Comparison of 67Ga planar imaging and SPECT for the evaluation of activity in undetermined minimal pulmonary tuberculosis / 결핵

BACKGROUND: We have studied the 67Ga SPECT to determine the activity of pulmonary tuberculosis, especially in patients with minimal extent of the disease on chest radiographs. Because active minimal pulmonary tuberculosis is sometimes difficult to diagnose by means of initial chest X-ray, sputum examination and 67Ga planar imaging, we compared 67Ga planar imaging with SPECT to evaluate minimal pulmonary tuberculosis activity. METHODS: 67Ga planar imagings and SPECTs of 69 patients suspected of minimal pulmonary tuberculosis by the initial chest X-ray were performed and compared to each other. Active pulmonary tuberculosis was defined by a positive AFB smear and/or culture in the sputum and changes shown on the serial chest X-ray findings. RESULTS: 1)67Ga planar imaging imagings showed positive uptakes in 24 patients and no uptakes in 13 patients, which confirms active pulmonary tuberculosis. But SPECT imagings showed positive uptakes in 25 patients and no uptakes in 12 patients. 2) Patients confirmed with inactive pulmonary tuberculosis showed no up-take on 67Ga planar imaging. Only one of the 32 patients confirmed as having inactive pulmonary tuberculosis showed positive uptake on 67Ga SPECT imaging. CONCLUSIONS: According to the results of our study, 67Ga planar imaging and SPECT are both sensitive in detecting the activity of minimal pulmonary tuberculosis. The difference between the two methods is not statistically significant, and the negative predictive value of the 67Ga SPECT is not higher than that of 67Ga planar imaging.

Diagnosis of Osteomyelitis by the Sequential Use of ⁹⁹mTc / 대한정형외과학회잡지

The sequential use of ⁹⁹mTc-methylene diphosphonate(⁹⁹mTc-MDP) and ⁶⁷Ga imaging is thought to be useful to diagnose acute hematogenous osteomyelitis, and to determine whether it is active or inactive in chronic osteomyelitis. We compared the results obtained by the sequential use of ⁹⁹mTc-MDP and ⁶⁷Ga imaging with those obtained by the surgical culture and biopsy in 31 patients who were supposed to have the osteomyelitis and admitted to Pusan National University Hospital from July 1987 to July 1989. The results were as follows:l. According to the diagnosis at discharge, 4 cases were normal, 20 cases active osteomyelitis, and 7 cases inactive osteomyelitis. 2. Four normal cases were negative both with ⁹⁹mTc-MDP and with ⁶⁷Ga. Twenty cases of active osteomyelitis showed positive results both with 99mTc-MDP and with ⁶⁷Ga. And of 7 cases of inactive osteomyelitis, 6 cases showed positive ⁹⁹mTc-MDP and negative ⁶⁷Ga, 1 cases was negative both with ⁹⁹mTc-MDP and with ⁶⁷Ga. 3. It is suggested that in active osteomyelitis both ⁹⁹mTc-MDP and ⁶⁷Ga were positive, in inactive osteomyelitis ⁹⁹mTc-MDP positive and ⁶⁷Ga negative and in normal or wastive ostemyelitis both ⁹⁹mTc-MDP and ⁶⁷Ga negative. 4. The sequential use of ⁹⁹mTc-MDP and ⁶⁷Ga imaging was particularly useful to diagnose acute hematogenous osteomyelitis in the case of the obscure diagnosis and supposedly normal radiological finding and to determine whether chronic osteomyelitis is active or complicated by an acute flare-up.