Biomedical subjects

Albert Kao

Publications and source records attributed to Albert Kao.

44 records · Page 3Linked to original sources

PubMedDate not supplied

Comparison of 18F-fluoro-2-deoxyglucose positron emission tomography and gallium-67 citrate scintigraphy for detecting malignant lymphoma.

This study evaluates and compares the accuracy of positron emission tomography with 18F-fluoro-2-deoxyglucose (FDG-PET) and gallium-67 citrate (Ga-67) scintigraphy in identifying disease sites in patients with malignant lymphoma at initial diagnosis or relapse. Histology subgroups included low (n=5), intermediate (n=6), high-grade (n=5) non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) (n=14). Ann-Arbor staging included 7 patients in stage I, 8 in stage II, 9 in stage II, 6 in stage IV and 11 extra-nodal. In this study, before any therapy, 25 contemporaneous FDG-PET and Ga-67 scintigraphies were performed on patients with either NHL (16) or HD (14). One hundred and eleven sites of disease were correlated on a site-by-site basis in corresponding areas of FDG-PET and Ga-67 scintigraphy. Discordant FDG-PET and Ga-67 scintigraphic findings were correlated with CT/MRI and clinical evaluation. FDG-PET detected malignant lymphoma in 24/25 patients (sensitivity: 96.0%). There was a false-negative FDG-PET result in only 1 patient with low-grade gastric malignant lymphoma. Ga-67 scintigraphy detected malignant lymphoma in 18/25 patients (sensitivity: 72.0%). There were false-negative Ga-67 scintigraphic results in 4 cases with low-grade non-Hodgkin's lymphoma, 2 cases with bone or bone marrow involvement, and 3 smaller disease sites. FDG-PET upstaged 6 patients in whom Ga-67 scintigraphy detected disease sites partially. In imaging lymphoma prior to therapy, FDG-PET had a higher sensitivity and detected significantly more disease sites when compared with Ga-67 scintigraphy in the initial evaluation of this group of patients. Upstaging of patients with FDG-PET may result in a change in treatment strategy. However, evaluation of the final sensitivity, specificity and accuracy of these imaging modalities will need a further study with a larger patient number.

Adult↗

PubMedDate not supplied

Tissue polypeptide specific antigen (TPS) as a tumor marker in renal cell carcinoma.

Tissue polypeptide specific antigen (TPS) is a new tumor marker that indicates tumor proliferative rate rather than tumor burden. The purpose of this study was to assess the clinical value of TPS in patients with renal cell carcinoma (RCC). Serum levels of TPS were measured in 30 patients with locoregional and in 20 patients with advanced disease before and after therapy. The results showed that: (1) the detection sensitivity of TPS for RCC is 60.0%; (2) the detection sensitivity of TPS in advanced RCC (100.0%) was significantly higher than in locoregional RCC (33.3%); (3) the 10 locoregional RCC patients without recurrence had normal serum TPS levels during a follow-up period of 1 year; and (4) the 8 advanced RCC patients with good response during therapy had normal serum TPS levels, while 12 patients with poor disease had significantly elevated serum TPS levels during a follow-up period of 1 year. Our results suggest that TPS may have a potential clinical role as a valuable tumor marker for RCC, especially in advanced diseases and follow-up therapy response.

Adult↗

PubMedDate not supplied

Tissue polypeptide specific antigen (TPS) and carbohydrate antigen 125 (CA-125) in the early prediction of recurrent ovarian cancer.

It is very important to establish a tumor marker combination with strong lead-time effects in early detection of recurrent ovarian cancer. This retrospective study included 32 patients with recurrent epithelial ovarian cancer after primary therapy. The serum levels of tissue polypeptide specific antigen (TPS) and carbohydrate antigen 125 (CA-125) were followed-up. Normal upper limits of serum levels of 78.5 U/l for TPS and 35 U/ml for CA-125 were selected according to the 95th percentile of serum concentrations measured in healthy control patients. When compared with other follow-up modalities, TPS and CA-125 appeared lead-time effective with early diagnosis of recurrent ovarian cancer in 18 and 16 patients, respectively. This difference was not statistically significant. The combination of TPS and CA-125 provided lead-time effects in 24 patients. Our data indicate that the combination of TPS and CA-125 is a potential tool in the early prediction of recurrent ovarian cancer.

Adult↗

PubMedDate not supplied

Using non-invasive radionuclide imaging to detect esophagitis in patients with gastroesophageal reflux disease.

BACKGROUND/AIMS: The aim of our study was to evaluate technetium-99m tetrofosmin SPECT (single photon emission computed tomography) of the chest as a potential non-invasive method to evaluate esophagitis among gastroesophageal reflux disease patients. METHODOLOGY: In this study, we used non-invasive radionuclide imaging technetium-99m tetrofosmin chest SPECT to detect and grade esophagitis in 60 patients with gastroesophageal reflux disease. RESULTS: Based on the endoscopic findings according to the Savary-Miller system, the sensitivity, specificity, and accuracy rates of technetium-99m tetrofosmin chest SPECT in detecting esophagitis were 95.2%, 72.2%, and 88.3%, respectively. The agreement between the endoscopic and technetium-99m tetrofosmin chest SPECT findings was evaluated and found to be good (kappa: 0.633, p < 0.001). CONCLUSIONS: Non-invasive technetium-99m tetrofosmin chest SPECT has excellent sensitivity and good accuracy as a screen for esophagitis among gastroesophageal reflux disease patients.

Adult↗

PubMedDate not supplied

Comparison between technetium-99m hexamethylpropyleneamineoxide labeled white blood cell abdomen scan and abdominal sonography to detect appendicitis in female patients with an atypical clinical presentation.

BACKGROUND/AIMS: Acute appendicitis is a clinically challenging surgical disease which is particularly difficult to diagnosis in women. An atypical presentation is a major obstacle to quickly diagnose acute appendicitis. METHODOLOGY: Fifty female patients with acute abdomen pain who were suspected of having appendicitis, but who had atypical findings were included in this study. After an intravenous injection of technetium-99m hexamethylpropyleneamineoxide (Tc-99m HMPAO) labeled white blood cells, serial anterior abdomen-pelvis images at 30 min, 60 min, 120 min and 240 min were obtained using a gamma camera. Meanwhile, at the point of maximal tenderness, abdominal sonography was performed with a graded compression technique for both longitudinal and transverse images. RESULTS: Thirty-two patients received a laparotomy for surgical and pathological diagnoses. The remaining 18 patients did not receive operations and showed no evidence of appendicitis after at least a one-month follow-up period. Two patients had false-positive white blood cell scan findings and 2 patients had false-negative white blood cell scan findings. The overall sensitivity, specificity, and accuracy for white blood cell scans in diagnosing appendicitis was 93.3%, 90.0%, 92.0%, respectively. One patient had false-positive abdominal sonographic finding and 5 patients had false-negative abdominal sonographic findings. The overall sensitivity, specificity, and accuracy for abdominal sonography scans in diagnosing appendicitis were 83.3%, 95.0%, and 88.0%, respectively. CONCLUSIONS: The Tc-99m HMPAO white blood cell scan provides a more sensitive and accurate method for the diagnosis of appendicitis in female patients with equivocal clinical presentation when compared with abdominal sonography.

Abdomen↗

PubMedDate not supplied

C-reactive protein and gallium scintigraphy in patients after abdominal surgery.

BACKGROUND/AIMS: Early detection of post-surgical infection is important to decrease mortality in patients after operation. Both C-reactive protein test and gallium-67 scan (gallium scan) are sensitive examinations in the detection of infection. In this study, we compared the diagnostic accuracy of the two modalities in the detection of infection after abdominal surgery. METHODOLOGY: Forty-six patients undergoing abdominal surgery were enrolled in this study. All patients received blood examination for C-reactive protein test and were referred to our department for gallium scan because of unknown fever after surgery. RESULTS: Of the 46 patients with abdominal surgery, 22 (47.8%) were diagnosed to have infection including 6 intra-abdominal abscesses, 8 wound infection and 8 with both intra-abdominal abscesses and wound infection. To achieve better diagnostic results, C-reactive protein value of 2.8 mg/dL was chosen as cut-off value. The diagnostic sensitivities for both gallium scan and C-reactive protein test were 100%. The diagnostic specificity of gallium scan was superior to C-reactive protein test (83.3% vs. 54.2%). The overall diagnostic accuracy of gallium scan and C-reactive protein test were 92.6% and 76%, respectively. CONCLUSIONS: Both C-reactive protein test and gallium scan have good sensitivity in the detection of infection after abdominal surgery. Gallium scan has better diagnostic specificity than the C-reactive protein test.

Abdominal Abscess↗

PubMedDate not supplied

The usefulness of technetium-99m tetrofosmin scan to detect non-Hodgkin's lymphoma.

The aim of this study was to evaluate the usefulness of the Tc-99m tetrofosmin (Tc-99m TF) scan to detect Non-Hodgkin's lymphoma (NHL). Before any therapy, 26 patients with NHL were included in this study to undergo Tc-99m TF scan. Whole body Tc-99m TF scan was performed 10 minutes after intravenous injection of 20 mCi Tc-99m TF. Tc-99m TF scan could detect NHL in 22 (84.6%) patients. However, there were no significant differences in the incidences of positive and negative Tc-99m TF scan results between female versus male patients, age > 40 years and < or = 40 years patients, stage I-II versus stage III-IV patients and patients with versus without B symptoms (p values > 0.05). Four (15.4%) infradiaphragmatic NHL had false-negative Tc-99m TF scan results. We concluded that the Tc-99m TF scan is a potential tool to detect supradiaphragmatic NHL.

Adult↗

PubMedDate not supplied

The clinical usefulness of dual phase 201Tl thyroid scan for false-negative fine-needle aspiration cytological diagnoses in non-functioning cold thyroid nodules.

We evaluated the clinical usefulness of dual phase 201Tl thyroid scan for 11 patients with false-negative fine-needle aspiration (FNA) cytological diagnoses to detect malignant non-functioning thyroid nodules. Benign FNA cytological diagnoses categorized by experienced pathologists were considered as false-negative diagnoses because the final diagnoses of surgical histopathology were malignant. Dual phase thyroid scan, including an early image and a delayed image, were acquired at 10 minutes and 3 hours, respectively, after 2 mCi (74 MBq) of 201Tl was injected intravenously. Dual phase 201Tl thyroid scan findings were visually interpreted as malignant or benign diagnoses. Dual phase 201Tl thyroid scan could accurately diagnose all of the 11 patients with false-negative FNA cytological diagnoses. We concluded that dual phase 201Tl thyroid scan was very useful in detecting malignant non-functioning thyroid nodules in 11 patients with false-negative FNA cytological diagnoses.

Adolescent↗