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1.
Medicine (Baltimore) ; 99(28): e21176, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664158

RESUMO

Tc-99m sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has been used to help surgeons explore the location of parathyroid diseases, but quantitative parameters have not been systemically investigated for this purpose. We aimed to establish objective criteria for adenoma and hyperplasia using the standardized uptake value (SUV) in patients with hyperparathyroidism.Thirty-nine hyperparathyroid patients (male/female: 17/22, age: 58.33 ±â€Š11.69 years) with at least 1 uptake-positive lesion of any degree by visual assessment in preoperative Tc-99m sestamibi quantitative SPECT/CT were included from Oct 2015 to Oct 2017. Pathologically, 44 lesions (32 adenomas and 12 hyperplasia) were identified. All patients experienced normalized levels of intact parathyroid hormone immediately after surgery. Quantitative SPECT/CT was performed at 10 minute and 2 hour post injection of Tc-99m sestabmibi (dose = 740 MBq), and maximum SUV (SUVmax) was measured for the parathyroid lesions. Experienced pathologists evaluated the percentage cellular proportions of chief cells, oxyphil cells, and clear cells.SUVmax (g/mL) of adenomas, hyperplasia, and reference thyroid tissue were 12.92 ±â€Š6.68, 7.90 ±â€Š5.49, and 7.01 ±â€Š2.62 at 10min (early phase), decreasing to 7.46 ±â€Š5.66, 4.65 ±â€Š3.14, and 2.21 ±â€Š1.07 at 2 hour (delayed phase), respectively. The adenomas showed significantly higher SUVmax than both the hyperplasia (P = .0131) and reference thyroid tissue (P < .0001) along the early and delayed phases, but the SUVmax of the hyperplasia did not differ from that of the reference thyroid tissue (P = .4196). The adenomas and hyperplasia were discriminated from the reference thyroid tissue using a cutoff SUVmax of 3.26 at the delayed phase. The adenomas had lower %proportions of oxyphil cells than the hyperplasia (P = .0054), but its SUVmax at the delayed phase was positively correlated with the %proportions of mitochondria-abundant oxyphil cells (rho = 0.418, P = .0173). The hyperplasia showed no correlation between SUVmax and cellular proportions.SUVmax at the delayed phase in the Tc-99m sestamibi quantitative SPECT/CT was useful for the identification and differentiation of parathyroid lesions causing hyperparathyroidism.


Assuntos
Adenoma/diagnóstico por imagem , Hiperparatireoidismo/diagnóstico por imagem , Glândulas Paratireoides/patologia , Neoplasias das Paratireoides/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Tecnécio Tc 99m Sestamibi , Adenoma/etiologia , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Hiperparatireoidismo/complicações , Hiperparatireoidismo/patologia , Hiperplasia/diagnóstico por imagem , Hiperplasia/etiologia , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/etiologia , Estudos Retrospectivos
2.
Medicine (Baltimore) ; 99(27): e21047, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629730

RESUMO

Repair of medial meniscus posterior root tear (MMPRT) is considered as an effective early intervention strategy for osteoarthritis. We aimed at evaluating whether or not single-photon emission computed tomography/computed tomography (SPECT/CT) could predict the treatment outcome.Eleven patients with MMPRT who underwent preoperative SPECT/CT were retrospectively enrolled. Clinical symptoms were evaluated based on the knee injury and osteoarthritis outcome score (KOOS) and visual analogue scale (VAS) for pain. The uptake pattern of the medial tibial plateau (MTP) on SPECT/CT was visually assessed. Additionally, the maximum lesion-to-cortical counts ratio (LCRmax) for the anterior and posterior aspects of MTP and anterior-posterior MTP ratio (APR) were quantitatively assessed. Spearman correlation analyses were performed between the change in clinical symptom scores and preoperative SPECT/CT patterns.All patients showed increased radiotracer uptake in MTP. Among them, 8 (73%) showed dominant uptake in the anterior aspect of MTP. The rest 3 (27%) showed posterior-dominant uptake. Patients with anterior-dominant patterns tended to show better outcomes in terms of the postoperative KOOS score (P = .07). Anterior MTP LCRmax showed a negative correlation with the change in VAS (ρ = -0.664, P < .03). APR showed a correlation with the change in the KOOS score (ρ = 0.655, P < .03).Patients with MMPRT with relatively higher uptake in the anterior aspect of MTP could have better clinical outcomes after the repair. The preoperative SPECT/CT pattern may have a predictive value in selecting patients with good postoperative outcomes.


Assuntos
Meniscos Tibiais/patologia , Osteoartrite/cirurgia , Ruptura/cirurgia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Idoso , Osso e Ossos/diagnóstico por imagem , Feminino , Humanos , Traumatismos do Joelho/cirurgia , Articulação do Joelho/diagnóstico por imagem , Meniscectomia/métodos , Pessoa de Meia-Idade , Período Pós-Operatório , Valor Preditivo dos Testes , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Escala Visual Analógica
3.
Clin Nucl Med ; 45(7): 531-533, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32502091

RESUMO

Some patients undergoing routine SPECT/CT and PET/CT examinations during the COVID-19 pandemic may incidentally reveal findings of COVID-19-associated pneumonia (C-19AP) on localizing CT. It is critical for nuclear medicine physicians to develop diagnostic skills for timely recognition of typical findings of C-19AP on a localizing CT. Furthermore, it is our responsibility to know the optimal practices for safely isolating and managing such patients while protecting the staff, other patients at the facility, family and/or friend accompanying the patients, and the public in general from risky exposure to COVID-19 sources. We offer several steps following an encounter suspicious of C-19AP.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumonia/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Diagnóstico Diferencial , Gerenciamento Clínico , Humanos , Achados Incidentais , Pandemias , Pneumonia/etiologia , Pneumonia/terapia , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/normas , Coluna Vertebral/diagnóstico por imagem
4.
Medicine (Baltimore) ; 99(19): e19989, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384452

RESUMO

This study aimed to establish an optimal protocol for Tc-sestamibi parathyroid imaging for lesion localization in patients with hyperparathyroidism (HPT).We retrospectively enrolled 35 consecutive patients who underwent dual-phase (at 10 minutes and 120 minutes) Tc-sestamibi parathyroid scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT). Twenty seven patients had primary HPT, and 8 had secondary or tertiary HPT. Three nuclear medicine physicians independently analyzed the parathyroid images for lesion localization at 9 predefined parathyroid locations using the following 4 different image sets blinded to the clinical information:All SPECT or SPECT/CT image sets were analyzed with dual-phase planar images. The image results were compared with the histopathological results after surgery.Dual-phase SPECT/CT showed the highest positive rate of 85.7% in the patient-based analysis and 13.7% in the location-based analysis. Of 35 patients, surgical pathological results were available in 21 (16 adenomas in 16 primary HPTs and 16 hyperplasias in 5 secondary or tertiary HPTs). Dual-phase SPECT/CT showed the sensitivity values of 100% and 84.4% in the patient-based and location-based analysis, respectively, which were the highest sensitivity values among all image sets. In the primary HPT subgroup, dual-phase SPECT/CT showed the highest sensitivity value of 93.8% in the location-based analyses, whereas dual-phase SPECT, early SPECT/CT, and delayed SPECT/CT showed the sensitivity values of 62.5%, 81.3%, and 81.3%, respectively. In the secondary or tertiary HPT subgroup, dual-phase SPECT/CT also showed the highest sensitivity value of 75.0%, whereas early SPECT/CT, delayed SPECT/CT, and dual-phase SPECT showed the sensitivity values of 43.8%, 56.3%, and 68.8%, respectively.Compared with dual-phase SPECT or single-phase SPECT/CT, the dual-phase SPECT/CT imaging protocol for Tc-sestamibi scintigraphy showed the highest positive rate and sensitivity, and was optimal for parathyroid lesion localization.


Assuntos
Hiperparatireoidismo , Hiperplasia , Glândulas Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides , Cintilografia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tecnécio Tc 99m Sestamibi/farmacologia , Feminino , Humanos , Hiperparatireoidismo/diagnóstico , Hiperparatireoidismo/etiologia , Hiperplasia/diagnóstico , Hiperplasia/patologia , Hiperplasia/cirurgia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/cirurgia , Cintilografia/métodos , Cintilografia/normas , Compostos Radiofarmacêuticos/farmacologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
5.
PLoS One ; 15(5): e0232480, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32365074

RESUMO

A five-compartmental biokinetic model of I-131 radioiodine based on in-vivo gamma camera scanning results was developed and successfully applied to nine thyroid cancer patients who were administered 1,110 MBq I-131 in capsules for the residual thyroid gland ablation. The I-131 solution activity among internal organs was analyzed via the revised biokinetic model of iodine recommended by the ICRP-30 and -56 reports. Accordingly, a five-compartmental (stomach, body fluid, thyroid, whole body, and excretion) model was established to simulate the metabolic mechanism of I-131 in thyroid cancer patients, whereas the respective four simultaneous differential equations were solved via a self-developed program run in MATLAB. This made it possible to provide a close correlation between MATLAB simulation results and empirical data. The latter data were collected through in-vivo gamma camera scans of nine patients obtained after 1, 4, 24, 48, 72, and 168 hours after radioactive I-131 administration. The average biological half-life values for the stomach, body fluid, thyroid, and whole body of thyroid cancer patients under study were 0.54±0.32, 12.6±1.8, 42.8±5.1, and 12.6±1.8 h, respectively. The corresponding branching ratios I12, I23, I25, I34, I42, and I45 as denoted in the biokinetic model of iodine were 1.0, 0.21±0.14, 0.79±0.14, 1.0, 0.1, and 0.9, respectively. The average values of the AT dimensionless index used to verify the agreement between empirical and numerical simulation results were 0.056±0.017, 0.017±0.014, 0.044±0.023, and 0.045±0.009 for the stomach, thyroid, body fluid + whole body, and total, respectively. The results obtained were considered quite instrumental in the elucidation of metabolic mechanisms in the human body, particularly in thyroid cancer patients.


Assuntos
Radioisótopos do Iodo/farmacocinética , Modelos Biológicos , Compostos Radiofarmacêuticos/farmacocinética , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/metabolismo , Adulto , Idoso , Simulação por Computador , Feminino , Câmaras gama , Meia-Vida , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Distribuição Tecidual
8.
Br J Radiol ; 93(1112): 20200206, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32463293

RESUMO

OBJECTIVE: To describe the characteristic imaging features of focal nodular marrow hyperplasia (FNMH). METHODS AND MATERIALS: Retrospective review of all patients with a diagnosis of FNMH between January 2007 and September 2019. RESULTS: The study included 53 patients, 7 males and 46 females with a mean age of 58 years (range 12-95 years). All had MRI with conventional spin echo sequences showing a poorly defined round/oval lesion with mild T1W iso/hyperintensity compared to skeletal muscle, low T2W turbo spin echo (TSE) signal intensity (SI) compared to marrow fat and variable SI on STIR, but never associated with reactive marrow oedema. All 53 patients had follow-up MRI, with all lesions remaining stable or partially resolving. In-phase (IP) and out-of-phase (OP) chemical shift imaging (CSI) was obtained in 31 of these, with 28 (90.3%) showing >20% SI drop on the OP sequence, while 3 (9.7%) demonstrated <20% SI drop. CT was available in 26 cases, 17 (65.4%) showing mild medullary sclerosis. Single-photon emission computed tomography CT (SPECT-CT) was available in four cases and Flourodeoxyglucose positron emission tomography CT (FDG PET-CT) in 2, all showing increased uptake. Focal uptake was also seen in three of eight patients who had undergone whole body bone scintigraphy. Only one lesion was biopsied, confirming FNMH. CONCLUSION: The imaging appearances of FNMH have been described on various modalities, particularly MRI with emphasis on the role of IP and OP CSI typically demonstrating >20% SI reduction. FNMH should be recognised and treated as a 'do not touch' lesion which does not require biopsy or prolonged follow-up. ADVANCES IN KNOWLEDGE: We describe and clarify the imaging characteristics of FNMH on MRI, including CSI, CT and various nuclear medicine modalities. An imaging algorithm is suggested for allowing a non-invasive diagnosis.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Medula Óssea/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/patologia , Doenças da Medula Óssea/patologia , Criança , Feminino , Humanos , Hiperplasia/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Estudos Retrospectivos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Adulto Jovem
9.
Khirurgiia (Mosk) ; (3): 5-12, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32271731

RESUMO

AIM: To improve the results of treatment of patients with focal liver formations by preventing the development of postoperative complications after liver resections. METHODS: The study included 304 patients with benign and malignant liver lesions. In 196 (64.4%) patients, resections were performed for malignant liver damage, in 108 (35.6%) - for a benign process. To assess the impact of ongoing measures to prevent the development of postoperative complications, patients were divided into two time periods: from 2007 to 2012 and from 2013 to 2018. RESULTS: The introduction of a protocol of preoperative examination of patients for whom resection of 3 or more liver segments is planned, with the inclusion of SPECT/CT, which allows determining the volume of the remaining functioning liver parenchyma, allowed to reduce the percentage of development of acute post-resection liver failure from 11.6% to 3.6% during the second time period (p=0.0064). The use of modern suture material, surgical binocular loops, as well as the use of the concept of predominantly performing parenchyma-saving resections, reduced the number of biliary complications from 8.1% to 5.7% (p=0.1). The use of a proprietary dissection algorithm for the liver parenchyma significantly reduced hemorrhagic complications from 5.3% to 1.04% (p=0.0074). CONCLUSION: The use of modern pre- and intraoperative technologies has reduced the number of postoperative complications after liver resections from 38.3% to 20.9% (p=0.018) and mortality from 2.6% to 0.5% (p=0.004), thereby improving the results of liver resections.


Assuntos
Hepatectomia/efeitos adversos , Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Fígado/cirurgia , Algoritmos , Doenças Biliares/etiologia , Doenças Biliares/prevenção & controle , Perda Sanguínea Cirúrgica/prevenção & controle , Protocolos Clínicos , Dissecação/efeitos adversos , Dissecação/métodos , Hepatectomia/instrumentação , Hepatectomia/mortalidade , Humanos , Fígado/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Hepatopatias/cirurgia , Falência Hepática/etiologia , Falência Hepática/prevenção & controle , Falência Hepática Aguda/etiologia , Falência Hepática Aguda/prevenção & controle , Neoplasias Hepáticas/diagnóstico por imagem , Tamanho do Órgão , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/prevenção & controle , Cuidados Pré-Operatórios , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Técnicas de Sutura/instrumentação
10.
Clin Nucl Med ; 45(4): e215-e216, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32049726

RESUMO

Three-phase bone scan was performed for evaluation of possible sinus tarsi syndrome in a 52-year-old man with chronic left ankle pain. MRI was initially read as unremarkable, and there was little symptomatic improvement after intra-articular anesthetic injection. The primary finding that appreciated only delayed bone SPECT/CT images was focal increased uptake associated with a well-corticated 8-mm bony fragment adjacent to the left calcaneus, thought to represent an accessory ossicle within the left sinus tarsi. The increased uptake suggested fracture or severe degenerative change of the ossicle, likely contributing to the patient's chronic pain.


Assuntos
Doenças do Pé/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Ossos do Tarso/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Ossos do Tarso/patologia
11.
Medicine (Baltimore) ; 99(7): e19162, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049844

RESUMO

RATIONALE: In the diagnostics of neuroendocrine tumors (NETs), scintigraphy and Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) with Indium-Octreotide occupy a prominent place.The introduction in clinical practice of Gallium-labelled somatostatin analogues (DOTA-TOC, DOTA-TATE, DOTA-NOC) for Positron Emission Tomography/Computed Tomography (PET/CT), significantly improved NETs diagnostics due to greater sensitivity and improved lesion detection in addition to better patient convenience and decreased radiation dose. PATIENT CONCERNS: We report a case of a patient who was diagnosed with a neuroendocrine tumor of the ileocecal valve. DIAGNOSES: Diagnosis was made by ultrasonography, CT, and colonoscopy. Hystology after surgery was G2 NET of ileo-cecal valve. Restaging was carried out by In-Octreotide SPECT/CT and, 1 month later, by Ga-DOTATOC PET/CT. F-FDG PET/C was also carried out. INTERVENTIONS: Ga-DOTATOC PET/CT showed larger disease that modified disease management from surgery to medical treatment. OUTCOMES: After an initial improvement in the patient clinical condition, the tumor caused a worsening with the appearance of ascites. LESSONS: Ga-DOTA-conjugate PET/CT is appropriate in low and intermediate NET (Ki67 index respectively ≤3% and 3%-20%) characterized by better survival and better response after Peptide Receptor Radionuclide Therapy.F-FDG is mostly useful in high grade (G3) of disease, so that Ga-DOTA-conjugate SUV and F-FDG SUV have an opposite trend in relation to the tumor grade. Ga-DOTATOC PET/CT changes, as in our case, therapeutic management in about 40% of cases.


Assuntos
Valva Ileocecal/diagnóstico por imagem , Tumores Neuroendócrinos/diagnóstico por imagem , Octreotida/análogos & derivados , Compostos Organometálicos , Idoso , Humanos , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
12.
Medicine (Baltimore) ; 99(4): e18905, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977903

RESUMO

Although pathological confirmation is the gold standard for diagnosis of amyloidosis, there is a need for a relevant imaging modality to identify involved organs and evaluate disease extent. Thus, we prospectively investigated imaging findings of Tc-DPD scintigraphy in AL and ATTR amyloidosis.A total of 21 subjects with pathologically confirmed AL or ATTR amyloidosis were included. Pretreatment whole body Tc-DPD planar scanning and regional SPECT/CT were performed in all subjects. For allegedly involved organs, Tc-DPD uptake was visually and semi-quantitatively evaluated on a 4-point scale (grade 0: no uptake, 1: uptake less than spine, 2: uptake similar to spine, and 3: uptake greater than spine).There were 29 organs involved in AL and 12 in ATTR. Significant Tc-DPD uptake was found in 24 organs (sensitivity = 82.8%) in AL and 9 organs (sensitivity = 75.0%) in ATTR. Additional SPECT/CT was helpful to ensure abnormal DPD uptake in the involved organs, which was uncertain by attenuation in planar imaging. Degree of Tc-DPD uptake was significantly higher in ATTR compared with AL amyloidosis (P = .017). Diffuse soft tissue uptake with photon defects in the liver area was found only in ATTR amyloidosis.This study showed that Tc-DPD scintigraphy might have capacity to differentiate between AL and ATTR subtypes with good sensitivity in various organs involving primary systemic AL and ATTR amyloidosis. Additional SPECT/CT significantly improved the diagnostic efficacy of Tc-DPD scintigraphy.


Assuntos
Neuropatias Amiloides Familiares/diagnóstico por imagem , Amiloidose de Cadeia Leve de Imunoglobulina/diagnóstico , Cintilografia/métodos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Compostos de Organotecnécio/administração & dosagem , Imagem Corporal Total
13.
Clin Nucl Med ; 45(3): e148-e150, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31977466

RESUMO

We present the case of a 69-year-old man with history of prostate carcinoma treated with prostatectomy and subsequently with external beam radiotherapy and hormone therapy because of biochemical recurrences. More than 10 years after the diagnosis, follow-up Tc-HDP bone scans and SPECT/CT images demonstrated an incidental diagnosis of osteoblastic pleural plaques that quickly evolve to mesothelioma. PET/CT achieved the definitive diagnosis by guiding the biopsy to the highest and most accessible focus of glucidic hypermetabolism. Our case report raises the association between prostate cancer patients treated with external beam radiotherapy and the development of pleural mesothelioma despite having no history of exposure to asbestos.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Mesotelioma/diagnóstico por imagem , Neoplasias Pleurais/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/complicações , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Idoso , Difosfonatos , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/complicações , Masculino , Mesotelioma/complicações , Compostos de Organotecnécio , Neoplasias Pleurais/complicações , Neoplasias da Próstata/sangue , Compostos Radiofarmacêuticos
14.
Clin Nucl Med ; 45(3): 232-233, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31977473

RESUMO

We present the case of a 13-year-old boy with bleeding complications from a Meckel diverticulum (MD), which was scintigraphically confirmed. A first exploratory laparoscopy was unsuccessful in identifying the diverticulum. A new Tc-pertechnetate scintigraphy (including SPECT/CT), 3 years later, suggested the anatomical location and was helpful during the surgical exploration for the MD by radioguided surgery. Radioguidance is helpful in pathologies characterized by small size or variable anatomical location. A MD with ectopic gastric mucosa can be distinguished from the rest of the small bowel based on selective Tc-pertechnetate uptake in the gastric mucosa, with limited background activity.


Assuntos
Divertículo Ileal/cirurgia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Cirurgia Assistida por Computador/métodos , Adolescente , Humanos , Masculino , Divertículo Ileal/diagnóstico por imagem , Compostos Radiofarmacêuticos , Pertecnetato Tc 99m de Sódio
15.
Clin Nucl Med ; 45(3): 250-251, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31977492

RESUMO

We report of a 71-year-old woman with a 2-cm somatostatin receptor-positive intrapancreatic lesion almost misdiagnosed as neuroendocrine neoplasm. By additional red blood cell scintigraphy with heat-damaged erythrocytes, the lesion was identified as an intrapancreatic accessory spleen, and unnecessary operation (which was already planned) could be avoided. This case report reminds colleagues to consider accessory spleen as differential diagnosis for somatostatin receptor-positive lesions even when located inside the pancreas. In doubtful cases, a scintigraphy with heat-damaged erythrocytes is a very useful and complementary imaging method and should be performed before any planning of surgery.


Assuntos
Tumores Neuroendócrinos/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Esplenopatias/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Octreotida/análogos & derivados , Compostos de Organotecnécio , Compostos Radiofarmacêuticos
16.
World Neurosurg ; 134: 201-210, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31655232

RESUMO

Facet joint osteoarthritis/arthropathy of the spine is a common cause of back and neck pain that frequently overlaps clinically with other diseases of the spine. Because of the possible overlap, it is crucial to have an accurate diagnostic strategy, especially when determining the management approach. Various strategies have been suggested and adopted, with several these still being used in clinics. Over the years, because of the disadvantages of single-modality imaging methods (computed tomography, magnetic resonance imaging, single-photon emission computed tomography), the interest in radiologic examination started to move toward hybrid imaging techniques. Although the data are mixed, many initial studies have shown promise. However, there are relatively few data with comparative medial branch blocks, and further investigation is needed. Given the advantages and disadvantages of these new techniques, the imaging results have to be interpreted within clinical context and with consideration of the current state of knowledge in the decision-making process.


Assuntos
Imagem Multimodal/métodos , Osteoartrite/diagnóstico por imagem , Articulação Zigapofisária/diagnóstico por imagem , Humanos , Artropatias/diagnóstico por imagem , Imagem por Ressonância Magnética , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X
18.
Chem Commun (Camb) ; 56(3): 415-418, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31821393

RESUMO

We report a novel 1,2-catechol based radioiodinated precursor for radioiodination of bicyclo[6.1.0]nonyne (BCN) installed biologically active molecules using a strain-promoted oxidation-controlled cyclooctyne-1,2-quinone cycloaddition reaction (SPOCQ) under ambient conditions. Compared to the reported methodologies, the new strategy demonstrates some clear advantages, including high in vitro and in vivo stability, high radiochemical yield, and exceptionally fast reaction kinetics at micro-molar concentration.


Assuntos
Reação de Cicloadição , Quinonas/química , Compostos Radiofarmacêuticos/química , Animais , Compostos Bicíclicos com Pontes/síntese química , Compostos Bicíclicos com Pontes/química , Catecóis/química , Coração/diagnóstico por imagem , Radioisótopos do Iodo/química , Marcação por Isótopo , Cinética , Camundongos , Camundongos Endogâmicos ICR , Oxirredução , Compostos Radiofarmacêuticos/síntese química , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
19.
Clin Nucl Med ; 45(2): 129-130, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31789918

RESUMO

Retroperitoneal liposarcoma is usually large and can press on other organs. We report a case of a 66-year-old woman with a history of retroperitoneal liposarcoma resection who presented to the emergency department with abdominal pain. Ultrasonography revealed a large abdominal mass with renal displacement. Dynamic renal scintigraphy with Tc-DTPA was conducted to evaluate renal function. However, severe impairment of the right kidney function and abnormal tracer accumulation were observed during the examination. SPECT/CT was performed; 2 kidneys were successfully localized, and the recurrence of tumor was correctly detected.


Assuntos
Rim/diagnóstico por imagem , Lipossarcoma/diagnóstico por imagem , Neoplasias Retroperitoneais/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Idoso , Feminino , Humanos , Compostos Radiofarmacêuticos , Pentetato de Tecnécio Tc 99m
20.
Clin Nucl Med ; 45(1): e1-e7, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31789907

RESUMO

PURPOSE: This study was conducted to identify the role of hepatobiliary scintigraphy (HBS) in the management of biliary tract injuries. METHODS: We retrospectively studied 54 patients (28 male and 26 female patients) aged 3 to 78 years with evidence of bile leak on HBS performed between January 2015 and October 2017. Following intravenous injection of Tc-mebrofenin, dynamic images were acquired for 30 minutes followed by static images until 24 hours. SPECT/CT was performed in patients with suspicion of bile leak on the planar images. Patients were classified as those with free intraperitoneal or localized bile leak. Any abdominal drain output was documented, and its statistical significance was assessed using Mann-Whitney U test. Subsequent management was also documented. RESULTS: Of the 54 patients, 28 demonstrated free intraperitoneal bile leak and 26 localized leak on HBS. Thirty-four patients (24 with free intraperitoneal leak and 10 with localized leak) had an abdominal drain. Drain output was significantly higher in patients with free intraperitoneal leak compared with patients with localized leak (370 vs 78 mL/d per patient, P < 0.01). All patients with free intraperitoneal bile leak underwent interventional procedures such as endoscopic retrograde cholangiopancreatography and stenting or Roux-en-Y hepaticojejunostomy later on. Patients with localized bile leak were managed conservatively and were free of symptoms at 1-year follow-up. CONCLUSIONS: Our findings indicate that, in addition to detecting biliary leak, HBS may be used to identify patients with localized bile leak (48% of patients in our study) who do not require active intervention.


Assuntos
Sistema Biliar/diagnóstico por imagem , Sistema Biliar/lesões , Fígado/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Adolescente , Adulto , Idoso , Procedimentos Cirúrgicos do Sistema Biliar , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
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