Sample records for 99mtc-mdp bone scintigraphy

  1. Bone scintigraphy in chondroblastoma

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    Humphry, A.; Gilday, D.L.; Brown, R.G.


    Scintigraphy in 3 patients with chondroblastoma showed that the tumors were hyperemic and avidly accumulated the radionuclide. These changes were also present in adjacent normal bone, but to a lesser degree. This suggests that radionuclide uptake in chondroblastoma is a function of the blood supply to the tumor rather than primary matrix extraction.

  2. Bone scintigraphy in psoriasis

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    Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.


    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

  3. Bone scintigraphy in ankylosing spondylitis

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    Otsuka, Nobuaki; Fukunaga, Masao; Tomomitsu, Tatsushi (Kawasaki Medical School, Kurashiki, Okayama (Japan)); Morita, Rikushi


    Twelve patients with ankylosing spondylitis (11 males and one female) were examined by both bone scintigraphy and dual energy X-ray absorptiometry (DEXA). Bone scintigraphy revealed increased accumulation in the sacroiliac joint in 6 patients, the spines in 10, and the other joints, including the sternoclavicular joint, in 8 patients. Each one patient had an intense tracer uptake in the finger and toe joints. In 4 patients in whom DEXA was concurrently performed at the level of 2nd to 4th lumbar vertebrae, there was no consistent tendency for mean bone mineral density. In 2 of 3 patients receiving DEXA for the radius, bone marrow density was within the normal range. (N.K.).

  4. Bone scintigraphy; Scintigraphie osseuse de l'appareil locomoteur

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    Moyen, B.; Chouteau, J. [Centre Hospitalier Universitaire Lyon-Sud, 69 - Pierre-Benite (France)


    Bone scintigraphy permit to detect the active osteoblastic sites. This technic is widely used in orthopaedic surgery either in adult or children. In Traumatology fatigue fractures are early diagnosed. This is also the case for reflex sympathetic dystrophy and bone necrosis. This technic is used for Paget disease, and articular inflammatory process. For bone tumors some specific aspects are recognized like for osteoid osteoma, malignant bone tumors and secondary bone tumors. In case of septic articular prosthesis the couple use of bone scintigraphy and marked polynuclear appear very useful. (author)

  5. Technical aspects of bone scintigraphy. (United States)

    Brown, M L; O'Connor, M K; Hung, J C; Hayostek, R J


    Optimal bone scintigraphy is obtained by using a current generation gamma camera with a high-resolution collimator, minimizing the patient-to-collimator distance, using scatter reduction techniques where possible, and obtaining a 500,000 to 1 million count image for 40-cm field of view camera. Hard copy images from an analog or digital formatter should be optimized to display all intensities either on the same images or, when necessary, to display the low count information on one image and the high count information on another. Additional images using different collimators, such as converging or pinhole collimators, and oblique and lateral views should be obtained when necessary to demonstrate or define the pathologic area. To optimize SPECT imaging, the following parameters should be used: a high-resolution collimator, a 128 x 128 acquisition matrix, and minimum separation between the patient and the collimator, which may require the use of an elliptic orbit. Between 64 and 128 views should be obtained, and depending on preference, the planar data should be prefiltered with a Butterworth, order 8-12 and a cutoff at 0.5 Nyquist. The data should then be reconstructed using a simple ramp filter. This method provides a good technique when one is first beginning to perform bone SPECT. Attenuation correction is not generally beneficial for SPECT bone studies, although sometimes weighted backprojection may improve image contrast and resolution. Finally, the use of volume rendering may help clarify the location of suspect lesions.

  6. Bone- and bone marrow scintigraphy in Gaucher disease type 1

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    Mikosch, P. [Dept. of Nuclear Medicine and Endocrinology, State Hospital Klagenfurt (Austria); Dept. of Internal Medicine II, State Hospital Klagenfurt (Austria); Zitter, F. [Dept. of Internal Medicine II, State Hospital Klagenfurt (Austria); Gallowitsch, H.J.; Lind, P. [Dept. of Nuclear Medicine and Endocrinology, State Hospital Klagenfurt (Austria); Wuertz, F. [Dept. of Pathology, State Hospital Klagenfurt (Austria); Mehta, A.B.; Hughes, D.A. [Lysosomal Storage Disorder Unit, Dept. of Academic Haematology, Royal Free and Univ. Coll. Medical School, London (United Kingdom)


    Scintigraphy is a method for imaging metabolism and should be viewed as complimentary to morphological imaging. Bone and bone marrow scintigraphy can particularly contribute to the detection of focal disease in Gaucher disease. In bone crises it can discriminate within three days after pain onset between local infection and aseptic necrosis. A further advantage of bone- and bone marrow scintigraphy is the visualization of the whole skeleton within one setting. Whole body imaging for focal lesions might thus be an objective in GD, in particular in patients complaining of several painful sites. Direct imaging of bone marrow deposits in GD by MIBI scintigraphy might be of special interest in children in whom bone marrow undergoes a developmental conversion from red to yellow marrow in the ap-pendicular skeleton. MRI interpretation in young GD patients is thus difficult in order to estimate the exact amount and extent of bone marrow infiltration by Gaucher cells. 99mTc-MIBI scintigraphy with its direct visualization of lipid storage could thus add interesting additional information not shown with other methods including MRI. Although MRI is the most accepted imaging modality in assessing the skeletal status in GD, a selective use of scintigraphy for imaging bone and bone marrow may add information in the evaluation of patients with Gaucher disease.

  7. Findings of Bone Scintigraphy After Leech Theraphy

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    Sinem Özyurt


    Full Text Available In this case report, we present a 70 year old female patient who had recieved Leech therapy (hirudotherapy on her leg without informing referring physician. In dynamic bone scintigraphy there was increased perfusion and hyperemia in her left ankle and leg, also in late static images moderate increased uptake was seen in soft tissue region and at the fracture site of ankle. We learned that she had Leech therapy applied on her leg, which could explain the increased perfusion and hyperemia in dynamic and blood pool phases of bone scintigraphy because of Leech therapy’s dilatory effects on superficial veins. Leech therapy may lead to an increase in perfusion and hyperemia in blood pool phase of bone scintigraphy, which may cause confusion in differential diagnosis. To our best knowledge this report is the first case that shows the scintigraphic findigs after Leech therapy.

  8. Bone scintigraphy in painful os peroneum syndrome

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    Jeppesen, Johanne B; Jensen, Frank K; Falborg, Bettina


    Lateral foot pain may be caused by various entities including the painful os peroneum syndrome. A case of a 68-year-old man is presented, who experienced a trauma with distortion of the right foot. Nine months later, he still had pain in the lateral part of the right foot. Bone scintigraphy showed...

  9. Bone-scintigraphy in painful bipartite patella

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    Iossifidis, A. [Orthopaedic Academic Unit, St. Thomas` Hospital, London (United Kingdom); Brueton, R.N. [Orthopaedic Academic Unit, St. Thomas` Hospital, London (United Kingdom); Nunan, T.O. [Dept. of Nuclear Medicine, St. Thomas` Hospital, London (United Kingdom)


    Although, the use of technetium scintigraphy in the assessment of anterior knee pain has been described, no reference has been made to the scintigraphic appearances of painful bipartite patella. We report the scintigraphic-appearances of painful bipartite patella in 25-year-old man a 2 1/2 years history of unexplained patellar pain. Painful bipartite patella is a rare cause of chronic post-traumatic patellar pain. Bone scintigraphy, by demonstrating increased uptake by the painful accessory bipartite fragment, appears to be an imaging method of choice in the diagnosis of this condition. (orig./MG)

  10. Cartilage Calcification Mimics Polychondritis in Bone Scintigraphy

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    Hasan Atilgan


    Full Text Available 58 year-old male patient with sternal pain was referred to our Nuclear Medicine Clinic for bone scintigraphy for 2.5 months. Markedly increased activity accumulation in the first bilateral sternocostal junction and increased activity accumulations in 3rd, 4th, 5th sternocostal junctions and lateral portion of inferior part of corpus sterni were seen in late static images without increased perfusion and hyperemia. Soft tissue density and lytic lesions were seen bilaterally in bilateral first costa, sternocostal joints and in right side of xiphoid in his 3D computed tomography (CT. Sternocostal lesions that were seen in bone scintigraphy and CT, was reported as normal in biopsy.

  11. Bone scintigraphy and metabolic disorders

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    Mari' , C.; Catafau, A.; Carrio' , I. [Hospital de Sant Pau, Barcelone (Spain). Serv. of Nuclear Medicine


    The paper discusses the main clinical value of bone scan in metabolic bone disease: its detection of focal conditions or focal complications of such generalized disease, its most common use of being the detection of fractures in osteoporosis, pseudo fractures in osteomalacia and the evaluation of Paget's disease.

  12. Studies on bone scintigraphy in renal osteodystrophy

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    Tsuchimochi, Makoto (Nippon Dental Univ., Niigata)


    Bone scintigraphy was superior over roentgenography for detection of abnormal bone findings in chronic dialysis patients. According to the type of scintigraphic findings, an increase in the hot area in the cranium or the mandibule seemed to express fibrous osteitis due to secondary hyperparathyroidism. Multiple coin-shaped hot areas in ribs were thought to indicate advanced osteomalacia or osteomalacia in patients with aluminum poisoning. The 4 hr-B/St ratio of the cranium was thought to serve as a quantitative indicator of the status of fibrous osteitis due to secondary hyperparathyroidism to show the progress and therapeutic course of the disease.

  13. Detectability of metastatic bone tumor by Ga-67 scintigraphy

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    Koizumi, Kiyoshi; Uchiyama, Guio; Araki, Tsutomu; Hihara, Toshihiko; Ogata, Hitoshi; Monzawa, Shuichi; Kachi, Kenji; Matsusako, Masaki


    Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake, only 7 (10%) mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.

  14. Bone scintigraphy in painful os peroneum syndrome

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    Jeppesen, Johanne B; Jensen, Frank K; Falborg, Bettina;


    Lateral foot pain may be caused by various entities including the painful os peroneum syndrome. A case of a 68-year-old man is presented, who experienced a trauma with distortion of the right foot. Nine months later, he still had pain in the lateral part of the right foot. Bone scintigraphy showe...... uptake in the area where an os peroneum was located and thus confirmed the clinical assumption of painful os peroneum syndrome. Familiarity with the clinical and imaging findings can prevent undiagnosed lateral foot pain....

  15. Bone scintigraphy for horses; Die Skelettszintigrafie beim Pferd

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    Jahn, Werner [Pferdeklinik Bargteheide (Germany)


    Scintigraphy (bone scan) is being used approximately since 1980 in the horse under general anaesthesia. With the construction of custom-made overhead gantries for gamma-cameras scintigraphy found widespread entry in big equine referral hospitals for bone-scanning of the standing horse. Indications for the use of a bone scan in the horse are inflammatory alterations in the locomotor apparatus. It is primarily used for diagnosis of lameness of unknown origin, suspect of stress fracture or hairline fracture and for horses with bad riding comfort with suspected painful lesions in the spine. (orig.)

  16. Bone scintigraphy in costo-iliac impingement syndrome

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    Madsen, Jan L


    fractures of several thoracic and lumbar vertebrae. She presented with progressive lower back pain and weight loss. Bone scintigraphy revealed increased uptake in the lower ribs on both sides compatible with the costo-iliac impingement syndrome. There were no signs of bone metastases....

  17. Chronological study for solitary bone metastasis in the sternum from breast cancer with bone scintigraphy

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    Miyoshi, Hidenao; Otsuka, Nobuaki; Sone, Teruki; Nagai, Kiyohisa; Tamada, Tsutomu; Mimura, Hiroaki; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Fukunaga, Masao [Kawasaki Medical School, Kurashiki, Okayama (Japan)


    Since breast cancer is frequently associated with bone metastasis, bone scintigraphies have been performed to determine pre-operative staging and to survey postoperative bone metastasis. The sternum, in particular, is a site at which is difficult to differentiate between benign bone disease and bone metastasis, because of varied uptake and wide individual variations. In this study, chronological bone images were scintigraphied in six cases with solitary sternal metastasis and three cases with benign bone disease including two fracture cases and one arthritis case. On bone scintigrams in which solitary sternal metastasis appeared, increased uptake was found in five cases, and photon deficiency was observed in one case. During follow-up scintigraphies, abnormal accumulations, such as hot spots and cold lesions, increased in the bone metastasis while abnormal uptake disappeared or was unchanged in the benign bone disease cases. On CT, four cases showed osteolytic change, and one exhibited osteosclerotic change. These findings indicate that sternal metastasis usually shows osteolytic change, even if a hot lesion is recognized on bone scintigraphy. In solitary sternal metastasis, for which early diagnosis is difficult, both an integrated diagnosis using other imaging techniques and chronological bone scintigraphy are important. (author)

  18. Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy. (United States)

    Moralidis, Efstratios; Gerasimou, Georgios; Theodoridou, Athina; Hilidis, Ilias; Mylonaki, Efrosyni; Gotzamani-Psarrakou, Anna


    Hypertrophic osteoarthropathy (HOA) is an incompletely understood syndrome characterized by digital clubbing and periosteal proliferation of long bones and it is commonly associated with primary lung tumors. Bone scintigraphy is a sensitive method in detecting HOA and characteristic findings have been reported. We present the case of a man with newly diagnosed non-small cell lung cancer, unremarkable clinical examination and blood tests and no digital clubbing. During disease staging, however, bone scintigraphy showed intense calcaneal cortical proliferation bilaterally without involvement of other parts of the skeleton. Cortical reaction of both calcanei resolved significantly after chemotherapy. This case indicates that HOA may manifest with isolated calcaneal periostitis bilaterally, which is a new addition to the literature.

  19. Cold metastases detected by bone scintigraphy in aggressive lung cancer

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    Martinez Carsi, C.; Perales Vila, A. [Servei de Medicina Nuclear de l`Hospital 9 d`Octubre, Valencia (Spain); Ruiz Hernandez, G. [Servei de Medicina Nuclear de l`Hospital Clinic Universitari, Valencia (Spain); Sanchez Marchori, C.; Oro Camps, J. [Servei de Traumatologia de l`Hospital 9 d`Octubre, Valencia (Spain)


    A case of a 55-year-old man was remitted to Traumatology Department to present back pain of two weeks of evolution. The results of bone scintigraphy and the patient`s evolution allowed the diagnosis. This case report and a literature review showed the importance of using a routine bone scan in diagnosis of bone metastases. (orig.) [Deutsch] Ein 55jaehriger Mann mit seit zwei Wochen andauernden lumbalen Schmerzen wurde in der orthopaedischen Klinik untersucht. Die Evolution des klinischen Bildes und eine Knochenszintigraphie ermoeglichten die Diagnose. Dieser klinische Fall und das wissenschaftliche Schrifttum zeigten, wie wichtig eine routinemaessige Knochenszintigraphie in der Diagnostik von Knochenmetastasen ist. (orig.)

  20. Comparative study of whole-body MRI and bone scintigraphy for the detection of bone metastases

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    Balliu, E., E-mail: [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Boada, M.; Pelaez, I. [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Vilanova, J.C. [Department of Magnetic Resonance, Clinica Girona - Hospital Sta Caterina, Girona (Spain); Barcelo-Vidal, C. [Department of Computer Science and Applied Mathematics, University of Girona (Spain); Rubio, A.; Galofre, P. [Department of Nuclear Medicine, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Castro, A. [Department of Internal Medicine, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Pedraza, S. [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain)


    Aim: To assess and compare the diagnostic accuracy of whole-body magnetic resonance imaging (MRI) and bone scintigraphy in the detection of metastases to bone. Material and methods: Forty randomly selected patients with known malignant tumours were prospectively studied using bone scintigraphy and whole-body MRI. Two patients were excluded. Symptoms of bone metastasis were present in 29 (76%) patients and absent in nine (24%). Findings were classified into four categories according to the probability of bone metastasis: (1) negative, (2) probably negative, (3) probably positive, and (4) positive. Diagnostic accuracy was determined according to the area under the receiver operating characteristic (ROC) curve. The definitive diagnosis was reached using other imaging techniques, biopsy, or 12 months clinical follow-up. Results: Metastases were present in 18 patients. The sensitivity, specificity, and diagnostic accuracy were 94, 90, and 92%, respectively, for whole-body MRI and 72, 75, and 74%, respectively, for bone scintigraphy. Diagnostic accuracy measured by the area under the ROC curve was significantly higher for whole-body MRI (96%) than for bone scintigraphy (77%; p<0.05). Interobserver agreement measured by the kappa index was significantly higher for whole-body MRI (0.895) than for bone scintigraphy (0.524; p<0.05). Whole-body MRI detected lesions in tissues other than bone in 17 (45%) patients. Conclusions: Whole-body MRI is more accurate and more objective than bone scintigraphy for the detection of bone metastases. Whole-body MRI can also detect lesions in tissues other than bone.

  1. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction

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    Poissonnet Gilles


    Full Text Available Abstract Background Bone scintigraphy was performed to monitor anastomotic patency and bone viability. Methods In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla. Results In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p Conclusion When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure.

  2. Thallium-201 scintigraphy for bone and soft tissue tumors

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    Tokuumi, Yuji; Tsuchiya, Hiroyuki; Sunayama, Chiaki; Matsuda, Eizo; Asada, Naohiro; Taki, Junichi; Sumiya, Hisashi; Miyauchi, Tsutomu; Tomita, Katsuro [Kanazawa Univ. (Japan). School of Medicine


    This study was undertaken to assess the usefulness of thallium-201 scintigraphy in bone and soft tissue tumors. Pre-therapy scintigraphy was undertaken in a total of 136 patients with histologically confirmed diagnosis, consisting of 74 with malignant bone and soft tissue tumors, 39 with benign ones, 12 with diseases analogous to tumors, and 11 others. Thallium activity was graded on a scale of 0-4: 0=background activity, 1=equivocal activity, 2=definitive activity, but less than myocardium, 3=definite activity equal to myocardium, and 4=activity greater than myocardium. In the group of malignant tumors, thallium-201 uptake was found in 80%, although it was low for chondrosarcoma (2/8) and malignant Schwannoma (one/3). The group of benign tumors, however, showed it in only 41%, being restricted to those with giant cell tumors, chondroblastoma, fibromatosis, and osteoid osteoma. Thallium-201 uptake was also found in all 8 patients with metastatic tumors. In 23 patients undergoing thallium imaging before and after chemotherapy, scintigraphic findings revealed a high correlation with histopathological findings. Thus, thallium-201 scintigraphy may be potentially used to distinguish malignant from benign bone and soft tissue tumors, except for a few histopathological cases, as well as to determine loco-regional metastases and response to chemotherapy. (N.K.).

  3. Magnetic resonance imaging and bone scintigraphy in bone metastasis detection: A comparative study

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    Lučić Silvija


    Full Text Available Background/Aim. Bone scintigraphy is well-known method for the detection of neoplastic lesions with a high sensitivity and, at the same time, a lower specificity. On the other hand magnetic resonance imaging (MRI is previously established noninvasive imaging method regarding its diagnostic specificity. The aim of this study was to determine the possibilities and to correlate two different diagnostic methods - bone scintigraphy and MRI in the detection of bone metastasis in the spine and pelvic bones. Methods. A total of 123 patients who underwent both bone scintigraphy and spine and pelvic MRI on 1.5 T MR imager were enrolled in this study. Scans were subsequently analyzed in total and divided in regions of interest (cervical, upper, middle and lower thoracic, upper and lower lumbar and pelvic region, which includes sacral spinal segment; afterwards the total number of 585 matching regions were compared and statistically analyzed. Results. The statistical analysis demonstrated significant correlation between the findings of both methods in total. Divided by regions of interest, significant degrees of correlation were demonstrated in all of them, except in the cervical spine region where the r-value was in the range of low correlation. Conclusion. Having a high mutual correlation, bone scintigraphy and MRI are to be considered as the complementary diagnostic methods in the detection of bone metastases. Still, increased diagnostic potential of MRI may highlights negative bone scintigraphy findings in the patients with solitary metastatic lesions or diffuse vertebral infiltration. Advances in the bone scintigraphy (single photon emission tomography - SPECT, SPECTcomputed tomography - SPECT-CT and MRI (whole body MRI, diffusion MRI, make it possible the diagnostic potential of both methods will result in a further improvement in bone metastasis detection.

  4. Three-phase bone scintigraphy in Pellegrini-Stieda disease. (United States)

    Liu, R S; Chou, C S; Yeh, S H


    In a patient with Pellegrini-Stieda disease, radiographs of the knees were unremarkable at the time the three-phase bone scintigraphy was abnormal. The results of follow-up radiographs three months later remained normal in the left knee, where local steroid injection was given, but revealed typical positive results in the right knee with no treatment. The three-phase bone scintigraphic pattern is rather typical and antedates the radiographic changes. Thus, the radionuclide technique would provide a useful procedure for the early diagnosis and treatment of Pellegrini-Stieda disease.

  5. Nurse exposure doses resulted from bone scintigraphy patient (United States)

    Tunçman, Duygu; Kovan, Bilal; Poyraz, Leyla; ćapali, Veli; Demir, Bayram; Türkmen, Cüneyt


    Bone scintigraphy is used for displaying the radiologic undiagnosed bone lesions in nuclear medicine. It's general indications are researching bone metastases, detection of radiographically occult fractures, staging and follow-up in primary bone tumors, diagnosis of paget's disease, investigation of loosening and infection in orthopedic implants. It is applied with using 99mTc labeled radiopharmaceuticals (e.g 99m Tc MDP,99mTc HEDP and 99mTc HMDP). 20 -25 mCi IV radiotracer was injected into vein and radiotracer emits gamma radiation. Patient waits in isolated room for about 3 hours then a gamma camera scans radiation area and creates an image. When some patient's situation is not good, patients are hospitalized until the scanning because of patients' close contact care need. In this study, measurements were taken from ten patients using Geiger Muller counter. After these measurements, we calculated nurse's exposure radiations from patient's routine treatment, examination and emergency station.

  6. Bone scintigraphy (B S) in testicle tumours

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    Braga, F.J.H.N.; Arbex, M.A.; Souza, J.F.; Haddad, J. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina


    Full text. Testicle tumours are not very frequent and radiotherapy has an important role in the cure of many patients. The detection of metastases is not an easy task and we do not know any study concerning B S in the search for bone metastases in such cases. We studied 28 patients (8-52 years old) with proven testicle tumours by means of 99 m Tc-M D P (750 MBq intravenously). Images were obtained 2 h after. B S was normal in 21 studies. In 7 evaluations the only abnormality we found was variable but diffuse involvement of the iliac bone on the same side as the affected testicle. Five out of these patients showed important uptake of M D P (4 seminoma and 1 epididymoma) and the 2 others showed moderate uptake of the radio pharmaceutical (2 seminoma). Metastases were confirmed by biopsy. Testicle tumour metastases are known to occur through the lymphatic drainage which goes to the iliac lymph node chain and this makes our findings very logical. The scintigraphic aspect of the affected iliac bone is characteristic and makes it possible to imagine an `iliac sign` for such cases. Early detection of metastases is very important because of radiotherapy efficacy and B S may play an important role in such cases. Testicle tumour metastases should be thought of when this scintigraphic aspect is seen. Differential diagnosis is Paget`s Disease

  7. The usefulness of early whole body bone scintigraphy in the detection of bone metastasis from prostatic cancer

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    Otsuka, Nobuaki; Fukunaga, Masao; Furukawa, Yohji; Tanaka, Hiroyoshi (Kawasaki Medical School, Kurashiki, Okayama (Japan))


    Early whole body bone scintigraphy was performed on 25 patients with prostatic cancer (15 cases with bone metastases and 10 cases without bone metastasis) to obtain anterior and posterior whole body images five minutes after administration of [sup 99m]Tc-hydroxymethylene diphosphonate(HMDP). The results were compared with the findings of routine bone scintigraphy after three hours, and the usefulness of the above method for the diagnosis of bone metastasis from prostatic cancer was evaluated. In cases in which increased activity was found in the upper and lower lumbar vertebrae by routine bone scintigraphy but no abnormality was seen by early whole body bone scintigraphy, senile degenerative bone changes such as spondylosis deformance were observed by bone radiography. In cases with multiple bone metastases, abnormal multiple accumulations were found by both early whole body bone scintigraphy and routine bone scintigraphy. In addition, in cases showing super bone scan, high accumulation in the skeletal system had already been detected by early whole body bone scintigraphy. When the courses before and after treatment in nine cases of multiple bone metastases were passaged from the results of early whole body bone scintigraphy and from changes in tumor markers (prostatic specific antigen, [gamma]-semino protein and prostatic acid phosphatase), increased activity and the appearance of new hot spots as well as an increase in tumor markers were detected by early whole body scintigraphy in three of the four advanced cases, whereas decreased accumulations and a decrease in and normalization of tumor markers were observed in five improved cases. (author).

  8. Whole body bone scintigraphy in osseous hydatosis: a case report

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    Ebrahimi Abdolali


    Full Text Available Abstract Hydatid disease is common in many parts of the world, and causes considerable health and economic loss. This disease may develop in almost any part of the body. Bone involvement is often asymptomatic, and its diagnosis is primarily based on radiographic findings. A whole body bone scan is able to show the extent and distribution of lesions. We describe an unusual case of multifocal skeletal hydatosis and also explain the clinical and diagnostic points. We hope to stimulate a high index of suspicion among clinicians to facilitate early diagnosis and to consider this disease as a differential diagnosis in cases of multiple abnormal activity in bone scintigraphy especially among people in endemic areas.

  9. The usefulness of bone scintigraphy in SAPHO syndrome

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    Lim, Seok Tae; Sohn, Myung Hee [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)


    SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Five patients (M:F=5:0, Age 22.8{+-}4.78 yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extent of spinal lesion. All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. Involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment.

  10. Bone reaction in temporomandibular joint dysfunction. An investigation with bone scintigraphy and gamma imaging

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    Kirveskari, P.; Alanen, P.; Kuusela, T.; Ruotsalainen, P. (Turku Univ. (Finland))


    Scintigraphy was used in eight patients with temporomandibular joint dysfunction to detect changes in bone metabolism assumed to be responses to altered activity of the masticatory muscles. Asymmetry in clinical signs and symptoms coincided with the asymmetry observed in the computed horizontal tomograms.

  11. Is bone scintigraphy necessary in the initial surgical staging of chondrosarcoma of bone?

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    Douis, Hassan; James, Steven L.; Davies, Mark A. [Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Grimer, Robert J. [Royal Orthopaedic Hospital, Department of Orthopaedic Oncology, Birmingham (United Kingdom)


    To assess the value of whole-body bone scintigraphy in the initial surgical staging of chondrosarcoma of bone. A retrospective review was conducted of the bone scintigraphy reports of a large series of patients with peripheral or central chondrosarcoma of bone treated in a specialist orthopaedic oncology unit over a 13-year period. Abnormal findings were correlated against other imaging, histological grade and the impact on surgical staging. A total of 195 chondrosarcomas were identified in 188 patients. In 120 (63.8%) patients the reports of bone scintigraphy noted increased activity at the site of one or more chondrosarcomas. In one patient the tumour was outside the field-of-view of the scan, and in the remaining 67 (35.6%) cases, there was increased activity at the site of the chondrosarcoma and further abnormal activity in other areas of the skeleton. Causes of these additional areas of activity included degenerative joint disease, Paget's disease and in one case a previously undiagnosed melanoma metastasis. No cases of skeletal metastases from the chondrosarcoma were found in this series. Multifocal chondrosarcomas were identified in three cases. In two it was considered that all the tumours would have been adequately revealed on the initial MR imaging staging studies. In only the third multifocal case was an unsuspected, further presumed low-grade, central chondrosarcoma identified in the opposite asymptomatic femur. Although this case revealed an unexpected finding the impact on surgical staging was limited as it was decided to employ a watch-and-wait policy for this tumour. There is little role for the routine use of whole-body bone scintigraphy in the initial surgical staging in patients with chondrosarcoma of bone irrespective of the histological grade. (orig.)

  12. Bone scintigraphy and osteo-articular tuberculosis in transplant patients: a study of 50 bone scans

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    Coulaud, J.P.; Mechali, D.; Morau, G. (Hopital Claude-Bernard, Paris (France))


    Bone scintigraphy with 99 m technecium labelled phosphorus compounds was achieved in 50 west Africans migrant workers in Paris. Bone and joint tuberculosis was assumed in 20 cases. In 5 of these 20 cases, bone scan, but not X-ray, showed abnormalities, and in 4, bone scan disclosed more localisations than X-rays. In 7 cases, yet, bone scan was normal, with major osteolytic X-rays lesions in 3 cases, minor in 2 cases, and isolated cold abcesses in two more cases: these means 7 false-negative results. Among the 30 other cases, 29 were considered as mechanical vertebral pathology, and 1 sacro-iliitis Brucellosis. Bone scan was normal in 28 cases the 2 others are unexplained false-positive. Although non-specific and not completely reliable, we think that bone-scanning is useful in bone-tuberculosis check-up, especially to obtain early diagnosis and detect multifocal localisations.

  13. Comparison of FDG-PET/CT and bone scintigraphy for detection of bone metastases in breast cancer

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    Hahn, Steffen; Heusner, Till; Forsting, Michael; Antoch, Gerald (Dept. of Diagnostic and Interventional Radiology and Neuroradiology, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)), email:; Kuemmel, Sherko; Koeninger, Angelika (Dept. of Gynecology and Obstetrics, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)); Nagarajah, James; Mueller, Stefan; Boy, Christian; Bockisch, Andreas; Stahl, Alexander (Dept. of Nuclear Medicine, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany))


    Background Bone scintigraphy is the standard procedure for the detection of bone metastases in breast cancer patients. FDG-PET/CT has been reported to be a sensitive tool for tumor staging in different malignant diseases. However, its accuracy for the detection of bone metastases has not been compared to bone scintigraphy. Purpose To compare whole-body FDG-PET/CT and bone scintigraphy for the detection of bone metastases on a lesion basis in breast cancer patients. Material and Methods Twenty-nine consecutive women (mean age 58 years, range 35-78 years) with histologically proven breast cancer were assessed with bone scintigraphy and whole-body FDG-PET/CT. Twenty-one patients (72%) were suffering from primary breast cancer and eight patients (28%) were in aftercare with a history of advanced breast cancer. Both imaging procedures were assessed for bone metastases by a radiologist and a nuclear medicine physician. Concordant readings between bone scintigraphy and FDG-PET/CT were taken as true. Discordant readings were verified with additional MRI imaging in all patients and follow-up studies in most patients. Results A total of 132 lesions were detected on bone scintigraphy, FDG-PET/CT or both. According to the reference standard, 70/132 lesions (53%) were bone metastases, 59/132 lesions (45%) were benign, and three lesions (2%) remained unclear. The sensitivity of bone scintigraphy was 76% (53/70) compared to 96% (67/70) for FDG-PET/CT. The specificity of bone scintigraphy and FDG-PET/CT was 95% (56/59) and 92% (54/59), respectively. According to the reference standard bone metastases were present in eight out of the 29 patients (28%), whereas 20 patients (69%) were free of bone metastases. One (3%) patient had inconclusive readings on both modalities as well as on MRI and follow-up studies. Bone scintigraphy and FDG-PET/CT correctly identified seven out of eight patients with bone metastases and 20 out of 20 patients free of metastases. Conclusion On a lesion

  14. Diffuse Hepatic and Spleen Uptake of Tc-99m MDP on Bone Scintigraphy Resembling Liver-Spleen Scintigraphy in a Patient of Plasma Cell Tumor. (United States)

    Ravanbod, Mohammad Reza; Nemati, Reza; Javadi, Hamid; Nabipour, Iraj; Assadi, Majid


    The present case demonstrates a diffuse intense hepatic and, to a lesser degree, spleen, Tc-99m MDP uptake on a routine bone scintigraphy resembling liver-spleen imaging. A 49-year-old female with a history of anaplastic plasma cell tumor and suffering from bone pain was referred for bone scintigraphy to evaluate possible bone metastases. The bone scintigraphy showed diffuse hepatic and spleen uptake of Tc-99m MDP resembling liver-spleen imaging. Furthermore, bone uptake of Tc-99m MDP was significantly diminished and there were no abnormal foci throughout the skeleton. The bone scintigraphy of the present case of an anaplastic plasma cell tumor suggests the possible presence of amyloidosis.

  15. Bone scintigraphy in Erdheim-chester disease: a case report

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    Siqueira, V.L.; Soares, L.M.M.; Ribeiro, V.P.B.; Coura Filho, G.B.; Sapienza, M.T.; Ono, C.R.; Watanabe, T.; Costa, P.L.A.; Hironaka, F.; Buchpiguel, C.A. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Fac. de Medicina. Hospital das Clinicas


    Full text: Introduction: Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis, of unknown etiology, characterized by infiltration of foamy histiocytes. Clinically, patients usually present with bone pain, and various extraskeletal manifestations. ECD differs from Langerhans cell histiocytosis (LCH) by radiologic and immunohistochemistry features. Case report: A 57-year-old woman presented with a history of intense pain on her left hand, besides eyelid xanthelasmas and xanthoms on frontal area ten years ago. Four years late she presented with pain on hips, legs and feet. Xanthoms spread to perioral area, mento and neck. Radiographs of the hands showed osteolysis of carpal bones bilaterally, osteolysis of fifth left metacarpal bone, osteosclerosis of all metacarpal bones bilaterally, except the fifth, and osteosclerosis of the second and third proximal falanges bilaterally. The legs showed bilateral diaphyseal and metaphyseal osteosclerosis. Bone scintigraphy demonstrated increased uptake on face bone (maxilla), and symmetric intense uptake on elbows, distal radii and ulnae, hands, distal area of femurs, tibias particularly on proximal and distal area, and feet. A tibia biopsy and a biopsy of neck lesion were made. The analysis of histology and immunohistochemistry were consistent with ECD. She has been treated with a-interferon for 1,5 year, and she reports delay in xanthoms progression and bone pain remission. Discussion: ECD is an adult multisystemic xanthogranulomatous infiltrative disease of unknown etiology. It may be confused with LCH, however ECD have distinctive immunohistochemistry and radiologic findings. LCH shows typically lytic bone lesions on axial skeleton, whereas symmetrical long-bone osteosclerosis is the radiologic sign for ECD. LCH stain positive for CD1a and S-100 protein, and the electron microscopy of cytoplasm discloses Biberck granules. ECD stain positive for CD68, negative for CD1a and S-100 protein, shows absent of

  16. Bone Scintigraphy Findings of A Case with Maffucci's Syndrome

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    Lee, Sang Mi; Lee, Jong Jin; Kim, Yu Kyeong; Lee, Jeong Won; Chung, Jin Haeng; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)


    Maffucci's syndrome is a sporadic rare congenital disease that is characterized by enchondromatosis and soft tissue hemangiomas. A systemic evaluation should be considered because this syndrome is related to generalized meso dermal dysplasia, which has a high likelihood of a malignant transformation. Whole-body bone scintigraphy might be helpful for detecting skeletal involvement. We present a case of Maffucci's syndrome suing bone scintigraphy to evaluate the extent of the disease.

  17. Open mouth bone scintigraphy is better than closed mouth bone scintigraphy in the diagnosis of temporomandibular osteoarthritis

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    Park, Ki Seong; Song, Ho Chun; Cho, Sang Geon [Dept. of Nuclear Medicine, Chonnam National University Hospital, Gwangju (Korea, Republic of); and others


    Closed-mouth bone scintigraphy (CM scan) and closed-mouth single-photon emission computed tomography (CM SPECT) are used for conventional evaluation of osteoarthritis of the temporomandibular joint (TMJ). However, the adequacy of open-mouth bone scintigraphy (OM scan) has not yet been evaluated. Therefore, the purpose of this study was to compare the diagnostic performance of CM scan, CM SPECT, and OM scan. Thirty-six patients with suspicion of an abnormality of the TMJ and who underwent a 99mTc-HDP CM scan, CM SPECT, and an OM scan were enrolled. The scans were assessed visually for the presence of positive focal uptake in the TMJ. Osteoarthritis was defined as arthralgia plus crepitus or radiologic signs of arthrosis. Of 72 TMJs, 21 (29.2 %) were diagnosed with osteoarthritis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90.5 %, 49.0 %, 42.2 %, 92.6 % and 61.1 % for the CM scan, 81.0 %, 58.8 %, 44.7 %, 88.2 % and 65.3 % for CM SPECT, and 81.0 %, 82.4 %, 65.4 %, 91.3 % and 81.9 % for the OM scan, respectively. The accuracy of the OM scan was higher than that of CM SPECT and the CM scans (p = 0.004 and p < 0.001, respectively). The OM scan was more accurate than the conventional CM scan and even CM SPECT for diagnosing TMJ osteoarthritis.

  18. Bone infection in patients suspected of complicating osteomyelitis: the diagnostic value of dual isotope bone-granulocyte scintigraphy

    DEFF Research Database (Denmark)

    Buhl, Thora; Stentzer, Kim; Hede, Adam;


    AIM: The purpose of this study was to evaluate the diagnostic value of dual isotope bone-granulocyte scintigraphy in patients with known bone pathology clinically suspected of osteomyelitis, i.e. complicating osteomyelitis, using per-operative bacterial culture from bone as reference. METHODS...... interpreted as positive for osteomyelitis if regions of interests of pathologic 111In granulocyte accumulation included 99mTc MDP activity on the bone images (except in the spine). RESULTS: The sensitivity, specificity, and accuracy were 84, 71 and 79%, respectively, for simultaneous, dual isotope bone......-granulocyte scintigraphy, higher than the other diagnostic parameters. CONCLUSION: Simultaneous bone-granulocyte scintigraphy is a valuable diagnostic tool in diagnosing osteomyelitis complicating other bone pathology with or without soft-tissue infection....

  19. Chronic recurrent multifocal osteomyelitis: typical patterns of bone involvement in whole-body bone scintigraphy. (United States)

    Acikgoz, Gunsel; Averill, Lauren W


    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease of unknown etiology. It affects children and adolescents predominantly and occurs mostly in the female population. It is characterized by the insidious onset of pain and swelling, with a fluctuating clinical course of relapses and remissions. Typically, several bones are affected, either synchronously or metachronously, and bilateral involvement is common. CRMO most commonly affects the metaphysis of long bones, especially the tibia, femur, and clavicle. The spine, pelvis, ribs, sternum, and mandible may also be affected. Although lesions are mostly multiple, patients may present with a single symptomatic focus. Radiographic findings may be negative early in the course of the disease. Bone scintigraphy is useful in determining the presence of abnormality and the extent of disease. The imaging and clinical features of CRMO overlap with those of infectious osteomyelitis, bone malignancy, and inflammatory arthritis. Nonetheless, CRMO can be confidently diagnosed with the recognition of typical imaging patterns in the appropriate clinical setting. This article reviews imaging findings with special emphasis on bone scintigraphy and specific disease sites.

  20. The role of whole-body bone scintigraphy in a case of osteopetrosis

    Directory of Open Access Journals (Sweden)

    Carlyle Marques Barral


    Full Text Available Male patient, 35 years old, with occasional mild intensity back pain. Lumbosacral spine radiography showed bone structure with increased density, diffusely and symmetrically, conferring to the vertebral bodies “bone-within-bone” aspect, suggesting osteopetrosis (OP. Whole-body bone scintigraphy showed abnormal uptake in proximal epiphysis of both the humeri, tibias and fibulas, distal epiphysis of the femurs and focal in the ribs suggesting old fractures. Conclusions: Nuclear Medicine may provide an important contribution as supporting diagnosis and extensive skeletal evaluation such as fractures and infection. Bone scintigraphy might also be used for baseline assessments, allowing longitudinal monitoring of the disease and patient follow-up.

  1. Implications of three phase bone scintigraphy for the diagnosis of bisphosphonate related osteonecrosis of the jaw

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    Hong, Chae Moon; Ahn, Byeong Cheol; Choi, So Young; Kim, Do Hoon; Lee, Sang Woo; Kwon, Tae Geon; Lee, Jaetae [Kyungpook National Univ., Daegu (Korea, Republic of)


    Bisphosphonate (BP) related osteonecrosis of the jaw (BRONJ) is a well known serious complication of BP treatment. This study was undertaken to evaluate the diagnostic usefulness of three phase bone scintigraphy in patients with BRONJ. Forty one patients (48 lesions)with clinically proven BRONJ (2 males, 39 females, age 74.3{+-}6.7 years)under went Tc 99m HDP bone scintigraphy. Visual interpretation and semiquantitative analysis of uptakes using lesion to contralateral uptake ratios during the blood pool phase (BUR)and during the osseous phase (OUR)were performed, and relations were sought between these and various clinical parameters. Three phase bone scintigraphy showed increased perfusion and blood pooling in 21 (63.6%)and 27 (81.8%)of 33 lesions, respectively. The osseous phase was positive for 45 (93.8%)of the 48 lesions. Of the four inflammatory clinical parameters of BRONJ [pus discharge, pain, swelling, and erythrocyte sedimentation rate (ESR)], patients with three or more parameters had more positive findings in vascular and blood pool phase images (p=0.033, p=0.027). By semiquantitative analysis, patients with a positive ESR had statistically higher BUR and OUR (both p<0.001). Higher stage BRONJ lesions had higher OUR than lower stage lesions (p=0.003). In addition, bone scintigraphy revealed three clinically covert BRONJ lesions without bone exposure, and four patients were up staged based on bone scintigraphy. Bone scintigraphy provides a relatively sensitive means of detecting BRONJ, so it was helpful for accurate BRONJ staging. Furthermore, Increased uptakes in vascular and blood pool phases of three phase bone scintigraphy were related to the inflammatory activity of BRONJ.

  2. Retrospective Analysis of Indication of Bone Scintigraphy Performed in Our Clinic

    Directory of Open Access Journals (Sweden)

    Fusun Aydogan


    Full Text Available Aim: Bone scintigraphy is one of the commonly used radionuclide imaging and it is successfully used in the diagnosis and follow-up of many diseases. The aim of this study is to determine the indications and filming protocols of bone scintigraphy which was performed in our clinic. Material and Method: Two hundred and fifty two patients (132 male, 120 female who was performed bone scintigprapy in our clinic between December 2011 and June 2013 included the study. Mean age was 50.1±20.2 years. Scintigraphic protocols were made in two ways as late static whole body imaging and three-phase bone scintigraphy according to the type of the diseases. Indications of scintigraphies and scintigraphic protocols were detected. Results: Bone scintigraphy was performed for diagnosis and monitoring of metastatic bone disease to 102 patients (40,5 %, for orthopedic applications to 57 patients (22,6 %, for diagnosis and monitoring of primary bone tumors to 29 patients (11,5 %, for diagnosis of osteomyelitis to 17 patients (6,7 %, for differential diagnosis of infection and loosening of the prosthesis to 12 patients (4,8 %, investigate the viability of the graft in 14 patients (4,6 %, for rheumatologic diseases to 9 patients (3,6 %, for investigate the pathological vertebral fractures and osteoporosis to 4 patients (1,6 %, for diagnosis the metabolic bone disease to 2 patients (0,8 %, for diagnosis of otitis externa to 5 patients (1,98 % and for for suspicion of malignancy to 1 patient (0,4 %. Late static whole body imaging protocol was applied to 136 patients (54 % and three-phase imaging protocol was applied to 116 patients (46 %. Discussion: The most common use of bone scintigraphy is the diagnosis and follow-up of metastatic bone disease. It is followed by reasons such as orthopedic applications, monitoring and diagnosis of primary bone tumors and diagnosis of osteomyelitis.

  3. The contribution of bone scintigraphy in occupational health or medical insurance claims: a retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Versijpt, J.; Dierckx, R.A.; Bondt, P. de [Division of Nuclear Medicine, University Hospital Gent (Belgium); Dierckx, I. [Department of Radiology, St. Elisabeth Hospital Antwerpen (Belgium); Lambrecht, L. [Outpatient Internal Medicine Clinic, Gent (Belgium); Sadeleer, C. de [Division of Nuclear Medicine, University Hospital Gent (Belgium)]|[Department of Nuclear Medicine, O.L.V. Hospital Geraardsbergen (Belgium)


    Patients with a suspicion of bone damage following an industrial or traffic accident are often referred for bone scintigraphy as part of an occupational health or medical insurance investigation. The aim of this study was to assess the contribution and the potential role of bone scintigraphy compared with X-ray investigations in the aforementioned situation. To this end we evaluated 70 consecutive patients referred for bone scintigraphy during 1996 and 1997 by occupational health or medical insurance physicians. The most common reasons for referral were the exclusion of occult fractures of hands and feet, whiplash injuries, reflex sympathetic dystrophy or avascular necrosis, or the differentiation between an old and a recent vertebral fracture. X-rays were only available for comparative review of 53 patients, so only those were analysed. The results of bone scintigraphy were compared with X-rays, and their contribution and potential role in occupational health or medical insurance investigations assessed. In 31 out of the 53 patients investigated, bone scintigraphy findings concurred with X-rays as to the number and location of abnormalities. For 19 of the 53 patients, bone scintigraphy showed clinically relevant additional foci when compared with X-rays, predominantly involving lesions to hands/wrists and feet/ankles. Among these 19 patients, scintigraphic diagnoses were subsequently confirmed in ten cases by means of X-ray or computed tomography. In four patients, supplementary radiological investigations revealed no abnormalities, and in five patients no further investigations were undertaken. Finally, in three of the 53 patients, X-rays revealed bone damage (burst fractures) whilst the corresponding bone scintigraphy was negative, thus excluding recent injury. In conclusion, in 22 patients, representing 42% of the cases analysed, bone scintigraphy was conclusive compared with X-ray imaging in the final diagnosis and in this way in detecting occult or excluding

  4. Pelvic and lumbar metastasis detected by bone scintigraphy in malignant pleural mesothelioma

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    Ruiz Hernandez, G.; Castillo Pallares, F.J.; Llorens Banon, L.; Romero de Avila y Avalos, C. [Hospital Clinic Universitari de Valencia (Spain). Servei de Medicina Nuclear; Garcia Garc`ia, T.; Azagra Ros, P. [Hospital Clinic Universitari de Valencia (Spain). Servei d`Oncologia; Maruenda Paulino, J.I. [Hospital Clinic Universitari de Valencia (Spain). Servei Traumatologia; Ferrer Albiach, C. [Hospital Clinic Universitari de Valencia (Spain). Servei Radioterapia


    A case of a 43-year-old man suffering from pleural mesothelioma with distant bone metastasis is reported. The results of bone scintigraphy and NMR findings allowed the diagnosis. The current case describes a hematogenous metastasis to the pelvis and vertebral column from a malignant pleural mesothelioma that was detected initally by bone scintigraphy. (orig.) [Deutsch] Fallbericht ueber einen 43jaehrigen Mann mit Pleural-Mesotheliom und Knochenmetastasen. Die Diagnose wurde durch Knochenszintigraphie und NMR gestellt. Der vorliegende Fall beschreibt die haematogene Metastasierung ins Becken und in die Wirbelsaeule, ausgehend von einem malignen Pleural-Mesotheliom, das urspruenglich durch Knochenszintigraphie diagnostiziert wurde. (orig.)

  5. Cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

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    Buell, U.; Winkler, U.


    Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases.

  6. Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

    DEFF Research Database (Denmark)

    Duer, Anne; Østergaard, M; Hørslev-Petersen, K;


    OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which...... joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone...

  7. Importance of bone scintigraphy in children from a surgical and orthopedic point of view

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    Martinez, A.D.; Carro, G.A.

    Sixty children with Legg-Perthes disease (19), bone tumor (27), osteogenesis imperfecta (7), osteomyelitis (5) and transient synovitis (2) were studied using sup(99m)Tc labeled diphosphonate. A number of benign or malign bone diseases of children need early detection in order to institute the best form - the fine form - of treatment. We recommend the bone scintigraphy in the initial screening of children with signs and symptoms of bone pathology.

  8. Whole-body MRI of Langerhans cell histiocytosis: comparison with radiography and bone scintigraphy

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    Goo, Hyun Woo; Yang, Dong Hyun [Asan Medical Center, Department of Radiology, University of Ulsan College of Medicine, Seoul (Korea); Ra, Young Shin [Asan Medical Center, Department of Neurosurgery, University of Ulsan College of Medicine, Seoul (Korea); Song, Joon Sup; Im, Ho Joon; Seo, Jong Jin; Ghim, Thad; Moon, Hyung Nam [Asan Medical Center, Department of Pediatric Oncology, University of Ulsan College of Medicine, Seoul (Korea)


    In Langerhans cell histiocytosis (LCH) evaluation of the extent of disease is one of the major predictors of patient outcome. Historically this is undertaken using plain radiography and bone scintigraphy. Recently, whole-body (WB) MRI has been reported to be useful in detecting skeletal and extraskeletal metastases in both adults and children. To evaluate the usefulness of WB MRI in patients with LCH in comparison with plain radiography and bone scintigraphy. In nine children (1-7 years of age; mean 3.3 years) who had a pathological diagnosis of LCH and had either plain radiography or bone scintigraphy for comparison, 43 WB MR examinations were performed. Skeletal and extraskeletal lesions of the disease on WB MRI were compared with those on plain radiography and bone scintigraphy. LCH showed unifocal single-system involvement in one patient, multifocal single-system involvement in three, and multifocal multisystem disease in five. WB MRI identified additional skeletal lesions in three (38%) of eight patients, compared with plain radiography, and in two (25%) of eight, compared with bone scintigraphy. WB MRI detected extraskeletal lesions of the disease in five (56%) of the nine patients exclusively, except for one patient whose lung lesions were also detected on plain radiography. In two patients, treatment was changed according to WB MRI findings. (orig.)

  9. Comparative diagnostic value of bone scintigraphy and roentgenography in children with Legg-Calve-Perthes disease

    Energy Technology Data Exchange (ETDEWEB)

    Cavailloles, F.; Brauner, M.; Dandine, M.; Lonchampt, M.F.; Esteban, C.; Bensahel, H.; Patois, E.; Alperovitch, A.; Bock, B.


    To compare the value of hip roentgenograms and bone scintigraphy in Legg-Calve-Perthes (LCP) disease, a double blind study was done in 153 children, of whom 51 had LCP. Each procedure was read separately by two investigators who had no knowledge of clinical data. Variations across investigators were less significant for roentgenograms than for bone scans. Agreement on diagnosis between the two investigators was 95% for roentgenograms, against only 89% for bone scans. As regards the detailed analysis of each separate finding upon bone scintigraphy and assessment of this procedure's prognostic value, major discrepancies occurred between the two investigators. Diagnostic accuracy was very similar for the two procedures. Both bone scintigraphy and roentgenography showed a 0.86 sensitivity. Specificities were 0.93 and 0.99 respectively. For the subgroup of patients with early-stage LCP disease (33 cases), scintigraphy identified a slightly greater number of cases than roentgenography (0.88 and 0.76 respectively). Some disagreements between our results and those previously published in the literature may stem from biases such as the criteria for entering patients into the study or for establishing the final diagnosis. Roentgenography is obviously the first procedure to perform in a child with a painful hip or a limp. However, the results may be inconclusive in early-stage disease. In such cases, scintigraphy is needed and often avoids unnecessary traction or diagnostic delay.

  10. Bone marrow accumulation in gallium scintigraphy in patients with adult still's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kanegae, Futoshi; Tada, Yoshifumi; Ohta, Akihide; Ushiyama, Osamu; Suzuki; Noriaki; Koarada, Syuichi; Haruta, Yoshio; Yoshikai, Tomonori; Nagasawa, Kohei [Saga Medical School (Japan)


    We investigated the features and the usefulness of gallium scintigraphy in the diagnosis and the assessment of Adult Still's disease (ASD) by retrospective case review. Gallium scintigraphy have been done for 11 cases of ASD (3 males and 8 females) and 4 females were positive. Among these, 67 Ga-citrate was accumulated to the bone marrow in all 4 cases and to the major joints in 2 cases. Positive cases were rather serious and administered more immunosuppressants than negative cases. In order to characterize gallium scintigraphy findings of ASD, i.e. bone marrow accumulation, we analyzed 130 cases of collagen vascular disease. Although 101 cases (77.7%) were positive, only 7 cases (5.4%) showed the accumulation of {sup 67}Ga-citrate to the bone marrow. These include 3 cases with ASD, and 1 case with systemic lupus erythematosus, polyarteritis nodosa, Wegener's granulomatosis and Sjogren's syndrome. We also accumulated 18 patients who exhibited bone marrow accumulation of {sup 69}Ga-citrate, and found that 7 patients had collagen vascular and their related diseases. In conclusion, bone marrow accumulation in gallium scintigraphy is a specific feature of collagen vascular diseases, especially ASD, and it is suggested that cases with positive gallium scintigraphy in ASD can be serious and resistant to treatment. (author)

  11. Collar Osteophytes Mimicking Osteonecrosis in Planar Bone Scintigraphy and Usefulness of SPECT/CT Images. (United States)

    Juang, Jr-Jian; Chen, Yi-Hsing; Tsai, Shih-Chuan; Lin, Wan-Yu


    The use of prednisolone is one major risk factor for osteonecrosis in patients with systemic lupus erythematosus. Bone scintigraphy can be a diagnostic tool for early diagnosis. We present a case who had collar osteophytes at the bilateral femoral heads, which mimicked osteonecrosis in the planar bone scintigram. An SPECT/CT scan avoided this pitfall and increased the diagnostic accuracy for osteonecrosis.

  12. Clinical experience of [sup 123]I-IMP scintigraphy in detecting vertebral bone metastases of hepatocellular carcinoma. A comparison with bone scintigraphy with [sup 99m]Tc-MDP

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Iwamiya, T. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Tanigawa, N. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Shabana, M. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Ohta, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan))


    [sup 123]I-IMP and bone scintigraphy with [sup 99m]Tc-MDP were consecutively performed in patients with vertebral bone metastases from hepatocellular carcinoma and lumbar spondylosis deformans in a 7-day interval or shorter. The intensity of uptake was compared. Eighteen of the 20 metastatic lesions (90%) were classified as increased uptake areas in [sup 123]I-IMP scintigraphy. MDP-scintigraphy disclosed 16 metastatic lesions (80%), 9 as ''hot'' lesions (56%) and 7 as ''cold'' lesions (44%). [sup 123]I-IMP scintigraphy was negative in all 12 lesions of lumbar spondylosis deformans. Compared to MDP-scintigraphy, [sup 123]I-IMP scintigraphy was more sensitive in detecting vertebral bone metastases of hepatocellular carcinoma with smaller rates of false-positive and false-negative findings. (orig./MG).

  13. Bone mineral density and bone scintigraphy in children and adolescents with osteomalacia

    Energy Technology Data Exchange (ETDEWEB)

    El-Desouki, M. [College of Medicine and King Khalid University Hospital, King Saud University, Riyadh (Saudi Arabia); Al-Jurayyan, N. [College of Medicine and King Khalid University Hospital, King Saud University, Riyadh (Saudi Arabia)


    In order to demonstrate the role of bone mineral density (BMD) measurement and bone scans in the management of patients with osteomalacia, radioisotope bone scintigraphy using technetium-99m methylene diphosphonate (MDP) and BMD measurements of the lumbar spine and femur by means of dual X-ray absorptiometry (DXA) were performed at the time of diagnosis and 6 months after therapy in 26 Saudi patients (17 females and nine males). Their mean age was 13.5 years (range, 5-16). BMD measurements were compared with those of normal Saudi subjects matched for age and sex. Bone scan showed an increase in tracer uptake throughout the skeleton (``superscan``) in all children and demonstrated multiple stress fractures in eight. The mean BMD for the lumbar spine was 0.53 g/cm{sup 2}(Z-score, -3.1) and for the femoral neck 0.55 g/cm {sup 2}(Z-score, -2.8). Repeated bone scan and BMD after 6 months of therapy with oral vitamin D, calcium and proper sun exposure demonstrated a significant increase (P <0.001) in BMD and healing of pseudofractures. In conclusion, as a non-invasive method with minimal radiation exposure, measurements of BMD in children with osteomalacia are to be recommended in the initial assessment of the severity of osteopenia and in the follow-up to monitor the response to therapy. Bone scintigraphy is valuable in demonstrating the site and severity of stress fractures. (orig.). With 2 figs., 1 tab.

  14. 99mTc-MDP bone scintigraphy in the diagnosis of stress fracture of the metatarsal bones mimicking oligoarthritis

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    Jauković Ljiljana


    Full Text Available Background. Stress fractures are the injuries of soft tissues and bones caused by intensive and repeated stress on a bone. Repeated submaximal stress disturbs the balance between the processes of bone production and resorption that results in fracture. Case report. We presented a case of a patient with stress fracture of metatarsal bone. The patient was diagnosed and treated as having reactive oligoarthritis caused by Chlamydia trachomatis and administered antibiotics. Initial plain radiography was negative for bone fracture. Tc-99m bone scintigraphy suggested stress fracture of the second metatarsal. Plain radiography was became positive three weeks later, showing callus formation in the proximal part of the second metatarsal. Conclusion. Bone scintigraphy is a diagnostic test of choice in early diagnosis of stress fracture, and it is important to apply it timely in order to include the entire therapy and prevent complications, as well as to let a patient return to previous daily activites.

  15. Quantitative bone and 67Ga scintigraphy in the differentiation of necrotizing external otitis from severe external otitis

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    Uri, N.; Gips, S.; Front, A.; Meyer, S.W.; Hardoff, R. (Department of Otolaryngology, Lady Davis Carmel Hospital, Haifa (Israel))


    Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 {plus minus} 0.16 in patients with NEO and 1.08 {plus minus} 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 {plus minus} 0.24 in NEO patients and 1.05 {plus minus} 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO.

  16. Unusual Case of Occult Brucella Osteomyelitis in the Skull Detected by Bone Scintigraphy

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    Sohn, Myung Hee; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Lee, Chang Seob [Chonbuk National University Medical School, Jeonju (Korea, Republic of)


    Brucellosis is a worldwide infectious disease of animals that can be transmitted to humans. Osteoarticular involvement is the most common complication of brucellosis. A 47-year-old man, who was a stock breeder, complained of myalgia with fever and chills for 2 weeks. The serology titers and blood cultures for brucellosis were positive. Bone scintigraphy demonstrated a focally increased uptake in the left supra orbital area. Plain radiographs showed an osteolytic lesion, and an MRI revealed signal abnormalities in the corresponding site. We present an unusual case of occult Brucella osteomyelitis in the frontal bone of the skull detected by done scintigraphy.

  17. Unusual appearance for urinary bladder obstruction detected with 99mTc-MDP bone scintigraphy. (United States)

    Wright, Chadwick L; Sharma, Akash


    Unanticipated but clinically significant nonosseous findings can be detected during routine bone scintigraphy. We present a case of an 83-year-old man who presented with a pathologic fracture of the right femur. Whole-body bone scintigraphy for osseous staging revealed intense radiotracer accumulation in the kidneys and ureters but no activity within the urinary bladder. The patient had not voided for 14 hours. A Foley catheter was inserted, and more than 2000 mL of urine was drained, most consistent with urinary bladder obstruction. Subsequent repeat images demonstrated marked reduction of the renal and ureteral activity with trace activity in the urinary bladder.

  18. Combined use of bone and bone marrow scintigraphies for the diagnosis of active sacroiliitis. A new approach

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    Bozkurt, M.F.; Ugur, O.; Ertenli, I.; Caner, B. [Hacettepe Univ., Ankara (Turkey). Faculty of Medicine


    Diagnosis of sacroiliitis (SI) with bone scintigraphy may involve difficulties even with a quantitative approach. The aim of this study was to evaluate the combined use of bone and bone marrow scintigraphies for the diagnosis of active sacroiliitis. Thirty-one patients who were clinically suspected to have SI were included in the study. Bone and marrow scintigraphies were done after injections of 740 MBq of {sup 99m}Tc-MDP (MDP) and 370 MBq of {sup 99m}Tc-sulfur colloid (SC) respectively with a 2-day interval. Both visual and quantitative assessment of MDP uptake and visual assessment of SC uptake in sacroiliac joints were performed. Also sacroiliac joint radiographic findings for each patient were evaluated and graded from 0 to 4 according to the New York grading system. Patients were divided into 2 groups according to their x-ray findings (Group A: grade 0-2, Group B: grade 3-4). A total of 14 patients (10 bilateral, 4 unilateral) had increased MDP uptake with decreased/normal SC uptake. Twelve of 14 patients had grade 0-2 radiographic changes while only 2 patients had grade 3-4 radiographic changes. Increased MDP uptake with decreased/normal SC uptake is the most common scintigraphic pattern seen in acute phase SI in which radiographic findings are generally found to be normal or slightly changed. In at least in 8 patients the decreased bone marrow uptake of SC was demonstrated, supporting the diagnosis. Although our results did not reveal any significant superiority of bone marrow scintigraphy to bone scan for the detection of active sacroiliitis, combined use of bone and bone marrow scintigraphies was presented as an alternative method to characterize patients with active sacroiliitis. (author)

  19. The use of bone scintigraphy to detect active Hansen's disease in mutilated patients

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    Braga, F.J.H.N. [Seccao de Medicina Nuclear do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, USP (Brazil); Departamento de Fisica e Biofisica, Instituto de Biociencias, UNESP, Botucato (Brazil); Foss, N.T.; Ferriolli, E. [Departamento de Clinica Medica da Faculdade de Medicina de Ribeirao Preto, USP (Brazil); Pagnano, C. [Secretaria da Saude, Ribeirao Preto (Brazil); Miranda, J.R.A.; De Moraes, R. [Departamento de Fisica e Biofisica, Instituto de Biociencias, UNESP, Botucato (Brazil)


    Mutilation of extremities was very frequent in patients affected by leprosy in the past; although it is now much less common, it is still seen, mainly in patients with long-term disease. In general, mutilation of the nose and ears is caused by the bacillus and mutilation of the hands and feet a consequence of chronic trauma. Leprosy must be chronically treated and any decision to interrupt therapy is based on laboratory tests and biopsy. Scintigraphy is a non-invasive procedure which could be of great value in to determining disease activity. We studied eight patients (five males and three females, aged 64-73 years) who presented with mutilation of the nose (2), ear (1), feet (3) or foot and hand (2). Conventional three-phase bone scintigraphy (750 MBq) and X-ray examinations of the affected areas were performed in all patients. Bone scintigraphy was abnormal in four patients (the presence of bacilli was confirmed by biopsy in two of them), and normal in the other four. In all patients except for the one with ear mutilation, radiography only showed the absence of bone. We conclude that bone scintigraphy is very useful to determine disease activity in cases of mutilation caused by leprosy. It seems to be superior to conventional radiography and may enable bone biopsies to be avoided. (orig.)

  20. Role of computed tomography and radionuclide scintigraphy in the localization of osteomyelitis in flat bones

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    Hernandez, R.J.; Conway, J.J.; Poznanski, A.K.; Tachdjian, M.O.; Dias, L.S.; Kelikian, A.S.


    The combined use of radionuclide scintigraphy and computed tomography is recommended for evaluating children with laboratory and clinical data suggestive of flat bone osteomyelitis despite normal conventional radiographs. In addition, computed tomography may be helpful in the presence of abnormal radiographs in determining the exact location of the focus of osteomyelitis and the most suitable route for appropriate drainage or to obtain culture material.

  1. Low-Dose Adefovir-Induced Hypophosphatemic Osteomalacia on Whole-Body Bone Scintigraphy

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    Kim, Sung Hoon; Won, Kyoung Sook; Song, Bongil; Jo, Il; Zeon, Seok Kil [Keimyung Univ., Daegu (Korea, Republic of)


    While adefovir dipivoxil (ADV) effectively suppresses the hepatitis B virus, it can cause proximal renal tubular dysfunction leading to phosphate wasting. The safety of low-dose ADV (a dose of 10 mg/day), which does not induce clinically significant nephrotoxicity, is well recognized, but a few cases of hypophosphatemic osteomalacia (HO) caused by low-dose ADV therapy have recently been reported. Although HO induced by low-dose ADV therapy is rare, the presence of bone pain in patients treated with ADV should be monitored. Bone scintigraphy can be performed to confirm the occurrence of osteomalacia and to determine the disease extent. Bone scintigraphic and radiological image findings with a brief review of the literature are presented in this article. We report two cases of HO induced by low-dose ADV therapy that showed multifocal increased radiotracer uptakes in the bilateral bony ribs, spines, pelvic bones and lower extremities on whole-body bone scintigraphy. Bone pain gradually improved after phosphate supplementation and by changing the antiviral agent. Whole-body bone scintigraphy is a highly sensitive imaging tool and can show disease extent at once in the setting of the wide range of the clinical spectrum with nonspecific radiological findings. Furthermore, frequent involvement of the lower extremities, as a result of maximum weight bearing, could be an additional scintigraphic clue for the diagnosis of HO. These cases could be helpful for both clinicians prescribing ADV and nuclear physicians to prevent delayed diagnosis and plan further appropriate treatment.

  2. Thalassemia paravertebral tumors and bone marrow scan; Thalassemies, tumeurs paravertebrales et scintigraphie medullaire

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    Huglo, D.; Rose, C.; Deveaux, M.; Bauters, F.; Marchandise, X. [Centre Hospitalier Universitaire, 59 - Lille (France)


    Two first cousins with thalassemia and with a paravertebral mass had had an indium 111 chloride bone marrow scan. Result of scan influenced therapy: medical treatment in one case where an extramedullary erythropoiesis was confirmed, surgical treatment in the other case. The use of dual-isotope SPECT (indium 111 chloride, HDP{sup -99}Tc) constitutes a contribution to the establishment of diagnosis of extramedullary erythropoiesis, giving to bone marrow scintigraphy a merited importance, avoiding the biopsy. (authors). 15 refs., 5 figs.

  3. Usefulness of three-phase bone scintigraphy and SPECT/CT for the diagnosis of bone lesions of systemic sarcoidosis

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    Shigeaki Higashiyama


    The findings of the three-phase bone scintigraphy and SPECT/CT suggested the presence of systemic sarcoidosis; however, a subsequent 18Ffluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT could not exclude the possibility of multiple metastases from testicular tumors. Therefore, testicular enucleation was performed, and the pathological examination confirmed the presence of sarcoidosis.

  4. Whole body bone scintigraphy in tenofovir-related osteomalacia: a case report

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    Di Biagio Antonio


    Full Text Available Abstract Introduction Tenofovir disoproxil fumarate (Viread® is the only nucleotide reverse transcriptase inhibitor currently approved for the treatment of HIV. It is frequently prescribed not only for its efficacy but also for its decreased side effect profile compared with other nucleotide analogs. In addition, it is now increasingly recognized as a cause of acquired Fanconi's syndrome in individuals with HIV. Case presentation We describe a 48-year-old woman infected with HIV, with chronic renal insufficiency, who developed Fanconi's syndrome after inclusion of tenofovir disoproxil fumarate in her antiretroviral therapy. A whole body bone scintigraphy was performed, revealing an abnormal distribution of radiotracer uptake, with characteristic changes compatible with osteomalacia. All symptoms disappeared after tenofovir discontinuation and mineral supplementation. No other explanation for the sudden and complete resolution of the bone disease was found. Conclusion The case highlights the role of whole body bone scintigraphy in the diagnosis of tenofovir-related osteomalacia.

  5. Osteodystrophy in liver cirrhosis. Its demonstration by 99m Tc methylene diphosphonate bone scintigraphy

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    Sezai, Shu-ichi; Ishizawa, Suguru; Yoshino, Katsumasa


    In order to investigate the osteodystrophy in liver cirrhosis, 21 liver cirrhotic patients having no malignancy and normal renal function were examined by 99m Tc Methylene Diphosphonate (MDP) bone scintigraphy. The cirrhotic subjects consisted of 14 males and 7 females. Their age was 31 - 80, average 55.7 years. The causes of their cirrhotic damage were 1 primary biliary cirrhosis, 9 alcoholic, 2 HB viral and 9 cryptogenic. The contents of their illness showed 9 cases in A, 4 in B and 8 in C of Child's classification. Abnormal hot spot(s) on bone in the cirrhotics could be observed very frequently in 99m Tc MDP bone scintigraphy (47.6 %; 10/21 cases). Those spots were seen more frequently in female and advanced stage of cirrhosis. The number of spot(s) increased also in advanced liver cirrhosis. Serum Ca, P and PTH were in normal range. All of three vitamin D/sub 3/ fractions decreased and especially 1,25 (OH)/sub 2/D/sub 3/ was depressed more in scinti-positive cases. Metacarpal bone X-p with an alumimum step wedge as a reference was analyzed by a microdensitometry (MD) method (Inoue T et al) and the pattern of osteopathy (i.e. porosis, malacia and poromalacia) was examined according to Sumi Y et al. MD method was not known yet if there was any definite correlation with bone scintigraphy and the osteopathic pattern belonged to border categories. In conclusion, more attension on hepatic osteodystrophy will be significantly necessary due to the fact that it has been found very frequently in liver cirrhosis. 99m Tc MDP bone scintigraphy is a good means for detection of the hepatic osteodystrophy.

  6. Painful pseudoarthrosis following lumbar spinal fusion: Detection by combined SPECT and planar bone scintigraphy

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    Slizofski, W.J.; Hellman, R.S.; Isitman, A.T.; Collier, B.D.; Carrera, G.F.; Flatley, T.J.


    Twenty-six adult patients more than 6-months post-lumbar spinal fusion were studied. Flexion and extension radiographs showing motion or bone scintigrams, showing focal areas of increased activity within the fusion mass were considered positive for pseudarthrosis. Patients were classified as either symptomatic or asymptomatic. Among the 15 symptomatic patients, scintigraphy had a sensitivity of 0.78 and a specificity of 0.83 which was superior to the 0.43 sensitivity and 0.50 specificity of radiography. Six of the 11 asymptomatic patients had focal areas of increased activity in the bony fusion mass, possibly reflecting painless pseudarthrosis. Planar imaging was substantially enhanced by SPECT in 14 of the 26 cases. It is concluded that for the patient who remains symptomatic after lumbar spinal fusion, bone scintigraphy with SPECT is of significant value in detecting painful pseudarthrosis.

  7. [Usefulness of top-hat transform processing in whole body bone scintigraphy]. (United States)

    Kita, Akinobu; Sugimoto, Katsuya; Tsuchida, Tatsurou; Kishimoto, Takahiro; Toi, Akiko; Shimada, Masato; Adachi, Toshiki


    To assess the usefulness of top-hat transform processing in whole body bone scintigraphy, five radiological technicians interpreted both original and top-hat processed images to determine the improvement of lesion detectability and interpretation time. For the evaluation of detectability, receiver operating characteristic (ROC) analysis was performed. The area under the curve (AUC) calculated from the ROC curve was improved in all observers (from 0.786 to 0.864 in average), although no significant difference was observed. However, the interpretation time was improved significantly (from 24.5 to 16.2 s in average). Top-hat transform processing in whole body bone scintigraphy is thought to be useful for the improvement of lesion detectability and interpretation time.

  8. A clinical study of temporomandibular disorder. The value of bone scintigraphy as an aid to diagnosis

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    Sugiura, Masashi [Nippon Dental Univ. (Japan). School of Dentistry at Niigata


    Temporomandibular disorder (TMD) is still not defined with respect to the point of an entity, terminological problems, and clinical classification and gradings. Moreover, diagnostic problems of internal deranegement and osteodeformity at the temporomandibular joint such as type IV and mechanism of bone remodeling at condylar head are also still not clear. In this investigation, we tried to classify the severity and progressive grading according to the symptoms and objective laboratory data taken from soft tissues such as muscles related to mastication, discs and ligaments, and hard tissues such as condylar head and temporal bone changes around the temporomandibular joint. Preliminary diagnostic clinical tool of the assessment of temporomandibular joint by maens of bone scintigraphy was attributed to the additional diagnostic procedure and research for the bone remodeling for the temporomandibular disorder because this can be defined between subjective and objective symptoms in this disorder. Bone scintigraphy will solve many problems concerning undefined degenerative bone changes in TMD, enable more accurate diagnosis, and the selection of treatment and prognosis in future investigation. Also, it is believed single photon emission computed tomography (SPECT) nuclear bone imaging is a highly accurate diagnostic method for craniomandibular disorders. (author)

  9. Uterine doughnut by intrauterine device-induced photon attenuation on three-phase bone scintigraphy: artifact

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    Sohn, Myung Hee; Jeong, Hwan Jeong; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)


    A 44-year-old female underwent three-phase bone scintigraphy for an evaluation of right hip joint pain. The blood-flow and blood-pool images show a pelvic blush with a photopenic center (doughnut) prior to bladder filling. On the three hour delayed image, the pelvic uptake disappeared. The scintigraphic findings indicated the possibility of an early pregnancy. However, plain radiography demonstrated an intrauterine device. A uterine doughnut developed as a result of photon attenuation of intrauterine device.

  10. Incidence and imaging characteristics of skeletal metastases detected by bone scintigraphy in lung cancer patients

    Directory of Open Access Journals (Sweden)

    Jauković Ljiljana


    Full Text Available Background/Aim. Detection of metastatic bone disease by skeletal scintigraphy is a classical application of nuclear medicine in cancer patients. Detection of bone metastases in patients with lung cancer is necessary for an appropriate treatment modality. The aim of this study was to report the frequency and imaging characteristics of bone metastases detected by bone scintigraphy (BS using technetium-99m phosphonates in patients with lung cancer. Methods. We retrospectively analyzed a total of one hundred patients (78 males and 22 females, mean age of 63.3 years, with the diagnosis of lung cancer, who underwent BS during a three-year period (2003−2005. Scintiscans were classified as positive, negative and suspicious with regard to the presence of bone metastases. Results. The incidence of positive, negative and suspicious findings were 57%. 32% and 11%, respectively. Out of 57 patients with bone metastases, 51 had multiple asymmetric foci of increased tracer activity localized in the ribs, spine, extremities, pelvis, sternum, scapula and skull in 72%, 54%, 49%, 37%, 12%, 9% and 5% of scans, respectively. BS revealed solitary metastases in 6 of the patients. The lesions were located in the lower limbs in three patients and in the upper limbs, pelvis and sternum in the remaining three patients. Conclusion. Bone scintigraphy plays a significant role in staging and selecting of patients for curative lung surgery. Due to the fact that metastatic involvment of the extremities was frequently shown, our study suggests that systematic inclusion of the limbs in BS acquisition should be obligatory.

  11. Bone scintigraphy in acute myeloid leukemia patient with fungal vertebral osteomyelitis

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    Zekiye Hasbek


    Full Text Available The result of the magnetic resonance imaging (MRI study was reported as “metastasis of primary disease on L2-L3 vertebrae” in a 63-year-old male patient, who developed a back pain after receiving four courses of treatment for AML. The patient, who did not respond to pain medication, was sent to nuclear medicine department for a bone scintigraphy. Diffuse increased osteoblastic activity was reported on L2-L3 vertebrae with a suspicion about infection or fracture, together with a focal osteoblastic activity involvement in the right sacroiliac joint in the bone scintigraphy which was made with Tc99m-MDP. In the mean time, the patient complained about progressive loss of strength on bilateral lower extremities and numbness in legs. Repeated MRI was reported as “irregularities in L2-L3 vertebral disc region concordant with infection, prominent thecal pressure, loss of height in L2-L3 vertebrae associated with osteomyelitis and a mass concordant with paravertebral abscess and granulation tissue”. The patient was operated and necrotic tissue was removed by curettage, relieving the compression on L2-L3 and on the disc distance. In culture examination of the sample “candida albicans” was isolated. Antifungal treatment with Amphotericin B was started. Patient's pain was reduced and MRI findings showed some regression in abscess following the treatment. There was improvement in neurological examination. However, relapse in AML was observed in bone marrow aspiration, performed during follow-up and chemotherapy was started again. On the second day of chemotherapy high fever started and cellulitis developed on the right leg. The patient received hemodialysis treatment due to increase in BUN and creatinine levels. Pulmonary edema and associated respiratory insufficiency was developed and the patient died. Fungal infections are one of the most important clinical problems in leukemia patients. However, vertebral osteomyelitis secondary to fungal

  12. Usefulness of bone marrow magnetic resonance imaging and indium-111-chloride bone marrow scintigraphy in patients with various hematological diseases

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    Kobayashi, Yutaka; Umekawa, Tsunekazu; Chikayama, Satoshi [Osaka General Hospital of West Japan Railway Compapy (Japan)] [and others


    This study investigated the ability of magnetic resonance (MR) imaging and indium-111 chloride (In-111) scintigraphy to assess bone marrow in various hematological lesions. The subjects were 7 with aplastic anemia (AA), 4 with myelodysplastic syndrome (MDS), 3 with polycythemia (PC), 3 with essential thrombocythemia (ET), 2 with multiple myeloma (MM), 2 with monoclonal gammopathy of undetermined significance (MGUS), 3 with idiopathic thrombocytopenic purpura (ITP), one with acute lymphocytic leukemia (ALL), and one with secondary anemia due to chronic inflammation (SA). Bone marrow cellularity was assessed on MR images and both uptake and tissue distribution were assessed on In-111 scintigraphy. Hypo-cellularity was seen in all AA patients, but not seen in any other patient in each group. On the other hand, hyper-cellularity was seen in 3 MDS, one PC, all 3 ET, one ALL, and one SA patients. In the group of MM, the vertebral body was seen as heterogenous signal intensity on MR images. Bone marrow was seen as iso-intensity in one MDS, 2 PC, all 2 MGUS, and all 3 ITP patients. In-111 scintigraphy showed decrease or disappearance of tracer uptake and decreased tissue distribution in all 7 AA, one MDS, one PC, and one ALL patients. Increased tracer uptake and enlarged tissue distribution were seen in one MDS, one PC, and one SA patients. One MDS, one ET, all 2 MM, all 2 MGUS, all 3 ITP patients had tracer uptake and tissue distribution that were equal to those in the normal tissues. Since MR imaging and In-111 scintigraphy provided qualitatively different information, the combination of both modalities would contribute to the understanding of bone marrow condition in hematopoietic diseases. (N.K.).

  13. Bone scintigraphy for the investigation of lameness in small animals; Einsatz der Skelettszintigrafie in der Lahmheitsdiagnostik beim Kleintier

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    Bolln, G.; Franke, C. [Tieraerztliche Klinik fuer Kleintiere, Norderstedt (Germany)


    Bone scintigraphy has been used as a helpful method in diagnosing lameness in small animals. It is a sensitive, non-invasive method to evaluate bone lesions and orthopaedic disorders. It provides a functional image of the skeleton and thereby aiding in the localisation and diagnosing of obscure lameness. Compared to human medicine one important difference is the inability of an animal to characterize its pain to the examiner. Another difference is the lacking cooperation of an animal during bone scintigraphy. Before this background are shown on the basis of 5 examples the advantages, the method and the different indication of bone scintigraphy. The technique of this method arrives from a human medicine protocol of a 2-phase-bone-scintigraphy and has to be done under light anaesthesia, to avoid artefacts of movement during acquisitions. The authors are convinced that bone scintigraphy is a very useful and diagnostic method for evaluation of obscure lameness because it can give a quick diagnosis and aimed therapy. Therefore secondary changes and additional costs can be avoided for the animal and its owner. (orig.)

  14. The features of HPOA on dynamic bone scintigraphy: A reflection of underlying pathophysiology

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    Bernard, E.J.; Howman-Giles, R.; Macauley, D.I.; Uren, R.F. [Royal Alexander Hospital for Children, Sydney, NSW (Australia)


    Full text: Hypertrophic pulmonary osteoarthropathy (HPOA) is the clinical syndrome of clubbing, arthritis and periostitis which may accompany a spectrum of underlying disease processes. Increased blood flow through involved extremities is an invariable accompaniment of the syndrome and it is hypothesised that the chronic increase in peripheral blood flow results in the known pathological changes of periosteal inflammation and proliferation, oedema, synovial congestion and exudation and hyperplasia of the finger pulp. The dynamic and blood pool phases of bone scintigraphy provide a unique tool for examining the vascular changes in bone and soft tissues and we describe the previously unreported features of the dynamic bone scan in HPOA. We performed three-phase bone scans on two adolescent patients with cystic fibrosis with knee discomfort. Both studies showed marked hyperaemia to the knees. On the blood pool phase, hyperaemia was seen to the tissues closely related to the periosteum of the long bones in upper and lower limbs, periarticular tissues and finger pulps. The delayed images showed the classic features of HPOA with linear uptake of tracer in the shafts and metaphyseal regions of the long bones and minor periarticular uptake of tracer. A WBC scan performed in one patient showed WBC accumulation in the periosteum of the metaphyseal regions, extending in the shafts, of the distal femurs and proximal tibias. Negligible WBC accumulation was seen in the synovium of the knees reflecting the non-inflammatory nature of the articular changes as is described in most patients with HPOA. In conclusion, the dynamic phases of the bone scan examination in HPOA reflect the pivotal underlying pathophysiological process of abnormally increased blood flow to the periosteal and periarticular tissues of involved long bones and finger pulps and further expands the known diagnostic features of this disease on bone scintigraphy.

  15. Fibrous dysplasia mimicking bone metastasis on both bone scintigraphy and {sup 18}F FDG PET CT: Diagnostic dilemma in a patient with breast cancer

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    KC, Sud Hir Suman; Sharma, Punit; Singh, Har Man Deep; Bal, Chand Rasekhar; Kumar, Rake Sh [India Institute of Medical Sciences, New Delhi (India)


    Bone is the most common distant site to which breast cancer metastasizes. Commonly used imaging modalities for imaging bone metastasis are bone scintigraphy, plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). Although bone scintigraphy gas high sensitivity for detecting bone metastasis, its specificity is low. This is because of the fact that bone scintigraphy images secondary changes in bone rather than just tumor cells {sup 18}F fluorodeoxyglucose ({sup 18}F FDG) PET CT, on the other hand, directly images the tumor cells' glucose metabolism. Unfortunately, similar to bone scintigraphy, benign bone conditions can also show increased {sup 18}F FDG uptake on PET CT, and PET positive asymptomatic fibrous dysplasia can be misinterpreted as a metastasis. Fibrous dysplasia of bone has wide skeletal distribution, with variability of {sup 18}F FDG uptake and CT appearance. It is therefore important to recognize the characteristics of this skeletal dysplasia, to allow differentiation from skeletal metastasis. Bone lesions with {sup 18}F FDG uptake need to be carefully interpreted when evaluating patients with known malignancy. In doubtful cases, fibrous dysplasia should be given as a differential diagnosis and histopathological diagnosis may be warranted, as highlighted in the present case.

  16. Radionuclide bone scintigraphy in the detection of significant complications after total knee joint replacement

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    Smith, S.L.; Wastie, M.L.; Forster, I


    AIM: Post-arthroplasty knee pain is common and clinically it can be difficult to identify those patients with complications requiring active treatment. The aim of this study was to determine the usefulness of{sup 99}Tc{sup m}-MDP bone scintigraphy. METHOD: A retrospective study of all patients having a{sup 99}Tc{sup m}-MDP bone scintigram for a painful knee arthroplasty between 1993 and 1999 was performed. Bone scintigrams were classified as normal or abnormal by a single observer. The results of these investigations were correlated with clinical outcome. RESULTS: Seventy-five patients with painful knee arthroplasties were referred for investigation. A total of 80 bone scintigrams were performed. The average patient age was 66.2 years (42 female and 33 male). The mean time period between surgery and onset of knee pain was 3 years. A final clinical diagnosis based on arthroscopy, open surgery, and extended clinical follow-up was available for all patients. Forty-three (53.8%) of the scintigrams were normal and 37 (46.3%) abnormal. Two patients with a normal bone scintigram has loose prostheses. Thirteen patients with an abnormal study had normal prostheses on follow-up and these tended to be patients scanned less than a year after surgery. The sensitivity, specificity, positive predictive value and negative predictive value of an unequivocally normal or abnormal bone scintigram was 92.3, 75.9, 64.9 and 95.0%, respectively. The pattern of isotope uptake in the abnormal studies was not specific enough to reliably differentiate aseptic from septic loosening. CONCLUSION: Radionuclide bone scintigraphy is useful in the assessment of the painful knee arthroplasty. A negative bone scintigram is reassuring and makes loosening or infection unlikely. Smith, S.L. et al. (2001)

  17. Grafted bone used in acetabular reconstruction: assessment by SPECT scintigraphy

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    Fujikawa, Yosuke [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Torisu, Takehiko [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Takasita, Mitsuhiro [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Masumi, Shogo [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan)


    Single photon emission computed tomography (SPECT) was carried out at the 1st, 6th, and 12th month after the operation and the uptakes on serial SPECT scintigrams were normalized. The horizontal histogram of scintigraphic activity at the level of the central grafted bone in the coronal image was designated the profile curve. Seven patients who had undergone bipolar hip arthroplasty for osteoarthritis of the hip were randomly selected. Five of seven profile curves obtained at the 1st month demonstrated a single peak at the host-graft junction. The profile curve obtained at the 6th month showed two peaks at the host-graft junction and the priphery of the grafted bone in all patients. The profile curve of the 12th month showed slightly increased activity in the center of the grafted bone. This preliminary study demonstrates that comparison of the serial profile curves on SPECT is valuable in evaluating the progress of incorporation of the grafted bone in hip arthroplasty. (orig.)

  18. Can bone scintigraphy predict the final outcome of pasteurized autografts?

    Energy Technology Data Exchange (ETDEWEB)

    Eid, Ahmed Shawky [Ain Shams University, Department of Orthopedic Surgery, Cairo (Egypt); Jeon, Dae-Geun; Cho, Wan Hyeong [Korea Cancer Center Hospital, Department of Orthopedic Surgery, Seoul (Korea)


    As pasteurization is becoming more widely used in limb salvage reconstruction, more study is required to understand about host-graft junction healing, graft revascularization and incorporation, and the incidence and type of complications among pasteurized autografts. This was mainly achieved by follow-up radiography. We aimed to clarify whether Tc99m bone scanning can be considered a reliable method in determining these three parameters. Twenty-seven osteosarcoma patients with pasteurized autograft reconstructions were retrospectively reviewed using available scintigraphic and radiographic follow-up every 6 months postoperatively for 36 months. Follow-up of the unhealed cases was continued for the maximum follow-up period available for each case beyond the original study period, ranging from 1 to 15 months. Tc99m uptake was classified as cold, faint, moderate and high uptake. Junction healing was classified as none, partial and complete healing. Seventy percent of junctions united with a mean of 22 months. Ninety to 100% of junctions showed increased uptake (high or moderate) at one time of the study regardless of final outcome. 85% of the pasteurized grafts showed the characteristic ''tramline appearance''. Four grafts (15%) were complicated: pseudoarthrosis and implant failure (1), fractured plate (1), intramedullary nail (IMN) fracture (1), and prosthesis stem loosening in the host bone (1), with underlying unhealed junctions in all cases. Bone scanning can determine the stages of the graft's rim revascularization and incorporation; however, it cannot detect or predict junction healing or occurrence of complications. Supplementary treatment of unhealed junctions showing either decreased junctional uptake or graft quiescence may be warranted. Otherwise, detection of distant metastasis and early local recurrence remains the main application of Tc99m scanning in the management of bone sarcomas. (orig.)

  19. Two-dimensional fusion imaging of planar bone scintigraphy and radiographs in patients with clinical scaphoid fracture: an imaging study

    DEFF Research Database (Denmark)

    Henriksen, Otto Mølby; Lonsdale, Markus Georg; Jensen, T D


    experienced nuclear medicine physicians. In addition to the diagnosis, the degree of diagnostic confidence was scored in each case. RESULTS: The addition of fusion images changed the interpretation of each of the three observers in seven, four, and two cases, respectively, reducing the number of positive....... Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. PURPOSE: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation...... in patients with suspected scaphoid fracture. MATERIAL AND METHODS: In 24 consecutive patients with suspected scaphoid fracture, a standard planar bone scintigraphy of both hands was supplemented with fusion imaging of the injured wrist. Standard and fusion images were evaluated independently by three...

  20. Two-Dimensional Image Fusion of Planar Bone Scintigraphy and Radiographs in Patients with Clinical Scaphoid Fracture: An Imaging Study

    DEFF Research Database (Denmark)

    Henriksen, O.M.; Lonsdale, M.N.; Jensen, T.D.


    experienced nuclear medicine physicians. In addition to the diagnosis, the degree of diagnostic confidence was scored in each case. Results: The addition of fusion images changed the interpretation of each of the three observers in seven, four, and two cases, respectively, reducing the number of positive....... Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. Purpose: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation...... in patients with suspected scaphoid fracture. Material and Methods: In 24 consecutive patients with suspected scaphoid fracture, a standard planar bone scintigraphy of both hands was supplemented with fusion imaging of the injured wrist. Standard and fusion images were evaluated independently by three...

  1. Insufficiency of Bone Scintigraphy in Vertebral Lesions of Langerhans Cell Histiocytosis Compared to F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Diagnostic Computed Tomography (United States)

    Koç, Zehra Pınar; Şimşek, Selçuk; Akarsu, Saadet; Balcı, Tansel Ansal; Onur, Mehmet Ruhi; Kepenek, Ferat


    Langerhans cell histiocytosis (LCH) is a benign disorder related to the histiocytes which can infiltrate bone tissue. The most effective method for demonstrating severity of this disease is PET/CT and bone scintigraphy might show bone lesions. We present a seventeen year old male patient with disseminated LCH presented with exophtalmos and having multiple vertebral lesions which were identified by F-18 FDG PET/CT scan and diagnostic CT but not in the bone scintigraphy. PMID:25800594

  2. Insufficiency of Bone Scintigraphy in Vertebral Lesions of Langerhans Cell Histiocytosis Compared to F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Diagnostic Computed Tomography

    Directory of Open Access Journals (Sweden)

    Zehra Pınar Koç


    Full Text Available Langerhans cell histiocytosis (LCH is a benign disorder related to the histiocytes which can infiltrate bone tissue. The most effective method for demonstrating severity of this disease is PET/CT and bone scintigraphy might show bone lesions. We present a seventeen year old male patient with disseminated LCH presented with exophtalmos and having multiple vertebral lesions which were identified by F-18 FDG PET/CT scan and diagnostic CT but not in the bone scintigraphy

  3. Aspects of osteo-articular complications in sickle-cell disease on planar bone scintigraphy (infection excluded). Apropos of three cases; Aspects des complications osteoarticulaires de la drepanocytose en scintigraphie osseuse planaire (infection exclue). A propos de trois observations

    Energy Technology Data Exchange (ETDEWEB)

    Oufroukhi, Y.; Biyi, A.; Zekri, A.; Doudouh, A. [HMI Med-V, Service de Medecine Nucleaire, Rabat (Morocco)


    Skeletal complications of sickle-cell anemia are multiple and can appear on the acute (osseous infarction, acute osteomyelitis) or chronic mode (osteonecrosis, chronic osteomyelitis). The radio-labelled diphosphonate bone scintigraphy remains an important tool in the early diagnosis and in the follow-up of these complications and must form part of the initial assessment of the disease. Through clinical observations, the authors undertake to sum up the bone scintigraphy aspects of these complications. (author)

  4. The role of bone scintigraphy in determining the etiology of heel pain

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    Ozdemir, H.; Soyuncu, Y.; Urguden, M. [Akdeniz Univ., Antalya (Turkey). Medical School; Ozdemir, A. [General State Hospital, Antalya (Turkey)


    In this study we aimed to determine the role of bone scintigraphy as an objective diagnostic method in patients with heel pain. Sixty-seven heels of 50 of 182 patients with defined features who attended the orthopedics outpatient clinic with heel pain over a 3-year period, were treated with combined methods such as nonsteroidal anti-inflammatory drugs (NSAID) and contrast baths, stretching exercises and changing of footwear habits. A one year follow-up was established. The criteria identified by Wolgin et al. were used in assessing the results of the treatment. Subcalcaneal spur was demonstrated by radiography in 44 of the 67 heels. There were two different imaging patterns observed on three phase bone scintigraphy. Type I imaging pattern: Focal increased activity in the heel region or normal activity on dynamic and the blood pool phases and focal increased activity at the inferior calcaneal surface in the late static phase. Type II imaging pattern: Diffuse increased activity along the plantar fascia in the dynamic and the blood pool phase, and focal increased activity at the inferior calcaneal surface in the late static phase. There were 34 (50.7%) type I and 18 (26.8%) type II imaging patterns on the scans. Type I and type II imaging patterns were described as osseous and fascial respectively. At the final examination, the results for pattern type I were good in 16 patients (66.7%), fair in 6 patients (25%) and poor in 2 patients (8.3%), whereas in pattern type II results were good in 12 patients (80%) and fair in 3 patients (20%). The recurrence frequency was 4.1% and 6.6%, respectively. Subcalcaneal spur was determined in 70.5% of the patients with osseous pathology and 55.5% of the patients with fascial pathology. Based on this result, it can be ascertained that calcaneal spurs develop during the pathological process causing heel pain. Other findings supporting this claim were the differences in symptom periods of the patients with type I and type II imaging

  5. Detection of bone metastasis in nasopharyngeal carcinoma by bone scintigraphy: A retrospective study in perspective of limited resource settings

    Directory of Open Access Journals (Sweden)

    Akhil Kapoor


    Full Text Available Background: Nasopharyngeal carcinoma (NPC is an aggressive tumor with a significant proportion of patients presenting with distant metastasis. The skeleton is one of the most common sites of distant failure. This retrospective study was performed to analyze the incidence and patterns of skeletal metastasis in NPC detected by bone scintigraphy in resource-poor settings. Materials and Methods: We analyzed records of 301 NPC patients attending our oncology outpatient department from January 2002 to December 2012. Of these, 33 patients who presented with bony pain underwent bone scan (BS for suspect of skeletal metastasis. In patients with positive scans, histological diagnosis to confirm metastasis was attempted. Results: Bone metastasis (BM was found in 19 patients (57.6% of patients undergoing BS, 6.3% of total NPC patients. About 36.8% and 15.8% of BM cases were in the age group 20-29 and 30-39 years, respectively (P = 0.27. 63.1% of metastatic cases were of World Health Organization type-II histology (P = 0.021. Of the patients diagnosed with BM, 52.6% belonged to stage IV at presentation (P = 0.022. Spine was involved in 56% of the positive cases, followed by the pelvis (32%, and ribs (24%. On univariate analysis, histology (P < 0.001, stage at diagnosis (P = 0.007 and age group (P = 0.001 were identified as significant factors affecting BM. However, on multivariate analysis, only stage (P = 0.001 was a significant factor. Conclusion: Bone scintigraphy can be considered in limited resource settings for the evaluation of distant metastasis in the patients of advanced NPC.

  6. Usefulness of {sup 99m}Tc-MDP bone scintigraphy for assessing vascular ingrowth on hydroxyapatite ocular implant

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Bong Joo; Sohn, Hyung Sun [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)


    This study was to evaluate the clinical usefulness of {sup 99m}Tc-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation or evisceration. Twenty-four patients (M : F=7:17, mean age: 36 years), who buried a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Dynamic and static scintigraphy on the orbit fossa were obtained after injection of 740 MBq {sup 99m}Tc-MDP to evaluate the status of vascularization. The study was performed from the 3 to 33 weeks after surgery. According to the visual analysis, activity greater than nasal bridge was graded as 4, equal to the nasal bridge as 3, less than nasal bridge but greater than normal orbit as 2, greater than normal orbit but less than grade 2 as 1. Uptake ratio was also calculated by measuring the implants activity (H) and contralateral orbit activity (N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. Twenty-one patients who had bone scintigraphy at 11 weeks after surgery showed increased uptake above grade 2 and greater H/N ratio than 1.56. Of these, 19 patients who had drilling surgery for permanent peg application showed adequate bleeding during the procedure. The activity grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. Accomplishment of vascularization was not affected by the surgical way such as enucleation or evisceration. {sup 99}mTc-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for {sup 99m}Tc-MDP bone scintigraphy may be 11-20 weeks after enucleation or evisceration.

  7. The value of bone scintigraphy on the determination of the full extent of tumor involvement in jaw bones%核素骨显像在预测颌骨肿瘤范围中的应用

    Institute of Scientific and Technical Information of China (English)

    Jiawei Xie; Chao Ma; Guoming Wang; Shuyao Zuo; Ningyi Li; Muyun Jia


    Objective: To prospectively investigate the value of bone scintigraphy on determining the full extent of tumor involvement in jaw bones and to assess the presence of metastases. Methods: This study had local ethical committee ap-proval, and all patients gave written informed consent. Thirty seven consecutive patients with primary malignant tumor in jaw bones were recruited for the study. Bone scintigraphy was performed in all patients before surgery to measure the full extent of bony involvement, which was compared with histologic findings. Results: Whole body scan revealed one case with multiple bony metastases. Resection specimens of 36 bone neoplasms were pathologically analyzed to identify type and size of each tumor. The lengths of the tumor involvement in jaw bones defined by bone scintigraphy and pathology were 5.62 ± 1.58 cm, 4.48 ± 1.57 cm, respectively (P < 0.05). The tumor negative margins from removed specimens according to bone scintigraphy were pathologically confirmed. With histologic findings as the standard of reference, the accuracy of bone scintigraphy was 100% (36 of 36 patients) in determining the full extent of tumor involvement in jaw bones. Conclusion: Bone scintigraphy tends to offer specific guidelines in determining the appropriate extent of bone resection while entirely clearing the tumor cells and preserving functions whenever possible and in establishing the bony metastases.

  8. The role of bone scintigraphy in Langerhans' cell histiocytosis; a case report; Interet de la scintigraphie osseuse dans l'histiocytose langerhansienne: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Razzouk, M.; Carrier, P.; Darcourt, J. [Centre TEP, Hopital de l' Archet-1, Service Universitaire de Medecine Nucleaire, 06 - Nice (France); Razzouk, M.; Carrier, P.; Darcourt, J. [Federation interhospitaliere, CHU, CAL universitaire de Nice, 06 - Nice (France); Deville, A. [Hopital de l' Archet, Service d' Hemato-Oncologie Pediatrique, 06 - Nice (France); Cadet, G. [Centre Hospitalier intercommunal de Grasse, Service de Pediatrie, 06 - Grasse (France)


    We present one case of bone-Langerhans cell histiocytosis in a three-year-old male child presenting osseous lesions in the skull and the femur, which are very frequent localizations in histiocytosis. Bone scintigraphy is useful for both initial staging and follow-up associated with other imaging modalities. (authors)

  9. A suggestion of reference data for flow distribution at ankle and foot level using quantitative 99Tc-HDP three-phase bone scintigraphy

    DEFF Research Database (Denmark)

    Tøndevold, Niklas; Reving, Sofie; Møller, Nette;


    To determine reference intervals for quantitative 99mTc-hydroxymethylene diphosphonate (99mTc-HDP) three-phase bone scintigraphy regarding flow distribution at ankle and mid-foot level.......To determine reference intervals for quantitative 99mTc-hydroxymethylene diphosphonate (99mTc-HDP) three-phase bone scintigraphy regarding flow distribution at ankle and mid-foot level....

  10. Two-Dimensional Image Fusion of Planar Bone Scintigraphy and Radiographs in Patients with Clinical Scaphoid Fracture: An Imaging Study

    Energy Technology Data Exchange (ETDEWEB)

    Henriksen, O.M.; Lonsdale, M.N.; Jensen, T.D.; Weikop, K.L.; Holm, O.; Duus, B.; Friberg, L. (Dept. of Clinical Physiology/Nuclear Medicine, Glostrup Hospital, Glostrup (Denmark))


    Background: Although magnetic resonance imaging (MRI) is now considered the gold standard in second-line imaging of patients with suspected scaphoid fracture and negative radiographs, bone scintigraphy can be used in patients with pacemakers, metallic implants, or other contraindications to MRI. Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. Purpose: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation in patients with suspected scaphoid fracture. Material and Methods: In 24 consecutive patients with suspected scaphoid fracture, a standard planar bone scintigraphy of both hands was supplemented with fusion imaging of the injured wrist. Standard and fusion images were evaluated independently by three experienced nuclear medicine physicians. In addition to the diagnosis, the degree of diagnostic confidence was scored in each case. Results: The addition of fusion images changed the interpretation of each of the three observers in seven, four, and two cases, respectively, reducing the number of positive interpretations of two of the observers from 11 and nine cases to six and seven cases, respectively. The degree of diagnostic confidence increased significantly in two observers, and interobserver agreement increased in all three pairs of observers from 0.83, 0.57, and 0.73 to 0.89, 0.8, and 0.9, respectively. Conclusion: Image fusion of planar bone scintigrams and radiographs has a significant influence on image interpretation and increases both diagnostic confidence and interobserver agreement

  11. Diagnosis of bone metastases: a meta-analysis comparing {sup 18}FDG PET, CT, MRI and bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hui-Lin; Liu, Tao [Hospital of Soochow University, Department of Orthopaedics, Suzhou (China); Wang, Xi-Ming [Hospital of Soochow University, Department of Radiology, Suzhou (China); Xu, Yong [Public Health School of Soochow University, Department of Epidemiology and Biostatistics, Suzhou (China); Deng, Sheng-Ming [Department of Nuclear Medicine, The first affiliated hospital of Soochow University, Suzhou (China)


    To perform a meta-analysis to compare {sup 18}FDG PET, CT, MRI and bone scintigraphy (BS) for the diagnosis of bone metastases. Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 1995 to January 2010. Software was used to obtain pooled estimates of sensitivity, specificity and summary receiver operating characteristic curves (SROC). 67 articles consisting of 145 studies fulfilled all inclusion criteria. On per-patient basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 89.7%, 72.9%, 90.6% and 86.0% respectively. PET=MRI>BS>CT. (''=''indicated no significant difference, P > 0.05; ''>'' indicated significantly higher, P < 0.05). The pooled specificity estimates for PET, CT, MRI and BS were 96.8%, 94.8%, 95.4% and 81.4% respectively. PET = CT = MRI>BS. On per-lesion basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 86.9%, 77.1%, 90.4% and 75.1% respectively. PET = MRI>BS>CT. The pooled specificity estimates for PET, CT, MRI and BS were 97.0%, 83.2%, 96.0% and 93.6% respectively. PET>MRI>BS>CT. PET and MRI were found to be comparable and both significantly more accurate than CT and BS for the diagnosis of bone metastases. (orig.)

  12. F-8 sodium fluoride position emission tomography/computed tomography for detection of thyroid cancer bone metastasis compared with bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jong; Lee, Won Woo; Park, So Yeon; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)


    The aim of the study was to compare the diagnostic performances of F-18 sodium fluoride positron emission tomography/computed tomography (bone PET/CT) and bone scintigraphy (BS) for the detection of thyroid cancer bone metastasis. We retrospectively enrolled 6 thyroid cancer patients (age = 44.7 ± 9.8 years, M:F = 1:5, papillary:follicular = 2:4) with suspected bone metastatic lesions in the whole body iodine scintigraphy or BS, who subsequently underwent bone PET/CT. Pathologic diagnosis was conducted for 4 lesions of 4 patients. Of the 17 suspected bone lesions, 10 were metastatic and 7 benign. Compared to BS, bone PET/CT exhibited superior sensitivity (10/10 = 100% vs. 2/10 = 20%, p = 0.008), and accuracy (14/17 = 82.4% vs. 7/17 = 41.2%, p < 0.025). The specificity (4/7 = 57.1%) of bone PET/CT was not significantly different from that of BS (5/7 = 71.4%, p > 0.05). Bone PET/CT may be more sensitive and accurate than BS for the detection of thyroid cancer bone metastasis.

  13. Three-phase bone scintigraphy pattern of loosening in uncemented hip prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Rubello, D. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Borsato, N. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Chierichetti, F. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Zanco, P. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Ferlin, G. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy)


    The three-phase bone scintigraphy pattern of loosening in uncemented hip prostheses (UHPs) has not previously been elucidated. We evaluated 28 patients with complicated UHPs who had undergone total hip arthroplasty a very long time previously (range 3-20 years, mean 8.4). All the patients were surgically reviewed: 26 UHPs were found to be loosened and two infected. Nine asymptomatic UHPs were taken as controls. The dynamic phase was invariably negative in both loosened and asymptomatic UHPs while markedly positive in the infected ones. The blood pool phase was positive to various degrees in 16 of the 26 loosened UHPs as well as in the infected UHPs, but was invariably negative in painless replacements. In the bone phase, areas of significantly (discrete to marked) increased uptake were observed in all the loosened prostheses as well as in two-thirds of the asymptomatic ones. However, the regions of the lesser trochanter and/or tip and/or shaft were involved exclusively in the case of the loosened UHPs, and diffuse periprosthetic uptake was found only with loosened or infected implants. Areas of slight methylene diphosphonate (MDP) uptake were found at every periprosthetic site and areas of discrete to marked MDP uptake were commonly found in the acetabulum and/or the greater trochanter with both loosened and painless prostheses and are thus considered to be nonspecific findings. (orig.)

  14. Establishment of an experimental human lung adenocarcinoma cell line SPC-A-1BM with high bone metastases potency by {sup 99m}Tc-MDP bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yang Shunfang [Department of Nuclear Medicine, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China)], E-mail:; Dong Qianggang [Laboratory of Mol-diagnosis, Shanghai Cancer Institute of Shanghai Jiaotong University, Shanghai 200032 (China); Yao Ming [Laboratory of Pathology, Shanghai Cancer Institute of Shanghai Jiaotong University, Shanghai 200032 (China); Shi Meiping [Department of Pathology, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Ye Jianding [Department of Radiology, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Zhao Langxiang [Department of Pathology, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Su Jianzhong; Gu Weiyong [Shanghai Thoracic Tumor Institute, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Xie Wenhui [Department of Nuclear Medicine, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Wang Kankan; Du Yanzhi [State Key Laboratory of Medical Genomics, Ruijin Hospital of Shanghai Jiaotong University, Shanghai 200025 (China); Li Yao [State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Science, Fudan University, Shanghai 200433 (China); Huang Yan [State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Science, Fudan University, Shanghai 200433 (China)], E-mail:


    Background: Bone metastasis is one of the most common clinical phenomena of late stage lung cancer. A major impediment to understanding the pathogenesis of bone metastasis has been the lack of an appropriate animal and cell model. This study aims to establish human lung adenocarcinoma cell line with highly bone metastases potency with {sup 99m}Tc-MDP bone scintigraphy. Methods: The human lung adenocarcinoma cancer cells SPC-A-1 were injected into the left cardiac ventricle of NIH-Beige-Nude-XID (NIH-BNX) immunodeficient mice. The metastatic lesions of tumor-bearing mice were imaged with {sup 99m}Tc-MDP bone scintigraphy on a Siemens multi-single photon emission computed tomography. Pinhole images were acquired on a GZ-B conventional gamma camera with a self-designed pinhole collimator. The mice with bone metastasis were sacrificed under deep anesthesia, and the lesions were resected. Bone metastatic cancer cells in the resected lesions were subjected for culture and then reinoculated into the NIH-BNX mice through left cardiac ventricle. The process was repeated for eight cycles to obtain a novel cell subline SPC-A-1BM. Real-time polymerase chain reaction (PCR) was used to compare the gene expression differences in the parental and SPC-A-1BM cells. Results: The bone metastasis sites were successfully revealed by bone scintigraphy. The established bone metastasis cell line SPC-A-1BM had a high potential to metastasize in bone, including mandible, humerus, thoracic vertebra, lumbar, femur, patella, ilium and cartilage rib. The expression level of vascular endothelial growth factor gene family, Bcl-2 and cell adhesion-related genes ECM1, ESM1, AF1Q, SERPINE2 and FN1 were examined. Gene expression difference was found between parental and bone-seeking metastasis cell SPC-A-1BM, which indicates SPC-A-1BM has metastatic capacity vs. its parental cells. Conclusion: SPC-A-1BM is a bone-seeking metastasis human lung adenocarcinoma cell line. Bone scintigraphy may be used as

  15. Evaluation of Bone or Soft Tissue Infection with Tc-99m Hmpao White Blood Cell Scintigraphy: Semiquantitative Method

    Directory of Open Access Journals (Sweden)

    Funda Aydın


    Full Text Available Objective: Aim the aim of this study was to investigate semiquantitatively the diagnostic performance of Tc-99m hexamethypropylene amine oxime labeled white blood cell (Tc-99m HMPAO-WBC scintigraphy in patients with suspected bone or soft tissue infections. Methods: Material and Method twenty one patients who applied to Nuclear Medicine Departmant (for suspected prosthesis infection, diabetic foot, bone infection, graft infection were evaluated retrospectively. Tc-99m HMPAO WBC scintigraphy imaging were performed to all patients. Planar images were taken 1., 2., and 4. hours after injecting the labeled leukocytes. Evaluation of infection with Tc-99m HMPAO WBC scintigraphy was done semiquantitatively. Relative uptake was determined by setting the region of interest (ROI of lesion area on the anterior view. Rectangular ROI was set on the against limb (nonlesion. The ratio of the average pixel count in the lesion (L to that in the non-lesion (NL (L/NL ratio was calculated at 1., 2., and 4. hours images. Final diagnosis was based on histopathology, microbiologic assays, or clinical and imaging follow-up. Results: 0.55 and 1.55±0.74, 1.42±0.55, 1.40±0.55 in positive and control groups, respectively. Positive group revealed a statistically significant increase L/NL values in the data 3 hours images (p=0.002. However, no statistically significant was found between L/NL values in 3 hours imaging data in control group (p=0.223. All the data in the positive group found a statistically increased steadily. Furthermore, statistically significant difference was found between the positive and control group at 2., and 4. hours images (p=0.015, and p=0.006 .±0.43, 2.05±0.35, 1.90±SD values were found to be 1.74±Results of the 21 patients, 11 were found to have infection (positive group, whereas 10 had normal (control group pathologies on histopathology, microbiologic assays, or clinical and imaging follow-up. First, 2., and 4. hours L/NL (mean Conclusion

  16. Assessment of an evolutive tertiary syphilis by bone scintigraphy. A case report; Evaluation d'une syphilis tertiaire evolutive en scintigraphie osseuse. A propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Andriamisandratsoa, N.; Scheiber, C.; Grucker, D. [Faculte de Medecine, Service de Medecine Nucleaire, Institut de Physique Biologique, 67 - Strasbourg (France); Dery, M. [Medecine Generale, Geriatrie, 67 - Strasbourg (France)


    One patient complained of persisting diffuse bone pain, with greater intensity in the pelvis. HDP {sup 99m}Tc bone scintigraphy showed increased uptake around the right sacro-iliac joint and in the right iliac area due to increased osteoblastic activity, thereby providing functional information about the evolutive nature of the bone lesion. The X-scanner only revealed osteolysis in the same location. A blood test confirmed the diagnosis of tertiary syphilis. (author)

  17. Detection of bone metastases in thyroid cancer patients : Bone scintigraphy or F-18-DG PET?

    NARCIS (Netherlands)

    Phan, Ha T. T.; Jager, Pieter L.; Plukker, John T. M.; Wolffenbuttel, Bruce H. R.; Dierckx, Rudi A.; Links, Thera P.


    Background Similar to the situation in other tumour types, it is currently unclear whether fluorodeoxyglucose (FDG) positron emission tomography (PET) is adequate in the detection of bone metastases of thyroid cancer. The purpose of this retrospective study was to evaluate the performance of bone sc

  18. Diagnostic value of SPECT in bone scintigraphy; Bedeutung der SPECT bei der Knochenszintigraphie

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    Gratz, S.; Becker, W. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin


    Single Photon Emission Computed Tomography (SPECT) reflects the realization of its ability to remove unwanted activity from bone structures with greater contrast. Especially in the spine SPECT improves the diagnostic accuracy compared with planar bone scintigraphy, because smaller structures of single vertebral bodies can be diagnosed with better anatomic resolution due to SPECT with consequently higher sensitivities and specificities. With SPECT, alterations of the lateral part of the vertebral body, pars interacticularis and smaller facet joints can be correctly diagnosed as spondylarthrotic degenerative alterations. In patients with suspected spine malignancies SPECT did not demonstrate to be a reliable instrument for diagnosing malignancy. We recommend to perform SPECT in case of patients with back pain and suspected spine pathologies seen on planar bone scans, since a correct diagnosis of especially benign spondylarthrotic spine lesions is possible with SPECT. With SPECT, a reduction of radiological examinations of 23% should be possible. (orig.) [German] Die Single-Photonenemissionscomputertomographie (SPECT) erlaubt bei der Knochenszintigraphie eine ueberlagerungsfreie Darstellung von Knochenstrukturen mit hoher Kontrastgenauigkeit. Insbesondere bei Wirbelsaeulenerkrankungen ermoeglicht SPECT einen deutlichen diagnostischen Zugewinn gegenueber planaren Aufnahmen, da kleinere Strukturen einzelner Wirbelkoerper aufgrund des hohen anatomischen Aufloesungsvermoegens mit SPECT sehr sensitiv und spezifisch dargestellt werden. Veraenderungen, die sich auf den lateralen Anteil des Wirbelkoerpers, die Pars interarticularis und die kleinen Facettengelenke projizieren, koennen mit SPECT als spondylarthrotisch degenerative Laesionen eingestuft werden. Zwingende SPECT-szintigraphische Kriterien, die eine Laesion als eindeutig maligne nachweisen, gibt es dagegen nicht. Wir denken, dass SPECT bei allen Patienten mit Rueckenschmerzen und planarszintigraphisch suspekten

  19. Guidelines for bone scintigraphy in children; Empfehlungen zur Knochenszintigraphie bei Kindern

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    Hahn, K.; Fischer, S. [LMU Muenchen (Germany). Klinik fuer Nuklearmedizin; Colarinha, P. [Instituto Portugues de Oncologia, Lisbon (Portugal); Gordon, I. [Great Osmond Street Hospital for Children, London (United Kingdom); Mann, M. [Red Cross Hospital, Cape Town (South Africa); Piepsz, A. [AZ VUB and CHU St. Pierre, Brussels (Belgium); Olivier, P. [CHU Vandoeuvre, Nancy (France); Sixt, R. [The Queen Silvia Children' s Hospital, Goeteborg (Sweden); Velzen, J. van


    The guidelines are intended to help nuclear medical teams in their daily routine. The guidelines give information relating to indications, performance of examinations, analysis and interpretation of the diagnostic results. The guidelines should be applied in the context of adopted basic quality criteria in nuclear medicine, requirements of the German radiation protection ordinance, as well as the regulatory codes for radiation protection in the medical field. The guidelines express the opinions of the Paediatric Committee of the EANM and hence focus on compliance with the relevant European standards in nuclear medicine. In order to enhance the specificity of results obtained with a bone scintigraphy, the interpretation of the results should be based on combined analysis with information drawn from X-rays. (orig./CB) [German] Zweck dieser Leitlinie ist es, dem nuklearmedizinischen Team eine Hilfe fuer die taegliche Praxis anzubieten. Diese Leitlinie enthaelt Informationen ueber die Indikationen, die Untersuchungsdurchfuehrung, Auswertung und Interpretation von Knochenszintigraphien bei Kindern. Sie sollte in Verbindung mit den ueblichen Qualitaetskriterien in der Nuklearmedizin und den Vorschriften der Strahlenschutzverordnung sowie der Richtlinie Strahlenschutz in der Medizin gesehen werden. Sie fasst die Meinung des Paediatric Committee der EANM zusammen und ist daher in einzelnen Bereichen mehr dem europaeischen Standard der Nuklearmedizin angepasst. Um die Spezifitaet der Knochenszintigraphie zu erhoehen, sollte immer eine gemeinsame Interpretation von Knochenszintigraphie und Roentgenbildern erfolgen. (orig.)

  20. Evaluation of the diagnostic performance of SPECT coupled to tomodensitometry (SPECT-CT) in the daily practice of bone scintigraphy at the Nuclear Medical station of Nancy; Apport de la TEMP-TDM en complement de la scintigraphie osseuse planaire dans la pratique courante du service de medecine nucluaire de Nancy

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    Netter, F.; Journo, A.; Mayer, J.C.; Grandpierre, S.; Daragon, N.; Karcher, G.; Olivier, P.; Scigliano, S. [CHU Hopital Brabois, Service de Medecine Nucleaire de Nancy, 54 - Vandoeuvre (France)


    Objective: The purpose of our study was to evaluate the diagnostic performance of SPECT coupled to computed axial tomography (SPECT- CT) in our daily practice of bone scintigraphy. Subjects and methods: SPECT- CT obtained as a complement to the planar bone scintigraphy in 39 patients were studied. Each type of image was retrospectively read by two different observers: a nuclear medicine physician who was unaware of SPECT- CT results analysed planar bone scintigraphy, a second one who was unaware of planar bone scintigraphy results analysed SPECT- CT images. In this population of patients, 17 patients were addressed in an oncologic setting. The 22 other patients were addressed for pain of indeterminate origin without neoplastic context. Results: In 13% of the cases, SPECT- CT specified the precise location of increased uptake foci seen on planar bone scintigraphy. In 38% of cases, SPECT- CT confirmed a diagnosis suspected by the planar bone scintigraphy. In 10% of cases, SPECT- CT established a diagnosis that was uncertain with planar bone scintigraphy. In 26% of cases, SPECT- CT brought no additional information. Finally in 3% of cases, SPECT- CT proved to be more sensitive than planar images. Conclusion: Our study demonstrates the utility of SPECT- CT in the daily practice of bone scintigraphy, this complementary imaging study benefited to 74% of our patients. (authors)

  1. Co-existent Paget’s Disease of the Bone, Prostate Carcinoma Skeletal Metastases and Fracture on Skeletal Scintigraphy-Lessons to be Learned

    Directory of Open Access Journals (Sweden)

    Luke I Sonoda


    Full Text Available Bone scintigraphy, despite being non-specific, is a very sensitive and simple investigation for patients with active Paget’s disease of the bone. Skeletal metastases and Paget’s disease may co-exist in the elderly patients as both conditions are commonly seen in this age group. Clinical and radiological correlation may help to improve the diagnostic specificity of a bone scintigram. We report a patient in whom concurrent Paget’s disease and a rib fracture became evident only on repeat scintigraphy following successful treatment of prostate carcinoma skeletal metastases.

  2. Detection of Unknown sites of multiple enchondroma (Ollier′s Disease mimicking like metastasis using bone scintigraphy

    Directory of Open Access Journals (Sweden)

    Koramadai Karuppusamy Kamaleshwaran


    Full Text Available Ollier′s disease characterized by multiple skeletal enchondroma is a rare noninherited disease of unknown etiology. Majority of the skeletal enchondroma are present in the metaphyses and diaphysis of tubular limb bones. Ollier′s disease has a predilection for unilateral distribution. Malignant changes in Ollier′s disease may occur in adult patients. Radionuclide bone scanning is one method used to assess lesions depicted on radiographs or magnetic resonance images that are presumed to be enchondromas. Furthermore, a bone scan may give a clue to the multifocality of the disease. We report a case of right first phalangeal enchondroma in a 23-year-old male, who underwent bone scintigraphy detected multifocal asymmetric right side involvement of radius, humerus, femur, and tibia which confirm a diagnosis of Ollier′s disease.

  3. (99m)Tc-methylene diphosphonate bone scintigraphy findings in posttransplant distal limb syndrome. (United States)

    Derlin, Thorsten; Busch, Jasmin D; Bannas, Peter


    We report a case of posttransplant distal limb syndrome (PTDLS) representing a rare complication in kidney transplant recipients characterized by a pain syndrome of the distal extremities. A 68-year-old man with a history of kidney transplantation presented with symmetrical and incapacitating pain in the feet and knees and underwent whole-body Tc-methylene diphosphonate (MDP) scintigraphy for further evaluation. Planar scintigraphy demonstrated marked tracer uptake in the distal femoral and tibial epiphyses, and magnetic resonance imaging showed corresponding osteoedema. Tc-MDP scintigraphy is a valuable tool for evaluation of the etiology of musculoskeletal pain and may demonstrate typical findings in case of PTDLS.

  4. An Unusual Bone Metastasis Mimicking SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis) Syndrome on Bone Scintigraphy. (United States)

    Ni, Jianming; Tang, Ping


    The costosternoclavicular region is not a common bone metastasis site, and symmetrical involvement is even rarer. Increased tracer uptake in the manubrium and sternoclavicular joints usually gives the typical "bull-horn" appearance seen in SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis). Herein, we report a case of a 47-year-old woman with a history of invasive ductal carcinoma who had undergone left radical mastectomy 3 years earlier and presented with typical increased tracer uptake in the bilateral sternocostoclavicular region resembling the so-called bull horn. The final diagnosis of metastasis from breast cancer was made histopathologically following biopsy.

  5. Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma by whole-body MRI: comparison with bone and {sup 67}Ga scintigraphies

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    Iizuka-Mikami, Masami; Nagai, Kiyohisa; Yoshida, Koji; Tamada, Tsutomu; Imai, Shigeki; Kajihara, Yasumasa; Fukunaga, Masao [Department of Radiology, Kawasaki Medical School, 577 Matsushima, 701-0192, Kurashiki, Okayama (Japan); Sugihara, Takashi; Suetsugu, Yoshimasa; Mikami, Makoto [Department of Hematology, Kawasaki Medical School, 577 Matsushima, 701-0192, Kurashiki, Okayama (Japan)


    The aim of this study was to evaluate the diagnostic potential of whole-body MRI (WB-MRI) for the detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma. WB-MRI, which was performed on 34 patients, consisted of the recording of T1-weighted spin-echo images and a fast STIR sequence covering the entire skeleton. The WB-MRI findings for bone marrow and extramedullary involvement were compared with those from {sup 67}Ga and bone scintigraphies and bone marrow biopsy results. Two MRI specialists reviewed the WB-MRI results and two expert radiologists in the field of nuclear medicine reviewed the bone and {sup 67}Ga scintigraphy findings. Bone marrow and extramedullary involvement of non-Hodgkin's lymphoma were confirmed by follow-up radiographs and CT and/or a histological biopsy. The detection rate of WB-MRI was high. More bone marrow involvement was detected by biopsy, and more lesions were detected by scintigraphies. In total, 89 lesions were detected by WB-MRI, whereas 15 were found by biopsy, 5 by {sup 67}Ga scintigraphy, and 14 by bone scintigraphy. WB-MRI could also detect more extramedullary lesions than {sup 67}Ga scintigraphy; i.e., 72 lesions were detected by WB-MRI, whereas 54 were discovered by {sup 67}Ga scintigraphy. WB-MRI is useful for evaluating the involvement of bone marrow and extramedullary lesions throughout the skeleton in patients with non-Hodgkin's lymphoma. (orig.)

  6. Shoulder uptake in the bone scintigraphy in patients with hemiplegic reflex sympathetic dystrophy syndrome

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    Lee, Jong Jin; Chung, June Key; Lee, Dong Soo; Hong, Joon Beom; Han, Tai Ryoon; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)


    Increased uptake of wrist and hand joints in three phase bone scintigraphy (TPBS) have been used in the detection of reflex sympathetic dystrophy syndrome (RSDS). TPBS frequently shows increased shoulder uptake in the hemiplegic RSDS patients. We investigated the significance of the shoulder uptake in the detection of these patients. Twenty three patients who had hemiplegia due to brain stroke and diagnosed as RSD were enrolled in this study (M:F=16:7, R:L=11:12). The mean age was 63{+-}10 yrs. Ten normal volunteer (mean age: 60{+-}5, M:F=1:9) data was used as control group. TPBS was performed 59{+-}32 days after stoke (acute stage). We obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in three phase images and compared to the count ratios of shoulders in the delayed image. Hand ROI included an ipsilateral wrist. Sensitivity of detecting the affected limb was defined using the right/left count ratio of normal control. Sensitivities using count ratios of hand blood flow, blood pool and delayed image were 45%, 76% and 78%, respectively. Sensitivity of shoulder count ratio was 74%. Log of right/left counts of hand delayed image and that of shoulder delayed image were correlated well with statistical significance (Spearman's R=0.824, p<0.001). Shoulder uptake showed good correlation with hand uptake in the delayed image of TPBS. Shoulder uptake maybe helpful in the diagnosis of reflex sympathetic dystrophy syndrome in patients with hemiplegia.

  7. The diagnostic utility of the flare phenomenon on bone scintigraphy in staging prostate cancer

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    Cook, Gary J.R.; Lewington, Valerie J.; Chua, Sue C. [Royal Marsden Hospital, Department of Nuclear Medicine and PET, Sutton, Surrey (United Kingdom); Venkitaraman, Ram; Huddart, Robert A.; Parker, Christopher C.; Dearnaley, David D.; Horwich, Alan [Royal Marsden Hospital, Academic Urology Unit, Sutton, Surrey (United Kingdom); Sohaib, Aslam S. [Royal Marsden Hospital, Department of Radiology, Sutton, Surrey (United Kingdom)


    Bone scintigraphy (BS) lacks sensitivity for detecting very early skeletal metastases (SM) in prostate cancer (PC) and is often limited by poor specificity. Also scintigraphic flare of SM can occur following effective treatment and mislead an early response assessment. We hypothesised that a flare reaction might amplify the signal from subclinical SM, increasing the sensitivity of BS and that the phenomenon may be specific for metastases. We conducted a prospective study to determine the frequency of the flare phenomenon in patients with metastatic PC starting hormone therapy and to explore its utility in patients with negative staging scans but considered at high risk of SM and in those with equivocal baseline BS abnormalities. Ninety-nine patients commencing first-line hormone therapy had repeat BS at 6 weeks to score a flare reaction. Of 22 patients with unequivocal SM on the baseline scan, a flare occurred in 9 (41%). Of 36 high-risk localised prostate cancer patients with normal BS pre-treatment, the scan became positive for metastases at 6 weeks in 4 (11%). Of 41 patients with pre-treatment scintigraphic abnormalities of uncertain aetiology, a flare occurred in 8 cases (20%). All eight were confirmed to have SM by follow-up and imaging. Of the 33 remaining patients without a flare, 2 developed SM at 14 months and the remainder did not develop SM in a median follow-up period of 36 months. The flare phenomenon following initial hormone therapy can be used to improve both sensitivity and specificity of BS in PC. (orig.)

  8. Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: Head-to-head comparison with CT and bone scintigraphy

    DEFF Research Database (Denmark)

    Baun, Christina; Falch Braas, Kirsten; Gerke, Oke

    ) of the thorax and the upper abdomen is used when looking for organ and lymph node metastases and if osseous metastases is suspected, bone scintigraphy is the preferred modality. Other modalities such as magnetic resonance imaging (MRI) are often used as a supplement to confirm or refute equivocal findings......Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: Head-to-head comparison with CT and bone scintigraphy  Kirsten Falch, Christina Baun, Oke Gerke, , Ziba A. Farahani, Poul F. Høilund-Carlsen, Lisbet B. Larsen*, Marianne Ewertz**, Katrine Søe*** and Malene G. Hildebrandt...... to evaluate the diagnostic accuracy of FDG PET/CT performed one and three hours after injection compared with CT and bone scintigraphy in patients suspected of BC recurrence Methods and materials: 39 patients suspected either clinically or diagnostically of BC recurrence were included. All patients underwent...

  9. Interpretation of distant focal accumulations revealed by bone scintigraphy using Tc-99m HMDP in patients with oral malignant tumors

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    Sato, Tsuyoshi; Morita, Yasuhiko; Iwashita, Youichirou; Kawabata, Yoshihiro; Noikura, Takenori [Kagoshima Univ. (Japan). Dental School


    Focal accumulations in the skeleton were analyzed in order evaluate the usefulness of bone scintigraphy in the detection of distant skeletal metastases originating from malignant oral tumors. Of 350 patients who underwent bone scintigraphy, 62 patients who showed distant focal accumulations in the skeleton were selected. Observations were performed on 12 skeletal regions: the skull, facial bone, clavicle, rib, scapula, sternum, cervical spine, thoracic spine, lumbar spine, pelvis, upper, and lower extremities. Distant focal accumulations were classified into 3 degrees: very hot, moderately hot and warm. A diagnosis of metastatic focal accumulation was made with reference to the CT, MR, X-ray and Ga-67 images, clinical features, and laboratory data. Four of the 350 cases showed skeletal metastases (1.1%). Sixty-two of the 350 patients showed 106 distant focal accumulations, with 10 accumulations proving to be skeletal metastases. The common sites of the skeletal metastases were the lumbar spine, rib, cervical spine, and sternum. Patients with skeletal metastases had a tendency to show distant focal accumulations of very hot images in some skeletal sites, and these focal accumulations were usually accompanied by severe pain. The most common cause of distant focal accumulations except metastasis was traumatic injury. The results in the present study indicate that the distant focal accumulations accompanied by severe pain and simultaneously observed in more than one skeletal site can be interpreted as skeletal metastases. (author)

  10. Comparison of diffusion-weighted whole body MRI and skeletal scintigraphy for the detection of bone metastases in patients with prostate or breast carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas; Doert, Aleksis; Froehlich, Johannes M.; Eckhardt, Boris P.; Meili, Andreas; Scherr, Patrick; Schmid, Daniel T.; Weymarn, Constantin A. von; Willemse, Edwin M.M.; Binkert, Christoph A. [Kantonsspital Winterthur, Department of Radiology, Winterthur (Switzerland); Graf, Nicole [University of Zurich, Clinical Trials Center, Center for Clinical Research, Zurich (Switzerland)


    To prospectively compare the diagnostic accuracy of diffusion-weighted whole body imaging with background whole body signal suppression (DWIBS) with skeletal scintigraphy for the diagnosis and differentiation of skeletal lesions in patients suffering from prostate or breast cancer. A diagnostic cohort of 36 patients was included in skeletal scintigraphy and 1.5 T DWIBS MRI. Based on morphology and signal intensity patterns, two readers each identified and classified independently, under blinded conditions, all lesions into three groups: (1) malignant, (2) unclear if malignant or benign and (3) benign. Finally, for the definition of the gold standard all available imaging techniques and follow-up over a minimum of 6 months were considered. Overall, 45 circumscribed bone metastases and 107 benign lesions were found. DWIBS performed significantly better in detecting malignant skeletal lesions in patients with more than 10 lesions (sensitivity: 0.97/0.91) compared to skeletal scintigraphy (sensitivity: 0.48/0.42). No statistical difference could be found between DWIBS (0.58/0.33) and skeletal scintigraphy (0.67/0.58) in the sensitivity values for malignant skeletal lesions in patients with less than 5 lesions. For benign lesions, scintigraphy scored best with a sensitivity of 0.93/0.87 compared to 0.20/0.13 for DWIBS. Interobserver agreement with Cohen's kappa coefficient was calculated as 0.784 in the case of scintigraphy and 0.663 for DWIBS. With respect to staging, in prostate and breast carcinoma, the DWIBS technique is not superior to skeletal scintigraphy, but ranks equally. However, in the cases with many bone lesions, markedly more metastases could be discovered using the DWIBS technique than skeletal scintigraphy. (orig.)

  11. Metastatic superscan on (99m)Tc-MDP bone scintigraphy in a case of carcinoma colon: Common finding but rare etiology. (United States)

    Chakraborty, Partha Sarathi; Sharma, Punit; Karunanithi, Sellam; Bal, Chandrasekhar; Kumar, Rakesh


    Bone scintigraphy in which there is excessive skeletal radioisotope uptake in relation to soft tissues along with absent or faint activity in the genitourinary tract is known as a 'superscan'. Prostate cancer is the most common malignancy associated with superscan along with others such as lung cancer, breast cancer and haematological malignancies. Here we present the case of a 41 year old woman with carcinoma colon with metastatic superscan on (99m)Tc-MDP bone scintigraphy, a very rare cause for metastatic superscan.

  12. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Punit; Kumar, Rakesh; Singh, Harmandeep; Bal, Chandrasekhar; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Julka, Pramod Kumar [All India Institute of Medical Sciences, Department of Radiation Oncology, New Delhi (India); Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India)


    The objective of the present study was to compare the role of single photon emission computed tomography (SPECT), computed tomography (CT) and SPECT-CT of selected volume in lung cancer patients with indeterminate lesions on planar bone scintigraphy (BS). The data of 50 lung cancer patients (53 {+-} 10.3 years; range 30-75; male/female 38/12) with 65 indeterminate lesions on planar BS (January 2010 to November 2010) were retrospectively evaluated. All of them underwent SPECT-CT of a selected volume. SPECT, CT and SPECT-CT images were independently evaluated by two experienced readers (experience in musculoskeletal imaging, including CT: 5 and 7 years) in separate sessions. A scoring scale of 1 to 5 was used, in which 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each modality, taking a score {<=}2 as metastatic. With receiver operating characteristic (ROC) curve analysis, areas under the curve (AUC) were calculated for each modality and compared. Clinical and imaging follow-up and/or histopathology were taken as reference standard. For both readers SPECT was inferior to CT (P = 0.004, P = 0.022) and SPECT-CT (P = 0.003, P = 0.037). However, no significant difference was found between CT and SPECT-CT for reader 1 (P = 0.847) and reader 2 (P = 0.592). The findings were similar for lytic as well as sclerotic lesions. Moderate inter-observer agreement was seen for SPECT images ({kappa} = 0.426), while almost perfect agreement was seen for CT ({kappa} = 0.834) and SPECT-CT ({kappa} = 0.971). CT alone and SPECT-CT are better than SPECT for accurate characterisation of indeterminate lesions on planar BS in lung cancer patients. CT alone is not inferior to SPECT-CT for this purpose and might be preferred because of shorter acquisition time and wider availability. (orig.)

  13. Bone scintigraphy for neonatal osteomyelitis: simulation by extravasation of intravenous calcium

    Energy Technology Data Exchange (ETDEWEB)

    Balsam, D.; Goldfarb, C.R.; Stringer, B.; Farruggia, S.


    Intravenously administered calcium gluconate has become increasingly popular in the treatment of neonatal tetany. Occasionally, extravasation results in cellulitis, leading to a clinical diagnosis of superimposed osteomyelitis. Osseous scintigraphy, as the accepted modality in the early detection of osteomyelitis, would tend to be used in this circumstance. This case illustrates a false-positive result, probably due to soft-tissue calcification.

  14. Bone scintigraphy with (99m)technetium-hydroxymethylene diphosphonate allows early diagnosis of cardiac involvement in patients with transthyretin-derived systemic amyloidosis

    NARCIS (Netherlands)

    Glaudemans, Andor W. J. M.; van Rheenen, Ronald W. J.; van den Berg, Maarten P.; Noordzij, Walter; Koole, Michel; Blokzijl, Hans; Dierckx, Rudi A. J. O.; Slart, Riemer H. J. A.; Hazenberg, Bouke P. C.


    Objective: To assess the usefulness of bone scintigraphy with (99m)Technetium-hydroxymethylene diphosphonate (Tc-99m-HDP) for the detection of cardiac involvement in a group of patients with ATTR amyloidosis in different phases of disease, to relate the findings to echocardiography, ECG and cardiac

  15. Assessment of vascularization within hydroxyapatite ocular implant by bone scintigraphy: compartive analysis of planar and SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Sohn, Myung Hee; Park, Soon Ah [College of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)


    Complete fibrovascular ingrowth within the hydroxyapatite ocular implant is necessary for peg drilling which is performed to prevent infection and to provide motility to the ocular prosthesis. We compared planar bone scintigraphy and SPECT for the evaluation of the vascularization within hydroxyapatite ocular implants. Seventeen patients (M:F=12:5, mean age: 50.4{+-}17.5 years) who had received a coralline hydroxyapatite ocular implant after enucleation surgery were enrolled. Patients underwent Tc-99m MDP planar bone and SPECT imaging by dual head gamma camera after their implant surgery (interval: 197{+-}81 days). Uptake on planar and SPECT images was graded visually as less than (grade 1), equal to (grade 2), and greater than (grade 3) nasal bridge activity. Quantitative ratio of implanted to non-implanted intraorbital activity was also measured. Vascularization within hydroxyapatite implants was confirmed by slit lamp examination and ocular movement. All but three patients were considered to be vascularized within hydroxyapatite implants. In visual analysis of planar image and SPECT, grade 1 was noted in 9/18 (50%) and 6/18 (33%), respectively. Grade 2 pattern 7/18 (39%) and 4/18 (22%), and grade 3 pattern was 2/18 (11%) and 8/18 (44%) respectively. When grade 2 or 3 was considered to be positive for vascularization, the sensitivity of planar and SPECT imaging were 60% (9/15) and 80% (12/15), respectively. In 3 patients with incomplete vascularization, both planar and SPECT showed grade 1 uptake. The orbital activity ratios on planar imaging were not significantly different between complete and incomplete vascularization (1.96{+-}9.87 vs 1.17{+-}0.08 , p>0.05), however, it was significantly higher on SPECT in patients with complete vascularization (8.44{+-}5.45 vs 2.20{+-}0.87, p<0.05). In the assessment of fibrovascular ingrowth within ocular implants by Tc-99m MDP bone scintigraphy, SPECT image appears to be more effective than planar scintigraphy.

  16. Diagnostic imaging of musculoskeletal infection. Roentgenography; Gallium, indium-labeled white blood cell, gammaglobulin, bone scintigraphy; and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Wegener, W.A.; Alavi, A. (Hospital of the University of Pennsylvania, Philadelphia (USA))


    A great deal of effort has been made to evaluate and define the role of various diagnostic imaging techniques in various clinical settings that complicate the diagnosis of osteomyelitis. Except possibly in neonates, bone scintigraphy remains generally recommended when there has been no previous osseous involvement. In other cases of chronic disease, previous fracture or trauma, prosthesis, and diabetic foot, In-WBC scintigraphy is generally accepted as an appropriate imaging technique. MRI will play an increasingly important role in diagnosing osteomyelitis and may prove to be an important adjunct in these cases. Research continues to improve our current diagnostic armamentarium. In-IgG appears to avoid practical deficiencies encountered with 67Ga and In-WBC; it remains to be seen what role this agent will play in routine clinical practice. All agents to date image inflammation, not infection, and most require delayed imaging sessions, usually at 24 hours. These shortcomings necessitate further research to develop new radiotracers that can provide useful images within several hours and that are specific for infection, perhaps ultimately delineating the particular microorganism involved.84 references.

  17. Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

    Directory of Open Access Journals (Sweden)

    Assadi Majid


    Full Text Available Abstract Introduction Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations. Case presentation A 73-year-old cachectic Asian man (Iranian presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement. Conclusion Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.

  18. Evaluation of Response to Therapy in a Patient with Lung Cancer: Correlation of Sclerotic Bone Lesions with F 18 FDG PET/CT and Bone Scintigraphy

    Directory of Open Access Journals (Sweden)

    Filiz Özülker


    Full Text Available A 64-year-old male patient with small cell lung cancer underwent Fluorine-18 fluorodeoxyglucose (F 18 FDG positron emission tomography (PET/CT scan which revealed multiple F 18 FDG uptake in the spine, both humeri, ribs, pelvis and proximal long bones. There was no obvious lytic or sclerotic bone destruction accompanying these lesions on CT component of the study. After the patient received six courses of chemotherapy a repeat F 18 FDG-PET/CT was performed for evaluation of therapy response. The PET/CT showed the presence of multiple sclerotic lesions on CT without FDG uptake, corresponding to the bone lesions on the previous PET/CT scan. A concomitant Tc 99m Methylene diphosphonate (Tc 99m MDP bone scintigraphy (BS revealed no pathologically increased Tc 99m MDP uptake in the skeletal system. The FDG avid lesions in the skeletal system, which were not sclerotic initially, were transformed into FDG non-avid sclerotic lesions after chemotherapy. This was attributed to the direct effect of previous successful therapy for bone metastases, leading to the transformation of metabolically active disease, into blastic metabolically inactive metastases. In conclusion, a F 18 FDG negative bone lesion, which is sclerotic on CT, may represent post-treatment osteoblastic change rather than active tumor and BS might play a role in the discrimination of these two situations. (MIRT 2011; 20: 29-33

  19. Three-minute SPECT/CT is sufficient for the assessment of bone metastasis as add-on to planar bone scintigraphy

    DEFF Research Database (Denmark)

    Zacho, Helle D; Manresa, José A Biurrun; Aleksyniene, Ramune


    BACKGROUND: The aim of this study is to assess whether ultra-fast acquisition SPECT/CT (UF-SPECT/CT) can replace standard SPECT/CT (std-SPECT/CT) as "add-on" to whole-body bone scintigraphy (WB-BS) for the investigation of bone metastases. Consecutive cancer patients referred for WB-BS who...... diagnosis was reached by two observers for each set of images (WB-BS + standard SPECT/CT or WB-BS + UF-SPECT/CT) using a three-category evaluation scale: M0: no bone metastases; M1: bone metastases; and Me: equivocal findings. RESULTS: Among the 104 included patients, most presented with prostate cancer (n...... in observer agreement between cancer types was detected. SPECT/CT provided a definitive classification in 90 of 104 cases in which WB-BS was not entirely diagnostic. CONCLUSIONS: To investigate potential bone metastases, UF-SPECT/CT can be conducted as add-on to WB-BS to notably reduce the SPECT acquisition...

  20. Detection of bone metastasis of prostate cancer. Comparison of whole-body MRI and bone scintigraphy; Nachweis ossaerer Metastasen des Prostatakarzinoms. Vergleich der Leistungsfaehigkeit der Ganzkoerper-MRT und der Skelettszintigrafie

    Energy Technology Data Exchange (ETDEWEB)

    Ketelsen, D.; Roethke, M.; Aschoff, P.; Lichy, M.P.; Claussen, C.D.; Schlemmer, H.P. [Abt. fuer Diagnostische und Interventionelle Radiologie, Eberhard-Karls-Univ. Tuebingen (Germany); Merseburger, A.S. [Klinik fuer Urologie, Eberhard-Karls-Univ. Tuebingen (Germany); Reimold, M. [Abt. fuer Nuklearmedizin, Eberhard-Karls-Univ. Tuebingen (Germany)


    Purpose: prostate cancer continues to be the third leading cancer-related mortality of western men. Early diagnosis of bone metastasis is important for the therapy regime and for assessing the prognosis. The standard method is bone scintigraphy. Whole-body MRI proved to be more sensitive for early detection of skeletal metastasis. However, studies of homogenous tumor entities are not available. The aim of the study was to compare bone scintigraphy and whole-body MRI regarding the detection of bone metastasis of prostate cancer. Materials and methods: 14 patients with histologically confirmed prostate cancer and a bone scintigraphy as well as whole-body MRI within one month were included. The mean age was 68 years. Scintigraphy was performed using the planar whole-body technique (ventral and dorsal projections). Suspect areas were enlarged. Whole-body MRI was conducted using native T1w and STIR sequences in the coronary plane of the whole body, sagittal imaging of spine and breath-hold STIR and T1w-Flash-2D sequences of ribs and chest. Bone scintigraphy and whole-body MRI were evaluated retrospectively by experienced radiologists in a consensus reading on a lesion-based level. Results: whole-body MRI detected significantly more bone metastasis (p = 0.024). 96.4% of the demonstrated skeletal metastases in bone scintigraphy were founded in whole-body MRI while only 58.6% of the depicted metastases in MRI were able to be located in scintigraphy. There was no significant difference regarding bone metastasis greater than one centimeter (p = 0.082) in contrast to metastasis less than one centimeter (p = 0.035). Small osteoblastic metastases showed a considerably higher contrast in T1w sequences than in STIR imaging. Further advantages of whole-body MRI were additional information about extra-osseous tumor infiltration and their complications, for example stenosis of spinal canal or vertebral body fractures, found in 42.9% of patients. (orig.)

  1. Post-traumatic changes of the temporo-mandibular joint by bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Harris, S.A.; Rood, J.P.; Testa, H.J.


    13 patients who sustained mandibular trauma were investigated with radiographs and scintiscans. The scintiscans showed abnormal uptake of radiopharmaceutical in the temporomandibular joint (TMJ). In patients with a long history of traumatic arthrosis, there was more positive correlation between the scintiscans, and clinical symptoms and histology than between radiographs, and symptoms and histology. In patients with mandibular body fractures and no TMJ symptoms, the scans showed abnormal uptake in the TMJ in 7/8 joints, in the absence of radiographic abnormality. The significance of the abnormal uptake and the value of scintigraphy is discussed.

  2. Role of positron emission tomography and bone scintigraphy in the evaluation of bone involvement in metastatic pheochromocytoma and paraganglioma: specific implications for succinate dehydrogenase enzyme subunit B gene mutations. (United States)

    Zelinka, Tomás; Timmers, Henri J L M; Kozupa, Anna; Chen, Clara C; Carrasquillo, Jorge A; Reynolds, James C; Ling, Alexander; Eisenhofer, Graeme; Lazúrová, Ivica; Adams, Karen T; Whatley, Millie A; Widimsky, Jirí; Pacak, Karel


    We performed a retrospective analysis of 71 subjects with metastatic pheochromocytoma and paraganglioma (30 subjects with mutation of succinate dehydrogenase enzyme subunit B (SDHB) gene and 41 subjects without SDHB mutation). Sixty-nine percent presented with bone metastases (SDHB +/-: 77% vs 63%), 39% with liver metastases (SDHB +/-: 27% vs 47%), and 32% with lung metastases (SDHB +/-: 37% vs 29%). The most common sites of bone involvement were thoracic spine (80%; SDHB+/-: 83% vs 77%), lumbar spine (78%; SDHB +/-: 78% vs 75%), and pelvic and sacral bones (78%; SDHB +/-: 91% vs 65%, P=0.04). Subjects with SDHB mutation also showed significantly higher involvement of long bones (SDHB +/-: 78% vs 30%, P=0.007) than those without the mutation. The best overall sensitivity in detecting bone metastases demonstrated positron emission tomography (PET) with 6-[(18)F]-fluorodopamine ([(18)F]-FDA; 90%), followed by bone scintigraphy (82%), computed tomography or magnetic resonance imaging (CT/MRI; 78%), 2-[(18)F]-fluoro-2-deoxy-d-glucose ([(18)F]-FDG) PET (76%), and scintigraphy with [(123/131)I]-metaiodobenzylguanidine (71%). In subjects with SDHB mutation, imaging modalities with best sensitivities for detecting bone metastases were CT/MRI (96%), bone scintigraphy (95%), and [(18)F]-FDG PET (92%). In subjects without SDHB mutations, the modality with the best sensitivity for bone metastases was [(18)F]-FDA PET (100%). In conclusion, bone scintigraphy should be used in the staging of patients with malignant pheochromocytoma and paraganglioma, particularly in patients with SDHB mutations. As for PET imaging, [(18)F]-FDG PET is highly recommended in SDHB mutation patients, whereas [(18)F]-FDA PET is recommended in patients without the mutation.

  3. FDG PET/CT in Early and Late Stages of SAPHO Syndrome: Two Case Reports With MRI and Bone Scintigraphy Correlation. (United States)

    Dong, Aisheng; Bai, Yushu; Cui, Yong; Zhang, Jian; Zuo, Changjing


    Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare disease, which may be underdiagnosed or misdiagnosed because of nonspecific clinical and imaging findings. We present 2 cases of SAPHO syndrome with MRI, bone scintigraphy, and FDG PET/CT findings. In case 1 with early-stage disease, the active osteitis showed osteolytic bone destruction with increased FDG uptake. In case 2 with late-stage disease, the inactive bone lesions presented as osteosclerosis with normal FDG uptake. Familiarity with the FDG PET/CT findings of SAPHO syndrome in different stages may be helpful for correct diagnosis.

  4. {sup 18}F-Fluoride PET/CT is highly effective for excluding bone metastases even in patients with equivocal bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Bortot, Daniel C.; Amorim, Barbara J.; Oki, Glaucia C.; Santos, Allan O.; Lima, Mariana C.L.; Etchebehere, Elba C.S.C.; Ramos, Celso Dario [State University of Campinas (UNICAMP), Division of Nuclear Medicine, Department of Radiology, Avenue Zeferino Vaz, S/N., PO Box 6149, Campinas (Brazil); Gapski, Sergio B. [Medicina Nuclear Diagnostico e Terapia, Nuclear Medicine Clinic, Campinas (Brazil); Barboza, Marycel F.; Mengatti, Jair [Nuclear and Energy Research Institute (IPEN)-CNEN, Radiopharmacy Directory, Sao Paulo (Brazil)


    Bone scintigraphy (BS) has been used extensively for many years for the diagnosis of bone metastases despite its low specificity and significant rate of equivocal lesions. {sup 18}F-Fluoride PET/CT has been proven to have a high sensitivity and specificity in the detection of malignant bone lesions, but its effectiveness in patients with inconclusive lesions on BS is not well documented. This study evaluated the ability of {sup 18}F-fluoride PET/CT to exclude bone metastases in patients with various malignant primary tumours and nonspecific findings on BS. We prospectively studied 42 patients (34-88 years of age, 26 women) with different types of tumour. All patients had BS performed for staging or restaging purposes but with inconclusive findings. All patients underwent {sup 18}F-fluoride PET/CT. All abnormalities identified on BS images were visually compared with their appearance on the PET/CT images. All the 96 inconclusive lesions found on BS images of the 42 patients were identified on PET/CT images. {sup 18}F-Fluoride PET/CT correctly excluded bone metastases in 23 patients (68 lesions). Of 19 patients (28 lesions) classified by PET/CT as having metastases, 3 (5 lesions) were finally classified as free of bone metastases on follow-up. The sensitivity, specificity, and positive and negative predictive values of {sup 18}F-fluoride PET/CT were, respectively, 100 %, 88 %, 84 % and 100 % for the identification of patients with metastases (patient analysis) and 100 %, 82 % and 100 % for the identification of metastatic lesions (lesion analysis). The factors that make BS inconclusive do not affect {sup 18}F-fluoride PET/CT which shows a high sensitivity and negative predictive value for excluding bone metastases even in patients with inconclusive conventional BS. (orig.)

  5. Comparison of bone scintigraphy and {sup 68}Ga-PSMA PET for skeletal staging in prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pyka, Thomas; Schwaiger, Markus; Eiber, Matthias [Klinikum rechts der Isar der TU Muenchen, Department of Nuclear Medicine, Munich (Germany); Okamoto, Shozo [Klinikum rechts der Isar der TU Muenchen, Department of Nuclear Medicine, Munich (Germany); Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan); Dahlbender, Marielena; Tauber, Robert; Retz, Margitta; Heck, Matthias; Maurer, Tobias [Klinikum rechts der Isar der TU Muenchen, Department of Urology, Munich (Germany); Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan)


    The aim of our study was to compare the diagnostic performance of {sup 68}Ga-PSMA PET and {sup 99m}Tc bone scintigraphy (BS) for the detection of bone metastases in prostate cancer (PC) patients. One hundred twenty-six patients who received planar BS and PSMA PET within three months and without change of therapy were extracted from our database. Bone lesions were categorized into benign, metastatic, or equivocal by two experienced observers. A best valuable comparator (BVC) was defined based on BS, PET, additional imaging, and follow-up data. The cohort was further divided into clinical subgroups (primary staging, biochemical recurrence, and metastatic castration-resistant prostate cancer [mCRPC]). Additionally, subgroups of patients with less than 30 days delay between the two imaging procedures and with additional single-photon emission computed tomography (SPECT) were analyzed. A total of 75 of 126 patients were diagnosed with bone metastases. Sensitivities and specificities regarding overall bone involvement were 98.7-100 % and 88.2-100 % for PET, and 86.7-89.3 % and 60.8-96.1 % (p < 0.001) for BS, with ranges representing results for 'optimistic' or 'pessimistic' classification of equivocal lesions. Out of 1115 examined bone regions, 410 showed metastases. Region-based analysis revealed a sensitivity and specificity of 98.8-99.0 % and 98.9-100 % for PET, and 82.4-86.6 % and 91.6-97.9 % (p < 0.001) for BS, respectively. PSMA PET also performed better in all subgroups, except patient-based analysis in mCRPC. Ga-PSMA PET outperforms planar BS for the detection of affected bone regions as well as determination of overall bone involvement in PC patients. Our results indicate that BS in patients who have received PSMA PET for staging only rarely offers additional information; however, prospective studies, including a standardized integrated x-ray computed tomography (SPECT/CT) protocol, should be performed in order to confirm the presented

  6. Routine bone scintigraphy in primary staging of soft tissue sarcoma - Is it worthwhile?

    NARCIS (Netherlands)

    Jager, PL; Hoekstra, HJ; Leeuw, JA; van der Graaf, WTA; de Vries, EGE; Piers, DA


    BACKGROUND. The incidence of bone metastases in soft tissue sarcoma (STS) patients seems to be low but has not been studied separately. In this study, the authors aimed to determine the value of routine radionuclide bone scanning in preoperative staging of STS patients. METHODS. Preoperative bone sc

  7. Usefulness of bone scintigraphy with HMDP {sup 99m}Tc in one case of atypical tuberculosis; Utilise de la scintigraphie osseuse a l'HMDP-{sup 99m}Tc dans un cas de tuberculose atypique

    Energy Technology Data Exchange (ETDEWEB)

    Evangelista, E.; Itti, E.; Maaloul, M.; Azah, T.; Maignan, M. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service de Medecine Nucleaire, 94 - Creteil (France); Bertocchi, M. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service d' immunologie, 94 - Creteil (France); Oniankitan, O.; Chevalier, X. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service de Rhumatologie, 94 - Creteil (France)


    We present a case of atypical osseous tuberculosis mimicking multiple secondary metastases on radiological and nuclear imaging. A multi-bacterial spondylitis of Ti was first diagnosed on a 56 year-old patient presenting with dorsal pain and neurological deficit of the left arm (fine needle aspiration was negative for Mycobacterium tuberculosis). Whole-body bone scintigraphy identified additional sites, including an asymptomatic sacroiliac lesion, which was accessible to biopsy that gave the final diagnosis of osseous tuberculosis. We propose, in the discussion, a practical review of imaging patterns in cases of typical or atypical osseous tuberculosis. (author)

  8. Usefulness of {sup 99m}Tc-depreotide scintigraphy for the diagnosis of bone metastases in non-small cell lung cancer stage 3-4; Apport de la scintigraphie au {sup 99m}Tc-depreotide pour le diagnostic de lesions osseuses secondaires dans le cancer bronchopulmonaire non a petites cellules stade 3-4

    Energy Technology Data Exchange (ETDEWEB)

    Costo, S.; Dunet, V.; Agostini, D.; Bouvard, G. [CHU Cote de Nacre, Service de Medecine Nucleaire et Isotopes, 14 - Caen (France); Halley, A. [Centre Havrais d' Imagerie Nucleaire, 76 - Montivilliers (France); Bergot, E.; Porret, E.; Zalcman, G. [CHU Cote de Nacre, Service de Pneumologie, 14 - Caen (France)


    Objective In non-small cell lung cancer (NSCLC), metastatic bone involvement is usually assessed using conventional {sup 99m}Tc-HMDP bone scintigraphy, which has a high sensitivity but a poor specificity. The purpose of this study was to assess the usefulness of the {sup 99m}Tc-D scintigraphy for the detection of malignant bone metastases in patients with NSCLC stage III or IV and to compare these results with {sup 99m}Tc-HMDP bone scan findings. Methods Nineteen patients (13 M and 6 F, mean age 59 years) with proven NSCLC, suspected to have stage III or IV were enrolled prospectively. All patients underwent whole body {sup 99m}Tc-HMDP and {sup 99m}Tc-D scintigraphy to detect bone metastases within a mean interval of 14 days. Each focal uptake of {sup 99m}Tc-D or {sup 99m}Tc-HMDP was considered benign or malignant, leading to positive or negative diagnosis for bone involvement. The final diagnosis of bone metastases was established by a lung specialist, on the basis of additional imaging modalities and of 12 months follow-up. Results Twelve bone lesions were identified by {sup 99m}Tc-D scintigraphy, 10 were classified as bone metastases and two were classified as inflammatory bone lesions. Four patients were metastatic. Fifty eight bone lesions were detected by {sup 99m}Tc-HMDP scintigraphy, 26 of whom were considered malignant, eight patients were thus considered metastatic. Thereby, the two nuclear medicine modalities were concordant for 13 patients, that is 68% of cases and were discordant for six patients, representing 32% of cases. Diagnostic sensitivity, specificity and accuracy of depreotide scintigraphy and {sup 99m}Tc-HMDP bone scintigraphy were 75% for both, 93.3 and 73.3%, and 89.5 and 73.3% respectively. Conclusion Our data suggest that depreotide scintigraphy with the same sensitivity, a better accuracy and specificity than those of {sup 99m}Tc-HMDP bone scan can detect metastatic bone lesions in patients with NSCLC suspected to have stage III or IV

  9. Combined bone scintigraphy and indium-111 leukocyte scans in neuropathic foot disease

    Energy Technology Data Exchange (ETDEWEB)

    Schauwecker, D.S.; Park, H.M.; Burt, R.W.; Mock, B.H.; Wellman, H.N.


    It is difficult to diagnose osteomyelitis in the presence of neurotrophic osteoarthropathy. We performed combined (99mTc)MDP bone scans and indium-111 (111In) leukocyte studies on 35 patients who had radiographic evidence of neuropathic foot disease and clinically suspected osteomyelitis. The (111In)leukocyte study determined if there was an infection and the bone scan provided the anatomic landmarks so that the infection could be localized to the bone or the adjacent soft tissue. Seventeen patients had osteomyelitis and all showed increased (111In)leukocyte activity localized to the bone, giving a sensitivity of 100%. Among the 18 patients without osteomyelitis, eight had no accumulation of (111In)leukocytes, seven had the (111In)leukocyte activity correctly localized to the soft tissue, two had (111In)leukocyte activity mistakenly attributed to the bone, and one had (111In)leukocyte accumulation in a proven neuroma which was mistakenly attributed to bone. These three false-positive results for osteomyelitis reduced the specificity to 83%. Considering only the 27 patients with a positive (111In)leukocyte study, the combined bone scan and (111In)leukocyte study correctly localized the infection to the soft tissues or bone in 89%. Uninfected neurotrophic osteoarthropathy does not accumulate (111In)leukocytes. We found the combined bone scan and (111In) leukocyte study useful for the detection and localization of infection to soft tissue or bone in patients with neuropathic foot disease.

  10. {sup 99m}Tc(V)-DMSA scintigraphy in monitoring the response of bone disease to vitamin D{sub 3} therapy in renal osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Sarikaya, A.; Sen, S.; Hacimahmutoglu, S.; Pekindil, G. [Trakya Univ., Edirne (Turkey). Faculty of Medicine


    Renal osteodystrophy (ROD) is a common and serious complication for uremic patients and patients are treated with 1,25-dihydroxyvitamin D{sub 3}. The bone scanning agent {sup 99m}Tc-phosphate has also been used to evaluate in ROD but it is not clear that bone scintigraphy has a role in the follow-up of treatment. In this study {sup 99m}Tc(V)-DMSA scintigraphy was performed in eleven patients [age 40.7{+-}17.3 (mean {+-}SD) yr] with ROD before and after vitamin D{sub 3} therapy. Images were obtained after hemodialysis performed following tracer injection to maintain normal blood levels of the radiopharmaceutical and to reduce soft tissue activity. Lumbar vertebra-to-soft tissue uptake ratios (LUR) were quantified with the planar {sup 99m}Tc(V)-DMSA images. Alkaline phosphatase and parathyroid hormone levels after tretment had significantly decreased compared with pre-therapy. In all patients there was visually decreased uptake in bone structures after treatment. After treatment the mean LUR ratio was significantly lower than those of before treatment (3.59{+-}2.63 vs. 1.65{+-}0.62; p=0.01). LUR values were correlated with pre-therapy alkaline phosphatase and parathyroid hormone. These findings indicate that {sup 99m}Tc(V)-DMSA scintigraphy is sensitive in evaluating the response of ROD to vitamin D{sub 3} therapy. (author)

  11. Bone marrow metastases from alveolar rhabdomyosarcoma with impressive FDG PET/CT finding but less-revealing bone scintigraphy. (United States)

    Yang, Jigang; Zhen, Lishi; Zhuang, Hongming


    An 18F-FDG PET/CT scan was performed in a 26-year-old man with a known alveolar rhabdomyosarcoma for staging. The PET/CT scan showed abnormally increased FDG activity involving almost all bones in the imaged regions. In contrast, 99mTc-MDP whole-body bone scan demonstrated only very limited bone metastases.

  12. [Evaluation of multiple myeloma with bone scintigraphy using Tc 99 diphosphonate. Review of the literature]. (United States)

    Solis, O J; Gonzales, R; De Luca, S; McKusick, K A; Potsaid, M S


    Bone Scanning using 99m Tc-Diphosphonate is another diagnostic modality in the evaluation of multiple mieloma which allows the identification of bone lesions not demonstrable by conventional radiography. The use of 99m Tc-Diphosphonate is more convenient and less harmful than other radioactive isotopes utilized before.

  13. Comparison of (18)F-FDG PET/CT and (99 m)Tc-MDP bone scintigraphy for detection of bone metastasis in osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Byung Hyun; Lim, Ilhan; Kim, Byung Il; Choi, Chang Woon; Lim, Sang Moo [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Nuclear Medicine, Seoul (Korea, Republic of); Kong, Chang-Bae; Song, Won Seok; Cho, Wan Hyeong; Jeon, Dae-Geun; Lee, Soo-Yong [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Orthopedic Surgery, Seoul (Korea, Republic of); Koh, Jae-Soo [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Pathology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)


    We compared the diagnostic performance of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and (99 m)Tc-methylene diphosphonate bone scintigraphy (BS) for the detection of bone metastasis in osteosarcoma. We retrospectively reviewed 206 patients with stage II-IV osteosarcoma treated with surgery and chemotherapy as well as at least one paired PET/CT and BS scan (defined as an examination). PET/CT and BS images were interpreted separately. When analyzing the diagnostic yield of a combination of PET/CT and BS (PET/CT+BS), an examination was considered positive if either PET/CT or BS scored positive. The final diagnosis was obtained from histological findings or clinical follow-up with imaging studies for at least 6 months. Diagnostic performances of PET/CT, BS, and their combinations were calculated. Out of 833 examinations in 206 patients, 55 with 101 lesions in 38 patients were confirmed as bone metastases. The sensitivity, specificity, and diagnostic accuracy were 95, 98, and 98 %, respectively, for PET/CT; 76, 97, and 96 %, respectively, for BS; and 100, 96, and 97 %, respectively, for PET/CT+BS in an examination-based analysis. Lesion-based analysis demonstrated that the sensitivity of PET/CT+BS (100 %) was significantly higher than that of PET/CT (92 %) or BS (74 %) alone. BS detected significantly less bone metastases in the growth plate region than outside the growth plate region (22 vs. 77 %). PET/CT is more sensitive and accurate than BS for diagnosing bone metastases in osteosarcoma. The combined use of PET/CT and BS improves sensitivity. (orig.)

  14. The skeleton in congenital, generalized lipodystrophy: evaluation using whole-body radiographic surveys, magnetic resonance imaging and technetium-99m bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fleckenstein, J.L.; Bonte, F.J. (Univ. of Texas Southwestern Medical Center, Dallas, TX (United States). Dept. of Radiology); Garg, A. (Univ. of Texas Southwestern Medical Center, Dallas, TX (United States). Dept. of Internal Medicine); Vuitch, M.F. (Univ. of Texas Southwestern Medical Center, Dallas, TX (United States). Dept. of Pathology); Peshock, R.M. (Univ. of Texas Southwestern Medical Center, Dallas, TX (United States). Dept. of Radiology Univ. of Texas Southwestern Medical Center, Dallas, TX (United States). Dept. of Internal Medicine)


    Congenital generalized lipodystrophy (CGL) is a rare genetic disease characterized by the absence of body fat from birth. Focal bone lesions have also been reported, but their pathophysiology is poorly understood. To characterize skeletal abnormalities further in 3 patients with CGL, we employed whole-body radiographic skeletal surveys, magnetic resonance imaging (MRI, including gadolinium enhancement), and triple phase technetium-99m methylene diphosphonate bone scintigraphy. We conclude that the appendicular skeleton of patients with CGL is diffusely abnormal and is predisposed to focal osteolysis and cyst formation. (orig./DG).

  15. Bone scintigraphic assessment of multifocal sequelae of staphylococcus aureus septicemia, a case report; Un cas de septicemie a staphylocoque dore: evaluation des sequelles multifocales en scintigraphie osseuse

    Energy Technology Data Exchange (ETDEWEB)

    Andriamisandratsoa, N.; Yu, O.; Grucker, D. [Faculte de Medecine, Service de Medecine Nucleaire, Institut de Physique Biologique, 67 - Strasbourg (France); Bole, J.C.; Weber, J.C. [Hopital Universitaire de Strasbourg, Hopital Civil, Service de Medecine Interne A, 67 - Strasbourg (France)


    A 71-year old patient suffering from untreated non-insulin-dependent diabetes presented anti-inflammatory drug-resistant lumbalgia with referred inguinal pain either on the right or left side, corresponding to the first signs of septicemia due to staphylococcus aureus, with urinary onset. Despite specific antibiotic treatment, pulmonary, cardiac and neurological complications followed. Simultaneous investigations by MRI and bone scintigraphy performed in the remitting patient showed multiple septic metastatic localization in the soft tissues and bones. It was hence necessary to pursue the antibiotic therapy to avoid relapses. (author)

  16. Concurrent bisphosphonate-related bilateral atypical subtrochanteric fractures and osteonecrosis of the jaw on bone scintigraphy. (United States)

    Kim, Jo Eun; Yun, Mijin; Lim, Sung-Kil; Rhee, Yumie


    An 82-year-old woman presented with bilateral thigh pain. She had pain in her right thigh operated for a low-trauma fracture 2 years earlier and newly developed pain in her left thigh without trauma. A whole-body bone scan revealed increased tracer uptake in her bilateral subtrochanteric femoral shafts and in the right mandible without evidence of metastatic bone disease. She had been taking bisphosphonates for 7 years to treat osteoporosis and was soon diagnosed with atypical subtrochanteric fractures and bisphosphonate-related osteonecrosis of the jaw. The bone scan simultaneously identified 2 serious adverse effects of long-term use of bisphosphonates.

  17. Disturbances of fluid balance reduce the image quality of bone scintigraphy. Experimental studies in mice

    Energy Technology Data Exchange (ETDEWEB)

    Cronhjort, M.; Schnell, P.-O.; Jacobsson, H. (Karolinska Sjukhuset, Stockholm (Sweden))


    The effects of hydration, dehydration and osmotic diuresis on the activity distribution of bone-seeking radiopharmaceuticals have been studied in an experimental mouse system. It was found that any change of the water balance impairs the activity distribution of the radiolabelled phosphonate in the potential bone scintigraphic image. The findings suggest that in order to maintain image quality, elderly patients should not be instructed to drink a large volume of fluid after the administration of a bone-seeking radiopharmaceutical. Further investigations, though, have to be performed in humans. (author).

  18. [The use of SPECT-CT with 99mTc-labeled phosphates in patients with suspected skeletal metastases in planar bone scintigraphy]. (United States)

    Krzhivitskiĭ, P I; Kanaev, S V; Novikov, S N; Zhukova, L A; Krivorot'ko, P V; Ponomareva, O I; Negustorov, Iu F


    We assessed the diagnostic capabilities of SPECT-CT in patients with unclear and suspicious on the secondary lesion with bone scintigraphy background in planar mode (227 patients (mean age - 57 years) with various primary malignancies). All patients underwent planar scintigraphy with 99mTc-labeled phosphates in the "whole body" mode and then - bizonal single-photon-emission computed tomography combined with X-ray computed tomography (SPECT-CT). In patients with the presence of lesions in the skeleton, suspicious on metastases, there was conducted comparison with the data of SPECT-CT. During planar investigation the suspicion on metastases was detected in 41 patients (18%). The use of SPECT-CT allowed excluding metastases in 29 (71%) and confirmed in 7 (17%) of them. In 5 (12%) cases the nature of the changes remained unclear. Thus, in cancer patients with revealed by planar bone scintigraphy unclear or suspicious for metastatic foci in the skeleton, the use of SPECT-CT allowed in most cases (88%) to clarify the nature of these changes.

  19. Preparation and evaluation of a radiogallium complex-conjugated bisphosphonate as a bone scintigraphy agent

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Kazuma, E-mail: [Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa 920-1192 (Japan); Takai, Kenichiro; Kanbara, Hiroya; Kiwada, Tatsuto [Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa 920-1192 (Japan); Kitamura, Yoji; Shiba, Kazuhiro [Advanced Science Research Center, Kanazawa University, Kanazawa 920-8640 (Japan); Odani, Akira [Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa 920-1192 (Japan)


    Introduction: {sup 68}Ga is a radionuclide of great interest as a positron emitter for positron emission tomography (PET). To develop a new bone-imaging agent with radiogallium, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) was chosen as a chelating site and Ga-DOTA complex-conjugated bisphosphonate, which has a high affinity for bone, was prepared and evaluated. Although we are interested in developing {sup 68}Ga-labeled bone imaging agents for PET, in these initial studies {sup 67}Ga was used because of its longer half-life. Methods: DOTA-conjugated bisphosphonate (DOTA-Bn-SCN-HBP) was synthesized by conjugation of 2-(4-isothiocyanatebenzyl)-1,4,7,10-tetraazacyclododecane-1,4,7, 10-tetraacetic acid to 4-amino-1-hydroxybutylidene-1,1-bisphosphonate (alendronate). {sup 67}Ga-DOTA-Bn-SCN-HBP was prepared by coordination with {sup 67}Ga, and its in vitro and in vivo evaluations were performed. Results: {sup 67}Ga-DOTA-Bn-SCN-HBP was prepared with a radiochemical purity of over 95% without purification. {sup 67}Ga-DOTA-Bn-SCN-HBP had great affinity for hydroxyapatite in binding assay. In biodistribution experiments, {sup 67}Ga-DOTA-Bn-SCN-HBP accumulated in bone rapidly but was hardly observed in tissues other than bone. Pretreatment of an excess amount of alendronate inhibited the bone accumulation of {sup 67}Ga-DOTA-Bn-SCN-HBP. Conclusions: {sup 67}Ga-DOTA-Bn-SCN-HBP showed ideal biodistribution characteristics as a bone-imaging agent. These findings should provide useful information on the drug design of bone imaging agents for PET with {sup 68}Ga.

  20. Baseline patterns of bone scintigraphy in patients with established post-poliomyelitis paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Marafi, Fahad A.; Esmail, Abdulredha A.; Elgazzar, Abdelhamid H. [Mubarak Alkabeer Hospital and Kuwait University, Departments of Nuclear Medicine, P.O. Box 24923, Safat (Kuwait); Al-Said Ali, Ali [Ministry of Health, Department of Surgery, Mubarak Alkabeer Hospital, Safat (Kuwait)


    Post-poliomyelitis syndrome causes variable musculoskeletal manifestations including pain, muscle weakness and fatigue. These manifestations are commonly secondary to overuse and misuse of muscles and joints and could follow a fall. Bone scan can be useful in determining the underlying cause and follow-up. The objective of this study was to describe the late scintigraphic patterns on bone scan following poliomyelitis. Bone scans of 8 adult patients (7 female and 1 male), aged 35 to 53 years, who were known to have paralytic poliomyelitis, were retrospectively studied. Six patients had unilateral while 1 had bilateral disease. All patients had three-phase bone scan and 5 had SPECT study as well. Studies were reviewed by two qualified nuclear medicine physicians and findings were recorded and analyzed. Several patterns were consistently identified: decreased blood pool activity in the affected lower limb of all patients; deformed ipsilateral hemi-pelvis with reduced uptake on the affected side in all patients with unilateral disease; stress changes with increased uptake in the bones of the contra-lateral lower extremity; and degenerative changes in multiple joints (shoulder, knee, hip, ankle and spine). Significant scoliosis was only noted in the patient with bilateral disease. Scintigraphic patterns on bone scan associated with the post-poliomyelitis syndrome and persistent weakness following a distant episode of poliomyelitis have been described. Awareness of these characteristic scintigraphic findings may facilitate an accurate diagnosis and lead to more appropriate patient management. (orig.)

  1. Quantitative Assessment of Radioisotope Uptake in Condyles by SPECT Bone Scintigraphy

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    Z. Dalili


    Full Text Available Statement of problem: Condylar hyperplasia of the mandible is a self limiting abnormality which can cause facial asymmetry, temporomandibular joint (TMJdysfunction and esthetic problems. Treatment planning is based on the results of isotope scanning, clinical findings and patient age. Single photon emission tomography(SPECT is considered to be a sensitive method in the calculation of condylar uptake differences.Purpose: The aim of this study was to determine the growth activity occurring in the mandibular condyles, and to devise an index of side-to-side differences in condylar activity in different individuals.Material and Methods: 38 patients, with an age range of 13 to 34 years, undergoing skeletal scintigraphy for a variety of conditions, were chosen for this study. 25 mci TC-99 was injected to all subjects in order to assess the difference between right (Rt andleft (Lt condylar uptake percentage and to calculate the Lt to Rt condylar uptake ratio.The normal index was determined.Results: The maximum amount of difference between the uptake of Rt and Lt condyles was 6.2 percent (Lt side and Rt side were 53.1 % and 46.9 %, respectively in the male patients and 5.7 percent in the female patients (Lt side and Rt side were 52.85 % and 47.15 %, respectively. The condylar activity difference and ratio of Lt to Rt condylar uptakes did not show a significant difference between the male and female groups.Conclusion: The difference between the growth activity of RT and LT normal TMJs was less than 6.2 percent.

  2. Juvenile Dermatomyositis Diagnosed by {sup 99m}Tc-HDP Three-phase Bone Scintigraphy

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    Kim, Ja Hye; Song, Ho Chun; Yoo, Su Ung; Ha, Jung Min; Chong, A Ri; Oh, Jong Ryool; Min, Jung Joon; Bom, Hee Seung; Jeong, Eun Hui; Lee, Min Chul [Chonnam National University Hospital, Gwangju (Korea, Republic of)


    Juvenile dermatomyositis is a common inflammatory muscle disease of childhood, characterized by weakness in proximal muscles and specific skin rash. In case of juvenile dermatomyositis without characteristic clinical features, non-invasive imaging tools such as {sup 99m}Tc-HDP three-phase bone scan are very helpful in diagnostic workup of myopathies. We report a case of 13-year old female with juvenile dermatomyositis, in which {sup 99m}Tc-HDP three-phase bone scan was useful in diagnosis and assessing therapy response.

  3. Influence of the Different Primary Cancers and Different Types of Bone Metastasis on the Lesion-based Artificial Neural Network Value Calculated by a Computer-aided Diagnostic System,BONENAVI, on Bone Scintigraphy Images

    Directory of Open Access Journals (Sweden)



    Full Text Available Objective(s: BONENAVI, a computer-aided diagnostic system, is used in bone scintigraphy. This system provides the artificial neural network (ANN and bone scan index (BSI values. ANN is associated with the possibility of bone metastasis, while BSI is related to the amount of bone metastasis. The degree of uptake on bone scintigraphy can be affected by the type of bone metastasis. Therefore, the ANN value provided by BONENAVI may be influenced by the characteristics of bone metastasis. In this study, we aimed to assess the relationship between ANN value and characteristics of bone metastasis. Methods: We analyzed 50 patients (36 males, 14 females; age range: 42–87 yrs, median age: 72.5 yrs with prostate, breast, or lung cancer who had undergone bone scintigraphy and were diagnosed with bone metastasis (32 cases of prostate cancer, nine cases of breast cancer, and nine cases of lung cancer. Those who had received systematic therapy over the past years were excluded. Bone metastases were diagnosed clinically, and the type of bone metastasis (osteoblastic, mildly osteoblastic,osteolytic, and mixed components was decided visually by the agreement of two radiologists. We compared the ANN values (case-based and lesion-based among the three primary cancers and four types of bone metastasis.Results: There was no significant difference in case-based ANN values among prostate, breast, and lung cancers. However, the lesion-based ANN values were the highest in cases with prostate cancer and the lowest in cases of lung cancer (median values: prostate cancer, 0.980; breast cancer, 0.909; and lung cancer, 0.864. Mildly osteoblastic lesions showed significantly lower ANN values than the other three types of bone metastasis (median values: osteoblastic, 0.939; mildly osteoblastic, 0.788; mixed type, 0.991; and osteolytic, 0.969. The possibility of a lesion-based ANN value below 0.5 was 10.9% for bone metastasis in prostate cancer, 12.9% for breast cancer, and 37

  4. Diagnostic efficacy of bone scintigraphy, magnetic resonance imaging, and positron emission tomography in bone metastases of myxoid liposarcoma. (United States)

    Conill, Carlos; Setoain, Xavier; Colomo, Luis; Palacín, Antonio; Combalia-Aleu, Andreu; Pomés, Jaime; Marruecos, Jordi; Vargas, Mauricio; Maurel, Joan


    Myxoid liposarcomas (MLS) have a tendency to metastasize to unusual sites. We report an unusual case of bone metastases not detected by bone scan and neither by fluorodeoxyglucose positron emission tomography (PET-FDG) and successfully identified with magnetic resonance imaging (MRI) in a patient with metachronic MLS. Histopathological examination of the primary tumor evidenced a tumor with unfavorable prognostic markers, and the biopsy of an iliac bone lesion confirmed the diagnosis of metastatic disease. On histological grounds, the tumor showed features of a more differentiated neoplasm without foci of round cells or necrosis in the latter. MRI allowed the identification of disseminated disease compared to computed tomography (CT) and PET scans. Thus, because of the heterogeneous histological features of MLS and the biological behavior of the disease, a combined approach of FDGPET-CT and MRI, may allow a more accurate staging of soft tissue sarcomas.

  5. Scintigraphy of spinal disorders in adolescents

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    Mandell, G.A. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States)); Harcke, H.T. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States))


    Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

  6. SPECT/CT imaging in bone scintigraphy of a case of clavicular osteoma

    Directory of Open Access Journals (Sweden)

    Yuka Yamamoto


    diphosphonate (HMDP. Whole-body image showed a focus of intensely increased uptake in the clavicle. Single photon emission computed tomography/ computed tomography (SPECT/CT images were also acquired and clearly showed intense uptake at the tumor site. Integrated SPECT/CT imaging supplies both functional and anatomic information about bone: the SPECT imaging improves sensitivity compared with planar imaging, the CT imaging provides precise localization of the abnormal uptake, and information on the shape and structure of the abnormalities improves the specificity of the diagnosis.

  7. A bone scintigraphy view of melorheostosis: about of a clinical report; Aspect scintigraphique de la melorheostose: a propos d'une observation clinique

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    Oufroukhi, Y.; Ismaili, N.A.; Caoui, M.; Ben Rais, N. [Centre Hospitalier Universitaire Avicenne, Rabat (Morocco)


    Melorheostosis is an unusual osteopathy. It is featured by a hyperostosis, known as 'dripping candle wax'; over the entire length of a member, and being accompanied by a muscular atrophy and a deterioration of dermis and epidermis, often monomelic and of chronic evolution. It remains of unknown etiology. Through a general review of the literature, and a case of melorheostosis of the lower limbs, we propose to study the clinical and radiological views of this pathology as well as the role of the bone scintigraphy in the initial assessment and the monitoring. (author)

  8. 脊柱转移瘤的MRI与核素骨显像的对比研究%A Comparative Study of MRI and Bone Scintigraphy in Spinal Metastases

    Institute of Scientific and Technical Information of China (English)

    张岚; 程敬亮


      目的比较MRI与核素骨显像对脊柱转移瘤的敏感性与诊断价值。方法对51例经临床确诊的脊柱转移瘤分别行MRI和核素骨显检查,比较二者的阳性病例检出率和阳性病灶检出率。结果 MRI与骨显像对阳性病例的检出率无统计学差异,阳性病灶检出率MRI高于骨显像,有统计学差异。结论 MRI对脊柱转移瘤的检测比骨显像更为敏感,对病灶的检出能力高于骨显像,是诊断脊柱转移瘤最敏感的影像学检查方法。%Objective To compare the sensitivity and diagnostic value of MRI and bone scintigraphy in spinal metastases. Methods MRI and bone scintigraphy were performed in 51 patients with spinal metastases confirmed by clinic. The detection rate of positive case and positive lesion were compared. Results There was no difference between MRI and bone scintigraphy in detection rate of positive case. MRI was superior to bone scintigraphy in detection rate of positive lesion. Conclusion MRI was more sensitive than bone scintigraphy in detecting spinal metastases, and MRI was superior to bone scintigraphy in detection of lesions. So MRI is the most sensitive modality for diagnosis of spinal metastases.

  9. 核素骨显像与MRI对骨转移癌的诊断比较%The comparation of skeletal scintigraphy and MRI in diasnosing bone metastasis

    Institute of Scientific and Technical Information of China (English)

    黄泽黎; 张宁; 张洋; 罗伟军; 曾晓红; 梁少强; 孙宗文


    目的 评价骨显像与MRI在诊断骨转移瘤中的价值.方法 对64例可疑骨转移的恶性肿瘤患者行核素骨显像与MRI检查(两种检查间隔时间不超过2周),凡骨显像表现为明显的放射性聚集或缺损和(或)MRI的T1加权像表现为低信号强度且T2加权像表现为高低混杂或高信号强度和(或)骨质破坏的椎体均认为是肿瘤骨转移.结果 核素骨显像能有效地检出全身骨转移癌灶;MRI对扫描范围内骨转移癌检出的病灶数高于核素骨显像;核素骨显像单发病灶有一定的假阳性(3,9),MRI单发病灶假阳性较少(0/7),但部分病例(3/7)经核素骨显像检查证实为多发骨转移;MRI能了解局部病灶的准确位置及周围软组织情况.结论 核素骨显像较MRI能更有效地检出全身骨转移癌灶,是早期诊断转移癌的首选方法 ;MRI特异性更高,解剖定位明确,并能显示软组织病灶,两种检查方法 相互结合,对骨转移的诊断和治疗有重要意义.%Objective To evaluate the values of skeletal scintigraphy and MRI in detecting osseous metastasis.Methods Skeletal scintigraphy and MRI were performed in sixty-four patients with suspicious bone metastasis malignant tumor;all patients underwent skeletal scintigrapghy and MRI examinations within two weeks.Metastatic foci were defined as lesions that showed aggravations/defections of bone tracer uptakes on serial scans,and/or low signal intensity on T1WI and/or high signal intensity on T2WI of MRI,and/or bone destruction.Results Planar skeletal scintigraphy could detect the whole body bone metastasis lesions more effectively;MRI discovered more metastasis lesions than planar skeletal scintigraphy in the range of the MRI scaned;certain amounts of false-positive cases might be present in single focal cases by skeletalscintigraphy(3/9).Relatively,MRI had less false-positive cases in single foci(0/7),but the three single foci cases detected by MRI were confirmed as multi

  10. [The position of scintigraphy in traumatology]. (United States)

    Kaiser, C; Neck, K; Ritter, R; Glanzmann, C; Schwarz, H


    A report on the findings of skeletal scintigraphy in 80 cases of traumatic bone lesions is discussed. After a short survey on the physiological process in the activity ensilage, the assertion of the scintigraphy is compared to the X-ray. The indication which has been approved in practice is discussed and described. In correct indication scintigraphy is a valuable diagnostic measure and it may influence the procedure.

  11. An osteomalacia related to phosphate diabetes - bone scintigraphy with SPECT/CT contribution; Une osteomalacie liee a un diabete phosphore - role de la scintigraphie osseuse couplee a la TEMP-TDM

    Energy Technology Data Exchange (ETDEWEB)

    Ruyer, A.; Granier, P.; Mourad, M. [Centre Hospitalier Antoine-Gayraud, Service de Medecine Nucleaire, 11 - Carcassonne (France)


    We report the case of a 59-year-old woman, investigated for disabling pain of the left thigh, unrelated to any traumatic event. Interrogation had found diffuse pain of myalgia-type and arthralgia-type for approximately a year without local inflammatory signs and insufficiency fractures of both calcaneus two years before. The Technetium {sup 99m}-labeled hydroxy-methylene diphosphonate ({sup 99m}Tc-H.D.P.) whole-body bone scintigraphy evidenced multiple hot spots on the higher third of left femur, rib cage, sternum, scapula, pelvis, right hip and both calcaneus. Moreover, a more diffuse and heterogeneous prominent uptake appeared on rib cage, spine and pelvis. These images suggested a diffuse metastatic disease of the skeleton. The single photon emission computerized tomography guided by computerized tomography (SPECT/CT), centered on lumbar spine, pelvis and the upper end of femurs showed that the multiple hot spots were in fact bone fractures. These findings pointed diagnosis to a metabolic disease. The clinical context was in favour of an osteomalacia. Further explorations showed an osteomalacia related to phosphate diabetes. A thorough work-up did not reveal any known aetiology. To date, idiopathic phosphate diabetes seems the most likely diagnosis. Nuclear medicine input in osteomalacia is discussed. (authors)

  12. 99mTc-MIBI Scintigraphy to differentiate malignancies from benign lesions detected on Planar bone scans

    Directory of Open Access Journals (Sweden)

    Aniqa Jabeen


    99mTc-MIBI scintigraphy provides its usefulness by distinguishing malignant from benign lesions along with correct identification of metastatic lesions. NPV points toward its ability to correctly diagnose the normal (benign cases. However biopsy still remains the gold standard and a definitive diagnostic modality.

  13. Detection of metastases in breast cancer patients. Comparison of FDG PET with chest X-ray, bone scintigraphy and ultrasound of the abdomen

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    Dose-Schwarz, J.; Mahner, S.; Schirrmacher, S.; Mueller, V. [Klinik und Poliklinik fuer Gynaekologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Jenicke, L.; Brenner, W. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Hamburg-Eppendorf (Germany); Habermann, C.R. [Klinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)


    Distant metastases at primary diagnosis are a prognostic key factor in breast cancer patients and play a central role in therapeutic decisions. To detect them, chest X-ray, abdominal ultrasound, and bone scintigraphy are performed as standard of care in Germany and many centers worldwide. Although FDG PET detects metastatic disease with high accuracy, its diagnostic value in breast cancer still needs to be defined. The aim of this study was to compare the diagnostic performance of FDG PET with conventional imaging. Patients, methods: a retrospective analysis of 119 breast cancer patients who presented for staging was performed. Whole-body FDG-PET (n = 119) was compared with chest X-ray (n = 106) and bone scintigraphy (n = 95). Each imaging modality was independently assessed and classified for metastasis (negative, equivocal and positive). The results of abdominal ultrasound (n = 100) were classified as negative and positive according to written reports. Imaging results were compared with clinical follow-up including follow-up imaging procedures and histopathology. Results: FDG-PET detected distant metastases with a sensitivity of 87.3% and a specificity of 83.3%. In contrast, the sensitivity and specificity of combined conventional imaging procedures was 43.1% and 98.5%, respectively. Regarding so-called equivocal and positive results as positive, the sensitivity and specificity of FDG-PET was 93.1% and 76.6%, respectively, compared to 61.2% and 86.6% for conventional imaging. Regarding different locations of metastases the sensitivity of FDG PET was superior in the detection of pulmonary metastases and lymph node metastases of the mediastinum in comparison to chest X-ray, whereas the sensitivity of FDG PET in the detection of bone and liver metastases was comparable with bone scintigraphy and ultrasound of the abdomen. Conclusions: FDG-PET is more sensitive than conventional imaging procedures for detection of distant breast cancer metastases and should be

  14. [{sup 11}C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer: comparison with bone scintigraphy

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    Picchio, Maria [San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); National Research Council (IBFM-CNR), Institute for Bioimaging and Molecular Physiology, Milan (Italy); Spinapolice, Elena Giulia; Crivellaro, Cinzia [University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); Fallanca, Federico; Gianolli, Luigi [San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Giovacchini, Giampiero [University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Messa, Cristina [National Research Council (IBFM-CNR), Institute for Bioimaging and Molecular Physiology, Milan (Italy); University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); San Gerardo Hospital, Department of Nuclear Medicine, Monza (Italy)


    The aim of this study was to evaluate the clinical usefulness of [{sup 11}C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa). Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2-500.0 ng/ml) referred for both [{sup 11}C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [{sup 11}C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive anti-androgenic treatment. Equivocal findings occurred in 1 of 78 (1%) cases in [{sup 11}C]choline PET/CT and in 21 of 78 (27%) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [{sup 11}C]choline PET/CT were 89-89%, 98-100%, 96-100%, 94-96% and 95-96%, respectively. For BS they were 100-70%, 75-100%, 68-100%, 100-86% and 83-90%, respectively. Concordant findings between [{sup 11}C]choline PET/CT and BS occurred in 55 of 78 (71%) cases. The accuracy of [{sup 11}C]choline PET/CT did not significantly (p = 0.30) differ between hormone-resistant patients (97%) and those who did not receive anti-androgenic treatment (95%). In clinical practice, [{sup 11}C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [{sup 11}C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [{sup 11}C]choline PET

  15. A meta-analysis of {sup 18}FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer

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    Liu, Tao; Yang, Hui-Lin [The First Affiliated Hospital of Soochow University, Department of Orthopaedic Surgery, Suzhou (China); Cheng, Tao [Shanghai Jiaotong University School of Medicine, Department of Orthopaedic Surgery, Shanghai Sixth People' s Hospital, Shanghai (China); Xu, Wen [Public Health School of Soochow University, Department of Epidemiology and Biostatistics, Suzhou (China); Yan, Wei-Li [Shanghai Jiaotong University School of Medicine, Departments of Nuclear Medicine, Shanghai Renji Hospital, Shanghai (China); Liu, Jia [Shanghai Jiaotong University School of Medicine, Departments of Radiology, Shanghai Renji Hospital, Shanghai (China)


    To perform a meta-analysis comparing the diagnostic value of {sup 18}FDG-PET, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with breast cancer. MEDLINE, EMBASE, Scopus, ScienceDirect, SpringerLink, Web of Knowledge, EBSCO, and the Cochrane Database of Systematic Review databases were searched for relevant original articles published from January 1995 to January 2010. Inclusion criteria was as follows: {sup 18}FDG-PET, MRI or {sup 99m}Tc-MDP BS was performed to detect bone metastases (the number of published CT studies was inadequate for meta-analysis and therefore could not be included in this study); sufficient data were presented to construct a 2 x 2 contingency table; histopathological analysis and/or close clinical and imaging follow-up for at least 6 months were used as the reference standard. Two reviewers independently assessed potentially eligible studies and extracted relevant data. A software program called ''META-DiSc'' was used to obtain the pooled estimates for sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the *Q index for each modality. Thirteen articles consisting of 23 studies fulfilled all inclusion criteria. On a per-patient basis, the pooled sensitivity estimates for MRI (97.1%) were significantly higher than those for PET (83.3%) and BS (87.0%; P <0.05). There was no significant difference between PET and BS (P <0.05). The pooled specificity estimates for PET (94.5%) and MRI (97.0%) were both significantly higher than those for BS (88.1%; P <0.05). There was no significant difference between PET and MRI (P >0.05). The pooled DOR estimates for MRI (298.5) were significantly higher than those for PET (82.1%) and BS (49.3%; P <0.05). There was no significant difference between PET and BS (P >0.05). The SROC curve for MRI showed better diagnostic accuracy than those for PET and BS. The SROC curve for PET was better than that for BS

  16. Skeletal Scintigraphy (Bone Scan) (United States)

    ... will insert an intravenous (IV) catheter into a vein in your hand or arm. The technologist will administer the radiopharmaceutical into a vein in your hand or arm. It takes a few hours, usually ...

  17. The role of 18FDG, 18FDOPA PET/CT and 99mTc bone scintigraphy imaging in Erdheim–Chester disease

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    García-Gómez, F.J., E-mail: [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Acevedo-Báñez, I.; Martínez-Castillo, R.; Tirado-Hospital, J.L.; Cuenca-Cuenca, J.I.; Pachón-Garrudo, V.M.; Álvarez-Pérez, R.M.; García-Jiménez, R. [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Rivas-Infante, E. [Department of Pathology, Virgen del Rocío Universitary Hospital, Seville (Spain); García-Morillo, J.S. [Department of Internal Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Borrego-Dorado, I. [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain)


    Highlights: • Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. • Multifocal nature of involvement in ECD can produce a wide variety of clinical signs. In our experience, neurological involvement is associated with mortality in all cases. Characteristic long bone osteosclerosis was a quasi-pathognomonic finding in bone scintigraphy. • To the best of our knowledge, the 18FDOPA-PET/CT not seem useful in the initial staging of ECD based on a single case report. • Bone scintigraphy and the 18FDG-PET/CT that were particularly useful in despite systemic involvement, locate the optimum site for biopsy and treatment response evaluation. In this context, a baseline 18FDG-PET/CT with an optional bone scintigraphy may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically follow-up 18FDG-PET/CT must be performed in the follow up to evaluate the treatment response. - Abstract: Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different

  18. Abnormal gastrointestinal accumulation of radiotracer by gastric bleeding during {sup 99m}Tc-MDP bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Kyung A.; Lee, Sang Woo; Lee, Jae Tae; Lee, Kyu Bo [College of Medicine, Kyungpook National Univ., Taegu (Korea, Republic of)


    We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during {sup 99m}Tc-methylene diphosphonate (MDP) skeletal scintigraphy. A hemorrhagic gastritis was subsequently demonstrated by endoscopy. The mechanism for the intestinal localization of {sup 99m}Tc-MDP in this patients is not clear, but we guess that the extravasated blood containing the radiopharmaceutical cannot recirculate and stays at the bleeding site, so we can see the intestinal activity.

  19. Complementary roles of bone scintigraphy and MR imaging in the detection and long-term follow-up of primary non-Hodgkin's bone lymphoma in a child-case report

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    Marina, Vlajkovic; Milena, Rajic [Center of Nucler Medicine, Clinical Center Nis, Nis (Serbia); Vesna, Petronijevic [Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Center Nis, Nis (Serbia); Sladana, Petrovic [Center of Radiology, Clinical Center Nis, Nis (Serbia); Vera, Artiko [Center of Nuclear Medicine, Clinical Center of Serbia, Belgrade (Serbia)


    The aim of our report is to demonstrate the complementary roles of bone scintigraphy (BS), magnetic resonance imaging (MR), and positron emission tomography using 2-deoxy-2-[18F]fluoro-D-glucose (F-18-FDG PET/CT) in the diagnosis and treatment monitoring of a child with primary non-Hodgkin's lymphoma of bone (PLB). Increased blood flow, high tissue accumulation, and markedly increased uptake on the late BS pointed toward an active bone process in the left femoral region. Bone marrow infiltration of the left femur and cortical sclerosis, which were both demonstrated by MR imaging, were later confirmed as PLB by bone marrow biopsy. The normalizations of the flow and tissue phases of BS a year after treatment and during the entire follow-up were in keeping with inactive disease and clinical remission. However, even 8 years after treatment and complete remission, MR imaging demonstrated persistent unmodified bone marrow alteration and appreciable cortical involvement. A slightly increased metabolic activity of the left femoral epiphysis demonstrated by F-18-FDG PET/CT and mild activity in the same region on delayed BS were demonstrated in the late follow-up. Our results strongly suggest that BS and MR imaging should be included in the diagnostic algorithm of children with undefined bone symptoms. However, mild metabolic activity on the F-18-FDG PET/CT scan could not reliably differentiate between the presence or absence of disease in a patient with PLB in clinical remission. (orig.)

  20. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy for the diagnosis of bone and joint infections: a retrospective study in 116 patients

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    Devillers, A. [Dept. of Nuclear Medicine, Centre Eugene Marquis, Rennes (France); Moisan, A. [Dept. of Nuclear Medicine, Centre Eugene Marquis, Rennes (France); Jean, S. [Dept. of Rheumatology, Pontchaillou CHU, Rennes (France); Arvieux, C. [Dept. of Infectious Diseases, Pontchaillou CHU, Rennes (France); Bourguet, P. [Dept. of Nuclear Medicine, Centre Eugene Marquis, Rennes (France)


    The aim of this study was to evaluate the diagnostic value of technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy (HMPAO-LS) by means of a retrospective review of 116 patients divided into three groups of bone and joint infection. One hundred and thirty-one LS examinations were performed, and 143 sites analysed. The final diagnosis of infection was based on surgical, histological and bacteriological data and follow-up. Ninety-four suspected localizations were examined in group 1, which included 74 patients with an infection suspected to involve orthopaedic implants. In this group, there were 38 true-positives, 1 false-negative, 49 true-negatives and 6 false-positives. Surgical confirmation was obtained in 34 cases. In group 2 (24 patients with suspected osteomyelitis), there were 27 localizations of which 14 were true-positives and 13 were true-negatives (including seven surgical confirmations). In group 3 (18 patients suspected of septic arthritis) there were eight true-positives, two false-negatives, ten true-negatives and two false-positives. Overall sensitivity of {sup 99m}Tc-HMPAO-LS for the detection of bone and joint infection was 95%, with a specificity of 90% (group 1: sensitivity 97%, specificity 89%; group 2: 100% and 100%; group 3: 80% and 83%). It may be concluded that HMPAO-LS is an effective tool for the diagnosis of both bone infection involving implants and chronic osteomyelitis. (orig.)

  1. New strategy in diagnostic, preventive and following way in osteonecrosis of sickle-cell disease in Cote d'Ivoire with bone scintigraphy; Nouvelle strategie dans le diagnostic, la prevention et le suivi de l'osteonecrose drepanocytaire en Cote d'Ivoire a partir de la scintigraphie osseuse

    Energy Technology Data Exchange (ETDEWEB)

    Kouame-Koutouan, A.; Aboukoua-Kouassi, N.; Koffi, D.; Sery, J.M. [Cocody Univ., UFR sciences Medicales (SMA), Service de Biophysique et Medecine Nucleaire, Abidjan (Cote d' Ivoire); Meite, M.; Sanogo, I. [Clinique du CHU de Yopougon, Service d' Hematologie (Cote d' Ivoire)


    Osteonecrosis is the most frequent complications of sickle-cell disease (S.C.D.) whose prevalence in Cote d'Ivoire is 21%. The main of this study was to compare scintigraphy, clinical and radiological observations to assess earlier diagnosis in S.C.D. osteonecrosis. It was a prospective study about 45 S.C.D. patients who presented coxopathy and had radio-labelled di phosphonates bone scintigraphy. The results revealed 49% of lesions whose 48% appeared with homogeneous hyper fixation, 11% homogeneous hypo fixation, 5% of hypo fixation got round by hyper fixation. Eighty-one percent of lesions concerned femoral head, 6% femoral condyle and 3% humoral head. Fifty percent of osteonecrosis was not visible in radiology and corresponded to the earlier stage. These invisible radiology aspects were observed in 100% hips without lameness, and in 43% permanent lameness. Scintigraphy (sensitive in 100%) isolated 38% more than conventional radiography. In main to improve S.C.D. osteonecrosis prognostic in Cote d'Ivoire, this preliminary study outline that scintigraphy is fundamental in management. (authors)

  2. The Comparison of Whole Body Diffusion-Weighted Imaging and Bone Scintigraphy in Detection of Bone Metastasis%MR全身弥散加权成像与核素骨扫描对骨转移瘤诊断价值的对比研究

    Institute of Scientific and Technical Information of China (English)

    张文文; 马强华; 杨晓萍; 叶建军; 陈纲; 安建平; 赵辉


    Objective To compare the capability of whole body diffusion-weighted imaging( WB-DWI) and bone scintigraphy in diagnosing bone metastases. Methods 22 patients with malignant tumors were enrolled in our study. All patients underwent WB-DWI and bone scintigraphy within two weeks. The sensitivities and specificities of WB-DWI and bone scintigraphy in detecting bone metastases were analyzed using receiver operating characteristic (ROC) curve. Results Total 182 lesions in 18 patients were diagnosed by pathological examinations or whole body MRI . 161 lesions were detected by WB-DWI and 157 lesions by bone scintigraphy. Based on the involving regions, the sensitivities and specificities were 87. 3 % and 92. 7% for WB-DWI, 84. 1% and 90. 5% for bone scintigraphy, respectively,the area under curve (AUC) of WB-DWI and bone scintigraphy were 0. 900 and 0. 873 , respectively . The Han-ley-McNeil test was used for testing the statistical significance of the difference between the areas under ROC curves ,Z=1. 582 ,P>0. 05 , there were no statistical significant differences between WB-DWI and bone scintigraphy in detecting bone metastases. Conclusion The capabilities of WB-DWI and bone scintigraphy were no of statistical significant differences for bone metastatic assessment. As a result, WB-DWI can be a new and no radiation method for bone metastatic assessment.%目的 对比磁共振全身弥散加权成像(WB-DWI)与全身核素骨扫描在诊断骨转移瘤中的价值.方法 连续收集经病理证实的恶性肿瘤患者22例,对病人同期行WBDWI及全身核素骨扫描检查,分区域记录WB-DWI及全身核素骨扫描显示的病灶数目以及受累区域.以受累区域为单位分析2种检查方法诊断骨转移瘤的灵敏度及特异度,并采用ROC曲线分析2种方法诊断骨转移瘤的效能.结果 经活检及常规MR断层显示18例有骨转移瘤,共计病灶数目182个,受累区域63处.WB-DWI共检出病灶161个,全身

  3. MRI versus scintigraphy with {sup 99m}Tc-HMPAO-labelled granulocytes in the diagnosis of bone infection; Confronto RM e scintigrafia con granulociti tecneziati nella diagnosi di infezione ossea

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    Vittolini, Enrico; Del Giudice, Eleonora; Caudana, Roberto [Azienda Ospedaliera Carlo Poma, Mantova (Italy). Dipartimento di diagnostica per immagini; Pizzoli, Andrea [Azienda Ospedaliera Carlo Poma, Mantova (Italy). Divisione di ortopedia e traumatologia


    Purpose: To assess the reliability of MRI and scintigraphy with {sup 99m}Tc-HMPAO-labelled granulocytes in the diagnosis of bone infection. Materials and methods: Between November 2001 and November 2003, 25 patients (16 men and 9 women; age range 22-72 years; mean age 48 years) with suspected bone infection were evaluated. The lower limbs were more frequently involved (20/25 cases). MRI (TI and T2-w sequences, both with and without fat suppression; TI-w fat-suppressed sequence after Gadolinium administration) and scintigraphy with {sup 99m}Tc-HMPAO-labelled granulocytes were performed in all patients; the study was performed 30 min, 150 min and 24 h after the injection of {sup 99m}Tc labelled autologous granulocytes. The maximum interval between MRI and scintigraphy was 15 days. The diagnosis was confirmed surgically (18/25 cases) or by clinical follow-up (7/25 cases). Results: In 10/25 cases the clinical suspicion of bone infection was confirmed by MRI, scintigraphy and surgery. In 12/25 cases the clinical suspicion of bone infection was not confirmed either by imaging, surgery (5/12 cases) or follow-up (7/12 cases). In 3/25 cases the results were discordant: in 1/3 cases with conic osteomyelitis confirmed by MRI and surgery, a false-negative diagnosis was made by scintigraphy. In 2/3 cases with negative diagnoses confirmed by surgery, a false-positive diagnosis was made by scintigraphy owing to the infection of adjacent soft tissues. Conclusions: MRI is more reliable for the detection and evaluation of the local spread of bone infection. Conversely, when metallic devices causing artefacts on MR images are present, scintigraphy is the preferred alternative modality. [Italian] Scopo: Valutare l'affidabilita della Risonanza Magnetica (RM) e della Scintigrafia (Scgrm) con granulociti autologhi marcati con 99mTc, nella diagnosi di infezione ossea (IO). Materiale e metodi: Nel periodo compreso tra nov. '01 e nov. '03, sono stati valutati 25 pazienti (16

  4. A rare case of polyostotic fibrous dysplasia assessed by bone scintigraphy with Tc-99m methylene diphosphonate (MDP)

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    Di Leo, C.; Ardemagni, A.; Bestetti, A.; Tagliabue, L.; Del Sole, A.; Conte, A.; Tarolo, G.L. [Milano Univ. (Italy). Servizio di Medicina Nucleare


    A 66-year-old man affected by polyostotic form of fibrous dysplasia in consequence of worsening of lower extremity bone pain aggravated by walking and concomitant increase of serum alkaline phosphatase and osteocalcin, was subjected first to a radionuclide study. Bone scan demonstrated a pathological uptake of the radiotracer in the craniofacial bones, right scapula, left and right posterior ribs, right hemipelvis and lower extremities confirming the diagnosis but establishing especially the extent of bone involvement, greater than expected on the basis of symptoms and X-ray findings, underlying the importance of nuclear medicine imaging in the assessment and follow-up of this rare disease. (orig.) [German] Bei einem 66jaehrigen Mann, der an der polyostotischen Form der fibroesen Dysplasie leidet, wurde aufgrund einer Verschlimmerung der Knochenschmerzen im Bereich der unteren Extremitaeten, die sich beim Gehen verschlechterten, und einer gleichzeitigen Erhoehung der Serumwerte fuer alkalische Phosphatase und Osteocalzin erstmals eine Radionuklid-Untersuchung durchgefuehrt. Das Knochenszintigramm zeigte eine pathologische Aufnahme des Radiotracers in den kraniofazialen Knochen, im rechten Schulterblatt, den linken und rechten posterioren Rippen, im Bereich von rechtem Hemipelvis und unteren Extremitaeten; damit wird die Diagnose bestaetigt, vor allem jedoch das Ausmass der Knochenbeteiligung nachgewiesen, das ueber das ausgehend von den Symptomen und Roentgenbefunden erwartete Ausmass hinausgeht; die Bedeutung des nuklearmedizinischen bildgebenden Verfahrens zur Beurteilung und Verlaufskontrolle dieser seltenen Erkrankung wird dadurch unterstrichen. (orig.)

  5. The role of 18FDG, 18FDOPA PET/CT and 99mTc bone scintigraphy imaging in Erdheim-Chester disease. (United States)

    García-Gómez, F J; Acevedo-Báñez, I; Martínez-Castillo, R; Tirado-Hospital, J L; Cuenca-Cuenca, J I; Pachón-Garrudo, V M; Álvarez-Pérez, R M; García-Jiménez, R; Rivas-Infante, E; García-Morillo, J S; Borrego-Dorado, I


    Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different presentations of the disease were observed in our casuistic: most indolent form was a cutaneous confined disease, presented in only one patient. Multifocal involvement with central nervous system (CNS) preservation was observed in two patients. Most aggressive form consisted in a systemic involvement with CNS infiltration, presented in three patients. In our experience neurological involvement, among one case with isolate pituitary infiltration, was associated with mortality in all cases. 18FDG-PET/CT and BS were particularly useful in despite systemic involvement; locate the site for biopsy and the treatment response evaluation. By our knowledge, 18FDOPA-PET/CT not seems useful in the initial staging of ECD. A baseline 18FDG-PET/CT and BS may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically 18FDG-PET/CT must be performed in the follow up to evaluate treatment response.

  6. ~(99)Tc~m标记双膦酸盐骨显像剂的研究进展%The new advanced of ~(99)Tc~m-labeled bisphosphonates as bone scintigraphy agent

    Institute of Scientific and Technical Information of China (English)

    刘键; 张现忠; 张仕坚; 王学斌


    双膦酸盐是一类具有很强亲骨性的药物,99Tcm标记的双膦酸盐如~(99)Tc~m-亚甲基二膦酸盐(~(99)Tc~m-MDP)等被广泛应用于骨显像.近些年来,为了克服~(99)Tc~m-MDP的缺点,许多新型的双膦酸配体被设计与合成,以期望获得性能更加优异的骨显像剂.该文对近10年来发展的99Tcm标记双膦酸盐类骨显像剂的结构与性能进行了综述.%Bisphosphonates have a strong affinity for bone tissue and hydroxyapatite.Some of them have been labelled with ~(99)Tc~m for bone scintigraphy agent.This article is intended to summarize research and development in some new ~(99)Tc~m labeled bisphosphonates as bone scintigraphy agent in recent years.

  7. The effect of MRI contrast agents on hepatic and splenic uptake in the rabbit during (99m) Tc-MDP bone scintigraphy. (United States)

    Qiu, Lin; Tang, Yuhui; Chen, Yue; Huang, Zhanwen; Zhu, Yan; Zhang, Li; Cai, Liang; Wan, Qiang; Feng, Yue


    The objective of this study was to investigate the effects of Omniscan® and Magnevist® on (99m) Tc-MDP uptake in rabbits during (99m) Tc-MDP bone scintigraphy. In Experiment Group 1, 30 healthy adult rabbits were randomized into six subgroups (n = 5); each subgroup experienced a different time interval between injections (30 min, 60 min, 120 min, 240 min, 360 min, 24 h). All six subgroups were injected first with Omniscan®, then with (99m) Tc-MDP. After 7 days, the same six subgroups were injected with normal saline followed by (99m) Tc-MDP at the same time intervals. In Experiment Group 2, 20 healthy adult rabbits were allocated randomly to four subgroups (n = 5); each subgroup experienced a different time interval between injections (30 min, 60 min, 120 min, 240 min). All four subgroups were injected first with Magnevist®, then with (99m) Tc-MDP. After 7 days, the same four subgroups were injected with normal saline followed by (99m) Tc-MDP. In all experiments, whole-body skeletal imaging was performed. Liver, spleen, and background were delineated to determine the target-to-background (T/B) ratio. Diffusely increased intake of the imaging agent was seen in the liver and spleen when the injection-time interval between Omniscan® and (99m) Tc-MDP varied from 30 min to 240 min and when the time interval between Magnevist® and (99m) Tc-MDP was 30 min-60 min. The imaging findings are consistent with the results of L/B and S/B ratios in each experiment group. Both Omniscan® and Magnevist® have an effect on (99m) Tc-MDP uptake during bone scanning; the main effect is diffusely increased hepatic and splenic activity.

  8. Gamma camera energy windows for Tc-99m bone scintigraphy: effect of asymmetry on contrast resolution. Work in progress

    Energy Technology Data Exchange (ETDEWEB)

    Collier, B.D.; Palmer, D.W.; Knobel, J.; Isitman, A.T.; Hellman, R.S.; Zielonka, J.S.


    By raising the lower threshold of the Tc-99m energy window, rejection of scattered photons can be made more efficient. Unfortunately, with most gamma cameras significant nonuniformities are produced when the window is changed to an asymmetric setting. Recently introduced designs with gain stabilization of the photomultiplier tubes and improved energy correction maintain field uniformity even for an asymmetric window. To assess the impact of an asymmetric energy window on clinical images, 33 Tc-99m-MDP scintigrams of the lumbar spine were taken with symmetrical (126-154 keV) and asymmetric windows (135-154 keV). Bone:soft tissue ratios improved with the asymmetric window, and the resulting images were preferred by the physicians.

  9. Aggressive Ewing's sarcoma appearing as a cold lesion on bone scan; Sarcome d'Ewing agressif apparaissant comme une lesion froide sur la scintigraphie osseuse

    Energy Technology Data Exchange (ETDEWEB)

    Chatti, K.; Guezguez, M.; Maha Ben Fredj, M.; Sfar, R.; Essabbah, H. [Hopital Universitaire de Sahloul, Dept. de Medecine Nucleaire, Sahloul (Tunisia); Mtaoumi, M. [Hopital Universitaire de Sahloul, Dept. d' Orthopedie, Sousse (Tunisia); Chatti, K. [Faculte de Medecine de Monastir, Lab. de Biophysique, Monastir (Tunisia)


    Ewing's sarcoma classically presents as a hot spot on bone scan as a result of increased vascularity of the tumor and new bone formation. Purpose We report and analyze an uncommon pattern of a 'cold' lesion in Ewing's sarcoma on bone scan and its pathophysiologic significance. Case report A 15-year-old boy complaining of thigh pain. CT scan evoked Ewing's sarcoma or osteitis. MRI evoked chronic osteitis. Scintigraphy showed a fairly intense and heterogeneous uptake on the femoral lesion and no abnormal uptake elsewhere. Biopsy showed none pathologic pattern. Three months later, a second biopsy concluded to Ewing's sarcoma. Bone scan showed a larger lesion with peripheral intense uptake centered by enlarged 'cold' area in the left femoral diaphysis and no evident bone metastasis. The patient underwent chemotherapy and surgery. Three months later, bone scan showed extensive skeletal metastasis. Conclusion Ewing's sarcoma appears usually as an intense lesion on bone scan. Nevertheless, decreased radiopharmaceutical uptake or 'cold' lesion may be seen in aggressive Ewing's sarcoma with lytic tumor, growth of which is very rapid and bony reaction is minimal. (authors)

  10. The Clinical usefulness of {sup 99mT}c HMPAO Leukocyte/{sup 99mT}c phytate bone marrow scintigraphy for diagnosis of prosthetic knee infection: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Kyung Pyo; Park, Ji Sun; Lee, Ah Young; Choi, Su Jung; Lee, Seok Mo; Bae, Sang Kyun [Inje Univ., Pusan Paik Hospital, Pusan (Korea, Republic of)


    The preferred radionuclide imaging procedure for diagnosing prosthetic joint infection is combined radiolabeled leukocyte/{sup 99mT}c sulfur colloid bone marrow scintigraphy, which has an accuracy of over 90%. Unfortunately, sulfur colloid is no longer available in South Korea. in this study, we evaluated the usefulness of {sup 99mT}c phytate, a substitute for {sup 99mT}c sulfur colloid, when combined with radiolabeled leukocyte scintigraphy in suspected prosthetic knee infections. Eleven patients (nine women, two men; mean age 72{+-}6 years) with painful knee prostheses and a suspicion of infection underwent both {sup 99mT}c phytate bone marrow scintigraphy (BMS). The combined images were interpreted as positive for infection when radioactivity in the LS at the sits of clinical interest clearly exceeded that of the BMS (discordant); they were interpreted as negative when the increased activity in the LS was consistent with an increased activity in the BMS(concordant). The final diagnosis was made with microbiological or intraoperative findings and a clinical follow up of at least 12 months. Five of eleven patients were diagnosed as having an infected prosthesis. The overall sensitivity, specificity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the combined LS/BMS were 100%, 83%, 83%, 100% and 91%, respectively. We find that combined {sup 99mT}c HMPAO LS/{sup 99mT}c phytate BMS shows comparable diagnostic performance to other studies utilizing sulfur colloid. Combined {sup 99mT}c HMPAO LS/{sup 99mT}c phytate BMS is therefore expected to be an acceptable alternative to combined radiolabeled LS/{sup 99ms}ulfur colloid BMS for diagnosing prosthetic knee infections.

  11. Clinical Value of 99Tcm-MDP SPECT Bone Scintigraphy in the Diagnosis of Unilateral Condylar Hyperplasia

    Directory of Open Access Journals (Sweden)

    Bing Wen


    Full Text Available Purpose. To investigate the clinical value of 99Tcm-MDP SPECT for the diagnosis of unilateral condylar hyperplasia (UCH. Methods. One hundred forty-nine patients who underwent mandibular 99Tcm-MDP SPECT between January 2009 and December 2012 were studied, including 105 cases that were clinically suspected of UCH and 44 comparable cases without UCH as a control group. Results. Increased bone activity was observed in the affected condyles for all UCH patients. In the UCH group, the relative percentage uptake on the affected side was 59% (SD±4.3%, significantly higher than the 41% (SD±4.1% uptake on the contralateral side (P<0.001. Similarly, the condyle/skull ratio was significantly higher for the affected side (1.66±0.63 than for the contralateral side (1.34±0.34, P<0.01. No significant difference was found in the control group between the left and right condyles. Values for the sensitivity (95%, specificity (61%, positive (84.4% and negative (84.6% predictive values, and accuracy (84.5% for 99Tcm-MDP SPECT in the diagnosis of UCH were calculated. However, for the hyperplastic condyle, no correlation was observed between the thickness of each cartilage layer and the relative uptake in the SPECT image. Conclusion. 99Tcm-MDP SPECT is accurate for diagnosing UCH and can provide a reference for treatment options.

  12. Metastatic calcifications of hyperparathyroidism detected by M.D.P.- Tc 99 m bone scintigraphy in patients with parathyroid carcinoma: A case report; Les calcifications metastatiques de l'hyperparathyroidie identifiees par scintigraphie osseuse au M.D.P.-Tc 99 m dans le cadre du carcinome parathyroidien: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Doudouh, A.; Biyi, A.; Oufroukhi, Y.; Zekri, A. [Hopital Militaire Mohammed-5, Service de Medecine Nucleaire, Rabat (Morocco); Sekkach, Y. [Hopital Militaire Mohammed-5, Service de Medecine B, Rabat (Morocco)


    The authors report a case of gastric, renal, pulmonary, and myocardial uptake of M.D.P.-Tc 99 m in a patient with parathyroid carcinoma. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism which becomes complicated during its evolution by metastatic calcifications. Metastatic calcifications are frequently located in lungs and heart. If an adequate treatment is not undertaken, these calcifications progress and evolve into severe respiratory and cardiac complications. In our patient, quasi-complete disappearance of metastatic calcifications on the follow-up bone scintigraphy, performed four weeks after surgical cure of parathyroid tumour, indicates the great interest of this examination in early identification of metastatic calcifications and monitoring of their disappearance after treatment. (authors)

  13. Application of large field diffusion-weighted imaging in the detection of bone metastases of malignant tumors: comparison with bone scintigraphy%大范围扩散加权成像检测恶性肿瘤骨转移瘤:与骨扫描相对照

    Institute of Scientific and Technical Information of China (English)

    张春燕; 任转琴; 孙洪跃; 王霄英; 蒋学祥


    Objective To evaluate large field diffusion-weighted imaging (DWI) in detection of bone metastases of malignant tumors. Methods Eighteen patients with various malignant tumors were enrolled in this study. All the patients underwent large field DWI and 99mTc-MDP bone scintigraphy within one month. Results Fifteen of 18 patients were diagnosed as bone metastases with conventional MRI; 7 of them were found more than 10 bone metastases, and 23 bone metastases were confirmed in the other 8 patients. When seven patients with multiple bone metastases (>10) were excluded, and lesions in the residual 11 patients with or without bone metastases were counted, the diagnostic sensitivity of bone metastases with large field DWI and bone scintigraphy was both 100%, and specificity were 100% and 33.33%, respectively. ROC study showed the area under curve (AUC) of large field DWI and bone scintigraphy were 1.00 and 0.67, respectively (P=0.04). With lesion numbers as study unit, the diagnostic sensitivity of large field DWI and bone scintigraphy were 86.96% and 78.26%, and the specificity was both 60.00%. ROC study showed the AUC of large field DWI and bone scintigraphy was 0.74, 0.69, respectively; and no statistical difference was found. Conclusion Large field DWI can be used in screening the bone metastases of malignant tumors.%目的 评价大范围扩散加权成像(DWI)在恶性肿瘤骨转移瘤检测中的应用.方法 18例手术证实的各种恶性肿瘤患者纳入本研究.所有患者均在1个月内同时接受大范围DWI检查和99mTc-MDP骨扫描检查. 结果 18例患者中,15例经常规MRI证实存在骨转移瘤,其中7例为多发骨转移瘤(>10处),另8例共证实23处转移瘤;余3例未见转移瘤.除外7例全身多发骨转移瘤(>10处)患者,对其余11例有(8例)或无(3例)骨转移瘤患者计数病灶数,以患者为单位计算的大范围DWI和骨扫描诊断骨转移瘤的敏感性均为100%,特异性分别为100%、33.33%;

  14. 核素骨显像在骶骨肿瘤术前诊断中的应用%Bone scintigraphy used in the preoperative diagnosis of sacral tumor

    Institute of Scientific and Technical Information of China (English)

    李原; 赵亚妹; 王茜; 岳明纲; 李河北; 洪莲; 聂玉新; 王玉; 张彩群; 梁铁军


    目的 评价术前骨显像在骶骨肿瘤诊断中的临床价值.方法 103例骶骨肿瘤患者术前进行了99Tcm-亚甲基二膦酸盐(MDP)全身骨显像,其中39例加做了局部断层显像.全身显像用于观察有无多骨病变及骶骨肿瘤对显像剂的摄取;断层显像用于进一步观察骶骨肿瘤的核素摄取特征.结果 该组恶性肿瘤为65例,良性病变38例.骨显像在17.5%(18/103)的患者中检出了多发病灶,51.7%(12/21)的转移性骶骨瘤患者在骨显像上仅表现骶骨单发病变.骶骨肿瘤表现为放射性减低型者在平面显像中占46.6%(48/103),在断层显像中占84.6%(33/39).放射性浓聚型或伴局部浓聚的放射性减低型骶骨肿瘤多为恶性病变;而单纯的放射性减低型骶骨肿瘤在无多骨病变发生的情况下多为良性病变;呈现"炸面圈"征的骶骨肿瘤则多为骨巨细胞瘤.结论 骶骨肿瘤术前骨显像有助于全身多发病变的筛查,但对于单发的转移性肿瘤其诊断价值有限;观察肿瘤对显像剂的摄取特征,可为其鉴别诊断提供帮助.%Objective To evaluate the clinical significance of bone scintigraphy in the preoperative diagnosis of sacral tumor. Methods Preoperative 99Tcm-methylene diphosphonate (MDP) whole body bone scintigraphy was performed in total of 103 patients with sacral tumor for whole body survey and radionuclide uptake in the sacral tumor. Of these 103 patients,39 had SPECT. According to the osteoblastic reaction in bone SPECT studies,patterns of tumor with a "hot" lesion was defined as type Ⅰ,a "cold" lesion accompanied with partial uptake was defined as type Ⅱ,a purely "cold" lesion was defined as type Ⅲ,and a "cold" lesion with marginal uptake which produced "doughnut sign" was defined as type Ⅳ. Imaging interpretation was correlated with the final pathologic diagnosis. Results Of the 103 patients,18 ( 17.5% ) had polyostotic involvement. About 46.6% (48/103 ) in planar and 84.6% ( 33/39 ) in

  15. Bone Metastases of Differentiated Thyroid Carcinoma: Could 99mTc-bone Scintigraphy be Substituted with Whole-body 18F-FDG SPECT%分化型甲状腺癌骨转移:18F-FDG SPECT显像能否取代全身骨显像

    Institute of Scientific and Technical Information of China (English)

    叶智轶; 王辉; 杜学亮; 傅宏亮


    Objective The purpose of this study was to compare 18 F-FDG SPECT and 99mTc-bone scintigraphy in the detection of bone metastases of DTC. Methods In this retrospective study, 17 bone metastastic DTC patients treated by radioiodine from January 2005to January 2009 were reviewed. 8 males and 9 females, age range 46 ~82. 8 had papillary carcinoma and 9 had follicular carcinoma. 7 were proved clinically or pathologically to have bone metastases only and 10 have bone metastases with lymph node and/or pulmonary metastases as well. All the patients underwent both 18 F-FDG SPECT and 99m Tc-bone scintigraphy from 2to10 days before the ra-dioiodine therapy to detect bone metastases. Statistical analysis was performed with SPSS11.0, and Chi-square test was used. Results There were overall 70 bone metastastic lesions confirmed in 17 patients. In evaluating the detection of bone metastases, 18F-FDG SPECT showed 71.34% (50/70) sensitivity, 97.76% (131/134) specificity and 88. 73% (181/204) accuracy, compared with 62.86% (44/70) , 91.04% (122/134) and 81.37% (166/204) , respectively, for bone scintigraphy. The sensitivity of 18F-FDG SPECT was similar to that of bone scintigraphy, this difference was not statistically significant( t = 1.17,P>0.05). While the specificity and accuracy of 18F-FDG SPECT were statistically significantly higher than those of bone scintigraphy(t =5.72,P<0.05)and(t = 4.34,P <0.05)individually. Conclusion This study suggested that "F-FDG SPECT has a higher specificity and a better accuracy than that of bone scintigraphy to detect bone metastases in patients with DTC. But bone scintigraphy was superior to 18F-FDG SPECT in tne detection of osteoblastic lesions. Thus bone scintigraphy should play a complementary role in detecting bone metastaaes with 18F-FDG SPECT and could not be replaced by it.%目的:比较18F-脱氧葡萄糖(FDG)SPECT显像和全身骨显像对于分化性甲状腺癌(DTC)骨转移灶检测能力的区别.方法:回顾性分析2005年1

  16. Diagnosis and evaluation of bone metastasis with PET/CT and bone scintigraphy in patients with malignancies%PET/CT显像与全身骨扫描诊断转移性骨肿瘤的比较研究

    Institute of Scientific and Technical Information of China (English)

    程旭; 李永军; 徐兆强; 王杰; 包丽华


    Objective:To evaluate diagnostic value of PET/CT with 18F-FDG and whole-body bone scintigraphy(BS)with Tc-MDP for metastatic bone tumor in patients with malignancies. Methods: A total of 75 patients with malignances,average of 59.85 ± 13.59 years old, were included in this study. All patients underwent PET/CT imaging with 18F-FDG and BS with Tc-MDP for two weeks. Based on the diagnostic results of patients,we calculated the sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV),and accuracy of PET/CT imaging and BS method to detect bone metastasis. Moreover,image features on different body regions were assessed and compared between two imaging methods. Results: There were 34 patients diagnosed with skeletal metastasis among all 75 patients. The sensitivity of PET/CT was 94.1% (32/34) in detecting bone metastasis. The specificity of PET/CT was 95.1% (39/41)The PPV,NPV and accuracy of PET/CT were 94.1%,95.1% and 94.7% , respectively. For BS with 99mTc-MDP, the sensitivity of detecting skeletal metastasis was 91.2%(31/34)and the specificity was 65.9%(27/41). The PPV,NPV and accuracy of BS were 68.9 %,90 % and 77.3 %,respectively. On basis of region analysis,the main abnormal uptakes of 18F-FDG were located in spine,rib and pelvis by PET/CT detection. For BS with 99mTc-MDP,the main lesions were located in rib,spine and bones of limbs. Conclusion:The specificity,accuracy and PPV of PET/CT imaging were higher than those of BS. However,there was no significant difference in sensitivity and NPV between PET/CT imaging and BS.%目的:评价正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)18F标记的氟脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)全身显像与99mTc标记的亚甲基二磷酸盐(99mTc-methylene diphosphonate,99mTc-MDP)全身骨扫描(bone scintigraphy,BS)诊断转移性骨肿瘤的效能.方法:共计75例临床确诊的恶性肿瘤患者纳入本研究,平均年龄(59.85±13

  17. A control study between DWIBS and bone scintigraphy mapping in the diagnosis of bone metastatic diseases%背景抑制扩散加权成像与核素骨扫描在恶性肿瘤骨转移病变诊断中的对照研究

    Institute of Scientific and Technical Information of China (English)

    沈茜刚; 岳磊; 周良平; 彭卫军; 毛健; 张灵; 姚之丰; 程竞仪; 刘晓航; 丁建辉


    Background and purpose:Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for MR imaging systemic examination, especially the lymph node and bone diseases can be clear, and the imaging result is similar with PET. The aim of this study was to compare the value of clinical application in the diagnosis of malignant metastatic osteopathic between DWIBS and bone scintigraphy mapping. Methods:Thirty-six specimens conifrmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods. Results:Thirty (165 positions in all) of 36 malignant tumor patients were conifrmed as having bone metastasis, compared that 26 patients (143 positions) with DWIBS method and 23 patients (132 positions) with bone scintigraphy mapping were detected, but there was no statistical signiifcance between this two imaging methods (χ2=1.002, P=0.506). The sensitivity, positive predictive value (PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with 86.7%, 96.3%, 86.1%and 76.7%, 88.5%, 72.2%, respectively;but the speciifcity and negative predictive value (NPV) in DWIBS (83.3%and 55.6%) was higher than that of in bone scintigraphy (50.0%and 30.0%). The detection rates of different bone metastasis with DWIBS and bone scintigraphy were 86.7%(143/165) and 80.0%(132/165), and it was no signiifcant difference (χ2=2.640, P=0.104);DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different signiifcant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is ifne consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.%背景与目的:背景

  18. A cintilografia óssea como exame complementar no diagnóstico da necrose avascular de sesamoide The bone scintigraphy as a complementary exam in the diagnosis of the avascular necrosis of the sesamoid

    Directory of Open Access Journals (Sweden)

    Carlyle Marques Barral


    Full Text Available OBJETIVO: Este estudo objetiva apresentar sete casos de necrose avascular de sesamoide e relatar o papel da cintilografia óssea no diagnóstico desses pacientes. MÉTODOS: Sete pacientes com suspeita clínica de necrose avascular de sesamoide submetidos a cintilografia óssea trifásica com 30mCi de MDP-99mTc. RESULTADOS: A maioria dos pacientes eram adultos jovens, do sexo feminino, com queixas de dor limitante em antepé, que faziam uso de calçados inadequados e/ou apresentavam relato de trauma associado ou não à fratura. Não houve predileção por um dos pés ou entre sesamoides tibial ou femoral. Dois (28,57% pacientes apresentavam sesamoides tibiais bipartidos e um (14,29% apresentava bipartição de sesamoides tibial e fibular. Em 100% dos pacientes a cintilografia óssea trifásica, associada a outros métodos propedêuticos, mostrou-se fundamental para o diagnóstico. A conduta inicial em todos os casos foi conservadora. Nos quatro casos (57,14% em que não houve remissão dos sintomas, excisão cirúrgica do tecido sesamoideo necrotizado foi realizada. Em todos os pacientes a terapia utilizada se mostrou eficaz, havendo completa remissão dos sintomas sem complicações ou deformidades do antepé. CONCLUSÕES: A cintilografia óssea trifásica torna-se angular na propedêutica da necrose avascular do sesamoide, concorrendo com diagnóstico precoce acurado e permitindo ao especialista tratamento adequado.OBJECTIVE: This study aimed to present seven cases of avascular necrosis of the sesamoid end report the role of bone scintigraphy in the diagnosis of these patients. METHODS: Seven patients with clinical suspicion of avascular necrosis of the sesamoid underwent three-phase bone scintigraphy with 30 mCi of 99mTc-MDP. RESULTS: Most of the patients were young female adults with complaints of limiting pain in the forefoot, who were making use of inappropriate footwear and/or had a history of injury with or without fracture. There was no

  19. Gout: Value of bone scanning

    Energy Technology Data Exchange (ETDEWEB)

    Oliva, J.P.; Cardenas, R.; Bell, L.; Gonzalez Griego, J.


    11 male patients with gout were studied by means of bone scintigraphy with /sup 99m/TcMDP. This diagnostic method rendered possible the diagnosis of clinically or roentgenologically occult bone involvement. Bone scintigraphy may be useful procedure to monitor therapy of gout.

  20. 应用99m锝-亚锡亚甲基二磷酸盐骨显像研究微波诱导高温对狗股骨缺损修复作用%99mTc-MDP Bone Scintigraphy for Study on Repair of Femoral Eefect Caused by Microwave-induced Hyperthermia in Dogs

    Institute of Scientific and Technical Information of China (English)

    赵廷宝; 范清宇; 张殿忠; 裘秀春; 文艳华


    Objective To investigated the biological procedure of allograft decalcified bone matrix(DBM)and bone cement(BC)combined with bovine bone morphogenetic protein (bBMP)used for the repair of femoral defect caused by microwave- induced hyperthermia in dogsby 99mTc- MDP bone scintigraphy.Method The canine femoral defect(length 25mm,width 10mm)was caused by microwave- induced hyperthermia(50℃ ,20minutes)and the composite material was implanted .Then the canine femurs were examined by 99mTc- MDP bone scintigraphy respectively at different postoperative time and the results were compared with that of X- ray photography and histological observation.Bone cement was implanted in the other femur as a contrast.Results It could be observed at the first and the second month that the radioisotope was gathered in the place where the composite material was implanted and the amount of radioisotope gathered in was the most abundant at the third month and it was lasted to the fourth month. That of the sixth month was decreased to that of the second month.The radiation count of the first, the second, the third the fourth and the sixth month were 93.9± 12.7, 110.7± 16.4,222.1± 24.0,201.3± 26.9 and 111.6± 20.7 respectively,and the count of the third month and the fourth month were more than that of the first, the second and the sixth month(P<0.01).Conclusion The composite material could be remodeled easily and the new bone could be formed by the induction of bBMP. So it could be merged with the normal bone.While the 99mTc- MDP bone scintigraphy is the object and reliable index to determine the biological procedure of the composite material in dogs.

  1. Osseous scintigraphy in exploration of fever osteo-articular pain in sickle cell disease; La scintigraphie osseuse dans l'exploration des douleurs osteoarticulaires febriles chez les drepanocytaires

    Energy Technology Data Exchange (ETDEWEB)

    El Ajmi, W.; Slim, I.; Zaabar, L.; Ben Sellem, D.; Letaief, B.; Mhiri, A.; Ben Slimene, M.F. [Institut Salah Azaiez, Service de medecine nucleaire, Tunis (Tunisia)


    Osteo articular complications of sickle cell disease are multiple and can occur in the acute mode, (Bone infarction, acute osteomyelitis) or chronic (osteonecrosis, osteomyelitis).Through 6 cases we present the interest, lack and limitations of planar scintigraphy with bis phosphonates. Two patients underwent an early bone scan supplemented by medullary scintigraphy with nano colloids, the diagnosis was a bone infarction. In two children, the bone scan was performed between 5 and 7 days after the beginning of symptoms and did not objectify image of acute osteo articular complication. In the last patient, abnormal scintigraphy does not allow to differentiate osteomyelitis and bone infarction. The bone scan remains an essential consideration in the exploration of bone manifestations in sickle cell disease. Its association with bone marrow scintigraphy provides better diagnostic accuracy in differentiating osteomyelitis and bone infarction and adjusting the therapeutic management. (N.C.)

  2. Diagnosis Value of 99 MTC-MIBI Combined with 99 MTC-MDP Imaging for Hyperparathyroidism%99mTc-MIBI联合99mTc-MDP显像诊断甲状旁腺功能亢进症的价值

    Institute of Scientific and Technical Information of China (English)

    刘晓杰; 桂文来; 蒋灵军


    目的 探讨应用99mTc-MIBI双时相显像联合99mTc-MDP骨显像在甲状旁腺功能亢进症诊断中的价值.方法 选择我院2015年2月至2016年1月收治的18例血清甲状旁腺激素(PTH)升高患者,行99mTc-MIBI双时相SPECT/CT甲状腺显像,并与同期B超结果 进行比较,最终以病理结果作为金标准,99mTc-MDP全身骨显像,通过99mTc-MDP在骨骼系统的分布情况以及在骨外组织的分布情况,了解体内钙代谢的变化情况.结果99mTc-MIBI双时相SPECT/CT显像甲状腺部位有异常影像15例,阳性率83.33%;同期B超阳性率66.67%;99mTc-MDP骨显像均呈现出代谢性骨病表现10例,其中既有代谢性骨病表现又有肺、心脏显影2例,既有代谢性骨病表现又有胃显影2例,单独肺、心脏、胃显影的2例,99mTc-MDP骨显像阳性率66.67%;其中99mTc-MIBI双时相SPECT/CT显像以及99mTc-MDP骨显像均异常10例.病理结果显示,甲状旁腺腺瘤10例,单发甲状旁腺腺瘤3例,甲状旁腺增生5例.结论 99mTc-MIBI双时相SPECT/CT显像对PHPT进行临床诊断具有重要价值,99mTc-MDP骨显像对于PHPT患者的临床评价和指导治疗方案也同样有着重要作用.

  3. 16层螺旋CT与99Tcm-MDP全身骨显像对腰椎骨转移瘤的诊断价值%Exploration on the diagnostic value of 16-slice spiral CT and whole body bone scintigraphy in lumbarspinebonemetastases

    Institute of Scientific and Technical Information of China (English)



    Objective:To explore the diagnostic value of 16-slice spiral CT and 99Tcm-MDP whole body bone scintigraphy in lumbar spine bone metastases. Methods:The retrospective analysis of 47 cases of hospitalized patients with the clinical diagnosis of lumbar bone metastases and complete information 63 lumbar bone metastases, and analyze the results of 16-slice spiral CT with 99Tcm-MDP whole body bone scintigraphy. Results:We calculated the sensitivity and specificity of the two inspection results. 16-slice spiral CT findings of 43 patients with a total of 59 vertebrae were damaged, sensitivity (84.6%), 16-slice spiral CT clear diagnosis of lumbar metastases in 37 cases, suspicious 13 cases;99Tcm-MDP whole body bone scintigraphy found 37 patientsa total of 41 the abnormal vertebral radioactive concentrated, sensitivity, whole body bone scintigraphy clear diagnosis of lumbar spine metastases in 27 cases, suspicious of nine cases;39 patients with systemic bone scintigraphy found multiple extrapyramidal radioactive anomalies concentrated. Conclusion:16-slice spiral CT diagnosis of lumbar bone metastases compared with 99Tcm-MDP bone scintigraphy has a higher sensitivity, but the majority of patients with a more definitive diagnosis can be obtained by 99Tcm-MDP bone scintigraphy.%目的:探讨16层螺旋CT与99Tcm-亚甲基二膦酸盐(99Tcm-MDP)全身骨显像对腰椎骨转移瘤的诊断价值。方法:回顾性分析临床确诊腰椎骨转移瘤且资料完整的住院患者47例63处腰椎骨转移瘤,分析其16层螺旋CT与99Tcm-MDP全身骨显像检查结果。计算两种检查结果的灵敏度及特异度。结果:16层螺旋CT发现43例患者共59处椎体破坏,其灵敏度为84.6%;明确诊断腰椎转移瘤37例,可疑13例;99Tcm-MDP全身骨显像检查发现37例患者共41处椎体放射性异常浓聚,其灵敏度为65.2%,全身骨显像明确诊断腰椎转移瘤27例,可疑9例;39例患者全身骨显像发现椎体外多发放

  4. Renal scintigraphy in veterinary medicine. (United States)

    Tyson, Reid; Daniel, Gregory B


    Renal scintigraphy is performed commonly in dogs and cats and has been used in a variety of other species. In a 2012 survey of the members of the Society of Veterinary Nuclear Medicine, 95% of the respondents indicated they perform renal scintigraphy in their practice. Renal scintigraphy is primarily used to assess renal function and to evaluate postrenal obstruction. This article reviews how renal scintigraphy is used in veterinary medicine and describes the methods of analysis. Species variation is also discussed.

  5. Decreased uptake with Sulesomab scintigraphy in a case of extra spinal osteitis;Hypofixation de la scintigraphie au sulesomab dans une osteite extrarachidienne

    Energy Technology Data Exchange (ETDEWEB)

    Ungureanu, C.M.; Angoue, O.; Blagosklonov, O.; Boulahdour, H. [CHU Jean-Minjoz, Service de medecine nucleaire, 25 - Besancon (France); Pauchot, J. [CHU Jean-Minjoz, Service de chirurgie orthopedique, traumatologique, plastique et readaptation fonctionnelle, 25 - Besancon (France)


    Decreased uptake of ischion osteitis with Sulesomab scintigraphy. We report the case of a 28-year-old man, who underwent surgery for a left gluteal muscle abscess. During the surgery multiple specimens were taken from the abscess and the left ischion. These specimens revealed a coagulase-negative Staphylococcus abscess and a coagulase-negative Staphylococcus ischion osteitis. Bone scintigraphy showed an increased uptake in the ischion, while Sulesomab scintigraphy demonstrated a decreased uptake in the same area. If a decreased uptake of Sulesomab has already been described in bone spine infection, it has not yet been described in extra spinal infectious osteitis, to our knowledge

  6. Unexplained Bone Pain Is an Independent Risk Factor for Bone Metastases in Newly Diagnosed Prostate Cancer

    DEFF Research Database (Denmark)

    Zacho, Helle D; Mørch, Carsten D; Barsi, Tamás;


    OBJECTIVE: To determine the relationship between bone pain and bone metastases in newly diagnosed prostate cancer. PATIENTS AND METHODS: This prospective study of bone scintigraphy enrolled 567 consecutive patients with newly diagnosed prostate cancer. The presence of all-cause bone pain, known b......: Unexplained bone pain was a strong independent risk factor for bone metastasis. Guidelines should recommend staging bone scintigraphy in patients with unexplained bone pain, regardless of other risk factors....

  7. Application of whole-body bone scintigraphy in diagnosis and staging of Langerhans cell histiocytosis in infants%全身骨显像在婴幼儿朗格汉斯组织细胞增多症诊断和分期中的应用

    Institute of Scientific and Technical Information of China (English)

    丁献敏; 刘保平; 韩星敏; 程兵; 阮翘


    目的 探讨全身骨显像在婴幼儿朗格汉斯组织细胞增多症(LCH)诊断和分期中的应用价值.方法 对20例经手术病理或骨髓穿刺、皮疹压片细胞学确诊为LCH的婴幼儿行全身骨显像检查,对骨显像阳性者加行局部X线或CT检查.利用ROI技术计算全身骨显像阳性病灶的F/N比值并求出位于相同部位病灶的F/N比值均值.结果 20例患儿全身骨显像10例阳性,4例为多发病灶,6例为单发病灶.单纯颅骨放射分布异常3例,颅骨合并其他部位骨3例,肩胛骨2例,肋骨1例,下肢骨1例;单发颅骨病灶的F/N比值均值为0.36,长骨病灶的F/N比值均值为3.52.结论 全身骨显像有助于婴幼儿LCH的诊断及分期.%Objective To assess the application value of whole-body bone scintigraphy in diagnosis and staging of Langerhans cell histiocytosis (LCH) in infants. Methods Whole-body bone scintigraphy was performed in 20 infants of LCH confirmed with surgical pathology or bone marrow aspiration and laboratory data. The infants with positive bone scintigraphy underwent X-ray or CT, and the F/N value of positive lesions and lesions located in the same area were calculated by ROI technology. Results Ten of 20 patients showed positive in bone scans, including 4 with multi-focal lesions and 6 with single lesion. Among 10 patients with positive scintigrams, there were 3 patients with abnormal bone uptakes limited to cranial, 3 with cranial and other parts of abnormal bone uptakes, 2 with scapula abnormal uptakes, as well as rib and lower limb bone involvement (each n= 1). The average ratios of F/N on cranial alone was 0. 36, while focused on long bones was 3. 52. Conclusion Whole-body bone scintigraphy is useful in the diagnosis and staging of LCH in infants.

  8. Testicular scintigraphy; Hodenszintigrafie

    Energy Technology Data Exchange (ETDEWEB)

    Tiling, R. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians Univ. Muenchen (Germany)


    In the clinical situation of an acute scrotum, differentiation between different reasons for scrotal pain may be crucial in certain cases. Beside clinical examination and laboratory tests, Color Doppler sonography is routinely applied. Testicular scintigraphy can only be suggested as a complementary tool if it is available as an emergency procedure. Acute testicular torsion that has already been reliably diagnosed by clinical examination is not an indication for testicular perfusion scintigraphy. This diagnostic procedure is, however, valuable if the clinical findings are equivocal and, especially, if a conservative treatment is planned. The method of and the results obtained with testicular scintigraphy in the differential diagnosis of acute scrotal pain are briefly described in this article. (orig.)

  9. Whole-body MRI for detecting osseous metastases:comparison with bone scintigraphy%全身MRI与核素骨扫描对骨转移瘤诊断价值的对照研究

    Institute of Scientific and Technical Information of China (English)

    鲁珊珊; 王德杭; 李永军; 冯阳; 周敏林; 刘许慧


    Objective The aim of the study was to evaluate the reliability of whole-body MRI(WBMRI)in detecting osseous metastases.Methods Thirty patients verified with malignant tumor by histology were enrolled.All the patients underwent WB-MRI and bone scintigraphy(BS)with a two week interval.Clinical information,conventional MRI and CT images,and follow-up data were collected as gold standard for the diagnosis of bone metastases.The data of 30 patients and 270 segments as study unit respectively were analyzed.The sensitivity and specificity between WB-MRI and BS were compared with McNemar test.Resuits Bone metastases were confirmed in 27 of 30 patients by gold standard.Twenty-five patients with bone metastases were detected by WB-MRI and no false-positive cases.Twenty-seven patients with bone metastases were Nund by BS but having two false-positive oases.With patients as study unit,the diagnostic sensitivity of WB-MRI and BS were both 92.6%(25/27)and the specificity were 100%(3/3)and 33.3%(1/3),respectively.The area under ROC curve of WB-MRI and BS were 0.9630 and 0.6296,respectively(P>0.05).With segments as study unit,119 bone metastases segments were confirmed.The diagnostic sensitivity of WB-MRI and BS were 90.8%(108/119)and 70.6%(84/119)(P0.05).以病灶部位为单位统计显示全身MRI的敏感度、特异度分别为90.8%(108/119)、98.0%(148/151),高于骨扫描的70.6%(84/119)、90.7%(137/151)(P值均<0.01).全身MRI的ROC曲线下面积为0.9438,大于BS的0.8066(P<0.01).全身MRI同时发现3例患者存在脑转移,4例患者存在肺转移,4例患者存在肝转移.结论 全身MRI对骨转移瘤的综合诊断能力较Bs好,具有一定的临床应用价值.

  10. Is femoral uptake of Tc99m-methylene diphosphonate on bone scintigraphy in bronchogenic carcinoma an alarming sign: A case report and brief review of literature?

    Directory of Open Access Journals (Sweden)

    Rayamajhi Sampanna Jung


    Full Text Available Detection of skeletal metastasis in patients with lung cancer is important from management point of view. We report the bone scan finding in a patient with non-small cell lung carcinoma showing isolated abnormal tracer in femur and having a characteristic appearance in computed tomography, highlighting the importance of bone scan in patients with bronchogenic carcinoma.

  11. White blood cell scintigraphy for differentiation of infection and aseptic loosening

    DEFF Research Database (Denmark)

    Simonsen, Lene; Buhl, Anna; Oersnes, Thue;


    Diagnosis of an infected arthroplasty is often difficult. Fever, abnormal physical findings, radiographic changes, findings at bone scintigraphy, an elevated erythrocyte sedimentation rate, CRP, and leucocytosis are not specific enough. We evaluated the diagnostic value of white blood cell...

  12. Increased technetium-99 m hydroxy diphosphonate soft tissue uptake on bone scintigraphy in chronic kidney disease patients with secondary hyperparathyroidism

    DEFF Research Database (Denmark)

    Enevoldsen, Lotte Hahn; Heaf, James Goya; Højgaard, Liselotte


    In bone scan patients with dialysis-treated chronic kidney disease (CKD) and hyperparathyroidism, soft tissue accumulation of technetium-99 m hydroxy/methylene diphosphonate (Tc-99 m-HDP/MDP) has been reported primarily in case reports and usually explained by hypercalcaemia and/or hyperphosphata......In bone scan patients with dialysis-treated chronic kidney disease (CKD) and hyperparathyroidism, soft tissue accumulation of technetium-99 m hydroxy/methylene diphosphonate (Tc-99 m-HDP/MDP) has been reported primarily in case reports and usually explained by hypercalcaemia and...... patients diagnosed with secondary hyperparathyroidism admitted for Tc-99 m-HDP bone scan. Baseline characteristics and mean concentrations of biochemical markers (including P-calcium and P-phosphate) taken 0-3 months prior to the bone scans were collected. Soft tissue uptake was detected on bone scans...... of the 36 patients without myocardial uptake. In conclusion, dialysis-treated CKD patients with secondary hyperparathyroidism have a high incidence of soft tissue uptake, and this finding is strongly correlated with elevated phosphate, but not calcium values....

  13. Value of 99Tcm-MDP SPECT bone scintigraphy in diagnosis of unilateral condylar hyperplasia of the mandible%99Tcm-MDP SPECT颞颌关节显像对髁突肥大的诊断价值

    Institute of Scientific and Technical Information of China (English)

    文兵; 沈影; 汪长银


    目的 探讨99Tcm-MDP SPECT颞颌关节显像对髁突肥大的诊断价值.方法 回顾性分析2009年至2010年行99Tcm-MDP SPECT颞颌关节显像的髁突肥大(临床确诊)患者56例(男22例,女34例,平均年龄21.5岁),其中31例接受了髁突高位切除术并有组织病理学结果.另收集10例因恶性肿瘤等其他疾病行骨显像的对照者,男女各5例,平均年龄22.6岁,加做颞颌关节显像.对所有研究对象进行SPECT图像分析及半定量分析,采用独立样本t检验比较髁突肥大组与对照组间患侧髁突/顶骨及患侧髁突/双侧髁突的摄取比差异,髁突肥大组患侧与健侧的摄取差异行配对t检验.对手术治疗患者的SPECT结果与其病理结果进行Pearson相关分析.结果 髁突肥大组患侧髁突/顶骨摄取比(1.66 ±0.63)及患侧髁突/双侧髁突摄取比(0.59±0.44)均明显高于对侧(1.34±0.34、0.41±0.04,t=3.687和6.590,均P<0.01),并且明显高于对照组左侧髁突相应数据(1.12 ±0.07和0.50±0.01,t =6.459和4.750,均P<0.001).SPECT检查诊断髁突生长活跃的灵敏度为95.2%(20/21),特异性为60.0%(6/10),阳性预测值为83.3% (20/24),阴性预测值为6/7.患侧髁突/双侧髁突摄取比与软骨组织增生的厚度无明显相关[软骨膜、增殖层、肥大层的平均厚度分别为(150.5±94.9)、(185.2±113.6)、(167.7 ±76.9)μm,r=0.46、0.47、-0.12,均P>0.05].结论 99Tcm-MDP SPECT颞颌关节显像能够有效评估髁突肥大患者的骨质生长活性,为手术方式的选择提供重要依据.%Objective To investigate the clinical value of 99Tcm-MDP SPECT bone scintigraphy in diagnosis of unilateral condylar hyperplasia (UCH) of the mandible.Methods Temporomandibular joint tomography using 99Tcm-MDP SPECT was performed in 56 UCH patients (22 males,34 females,mean age 21.5 y) preoperatively and 10 controls with other diseases (5 males,5 females,mean age 22.6 y).Thirtyone UCH patients received high condylar resection

  14. SPECT/spiral CT and bone scintigraphy in cancer patients: Impact of a low dose CT acquisitions in indeterminate or suspicious solitary focus; TEMP/TDM et scintigraphie osseuse en cancerologie: impact d'une acquisition scannographique basse dose chez les patients avec foyer isole suspect ou de nature indeterminee

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    Franson, T.; Bardet, S.; Switsers, O.; Aide, N. [CRLCC Francois-Baclesse, 14 - Caen (France); CHU Lyon-Sud, Pierre-Benite, Service de Medecine Nucleaire, 69 - Lyon (France); Loiseau, C. [CRLCC Francois-Baclesse, Unite de Biophysique, 14 - Caen (France); Allouache, D.; Gunzer, K. [CRLCC Francois-Baclesse, Oncologie Medicale, 14 - Caen (France); Allouache, N. [CRLCC Francois-Baclesse, Radiotherapie, 14 - Caen (France)


    Aim: To evaluate the usefulness of a low dose SPECT/CT and the added value of an additional 'diagnostic' centred CT-scan in cancer patients with a solitary focus observed on planar whole-body bone scintigraphy (P.W.B.S.) and classified as indeterminate or suspicious. Material and methods Sixty consecutive patients underwent a low dose SPECT/CT acquisition (120 kV, 30 m As, 3 mm slice thickness) followed by a 'diagnostic' CT-scan (120 kV, 100 m As, 1.25 mm slice thickness) centred on the focus. The first observer considered prospectively W.B.S., low-dose SPECT/CT and finally the centred SPECT/CT. A blinded review was performed by a second observer. Results P.W.B.S. depicted solitary indeterminate or suspicious foci in 38 and 22 patients, respectively. SPECT/CT acquisitions clarified 73% (44/60) of the foci. Additional diagnostic CT-scan altered low-dose SPECT/CT results in nine patients. Additional foci (not found by P.W.B.S.) located outside the scanning area of the centred diagnostic CT-scan were found in 20 patients. Inter observer agreement for P.W.B.S., low-dose SPECT/CT and diagnostic SPECT/CT was equal to 0.542, 0.68 and 0.694, respectively. R.O.C. analysis showed no difference between low-dose SPECT/CT and diagnostic SPECT/CT for observer 1 and observer 2. Conclusion This study shows that a conventional low-dose SPECT/CT in patients presenting with a solitary focus on P.W.B.S. is sufficient to improve both accuracy and inter observer variability of bone scanning. A CT volume session should not be limited to the area of the solitary focus since additional foci located outside the centred CT-scan frequently occurred. (authors)

  15. Increased technetium-99 m hydroxy diphosphonate soft tissue uptake on bone scintigraphy in chronic kidney disease patients with secondary hyperparathyroidism: correlation with hyperphosphataemia. (United States)

    Enevoldsen, Lotte Hahn; Heaf, James; Højgaard, Liselotte; Zerahn, Bo; Hasbak, Philip


    In bone scan patients with dialysis-treated chronic kidney disease (CKD) and hyperparathyroidism, soft tissue accumulation of technetium-99 m hydroxy/methylene diphosphonate (Tc-99 m-HDP/MDP) has been reported primarily in case reports and usually explained by hypercalcaemia and/or hyperphosphataemia. As human vascular smooth muscle cells produce hydroxyapatite during cell culture with increased phosphate levels and as Tc-99 m-HDP/MDP primarily binds to hydroxyapatite, we hypothesized that soft tissue accumulation would be found in patients with hyperphosphataemia. We identified 63 CKD patients diagnosed with secondary hyperparathyroidism admitted for Tc-99 m-HDP bone scan. Baseline characteristics and mean concentrations of biochemical markers (including P-calcium and P-phosphate) taken 0-3 months prior to the bone scans were collected. Soft tissue uptake was detected on bone scans in 37 of 63 (59%) patients. Primary locations were in the heart (27/37 = 73%), muscles (12/37 = 32%), lung (9/37 = 24%) and gastrointestinal tract (6/37 = 16%), and 13 of 37 (35%) patients had simultaneous uptake in more than one location. Regarding biochemical markers, patients with soft tissue uptake only differed from patients without in terms of plasma phosphate levels (1·95 ± 0·15 (n = 37) versus 1·27 ± 0·08 (n = 26), P = 0·0012). All patients with myocardial uptake (n = 27) had a coronary arteriography-verified history of coronary artery disease (CAD), whereas CAD was only present in six of the 36 patients without myocardial uptake. In conclusion, dialysis-treated CKD patients with secondary hyperparathyroidism have a high incidence of soft tissue uptake, and this finding is strongly correlated with elevated phosphate, but not calcium values.

  16. Bone scan and joint scan of hands and feet in rheumatoid arthritis; Scintigraphie osseuse et articulaire des mains et des pieds dans la polyarthrite rhumatoide

    Energy Technology Data Exchange (ETDEWEB)

    Carpentier, N.; Verbeke, S.; Perdrisot, R.; Grilo, R.M.; Quenesson, E.; Bonnet, C.; Vergne, P.; Treves, R.; Bertin, P.; Boutros-Toni, F. [Centre Hospitalier Universitaire Dupuytren, Faculte de Medecine, 87 - Limoges (France)


    The aim of this study was to determine the ability of joint scan and bone scan of hands and feet, in patients with rheumatoid arthritis, to localize the altered joints. The sensitivity, the specificity, the positive predictive value (PPV) and the negative predictive value (NPV) of joint scan were determined in comparison with clinical joint assessment. Fifteen patients (780 joints) were clinically examined (pain and synovitis); during the same day, a bone scan and a joint scan were realized by oxidronate {sup 99m}Tc intravenous injection. Patients were scanned 5 minutes (tissual time, T{sub t}) and 3 hours 1/4 (bone time, T{sub 0}) after the administration. The uptake of the bi-phosphonate was evaluated with a qualitative method using a grey scale. The uptake of {sup 99m}Tc oxidronate was quantitated using an extra-articular region of interest. The sensitivity, specificity, PPV and NPV of the scan at Tt were 46%, 96%, 85% et 78%. The same parameters were 75%, 66%, 53% and 84% for the scan realized at T{sub 0}. The joint scan has showed 22% of false positive. These false positives could be a consequence of an earlier detection of joint alterations by scan. The joint scan should forecast the evolution of joints in patients with rheumatoid arthritis. (author)

  17. Application of bone scintigraphy in therapy response monitoring and prognosis prediction in patients with bone metastasis from lung cancer and prostate cancer%骨扫描在肺癌和前列腺癌骨转移疗效监测及预后判断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    潘懿范; 刘建军; 黄钢; 马玉波


    目的 探讨全身骨扫描在肺癌和前列腺癌骨转移疗效监测及预后判断中的应用价值.方法 将40例肺癌患者和31例前列腺癌患者在系统治疗前1个月内及治疗≥3个月后分别行全身骨扫描,观察治疗前后骨转移灶的变化与肿瘤临床综合疗效的相关性.采用Kaplan-Meier法计算生存率,Log-rank检验及Cox回归模型分析影响肺癌或前列腺癌骨转移预后的危险因素.结果 肿瘤临床综合治疗有效者( 59.68%,37/62)的骨转移疗效明显好于无效者(40.32%,25/62)(P<0.05).肺癌骨转移患者的1年生存率为54.5%,2年生存率为22.6%;前列腺癌骨转移患者的1年生存率为87.3%,2年生存率为72.3%.单因素及Cox多因素分析均显示:肺癌和前列腺癌骨转移患者的生存率与肿瘤类型及骨转移时长相关(P<0.05).肺癌与前列腺癌分组行Cox多因素分析结果显示:肺癌骨转移的预后危险因素为病理类型、治疗前骨扫描病变范围及骨转移时长;而前列腺癌骨转移的预后与骨转移时长有关.结论 全身骨扫描为肺癌和前列腺癌骨转移的疗效监测及预后判断提供了更丰富、更准确的信息.%Objective To investigate the application of bone scintigraphy in therapy response monitoring and prognosis prediction in patients with bone metastasis from lung cancer and prostate cancer. Methods Whole-body bone scintigraphy was performed in 40 patients with lung cancer and 31 patients with prostate cancer one month before systematic therapy and no less than 3 months after treatment. The changes of bone metastasis lesions were observed before and after treatment, and the correlation of bone metastasis with therapy response was explored. Survival rates were calculated by Kaplan-Meier method, and prognostic factors for survival were analysed by Log-rank test and Cox regression model. Results The therapeutic effect of bone metastasis in clinical therapy responders in primary

  18. Comparison of Whole-body MRI and Bone Scintigraphy for Diagnosing Osseous Metastasis in Patients with Breast Cancer%全身MRI和骨扫描诊断乳腺癌骨转移比较

    Institute of Scientific and Technical Information of China (English)

    王警建; 崔尊社; 李娜


    Objective To assess the diagnostic accuracy of whole-body MR] (WB-MRI) and bone scintigraphy(BS) for osseous metastasis in patients with breast cancer. Methods Twenty-two patients with breast cancer were underwent both planar BS and WB-MRI,in order to determine whether there were osseous metastases. Results The sensitivity,specificity,diagnostic accuracy,positive and negative likehood ratio of WB-MRI were 91.7% ,90% ,90.9% ,9.17 and 0.11 and for BS those were 83.3% ,80% ,81.8% ,4.16 and 0.24,respectively. Conclusion The diagnostic efficacy of WB-MRI was superior to BS for osseous metastasis in patients with breast cancer.%目的:探讨全身MRI和骨扫描对乳腺癌患者骨转移首诊的准确性.方法:对22例乳腺癌患者行全身MRI和骨扫描检查以确定有无骨转移.结果:全身MRI和骨扫描诊断骨转移的敏感度、特异度、准确度分别为91.7%、90%、90.9%和83.3%、80%、81.8%;阳性和阴性似然比分别为9.17、0.11和4.16、0.24.结论:乳腺癌患者骨转移全身MRI效果优于骨扫描.

  19. Analysis of artifact imaging of extraosseous tissues in whole-body bone scintigraphy%全身骨显像骨外伪影的原因分析

    Institute of Scientific and Technical Information of China (English)

    王娜; 刘生


    Whole-body bone seintigraphy using 99Tcm-methylene diphosphonate, one of the most commonly performed radionuclide examinations, is the first choice for early diagnosis of bone metastases. However, the artifact imaging of the extraosseoas tissues invariably affects the accuracy of the diagnosis. It is important to consider all the possible factors of the extraosseous uptake of the imaging agent and aggregate analyse during interpreting the examination.The common causes including the radioactive drug, the injection, the patient-serf and so on.%全身骨显像是目前公认的早期诊断骨转移瘤的首选方法,是核医学最常规显像项目之一.然而,骨外组织显影导致的伪影常影响诊断的准确性.对全身骨显像进行评价时,要针对骨外组织显影的各种可能的发生机制(包括药物因素、注射因素、患者因素等)进行综合分析,提高骨显像诊断的准确性.

  20. Different fibrovascularization rate between coralline hydroxyapatite and high density porous polyethylene (Medpore) measured by 99mTc-MDP bone scintigraphy 6 months after intraorbital implantation. (United States)

    Pan, M-H; Wu, Y-W; Yen, R-F; Tzen, K-Y; Liao, S-L; Kao, C-H


    Many materials and types of implant have been used to achieve a cosmetic effect and prosthesis motility in the anophthalmic socket. Hydroxyapatite remains the implant material of choice for producing the most natural prosthesis motility while porous polyethylene shows promising characteristics as another useful material. The aim of this study was to compare the fibrovascular ingrowth rates of orbital implants between coralline hydroxyapatite and high density porous polyethylene (Medpore). The fibrovascularization rate is determined by bone imaging using 99mTc methylene diphosphonate (99mTc-MDP) 6 months after implantation. Our study included 29 patients with coralline, and nine patients with Medpore implants. Our results showed that groups with coralline implants appearing to achieve complete fibrovascularization at a much more rapid rate than those with Medpore. The differences in rate were statistically significant.

  1. Evaluation of bone scintigraphy in early diagnosis of ankylosing spondylitis%骨关节闪烁显像在强直性脊柱炎早期诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    张成君; 罗修文; 林琛; 李俊雄; 欧阳亮; 关楚文


    value of SI/S exceed 1.5 was considered as abnormal, 20 of 27 possible AS were positive (74.07% ), while 11 of 23 confirmed AS were positive(47.83%) (P<0.05). The presence of typical uptake pattern outside SIJ, especially costovertebral and spine in 12 of 27 patients with possible AS (44.44%), and in 14 of 23 confirmed AS(60. 87% ) were useful in suggesting the diagnosis. Conclusion: The study indicates that bone scintigraphy is useful in early diagnosis of ankylosing spondylitis and screening the sites of abnormality in bones and joints.

  2. Scrotal scintigraphy; Hodenperfusionsszintigraphie

    Energy Technology Data Exchange (ETDEWEB)

    Gruss, A. [Wuerzburg Univ. (Germany). Urologische Klinik und Poliklinik; Scheubeck, M. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Timm, P. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Hofmockel, G. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Reiners, C. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Frohmueller, H.G.W. [Wuerzburg Univ. (Germany). Urologische Klinik und Poliklinik


    Scrotal scintigraphy has two indications in urology; first to prove the vitality of the injured testis after scrotal trauma, second to differentiate the diagnosis of the acute scrotum. The term `acute scrotum` stands for a clinical emergency which needs to be clarified and treated immediately. The most common reason for the acute scrotum is either acute testicular torsion or acute epididymitis. The therapy of both differs totally. Acute testicular torsion requires open surgery within four to six hours in order to prevent loss of the organ, epididymitis will be treated conservatively. It is very difficult to differentiate the diagnosis by the clinical status. In the literature the rate of failure amounts up to 30% because of an unnecessary surgical intervention for the epididymitis or because of a loss of the testicle after a nondiagnosed testicular torsion. Therefore, the use of an additional procedure seems to be necessary to enable a correct assessment of testicular blood supply. Scrotal scintigraphy represents a valuable diagnostic procedure which allows to reduce the rate of clinical failure with an acceptable time expense and a good chance of reproducibility. The sensitivity and specifity of scrotal scintigraphy is 90-96% and 93-100% respectively. Compared to duplex sonography scrotal scintigraphy derives a great advantage form the independance of the investigator and from the painless procedure for the patient. Scrotal scintigraphy is not needed in the clinical definite acute testicular torsion, but it is indicated in each unclear situation especially when a differential diagnosis is not available by palpation. (orig./MG) [Deutsch] Fuer die Hodenperfusionsszintigraphie finden sich in der klinischen Urologie zwei Einsatzbereiche: Zum einen ermoeglicht die Hodenperfusionsszintigraphie eine Vitalitaetspruefung des Hodens nach einem Skrotaltrauma und bietet in Kombination mit der Sonographie eine wesentliche Entscheidungshilfe zur operativen oder konservativen

  3. The Clinical Value of 99mTc-MDP Bone Scintigraphy in the Diagnosis of Bone Metastases%99mTc-MDP全身骨显像在骨转移瘤诊断中的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    张婷; 姚昊; 王志忠; 何宝明


    目的:探讨在骨转移瘤临床诊断中99mTc-MDP全身骨显像的诊断价值。方法:选取2011年1月至2012年12月间于我院临床诊断为恶性肿瘤患者330例,所有患者均进行CT及99mTc-MDP全身骨显像检查确认是否存在骨转移瘤,并将两种检查结果采用统计学软件进行对比分析。结果:330例恶性肿瘤患者中确诊恶性肿瘤骨转移者277例,CT检查诊断280例,误诊率为11.55%,漏诊率为10.11%,准确率为81.82%,敏感性为89.89%,特异性为88.45%,阳性预测值为86.28%,阴性预测值为22.64%,99mTc-MDP检查诊断242例,误诊率为4.69%,漏诊率为5.78%,准确率为91.21%,敏感性为94.22%,特异性为95.31%,阳性预测值为87.36%,阴性预测值为39.62%,两组患者敏感性、特异性及准确率间差异均比较明显,在统计学上有意义(P<0.05)。结论:99mTc-MDP全身骨显像是早期诊断骨转移瘤的安全、有效检查方法,对于恶性肿瘤患者的分期、治疗、预后具有重要意义,值得推广。%Objective:To investigate the diagnostic value in the clinical diagnosis of bone metastases, 99mTc-MDP bone scintigraphy. Methods: Selected 330 cases of patients with malignant tumors in our hospital from January 2011 to December 2012, all patients underwent CT and 99mTc-MDP whole body bone scintigraphy to confirm the presence of bone metastases, and two test results were analyzed using statistical software. Results:330 patients with malignant tumors diagnosed with bone metastases of malignant tumors in 277 cases, CT examination diagnosis of 280 cases, the misdiagnosis rate was 11.55%, missed diagnosis rate was 10.11%, the accuracy rate of 81.82%, a sensitivity of 89.89%and a specificity of 88.45%, positive predictive value of 86.28%, negative predictive value of 22.64%, 99mTc-MDP check diagnosis of 242 cases, the misdiagnosis rate was 4.69%, the misdiagnosis rate was 5.78%, the accuracy was 91.21%, the sensitivity was 94.22%, specificity resistance of 95

  4. Assessment of the impact of application of singlephoton emission computed tomography and SPECT-CT on lesion categorisation in bone scintigraphy

    Directory of Open Access Journals (Sweden)

    Garba H. Yunusa


    Full Text Available Objectives: To assess initial experience with the use of a new single-photon emission computed tomography-computed tomography (SPECT-CT in the evaluation of lesions.Methods: The folder number, radiopharmaceutical used and type of scan of patients examined with a new Siemens T6 SPECT-CT between 02 April 2016 and 31 December 2013 were retrieved. The number of 99mTc-MDP bone scans was sufficient for a detailed analysis. The scans were re-processed and reported by the observer before he was given any clinical information. Whole body planar, whole body planar plus SPECT and whole body planar plus SPECT-CT images were assessed successively in three separate sessions at least 2 weeks apart. At each session, the certainties of detection, localisation and categorisation of each lesion were recorded.Results: A total of 539 lesions were seen on the whole body, SPECT and computed tomography (CT images in 133 patients. The whole body images showed no lesions in 3 patients and 378 lesions in 130 patients. SPECT detected 122 additional lesions in 79 patients. Thirty-nine (12.2% lesions were seen only on CT in 32 (24.1% patients. For the 261 lesions seen on the planar images in the SPECT field of view, lesion detection was definite in 233 (89.3%, localisation definite in 151 (57.9% and categorisation definite in 123 (47.1% lesions. On the SPECT, definite lesion detection, localisation and categorisation were recorded, respectively, for 259 (99.2%, 228 (87.4% and 176 (67.4% of the 261 lesions. Lesion detection, localisation and categorisation certainties were definite for 100%, 99.1% and 94.7% of the SPECT-CT lesions, respectively.Conclusion: SPECT markedly improves lesion detection and localisation, and CT enhances lesion categorisation.

  5. Tc-99m HIG Scintigraphy in Detection of Active Inflammation in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Özhan Özdoğan


    Full Text Available Objective: The diagnosis of active inflammation in ankylosing spondylitis (AS is crucial for treatment to delay possible persistent deformities. There are no specific laboratory tests and imaging methods to clarify the active disease. We evaluated the value of Tc-99m human immunoglobulin (HIG scintigraphy in detection of active inflammation. Material and Methods: Twenty-nine patients were included. Tc-99m methylenediphosphonate bone (MDP and HIG scintigraphies were performed within 2-5 day intervals. Two control groups were constituted both for MDP and HIG scintigraphies. Active inflammation was determined clinically and by serologic tests. Both scintigraphies were evaluated visually. Sacroiliac joint index values (SII were calculated. Results: Active inflammation was considered in five (sacroiliitis in 2, sacroiliitis-spinal inflammation in 1, achilles tendinitis in 1, arthritis of coxafemoral joints in 1 patients. HIG scintigraphy demonstrated active disease in all 3 patients with active sacroiliitis. But, it was negative in the rest. The other 2 active cases were HIG negative. Right and left SII obtained from HIG scintigraphy was higher (p<0.05 in clinically active patients than inactive patients. There was not any significant difference between patients with inactive sacroiliitis and normal controls. Right and left SII obtained from bone scintigraphy was higher (p<0.05 in patient group than in control group. Conclusion: Clinically inactive AS patients, behave no differently than normal controls with quantitative sacroiliac joint evaluation on HIG scintigraphy. HIG scintigraphy may be valuable for evaluation of sacroiliac joints in patients with uncertain laboratory and clinical findings. (MIRT 2011;20:52-58

  6. Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer - a prospective double-blinded study at two hospital centers; Diagnostischer Stellenwert der Ganzkoerper-MRT und der Skelettszintigrafie in der ossaeren Metastasendetektion bei Mammakarzinompatientinnen - eine prospektive Doppelblindstudie an zwei Klinikzentren

    Energy Technology Data Exchange (ETDEWEB)

    Ohlmann-Knafo, Susanne; Pickuth, D. [Caritasklinik St. Theresia, Akademisches Lehrkrankenhaus der Univ. des Saarlandes, Saarbruecken (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Kirschbaum, M. [Caritasklinik St. Theresia, Akademisches Lehrkrankenhaus der Univ. des Saarlandes, Saarbruecken (Germany). Klinik fuer Gynaekologie und Geburtshilfe, Brustzentrum Saar Mitte; Fenzl, G. [Knappschaftskrankenhaus Puettlingen (Germany). Inst. fuer Radiologie und Nuklearmedizin


    The purpose of this study was to compare the diagnostic accuracy of whole-body MRI (WB-MRI) and bone scintigraphy (BS) for the screening of bone metastases for the first time in a large and homogeneous patient collective with breast cancer in a systematic and controlled study. 213 breast cancer patients were evaluated for bone metastases under randomized, double-blinded and prospective conditions at two hospitals. All participants were examined by WB-MRI and BS over an average period of four days. The examinations were performed separately at two different locations. The WB-MRI protocol included T 1-TSE and STIR sequences. WB-MRI and BS were reviewed independently by experienced radiologists and nuclear medicine specialists in a consensus reading. In 66 % of cases bone metastases were excluded by both procedures, and bone metastases were detected concordantly in 2 % of cases. In 7 % of cases there were discrepant results: in 7 cases BS was false-positive when WB-MRI was negative. In 5 / 7 cases BS was negative when WB-MRI identified bone metastases. In 89 % of cases BS was uncertain when WB-MRI was true-negative. In 17 % of cases WB-MRI showed important (non-) tumor-associated findings. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy for WB-MRI were 90 %, 94 %, 82 %, 98 % and 99 % and for BS those were 40 %, 81 %, 36 %, 91 % and 93 %. (orig.)

  7. Contribution of osseous scintigraphy in the fractures of constraint- about five cases; Apport de la scintigraphie osseuse dans les fractures de contrainte- a propos de 5 cas

    Energy Technology Data Exchange (ETDEWEB)

    Berehou, F.; Haddam, A.; Ben Rais, N. [Service de medecine nucleaire, CHU Ibn Sina, Rabat, (Morocco)


    The fracture of constraint lies on an unbalance between the bone resistance and the constraints at which it is submitted. The early diagnosis lies always on four principal elements: anamnesis, the poorness of the clinical examination, an early positive dual phase skeleton scintigraphy, and the delayed emergence of radiological signs. The highlighting of a hyper fixation at the skeleton scintigraphy on a bone prone to a constraint fracture in a context of intense physical activity or osseous insufficiency is highly evocative of the diagnosis. (N.C.)

  8. RI scintigraphy in myasthenia gravis

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Yoshikazu; Miyamoto, Mariko (Tokyo Metropolitan Fuchu Hospital (Japan)); Maki, Masako; Yamazaki, Toshiro


    35 cases of myasthenia gravis were studied with RI scintigraphy. /sup 67/Ga-citrate was used in 34 patients and /sup 76/Se-selenomethionine in 5 patients for thymus scintigraphy. RI scintigram was negative in non-tumorous thymus, regardless of the severity of illness and it was positive in seven of nine patients with thymomas. RI accumulation in thymus was found both in benign and malignant thymomas. RI seems to accumulated in lymphocytic and mixed thymus more than epithelial type.

  9. 99Tcm-MDP骨三相显像在慢性骨髓炎外科手术治疗中的应用%Application of 99Tcm-MDP Three-Phase Bone Scintigraphy in the Surgery of Chronic Osteomyelitis

    Institute of Scientific and Technical Information of China (English)

    吉蘅山; 薛杨波; 朱虹; 胡裕效; 张垒


    Objective To investigate the effect of 99Tcm-MDP three-phase bone scintigraphy in the surgery of chronic osteomyelitis. Methods Combined with surgical operation methods, the 99Tcm-MDP three-phase bone scintigraphy data of 34 patients with chronic osteomyelitis who were recruited from 2002 to 2008 in our hospital was analyzed to explore the diagnostic and therapeutic value of 99Tcm-MDP three-phase bone scintigraphy in chronic osteomyelitis. Results The A/N ratio was increased in 28 patients in blood lfow phase, which indicated that the positive rate of chronic osteomyelitis in blood lfow phase was 82.4%. The abnormal gather of tracer agent was occurred in soft tissues of 10 patients in blood pool phase and bones of 34 patients in delayed phase, which indicated that the positive rates of chronic osteomyelitis in blood pool phase and delayed phase were 29.4% and 100%, respectively. Conclusion The scope, position and size of bone lesions can be evaluated with 99Tcm-MDP three-phase bone scintigraphy, which can provide a correct guidance for the surgeon to thoroughly remove necrotic tissue of bone lesions.%目的:探讨99Tcm-MDP骨三相显像在慢性骨髓炎外科手术治疗中的作用。方法回顾性分析我科2002~2008年34例慢性骨髓炎患者99Tcm-MDP骨三相显像的资料,结合临床骨科手术方法,探讨99Tcm-MDP骨三相显像对慢性骨髓炎的诊断及治疗价值。结果34例患者中,28例患者血流相患/健侧摄取比值(A/N比值)明显增加,阳性率为82.4%;血池相10例患者软组织内可见示踪剂异常浓聚,阳性率为29.4%;延迟相34例患者骨骼均可见示踪剂异常浓聚,阳性率为100%。结论核素骨三相显像可以评估病灶的范围、死骨的大小及位置,为术中彻底清除骨性病灶的坏死组织提供正确的指导作用。

  10. Role of positron emission tomography and bone scintigraphy in the evaluation of bone involvement in metastatic pheochromocytoma and paraganglioma: specific implications for succinate dehydrogenase enzyme subunit B gene mutations.

    NARCIS (Netherlands)

    Zelinka, T.; Timmers, H.J.L.M.; Kozupa, A.; Chen, C.C.; Carrasquillo, J.A.; Reynolds, J.C.; Ling, A.; Eisenhofer, G.; Lazurova, I.; Adams, K.T.; Whatley, M.A.; Widimsky, J.Jr.; Pacak, K.


    We performed a retrospective analysis of 71 subjects with metastatic pheochromocytoma and paraganglioma (30 subjects with mutation of succinate dehydrogenase enzyme subunit B (SDHB) gene and 41 subjects without SDHB mutation). Sixty-nine percent presented with bone metastases (SDHB +/-: 77% vs 63%),

  11. Liver scintigraphy in veterinary medicine. (United States)

    Morandi, Federica


    The most common veterinary application of liver scintigraphy is for the diagnosis of portosystemic shunts (PSSs). There has been a continual evolution of nuclear medicine techniques for diagnosis of PSS, starting in the early 1980s. Currently, transplenic portal scintigraphy using pertechnetate or (99m)Tc-mebrofenin is the technique of choice. This technique provides both anatomical and functional information about the nature of the PSS, with high sensitivity and specificity. Hepatobiliary scintigraphy has also been used in veterinary medicine for the evaluation of liver function and biliary patency. Hepatobiliary scintigraphy provides information about biliary patency that complements finding in ultrasound, which may not be able to differentiate between biliary ductal dilation from previous obstruction vs current obstruction. Hepatocellular function can also be determined by deconvolutional analysis of hepatic uptake or by measuring the clearance of the radiopharmaceutical from the plasma. Plasma clearance of the radiopharmaceutical can be directly measured from serial plasma samples, as in the horse, or by measuring changes in cardiac blood pool activity by region of interest analysis of images. The objective of this paper is to present a summary of the reported applications of hepatobiliary scintigraphy in veterinary medicine.

  12. Radionuclide scintigraphy of the scrotum

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jun Hyung; Park, Young Hee; Lee, Soon Jin; Lee, Sun Wha; Ko, Young Tae; Kim, Soon Yong [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)


    Radionuclide scrotal scintigraphy with {sup 99m}Tc-pertechnetate is an easy, well established, useful and readily available technique for evaluation of acute scrotum. We studied 41 cases of radionuclide scrotal scintigraphy and the results were as follows: 1. The over all diagnostic accuracy of scrotal scintigraphy was 93% (38/41 cases). 2. Scrotal scintigraphy was very useful and accurate in differential diagnosis of epididymo-orchitis and testticular torsion in patient with acute scrotal pain and swelling, while there was some limitation in differential diagnosis of hematoma from acute epididymo-orchitis or torsion. 3. Scintigraphy of epididymo-orchitis showed increased perfusion and radioactivity in the epididymis and/or testis and its diagnosis accuracy was 90% (19/21 cases). 4. Acute testicular torsion showed normal flow in perfusion and cold defect occupying affected testis in static image, while missed torsion showed slightly increased flow in perfusion image and cold defect surrounded by an uniform rim of hyperactivity (halo sign). Diagnostic accuracy of testicular torsion was 86% (6/7 cases)

  13. [A worrisome scintigraphy]. (United States)

    Cardano, Sergio; Cornaglia, Gabriella; Monteverde, Anna Irene


    This report describes a patient who was admitted to the hospital with suspicion of occult neoplasia, widely spreading to bone. In fact, he had osteoporosis and osteomalacia due to hypovitaminosis D caused by chronic use of antiepileptic drugs.

  14. Thyroid scintigraphy in veterinary medicine. (United States)

    Daniel, Gregory B; Neelis, Dana A


    Thyroid scintigraphy is performed in cats and dogs and has been used to a limited degree in other species such as the horse. Thyroid scintigraphy is most commonly used to aid in the diagnosis and treatment management of feline hyperthyroidism but is also used in the evaluation of canine hypothyroidism and canine thyroid carcinoma. This article reviews the normal scintigraphic appearance of the thyroid in the cat, the dog, and the horse and the principles of interpretation of abnormal scan results in the cat and the dog. Radioiodine is the treatment of choice for feline hyperthyroidism, and the principles of its use in the cat are reviewed.

  15. Evaluation of diagnostic procedures such as plain-film scintigraphy and MR imaging for spinal metastases in relation to biological characteristics in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Hiroya; Nagao, Kazuharu; Nishimura, Reiki; Matsuda, Kazumasa; Baba, Kenichiro; Matsuoka, Yukio; Fukuda, Makoto; Higuchi, Akihiro; Saeki, Takahito [Kumamoto City Hospital (Japan)


    The relationship between spinal metastases diagnosed by plain-film, bone scintigraphy, and MR imaging and biological characteristics in 26 patients with breast cancer was investigated retrospectively. It was found that bone scintigraphy is useful for detecting metastases in case with slow-growing tumors determined by DNA polymerase {alpha} or with estrogen-receptor (ER) positivity. In contrast, cases with rapidly growing tumors showed false-negative plain-film or bone scintigraphy results, including cases with ER-negative tumors or DNA polymerase {alpha} of more than 20%. MR imaging was found to be highly sensitive in detecting spinal metastases even in aggressive cases. MR imaging was found to have greater reliability in detecting spinal metastases of breast cancer compared to bone scintigraphy. In conclusion, it may be important to consider the degree of malignancy of each case with spinal metastases of breast cancer in evaluating imaging diagnosis. (author).

  16. Performance of the SPECT-CT after a non contributive osseous scintigraphy in the pulmonary cancers with suspect pains; Performances de la TEMP-TDM apres une scintigraphie osseuse non contributive dans les cancers pulmonaires avec douleurs suspectes

    Energy Technology Data Exchange (ETDEWEB)

    Granier, P.H.; Mourad, M. [centre hospitalier de Carcassonne, Service de medecine nucleaire, 11 (France)


    Purpose: evaluate the performance of the SPECT-CT after a normal or litigious planar bone scintigraphy in the pulmonary cancers with suspicious pains. conclusions: The SPECT-CT has good performances in the exploration of suspicious pains of pulmonary cancers. The comparison of results got at one year interval shows that these performances are clearly improved par experience. It seems logical to use the planar bone scintigraphy coupled to SPECT-CT in this indication. This bone imaging can have an interest in the surveillance of patients after curative or palliative treatment, when pains appear. (N.C.)

  17. Bone (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  18. Three-phase scintigraphy in epicondylitis of the lateral lower humerus

    Energy Technology Data Exchange (ETDEWEB)

    Koppers, B.; Riel, K.


    Ten patients with tennis elbow were examined by three-phase scintigraphy, using sup(99m)Tc-MDP. In agreement with the histological findings of H. Schneider (14), there was no uptake during the perfusion and soft tissue phase. In the phase, there was focal bone uptake in one patient only.

  19. 全身MR扩散加权成像与骨扫描探测骨转移灶的初步对比研究%Comparison of whole body MR diffusion weighted imaging and skeletal scintigraphy In detecting bone metastasis

    Institute of Scientific and Technical Information of China (English)

    徐贤; 马林; 张金山; 蔡幼铨; 徐白萱; 程流泉; 郭行高


    目的 通过与单光子发射计算机体层摄影术(SPECT)骨扫描对比,初步探讨全身MR扩散加权成像(DWI)技术探测骨转移灶的可行性.方法 对42名正常志愿者及38例可疑合并骨转移的恶性肿瘤患者行全身MR DWI及SPECT骨扫描,并将骨骼系统分为8个区域,分别记录每例患者各区域全身MR DWI和SPECT骨扫描分别显示的病灶数目及各区域阳性病例数,进行每一患者及每一区域的全身MR DWI及骨扫描的对照分析.结果 全身MR DWI阳性病例30例,受累区域69处,共探测出病灶数169处;骨扫描阳性病例29例,受累区域68处,共探测出病灶数156处;全身MR DWI阳性而SPECT骨扫描阴性者2例,SPECT骨扫描阳性而全身MR DWI阴性者1例;SPECT骨扫描阴性而全身MR DWI阳性区域8例,其中,脊柱3例、骨盆2例、股骨3例;骨扫描阳性而全身MRDWI阴性区域7例,其中颅骨4例、肩胛骨2例、胸锁骨1例.结论 全身MR DWI与SPECT骨扫描对检测骨转移病灶有很好的一致性,且两者可互相补充;全身MR DWI还可检测各脏器及淋巴结病灶,适用于肿瘤患者随访.%0bjective To evaluate the application of whole body MR diffusion weighted imaging (DWI)in the detection of bone metastasis using skeletal scintigraphy as the referenee.Methods Fonv.two healthy volunteers and 38 patients with malignant tumors were enrolled in our studv.A11 the patients received MR examination and skeletal scintigraphy within one week.MR examination was performed on GE signa 3.0T MR scanner using a body coil.The skeletal system Was divided into eight regons and the images of the whole body MR DWI and skeletal seintigraphy were reviewed to compare the two modalities patient by patient and region by region.The images were reviewed separately by two radiologists and two nuclear medicine physicians,who were blinded to the results of another imaging modality.Results A total of 169 metastatic lesions in 69 regions of 30 patients were

  20. Predictive value of prostate-specific antigen and Gleason sum for results of radionuclide bone scintigraphy in patients with prostate cancer%前列腺特异性抗原和Gleason评分对前列腺癌患者核素骨扫描结果的预测价值

    Institute of Scientific and Technical Information of China (English)

    王天昱; 何志嵩; 周利群; 陈晓鹏; 李学松; 贾元歆; 成俊; 张建华; 蔡林; 张争; 龚侃


    该进行骨扫描检查.%Objective: To investigate the predictive value of prostate-specific antigen (PSA) and Gleason sum for results of radionuclide bone scintigraphy in prostate cancer patients, in order to determine when to perform a radionuclide bone scintigraphy in Chinese patients with newly diagnosed prostate cancer. Methods: We retrospectively reviewed the charts of 624 consecutive patients with a pathology diagnosis of prostate cancer hospitalized in Department of Urology, Peking University First Hospital between Jan. 1994 and Dec. 2005, and evaluated the relationships between results of bone scintigraphy and serum tPSA, and between bone scintigraphy and Gleason sum. The receiver operating characteristics ( ROC) curves were analyzed to determine the cut-off values of tPSA and Gleason sum for predicting positive results of bone scintigraphy. Results: In the study, 443 patients underwent both a radionuclide bone scan and a serum PSA test prior to treatment, of whom, 216 (48. 8% ) got positive results, and 338 also possessed the Gleason sum for pathological evaluation. The serum tPSA levels were significantly higher in patients with positive results of the bone scan ( median: 71.00 μg/L; range; 1.30 -2 400.00 μg/L) than those with negative results ( median; 60. 00 μg/L; range; 0. 60 - 201. 00 μg/L; rank P < 0. 001 ) , and the Gleason sums were also significantly higher in positive-bone-scan patients than in negative-bone-scan patients (7.1 ±1.5 vs. 6. 7 ± 1. 8, P <0. 001) . Linear regression analysis suggested significant positive correlation between the results of the bone scan and the two afore-mentioned parameters, respectively (lg[PSA]: r=0.933, B=0.352, P=0.001; Gleason sum; r=0.971, 5=0.096, P< 0.001 ). The incidence of a positive bone scan result was 9. 0% in patients with tPSA < 10 μg/L and 3. 8% in patients with Gleason sum <5. When the indication for bone scan was established as tPSA > 15 μg/L or Gleason sum ≥7, its sensitivity, specificity, positive predictive

  1. Detection of synovial pseudarthrosis by 99mTc scintigraphy: application to treatment of traumatic nonunion with constant direct current

    Energy Technology Data Exchange (ETDEWEB)

    Esterhai, J.L. Jr.; Brighton, C.T.; Heppenstall, R.B.; Alavi, A.; Desai, A.G.

    A prospective study utilizing technetium scintigraphy to evaluate nonunion patients prior to the electrical stimulation of osteogenesis is reported. Roentgenographic evaluation and scintigraphy must include four views (anteroposterior, lateral and both obliques). Although all nonunion technetium scans showed increased uptake of the radionuclide at the fracture site, three bone scan patterns were identified: (1) intense, uniformly increased uptake at the nonunion site (69.5%); (2) photon deficient (cold) cleft between two intense areas of uptake (23.4%); and (3) indeterminate pattern (7.1%). The presence of a cold cleft between two intense areas of uptake on scintigraphy correlated closely with the presence of a synovial pseudarthrosis at surgery. Nonunions of the humerus were most frequently associated with synovial pseudarthrosis (57.1%). The presence of a synovial pseudarthrosis as suggested by technetium scintigraphy mandates open excision of the lining membrane at the time of electrode insertion.

  2. Exploration of the S.A.P.H.O. syndrome: PET/CT with {sup 18}FNa vs planar osseous scintigraphy; Exploration du syndrome SAPHO: TEP/TDM au {sup 18}FNa vs scintigraphie osseuse planaire

    Energy Technology Data Exchange (ETDEWEB)

    Ben Ali, K.; Poisson, T.; Hayem, G.; Lebtahi, R.; Sarda-Mantel, L.; Burg, S.; Meyer, O.; Le Guludec, D. [Groupe hospitalier Bichat-Claude-Bernard, 75 - Paris (France)


    Our purpose was to study the interest of the PET/CT with {sup 18}FNa (F Na-PET/CT) in the assessment of the lesions synovitis acne pustulosis hyperostosis osteitis (S.A.P.H.O.) syndrome compared to bone planar scintigraphy with hydroxy-methylene diphosphonate (H.M.D.P.) labelled with {sup 99m}Tc. The preliminary results suggest an increase of sensitivity of the F Na-PET/CT compared to bone scintigraphy in the S.A.P.H.O. syndrome exploration ( particularly for the rachis injuries, tips and enthesopathies), without loss of specificity. (N.C.)

  3. The role of scintigraphy in the lameness evaluation. (United States)

    Steckel, R R


    Bone scanning to help diagnose orthopedic disease has been used in human patients for over two decades. The value of this diagnostic tool has been well established in helping to identify a variety of musculoskeletal conditions. It has only recently been used by veterinarians for more accurate characterization of equine musculoskeletal disease. The technique offers the major advantage of increased sensitivity over standard radiographic imaging. The case material illustrated here shows that except for consistent identification of bone cysts, most of the pathologic changes to the horse's musculoskeletal system that might cause lameness are detected on bone scans. Many acute bone diseases can be diagnosed by scintigraphy that cannot be discerned by radiographs until the condition has become chronic: Because of their body size, these conditions may not be diagnosed at all in horses. Scintigraphy in horses offers the other major advantage of affording accurate imaging of the upper limbs, pelvis, and vertebral column without general anesthesia. Therefore, it has a final advantage of increased safety over conventional radiography because it eliminates the need to perform general anesthesia to study these areas. In the author's experience, if abnormal uptake of isotope in the upper limbs, pelvis or spine is not observed, general anesthesia to radiograph those areas is not warranted. A second major benefit of scintigraphic imaging is to differentiate mixed lameness conditions in which the component of bone disease must be separated from that of soft tissues to arrive at a rational course of treatment or prognosis. Finally, for athletic horses suspected of having lameness due to localized myositis, scintigraphy not only allows confirmation of muscle inflammation but also identifies the muscle bellies injured reasonably accurately so that specific local treatment may be given. Nuclear imaging of equine skeletal disease is an option that should be employed more frequently by

  4. 18F-FDG符合线路显像与99mTc-MDP骨显像及二者联合对乳腺癌骨转移的检出效能%18F-FDG SPECT coincidence, 99mTc-MDP bone scintigraphy and combination of the two techniques for detecting malignant bone metastasis from breast cancer

    Institute of Scientific and Technical Information of China (English)

    陆涤宇; 夏亮; 王志; 乔雪玲


    目的 采用ROC曲线比较18F-FDG符合线路显像、99mTc-MDP骨显像及二者联合对乳腺癌骨转移的检出效能.方法 收集手术病理诊断为乳腺癌的女性患者113例,均于4周内先后接受18F-FDG符合线路显像及99mTc-MDP骨显像;对两种显像结果按5分法评分,以二者评分之和为联合评分值,以病理诊断或临床随访为确诊“金标准”,比较ROC曲线下面积(AUC),评价99mTc-MDP骨显像、18F-FDG符合线路显像及联合评分法对乳腺癌骨转移患者的检出效能,比较不同方法在各自最佳诊断阈值下的灵敏度、特异度、准确率、阳性预测值(PPV)和阴性预测值(NPV).结果 113例中,12例(10.62%)最终确诊为骨转移,101例(89.38%)无骨转移.99mTc-MDP骨显像、18 F-FDG符合线路显像以及二者联合诊断评分的ROC曲线分析显示三者AUC分别为0.991、0.874和0.993,三种方法对乳腺癌骨转移的诊断效能均佳,尤以99mTc-MDP骨显像与联合诊断为最佳(P均<0.01).最佳阈值点下,单独18F-FDG符合线路显像、99mTc-MDP骨显像及联合检出骨转移患者的灵敏度分别为75.00%(9/12)、75.00%(9/12)、83.33%(10/12),特异度为100%(101/101)、98.02%(99/101)、98.02%(99/101),准确率为97.35%(110/113)、95.58%(108/113)、96.46%(109/113),PPV为100%(9/9)、81.82%(9/11)、83.33%(10/12),NPV为97.12%(101/104)、97.06%(99/102)、98.02%(99/101).结论 99mTc-MDP骨显像对乳腺癌骨转移患者的检出效能优于18F-FDG符合线路显像,二者联合可提高对骨转移患者的检出率.%Objective To observe the efficacy of 18F-FDG SPECT coincidence (18F-FDG SPECT) , 99mTc-MDP bone scintigraphy (BS) and combination of the two techniques (18F-FDG SPECT+99mTc-MDP BS) for detecting bone metastasis from breast cancer by ROC curve analysis. Methods Totally 113 patients with breast cancer underwent both 99mTc-MDP BS and 18F-FDG SPECT within 4 weeks. The images were interpreted according to 5

  5. Comparison of 18F-fluorodeoxyglucose dual-head tomography with coincidence and 99mTc-methylenediphosphonate bone scintigraphy in diagnosis and therapeutic evaluation of bone metastases%18F-FDG符合探测显像与99mTc-MDP骨显像评价肿瘤骨转移的对比研究

    Institute of Scientific and Technical Information of China (English)

    武新宇; 高永举; 闫新慧


    Objective To compare the value of 18F-fluorodeoxyglucose (18F-FDG) dual-head tomography with coincidence (DHTC) and 99mTc-methylenediphosphonate (99mTc-MDP) bone scintigraphy (BS) in diagnosis and therapeutic evaluation of bone metastases. Methods A total of 42 cases with cancer bone metastases, averagely aged (53.62±12.48) years old, were enrolled in this study. 18 cases did not receive any treatment, and 11 patients received inspection 2-5 times for assessment of therapeutic effects. 18F-FDG DHTC and 99mTc-MDP BS were performed within one week in all patients. The sensitivity, specificity and accuracy of 18F-FDG DHTC and 99mTc-MDP BS were compared. Results Of the 42 patients with bone metastases, 36 cases were correctly detected by 18F-FDG DHTC, and 32 were correctly detected by 99mTc-MDP BS. The difference of the sensitivity was not significant (χ2=1.25,P=0.320). Among 18 patients who did not receive any treatment, all got correct diagnosis by 18F-FDG DHTC, and 12 were positive on 99mTc-MDP BS. The difference of the diagnostic accuracy was significant (χ2=4.17,P<0.05). The result of 18F-FDG DHTC was strongly correlated with the clinical therapeutic evaluation(r=0.834,P<0.02). Conclusion 18F-FDG DHTC offers an advantage in diagnosis and therapeutic evaluation of bone metastases over 99mTc-MDP BS.%目的:比较18F-脱氧葡萄糖(18F-FDG)符合探测显像及99mTc-亚甲基二膦酸盐(99mTc-MDP)骨显像在肿瘤骨转移诊断及疗效评价中的价值。方法收集本院行18F-FDG符合探测显像及99mTc-MDP骨显像的骨转移患者42例,平均年龄(53.62±12.48)岁。其中未进行任何治疗患者18例,另11例治疗后多次(2~5次)行18F-FDG符合探测显像及99mTc-MDP全身骨显像。两种检查在1周内完成。比较两种方法在肿瘤骨转移诊断及疗效评价中的价值。结果18F-FDG符合探测显像有36例明确诊断,99mTc-MDP骨显像有32例明确诊断,两种方法的诊断准确率

  6. Impact Analysis of Serum PSA Combined Gleason Score and Clinical Stage of Prostate Cancer Bone Scintigraphy to Predict%血清PSA联合Gleason评分与临床分期预测前列腺癌核素骨显像的影响分析

    Institute of Scientific and Technical Information of China (English)



    Objective To explore the serum PSA combined Gleason score and clinical stage of prostate cancer hormone predict bone imaging relationship. Methods The patients were randomly selected 117 cases of prostate cancer from March 2010 to March 2014 in our hospital, according to serum PSA and Gleason score, comparing the different threshold NPV, PPV, and predictive analysis bone imaging.Results PSA0-10 ng/mL, Gleason score less than 8 minutes patients, PPV, NPV were 71%, 100%; PSA greater than 100 ng/mL/Gleason score greater than 7 points patient, NPV, PPV 42%, 93%, suggesting that serum PSA level and Gleason score and clinical stage, prostate cancer is an independent predictor of bone scintigraphy.Conclusion In the treatment of T1, T2 stage underwent ECT bone imaging, can reduce treatment response, and T3, T4 patients with bone metastasis has occurred.%目的:探究血清PSA联合Gleason评分与临床分期预测前列腺癌素骨显像结果关系。方法随机选取2010年3月至2014年3月我院收治的前列腺癌患者117例,根据血清PSA与Gleason评分,对比各不同临界值的NPV、PPV,并预测分析骨显像结果。结果PSA0~10 ng/mL、Gleason评分<8分患者,PPV、NPV分别为71%、100%;PSA>100 ng/mL/Gleason评分>7分患者,NPV、PPV分别为42%、93%,提示血清PSA水平与Gleason评分及临床分期,都是前列腺癌骨显像的独立预测因子。结论在诊疗上,对T1、T2分期患者行ECT骨显像,可降低治疗反应,而T3、T4期患者,骨转移已经发生。

  7. Platelet scintigraphy in atherothrombotic disease

    Energy Technology Data Exchange (ETDEWEB)

    Isaka, Yoshinari (Osaka National Hospital (Japan))


    Indium-111 platelet scintigraphy for the measurement of in vivo thrombogenicity is a useful noninvasive technique with a number of applications. From 1982 to 1989, we explored clinical relevance of this method for 576 consecutive patients with atherothrombotic disease. There was a disease-related difference in the percentage of positive platelet accumulation; 85% in patients with Dacron bifurcation graft, 75% in abdominal or thoracic aneurysm, 40% in intra-cardiac thrombi, 33% in arteriosclerosis obliterans and 25% in ischemic cerebrovascular disease. Labelled platelets accumulated frequently in the lesion with severe arteriographic abnormality. Aspirin clearly inhibited platelet accumulation on carotid atheroma but the effect of ticlopidine has been less conclusive. Short-term orally active PGI[sub 2] analogue had inhibitory effects on platelet accumulation in carotid atheroma and platelet aggregability, but did not cause significant reduction in plaque size. The results suggest the usefulness of platelet scintigraphy for monitoring the thrombogenicity in various atherothrombotic diseases. It will be necessary, however, to simplify the labelling procedures and to develop a new [sup 99m]Tc-labelled thrombus imaging agent, if thrombus imaging is to be considered for more generall use for patients with atherosclerosis. (author).

  8. Esophageal scintigraphy: A comparison with esophagoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kjellen, G.; Andersson, P.; Sandstroem, S.


    Fifty consecutive patients with different esophageal symtoms were investigated with esophageal endoscopy, transit scintigraphy, and gastroesophageal (GE) scintigraphy with extra-abdominal compression. Scintigraphic findings were abnormal in 27 of those 31 patients (87%) who were classified as abnormal at endoscopy. A prolonged transit time was the commonest finding, but hiatal hernia and GE reflux were also found. However, the scintigraphic procedure showed abnormalities in 6 of 19 (31%) patients who were classified as normal at endoscopy. Esophageal scintigraphy is recommended as a screening test before endoscopy is decided on. 20 refs.

  9. {sup 123}I-MIBG scintigraphy/SPECT versus {sup 18}F-FDG PET in paediatric neuroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Melzer, Henriette Ingrid; Bartenstein, Peter; Pfluger, Thomas [Ludwig Maximilian University of Munich, Department of Nuclear Medicine, Munich (Germany); Coppenrath, Eva [Ludwig Maximilian University of Munich, Department of Radiology, Munich (Germany); Schmid, Irene; Albert, Michael H. [Ludwig Maximilian University of Munich, Department of Paediatric Haematology/Oncology, Munich (Germany); Schweinitz, Dietrich von [Ludwig Maximilian University of Munich, Department of Paediatric Surgery, Munich (Germany); Tudball, Coral [Royal Children' s Hospital, Department of Nuclear Medicine, Melbourne, VIC (Australia)


    To analyse different uptake patterns in {sup 123}I-MIBG scintigraphy/SPECT imaging and {sup 18}F-FDG PET in paediatric neuroblastoma patients. We compared 23 {sup 123}I-MIBG scintigraphy scans and 23 {sup 18}F-FDG PET scans (mean interval 10 days) in 19 patients with a suspected neuroblastic tumour (16 neuroblastoma, 1 ganglioneuroblastoma, 1 ganglioneuroma and 1 opsomyoclonus syndrome). SPECT images of the abdomen or other tumour-affected regions were available in all patients. Indications for {sup 18}F-FDG PET were a {sup 123}I-MIBG-negative tumour, a discrepancy in {sup 123}I-MIBG uptake compared to the morphological imaging or imaging results inconsistent with clinical findings. A lesion was found by {sup 123}I-MIBG scintigraphy and/or {sup 18}F-FDG PET and/or morphological imaging. A total of 58 suspicious lesions (mean lesion diameter 3.8 cm) were evaluated and 18 were confirmed by histology and 40 by clinical follow-up. The sensitivities of {sup 123}I-MIBG scintigraphy and {sup 18}F-FDG PET were 50% and 78% and the specificities were 75% and 92%, respectively. False-positive results (three {sup 123}I-MIBG scintigraphy, one {sup 18}F-FDG PET) were due to physiological uptake or posttherapy changes. False-negative results (23 {sup 123}I-MIBG scintigraphy, 10 {sup 18}F-FDG PET) were due to low uptake and small lesion size. Combined {sup 123}I-MIBG scintigraphy/{sup 18}F-FDG PET imaging showed the highest sensitivity of 85%. In 34 lesions the {sup 123}I-MIBG scintigraphy and morphological imaging findings were discrepant. {sup 18}F-FDG PET correctly identified 32 of the discrepant findings. Two bone/bone marrow metastases were missed by {sup 18}F-FDG PET. {sup 123}I-MIBG scintigraphy and {sup 18}F-FDG PET showed noticeable differences in their uptake patterns. {sup 18}F-FDG PET was more sensitive and specific for the detection of neuroblastoma lesions. Our findings suggest that a {sup 18}F-FDG PET scan may be useful in the event of discrepant or inconclusive

  10. Parathyroid scintigraphy during hypocalcaemia in primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Øgard, Christina G; Thomsen, Jørn Bo; Jakobsen, Henrik


    Minimally invasive parathyroid surgery in patients with primary hyperparathyroidism (PHPT) demands high imaging accuracy. By increasing blood flow to the parathyroid adenoma before injection of a perfusion marker, we intended to improve the parathyroid scintigraphy. We have named the technique...

  11. Clinical roles in indium-111 octreotide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hain, S.F.; Roach, P.J [Royal North Shore Hospital, St Leonards, NSW (Australia). Department of Nuclear Medicine


    Full text: Octreotide is being increasingly used in the assessment of various tumour types, particularly those of neuroendocrine origin. It has even been proposed that octreotide scintigraphy should be used as the first localisation technique in such tumours. We present three cases which show different clinical roles for 111 In- octreotide scintigraphy in both evaluating the extent of disease and assessing likely response to somatostatin therapy. In the first case, a 55-year-old male presented with flushing, diarrhoea, weight loss and elevated urinary 5-HIM levels. Clinical examination showed left supraclavicular Iymphadenopathy and CT revealed only paraaortic Iymphadenopathy. In comparison, octreotide scintigraphy revealed much more extensive disease than noted on CT in both the abdomen and chest. Lesions were histologically confirmed as carcinoid tumour. In the second case, a 52-year-old male underwent scintigraphy for staging of small cell lung carcinoma. Similarly, more extensive disease was noted on octreotide scintigraphy than on CT scanning. In the third case, a 1 6-year-old female underwent debulking surgery for a growth hormone and prolactin producing pituitary tumour. The presence of somatostatin receptors was demonstrated by octreotide scintigraphy. This was performed to determine the potential response to somatostatin therapy which has been reported to reduce tumour size in these patients. These cases show a clinical role for {sup 111}In octreotide scintigraphy in the evaluation of disease extent in neuroendocrine tumours as well as some other tumour sub-types. In the first two cases described, scintigraphy revealed more extensive disease than CT scanning. Indium-111 octreotide can also be used to predict the response of such patients to somatostatin therapy

  12. Quantitative Determination of Bone Scintigraphy for Early Necrosis of Femoral Head%骨闪烁摄影定量分析检测早期股骨头坏死

    Institute of Scientific and Technical Information of China (English)

    许瑞江; 马承宣; 赫荣国; 房论光; 刘贵林; 田嘉禾; 游联壁


    This research aimed at the prediction of the early necrosis of the femoral head by Technetium-99m-Methylene. diphosphorate scintimetry. The relationship between the isotope activity and histopathological change of the bone ceils of the femoral head was described. Necrosis of bone cells closely related to the ratio of isotope activity between the femoral heads of both sides. If the ratio (diseased: healthy)is markedly over 1, there would be necrosis of bone cells with repro duction, if the ratio is below 1, only necrosis of bone cells; if the ratio is exactly 1, no necrosis of bone cells. It is showed that the quantitative determination of bone sciutigraphy is a sensitive method of the diagnosis for early necrosis of the femoral head.%作者报告采用骨闪烁摄影定量分析检测幼犬早期股骨头坏死.分析双侧摄取放射活性与病理所见,头/头比值大于1.0或小于1.0者,均有骨细胞坏死;明显增大者,多同时伴有新生骨样组织;降低者,均为单纯骨坏死;相等者未见骨细胞坏死.作者认为骨闪烁摄影定量分析是预测和诊断早期股骨头坏死的灵敏度较高的一种方法.

  13. Postoperative osteomyelitis following implant arthroplasty of the foot: diagnosis with indium-111 white blood cell scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Bakst, R.H.; Kanat, I.O.


    Many complications can occur following insertion of silicone elastomer implants into the foot. Postoperative infection may be difficult to distinguish from other conditions such as dislodgment, fracture, ectopic and heterotopic new bone formation, synovitis, and bursitis. White blood cell scintigraphy, in conjunction with the clinical scenario, may prove to be an invaluable tool in the diagnosis of postoperative osteomyelitis, subsequent to implant arthroplasties. 32 references.

  14. Combined scintigraphic and radiographic diagnosis of bone and joint diseases

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee (Catholic Medical Coll., Seoul (Korea, Republic of). Dept. of Radiology and Nuclear Medicine)


    This book is intended to emphasize the tremendous value of pinhole scintigraphy in diagnosing nearly the whole spectrum of bone and joint diseases. Pinhole scintigraphy discloses anatomic and pathologic as well as chemical alterations in greater detail, permitting analytical interpretation and raising the sensitivity as well. Infections, nonspecific bone inflammation, rheumatic disorders, metabolic and endocrine bone diseases, trauma, and both primary tumors and metastasis can be effectively and specifically examined. By improving sensitivity, many false negative readings can be avoided in early bone metastasis, synovitis, enthesopathies, bone contusion, etc. (orig.)

  15. Whole-body (99m)Tc-octreotide scintigraphy with SPECT/CT to detect occult tumor inducing paraneoplastic osteomalacia. (United States)

    Rodrigues, Napoleão Ramalho; Calich, Ana Luisa; Etchebehere, Mauricio; Ichiki, Wilson Andre; Pereira, Fabio Payao; Amstalden, Elaine Maria Ingrid; de Sa Etchebehere, Elba Cristina


    A 32-year-old woman presented with progressive myalgia, bone pain, fatigue, insufficiency hip fractures, high urine phosphate, and low serum phosphate and vitamin D levels. These findings were suggestive of oncogenic osteomalacia. A whole-body Tc-octreotide scintigraphy with SPECT/CT showed uptake on a sclerotic intramedullary lesion in the left medial tibia plateau. MRI depicted a solid lesion. The lesion was surgically removed; the patient became asymptomatic, and follow-up laboratory results normalized. Histopathologic examination revealed a vascular hemangiopericytoma-like tumor, positive for somatostatin receptor (SSR-2). Whole-body Tc-octreotide scintigraphy with SPECT/CT may detect occult oncogenic osteomalacia tumors.

  16. Scintigraphy in postoperative follow-up of osteosynthesis of the femur with a bridge plate associated with an intramedullary pin in rabbits

    Directory of Open Access Journals (Sweden)

    N.F. Borges


    Full Text Available The objective of this work was to monitor the consolidation of the femur after osteosynthesis with a bridge plate associated with the intramedullary pin using scintigraphy. We used seven New Zealand breed male rabbits, at 4 months of age, with a mean weight of 3.5 kg. We performed a three-phase bone scintigraphy with technetium-labeled methylene diphosphonate (99mTc-MDP before and after surgery, and 20, 50 and 90 days postoperatively. The activity index (AI was calculated by dividing the average number of uptake counts in the region of the osteotomy by the average number of counts in the corresponding region in the contralateral limb. Radiography was performed before surgery, after surgery, and 15, 30, 45, 60 and 90 days postoperatively. We found a direct relationship between the activity index and progress of bone scintigraphy in the evaluation sequence over the period of observation. Scintigraphy allows monitoring of bone metabolism and measurement of vascularization and/or bone or tissue perfusion. The images obtained in the blood pool and static phases are the most appropriate for assessing bone metabolism in the context of this study. The bridge plate associated with the intramedullary pin promotes osteosynthesis with sufficient stability to allow bone consolidation.

  17. 99mTc-MDP 全身骨扫描和血清 CEA、NSE、CYFR21-1、CA125 测定对小细胞肺癌骨转移的临床评价%Clinical evaluation of 99mTc-MDP bone scintigraphy and serum CEA, NSE,CYFRA21-1 and CA125 in skeletal metastasis of the small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    张炜; 郭万华


    目的:分析99m Tc-MDP全身骨扫描小细胞肺癌骨转移病灶分布特点及血清肿瘤标志物CEA、NSE、CYFRA21-1、CA125与小细胞肺癌骨转移发生的相关性. 方法:回顾性分析56例经病理证实的小细胞肺癌患者 99m Tc-MDP全身骨扫描影像表现及血清肿瘤标志物水平,用ROC曲线及Spearman相关分析评价肿瘤标志物水平对肺癌骨转移发生及发展的诊断意义. 结果:21 例骨转移阳性病灶中胸部占46.60%,脊柱34.95%,骨盆9.71%,四肢5.83%,头颅2.91%. 骨转移阳性组CEA、NSE 质量浓度高于骨转移阴性组(均P<0.05),曲线下面积(AUC)分别为0.789、0.717,且CEA、NSE质量浓度与骨转移分级呈正相关(r值分别为0.540、0.417). 结论:小细胞肺癌以胸部及脊柱等中轴骨多发性骨转移为主,CEA、NSE血清水平随着骨转移病灶数的增加有显著上升趋势,对判定小细胞肺癌骨转移的发生及发展有一定的参考意义.%Objective:To analyze the distribution characteristic of the skeletal metastasis lesion in 99mTc-MDP bone scintigraphy and the correlation between serum tumor marker (CEA,NSE, CYFRA21-1 and CA125) and skeletal metastasis in small cell lung cancer .Methods:56 cases with small cell lung confirmed by pathology were examined with 99m Tc-MDP bone scintigraphy .Serum concentration of CEA , NSE, CYFRA21-1 and CA125 were measured one week before whole-body bone scanning .ROC curve and spearman correlation analysis were used to evaluate the serum tumor markers in diagnose the development of the skeletal metastasis .Results: 21 imaging positive lesions were identified as the skeletal metastasis .The distribution of the skeletal metastasis lesions were:chest(46.60%), spine(34.95%), pelvis(9.71%), four limbs(5.83%), skull(2.91%).CEA,NSE levels in bone metastasis group were significant higher than those in the negative group ( P<0.05 ) and the area of ROC curve were 0.789 and 0.717 respectively(P<0.05).There was a correlation between

  18. Evaluation of the inflammatory activity in chronic osteomyelitis. Contribution of the scintigraphy with polyclonal antibodies; Avaliacao de atividade inflamatoria em osteomielite cronica. Contribuicao da cintilografia com anticorpos policlonais

    Energy Technology Data Exchange (ETDEWEB)

    Sapienza, Marcelo Tatit


    Active chronic osteomyelitis or complicating osteomyelitis (superimposed on diseases that changes the normal bone structure fractures, post-surgery, prosthesis) can be difficult to diagnose by anatomic radiological imaging modalities, like plain radiograph and CT. These diseases frequently cause also increased bone remodeling, leading to nonspecific uptake of Tc-99m-bone scan agents and gallium-67. New radiopharmaceuticals with greater inflammation/infection avidity and specificity are being developed, including the nonspecific polyclonal immunoglobulin (IgG) labeled with technetium-99. Tc-99m-IgG may be available as a ready to use kit, with no reported side effects, low patient absorbed radiation dose and low cost. The mechanism of IgG uptake at the inflammation site has not been fully elucidated yet. Specific (receptor linking, physico-chemical immunoglobulin properties) and nonspecific mechanisms (enhanced vascular permeability and macromolecular exudate) has been suggested. IgG scintigraphy results are affected by the isotope, labeling procedure adopted and characteristics of the inflammatory focus. Nineteen patients with suspected osteomyelitis (active chronic osteomyelitis or violated bone osteomyelitis) were studied by Tc-99m-IgG scintigraphy (directly labeled polyclonal immunoglobulin, Sandoglobuilina - Sandoz). All patients also underwent standard three-phase bone scintigraphy using methylene diphosphonate (Tc-99m-MDP), gallium-67 scintigraphy and plain radiographs. Infection was found in 8 sites. Sensitivity and specificity for Tc-99m-MDP, gallium-67 and Tc 99m-IgG scintigraphy were, respectively, 88 and 36%, 75 and 73%,88 and 82%. All patients with false positive IgG scintigraphies had previous surgery. Other current scintigraphic procedures used in the diagnosis of osteomyelitis are also reviewed. (author)

  19. Guidelines for radioiodinated MIBG scintigraphy in children. (United States)

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette


    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations.

  20. Colovesical fistula demonstrated on renal cortical scintigraphy. (United States)

    Stathaki, Maria; Vamvakas, Lampros; Papadaki, Emmanouela; Papadimitraki, Elisavet; Tsaroucha, Angeliki; Karkavitsas, Nikolaos


    A 70-year-old man with a history of weight loss, changes in bowel habits, and hematochezia had rectal adenocarcinoma. He was palliated with diverting colostomy, followed by radiochemotherapy. Bilateral hydronephrosis was found incidentally on lower abdominal CT scan. He underwent 99mTc dimercaptosuccinic acid scan prior to percutaneous nephrostomy tube placement. Apart from the renal cortex, scintigraphy showed activity in the ascending colon continuous to the activity of the bladder. This indicated urine extravasation on account of a colovesical fistula, complicating postoperative radiation treatment. Here we highlight the contribution of renal cortical scintigraphy in the detection of colovesical fistulas.

  1. Usefulness of {sup 67}Ga scintigraphy in deciding surgical indication in secondary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Otsuka, Nobuaki; Mimura, Hiroaki; Sone, Teruki; Tamada, Tsutomu; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Fukunaga, Masao [Kawasaki Medical School, Kurashiki, Okayama (Japan); Katagiri, Makoto


    In order to evaluate the usefulness in deciding surgical indication in secondary hyperparathyroidism (SHP), {sup 67}Ga scintigraphy was performed in 37 patients of SHP before parathyroidectomy (PTx). The radionuclide accumulation in skull and submandible was classified into 4 patterns (skull-submandibular pattern, skull pattern, submandibular pattern and normal pattern). Serum alkaline phosphatase levels were significantly elevated in patients of skull-submandibular pattern (13 cases) compared with skull pattern (6 cases), submandibular pattern (6 cases) and normal pattern (12 cases). Serum intact parathyroid hormone levels were significantly elevated in patients of skull-submandibular and skull patterns compared with normal pattern. No significant difference was observed among the weight of resected parathyroid glands. In 4 of 6 patients of normal pattern on {sup 67}Ga scintigram, bone scintigraphy showed a characteristic pattern of SHP including an increased accumulation in the skull and submandible. Bone mineral density (BMD) in the distal radius was increased within six to twelve months after PTx in 10 of 11 patients of skull-submandibular pattern on {sup 67}Ga scintigram, whereas only one patient showed an increase in BMD in 9 patients of normal pattern. In summary, it was concluded that {sup 67}Ga scintigraphy could provide a useful information in deciding the indication for PTx in secondary hyperparathyroidism. (author)

  2. Osseous scintigraphy and auxiliary graft. Scintigraphie osseuse et greffe d'appoint

    Energy Technology Data Exchange (ETDEWEB)

    Khelifa, F.; Siles, S. (Hopital de la Timone, 13 - Marseille (France)); Puech, B.


    The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs.


    Institute of Scientific and Technical Information of China (English)

    Xian Xu; Lin Ma; Jins-han Zhang; You-quan Cai; Bai-xuan Xu; Liu-quan Chen; Fei Sun; Xing-gao Guo


    Objective To evaluate the feasibility of whole body diffusion weighted imaging (DWI) in bone metastasis detection using bone scintigraphy as comparison.Methods Forty-five patients with malignancy history were enrolled in our study. All the patients received the whole body DWI and bone scintigraphy scan within 1 week. The magnetic resonance (MR) examination was performed on 3.0T MR scanner using embedded body coil. The images were reviewed separately by two radiologists and two nuclear medicine physicians, who were blinded to the results of the other imaging modality. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the two techniques for detecting bone metastasis were analyzed.Results A total of 181 metastatic lesions in 77 regions of 34 patients were detected by whole body DWI, and 167 metastatic lesions in 76 regions of 31 patients were identified by bone scintigraphy. The patient-based sensitivity and PPV of whole body DWI and bone scintigraphy were similar (89.5% vs. 81.6%, 97.1% vs. 91.2%), whereas, the patient-basod specificity and NPV of whole body DW1 were obviously higher than those of bone scintigraphy (85.7% vs. 57.1%, 60.0% vs. 36.4%). Ten regions negative in scintigraphy but positive in whole body DWI, mainly located in spine, pelvis, and femur; nine regions only detected by scintigraphy, mainly located in skull, sternum, clavicle, and scapula. The region-based sensitivity and specificity of whole body DWI were slightly higher than those of bone scintigraphy (89.5% vs. 88.4%, 95.6% vs. 87.6%). Conclusion Whole body DWI reveals excellent concordance with bone scintigraphy regarding detection of bone metastasis, and the two techniques are complementary for each other.

  4. {sup 99m}Tc-HMPAO-labelled leucocyte scintigraphy in the diagnosis of infection after total knee replacement arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Park, Dong Rib [College of Medicine, Kunkuk Univ., Seoul (Korea, Republic of); Kim, Jae Seung; Ryu, Jin Sook; Moon, Dae Hyuk; Bin, Seong Il; Cho, Woo Shin; Lee, Hee Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)


    This study was performed to evaluate the usefulness of {sup 99m}Tc-HMPAO-labelled leucocyte scintigraphy for diagnosing prosthetic infection after total knee replacement arthroplasty without the aid of following bone marrow scintigraphy. The study subjects were 25 prostheses of 17 patients (one man and 16 women, mean age: 65 years) who had total knee replacement arthroplasty. After injection of {sup 99m}Tc-HMPAO-labelled leucocyte, the whole body planar and knee SPECT images were obtained in all patients. The subjects were classified into three groups according to clinical suspicion of prosthetic infection: Group A (n=11) with high suspicion of infection; Group B (n=6) with equivocal suspicion of infection, and Group C (n=8) with asymptomatic contralateral prostheses. Final diagnosis of infection was based on surgical, histological and bacteriological data and clinical follow-up. Infection was confirmed in 13 prostheses (11 in Group A and 2 in Group B). All prostheses in Group A were true positive. There were two true positive, one false positive and three true negative in Group B, and six true negatives and two false positive in Group C. Overall sensitivity, specificity, and accuracy for diagnosis of the infected knee prosthesis were 100%, 75% and 88%, respectively. {sup 99m}Tc-HMPAO-labelled leucocyte scintigraphy is a sensitive method for the diagnosis of infected knee prosthesis. However, false positive uptakes even in asymptomatic prosthesis suggest that bone marrow scintigraphy may be needed to achieve improved specificity.

  5. Effect of intertrochanteric osteotomy on the proximal femur of rabbits: assessment with power Doppler sonography and scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Doria, Andrea S. [University of Toronto (Canada). Hospital for Sick Children. Dept. of Diagnostic Imaging; Cunha, Fabiano G.; Modena; Marcelo; Godoy Junior, Rui de; Bolliger Neto, Raul; Guarniero, Roberto [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. of Cirurgia Ortopedica]. E-mail:; Rodrigues, Consuelo Junqueira [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Patologia; Garcez, Alexandre Teles; Melo, Ivani Bortoleti; Buchpiguel, Carlos; Molnar, Laszlo J. [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Medicina Nuclear


    Objective: In bone injury, repair results in local increased vascularity and bone marrow remodeling. Characterizing the vascular and metabolic imaging patterns of the proximal femur following an intertrochanteric osteotomy may help clinicians decide proper management of the patient. Our objective was to measure Doppler sonography and scintigraphy interval changes in the proximal femur following intertrochanteric osteotomy and compare imaging and histomorphometric measurements in the late post-operative stage (6 weeks after surgery) in a rabbit model of bone injury. Materials and methods: Both hips of 12 adult rabbits were imaged with power Doppler sonography and scintigraphy prior to and after (7 days and 6 weeks) unilateral osteotomy. Accuracy of the imaging methods was evaluated using hip operative status and histomorphometric results (vascular fractional area and number of vessels per area unit) as reference standard measures. Results: A significant difference in the mean number of pixels was noted between operated and non-operated femura in late post-operative power Doppler examinations (P=0.049). Although without reaching statistical significance, the AUC of Doppler measurements (AUC=0.99) was numerically greater than the AUC of scintigraphy measurements (AUC=0.857{+-}0.099) (P=0.15) in differentiating proximal femura with regard to their fractional vascular areas in the late post-operative stage. In contrast, scintigraphy tended to perform better (AUC=0.984{+-}0.022) than Doppler ultrasound (AUC=0.746{+-}0.131) to demonstrate the vascularity intensity per area unit (P=0.07) in the late stage. Conclusion: Our results warrant further investigation to determine the value of different imaging modalities for assessment of pathologic changes following hip surgery. Power Doppler sonography demonstrated larger AUCs (representing higher accuracy) for the discrimination of vascular fractional areas and scintigraphy, for discrimination of the number of vessels per area

  6. Diagnosis of neuroblastoma with I-131 meta-iodobenzylguanidine scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo; Ohsawa, Yoshihiro; Iwabuchi, Makoto; Sakai, Kunio; Hayashi, Mikio (Niigata Univ. (Japan). School of Medicine); Asami, Keiko; Utsumi, Jiro


    Pre- or post-operative I-131 meta-iodobenzylguanidine (I-131 MIBG) scans were reviewed for its diagnostic significance in neuroblastoma. The subjects were 18 patients with histologically proven neuroblastoma, who ranged in age from 6 months to 9 years. Abnormal uptake of I-131 MIBG was detected in all 10 patients showing positive urinary vanillylmandelic acid (VMA); there was a significant correlation between I-131 MIBG uptake and urinary VMA. For 10 patients undergoing preoperative I-131 MIBG scans, I-131 MIBG was taken up by primary tumors as small as one cm in diameter in 9 patients; the other one had negative urinary VMA. In detecting metastatic foci, the sensitivity of I-131 MIBG scans was 89% for the bone, 50% for the liver, 75% for the lymph nodes, and 38% for the bone marrow. In view of a high specificity, I-131 MIBG scintigraphy may be a useful approach to the localization of primary foci, as well as the diagnosis of metastasis and recurrence in neuroblastoma. (N.K.).

  7. Contribution of technetium-99m hexamethylpropylene amine oxime labelled leucocyte scintigraphy to the diagnosis of diabetic foot infection

    Energy Technology Data Exchange (ETDEWEB)

    Devillers, A.; Moisan, A.; Garin, E.; Bourguet, P. [CRLCC Eugene Marquis, Service de Medecine Nucleaire, Rennes (France); Hennion, F.; Poirier, J.Y. [CHRU Pontchaillou, Service d`Endocrinologie, Rennes (France)


    We conducted a prospective study in order to evaluate the contribution of technetium-99m hexamethylpropylene amine oxime (HMPAO) labelled leucocyte scintigraphy to the diagnosis and follow-up of osteomyelitis in the diabetic foot. The study was conducted between October 1992 and November 1996 and included 42 patients (30 men and 12 women; mean age 63 years) with diabetes mellitus (type 1, n = 22, type 2, n = 20) who had a total of 56 diabetic foot ulcers. The initial exploration included standard radiography, three-phase bone scintigraphy and {sup 99m}Tc-HMPAO labelled leucocyte scintigraphy (HMPAO-LS), performed within a 3-day interval. For the 56 ulceration sites, 26 cases of osteomyelitis were diagnosed: ten on the basis of radiographic and histological/bacteriological criteria after bone biopsy, 11 after radiographic follow-up and five on the basis of biopsy results alone. No osteomyelitis was present at 30 sites, there were seven cases of cellulitis. The sensitivity and specificity of {sup 99m}Tc-HMPAO-LS were 88.4% and 96.6% respectively (23 true-positives, 29 true-negatives, one false-positive, three false-negatives). The accuracy of radiography, {sup 99m}Tc-methylene diphosphonate and HMPAO-LS was 69.6%, 62.5%, and 92.9%, respectively. Follow-up scintigraphy (n = 14) 4 months after initial diagnosis and 1 month after antibiotic withdrawal confirmed cure of osteomyelitis despite the absence of complete clinical regression of the ulcers. In conclusion, {sup 99m}Tc-HMPAO labelled leucocyte scintigraphy was found to be an excellent method for the diagnosis of osteomyelitis in the diabetic foot. It can contribute to follow-up, particularly when clinical regression of perforating ulcers is incomplete and cure of osteomyelitis must be confirmed in order that antibiotic treatment may be discontinued. (orig.) With 5 figs., 3 tabs., 28 refs.

  8. A role for gamma scintigraphy in cancer immunology and immunotherapy. (United States)

    Perkins, A C; Pimm, M V


    Facilities for radiolabelling and gamma scintigraphy are largely restricted to nuclear medicine departments or specialised research institutions and are therefore not widely available to workers in cancer research. Despite this, there is growing interest in gamma scintigraphy, which can provide information relevant to the entire field of cancer immunology. This review discusses the present and future roles of gamma scintigraphy in respect of antibody-targeted, cell-mediated and cytokine therapy. The authors aim to show that gamma scintigraphy is an investigative tool of great potential.

  9. A role for gamma scintigraphy in cancer immunology and immunotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Perkins, A.C. (Nottingham Univ. Hospital (United Kingdom). Dept. of Medical Physics); Pimm, M.V. (Nottingham Univ. (United Kingdom). Cancer Research Campaign Labs.)


    Facilities for radiolabelling and gamma scintigraphy are largely restricted to nuclear medicine departments or specialised research institutions and are therefore not widely available to workers in cancer research. Despite this, there is growing interest in gamma scintigraphy, which can provide information relevant to the entire field of cancer immunology. This review discusses the present and future roles of gamma scintigraphy in respect of antibody-targeted, call-mediated and cytokine therapy. The authors aim to show that gamma scintigraphy is an investigated tool of great potential. (orig.).

  10. Esophageal transit scintigraphy in systemic sclerosis. (United States)

    Chojnowski, Marek; Kobylecka, Małgorzata; Olesińska, Marzena


    Systemic sclerosis is a rare connective tissue disease, distinctive features of which are fibrosis and microangiopathy. The esophagus is one of the most commonly involved internal organs. Most patients experience dysphagia, difficulties in swallowing and gastro-esophageal reflux. However, in up to one third of cases, the initial onset of esophageal disease may be clinically silent. There are several diagnostic modalities available for assessing both morphological and functional abnormalities of the esophagus. If structural abnormalities are suspected, endoscopy is the method of choice. Functional evaluation is best achieved with manometry. Both endoscopy and manometry are invasive techniques, with low patient acceptance. Barium-contrast study is well tolerated, but qualitative assessment of functional abnormalities is imprecise. Esophageal scintigraphy is an easy, non-invasive, sensitive and specific diagnostic modality. It can detect esophageal dysfunction even in asymptomatic patients. In patients already diagnosed with systemic sclerosis, scintigraphy is useful in evaluating severity and progression of the disease.

  11. Clinical and experimental studies concerned with /sup 201/Tl-scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Umeda, Tohru; Takada, Norihiko; Hotaka, Eiji (Chiba Cancer Center Hospital (Japan)); Inoue, Shunichi; Endo, Fujinori


    Basic autoradiographic study demonstrated that /sup 201/Tl concentrated in the area of increased proliferation of the cells. On diagnosis of bone lesions, /sup 201/Tl-scintigram showed a higher specificity than sup(99m)Tc-MDP-bone scintigram, and negative results of /sup 201/Tl-scintigraphy was highly suggestive of benign changes. However, positive results were sometimes obtained from benign lesions and negative results from malignant ones. /sup 201/Tl-scintigram was useful in differentiating compression fracture or inflammation from malignant lesions, observing the effect of radiation therapy, revealing the metastasis of thyroid carcinoma, and according to literature, in detecting the recurrence of giant cell tumor. /sup 201/Tl-scintigram provides information different from that of bone-scintigram in the extremity and the superficial area, because of rapid clearance of /sup 201/Tl, and it is thought to be useful for screening.

  12. New agents for scintigraphy in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Bois, M.H.W. de [Department of Rheumatology, University Hospital, Leiden (Netherlands); Pauwels, E.K.J. [Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, Leiden (Netherlands); Breedveld, F.C. [Department of Rheumatology, University Hospital, Leiden (Netherlands)


    Radiopharmaceuticals have been used as investigative tools for the detection and treatment of arthritis activity in rheumatoid arthritis (RA) since the 1950s. Against the background of the pathophysiology of RA, the current status of joint scintigraphy and possible future developments are reviewed. Both non-specific (radiolabelled leucocytes and technetium-99m labelled human immunoglobulin) and specific targeting radiopharmaceuticals (including radiolabelled antibodies) are considered. The use of radiopharmaceuticals in the detection of arthritis activity has the advantages of allowing direct imaging of joints by means of whole-body scintigraphy and of joints that are difficult to assess clinically or radiographically. Promising results have been obtained with radiolabelled anti-CD4 and anti-E-selectin antibodies and with somatostatin receptor imaging, but more data are available regarding {sup 99m}Tc-IgG scintigraphy, which differentiates between the various degrees of arthritis activity and thus facilitates the choice of antirheumatic drug. Newer promising approaches to the imaging of RA include the use of radiolabelled J001 and cytokines, though studies on these are limited at present. (orig.)

  13. Skeletal scintigraphy following incidental trauma. [/sup 99m/Tc-pyrophosphate

    Energy Technology Data Exchange (ETDEWEB)

    Kim, H.R.; Thrall, J.H.; Keyes, J.W. Jr.


    The significance of antecedent trauma in skeletal scintigraphy was assessed in 503 patients, of whom 241 (46%) had prior fracture or tooth extraction. In patients with sufficiently accurate histories for site-by-site analysis, 33 of 131 fracture sites and 16 of 83 dental-procedure sites were positive scintigraphically. In general, the frequency of scan positivity diminished as the interval between trauma and scanning increased, but a significant number of patients showed prolonged uptake at fracture sites. Several patterns of uptake suggested trauma rather than metastatic disease. Knowledge of a history of trauma is often critical in bone scan interpretation.

  14. Sodium pertechnetate scintigraphy in detection of Meckel's diverticulum

    DEFF Research Database (Denmark)

    Poulsen, K A; Qvist, N


    OBJECTIVE: To evaluate the results of 99mTc-Na-pertechnetate scintigraphy in children presenting with symptoms suspicious of Meckel's diverticulum (MD). METHOD: Retrospective study. A total of 55 99mTc-Na-pertechnetate scintigraphies in 53 patients were compared with the results from surgery and ...

  15. Approach of age-related changes of whole body bone distribution using 99mTc-MDP bone scintigraphy in women%99mTc-MDP在女性全身骨骼分布随年龄相关改变初探

    Institute of Scientific and Technical Information of China (English)

    张凯军; 张永学; 安锐; 高再荣; 童安利


    Objective: To study metabolic features of age-related changes of whole-body or regional bone in women, we attempted to obtain the skeletal metabolic regulation of age-related changes and to investigate the mechanism of skeletal turnover or loss in order to provide the theoretical foundation of suitable treatment for it. Methods: The whole-body skeletal uptake(WBSU) and wholebody skeletal tracer distribution pattern were studied or quantified by setting regions of interest(ROI) on selected regions using 99mTcmethane-diphosphonate (99mTc-MDP, injected doses: 925MBq) bone scan and correlated with biochemical bone metabolic markers reflecting total skeletal metabolism in blood and urine. Bone scans were performed using a standard protocol of SPECT (Sopha, France).Result: In women, uptake of 99mTc-MDP in the whole-body, head and legs regions increases with age, but that of thoracic region reduces with age. The increasing uptake of head and legs has a medium correlation with the levels of alkaline phosphatase(ALP, in the meantime, uptake of head has a medium correlation with hydroxy-proline/creatinine, HOP/Cr), but reduction of uptake of thorax has a medium correlation with ALP. Conclusions: These results show that bone turnover and regional bone metabolism relate with women's age. The aged-related changes can be observed in bone scan; it may be a sign of progressive bone loss and also reflect changes of regional bone metabolism.%目的:了解女性全身及局部骨质代谢特点,初步探讨其随年龄变化的一些规律,对骨质转换或丢失的机理进行初步研究,为临床治疗骨质丢失性疾病提供理论基础。方法:用法国Soph公司SPECT标准程序进行全身骨显像,显像剂为99mTc-Methane-diphosphonate(99mTc-MDP),注射剂量为925MBq。通过设置感兴趣区(ROI)来评价全身骨的代谢,并与反映骨质代谢的指标进行比较。结果:在女性,全身骨99mTc-MDP的摄取率随着年龄的增长而增加

  16. Degenerative disc disease in the lumbar spine: Another cause for focally reduced activity on marrow scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, M. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology); Miles, K.A. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine); Wraight, E.P. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine); Dixon, A.K. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology Cambridge Univ. (United Kingdom))


    A patient is presented in whom a focal reduction in marrow activity in the lumbar spine on both leucocyte and nanocolloid marrow scintigraphy was subsequently shown to be due to fatty infiltration of marrow in association with disc degeneration. Degenerative disease in the lumbar spine has not been previously described as a cause of abnormal bone marrow distribution by such means and needs to be distinguished from a more serious pathology, such as malignant infiltration and vertebral infection, which it may mimic. In a retrospective review of 33 nanocolloid bone marrow and 117 leucocyte scintigrams, 8 showed a degree of reduced marrow activity in the lumbar spine consistent with that caused by degenerative changes. (orig.).

  17. Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

    Directory of Open Access Journals (Sweden)

    Ajdinović Boris


    Full Text Available Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU less than 40% was found in three, and poor kidney function (RKU less than 10% in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

  18. Indium-111 platelet scintigraphy in carotid disease

    Energy Technology Data Exchange (ETDEWEB)

    Branchereau, A.; Bernard, P.J.; Ciosi, G.; Bazan, M.; de Laforte, C.; Elias, A.; Bouvier, J.L.


    Forty-five patients (35 men, 10 women) undergoing carotid surgery had Indium-111 platelet scintigraphy as part of their preoperative work-up. Imaging was performed within three hours after injection of the Indium-111. A second series of views was obtained 24 hours later and repeated at 24 hour intervals for two days. Of 54 scintigrams, 22 were positive and 32 negative. Positive results were defined as a twofold or more increase in local activity on a visualized carotid after 24 hours. The sensitivity of the method was 41%, intraoperatively, and the specificity, 100%. The low sensitivity places this method behind sonography and duplex-scanning for screening patients for surgery. We believe that indications for platelet scintigraphy are limited to: 1. Repeated transient ischemic attacks in the same territory with minimal lesions on arteriography and non-homogeneous plaque on duplex scan; 2. Symptomatic patients being treated medically as a possible argument for surgery; 3. Determining therapeutic policy for patients having experienced a transient ischemic attack with a coexisting intracardiac thrombus.

  19. Optimum Energy Window In Liver Scintigraphy

    Directory of Open Access Journals (Sweden)

    Alireza Sadremomtaz


    Full Text Available Abstract In liver scintigraphy radioactive tracers in addition to liver are accumulated in other organs such as spleen. It leads to the presence of secondary source which affects image quality. Therefore knowing the influence of the noise arising from the secondary source and trying to reduce the additional data is necessary. In nuclear medicine imaging using of energy window is a useful way to reduce the noise. In this paper we try to find an optimum energy window to reduce the noise for two different low energy collimators. Liver scintigraphy images with and without activity in spleen were simulated by SIMIND software with different energy window percentages and with Low-Energy High-Resolution LEHR and Low-Energy General-Purpose LEGP collimators. We used with activity of 190 MBq. Spleen was outside of the camera field of view so that just its noise effects on the liver image is examined. Finally the images of liver with activity in spleen were compared with that without activity in spleen by MATLAB code.

  20. Growth arrest line mimicking lymphoma involvement: The findings of {sup 99m}Tc-MDP bone SPECT/CT and serial bone scan in a child with non-Hodgkin's lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chan Woo; Kim, Ji Young; Choi, Yun Young; Lee, Seung Hun; Lee, Young Ho [Hanyang University Medical Center, Seoul (Korea, Republic of)


    Growth arrest lines appear as dense sclerotic lines parallel to the growth plate of long bones on radiography. We describe the case of a 9-year-old female with growth arrest lines initially masquerading as lymphoma involvement on {sup 99m}Tc-MDP bone scintigraphy who had been treated with chemotherapy for non-Hodgkin's lymphoma about 3 years previously. Subsequent regional bone SPECT/CT clearly diagnosed the growth arrest lines, and retrograde review of previous bone scintigraphy demonstrated line migration in this patient. Growth arrest lines should be considered a possible diagnosis on bone scintigraphy, especially in the surveillance of children who have experienced severe childhood infections, malnutrition, immobilization, or treatment with immunosuppressive or chemotherapeutic drugs that may inhibit bone growth.

  1. Growth Arrest Line Mimicking Lymphoma Involvement: The Findings of (99m)Tc-MDP Bone SPECT/CT and Serial Bone Scan in a Child with Non-Hodgkin's Lymphoma. (United States)

    Kim, Chanwoo; Kim, Ji Young; Choi, Yun Young; Lee, Seunghun; Lee, Young-Ho


    Growth arrest lines appear as dense sclerotic lines parallel to the growth plate of long bones on radiography. We describe the case of a 9-year-old female with growth arrest lines initially masquerading as lymphoma involvement on (99m)Tc-MDP bone scintigraphy who had been treated with chemotherapy for non-Hodgkin's lymphoma about 3 years previously. Subsequent regional bone SPECT/CT clearly diagnosed the growth arrest lines, and retrograde review of previous bone scintigraphy demonstrated line migration in this patient. Growth arrest lines should be considered a possible diagnosis on bone scintigraphy, especially in the surveillance of children who have experienced severe childhood infections, malnutrition, immobilization, or treatment with immunosuppressive or chemotherapeutic drugs that may inhibit bone growth.

  2. Localization of a pheochromocytoma using I-123 MIBG adrenal scintigraphy.

    Directory of Open Access Journals (Sweden)

    Shirkare S


    Full Text Available In a patient with the clinical diagnosis of pheochromocytoma, the localization of the tumor is essential for planning treatment. Recently, we have performed I-123 metaiodobenzylguanidine (MIBG adrenal scintigraphy in a patient presenting with a history of paroxysmal hypertension. Scintigraphy accurately located an ectopic unilateral pheochromocytoma. The scintigraphic diagnosis was confirmed by surgery and a diagnosis of ectopic unilateral pheochromocytoma was made by histopathological examination. This case report illustrates the specific diagnosis of pheochromocytoma by I-123 MIBG scintigraphy which is especially useful when other diagnostic procedures are equivocal.

  3. Infrared laser and bone metabolism; A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Gordjestani, M.; Dermaut, L. (Department of Orthodontics, University of Ghent (Belgium)); Thierens, H. (Institute of Medical Physics, University of Ghent (Belgium))


    A circular defect in each parietal bone of six Wislander rats was created. The animals were divided into two three-unit subgroups. The experimental group received infrared laser radiation on the left defect. The control group was sham irradiated. After 28 days, the bone metabolism was evaluated by technetium-99m methylene diphosphonate scintigraphy. The obtained results revealed no differences in bone metabolic activity between the laser-treated and the control defects. (au) (18 refs.).

  4. Exercise to Counteract Loss of Bone and Muscle During Androgen Deprivation Therapy in Men with Prostate Cancer (United States)


    to get a bone scintigraphy, 1) and 13 did not qualify (started medications that influence bone metabolism, 4; unrepaired hernias , 2; positive bone...before vs 0.785±0.098 g/cm2 after) subregions of the hip. However, BMD at the femoral neck, a common site of osteoporotic fracture, decreased over the

  5. Scintigraphy of parathyroids in secondary hyperparathyroidism; Scintigraphie des parathyroides dans l`hyperparathyroidie secondaire

    Energy Technology Data Exchange (ETDEWEB)

    Hublo, D.; Beauchat, V.; Pattou, F.; Lecomte-Houcke, M.; Prangere, T.; Ziegels, P.; Carnaille, B.; Proye, C.; Marchandise, X.; Steiling, M. [Medecine Nucleaire, Chirurgie Endocrinienne et Anatomie et Cytologie Pathologiques - CHU de Lille - 59037 Lille cedex (France)


    Use of pre-surgery imaging of parathyroids is still questioned. The goal of this study is to evaluate the sensitivity of the scintigraphy in the detection of secondary parathyroid anomalies with renal insufficiency. Thirty two patients (20 F, 12 M) of 14 - 74 years old were operated of secondary hyperparathyroidism with renal insufficiency. It was a matter of re-intervention in 9 cases. The acquisitions were achieved 20 min and 2 h after injection of 550 MBq of MIBI-{sup 99m}Tc or of Tetrofosmine - {sup 99m}Tc and 2 h after injection of 5.5 MBq of iodine 123. Eighty seven glands of 28 to 3820 mg were pulled out in 23 first surgeries while the parathyroid tissue was found in thymic prolongations in 5 of these patients. The masses of 41 glands, positive by scintigraphy (from 69 to 3829 mg), were significantly higher (Wilcoxon`s test, p < 10{sup -8}) than the 46 not-seen (from 28 to 1050 mg). The sensitivity of total detection is 47%, of 85% for the 33 glands of 500 mg or more and of 24% for the 54 glands of less than 500 mg. In 9 re-interventions, 12 abnormal glands were pulled out: 11 of 430 to 4500 mg were positive by scintigraphy, while only one gland of 80 mg was not seen. In conclusion, the scintigraphy realised before first surgery for secondary hyperparathyroidism with renal insufficiency presents low sensitivity, related partly, at least, to the low mass of glands and justifies itself only by search for positive ectopic parathyroids. Instead, it appears performing and indispensable in case of re-intervention

  6. /sup 131/I-meta-iodobenzylguanidine scintigraphy of neuroblastomas

    Energy Technology Data Exchange (ETDEWEB)

    Munkner, T.


    Sixteen neuroblastoma patients have been studied by /sup 131/I-meta-iodobenzylguanidine (MIBG) scintigraphy. Three patients were possibly cured, and their scintigraphy results were normal. Thirteen patients had tumors and metastases demonstrated by /sup 131/I-MIBG, two of these patients had a normal vanillylmandelic acid (VMA) excretion level. One patient has been treated by /sup 131/I-MIBG, but died. /sup 131/I-MIBG was concentrated in other cells too, eg, in erythrocytes and platelets.

  7. Thyroidal malignancy and scintigraphy; Schilddrsenmalignitaet und Szintigrafie

    Energy Technology Data Exchange (ETDEWEB)

    Brandt-Mainz, K.; Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin Radionuk, Essen (Germany)


    Thyroid hypofunctional ('scintigraphic cool or cold') nodules are detected frequently. Dependent on the clinical situation, on morbidity and on economic aspects it is necessary to select patients for surgery and to avoid unnecessary surgical treatment. Therefore it is necessary to develop appropriate diagnostic algorithm to manage hypofunctional thyroid nodules. The ultrasound guided fine-needle aspiration cytology (FNA) is on the one hand side a useful diagnostic tool, but on the other hand side there exist certain limitations. It is questionable if the nodule is correctly reached. In case of heterogeneous larger mixed nodules or multiple hypofunctional nodules, it is difficult to choose the correct location of punctation. Furthermore a certain number of FNA's is not diagnostic without any result or due to 'follicular neoplasia'. {sup 99m}Tc-MIBI-sctintigraphy (MIBI) and {sup 18}F-FDG-positron-emission-tomography (FDG-PET) are established methods in the follow-up of differentiated thyroid cancer after thyroidectomy with elevated thyroglobulin-levels without adequate 131-Iodine-uptake. Moreover in case of parafollicular medullary thyroid carcinomas after thyroidectomy with elevated calcitonin-concentrations the FDG-PET is a valuable diagnostic method in localizing tumor. However these tracers gain in importance in differentiating malignant from benign preoperative hypofunctional nodules. In conclusion MIBI-scintigraphy should be used routinely to plan the correct guide of FNA. The application of both methods (MIBI and FNA) improves the differentiation of dignity, whereas a negative MIBI-examination and a negative FNA is able to exclude malignancy nearly. In this way the number of unnecessary numbers of surgical treatments can be reduced. FDG-PET is not definitely superior compared to MIBI-scintigraphy. From the cost perspective MIBI is more attractive than FDG-PET. (orig.)

  8. Gallium 67 scintigraphy in glomerular disease

    Energy Technology Data Exchange (ETDEWEB)

    Bakir, A.A.; Lopez-Majano, V.; Levy, P.S.; Rhee, H.L.; Dunea, G.


    To evaluate the diagnostic usefulness of gallium 67 scintigraphy in glomerular disease, 45 patients with various glomerulopathies, excluding lupus nephritis and renal vasculitis, were studied. Persistent renal visualization 48 hours after the gallium injection, a positive scintigram, was graded as + (less than), ++ (equal to), and +++ (greater than) the hepatic uptake. Positive scintigrams were seen in ten of 16 cases of focal segmental glomerulosclerosis, six of 11 cases of proliferative glomerulonephritis, and one case of minimal change, and one of two cases of membranous nephropathy; also in three of six cases of sickle glomerulopathy, two cases of diabetic neuropathy, one of two cases of amyloidosis, and one case of mild chronic allograft rejection. The 25 patients with positive scans were younger than the 20 with negative scans (31 +/- 12 v 42 +/- 17 years; P less than 0.01), and exhibited greater proteinuria (8.19 +/- 7.96 v 2.9 +/- 2.3 S/d; P less than 0.01) and lower serum creatinine values (2 +/- 2 v 4.1 +/- 2.8 mg/dL; P less than 0.01). The amount of proteinuria correlated directly with the intensity grade of the gallium image (P less than 0.02), but there was no correlation between the biopsy diagnosis and the outcome of the gallium scan. It was concluded that gallium scintigraphy is not useful in the differential diagnosis of the glomerular diseases under discussion. Younger patients with good renal function and heavy proteinuria are likely to have a positive renal scintigram regardless of the underlying glomerulopathy.

  9. Colon visualization on (99m)Tc-HDP whole-body bone scan due to sigmoid colon cancer-related enterovesical fistula. (United States)

    Kim, Sung Hoon; Song, Bong-Il; Won, Kyoung Sook


    An abnormally increased uptake of the bone-seeking agent is rarely observed in structures other than the bone and urinary track on bone scintigraphy. The general etiologies of soft tissue uptake can be explained by heterotopic ossification or dystrophic and metastatic calcification. We report a case of serendipitous visualization of the entire colon on bone scintigraphy. Diffuse colonic uptake was detected on the whole-body bone scan in a patient with biopsy-proven sigmoid colon cancer. Additional imaging studies clearly showed direct bladder invasion of the sigmoid colon cancer. Imaging findings with a brief review of the literature are presented in this article.

  10. Atypical bisphosphonate-associated subtrochanteric and femoral shaft stress fractures: diagnostic features on bone scan. (United States)

    Probst, Stephan; Rakheja, Rajan; Stern, Jerry


    A 69-year-old woman presented with a spontaneous right subtrochanteric hip fracture. Pan-imaging following orthopedic repair failed to identify a primary malignancy to explain the presumed pathologic basis for this fracture. The patient then underwent bone scintigraphy and SPECT/CT which showed mild uptake in multifocal endosteal thickening of the lateral left femoral diaphysis, diagnostic of bisphosphonate-associated femoral shaft stress fractures, but no evidence of metastatic bone disease. Atypical bisphosphonate-associated subtrochanteric and femoral shaft stress fractures have a fairly specific appearance on bone scintigraphy, and nuclear medicine physicians should be aware of this relatively infrequent emerging pathology.

  11. Septic arthritis of a lumbar facet joint: Detection with bone SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Swayne, L.C.; Dorsky, S.; Caruana, V.; Kaplan, I.L. (Morristown Memorial Hospital, NJ (USA))


    We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements.

  12. Omission of bone scanning according to staging guidelines leads to futile therapy in non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schirrmeister, Holger [Department of Nuclear Medicine, University of Kiel, Kiel (Germany); Arslandemir, Coskun; Hetzel, Martin [Department of Internal Medicine II, University of Ulm, Robert-Koch-Strasse 8, 89081, Ulm (Germany); Glatting, Gerhard; Buck, Andreas [Department of Nuclear Medicine, University of Ulm, Ulm (Germany); Mayer-Steinacker, Regine; Bommer, Martin [Department of Hematology and Oncology, University of Ulm, Ulm (Germany); Dreinhoefer, Karsten [Department of Orthopedics, University of Ulm, Ulm (Germany)


    The leading European and American professional societies recommend that bone scans (BS) should be performed in the staging of lung cancer only in those patients with bone pain. This prospective study investigated the sensitivity of conventional skeletal scintigraphy in detecting osseous metastases in patients with lung cancer and addressed the potential consequences of failure to use this method in the work-up of asymptomatic patients. Subsequent to initial diagnosis of non-small cell lung cancer, 100 patients were examined and questioned regarding skeletal complaints. Two specialists in internal medicine decided whether they would recommend a bone scan on the basis of the clinical evaluation. Skeletal scintigraphy was then performed blinded to the findings of history and physical examination. The combined results of magnetic resonance imaging (MRI) of the vertebral column, positron emission tomography (PET) of skeletal bone and the subsequent clinical course served as the gold standard for the identification of osseous metastases. Bone scintigraphy showed an 87% sensitivity in the detection of bone metastases. Failure to perform skeletal scintigraphy in asymptomatic patients reduced the sensitivity of the method, depending on the interpretation of the symptoms, to 19-39%. Without the findings of skeletal scintigraphy and the gold standard methods, 14-22% of patients would have undergone unnecessary surgery or neoadjuvant therapy. On this basis it is concluded that bone scans should not be omitted in asymptomatic patients. (orig.)

  13. Evaluation of quantitative sacro-iliac scintigraphy in the early diagnosis of ankylosing spondylitis. (United States)

    Kjällman, M; Nylén, O; Hansén, M


    Over the period 1976-83 the clinical records were studied of 150 patients with the diagnosis of confirmed or possible sacro-iliitis. All these patients had pathologic sacro-iliac indices on quantitative bone scintigraphy. The most recent radiographs of the sacro-iliac joints were examined by two radiologists independently of each other. 103 (68%) patients with a mean duration of symptoms of 6.7 years, had normal radiographs. The frequency of HLA B27 in this group was only 27%, contrary to the expected 90-100% in an ankylosing spondylitis (AS) population. In a follow-up study, 30 patients, who in 1976-79 had normal sacro-iliac joint X-rays, were further investigated. The mean duration of symptoms was 11.3 years. 21 patients (70%) still had normal radiographs of their sacro-iliac joints and the HLA B27 frequency in this group was 28%. Normal radiographs of the sacro-iliac joints, in spite of the long duration of symptoms together with a low frequency of HLA B27, makes the diagnosis of AS most unlikely. This indicates a low specificity for quantitative sacro-iliac scintigraphy in the early diagnosis of AS. In the follow-up study, Calin's screening test for AS was included and was also found to have a low specificity.

  14. Value of bone scan in the McCune-Albright syndrome. Report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Edeburn, G.F.; Mortensson, W.

    Bone scintigraphy proved valuable in diagnosing McCune-Albright's syndrome in a 6-year-old girl by detecting multiple, non-symptomatic foci in the skull, axial skeleton and in the extremities. Subsequent roentgen examination showed abnormal bone structure in the affected areas, consistent with fibrous dysplasia.

  15. Radiography, Bone Scan, and F-18 FDG PET/CT Imaging Findings in a Patient with Paget's Disease

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eun Tae; Kim, Sung Eun [Korea University Guro Hospital, Seoul (Korea, Republic of)


    Background A 52-year-old female patient sought evaluation at our hospital for an incidental abnormal finding on an abdominal radiograph. The initial radiograph showed irregular sclerotic changes involving the right pelvic bone. At the same time, bone scintigraphy showed intense hot uptake in the right iliac and pubic bones. CT images showed characteristic thickening of the pelvic brim, suggesting the mixed phase of Paget's disease. The level of alkaline phosphatase (ALP) was 266 IU/I. {sup 18}F-FDG PET/CT images also showed diffusely increased {sup 18}F-FDG uptake in the right pelvic bone. However, the findings of {sup 18}F-FDG PET/CT were less notable than those of bone scintigraphy. We report the imaging findings of a patient with Paget's disease evaluated by radiography, bone scintigraphy, and {sup 18}F-FDG PET/CT.

  16. Diagnostic and Pathophysiological Impact of Myocardial MIBG Scintigraphy in Parkinson's Disease



    Myocardial MIBG scintigraphy is established in the diagnosis and differential diagnosis of Parkinson's disease (PD). Numerous studies address the pathophysiological impact of myocardial MIBG scintigraphy: the myocardial MIBG uptake correlates with the clinical phenotype of PD; the background of this phenomenon is unclear. Furthermore MIBG scintigraphy enables to study the extracranial Lewy body type-degeneration. In combination with cerebral dopamine transporter imaging, MIBG scintigraphy all...

  17. Clinical diagnostic potentials of thyroid ultrasonography and scintigraphy; An evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Tatsuo; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Konishi, Junji (Kyoto Univ. (Japan). Hospital); Endo, Keigo


    This prospective study was designed to evaluate the potential contributions of high resolution ultrasonography (US) and Tc-99m scintigraphy in the routine diagnosis of thyroid disease. The diagnostic impacts of US and Tc-99m scintigraphy results in 177 patients visiting our thyroid clinic were assessed and scored according to the following criteria: when the information provided by either test supported, confirmed or changed the initial clinical diagnosis, they received scores of 2, 3 and 4 respectively, while score 1 was given when the test itself was useless for the differential diagnosis. US identified focal lesions that both palpation and scintigraphy had failed to detect in 14 (12.1%) of 116 patients with diffuse thyroid diseases, suggesting the necessity of Hashimoto's thyroiditis, adenoma, adenocarcinoma and adenomatous goiter, and vice versa in the diagnosis of hyperthyroid and euthyroid Graves's diseases. Thus, the advantages of US over scintigraphy for morphological evaluation were confirmed. US was particularly useful for the differential diagnosis of adenomatous goiter from Hashimoto's thyroiditis or a single nodular disease. In contrast, scintigraphy gave functional images, being especially helpful for the differential diagnosis of thyrotoxicosis. (author).

  18. Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism (United States)

    Khan, Shoukat H; Madhu, Vijay P; Rather, Tanveer A; Laway, Bashir A


    Background/Aims Esophageal dysmotility is associated with gastrointestinal dysmotility in various systemic and neuroregulatory disorders. Hypothyroidism has been reported to be associated with impaired motor function in esophagus due to accumulation of glycosaminoglycan hyaluronic acid in its soft tissues, leading to changes in various contraction and relaxation parameters of esophagus, particularly in the lower esophageal sphincter. In this study we evaluated esophageal transit times in patients of primary hypothyroidism using the technique of radionuclide esophageal transit scintigraphy. Methods Thirty-one patients of primary hypothyroidism and 15 euthyroid healthy controls were evaluated for esophageal transit time using 15–20 MBq of Technetium-99m sulfur colloid diluted in 10–15 mL of drinking water. Time activity curve was generated for each study and esophageal transit time was calculated as time taken for clearance of 90% radioactive bolus from the region of interest encompassing the esophagus. Esophageal transit time of more than 10 seconds was considered as prolonged. Results Patients of primary hypothyroidism had a significantly increased mean esophageal transit time of 19.35 ± 20.02 seconds in comparison to the mean time of 8.25 ± 1.71 seconds in healthy controls (P hypothyroidism may have subclinical esophageal dysmotility with prolonged esophageal transit time which can be reversible by thyroxine treatment. Prolonged esophageal transit time in primary hypothyroidism may correlate with serum thyroid stimulating hormone levels. PMID:27444283

  19. Current role of bone scan with phosphonates in the follow-up of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Maffioli, Lorenzo; Florimonte, Luigia; Pagani, Luca; Butti, Ivana [Division of Nuclear Medicine, Ospedale ' ' A. Manzoni' ' , Via dell' Eremo 9/11, 23900, Lecco (Italy); Roca, Isabel [Division of Nuclear Medicine, Hospital Universitari Vall Hebron, 08035, Barcelona (Spain)


    A number of studies have demonstrated that bone scintigraphy has high sensitivity and efficacy in the early detection of bone metastases from several tumours, including breast cancer. Bone scintigraphy is the most definitive tool for diagnosing and monitoring metastatic spread of breast cancer. However, in the past decade there has been a wide debate on its impact on survival time, morbidity and quality of life. Worldwide economic restrictions and these studies have led to the adoption of an almost minimalist policy for breast cancer follow-up using evidence-based guidelines. The recommended breast cancer surveillance testing includes only a few procedures (history, physical and breast self-examination, patient education on symptoms, pelvic examination). The routine use of additional tests, such as blood cell count, tumour markers, liver ultrasonography, bone scan and chest X-rays, is not recommended. Accordingly, scintigraphy should be reserved for a limited number of patients. On the other hand, early diagnosis of bone involvement may reduce the risk of skeletal related events, thus leading to a significant improvement in quality of life. Furthermore, new drugs (e.g. bisphosphonates) can now delay the onset of bone metastasis and reduce the number of patients who experience skeletal complications. In conclusion, the evidence of the clinical usefulness of bone scintigraphy (to allow early planning of new treatments in advanced disease) has to be re-evaluated, possibly by large randomised prospective trials. (orig.)

  20. Bone tumor (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  1. Scintigraphy usefulness in the diagnosis of visceral candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Ythier, H.; Legghe, R.; Foucher, C.


    From the features of two cases, the authors stress the usefulness of the scintigraphy as regards to the diagnosis of visceral candidial abscesses. Such fungal localisations are not unfrequent, especially in immunodeficient patients (haematologic malignancies undergoing chemotherapy, lupus, serious visceral illness...). The positive diagnosis is uneasy because of non-specific clinical features and frequent negative blood cultures. Splenic localisation is the most likely. Citrate Gallium scintigraphy together with splenic labelled RBC scan enables us to give a precise view of the splenic involvment and even of the abdominal extension of the fungal abscess. From the literature review and these two cases, the excellent adequacy of the scintigraphy to the follow-up of systemic candidiasis is underlined and is compared to other usual morphological studies such as US scan and CT examination. In both cases, the diagnosis is fully confirmed by mycological examination.

  2. Gallium-67 scintigraphy in patients with hemochromatosis treated by deferoxamine

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Jinnouchi, Seishi; Ono, Seiji; Watanabe, Katsushi


    Gallium scintigraphy was performed as an aid for determining the presence or absence of malignant neoplasm in two patients with hemochromatosis treated by deferoxamine. However, gallium scan images could not be obtained. So gallium scintigraphy was performed once more to investigate the cause of low activity. Both patients had heavy urinary excretion of gallium in the first 24 hrs after the injection, and activity was very low on the day of examination. This phenomenon may be attributed to the effect of deferoxamine which is highly bound to the gallium.

  3. Testis Scintigraphy in a Patient with Acute Lymphoblastic Leukemia

    Directory of Open Access Journals (Sweden)

    Mine Şencan Eren


    Full Text Available Acute lymphoblastic leukemia (ALL is a pediatric malignancy associated with remissions and relapses. Common relapsing sitesare meninges, testis and ovary. Testicular scintigraphy is a highly specific modality used mainly in the differential diagnosis of testicular torsion and epidydimitis/epidydimo-orchitis. There is only one interesting image on leukemic infiltration with scrotal scintigraphy in the literature. The aim of this case presentation is to report that although the scintigraphic appearance of testicular torsion was observed in a patient with the diagnosis of ALL, testicular ALL infiltration was revealed in pathologic examination.

  4. Myocardial scintigraphy - 25 years after start

    Energy Technology Data Exchange (ETDEWEB)

    Hoer, G.


    The development of myocardial scintigraphy (MS) reflects the clinical success of a representative procedure in nuclear medicine. Radiopharmaceuticals for visualizing vital and damaged myocardium and techniques (planar-qualitative, planar-quantitative, SPECT-qualitative-quantitative with comparative sensitivities) are briefly reviewed with the main focus on their clinical application in coronary (CHD) and noncoronary heart disease, where recent literature from the United States and Europe is considered. The limited value of MS for screening of CHD is outlined and its present and future role in detecting asymptomatic (silent) ischemia/infarction and asymptomatic patients at professional risk is stressed. The present state of MS in coronary heart disease is discussed for single and multivessel disease, previous infarction, and risk stratification (myocardial washout, pulmonary uptake, ischemic dilation, absent heart sign), reflecting the importance of the procedure in exercise-induced ischemia as well as in ischemia at rest for prognostication of the natural and therapeutic course, i.e., therapy control (angioplasty, bypass, lysis, cardiac drugs). More marginal but upcoming clinical indications are mentioned, such as progressive systemic sclerosis cardiac transplantation, pediatric cardiology, and problems of nephrology/urology. The ''normal'' values and the impact of digital radiology and of contrast cardiography are touched upon. Preliminary cases with /sup 111/In-antimyosin and /sup 99m/TC-Isonitriles are presented including correlative results between globla ejection fraction determination according to gated /sup 99m/Tc-isonitrile and conventional /sup 99m/Tc-erythrocyte ventriculogram (r=0,75; n=10).

  5. Extraosseous radiotracer uptake on bone scan in beta-thalassemia: report of one case; Fixation extraosseuse du radiotraceur lors de la realisation d'une scintigraphie du squelette chez un patient atteint de beta-thalassemie: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Guezguez, M.; Nouira, M.; Sfar, R.; Chatti, K.; Ben Fradj, M.; Ben Ali, K.; Ajmi, S.; Essabbah, H. [CHU Sahloul, Service de Medecine Nucleaire, Sousse (Tunisia); Zrour, S. [EPS F. Bourguiba, Service de Rhumatologie, Monastir (Tunisia)


    Red blood cell transfusion, main therapeutic modality of beta-thalassemia, leads to iron overload which may perturb several metabolic ways. The aim of this paper is to illustrate the uptake abnormalities observed on bone scan of thalassaemic patients and to discuss mechanisms of extraosseous accumulation of the radiopharmaceutical in this pathology. We report a 16-year-old child suffering from beta-thalassemia major undergoing transfusion therapy. A bone scan was indicated to look for osseous infection. This study revealed a little skeletal uptake and abnormal liver, splenic and renal accumulation. A repeat bone scan, performed three weeks later showed a better skeletal uptake which enabled the discovery of focal abnormalities and made the diagnostic easier. The effect of iron overload on radiopharmaceuticals uptake in bone scan is known since 1975. Dissociation of {sup 99m}Tc from the carrier ligand due to the presence of iron excess seems the most plausible hypothesis. Free {sup 99m}Tc can be bound to other tissular substrates which can explain extraosseous uptake. The normally available pool for bone is reduced and then the skeletal uptake decreased. This report limits considerably the sensitivity of the bone scan. A well-led iron chelation and eventually the use of diuretic drug may guarantee a better quality of bone scan images. (authors)

  6. Diagnostic value of MAG3 scintigraphy and DMSA scintigraphy in renal parenchyma damage and acute pyelonephritis of children

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    Buket Kilicaslan


    Results: The fever, elevated leukocytes, C-reactive protein and sedimentation rate were found statistically significant in the detection of pyelonephritis. However, these values were not significant statistically in the demonstration of the severity of parenchyma damage. In the detection of damage in renal parenchyma, MAG3 scintigraphy had a sensitivity of 32.5 % and a specificity of 98.1 %. Conclusion: MAG3 scintigraphy can not replace DMSA scan to determine the renal parenchyma damage in childhood. [Cukurova Med J 2016; 41(3.000: 464-471

  7. Accuracy of Hepatobiliary Scintigraphy after Liver Transplantation and Liver Resection

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    Manuel Eckenschwiller


    Full Text Available Background and Aims. Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS and impact of hyperbilirubinemia were evaluated. Methods. Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (n=13 or hepatic resection (n=26 were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin. The results were compared to ERCP as gold standard performed within one month after HBS. We calculated sensitivity, specificity, PPV, and NPV. We compared LTX patients to patients with other liver surgeries. Furthermore the influence of hyperbilirubinemia on HBS scans was evaluated. Results. HBS always provided the correct diagnosis in cases of bile leak in the liver-resected group (14/14. Overall diagnostic accuracy was 76% (19/25 in this group and 54% (7/13 in the LTX group. False negative (FN diagnoses occurred more often among LTX patients (p=0.011. Hyperbilirubinemia (>5 mg/dL significantly influenced the excretion function of the liver, prolonging HBS’s time-activity-curve (p=0.001. Conclusions. Hepatobiliary scintigraphy is a reliable tool to detect biliary complications, but reduced accuracy must be considered after LTX.

  8. Hippuran renography and scintigraphy in children with myelomeningocele

    DEFF Research Database (Denmark)

    Thomsen, F; Thorup, Jørgen Mogens; Johnsen, A


    Long-term surveillance of the urinary tract is necessary in children with myelomeningocele and neurogenic bladder dysfunction. The results of Hippuran renography and scintigraphy were analyzed in 52 cases and compared to those of intravenous urography. In addition the radionuclide evaluation...

  9. Myopericarditis in acquired immunodeficiency syndrome diagnosed by gallium scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Cregler, L.L.; Sosa, I.; Ducey, S.; Abbey, L. (Bronx VA Medical Center, NY (USA))


    Myocarditis is among the cardiac complications of acquired immunodeficiency syndrome and, yet, is often not discovered until autopsy. Gallium scintigraphy has been employed in diagnosing this entity, but few data are available about its diagnostic accuracy and value. Here, the authors report two cases of myopericarditis as diagnosed by gallium scan.

  10. Clinical aspects of pulmonary radioactivity observed in radiocolloid liver scintigraphy

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    So, Young; Lee, Kang Wook; Lee, Heon Young; Lee, Won Woo [College of Medicine, Chungnam National Univ., Taejon (Korea, Republic of)


    We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Forty-nine patients with pulmonary radioactivity were classified into 5 diseases groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence of absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver desctruction in liver diseases.

  11. A new case of metastatic visceral calcifications detected in osseous scintigraphy with technetium-{sup 99m} hydroxy-methylene diphosphonate ({sup 99m}Tc-H.M.D.P.); Un nouveau cas de calcifications viscerales metastatiques detectees en scintigraphie osseuse au technetium-{sup 99m} hydroxymethylene diphosphonate ({sup 99m}Tc-HMDP)

    Energy Technology Data Exchange (ETDEWEB)

    Triby-Moreau, C.; Pina-Jomir, G.; Scheiber, C. [Centre de medecine nucleaire, GHE, hospices civils, 69 - Lyon (France); Girma, A.; Paycha, F. [Hopital Louis-Mourier, unite de medecine nucleaire, 92 - Colombes (France)


    Metastatic calcification of malignancy are rare, asymptomatic and reversible in most cases. Hypercalcemia and / or an increase of calcemia-phosphoremia product(70 mg{sup 2}/dL{sup 2}) promotes the formation of crystals of calcium phosphate and hydroxyapatite essential to the precipitation of {sup 99m}Tc-bi-phosphonate.As in our case, the acid Ph tissues are preferentially affected. The whole-body bone scintigraphy seems more sensitive and specific than CT in the calcifications detection particularly of small size. The bone metabolic imaging showed an interest to evaluate the therapeutic response. (N.C.)

  12. Cardiac amyloidosis detection with pyrophosphate-99mTc scintigraphy

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    Souza, D.S.F.; Ichiki, W.A.; Coura Filho, G.B.; Izaki, M.; Giorgi, M.C.P.; Soares Junior, J; Meneghetti, J.C. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Fac. de Medicina. Instituto do Coracao. Servico de Medicina Nuclear e Imagem Molecular


    Full text: Introduction: Amyloidosis is a rare disease, characterized by extracellular deposition of insoluble amyloid fibrils in organs and tissues. It may affect virtually any system, preferably heart, kidneys and liver. The cardiac involvement produces a spectrum of clinical features, usually with progressive dysfunction. Early diagnosis is important for institution of appropriate therapy. Case report: Male patient, 75 years old, with diagnosed congestive heart failure functional class III and Mobitz II second-degree atrial-ventricular block, was hospitalized for implantation of definitive cardiac pacemaker. Patient mentioned history of worsening effort dyspnoea over a one-month period, progressing to minimum effort, orthopnea, paroxysmal nocturnal dyspnoea and paroxysms of dry cough, and swelling of lower limbs. Echocardiography showed diffuse hypertrophy of left ventricle (LV), with systolic dysfunction due to diffuse hypokinesia and hyperrefringent aspect in the septum. It was questioned a cardiac infiltrating process. Cardiac amyloidosis was considered as a diagnostic hypothesis. The patient underwent a pyrophosphate-{sup 99m}Tc scintigraphy, which showed abnormal tracer uptake in the heart projection, with diffuse pattern on the left ventricle walls, compatible with the clinical suspicion cardiac amyloidosis, which was later confirmed by endomyocardial biopsy. Discussion: In this case report, the patient had clinical and other auxiliary examinations, such as electrocardiography and Doppler echocardiography, compatible with cardiac amyloidosis, which led to implementation with pyrophosphate-{sup 99m}Tc scintigraphy and later endomyocardial biopsy. Cardiac amyloidosis occurs in about half the cases of primary amyloidosis (AL) and is rare in secondary amyloidosis (AA). Its clinical presentation is polymorphic and it can be classified into four distinctive types: restrictive cardiomyopathy, systolic dysfunction, postural hypotension and conduction disorders

  13. Role of thallium-201 total-body scintigraphy in follow-up of thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hoefnagel, C.A.; Delprat, C.C.; Marcuse, H.R.; de Vijlder, J.J.


    To evaluate the reliability of total-body scintigraphy using (/sup 201/Tl)chloride in postoperative follow-up of thyroid carcinoma, this procedure was performed in 326 patients after total thyroidectomy for thyroid carcinoma. The results were compared with those of 131I scintigraphy and thyroglobulin assays. /sup 201/Tl total-body scintigraphy was found to have the greatest sensitivity (94%), whereas /sup 131/I scintigraphy had the highest specificity (99%). It is shown that /sup 201/Tl total-body scintigraphy is a useful procedure in follow-up of thyroid cancer, however, the combination of parameters provides the greatest reliability. In medullary thyroid carcinoma, which is usually /sup 131/I negative, /sup 201/Tl total-body scintigraphy can be of great value for the localization of metastases which are indicated by elevated serum levels of calcitonin and carcinoembryonic antigen.

  14. Multiple bone metastases detected on 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography in a breast cancer patient: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Zeki Dostbil


    Full Text Available Bone scintigraphy has been widely used to assess skeletal metastasis in patients with breast cancer. 18F-FDGPET/CT is another imaging modality that has gained previously wide use to determine metastasis based on increased glucose metabolism in malignant cells. Generally, these two modalities give similar results in evaluation of bone metastasis of breast cancer. In this breast cancer case, 99mTc-MDP bone scintigraphy showed normal findings in regards to skeletal metastasis while 18FFDG-PET/CT, contrast-enhanced CT and MRI revealed multiple metastatic focuses. J Clin Exp Invest 2012; 3 (3: 426-429Key words: 18F-fluorodeoxyglucose, bone metastasis, bone scintigraphy, positron emission tomography

  15. Iodine-123 scintigraphy in the evaluation of pediatric thyroid disorders: a ten year experience

    Energy Technology Data Exchange (ETDEWEB)

    Paltiel, H.J.; Summerville, D.A.; Treves, S.T. (Children' s Hospital, Boston, MA (United States). Div. of Nuclear Medicine Harvard Medical School, Boston, MA (United States))


    Between 1978 and 1987, we studied 280 children with iodine-123 ([sup 123]I) scintigraphy. Indications for scintigraphy included hypothyroidism, neck masses, hyperthyroidism, and miscellaneous reasons. Scintigraphy was helpful in distinguishing anatomic from functional causes of hyothyroidism. It reliably identified the location of the thyroid gland in patients with neck masses. The functional status of thyroid nodules was readily assessed and was important in directing further treatment. Scintigraphy added little to the management of children with post-irradiation hypothyroidism without a palpable nodule, patients with Hashimoto thyroiditis or Graves disease when the clinical diagnosis was straightforward. (orig./GDG).

  16. ROC analysis of diagnostic performance in liver scintigraphy. (United States)

    Fritz, S L; Preston, D F; Gallagher, J H


    Studies on the accuracy of liver scintigraphy for the detection of metastases were assembled from 38 sources in the medical literature. An ROC curve was fitted to the observed values of sensitivity and specificity using an algorithm developed by Ogilvie and Creelman. This ROC curve fitted the data better than average sensitivity and specificity values in each of four subsets of the data. For the subset dealing with Tc-99m sulfur colloid scintigraphy, performed for detection of suspected metastases and containing data on 2800 scans from 17 independent series, it was not possible to reject the hypothesis that interobserver variation was entirely due to the use of different decision thresholds by the reporting clinicians. Thus the ROC curve obtained is a reasonable baseline estimate of the performance potentially achievable in today's clinical setting. Comparison of new reports with these data is possible, but is limited by the small sample sizes in most reported series.

  17. Bone Biopsy (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  18. Pulmonary scintigraphy in fibrosing mediastinitis due to histoplasmosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, H.M.; Jay, S.J.; Brandt, M.J.; Holden, R.W.


    The pulmonary scintigraphic findings from our patients with fibrosing mediastinitis due to histoplasmosis are reported. The ventilation/perfusion (V/Q) mismatch mimicked pulmonary emboli. However, in these cases the chest radiographs and/or gallium-67 scintigraphy were abnormal, suggesting mediastinal or hilar disease. Awareness of the nonembolic conditions that can result in V/Q mismatches is important in the interpretation of lung scans.

  19. Pectus excavatum defect on liver-spleen scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, A.J.; Turnbull, G.L.; Parker, A.L.; Fredericks, P.


    A 58-year-old man with a pectus excavatum demonstrated a photon-deficient defect within the left lobe of the liver on liver-spleen scintigraphy using Tc-99m SCOL. Computed tomography of the liver clearly revealed the abnormal defect seen on the liver-spleen scan to be due to the pectus excavatum. This case confirms the impression that these skeletal aberrations may cause false-positive hepatic defects.

  20. Gastrointestinal Bleeding Scintigraphy in the Early 21st Century. (United States)

    Grady, Erin


    Gastrointestinal bleeding scintigraphy performed with (99m)Tc-labeled autologous erythrocytes or historically with (99m)Tc-sulfur colloid has been a clinically useful tool since the 1970s. This article reviews the history of the techniques, the different methods of radiolabeling erythrocytes, the procedure, useful indications, diagnostic accuracy, the use of SPECT/CT and CT angiography to evaluate gastrointestinal bleeding, and Meckel diverticulum imaging. The causes of pediatric bleeding are discussed by age.

  1. Bone Scintigraphic Findings in Leukemic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyo Sun; Park, Jeong Mi; Shon, Hyeong Seon; Chang, Soo Kyo; Kim, Choon Yul; Bahk, Yong Hee; Shinn, Kyung Sub [Catholic University College of Medicine, Seoul (Korea, Republic of)


    The leukemias represent diffuse lesions of the bone marrow and significant bony abnormalities are associated with the more aggressive varieties of leukemias and with the younger age groups. On plain film, several roentgenographic findings are observed such as diffuse osteopenia, radiolucent metaphyseal bands, osteolytic lesions and periostitis. We evaluated bone scintigraphic findings using {sup 99m}Tc-methylene diphosphonate ({sup 99m}Tc-MDP) in ten patients with proven leukemia. The scan is abnormal in 90%. We classified abnormal scintigraphic findings to 3 types and these are increased diffuse juxta-articular uptake, focal increase of uptake and combined type. The common sites of focal uptake were femur, humerus, tibia, spine, ribs, calvarium, scapula and mandible. We concluded that {sup 99m}Tc-MDP bone scintigraphy is sensitive imaging modality in leukemic patients with bone pain.

  2. Somatostatin receptor scintigraphy in patients with cat-scratch disease

    Energy Technology Data Exchange (ETDEWEB)

    Krause, R.; Schnedl, W.J.; Hoier, S. [Div. of Infectious Diseases, Dept. of Internal Medicine, Univ. Graz (Austria); Piswanger-Soelkner, C.; Lipp, R.W. [Div. of Nuclear Medicine, Dept. of Internal Medicine, Univ. Graz (Austria); Daxboeck, F. [Clinical Inst. for Hygiene and Medical Microbiology, Div. of Hospital Hygiene, Univ. of Vienna (Austria); Reisinger, E.C. [Div. of Infectious Diseases and Tropical Medicine, Dept. of Internal Medicine, Univ. Rostock (Germany)


    Aim: somatostatin receptor scintigraphy images various neoplastic, granulomatous, and auto-immun diseases. Cat-scratch disease in an infectious granulomatous disease usually affecting the lymphnodes. It is not known whether cat-scratch disease provides positive somatostatin receptor scintigrams. Patients, methods: twelve patients with lymphadenitis and suspected cat-scratch disease were investigated by immunofluorescence antibody testing and somatostatin receptor scintigraphy. Suppurated lymphnodes were extracted or drained and Bartonella henselae specific PCR was then performed. Results: eleven of 12 patients showed IgG antibodies against B. henselea. SRS showed positive scintigraphic results in 6 of 11 patients with CSD. B. henselae DNA was detected in tissue of lymphnodes from 4 of 5 patients with lymphnode extraction or lymphnode drainage. SRS demonstrated positive scintigrams in all patients with a positive PCR. In one patient with suspected CSD SRS was negative as well as antibody testing. Conclusion: somatostatin receptor scintigraphy correlated with positive Bartonella henselae specific PCR tests and positive Bartonella henselae specific antibody tests in patients with CSD. (orig.)

  3. Whole-body /sup 67/Ga scintigraphy in dermatomyositis

    Energy Technology Data Exchange (ETDEWEB)

    Hiraki, Yoshio; Okazaki, Yoshio; Murakami, Kiminori; Inoue, Nobuhiro; Noriyasu, Toshiaki; Takeda, Yoshihiro; Morimoto, Setsuo; Aono, Kaname


    The presence or absence of abnormal accumulation of gallium-67 in soft tissues was studied in 11 patients undergoing /sup 67/Ga scintigraphy out of 25 patients with dermatomyositis and polymyositis (DM-PM) who had visited our hospital during the period between July 1981 and March 1987 and met the diagnostic criteria of muscle biopsy, etc. A definite image of abnormal accumulation was obtained by /sup 67/Ga scintigraphy in 3 of the patients. Although the positive site tended to be in agreement with the site of muscular symptoms in the DM-PM active stage, the accumulation was not necessarily correlated with the variations in creatine phosphokinase. From these results, it seems necessary to keep in mind the possibility that gallium-67 may also accumulate abnormally in the soft tissue lesion owing to the pathogenic process specific to DM-PM when /sup 67/Ga scintigraphy is undertaken for the purpose of screening, etc., for complication by a malignant tumor in DM-PM patients

  4. Diagnostic capabilities of I-131, TI-201, and Tc-99m-MIBI scintigraphy for metastatic differentiated thyroid carcinoma after total thyroidectomy.

    Directory of Open Access Journals (Sweden)



    Full Text Available

    We investigated the diagnostic capabilities of I-131, Tl-201, and Tc-99m-MIBI (hexakis-2-methoxyisobutyl- isonitrile scintigraphy for thyroid cancer metastases after total thyroidectomy over the entire body and for every locus before and after thyroid bed ablation. After total thyroidectomy of thyroid cancer, 36 cases were subjected to I-131 treatment 64 times. They consisted of 17 men and 19 women with 31 papillary carcinomas and 5 follicular carcinomas. Their ages were 22--75(an average of 60.5+/-12.3 years. I-131 scintigraphy(I-131, Tl-201 scintigraphy(Tl-201, and Tc-99m- MIBI scintigraphy (Tc-99m-MIBI were performed. We defined the metastases as those cases in which serum thyroglobulin (Tgincreased significantly or in which we were able to prove the lesions on CT (computed tomography, MRI (magnetic resonance imaging or bone scintigram. Three radiology medical specialists visually evaluated each scintigram and calculated the sensitivity, specificity, and likelihood ratio. For whole-body sensitivity, both Tl-201 and Tc-99m-MIBI were high before ablation and I-131 was high after ablation. Before ablation, the negative likelihood ratio was less than 0.1 for Tl-201 and Tc-99m-MIBI, while the positive likelihood ratio was more than 10 for Tl-201. After ablation, the positive likelihood ratio for I-131, Tl-201, and Tc-99m-MIBI was more than 10. The sensitivity of the mediastinum was appropriate, except for I-131 before ablation, and the sensitivity of the lung before and after ablation was inferior for either tracer. The specificity of the cervix for I-131 before ablation was markedly deteriorated, but it increased after ablation.

  5. Bone Densitometry (Bone Density Scan) (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Densitometry (DEXA) Bone densitometry, also called dual-energy ... limitations of DEXA Bone Densitometry? What is a Bone Density Scan (DEXA)? Bone density scanning, also called ...

  6. Effects of background substraction on differential kidney function measured by static scintigraphy with DMSA and dynamic scintigraphy with MAG 3

    Energy Technology Data Exchange (ETDEWEB)

    Girotto, N.; Smokvina, A.; Grbac Ivankovic, S.; Licul, V. [Dept. of Nuclear Medicine, Clinical Hospital Centre Rijeka (Croatia)


    The aim of this study was to assess the influence of background subtraction (BS) on estimation of differential kidney function (DF) on the static scintigraphy with {sup 99m}Tc dimercaptosuccinic acid (DMSA) and dynamic scintigraphy with {sup 99m}Tc mercaptoacetyltriglicine (MAG3) and to establish possible differences between DF values estimated with these methods. Patients, methods: patients (n = 106) were selected among those scheduled to static and dynamic scintigraphies within 3 months, with no interim clinical and laboratory changes, regardless the kidney pathology. DF was estimated according to the uptake ratio method. Four background regions of interest (ROIs) were applied, identical for both studies, and DF values were recalculated after BS. The corrected values were compared to the values before correction, separately for DMSA and MAG3, and between the studies. The results showed that ROIs used introduce variable results for the same patients, predominantly when noncorrected DF values were < 45%. There were no significant differences between DF values (corrected and noncorrected) obtained from static and dynamic scintigraphy in all groups of patients. Since numerous reasons can bring to the errors in DF estimation when BS is used, the conclusions are that it would probably be more accurate to avoid BS, particularly when DF values are compared in a patient follow-up, and when kidney function is normal. BS should be used, but always in the same way, only when there is a significant difference in kidney size, or when DF is < 25%, since background activity is then considerable. MAG3 and DMSA can be equally used for DF estimation and their results compared in patient follow-up. (orig.)

  7. Failure of Gallium-67 scintigraphy to identify reliably noninfectious interstitial nephritis: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Graham, G.D.; Lundy, M.M.; Moreno, A.J.


    Gallium-67 scintigraphy has been reported to be useful in the diagnosis of noninfectious interstitial nephritis. We studied 12 patients with Ga-67 citrate that were diagnosed as having noninfectious interstitial nephritis on renal biopsy. Only seven of the twelve patients with interstitial nephritis on biopsy were scan-positive. Gallium-67 scintigraphy may not reliably identify noninfectious interstitial nephritis.

  8. Incidental detection of a bleeding gastrointestinal stromal tumor on Tc-99m red blood cell scintigraphy. (United States)

    Santhosh, Sampath; Bhattacharya, Anish; Gupta, Vikas; Singh, Rajinder; Radotra, Bishan Dass; Mittal, Bhagwant Rai


    The role of 99m-technetium labeled red blood cell (RBC) scintigraphy in acute gastro-intestinal bleed is well-established. The authors report a case of a bleeding gastrointestinal stromal tumor (GIST) incidentally discovered on Tc-99m RBC scintigraphy.

  9. Synovial visualization during Tc-99m MDP bone scanning in septic arthritis of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Yon, J.W. Jr.; Spicer, K.M.; Gordon, L.


    During Tc-99m medronate (MDP) bone scintigraphy, visualization of the synovium during blood flow and blood pool phases was present in a patient with septic arthritis of the left knee. Inflammation with hyperemia of the synovium was the cause for radionuclide localization, which was enhanced by the large photon-deficient effusion distending the suprapatellar bursa. The synovium was not seen on delayed images after redistribution of the radionuclide from blood pool to bone phase.

  10. MRI evaluation and follow-up of bone necrosis after meningococcal infection and disseminated intravascular coagulation

    Energy Technology Data Exchange (ETDEWEB)

    Damry, N. (Dept. of Radiology, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium)); Schurmans, T. (Dept. of Peadiatrics, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium)); Perlmutter, N. (Dept. of Radiology, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium))


    Disseminated intravascular coagulation (DIC) is a serious complication of meningococcal septicaemia. It often results in infarction of various tissues namely the skin, adrenal glands, kidneys, brain and, much less commonly, bones. We describe a patient who presented bone lesions after meningococcal septicaemia. In addition to plain radiography and scintigraphy the lesions were evaluated with MRI and have proved to be extensive and still progressive, approxximately 18 months after the onset of the disease. (orig.)

  11. Performances of scintigraphy in the primitive hyperparathyroidism and the associated thyroid pathologies; Performances de la scintigraphie dans les hyperparathyroidies primitives et les pathologies thyroidiennes associees

    Energy Technology Data Exchange (ETDEWEB)

    Monteil, J. [Service de Medecine Nucleaire, CHRU de Limoges (France); Mathonnet, M. [Service de Chirurgie Endocrinienne, CHRU de Limoges (France); Chianea, T. [Service de Medecine Nucleaire, CHRU de Limoges (France); Cubertafond, P. [Service de Chirurgie Endocrinienne, CHRU de Limoges (France); Piquet, L.; Rince, C.; Bournaud, E.; Verbeke, S.; Perdrisot, R.; Vandroux, J.C. [Service de Medecine Nucleaire, CHRU de Limoges (France)


    The data from scintigraphic and echographic exploration were compared to the surgery results in 32 patients (29 F and 3 M) presenting a primitive hyperparathyroidism, biologically proved, associated to a thyroid pathology. The scintigraphies were achieved with a collimator placed anteriorly and oblique-anteriorly, 4 h after injection by iodine 123 (7 MBq) and 30 min and 2 h after injection of {sup 99m}Tc-MIBI (555 MBq). The cervical echography and scintigraphy are independently interpreted. The results are given in a table containing the sensitivity, specificity, V.P.P. and V.P.N. for scintigraphy and echography, respectively. The association of a primary hyperparathyroidism and of a thyroid pathology (with a prevalence of 70% in our region) appears to affect less the performances of scintigraphy imaging than those of morphologic imaging

  12. Diagnostic value of (111)In-granulocyte scintigraphy in patients with fever of unknown origin

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Lebech, Anne-Mette


    111In-granulocyte scintigraphy is often used as a diagnostic tool in patients with fever of unknown origin (FUO). However, its diagnostic performance has been studied in only a limited number of investigations, with most having been published more than 10 y ago; in addition, a broad range...... to select patients for scintigraphy to raise the diagnostic value. METHODS: For 31 patients with true FUO who underwent granulocyte scintigraphy at a third-line referral hospital between 1995 and 2000, the files and scintigraphy findings were reviewed retrospectively to test the ability of scintigraphy...... to identify infection or chronic inflammatory bowel disease as the cause of FUO. In addition, leukocyte counts and CRP values were recorded. RESULTS: Scintigrams were true-positive in 6 cases, false-positive in 4 cases, true-negative in 19 cases, and false-negative in 2 cases. Sensitivity was 75%, specificity...

  13. Technetium-99m labelled human immunoglobulin scintigraphy predicts rheumatoid arthritis in patients with arthralgia

    Energy Technology Data Exchange (ETDEWEB)

    Bois, M.H.W. de; Arndt, J.W.; Speyer, I.; Pauwels, E.K.J.; Breedveld, F.C.


    The ability of {sup 99m}Tc-IgG scintigraphy to predict the development of rheumatoid arthritis (RA) in 47 patients with arthralgia was investigated. {sup 99m}Tc-IgG scintigraphy and the serum test for rheumatoid factor (RF), measured at the beginning of a year long study, were compared for their ability to predict RA. During the study 8 patients developed RA. The specificity and positive predictive values of RF in predicting RA were 79% and 50% respectively, and for {sup 99m}Tc-IgG scintigraphy 97% and 88%. The sensitivity and negative predictive values of RF were 100% and of {sup 99m}Tc-IgG-scintigraphy 88% and 97%, respectively. In conclusion, {sup 99m}Tc-IgG scintigraphy has additional value to RF with respect to the prediction of the development of RA in patients with arthralgia. 27 refs.

  14. Place of the parathyroid scintigraphy in the preoperative detection of pathological parathyroid glands; Place de la scintigraphie parathyroidienne dans la detection preoperatoire des glandes parathyroides pathologiques

    Energy Technology Data Exchange (ETDEWEB)

    Rejeb, O.; Sellem, A.; Elbez, I.; Elkadri, N.; Hammami, H. [Service de medecine nucleaire, hopital militaire, Tunis, (Tunisia)


    The aim of this work is to evaluate the performances of the scintigraphy in the preoperative localization of pathological parathyroid glands. The parathyroid scintigraphy is a simple, non invasive technique that proved its performances in the preoperative detection of pathological parathyroid glands, mostly in the case of adenoma. It should be indicated in first intention in the topographic diagnosis of a hyperparathyroidism. (N.C.)

  15. Choice of the protocol for the realisation of the parathyroid scintigraphy; Choix du protocole pour la realisation de la scintigraphie parathyroidienne

    Energy Technology Data Exchange (ETDEWEB)

    Nacer-Khodja, M.; Medjaher, M.; Menad, F.; Haffaf, E.M. [Service de medecine nucleaire, hopital central de l' armee, Alger, (Algeria)


    The objective was to have the choice between the different protocols of parathyroid scintigraphy realisation, for a population having a nodule (or multi nodules) goiter with the non availability to iodine 123. The factorial analysis of a dynamic sequence with sestamibi {sup 99m}Tc is the most used protocol in first intention for a population with a nodule goiter in the lack of iodine 123 during the realization of a parathyroid scintigraphy. (N.C.)

  16. Specific diagnosis of neural crest tumours by MIBG scintigraphy; Diagnostic specifique des tumeurs issues de la crete neurale par la scintigraphie a la MIBG

    Energy Technology Data Exchange (ETDEWEB)

    Hoefnagel, C.A. [Het Nederlands Kanker Instituut, Amsterdam (Netherlands)


    MIBG scintigraphy has been used since 1981 as a diagnostic tool in pheochromocytoma and subsequently in a wide variety of neural crest tumors. The authors give the criteria for the choice between {sup 123}I and {sup 123}I-MIBG, remind drug interactions, report sensitivity and specificity values in main indications and discuss the relative merits of MIBG and pentetreotide scintigraphy. (author). 7 refs., 4 figs., 1 tab.

  17. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)


    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  18. Pethidine-augmented white cell scintigraphy in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J.; Poon, F.W.; Bessent, R.G.; Neilly, J.B.; Gray, H.W. [Dept. of Nuclear Medicine, Glasgow Royal Infirmary, Alexander Parade, Glasgow (United Kingdom)


    Technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) white cell scintigraphy is invaluable for assessing the presence and extent of disease activity in patients with inflammatory bowel disease. Interpretation of images can be compromised by physiological excretion of tracer into the bowel via the biliary tree. This study assesses the effect of intravenous pethidine administered with the labelled white cells in an attempt to reduce the enterohepatic circulation of the tracer. Ninety-one subjects with proven or suspected inflammatory bowel disease were included in this study, all of whom underwent {sup 99m}Tc-HMPAO white cell scintigraphy. The control group of 50 subjects underwent the standard protocol for this study performed in our department. The other 41 subjects received an intravenous injection of 0.3 mg/kg of pethidine at the same time as re-injection of the labelled white cells. Images were graded using a five-point scale at both 1 and 2.5 h and categorised as positive, negative or non-diagnostic. Each scan was also assessed for the presence of a visible gall-bladder. The pethidine group had significantly fewer non-diagnostic scans than the control group (P=0.003), and significantly (P=0.001) more studies in which the gall-bladder was visualised. It is concluded that the use of pethidine appears to reduce biliary excretion of tracer during {sup 99m}Tc-HMPAO white cell scintigraphy. This may allow the delayed images, and early images with low-grade tracer uptake in the bowel, to be interpreted with greater confidence and thereby reduce the number of scans classified as non-diagnostic. (orig.)

  19. Usefulness of 99mTc MIBI scintigraphy in hyperparathyroidism. A retrospective analysis of the surgical patients

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Toshiyuki; Kobayashi, Shinya; Fujimori, Minoru [Shinshu Univ., Matsumoto, Nagano (Japan). School of Medicine] [and others


    In patients who receive surgery for primary or secondary hyperparathyroidism, preoperative diagnosis of the location of the parathyroid glands is important. Ninety-nine-m Technetium methoxyisobutylisonitrile (MIBI) accumulates in the pathological parathyroid. We used MIBI scintigraphy to detect diseased parathyroid glands in 20 patients with hyperparathyroidism, and successfully located the glands in seventeen. The accuracy of MIBI scintigraphy (100%) is significantly (p<0.05) better than that of Thallium-Technetium subtraction scintigraphy (56%). In a patient with hyperparathyroidism due to an ectopic parathyroid gland, MIBI scintigraphy showed accumulation in a mediastinal gland. MIBI scintigraphy is thus useful for gland location in hyperparathyroidism. (author)

  20. Technetium-99m HMPAO labelled-leukocytes and gallium-67 scintigraphies in a Munchhausen's syndrome; Scintigraphies aux polynucleaires marques (technitium-99m-HMPAO) et au gallium-67 dans le cadre d'un syndrome de Munchhausen

    Energy Technology Data Exchange (ETDEWEB)

    Alberini, J.L.; Devaux, J.Y.; Tenenbaum, F.; Richard, B. [Groupe Hospitalier Cochin - Saint-Vincent-de-Paul, 75 - Paris (France); Universite Rene Descartes, 75 - Paris (France); Dell' Isola, D. [Hopital Suisse de Paris, 92 - Issy-les-Moulineaux (France)


    We report an observation of investigations performed in a patient with several cervical abscesses in his previous history. Aim of scintigraphic examinations was to detect an evolutive infection and/or to identify a general disease like granulomatosis. Although there was no abnormality on the labelled-leucocytes scintigraphy, an infra-mandibular uptake was observed 10 days later on {sup 67}Ga, without bone involvement. This 'discrepancy' between scintigraphic results and the clinical evolution allowed to confirm its management in nuclear medicine were discussed. (author)

  1. Radiography and scintigraphy in the assessment of early gonarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Egund, N.; Frost, S.; Brismar, J.; Gustafson, T.

    The radiographic and scintigraphic appearances in early gonarthrosis were compared in 62 knees. Early femorotibial osteoarthrosis was found to be confined to one compartment (medial or lateral) of the joint. However, concomitant patellofemoral osteoarthrosis was common. /sup 99/Tc/sup m/-MDP scintigraphy was consistently positive when the joint space (femorotibial and patellofemoral) was reduced by 75% or more. Joint space narrowing by as much as 50% could be observed in a scintigraphically normal knee. The inconsistency between the radiologic and scintigraphic findings in the earliest stages of gonarthrosis points to the importance of appropriate radiographic technique.

  2. Gated blood pool scintigraphy in patients with valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Breuel, H.P.; Heusinger, J.H.; Hanisch, K.


    In 58 patients suffering from either stenosis or insufficiency of a single heart valve, gated blood pool scintigraphy was performed to determine the ejection fraction as well as the peak filling and peak ejection rates. It could be demonstrated that in patients with valvular disorders the ejection fraction was only moderately decreased, generally remaining in the lower reference range. The peak filling and ejection rates showed no pathologic changes with the exception of patients with aortic regurgitation where these rates were significantly decreased. Thus, the estimation of left ventricular peak filling and ejection rates may permit diagnosis of myocardial impairment in patients with valvular disease even under resting conditions.

  3. Cerebrospinal fluid scintigraphy in traumas to the nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Nikolov, P. (Meditsinska Akademiya, Sofia (Bulgaria). Nauchen Inst. po Rentgenologiya i Radiobiologiya)


    The results of cerebrospinal fluid scintigraphy in 48 patients who had undergone trauma to the nervous system were studied. This method has gained rather insufficient acceptance in the diagnosis of this disease, in fact, it was helpful in detecting a high percentage of pathologic changes (80 per cent). Their type and localization structure was as follows: Narrowing of the spinal CSF space in 25 patients and 1 suspective; encephalonasal fistula - 3 patients; blockade of the lateral pathway of the CSF to the brain convexity - 4 patients; pathologic CSF circulation; dilatation of the convex brain cysterns with disturbances at the resorption site - 3 patients; combined spino-encephalic lesion - 1 patient.

  4. Hepatobiliary scintigraphy for early diagnosis of biliary atresia

    DEFF Research Database (Denmark)

    Brittain, Jane Maestri; Kvist, Nina; Johansen, Lars Søndergaard;


    INTRODUCTION: The aim of this study was to evaluate the validity of (99m)Technetium-trimethylbromo-iminodiacetic acid hepatobiliary scintigraphy (HS) for the diagnosis of biliary atresia (BA). METHODS: From January 2005 to December 2009, a total of 47 infants with conjugated hyperbilirubinaemia...... sensitivity and NPV prevent un-necessary surgery. Because of the low specificity of HS in diagnosing BA, it should be part of a multimodality imaging strategy when the result supports a clinical suspicion of BA. In cases with non-draining HS and normal GGTP blood levels, supplemental imaging modalities...

  5. Bone within a bone

    Energy Technology Data Exchange (ETDEWEB)

    Williams, H.J.; Davies, A.M. E-mail:; Chapman, S


    The 'bone within a bone' appearance is a well-recognized radiological term with a variety of causes. It is important to recognize this appearance and also to be aware of the differential diagnosis. A number of common conditions infrequently cause this appearance. Other causes are rare and some remain primarily of historical interest, as they are no longer encountered in clinical practice. In this review we illustrate some of the conditions that can give the bone within a bone appearance and discuss the physiological and pathological aetiology of each where known.

  6. PET and PET/CT with {sup 18}F-fluoride in the diagnosis of bone metastases; PET und PET/CT mit {sup 18}F-Fluorid in der Diagnostik von Knochenmetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Schmiedel, B.; Palmedo, H. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Bonn (Germany)


    The exact tumor stage needs to be determined with the help of the TNM classification before the optimal therapeutic procedure for the patient is proposed. If M-staging is under question bone metastases must be excluded or be proven. Bone scintigraphy plays a major role for bone metastases screening of patients with lung cancer, prostate and breast cancer in whom osseous disease is often present. The result of bone scintigraphy has a significant impact on further therapy e.g. whether curative treatment is possible, whether operative resection or chemotherapy must be performed. PET and PET/CT with {sup 18}F sodium fluoride are new imaging modalities for the detection of bone metastases. PET with {sup 18}F fluoride allows for cross sectional imaging with high resolution in a way that is not achievable by conventional bone scintigraphy. Pharmacokinetic properties of {sup 18}F fluoride are advantageous and lead to high tracer uptake and quick renal clearance. This allows the acquisition of high quality images as early as one hour after the injection. Compared with planar whole body scintigraphy, {sup 18}F fluoride is able to detect significantly more bone metastases (especially in the vertebral column). In comparison to bone SPECT, less additional metastatic lesions are detected by bone PET. This could be demonstrated in detail for lung and prostate cancers. In a small group of patients, {sup 18}F fluoride will diagnose osseous metastatic disease in spite of a negative planar whole body scintigraphy and a negative bone SPECT. However, specificity of bone SPECT is not markedly improved by {sup 18}F fluoride PET. It seems that new camera systems like PET/CT and SPECT/CT can enhance specificity impressively by adding the CT component to exactly localize a tracer accumulation. (orig.)

  7. The possibility of evaluation on inflammatory change at respiratory tract in chronic bronchial asthma using {sup 67}Ga scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fukumitsu, Nobuyoshi; Uchiyama, Mayuki; Mori, Yutaka; Kawakami, Kenji [Jikei Univ., Tokyo (Japan). School of Medicine; Kikuchi, Ichiro; Shimada, Takao


    {sup 67}Ga scintigraphy was performed in 17 patients with chronic bronchial asthma to grasp the inflammatory change of respiratory tract. On {sup 67}Ga scintigraphy, abnormal accumulations were detected on lung fields in 6 cases (35.3%) of 17 cases. In 5 cases of these 6 cases, the defect areas which were pointed out on {sup 81m}Kr ventilation scintigraphy were matched to the abnormal accumulation areas which were pointed out on {sup 67}Ga scintigraphy. In dynamics, the abnormal accumulation areas which were pointed out on {sup 67}Ga scintigraphy were matched to the defect areas which had been at all times pointed out on {sup 81m}Kr ventilation scintigraphy. {sup 67}Ga scintigraphy was expected to be one of index to grasp the inflammatory change of respiratory tract in patients with chronic bronchial asthma. (author)

  8. Indium-111-labeled platelet scintigraphy in carotid atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Minar, E.; Ehringer, H.; Dudczak, R.; Schoefl, R.J.; Jung, M.; Koppensteiner, R.; Ahmadi, R.; Kretschmer, G.


    We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index.

  9. Antimyosin scintigraphy in patients with acquired and hereditary muscular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Loefberg, M. (Dept. of Neurology, Helsinki Univ. Central Hospital (Finland)); Liewendahl, K. (Dept. of Clinical Chemistry, Helsinki Univ. Central Hospital (Finland)); Savolainen, S. (Dept. of Clinical Chemistry, Helsinki Univ. Central Hospital (Finland)); Nikkinen, P. (Dept. of Clinical Chemistry, Helsinki Univ. Central Hospital (Finland)); Lamminen, A. (Dept. of Radiology, Helsinki Univ. Central Hospital (Finland)); Tiula, E. (First Dept. of Internal Medicine, Helsinki Univ. Central Hospital (Finland)); Somer, H. (Dept. of Neurology, Helsinki Univ. Central Hospital (Finland))


    Scintigraphy with indium-111 labelled antimyosin has an established role in the evaluation of cardiac muscle damage. This antibody has been shown to cross-react with myosin in skeletal muscle. We therefore studied the usefulness of this method for the detection of skeletal muscle lesions in rhabdomyolysis, myositis and hereditary muscular dystrophies. All nine patients with rhabdomyolysis had focal uptake of antimyosin antibody which correlated with the clinical findings of soft tissue damage. However, a number of symptomless lesions were also detected by immunoscintigraphy. In rhabdomyolysis the target to non-target uptake ratios varied from 1.3 to 7.6. Diffuse uptake of antibody in skeletal muscle was observed in all three patients with polymyositis-dermatomyositis and in 12 out of 13 patients with muscular dystrophies. In myositis the intensity of antibody accumulation correlated reasonably well with the magnitude of oedema detected by magnetic resonance imaging (MRI). Most patients with Becker type or non-X-chromosomal muscular dystrophies showed slight or moderate uptake of antibody, mainly in the lower extremities. In these patients more antibody accumulated in the calves than in the thighs, whereas the findings on MRI were more prominent in the thighs than in the calves, presumably because of the better preserved muscle bulk in the calves. We conclude that antimyosin scintigraphy can be used for the detection of muscle lesions not only in acquired muscle diseases but also in hereditary muscular disorders, and that immunoscintigraphy provides information on muscle disease activity not obtainable with MRI. (orig.)

  10. Myocardial scintigraphy: methods and indications. Myokardszintigraphie: Methoden und Indikationen

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, W.H. (Herzzentrum Nordrhein-Westfalen, Bad Oeynhausen (Germany). Inst. fuer Nuklearmedizin)


    Myocardial scintigraphy comprises perfusion imaging using TI-201 or - more recently - Tc-99m-labeled compounds with high affinity to myocytes. Imaging with these agents has become an important procedure in the detection of coronary artery disease, particularly in patients with non-diagnostic stress-ECG, in the functional evaluation of coronary stenoses after angiographical documentation in order to meet the adequate therapy decision, in therapy monitoring and follow-up, in the post infarction assessment of myocardial viability and differentiation between severe ischemia and scar and, occasionally, in acute ischemia. The use of positron emitters does not offer significant advantages for mere perfusion imaging, but is indispensable for the scintigraphic investigation of certain aspects of myocardial metabolism, particularly for the differentiation of viable ischemic wall segments from irreversibly damaged tissue. Imaging of myocardial necrosis has been improved by the introduction of labeled antimyosin antibody fragments and offers a considerable clinical potential in the diagnosis of myocarditis and cardiac transplant rejection. Neurohumoral aspects are increasingly involved in our understanding of myocardial failure. Scintigraphy of innervation/neurotransmission contributes to the investigation of pathophysiological alterations in myocardial insufficiency and in heart transplants. (orig.).

  11. A Giant Scapular Aneurysmal Bone Cyst in a Child

    Directory of Open Access Journals (Sweden)

    Theodoros Beslikas


    Full Text Available Aneurysmal bone cysts (ABCs are rare benign bone tumours. Scapula is a very rare location, and the relative literature is sparse. The purpose of this study is to present a case of a giant aggressive scapular aneurysmal bone cyst in a child. A 7-year-old boy presented to our hospital with pain and a palpated mass on the right scapula. Imaging studies (radiographs computed tomography scintigraphy were indicative of aneurysmal bone cyst. We performed curettage and bone grafting after the diagnosis was set by pathological examination through a posterior shoulder approach. Five years later, the patient has only residual signs of the lesion on radiographic control without signs of recurrence.

  12. Multiple Metastasis-Like Bone Lesions in Scintigraphic Imaging

    Directory of Open Access Journals (Sweden)

    Ying Zhang


    Full Text Available Multiple benign osteolytic lesions are very hard to differentiate from disseminated bone metastasis. Whole-body bone scintigraphy (WBBS with technetium-99m methylene diphosphonate (Tc-99m MDP demonstrates multiple lesions with increased uptake in any bone involved. Even combined with medical history and multiple imaging results, such as MRI and CT, the clinical diagnosis of metastasis lesion remains as a challenge. These clinical characteristics are similar to multiple malignant bone metastases and therefore affect the following treatment procedures. In this paper, we analyzed multiple benign osteolytic lesions, like eosinophilic granuloma (EG, multiple myeloma (MM, disseminated tuberculosis, fibrous dysplasia, or enchondroma, occurring in our daily clinical work and concluded that additional attention should be paid before giving the diagnosis of multiple bone metastases.

  13. SPECT/spiral-CT hybrid imaging in unclear foci of increased bone metabolism: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, W.; Kuwert, T. [Nuklearmedizinische Klinik, Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany); Beckmann, M.W. [Frauenklinik, Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany); Forst, R. [Lehrstuhl fuer Orthopaedie mit Orthopaedischer Chirurgie, Friedrich-Alexander Univ. Erlangen/Nuernberg (Germany); Bautz, W. [Radiologisches Inst., Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany)


    In bone scintigraphy, the differentiation between degenerative processes and bone metastases is still difficult. Therefore, additional radiological studies are regularly needed after bone scintigraphy. The now introduced hybrid-cameras combining single-photon emission computed tomography (SPECT) and spiral-CT are unique in the sense that they offer the opportunity to correlate the functional information with morphology in one session. We herein present two patients in whom this technological setup allowed a definite diagnosis in scintigraphically unclear vertebral lesions. In a patient with breast cancer, hypermetabolic lesions were clearly correlated with osteolyses. In another patient with synovial carcinoma, spondylosis and spondylarthrosis caused focal tracer uptake in the lumbar spine. In addition to an improved diagnostic accuracy, SPECT/Spiral-CT will considerably abbreviate the diagnostic process. (orig.)

  14. I-Metaiodobenzylguanidine Myocardial Scintigraphy in Lewy Body-Related Disorders: A Literature Review

    Directory of Open Access Journals (Sweden)

    Eun Joo Chung


    Full Text Available Lewy body-related disorders are characterized by the presence of Lewy bodies and Lewy neurites, which have abnormal aggregations of α-synuclein in the nigral and extranigral areas, including in the heart. 123I-metaiodobenzylguanidine (MIBG scintigraphy is a well-known tool to evaluate cardiac sympathetic denervation in the Lewy body-related disorders. MIBG scintigraphy showed low uptake of MIBG in the Lewy body-related disorders, including Parkinson’s disease, dementia with Lewy bodies, pure autonomic failure and rapid eye movement sleep behavior disorder. This review summarizes previous results on the diagnostic applications of MIBG scintigraphy in Lewy body-related disorders.

  15. Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET

    DEFF Research Database (Denmark)

    Binderup, Tina; Knigge, Ulrich; Jakobsen, Annika Loft


    Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In-diethylenetriamin......Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In......-diethylenetriaminepentaacetic acid-octreotide, scintigraphy with (123)I-metaiodobenzylguanidine (MIBG), and (18)F-FDG PET. METHODS: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET on average within 40 d. The functional images were fused with low......-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. RESULTS: The overall sensitivity of SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were (18)F-FDG PET...

  16. Comparative evaluation of scintigraphy and upper gastrointestinal tract endoscopy for detection of duodenogastric reflux

    Energy Technology Data Exchange (ETDEWEB)

    Mittal, B.R.; Ibrarullah, Mohammad; Agarwal, D.K.; Maini, Atul; Ali, Wasif; Sikora, S.S.; Das, B.K. (Sanjay Gandhi Postgraduate Inst. of Medical Sciences (India))


    Duodenogastric reflux, the reflux of duodenal bile into stomach, when suspected clinically requires an objective evaluation for proper management. In this study hepatobiliary scintigraphy in 91 patients of different clinical conditions was evaluated for presence of duodenogastric reflux. Upper gastrointestinal endoscopy was also performed in 44 of these patients. On scintigraphy duodenogastric reflux was present in 26 (29%) of 91 patients. Upper gastrointestinal endoscopy revealed presence of refluxed bile in the stomach in 12 (27%) of 44 patients. In the same groups of patients scintigraphy detected reflux in 18 (41%) of 44 patients. This shows that hepatobiliary scintigraphy is superior to upper gastrointestinal endoscopy in detection of duodenogastric reflux and also has the advantage of being non-invasive and physiological. (author).

  17. A decision support system for stress only myocardial perfusion scintigraphy may save unnecessary rest studies

    DEFF Research Database (Denmark)

    Tägil, K; Jakobsson, D; Lomsky, M


    The aim of this study was to investigate the influence of a computer-based decision support system (DSS) on performance and inter-observer variability of interpretations regarding ischaemia and infarction in myocardial perfusion scintigraphy (MPS)....

  18. Quantitative kidney scintigraphy in children, using technetium-labelled dimercaptosuccinic acid

    Energy Technology Data Exchange (ETDEWEB)

    Bouissou, F.; Danet, B.; Meguira, B. and others


    Separate measurement of renal function is essential in children with urinary tract disease. This can be done satisfactorily by means of kidney scintigraphy with technetium 99m-labelled dimercaptosuccinic acid. A retrospective study of the records of 415 children, which comprised renal function tests, radiology and scintigraphy, confirmed the value of the radioisotope technique. Graphs of height, kidney uptake and kidney uptake density in relation to age were established, showing highly significant correlations with renal function tests and intravenous urography results, but many dissociations were encountered. Separate renal function evaluation by radioisotope scintigraphy seems to be more reliable than evaluation extrapolated from measurement of the cortical areas at intravenous urography. In vesico-ureteral reflux scintigraphy makes it possible to detect reflux nephropathy at an earlier stage than with other methods.

  19. Bone Markers (United States)

    ... markers may be seen in conditions such as: Osteoporosis Paget disease Cancer that has spread to the bone (metastatic bone disease) Hyperparathyroidism Hyperthyroidism Osteomalacia in adults and rickets in children—lack of bone mineralization, ...

  20. Bone scan (United States)

    ... legs, or spine fractures) Diagnose a bone infection (osteomyelitis) Diagnose or determine the cause of bone pain, ... 2015:chap 43. Read More Broken bone Metabolism Osteomyelitis Review Date 12/10/2015 Updated by: Jatin ...

  1. Bone Cancer (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  2. Bone Diseases (United States)

    Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly ... childhood and your teens, your body adds new bone faster than it removes old bone. After about ...

  3. A Matlab Tool for Tumor Localization in Parathyroid Sestamibi Scintigraphy

    Directory of Open Access Journals (Sweden)

    M. Đurović


    Full Text Available Submarine method for localization of parathyroid tumors (PT has proved to be effective in case of typical pitfalls of conventional scintigraphic methods (combined subtraction and double phase methods. It uses images obtained by standard dynamic parathyroid sestamibi scintigraphy suggested by European Association of Nuclear Medicine. This paper presents: 1 the developed Matlab interface that enables the implementation and evaluation of algorithms for the automatic application of Submarine method; 2 the algorithm for automatic extraction of the entire thyroid region from the background radioactivity using operations from mathematical morphology applied on dynamic scintigrams; 3 the results obtained by algorithm for localization and visualization of PTs based on estimation of exponential decreasing trend of time-activity curves. The algorithm was tested on a group of 20 patients with histopathologically proven PTs using developed Matlab interface.

  4. Esophageal clearance scintigraphy in, diabetic patients; A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Karayalcin, B.; Karayalcin, U.; Aburano, Tamio; Nakajima, Kenichi; Hisada, Kinichi; Morise, Toshio; Okada, Toshihide; Takeda, Ryoyu (Kanazawa Univ. (Japan). School of Medicine)


    The aim of this preliminary study was to evaluate the predictive value of esophageal clearance scintigraphy (ECS) in the diagnosis of esophageal autonomic neuropathy in diabetic patients without any esophageal symptoms. A single swallon ECS was performed in 12 diabetic patients and 15 normal volunteers, and esophageal transit time (ETT) and esophageal (Es) T 1/2 values were calculated. ETT and Es 1/2 were found to be significantly prolonged in the diabetic group (p<0.01 and p<0.05, respectively). In this preliminary study, our results strongly suggest that ECS may be an important noninvasive diagnostic tool in the evaluation of diabetic patients with asymptomatic esophageal autonomic neuropathy. (author).

  5. Peritoneal scintigraphy: a simple pre-therapy test. Technical features

    Energy Technology Data Exchange (ETDEWEB)

    De Rossi, G. [Ist. di Medicina Nucleare, Universita Cattolica del Sacro Cuore, Rome (Italy); Valenza, V. [Ist. di Medicina Nucleare, Universita Cattolica del Sacro Cuore, Rome (Italy)


    Peritoneal scintigraphy with 99mTc-MAA was used for monitoring intra-abdominal chemotherapy in refractory metastatic ascites fom various primary tumors. Scintigraphic patterns appeared to be the simplest, most accurate and reliable method to visualize the possible presence of intraperitoneal sacs due to adhesions. In addition, this technique is able to evidentiate the patency of intra-abdominal catheters. (orig.) [Deutsch] Die peritoneale Szintigraphie mit 99mTc-MAA wurde zur Ueberwachung der intraabdominellen Chemotherapie bei therapieresistentem malignen Aszites unterschiedlicher Primaertumorgenese eingesetzt. Die Szintigraphie erwies sich als die einfachste, sensitivste und angemessenste Methode, um moeglicherweise vorliegende intraperitoneale Fluessigkeitsverhalte durch Adhaesionen sichtbar zu machen. Die Methode ist darueber hinaus gut geeignet, um die Durchgaengigkeit intraabdomineller Katheter zu ueberpruefen. (orig.)

  6. /sup 111/In platelet scintigraphy in cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Powers, W.J.; Siegel, B.A.; Davis, H.H.; Mathias, C.J.; Clark, H.B.; Welch, M.J.


    We obtained scintigraphic images of the neck from 100 patients with suspected cerebrovascular disease after injecting /sup 111/In-labeled autologous platelets. One or more focuses of increased activity, implying local platelet accumulation, were seen along the course of the cervical carotid arteries in 52 patients. In 64 patients, there was a highly significant correlation between the results of scintigraphy and carotid arteriography (p . 10(6)). There was no significant correlation between the scintigraphic findings and the previous or subsequent occurrence of transient ischemic attack or cerebral infarction in the carotid circulation. These data suggest that factors other than the simple formation of platlet thrombi in the cervical carotid arteries are of primary importance in the pathogenesis of stroke.

  7. Patterns of salivary gland uptake in I-131 MIBG scintigraphy. (United States)

    Salanci, B Volkan; Ergün, E Lay


    I-131 MIBG scintigraphy is routinely used in the diagnosis of neuroendocrine tumours with high specificity. The radiopharmaceutical is taken up via uptake mechanism and actively transported into storage vesicules. The organs with dense sympathetic innervation such as salivary glands, heart, lachrymal glands, spleen and rarely adrenal medulla are normally visualized with I-131 MIBG. Asymetrical salivary gland uptake is important in a patient with suspected neuroendocrine tumours. Absence of radioactivity may be a result of sympathic denervation or tumor. Bilateral radioactivity absence is observed usually due to drugs or radiopharmaceutical storage conditions. Detailed examination of cervical region is crucial for localisation of neuroendocrine tumours. Therefore, possible false positives should be kept in mind.

  8. In-111 labeled leukocyte scintigraphy in a case of multifocal candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Palestro, C.J.; Vega, A.; Kim, C.K.; Goldsmith, S.J. (Mount Sinai School of Medicine, New York, NY (USA))


    The value of indium-111 labeled leukocyte scintigraphy for the diagnosis of infection in the general population is well documented; there is less information available on its role in the evaluation of the immunocompromised patient. In this study, leukocyte scintigraphy was performed on a 31-year-old immunocompromised woman who had a possible intra-abdominal abscess. No abscess was detected, but intense oral, esophageal, gastric, and vaginal uptake was observed. Candida infection was histologically confirmed at all four sites.

  9. Multifocal peritoneal splenosis in Tc-99m-labeled heat-denatured red blood cell scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Min Ki; Hwang, Kyung Hoon; Choe, Won Sick [Gachon University Gil Medical Center, Incheon (Korea, Republic of)


    A 44-year-old man with a past medical history of splenectomy came to hospital because of epigastric pain abdominopelvic computed tomography(CT) showed a soft tissue mass and multifocal variable-sized nodules as well as finding suggestive of cholecystitis. Subsequently, he underwent Tc-99m-labeled heat- denatured red blood cell(RBC) scintigraphy to evaluate the mass and nodules. The scintigraphy confirmed multifocal peritoneal splenosis in the abdominopelvic cavity.

  10. Prostate cancer in patients from rural and suburban areas – PSA value, Gleason score and presence of metastases in bone scan

    Directory of Open Access Journals (Sweden)

    Wojciech Szot


    Full Text Available [b]Introduction[/b]. Prostate cancer is the second most common neoplasm among men both worldwide and in Poland. In prostate cancer, bone metastasis is related to a poorer prognosis. A diagnosis of metastatic bone disease is important in prostate cancer patients prior to therapy. Prostate specific antigen (PSA serum value is used both as a screening tool and for staging of prostate cancer. aim. To evaluate whether there is a link between symptoms presented by patients, pain in particular, and the presence, number and location of bone metastases as assessed by bone scan scintigraphy in concordance with PSA values and Gleason scores. [b]material[/b]. A group of 186 patients (aged: 68.38±6.16 diagnosed with prostate cancer, from rural and suburban areas of Małopolska province, that was directed for bone scan scintigraphy to the Nuclear Medicine Dept, John Paul II Hospital in Kraków. [b]methods[/b]. Analysis of all laboratory findings (including PSA value and a biopsy were performed. Then, bone scan scintigraphy was done with the use of methylene disphosphonate (MDP labeled with Tc-99m. [b]results[/b]. In patients with a Gleason value ≤7 and a PSA value ≤20 ng/ml, the cutoff value for a negative bone scan with a confidence interval of 0.95 was established at a PSA value below 10 ng/ml (p<0.01. Correlations were established between PSA value and presence of metastases in bone scan (r=0.45, p=0.05, the number of metastases (r=0.66, p<0.01, and their presence in particular body regions. [b]conclusions[/b]. The correlation between PSA value and both presence and number of metastases confirms the usefulness of bone scan scintigraphy in prostate cancer staging. The cutoff value for negative bone scan with a 95% confidence interval was established at PSA = 10 ng/ml.

  11. Computer-aided diagnosis system for bone scintigrams from Japanese patients: importance of training database

    DEFF Research Database (Denmark)

    Horikoshi, Hiroyuki; Kikuchi, Akihiro; Onoguchi, Masahisa


    Japanese patients. The two CAD softwares were evaluated using the same group of 257 Japanese patients, who underwent bone scintigraphy because of suspected metastases of malignant tumors in 2009. The final diagnostic results made by clinicians were used as gold standard.The Japanese CAD software showed......Computer-aided diagnosis (CAD) software for bone scintigrams have recently been introduced as a clinical quality assurance tool. The purpose of this study was to compare the diagnostic accuracy of two CAD systems, one based on a European and one on a Japanese training database, in a group of bone...... scans from Japanese patients.The two CAD software are trained to interpret bone scans using training databases consisting of bone scans with the desired interpretation, metastatic disease or not. One software was trained using 795 bone scans from European patients and the other with 904 bone scans from...

  12. Joint scintigraphy using technetium-99m pyrophosphate in experimental hemarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Salimi, Z.; Vas, W.; Restrepo, G.


    To determine the validity of a method for induction of experimental hemarthrosis in dogs and for the nuclear imaging of hemarthrosis, serial technetium-99m pyrophosphate ((/sup 99m/Tc)PYP) flow and blood-pool scans were performed monthly in eight dogs who received bi-weekly injections of autologous blood into their femoro-tibial joints (also called stifle joint). In four control dogs, one joint was injected with saline while the other joint received only a sham injection. In addition, two dogs received intra-articular injections of autologous blood into their right stifle joint and saline into their left stifle joint. These dogs were studied with /sup 99m/TcO/sub 4/ joint scintigraphy at monthly intervals. The dogs were periodically taken out of the study and explored surgically. Pathologic examination of synovial tissue was performed. Serial radiographs were also obtained and correlated with the scan and surgical findings. There was a striking abnormal increase in blood-pool activity of (/sup 99m/Tc)PYP in the treated stifle joints, commencing at the first examination after 1 mo of blood injections and continuing for the length of the study. All radiographs showed only minimal joint space widening and some soft-tissue swelling. On pathologic examination, both grossly and microscopically, there was profuse pannus formation, with intense inflammatory infiltrate replacing much of the subsynovial fat. The scintigraphic findings correlated well with these pathologic findings. This study not only validates this method for simulating hemophilic hemarthrosis but also suggests that (/sup 99m/Tc)PYP joint scintigraphy is a simple, and noninvasive method for monitoring the early changes in hemophilic arthropathy and is superior to pertechnetate imaging for this disease process.

  13. Variability in the interpretation of DMSA scintigraphy after urine infection

    Energy Technology Data Exchange (ETDEWEB)

    Craig, J.; Howman-Giles, R.; Uren, R.; Irwig, L.; Bernard, E.; Knight, J.; Sureshkumar, P.; Roy, L.P. [New Childrens Hospital, Westmead, NSW, (Australia). Centre for Kidney Research, Department of Nuclear Medicine]|[University of Sydney, Sydney, NSW. (Australia)


    Full text: This study investigated the extent of and potential reasons for interpretation disagreement of {sup 99m}Tc-DMSA scans after urine infection in children. Methods: 441 scans were selected from children with first urine infection (UTI) from 1993-1995. 294 scans were performed at a median time of seven days after UTI and 147 in children free from infection over one year follow-up. Two nuclear medicine physicians independently reported according to whether renal abnormality was present or absent and used the four level grading system described by Goldraich: grade 1-no more than two cortical defects; grade 2 -more than 2 defects; grade 3-diffuse reduction in uptake with or without defects; grade 4 -shrunken kidney <10% function. Indices for variability used were the percentage of agreement and kappa statistic, expressed as a percentage. For the grading scale used, both measures were weighted with integers representing the number of categories from perfect agreement. Disagreement was analysed for children, kidneys and kidney zones. Results: There was agreement in 86 per cent (kappa 69%) for the normal-abnormal DMSA scan dichotomy, the weighted agreement was 94 per cent (kappa 82%) for the grading scale. Disagreement of DMSA scan interpretation {>=} two grades was present in three cases (0.7%). The same level of agreement was present for the patient, kidney and kidney zones comparisons. Agreement was not influenced by age or the timing of scintigraphy after urine infection. Conclusion: Two experienced physicians showed good agreement in the interpretation DMSA scintigraphy in children after urine infection and using the grading system of Goldraich.

  14. Complicated bone and soft-tissue infections. Imaging with 0.1 T MR and {sup 99m}Tc-HMPAO-labeled leukocytes

    Energy Technology Data Exchange (ETDEWEB)

    Hovi, I. [Univ. Central Hospital, Helsinki (Finland). Dept. of Radiology


    Purpose: To assess the value of imaging by 0.1 T MR and by {sup 99m}Tc-HMPAO-labeled leukocytes in confirming skeletal infection in patients with soft-tissue infections and/or bone pathology. Methods: Thirty-nine anatomical sites (35 patients) with suspected bone infection were prospectively imaged with 0.1 T MR and {sup 99m}Tc-HMPAO-labeled leukocytes. Thirty-two infected areas were confirmed: 12 osteomyelitis (out of which 3 were spondylitis) and 27 soft-tissue infections (both bone and soft-tissue infection in 7 areas). Results: MR imaging showed 31 true-positive, 2 true-negative, 4 false-positive and one false-negative diagnosis of infection and scintigraphy 27, 7, 0 and 5 respectively. The sensitivity of MR for osteomyelitis was 100% (12/12) and of scintigraphy 42% (5/12), p<0.01. The specificity of MR and of scintigraphy for osteomyelitis were 81% (22/27) and 93% (25/27) respectively. The sensitivity of MR for soft-tissue infection was 96% (26/27) and specificity 75% (9/12). The corresponding figures for scintigraphy were 85% (23/27) and 100% (12/12). MR and scintigraphy were concordant with respect to the final diagnosis in 28/39 (72%) sites and discordant in 10 (26%). In one patient with Charcot osteoarthropathy a flase-positive finding was found by both methods. MR detected all 3 cases of spondylitis, scintigraphy one. Nonpyogenic inflammations and neuroarthropathic joints were indistinguishable from infection by MR. Conclusion: Combined imaging with MR and {sup 99m}Tc-labelled leukocytes is recommended in diagnostically complicated bone infections except for spondylitis where MR is the method of choice. Congruent positive findings are highly suggestive of infection, the extent of which can be determined. Congruent negative results exclude infection. (orig.).

  15. Childhood acute pyelonephritis: comparison of power Doppler sonography and Tc-DMSA scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Stogianni, Aggeliki; Oikonomou, Ippoliti; Dimitriadis, Athanasios [Aristotle University of Thessaloniki, Department of Radiology, AHEPA Hospital, Thessaloniki (Greece); Nikolopoulos, Panagiotis [424 Army Hospital, Department of Radiology, Thessaloniki (Greece); Gatzola, Magdalini [Aristotle University of Thessaloniki, 2nd Paediatric Clinic, AHEPA Hospital, Thessaloniki (Greece); Balaris, Vassilios [Aristotle University of Thessaloniki, Department of Nuclear Medicine, AHEPA Hospital, Thessaloniki (Greece); Farmakiotis, Dimitrios [Infectious Diseases Hospital of Thessaloniki, Department of Medicine, Thessaloniki (Greece)


    Tc 99m DMSA scintigraphy is regarded as the gold standard for the detection and localization of acute pyelonephritis (APN) in children. Power Doppler sonography (PD US) is a radiation-free and cost-effective technique that could be useful in the diagnosis of APN in children. To compare the predictive value of PD US with DMSA scintigraphy in the diagnosis of APN in children. A total of 74 neonates and children with clinical findings consistent with possible upper urinary tract infection were evaluated with PD US and DMSA scintigraphy. Children with anatomic (grey-scale) abnormalities were excluded. A total of 147 kidneys were examined within the first 48 h after the onset of symptoms. Each kidney was divided into three zones (upper, middle, and lower third). APN was diagnosed by PD US in 46 kidneys. Sensitivity and specificity for detecting APN using DMSA scintigraphy as the reference standard were 73.8% and 85.7%, respectively. There was good agreement between PD US and DMSA scintigraphy in the localization of lesions. In clinically suspected APN, PD US has acceptable specificity and sensitivity, if performed within the first 48 h and could be helpful in neonates and children under 3 months of age in whom the use of scintigraphy is generally discouraged. (orig.)

  16. Evaluation of DMSA scintigraphy and urography in assessing both acute and permanent renal damage in children

    Energy Technology Data Exchange (ETDEWEB)

    Stokland, E.; Jacobsson, B. [Dept. of Pediatric Radiology, Sahlgrenska Univ. Hospital, Goeteborg Univ. (Sweden).; Hellstroem, M. [Dept. of Radiology, Sahlgrenska Univ. Hospital, Goeteborg Univ. (Sweden); Jodal, U. [Dept. of Pediatrics, Sahlgrenska Univ. Hospital, Goeteborg Univ. (Sweden); Sixt, R. [Dept. of Pediatric Clinical Physiology, Sahlgrenska Univ. Hospital, Goeteborg Univ. (Sweden)


    Purpose: To evaluate dimercaptosuccinic acid (DMSA) scintigraphy and urography in the detection of renal involvement in children with urinary tract infection (UTI) in order to identify patients with a high risk of developing renal damage. Material and Methods: A total of 157 children (median age 0.4 years, range 5 days to 5.8 years) with first-time symptomatic UTI were examined scintigraphy (with an assessment of renal area involvement) and urography at the time of UTI and 1 year later. All evaluations were made blindly. Results: Of the total 314 kidneys, 80 (25%) were abnormal at initial scintigraphy. Of these 80 kidneys, 44 (55%) had normalized at follow-up. Of the 234 initially normal kidneys, 29 (12%) were abnormal at follow-up. One year after UTI, abnormalities were seen in 59 children at scintigraphy and in 18 children at urography. Renal area involvement was larger and split function abnormalities more common in kidneys that were abnormal at both scintigraphy and urography than in kidneys with only scintigraphic abnormalities. Conclusion: Quantitation of renal area involvement and split renal function at early scintigraphy would seem to be useful in identifying patients at risk of developing renal damage. Urography at 1 year after infection identified mainly those with the most severe scintigraphic abnormalities. The clinical importance of scintigraphic abnormalities that are not confirmed by urography is not known. (orig.)

  17. Renal anomalies in patients with turner syndrome: Is scintigraphy superior to ultrasound? (United States)

    Hamza, Rasha T; Shalaby, Mennatallah H; Hamed, Laith S; Abdulla, Dunya B A; Elfekky, Sahar M; Sultan, Omar M


    Renal anomalies are present in up to 30% of patients with Turner syndrome (TS). Renal ultrasound (U/S) detects anatomical renal anomalies only while renal scintigraphy detects anomalies, detects early renal malfunction, and estimates glomerular filtration rate (GFR). Thus, we aimed to assess frequency of renal abnormalities detected by scintigraphy in comparison to renal U/S in TS patients. Ninety TS patients were subjected to auxological assessment, measurement of serum creatinine; and renal U/S and scintigraphy. Renal U/S detected renal anomalies in 22.22% of patients versus 17.78 % detected by scintigraphy (P = 0.035). Scintigraphy detected renal functional abnormalities in 44.44% of patients in the form of subnormal total GFR, abnormal renogram curve pattern, improper tracer handling and perfusion; and difference in split renal function >10% between both kidneys. Patients with a 45,X karyotype had more renal functional abnormalities (56%) than those with mosaic karyotype (33.33%), P = 0.04. In conclusion, renal scintigraphy is not superior to U/S in detection of renal anomalies but is a reliable method for early detection of renal malfunction in TS patients especially those with 45,X to ensure early management to offer a better quality of life.

  18. [Comparative investigations of osteotropic radionucleides. IV. The dynamics of uptake in normal and abnormal bone (author's transl)]. (United States)

    Creutzig, H; Gerdts, K G; Creutzig, A


    The dynamics of uptake of osteotropic radionucleides in normal and abnormal bone were studied by means of sequential and functional scans. Various phosphate and phosphonate complexes were compared in vivo and in vitro. Only phosphonates were considered as suitable for bone scanning. In normal bones in beagles, radioactivity after HEDP fell to 65% after two hours, but was 105% with 18F. In relation to healing fractures, the curves differ quantitatively and qualitatively. In this situation, functional curves derived from dynamic scans provide a better parallel with histological findings than does static scintigraphy with an uptake quotient. Sequential and functional scanning are able to document the therapeutic effect of irradiation of bone metastases.

  19. Acute postoperative osteomyelitis in femur fracture: contribution of bone scintilography (case report)

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Natalie Ferreira; Rezende, Cleuza Maria de Faria; Sanchez-Ucros, Natalia; Laguardia, Priscilla [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Escola de Veterinaria; Diniz, Simone Odilia Fernandes; Cardoso, Valbert Nascimento [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Farmacia; Rodrigues, Carlos Jorge Simal [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Santos, Raquel Gouvea dos [Centro de Desenvolcimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Lab. de Radiobiologia


    The treatment of bone fractures is aimed at consolidating and returns of function as soon as possible and can be performed by different methods. Treatment with the plate in fractures of the femur in bridge aims not to address the location of fracture and stabilize it, maintaining the anatomical axis by the fixation of proximal and distal segments. Postoperative follow-up of the fracture is necessary to evaluate the irrigation of the bone structure and the effect of the method. The scintigraphy is a method capable of assessing the degree of bone remodeling and the presence or absence of local bone homeostasis. The objective of this report is to present the case of a rabbit, male, which was subjected to osteotomy and fixation of the femoral diaphysis by means of the plate in the bridge. After 10 days the animal was subjected to scintigraphic and radiographic evaluations. The animal came to death and an autopsy was performed on the same when it was observed macroscopy consistent with acute osteomyelitis due to contamination postoperative time. Radiographic evaluation in acute osteomyelitis is unclear. The methods assist in the scintigraphic diagnosis of osteomyelitis by allowing the detection of functional changes in this infectious process. The bone scintigraphy with diphosphonates labeled with technetium-99m shows increased bone turnover in the infected area and its high sensitivity, even in an early stage makes it the method of choice in the diagnosis of acute osteomyelitis in patients without prior bone disease and bone radiologically normal. (author)

  20. Performance of thyroid scintigraphy in the thyrotoxicosis etiological diagnosis: about 210 cases; Performance de la scintigraphie thyroidienne dans le diagnostic etiologique des thyrotoxicoses: a propos de 210 cas

    Energy Technology Data Exchange (ETDEWEB)

    Chatti, K.; Nouira, M.; Guezguez, M.; Sfar, R.; Essabbah, H. [CHU Sahloul, Service de medecine nucleaire, Sousse (Tunisia); Zantour, B. [CHU Mahdia, service d' endocrinologie (Tunisia)


    Purpose: The thyrotoxicosis is a syndrome linked to thyroid hormones excess grouping any causes leading to a overload in circulating hormones, including these ones linked to an inflammatory process (thyroiditis) or an exogenous contribution. The etiologic diagnosis is based on complementary examinations. The objective of our work is to elucidate the performance of scintigraphy in the etiologic diagnosis and the therapy approach of thyrotoxicosis through the experience of our service. Conclusions: Scintigraphy has a place in the etiologic diagnosis of thyrotoxicosis. it brings functional and morphological information and allows to guide the diagnostic and therapeutic approach. (N.C.)

  1. Parosteal osteoma of the iliac bone

    Energy Technology Data Exchange (ETDEWEB)

    Soler, R.R.; Martinez, S.; Granados, J. [Department of Rheumatology, Hospital Mutua de Terrassa, Barcelona (Spain); de Marcos, J.A. [Department of Radiology, Hospital Mutua de Terrassa, Barcelona (Spain); Salas, A. [Department of Pathology, Hospital Mutua de Terrassa, Barcelona (Spain); Lluc, P. [Primary Care Setting, Sa Canal Salat, Menorca (Spain)


    A 33-year-old patient with a 2-year history of intermittent pain in the right gluteal region and thigh presented with a large sclerotic lesion of the iliac bone. From the findings on radiography, scintigraphy, CT and MRI, a giant parosteal osteoma was suspected. The histological examination confirmed the diagnosis. Since the lesion was extensive it was observed with periodic follow-up examinations. At present, 5 years after the diagnosis, the patient is asymptomatic and imaging studies show that the lesion persists with reduction of sclerosis and size. The tumor was on the surface as well as intramedullary - only one other case with such a distribution is known to us - and it was also in the iliac bone. (orig.) With 7 figs., 14 refs.

  2. Value of post-therapeutic ¹³¹I scintigraphy in stimulated serum thyroglobulin-negative patients with metastatic differentiated thyroid carcinoma. (United States)

    Shen, Chen-Tian; Wei, Wei-Jun; Qiu, Zhong-Ling; Song, Hong-Jun; Luo, Quan-Yong


    Metastatic differentiated thyroid carcinoma (DTC) with positive (131)I scintigraphy, but negative stimulated Tg (sTg) is relatively rare in clinical practice. The clinical characteristics of these patients were analyzed in the current study. A total of 3367 consecutive histologically proven DTC patients were analyzed retrospectively from January 2007 to June 2013. Tg negativity was defined as a sTg level of post-therapeutic (131)I-SPECT/CT positive and sTg negative (PTP-TN) constituting 2.1 % of all patients. Of these 71 patients, 2 (2.8 %) had bone metastasis, 11 (15.5 %) had lung metastasis, and 59 (83.1 %) had lymph node metastasis. Fifty-six patients had cervical lymph node metastasis (cLNM), and US was positive in 15 patients (26.8 %), while negative in 41 patients (73.2 %). When compared to patients with concordant positive results for sTg and (131)I scintigraphy, US showed a relatively lower positive rate in the detection of cLNM in PTP-TN patients (28.8 vs. 53.8 %; χ (2) = 6.70; P = 0.01). In conclusion, even with sTg post-therapy (131)I-SPECT/CT demonstrated an advantage in the detection of functioning metastasis despite low sTg levels in patients with metastatic DTC.

  3. The usefulness of {sup 99m}Tc-Sn colloid scintigraphy for the evaluation of splenic autotransplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, Yoshirou; Oshima, Motoo; Shirai, Tatsuo; Yokokawa, Tokuzou; Kaminaga, Tatsurou; Yasukouchi, Hiroshi; Furui, Shigeru [Teikyo Univ., Tokyo (Japan). Faculty of Medicine


    The purpose of this study is to examine whether splenic scintigraphy is useful for an evaluation of viability of graft after splenic autotransplantation. Nine patients who underwent splenic autotransplantation for the diseases of liver cirrhosis (8 patients) and pancreas cancer (one patient) were examined of abdominal CT scan and splenic scintigraphy with {sup 99m}Tc-Sn colloid. Detection of splenic graft was difficult with CT scan. However, visualization of graft of spleen was obtained with splenic scintigraphy in all cases three months later after the surgery. In conclusion, splenic scintigraphy with {sup 99m}Tc-Sn colloid is useful for the evaluation of viability of splenic graft. (author)

  4. The role of hepatobiliary scintigraphy and oral cholecystography in predicting the performance of laparoscopic cholecystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Won, Kyoung Sook [Kangnung Hospital, Kangnung (Korea, Republic of); Ryu, Jin Sook; Moon, Dae Hyuk [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)] [and others


    Laparoscopic cholecystectomy can be performed safely in most patients with symptomatic cholelithiasis. Preoperative evaluation should assess the potential problems that affect the performance of laparoscopic cholecystectomy. Hepatobiliary scintigraphy or oral cholecystography can assess the gallbladder function and nonvisualization of gallbladder usually indicates acute or severe chronic cholecystitis. The purpose of this study was to evaluate the role of preoperative hepatobiliary scintigraphy or oral cholecystography in predicting the performance of laparoscopic cholecystectomy. The study group consists of 176 patients who underwent both hepatobiliary scintigraphy with Tc-99m DISIDA and oral choelcystography within one month before laparoscopic cholecystectomy. Nonvisualization of gallbladder was defined as persistent nonvisualization of gallbladder until 4 hours on hepatobiliary scintigraphy or 12 hours on oral cholecystography. Among 176 patients, gallbladder was not visualized in 38 patients on hepatobiliary scintigraphy and 41 patients on oral cholecystography. Concordance rate between hepatobiliary scintigraphy and oral cholecystography was 89.2%. The conversion rate to open cholocystectomy was significantly higher in patients with nonvisualization of gallbladder than in patients with gallbladder higher in patients with nonvisualization of gallbladder visualization (15.8% vs 2.9% on hepatobiliary scintigraphy, 12.2% vs 3.7% on oral cholecystography: p<0.01 and p<0.05 respectively). The operative complication rate was also significantly higher in patients with nonvisualization of gallbladder (13.2% vs 2.9% on hepatobiliary scintigraphy, 14.6% vs 2.2% on oral cholecystography : p<0.01 and p<0.001, respectively). Similarly, operation time was significantly prolonged in patients with nonvisualization of gallbladder (88.8{+-}41.9 min vs 62.5{+-}23.6 min on hepatobiliary scintigraphy : p<0.001, 89.4{+-}41.3 min vs 61.8{+-}22.8 min on oral cholecystography :p<0

  5. Scintigraphic bone scans in patients after total hip replacement; Badanie scyntygraficzne koscca w ocenie aseptycznego i septycznego obluzowania endoprotez stawu biodrowego

    Energy Technology Data Exchange (ETDEWEB)

    Bohatyrewicz, A.; Birkenfeld, B.; Mazurkiewicz, H.; Tustanowski, S. [Pomorska Akademia Medyczna, Szczecin (Poland)


    The results of clinical examination, three-phase bone scintigraphy and intraoperative findings were compared in 29 patients. Scintigraphic criteria of infection or aseptic loosening have been presented. The method proved to be highly useful with sensitivity and accuracy being 100, 73 and 90% respectively. (author). 17 refs, 2 figs, 2 tabs.

  6. Bone Densitometry (Bone Density Scan) (United States)

    ... of DXA Bone Densitometry? What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry ( ... is today's established standard for measuring bone mineral density (BMD). An x-ray (radiograph) is a noninvasive ...

  7. Somatostatin analogue scintigraphy and tuberculosis: case report; Scintigraphie des analogues de la somatostatine et tuberculose: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Biancheri, I.; Rudenko, B.; Vautrin, P.; Raddoul, J.; Lamfichek, N. [Centre Hospitalier General Andre Boulloche, 25 - Montbeliard (France); Kantelip, B.; Mantion, G. [Centre Hospitalier Universitaire Jean Minjoz, 25 - Besancon (France)


    Scintigraphy using a radiolabelled somatostatin analogue (111 In-pentetreotide) is useful in the detection of neuroendocrine tumors. But this radiopharmaceutical accumulates also in solid tumours or in inflammatory diseases such as granulomatosis. We present a case of 111 In-pentetreotide uptake in a tuberculous adenopathy. (author)

  8. Bone marrow aspiration (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  9. CT opacity in the lungs was preceded by increased MDP activity on bone scintigraphy. (United States)

    Song, Le; Zhang, Weifang; Zhang, Yanyan


    Elevated 99mTc-methylene diphosphonate (MDP) uptake in the left lung was demonstrated in a 41-year-old man with chronic lymphocytic leukemia. Lung infection was considered because the patient also had fever and pancytopenia. However, the thoracic CT performed the next day did not reveal abnormality which could explain the cause of left lung MDP activity. The repeated thoracic CTs weeks later demonstrated multiple ground-glass opacity in the left lung.

  10. Contribution of the SPECT-T.D.M. in complement of the planar osseous scintigraphy in running practice; Apport de la TEMP-TDM en complement de la scintigraphie osseuse planaire en pratique courante

    Energy Technology Data Exchange (ETDEWEB)

    Netter, F.; Journo, A.; Mayer, J.C.; Daragon, N.; Grandpierre, S.; Scigliano, S.; Olivier, P.; Karcher, G. [Service de medecine nucleaire, CHU de Nancy, (France)


    The aim of our study was to evaluate the contribution of the SPECT-T.D.M. in our daily practice of the osseous scintigraphy. Our study, enlightens a contribution of the SPECT-T.D.M; for 74% (29/39) addressed for an osseous scintigraphy and having got a complementary examination by SPECT-T.D.M. (N.C.)

  11. Diagnostic potential of renal scintigraphy following ACE-inhibition ('captopril scintigraphy') for the detection of renovascular hypertension. Wertigkeit der Nierenszintigraphie unter ACE-Blockade ('Captoprilszintigraphie') in der Diagnostik der renovaskulaeren Hypertonie

    Energy Technology Data Exchange (ETDEWEB)

    Baum, R.P.; Maul, F.D.; Hoer, G. (Frankfurt Univ. (Germany). Abt. fuer Nuklearmedizin)


    The purpose of this paper is to: (a) briefly review the pathophysiological basis of renovascular hypertension and the renin-angiotensin-system; (b) to outline the potential of captopril scintigraphy especially using Tc-99m MAG{sub 3}; and (c) to propose a practical protocol for captopril scintigraphy and its role in screening for renovascular hypertension. (orig./MG).

  12. Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function

    Directory of Open Access Journals (Sweden)

    Nevena Manevska


    Full Text Available BACKGROUND: Radionuclide techniques, as direct radionuclide cystography and 99mTc-DMSA scintigraphy, have been used in evaluation of vesicoureteral reflux (VUR and reflux nephropathy (RN in children. Dynamic 99mTc-DTPA scintigraphy is reserved for evaluation of differential renal function and obstruction in children, where hydronephrosis is detected by ultrasonography (US pre- or postnatally. CASE REPORT: Six year old boy was prenatally diagnosed with bilateral hydronephrosis. Postnatal, severe bilateral VUR was detected by voiding urethrocytography. US and 99mTc-DTPA scintigraphy performed in the first month of life showed small left kidney that participated with 2% in the global renal function. Bilateral cutaneous ureterostomy has been performed in order to obtain good renal drainage and promote optimal renal growth. Twelve months later, classic antireflux procedure was done. Control 99mTc-DTPA scintigraphy, 5 ys after antireflux surgery, revealed persisting radioactivity during the diuretic phase, in the left kidney that indicated antireflux procedure failure with VUR reappearance. CONCLUSION: 99mTc-DTPA scintigraphy is the first method of choice for long-term monitoring of individual kidney function in children with VUR and other congenital urinary tract anomalies. Additionally, it can be used as indirect radionuclide cystography when rising of radioactivity in the kidney region, during the diuretic phase can indicate presence of VUR.

  13. Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function (United States)

    Manevska, Nevena; Stojanoski, Sinisa; Majstorov, Venjamin; Pop-Gjorcheva, Daniela; Zdraveska, Nikolina; Kuzmanovska, Dafina


    BACKGROUND: Radionuclide techniques, as direct radionuclide cystography and 99mTc-DMSA scintigraphy, have been used in evaluation of vesicoureteral reflux (VUR) and reflux nephropathy (RN) in children. Dynamic 99mTc-DTPA scintigraphy is reserved for evaluation of differential renal function and obstruction in children, where hydronephrosis is detected by ultrasonography (US) pre- or postnatally. CASE REPORT: Six year old boy was prenatally diagnosed with bilateral hydronephrosis. Postnatal, severe bilateral VUR was detected by voiding urethrocytography. US and 99mTc-DTPA scintigraphy performed in the first month of life showed small left kidney that participated with 2% in the global renal function. Bilateral cutaneous ureterostomy has been performed in order to obtain good renal drainage and promote optimal renal growth. Twelve months later, classic antireflux procedure was done. Control 99mTc-DTPA scintigraphy, 5 ys after antireflux surgery, revealed persisting radioactivity during the diuretic phase, in the left kidney that indicated antireflux procedure failure with VUR reappearance. CONCLUSION: 99mTc-DTPA scintigraphy is the first method of choice for long-term monitoring of individual kidney function in children with VUR and other congenital urinary tract anomalies. Additionally, it can be used as indirect radionuclide cystography when rising of radioactivity in the kidney region, during the diuretic phase can indicate presence of VUR. PMID:27275347

  14. Quantification of left ventricular dilatation in myocardial perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, Mauren B. Azambuja, E-mail:, E-mail: [Pontificia Universidade Catolica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS (Brazil). Clinica Medica. Programa de Pos-Graduacao em Medicina e Ciencias da Saude; Azambuja, Roberto Alves [Hospital Sao Vicente de Paulo, Passo Fundo, RS (Brazil); Bodanese, Luiz Carlos [Pontificia Universidade Catolica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS (Brazil). Hospital Sao Lucas. Serv. de Cardiologia


    Background: the rate of transient dilatation can be determined by exercise testing or pharmacological stress test. It is unknown whether the type of stress has an impact on average transient dilatation index values. Objective: to compare average transient dilation index values in 99mTc-sestamibi scintigraphy in patients undergoing treadmill stress test, versus dipyridamole stress test. The secondary purpose was to evaluate the impact on the average index value by demographic characteristics, risk factors for coronary artery disease and severity of ischemia. Methods: the cross-sectional study included 200 patients between 40 and 70 years old, with or without risk factors for ischemic heart disease, with or without a previous diagnosis of ischemic heart disease. The separation between groups was sequential. The software 4D-MSPECT calculated the transient dilatation index and provided a scoring system for perfusion analysis. Results: the average transient dilation index value of the group undergoing exercise stress test was 1.06 ({+-}0.23). For the group undergoing the dipyridamole stress test, it was 1.10 ({+-}0.22); (p = 0.200). There was no association between the type of stress and the average transient dilatation index values. An association was found between the average index values and age only for those patients from the exercise test group (p = 0.009). Conclusion: the results of our study demonstrate that the transient dilation index does not differ when patients undergo exercise stress test on a treadmill or pharmacological stress by dipyridamole. (author)

  15. Incidental Hiatal Hernia Detected with Meckel's Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Aksoy, Tamer [Afyon Kocatepe Univ. Medical Faculty, Afyon (Turkmenistan); Kiratli, Pinar Ozgen [Hacettepe Univ. Medical Faculty, Ankara (Turkmenistan)


    Congenital hiatal hernia (CHH) in children is a very rare condition that occurs in about 1 in every 2,000 to 5,000 live births, with a male to female ratio of 2:3. In 97% of cases the anomaly is unilateral with a left side preponderance. The hernia content can include the stomach, bowel loops, spleen or part of the liver. CHH may remain asymptomatic or induce only nonspecific gastro intestinal and/or thoracic symptoms. The symptomatology og these patients is usually non specific, in the form of repeated attacks of chest infection and/or recurrent vomiting, but can be associated with serious complications such as intrathoracic gastric volvulus with incarceration and strangulation. Because of the gastroesophageal reflux, linear ulcerations on the esophageal mucosa might occur and cause intermittent bleeding. Plan chest radiographs, AP and lateral, may raise a suspicion of the condition, while upper gastrointestinal contrast series are diagnostic. The treatment is surgery consisting of excision of the hernial sac after reducing the stomach and repair of the diaphragmatic defect by tightening the crura of the esophageal hiatus. If the defect is large and associated with displacement of the gastroesophageal junction (GEJ) into the thorax, adding an anti reflux procedure to the repair is appropriate. This can be achieved transabdominally either by laparotomy or laparoscopically. To the best of our knowledge, this is the second case diagnosed with Meckel's scintigraphy.

  16. Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

    Directory of Open Access Journals (Sweden)

    Umut Elboga


    Full Text Available Aim: Coronary artery disease (CAD is one of the most frequent causes of mortality and morbidity worldwide. Coronary angiography is the gold standard for the anatomical diagnosis of coronary artery stenosis. Myocardial Perfusion Scintigraphy (MPS is a non-invasive imaging modality used for the diagnosis of CAD. In this study, we aimed to compare the findings of MPS and coronary angiogram. Material and Method: Eighty-one patients (37 males, 44 females; mean age 55 ± 10.95 years with angina and detected perfusion defects on MPS were included in this study. All of the patients underwent coronary angiogram. A narrowing %u2265 50% was considered pathological on the coronary angiography. Results: Findings of the coronary angiogram and MPS were compared and found consistent in 51 (63% patients. A coronary narrowing < 50% was detected by coronary angiogram in 4 (5% of the remaining patients. Coronary angiogram was found to be normal in the remaining 26 patients (32% and these patients were evaluated as cardiac syndrome X (CSX known as microvascular angina (MA. Discussion: The findings showed that MPS is superior to coronary angiogram in the early diagnosis of myocardial perfusion disorders at the microvascular level. Therefore, we concluded that MPS should be the primary diagnostic tool to begin treatment before an anatomically large narrowing occurs in the coronaries.

  17. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Anderson de [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Comissão Nacional de Energia Nuclear - CNEN (Brazil); Rezende, Maria Fernanda [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Corrêa, Renato; Mousinho, Rodrigo [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Azevedo, Jader Cunha [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Miranda, Sandra Marina; Oliveira, Aline Ribeiro [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Gutterres, Ricardo Fraga [Comissão Nacional de Energia Nuclear - CNEN (Brazil); Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)


    Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  18. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Directory of Open Access Journals (Sweden)

    Anderson de Oliveira


    Full Text Available Background: Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC e American Society of Nuclear Cardiology (ASNC to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective: To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. Methods: We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Results: Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3% studies were performed in men and 75 (20.4% were internee. To ACC 2005, 255 (69.5% were considered appropriate indication and 13 (3.5% inappropriate. With ACC 2009, 249 (67.8% were considered appropriate indications and 13 (5.2% inappropriate. Conclusions: We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  19. Dexamethasone-suppression adrenal scintigraphy in hyperandrogenism: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Gross, M.D.; Freitas, J.E.; Swanson, D.P.; Woodbury, M.C.; Schteingart, D.E.; Beierwaltes, W.H.


    To assess the contribution of adrenal-derived androgens in women with hirsutism, adrenal scintigrams under dexamethasone suppression (DS) were performed on 35 women with increasing facial or body hair and irregular or absent menses. Based upon the DS regimen chosen (8 mg/d for 2 days or 4 md/d for 7 days before the injection of 6..beta..-(/sup 131/I)iodomethylnorcholesterol), three imaging patterns were identified. The first was the absence of uptake before 3 days (8-mg DS) or before 5 days (4-mg DS) after injection. This imaging pattern was seen in 17 of the 35 patients studied and was considered normal. The second pattern was bilateral uptake earlier than 3 days (8-mg DS regimen) or 5 days (4-mg DS) after injection. This was seen in 13 of the 35 patients and was interpreted as bilateral early visualization. Adrenal-vein catheterization performed on six patients with this pattern showed increased adrenal-vein testosterone. The third pattern, observed in five patients, was unilateral early visualization, which in four cases investigated to date was the result of an adrenocortical adenoma. This study confirms the adrenal cortex as a source of androgens in women with hirsutism and hyperandrogenism and demonstrates that DS adrenal scintigraphy can be utilized to identify those women in whom adrenal-derived androgens contribute to their hyperandrogenism.

  20. Role of radionuclide scintigraphy in the detection of parathyroid adenoma

    Directory of Open Access Journals (Sweden)

    Singh N


    Full Text Available Background: Preoperative detection of parathyroid adenoma is a diagnostic challenge. The sonography and computerized tomography (CT scan demonstrate high sensitivity but low specificity. The advent of radionuclide scanning technique has enhanced the specificity in this context. Aim: We undertook a study to assess the role of radionuclide scanning in suspected cases of parathyroid adenomas. Materials And Methods: Totally 28 cases were incorporated in the study. The suspicion was raised either due to raised PTH levels or recurrent calcinosis. Most of these patients had estimation of calcium done as a routine or specific investigation. The parathyroid scan was performed using either of the two techniques - Dual isotope subtraction or Sestamibi washout technique. We also used the recent approach of fusion imaging (CT + tomographic nuclear images in selected cases. Results: There were 16 true positive, 10 true negative, 1 false negative and 1 equivocal scan findings. The findings were compared with sonography, CT Scan and PTH values. The true positive yield in our study was 57%, true negative 35% and the overall sensitivity and specificity was found to be 94% and 100% respectively. Conclusion: We conclude that parathyroid scintigraphy is a reliable and sensitive technique in the preoperative detection of parathyroid adenomas and should be the first choice of imaging modality in suspicion of parathyroid adenoma.

  1. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France); University Bordeaux Segalen, Bordeaux Cedex (France); Bullier, Eric; Riviere, Annalisa [Hopital Haut-Leveque, CHU Bordeaux, Department of Nuclear Medicine, Pessac (France); Dromer, Claire [Hopital Haut-Leveque, CHU Bordeaux, Department of Respiratory Diseases, Pessac (France); Picard, Francois [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiology, Pessac (France); Billes, Marc-Alain [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiac Surgery, Pessac (France); Corneloup, Olivier [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France)


    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  2. When to perform positron emission tomography/computed tomography or radionuclide bone scan in patients with recently diagnosed prostate cancer

    Directory of Open Access Journals (Sweden)

    Caldarella C


    Full Text Available Carmelo Caldarella,1 Giorgio Treglia,2 Alessandro Giordano,1 Luca Giovanella2 1Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy; 2Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland Abstract: Skeletal metastases are very common in prostate cancer and represent the main metastatic site in about 80% of prostate cancer patients, with a significant impact in patients' prognosis. Early detection of bone metastases is critical in the management of patients with recently diagnosed high-risk prostate cancer: radical treatment is recommended in case of localized disease; systemic therapy should be preferred in patients with distant secondary disease. Bone scintigraphy using radiolabeled bisphosphonates is of great importance in the management of these patients; however, its main drawback is its low overall accuracy, due to the nonspecific uptake in sites of increased bone turnover. Positron-emitting radiopharmaceuticals, such as fluorine-18-fluorodeoxyglucose, choline-derived drugs (fluorine-18-fluorocholine and carbon-11-choline and sodium fluorine-18-fluoride, are increasingly used in clinical practice to detect metastatic spread, and particularly bone involvement, in patients with prostate cancer, to reinforce or substitute information provided by bone scan. Each radiopharmaceutical has a specific mechanism of uptake; therefore, diagnostic performances may differ from one radiopharmaceutical to another on the same lesions, as demonstrated in the literature, with variable sensitivity, specificity, and overall accuracy values in the same patients. Whether bone scintigraphy can be substituted by these new methods is a matter of debate. However, greater radiobiological burden, higher costs, and the necessity of an in-site cyclotron limit the use of these positron emission tomography methods as first-line investigations in patients with prostate cancer

  3. Skeletal scintigraphy and SPECT/CT in orthopedic imaging; Knochenszintigrafie und SPECT/CT bei orthopaedischen Fragestellungen

    Energy Technology Data Exchange (ETDEWEB)

    Klaeser, B.; Walter, M.; Krause, T. [Inselspital Bern (Switzerland). Universitaetsklinik fuer Nuklearmedizin


    Multi-modality imaging with SPECT-CT in orthopaedics combines the excellent sensitivity of scintigraphy with the morphological information of CT as a key for specific interpretation of findings in bone scans. The result is an imaging modality with the clear potential to prove of value even in a competitive setting dominated by MRI, and to significantly add to diagnostic imaging in orthopaedics. SPECT-CT is of great value in the diagnostic evaluation after fractures, and - in contrast to MRI - it is well suited for imaging in patients with osteosyntheses and metallic implants. In sports medicine, SPECT-CT allows for a sensitive and specific detection of osseous stress reactions before morphological changes become detectable by CT or MRI. In patients with osseous pain syndromes, actively evolving degenerative changes as a cause of pain can be identified and accurately localized. Further, particularly prospective diagnostic studies providing comparative data are needed to strengthen the position of nuclear imaging in orthopaedics and sports medicine and to help implementing SPECT/CT in diagnostic algorithms. (orig.)

  4. Clinical study of scrotum scintigraphy in 49 patients with acute scrotal pain. A comparison with ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Yuan Zhibin; Luo Quanyong; Chen Libo; Zhu Jifang; Zhu Ruisen [Shanghai 6th People' s Hospital, Shanghai (China)


    The significance of scrotum scintigraphy in differentiating acute testicular torsion from acute orchiepididymitis was evaluated. In this report, 49 patients with acute scrotal pain were examined with radionuclide scrotum scintigraphy and ultrasonography in parallel for comparison. Of 37 patients with decreased radioactivity in the abnormal side scrotum, 35 were diagnosed with testicular torsion surgically and the other 2 were diagnosed with indirect inguinal hernia. Only 17 among the 35 patients were diagnosed by ultrasonography as having testicular torsion. The remaining 12 patients with increased radioactivity in the abnormal side of the scrotum were all diagnosed with orchiepididymitis through conservative treatment and clinical follow-up, but only 8 of the 12 were correctly and exactly diagnosed by ultrasonography. In the process of diagnosing acute scrotal pain, radionuclide scrotum scintigraphy has obvious advantage over ultrasonography. It also has the advantage of being simple, fast and accurate but without any detrimental effect on the human body. (author)

  5. Limitations and pitfalls of 99mTc-EDDA/HYNIC-TOC (Tektrotyd) scintigraphy. (United States)

    Garai, Ildikó; Barna, Sandor; Nagy, Gabor; Forgacs, Attila


    Tektrotyd kit was developed by Polatom company for 99mTc labeling to make an alternative tracer of somatostatin receptor scintigraphy available. Since 2005, 99mTc-EDDA/HYNIC-Tyr3-Octreotide has been used in clinical imaging and achieved high impact in management of patients with neuroendocrine tumors. Knowing the limitations and pitfalls is essential to provide ac-curate diagnosis. Therefore, the potential pitfalls associated with the use of 99mTc-EDDA/HYNIC-TOC are reviewed on the basis of own experience. Data were analyzed of 310 patients who underwent somatostatin receptor scintigraphy with 99mTc-Tektrotyd. Pitfalls during radiolabeling process or acquisition can worsen the sensitivity of SRS (somatostatin receptor scintigraphy). Recognizing physi-ological and clinical pitfalls, the diagnostic accuracy will improve.

  6. The value of RI scintigraphy and angiography in small intestinal bleeding; Report of eight cases

    Energy Technology Data Exchange (ETDEWEB)

    Kurosawa, Susumu; Kuwata, Hajime; Kushibiki, Kyoko; Akimoto, Kimihiko; Hashimoto, Toshiyuki; Kojima, Toshiya (Showa General Hospital, Kodaira, Tokyo (Japan))


    We retrospectively reviewed eight cases of small intestinal bleeding and assessed the value of RI scintigraphy and angiography in diagnosing the bleeding site. The patients' average age was 56.2 years. Chief complaint was melena of variable degree. In most cases neither upper endoscopy nor colonoscopy was diagnostic. RI scientigraphy (Tc-99 labeled human serum albumin) showed 75% of positive rate whereas angiography showed 66.7% (4/6) of positive rate. All four cases of leiomyosarcoma and leiomyoma demonstrated hypervascular stain and/or extra-vasation in angiography whereas RI scintigraphy failed to detect active gastrointestinal bleeding in 2 of the 4 cases. Therefore angiography was considered useful for the detection of bleeding from leiomyoma and leiomyosarcoma which are often hypervascular. Scintigraphy is thought of most value in the demonstration of small amount of bleeding with minimum vascular abnormality. (author).

  7. Samarium-153 EDTMP reduces multiple bone metastasis besides pain relieve; Reduction des metastases osseuses apres traitement au samarium 153-EDTMP en complement de son effet antalgique

    Energy Technology Data Exchange (ETDEWEB)

    Haffaf, E.M.; Oufriha, N. [Hopital Central de l' Armee, Service de Medecine Nucleaire, Alger (Algeria)


    This case report shows an almost disappearance of multiple painful bone metastases, on a {sup 99m}Tc-HMDP bone scintigraphy, about three months after administration of {sup 153}Sm-EDTMP (Quadramet in a 78 year-old man with hormone refractory prostate adenocarcinoma. One {sup 153}Sm-EDTMP reduced the PSA level in this patient by more than 70% for at least 2 months. It raises the possibility that this radiopharmaceutical could have therapeutic effect on bone metastasis in addition to its bone pain palliation effect. (authors)

  8. Imaging of pulmonary disease in rheumatoid arthritis using JOO1X scintigraphy: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Goupille, P. [Service de Rhumatologie, Hopital Trousseau, Tours (France); Diot, P. [Service de Pneumologie, Hopital Bretonneau, Tours (France); Valat, J.P. [Service de Rhumatologie, Hopital Trousseau, Tours (France); Lemarie, E. [Service de Pneumologie, Hopital Bretonneau, Tours (France); Valat, C. [Service de Medecine Nucleaire, Hopital Bretonneau, Tours (France); Asquier, E. [Service de Radiologie, Hopital Bretonneau, Tours (France); Delarue, A. [Centre de Developpement Pierre Fabre, Labege (France); Pape, A.L. [Lab. de Biophysique Cellulaire et RMN, INSERM U316, Univ. Tours (France)


    The purpose of this study was to determine the ability of technetium-99m J001X scintigraphy to image active pulmonary involvement in patients suffering from rheumatoid arthritis (RA). J001X is a fully characterized acylated poly(1,3)galactoside, isolated from Klebsiella membranes, which is able to bind recruited macrophages after aerosol administration. J001X scintigraphy was compared with high-resolution computed tomography (HRCT), pulmonary function tests (PFTs) and bronchoalveolar lavage (BAL) in 15 patients suffering from RA. Patients were considered to have pulmonary involvement when they had an interstitial syndrome on HRCT and a decrease of 20% in TCO/VE (transfer coefficient) on PFTs and/or an abnormal BAL (lymphocytosis higher than 20% and/or percentage of neutrophils higher than 10%). Pulmonary involvement was present in eight patients, and absent in seven. Of the eight patients with pulmonary involvement, all had abnormal BAL, two had an interstitial syndrome on HRCT, two had decreased TCO/VE and three had positive J001X scintigraphy. Of the seven patients without pulmonary involvement, six had normal BAL (not available in one), two had an interstitial syndrome on HRCT, one had decreased TCO/VE and two had positive J001X scintigraphy. According to our gold standard of pulmonary involvement, the sensitivity of J001X scintigraphy for the detection of pulmonary involvement in RA was 37.5%, the specificity was 71.4% and the positive predictive value was 60%. The ability of J001X scintigraphy to detect active pulmonary involvement during RA appears unclear in this study but it may detect processes unnoticed by the other modalities. (orig./MG)

  9. Clinical need for both scintigraphy with technetium-99m GSA and per-rectal portal scintigraphy in some patients with chronic liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Shiomi, Susumu; Iwata, Yoshinori; Sasaki, Nobumitsu [Osaka City Univ. (Japan). Medical School] (and others)


    Scintigraphy with {sup 99m}Tc-diethylenetriaminepentaacetate with galactosyl human serum albumin ({sup 99m}Tc-GSA) and per-rectal portal scintigraphy are useful for evaluating hepatic functional reserve and portal circulation, respectively. We did the procedures simultaneously in some patients to examine the relationship between hepatic functional reserve and portal circulation in chronic liver disease. Scintigraphy with {sup 99m}Tc-GSA was done in 10 healthy subjects, 45 patients with chronic hepatitis, and 165 patients with cirrhosis. Fifty-seven patients (13 with hepatitis and 44 with cirrhosis) also underwent per-rectal portal scintigraphy with {sup 99m}Tc-pertechnetate within two weeks. A receptor index was calculated by dividing the radioactivity of the liver region of interest (ROI) by that of the liver-plus-heart ROI at 15 min after the injection of {sup 99m}Tc-GSA. The index of blood clearance was calculated by dividing the radioactivity of the heart ROI at 15 min by that of the heart ROI at 3 min. A solution containing {sup 99m}Tc-pertechnetate was instilled into the rectum, and serial scintigrams were taken while radioactivity curves for the liver and heart were recorded sequentially. A per-rectal portal shunt index was determined by calculating the ratio of counts for the liver to counts for the heart integrated for 24 seconds immediately after the appearance of the liver time-activity curve. The median receptor index was lower for more severe liver disorders, increasing in the order of chronic hepatitis, compensated cirrhosis and decompensated cirrhosis, and the median index of blood clearance was higher. The median receptor index was significantly lower when a complication (varices, ascites, or encephalopathy) was present, and the median index of blood clearance was higher. The shunt index was correlated significantly with the two other indices, but these values for some one-third of the patients disagreed in either indices. Scintigraphy with {sup 99m

  10. The Role of 99mTc-Annexin V Apoptosis Scintigraphy in Visualizing Early Stage Glucocorticoid-Induced Femoral Head Osteonecrosis in the Rabbit

    Directory of Open Access Journals (Sweden)

    Xiaolong Wang


    Full Text Available Objective. To validate the ability of 99mTc-Annexin V to visualize early stage of glucocorticoid-induced femoral head necrosis by comparing with 99mTc-MDP bone scanning. Methods. Femoral head necrosis was induced in adult New Zealand white rabbits by intramuscular injection of methylprednisolone. 99mTc-Annexin scintigraphy and 99mTc-MDP scans were performed before and 5, 6, and 8 weeks after methylprednisolone administration. Rabbits were sacrificed at various time points and conducted for TUNEL and H&E staining. Results. All methylprednisolone treated animals developed femoral head necrosis; at 8 weeks postinjection, destruction of bone structure was evident in H&E staining, and apoptosis was confirmed by the TUNEL assay. This was matched by 99mTc-Annexin V images, which showed a significant increase in signal over baseline. Serial 99mTc-Annexin V scans revealed that increased 99mTc-Annexin V uptake could be observed in 5 weeks. In contrast, there was no effect on 99mTc-MDP signal until 8 weeks. The TUNEL assay revealed that bone cell apoptosis occurred at 5 weeks. Conclusion. 99mTc-Annexin V is superior to 99mTc-MDP for the early detection of glucocorticoid-induced femoral head necrosis in the rabbit and may be a better strategy for the early detection of glucocorticoid-induced femoral head necrosis in patients.

  11. Radiation protect during the ventilation scintigraphy of Tc99m DTPA radioaerosol in pediatric application

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    Chen, Yu-Wen; Dai, Zen-Kong; Huang, Ying-Fong; Jong, Shiang-Bing [Chou-Hon Memorial Hospital, Kaohsiung Medical Univ., Kaohsiung, Taiwan (China)


    Lung ventilation-perfusion scintigraphy is of great value for the management of patients with both primary lung disease and heart disease, by proving patho- physiological information of importance for the diagnosis, follow-up and functional evaluation of the patients. Krypton 81m radioactive gas is preferable for pediatric application due to its short half-life. However, the rubidium-krypton 81m generator is not popular in hospital of our country. Tc99m DTPA radioaerosol ventilation scintigraphy has its unique convenient for clinical application. But, the most disadvantage of clinical application of Tc99m DTPA radioaerosol is contamination of environment when the poor-cooperative patient can't breathe by mouth. For this reason, we design the certain procedure to reduce the radioaerosol contamination. During May to Aug., 1999, we collect 36 pediatric patients (male to female ratio 2:1, age from 6 months to 20 years old) with clinical history of lung or heart disease, including congenital heart disease, asthma and so on. Before the cases receive 10 to 15 mCi Tc99m DTPA radioaerosol ventilation scan, all of them were trained with breath training. And during the ventilation scintigraphy, the special mouth mask is designed to prevent the radioaerosol leakage into atmosphere. Then Geiger-Muller survey meter was arranged to detect the environmental contamination of radioaerosol in the mask, one and two metes away from the mask every 10 minutes during ventilation scintigraphy procedure and 1 hour after finishing image. Two nuclear medicine physicians evaluated imaging quality of ventilation scintigraphy. Results: Among thirty-six pediatric patients with prior breath training, thirty-two cases are successful to proceed the Tc99m DTPA ventilation scintigraphy. The other four cases that were under three-year-old fail to receive ventilation scintigraphy. There is limited detectable radioactivity in the mouth mask at early 10 minute by Geiger-Muller counter. No significant

  12. Functional fecal retention visualized by (111)In-DTPA colon transit scintigraphy. (United States)

    Infante, Jose Rafael; Rayo, Juan I; Serrano, Justo; Dominguez, Maria L; Garcia, Lucia; Moreno, Manuel


    Constipation is an extremely common problem in children, varying from mild and short-lived to severe and chronic. Chronic constipation is a serious childhood condition and requires further investigation, including blood test, colonoscopy, radio-opaque marker study, and/or scintigraphy. We present small bowel and colon transit scintigraphy of a 14-year-old girl with history of chronic constipation, abdominal pain, weight loss, and poor response to medical treatment. After oral administration of In-DTPA in water, planar and SPECT/CT images showed normal small bowel transit time and functional fecal retention in colon transit study.

  13. Radionuclide scintigraphy in the evaluation of gastroesophageal reflux in symptomatic and asymptomatic pre-term infants

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    Morigeri, C.; Mukhopadhyay, K.; Narang, A. [Postgraduate Institute of Medical Education and Research (PGIMER), Division of Neonatology, Department of Paediatrics, Chandigarh (India); Bhattacharya, A.; Mittal, B.R. [Postgraduate Institute of Medical Education and Research (PGIMER), Department of Nuclear Medicine, Chandigarh (India)


    Gastroesophageal reflux (GER) is very common in pre-term infants. The diagnosis based on symptoms is always questionable. The incidence of GER in symptomatic babies varies from 22% to 85%, but literature regarding the incidence of reflux in asymptomatic pre-term infants is lacking. We used radionuclide scintigraphy to evaluate the incidence of GER in symptomatic as well as asymptomatic pre-term neonates and to assess whether symptoms have any relation with positive scintigraphy. We studied 106 pre-term infants (52 symptomatic, 54 asymptomatic) of less than 34 weeks of gestation, who fulfilled the eligibility criteria. Babies were considered symptomatic in the presence of vomiting, regurgitation, apnea, de-saturations, unexplained bradycardia and recurrent lung collapses. Radionuclide scintigraphy was conducted at post-conceptional age of 32-34 weeks when they were clinically stable for 72 h. Feeding was avoided for 2 h preceding the study. {sup 99m}Tc sulphur colloid was administered in a dose of 1.85 MBq (0.05 mCi) in 1 ml, followed by milk (full feed) through an orogastric tube, prior to imaging under a gamma camera. Reflux was graded as low or high, and reflux episodes during the study were counted. The incidence of GER in the symptomatic group was 71.2% and in asymptomatic babies 61.1% (p=0.275). High-grade reflux was more common (71.4%) than low-grade (28.6%) in both groups (p=0.449). Mean number of reflux episodes in 20 min was 4.4{+-}2.4 in symptomatic babies and 4.9 {+-}2.2 in asymptomatic babies (p=0.321). Babies with positive scintigraphy were similar in birth weight, gestation, time to achieve full feeds, weight and age at discharge to those with negative scintigraphy. GER is common in pre-term infants of less than 34 weeks gestation. The incidence of positive scintigraphy and grade of reflux is not significantly different in symptomatic vs. asymptomatic babies. Though radionuclide scintigraphy is a simple, quick and non-invasive investigation in

  14. sup 99m Tc-sucralfate scintigraphy in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, P.B.; Lech, Y.; Moeller-Petersen, J.; Vilien, M.; Fallingborg, J. (Aalborg Sygehus (Denmark)); Ekelund, S. (Copenhagen County Hospital (Denmark))


    Technetium-99m-labelled albumin-sucralfate was orally administered to 11 patients (Crohn's disease, 8; ulcerative colitis, 3) and 3 healthy volunteers. Serial scintigraphy was performed, and scintigraphic interpretations were compared with radiographic end endoscopic findings in an open study. It was not possible in any patient to relate the scintigraphic findings to the localizations of inflammatory bowel disease, nor was it possible to distinguish the scans in the patients from the scans of the healthy volunteers. It is concluded the {sup 99m}Tc-albumin-sucralfate scintigraphy is of no value in the detection of inflammatory bowel disease. 8 refs.

  15. Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

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    Smanio, Paola Emanuela Poggio, E-mail:; Silva, Juliana Horie; Holtz, João Vitor; Ueda, Leandro; Abreu, Marilia; Marques, Carlindo; Machado, Leonardo [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil Mailing (Brazil)


    Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined. To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea) that underwent myocardial scintigraphy (MS), over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group. This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05. Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5%) had non-fatal myocardial infarction and six individuals (0.7%) died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036) and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0.043). The occurrence of major cardiac events in 8 years

  16. Detection of acute cerebral ischaemia with Tc-99m apcitide scintigraphy

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    Tepmongkol, S. [Nuclear Medicine Division, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Bangkok 10330 (Thailand)


    The established indication for Tc99m apcitide scintigraphy is for detecting deep venous thrombosis. However, due to its mechanism of binding to GP IIb/IIIa receptors on activated platelets, it can be used to image acute cerebral thrombosis. I report a patient with an acute ischaemic stroke, with right leg swelling, referred for Tc99m apcitide scintigraphy to show of deep venous thrombosis. There was no abnormal uptake in the legs but there was in the left parieto-occipital region. This correlated with the clinical and CT data, indicating an acute ischaemic stroke in this area. (orig.)

  17. Comparative bone uptake study of alendronate sodium from vaginal suppositories prepared with polyethylene glycol and massa estarinum bases

    Directory of Open Access Journals (Sweden)

    Derya İlem-Özdemir


    Full Text Available The aim of this study was to compare the bone uptake of alendronate sodium (ALD from vaginal suppositories prepared with massa estarinum AB (ME and polyethylene glycol 1500 (PEG bases. For this purpose, ALD was radiolabeled with 99mTecnetium Pertechnetate (99mTc by direct method. Radiochemical purity and stability of 99mTc-ALD was performed with chromatographic studies. 99mTc-ALD containing suppositories were prepared with ME and PEG bases. Physical properties of suppositories were evaluated. The physicochemical diffusion study was carried out to compare the release of ALD from different suppository bases. The bone uptake of 99mTc-ALD was observed by gamma scintigraphy studies. 99mTc-ALD containing suppositories were administrated to rabbits via vaginal route. The scintigraphic images were obtained with a gamma camera at different time intervals up to 240 minutes. According to our studies, radiochemical purity of 99mTc-ALD was observed more than 95% up to 6 hours. At 240 minutes of physicochemical diffusion studies, released ALD has 0.620 ± 0.091 mm and 10.465 ± 0.651 mm diameter zone from ME and PEG base suppositories respectively. According to the gamma scintigraphy studies, although no bone uptake observed after ME suppositories application, rabbit’s bones were clearly visible after PEG suppositories applied. The results of physicochemical diffusion and gamma scintigraphy studies were found compatible in each other

  18. Assessment of the Effects of Zoledronic Acid Therapy on Bone Metabolic Indicators in Hormone-Resistant Prostate Cancer Patients with Bone Metastatasis (United States)

    Demirtas, Abdullah; Sahin, Nurettin; Caniklioglu, Mehmet; Kula, Mustafa; Ekmekcioglu, Oguz; Tatlisen, Atila


    Purpose. Assessment of effects of zoledronic acid therapy on bone metabolic indicators in hormone-resistant prostate cancer patients with bone metastasis. Material and Methods. Hormone-resistant prostate cancer patients who were identified to have metastases in their bone scintigraphy were taken to trial group. Before administration of zoledronic acid, routine tests for serum calcium, total alkalen phosphates were studied. Sample sera for bone metabolic indicators BALP, PINP, and ICTP were collected. Bone pain was assessed via visual analogue scale and performance via Karnofsky performance scale. Four mg zoledronic acid was administered intravenously once a month. Results. When serum levels of bone forming indicators PINP; BALP were compared before and after therapy, there were insignificant decreases (P = .33, P = .21, resp.). Serum levels of bone destruction indicator ICTP was compared, and there was a significant decrease after zoledronic acid therapy (P = .04). When performances of the patients were compared during therapy period, performances decreased significantly due to progress of illness (P = .01). All patients had ostalgia caused by bone metastases at various degrees. Significant decrease in pain scores was observed (P < .01). Conclusion. Zoledronic acid therapy decreased bone destruction and was effective in palliation of pain in patient with bone metastasis. Using bone metabolic indicators during followup of zoledronic acid therapy might be useful. PMID:22084798

  19. Tc-99m labeled leukocyte scintigraphy and CT for the evaluation of patients with inflammatory bowel disease

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    Miyazaki, Chihoko; Kubo, Kohzoh; Aoyama, Hidefumi; Endoh, Hideho; Odashima, Yae; Saitoh, Eri [Sapporo City General Hospital (Japan)


    Seventeen cases of inflammatory bowel disease (IBD) were studied to define the intensity and extent of disease by {sup 99m}Tc-HMPAO-labeled leukocytes scintigraphy (TLLS), and 10 cases underwent CT examination to evaluate the bowel wall, lymph-nodes, and mesenteric surroundings. Serial TLLS were obtained up to 4 hours and CT was carried out within one week before or after TLLS. The sensitivities to early and delayed TLLS were 91% and 100%, respectively. The respective specificities were 100% and 33%. However, it appeared that mild IBD may yield false negative results in early TLLS while nonspecific bowel activity and migration of white cells may cause false positive results in delayed imaging. By setting the diagnostic criteria for labeled leukocyte accumulation on visualization of the small bowel regardless of uptake or activity of the large bowel similar to or greater than lumbar bone marrow, the sensitivity and specificity of delayed TLLS changed to 91% and 83%, respectively. On CT examination, mesenteric lymph-node swelling, periintestinal blurring and dilatation of mesenteric vasa recta were observed in all five patients with active Crohn`s disease, while wall thickening and enhancement were seen in four of them. None of the other three cases of inflammatory disease showed positive findings of dilatation of the mesenteric vasa recta, and they revealed relatively low uptake of labeled leukocytes in TLLS. A `scintigram score` was calculated by comparing uptake of tracer in five bowel segments with lumbar bone marrow activity, and a `CT score` was calculated by adding abnormalities of the intestine and mesenteric surroundings. The scintigram score correlated closely with CT score and clinical disease activity. (K.H.)

  20. Assessment of takotsubo (ampulla) cardiomyopathy using iodine-123 metaiodobenzylguanidine scintigraphy

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    Pessoa, Pinheiro M.C.; Xavier, Salles S.; Lima, Souza Leao R.; Mansur, J.; Almeida, Altino S. de; Carvalho, Pires A.C.; Gutfilen, B.; Fonseca, Barbosa L.M. da [Hospital Univ. Clementino Fraga Filho, Univ. Federal do Rio de Janeiro (Brazil). Dept. de Radiologia


    Purpose: To evaluate the role of cardiac sympathetic innervation in patients whose clinical features consisted of chest pain, transient ST-segment elevation, left ventricular apical akinesis, minimal elevation of cardiac enzymes, and onset of symptoms shortly after a severe stress condition. Material and Methods: Five female patients, mean age 67{+-}14 years, underwent thoracic {sup 123}I-MIBG (planar and SPECT) and 67Ga citrate (planar) scans within 5 days after the onset of symptoms. The {sup 123}I-MIBG myocardial washout rate between early (30 min) and delayed (3 hours) planar images was calculated. All patients presented findings consistent with takotsubo-like syndrome. Echocardiograms showed the characteristic wall motion pattern of significant apical dysfunction. Acute-phase coronary angiographies revealed a non-obstructive pattern. A peculiar apical akinesis and basal normokinesis were observed on the ventriculograms. Results: Impairment of cardiac neuronal uptake of {sup 123}I-MIBG based on a reduction of the heart-to-mediastinum uptake ratio was observed in all patients, while the washout rate was raised in four patients. All patients presented an apical uptake defect in the {sup 123}I-MIBG SPECT and planar images and a normal 67Ga scintigraphy. Conclusion: Our data indicate that ampulla cardiomyopathy (AC) is associated with a cardiac sympathetic innervation deficit characterized by a reduced global {sup 123}I-MIBG uptake and an apical uptake defect. The lack of 67Ga uptake in the acute phase of this syndrome indicates that AC is probably not associated with an inflammatory process.

  1. Role of Gallium and labeled leukocyte scintigraphy in AIDS patient

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    Palestro, C.J. [Division of nuclear medicine, Long Island Jewish Medical Center, New Hyde Park, New York (United States); Goldsmith, S.J. [Division of nuclear medicine, New York Hospital, Cornell Medical Center, New York (United States)


    Because AIDS patients frequently present with minimal symptomatology, radionuclide imaging with its ability to survey the entire body, is especially valuable. Gallium-67 citrate, the most commonly performed radionuclide study for localizing infection in these patients, is most useful for detecting opportunistic infections, especially in the thorax. A negative gallium scan, particularly when the chest X-ray is unremarkable, rules strongly against pulmonary disease. A negative gallium scan in a patient with an abnormal chest X-ray and Kaposi`s sarcoma, suggests that the patient`s respiratory distress is related to the neoplasm. Diffuse pulmonary parenchymal uptake of gallium in the HIV (+) patient is most often associated with PCP. While there are other causes of diffuse pulmonary uptake, the more intense or heterogeneous the uptake, the more likely the patient is to have PCP. Focal pulmonary uptake is usually associated with bacterial pneumonia although PCP may occasionally present in this fashion. Lymph node uptake of gallium is usually associated with Mycob acterium avium complex, tuberculosis, or Iymphoma. When corresponding abnormalities are present on thallium scintigraphy lymphoma is likely. Gallium positive, thallium negative, studies suggest mycobacterial disease. Labeled leukocyte imaging is not useful for detecting opportunistic infections probably because of the inflammatory response incited by these organisms. Leukocyte imaging is, however, more sensitive for detecting bacterial pneumonia. In the abdomen, gallium imaging is most useful for identifying lymphadenopathy, while labeled leukocyte imaging is superior for detecting AlDS-associated colitides. In summary, radionuclide studies are valuable diagnostic modalities in AIDS. Their success can be maximized by tailoring the study to the individual`s needs.

  2. Clinical validation of simultaneous dual-isotope myocardial scintigraphy

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    Weinmann, Pierre; Moretti, Jean Luc [Department of Nuclear Medicine, Avicenne Hospital, Paris XIII University, 125, Rue de Stalingrad, 93 009 Bobigny Cedex (France); Faraggi, Marc [Department of Nuclear Medicine, Bichat Hospital, Paris VII University (France); Hannequin, Pascal [Centre d' Imagerie Nucleaire, Annecy (France)


    Simultaneous dual-isotope (rest thallium-201/stress technetium-99m sestamibi) myocardial single-photon emission tomography (SPET) would be an ideal procedure; however, {sup 99m}Tc cross-talk on the {sup 201}Tl window hampers its routine use. Photon energy recovery (PER) is a spectral deconvolution technique validated for scatter and cross-talk removal in phantom studies and a limited series of patients. In this study we aimed to validate the technique in 295 patients within a context of clinical routine practice. Conventional separate rest {sup 201}Tl myocardial SPET data sets were visually compared with simultaneous dual-isotope data sets corrected by PER. Conventional separate rest {sup 201}Tl data sets were identical to dual PER-corrected {sup 201}Tl data sets in 173 (58.6%) patients. As dual PER {sup 201}Tl data sets are corrected for {sup 99m}Tc cross-talk but also for {sup 201}Tl scatter, they were compared with separate rest {sup 201}Tl data sets corrected by PER in the 122 discordant patients. No difference was found in 77 (26.1%) patients. In 26 (8.8%) patients, the difference consisted in the presence of a defect on dual PER {sup 201}Tl data sets only, mirroring an ischaemic defect on {sup 99m}Tc-sestamibi data sets. This difference can be attributed to the influence of stress on the kinetics of {sup 201}Tl injected at rest. In the remaining 19 (6.4%) patients, the difference between separate and simultaneous PER-corrected data sets was scored as mild in 11 and moderate in eight patients and seemed to be related to multiple methodological factors. It is concluded that PER correctly removes {sup 99m}Tc cross-talk. With the addition of an appropriate attenuation correction, the PER technique may allow the routine use of simultaneous dual-isotope myocardial scintigraphy in the near future. (orig.)

  3. Coded Aperture Nuclear Scintigraphy: A Novel Small Animal Imaging Technique

    Directory of Open Access Journals (Sweden)

    Dawid Schellingerhout


    Full Text Available We introduce and demonstrate the utility of coded aperture (CA nuclear scintigraphy for imaging small animals. CA imaging uses multiple pinholes in a carefully designed mask pattern, mounted on a conventional gamma camera. System performance was assessed using point sources and phantoms, while several animal experiments were performed to test the usefulness of the imaging system in vivo, with commonly used radiopharmaceuticals. The sensitivity of the CA system for 99mTc was 4.2 × 103 cps/Bq (9400 cpm/μCi, compared to 4.4 × 104 cps/Bq (990 cpm/μCi for a conventional collimator system. The system resolution was 1.7 mm, as compared to 4–6 mm for the conventional imaging system (using a high-sensitivity low-energy collimator. Animal imaging demonstrated artifact-free imaging with superior resolution and image quality compared to conventional collimator images in several mouse and rat models. We conclude that: (a CA imaging is a useful nuclear imaging technique for small animal imaging. The advantage in signal-to-noise can be traded to achieve higher resolution, decreased dose or reduced imaging time. (b CA imaging works best for images where activity is concentrated in small volumes; a low count outline may be better demonstrated using conventional collimator imaging. Thus, CA imaging should be viewed as a technique to complement rather than replace traditional nuclear imaging methods. (c CA hardware and software can be readily adapted to existing gamma cameras, making their implementation a relatively inexpensive retrofit to most systems.

  4. Heart failure and 1231-M.I.B.G. scintigraphy: comeback; Scintigraphie cardiaque a la 1231-metaiodobenzylguanidine et cardiomyopathies: le retour

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    Agostini, D.; Hugentobler, A.; Costo, S.; Bouvard, G. [Centre Hospitalier Universitaire Cote de Nacre, Service de Medecine Nucleaire, 14 - Caen (France); Manrique, A. [Centre de Lutte Contre le Cancer Henri-Becquerel, Service de Medecine Nucleaire, 76 - Rouen (France); Sabatier, R.; Grollier, G. [Centre Hospitalier Universitaire Cote de Nacre, Service de Cardiologie, 14 - Caen (France); Belin, A. [Hopital de Trouville, Service de Readaptation Cardiaque, 14 - Trouville (France)


    Congestive heart failure is a often associated with an impairment of sympathetic nervous system, i.e., global hyperactivity and regional impairment of adrenergic system. Cardiac {sup 123}I-meta-iodo-benzyl-guanidine (M.I.B.G.) scintigraphy is a radionuclide technique which can explore the presynaptic adrenergic function. Cardiac fixation of M.I.B.G. is decreased in congestive heart failure, reflecting a reduction of norepinephrine uptake by the myocardial presynaptic ending nerves. The impairment of presynaptic function is early and actually involved in the pathogenesis of cardiac failure. Cardiac M.I.B.G. scintigraphy is a useful tool to explore the myocardial adrenergic stores in patients with congestive heart failure. (authors)

  5. Comparison of relative renal function measured with either 99m Tc-DTPA or 99m Tc-EC dynamic scintigraphies with that measured with 99m Tc-DMSA static scintigraphy

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    Domingues, F.C.; Fujikawa, G.Y.; Decker, H.; Alonso, G.; Pereira, J.C.; Duarte, P.S. [Centro de Diagnostico Fleury, Sao Paulo, SP (Brazil). Secao de Medicina Nuclear; Sao Paulo Univ. (USP), SP (Brazil). Escola de Saude Publica. Dept. de Epidemiologia]. E-mail:


    Objective: The aim of this study was to compare the renal function measured with either {sup 99m}Tc-DTPA or {sup 99m}Tc-EC dynamic scintigraphies with that measured using {sup 99m}Tc-DMSA static scintigraphy. Methods: the values of relative renal function measured in 111 renal dynamic scintigraphies performed either with {sup 99m}Tc-DTPA (55 studies) or with {sup 99m}Tc-EC (56 studies) were compared with the relative function measured using {sup 99m}Tc-DMSA static scintigraphy performed within a 1-month period. The comparisons were performed using Wilcoxon signed rank test. The number of {sup 99m}Tc-DTPA and {sup 99m}Tc-EC studies that presented relative renal function different by more than 5% from that measured with {sup 99m}Tc-DMSA, using chi square test were also compared. Results: the relative renal function measured with {sup 99m}Tc-EC is not statistically different from that measured with {sup 99m}Tc-DMSA (p = 0.97). The relative renal function measured with {sup 99m}Tc-DTPA was statistically different from that measured using {sup 99m}Tc-DMSA, but with a borderline statistical significance (p = 0.05). The number of studies with relative renal function different by more than 5% from that measured with {sup 99m}Tc-DMSA is higher for the {sup 99m}Tc-DTPA scintigraphy (p 0.04) than for {sup 99m}Tc-EC. Conclusion: the relative renal function measured with {sup 99m}Tc-EC dynamic scintigraphy is comparable with that measured with {sup 99m}Tc-DMSA static scintigraphy, while the relative renal function measured with {sup 99m}Tc-DTPA dynamic scintigraphy presents a significant statistical difference from that measured with {sup 99m}Tc-DMSA static scintigraphy. (author)

  6. Comparison of relative renal function measured with either 99mTc-DTPA or 99mTc-EC dynamic scintigraphies with that measured with 99mTc-DMSA static scintigraphy

    Directory of Open Access Journals (Sweden)

    F. C. Domingues


    Full Text Available OBJECTIVE: The aim of this study was to compare the renal function measured with either 99mTc-DTPA or 99mTc-EC dynamic scintigraphies with that measured using 99mTc-DMSA static scintigraphy. METHODS: the values of relative renal function measured in 111 renal dynamic scintigraphies performed either with 99mTc-DTPA (55 studies or with 99mTc-EC (56 studies were compared with the relative function measured using 99mTc-DMSA static scintigraphy performed within a 1-month period. The comparisons were performed using Wilcoxon signed rank test. The number of 99mTc-DTPA and 99mTc-EC studies that presented relative renal function different by more than 5% from that measured with 99mTc-DMSA, using chi square test were also compared. RESULTS: the relative renal function measured with 99mTc-EC is not statistically different from that measured with 99mTc-DMSA (p = 0.97. The relative renal function measured with 99mTc-DTPA was statistically different from that measured using 99mTc-DMSA, but with a borderline statistical significance (p = 0.05. The number of studies with relative renal function different by more than 5% from that measured with 99mTc-DMSA is higher for the 99mTc-DTPA scintigraphy (p = 0.04 than for 99mTc-EC. CONCLUSION: the relative renal function measured with 99mTc-EC dynamic scintigraphy is comparable with that measured with 99mTc-DMSA static scintigraphy, while the relative renal function measured with 99mTc-DTPA dynamic scintigraphy presents a significant statistical difference from that measured with 99mTc-DMSA static scintigraphy.

  7. Pulmonary scintigraphy by citrate of Ga67 for HIV(+) patients or AIDS. Scintigraphie pulmonaire au citrate de Ga67 chez des patients VIH(+) ou sida

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    Daumal, J.; Pena, C.; Mata, F.; Paternostro, C.; Penafiel, A. (Hopital Son Dureta, Palma de Mallorca (Spain))


    Pulmonary scintigraphy with citrate of gallium 67 is useful when combined with a thorax radiography to establish the presence of an infection. When the two examinations are negative we can conclude there is no infection, but if the radiography is positive with a scintiscanning negative the most possible diagnosis is tuberculosis. If the scintiscanning is positive with a diffuse model we can envisage a pneumonia by Pneumocystis Carinii and if the model is ganglionic we can think to tuberculosis. 4 tabs.

  8. Fatigue fracture of the sacral bone associated with septic arthritis of the symphysis pubis

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    Albertsen, A.M.B. [Department of Radiology, Odense University Hospital (Denmark); Egund, N. [Department of Radiology, Odense University Hospital (Denmark); Jurik, A.G. [Department of Radiology, Aarhus University Hospital (Denmark)


    Two women, aged 50 and 67 years, with septic arthritis of the symphysis pubis attended by severe low back pain, were followed with CT and MR imaging of the pelvis, as well as bone scintigraphy in one patient. In the first patient sacral fractures with severe displacement were revealed, prompting stabilizing symphysiodesis. In the second patient an undisplaced fatigue fracture was confirmed in the right half of the sacrum. In patients with pelvic laxity following arthritis of the symphysis and post-traumatic osteolysis associated with low back pain, displaced or occult fractures of the bones adjacent to the sacroiliac joints should be considered. (orig./MG)

  9. Baseline Tc-99m DTPA renal scintigraphy as a predictor of outcome in children with urinary tract infection

    Energy Technology Data Exchange (ETDEWEB)

    Yun, J. G.; An, Y. S.; Lee, M. H.; Cho, C. W.; Yun, S. N.; Pai, G. S [Ajou University Medical Center, Suwon (Korea, Republic of)


    Tc-99m DTPA renal scintigraphy is useful in detecting urinary tract obstruction in patients with urinary tract infection (UTI). We evaluated the prognostic significance of baseline Tc-99m DTPA renal scintigraphy in children with UTI. Among children, who underwent both baseline/follow-up Tc-99m DMSA scintigraphies and baseline Tc-99m DTP A scintigraphy for evaluation of UTI, 32 patients with unilateral cortical defects on baseline Tc-99m DMSA scintigraphy were included in the study. The outcome of cortical defects was evaluated on follow-up Tc-99m DMSA scintigraphy by visual analysis. ROIs were drawn on the Tc-99m DPTA scintigraphy for calculation of ipsilateral to contralateral kidney ratio (ICR) at blood flow phase (< 60s, BFP) and cortical uptake phase (1-5 min, CUP). Median follow-up period of Tc-99m DMSA scintigraphy was 3.2 months (1.4 - 14 months). There were 24 patients with healing cortical defects and 8 with cortical scarring. Average ICRs of patients with healing defects were 1.11 {+-} 0.18 (0.44 - 1.57) at BFP and 0.97 {+-} 0.21 (0.31 - 1.28) at CUP, while those of patients with cortical scarring were 0.97 {+-} 0.47 (0.21 - 0.89) at BFP and 0.75 {+-} 0.49 (0.19 - 1.65) at CUP. ICR more than 0.9 was determined as a good prognostic indicator. The sensitivity, specificity, positive predictive value, and negative predictive value of ICR was 83.3%, 100%, 100% and 66.7% at BFP, and 79.0%, 62.5%, 86.4% and 50.0% at CUP. Ipsilateral to contralateral kidney ratio on baseline Tc-99m DPTA renal scintigraphy, especially at blood flow phase, is helpful in predicting outcome of children with UTI.

  10. Transdiaphragmatic peritoneal hernia complicating peritoneal dialysis: demonstration with spiral computed tomography peritoneography and peritoneal scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Coche, Emmanuel [Universite Catholique de Louvain, Department of Radiology, Cliniques Universitaires St-Luc, Brussels (Belgium); Lonneux, Max [Universite Catholique de Louvain, Department of Nuclear Medicine, Cliniques Universitaires St-Luc, Brussels (Belgium); Goffin, Eric [Universite Catholique de Louvain, Department of Nephrology, Cliniques Universitaires St-Luc, Brussels (Belgium)


    The authors describe a rare case of peritoneal transdiaphragmatic hernia discovered immediately after a car accident in a young male patient on peritoneal dialysis. The potential role of CT peritoneography and peritoneal scintigraphy to demonstrate and understand thoracic complications of ambulatory peritoneal dialysis is discussed. (orig.)

  11. Transdiaphragmatic peritoneal hernia complicating peritoneal dialysis: demonstration with spiral computed tomography peritoneography and peritoneal scintigraphy. (United States)

    Coche, Emmanuel; Lonneux, Max; Goffin, Eric


    The authors describe a rare case of peritoneal transdiaphragmatic hernia discovered immediately after a car accident in a young male patient on peritoneal dialysis. The potential role of CT peritoneography and peritoneal scintigraphy to demonstrate and understand thoracic complications of ambulatory peritoneal dialysis is discussed.

  12. The clinical usefulness of NP-59 scintigraphy in adrenal cortical diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Duk Kyu [College of Medicine, Donga Univ., Pusan (Korea, Republic of)


    {sup 131}I-6-{beta}-iodomethyl-19-norcholesterol (NP-59) has an advantage to assess adrenal dysfunction caused by adrenal cortical disorders. The aim of this study is to evaluate the clinical usefulness of NP-59 scintigraphy in each adrenal disease. Ten patients who did eleven NP-59 adrenal scintigraphies at Dong-A University Hospital from March 1990 to December 1996 were selected as the subject. Among the subject there were 5 cases of Cushing's syndrome, 2 cases of incidentaloma, 1 case of metastatic adrenal tumor, liver cirrhosis with hirsutism and hypertension respectively. Among 5 cases of Cushing's syndrome, there were 2 cases of Cushing's disease, 2 cases of adrenal adenoma and 1 case of adrenal carcinoma. There are no disagreement between clinical diagnosis and scan finding in Cushing's syndrome. In 2 incidentaloma cases, even though one is interpretated as a functioning tumor, both of 2 cases could avoid unnecessary biopsy according to scintigraphy result. One case of hirsutism, clinically adrenal originated, revealed the normal scintigraphic finding after dexamethasone suppression scan. It could suggest that the etiology of hirsutism was extra-adrenal origin. One case of hypertension took the study to exclude the possibility of primary aldosteronism. Normal suppression scan finding revealed that primary aldosteronism did not exist in this case. In conclusion, NP-59 scintigraphy was very useful in diagnosis and differential diagnosis of Cushing's syndrome and it could avoid unnecessary biopsy in the incidental adrenal tumor.

  13. Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

    NARCIS (Netherlands)

    Gotthardt, M.; Bleeker-Rovers, C.P.; Boerman, O.C.; Oyen, W.J.G.


    Nuclear medicine imaging procedures play an important role in the assessment of inflammatory diseases. With the advent of 3-dimensional anatomic imaging, there has been a tendency to replace traditional planar scintigraphy by CT or MRI. Furthermore, scintigraphic techniques may have to be combined w

  14. Sialoscintigraphy, dacryoscintigraphy, and /sup 67/Ga-scintigraphy in SJOGREN's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    De Rossi, G.


    In 68 cases of SJOGREN's syndrome (SS) dacryoscintigraphy (DS), sialoscintigraphy (SIS), and /sup 67/Ga scintigraphy (GS) were performed along with other diagnostic examinations. Pre- and post-therapy results were available. The DS, SIS, and GS triad proves to be a simple, sensitive, and easy repeatable method to improve the diagnosis and follow-up of SS.


    NARCIS (Netherlands)

    LIMBURG, A.J.; Beekhuis, H; Smit, A.J; Kallenberg, Cees; Piers, D.A; Kleibeuker, Jan


    Esophageal motility was assessed by manometry and scintigraphy in 25 patients with primary Raynaud's phenomenon and 24 patients with secondary Raynaud's phenomenon as part of a connective tissue disorder. Methods: For each scintigraphic study, transit time was evaluated after three separate swallows

  16. Scintigraphy for the detection of myocardial damage in the indeterminate form of Chagas disease

    Energy Technology Data Exchange (ETDEWEB)

    Pedroso, Enio Roberto Pietra; Rezende, Nilton Alves de, E-mail: [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Abuhid, Ivana Moura [Instituto de Medicina Nuclear e Diagnostico Molecular, Belo Horizonte, MG (Brazil)


    Background: non-invasive cardiological methods have been used for the identification of myocardial damage in Chagas disease. Objective: to verify whether the rest/stress myocardial perfusion scintigraphy is able to identify early myocardial damage in the indeterminate form of Chagas disease. Methods: eighteen patients with the indeterminate form of Chagas Disease and the same number of normal controls, paired by sex and age, underwent rest/stress myocardial scintigraphy using sestamibi-99mTc, aiming at detecting early cardiac damage. Results: the results did not show perfusion or ventricular function defects in patients at the indeterminate phase of Chagas disease and in the normal controls, except for a patient who presented signs of ventricular dysfunction in the myocardial perfusion scintigraphy with electrocardiographic gating. Conclusion: the results of this study, considering the small sample size, showed that the rest/stress myocardial scintigraphy using sestamibi-99mTc is not an effective method to detect early myocardial alterations in the indeterminate form of Chagas disease (author)

  17. Uncomplicated duplex kidney and DMSA scintigraphy in children with urinary tract infection

    Energy Technology Data Exchange (ETDEWEB)

    Stokland, Eira [The Sahlgrenska Academy at Goeteborg University, Department of Paediatric Radiology, Goeteborg (Sweden); The Queen Silvia Children' s Hospital, Department of Paediatric Radiology, Goeteborg (Sweden); Jodal, Ulf; Swerkersson, Svante; Hansson, Sverker [The Sahlgrenska Academy at Goeteborg University, Department of Paediatrics, Goeteborg (Sweden); Sixt, Rune [The Sahlgrenska Academy at Goeteborg University, Department of Paediatric Clinical Physiology, Goeteborg (Sweden)


    Renal duplication is the most common malformation of the urinary tract and is frequently seen among children with urinary tract infection (UTI). To evaluate problems in the interpretation of dimercaptosuccinic acid (DMSA) scintigraphy and to establish the range of relative function in uncomplicated unilateral duplication. Retrospective analysis of 303 children less than 2 years of age with first time non-obstructive urinary tract infection investigated by both urography and DMSA scintigraphy. At DMSA scintigraphy, renal lesions and/or relative function below 45% was considered abnormal. Urography was used as reference for the diagnosis of duplication. Duplex kidneys were found in 22 of 303 patients (7%). Of the 16 children with unilateral duplication, 10 had bilaterally undamaged kidneys with a range of relative function varying between 51% and 57% in the duplex kidney. In two of the children with unilateral duplication the imaging results were discordant. There was risk of underdiagnosis as well as overdiagnosis of renal damage at scintigraphy. Although it is important to be aware of this risk, the rate of misinterpretation was low. A range of 51% to 57% can be used as the limit for normality of the relative function of a unilateral duplex kidney. (orig.)

  18. Evaluation of Feline Renal Perfusion with Contrast-Enhanced Ultrasonography and Scintigraphy (United States)

    Vanderperren, Katrien; Bosmans, Tim; Dobbeleir, André; Duchateau, Luc; Hesta, Myriam; Lybaert, Lien; Peremans, Kathelijne; Vandermeulen, Eva; Saunders, Jimmy


    Contrast-enhanced ultrasound (CEUS) is an emerging technique to evaluate tissue perfusion. Promising results have been obtained in the evaluation of renal perfusion in health and disease, both in human and veterinary medicine. Renal scintigraphy using 99mTc-Mercaptoacetyltriglycine (MAG3) is another non-invasive technique that can be used to evaluate renal perfusion. However, no data are available on the ability of CEUS or 99mTc- MAG3 scintigraphy to detect small changes in renal perfusion in cats. Therefore, both techniques were applied in a normal feline population to evaluate detection possibilities of perfusion changes by angiotensin II (AT II). Contrast-enhanced ultrasound using a bolus injection of commercially available contrast agent and renal scintigraphy using 99mTc-MAG3 were performed in 11 healthy cats after infusion of 0,9% NaCl (control) and AT II. Angiotensin II induced changes were noticed on several CEUS parameters. Mean peak enhancement, wash-in perfusion index and wash-out rate for the entire kidney decreased significantly after AT II infusion. Moreover, a tendency towards a lower wash-in area-under-the curve was present. Renal scintigraphy could not detect perfusion changes induced by AT II. This study shows that CEUS is able to detect changes in feline renal perfusion induced by AT II infusion. PMID:27736928

  19. Cochleomeatal scintigraphy - a new tool in modern neuroradiological diagnosis of acoustic neuroma

    Energy Technology Data Exchange (ETDEWEB)

    Bornemann, H.; Galanski, M.; Vogelsang, H.


    Cochleomeatal scintigraphy (CMS) and CT or air CT cisternography are today the methods of choice for the detection or exclusion of a neuro-otologically suspect acoustic neuroma. Whereas CT as a morphological method of investigation provides better preoperative information, CMS is likely to be superior to CT as a functional investigation technique in relapse diagnosis.

  20. Nasal visualization on radioiodine whole-body scintigraphy due to benign abnormality. (United States)

    Jiang, Xue; Wang, Qiao; Huang, Rui


    Nasal iodine activity can be observed on 123Iodine (123I) or 131I whole-body scintigraphy (WBS) commonly as a normal variant caused by nasal or salivary secretion of the tracer. We encountered 2 patients whose increased accumulation of 131I activity was associated with underlying abnormalities. One patient had a nasal polyp, whereas the other had an abscess.

  1. Dual energy CT for the assessment of lung perfusion-Correlation to scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Sven F.; Becker, Christoph R. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany); Hacker, Marcus [Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich (Germany); Nikolaou, Konstantin; Reiser, Maximilian F. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany); Johnson, Thorsten R.C. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany)], E-mail:


    Purpose of this study was to determine the diagnostic value of dual energy CT in the assessment of pulmonary perfusion with reference to pulmonary perfusion scintigraphy. Thirteen patients received both dual energy CT (DECT) angiography (Somatom Definition, Siemens) and ventilation/perfusion scintigraphy. Median time between scans was 3 days (range, 0-90). DECT perfusion maps were generated based on the spectral properties of iodine. Two blinded observes assessed DECT angiograms, perfusion maps and scintigrams for presence and location of perfusion defects. The results were compared by patient and by segment, and diagnostic accuracy of DECT perfusion imaging was calculated regarding scintigraphy as standard of reference. Diagnostic accuracy per patient showed 75% sensitivity, 80% specificity and a negative predictive value of 66%. Sensitivity per segment amounted to 83% with 99% specificity, with 93% negative predictive value. Peripheral parts of the lungs were not completely covered by the 80 kVp detector in 85% of patients. CTA identified corresponding emboli in 66% of patients with concordant perfusion defects in DECT and scintigraphy. Dual energy CT perfusion imaging is able to display pulmonary perfusion defects with good agreement to scintigraphic findings. DECT can provide a pulmonary CT angiogram, high-resolution morphology of the lung parenchyma and perfusion information in one single exam.

  2. Pre-operative sestamibi-technetium subtraction scintigraphy in primary hyperparathyroidism: Experience with 156 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Jones, J. Mark; Russell, Colin F.J.; Ferguson, W. Rodney; Laird, James D


    AIM: The aim of this study was to assess the usefulness of pre-operative sestamibi-technetium subtraction scintigraphy in a large cohort of patients with primary hyperparathyroidism (HPT). MATERIALS AND METHODS: A group of 156 consecutive patients with biochemically proven HPT underwent sestamibi-technetium subtraction scintigraphy before cervical exploration. Images were interpreted and reported prospectively and influenced the extent of surgical exploration. The intraoperative findings were compared retrospectively with the pre-operative scintigram reports in 154 individuals with technically satisfactory scintigrams. RESULTS: Of the 154 patients with satisfactory scintigrams, 122 (78.2%) demonstrated a single focus of activity following subtraction, 31 (19.9%) had negative findings and the remaining scintigram showed four foci of activity. At operation 138 (89.6%) solitary adenomas were removed, 13 patients (8.4%) had multi-gland disease and in three individuals (2.0%) no abnormal parathyroid tissue was found. The pre-operative scintigram accurately localized 91 of 98 (92.9%) solitary tumours weighing > 500 mg but only 18 of 35 (51.4%) adenomas weighing < 500 mg, (P < 0.0001). Overall sensitivity of sestamibi-technetium scintigraphy for localizing single parathyroid adenomas was 83.7%. CONCLUSION: Sestamibi-technetium subtraction scintigraphy will accurately localize a high proportion of solitary parathyroid adenomas but its usefulness is diminished by its inability to consistently identify smaller tumours. Jones, J.M. et al. (2001)

  3. Technetium-99m-sestamibi/pertechnetate subtraction scintigraphy vs ultrasonography for preoperative localization in primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Berczi, C.; Lukacs, G.; Balazs, G. [Department of Surgery, University of Debrecen (Hungary); Mezosi, E.; Bajnok, L. [1. Department of Internal Medicine, University of Debrecen (Hungary); Galuska, L.; Varga, J. [Department of Nuclear Medicine, University of Debrecen (Hungary)


    A prospective study was performed to evaluate the efficacy of technetium-99m-sestamibi and technetium-99m-pertechnetate subtraction scanning and US for imaging parathyroid glands in primary hyperparathyroidism. Sixty-three patients were surgically treated for primary hyperparathyroidism (HPT). Preoperative scintigraphy and US were performed in all cases. Bilateral neck exploration was carried out on each patient. Results of radionuclide studies and US were compared with surgical and histological findings. In 57 patients with primary HPT the radionuclide scanning gave true-positive results. Four false-negative and two false-positive scintigrams were obtained. The sensitivity and the positive predictive value (PPV) of scintigraphy were 93 and 97%, respectively. Forty-one cases were correctly localized by the US. Seventeen US results were false negative and five were false positive. The sensitivity and the PPV for US were 71 and 89%, respectively. There was a statistically significant difference between the sensitivity of the scintigraphy compared with the US (p=0.001). Sensitivities of radionuclide scans and US were higher for adenomas (100 and 83%) than for hyperplastic glands (75 and 40%). The sensitivity of technetium-99m-sestamibi and technetium-99m-pertechnetate subtraction scintigraphy was significantly higher compared with US. This sensitive method could help surgeons in performing a rapid and directed parathyroidectomy. (orig.)

  4. Estimation of cardiac function by thallium-201 myocardial scintigraphy in mitral regurgitation

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Mitsunori (Ehime Univ., Shigenobu (Japan). School of Medicine)


    To estimate whether thallium-201 myocardioal scintigraphy is a valid method to evaluate cardiac condition in mitral regurgitation, thallium myocardial scintigraphy was performed in 24 patients with mitral regurgitation. The extent score was calculated as the index of thallium-201 myocardial scintigraphy. The extent score was high (28.7[+-]5.5%) and was significantly correlated with severity of mitral regurgitant flow volume. There were correlations among extent score and fractional shortening (r=-0.78, p<0.01), left ventricular end-systolic dimension (r=0.79, p<0.01) and end-systolic wall stress (r=0.68, p<0.01). Extent scores significantly decreased after the mitral valve replacement. The decrease in extent scores associated with mitral valve replacement was greater in patients with a smaller preoperative extent score and smaller in patients with a greater preoperative extent score. In conclusion, extent score obtained by thallium-201 myocardial scintigraphy accurately reflects the myocardial damages associated with mitral regurgitation, and it may be useful for predicting the postoperative prognosis. (author).

  5. Gastric emptying scintigraphy results in children are affected by age, anthropometric factors, and study duration (United States)

    A standardized 4-hour adult-based gastric emptying scintigraphy (GES) protocol is increasingly being used in children to evaluate for gastroparesis. We sought to determine the effect of age, anthropometrics, and study duration on GES results using this protocol in children. Retrospective review of c...

  6. Bone cutting. (United States)

    Giraud, J Y; Villemin, S; Darmana, R; Cahuzac, J P; Autefage, A; Morucci, J P


    Bone cutting has always been a problem for surgeons because bone is a hard living material, and many osteotomes are still very crude tools. Technical improvement of these surgical tools has first been their motorization. Studies of the bone cutting process have indicated better features for conventional tools. Several non-conventional osteotomes, particularly ultrasonic osteotomes are described. Some studies on the possible use of lasers for bone cutting are also reported. Use of a pressurised water jet is also briefly examined. Despite their advantages, non-conventional tools still require improvement if they are to be used by surgeons.

  7. Fat/water separation in MRI. Detection of bone marrow reactions in patients with degenerative disc disease

    Energy Technology Data Exchange (ETDEWEB)

    Assheuer, J.; Lenz, G.; Lenz, W.; Gottschlich, K.W.; Schulitz, K.P.


    We examined 410 patients with lumbar disc degeneration. In 23% fat suppressing IR sequences and phase contrast techniques displayed marrow reactions in subchondral bone adjacent to the affected discs. Only in some cases conventional MRI sequences were able to depict these marrow reactions. CT, plain X-ray and scintigraphy did not show marrow changes. Bacterial infection was excluded. Histological analysis showed substitution of haematopoietic marrow by fatty tissue, necrobiosis and increase in mucoid extracellular fluid.

  8. Additional Detection of Multiple Osteomas in a Patient with Gardner's Syndrome by Bone SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo Hyoung; Kim, Daeweung; Kim, Chang Guhn; Kim, Myoung Hyoun [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)


    Familial adenomatous polyposis (FAP) is an autosomal dominant disorder which generally develops numerous polyps in the colon and rectum during the second decade of life. Gardner's syndrome is a variant of FAP which has multiple osteomas, dental abnormalities, and fibromas, with incidence ranging between 1 in 4,000 and 1 in 40,000, depending on the region. We present the case of a 35-year-old man referred to our department for bone scintigraphy who was shown to have multiple colon polyps and nuchal type fibroma. In this patient, planar image showed intensely increased uptakes of bone agent in the maxilla and mandible, which are typical findings of Gardner's syndrome. Single photon emission computed tomography/computed tomography (SPECT/CT) was acquired to accurately identify and locate abnormal uptakes detected on planar images. SPECT/CT showed numerous osteomas in the maxilla and mandible where intense uptakes of bone agent were seen. Mildly asymmetrical, focally increased uptake in the superomedial aspect of the left orbit on anterior planar image was shown to be a fontal sinus osteoma on SPECT/CT. Enhanced sensitivity of detecting lesions of SPECT/CT superior to planar scintigraphy has been reported in previous studies. In this report, additional osteomas of sphenoidal and ethmoidal sinuses, which were not seen on planar scintigraphy, were detected by SPECT/CT. This case emphasizes that nuclear physicians should be aware of the typical findings of bone scintigraphy for Gardner's syndrome and also that SPECT/CT could be helpful to diagnose additional lesions not seen on planar images.

  9. Early detection and monitoring of cartilage alteration in the experimental meniscectomised guinea pig model of osteoarthritis by {sup 99m}Tc-NTP 15-5 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Miot-Noirault, Elisabeth; Vidal, Aurelien; Bonafous, Jacques; Audin, Laurent; Madelmont, Jean-Claude; Moins, Nicole [UMR 484 INSERM, Rue Montalembert, BP 184, Clermont-Ferrand Cedex (France); Pastoureau, Philippe; Chomel, Agnes [Institut de Recherches Servier, Suresnes (France); Sarry, Laurent [ERI 14 INSERM - Faculte de Medecine, Clermont-Ferrand (France)


    This study in the meniscectomised guinea pig aimed to demonstrate that the radiotracer {sup 99m}Tc-NTP 15-5 would have pathophysiological validity for in vivo osteoarthritis imaging. The specificity of {sup 99m}Tc-NTP 15-5 for cartilage was determined in healthy animals (n = 13), by tissue radioactivity counting, joint autoradiography and scintigraphy. {sup 99m}Tc-NTP 15-5 scintigraphy was performed at 20, 50, 80, 115, 130, 150 and 180 days after medial meniscectomy (n = 10 MNX) or sham operation (n = 5), and scintigraphic ratios (operated/contralateral) were calculated for femoral (F) and tibial (T) areas. F and T ratios were compared with those of {sup 99m}Tc-MDP bone scintigraphy. At the study end-point, autoradiographic analysis of joint {sup 99m}Tc-NTP 15-5 distribution and macroscopic scoring of cartilage integrity were performed. The high and specific accumulation of {sup 99m}Tc-NTP 15-5 in normal cartilage (about 5.5 {+-} 1.7 % of injected dose/g of tissue), which permitted joint imaging with high contrast, was affected by osteoarthritis. In the MNX group, {sup 99m}Tc-NTP 15-5 accumulation in cartilage within the operated joint, relative to the contralateral joint, was observed to change in the same animals as pathology progressed. Although F and T ratios were significantly higher in MNX (F = 1.7 {+-} 0.2; T = 1.6 {+-} 0.1) than in shams (F = 1.0 {+-} 0.1; T = 1.0 {+-} 0.1) at day 50, they were significantly lower in MNX (F = 0.6 {+-} 0.1; T = 0.7 {+-} 0.1) than in shams (F = 1.0 {+-} 0.1; T = 0.9 {+-} 0.1) at day 180. No change in {sup 99m}Tc-MDP uptake was observed over 6 months. Macroscopic analysis confirmed features of osteoarthritis only in MNX knees. These results in MNX guinea pigs provide additional support for the use of {sup 99m}Tc-NTP 15-5 for in vivo imaging of osteoarthritis. (orig.)

  10. Extensive hemangiomatosis diagnosed by scintigraphy with 99mTc-labeled red blood cells in a patient with lower gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Souza, D.S.F.; Ichiki, W.A.; Borges, A.C.; Coura Filho, G.B.; Vecchia, J.F.; Sapienza, M.T.; Ono, C.R.; Watanabe, T.; Costa, P.L.A.; Hironaka, F.; Cerri, G.G.; Buchpiguel, C.A. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Inst. de Radiologia. Servico de Medicina Nuclear


    Full text: Introduction: The gastrointestinal bleeding may be caused by vascular tumors and other lesions like inflammatory disorders, intestinal obstruction or vascular malformation. The Klippel-Trenaunay syndrome and blue rubber bleb nevus syndrome are hemangiomatosis diseases that may involve the gastrointestinal tract and cause recurrent hemorrhage. The signs and symptoms usually appear at childhood. Case report: male patient, 31 years old, presenting three days of gastrointestinal bleeding and an hemorrhage shock (Hb=3,9). Previous reports of small volume bleeding since childhood and schistossomosis. Dilated veins, hemorrhoid and port wine stain lesions were detected at physical examination in perineal region, penis and scrotum. Inferior limbs were symmetric at inspection. The upper endoscopy showed esophageal varices with no signs of active bleeding. The scintigraphy with {sup 99m}Tc-labeled red blood cells showed active hemorrhage at recto-sigmoid topography during the first hour of study. Extensive and heterogeneous uptake was seen in gluteus, posterior right thigh and scrotum at the second and fifth hours of study. Then the hypothesis of vascular tumor was considered. The magnetic resonance (MR) of pelvis demonstrated extensive hemangiomatosis at the regions described by the scintigraphy. The clinical and imaging findings suggested the diagnosis of Klippel-Trenaunay syndrome. Discussion: The Klippel-Trenaunay syndrome is a rare disease characterized by congenital vascular and lymphatic malformations (port wine stain lesions, congenital varices) and bone growth and soft tissue disorder. Dilated veins may involve abdominal and pelvic structures, with rectal bleeding and haematuria occurring on average of 20%. The clinical investigation must approach the type, the extent and the severity of the malformation, since the morbidity and the mortality depends on the visceral involvement. The Doppler ultrasound, scanometry of lower extremities, MR, angiography and

  11. Diagnosis of pyogenic pelvic inflammatory diseases by {sup 99m}Tc-HMPAO leucocyte scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Rachinsky, I.; Boguslavsky, L.; Golan, H.; Lantsberg, S. [Department of Nuclear Medicine, Ben-Gurion Univ. of the Negev (Israel); Goldstein, D.; Pak, I.; Katz, M. [Department of Obstetrics and Gynecology, Ben-Gurion Univ. of the Negev, Beer-Sheva (Israel)


    Pelvic inflammatory disease (PID) is one of the major health problems of women of child-bearing age. Among the most serious complications of PID is the formation of a tubo-ovarian abscess (TOA). Early diagnosis of this condition may prevent serious surgical complications such as peritonitis and sepsis, which may be fatal. The purpose of this study was to investigate the efficacy of technetium-99m hexamethylpropylene amine oxime (HMPAO) leucocyte scintigraphy in the diagnosis of TOA. Twenty women with high clinical suspicion of TOA underwent {sup 99m}Tc-HMPAO leucocyte scintigraphy. The labelling of leucocytes with {sup 99m}Tc-HMPAO was performed according to a standard protocol. Scans were obtained at 1, 3 and 24 h following the injection of the labelled leucocytes. In eight cases the early and/or late scan was positive, in 11 cases it was negative, and in one case of ovarian cyst torsion, confirmed by laparoscopy, it showed slight uptake in the capsule of the cyst (false-positive). The sensitivity of {sup 99m}Tc-HMPAO leucocyte scintigraphy was 100%, specificity 91.6%, positive predictive value 89%, negative predictive value 100% and overall accuracy 95%. It is concluded that leucocyte scintigraphy is a non-invasive, safe, physiological and accurate procedure for the diagnosis of TOA. The 24-h scan is crucial, since in some cases the abscess was not clearly visualized on the early scan. Leucocyte scintigraphy may reduce the need for CT, diagnostic laparoscopy and unnecessary invasive surgical procedures. (orig.)

  12. Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.

    LENUS (Irish Health Repository)

    Ridge, Carole A


    OBJECTIVE: The purpose of this study was to retrospectively compare the diagnostic adequacy of lung scintigraphy with that of pulmonary CT angiography (CTA) in the care of pregnant patients with suspected pulmonary embolism. MATERIALS AND METHODS: Patient characteristics, radiology report content, additional imaging performed, final diagnosis, and diagnostic adequacy were recorded for pregnant patients consecutively referred for lung scintigraphy or pulmonary CTA according to physician preference. Measurements of pulmonary arterial enhancement were performed on all pulmonary CTA images of pregnant patients. Lung scintigraphy and pulmonary CTA studies deemed inadequate for diagnosis at the time of image acquisition were further assessed, and the cause of diagnostic inadequacy was determined. The relative contribution of the inferior vena cava to the right side of the heart was measured on nondiagnostic CTA images and compared with that on CTA images of age-matched nonpregnant women, who were the controls. RESULTS: Twenty-eight pulmonary CTA examinations were performed on 25 pregnant patients, and 25 lung scintigraphic studies were performed on 25 pregnant patients. Lung scintigraphy was more frequently adequate for diagnosis than was pulmonary CTA (4% vs 35.7%) (p = 0.0058). Pulmonary CTA had a higher diagnostic inadequacy rate among pregnant than nonpregnant women (35.7% vs 2.1%) (p < 0.001). Transient interruption of contrast material by unopacified blood from the inferior vena cava was identified in eight of 10 nondiagnostic pulmonary CTA studies. CONCLUSION: We found that lung scintigraphy was more reliable than pulmonary CTA in pregnant patients. Transient interruption of contrast material by unopacified blood from the inferior vena cava is a common finding at pulmonary CTA of pregnant patients.

  13. The scintigraphic reaction pattern of traumatic bone lesions; Das szintigraphische Reaktionsmuster knoecherner Verletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Spitz, J. [Praxis fuer Nuklearmedizin, Staedtisches Klinikum Wiesbaden (Germany)


    The indications for bone scintigraphy in traumatology result: 1. Definite exclusion of bone lesions by normal scintigraphic findings (except for the scull). 2. Unclear result of X-ray or a mismatch between clinical investigation and X-ray result. 3. Screening after multiple injury which leads to the detection of an unknown bone lesion in every second patient. 4. Suspicion of a complicated healting course in cases of doubtful X-ray results. 5. The estimation of relative fracture age. This question always rises, if a pre-existing trauma or morphologic changes in X-ray make a clear diagnosis impossible. The additional information gained by bone scintigraphy is in part exclusive and not to be drawn from any other imaging modality. This renders bone scintigraphy to an important tool in the work up of medico-legal questions in traumatology. (orig.) [Deutsch] Aus den speziellen szintigraphischen Eigenschaften knoecherner Verletzungen ergeben sich die Indikationen fuer die Skelettszintigraphie in der Traumatologie: 1. Ausschluss einer ossaeren Laesion durch einen szintigraphischen Normalbefund (bei Einhaltung eines ausreichenden Abstandes zum Trauma bilden nur die Schaedelknochen eine Ausnahme); 2. ein unklarer Roentgenbefund oder eine Diskrepanz zwischen Klinik, Anamnese und Roentgenbild; 3. das Screening nach Polytrauma, das bei jedem zweiten unfallverletzten Patienten eine zusaetzliche, bis dahin noch nicht bekannte und radiologisch dann nachvollziehbare Fraktur nachweist; 4. der Verdacht auf einen gestoerten Heilungsverlauf, soweit die primaer eingesetzte Roentgendiagnostik keine verbindliche Interpretation erlaubt; 5. die Bestimmung des relativen Frakturalters, die von Bedeutung ist, wenn vorbestehende Unfaelle in der Anamnese oder morphologische Veraenderungen die Interpretation des Roentgenbildes beeintraechtigen. Die mit Hilfe der Skelettszintigraphie erhaltenen Informationen sind zum Teil exklusiv und mit keinem anderen bildgebenden Verfahren so einfach zu

  14. Myeloma, source of false positive of parathyroid scintigraphy with {sup 99m}Tc-MIBI; Le myelome, source de faux-positif de la scintigraphie parathyroidienne au 99mTc-MIBI

    Energy Technology Data Exchange (ETDEWEB)

    Zaabar, L.; Ben Sellem, D.; El Ajmi, W.; Slim, I.; Letaief, B.; Mhiri, A.; Ben Slimene, M.F. [Institut Salah Azaiez, Service de medecine nucleaire, Tunis (Tunisia)


    Purpose: Considering a specificity of the MIBI dual-phase parathyroid scintigraphy with {sup 99m}Tc-MIBI presents false positives which number has declined since the systematic implementation of the SPECT. We report a case of a superior mediastinal false-positive. Conclusions: the myeloma represents a potential cause of false-positive of parathyroid scintigraphy with {sup 99m}Tc-MIBI. (N.C.)

  15. Evaluation of the renal lithiasis functional value: scintigraphy with dimercaptosuccinic acid (D.M.S.A.) versus intravenous urography (I.V.U.); Evaluation de la valeur fonctionnelle des reins lithiasiques: scintigraphie au DMSA versus UIV

    Energy Technology Data Exchange (ETDEWEB)

    El Ajmi, W.; Slim, I.; Zaabar, L.; Ben Sellem, D.; Letaief, B.; Mhiri, A.; Ben Slimene, M.F. [Institut Salah Azaiez, Service de medecine nucleaire, Tunis (Tunisia)


    Purpose: elucidate the place of renal scintigraphy with di-mercapto-succinic acid labelled with metastable technetium 99 ({sup 99m}Tc-Dmsa) in exploration of labeled dumb or dysfunctional to intravenous urography lithiasic kidneys. Conclusions: the renal scintigraphy with {sup 99m}Tc-Dmsa is the gold standard in evaluation of relative renal function, and particularly, in the lithiasic nephro-pathies. It allows to overcome the limitations of intravenous urography and to consolidate the surgery decision. (N.C.)

  16. Contribution of the Technetium-99m-sestamibi (MIBI) scintigraphy in primary hyperparathyroidism to determination of parathyroidectomy

    Energy Technology Data Exchange (ETDEWEB)

    Nishida, Takuro; Hayakawa, Katsumi; Nishimura, Kazumasa; Kawakami, Satoshi; Sakamoto, Makoto; Koh, Toshikiyo; Hida, Shuichi [Kyoto City Hospital (Japan)


    We reviewed retrospectively the 12 patients who underwent parathyroidectomy because of hyperparathyroidism and judged to what degree the Technetium-99m-sestamibi (MIBI) scintigraphy contributed to determination of parathyroidectomy. From the view point that weather parathyroidectomy could be decided without the MIBI scintigraphy, we classified the cases into three groups; great, fair, and poor contribution. We judged 4 cases as great contribution, 5 cases as fair contribution and 3 cases as poor contribution. We concluded that if the MIBI scintigraphy is positive in patients with primary hyperparathyroidism, parathyroidectomy is strongly recommended, because of its high sensitivity and accuracy for detection of parathyroid adenomas and because there were no false-positive cases with the MIBI scintigraphy. (author)

  17. Scintigraphy to antimyosin antibodies labelled with Indium 111 in the diagnosis of acute myocarditis: first results; La scintigraphie aux anticcorps antimyosine marques a l`Indium 111 dans le diagnostique des myocardites aigues: premiers resultats

    Energy Technology Data Exchange (ETDEWEB)

    Hossein-Foucher, Claude [Medecine Nucleaire CHRU Lille, 59037 Lille Cedex (France); Millaire, Alain; De Groote, Pascal [Cardiologie C CHRU Lille, 59037 Lille Cedex (France); Marchandise, Xavier [Medecine Nucleaire CHRU Lille, 59037 Lille Cedex (France)


    The utility of antimyosin antibody scintigraphy is rather well established in severe myocarditis in which the certainty of diagnosis is based on endo-myocardial biopsies. However, only a few studies concern the moderated forms of myocarditis in which the biopsy was generally not realised. In our study the myocarditis diagnosis is based on a bunch of clinical, electrocardiographic and echocardiographic arguments. Eighteen patients were explored (13 males, 5 females of 37 {+-} 17 years old). The scintigraphy was achieved 48 hours after injecting 2 mCi of Myoscint and compared with a thallium scintigraphy at rest. Zones of interest were established in order to calculate a heart/lung index. An ischemic cardiopathy was excluded either by coronary-graphy or thallium scintigraphy. In 11 patients diagnosis of myocarditis or myo-pericarditis was thought as certain when the the rate of CPK mb increased significantly. The other 7 patients presented either isolated pericarditis or another heart pathology. ROC curves were established in order to determine the best threshold to pose a myocarditis diagnosis. An index of 1.55 represents the best compromise between sensitivity (91%) and specificity (100%). When the scintigraphy was positive the positioning was more often localised (80% of cases) than smeared out. In conclusion, our results indicate that the antimyosin antibody heart scintigraphy is a precise and reliable investigation in myocarditis diagnosis

  18. Importance of Heparin Provocation and SPECT/CT in Detecting Obscure Gastrointestinal Bleeding on 99mTc-RBC Scintigraphy



    Abstract We presented a pediatric case with a history of intermittent melena for 3 years because of angiodyplasia of small intestine. The results of frequent upper gastrointestinal endoscopies and colonoscopies as well as both 99mTc-red blood cell (RBC) and Meckel's scintigraphies for several times were negative in detection of bleeding site. However, 99mTc-RBC scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) after heparin augmentation detected a s...

  19. Bone x-ray (United States)

    ... or broken bone Bone tumors Degenerative bone conditions Osteomyelitis (inflammation of the bone caused by an infection) ... Multiple myeloma Osgood-Schlatter disease Osteogenesis imperfecta Osteomalacia Osteomyelitis Paget disease of the bone Rickets X-ray ...

  20. Diagnosis, characterisation and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Bhatnagar, Aseem; Sawroop, Krishan; Chopra, M.K.; Sinha, Noaline; Kashyap, Ravi [Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, Delhi (India); Sarker, B.B. [Defence Institute of Physiology and Allied Sciences, Delhi (India)


    In the present study, we performed early blood pool scintigraphy with technetium-99m pertechnetate in 20 patients (10-180 days after frostbite injury; 71 clinical lesions) referred for a topical treatment protocol for mild to moderately severe frostbite, and in 22 asymptomatic controls. The aims of the study were to define the ''normal'' microcirculation of the hands and feet, to characterise the appearances of frostbite lesions on scintigraphy and correlate these with the clinical presentation, and to evaluate the usefulness of scintigraphy for assessing the treatment response. Six patients were ''fresh'', 12 had been undergoing conservative treatment (topical homeopathic) for several weeks and two had permanent fibrotic hand phalanges. Nine patients on treatment underwent serial scintigraphy a total of 22 times. Eleven patients were imaged only once, including the two with permanent fixed defects. Three distinct physiological microcirculation patterns were evident in control hands or feet: right- or left-handedness (seven subjects), subclinical inflammatory foci correlating with callosity or pressure points (36 lesions) and distinctly increased pooling of radiotracer at the thenar or hypothenar region (eight subjects). In frostbite patients, 128 lesions (48 inflammatory, 80 ischaemic) were seen on the scan. This number included all 71 lesions identified clinically, the rest being subclinical. Subclinical frostbite lesion as an entity has not been described previously. Microvasculature of normal muscle groups (in the hands, elbow or feet) was shown on scintigraphy to improve after topical treatment. The treatment resulted in improved or normalised perfusion scan in 25 of 45 ischaemic segments with matching clinical improvement, and reduction or normalisation of uptake in inflammatory lesions (n=30). The data confirm the vasodilator and anti-inflammatory action of the topical preparation, and the sensitivity of the

  1. 99mTechnetium-labelled red blood cell scintigraphy as an alternative to angiography in the investigation of gastrointestinal bleeding: clinical experience in a district general hospital. (United States)

    Bearn, P.; Persad, R.; Wilson, N.; Flanagan, J.; Williams, T.


    99mTechnetium-labelled red blood cell scintigraphy (99mTc RBC scintigraphy) was used as the second-line investigation to localise bleeding in 23 patients (11 male, 12 female; mean age 67 years) presenting with active bleeding per rectum. Scintigraphy was available on a 24 h basis. A total of 18 patients had positive scans (78%). Surgery was performed urgently in 11 patients and the site of bleeding, as predicted by scintigraphy, was confirmed in 9 (82%). 99mTc RBC scintigraphy was less useful in patients who were not bleeding actively or who were being investigated for chronic anaemia. This study suggests that 99mTc RBC scintigraphy can play a useful role in the preoperative localisation of unexplained gastrointestinal bleeding in hospitals with nuclear medicine facilities, but confirms it has little place in the management of patients unless they are bleeding actively. PMID:1319696

  2. Performance of orthopantomography, planar scintigraphy, CT alone and SPECT/CT in patients with suspected osteomyelitis of the jaw

    Energy Technology Data Exchange (ETDEWEB)

    Bolouri, Carmen; Huellner, Martin W.; Veit-Haibach, Patrick; Perez-Lago, Marisol; Strobel, Klaus [Lucerne Cantonal Hospital, Department of Radiology and Nuclear Medicine, Lucerne (Switzerland); Merwald, Michael; Kuttenberger, Johannes [Lucerne Cantonal Hospital, Department of Oral and Maxillofacial Surgery, Lucerne (Switzerland); Seifert, Burkhardt [University of Zurich, Division of Biostatistics, Zurich (Switzerland)


    The aim of this study was to evaluate the performance of a novel flat-panel single photon emission computed tomography (SPECT)/CT in patients with suspicion of osteomyelitis (OM) of the jaw in comparison with conventional orthopantomography (OPT), planar bone scintigraphy (PS) and CT alone. Forty-two patients (21 female, 21 male, mean age 52, range 10-84 years) with suspected OM (n = 38) or exacerbation of a known OM (n = 4) were investigated with OPT, CT alone, PS and combined SPECT/CT. Images were separately reviewed by a nuclear physician/radiologist and jaw surgeon regarding presence of OM. Additionally, the different methods were rated regarding their usefulness for diagnosis (5-point scale: from 1 = diagnostic to 5 = useless). Biopsy served as the standard of reference in 30 patients and clinical/imaging follow-up of at least 6 months in 12 patients. In 35 of 42 patients the final diagnosis of OM was established according to the reference standard. Sensitivity, specificity and accuracy for OPT was 59, 100 and 66 %, for CT alone 77, 86 and 79 %, for PS 100, 71 and 95 % and for SPECT/CT 100, 86 and 98 %. SPECT/CT was significantly more accurate compared with CT alone (p = 0.0078) and OPT (p = 0.001). SPECT/CT was rated as the most useful imaging modality (mean value 1.2) compared with PS (2.2), CT (2.5) and OPT (3.2). SPECT/CT is an accurate method to assess the presence of OM of the jaw and superior to CT alone and OPT. SPECT/CT slightly improved the specificity of PS. However, SPECT/CT in this study was not significantly more accurate compared with PS and whether the advantages to the patient of a one-stop study as opposed to doing separate CT and PS justifies its routine use in terms of cost requires further study. (orig.)

  3. (18)F-FDG positron emission tomography/computed tomography and (99m)Tc-MDP skeletal scintigraphy in a case of Erdheim-Chester disease. (United States)

    Asabella, Artor Niccoli; Cimmino, Antonietta; Altini, Corinna; Notaristefano, Antonio; Rubini, Giuseppe


    of (18)F-FDG, leading to the suspision of ECD. A technetium-99m-methyl-diphosphonate skeletal scintigraphy ((99m)Tc-MDP) scan showed diffuse uptake of the radiopharmaceutical, in the diaphysis of long bones and in the left portion of the body and the spinous process of L2. Considering the difficulties of an osteomedullary or brain biopsy, biopsy was performed on a right anterior thoracic cutaneous xanthelasma. Histology showed lipid-laden histiocytes (CD1a-, CD68+, S-100 protein -) with small nuclei, Touton giant, lymphocytic infiltrates, eosinophils and fibrosis, ECD gold standard patterns as reported in literature. The patient was discharged with the diagnosis of ECD with central nervous system (CNS) manifestations, and treatment started. The diagnosis can be lead by the most charateristic bone findings of symmetrical osteosclerosis of the long bones, especially the lower limbs (tibia and fibula), involving metaphyses and diaphyses but sparing epiphyses. The typical pattern of osteoscerosis of the long bones reflects increased osteoblastic activity. About half of all ECD patients may experience extraskeletal manifestations, including CNS. Visceral involvement in ECD is not specific, and this enforces the diagnostic value of skeletal imaging findings. Furthermore xanthomas can be found at any location on the skin, especially the eyelids as in our patient. For visceral involvement, CT is most useful, while MRI is more sensitive for CNS lesions. Involvement of CNS may be frequently revealed clinically by diabetes insipidus. Few case reports have shown that (18)F-FDG PET/CT scanning could be useful in assessing the extension of ECD lesions. Both radiography and (99m)Tc-MDP skeletal scintigraphy may reveal osteosclerosis of the long bones, which is a typical finding in ECD. The typical bone pattern of (18)F-FDG PET/CT scan is specific for ECD and (99m)Tc-MDP skeletal scintigraphy may be performed in patients in whom initial (18)F-FDG PET/CT scans present the possibility

  4. Bone pain

    DEFF Research Database (Denmark)

    Frost, Charlotte Ørsted; Hansen, Rikke Rie; Heegaard, Anne-Marie


    Skeletal conditions are common causes of chronic pain and there is an unmet medical need for improved treatment options. Bone pain is currently managed with disease modifying agents and/or analgesics depending on the condition. Disease modifying agents affect the underlying pathophysiology...... of the disease and reduce as a secondary effect bone pain. Antiresorptive and anabolic agents, such as bisphosphonates and intermittent parathyroid hormone (1-34), respectively, have proven effective as pain relieving agents. Cathepsin K inhibitors and anti-sclerostin antibodies hold, due to their disease...... modifying effects, promise of a pain relieving effect. NSAIDs and opioids are widely employed in the treatment of bone pain. However, recent preclinical findings demonstrating a unique neuronal innervation of bone tissue and sprouting of sensory nerve fibers open for new treatment possibilities....

  5. Bone graft (United States)

    ... around the area. The bone graft can be held in place with pins, plates, or screws. Why ... Orthopaedic Surgery, San Francosco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...

  6. Results of Chiari pelvic osteotomy for acetabular dysplasia in adults; Association with bone scintigraphic findings

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Nobuo; Ozono, Kenji; Sugano, Nobuhiko; Takaoka, Kunio; Ono, Hiroo (Osaka Univ. (Japan). Faculty of Medicine)


    In an attempt to determine indications of Chiari pelvic osteotomy in acetabular dysplasia, postoperative outcome of hip joint (64 joints) was examined on the basis of findings of bone scintigraphy. The subjects were 61 patients with osteoarthrosis of hip joint who underwent preoperative bone scintigraphy. The follow-up period ranged from 2 years to 9 years and 7 months with a mean of 4 years and 9 months. According to X-ray findings, 37 osteoarthrosis joints were staged as early and 27 as progressive. Preoperative bone scintigraphic findings fell into three: (I) normal or slight hot type (33 joints), (II) hot type at the weighting part (16 joints), and (III) double hot type in the weighting part and inside part (15 joints). None of the patients had severe surgical complications such as deep-seated infection, neuroparalysis and pseudojoint. According to the clinical staging for hip joint function, 7 (47%) of 64 joints were judged as poor after osteotomy, belonging to type III. Deterioration of osteoarthrosis was seen in 11 joints (41%) on X-ray films. Of these, 9 had type III. In conclusion, Chiari pelvic osteotomy should not be indicated when type III is shown on bone scintigrams. (N.K.).

  7. Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia (United States)

    Krivonogov, Nikolay G.; Efimova, Nataliya Y.; Zavadovsky, Konstantin W.; Lishmanov, Yuri B.


    Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

  8. Postoperative follow-up studies in congenital dilatation of the common bile duct using hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hirobe, Seiichi; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Fuchimoto, Yasufumi; Mizuno, Dai; Yano, Tsunehiro [Tokyo Metropolitan Kiyose Children`s Hospital (Japan); Ishii, Katsumi


    Follow-up studies in congenital dilatation of the common bile duct were done in 20 cases ranging 3 to 20 years after operation. Operative cholangiography had shown dilatation of the intrahepatic bile ducts in 15 patients (75%), of these, 7 patients had cystic dilatation. Five cases of these 7 patients showed prolonged stasis of the nuclide in the cystic dilated intrahepatic bile ducts by {sup 99m}Tc-PMT hepatobiliary scintigraphy in the follow-up studies even at 10 years after operation. But none of 20 cases had complication such as intrahepatic lithiasis, cholangitis, and liver dysfunction. Hepatobiliary scintigraphy could provide moderate anatomic and excellent functional information which were useful for these follow-up studies and careful follow-up should be done in the case of cystic dilatation of the intrahepatic bile ducts. (author).

  9. Somatostatin Receptor Scintigraphy Findings in a Patient with Metastatic Gastrinoma and MEN 1 Syndrome

    Directory of Open Access Journals (Sweden)

    Gözde Mütevelizade


    Full Text Available Liver metastases from neuroendocrine tumours frequently occur and significantly worsen their prognosis. Somatostatin receptor scintigraphy (SRS is a valuable method for the detection of somatostatin receptor-positive lesions like gastrinoma. In this case report, the importance of SRS to localize the primary tumor and the spread of disease is emphasized in a patient with neuroendocrine liver metastases. A 45-year-old man was admitted to hospital with multiple liver metastasis of neuroendocrine carcinoma. Somatostatin receptor scintigraphy showed multiple intense radiotracer uptakes in the liver and a focal tracer uptake at the right side of the upper abdominal region corresponding to duodenum or pancreas. Elevated serum gastrin levels confirmed the gastrinoma diagnosis. (MRT 2011;20:117-120

  10. Osteomyelitis and infarction in sickle cell hemoglobinopathies: differentiation by combined technetium and gallium scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Amundsen, T.R.; Siegel, M.J.; Siegel, B.A.


    Clinical records and scintigrams were reviewed of 18 patients with sickle cell hemoglobinophaties who had undergone combined technetium and gallium scintigraphy during 22 separate episodes of suspected osseous infection. The combined scintigrams were correctly interpreted as indicating osteomyelitis in four studies. Of 18 studies in patients with infarction, the combined scintigrams were correctly interpreted in 16 and showed either no local accumulation of Ga-67 or less accumulation than that of Tc-99m MDP at symptomatic sites. In the other two studies, the scintigrams were falsely interpreted as indicating osteomyelitis and showed congruent, increased accumulation of both Tc-99, MDP and Ga-67. This pattern must be considered indeterminate. Overall, the results indicate that the combination of technetium and gallium scintigraphy is an effective means to distinguish osteomyelitis from infarction in patients with sickle cell hemoglobinopathies.

  11. Detection of Superior Vena Cava Obstruction on Dynamic 99mTc-DTPA Renal Transplant Scintigraphy

    Directory of Open Access Journals (Sweden)

    Elahe Pirayesh


    Full Text Available We present an asymptomatic patient with a history of prolonged hemodialysis through a right internal jugular vein catheter who was diagnosed with superior vena cava (SVC obstruction on 99mTechnetium-diethylenetriaminepentaacetic acid renal transplant scintigraphy. During the angiographic phase, an unusual vascular filling pattern was detected on the anterior view of the abdomen. Angioscintigraphic imaging of the chest wall was suggestive of SVC obstruction. The SVC obstruction in our patient was related to the long-term use of an indwelling catheter in the central venous system, which is a well-known complication of such a procedure. There is also evidence of a hypercoagulable state in dialyzed uremic cases; therefore, our patient may have been more susceptible to an SVC thrombosis. Acquired compensatory dilatation of the azygos vein is rather a rare finding. To the best of our knowledge, this is the first report describing an asymptomatic patient with SVC obstruction who was diagnosed by renal scintigraphy.

  12. Detection of bladder hemangioma in a child by blood-pool scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Ken; Saitoh, Masahiko; Chida, Shoichi [Department of Pediatrics, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka (Japan)


    Bladder hemangioma is a rare cause of gross hematuria. A 5-year-old boy was investigated for recurrent episodes of asymptomatic gross hematuria, but no abnormalities were found. Blood-pool scintigraphy using {sup 99m}technetium-human serum albumin combined with diethylene triamine penta-acetic acid (DTPA) revealed an area of increased activity in the right side of the bladder, which was confirmed by cystoscopy as a bladder hemangioma. Endoscopic laser therapy was used to remove two lesions successfully that were diagnosed histologically as cavernous hemangioma. The patient had no further episodes of hematuria in the 2-year period after this treatment. This case study indicates blood-pool scintigraphy may be a useful technique for detecting bladder hemangiomas. (orig.)

  13. Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease (United States)

    Siqueira, Fabio Paiva Rossini; Mesquita, Claudio Tinoco; dos Santos, Alair Augusto Sarmet M. Damas; Nacif, Marcelo Souto


    Half the patients with coronary artery disease present with sudden death - or acute infarction as first symptom, making early diagnosis pivotal. Myocardial perfusion scintigraphy is frequently used in the assessment of these patients, but it does not detect the disease without flow restriction, exposes the patient to high levels of radiation and is costly. On the other hand, with less radiological exposure, calcium score is directly correlated to the presence and extension of coronary atherosclerosis, and also to the risk of cardiovascular events. Even though calcium score is a tried-and-true method for stratification of asymptomatic patients, its use is still reduced in this context, since current guidelines are contradictory to its use on symptomatic diseases. The aim of this review is to identify, on patients under investigation for coronary artery disease, the main evidence of the use of calcium score associated with functional evaluation and scintigraphy. PMID:27437867

  14. Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohn's disease

    DEFF Research Database (Denmark)

    Almen, Sven; Granerus, Göran; Ström, Magnus


    Background: Leukocyte scintigraphy is a noninvasive investigation to assess inflammation. We evaluated the utility of labeled leukocytes to detect small bowel inflammation and disease complications in Crohn's disease and compared it to whole small bowel enteroscopy and laparotomy findings. Methods......: Scintigraphy with technetium-99m exametazime-labeled leukocytes was prospectively performed in 48 patients with Crohn's disease a few days before laparotomy; 41 also had an intraoperative small bowel enteroscopy. The same procedures were performed in 8 control patients. Independent grading of scans...... was compared with the results of enteroscopy and with surgical, histopathologic, and clinical data. Results: In the 8 control patients leukocyte scan, endoscopy, and histopathology were all negative for the small bowel. In patients with Crohn's disease and small bowel inflammation seen at enteroscopy and...

  15. Significance of silent ischemia in dipyridamole perfusion scintigraphy. Evaluation in patients with angina

    Energy Technology Data Exchange (ETDEWEB)

    Kitaoka, Hiroaki; Takata, Jun; Yamada, Mitsutoshi; Seo, Hiromi; Doi, Yoshinori [Kochi Medical School, Nankoku (Japan)


    The significance of silent myocardial ischemia detected by dipyridamole perfusion scintigraphy was evaluated in 80 patients with stable angina and reversible defects (RD) but no infarction. The patients consisted of 26 patients with silent RD and 54 patients with painful RD. There was no significant difference in the incidence of coronary risk factors between the two groups, except for hyperlipidemia which was less frequently observed in patients with silent RD than in those with painful RD (8% vs 41%), Coronary angiography revealed a higher prevalence of insignificant lesions or single vessel disease in patients with silent RD than in those with painful RD (73% vs 39%). Dipyridamole perfusion scintigraphy revealed a lower degree of RD in patients with silent RD than in those with painful RD (4.4{+-}3.3 vs 9.0{+-}4.1 segments), though there was no significant difference in the localization of RD between these two groups. Treadmill stress testing revealed a lower incidence of chest pain in patients with silent RD than in those with painful RD (26% vs 65%), despite the mean exercise-duration being significantly longer in the former than in the latter (5.5{+-}1.7 vs 3.9{+-}11.7 min). Although initial percutaneous transluminal coronary angioplasty (PTCA) and/or coronary artery bypass grafting (CABG) were less frequently performed in patients with silent RD than in those with painful RD (12% vs 31%), there was no significant difference in the cardiac event rate during the mean follow-up period of 24{+-}14 months between the two groups. Patients with stable angina and silent RD on dipyridamole perfusion scintigraphy may have less extensive coronary lesions and smaller amounts of ischemic myocardium than patients with painful RD. Dipyridamole perfusion scintigraphy is useful for detecting and evaluating silent myocardial ischemia, even in those patients who cannot exercise adequately. (J.P.N.).

  16. 16-Detector multislice CT in the detection of stress fractures: a comparison with skeletal scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Groves, A.M. [Department of Radiology, Addenbrooke' s Hospital NHS Trust, University of Cambridge, Cambridge (United Kingdom)]. E-mail:; Cheow, H.K. [Department of Nuclear Medicine, Addenbrooke' s Hospital NHS Trust, University of Cambridge, Cambridge (United Kingdom); Balan, K.K. [Department of Nuclear Medicine, Addenbrooke' s Hospital NHS Trust, University of Cambridge, Cambridge (United Kingdom); Housden, B.A. [Department of Radiology, Addenbrooke' s Hospital NHS Trust, University of Cambridge, Cambridge (United Kingdom); Bearcroft, P.W.P. [Department of Radiology, Addenbrooke' s Hospital NHS Trust, University of Cambridge, Cambridge (United Kingdom); Dixon, A.K. [Department of Radiology, Addenbrooke' s Hospital NHS Trust, University of Cambridge, Cambridge (United Kingdom)


    AIMS: To test the hypothesis that the improved resolution afforded by 16-detector computed tomography (CT) would translate to better stress fracture detection when compared with skeletal scintigraphy. MATERIALS AND METHODS: Thirty-three cases of suspected stress fractures in 26 patients were investigated using skeletal scintigraphy and 16-detector CT performed on the same day. Planar images of the lower limbs were taken 3 h post-injection of 400 MBq {sup 99m}Tc-methylene diphosphonate ({sup 99m}Tc-MDP). {sup 99m}Tc-MDP uptake was quantified at suspected fracture sites. CT was performed using a 16-detector multisection machine employing 0.75 mm detectors and images reconstructed in 0.5 mm increments. Examinations were reported independently and discordant results were compared at follow-up. RESULTS: At initial reporting scintigraphy identified fractures in 13 of the 33 cases and CT identified four of the 33. In one case, on review of the CT images, a fracture was present in the distal fibula that was not initially identified. This resulted in eight scintigraphic-positive CT-negative discordant cases. The {sup 99m}Tc-MDP uptake was significantly lower in the discordant fracture group compared with the concordant group (p<0.01). CONCLUSIONS: Despite technological advances in CT, scintigraphy appeared to detect more stress fractures. As such, multidetector CT should not be used as a routine initial investigation in stress fracture detection. The potential use of {sup 99m}Tc-MDP quantification at fracture sites is of interest and may be worth further investigation.

  17. Comparison between doppler ultrasonography and renal scintigraphy in assessment of post-transplant renal function

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yeo Chang; Shin, Byung Seok; Ohm, Joon Young; Kim, Seong Min; Ahn, Moon Sang; Yang, Shin Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of)


    To compare the usefulness of Doppler ultrasonography and renal scintigraphy in the assessment of short- and long-term function of transplanted kidneys. We retrospectively reviewed the cases of 79 patients who underwent Doppler ultrasonography and technetium-99m diethylene triamine pentaacetic acid renal scintigraphy on the same day, within 4 days of renal transplantation. Image parameters were evaluated for statistical differences. There was a strong positive correlation between the glomerular filtration rate (GFR) as measured by renal scintigraphy and the estimated GFR (eGFR) based on serum creatinine levels (correlation coefficient = 0.71). Scan grade according to the time-activity curve, resistive index, and end diastolic velocity showed moderate correlations with the eGFR (correlation coefficients = -0.557, -0.329, and 0.370, respectively) in the early post-transplantation period. The mean survival time was longer in patients with lower resistive indices (≤ 0.68, 54.9 months vs. > 0.68, 29.5 months) and lower pulsatility indices (≤ 1.32, 53.8 months vs. > 1.32, 28.7 months); however, there were no statistically significant differences in the long-term follow-up period (p = 0.121 for resistive index and p = 0.074 for pulsatility index). Renal scintigraphy is a more sensitive method than Doppler ultrasonography for assessing transplanted kidney function in the early post-transplantation period. Doppler ultrasonography might reflect the long-term survival time. However, it is difficult to predict long-term renal function using either method.

  18. Dual ectopic thyroid gland: sonography and scintigraphy of lingual and sublingual thyroid. (United States)

    Marković, Vinko; Glavina, Gordana; Eterović, Davor; Punda, Ante; Brdar, Dubravka


    Dual ectopic lingual and sublingual thyroid gland is an extraordinarily rare condition. We present 1 patient with subclinical hypothyroidism. The clinical examination revealed that the thyroid gland was not palpable in its usual cervical location, whereas ultrasonography confirmed an empty thyroid bed without any ectopic thyroid tissue in the rest of the neck. The final diagnosis of dual ectopic lingual and sublingual thyroid was established by ultrasound examination through the mouth floor and confirmed by scintigraphy and CT thereafter.

  19. Clinical value, cost-effectiveness, and safety of myocardial perfusion scintigraphy: a position statement

    DEFF Research Database (Denmark)

    Marcassa, C.; Bax, J.J.; Bengel, F.


    Mortality rates due to coronary artery disease (CAD) have declined in recent years as result of improved prevention, diagnosis, and management. Nonetheless, CAD remains the leading cause of death worldwide with most casualties expected to occur in developing nations. Myocardial perfusion...... scintigraphy (MPS) provides a highly cost-effective tool for the early detection of obstructive CAD in symptomatic individuals and contributes substantially to stratification of patients according to their risk of cardiac death or nonfatal myocardial infarction. MPS also provides valuable information...

  20. Potential Role of Lung Ventilation Scintigraphy in the Assessment of COPD


    Cukic, Vesna; Begic, Amela


    Objective: To highlight the importance of the lung ventilation scintigraphy (LVS) to study the regional distribution of lung ventilation and to describe most frequent abnormal patterns of lung ventilation distribution obtained by this technique in COPD and to compare the information obtained by LVS with the that obtained by traditional lung function tests. Material and methods: The research was done in 20 patients with previously diagnosed COPD who were treated in Intensive care unit of Clini...

  1. Demonstration of an infected popliteal (Baker's) cyst with three-phase skeletal scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Wallner, R.J.; Dadparvar, S.; Croll, M.N.; Brady, L.W.


    A case is reported of an infected popliteal (Baker's) cyst demonstrated with triple phase skeletal scintigraphy. Although double-contrast arthrography and ultrasonography are currently the modalities most frequently employed to diagnose the presence of popliteal cysts, they may also be detected utilizing this radionuclide technique in the course of evaluation for knee joint disease or septic arthritis. Radionuclide studies may be more sensitive for the evaluation of associated inflammatory disease involving the knee joint.

  2. Somatostatin receptor scintigraphy to predict the clinical evolution and therapeutic response of thyroid-associated ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Nocaudie, M.; Bailliez, A.; Itti, E. [Centre Hospitalier Regional et Universitaire, Lille (France). Service Central de Medecine Nucleaire et Imagerie Fonctionnelle; Bauters, C.; Wemeau, J.L. [Clinique d`Endocrinologie, Centre Hospitalier Regional et Universitaire de Lille (France); Marchandise, X.


    Management of thyroid-associated ophthalmopathy remains a topic of controversy. Immunosuppressive treatments have to be applied at peak disease activity and before criteria of severity develop. Expression of somatostatin receptors on activated lymphocytes allows scintigraphic imaging with indium-111 pentetreotide. We conducted a prospective study with 17 patients who presented severe ophthalmopathy (11 Graves` disease, four Hashimoto`s thyroiditis, two isolated in appearance: Means` syndrome). Each patient underwent hormonal (free T{sub 3} and TSH) and immunological (TBII) assessment, an orbital computed tomography scan or magnetic resonance imaging, a visual functional examination and {sup 111}In-pentetreotide orbital scintigraphy before undergoing treatment by steroids and/or radiotherapy, independently of scintigraphic results. At 4 and 24 h after the intravenous injection of 111 MBq of {sup 111}In-pentetreotide, planar imaging centred on the head and neck (anterior and both lateral views) was carried out. Retrobulbar uptake was assessed by visual semi-quantitative analysis (score given by two independent trained observers) and by quantitative analyses (regions of interest, orbit/brain uptake indices). Patients were ophthalmologically followed up for 6 months and then classified as improved or not. Visual semi-quantitative analysis of 4-h/24-h planar images was correlated with the ophthalmological evolution ({chi}{sup 2} test, P<0.01). All ten patients in whom scintigraphy was considered positive were clinically improved at 6 months, and of the seven patients in whom scintigraphy was negative, six were not improved. Nevertheless, objective quantitative analysis did not succeed in confirming these results. We conclude that {sup 111}In-pentetreotide scintigraphy requires further developments, including quantitative single-photon emission tomographic acquisition, if its role as a guide to therapeutic strategy in thyroid-associated ophthalmopathy is to be confirmed

  3. Leakage assessment in adjustable laparoscopic gastric banding: radiography versus {sup 99m}Tc-pertechnetate scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Van Den Bossche, B.; Goethals, I.; Dierckx, R.A.; Van de Wiele, C. [Division of Nuclear Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Villeirs, G. [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Pattyn, P. [Department of Surgery, Ghent University Hospital, Ghent (Belgium)


    The least invasive of all surgical weight-lowering procedures is the adjustable laparoscopic gastric banding (ALGB) technique. A rare complication (0.9%-1.8% of patients) but one that may require surgical revision is leakage of the gastric banding device. This paper reports on the usefulness of technetium-99m scintigraphy for the assessment of gastric band leaks as compared with radiography. Between March 1997 and October 2001, 23 obese patients (20 women and 3 men; mean age 35 years; range 23-60 years; mean body mass index before gastric banding procedure, 39.2 kg/m{sup 2}; range 29.3-52.1 kg/m{sup 2}) were referred for exclusion of gastric banding leakage by means of radiography and {sup 99m}Tc-pertechnetate scintigraphy. Both procedures were performed on the same day in all patients. Two patients underwent both procedures, respectively two and three times. A total of 27 radiographic and scintigraphic examinations were performed. Radiographs were judged positive for leakage when escape of contrast agent through a defect in the gastric banding device was visualised or when indirect criteria, e.g. smooth passage of barium suspension through the stoma after injection of contrast agent, were present. Scintigraphic images were judged positive when tracer disappearance out of the banding device and uptake in the thyroid gland as well as enhancement of the gastric mucosa were observed 30 min and/or 3 h post injection. Overall sensitivity, specificity and accuracy for radiography and {sup 99m}Tc scintigraphy were 81.8% vs 81.8%, 75% vs 100% and 77.7% vs 92.6%. Leakage from the reservoir or the connecting tube is a late complication of ALGB. The presented data suggest that {sup 99m}Tc-pertechnetate scintigraphy is more efficient than radiography in determining the presence of such leaks. (orig.)

  4. Scintigraphy-based analysis of possible pulmonary lesions after foam sclerotherapy: a pilot study

    Directory of Open Access Journals (Sweden)

    Lorenzo Tessari


    Full Text Available The aims of this study were to assess extemporaneous in vivo binding between 99mTcO4- and two sclerosant detergents in foam sclerotherapy, and subsequently to control any possible damage in lungs and other organs related to sclerosant foam passage. A prospective comparative pilot study was performed on two male patients (62 and 56 years old affected by varicose veins; each of them underwent scintigraphy investigations with free radiotracer and a scintigraphy investigation after each of the four sessions of sclerotherapy of varicose tributaries of the lower limbs with labeled sclerosant foam. One of the two patients underwent two further scintigraphic investigations, with free radiotracer and with labeled sclerosant foam, at a later stage. Four mL of 2% polidocanol (POL foam, or four mL of 1% sodiumtetradecylsulfate (STS foam for session were injected. The sclerosant foam was labeled with the radioactive tracer technetium pertechnetate, 99mTcO4- (120 MBq per exam. Two scintigraphy assessments for free tracer (basal and five scintigraphy investigations of bound-tosclerosant tracer uptake/transit were obtained. No relevant variations in time/activity curves of the lungs and other organs were documented between the basal and post-sclerotherapy findings, also at the later stage. Free radiotracer mean region-of-interest data were: 336 counts (heart, 208 counts (lungs and 371 counts (thyroid. Mean values extrapolated from each curve at each step for labeled CO2O2-based sclerosant foam were respectively: 351 counts (POL and 328 counts (STS for heart, 202 counts (POL and 188 counts (STS for lungs, 335 (POL and 263 (STS for thyroid. No pulmonary damage by sclerosant foam was caused. Neither immediately after treatments, nor at short-term follow-up.

  5. Effects of radiofrequency ablation on individual renal function: assessment by technetium-99m mercaptoacetyltriglycine renal scintigraphy.

    Directory of Open Access Journals (Sweden)



    Full Text Available We quantitatively evaluated total and individual renal function by technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3 renal scintigraphy before and after radiofrequency ablation (RFA of renal tumors. Eleven patients who underwent Tc-99m MAG3 renal scintigraphy 1 week before and after RFA were evaluated (7 men and 4 women ; age range : 23-83 years ; mean age : 60.6 years. Five patients had solitary kidneys, and five had normally or minimally functioning contralateral kidneys. One patient had a renal cell carcinoma in the contralateral kidney. One patient with a solitary kidney underwent RFA a second time for a residual tumor. In patients with a solitary kidney, MAG3 clearance decreased after 5 of 6 RFAs, and in patients with a normally functioning contralateral kidney, MAG3 clearance decreased after 4 of 5 RFAs, but no significant differences were observed between before and after treatments. In addition to the total MAG3 clearance, the split MAG3 clearance was evaluated in patients with a normally functioning contralateral kidney. MAG3 clearance decreased in 4 of 5 treated kidneys, while it adversely increased in the contralateral kidneys after 4 of 5 RFAs. No significant differences, however, were observed between before and after treatments. The results of our study revealed no significant differences in sCr, BUN, CCr, or MAG3 clearance between pre- and post-RFA values. These results support data regarding the functional impact and safety of renal RFA in published reports. We evaluated total and individual renal function quantitatively using Tc-99m MAG3 renal scintigraphy before and after treatment. This scintigraphy was very useful in assessing the effects of RFA on renal function.

  6. Low Bone Density (United States)

    ... Information › Bone Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your ... compared to people with normal bone density. Detecting Low Bone Density A bone density test will determine ...

  7. Exclusive wearing of shoes of impregnated cloth by an adolescent girl during a cold winter: late effects in osseous tomo-scintigraphy and in magnetic resonance imaging; Froid hivernal et port exclusif de chaussures de sport en tissu par une adolescente: effets tardifs en tomoscintigraphie osseuse et en resonance magnetique nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Als, C.; Marugg, S. [Medical Imaging Luzern, Lucerne (Switzerland); Als, C. [Zithaklinic, Service de Medecine Nucleaire, Grand-Duche de Luxembourg (Luxembourg)


    We present a rare clinical case of a 14-year-old adolescent girl from central Switzerland with an algoneurodystrophy of the left foot and leg 6 months after grade I frostbite(s) of the feet. After 6 months of constant pain of the digits, not attenuated by non steroid anti-inflammatory drugs, MRI of the feet reveals a predominantly left-sided and distal medullary edema, limited to the phalanges. Bone scintigraphy shows a predominantly left-sided diffuse feet hypoperfusion, coupled with an increased bone uptake of the left leg at late images. Inadequate life-style of adolescents, i.e., exclusively wearing shoes made of cloth and not of leather - even with temperatures below 0 Celsius degree in winter - might be a cause of chronic pain of foot digits. This is a rare demonstration of late effects of cold on foot digits by combined MRI and bone scintigraphy. Algoneurodystrophy in children and adolescents is an under diagnosed clinical entity. (authors)

  8. Availability of /sup 111/In-labeled platelet scintigraphy in patients with postinfarction left ventricular aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Takatoshi; Kubota, Masahiro; Iwakubo, Akifumi and others


    Eighteen patients with postinfarction left ventricular aneurysm (LVA) were examined with indium-111-labeled autologous platelet scintigraphy to identify intracardiac thrombi and to investigate the effect of antithrombotic agents on thrombogenesitiy within the LVA. Indium-111-platelet scintigraphy had a sensitivity of 60% and a specificity of 100% in detecting LVA mural thrombi. Among 6 patients showing false-negative scintigraphic studies, 4 was managed on antiplatelet therapy. Of 9 patients showing active platelet deposition on initial study, including 8 not receiving antiplatelet therapy, 5 were treated with tichlopidine (300 mg/day) for 29.8+-5.0 days. For the 5 patients, 2 had resolution and the 3 others had interruption of intraaneurysmal deposition in the second platelet study. For one patient receiving the third platelet study after warfarin therapy, it took two weeks to completely interrupt platelet deposition within the LVA. ECG gated radionuclide ventriculography and thallium-201 myocardial SPECT were also performed to assess left ventricular wall motion of left ventricular ejection fraction (LVEF) and myocardial blood perfusion. Thallium-201 SPECT showed apical or anteroapical perfusion defects. Radionuclide ventriculography pinpointed all 18 apical and anteroseptal aneurysms. A comparison between the thrombus positive group and the thrombus negative group revealed no statistical differences in LVEF and the period from the last myocardial infarction to the initial platelet scanning. These results suggest that indium-111 labeled platelet scintigraphy may be useful for identifying active left ventricular mural thrombi and for judging antiplatelet and anticoagulant therapy. (Namekawa, K).

  9. Clinical evaluation of efonidipine hydrochloride in angina pectoris. Evaluation in exercise {sup 201}Tl myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hori, Masatsugu; Nishimura, Tsunehiko [Osaka Univ., Suita (Japan). Medical School


    Clinical usefulness of once-daily administration of 20 to 60 mg of efonidipine hydrochloride and coronary hemodynamics during exercise {sup 201}Tl myocardial scintigraphy were investigated in patients with angina pectoris. Out of 11 patients enrolled in this study, 9 patients were included in the evaluation of patients` impression, in improvement rating in subjective symptoms, in the analysis of the exercise test, in the improvement rating of images on {sup 201}Tl myocardial scintigraphy, and in the global improvement rating, while 10 patients were included in the overall safety rating. Four patients in improvement rating in subjective symptoms, 2 in improving rating in the exercise test, and 5 in the global improvement rating were rated `improved` or better. In the improvement rating on the exercise {sup 201}Tl myocardial scintigraphy image, reduction of the image was observed in 5 patients, 3 out of which were evaluated as `improved` or better. A distinctive reduction of ischemic regions was observed in 2 patients out of the 3. A significant decrease in the number of angina pectoris events and a decreasing tendency in consumption of fast-acting nitrates were observed in spite of the low number of the patients studied. An adverse effect was observed in 1 patient and abnormal laboratory values were observed in 2 patients which were improved promptly after withdrawal of the drug. It was in 7 patients evaluated as `no problem`, while in 4 patients it was evaluated as `useful` or more. (author)

  10. Evaluation of left ventricular eccentric hypertrophy by /sup 201/Tl-myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Junichi; Kawamura, Yasuaki; Okuzumi, Ichio; Morishita, Takeshi; Koyama, Nobuya; Komatsu, Hisashi; Ohsawa, Hidefumi; Yabe, Yoshimasa


    In order to elucidate the mechanism of left ventricular eccentric hypertrophy in conditions of volume overload, Tl-201 myocardial scintigraphy was performed in patients with aortic valve regurgitation and mitral valve regurgitation. There was a good relationship between the severity of Tl-defects, as determined by Tl-201 myocardial scintigraphy, and the changes in the T wave on the ECG on the one hand and the NYHA functional classification of heart diseases. In 17 of 18 patients where LVDd increased with increasing severity of Tl-defects and the defects were moderate to severe, LVDd was 65 mm or larger. There was a significant negative correlation between the washout rate for the whole circumference of the left ventricle, as determined by exercise Tl-201 SPECT, and LVDd (r=-0.603, p<0.01). The phenomenon of redistribution as determined by exercise Tl-201 myocardial scintigraphy was observed relatively early. Our results suggest that mechanical volume overload and ischemic changes are involved in left ventricular wall damage in left ventricular eccentric hypertrophy. For patients with moderate to severe Tl-defects valve replacement is indicated, no matter whether they may have heart failure or arrhythmia.

  11. Is radiolabelled sucralphate scintigraphy of any use in the diagnosis of inflammatory bowel disease? (United States)

    Crama-Bohbouth, G E; Arndt, J W; Peña, A S; Blok, D; Verspaget, H W; Weterman, I T; Lamers, C B; Pauwels, E K


    Previous optimistic reports led us to undertake a study to determine the value of 99Tcm-sucralphate scintigraphy in the assessment of localization and extent of active inflammatory bowel disease. Eight patients were studied; four had Crohn's disease (three small bowel and one colon localization) and four patients had ulcerative colitis. The results obtained by scintigraphy were compared with those obtained by diagnostic radiology and/or endoscopy. In five patients indium-111 granulocyte scintigraphy was also performed. 99Tcm-sucralphate scans showed total discrepancy with standard investigations in four patients and partial discrepancy in the other four. Furthermore, it was difficult from the images to decide whether the radiolabelled sucralphate indicated true inflammation or normal distribution of the radiopharmaceutical. Patient acceptability was very low due to frequent scanning times and the recommended purgation which was not well tolerated and is contraindicated in severely ill patients. We conclude that this technique is not a good screening test for diagnosing inflammatory bowel disease and we have, therefore, discontinued the study.

  12. Tc-99m-EDDA-HYNIC-TOC somatostatin receptor scintigraphy in patients with carcinoids

    Directory of Open Access Journals (Sweden)

    Vlajković Marina


    Full Text Available The aim of this paper is to determine the influence of Ki-67 proliferation index on somatostatin receptor scintigraphy (SSRS with Tc-99m-EDDA-HYNIC-TOC (Tc-99m-Tektrotyd somatostatin analogue in patients with carcinoid tumors. Sixty-one patients (31 female, 30 male; age range: 33-76 years were examined: 13 patients highly suspected of having a carcinoid, and 48 patients who had undergone the surgical removal of the tumor. Whole body SSRS at 4 h postinjection, spot scintigrams and SPECT of the selected regions were obtained for all patients. Tc-99m-Tektrotyd scintigraphy was classified as true positive in 26 out of 30 and true negative in 24 out of 28 patients. The sensitivity of Tc-99mTc-Tektrotyd scintigraphy was found to be as high as 94.74% in the group of patients with low mitotic index Ki67 (20%. The likelihood of Tc-99m-Tektrotyd scan being positive when a carcinoid is present was found to be inversely proportional to the value of Ki67 proliferation index. The results showed that Tc-99m-Tektrotyd SSRS is a sensitive method for diagnosing and staging patients with well-differentiated carcinoid tumors. However, in poorly differentiated tumors with high Ki67 proliferation index, additional analyses are necessary for precise staging.

  13. Recognition of Abnormal Uptake through 123I-mIBG Scintigraphy Entropy for Paediatric Neuroblastoma Identification

    Directory of Open Access Journals (Sweden)

    Milagros Martínez-Díaz


    Full Text Available Whole-body 123I-Metaiodobenzylguanidine (mIBG scintigraphy is used as primary image modality to visualize neuroblastoma tumours and metastases because it is the most sensitive and specific radioactive tracer in staging the disease and evaluating the response to treatment. However, especially in paediatric neuroblastoma, information from mIBG scans is difficult to extract because of acquisition difficulties that produce low definition images, with poor contours, resolution and contrast. These problems limit physician assessment. Current oncological guidelines are based on qualitative observer-dependant analysis. This makes comparing results taken at different moments of therapy, or in different institutions, difficult. In this paper, we present a computerized method that processes an image and calculates a quantitative measurement considered as its entropy, suitable for the identification of abnormal uptake regions, for which there is enough suspicion that they may be a tumour or metastatic site. This measurement can also be compared with future scintigraphies of the same patient. Over 46 scintigraphies of 22 anonymous patients were tested; the procedure identified 96.7% of regions of abnormal uptake and it showed a low overall false negative rate of 3.3%. This method provides assistance to physicians in diagnosing tumours and also allows the monitoring of patients’ evolution.

  14. Use of {sup 99m}Tc-Mononuclear Leukocyte Scintigraphy in Nosocomial Fever

    Energy Technology Data Exchange (ETDEWEB)

    Gutfilen, B.; Lopes de Souza, S.A.; Martins, F.P.P.; Cardoso, L.R.; Pinheiro Pessoa, M.C.; Fonseca, L.M.B. [Univ. Federal do Rio de Janeiro (Brazil). Dept. de Radiologia


    Purpose: To determine the overall diagnostic accuracy of mononuclear leukocyte-{sup 99m}Tc scintigraphy in the routine detection of infectious lesions and fever of unknown origin (FUO) in inpatients. Material and Methods: The use of mononuclear leukocyte {sup 99m}Tc scintigraphy is presented in 87 patients who fulfilled the Durack and Street diagnostic criteria of nosocomial FUO; 66 patients were suspected of having infectious lesions (myocarditis, endocarditis, infected catheters, diabetic foot, and osteomyelitis) and 21 patients presented with unknown causes of FUO. Scans were carried out 1, 3, and 24 h after injection of labeled leukocytes. Results: In three cases (3/27) where scintigraphs were negative, biopsies were positive. There were two (2/87) false-positive scintigrams. We found a 95.8% sensitivity and 92.3% specificity. PPV was 93.8%, PPN 94.7%, and accuracy 94.2%. Conclusion: Mononuclear leukocyte {sup 99m}Tc scintigraphy showed high sensitivity, specificity, positive and negative predictive values in patients with nosocomial FUO. These results suggest an important role for nuclear medicine in the management of patients with infection/inflammation.

  15. Parameters Obtained by Hepatobiliary Scintigraphy Have Significant Correlation with Biochemical Factors Early After Liver Transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kansoul, H.A.; Axelsson, R.; Yamamoto, S.; Savicheva, I.; Aspelin, P.; Ericzon, B.G.; Gjertsen, H. [Div. of Transplantation Surgery and Div. of Radiology, Dept. of Clinical Science, Intervention, and Technology, Karolinska Inst., Karolinska Univ. Hospital, Stockholm (Sweden)


    Background: Early postoperative hepatobiliary scintigraphy after liver transplantation is performed worldwide, but data on its significance for graft function are currently limited. Purpose: To examine the correlation between the result of early postoperative hepatobiliary scintigraphy and pre- and postoperative biochemical parameters in liver transplantation (LTx) patients. Material and Methods: Six parameters of hepatobiliary scintigraphy using {sup 99m}Tc mebrofenin were statistically analyzed in 108 LTx patients: 1) half-life of the activity of elimination of mebrofenin from the blood; 2) total clearance of mebrofenin from the blood due to all possible routes; 3) half-life of the activity due to liver uptake; 4) clearance of mebrofenin from the blood due to liver uptake; 5) time to maximal uptake in the liver; and 6) the hepatic extraction fraction (HEF) and biochemical data. Analysis between patients with preoperative normal liver function, familial amyloid polyneuropathy (FAP), and end-stage liver disease (non-FAP) was also performed. Results: Univariate and multivariate analysis revealed that total bilirubin postoperative day 3 correlated with all three scintigraphic parameters, and peak aspartate aminotransferase and alanine aminotransferase correlated with HEF. The analysis between patients with FAP and non-FAP revealed no significant difference of scintigraphic data between the two groups. Conclusion: A significant correlation between early postoperative scintigraphic results and biochemical parameters was demonstrated.

  16. Per rectal portal scintigraphy as a useful tool for predicting esophageal variceal bleeding in cirrhotic patients

    Institute of Scientific and Technical Information of China (English)

    Taned Chitapanarux; Ong-ard Praisontarangkul; Satawat Thongsawat; Pises Pisespongsa; Apinya Leerapun


    AIM: To investigate potential roles of per rectal portal scintigraphy in diagnosis of esophageal varices and predicting the risk of bleeding.METHODS: Fifteen normal subjects and fifty cirrhotic patients with endoscopically confirmed esophageal varices were included. Patients were categorized into bleeder and non-bleeder groups according to history of variceal bleeding. All had completed per rectal portal scintigraphy using 99mTechnetium pertechnetate.The shunt index was calculated from the ratio of 99mTechnetium pertechnetate in the heart and the liver.Data were analyzed using Student's t-test and receiver operating characteristics.RESULTS: Cirrhotic patients showed a higher shunt index than normal subjects (63.80 ± 25.21 vs 13.54 ± 6.46, P < 0.01). Patients with variceal bleeding showed a higher shunt index than those without bleeding (78.45 ± 9.40 vs 49.35 ± 27.72, P < 0.01). A shunt index of over 20% indicated the presence of varices and that of over 60% indicated the risk of variceal bleeding.CONCLUSION: In cirrhotic patients, per rectal portal scintigraphy is a clinically useful test for identifying esophageal varices and risk of variceal bleeding.

  17. Quantitative assessment of left-sided valvular regurgitation by multi-gated equilibrium scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Kosuda, Shigeru; Kunieda, Etsuo; Takagi, Yaeko (Keio Univ., Tokyo (Japan). School of Medicine)


    In order to evaluate quantitatively left-sided valvular regurgitation by multi-gated equilibrium scintigraphy, regurgitant fraction (RF) was defined as following, RF = (LVCO - RVCO)/RVCO = SVR - 1. LVCO; left ventricular count output. RVCO; right ventricular count output. SVR; stroke volume ratio. RF values in 70 subjects were calculated after multigated equilibrium scintigraphies were performed. In 85% of 54 subjects without regurgitation, RF was less than 0.5 (MEAN +- S.D. 0.29 +- 0.28). In all of 16 patients with mitral and/or aortic regurgitation, RF was more than 0.5 (MEAN +- S.D. 1.68 +- 0.99) (P<0.001). Furthermore, the value of RF indicated the severity of regurgitation based on Sellers' criteria determined by contrast angiography. After successful valve replacement, post-operative RF reduced and were within normal values. We conclude that RF by multi-gated equilibrium scintigraphy permits noninvasive, quantitative assessment of left-sided valvular regurgitation, and RF is highly reproducible and useful for post-operative assessment in patients with valvular regurgitation.

  18. Metastatic bone cancer as a recurrence of early gastric cancer - characteristics and possible mechanisms

    Institute of Scientific and Technical Information of China (English)

    Michiya Kobayashi; Takehiro Okabayashi; Takeshi Sano; Keijiro Araki


    The surgical outcome of most early gastric cancer (EGC)is usually satisfactory. Some cases show bone metastasis even though the depth of cancer invasion is confined to the mucosa. The most frequent site for recurrence of EGC is the liver. Cases of EGC with bone metastasis are reviewed to clarify the clinicopathological characteristics of EGC giving rise to bone metastasis. Possible mechanisms and risk factors underlying this rare condition are proposed.Forty-six cases of bone metastasis from EGC are reviewed from published reports and meeting proceedings in Japan.This investigation suggests that risk factors for bone metastasis from EGC include depressed-type signet-ring cell carcinoma, poorly differentiated carcinoma, and/or the likely involvement of lymph node metastasis, even though the cancer is confined to the gastric mucosa. The risk factors do not include recurrence of EGC in the liver. We speculate that the mechanism of bone metastasis from EGC is via lymphatic channels and systemic circulation. Postoperative follow-up of cases should consider the development of bo