Imaging: magnetic resonance imaging (MRI).
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Brain↗
Biomedical subjects
S D Richman
Publications and source records attributed to S D Richman.
Digital subtraction angiography.
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Angiography↗
Superselective transcatheter embolization of traumatic renal hemorrhage.
Selective angiography is an established diagnostic modality in acute renal trauma [1-3]. Renal hemorrhage, once demonstrated by angiography, can then be treated by arterial embolization [4-5]. This paper describes the successful transcatheter management of a renal laceration in a patient with multiple injuries secondary to an abdominal gunshot wound. Adominal exploration had established that the renal hemorrhage could not be surgically controlled without performing a nephrectomy.
Adult↗
Mediastinoscopy: a diagnostic aid in metastatic carcinoma of the breast.
Six patients with metastatic carcinoma of the breast underwent mediastinoscopy to obtain tissue for estrogen receptor analysis and pathologic confirmation of metastatic tumor. The indication for mediastioxcopy was an abnormal mediastinal accumulation of gallium in five patients, only two of whom had an abnormality noted on tomography. All six patients had tumor recovered by mediastinoscopy as demonstrated by pathologic examination and/or estrogen receptor assay, Therefore, the diagnosis of mediastinal metastases in breast cancer may be suggested by either chest roentgenograms, mediastinal tomography, or gallium scintigraphy. Mediastinoscopy is a safe, effective procedure capable of establishing the diagnosis of metastatic carcinoma of the breast and of procuring sufficient tissue for estrogen receptor analysis in patients without more readily accessible sites of metastases.
Adult↗
Abnormal pulmonary gallium accumulation in P. carinii pneumonia.
The potentially fatal interstitial pneumonia of Pneumocystis carinii is a frequent opportunistic invader of patients treated for malignancy with immunosuppressive and cytotoxic agents. Generalized Ga-67 pulmonary localization which is markedly disproportionate to the clinical and radiographic findings has led to earlier diagnoses by open lung biopsy in this setting. The potential usefulness of gallium scintigraphy in patients with suspected P. Carini pneumonia is presented.
Adult↗
67Ga accumulation in pulmonary lesions associated with bleomycin toxicity.
The radionuclide, gallium-67, accumulates in a wide variety of neoplastic and inflammatory lesions. Diffuse bilateral lung localization of 67Ga occurred in two cases of interstitial pneumonitis associated with bleomycin therapy. Clinical symptoms and laboratory evaluation of pulmonary status correlated with scintigraphic studies in these two patients, while discrepancies between scintigraphic and roentgenographic findings were observed.
Bleomycin↗
Radionuclide studies in Hodgkin's disease and lymphomas.
A rational, multidisciplinary approach to Hodgkin's disease and the non-Hodgkin's lymphomas has been responsible for major advances in therapy. Invasive diagnostic procedures and exploratory laparotomy, with their associated complications, make nontraumatic radionuclide imaging most appealing in both the clinical staging of disease and in evaluating therapy. Gallium-67-citrate, the tumor scanning agent of the early 1970's, has demonstrated a marked affinity for Hodgkin's disease and the other lymphomas. False positives are few, with sensitivity greater than 70% throughout the spectrum of Hodgkin's disease and the histiocytic lymphomas. In addition to confirming sites of suspected neoplasm, this agent has proved useful in the detection of occult involvement. Moreover, resolution of abnormal gallium-67 concentrations on follow-up studies functions as a visual ancillary index of therapeutic response. The value of wholebody gallium-67 scintigraphy is further enhanced when used in conjunction with routine technetium brain, bone, liver, and spleen scans. While the diagnostic accuracy of gallium-67 studies has been limited in the abdomen due to bowel activity, our attempts to improve these results with the tumor-seeking radiopharmaceutical indium-111-Bleomycin were unrewarding and subsequently were discontinued. Finally, radionuclide lymphography has also been explored. Its diagnostic usefulness in detecting pelvic and abdominal lymph node involvement warrants further investigation.
Adult↗
Renal localization of gallium-67 citrate.
Renal localization of 67Ga citrate has been observed in 1.7% of 2,000 whole-body gallium scans in three major diseases: lymphoreticular neoplasms, leukemia, and malignant melanoma. Correlation of this finding with autopsy data in 13 cases revealed 9 with tumor and 2 with an inflammatory process. Findings in two cases were normal. In the remaining patients, correlation with abnormal urograms and laboratory data was poor. Nevertheless, gallium localization in the kidneys may be the first indicator of renal involvement with either tumor or inflammation.
Citrates↗
67Ga radionuclide imaging in Burkitt's lymphoma.
Whole-body gallium imaging was evaluated as a diagnostic tool for 14 patients with Burkitt's lymphoma, and a dramatic gallium affinity for the tumor was demonstrated. The gallium image is recommended as a staging procedure and as an effective test for determining the therapeutic response.
Adolescent↗
Breast scintigraphy with 99mTc-pertechnetate and 67Ga-citrate.
Radionuclide breast scintigraphy was evaluated as a noninvasive tumor-localizing modality. Technetium-99m-pertechnetate (99mTcO4) demonstrated good correlation between malignancy and postive scintigraphy (88% accuracy in 16 cases of breast carcinoma). The high false-positive rate (29% of proven benign breast disease) limits the use of 99mTcO4 as an aid to differential diagnosis. Gallium-67-citrate (67Ga) is limited as a diagnostic adjunct (localizing in only five of ten breast malignancies). Refined techniques of positioning, shielding, gamma camera imaging, and computer assistance have helped in visualizing abnormal radionuclide accumulation.
Adult↗
Usefulness of gallium scintigraphy in primary and metastatic breast carcinoma.
Gallium-67-citrate whole-body scintigraphy was incorporated into the evaluation of 125 patients with primary and metastatic breast carcinoma. A prospective analysis of these patients demonstrated gallium scanning to be limited in its corroborative value and of practical use only in detecting metastatic breast carcinoma in the mediastinum. Since the extent of tumor involvement is a significant prognostic factor, the gallium scan merits consideration for the detection of mediastinal metastases.
Adult↗