Comparison of three with six regions of interest analyses in patients with idiopathic constipation undertaking colon transit scintigraphy using 67Ga-citrate

OBJECTIVE AND INTRODUCTION: Preparation of data from 6 geometric regions of interest in the colon is time consuming, and can become impractical in the environment of busy Nuclear Medicine Departments. Therefore, we have investigated and demonstrated an alternative method for obtaining the same diagnostic information from an analysis of patients with idiopathic constipation who underwent colon transit scintigraphy using 67Ga-citrate. Data analysis methods using three regions of interest are compared to the results obtained using the more time consuming 6 regions of interest method to analyze the data. MATERIALS AND METHODS: In this study, we report our results of the comparative reanalysis of data obtained by more traditional methods. We compare 3 regions of interest (ROI) which were taken from areas including the right colon, left colon and the rectosigmoid colon, with original work using our alternative 6 (ROI) diagnostic methodology. In addition, the proximal colonic emptying (PCE) was determined at 24 hr post ingestion among members of 3 identified subject groups. RESULTS: The distribution of activity as the ingested 67Ga-citrate passes through the colon constitutes an activity profile. The mean activity position in the colon can be determined from subsequent radiographic images and from this the mean clearance time can be calculated. In quantitative assessment, this represents the time at which half of activity was eliminated from colon (mean half clearance time - MCT) which did not appear different in the reanalysis. There is no significant difference in the current study in GMC 24h, GMC 48h and GMC 72h between two groups using the Man Whitney u test (p > 0.05), while in the previous work the results were statistically significant for the two later time periods GMC (GMC 48h and GMC 72h) (p = 0.016 and p = 0.027 respectively). The PCE in the group 1 was = 2.50 (0.37); group 2, 1.57 (0.47) and group 3, 2.97. The PCE was not different between the two groups (p = 0.21). CONCLUSIONS: This investigation demonstrated that the radionuclide colon transit study using 67Ga-citrate is a safe, physiologic, and quantitative method for evaluating the transit of fecal material from cecum to rectum. Although, the visual assessment of diagnosis of the subjects in the two analyses is the same, it was not completely supported by quantitative measurements. Therefore, further studies need to be done

Comparison of technetium-99m IgG with technetium-99m red blood cells labeling in cardiac blood-pool scintigraphy: A preliminary study

This first clinical prospective study was conducted to use of technetium-99m immunoglobulin G (99mTc-IgG) as compared with autologous 99mTc-red blood cells (RBC) in gated blood pool ventriculography. We studied 12 patients who referred to us for a possible diagnosis of liver hemangioma or infection. Six patients underwent gated planar blood pool (GPBP) acquisition using 99mTc-RBC and 6 GPBP acquisition using 99mTc-IgG. The use of 99mTc-IgG in cardiac blood pool studies provided comparable images to 99mTc-RBC. In conclusion, 99mTc-IgG, which is readily available and needs only a single injection, may be an attractive alternative to 99mTc-RBC for the estimation of various cardiac function parameters like left ventricular function

Scintigraphy with 99mTc(V)-DMSA in monitoring patients with inflammatory bowel disease

The clinical significance of pentavalent technetium-99m dimercaptosuccinic acid (99mTc(V)-DMSA) scintigraphy in diagnosing inflammatory bowel disease (IBD) has not yet been fully elucidated. The aim of this prospective paper was to study the above. This study included 54 patients, 22 females and 32 males (mean age: 36.68±11.49; range: 18-63 years) with IBD who came to our clinics for follow-up and were examined clinically by colonoscopy and 99mTc(V)-DMSA scintigraphy. On the follow-up studies, five patients (9.25%) relapsed, and 49 (90.74%) remained at a steady condition. There was a good correlation between the scintigraphic results and the clinical and colonoscopy data of the patients (P<0.05). In conclusion, our results indicated that 99mTc(V)DMSA scintigraphy can be complementary to colonoscopy for the diagnostic evaluation of IBD

The association of increased stomach wall radiotracer uptake with prolonged use of Omeprazole capsules on myocardial perfusion imaging (MPI) using 99mTc-sestamibi SPECT

Myocardial perfusion imaging (MPI) is widely used in routine practice for diagnosis and risk stratification of coronary artery disease (CAD). Intense curvilinear activity in the stomach wall of a patient was seen on MPI raw data. This phenomenon was completely dissimilar to the familiar intraluminal gastric reflux of sestamibi. This observed activity could have resulted in false-positive or false-negative artifacts - and inaccurate diagnosis - of the inferior wall of the left ventricle after MPI processing. On further exploration, the current researchers found that the patient had a history of 10-year Omeprazole capsule consumption. The authors present this infrequent case of intense stomach uptake to stress the related clinical and diagnostic implications with the aim to stimulate acute awareness of possible, unexpected infringements on image quality that could potentially interfere with accurate interpretation of the data. Copyright © 2013 Via Medica

The effect of an iodine restricted including no sea foods diet, on technetium-99m thyroid scintigraphy: A neglected issue in nuclear medicine practice

Although it is recommended to patients to avoid sea food and iodine-containing medications prior to iodine-131 ( 131I) scanning, the efficacy of this diet as for technetium-99m pertechnetate ( 99mTc-P) thyroid scintigraphy is not well addressed in the literature. We evaluated a self-managed, outpatients, iodine restricted diet (IRD) designed to reduce total body iodine in preparation for such a scan. We have studied 39 patients who referred to our Department for multinodular goiter, 30 females and 9 males, aged: 14-54 years and their 99mTc-P thyroid scintigraphy showed poor visualization of the thyroid gland. These patiens were living in regions with high consumption of sea foods went underwent a two-weeks iodine restriction including restriction of sea food diet for the reduction of iodine body content. These patients were called for a repeated scan after going on a IRD for at least two weeks. The two scans were compared visually, and by semiquantitative analysis. Semiquantitative analysis was applied in 8 regions of interest (ROI) by using Wilcoxon signed rank test. Thirty-six subjects had better quality scintigraphy images in the post IRD thyroid scan, as was visually assessed by two nuclear medicine physicians. Semiquantitatetively, there was a significant difference in the mean counts of ROI of the right and the left thyroid lobes in favor of the post IRD scans (P<0.05). In conclusion, this study suggests that in patients with multinodular goiter, living in regions with high consumption of sea foods a two-weeks diet for the reduction of iodine body content induces in most of the cases a slightly better diagnostic thyroid 99mTc-P scan

Concurrent papillary thyroid cancer and parathyroid adenoma as a rare condition: A case report

Although the pathological relationship between parathyroid and thyroid diseases is common, an association between parathyroid adenoma and thyroid cancer is rare. Concomitant thyroid cancer in patients with primary hyperparathyroidism (pHPT) has been reported at varying frequencies. WE present here a 23-year-old man who had papillary thyroid carcinoma in the right thyroid lobe and a parathyroid adenoma in the left thyroid lobe, which were confirmed surgically. Copyright © 2012 Via Medica

Size Control in the Nanoprecipitation Process of Stable Iodine (127I) Using Microchannel Reactor—Optimization by Artificial Neural Networks

In this study, nanosuspension of stable iodine (127I) was prepared by nanoprecipitation process in microfluidic devices. Then, size of particles was optimized using artificial neural networks (ANNs) modeling. The size of prepared particles was evaluated by dynamic light scattering. The response surfaces obtained from ANNs model illustrated the determining effect of input variables (solvent and antisolvent flow rate, surfactant concentration, and solvent temperature) on the output variable (nanoparticle size). Comparing the 3D graphs revealed that solvent and antisolvent flow rate had reverse relation with size of nanoparticles. Also, those graphs indicated that the solvent temperature at low values had an indirect relation with size of stable iodine (127I) nanoparticles, while at the high values, a direct relation was observed. In addition, it was found that the effect of surfactant concentration on particle size in the nanosuspension of stable iodine (127I) was depended on the solvent temperature. © 2015, American Association of Pharmaceutical Scientists

Complete improvement in a patient with multiple irreversible defects of the left ventricle on 99m technetium-sestamibi SPECT after percutaneous coronary intervention.

99mTc-sestamibi has been investigated as a potential viability marker; initial studies have shown good concordance between 201Tl and 99mTc-sestamibi activities in both viable and nonviable myocardium. However, assessment of myocardial viability by 99mTc-sestamibi remains controversial for tissue recovery after revascularization. Here, we present a patient with several regions of severely diminished and irreversible (defect persisting in both early and delay images of each set scanning) defects on initial scan which were dissolved completely on the follow up scan after an intervention. In a 75 year-old Asian woman with acute myocardial infarction who received thrombolytic therapy and subjected to percutaneous coronary angiography (PCI) on day 28 after acute myocardial infarction(MI), resting 99mTc-sestamibi SPECT was applied on day 4 (initial scan) and 138 (follow up scan) after acute MI at 30 and 180 min after injection of tracer (740 MBq); Two-dimensional echocardiography was carried out at the same time. On the initial image set, there was irreversible defects in the apex, anteroapical, inferoapical, anteroseptal, septal and also anterior walls, while the follow up image was normal in all regions.The angiography intervention showed just significant stenosis on left anterior descending (LAD) vessel (95). This may highlight the failure of 99mTc-sestamibi as a marker of myocardial viability and also mandate further validating of the procedure with follow up scan or other modalities for myocardial viability investigation