Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 854
Filtrar
1.
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
2.
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
3.
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
4.
Clin Nucl Med ; 45(2): 105-112, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31876822

RESUMO

BACKGROUND: Tc-MIP-1404 is a SPECT-suitable prostate-specific membrane antigen (PSMA) ligand for detection of prostate cancer. In patients with metastatic prostate cancer, there are no data as yet on interobserver and intraobserver variability when assessing PSMA-positive lesions for longitudinal changes of tracer uptake. METHODS: Tc-MIP-1404 SPECT/CT scans of 22 patients with metastatic prostate cancer were analyzed, and each subject was imaged at 2 separate points in time, before and after treatment. Mean interval between scans was 10 months. Three independent observers visually assessed a total of 96 PSMA-positive metastases (bone, 69; lymph node, 22; viscera, 3) or local recurrences (n = 2) for longitudinal changes in tracer uptake on planar scintigraphy and SPECT/CT. All lesions were categorized as regressive, stable, or progressive based on visual findings and on peak SUV (SUVpeak) of quantitative SPECT/CT (progressive, >30% SUVpeak increase; regressive, <30% SUVpeak decrease; or stable, all others). RESULTS: Quantitative analysis of PSMA-positive lesions yielded significantly higher interobserver agreement (90.6%; 95% confidence interval [CI], 0.83%-0.96%) than visual assessments by either SPECT/CT (76.0%; 95% CI, 0.66%-0.84%) or planar scintigraphy (56.3%; 95% CI, 0.46%-0.66%). Intermethod comparison of aggregated results yielded significantly higher agreement between quantitative and visual SPECT/CT (85.1%; 95% CI, 0.80%-0.89%), as opposed to quantitative SPECT/CT and planar scintigraphy (53.1%; 95% CI, 0.47%-0.59%) or visual SPECT/CT and planar scintigraphy (54.9%; 95% CI, 0.49%-0.61%). In visual and quantitative analysis of 96 PSMA-positive lesions, the number of discrepancies ranged from 9 (9.4%) for quantitative SPECT/CT to 42 (43.8%) for planar scintigraphy. Overall reader confidence was higher for SPECT/CT than for planar scintigraphy (P < 0.001). Intraobserver agreement was near-perfect for all methods, whether SPECT/CT (visual, all κ = 0.94-0.97; quantitative κ = 0.94-0.98) or planar scintigraphy (all κ = 0.90-0.94). CONCLUSIONS: Quantitative evaluation of longitudinal change in tracer uptake by PSMA-positive lesions measured via SPECT/CT is superior to visual interpretation of images by planar scintigraphy or SPECT/CT. Compared with visual evaluation, quantitative SPECT/CT is highly reproducible, showing near-perfect agreement among observers and higher reader confidence.


Assuntos
Antígenos de Superfície/metabolismo , Glutamato Carboxipeptidase II/metabolismo , Compostos de Organotecnécio , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Variações Dependentes do Observador , Neoplasias da Próstata/metabolismo
5.
Clin Nucl Med ; 45(1): 60-62, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31693613

RESUMO

We report a large mobile bladder calculus with intense Tc-MDP uptake demonstrated on both whole-body bone scintigraphy and SPECT/CT images in a patient with complicated chronic history of urolithiasis and urinary tract infection. Bone tracer uptake in bladder calculus is a rare phenomenon and might be related to the composition and matrix of calculus, direct exposure to excreted radiotracer, and bacterial colonization on the surface of calculus.


Assuntos
Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Cálculos da Bexiga Urinária/diagnóstico por imagem , Humanos , Masculino , Compostos Radiofarmacêuticos , Medronato de Tecnécio Tc 99m
6.
Clin Nucl Med ; 45(1): 87-89, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31714275

RESUMO

A 6-year-old girl with high-risk neuroblastoma underwent a I-MIBG scan to monitor the disease status. In addition to the known lesion in the right retroperitoneal region, there were additional foci of increased activity in the right upper quadrate of the abdomen, which were not typical bowel activity. SPECT/CT images located the activity in the cortex of the lower pole of the right kidney, which was partially calcified. Subsequent biopsy confirmed neuroblastoma metastasis to the right kidney, which is extremely rare.


Assuntos
Neoplasias Renais/diagnóstico por imagem , Neuroblastoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , 3-Iodobenzilguanidina , Criança , Feminino , Humanos , Neoplasias Renais/secundário , Neuroblastoma/patologia , Compostos Radiofarmacêuticos
7.
Clin Nucl Med ; 45(1): 90-91, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31789915

RESUMO

A 64-year-old woman with a history of cirrhosis and progressive difficulty breathing underwent pulmonary ventilation/perfusion SPECT to evaluate possible pulmonary embolism. The images demonstrated multiple mismatched ventilation/perfusion defects in both lungs, suggesting pulmonary embolism. However, there was also Tc-MAA radioactivity in the brain and bilateral kidney, with a right-to-left shunting rate of 8.8%. In addition, CT pulmonary angiography did not demonstrate embolus. The findings indicated that perfusion defects were caused by hepatopulmonary syndrome.


Assuntos
Síndrome Hepatopulmonar/diagnóstico por imagem , Embolia Pulmonar/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Angiografia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos , Compostos de Sulfidrila , Agregado de Albumina Marcado com Tecnécio Tc 99m
8.
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
9.
Cancer Imaging ; 19(1): 77, 2019 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31783917

RESUMO

BACKGROUND: Kirsten rat sarcoma viral oncogene homolog (KRAS) and epidermal growth factor receptor (EGFR) are the two most frequent and well-known oncogene of lung adenocarcinoma. The purpose of this study is to compare the characteristics measured with dual-energy spectral computed tomography (DESCT) in lung adenocarcinoma patients who have KRAS and EGFR gene mutations. METHODS: Patients with surgically resected lung adenocarcinoma (n = 72) were enrolled, including 12 patients with KRAS mutations and 60 patients with EGFR mutations. DESCT quantitative parameters, including the CT number at 70 keV, the slopes of the spectral attenuation curves (slope λ HU), normalized iodine concentration (NIC), normalized water concentration (NWC), and effective atomic number (effective Z), were analyzed. A multiple logistic regression model was applied to discriminate clinical and DESCT characteristics between the types of mutations. RESULTS: The KRAS mutation was more common in people who smoked than the EGFR mutation. Nodule type differed significantly between the KRAS and EGFR groups (P = 0.035), and all KRAS mutation adenocarcinomas were solid nodules. Most DESCT quantitative parameters differed significantly between solid nodules and subsolid nodules. CT number at 70 keV, slope λ HU, NIC, and effective Z differed significantly between the KRAS and EGFR groups (P = 0.006, 0.017, 0.013 and 0.010) with solid lung adenocarcinoma. Multivariate logistic analysis of DESCT and clinical features indicated that besides smoking history, the CT value at 70 keV (OR = 0.938, P = 0.009) was significant independent factor that could be used to differentiate KRAS and EGFR mutations in solid lung adenocarcinoma. CONCLUSIONS: DESCT would be a potential tool to differentiate lung adenocarcinoma patients with a KRAS mutation from those with an EGFR mutation.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/genética , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/cirurgia , Adulto , Idoso , Animais , Receptores ErbB/genética , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Mutação , Ratos , Estudos Retrospectivos
11.
Clin Nucl Med ; 44(12): 929-935, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31689274

RESUMO

PURPOSE: The aim of this study was to assess the value of intravenously contrast-enhanced CT in conjunction with Tc-MIBI SPECT for preoperative localization of parathyroid adenoma. METHODS: One hundred ninety-two patients with primary hyperparathyroidism were enrolled in the study between May 2015 and May 2017. The patients underwent a preoperative "one-stop shop" examination with Tc-MIBI SPECT/CT by using dual time-point (10 and 90 minutes) protocol and both nonenhanced CT and contrast-enhanced CT acquisition in the arterial and venous phase, 35 and 75 seconds, respectively, after contrast medium injection start. For 149 patients, the imaging results could be correlated to those at surgery and histopathology. RESULTS: The median adenoma weight was 330 mg. The addition of contrast-enhanced CT increased the sensitivity from 81.1% to 89.9% (P = 0.003). The specificity of nonenhanced SPECT/CT was similar to contrast-enhanced CT (96.1% vs 97.9%; P = 0.077). For patients with uniglandular disease (n = 140, 94.0%), the sensitivity increased from 86.4% to 93.6% (P = 0.021) and the specificity from 96.2% to 97.9% (P = 0.118) by adding contrast-enhanced CT. In patients with multiglandular disease (n = 9, 6.0%), adding contrast-enhanced CT improved detection sensitivity from 42.1% to 63.2%. However, these patients were few and significance was not reached (P = 0.125). CONCLUSIONS: In this cohort, with generally small parathyroid adenomas, the sensitivity in preoperative localization was greatly improved by adding contrast-enhanced CT to Tc-MIBI SPECT/CT.


Assuntos
Adenoma/diagnóstico por imagem , Meios de Contraste/química , Iodo/química , Neoplasias das Paratireoides/diagnóstico por imagem , Período Pré-Operatório , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adenoma/patologia , Adenoma/cirurgia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/cirurgia , Sensibilidade e Especificidade , Tecnécio Tc 99m Sestamibi , Carga Tumoral
12.
Medicine (Baltimore) ; 98(46): e16525, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725599

RESUMO

To evaluate the clinical value of NeuroGam software in assessing the brain foci perfusion changes by TC-ECD single photon emission computed tomography/computed tomography (SPECT/CT) brain imaging in patients with Moyamoya Disease (MMD).Seventy-two patients with MMD who underwent superficial temporal artery-middle cerebral artery (STA-MCA) bypass combined with encephalo-duro-myo-synangiosis (EDMS) surgical revascularization were included. Baseline and follow-up TC-ECD SPECT/CT brain scans were performed on all patients at least twice before and after operation. Pre- and post-SPECT dicom images were reoriented into Talairach space using NeuroGam Software package. Additional visual analysis was performed. Differences mean pixel value between pre- and post- operation brain perfusion were assessed with paired t test and McNemar test.Significant differences in the number of hypoperfusion foci were found between visual assessment and NeuroGam aided assessment. More hypoperfusion foci were found by NeuroGam software aided assessment in the frontal, parietal, temporal, occipital lobe, thalamus, basal ganglia and cerebellum before and after surgery (P < .0001). According to NeuroGam software assessment, the perfusion of frontal, parietal, temporal lobe, anterior and middle cerebral regions on the operative side significantly improved before and after surgery (t = -3.734, t = -3.935, t = -5.099, t = -4.006, t = -5.170, all P < .001). However, no significant differences were found in the occipital lobe (t = -1.962, P = .054), thalamus (t = 1.362, P = .177), basal ganglia (t = -2.394, P = .019), and cerebellum (t = 1.383, P = .171) before and after surgery.The NeuroGam software provides a quantitative approach for monitoring surgical effect of MMD in a variable time (3-12 months after surgery). It could discover the perfusion changes that are neglected in conventional visual assessment.


Assuntos
Cisteína/análogos & derivados , Interpretação de Imagem Assistida por Computador/métodos , Doença de Moyamoya/diagnóstico por imagem , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/estatística & dados numéricos , Adolescente , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/cirurgia , Revascularização Cerebral/métodos , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Cerebral Média/cirurgia , Doença de Moyamoya/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Software , Artérias Temporais/cirurgia , Resultado do Tratamento , Adulto Jovem
13.
Zhonghua Zhong Liu Za Zhi ; 41(11): 801-804, 2019 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-31770845

RESUMO

Internal mammary lymph node (IMLN) metastasis forms the part of the N-staging of breast cancer, and affects the treatment program and prognosis. At present, IMLN metastasis is clinically diagnosed by anatomical imaging, functional imaging and postoperative pathology. Anatomical imaging includes ultrasound, CT and MRI. Functional image includes positron emission computed tomography (PET-CT), PET-MRI, single photon emission computed tomography (SPECT) and SPECT-CT. Because of the special location of the internal mammary region and the complex anatomical structure around it, the imaging diagnosis rate and pathological diagnosis rate of IMLN are often different. Therefore, it is important to identify the relevant factors of IMLN metastasis for guiding the local treatment of internal mammary region, including the scope of surgery and radiotherapy.


Assuntos
Neoplasias da Mama/patologia , Metástase Linfática/patologia , Neoplasias da Mama/diagnóstico por imagem , Humanos , Incidência , Linfonodos/patologia , Metástase Linfática/diagnóstico por imagem , Imagem por Ressonância Magnética , Estadiamento de Neoplasias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Fatores de Risco , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
14.
Am Surg ; 85(9): 939-943, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638503

RESUMO

Reoperative parathyroid surgery (REOPS) is often associated with lower cure rates and greater risk of nerve injury and hypoparathyroidism. The aim of this study was to evaluate cure rates, pathology, complications, and the efficacy of preoperative localization in patients requiring REOPS. Between 1992 and 2017, 2491 consecutive patients underwent parathyroidectomy for primary hyperparathyroidism. With Institutional Review Board approval, our prospectively collected parathyroidectomy outcomes database was queried for operative findings, outcomes, pathology, and localization methodology. Three hundred forty-six patients had REOPS (111 men/32% and 235 women/68%), with an overall cure rate of 91 per cent and a mean follow-up of 1.9 ± 0.7 years. The average preoperative serum calcium and parathyroid hormone were 11 ± 1 mg/dL and 373 ± 796 pg/mL, respectively. Normalization of intraoperative parathyroid hormone occurred in 248 patients and it was predictive of cure in 98.8 per cent of patients. A single adenoma was resected in 253 patients (75%), and the superior gland location was most common at 57 per cent. Ectopic glands were identified in only 33 patients. When preoperative imaging localized a lesion, a tumor was identified in that location in 75.4 per cent of sestamibi or SPECT/CT scans, 57.8 per cent of CT, 61.2 per cent of MRI, and 46.2 per cent of US. When at least two imaging modalities were concordant, sensitivity improved to 91.6 per cent (P < 0.001). Complication rates of permanent hypoparathyroidism and recurrent nerve palsy occurred in 0.03 per cent of patients. REOP for recurrent or persistent primary hyperparathyroidism has a cure rate of 91 per cent. Most missed parathyroid tumors are in the neck, and multimodal imaging improves preoperative localization and success.


Assuntos
Adenoma/cirurgia , Hiperparatireoidismo Primário/cirurgia , Neoplasias das Paratireoides/cirurgia , Paratireoidectomia/métodos , Reoperação , Adenoma/sangue , Adenoma/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cálcio/sangue , Feminino , Seguimentos , Humanos , Hiperparatireoidismo Primário/sangue , Hiperparatireoidismo Primário/diagnóstico por imagem , Hipoparatireoidismo , Masculino , Pessoa de Meia-Idade , Paralisia , Hormônio Paratireóideo/sangue , Neoplasias das Paratireoides/sangue , Neoplasias das Paratireoides/diagnóstico por imagem , Paratireoidectomia/efeitos adversos , Complicações Pós-Operatórias , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Tecnécio Tc 99m Sestamibi , Adulto Jovem
15.
BMC Neurol ; 19(1): 260, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660902

RESUMO

BACKGROUND: Parkinsonism is a complex multifactorial neurodegenerative disorder, in which genetic and environmental risk factors may both play a role. Among environmental risk factors cocaine was earlier ambiguously linked to Parkinsonism. Former single case reports described Parkinsonism in chronic cocaine users, but an epidemiological study did not confirm an increased risk of Parkinson's disease. Here we report a patient, who developed Parkinsonism in young age after chronic cocaine use, in whom a homozygous LRRK2 risk variant was also detected. CASE PRESENTATION: The patient was investigated because of hand tremor, which started after a 1.5-year period of cocaine abuse. Neurological examination suggested Parkinsonism, and asymmetrical pathology was confirmed by the dopamine transporter imaging study. The genetic investigations revealed a homozygous risk allele in the LRRK2 gene. After a period of cocaine abstinence, the patient's symptoms spontaneously regressed, and the dopamine transporter imaging also returned to near-normal. CONCLUSIONS: This case report suggests that cocaine abuse indeed might be linked to secondary Parkinsonism and serves as an example of a potential gene-environmental interaction between the detected LRRK2 risk variant and cocaine abuse. The reversible nature of the DaTscan pathology is a unique feature of this case, and needs further evaluation, whether this is incidental or can be a feature of cocaine related Parkinsonism.


Assuntos
Transtornos Relacionados ao Uso de Cocaína/complicações , Interação Gene-Ambiente , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/genética , Doença de Parkinson/etiologia , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Humanos , Masculino , Neuroimagem/métodos , Doença de Parkinson/diagnóstico por imagem , Doença de Parkinson/patologia , Fatores de Risco , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
16.
Nucl Med Commun ; 40(11): 1158-1165, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31609880

RESUMO

PURPOSE: Sickle cell disease (SCD) is a common hematologic hereditary disorder characterized by vaso-occlusive episodes affecting multiple organs, and substantially alters renal structure and function. We aimed to evaluate the utility of renal scintigraphy and single photon emission computed tomography/computed tomography (SPECT/CT) with technetium-99m-dimercaptosuccinic acid (Tc-DMSA) in adult patients with SCD and no clinical evidence of renal insufficiency. MATERIALS AND METHODS: Twenty-six patients (16 female) aged 23-58 years with SCD and no clinical evidence of renal insufficiency were prospectively studied. Planar and SPECT/CT images were, respectively, obtained after 3 and 4 hours of the injection of 110-180 MBq of Tc-DMSA. The relative radiopharmaceutical uptake and renal length were, respectively, determined using SPECT and CT images. Planar and SPECT/CT images were visually analyzed to identify focal areas of Tc-DMSA reduced uptake and anatomical deformities of the kidneys. RESULTS: Focal areas of reduced Tc-DMSA uptake with an image aspect of renal scars or inflammation were present in 21/26 patients (81%). In 11/21 (52%) of these patients, the cortical lesions were clearly identified only on SPECT images. Prominent renal columns were observed in 17/26 (65%) patients. The left kidney tended to be more affected than the right kidney. Most patients had enlarged kidneys. CONCLUSION: Tc-DMSA scintigraphy and SPECT/CT identify renal lesions possible related to renal infarcts or infections in most adult patients with SCD and no clinical evidence of renal insufficiency. Prominent renal columns and increased renal size tend to occur in most of these patients.


Assuntos
Anemia Falciforme/diagnóstico por imagem , Anemia Falciforme/fisiopatologia , Rim/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Ácido Dimercaptossuccínico Tecnécio Tc 99m , Adulto , Anemia Falciforme/patologia , Feminino , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
J Stroke Cerebrovasc Dis ; 28(12): 104400, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31606321

RESUMO

BACKGROUND AND OBJECTIVES: Ischemic stroke (IS) and coronary artery disease (CAD) share common risk factors and one may be the harbinger of the other. We aimed to study prevalence of symptomatic and asymptomatic CAD in a cohort of consecutive patients with IS and assess its relationship with intracranial and extracranial large artery cerebrovascular disease (LAD). METHODS: All consecutive eligible IS and Transient Ischemic Attack (TIA) patients were recruited into the study. Both clinically suspected and asymptomatic patients (N = 259) underwent myocardial Stress-rest Gated Technetium-99m (Tc99m) MIBI Myocardial Perfusion SPECT scan performed on a dual head SPECT-CT to estimate evidence of myocardial ischemia. RESULTS: Three hundred patients completed the study. Forty one patients were previously diagnosed cases of definitive CAD. Twelve patients were clinically suspected to have CAD and 247 patients were asymptomatic. Among these, 12 patients (4.81%) had a positive SPECT. The overall prevalence of CAD was 17.67% (n = 53). Presence of diabetes was an independent predictor of CAD (OR 1.98, 95% CI 1.07-3.67. P .02). No significant association was found between the presence of LAD and CAD in all subgroup comparisons. However, there was a suggestion of higher LAD among patients with known CAD compared with others. CONCLUSIONS: CAD is prevalent in patients with ischemic stroke. No definitive relationship was found between CAD and intracranial or extracranial LAD. Population based stratification tools are needed to further assess the need to detect subclinical CAD in patients with stroke.


Assuntos
Isquemia Encefálica/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Ataque Isquêmico Transitório/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Isquemia Encefálica/diagnóstico por imagem , Doença da Artéria Coronariana/diagnóstico por imagem , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Ataque Isquêmico Transitório/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Imagem de Perfusão do Miocárdio/métodos , Prevalência , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Adulto Jovem
19.
Endocrinology ; 160(12): 2959-2968, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31613319

RESUMO

Longitudinal observation of pancreatic ß-cell mass (BCM) remains challenging because noninvasive techniques for determining BCM in vivo have not been established. Such observations would be useful for the monitoring of type 2 diabetes mellitus, a progressive disease involving loss of pancreatic BCM and function. An indium 111 (111In)-labeled exendin-4 derivative ([Lys12(111In-BnDTPA-Ahx)]exendin-4) targeting the glucagon-like peptide-1 receptor has been developed recently as a promising probe for quantifying the BCM noninvasively. In the present study, we used the 111In-exendin-4 single-photon emission CT/CT (SPECT/CT) technique to investigate the efficacy of DS-8500a, a novel G protein-coupled receptor-119 agonist currently under investigation for type 2 diabetes mellitus treatment in prediabetic db/db mice under dietary restriction. During the 8-week study, the treatment of mice with DS-8500a delayed and attenuated the progression of glucose intolerance compared with mice under dietary restriction alone. 111In-exendin-4 SPECT/CT of db/db mice revealed continuously decreasing radioactive isotope (RI) intensity in the pancreas during the 8-week intervention. DS-8500a attenuated this decrease and preserved pancreatic RI accumulation compared with dietary restriction alone at the end of the observation period. This result was corroborated not only by ex vivo pancreatic analysis using the [Lys12(111In-BnDTPA-Ahx)]exendin-4 probe but also by conventional histological BCM analysis. These results indicate that DS-8500a attenuates the progression of BCM loss beyond that of dietary restriction alone in prediabetic db/db mice. These results have shown that 111In-exendin-4 SPECT/CT will be useful for noninvasive longitudinal investigation of BCM in vivo.


Assuntos
Benzamidas/farmacologia , Ciclopropanos/farmacologia , Diabetes Mellitus Experimental/diagnóstico por imagem , Hipoglicemiantes/farmacologia , Células Secretoras de Insulina/efeitos dos fármacos , Oxidiazóis/farmacologia , Receptores Acoplados a Proteínas-G/agonistas , Animais , Benzamidas/uso terapêutico , Ciclopropanos/uso terapêutico , Diabetes Mellitus Experimental/tratamento farmacológico , Exenatida , Hipoglicemiantes/uso terapêutico , Radioisótopos de Índio , Estudos Longitudinais , Masculino , Camundongos Endogâmicos C57BL , Oxidiazóis/uso terapêutico , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
20.
Phys Med ; 64: 109-113, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31515009

RESUMO

PURPOSE: This paper aims to review the dosimetry and utility of currently implemented imaging modalities for assessment of multiple myeloma and consider the role of tin filtration computed tomography (CT) as a potential replacement to current standard practice. METHODS: Radiation output of tin CT was measured experimentally and used for software-based dose calculation. Resultant effective dose was then compared to calculated planar radiography doses and published doses of other imaging modalities. RESULTS: Based on example patient parameters used for modalities and 14 projection planar radiography site protocols, doses are comparable between planar radiography and tin filtration CT (approximately 0.9 and 1.0 mSv respectively). Both studies carried a reduced radiation burden compared to Expected Pathologically Increased Contrast-CT (EPIC-CT), FDG-PET and MIBI SPECT/CT (5.7, 11.1-20.0 and 13.0 mSv respectively). CONCLUSION: Tin filtered CT provided visualisation of multiple myeloma at doses comparable to planar radiography and where available may be a suitable alternative, following due consideration of patient specific justification and optimisation in line with best practice.


Assuntos
Osso e Ossos/diagnóstico por imagem , Mieloma Múltiplo/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Humanos , Processamento de Imagem Assistida por Computador , Tomografia por Emissão de Pósitrons , Doses de Radiação , Radiometria , Software
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA