99m Technetium Pertechnetate Thyroid Scan for remnant thyroid tissue detection among post-thyroidectomy patients at Jose R. Reyes Memorial Medical Center: A retrospective analysis

@#This study aims to determine the diagnostic value of a 99mTc-pertechnetate (99m TcO-4) thyroid scan among patients with DTC who underwent thyroidectomy to assess functioning thyroid remnants before radioactive iodine therapy. A retrospective non-experimental cross-sectional design was done to compare the results of the 99m TcO-4 thyroid scan with the patient's post-RAI scan. A review of all our patients' charts was done for eight years, and after excluding those that did not fit the criteria, 70 patients were included in the study. Data collected was analyzed on a "per patient" basis– where patients either had a "positive scan" or "negative scan", and on a "per lesion" basis – where every lesion's presence and size were compared on both modalities. 99m TcO-4 thyroid scan in the "per patient" analysis showed a sensitivity of 73.91%, specificity of 100%, positive predictive value (PPV) or 100%, and accuracy of 74.29%, however, negative predictive value was determined to be 5.26%. In the "per lesion" analysis, the scan had a less favorable performance with the computed sensitivity of 61.69%, PPV of 94.93%, and accuracy at 59.41%. It was then concluded that 99mTc-pertechnetate scan may be useful in determining functioning remnant thyroid tissue and subsequent management of DTC patients after thyroidectomy, but must take note of its low negative predictive value.

Impact of percutaneous nephrolithotomy operation on non-operated kidney: a single center based study

Background: Effects of percutaneous nephrolithotomy (PCNL) operation on ipsilateral renal function are widely known but functional changes in opposite kidney are limited. Authors have conducted this study to evaluate the impact of PCNL operation on the contralateral side during early post-operative period.Methods: From 1st November 2016 to 30th September 2018, those patients presented with unilateral renal stone disease were enrolled. After exclusion they were subjected to PCNL operation under general anaesthesia. Along with preoperative period, 99 m Tc DTPA renal scan is repeated at 3rd and 14th post-operative period.Results: Out of 121 patients enrolled we included 96 patients after exclusion. They are divided into 3 age groups, 19-32, 33-47 and 48-60 years. The mean GFR at pre-operative, post-operative day-3 and 14 of normal kidney in these 3 age groups are 47.32, 47.63 and 42.32 ml/min, 44.29, 45.78 and 40.63 ml/min and 47.10, 48.47 and 41.01 ml/min respectively. At post op day-3 there are reduction of mean GFR in all age groups but statistically not significant (p >0.05). At post-operative day-14 GFR improved towards the pre-op value but the change is also not significant (p >0.05).Conclusions: There are reduction of GFR of contralateral normal kidney following PCNL operation in early post-operative period. So, along with operated kidney normal kidney also showed decrease GFR. It is better to avoid further trauma in post PCNL patient like avoidance of using nephrotoxic medication, contrast agents, ESWL, etc. This study can guide us to avoid further trauma of any kidney.

The Lymphatic Drainage Pattern of Internal Mammary Sentinel Lymph Node Identified by Small Particle Radiotracer ((99m)Tc-Dextran 40) in Breast / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to detect the lymphatic drainage pattern of internal mammary area and verify the concept of internal mammary sentinel lymph node (IM-SLN) in breast. MATERIALS AND METHODS: A small particle radiotracer ((99m)Tc-Dextran 40) was prepared and tested. (99m)Tc-Dextran 40 was injected into intraparenchyma at the sound breast by a modified radiotracer injection technique. Subsequently, dynamic single-photon emission computed tomography (SPECT), computed tomography (CT), and SPECT/CT combination images were performed to identify the radioactive lymph vessels and internal mammary lymph nodes (IMLNs). The direction of lymph drainage and the location of the IMLNs were identified in the SPECT/CT imaging. RESULTS: The radiochemical purity of (99m)Tc-Dextran 40 was > 95%. (99m)Tc-Dextran 40 could drainage into first, second, and third lymph node and the radioactive lymph node could be detected by the γ detector in the animal experiment. After (99m)Tc-Dextran 40 injecting into intraparenchyma, 50.0% cases (15/30) were identified the drainage lymphatic vessels and radioactive IMLNs by SPECT. The drainage lymphatic vessel was found from injection point to the first IMLN (IM-SLN) after 10.5±0.35 minutes radiotracer injection, and then (99m)Tc-Dextran 40 was accumulated into the IM-SLN. The combination imaging of SPECT/CT showed the second IMLN received the lymph drainage from the IM-SLN. The lymphatic drainage was step by step in the internal mammary area. CONCLUSION: The lymph was identified to drain from different regions of the breast to IM-SLN, and then outward from IM-SLN to other IMLN consecutively. It demonstrated the concept of the IM-SLN and provided more evidences for the application of internal mammary sentinel lymph node biopsy.

Characteristics of 99m Tc-MDP bone imaging in patients with bone tumors and tumor-like lesions of extremities and their differential diagnosis significances / 吉林大学学报(医学版)

Objective: To explore the radionuclide distribution characteristics of99m Tc-MDP bone imaging of bone tumors or tumor-like lesions in extremities, to clarify the application value of radionuclide distribution characteristics of99mTc-MDP bone imaging of bone tumor and tumor-like lesions with different pathological types in the differential diagnosis, and to provide the clues for clinical diagnosis. Methods: A total of 76 patients with abnormal radionuclide distribution characterics of exetremities showed in99mTc-MDP bone imaging were selected. The results of99mTc-MDP bone imaging were compared with the results of the final clinica diagnosis. The differences in the age, lesion location, radienuclide distribution characteristics of the patients with different pathological types were analyzed. Semi quantitative method (T/N) was used to detect the degree of radioactivity and the differences in T/N between benign and malignant lesions groups. Results: (1) Among 76 patients with bone tumors and tumor-like lesions, the pathological benign findings were in 24 cases and the malignant findings were in 52 cases. (2)The age of the patients with giant cell tumor of bone around knee joint was (42. 1 ± 17. 4) years old, and the age of the patients with fibrous dysplasia in proximal femur was (48. 0 ± 17. 1) years old. In malignant lesions, the age of the patients with metastatic carcinoma located in femoral shaft was (64.0 ± 14.2) years old; the age of the patients with osteosarcoma around epiphysis end was (30. 3± 15. 3) years old; the age of the patient with Ewing' s sarcoma located in femur was (49. 2 ± 4. 7) years old; the age of patients with fibrosarcoma in long bone was (39. 5 ± 17. 2) years old; the age of patients with chondrosarcoma occurred in long bone was (63. 0± 14. 8) years old. (3)The radionuclide distribution characteristics of giant cell tumor, osteosarcoma, Ewing's sarcoma, chondrosarcoma and fibrosarcoma were "wedge" or "lumpy"; the radiological defect of giant cell tumor was greater than Ewing' s sarcoma and fibrosarcoma, while osteosarcoma and chondrosarcoma rarely had center defects; the radionuclide distribution characteristics of fibrous dysplasia and metastasis were " strip-type", and the metastases involving bilateral cortical bone had the radioactive defect in the central region, but fibrous dysplasia distributed uniformly along with the unilateral cortical bone. (4) The average value of T/N in malignant lesions (3. 38±1. 95) was higher than that in benign lesions (1. 43±0. 51) (t=-11.35, P<0. 01). Conclusion: The pathological types of lesions can be preliminarily speculated according to the characteristics of99mTc-MDP bone imaging of bone tumors and tumor-like lesions of extremities, which can provide a reliable reference for clinical diagnosis and differential diagnosis.

Altered Biodistribution of (99m)Tc-DPD on Bone Scan After Intravenous Iron Supplement / 대한핵의학회잡지

We report a casewith altered biodistribution of (99m)Tc-dicarboxypropane diphosphonate ((99m)Tc-DPD) on whole body bone scan after intravenous iron supplement therapy. A 47-year-old male patient who had recently been detected with a hepatic mass suggestive of hepatocellular carcinoma underwent bone scan as staging work-up before surgery. Bone scan images at 3 h after injection of (99m)Tc-DPD demonstrated unusually increased blood pool activities in the heart, liver, and spleen with usual skeletal uptakes. The patient had been treated for severe anemia from hemorrhoid with two intravenous administration of ferric hydroxide carboxymaltose complex at approximately 22 h and 2 h prior to the (99m)Tc-DPD injection, which we consider as themost probable cause of altered biodistribution of (99m)Tc-DPD.

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal (99m)Tc-Sestamibi Retention / 대한핵의학회잡지

PURPOSE: Parathyroid adenoma detection with dual-phase (99m)Tc-sestamibi (MIBI) scintigraphy depends on differential MIBI washout from thyroid. However, autoimmune thyroid disease (AITD) may cause MIBI to be retained in the thyroid gland and reduce parathyroid detection.We evaluated the impact of AITD on MIBI thyroid retention and additional benefit of SPECT/CT in these patients.METHODS: Dual phase planar MIBI and SPECT/CT was performed on 82 patients. SPECT/CTwas performed immediatelyafter delayed planar scan. Thyroid density (Hounsfield unit, CT-HU) and size were measured on CT component of SPECT/CT. MIBI uptake in early scans and retention in delayed scans were visually graded and correlated with clinical factors and CT findings. Finally, planar and SPECT/CT findings were compared for parathyroid lesion visualization according to thyroid MIBI retention.RESULTS: In early scan, multivariate analysis showed only thyroid size predicted early uptake. In delayed scan, multivariate analysis showed higher visual grade in early scan, lower CTHU or AITD were significant predictors for delayed thyroid parenchymal retention. Overall, ten more parathyroid lesions were visualized on SPECT/CT compared to planar scans (57 vs. 47, p = 0.002). SPECT/CT was especially more useful in patients with thyroidal MIBI retention, as eight out of the ten additional lesions detected were found in patients with thyroid MIBI retention.CONCLUSION: AITD is an important factor for MIBI thyroid parenchymal retention on delayed scans, and may impede parathyroid lesion detection. Patients with MIBI retention in the thyroid parenchyma on delayed scans are likely to benefit from an additional SPECT/CT.

Comparative Analysis of (99m)Tc-MDP Three-Phase Bone Scan with SPECT/CT and (99m)Tc-HMPAO-Labeled WBC SPECT/CT in the Differential Diagnosis of Clinically Suspicious Post-traumatic Osteomyelitis / 대한핵의학회잡지

PURPOSE: To identify differences between three-phase bone scan and SPECT/CT (TBS) and WBC SPECT/CT (WS) and compare diagnostic accuracies of each modality in patients with suspicious post-traumatic osteomyelitis (OM).METHODS: Twenty-one patients with suspicious post-traumatic OM were enrolled. All patients performed TBS and WS within 1 week. Foci ofMDP andWBC accumulation were divided into three categories: bone (OM), soft tissue (soft tissue inflammation; STI), negative for inflammation (NI). Confirmative diagnosis was made upon operative pathology or long-term clinical follow-up.RESULTS: Of 21 patients, four OM, eight STI, nine NI were finally diagnosed. TBS diagnosis was correct in three of four positive cases and nine of 17 negative cases. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) of TBS were 75 %, 52.9 %, 57.1 %, 27.3 %, 90 %. WS diagnosis was correct in two of four positive cases and 17 of 17 negative cases. Sensitivity, specificity, accuracy, PPV, NPV were 50 %, 100 %, 81.0 %, 100 %, 89.5 %. Twelve of 21 cases showed agreement between TBS and WS. TBS misdiagnosed nine cases (six STI and two NI as eight OM; one OM as one STI), while WS misdiagnosed four cases (two OM as two STI; two STI as two NI). Combining results from TBS and WS led to better diagnostic accuracy (91.7 %) than either TBS or WS alone.CONCLUSION: TBS and WS showed moderate agreement in assessment of clinically suspected post-traumatic OM. WS better evaluated inflammation than TBS. WS tended to underestimate inflammation whereas TBS tended to overestimate inflammation. Combining TBS and WS enhanced diagnostic accuracy.

Correlations between Tumor to Background Ratio on Breast-Specific Gamma Imaging and Prognostic Factors in Breast Cancer

The purpose of this study was to investigate the correlations between tumor-to-background ratio (TBR) obtained from breast-specific gamma imaging (BSGI) and the prognostic factors of breast cancer. Sixty-seven patients with invasive ductal carcinoma who underwent preoperative BSGI were enrolled. The BSGI images were visually scored from 1 to 5 according to a breast imaging reporting and data system (BIRADS). The TBR results obtained from positive BSGI images were compared according to the following prognostic factors: tumor size; axillary lymph node metastasis; nuclear grade (NG); histologic grade (HG); subtype; Ki-67; and the expression profile of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Among 67 images, 60 were classified as a positive finding (sensitivity 89.6%). A higher TBR value was significantly correlated with tumor size ≥ 2 cm (P = 0.001), axillary lymph node metastasis (P = 0.007), high HG (P = 0.029), negative PR status (P = 0.036), and Ki-67 ≥ 14% (P = 0.007). The TBR showed a significant difference between the luminal A and non-luminal A subtypes (P = 0.007). On multivariate analysis, TBR had a high correlation with tumor size ≥ 2 cm, axillary lymph node metastasis, and negative PR status (P = 0.003, 0.048, and 0.030, respectively). A high TBR on BSGI was significantly correlated with poor prognostic factors of breast cancer. Luminal A subtype, a breast cancer subtype with more favorable prognosis, was associated with a low TBR on BSGI.

Evaluation of reversal effect of 2-DG on multidrug resistance by detecting uptake of 99mTc-MIBI in HNE-1/DDP cells / 中国药理学通报

Aim To evaluate the reversal effect of 2-deoxy-D-glucose ( 2-DG ) on multidrug resistance ( MDR) by observing the uptake change of 99m Tc-MIBI in HNE-1/DDP cells, and to explore its mechanism. Methods The uptake of 99m Tc-MIBI in HNE-1/DDP cells under different concentrations of 2-DG was detec-ted by γ-counter, and the clearance rates of 99m Tc-MI-BI in HNE-1 cells and HNE-1/DDP cells after treated with 2-DG (10 mmol·L-1 ) were compared. The con-tent of ATP in HNE-1/DDP cells was detected after treated with 2-DG. P-glycoprotein ( P-gp ) and multi-drug resistance-associated proteins ( MRP ) expression were measured by Western blot. Apoptotic HNE-1/DDP cells treated with DDP alone or combined with 2-DG (10 mmol·L-1 ) were detected by propidium io-dide ( PI ) staining. Results The clearance rate of 99m Tc-MIBI in HNE-1/DDP cells was 54. 8%, which was significantly higher than that ( - 41. 3%) in HNE-1 cells (P<0. 01). The clearance rate of 99mTc-MIBI in HNE-1/DDP cells was -203. 7% after treat-ment with 2-DG ( 10 mmol · L-1 ) , which could be significantly reduced compared with the control group ( P<0. 01 ) . The level of ATP was 55 . 69% compared with the negative control group and the expression of P-gp and MRP protein decreased dramatically in HNE-1/DDP. With the combination of 2-DG and DDP, the ap-optotic rate of HNE-1/DDP cells reached 49 . 4%which was significantly higher than DDP treated group (22. 5%) . Conclusion Multidrug resistance and the reversal effect of 2-DG on multidrug resistance could be evaluated effectively by detecting the uptake change of 99m Tc-MIBI in HNE-1/DDP cells. The mechanism may be related with the inhibition of ATP level and the re-duced expression of P-gp and MRP protein in cancer cells.

The Value of SPECT/CT in Localizing Pain Site and Prediction of Treatment Response in Patients with Chronic Low Back Pain

In many circumstances, causing sites of low back pain (LBP) cannot be determined only by anatomical imaging. Combined functional and morphological imaging such as bone scan with single-photon emission computed tomography/computed tomography (SPECT/CT) may be helpful in identifying active lesions. The purpose of this study was to evaluate the usefulness of bone SPECT/CT in localizing the pain site and the treatment of chronic LBP. One hundred seventy-five patients suffering from chronic LBP who underwent SPECT/CT were included, retrospectively. All of the patients received multiple general treatments according to the symptoms, and some of them underwent additional target-specific treatment based on SPECT/CT. Numerical rating scale (NRS) pain score was used to assess the pain intensity. Of 175 patients, 127 showed good response to the given therapies, while the rest did not. Overall, 79.4% of patients with definite active lesions showed good response. Patients with mild active or no lesions on SPECT/CT had relatively lower response rate of 63.0%. Good response was observed by the treatment with the guidance of active lesions identified on SPECT/CT. SPECT/CT could be useful in identifying active lesions in patients with chronic LBP and guiding the clinicians to use adequate treatment.

In vivo imaging of 99 m Tc-Glucarate-labeled acute necrotic myocardium using microSPECT/CT / 中国比较医学杂志

Objective To evaluate the anatomic localization and size of acute necrotic myocardium in the ischemic-reperfused rat hearts using 99m TC-Glucarate and microSPECT/CT.Methods The ischemic-reperfused ( IR) rat heart models were established by ligating left anterior descending coronary artery for 60 min.99mTC-Glucarate was intravenously injected into the rats 24 hours after IR operations .Images were acquired 30 min after administration of 99m TC-Glucarate using microSPECT/CT. Anatomic localization and size of acute necrotic myocardium were analyzed with microSPECT/CT imaging , and these results were compared to those determined by triphenyltetrazolium chloride ( TTC ) staining.Results The microSPECT/CT images showed hot spot accumulations of 99mTC-Glucarate in IR hearts (the heart-to-liver ratio was 1.90 ±0.33), not in controls (P <0.05).The anatomic localization of 99mTC-Glucarate-labeled necrotic myocardium were in correspondence with TTC staining results .The hot spot size was related significantly to necrotic myocardial size determined by TTC staining ( R2 =0.964 ) .Conclusions The localization and size of acute necrotic myocardium can be assessed by non-invasive microSPECT/CT imaging with99m Tc-Glucarate.

Changes in Cerebral Vascular Reserve Capacity after Carotid Artery Stenting: A 6-Month Follow-up Study

BACKGROUND: Assessment of cerebral vascular reserve capacity prior to carotid artery stenting is used for predicting hyperperfusion syndrome. However, the changes in vascular reserve capacity after carotid stenting are not fully understood. In this study we investigated the effects of carotid artery stenting on the restoration of vascular reserve capacity using (99m)TC-hexamethylpropylene amine oxime (HMPAO) single-photon-emission computed tomography (SPECT). METHODS: The study population comprised 29 patients who underwent carotid artery stenting. Patients were divided into groups according to occlusion of the contralateral internal carotid artery (unilateral group vs bilateral group) and according to the presence or absence of symptoms related to carotid stenosis (symptomatic group vs asymptomatic group). Pre- and postacetazolamide-activated (99m)TC-HMPAO SPECT were performed prior to stent insertion and at 1 and 6 months postoperatively. Vascular reserve capacity was assessed based on pre-, and 1- and 6-month postacetazolamide gamma count ratio (Post0, Post1, and Post6, respectively) and cerebrovascular reactivity (CVR0, CRV1, and CRV6, respectively). RESULTS: The postacetazolamide gamma count ratio and cerebrovascular reactivity tended to improve at 1 month after stenting, but tended to deteriorate at 6 months after stenting in the unilateral group compared with the bilateral group [Post0-Post1=0.045+/-0.078 (mean+/-SD), p=0.014; Post0-Post6=0.025+/-0.063, p=0.042; Post1-Post6=-0.020+/-0.047, p=0.102; CVR0-CVR1=0.043+/-0.071, p=0.008, CVR0-CVR6=0.019+/-0.063, p=0.097; CVR1-CVR6=-0.024+/-0.047, p=0.008] and in the symptomatic group compared with the asymptomatic group (Post0-Post1=0.058+/-0.106, p=0.038; Post0-Post6=0.048+/-0.103, p=0.061; Post1-Post6=-0.010+/-0.048, p=0.700; CVR0-CVR1=0.037+/-0.083, p=0.074; CVR0-CVR6=0.014+/-0.073, p=0.344; CVR1-CVR6=-0.023+/-0.054, p=0.055). CONCLUSIONS: The observed increases in postacetazolamide gamma count ratio and cerebrovascular reactivity at 1 month followed by decreases at 6 months may reflect the restoration of vascular reserve capacity. Carotid artery stenting can improve vascular reserve capacity, especially in patients with unilateral stenosis and with symptomatic stenosis.

Utilidad del [99m] Tc TRODAT-1 en el diagnóstico de la enfermedad de Parkinson / Utility of (99m) Tc TRODAT-1 imaging in diagnosing Parkinson's disease

Propósito de la revisión: la enfermedad de Parkinson (EP) es un trastorno degenerativo caracterizado clínicamente por presentar temblor en reposo, rigidez y bradicinesia. El propósito es determinar la utilidad de la molécula TRODAT-1 en el diagnóstico de la EP. Metodología: se realizó una búsqueda en las bases de datos: PUBMED, COCHRANE , MEDLINE , LILACS y SCIE LO en un periodo de 10 años desde enero de 1998 a enero de 2008. Se obtuvieron 26 artículos, éstos se analizaron y se seleccionaron 10, de los cuales sólo seis respondían a las necesidades del estudio, de acuerdo con los criterios de inclusión. De los seis artículos analizados, cuatro fueron clasificados como evidencia grado (+) y los dos restantes evidencia grado (-) de acuerdo con las guías NI CE. Todos los artículos revisados reportan una disminución importante en la captación del TRODAT-1 a nivel estriatal, su utilidad en el diagnóstico de EP en estadios tempranos, bajo costo y seguridad. Sólo tres reportan valores de sensibilidad y especificidad, pero su nivel de calidad no permite hacer una comparación de los mismos. Conclusiones: se propone realizar estudios de prueba diagnóstica comparados con el diagnóstico clínico de la enfermedad, que tengan un acuerdo en la forma de plantear las mediciones semicuantitativas de las unidades de captación utilizando las mismas fórmulas para hacerlos comparables (Acta Med Colomb 2010; 35: 119-125).

Purpose: Parkinson disease (PD) is a degenerative disorder. The clinical symptoms of this disease are resting tremor, rigidity and bradykinesia. The purpose of this literature review is to determine the utility of TRODAT -1 in the diagnosis of PD. A search covered PUBMED, COCHRANE, MEDLINE, LILACS and SCIELO databases, between January 1998 and January 2008. Study selection: twenty six articles were obtained with their respective abstracts. After the first review, ten of them were chosen and only six of them met the inclusion criteria. Four articles were classified as grade evidence (+) and two as grade evidence (-) according to NICE guides. All the articles reviewed report significantly decreased striatal uptake of TRODAT-1 in early PD patients, suggesting that this is a useful, safe, and inexpensive tool in the diagnosis of early PD. It was not possible to perform a meta-analysis with the chosen articles because only three of them reported sensitivity and specificity, and each of these used different criteria for their semi-quantitative analyses. This variability makes comparison of the semiquantitative uptake criteria impossible. Conclusions: establishment of a universal technique for quantitation of TRODAT-1 uptake is necessary in order to make meta-analysis viable and allow comparison of the usefulness of this agent among large numbers of patients and multiple populations (Acta Med Colomb 2010; 35: 119-125).

Scintigraphy of the salivary gland in patients with Sjõgren's syndrome treated with pilocarpine / Cintigrafia da glândula salivar em pacientes com Síndrome de Sjogren tratados com pilocarpina

OBJECTIVE: This report describes monitoring of salivary glands through scintigraphy in one patientwith SS before and after the administration of 1% pilocarpine. DISCUSSION: Sjõgren’s Syndrome(SS) is an immune-mediated disease that most commonly attacks the exocrine glands. The diagnosisof SS is based on the objective and subjective criteria that confirm the damage or diminished activityof salivary and lachrymal glands, in turn resulting in xerostomia and xerophthalmia. CONCLUSION:Scintigraphy with [99mTc] pertechnetate can be used to assess the progression of disease activity, thelocation affected and severity on the glands involved. Scintigraphy can also be used to assess xerostomiathrough activity time analyses, numeric indices, visual interpretations, and radiopharmaceuticalpercentages retained in the gland.

OBJETIVO: Este relato descreve a monitoração de glândulas salivares por meio de cintigrafia em umpaciente com Síndrome de Sjogren antes e após administração de pilocarpina a 1%. DISCUSSÃO: ASíndrome de Sjogren (SJ) é uma doença imunomediada que mais comumente ataca as glândulas exócrinas. O diagóstico da SJ é baseado em critérios objetivos e subjetivos que confirmam o dano ou atividadediminuída das glândulas salivares e lacrimais, resultando em xerostomia e xeroftalmia. CONCLUSÃO:Cintigrafia com pertecnato [99mTc] pode ser para determinar a progressão da doença, o local afetado ea severidade do envolvimento glandular. A cintigrafia pode também ser usada para avaliar xerostomiapor análises de atividade no tempo, índices numéricos, interpretação visual e porcentagensradiofarmacêuticas retidas na glândula.

Comparative Study on Initial Symptoms Using Single Photon Emission Computer Tomography in Schizophrenia

OBJECTIVES: This study was conducted to compare between hallucination group and delusion group in patient with schizophrenia, using Brain (99m)Tc-ECD SPECT. METHODS: Among 16 patients with less than 3 schizophrenic episodes, 8 patients whose initial symptom was hallucination were assigned to the hallucination group, and other 8 patients with initial sumptom of delusion were assinged to the hallucination group. All of the patients clinically evaluated using the PANSS and BPRS. Both groups of patients and 8 healthy subjects underwent (99m)Tc-ECD SPECT. RESULTS: Score of thinking disturbance subscale of BPRS were significantly lower in the hallucination group than the delusion group. In SPECT analysis, the hallucination group showed significantly increased perfusion in some areas of the right temporal lobe, bilateral limbic lobes and left parietal lobe compared to delusion group. Both group had a reduced rCBF in some areas of the frontal lobe. CONCLUSION: The hallucniation group, compared with the delusion group, showed significantly increased regional cerebral blood flow in some regions. Therefore, this data suggests that different neural substrates may affect the process of auditory hallucination and delusion.

The measurement of affinity of site-specific labeled annexin V with ~(99m)Tc by calcium titration / 基础医学与临床

Objective To derermine the affinity of site-specific labeled annexin V with ~(99m)Tc to phosphatidylserine (PS)exposed erythrocytes.Methods The annexin V fused with a metal chelating binding site was obtained from Pichia Pastoris culture and methanol induction expression.The annexin V was purified from the culture supernatant crude product by uhrafihration.The annexin V was conjugated with ~(99m)Tc site-specifically through sodium glucoheptonic acid and SnCl_2.The radioactive annexin V was added to determine its affinity to PS exposed erythrocytes.Results The calcium concentration at which half of the protein is bound to cells(EC50)is changed with varying ratio of protein to cells.The affinity was determined at a low protein/cell ratio as 33.4.Conclusion The annexin V recombinantly expressed in Pichia Pastoris shows high affinity to PS exposed erythrocytes.

False negative bone scan finding of vertebral metastatic compression fracture: A case report

Bone scan using (99m)Tc-MDP is the most accurate and reliable method for the early detection of fracture, and that is the screening procedure of choice for the demonstration of bone metastases. It is well known that it has superior sensitivity to radiography for this purpose. We report the case of 41 years old man with known primary tumor and metastatic vertebral fracture presenting false negative bone scan finding.

(99m)Tc-HDP Bone Scintigraphy Finding of Metastatic Renal Cell Carcinoma Bone Lesion Changed from Hot to Cold Lesion: Comparing with (18)F-FDG PET/CT / 핵의학분자영상

A 26-year-old man with renal cell carcinoma underwent (99m)Tc-HDP bone scintigraphy for detecting bony metastasis after left total nephrectomy for renal cell carcinoma. (99m)Tc-HDP bone scintigraphy showed small hot lesion in the first lumbar spine. About 12 months later, he underwent spinal MRI for lower back pain. A large mass was seen around spinous process of the first lumbar spine (L1) on spinal MRI and confirmed as metastatic renal cell carcinoma by bone biopsy. (99m)Tc-HDP bone scintigraphy and (18)F-FDG PET/CT were underwent for further evaluation. (99m)Tc-HDP bone scintigraphy showed cold lesion in the first lumbar spine which was initially hot and newly developed hot lesion in the twelfth thoracic spine, and which were shown as hypermetabolic lesions in (18)F-FDG PET/CT. We report a case of bony metastasis from renal cell carcinoma which is changed from hot lesion to cold lesion in (99m)Tc-HDP bone scintigraphy and compare with (18)F-FDG PET/CT.

Juvenile Dermatomyositis Diagnosed by (99m)Tc-HDP Three-phase Bone Scintigraphy / 핵의학분자영상

Juvenile dermatomyositis is a common inflammatory muscle disease of childhood, characterized by weakness in proximal muscles and specific skin rash. In case of juvenile dermatomyositis without characteristic clinical features, non-invasive imaging tools such as (99m)Tc-HDP three-phase bone scan are very helpful in diagnostic workup of myopathies. We report a case of 13-year old female with juvenile dermatomyositis, in which (99m)Tc-HDP three-phase bone scan was useful in diagnosis and assessing therapy response.

Camurati-Engelmann's Disease on (99m)Tc-MDP Bone Scan / 핵의학분자영상

A 24 year-old female presented for a (99m)Tc-methylene diphosphonatae (MDP) whole body bone scan due to chronic pain in the bilateral lower extremities that has aggravated since 2002. She was diagnosed with Camurati-Engelmann disease (CED) based on the clinical and radiological findings in 2002, and she re-visited our institute to evaluate disease status at this time. CED is a rare autosomal dominant type of bone dysplasia characterized by progressive cortical thickening of long bones, and narrowing of medullary cavity, and thus presents with typical clinical symptoms and signs such as chronic pain in the extremities, muscle weakness, and waddling gait. On the (99m)Tc-MDP bone scan performed to evaluate disease status, intense increased uptake was seen in the skull, facial bones, bilateral scapulae, bilateral long bones, and bilateral pelvic bones, which clearly demonstrated the extent of CED involvement.