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1.
Eur J Radiol ; 137: 109605, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33621855

RESUMO

PURPOSE: This article reviews the pathological mechanisms and progress of imaging of severe frostbite to assist in the search for targets for clinical diagnosis and treatment of severe frostbite. This review also aims to provide strong evidence for clinical diagnosis and treatment of deep frostbite. METHODS: The review was based on the summary and analysis of the existing literature, and explored the pathological mechanism of deep frostbite and the advantages and disadvantages of imaging diagnostic methods. RESULTS: According to the depth of tissue involvement, frostbite is divided into 4 levels. Severe frostbite includes Grade 3 and Grade 4 frostbite. Clinical performance evaluation and imaging diagnostic research have always been the mainstream of severe frostbite diagnosis. Imaging methods focus on vascular patency and tissue vitality. This article introduces angiography, SETCT/CT and MRA, and we summarize the advantages and disadvantages of these imaging methods. We recommend corresponding imaging modalities according to the state of frostbite patients. CONCLUSIONS: Imaging examination, especially angiography and bone scans, provide useful information for determining the diagnosis and prognosis of severe frostbite. In order to obtain a good clinical prognosis, clinicians should first perform SPECT/CT. MRA does not burden the patient's body, but the balance between cost and benefit must be considered. Angiography provides a good feedback on the changes in blood vessel status before and after treatment, which is helpful for discovering the response of limbs to treatment.


Assuntos
Congelamento das Extremidades , Tomografia Computadorizada por Raios X , Angiografia , Congelamento das Extremidades/diagnóstico por imagem , Humanos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
2.
Clin Nucl Med ; 46(5): 361-368, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33630798

RESUMO

PURPOSE: Third-generation total ankle replacement (TAR) is an increasingly popular and effective treatment for end-stage osteoarthritis, yet identifying causes of failure remains challenging. We evaluated integrated bone SPECT/CT in recurrent pain after TAR by validating a standardized reporting scheme, identifying uptake patterns, and assessing diagnostic performance and impact on clinical management. PATIENTS AND METHODS: A total of 24 TARs in 16 patients with persistent or recurrent pain received integrated bone SPECT/CT using diagnostic CT settings. Images were retrospectively reviewed, and a novel localization scheme was validated by assessing interrater agreement. Distinct uptake patterns were identified, and diagnostic test characteristics were estimated. Reference standard consisted of clinical follow-up, laboratory findings, and subsequent procedures, including revision surgery. RESULTS: Standardized scoring of bone SPECT/CT uptake was highly reproducible (intraclass correlation coefficient, 0.79; 95% confidence interval [CI], 0.75-0.82). The final diagnoses were gutter impingement (n = 12), periprosthetic (stress) fracture (n = 5), loosening (n = 5), tarsal arthritis (n = 1), and erysipelas (n = 1). Overall, the diagnostic test characteristics of bone SPECT/CT were as follows: sensitivity of 100% (95% CI, 82%-100%), specificity of 80% (95% CI, 28%-99%), and accuracy of 96% (95% CI, 79%-100%). Gutter impingement, periprosthetic fracture, and loosening were correctly identified in all cases revealing distinct uptake patterns. Importantly, persistent diffuse uptake was frequently observed, warranting cautious interpretation. Bone SPECT/CT impacted clinical management in 86%, with symptomatic improvement in 83% of patients. CONCLUSIONS: Integrated bone SPECT/CT of painful TARs may benefit from standardized localization to reveal distinct uptake patterns representing common complications after TAR. Initial results show highly promising diagnostic value with potentially important impact on clinical management.


Assuntos
Artroplastia de Substituição do Tornozelo/efeitos adversos , Osso e Ossos/diagnóstico por imagem , Dor/diagnóstico por imagem , Dor/etiologia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
Clin Nucl Med ; 46(5): 405-408, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33630800

RESUMO

ABSTRACT: Pigmented villonodular synovitis (PVNS) is a rare proliferative synovial benign disorder, which is characterized by villonodular hyperplasia of joints, tendon sheath, and synovium; invasion of adjacent tissue; and sometimes visible hemosiderin deposition. Studies regarding bone scan findings of PVNS were relatively limited. Here, we report our findings on 99mTc-MDP 3-phase bone scan with SPECT/CT images on delayed phase in 3 patients with joint PVNS.


Assuntos
Osso e Ossos/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Sinovite Pigmentada Vilonodular/diagnóstico por imagem , Medronato de Tecnécio Tc 99m , Feminino , Humanos , Masculino
5.
Clin Nucl Med ; 46(4): 358-360, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33492860

RESUMO

ABSTRACT: A 64-year-old woman with metastatic papillary thyroid cancer underwent a total thyroidectomy followed by 2 courses of 131I therapy. The posttherapeutic whole-body scan after the second dose of 131I therapy showed multifocal bone metastasis. In addition, there is focal abnormal intense radiotracer uptake at the right inguinal region. SPECT/CT revealed that this abnormal focal radioactivity was from a superficial skin lesion. Further physical examination revealed a raised, approximately 1-cm, irregular grayish-brown lesion on the right groin skin. Histopathological examination confirmed the diagnosis of basal cell papilloma (seborrheic keratosis).


Assuntos
Radioisótopos do Iodo/metabolismo , Neoplasia de Células Basais/metabolismo , Neoplasia de Células Basais/secundário , Papiloma/metabolismo , Câncer Papilífero da Tireoide/patologia , Reações Falso-Positivas , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasia de Células Basais/diagnóstico por imagem , Papiloma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Tireoidectomia , Imagem Corporal Total
6.
Medicine (Baltimore) ; 100(1): e24138, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429788

RESUMO

ABSTRACT: Although the importance of quadriceps femoris function was reported previously, little is known about volume-related factors and their effects on clinical outcomes after total knee arthroplasty (TKA). We sought to determine whether there was a bilateral difference in vastus medialis muscle volume measured on single-photon emission computed tomography-computed tomography (SPECT-CT) in patients who underwent unilateral TKA. We also aimed to determine whether vastus medialis volume was related to osteoarthritis (OA) severity or scintigraphic uptake degree around the knee joint on SPECT-CT. And finally, we attempted to investigate the factors, such as vastus medialis volume and scintigraphic uptake degree, associated with the functional outcomes of TKA.This retrospective study included 50 patients (41 female, 9 male) undergone unilateral TKA due to primary OA. The maximal cross-sectional area of the vastus medialis was measured on axial SPECT-CT images. Scintigraphic uptake degrees and Kellgren-Lawrence (K-L) grade at the tibiofemoral joints were assessed. We compared maximal cross-sectional area of the vastus medialis on SPECT-CT for difference of bilateral lower limbs. We also analyzed the relationship between volume of vastus medialis and scintigraphic uptake measured on SPECT-CT and the severity of OA on conventional radiographs. The clinical outcomes were evaluated using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index at baseline and at 1 and 2 years after surgery. The relationship between preoperative muscle volume and scintigraphic uptake on SPECT-CT and WOMAC index was analyzed.The amount of muscle volume measured on SPECT-CT was smaller in operated limb in patients who underwent unilateral TKA. Preoperative vastus medialis muscle volume was not related to preoperative OA severity measured on conventional radiographs and scintigraphic uptake on SPECT-CT. However, a decreased vastus medialis muscle volume was related to worse clinical outcomes after TKA (P = .045), whereas the degree of scintigraphic uptake on SPECT-CT was not associated with postoperative clinical outcomes.Muscle volume of vastus medialis was decreased in the operated knee than in the nonoperated knee, and that was correlated with worse postoperative results. Even if the preoperative volume of vastus medialis were not related to OA severity on conventional radiographs and scintigraphic uptake on SPECT-CT, preservation and improvement of the muscle mass of the knee undergoing TKA is important.


Assuntos
Artroplastia do Joelho/estatística & dados numéricos , Complicações Pós-Operatórias/etiologia , Músculo Quadríceps/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/estatística & dados numéricos , Idoso , Artroplastia do Joelho/métodos , Feminino , Humanos , Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Pesos e Medidas/instrumentação
7.
Clin Nucl Med ; 46(1): e8-e10, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33031234

RESUMO

A 68-year-old man with hereditary hypercoagulability was referred to nuclear medicine for elevated aminotransferases after a recent living-donor liver transplant. A hepatic infarction was suspected. A Tc-mebrofenin SPECT/CT was performed and showed decreased radiotracer uptake in a wedge-shaped distribution in the anterior liver suggestive of a hepatic infarction. Subsequently, an enhanced MRI corroborated the diagnosis. Oral anticoagulation therapy was then initiated, and aminotransferases soon normalized.


Assuntos
Infarto Hepático/diagnóstico por imagem , Iminoácidos , Compostos de Organotecnécio , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Idoso , Infarto Hepático/tratamento farmacológico , Infarto Hepático/fisiopatologia , Humanos , Transplante de Fígado , Masculino
8.
Clin Nucl Med ; 46(4): e181-e187, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323744

RESUMO

PURPOSE: The clinical introduction of a radioactive and fluorescent hybrid tracer allowed for preoperative lymphatic mapping and intraoperative real-time fluorescence tracing of the sentinel lymph node (SLN) by a single injection. The aim of this feasibility study is to evaluate the first-in-human use of the hybrid tracer by combining indocyanine green (ICG) and radiocolloid based on Nanotop compound (99mTc Nanotop) for SLN biopsy (SLNB) in breast cancer patients. METHODS: The day before surgery, ICG-99mTc Nanotop was injected periareolarly in breast cancer patients scheduled for SLNB. Planar lymphoscintigraphic (PL) and SPECT/CT images were then acquired. An intraoperative optonuclear probe was used to detect SLN gamma and fluorescent signals. The harvested SLNs were examined by hematoxylin-eosin staining, and patients were clinically evaluated 1 month after surgery. RESULTS: Twenty-one consecutive patients were enrolled. The PL and SPECT/CT techniques identified at least 1 SLN in all patients for a preoperative sentinel detection rate of 100%. SPECT/CT revealed 3 additional lymph nodes in the same nodal basin, which had not been visualized on conventional PL (κ = 0.747; P < 0.005). All 30 preoperative SLNs were localized and excised up to 16 hours after injection. The counts measured via gamma tracing showed a very strong correlation with those measured via near-infrared fluorescent tracing (P < 0.005, r = 0.964). No adverse reactions were observed. CONCLUSIONS: The SLNB technique used with the ICG-99mTc Nanotop tracer resulted to be feasible, reliable, and safe. This hybrid compound allowed us to obtain excellent performance in terms of both preoperative lymphatic mapping and intraoperative SLN detection in breast cancer patients.


Assuntos
Neoplasias da Mama/patologia , Verde de Indocianina/química , Biópsia de Linfonodo Sentinela/métodos , Tecnécio/química , Adulto , Idoso , Neoplasias da Mama/diagnóstico por imagem , Estudos de Viabilidade , Feminino , Humanos , Linfadenopatia , Metástase Linfática , Pessoa de Meia-Idade , Traçadores Radioativos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
9.
Clin Nucl Med ; 46(2): 161-163, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315674

RESUMO

ABSTRACT: A 75-year-old man with suspected prostate cancer underwent a 99mTc-MDP bone scan to exclude the possibility of bone metastasis. Scans revealed areas of increased tracer uptake in a symmetric distribution on both sides of the pelvis. Further SPECT/CT imaging showed focal 99mTc-MDP accumulation within 2 cystic lesions on both sides of the bladder. Subsequent x-ray cystography showed contrast agent filling within both cystic lesions, which suggested double bladder diverticula. Eventually, these 2 cystic lesions were confirmed by surgery and pathology as double congenital bladder diverticula.


Assuntos
Osso e Ossos/diagnóstico por imagem , Divertículo/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Bexiga Urinária/anormalidades , Idoso , Humanos , Masculino , Medronato de Tecnécio Tc 99m , Bexiga Urinária/diagnóstico por imagem
10.
Clin Nucl Med ; 46(3): 238-239, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323737

RESUMO

ABSTRACT: A 58-year-old man with progressive dyspnea and recurrent extensive left-sided pleural effusion underwent pulmonary ventilation/perfusion SPECT/CT, which showed a pronounced mismatched perfusion deficit of the entire, normally ventilated left lung. As unilateral perfusion deficits of an entire lobe are generally not due to pulmonary embolism, further CT angiography and cardiac MRI were conducted. These examinations revealed high-grade left pulmonary vein stenosis (PVS) caused by pulmonary vein isolation performed for atrial fibrillation 3 and 4 years earlier. Thus, in addition to, for example, neoplastic processes or pulmonary congenital vascular abnormalities, PVS must be considered as a differential diagnosis and possible pitfall in ventilation/perfusion SPECT/CT in dyspneic patients with prior pulmonary vein isolation.


Assuntos
Imagem de Perfusão/efeitos adversos , Embolia Pulmonar/diagnóstico por imagem , Ventilação Pulmonar , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/efeitos adversos , Estenose de Veia Pulmonar/etiologia , Humanos , Masculino , Pessoa de Meia-Idade
11.
J Surg Oncol ; 123(4): 846-853, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33333583

RESUMO

BACKGROUND: This study characterizes the physiological drainage of the normal upper extremity using single-photon emission computed tomography/computed tomography (SPECT/CT) lymphoscintigraphy axillary reverse lymphatic mapping (ARM). METHODS: A consecutive series of patients assessed with SPECT/CT lymphoscintigraphy ARM of the upper extremity were included. Anatomical localization of the axillary sentinel lymph nodes (SLN) was completed in normal axillae in relation to consistent anatomic landmarks. Retrospective case note analysis was performed to collect patient demographic data. RESULTS: A total of 169 patients underwent SPECT/CT lymphoscintigraphy, and imaging of 182 normal axillae was obtained. All patients (100%) had an axillary SLN identified: 19% had a single contrast-enhanced SLN in the axilla and the remainder had multiple. The SLN(s) of the upper extremity was located in the upper outer quadrant (UOQ) of the axilla in 97% of cases (177 axillae). When the SLN(s) was found in the UOQ of the axilla, second-tier lymph nodes were found predominantly in the upper inner quadrant (50% of cases). CONCLUSIONS: The upper extremity SLN(s) is located in a constant region of the axilla. This study provides the most complete investigation to date and results can be directly applied clinically to ARM techniques and adjuvant radiation planning.


Assuntos
Neoplasias da Mama/patologia , Linfocintigrafia/métodos , Biópsia de Linfonodo Sentinela/métodos , Linfonodo Sentinela/patologia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Extremidade Superior/patologia , Adulto , Idoso , Axila , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Linfonodo Sentinela/diagnóstico por imagem , Linfonodo Sentinela/cirurgia , Extremidade Superior/cirurgia , Adulto Jovem
12.
Clin Nucl Med ; 46(1): e54-e56, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32956115

RESUMO

Spinal facet joint septic arthritis is a rare pathology associated with pyogenic organisms. It may present in older adults with back pain, fever, and positive bacterial blood cultures. However, clinical presentation may be equivocal, and diagnosis relies on anatomic imaging for differentiation from other pathologies. Magnetic resonance is considered the imaging modality of choice and has been found superior to CT; however, it is unable to differentiate facet joint septic arthritis from other inflammatory arthropathies. We present a case of lumbosacral facet joint septic arthritis as seen on In-oxine-WBC scintigraphy and SPECT/CT.


Assuntos
Artrite Infecciosa/diagnóstico por imagem , Compostos Organometálicos , Oxiquinolina/análogos & derivados , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Articulação Zigapofisária/diagnóstico por imagem , Idoso , Artrite Infecciosa/microbiologia , Diagnóstico Diferencial , Humanos , Masculino , Articulação Zigapofisária/microbiologia , Articulação Zigapofisária/patologia
13.
Clin Nucl Med ; 46(1): e34-e35, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33031249

RESUMO

Primary intestinal lymphangiectasia is an unusual cause of protein losing enteropathy due to either congenital malformation or obstruction of lymphatics of intestine. The disease can affect all or only a small part of the small intestine. Peripheral lymphedema may be associated. The diagnosis is based on endoscopic and histopathological findings. A 30-year-old woman presents lower extremity edema with hypoproteinemia, hypoalbuminemia, and hypogammaglobulinemia. Tc-labeled human serum albumin nanocolloid lymphoscintigraphy of the lower extremity demonstrated a dermal backflow in the right extremity consistent with lymphedema and an unusual ileal uptake on SPECT/CT. Diagnosis is confirmed on histopathological evaluation of biopsy of ileum.


Assuntos
Linfangiectasia Intestinal/diagnóstico por imagem , Linfangiectasia Intestinal/patologia , Compostos de Organotecnécio , Albumina Sérica , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Biópsia , Feminino , Humanos , Linfangiectasia Intestinal/complicações , Sensibilidade e Especificidade
14.
Clin Nucl Med ; 46(1): 40-42, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33086275

RESUMO

The most common sites of metastasis for pheochromocytoma are the lymph nodes, bones, lungs, and liver. Peritoneal metastasis or implantation is very rare. We present a case of recurrent malignant pheochromocytoma with unusual multiple peritoneal carcinomatosis on I-MIBG SPECT/CT after laparoscopic adrenalectomy.


Assuntos
3-Iodobenzilguanidina , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/secundário , Feocromocitoma/patologia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva
15.
Clin Nucl Med ; 46(1): 45-46, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33086279

RESUMO

Haglund syndrome-the combination of Haglund's deformity, retrocalcaneal bursitis, and achilles tendinopathy-is a common cause of hind foot pain in adults; however, diagnosis on planar scintigraphy can be challenging. We present a case of Haglund syndrome and show the key role that SPECT/CT can play in its diagnosis.


Assuntos
Ossos do Pé/diagnóstico por imagem , Doenças do Pé/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Tendão do Calcâneo/diagnóstico por imagem , Adulto , Bursite/complicações , Calcâneo/diagnóstico por imagem , Feminino , Doenças do Pé/complicações , Humanos , Masculino , Tendinopatia/complicações
16.
Molecules ; 26(1)2020 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-33379310

RESUMO

Hydrogen sulfide (H2S) is the third gasotransmitter and is generated endogenously in hypoxic or inflammatory tissues and various cancers. We have recently demonstrated that endogenous H2S can be imaged with [99mTc]Tc-gluconate. In the present study, we detected H2S generated in hypoxic tissue, both in vitro and in vivo, using [99mTc]Tc-gluconate. In vitro uptake of [99mTc]Tc-gluconate was measured under hypoxic and normoxic conditions, using the colon carcinoma cell line CT26, and was higher in hypoxic cells than that in normoxic cells. An acute hindlimb ischemia-reperfusion model was established in BALB/c mice by exposing the animals to 3 h of ischemia and 3 h of reperfusion prior to in vivo imaging. [99mTc]Tc-gluconate (12.5 MBq) was intravenously injected through the tail vein, and uptake in the lower limb was analyzed by single-photon emission computed tomography/computed tomography (SPECT/CT). SPECT/CT images showed five times higher uptake in the ischemic limb than that in the normal limb. The standard uptake value (SUVmean) of the ischemic limb was 0.39 ± 0.03, while that of the normal limb was 0.07 ± 0.01. [99mTc]Tc-gluconate is a novel imaging agent that can be used both in vitro and in vivo for the detection of endogenous H2S generated in hypoxic tissue.


Assuntos
Gluconatos/metabolismo , Sulfeto de Hidrogênio/metabolismo , Hipóxia/metabolismo , Compostos de Organotecnécio/metabolismo , Compostos Radiofarmacêuticos/metabolismo , Tecnécio/metabolismo , Animais , Linhagem Celular Tumoral , Modelos Animais de Doenças , Membro Posterior/metabolismo , Isquemia/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Traumatismo por Reperfusão/metabolismo , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos
17.
PLoS One ; 15(12): e0244256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33362280

RESUMO

INTRODUCTION: Patients presenting with tears of the triangular fibrocartilage complex (TFCC) can have ulnar positive variance, for which the clinical relevance to concomitant ulnar impaction syndrome (UIS) may be unclear. We hypothesized that maximum standardized uptake value (SUVmax), a semiquantitative single-photon-emission computed tomography/computed tomography (SPECT/CT) value, would distinguish between the traumatic TFCC tear and degenerative TFCC tear associated with the UIS. This study aimed to compare SUVmax between patients with TFCC tear only and patients with TFCC tear and UIS. METHODS: A total of 26 patients presenting with TFCC tears on magnetic resonance imaging (MRI) underwent semiquantitative SPECT/CT examinations. The diagnosis of concomitant UIS was made based on positive ulnar impaction tests and MRI findings. We compared the SUVmax between patients with and without concomitant UIS. We also calculated the cutoff value for the diagnosis of UIS using receiver operating characteristic curve analysis. RESULTS: Of 26 patients, 14 had concomitant UIS, and 12 had TFCC tears only. The SUVmax was significantly higher in patients with concomitant UIS than in those without UIS (p = 0.048). With a SUVmax cutoff value of 4.09 for UIS, sensitivity of 67% and specificity of 82% were obtained. CONCLUSIONS: In the semiquantitative SPECT/CT examinations of patients with TFCC tears, those with concomitant UIS had a higher SUVmax than those without UIS. Semiquantitative SPECT/CT can be helpful in confirming concomitant UIS in patients with TFCC tears.


Assuntos
Artralgia/patologia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Fibrocartilagem Triangular/fisiopatologia , Ulna/lesões , Traumatismos do Punho/patologia , Articulação do Punho/diagnóstico por imagem , Adulto , Artralgia/diagnóstico por imagem , Artralgia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Fibrocartilagem Triangular/lesões , Ulna/diagnóstico por imagem , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/etiologia , Adulto Jovem
18.
PLoS One ; 15(12): e0244235, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33378338

RESUMO

OBJECTIVE: SPECT/CT with 99mTc-macroaggregated albumin (MAA) is generally used for diagnostic work-up prior to transarterial radioembolization (TARE) to exclude shunts and to provide additional information for treatment stratification and dose calculation. C-arm CT is used for determination of lobular vascular supply and assessment of parenchymal blood volume (PBV). Aim of this study was to correlate MAA-uptake and PBV-maps in hepatocellular carcinoma (HCC) and hepatic metastases of the colorectal carcinoma (CRC). MATERIALS AND METHODS: 34 patients underwent a PBV C-arm CT immediately followed by 99mTc-MAA injection and a SPECT/CT acquisition after 1 h uptake. MAA-uptake and PBV-maps were visually assessed and semi-quantitatively analyzed (MAA-tumor/liver-parenchyma = MAA-TBR or PBV in ml/100ml). In case of a poor match, tumors were additionally correlated with post-TARE 90Y-Bremsstrahlung-SPECT/CT as a reference. RESULTS: 102 HCC or CRC metastases were analyzed. HCC presented with significantly higher MAA-TBR (7.6 vs. 3.9, p<0.05) compared to CRC. Tumors showed strong intra- and inter-individual dissimilarities between TBR and PBV with a weak correlations for capsular HCCs (r = 0.45, p<0.05) and no correlation for CRC. The demarcation of lesions was slightly better for both HCC and CRC in PBV-maps compared to MAA-SPECT/CT (exact match: 52%/50%; same intensity/homogeneity: 38%/39%; insufficient 10%/11%). MAA-SPECT/CT revealed a better visual correlation with post-therapeutic 90Y-Bremsstrahlung-SPECT/CT. CONCLUSION: The acquisition of PBV can improve the detectability of small intrahepatic tumors and correlates with the MAA-Uptake in HCC. The results indicate that 99mTc-MAA-SPECT/CT remains to be the superior method for the prediction of post-therapeutic 90Y-particle distribution, especially in CRC. However, intra-procedural PBV acquisition has the potential to become an additional factor for TARE planning, in addition to improving the determination of segment and tumor blood supply, which has been demonstrated previously.


Assuntos
Carcinoma Hepatocelular/radioterapia , Neoplasias Colorretais/radioterapia , Embolização Terapêutica/métodos , Neoplasias Hepáticas/radioterapia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Agregado de Albumina Marcado com Tecnécio Tc 99m/química , Radioisótopos de Ítrio/uso terapêutico , Idoso , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/patologia , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/patologia , Feminino , Seguimentos , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Masculino , Prognóstico , Estudos Retrospectivos
19.
Medicine (Baltimore) ; 99(39): e22414, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991473

RESUMO

The purpose of this study was to investigate the role of Tc-antimony sulfide colloid (ASC) lymphoscintigraphy and single photon emission computed tomography/computed tomography (SPECT/CT) in the evaluation of rare lymphatic disorders, including Gorham--Stout disease (GSD), lymphangioma, and lymphangioleiomyomatosis (LAM).Nine patients suspected to have rare lymphatic disorders were included in this retrospective study. All patients underwent Tc-ASC lymphoscintigraphy and SPECT/CT to evaluate the lesions. The lymphoscintigraphy results were compared with the clinical and immunopathological findings.Tc-ASC lymphoscintigraphy and SPECT/CT could provide lymphatic draining and anatomical information for rare lymphatic disorders. Among the 9 patients, 3 were diagnosed with GSD (1 female, 2 males; aged 15-34 years, range 27.0 ±â€Š10.4 years), 3 with lymphangioma (1 female, 2 males; aged 17-42 years, range 32.0 ±â€Š13.2 years), and 3 patients were diagnosed with LAM (3 females; aged 33-50 years, range 43.7 ±â€Š9.3 years]. GSD is characterized by multiple bone destruction, including spine, ribs, ilium, pubis, ischium, and femur. The tracer uptake of involved bones and soft tissue around bone is increased, accompanied by chylothorax, chylopericardium, and chylous leakage in abdominal and pelvic cavity. Lymphangiomas present as multiple cystic lesions with increased tracer uptake in the peripancreatic, retroperitoneal, and iliac areas, and in the abdominopelvic cavity. LAM presents as multiple thin-walled cysts in the bilateral lungs and multiple retroperitoneal enlarged lymph nodes with increased tracer uptake.Tc-ASC lymphoscintigraphy and SPECT/CT could comprehensively and specifically detect some rare lymphatic disorders, namely, GSD, lymphangioma, and LAM. This technique is useful for the evaluation of GSD, lymphangioma, and LAM.


Assuntos
Antimônio , Linfangioleiomiomatose/diagnóstico por imagem , Linfangioma/diagnóstico por imagem , Linfocintigrafia , Osteólise Essencial/diagnóstico por imagem , Compostos de Tecnécio , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Adulto Jovem
20.
Clin Nucl Med ; 45(11): 871-872, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32969903

RESUMO

A 61-year-old woman diagnosed with left breast cancer underwent a bone scan for the evaluation of possible bone metastases. Multiple foci of elevated activity were noticed in the spine and pelvis. In addition, a focus of intense activity was observed in the right lung on the SPECT/CT images without corresponding anatomic abnormality.


Assuntos
Pulmão/diagnóstico por imagem , Pulmão/metabolismo , Medronato de Tecnécio Tc 99m/metabolismo , Transporte Biológico , Neoplasias Ósseas/secundário , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
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