ABSTRACT
Evaluation of pattern of distribution of skeletal metastases in patients with breast carcinoma. by using [99m]Tc MDP Skeletal Scintigraphy. Retrospective Analysis. Study was conducted at Punjab Institute of Nuclear Medicine [PINUM], Faisalabad Pakistan from January 2006 to June 2009. A retrospective study was performed on 465 consecutive patients having CA Breast irrespective of preoperative/postoperative status, presenting for bone scan at Punjab Institute of Nuclear Medicine. Whole body bone scan was performed, along with additional spot views, where needed. The images were interpreted for metastatic deposits by three independent observers. Where needed, plain X-ray was performed to correlate in favor of benign pathology. Out of 465 patients [453 female and 12 Male], 286 [62%] patients were having either normal bone scan or some benign pathology as correlated with plain x-ray of the suspected area. 179 [38%] patients were positive for metastases within skeleton. Among these, 61.4% patients were having multiple, 14% with two, while 24.6% were diagnosed as having solitary lesions within the skeleton. In patients having multiple skeletal lesions, highest number was noted in spine [84.5%- most common in thoracolumbar], followed by ribs [55.5%], pelvis [37.3%---most frequent in iliac bone], skull [32%], scapula [27.3%], sternum [26.4%], femur [19.1%], humerus [14.5%], clavicle [3.6%] and tibia [0.9%]. In humerus and femur, most lesions were located in their upper ends, followed by shafts. Right side of skeleton was more frequently involved than the left. In patients having lesions in ribs and pelvis, most of the lesions were bilateral. Patients with two lesions showed maximum number of lesions in rib cage [44%], followed by spine [32%-all being in thoracolumbar region], scapula [24%], pelvis and scapula [24% in each], sternum [16%], skull [8%], humerous and femur [4% in each]. In patients having solitary focal lesion, highest number was noted in spine [45.5%-most common in thoracolumbar spine], followed by ribs [22.7%], sternum and pelvis [13.6% each], and skull [6.8%]. No lesion was noted in appendicular skeleton. Multiple skeletal metastases are much more common than solitary or two lesions in cases of known breast carcinoma. Axial skeleton including skull is most commonly involved. Spine [especially thoracolumbar] is the most frequent site of involvement followed by rib cage, pelvis and then skull. In peripheral bones, most frequent site is the upper end of femur followed by humerus
ABSTRACT
Renal scintigraphy evaluates the renal function non-invasively. The present study was conducted to compare 99mTc MAG3 and 99mTc DTPA in renal transplant patients for the evaluation of renal functions. Materials and 99mTc MAG3 and 99mTc DTPA studies were performed on 33 renal transplant patients and 10 normal subjects, with 1 day interval in between the two studies. Renal transplant patients were categorized as normal, acute tubular necrosis, rejection, urine outflow obstruction and urinary tract infection groups on the basis of routine clinical investigations and preliminary results of scintigraphic studies. Both radiopharmaceuticals, 99mTc MAG3 and 99mTc DTPA were having equal diagnostic efficacy, however image quality with 99mTc MAG3 was superior to that of 99mTc DTPA. Renograms clearly differentiated various renal groups. Correlation between glomerular filtration rate [GFR] and effective renal plasma flow [ERPF] was good [r=0.89 at P<0.00001]. In terms of perfusion index [PI] our results with both agents were similar [r=0.96 at p<0.00001], clearly differentiating all cases of rejection from acute tubular necrosis. PI was raised in rejection cases, while normal in all other groups. In cases of acute tubular necrosis and rejection, 99mTc MAG3 based parenchymal retention index [R-20/3] was markedly raised, compared to that of 99mTc DTPA [p<0.00001]. 99mTc- MAG3 and 99mTc DTPA have equal diagnostic efficacy in renal transplant patients. However visual delineations of the kidneys is better with 99mTc MAG3, especially in cases with compromised renal functions