PubMed Health⌕ Search

Biomedical subjects

H T Turoglu

Publications and source records attributed to H T Turoglu.

13 recordsLinked to original sources

Correlation of technetium-99m MIBI and thallium-201 retention in solitary cold thyroid nodules with postoperative histopathology.

A comparative prospective study of technetium-99m methoxyisobutylisonitrile (MIBI) and thallium-201 with early (15 min) and delayed (90 min for MIBI, 3 h for 201Tl) imaging in the differentiation of thyroid lesions is presented. Forty patients with cold thyroid nodules visualised on 99mTc-pertechnetate scan and with dyskaryotic or atypical epithelial cells verified by fine needle aspiration biopsy underwent MIBI and 201Tl scintigraphy at 3-day intervals. Subsequent thyroidectomies were carried out in all patients. Semiquantitative analysis was performed using a lesion to non-lesion ratio on early (ER) and delayed images (DR). Additionally, a retention index (RI) was calculated using the formula RI=(DR-ER) x 100/ER. The reproducibility of the method for the early and delayed measurements was tested by analysing intra- and inter-observer variability and repeatability coefficients. Histopathologically, the nodules were found to be well-differentiated thyroid cancer in 21 patients and benign in 19 patients. There was no significant difference in the ER between malignant and benign lesions for either 201Tl or MIBI (P>0.05). However, for both agents significant differences were found between malignant and benign lesions with regard to DR (P<0.01 for 201Tl and P<0.001 for MIBI) and RI (P<0.001 for both agents). Statistical comparison of the two agents showed no significant differences (P>0.05) except with regard to DR and RI in malignant nodules (P<0.05). A receiver operating characteristic analysis was performed to determine threshold levels for the differentiation of malignant from benign nodules. Following this analysis, ER, DR and RI levels of 1.03, 1.54 and 2 for MIBI and < or =1.42, 1.24 and 5 for 201Tl were selected. Using these threshold levels, the sensitivity, specificity and accuracy of the study were 90.5%, 36.8% and 65% for ER MIBI, 61.9%, 94.7% and 77.5% for DR MIBI, 95.2%, 89.4% and 92.5% for RI MIBI, 85.7%, 47.3% and 67.5% for ER 201Tl, 80.9%, 73.6% and 77.5% for DR 201Tl, and 90.5%, 94.7% and 92.5% for RI 201Tl. In conclusion, the DR for MIBI and 201Tl is superior to the ER in detecting malignant nodules, and the RI for both MIBI and 201Tl is more valuable than the DR in differentiating malignant from benign thyroid nodules.

Adult↗

Tumor and infection localization in AIDS patients: Ga-67 and Tl-201 findings.

Examples of Ga-67 and Tl-201 scans in AIDS patients performed at St. Vincent's Hospital and Medical Center of New York are presented. Use of these methods is the adopted approach at this institution in AIDS patients for localizing sites of tumor or infection involvement. A Ga-67 scan is the most common nuclear medicine examination performed on AIDS patients. Sequential Tl-201 and Ga-67 scans have a role in differentiating Kaposi's sarcoma from malignant lymphoma and opportunistic infections. For intracranial lesions, Tc-99m MIBI or Tl-201-201-201-201 chloride can differentiate malignant from benign inflammatory lesions.

AIDS Dementia Complex↗

Incidence of subclavian vein thrombosis detected during first-pass phase of radionuclide angiocardiogram.

A 79-yr-old woman with asymptomatic subclavian vein thrombosis associated with transvenous pacemaker electrode and congestive heart failure is reported. The subclavian thrombosis was discovered accidentally from the first-pass radionuclide angiogram that is routinely performed with the intravenous bolus injection of the radiopharmaceutical for a gated blood-pool study. It demonstrated venous obstruction at the level of the subclavian vein and abnormal collateral circulation over the chest wall consistent with subclavian thrombosis. This case report and literature review demonstrates the importance of performing first-pass radionuclide cardioangiography routinely before multigated blood-pool studies in patients with pacemakers.

Aged↗

Lung-heart ratio in stress thallium myocardial perfusion imaging in patients with a history of a previous pneumonectomy.

Increased TI-201 lung-heart ratio after treadmill exercise or pharmacologic stress is an indicator of left ventricular dysfunction. After pneumonectomy, it is not reliable because of increased pulmonary circulation in the remaining lung. The authors present an example of normal stress TI-201 myocardial perfusion imaging with an increased lung-heart ratio of TI-201 uptake.

Aged↗

Evaluation of sequential thallium and gallium scans of the chest in AIDS patients.

UNLABELLED: With decreasing incidence of pneumocystis carinii pneumonia (PCP) in AIDS as a result of prophylactic regimens, there is a higher incidence of tuberculosis (TB), mycobacterium avii complex (MAC), kaposi sarcoma and malignant lymphoma. There is a need for differentiating these various pathological entities. The purpose of this study was for a retrospective evaluation of sequential thallium and gallium scans in AIDS patients for differentiating intrathoracic kaposi sarcoma from malignant lymphoma and opportunistic infections. METHODS: A total of 181 patients had both studies completed between March 1992 and May 1994. The final diagnosis was verified only in 83 patients. Results were correlated with the CD4 counts, bronchoscopic and chest radiograph findings. RESULTS: In patients with pulmonary kaposi sarcoma and no opportunistic infections (19 patients), a thallium-positive, gallium-negative pattern was detected in 17 patients with a sensitivity of 89%. In the presence of kaposi sarcoma plus opportunistic infections, this pattern was only detected in 7 of 19 patients (sensitivity dropped to 37%). In 45 patients with opportunistic infections and no kaposi sarcoma, only two false-positive findings were found in patients with cytomegalic virus pneumonia for a specificity of 96%. For the whole group of 83 patients, sensitivity was 63%; specificity 95%; positive predictive value 92%; accuracy 81%; and negative predictive value 75%. CONCLUSION: A thallium-positive, gallium-negative pattern in AIDS patients has a high specificity for the diagnosis of kaposi sarcoma, however, the sensitivity dropped from 89% to 37% in the presence of opportunistic infections.

AIDS-Related Opportunistic Infections↗

Gastric emptying patterns in Kaposi's sarcoma and gastroenteritis secondary to human immunodeficiency virus infection.

The study included 11 patients with AIDS who underwent gastric emptying studies for solid food, endoscopy (esophagogastroduodenoscopy), and gastric biopsy whenever gastritis was diagnosed on endoscopy. All studies were performed within 1 week. The studies were retrospectively reviewed to analyze the changes in gastric emptying secondary to Kaposi's sarcoma (KS) with or without opportunistic infections. Two patients with KS only had rapid gastric emptying (T1/2 6.7 and 45 minutes). Two other patients with KS and opportunistic infections had normal gastric emptying (T1/2 56.7 and 70 minutes), and one patient with KS and opportunistic infections had rapid gastric emptying (T1/2 25.9 minutes). Four patients with gastritis secondary to opportunistic infections and no KS had delayed gastric emptying (T1/2 622, 92, 266.5, and 179.4 minutes). The remaining two patients had endoscopy showing gastritis not proven by biopsy, and both had rapid gastric emptying. One patient had gastric ulcer (T1/2 39 minutes), and the other had chronic active hepatitis and early cirrhosis (T1/2 15 minutes). Esophagitis was present in 6 out of 7 patients who had gastritis. Esophageal candidiasis was confirmed in three patients, and cytomegalovirus was confirmed in one patient. The findings suggest that gastroduodenal KS is associated with fast gastric emptying in patients with AIDS. However, normal gastric emptying study does not reflect normal gastric physiology in patients with AIDS.

AIDS-Related Opportunistic Infections↗

Ewing's tumor of the mandible.

A primary Ewing's tumor in the mandible is reported, and the diagnostic imaging features of this lesion are discussed. Modalities used included panoramic and plain films, computed tomography, and 99mTc-MDP scintigraphy.

Adolescent↗

Imaging of regional spread of breast cancer by internal mammary lymphoscintigraphy, CT, and MRI.

Forty women with breast cancer underwent imaging by internal mammary lymphoscintigraphy (IMLS), which was correlated with the results of CT and MRI of the chest. IMLS was performed and interpreted using the previously described methods of Ege. It identified 22 instances of ipsilateral internal mammary nodal involvement, none of which corresponded to cases of abnormally enlarged (diameter greater than 1.0 cm) internal mammary nodes on CT and/or MRI. Positive IMLS was associated with axillary nodal metastases in 15 out of 22 instances. The authors conclude that IMLS provides information on regional nodal spread of breast cancer that is not available with either CT/MRI imaging or axillary biopsy.

Antimony↗

Bone scan: a useful test for evaluating patients with low back pain.

For many years it has been known that the sensitivity of bone scanning to the presence of destructive bony lesions favors its use in screening for bone metastases and osteomyelitis. More recently bone scanning has been routinely employed in evaluating benign skeletal pathology that may be the cause of low back pain. Bone scanning can play an important part in (1) identifying the cause of pain, (2) clarifying the significance of radiographic findings, and (3) evaluating the results of spinal surgery. This expansion of the role of nuclear medicine in diagnosing and managing low back pain is based in part upon novel diagnostic applications of 99mTc-methylene diphosphonate, a radiopharmaceutical that has been available for over 15 years. Equally important for this development, however, has been the recent availability of SPECT, a tomographic imaging technique that can be used to display the spine in a series of 6- to 8-mm thick sections. Slightly more than one-half of newly purchased gamma cameras are rotating systems suitable for bone SPECT studies. Thus, many community hospitals can now perform state-of-the-art bone scans for low back pain.

Adult↗