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At least 163 records · Page 9Linked to original sources
PubMed2002

Diagnostic accuracy of radionuclide imaging using 131I nor-cholesterol or meta-iodobenzylguanidine in patients with hypersecreting or non-hypersecreting adrenal tumours.

The aim of this retrospective study was to evaluate the diagnostic accuracy of nor-cholesterol and meta-iodobenzylguanidine radionuclide imaging in two separate groups of patients with adrenal tumours to characterize lesions as adenoma or pheochromocytoma. We studied 75 patients (22 male and 53 female, mean age 47 +/- 15 years) with hypersecreting (n = 32) or non-hypersecreting (n = 43) unilateral adrenal tumours detected by computerized tomography or magnetic resonance scans. 131I nor-cholesterol adrenal scintigraphy was performed in 41 patients. Meta-[131I]iodobenzylguanidine (131I-MIBG) imaging was acquired in the other 34 patients. Pathology examinations (n = 58) or computerized tomography follow-up studies (n = 17) were obtained. Adrenal lesions were represented by 44 adenomas, four cysts, one myelolipoma, one pseudotumour, one ganglioneuroma, 16 pheochromocytomas, three carcinomas, four metastases and one sarcoma. Radionuclide studies were qualitatively evaluated and the corresponding results were classified as true positive, true negative, false positive and false negative. Diagnostic sensitivity, specificity and accuracy as well as positive and negative predictive values were calculated. The diagnostic values of nor-cholesterol scintigraphy in identifying adrenal adenomas were sensitivity 100%, specificity 71%, accuracy 95%, positive predictive value 94% and negative predictive value 100%; of note, two false positive cases were observed represented by a pheochromocytoma and a myelolipoma. The diagnostic values of MIBG scintigraphy in recognizing pheochromocytoma were sensitivity 100%, specificity 95%, accuracy 97%, positive predictive value 94% and negative predictive value 100%; only one false positive case occurred consisting of a carcinoma. It is concluded that, in the large majority of cases, adrenal scintigraphy using nor-cholesterol or MIBG is able to characterize specific lesions such as adenoma and pheochromocytoma, respectively. These findings show relevant clinical impact, particularly in patients with non-hypersecreting adrenal lasions. Radiotracer selection depends on clinical patient history and department availability; since benign adenomas are the most common cause of non-hypersecreting tumours, nor-cholesterol should be the first choice followed by MIBG if nor-cholesterol shows normal images. However, rare as well as unusual findings may be observed; nor-cholesterol uptake may occasionally be also found in non-adenoma tumours such as myelolipoma and pheochromocytoma. Similarly, MIBG accumulation may occur not only in lesions arising from medullary chromaffin tissue, but also rarely in cortical adrenal carcinoma.

19-Iodocholesterol↗
PubMed1980

Exercise radionuclide imaging approaches to coronary artery disease.

Exercise thallium-201 myocardial imaging and exercise radionuclide angiography are the two techniques of nuclear cardiology most widely used for the diagnosis of coronary artery disease. EAch of these tests provides information of diagnostic and functional value. The diagnostic accuracy and clinical utility of these two tests for the detection of coronary artery disease are compared. The strengths and weaknesses of each approach are discussed. A clinical approach to the detection and evaluation of coronary artery disease using these radionuclide exercise techniques is presented.

Blood Volume↗
PubMed1987

Radionuclide imaging in the diagnosis of hernias related to peritoneal dialysis.

Abdominal hernias are noted with increasing frequency in association with peritoneal dialysis as this mode of dialysis becomes increasingly popular. These hernias often present as localized groin edema, without evidence of a mass, on physical examination. Diagnosis is more difficult when the edema encompasses both groins. Radionuclide imaging peritoneography offers a safe, simple, well-tolerated, highly accurate method of localizing peritoneal defects. We used this method to locate and lateralize inguinal hernias in three patients receiving continuous ambulatory peritoneal dialysis who presented with bilateral scrotal edema and who had unrevealing physical examination findings. All three had unilateral, indirect inguinal herniorrhaphies under local anesthesia and have returned successfully to peritoneal dialysis without complication.

Aged↗
PubMed2003

Radionuclide imaging of rare congenital renal fusion anomalies.

Demonstration of a congenital renal anomaly plays an important role in the treatment of patients with renal infection. These patients are prone to infections because of coexisting urinary tract anomalies such as duplicated ureter, ureter opening anomalies, and urinary stasis. Assessment of renal parenchymal damage resulting from acute or chronic renal infection is the primary indication for radionuclide imaging with Tc-99m DMSA. In addition, this technique allows congenital anomalies to be identified. The authors review congenital renal fusion anomalies identified in children through Tc-99m DMSA imaging. They conclude that Tc-99m DMSA imaging can reveal important diagnostic information about various congenital anomalies, including fusion anomalies.

Adolescent↗
PubMed2002

Low-grade chondrosarcomas: a difficult target for radionuclide imaging. Case report and review of the literature.

Bone scan with Tc-99m (technetium) diphosphonate is sensitive, but non-specific for musculoskeletal tumors. Tl-201 (thallium), Tc-99m-sestamibi, Tc-99m-tetrofosmin, and F-18-fluorodeoxyglucose (F-18-FDG) can visualize tumors more specifically and are therefore useful in orthopedic oncology. However, cartilaginous tumors are characterized by histological and biological features, which potentially impair specific radionuclide imaging. A case of a patient with a low-grade primary chondrosarcoma of the femur and a false negative Tl-201 scan is presented. Tc-99m-based tumor-localizing compounds (sestamibi, tetrofosmin), as well as metabolic and receptor-imaging radiopharmaceuticals have also been reported to fail in low-grade chondrosarcomas imaging. Low cellularity, mitochondrial specialization and the presence of an efflux membrane pump may contribute to poor imaging. A negative Tl-201 or Tc-99m-sestamibi scan should be interpreted with caution, when the possibility of a chondrosarcoma is not negligible.

Aged↗
PubMed1991

[Quantitative assessment of qualitative traits of radionuclide images of the bones].

The results of radionuclide visualization of 147 patients with primary bone pathology were analyzed using probability algorithms. This analysis resulted in the determination of several groups of signs of various degrees of reliability in the diagnosis of some types of bone pathology. Diagnostic algorithms allow summing up and classifying practical experience and to test hypotheses, put forward by some of the physicians as a result of their practical activities. The use of probability algorithms in radionuclide studies is necessitated by a great variety of radiopharmaceuticals and a multitude of radiodiagnostic approaches to the standardization of methods and unification of diagnostic decisions.

Algorithms↗
PubMed1977

Pancreatic cancer screening. Analysis of the problem and the role of radionuclide imaging.

The clinical, surgical, and pathologic findings in a five year prospective study of 192 patients referred with a high probability of pancreatic cancer are reported. We have defined the requirements of any pancreatic imaging procedure as its ability to distinguish a normal pancreas from pancreatic cancer or chronic pancreatitis and the capability of detecting tumors less than 5 cm in diameter. There was a 47 percent incidence of pancreatic disease (27 percent pancreatic cancer and 20 percent chronic pancreatitis). Prospective radionuclide imaging as routinely performed was found to be of little clinical value in this patient population; it was neither specific nor sensitive to pancreatic cancer or chronic pancreatitis. Preliminary data with longitudinal multiplane emission tomography show an improved diagnostic accuracy and the ability to detect resectable tumors, but its efficacy needs to be prospectively compared with other screening tests on a carefully defined patient population.

Adenoma↗
PubMed1981

Radionuclide imaging in the nonsurgical treatment of liver and spleen trauma.

Twenty-nine patients had splenic or hepatic defects on 99mTc sulfur colloid scintigraphy performed after abdominal trauma. All were treated conservatively. One additional patient had a scan after a laceration was oversewn. Followup scans in 24 patients 1 to 13 months later showed resolution that was complete in nine, partial in 12, and unchanged in three. No defects enlarged. All but two patients were completely asymptomatic; two children with occasional unexplained upper abdominal pain had progressively resolving splenic defects. We conclude that surgery may not always be necessary for liver-spleen injury, that radionuclide imaging is useful in valuation of healing as well as in initial diagnosis, and that the risk of 'delayed' rupture is much smaller than heretofore feared.

Adolescent↗
PubMed1997

[Recent progress in radionuclide imaging of parathyroid glands].

Scintigraphic imaging of parathyroid glands has been the subject of new developments. Efficiency of the technique has been improved by the use of a new agent Tc-99m sestamibi (MIBI). A meta-analysis study of the literature confirmed the superiority of this agent toward the conventional Tc/T1201. Various protocols have been proposed for parathyroid imaging with MIBI they are described with a comparison of their advantages and drawbacks. The superiority of a two isotopes protocol using Tc-99m sestamibi with Iodine 123 and a subtraction processing seems proven. Moreover, this latter protocol allows the use of lateral views resulting in a higher accuracy. The visualization of hyperplasic glands is also improved by this technique. Comparison of ultrasonography versus Tc-99m sestamibi scintigraphy is discussed in the light of recent published materials. The scintigraphy appears more sensitive than ultrasonography and specially in the detection of mediastinal ectopic glands. Finally the exact role of radionuclid imaging of the parathyroids in the management of primary hyperparathyroidism is described.

Humans↗
PubMed1989

Reversed left internal mammary artery graft for coronary bypass. Evaluation of function with digital subtraction angiography and radionuclide imaging.

Reversed left internal mammary artery grafting with retrograde flow to the left anterior descending coronary branch was used in five of 500 consecutive bypass operations. The indications were significant stenosis in the left subclavian artery (3 patients) or the proximal left internal mammary artery (1) and proximal damage to the left internal mammary artery during dissection from the thoracic wall (1). The postoperative clinical course was smooth in all five patients, with no evidence of myocardial ischemia. In follow-up averaging 14 months four patients were asymptomatic. The reversed internal mammary artery graft was visualized with digital subtraction angiography in four cases. Radionuclide imaging during exercise confirmed graft patency in all but the symptomatic patient, who was found to have an area of reversible ischemia anteriorly in the left ventricle.

Adult↗
PubMedDate not supplied

Radionuclide imaging of the heart in myocardial infarction and acute ischemia by 99mtechnetium diphosphonate.

99mtechnetium diphosphonate was used in 81 patients for myocardial imaging. 46 of the patients suffered, 2-6 days prior to the test, from an acute transmural infarction provided by clinical, ECG, and enzymatic evidence; the scintigram was definitely positive in 43, equivocal in 2, and negative in 1. In 16 patients with subendocardial infarctions, in 9 the scintigram showed a positive result, in 1 it was equivocal, and in6 patients negative. In 6 other patients who suffered from acute chest pain, followed by enzyme changes, but no ECG evidence of infarction throughout the hospitalization period, the scan was positive in all. In 13 patients with acute ischemia (unstable 'crescendo' angina), 9 had a positive, 1 an equivocal, and 3 a negative scan. We conclude that radionuclide imaging is a valuable addition to the methods already available for diagnosis of myocardial infarction. With the use of diphosphonate as the tracer, we found that acutely ischemic myocardium that later may recover, gives also positive imaging.

Adult↗
PubMed2005

Polyamine deactivation of integrated poly(dimethylsiloxane) structures investigated by radionuclide imaging and capillary electrophoresis experiments.

The poly(dimethylsiloxane) (PDMS) material provides a number of advantageous features, such as flexibility, elasticity, and transparency, making it useful in integrated analytical systems. Hard fused-silica capillary structures and soft PDMS channels can easily be combined by a tight fit, which offers many alternatives for structure combinations. PDMS and fused silica are in different ways prone to adsorption of low levels of organic compounds. The need for modification of the inner wall surface of PDMS channels may often be necessary, and in this paper, we describe an easy and effective method using the amine-containing polymer PolyE-323 to deactivate both fused-silica and PDMS surfaces. The adsorption of selected peptides to untreated surfaces was compared to PolyE-323-modified surfaces, using both radionuclide imaging and capillary electrophoresis experiments. The polyamine modification displayed a substantially reduced adsorption of three hydrophobic test peptides compared to the native PDMS surface. Filling and storage of aqueous solution were also possible in PolyE-323-modified PDMS channels. In addition, hybrid microstructures of fused silica and PDMS could simultaneously be deactivated in one simple coating procedure.

Adsorption↗
PubMed2000

[Radionuclide imaging in oral implantations. Personal experience in maxillary sinus elevation].

PURPOSE: Presently nuclear medicine techniques are not very popular in oral implantology, but they can play an interesting role in this surgical field too. In particular bone scan with 99mTc-MDP allows to evaluate the function of oral implants and the survival of bone grafts. We report our experience with skull bone scan in maxillary sinus lifting. MATERIAL AND METHODS: We performed a three-year follow-up on 13 patients treated with inlay-one stage uni- or bilateral sinus lifting with a mixture composed of 90% bovine bone powder and of 10% small bone splinters and autogenous fibrin glue. We performed imaging studies and quantitated implant MDP uptake from the mean values at the surgical site to the 5th neck vertebral ratio (M/V index). The M/V index was also statistically compared with the one measured in 13 patients with severe resorption of distal upper dental arches (bone height less than 0.5 cm) and in 63 patients with normal dental status. Scintigraphic data were interpreted in the light of clinical, radiological and histologic findings. RESULTS: All oral implants appeared to be fixed and radiographs showed good positioning and bone adhesion; bone height exceeded 1 cm. Peri implant biopsy material was formed by normal mature bone tissue without bovine bone granules, necrotic areas and inflammatory cells. The highest bone activity (M/V index: 1.54-2.57) was observed 1-4 months after sinus lifting. Then MDP uptake decreases and 18 months after surgery radionuclide uptake in maxillary arches is homogeneous, with M/V values of 0.81-0.88. The average M/V value in the 18 surgical sites was clearly higher than in the resorbed (1.44 vs 0.64; Kruskall-Wallis ANOVA test; Dunn's method; p < 0.05) and normal (1.44 vs 0.73; p < 0.05) maxillary arches. DISCUSSION AND CONCLUSIONS: 99mTc-MDP can show the transformation of newformed into mature bone and then allows in vivo visualization of implant osteointegration. The importance of our work lies in the use of radionuclide imaging to assess both the function of oral implants inserted by a complex surgical technique and the expected bioactive properties of the filling mixture. Nevertheless the strong active autogenous compounds do not permit to detect the real agent of local bone induction. An interesting finding is that implant stability is biologically gained 18 months after intervention and that the uptake index facilitates comparison of sequential scans and confirmation of local bone growth. Therefore high MDP uptake by the implant 2-3 years after surgery can suggest mechanical or septic bone injury which can lead to implant failure if not treated promptly. In conclusion we believe that quantitative bone scan is a valid diagnostic tool in the follow-up of oral implants inserted with sinus lifting, though our experience needs confirmation on larger series and new research is warranted to understand the real mechanisms of assisted bone regeneration.

Adult↗
PubMed1996

Radionuclide imaging in interstitial lung disease.

The use of radionuclides to evaluate interstitial lung disease (ILD) has a long history. In the mid- and late 1970 s, it was appreciated that gallium uptake was seen in the lungs of patients with sarcoidosis or idiopathic pulmonary fibrosis. In both of these conditions, the amount of uptake seemed to correlate with other measures of inflammation in the lung. Gallium uptake was shown to predict response to therapy and persistent disease. However, several limitations to gallium scanning soon became apparent. The procedure is costly, it requires 48 to 72 hours for proper interpretation, and the uptake reverses quickly during corticosteroid therapy. The use of aerosol scanning with 99mTc-pentetic acid (DTPA) has also been shown to be useful in ILD. The clearance of 99mTc-DTPA aerosol is markedly increased in both sarcoidosis and other inflammatory lung diseases. However, the limitations of 99mTc-DTPA include the fact that cigarette smoking will also cause increased clearance. Therefore, the value of 99mTc-DTPA scanning value seems to be limited to nonsmokers. Several recent papers published on these and other techniques are reviewed here.

Administration, Inhalation↗
PubMed1982

Diagnosis and screening of small hepatocellular carcinomas. Comparison of radionuclide imaging, ultrasound, computed tomography, hepatic angiography, and alpha 1-fetoprotein assay.

Twenty-nine small (less than 5 cm) hepatocellular carcinomas in 18 patients were examined by radionuclide imaging (RN), ultrasound (US), computed tomography (CT), hepatic angiography, and serum alpha 1-fetoprotein (AFP) assay. Sensitivity was 39% with RN, 50% with US, 56% with CT, and 94% with angiography, including infusion hepatic angiography (IHA). Lesions larger than 3 cm could be detected by all of these methods; those between 2 and 3 cm were generally shown by US and CT but not RN. IHA was essential for diagnosis of lesions less than 2 cm, which were otherwise difficult or impossible to detect except with angiography. As a screening method, AFP was best, followed by US and CT. The authors recommend using AFP and US to minimize expense and radiation exposure. In questionable cases, IHA should be performed.

Adult↗
PubMed1995

Radionuclide imaging after skeletal interventional procedures.

Although nuclear medicine is often used as an adjunct to planning skeletal therapeutic interventions, its role in the assessment of these various interventional procedures, after the fact, is equally important. Skeletal therapeutic interventions studied with radionuclide imaging include bone grafts, the postoperative spine, and joint replacements. Vascularized bone grafts allow the successful reconstruction of large bone gaps. Early detection of vascular compromise permits prompt reevaluation of the vascular anastomosis so that potentially reversible causes of ischemia can be corrected. Radionuclide bone scintigraphy is a simple noninvasive method to evaluate the anastomotic patency of these grafts. Scintigraphically, vascular patency is characterized by normal or diffusely increased tracer uptake throughout the graft, whereas failure of the graft presents as photopenia. Bone scintigraphy, especially single photon emission computed tomography (SPECT), is of considerable value in the work-up of patients with persistent back pain after spinal surgery. Postoperatively, spinal fusion is characterized by diffusely increased uptake of radiotracer in the fused area. In contrast, focally increased uptake has been shown to be related to bony nonunion or pseudoarthroses. In patients who have undergone laminectomy, SPECT bone scintigraphy can localize the level of maximum instability and vertebral stress. The radionuclide evaluation of joint replacement complications, especially of hip and knee prostheses, has been extensively studied for nearly 2 decades. Bone scintigraphy is probably most useful when the images are normal. Although periprosthetic sites of increased uptake may be indicative of postoperative problems such as loosening or infection, they may also merely reflect postoperative changes. Dual tracer studies, focusing primarily on the diagnosis of the infected joint replacement, have consequently become the norm. Bone-gallium scintigraphy was the earliest dual tracer modality used, with an accuracy of 60% to 80%. The current radionuclide study of choice for diagnosing the infected prosthesis is labeled leukocyte-marrow imaging. Both leukocytes and colloid tracers accumulate in marrow, whereas only leukocytes accumulate in infection. This technique facilitates the discrimination of labeled leukocyte uptake in aberrant, but not abnormal, marrow from uptake in infection. The reported accuracy of this technique consistently exceeds 90%.

Bone Transplantation↗