Clin Nuclear Med最新文献

{"title":"Can Preoperative Lymphoscintigraphy Be Used as a Guide in Treatment Planning of Breast Cancer?","authors":"A. Mudun, I. Aslay, M. Aygen, M. Muslumanoglu, Y. Bozfakioǧlu, S. Cantez","doi":"10.1097/00003072-200105000-00007","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00007","url":null,"abstract":"Purpose The purpose of this study was to map the lymphatic drainage patterns of breast cancer with lymphoscintigraphy to evaluate the variability of drainage and to determine whether lymphatic mapping can help to increase the certainty of breast cancer staging. Materials and Methods Fifty women with breast cancer (mean age, 49 years) were included in the study. Lymphoscintigraphy was performed with 1 mCi Tc-99m rhenium sulfide colloid in a 2-ml volume injected into the four quadrants of the peritumoral area using a 25-gauge needle. Ten-minute dynamic images and 2-hour delayed static images were obtained in the anterior and lateral positions using a gamma camera with a high-resolution collimator. All patients had a modified radical mastectomy and axillary dissection. The results were evaluated with histopathologic findings of the axilla. Results Six patients had excision biopsies before surgery. Of 13 patients with centrally located tumors, 84% had axillary lymphatic drainage, whereas 53% drained to internal mammary lymphatics. Of 23 patients with outer quadrant tumors, 4 showed no lymphatic drainage and all of them had metastatic tumor in the axillary lymph nodes. Axillary drainage was seen in 82% of patients and internal mammary lymphatic drainage in 23%. Of eight patients with inner quadrant tumors, one patient with no lymphatic drainage was found to have metastases in the axilla. In this group, 62% had axillary and 50% had internal mammary lymphatic drainage, and one patient had supraclavicular drainage. Conclusions Lymphoscintigraphy indicates that drainage routes may vary, and thus it may play a guiding role in patients with breast cancer who need radiotherapy. In patients with internal mammary lymphatic drainage, the accuracy of radiotherapy planning may increase if internal mammary lymphoscintigraphy is added to the protocol. In patients with internal mammary drainage, obtaining an internal mammary lymphatic biopsy during surgery will also increase the accuracy of staging.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"477 1-2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131704483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recombinant Human Thyroid-Stimulating Hormone–Aided Scintigraphy: Comparison of Imaging at Multiple Times After I-131 Administration","authors":"S. Sarkar, M. Afriyie, C. Palestro","doi":"10.1097/00003072-200105000-00003","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00003","url":null,"abstract":"Purpose Recombinant human thyroid-stimulating hormone (rhTSH) may be used in lieu of thyroid hormone withdrawal for the evaluation of thyroid cancer. Scintigraphy using the existing rhTSH protocol is performed 48 hours after I-131 administration. The authors investigated the feasibility of whole-body imaging at 72 hours and evaluated thyroid tissue uptake at 48 to 144 hours. Methods Thirty-two patients who previously had thyroidectomy for thyroid cancer were examined. Whole-body imaging was performed routinely at 48 and 72 hours after I-131 administration. Thyroid tissue was visualized in 12 patients, and large foci were imaged for as long as 144 hours. Activity ratios for thyroid tissue to background were determined for 10 patients. Results Whole-body images at 48 and 72 hours were comparable, generally with lower background activity at 72 hours, and thyroid tissue was well visualized at all times after 48 hours. Thyroid tissue-to-background activity ratios at 72 to 144 hours were equal to or greater than those at 48 hours in 9 of 10 patients. Conclusions Recombinant human TSH–aided whole-body scintigraphy is possible 72 hours after I-131 administration, adding flexibility and convenience to the existing protocol and permitting confirmation of findings at 48 hours. Tracer uptake in thyroid tissue persists at later times. Therefore, rapid clearance of background activity appears to be the primary cause of the previously reported decrease in radioiodine retention in euthyroid persons receiving rhTSH.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131327162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Cranial Metastases by F-18 FDG Positron Emission Tomography","authors":"A. Yamamoto, H. Zhuang, A. Alavi","doi":"10.1097/00003072-200105000-00006","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00006","url":null,"abstract":"Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) scanning has been useful in the management of various cancers. The normal glucose use of gray matter often limits the detection of metastatic lesions to the brain and skull with FDG PET. The authors report two cases of calvarial metastases: one with pheochromocytoma and the other with non–small-cell lung carcinoma. These cases illustrate the crucial role that FDG PET can play when patients are examined for metastases. The important concept of contrast resolution that is achieved with PET imaging is discussed as an advantage that significantly overcomes its limited spatial resolution in detecting small lesions that may not be detected by anatomic imaging techniques with high spatial resolution.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121165670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Viable Splenic Tissue in Massive Splenic Infarction with a Tc-99m Heat-Damaged RBC Scan","authors":"M. Hickeson, V. Derbekyan, J. Novales-Diaz","doi":"10.1097/00003072-200105000-00009","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00009","url":null,"abstract":"A 59-year-old man with essential thrombocytosis was examined for abdominal pain. Splenic infarction was diagnosed on a computed tomographic scan. The Tc-99m heat-denatured RBC scan showed viable splenic tissue that was not evident on the computed tomographic scan or Tc-99m sulfur colloid scintigraphy.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127973276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subacute Thyroiditis in a Single Lobe","authors":"O. Sarı, B. Erbaş, T. Erbas","doi":"10.1097/00003072-200105000-00005","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00005","url":null,"abstract":"A 33-year-old woman with no history of thyroid disease reported pain in her neck and a sore throat. On physical examination, the thyroid gland was palpable. Serum T3 and T4 levels were increased, and the thyroid-stimulating hormone level was decreased. Thyroid scintigraphy with Tc-99m pertechnetate revealed nonvisualization of the left lobe of the thyroid. Ultrasonographic examination confirmed the presence of the left thyroid lobe. Fine-needle aspiration biopsy revealed thyroiditis of the left lobe of the thyroid. The patient was started on an anti-inflammatory drug. The follow-up thyroid scan showed a normal thyroid gland.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128421614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Thyroid Cancer Occurring as an Unknown Primary Lesion: The Role of F-18 FDG Positron Emission Tomography","authors":"Faut Dede, Nyimas Diana YULISA AJOEDI, S. M. Ansari, S. Heiba, H. Abdel-Dayem","doi":"10.1097/00003072-200105000-00004","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00004","url":null,"abstract":"Thyroid cancer can appear as metastatic disease of an unknown primary origin, and fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomographic (PET) studies are helpful in the workup evaluation of these patients. The authors describe two patients who had metastatic disease from an unknown primary lesion. F-18 FDG PET studies played an important role in localizing the primary malignant site in the thyroid gland. The utility of F-18 FDG imaging in decreasing the number of procedures, cost, and inconvenience to patients is shown clearly in both cases.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129104584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staging and Managing Lung Tumors Using F-18 FDG Coincidence Detection","authors":"M. R. Roman, M. Rossleigh, S. Angelides, Brenda M. Walker, J. Dixon","doi":"10.1097/00003072-200105000-00001","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00001","url":null,"abstract":"Purpose Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomographic (PET) imaging can be a vital tool in the evaluation and preoperative staging of pulmonary neoplasms. Imaging studies on the gamma camera using coincidence PET (co-PET) were introduced recently into clinical practice. This prospective study assessed the efficacy of co-PET for identifying primary tumors, mediastinal lymph node involvement, the presence of distant spread, the effect on disease staging, and influence on disease management. Patients and Methods Sixty consecutive patients with 61 lung tumors were enrolled in the study (36 men, 24 women; age range, 32—87 years; mean age, 67 years). Histopathologic confirmation was obtained in 58 patients (59 tumors). Results In assessments of a primary lesion to establish its malignant or benign nature, the sensitivity rate of co-PET was 96% (53 of 55 lesions), the specificity rate was 83% (5 of 6 lesions), and the accuracy rate was 95% (58 of 61 lesions). In the co-PET assessment of lymph node involvement in which histopathologic confirmation was obtained (n = 32), the sensitivity rate was 89% (8 of 9 lesions), the specificity rate was 91% (21 of 23 lesions), and the accuracy rate was 91% (29 of 32 lesions). Previously unknown distant metastases were correctly identified in eight patients, but five false-positive lesions were detected in the brain. Disease staging was correctly altered in 20 patients (33%), and disease management plans were changed in 20 patients (33%) based on the co-PET findings. Unnecessary surgery was obviated in six patients (10%). One patient was given the chance for curative treatment based on the findings of the co-PET study. Conclusion The evaluation of patients with lung neoplasms using F-18 FDG coincidence detection appears to be reliable.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122320199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Normal Variant on Tl-201 and Tc-99m MIBI Whole-Body Imaging: The Superior Right Atrial Wall (Auricle) and Superoanterior Right Ventricular Wall Are Often Seen as Mediastinal Lesions","authors":"Chun K. Kim, E. Jung, M. Yun, M. Lorberboym, J. Mechanick, D. Bergman, B. Krynyckyi, J. Machac","doi":"10.1097/00003072-200105000-00008","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00008","url":null,"abstract":"Purpose The authors have often observed on Tl-201 and Tc-99m sestamibi (MIBI) scans in patients with thyroid cancer a small focus of increased uptake in the right midparasternal region (focus A) or sometimes in the lower mid chest at the level of the lower sternum (focus B) just inferomedial to focus A. The objective of this study was to assess the frequency of this finding on Tl-201 MIBI studies, to assess the incidence of true pathologic lesions corresponding to these foci, and to identify their nature. Materials and Methods One hundred ten whole body Tl-201 studies using 4 mCi (148 MBq) and 84 MIBI studies using 20 mCi (740 MBq: first-pass, planar, and SPECT images) were reviewed. The appearance of either focus A or focus B on three orthogonal SPECT images was correlated with an atlas of cross-sectional anatomy and computed tomography. If focus A was seen on the immediate static image (obtained at the end of the first-pass acquisition without moving the patient), this image was coregistered with a selected image from the first-pass study showing the superior vena cava and also with another selected image showing the ascending aorta. Results Focus A was seen in 40% of Tl-201 scans and in 49% of MIBI scans, whereas focus B was seen in 20% of Tl-201 scans and 39% of MIBI scans. On correlation of the SPECT images with a cross-sectional anatomy atlas, focus A and focus B invariably corresponded to the superior portion of the right auricle and basal superoanterior right ventricular wall, respectively. These myocardial regions are prominent and sometimes appear as discrete foci because they are considerably thicker than other parts of the right atrial and right ventricular muscle, respectively, and because they are seen partly end-on in the anterior projection. Conclusions The superior portion of the right auricle and basal superoanterior right ventricular myocardium often appear as isolated foci on whole-body Tl-201 and MIBl scans. Neither focus should be interpreted as a metastatic lesion in patients with possible cancer or as an ectopic parathyroid adenoma in patients with hyperparathyroid disease.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116253733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up of Acute Pyelonephritis in Children by Tc-99m DMSA Scintigraphy: Quantitative and Qualitative Assessment","authors":"L. Wallin, I. Helin, M. Bajc","doi":"10.1097/00003072-200105000-00010","DOIUrl":"https://doi.org/10.1097/00003072-200105000-00010","url":null,"abstract":"Purpose The author’s goal was to create a system to identify children at risk for development of progressive renal damage. Methods Thirty-four children were examined with Tc-99m DMSA scintigraphy in the acute stage of an initial episode of pyelonephritis, after 6 months, and again after 1 year. The scintigraphic findings were correlated with clinical and laboratory data. Results All children had parenchymal defects in the acute stage: 93% of the kidneys and 85% bilaterally. After 6 months, the defects had diminished or disappeared in 66% of the kidneys. New defects appeared in 22%. At 1 year, no further improvement was seen in the kidneys, with an improved or unchanged pattern at 6 months. New defects appeared in 34%. Mean kidney activity uptake expressed as the percentage of administered dose (KU/AD), was low in the acute stage, increased at 6 months, with no further significant increase at 1 year. Eighty-three percent of children with urine cultures growing ≥ 104 bacteria/ml at follow-up had decreased KU/AD values, whereas all children with urine cultures growing < 104 bacteria/ml had increased KU/AD values. Conclusions Quantitative assessment increases the sensitivity of Tc-99m DMSA scintigraphy. Follow-up with this method makes it possible to identify the children with decreasing renal tubular function who may be at risk for progressive renal damage. Moderate bacteruria of 104 bacteria/ml urine is associated with deterioration of renal tubular function.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122115504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphoscintigraphic Sentinel Node Imaging and Gamma Probe Detection in Breast Cancer with Tc-99m Nanocolloidal Albumin: Results of an Optimized Protocol","authors":"T. Rink, T. Heuser, Hartmut Fitz, H. Schroth, E. Weller, H. Zippel","doi":"10.1097/00003072-200104000-00002","DOIUrl":"https://doi.org/10.1097/00003072-200104000-00002","url":null,"abstract":"Purpose The purpose of this study was to aid in the standardization of lymphoscintigraphy for detecting the sentinel node (SN) in breast cancer using Tc-99m–labeled nanocolloidal albumin. Materials and Methods One hundred twenty-three women with proved breast cancer were enrolled. Four injections of 10 to 15 MBq (0.27 to 0.41 mCi) Tc-99m nanocolloid in 0.1 ml physiologic saline were administered intra- and subdermally at the margin of the skin overlying the tumor. Planar scintigraphic images in the lateral and anterior projections were obtained 2.5 to 18 hours after tracer administration. With a gamma probe used as a guide, all radioactive lymph nodes in the axilla were resected. Complete dissection then followed. Results In 116 of the 123 (94%) women, axillary nodal tracer uptake was revealed. Six of the 7 women in whom detection failure occurred had histologically proved tumor infiltration of the lymphatics and axillary involvement. In 36 (31%) of the patients with visualized lymph nodes, the SN was metastatic. The remaining 80 patients with negative SN included three cases with axillary involvement. The sensitivity of the SN with respect to the histologic status of the entire axilla thus was 92.3%, and the negative predictive value was 96.3%. The overall accuracy of the method was 97.4%. The number of hot nodes in women with and without axillary involvement was significantly different. Conclusions The described protocol represents an easily reproduced and reliable method for SN detection in breast cancer. Furthermore, the number of visualized axillary nodes reflects the histologic status of the axilla.","PeriodicalId":236509,"journal":{"name":"Clin Nuclear Med","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124873619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}