Comparison of absolute renal uptake by using Tc-99m MAG-3 and Tc-99m DMSA

PURPOSE

The purpose of this study is to compare the value of absolute renal uptake (ARU %) in patients by using Tc-99m MAG-3 and Tc-99m DMSA scan.

MATERIAL AND METHODS

Absolute renal uptake is calculated using Tc-99m MAG-3 and Tc-99m DMSA in renal scintigraphy, Itoh and Tauex kidney depth methods used, respectively. n = 40 adult patients of both genders were included. All patients underwent Tc-99m MAG-3 and Tc-99m DMSA, respectively.

RESULTS

The values of ARU (%) were calculated separately in selected patients n = 40, (left = 17, right = 23 normal functioning kidneys) by MAG-3 and DMSA. Absolute renal uptake (%) of Tc-99m MAG-3 in left kidneys was found to be 15.2 ± 3.4, with spilt renal function 79.2 ± 14.7 and ARU (%) in right kidneys 16.2 ± 3.4 with spilt renal function 77.5 ± 19. Absolute renal uptake of Tc-99m DMSA in left kidneys was 17.5 ± 3.2 and in right kidneys 17.9 ± 4.5 with spilt renal function 81.8 ± 10.7 and 79.3 ± 13.8 for left and right kidney, respectively. Statistical analysis showed strong Pearson correlation.

CONCLUSION

Absolute renal uptake % was found to be more reliable in cases of bilateral compromised kidneys. ARU (%) calculated by Tc-99m MAG-3 solely can be used as predictor of renal function. The use of Tc-99m MAG-3 has more advantages than Tc-99m DMSA alone in renal scintigraphy as dynamic scintigraphy gives less radiation burden to patient, more information regarding renal function, and shorter stay time at hospital in comparison to static renal imaging. SRF % is less reliable than ARU (%).

Gastric Metastasis from Invasive Lobular Breast Cancer, Resembling Primary Gastric Cancer

Invasive lobular carcinoma (ILC) is the second most common subtype of invasive breast cancer and sometimes presents with an unusual metastatic pattern. Its gastric metastasis is difficult to differentiate from primary adenocarcinoma. This report presents a case of breast ILC for which the initial presentation was gastric metastasis. A 62-y-old woman presented with gastric outlet obstruction secondary to a gastric mass that had been diagnosed on upper gastrointestinal endoscopy and biopsy. The patient had been referred for 18F-FDG PET/CT for staging. The baseline 18F-FDG PET/CT scan demonstrated extensive axillary nodal and gastric metastases with a breast mass, which raised suspicion of a primary breast carcinoma. Distinguishing primary gastric adenocarcinoma from metastatic breast ILC is essential, considering that the 2 diagnoses lead to divergent treatments. Therefore, this entity needs to be considered in the differential diagnosis in clinical practice.

Bifid mandibular condyle with associated temporomandibular joint ankylosis: a computed tomography study of the patterns and morphological variations

OBJECTIVES

Bifid mandibular condyle (BMC) with associated temporomandibular joint ankylosis (TMJA) is extremely rare with only four cases reported. We present the first case series of BMC with TMJA in an attempt to elucidate the morphological pattern in this rare condition.

METHODS

Retrospective examination of CTs over a period of 6 years revealed 37 patients with TMJA, of whom 10 had BMC. Clinical and CT features of these were analysed. Patients were grouped according to sides of involvement and orientation of condyles.

RESULTS

The male:female ratio was 1:1. Nine were post-traumatic and one post-infectious. The aetiology was sustained in childhood in all patients. Six patients had unilateral BMCs and four had bilateral. One patient had bilateral BMCs with bilateral TMJA. This was anteroposterior (AP) in orientation. Three patients had bilateral BMCs with unilateral TMJA, among which one was AP and two mediolateral (ML). Six patients had unilateral BMC with ipsilateral TMJA; all of the ML anterior condylar process was ankylosed in joints with AP BMC and TMJA. Lateral condylar process was ankylosed in post-traumatic ML BMC with TMJA, while the medial condylar process ankylosed in the post-infectious patient. In general, ankylosed heads were found to be larger, sclerotic and often mushroom shaped compared with non-ankylosed heads.

CONCLUSIONS

This series attempts to elucidate patterns of ankylosis and CT morphology in BMC with associated TMJA. Also included are hitherto unreported cases such as bilateral AP BMC with TMJA and post-infectious BMC with TMJA.