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Background The concentration and persisting time of antimicrobial agents in the periodontal pockets are important factors for their antimicrobial efficacy. Increased clearance time in the periodontal pocket is a significant criterion for the selection of intrapocket irrigants. The aim of this study was to estimate the clearance time of a cationic agent from the periodontal pocket. Methods Thallium-201(Tl-201) was chosen as a tracer to simulate the clearance of cationic substance because of its electrical activity. Twenty patients with periodontitis and probing depths 6 to 9 mm were included in this study. In each patient, 3 Mega Becquerel (MBq) of Tl-201 were inserted into the periodontal pocket. Dynamic imaging was performed and clearance of radioactivity was measured. Results Clearance of radioactivity was 67.1 ± 16.9, 83.1 ± 13.9, 90.4 ± 10.4, 93.39 ± 8.0% at 30, 60, 90 and 120 min, respectively. Half-life of wash-out was determined as 20.3 ± 10.2 min. Conclusion The results of this study demonstrate that the half-life of the cationic solution applied subgingivally was approximately 20 min and labelling of oral irrigants with radiotracers may be used to determine their clearance in further research.

WOS: 000387809000007 PubMed: 27466019 BackgroundIn routine noncontrast-enhanced PET/computed tomography (CT) studies, the female pelvis is one of the most challenging anatomical regions to interpret. In surgically treated patients, it may be more difficult to determine the accurate location of paravaginal hypermetabolic lesions. In this study, the aim was to investigate the contribution of additional PET/CT imaging using a vaginal catheter in patients with pelvic malignant disease.MethodsForty-seven patients with pelvic malignancies were enrolled in this study. Following routine whole-body fluorine-18 fluorodeoxyglucose (F-18-FDG) PET/CT scanning, an additional pelvic scan was obtained after placement of a plastic catheter in the vaginal lumen (v-catheter). All suspected foci in vaginal and paravaginal areas were evaluated for both studies. The contribution of additional v-catheter imaging was determined visually by five experienced interpreters.ResultsPathological F-18-FDG uptake in various vaginal and/or paravaginal locations was detected in 24 of 47 patients after conventional PET/CT imaging. In 10 of these 24 patients, anatomic relations within the uptake area could not be confidently described and v-catheter imaging provided a significant contribution in all 10 cases. In seven of these 10 sites examined, pathological F-18-FDG uptake was safely ruled out and three sites were confirmed to be malignant. In total, the final interpretation in 13 of 24 patients (54%) was modified by additional v-catheter imaging. The contribution rate of catheter imaging was 89% in treated patients and 33% in untreated patients with vaginal and/or paravaginal lesions on initial scans.ConclusionsAdditional v-catheter imaging of pelvis may be of diagnostic value in the accurate anatomical definition of hypermetabolic lesions in the vaginal/paravaginal area on noncontrasted PET/CT studies.

Radyoaktif iyot tedavisi benign ve malign tiroit hastalıklarında kullanılan bir tedavi yöntemidir. Hiperfonksiyonel odakların ve tiroidektomi sonrası rezidü dokunun ablasyonu veya iyot yakalama yeteneğinde olan metastazların tedavisinde kullanılabilmektedir. Genel olarak basit, emniyetli ve efektif bir yöntem olarak kabul edilmektedir., Radioiodine therapy has been an accepted treatment modality of the benign and malignant thyroid disorders. It can be used for the ablation of the hyperfunctioning tissue or postthyroidectomy remnant and treatment of the iodine avid metastases. It is the simplest and safest method of therapy in addition to the effectiveness for most patients.

This study was aimed to investigate the effect of sedation on plasma soluble P-selectin (sP-selectin) levels and initiation phase of coagulation following coronary intervention. A total of 58 patients with unstable angina were randomised into two groups of sedated (n = 29) and nonsedated (n = 29) patients. sP-Selectin, adrenaline, noradrenaline, von Willebrand factor (vWF), fibrinogen, platelet and troponin-I levels were measured before the intervention and at 30 min and 24 h after the intervention. In the sedated group, adrenaline, noradrenaline, sP-selectin and fibrinogen levels remained stable 30 min after the intervention (p > 0.05), whereas vWF level increased (p < 0.05). In the nonsedated group, 30-min sP-selectin (p < 0.001), adrenaline (p < 0.05), noradrenaline (p = 0.012), vWF (p < 0.001) and fibrinogen (p < 0.001) levels were found to be increased. Also, 24-h sP-selectin, vWF and fibrinogen levels for both groups showed significant increases when compared with the values both 30 h before (p < 0.001) and 30 min after the intervention (p < 0.001). Sedation before interventions reduces sP-selectin levels, initial phase of coagulation and, consequently, myocardial damage.

Summary The aim of the study was to compare lipoprotein(a) [Lp(a)] levels in patients with cTroponin-I (cTn-I)-positive or -negative unstable angina and to investigate their relationship with atherothrombosis. A total of 202 consecutive patients were enrolled in the study. Lp(a), fibrinogen, plasminogen, PAI-1 and t-PA levels were measured and C-reactive protein (CRP) assays were performed on admission for all patients, and venous blood samples were drawn 12 and 24 h later for cTn-I measurements. The patients were divided into cTn-I-negative (cTn-I

WOS: 000179279000014 PubMed: 12397470 Oxygen (O-2) inhalation after acute myocardial ischaemia has long been a part of standard therapy in cardiology. It has also been demonstrated that therapeutic hyperoxia diminishes myocardial stunning. The aim of this pilot study was to investigate whether the uptake kinetics of the myocardial perfusion agent technetium-99m sestamibi (MIBI) during O-2-enriched breathing is modified in comparison with the kinetics observed under conventional rest imaging performed after injection during inhalation of room air. Nine patients scheduled for coronary intervention (CI) with a documented significant stenosis (greater than or equal to50%) of at least one epicardial coronary vessel and one patient with slow flow on coronary angiography were investigated. First, rest MIBI electrocardiogram-gated single-photon emission tomography (G-SPET) with 740 MBq was performed. Two days later, the tracer was injected following a 5-min period of 100% O-2-supported (nasal catheter) breathing at rest (6 1/min) and a second G-SPET acquisition (O-2+MIBI G-SPET) was carried out. Patients' medication was not withdrawn and was matched throughout the study. The mean elevation of arterial oxygen saturation achieved was 2.95%. No significant changes in arterial blood pressure or heart rate could be detected at any time during the procedure. Compared with the results of baseline G-SPET, on O-2+MIBI G-SPET five patients scheduled for CI and the patient with slow flow showed increased tracer uptake in initially ischaemic regions without any alterations in other myocardial regions. In three of these five patients, post-CI imaging could be performed and showed increased tracer uptake in all additional areas detected previously by O-2+MIBI imaging. In three patients, besides improvement in ischaemic regions, a mild reduction in tracer uptake was observed in myocardium that initially appeared normal. In one of these patients, thallium-201 rest-redistribution SPET was performed and showed an uptake pattern more similar to that seen on O-2+MIBI images than that on baseline MIBI G-SPET.In one patient, no difference in tracer uptake was observed in pre- and post-CI studies. Improvement was detected in the wall thickening images of the O-2+MIBI study in seven of the ten patients. Four of these patients showed improvement in the same regions after CI. In this pilot study, it was demonstrated that MIBI injection during O-2-enriched breathing can be a useful technique for enhancing the detection of viable myocardial tissue. The possible mechanisms of altered tracer kinetics are discussed.

Purpose The lymphatic system may show variations throughout the entire body. Knowledge of the variations and aberrant lymph drainage are important when planning surgical treatment and radiotherapy. The aim of this study was to evaluate the intratumoral injection technique in the detection of lymphatic drainage of proved or possibly malignant cold thyroid nodules. Materials and Methods The study group consisted of 13 patients with palpable solitary cold thyroid nodules. None of the patients had cystic nodules on ultrasound examination. After fine-needle aspiration biopsy (at least 3 days later), 15 MBq (0.4 mCi) Tc-99m nanocolloid particles in a small volume (0.2 ml) were injected into the nodule. Dynamic images (60 frame × 1 minute) were acquired during the first hour, followed by static anterior and lateral images at 90 and 120 minutes. Results Radiopharmaceutical was present in the systemic circulation in two patients, possibly as a result of paratumoral injection. Eleven patients had intratumoral accumulation in early frames. Lymph nodes draining the thyroid nodule were visualized in 10 of 11 patients. In the dynamic acquisition period of 7 of 10 patients, the first draining lymph node could also be identified. Only 5 of 13 patients had malignant nodules. Lymphatic metastases were detected in one patient’s specimens. Conclusions Preoperative visualization of lymphatic pathways may be used when planning for thyroid cancer surgery. Sentinel node detection could yield valuable additional information in these patients.

WOS: 000084782900004 PubMed: 10656272 Tc-99m polyclonal immunoglobulin-a has been shown to be a successful agent in the depiction of active inflammation in rheumatoid arthritis (RA). The objective of this study was to compare the uptake behaviors of Tc-99m HIG and Tc-99m MDP in RA and variants of rheumatoid arthritis (VRA). Seventeen patients with RA and 8 patients with VRA presenting with active inflammation were included in this study. Ten subjects with well-diagnosed degenerative joint disease constituted the control group. All joints in patients were also imaged with Tc-99m HSA to evaluate the vascularization status of the joints. Tc-99m HIG and HSA scans were obtained at 2, 4 and 24 hours after the injection of 555 MBq Tc-99m HIG and 296 MBq Tc-99m HSA. Conventional bone scans were performed 4 hours after the injection of 740 MBq Tc-99m MDP. Target-to-background (T/B) ratios were obtained exclusively over the joint regions. Tc-99m HIG T/B ratios of the active joints in RA were significantly higher than those of the non-active joints and the control group (p < 0.05). Tc-99m HIG T/B ratios in active joints showed a progressive increase between 2 and 24 hour images (p < 0.05). In contrast, Tc-99m HSA TIE ratios decreased in all active joints significantly (p < 0.05) except the ankle joint region (p > 0.05). The T/B ratios in Tc-99m MDP bone scans were higher in all active joints than in non-active RA joints and joints of controls but significantly differences were only detected in wrist and elbow joints. All clinically active joints in VRA patients accumulated Tc-99m HIG and HSA, and showed increased Tc-99m MDP uptake. These joints had a very similar Tc-99m HIG retention pattern to the RA joints. The detection rate of active joint inflammation with Tc-99m HIG was much higher than that with Tc-99m MDP. The increasing Tc-99m HIG uptake ratio between 2 and 24 hours in contrast to Tc-99m HSA indicates the presence of other binding mechanisms besides increased vascularity in RA.

GOKCE, SABAN CAKIR/0000-0003-2586-3243 WOS: A1995QL18900015 PubMed: 7750222 Myositis ossificans is primarily a disorder of adolescents or adults, whereby an area of muscle mass undergoes progressive ossification. Its radiographic and scintigraphic appearances have been well documented. In this paper, a case of histopathologically demonstrated myositis ossificans in the proximal thigh with unexpected TI-201 accumulation was presented.

WOS: 000307199900043 We reported a case that shows two simultaneous pitfalls of positron emission tomography/computed tomography (PET/CT), including mislocalization and iatrogenic F-18-Fluorodeoxy-glucose (F-18-FDG) microembolism in the lung. A follow up F-18-FDG scan of the patient operated due to a cutaneous leiomyosarcoma indicated a focus of intense radiotracer accumulation in the right liver lobe and in the right inferior paratracheal lymph node. Focal accumulation of 18F-FDG in the lung can be observed following paravenous injection. The difference in respiratory cycles between PET and CT images may potentially result in mislocalization if the radiotracer activity is close to either side of the diaphragm.

Tc-99m MDP and Tc-99m (V) DMSA images are described from a 49-year-old woman with chronic renal insufficiency complicated by osteomalacia. Clinical, biochemical, and radiologic bone profiles were compatible with osteomalacia. Osteomalacia is a condition associated with disorders in which mineralization of the organic matrix is defective. All bone lesions visualized with Tc-99m MDP also showed increased uptake of Tc-99m (V) DMSA. Tc-99m (V) DMSA accumulation has been reported in many malignant and some benign conditions. Pseudofractures in osteomalacia could be included in the spectrum of benign lesions that accumulate Tc-99m (V) DMSA.

PubMed: 9212898 A Meckel study was performed in a patient with melena who at the same time had a peritoneal catheter for dialysis because of renal failure. There was no pathological or abnormal accumulation of Tc-99m pertechnetate in the abdomen, except for the stomach where gastric dilatation was observed. This incidental finding of gastric dilatation which was thought to be a result of irritation of the peritoneal cavity, disappeared 24 hours after the peritoneal catheter was removed.

PubMed: 8800454 Tc-99m-DTPA captopril scintigraphy was performed in a patient with suspected renovascular hypertension. Markedly impaired right renal function (Glomerular filtration rate (GFR) values for the right kidney = 14 ml/min, left kidney = 79 ml/min) was detected in the initial captopril study. Only lower pole activity of the right kidney was observed during the whole study. Since prior ultrasonographic examinations have shown bilateral normal kidney parenchyma, branch stenosis of the right upper pole was suspected. Besides significant function improvement in the following baseline study (GFR values for the right kidney = 59 ml/min, left kidney = 79 ml/min), the right kidney, this time normally shaped, was visibly higher positioned. Because of the possibility of mobile kidney and/or branch stenosis, the patient underwent selective renal angiography. A long pediculed right kidney without renal artery stenosis was found. The final diagnosis was essential hypertension. Kidney position anomalies could influence the reliability of the captopril scintigraphy, particularly when a theoretical kidney depth formula is employed for the attenuation correction.

Behçet's disease (BD) is a systemic disorder of unknown cause. In our study, we investigated the utility of Tc-99m HMPAO SPECT and MRI in patients with neuro-Beh,cet's disease (n-BD).Twelve patients (two females, ten males; mean age 33 +/- 9.6 yr; age range 18-45 yr) with n-BD, fulfilling the criteria of the International Study Group for BD, were included in the study. MRI was performed according to a standard protocol with 1 or 1.5 T imagers. Brain SPECT data were obtained using a single head gamma camera after 555 MBq Tc-99m HMPAO injections. Following image reconstruction, regional cerebral perfusion was evaluated both visually and semi quantitatively.Neurological examination showed parenchymal brain involvement in 6 of 12 patients (50%). All 6 patients had white matter lesions on MRI, while only 5 of them showed perfusion defects on brain SPECT. Out of 6 patients (50%) without clinical signs of parenchymal brain involvement, 1 patient showed a pathological brain SPECT and 3 patients showed pathological MRI findings. Semiquantitative analysis of brain regions on SPECT study showed statistically significant hypoperfusion of biparietal regions.This study investigates the correlation between clinical, MRI and SPECT findings and it shows discrepancy between these findings in some cases. Brain SPECT may act as a complementary modality to increase the detection rate of affected regions in patients with n-BD.

WOS: 000221203400007 PubMed: 15100505 Objectives The accuracy of viability and defect size detection by Tc-99m-tetrofosmin has been discussed by several authors. The lower myocardial extraction fraction of the latter compared with Tc-99m-sestamibi or (TI)-T-201 has often been emphasized. We hypothesized that the intracoronary (i.c.) injection of tracer activity, i.e. higher than that theoretically achievable in the case of intravenous (i.v.) administration, could demonstrate the clinical relevance of this finding intra-individually. In this study, myocardial perfusion images obtained after tracer injection down the infarct-related artery were compared with i.v. injection images in the same patients. The trial also provided us with the opportunity to compare the wall motion values calculated using conventional Tc-99m-tetrofosmin Elated single-photon emission computed tomography (SPECT) studies with those obtained using optimal target/background ratios after i.c. injection. Methods Fourteen patients with acute myocardial infarction, no history of previous cardiac events, single vessel disease and no visible collaterals in the coronary arteriogram were included in the study. Electrocardiogram gated SPECT was carried out separately after i.c. and i.v. injections of the tracer within 5-7 days following thrombolytic therapy. Myocardial perfusion patterns were compared by contingency table analysis after semi-quantitative visual scoring. Segmental wall motion was compared using quantified polar map data in a subset of patients (eight of 14) with normal to moderately hypoperfused myocardium supplied by the left coronary artery. Results Visual perfusion scores of both studies showed good concordance (kappa, 0.70), with complete agreement in 94 of 119 segments. Nearly all of the discordant segments (24 of 25) were mildly better scored in i.c. studies than in i.v. studies. The mean wall motion values calculated on polar maps of 78 segments for i.c. and i.v. studies were 8.4 +/- 1.2 mm and 8.2 +/- 1.3 mm (mean Delta wall motion = 0.23 mm), respectively. High segmental wall motion correlation was observed (R = 0.90; P < 0.0001). Conclusion It can be concluded that infarct-related myocardial perfusion scores obtained after i.c. and i.v. injections of Tc-99m-tetrofosmin compare favourably, with a total agreement rate of 79%. However, the additional information obtained in 21% of the total number of myocardial segments by i.c. injection may indicate a mild underestimation of myocardial viability by i.c. injection. Conventional gated SPECT using i.v. Tc-99m-tetrofosmin was demonstrated to be a reliable technique in the detection of true wall motion.

WOS: 000181707100002 PubMed: 12691126 Assessment of ventricular function is an important diagnostic and prognostic tool in coronary heart disease (CHD). The objective of this study was to compare radionuclide ventriculography (RVG), echocardiography (ECHO) and gated planar tetrofosmin myocardial scintigraphy (GPTF) in patients with CHD. Radionuclide ventriculography in left anterior oblique (LAO) and left lateral (LLT) projections was performed in 44 patients. Two days later, rest tetrofosmin perfusion tomoscintigraphy (SPECT) and rest GPTF in RVG identical parameters and projections were acquired. Within the two following days, the patients underwent two-dimensional ECHO. GPTF studies were processed and interpreted in original (NI-GPTF) and image inverted, RVG like form (I-GPTF). All visual interpretations were evaluated with a semi-quantitative scoring system. Quantitative analysis was performed on parametric images by means of segmental regions of interest. Linear regression and contingency analysis were carried out in overall analysis and on a segmental basis separately by accepting the RVG as the standard for the whole investigation. In overall cine-mode evaluation, NI-GPTF (r = 0.77, p < 0.001, complete agreement (CA) = 84%) was superior to I-GPTF (r = 0.73, p < 0.001, CA = 82%) and ECHO (r = 0.39, p < 0.001, CA = 78%), compared to RVG. On a segmental basis, NI-GPTF showed the best RVG-correlations except for inferoapical, mid-inferior, mid-anterior and anterobasal segments. In visual analysis of functional images, the best RVG-agreement was observed in I-GPTF (r = 0.72, p < 0.001, CA = 77%). On a segmental basis, I-GPTF showed the best RVG-correlations except for posterolateral, mid-inferior, mid-anterior and anterobasal segments. In overall quantitative evaluation, amplitude values in both I-GPTF (r = 0.76, p < 0.001) and NI-GPTF (r = 0.75, p < 0.001) studies were well correlated with RVG amplitude. I-GPTF gave the best RVG-correlation of phase (r = 0.59, p < 0.001). The mean phase and standard deviation RVG-correlations of I-GPTF were r = 0.92, p < 0.001 and r = 0.53, p < 0.001 respectively. In segmental quantification, amplitude values of all segments in I-GPTF were better RVG-correlated than in NI-GPTF. In conclusion, GPTF could be a time saving alternative to ECHO in the evaluation of wall motion by the nuclear medicine physician. Because of differing segmental RVG correlations, NI-GPTF and I-GPTF should be both interpreted to improve the diagnostic value of the method. Cine-mode and parametric image interpretations in GPTF studies should be done simultaneously since the former is more closely correlated to RVG.

WOS: 000180086600009 PubMed: 12464786 The state of no-reflow (i.e. inadequate myocardial tissue perfusion despite normal arterial flow proven in angiography after pharmacological or mechanical interventions) is considered to be a marker of a poor prognosis. Although the Thrombolysis in Myocardial Infarction (TlMI) flow grade is a valuable and widely used qualitative measure in angiography trials, it is limited by its subjective and categorical nature. Recently, the TIMI frame count method (TFC) was proposed for detecting no-reflow. In our study we aimed to compare TFC values with myocardial perfusion single photon emission computed tomography (SPECT) findings to investigate the additional role of the former method in the evaluation of no-reflow. Twenty patients (16 men and four women; mean age 58 +/- 9 years) with first acute myocardial infarction were included in the study after thrombolytic therapy. Coronary angiography (CAG) was performed 5-7 days later. The TIMI flow grade and TFC values were determined in angiography examinations. A TIMI flow of less than grade 3 and a TFC value > 27 were considered to be pathologically decreased for coronary artery blood flow. Tc-99m tetrofosmin myocardial rest SPECT was carried out 24 h after coronary angiography. SPECT images were scored on a four-point scale in 20 myocardial segments and the total defect score was calculated from the sum of defect scores in 20 segments. Wall motion was assessed using the wall motion score index in echocardiography (ECWSI). The occurrence rates of angiographic no-reflow, pathological TFC and perfusion defects in SPECT were calculated as 40% (8/20), 47% (8/17; nonmeasurable in three patients with TIMI grade 0), and 55% (11/20), respectively. Perfusion defects were present and the TIMI frame count value was increased in all patients with angiographic no-reflow (TIMI grade

WOS: 000168278800004 PubMed: 11137359 Objective: Perfusion of the areas of cochleovestibular structures was investigated using Tc-99m HMPAO single photon emission computerized tomography (SPECT) in the young patients with vertigo presumed to have peripheral vestibular abnormalities and compared the results with cochleovestibular test results, and vertebrobasilar angiography findings. Methods and patients: The study was performed on 20 patients with vertigo and 17 control subjects who had performed vertebral arteriography due to another disease. The patients with vertigo presumed to be on peripheral vestibular disorder were included in the study. Systemic and otorhinolaryngological examination were carried out. Audiovestibular function was evaluated in all patients and control subjects. Brain SPECT was performed with a one-head rotating gamma camera system from 64 projections into a 64 x 64 matrix, using low energy and high-resolution fan beam collimators with a sampling time of 30 s. The images taken from cerebellum, temporal, parietal and occipital lobes which are supplied by a vertebrobasilar system were compared visually with the other side and asymmetry in the perfusion was searched. After cochleovestibular tests and laboratory had been completed, vertebral arteriography was performed bilaterally in all patients. Results of digital subtraction angiography (DSA) and the vestibulocochlear test were compared with images of SPECT. Data analysis was done with Yates chi (2) and percentages of sensitivity and specificity were calculated. Results: There was vestibular test and cochlear test abnormalities in eight and ten of the patients with vertigo, respectively. SPECT imaging showed hypoperfusion and decreased regional blood flow in 12 of the patients. There was statistically significant differences between the study and control groups in SPECT (P < 0.05). Five patients showed abnormal findings in DSA examinations. Conclusion: It is believed that SPECT may be helpful in the detection of vascular pathology in the patients with vertigo. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

WOS: 000086400800009 PubMed: 10823327 The aim of this study was to establish the value of Tc-99(m)(V)-DMSA scintigraphy in the detection of metastatic bone lesions and compare the results to Tc-99(m)-MDP bone scintigraphy. Thirty-four patients presenting with metastatic bone disease (Group 1) and 12 controls with degenerative skeletal lesions (Group 2) were studied. Conventional bone scanning and Tc-99(m)(V)-DMSA whole-body scanning were performed on all patients. All scans were interpreted visually. Furthermore, lesion-to-normal bone ratios (L/N) in vertebral metastases on the 4 and 24 h bone scans were obtained in 58 lesions of cancer patients and in 23 benign (degenerative) vertebral lesions of the control group. Tc-99(m)-MDP L/N ratios at 24 h (3.08 +/- 0.32) were significantly higher than those at 4 h (2.48 +/- 0.24) in the malignant foci (P < 0.001). No significant difference was observed in benign lesions (P > 0.05). In 167 (164 metastatic, 3 traumatic) of 186 Tc-99(m)-MDP positive lesions (90%) of Group 1, Tc-99(m)(V)-DMSA uptake was observed. The remaining 19 lesions (10%) were Tc-99(m)(V)-DMSA negative. Fourteen of these 19 sites were diagnosed as benign. The remaining five foci were malignant. In four lung cancer metastases showing no Tc-99(m)-MDP uptake, Tc-99(m)(V)-DMSA uptake was observed. There was no Tc-99(m)(V)-DMSA accumulation in any of the Tc-99(m)-MDP positive degenerative lesions of Group 2. All quantitatively evaluated (n = 42) vertebral metastatic foci and two compression fractures in Group 1 showed 99Tcm(V)-DMSA accumulation and an increased Tc-99(m)-MDP L/N ratio at 24 h. A total of 36 degenerative lesions (Groups 1 and 2) and one compression fracture (Group 1) showed neither Tc-99(m)(V)-DMSA uptake nor an increased Tc-99(m)-MDP L/N ratio at 24 h. Our results indicate that quantitative 4/24 h analysis of vertebral lesions on 99Tcm-MDP scans has a similar diagnostic value to Tc-99(m)(V)-DMSA imaging in the detection of bone metastases. However, the accumulation of Tc-99(m)(V)-DMSA in four lung cancer metastases showing no Tc-99(m)-MDP uptake is encouraging and justifies further research in patients with proven bone metastases and negative bone scans. ((C) 2000 Lippincott Williams & Wilkins).

The authors present a case of extrapulmonary Tc-99m macroaggregated albumin uptake in a patient with reversed atrial septal defect and cleft lip. Perfusion lung scanning was performed to rule out pulmonary embolism because of dyspnea, cyanosis, and tachy-arrhythmia. Besides minimal systemic activity, significant myocardial uptake of the tracer was observed. Coronary angiography could not be performed because of the severely altered general condition of the patient. It was postulated that this was most probably due to an anomalous origin of the left coronary artery from the pulmonary trunk.

PubMed: 9310179 A 67-yr-old woman with a history of myocardial infarct was admitted to emergency for marked dyspnea, nonproductive cough, nausea and fever. The thorax X-ray revealed a bilateral alveolar and interstitial infiltration pattern with basal accentuation. The cardiac examinations were normal. Technegas ventilation and Tc-99m-macroaggregated albumin (MAA) perfusion scans were performed to rule out pulmonary embolism. Bilateral multiple ventilation defects with normal perfusion was observed. The patient had been taking nitrofurantoin for four days for a bladder infection. Hypersensitivity to nitrofurantoin was suspected and the drug was discontinued. An antihistaminic and anxiolytic medication was started. The majority of the clinical symptoms disappeared within 24 hours. The control chest X-rays disclosed a marked improvement. Ventilation and perfusion scans obtained 48 hours after nitrofurantoin withdrawal were normal. The drug-related pulmonary reactions should be taken into account in patients on medication. Reversible ventilation defects can be the only lung-scintigraphic finding encountered in acute pulmonary nitrofurantoin reaction.

biriken, Derya/0000-0002-6254-4578 WOS: A1996VL83900064 PubMed: 8893201 …

WOS: A1996VL83900065 PubMed: 8893202 …

Technetium-99m-tetrofosmin is a new myocardial imaging agent which has yielded promising results compared to thallium-201. The tumour-seeking properties of the routinely used cardiac radiopharmaceuticals 201TI and 99mTc-methoxyisobutylisonitrile are well known. Here we report the results of a pilot study demonstrating 99mTc-tetrofosmin uptake in malignant lung tumours. Five patients with bronchial carcinoma, each in different stages of chemo- or radiotherapy, were imaged. Dynamic and static acquisitions were performed to evaluate the uptake and kinetics of 99mTc-tetrofosmin in the lesions. In four of the five patients localized tumour uptake of 99mTc-tetrofosmin was observed. Time to peak tumour activity and tracer washout in the tumour, myocardium and contralateral normal lung at 30 min post injection (p.i.) were determined. Tumour/normal lung, heart/tumour and heart/contralateral normal lung ratios were calculated for 5-10, 25-30 and 85-90 min p.i. The peak concentration in all tumours was reached at the end of the first minute. The mean tumour and contralateral normal lung washout rates of 99mTc-tetrofosmin at 30 min p.i. were 18.3% +/- 9.2% and 19.5% +/- 5.85% respectively. The tumour/contralateral normal lung ratio remained higher than 1.25 until 90 min p.i. in all four patients. It is concluded that 99mTc-tetrofosmin seems to be of value in lung tumour imaging, although larger studies are necessary to ascertain its sensitivity, specificity and usefulness in clinical practice.

WOS: A1994NG03700016 PubMed: 8004871 Vipoma syndrome, or the diarrheogenic syndrome, is often caused by a pancreatic islet cell tumor or a retroperitoneal neural tumor and is mainly characterized by watery diarrhea, hypokalemia, and achlorhydria. Vasoactive intestinal polypeptide (VIP) Is generally the mediator in most cases. Intestinal uptake of Tc-99m MDP in a 32-year-old man with Vipoma syndrome is reported. He had normal calcium and phosphate levels. Multiple intestinal biopsies revealed no metastatic calcifications, necrosis, or amyloidosis, but only diffuse intestinal edema and an 80-centimeter-long ischemic segment in the ileum. A synthetic somatostatin analog that was administered to the patient can also be the reason for the intestinal concentration of Tc-99m MDP in this case. To our knowledge, intestinal accumulation of a bone agent in the Vipoma syndrome has not been described.

PubMed: 7816311 [No abstract available]

PubMed: 7535551 Reflex sympathetic dystrophy or Sudeck' s atrophy is a syndrome that can usually be followed by a traumatic insult. This disorder is accompanied by signs and symptoms of vasomotor instability, trophic skin changes, and rapid development of bony demineralization. This report presents a case with reflex sympathetic dystrophy syndrome secondary to organophosphate intoxication induced neuropathy. The patient was threated with calcitonin well. © 1994 Springer-Verlag.

PubMed: 8697695 A 47-year-old man with Behcet disease was hospitalized because of abdominal pain. Abdominal ultrasonography revealed a 3 cm x 3 cm hepatic mass and chest x-ray showed an empyema of the right lung. The patient was placed in a protocol for Tl-201 uptake in hepatic tumors. Surprisingly, Tl-201 accumulation was seen in the inferior lobe of the right lung within the empyema.