Evaluation of diffuse lymphadenopathy via various quantitative PET/CT parameters.

OBJECTIVE: Discovery of diffuse lymphadenopathy (DLAP) in fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging alerts for the existence of many pathologic conditions with severity ranging from benign to malignancy. This study examines the role of various metabolic parameters reflecting 18F-FDG characteristics of organs/tissues to reach an accurate differential diagnosis for further clinical assessment. MATERIALS AND METHODS: Positron emission tomography/CT images of 78 patients with DLAP were reviewed retrospectively. The diameter of the largest lymph node (DLlyn), maximum standardized uptake value (SUVmax) of the liver (L), the largest lymph node (Llyn), spleen (S), and bone marrow (BM) were measured. Ratios to liver SUVmax were calculated for all, resulting LLRmax, SLRmax, and BMLRmax respectively. RESULTS: The diameter of the largest lymph node, Llyn.SUVmax, LLRmax, and SLRmax produced cut-off values as 25.5, 8.86, 2.80, and 0.82 with corresponding sensitivity:specificity values as 65%:83%, 74%:77%, 74%:71%, and 79%:63% respectively for risk stratification of malignant causes. To differentiate lymphoma from sarcoidosis, DLlyn, SLRmax, and BMLRmax were found valuable with cut-off values obtained as 28.5, 0.84, and 1.19 with corresponding sensitivity:specificity values as 79%:91%, 79%:82%, and 54%:91%, respectively.Interdependency between parameters was also evaluated. CONCLUSION: High values of Llyn.Maximum SUV and LLRmax are the main characteristics of lymphoma, metastasis, and sarcoidosis. The diameter of the largest lymph node, SLRmax, and BMLRmax are determined as distinct parameters for distinguishing lymphoma from sarcoidosis. Besides, observed correlation structures amongst some PET/CT parameters were identified as nodal, extranodal, and diffuse patterns for three disease groups except sarcoidosis. These findings extend the knowledge about diagnostic factors based on 18F-FDG PET/CT patterns for DLAP.

Effect of melatonin on low and high dose radiotherapy induced thyroid injury.

We investigated the radioprotective effect of melatonin (MEL) against thyroid gland damage in rats caused by flattening filter (FF) and flattening filter free (FFF) single dose X-ray beams. We used 48 female rats divided into six groups of eight: group 1, untreated control group; group 2, MEL treated group; group 3, FF-low dose rate radiotherapy (FF-LDR) group; group 4, FF-LDR + MEL group; group 5, FFF-high dose rate radiotherapy (FFF-HDR) group; group 6, FFF-HDR + MEL group. Groups 2, 4 and 6 rats were injected intraperitoneally (i.p.) with 10 mg/kg MEL 15 min before exposure to radiation. The head and neck regions of each rat in groups 3 and 5 and groups 4 and 6 were irradiated with 16 Gy at 6 MV X-ray in FF and FFF beam modes. The histopathology of the thyroid gland and salient biochemical parameters were assessed in all rats 10 days after radiotherapy. We found increased inflammation, vacuolization, degradation, swelling and necrosis, and M30 apoptosis and M65 necrosis indicators in groups 3 and 5 compared to group 1; however, we found significant reductions in histopathological and biochemical parameters following application of MEL. MEL treatment before FF-LDR and FFF-HDR radiotherapy minimized thyroid gland injury due to irradiation.

Accuracy of Metabolic Imaging-guided Transthoracic Biopsy in Lung Cancer.

OBJECTIVE: To compare the detection of transthoracic tru-cut biopsy performed on metabolically active areas in positron emission tomography (PET) for the diagnosis of lung cancer, compared to only CT scan-guided biopsy. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Thoracic Surgery, Kayseri City Training and Research Hospital, Turkey, between December 2020 to June 2021. METHODOLOGY: Patients of suspected lung cancer with pre-transthoracic biopsy chest computerised tomography and without positron emission tomography were included in Group A; while, patients with both and positron emission tomography chest computerised tomography were included in Group B. Based on the CT findings of the patients in Group A, a biopsy was obtained from the most appropriate place. The patients in Group B were evaluated by a nuclear medicine specialist and the place with the highest maximum standardised uptake value before the biopsy was marked and the area to be biopsied was determined. RESULTS: The malignancy detection rate was significantly higher in Group B (48/50 patients, 96%) than in Group A (36/50 patients, 72%, p=0.001). Two lesions in the Group B (4 %) and 14 lesions in the Group A (28 %) were found to give benign results (p=0.001). Biopsy was repeated in one patient of Group B, and in five patients of Group A due to an initial negative diagnosis. The sensitivity of PET/CT in predicting malignant tumor was 96%, with the positive predictive value (PPV) of 98.0%; while the sensitivity of CT was 74.5%, with PPV of 82%. CONCLUSION: Transthoracic biopsies taken by considering metabolically active areas of the mass in positron emission tomography-guided can both increase diagnosis rate and reduce the complication rate by preventing repeated biopsies. Key Words: Transthoracic biopsy, PET/CT, Metabolic active lesion, Malignant tumor.

Tc-99m MDP Bone SPECT/CT Findings of a Patient Detected with a New Mutation in LEMD3 Gene: A Case of Osteopoikilosis.

Osteopoikilosis is an inherited condition with autosomal dominant trait resulting in sclerotic foci throughout the skeleton. It has been suggested that loss-of-function mutations of LEMD3 gene located on 12q14.3 result in osetopoikilosis. A bp heterozygote deletion was detected in our patient at the cytosine nucleotide at position 1105 with molecular genetic analysis. Although this mutation has not been previously described, it was considered to be the most likely cause of the disease in our patient due to frame shift and premature stop codon formation. As in our case, three phase bone scintigraphy and whole body imaging did not reflect the true extent of lesion sites and lesion activity. SPECT/CT images could reflect lesion location and activity more accurately, and could be a good alternative for differential diagnosis of unexplained bone pain and sclerotic lesions in one examination.

Can Laws Be a Potential PET Image Texture Analysis Approach for Evaluation of Tumor Heterogeneity and Histopathological Characteristics in NSCLC?

We investigated the association between the textural features obtained from 18F-FDG images, metabolic parameters (SUVmax, SUVmean, MTV, TLG), and tumor histopathological characteristics (stage and Ki-67 proliferation index) in non-small cell lung cancer (NSCLC). The FDG-PET images of 67 patients with NSCLC were evaluated. MATLAB technical computing language was employed in the extraction of 137 features by using first order statistics (FOS), gray-level co-occurrence matrix (GLCM), gray-level run length matrix (GLRLM), and Laws' texture filters. Textural features and metabolic parameters were statistically analyzed in terms of good discrimination power between tumor stages, and selected features/parameters were used in the automatic classification by k-nearest neighbors (k-NN) and support vector machines (SVM). We showed that one textural feature (gray-level nonuniformity, GLN) obtained using GLRLM approach and nine textural features using Laws' approach were successful in discriminating all tumor stages, unlike metabolic parameters. There were significant correlations between Ki-67 index and some of the textural features computed using Laws' method (r = 0.6, p = 0.013). In terms of automatic classification of tumor stage, the accuracy was approximately 84% with k-NN classifier (k = 3) and SVM, using selected five features. Texture analysis of FDG-PET images has a potential to be an objective tool to assess tumor histopathological characteristics. The textural features obtained using Laws' approach could be useful in the discrimination of tumor stage.

[Can ischemia-modified albumin help in differentiating myocardial perfusion scintigraphy results?]. / Iskemi modifiye albümin miyokart perfüzyon sintigrafisi sonuçlarinin ayirici tanisinda faydali olabilir mi?

OBJECTIVE: Myocardial perfusion scintigraphy (MPS) is a diagnostic tool commonly used to detect significant coronary lesion. However equivocal, false negative or positive results can be yielded. Controversial findings regarding the role of ischemia-modified albumin (IMA) in MPS evaluation persist. The aim of the present study was to examine the role of serum IMA in the assessment of MPS results. METHODS: MPS using technetium (99mTc) sestamibi and transthoracic echocardiography was performed on 62 consecutive subjects prospectively enrolled. Exercise treadmill test (ETT) with modified Bruce protocol was used to induce coronary ischemia. During MPS performance, blood samples for serum IMA were obtained at 3 times: at pre-exercise, at the peak of ETT, and 6 hours after ETT. Patients were classified into 3 groups according to MPS results (normal, equivocal, and ischemia). RESULTS: Sixty-two patients (23 normal, 20 equivocal, 19 with ischemia) were included. Pre- and peak-exercise IMA values were similar among the groups (p=0.706 and 0.904). Post-exercise IMA values of the normal and equivocal groups were similar (p=0.733), while that of the ischemia group was significantly higher than the values of either the normal (p<0.001) or equivocal groups (p<0.001). ΔIMA (the difference between post-exercise and peak-exercise IMA) of the ischemia group was significantly higher than that of either the normal (p<0.001) or equivocal groups (p<0.001). CONCLUSION: Serum IMA was found to be significantly increased in cases of ischemia on MPS. Subjects with normal and equivocal MPS had a similar pattern during the test. IMA may be used in differentiation of equivocal results from false positive results.

Scintigraphic evaluation of the osteoblastic activity of rabbit tibial defects after HYAFF11 membrane application.

BACKGROUND: An unfavorable condition for bone healing is the presence of bone defects. Under such conditions, a material can play a role to cover fractured or defective bone. Technological advances now allow for the use of such material. Hyalonect(®) (Fidia Advanced Biopolymers SLR, Italy), a novel membrane comprising knitted fibers of esterified hyaluronan (HYAFF11) can be used to cover fractured or grafted bone and can also serve as a scaffold to keep osteoprogenitor cells in place. The aim of this study was to compare osteoblastic activity by the use of scintigraphic methods in defective rabbit tibias during early-phase bone healing with or without a hyaluronan-based mesh. METHODS: Two groups (A and B) of New Zealand albino rabbits were used; each group included 10 animals. Operations on all rabbits were performed under general anesthesia. We also resected 10-mm bone segments from each animal's tibial diaphysis. After resection, tibias with defects were fixed using Kirschner wires. In group A, no hyaluronan-based mesh was used. In group B, tibial segmental defects were enclosed with a hyaluronan-based mesh. The rabbits were followed up for 4 weeks postoperatively, after which bone scintigraphic studies were performed on each animal to detect and compare osteoblastic activity. RESULTS: The mean count in the fracture side of the hyaluronan-based mesh group was significantly higher compared to that of the group A (p = 0.019). However, there was no significant difference between group B and control rabbits with respect to the mean count on the intact bone side (p = 0.437). The bone defect (fracture)/intact bone mean count ratio was significantly higher in group B compared to group A (p = 0.008). CONCLUSIONS: A hyaluronan-based mesh plays a role in promoting osteoblastic activity. Hyalonect(®) is suitable for restoring tissue continuity whenever the periosteal membrane is structurally impaired or inadequate. Our results demonstrated that, during early-phase bone healing, osteoblastic activity was increased in bone defect sites when a hyaluronan-based mesh was also used. The most important aspect of this study concerns its scintigraphy-based design. This study is the first to use a scintigraphic method to demonstrate the effectiveness of hyaluronic acid-based material for bone healing.

Hepatic vein and portal vein Doppler ultrasound of maternal liver in normal pregnancy.

OBJECTIVE: The purpose of our study was to evaluate the changes occurring in maximum flow velocity and waveform patterns of the portal and hepatic veins during pregnancy in second and third trimesters. METHODS: A total of 204 patients were randomly divided into the study and control groups. The control group was classified as group I; the study group was divided into two groups: group II, second trimester pregnancy (14-26 weeks, n = 91) and group III, third trimester pregnancy (26-40 weeks, n = 63). Vein waveforms were classified as triphasic, biphasic and monophasic. RESULTS: Maximum flow velocities of both right hepatic vein and main portal veins were lower in group III compared with group I and group II (p < 0.05). On the basis of hepatic vein and portal vein waveforms, the incidence of biphasic pattern was prominent in group II (p < 0.05) whereas the monophasic pattern was prominent in group III (p < 0.05). CONCLUSION: The results demonstrate that as gestational age progresses, maximum flow velocities of both right hepatic vein and main portal veins intend to be decreased with an increased incidence of monophasic wave form pattern, and may be accepted as sensitive parameters of indicators of physiological adaptations related to pregnancy.

Serum copeptin level can be a helpful biomarker in evaluation of myocardial perfusion scintigraphy results.

BACKGROUND: Myocardial perfusion scintigraphy (MPS) is a well-established diagnostic tool. The sensitivity and specificity of single photon emission computed tomography (SPECT) MPS to detect significant coronary lesion were 86% and 74%, respectively. The aim of this study was to examine the role of serum copeptin in evaluation of MPS. METHODS: Sixty-two consecutive patients underwent both SPECT MPS using 99mTc-sestamibi and transthoracic echocardiography were enrolled prospectively. Age, gender, height, weight, presence of cardiovascular risk factors were recorded. Exercise treadmill test (ETT) with modified Bruce protocol was used to induce coronary ischemia during MPS. While performing MPS, blood samples for serum copeptin level were drawn three times at pre-exercise, at the peak of ETT, and 6 h after ETT, respectively. The patients were enrolled into three groups according to MPS results (normal, equivocal and ischemia). RESULTS: The study included 62 patients (23 with normal, 20 with equivocal, 19 with ischemia on MPS). Pre-, peak-, and post-exercise B-type natriuretic peptide and troponin I values were similar across the groups (p > 0.05 for all comparisons). Serum copeptin values for pre- and peak-exercise were similar among all groups (p = 0.883 and p = 0.089). Post-exercise copeptin values of the normal and equivocal groups were similar (p = 0.661, z = -0.438) while that of the ischemia group was significantly higher than both the normal (p < 0.001) and equivocal group (p < 0.001). CONCLUSIONS: Serum copeptin was found to be increasing significantly in case of ischemia on MPS. It may be used in differentiation of equivocal results from false positive results.

Clinical Significance of Lymphoscintigraphy Findings in the Evaluation of Lower Extremity Lymphedema.

OBJECTIVE: The purpose of this study was to investigate the clinical significance of lymphoscintigraphy imaging in the evaluation of lower extremity lymphedema. METHODS: Technetium-99m-labeled nanocolloid was injected subcutaneously in the first web spaces of both feet of 123 patients (M/F: 43/80, mean age 57.5±13.1 years, range 16-78 years) who had clinical evidence of lower extremity swelling with suspicion of lymphedema, and were referred for routine lymphoscintigraphy. Lymphoscintigraphy scan was started as dynamic viewing followed by static whole body imaging at 10 minute, 1 hour and 4 hours after injection. RESULTS: Eighty-seven patients had lymphedema. Patients who had lymphedema were divided into two groups according to their scintigraphy findings: Group I included 58 patients without uptake in the popliteal nodes, and group II included 29 patients with positive popliteal nodes. The rate of popliteal node visualization was higher in patients with dermal backflow as compared to those without dermal backflow (p<0.001). The duration of lymphedema was also longer in patients with dermal backflow and popliteal nodes (p<0.004). CONCLUSION: Lymphoscintigraphy is a reliable, easily applied and well-tolerated objective method to diagnose lower extremity lymphedema. Uptake by popliteal lymph nodes and the presence of dermal backflow on lymphoscintigraphy, which is performed for evaluation of the lower limb lymphedema, were important signs indicating longer disease duration and higher severity of lymphatic dysfunction.

Evaluation of bone density measurement in type 2 diabetic postmenopausal women with hypertension and hyperlipidemia.

OBJECTIVES: The aim of the study was to compare bone mineral density (BMD) in healthy postmenopausal women to BMD in type 2 diabetic hypertensive postmenopausal women with hyperlipidemia. METHODS: Fifty type 2 diabetic and hypertensive postmenopausal women with hyperlipidemia and 51 age and body mass index (BMI) matched healthy postmenopausal women were included. Lumbar spine and femoral neck BMD were noted in both groups. BMD was measured using dual energy X-ray absorptiometry (DXA). Serum alkaline phosphatase (ALP), calcium and phosphorous were also measured. Pearson correlation coefficients were used to establish the relationship between various clinical characteristics. RESULTS: There were no significant differences between two groups in respect to lumbar and vertebral BMD values, age, BMI, gravidity, parity. Serum cholesterol and fasting glucose levels were significantly different between each groups (P = 0.0001, P = 0.002). CONCLUSION: We found that, accompanying chronic diseases such as diabetes, hypertension and hyperlipidemia don't affect the BMD measurements at postmenopausal period. So these postmenopausal women don't have excess risk regarding osteoporosis.

Evaluation of the diagnostic and prognostic use of gated myocardial perfusion single-photon emission computed tomography in patients with acute chest pain: comparison with the SYNTAX score.

OBJECTIVE: The aim of this study was to evaluate the diagnostic and prognostic efficacy of gated single-photon emission computed tomography (GSPECT) in patients with acute chest pain and to compare quantitative GSPECT parameters and the coronary angiographic SYNTAX score. MATERIALS AND METHODS: A total of 168 patients who presented with clinical symptoms of acute chest pain were enrolled in the study. Study participants were divided into two groups according to the risk of acute coronary syndrome (ACS): low-intermediate and high risk. All participants underwent rest or stress-GSPECT (R/S-GSPECT). Coronary angiography was performed in all high-risk patients and the SYNTAX score was determined. All patients were followed for 24 ± 3 months and monitored for the occurrence of major adverse coronary events (MACE). RESULTS: Among patients with low-intermediate ACS risk, R-GSPECT and S-GSPECT were associated with 100 and 86% sensitivity, 99 and 98% specificity, 100 and 98% negative predictive value, 80 and 86% positive predictive value, and 98 and 97% accuracy, respectively. At follow-up, MACE occurred in 16 patients. Among high-risk patients, GSPECT quantitative parameters were the most significant predictors of MACE in Cox regression analysis. CONCLUSION: R/S-GSPECT, a noninvasive diagnostic method, is associated with an excellent safety profile and exceptional diagnostic and prognostic accuracy in cases of ACS.

The role of Tc-99m DTPA aerosol scintigraphy in the differential diagnosis of COPD and asthma.

OBJECTIVE: Chronic obstructive lung disease (COPD) and asthma are characterized as similar to each other in causing airway obstruction and being an inflammatory process. The purpose of this study was to investigate whether technetium-99m diethylenetriaminepentaacetic acid ((99m) Tc-DTPA) aerosol scintigraphy could be used in the differential diagnosis of asthma and COPD. METHODS: Eighty-four patients (male/female: 32/52; mean age 50.2 ± 12.7 years) with obstructive lung disease and 30 healthy volunteers as the control group were enrolled in the study. The patients were divided into two groups as COPD and asthma and also smoking subgroups. Alveolar clearance study was performed using a radiolabeled aerosol of (99m) Tc-DTPA. Mucociliary clearance was evaluated with T½ , cap value and penetration index parameters. All patient underwent pulmonary function tests and Forced expiratory volume (FEV1 ), forced vital capacity (FVC) and FEV1 /FVC parameters were obtained. RESULTS: The mean of T½ values of (99m) Tc-DTPA aerosol and FEV1 /FVC value among spirometric tests of the nonsmoking COPD patients were significantly lower than nonsmoking asthma patients (46.1 ± 14.3, 62.3 ± 18.7, P = 0.02; 65.2 ± 10.8, 81.4 ± 16.5, P = 0.04, respectively). The cap value was significantly higher in nonsmoking COPD patients (1.21 ± 0.49, 0.76 ± 0.22, P = 0.03). While there were no statistically and significantly different between control and asthmatic groups at the scintigraphic parameters and spirometric parameters, the mean of T½ values, cap value and spirometric parameters were statistically different between control and COPD groups (P < 0.05). CONCLUSION: We showed that assessment of mucociliary permeability with (99m) Tc-DTPA aerosol scintigraphy was a useful, easy to apply and a noninvasive technique to use in the differential diagnosis of nonsmoker COPD and asthma.

A Comparison between Quantitative Gated Myocardial Perfusion Scintigraphy and Strain Echocardiography as Indicators of Ventricular Functions in Patients with Anterior Myocardial Infarction.

The purpose of this study is to compare the strain echocardiographic and scintigraphic parameters for evaluating of the left ventricular (LV) functions in patients with anterior myocardial infarction (MI). Fifty-four patients (male/female: 36/18; mean age 62 ± 13 years) with anterior MI were prospectively enrolled. All patients were performed gated myocardial perfusion scintigraphy gated single-photon emission computed tomography (GSPECT) and echocardiography (EC). GSPECT data were processed and analyzed using 4D-MSPECT (4DM, Invia Medical Imaging Solutions, Ann Arbor, MI, USA). The echocardiographic strain (S) and strain rate (SR) values were calculated. The results obtained by these techniques were compared each other. A total of 918 segments of LV wall were evaluated. In all patients, 385 segments were automatically scored as normokinetic, 206 as hypokinetic, 122 as akinetic, 205 as dyskinetic and 300 as normal thickening, 348 as decrease thickening and 270 as no thickening. The means of S and SR values in thickening and motion score groups according to GSPECT were statistically different from each other (P < 0.001). There was a negative significant correlation between LV wall thickening sum score and S and SR and between LV wall motion sum score and S and SR (P < 0.001). There was a good correlation between GSPECT and echocardiographic LV-ejection fraction (r = 0.7, P < 0.001). GSPECT and strain EC are similar in quantitative grading of the severity of regional and global myocardial dysfunction in patients with anterior MI and these techniques provide valuable diagnostic information.

Relationship between kidney volume and body indexes in the Turkish population determined using ultrasonography

Objective To estimate the kidney volume of the healthy Turkish population using ultrasound and to evaluate the relationship between kidney volume and body indexes. Materials and methods Kidney ultrasound evaluation was performed on 152 patients (mean age: 42±13.7 years). Kidney length, width and thickness were measured using ultrasound. Mean total and parenchymal volume were also calculated. Patients’ age, sex, weight, height and body mass index (BMI) (kg/m2) were recorded. Results According to ultrasound, kidney lengths were 10.3±7.8 cm for the right and 10.4±9 cm for the left. Volumes were 158±39 cm3 for the right and 168±40 cm3 for the left. Volumes in women were 151.8±39 cm3 for the right and 159.8±37 cm3 for the left, and 164.3±38 cm3 for the right and 175.8±41 cm3 for the left in men. Kidney measurements correlated with body height and weight. A strong correlation with total kidney volume and kidney measurements was determined for body weight for both kidneys (p<0.001). A significant correlation with kidney volume and width was determined for both kidneys (p<0.001). A positive correlation was also found between parenchymal and total kidney volume for both kidneys (p<0.001). Conclusion The most significant factors associated with kidney volume for both kidneys in the Turkish population are kidney width and body weight. Measuring kidney volume with ultrasound is a feasible modality and is widely available for daily clinical practice. .

Mean platelet volume is associated with myocardial perfusion defect in diabetic patients.

AIM: Our aim was to evaluate whether there was a relationship between mean platelet volume and myocardial perfusion defect in diabetic patients using myocardial perfusion imaging. METHODS: Forty-four diabetic patients with myocardial perfusion defect (group 1) and 44 diabetic patients without myocardial perfusion defect (group 2), matched for age and gender, were retrospectively examined. Levels of mean platelet volume (MPV) in the two groups were assessed. RESULTS: MPV was higher in group 1 than group 2 patients (8.76 ± 0.76 and 8.25 ± 0.78 fl), respectively, p = 0.003). Levels of glucose, triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, haemoglobin (Hb) and glycosylated haemoglobin (HbA1c), and body mass index (BMI) in the two groups were not statistically significantly different. Multivariate logistic regression analyses showed that MPV was the only variable independently associated with myocardial perfusion defects (OR: 2.401, 95% CI: 1.298-4.440, p = 0.013). CONCLUSION: This study showed that higher MPV was associated with myocardial perfusion defects. Higher MPV in diabetic patients was independently related to myocardial perfusion defects and may be an indicator of myocardial ischaemia.

Can left ventricular parameters examined by gated myocardial perfusion scintigraphy and strain echocardiography be prognostic factors for major adverse cardiac events?

Assessment of left ventricular (LV) function in patients with myocardial infarction (MI) provide useful diagnostic and prognostic information. Up to date, single photon emission tomography (SPET), positron emission tomography (PET), multidetector computed tomographic angiography, echocardiography (EC) and magnetic resonance imaging (MRI), have been used to examine LV parameters. However, due to limitations of some imaging methods, new studies are directed to improve myocardium function evaluation. In conclusion, SEC and GSPET can be applied to semi-quantitatively assess LVEF and regional wall motion abnormalities in a noninvasive manner. These techniques can provide strong diagnostic and prognostic information related to anterior myocardial infarction. In addition to this, nitrate enhanced GSPET allows to identify stunning and hibernating myocardium. New methods of reconstruction on GSPET systems will better improve image quality using lower count rates.

Is there a relationship between symptoms of patients and tomographic characteristics of styloid process?

OBJECTIVES: To investigate the angulations and length of the styloid process (SP) on three-dimensional computed tomography (3D-CT) images between the patients having elongated SP complaints and those without any stylalgia symptoms. PATIENTS AND METHODS: One hundred patients underwent 3D-CT evaluation of the bilateral temporomandibular joints to investigate for symptomatic elongated styloid process (ESP) at our institution. The differences between the mean angulations and lengths of the SP and comparisons between patient and control groups were analyzed by student t test. RESULTS: In study group, mean length of styloid processes was 40.7 ± 10.8 mm on the right and 40.3 ± 10.9 mm on the left. Mean medial angles of SP were measured as 22.60 ± 4.0 on the right side and 22.60 ± 4.5 on the left side. In the same group, mean anterior angles of SP were 16.10 ± 6.9 on the right and 16.70 ± 7.1 on the left side. The "in-group" comparisons of lengths, medial and anterior angles did not produce statistically significant results. The comparison of medial angulations between the symptomatic and asymptomatic patients was the only statistically meaningful result in our study. CONCLUSION: 3D-CT has several advantages according to conventional tomography for visualization of head and neck anatomy. The increase of medial angulation of SP may be responsible for the development of complaints in ESP.

Relationship between kidney volume and body indexes in the Turkish population determined using ultrasonography.

OBJECTIVE: To estimate the kidney volume of the healthy Turkish population using ultrasound and to evaluate the relationship between kidney volume and body indexes. MATERIALS AND METHODS: Kidney ultrasound evaluation was performed on 152 patients (mean age: 42 ± 13.7 years). Kidney length, width and thickness were measured using ultrasound. Mean total and parenchymal volume were also calculated. Patients' age, sex, weight, height and body mass index (BMI) (kg/m²) were recorded. RESULTS: According to ultrasound, kidney lengths were 10.3 ± 7.8 cm for the right and 10.4 ± 9 cm for the left. Volumes were 158 ± 39 cm3 for the right and 168 ± 40 cm3 for the left. Volumes in women were 151.8 ± 39 cm3 for the right and 159.8 ± 37 cm3 for the left, and 164.3 ± 38 cm3 for the right and 175.8 ± 41 cm3 for the left in men. Kidney measurements correlated with body height and weight. A strong correlation with total kidney volume and kidney measurements was determined for body weight for both kidneys (p<0.001). A significant correlation with kidney volume and width was determined for both kidneys (p<0.001). A positive correlation was also found between parenchymal and total kidney volume for both kidneys (p<0.001). CONCLUSION: The most significant factors associated with kidney volume for both kidneys in the Turkish population are kidney width and body weight. Measuring kidney volume with ultrasound is a feasible modality and is widely available for daily clinical practice.