ABSTRACT
Myocardial perfusion imaging with stress testing by exercise or pharmacologic methods and functional evaluation of the left ventricle are useful in many patients. Uses include determination of diagnosis and prognosis of patients with coronary artery disease, preoperative evaluation, management and risk stratification following cardiac events, evaluation of therapy and assessment of left ventricular status in many situations, including postmyocardial infarction and chemotherapy with cardiotoxic drugs. Many recent advances in imaging techniques, stress methods and radiopharmaceuticals make this a complex area of clinical diagnosis. It requires a coordinated effort of primary care, cardiology and nuclear medicine specialists to provide optimal patient care.
Subject(s)
Heart Diseases/diagnostic imaging , Algorithms , Exercise Test , Heart Diseases/physiopathology , Humans , Patient Selection , Radioisotopes , Radionuclide ImagingABSTRACT
A case of progressive bilateral upper lobe Pneumocystis carinii pneumonia in a patient receiving aerosolized pentamidine is presented. This is a recently recognized pattern in patients with acquired immunodeficiency syndrome on aerosolized pentamidine. Pneumocystis carinii pneumonia must be considered as a possibility when this select subset of patients presents with this atypical upper lobe pattern.
Subject(s)
Opportunistic Infections/complications , Pentamidine/administration & dosage , Pneumonia, Pneumocystis/complications , Acquired Immunodeficiency Syndrome/complications , Aerosols , Humans , Lung/pathology , Male , Pentamidine/therapeutic use , Pneumonia, Pneumocystis/diagnostic imaging , Pneumonia, Pneumocystis/pathology , Tomography, X-Ray ComputedABSTRACT
We have presented a case of sporadic medullary carcinoma of the thyroid with documentation of localization of tracer 131I-MIBG within the primary neoplasm. A review of the nuclear medicine literature of localization techniques for MCT demonstrates that 131I-MIBG, while an excellent choice for diagnosis of pheochromocytoma and neuroblastoma, produces low yield and unpredictable concentration in other neural crest apudomas, including MCT. A low incidence of true-positive results with 131I-MIBG uptake and a high incidence of false-negative results make this radiopharmaceutical a suboptimal choice for diagnostic studies, but a potentially promising one as a therapeutic agent.
Subject(s)
Antineoplastic Agents , Carcinoma/diagnostic imaging , Iodobenzenes , Thyroid Neoplasms/diagnostic imaging , 3-Iodobenzylguanidine , Aged , Antineoplastic Agents/therapeutic use , Carcinoma/drug therapy , Female , Humans , Iodine Radioisotopes , Iodobenzenes/therapeutic use , Organotechnetium Compounds , Radionuclide Imaging , Succimer , Technetium Tc 99m Dimercaptosuccinic Acid , Thyroid Neoplasms/drug therapy , Tomography, X-Ray ComputedABSTRACT
Various causes for cold defects on bone scans (e.g., avascular necrosis) have been described. A case is presented in which a cold defect on a technetium-99m-methylene diphosphonate bone scan was the result of malignant fibrous histiocytoma.
