ABSTRACT
Molybdenum-99 breakthrough is a rare but potential cause of enormous and unjustified radiation exposure to patients and technologist in nuclear medicine. Recommended limit of [99] Mo in an eluate is 0.15 uCi of [99] Mo / mCi of [99m]Tc. The purpose of this clinical audit was to measure the Mo-99 concentration in eluate of PAKGEN [[99] Mo-[99m]Tc generator] before administering to patients as a part of Good Medical Practice [GMP]. This clinical audit was conducted at The Aga Khan University Hospital, Karachi from January to May 2012 and during this period we evaluated 44 [99] Mo-[99m] Tc generators [PAKGEN]. In 369 elutions during this audit period, we did not find any evidence of [99] Mo breakthrough. This clinical audit proves that PAKGEN generators supplied by IPD, PINSTECH, Islamabad had good performance and proved generally to be a reliable source of [99m] Tc-pertechnetate. The application was safe and fulfilled the requirements for good medical practice
ABSTRACT
Paraganglioma are tumors originating from paraganglial system and may be associated with parasympathetic [head, neck and anterior mediastinum tumors] or sympathetic [adrenal or extraadrenal or posterior mediastinal tumor] system. Majority of sympathetic paraganglioma and minority of parasympathetic tumor are functional and [131I or [132]I labeled MIBG [Meta Iodio Benzyl Guanidine] is a well established tool with good sensitivity and exceedingly high specificity. We are presenting a case report of a large extradrenal paraganglioma with extensive bony metastases and raised serum Chromogranin-A level. In this case [131]-MIBG was not only helpful in revealing the true burden of functional disease but also showed an overwhelming therapeutic response proven on post-therapy MIBG scan and normalization of serum Chromogranin-A level. This case report is followed by a mini-review about pathology, genetic mutation, diagnosis and treatment of focused on extraadrenal paragangliomas
ABSTRACT
Solitary metastasis involving sternum in breast cancer is very uncommon and less is known about the possible mechanism. Similarly, clinical significance of this uncommon presentation is elusive. We are presenting a case of breast cancer with isolated sternal metastasis on radionuclide bone scan which was also documented on chest CT study. In this mini-review we will be discussing the possible mechanisms for isolated sternal metastasis in breast cancer, its clinical significance and therapeutic approaches used
ABSTRACT
Chyluria is an abnormal condition in which chyle appears in the urine because of a fistulous communication between the lymphatics and the urinary tract. It is not life-threatening and spontaneous regression is reported in 50% of cases. Lymphangiography has been the main imaging modality for localization of the site of fistula, but it is invasive and requires expertise. Lymphoscintigraphy using Tc-99m labelled colloid is a safe, non-invasive, reproducible technique, which bears less radiation exposure. A 67-year-old male presented with 7-month history of chyluria following a spinal surgery. Bilateral lower limb lymphoscintigram revealed sluggish lymph flow in the left lower limb and visualization of tracer in the left kidney consistent with lymphorenal fistula. Subsequent cystography revealed appearance of chylous urine from left ureter. Patient refused surgery
Subject(s)
Humans , Male , Technetium , Chyle , Urine , Lymphatic System/pathology , Kidney Diseases , Lymphography , Spine/surgery , Urologic Diseases/diagnostic imaging , Urologic Diseases/diagnosis , Radionuclide ImagingABSTRACT
Reflex sympathetic dystrophy is a consequence of overactive sympathetic nervous system that results in burning pain, stiffness, swelling and discoloration of the affected limb. This case report describes the condition in a man that was diagnosed with the help of radionuclide bone scan