Meta-analysis of technetium-99 methylene disphosphonate combined with methylprednisolone for thyroid-associated ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical effects of using technetium-99 methylene diphosphonate(99Tc-MDP)with methylprednisolone to treat thyroid-associated ophthalmopathy(TAO). <p>METHODS: We retrieved from 9 databases, from their foundation to March 2019, including Pubmed, the Cochrane Library, EMbase, ClinicalTrial.gov, Web of Science, CNKl, VIP database, China Biology Medicine disc, Wanfang database and collected the randomized controlled trail(RCT)of 99Tc-MDP combined with methylprednisolone for treatment of TAO. According to inclusion and exclusion criteria, two researchers retrieved the literature independently, extracted data and evaluate methodological quality. Meta analysis was performed by Review Manager 5.3 software.<p>RESULTS: A total of 8 RCTs were identified with 644 patients. There was significant difference in the overall clinical effective rate between 99Tc-MDP combined with methylprednisolone and methylprednisolone alone(<i>RR</i>=1.14, 95% <i>CI</i>: 1.03-1.26, <i>P</i>=0.01). Significant difierence was found in the effective rate of proptosis between intravenous injection of 99Tc-MDP with methyprednisone and methyprednisone only(<i>RR</i>=1.28, <i>95% CI</i>: 1.16-1.41, <i>P</i><0.00001). Meanwhile, great improvement was seen in diplopia(<i>RR</i>=1.64, <i>95% CI</i>: 1.04-2.58, <i>P</i>=0.03), but there was no significant difference in disturbance of ocular dyskinesia(<i>P</i>=0.37).<p>CONCLUSION: Applying 99Tc-MDP combined with methylprednisolone is better than methylprednisolone alone for TAO with less adverse reaction, which appears to be an effective treatment for TAO.

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.

SPECT/CT fusion of bone scintigraphy in evaluation on long-term healing of limb fractures / 中国医学影像技术

Objective To explore the value of SPECT/CT in evaluation on long-term healing of limb fractures.Methods SPECT/CT imaging characteristics of 68 patients with limb fractures 6 months after treatment were analyzed retrospectively,and the self-healing property of fractures was evaluated.Compared with clinical follow-up results or surgical findings,the accuracy of SPECT/CT in evaluation on long-term healing of fractures was calculated.Results For all 68 patients with limb fractures,X-ray and CT were not able to determine whether the fractures would heal in the future.On SPECT/CT fusion images,radioactivity concentrations through the fracture lines and cross on both sides of fracture were found in 52 patients,which indicated that the fractures were in the process of healing and had the ability of healing in the future.Clinical follow-up confirmed that fractures then healed in 46 patients,while in 6 patients did not.Another 16 patients showed no nuclide concentrations on the fractures,indicated that the fractures were nonunion and had little ability of healing in the future,and were finally confirmed with surgery.The accuracy of SPECT/CT in evaluation on fracture healing was 91.18％ (62/68).Conclusion SPECT/CT imaging can accurately evaluate the long-term healing of limb fractures,which contributes to therapeutic planning in the clinic.

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.

Studies Involving a Commercial Extract of three Ballerina: I- Characterization and the Effect on the Binding of two 99mtechnetium-Radiopharmaceuticals on Blood Constituents.

We have determined some physicochemical parameters of an aqueous extract of Three ballerina (3TB) and its influence on the binding of the radiopharmaceuticals sodium pertechnetate (Na99mTcO4) and 99mTc-methylene diphosphonate (MDP-99mTc) on blood constituents. Whole blood of rats was incubated with a 3TB extract and with Na99mTcO4 or MDP-99mTc. Plasma (P) and blood cells (BC) from Wistar rats (control and treated) were separated. P and BC were precipitated with trichloroacetic acid (TCA) and soluble (SF) and insoluble fractions (IF) isolated. The percentage of incorporated radioactivity (%ATI) in each fraction was determined. The treatment not influenced statistically (p>0.05) the %ATI of both radiopharmaceuticals on BC and P compartments, as well as on IF-P and SF-P isolated by TCA precipitation. However, 3TB has altered the fixation of the 99mTc-MDP on the IF-BC and SF-BC. We are firstly reported physicochemical parameters (absorption spectrum, viscosimetry and phmetry) about an aqueous 3TB extract. Moreover, it is possible to speculate that an alteration would be not found on the biodistribution of the 99mTc-pertechnetate in the person that is undergoing 3TB extract. However, this would be found with the 99mTc-MDP.

Technetium-99 conjugated with methylene diphosphonate:An effective agent for adjuvant arthritis in rats / 医学研究生学报

Objective: To analyze the effects of technetium99 conjugated with methylene diphosphonate(99Tc-MDP) on adjuvant arthritis in rats.Methods: Thirty SD rats were randomly and equally divided into a normal control group an adjuvant arthritis control group and a 99Tc-MDP treatment group.Intraperitoneal injection of 99Tc-MDP(2.5?10-3?g/kg) was given to the rats in the treatment group on the tenth day and repeated every other day after arthritis induction.The left-right diameter of the left hind ankle,arthritic index,serum TNF and IL-1? levels,articular radionuclide imaging and histopathological changes were observed.Results: Compared with the adjuvant arthritis group,the diameter of the left hind ankle,arthritic index,the serum TNF and IL-1? levels and the T/NT value were decreased in the treatment group,and histopathology showed less synovium hyperplasia and fewer infiltration of inflammatory cells in the group treated with 99Tc-MDP intraperitoneal injection than in the adjuvant arthritis control group.Conclusion: 99Tc-MDP intraperitoneal injection is effective for adjuvant arthritis in rats.

Comparison of Radiation Adaptive Responses in Peripheral Lymphocytes of Patients Undergoing Tc-99m MDP and Tc-99m DTPA Scintigraphies / 대한핵의학회잡지

PURPOSE: The purpose of this study was to compare the radiation adaptive response (RAR) in peripheral lymphocytes (PL) of patients induced by Tc.-99m MDP and Tc-99m DTPA scintigraphies. MATERIALS AND METHODS: Lymphocytes from 45 patients (25 males, 20 females, mean age 44+/-18 years) were collected before and after scintigraphies using 740 MBq Tc-99m MDP (n=22) or Tc-99m L)TPA (n=23). Lympho-cytes from 20 controls (12 males, 8 females, mean age 43+/-7 years) were also callected. They were exposed to challenge dose of 2 Gy gamma-rays using a Cs-137 cell irradiator, Number of ring-form (R) and dicentric (D) chromosomes was counted under the light microscope. From them a representative score, Ydr, was calculated as Ydr=(D+R)/cells. Adaptation index (AI) was defined as difference of Ydr between unconditioned and conditioned lymphocytes. Ydr was also measured after an administration of cyclohexi-mide (CHM), a protein synthesis inhibitor, before challenge dose. RESULTS: RAR was induced in both groups of patients. CHM abolished the adaptive response in both groups. AI of Tc-99m MDP group was significantly higher than that of Tc-99m DTPA group. CONCLUSION: Tc-99m MDP induced RAR was more prominent than those induced by Tc-99m DTPA.

Induction of Radiation Adaptive Response in Lymphocytes of patients Undergoing Bone Scintigraphy / 대한핵의학회잡지

PURPOSE: The purpose of this study was to ascertain whether radiation adaptive response could be induced by Tc-99m-methylene diphosphonate (Tc-99m-MDP) in peripheral lymphocytes of patients undergoing bone scintigraphy. MATERIALS AND METHODS: Lymphocytes from 22 patients (6 males, 16 females, mean age 50+/-14 years) were collected before and after bone scintigraphy using 740 MBq Tc-99m-MDP. Lymphocytes from 10 controls (6 males, 4 females, mean age 43+/-7 years) were also collected. They were exposed challenge dose of 2 Gy gamma rays using a cell irradiator Number of ring-form and dicentric chromosomal per 600 cells (chromosomal aberrations) was counted under the light microscope. RESULTS: Chromosomal aberrations in patients before bone scintigraphy (385.1+/-30.5) was not different from that of controls (367.8+/-36.6). However, chromosomal aberrations in patients after bone scintigraphy was significantly decreased 192.6+/-22.1 (p=0.0001). CONCLUSION: Low dose gamma-irradiation by Tc-99m-MDP used for bone scintigraphy induces a cytogenetic adaptive response in peripheral lymphocytes.