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J M Carril

Publications and source records attributed to J M Carril.

At least 37 records · Page 2Linked to original sources
PubMed1997

Total-body scintigraphy with thallium-201 and iodine-131 in the follow-up of differentiated thyroid cancer.

UNLABELLED: We analyzed the significance of total body scintigraphy with 201Tl in the follow-up of patients with differentiated thyroid cancer, both in the preablation and ablated stages. METHODS: Prospective assessment was performed in 116 patients who were involved in 178 studies (115 in preablation and 63 after ablation). For ablation, an absence of uptake in the thyroid bed was required in the total 131I follow-up scan after 131I ablation therapy. Each study consisted of a 201Tl scan performed while the patient was receiving thyroid hormone therapy, an 131I scan performed when endogenous thyroid-stimulating hormone levels were higher than 50 mlU/ml and determination of thyroglobulin (Tg) concentration using the same sample. RESULTS: In the 115 scans in the preablation group, the findings for 201Tl and 131I agreed in 26 scans and disagreed in 89 scans. In 59 discordant studies, only 131I detected focal accumulation, and, in 54 of these, Tg levels were undetectable. Of the other 30 discordant studies, 201Tl and 131I detected focal uptake in 27 studies, although they did not reveal the same lesions, and in 3 studies, only 201Tl detected focal accumulation; in these 30 studies, the association of detectable Tg predominated. Of the 63 studies in the ablated group, the results agreed for the two tracers in 49 and disagreed in 14 studies. In 13 of the 14 discordant studies, 201Tl detected focal uptake, and, in 10 of these, Tg was detectable. Thus, 31 of the 116 patients assessed (15 preablation and 16 ablated) had at least one lesion that was detected by 201Tl but not detected by 131I. A definitive diagnosis could be established in 26 patients, and the presence of thyroid cancer was confirmed in 23. The sensitivity and specificity in the ablated group were 94% and 96%, respectively, for 201Tl and 29% and 100%, respectively, for 131I. CONCLUSION: The high sensitivity of 201Tl scintigraphy in detecting tumor tissue indicates that the inclusion of this technique in the follow-up of patients with differentiated thyroid carcinoma should be considered in both the preablation and the ablated stages.

Adenocarcinoma, Follicular↗
PubMed1996

Assessment of cerebral blood flow in diabetic patients with no clinical history of neurological disease.

We assessed cerebral blood flow in 78 diabetic patients (40 Type 1 and 38 Type 2) with no previous history of central nervous system disease using 99Tcm-hexamethylpropylene amine oxime (99Tcm-HMPAO) single photon emission tomography (SPET) and found areas of severe hypoperfusion in 36% of them. All cerebral anatomical regions showed abnormalities related to hypoperfusion, but they were most frequently seen in the fronto-temporal region, followed by the occipital and parietal regions. 99Tcm-HMPAO SPET has been shown to be able to detect subclinical alterations in blood flow in diabetes, a finding that may account for the high prevalence of cerebrovascular disease seen in these patients. This technique could, therefore, play an important role in future preventative strategies.

Adult↗
PubMed1992

Ga-67 citrate scan in vascular graft infection.

The clinical utility of the Ga-67 scan has been studied in 9 patients with clinical suspicion of vascular graft infection. Eleven grafts were analyzed: 4 aortobifemoral, 2 iliofemoral, 3 femoropopliteal, 1 axillofemoral, and 1 axillobifemoral. The Ga-67 scan was positive in 8 grafts with bacteriological proof of infection and negative in 3 grafts in which infection was ruled out by clinical follow-up. A Ga-67 scan also demonstrated the spread of infection to the thigh in two patients and to the pelvis in another two patients. In 4 patients CT was performed. The CT findings included graft thrombosis, perigraft fluid collection and thickened graft wall. No discrepancies were found between the CT scan and Ga-67 scan. In three patients a control Ga-67 scan was carried out after specific antibiotic and surgical treatment. Two of these showed increased Ga-67 uptake and spreading of infection along the graft; in the other patient, a Ga-67 scan revealed normalization after resolution of an abdominal abscess. In conclusion, the Ga-67 scan proved useful in the diagnosis of vascular graft infection, the definition of location of the extent of the disease and in the evaluation of the efficiency of treatment.

Aged↗
PubMed1991

Detection of mediastinitis after heart transplantation by gallium-67 scintigraphy.

We report the findings of a patient with post-cardiac transplant mediastinitis detected by 67Ga-citrate imaging. Fever and leukocytosis were the first clinical signs suggesting infection. The usual diagnostic modalities, including CT and ultrasound, failed to identify the site of infection. A 67Ga scan showed intense abnormal uptake behind the sternum. The site of uptake was shown by necropsy to be necrotic tissue involving cardiac sutures, pulmonary arteries, and the aorta due to infection with Haemophilus aphrophilus.

Citrates↗
PubMed1980

Contribution of radioisotope CAT to the detection of recurrent tumour in the brain.

Two cases are described showing the value of Radioisotope Computerized Axial Tomography in the early detection of tumour recurrence in the brain. The possibility of recurrence could not be excluded from the information provided by the conventional views since the suspicious areas found could be due to post-operative uptake. In the first case, reliable identification of tumour recurrence was provided by the transverse section scan through the suspicious area. In the second case, the transverse scan showed the uptake to be due to previous craniotomy.

Brain Neoplasms↗
PubMed1979

Cranial scintigraphy: value of adding emission computed tomographic sections to conventional pertechnetate images (512 cases).

A prospective trial was carried out to assess the contribution made by a radionuclide transverse-section view to conventional radionuclide scans of the brain. Each set of scans was reported by two independent teams of observers, but only one team viewed the tomography section. An abnormality rating was used to decide whether a set of scans was positive or normal. The reports for 512 patients were analyzed and compared with the final independent diagnosis. Greater accuracy of diagnosis with the section view was significant at the 0.1% level; the results showed that failure to detect tumors was almost halved while there was a 16% improvement for the detection of infarcts. Abnormality ratings were also used to plot ROC curves and rating curves; these showed that the addition of the tomographic view increased markedly the proportion of true positives without any increase in the proportion of false-positive reports.

Brain Neoplasms↗
PubMed1977

Value of radioisotope axial tomography in the diagnosis of a cystic malignant glioma.

A case is presented in which the patient had a deep tumour in the posterior aspect of the temporal lobe close to midline. The brain scan including a transverse section view at 8 cm from the vertex was negative and the other neuroradiological examinations inconclusive. One month later a follow up brain scan was performed and the conventional views were negative whereas the transverse section scan done at 10 cm from the vertex showed a lesion in the left temporo-parietal region and near midline. Three months later a repeat brain scan was done, and the lesion was visualized in the conventional views and confirmed by angiogram.

Adult↗
PubMedDate not supplied

[Effect of attenuation correction and scatter compensation on the 99mTc-MIBI myocardial perfusion spect in patients without coronary artery disease].

OBJECTIVE: Attenuation correction (AC) and scatter compensation (SC) techniques are recent developments of myocardial perfusion SPECT. Our aim was to evaluate the effect of AC + SC on the myocardial distribution of 99mTc-MIBI in a population without coronary artery disease. MATERIAL AND METHODS: A multiarray of Gd-153 linear sources was used for simultaneous transmission/emission 99mTc-MIBI myocardial perfusion SPECT in 27 patients without coronary artery disease. A visual analysis and polar map quantification was performed. Changes between non-corrected (NC) and corrected (AC + SC) studies were compared. RESULTS: AC + SC produced an increase in liver activity and better visualization of the right ventricle. Intestinal activity increased in six patients. Myocardial homogeneity was increased by AC + SC. No differences by gender were observed after AC + SC. In females AC + SC led to a decrease of uptake in the anterior wall, apex and apical segments of the lateral wall and septum, and an increase in the inferior wall. In males AC + SC caused an increase of uptake in the inferior wall and in the basal segments of septum and a decrease of uptake in apex and apical segments of anterior and lateral walls. AC + SC generated false defects in the anterior wall of five patients. CONCLUSIONS: Our results show the usefulness of AC + SC for compensating the interferences produced by attenuation on the myocardial distribution of 99mTc-MIBI. Because AC + SC may introduce false defects, it must not be applied to normal perfused myocardium.

Adult↗
PubMedDate not supplied

[Scintigraphic image in a case of atypical presentation of Burkitt lymphoma. The role of the scintigraphy with 67Ga SPECT in the diagnosis and post-treatment control].

We present a case of Burkitt's disease with bone (thoracic wall, femur) and lymph node involvement. The patient had symptoms of fever with thoracic wall and femur pain. Lymph node involvement was detected by clinical exploration. A chest X-ray showed rib abnormalities. 99mTc-DPD scan showed thoracic wall (one rib) and femur involvement. 67Gallium SPECT and CT were performed at diagnosis. 67Gallium SPECT showed thoracic wall (one rib more) and abdominal lymph node involvement that was not detected by planar images. A CT scan did not show metastatic disease in mediastinal and abdominal lymph node chains but did show it in one rib and femur. After 6 chemotherapy sessions a new 67gallium scan and CT scan were performed. 67Gallium SPECT showed involvement in the thoracic wall (one rib) that was not detected in planar images. The CT scan was considered normal.

Adolescent↗
PubMedDate not supplied

[Diagnostic accuracy of the SPECT of post-stress myocardial perfusion with attenuation and scatter correction].

OBJECTIVE: To evaluate the effect of attenuation and scatter correction (AC-SC) on the diagnostic accuracy of post-stress myocardial perfusion (MP) SPECT. MATERIAL AND METHODS: The retrospective analysis included 121 patients who had a non-corrected (NC) and AC-SC 99mTc-Tetrofosmin MP SPECT after stress. The left ventricle was divided into 13 segments. Two observers performed a visual assessment of the MP on a scale from 0 (perfusion defect) to 3 (normal uptake). A consensus on concordances and discordances between the NC and AC-SC images was established. Final diagnosis of coronary artery disease (CAD) was established by coronary angiography (CANG) (stenosis > or = 70 %). RESULTS: The combined analysis of NC and AC-SC images produced 93 concordances and 28 discordances. Of the 93 concordances, both studies were abnormal in 67 patients (abnormal CANG in 57) and normal in 26 patients (normal CANG in 20). Among the 28 discordances, 23 were abnormal NC/normal AC-SC (normal CANG in 18) and 5 normal NC/abnormal AC-SC. In these 5 patients AC-SC generated anterior perfusion defects but the CANG was normal. Overall, the appearance of NC and AC-SC images were in agreement with the CANG findings in the 72 % (87/121) and 78 % (95/121) of the patients, respectively. Sixty-seven of the 90 patients with abnormal NC had also abnormal AC-SC (abnormal CANG in 57) and the other 23 had normal AC-SC (normal CANG in 18). The appearance of AC-SC was in agreement with CANG finding in the 83 % (75/90) of patients with abnormal NC. MP abnormalities in NC normalized by AC-SC were more frequently located in inferior wall CONCLUSION: AC-SC improves the diagnostic accuracy of post stress NC MP SPECT for the diagnosis of CAD. From these results we consider that AC-SC is of clinical value for the correction of attenuation artifacts, more frequently observed in the inferior wall. The presence of antero-apical perfusion defects in AC-SC with normal NC does not mean CAD. So it is necessary to adjust the normalcy pattern of MP SPECT when AC-SC is performed.

Adult↗
PubMedDate not supplied

Decreased plasma endothelin-1 levels in asymptomatic type I diabetic patients with regional cerebral hypoperfusion assessed by Spect.

The prevalence of stroke is increased in diabetic patients. The vasoconstrictor peptide endothelin-1 (ET-1) has been implicated in the development of cerebral vasospasm after stroke but its role in the physiological regulation of cerebral blood flow (CBF) is not well known. Our aim was to assess the relationship between CBF and plasma ET-1 levels in type I diabetic patients. Regional CBF was assessed semi-quantitatively by 99Tc(m)-hexamethylpropylene-amine-oxime (99Tc(m)-HMPAO) single photon emission computed tomography (SPECT) in 50 cerebral "regions of interest" (ROIs) of 19 type I diabetic patients without clinical evidence of cerebral disease, and 10 healthy control subjects. In both groups, plasma ET-1 levels were measured. Results showed that type I diabetic patients had significantly more hypoperfusion ROIs than control subjects. While up to 68.4% of the type I diabetic patients showed 3 or more hypoperfusion ROIs, only 10% of the control subjects did. Plasma ET-1 levels were lower in the type I diabetes subgroup with 3 or more hypoperfusion ROIs than in the type I diabetes subgroup with less than 3 hypoperfusion ROIs and in the control group. Moreover, an inverse correlation between the number of hypoperfusion ROIs and plasma ET-1 levels (r = 0.47, p = 0.04) was found in the type I diabetes group. It is concluded that plasma ET-1 is decreased in type I diabetic patients with subclinical abnormalities of regional CBF assessed by cerebral SPECT. This fact may reflect a compensatory response to the reduction of the brain perfusion in order to prevent ischemic events in these patients.

Adult↗