The Usefulness of Scintigraphic Studies in the Assessment of Asymptomatic Bowel Disease in Patients with Primary Antibody Diseases.

Enteropathy may be the first presentation of immunodeficiency or it may occur during the course of the disease and in association with malabsorption in patients affected by primary antibody diseases. For these patients, immunoglobulin G (IgG) replacement therapy prevents infectious and non-infectious complications. Nonetheless some patients cannot achieve optimal IgG trough levels, even when treated with high Ig doses in absence of protein-losing syndromes. We investigated seven patients affected by common variable immunodeficiencies (CVIDs) and treated with high Ig doses (600-800 mg/kg/month) showing low IgG trough level. Patients underwent abdominal scintigraphy with human polyclonal immunoglobulin G labeled with 99mTc and with white blood cells labeled by 111 Indium-oxinate to investigate asymptomatic bowel inflammation. A concentration of labeled leukocytes in abdominal segments greater than that observed with human polyclonal immunoglobulin G was evident only in one patient. In five patients a slight concentration of both radiopharmaceuticals was reported, due to mild intestinal inflammatory response. These data might be related to mild increase of capillary permeability in the absence of inflammation leukocyte mediated. This study discloses a new cause of IgG-accelerated catabolism due to inflammatory bowel conditions without diarrhea in CVID patients.

Cerebral perfusional effects of 1-year rivastigmine treatment in Alzheimer disease: a case report.

It is described the case of a 74-years-old woman with probable Alzheimer Disease who showed good clinical response to rivastigmine associated with relevant improvement of cerebral perfusion after 1 year of treatment. The single-photon emission computed tomography (SPECT) scan showed a significant improvement in cortical uptake of the tracer in temporo-parietal and frontal regions in comparison to the examination performed before the treatment.

Effect of external magnetic field on IV 99mTc-labeled aminosilane-coated iron oxide nanoparticles: demonstration in a rat model: special report.

Among the most interesting applications of ferromagnetic nanoparticles (NPs) in medicine is the potential for localizing pharmacologically or radioactively tagged agents directly to selected tissues selected by an adjustable external magnetic field. This concept is demonstrated by the application external magnetic field on IV Tc-labeled aminosilane-coated iron oxide NPs in a rat model. In a model comparing a rat with a 0.3-T magnet over a hind paw versus a rat without a magnet, a static acquisition at 45 minutes showed that 27% of the administered radioactivity was in the area subtended by the magnet, whereas the liver displays a percentage of binding of 14% in the presence of the magnet and of 16% in the absence of an external magnetic field. These preliminary results suggest that the application of an external magnetic field may be a viable route for the development of methods for the confinement of magnetic NPs labeled with radioactive isotopes targeted for predetermined sites of the body.

Multiple metastases of soft tissue visualized by technetium-99m-methylene diphosphonate scintigraphy: a case report.

INTRODUCTION: Lungs and liver are the most common sites of colorectal cancer metastases after regional lymph nodes, but metastases to unusual sites are reported. Heterotopic bone formation in soft tissues from colorectal cancer is a rare metastatic occurrence. CASE PRESENTATION: We present the case of a 29-year-old Caucasian man affected by colon adenocarcinoma with multiple soft tissue metastases visualized by magnetic resonance imaging, computed tomography scan and scintigraphic bone scan. We suppose that these findings can be due to the fact that the tracer is concentrated in the ossification nidus of soft metastases. CONCLUSIONS: Our experience suggests that, in the presence of colon adenocarcinoma, a bone scan could be a sensible tool to highlight bone lesions or heterotopic bone nidus in soft tissues and that any subcutaneous lesion should be resected to avoid underestimating a potential malignancy.

Advanced imaging for the early diagnosis of local recurrence prostate cancer after radical prostatectomy.

Currently the diagnosis of local recurrence of prostate cancer (PCa) after radical prostatectomy (RT) is based on the onset of biochemical failure which is defined by two consecutive values of prostate-specific antigen (PSA) higher than 0.2 ng/mL. The aim of this paper was to review the current roles of advanced imaging in the detection of locoregional recurrence. A nonsystematic literature search using the Medline and Cochrane Library databases was performed up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of PET/CT in the restaging of PCa after RP; the second part is intended to provide the impact of multiparametric-MRI (mp-MRI) in the depiction of locoregional recurrence. Published data indicate an emerging role for mp-MRI in the depiction of locoregional recurrence, while the performance of PET/CT still remains unclear. Moreover Mp-MRI, thanks to functional techniques, allows to distinguish between residual glandular healthy tissue, scar/fibrotic tissue, granulation tissue, and tumour recurrence and it may also be able to assess the aggressiveness of nodule recurrence.

Labelling of granulocytes by phagocytic engulfment with 64Cu-labelled chitosan-coated magnetic nanoparticles.

PURPOSE: The aim of the present work was to perform the labelling of granulocytes by their engulfment with chitosan-coated magnetic (64)Cu nanoparticles (MNPs) in order to obtain a radiopharmaceutical suitable for dual imaging (PET-MRI) of inflammatory/infective diseases. PROCEDURES: Specimens of 5-20 mg MNPs were washed with saline-isotonic solution and recuperated by magnetic decantation; 15-58 µg Cu(2+) (CuCl(2)·H(2)O) in 50 µl of acidified (pH 5.5) saline solution was added to the MNPs re-suspended saline-isotonic solution; 10 mg MNPs was allowed to react with 16 µg (64)Cu [(64)Ni(p,n) at 12-9 MeV] followed by anion exchange chromatography with a specific activity of 56 MBq/µg. Pellets of granulocytes were obtained from peripheral blood; MNPs engulfment by granulocytes was obtained and granulocyte-engulfed viability was assessed by the trypan blue exclusion (TBE) test performed at 5 min, 2 h and 4 h; assessment of the release of (64)Cu from labelled granulocytes in plasma was performed by measuring the radioactivity of both the cellular pellet and the supernatant solution. RESULTS: Our data showed the binding capacity of chitosan-coated MNPs for cationic metal. The amount of Cu(+2) chelated captured per milligram of MNPs was constant and independent of the reagent concentrations. In all cases, more than 90% of the engulfed granulocytes were positive to the TBE test. The MNPs were localised within the cells. CONCLUSION: In our in vitro model, MNPs are taken up by granulocytes through phagocytosis, whereas previously described methods were based on the use of a chelating agent that permit Cu to cross the cell membrane. Moreover, the (64)Cu-engulfed granulocytes showed a high stability of up to 80% of retained radioactivity after 24 h of incubation.

The labeled-leukocyte scan in the study of abdominal abscesses.

AIM: The purpose of the present paper was to review the literature over the last 30 years to assess the value of radionuclide imaging, particularly labeled leukocyte scan, as compared to other imaging modalities in the management of abdominal abscesses. METHODS: A systematic review of the published studies in humans cited in PubMed written in English, French, German, Italian, and Spanish was made. RESULTS: Ultrasound (US) has lower sensitivity than leukocyte scan (LS), particularly in patients without localizing signs, while CT has higher sensitivity than US, but less than LS. On the other hand, CT had higher specificity than both LS and US. DISCUSSION: LS is the more sensitive method to localize abdominal abscesses and may guide dedicated US and CT investigations to improve their diagnostic potential. Further diagnostic evolution is expected from the routine use of hybrid SPECT/CT systems.