摘要:

The difference in sensitivity of early imaging at 30 minutes after injection of Tc-99m HMPAO WBC versus delayed imaging at 2 or 3 hours for depiction of active inflammation in children with inflammatory bowel disease was established. The charts of 220 children who had early (30-minute) and delayed (2 or 3 hours) imaging performed for evaluation of inflammatory bowel disease were reviewed. There were 107 boys and 113 girls (average age, 12 years; median, 13 years). The bowel was divided into eight segments (with the total for all patients being 3,520) graded on a scale of 0 to 6 (with reference points in the iliac crest and liver). Any grade ⩾1 was abnormal. The uptake in each segment was summed. One hundred and twenty-two studies were abnormal (55%). The average uptake in the early images was 5.1 ± 0.41 and that in the late images was 9.3 ± 0.64. The Friedman nonparametric test of comparison of rank was significant at the 0.001 level. One hundred and five patients had abnormal studies at 30 minutes (88%). An additional 12% of patients had abnormal studies only on the late images. There were 245 abnormal segments at 30 minutes and 413 abnormal segments at 2 or 3 hours. When the uptake was analyzed segment by segment, 62 patients (52%) had abnormal segments at 30 minutes but also had additional abnormal segments at 3 hours. Sensitivity of Tc-99m HMPAO WBC imaging was significantly improved when late imaging was performed.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A patient had both the clinical presentations and the ventilation-perfusion scan that simulated pulmonary embolism so closely that anticoagulant therapy was administered. Computed tomography of the chest and Ga-67 citrate scintigraphy identified hilar adenopathy due to sarcoidosis as the cause of a ventilation-perfusion mismatch.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

In this report the usefulness of Tl-201 SPECT and modified retention images in the differentiation of lung cancer and postobstructive collapse was studied. Two-phase Tl-201 SPECT was performed in 20 lung cancer lesions in which postobstructive collapse was suspected on CT. Retention imaging was done afterward. Three types of Tl-201 images were compared with the bolus CT images. Bolus CT differentiated lung cancer from postobstructive collapse in 7 of the 20 lesions (35%). Tl-201 SPECT differentiated the two conditions in 9 of 20 lesions (45%) on early Tl-201 SPECT and in 13 of 20 lesions (65%) on delayed imaging. With modified retention images, differentiation was possible in 13 of 20 lesions (65%). By combining delayed Tl-201 SPECT and modified retention images, lung cancer alone could be demonstrated in 18 of 20 lesions (90%). Combined delayed Tl-201 SPECT and modified retention images were more effective than bolus CT in delineating the extent of lung cancer in the presence of postobstructive collapse.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

To determine the potential of Tc-99m MIBI for detecting bone marrow malignancy, MIBI imaging of the femur was evaluated. There was no detectable MIBI activity in 125 of 141 (89%) control patients. Clearly demonstrated focal or tubular MIBI activity indicating intramedullary accumulation was demonstrated in 44 of 45 (98%) patients with proven marrow malignancy: 9 patients with multiple myeloma, 10 patients with malignant lymphoma, 11 patients with acute leukemia, 1 patient with chronic leukemia, and 14 patients with skeletal metastases. No abnormal MIBI activity was observed in the femur in 19 of 22 (86%) patients who had no evidence of malignant involvement in the femoral marrow, in 3 patients with solitary plasmacytomas of the spine, sternum or iliac bone, or in 16 patients with malignant lymphoma. In 12 of 24 patients with acute leukemia in complete remission, no abnormal MIBI accumulation was shown in the femur, but in 12 patients, abnormal accumulation indicating residual leukemic activity was demonstrated. MIBI imaging correlated extremely well with MRI studies; 26 of 28 patients with focal or tubular increased MIBI activity in the femur showed decreased signal on T1-weighted images and a high signal on short inversion recovery images, and 11 patients with no abnormal activity showed a high signal on T1 images. MIBI imaging of the femoral bone marrow may be a new modality for detecting marrow malignancy.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

This study evaluated the utility of In-111 capromab pendetide imaging to detect prostate cancer metastases or local recurrence. The specific goal was to identify clinical factors such as prostate-specific antigen, pathologic stage, and Gleason score that were most predictive of a positive scan outcome. In addition, a new concept of a weighted Gleason score was defined and correlated with the scan outcome.Fifty-one patients with an elevated prostate-specific antigen level and otherwise negative workup were studied. Forty-eight patients had been treated by radical prostatectomy, two by radiation therapy, and one patient was studied before prostatectomy. Each patient received an intravenous injection of approximately 5 mCi of In-111 containing 0.5 mg of CYT 356, a conjugated site-specific monoclonal antibody against prostate specific membrane antigen. Tomographic blood pool images were obtained the day of injection. Four days later planar images and tomographic images of the abdomen and pelvis were obtained. Scans were interpreted by two experienced nuclear medicine physicians. Differences in the scan interpretation were settled by consensus. Scan outcomes were correlated with prostate-specific antigen levels, pathologic stage, Gleason score, weighted Gleason score, and clinical data.Of 51 scans, 70.6% (36 of 51) were positive. Eight patients had abnormal activity in the prostatic fossa, 12 patients had abnormal activity in the abdominal or pelvic lymph nodes, and 16 patients demonstrated abnormal activity in both areas. One patient with a positive scan underwent lymphadenectomy and was confirmed to be a true positive. Patients with a prostate-specific antigen level greater than 10 ng/ml, a weighted Gleason score higher than 4.5, or prostate-specific antigen levels greater than 2 ng/ml plus a weighted score higher than 4.5 showed positive rates of 100% (6 of 6), 88.2% (14 of 16), and 100% (6 of 6), respectively. In-111 capromab pendetide imaging was useful to detect metastases or local recurrence. Serum prostate-specific antigen levels and weighted Gleason scores are good predictive factors of the likelihood of a positive scan outcome.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The role of Tc-99m tetrofosmin single-photon emission tomography (SPECT) in the evaluation of myocardial perfusion before and 6 months after successful percutaneous transluminal coronary angioplasty (PTCA) was assessed in 41 consecutive patients (32 men and 9 women). Twenty-five patients had one-vessel disease, 14 had two-vessel disease, and 2 had three-vessel disease. Thirty-six patients had dilation of one vessel and five patients dilation of two stenosed vessels, with a total of 46 dilated vessels. All patients underwent coronary angiography both before PTCA and 6 months after revascularization. Restenosis was angiographically demonstrated in 16 (39%) patients and 16 (34.8%) vessels. Tc-99m tetrofosmin myocardial SPECT was 81.3% sensitive and 88% specific for the detection of restenosis in the group of patients with a positive predictive value of 81.3% and a negative predictive value of 88%. Sensitivity, specificity, positive predictive value, and negative predictive value were 81.3%, 90%, 76.5%, and 89.7%, respectively, for restenosis detection in specific vessels. It was concluded that most patients who underwent successful PTCA (34 of 41, or 82.9%) had significant (P< 0.001) improvement in their scan image 6 months after the angioplasty, and that Tc-99m tetrofosmin myocardial SPECT is an excellent tool to follow these patients because it can detect restenosis accurately and noninvasively.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Two cases of malignant melanoma (primary and metastatic lesions) imaged with Tc-99m tetrofosmin are reported. One patient showed intense uptake in a primary skin lesion of the thorax, and the other patient had accumulation in skin, cerebellum, breast, and lymph node metastases. Like Tc-99m MIBI, Tc-99m tetrofosmin imaging may be of clinical relevance in the evaluation of suspicious skin lesions and in patients with known cutaneous malignant melanoma in the assessment of recurrent disease during follow-up evaluation.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Discrepancies have been reported between the findings of Tc-99m HMPAO and Tc-99m ECD brain perfusion SPECT imaging. This study investigated the discrepancies in the accumulation of these tracers using dynamic SPECT to detect the super early phase of distribution. Thirteen patients with luxury perfusion or high flow states were studied with both dynamic and standard SPECT using Tc-99m HMPAO and Tc-99m ECD within 1-3 days. Standard SPECT showed discrepancies in 6 of 13 patients. Patients with meningioma and cerebral thrombosis had increased accumulation of Tc-99m HMPAO and decreased uptake of Tc-99m ECD. Patients with arteriovenous malformation, subarachnoid hemorrhage, and cavernous angioma had decreased accumulation of both tracers, but to different degrees. Dynamic SPECT showed increased or normal accumulation (i.e., essentially no discrepancy) in the first few minutes. However, Tc-99m HMPAO had a longer retention time than Tc-99m ECD in the ensuing 5-10 minutes. Dynamic SPECT revealed a similar accumulation pattern but different washout rates for the two tracers. Tc-99m HMPAO might be a more suitable tracer to detect high flow states or luxury perfusion because the findings on standard SPECT were more in agreement with those of dynamic SPECT using this tracer.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The objective of this study was to determine which semiquantitative thallium-201 brain tumor index correlated best with clinical outcome. Fifty-two patients had Tl-201 brain single-photon emission computer tomography (SPECT) performed for the evaluation of recurrent brain tumor. A semi-quantitative tumor index was calculated utilizing four currently available techniques: 1) the ratio of average counts of the region of interest (ROI) in the lesion area and its mirror image in normal brain tissue, 2) the ratio of maximum counts of the region of interest in the lesion area and its average counts in the mirror image, 3) the ratio of maximum counts of the region of interest in the lesion area and its mirror image and 4) the ratio of the average counts of the region of interest in the lesion area and the region of interest of the scalp. A two-tailed Student'sttest was performed. The mean value plus one standard deviation was used to assess the sensitivity and specificity correlated with clinical follow-up evaluation, defined as inactive or active at the time of brain SPECT by the referring neurosurgeons.Results of correlation coefficient,Pvalue, mean, standard deviation, sensitivity, and specificity of each index using cutoff values were obtained. For those patients with recurrence or residual malignant tumor after therapy, the maximum count ratio index correlated best with clinical outcome. It provided a sensitivity of 92% and specificity of 88% in differentiating active from inactive brain tumors.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Bone scanning agents have been reported to accumulate in many different benign and malignant neoplasms. The degree of uptake has been shown to relate to calcium content. Pulmonary hamartoma is the most common benign lung tumor. Calcifications are present in 25-30% of cases and are best demonstrated by CT. A 73-year-old man underwent bone scintigraphy to exclude skeletal metastases from a prostatic primary tumor. There were no metastases, but abnormal uptake was noted in the left lower lobe. A CT scan showed a 4-cm lung mass containing multiple calcifications typical for pulmonary hamartoma.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID