ABSTRACT
Objective[s]: in this study, we aimed to analyze the relationship between the diagnostic ability of fused single photon emission computed tomography/computed tomography [SPECT/CT] images in localization of parathyroid lesions and the size of adenomas or hyperplastic glands
Methods: five patients with primary hyperparathyroidism [PHPT] and 4 patients with secondary hyperparathyroidism [SHPT] were imaged 15 and 120 minutes after the intravenous injection of technetium99mmethoxyisobutylisonitrile [[99m]Tc-MIBI]. All patients underwent surgery and 5 parathyroid adenomas and 10 hyperplastic glands were detected. Pathologic findings were correlated with imaging results
Results: the SPECT/CT fusion images were able to detect all parathyroid adenomas even with the greatest axial diameter of 0.6 cm. Planar scintigraphy and SPECT imaging could not detect parathyroid adenomas with an axial diameter of 1.0 to 1.2 cm. Four out of 10 [40%] hyperplastic parathyroid glands were diagnosed, using planar and SPECT imaging and 5 out of 10 [50%] hyperplastic parathyroid glands were localized, using SPECT/CT fusion images
Conclusion: SPECT/CT fusion imaging is a more useful tool for localization of parathyroid lesions, particularly parathyroid adenomas, in comparison with planar and or SPECT imaging
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the urine of renal recipients for the presence of donor DNA in an attempt to establish an alternative diagnostic means of acute rejection.</p><p><b>METHODS</b>Sixty-four renal transplant recipients were examined. Thirty-seven were normal after transplantation, while 22 others developed acute rejection, based on serum creatinine levels and/or needle biopsy findings of the graft. Five developed drug-induced renal dysfunction. In female recipients with a male graft, we examined urine for the presence of Y chromosome (SRY and DYZ-1) and in recipients receiving an HLA mismatched graft, we looked for HLA-DR gene (DRB1) using PCR.</p><p><b>RESULTS</b>Among the 14 female recipients with male grafts demonstrating stable renal function, only one was positive for SRY and DYZ-1 on the Y chromosome. However, SRY and DYZ-1 were found in the urine of four female patients with acute rejection, but these DNA fragments were not detected in 3 of the 4 after anti-rejection therapy. The last patient was referred to hemodialysis. Of 23 recipients of a graft from HLA mismatch donors with stable renal function, DRB1 was negative in 21 (91%). Of 18 patients with acute rejection, DRB1 was positive in 16 (89%) and negative in 2. These DNA fragments were no longer found in 13 patients after anti-rejection therapy. In all patients with drug induced renal dysfunction, donor-derived DNA was negative.</p><p><b>CONCLUSIONS</b>Presence of door specific DNA in the urine of the recipient is strongly associated with acute rejection. Analysis of DNA derived from donor cells in urine was an effective and accurate method for the diagnosis of acute rejection of a renal transplant.</p>