Biomedical subjects
S Challa
Publications and source records attributed to S Challa.
Positron emission tomography with f18-fluorodeoxyglucose in the staging and preoperative evaluation of malignant pleural mesothelioma.
OBJECTIVES: The purpose of this study was to evaluate the utility of positron emission tomography with F18-fluorodeoxyglucose in the preoperative evaluation and staging of malignant mesothelioma in patients who were candidates for aggressive combined modality therapy. METHODS: Eighteen consecutive patients with biopsy-proven malignant mesothelioma underwent positron emission tomographic scanning. The results of positron emission tomographic imaging were compared with results obtained by computed tomography, mediastinoscopy, thoracoscopy, and pathologic examination of surgical specimens. All patients fasted and received an average of 14.5 +/- 2.7 mCi of F18-fluorodeoxyglucose for positron emission tomographic scanning. Attenuation-corrected whole-body and regional emission images of the chest and upper abdomen were acquired and formatted into transaxial, coronal, and sagittal images. RESULTS: All primary malignant mesotheliomas accumulated F18-fluorodeoxyglucose, and the mean standardized uptake value was 7. 6 (range, 3.33-14.85; n = 9). There were no false-negative results of positron emission tomography. Identification of occult extrathoracic metastases by positron emission tomography was the basis for excluding two patients from surgical therapy. There were two false-positive results of positron emission tomography: increased F18-fluorodeoxyglucose uptake in the contralateral chest that was negative by thoracoscopic biopsy (n = 1) and increased abdominal F18-fluorodeoxyglucose uptake after partial colectomy for diverticular disease (n = 1). CONCLUSIONS: Positron emission tomography can identify malignant pleural mesothelioma and appears to be a useful noninvasive staging modality for patients being considered for aggressive combined modality therapy.
An unusual presentation of non-Hodgkin's lymphoma: a case report.
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Floating gallbladder: a questionable prelude to torsion: a case report.
A 55-year-old woman had recurrent bouts of low substernal and epigastric pain radiating into the interscapular region. A hepatobiliary scan initially showed what was believed to be a dilated common bile duct and nonvisualization of the gallbladder. A delayed image obtained after having the patient move about revealed the presence of a filled gallbladder and normal common bile duct. The combination of recurrent pain with this scintigraphic picture may be representative of a floating gallbladder or an incomplete torsion with spontaneous detorsion. This case is presented to describe the scintigraphic appearance of a mobile gallbladder that may be prone to volvulus and to emphasize the importance of obtaining decubitus or oblique views at the end of a hepatobiliary study in selected cases of unusual findings.
Unusual appearance of thromboembolism on perfusion lung imaging.
A 46-year-old woman with advanced ovarian carcinoma had progressive dyspnea and was evaluated with ventilation and perfusion lung imaging. A characteristic pattern of multiple branching perfusion defects of a segmental nature on the perfusion scan suggested tumor microembolism and lymphangitic carcinomatosis. However, in this case, this pattern was associated with pulmonary thromboembolism and was documented by the post mortem examination. Pulmonary thromboembolism should be included among the differential diagnoses in a patient with clinical symptoms and a perfusion scan that reveals multiple branching perfusion defects.
Extraskeletal uptake of technetium-99m-MDP in sites of heparin administration.
A 19-yr-old woman with juvenile diabetes and protein C deficiency was referred for a bone scan to rule out osteomyelitis of the right tibia. The bone scan did not reveal evidence of osteomyelitis. There was, however, extraskeletal uptake of the 99mTc bone tracer in the anterior abdominal wall confined to the sites of subcutaneous heparin administration. This case is presented because of its interesting scintigraphic findings and to discuss the association of protein C deficiency and heparin administration as a cause of extraskeletal 99mTc bone tracer accumulation.
Relative sensitivity of Tc-99m WBC versus In-111 WBC in a patient with Crohn's disease on steroids.
Numerous studies have shown that chemotaxis is affected by certain antibiotics and steroids. A patient had Crohn's disease in relapse with multiple small bowel fistulae and mesenteric abscesses. Although the Tc-99m WBC scan did not show the intra-abdominal inflammatory foci, an In-111 WBC scan performed within a week delineated the abscesses and these were later confirmed at surgery. This case is being presented not only to show the relative sensitivities of a Tc-99m WBC vs. an In-111 WBC scan, but also to discuss the impediment to polymorphonuclear leukocyte chemotaxis by steroids, which may be a contributory factor to the sensitivities of the different radiopharmaceuticals selected for detection of intra-abdominal septic foci.
Pancreatitis secondary to endoscopic retrograde cholangiopancreatography on a whole-body Ga-67 scan.
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Relative sensitivity of Tc-99m WBC versus In-111 WBC in a patient with Crohn disease and steroid use.
Numerous studies have shown that chemotaxis is affected by certain antibiotics and steroids. The authors present the case of a patient with Crohn disease relapse with multiple small-bowel fistulae and mesenteric abscesses. Whereas the Tc-99m WBC scan failed to show the intra-abdominal inflammatory foci, an In-111 WBC scan performed within a week delineated the abscesses very well, and these were later confirmed at surgery. This case is presented not only to illustrate the relative sensitivities of a Tc-99m WBC versus an In-111 WBC scan, but also to discuss the impediment to polymorphonuclear chemotaxis by steroids, which may be a contributory factor to the sensitivities of the different radiopharmaceuticals selected for detection of intra-abdominal septic foci.
Symmetric tibial stress fractures from extensive jump roping.
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Ga-67 uptake in a perisplenic fluid collection: planar and SPECT images.
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Radiology of pancreatic tuberculosis: a report of three cases.
We report three cases of biopsy proven pancreatic tuberculosis. The patients presented with abdominal pain and intermittent fever. Ultrasound and computed tomography revealed a diffusely enlarged pancreas with focal hypoechoic/hypodense lesions in all three patients. In addition, one patient had a large pancreatic cyst with internal echoes. Associated findings included peripancreatic and mesenteric lymph nodes, bowel wall thickening of ileocecal junction, focal hepatic or splenic lesions, splenic vein thrombosis, and ascites. Pancreatic tuberculosis should be considered in the differential diagnosis of focal pancreatic lesions, especially if associated with ancillary findings such as enlarged hypodense nodes in the peripancreatic region or in the mesentery in patients presenting with longstanding fever and abdominal pain.
Haemorrhagic pseudocyst of the adrenal in an adult (a case report).
An adult female patient presenting with a cystic abdominal mass and intermittent fever, was found at surgery to have a large cyst of the left adrenal gland. The imaging findings and pathology of this uncommon entity are discussed.
Pulmonary alveolar microlithiasis.
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