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I Cullum

Publications and source records attributed to I Cullum.

8 recordsLinked to original sources

Clinical outcome after one year following samarium-153 particulate hydroxyapatite radiation synovectomy.

The clinical outcome and tolerability following treatment with samarium-153 particulate hydroxyapatite was evaluated in patients with persistent rheumatoid knee synovitis. The clinical review of 18 patients treated with intra-articular samarium-153 particulate hydroxyapatite combined with triamcinolone hexacetonide who had failed to obtain more than 4 weeks symptom relief from a prior intra-articular glucocorticoid injection was undertaken. No unwanted effects from the treatment were observed. Symptom relief was maintained in 56% patients at 6 months and in 44% of patients at 12 months following treatment. Median duration of symptom relief was 9 months. There was a significantly higher mean baseline Ritchie Articular Index in patients relapsing within 3 months and a trend towards earlier relapse in patients with higher indices of disease activity at the time of treatment. There was a trend towards earlier relapse in patients with a poor range of knee flexion at baseline and with worse indices of intra-articular radiopharmaceutical distribution. Samarium-153 particulate hydroxyapatite knee synovectomy is well tolerated and may be an effective treatment for carefully selected patients with persistent rheumatoid knee synovitis.

Adult↗

Samarium-153-particulate hydroxyapatite radiation synovectomy: biodistribution data for chronic knee synovitis.

UNLABELLED: Biodistribution data for the radiation synovectomy agent samarium-153-particulate hydroxyapatite (153Sm-PHYP) are reported. METHODS: Mean extra-articular activity accumulation calculated from serial whole-body scans in 13 patients treated for chronic knee synovitis was 0.74% of injected activity (range 0%-3%). RESULTS: In four patients (31%), activity was noted in the lung (mean 0.68% of injected activity). In six patients (46%), 0.29% of injected activity accumulated in the regional lymph nodes and in three patients (23%), 0.62% of injected dose accumulated in the liver. Absorbed dose estimates were lung: 14 mGy, regional lymph nodes; 50 mGy, liver; 4 mGy. SPECT demonstrated good distribution of 153Sm-PHYP throughout the anterior knee compartments, although distribution to the posterior compartment was variable. CONCLUSION: Distribution is dependent on adequate knee flexion immediately following injection and may be influenced by the size range of labeled particles. Favorable biodistribution data suggest that 153Sm-PHYP is a potentially useful radiation synovectomy agent.

Adult↗

Collimator design for single photon emission tomography.

We discuss recent trends in collimator design and technology, with emphasis on theoretical and practical issues of importance for single photon emission tomography (SPET). The well-known imaging performance parameters of parallel-hole collimators are compared with those of fan-beam collimators, which have enjoyed considerable success in recent years, particularly for brain SPET. We review a simplistic approach to the collimator optimization problem, as well as more sophisticated "task-dependent" treatments and important considerations for SPET collimator design. Practical guidance is offered for understanding trade-offs that must be considered for clinical imaging. Finally, selective comparisons among different SPET systems and collimators are presented for illustrative purposes.

Equipment Design↗

A 99Tcm-labelled radiotracer for the investigation of cerebral vascular disease.

The first clinical data is given on 99Tcm-hexamethylpropyleneamine oxime (HM-PAO) in normal subjects and patients with established stroke. Regional cerebral blood flow maps (rCBF) have been recorded and displayed in tomographic mode with this new radiopharmaceutical. Good images were obtained, comparable to those achieved with 123I-isopropylamphetamine (IMP).

Amphetamines↗

Cerebral blood flow studies with 123iodine-labelled amines.

The cerebral distribution of a new class of 123I radiopharmaceuticals was determined by emission tomography after the isotope had been injected intravenously into 20 patients with a variety of neurological disorders. Regional cerebral blood flow images of diagnostic quality were obtained in all cases. Early and late ischaemic stroke showed up as areas of impaired perfusion, and gliomas and secondary deposits as areas of increased or reduced blood flow. A hyperaemic focus was clearly seen in an epileptic patient in whom other imaging techniques, including CT scanning and electroencephalography, had been uninformative. This new technique promises to be an extremely useful addition to the range of radioisotope brain scanning methods.

Adult↗

Radionuclide section scanning of the lungs in pulmonary embolism.

A new approach to the radionuclide imaging of the lungs is illustrated in this paper, describing four patients who were subjected to section scanning of the chest in addition to conventional planar imaging. The significance of this new method in the investigation of patients suspected of having pulmonary embolism is discussed. The main advantages of the new approach include increased information with depth, clearer definition of the mediastinal space, and the detection in some instances of new lesions not seen by conventional means.

Adult↗