05, very small SPIO particles versus the low-molecular-weight gadolinium-based compounds). Differences in the blood-to-myocardium contrast-to-noise ratio and visualization of the coronary arteries and their branches were also significant. VSOP-C91 significantly improves visualization of the coronary arteries at MR angiography from immediately to 35 minutes after injection.

  17. Pelvic blood pooling of men and women during lower body negative pressure.

    PubMed

    White, D D; Montgomery, L D

    1996-06-01

    The objective of this study was to investigate possible gender differences in the hemodynamic responses of the lower body during lower body negative pressure (LBNP). In this study, 17 women (mean age = 56 yrs) and 15 men (mean age = 55 yrs) underwent a 15 min exposure to -50 mm Hg LBNP. A Beckman (BR-100) Impedance Plethysmograph was used to measure each subject's leg and pelvic blood flow and pooling during the LBNP test. The women had an 83% greater increase in blood volume in the pelvic region than men as a result of the LBNP exposure. Women and men had similar increases in leg blood volume as a result of the 15 min exposure to -50 mm Hg. There was no significant gender difference in the decreased amount of blood flow to the leg or pelvic regions by the end of -50 mm Hg LBNP. These results demonstrate that women have greater blood pooling in the pelvic region compared to men when exposed to -50 mm Hg LBNP. These results should be considered when designing life-support equipment for men and women pilots and astronauts, especially the designing of anti-G and Space Shuttle re-entry garments.

  18. Incidental diagnosis of pregnancy on bone and gallium scintigraphy

    SciTech Connect

    Palestro, C.J.; Malat, J.; Collica, C.J.; Richman, A.H.

    1986-03-01

    Bone and gallium scintigraphy were performed as part of the diagnostic workup of a 21-yr-old woman who presented at our institution with a history of progressively worsening low back pain over a 1-wk period of time. The angiographic phase of the bone scan demonstrated a well-defined radionuclide blush within the pelvis just cephalad to the urinary bladder with persistent hyperemia noted in the blood-pool image. We attribute these findings to a uterine blush secondary to the pronounced uterine muscular hyperplasia, hyperemia, and edema that accompany pregnancy. Gallium scintigraphy demonstrated intense bilateral breast accumulation of the imaging agent in a typical doughnut pattern which is commonly found in the prelactating and lactating breast. Also demonstrated was apparent gallium accumulation in the placenta. This case is presented to emphasize the radionuclide findings that occur during pregnancy, particularly the incidental finding of radionuclide blush during the angiographic phase of a radionuclide scintigraphy which should alert the nuclear physician to the possibility of pregnancy in a woman of childbearing age.

  19. Nuclear scintigraphy in horses.

    PubMed

    Winter, Matthew D; Berry, Clifford R; Reese, David J

    2010-12-01

    Nuclear scintigraphy has been used successfully for various applications in horses in the past 30 years. Many private practices and most veterinary schools have gamma cameras, which are used to image an injected radionuclide in an equine patient. Unique exercise-related demands place specific physiologic stressors on the musculoskeletal system of horses. Horses are often pushed beyond normal physiologic limits because of specific performance stresses; therefore, injury to their musculoskeletal system is common. Skeletal scintigraphy is exceedingly sensitive but relatively nonspecific for determining a definitive etiology. Equine scintigraphy is best suited for detecting acute soft tissue and osseous abnormalities because radiopharmaceutical uptake often precedes radiographic detection. However, scintigraphy can also be used to locate potential areas of abnormal osseous turnover in horses with chronic, vague lameness. This article reviews the basic principles of equine scintigraphy, with an emphasis on bone scintigraphy and the clinical applications of this technique. Vascular-, soft tissue-, and bone-phase acquisition are described along with basic image interpretation. Potential pitfalls in image acquisition and interpretation are discussed.

  20. (18)F-FDG-labeled red blood cell PET for blood-pool imaging: preclinical evaluation in rats.

    PubMed

    Matsusaka, Yohji; Nakahara, Tadaki; Takahashi, Kazuhiro; Iwabuchi, Yu; Nishime, Chiyoko; Kajimura, Mayumi; Jinzaki, Masahiro

    2017-12-01

    Red blood cells (RBCs) labeled with single-photon emitters have been clinically used for blood-pool imaging. Although some PET tracers have been introduced for blood-pool imaging, they have not yet been widely used. The present study investigated the feasibility of labeling RBCs with (18)F-2-deoxy-2-fluoro-D-glucose ((18)F-FDG) for blood-pool imaging with PET. RBCs isolated from venous blood of rats were washed with glucose-free phosphate-buffered saline and labeled with (18)F-FDG. To optimize labeling efficiency, the effects of glucose deprivation time and incubation (labeling) time with (18)F-FDG were investigated. Post-labeling stability was assessed by calculating the release fraction of radioactivity and identifying the chemical forms of (18)F in the released and intracellular components of (18)F-FDG-labeled RBCs incubated in plasma. Just after intravenous injection of the optimized autologous (18)F-FDG-labeled RBCs, dynamic PET scans were performed to evaluate in vivo imaging in normal rats and intraabdominal bleeding models (temporary and persistent bleeding). The optimal durations of glucose deprivation and incubation (labeling) with (18)F-FDG were 60 and 30 min, respectively. As low as 10% of (18)F was released as the form of (18)F-FDG from (18)F-FDG-labeled RBCs after a 60-min incubation. Dynamic PET images of normal rats showed strong persistence in the cardiovascular system for at least 120 min. In the intraabdominal bleeding models, (18)F-FDG-labeled RBC PET visualized the extravascular blood clearly and revealed the dynamic changes of the extravascular radioactivity in the temporary and persistent bleeding. RBCs can be effectively labeled with (18)F-FDG and used for blood-pool imaging with PET in rats.

  1. Dendrimers meet zwitterions: development of a unique antifouling nanoplatform for enhanced blood pool, lymph node and tumor CT imaging.

    PubMed

    Xiong, Zhijuan; Wang, Yue; Zhu, Jingyi; Li, Xin; He, Yao; Qu, Jiao; Shen, Mingwu; Xia, Jindong; Shi, Xiangyang

    2017-08-31

    We report the synthesis and characterization of antifouling zwitterion carboxybetaine acrylamide (CBAA)-modified dendrimer-entrapped gold nanoparticles (Au DENPs) for enhanced CT imaging applications. The CBAA-modified nanodevice displays a better protein resistance property, less macrophage cellular uptake and liver accumulation, and longer blood half-delay time than the PEGylated counterpart material, thereby enabling enhanced blood pool, lymph node, and tumor CT imaging.

  2. Stability of echogenic liposomes as a blood pool ultrasound contrast agent in a physiologic flow phantom.

    PubMed

    Radhakrishnan, Kirthi; Haworth, Kevin J; Huang, Shao-Ling; Klegerman, Melvin E; McPherson, David D; Holland, Christy K

    2012-11-01

     vivo investigations will be needed to evaluate the optimal usage of ELIP as blood pool contrast agents.

  3. 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.

  4. Blood Pool Segmentation Results in Superior Virtual Cardiac Models than Myocardial Segmentation for 3D Printing.

    PubMed

    Farooqi, Kanwal M; Lengua, Carlos Gonzalez; Weinberg, Alan D; Nielsen, James C; Sanz, Javier

    2016-08-01

    The method of cardiac magnetic resonance (CMR) three-dimensional (3D) image acquisition and post-processing which should be used to create optimal virtual models for 3D printing has not been studied systematically. Patients (n = 19) who had undergone CMR including both 3D balanced steady-state free precession (bSSFP) imaging and contrast-enhanced magnetic resonance angiography (MRA) were retrospectively identified. Post-processing for the creation of virtual 3D models involved using both myocardial (MS) and blood pool (BP) segmentation, resulting in four groups: Group 1-bSSFP/MS, Group 2-bSSFP/BP, Group 3-MRA/MS and Group 4-MRA/BP. The models created were assessed by two raters for overall quality (1-poor; 2-good; 3-excellent) and ability to identify predefined vessels (1-5: superior vena cava, inferior vena cava, main pulmonary artery, ascending aorta and at least one pulmonary vein). A total of 76 virtual models were created from 19 patient CMR datasets. The mean overall quality scores for Raters 1/2 were 1.63 ± 0.50/1.26 ± 0.45 for Group 1, 2.12 ± 0.50/2.26 ± 0.73 for Group 2, 1.74 ± 0.56/1.53 ± 0.61 for Group 3 and 2.26 ± 0.65/2.68 ± 0.48 for Group 4. The numbers of identified vessels for Raters 1/2 were 4.11 ± 1.32/4.05 ± 1.31 for Group 1, 4.90 ± 0.46/4.95 ± 0.23 for Group 2, 4.32 ± 1.00/4.47 ± 0.84 for Group 3 and 4.74 ± 0.56/4.63 ± 0.49 for Group 4. Models created using BP segmentation (Groups 2 and 4) received significantly higher ratings than those created using MS for both overall quality and number of vessels visualized (p < 0.05), regardless of the acquisition technique. There were no significant differences between Groups 1 and 3. The ratings for Raters 1 and 2 had good correlation for overall quality (ICC = 0.63) and excellent correlation for the total number of vessels visualized (ICC = 0.77). The intra-rater reliability was good for Rater A (ICC = 0.65). Three models were successfully printed

  5. Diagnosis of Raynaud's phenomenon by (99m)Tc-pertechnetate hand perfusion scintigraphy: a pilot study.

    PubMed

    Pavlov-Dolijanovic, Slavica; Petrovic, Nebojsa; Vujasinovic Stupar, Nada; Damjanov, Nemanja; Radunovic, Goran; Babic, Dragan; Sobic-Saranovic, Dragana; Artiko, Vera

    2016-12-01

    We assess the usefulness of (99m)Tc-pertechnetate hand perfusion scintigraphy in patients with Raynaud's phenomenon (RP). The study population consisted of 18 patients with primary RP, 25 patients with secondary RP within systemic sclerosis (SSc), and ten healthy individuals. Gamma camera dynamic first-pass study during the first 60 s and a static scintigraphy after 5 min were recorded following a bolus injection of (99m)Tc-pertechnetate via a cubital vein. Regions of interest were drawn on the summed images around the fingers and the palmar region. The fingers-to-palm ratios were then calculated. The mean fingers-to-palm ratio for dynamic study (blood flow) was 0.58 ± 0.19 for the healthy group, 0.45 ± 0.18 for the primary RP, and 0.43 ± 0.21 for the SSc patients. The mean fingers-to-palm ratio for static study (blood pool) was 0.44 ± 0.06 for the healthy group, 0.42 ± 0.06 for the primary RP, and 0.36 ± 0.07 for the SSc patients. Analysis of variance showed these differences to be significant (p = 0.039 from blood flow and p = 0.004 from blood pool). The receiver operating characteristic curve showed sensitivity of 80% and a specificity of 60% when using cutoff values of 0.40 for blood flow and sensitivity of 79% and a specificity of 70% when using cutoff values of 0.37 for blood pool. Our method is able to differentiate between patients with normal and those with abnormal microcirculation of the hands. Dynamic study separates the healthy subjects from patients with RP, while static study separates primary from secondary RP.

  6. Ultrastable polyethyleneimine-stabilized gold nanoparticles modified with polyethylene glycol for blood pool, lymph node and tumor CT imaging.

    PubMed

    Zhang, Yongxing; Wen, Shihui; Zhao, Lingzhou; Li, Du; Liu, Changcun; Jiang, Wenbin; Gao, Xiang; Gu, Wentao; Ma, Nan; Zhao, Jinhua; Shi, Xiangyang; Zhao, Qinghua

    2016-03-14

    Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG monomethyl ether via PEI amine-enabled conjugation chemistry, followed by acetylation of the remaining PEI surface amines. The formed PEGylated Au PSNPs were characterized via different methods. We show that the PEGylated Au PSNPs with an Au core size of 5.1 nm have a relatively long half-decay time (7.8 h), and display a better X-ray attenuation property than conventionally used iodine-based CT contrast agents (e.g., Omnipaque), and are hemocompatible and cytocompatible in a given concentration range. These properties of the Au PSNPs afford their uses as a contrast agent for effective CT imaging of the blood pool and major organs of rats, lymph node of rabbits, and the xenografted tumor model of mice. Importantly, the PEGylated Au PSNPs could be excreted out of the body with time and also showed excellent in vivo stability. These findings suggest that the formed PEGylated Au PSNPs may be used as a promising contrast agent for CT imaging of different biological systems.

  7. Multimodality evaluation of ventricular function: comparison of cardiac magnetic resonance imaging, echocardiography, and planar and SPECT blood pool imaging

    NASA Astrophysics Data System (ADS)

    Feiglin, David H.; Krol, Andrzej; Tillapaugh-Fay, Gwen M.; Szeverenyi, Nikolaus M.; Thomas, Frank D.

    2001-05-01

    Fifteen patients underwent resting echocardiography (EC), ECG gated cardiac MR ventriculography (MRV) and blood pool planar and SPECT ventriculography (SPV) sequentially on the same day. In addition, 36 patients had sequential ECG gated blood pool and SPV and 20 normal volunteers, age > 18 years, had sequential ECG gated cardiac MRI performed on both Siemens closed, 1.5T, and open, 0.2T, magnets. Echocardiography was performed using a HP 5500 system equipped with an S4 transducer in 2D mode. MRV at 0.2T and 1.5T used a circular polarized body coil. Nuclear Medicine studies used 25 mCi Tc- 99m labeled red blood cells. Gated planar and SPV were acquired on a dual head Siemens E-Cam system. We have found that MRV affords the most accurate measurement of ventricular function. SPV and MRV provide similar estimations of left ventricular function (LVEF). Further, SPV consistently provides higher LVEF, as compared to the planar data simultaneously acquired. Observed significant differences in intermodality measurements indicate that follow up studies in patients, especially in patients whose management is critically dependent on functional measurement changes, should be monitored by one modality only.

  8. Independent effects of heart-head distance and caudal blood pooling on blood pressure regulation in aquatic and terrestrial snakes.

    PubMed

    Seymour, Roger S; Arndt, Joachim O

    2004-03-01

    Changes in orientation in a gravitational field markedly alter the patterns of blood pressure and flow in animals, especially tall or long ones such as giraffes or snakes. Vertical orientation tends to reduce blood flow and pressure in the head for two major reasons. First, the increased vertical blood column above the heart creates a gravitational hydrostatic pressure against which the heart must work. Second, expansion of dependent vessels in the lower extremities causes blood pooling and reduces return of venous blood to the heart, thereby lowering flow and pressure. For most animals, it is difficult to separate these two effects, but snakes offer the possibility of bending the animal in the region of the heart and manipulating the two ends of the body independently. We studied baroregulatory responses in terrestrial pythons (Liasis fuscus) and aquatic file snakes (Acrochordus arafurae) by tilting only the front or rear parts and then the whole animal. Changes in head blood pressure during partial tilts added up to the change during full tilt. The vertical distance to the head had twice as much influence on head blood pressure than did blood pooling in the pythons and four times as much in file snakes. This accounts for the cephalad location of the heart in terrestrial species compared with aquatic ones.

  9. Colloidal gold nanoparticles as a blood-pool contrast agent for X-ray computed tomography in mice.

    PubMed

    Cai, Quan-Yu; Kim, Sun Hee; Choi, Kyu Sil; Kim, Soo Yeon; Byun, Seung Jae; Kim, Kyoung Woo; Park, Seong Hoon; Juhng, Seon Kwan; Yoon, Kwon-Ha

    2007-12-01

    To present the pharmacokinetics and computed tomographic imaging efficacy of colloidal gold nanoparticles (AuNPs) as a blood-pool agent for x-ray computed tomography (CT). To prepare the colloidal AuNPs, gold nanocrystals were modified using sulfhydrated polyethylene glycol (PEG). Cytotoxicity and histopathologic tests were carried out for toxicity evaluation. Six adult Balb/c mice underwent microcomputed tomography scans after injection of colloidal AuNPs (2.5 micromol Au/g body weight). Four mice with HT-1080 tumors were imaged for visualization of the tumor vasculature. The PEG coated colloidal AuNPs appeared as spherical nanoparticles with 38-nm diameters. The AuNPs-PEG showed a biocompatibility without toxicity in the mice. We identified a stable imaging window for visualizing the vasculature system, immediately to 24 hours after injection. Microcomputed tomography imaging using AuNPs-PEG clearly visualized the tumor vascular structures. Colloidal AuNPs show potential as a blood-pool agent for x-ray CT imaging.

  10. Ultrastable polyethyleneimine-stabilized gold nanoparticles modified with polyethylene glycol for blood pool, lymph node and tumor CT imaging

    NASA Astrophysics Data System (ADS)

    Zhang, Yongxing; Wen, Shihui; Zhao, Lingzhou; Li, Du; Liu, Changcun; Jiang, Wenbin; Gao, Xiang; Gu, Wentao; Ma, Nan; Zhao, Jinhua; Shi, Xiangyang; Zhao, Qinghua

    2016-03-01

    Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG monomethyl ether via PEI amine-enabled conjugation chemistry, followed by acetylation of the remaining PEI surface amines. The formed PEGylated Au PSNPs were characterized via different methods. We show that the PEGylated Au PSNPs with an Au core size of 5.1 nm have a relatively long half-decay time (7.8 h), and display a better X-ray attenuation property than conventionally used iodine-based CT contrast agents (e.g., Omnipaque), and are hemocompatible and cytocompatible in a given concentration range. These properties of the Au PSNPs afford their uses as a contrast agent for effective CT imaging of the blood pool and major organs of rats, lymph node of rabbits, and the xenografted tumor model of mice. Importantly, the PEGylated Au PSNPs could be excreted out of the body with time and also showed excellent in vivo stability. These findings suggest that the formed PEGylated Au PSNPs may be used as a promising contrast agent for CT imaging of different biological systems.Development of new long-circulating contrast agents for computed tomography (CT) imaging of different biological systems still remains a great challenge. Here, we report the design and synthesis of branched polyethyleneimine (PEI)-stabilized gold nanoparticles (Au PSNPs) modified with polyethylene glycol (PEG) for blood pool, lymph node, and tumor CT imaging. In this study, thiolated PEI was first synthesized and used as a stabilizing agent to form AuNPs. The formed Au PSNPs were then grafted with PEG

  11. Synthesis and characterization of PEGylated polyethylenimine-entrapped gold nanoparticles for blood pool and tumor CT imaging.

    PubMed

    Zhou, Benqing; Zheng, Linfeng; Peng, Chen; Li, Du; Li, Jingchao; Wen, Shihui; Shen, Mingwu; Zhang, Guixiang; Shi, Xiangyang

    2014-10-08

    The synthesis and characterization of gold nanoparticles (AuNPs) entrapped within polyethylene glycol (PEG)-modified polyethylenimine (PEI) for blood pool and tumor computed tomography (CT) imaging are reported. In this approach, partially PEGylated PEI was used as a template for AuNP synthesis, followed by acetylating the PEI remaining surface amines. The synthesized PEGylated PEI-entrapped AuNPs (Au PENPs) were characterized via different methods. Our results reveal that the synthesized Au PENPs can be tuned to have an Au core size in a range of 1.9-4.6 nm and to be water-soluble, stable, and noncytotoxic in a studied concentration range. With a demonstrated better X-ray attenuation property than that of clinically used iodinated small molecular contrast agent (e.g., Omnipaque) and the prolonged half-decay time (11.2 h in rat) confirmed by pharmacokinetics studies, the developed PEGylated Au PENPs enabled efficient and enhanced blood pool CT imaging with imaging time up to 75 min. Likewise, thanks to the enhanced permeability and retention effect, the PEGylated Au PENPs were also able to be used as a contrast agent for effective CT imaging of a tumor model. With the proven organ biocompatibility by histological studies, the designed PEGylated Au PENPs may hold great promise to be used as contrast agents for CT imaging of a variety of biological systems. The significance of this study is that rather than the use of dendrimers as templates, cost-effective branched polymers (e.g., PEI) can be used as templates to generate functionalized AuNPs for CT imaging applications.

  12. 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.

  13. 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.

  14. Imaging of pulmonary embolism and t-PA therapy effects using MDCT and liposomal iohexol blood pool agent: preliminary results in a rabbit model.

    PubMed

    Burke, Stephen J; Annapragada, Ananth; Hoffman, Eric A; Chen, Emmanuel; Ghaghada, Ketan B; Sieren, Jered; van Beek, Edwin J R

    2007-03-01

    Polyethylene glycol-coated liposomal blood pool contrast agents maintain contrast enhancement over several hours. This study aimed to evaluate (long-term) imaging of pulmonary arteries, comparing conventional iodinated contrast with a liposomal blood pool contrast agent. Also, visualization of the (real-time) therapeutic effects of tissue plasminogen activator (t-PA) on pulmonary embolism (PE) was attempted. Six rabbits (weight approximately 4 kg) had autologous blood clots injected through the superior vena cava. Imaging was performed using conventional contrast (iohexol, 350 mg I/ml; GE HealthCare, Princeton, NJ) at a dose of 1400 mg I per animal, and after wash-out, animals were imaged using an iodinated liposomal blood pool agent (88 mg I/mL, dose 900 mg I/animal). Subsequently, five animals were injected with 2 mg of t-PA and imaging continued for up to 4(1/2) hours. Both contrast agents identified PE in the pulmonary trunk and main pulmonary arteries in all rabbits. Liposomal blood pool agent yielded uniform enhancement, which remained relatively constant throughout the experiments. Conventional agents exhibited nonuniform opacification and rapid clearance postinjection. Three of six rabbits had mistimed bolus injections, requiring repeat injections. Following t-PA, pulmonary embolus volume (central to segmental) decreased in four of five treated rabbits (range 10-57%, mean 42%). One animal showed no response to t-PA. Liposomal blood pool agents effectively identified acute PE without need for reinjection. PE resolution following t-PA was quantifiable over several hours. Blood pool agents offer the potential for repeated imaging procedures without need for repeated (nephrotoxic) contrast injections.

  15. Imaging of pulmonary embolism and t-PA therapy effects using MDCT and liposomal iohexol blood pool agent – preliminary results in a rabbit model

    PubMed Central

    Burke, Stephen J; Annapragada, Ananth; Hoffman, Eric A; Chen, Emmanuel; Ghaghada, Ketan B; Sieren, Jered; van Beek, Edwin JR

    2007-01-01

    Hypothesis and Objectives PEGylated liposomal blood pool contrast agents maintain contrast enhancement over several hours. This study aimed to evaluate (long-term) imaging of pulmonary arteries, comparing conventional iodinated contrast with a liposomal blood pool contrast agent. Secondly, visualization of the (real-time) therapeutic effects of tissue-Plasminogen Activator (t-PA) on pulmonary embolism (PE) was attempted. Materials and Methods Six rabbits (approximate 4 kg weight) had autologous blood clots injected through the superior vena cava. Imaging was performed using conventional contrast (iohexol, 350 mg I/ml, GE HealthCare, Princeton, NJ) at a dose of 1400 mgI per animal and after wash-out, animals were imaged using an iodinated liposomal blood pool agent (88 mg I/mL, dose 900 mgI/animal). Subsequently, five animals were injected with 2mg t-PA and imaging continued for up to 4 ½ hours. Results Both contrast agents identified PE in the pulmonary trunk and main pulmonary arteries in all rabbits. Liposomal blood pool agent yielded uniform enhancement, which remained relatively constant throughout the experiments. Conventional agents exhibited non uniform opacification and rapid clearance post injection. Three out of six rabbits had mistimed bolus injections, requiring repeat injections. Following t-PA, Pulmonary embolus volume (central to segmental) decreased in four of five treated rabbits (range 10–57%, mean 42%). One animal showed no response to t-PA. Conclusions Liposomal blood pool agents effectively identified acute PE without need for re-injection. PE resolution following t-PA was quantifiable over several hours. Blood pool agents offer the potential for repeated imaging procedures without need for repeated (nephrotoxic) contrast injections. PMID:17307669

  16. Radionuclide angiography and blood pool imaging to assess skin ulcer healing prognosis in patients with peripheral vascular disease

    SciTech Connect

    Alazraki, N.; Lawrence, P.F.; Syverud, J.B.

    1984-01-01

    Several non-invasive diagnostic techniques including segmental limb blood pressures, skin fluoresence, and photo plethysmography, have been evaluated as predictors of skin ulcer healing in patients with peripheral vascular disease, but none are widely used. Using 20mCi of Tc-99m phosphate compounds, four phase bone scans were obtained, including (1) radionuclide angiogram (2) blood pool image (3) 2 hour and 4-6 hour static images and (4) 24 hour static delayed images. The first two phases were used to assess vacularity to the region of distal extremity ulceration; the last two phases evaluated presence or absence of osteomyelitis. Studies were performed in 30 patients with non-healing ulcers of the lower extremities. Perfusion to the regions of ulceration on images was graded as normal, increased, or reduced with respect to the opposite (presumed normal) limb or some other normal reference area. Hypervascular response was interpreted as good prognosis for healing unless osteomyelitis was present. Clinicians followed patients for 14 days to assess limb healing with optimum care. If there was no improvement, angiography and/or surgery (reconstructive surgery, sympathectomy, or amputation) was done. Results showed: sensitivity for predicting ulcer healing was 94%, specificity 89%. Patients who failed to heal their ulcers showed reduced perfusion, no hypervascular response, or osteomyelitis. Microcirculatory adequacy for ulcer healing appear predictable by this technique.

  17. Integrating atlas and graph cut methods for right ventricle blood-pool segmentation from cardiac cine MRI

    NASA Astrophysics Data System (ADS)

    Dangi, Shusil; Linte, Cristian A.

    2017-03-01

    Segmentation of right ventricle from cardiac MRI images can be used to build pre-operative anatomical heart models to precisely identify regions of interest during minimally invasive therapy. Furthermore, many functional parameters of right heart such as right ventricular volume, ejection fraction, myocardial mass and thickness can also be assessed from the segmented images. To obtain an accurate and computationally efficient segmentation of right ventricle from cardiac cine MRI, we propose a segmentation algorithm formulated as an energy minimization problem in a graph. Shape prior obtained by propagating label from an average atlas using affine registration is incorporated into the graph framework to overcome problems in ill-defined image regions. The optimal segmentation corresponding to the labeling with minimum energy configuration of the graph is obtained via graph-cuts and is iteratively refined to produce the final right ventricle blood pool segmentation. We quantitatively compare the segmentation results obtained from our algorithm to the provided gold-standard expert manual segmentation for 16 cine-MRI datasets available through the MICCAI 2012 Cardiac MR Right Ventricle Segmentation Challenge according to several similarity metrics, including Dice coefficient, Jaccard coefficient, Hausdorff distance, and Mean absolute distance error.

  18. Detection of rejection of canine orthotopic cardiac allografts with indium-111 lymphocytes and gamma scintigraphy

    SciTech Connect

    Eisen, H.J.; Rosenbloom, M.; Laschinger, J.C.; Saffitz, J.E.; Cox, J.L.; Sobel, B.E.; Bolman, R.M. III; Bergmann, S.R.

    1988-07-01

    Previous studies have demonstrated the feasibility of detecting canine heterotopic cardiac allograft rejection scintigraphically after administration of 111In lymphocytes. To determine whether the approach is capable of detecting rejection in orthotopic cardiac transplants in which labeled lymphocytes circulating in the blood pool may reduce sensitivity, the present study was performed in which canine orthotopic cardiac transplants were evaluated in vivo. Immunosuppression was maintained with cyclosporine A (10-20 mg/kg/day) and prednisone (1 mg/kg/day) for 2 wk after transplantation. Subsequently, therapy was tapered. Five successful allografts were evaluated scintigraphically every 3 days after administration of 100-350 microCi 111In autologous lymphocytes. Correction for labeled lymphocytes circulating in the blood pool, but not actively sequestered in the allografts was accomplished by administering 3-6 mCi 99mTc autologous erythrocytes and employing a previously validated blood-pool activity correction technique. Cardiac infiltration of labeled lymphocytes was quantified as percent indium excess (%IE), scintigraphically detectable 111In in the transplant compared with that in blood, and results were compared with those of concomitantly performed endomyocardial biopsy. Scintigraphic %IE for hearts not undergoing rejection manifest histologically was 0.7 +/- 0.4. Percent IE for rejecting hearts was 6.8 +/- 4.0 (p less than 0.05). Scintigraphy detected each episode of rejection detected by biopsy. Scintigraphic criteria for rejection (%IE greater than 2 s.d. above normal) were not manifest in any study in which biopsies did not show rejection. Since scintigraphic results with 111In-labeled lymphocytes were concordant with biopsy results in orthotopic cardiac transplants, noninvasive detection of graft rejection in patients should be attainable with the approach developed.

  19. Bone scintigraphy elucidates different metabolic stages of melorheostosis

    PubMed Central

    Izadyar, Sina; Gholamrezanezhad, Ali

    2012-01-01

    Melorheostosis is a rare benign non-hereditary sclerosing dysplasia involving the bone, often in a sclerotomal distribution. we report the case of a 27 years old lady with painful swelling of the left hand and forearm lasting for almost 15 years. The patient experienced aggravation of symptoms and limitation of motion during the past two months. Radiographic assessment revealed hyperostosis involving the left 3rd and 4th metacarpal bones and corresponding digits as well as the left ulna and distal humerus, with no soft tissue ossification. Angiographic and blood pool images of bone scintigraphy showed increased activity of mid-metacarpal region, corresponding to the sclerotom C-8. Delayed static views showed increased radiotracer uptake of the left 4th metacarpal bone and the corresponding digit as well as the left ulna and humerus, but no abnormal osteoblastic activity of the 3rd left metacarpal and digit. Histopathologic assessment confirmed the diagnosis of Melorheostosis. The case confirms that even in the same sclerotomal distribution, the multiple foci of involvement can present in different metabolic stages. In fact, the disease does not progress uniformly and different lesions can be seen in dissimilar stages of activity. Hence, metabolic imaging can be important to unmask which of the radiographically detected bony lesions are metabolically active and have the potential to be the source of current patient's symptoms and which of them are old, metabolically inactive and silent lesions, which are not clinically relevant to the patient's complaints. PMID:22514755

  20. Bone scintigraphy elucidates different metabolic stages of melorheostosis.

    PubMed

    Izadyar, Sina; Gholamrezanezhad, Ali

    2012-01-01

    Melorheostosis is a rare benign non-hereditary sclerosing dysplasia involving the bone, often in a sclerotomal distribution. we report the case of a 27 years old lady with painful swelling of the left hand and forearm lasting for almost 15 years. The patient experienced aggravation of symptoms and limitation of motion during the past two months. Radiographic assessment revealed hyperostosis involving the left 3(rd) and 4(th) metacarpal bones and corresponding digits as well as the left ulna and distal humerus, with no soft tissue ossification. Angiographic and blood pool images of bone scintigraphy showed increased activity of mid-metacarpal region, corresponding to the sclerotom C-8. Delayed static views showed increased radiotracer uptake of the left 4(th) metacarpal bone and the corresponding digit as well as the left ulna and humerus, but no abnormal osteoblastic activity of the 3(rd) left metacarpal and digit. Histopathologic assessment confirmed the diagnosis of Melorheostosis. The case confirms that even in the same sclerotomal distribution, the multiple foci of involvement can present in different metabolic stages. In fact, the disease does not progress uniformly and different lesions can be seen in dissimilar stages of activity. Hence, metabolic imaging can be important to unmask which of the radiographically detected bony lesions are metabolically active and have the potential to be the source of current patient's symptoms and which of them are old, metabolically inactive and silent lesions, which are not clinically relevant to the patient's complaints.

  1. 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.

  2. Dynamic esophageal scintigraphy

    SciTech Connect

    Reilley, J.J.; Malmud, L.S.; Fisher, R.S.; Applegate, G.; DeVegvar, M.L.

    1982-06-01

    Esophageal scintigraphy was developed in order to quantitatively evaluate esophageal transit in patients with a variety of esophageal disorders. The study is performed with orally administered technetium-99m sulfur colloid in water, using a gamma camera on-line to a digital computer. Esophageal transit is expressed as the percent emptying for each of the first 15-sec intervals for 10 min after an initial swallow and at 15-sec intervals after serial swallows. Esophageal transit is significantly decreased in patients with motor disorders of the esophagus, compared to normal controls. In patients with reflux esophagitis, esophageal transit was abnormal when the reflux disease was accompanied by abnormal motor function. The technique we describe is the first quantitative test of esophageal function; it is a useful, sensitive, scintigraphic technique for evaluation of esophageal transit.

  3. High-Resolution Magnetic Resonance Angiography in the Mouse Using a Nanoparticle Blood-Pool Contrast Agent

    PubMed Central

    Howles, Gabriel P.; Ghaghada, Ketan B.; Qi, Yi; Mukundan, Srinivasan; Johnson, G. Allan

    2009-01-01

    High-resolution magnetic resonance angiography is already a useful tool for studying mouse models of human disease. Magnetic resonance angiography in the mouse is typically performed using time-of-flight) contrast. In this work, a new long-circulating blood-pool contrast agent—a liposomal nanoparticle with surface-conjugated gadolinium (SC-Gd liposomes)—was evaluated for use in mouse neurovascular magnetic resonance angiography. A total of 12 mice were imaged. Scan parameters were optimized for both time-of-flight and SC-Gd contrast. Compared to time-of-flight contrast, SC-Gd liposomes (0.08 mmol/kg) enabled improved small-vessel contrast-to-noise ratio, larger field of view, shorter scan time, and imaging of venous structures. For a limited field of view, time-of-flight and SC-Gd were not significantly different; however, SC-Gd provided better contrast-to-noise ratio when the field of view encompassed the whole brain (P < 0.001) or the whole neurovascular axis (P < 0.001). SC-Gd allowed acquisition of high-resolution magnetic resonance angiography (52 × 52 × 100 micrometer3 or 0.27 nL), with 123% higher (P < 0.001) contrast-to-noise ratio in comparable scan time (~45 min). Alternatively, SC-Gd liposomes could be used to acquire high-resolution magnetic resonance angiography (0.27 nL) with 32% higher contrast-to-noise ratio (P < 0.001) in 75% shorter scan time (12 min). PMID:19902507

  4. Gd complexes of macrocyclic diethylenetriaminepentaacetic acid (DTPA) biphenyl-2,2'-bisamides as strong blood-pool magnetic resonance imaging contrast agents.

    PubMed

    Jung, Ki-Hye; Kim, Hee-Kyung; Lee, Gang Ho; Kang, Duk-Sik; Park, Ji-Ae; Kim, Kyeong Min; Chang, Yongmin; Kim, Tae-Jeong

    2011-08-11

    We report the synthesis of macrocyclic DTPA conjugates of 2,2'-diaminobiphenyl and their Gd complexes of the type [Gd(L)(H(2)O)]·xH(2)O (2a,b; L = 1a,b) for use as new MRI blood-pool contrast agents (MRI BPCAs). Pharmacokinetic inertness of 2 compares well with those of analogous Gd-DTPA MRI CAs currently in use. The present system also shows very high stability in human serum. The R(1) relaxivity reaches 10.9 mM(-1) s(-1), which is approximately 3 times as high as that of structurally related Gd-DOTA (R(1) = 3.7 mM(-1) s(-1)). The R(1) relaxivity in HSA goes up to 37.2 mM(-1) s(-1), which is almost twice as high as that of MS-325, a leading BPCA, demonstrating a strong blood pool effect. The in vivo MR images of mice obtained with 2b are coherent, showing strong signal enhancement in heart, abdominal aorta, and small vessels. Even the brain tumor is vividly enhanced for an extended period of time. The structural uniqueness of 2 is that it is neutral in charge and thus makes no resort to electrostatic interaction, supposedly one of the essential factors for the blood-pool effect.

  5. Pulmonary Hemorrhage: Imaging with a New Magnetic Resonance Blood Pool Agent in Conjunction with Breathheld Three-Dimensional Magnetic Resonance Angiography

    SciTech Connect

    Weishaupt, Dominik; Hilfiker, Paul R.; Schmidt, Michaela; Debatin, Joerg F.

    1999-07-15

    Purpose: To describe the three-dimensional magnetic resonance angiography (3D MRA) imaging appearance of the pulmonary arteries following administration of a superparamagnetic iron oxide blood pool agent to human volunteers, and to demonstrate in an animal model (pigs) how this technique can be used to detect pulmonary parenchymal hemorrhage. Methods: Two volunteers were examined following the intravenous administration of a superparamagnetic iron oxide blood pool agent (NC100150 Injection, Nycomed Amersham Imaging, Wayne, PA, USA). T1-weighted 3D gradient recalled echo (GRE) image sets (TR/TE 5.1/1.4 msec, flip angle 30 deg.) were acquired breathheld over 24 sec. To assess the detectability of pulmonary bleeding with intravascular MR contrast, pulmonary parenchymal injuries were created in two animals under general anesthesia, and fast T1-weighted 3D GRE image sets collected before and after the injury. Results: Administration of the intravascular contrast in the two volunteers resulted in selective enhancement of the pulmonary vasculature permitting complete visualization and excellent delineation of central, segmental, and subsegmental arteries. Following iatrogenic injury in the two animals, pulmonary hemorrhage was readily detected on the 3D image sets. Conclusion: The data presented illustrate that ultrafast 3D GRE MR imaging in conjunction with an intravenously administered intravascular blood pool agent can be used to perform high-quality pulmonary MRA as well as to detect pulmonary hemorrhage.

  6. Pre-clinical evaluation of a nanoparticle-based blood-pool contrast agent for MR imaging of the placenta.

    PubMed

    Ghaghada, Ketan B; Starosolski, Zbigniew A; Bhayana, Saakshi; Stupin, Igor; Patel, Chandreshkumar V; Bhavane, Rohan C; Gao, Haijun; Bednov, Andrey; Yallampalli, Chandrasekhar; Belfort, Michael; George, Verghese; Annapragada, Ananth V

    2017-09-01

    Non-invasive 3D imaging that enables clear visualization of placental margins is of interest in the accurate diagnosis of placental pathologies. This study investigated if contrast-enhanced MRI performed using a liposomal gadolinium blood-pool contrast agent (liposomal-Gd) enables clear visualization of the placental margins and the placental-myometrial interface (retroplacental space). Non-contrast MRI and contrast-enhanced MRI using a clinically approved conventional contrast agent were used as comparators. Studies were performed in pregnant rats under an approved protocol. MRI was performed at 1T using a permanent magnet small animal scanner. Pre-contrast and post-liposomal-Gd contrast images were acquired using T1-weighted and T2-weighted sequences. Dynamic Contrast enhanced MRI (DCE-MRI) was performed using gadoterate meglumine (Gd-DOTA, Dotarem(®)). Visualization of the retroplacental clear space, a marker of normal placentation, was judged by a trained radiologist. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated for both single and averaged acquisitions. Images were reviewed by a radiologist and scored for the visualization of placental features. Contrast-enhanced CT (CE-CT) imaging using a liposomal CT agent was performed for confirmation of the MR findings. Transplacental transport of liposomal-Gd was evaluated by post-mortem elemental analysis of tissues. Ex-vivo studies in perfused human placentae from normal, GDM, and IUGR pregnancies evaluated the transport of liposomal agent across the human placental barrier. Post-contrast T1w images acquired with liposomal-Gd demonstrated significantly higher SNR (p = 0.0002) in the placenta compared to pre-contrast images (28.0 ± 4.7 vs. 6.9 ± 1.8). No significant differences (p = 0.39) were noted between SNR in pre-contrast and post-contrast liposomal-Gd images of the amniotic fluid, indicating absence of transplacental passage of the agent. The placental margins were

  7. Dipyridamole thallium-201 myocardial scintigraphy

    SciTech Connect

    Not Available

    1988-09-01

    Thallium-201 (/sup 201/Tl) myocardial scintigraphy is a sensitive technique for detecting coronary artery disease. Standardized exercise testing is the most common method for inducing myocardial stress for /sup 201/Tl imaging. Unfortunately, a significant number of patients are unable to undergo adequate treadmill or bicycle exercise. In these patients, pharmacologic stress with dipyridamole provides a safe, efficacious, and reliable alternative.

  8. 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.

  9. 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

  10. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach

    PubMed Central

    Jung, Caroline; Kaul, Michael Gerhard; Werner, Franziska; Them, Kolja; Reimer, Rudolph; Nielsen, Peter; vom Scheidt, Annika; Adam, Gerhard; Knopp, Tobias; Ittrich, Harald

    2016-01-01

    Purpose In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI) / magnetic resonance imaging (MRI) road map approach and an MPI-guided approach using a blood pool tracer. Materials and Methods A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superparamagnetic iron oxide nanoparticles (MM4) was equipped with bimodal fiducial markers for co-registration in preclinical 7T MRI and MPI. In-vitro angioplasty was performed inflating the balloon with saline or MM4. MPI data were acquired using a field of view of 37.3×37.3×18.6 mm3 and a frame rate of 46 volumes/sec. Analysis of the magnetic lacquer-marks on the devices were performed with electron microscopy, atomic absorption spectrometry and micro-computed tomography. Results Magnetic marks allowed for MPI/MRI guidance of interventional devices. Bimodal fiducial markers enable MPI/MRI image fusion for MRI based roadmapping. MRI roadmapping and the blood pool tracer approach facilitate MPI real time monitoring of in-vitro angioplasty. Successful angioplasty was verified with MPI and MRI. Magnetic marks consist of micrometer sized ferromagnetic plates mainly composed of iron and iron oxide. Conclusions 4D real time MP imaging, tracking and guiding of endovascular instruments and in-vitro angioplasty is feasible. In addition to an approach that requires a blood pool tracer, MRI based roadmapping might emerge as a promising tool for radiation free 4D MPI-guided interventions. PMID:27249022

  11. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach.

    PubMed

    Salamon, Johannes; Hofmann, Martin; Jung, Caroline; Kaul, Michael Gerhard; Werner, Franziska; Them, Kolja; Reimer, Rudolph; Nielsen, Peter; Vom Scheidt, Annika; Adam, Gerhard; Knopp, Tobias; Ittrich, Harald

    2016-01-01

    In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI) / magnetic resonance imaging (MRI) road map approach and an MPI-guided approach using a blood pool tracer. A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superparamagnetic iron oxide nanoparticles (MM4) was equipped with bimodal fiducial markers for co-registration in preclinical 7T MRI and MPI. In-vitro angioplasty was performed inflating the balloon with saline or MM4. MPI data were acquired using a field of view of 37.3×37.3×18.6 mm3 and a frame rate of 46 volumes/sec. Analysis of the magnetic lacquer-marks on the devices were performed with electron microscopy, atomic absorption spectrometry and micro-computed tomography. Magnetic marks allowed for MPI/MRI guidance of interventional devices. Bimodal fiducial markers enable MPI/MRI image fusion for MRI based roadmapping. MRI roadmapping and the blood pool tracer approach facilitate MPI real time monitoring of in-vitro angioplasty. Successful angioplasty was verified with MPI and MRI. Magnetic marks consist of micrometer sized ferromagnetic plates mainly composed of iron and iron oxide. 4D real time MP imaging, tracking and guiding of endovascular instruments and in-vitro angioplasty is feasible. In addition to an approach that requires a blood pool tracer, MRI based roadmapping might emerge as a promising tool for radiation free 4D MPI-guided interventions.

  12. The use of hand perfusion scintigraphy to assess Raynaud's phenomenon associated with hand-arm vibration syndrome.

    PubMed

    Lee, Kyung-Ann; Chung, Hyung Woo; Lee, Sang-Heon; Kim, Hae-Rim

    2017-06-30

    This study aimed to evaluate the hand perfusion scintigraphic features of hand-arm vibration syndrome (HAVS) and to compare these with the features of primary and secondary Raynaud's phenomenon (RP) associated with systemic sclerosis (SSc). Hand perfusion scintigraphy was performed in 57 patients with primary RP, 71 patients with HAVS-related RP, and 15 patients with SSc-related RP. We calculated 6 ratios: chilled to ambient hand and wrist ratios of the first peak height, initial slope, and blood pool uptake. We analysed 3 morphologic characteristics: slow progress pattern, paradoxically increased uptake pattern, and inhomogeneous radioactivity uptake. All of the 71 patients with HAVS-related RP were mine workers. The chilled to ambient hand ratios of the first peak height, the initial slope, and the blood pool uptake were significantly lower in patients with HAVS-related occupational RP than in patients with primary RP. The presence of a paradoxically increased uptake pattern was significantly lower in HAVS than in primary RP. There were significant differences in hand perfusion scintigraphic features between primary RP and HAVS. These results suggest that the underlying pathophysiology of the two diseases differs.

  13. [The position of scintigraphy in traumatology].

    PubMed

    Kaiser, C; Neck, K; Ritter, R; Glanzmann, C; Schwarz, H

    1978-12-01

    A report on the findings of skeletal scintigraphy in 80 cases of traumatic bone lesions is discussed. After a short survey on the physiological process in the activity ensilage, the assertion of the scintigraphy is compared to the X-ray. The indication which has been approved in practice is discussed and described. In correct indication scintigraphy is a valuable diagnostic measure and it may influence the procedure.

  14. Polyphosphoric acid capping radioactive/upconverting NaLuF4:Yb,Tm,153Sm nanoparticles for blood pool imaging in vivo.

    PubMed

    Peng, Juanjuan; Sun, Yun; Zhao, Lingzhi; Wu, Yongquan; Feng, Wei; Gao, Yanhong; Li, Fuyou

    2013-12-01

    Nanoparticles that circulate in the bloodstream for a prolonged period of time have important biomedicine applications. However, no example of lanthanide-based nanoparticles having a long-term circulation bloodstream has been reported to date. Herein, we report on difunctional radioactive and upconversion nanoparticles (UCNP) coated with polyphosphoric acid ligand, that is ethylenediamine tetramethylenephosphonic acid (EDTMP), for an application in single-photon emission computed tomography (SPECT) blood pool imaging. The structure, size and zeta-potential of the EDTMP-coated nanoparticles (EDTMP-UCNP) are verified using transmission electron microscopy and dynamic light scattering. Injection of radioisotope samarium-153-labeled EDTMP-UCNP (EDTMP-UCNP:(153)Sm) into mice reveal superior circulation time compared to control nanoparticles coated with citric acid (cit-UCNP:(153)Sm) and (153)Sm complex of EDTMP (EDTMP-(153)Sm). The mechanism for the extended circulation time may be attributed to the adhesion of EDTMP-UCNP on the membrane of red blood cells (RBCs). In vivo toxicity results show no toxicity of EDTMP-UCNP at the dose of 100 mg/kg, validating its safety as an agent for blood pool imaging. Our results provide a new strategy of nanoprobe for a long-term circulation bloodstream by introducing polyphosphoric acid as surface ligand. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Three-dimensional MR pulmonary perfusion imaging and angiography with an injection of a new blood pool contrast agent B-22956/1.

    PubMed

    Zheng, J; Carr, J; Harris, K; Saker, M B; Cavagna, F M; Maggioni, F; Laub, G; Li, D; Finn, J P

    2001-10-01

    Initial evaluation of a new blood pool agent, B-22956/1, for pulmonary imaging was performed in five domestic pigs with artificial embolism. Pre-embolism 3D pulmonary perfusion images were first acquired by injecting an extravascular agent, gadoteridol. The pulmonary arteries of the pigs were then occluded by the artificial emboli. Post-embolism perfusion scans were subsequently performed by injecting B-22956/1. Additional post-embolism high-spatial-resolution angiograms were also acquired. Parenchyma perfusion deficits were well depicted in the post-embolism perfusion maps. The post-embolism angiography clearly revealed the location and extent of the filling defects in the pulmonary vessels. Signal intensities of perfusion maps on the normal parenchyma were significantly improved (30%) by using B-22956/1, in comparison with perfusion images using gadoteridol (P < 0.01). Many pulmonary angiograms with approximately equal contrast could be obtained even at 22 minutes after the injection of B-22956/1. Our initial results indicate that blood pool agent B-22956/1 may provide opportunities for whole-lung-coverage perfusion mapping and additional high-resolution target angiograms after a single injection.

  16. Gd-AAZTA-MADEC, an improved blood pool agent for DCE-MRI studies on mice on 1 T scanners.

    PubMed

    Longo, Dario Livio; Arena, Francesca; Consolino, Lorena; Minazzi, Paolo; Geninatti-Crich, Simonetta; Giovenzana, Giovanni Battista; Aime, Silvio

    2016-01-01

    A novel MRI blood-pool contrast agent (Gd-AAZTA-MADEC) has been compared with established blood pool agents for tumor contrast enhanced images and angiography. Synthesis, relaxometric properties, albumin binding affinity and pharmacokinetic profiles are reported. For in vivo studies, angiographic images and tumor contrast enhanced images were acquired on mice with benchtop 1T-MRI scanners and compared with MS-325, B22956/1 and B25716/1. The design of this contrast agent involved the elongation of the spacer between the targeting deoxycholic acid moiety and the Gd-AAZTA imaging reporting unit that drastically changed either the binding affinity to albumin (KA(HSA) = 8.3 × 10(5) M(-1)) and the hydration state of the Gd ion (q = 2) in comparison to the recently reported B25716/1. The very markedly high binding affinity towards mouse and human serum albumins resulted in peculiar pharmacokinetics and relaxometric properties. The NMRD profiles clearly indicated that maximum efficiency is attainable at magnetic field strength of 1 T. In vivo studies showed high enhancement of the vasculature and a prolonged accumulation inside tumor. The herein reported pre-clinical imaging studies show that a great benefit arises from the combination of a benchtop MRI scanner operating at 1 T and the albumin-binding Gd-AAZTA-MADEC complex, for pursuing enhanced angiography and improved characterization of tumor vascular microenvironment.

  17. Quantitative dynamic contrast enhanced MRI of experimental synovitis in the rabbit knee: comparison of macromolecular blood pool agents vs. Gadolinium-DOTA.

    PubMed

    Watrin-Pinzano, Astrid; Loeuille, Damien; Goebel, Jean-Christophe; Lapicque, Françoise; Walter, Fredéric; Robert, Philippe; Netter, Patrick; Corot, Claire; Gillet, Pierre; Blum, Alain

    2008-01-01

    The purpose of this study was to assess 2 Gd-based macromolecular intravascular contrast agents (P792, rapid clearance blood pool agent (rBPA) and P717, slow clearance blood pool agent (sBPA)) compared to Gd-DOTA (representative extracellular non specific agent) in MR imaging of knee rabbit experimental synovitis. Quantitative dynamic contrast enhanced MRI (qDCE-MRI) after intravascular injection of a low molecular weight contrast agent of 0.56 kDa (Gd-DOTA) and 2 high-molecular-weight contrast agents of 6.47 kDa (P792) and 52 kDa (P717) was performed in rabbits with carrageenan-induced synovitis of the right knee. P792 and P717 provided a progressive and persistent enhancement of arthritic synovial tissue while Gd-DOTA provided an early and rapidly declining enhancement with a concomitant diffusion in synovial fluid, thus limitating delineation of synovial pannus. P792 allowed acquisition of high-quality MR arthrograms, due to both a better diffusion in synovial pannus (vs. P717) and a concomitant restricted diffusion into the synovial fluid (vs. Gd-DOTA). In fact, experimental rabbit synovitis represent a specific entity that favors the T1 effect of high-molecular-weight agents, and especially rBPA P792, entrapped in synovial pannus, without diffusion in the synovial fluid. Due to this lack of arthrographic effect, P792 accumulation could be specifically sequentially analyzed by qDCE-MRI for detecting, characterizing and monitoring synovial vascular permeability changes during mono- or polysynovitis.

  18. 3D pulmonary perfusion MRI and MR angiography of pulmonary embolism in pigs after a single injection of a blood pool MR contrast agent.

    PubMed

    Fink, Christian; Ley, Sebastian; Puderbach, Michael; Plathow, Christian; Bock, Michael; Kauczor, Hans-Ulrich

    2004-07-01

    The purpose of this study was to assess the feasibility of contrast-enhanced 3D perfusion MRI and MR angiography (MRA) of pulmonary embolism (PE) in pigs using a single injection of the blood pool contrast Gadomer. PE was induced in five domestic pigs by injection of autologous blood thrombi. Contrast-enhanced first-pass 3D perfusion MRI (TE/TR/FA: 1.0 ms/2.2 ms/40 degrees; voxel size: 1.3 x 2.5 x 4.0 mm3; TA: 1.8 s per data set) and high-resolution 3D MRA (TE/TR/FA: 1.4 ms/3.4 ms/40 degrees; voxel size: 0.8 x 1.0 x 1.6 mm3) was performed during and after a single injection of 0.1 mmol/kg body weight of Gadomer. Image data were compared to pre-embolism Gd-DTPA-enhanced MRI and post-embolism thin-section multislice CT (n = 2). SNR measurements were performed in the pulmonary arteries and lung. One animal died after induction of PE. In all other animals, perfusion MRI and MRA could be acquired after a single injection of Gadomer. At perfusion MRI, PE could be detected by typical wedge-shaped perfusion defects. While the visualization of central PE at MRA correlated well with the CT, peripheral PE were only visualized by CT. Gadomer achieved a higher peak SNR of the lungs compared to Gd-DTPA (21 +/- 8 vs. 13 +/- 3). Contrast-enhanced 3D perfusion MRI and MRA of PE can be combined using a single injection of the blood pool contrast agent Gadomer.

  19. Synthesis and evaluation of a polydisulfide with Gd-DOTA monoamide side chains as a biodegradable macromolecular contrast agent for MR blood pool imaging.

    PubMed

    Ye, Zhen; Wu, Xueming; Tan, Mingqian; Jesberger, Jack; Grisworld, Mark; Lu, Zheng-Rong

    2013-01-01

    Macromolecular Gd(III)-based contrast agents are effective for contrast-enhanced blood pool and cancer MRI in preclinical studies. However, their clinical applications are impeded by potential safety concerns associated with slow excretion and prolonged retention of these agents in the body. To minimize the safety concerns of macromolecular Gd contrast agents, we have developed biodegradable macromolecular Gd contrast agents based on polydisulfide Gd(III) complexes. In this study, we designed and synthesized a new generation of the polydisulfide Gd(III) complexes containing a macrocyclic Gd(III) chelate, Gd-DOTA monoamide, to improve the in vivo kinetic inertness of the Gd(III) chelates. (N6-Lysyl)lysine-(Gd-DOTA) monoamide and 3-(2-carboxyethyldisulfanyl)propanoic acid copolymers (GODC) were synthesized by copolymerization of (N6-lysyl)lysine DOTA monoamide and dithiobis(succinimidylpropionate), followed by complexation with Gd(OAc)3. The GODC had an apparent molecular weight of 26.4 kDa and T1 relaxivity of 8.25 mM(-1) s(-1) per Gd at 1.5 T. The polymer chains of GODC were readily cleaved by L-cysteine and the chelates had high kinetic stability against transmetallation in the presence of an endogenous metal ion Zn(2+). In vivo MRI study showed that GODC produced strong and prolonged contrast enhancement in the vasculature and tumor periphery of mice with breast tumor xenografts. GODC is a promising biodegradable macromolecular MRI contrast agent with high kinetic stability for MR blood pool imaging.

  20. 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.

  1. Validation of Perfusion Quantification with 3D Gradient Echo Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using a Blood Pool Contrast Agent in Skeletal Swine Muscle.

    PubMed

    Hindel, Stefan; Sauerbrey, Anika; Maaß, Marc; Maderwald, Stefan; Schlamann, Marc; Lüdemann, Lutz

    2015-01-01

    The purpose of our study was to validate perfusion quantification in a low-perfused tissue by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with shared k-space sampling using a blood pool contrast agent. Perfusion measurements were performed in a total of seven female pigs. An ultrasonic Doppler probe was attached to the right femoral artery to determine total flow in the hind leg musculature. The femoral artery was catheterized for continuous local administration of adenosine to increase blood flow up to four times the baseline level. Three different stable perfusion levels were induced. The MR protocol included a 3D gradient-echo sequence with a temporal resolution of approximately 1.5 seconds. Before each dynamic sequence, static MR images were acquired with flip angles of 5°, 10°, 20°, and 30°. Both static and dynamic images were used to generate relaxation rate and baseline magnetization maps with a flip angle method. 0.1 mL/kg body weight of blood pool contrast medium was injected via a central venous catheter at a flow rate of 5 mL/s. The right hind leg was segmented in 3D into medial, cranial, lateral, and pelvic thigh muscles, lower leg, bones, skin, and fat. The arterial input function (AIF) was measured in the aorta. Perfusion of the different anatomic regions was calculated using a one- and a two-compartment model with delay- and dispersion-corrected AIFs. The F-test for model comparison was used to decide whether to use the results of the one- or two-compartment model fit. Total flow was calculated by integrating volume-weighted perfusion values over the whole measured region. The resulting values of delay, dispersion, blood volume, mean transit time, and flow were all in physiologically and physically reasonable ranges. In 107 of 160 ROIs, the blood signal was separated, using a two-compartment model, into a capillary and an arteriolar signal contribution, decided by the F-test. Overall flow in hind leg muscles, as measured by the

  2. Validation of Perfusion Quantification with 3D Gradient Echo Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using a Blood Pool Contrast Agent in Skeletal Swine Muscle

    PubMed Central

    Hindel, Stefan; Sauerbrey, Anika; Maaß, Marc; Maderwald, Stefan; Schlamann, Marc; Lüdemann, Lutz

    2015-01-01

    The purpose of our study was to validate perfusion quantification in a low-perfused tissue by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with shared k-space sampling using a blood pool contrast agent. Perfusion measurements were performed in a total of seven female pigs. An ultrasonic Doppler probe was attached to the right femoral artery to determine total flow in the hind leg musculature. The femoral artery was catheterized for continuous local administration of adenosine to increase blood flow up to four times the baseline level. Three different stable perfusion levels were induced. The MR protocol included a 3D gradient-echo sequence with a temporal resolution of approximately 1.5 seconds. Before each dynamic sequence, static MR images were acquired with flip angles of 5°, 10°, 20°, and 30°. Both static and dynamic images were used to generate relaxation rate and baseline magnetization maps with a flip angle method. 0.1 mL/kg body weight of blood pool contrast medium was injected via a central venous catheter at a flow rate of 5 mL/s. The right hind leg was segmented in 3D into medial, cranial, lateral, and pelvic thigh muscles, lower leg, bones, skin, and fat. The arterial input function (AIF) was measured in the aorta. Perfusion of the different anatomic regions was calculated using a one- and a two-compartment model with delay- and dispersion-corrected AIFs. The F-test for model comparison was used to decide whether to use the results of the one- or two-compartment model fit. Total flow was calculated by integrating volume-weighted perfusion values over the whole measured region. The resulting values of delay, dispersion, blood volume, mean transit time, and flow were all in physiologically and physically reasonable ranges. In 107 of 160 ROIs, the blood signal was separated, using a two-compartment model, into a capillary and an arteriolar signal contribution, decided by the F-test. Overall flow in hind leg muscles, as measured by the

  3. Cardiac magnetic resonance angiography using blood-pool contrast agents: comparison of citrate-coated very small superparamagnetic iron oxide particles with gadofosveset trisodium in pigs.

    PubMed

    Schnorr, J; Taupitz, M; Schellenberger, E A; Warmuth, C; Fahlenkamp, U L; Wagner, S; Kaufels, N; Wagner, M

    2012-02-01

    To compare citrate-coated very small superparamagnetic iron oxide particles (VSOP) with gadofosveset trisodium as blood pool contrast agents for cardiac magnetic resonance angiography (CMRA) in pigs. Animal experiments were approved by the responsible authority. 10 CMRA-like examinations were performed at 1.5 T after administration of VSOP (0.06  mmol Fe/kg; 5 examinations) and gadofosveset trisodium (0.03  mmol Gd/kg; 5 examinations). The CMRA protocol included ECG-gated inversion-recovery-prepared T1-weighted gradient echo imaging (IR-GRE; one slice) and ECG-gated inversion recovery prepared steady state free precession imaging (IR SSFP; one slice) before and 1, 3, 5, 10, 15, 20, 25, 30, 40, 50, and 60  min after injection. At each time point, three different inversion times (TI; 200  msec, 300  msec, and 400  msec) were applied. Contrast-to-noise ratios (CNR) between blood and myocardium were calculated and compared using mixed linear models. No significant differences of CNR were found between IR-GRE and IR SSFP. At 3 and 5  min after contrast agent administration, VSOP showed a significantly higher CNR than gadofosveset trisodium when TI of 200  msec and 300 msec were applied (TI of 200  msec at 3 min: 8.2 ± 0.7 vs. 5.4 ± 0.7; TI of 200  msec at 5 min: 7.9 ± 0.7 vs. 3.5 ± 0.8; TI of 300  msec at 3  min: 11.7 ± 0.7 vs. 8.8 ± 0.8; TI of 300  msec at 5  min: 11.4 ± 0.7 vs. 8.0 ± 0.8; p < 0.05). Moreover, significant differences in favor of VSOP were found for all time points from 10 to 40  min irrespective of TI (p < 0.05). VSOP has superior blood-pool properties compared to gadofosveset trisodium resulting in prolonged improvement of CNR on CMRA. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Diagnostic accuracy of colour Doppler ultrasonography, CT angiography and blood-pool-enhanced MR angiography in assessing carotid stenosis: a comparative study with DSA in 170 patients.

    PubMed

    Anzidei, M; Napoli, A; Zaccagna, F; Di Paolo, P; Saba, L; Cavallo Marincola, B; Zini, C; Cartocci, G; Di Mare, L; Catalano, C; Passariello, R

    2012-02-01

    This study was undertaken to prospectively evaluate the diagnostic performance of colour Doppler ultrasonography (CDUS), first-pass (FP) and steady-state (SS) contrast-enhanced magnetic resonance angiography (MRA) and computed tomography angiography (CTA) of the carotid arteries using digital subtraction angiography (DSA) as the reference standard. A total of 170 patients with previous cerebrovascular events and suspected carotid artery stenoses underwent CDUS, blood-pool MRA, CTA and DSA. Accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for CDUS, FP MRA, SS MRA and CTA. The McNemar and Wilcoxon tests and receiver operating characteristic (ROC) curve analysis were used to determine significant differences (p<0.05) between the diagnostic performances of the four modalities, and the degree of stenosis was compared using linear regression. A total of 336 carotid bifurcations were studied. The area under the curve (AUC) for degree of stenosis was: CDUS 0.85±0.02, FP MRA 0.982±0.005, SS MRA 0.994±0.002 and CTA 0.997±0.001. AUC analysis showed no statistically significant difference between CTA and MRA (p=0.0174) and a statistically significant difference between CDUS and the other techniques (p<0.001). Plaque morphology analysis showed no significant difference between CTA and SS MRA; a significant difference was seen between CTA and SS MRA versus FP MRA (p=0.04) and CDUS (p=0.038). Plaque ulceration analysis showed a statistically significant difference between MRA and CTA (0.04< p<0.046) versus CDUS (p=0.019). CTA is the most accurate technique for evaluating carotid stenoses, with a slightly better performance than MRA (97% vs. 95% for SS MRA and 92% for FP MRA) and a greater accuracy than CDUS (97% vs. 76%). Blood-pool contrast-enhanced SS sequences offer improved evaluation of degree of stenosis and plaque morphology with accuracy substantially identical to CTA.

  5. 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.

  6. Evaluation of biliary disease by scintigraphy

    SciTech Connect

    Ram, M.D.; Hagihara, P.F.; Kim, E.E.; Coupal, J.; Griffen, W.O.

    1981-01-01

    The value of biliary scintigraphy was studied in 180 patients with suspected biliary tract disease. Most of the patients were investigated additionally by conventional techniques such as cholecystography, cholangiography and ultrasonography. It is concluded that biliary scintigraphy is a simple and safe technique for visualization of the biliary tract. It is particularly useful in the evaluation of acute cholecystitis, in patients with iodine sensitivity obstructive from nonobstructive jaundice.

  7. Detection of Type II Endoleak After Endovascular Aortic Repair: Comparison Between Magnetic Resonance Angiography and Blood-Pool Contrast Agent and Dual-Phase Computed Tomography Angiography

    SciTech Connect

    Wieners, Gero; Meyer, Frank; Halloul, Zuhir; Peters, Nils; Ruehl, Ricarda; Dudeck, Oliver; Tautenhahn, Joerg; Ricke, Jens; Pech, Maciej

    2010-12-15

    PurposeThis prospective study was designed to assess the diagnostic value of magnetic resonance angiography (MRA) with blood-pool contrast agent (gadofosveset) in the detection of type-II endoleak after endovascular aortic repair (EVAR).MethodsThirty-two patients with aortic aneurysms who had undergone EVAR were included in this study. All patients were examined by dual-phase computed tomography angiography (CTA) as well as MRA with gadofosveset in the first-pass and steady-state phases. Two independent readers evaluated the images of CTA and MRA in terms of endoleak type II, feeding vessel, and image quality.ResultsMedian follow-up-time after EVAR was 22 months (range 4 to 59). Endoleak type II was detected by CTA in 12 of 32 patients (37.5%); MRA detected endoleak in all of these patients as well as in another 9 patients (n = 21, 65.6%), of whom the endoleaks in 6 patients showed an increasing diameter. Most endoleaks were detected in the steady-state phase (n = 14). The decrease in diameter of the aneurysmal sac was significantly greater in the patients without a visible endoleak that was visible on MRA (P = 0.004). In the overall estimation of diagnostic accuracy, MRA was judged superior to CTA in 66% of all examinations.ConclusionMRA with gadofosveset appeared superior to CTA, and has higher diagnostic accuracy, in the detection of endoleak after EVAR.

  8. Glomerular filtration rate in adults estimated from 123iodine-hippuran and 99mtechnetium-diethylenetriaminepenta-acetic acid gamma camera renography.

    PubMed

    Carlsen, O; Nathan, E

    1988-08-01

    In a retrospective study a close relationship was found between the rate constant for renal clearance of the radioactive indicator (lambda pk) and the glomerular filtration rate (GFR) measured by 51Cr-EDTA plasma clearance. The material comprised eighteen adult subjects submitted to 123I-hippuran gamma camera renography (IHGR) and twenty-two adult subjects to 99mTc-DTPA gamma camera renography (TDGR). The rate constant was calculated from a bi-exponential decomposition of the activity-time curve recorded within a small region of interest over the left ventricle. The total cleared renal fraction (TCRF) of the cardiac output with respect to the radioactive indicator has previously been shown to be closely related to GFR. A pooled estimate of GFR (GFRp) was calculated from the stochastically independent estimates of GFR based on lambda pk and TCRF. The comparison of GFRp with measured GFR was satisfactory and yielded substantially smaller standard deviations (SD) of GFRp than estimates based on lambda pk and TCRF separately. The standard deviations of GFRp were about 7 and 12 ml/min/1.73 m2 in IHGR for GFR equal to 50 and 100 ml/min/1.73 m2, respectively. The corresponding SD in TDGR were about 7 and 11 ml/min/1.73 m2. These standard deviations are sufficiently small for many clinical purposes and the method requires no blood samples or urine collections.

  9. 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.

  10. Technical aspects of bone scintigraphy.

    PubMed

    Brown, M L; O'Connor, M K; Hung, J C; Hayostek, R J

    1993-07-01

    Optimal bone scintigraphy is obtained by using a current generation gamma camera with a high-resolution collimator, minimizing the patient-to-collimator distance, using scatter reduction techniques where possible, and obtaining a 500,000 to 1 million count image for 40-cm field of view camera. Hard copy images from an analog or digital formatter should be optimized to display all intensities either on the same images or, when necessary, to display the low count information on one image and the high count information on another. Additional images using different collimators, such as converging or pinhole collimators, and oblique and lateral views should be obtained when necessary to demonstrate or define the pathologic area. To optimize SPECT imaging, the following parameters should be used: a high-resolution collimator, a 128 x 128 acquisition matrix, and minimum separation between the patient and the collimator, which may require the use of an elliptic orbit. Between 64 and 128 views should be obtained, and depending on preference, the planar data should be prefiltered with a Butterworth, order 8-12 and a cutoff at 0.5 Nyquist. The data should then be reconstructed using a simple ramp filter. This method provides a good technique when one is first beginning to perform bone SPECT. Attenuation correction is not generally beneficial for SPECT bone studies, although sometimes weighted backprojection may improve image contrast and resolution. Finally, the use of volume rendering may help clarify the location of suspect lesions.

  11. Rater agreement in lung scintigraphy.

    PubMed

    Christiansen, F; Andersson, T; Rydman, H; Qvarner, N; Måre, K

    1996-09-01

    The PIOPED criteria in their original and revised forms are today's standards in the interpretation of ventilation-perfusion scintigraphy. When the PIOPED criteria are used by experienced raters with training in consensus interpretation, the agreement rates have been demonstrated to be excellent. Our purpose was to investigate the rates of agreement between 2 experienced raters from different hospital who had no training in consensus interpretation. The 2 raters investigated a population of 195 patients. This group included 72 patients from a previous study who had an intermediate probability of pulmonary embolism and who had also been examined by pulmonary angiography. The results demonstrated moderate agreement rates with a kappa value of 0.54 (0.45-0.63 in a 95% confidence interval), which is similar to the kappa value of the PIOPED study but significantly lower than the kappa values of agreement rates among consensus-trained raters. There was a low consistency in the intermediate probability category, with a proportional agreement rate of 0.39 between the experienced raters. The moderate agreement rates between raters from different hospitals make it difficult to compare study populations of a certain scintigraphic category in different hospitals. Further investigations are mandatory for accurate diagnosis when the scintigrams are in the category of intermediate probability of pulmonary embolism.

  12. High-resolution blood-pool-contrast-enhanced MR angiography in glioblastoma: tumor-associated neovascularization as a biomarker for patient survival. A preliminary study.

    PubMed

    Puig, Josep; Blasco, Gerard; Daunis-I-Estadella, Josep; Alberich-Bayarri, Angel; Essig, Marco; Jain, Rajan; Remollo, Sebastián; Hernández, David; Puigdemont, Montserrat; Sánchez-González, Javier; Mateu, Gloria; Wintermark, Max; Pedraza, Salvador

    2016-01-01

    The objective of the study was to determine whether tumor-associated neovascularization on high-resolution gadofosveset-enhanced magnetic resonance angiography (MRA) is a useful biomarker for predicting survival in patients with newly diagnosed glioblastomas. Before treatment, 35 patients (25 men; mean age, 64 ± 14 years) with glioblastoma underwent MRI including first-pass dynamic susceptibility contrast (DSC) perfusion and post-contrast T1WI sequences with gadobutrol (0.1 mmol/kg) and, 48 h later, high-resolution MRA with gadofosveset (0.03 mmol/kg). Volumes of interest for contrast-enhancing lesion (CEL), non-CEL, and contralateral normal-appearing white matter were obtained, and DSC perfusion and DWI parameters were evaluated. Prognostic factors were assessed by Kaplan-Meier survival and Cox proportional hazards model. Eighteen (51.42 %) glioblastomas were hypervascular on high-resolution MRA. Hypervascular glioblastomas were associated with higher CEL volume and lower Karnofsky score. Median survival rates for patients with hypovascular and hypervascular glioblastomas treated with surgery, radiotherapy, and chemotherapy were 15 and 9.75 months, respectively (P < 0.001). Tumor-associated neovascularization was the best predictor of survival at 5.25 months (AUC = 0.794, 81.2 % sensitivity, 77.8 % specificity, 76.5 % positive predictive value, 82.4 % negative predictive value) and yielded the highest hazard ratio (P < 0.001). Tumor-associated neovascularization detected on high-resolution blood-pool-contrast-enhanced MRA of newly diagnosed glioblastoma seems to be a useful biomarker that correlates with worse survival.

  13. Coronary MR angiography using citrate-coated very small superparamagnetic iron oxide particles as blood-pool contrast agent: initial experience in humans.

    PubMed

    Wagner, Moritz; Wagner, Susanne; Schnorr, Jörg; Schellenberger, Eyk; Kivelitz, Dietmar; Krug, Lasse; Dewey, Marc; Laule, Michael; Hamm, Bernd; Taupitz, Matthias

    2011-10-01

    To evaluate very small superparamagnetic iron oxide particles (VSOP-C184) as blood-pool contrast agent for coronary MR angiography (CMRA) in humans. Six healthy volunteers and 14 patients with suspected coronary artery disease underwent CMRA after administration of VSOP-C184 at the following doses: 20 μmol Fe/kg (4 patients), 40 μmol Fe/kg (5 patients), 45 μmol Fe/kg (6 healthy volunteers), and 60 μmol Fe/kg (5 patients). In healthy volunteers, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and vessel edge definition (VED) of contrast-enhanced CMRA were compared with non-contrast-enhanced CMRA. In patients, a per-segment intention-to-diagnose evaluation of contrast-enhanced CMRA for detection of significant coronary stenosis (≥50%) was performed. Three healthy volunteers (45 μmol Fe/kg VSOP-C184) and two patients (60 μmol Fe/kg VSOP-C184) had adverse events of mild or moderate intensity. VSOP-C184 significantly increased CNR (15.1 ± 4.6 versus 6.9 ± 1.9; P = 0.010), SNR (21.7 ± 5.3 versus 15.4 ± 1.6; P = 0.048), and VED (2.3 ± 0.6 versus 1.2 ± 0.2; P < 0.001) compared with non-contrast-enhanced CMRA. In patients, contrast-enhanced CMRA yielded sensitivity, specificity, and diagnostic accuracy for detection of significant coronary stenosis of 86.7%, 71.0%, 73.1%, respectively. CMRA using VSOP-C184 was feasible and yielded moderate diagnostic accuracy for detection of significant coronary stenosis within this proof-of-concept setting. Copyright © 2011 Wiley-Liss, Inc.

  14. Qualitative and quantitative comparison of gated blood pool single photon emission computed tomography using low-energy high-resolution and SMARTZOOM collimation.

    PubMed

    Erwin, William D; Jessop, Aaron C; Mar, Martha V; Macapinlac, Homer A; Mawlawi, Osama R

    2017-01-01

    The aim of this study was to assess the feasibility of IQ-SPECT gated blood pool (MUGA) under conditions of decreased scan time (ST). Ten patients underwent routine 26-min, two-view planar, followed by LEHR and IQ-SPECT MUGA, on a Siemens dual-head Symbia scanner. Six 'back and forth' 4-min SPECT scans were summed into 4-, 8-, 12-, 16-, 20-, and 24-min equivalent scans, and reconstructed iteratively (IQ-SPECT and LEHR) and with FBP (LEHR). Uniformity, contrast, and wall motion were scored on a five-point scale. Linear regressions of left ventricular (LV) ejection fraction (EF) were performed between FBP, Flash 3D, and IQ-SPECT versus planar and Flash 3D and IQ-SPECT versus FBP. Agreement tables between Flash 3D and IQ-SPECT versus FBP LV EF were generated using a normal versus cardiotoxicity threshold of 50%. IQ-SPECT had the best scores for all STs, and 4, 8, and 16 min IQ-SPECT were judged to be similar to 24-min LEHR FBP, Flash 3D, and planar, respectively. The average LV EF correlation coefficients were 0.69, 0.71, and 0.63 between IQ-SPECT, Flash 3D, and FBP versus planar, respectively; 0.70 between IQ-SPECT and FBP; and 0.88 between Flash 3D and FBP, and all were statistically significant (P<0.05), except for 16-min FBP LEHR versus planar. Agreement tables showed diagnostic equivalence of IQ-SPECT, Flash 3D, and FBP. These preliminary results suggest that IQ-SPECT is equivalent to LEHR Flash 3D and FBP for MUGA SPECT, and better at reduced ST. A larger patient population study is necessary for a more definitive assessment.

  15. Simultaneous pancreatic-renal transplant scintigraphy

    SciTech Connect

    Shulkin, B.L.; Dafoe, D.C.; Wahl, R.L.

    1986-12-01

    99mTc-DTPA scintigraphy was evaluated in seven patients as a technique to assess perfusion of the transplanted pancreas and kidney. Such scans provide high-quality images of both organs in both the flow phase and later phases. The radionuclide is readily available and its brief effective half-life allows repeated evaluations at short intervals. /sup 131/I-hippuran, the major radiopharmaceutical for renal transplant scintigraphy, does not allow visualization of the transplanted pancreas or evaluation of its blood supply. Although the blood glucose is a gross indicator of the function of the pancreatic allograft, pancreatic scintigraphy with 99mTc-DTPA in one case was capable of detecting graft dysfunction before elevation of the blood glucose occurred. While additional studies will be necessary to determine the predictive value of this test, 99mTc-DTPA is valuable for pancreatic-renal transplant evaluation.

  16. Intraoperative scintigraphy for active small intestinal bleeding

    SciTech Connect

    Biener, A.; Palestro, C.; Lewis, B.S.; Katz, L.B. )

    1990-11-01

    Localizing active sites of bleeding within the small intestine remains a difficult task. Endoscopic, angiographic or scintigraphic studies may point to the small intestine as the site of blood loss, but at operation, without a palpable lesion, the exact site of bleeding remains elusive. Patients are managed at laparotomy with intraoperative endoscopy, angiography, multiple enterotomies, blind resections, or placement of an enterostomy. We describe two patients in whom intraoperative scintigraphy accurately identified active sites of bleeding in the small intestine when other modalities failed. Intraoperative scintigraphy is rapid, easy to perform and is an effective means of identifying active sites of bleeding within the small intestine.

  17. 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.

  18. Colovesical fistula demonstrated on renal cortical scintigraphy.

    PubMed

    Stathaki, Maria; Vamvakas, Lampros; Papadaki, Emmanouela; Papadimitraki, Elisavet; Tsaroucha, Angeliki; Karkavitsas, Nikolaos

    2012-11-01

    A 70-year-old man with a history of weight loss, changes in bowel habits, and hematochezia had rectal adenocarcinoma. He was palliated with diverting colostomy, followed by radiochemotherapy. Bilateral hydronephrosis was found incidentally on lower abdominal CT scan. He underwent 99mTc dimercaptosuccinic acid scan prior to percutaneous nephrostomy tube placement. Apart from the renal cortex, scintigraphy showed activity in the ascending colon continuous to the activity of the bladder. This indicated urine extravasation on account of a colovesical fistula, complicating postoperative radiation treatment. Here we highlight the contribution of renal cortical scintigraphy in the detection of colovesical fistulas.

  19. Three-phase bone scan and indium white blood cell scintigraphy following porous coated hip arthroplasty: A prospective study of the prosthetic tip

    SciTech Connect

    Oswald, S.G.; Van Nostrand, D.; Savory, C.G.; Callaghan, J.J. )

    1989-08-01

    Although few reports address the use of three-phase bone scanning (TPBS) and {sup 111}In-labeled white blood cell (In-WBC) scintigraphy in hip arthroplasty utilizing a porous coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ from that seen in 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 In-WBC at approximately 7 days, and at 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the prosthetic tip. Only one of 136 flow studies were abnormal and only two of 136 blood-pool images demonstrated focally increased activity. All 25 prostheses (120 of 143 scans) demonstrated increased uptake on the bone phase images. The area about the tip was divided into three segments; increased uptake at 24 mo was noted in the medial, distal, and lateral segments in 16%, 72%, and 56% of prostheses, respectively. Twenty of 25 prostheses (82 of 142 scans) showed uptake on In-WBC scintigraphy, being noted in 48% of prostheses at 24 mo. We conclude that scintigraphic patterns in the uncomplicated patient with a porous coated prosthesis appear to differ from patterns described in cemented prostheses.

  20. Missed torsion in undescended testes detected by scintigraphy: testicular scintigraphy a decisive complementary tool.

    PubMed

    Kodali, Sunil Kumar; Abdullah, Zuhair Saleh; Sharma, Punit; Khan, Muhammad Umar; Naeem, Muhammad

    2013-01-01

    Torsion of undescended testis, although not uncommon, causes diagnostic difficulties. We here present testicular scintigraphy images of a typical case of torsion of an undescended inguinal testis with disparity between clinical and ultrasonography (USG) findings in the contralateral retractile testis.

  1. Cost-effectiveness of a novel blood-pool contrast agent in the setting of chest pain evaluation in an emergency department.

    PubMed

    Espinosa, Gabriela; Annapragada, Ananth

    2013-10-01

    We evaluated three diagnostic strategies with the objective of comparing the current standard of care for individuals presenting acute chest pain and no history of coronary artery disease (CAD) with a novel diagnostic strategy using an emerging technology (blood-pool contrast agent [BPCA]) to identify the potential benefits and cost reductions. A decision analytic model of diagnostic strategies and outcomes using a BPCA and a conventional agent for CT angiography (CTA) in patients with acute chest pain was built. The model was used to evaluate three diagnostic strategies: CTA using a BPCA followed by invasive coronary angiography (ICA), CTA using a conventional agent followed by ICA, and ICA alone. The use of the two CTA-based triage tests before ICA in a population with a CAD prevalence of less than 47% was predicted to be more cost-effective than ICA alone. Using the base-case values and a cost premium for BPCA over the conventional CT agent (cost of BPCA ≈ 5× that of a conventional agent) showed that CTA with a BPCA before ICA resulted in the most cost-effective strategy; the other strategies were ruled out by simple dominance. The model strongly depends on the rates of complications from the diagnostic tests included in the model. In a population with an elevated risk of contrast-induced nephropathy (CIN), a significant premium cost per BPCA dose still resulted in the alternative whereby CTA using BPCA was more cost-effective than CTA using a conventional agent. A similar effect was observed for potential complications resulting from the BPCA injection. Conversely, in the presence of a similar complication rate from BPCA, the diagnostic strategy of CTA using a conventional agent would be the optimal alternative. BPCAs could have a significant impact in the diagnosis of acute chest pain, in particular for populations with high incidences of CIN. In addition, a BPCA strategy could garner further savings if currently excluded phenomena including renal disease

  2. Phase analysis of gated blood pool SPECT for multiple stress testing assessments of ventricular mechanical dyssynchrony in a tachycardia-induced dilated cardiomyopathy canine model.

    PubMed

    Salimian, Samaneh; Thibault, Bernard; Finnerty, Vincent; Grégoire, Jean; Harel, François

    2017-02-01

    Stress-induced dyssynchrony has been shown to be independently correlated with clinical outcomes in patients with dilated cardiomyopathy (DCM) and narrow QRS complexes. However, the extent to which stress levels affect inter- and intraventricular dyssynchrony parameters remains unknown. Ten large dogs were submitted to tachycardia-induced DCM by pacing the right ventricular apex for 3-4 weeks to reach a target ejection fraction (EF) of 35% or less. Stress was then induced in DCM dogs by administering intravenous dobutamine up to a maximum of 20 μg·kg(-1)·min(-1). Hemodynamic and ventricular dyssynchrony data were analyzed by left ventricular (LV) pressure measurements and gated blood pool SPECT (GBPS) imaging. In order to assess mechanical dyssynchrony in DCM subjects and compare it with that of 8 normal counterparts, we extracted the following data: count-based indices of LV contraction homogeneity index (CHI), entropy and phase standard deviation, and interventricular dyssynchrony index. A significant LV intraventricular dyssynchrony (CHI: 96.4 ± 1.3% in control vs 78.6% ± 10.9% in DCM subjects) resulted in an intense LV dysfunction in DCM subjects (EF: 49.5% ± 8.4% in control vs 22.6% ± 6.0% in DCM), compared to control subjects. However, interventricular dyssynchrony did not vary significantly between the two groups. Under stress, DCM subjects showed a significant improvement in ventricular functional parameters at each level (EF: 22.6% ± 6.0% at rest vs 48.1% ± 5.8% at maximum stress). All intraventricular dyssynchrony indices showed a significant increase in magnitude of synchrony from baseline to stress levels of greater than or equal to 5 μg·kg(-1)·min(-1) dobutamine. There were individual differences in the magnitude and pattern of change in interventricular dyssynchrony during the various levels of stress. Based on GBPS analyses, different levels of functional stress, even in close intervals, can have a significant impact on

  3. Myocardial perfusion scintigraphy: the evidence

    PubMed Central

    Anagnostopoulos, C.; Cerqueira, M.; Ell, P. J.; Flint, E. J.; Harbinson, M.; Kelion, A. D.; Al-Mohammad, A.; Prvulovich, E. M.; Shaw, L. J.; Tweddel, A. C.

    2003-01-01

    This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by

  4. [Osteoarticular scintigraphy in comparison with clinical evidence].

    PubMed

    del Puente, Antonio; Venditti, Carlo; Peluso, Rosario; Esposito, Antonella; Cimmino, Michele; De Luca Bossa, Rosa; Loi, Gabriella; Spanò, Angelo; Oriente, Alfonso; Oriente, Pasquale

    2003-01-01

    Bone scintigraphy is a technique which is often resorted to in diagnostic rheumatology. There are few data on the effective relevance of bone scintigraphy in the evaluation of chronic inflammatory diseases of the joints. The aim of this study was to compare the results of bone scintigraphy with clinical evidence in patients with rheumatoid arthritis or osteoarthritis. Seventy-five patients were submitted to total body bone scintigraphy (44 rheumatoid arthritis, 31 osteoarthritis). The nuclear medicine specialist indicated the list of joints showing uptake. For the same patients a rheumatologist indicated the number of affected joints. The laboratory and clinical data were recorded. The patients were first stratified according to the prevalence of the clinical evidence and scintigraphic uptake. The distribution was found to be not significant. Only 5.3% of patients showed no uptake. Thirty-three patients had no clinical evidence of disease; among these, 30 showed joint uptake. Considering only the patients with clinical evidence, 97.6% showed joint uptake. These results were confirmed even when the data were analyzed by sex, disease and therapy. Considering the patients with clinical evidence, the uptake/clinical ratio did not show any significant correlation. The number of joints with clinical evidence correlated with the erythrocyte sedimentation rate. The number of joints showing uptake correlated only with age. In conclusion, on average, scintigraphy, performed in patients with rheumatoid arthritis and osteoarthritis, highlights a significantly higher number of joints involved as compared to what would be expected on the basis of clinical evaluation. It remains to be defined whether this is an overestimation related to the characteristics of the scan or whether it is sign of a higher sensitivity in highlighting the site of inflammation. Against the latter hypothesis is the absence of correlation with the inflammatory indexes.

  5. 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.

  6. Efficacy of thyroid scintigraphy in the diagnosis of intrathoracic goiter

    SciTech Connect

    Park, H.M.; Tarver, R.D.; Siddiqui, A.R.; Schauwecker, D.S.; Wellman, H.N.

    1987-03-01

    For evaluation of the usefulness of thyroid scintigraphy in the diagnosis of intrathoracic goiter, we analyzed the results of radionuclide thyroid scintigraphy in 54 consecutive cases with suspected upper mediastinal masses. Intrathoracic goiters were found in 42. The sensitivity, specificity, and accuracy of the scintigraphy for intrathoracic goiter were 93% (39/42), 100% (12/12), and 94% (51/54), respectively. Scintigraphic morphology, scanning technique, and pitfalls are discussed. The results show that most intrathoracic goiters do have thyroid function and that radioiodine scintigraphy is a definitive and cost-effective diagnostic procedure for this disease.

  7. Adenosine thallium 201 myocardial perfusion scintigraphy

    SciTech Connect

    Verani, M.S. )

    1991-07-01

    Pharmacologic coronary vasodilation as an adjunct to myocardial perfusion imaging has become increasingly important in the evaluation of patients with coronary artery disease, in view of the large number of patients who cannot perform an adequate exercise test or in whom contraindications render exercise inappropriate. Adenosine is a very potent coronary vasodilator and when combined with thallium 201 scintigraphy produces images of high quality, with the added advantages of a very short half-life (less than 10 seconds) and the ability to adjust the dose during the infusion, which may enhance safety and curtail the duration of side effects. The reported sensitivity and specificity of adenosine thallium 201 scintigraphy for the detection of coronary artery disease are high and at least comparable with imaging after exercise or dipyridamole administration. 23 refs.

  8. [Utility of SPECT in gallium scintigraphy].

    PubMed

    Uto, Tomoyuki

    2002-11-01

    Whole-body gallium planar scintigraphy is a mainstay for the detection of tumors and inflammatory lesions. Recently, gallium SPECT (single photon emission computed tomography) has become more common in the clinical setting. This diagnostic modality is widely employed in our hospital, and lesions are actually detected by SPECT in some cases. Although the contrast of SPECT images is better than that of planar images, spatial resolution is limited by the limited matrix size. Thus, the overall diagnostic utility of SPECT remains to be confirmed. The usefulness of SPECT for the detection of gallium-accumulated lesions was evaluated in a phantom. In this study, we showed that SPECT is able to detect more smaller and lower gallium accumulations than planar imaging. Thus, SPECT imaging is useful in gallium scintigraphy.

  9. Cervical venous reflux in dynamic brain scintigraphy.

    PubMed

    Hayt, D B; Perez, L A

    1976-01-01

    Cervical venous reflux, shown by dynamic brain scintigraphy, was investigated through three avenues of approach: (A) by reviewing 371 randomly chosen routine dynamic intracerebral bloodflow studies to estimate its incidence; (B) by correlative positive-contrast superior venacavography in patients with characteristic cervical venous reflux; and (C) by performing dynamic brain scintigraphy while utilizing various positional and physiologic maneuvers to attempt to produce cervical venous reflux in patients who did not exhibit this phenomenon on earlier examination. Although any obstruction of the superior vena cava or a properly timed Valsalva maneuver in selected patients can produce the scintigraphic picture of cervical venous reflux, in most cases it is a normal phenomenon due to incompetent or absent cervical venous valves.

  10. Esophageal transit scintigraphy in systemic sclerosis

    PubMed Central

    Kobylecka, Małgorzata; Olesińska, Marzena

    2016-01-01

    Systemic sclerosis is a rare connective tissue disease, distinctive features of which are fibrosis and microangiopathy. The esophagus is one of the most commonly involved internal organs. Most patients experience dysphagia, difficulties in swallowing and gastro-esophageal reflux. However, in up to one third of cases, the initial onset of esophageal disease may be clinically silent. There are several diagnostic modalities available for assessing both morphological and functional abnormalities of the esophagus. If structural abnormalities are suspected, endoscopy is the method of choice. Functional evaluation is best achieved with manometry. Both endoscopy and manometry are invasive techniques, with low patient acceptance. Barium-contrast study is well tolerated, but qualitative assessment of functional abnormalities is imprecise. Esophageal scintigraphy is an easy, non-invasive, sensitive and specific diagnostic modality. It can detect esophageal dysfunction even in asymptomatic patients. In patients already diagnosed with systemic sclerosis, scintigraphy is useful in evaluating severity and progression of the disease. PMID:27994270

  11. Esophageal transit scintigraphy in systemic sclerosis.

    PubMed

    Chojnowski, Marek; Kobylecka, Małgorzata; Olesińska, Marzena

    2016-01-01

    Systemic sclerosis is a rare connective tissue disease, distinctive features of which are fibrosis and microangiopathy. The esophagus is one of the most commonly involved internal organs. Most patients experience dysphagia, difficulties in swallowing and gastro-esophageal reflux. However, in up to one third of cases, the initial onset of esophageal disease may be clinically silent. There are several diagnostic modalities available for assessing both morphological and functional abnormalities of the esophagus. If structural abnormalities are suspected, endoscopy is the method of choice. Functional evaluation is best achieved with manometry. Both endoscopy and manometry are invasive techniques, with low patient acceptance. Barium-contrast study is well tolerated, but qualitative assessment of functional abnormalities is imprecise. Esophageal scintigraphy is an easy, non-invasive, sensitive and specific diagnostic modality. It can detect esophageal dysfunction even in asymptomatic patients. In patients already diagnosed with systemic sclerosis, scintigraphy is useful in evaluating severity and progression of the disease.

  12. Biliary atresia and neonatal hepatobiliary scintigraphy

    SciTech Connect

    Wynchank, S.; Guillet, J.; Leccia, F.; Soubiran, G.; Blanquet, P.

    1984-03-01

    Hepatobiliary scintigraphy using Tc-99m diethyl IDA was performed on 14 jaundiced neonates. It aided greatly the differential diagnosis between neonatal hepatitis and biliary atresia. Limitations in the interpretation of the results are described, as neonatal hepatitis may be accompanied by biliary excretion ranging from zero to normal. Also both biliary atresia (intra- and extrahepatic) and neonatal hepatitis may show no biliary excretion within 24 hours.

  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 patients with pain

    PubMed Central

    Kim, Seong Jang

    2017-01-01

    Nuclear medicine imaging is widely used in pain medicine. Low back pain is commonly encountered by physicians, with its prevalence from 49% to 70%. Computed tomography (CT) or magnetic resonance imaging (MRI) are usually used to evaluate the cause of low back pain, however, these findings from these scans could also be observed in asymptomatic patients. Bone scintigraphy has an additional value in patients with low back pain. Complex regional pain syndrome (CRPS) is defined as a painful disorder of the extremities, which is characterized by sensory, autonomic, vasomotor, and trophic disturbances. To assist the diagnosis of CRPS, three-phase bone scintigraphy is thought to be superior compared to other modalities, and could be used to rule out CRPS due to its high specificity. Studies regarding the effect of bone scintigraphy in patients with extremity pain have not been widely conducted. Ultrasound, CT and MRI are widely used imaging modalities for evaluating extremity pain. However, SPECT/CT has an additional role in assessing pain in the extremities. PMID:28757916

  15. 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.

  16. The pathological basis for skeletal scintigraphy.

    PubMed

    Galasko, C S

    1975-08-01

    Skeletal scintigraphy, which has now been established as a useful and accurate method of detecting early skeletal metastases and assessing their response to treatment, has been investigated for its pathological basis. Histological examination of several hyndred necropsy specimens, from sixty-eight patients who died from malignant disease, showed a significant increase of osteoid and immature woven bone in the presence of metastatic cancer. Tumour-cell suspensions of the VX2 carcinoma were injected into the medullary cavity or on to the periosteal surface of the ilia or tibiae of New Zealand white rabbits. A combination of bone destruction and new bone formation, similar to the autopsy material, was seen. There were at least two mechanisms for the new bone production. Initially, intramembranous ossification was seen in the fibrous stroma surrounding the tumour. Once the cortex was involved and cortical bone destruction had occurred, large amounts of woven bone resembling fracture callus were laid down. The new bone had a markedly increased avidity for bone-seeking isotopes, indicating why skeletal scintigraphy was useful. A further twenty rabbits, in whose ilia the VX2 carcinoma was growing, were treated by local irradiation. When treatment was successful the tumour was destroyed, the production of new bone ceased, and the lesion lost its increased avidity for bone-seeking isotopes, indicating that skeletal scintigraphy could be used to assess the response of skeletal metastases to therapy.

  17. Pediatric skeletal scintigraphy: applications of pinhole magnification.

    PubMed

    Connolly, L P; Treves, S T; Connolly, S A; Zimmerman, R E; Bar-Sever, Z; Itrato, D; Davis, R T

    1998-01-01

    Pinhole magnification scintigraphy is an effective means of evaluating the pediatric skeleton because it provides optimal high-resolution images. This technique is indicated when diagnostic uncertainty persists after high-resolution imaging with parallel hole collimation. Pinhole magnification scintigraphy requires approximately 20 minutes of acquisition time per image and meticulous attention to details such as choice of pinhole insert, collimator positioning, and patient immobilization. However, the technique is superior to planar imaging in demonstrating acute osteomyelitis in bone adjacent to growth centers and epiphyseal involvement that is either primary or the result of local spread of infection. In addition, pinhole imaging has proved highly reliable in the early diagnosis of Legg-Calvé-Perthes disease and is useful in depicting osteonecrosis related to specific causes such as corticosteroid treatment or trauma. Scintigraphic manifestations of femoral head ischemia or infarction and findings indicative of osteomyelitis associated with a hip effusion are well demonstrated with pinhole imaging. This technique also helps characterize osteoid osteomas and may be used intraoperatively to confirm the complete excision of this benign tumor. Finally, pinhole magnification scintigraphy clearly depicts fractures of the femoral neck and allows a high degree of confidence in diagnosing injuries to the small bones of the hands and feet.

  18. [Renal scintigraphy with 99mTc-penicillamine].

    PubMed

    Lichte, H; Hör, G

    1975-02-01

    By application of 99mTc-Penicillamine in renal scintigraphy excellent scintigraphies of the kidneys, especially by using the gamma-camera, can be obtained, even in case of damaged renal function, up to an increase of creatinine in serum of about 7 mg %.

  19. Diuretic renal scintigraphy in normal cats.

    PubMed

    Hecht, Silke; Lane, India F; Daniel, Gregory B; Morandi, Federica; Sharp, Dorothy E

    2008-01-01

    The purpose of this study was to develop a protocol for diuretic renal scintigraphy (renography) in cats and describe normal findings. 99mTc-DTPA renal scintigraphy was performed twice in 10 healthy cats. Furosemide or saline were injected 4.5 min after radiopharmaceutical administration for the diuretic or control scan, respectively. A dynamic acquisition was performed for 8 min. The following parameters were evaluated: (1) global and individual glomerular filtration rate (GFR); (2) shape of the time-activity curve (TAC); (3) time of peak (TOP); (4) individual kidney excretion half-time (T1/2) of the radiopharmaceutical; (5) percentage of maximum activity measured at the end of the study. Global GFR in the control studies (2.79 +/- 0.83 ml/min/kg, mean +/- SD) did not differ significantly from the diuretic scans (2.34 +/- 0.51 ml/min/kg). The shape of most (16/ 20) TAC of diuretic renograms was similar to those of control renograms. The TOP of the diuretic renogram curves was 3.06 +/- 0.58 min, and did not differ from that of the control scans (3.01 +/- 0.61 min). T1/2 of the diuretic renograms was significantly shorter (5.15 +/- 0.83 min) than that of the control renograms (6.31 +/- 1.50 min). A significantly lower percentage of maximum activity was present at the end of the study in diuretic renograms (median: 47.25%; range: 33.60-59.60%) compared with control renograms (63.40%; 30.00-69.40%). Diuretic renal scintigraphy is a noninvasive and fast procedure to perform in cats. The applicability of this technique needs to be investigated in patients with significantly impaired renal function and obstructive uropathies.

  20. 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.

  1. Detection of gastrointestinal bleeding by radionuclide scintigraphy

    SciTech Connect

    Gupta, S.; Luna, E.; Kingsley, S.; Prince, M.; Herrera, N.

    1984-01-01

    Scanning with Technetium /sup 99m/ labeled autologous red blood cells was performed in 59 patients with clinical suspicion of acute and/or intermittent, chronic gastrointestinal bleeding. In 36 patients (61%), a definite site of bleeding could be demonstrated. A strong correlation with other modalities such as upper and lower gastrointestinal endoscopy, contrast angiography, and surgical exploration was found. Overall sensitivity of the procedure was 91%; specificity 100% and accuracy 93.3%. It is suggested that radionuclide scintigraphy provides a completely noninvasive, simple, and sensitive procedure which may be routinely used for the detection and localization of gastrointestinal bleeding.

  2. Renal scintigraphy in the acute care setting.

    PubMed

    Sfakianaki, Efrosyni; Sfakianakis, George N; Georgiou, Mike; Hsiao, Bernard

    2013-03-01

    Renal scintigraphy is a powerful imaging method that provides both functional and anatomic information, which is particularly useful in the acute care setting. In our institution, for the past 2 decades, we have used a 25-minute renal diuretic protocol, technetium-99m ((99m)Tc) mercaptoacetyltriglycine with simultaneous intravenous injection of furosemide, for all ages and indications, including both native and transplant kidneys. As such, this protocol has been widely used in the workup of acutely ill patients. In this setting, there are common clinical entities which affect patients with native and transplant kidneys. In adult patients with native kidneys one of the most frequent reasons for emergency room visits is renal colic due to urolithiasis. Although unenhanced computed tomography is useful to assess the anatomy in cases of renal colic, it does not provide functional information. Time zero furosemide renal scintigraphy can do both and we have shown that it can effectively stratify patients with renal colic. To this end, 4 characteristic patterns of scintirenography have been identified, standardized, and consistently applied: no obstruction, partial obstruction (mild vs high grade), complete obstruction, and stunned (postdecompressed) kidney. With the extensive use of this protocol over the past 2 decades, a pattern of "regional parenchymal dysfunction" indicative of acute pyelonephritis has also been delineated. This information has proved to be useful for patients presenting with urinary tract infection and suspected pyelonephritis, as well as for patients who were referred for workup of renal colic but were found to have acute pyelonephritis instead. In instances of abdominal trauma, renal scintigraphy is uniquely suited to identify urine leaks. This is also true in cases of suspected leak following renal transplant or from other iatrogenic/postsurgical causes. Patients presenting with acute renal failure can be evaluated with renal scintigraphy. A

  3. Scintigraphy for Pulmonary Capillary Protein Leak

    DTIC Science & Technology

    1982-09-01

    lnate? o~~d) - aREPORT DOCUMENTATION PAGE UFFiEI.N C011l’Ll1TING FORM Anteuim Swvnuztl R porta IepoI Scintigraphy for Pulmonary Capillary Protein Leak...higher "slope of injury" (pɘ.01) following thoractomy, lung , retraction and lym..,ph duct cannulation. Further studies are required in animals...undergoing thoracotomyw only. This suggests that the acute sheep lung lymph model is associated with acute pulmonary injury and, therefore, will make

  4. Horseshoe Kidney Incidentally Revealed on Meckel Scintigraphy.

    PubMed

    Bai, Xia; Codreanu, Ion; Yang, Hua; Servaes, Sabah; Zhuang, Hongming

    2015-09-01

    An 8-year-old male patient with history of bloody stools underwent a Meckel diverticulum scintigraphy to evaluate for ectopic gastric mucosa. The static images showed 2 abnormal foci of radiotracer accumulation in the mid-abdomen. Contrary to the renal activity, the foci appeared more prominent on the anterior view and localized anteriorly to the expected kidneys location on the left lateral view. Carefully reviewed dynamic acquisition revealed faint catenary-shaped activity in this region on earlier images, gradually evolving into 2 prominent foci on later images. A horseshoe kidney was suspected, the pathology being confirmed by abdominal ultrasonography.

  5. Congenital heart disease in adults: Quantitative and qualitative evaluation of IR FLASH and IR SSFP MRA techniques using a blood pool contrast agent in the steady state and comparison to first pass MRA.

    PubMed

    Febbo, Jennifer A; Galizia, Mauricio S; Murphy, Ian G; Popescu, Andrada; Bi, Xiaoming; Turin, Alexander; Collins, Jeremy; Markl, Michael; Edelman, Robert R; Carr, James C

    2015-10-01

    To evaluate magnetic resonance angiography sequences during the contrast steady-state (SS-MRA) using inversion recovery (IR) with fast low-angle shot (IR-FLASH) or steady-state free precession (IR-SSFP) read-outs, following the injection of a blood-pool contrast agent, and compare them to first-pass MR angiography (FP-MRA) in adults with congenital heart disease (CHD). Twenty-three adult patients with CHD who underwent both SS-MRA and FP-MRA using a 1.5-T scanner were retrospectively identified. Signal-to-noise and contrast-to-noise ratios were obtained at eight locations within the aorta and pulmonary vessels.. Image quality and the presence of artifacts were subjectively assessed by two radiologists. The presence of pathology was noted and given a confidence score. There was no difference in vessel dimensions among the sequences. IR-SSFP showed better image quality and fewer artifacts than IR-FLASH and FP-MRA. Confidence scores were significantly higher for SS-MRA compared to FP-MRA. Seven cases (30.4%) had findings detected at SS-MRA that were not detected at FP-MRA, and 2 cases (8.7%) had findings detected by IR-SSFP only. SS-MRA of the thoracic vasculature using a blood pool contrast agent offers superior image quality and reveals more abnormalities compared to standard FP-MRA in adults with CHD, and it is best achieved with an IR-SSFP sequence. These sequences could lead to increased detection rates of abnormalities and provide a simpler protocol image acquisition. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. [Positron emission tomography and scintigraphy. Nuclear imaging in clinical orthopaedics].

    PubMed

    Kirsch, C M

    2006-09-01

    Nuclear medicine uses the function of organs or organ systems to diagnose and treat disease. The source of radiation is brought into the patient's body by means of a radioactive labelled pharmaceutical. Its way through the body is recorded by appropriate equipment on the outside. Of the many nuclear medical procedures, those primarily applicable to orthopaedic problems are explained here, such as bone scintigraphy, scintigraphy of inflammatory lesions, and tumour scintigraphy. Besides their use in diagnostics, therapeutic applications are covered as well. Using examples from clinical practice, "conventional" nuclear medicine and positron emission tomography are also covered.

  7. Postcholecystectomy syndrome: evaluation using biliary scintigraphy and endoscopic retrograde cholangiopancreatography

    SciTech Connect

    Zeman, R.K.; Burrell, M.I.; Dobbins, J.; Jaffe, M.K.; Choyke, P.L.

    1985-09-01

    The authors prospectively studied 30 patients with postcholecystectomy syndrome to determine the efficacy of biliary scintigraphy in the detection of stenosis of the sphincter of Oddi. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP). Biliary scintigraphy disclosed stenosis of the sphincter by agreement with the ERCP or surgical findings in nine (90%) of ten patients and in eight (100%) of eight patients with biliary obstruction from other causes. Retention of activity at 2 hours in visually prominent ducts was the best predictor of abnormal biliary drainage. Biliary scintigraphy is a useful, noninvasive screening test for the detection of postcholecystectomy biliary obstruction.

  8. Ventilation/perfusion lung scintigraphy. Multiple applications besides pulmonary embolism.

    PubMed

    Sinzinger, Helmut; Rodrigues, Margarida; Kummer, Friedrich

    2013-01-01

    Ventilation/perfusion scintigraphy is the diagnostic tool of choice for detection and monitoring of pulmonary embolism. However, the knowledge on its value for other or concurrent pathologies is poor. In this review scintigraphic characteristics of the main pathologies, interpretation and artefacts are described. Together with the understanding of pathophysiology of the lung, the potential gain of information derived from ventilation/perfusion scintigraphy is much higher than generally believed. In conclusion, ventilation/perfusion scintigraphy not only in PE but also in other lung diseases is underused, its value and clinical potential underestimated.

  9. Primary pericardial mesothelioma detected by gallium-67 scintigraphy

    SciTech Connect

    Nishikimi, T.; Ochi, H.; Hirota, K.; Ikuno, Y.; Oku, H.; Takeuchi, K.; Takeda, T.

    1987-07-01

    We present a case report of a 73-yr-old woman with progressive systemic sclerosis who showed extensive pericardial uptake of /sup 67/Ga by scintigraphy. At autopsy, primary pericardial mesothelioma was found.

  10. The independent value of exercise thallium scintigraphy to physicians

    SciTech Connect

    Hlatky, M.; Botvinick, E.; Brundage, B.

    1982-11-01

    To determine the effect of exercise myocardial scintigraphy with thallium-201 on diagnostic accuracy and the need for coronary angiography, consecutive patients with a variety of clinical presentations were identified. Clinical summaries, including a detailed history, physical examination, and complete data from a standard treadmill exercise test, were presented to 91 cardiologists. The cardiologists assessed the probability of coronary disease and the need for coronary angiography. They were then presented the results of thallium scintigraphy and revisd their assessments if warranted. Scintigraphy significantly increased the cardiologists' diagnostic accuracy beyond that attained with other clinical information (p<0.0001). The change in accuracy varied from +4% to +20% in different patient groups, and was greatest in patients with atypical angina and a positive exercise ECG. Ratings of the need for coronary angiography changed from -13% to +21% in different patient groups. We conclude that exercise thallium scintigraphy can provide independent diagnostic information and influence the need for coronary angiography.

  11. The independent value of exercise thallium scintigraphy to physicians

    SciTech Connect

    Hlatky, M.; Botvinick, E.; Brundage, B.

    1982-11-01

    To determine the effect of exercise myocardial scintigraphy with /sup 201/Tl on diagnostic accuracy and the need for coronary angiography, consecutive patients with a variety of clinical presentations were identified. Clinical summaries, including a detailed history, physical examination, and complete data from a standard treadmill exercise test, were presented to 91 cardiologists. The cardiologists assessed the probability of coronary disease and the need for coronary angiography. They were then presented the results of thallium scintigraphy and revised their assessments if warranted. Scintigraphy significantly increased the cardiologists' diagnostic accuracy beyond that attained with other clinical information (p less than 0.0001). The change in accuracy varied from + 4% to + 20% in different patient groups, and was greatest in patients with atypical angina and a positive exercise ECG. Ratings of the need for coronary angiography changed from -13% to +21% in different patient groups. We conclude that exercise thallium scintigraphy can provide independent diagnostic information and influence the need for coronary angiography.

  12. Clinical implications of increased lung uptake of /sup 201/Tl during exercise scintigraphy 2 weeks after myocardial infarction

    SciTech Connect

    Gibson, R.S.; Watson, D.D.; Carabello, B.A.; Holt, N.D.; Beller, G.A.

    1982-05-01

    To determine the prevalence and clinical significance of increased lung /sup 201/Tl uptake during submaximal exercise myocardial scintigraphy performed 2 weeks after acute myocardial infarction, 61 patients underwent submaximal exercise testing (target heart rate, 120 beats/min), multigated blood pool imaging at rest and coronary angiography before hospital discharge. Thallium lung uptake on the initial anterior projection image was graded qualitatively by comparing the intensity of /sup 201/Tl activity in the lungs with that in the mediastinum. In 39 patients (64 percent), it was normal (equal to mediastinal activity) and in 22 (36 percent), it was increased (greater than mediastinal activity). Compared with patients with normal lung uptake, those with increased uptake had a greater prevalence of prior infarction (13 versus 36 percent, probability (p) less than 0.05), less global cardiac reserve as assessed by the four level New York Heart Association classification (p less than 0.05), more advanced Killip class in the coronary care unit (p less than 0.05), a higher Norris coronary prognostic index (2.6 +/- 1.9 versus 4.6 +/- 2.3 (mean +/- standard deviation), p less than 0.01), failure to achieve the target heart rate because of dyspnea, fatigue or angina (36 versus 86 percent, p less than 0.01), a greater prevalence of exercise-induced S-T segment depression (18 versus 45 percent, p less than 0.05), a greater number of anterior /sup 201/Tl myocardial defects (p less than 0.05); a lower radionuclide ejection fraction at rest (50.4 +/- 6.1 versus 39.6 +/- 9.3 percent, p less than 0.01) and a greater number of asynergic left ventricular segments (p less than 0.05). Thus, the occurrence of increased lung /sup 201/Tl uptake during submaximal exercise scintigraphy in the early postinfarction period is frequent and appears to be a marker of severe and functionally more important coronary artery disease associated with left ventricular dysfunction.

  13. Cerebral scintigraphy--the phoenix rises again.

    PubMed Central

    Shepstone, B. J.

    1988-01-01

    This paper reviews the development of cerebral scintigraphy from its early days of planar imaging with simple technetium-99m labelled compounds to the recent revival of the technique in the form of positron-emission and single-photon emission tomography. A short explanation of instrumentation and radiopharmaceuticals is given as a prelude to a description of both techniques in normal and pathological situations. Particular emphasis is placed on the more readily-available single-photon emission-tomographic techniques using labelled amines in the functional investigation of disorders not readily diagnosed by computed tomography. Images Figure 2(a) Figure 3 Figure 4 Figure 5 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 PMID:3047720

  14. Radionuclide bone scintigraphy in sports injuries.

    PubMed

    Van der Wall, Hans; Lee, Allen; Magee, Michael; Frater, Clayton; Wijesinghe, Harindu; Kannangara, Siri

    2010-01-01

    Bone scintigraphy is one of the mainstays of molecular imaging. It has retained its relevance in the imaging of acute and chronic trauma and sporting injuries in particular. The basic reasons for its longevity are the high lesional conspicuity and technological changes in gamma camera design. The implementation of hybrid imaging devices with computed tomography scanners colocated with the gamma camera has revolutionized the technique by allowing a host of improvements in spatial resolution and anatomical registration. Both bone and soft-tissue lesions can be visualized and identified with greater and more convincing accuracy. The additional benefit of detecting injury before anatomical changes in high-level athletes has cost and performance advantages over other imaging modalities. The applications of the new imaging techniques will be illustrated in the setting of bone and soft-tissue trauma arising from sporting injuries.

  15. Quantitative planar imaging in renal scintigraphy

    NASA Astrophysics Data System (ADS)

    Lárraga, J. M.; Martínez-Dávalos, A.; Martínez-Duncker, C.; Rodríguez, R. Herrera

    2002-08-01

    In this work we show the results of the implementation of the double energy window method (DEW) to correct for scatter and geometric mean of opposite image to correct for attenuation of radiation within the patient for absolute quantification of radiotracer in renal scintigraphy studies. We show that DEW method subestimates the scatter radiation within main energy window and that result in a 11% of maximun error for the determination of true activity of a renal kidney phantom. Moreover, in order to avoid transmission scans of patients we perform a Monte Carlo simulation (MC) for the determination of scatter component of the main energy window. The results of the MC simulation was validated with experimental data of emission studies.

  16. 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.

  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. 111In-pentetreotide scintigraphy is superior to 123I-MIBG scintigraphy in the diagnosis and location of chemodectoma.

    PubMed

    Muros, M A; Llamas-Elvira, J M; Rodríguez, A; Ramírez, A; Gómez, M; Arráez, M A; Valéncia, E; Vílchez, R

    1998-08-01

    Chemodectomas, or glomus tumours, are unusual head and neck paragangliomas. A non-invasive imaging technique, 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy, has long been used for the diagnosis of all types of paraganglioma. The aim of this study was to evaluate and compare classic 123I-MIBG scintigraphy with the more recent 111In-pentetreotide scintigraphy in the diagnosis and location of chemodectomas. We performed 123I-MIBG and 111In-pentetreotide scintigraphy in eight patients (7 females, 1 male) with histologically or radiologically confirmed chemodectomas (five carotid body and three jugulotympanic chemodectomas). 123I-MIBG uptake was visualized in four patients on planar views and SPET images (sensitivity 50%); uptake was low in three patients. Using 111In-pentetreotide scintigraphy, all chemodectomas in eight patients were visualized (sensitivity 100%) and 111In-pentetreotide uptake was high in all cases. In conclusion, our results indicate that 111In-pentetreotide scintigraphy is superior to 123I-MIBG scintigraphy in the diagnosis and location of chemodectomas. In-pentetreotide or 123I-MIBG uptake suggests a neuroendocrine origin, providing important functional information in the diagnosis of chemodectomas. Moreover, 111In-pentetreotide scintigraphy permits a good classification of patients with or without somatostatin receptors in the chemodectoma in the application of pharmacological therapy with somatostatin analogues to inoperable tumours. The main therapeutic action of cold somatostatin analogues is to inhibit hormonal hypersecretion in different neuroendocrine tumours. In chemodectomas, however, the most important effect of somatostatin analogues is to reduce tumour volume or inhibit growth progression.

  20. 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.

  1. Diagnostic and Pathophysiological Impact of Myocardial MIBG Scintigraphy in Parkinson's Disease.

    PubMed

    Spiegel, Jörg

    2010-01-01

    Myocardial MIBG scintigraphy is established in the diagnosis and differential diagnosis of Parkinson's disease (PD). Numerous studies address the pathophysiological impact of myocardial MIBG scintigraphy: the myocardial MIBG uptake correlates with the clinical phenotype of PD; the background of this phenomenon is unclear. Furthermore MIBG scintigraphy enables to study the extracranial Lewy body type-degeneration. In combination with cerebral dopamine transporter imaging, MIBG scintigraphy allows to correlate cerebral and extracranial Lewy body type-degeneration in PD.

  2. The current status of bone scintigraphy in malignant diseases.

    PubMed

    Dasgeb, Bahar; Mulligan, Michael H; Kim, Chun K

    2007-12-01

    For the past few decades, planar bone scintigraphy has been the most frequently performed imaging study in the evaluation of metastatic bone disease. Although scintigraphic findings alone are often nonspecific for skeletal pathologies, this technique reportedly has an exquisite sensitivity. However, recently accumulated data on the efficacy of positron emission tomography with fluorine-18 fluorodeoxyglucose and fluorine-18 sodium fluoride as well as magnetic resonance imaging for evaluating skeletal metastatic disease now indicate that conventional planar bone scintigraphy is not very sensitive in the detection of metastatic bone lesions in selected malignancies. Nevertheless, bone scintigraphy still remains the primary imaging modality for evaluation of metastatic bone disease owing mainly to its cost effectiveness and wide availability. In addition, recently introduced hybrid imaging systems combining single-photon emission computed tomography and spiral computed tomography, although not widely available yet, increase considerably both the sensitivity and specificity of bone scintigraphy. This article focuses primarily on the current role of bone scintigraphy and its strengths and weaknesses in assessing different types of malignant diseases relative to other imaging modalities in selected malignancies.

  3. Thallium-201 stress scintigraphy in Takayasu arteritis

    SciTech Connect

    Hashimoto, Y.; Numano, F.; Maruyama, Y.; Oniki, T.; Kasuya, K.; Kakuta, T.; Wada, T.; Yajima, M.; Maezawa, H. )

    1991-04-15

    Thirty-eight women with Takayasu arteritis were studied using thallium-201 stress myocardial scintigraphy to assess the prevalence and pathophysiology of the perfusion abnormality. Twenty (53%) had abnormal scintigraphic findings (group A). Abnormal scans were divided into 3 groups: permanent defects in 6, reversible defects in 7 and slow washout in 7. The remaining 18 patients had normal scintigrams (group N). Group A had a tendency to be older and to have a high prevalence of complicated significant aortic regurgitation. Interventricular thickness plus left ventricular posterior wall thickness (26 +/- 7 vs 17 +/- 2 mm, p less than 0.01) and left ventricular mass (267 +/- 121 vs 133 +/- 39 g, p less than 0.01) were all greater in group A on echocardiography. The mean value of the central aortic pressure in systole was 170 +/- 15 mm Hg in the 7 catheterized patients in group A. Coronary ostial stenoses were present in 2 group A patients who showed reversible defects on scintigrams. These data indicate that the abnormal perfusion detected by imaging in patients with Takayasu arteritis was responsible for a decrease in coronary reserve or myocardial damage, or both, due to long-standing systemic hypertension or aortic regurgitation. Coronary artery disease should be considered if a reversible defect is present.

  4. Bone scintigraphy and radiolabeled white blood cell scintigraphy for the diagnosis of mandibular osteomyelitis.

    PubMed

    Boronat-Ferrater, María; Simó-Perdigó, Marc; Cuberas-Borrós, Gemma; Aguadé-Bruix, Santiago; Dellepiane-Clarke, Fiorella; Torrent-Llongarriu, Elia; Negre-Busó, Montserrat; Porta-Biosca, Francisco; Sáez, Manel; Castell-Conesa, Joan

    2011-04-01

    The aim of this study was to evaluate the diagnostic efficacy of bone scintigraphy (BS) and radiolabeled white blood cell scintigraphy (WBCS) in detecting septic activity in the flat bones of the jaw. A retrospective analysis was conducted using 38 studies of combined BS plus WBCS: 33 of them 3-phase BS and 36 of them 2-phase WBCS. These studies were performed on 34 patients, 19 women and 15 men with a mean age of 56 years (22-79), who presented with suspected mandibular osteomyelitis, either acute or chronic exacerbation. The results were compared with histologic findings (55%) or with a minimum clinical/radiologic follow-up of 6 months (average, 21 months), when biopsy results were not available. BS showed a sensitivity of 100%, a specificity of 6.7%, a positive predictive value of 62%, and a negative predictive value of 100%. For WBCS, the corresponding values were as follows: 73.7%, 78.6%, 82%, and 69%. Accuracy was 63.2% for BS and 94.7% for WBCS. WBCS has proven to be a useful test for detecting septic activity in the jaw bone, being more effective than BS alone, which under certain circumstances, can return a very high false-positive rate.

  5. AIDS-related Kaposi sarcoma: findings on thallium-201 scintigraphy

    SciTech Connect

    Lee, V.W.; Rosen, M.P.; Baum, A.; Cohen, S.E.; Cooley, T.P.; Liebman, H.A.

    1988-12-01

    No simple, noninvasive method is available for evaluating extracutaneous Kaposi sarcoma in AIDS patients or for following the tumor's response to treatment. We report our preliminary experience with thallium-201 scintigraphy in nine AIDS patients with proved Kaposi sarcoma. Eight of the nine had abnormal uptake of the radionuclide in skin, lymph nodes, oral cavity, vagina, and lungs. Only four of the nine had cutaneous Kaposi sarcoma at the time of scanning. All cutaneous and mucosal lesions were thallium avid. Two of the six patients with thallium-avid nodes underwent nodal biopsy. Both biopsies confirmed the diagnosis of Kaposi sarcoma. Cutaneous Kaposi sarcoma developed later in one of these patients, showing the efficacy of thallium scintigraphy for the early detection of extracutaneous lesions. These preliminary results show thallium avidity in Kaposi sarcoma involving the skin and various extracutaneous sites (lymph nodes, lung, mucosa, and vagina). Thallium scintigraphy is a potentially useful procedure for detecting extracutaneous Kaposi sarcoma in AIDS patients.

  6. Arteriovenous fistula stent infection diagnosed with radiolabelled leucocyte scintigraphy.

    PubMed

    Yoo, Jeong Rae; Heo, Sang Taek; Kim, Miyeon; Kim, Hyun Woo; Chang, Jee Won; Song, Heesung

    2015-07-01

    Infectious complications of haemodialysis in patients with arteriovenous fistula stent are rare. In addition, patients with low-grade infection are more difficult to diagnose. Here, we report the first case of low-grade infection of an arteriovenous fistula stent diagnosed using (99m)Tc-hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy. A 62-year-old man with end-stage renal disease was referred for prolonged fever. We performed (99m)Tc-HMPAO-labelled leucocyte scintigraphy following a work-up according to fever of unknown origin. A focal uptake on the left forearm compatible with the arteriovenous fistula stent insertion site was shown, and the stent was removed. (99m)Tc-HMPAO-labelled leucocyte scintigraphy could be a suitable method for assessing vascular stent infection in low-grade fever.

  7. Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism

    PubMed Central

    Khan, Shoukat H; Madhu, Vijay P; Rather, Tanveer A; Laway, Bashir A

    2017-01-01

    Background/Aims Esophageal dysmotility is associated with gastrointestinal dysmotility in various systemic and neuroregulatory disorders. Hypothyroidism has been reported to be associated with impaired motor function in esophagus due to accumulation of glycosaminoglycan hyaluronic acid in its soft tissues, leading to changes in various contraction and relaxation parameters of esophagus, particularly in the lower esophageal sphincter. In this study we evaluated esophageal transit times in patients of primary hypothyroidism using the technique of radionuclide esophageal transit scintigraphy. Methods Thirty-one patients of primary hypothyroidism and 15 euthyroid healthy controls were evaluated for esophageal transit time using 15–20 MBq of Technetium-99m sulfur colloid diluted in 10–15 mL of drinking water. Time activity curve was generated for each study and esophageal transit time was calculated as time taken for clearance of 90% radioactive bolus from the region of interest encompassing the esophagus. Esophageal transit time of more than 10 seconds was considered as prolonged. Results Patients of primary hypothyroidism had a significantly increased mean esophageal transit time of 19.35 ± 20.02 seconds in comparison to the mean time of 8.25 ± 1.71 seconds in healthy controls (P < 0.05). Esophageal transit time improved and in some patients even normalized after treatment with thyroxine. A positive correlation (r = 0.39, P < 0.05) albeit weak existed between the serum thyroid stimulating hormone and the observed esophageal transit time. Conclusions A significant number of patients with primary hypothyroidism may have subclinical esophageal dysmotility with prolonged esophageal transit time which can be reversible by thyroxine treatment. Prolonged esophageal transit time in primary hypothyroidism may correlate with serum thyroid stimulating hormone levels. PMID:27444283

  8. Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism.

    PubMed

    Khan, Shoukat H; P, Madhu Vijay; Rather, Tanveer A; Laway, Bashir A

    2017-01-30

    Esophageal dysmotility is associated with gastrointestinal dysmotility in various systemic and neuroregulatory disorders. Hypothyroidism has been reported to be associated with impaired motor function in esophagus due to accumulation of glycosaminoglycan hyaluronic acid in its soft tissues, leading to changes in various contraction and relaxation parameters of esophagus, particularly in the lower esophageal sphincter. In this study we evaluated esophageal transit times in patients of primary hypothyroidism using the technique of radionuclide esophageal transit scintigraphy. Thirty-one patients of primary hypothyroidism and 15 euthyroid healthy controls were evaluated for esophageal transit time using 15-20 MBq of Technetium-99m sulfur colloid diluted in 10-15 mL of drinking water. Time activity curve was generated for each study and esophageal transit time was calculated as time taken for clearance of 90% radioactive bolus from the region of interest encompassing the esophagus. Esophageal transit time of more than 10 seconds was considered as prolonged. Patients of primary hypothyroidism had a significantly increased mean esophageal transit time of 19.35 ± 20.02 seconds in comparison to the mean time of 8.25 ± 1.71 seconds in healthy controls (P < 0.05). Esophageal transit time improved and in some patients even normalized after treatment with thyroxine. A positive correlation (r = 0.39, P < 0.05) albeit weak existed between the serum thyroid stimulating hormone and the observed esophageal transit time. A significant number of patients with primary hypothyroidism may have subclinical esophageal dysmotility with prolonged esophageal transit time which can be reversible by thyroxine treatment. Prolonged esophageal transit time in primary hypothyroidism may correlate with serum thyroid stimulating hormone levels.

  9. Comparison of the iron oxide-based blood-pool contrast medium VSOP-C184 with gadopentetate dimeglumine for first-pass magnetic resonance angiography of the aorta and renal arteries in pigs.

    PubMed

    Schnorr, Jörg; Wagner, Susanne; Abramjuk, Claudia; Wojner, Ines; Schink, Tania; Kroencke, Thomas J; Schellenberger, Eyk; Hamm, Bernd; Pilgrimm, Herbert; Taupitz, Matthias

    2004-09-01

    VSOP-C184 at a dose of 0.045 mmol Fe/kg has been shown to be an efficient blood pool contrast medium for equilibrium magnetic resonance angiography (MRA) that can be administered as a bolus. The present study was performed to determine whether VSOP-C184 is also suitable for first-pass MRA. Fifteen MRA examinations at 1.5 T were performed in minipigs using a fast 3D fast low-angle shot (FLASH) sequence (repetition time = 4.5 ms, echo time = 1.7 ms, excitation angle = 25 degrees, matrix 256, body phased-array coil). The citrate-stabilized iron oxide preparation VSOP-C184 was investigated (total particle diameter: 7.0 +/- 0.15 nm; core size: 4 nm) and compared with gadopentetate dimeglumine (Gd-DTPA). The following doses were tested: VSOP-C184: 0.015, 0.025, and 0.035 mmol Fe/kg; Gd-DTPA: 0.1 and 0.2 mmol Gd/kg; n = 3 examinations/dose. Data were analyzed quantitatively (signal enhancement (ENH) and vessel edge definition (VED)) and qualitatively. First-pass MRA using the 3 doses of VSOP-C184 yielded the following ENH: aorta: 9.4 +/- 2.6; 12.31 +/- 1.2; 16.53 +/- 1.7; renal arteries: 7.6 +/- 2.2; 9.9 +/- 1.0; 13.2 +/- 0.5. The values for the 2 doses of Gd-DTPA were aorta: 12.9 +/- 1.0; 16.8 +/- 2.2; renal arteries: 11.2 +/- 1.23; 11.3 +/- 1.7. VED for the 3 doses of VSOP-C184 was aorta: 106.3 +/- 31.0; 135.3 +/- 58.8; 141.3 +/- 71.0; renal arteries: 102.2 +/- 24.3; 146.8 +/- 63.0; 126.9 +/- 37.6 and for the 2 doses of Gd-DTPA, aorta: 157.2 +/- 47.8; 164.2 +/- 36.8; renal arteries: 165.9 +/- 30.4; 170.3 +/- 38.2 respectively. The differences between VSOP-C184 and Gd-DTPA are clinically not relevant and statistically not significant (p > or = .05). Qualitative evaluation of image quality, contrast, and delineation of vessels showed the results obtained with VSOP-C184 at doses of 0.025 and 0.035 mmol Fe/kg to be similar to those of Gd-DTPA at 0.1 and 0.2 mmol Gd/kg. VSOP-C184 is suitable for first-pass MRA at doses of 0.025 and 0.035 mmol Fe/kg and thus, in addition to

  10. 99mTc red blood cell scintigraphy in evaluating focal liver lesions

    SciTech Connect

    Rabinowitz, S.A.; McKusick, K.A.; Strauss, H.W.

    1984-07-01

    To determine the accuracy of blood-pool imaging in the diagnosis of hepatic hemangiomas, 39 patients with various focal hepatic lesions were studied. The diagnoses in these patients were made by biopsy, angiography, surgical exploration, or clinical stability for a minimum of 14 months. The diagnoses were: hemangiomas (13 patients), hepatoma (three), metastases (19), abscesses (two), and liver cysts (two). After modified in vivo labeling of red blood cells with 20 mCi (740 MBq) of 99mTc pertechnetate, an initial flow study and early (1-15 min) and delayed (1-2 hr) static images were obtained. Increased blood-pool activity with a discordant flow pattern was seen in 11 of 13 patients with hemangiomas. False-negative scans occurred in two hemangiomas with extensive fibrosis. Two of three hepatomas had increased blood-pool activity associated with increased flow in a pattern identical to the increased blood-pool activity. None of the metastatic, abscess, or cystic lesions had increased blood-pool activity at any time after injection. It is concluded that 99mTc red blood cell imaging can distinguish hemangiomas from other focal liver lesions.

  11. [Evaluation of lung perfusion scintigraphy without ventilation scintigraphy in the diagnosis of pulmonary thromboembolism].

    PubMed

    Jurkiene, Nemira

    2002-01-01

    The role of perfusion lung scintigraphy in the diagnosis of pulmonary embolism (PE) is reviewed. During the study 227 perfusion lung scans were obtained. The scans were grouped according to the PIOPED criteria into 5 groups: normal scans, very low, low, intermediate and high PE probability. The perfusion scans were analyzed according to the original PIOPED criteria, without ventilation scans. Evidence is provided that a normal perfusion scan excludes pulmonary embolism, and that a high probability lung scan, defined as a segmental perfusion defect with locally normal chest X-ray or findings in X-ray are smaller, sufficiently confirms the presence of pulmonary embolism in the majority of these patients (92.2%).

  12. 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.

  13. Myopericarditis in acquired immunodeficiency syndrome diagnosed by gallium scintigraphy

    SciTech Connect

    Cregler, L.L.; Sosa, I.; Ducey, S.; Abbey, L. )

    1990-07-01

    Myocarditis is among the cardiac complications of acquired immunodeficiency syndrome and, yet, is often not discovered until autopsy. Gallium scintigraphy has been employed in diagnosing this entity, but few data are available about its diagnostic accuracy and value. Here, the authors report two cases of myopericarditis as diagnosed by gallium scan.

  14. 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.

  15. Hepatic hemangiomas: evaluation by magnetic resonance imaging and technetium-99m red blood cell scintigraphy

    SciTech Connect

    Brown, R.K.; Gomes, A.; King, W.; Pusey, E.; Lois, J.; Goldstein, L.; Busuttil, R.W.; Hawkins, R.A.

    1987-11-01

    A study was performed to evaluate and compare the sensitivity of magnetic resonance imaging (MRI) and radionuclide blood-pool scanning in the detection of hepatic hemangiomas. All patients had known hemangiomas which were first detected on either ultrasound or computed tomography. Sixteen patients with a total of 23 lesions were investigated. Eleven patients had both MRI and blood-pool scans performed. In the group studied by both modalities, 18 lesions were detected ranging in size from 1 to 11 cm. All lesions were detected by both techniques. However, two of the 18 lesions had an atypical appearance on MRI. Our experience to date indicates that the anatomic location and specific diagnosis of hemangiomas can be made with a high degree of certainty when both MRI and blood-pool scanning techniques are utilized.

  16. Utility of thallium-201 scintigraphy in Tolosa-Hunt syndrome.

    PubMed

    Kakisaka, Yosuke; Kobayashi, Tomoko; Uematsu, Mitsugu; Numata, Yurika; Hirose, Mieko; Hino-Fukuyo, Naomi; Tsuchiya, Shigeru; Doi, Hiroshi; Fukuda, Hiroshi; Kure, Shigeo

    2013-01-01

    Tolosa-Hunt syndrome (THS) is a rare disorder, especially in the pediatric population, characterized by unilateral painful ophthalmoplegia with a relapsing-remitting course. Because the diagnosis of THS is based on the exclusion of other causes of painful ophthalmoplegia, attention should be paid to possible alternative diagnoses. Thallium-201 chloride ((201)Tl) scintigraphy has been used to evaluate tissue histology in clinical oncology with a marker, the retention index (RI). A higher value indicates histological malignancy. Although its utility in pediatric THS has not been discussed, we suggest that (201)Tl scintigraphy may be informative as a marker in the diagnosis. We present an 11-year-old boy with THS who was evaluated with (201)Tl scintigraphy before treatment with corticosteroids, when he had headache, photophobia, and diplopia. The RI of (201)Tl indicated that the lesion would be benign. Although his clinical symptoms did not fulfill the THS criteria completely, his eye symptoms disappeared 2 weeks after corticosteroid treatment, which was not within the 72 h as in the diagnostic criteria of THS. He has been symptom-free for more than 2 years with only an initial 4-week corticosteroid therapy. This report not only shows the potential of (201)Tl scintigraphy to contribute to the correct diagnosis of pediatric THS but also suggests the possibility that the diagnosis of THS could be supported uniquely even in a pediatric THS-suspicious patient who did not fulfill the current THS criteria completely. In conclusion, we suggest that (201)Tl scintigraphy may be useful for making the diagnosis of THS, especially in pediatric patients.

  17. Utilization of nuclear medicine scintigraphy in Taiwan, 1997-2009.

    PubMed

    Hung, Mao-Chin; Hsieh, Wanhua Annie; Chang, Peter Wushou; Hwang, Jeng-Jong

    2011-12-01

    To analyze the utilization of nuclear medicine scintigraphy in the Taiwanese population within the national health-care system between 1997 and 2009. Based on the Taiwan's National Health Insurance Research Database of 1997-2009, a retrospective population-based analysis was conducted. Descriptive statistics and regression analysis were employed to analyze the frequencies and longitudinal trends in the utilization of diagnostic nuclear medicine procedures during the period. In addition, correlation analysis was applied to determine the correlated factors in the utility of nuclear medicine scintigraphy. The annual total nuclear medicine scintigraphy was estimated to be 256,389 on average in 1997-2009 and 11.7 per 1,000 population over the period. The frequency had increased by 67% over the years, from 8.2 per 1,000 population in 1997 to 13.7 per 1,000 population in 2009. The most frequently performed procedures were whole-body bone scans (33.4% of total) and myocardial perfusion scans (29.4% of total), with 4,615 and 5,620 increments per year, respectively. Most patients were in the age group of 41-65 years old when taking examinations. In addition, male subjects were slightly more than female patients (51.5 vs. 48.5%). Furthermore, the frequencies of whole-body bone scans and PET scans were proportional to the incidences of cancers (correlation coefficients were 0.96 and 0.94, respectively). The utilization of nuclear medicine scintigraphy with the National Health Insurance system in Taiwan has been changed considerably in the past 13 years. Both whole-body bone scan and myocardial perfusion scan were performed most often with significantly increases. The trend of nuclear medicine scintigraphy may have potential impact on making health-care policy in Taiwan.

  18. 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

  19. Role of thallium-201 total-body scintigraphy in follow-up of thyroid carcinoma

    SciTech Connect

    Hoefnagel, C.A.; Delprat, C.C.; Marcuse, H.R.; de Vijlder, J.J.

    1986-12-01

    To evaluate the reliability of total-body scintigraphy using (/sup 201/Tl)chloride in postoperative follow-up of thyroid carcinoma, this procedure was performed in 326 patients after total thyroidectomy for thyroid carcinoma. The results were compared with those of 131I scintigraphy and thyroglobulin assays. /sup 201/Tl total-body scintigraphy was found to have the greatest sensitivity (94%), whereas /sup 131/I scintigraphy had the highest specificity (99%). It is shown that /sup 201/Tl total-body scintigraphy is a useful procedure in follow-up of thyroid cancer, however, the combination of parameters provides the greatest reliability. In medullary thyroid carcinoma, which is usually /sup 131/I negative, /sup 201/Tl total-body scintigraphy can be of great value for the localization of metastases which are indicated by elevated serum levels of calcitonin and carcinoembryonic antigen.

  20. ROC analysis of diagnostic performance in liver scintigraphy.

    PubMed

    Fritz, S L; Preston, D F; Gallagher, J H

    1981-02-01

    Studies on the accuracy of liver scintigraphy for the detection of metastases were assembled from 38 sources in the medical literature. An ROC curve was fitted to the observed values of sensitivity and specificity using an algorithm developed by Ogilvie and Creelman. This ROC curve fitted the data better than average sensitivity and specificity values in each of four subsets of the data. For the subset dealing with Tc-99m sulfur colloid scintigraphy, performed for detection of suspected metastases and containing data on 2800 scans from 17 independent series, it was not possible to reject the hypothesis that interobserver variation was entirely due to the use of different decision thresholds by the reporting clinicians. Thus the ROC curve obtained is a reasonable baseline estimate of the performance potentially achievable in today's clinical setting. Comparison of new reports with these data is possible, but is limited by the small sample sizes in most reported series.

  1. Bone scintigraphy in children with cat scratch disease.

    PubMed

    Donoso, Gilda; Paulsen, Cesar; Riquelme, Paulina; Lobo, Gabriel; Gutierrez, Daniela; Perez, Andrés; Jiménez, César

    2013-12-01

    The objective of this study was to evaluate the degree and incidence of bone involvement in patients with cat scratch disease. Patients admitted between 2004 and 2011 at the pediatric department for cat scratch disease and a positive serology for Bartonella henselae were identified. Only those having undergone a bone scintigraphy (BS) were included in this retrospective study. Sixteen girls and 8 boys with a mean age of 7 years were studied. Bone scintigraphy was positive in 6 (25%), but only 2 had bone pain. Axial involvement was present in all 6 patients, and appendicular lesions in 3 of them. Three patients had a BS control, with improvement or normalization after treatment with antibiotics. Bone involvement occurs infrequently in patients with cat scratch disease and is not always associated with specific signs. Cat scratch disease must be suspected in patients with fever of unknown origin presenting multifocal lesions on BS.

  2. Absorbed dose to the fetus during bone scintigraphy

    SciTech Connect

    Hedrick, W.R.; DiSimone, R.N.; Wolf, B.H.; Langer, A.

    1988-07-01

    The authors observed the uptake of radiopharmaceutical and calculated absorbed dose in fetuses of two patients who underwent bone scintigraphy with technetium-99m methylene diphosphonate. Dose estimates per administered activity were 17 mrad/mCi (4.6 microGy/MBq) for an 8-week-old fetus and 9.7 mrad/mCi (2.6 microGy/MBq) for an 18-week-old fetus. Neither fetus demonstrated radionuclide uptake above maternal background levels. The uterine activity showed rapid clearance, with an effective half-life of 12 minutes after reaching a maximum within 1 minute after injection. Major contribution to fetal dose comes from the presence of the radionuclide in the maternal bladder. The authors conclude that bone scintigraphy performed unknowingly in pregnant individuals presents negligible increased risk to the fetus.

  3. Pulmonary scintigraphy and the diagnosis of pulmonary embolism. A perspective

    SciTech Connect

    Polak, J.F.; McNeil, B.J.

    1984-09-01

    The authors attempt to demonstrate those circumstances for which perfusion scintigraphy, by itself, or in combination with ventilation scintiscanning, offers the best adjunctive information in excluding or confirming the presence of pulmonary embolism. They then identify those circumstances in which scintiscanning does not or cannot contribute significantly to the medical decision-making process. In these cases, the use of pulmonary angiography or possibly peripheral venography is not only recommended but, if warranted clinically, is absolutely necessary.

  4. Visualization of bullet track and bullet by radionuclide brain scintigraphy.

    PubMed

    Sinha, Partha; Conrad, Gary R; Williams, Brad L

    2005-04-01

    Radionuclide brain scintigraphy is a commonly performed examination for the confirmation of brain death. Although the absence of scintigraphically detectable flow of lipophilic tracers to the brain combined with the lack of uptake in the brain is considered consistent with brain death in the appropriate clinical scenario, the cause of death itself is usually not apparent on the scan. A case of bullet track and bullet visualization during a radionuclide brain death study with Tc-99m hexamethylpropyleneamine oxime (HMPAO) is described.

  5. 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.

  6. Pulmonary scintigraphy in fibrosing mediastinitis due to histoplasmosis

    SciTech Connect

    Park, H.M.; Jay, S.J.; Brandt, M.J.; Holden, R.W.

    1981-04-01

    The pulmonary scintigraphic findings from our patients with fibrosing mediastinitis due to histoplasmosis are reported. The ventilation/perfusion (V/Q) mismatch mimicked pulmonary emboli. However, in these cases the chest radiographs and/or gallium-67 scintigraphy were abnormal, suggesting mediastinal or hilar disease. Awareness of the nonembolic conditions that can result in V/Q mismatches is important in the interpretation of lung scans.

  7. [Variability in interpretation of static renal scintigraphy findings].

    PubMed

    Jaksić, Emilija; Beatović, Slobodanka; Paunković, Nebojsa; Stefanović, Aida; Han, Ruben

    2005-03-01

    Static renal scintigraphy with 99mTc-DMSA is a sensitive method for evaluation of any reduction of cortical mass function. There is not enough reliable references in the literature on scintigraphic reports in terms of objectivity and standardization. The aim of this paper was to assess the differences in interpretation of routine renal scintigraphic findings by nuclear medicine specialists from various institutions (interobserver variability). Both interobserver variability and agreement in the interpretation were evaluated in two groups. Six observers from four different institutions (group A), and three observers from the same institution (group B) interpreted independently 60 static renal scintigraphy findings obtained by analogous imaging using x-ray films in four standard projections. Using at least two options, seven parameters of renal scintigraphy protocols were analysed: size (1), uptake (2), outlines (3), scars (4), focal changes (5), relative function (6), and conclusions (7). The interpretations of scintigraphic findings were in accordance in items 1 to 7 within the group A: 62, 42.5, 45, 9, 47, 52, and 34 percent respectively, and within the group B: 72, 55, 59, 22, 62, 60, and 41 percent, respectively. The conformity was more significant in the findings observed in group B as opposed to group A, which was statistically highly significant, especially for the category of scars (p < 0.01). Significant variability was also observed by six observers in all the parameters of scintigraphic protocol, especially, again, in the scars analysis (p < 0.01). Insignificant degree of accordance, especially in the assessment of scars necessitates the standardization of criteria and terminology in order to interprete the renal scintigraphy with more accuracy and objectivity.

  8. 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.

  9. Diagnostic significance of indium-111 granulocyte scintigraphy in febrile patients

    SciTech Connect

    Syrjaelae, M.T.Va.; Valtonen, V.; Liewendahl, K.; Myllylae, G.

    1987-02-01

    Sixty-eight patients with fever of unknown origin, 32 patients with postoperative fever, and 26 patients with therapy-resistant fever after bacteremia were investigated with (/sup 111/In) granulocyte scintigraphy for the detection of abscesses. The results showed that the value of (/sup 111/In)granulocyte scintigraphy in the detection of infectious foci vary in these three types of febrile conditions. The overall sensitivity and specificity were 86.5% and 87.8%, respectively. We observed, however, a relatively low predictive value of a positive result in the fever of unknown origin group (73.1%), and also a low predictive value of a negative result in the bacteremia group (66.7%). The C-reactive protein (CRP) levels in patients with a true-positive scintigram were significantly (p less than 0.001) higher than in patients with a true-negative scintigram. There was also a significant positive correlation (p less than 0.01) between the serum CRP concentration and the intensity of the granulocyte accumulations. There was no correlation between the peripheral leukocyte count or the erythrocyte sedimentation rate (ESR) and the intensity of the granulocyte uptake. Therefore CRP, but not the leukocyte count or ESR, appears useful for selecting the patients who benefit most from granulocyte scintigraphy.

  10. [Pulmonary scintigraphy in the diagnosis of pulmonary embolism].

    PubMed

    Favretto, Giuseppe

    2002-01-01

    Pulmonary scintigraphy constitutes an important step in the non invasive diagnosis of pulmonary embolism (PE). This technique may be employed for the evaluation of the pulmonary perfusion alone, as in Italy and in the PISA-PED study, or else even for the evaluation of the pulmonary ventilation (as in Anglo-Saxon countries and in the PIOPED study). In the present study, the reasons which have prompted the ANMCO-SIC Commission for the Guidelines for The Prophylaxis, Diagnosis and Therapy of Pulmonary Thromboembolism to propose, for the diagnostic work-up of the patient with clinically suspected PE, the use of perfusion scintigraphy alone and of the classification criteria employed in the PISA-PED study instead of the more commonly utilized ventilatory-perfusion scintigraphy and of the criteria included in the PIOPED article, are discussed. Besides, the Commission's decision to consider PE as being present in case of agreement between the scintigraphic and clinical pictures, and to exclude this condition when the scintigraphic outcome is normal/almost normal regardless of the clinical probabilities, is also motivated.

  11. 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.

  12. Statin induced myopathy does not show up in MIBI scintigraphy.

    PubMed

    Lupattelli, G; Palumbo, B; Sinzinger, H

    2001-05-01

    Statin induced myopathy is the most commonly seen side effect in users of this family of drugs. Their different forms present with either creatine phosphokinase (CK) elevation or not, signs of in vivo oxidation injury or not or a combination of both. The pathogenetic background, however, still remains obscure. As MIBI, beside myocardial and tumour scintigraphy, is useful in detecting muscle metabolic abnormalities, an increased uptake of MIBI in the diseased muscular segments could be expected. We investigated seven patients (five males, two females; aged 36-56 years) with statin induced myopathy with either elevated CK, isoprostanes or muscle pains at varying combinations. MIBI whole-body imaging was done immediately, the patients still being on the respective statin. Sixteen patients (six males, 10 females) suffering from lung or breast cancer and being on statins served as controls. No uptake abnormalities in any muscular segment either in the patients or the control group were seen. Thus, MIBI scintigraphy is not useful, apparently, in diagnosing and eventually localizing statin induced myopathy. These findings indicate that MIBI scintigraphy is of no help for diagnosis and gaining further insight into statin induced myopathy.

  13. Comparison of scintigraphy and magnetic resonance imaging for stress injuries of bone.

    PubMed

    Ishibashi, Yasuyuki; Okamura, Yoshihisa; Otsuka, Hironori; Nishizawa, Kazuharu; Sasaki, Taisuke; Toh, Satoshi

    2002-03-01

    To compare findings of radiography, scintigraphy, and magnetic resonance imaging (MRI) in stress injuries of bone and evaluate changes of these findings with time correlated with clinical symptoms. Prospective study. A primary care hospital outpatient orthopedic clinic. All 31 patients with stress injuries of bone who visited our clinic from July 1996 to June 2000. Radiography, scintigraphy, MRI, and clinical examinations were performed on the same day or at least within 1 week of each other, and the findings were compared. If symptoms of stress injury of bone continued, these examinations were repeated at intervals of 2 months until symptoms disappeared. These radiologic findings were assessed by an independent radiologist who was blinded to the clinical symptoms of the patients. Correlation accuracy of MRI and scintigraphy findings with clinical symptoms. Even with negative initial radiographic findings, all initial scintigraphy and MRI indicated stress injury of bone. There were no patients with positive/negative examinations. Grade of scintigraphy and MRI were closely correlated, and these findings also correlated with the degree of clinical symptoms. Compared with scintigraphy, MRI showed more diagnostic information, such as fracture line and periosteal edema. Areas of increased activity in scintigraphy were consistent with the grades of MRI, especially high signal intensity areas of STIR (short tau inversion recovery) image. From these observations, MRI is less invasive, provides more information than scintigraphy, and is recommended for initial diagnosis and assessment stages of stress injury of bone.

  14. Failure of Gallium-67 scintigraphy to identify reliably noninfectious interstitial nephritis: concise communication

    SciTech Connect

    Graham, G.D.; Lundy, M.M.; Moreno, A.J.

    1983-07-01

    Gallium-67 scintigraphy has been reported to be useful in the diagnosis of noninfectious interstitial nephritis. We studied 12 patients with Ga-67 citrate that were diagnosed as having noninfectious interstitial nephritis on renal biopsy. Only seven of the twelve patients with interstitial nephritis on biopsy were scan-positive. Gallium-67 scintigraphy may not reliably identify noninfectious interstitial nephritis.

  15. Salivary Gland Scintigraphy in Patients with Sjogren's Syndrome: A local Experience with Dual-tracer.

    PubMed

    Luk, Wing Hang; Yeung, Jessie Tse Hang; Fung, Eliza Po Yan; Lok, Chiu Ming; Ng, Yuet Ming

    2017-01-01

    To review the findings of the patients with Sjögren's syndrome (SS) having technetium99-m-pertechnetate ((99m)Tc-pertechnetate) and gallium67- citrate (Ga-67) salivary gland scintigraphy in the past eight years. The patients with SS, who were referred to our department for salivary gland scintigraphy during January -2008December 2015 were studied using both (99m)Tc-pertechnetate and Ga-67 citrate scintigraphy. Eighteen patients were included in the study, 17 of whom had positive findings on (99m)Tc-pertechnetate salivary gland scintigraphy. One patient had negative parotid glands findings on (99m)Tc-pertechnetate, but positive findings in Ga-67 study. Four patients had asymmetric involvement of the parotid glands, and one patient had asymmetric involvement of the submandibular glands in (99m)Tc-pertechnetate salivary gland scintigraphy. On the other hand, one patient had only submandibular gland involvement in the (99m)Tc-pertechnetate scan. Nine patients (18/9) had positive parotid gland findings on Ga-67 study. The involvements of the parotid glands were all symmetrical, except for one patient. No abnormal gallium uptake in the submandibular glands in our patients was noted. (99m)Tc-pertechnetate salivary gland scintigraphy is sufficient for the assessment in the majority of patients with SS. Ga-67 scintigraphy may be a useful supplementary test, especially if the result of (99m)Tc-pertechnetate scintigraphy is not conclusive.

  16. Incidental detection of a bleeding gastrointestinal stromal tumor on Tc-99m red blood cell scintigraphy.

    PubMed

    Santhosh, Sampath; Bhattacharya, Anish; Gupta, Vikas; Singh, Rajinder; Radotra, Bishan Dass; Mittal, Bhagwant Rai

    2012-10-01

    The role of 99m-technetium labeled red blood cell (RBC) scintigraphy in acute gastro-intestinal bleed is well-established. The authors report a case of a bleeding gastrointestinal stromal tumor (GIST) incidentally discovered on Tc-99m RBC scintigraphy.

  17. False-positive technetium 99m depreotide scintigraphy resulting from round atelectasis.

    PubMed

    Thomas, Linda P; Balingit, Antonio G; Morison, David S; Gilman, Matthew D

    2003-04-01

    The authors report two cases of round atelectasis that showed increased accumulation of technetium (Tc) 99m depreotide on planar and single photon emission computed tomographic scintigraphy. It should be considered that round atelectasis is a potential nonmalignant cause for positive 99mTc depreotide scintigraphy.

  18. Value of bone scintigraphy for detection and ageing of vertebral fractures in patients with severe osteoporosis and correlation between bone scintigraphy and mineral bone density.

    PubMed

    Kucukalic-Selimovic, Elma; Begic, Amela

    2004-01-01

    Osteoporosis is the most common of the metabolic bone diseases, and is an important cause of morbidity in the elderly. Bone scintigraphy is used to detect skeletal lesions at the earliest possible time, to monitor the course of the skeletal discase and to evaluate the metabolic activity of skeletal lesions. The aim of this study was to determine, by using the bone scan age of vertebral fractures in patients with severe osteoporosis, and make correlation between bone scintigraphy and mineral bone density. Material and methods 30 female patients were studied with bone scintigraphy after BMD.BMD was measurred with DEXA Hologic QDR 4500 Elite System. Correlation between T-score and uptake of radiofarmaceutical (Tc-99mMDP) was 0.849, and it was high. Intensity of uptake of Tc-99m MDP scintigraphy is an accurate method for the detection and ageing of fractures in osteoporotic patients.

  19. Diffuse Hepatic and Spleen Uptake of Tc-99m MDP on Bone Scintigraphy Resembling Liver-Spleen Scintigraphy in a Patient of Plasma Cell Tumor.

    PubMed

    Ravanbod, Mohammad Reza; Nemati, Reza; Javadi, Hamid; Nabipour, Iraj; Assadi, Majid

    2014-01-01

    The present case demonstrates a diffuse intense hepatic and, to a lesser degree, spleen, Tc-99m MDP uptake on a routine bone scintigraphy resembling liver-spleen imaging. A 49-year-old female with a history of anaplastic plasma cell tumor and suffering from bone pain was referred for bone scintigraphy to evaluate possible bone metastases. The bone scintigraphy showed diffuse hepatic and spleen uptake of Tc-99m MDP resembling liver-spleen imaging. Furthermore, bone uptake of Tc-99m MDP was significantly diminished and there were no abnormal foci throughout the skeleton. The bone scintigraphy of the present case of an anaplastic plasma cell tumor suggests the possible presence of amyloidosis.

  20. 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.

  1. 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

  2. Perfusion scintigraphy and patient selection for lung volume reduction surgery.

    PubMed

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

    2010-10-01

    It is unclear if lung perfusion can predict response to lung volume reduction surgery (LVRS). To study the role of perfusion scintigraphy in patient selection for LVRS. 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. 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. 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.

  3. Gallium scintigraphy in a case of tuberculous trochanteric bursitis.

    PubMed

    Kawamura, Etsushi; Kawabe, Joji; Tsumoto, Chikako; Hayashi, Takehiro; Oe, Ai; Kurooka, Hiroko; Kotani, Jin; Higashiyama, Shigeaki; Tsushima, Hiroyuki; Habu, Daiki; Shiomi, Susumu

    2007-06-01

    We report a 67-year-old woman with systemic lupus erythematosus and systemic disseminated tuberculosis affecting the femoral trochanteric bursae, a site rarely affected by tuberculosis. For quantification of the inflammation with gallium-67 scintigraphy, we calculated the radioisotope count ratio in the most inflamed areas, the right lateral thorax and bursa of the right greater trochanter. Systemic scanning with this modality allowed evaluation of the extent of lesions and simple quantitative determination of the severity of inflammation, yielding information useful for the follow-up of the patient during the course of tuberculosis treatment.

  4. Skeletal Scintigraphy in Radiation-Induced Fibrosis With Lymphedema.

    PubMed

    Wang, Jieqi; Iranmanesh, Arya M; Oates, M Elizabeth

    2017-03-01

    Despite increasing reliance on CT, MRI, and FDG PET/CT for oncological imaging, whole-body skeletal scintigraphy remains a frontline modality for staging and surveillance of osseous metastatic disease. We present a 54-year-old woman with metastatic breast cancer who received palliative external-beam radiation to the left ilium. Serial follow-up Tc-MDP bone scans demonstrated progressive soft-tissue uptake in her left lower extremity, extending from thigh to leg, with associated enlargement and skin thickening, consistent with lymphedema related to radiation-induced fibrosis. Correlative abdominopelvic CT scans confirmed fibrotic changes in the left thigh.

  5. Three-phase bone scintigraphy in Pellegrini-Stieda disease.

    PubMed

    Liu, R S; Chou, C S; Yeh, S H

    1987-01-01

    In a patient with Pellegrini-Stieda disease, radiographs of the knees were unremarkable at the time the three-phase bone scintigraphy was abnormal. The results of follow-up radiographs three months later remained normal in the left knee, where local steroid injection was given, but revealed typical positive results in the right knee with no treatment. The three-phase bone scintigraphic pattern is rather typical and antedates the radiographic changes. Thus, the radionuclide technique would provide a useful procedure for the early diagnosis and treatment of Pellegrini-Stieda disease.

  6. Radiation hazards from horses undergoing scintigraphy using technetium-99m.

    PubMed

    Whitelock, R G

    1997-01-01

    This paper quantifies the extent of the radiation hazard to personnel from horses undergoing scintigraphy using technetium99m methylene diphosphonate (99Tcm-MDP). From the data produced it is possible to derive safe working protocols which are comfortably within the legislated limits for whole body doses as set out in the Ionising Radiations Regulations 1985. Measurements were made of the surface and environmental activities which result from individuals undergoing scintigraphic evaluation and also from urine contaminated bedding. The use of both high and low activities in the assessment of the radiation hazard to personnel and owners is considered.

  7. Papillary carcinoma in ectopic thyroid detected by Tl-201 scintigraphy

    SciTech Connect

    Michigishi, T.; Mizukami, Y.; Mura, T.; Nomura, T.; Watanabe, K.; Tonami, N.; Hisada, K. )

    1991-05-01

    A 37-year-old man with papillary carcinoma in an ectopic thyroid is presented. Excisional biopsy revealed the cervical mass to be a metastasis from thyroid cancer. X-ray, ultrasonography, and computed tomography, however, failed to identify the primary tumor in the thyroid. Incidental TI-201 uptake was noted in the midline of the anterior neck, and a palpable nodule was discovered in this area. Fine needle aspiration cytology demonstrated Class V papillary adenocarcinoma, and subsequent surgery confirmed a papillary carcinoma in the ectopic thyroid. This case suggests the usefulness of TI-201 scintigraphy for the detection of ectopic thyroid malignancy.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. [Adrenal cortex scintigraphy with and without dexamethasone suppression in the study of primary aldosteronism].

    PubMed

    Milà López, M; Castell-Conesa, J; Pifarré Montaner, P; Lorenzo Bosquet, C; García-Burillo, A; Porta Biosca, F; Roca Bielsa, I

    2004-01-01

    To evaluate the diagnostic performance and efficacy of adrenal scintigraphy in primary aldosteronism following the protocol that combines adrenal suppression scintigraphy plus non-suppression study. 20 patients referred to our service with the suspicion of primary aldosteronism were studied by combined scintigraphy. Thirteen men and 7 women, mean age of 52 years, aged from 31 to 73 years, were included. Uptake of free iodine by the thyroid was inhibited by oral Lugol 5 % administration. Dexamethasone 4 mg per day was administered from day 7 to the third day of detection, when administration was stopped. Adrenal scintigraphy was performed after intravenous injection of I-131-norcolesterol (37 MBq). Images were taken at 24 and/or 48 hours and on the third day. Afterwards, dexamethasone administration was stopped and late images on 5th and/or 7th days were obtained. The scintigraphic result was confirmed with the final clinical evaluation (FCE) of the patient. 11 patients presented pathological studies, 9 adenomas (8TP + 1FP) and 2 bilateral adrenal hyperplasia (2TP); 7 normal scintigraphies (6TN and 1 non-conclusive FCE) and 2 non-conclusive scintigraphies (1 incidentaloma and 1 non-conclusive FCE). Normal adrenal glands were visualized in all cases on the 5th and/or 7th day scintigraphy. The study of adrenal functionalism by the combined protocol of adrenal suppression study plus later non-suppression study made it possible to identify with high precision primary aldosteronism and to confirm the function of normal adrenal glands.

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

    PubMed

    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. 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.

  16. Acute pyelonephritis resulting in intense vascular blush during dynamic renal scintigraphy

    PubMed Central

    Joshi, Prathamesh; Deshpande, Sushil; Kulkarni, Mukta; Shetkar, Shubhangi

    2016-01-01

    A thirty-year-old male underwent Tc-99m diethylenetriaminepentaacetic acid renal scintigraphy for evaluation of gross hydronephrosis of left kidney. The perfusion phase revealed an intense vascular blush in left renal fossa. The uptake phase of scintigraphy revealed the absence of tracer uptake in left kidney. Contrast-enhanced computed tomography (CECT) was performed for evaluating the cause of vascular blush. CECT demonstrated features suggestive of acute pyelonephritis (APN) involving lower pole of the hydronephrotic left kidney, corresponding to the site of vascular blush seen on renal scintigraphy. The postnephrectomy specimen confirmed the diagnosis of APN suggested on CECT. PMID:26917903

  17. 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.

  18. Gamma scintigraphy using Tc-99m labeled antibody to human chorionic gonadotropin

    SciTech Connect

    Morrison, R.T.; Lyster, D.M.; Alcorn, L.N.; Rhodes, B.A.; Breslow, K.; Burchiel, S.W.

    1984-01-01

    A case report is presented describing a 27-year-old woman with invasive trophoblastic hydatidiform mole metastatic to the lung. Gamma scintiscanning, using a polyclonal and monoclonal antibody specific to human chorionic gonadotropin, hCG, and labeled with Tc-99m, is described. The area of the primary lesion in the uterus was demonstrated with both antibodies tested without computer subtraction techniques; metastatic deposits in the lung were detected only with the aid of blood pool subtraction techniques.

  19. /sup 99m/Tc red blood cell scintigraphy in evaluating focal liver lesions

    SciTech Connect

    Rabinowitz, S.A.; McKusick, K.A.; Strauss, H.W.

    1984-07-01

    To determine the accuracy of blood-pool imaging in the diagnosis of hepatic hemangiomas, 39 patients with various focal hepatic lesions were studied. The diagnoses in these patients were made by biopsy, angiography, surgical exploration, or clinical stability for a minimum of 14 months. The diagnoses were: hemangiomas (13 patients), hepatoma (three), metastases (19), abscesses (two), and liver cysts (two). After modified in vivo labeling of red blood cells with 20 mCi (740 MBq) of /sup 99m/Tc pertechnetate, an initial flow study and early (1-15 min) and delayed (1-2 hr) static images were obtained. Increased blood-pool activity with a discordant flow pattern was seen in 11 of 13 patients with hemangiomas. False-negative scans occurred in two hemangiomas with extensive fibrosis. None of the metastatic, abscess, or cystic lesions had increased blood-pool activity at any time after injection. It is concluded that /sup 99m/Tc red blood cell imaging can distinguish hemangiomas from other focal liver lesions.

  20. The role of scintigraphy in the lameness evaluation.

    PubMed

    Steckel, R R

    1991-08-01

    Bone scanning to help diagnose orthopedic disease has been used in human patients for over two decades. The value of this diagnostic tool has been well established in helping to identify a variety of musculoskeletal conditions. It has only recently been used by veterinarians for more accurate characterization of equine musculoskeletal disease. The technique offers the major advantage of increased sensitivity over standard radiographic imaging. The case material illustrated here shows that except for consistent identification of bone cysts, most of the pathologic changes to the horse's musculoskeletal system that might cause lameness are detected on bone scans. Many acute bone diseases can be diagnosed by scintigraphy that cannot be discerned by radiographs until the condition has become chronic: Because of their body size, these conditions may not be diagnosed at all in horses. Scintigraphy in horses offers the other major advantage of affording accurate imaging of the upper limbs, pelvis, and vertebral column without general anesthesia. Therefore, it has a final advantage of increased safety over conventional radiography because it eliminates the need to perform general anesthesia to study these areas. In the author's experience, if abnormal uptake of isotope in the upper limbs, pelvis or spine is not observed, general anesthesia to radiograph those areas is not warranted. A second major benefit of scintigraphic imaging is to differentiate mixed lameness conditions in which the component of bone disease must be separated from that of soft tissues to arrive at a rational course of treatment or prognosis. Finally, for athletic horses suspected of having lameness due to localized myositis, scintigraphy not only allows confirmation of muscle inflammation but also identifies the muscle bellies injured reasonably accurately so that specific local treatment may be given. Nuclear imaging of equine skeletal disease is an option that should be employed more frequently by

  1. Dual-phase (99m)Tc-MIBI scintigraphy with delayed neck and thorax SPECT/CT and bone scintigraphy in patients with primary hyperparathyroidism: correlation with clinical or pathological variables.

    PubMed

    Qiu, Zhong-Ling; Wu, Bo; Shen, Chen-Tian; Zhu, Rui-Sen; Luo, Quan-Yong

    2014-10-01

    The purpose of this study was to assess the relationship between (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy and clinical or pathological variables, including preoperative serum PTH levels and tumor diameter, in patients with newly diagnosed PHPT. Dual-phase (99m)Tc-MIBI planar scintigraphy was performed in 244 patients with PHPT. Of these patients, 155 underwent (99m)Tc-MDP bone scintigraphy to detect bone changes before parathyroidectomy. Factors influencing (99m)Tc-MIBI scintigraphy and (99m)Tc-MDP bone scintigraphy detection rate were assessed using univariate and multivariate logistic regression analysis; optimal cutoff values for predicting positive (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy were evaluated using ROC analysis. Among 244 patients, 174 (71.31 %) patients with 181 foci had a positive (99m)Tc-MIBI planar scintigraphy; delayed neck and thorax SPECT/CT could identify and locate the (99m)Tc-MIBI lesions but could not find more lesions than planar scintigraphy. 70 (28.69 %) patients had a negative (99m)Tc-MIBI planar scintigraphy. Tumor diameter, serum PTH level and symptoms were statistically significant predictive factors in predicting positive (9m)Tc-MIBI scintigraphy both univariate and multivariate logistic regression analyses. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.03 cm and 127.60 ng/L, respectively. Among 155 patients with bone scintigraphy, (99m)Tc-MDP bone scintigraphy showed positive finding in 80 (51.61 %) patients and negative finding in 75 patients. Univariate logistic regression analysis showed that patient age, sex, tumor diameter and PTH level (≥150 ng/L) were statistically significant in predicting positive (99m)Tc-MDP bone scintigraphy. Multivariate logistic regression analysis showed both tumor diameter and PTH ≥ 150 ng/L were statistically significant in predicting positive (99m)Tc-MDP bone scintigraphy. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were

  2. Altered biodistribution of radiopharmaceuticals used in bone scintigraphy.

    PubMed

    Zuckier, Lionel S; Martineau, Patrick

    2015-01-01

    Bone scintigraphy has remained a mainstay of clinical nuclear medicine for more than 4 decades. Extensive medical literature has developed surrounding the etiology and significance of alterations in distribution of bone radiopharmaceuticals. Altered biodistribution may be of a global nature, reflecting altered partition of radiopharmaceutical between bone and soft tissues, or more focal, reflecting regional abnormalities, including those related to bone or soft tissues. A third category of alterations in the distribution of bone radiopharmaceuticals is those due to errors and blunders, colloquially termed "artifactual" in the medical imaging literature. Being cognizant of these unexpected abnormalities, and understanding their etiology, will prepare the reader to more readily appreciate the significance of these findings when encountered in clinical practice.

  3. /sup 111/In platelet scintigraphy in cerebrovascular disease

    SciTech Connect

    Powers, W.J.; Siegel, B.A.; Davis, H.H.; Mathias, C.J.; Clark, H.B.; Welch, M.J.

    1982-09-01

    We obtained scintigraphic images of the neck from 100 patients with suspected cerebrovascular disease after injecting /sup 111/In-labeled autologous platelets. One or more focuses of increased activity, implying local platelet accumulation, were seen along the course of the cervical carotid arteries in 52 patients. In 64 patients, there was a highly significant correlation between the results of scintigraphy and carotid arteriography (p . 10(6)). There was no significant correlation between the scintigraphic findings and the previous or subsequent occurrence of transient ischemic attack or cerebral infarction in the carotid circulation. These data suggest that factors other than the simple formation of platlet thrombi in the cervical carotid arteries are of primary importance in the pathogenesis of stroke.

  4. Rim sign in Tc-99m sulfur colloid hepatic scintigraphy.

    PubMed

    Joseph, Usha A; Barron, Bruce J; Lamki, Lamk M

    2005-04-01

    A case of pericholecystic hyperperfusion on Tc-99m sulfur colloid (SC) flow images with a pericholecystic rim of increased activity (PCHA) on delayed planar and single-photon emission computed tomography images of the liver was seen in a patient with a history of multiple renal transplants admitted with cramping right lower quadrant abdominal pain. Laparotomy performed 5 days after the scan revealed an acutely perforated gangrenous gallbladder and occluded cystic duct. The secondary findings of gallbladder hyperperfusion and PCHA or "rim sign" have been frequently reported with Tc-99m IDA hepatobiliary imaging. These secondary findings in conjunction with a nonvisualized gallbladder on an IDA scan suggest a complicated or advanced stage of acute cholecystitis and usually require urgent surgical intervention. The rim sign on Tc-99m SC scintigraphy also likely indicates the same grave diagnosis.

  5. 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.

  6. 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.

  7. Diagnostic value of image processing in myocardial scintigraphy

    SciTech Connect

    Cinotti, L.; Meignan, M.; Usdin, J.P.; Vasile, N.; Castaigne, A.

    1983-09-01

    The diagnostic value of stress myocardial analog scintigrams, and of five image-processing methods, was assessed by a decisional analysis in 96 patients undergoing coronary arteriography. The methods involved digitalization, nine-point binomial smoothing, background subtraction by linear interpolation, stationary filtering, and a combination of them. The difference between after-test probabilities of having the disease with a postive or a negative examination provided a discriminant index for different prevalences of the disease. Though the processing methods failed to improve the detection of a circumflex stenosis, the stationary filter significantly increased the diagnostic value for the detection of stenosis in a left anterior descending artery for a large range of prevalence, and in a right coronary artery at high prevalence. Thus, the filter seemed to provide a useful tool for enhancing the diagnostic value of myocardial scintigraphy.

  8. Diagnostic value of image processing in myocardial scintigraphy

    SciTech Connect

    Cinotti, L.; Meignan, M.; Usdin, J.P.; Vasile, N.; Castaigne, A.

    1983-09-01

    The diagnostic value of stress myocardial analog scintigrams, and of five image-processing methods, was assessed by a decisional analysis in 96 patients undergoing coronary arteriography. The methods involved digitalization, nine-point binomial smoothing, background subtraction by linear interpolation, stationary filtering, and a combination of them. The difference between after-test probabilities of having the disease with a positive or a negative examination provided a discriminant index for different prevalences of the disease. Though the processing methods failed to improve the detection of a circumflex stenosis, the stationary filter significantly increased the diagnostic value for the detection of stenosis in a left anterior descending artery for a large range of prevalence, and in a right coronary artery at high prevalence. Thus, the filter seemed to provide a useful tool for enhancing the diagnostic value of myocardial scintigraphy.

  9. 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.

  10. [Imaging of hyperparathyroidism-Ultrasonography and 99mTc-MIBI scintigraphy-].

    PubMed

    Kawabe, Joji; Higashiyama, Shigeaki; Yoshida, Atsushi; Kotani, Kohei; Shiomi, Susumu

    2016-06-01

    Treatments for primary hyperparathyroidism due to adenoma, hyperplasia and carcinoma and secondary hyperparathyroidism are mainly surgical resections of them. Accurate imaging diagnoses of the existences and the regions are very important for reductions of invasiveness. We describe ultrasonography and (99m)Tc-MIBI scintigraphy of hyperparathyroidism. We explain an advantage, a disadvantage and diagnosability of these modalities. We mention utilities of SPECT/CT, too. We show echogram and (99m)Tc-MIBI scintigraphy images about 3 cases of hyperparathyroidism.

  11. 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.

  12. Tc-99m Labeled HMPAO white Blood Cell Scintigraphy in Pediatric Patients.

    PubMed

    Aydın, Funda; Kın Cengiz, Arzu; Güngör, Fırat

    2012-04-01

    (99m)Tc labeled hexamethylpropylene amine oxime (HMPAO) white blood cell (WBC) scintigraphy is a frequently used option for acute infection, particularly in pediatric patients. This scintigraphy is applied to detect sites of infection/inflammation in patients with fever of unknown origin, to find and follow up osteomyelitis, and to detect suspicion of acute appendicitis. The aim of this retrospective study was to evaluate the value of (99m)Tc-HMPAO labeled WBC scintigraphy in pediatric patients. The study was conducted between January 2006 and December 2008 and included 13 patients (5 boys, 8 girls; mean age 6.9±6.2 years). Those patients who had suspicion of bone infection (n=7), fever of unknown origin (n=3), and suspicion of acute appendicitis (n=3) were evaluated retrospectively. (99m)Tc-HMPAO labeled WBC scintigraphy imaging was performed to all patients. Diagnosis was done according to operation and pathological results or clinical follow-up. (99m)Tc-HMPAO labeled WBC scintigraphy has been found to be true positive in 6 cases, true negative in 6 cases, and false negative in one patient who had fewer unknown origin. The false negative case has been found to have encephalitis with MRI. Leukocyte scintigraphy has been described as a useful diagnostic tool in the diagnosis of suspicion of bone infection, fever of unknown origin and suspicion of acute appendicitis. (99m)Tc-HMPAO labeled WBC scintigraphy is a rapid and very accurate method for detecting those pathologies. Our results showed that WBC scintigraphy might be reliably used for diagnosis of suspected bone infection and acute appendicitis, fever of unknown origin, and acute appendicitis, in pediatric patient population. None declared.

  13. Spontaneous perforation of common bile duct in a pediatric patient: application of hepatobiliary scintigraphy.

    PubMed

    Joodi, Marjan; Norouzbeigi, Nasim; Rad, Mohammad Ali Ghodsi; Shojaeian, Reza; Kakhki, Vahid Reza Dabbagh; Sadeghi, Ramin

    2012-10-01

    We report a case of spontaneous biliary perforation in a 21-month old female pediatric patient with the presenting symptoms of abdominal distension, jaundice, and umbilical hernia. Hepatobiliary scintigraphy showed tracer accumulation in the peritoneal cavity. Preliminary diagnosis of spontaneous biliary perforation was confirmed during surgery. After surgical repair of the biliary leakage, the patient recovered fully. This case shows the importance of hepatobiliary scintigraphy in patients suspicious for this condition.

  14. 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.

  15. Improving the diagnostic performance of lung scintigraphy in suspected pulmonary embolic disease.

    PubMed

    Gleeson, F V; Turner, S; Scarsbrook, A F

    2006-12-01

    to determine the effectiveness of a new imaging algorithm in the investigation of suspected pulmonary embolism (PE). A new imaging algorithm for suspected PE was introduced following the installation of a multisection computed tomography (CT) machine at our institution. Before its installation, patients with suspected PE were evaluated with ventilation/perfusion (V/Q) scintigraphy. Subsequently, patients were triaged according to chest radiography (CR) and respiratory history to either lung scintigraphy or CT pulmonary angiography (CTPA). Patients with a normal CR and no history of lung disease were evaluated using perfusion (Q) scintigraphy [ventilation (V) scintigraphy was no longer performed]. Patients with an abnormal CR, asthma or chronic lung disease were evaluated using CTPA. All V/Q images in a continuous 3-year period before the introduction of the new imaging algorithm and all Q images performed in a 3-year period after its introduction were retrospectively reviewed. Imaging reports were categorized into normal, non-diagnostic (low or intermediate probability) or high probability for PE. Patients in the later group who subsequently underwent CTPA, were also reviewed. After the policy change the percentage of normal scintigrams significantly increased (39 to 60%; p<0.001). There was a non-significant increase in the percentage of high probability scintigrams (15 to 18%; p=0.716). Overall the diagnostic yield of lung scintigraphy improved significantly (54 to 78%; p<0.001). the diagnostic performance of lung scintigraphy can be improved by careful triage of patients to either Q scintigraphy or CTPA based on clinical history and CR findings. Q scintigraphy remains a valuable diagnostic test in the investigation of suspected PE in carefully selected patients.

  16. Bone scintigraphy of severe hypercalcemia following simvastatin induced rhabdomyolysis

    PubMed Central

    Mirza, Zubair B.; Hu, Sophia; Amorosa, Louis F.

    2016-01-01

    Summary Simvastatin induced rhabdomyolysis with renal failure is a well reported clinical entity with hyperkalemia recognized as a life threatening risk. The risk of delayed hypercalcemia during the recovery of renal function is not well appreciated as this varies in severity and can be caused by multiple mechanisms. We present a patient with high dose simvastatin induced rhabdomyolysis leading to late onset of severe hypercalcemia due to calcium phosphate deposition in muscles diagnosed by distinctive bone scintigraphy. A 60-year-old Asian male was admitted to the hospital for profound weakness one week following the initiation of simvastatin 80 mg daily post myocardial infarction. His clinical course was complicated by contrast nephropathy. One week later, he developed progressive weakness in all his extremities and inability to raise his head and eat. Simvastatin was discontinued at this point. CPK elevation to greater than 425,000 U was found, consistent with rhabdomyolysis. He became oliguric requiring hemodialysis. Muscle biopsy showed severe muscle necrosis and type 2 fiber atrophy. One month later, he developed hypercalcemia with suppressed intact PTH and 1, 25(OH) D levels. Whole body bone scintigraphy showed calcium phosphate deposition throughout his musculature. His calcium levels normalized in 1 week on hemodialysis. This patient’s experience illustrates the marked risk of delayed severe hypercalcemia from rhabdomyolysis due to dissolution of myocellular calcium phosphate deposits. It also provides an opportunity to review the different mechanisms of hypercalcemia especially in statin induced rhabdomyolysis. Recognition of this phenomenon is critical for appropriate follow up and treatment of such patients. PMID:28228795

  17. Characterization of multiple acquired portosystemic shunts using transplenic portal scintigraphy.

    PubMed

    Morandi, Federica; Sura, Patricia A; Sharp, Dorothy; Daniel, Gregory B

    2010-01-01

    We describe the scintigraphic patterns observed in 14 patients with confirmed multiple portosystemic shunts imaged via transplenic portal scintigraphy. Parameters evaluated included presence of multiple anomalous vessels, presence of hepatofugal flow caudal to spleen, and/or to cranial margin of the kidneys, slow absorption resulting in longer spleen to heart transit time, and presence of biphasic or fragmented bolus. Twenty-eight additional patients, 14 with a confirmed single portocaval and 14 with a portoazygos shunt, were used for comparison. Nine of 14 (64.3%) patients with multiple shunts had multiple vessels, five (35.7%) had a biphasic bolus, 13 (92.9%) had hepatofugal flow caudal to the cranial margin of the kidneys. In all single portocaval shunts, a single anomalous vessel was identified. None had hepatofugal flow caudal to the border of the kidneys. Among portoazygos shunts, 4/14 (28.6%) had flow caudal to the injection site. Six portoazygos and one portocaval shunts had biphasic bolus. Median transit time from spleen to heart was significantly longer (1.9 s) in patients with multiple shunts than in patients with a portocaval shunt (1.0 s), but not in patients with a portoazygos shunt (1.3 s). Although a distinct plexus of anomalous vessels is not detected in all patients with multiple shunts imaged using transplenic portal scintigraphy, findings of hepatofugal flow caudal to the margin of the kidneys, and longer transit time compared with single portocaval shunts were characteristic. Flow caudal to the splenic injection site but cranial to the kidneys and biphasic bolus can also be seen with a single congenital shunt.

  18. Evaluation of antral motility in humans using manometry and scintigraphy.

    PubMed Central

    Jones, K; Edelbroek, M; Horowitz, M; Sun, W M; Dent, J; Roelofs, J; Muecke, T; Akkermans, L

    1995-01-01

    Recent studies suggest that scintigraphy can be used to evaluate non-invasively antral motility in humans, although scintigraphic techniques have not yet been compared with more conventional measurements of intraluminal pressures by manometry. Simultaneous scintigraphic and manometric measurements of antral motility were performed in nine healthy volunteers. After intubation with a sleeve/sidehole catheter which incorporated five pressure sideholes located at 1.5 cm intervals spanning the antrum, each subject ingested 100 g minced beef labelled with 100 MBq 99mTc-chicken liver and 150 ml water. Between 40-43, 60-63, 80-83, and 100-103 minutes after meal ingestion, radioisotopic data were acquired in two second frames. Time-activity curves showing antral 'contractions' resulting from wall motion were derived by drawing small regions of interest over the antrum to coincide with the position of the antral manometric sideholes. Scintigraphic contraction rates approximated 3/minute, whereas antral pressure waves that occluded the lumen were less frequent (p < 0.01 for all), particularly in the proximal antrum. The amplitude of wall motion, evaluated scintigraphically, and the amplitude of pressure waves were both inversely related to the distance from the pylorus (r > -0.32, p < 0.05) and antral volume r > -0.29 (p < 0.05). There were significant relationships between the amplitude of contractions assessed scintigraphically and the number of lumen-occlusive antral pressure waves in the distal antrum (r -0.48, p < 0.05) but not in the more proximal antral regions. It is concluded that scintigraphy can detect antral wall motion with greater sensitivity than manometry, particularly in the proximal antrum. As manometry gives information on the amplitude as well as the temporal and spatial organisation of those contractions which result in lumen occlusion, the combination of scintigraphic and manometric techniques in the evaluation of antral motility shows considerable

  19. [Somatostatin receptor scintigraphy in pediatric bronchial carcinoid tumor].

    PubMed

    Hervás Benito, I; Bello Arques, P; Loaiza, J L; Vercher, J L; Velasco, R P; Rivas Sánchez, A; Ruiz Llorca, C; Martí Vidal, J F; Mateo Navarro, A

    2010-01-01

    Carcinoid tumor is a rare neuroendocrine neoplasm with different locations, the most frequent ones during the pediatric age being the appendix and lung. Scintigraphy with (111)In-DTPA-d-Phe(1)-octreotide has led to an importance advance in the diagnosis of extension in carcinoid tumor patients. We present three pediatric patients with bronchial carcinoid studied with somatostatin analogue scintigraphy (SSRS). The first patient (9 years) was studied using the SSRS after surgery due to carcinoid tumor in the right lower lobe in which tumor remains was observed (this being clearer in the tomography study). The second patient (10 years) presented due to endobronchial tumor in the left lower lobe together with atelectasis of the LUL and emphysema of the LLL. Radiology imaging techniques suggested the differential diagnosis between the endobronchial carcinoid tumor or plasma cells or foreign body gramuloma. The SSRS showed an abnormal deposit of activity in the left hemithorax consisted with carcinoid tumor. No other areas suggesting metastasis were observed. After the surgery (endobronchial resection), new controls with SSRS showed absence of disease. The third patient (12 years) came after a lobectomy (RUL) due to bronchial carcinoid. The SSRS did not show any abnormal areas of activity. In the subsequent control (3 months), a deposit of activity was observed in the middle third of the right hemithorax, after which a lobectomy was performed (RLL and ML) that showed small remains of neuroendocrine carcinoid. Subsequent controls were negative. The SSRS has demonstrated great utility in the diagnosis, follow-up and staging of pediatric patients, carriers of neuroendocrine carcinoid tumors. Copyright 2008 Elsevier España, S.L. y SEMNIM. All rights reserved.

  20. Thyroid scintigraphy findings in 2096 cats with hyperthyroidism.

    PubMed

    Peterson, Mark E; Broome, Michael R

    2015-01-01

    Thyroid scintigraphy is currently the reference standard for diagnosing and staging cats with hyperthyroidism, but few studies describing the scintigraphic characteristics in a large number of cats have been reported. The objective of this study was to better characterize thyroid scintigraphy findings by evaluating 2096 consecutive cats with hyperthyroidism that were referred over a 3.5-year period. Of these cats, 2068 (98.7%) had a high thyroid-to-salivary ratio (>1.5), whereas 2014 (96.1%) were found to have a high thyroid-to-background ratio (>6.1). When the patterns of the cats' thyroid disease were recorded, 665 (31.7%) had unilateral disease, 1060 (50.6%) had bilateral-asymmetric disease (two thyroid lobes unequal in size), 257 (12.3%) had bilateral-symmetric disease (both lobes similar in size), and 81 (3.9%) had multifocal disease (≥3 areas of increased radionuclide uptake). The number of areas of (99m) TcO(-) 4 uptake in the 2096 cats ranged from 1 to 6 (median, 2), located in the cervical area in 2057 (98.1%), thoracic inlet in 282 (13.5%), and in the thoracic cavity in 115 (5.5%). Ectopic thyroid tissue (e.g. lingual or mediastinal) was diagnosed in 81 (3.9%) cats, whereas thyroid carcinoma was suspected in 35 (1.7%) of the cats. The results of this study support conclusions that most hyperthyroid cats have unilateral or bilateral thyroid nodules, but that multifocal disease will develop in a few cats that have ectopic thyroid disease or thyroid carcinoma. Both ectopic thyroid disease and thyroid carcinoma are relatively uncommon in hyperthyroid cats, with a respective prevalence of ∼4% and ∼2% in this study.

  1. Role of red blood cell scintigraphy for determining the localization of gastrointestinal bleeding.

    PubMed

    Sanlı, Yasemin; Ozkan, Zeynep Gözde; Kuyumcu, Serkan; Yanar, Hakan; Balık, Emre; Tokmak, Handan; Türkmen, Cüneyt; Adalet, Işık

    2012-05-01

    We aimed to evaluate the role of Tc-99m labeled red blood cell (RBC) scintigraphy for determination of localization of gastrointestinal system (GIS) bleeding. Fifty-seven cases (27 females, 30 males; mean age 43.9±24; range 1 to 91 years) who referred to our clinic between 1995-2010 were evaluated for determination of localization of GIS bleeding with RBC scintigraphy. Prior to scintigraphy, gastroscopy in 51, colonoscopy in 45, and angiography in 9 patients were performed. RBC scintigraphies were positive and negative in 31 and 26 patients, respectively. Positive scintigraphic findings were obtained within the 1st hour of dynamic imaging in 19 patients, within the 1st-4th hour static images in 7, and within the 4th-24th hour images in 5 patients. Fourteen patients underwent surgical exploration. In 13 patients, the surgery confirmed the diagnosis by RBC scintigraphy (accuracy: 92.8%). Of 43 patients without surgical exploration, 12 had anemia due to iron deficiency and their scintigraphic evaluation were negative. Four patients died and in 27 patients, GIS bleeding ceased spontaneously or with conservative measures. Scintigraphy should be the primary tool for accurate diagnosis of patients with active GIS bleeding. Positive dynamic images obtained within the first hour of imaging may be more accurate for demonstrating bleeding localization and a good predictor of requirement of surgical exploration.

  2. 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.

  3. [Value of radionuclide lung scintigraphy in the diagnosis and quantitative analysis of chronic thromboembolic pulmonary hypertension].

    PubMed

    Fang, Wei; Ni, Xin-Hai; He, Jian-Guo; Liu, Zhi-Hong; Xiong, Chang-Ming; He, Zuo-Xiang

    2008-01-01

    This study was to assess the reliability of perfusion/ventilation (Q/V) lung scintigraphy in the diagnosis and quantitative analysis of chronic thromboembolic pulmonary hypertension (CTEPH). A total of 78 in-patients with pulmonary hypertension who had no history of congenital heart disease, valvular disease and acute pulmonary embolism were included in this study. All patients underwent Q/V scintigraphy for detecting CTEPH. The sensitivity, specificity and accuracy of Q/V scintigraphy were defined by comparing with the results of pulmonary angiography. Percentage of Perfusion Defect score (PPDs%) was calculated in patients with CTEPH confirmed by pulmonary angiography. The correlations between PPDs% and mPAP, PPDs% and SPAP were analyzed. The sensitivity, specificity and accuracy of a high-probability Q/V scintigraphy interpretation were 96.0%, 81.1% and 86.9%, respectively, compared with 100%, 69.8% and 79.5% for the combination of high- and intermediate- probability Q/V scintigraphy interpretation. PPDs% was significantly correlated with mPAP and SPAP (r = 0.538 for mPAP, P < 0.01 and r = 0.456 for SPAP, P < 0.05). Perfusion/ventilation lung scintigraphy is a valuable technique for diagnosis and quantitative analysis of CTEPH.

  4. 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.

  5. Gastrointestinal bleeding diagnosed by red blood cell scintigraphy in a patient with aortic stenosis: a case of Heyde syndrome.

    PubMed

    Corrêa, Patrícia L; Felix, Renata C M; Azevedo, Jader C; Silva, Paulo R D; Oliveira, Amarino C; Cortes, Denise; Dohmann, Hans F R; Mesquita, Cláudio T

    2005-04-01

    The authors report a case of small bowel bleeding diagnosed by Tc-99m-labeled red blood cell (RBC) scintigraphy during the postoperative period after aortic valve replacement. There is a relationship between aortic valve stenosis and gastrointestinal bleeding in elderly patients, called Heyde syndrome. The described patient had chronic anemia that worsened after surgery. RBC scintigraphy localized the source of bleeding from jejunal angiodysplasia confirmed by mesenteric angiography. This case illustrates the diagnostic information provided by RBC scintigraphy in this syndrome.

  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. (99m)Tc-HYNIC-TOC scintigraphy in evaluation of active Graves' ophthalmopathy (GO).

    PubMed

    Sun, Hua; Jiang, Xu-Feng; Wang, Shu; Chen, Hao-Yan; Sun, Jiao; Li, Pei-Yong; Ning, Guang; Zhao, Yong-Ju

    2007-06-01

    A promising radiopharmaceutical (99m)Tc-HYNIC-TOC ((99m)Tc-HYNIC-Octreotide) can be applied for somatostatin receptor scintigraphy with the potential to replace Indium-111 labeled somatostatin analogus. Here we evaluate whether orbital (99m)Tc-HYNIC-TOC scintigraphy can be used as a Graves' ophthalmopathy (GO) activity parameter to predict the retrobulbar irradiation response. Orbital (99m)Tc-HYNIC-TOC scintigraphy was performed on 14 consecutive patients demonstrating moderated to severe Graves' ophthalmopathy. The patients were treated with retrobulbar irradiation following the octreoscan and the response to this therapy was assessed at 3 months after the start of treatment. The orbital (99m)Tc-HYNIC-TOC uptake was calculated to assess the effects of treatment. Among the 14 GO patients, eight (57.1%) responded to retrobulbar radiotherapy; six (42.9%) showed no change. We compared the eight responders and six non-responders in terms of orbital (99m)Tc-HYNIC-TOC uptake, using the orbital/occipital ratio. On the 4-h (99m)Tc-HYNIC-TOC scintigraphy, responders had a higher orbital/occipital uptake ratio than the no-responders (P = 0.001). A significant correlation was found between the orbital/occipital ratio and the clinical activity score (CAS) (P = 0.034). The Receiving-Operator-Characteristic curve showed the best threshold for discriminating active and inactive disease was 1.40 (sensitivity, 100%; specificity, 83.3%). In the responders group, all these eight patients had positive scintigraphy. While there were five patients who had negative scintigraphy in the non-responders group. Orbital (99m)Tc-HYNIC-TOC scintigraphy can be a useful method for the estimation of disease activity and prediction the response to subsequent radiotherapy in GO patient. And the patients with positive octreoscan were more likely to respond to irradiation.

  8. Detection of pulmonary embolism during pregnancy: comparing radiation doses of CTPA and pulmonary scintigraphy.

    PubMed

    Astani, Seyed A; Davis, Leah C; Harkness, Beth A; Supanich, Mark P; Dalal, Ishani

    2014-07-01

    In pregnant patients pulmonary embolism is a common occurrence with potentially devastating outcomes, necessitating timely imaging diagnosis. In every patient, especially in pregnant patients, radiation exposure is an important consideration while selecting the best imaging modality. We performed a retrospective analysis comparing radiation doses of computed tomography pulmonary angiography (CTPA), perfusion scintigraphy, and perfusion/ventilation scintigraphy for suspected pulmonary embolism in 53 pregnant patients at our hospital between 2006 and 2012. Effective dose and breast-absorbed and uterus-absorbed doses for CTPA as well as effective dose and breast and fetus-absorbed doses for pulmonary scintigraphy were estimated using International Commission on Radiological Protection 103 weighting factors. For CTPA and perfusion scintigraphy, average doses were estimated as effective doses of 21 and 1.04 mSv, breast-absorbed doses of 44 and 0.28 mGy, and uterus-absorbed dose of 0.46 mGy and fetal-absorbed dose of 0.25 mGy, respectively. With inclusion of the ventilation component of pulmonary scintigraphy, doses increased to an effective dose of 1.29 mSv, a breast-absorbed dose of 0.37 mGy, and a fetal-absorbed dose of 0.40 mGy. Perfusion nuclear medicine study has a statistically significantly lower effective and breast-absorbed dose (P<0.0001) when compared with CTPA. Similarly, the fetal-absorbed dose for pulmonary scintigraphy has a statistically lower dose (P=0.0010) when compared with CTPA, even if the ventilation component of pulmonary scintigraphy is performed, although these values are so small that they are unlikely to be clinically significant.

  9. The value of scintigraphy in the evaluation of oropharyngeal dysphagia.

    PubMed

    Argon, Murat; Secil, Yaprak; Duygun, Ulkem; Aydogdu, Ibrahim; Kocacelebi, Kenan; Ozkilic, Hayal; Ertekin, Cumhur

    2004-01-01

    Healthy adults can swallow boluses of 20 ml water in a single swallow. Individuals with impaired swallowing, however, may be unable to do so, instead requiring two or more swallows; this phenomenon is called "piecemeal deglutition". The term "dysphagia limit" refers to the volume at which piecemeal deglutition occurs. The aim of our study was to investigate the potential value of scintigraphic evaluation of piecemeal deglutition and dysphagia limit in patients with dysphagia, based on correlation with the results of submental electromyography (SM-EMG) and laryngeal sensor monitoring (LS). The study population comprised 24 patients with dysphagia secondary to neurological disorders and ten normal adults, who formed a control group. In the scintigraphic evaluation, subjects underwent four separate dynamic studies using 5, 10, 15 and 20 ml of water containing 0.5 mCi technetium-99m labelled sulphur colloid, and time-activity curves (TACs) were created for each study. Static thoracic images were also recorded in order to detect airway aspiration Observation of two or more peaks on TACs within the 10-s acquisition period was considered a sign of piecemeal deglutition. If piecemeal deglutition occurred at or below 20 ml, this volume was regarded as the dysphagia limit. Piecemeal deglutition was not found in any normal subjects; by contrast, it was observed in 14 of the 24 (58%) patients on scintigraphy and in 17 (71%) patients on EMG and LS. In three patients, signs of the airway aspiration were observed on static thoracic images. Scintigraphic and electrophysiological findings were in agreement in 19 patients (79%), and the correlation between scintigraphy and the electrophysiological methods for the evaluation of dysphagia was statistically significant (r=0.57, P=0.003). The novel finding of this study is the demonstration of piecemeal deglutition and dysphagia limit on scintigraphic studies in patients with neurogenic dysphagia. Based on this finding we consider that

  10. Pulmonary embolism during pregnancy: diagnosis with lung scintigraphy or CT angiography?

    PubMed

    Revel, Marie-Pierre; Cohen, Stéphanie; Sanchez, Olivier; Collignon, Marie-Anne; Thiam, Rokhaya; Redheuil, Alban; Meyer, Guy; Frija, Guy

    2011-02-01

    To evaluate the rate of positive, negative, and indeterminate results and the agreement between initial and expert readings for lung scintigraphy and computed tomographic (CT) angiography performed in patients suspected of having pulmonary embolism (PE) during pregnancy. Institutional review board approval was obtained. The authors retrospectively analyzed the images from lung scintigraphy and CT angiography performed in pregnant patients during the past 9 years. Images from 46 CT angiographic examinations performed in 43 patients and 91 of 94 lung scintigraphic examinations were reviewed by experts, whose readings were then compared with the initial reports. For CT angiography, the quality of opacification was graded as good, suboptimal, or poor and intraarterial attenuation was measured. The rates of positive findings (seven of 43 patients [16%] with CT angiography and 10 of 91 patients [11%] with scintigraphy, P = .36), negative findings (28 of 43 patients [65%] with CT angiography and 64 of 91 patients [70%] with scintigraphy, P = .54), and indeterminate findings (eight of 43 patients [19%] with CT angiography and 17 of 91 patients [19%] with scintigraphy, P = .99) were similar for CT angiography and lung scintigraphy. There were four discrepancies between initial and expert readings for CT angiography (κ = 0.84; confidence interval: 0.68, 0.99) and 14 for lung scintigraphy (κ = 0.75; 95% confidence interval: 0.63, 0.87). Opacification was classified as good for only 23 of the 46 CT angiographic examinations (50%). Attenuation values were significantly different among the groups with good, suboptimal, or poor opacification. Alternative diagnoses unsuspected at chest radiography were demonstrated at CT angiography in five of the 43 patients (12%). The mean maternal radiation dose was 0.9 mSv for lung scintigraphy and 7.3 mSv for CT angiography. Lung scintigraphy and CT angiography have comparable performances for PE diagnosis during pregnancy. Interobserver

  11. Clinical applications of oro-pharyngo-oesophageal scintigraphy in the study of dysphagia

    PubMed Central

    Fattori, B; Grosso, M; Ursino, F; Matteucci, F; Mancini, V; Rizza, E; Mattone, V; Mariani, G; Nacci, A

    2007-01-01

    Summary The diagnostic approach to patients with dysphagia is well established and relies mainly on videofluoroscopy and endoscopy. Oro-pharyngo-oesophageal scintigraphy permits both a functional and a semi-quantitative study of the various stages of swallowing. Moreover, by means of this investigation, it is possible to estimate the amount of inhaled bolus. Oro-pharyngo-oesophageal scintigraphy with 99mTc-nanocolloid has been found to be easy to use, economical, well tolerated and, supplying precise indications regarding the extent of the swallowing disorder, then permits a better clinical definition of the patient. The limitations of swallowing scintigraphy are: poor definition in visualizing anatomic structures and low specificity when used as the only diagnostic test. Scintigraphy plays an important role in the diagnosis and follow-up of dysphagia, and its use, together with other diagnostic techniques, increases diagnostic accuracy. In this study, the role of oro-pharyngo-oesophageal scintigraphy has been analysed in patients with post-surgical, neurological and oesophageal dysphagia. PMID:17957850

  12. Use of thallium-201 redistribution scintigraphy in the preoperative differentiation of reversible and nonreversible myocardial asynergy.

    PubMed

    Rozanski, A; Berman, D S; Gray, R; Levy, R; Raymond, M; Maddahi, J; Pantaleo, N; Waxman, A D; Swan, H J; Matloff, J

    1981-11-01

    Thallium-201 (201Tl) redistribution scintigraphy might differentiate reversibly from nonreversibly asynergic myocardial segments and thus predict the response of these segments to coronary artery bypass grafting (CABG). To test this hypothesis, 25 consecutive patients undergoing CABG, preoperative stress-redistribution 201Tl scintigraphy, and both pre- and postoperative resting equilibrium radionuclide ventriculography were evaluated. For both types of scintigraphic study, each patient was imaged in the same three views. Because of the effects of CABG on septal motion, this region was considered separately. Postoperative improvement was noted in 54% of 72 preoperative asynergic segments. Improvement was common not only in hypokinetic but also in akinetic and dyskinetic segments, and occurred in a similar proportion of studies performed early (less than 2 weeks) or late (3-6 months) after CABG. Thallium-201 redistribution scintigraphy was highly predictive of the pattern of postoperative asynergy: The redistribution pattern was normal in 90% of segments with reversible asynergy and abnormal in 76% of segments with nonreversible asynergy. The presence or absence of pathologic Q waves was less sensitive in this differentiation. Septal segments, however, frequently demonstrated abnormal wall motion postoperatively, despite normal 201Tl redistribution scintigraphy. Resting left ventricular ejection fraction (LVEF) was generally unchanged postoperatively, but in some patients with multiple areas of reversible asynergy it did improve. Thus, 201Tl redistribution scintigraphy appears to reliably distinguish viable from nonviable asynergic myocardial zones, and predicts the response of these segments to CABG.

  13. Thallium 201 Exercise Scintigraphy for Detection of Multivessel Coronary Artery Disease After Transmural Myocardial Infarction

    PubMed Central

    Ahmadpour, Hedayatolah; Siegel, Michael E.; Colletti, Patrick; Haywood, L. Julian

    1984-01-01

    Fifty patients with prior transmural myocardial infarction were studied with cardiac catheterization, coronary angiography, and thallium 201 exercise perfusion scintigraphy. Obstructive coronary disease involved two or three vessels in 37 patients. The sensitivity of a positive electrocardiographic test during exercise for detecting multivessel coronary disease was only 40 percent (15/37), and the sensitivity of a reversible defect on 201Tl perfusion scintigraphy was 48 percent (18/37). The combination of exercise testing and 201Tl scintigraphy detected multivessel coronary disease in 75 percent (28/37) (P < .05). New perfusion defects occurred in 61 percent (13/21) of patients with inferior myocardial infarction and multivessel coronary disease whereas it occurred in only 35 percent (5/14) of patients with prior anterior infarction and multivessel coronary disease (P < .05). 201Tl exercise perfusion scintigraphy appears to be more sensitive for detecting significant multivessel coronary disease in the presence of previous inferior infarction compared with previous anterior infarction. Combined graded exercise testing and 201Tl perfusion scintigraphy can reliably detect the presence of significant multivessel coronary disease after transmural myocardial infarction. ImagesFigure 3 PMID:6512876

  14. 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.

  15. 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

  16. Comparison of dipyridamole-echocardiography with dipyridamole-thallium scintigraphy for the diagnosis of myocardial ischemia

    SciTech Connect

    Perin, E.C.; Moore, W.; Blume, M.; Hernandez, G.; Dhekne, R.; DeCastro, C.M. )

    1991-06-01

    After an intravenous infusion of dipyridamole (0.56 mg/kg), the authors performed both echocardiography and thallium scintigraphy in 63 patients who were referred for known or suspected coronary artery disease. Of those patients, 25 returned for coronary arteriography within 1 month after the tests, thus forming the study group for this report. Sensitivity for detection of coronary artery disease, when analyzed region-by-region, was 80% for thallium scintigraphy and 57% for echocardiography, whereas specificity was 85% and 98%, respectively. When evaluating individual patients for the presence or absence of ischemia, they found a sensitivity of 95% for scintigraphy and 58% for echocardiography; corresponding specificities were 50% and 100%. By using arteriography as the gold standard for comparison, it appears that thallium scintigraphy has a significantly higher sensitivity but lower specificity for the detection of coronary artery disease than does echocardiography. Echocardiography may, however, be a useful adjunct to thallium scintigraphy in the evaluation of patients with coronary artery disease.

  17. 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

  18. 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

  19. 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.

  20. Nurse exposure doses resulted from bone scintigraphy patient

    SciTech Connect

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

    2016-03-25

    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 {sup 99m}Tc labeled radiopharmaceuticals (e.g {sup 99m} Tc MDP,{sup 99m}Tc HEDP and {sup 99m}Tc 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.

  1. Increased Background Activity in DMSA Scintigraphy of a Nonazotemic Patient With β-Thalassemia Major.

    PubMed

    Paschali, Anna; Tsiouris, Spyridon

    2016-09-01

    Renal DMSA uptake provides an index for evaluation of the functional tubular mass, which depends on the renal blood flow, proximal tubular cell membrane function, and urinary acid-base balance. We present a case of a nonazotemic 48-year-old adult with β-thalassemia major under regular blood transfusions and iron chelation therapy that underwent DMSA scan showing minor cortical abnormalities and high background activity, featuring prominent cardiac blood pool and liver uptake. This case highlights the pitfall of high background activity during DMSA study in patients with β-thalassemia major due to tubular disorders.

  2. Unexpected Tc-99m labelled erythrocyte scintigraphy finding of a patient with suspicion of active bleeding into renal haematoma.

    PubMed

    Koç, Zehra Pinar; Balci, Tansel Ansal; Celiker, Hüseyin

    2011-08-11

    A 36-year-old male patient with suspicion of active bleeding into renal haematoma loge was sent to our clinic for Tc-99m labelled erythrocyte scintigraphy. Scintigraphy showed no active bleeding to renal haematoma but coexisting active haemorrhage of stomach which was confirmed as erosive bulbitis with further endoscopy.

  3. Traumatic retroperitoneal hematoma illustrated on Tc-99m methylene diphosphonate bone scintigraphy in a patient presenting with a fall.

    PubMed

    Nguyen, Huong Van; Chiam, Quee Li; Dixson, Hugh; Goddard, Kim A

    2007-08-01

    Retroperitoneal haematoma is rarely described in the context of bone scintigraphy, as it is usually an incidental discovery on bone scan carried out for another purpose. We report a case of a right retroperitoneal haematoma detected on Tc-99m-methylene diphosphonate bone scintigraphy taken in an elderly patient presenting with a mechanical fall and a right acetabular fracture.

  4. Pre- and postcaptopril renal scintigraphy as a screening test for renovascular hypertension in children.

    PubMed

    Abdulsamea, Sameh; Anderson, Peter; Biassoni, Lorenzo; Brennan, Eileen; McLaren, Clare A; Marks, Stephen D; Roebuck, Derek J; Selim, Sabry; Tullus, Kjell

    2010-02-01

    We studied the ability of pre- and postcaptopril renal scintigraphy to predict renovascular disease (RVD) in children. Retrospective review of medical notes and radiology reports of all hypertensive children who had had both pre- and postcaptopril renal scintigraphy with [(99m)Tc] dimercaptosuccinic acid (DMSA) and/or [(99m)Tc] mercaptoacetyltriglycine (MAG3) and digital subtraction angiography (DSA). 81 children aged 1-18 (median 10) years were studied with 62% (51) having a diagnosis of RVD. Main renal artery disease, intrarenal disease, and both main and intrarenal artery disease were present in 25, 14, and 12 patients respectively. The isotope study accurately diagnosed RVD, confirmed by DSA, in 47% (24 of 51) children, with eight false positive studies. The sensitivity, specificity, and positive and negative predictive values of the isotope study to predict RVD were 48%, 73%, 76%, and 51%, respectively. Pre- and postcaptopril renal scintigraphy was unable to predict RVD in children.

  5. Iodine-131 metaiodobenzylguanidine scintigraphy for the location of neuroblastoma: preliminary experience in ten cases

    SciTech Connect

    Geatti, O.; Shapiro, B.; Sisson, J.C.; Hutchinson, R.J.; Mallette, S.; Eyre, P.; Beierwaltes, W.H.

    1985-07-01

    Ten patients with histologically proven neuroblastoma were studied by (/sup 131/I)MIBG scintigraphy. Tumor uptake of the radiopharmaceutical showed a spectrum varying from no uptake in one case, to slight uptake in two, moderate uptake in two and intense uptake in five cases. Iodine-131 MIBG scintigraphy was more effective in demonstrating the extent of neuroblastoma spread than were conventional bone scan and CT in one patient, equal to these modalities in four cases, almost equal in two cases and significantly inferior in three cases. These preliminary results suggest that (/sup 131/I)MIBG scintigraphy is useful in detecting the presence and delineating the distribution of neuroblastoma and may, in certain cases, have therapeutic potential.

  6. Symptomatic and asymptomatic accessory navicular bones: findings of Tc-99m MDP bone scintigraphy.

    PubMed

    Chiu, N T; Jou, I M; Lee, B F; Yao, W J; Tu, D G; Wu, P S

    2000-05-01

    The accuracy of bone scintigraphy in diagnosing symptomatic accessory navicular bones has not been well studied. We conducted a retrospective study to explore the results and use of scintigraphy in symptomatic and asymptomatic accessory navicular bones. Thirteen patients with a total of 13 symptomatic and 10 asymptomatic accessory navicular bones were included in the study. We used a scoring system to grade the scintigraphic abnormalities. The patients' symptoms and scintigraphic findings were recorded. Though focally increased radiopharmaceutical uptake was observed in all symptomatic accessory naviculars, half of the asymptomatic accessory navicular bones had the same manifestations. The scoring system was of no value in differentiating symptomatic from asymptomatic accessory navicular bones. Bone scintigraphy is a sensitive but not a specific tool for diagnosing a symptomatic accessory navicular. Copyright 2000 The Royal College of Radiologists.

  7. The effect of bevacizumab for bone scintigraphy imaging: A case report.

    PubMed

    Asano, Takamitsu; Takakuwa, Osamu; Maeno, Ken; Oguri, Tetsuya; Niimi, Akio

    2015-01-01

    A 65-year-old man presented with pulmonary nodules and a right humeral fracture. The 99mTc-hydroxy-methylene-diphosphonate (HMDP) bone scintigraphy showed high-intensity radioisotope (RI) uptake by a tumor of the right arm. Adenocarcinoma of the lung with an epidermal growth factor receptor (EGFR) mutation was diagnosed on pathological examination of the computed tomography (CT)-guided needle biopsy of the right humerus. Although, gefitinib therapy was initiated, the tumor progressed. The patient was then treated with second-line chemotherapy including bevacizumab. The CT scan showed a new bone metastasis in the ilium and right sacroiliac articulation. However, this new bone metastasis was not detected by HMDP-bone scintigraphy. Physicians should be wary of the interpretations of the findings of the 99mTc HMDP bone scintigraphy after the bevacizumab treatment.

  8. Gastrointestinal Transit Assessment: Role of Scintigraphy: Where Are We Now? Where Are We Going?

    PubMed

    Ziessman, Harvey A

    2016-12-01

    The diagnostic imaging evaluation of patients with suspected esophagogastrointestinal transit disorders is changing. Anatomical methods, e.g., barium studies, endoscopy, manometry, radiopaque markers, have long been the techniques available and used for diagnosis. The one exception has been gastric emptying, where radionuclide scintigraphy has been the standard for decades. Esophageal transit scintigraphy is an old and reliable methodology but probably underutilized. The diagnostic use of small and large intestinal transit scintigraphy is increasing, in part, because of the limitations of the other methods but, most importantly, because it is truly physiologic, i.e., the transit of radiolabeled food can be imaged and quantified from the mouth to rectum. Limitations to its wider use have been the lack of standardization, general availability, and reimbursement issues. Radionuclide methods are increasingly being used to evaluate esophagogastrointestinal transit in a single study, from top to bottom.

  9. Technetium-99m BIDA biliary scintigraphy in the evaluation of the jaundiced patient

    SciTech Connect

    Lee, A.W.; Ram, M.D.; Shih, W.J.; Murphy, K.

    1986-09-01

    Biliary scintigraphy using 99mTc p-butyl acetanilidiminodiacetic acid (BIDA) was performed as part of the diagnostic evaluation on 96 patients with jaundice (serum bilirubin greater than 2 mg/dl) to assess its value in this group of patients. The results of scintigraphy revealed no obstruction to the flow of the scintigraphic agent into the duodenum in 54 patients, delayed appearance of the agent (normal upper limit 60 min) in the duodenum indicating partial obstruction in 22 patients, and complete obstruction of the duct demonstrated by absence of agent in the duodenum in 20 patients. The findings were correlated with the final diagnosis and the overall results show accuracy of 92.7%, sensitivity of 97.3%, and specificity of 89.8%. Biliary scintigraphy was thus found to be useful in differentiating nonobstructive, partially obstructive, and completely obstructive causes of jaundice.

  10. 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.

  11. 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.

  12. 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.

  13. Effect of histamine on technetium-99m excretion by gastric mucosa.

    PubMed

    Wine, C R; Nahrwold, D L; Rose, R C; Miller, K L

    1976-11-01

    The ability of histamine to increase excretion of 99mtechnetium by gastric mucosa was investigated in dogs with Heidenhain pouches and denervated antral pouches. Histamine increased Heidenhain pouch 99mtechnetium output in a dose-related manner, and 99mtechnetium output was related linearly to acid output. Antral pouch 99mtechnetium output was unchanged by increasing doses of histamine. The study suggests that concomitant use of histamine may improve the accuracy of 99mtechnetium scanning in the clinical diagnosis of conditions caused by ectopic gastric mucosa.

  14. A meta-analysis of fluorodeoxyglucose-positron emission tomography versus scintigraphy in the evaluation of suspected osteomyelitis.

    PubMed

    Wang, Guo-lin; Zhao, Kui; Liu, Zhen-feng; Dong, Meng-jie; Yang, Shu-ye

    2011-12-01

    Functional nuclear medicine imaging techniques have become particularly important in the diagnosis of osteomyelitis. The aim of our study was to perform a meta-analysis to obtain a reliable estimate of the diagnostic performance of fluorodeoxyglucose-positron emission tomography (FDG-PET), three-phase bone scintigraphy, leukocyte scintigraphy, and monoclonal antigranulocyte antibody (MOAB) scintigraphy in the assessment of suspected osteomyelitis and to perform pairwise comparisons of the diagnostic accuracy between these different imaging modalities. A total of 23 studies representing 851 examinations that were published from January 1980 to October 2010 were reviewed. These studies evaluated the role of FDG-PET, three-phase bone scintigraphy, leukocyte scintigraphy, and MOAB scintigraphy in the assessment of suspected osteomyelitis. Systematic methods were used to identify, select, and evaluate the methodological quality of the studies and to summarize the overall findings of sensitivity and specificity. Two-sample Z-tests were conducted to evaluate for differences in sensitivity, specificity, area under the curve (AUC), and the Q* index between any two diagnostic modalities. The FDG-PET had a pooled sensitivity of 0.923, specificity of 0.920, and AUC of 0.9666, whereas for bone scintigraphy, the corresponding values were 0.827, 0.446, and 0.6514, respectively, for leukocyte scintigraphy, the corresponding values were 0.742, 0.881, and 0.9139, respectively, and for MOAB, the corresponding values were 0.883, 0.705, and 0.8897, respectively. Our meta-analysis did not find statistically significant differences in the sensitivity, specificity, AUC, and Q* index between FDG-PET and leukocyte scintigraphy. Leukocyte scintigraphy can be used with satisfactory diagnostic accuracy for detecting osteomyelitis when positron emission tomography systems are not available. The FDG-PET appears to be superior in terms of accuracy compared with other radionuclide imaging

  15. Relating gastric scintigraphy and symptoms to motility capsule transit and pressure findings in suspected gastroparesis.

    PubMed

    Hasler, W L; May, K P; Wilson, L A; Van Natta, M; Parkman, H P; Pasricha, P J; Koch, K L; Abell, T L; McCallum, R W; Nguyen, L A; Snape, W J; Sarosiek, I; Clarke, J O; Farrugia, G; Calles-Escandon, J; Grover, M; Tonascia, J; Lee, L A; Miriel, L; Hamilton, F A

    2017-09-05

    Wireless motility capsule (WMC) findings are incompletely defined in suspected gastroparesis. We aimed to characterize regional WMC transit and contractility in relation to scintigraphy, etiology, and symptoms in patients undergoing gastric emptying testing. A total of 209 patients with gastroparesis symptoms at NIDDK Gastroparesis Consortium centers underwent gastric scintigraphy and WMCs on separate days to measure regional transit and contractility. Validated questionnaires quantified symptoms. Solid scintigraphy and liquid scintigraphy were delayed in 68.8% and 34.8% of patients; WMC gastric emptying times (GET) were delayed in 40.3% and showed 52.8% agreement with scintigraphy; 15.5% and 33.5% had delayed small bowel (SBTT) and colon transit (CTT) times. Transit was delayed in ≥2 regions in 23.3%. Rapid transit was rarely observed. Diabetics had slower GET but more rapid SBTT versus idiopathics (P ≤ .02). GET delays related to greater scintigraphic retention, slower SBTT, and fewer gastric contractions (P ≤ .04). Overall gastroparesis symptoms and nausea/vomiting, early satiety/fullness, bloating/distention, and upper abdominal pain subscores showed no relation to WMC transit. Upper and lower abdominal pain scores (P ≤ .03) were greater with increased colon contractions. Constipation correlated with slower CTT and higher colon contractions (P = .03). Diarrhea scores were higher with delayed SBTT and CTT (P ≤ .04). Wireless motility capsules define gastric emptying delays similar but not identical to scintigraphy that are more severe in diabetics and relate to reduced gastric contractility. Extragastric transit delays occur in >40% with suspected gastroparesis. Gastroparesis symptoms show little association with WMC profiles, although lower symptoms relate to small bowel or colon abnormalities. © 2017 John Wiley & Sons Ltd.

  16. 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

  17. Miscellaneous indications in bone scintigraphy: metabolic bone diseases and malignant bone tumors.

    PubMed

    Cook, Gary J R; Gnanasegaran, Gopinath; Chua, Sue

    2010-01-01

    The diphosphonate bone scan is ideally suited to assess many global, focal or multifocal metabolic bone disorders and there remains a role for conventional bone scintigraphy in metabolic bone disorders at diagnosis, investigation of complications, and treatment response assessment. In contrast, the role of bone scintigraphy in the evaluation of primary malignant bone tumors has reduced with the improvement of morphologic imaging, such as computed tomography and magnetic resonance imaging. However, an increasing role for (18)F-fluorodeoxyglucose positron emission tomography and positron emission tomography/computed tomography is emerging as a functional assessment at diagnosis, staging, and neoadjuvant treatment response assessment.

  18. Incidental vesicocolic fistula on routine bone scintigraphy: Value of additional delayed images and direct radionuclide cystography.

    PubMed

    Sohn, Myung-Hee; Tae Lim, Seok; Jin Jeong, Young; Wook Kim, Dong; Jeong, Hwan-Jeong; Yim, Chang-Yeol

    2010-09-01

    An unexpected vesicocolic fistula can be detected incidentally on routine bone scintigraphy. A 55-year-old man who had a radical colectomy for carcinoma of the sigmoid colon 1 year previously underwent bone scintigraphy to evaluate bone metastasis. Whole-body images showed an abnormal accumulation of radioactivity in the right lower quadrant of the abdomen, but the radioactivity did not precisely define a structure. Additional delayed images obtained after 15 and 24 hours of the initial image localized a vesicocolic fistula. Subsequent radionuclide cystography confirmed leakage of the radioactivity from the bladder.

  19. 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.

  20. Early diagnosis of acute postoperative renal transplant rejection by indium-111-labeled platelet scintigraphy

    SciTech Connect

    Tisdale, P.L.; Collier, B.D.; Kauffman, H.M.; Adams, M.B.; Isitman, A.T.; Hellman, R.S.; Hoffmann, R.G.; Rao, S.A.; Joestgen, T.; Krohn, L.

    1986-08-01

    A prospective evaluation of /sup 111/In-labeled platelet scintigraphy (IPS) for the early diagnosis of acute postoperative renal transplant rejection (TR) was undertaken. The results of IPS were compared with in vitro biochemical tests, the clinical finding of graft tenderness, and combined (/sup 99m/Tc)DTPA and (/sup 131/I)orthoiodohippurate scintigraphy. With a sensitivity of 0.93 and a specificity of 0.95, IPS provided otherwise unavailable diagnostic information. Furthermore, postoperative IPS was a good predictor of long-term allograft survival.

  1. Bone scintigraphy in the initial staging of patients with renal-cell carcinoma: concise communication

    SciTech Connect

    Rosen, P.R.; Murphy, K.G.

    1984-03-01

    The records of 40 consecutive patients who received bone scintigraphy in conjunction with the initial evaluation and staging of renal-cell carcinoma were reviewed to determine the role of bone imaging in this clinical context. Bone scintigrams were positive in three out of 40 patients at the time of diagnosis. In view of the low yield of bone imaging, it appears that routine scintigraphy is unwarranted in the absence of skeletal symptoms before the diagnosis of renal lesions. The presence of a positive bone image did not alter the indication for nephrectomy.

  2. 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.

  3. An incidental detection of aortic aneurysm on Tc-99m MAG3 renal scintigraphy.

    PubMed

    Sadic, Murat; Demirel, Koray; Koca, Gökhan; Atilgan, Hasan Ikbal; Korkmaz, Meliha

    2013-01-01

    A 71-year-old man with newly diagnosed hypertension was referred for Technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) renal scintigraphy to evaluate the recent onset of impairment in renal functions. Dynamic imaging revealed activity flow which was suspicious for aortic aneurysm (AA) with a concurrent decrease in left renal blood flow. CT angiography of the thoracoabdominal aorta confirmed that this area corresponded to AA. The purpose of this report was to present the first case of incidental detection of AA on Tc-99m MAG3 scintigraphy and highlight the importance of correlative imaging for the diagnosis of abnormal radioactivity accumulation in the region of vascular structures.

  4. 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.

  5. Lung scintigraphy in the diagnosis of pulmonary embolism: current methods and interpretation criteria in clinical practice

    PubMed Central

    Skarlovnik, Ajda; Hrastnik, Damjana; Fettich, Jure; Grmek, Marko

    2014-01-01

    Background In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Modified diagnostic criteria for planar lung scintigraphy are considered, as newer scitigraphic methods, especially single photon emission computed tomography (SPECT) are becoming more popular. Patients and methods. Data of 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients who underwent V/Q SPECT from the emergency department (ED) were retrospectively collected. Planar V/Q images were interpreted according to 0.5 segment mismatch criteria and revised PIOPED II criteria and perfusion scans according to PISA-PED criteria. V/Q SPECT images were interpreted according to the criteria suggested in EANM guidelines. Final diagnosis of PE was based on the clinical decision of an attending physician and evaluation of a 12 months follow-up period. Results Using 0.5 segment mismatch criteria and revised PIOPED II, planar V/Q scans were diagnostic in 93% and 84% of cases, respectively. Among the diagnostic planar scans readings specificity for 0.5 segment mismatch criteria was 98%, and 99% for revised PIOPED II criteria. V/Q SPECT showed a sensitivity of 100% and a specificity of 98%, without any non-diagnostic cases. In patients with low pretest probability for PE, planar V/Q scans assessed by 0.5 segment mismatch criteria were diagnostic in 92%, and in 85% using revised PIOPED II criteria, while perfusion scintigraphy without ventilation scans was diagnostic in 80%. Conclusions Lung scintigraphy yielded diagnostically definitive results and is reliable in ruling out PE in patients from ED. V/Q SPECT has excellent specificity and sensitivity without any non-diagnostic results. Percentage of non-diagnostic results in planar lung scintigraphy is considerably smaller when 0.5 segment mismatch criteria instead of revised PIOPED II criteria are used. Diagnostic value of perfusion scintigraphy according to PISA-PED criteria is

  6. Lung scintigraphy in the diagnosis of pulmonary embolism: current methods and interpretation criteria in clinical practice.

    PubMed

    Skarlovnik, Ajda; Hrastnik, Damjana; Fettich, Jure; Grmek, Marko

    2014-06-01

    In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Modified diagnostic criteria for planar lung scintigraphy are considered, as newer scitigraphic methods, especially single photon emission computed tomography (SPECT) are becoming more popular. Data of 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients who underwent V/Q SPECT from the emergency department (ED) were retrospectively collected. Planar V/Q images were interpreted according to 0.5 segment mismatch criteria and revised PIOPED II criteria and perfusion scans according to PISA-PED criteria. V/Q SPECT images were interpreted according to the criteria suggested in EANM guidelines. Final diagnosis of PE was based on the clinical decision of an attending physician and evaluation of a 12 months follow-up period. Using 0.5 segment mismatch criteria and revised PIOPED II, planar V/Q scans were diagnostic in 93% and 84% of cases, respectively. Among the diagnostic planar scans readings specificity for 0.5 segment mismatch criteria was 98%, and 99% for revised PIOPED II criteria. V/Q SPECT showed a sensitivity of 100% and a specificity of 98%, without any non-diagnostic cases. In patients with low pretest probability for PE, planar V/Q scans assessed by 0.5 segment mismatch criteria were diagnostic in 92%, and in 85% using revised PIOPED II criteria, while perfusion scintigraphy without ventilation scans was diagnostic in 80%. Lung scintigraphy yielded diagnostically definitive results and is reliable in ruling out PE in patients from ED. V/Q SPECT has excellent specificity and sensitivity without any non-diagnostic results. Percentage of non-diagnostic results in planar lung scintigraphy is considerably smaller when 0.5 segment mismatch criteria instead of revised PIOPED II criteria are used. Diagnostic value of perfusion scintigraphy according to PISA-PED criteria is inferior to combined V/Q scintigraphy; the difference is

  7. 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.

  8. Radionuclide scintigraphy in the evaluation of gastroesophageal reflux in symptomatic and asymptomatic pre-term infants.

    PubMed

    Morigeri, C; Bhattacharya, A; Mukhopadhyay, K; Narang, A; Mittal, B R

    2008-09-01

    Gastroesophageal reflux (GER) is very common in pre-term infants. The diagnosis based on symptoms is always questionable. The incidence of GER in symptomatic babies varies from 22% to 85%, but literature regarding the incidence of reflux in asymptomatic pre-term infants is lacking. We used radionuclide scintigraphy to evaluate the incidence of GER in symptomatic as well as asymptomatic pre-term neonates and to assess whether symptoms have any relation with positive scintigraphy. We studied 106 pre-term infants (52 symptomatic, 54 asymptomatic) of less than 34 weeks of gestation, who fulfilled the eligibility criteria. Babies were considered symptomatic in the presence of vomiting, regurgitation, apnea, de-saturations, unexplained bradycardia and recurrent lung collapses. Radionuclide scintigraphy was conducted at post-conceptional age of 32-34 weeks when they were clinically stable for 72 h. Feeding was avoided for 2 h preceding the study. (99m)Tc sulphur colloid was administered in a dose of 1.85 MBq (0.05 mCi) in 1 ml, followed by milk (full feed) through an orogastric tube, prior to imaging under a gamma camera. Reflux was graded as low or high, and reflux episodes during the study were counted. The incidence of GER in the symptomatic group was 71.2% and in asymptomatic babies 61.1% (p = 0.275). High-grade reflux was more common (71.4%) than low-grade (28.6%) in both groups (p = 0.449). Mean number of reflux episodes in 20 min was 4.4 +/- 2.4 in symptomatic babies and 4.9 +/- 2.2 in asymptomatic babies (p = 0.321). Babies with positive scintigraphy were similar in birth weight, gestation, time to achieve full feeds, weight and age at discharge to those with negative scintigraphy. GER is common in pre-term infants of less than 34 weeks gestation. The incidence of positive scintigraphy and grade of reflux is not significantly different in symptomatic vs. asymptomatic babies. Though radionuclide scintigraphy is a simple, quick and non-invasive investigation in

  9. Scintigraphy of infected total hip arthroplasty (THA): A canine model

    SciTech Connect

    Merkel, K.D.; Brown, M.L.; Fitzgerald, R.H.; Dewanjee, M.K.

    1984-01-01

    Differentiating low-grade sepsis from aseptic loosening of an orthopedic prosthesis is difficult. This study was designed to compare the ability of Tc-99m-HMDP, Ga-67, and In-111 leukocytes (WC) to differentiate low-grade sepsis from aseptic THA component loosening in a canine model. A canine THA was implanted in 14 dogs. Six dogs were given infected femoral components by injecting 10/sup 5/ colony-forming units of Staphylococcus aureus into the femoral canal 6y0 to 90 seconds prior to cementing. Four dogs had an aseptic loose femoral component, and four dogs had an aseptic tight femoral component (control). At six months all dogs were evaluated with X-ray, lab scintigraphy, and tissue quantitation of each tracer. Diagnosis was confirmed by histology and quantitative microbiology. White blood cell counts and differentials were normal in all dogs, and in only one out of six infected dogs was the sedimentation rate abnormal. X-rays were interpreted as possible infection in five dogs and probable infection in only one dog. In-111 WBC scans were more accurate than sequential Tc-Ga scans (sensitivity 94% vs 61%, specificity 86% vs 71% accuracy 90% vs 67%). Quantitative counting of gamma camera data and tissue samples demonstrated significantly (P < .01) higher accumulation of In-111 WBC about the infected than the loose or control component. No significant difference was demonstrated between the loose and septic components with TC-HMDP or Ga. These results correlate well and confirm our clinical data that In-111 WBC scanning is accurate and useful in the workup of the painful orthopedic prosthesis.

  10. Superimposed display of coronary artery on gated myocardial perfusion scintigraphy.

    PubMed

    Nishimura, Yoshihiro; Fukuchi, Kazuki; Katafuchi, Tetsuro; Sagou, Masayoshi; Oka, Hisashi; Ishida, Yoshio; Murase, Kenya

    2004-09-01

    Fusion of images of vascular anatomy and of myocardial perfusion images might be helpful for understanding the relationship between ischemia and the responsible vessels. The aim of this study was to develop a simple means of superimposing the images obtained from coronary angiography and gated myocardial perfusion SPECT. Right and left oblique views from conventional coronary angiography and left ventriculography (LVG) were stored as 512 x 512 x 8-bit digital datasets and combined. We reconstructed images from routine gated myocardial perfusion imaging (MPI) by using (99m)Tc-tetrofosmin to match the oblique positions between the image from MPI and combined angiographic images. We then generated a 3-dimensional (3D) surface map by using the quantitative gated SPECT (QGS)/quantitative perfusion SPECT (QPS) program. Both the combined angiographic images and the 3D surface map were rescaled and unified by registering the internal landmarks between the 2 images. After subtraction of the LVG image, the coronary angiogram and the 3D surface map were fused into 1 image. All processes were performed with the QGS/QPS program and commercially available graphic software. We applied this method to datasets from a cardiac phantom and from several patients with coronary artery disease. In the phantom study, our technique could obtain a 3D surface map in which the oblique angle was identified as that of radiography and could realize image registration and superimposition of radiography on scintigraphy. The preliminary results from the patients indicated that the markedly stenotic vessels showed good coincidence with the regional myocardial perfusion abnormalities on the unified images. In addition, these images could show the relationship between the coronary artery and regional wall motion in the gated mode. We developed a simple method of superimposing the image of the coronary artery tree on images from gated MPI. The technique yielded useful information about myocardial

  11. Limitations of somatostatin scintigraphy in primary small bowel neuroendocrine tumors.

    PubMed

    Maxwell, Jessica E; Sherman, Scott K; Menda, Yusuf; Wang, Donghong; O'Dorisio, Thomas M; Howe, James R

    2014-08-01

    Somatostatin receptor scintigraphy (SRS; octreoscan) is used in neuroendocrine tumors to locate the primary tumor site and delineate the extent of disease. SRS has decreased sensitivity for small bowel neuroendocrine tumors (SBNETs). The reasons for SRS nonlocalization are not clear. We sought to determine factors that correlate with successful primary tumor localization by SRS in patients with resected SBNETs, and also identify factors that confound interpretation of SRS reports. Records of patients with resected SBNETs were reviewed for SRS results, tumor size, multifocality, N, and M status. Somatostatin receptor 2 (SSTR2) expression was analyzed in resected tumors by quantitative polymerase chain reaction. SRS reports were reviewed and categorized as localizing the primary tumor or not. A nuclear medicine physician independently reviewed available images. Of 37 patients with preoperative SRS, the primary tumor was localized in 37%. Of all the factors tested, only small tumor size correlated significantly with SRS nonlocalization. Overexpression of SSTR2 was not significantly different between tumors that were or were not localized by SRS, regardless of tumor size. There were three instances where the SRS report did not agree with the nuclear medicine physician's interpretation as to whether SRS localized the primary tumor. In each case, uptake in mesenteric nodes was a confounding factor. SBNETs <2 cm are most likely to be missed by SRS. SSTR2 expression did not correlate with SRS nonlocalization of the primary tumor. Uptake in mesenteric nodes may help indicate an SBNET primary but can also interfere with its visualization within the small bowel. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Tc-99m sestamibi bone marrow scintigraphy in Gaucher disease.

    PubMed

    Aharoni, Dvora; Krausz, Yodphat; Elstein, Deborah; Hadas-Halpern, Irith; Zimran, Ari

    2002-07-01

    No imaging technique has been found to be adequate to assess the severity and extent of bone involvement in patients with Gaucher disease. Marrow involvement, as determined by Tc-99m sulfur colloid, correlated well with the clinical and radiologic changes of the skeleton, but a normal pattern was found in the early stages of the disease. Subsequently, Tc-99m sestamibi (MIBI) has been suggested for direct visualization of glycolipid deposits in the bone marrow. This study was initiated as a pilot using MIBI to detect various forms of bone disease in patients with Gaucher disease of varying severity. Eleven patients (9 men; median age, 39.9; age range, 21 to 61 years) were evaluated. The clinical severity of disease was scored at presentation, and four patients with moderate to severe disease were treated with enzyme replacement therapy. Each patient underwent a radiographic skeletal survey, bone densitometry, and MIBI scintigraphy. The scan included static images of the lower limbs, with a whole-body scan acquired between the early and late acquisition. Tracer uptake in the bone marrow was graded and correlated with clinical and objective variables. All but one patient had increased MIBI uptake in the bone marrow. No correlation was noted between MIBI uptake and severity score, radiographic changes, densitometry z score, or treatment status. MIBI scanning is a sensitive technique for detecting bone marrow deposits in Gaucher disease, but it is inadequate for early identification of patients at high risk for skeletal complications or for the follow-up of patients treated with enzyme replacement.

  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. Applying preoperative dipyridamole thallium-201 scintigraphy for preventing cardiac mortality and complications for patients with secondary hyperparathyroidism undergoing parathyroidectomy.

    PubMed

    Yin, Shih-Min; Chou, Fong-Fu; Wu, Shao-Chun; Chi, Shun-Yu

    2017-07-06

    To evaluate the value of preoperative dipyridamole thallium-201 scintigraphy for reducing cardiovascular complication in secondary hyperparathyroidism (SHPTH) patients. Thallium scintigraphy was arranged for all dialysis patients who underwent parathyroidectomy from Jan 2011 to July 2015. Management of defects on thallium scintigraphy included cardiac catheterization and ultrasonography. Analysis includes 30-day mortality, morbidity and the predicting factors for thallium scintigraphy defect. Of 249 patients with SHPTH, 19 (7.6%) had defects on thallium scintigraphy, 15 (88%) of whom had coronary artery disease on angiography. History of acute coronary syndrome (ACS, p < 0.001), diabetes mellitus (DM, p = 0.03), male sex (p = 0.03), and higher body mass index (BMI, p = 0.001) were significant predictors of positive thallium scintigraphy results. History of ACS was the most significant predictor after adjustment in the multivariate logistic analysis (odds ratio, 22.56; 95% confidence interval, 7.02-72.53). All the patients survived the 30-day postoperative period, with minimal cardiovascular morbidity. Preoperative dipyridamole thallium-201 scintigraphy is useful for SHPTH patients to minimized surgical mortality and morbidity. Copyright © 2017. Published by Elsevier Taiwan.

  15. Dynamic scintigraphy with thallium-201 chloride (Tl-201) for the diagnosis of tumors of the head and neck.

    PubMed

    Sato, T; Indo, H; Kawabata, Y; Iwashita, Y; Morita, Y; Noikura, T; Sugihara, K; Mimura, T

    2001-08-01

    The purpose of this study was to differentiate between malignant tumors and benign tumors of the head and neck by means of thallium-201 chloride scintigraphy. Thallium-201 chloride (Tl-201) scintigraphy and Ga-67 citrate (Ga-67) scintigraphy were performed in 10 patients with a benign tumor and in 90 patients with a malignant tumor. The blood flow index and the tumor retention index were obtained by means of Tl-201 scintigraphy. The blood flow index = the count of tumor/the count of control in the early dynamic scan from 30 to 120 seconds after injection, and the tumor retention index = (the count of tumor/the count of control in the delayed dynamic scan 2.5 hours after injection)/(the count of tumor/the count of control in the early dynamic scan from 4 to 5 minutes after injection). The early and delayed scans with Tl-201 demonstrated a very high correlation with the blood flow index. The tumor retention index had a tendency to increase in malignant tumors, especially in the poorly differentiated tumors and the severely invasive tumors. Likewise, the tumor retention index decreased in benign tumors. These results proved to be statistically significant, and in turn Tl-201 scintigraphy was deemed superior to Ga-67 scintigraphy. Tl-201 scintigraphy was also useful in detecting small-size tumors. The tumor retention index of Tl-201 was useful for the differentiation of malignant tumors of the head and neck from benign tumors of the same areas.

  16. Transdiaphragmatic peritoneal hernia complicating peritoneal dialysis: demonstration with spiral computed tomography peritoneography and peritoneal scintigraphy.

    PubMed

    Coche, Emmanuel; Lonneux, Max; Goffin, Eric

    2005-08-01

    The authors describe a rare case of peritoneal transdiaphragmatic hernia discovered immediately after a car accident in a young male patient on peritoneal dialysis. The potential role of CT peritoneography and peritoneal scintigraphy to demonstrate and understand thoracic complications of ambulatory peritoneal dialysis is discussed.

  17. 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.

  18. Levodopa challenge test and (123) I-metaiodobenzylguanidine scintigraphy for diagnosing Parkinson's disease.

    PubMed

    Asayama, S; Wate, R; Kaneko, S; Asayama, T; Oki, M; Tsuge, A; Nagashima, M; Morita, J; Nakamura, S; Nakamura, M; Nishii, M; Fujita, K; Saito, A; Nakano, S; Ito, H; Kusaka, H

    2013-09-01

    To explore the possibility of a generally applicable tool for the immediate diagnosis of Parkinson's disease (PD) in its early stage, we compared the sensitivity and specificity of an acute levodopa challenge test with that of (123) I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. A consecutive series of 45 patients with extrapyramidal symptoms were recruited to the acute levodopa challenge and evaluated for improvement by use of the Unified Parkinson's Disease Rating Scale motor scores. Of these patients, 32 of them were also examined by MIBG scintigraphy. The patients were followed up for at least 24 months, and 22 patients were diagnosed as having clinically definite PD. The sensitivity and specificity of the acute levodopa challenge test to predict clinical diagnosis of PD were 81.8% and 81.8%, respectively, which were better than those obtained by MIBG scintigraphy (62.5% and 62.5%). In both early- and middle-stages of PD, the test gave better sensitivity than MIBG scintigraphy. Considering that the well-established and frequently referred clinical diagnostic criteria require longitudinal observation for at least 24 months, the acute levodopa challenge test can be used as an immediate diagnostic tool for PD with sensitivity and specificity comparable to those of MIBG. © 2013 John Wiley & Sons A/S.

  19. 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.

  20. Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells

    SciTech Connect

    Wukich, D.K.; Abreu, S.H.; Callaghan, J.J.; Van Nostrand, D.; Savory, C.G.; Eggli, D.F.; Garcia, J.E.; Berrey, B.H.

    1987-12-01

    Scintigraphy with indium-labeled white blood cells has been reported to be sensitive and specific in the diagnosis of low-grade sepsis of the musculoskeletal system. We reviewed the records of fifty patients who had suspected osteomyelitis or suspected infection about a total joint prosthesis and who underwent scintigraphy with technetium-99m methylene diphosphonate and scintigraphy with indium-111 oxine-labeled white blood cells before an open surgical procedure. Any patient who received preoperative antibiotics was not included in the study. For all of the patients, gram-stain examination of smears, evaluation of a culture of material from the operative site, and histological examination were done. The patients were divided into two groups. Group I was composed of twenty-four patients, each of whom had a prosthesis in place and complained of pain. Group II was composed of twenty-six patients for whom a diagnosis of chronic osteomyelitis had to be considered. With the indium scans alone, there was only one false-negative result (in Group II), but there were eighteen false-positive results (eight patients in Group II and ten patients in Group I). Although scintigraphy with indium-labeled white blood cells is quite sensitive, it is not specific in detecting chronic osteomyelitis; a negative scan should be considered highly suggestive that osteomyelitis is not present. Specificity can be increased by interpreting the indium scan in conjunction with the technetium scan.

  1. Leucocyte scintigraphy or computed tomography for the febrile post-operative patient?

    PubMed

    Bearcroft, P W; Miles, K A

    1996-09-01

    The optimal initial investigation for the post-operative patient with suspected occult intra-abdominal sepsis is controversial, although the diagnostic accuracy of a variety of techniques is known. Our objective is to determine which investigation has the greatest positive effect on patient management. We reviewed 67 consecutive post-operative patients investigated for suspected occult sepsis retrospectively and analysed the sequence of investigations required to achieve the diagnosis depending on the choice of initial investigation, and the interval between between initiating investigations and performing definitive percutaneous drainage. Forty patients had scintigraphy as the initial investigation and 21 of these went on to require CT. None of the 27 patients who had CT as the initial investigation required any other imaging (chi 2 = 20.6, P < 0.0001) and appropriate percutaneous drainage was offered immediately. Conversely, the average interval to drainage in those who had scintigraphy first was 3.1 days. Fourteen out of 20 patients (70%) who had scintigraphy as the initial investigation following recent surgery, and 7 of 20 (35%) following old surgery, needed subsequent CT. None of the 20 and 7 patients in the recent and old surgery groups respectively who had CT initially required further imaging. Our results suggest recommending CT as the initial investigation in the early post-operative period as this will reduce the total number of investigations required to achieve the diagnosis and the time to definitive drainage. In the late post-operative period, scintigraphy will resolve the majority of problems.

  2. 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.

  3. Thallium-201 scintigraphy for the assessment of long-term prognosis in patients with osteosarcoma.

    PubMed

    Inaki, Anri; Taki, Junichi; Wakabayashi, Hiroshi; Sumiya, Hisashi; Zen, Yoh; Tsuchiya, Hiroyuki; Kinuya, Seigo

    2012-08-01

    The aim of this study was to confirm the prognostic value of (201)Tl scintigraphy in the midcourse of preoperative chemotherapy in patients with osteosarcoma. The 28 patients with biopsy-proven osteosarcoma were enrolled retrospectively in this study. Planar scintigraphy was performed 15 min after injection of 111 MBq (201)Tl before preoperative chemotherapy and after third course (midcourse) of chemotherapy in all patients. The (201)Tl uptake ratio was calculated by dividing the count density of the lesion by that of the contralateral normal area. The percentage reduction of the (201)Tl uptake ratio calculated by 100 × [(pre-chemotherapy ratio - mid-chemotherapy ratio)/pre-chemotherapy ratio] was compared with the histopathological response and long-term survival rate. Good histopathological response was observed in 16 patients. Mean follow-up period was 58.0 ± 41 months. Both overall and event-free survival rates of histopathologically good responders were significantly higher than that of poor responders (P = 0.018 and P = 0.0076). There was also significant correlation between pre-chemotherapeutic effect evaluated with (201)Tl scintigraphy and overall and event-free survival rate in all patients (P = 0.045 and P = 0.017, respectively), and in patients without metastasis at initial diagnosis (P = 0.043 and P = 0.031, respectively). (201)Tl scintigraphy performed in the middle of neoadjuvant chemotherapy can predict overall survival and event-free survival in patients with osteosarcoma.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  5. Improvement of inter-services communication through a CDSS dedicated to myocardial perfusion scintigraphy.

    PubMed

    Nies, Julie; Georg, Gersende; Faraggi, Marc; Colombet, Isabelle; Durieux, Pierre

    2011-01-01

    This study addresses the question of communication between medical wards and the nuclear medicine department for the realization of myocardial perfusion scintigraphy. It analyses the effects of a reminder for completing the content of an order form. It shows that the CDSS impacted ordering practices. It could be seen as a system enabling to structure the information and improve the quality of orders.

  6. 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

  7. Evaluation of gadolinium compounds potentially suitable for magnetic resonance using Gd-153 scintigraphy

    SciTech Connect

    Engelstad, B.; Huberty, J.; White, D.; Wynne, C.; Ramos, E.; Goldberg, H.

    1985-05-01

    Gd-153 is not customarily considered for scintigraphy, yet it: 1) is available at acceptable cost, 2) has a 242 day half-life suitable for prolonged animal studies and 3) has 97 keV (40%) and 103 keV (59%) photopeaks suitable for conventional scintigraphy. Gd-153 (10-15 ..mu..Ci; 370-555 kBq) was administered to normal rats in 5 forms: 1) carrier 0.1 mmole/kg Gd-EIDA (diethyl iminodiacetic acid), 2) tracer (<.1 umole/kg) Gd-EIDA, 3) tracer Gd-ISIDA (diisopropyl iminodiacetic acid), 4) tracer GdCl/sub 3/, and 5) tracer Gd-DTPA. Scintigraphy, performed continuously for 90 minutes following intravenous injection and at intervals at up to 2 weeks, depicted: 1) rapid, partial hepatobiliary and renal clearance of tracer Gd-EIDA and Gd-ISIDA; 2) slow blood clearance and partial hepatobiliary clearance of carrier Gd-EIDA; and 3) prolonged reticuloendothelial retention of all IDA complexes, similar to GdCl3. Whole body and tissue distribution data paralleled the scintigraphic findings. Gd-153 scintigraphy provides a simple method to assess balance, distribution, kinetics, and stability of new paramagnetic contrast agents, and bis-iminodiacetate gadolinium complexes, unlike technetium analogues, lack effective stability to prevent gadolinium hydrolysis or translocation.

  8. Evaluation of hypertensive patients by means of captopril enhanced renal scintigraphy with technetium-99m DTPA

    SciTech Connect

    Dondi, M.; Franchi, R.; Levorato, M.; Zuccala, A.; Gaggi, R.; Mirelli, M.; Stella, A.; Marchetta, F.; Losinno, F.; Monetti, N.

    1989-05-01

    One-hundred five hypertensive patients underwent conventional renal scintigraphy followed 2 or 3 days later by Captopril-enhanced renal scintigraphy, performed 1 hr after premedication with 50 mg of Captopril per os. All patients were then submitted to renal arteriography, performed within 15-30 days. Fifty-five patients had no renal artery stenosis, 29 had unilateral disease, and 21 bilateral. Overall, 34/37 patients were diagnosed by the provocative test as having at least one renal artery affected by a stenosis greater than 50%. Of those with no stenosis (n = 55) or stenosis less than 50% (n = 13) only two cases were falsely positive. Thus sensitivity was 92% and specificity 97%. For single kidney identification with stenosis greater than 50%, sensitivity of renal scintigraphy after Captopril administration was 94% and specificity 98%. Captopril enhanced renal scintigraphy is thus suggested as the first test to be performed in hypertensive patients referred for renal scintigraphic studies. Only those cases with equivocal results require a baseline study for better assessment.

  9. Meta-iodobenzylguanidine scintigraphy in neuroblastoma--a comparison with conventional X-ray and ultrasound

    SciTech Connect

    Mueller-Gaertner, H.W.Er.; Erttmann, R.; Helmke, K. )

    1986-01-01

    To evaluate the accuracy of meta-iodobenzylguanidine (MIBG) imaging in comparison with bone X-ray and ultrasound, 15 patients with histologically verified neuroblastoma were investigated using 123- or 131MIBG scintigraphy. 123MIBG and 131MIBG are used as the abbreviations for 123-iodine-labeled-MIBG and 131-iodine-labeled-MIBG, respectively. Either 7.4 MBq 131MIBG (n = 4) or 111-185 MBq 123MIBG (n = 11) was applied, and scans were performed 24 and 48 h PI. Anatomical orientation was provided in selected cases by single-photon emission CT or scintigraphy of other organs. X-ray procedures or ultrasound depicted 27 neuroblastoma manifestations (primary tumors and metastatic deposits); 24 of these (89%) were identified by MIBG scintigraphy. Of 42 primary neuroblastomas and metastatic deposits, 27 (64%) were detected by corresponding bone X-ray or ultrasound. The 15 neuroblastoma lesions depicted solely by MIBG scans were mainly (80%) situated in the skeletal system. Because of the pronounced physiological MIBG uptake by liver tissue, detection of intrahepatic or perihepatic tumor involvement is difficult. MIBG scintigraphy is a safe and noninvasive means of locating a wide range of neuroblastoma lesions. Its main diagnostic advantage in comparison with bone X-ray lies in the detection of bone marrow infiltration.

  10. Collar Osteophytes Mimicking Osteonecrosis in Planar Bone Scintigraphy and Usefulness of SPECT/CT Images.

    PubMed

    Juang, Jr-Jian; Chen, Yi-Hsing; Tsai, Shih-Chuan; Lin, Wan-Yu

    2017-03-01

    The use of prednisolone is one major risk factor for osteonecrosis in patients with systemic lupus erythematosus. Bone scintigraphy can be a diagnostic tool for early diagnosis. We present a case who had collar osteophytes at the bilateral femoral heads, which mimicked osteonecrosis in the planar bone scintigram. An SPECT/CT scan avoided this pitfall and increased the diagnostic accuracy for osteonecrosis.

  11. Gastroesophageal reflux: the acid test, scintigraphy or the pH probe

    SciTech Connect

    Seibert, J.J.; Byrne, W.J.; Euler, A.R.; Latture, T.; Leach, M.; Campbell, M.

    1983-06-01

    The best established technique for diagnosing gastroesophageal reflux in children is the 24 hr esophageal pH probe test. No simultaneous comparison of this technique with radionuclide scans has been reported. Therefore, simultaneous 1 hr pH monitoring and gastroesophageal scintigraphy were performed in 49 infants and children with suspected gastroesophageal reflux. Forty-seven of these patients also were later monitored by the 24 hr pH probe test. Upper gastrointestinal series were performed on all patients. All patients with a positive 1 hr pH monitoring also had positive simultaneous scintigraphy. All patients with positive scintigraphy and pH probe monitoring also had a positive upper gastrointestinal series for reflux. The sensitivity of gastroesophageal scintigraphy, when compared to the 24 hr probe as a standard, was 79%; its specificity was 93%. The sensitivity of the upper gastrointestinal series was 86%, when compared to the 24 hr pH probe test. However, its specificity was only 21%.

  12. Continuing impact of thyroid scintigraphy on the diagnosis of thyroid enlargement

    SciTech Connect

    Maxon, H.R.; Hertzberg, V.; Vasavada, P.; Pu, M.Y.; Volarich, D.

    1986-05-01

    The impact of thyroid scintigraphy on the working diagnosis was evaluated in 204 consecutive patients referred for thyroid testing. The a priori and a posteriori diagnoses were discordant about one third of the time. The differences were highly significant (P less than 0.001) in the cases of uninodular and multinodular goiter.

  13. Detection of meningioma metastasis to liver and lung using somatostatin receptor scintigraphy.

    PubMed

    Lanfranchi, Michael; Nikpoor, Nayer

    2013-08-01

    Extracranial meningioma metastasis is rare. We report a case of a 74-year-old Caucasian man with intracranial recurrence of atypical meningioma treated with a combination of surgical resection and gamma knife radiotherapy over a 4-year period. Somatostatin receptor scintigraphy using (111)In pentreotide for surveillance of tumor recurrence showed multiple pulmonary and hepatic metastases.

  14. 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

  15. The effect of scatter and attenuation on aerosol deposition as determined by gamma scintigraphy.

    PubMed

    Lee, Z; Berridge, M S; Nelson, A D; Heald, D L

    2001-01-01

    Gamma scintigraphy is often used to quantify deposition patterns from aerosol inhalers. The errors caused by scatter and tissue attenuation in planar Tc-99m gamma scintigraphy were investigated based on the data collected from four subjects in this study. Several error correction methods were tested. The results from two scatter correction methods, Jaszczak's method and factor analysis of dynamic sequences (FADS), were similar. Scatter accounted for 20% of raw data in the whole lung, 20% in the oropharynx, and 43% in the central airways and esophagus. Three attenuation correction methods were investigated and compared. These were: uniform attenuation correction (UAC), a known method used for inhalation drug imaging work; the broad-beam attenuation correction used for organ imaging in nuclear medicine; and a narrow-beam inhomogeneous tissue attenuation correction proposed in this study. The three methods differed significantly (p < 0.05), but all indicated that attenuation is a severe quantification problem. The narrow beam attenuation correction with scatter correction, showed that raw data underestimated tracer deposition by 44% in the lung, 137% in the oropharynx, and 153% in the trachea/esophageal region. To quantify aerosol lung deposition using planar scintigraphy even in relative terms, corrections are necessary. Much of the literature concerning quantified aerosol dose distributions measured by gamma scintigraphy needs to be interpreted carefully.

  16. Bone scintigraphy for neonatal osteomyelitis: simulation by extravasation of intravenous calcium

    SciTech Connect

    Balsam, D.; Goldfarb, C.R.; Stringer, B.; Farruggia, S.

    1980-04-01

    Intravenously administered calcium gluconate has become increasingly popular in the treatment of neonatal tetany. Occasionally, extravasation results in cellulitis, leading to a clinical diagnosis of superimposed osteomyelitis. Osseous scintigraphy, as the accepted modality in the early detection of osteomyelitis, would tend to be used in this circumstance. This case illustrates a false-positive result, probably due to soft-tissue calcification.

  17. Contribution of V/Q SPECT to planar scintigraphy in the diagnosis of pulmonary embolism.

    PubMed

    Quirce, R; Ibáñez-Bravo, S; Jiménez-Bonilla, J; Martínez-Rodríguez, I; Martínez-Amador, N; Ortega-Nava, F; Lavado-Pérez, C; Bravo-Ferrer, Z; Carril, J M

    2014-01-01

    To evaluate the feasibility of V/Q SPECT and analyze its contribution to planar V/Q lung scintigraphy in the diagnosis of pulmonary embolism (PE). A total of 109 patients with suspected PE showing Wells score>2 and elevated D-dimer were studied. The V/Q could not be completed in 7 patients, so they were excluded. Ventilation and perfusion scans were done using Technegas and (99m)Tc-MAA. Planar study included 8 projections on a 256×256 matrix and 128 projections on a 128×128 matrix were acquired for the SPECT study, applying an iterative method. Planar images were interpreted according to modified PIOPED criteria, and SPECT by the guidelines of the EANMMI. The results with both techniques were compared. V/Q planar scintigraphy and SPECT could be performed in 102 patients. V/Q planar scintigraphy was considered "diagnostic" in 39 of the 102 patients, and "non-diagnostic" in 63. Of the 39 "diagnostic" studies, 31 were reported as high probability of PE and 8 as normal. Of the 63 "non-diagnostic", 26 corresponded to intermediate, 29 to low, and 8 to very low probability. The SPECT study was "diagnostic" in 97 and indeterminate in only 5. All patients with a high probability planar scintigraphy had a positive SPECT. In the 8 patients with a normal planar scintigraphy SPECT was negative in 5 and positive in 3. In the 63 patients with a "non-diagnostic" planar scintigraphy SPECT was "diagnostic" in 58 of them, positive in 17 and negative in 41. V/Q SPECT is a feasible technique as it was performed in 102 of the 109 patients who were enrolled in the study (94%). The addition of V/Q SPECT to planar V/Q decreases the number of "non-diagnostic" reports from 62% in planar scintigraphy to 4.9% in SPECT. Therefore, V/Q SPECT should be included in the diagnosis approach of PE due to its high diagnostic yield. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  18. Thallium-201 chloride scintigraphy in soft tissue tumors.

    PubMed

    Otsuka, Hideki; Terazawa, Kaori; Morita, Naomi; Otomi, Yoichi; Takao, Shoichiro; Iwamoto, Seiji; Osaki, Kyosuke; Harada, Masafumi; Nishitani, Hiromu

    2009-08-01

    We report the findings of Thallium-201 chloride ((201)TlCl) scintigraphy and consider how to use this technique to evaluate the character of soft tissue lesions. We enrolled 91 consecutive patients (45 males and 46 females, age range 8-91-years-old). Nineteen patients were malignant and 72 were benign. Patients were scanned 15 minutes (early phase) and 3 hours (delayed phase) after (201)TlCl injection. More intense uptake in the lesion compared to the normal side was considered as 'high', the same degree of uptake was considered 'iso', and decreased uptake was 'low'. The retention index (RI) was calculated in 9 patients in the malignant group and in 16 patients in the benign group. In malignant tumors, 15 of 19 patients showed high uptake in both the early and delayed phases. One malignant fibrous histiocytoma patient was high only in the delayed phase and 1 liposarcoma patient was high only in the early phase. Two liposarcoma patients showed an iso uptake in both phases. One of these patients was pathologically diagnosed as a myxoid type. In benign lesions, no lipoma showed increased uptake. All neurogenic tumors except for 2 demonstrated high uptake. All 3 ganglions of the lower extremities showed iso uptake. Most inflammatory diseases showed increased uptake. Clinically-considered benign patients consisted of tumorous lesions or inflammatory disease. Only 2 patients were considered 'low', and these were diagnosed as intramuscular hematoma and cyst. RI was variable in both malignant and benign lesions and no statistically significant difference was seen between malignant and benign lesions by t-test (p=0.72). A high (201)TlCl uptake lesion is more frequently seen in malignant tumors, but regardless of whether the tumor is benign or malignant, according to the histopathological variety, the (201)TlCl uptake pattern can not be the only indicator to differentiate malignant from benign tumors. We ultimately need to evaluate the nature of tumors by a combination of

  19. Update: improvement strategies for peptide receptor scintigraphy and radionuclide therapy.

    PubMed

    de Visser, Monique; Verwijnen, Suzanne M; de Jong, Marion

    2008-04-01

    Somatostatin receptor-targeting peptides are widely used for the imaging and therapy of neuroendocrine tumors. Peptide-receptor radionuclide therapy (PRRT) in neuroendocrine tumor patients with radiolabeled somatostatin analogs has resulted in symptomatic improvement, prolonged survival, and enhanced quality of life. The side-effects of PRRT are few and mostly mild, certainly when using kidney protective agents. If a more widespread use of PRRT is possible, such therapy might become the therapy of first choice in patients with metastasized or inoperable neuroendocrine gastroenteropancreatic tumors. Yet, much profit can be gained from improving the receptor-targeting strategies available and developing new strategies. This review presents an overview of several options to optimize receptor-targeted imaging and radionuclide therapy. These include the optimization of peptide analogs, increasing the number of receptors on the tumor site, and combining PRRT with other treatment strategies. The development of new peptide analogs with increased receptor-binding affinity and improved stability might lead to a higher accumulation of radioactivity inside tumor cells. Analogs of somatostatin have been widely studied. However, much profit can be gained in improving peptide analogs targeting other tumor-related receptors, including gastrin-releasing peptide (GRP) receptors, neurotensin (NT) receptors, cholecystokinin (CCK) receptors, and glucagon-like peptide-1 (GLP-1) receptors. Several peptide analogs targeting these receptors are well on their way to clinical utilization. The literature shows that it is possible to increase the receptor density on tumor cells by using different methods, which results in higher binding and internalization rates and thus a higher contrast during peptide-receptor scintigraphy. In PRRT treatment, this would enable the administration of higher therapeutic doses to tumors, which might lead to a higher cure rate in patients. Combinations of

  20. 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

  1. Symptomatic rotator cuff tears show higher radioisotope uptake on bone scintigraphy compared with asymptomatic tears.

    PubMed

    Koike, Yoichi; Sano, Hirotaka; Kita, Atushi; Itoi, Eiji

    2013-09-01

    Some patients with rotator cuff tears complain of pain, whereas others are asymptomatic. Previous studies have pointed out the presence of active bone metabolism in the painful shoulder, identified with increased radioisotope uptake during bone scintigraphy. Shoulders with symptomatic rotator cuff tears will demonstrate higher radioisotope uptake than shoulders with asymptomatic tears with bone scintigraphy, reflecting active bone metabolism in symptomatic tears. Cross-sectional study; Level of evidence, 3. The study consisted of 3 groups: patients with symptomatic tears (symptomatic group), patients with asymptomatic tears (asymptomatic group), and controls (no tear group). The symptomatic group consisted of 28 shoulders from 28 patients with symptomatic rotator cuff tears (pain score ≤4 on the University of California, Los Angeles [UCLA] shoulder evaluation form) who underwent bone scintigraphy followed by rotator cuff repair. Of 70 volunteers who had previously undergone bone scintigraphy for diseases unrelated to their shoulder, 34 were selected for the asymptomatic group (pain score ≥8 on the UCLA shoulder form), and 32 were selected for the no tear group. The mean radioisotope uptake in the symptomatic group was significantly higher than that in the asymptomatic group (P = .02) and the no tear group (P = .02). Ten of 28 shoulders (36%) in the symptomatic group showed increased radioisotope uptake exceeding 2 standard deviations from the mean of the no tear group. This percentage was significantly higher when compared with the asymptomatic group (0%) (P < .01). Shoulders with a symptomatic rotator cuff tear showed higher radioisotope uptake on bone scintigraphy than those with an asymptomatic tear. The radioisotope uptake in shoulders with an asymptomatic tear was comparable with that in shoulders without a tear. Positive radioisotope uptake may be associated with pain in a subgroup of patients with rotator cuff tears.

  2. Usefulness of lung perfusion scintigraphy before lung cancer resection in patients with ventilatory obstruction.

    PubMed

    Mineo, Tommaso C; Schillaci, Orazio; Pompeo, Eugenio; Mineo, Davide; Simonetti, Giovanni

    2006-11-01

    The study was conducted to evaluate the efficacy of preoperative lung perfusion scintigraphy performed by planar acquisition and single-photon emission computed tomography (SPECT) in predicting postoperative pulmonary function of patients with resectable lung cancer and obstructive ventilatory defect. The study enrolled 39 patients (mean age, 67 +/- 2.1 years). All patients underwent preoperative and postoperative pulmonary function tests. Cut-off values for postoperative forced expiratory volume in 1 second (FEV1) were 65% of the predicted value for pneumonectomy and 45% for lobectomy. A semiquantitative analysis of planar and SPECT lung perfusion scintigraphy images was performed preoperatively to estimate postoperative predicted FEV1 (FEV1ppo). Relationships between FEV1ppo and measured postoperative FEV1 were tested by the Pearson correlation and Bland Altman agreement tests. Twenty-eight lobectomies and 11 pneumonectomies were performed. The FEV1ppo estimated by mean planar lung scintigraphy was 1.85 +/- 0.38 L, with a Pearson correlation coefficient to the measured FEV1 of 0.8632 (p < 0.001). The mean FEV1ppo estimated by SPECT was 1.78 +/- 0.31 L, with a Pearson coefficient to the measured FEV1 of 0.8527 (p < 0.001). Both values showed a more significant correlation with postoperative measured FEV1 after lobectomy (p < 0.001) than after pneumonectomy (p = 0.045). The Bland Altman test confirmed satisfactory agreement of FEV1ppo estimated by both planar lung scintigraphy and SPECT with FEV1 measured by spirometry. Both planar lung scintigraphy and SPECT can accurately predict postoperative FEV1 and can therefore be considered reliable tools in establishing operability of patients with lung cancer and ventilatory obstruction.

  3. Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.

    PubMed

    Ridge, Carole A; McDermott, Shaunagh; Freyne, Bridget J; Brennan, Donal J; Collins, Conor D; Skehan, Stephen J

    2009-11-01

    The purpose of this study was to retrospectively compare the diagnostic adequacy of lung scintigraphy with that of pulmonary CT angiography (CTA) in the care of pregnant patients with suspected pulmonary embolism. Patient characteristics, radiology report content, additional imaging performed, final diagnosis, and diagnostic adequacy were recorded for pregnant patients consecutively referred for lung scintigraphy or pulmonary CTA according to physician preference. Measurements of pulmonary arterial enhancement were performed on all pulmonary CTA images of pregnant patients. Lung scintigraphy and pulmonary CTA studies deemed inadequate for diagnosis at the time of image acquisition were further assessed, and the cause of diagnostic inadequacy was determined. The relative contribution of the inferior vena cava to the right side of the heart was measured on nondiagnostic CTA images and compared with that on CTA images of age-matched nonpregnant women, who were the controls. Twenty-eight pulmonary CTA examinations were performed on 25 pregnant patients, and 25 lung scintigraphic studies were performed on 25 pregnant patients. Lung scintigraphy was more frequently adequate for diagnosis than was pulmonary CTA (4% vs 35.7%) (p = 0.0058). Pulmonary CTA had a higher diagnostic inadequacy rate among pregnant than nonpregnant women (35.7% vs 2.1%) (p < 0.001). Transient interruption of contrast material by unopacified blood from the inferior vena cava was identified in eight of 10 nondiagnostic pulmonary CTA studies. We found that lung scintigraphy was more reliable than pulmonary CTA in pregnant patients. Transient interruption of contrast material by unopacified blood from the inferior vena cava is a common finding at pulmonary CTA of pregnant patients.

  4. Use of quantitative lung scintigraphy to predict postoperative pulmonary function in lung cancer patients undergoing lobectomy.

    PubMed

    Win, Thida; Laroche, Clare M; Groves, Ashley M; White, Carol; Wells, Francis C; Ritchie, Andrew J; Tasker, Angela D

    2004-10-01

    In patients with non-small cell lung cancer, the only realistic chance of cure is surgical resection. However, in some of these patients there is such poor respiratory reserve that surgery can result in an unacceptable quality of life. In order to identify these patients, various pulmonary function tests and scintigraphic techniques have been used. The current American College of Physicians and British Thoracic Society guidelines do not recommend the use of quantitative ventilation-perfusion scintigraphy to predict postoperative function in lung cancer patients undergoing lobectomy. These guidelines may have been influenced by previous scintigraphic studies performed over a decade ago. Since then there have been advances in both surgical techniques and scintigraphic techniques, and the surgical population has become older and more female represented. We prospectively performed spirometry and quantitative ventilation-perfusion scintigraphy on 61 consecutive patients undergoing lobectomy for lung cancer. Spirometry was repeated one-month postsurgery. Both a simple segment counting technique alone and scintigraphy were used to predict the postoperative lung function. There was statistically significant correlation (p < 0.01) between the predicted postoperative lung function using both the simple segment counting technique and the scintigraphic techniques. However, the correlation using simple segment counting was of negligible difference compared to scintigraphy. In keeping with current American Chest Physician and British Thoracic Society guidelines, our results suggest that quantitative ventilation-perfusion scintigraphy is not necessary in the preoperative assessment of lung cancer patients undergoing lobectomy. The simple segmenting technique can be used to predict postoperative lung function in lobectomy patients.

  5. Pitfalls in establishing the diagnosis of deep venous thrombophlebitis by indium-111 platelet scintigraphy

    SciTech Connect

    Seabold, J.E.; Conrad, G.R.; Kimball, D.A.; Ponto, J.A.; Bricker, J.A.

    1988-07-01

    Forty-seven /sup 111/In-platelet scintigraphs (In-PS) were analyzed retrospectively to identify sources of diagnostic error and to optimize the diagnostic criteria for active deep venous thrombophlebitis (DVT). The results of In-PS were compared with contrast venography, additional diagnostic studies, and clinical outcome. Three patterns of platelet localization emerged as the best predictors of active DVT: (a) focal or (b) linear 4-hr localization, or (c) an asymmetric blood-pool pattern on 4-hr imaging that evolved into a focal or linear pattern by 16 to 24 hr. All false-positive studies had abnormal patterns confined to the inguinal region at 24 hr. All patients with false-negative studies had received heparin between 4 and 24 hr. The potential pitfalls encountered in the evaluation of the iliac, femoral, and popliteal veins are reviewed and the importance of delayed imaging in selected cases is emphasized.

  6. 99mTc technegas ventilation and perfusion lung scintigraphy for the diagnosis of pulmonary embolus.

    PubMed

    Howarth, D M; Lan, L; Thomas, P A; Allen, L W

    1999-04-01

    Lung scintigraphy is used widely for diagnosis of pulmonary embolus (PE). Technegas ventilation imaging has many advantages over other methods, but little outcome data exists on this technique. The aims of this study were to better define the role of lung scintigraphy in the management of patients with suspected PE and to evaluate technegas ventilation imaging by following patient outcomes. A group of 717 out of 834 consecutive patients, referred to a university teaching hospital for lung scintigraphy to confirm or refute the diagnosis of PE, was followed for 18-30 mo to determine clinical outcome. The follow-up endpoints were death as a result of PE, death as a result of hemorrhage after treatment for PE, uncomplicated survival, survival with subsequent PE, nonfatal hemorrhage after treatment for PE and recurrence of PE in treated patients. Ventilation imaging was performed using technegas, and perfusion imaging was performed using intravenous 99mTc macroaggregated albumin. The modified PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) diagnostic criterion was used for interpretation of lung scintigraphy. Diagnostic results included 3.5% normal studies, 67.4% assessed as low probability for PE, 10% as moderate probability for PE and 19.1% as high probability for PE. A total of 231 patents received therapy with heparin, followed by warfarin, including those receiving anticoagulation therapy for other conditions. Ninety-six percent of patients with normal and low probability studies (n = 508) had good outcomes, 6 patients died as a result of PE and 12 subsequently developed PE. The odds ratio for death by PE in this group was 0.2. Of the 72 moderate probability studies, 39 patients were untreated. In this group there was 1 death due to PE, and PE subsequently developed in 2 patients. None of the remaining 33 treated patients died, but 4 patients experienced bleeding complications. The odds ratio for death by PE in the moderate probability group was

  7. Lack of correlation between extended pH monitoring and scintigraphy in the evaluation of infants with gastroesophageal reflux

    SciTech Connect

    Tolia, V.; Calhoun, J.A.; Kuhns, L.R.; Kauffman, R.E. )

    1990-05-01

    Sixty-nine infants younger than 1 year of age, with symptoms of persistent vomiting, recurrent choking, apnea, persistent cough, or stridor, were evaluated for gastroesophageal reflux. All infants underwent extended intraesophageal pH monitoring for 16 to 24 hours as well as gastroesophageal scintigraphy with technetium 99m sulfur colloid to study the correlation between the two tests. Forty-eight infants exhibited reflux with extended pH monitoring whereas 46 infants showed reflux with scintigraphy. However, the diagnosis of reflux in individual patients by extended pH monitoring corresponded poorly with the diagnosis of reflux in the same patients by scintigraphy. Similarly, no correlation was observed between extended pH monitoring and scintigraphy results, whether expressed as percent gastric emptying or as gastroesophageal reflux ratio. We conclude that extended pH monitoring and scintigraphy measure different pathophysiologic phenomena and detect reflux under different conditions. The ability of these tests to detect reflux may be complementary and they may be of greatest value when used together to enhance the sensitivity and specificity of the diagnostic evaluation. Extended pH monitoring and scintigraphy should not be used interchangeably to monitor gastroesophageal reflux.

  8. Comparison of whole-body MRI and bone scintigraphy in the detection of bone metastases in renal cancer.

    PubMed

    Sohaib, S A; Cook, G; Allen, S D; Hughes, M; Eisen, T; Gore, M

    2009-08-01

    This study aims to compare the sensitivity of whole-body MRI with bone scintigraphy in the detection of bone metastases in patients with renal cancer. A prospective study was carried out in 47 patients with renal cancer (mean age 62 years, range 29-79 years). All patients had assessment of the skeleton with whole-body bone scintigraphy (with technetium-99m methylene diphosphonate) and whole-body MRI (coronal T(1) weighted and short tau inversion recovery sequences). The number and sites of bony metastases were assessed on each imaging investigation independently. Sites of extra-osseous metastasis on MRI were also noted. The imaging findings were correlated with other imaging modalities and follow-up. 15 patients (32%) had bone metastases at 34 different sites. Both scintigraphy and MRI were highly specific (94% and 97%, respectively), but the sensitivity of MRI (94%) was superior (p = 0.007) to that of scintigraphy (62%). MRI identified more metastases in the spine and appendicular skeleton, whereas scintigraphy showed more lesions in the skull/facial and thoracic bones. MRI identified extra-osseous metastases in 33 patients (70%), these were mainly lung and retroperitoneal in site. Whole-body MRI is a more sensitive method for detection of bone metastases in renal cancer than bone scintigraphy, and also allows the assessment of soft-tissue disease.

  9. /sup 201/Tl scintigraphy after surgical repair of hemodynamically significant primary coronary artery anomalies

    SciTech Connect

    Rajfer, S.I.; Oetgen, W.J.; Weeks, K.D. Jr.; Kaminski, R.J.; Rocchini, A.P.

    1982-06-01

    Nine patients with hemodynamically significant congenital coronary artery anomalies underwent surgical repair at our institution during the period 1960 to 1979. Four received diagnoses of anomalous left coronary artery arising from the pulmonary artery, while five patients had coronary artery fistulae. Stress /sup 201/Tl scintigraphy was performed on these patients 0.5 to 18 years after surgical correction as a means of assessing the adequacy of myocardial perfusion. No perfusion defects were visualized on any of the thallium studies. The surgical procedure used did not appear to influence the results of /sup 201/Tl stress imaging. Thus, these nine patients with surgically corrected primary coronary artery anomalies had no evidence of ischemia as assessed by stress thallium scintigraphy. Serial preoperative and postoperative thallium studies are now indicated to determine the role of this procedure in the management of hemodynamically significant congenital coronary artery anomalies.

  10. Nonvisualization of an enlarged spleen on Ga-67 scintigraphy but demonstrated by CT after splenic irradiation

    SciTech Connect

    Shih, W.J.; Domstad, P.A.; DeLand, F.H.; Maruyama, Y.

    1985-03-01

    The presence of an enlarged spleen using CT with the absence of splenic visualization in Ga-67 citrate images in a patient with chronic myelogenous leukemia and splenomegaly after splenic irradiation was observed. Since Howell-Jolly bodies had not been identified in the peripheral circulation, the finding of splenic nonvisualization was explained by disassociated splenic functions, which are not tightly coupled, and some activities that can be suppressed by irradiation without impairing others. The Ga-67 splenic localization mechanism is probably more sensitive and liable to disruption by irradiation, and was independent of spleen size. Ga-67 scintigraphy and Tc-99m sulfur colloid liver-spleen scintigraphy are two organ function-dependent imaging procedures, while CT provides anatomic information.

  11. 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.

  12. [Osteoid osteoma on distal phalanx tip of second toe, without scintigraphy fixation].

    PubMed

    Feron, M; Desdoits, A; Bronfen, C; Jeanne-Pasquier, C; Haumont, T

    2015-12-01

    Osteoid osteoma is a very small painful, benign tumor, located preferentially on long bones. Cases on the phalanxes of the toes are very rare. Pain takes up nearly all the clinical presentation. Poor clinical signs and atypical location make diagnosis difficult and delayed. Sometimes, it can be confused with local infection. Various additional tests are described to help diagnosis. Technetium 99-m scintigraphy coupled with CT is the key exam with high sensitivity and morphological accuracy. We report on the case of a 10-year-old boy with an atypical location of osteoid osteoma on the distal phalanx tip of the second toe, without scintigraphy fixation and obvious nidus on X-ray and CT scan.

  13. [Usefulness of gastric emptying scintigraphy for the evaluation and management of scleroderma related gastroparesis].

    PubMed

    Piskorz, María M; Rank, Gerardo; Velázquez Espeche, María; García Cainzo, Analisa; Pisarevsky, Andrea; Sorda, Juan A; Olmos, Jorge

    2015-03-01

    Scleroderma is a chronic autoimmune disease of unknown cause characterized by fibrotic skin and multiple organs involvement, including the gastrointestinal tract. It occurs mainly in women between 35 and 65 years of age. It is classified as limited or diffuse based on the extent of skin involvement. Gastrointestinal dysmotility is observed in up to 90% of patients with a diffuse and limited scleroderma. It may involve any segment of the gastrointestinal tract from the esophagus to the anus and is related to collagen deposition at the level of enteric and vascular smooth muscle. Gastroparesis is a condition characterized by abnormal gastric motility, delay gastric emptying, in the absence of a mechanical obstruction to outflow. Gastric scintigraphy with radiolabeled solid food is the gold standard for the diagnosis of gastroparesis. Two cases of patients with systemic scleroderma and severe gastroparesis are presented in order to discuss the diagnostic and therapeutic approach, emphasizing the utility of gastric emptying scintigraphy.

  14. 99mTc-trimethyl-BrIDA scintigraphy in HIV-related cholangiopathy.

    PubMed

    Bair, H J; Behr, T; Rubbert, A; Becker, W; Wolf, F

    1995-12-01

    A HIV-infected 37-year-old man with diffuse mid-abdominal pain and elevated liver enzymes was sequentially studied by sonography, computed tomography (CT), 99mTc-trimethyl-BrIDA scintigraphy and endoscopic retrograde cholangiopancreatography (ERCP). CT and sonography did not lead to a final diagnosis. Cholescintigraphy showed signs of cholecystitis and sclerosing cholangitis with intra- and extrahepatic bile duct dilatation. These findings could be confirmed by ERCP, rendering HIV-associated cholepathy probable. Cytomegalovirus infection was demonstrated by polymerase chain reaction from bile fluid and the presence of cryptosporidia infection in a histology specimen isolated by ERCP. Therefore, biliary scintigraphy seems promising for screening for HIV-associated cholangio- and cholecystopathy, being less invasive and less bothering for the patient than ERCP.

  15. Study of the auditory tube by ventilation scintigraphy with technetium-99m.

    PubMed

    Timoshenko, Andrei P; Denis, Christian; Dubois, Francis; Martin, Christian; Prades, Jean-Michel

    2005-12-01

    The two essential regulating mechanisms of the middle ear pressure are the trans-mucosal gas exchange in the middle ear and the ventilation function of the eustachian tube (ET). The physiological mechanism of these both functions is not yet clear. The purpose of this study was to evaluate the role of the ET pressure equilibrium function by ventilation scintigraphy with technetium-99m. The rabbit animal model in vivo was used to study the presence and role of the ventilation of the tympanic cavity via auditory tube. The obtained results did not show any ventilation function of the ET despite active opening by muscle movement. In our experience, ventilation scintigraphy with technetium-99m is not a reliable method to study the auditory tube pressure equilibrium function in physiological conditions.

  16. Exercise thallium-201 perfusion scintigraphy in the assessment of coronary artery disease

    SciTech Connect

    Mahmarian, J.J.; Verani, M.S. )

    1991-05-21

    Exercise thallium-201 perfusion scintigraphy has been used extensively over the last decade for the detection and localization of coronary artery disease. Single-photon emission computed tomography (SPECT) is a refinement of presently available techniques, offering improved identification over planar imaging of individual vessel stenosis and quantification of the extent of abnormally perfused myocardium. In this review, the planar and SPECT techniques are discussed in light of the most recently published large patient series, and with regard to the many factors that affect the sensitivity and specificity of perfusion imaging in identifying coronary artery disease. The clinical implications of exercise perfusion scintigraphy and its future applications in cardiology practice are discussed.67 references.

  17. 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.

  18. 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.

  19. Evaluation of the post-coronary artery bypass patient by myocardial perfusion scintigraphy and computed tomography

    SciTech Connect

    Engelstad, B.L.; Wagner, S.; Herfkens, R.; Botvinick, E.; Brundage, B.; Lipton, M.

    1983-09-01

    The clinical utility of /sup 201/Tl scintigraphy and of computed tomography for the noninvasive assessment of graft patency and regional myocardial perfusion was evaluated in 24 patients who had undergone aortocoronary bypass surgery. Perfusion defects on /sup 201/Tl scintigraphy (reversible or new, fixed) correlated (100% sensitivity, 78% specificity) with occlusion or stenosis of a graft or significant new native vessel disease. Graft occlusion was accurately demonstrated by dynamic computed tomography (100% sensitivity, 96% specificity) but did not uniformly correlate with regional perfusion. Perfusion defects in the distribution of patent grafts resulted from progressive native vessel disease or graft stenosis without complete occlusion. The absence of exercise-induced perfusion defects in regions of occluded grafts was attributed to suboptimal exercise, collateralization, or noncritical native vessel stenosis. The two studies provide complementary anatomic and physiologic information in the evaluation of the postbypass patient.

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

    SciTech Connect

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

    2016-08-02

    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.

  1. Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease

    PubMed Central

    Siqueira, Fabio Paiva Rossini; Mesquita, Claudio Tinoco; dos Santos, Alair Augusto Sarmet M. Damas; Nacif, Marcelo Souto

    2016-01-01

    Half the patients with coronary artery disease present with sudden death - or acute infarction as first symptom, making early diagnosis pivotal. Myocardial perfusion scintigraphy is frequently used in the assessment of these patients, but it does not detect the disease without flow restriction, exposes the patient to high levels of radiation and is costly. On the other hand, with less radiological exposure, calcium score is directly correlated to the presence and extension of coronary atherosclerosis, and also to the risk of cardiovascular events. Even though calcium score is a tried-and-true method for stratification of asymptomatic patients, its use is still reduced in this context, since current guidelines are contradictory to its use on symptomatic diseases. The aim of this review is to identify, on patients under investigation for coronary artery disease, the main evidence of the use of calcium score associated with functional evaluation and scintigraphy. PMID:27437867

  2. Evaluation of indium scintigraphy in patients with active inflammatory bowel disease.

    PubMed Central

    Buxton-Thomas, M S; Dickinson, R J; Maltby, P; Hunter, J O; Wraight, E P

    1984-01-01

    Recent reports have indicated a possible role for 111Indium leucocyte scintigraphy in the management of patients with acute inflammatory bowel disease. Our experience with this technique in 15 patients (nine with ulcerative colitis, six with Crohn's disease) is described. Perfect agreement was not obtained between scintigraphic appearances and other conventional means in the assessment of extent of disease. Good correlation, however, was found between disease activity and recovery of labelled leucocytes in the faeces. While this latter finding could be used as an objective means of assessing response to therapy, it is concluded that conventional indium scintigraphy, using indium oxine-labelling of mixed leucocytes, is insufficiently reliable to replace usual methods for determining extent of disease in patients with inflammatory bowel disease. Images Fig. 1 Fig. 2 PMID:6439610

  3. Iodine-131 MIBG scintigraphy of the extremities in metastatic pheochromocytoma and neuroblastoma

    SciTech Connect

    Shulkin, B.L.; Shen, S.W.; Sisson, J.C.; Shapiro, B.

    1987-03-01

    Iodine-131 MIBG scintigraphy may be used to determine the presence or absence of metastases to the appendicular skeleton in malignant pheochromocytoma and neuroblastoma. Normal bones show no uptake of (/sup 131/I)MIBG and the joints are seen as photon-deficient areas surrounded by background muscle activity. Discrete concentrations of radioactivity in bone are often seen in patients with malignant pheochromocytoma and neuroblastoma. Bone marrow involvement in neuroblastoma may be indicated by diffuse uptake of (/sup 131/I)MIBG or focal accumulation at the metaphyses. Uncommonly, bone involvement may not be displayed by the (/sup 131/I)MIBG images. Since conventional bone scanning agents may also fail to detect these tumors, skeletal scintigraphy with both (/sup 131/I)MIBG and (/sup 99m/Tc)MDP is necessary to reliably stage malignant pheochromocytoma and neuroblastoma.

  4. Effect of phenobarbital on 99mTc-IDA scintigraphy in the evaluation of neonatal jaundice

    SciTech Connect

    Majd, M.; Reba, R.C.; Altman, R.P.

    1981-07-01

    Hepatobiliary scintigraphy with 99mTc-IDA derivatives was used to evaluate 40 neonates with mixed jaundice. Fourteen patients proved to have biliary atresia. The remaining 26 patients had intrahepatic cholestasis with patent extrahepatic ducts. Sixteen of the 40 patients underwent examinations without phenobarbital stimulation. Sixteen patients had two examinations, one before and one after 3-7 days of phenobarbital therapy. The remaining 8 patients had their initial examinations after phenobarbital therapy. The results of this study show that administration of phenobarbital in a dose of 5 mg/kg/day for at least 5 days prior to the examination enhances and accelerates biliary excretion of IDA compounds and thereby significantly increases the accuracy of 99mTc-IDA scintigraphy in differentiating extrahepatic biliary atresia from neonatal hepatitis. Its routine use in the evaluation of neonatal jaundice is therefore highly recommended.

  5. 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.

  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. 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.

  8. [Diagnostic imaging in acute pulmonary embolism. The use of spiral computed tomography, lung scintigraphy and echocardiography].

    PubMed

    Hess, Søren; Madsen, Poul Henning; Jørgensen, Henrik Boel; Høilund-Carlsen, Poul Flemming

    2005-10-10

    Acute pulmonary embolism is an underdiagnosed and potentially lethal condition. Treatment may be lifesaving but is associated with severe side effects. Thus, reliable diagnostic imaging is essential. We conducted a literature review on the use of spiral computed tomography, lung scintigraphy and echocardiography in acute pulmonary embolism and identified 562 articles, of which 16 original papers met our inclusion criteria. From these, we concluded that none of the modalities is applicable in every situation. Spiral computed tomography can confirm the diagnosis but cannot rule out subsegmental embolism. With lung scintigraphy, perfusion imaging alone is probably sufficient and suited to both confirming and ruling out the diagnosis. Echocardiography should be reserved for patients with an emergent need for treatment and cannot rule out the diagnosis.

  9. 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

  10. Postoperative osteomyelitis following implant arthroplasty of the foot: diagnosis with indium-111 white blood cell scintigraphy

    SciTech Connect

    Bakst, R.H.; Kanat, I.O.

    1987-11-01

    Many complications can occur following insertion of silicone elastomer implants into the foot. Postoperative infection may be difficult to distinguish from other conditions such as dislodgment, fracture, ectopic and heterotopic new bone formation, synovitis, and bursitis. White blood cell scintigraphy, in conjunction with the clinical scenario, may prove to be an invaluable tool in the diagnosis of postoperative osteomyelitis, subsequent to implant arthroplasties. 32 references.

  11. Demonstration of an infected popliteal (Baker's) cyst with three-phase skeletal scintigraphy

    SciTech Connect

    Wallner, R.J.; Dadparvar, S.; Croll, M.N.; Brady, L.W.

    1985-03-01

    A case is reported of an infected popliteal (Baker's) cyst demonstrated with triple phase skeletal scintigraphy. Although double-contrast arthrography and ultrasonography are currently the modalities most frequently employed to diagnose the presence of popliteal cysts, they may also be detected utilizing this radionuclide technique in the course of evaluation for knee joint disease or septic arthritis. Radionuclide studies may be more sensitive for the evaluation of associated inflammatory disease involving the knee joint.

  12. Rupture of a spontaneous aortoduodenal fistula visualized with Tc-RBC scintigraphy

    SciTech Connect

    Yen, C.K.; Pollycove, M.; Parker, H.; Nalls, G.

    1983-04-01

    We present what we believe is the first reported case of a spontaneous aortoduodenal fistula, with massive rupture into the duodenum during the performance of a radionuclide study of gastrointestinal bleeding. Our experience suggests that nuclear scintigraphy with labeled red blood cells can help in the diagnosis of this disorder by demonstrating both the presence of an abdominal aortic aneurysm and bleeding in the gut.

  13. Postoperative osteomyelitis following implant arthroplasty of the foot: diagnosis with indium-111 white blood cell scintigraphy

    SciTech Connect

    Bakst, R.H.; Kanat, I.O.

    1987-11-01

    Many complications can occur following insertion of silicone elastomer implants into the foot. Postoperative infection may be difficult to distinguish from other conditions such as dislodgment, fracture, ectopic and heterotopic new bone formation, synovitis, and bursitis. White blood cell scintigraphy, in conjunction with the clinical scenario, may prove to be an invaluable tool in the diagnosis of postoperative osteomyelitis, subsequent to implant arthroplasties. 32 references.

  14. In-111-leukocyte scintigraphy for detection of infection associated with peritoneal dialysis catheters

    SciTech Connect

    Kipper, S.L.; Steiner, R.W.; Witztum, K.F.; Basarab, R.M.; Kipper, M.S.; Halpern, S.E.; Ashburn, W.L.

    1984-05-01

    In-111-labeled leukocytes were administered to 13 patients on continuous ambulatory peritoneal dialysis in order to locate catheter-associated infections. Using a marker to indicate the catheter exit site, infections of the catheter tunnel were correctly identified prior to surgery in 4 patients with relapsing peritonitis and infections of the exit site were diagnosed in 5 out of 7 patients. The authors conclude that In-111-leukocyte scintigraphy appears to be accurate in diagnosing peritoneal infections of the dialysis catheter tunnel.

  15. Perfusion scintigraphy in the diagnosis of pulmonary embolism: a self-assessment quiz

    SciTech Connect

    Egermayer, P.; Rutland, M.D.

    1982-07-01

    The authors present ten case reports with lung scintigrams in a format suitable for a self-assessment quiz. The first seven cases include perfusion scintigrams and the final diagnosis was established by postmortem examination. The last three studies include ventilation images (using nebulized /sup 99m/Tc tin colloid) and the final diagnosis established by nonradionuclide studies. The authors believe this quiz demonstrates the necessity for ventilation studies when using lung scintigraphy for a positive diagnosis.

  16. 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.

  17. Technetium sulfur colloid scintigraphy in the detection of lower gastrointestinal tract bleeding

    SciTech Connect

    Simpson, A.J.; Previti, F.W.

    1982-07-01

    /sup 99m/Tc sulfur colloid scintigraphy is a technique which can be used to localize sites of lower gastrointestinal hemorrhage. Two reports of patients illustrate its use clinically. This procedure is non-invasive, relatively inexpensive, easily performed and has a high degree of sensitivity. The technique may, in some instances, replace angiography or endoscopy as the initial procedure used to diagnose the site of lower gastrointestinal bleeding or, more likely, serve as a complementary diagnostic modality.

  18. Assessment of the Prevalence of Diabetic Gastroparesis and Validation of Gastric Emptying Scintigraphy for Diagnosis

    PubMed Central

    Alipour, Zeinab; Khatib, Foad; Tabib, Seyed Masoud; Javadi, Hamid; Jafari, Esmail; Aghaghazvini, Leila; Mahmoud-Pashazadeh, Ali; Nabipour, Iraj; Assadi, Majid

    2017-01-01

    Objective: Gastroparesis is defined as delayed gastric emptying and is a common medical condition in diabetic patients. Scintigraphy is commonly used as a standard diagnostic procedure for the quantitative assessment of gastroparesis. The aims of this study were to determine an optimum imaging time for the diagnosis of gastroparesis, to assess the prevalence of gastroparesis, to evaluate the correlation between endoscopy and scintigraphy findings as well as the correlation between gastric emptying with patient genders, blood glucose concentration, and functional dyspepsia. Methods: Gastric emptying was assessed in 50 diabetic patients with a mean age of 50.16 years. For evaluation of gastric emptying, a test meal containing 2 pieces of toast, 120 cc non-labeled water and fried egg labeled with 1 mCi of 99mTc was given to each patient. The scintigraphy was performed immediately after ingestion and was repeated at 1, 1.5, 2 and 4 hours after ingestion. In some patients, an additional 90-minute dynamic scan was also acquired. Results: The prevalence of gastroparesis in this study population was determined as 64%. Also, the results of this study revealed that a 4-hour scan after ingestion is more relevant than a 90-minute dynamic scan for the evaluation of delayed gastric emptying. There was no statistically significant difference between 1-hour and 2-hour scans, 1-hour and 90-minute scans, 2-hour and 90-minute scans, 2-hour and 4-hour scans. Likewise there was no significant correlation between blood glucose levels, gender and calculated values of gastric emptying time in all groups. Conclusion: According to our findings, it can be suggested that the prevalence of gastroparesis is higher than that mentioned in some previous studies. Also, this study indicates that a gastric emptying scintigraphy at 2 and 4 hours after meal ingestion might provide the anticipated clinical information in diabetic patients with dyspepsia without other evident reasons. PMID:28291006

  19. Diagnosis of segmental necrosis in a pancreas transplant by thallium-201 perfusion scintigraphy

    SciTech Connect

    Hirsch, H.; Fernandez-Ulloa, M.; Munda, R.; Fisher, R.A.; Moulton, J.S.; Huth, C.J. )

    1991-08-01

    Thallium-201 was used to image a patient with a pancreatic transplant. Incomplete visualization of the graft on the 201Tl scan, compared to CT, led to the diagnosis of segmental necrosis of the tail of the graft. Due to the low background and favorable target-to-non-target ratio, 201Tl pancreas scintigraphy may be useful in the follow-up of pancreatic transplants.

  20. Thallium-201 scintigraphy perfusion defect with dipyridamole in a patient with a myocardial bridge

    SciTech Connect

    Bennett, J.M.; Blomerus, P.

    1988-04-01

    A patient with myocardial bridging and a thallium-201 scintigraphy perfusion defect after the administration of intravenous dipyridamole is presented. The same patient had a normal perfusion study on exercise stress testing. The effects of coronary vasodilators and dipyridamole on coronary artery flow patterns in patients with myocardial bridging are discussed. We suggest that coronary vasodilators may induce perfusion defects in patients with myocardial bridging and should be avoided in such patients.

  1. Renal scintigraphy predicts global cardiovascular risk in hypertensive subjects with normal serum creatinine levels.

    PubMed

    Mazza, Alberto; Rampin, Lucia; Montemurro, Domenico; Schiavon, Laura; Zuin, Marco; Grassetto, Gaia; Chondrogiannis, Sotirios; Al-Nahhas, Adil; Ramazzina, Emilio; Rubello, Domenico

    2011-12-01

    BACKGROUND. This cross-sectional study investigates the role of renal scintigraphy on cardiovascular (CV) risk stratification in normoalbuminuric, non-diabetic hypertensive subjects (HTs) free from CV disease and renal dysfunction. METHODS. In 200 HTs aged 55-75 years, glomerular filtration rate (GFR) was measured by technetium-99m-diethylene triamine pentacetic acid clearance during renal scintigraphy. Stage III chronic kidney disease (CKD) was defined as GFR < 60 ml/min/1.73 m(2). For comparing the impact of different methods for CKD diagnosis on CV risk stratification, CKD was also considered as GFR estimated by the Modification of Diet in Renal Disease (MDRD) equation and Cockcroft-Gault's formula. Target organ damage (TOD) was assessed by echocardiography and carotid ultrasonography. Gender-specific odds ratio (OR) with 95% confidence intervals for CKD were derived from a multiple stepwise logistic regression analysis. Global CV risk was stratified according to routine examinations, TOD and CKD. RESULTS. In 38% of cases, an unknown stage III CKD was found. Independent of age, CKD was predicted by history of hypertension (OR = 1.69, p = 0.0001), albuminuria (OR = 1.25, p = 0.0001), smoking (OR = 1.85, p = 0.028) and pulse pressure (OR = 1.21, p = 0.019) in men only. Men had an increased risk of CKD (OR = 2.62, p = 0.002) in comparison with women. Prevalence of TOD was significantly higher only in HTs having CKD diagnosed by renal scintigraphy; TOD and CKD assessment added to classic risk factors modified the CV risk stratification from low-moderate to high and very high. CONCLUSIONS. Renal scintigraphy is an important aid in risk stratification and should be performed in HTs aged >55 years. Pulse pressure was the main blood pressure component that predicted the risk of stage III CKD.

  2. NOTE: Estimation of renal scintigraphy parameters using a linear piecewise-continuous model

    NASA Astrophysics Data System (ADS)

    Zhang, Jeff L.; Zhang, L.; Koh, T. S.; Shuter, B.

    2003-06-01

    Instead of performing a numerical deconvolution, we propose to use a linear piecewise-continuous model of the renal impulse response function for parametric fitting of renal scintigraphy data, to obtain clinically useful renal parameters. The strengths of the present model are its simplicity and speed of computation, while not compromising on accuracy. Preliminary patient case studies show that the estimated parameters are in good agreement with a more elaborate model.

  3. Effects of radiofrequency ablation on individual renal function: assessment by technetium-99m mercaptoacetyltriglycine renal scintigraphy.

    PubMed

    Mukai, Takashi; Sato, Shuhei; Iguchi, Toshihiro; Mimura, Hidefumi; Yasui, Kotaro; Gobara, Hideo; Saika, Takashi; Nasu, Yasutomo; Kumon, Hiromi; Kanazawa, Susumu

    2006-04-01

    We quantitatively evaluated total and individual renal function by technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) renal scintigraphy before and after radiofrequency ablation (RFA) of renal tumors. Eleven patients who underwent Tc-99m MAG3 renal scintigraphy 1 week before and after RFA were evaluated (7 men and 4 women; age range: 23-83 years; mean age: 60.6 years). Five patients had solitary kidneys, and five had normally or minimally functioning contralateral kidneys. One patient had a renal cell carcinoma in the contralateral kidney. One patient with a solitary kidney underwent RFA a second time for a residual tumor. In patients with a solitary kidney, MAG3 clearance decreased after 5 of 6 RFAs, and in patients with a normally functioning contralateral kidney, MAG3 clearance decreased after 4 of 5 RFAs, but no significant differences were observed between before and after treatments. In addition to the total MAG3 clearance, the split MAG3 clearance was evaluated in patients with a normally functioning contralateral kidney. MAG3 clearance decreased in 4 of 5 treated kidneys, while it adversely increased in the contralateral kidneys after 4 of 5 RFAs. No significant differences, however, were observed between before and after treatments. The results of our study revealed no significant differences in sCr, BUN, CCr, or MAG3 clearance between pre- and post-RFA values. These results support data regarding the functional impact and safety of renal RFA in published reports. We evaluated total and individual renal function quantitatively using Tc-99m MAG3 renal scintigraphy before and after treatment. This scintigraphy was very useful in assessing the effects of RFA on renal function.

  4. Technetium-99m MAG3 renal scintigraphy with demonstration of aortic dissection.

    PubMed

    Nguyen, Ba D

    2005-08-01

    Demonstration of type B aortic dissection is rare during renal scintigraphy. The discordant radionuclide pattern of asymmetric renal flow with equivalent renal function and excretion has been previously reported in aortic dissection. However, delayed scintigraphic features of the false lumen have not been described. The author presents such a case with persistent technetium-99m MAG3 accumulation in the posterior mediastinum on postvoid planar imaging.

  5. Technetium-99m hexamethyl propylene amine oxime granulocyte scintigraphy in Crohn's disease: diagnostic and clinical relevance.

    PubMed Central

    Sciarretta, G; Furno, A; Mazzoni, M; Basile, C; Malaguti, P

    1993-01-01

    Scintigraphy with autologous granulocytes labelled by technetium-99m hexamethyl, propylene amine oxime (99mTc-HMPAO) was performed in 103 Crohn's disease patients and 52 healthy controls. In 31 patients endoscopic and histologic activity was compared with scan activity index. In the 98 patients with a positive scan, the extent of Crohn's disease, assessed by scintigraphy, was compared with that evaluated by small bowel x ray or colonoscopy with biopsies. In 48 patients, Crohn's disease activity index, activity index, simple index, erythrocyte sedimentation rate, C-reactive protein were correlated with the scan results. In 16 patients the five parameters and scan were repeated after treatment with methyl-prednisolone (10 cases), enteral nutrition (3), and 5-acetylsalicylic acid (3). The results showed that 99mTc-HMPAO granulocyte scan had a 95% sensitivity and 100% specificity to detect active inflammation; it correctly showed an abscess or a fistula in all the 24 cases found. The correlation between histological inflammatory activity and scan activity index was highly significant (r = 0.85; p < 0.01), less significant (r = 0.65; p < 0.01) between endoscopy and scan activity index. The evaluation for the extent of Crohn's disease by scan was completely correct in the small bowel (100%) and 93% correct in the large bowel. No correlation was seen between the three clinical activity parameters and scanning; in more than 80% of the cases in remission on the basis of a clinical or laboratory index, scintigraphy remained positive. Medical treatment was effective on the clinical indices but not on the active inflammation in the ileum, whereas it led to a negative scan in 5/11 cases in the large intestine. Scintigraphy with 99mTc-HMPAO granulocyte plays an important part in Crohn's disease for the diagnosis of complications, for activity and assessment of the extent, and for the treatment results evaluation. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:8244102

  6. Late presentation of metastatic pheochromocytoma: A problem case solved by I-131 MIBG scintigraphy

    SciTech Connect

    Geatti, O.; Shapiro, B.; Virgolini, L. )

    1990-02-01

    A patient presented with recurrent pheochromocytoma 10 years following the apparently successful surgical cure of a right adrenal pheochromocytoma. Conventional medical imaging techniques, (chest radiograph, abdominal ultrasound, and abdominal CT) suggested local recurrence for which surgery was planned. I-131 MIBG scintigraphy revealed disseminated metastatic disease that rendered attempts at surgical cure futile. The patient was treated with three therapeutic doses of I-131 MIBG with good symptomatic palliation and improvement of some biochemical parameters.

  7. Assessment of yttrium-90 citrate radiosynovectomy treatment with bone scintigraphy in lipoma arborescens.

    PubMed

    Vatankulu, Betul; Nemetyazar, Jamal; Demir, Yusuf; Samancı, Cesur; Sager, Sait

    2016-01-01

    A 37-year-old male patient presented with right knee pain and swelling. The patient had a 6-year history of rheumatoid arthritis. Physical examination was notable for swelling and tenderness of the right knee. The diagnosis of lipoma arborescens (LA) was confirmed from the magnetic resonance imaging of the right knee. Herein, we report the use of bone scintigraphy in a case of LA treated with yttrium-90 radiosynovectomy.

  8. Evaluation of gastroesophageal reflux before and after sleeve gastrectomy using symptom scoring, scintigraphy, and endoscopy.

    PubMed

    Sharma, Aditya; Aggarwal, Sandeep; Ahuja, Vineet; Bal, Chandrashekhar

    2014-01-01

    The effect of laparoscopic sleeve gastrectomy (SG) on gastroesophageal reflux disease (GERD) has been a controversial issue. There have been limited studies on this aspect and most of the published studies are retrospective. Therefore, a prospective study was designed to objectively assess the problem. The objective of this study was to assess the impact of SG on symptoms of gastroesophageal reflux using questionnaire, endoscopy, and radionuclide scintigraphy. Thirty-two patients undergoing laparoscopic sleeve gastrectomy were assessed for gastroesophageal reflux using Carlsson Dent Questionnaire and GERD questionnaire before and after surgery at three monthly intervals. They were also subjected to upper GI endoscopy (UGIE) and radionuclide scintigraphy both pre- and postoperatively. Mean preoperative weight and body mass index were 126.5 kg and 47.8 kg/m2, respectively. Mean percent excess weight loss at 12 months was 64.3 ± 18.4. Both the Carlsson Dent Score (CDS) and Severity Score (SS) exhibited a decline from 2.88 to 1.63 (p<0.05) and 2.28 to 1.06 (p<0.05), respectively after 12 months. Radionuclide scintigraphy revealed a significant rise of GERD from 6.25% to 78.1% in the postoperative period (p<0.001). UGIE showed a rise in incidence of esophagitis from 18.8% to 25%; however, there was improvement in all patients except one in terms of reduction of severity of esophagitis. Presence of GERD may not be considered as a contra-indication for sleeve gastrectomy. There is improvement of GERD as assessed by symptom questionnaires, as well as improvement in grade of esophagitis. The new onset GERD detected on scintigraphy may not be pathologic as there is a decrease in total acid production postsurgery; however, it still remains an important issue and needs long-term follow-up. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  9. Parallax error in pinhole thyroid scintigraphy: a critical consideration in the evaluation of substernal goiters

    SciTech Connect

    McKitrick, W.L.; Park, H.M.; Kosegi, J.E.

    1985-04-01

    Parallax error is found to be another pitfall in pinhole thyroid scintigraphy, i.e., a substernal goiter may appear between the thyroid cartilage marker and the suprasternal notch marker. Unless one is aware of this pitfall, a substernal extension of the thyroid may not be realized or be seriously underestimated in its size and extent. We illustrated the parallax error using a thyroid phantom. An illustrative case is shown.

  10. Correlation between lung scintigraphy and long-term outcome in survivors of congenital diaphragmatic hernia.

    PubMed

    Okuyama, Hiroomi; Kubota, Akio; Kawahara, Hisayoshi; Oue, Takaharu; Kitayama, Yasuhiro; Yagi, Makoto

    2006-09-01

    Lung scintigraphy has been used to evaluate the degree of pulmonary hypoplasia in infants with congenital diaphragmatic hernia (CDH). However, the relationship between lung scintigraphy and long-term outcome of CDH remains unclear. The aim of this study is to determine whether lung scintigraphy correlates with long-term pulmonary morbidity and nutritional status in survivors of CDH. Consecutive 31 survivors of CDH were enrolled in this study. The initial scan was performed at 1-2 months when the patients were ready for discharge and the follow-up scan was performed following an approximately 1-year interval. The regional ventilation and perfusion were evaluated using (133)Xe-inhalation and intravenous (99m)Tc-MAA injection, respectively. The ventilation and perfusion of the ipsilateral lung was expressed as a percentage of that of the contralateral lung. Physical growth at 1 and 2 years, and pulmonary morbidity were reviewed from medical records. The ventilation and perfusion of the ipsilateral lung at the follow-up scan increased significantly from those at the initial scan. Ten patients had pulmonary morbidity. The ventilation and perfusion of the ipsilateral lung was significantly lower in the patients with pulmonary morbidity compared to the patients without pulmonary morbidity. The initial ventilation and perfusion of the ipsilateral lung were strongly correlated with body weight at 1 and 2 years (ventilation: R = 0.503, P < 0.01; perfusion: R = 0.760, P < 0.0001). These results suggest that lung scintigraphy is useful to predict long-term pulmonary morbidity and poor nutritional status in survivors of CDH.

  11. The effects of 201Tl myocardial perfusion scintigraphy studies on oxidative damage in patients.

    PubMed

    Cicek, E; Yildiz, M; Delibas, N; Bahçeli, S

    2009-01-01

    The aim of this study was to investigate gamma radiation-induced oxidative damage in erythrocytes after 201Tl myocardial perfusion scintigraphy. Twenty patients (8 women and 12 men) who performed 201Tl myocardial perfusion scintigraphy were included in this study. The blood samples were taken from patients just before, 1 hour after and three hours after injection of the radiopharmaceutical. Malondialdehyde (MDA) and antioxidant enzymes such as glutathione peroxidase (GPX), superoxide dismutase (SOD) and catalase (CAT) levels were measured to evaluate the gamma radiation induced oxidative damage. The enzyme activities of SOD, GPX and CAT were decreased 1 hour after (p = 0.042, p = 0.697 and p = 0.653 respectively) and 3 hours after (p = 0.003, p = 0.573 and p = 0.002 respectively) injection of the radiopharmaceutical. Malondialdehyde levels were increased 1 hour after (p = 0.10) and 3 hours after (p = 0.47) injection of the radiopharmaceutical. In this study, we found that radiation due to 201Tl myocardial perfusion scintigraphy decreased the erythrocyte antioxidant levels and increased MDA levels.

  12. 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.

  13. Gastroesophageal scintigraphy and endoscopy in the diagnosis of esophageal reflux and esophagitis

    SciTech Connect

    Fung, W.P.; Van der Schaaf, A.; Grieve, J.C.

    1985-04-01

    The value of gastroesophageal (G/E) scintigraphy in the diagnosis of gastroesophageal reflux was assessed in 51 subjects, who presented with heartburn and had endoscopic evidence of reflux esophagitis. G/E scintigraphy was done using /sup 99m/Tc sulfur-colloid in acidified orange juice. The G/E reflux index was calculated according to previous reports. The mean (+/- SD) G/E reflux index in 18 patients with severe esophagitis and 30 patients with moderate esophagitis were 1.6% (+/- 1.5) and 3.2% (+/- 5.0), respectively. The mean G/E reflux index in 14 control subjects was 2.4% (+/- 1.1). There was no significant difference between the esophagitis and control groups. Furthermore, if 4% was taken as upper limit of normal, this will include almost all the esophagitis patients and controls. It is concluded that the G/E reflux index based on G/E scintigraphy is of little value in the diagnosis of G/E reflux.

  14. 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.

  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. Diagnostic value of Thallium-201 scintigraphy in differentiating malignant bone tumors from benign bone lesions.

    PubMed

    Inai, Ryota; Shinya, Takayoshi; Tada, Akihiro; Sato, Shuhei; Fujiwara, Tomohiro; Takeda, Ken; Kunisada, Toshiyuki; Yanai, Hiroyuki; Ozaki, Toshifumi; Kanazawa, Susumu

    2015-10-01

    This retrospective study aims to evaluate the diagnostic capacity of thallium-201 (201Tl) scintigraphy for differentiating malignant bone tumors from benign bone lesions. Between January 2006 and December 2012, 279 patients with bone lesions (51 malignant and 228 benign) underwent 201Tl scintigraphy before treatment. To evaluate 201Tl uptake, we investigated tumor-to-background contrast (TBC) as well as TBC washout rate (WR). The differences of TBC on early and delayed images and WR were estimated by the Mann-Whitney U test. Receiver operating characteristic (ROC) analyses were used to determine the cut-off TBC values for differentiating malignant bone tumors from benign bone lesions. There were statistically significant differences in median TBC between malignant tumors and benign lesions. These differences occurred for early imaging (1.57 vs. 0.09, p < 0.001) as well as for delayed imaging (0.83 vs. 0.07, p < 0.001). However, there was no statistical difference in WR between malignant tumors and benign lesions (44 vs. 43 %, NS). The chosen TBC cut-off value was 0.68 for early imaging and 0.38 for delayed imaging. Using these cut-off values, the prediction of malignancy had a 77 % sensitivity, 74 % specificity, and 75 % accuracy for early imaging and an 80 % sensitivity, 76 % specificity, and 77 % accuracy for delayed imaging. 201Tl scintigraphy may have the ability to distinguish malignant bone tumors from benign bone lesions.

  17. Detection of coronary artery disease by thallium scintigraphy in patients with valvar heart disease.

    PubMed Central

    Huikuri, H V; Korhonen, U R; Heikkilä, J; Takkunen, J T

    1986-01-01

    In patients with valvar heart disease detection of coronary artery disease by conventional non-invasive methods may be difficult. The usefulness of thallium-201 exercise scintigraphy for detecting coronary artery disease was evaluated in 16 patients with aortic stenosis, 17 with aortic regurgitation, nine with mitral stenosis, and six with mitral regurgitation who were investigated by coronary angiography. Only two of 21 patients with greater than or equal to 50% coronary artery obstruction had normal thallium images. Three patients without angiographic evidence of coronary artery stenoses had perfusion defects demonstrated by thallium scintigraphy. Only one patient with greater than or equal to 75% coronary stenosis had a normal thallium scan. Angina pectoris or ST segment depression evoked by exercise test were not useful in distinguishing patients with coronary artery disease from those with normal coronary vessels. These data suggest that thallium exercise scintigraphy may be a useful non-invasive test for detecting coronary artery disease in patients with valvar heart disease. Images Fig. 1 Fig. 2 PMID:3730215

  18. 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.

  19. Gamma scintigraphy for testing bioequivalence: a case study on two cromolyn sodium nasal spray preparations.

    PubMed

    Al-Ghananeem, Abeer M; Sandefer, Erik P; Doll, Walter J; Page, Richard C; Chang, Yunik; Digenis, George A

    2008-06-05

    The present work was carried out to study the deposition patterns and clearance of technetium-99m (99mTc) DTPA labeled cromolyn sodium (CS) solutions when administered from two different CS nasal products using gamma scintigraphy. Five healthy volunteers received a single dose with complete crossover design involving treatment A (test formulation) and treatment B (reference formulation). The deposition patterns as well as the changes in distribution of the radiolabeled CS solutions due to the mucociliary transport were monitored by gamma scintigraphy. Primary deposition of the aforementioned nasal solutions occurred in the anterior portion of the nose. After migration into the posterior nasal cavity, the solutions were rapidly cleared by ciliary action into the nasopharynx where it was swallowed. The test product of cromolyn sodium was shown to be equivalent to the reference product with regard to nasal deposition and clearance. The results from this study indicate that external gamma scintigraphy can be used to demonstrate the equivalence of nasal sprays that are intended for local therapeutic action where the drug is not systemically absorbed into the blood circulation. Furthermore, a non-invasive imaging method such as rhinoscintigraphy may prove to be a useful technique to be utilized during the regulatory approval process for local-acting nasal products, and may facilitate the early introduction of these products to the market.

  20. Segmental analysis of thallium 201 myocardial perfusion scintigraphy: its value in a community hospital

    SciTech Connect

    Tendera, M.; Campbell, W.B.; Moyers, J.R.

    1984-08-01

    In a community hospital, we correlated results of thallium 201 myocardial scintigraphy with coronary arteriographic data in 79 patients. Scintigraphy was 92% sensitive and 85% specific in detecting coronary artery disease. There were no false-negative scintigrams in patients with double or triple vessel disease. The most important factors determining sensitivity of the method in detecting individual coronary stenoses were (1) location of the stenosis in the coronary tree, (2) number of vessels involved, and (3) degree of obstruction. Higher prevalence of perfusion defects in areas of 90% to 99% stenosis as compared with 50% to 89% lesions was of borderline statistical significance (86% vs 59%; P . .06). Myocardial perfusion scintigraphy was unable to predict the number of significantly narrowed coronary vessels. Predictive value of a perfusion defect for a significant coronary stenosis was 87% for anterior, 88% for septal, 90% for lateral, 89% for posterior, and 78% for inferior segment. We conclude that segmental analysis of myocardial scintigrams may be of value in a community hospital.

  1. Segmental analysis of thallium 201 myocardial perfusion scintigraphy: its value in a community hospital

    SciTech Connect

    Tendera, M.; Campbell, W.B.; Moyers, J.R.

    1984-08-01

    In a community hospital, the authors correlated results of thallium 201 myocardial scintigraphy with coronary arteriographic data in 79 patients. Scintigraphy was 92% sensitive and 85% specific in detecting coronary artery disease. There were no false-negative scintigrams in patients with double or triple vessel disease. The most important factors determining sensitivity of the method in detecting individual coronary stenoses were (1) location of the stenosis in the coronary tree, (2) number of vessels involved, and (3) degree of obstruction. Higher prevalence of perfusion defects in areas of 90% to 99% stenosis as compared with 50% to 89% lesions was of borderline statistical significance. Myocardial perfusion scintigraphy was unable to predict the number of significantly narrowed coronary vessels. Predictive value of a perfusion defect for a significant coronary stenosis was 87% for anterior, 88% for septal, 90% for lateral, 89% for posterior, and 78% for inferior segment. It was concluded that segmental analysis of myocardial scintigrams may be of value in a community hospital.

  2. Sensitivity of scintigraphy with /sup 111/In-lymphocytes for detection of cardiac allograft rejection

    SciTech Connect

    Eisenberg, S.B.; Eisen, H.J.; Sobel, B.E.; Bergmann, S.R.; Bolman, R.M. 3d.

    1988-12-01

    We recently demonstrated the feasibility of noninvasive detection of cardiac allograft rejection after administration of indium-111-labeled lymphocytes. To determine the sensitivity and specificity of the technique, as well as its value for delineating the severity of rejection, we studied 16 dogs with heterotopic thoracic cardiac allografts. Five animals were evaluated while exposed to immunosuppressive agents. Animals were scanned sequentially after administration of 100-400 microCi of indium-111-labeled autologous lymphocytes. Myocardial lymphocyte infiltration was expressed as the indium excess (IE), defined as the ratio of indium activity of the transplant or native heart compared with that in blood. Scintigraphic results were compared with characteristics of simultaneously obtained endomyocardial biopsies. Among 17 biopsy documented episodes of rejection, 16 were detected scintigraphically. Among 18 biopsies with no evidence of rejection, scintigraphy was uniformly negative. Thus, the sensitivity and specificity of scintigraphy were 94 and 100%, respectively. Biopsies graded as showing no rejection were associated with an IE of 0.3 +/- 0.5 (+/- SD); those graded as mild, 2.8 +/- 1.7; those as moderate, 10.7 +/- 7.2; and those graded as indicative of severe rejection, 14.2 +/- 4.5. Thus, scintigraphy with indium-111-labeled lymphocytes sensitively and specifically detects cardiac allograft rejection and delineates the intensity of the rejection process. It should be useful clinically for assessing potential allograft rejection noninvasively.

  3. Transformation of a Nonfunctional Paraganglioma With I-123 MIBG Scintigraphy Correlation: A Case Report.

    PubMed

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

    2016-01-01

    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. 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 paragangliomas and scintigraphic negative chromaffin cell tumors, there has been no prior documented case of scintigraphic transformation on MIBG.

  4. Lung amyloid nodule detected by 99mTc-aprotinin scintigraphy.

    PubMed

    Ishii, Satoru; Kubota, Kazuo; Minamimoto, Ryogo; Kouketu, Rikiya; Morooka, Miyako; Kawai, Shigeo; Takeda, Yuichiro; Kobayashi, Nobuyuki; Sugiyama, Haruhito

    2012-07-01

    We present a case in which an amyloid lung nodule was diagnosed preoperatively by amyloid scintigraphy (99m)Tc-aprotinin. A 65-year-old man complained of marked weight loss (9 kg) over a period of 6 months. An abnormal shadow in the middle field of the right lung was detected on chest X-ray, corresponding to a 16-mm nodule in the right middle lobe on thoracic computed tomography (CT). Total protein and immunoglobulin G levels were elevated to 8.3 and 2245 mg/dl, respectively, but other blood tests including several tumor marker levels and Cryptococcus antibodies were all within normal range. Fluorodeoxyglucose positron emission tomography showed no uptake by the lung nodule, so lung amyloidosis was considered as differential diagnosis. To avoid risk of bleeding on bronchoscopy, noninvasive amyloid scintigraphy using (99m)Tc-aprotinin was first performed. A nodular, abnormal accumulation was observed in the right middle lung lobe. Diagnostic imaging strongly suggested amyloidosis, so video-assisted thoracic surgery was performed rather than bronchoscopy. Pathological samples showed positive staining with Congo red, and A-λ amyloidosis was diagnosed on the basis of immunostaining. Scintigraphy using (99m)Tc-aprotinin offers a useful, noninvasive method for assessing lung amyloidosis.

  5. Ventilation imaging of the lung: comparison of hyperpolarized helium-3 MR imaging with Xe-133 scintigraphy.

    PubMed

    Altes, Talissa A; Rehm, Patrice K; Harrell, Frank; Salerno, Michael; Daniel, Thomas M; De Lange, Eduard E

    2004-07-01

    To compare hyperpolarized helium-3 (HHe) magnetic resonance imaging (MRI) of the lung with standard Xe-133 lung ventilation scintigraphy. We performed a retrospective review of 15 subjects who underwent HHe MRI and Xe-133 lung ventilation imaging. Coronal MRI sections were acquired after a single inhalation of HHe gas, and standard posterior planar lung ventilation scintigraphy was performed during continuous breathing of Xe-133 gas. The first breath scintigram of each patient was compared with a composite MR image composed of the sum of the individual MR images and with the individual helium-3 MR images. Ventilation defects on the two imaging modalities were compared for size, conspicuity, and concordance in presence and location. Assessment was done separately for each of four lung quadrants. Comparing the composite HHe MR images with Xe-133 scintigraphy, ventilation defect size, conspicuity and concordance were the same in 67% (40/60), 63% (38/60), and 62% (37/60) quadrants, respectively. Comparing the individual HHe MR image sections with the Xe-133 ventilation scan, there was concordance between the ventilation defects in 27% (16/60) of quadrants. More defects were identified on the individual HHe MR images in 62% (37/60) of quadrants. There was good agreement between composite HHe MR image and first breath Xe-133 scintigraphic images, supporting the widely held assumption that HHe MRI likely depicts first breath lung ventilation.

  6. Technetium-99m diethylenetriaminepentaacetic acid radioaerosol scintigraphy in organophosphate induced pulmonary toxicity: experimental study.

    PubMed

    Yavuz, Yucel; Kaya, Eser; Yurumez, Yusuf; Sahin, Onder; Bas, Orhan; Fidan, Huseyin; Sezer, Murat

    2008-09-01

    The aim of this experimental study was to investigate pathological signs of lung damages caused by acute organophosphate (OP) poisoning by using Tc-99m DTPA radioaerosol scintigraphy and histopathological investigation. Fourteen rabbits were divided into two equal groups (n = 7). Group 1 (control group) received normal saline (same volume of fenthion, 2 ml/kg) via orogastric tube. Group 2 (OP toxicity group) received 150 mg/kg of fenthion (diluted fenthion, 2 ml/kg) via orogastric tube. Six hours later, Tc-99m-DTPA aerosol inhalation lung scintigraphy was performed in both groups. Then all rabbits were anesthetized with ketamine hydrochloride (35 mg/kg, i.p.) and xysilazine (5 mg/kg, i.p.), and sacrificed by intracardiac blood discharge. The lungs were then removed. There was a significant difference in T1/2 values of Tc-99m DTPA clearance between control group and OP toxicity group (p = 0.04). Intraparenchymal vascular congestion and thrombosis, intraparenchymal hemorrhage, respiratory epithelial proliferation, number of macrophages in the alveolar, and bronchial lumen, alveolar destruction, emphysematous changes, and bronchoalveolar hemorrhage scores were significantly higher in the rabbits exposed to OP compared with the control group (p < 0.05). This study showed that OP toxicity caused a decrease in the alveolar clearance. Tc-99m DTPA radioaerosol inhalation lung scintigraphy was found to be a sensitive determination of acute lung damage in OP poisoning.

  7. [Incidence and imaging characteristics of skeletal metastases detected by bone scintigraphy in lung cancer patients].

    PubMed

    Jauković, Ljiljana; Ajdinović, Boris; Janković, Zoran; Dugonjić, Sanja

    2006-12-01

    Detection of metastatic bone disease by skeletal scintigraphy is a classical application of nuclear medicine in cancer patients. Detection of bone metastases in patients with lung cancer is necessary for an appropriate treatment modality. The aim of this study was to report the frequency and imaging characteristics of bone metastases detected by bone scintigraphy (BS) using technetium-99m phosphonates in patients with lung cancer. We retrospectively analyzed a total of one hundred patients (78 males and 22 females), mean age of 63.3 years, with the diagnosis of lung cancer, who underwent BS during a three-year-period (2003-2005). Scintiscans were classified as positive, negative and suspicious with regard to the presence of bone metastases. The incidence of positive, negative and suspicious findings were 57%. 32% and 11%, respectively. Out of 57 patients with bone metastases, 51 had multiple asymmetric foci of increased tracer activity localized in the ribs, spine, extremities, pelvis, sternum, scapula and skull in 72%, 54%, 49%, 37%, 12%, 9% and 5% of scans, respectively. BS revealed solitary metastases in 6 of the patients. The lesions were located in the lower limbs in three patients and in the upper limbs, pelvis and sternum in the remaining three patients. Bone scintigraphy plays a significant role in staging and selecting of patients for curative lung surgery. Due to the fact that metastatic involvment of the extremities was frequently shown, our study suggests that systematic inclusion of the limbs in BS acquisition should be obligatory.

  8. [Therapeutic consequences of lung scintigraphy in patients with intermediate probability of pulmonary embolism].

    PubMed

    Marmolin, Ea Sofie; Møller, Louise; Johansen, Allan; Madsen, Poul Henning; Hess, Søren

    2009-05-04

    Pulmonary embolism has a high mortality and is difficult to diagnose. Lung scintigraphy is widely used. However, a significant number of patients receive an inconclusive result. The aim of this study was to determine how patients with an intermediate result were handled. Case notes from 321 (77%) of a total of 416 consecutive patients who underwent lung scintigraphy at Odense University Hospital in 2004 were examined retrospectively. We found 98 (30%) patients with an intermediate probability of pulmonary embolism, among whom 14 (14%) underwent further investigation, 28 (29%) received treatment, and in 29 (30%) cases, the result was interpreted as negative for pulmonary embolism. We found no significant difference in demographic data or results of investigations performed before the scintigraphy between those who received treatment and those who did not, nor was there any difference between those who were interpreted as negative and those who were not. Few patients with intermediate probability underwent further investigation and one third was interpreted as negative for pulmonary embolism, contrary to the recommendations of several guidelines. In patients with intermediate probability of pulmonary embolism we demonstrated no differences in patient history or clinical presentation between those who received treatment and those who did not.

  9. 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.

  10. [Screening with angiographic images prior to (99m)Tc-HMPAO labelled leukocyte scintigraphy in the diagnosis of periprosthetic infection].

    PubMed

    Granados, U; Fuster, D; Soriano, A; García, S; Bori, G; Martínez, J C; Mayoral, M; Perlaza, P; Tomás, X; Pons, F

    2015-01-01

    To evaluate the impact of the angioscintigrapy of the three phase bone scan as screening method to rule out infection of the hip and knee prosthesis prior to performing the (99m)Tc-HMPAO leukocyte scintigraphy. A total of 120 (70 women, 50 men; mean age 71±11years) with clinical suspicion of hip (n=63) or knee (n=57) infection of the prosthesis and clinical suspicion of infection were evaluated prospectively. All patients underwent three-phase bone scan (angioscintigraphy, vascular and bone phase) and (99m)Tc-HMPAO-labelled white blood cell scintigraphy. Final diagnosis of infection was made by microbiological documentation or clinical follow-up for at least 12months. Eighteen out of 120 patients were diagnosed of infection of hip prosthesis (n=10) or knee prosthesis (n=8). The angioscintigraphy was positive in 15/18 infected cases and in 21/102 of the non-infected cases with a sensitivity of 83%, specificity of 79% and negative predictive value of 97%. Sensitivity and specificity of (99m)Tc-HMPAO leukocyte scintigraphy were 72% and 95%, respectively. If the leukocyte labeled scintigraphies had been used exclusively for patients with positive angioscintigraphy, this would have saved up to 70% of the (99m)Tc-HMPAO leukocyte scintigraphies performed. There were no cases of infection with positive labeled leukocyte scintigraphy and negative angioscintigraphy. Angioscintigraphy (blood flow phase of bone scan) is a useful technique for screening for hip and knee joint prosthesis infection, significantly reducing the need for (99m)Tc-HMPAO leukocyte scintigraphy without affecting the sensitivity of the technique. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  11. Vibration-response imaging versus quantitative perfusion scintigraphy in the selection of patients for lung-resection surgery.

    PubMed

    Comce, Fatma; Bingol, Zuleyha; Kiyan, Esen; Tanju, Serhan; Toker, Alper; Cagatay, Pembe; Ece, Turhan

    2011-12-01

    In patients being considered for lung-resection surgery, quantitative perfusion scintigraphy is used to predict postoperative lung function and guide the determination of lung-resection candidacy. Vibration-response imaging has been proposed as a noninvasive, radiation-free, and simpler method to predict postoperative lung function. We compared vibration-response imaging to quantitative perfusion scintigraphy for predicting postoperative FEV(1) and diffusing capacity of the lung for carbon monoxide (D(LCO)). We enrolled 35 candidates for lung resection. Twenty-five patients had preoperative FEV(1) and D(LCO) MEASUREMENTS: The vibration-response-imaging measurements showed strong correlation with the quantitative-perfusion-scintigraphy measurements of predicted postoperative FEV(1)% (r = 0.87, P < .001), predicted postoperative FEV(1) (r = 0.90, P < .001), and predicted postoperative D(LCO)% (r = 0.90, P < .001). There was a correlation between predicted postoperative FEV(1) (% and L) measured via quantitative perfusion scintigraphy and the actual postoperative FEV(1) (% and L) (r = 0.47, P = .048, r = 0.73, P < .001). There was no difference between the vibration-response-imaging measurements and the actual postoperative measurements of predicted postoperative FEV(1) (% and L). There was a correlation between predicted postoperative FEV(1) (% and L) measured via vibration-response imaging and actual postoperative FEV(1) (% and L) (r = 0.52, P = .044, r = 0.79, P < .001). The mean differences between the predicted and actual postoperative FEV(1) values were 49 mL with vibration-response imaging, versus 230 mL with quantitative perfusion scintigraphy. Neither the vibration-response imaging nor the quantitative perfusion scintigraphy predicted postoperative D(LCO)% values agreed with the actual postoperative D(LCO)% values. Vibration-response imaging may be a good alternative to quantitative perfusion scintigraphy in evaluating lung-resection candidacy.

  12. Intravenous bisphosphonate-related osteonecrosis of the jaw: bone scintigraphy as an early indicator.

    PubMed

    O'Ryan, Felice S; Khoury, Sam; Liao, Wendy; Han, Myo M; Hui, Rita L; Baer, David; Martin, Daniel; Liberty, Donald; Lo, Joan C

    2009-07-01

    Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is recognized as a serious complication among patients receiving bisphosphonate therapy. However, methods for early detection and identification of patients at risk for osteonecrosis of the jaw (ONJ) need further investigation. The purpose of this study was to characterize BRONJ among patients receiving intravenous bisphosphonates and to examine bone scintigraphy findings that preceded manifestation of frank ONJ. We identified all known cases of BRONJ (defined according to 2006 American Association of Oral and Maxillofacial Surgeons criteria) diagnosed between January 2004 and September 2008 among patients who received intravenous bisphosphonate therapy (IVBP). The medical records were abstracted, and the clinical and radiographic features of BRONJ and relevant comorbidities were characterized. Technetium Tc 99 bone scintigrams were systematically reviewed among the subset of patients who received these imaging studies for oncologic care and imaging findings were correlated with the temporal development of ONJ. We identified 59 cases of intravenous BRONJ (median age, 61.4 +/- 10.7 years; 57.6% female), of whom 44.1% had breast cancer, 33.9% had multiple myeloma, and the remainder had metastatic prostate cancer (15.3%) or other cancers (6.8%). One third (32.2%) of the cohort was diabetic. In addition to IVBP, the vast majority (86.4%) had also received prior systemic glucocorticoid therapy. The median cumulative number of IVBP doses was 25 (interquartile range, 16-39) at the time of BRONJ diagnosis. Half of the patients had prior invasive dental procedures; ONJ developed spontaneously in 27.1%, and in the remainder ONJ developed in the setting of periodontal disease (10.1%) or local trauma (8.4%). Most patients presented with painful stage 2 disease involving the mandible (75%), and Actinomyces was present in more than 77% of available histologic specimens. During the median follow-up of 1.5 years, 15 patients

  13. Imaging of the peritoneum evaluated by 99mTc-icodextrin scintigraphy in peritoneal dialysis patients: preliminary data.

    PubMed

    Argentino, Gennaro; Russo, Roberta; Maresca, Immacolata Daniela; Strazzullo, Tommasina; Memoli, Andrea; Sodo, Maurizio; Celentano, Luigi; Memoli, Bruno

    2014-01-01

    In this study, we proposed a peritoneal scintigraphy with a different marker, the 99mTechnetium-Icodextrin, to evaluate the distribution of the dialysate within the peritoneal cavity in peritoneal dialysis (PD) patients. 99mTc-Icodextrin scintigraphy was performed in 16 PD patients. 0.5 ml of 7.5% Icodextrin solution was labeled with 74 megabecquerel (MBq) of 99mTc and then added to 2,000 ml of dialysate solution (2.5% dextrose). The peritoneum scintigraphy was performed by a SPECT gamma camera with the peritoneal cavity filled and after the complete drainage of the radio compound-dialysate mixture. The images were reviewed for evidence of peritoneal leaks, hernias, loculated fluid collections, and peritoneal membrane adhesions. Abnormal findings were detected by 99mTc-Icodextrin scintigraphy in 4 (25%) out of 16 patients and included retroperitoneal (n = 1), diaphragmatic (n = 1) and inguinal (n = 1) leakages and peritoneal membrane adhesions (n = 1). Peritoneum scintigraphy with 99mTc-Icodextrin is a useful method to detect some complications occurring during peritoneal dialysis; it offers excellent imaging to assess these complications. © 2014 S. Karger AG, Basel.

  14. 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

  15. 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

  16. Detection of Rib Metastases in Patients with Lung Cancer: A Comparative Study of MRI, CT and Bone Scintigraphy

    PubMed Central

    Chen, Yan-Qing; Yang, Yang; Xing, Yan-Fen; Jiang, Sen; Sun, Xi-Wen

    2012-01-01

    We retrospectively investigated the imaging findings of bone scintigraphy, chest CT and chest MRI in 55 cases of lung cancer. The sensitivity, specificity and accuracy of the detection of rib metastases were compared between imaging modalities on both a per-lesion and a per-patient basis. On a per-lesion basis, MRI sensitivity and accuracy were significantly higher than that of bone scintigraphy and CT (P<0.05). The sensitivities, specificities, and accuracy levels between CT and bone scintigraphy did not differ on either a per-lesion or per-patient basis (P>0.05). MRI appears to be superior for the detection of ribs metastases in lung cancer. PMID:23300617

  17. Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis?

    PubMed

    Chiewvit, Pipat; Danchaivijitr, Nasuda; Sirivitmaitrie, Kaewta; Chiewvit, Sunanta; Thephamongkhol, Kullatorn

    2009-06-01

    To determine the role of Magnetic Resonance (MR) imaging for the investigation ofpatients with suspected metastasis to the spine by bone scintigraphy. Retrospectively reviewed with comparison was made between Technetium-99m Methylene Diphosphonate (99(m)Tc-MDP) bone scintigraphy and corresponding spine MR images in 48 cases of vertebral metastasis at Siriraj Hospital. The intervals between bone scintigraphy and MR images did not exceed 1 month. The authors studied between January 2005 and December 2006 Bone scintigraphy were performed with planar imaging of the entire body and MR imaging was performed with the 1.5 tesla and 3.0 tesla scanner using standard techniques with T1-, T2-weighted images and fat-suppressed T1-weighted images with intravenous administration of gadopentetate dimeglumine. The MR imaging findings were studied: location (cervical or thoracic or lumbar or sacrum spine), number of lesions (solitary or multiple lesions), pattern of enhancement (homogeneous or inhomogeneous), involvement of spinal canal, compression of spinal cord, extradural extension, other incidental findings such as pulmonary metastasis, pleural effusion, lymphadenopathy The final diagnosis was confirmed clinically and followed-up for further management (radiation or surgery) or followed-up by MR imaging (1 month-16 months) and bone scintigraphy (5 months-12 months). Forty-eight cases (80 lesions) of vertebral metastasis were identified (25 men and 23 women; mean age 61 years and range 8-84 years). Primary neoplasms include breast cancer (n=11), colorectal cancer (n=7), lung cancer (n=6), prostate cancer (n=5), nasopharyngeal cancer (n=5), head and neck cancer (n=3), thyroid cancer (n=2), liver cancer (n=2), esophagus cancer (n=1), bladder cancer (n=1), retroperitoneum cancer (n=1), medulloblastoma (n=1), cervical cancer (n=1), ovarian cancer (n=1), malignant melanoma (n=1). The result of bone scintigraphy and MR imaging is used to evaluate vertebral metastasis: in 44 lesions of

  18. Detection of rib metastases in patients with lung cancer: a comparative study of MRI, CT and bone scintigraphy.

    PubMed

    Chen, Yan-Qing; Yang, Yang; Xing, Yan-Fen; Jiang, Sen; Sun, Xi-Wen

    2012-01-01

    We retrospectively investigated the imaging findings of bone scintigraphy, chest CT and chest MRI in 55 cases of lung cancer. The sensitivity, specificity and accuracy of the detection of rib metastases were compared between imaging modalities on both a per-lesion and a per-patient basis. On a per-lesion basis, MRI sensitivity and accuracy were significantly higher than that of bone scintigraphy and CT (P<0.05). The sensitivities, specificities, and accuracy levels between CT and bone scintigraphy did not differ on either a per-lesion or per-patient basis (P>0.05). MRI appears to be superior for the detection of ribs metastases in lung cancer.

  19. Thyroid Remnant Estimation by Diagnostic Dose (131)I Scintigraphy or (99m)TcO4(-) Scintigraphy after Thyroidectomy: A Comparison with Therapeutic Dose (131)I Imaging.

    PubMed

    Liu, Guanghui; Li, Na; Li, Xuena; Chen, Song; Du, Bulin; Li, Yaming

    2016-01-01

    In this clinical study, we have compared routine diagnostic dose (131)I scan and (99m)TcO4(-) thyroid scintigraphy with therapeutic dose (131)I imaging for accurate thyroid remnant estimation after total thyroidectomy. We conducted a retrospective review of the patients undergoing total thyroidectomy for differentiated thyroid carcinoma (DTC) and subsequently receiving radioactive iodine (RAI) treatment to ablate remnant thyroid tissue. All patients had therapeutic dose RAI whole body scan, which was compared with that of diagnostic dose RAI, (99m)TcO4(-) thyroid scan, and ultrasound examination. We concluded that therapeutic dose RAI scan reveals some extent thyroid remnant in all DTC patients following total thyroidectomy. Diagnostic RAI scan is much superior to ultrasound and (99m)TcO4(-) thyroid scan for the postoperative estimation of thyroid remnant. Ultrasound and (99m)TcO4(-) thyroid scan provide little information for thyroid remnant estimation and, therefore, would not replace diagnostic RAI scan.

  20. 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.

  1. Predictive value of bone scintigraphy for the detection of joint involvement in Behçet's disease: Dermatologists' perspectives.

    PubMed

    Seo, Jimyung; Lee, Minseok; Choi, Min Ju; Zheng, Zhenlong; Cho, Arthur; Bang, Dongsik; Kim, Do Young

    2015-01-01

    Behçet's disease (BD) is a multisystemic inflammatory disease with articular involvement. Non-specific arthralgia without objective signs of arthritis, such as swelling or effusion, is common in such patients. Thus, an accurate diagnosis of joint involvement may be challenging for dermatologists. To evaluate the validity of (99m)Tc-methylene diphosphonate (Tc-99m-MDP) bone scintigraphy for joint involvement assessment in patients with BD. In 211 patients with BD who had scintigraphic evaluations due to joint symptoms, agreement between bone scintigraphy findings and clinically evaluated joint complaints was retrospectively assessed using Cohen's kappa (κ) statistic. A patient subset (n = 104) showing agreement between joint complaints and scintigraphy results was re-evaluated by a rheumatologist to determine the level of diagnostic specificity attained by combining bone scintigraphy with clinical examinations of dermatologists. The total kappa value (211 patients) was 0.604, indicating fair agreement between joint complaints and scintigraphy results. Individual analysis of eleven joint categories revealed statistically significant correlations for wrist (κ = 0.677), shoulder (κ = 0.661), and foot joints (κ = 0.618). Of the 104 referrals to a rheumatologist, 95 (91.34%) were confirmed as having BD-associated articular involvement. Joint acral areas (e.g., foot, hand, wrist and shoulder) that had the highest kappa value correlations also ranked highest in diagnostic specificity. Bone scintigraphy presents a simple and useful option for dermatologists to assess joint involvement in BD patients, especially for specific anatomic sites.

  2. 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

  3. Evaluation of thyroid nodules with technetium-99m tetrofosmin dual-phase scintigraphy.

    PubMed

    Kresnik, E; Gallowitsch, H J; Mikosch, P; Molnar, M; Pipam, W; Gomez, I; Lind, P

    1997-07-01

    Technetium-99m tetrofosmin, a lipophilic cationic complex molecule, was introduced for myocardial imaging. In some biodistribution studies it has also been reported to accumulate in the thyroid gland. Our objectives were to determine which thyroid nodules retain tetrofosmin and whether preoperative evaluation of malignancy is possible. Tetrofosmin scintigraphy was performed in 57 patients with a cold thyroid nodule on previously performed pertechnetate scintigraphy. All patients had undergone ultrasonography and sonographically guided fine-needle aspiration biopsy. The tetrofosmin scintigrams were obtained 5 min (early image) and 1 h (late image) after intravenous injection of 370 MBq. Only nodules that showed clear tracer retention after 1 h in comparison with retention at 5 min were classified as TETRO positive. Nodules without late retention were classified as TETRO negative. All patients underwent surgery and the histological results were compared with the results of tetrofosmin scintigraphy. Ten out of 11 patients with thyroid carcinoma (two pT1, three pT2, five pT4) were TETRO negative. One patient with papillary carcinoma (pT2) was TETRO positive. The mean nodular to thyroid tissue (N/T) ratio for the late scan was 1.0+/-0.20. There were 21 patients with thyroid adenomas (seven follicular, seven microfollicular and seven oxyphilic); 15 of these patients were TETRO positive and six TETRO negative. The mean N/T ratio for the late images was 1.34+/-0.41. All patients with degenerative goitre (24 cases) and the one patient with Hashimoto's disease were TETRO negative after 1 h and the N/T ratio was 0.92+/-0.12 on the late scan. Our results indicate that 99mTc-tetrofosmin scanning is of little value preoperatively in distinguishing thyroid carcinoma from other thyroid nodules. Tetrofosmin tends to demonstrate thyroid adenomas but does not have a routine role in the assessment of thyroid nodules.

  4. Clinical value of gallium-67 scintigraphy in assessment of disease activity in Wegener's granulomatosis

    PubMed Central

    Slart, R; Jager, P; Poot, L; Piers, D; Cohen, T; Stegeman, C

    2003-01-01

    Background: Diagnosis of active pulmonary and paranasal involvement in patients with Wegener's granulomatosis (WG) can be difficult. The diagnostic value of gallium-67 scintigraphy in WG is unclear. Objective: To evaluate the added diagnostic value of gallium-67 scintigraphy in patients with WG with suspected granulomatous inflammation in the paranasal and chest regions. Methods: Retrospectively, the diagnostic contribution of chest and head planar gallium scans in 40 episodes of suspected vasculitis disease activity in 28 patients with WG was evaluated. Scans were grouped into normal or increased uptake for each region. Histological proof or response to treatment was the "gold standard" for the presence of WG activity. Results: WG activity was confirmed in 8 (20%) episodes, with pulmonary locations in three, paranasal in four, and both in one (n=7 patients); all these gallium scans showed increased gallium uptake (sensitivity 100%). Gallium scans were negative for the pulmonary area in 23/36 scans (specificity 64%), and negative for paranasal activity in 13/16 scans (specificity 81%) in episodes without WG activity. Positive predictive value of WG activity for lungs and paranasal region was 24% and 63%, respectively, negative predictive value was 100% for both regions. False positive findings were caused by bacterial or viral infections. Conclusion: Gallium scans are clinically helpful as a negative scan virtually excludes active WG. Gallium scintigraphy of chest and nasal region has a high sensitivity for the detection of disease activity in WG. However, because of positive scans in cases of bacterial or viral infections, specificity was lower. PMID:12810430

  5. Somatostatin receptor subtypes, octreotide scintigraphy, and clinical response to octreotide treatment in patients with neuroendocrine tumors.

    PubMed

    Kölby, L; Wängberg, B; Ahlman, H; Tisell, L E; Fjälling, M; Forssell-Aronsson, E; Nilsson, O

    1998-07-01

    Several types of neuroendocrine tumor express high numbers of somatostatin receptors (sstr). We have compared the expression of sstr subtypes with the outcome of octreotide scintigraphy in patients with carcinoids and medullary thyroid carcinoma (MTC) in comparison with Hürthle cell tumors. The effect of sstr activation (octreotide treatment) on tumor markers was also studied in patients with disseminated carcinoid tumors. Six patients with carcinoid tumors (four midgut and two foregut), and three patients with thyroid tumors (one MTC, one Hürthle cell carcinoma, and one Hürthle cell adenoma) were studied. Octreotide scintigraphy visualized tumor sites in all nine patients. Macroscopic tumor was verified at these sites at subsequent surgical exploration. Using Northern blotting and subtype-specific riboprobes, sstr could be detected in all tumors examined. All five sstr subtypes were detected in most of the carcinoid tumors. All six carcinoids expressed sstr2. This was in contrast to the findings for the thyroid tumors analyzed, which also expressed several sstr subtypes but in some cases lacked expression of sstr2. This was also the case for normal thyroid tissue. Clinically, octreotide treatment of the patients with midgut carcinoid tumors resulted in palliation of hormonal symptoms accompanied by a significant reduction of urinary 5-HIAA levels (28-71%). These results indicate that carcinoid tumors frequently express all five sstr subtypes. The thyroid tumors also expressed multiple sstr but could lack expression of sstr2. Nevertheless, these tumors were visualized by octreotide scintigraphy, indicating that sstr2 expression is not a prerequisite for tumor imaging.

  6. 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

  7. Noninvasive imaging with thallium-201 scintigraphy may not correlate with survival in patients with osteosarcoma.

    PubMed

    Magnan, Heather; Chou, Alexander J; Chou, Joanne F; Yeung, Henry W D; Healey, John H; Meyers, Paul A

    2010-09-01

    Histologic response to preoperative chemotherapy is a strong prognostic factor for osteosarcoma (OS). Thallium-201 (Tl-201) scintigraphic response to initial chemotherapy has previously been described as a predictor of histologic response. In the current study, the authors re-examined a series of patients studied using Tl-201 scintigraphy to determine the correlation between changes observed on Tl-201 scintigraphy and event-free survival (EFS). A total of 22 patients with biopsy-proven OS of the extremity underwent Tl-201 imaging before and immediately after preoperative chemotherapy. The maximum pixel counts taken over the tumor divided by those taken of a background region yielded a tumor-to-background ratio (TBR). The percentage of change in the TBR before and after adjuvant chemotherapy, defined as the alteration ratio (AR), was correlated with EFS. The median AR was 85% (range, 28-100%). The 3-year EFS was 0.72 (95% confidence interval [95% CI], 0.48-0.86) and the 5-year EFS was 0.67 (95% CI, 0.43-0.86). There was no association between AR and EFS detected in this cohort (hazard ratio, 0.99; 95% CI, 0.95-1.02 [Somers rank correlation coefficient, 0.15]). Although Tl-201 scintigraphy was used as a tool for the assessment of response to chemotherapy in patients with OS, the AR did not appear to be predictive of EFS in this small group of patients. It is necessary to use the outcome variables of ultimate interest-EFS and overall survival- and not rely on surrogates for outcome to evaluate potential prognostic factors. Cancer, 2010. (c) 2010 American Cancer Society.

  8. DTPA aerosol in ventilation/perfusion scintigraphy for diagnosing pulmonary embolism.

    PubMed

    Trujillo, N P; Pratt, J P; Talusani, S; Quaife, R A; Kumpe, D; Lear, J L

    1997-11-01

    The use of lung scintigraphy in evaluating suspected pulmonary embolism (PE) is controversial. Several diagnostic methods have been described for lung scans, of which the most widely applied uses 99mTc-MAA for perfusion, 133Xe for ventilation and PIOPED diagnostic criteria. This study evaluates the accuracy of lung scintigraphy using an alternative ventilation agent, 99mTc-diethylenetriamine pentacetic acid (DTPA) aerosol, and specific criteria. Diagnostic criteria for DTPA aerosol ventilation were prospectively applied to 5017 patients over a 9-yr period. Lung scan interpretations were analyzed for frequency of occurrence, and results were compared to those of angiography in 455 patients. Scans were interpreted as normal, low or high probability in 79% of patients and as either indeterminate or medium probability in 21% of patients. Three patients had normal scans and negative angiography. In patients with low-probability scans, 111 angiograms were performed: 103 (93%) were negative, and 8 (7%) were positive. In patients with indeterminate scans, 114 angiograms were performed: 85 (75%) were negative, and 29 (25%) were positive. In patients with medium-probability scans, 149 angiograms were performed: 86 (58%) were negative, and 63 (42%) were positive. In patients with high-probability scans, 78 angiograms were performed: 6 (8%) were negative, and 72 (92%) were positive. These results indicate that lung scintigraphy using DTPA aerosol and our criteria is accurate in diagnosing and stratifying risk of pulmonary embolic disease. Compared with 133Xe and PIOPED criteria, DTPA ventilation and our criteria reduced the false-negative rate in low-probability scans (7% versus 16%, p < 0.005) and decreased the fraction of intermediate-probability scans (21 % versus 39%, p < 0.01).

  9. The effects of iohexol administration on technetium thyroid scintigraphy in normal cats.

    PubMed

    Lee, William R; Pease, Anthony P; Berry, Clifford R

    2010-01-01

    Administration of iodinated contrast medium interferes with iodide uptake in the human thyroid gland and compromises diagnostic thyroid scintigraphy and radioiodine treatment for 4-6 weeks. However, the degree and duration of inhibition of thyroid uptake of pertechnetate (99mTcO4-) by iodinated contrast medium has not been established in any species. The main objective of this study was to better understand the temporal characteristics and magnitude of inhibition of feline thyroid uptake of 99mTcO4- due to iohexol administration. Routine thyroid scintigraphy was performed in eight cats by intravenous (IV) injection of 185 MBq (5 mCi) of 99mTcO4- both 4 days before and 0, 1, 3, 7, 14, and 28 days after IV administration of 880 mg I/kg iohexol (240 mg I/ml). Thyroid scintigraphy data were used to calculate thyroid:salivary gland ratios (T:S) and the percentage of total injected 99mTcO4- dose uptake within the thyroid (%TU) at 20 min postinjection. After iohexol administration, mean T:S was significantly decreased below baseline only on day 1. At no point during the study did any cat have a T:S that fell below the published normal reference range of 0.71 +/- 0.14. There was a significant decrease in %TU on day 1, 3, and 14; however, at no point during the study, did any cat have a %TU that fell below the published normal reference ranges of 0.64 +/- 0.57, 0.68 +/- 0.9, or 0.75 +/- 1.38.

  10. Technetium-99m hexamethylpropylene amine oxime lung scintigraphy findings in low-dose amiodarone therapy.

    PubMed

    Kaya, G Capa; Ertay, T; Tuna, B; Bekis, R; Tasci, C; Sayit, E; Yilmaz, O; Kargi, A; Durak, H

    2006-01-01

    Amiodarone (AD)-induced pulmonary toxicity is one of the major complications of long-term AD therapy. Technetium-99m-labeled D: ,L: -hexamethylpropylene amine oxime (Tc-99m HMPAO) scintigraphy has been used to assess lung injury. We designed this study to clarify lung uptake changes of Tc-99m HMPAO using low doses of AD (5 mg/kg/day) during long-term therapy in a rabbit model. Group 1 consisted of 7 rabbits fed with AD by gavage for 6 months. To investigate the effect of ketamine on Tc-99m HMPAO uptake, 5 rabbits were included in Group 2 as a control group. Tc-99m HMPAO scintigraphy was performed in both Group 1 and Group 2 at baseline and after 2, 4, 6, 8, and 12 weeks of AD intake. After 16, 20, and 24 weeks of drug intake, Tc-99m HMPAO scintigraphy was repeated only in group 1. One-min anterior images were acquired 30 min after the injection of 37 MBq of Tc-99m HMPAO. For semiquantitative evaluation, the mean count values were obtained and lung/background and liver/background ratios were calculated. Histopathologic evaluation was performed. No increase in lung and liver uptake of Tc-99m HMPAO was found 2, 4, 6, 8, and 12 weeks after drug intake. There was no significant increase in L/B and H/B ratios of Tc-99m HMPAO in Group 1 compared with Group 2. Both scintigraphic studies and histopathologic examinations showed nonspecific changes. Longitudinal studies investigating Tc-99m HMPAO lung uptake may be planned in patients carrying risk factors for AD-induced lung toxicity.

  11. Detection of orchitis and sacroiliitis due to brucellosis by 99mTc polyclonal human immunoglobulin scintigraphy.

    PubMed

    Kadanali, Ayten; Uslu, Hatice; Bayraktar, Rezan; Varoglu, Erhan

    2012-07-01

    Here, we report 1 case of Brucella orchitis detected by 99mTc human immunoglobulin scintigraphy and confirmed by testicular ultrasound. A 29-year-old farmer was admitted to our hospital with fever, fatigue, arthralgia, and painful scrotal swelling that had appeared 12 days before admission. Clinically, right sacroiliitis was recorded through the Fabere test Unilateral sacroiliitis and orchitis were detected by 99mTc human immunoglobulin scintigraphy. Hypoechoic left testicular lesions and swelling of the concurrent epididymis were seen on a testicular ultrasound examination. Wright agglutination test and blood specimen culture for Brucella species were positive.

  12. Evolution of a ureteric stone from the renal pelvis to the ureter on skeletal scintigraphy with CT correlation.

    PubMed

    Gupta, Pushpender; Kota, Gopi; Mintz, Akiva

    2012-02-01

    Because bone-seeking radiopharmaceuticals are excreted into the urine by the kidneys, normal kidneys and bladder are well visualized on skeletal scintigrams leading to incidental detection of urinary tract abnormalities in up to 15% of bone scans. Although the findings pertaining to the urinary tract on skeletal scintigraphy are seldom suggestive of a definitive diagnosis, they are highly specific for renal disease, with fewer than 2% false-positive studies reported. In the presented case, we demonstrate the evolution of a ureteric stone from the renal pelvis into the ureter on sequential skeletal scintigraphy with CT correlation.

  13. 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.

  14. Reproducibility of planar (123)I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy in patients with heart failure.

    PubMed

    Veltman, Caroline E; Boogers, Mark J; Meinardi, Joris E; Al Younis, Imad; Dibbets-Schneider, Petra; Van der Wall, Ernst E; Bax, Jeroen J; Scholte, Arthur J H A

    2012-10-01

    Despite its high prognostic value, widespread clinical implementation of (123)I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy is hampered by a lack of validation and standardization. The purpose of this study was to assess the reliability of planar (123)I-MIBG myocardial scintigraphy in patients with heart failure (HF). Planar myocardial MIBG images of 70 HF patients were analysed by two experienced and one inexperienced observer. The reproducibility of early and delayed heart-to-mediastinum (H/M) ratios, as well as washout rate (WR) calculated by two different methods, was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman analysis. In addition, a subanalysis in patients with a very low H/M ratio (delayed H/M ratio <1.4) was performed. The delayed H/M ratio was also assessed using fixed-size oval and circular cardiac regions of interest (ROI). Intra- and interobserver analyses and experienced versus inexperienced observer analysis showed excellent agreement for the measured early and delayed H/M ratios and WR on planar (123)I-MIBG images (the ICCs for the delayed H/M ratios were 0.98, 0.96 and 0.90, respectively). In addition, the WR without background correction resulted in higher reliability than the WR with background correction (the interobserver Bland-Altman 95 % limits of agreement were -2.50 to 2.16 and -10.10 to 10.14, respectively). Furthermore, the delayed H/M ratio measurements remained reliable in a subgroup of patients with a very low delayed H/M ratio (ICC 0.93 for the inter-observer analysis). Moreover, a fixed-size cardiac ROI could be used for the assessment of delayed H/M ratios, with good reliability of the measurement. The present study showed a high reliability of planar (123)I-MIBG myocardial scintigraphy in HF patients, confirming that MIBG myocardial scintigraphy can be implemented easily for clinical risk stratification in HF.

  15. 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.

  16. 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.

  17. [Synopsis of computed tomography, scintigraphy and bronchoscopy in the diagnosis of bronchial carcinoma].

    PubMed

    Beyer-Enke, S A; Clorius, J; Becker, H; Goerich, J; Probst, G; van Kaick, G

    1988-08-01

    In 87 patients with histologically proven bronchogenic carcinoma, computerised tomography (CT) and bronchoscopy were performed to assess the accuracy of CT in detecting bronchial stenosis. Whereas patent airways and mainstem stenosis were recognised in 85% of the cases, the overall accuracy was only 57%. Furthermore, the results of both methods were compared to scintigraphy (ventilation, perfusion) to evaluate the functional impairment due to altered lung morphology and bronchial stenosis. With an increasing number of CT-diagnosed atelectatic or infiltrated segments an almost linear decrease in ventilation and perfusion values was observed. In comparison, bronchoscopy-diagnosed tumour stenosis resulted in decreased ventilation and perfusion data only if the lesion was centrally located.

  18. Unusual Displacement of Urinary Bladder by a Dilated Rectosigmoid Colon on Bone Scintigraphy.

    PubMed

    Alavi, Mehrosadat; Kalhor, Leila; Ghaedian, Tahereh

    2017-04-01

    A 7-year-old boy with chief complaint of chronic pelvic pain was referred to our nuclear medicine department for bone scintigraphy. The images showed a focus of radiotracer activity in the right side of pelvic cavity, which is further confirmed as urinary bladder by single-photon emission computed tomography (SPECT) and delayed images. Because of high possibility of mass effect in pelvic cavity, pelvic magnetic resonance imaging (MRI) was performed, and it revealed an unusual dilatation of rectosigmoid colon with no evidence of pelvic mass.

  19. Technetium-99m-dimercaptosuccinic acid renal scintigraphy in children with urinary tract infections.

    PubMed

    Ajdinović, Boris; Jauković, Ljiljana; Krstić, Zoran; Dopuda, Marija

    2006-01-01

    The aim of this study was to determine the incidence of abnormal dimercaptosuccinic acid-Tc-99m ((99m)Tc-DMSA) renal scintigraphy findings in children with culture proved urinary tract infection (UTI) with or without vesicoureteral reflux (VUR). (99m)Tc-DMSA renal scintigraphy was performed in 343 children with culture documented UTI (247 girls and 96 boys) aged from three months to 14 years (middle age of 4.82 years). The children studied were all those submitted for renal scintiscan to the Institute of Nuclear Medicine, Military Medical Academy, Belgrade during a five-year period (2000-2004). Micturating cystoureterography (MCU) performed in all patients before (99m)Tc-DMSA scan, revealed VUR in 213 children, while in 130 children VUR was not detected by MCU. In 15 of the 213 children the grade of VUR was I, in 88 was II, in 57 was III, in 33 was IV and 20 children had grade V of VUR. Findings of (99m)Tc-DMSA renal scintigraphy were classified as: normal, equivocal and abnormal. Statistical analysis was performed using c(2)test. In all patients abnormal findings were detected in 38% (131/343), normal in 51% (174/343) and equivocal findings in 11% (38/343). In children with UTI and VUR the incidence of abnormal findings was 53% (112/213), of normal 37% (80/213) and of equivocal findings 10% (21/213). In children with UTI without VUR the incidence of abnormal findings was 15% (19/130), of normal findings 72% (94/130), and of equivocal findings 13% (17/130). The incidence of abnormal findings was significantly higher in children with UTI and VUR than in those with UTI without VUR (P<0.001). In children with VUR grades I, II, III, IV and V abnormal findings were 33%, 32%, 60%, 79% and 95% respectively. The incidence of abnormal findings was higher in children with VUR grades IV and V, than in grade I and II (P<0.001). Our results suggest that (99m)Tc-DMSA renal scintigraphy in children can discriminate between grade I-II and IV-V of VUR and also that in children with

  20. 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.

  1. The "hot nose" sign on brain death nuclear scintigraphy: where does the flow really go?

    PubMed

    Appelt, Eric A; Song, Won S; Phillips, William T; Metter, Darlene F; Salman, Umber A; Blumhardt, Ralph

    2008-01-01

    Nuclear scintigraphy has been used in patients with brain death since the 1970s. Many studies report a "hot nose" sign as predictive of brain death and lack of cerebral flow. Current nuclear medicine textbooks state that increased flow to the nose occurs secondary to occlusion of the internal carotid artery with flow rerouted to the nose via the external carotid artery. This explanation has been provided for decades assuming that the blood flow is actually increased to the nose. We performed a study to determine whether flow is really seen in the nose when a hot nose sign is present.

  2. Skeletal Metastasis From Carcinoma of the Gall Bladder: Need for Bone Scintigraphy Justified?

    PubMed

    Aswani, Yashant; Hira, Priya

    2016-01-01

    Carcinoma of the gall bladder has a guarded prognosis with predominant sites of involvement being liver and regional nodes. Osseous metastasis in carcinoma of the gall bladder is rare and hence bone scintigraphy does not form a part of the routine work-up for such patients. We describe two patients with carcinoma of the gall bladder with osteolytic metastasis (stage 4). Conservative treatment was planned but both of them succumbed to the illness. We thus highlight the importance of performing a bone scan or PET CT in cases of carcinoma of the gall bladder. Besides, our cases challenge Paget's seed - soil theory for sites of metastasis.

  3. The effects of thyroid scintigraphy studies on oxidative damage in patients.

    PubMed

    Ciçek, E; Yildiz, M; Delibaş, N; Bahçeli, S

    2006-06-01

    The majority of radiation injury in cells depends on oxidative stress. Irradiation and absorbed doses, duration of the irradiation and the susceptibility of the tissue against radiation are the factors that cause variations on living cells. The aim of this study was to investigate gamma radiation-induced oxidative damage in erythrocytes after thyroid scintigraphy with Tc-99m pertechnetate. Fifteen patients (8 women and 7 men) who performed thyroid scintigraphy with Tc-99m pertechnetate were included in this study. The median age was 52 +/- 8 years (range 33-65). The blood samples were taken from patients just before, 1 hour after and three hours after injection of radiopharmaceutical. Malondialdehyde (MDA) and antioxidant enzymes such as glutathione peroxidase (GPX), superoxide dismutase (SOD), and catalase (CAT) levels were measured to evaluate the gamma radiation induced oxidative damage. No difference was detected in any final measurement activities of erythrocyte antioxidant enzyme such as SOD and GPX in the direct comparison between the before and after injection of the radiopharmaceutical groups, except erythrocyte CAT activities measured 1 hour after and 3 hours after injection of the radiopharmaceutical (p < 0.05). MDA levels were decreased 1 hour after and 3 hours after injection of the radiopharmaceutical.

  4. Skeletal scintigraphy and radiography at onset of acute lymphocytic leukemia in children

    SciTech Connect

    Clausen, N.; Gotze, H.; Pedersen, A.; Riis-Petersen, J.; Tjalve, E.

    1983-01-01

    /sup 99m/Technetium skeletal scintigraphy performed at the time of diagnosis was compared with pain and radiographs in 24 children with acute lymphocytic leukemia. Localized intense uptake of the labeled compound in one or several metaphyses and increased uptake in diaphyses were typical findings by scintigraphy. The skeleton of each child was subdivided into 18 regions, and investigated for the presence of pain and for possible radiographic and scintigraphic abnormalities. In a total of 432 regions (18 regions in each of 24 children), pain was present in 23 regions, radiographic anomalies in 54 regions, and abnormal technetium uptake in 98 regions. Signs and symptoms were most often found in the lower extremities. Pain and radiographic or scintigraphic abnormalities were not regularly found in the same skeletal regions. The individual number of radiographic abnormalities was negatively correlated with age, whereas the number of regions with abnormal technetium uptake was positively correlated with age. No significant correlation was found between the number of abnormal scintigraphic or radiographic regions and the clinical outcome of the disease.

  5. Myocardial imaging using thallium 201 scintigraphy after dipyridamole infusion: A case history

    SciTech Connect

    Niemeyer, M.G.; van der Wall, E.E.; Leijtens, J.P.; Wever, J.; van der Pol, J.M.; Willekens, F.G. )

    1989-12-01

    Coronary artery disease frequently occurs in combination with peripheral vascular disorders and is an important cause of morbidity and mortality during or after peripheral vascular surgery. However, the detection of coronary artery disease in patients with peripheral vascular disease may be complicated, since most of these patients are unable to perform conventional exercise testing. The authors report a sixty-two-year-old man with an infrarenally located aneurysm of the abdominal aorta who underwent thallium 201 scintigraphy combined with dipyridamole infusion as an alternative exercise test. The subsequent thallium 201 images showed perfusion defects indicative of severe coronary artery disease. Coronary angiography showed an occluded right coronary artery and a significant proximal stenosis in the left anterior descending coronary artery. The patient underwent successful aortocoronary bypass surgery, and two months later, the aortic aneurysm was operated on without complications. As a result, dipyridamole thallium 201 scintigraphy should be considered as a valuable diagnostic test to detect coronary artery disease in patients with peripheral vascular disorders.

  6. 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.

  7. 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.

  8. 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

  9. Screening for a renovascular etiology in hypertensive patients undergoing myocardial scintigraphy: differential renal thallium-201 uptake.

    PubMed

    Hurwitz, G A; Mattar, A G; Bhargava, R; Powe, J E; Driedger, A A

    1990-06-01

    In hypertensive patients with target organ damage the search for possible etiologic factors may be particularly relevant. To evaluate renal symmetry, differential renal uptake of thallium-201 was quantified on renal images at 30 mins to 3 h after tracer injection in 112 hypertensive patients undergoing myocardial perfusion scintigraphy for chest pain. In some patients, renal angiographic status was known at the time of thallium-201 scintigraphy (n = 10), or disease was highly suspected (failed angioplasty, n = 6); the remainder (n = 96) were 'screened' for renovascular disease by renal thallium-201 imaging; 32 normotensive patients with no history of renal disease served as controls. Validation of thallium-201 renal imaging was obtained in a total of 17 hypertensive patients who had correlating contrast angiography, confirming eight cases of unilateral or asymmetric bilateral renovascular disease. Renography with technetium-99m DTPA was performed in 28 patients; differential renal function according to this modality correlated well with differential renal uptake of thallium-201 (r = 0.98). Of the screened hypertensives, eight had marked asymmetry of differential renal uptake and eight had possibly significant asymmetry. Renal thallium-201 imaging provided the first evidence of asymmetric renal perfusion in four cases subsequently confirmed by abdominal angiography. In addition, four post angioplasty cases had persistent or progressive asymmetry of renal perfusion disclosed by this technique. Thus, ancillary renal imaging with thallium-201 can be used to identify hypertensive patients who should be considered for renal angiographic evaluation.

  10. Dipyridamole combined with symptom-limited exercise for myocardial perfusion scintigraphy: image characteristics and clinical role.

    PubMed

    Hurwitz, G A; Powe, J E; Driedger, A A; Finnie, K J; Laurin, N R; MacDonald, A C

    1990-01-01

    Although dipyridamole can be used with myocardial scintigraphy to demonstrate reversible perfusion defects, combining exercise with the pharmacologic tool could improve image quality and information yield. The incidence of perfusion defects and the quality of thallium 201 images were reviewed in a series of 820 patients who had been assigned to a specific stress-test mode. Supine bicycle exercise alone was used (group I) where no pharmacologic or physical factors (e.g., beta-blockers, arthritis) limited performance; otherwise, intravenous dipyridamole was followed by symptom-limited exercise (group II). Angiographic correlation was available in 57 patients in group I, and in 158 in group II; of these, 109 performed significant exercise (greater than or equal to 3 min at increasing workloads) following dipyridamole (group IIA), whereas in 49 (group IIB) the exercise phase following dipyridamole was truncated. All test-mode groups were similar with respect to the incidence of ST segment depression during testing, patient throughput, and the sensitivity of perfusion defects. Chest pain and reversible defects were induced more frequently in group II than in group I. In group IIA, splanchnic background activity was lower (P less than 0.001) than in group IIB, and the false-positive rate tended to be lower. Thus, combining exercise with dipyridamole in patients with non-cardiac limitations to exercise enabled the achievement of optimal results for perfusion scintigraphy.

  11. Usefulness of scintigraphy with labelled leucocytes and SPECT/CT in vascular graft infection.

    PubMed

    Marín-Oyaga, V; Gutierrez-Villamil, C; García-Concha, D; Arevalo-Leal, S

    2017-06-12

    Vascular graft infections are a rare complication in this type of procedure. However, when they do occur, they usually have high morbidity, and even a high mortality. Proper identification and location is crucial for the appropriate and early management, whether medical or surgical, thus knowledge of the right tools is paramount. Nuclear medicine studies play an important role in this regard, either by using labelled white blood cells scintigraphy or (18)F-FDG. The choice, among other factors, will depend on the experience with both techniques by the different groups, their knowledge of them, as well as their availability. Two cases are presented in which (99m)Tc-HMPAO-white blood cells SPECT/CT scintigraphy was very useful in the diagnosis and location of the suspected infectious compromise, which led to the subsequent appropriate and guided management. Both cases were confirmed clinically and microbiologically. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  12. Follow-up Thallium-201 scintigraphy after mantle field radiotherapy for Hodgkin's disease

    SciTech Connect

    Pierga, J.Y.; Girinski, T.; Henry-Amar, M. ); Maunoury, C.; Valette, H.; Tchernia, G.; Desgrez, A. ); Socie, G. Hopital St Louis, Paris ); Cosset, J.M. Institut Curie, Paris )

    1993-04-02

    Assessment of the long-term cardiac effects of mediastinal radiotherapy for Hodgkin's disease, by Thallium scintigraphy. 32 patients (14 males and 18 females) who underwent mantle field radiotherapy for Hodgkin's disease were included in this study. Twenty patients received 4 fractions of 2.5 Gy per week and 12, five fraction of 2 Gy per week, delivered on alternate days. All the patients, except three, performed exercise testing electrocardiogram and Thallium-201 tomoscintigraphy. The average time interval from completion of treatment to the study was 7 years (range 3--13 years). No patients had clinical symptoms of cardiac disease. Mean age at the time of the study was 35 years (range 23--48 years). Two electrocardiograms revealed left bundle branch block and the patients were excluded from the study. Only one out of 27 exercise electrocardiograms was abnormal in a patient with mitral valve prolapse, who was also excluded from the study. Twenty-six scintigraphies were evaluable. Twenty-two (85%) were clearly abnormal with partial or complete redistribution on delayed images. The anterior region was affected in 19 of these cases (86%). Four explorations were undoubtedly normal. Coronary angiography was not performed for ethical reasons in these asymptomatic patients. Despite possible false positive tests, the high rate of abnormality (85%) in this small series is striking. These preliminary data justify larger studies and a close long-term follow-up of these patients. 24 refs., 1 fig., 2 tabs.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Solitary Fibrous Tumor of Neck Mimicking Cold Thyroid Nodule in 99m Tc Thyroid Scintigraphy

    PubMed Central

    Topaloglu, Oya; Ucan, Bekir; Demirci, Taner; Sayki Arslan, Muyesser; Saylam, Guleser; Onder, Evrim; Gultekin, Sinan; Dilli, Alper; Sahin, Mustafa; Cakal, Erman; Ozbek, Mustafa; Delibasi, Tuncay

    2013-01-01

    A 68-year-old man had a rapidly growing, painless neck mass, thought to be nodular goiter. Ultrasonography showed a giant, heterogeneous mass occupying the middle and superior poles and protruding outside of the left thyroid lobe. The results of the thyroid function tests were normal. Thyroid scintigraphy revealed a large hypoactive nodule in the left thyroid lobe. Complete surgical removal of tumor was performed and macroscopically demonstrated a well-demarked lesion outside the thyroid gland. Microscopically, the lesion was composed of fibroblast-like spindle cells in a patternless architecture and extensive stromal hyalinization. Immunohistochemistry showed positive reaction for CD34 in spindle cells and diffuse bcl-2 staining. The pathology was confirmed as solitary fibrous tumor. In the follow-up period after surgery, thyroid scintigraphy showed normal left thyroid lobe. Solitary fibrous tumor originated from or associated with thyroid gland is extremely rare. According to our knowledge, this is the first reported solitary fibrous tumor presenting like a cold thyroid nodule. This pathology must be considered for differential diagnosis of neck masses in the thyroid region. PMID:24194989

  18. Scintigraphy can be used to compare delivery of sore throat formulations.

    PubMed

    Limb, M; Connor, A; Pickford, M; Church, A; Mamman, R; Reader, S; Shephard, A; Aspley, S; Goulder, M A

    2009-04-01

    Sore throat (pharyngitis) is commonly treated with over-the-counter lozenges, tablets, sprays and gargles. While the efficacy of the active ingredients has been examined, less is known about the comparative efficacy of the different delivery formats. A pilot study was initially performed, followed by an open-label, four-way crossover study in healthy volunteers to quantitatively assess the delivery efficacy of a lozenge, tablet, spray and gargle, using technetium-99m and scintigraphy as a marker of deposition and clearance of the active ingredients. Initial deposition in the mouth and throat combined was significantly greater for the solid dose forms (lozenge and tablet) than for the spray or gargle. Rates of clearance were initially similar for the tablet and lozenge with low levels of radioactivity present at up to 2 h. At 10 and 20 min, significantly more of the dose remained for the lozenge than for the tablet. The mouth appeared to act as a reservoir for continued clearance to the throat. Scintigraphy is an effective means of quantifying the delivery efficiency, and hence availability, of sore throat medications. The results presented here suggest that both lozenges and tablets offer considerable advantages over sprays or gargles, both in terms of proportion of the dose delivered to the mouth and throat, combined, and clearance from these regions. These delivery formats provide fast, effective and prolonged delivery of active ingredients, highlighting their potential benefits for sore throat medication.

  19. Atrial pacing and thallium-201 scintigraphy in patients with chest pain: correlation with coronary anatomy

    SciTech Connect

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

    1989-04-01

    Atrial pacing and thallium-201 scintigraphy were performed in 72 patients referred for evaluation of chest pain. Coronary artery disease (CAD) was present in 63 patients, as documented by cardiac catheterization performed at the same time or within 2 months of atrial pacing. Nine patients had no or insignificant (less than 50% stenosis) CAD. The sensitivity of pacing-induced angina for CAD was 51%, and was 49% for ST depression. Specificities were 89% and 78%, respectively. A reversible perfusion defect was seen in 54% of patients with CAD (specificity 89%), and a fixed defect in 29% (specificity 100%). The sensitivity of an abnormal thallium-201 scan (one or more reversible or fixed defects) was 79% (p less than 0.05 compared to angina or ST depression). Combined sensitivity of ST depression and/or an abnormal thallium-201 scan was 87%. There were no significant changes in any of these sensitivities as the number of vessels with CAD increased. Thallium-201 scintigraphy correctly identified 11 of 19 (58%) patients with single-vessel disease as having CAD in only one vessel, but underestimated the extent of disease in all but a few patients with multivessel disease. The sensitivity of perfusion imaging to identify lesions in specific vessels ranged from 27% (circumflex) to 57% (right coronary artery). Specificities were 100% for circumflex, 78% for anterior descending, and 83% for right coronary artery lesions.

  20. Exercise thallium-201 myocardial scintigraphy in the follow-up of aortocoronary bypass graft surgery.

    PubMed Central

    Wainwright, R J; Brennand-Roper, D A; Maisey, M N; Sowton, E

    1980-01-01

    The predictive accuracy of exercise thallium-201 (201Tl) myocardial scintigraphy in the evaluation of aortocoronary bypass graft surgery was assessed in 48 patients undergoing angiographic investigation 15 months (mean time) after myocardial revascularisation. 201Tl scintigrams detected 61 out of 77 (79%) patent grafts but only 21 out of 42 (50%) occluded grafts, though, for grafts supplying non-infarcted myocardium, the predictive accuracy of graft patency and graft occlusion was 85 per cent and 81 per cent, respectively. Stress electrocardiography failed to detect 15 out of 21 patients with scintigraphic evidence of regional myocardial ischaemia. Residual ischaemia in the proximal left anterior descending coronary distribution was commonly detected in 201Tl scintigrams despite a patent, well-functioning left anterior descending graft to the distal coronary segment. Additional residual ischaemia attributable to ungrafted coronary disease was detected by scintigraphy in 32 (67%) patients and most commonly occurred in the distribution of the diagonal branch of the left anterior descending especially in the presence of a patent distal left anterior descending graft. Thus, independent grafts to the diagonal branch of the left anterior descending are recommended at the time of aortocoronary bypass graft surgery. Images PMID:6965585

  1. SPECT thallium-201 scintigraphy for the detection of left-ventricular aneurysm

    SciTech Connect

    Morton, K.A.; Alazraki, N.P.; Taylor, A.T.; Datz, F.L.

    1987-02-01

    We have noted that the presence of left ventricular anterior/apical aneurysm on contrast ventriculography or echocardiography correlates well with the finding of failure of convergence of the left ventricular walls toward the apex on single photon emission computed tomography (SPECT) thallium-201 images. To assess this observation, we analyzed the SPECT thallium scans of 74 sequential patients who had SPECT thallium scintigraphy and contrast ventriculography and/or echocardiography for evaluation of coronary artery disease. Immediate post-stress and 4-hr redistribution thallium-201 SPECT images, obtained following i.v. administration of 2 mCi of thallium-201, were reconstructed with no attenuation correction using three-dimensional linear and nonlinear filters and displayed in short, vertical-long, and horizontal-long axes. Of the 74 patients, contrast ventriculography and/or echocardiography showed anterior/apical aneurysms in 15 and a posterolateral aneurysm in one. SPECT thallium scans detected 14 of the 16 aneurysms, based on the criterion of failure of convergence of the ventricular walls toward the apex. There were two false-positives. Thus SPECT thallium-201 scintigraphy for the detection of left-ventricular aneurysm in this series had a sensitivity of 94%, a specificity of 97%, and an accuracy of 96%.

  2. 99mTc-DTPA diuretic renal scintigraphy in dogs with nephroureterolithiasis

    PubMed Central

    Hecht, Silke; Lawson, S. Meg; Lane, India F.; Sharp, Dorothy E.; Daniel, Gregory B.

    2010-01-01

    This study evaluated the results of diuretic renal scintigraphy in dogs with urolithiasis. Eighty-three kidneys with nephroureterolithiasis +/− renal pelvis/ureteral dilation were included in the study. Sixty-three kidneys showed a non-obstructive pattern, with a steep drop or gradual downward slope of renal time-activity curve (TAC). Excretion half-time of radiopharmaceutical (T1/2) was 3.99 (2.99 to 7.95) min. Three kidneys showed an obstructive pattern, with continuous rise of the TAC and median T1/2 of −10.71 (−5.20 to −17.56) min. Fifteen kidneys had non-diagnostic studies characterized by flat TAC. Individual kidney glomerular filtration rate was < 0.5 mL/min/kg body weight in most non-diagnostic studies. Diuretic renal scintigraphy appears to be a useful adjunct modality to rule out or confirm ureteral obstruction in dogs. Additional diagnostic procedures may be necessary to achieve a definitive diagnosis in cases of severely impaired renal function. PMID:21358928

  3. Pretreatment with ursodeoxycholic acid (UDCA) as a novel pharmacological intervention in hepatobiliary scintigraphy.

    PubMed

    Jeong, Hwan Jeong; Kim, Chang Guhn

    2005-06-30

    The purpose of this volunteer study was to investigate whether pretreatment with UDCA before the administration of (99m)Tc DISIDA affects the biliary excretion of the DISIDA, and whether it can shorten the total imaging time. Ten young, healthy volunteers (eight males, two females, mean age: 26.3 +/- 2.1 years) participated in the study. Hepatobiliary scintigraphies were performed twice per volunteer within three days, for the control and the UDCA-pretreated studies. In the control study, the gallbladder (GB) was observed first in four cases and the intestine was observed first in another four cases; in contrast, in the UDCA challenge study, the GB was observed first in eight cases. The quantitative results for the factors related to the GB differed significantly between the control and challenge studies. When the subjects were pretreated with UDCA, the time duration until visualization of the GB was shortened, and the maximum activity of the GB became more intense. In conclusion, UDCA pretreatment before hepatobiliary scintigraphy can shorten the total imaging time for evaluating functional obstructions of the cystic duct and increase the specificity of the process.

  4. Detection of platelet deposition at the site of peripheral balloon angioplasty using indium-111 platelet scintigraphy

    SciTech Connect

    Pope, C.F.; Ezekowitz, M.D.; Smith, E.O.; Rapoport, S.; Glickman, M.; Sostman, H.D.; Zaret, B.L.

    1985-02-01

    Restenosis after balloon angioplasty may be mediated through platelet deposition at the site of arterial dilatation. The purpose of this study was to determine whether platelet deposition at the site of dilatation could be detected using indium-111 platelet scintigraphy. Fifteen patients, aged 60 +/- 9 years, with iliac or femoral (n . 12), renal artery (n . 2) or distal aortic (n . 1) stenoses were studied. All patients received intravenous heparin at the time of dilatation. Labeled platelets containing 471 +/- 65 muCi indium-111 were injected 0.25 to 4 hours after dilatation and 1 to 24 hours after imaging. In 11 of 12 patients with iliac and femoral dilatations, focal uptake was demonstrated at the angioplasty site. In 4 patients (2 patients with renal, 1 patient with iliofemoral, and 1 with distal aortic stenoses), uptake at the dilatation sites was not detected. This preliminary study indicates that despite intravenous heparin, platelets accumulate at sites of balloon dilatation. Platelet scintigraphy may be useful in predicting sites of future narrowing after angioplasty and may be used to test the efficacy of antiplatelet therapy in retarding restenosis.

  5. 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.

  6. (99m)Tc-DTPA diuretic renal scintigraphy in dogs with nephroureterolithiasis.

    PubMed

    Hecht, Silke; Lawson, S Meg; Lane, India F; Sharp, Dorothy E; Daniel, Gregory B

    2010-12-01

    This study evaluated the results of diuretic renal scintigraphy in dogs with urolithiasis. Eighty-three kidneys with nephroureterolithiasis +/- renal pelvis/ureteral dilation were included in the study. Sixty-three kidneys showed a non-obstructive pattern, with a steep drop or gradual downward slope of renal time-activity curve (TAC). Excretion half-time of radiopharmaceutical (T(1/2)) was 3.99 (2.99 to 7.95) min. Three kidneys showed an obstructive pattern, with continuous rise of the TAC and median T(1/2) of -10.71 (-5.20 to -17.56) min. Fifteen kidneys had non-diagnostic studies characterized by flat TAC. Individual kidney glomerular filtration rate was <0.5 mL/min/kg body weight in most non-diagnostic studies. Diuretic renal scintigraphy appears to be a useful adjunct modality to rule out or confirm ureteral obstruction in dogs. Additional diagnostic procedures may be necessary to achieve a definitive diagnosis in cases of severely impaired renal function.

  7. (99m)Tc-DTPA diuretic renal scintigraphy in cats with nephroureterolithiasis.

    PubMed

    Hecht, Silke; Lawson, Sarah M; Lane, India F; Sharp, Dorothy E; Daniel, Gregory B

    2010-06-01

    The purpose of this study was to evaluate results of diuretic renal scintigraphy in 32 feline kidneys with nephroureterolithiasis and variable degrees of renal pelvis/ureteral dilation. Six kidneys showed a non-obstructive scintigraphic pattern, with a downward slope of time-activity curves (TAC) and a median excretion half-time of radiopharmaceutical (T((1/2))) of 6.09 (5.08-8.43) min. Eight kidneys showed an obstructive pattern, with a continuous rise of TAC and median T((1/2)) of -7.91 (-43.13-0.00) min. In one kidney with presumptive partial obstruction scintigraphic results were equivocal. Seventeen kidneys, most of which had an individual kidney glomerular filtration rate below 0.5ml/min/kg, had non-diagnostic studies. Diuretic renal scintigraphy may be a useful adjunct modality in the diagnosis of ureteral obstruction in some cats if renal function is maintained. However, the large number of non-diagnostic studies in animals with decreased renal function represents a clear limitation of the technique.

  8. Intrathoracic splenosis: evaluation by superparamagnetic iron oxide-enhanced magnetic resonance imaging and radionuclide scintigraphy.

    PubMed

    Ishibashi, Mana; Tanabe, Yoshio; Miyoshi, Hidenao; Matusue, Eiji; Kaminou, Toshio; Ogawa, Toshihide

    2009-11-01

    Splenosis represents the heterotopic autotransplantation of splenic tissue after either splenic trauma or surgery. Intrathoracic splenosis is a rare condition resulting from concomitant rupture of the spleen and the left hemidiaphragm. We report a case of splenosis in a 41-year-old male patient who had experienced severe thoracoabdominal injury including rupture of the spleen and left hemidiaphragm and post-traumatic splenectomy 20 years previously. Abnormal opacities in the cardiac region were noted on a chest radiograph at an annual checkup. Computed tomography (CT) of the chest demonstrated multiple, well-circumscribed pleura-based nodules at the posterior base of the left hemithorax and the left subdiaphragmatic area. On magnetic resonance imaging (MRI), the lesions were hypointense on T1-weighted images and hyperintense on T2-weighted images. After administration of superparamagnetic iron oxide (SPIO), the lesions showed decreased signal intensity but remained slightly hyperintense relative to liver parenchyma on T2-weighted images. (99m)Tc-labeled Sn colloid scintigraphy revealed multiple areas of increased activity consistent with the lesions on the CT and MRI scans. In addition to the history of splenic trauma and left hemothorax, SPIO-enhanced MRI and radionuclide scintigraphy, which can demonstrate phagocytic ability in the ectopic splenic tissue, were useful for confirming the diagnosis.

  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. Carcinoid tumors: CT and I-131 meta-iodo-benzylguanidine scintigraphy

    SciTech Connect

    Adolph, J.M.; Kimmig, B.N.; Georgi, P.; zum Winkel, K.

    1987-07-01

    The diagnostic value of computed tomography (CT) and iodine-131 meta-iodo-benzylguanidine (MIBG) scintiscanning was studied in nine patients with histologically proved carcinoid tumors of intestinal (n = 4), bronchial (n = 3), or thymic (n = 2) origin. CT scans clearly depicted the tumors and metastases in relation to surrounding vital structures but did not provide findings specific for carcinoids. The appearance on CT of an abdominal soft-tissue mass with a radiating pattern of linear densities was found to be highly suggestive of intestinal carcinoid tumors. I-131 MIBG scintiscans disclosed intense tracer uptake in the tumors and metastases in five patients. MIBG studies correctly depicted nine of nine tumor manifestations in intestinal carcinoids and four of six tumor manifestations in bronchus carcinoids. No MIBG concentration was found in thymus carcinoids. Because of its selective uptake mechanism, I-131 MIBG scintigraphy can allow specific detection and localization of neuroendocrine tumor tissue in patients with suspected carcinoid tumors. MIBG scintigraphy has diagnostic potential as a screening procedure in carcinoid tumors, especially those of intestinal origin.

  11. 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.

  12. Improved interpretation of exercise Tl-201 myocardial perfusion scintigraphy in women: characterization of breast attenuation artifacts

    SciTech Connect

    Goodgold, H.M.; Rehder, J.G.; Samuels, L.D.; Chaitman, B.R.

    1987-11-01

    Thallium-201 myocardial perfusion scintigraphy is reported to be a less accurate diagnostic test for coronary artery disease in women than in men. We retrospectively analyzed 34 Tl-201 studies obtained in 28 symptomatic women and compared them with those obtained in 32 men during the same interval. Three criteria were tested: criterion 1 was defined as abnormal scans showing any defect; criterion 2, scans showing only transient (reversible) defects; and criterion 3, scans showing either transient or significant (i.e., not due to breast attenuation) fixed defects. The sensitivity in women was 1.00, 0.73, and 0.93, respectively; the specificity, 0.26, 0.84, and 0.85. The best values in men were a sensitivity of 1.00 and a specificity of 0.86. The three criteria were then prospectively tested in 33 scans of 29 additional women. The sensitivity was 0.90, 0.65, and 0.80, respectively, and the specificity, 0.18, 1.00, and 0.92. Defects (usually fixed) due to breast attenuation artifact were seen frequently (30%). Criterion 3 best differentiates such defects from those resulting from coronary artery disease, making Tl-201 myocardial perfusion scintigraphy as accurate in women as in men.

  13. Planning mantle radiation therapy in patients with Hodgkin disease: role of gallium-67 scintigraphy

    SciTech Connect

    Jochelson, M.S.; Herman, T.S.; Stomper, P.C.; Mauch, P.M.; Kaplan, W.D.

    1988-12-01

    Detection of all sites of lymphoma is imperative for accurate planning of radiation therapy. In patients with Hodgkin disease, mantle radiation is used to treat the thoracic lymph nodes; in those with early-stage or nonbulky disease, mantle and paraaortic radiation may be the only treatment given. CT scanning of the chest adds important information to that obtained from chest radiographs. Gallium-67 scintigraphy has also been used to provide additional information on sites of active tumor. To determine the usefulness of 67Ga-citrate scintigraphy in planning the portals for radiation therapy, we analyzed the radiation treatment plans in 26 consecutive patients with Hodgkin disease; in all 26 patients, the disease had been staged by chest radiographs, chest CT scans, and gallium-67 images. Gallium-67 imaging alone provided unique information that affected the treatment plans in three patients (12%). The combined results of gallium-67 imaging and CT scans influenced the planning of radiation therapy in eight patients (31%). Gallium-67 imaging was found to be an important adjunctive study for optimal planning of radiation therapy in patients with Hodgkin disease.

  14. Hepatobiliary scintigraphy with 99mTc-PIPIDA in the evaluation of neonatal jaundice

    SciTech Connect

    Majd, M.; Reba, R.C.; Altman, R.P.

    1981-01-01

    Hepatobiliary scintigraphy with technetium 99m-labeled p-isopropylacetanilido iminodiacetic acid (99mTc-PIPIDA) was used to evaluate 22 neonates with mixed jaundice. Ten patients were proved to have biliary atresia; ten others were diagnosed as having neonatal hepatitis. In the remaining two, jaundice was secondary to prolonged hyperalimentation. Initial studies in all ten patients with biliary atresia showed no evidence of excretion of the tracer into the intestinal tract. Following three to seven days of oral administration of phenobarbital, repeat studies were performed in six of the ten patients. None showed evidence of excretion. Initial studies of the 12 patients with intrahepatic cholestasis showed definite excretion in five, questionable evidence of excretion in two, and no demonstrable excretion in five. Studies after phenobarbital therapy in five of the seven patients with questionable or no excretion on the initial studies showed definite excretion in four. Only in one patient who had poor hepatic extraction did the phenobarbital therapy not change the scintigraphic pattern. The authors conclude that hepatobiliary scintigraphy with 99mTc-PIPIDA after three to seven days of phenobarbital therapy is a highly accurate test for differentiating biliary atresia from other causes of neonatal jaundice.

  15. Referral Patterns and Diagnostic Yield of Lung Scintigraphy in the Diagnosis of Acute Pulmonary Embolism

    PubMed Central

    Zannier, Erik; Zuckier, Lionel S.

    2017-01-01

    Introduction. The purpose of this study is to assess referral patterns and the yield of ventilation-perfusion (V/Q) scintigraphy in patients referred for acute pulmonary embolism (PE). Methods. We retrospectively reviewed the charts of all patients who underwent V/Q studies between April 1, 2008, and March 31, 2010. Patients were subdivided into 4 groups based on their referral source: emergency department (ED), hospital inpatient ward, outpatient thrombosis clinic, and all other outpatient sources. Results. A total of 1008 patients underwent V/Q scintigraphy to exclude acute PE. The number of ED, inpatient, thrombosis clinic, and outpatient studies was 43 (4.3%), 288 (28.6%), 351 (34.8%), and 326 (32.3%). Proportion of patients with contrast contraindication varied significantly among the different groups. Of the 1,008 studies, 331 (32.8%) were interpreted as normal, 408 (40.5%) as low, 158 (15.7%) as intermediate, and 111 (11.0%) as high probability for PE. 68 (6.7%) patients underwent CTPA within 2 weeks following V/Q. Conclusion. The rate of nondiagnostic studies is lower than that reported in previously published data, with a relatively low rate of intermediate probability studies. Only a small fraction of patients undergoing a V/Q scan will require a CTPA. PMID:28491475

  16. Quantitative scintigraphy: Relation to unperfused volume at necropsy, immediately and 1 week after coronary occlusion

    SciTech Connect

    Goodenday, L.S.; Wilkerson, R.D.; Leighton, R.F.; Muswick, G.J.; Hire, N.E.; Nelson, A.D.; Brewster, P.; Yasnoff, W.A.

    1985-05-01

    Interventions such as thrombolytic therapy, designed to preserve jeopardized myocardium after coronary thrombosis, suffer from inadequate scientific validation because of present limitations in the ability to measure the cardiac volume at risk initially, or to predict the eventual volume of unperfused tissue in the absence of intervention. To determine whether the unimpeded change in perfused myocardial volume over time could be predicted accurately in vivo, Tl-201 quantitative scintigraphy was performed in 10 dogs at 5 minutes and at 1 week after closed-chest coronary artery occlusion (CAO). Initial and final ischemic cardiac volumes (ICV) were measured at necropsy by autoradiography: Initial ICV from Ce-141 microspheres injected into the left ventricle 5 minutes after CAO and final ICV from autoradiography of Tl-201 given 1 week after CAO. Planar scintigrams were computer-analyzed with a quantitative anatomically-referenced technique. Early scintigraphic perfusion defect (SPD) size was closely related to initial ICV measured at necropsy, r=.93. SPD size decreased predictably by 50% during 1 week. Late SPD size correlated with final ICV at necropsy, r=.92. Size of the SPD 5 minutes after CAO predicted both size of the SPD 1 week later, r=.87, and also final ICV, r=.92. These data demonstrate that: 1) after acute canine CAO without therapeutic intervention, SPD size becomes predictably smaller with time; 2) this change reflects a change in the volume of ischemic myocardium; 3) quantitative scintigraphy accurately predicts both early and late ischemic cardiac volume as confirmed at autopsy.

  17. Clinical experience with technetium-99m DTPA aerosol with perfusion scintigraphy in suspected pulmonary embolism

    SciTech Connect

    Selby, J.B.; Gardner, J.J.

    1987-01-01

    To evaluate the clinical value of radioaerosol imaging, 156 patients with suspected pulmonary embolism (PE) were studied. In 25 patients, a preperfusion xenon-133 (Xe-133) study was compared with a postperfusion study using Tc-99m DTPA aerosol. It was found that they were of equal value most of the time (56%), but that the aerosol study was more often helpful. Because of this, and the technical ease of using six standard views with radioaerosol, the series was completed using perfusion scintigraphy followed by radioaerosol images. In 19 patients the perfusion scintigraphy with Tc-99 macroaggregated albumin (Tc-99m MAA) was normal or nearly normal and no aerosol study was required. Tc-99m DTPA aerosol images were satisfactory when the count rate was at least twice and preferably three times that of the previous perfusion study. There were 17 studies (11%) classified as intermediate. There were 26 patients classified as high probability for PE, and angiographic or autopsy correlation was available in 14. All of the 14 proved to have PE. In the 113 patients classified as low probability, there were ten with angiographic or autopsy correlation. In the ten, there was one patient with a small pulmonary embolus found at autopsy. Clinical follow-up for over two months confirmed the absence of PE in the remainder of this group. Aerosol studies have proven technically easier to perform and a satisfactory substitute for xenon imaging in suspected PE.

  18. Quantitative evaluation of bile diversion surgery utilizing /sup 99m/Tc HIDA scintigraphy

    SciTech Connect

    Wickremesinghe, P.C.; Dayrit, P.Q.; Manfredi, O.L.; Fazio, R.A.; Fagel, V.L.

    1983-02-01

    This is a report of 21 patients presenting with epigastric pain, bilious vomiting, upper gastrointestinal bleeding, iron-deficiency anemia, and weight loss, who had undergone Billroth II gastrectomy from 3 to 35 yr earlier. Eighteen of 21 patients were found to have significant enterogastric reflux indices varying from 60% to 95% demonstrated by /sup 99m/Tc HIDA scintigraphy. Thirteen patients had diversion antireflux surgery in the form of a Roux-en-Y procedure, and 1 patient had a Henley loop jejunal interposition. Postoperative /sup 99m/Tc HIDA scintigraphic studies showed the enterogastric reflux indices to have decreased significantly to a range of 2%-26% (p less than 0.00001). There was marked improvement of symptoms, including correction of anemia and weight gain in those patients who had been anemic or who had sustained earlier weight loss. The enterogastric reflux indices of 10 asymptomatic control patients after Billroth II gastrectomy ranged from 4% to 45%. /sup 99m/Tc HIDA scintigraphy is useful in evaluating patients before and after bile diversion surgery, and demonstrates the quantitative decrease in enterogastric reflux after such surgery.

  19. Cleansing the colon in gallium-67 scintigraphy: a prospective comparison of regimens

    SciTech Connect

    Novetsky, G.J.; Turner, D.A.; Ali, A.; Raynor, W.J. Jr.; Fordham, E.W.

    1981-01-01

    Colonic accumulation of gallium-67 frequently complicates the interpretation of gallium-67 scintigrams. Although various modes of cleansing the colon prior to scintigraphy have been suggested, there is controversy over their efficacy and none have been tested prospectively. Three hundred nine patients undergoing gallium-67 scintigraphy were randomly assigned to one of four cleansing regimens: (1) a high fiber diet (78 patients); (2) castor oil (76); (3) milk of magnesia and cascara (76); and (4) not preparation (79). Patient compliance rates for the four regimens were 17%, 32%, 36%, and 46%, respectively. After noncompliant patients were excluded, gallium-67 scintigrams were graded for colonic activity on a scale of 0-3 by three independent, experienced observers. Gallium-67 activity in the colon was significantly less after administration of castor oil than after no preparation (p . 0.047). A high fiber diet also resulted in a substantial reduction of colonic activity when compared with no preparation; the difference, however, was not statistically significant (p . 0.083). Regimen 3 did not produce significantly better results than regimen 4 (p . 0.42). A major impediment to the success of any cleansing regimen seems to be poor compliance of patients.

  20. Cleansing the colon in gallium-67 scintigraphy: a prospective comparison of regimens

    SciTech Connect

    Novetsky, G.J.; Turner, D.A.; Ali, A.; Raynor, W.J.; Fordham, E.W.

    1981-11-01

    Colonic accumulation of gallium-67 frequently complicates the interpretation of gallium-67 scintigrams. Although various modes of cleansing the colon prior to scintigraphy have been suggested, there is controversy over their efficacy and none have been tested prospectively. Three hundred nine patients undergoing gallium-67 scintigraphy were randomly assigned to one of four cleansing regimens: (1) a high fiber diet (78 patients); (2) castor oil (76); (3) milk of magnesia and cascara (76); and (4) no preparation (79). Patient compliance rates for the four regimens were 17%, 32%, 36%, and 46%, respectively. After noncompliant patients were excluded, gallium-67 scintigrams were graded for colonic activity on a scale of 0-3 by three independent, experienced observers. Gallium-67 activity in the colon was significantly less after adminstration of castor oil than after no prepartion (p = 0.083). Regimen 3 did not produce significantly better results than regimen 4 (p = 0.42). A major impediment to the success of any cleansing regimen seems to be poor compliance of patients.

  1. 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

  2. Bone scintigraphy as cornerstone in the diagnosis of Erdheim-Chester disease.

    PubMed

    García-Gómez, F J; Cambil-Molina, T; Ríos-Martín, J J; de la Riva-Pérez, P A; Calvo-Morón, C; Castro-Montaño, J

    2016-01-01

    The Erdheim-Chester disease (ECD) is an extremely rare form of non-Langerhans cell histiocytosis. The main difficulty for its diagnosis lies in the wide variety of non-specific symptoms and signs that can occur in the disease process, leading, therefore, to there being no clear-cut algorithm as a guide for an optimal biopsy to confirm the diagnosis. An 81-year-old male with history of diabetes insipidus was admitted due to non-specific respiratory signs. Imaging techniques revealed osteoblastic lesions in the lumbar spine. Whole-body bone-scintigraphy (BS) was performed, in which lesions involving the axial and appendicular skeleton, with different rates of osteoblastic activity, were observed. This highlighted a symmetrical severely intense uptake in the knees, leading to an accurate biopsy specimen that enabled making the definitive diagnosis. BS is a widely available, safe, and inexpensive technique that shows a characteristic pattern of uptake for ECD, thus its use is highly recommended for screening and guiding biopsy if clinical suspicion exists. Furthermore, when the scintigraphy pattern is incidentally observed, biopsy of increased uptake areas (tibia preferably) is mandatory in order to rule out the disease.

  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. 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.

  5. [Examination of R-L shunt ratio mensuration using dynamic images in lung perfusion scintigraphy].

    PubMed

    Ichikawa, Hajime; Yamada, Sayaka; Yoshioka, Chiho; Tamaoki, Toyoshi; Miura, Syunichi; Suzuki, Motoki; Makino, Tetsuzou

    2008-05-20

    We examined a method of quantitative analysis that used dynamic and static images to measure the Right-left (R-L) shunt ratio in lung perfusion scintigraphy. A total of 18 patients suspected of having R-L shunt brought on by congenital heart disease were referred for lung perfusion scintigraphy from November 2005 to February 2007 at our hospital. We acquired anterior dynamic images, set ROIs in all fields of view, and measured the highest count. We acquired anterior and posterior static images of the chest and measured lung counts. We considered the highest count on dynamic images to be the total injection dose per one second, normalized the acquisition time of static images, and calculated the R-L shunt ratio. We weighed the measurement results of the R-L shunt ratio obtained by the dynamic method against that of the whole-body method by t-test and the least-squares method. When we used a posterior static image in the dynamic method, we found that the coefficient of correlation (r) was 0.9831. The result of the t-test was that there was no significant difference at a level of significance of 1%. We think the use of the dynamic method is possible in R-L shunt ratio measurement and can shorten the examination time.

  6. The value of lung scintigraphy in the management of airways foreign bodies in children.

    PubMed

    Guanà, R; Gesmundo, R; Maiullari, E; Bianco, E R; Vinardi, S; Cortese, M G; Silvestro, L; Canavese, F

    2009-10-01

    A retrospective analysis was made to evaluate our experience in the management of tracheobronchial foreign bodies (TFB) in children (age scintigraphy in patients' selection. The authors retrospectively reviewed all pediatric bronchoscopies performed by the bronchoscopic team at their Institution from July 2001 to December 2007 in the suspicion of TFB in children <14 years of age. A total of 32 TFB were identified in 25 boys and 7 girls with a mean age of 2.7 years (range, 6 months to 13 years). Diagnostic algorithm included: historical data, clinical evaluation, X-rays and nuclear medicine imaging. Bronchoscopy was performed under general anesthesia only in scintigraphy positive patients. In the procedure, a 2.7 mm pediatric flexible bronchoscope, passed through the endotracheal tube, was used exclusively for demonstrate and localize TFB and a 3.5-4 mm rigid bronchoscope to extract it. Extraction with the rigid bronchoscope was successful in all cases. The average time of the procedure using both instruments was 46 min (range 35 to 200 minutes). There were no complications associated with any of the procedures in these children. Rigid bronchoscopic extraction of paediatric TFB can be performed safely with minimal risks and complications. Careful patient's' selection remains crucial for choosing candidates to bronchoscopy. In our experience scintigraphic evaluation demonstrated to be of great value in order to have a correct pre-endoscopic diagnosis.

  7. Diagnostic performance of [18F] FDG PET-CT compared to bone scintigraphy for the detection of bone metastases in lung cancer patients.

    PubMed

    Rodrigues, Margarida; Stark, Hannes; Rendl, Gundula; Rettenbacher, Lukas; Datz, Lidwina; Studnicka, Michael; Pirich, Christian

    2016-03-01

    Accurate staging of lung cancer is essential for effective patient management and selection of appropriate therapeutic strategy. The aim of this paper was to compare the value of bone scintigraphy and FDG PET-CT for detecting bone metastases in lung cancer patients and the impact of these modalities in disease staging. One hundred sixty-four lung cancer patients who had undergone both FDG PET-CT and bone scintigraphy within 14 days were included into this study. The analysis of FDG PET-CT and bone scintigraphy was carried out patient- and lesion-based. One hundred twenty-one patients were negative and 43 patients positive for bone metastases. FDG PET-CT found bone metastases in 42/43 patients and bone scintigraphy in 38/43 patients. Sensitivity, specificity and accuracy of FDG PET-CT and bone scintigraphy for detecting bone metastases were 97.7%, 100% and 99.4%, and 87.8%, 97.5% and 94.2%, respectively. FDG PET-CT identified 430 bone metastases and bone scintigraphy 246 bone metastases. Skull was the only region where bone scintigraphy identified more lesions than FDG PET-CT. Based on both scintigraphic modalities disagreement concerning disease stage was found in 3 patients. FDG PET-CT yielded a higher sensitivity, specificity and accuracy than bone scintigraphy for identifying bone metastases in lung cancer patients. FDG PET-CT thus can be recommended for initial staging of lung cancer patients without applying bone scintigraphy for the detection of bone metastases.

  8. Tc-99m Sulfur Colloid Scintigraphy for Detecting Perigraft Flow Following Endovascular Aortic Aneurysm Repair: A Feasibility Study

    SciTech Connect

    Hovsepian, David M.; Siegel, Barry A.; Kimbiris, George; Sicard, Gregorio A.; Allen, Brent T.; Picus, Daniel

    1999-11-15

    Purpose: To determine if scintigraphy with Tc-99m sulfur colloid can be used to detect perigraft flow after stent-graft repair of abdominal aortic aneurysm (AAA). Methods: Twenty-three men and two women aged 56-84 years (mean 71 years) underwent endoluminal AAA repair as part of the EVT Phase II trial [EVT = Endovascular Technologies (Menlo Park, CA, USA)]. Aneurysm size averaged 5.4 cm (range 3-8 cm). Sixteen bifurcated, seven tube, and two aorto-uniiliac grafts were placed. Two days after stent-graft placement, patients underwent both contrast-enhanced computed tomography (CT), including delayed views, and Tc-99m sulfur colloid scintigraphy. Results: Perigraft flow was found in only one patient at completion of angiography. Four additional patients had perigraft flow, discovered during their postoperative follow-up CT. Four patients had leaks at an attachment site and one had retrograde branch flow. Tc-99m sulfur colloid scintigraphy failed to diagnose any of the five leaks prospectively. In two of these patients, however, some abnormal paraaortic activity was noted in retrospect. Conclusion: Tc-99m sulfur colloid scintigraphy was unable to demonstrate endoleak with either rapid flow (attachment site leak) or slow filling (branch flow)

  9. Thallium-201 scintigraphy is an effective diagnostic modality to distinguish malignant from benign soft-tissue tumors.

    PubMed

    Kawakami, Naoaki; Kunisada, Toshiyuki; Sato, Shuhei; Morimoto, Yuki; Tanaka, Masato; Sasaki, Tsuyoshi; Sugihara, Shinsuke; Yanai, Hiroyuki; Kanazawa, Susumu; Ozaki, Toshifumi

    2011-11-01

    The aim of this study is to evaluate whether thallium-201 (201-Tl) scintigraphy can differentiate malignant from benign soft-tissue tumors. Between April 1995 and December 2005, 192 patients with soft-tissue tumors (85 malignant and 107 benign) underwent 201-Tl scintigraphy before treatment. Isotope uptake was used as a proxy for tumor-to-background ratio (TBR). The accuracy of TBR on early and delayed imaging was evaluated using the Mann-Whitney U and χ(2) tests. There was a statistically significant difference in mean TBR on early and delayed imaging of malignant and benign soft-tissue tumors (124% ± 109% vs. 22% ± 42%, and 82% ± 83% vs. 12% ± 25%, P < 0.0001). A TBR cutoff of 20% indicated the probability of malignancy on early and delayed imaging (82% sensitivity and 77% specificity; 82% sensitivity and 84% specificity, P < 0.0001). Well-differentiated liposarcomas showed low isotope accumulation, while pigmented villonodular synovitis and giant cell tumors of the tendon sheath showed high isotope accumulation. Thallium-201 scintigraphy can distinguish malignant from benign tumors with relatively high accuracy. With the exception of low grade liposarcomas and locally aggressive benign tumors, 201-Tl scintigraphy may be an effective diagnostic modality to differentiate malignant from benign soft-tissue tumors.

  10. Thyrotropinoma with Graves’ disease detected by the fusion of indium-111 octreotide scintigraphy and pituitary magnetic resonance imaging

    PubMed Central

    Okuyucu, Kursat; Alagoz, Engin; Arslan, Nuri; Taslipinar, Abdullah; Deveci, Mehmet Salih; Bolu, Erol

    2016-01-01

    Thyroid-stimulating hormone-secreting pituitary adenoma (TSHoma) is a rare benign endocrinological tumor which produces TSH in the pituitary gland. Herein, we presented a female patient having TSHoma with Graves’ disease during and just after pregnancy that we found by indium-111 octreotide scintigraphy while investigating the patient for hyperthyroidism symptoms. PMID:27095865

  11. Assessment of salivary gland function in patients after successful kidney transplantation using (99m)Tc-pertechnetate salivary gland scintigraphy.

    PubMed

    Orsal, Ebru; Seven, Bedri; Keles, Mustafa; Ayan, Arif Kursad; Cankaya, Erdem; Ozkan, Ozalkan

    2013-01-01

    Chronic renal failure and its treatment can induce oral health problems and salivary glands dysfunction. The purpose of this study was to assess salivary glands function in patients with kidney transplantation using technetium-99m pertechnetate ((99m)Tc-P) salivary glands scintigraphy. We prospectively studied 34 patients with kidney transplantation (30 males and 4 females,mean age 39.76±11.6 years) and 28 healthy controls (12 males and 16 females, mean age 36.1±9.5 years). Salivary gland scintigraphy was performed nearly 4.4±2.9 years after successful kidney transplantation. Dynamic salivary glands scintigraphy was performed during 25min after the intravenous administration of 185MBq of (99m)Tc-P. Time-activity curves and glands functional parameters were calculated for the parotid and submandibular salivary glands: uptake ratio, maximum accumulation of the radionuclide, and excretion fraction. Statistical analysis of the functional parameters showed no significant differences between patients with kidney transplantation and healthy controls (P>0.05). In conclusion, this study showed that using (99m)Tc-P salivary gland scintigraphy, salivary glands function of patients with successful kidney transplantation do not differ statistically from those in healthy controls.

  12. 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

  13. False-positive "halo" sign on testicular scintigraphy in a 5-year-old boy with epididymitis and hydrocele.

    PubMed

    Santhosh, Sampath; Guha, Poonam; Bhattacharya, Anish; Bawa, Monika; Mittal, Bhagwant Rai

    2011-07-01

    Scintigraphic differentiation between acute torsion, hydrocele and testicular or scrotal abscess can be difficult. Doppler sonography may provide useful complimentary information toward diagnosis. The authors describe a 5-year-old child where epididymitis with hydrocele was misdiagnosed as testicular torsion on scrotal scintigraphy.

  14. 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.

  15. Integrated imaging using MRI and 123I metaiodobenzylguanidine scintigraphy to improve sensitivity and specificity in the diagnosis of pediatric neuroblastoma.

    PubMed

    Pfluger, Thomas; Schmied, Christoph; Porn, Ute; Leinsinger, Gerda; Vollmar, Christian; Dresel, Stefan; Schmid, Irene; Hahn, Klaus

    2003-10-01

    The objectives of this study were to compare MRI and iodine-123 ((123)I) metaiodobenzylguanidine (MIBG) scintigraphy in the detection of neuroblastoma lesions in pediatric patients and to assess the additional value of combined imaging. Fifty MRI and 50 (123)I MIBG examinations (mean interval, 6.4 days) were analyzed retrospectively with regard to suspected or proven neuroblastoma lesions (n = 193) in 28 patients. MRI and MIBG scans were reviewed by two independent observers each. Separate and combined analyses of MRI and MIBG scintigraphy were compared with clinical and histologic findings. With regard to the diagnosis of neuroblastoma lesion, MIBG scintigraphy, MRI, and combined analysis showed a sensitivity of 69%, 86%, and 99% and a specificity of 85%, 77%, and 95%, respectively. On MRI, 15 false-positive findings were recorded: posttherapeutic reactive changes (n = 10), benign adrenal tumors (n = 3), and enlarged lymph nodes (n = 2). On MIBG scintigraphy, 10 false-positive findings occurred: ganglioneuromas (n = 2), benign liver tumors (n = 2), and physiologic uptake (n = 6). Thirteen neuroblastoma metastases and two residual masses under treatment with chemotherapy were judged to be false-negative findings on MRI. Two primary or residual neuroblastomas and one orbital metastasis were misinterpreted as Wilms' tumor, reactive changes after surgery, and rhabdomyosarcoma on MRI. Thirty-two bone metastases, six other neuroblastoma metastases, and one adrenal neuroblastoma showed no MIBG uptake. On combined imaging, one false-negative (bone metastasis) and three false-positive (two ganglioneuromas and one pheochromocytoma) findings remained. In the assessment of neuroblastoma lesions in pediatric patients, MRI showed a higher sensitivity and MIBG scintigraphy a higher specificity. However, integrated imaging showed an increase in both sensitivity and specificity.

  16. White blood cell scintigraphy in the diagnosis of infection of endovascular prostheses within the first month after implantation.

    PubMed

    Liberatore, Mauro; Misuraca, Maria; Calandri, Enrico; Rizzo, Luigi; Speziale, Francesco; Iurilli, Anna Paola; Anagnostou, Cristos

    2006-03-01

    99mTc-HMPAO-labeled leukocyte scintigraphy (WBCs) is useful in the diagnosis of vascular graft infection. However, false positives can occur in the early postoperative period. There are no data concerning the usefulness of WBCs in detecting endovascular prosthesis infection during this period. The aim of our study was to assess the reliability of WBCs in the diagnosis of early infection after endovascular prosthesis implantation. 23 patients treated with endovascular grafts were submitted to preoperative diagnostic screening and to 3 WBCs (1 week before, 1 week after, and 1 month after surgery). After the last WBCs, all patients underwent a 14-month follow-up (range 6-37 months, median 12 months). Three patients died, at 3, 4 and 5 months after surgery respectively. At the end of the follow-up, the presence of infection was demonstrated in one patient. Of the 70 WBCs performed, 4 gave positive results. No positive scintigraphies were obtained in the preoperative period. A positive scintigraphy was found one week after surgery in a patient who showed lymphorrhage at the site of surgical access. In the same patient, the scintigraphic result returned to normal at 1-month scintigraphy. At 12-month follow-up the patient did not present signs of infection. Three positive scintigraphies were obtained in the same patient. In this patient clinical symptoms of graft infection became evident about 19 months after surgery. WBCs was repeated and showed extension of the infection. The infection was confirmed at surgery. WBCs do not provide false-positives in the first month after endovascular prosthesis implantation.

  17. Predicting the extent and location of coronary artery disease during the early postinfarction period by quantitative thallium-201 scintigraphy

    SciTech Connect

    Gibson, R.S.; Taylor, G.J.; Watson, D.D.; Stebbins, P.T.; Martin, R.P.; Crampton, R.S.; Beller, G.A.

    1981-05-01

    The ability of quantitative thallium-201 scintigraphy to predict the extent and location of coronary artery disease before hospital discharge after acute myocardial infarction was evaluated in 52 patients. All patients underwent coronary angiography and serial thallium-201 imaging either at rest or after submaximal exercise stress. Two or three vessel disease was designated if abnormal thallium-201 uptake or washout patterns, or both, were seen in two or three vascular segments, respectively. Of 156 vessels analyzed in the 52 patients, 91 stenoses of 70 percent or greater were found by angiography. Seventy-four of these were predicted by scintigraphy. The specificity of scintigraphy for identifying vessel stenoses was 92 percent. Sensitivity for detecting and localizing stenoses supplying an infarct zone was 96 percent compared with 62 percent for stenoses supplying myocardium remote from the acute infarct. Perfusion abnormalities were more frequently seen in the distribution of vessels with severe stenoses than in those with moderate stenoses. Scintigraphy detected a greater proportion of left anterior descending and right coronary arterial stenoses than circumflex stenoses. In the 42 patients who underwent submaximal exercise testing, multivariate analysis of 23 clinical and laboratory variables identified multiple thallium-201 defects as the best predictor of multivessel disease. The predictive accuracy of exercise-induced S-T segment depression was only 45 percent compared with 88 percent for thallium-201 scintigraphy. Thallium-201 imaging at rest is reliable in assessing the extent of coronary disease in hospitalized patients who cannot undergo exercise testing because of unstable angina, uncompensated heart failure, poorly controlled arrhythmias or physical limitations.

  18. [First diagnostic choice in patients with high clinical suspicion of pulmonary thromboembolism: helical CT or ventilation/perfusion pulmonary scintigraphy?].

    PubMed

    Ferrán, N; Martín-Comín, J; Bajén, M; Carrera, D; Mora, J; Ricart, Y; Sánchez, F; Mast, R

    2005-01-01

    Comparative analysis about helical CT (ThC) vs ventilation-perfusion pulmonary scintigraphy (V/P Sc) diagnosis effectiveness, as a first diagnosis technique in patients with high clinical suspicion of pulmonary thromboembolism (PT). Prospective study of 30 patients with high clinical suspicion and high Dimer-D levels (> 250 microg/l). The diagnosis was defined as anticoagulant therapeutic prescription and posterior clinical evolution. V/P Sc were performed to each patient within the next 48 h (an average of 14.8 h) after TCh, without anticoagulant treatment. We classified the scintigrams according to the PIOPED criteria and hTC images as positive, negative and indeterminated. In sixteen patients final diagnosis was PT: in 9 both techniques were positive; in 5 scintigraphy was positive with normal hTC and in 1, hTC was normal with negative scintigraphy. The last case was an indeterminated hTC with negative scintigraphy. In fourteen patients, final diagnosis was non-PT: in 6 both techniques were negative; in 7 scintigraphy was negative with positive hTC and in 1, both results were indeterminated. The sensitivity, specificity, positive predictive value, negative predictive value and efficiency were respectively 87.5, 100, 100, 87.5 and 93 % for V/P Sc and 62, 50, 58.8, 53.8 and 53 % for TCh. V/P Sc has better PT diagnosis reliability. It is recommended to do V/P Sc in all patients with high clinical suspicion of PT.

  19. Somatostatin receptor scintigraphy using 99mTc-EDDA/HYNIC-TOC in patients with medullary thyroid carcinoma.

    PubMed

    Czepczyński, Rafał; Parisella, Maria Gemma; Kosowicz, Jerzy; Mikołajczak, Renata; Ziemnicka, Katarzyna; Gryczyńska, Maria; Sowiński, Jerzy; Signore, Alberto

    2007-10-01

    Several new somatostatin analogues have been developed for the diagnosis and therapy of different tumours. Since somatostatin receptors are often over-expressed in medullary thyroid carcinoma (MTC), the aim of our study was to evaluate the utility of scintigraphy with the somatostatin analogue (99m)Tc-EDDA/HYNIC-TOC in MTC in comparison with other diagnostic techniques. Forty-five patients with MTC, aged 14-83 years, were investigated. Scintigraphy using (99m)Tc-EDDA/HYNIC-TOC (Tektrotyd) was performed 2 and 4 h post injection of 740 MBq (20 mCi) of the tracer. Other imaging techniques were also applied and analysed in individual cases (ultrasonography, computed tomography, (99m)Tc(V)-DMSA, (131)I-MIBG, (99m)Tc-MDP, (111)In-DTPA-octreotide and (18)F-FDG-PET) and compared with (99m)Tc-EDDA/HYNIC-TOC. In group 1 (eight patients before thyroidectomy), uptake of the tracer was found in the primary tumours. In group 2 (six patients with remission), a false positive result was found in one patient; in the remaining five patients, no pathological foci were visualised. In group 3 (31 patients with post-surgical hypercalcitoninaemia), scintigraphy was true positive in 23 patients (74.2%): uptake in the thyroid bed was found in five patients, in the lymph nodes in 18 and in bone metastases in four. Using (99m)Tc-EDDA/HYNIC-TOC scintigraphy, the overall sensitivity was 79.5%, specificity 83.3%, accuracy 80.0%, positive predictive value 96.9% and negative predictive value 38.5%. (99m)Tc-EDDA/HYNIC-TOC is clinically useful for scintigraphy in the follow-up of patients with MTC. It can be used in clinical practice for preoperative evaluation, for localisation of local recurrence or distant metastases and particularly for therapy decision making.

  20. The role of renal scintigraphy and unenhanced helical computerized tomography in patients with ureterolithiasis.

    PubMed

    Lorberboym, M; Kapustin, Z; Elias, S; Nikolov, G; Katz, R

    2000-04-01

    Unenhanced helical computerized tomography (UHCT) has recently evolved as an accurate imaging modality for determination of the presence or absence of ureterolithiasis in patients with acute flank pain. Functional renal scintigraphy is considered the gold standard for urinary tract obstruction. The objective of this study was to correlate the secondary signs of urinary obstruction on UHCT with findings of functional renal scintigraphy. UHCT was performed in 30 patients admitted to the emergency room with acute flank pain. All patients had a calcified urinary stone identified on UHCT. The location of each urinary stone was classified as ureteral or in the ureterovesical junction. The presence of secondary CT signs of ureteral obstruction was determined for each patient. After oral or intravenous hydration, a technetium-99m diethylene triamine penta-acetic acid renal scan was performed in all patients within 12 h of the CT scan. Follow-up delayed scintigraphic images were obtained at 2 h and 24 h in patients with evidence of ureteral obstruction. The sensitivity, specificity and predictive values of each possible combination of CT findings were determined by comparison with the scintigraphic results. The distal ureter was the most common location for a calculus on UHCT, followed in frequency by the ureterovesical junction, proximal ureter and mid-ureter. The renograms showed high-grade, unilateral obstruction in 12 patients, indeterminate scans in five patients and normal renograms in 13 patients. The sensitivities and specificities of individual CT findings ranged from 50% to 75% and from 8% to 69%, respectively. Perinephric stranding gave the highest positive predictive value (PPV) for obstruction (69% including indeterminate renograms). None of the individual CT findings showed a statistically significant correlation with scintigraphic findings. A combination of one or two positive CT findings had a PPV of only 25% for obstruction. A combination of three or four

  1. The role of dynamic renal scintigraphy on clinical decision making in hydronephrotic children.

    PubMed

    Çamlar, Seçil Arslansoyu; Deveci, Nazlı; Soylu, Alper; Türkmen, Mehmet Atilla; Özmen, Derya; Çapakaya, Gamze; Kavukçu, Salih

    2017-01-01

    Hydronephrosis may be related to an obstructive cause, ureteropelvic/uretero-vesical junction obstruction or nonobstructive [vesicoureteral reflux (VUR)]. When an obstructive pathology is considered, dynamic renal scintigraphy may help to predict whether it is a true obstruction or not. In this study, we aimed to determine the contribution of dynamic renal scintigraphy with [99] mTc-MAG-3 to the clinical decision-making for surgery in hydronephrotic children. Files of the patients evaluated by MAG-3 scintigraphy for antenatal (AH)/postnatal (PH) hydronephrosis between 1992 and 2014 were reviewed. Gender, age, hydronephrosis (HN) grade by ultrasound (US), presence of VUR, MAG-3 result (obstructive vs. nonobstructive), ultimate diagnosis, and need for surgery were assessed. Cases with double collecting system and neurogenic bladder were excluded from the study. All of the patients had normal serum creatinine and eGFR. There were a total of 178 patients with 218 hydronephrotic renal units (mean age 34.7 ± 52.7 months; male/ female = 121/57, AH of 62%). MAG-3 was nonobstructive in 134 and obstructive in 84 hydronephrotic renal units. MAG-3 was obstructive in 47 of 121 (39%) males and 30 of 57 (53%) females (P = 0.058, odds ratio (OR) for obstruction was 1.9 for girls). MAG-3 was obstructive in 47 of 135 (35%) units with AH and 37 of 83 (45%) units with PH (P = 0.137). In 81 units with the society of fetal urology-4 HN by US, MAG-3 was obstructive in 55 (68%), and surgery was required in 52 of 55 (95%). Surgery was required for only two (7%) of the remaining 26 units with nonobstructive dilatation (P <0.001, sensitivity 96%, specificity 89%, OR 208). Antero-posterior diameter >16.5 mm was the best cutoff level for predicting obstruction by MAG-3 (sensitivity 75.2%; specificity 71%; OR 3.8). MAG-3 significantly affects clinical decision for surgery in HN. Hydronephrotic girls have more risk in terms of true obstruction. Combining MAG-3 with US improves the

  2. Increasing the accuracy of lung perfusion scintigraphy in children with bidirectional Glenn circulation.

    PubMed

    Fukuda, Yutaka; Momoi, Nobuo; Mitomo, Masaki; Aoyagi, Yoshimichi; Endo, Kisei; Matsumoto, Ayumi; Hosoya, Mitsuaki

    2010-12-01

    In children who have undergone a bidirectional Glenn procedure without antegrade or additional pulmonary blood flow, we have often noted a discrepancy between apparent lung perfusion on scintigraphy and superior vena cava angiography when evaluating right and left pulmonary blood flow. We found a tendency for radionuclide, tracer 99mTc-MAA, when administered through a single upper extremity vein, to preferentially accumulate in the ipsilateral lung. In the present study, we examined whether the ratio of right-to-left pulmonary flow varied when 99mTc-MAA was administered via either the right upper or the left upper extremity vein. We studied six children (median age 1.3 ± 0.23 years) who underwent a bidirectional Glenn before total cavopulmonary connection. Five children who underwent biventricular repair served as a control. Perfusion scintigraphy using 99mTc-labeled macroaggregated albumin (99mTc-MAA) was performed in all children. First, we injected radionuclide via the right upper extremity and calculated the pulmonary accumulation in both lungs (R-image). Second, we injected the same dose of radionuclide via the left upper extremity and calculated the pulmonary accumulation (B-image), which represented the resulting administration via both upper extremities. The lung accumulation that resulted from radionuclide administration via the left upper extremity (L-image) was determined by subtracting the R-image from the B-image. We evaluated the right-to-total pulmonary blood flow ratio (radionuclide accumulation in right lung / radionuclide accumulation in both lungs) in the R-, L- and B-images. The right-to-total pulmonary blood flow ratios in the R-, L- and B-images were 815 ± 15.3%, 39.8 ± 11.7% and 61.3 ± 11.8%, respectively, and there were significant differences among the three images (P < 0.01). On the other hand, in the control group, the right-to-total pulmonary blood flow ratios in the R-, L- and B-images were 59.3 ± 22.4%, 57.8 ± 26.4% and 58.8

  3. A Family with Von Hippel-Lindau Syndrome: The Findings of Indium-111 Somatostatin Receptor Scintigraphy, Iodine-123 Metaiodobenzylguanidine Scintigraphy and Single Photon Emission Computerized Tomography

    PubMed Central

    Arıcan, Pelin; Okudan Tekin, Berna; Naldöken, Seniha; Şefizade, Rıza; Berker, Dilek

    2017-01-01

    Von Hippel-Lindau syndrome (VHLS) is an autosomal dominant hereditary familial disorder characterized by development of malignant and benign neoplasms. Differential diagnosis of the adrenal and pancreatic masses are difficult in patients with VHLS. Iodine-123 metaiodobenzylguanidine (I-123 MIBG) and indium-111 somatostatin receptor scintigraphies (In-111 SRS) have important roles in the differential diagnosis of adrenal and pancreatic masses in those patients. In this case report, we present the findings of I-123 MIBG single-photon emission computerized tomography (SPECT/CT) and In-111 SRS SPECT/CT in three members of a family with VHLS. In case 1, a residual neuroendocrine tumor (NET) was detected in the head of pancreas on In-111 SRS SPECT/CT images. In case 2 and 3, I-123 MIBG SPECT/CT confirmed the adrenal masses as pheochromocytoma, and the extra-adrenal mass as NET, before surgery. We thought that In-111 SRS and I-123 MIBG scan might be helpful in the routine work up of VHLS patients for diagnostic and therapeutic purposes. Hybrid SPECT/CT system may improve diagnostic accuracy of planar images since it assesses morphologic and functional information together. PMID:28291009

  4. 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.

  5. [Postoperative uptake of Ga-67 in planar scintigraphy and SPECT after median sternotomy].

    PubMed

    Montero, A; Carril, J; Quirce, R; Gutiérrez Mendiguchía, C; Uriarte, I; Rabasa, J; Vallina, N K

    1998-01-01

    Surgical alterations after median sternotomy can difficult the interpretation of scintigraphic images with Ga67. To analize the use of Ga67 scintigraphy in this patology, we wanted to know the Ga67 distribution in patients who had suffered median sternotomy. We studied 8 patients in the first month after median sternotomy without infection complication and performed planar images and SPECT. Ga67 showed uptake in liver, spleen and bone. Sternal uptake was greater or lesser than liver uptake but always showed an homogeneous distribution. No mediastinum uptake was observed. Surgical wound showed Ga67 uptake during the first week after sternotomy. To know the distribution of Ga67 in patients after median sternotomy allows the scan interpretation when we suspect infectous complications.

  6. Comparison of radiography and scintigraphy in the diagnosis of dental disorders in the horse.

    PubMed

    Weller, R; Livesey, L; Maierl, J; Nuss, K; Bowen, I M; Cauvin, E R; Weaver, M; Schumacher, J; May, S A

    2001-01-01

    Scintigraphy, with 99mTechnetium methylenediphosphonate (99mTc-MDP) and 99mTc-labelled leucocytes, was compared to radiography in the diagnosis of dental disease in the horse in a prospective case-controlled study, comprising 30 horses with clinical signs of dental disease and 30 control horses. In each case, right and left lateral, ventral and dorsal soft tissue and bone phase scintigraphic images were obtained after i.v. injection of 1 GBq/100 kg bwt 99mTc-MDP, using a gamma camera. The same views were acquired in 10 horses with clinical signs of dental disease and 12 control horses after injection of 99mTc-labelled leucocytes. Standard radiographic projections of the paranasal sinuses and of the apices of the maxillary and mandibular teeth were obtained. The scintigraphs and radiographs were assessed subjectively by 2 board-certified surgeons and one board-certified radiologist, with extensive experience of equine radiology, from who the clinical history was withheld. Sensitivity, specificity and kappa, as a measure of agreement, were calculated for the different methods. Bone phase images were also scored subjectively on a scale from 0 to 3 on the basis of isotope uptake over the teeth. Regions of interest were defined over the teeth, and normal teeth compared to diseased counterparts. Total scintigraphic counts were related to the age of the animal and to the disease process. Differences in density ratios between left and right teeth were evaluated using the Mann-Whitney Test. Dental disease was confirmed in 22 horses at surgery or postmortem examination. Horses with dental disease showed a significant increase in scintigraphic activity over the affected tooth compared to the contralateral tooth, with a typical pattern for different diseases. The sensitivity of scintigraphy with 99mTc-MDP proved to be excellent (95.5%), whereas the specificity was moderate (86.4%). In contrast, radiography had excellent specificity (95.0%) and a low sensitivity (51.5%). The

  7. Silent myocardial ischemia: Assessment by exercise thallium-201 scintigraphy and coronary arteriography

    SciTech Connect

    Reisman, S.; Berman, D.S.; Maddahi, J.; Swan, H.J.C.

    1985-05-01

    To determine the relationship between the presence or absence of exertional angina during treadmill testing (TT) and the extent and severity of exercise-induced ischemia (EII), the authors studied 96 consecutive patients (pts) with EII by Bruce protocol exercise (Ex) Tl-201 scintigraphy (greater than or equal to1 reversible segment (rev seg)). All pts underwent coronary angiography. Three-view Tl scintigrams were divided into 15 segs, and Tl uptake was graded visually in each seg using a 4 point score. Tl severity score (SS) was determined at Ex Tl imaging (ESS) and redistribution imaging (RSS). Severity of EII=ischemic severity score (ISS) derived as ESS-RSS. Extent of EII=number rev segs. Exertional angina was present in 48 pts (Gp I) and absent in 48 pts (Gp II).

  8. Lung mass appearing as a dilated left ventricle on Tc-99m tetrofosmin myocardial perfusion scintigraphy.

    PubMed

    Gnanasegaran, Gopinath; Williams, Robert; Mclean, Emma; O' Connell, Rachel; Nunan, Thomas O; O'Doherty, Michael J

    2009-09-01

    Tc-99m tetrofosmin is a common tracer used in myocardial perfusion scintigraphy. Several benign and malignant tumors also take up tetrofosmin. We present a case of a 60-year-old woman with a history of a left lung mass awaiting resection. The patient was referred for a myocardial perfusion scan for preoperative risk assessment. The myocardial perfusion scan revealed a large cavitated lesion mimicking a dilated left ventricle and the CT scan revealed a large mass in the left lung with central necrosis displacing the heart and mediastinum. The patient underwent thoracotomy with resection of the mass and the histology confirmed atypical carcinoid. This case highlights noncardiac uptake of Tc-99m tetrofosmin in an atypical carcinoid.

  9. Pectus excavatum in children: pulmonary scintigraphy before and after corrective surgery

    SciTech Connect

    Blickman, J.G.; Rosen, P.R.; Welch, K.J.; Papanicolaou, N.; Treves, S.T.

    1985-09-01

    Regional distribution of pulmonary function was evaluated preoperatively and postoperatively with xenon-133 perfusion and ventilation scintigraphy in 17 patients with pectus excavatum. Ventilatory preoperative studies were abnormal in 12 of 17 patients, resolving in seven of 12 postoperatively. Perfusion scans were abnormal in ten of 17 patients preoperatively; six of ten showed improvement postoperatively. Ventilation-perfusion ratios were abnormal in ten of 17 patients, normalizing postoperatively in six of ten. Symmetry of ventilation-perfusion ratio images improved in six out of nine in the latter group. The distribution of regional lung function in pectus excavatum can be evaluated preoperatively to support indications for surgery. Postoperative improvement can be documented by physiological changes produced by the surgical correction.

  10. Esophageal scintigraphy: applications and limitations in the study of esophageal disorders.

    PubMed

    O'Connor, M K; Byrne, P J; Keeling, P; Hennessy, T P

    1988-01-01

    This study examines the scintigraphic transit pattern in a variety of esophageal disorders. Scintigraphy was performed with a semi solid bolus and the patient in an upright position. Condensed esophageal images were obtained from which we derived the esophageal transit time. The pattern of bolus transit was graded by the duration of transit and by the presence of hold up or retrograde motion. Scintigrams were performed in 11 volunteers and 88 patients whose esophageal function had been confirmed by conventional gastroesophageal techniques. Esophageal disorders examined included achalasia (20), scleroderma (9), esophageal carcinoma (8), Barrett esophagus (5), and reflux esophagitis (27). We also examined the effects of gastroesophageal surgery on esophageal function. Transit times distinguished grossly abnormal esophageal function from normal but did not distinguish between different esophageal disorders. Graded transit patterns were a more sensitive indicator of esophageal function and permitted some differentiation between esophageal disorders and allowed evaluation of the effects of gastroesophageal surgery.

  11. 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.

  12. Iodine-123-metaiodobenzylguanidine scintigraphy in patients with chemodectomas of the head and neck region

    SciTech Connect

    van Gils, A.P.; van der Mey, A.G.; Hoogma, R.P.; Falke, T.H.; Moolenaar, A.J.; Pauwels, E.K.; van Kroonenburgh, M.J. )

    1990-07-01

    While studying the uptake of iodine-123-metaiodobenzylguanidine (({sup 123}I)MIBG) in chemodectomas, we coincidentally detected catecholamine secreting tumors in 5 out of 14 patients. In three of these cases, a norepinephrine secreting abdominal paraganglioma was subsequently removed. One patient had a norepinephrine secreting chemodectoma and one had a dopamine secreting chemodectoma. Prior to ({sup 123}I)MIBG imaging and urinary catecholamine measurements, endocrine activity was suspected in only one of these five patients. Apart from these five cases, two other patients showed elevated catecholamine secretion and abnormal abdominal ({sup 123}I)MIBG concentrations. However, these two patients were not surgically explored, because of normal computed tomography (CT) and magnetic resonance (MRI) studies. We suspect that catecholamine-secreting tumors are more common in patients with chemodectomas than is assumed in the literature, and we therefore recommend urinary catecholamine screening for all patients with chemodectomas. In case of elevated catecholamine secretion, MIBG scintigraphy is indicated.

  13. [99mTc-MAA peritoneal scintigraphy in pleuroperitoneal comunication in peritoneal dialysis patients].

    PubMed

    Hernández Martínez, A C; Marín Ferrer, M D; Coronado Poggio, M; Escabias Del Pozo, C; Coya Viña, J; Martín Curto, L

    2010-01-01

    Peritoneal dialysis is a fully-contrasted alternative for the treatment of end-stage renal disease although it is not exempt of complications. Peritonitis and exit-site infections are among the most frequent complications found. Pleural effusion secondary to pleuroperitoneal communication (PPC) is a serious and uncommon complication in these patients. We present the case of a 50-year old man diagnosed of end-stage renal disease undergoing treatment with peritoneal dialysis who presented progressive dyspnea and right pleural effusion. The peritoneal scintigraphy with (99m)Tc-MAA makes it possible to confirm communication of intraperitoneal dialysis fluid to the pleural cavity. Copyright 2009 Elsevier España, S.L. y SEMNIM. All rights reserved.

  14. 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.

  15. 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.

  16. Vicarious liver visualization in solitary functioning kidney with technetium-99m ethylenedicysteine renal scintigraphy

    PubMed Central

    Jain, Tarun Kumar; Phulsunga, Rohit Kumar; Gupta, Nitin; Sood, Ashwani; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2015-01-01

    We present a case of 3-year-old boy who was incidentally diagnosed to have single left kidney on ultrasonography. Dynamic technetium-99m ethylenedicysteine renal scintigraphy was acquired for assessing the existing kidney function showed the tracer localization in bilateral renal fossae during the entire study. The single-photon emission computerized tomography/computerized tomography study revealed activity in the right renal fossa to be in the enlarged right lobe of the liver, which was mimicking as impaired functioning right kidney in planar images. The hybrid imaging helped in accurate delineation of tracer uptake by confirming it to be the false appearance of the right kidney in planar imaging. This case report also highlights the possible mechanism of renal tracer uptake in the liver parenchyma. PMID:26170576

  17. 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

    2015-02-05

    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.

  18. 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.

  19. The role of preoperative ultrasonography, computed tomography, and sestamibi scintigraphy localization in secondary hyperparathyroidism

    PubMed Central

    Lee, Jae Bok; Kim, Woo Young

    2015-01-01

    Purpose The role of preoperative localization studies is controversial in surgery of secondary hyperparathyroidism (sHPT). The aim of study was to evaluate the accuracy of preoperative ultrasonography (USG), CT, and 99mTc sestamibi scintigraphy (MIBI) in localizing enlarged parathyroid glands and to find the impact of correct localization in successful parathyroidectomy. Methods We compared operative findings with the preoperative localization of ultrasonography, computerized tomography and sestamibi scintigraphy in 109 patients with sHPT and identified well-visualized locations of abnormal parathyroid glands by evaluating the sensitivity of each imaging study with regard to typical locations of glands. We investigated the effect of preoperative imaging localization on the surgical outcomes by measuring the intraoperative parathyroid hormone (ioPTH) decrement for positive or negative imaging localization. Results USG (91.5%) had the highest sensitivity and MIBI (56.1%) had the lowest among 3 modalities. The sensitivity of combined USG and CT (95.0%) was the highest among combined 2 modalities. The combination of all 3 modalities (95.4%) had the highest sensitivity among the combinations of modalities. The reduction of ioPTH in patients with positive imaging localization (86.6%) was greater than negative imaging localization (84.2%), with no significant difference (P = 0.586). The recurrence or persistence of sHPT was not correlated with preoperative imaging localization (19 patients in negative, 16 in positive; P = 0.14). Conclusion Preoperative imaging localization contributed to surgical success but not to surgical outcomes. The combination of ioPTH measurement with imaging localization might be valuable for better surgical results in sHPT. PMID:26665124

  20. 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