1
|
Campennì A, Ovčariček PP, Giovanella L. On the rational use of thyroid scintigraphy in thyrotoxic patients in the age of integrated diagnostics. Eur J Nucl Med Mol Imaging 2024; 51:1682-1684. [PMID: 38308176 DOI: 10.1007/s00259-024-06629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Affiliation(s)
- Alfredo Campennì
- Department of Biomedical and Dental Sciences and Morpho‑Functional Imaging, Unit of Nuclear Medicine, University of Messina, Messina, Italy.
| | - Petra Petranović Ovčariček
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Luca Giovanella
- Department of Nuclear Medicine, Gruppo Ospedaliero Moncucco, Lugano, Switzerland
- Clinic for Nuclear Medicine, University Hospital Zürich, Zurich, Switzerland
| |
Collapse
|
2
|
Mallón Araujo MDC, Abou Jokh Casas E, Abou Jokh Casas C, Aguiar Fernández P, Martínez Monzonís MA, Sopeña Pérez-Argüelles B, Pubul Núñez V. Enhanced quantitative method for the diagnosis of grade 1 cardiac amyloidosis in 99mTc-DPD scintigraphy. Sci Rep 2022; 12:1740. [PMID: 35110594 PMCID: PMC8810978 DOI: 10.1038/s41598-022-05689-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 12/28/2021] [Indexed: 11/28/2022] Open
Abstract
The lack of a standardized cut-off value in the quantitative method and an inter-observer disagreement in the evaluation of the semiquantitative score in 99mTc-DPD scintigraphy leaves several patients with cardiac amyloidosis (CA) undiagnosed (grade 1 and H/CL: 1-1.49). This study aims to increase diagnostic productivity of 99mTc-DPD scintigraphy in CA. This is a retrospective study of 170 patients with suspicion of CA. A total of 81 (47.6%) were classified as transthyretin CA (TTR-CA) and 9 (5.3%) as light-chain CA (LC-CA) applying the visual score. An enhanced quantitative method and cut-off point were attempted to reclassify inconclusive patients and reduce inter-observer variability. Applying the proposed quantitative method, of the 19 patients with grade 1 uptake, 2 became grade 0 (none-CA), 2 were reclassified as grade 3 (TTR-CA), and 2 were regrouped as grade 2 (1 TTR-CA and 1 LC-CA). Adjusting the quantitative method's cut-off value to 1.3, four patients previously inconclusive were reclassified as TTR-CA, the diagnosis was confirmed in 3 and rejected in 1. When a 1.3 threshold is compared to 1.5, the sensitivity increases to 94% without reducing its specificity. The quantitative method improves the visual interpretation, reclassifying doubtful cases. The optimization of the cut-off value from 1.5 to 1.3 reclassifies a higher percentage of patients as TTR-CA with a higher sensitivity without reducing its specificity.
Collapse
Affiliation(s)
| | - Estephany Abou Jokh Casas
- Department of Nuclear Medicine, Santiago de Compostela University Hospital, Santiago de Compostela, Spain.
| | - Charigan Abou Jokh Casas
- Department of Cardiology, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
| | - Pablo Aguiar Fernández
- Molecular Imaging and Medical Physics Group, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
| | | | | | - Virginia Pubul Núñez
- Department of Nuclear Medicine, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
| |
Collapse
|
3
|
Liu P, Shi J. Growth trends analysis of unilateral condylar hyperplasia followed up with planar scintigraphy: Retrospective overview of 249 cases. Medicine (Baltimore) 2021; 100:e28226. [PMID: 34941087 PMCID: PMC8702254 DOI: 10.1097/md.0000000000028226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/24/2021] [Indexed: 01/05/2023] Open
Abstract
The current research aimed to retrospectively investigate the trends of the growth of condylar hyperplasia with serial planar scintigraphs.Patients of unilateral condylar hyperplasia with at least one follow-up planar scintigraph were retrospectively included in the study. Patients' age, gender at the initial scan, durations of following scans, and ratios between condylar activities were recorded.The study retrospectively included 111 patients of unilateral condylar hyperplasia. Patients were divided into 3 groups (progressive, relatively stable, regressive) according to ratio variation between initial and last scans. There were 23 (21%) patients fell into the progressive group, 40 (36%) patients into the relatively stable group, and 48 (43%) patients into the regressive group. More female patients were in the progressive group than those in the other groups (P < .01). There were no significant differences among the 3 groups in terms of age or durations of follow-up (P > .05). There were no strong relations between ratio differences and ages. However, a weak relation seems to exist in the regressive group with r = -0.240, (P = .10).Our investigation showed that more than a half of patients with condylar hyperplasia remain constantly or progressively active growth in patients in the follow-up scans. Roughly less than a half of patients showed regressive trends toward normal growth. Patients' age seemly does not play a role in the growth trend pattern, although there are no optimum follow-up periods, regularly follow-up scans are needed to determine the growth status of condylar hyperplasia.
Collapse
Affiliation(s)
- Pingan Liu
- Department of Nuclear Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Shi
- Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
4
|
Hansen JA, Naghavi-Behzad M, Gerke O, Baun C, Falch K, Duvnjak S, Alavi A, Høilund-Carlsen PF, Hildebrandt MG. Diagnosis of bone metastases in breast cancer: Lesion-based sensitivity of dual-time-point FDG-PET/CT compared to low-dose CT and bone scintigraphy. PLoS One 2021; 16:e0260066. [PMID: 34793550 PMCID: PMC8601566 DOI: 10.1371/journal.pone.0260066] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 11/02/2021] [Indexed: 11/18/2022] Open
Abstract
We compared lesion-based sensitivity of dual-time-point FDG-PET/CT, bone scintigraphy (BS), and low-dose CT (LDCT) for detection of various types of bone metastases in patients with metastatic breast cancer. Prospectively, we included 18 patients with recurrent breast cancer who underwent dual-time-point FDG-PET/CT with LDCT and BS within a median time interval of three days. A total of 488 bone lesions were detected on any of the modalities and were categorized by the LDCT into osteolytic, osteosclerotic, mixed morphologic, and CT-negative lesions. Lesion-based sensitivity was 98.2% (95.4-99.3) and 98.8% (96.8-99.5) for early and delayed FDG-PET/CT, respectively, compared with 79.9% (51.1-93.8) for LDCT, 76.0% (36.3-94.6) for BS, and 98.6% (95.4-99.6) for the combined BS+LDCT. BS detected only 51.2% of osteolytic lesions which was significantly lower than other metastatic types. SUVs were significantly higher for all lesion types on delayed scans than on early scans (P<0.0001). Osteolytic and mixed-type lesions had higher SUVs than osteosclerotic and CT-negative metastases at both time-points. FDG-PET/CT had significantly higher lesion-based sensitivity than LDCT and BS, while a combination of the two yielded sensitivity comparable to that of FDG-PET/CT. Therefore, FDG-PET/CT could be considered as a sensitive one-stop-shop in case of clinical suspicion of bone metastases in breast cancer patients.
Collapse
Affiliation(s)
- Jeanette Ansholm Hansen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Mohammad Naghavi-Behzad
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- * E-mail:
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Christina Baun
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Kirsten Falch
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sandra Duvnjak
- Radiology Department–Breast Imaging, Herlev Gentofte Hospital, Copenhagen, Denmark
- Mammography Screening Center in the Capital Region, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Abass Alavi
- Division of Nuclear Medicine, Department of Radiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States of America
| | - Poul Flemming Høilund-Carlsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Malene Grubbe Hildebrandt
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, Odense, Denmark
| |
Collapse
|
5
|
Bae JK, Kim KI, Kim JH, Gwak HG, Kim C. Does postoperative quantitative bone scintigraphy reflect outcomes following medial open-wedge high tibial osteotomy? PLoS One 2021; 16:e0257315. [PMID: 34520482 PMCID: PMC8439459 DOI: 10.1371/journal.pone.0257315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/30/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose The present study evaluated changes in bone tracer uptake (BTU) after medial open-wedge high tibial osteotomy (MOWHTO) and determined whether postoperative BTU correlates with clinical symptoms, radiologic parameters, or cartilage regeneration following MOWHTO. Methods A total of 210 knees underwent MOWHTO for medial compartmental osteoarthritis (OA) were enrolled in this study. Mean follow-up period was 42.7 months. We assessed BTU for the medial compartment of the knee before MOWHTO and at the time of plate removal. Radiologic parameters included Kellgren-Lawrence (K-L) grade and Hip-Knee-Ankle angle (HKAA). Clinical evaluation included American Knee Society (AKS) score and cartilage status was graded at the time of MOWHTO and second-look arthroscopy according to the International Cartilage Repair Society (ICRS) grading system and articular cartilage regeneration stage. Statistical analysis performed to assess the relationships among postoperative BTU of the medial compartment, radiologic parameters, arthroscopic changes and clinical outcomes. Results BTU of medial femoral condyle and tibial plateau were significantly decreased at 2 years after MOWHTO (p<0.001). AKS scores and arthroscopic cartilage status were also significantly improved following MOWHTO. BMI and postoperative HKAA showed significant correlations with postoperative changes of BTU in uni- and multi-variable analysis. Meanwhile, postoperative changes of BTU did not show significant correlation with clinical outcomes or cartilage regeneration following MOWHTO. Conclusion Lower BMI and postoperative valgus alignment were significant predictor for postoperative BTU decrease of the medial compartment following MOWHTO. However, postoperative changes of BTU did not reflect cartilage regeneration or clinical outcomes until the midterm follow-up.
Collapse
Affiliation(s)
- Jung-Kwon Bae
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Kang-Il Kim
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea
- * E-mail:
| | - Jun-Ho Kim
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Hyun-Gon Gwak
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Chanwoo Kim
- Department of Nuclear Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| |
Collapse
|
6
|
Wise JL, Vazquez-Roque MI, McKinney CJ, Zickella MA, Crowell MD, Lacy BE. Gastric Emptying Scans: Poor Adherence to National Guidelines. Dig Dis Sci 2021; 66:2897-2906. [PMID: 32418002 DOI: 10.1007/s10620-020-06314-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 05/02/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Accurately diagnosing gastroparesis relies upon gastric emptying scintigraphy (GES) being performed correctly. Jointly published protocol guidelines have long been available; however, the extent to which practitioners adhere to these guidelines is unknown. AIMS This study aimed to assess national compliance with established GES protocol guidelines. METHODS We developed a questionnaire addressing the key protocol measures outlined in the Consensus Recommendations for Gastric Emptying Scintigraphy. Survey questions addressed patient information collection (15), patient preparation and procedure protocol (16), meal content and preparation (7), imaging (3), interpretation (4), reporting (7), and institutional demographic data (7). The anonymous questionnaire was distributed electronically to members of the Society of Nuclear Medicine and Medical Imaging (SNMMI) and non-member recipients of the SNMMI daily email newsletter. One response per medical institution was permitted. RESULTS A total of 121 out of 872 potential medical institutions (MI) responded (13.9%); 49 (40.4%) were academic/teaching medical centers. The annual number (mean) of GES procedures was 199.9 (range 5-2000 GES/year). On average, MI performed 33.5/52 (64%) of protocol measures according to guidelines while academic medical centers performed 31.5/52 (61%) of protocol measures according to guidelines. Only 4 out of 88 MI (4.5%) performed GES while adhering to three critical measures: validated study duration; controlled blood glucose levels; and proper restriction of medications. CONCLUSIONS Low compliance with GES protocol guidelines, even among academic medical centers, raises the likely possibility of misdiagnosis and improper management of upper gastrointestinal symptoms. These results highlight a need for increased awareness of protocol guidelines for gastric scintigraphy.
Collapse
Affiliation(s)
- Journey L Wise
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Maria I Vazquez-Roque
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Caleb J McKinney
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Michael A Zickella
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Michael D Crowell
- Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
| | - Brian E Lacy
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
| |
Collapse
|
7
|
Aryal A, Kumar VS, Shamim SA, Gamanagatti S, Khan SA. What Is the Comparative Ability of 18F-FDG PET/CT, 99mTc-MDP Skeletal Scintigraphy, and Whole-body MRI as a Staging Investigation to Detect Skeletal Metastases in Patients with Osteosarcoma and Ewing Sarcoma? Clin Orthop Relat Res 2021; 479:1768-1779. [PMID: 33635285 PMCID: PMC8277296 DOI: 10.1097/corr.0000000000001681] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/26/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Skeletal metastases of bone sarcomas are indicators of poor prognosis. Various imaging modalities are available for their identification, which include bone scan, positron emission tomography/CT scan, MRI, and bone marrow aspiration/biopsy. However, there is considerable ambiguity regarding the best imaging modality to detect skeletal metastases. To date, we are not sure which of these investigations is best for screening of skeletal metastasis. QUESTION/PURPOSE Which staging investigation-18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT), whole-body MRI, or 99mTc-MDP skeletal scintigraphy-is best in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in detecting skeletal metastases in patients with osteosarcoma and those with Ewing sarcoma? METHODS A prospective diagnostic study was performed among 54 of a total 66 consecutive osteosarcoma and Ewing sarcoma patients who presented between March 2018 and June 2019. The institutional review board approved the use of all three imaging modalities on each patient recruited for the study. Informed consent was obtained after thoroughly explaining the study to the patient or the patient's parent/guardian. The patients were aged between 4 and 37 years, and their diagnoses were proven by histopathology. All patients underwent 99mTc-MDP skeletal scintigraphy, 18F-FDG PET/CT, and whole-body MRI for the initial staging of skeletal metastases. The number and location of bone and bone marrow lesions diagnosed with each imaging modality were determined and compared with each other. Multidisciplinary team meetings were held to reach a consensus about the total number of metastases present in each patient, and this was considered the gold standard. The sensitivity, specificity, PPV, and NPV of each imaging modality, along with their 95% confidence intervals, were generated by the software Stata SE v 15.1. Six of 24 patients in the osteosarcoma group had skeletal metastases, as did 8 of 30 patients in the Ewing sarcoma group. The median (range) follow-up for the study was 17 months (12 to 27 months). Although seven patients died before completing the minimum follow-up, no patients who survived were lost to follow-up. RESULTS With the number of patients available, we found no differences in terms of sensitivity, specificity, PPV, and NPV among the three staging investigations in patients with osteosarcoma and in patients with Ewing sarcoma. Sensitivities to detect bone metastases for 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy were 100% (6 of 6 [95% CI 54% to 100%]), 83% (5 of 6 [95% CI 36% to 100%]), and 67% (4 of 6 [95% CI 22% to 96%]) and specificities were 100% (18 of 18 [95% CI 82% to 100%]), 94% (17 of 18 [95% CI 73% to 100%]), and 78% (14 of 18 [95% CI 52% to 94%]), respectively, in patients with osteosarcoma. In patients with Ewing sarcoma, sensitivities to detect bone metastases for 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy were 88% (7 of 8 [95% CI 47% to 100%]), 88% (7 of 8 [95% CI 47% to 100%]), and 50% (4 of 8 [95% CI 16% to 84%]) and specificities were 100% (22 of 22 [95% CI 85% to 100%]), 95% (21 of 22 [95% CI 77% to 100%]), and 95% (21 of 22 [95% CI 77% to 100%]), respectively. Further, the PPVs for detecting bone metastases for 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy were 100% (6 of 6 [95% CI 54% to 100%]), 83% (5 of 6 [95% CI 36% to 100%]), and 50% (4 of 8 [95% CI 16% to 84%]) and the NPVs were 100% (18 of 18 [95% CI 82% to 100%]), 94% (17 of 18 [95% CI 73% to 100%]), and 88% (14 of 16 [95% CI 62% to 98%]), respectively, in patients with osteosarcoma. Similarly, the PPVs for detecting bone metastases for 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy were 100% (7 of 7 [95% CI 59% to 100%]), 88% (7 of 8 [95% CI 50% to 98%]), and 80% (4 of 5 [95% CI 28% to 100%]), and the NPVs were 96% (22 of 23 [95% CI 78% to 100%]), 95% (21 of 22 [95% CI 77% to 99%]), and 84% (21 of 25 [95% CI 64% to 96%]), respectively, in patients with Ewing sarcoma. The confidence intervals around these values overlapped with each other, thus indicating no difference between them. CONCLUSION Based on these results, we could not demonstrate a difference in the sensitivity, specificity, PPV, and NPV between 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy for detecting skeletal metastases in patients with osteosarcoma and Ewing sarcoma. For proper prognostication, a thorough metastatic workup is essential, which should include a highly sensitive investigation tool to detect skeletal metastases. However, our study findings suggest that there is no difference between these three imaging tools. Since this is a small group of patients in whom it is difficult to make broad recommendations, these findings may be confirmed by larger studies in the future. LEVEL OF EVIDENCE Level II, diagnostic study.
Collapse
Affiliation(s)
- Aayush Aryal
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shamim Ahmed Shamim
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shivanand Gamanagatti
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Shah Alam Khan
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
8
|
Schenke SA, Görges R, Seifert P, Zimny M, Kreissl MC. Update on diagnosis and treatment of hyperthyroidism: ultrasonography and functional imaging. Q J Nucl Med Mol Imaging 2021; 65:102-112. [PMID: 33494588 DOI: 10.23736/s1824-4785.21.03333-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Ultrasonography and radionuclide imaging using [99mTc]Pertechnetate or radioactive iodine isotopes are essential tools used during the diagnostic workup of hyperthyroidism with or without structural alterations of the thyroid. Color duplex sonography and ultrasound elastography may add important information to find the cause of the hormone excess. During the last few years, hybrid imaging using SPECT/-(CT) or PET-based methods, such as [124]Iodine-PET/CT or [124]Iodine-PET/ultrasound have been increasingly used, playing a role in the context of localizing ectopic thyroid tissue or in multinodular goiter. Recently, promising data has been published on the use of [99mTc]MIBI imaging in amiodarone induced hyperthyroidism.
Collapse
Affiliation(s)
- Simone A Schenke
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany -
| | - Rainer Görges
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Philipp Seifert
- Clinic for Nuclear Medicine, University Hospital of Jena, Jena, Germany
| | | | - Michael C Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| |
Collapse
|
9
|
Bianco M, Parente A, Biolè C, Righetti C, Spirito A, Luciano A, Destefanis P, Nangeroni G, Angusti T, Anselmino M, Montagna L. The prevalence of TTR cardiac amyloidosis among patients undergoing bone scintigraphy. J Nucl Cardiol 2021; 28:825-830. [PMID: 33728572 DOI: 10.1007/s12350-021-02575-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Radiolabeled bisphosphonates bone scintigraphy is highly sensitive in detecting transthyretin (TTR) cardiac amyloidosis; data on the true prevalence of cardiac involvement in TTR amyloidosis are lacking. METHODS AND RESULTS This retrospective observational, monocentric study aims to estimate the prevalence of positive bone scan suspect for TTR cardiac amyloidosis among an all-comers population who underwent a bone scintigraphy. ECG, echocardiography and clinical status of patients with unexpected cardiac uptake (Perugini score 2-3) who underwent bone scintigraphy with [99mTc]-HDP or [99mTc]-DPD at San Luigi Gonzaga University Hospital between January 2015 and May 2020 have been collected. The prevalence of bone scintigraphy suspect for cardiac involvement was 0.54% (23/4,228). The bone scintigraphy was mainly performed using [99mTc]-HDP (82.9%) and the dominant indication for the test was oncology in the 47.9% of cases. 8 Subjects had a history of neuropathy (34.8%) and 5 of carpal tunnel syndrome (21.7%). 11 Patients suffered a previous episode of heart failure (48%) while 5 patients (21.7%) were totally asymptomatic, without any sign or symptom before the bone scintigraphy making the nuclear examination crucial for an early diagnosis of TTR amyloidosis. CONCLUSION Bone scintigraphy allows suspecting TTR amyloidosis in a pre-clinical stage of the disease in an all-comers population of patients undergoing bone scintigraphy mainly for oncology reasons.
Collapse
Affiliation(s)
- Matteo Bianco
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.
| | - A Parente
- Division of Nuclear Medicine, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - C Biolè
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - C Righetti
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - A Spirito
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - A Luciano
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - P Destefanis
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - G Nangeroni
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - T Angusti
- Division of Nuclear Medicine, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - M Anselmino
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza di Torino" Hospital, University of Turin, Turin, Italy
| | - L Montagna
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| |
Collapse
|
10
|
Atieh J, Sack J, Thomas R, Rahma OE, Camilleri M, Grover S. Gastroparesis Following Immune Checkpoint Inhibitor Therapy: A Case Series. Dig Dis Sci 2021; 66:1974-1980. [PMID: 32594464 PMCID: PMC7867661 DOI: 10.1007/s10620-020-06440-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/21/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) have improved outcomes in patients with various malignancies; however, they can cause immune-related hepatitis and enterocolitis. Patients on ICI may also develop upper gastrointestinal symptoms and undergo measurement of gastric emptying. AIMS Our aim was to review records of patients with gastroparesis following ICI therapy at two medical centers. METHODS We performed a retrospective review of all patients at Mayo Clinic and Brigham and Women's/Dana-Farber Cancer Center (BWH/DFCC) who underwent gastric scintigraphy for the assessment of symptoms of gastroparesis following ICI treatment up to January 2020. Clinical presentation, medical history, laboratory evaluation, imaging, treatment, and outcomes were retrieved from the records. Gastroparesis was diagnosed as delayed gastric emptying (GE) measured by gastric scintigraphy. RESULTS At Mayo Clinic, 2 patients (median age 59 years, 1 male [M], 1 female [F]) had delayed GE, while 4 patients (median age 53 years, 3M, 1F) had normal GE following ICI use. Of those with delayed GE (diagnosed after 38 and 2 months of ICI initiation), 1 patient was treated for non-Hodgkin's lymphoma and melanoma with ipilimumab; a second patient with breast cancer was treated with pembrolizumab. At BWH/DFCC, 2 patients (median age 56 years, 1M, 1F) had normal GE after ICI treatment, while a 62-year-old female with non-small cell lung cancer developed gastroparesis 3 months following initiation of nivolumab. CONCLUSION This report documents gastroparesis as a potential adverse effect of ICI. Further studies should explore the potential for ICI therapy to damage anti-inflammatory macrophages that preserve the enteric neurons.
Collapse
Affiliation(s)
- Jessica Atieh
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) and Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, USA
| | - Jordan Sack
- Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Richard Thomas
- Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Osama E Rahma
- Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Brookline, MA, USA
| | - Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) and Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. S.W., Rochester, MN, USA.
| | - Shilpa Grover
- Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
11
|
Eng L, Lam L. 50 Years Ago in TheJournalofPediatrics: Evolution of Imaging for Diagnosis of Abnormal Migration of the Thyroid Gland. J Pediatr 2021; 232:153. [PMID: 33482218 DOI: 10.1016/j.jpeds.2021.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Liane Eng
- Division of Pediatric Endocrinology & Diabetes, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Leslie Lam
- Division of Pediatric Endocrinology & Diabetes, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| |
Collapse
|
12
|
Zeng Y, Poterucha TJ, Einstein AJ, Zhang Q, Chen Y, Xie H, Wan K, Liang Y, Chen J, Tang G. False positive technetium-99m pyrophosphate scintigraphy in a patient with cardiac amyloidosis light chain: Case report. Medicine (Baltimore) 2021; 100:e25582. [PMID: 33907108 PMCID: PMC8084032 DOI: 10.1097/md.0000000000025582] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/31/2021] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Patients with cardiac amyloidosis light chain (AL) present with negative Tc-99m pyrophosphate (PYP) scintigraphy (absent or mild heart uptake). On the contrary, patients with cardiac amyloidosis transthyretin (ATTR) present with positive Tc-99m PYP scanning (intensive heart uptake). We present a false positive Tc-99m PYP scintigraphy (grade 2, the heart-to-contralateral ratio is 1.65) in a patient with AL. PATIENT CONCERNS A 42-year-old Chinese man complained of effort intolerance, chest discomfort, and short of breath progressively over 1 year. New York Heart Association Class III. Physical examination showed legs swelling. Laboratory revealed elevated brain natriuretic peptide of 23,031 ng/mL (0-88) and Troponin-T of 273.4 ng/mL (0-14). DIAGNOSIS Cardiac amyloidosis light chain. Evidences: free light chains (FLCs): decreased serum free kappa/lambda ratio of 0.043 (0.31-1.56). Immunofixation electrophoresis: a positive lambda light chain monoclonal protein. Cardiac biopsy: HE: Ambiguity Congo red strain. Myocardial immunofluorescence: positive lambda light chain. Myocardial immunohistochemistry: positive lambda light chain, negative kappa light chain, and TTR. INTERVENTIONS Furosemide 40 mg qd, torasemide 20 mg qd, spirolactone 20 mg qd, potassium chloride 10 mL per 500 mL urine, atorvastatin calcium tablet 20 mg qd, aspirin enteric-coated tablets 100 mg qd during the 2-weeks in-hospital. OUTCOMES The patient died 2 months later after discharge. CONCLUSION False positive Tc-99m PYP scintigraphy may rarely presented in patients with cardiac amyloidosis light chain. So, the clonal plasma cell process based on the FLCs and immunofixation is a base to rule out AL cardiac amyloidosis when we interpret a positive Tc-99m PYP scintigraphy.
Collapse
Affiliation(s)
| | - Timothy J. Poterucha
- Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine
| | - Andrew J. Einstein
- Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine
- Department of Radiology, Columbia University Irving Medical Center, New York, New York
| | | | | | | | | | - Yujia Liang
- Echocardiology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | | | | |
Collapse
|
13
|
Griepp DW, Sajan A, Sighary M. Diffuse Paget's Disease of the Skull with Intense Uptake of Technetium-99m-Labeled Diphosphonate Tracer in Bone Scintigraphy. World Neurosurg 2021; 151:89-90. [PMID: 33940269 DOI: 10.1016/j.wneu.2021.04.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/21/2021] [Indexed: 11/17/2022]
Abstract
Imaging in patients with Paget's disease of bone is very important clinically to show the presence of Pagetic abnormalities, assess disease progression, and identify adversely affected structures throughout disease course. Abnormalities and progression may be seen on radiographs, computed tomography, magnetic resonance imaging, and nuclear imaging. Herein, we report a case Paget's disease of bone showing diffuse characteristic pathology using technetium-99m-labelled diphosphonate tracer in bone scintigraphy (nuclear imaging). This case emphasizes the ability of nuclear imaging to rapidly visualize and assess progressive distribution of Pagetic involvement in a patient previously diagnosed with pituitary adenoma and mild Paget's disease of the skull.
Collapse
Affiliation(s)
- Daniel W Griepp
- College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, New York, USA; Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Abin Sajan
- Department of Surgery, NYU Langone Hospital-Long Island, Mineola, New York, USA.
| | - Maziar Sighary
- Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| |
Collapse
|
14
|
Vahidfar N, Aghanejad A, Ahmadzadehfar H, Farzanehfar S, Eppard E. Theranostic Advances in Breast Cancer in Nuclear Medicine. Int J Mol Sci 2021; 22:4597. [PMID: 33925632 PMCID: PMC8125561 DOI: 10.3390/ijms22094597] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023] Open
Abstract
The implication of 'theranostic' refers to targeting an identical receptor for diagnostic and therapeutic purposes, by the same radioligand, simultaneously or separately. In regard to extensive efforts, many considerable theranostic tracers have been developed in recent years. Emerging evidence strongly demonstrates the tendency of nuclear medicine towards therapies based on a diagnosis. This review is focused on the examples of targeted radiopharmaceuticals for the imaging and therapy of breast cancer.
Collapse
Affiliation(s)
- Nasim Vahidfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran 1419733141, Iran;
| | - Ayuob Aghanejad
- Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz 51368, Iran;
| | | | - Saeed Farzanehfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran 1419733141, Iran;
| | - Elisabeth Eppard
- Positronpharma SA. Rancagua 878, Santiago 7500621, Chile;
- Department of Nuclear Medicine, University Hospital Magdeburg, Leipziger Strass 44, 39120 Magdedurg, Germany
| |
Collapse
|
15
|
Berland L, Kim L, Abousaway O, Mines A, Mishra S, Clark L, Hofman P, Rashidian M. Nanobodies for Medical Imaging: About Ready for Prime Time? Biomolecules 2021; 11:637. [PMID: 33925941 PMCID: PMC8146371 DOI: 10.3390/biom11050637] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/13/2022] Open
Abstract
Recent advances in medical treatments have been revolutionary in shaping the management and treatment landscape of patients, notably cancer patients. Over the last decade, patients with diverse forms of locally advanced or metastatic cancer, such as melanoma, lung cancers, and many blood-borne malignancies, have seen their life expectancies increasing significantly. Notwithstanding these encouraging results, the present-day struggle with these treatments concerns patients who remain largely unresponsive, as well as those who experience severely toxic side effects. Gaining deeper insight into the cellular and molecular mechanisms underlying these variable responses will bring us closer to developing more effective therapeutics. To assess these mechanisms, non-invasive imaging techniques provide valuable whole-body information with precise targeting. An example of such is immuno-PET (Positron Emission Tomography), which employs radiolabeled antibodies to detect specific molecules of interest. Nanobodies, as the smallest derived antibody fragments, boast ideal characteristics for this purpose and have thus been used extensively in preclinical models and, more recently, in clinical early-stage studies as well. Their merit stems from their high affinity and specificity towards a target, among other factors. Furthermore, their small size (~14 kDa) allows them to easily disperse through the bloodstream and reach tissues in a reliable and uniform manner. In this review, we will discuss the powerful imaging potential of nanobodies, primarily through the lens of imaging malignant tumors but also touching upon their capability to image a broader variety of nonmalignant diseases.
Collapse
Affiliation(s)
- Léa Berland
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (L.B.); (L.K.); (O.A.); (A.M.); (S.M.); (L.C.)
- Université Côte d’Azur, CNRS, INSERM, IRCAN, 06100 Nice, France;
| | - Lauren Kim
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (L.B.); (L.K.); (O.A.); (A.M.); (S.M.); (L.C.)
- Department of Chemistry and Bioengineering, Harvard University, Cambridge, MA 02138, USA
| | - Omar Abousaway
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (L.B.); (L.K.); (O.A.); (A.M.); (S.M.); (L.C.)
| | - Andrea Mines
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (L.B.); (L.K.); (O.A.); (A.M.); (S.M.); (L.C.)
| | - Shruti Mishra
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (L.B.); (L.K.); (O.A.); (A.M.); (S.M.); (L.C.)
| | - Louise Clark
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (L.B.); (L.K.); (O.A.); (A.M.); (S.M.); (L.C.)
| | - Paul Hofman
- Université Côte d’Azur, CNRS, INSERM, IRCAN, 06100 Nice, France;
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Nice Center Hospital, 06100 Nice, France
| | - Mohammad Rashidian
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (L.B.); (L.K.); (O.A.); (A.M.); (S.M.); (L.C.)
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
16
|
Toyama Y, Werner RA, Ruiz-Bedoya CA, Ordonez AA, Takase K, Lapa C, Jain SK, Pomper MG, Rowe SP, Higuchi T. Current and future perspectives on functional molecular imaging in nephro-urology: theranostics on the horizon. Theranostics 2021; 11:6105-6119. [PMID: 33897902 PMCID: PMC8058716 DOI: 10.7150/thno.58682] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/21/2021] [Indexed: 01/01/2023] Open
Abstract
In recent years, a paradigm shift from single-photon-emitting radionuclide radiotracers toward positron-emission tomography (PET) radiotracers has occurred in nuclear oncology. Although PET-based molecular imaging of the kidneys is still in its infancy, such a trend has emerged in the field of functional renal radionuclide imaging. Potentially allowing for precise and thorough evaluation of renal radiotracer urodynamics, PET radionuclide imaging has numerous advantages including precise anatomical co-registration with CT images and dynamic three-dimensional imaging capability. In addition, relative to scintigraphic approaches, PET can allow for significantly reduced scan time enabling high-throughput in a busy PET practice and further reduces radiation exposure, which may have a clinical impact in pediatric populations. In recent years, multiple renal PET radiotracers labeled with 11C, 68Ga, and 18F have been utilized in clinical studies. Beyond providing a precise non-invasive read-out of renal function, such radiotracers may also be used to assess renal inflammation. This manuscript will provide an overview of renal molecular PET imaging and will highlight the transformation of conventional scintigraphy of the kidneys toward novel, high-resolution PET imaging for assessing renal function. In addition, future applications will be introduced, e.g. by transferring the concept of molecular image-guided diagnostics and therapy (theranostics) to the field of nephrology.
Collapse
Affiliation(s)
- Yoshitaka Toyama
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Diagnostic Radiology, Tohoku University, Sendai, Japan
| | - Rudolf A. Werner
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
- Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg Germany
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Camilo A. Ruiz-Bedoya
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alvaro A. Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University, Sendai, Japan
| | - Constantin Lapa
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Sanjay K. Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Martin G. Pomper
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Steven P. Rowe
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Takahiro Higuchi
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
- Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg Germany
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| |
Collapse
|
17
|
Benderradji H, Beron A, Wémeau JL, Carnaille B, Delcroix L, Do Cao C, Baillet C, Huglo D, Lion G, Boury S, Cussac JF, Caiazzo R, Pattou F, Leteurtre E, Vantyghem MC, Ladsous M. Quantitative dual isotope 123iodine/ 99mTc-MIBI scintigraphy: A new approach to rule out malignancy in thyroid nodules. Ann Endocrinol (Paris) 2021; 82:83-91. [PMID: 33727116 DOI: 10.1016/j.ando.2021.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the role of dual isotope 123Iodine/99mTc-MIBI thyroid scintigraphy (IMS) in discriminating between malignant and benign lesions in indeterminate nodules using quantitative analysis methods. METHODS Thirty-five consecutive patients with thyroid nodules of indeterminate or non-diagnostic cytology and cold on 123Iodine scintigraphy (10 Bethesda I, 24 Bethesda III-IV, 1 in which cytology was impossible) underwent IMS between 2017 and 2019 with uptake quantification at two time points ahead of thyroidectomy: early and late. Images were analyzed by two blinded physicians. RESULTS Twelve nodules were malignant and 23 benign on histopathology. Mean uptake values were lower in benign than in malignant nodules at both time points: early, 8.7±4.1 versus 12.9±3.5 (P=0.005); and late, 5.3±2.7 versus 7.7±1.1 (P=0.008). Interobserver reproducibility was excellent. The intraclass correlation coefficient was 0.86 in benign and 0.92 in malignant lesions for early uptake result (ER) and 0.94 and 0.85 respectively for late uptake result (LR). The optimal LR cut-off to exclude a diagnosis of malignancy was set at 5.9 . The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this cut-off were, respectively, 100%, 65.2%, 60%, 100% and 77.1%. CONCLUSION Despite some study limitations, quantitative analysis of 99mTc-MIBI thyroid scintigraphy had a good reproducibility, which could help to rule out malignancy in non-diagnostic or indeterminate thyroid nodules and thereby reducing the number of patients undergoing unnecessary surgery when LR is below 5.9.
Collapse
Affiliation(s)
- Hamza Benderradji
- Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France; Inserm, U 1172, Lille University, Lille, France.
| | - Amandine Beron
- Department of Nuclear Medicine, Lille University Hospital, Lille, France
| | - Jean-Louis Wémeau
- Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France
| | - Bruno Carnaille
- Department of General and Endocrine Surgery, Lille University Hospital, Lille, France
| | - Laurent Delcroix
- Department of Nuclear Medicine, Lille University Hospital, Lille, France
| | - Christine Do Cao
- Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France
| | - Clio Baillet
- Department of Nuclear Medicine, Lille University Hospital, Lille, France
| | - Damien Huglo
- Department of Nuclear Medicine, Lille University Hospital, Lille, France; Inserm, U 1189, Lille University, Lille, France
| | - Georges Lion
- Department of Nuclear Medicine, Lille University Hospital, Lille, France
| | - Samuel Boury
- Department of Radiology, Lille University Hospital, Lille, France
| | | | - Robert Caiazzo
- Department of General and Endocrine Surgery, Lille University Hospital, Lille, France; Inserm, U1190-EGID, Lille University, Lille, France
| | - François Pattou
- Department of General and Endocrine Surgery, Lille University Hospital, Lille, France; Inserm, U1190-EGID, Lille University, Lille, France
| | - Emmanuelle Leteurtre
- Department of Pathology, Lille University Hospital, Lille, France; Inserm, CNRS, UMR9020, U1277 - CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies, Lille University, Lille, France
| | - Marie-Christine Vantyghem
- Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France; Inserm, U1190-EGID, Lille University, Lille, France
| | - Miriam Ladsous
- Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France; Department of Endocrinology, Valenciennes General Hospital, Valenciennes, France
| |
Collapse
|
18
|
Ching-Roa VD, Olson EM, Ibrahim SF, Torres R, Giacomelli MG. Ultrahigh-speed point scanning two-photon microscopy using high dynamic range silicon photomultipliers. Sci Rep 2021; 11:5248. [PMID: 33664354 PMCID: PMC7933192 DOI: 10.1038/s41598-021-84522-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/17/2021] [Indexed: 11/09/2022] Open
Abstract
Conventional two-photon microscopes use photomultiplier tubes, which enable high sensitivity but can detect relatively few photons per second, forcing longer pixel integration times and limiting maximum imaging rates. We introduce novel detection electronics using silicon photomultipliers that greatly extend dynamic range, enabling more than an order of magnitude increased photon detection rate as compared to state-of-the-art photomultiplier tubes. We demonstrate that this capability can dramatically improve both imaging rates and signal-to-noise ratio (SNR) in two-photon microscopy using human surgical specimens. Finally, to enable wider use of more advanced detection technology, we have formed the OpenSiPM project, which aims to provide open source detector designs for high-speed two-photon and confocal microscopy.
Collapse
Affiliation(s)
- Vincent D Ching-Roa
- Department of Biomedical Engineering, University of Rochester, 207 Goergen Hall, BOX 270168, Rochester, NY, 14627, USA
| | - Eben M Olson
- Department of Laboratory Medicine, Yale University, New Haven, CT, USA
| | - Sherrif F Ibrahim
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY, USA
- Rochester Dermatologic Surgery, PC,, Victor, NY, USA
| | - Richard Torres
- Department of Laboratory Medicine, Yale University, New Haven, CT, USA
| | - Michael G Giacomelli
- Department of Biomedical Engineering, University of Rochester, 207 Goergen Hall, BOX 270168, Rochester, NY, 14627, USA.
| |
Collapse
|
19
|
Lu CC, Yen RF, Peng KY, Huang JY, Wu KD, Chueh JS, Lin WY. NP-59 Adrenal Scintigraphy as an Imaging Biomarker to Predict KCNJ5 Mutation in Primary Aldosteronism Patients. Front Endocrinol (Lausanne) 2021; 12:644927. [PMID: 33995277 PMCID: PMC8113947 DOI: 10.3389/fendo.2021.644927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/06/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Somatic KCNJ5 mutation occurs in half of unilateral primary aldosteronism (PA) and is associated with more severe phenotype. Mutation status can only be identified by tissue sample from adrenalectomy. NP-59 adrenal scintigraphy is a noninvasive functional study for disease activity assessment. This study aimed to evaluate the predictive value of NP-59 adrenal scintigraphy in somatic KCNJ5 mutation among PA patients who received adrenalectomy. METHODS Sixty-two PA patients who had NP-59 adrenal scintigraphy before adrenalectomy with available KCNJ5 mutation status were included. Two semiquantitative parameters, adrenal to liver ratio (ALR) and lesion to contralateral ratio of bilateral adrenal glands (CON) derived from NP-59 adrenal scintigraphy, of mutated and wild-type patients were compared. Cutoff values calculated by receiver-operating characteristic (ROC) analysis were used as a predictor of KCNJ5 mutation. RESULTS Twenty patients had KCNJ5 mutation and 42 patients were wild type. Patients harboring KCNJ5 mutation had both higher ALR and CON (p = 0.0031 and 0.0833, respectively) than wild-type patients. With ALR and CON cutoff of 2.10 and 1.95, the sensitivity and specificity to predict KCNJ5 mutation were 85%, 57% and 45%, 93%, respectively. Among 20 patients with KCNJ5 mutation, 16 showed G151R point mutation (KCNJ5- G151R) and 4 showed L168R point mutation (KCNJ5-L168R), which former one had significantly lower ALR (p=0.0471). CONCLUSION PA patients harboring somatic KCNJ5 mutation had significantly higher NP-59 uptake regarding to ALR and CON than those without mutation. APAs with KCNJ5-L168R point mutation showed significantly higher ALR than those with KCNJ5-G151R point mutation.
Collapse
Affiliation(s)
- Ching-Chu Lu
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kang-Yung Peng
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jei-Yie Huang
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kwan-Dun Wu
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeff S. Chueh
- Glickman Urological and Kidney Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Wan-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- *Correspondence: Wan-Yu Lin,
| |
Collapse
|
20
|
Jensen JK, Zobel EH, von Scholten BJ, Rotbain Curovic V, Hansen TW, Rossing P, Kjaer A, Ripa RS. Effect of 26 Weeks of Liraglutide Treatment on Coronary Artery Inflammation in Type 2 Diabetes Quantified by [ 64Cu]Cu-DOTATATE PET/CT: Results from the LIRAFLAME Trial. Front Endocrinol (Lausanne) 2021; 12:790405. [PMID: 34917038 PMCID: PMC8669791 DOI: 10.3389/fendo.2021.790405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/04/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Quantification of coronary artery inflammation and atherosclerosis remains a challenge in high-risk individuals. In this study we sought to investigate if the glucagon like peptide-1 receptor agonist liraglutide has a direct anti-inflammatory effect in the coronary arteries using positron emission tomography (PET) with a radioactive tracer targeting activated macrophages in the vessel-wall. METHODS Thirty randomly selected participants with type 2 diabetes from the placebo-controlled trial LIRAFLAME were enrolled in this sub-study. Participants were, prior to enrollment in this sub-study, randomized to either treatment with daily liraglutide (n=15) or placebo (n=15). Both groups underwent a combined [64Cu]Cu-DOTATATE positron emission tomography and computed tomography scan of the heart at baseline and after 26 weeks of treatment. Coronary artery uptake of [64Cu]Cu-DOTATATE were measured as maximum standardized uptake values (SUVmax); and means of the maximum values (mSUVmax), both values were calculated at the level of each participant and each individual coronary-segment. RESULTS SUVmax and mSUVmax values decreased significantly in the liraglutide group both at the participant level (SUVmax: p=0.013; mSUVmax: p=0.004) and at the coronary-segment level (SUVmax: p=0.001; mSUVmax: p<0.0001). No change was observed in the placebo group neither at the participant level (SUVmax: p=0.69; mSUVmax: p=0.67) or at the coronary-segment level (SUVmax: p=0.49; mSUVmax: p=0.30). When comparing the mean change in uptake values between the two groups at both the participant level (SUVmax: p=0.076; mSUVmax: p=0.077) and the coronary segment level (SUVmax: p=0.13; mSUVmax: p=0.11) a borderline significant difference was observed. Baseline SUVmax [64Cu]Cu-DOTATATE uptake values showed a weak positive correlation with the inflammatory biomarker high-sensitivity c-reactive protein (τ =0.26, p=0.045). CONCLUSION Liraglutide treatment for 26-weeks caused a significant reduction in [64Cu]Cu-DOTATATE uptake in the coronary arteries whereas this was not seen in the placebo treated group. In addition, [64Cu]Cu-DOTATATE PET/CT as a marker of coronary inflammation correlated with the systemic inflammation marker hs-CRP.
Collapse
Affiliation(s)
- Jacob K. Jensen
- Department of Clinical Physiology, Nuclear Medicine and PET & Cluster for Molecular Imaging, Copenhagen University Hospital – Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Jacob K. Jensen,
| | - Emilie H. Zobel
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Novo Nordisk A/S, Søborg, Denmark
| | - Bernt J. von Scholten
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Novo Nordisk A/S, Søborg, Denmark
| | | | | | | | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine and PET & Cluster for Molecular Imaging, Copenhagen University Hospital – Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus S. Ripa
- Department of Clinical Physiology, Nuclear Medicine and PET & Cluster for Molecular Imaging, Copenhagen University Hospital – Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
21
|
Chakraborty U, Ghosh S, Chandra A, Ray AK. Subacute thyroiditis as a presenting manifestation of COVID-19: a report of an exceedingly rare clinical entity. BMJ Case Rep 2020; 13:e239953. [PMID: 33370933 PMCID: PMC10577769 DOI: 10.1136/bcr-2020-239953] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
The SARS-CoV-2 has wreaked havoc globally and has claimed innumerable lives all over the world. The symptoms of this disease may range from mild influenza-like symptoms to severe acute respiratory distress syndrome with high morbidity and mortality. With improved diagnostic techniques and better disease understanding, an increased number of cases are being reported with extrapulmonary manifestations of this disease ranging from renal and gastrointestinal to cardiac, hepatic, neurological and haematological dysfunction. Subacute thyroiditis is a self-limiting and painful thyroid gland inflammation most often secondary to viral infections. We report a case of subacute thyroiditis in a 58-year-old gentleman presenting with a painful swelling in the neck who was subsequently detected to be positive for SARS-CoV-2. We seek to highlight the broad clinical spectrum of the COVID-19 by reporting probably the first case of subacute thyroiditis possibly induced by SARS-CoV-2 infection from India.
Collapse
Affiliation(s)
- Uddalak Chakraborty
- Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Shrestha Ghosh
- Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Atanu Chandra
- Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Aritra Kumar Ray
- Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| |
Collapse
|
22
|
Sood A, Singh D, Dutta U, Mittal BR, Parmar M, Kaur G, Kaur K. Effect of ursodeoxycholic acid in facilitating early hepatic clearance of radiotracer among patients undergoing 99mTc-sestamibi myocardial perfusion scintigraphy: A randomized double blind placebo controlled parallel trial. J Nucl Cardiol 2020; 27:2337-2348. [PMID: 30697661 DOI: 10.1007/s12350-019-01597-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/27/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Infra-cardiac tracer activity due to persistent hepatic activity interferes in inferior and infero-septal wall assessment during 99mTc-MIBI SPECT/CT myocardial perfusion scintigraphy (MPS) in evaluation of patients with coronary artery disease. It affects image interpretation with increased study duration. Ursodeoxycholic acid (UDCA) is known to enhance hepatic excretion of bilirubin and bile salts, though its role in enhancing the hepatic tracer clearance in facilitating cardiac imaging is not known. METHODS This prospective, randomized double-blind, placebo controlled clinical trial of 120 patients, referred for adenosine stress or viability MPS studies were randomized 1:1 to receive either UDCA or placebo. Outcome was quantitative & qualitative improvement in imaging for better interpretation and to reduce the waiting time for scan. RESULTS 118 participants (59 ± 11.9 years; 84 men) underwent adenosine stress MPS or viability MPS. Sixty participants had UDCA while 58 had placebo intervention. The study showed significant decrease in liver counts with improved myocardial to liver ratio at 30 and 60 minutes in adenosine stress MPS group, and marginally significant alteration in liver counts at 60 minutes in viability MPS group receiving UDCA, resulting in better images. CONCLUSION UDCA intervention in MPS provides early and better image due to faster hepatic tracer clearance.
Collapse
Affiliation(s)
- Ashwani Sood
- Post Graduate Institute of Medical Education and Research (PGIMER), Nuclear Medicine, Chandigarh, India
| | - Deepa Singh
- Post Graduate Institute of Medical Education and Research (PGIMER), Nuclear Medicine, Chandigarh, India
| | - Usha Dutta
- Post Graduate Institute of Medical Education and Research (PGIMER), Gastroenterology, Chandigarh, India
| | - Bhagwant Rai Mittal
- Post Graduate Institute of Medical Education and Research (PGIMER), Nuclear Medicine, Chandigarh, India.
| | - Madan Parmar
- Post Graduate Institute of Medical Education and Research (PGIMER), Nuclear Medicine, Chandigarh, India
| | - Gurvinder Kaur
- Post Graduate Institute of Medical Education and Research (PGIMER), Nuclear Medicine, Chandigarh, India
| | - Komalpreet Kaur
- Post Graduate Institute of Medical Education and Research (PGIMER), Nuclear Medicine, Chandigarh, India
| |
Collapse
|
23
|
Baghel V, Kaushik P, Seth S, Patel C. Somatostatin analogue scintigraphy in myocardial inflammation: An interesting image. J Nucl Cardiol 2020; 27:2436-2437. [PMID: 31933155 DOI: 10.1007/s12350-019-02023-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Vivek Baghel
- Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Prateek Kaushik
- Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Seth
- Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Chetan Patel
- Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
24
|
Ng TSC, Putta N, Kwatra NS, Drubach LA, Rosen R, Fahey FH, Flores A, Nurko S, Voss SD. Pediatric Solid Gastric Emptying Scintigraphy: Normative Value Guidelines and Nonstandard Meal Alternatives. Am J Gastroenterol 2020; 115:1830-1839. [PMID: 33156102 DOI: 10.14309/ajg.0000000000000831] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Adult standards for gastric emptying scintigraphy, including the type of meal and range of normative values for percent gastric emptying, are routinely used in pediatric practice, but to date have not been validated. The purpose of this study is to determine whether the use of adult criteria for gastric emptying scintigraphy is valid for children and whether alternative nonstandard meals can also be offered based on these criteria. METHODS This retrospective study analyzed patients (n = 1,151 total) who underwent solid-phase gastric emptying scintigraphy. Patients were stratified into normal and delayed gastric emptying cohorts based on adult criteria, i.e., with normal gastric emptying defined as ≤10% gastric retention at 4 hours. Patients were further stratified based on the type of meal, namely complete or partial adult standard meals or alternative cheese-based meals. Percent gastric retention values at 1, 2, 3, and 4 hours were compared. RESULTS The median (95% upper reference limit) percentage gastric retention values for the complete standard meal were 72% (93%) at 1 hour, 39% (65%) at 2 hours, 15% (33%) at 3 hours, and 6% (10 %) at 4 hours. By comparison, the values for cheese-based meals were 60% (87%) at 1 hour, 29% (61%) at 2 hours, 10% (30%) at 3 hours, and 5% (10%) at 4 hours. Consumption of at least 50% of the standard meal yielded similar retention percentages; 68% (89%) at 1 hour, 32% (57%) at 2 hours, 10% (29%) at 3 hours, and 5% (10%) at 4 hours. There were no significant age- or sex-specific differences using the adult criteria. DISCUSSION The adult normative standards for gastric emptying scintigraphy are applicable for use in the pediatric population. These same standards can be also be applied to nonstandard meal options, including cheese-based alternative meals and partial standard meals.
Collapse
Affiliation(s)
- Thomas S C Ng
- Joint Program in Nuclear Medicine, Department of Radiology, Brigham and Women's' Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Neha S Kwatra
- Joint Program in Nuclear Medicine, Department of Radiology, Brigham and Women's' Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Laura A Drubach
- Joint Program in Nuclear Medicine, Department of Radiology, Brigham and Women's' Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rachel Rosen
- Division of Gastroenterology, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Frederic H Fahey
- Joint Program in Nuclear Medicine, Department of Radiology, Brigham and Women's' Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alejandro Flores
- Division of Gastroenterology, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
- Colorectal Program, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Samuel Nurko
- Division of Gastroenterology, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
- Colorectal Program, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stephan D Voss
- Joint Program in Nuclear Medicine, Department of Radiology, Brigham and Women's' Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
25
|
Fujita T, Nishi M, Ishii D, Matsumoto K, Yoshida K, Iwamura M. Renal functional outcome after laparoscopic partial nephrectomy using dynamic renal scintigraphy. Can J Urol 2020; 27:10402-10406. [PMID: 33049194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
UNLABELLED INTRODUCTION To explore postoperative operation-side renal functional outcome after laparoscopic partial nephrectomy (LPN) using dynamic renal scintigraphy. MATERIALS AND METHODS Between July 2006 and December 2014, 62 patients with localized renal tumor received ischemic LPN at our institution. Preoperative, 6 months postoperative, and 12 months postoperative split renal functions were evaluated by dynamic renal scintigraphy using radionuclide technetium-99m-mercaptoacetyltriglycine. Postoperative operation-side renal function was calculated. To assess the significant factors affecting postoperative operation-side renal functional decrease, simple regression and multiple regression analyses were carried out. RESULTS Postoperative operation-side renal functions were significantly decreased to 86.6% at 6 months and 86.9% at 12 months postoperatively (p < 0.0001). Simple regression analyses revealed that postoperative operation-side renal functions were significantly decreased with prolonged warm ischemia time at 6 months and 12 months postoperatively (p = 0.0058 and 0.0032, respectively). Multiple regression analysis identified warm ischemia time as an independent predictive factor for operation-side renal functional decreases at 6 months and 12 months postoperatively (p = 0.0158 and 0.0109, respectively). CONCLUSIONS Irreversible renal damage using dynamic renal scintigraphy after LPN was observed. With prolongation of warm ischemia time during LPN, postoperative operation-side renal function was significantly decreased.
Collapse
Affiliation(s)
- Tetsuo Fujita
- Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan
| | | | | | | | | | | |
Collapse
|
26
|
Hemke R, Herregods N, Jaremko JL, Åström G, Avenarius D, Becce F, Bielecki DK, Boesen M, Dalili D, Giraudo C, Hermann KG, Humphries P, Isaac A, Jurik AG, Klauser AS, Kvist O, Laloo F, Maas M, Mester A, Oei E, Offiah AC, Omoumi P, Papakonstantinou O, Plagou A, Shelmerdine S, Simoni P, Sudoł-Szopińska I, Tanturri de Horatio L, Teh J, Jans L, Rosendahl K. Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider. Eur Radiol 2020; 30:5237-5249. [PMID: 32399709 PMCID: PMC7476913 DOI: 10.1007/s00330-020-06807-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/08/2020] [Accepted: 03/12/2020] [Indexed: 12/17/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common paediatric rheumatic disease. It represents a group of heterogenous inflammatory disorders with unknown origin and is a diagnosis of exclusion in which imaging plays an important role. JIA is defined as arthritis of one or more joints that begins before the age of 16 years, persists for more than 6 weeks and is of unknown aetiology and pathophysiology. The clinical goal is early suppression of inflammation to prevent irreversible joint damage which has shifted the emphasis from detecting established joint damage to proactively detecting inflammatory change. This drives the need for imaging techniques that are more sensitive than conventional radiography in the evaluation of inflammatory processes as well as early osteochondral change. Physical examination has limited reliability, even if performed by an experienced clinician, emphasising the importance of imaging to aid in clinical decision-making. On behalf of the European Society of Musculoskeletal Radiology (ESSR) arthritis subcommittee and the European Society of Paediatric Radiology (ESPR) musculoskeletal imaging taskforce, based on literature review and/or expert opinion, we discuss paediatric-specific imaging characteristics of the most commonly involved, in literature best documented and clinically important joints in JIA, namely the temporomandibular joints (TMJs), spine, sacroiliac (SI) joints, wrists, hips and knees, followed by a clinically applicable point to consider for each joint. We will also touch upon controversies in the current literature that remain to be resolved with ongoing research. KEY POINTS: • Juvenile idiopathic arthritis (JIA) is the most common chronic paediatric rheumatic disease and, in JIA imaging, is increasingly important to aid in clinical decision-making. • Conventional radiographs have a lower sensitivity and specificity for detection of disease activity and early destructive change, as compared to MRI or ultrasound. Nonetheless, radiography remains important, particularly in narrowing the differential diagnosis and evaluating growth disturbances. • Mainly in peripheral joints, ultrasound can be helpful for assessment of inflammation and guiding joint injections. In JIA, MRI is the most validated technique. MRI should be considered as the modality of choice to assess the axial skeleton or where the clinical presentation overlaps with JIA.
Collapse
Affiliation(s)
- Robert Hemke
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Nele Herregods
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Jacob L Jaremko
- Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Gunnar Åström
- Department of Radiology, Uppsala University, Uppsala, Sweden
| | - Derk Avenarius
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Dennis K Bielecki
- Department of Diagnostic Imaging, Kings College Hospital, London, UK
| | - Mikael Boesen
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Danoob Dalili
- Department of Radiology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Chiara Giraudo
- Radiology Institute, Department of Medicine - DIMED, Padova University, Padua, Italy
| | - Kay-Geert Hermann
- Department of Radiology, University Hospital Charité, Berlin, Germany
| | - Paul Humphries
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - Amanda Isaac
- Department of Radiology, Guy's & St Thomas Hospitals, London, UK
| | - Anne Grethe Jurik
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Andrea S Klauser
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ola Kvist
- Department of Paediatric Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Frederiek Laloo
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Adam Mester
- Department of Radiology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | - Edwin Oei
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center (Erasmus MC), Rotterdam, The Netherlands
| | - Amaka C Offiah
- Academic Unit of Child Health, University of Sheffield, Western Bank, Sheffield, UK
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | | | | | - Paolo Simoni
- Department of Radiology, Reine Fabiola Children's University Hospital of Bruxelles, University of Bruxelles, Brussels, Belgium
| | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation and Department of Medical Imaging, Medical University of Warsaw, Warsaw, Poland
| | | | - James Teh
- Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Lennart Jans
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Karen Rosendahl
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| |
Collapse
|
27
|
Bafaraj SM. Significance of nuclear medicine scan in comparison with diethylenetriamine pentaacetic acid and ultrasound imaging in diagnosing renal disorders: An observational study. Medicine (Baltimore) 2020; 99:e22038. [PMID: 32899061 PMCID: PMC7478558 DOI: 10.1097/md.0000000000022038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The effectiveness of diethylenetriamine pentaacetic acid scan is regularly monitored for the assessment of any potential modifications in treatment responses or kidney functions in the pediatric population.This study attempts to compare the usefulness of diethylenetriamine pentaacetic acid and ultrasound imaging of renal disorders among paediatric patients.A retrospective observational study was conducted by enrolling 106 children. The demographic details such as: participant's age, gender, and the history of renal disease of each patient were recorded. Patients were administered radiopharmaceuticals in a fixed dose and were later subjected to computed tomography (CT) scan. The obtained data was analysed using descriptive statistics.Findings indicated increased sensitivity for CT (61.20%); whereas, a major decrease in specificity (23.68%) was observed. Comparison of Single-photon emission CT (SPECT) and CT findings revealed the increased sensitivity (90.90%) for ultrasound; whereas, there was a slight decrease in the specificity (40%) for SPECT. However, SPECT findings show 91% sensitivity among patients with 71.42% positive predictive value. Moreover, an increase in sensitivity for CT (61.20%), followed by a major decrease in specificity (23.68%) was observed.Ultrasonography has been proved to be the safest and the most effective method for the diagnosis and the treatment of most renal disorders, due to the higher predictive value of SPECT scans. It is thus suggested that patients with ureteral calculi should be diagnosed with renal scintigraphy and unenhanced helical computerized tomography.
Collapse
|
28
|
Peplau E, De Rose F, Reder S, Mittelhäuser M, Scafetta G, Schwaiger M, Weber WA, Bartolazzi A, Skerra A, D'Alessandria C. Development of a Chimeric Antigen-Binding Fragment Directed Against Human Galectin-3 and Validation as an Immuno-Positron Emission Tomography Tracer for the Sensitive In Vivo Imaging of Thyroid Cancer. Thyroid 2020; 30:1314-1326. [PMID: 32200708 DOI: 10.1089/thy.2019.0670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: The lack of facile methods for the specific characterization of malignant thyroid nodules makes the diagnosis of thyroid cancer (TC) challenging. Due to its restricted expression in such nodules, the cell-associated lectin galectin-3 (Gal3) has emerged as a marker for TC with growing interest for in vivo imaging as well as targeted radionuclide therapy. To accelerate translation into clinical application, we have developed a cognate chimeric human antigen-binding fragment (Fab) derived from the rat anti-Gal3 monoclonal antibody M3/38. Methods: The variable immunoglobulin (Ig) light and heavy chain sequences were cloned from the hybridoma cell line, and the corresponding Fab carrying human IgG1/κ constant genes was functionally produced in the periplasm of Escherichia coli and purified to homogeneity. To moderately prolong its plasma half-life and, thus, increase tumor uptake, the recombinant Fab was fused with a long disordered amino acid chain comprising in total 200 Pro, Ala, and Ser residues (PASylation). This novel tracer was subjected to in vitro characterization and in vivo validation by using two thyroid cancer orthotopic murine models. To this end, the αGal3-Fab-PAS200 was conjugated with deferoxamine (Dfo), labeled with 89Zr under mild conditions and tested for binding on TC cell lines. Athymic nude mice were inoculated either with FRO82-1 or with CAL62 tumor cells into the left thyroid lobe. After intravenous injection with ∼3.0 MBq of 89Zr-Dfo-PAS200-Fab, these mice were subjected to positron emission tomography (PET)/computed tomography imaging followed by quantification of tumor accumulation and immunohistochemical analysis. Results: The αGal3-Fab-PAS200 revealed high affinity toward the recombinant Gal3 antigen, with a dissociation constant ≤1 nM as measured via enzyme-linked immunosorbent assay, surface plasmon resonance spectroscopy, and radioactive cell binding assay. The in vivo Gal3-targeting by the 89Zr(IV)-labeled protein tracer, as investigated by immuno-PET, demonstrated highly selective and fast accumulation in orthotopically implanted tumors, with strong contrast images achieved 24 hours postinjection, and no uptake in the tumor-free thyroid lobe, as also confirmed by biodistribution studies. Conclusions: The chimeric αGal3 89Zr-Dfo-PAS200-Fab tracer exhibits selective accumulation in the tumor-bearing thyroid lobe of xenograft mice. Thus, this novel radioactive probe offers potential to change TC management, in addition to current diagnostic procedures, and to reduce unnecessary thyroidectomies.
Collapse
Affiliation(s)
- Emanuel Peplau
- Lehrstuhl für Biologische Chemie, Technische Universität München, Freising, Germany
| | - Francesco De Rose
- Klinikum rechts der Isar, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Sybille Reder
- Klinikum rechts der Isar, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Markus Mittelhäuser
- Klinikum rechts der Isar, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Giorgia Scafetta
- Pathology Research Laboratory, Sant'Andrea Hospital, University Sapienza, Rome, Italy
| | - Markus Schwaiger
- Klinikum rechts der Isar, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Wolfgang A Weber
- Klinikum rechts der Isar, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Armando Bartolazzi
- Pathology Research Laboratory, Sant'Andrea Hospital, University Sapienza, Rome, Italy
- Pathology Research Laboratory, Cancer Center Karolinska, Karolinska Hospital, Stockholm, Sweden
| | - Arne Skerra
- Lehrstuhl für Biologische Chemie, Technische Universität München, Freising, Germany
| | - Calogero D'Alessandria
- Klinikum rechts der Isar, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| |
Collapse
|
29
|
Papandrianos N, Papageorgiou E, Anagnostis A, Papageorgiou K. Bone metastasis classification using whole body images from prostate cancer patients based on convolutional neural networks application. PLoS One 2020; 15:e0237213. [PMID: 32797099 PMCID: PMC7428190 DOI: 10.1371/journal.pone.0237213] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 07/22/2020] [Indexed: 12/21/2022] Open
Abstract
Bone metastasis is one of the most frequent diseases in prostate cancer; scintigraphy imaging is particularly important for the clinical diagnosis of bone metastasis. Up to date, minimal research has been conducted regarding the application of machine learning with emphasis on modern efficient convolutional neural networks (CNNs) algorithms, for the diagnosis of prostate cancer metastasis from bone scintigraphy images. The advantageous and outstanding capabilities of deep learning, machine learning's groundbreaking technological advancement, have not yet been fully investigated regarding their application in computer-aided diagnosis systems in the field of medical image analysis, such as the problem of bone metastasis classification in whole-body scans. In particular, CNNs are gaining great attention due to their ability to recognize complex visual patterns, in the same way as human perception operates. Considering all these new enhancements in the field of deep learning, a set of simpler, faster and more accurate CNN architectures, designed for classification of metastatic prostate cancer in bones, is explored. This research study has a two-fold goal: to create and also demonstrate a set of simple but robust CNN models for automatic classification of whole-body scans in two categories, malignant (bone metastasis) or healthy, using solely the scans at the input level. Through a meticulous exploration of CNN hyper-parameter selection and fine-tuning, the best architecture is selected with respect to classification accuracy. Thus a CNN model with improved classification capabilities for bone metastasis diagnosis is produced, using bone scans from prostate cancer patients. The achieved classification testing accuracy is 97.38%, whereas the average sensitivity is approximately 95.8%. Finally, the best-performing CNN method is compared to other popular and well-known CNN architectures used for medical imaging, like VGG16, ResNet50, GoogleNet and MobileNet. The classification results show that the proposed CNN-based approach outperforms the popular CNN methods in nuclear medicine for metastatic prostate cancer diagnosis in bones.
Collapse
Affiliation(s)
| | - Elpiniki Papageorgiou
- Faculty of Technology, Dept. of Energy Systems, University of Thessaly, Geopolis Campus, Larisa, Greece
- Institute for Bio-economy and Agri-technology, Center for Research and Technology Hellas, Greece
| | - Athanasios Anagnostis
- Institute for Bio-economy and Agri-technology, Center for Research and Technology Hellas, Greece
- Department of Computer Science and Telecommunications, University of Thessaly, Lamia, Greece
| | | |
Collapse
|
30
|
Martin JG, Goldman DT, Dabrowiecki AM, Newsome J, Bercu ZL, Gilliland C. Additional Magnetic Resonance or Nuclear Scintigraphy Imaging Influences Approach to Vertebral Augmentation: A Single Institution Experience. Spine (Phila Pa 1976) 2020; 45:E927-E932. [PMID: 32675605 DOI: 10.1097/brs.0000000000003420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective review. OBJECTIVE To ascertain impact of preprocedural magnetic resonance imaging (MRI) or nuclear medicine Tc99m-DMP scintigraphy on the treatment plan when compared with plain films and/or computed tomography prior to vertebral augmentation procedures. SUMMARY OF BACKGROUND DATA Over 1 million vertebral compression fractures (VCFs) occur in the United States annually with over 150,000 individuals hospitalized each year. Physical examination and history are essential to the workup of VCFs, but imaging remains necessary for confirming the diagnosis. VCFs can be imaged with various modalities and there is limited data on the comparative effectiveness of different imaging modalities. METHODS Six hundred fifty consecutive patients treated with vertebral augmentation at a single institution between May of 2013 and April of 2018 were reviewed. Preprocedure imaging of the spine obtained within 30 days prior to the procedure were reviewed. Preprocedure imaging results were cross-referenced against the levels treated by vertebral augmentation to determine whether there was a change in the levels treated after receiving an MRI or NM imaging study. RESULTS Three hundred sixty-three patients had adequate imaging for inclusion. One hundred fifty-four of these 363 patients (42.4%) had an alteration of their treatment plan based upon the MR or NM imaging. Fewer vertebral levels were treated in 33, different levels were treated in 41, and more levels were treated in 80 patients. CONCLUSION MRI or nuclear medicine bone scan imaging prior to vertebral augmentation altered the location and number of levels treated in a large percentage of patients, adding specificity to treatment over findings on radiographs or computed tomography alone. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- Jonathan G Martin
- Division of Interventional Radiology, Department of Radiology, Duke University, Durham, NC
| | - Daryl T Goldman
- Division of Interventional Radiology, Department of Radiology, Ichan School of Medicine at Mount Sinai, New York, NY
| | - Alexander M Dabrowiecki
- Division of Interventional Radiology, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA
| | - Janice Newsome
- Division of Interventional Radiology, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA
| | - Zachary L Bercu
- Division of Interventional Radiology, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA
| | | |
Collapse
|
31
|
Sato S, Imachi H, Kobayashi T, Fukunaga K, Lyu J, Dong T, Yoshioka Y, Saheki T, Fukata Y, Ban N, Urushihara K, Kadota K, Murao K. Ectopic Cortisol-producing Adrenocortical Adenoma Detected by 131I-6β-iodomethyl-norcholesterol Scintigraphy. Intern Med 2020; 59:1731-1734. [PMID: 32238722 PMCID: PMC7434542 DOI: 10.2169/internalmedicine.4180-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A 50-year-old man was referred to our department for overt Cushing's syndrome (CS). His plasma cortisol concentrations were 314 μg/L, and his urinary cortisol concentrations were 431 μg/day. The plasma adrenocorticotropic hormone (ACTH) concentration was below the detectable limit. Computed tomography revealed atrophy of both adrenal glands and the presence of a left pararenal tumor. 131I-6β-iodomethyl-norcholesterol scintigraphy showed an intense uptake by the left pararenal tumor. These findings suggested that the left pararenal tumor was ectopic cortisol-producing adrenocortical adenoma. This case serves as a reminder that 131I-6β-iodomethyl-norcholesterol scintigraphy is an effective method for diagnosing ACTH-independent CS in which no adrenal tumor has been found.
Collapse
Affiliation(s)
- Seisuke Sato
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Hitomi Imachi
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Toshihiro Kobayashi
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Kensaku Fukunaga
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Jingya Lyu
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Tao Dong
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Yuuki Yoshioka
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Takanobu Saheki
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Youko Fukata
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Natsuki Ban
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Kurumi Urushihara
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| | - Kyuuichi Kadota
- Department of Pathology, Faculty of Medicine, Kagawa University, Japan
| | - Koji Murao
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
| |
Collapse
|
32
|
Abstract
RATIONALE Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare disease without standard treatments. Tripterygium wilfordii hook f (TwHF) is a traditional Chinese herb with anti-inflammatory effect, and 1.0 mg/(kg·d) dose of Tripterygium glycosides has been reported to significantly improve the disease activity of a SAPHO patient in a case report. However, the optimal dose of TwHF is still unclear. Here, we report the first case of SAPHO patient who achieved rapid remission in clinical symptoms after receiving 1.5 mg/(kg·d) dose of Tripterygium glycosides treatment. PATIENT CONCERNS A 67-year-old woman noted palmoplantar pustulosis and pain in the anterior chest wall and waist. Bone scintigraphy demonstrated the typical tracer accumulation feature and magnetic resonance images showed bone marrow edema in lumbosacral vertebra. DIAGNOSES The diagnosis was made by dermatological and osteoarticular manifestations and classical signs in bone scintigraphy in accordance with the diagnostic criteria proposed in 2012. INTERVENTIONS Tripterygium glycosides was given with a primary dose of 1.5 mg/(kg·d) for 1 month and then reduced at a rate of 10 mg every 2 weeks until 1.0 mg/(kg·d) for a long-term maintenance. OUTCOMES Fast-induced remission on clinical manifestations was achieved and magnetic resonance imaging abnormality was improved significantly. Additionally, no apparent side effects were observed. LESSONS 1.5 mg/(kg·d) dose of Tripterygium glycosides seems to have fast-induced remission than 1.0 mg/(kg·d) with reliable safety. Besides, Tripterygium glycosides may also have a pharmacological effect of inhibiting osteolysis and enhancing bone strength.
Collapse
Affiliation(s)
| | | | | | - Chen Li
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Beijing, China
| |
Collapse
|
33
|
Majewski M, Nestler K, Veit DA, Diekmeyer B, Waldeck S, Port M, Becker BV. Detection of Embedded Low-level Radioactive Shrapnel after the Explosion of a Radiological Dispersal Device in Radiological Emergency Imaging. Health Phys 2020; 119:95-100. [PMID: 31913860 DOI: 10.1097/hp.0000000000001203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Concern about the threat of a terrorist attack with a Radiological Dispersal Device has increased considerably over the last few years, and this comes along with an immense challenge, especially regarding medical treatment of combined injuries with incorporated radioactive fragments. In such scenarios, the identification and surgical exploration of radioactive fragments is a major issue to prevent further radiation-induced effects like wound healing disorders, onset of acute radiation syndrome, and as a late-effect cancer. However, in a usual emergency setting, it is unclear how this task can be achieved. Within this study, we evaluated the feasibility of different radiological methods to identify and locate an incorporated radioactive fragment. We placed two different Cs sources and several non-radioactive fragments representing sham control samples within a human spine phantom. Standard emergency imaging procedures were performed, including plane radiography and different CT scans (64 row, 384 row dual energy, 320 row without iterative metal artifact reduction), respectively. Eight radiologists were blinded toward the results and asked to identify the radioactive fragments within the provided images. For both sources, correct identification was rather low (15.63%). Furthermore, none of the questioned radiologists (N = 0) stated that they were able to identify the radioactive shrapnel distinctly. Positive predictive value was accordingly low (15.63%). Most participants recommended a scintigraphy-based technique for identification (26.67%) rather than radiographic procedures (6.67%). Identification and location of incorporated small radioactive fragments with low energies by standard radiological procedures prior to surgical exploration is not promising. Nevertheless, procedures that can achieve this aim are needed direly in the case of a terrorist attack with a radiological dispersal device and should be available in an emergency department.
Collapse
Affiliation(s)
- Matthäus Majewski
- Bundeswehr Institute of Radiobiology affiliated to Ulm University, Genomics I, Neuherbergstrasse 11, 80804, Munich, Germany
| | - Kai Nestler
- Department for Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacherstrasse 170, 56072, Koblenz, Germany
| | - Daniel A Veit
- Department for Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacherstrasse 170, 56072, Koblenz, Germany
| | - Birte Diekmeyer
- Department for Nuclear Medicine, Bundeswehr Central Hospital, Rübenacherstrasse 170, 56072, Koblenz, Germany
| | - Stephan Waldeck
- Department for Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacherstrasse 170, 56072, Koblenz, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology affiliated to Ulm University, Genomics I, Neuherbergstrasse 11, 80804, Munich, Germany
| | - Benjamin V Becker
- Department for Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacherstrasse 170, 56072, Koblenz, Germany
| |
Collapse
|
34
|
Abstract
BACKGROUND Gastro-esophageal reflux disease (GERD) can present with typical or atypical or laryngo-pharyngeal reflux (LPR) symptoms. Pulmonary aspiration of gastric refluxate is one of the most serious variants of reflux disease as its complications are difficult to diagnose and treat. The aim of this study was to establish predictors of pulmonary aspiration and LPR symptoms. METHODS Records of 361 consecutive patient from a prospectively populated database were analyzed. Patients were categorized by symptom profile as predominantly LPR or GERD (98 GER and 263 LPR). Presenting symptom profile, pH studies, esophageal manometry and scintigraphy and the relationships were analyzed. RESULTS Severe esophageal dysmotility was significantly more common in the LPR group (p = 0.037). Severe esophageal dysmotility was strongly associated with isotope aspiration in all patients (p = 0.001). Pulmonary aspiration on scintigraphy was present in 24% of patients. Significant correlation was established between total proximal acid on 24-h pH monitoring and isotope aspiration in both groups (p < 0.01). Rising pharyngeal curves on scintigraphy were the strongest predictors of isotope aspiration (p < 0.01). CONCLUSIONS Severe esophageal dysmotility correlates with LPR symptoms and reflux aspiration in LPR and GERD. Abnormal proximal acid score on 24-h pH monitoring associated with pulmonary aspiration in reflux patients. Pharyngeal contamination on scintigraphy was the strongest predictor of pulmonary aspiration.
Collapse
Affiliation(s)
- Oleksandr Khoma
- Department of Upper Gastro-Intestinal Surgery, Concord Repatriation General Hospital, Sydney, Australia.
- University of Notre Dame Australia, Sydney, Australia.
| | | | | | | | - Gregory L Falk
- Department of Upper Gastro-Intestinal Surgery, Concord Repatriation General Hospital, Sydney, Australia
- Sydney Heartburn Clinic, Sydney, Australia
- University of Sydney, Sydney, Australia
| |
Collapse
|
35
|
Lu Y, Zhu X, Yan SX, Lan X. Emerging Attack and Management Strategies for Nuclear Medicine in Responding to COVID-19-ACNM Member Experience and Advice. Clin Nucl Med 2020; 45:534-535. [PMID: 32404711 PMCID: PMC7268864 DOI: 10.1097/rlu.0000000000003077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/18/2020] [Indexed: 01/08/2023]
Abstract
As the World Health Organization declared COVID-19 as "global pandemic," it is important for everyone, including nuclear medicine personnel, to know how to stop transmission, contain, and prevent the spread of COVID-19. We reach out to our ACNM (American College of Nuclear Medicine) international members from Wuhan, China and Singapore, who have participated in dealing with COVID-19 for the last 2 months, to learn from their lessons and experiences, so to provide advice to all ACNM members for their clinical practice and management strategies in responding to COVID-19.
Collapse
Affiliation(s)
- Yang Lu
- From the Division of Diagnostic Imaging, Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Xiaohua Zhu
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sean Xuexian Yan
- Department of Nuclear Medicine, Singapore General Hospital, Singapore
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
36
|
Abstract
PURPOSE OF REVIEW Ectopic adrenocorticotropic hormone (ACTH)-secreting tumors are commonly small, yet they often lead to fulminant forms of Cushing syndrome. High-resolution functional imaging modalities, such as [Ga]-DOTATATE, have been recently introduced in clinical practice for the identification of neuroendocrine tumors. In this review, we focus on the performance of [Ga]-DOTATATE as a tool for localizing primary and metastatic sources of ectopic Cushing syndrome (ECS). RECENT FINDINGS Prompt surgical removal of ectopic ACTH-secreting tumors is the mainstay of therapy in patients with ECS. Detecting such tumors with conventional cross-sectional imaging is often unsuccessful, owing to their small size. [Ga]-DOTATATE has been approved in 2016 by the Federal Drug Administration for imaging well differentiated neuroendocrine tumors. Data regarding the performance of [Ga]-DOTATATE for detecting ectopic ACTH-secreting tumors remain limited, in part owing to the recent introduction of this imaging modality in clinical practice, and in part because of the low prevalence of ECS. Nevertheless, [Ga]-DOTATATE has been reported to be useful in identifying primary and metastatic ectopic ACTH-secreting lesions that were not apparent on other imaging studies, impacting the clinical care of many patients with ECS. SUMMARY [Ga]-DOTATATE-based imaging, which targets the somatostatin receptors abundantly expressed in neuroendocrine tumors, has generally high, although variable resolution in detecting the source(s) of ECS.
Collapse
Affiliation(s)
- Seda Grigoryan
- Department of Internal Medicine, Michigan State University, East Lasing
| | | | - Adina F Turcu
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
37
|
Koutsikos J, Angelidis G. Challenges and priorities in skeletal, gastrointestinal, hepatobiliary, genitourinary and lung scintigraphy during the COVID-19 pandemic. Hell J Nucl Med 2020; 23 Suppl:21-25. [PMID: 32860392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
On December 29, 2019, a hospital in the City of Wuhan, Hubei Province, in Central China, admitted four individuals with pneumonia. The hospital reported this occurrence to the local center for disease control (CDC), which lead Wuhan CDC staff to initiate a field investigation with a retrospective search for pneumonia patients. On December 31, 2019, the World Health Organization (WHO) was alerted by the Chinese authorities for several cases of pneumonia of unknown origin in the City of Wuhan. On January 7, 2020, a novel virus was identified as the causative agent, belonging to the Coronaviridae family (Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2). Within the same month, the virus spread to other provinces of China, as well as a number of neighbouring countries. On February 11, 2020, the WHO announced that the SARS-CoV-2 - caused infection would be called coronavirus disease 2019 (COVID-19). On February 15, 2020, the first death due to COVID-19 in Europe was reported; a Chinese tourist who died in France. The first COVID-19 case was diagnosed in Greece on February 26th. The WHO declared COVID-19 a pandemic on 11 March 2020. On March 12th, movie theaters, gyms and courtrooms were closed in Greece and on March 13th, with 190 confirmed cases and 1 death, malls, cafés, restaurants, bars, beauty parlors, museums and archaeological sites were also closed. So far, COVID-19 pandemic has affected the way people live and work globally, and has resulted in extreme strain on the healthcare systems worldwide. Most of the nuclear medicine studies are performed on an out-patient basis. Therefore, without effective implementation of the required preventive measures, there is a significant risk for viral transmission when visiting nuclear medicine departments, particularly in periods of high community spread.
Collapse
Affiliation(s)
- John Koutsikos
- Nuclear Medicine Department, 401 General Army Hospital, Athens, Greece.
| | | |
Collapse
|
38
|
Lee SH, Shin E, Ha S, Oh JS, Song DE, Ryu JS. Is dual-phase SPECT/CT with 99mTc-sestamibi better than single-phase SPECT/CT for lesion localization in patients with hyperparathyroidism? Medicine (Baltimore) 2020; 99:e19989. [PMID: 32384452 PMCID: PMC7220364 DOI: 10.1097/md.0000000000019989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to establish an optimal protocol for Tc-sestamibi parathyroid imaging for lesion localization in patients with hyperparathyroidism (HPT).We retrospectively enrolled 35 consecutive patients who underwent dual-phase (at 10 minutes and 120 minutes) Tc-sestamibi parathyroid scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT). Twenty seven patients had primary HPT, and 8 had secondary or tertiary HPT. Three nuclear medicine physicians independently analyzed the parathyroid images for lesion localization at 9 predefined parathyroid locations using the following 4 different image sets blinded to the clinical information:All SPECT or SPECT/CT image sets were analyzed with dual-phase planar images. The image results were compared with the histopathological results after surgery.Dual-phase SPECT/CT showed the highest positive rate of 85.7% in the patient-based analysis and 13.7% in the location-based analysis. Of 35 patients, surgical pathological results were available in 21 (16 adenomas in 16 primary HPTs and 16 hyperplasias in 5 secondary or tertiary HPTs). Dual-phase SPECT/CT showed the sensitivity values of 100% and 84.4% in the patient-based and location-based analysis, respectively, which were the highest sensitivity values among all image sets. In the primary HPT subgroup, dual-phase SPECT/CT showed the highest sensitivity value of 93.8% in the location-based analyses, whereas dual-phase SPECT, early SPECT/CT, and delayed SPECT/CT showed the sensitivity values of 62.5%, 81.3%, and 81.3%, respectively. In the secondary or tertiary HPT subgroup, dual-phase SPECT/CT also showed the highest sensitivity value of 75.0%, whereas early SPECT/CT, delayed SPECT/CT, and dual-phase SPECT showed the sensitivity values of 43.8%, 56.3%, and 68.8%, respectively.Compared with dual-phase SPECT or single-phase SPECT/CT, the dual-phase SPECT/CT imaging protocol for Tc-sestamibi scintigraphy showed the highest positive rate and sensitivity, and was optimal for parathyroid lesion localization.
Collapse
Affiliation(s)
- Suk Hyun Lee
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine
- Division of Nuclear Medicine, Department of Radiology, Hallym University Kangnam Sacred Heart Hospital
| | - Eonwoo Shin
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine
| | - Sejin Ha
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine
| | - Jungsu S. Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine
| | - Dong Eun Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin-Sook Ryu
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine
| |
Collapse
|
39
|
Valotassiou V, Angelidis G, Georgoulias P. Recommendations for nuclear neuroimaging of patients with neurological disorders in the COVID-19 era. Hell J Nucl Med 2020; 23 Suppl:57-64. [PMID: 32862216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has changed people's normal lives in a very short time causing extensive infections and mortality, which required the national health systems to be adapted to new situation. Changes in healthcare services included modifications of standard procedures in nuclear medicine departments in order to limit COVID-19 spreading and protect patients and personnel. Here, we recommend management of patients with neurological diseases and especially dementia and movement disorders, who are referred for neuroimaging with nuclear medicine techniques.
Collapse
|
40
|
Abstract
Ask-Upmark kidney (AUK) is a scarred segment of the kidney, characterized by formation of primitive tubular and glomerular structures, and sporadically diagnosed as a cause of hypertension (HTN). A 6-year-old girl with neurofibromatosis type 1 (NF1) and moyamoya syndrome had severe HTN. Based on past history, she had HTN at the age of 1.5 years. Laboratory examination revealed slightly elevated plasma and renal venous renin activity without lateralization. No evidence of pheochromocytoma, or coarctation of the aorta was found. Contrast-enhanced computed tomography (CT) showed an area of hypoperfusion in the upper and middle poles with reduced size of the right kidney. The results of dimercaptosuccinic acid scintigraphy were in accordance with those of contrast-enhanced CT. Selected renal arteriography revealed a paucity of peripheral vascularity in the same parts of the right kidney. In the absence of a history of urinary tract infection and vesicoureteral reflux by cystography, we presumed that the severe HTN may be due to segmental hypoplasia of the kidney, AUK, with a possible contribution from NF1. Although renal artery stenosis and pheochromocytoma are well-known causes of HTN in NF1, this case demonstrates that HTN can be caused by AUK in patients with NF1.
Collapse
Affiliation(s)
- Yuri Dote
- Department of Pediatrics, Seirei-Mikatahara General Hospital, 3453 Mikatahara, Hamamatsu, Shizuoka, 433-8558, Japan.
| | - Tetsuya Kibe
- Department of Pediatrics, Seirei-Mikatahara General Hospital, 3453 Mikatahara, Hamamatsu, Shizuoka, 433-8558, Japan
| | - Tomotaka Murakami
- Department of Pediatrics, Seirei-Mikatahara General Hospital, 3453 Mikatahara, Hamamatsu, Shizuoka, 433-8558, Japan
| | - Midori Awazu
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
41
|
Granata A, Sessa C, Fiorini F, Randone S, Di Nicolò P, Zanoli L, Piranio S. [Management of hemodialysis patient subject to medical-nuclear investigation]. G Ital Nefrol 2020; 37:37-02-2020-11. [PMID: 32281763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In recent years imaging techniques that use radionuclides have become more and more clinically relevant as they can provide functional information for specific anatomical districts. This has also involved nephrology, where radionuclides are used to study patients with different degrees of renal function failure up to terminal uremia. Although chronic kidney disease, and dialysis in particular, may affect the distribution and the elimination of radiopharmaceuticals, to date there are no consistent data on the risks associated with their use in this clinical context. In addition to the lack of data on the safety of radio-exposure in dialysis patients, there is also a shortage of information concerning the risk for healthcare staff involved in conducting the dialysis sessions performed after a nuclear test. This study, performed on 29 uremic patients who underwent hemodialysis immediately after a scintigraphic examination, assessed the extent of radio-contamination of the staff and of hemodialysis devices such as monitor, kits and dialysate. The data collected has been used to quantify the radiological risk in dialysis after the exposure to the most common radionuclides.
Collapse
Affiliation(s)
- Antonio Granata
- U.O.C di Nefrologia, Azienda Ospedaliera per l'Emergenza "Cannizzaro" - Catania, Italia
| | - Concetto Sessa
- U.O.C. Nefrologia e Dialisi, P.O. "Maggiore", Modica (RG), Italia
| | - Fulvio Fiorini
- U.O.C. Nefrologia e Dialisi, PO Santa Maria della Misericordia, Rovigo (RO), Italia
| | | | - Pierpaolo Di Nicolò
- U.O.C. Nefrologia e Dialisi - P.O. "S. Maria della Scaletta", Imola (BO), Italia
| | - Luca Zanoli
- Dipartimento di Medicina Clinica e Sperimentale, Nefrologia, Università degli Studi di Catania (CT), Italia
| | - Salvatore Piranio
- Divisione di Fisica Medica - P.O. "San Giovanni di Dio", Agrigento (AG), Itali
| |
Collapse
|
42
|
Li X, Wang D, Liao S, Guo L, Xiao X, Liu X, Xu Y, Hua J, Pillai JJ, Wu Y. Discrimination between Glioblastoma and Solitary Brain Metastasis: Comparison of Inflow-Based Vascular-Space-Occupancy and Dynamic Susceptibility Contrast MR Imaging. AJNR Am J Neuroradiol 2020; 41:583-590. [PMID: 32139428 DOI: 10.3174/ajnr.a6466] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/03/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Accurate differentiation between glioblastoma and solitary brain metastasis is of vital importance clinically. This study aimed to investigate the potential value of the inflow-based vascular-space-occupancy MR imaging technique, which has no need for an exogenous contrast agent, in differentiating glioblastoma and solitary brain metastasis and to compare it with DSC MR imaging. MATERIALS AND METHODS Twenty patients with glioblastoma and 22 patients with solitary brain metastasis underwent inflow-based vascular-space-occupancy and DSC MR imaging with a 3T clinical scanner. Two neuroradiologists independently measured the maximum inflow-based vascular-space-occupancy-derived arteriolar CBV and DSC-derived CBV values in intratumoral regions and peritumoral T2-hyperintense regions, which were normalized to the contralateral white matter (relative arteriolar CBV and relative CBV, inflow-based vascular-space-occupancy relative arteriolar CBV, and DSC-relative CBV). The intraclass correlation coefficient, Student t test, or Mann-Whitney U test and receiver operating characteristic analysis were performed. RESULTS All parameters of both regions had good or excellent interobserver reliability (0.74∼0.89). In peritumoral T2-hyperintese regions, DSC-relative CBV (P < .001), inflow-based vascular-space-occupancy arteriolar CBV (P = .001), and relative arteriolar CBV (P = .005) were significantly higher in glioblastoma than in solitary brain metastasis, with areas under the curve of 0.94, 0.83, and 0.72 for discrimination, respectively. In the intratumoral region, both inflow-based vascular-space-occupancy arteriolar CBV and relative arteriolar CBV were significantly higher in glioblastoma than in solitary brain metastasis (both P < .001), with areas under the curve of 0.91 and 0.90, respectively. Intratumoral DSC-relative CBV showed no significant difference (P = .616) between the 2 groups. CONCLUSIONS Inflow-based vascular-space-occupancy has the potential to discriminate glioblastoma from solitary brain metastasis, especially in the intratumoral region.
Collapse
Affiliation(s)
- X Li
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - D Wang
- School of Biomedical Engineering (D.W.), Shanghai Jiao Tong University, Shanghai, P.R. China
| | - S Liao
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
- Division of CT and MR, Radiology Department (S.L.), First Affiliated Hospital of Gannan Medical University, Ganzhou, P.R. China
| | - L Guo
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - X Xiao
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - X Liu
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Y Xu
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - J Hua
- Neurosection, Division of MR Research (J.H.)
- F.M. Kirby Research Center for Functional Brain Imaging (J.H.), Kennedy Krieger Institute, Baltimore, Maryland
| | - J J Pillai
- Division of Neuroradiology (J.P.); Russell H. Morgan Department of Radiology and Radiological Science and
- Department of Neurosurgery (J.P.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Y Wu
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| |
Collapse
|
43
|
Flaherty KR, Morgenstern R, Pozniakoff T, DeLuca A, Castano A, Maurer MS, Bokhari S. 99mTechnetium pyrophosphate scintigraphy with cadmium zinc telluride cameras is a highly sensitive and specific imaging modality to diagnose transthyretin cardiac amyloidosis. J Nucl Cardiol 2020; 27:371-380. [PMID: 31463816 DOI: 10.1007/s12350-019-01831-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/24/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Transthyretin cardiac amyloidosis (ATTR) is a rare, but underdiagnosed, cardiomyopathy. Traditionally diagnosed invasively, ATTR can be diagnosed with non-invasive 99mTechnetium pyrophosphate (99mTc-PYP) planar scintigraphy. Non-planar imaging has not been validated for ATTR diagnosis. Here, we develop and validate a Cadmium Zinc Telluride (CZT) protocol for diagnosing ATTR. METHODS Forty-three subjects (24 ATTR, 19 non-ATTR) were imaged with Philips Dual-Head Anger (planar) and General Electric CZT cameras. Myocardial uptake was quantified by heart-to-contralateral (H/CL) ratios. CZT scans were quantified by two readers blinded to planar H/CL, with one repeating blinded quantification. Using the previously validated diagnostic threshold (H/CL ≥ 1.5), sensitivity and specificity of CZT scintigraphy was measured. McNemar's test and Pearson's correlation coefficient were calculated. RESULTS Among subjects (76.7% male, age 77 ± 9), there was no significant difference in proportion of ATTR-positive identification between modalities. There was high correlation between CZT and planar H/CL ratios (r = 0.92, P < 0.0001), with low intra- [ICC = 0.89 (0.80-0.94)] and inter-observer [ICC = 0.80 (0.65-0.89)] variability. CZT scintigraphy had 100% sensitivity and specificity for diagnosing ATTR. CONCLUSION 99mTc-PYP CZT imaging is as highly sensitive and specific diagnosing ATTR as planar imaging. These findings are clinically salient given the emergence of disease-modifying ATTR therapies, as it could expand diagnostic capability.
Collapse
Affiliation(s)
- Kathleen R Flaherty
- Division of Cardiology, Department of Internal Medicine, Columbia University Medical Center, 630 West 168th Street, P&S 10-445(4), New York, NY, 10032, USA.
- Laboratory of Nuclear Cardiology, Columbia University Medical Center, New York, USA.
| | | | - Ted Pozniakoff
- Division of Cardiology, Department of Internal Medicine, Columbia University Medical Center, 630 West 168th Street, P&S 10-445(4), New York, NY, 10032, USA
- Laboratory of Nuclear Cardiology, Columbia University Medical Center, New York, USA
| | - Albert DeLuca
- Division of Cardiology, Department of Internal Medicine, Columbia University Medical Center, 630 West 168th Street, P&S 10-445(4), New York, NY, 10032, USA
- Laboratory of Nuclear Cardiology, Columbia University Medical Center, New York, USA
| | - Adam Castano
- Division of Cardiology, Department of Internal Medicine, Columbia University Medical Center, 630 West 168th Street, P&S 10-445(4), New York, NY, 10032, USA
| | - Mathew S Maurer
- Division of Cardiology, Department of Internal Medicine, Columbia University Medical Center, 630 West 168th Street, P&S 10-445(4), New York, NY, 10032, USA
- Center for Advanced Cardiac Care, Columbia University Medical Center, New York, NY, USA
| | - Sabahat Bokhari
- Division of Cardiology, Department of Internal Medicine, Columbia University Medical Center, 630 West 168th Street, P&S 10-445(4), New York, NY, 10032, USA
- Laboratory of Nuclear Cardiology, Columbia University Medical Center, New York, USA
| |
Collapse
|
44
|
Bernsen MLE, Koppes JCC, Straver B, Verberne HJ. Left ventricular ischemia after arterial switch procedure: Role of myocardial perfusion scintigraphy and cardiac CT. J Nucl Cardiol 2020; 27:651-658. [PMID: 31119712 PMCID: PMC7174277 DOI: 10.1007/s12350-019-01738-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/12/2019] [Indexed: 11/05/2022]
Abstract
Transposition of the great arteries is a congenital heart defect defined by an abnormal connection between the aorta, pulmonary artery, and the ventricles, resulting in parallel systemic and pulmonary circulations. Long-term follow-up data of patients who underwent correction via an arterial switch operation have recently shown that as a result of re-implantation of the coronary arteries in the neo-aorta, coronary stenosis and occlusion are relatively common complications. In this report, we discuss two cases illustrating the added value of myocardial perfusion imaging (MPI) and cardiac CT for the assessment of these patients. Based on the available literature we conclude that MPI and cardiac CT are excellent non-invasive methods to evaluate coronary anatomy and myocardial function also in this specific group of patients.
Collapse
Affiliation(s)
- Marie Louise E Bernsen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Meibergdreef 9, 1109 AZ, Amsterdam, The Netherlands.
| | - Josephina C C Koppes
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Meibergdreef 9, 1109 AZ, Amsterdam, The Netherlands
| | - Bart Straver
- Department of Cardiology, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Meibergdreef 9, 1109 AZ, Amsterdam, The Netherlands
| |
Collapse
|
45
|
Zhao H, Tsauo J, Zhang XW, Ma HY, Weng NN, Tang GS, Li X. Technetium-99m-labeled macroaggregated albumin lung perfusion scan for diagnosis of hepatopulmonary syndrome: A prospective study comparing brain uptake and whole-body uptake. World J Gastroenterol 2020; 26:1088-1097. [PMID: 32205999 PMCID: PMC7080996 DOI: 10.3748/wjg.v26.i10.1088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/06/2020] [Accepted: 01/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatopulmonary syndrome (HPS) is an arterial oxygenation defect induced by intrapulmonary vascular dilatation (IPVD) in the setting of liver disease and/or portal hypertension. This syndrome occurs most often in cirrhotic patients (4%–32%) and has been shown to be detrimental to functional status, quality of life, and survival. The diagnosis of HPS in the setting of liver disease and/or portal hypertension requires the demonstration of IPVD (i.e., diffuse or localized abnormally dilated pulmonary capillaries and pulmonary and pleural arteriovenous communications) and arterial oxygenation defects, preferably by contrast-enhanced echocardiography and measurement of the alveolar-arterial oxygen gradient, respectively.
AIM To compare brain and whole-body uptake of technetium for diagnosing HPS.
METHODS Sixty-nine patients with chronic liver disease and/or portal hypertension were prospectively included. Brain uptake and whole-body uptake were calculated using the geometric mean of technetium counts in the brain and lungs and in the entire body and lungs, respectively.
RESULTS Thirty-two (46%) patients had IPVD as detected by contrast-enhanced echocardiography. The demographics and clinical characteristics of the patients with and without IPVD were not significantly different with the exception of the creatinine level (0.71 ± 0.18 mg/dL vs 0.83 ± 0.23 mg/dL; P = 0.041), alveolar-arterial oxygen gradient (23.2 ± 13.3 mmHg vs 16.4 ± 14.1 mmHg; P = 0.043), and arterial partial pressure of oxygen (81.0 ± 12.1 mmHg vs 90.1 ± 12.8 mmHg; P = 0.004). Whole-body uptake was significantly higher in patients with IPVD than in patients without IPVD (48.0% ± 6.1% vs 40.1% ± 8.1%; P = 0.001). The area under the curve of whole-body uptake for detecting IPVD was significantly higher than that of brain uptake (0.75 vs 0.54; P = 0.025). The optimal cut-off values of brain uptake and whole-body uptake for detecting IPVD were 5.7% and 42.5%, respectively, based on Youden’s index. The sensitivity, specificity, and accuracy of brain uptake > 5.7% and whole-body uptake > 42.5% for detecting IPVD were 23%, 89%, and 59% and 100%, 52%, and 74%, respectively.
CONCLUSION Whole-body uptake is superior to brain uptake for diagnosing HPS.
Collapse
Affiliation(s)
- He Zhao
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jiaywei Tsauo
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xiao-Wu Zhang
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Huai-Yuan Ma
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ning-Na Weng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Gong-Shun Tang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| |
Collapse
|
46
|
Huang J, Wu J, Zhao L, Liu W, Wei J, Hu Z, Hao B, Wu H, Sun L, Chen H. Quantitative evaluation of salivary gland scintigraphy in Sjögren's syndrome: comparison of diagnostic efficacy and relationship with pathological features of the salivary glands. Ann Nucl Med 2020; 34:289-298. [PMID: 32078122 DOI: 10.1007/s12149-020-01448-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/07/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The value of salivary gland scintigraphy (SGS) in the evaluation of Sjögren's syndrome (SS) remains controversial. The aim of this study was to evaluate the diagnostic efficacy of quantitative SGS in patients with xerostomia and to assess the correlation between scintigraphic parameters and pathological features of salivary glands. METHODS Medical records of 165 patients with xerostomia who underwent [99mTc] pertechnetate SGS and labial biopsy were retrospectively reviewed. The maximum accumulation ratio (MAR), maximum secretion ratio (MSR), and time interval from stimulation to minimum count (Tmin) of the parotid glands were calculated to quantify the glandular activity. Furthermore, pre-stimulatory oral activity index (PRI) and post-stimulatory oral activity index (POI) were calculated to quantify the oral activity. RESULTS All parameters except for Tmin were significantly lower in patients with SS than in those without SS. Among the five SGS parameters, PRI showed the highest areas under the curve value (0.9005; p < 0.001), and PRI > 32.75 was associated with a sensitivity of 78.5% and specificity of 86.4% for the diagnosis of SS. A decrease in MAR, MSR, PRI, and POI and an increase in Tmin correlate significantly with the histopathologic grade of labial gland biopsy and disease severity of SS. No significant differences in glandular parameters (MAR, MSR, and Tmin) were found between the non-SS and early-stage SS groups. CONCLUSION Conventional scintigraphic parameters could be used as simple, reliable, and sensitive indicators for the early diagnosis of SS and determination of disease severity.
Collapse
Affiliation(s)
- Jingxiong Huang
- Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jing Wu
- Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Liang Zhao
- Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wen Liu
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jihong Wei
- Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Zhenguo Hu
- Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Bing Hao
- Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Hua Wu
- Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Long Sun
- Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Haojun Chen
- Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China.
| |
Collapse
|
47
|
Tajra JBM, Calegaro JU, de Paula AP, Bachour D, Silveira D, Ribeiro LM. Accuracy of Oral 67Gallium Citrate Scintigraphy in assessment of inflammatory activity of Crohn's disease. Ann Nucl Med 2020; 34:263-271. [PMID: 32076955 DOI: 10.1007/s12149-020-01447-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 01/29/2020] [Indexed: 01/08/2023]
Abstract
AIM The main goal in Crohn´s disease (CD) is a sustained suppression of inflammatory activity associated with mucosa healing in endoscopic evaluation. During clinical routine, there are small numbers of good markers to monitor inflammatory activity under treatment. We postulated that Oral 67Gallium Citrate Scintigraphy is able to mark inflammatory disease in mucosa and deep inflammation in CD, when used in oral form. OBJECTIVE Measure the accuracy of Oral 67Gallium Citrate Scintigraphy in intestinal inflammatory activity of Crohn´s disease. PATIENTS AND METHODS In a prospective consecutive cross-sectional study from January 2018 to June 2019, the ileocolonic region of 32 patients with CD were studied by dividing into four regions of interest (ROI) from the ileum to the rectum. A total of 128 intestinal segments were analyzed in cluster data. Accuracy values of Oral 67Gallium Scintigraphy and colonoscopy tests were evaluated with the histological reference test. Values of the respective receiver operating characteristic (ROC) curves were obtained and compared. The reliability between the tests was evaluated by Kappa statistical with the segment-level analyses using variance adjustments. All statistical analyses were performed with a test significance level of 0.05. RESULTS The study population included 32 patients with CD (10 men, 22 women; average age 39 years). Disease time was five years on average. Anti-TNFs treatment was found in 71%. The most found phenotype of the Montreal classification was L3. Differences in ROC curves for colonoscopy (0.94) and Oral 67Ga Scintigraphy (0.96) did not show significant value (p = 0.32). The sensitivity of scintigraphy to detect intestinal inflammatory activity in CD was 64%, specificity of 96% and accuracy of 84%. A high agreement was found between oral scintigraphy and histological measurements with kappa = 0.64. CONCLUSIONS Oral 67Ga Scintigraphy had similar accuracy and agreement compared to colonoscopy in the identification of inflammatory activity in Crohn´s Disease. This new approach may be useful and less invasive for long term follow-ups.
Collapse
Affiliation(s)
- João Batista Monteiro Tajra
- Coloproctology Department, Hospital de Base do Distrito Federal, SMHS área especial Q.101 Asa Sul, Brasília, Distrito Federal, Brazil.
- Brasília University (UnB), Brasília, Brazil.
| | | | - Ana Patrícia de Paula
- Rheumatology Department, Hospital de Base do Distrito Federal, Brasília, Brazil
- Brasília University (UnB), Brasília, Brazil
| | - Dunya Bachour
- Pathology Department, Hospital de Base do Distrito Federal, Brasília, Brazil
| | - Dannilo Silveira
- Coloproctology Department, Hospital de Base do Distrito Federal, SMHS área especial Q.101 Asa Sul, Brasília, Distrito Federal, Brazil
| | - Liliana Moscoso Ribeiro
- Epidemiology Surveillance Department, Hospital de Base do Distrito Federal, Brasília, Brazil
| |
Collapse
|
48
|
Finkelstein JB, Rague JT, Chow J, Venna A, Logvinenko T, Nelson CP, Lee RS. Accuracy of Ultrasound in Identifying Renal Scarring as Compared to DMSA Scan. Urology 2020; 138:134-137. [PMID: 32004557 DOI: 10.1016/j.urology.2020.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/13/2020] [Accepted: 01/17/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the accuracy of renal ultrasound (RUS) in detecting renal scarring (RS). METHODS All initial DMSA scans performed from 2006 to 2009 for history of urinary tract infection (UTI) or vesicoureteral reflux (VUR) in patients under 14 years old were identified, and clinical history obtained via chart review. Patients who had RUS within 4 months of DMSA scan and no documented UTI during that interval were included. Decreased uptake of tracer associated with loss of contours or cortical thinning defined a positive DMSA study. Increased echogenicity/dysplasia, cortical thinning, atrophic kidney and/or abnormal corticomedullary differentiation defined a positive RUS. The sensitivity and specificity of RUS in identifying RS were calculated using DMSA scan as the gold standard. RESULTS A total of 144 patients had initial DMSA scans performed for UTI or VUR, with a RUS within 4 months, and no UTI between the 2 studies. Ninety-five of 144 (66%) had RS on DMSA and 49/144 (34%) did not. Patients with or without RS on DMSA were not different in gender (P = .073), age (P = .432), insurance (P = 1.000) or VUR grade (P = .132). Only 39/144 (27.1%) patients had positive RUS. The sensitivity of RUS for RS was 35.8% and the specificity was 89.8%, leading to an accuracy of 54.2% (95%CI; 45.7-62.5%, P = .999). CONCLUSION RUS demonstrated poor sensitivity for RS visualized on DMSA scan. This suggests that RUS is a poor screening test for RS or indicators of future renal scar. A normal ultrasound does not rule out RS or risk of future renal scar. Specificity of RUS was excellent.
Collapse
Affiliation(s)
| | - James T Rague
- Department of Urology, Boston Medical Center, Boston, MA
| | - Jeanne Chow
- Department of Radiology, Boston Children's Hospital, Boston, MA
| | - Alyssia Venna
- Department of Urology, Boston Children's Hospital, Boston, MA
| | | | - Caleb P Nelson
- Department of Urology, Boston Children's Hospital, Boston, MA
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, MA.
| |
Collapse
|
49
|
Smith R. Nuclear Medicine Bone Imaging. Radiol Technol 2020; 91:249-263. [PMID: 32060081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Nuclear medicine bone scans are a highly effective diagnostic tool, particularly when conducted in conjunction with other radiologic examinations. Typically, bone scans are used to diagnose a variety of skeletal conditions that cover the entire skeleton or occur in a specific location, including metastatic bone cancer, bone infections, or bone injuries. For each procedure, a small amount of a radiopharmaceutical agent is administered to the patient before scanning, and areas of the body that might be damaged or under repair will adsorb the agent. In general, bone scans are noninvasive with little to no adverse effects and are an important step in assessing the health of the skeletal system.
Collapse
|
50
|
Abstract
Although pathological confirmation is the gold standard for diagnosis of amyloidosis, there is a need for a relevant imaging modality to identify involved organs and evaluate disease extent. Thus, we prospectively investigated imaging findings of Tc-DPD scintigraphy in AL and ATTR amyloidosis.A total of 21 subjects with pathologically confirmed AL or ATTR amyloidosis were included. Pretreatment whole body Tc-DPD planar scanning and regional SPECT/CT were performed in all subjects. For allegedly involved organs, Tc-DPD uptake was visually and semi-quantitatively evaluated on a 4-point scale (grade 0: no uptake, 1: uptake less than spine, 2: uptake similar to spine, and 3: uptake greater than spine).There were 29 organs involved in AL and 12 in ATTR. Significant Tc-DPD uptake was found in 24 organs (sensitivity = 82.8%) in AL and 9 organs (sensitivity = 75.0%) in ATTR. Additional SPECT/CT was helpful to ensure abnormal DPD uptake in the involved organs, which was uncertain by attenuation in planar imaging. Degree of Tc-DPD uptake was significantly higher in ATTR compared with AL amyloidosis (P = .017). Diffuse soft tissue uptake with photon defects in the liver area was found only in ATTR amyloidosis.This study showed that Tc-DPD scintigraphy might have capacity to differentiate between AL and ATTR subtypes with good sensitivity in various organs involving primary systemic AL and ATTR amyloidosis. Additional SPECT/CT significantly improved the diagnostic efficacy of Tc-DPD scintigraphy.
Collapse
Affiliation(s)
| | - Kihyun Kim
- Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin-Oh Choi
- Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Jin Kim
- Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun-Seok Jeon
- Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | |
Collapse
|