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PubMedDate not supplied

The prognostic value and significance of serial bone scintigraphy in Legg-Calvé-Perthes disease.

We reviewed 44 consecutive patients treated for Legg-Calvé-Perthes disease who underwent serial technetium 99m diphosphonate bone scintigraphy. The average follow-up was 4.4 years. The bone-scintigraphy classification characterizes the A pathway by early lateral column formation not seen in the B pathway. Pathway A had 20 hips. The average age at presentation was 6.1 years. At last follow-up, this group had an average Mose classification of 1.2 and Catterall score of 2.4, without any patient having "head-at-risk" signs or requiring operative treatment. Pathway B had 20 hips. The average age at presentation was 5.8 years. At last follow-up, this group had an average Mose classification of 5.2, a Catterall score of 3.5, and 18 patients had head-at-risk signs, with 11 requiring operative treatment. Our bone-scintigraphy classification preceded the radiographic head-at-risk signs by an average of 3 months, allowing earlier treatment and correlated with subsequent femoral head involvement.

Child↗
PubMed1987

Antibody to endotoxin core glycolipid reverses reticuloendothelial system depression in an animal model of severe sepsis and surgical injury.

To study the effect of severe sepsis on the function of the reticuloendothelial system (RES) we have measured the clearance kinetics and organ distribution of both low-dose technetium tin colloid (TTC) and 75selenomethionine-labelled E. coli in rabbits 24 hours after either sham laparotomy or appendix devascularization. Sepsis resulted in similar delayed blood clearance and reduced liver (Kupffer cell) uptake of both TTC and E. coli. To investigate the ability of polyclonal antibody to E. coli-J-5 (core glycolipid) to improve RES function in the same model of sepsis, further animals were pretreated with either core glycolipid antibody or control serum (10 ml IV) 2 hours before induction of sepsis. TTC clearance kinetics were determined 24 hours later. Antibody pretreated animals showed: a reduced incidence of bacteremia; normalization of the rate of blood clearance and liver uptake of TTC; and a 'rebound' increase in splenic uptake of TTC. We conclude that antibody to E. coli-J-5 enhances bacterial clearance by the RES.

Animals↗
PubMed1995

Detection of acute bacterial infection within soft tissue injuries using a 99mTc-labeled chemotactic peptide.

OBJECTIVE: Infection imaging with a 99mTc-labeled chemotactic peptide was evaluated in a rabbit model of Escherichia coli infections in burned tissue. MATERIALS AND METHODS: The peptide was radiolabeled with 99mTc via the hydrazino nicotinamide derivative. Three groups of six animals were studied: (group A) unilateral infected burns; (group B) bilateral burns with unilateral infection; and (group C) uninfected burns. Twenty-four hours after injury, groups A and B were infected, and 8 hours later, all animals were injected with approximately 0.50 mCi of 99mTc-peptide. MEASUREMENTS AND MAIN RESULTS: In groups A and B, excellent images of the infections were obtained at 3 to 4 and 16 to 18 hours after injection of the peptide. At 3 to 4 hours after injection, the target-to-background ratios (T/B) were 3.12 +/- 0.28 for group A and 4.33 +/- 0.61 for group B (p = n.s.). At 16 to 18 hours, the T/B ratios increased significantly (p < 0.01): group A = 8.10 +/- 1.03 and B = 7.70 +/- 1.25. The T/B ratio for group C was only slightly greater than unity. CONCLUSIONS: These results indicate that 99mTc-labeled chemotactic peptides are effective radiopharmaceuticals for the rapid detection of focal sites of infection within thermally injured tissues.

Animals↗
PubMed1984

Measurement of 24 hour whole body retention of 99Tcm-diphosphonate by a single thyroid probe.

In a comparative study with a thyroid probe and a whole body counter (WBC) we found that whole body retention (WBR) (2 h and 24 h) may be correctly obtained using a single probe, provided that measurements are taken carefully. With the detecting geometry presented, the single probe yielded only a slightly higher WBR than the WBC (less than 3 percentage points). We conclude that the method is capable of differentiating between pathological and normal WBR values.

Diphosphonates↗
PubMed1985

Nycthemeral variations of 99Tcm-labelled heparin pharmacokinetic parameters.

Six healthy volunteers (5 males and one female) received four i.v. boluses of 160 U.I. of 99Tcm-heparin at 8.00, 14.00, 20.00 and 02.00 hours at seven-day intervals. Nine blood samples were taken covering a period of 2 h after administration. Simultaneously urine was collected and diuresis was noted. Plasma and urinary radioactivity were measured and standard pharmacokinetic parameters were calculated. Nycthemeral variations of these kinetic parameters were detected by means of distribution-free tests. Circadian rhythms (period = 24 h) were analysed by means of the cosinor method and the Gauss-Marquardt method. The mean raw value of the following parameters: apparent volume of distribution, plasmatic clearance and extra-renal metabolic clearance, increased significantly between 8.00 and 14.00 (p less than 0.01) and decreased between 14.00 and 20.00 (p less than 0.05). A circadian rhythm was found for the plasmatic clearance only (p less than 0.04). On the other hand the elimination half-lives and the renal clearance were unaffected by the time of the injections. These results obtained for low doses of 99Tcm-heparin suggest a circadian rhythm of the bio-availability of heparin in man. This fact should be taken into account for the use of 99Tcm-heparin in the diagnosis of deep-vein thrombosis and for the safe adjustment of the heparin dosages in the treatment of severe thromboembolism.

Circadian Rhythm↗
PubMed1985

Normal volunteer studies with modified 99Tcm tin colloid.

99Tcm tin colloid, modified by the addition of various amounts of the surfactant Pluronic F68 was evaluated as a new liver imaging agent in normal adult male volunteers. The relative amounts taken up in the liver and spleen were measured by two quantitative methods with a view to establishing the most useful technique. The changes in biodistribution resulting from mechanical shaking during preparation of the colloids and in vitro ageing of the preparations were assessed. The pharmacokinetics of uptake into liver and spleen of the various formulations tested were independent of Pluronic F68 content. However, at low levels of Pluronic F68 the liver:spleen ratio decreased as the colloid preparation was aged before use. At high levels of Pluronic F68 there was increased background activity. An optimum formulation was identified combining low background activity with a stable pattern of biodistribution independent of preparation age.

Adult↗
PubMed1986

Liver scintiscanning as a screening test in the detection of alcoholic cirrhosis.

Ninety-nine patients with alcohol related problems underwent a liver scintiscan and biopsy. The scan changes were graded and compared with the histological changes found from percutaneous liver biopsy. The overall correlation between scan and biopsy changes was poor. However, scintiscanning was found to be highly sensitive (90%) in detecting cirrhosis and for this reason is useful as a screening test in selecting alcoholic patients for biopsy.

Biopsy↗
PubMed1986

Formation of labelled colloid in 99Tcm-DMSA due to the presence of bactericidal fluid.

The possibility that traces of bactericidal fluid in 99Tcm-DMSA could lead to the formation of labelled colloid, was explored. In vitro investigations were undertaken using ultracentrifugation techniques and photon correlation spectroscopy. The latter showed that both contaminated and uncontaminated DMSA contained colloidal (or particulate) material. However the presence of 10 microliters bactericidal fluid as contaminant was shown by ultracentrifugation to result in labelling of this colloidal material when 99Tcm was added to DMSA. Studies in a normal volunteer confirmed the results of the in vitro studies, in that significant liver and spleen uptake was observed after the administration of contaminated 99Tcm-DMSA.

Anti-Infective Agents, Local↗
PubMed1986

Biodistribution in rats of 99Tcm-labelled human serum albumin.

Three different 99Tcm-human serum albumin (HSA) preparations were simultaneously studied by high pressure liquid chromatography (HPLC) and gamma camera techniques in rats. The products contained variable amounts of 99Tcm-human albumin, 99Tcm-tin colloid and a 99Tcm-low molecular weight complex. The biological half life varied from 55 to 132 min and the bladder excretion for the first 60 min from 2 to 31%. Separated HPLC fractions of 99Tcm-albumin and 99Tcm-tin colloid both showed considerably longer biological half life when injected separately than when injected in the unfractionated preparation. A final evaluation of the quality of such products seem to require evaluation in humans.

Animals↗
PubMed1986

Formation of large particles in a 99Tcm-tin colloid preparation.

The effect of prolonged continuous movement on particle size within a 99Tcm-tin colloid preparation was investigated, making use of photon correlation spectroscopy for size estimation. No increase in particle size was found when the preparation was left undisturbed for up to 7 h, the mean (+/- S.D.) size being found to be 239 +/- 24 nm. When the preparation was placed in a laboratory rotator for the same period of time, there was a gradual increase in mean particle size to 404 +/- 127 nm. The increase in size was much greater, however, after 7 h of continuous agitation in a laboratory shaker, a mean value of 2260 +/- 746 nm being observed. An antimony sulphide colloid was subjected to continuous agitation for the same period of time but there was no evidence of aggregation. It is supposed that continuous movement of reconstituted 99Tcm-tin colloid, leading to a marked increase in particle size, may explain occasional instances of significant lung intake.

Humans↗
PubMed1986

99Tcm-(tin) colloid scans in the evaluation of renal transplant rejection.

Technetium-99m-(tin) colloid uptake in renal transplants was quantified to evaluate rejection. A dynamic acquisition following i.v. injection of 110 MBq of this radiopharmaceutical enabled quantification of 15 to 20 min transplant uptake (PU), in terms of percentage of an injected dose after allowing for attenuation in the patient. An uptake ratio (UR) i.e. the ratio of 15 to 20 min uptake over the 0 to 5 min uptake was also derived. Normal values were obtained in 20 stable functioning transplants (normal PU less than or equal to 1%, normal UR less than or equal to 0.7). In 66 patients, PU and UR were compared with clinical, biochemical, histological and radiological, evidence of rejection. A sensitivity of 70% and specificity of 85% was obtained for this 99Tcm-(tin) colloid study in the diagnosis of renal transplant rejection.

Colloids↗
PubMed1987

The determination of relative kidney function in obstructive uropathy with 99Tcm-DMSA.

In this investigation differential kidney function studies were carried out for eight patients with obstructive uropathy and seven patients who did not suffer from obstruction. The aim of this investigation was to determine whether possible retention of 99Tcm-DMSA in the dilated system would lead to overestimation of the functional mass of an obstructed kidney. The clinical examination took place 4 and 24 h after i.v. injection of the 99Tcm-DMSA. From our results we conclude that this is not a major problem. It appeared that the 4 h values are as reliable as the 24 h values in the clinical situation.

Humans↗
PubMed1987

Relative and absolute 99Tcm-DMSA uptake measurements in normal and obstructed kidneys.

Relative and absolute 99Tcm-DMSA uptake measurements were carried out on 25 adult patients among whom there were 23 normal and 25 malfunctioning kidneys. Data were collected at 3 and 6 h post intravenous tracer injection. Four methods of calculating absolute uptake were investigated and evaluated. These were based on: (1) posterior view and measured kidney depth; (2) posterior view and Raynauld's depth; (3) geometric mean assuming kidney thickness is small enough not to introduce self attenuation of counts in the kidney itself; (4) geometric mean taking kidney thickness into account. Whilst (1) and (2) were found to overestimate and underestimate renal uptake by up to 5 and 14%, respectively, (3) and (4) were found to be more accurate and comparable. The measurement of relative DMSA uptake (right to left) showed no change between the 1 and 6 h measurements for both obstructed and non-obstructed kidneys. Based on the results from method 4, the absolute renal DMSA uptake had a mean value of 25.4%, S.D. 8.9% and 30.0%, S.D. 9.2% at 3 and 6 h, respectively, for normal/non obstructed kidneys. For obstructed kidneys (responding to frusemide), the mean uptake was 23.0%, S.D. 7.2 and 25.6%, S.D. 6.7% at 3 and 6 h, respectively. For obstructed kidneys not responding to frusemide, the mean uptake was 16.8%, S.D. 3.9 and 20.6%, S.D. 4.8% at 3 and 6 h, respectively. No correlation was found between absolute DMSA uptake and degree of renal obstruction.

Adult↗
PubMed1987

Reliability of the hepatic perfusion index for the detection of liver metastases.

The reliability of the technique for measuring the hepatic perfusion index (HPI) for the detection of liver metastases has been examined. Dynamic images from 173 patients with primary and recurrent colorectal cancer have been analysed by two operators using the peak values of both the right and left kidney time-activity curves. In 14.4% of analyses the right kidney HPI method failed, while only 5.7% of analyses failed using the left kidney method. The results showed (a) that disagreement between the operators HPI values was small but statistically significant (p less than 0.05) and (b) that disagreement between the two methods was highly significant (p less than 10(-7)), with the left kidney method resulting in a lower HPI value. An upper limit of normal for left kidney HPI of 0.37 was predicted from the data, assuming the corresponding right kidney value to be 0.40.

Evaluation Studies as Topic↗
PubMed1988

A comparison of planar and tomographic imaging of the myocardium using 99Tcm-t-butyl isonitrile.

Oblique reconstruction tomography for stress imaging of 99Tcm-t-butyl isonitrile was performed. Oblique reconstructions, transaxial reconstructions and conventional planar images were reported by three observers. These reports were compared in 12 patients with suspected heart disease, using ECG, cardiac enzymes and coronary angiography to derive diagnostic standards. Oblique reconstruction tomography gave better agreement between the observers and more accurate diagnoses than either transaxial reconstruction or planar imaging.

Adult↗