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Biomedical subjects

L C Swayne

Publications and source records attributed to L C Swayne.

At least 37 records · Page 2Linked to original sources
PubMed1995

Three-phase bone imaging in bone marrow edema of the knee.

Transient bone marrow edema has been thought to be related to other similar entities including transient regional osteoporosis and spontaneous osteonecrosis. Although the findings of three-phase bone imaging have been described in osteonecrosis, scant attention has been paid in the nuclear medicine literature to patients with transient bone marrow edema. The authors report the findings of three-phase bone imaging in two patients with knee pain and a transient bone marrow edema pattern as documented by MRI.

Bone Marrow Diseases↗
PubMed1995

Indium-111-white blood cell detection of postradiation vesicocutaneous fistulas.

We present a case of urinary bladder fistulization which occurred approximately 25 yr after successful radiation therapy for uterine carcinoma. The extensive fistulas were detected with 111In-oxine-labeled white blood cell scintigraphy and were confirmed with a fistulogram, computed tomography and surgery. Scintigraphy was valuable for both initial detection as well as staging the extent of inflammation for subsequent diagnostic studies and surgical resection.

Cutaneous Fistula↗
PubMed1994

Scintigraphic localization of the bleeding site of a large retroperitoneal hematoma following renal angioplasty.

Although the scintigraphic detection of a few soft tissue hematomas have been reported, these usually have been serendipitous discoveries that were small and self-limited. The authors report a case of a large, rapidly expanding retroperitoneal hematoma that occurred following a left renal angioplasty. While the hematoma was initially detected by CT imaging, the precise source of the bleeding could not be definitively localized. Scintigraphy with labeled RBC cells, however, identified the left femoral artery puncture site as the bleeding source, which was subsequently surgically repaired.

Aged↗
PubMed1994

Credentialing of crossover privileges in fluoroscopy for nonradiologists.

PURPOSE: To comply with federal and state guidelines, a credentialing process was developed for nonradiologist medical users of fluoroscopy. MATERIALS AND METHODS: Seventy-three nonradiologist physicians participated in a program consisting of (a) an introductory 1-hour lecture; (b) a 10-page booklet providing basic information on radiation physics, radiobiology, and radiation safety; and (c) successful completion of a 15-question self-study quiz on fluoroscopy RESULTS: Mean fluoroscopy times per surgical case were compared for a 7-month period before (7.01 minutes in 201 cases) and after (4.39 minutes in 396 cases) the program and showed a 37.4% decrease (P < .05). Participating physician attitudes were surveyed at the completion of the program and showed an average physician time investment of 2 1/2 hours and a 4.1 approval rating for the credentialing program on a 5-point Likert scale. CONCLUSION: This fluoroscopic credentialing process for nonradiologist medical users (a) achieved a statistically significant reduction in fluoroscopic time per surgical case, (b) required a minimal investment of physician time, and (c) was well received by the medical staff.

Credentialing↗
PubMed1994

Accuracy of SPECT thallium studies in a community hospital.

The present study shows an overall accuracy to the Cedars-Sinai trial on a patient and a combined vascular territory basis. These results suggest SPECT thallium studies can provide information despite the referral biases and unselected patient population inherent in a busy clinical practice.

Adult↗
PubMed1994

Immunoscintigraphy of Pneumocystis carinii pneumonia in AIDS patients.

UNLABELLED: The diagnosis of Pneumocystis carinii pneumonia (PCP) currently relies upon cytological demonstration of the organism in sputum or bronchoscopy specimens. The purpose of this study was to develop a radiolabeled monoclonal antibody (Mab) against Pneumocystis carinii (P. carinii) and to evaluate its use for imaging PCP. METHODS: We studied 16 HIV-infected patients with pneumonia in order to evaluate a new Mab-based imaging method for diagnosing PCP. Most patients were managed for opportunistic pneumonia associated with AIDS, including standard cytological tests, and, in all cases, intensive chemotherapy. Prior to the clinical study, the Mab raised to P. carinii was shown to react with human P. carinii but not with rat P. carinii or human white blood cells. RESULTS: After labeling a 1-mg Mab Fab' fragment with 30 mCi of 99mTc, the presence or absence of PCP could be confirmed in six of seven or seven of eight assessable patients, respectively, by external photoscanning within 24 hr. This shows a sensitivity of 85.7% and a specificity of 86.7%. CONCLUSION: Our findings suggest that PCP can be diagnosed by a noninvasive imaging method employing a small dose of a 99mTc-labeled Mab showing specificity for the infectious organism, since patients with P. carinii-free pneumonia were correctly negative in 87.5% of cases. Rapid diagnosis and organ-localization of other infectious lesions with organism-specific, radiolabeled Mabs may be feasible.

AIDS-Related Opportunistic Infections↗
PubMed1992

Lymphoma imaging with a new technetium-99m labelled antibody, LL2.

The lesion detection capability of a new technetium-99m labelled B-cell lymphoma monoclonal antibody (MoAb) imaging agent, LL2, was evaluated in 8 patients with non-Hodgkin's lymphoma and 1 patient with chronic lymphocytic leukaemia. The MoAb kit consists of a 1-vial, 1-mg Fab' form of LL2 ready for instant labelling with technetium. The patients were injected with approximately 925 MBq (25 mCi) of 99mTc-LL2 Fab' (1 mg), and planar and single photon emission tomography (SPET) studies were performed at 3-4 h post injection and at 24 h. There was no evidence of thyroid or stomach activity up to 24 h. Uniform splenic uptake was seen in all patients. Two non-lymphoma patients were also administered with the same agent and demonstrated a similar splenic distribution; therefore, splenic targeting was not scored as tumour-specific. A total of 29 from 48 tumour sites were detected by scintigraphy, including tumours of various grades and histological types. Excluding 1 patient who had a large tumour burden of over 500 g, 29 of 33 lesions were detected. One patient was free of disease at the time of the study and had a negative scan. Another patient showed excellent targeting of gallium-negative sites in the liver and bone. The bone involvement was not known prior to the antibody study and was subsequently confirmed by a bone scan. Additional sites of MoAb localization could not be followed in this group, since most patients went on to radioimmunotherapy immediately following the 99mTc-LL2 study.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Monoclonal↗
PubMed1992

The correlation between three methods of skin perfusion pressure measurement: radionuclide washout, laser Doppler flow, and photoplethysmography.

The most accurate measurement of skin perfusion pressure is made with use of radioisotopic clearance techniques. We compared the skin perfusion pressure using radioisotope to the skin perfusion pressure measured simultaneously by placing laser Doppler and photoplethysmography probes within a transparent polyvinylchloride plastic blood pressure cuff in 13 subjects. A new device, which was created for this experiment, consisted of a plastic bladder into which light-emitting probes can be placed, so that the pressure applied to the skin was transmitted by the surface of the bladder, rather than by the surface of a rigid probe. The cuff was inflated to a supra-systolic pressure over the intradermal injection site of technetium Tc 99m, then deflated in 10 mm Hg decrements at 3-minute intervals. The pressures at which radioisotope clearance began, at which microcirculatory flow was detected by laser Doppler, and at which deflection of the photoplethysmography (DC mode) output occurred, were recorded as the skin perfusion pressure. The range of radioisotopic determined skin perfusion pressure was 0 to 100; skin perfusion pressure-laser Doppler was 0 to 100; and skin perfusion pressure-photoplethysmography was 60 to 100, with 7 of 13 limbs demonstrating no clear deflection point and thus an unobtainable skin perfusion pressure-photoplethysmography reading. Linear regression revealed a coefficient of correlation of 0.991 for skin perfusion pressure when the radioisotopic and laser Doppler methods were compared. Our study is not in agreement with previous reports of the successful determination of skin perfusion pressure with use of photoplethysmography. This may be due to differences in our technique when compared with previous reports of skin perfusion pressure-photoplethysmography determination.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Change in presentation of breast cancer in a community hospital.

An aggressive mammographic screening program under the auspices of a community hospital resulted in a significantly earlier detection of breast cancer at presentation in 1990 as compared to 1980. It is anticipated that further followup will show a reduction in cancer mortality as a result of this earlier detection.

Adult↗
PubMed1992

Computer-assisted fusion of single-photon emission tomographic and computed tomographic images. Evaluation in complicated inflammatory disease.

Fusion of single-photon emission computed tomographic (SPECT) and x-ray computed tomographic (CT) images can facilitate the direct comparison of function and anatomy by simultaneously displaying comparable cross-sectional images. A computer-assisted fusion method was used to prospectively evaluate 10 patients with suspected inflammatory disease complicated by an associated condition. CT images were transferred to the nuclear computer. Image fusion was accomplished with standard scaling, rotation, translation, and stretching transformations, using anatomic or external landmarks. SPECT-CT fusion correctly localized the inflammatory process in all 10 cases and facilitated percutaneous drainage or preoperative surgical planning in 6.

Adolescent↗
PubMed1991

Granulomatous prostatitis: a hypoechoic lesion of the prostate.

Numerous benign and malignant entities can disrupt the normal prostatic parenchymal architecture producing hypoechoic lesions in the peripheral zone. We report two cases of granulomatous prostatitis mimicking carcinoma. The differential diagnosis of hypoechoic lesions and the etiologies of granulomatous prostatitis are discussed. All hypoechoic lesions in the peripheral zones of the prostate require biopsy for histologic diagnosis.

Administration, Intravesical↗
PubMed1991

False-positive hepatic blood pool scintigraphy in metastatic colon carcinoma.

A rare false-positive red blood cell scintigram occurred in a 49-year-old woman with two metastases from a primary adenocarcinoma of the sigmoid colon. Although the blood flow and static planar images were unremarkable, a 1-hour postinjection SPECT study showed a focus of increased activity in the inferior right lobe and a second photopenic focus in the dome. Following a trisegmentectomy, pathologic examination revealed the two metastases with no evidence of a hepatic hemangioma. Microscopy, however, showed a discrete area of nonspecific reactive changes (focal sinusoidal dilation and congestion) immediately adjacent to teh metastasis in the inferior right lobe. It is postulated that the SPECT focus of increased activity occurred secondary to the labeled blood pool within the area of sinusoidal dilation, rather than within the adjacent metastasis.

Adenocarcinoma↗