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1.
Clin Nucl Med ; 46(3): 236-237, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323742

RESUMO

ABSTRACT: Lymphangiomyomas are relatively rare, benign neoplasms. Many patients present with symptoms including effusions, and some cases are incidentally detected. Surgical excision is the treatment of choice, but because of its location, complete surgical resection of a lymphangioma can be technically difficult, and recurrent cases can present with symptoms including effusions. 99mTc-sulfur colloid scan can be used to confirm the leak and nature of the effusion fluid. Here, we present an 8-year-old girl with recurrent pleural and pericardial effusions after lymphocele excision and total pericardiectomy. 99mTc-sulfur colloid lymphoscintigraphy was done to rule out secondary chylopericardium.


Assuntos
Linfangiomioma/complicações , Linfocintigrafia , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Criança , Feminino , Humanos , Neoplasia Residual/complicações
2.
Clin Nucl Med ; 45(12): 994-996, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33065621

RESUMO

Continuous ambulatory peritoneal dialysis is a convenient alternate form of treatment in patients receiving hemodialysis for renal failure. Sometimes during the procedure, patients may develop scrotal swelling because of patent processus vaginalis. The diagnostic utility of the peritoneal scintigraphy, an infrequently performed nuclear medicine scan to identify peritoneoscrotal communication, has been reported by many authors. Most of the previous case reports in the literature demonstrated unilateral peritoneoscrotal communication. We present an interesting Tc-sulfur colloid peritoneal scintigraphic image finding of bilateral peritoneoscrotal communication in a 67-year-old man who developed scrotal swelling while undergoing continuous ambulatory peritoneal dialysis.


Assuntos
Doenças dos Genitais Masculinos/diagnóstico por imagem , Peritônio/patologia , Escroto/patologia , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Idoso , Edema/complicações , Doenças dos Genitais Masculinos/complicações , Doenças dos Genitais Masculinos/etiologia , Doenças dos Genitais Masculinos/patologia , Humanos , Masculino , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Cintilografia
3.
BMC Gastroenterol ; 20(1): 293, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867699

RESUMO

BACKGROUND: It is unclear if the 99mTc-sodium phytate (99mTc-SP) is as reliable as the gold-standard 99mTc-sulfur colloid (99mTc-SC) for gastric emptying scintigraphy (GES). This study is aimed to compare the emptying rates of both radiotracers in a prospective, randomized cross-over trial and to determine the normative data of a healthy multi-ethnic Asian population. METHODS: Out of the 44 healthy individuals screened, 31 (14 females; mean age: 28.4 ± 7.0 years) were enrolled and underwent GES using the standardized egg-white meal. All participants were randomly assigned to either 99mTc-SP or 99mTc-SC on the first GES session before crossed over to the other formulation after 2 weeks. RESULTS: Both kits achieved the radiochemical purities of > 95%. The median rate (95th upper normative limit) of gastric emptying, reported as total gastric meal retention between 99mTc-SP and 99mTc-SC, was found to be comparable at all measured time points: 0.5 h [85.0% (96.6%) vs. 82.0% (94.0%)], 1 h [70.0% (86.4%) vs. 65.0% (86.6%)], 2 h [31.0% (55.8%) vs. 25.0% (64.4%)], 3 h [7.0% (26.3%) vs. 5.0% (29.9%)], and 4 h [3.0% (10.3%) vs. 2.0% (9.9%)]; P > 0.05. In addition, both radiotracers correlated well (Kendall's Tau (τ) coefficient = 0.498, P < 0.001) and presented with a good agreement at the 4th-hour time frame based on the Bland-Altman plot analysis. CONCLUSIONS: 99mTc-SP is a valid radiotracer alternative to 99mTc-SC for routine GES examination. The normative values for both radiotracers have also been determined for the healthy multi-ethnic Asian population. TRIAL REGISTRATION: This trial was registered retrospectively in the Thai Clinical Trials Registry on May 23rd, 2020 (Identifier: TCTR20200526004; http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6296 ).


Assuntos
Esvaziamento Gástrico , Ácido Fítico , Adulto , Coloides , Estudos Cross-Over , Feminino , Humanos , Estudos Prospectivos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Enxofre , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Adulto Jovem
4.
Vet Radiol Ultrasound ; 61(6): 659-666, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32929849

RESUMO

Sentinel lymph node (SLN) mapping by various means has become standard of care in certain types of human cancers and is receiving more attention in veterinary oncology. Current SLN mapping techniques can be costly and often require advanced imaging equipment. The objective of this prospective, method comparison study was to compare an SLN mapping protocol of lymphoscintigraphy to lymphography using water soluble iodinated contrast medium (WIC) and digital radiography for identification of an SLN. Lymphoscintigraphy and lymphography were performed on eight healthy purpose-bred dogs using technetium-99m sulfur colloid and WIC injected into the subcutaneous tissues in a four-quadrant technique around a predefined area of skin on the brachium. Images were obtained using a gamma camera and digital radiography at different time points post-injection. Image sequences were evaluated by one of two American College of Veterinary Radiology board-certified veterinary radiologists. Data obtained were compared between methods using descriptive statistics. An SLN was identified in all dogs with lymphoscintigraphy and seven of eight dogs with lymphography. Agreement between results of the lymphoscintigraphy and lymphography studies was a complete match in three dogs, a partial match in four dogs, and no match in one dog. The SLN detected differed based on the imaging modality used.


Assuntos
Cães/anatomia & histologia , Linfonodo Sentinela/diagnóstico por imagem , Animais , Axila , Vértebras Cervicais , Meios de Contraste/administração & dosagem , Linfografia/veterinária , Linfocintigrafia/veterinária , Masculino , Intensificação de Imagem Radiográfica , Valores de Referência , Coloide de Enxofre Marcado com Tecnécio Tc 99m/administração & dosagem
5.
Vet Surg ; 49(6): 1118-1124, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32584435

RESUMO

OBJECTIVE: To determine the effect of surgery on lymphoscintigraphy drainage patterns from the canine brachium. STUDY DESIGN: Experimental study. ANIMALS: Eight healthy research beagles. METHODS: A predefined area of skin measuring 2 × 1.5 cm in dimension was designated on either the right or left brachium. Preoperative lymphoscintigraphy was performed with technetium sulfur colloid injected into the subcutaneous tissues around the predefined anatomic location in a four-quadrant technique. Dogs underwent surgery for excision of the predefined area of skin, subcutis, and fascia of the lateral head of the triceps muscle with 1-cm margins. Eighteen days after surgery, lymphoscintigraphy was again performed with technetium sulfur colloid injected into the subcutaneous tissues around the surgical scar in a four-quadrant technique. RESULTS: Sentinel lymph nodes were identified in eight of eight dogs preoperatively and in eight of eight dogs postoperatively. Agreement between the results of the preoperative and postoperative lymphoscintigraphy studies was identified as complete in four of eight dogs and partial in four of eight dogs. Sentinel lymph node identification occurred immediately in three of eight dogs preoperatively and in eight of eight dogs postoperatively. CONCLUSION: Sentinel lymph node identification occurred faster postoperatively. Agreement or partial agreement between the results of the preoperative and postoperative lymphoscintigraphy studies was observed in eight of eight dogs. CLINICAL SIGNIFICANCE: Surgery appears to have an effect on lymphoscintigraphy drainage patterns. Additional studies are required to compare preoperative and postoperative sentinel lymph node mapping patterns in tumor-bearing dogs. However, this study provides preliminary information regarding the effect of surgery on sentinel lymph node identification.


Assuntos
Cães/cirurgia , Drenagem/veterinária , Membro Anterior/cirurgia , Linfonodos/fisiologia , Linfocintigrafia/veterinária , Animais , Masculino , Compostos Radiofarmacêuticos/administração & dosagem , Coloide de Enxofre Marcado com Tecnécio Tc 99m/administração & dosagem
6.
Ann Agric Environ Med ; 27(1): 123-128, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32208590

RESUMO

INTRODUCTION AND OBJECTIVE: Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis. MATERIAL AND METHODS: Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2-40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant. RESULTS: Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012). CONCLUSIONS: SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Linfangiogênese , Metástase Linfática/diagnóstico , Linfonodo Sentinela/patologia , Neoplasias Vulvares/diagnóstico , Idoso , Animais , Anticorpos Monoclonais Murinos , Carcinoma de Células Escamosas/patologia , Feminino , Virilha , Humanos , Imuno-Histoquímica , Camundongos , Estadiamento de Neoplasias , Estudos Prospectivos , Corantes de Rosanilina , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Neoplasias Vulvares/patologia
7.
J Nucl Med Technol ; 48(1): 51-53, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31182657

RESUMO

Breast lymphoscintigraphy with 99mTc-sulfur colloid is frequently performed before breast-conserving surgery to delineate drainage to a sentinel node. Tracer injection for lymphoscintigraphy can be painful. Our aims were to determine whether administering a solution of buffered lidocaine immediately before lymphoscintigraphy injection could both reduce the patients' pain and increase nuclear medicine technologists' satisfaction with performing the procedure. Methods: A pain scale survey was obtained from patients undergoing breast lymphoscintigraphy with or without buffered lidocaine. Our nuclear medicine technologists were also surveyed for their satisfaction with the procedure, both with and without the addition of buffered lidocaine. Results: The patients' reported pain decreased by 86% with the addition of buffered lidocaine. Technologist satisfaction with performing the procedure increased by 36%. Conclusion: Lidocaine buffered with sodium bicarbonate injected before lymphoscintigraphy significantly reduces pain experienced by the patient and improves nuclear medicine technologist satisfaction in performing the procedure.


Assuntos
Anestésicos Locais/uso terapêutico , Lidocaína/uso terapêutico , Linfocintigrafia/efeitos adversos , Dor/etiologia , Dor/prevenção & controle , Coloide de Enxofre Marcado com Tecnécio Tc 99m/administração & dosagem , Idoso , Atitude do Pessoal de Saúde , Neoplasias da Mama/cirurgia , Feminino , Humanos , Injeções , Pessoa de Meia-Idade , Satisfação do Paciente , Cuidados Pré-Operatórios/métodos , Compostos Radiofarmacêuticos/administração & dosagem
8.
Am J Physiol Gastrointest Liver Physiol ; 318(1): G203-G209, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31682161

RESUMO

Our aim was to investigate the feasibility of measuring antral contractions and duodenal bolus propagation (DBP) during dynamic antral contraction scintigraphy (DACS) as an assessment of antro-pyloro-duodenal coordination (APDC). Gastric emptying scintigraphy (GES) with DACS was performed with Tc-99m sulfur colloid (SC) using increasing doses of 74 MBq (2 mCi) for 10 subjects, 185 MBq (5 mCi) for 11, and 370 MBq (10 mCi) for 11. DACS was performed for 10 min after static images at 0, 30, 60, 120, 180, and 240 min in anterior and right anterior oblique (RAO) projections. Best projection and lowest dose of Tc-99m SC were assessed visually. DBP were quantified utilizing duodenal activity peaks from a region of interest in the first portion of the duodenum. DBP was better visualized in the RAO projection than anterior projection and using 185 MBq (5 mCi) and 370 MBq (10 mCi) compared with 74 MBq (2 mCi). DBP showed infrequent and irregular bolus transfers from the antrum to the duodenum. Antral activity peaks at 60 min averaged 2.91 ± 0.66 per minute and duodenum bolus peaks 0.36 ± 0.18 per minute (ratio 0.36/2.91 = 0.12). DBP activity peaks can be measured during GES with DACS but requires a 185-MBq (5 mCi) dose of Tc-99m SC radiolabeled test meal for adequate DBP signal detection and is better imaged in RAO than anterior projection. DBPs over the first 60 min postmeal ingestion are infrequent with only 12% of the antral contractions propagating into the duodenum. This methodology appears promising to assess APDC.NEW & NOTEWORTHY This study shows that duodenal bolus propagations after meal ingestion can be measured during gastric emptying scintigraphy using dynamic scintigraphy. Duodenal bolus propagation over the first 60 min postmeal ingestion are infrequent with only 12% of the antral contractions propagating into the duodenum. This methodology appears promising to assess antropyloroduodenal coordination in patients with unexplained symptoms of upper gastrointestinal dysmotility.


Assuntos
Duodeno/diagnóstico por imagem , Duodeno/fisiologia , Esvaziamento Gástrico , Trânsito Gastrointestinal , Antro Pilórico/diagnóstico por imagem , Antro Pilórico/fisiologia , Cintilografia , Compostos Radiofarmacêuticos/administração & dosagem , Coloide de Enxofre Marcado com Tecnécio Tc 99m/administração & dosagem , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Tempo , Adulto Jovem
9.
AJR Am J Roentgenol ; 213(6): 1358-1365, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31461320

RESUMO

OBJECTIVE. The purpose of this study was to compare the sensitivity, specificity, and helpfulness to referring clinicians of labeled leukocyte scintigraphy versus FDG PET/CT in inpatients with suspected infection. MATERIALS AND METHODS. In this retrospective study, labeled leukocyte scintigraphy and FDG PET/CT examinations performed from 2009 to 2017 for suspected infection in inpatients were identified. Sensitivity, specificity, and helpfulness of PET/CT versus labeled leukocyte scintigraphy were calculated by means of a mixed generalized linear model. Number of yearly tests and radiopharmaceutical costs were also assessed. RESULTS. Fifty-seven patients (30 men, 27 women; median age, 65 years; range, 21-91 years) underwent whole-body labeled leukocyte scintigraphy. Forty-two patients (30 male patients, 12 female patients; median age, 62.5 years; range, 12-91 years) underwent PET/CT for suspected infection. Labeled leukocyte scintigraphy was 66.7% sensitive, whereas the sensitivity of PET/CT was 89.7% (p = 0.0485). The higher sensitivity of PET/CT did not come at a cost to specificity, which was 73.3% as opposed to 76.9% for labeled leukocyte scintigraphy (p = 0.8050). The odds of a positive study being helpful increased 4.6-fold for PET/CT versus labeled leukocyte scintigraphy (p = 0.0412). From 2009 to 2011, 33 labeled leukocyte scintigraphic examinations were performed versus two PET/CT examinations; and from 2012 to 2014, 16 labeled leukocyte scintigraphic versus 22 PET/CT examinations; from 2015 to 2017, eight labeled leukocyte scintigraphic versus 18 PET/CT examinations. The cost of labeled leukocytes increased between 2009 and 2017, but that of FDG decreased. By 2017, a labeled leukocyte radiopharmaceutical dose was approximately 10 times the cost of an FDG dose. CONCLUSION. PET/CT was more sensitive than and as specific as labeled leukocyte scintigraphy for identifying a source of infection in inpatients, and it was more helpful to referring clinicians. Use of PET/CT increased over time and was associated with substantial savings in radiopharmaceutical cost.


Assuntos
Infecções/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fluordesoxiglucose F18 , Humanos , Radioisótopos de Índio , Leucócitos , Masculino , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Sensibilidade e Especificidade , Tecnécio Tc 99m Exametazima , Coloide de Enxofre Marcado com Tecnécio Tc 99m
11.
Medicine (Baltimore) ; 98(14): e15023, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946335

RESUMO

RATIONALE: Gorham-Stout disease (GSD) is a rare disorder characterized by multiple osteolytic lesions, sometimes complicated by chylothorax. The aim of this case report is to introduce a very rare case of Gorham-Stout syndrome, which involved several bones along with chylous pericardial and pleural effusions detected by Tc-sulfur colloid (SC) lymphoscintigraphy and single photon emission computed tomography/computed tomography (SPECT/CT). PATIENT CONCERNS: A 15-year-old girl presented to our hospital complaining of shortness of breath and bone pain. DIAGNOSIS: The CT showed multiple osteolytic lesions, left-sided pleural effusion, and pericardial effusion. Tc-SC lymphoscintigraphy showed discontinuation of thoracic duct and tracer accumulation on the left side chest. SPECT/CT revealed increased radioactivity uptake in pleural, pericardial effusions, and some thoracolumbar spines. Diagnostic thoracentesis to identify the nature of pleural effusion and histopathology of biopsy in the right femoral to that of the bone lesion were performed. Based on the clinical information, histopathologic, and radiographic findings, the diagnosis of GSD was made. INTERVENTIONS: The patient received thoracic duct ligation and bisphosphonates treatment. OUTCOMES: After receiving thoracic duct ligation and bisphosphonates treatment, the patient's symptoms of bone pain and dyspnea were relieved, and the pericardial and pleural fluid was diminished dramatically. At the 3-month and 9-month follow-up visit, the patient had nearly complete remission without any complication. LESSONS: The Tc-SC lymphoscintigraphy and SPECT/CT could provide significant value assessing the lymphatic abnormity and evaluating the extent of disease, therefore aiding to guide decision making in the clinic.


Assuntos
Quilotórax/diagnóstico por imagem , Linfocintigrafia/métodos , Dor Musculoesquelética/diagnóstico por imagem , Osteólise Essencial/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adolescente , Quilotórax/etiologia , Feminino , Humanos , Dor Musculoesquelética/etiologia , Osteólise Essencial/complicações , Compostos Radiofarmacêuticos , Coloide de Enxofre Marcado com Tecnécio Tc 99m
12.
J Nucl Med Technol ; 47(4): 300-304, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31019032

RESUMO

Lymphoscintigraphy plays a vital role in sentinel lymph node (SLN) identification in oncologic breast surgery. The effectiveness of SLN localization and the degree of patient pain were compared between filtered 99mTc-sulfur colloid (99mTc-SC) and 99mTc-tilmanocept. Methods: A retrospective review of patients undergoing lymphoscintigraphy for breast cancer using 99mTc-SC (June 1, 2010, to December 31, 2011) or 99mTc-tilmanocept (June 1, 2013, to January 31, 2014) was performed. SLN appearance time and uptake, SLN pathology, proportion of positive SLNs removed, and pain scores were compared for each radiopharmaceutical using the χ2 test, Fisher exact test, and unequal variance t test, as appropriate. Results: In total, 76 patients, with 86 evaluated axillae, underwent lymphoscintigraphy: 29 with 99mTc-SC and 47 with 99mTc-tilmanocept. The mean SLN appearance time was 11.0 min for 99mTc-SC and 19.3 min for 99mTc-tilmanocept (P = 0.003). There was no difference in the mean transit uptake percentage: 2.2% for 99mTc-SC and 1.9% for 99mTc-tilmanocept (P = 0.55). 99mTc-tilmanocept identified a greater proportion of intraoperative blue nodes than did 99mTc-SC (P = 0.03). There was no significant difference between 99mTc-SC and 99mTc-tilmanocept in the number of SLNs removed, number of patients with positive SLNs, or pain score. Conclusion: 99mTc-SC use in lymphoscintigraphy is an acceptable alternative to 99mTc-tilmanocept for SLN detection in breast cancer, on the basis of the similarity in intraoperative SLN identification and pain scores.


Assuntos
Dextranos , Linfocintigrafia/métodos , Mananas , Dor/etiologia , Biópsia de Linfonodo Sentinela/efeitos adversos , Biópsia de Linfonodo Sentinela/métodos , Pentetato de Tecnécio Tc 99m/análogos & derivados , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Ferimentos e Lesões
13.
J Nucl Med Technol ; 47(2): 144-148, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31019042

RESUMO

The accuracy and reproducibility of nuclear medicine gastric emptying scintigraphy (GES) require strict adherence to the Society of Nuclear Medicine and Molecular Imaging standardized protocol, which contains precise instructions for meal ingredients and preparation. Previous research demonstrated that many laboratories were using whole eggs in the test meal as opposed to the guideline-recommended liquid egg whites and that some laboratories were attempting to radiolabel the egg by adding the radiotracer after cooking. This study aimed to document the labeling efficiency of 99mTc-sulfur colloid (SC) added to whole eggs before and after microwave cooking. Methods: Whole eggs were mixed with 99mTc-SC before and after microwave cooking. The radiolabeling stability of the eggs was tested after 2 and 4 h of incubation in gastric fluid simulated using just hydrochloric acid (HCl) and using HCl with pepsin. Results: The experiment showed that no matter what the testing condition, radiolabeling by adding 99mTc-SC to whole eggs before cooking resulted in a significantly higher labeling efficiency than radiolabeling by squirting the 99mTc-SC on eggs after cooking. This finding persisted over time, with the precooking method still showing significantly higher radiolabeling at 2 and 4 h after the egg was placed in the incubation medium for both gastric fluid mediums. For simulated gastric fluid with pepsin at 2 h, the labeling was significantly higher, at 73.3%, when the radiotracer was added before cooking than the 43.3% when added after cooking (P < 0.001). The results of this study further showed that when egg labeling efficiency was tested in HCl without pepsin, the labeling was less stable than when tested in HCl with pepsin. In the HCl-only medium, the labeling efficiency decreased significantly between 2 and 4 h for both radiolabeling methods. Conclusion: The results of this study demonstrated that the addition of 99mTc-SC to whole eggs after cooking resulted in considerably inferior binding of the radiotracer to the eggs and that binding deteriorated significantly over time. The study further demonstrated that the results of radiolabeling efficiency varied depending on whether HCl or HCl with pepsin was used to simulate gastric fluid. Radiolabeling stability decreased over time when HCl without pepsin was used. The findings emphasize the criticality of adhering to the standardized meal and preparation, as alternate cooking methods have different radiolabeling efficiencies.


Assuntos
Ovos , Esvaziamento Gástrico , Cintilografia/métodos , Humanos , Marcação por Isótopo , Coloide de Enxofre Marcado com Tecnécio Tc 99m/química
14.
Paediatr Respir Rev ; 32: 23-27, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31005455

RESUMO

BACKGROUND: Aspiration can cause acute symptoms and chronic lung disease in the developing lung. However, the source of aspiration in infants is often unclear, making the choice of intervention difficult. OBJECTIVE: To quantify the source, amount and duration of lung aspiration in infants using gamma scintigraphy. METHODS: Two infants with clinical evidence of gastroesophageal reflux and oropharyngeal dysphagia swallowed formula radiolabeled with 99mtechnetium on Visit 1. Radiolabeled-formula was instilled by nasogastric tube on Visit 2. Lung aspiration was quantified over four hours and expressed as percent of total radioactivity administered. RESULTS: Aspiration was greatest with swallowing, compared to instillation, peaking between 2.0% and 2.4% within 30 min and between 0.40% and 0.65% within 20 min, respectively. Radioactivity remained above zero four hours after either administration. CONCLUSIONS: Quantification of the source, amount and duration of lung aspiration in infants is feasible using gamma scintigraphy. The impact of aspiration accrual on clinical care deserves further investigation.


Assuntos
Transtornos de Deglutição/diagnóstico por imagem , Deglutição , Refluxo Gastroesofágico/diagnóstico por imagem , Aspiração Respiratória de Conteúdos Gástricos/diagnóstico por imagem , Aspiração Respiratória/diagnóstico por imagem , Humanos , Lactente , Intubação Gastrointestinal , Masculino , Cintilografia/métodos , Compostos Radiofarmacêuticos , Coloide de Enxofre Marcado com Tecnécio Tc 99m
15.
Phys Med Biol ; 64(11): 115028, 2019 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-30965313

RESUMO

BACKGROUND: When locating the sentinel lymph node (SLN), surgeons use state-of-the-art imaging devices, such as a 1D gamma probe or less widely spread a 2D gamma camera. These devices project the 3D subspace onto a 1D respectively 2D space, hence loosing accuracy and the depth of the SLN which is very important, especially in the head and neck area with many critical structures in close vicinity. Recent methods which use a multi-pinhole collimator and a single gamma detector image try to gain a depth estimation of the SLN. The low intensity of the sources together with the computational cost of the optimization process make the reconstruction in real-time, however, very challenging. RESULTS: In this paper, we use an optimal design approach to improve the classical pinhole design, resulting in a non-symmetric distribution of the pinholes of the collimator. This new design shows a great improvement of the accuracy when reconstructing the position and depth of the radioactive tracer. Then, we introduce our Sentinel lymph node fingerprinting (SLNF) algorithm, inspired by MR-fingerprinting, for fast and accurate reconstruction of the tracer distribution in 3D space using a single gamma detector image. As a further advantage, the method requires no pre-processing, i.e. filtering of the detector image. The method is very stable in its performance even for low exposure times. In our ex vivo experiments, we successfully located multiple Technetium 99m (Tc-99m) sources with an exposure time of only one second and still, with a very small L 2-error. CONCLUSION: These promising results under short exposure time are very encouraging for SLN biopsy. Although, this device has not been tested on patients yet, we believe: that this approach will give the surgeon accurate 3D positions of the SLN and hence, can potentially reduce the trauma for the patient.


Assuntos
Cintilografia/instrumentação , Cintilografia/métodos , Linfonodo Sentinela/diagnóstico por imagem , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Humanos , Compostos Radiofarmacêuticos , Linfonodo Sentinela/patologia , Biópsia de Linfonodo Sentinela
16.
J Gastrointest Surg ; 23(6): 1113-1121, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30859424

RESUMO

INTRODUCTION: Although endoscopic resection for early gastric cancer is well established, anatomical resection with regional lymphadenectomy is recommended for lesions at high risk for occult lymph node metastasis (e.g., lymphovascular invasion, poor grade, and deep submucosal invasion). However, 75-95% high-risk early gastric cancer (HR-EGC) patients ultimately have node-negative disease and could potentially have undergone organ-sparing resection. Due to the inadequacy of standard modalities to reliably rule out nodal metastases in HR-EGC patients, sentinel lymph node (SLN) sampling was developed in Asia with promising results. However, the applicability of this technique in the West has been brought into question due to potential differences in tumor histology and body habitus. This prospective study aimed to test SLN sampling for North American EGC patients. METHODS: All patients with biopsy-confirmed T0-2 N0-1 M0 gastric adenocarcinoma at the Montreal General Hospital-McGill University Health Centre were eligible for enrollment. Esophageal and GEJ cancers were excluded due to the high rate of intrathoracic lymph node involvement. Peritumoral submucosal injection with T99 radiocolloid was performed endoscopically 24-30 h prior to surgery. Methylene blue dye injection was performed after induction of anesthesia. SLN basins were identified as those having > 10% of baseline tumor radiation signal or blue color, or both. After basins were individually removed, standard laparoscopic anatomical resection was then performed with D2 lymphadenectomy. ( ClinicalTrials.gov identifier: NCT03049345). Data are presented as median (interquartile range). RESULTS: From July 2016-April 2018, 253 patients with esophagogastric adenocarcinoma were evaluated. Of these, 10 met inclusion criteria (90% male, age 66(30) years). Subtotal gastrectomy was performed in nine patients (90%) and length of stay was 4 (2) days. At least one SLN basin was identified in nine cases (90%). The median #SLN basins identified was 2(2) with a median of 5(5) total SLNs retrieved per patient. In the one case for which no SLN basins were identified, only blue dye injection was used, whereas SLNs were identified in all cases using the dual tracer method. Final T-stage was pT1b/T2 in four (40%), pT1a in two (20%), and Tx in four (40%). Two patients (20%) had lymph node metastases on final pathological analysis, both of which were identified by SLN sampling (accuracy 100%; false negative rate 0%). No adverse events related to SLN retrieval were identified. CONCLUSIONS: This study represents the first prospective feasibility evaluation of sentinel lymph node sampling for early gastric cancer in North America with promising preliminary results. The dual tracer method was superior to single agent blue dye in identifying sentinel nodal basins. Considerable further study is necessary to verify the safety and utility of SLN mapping in North American patients with early gastric adenocarcinoma.


Assuntos
Adenocarcinoma/secundário , Linfonodo Sentinela/patologia , Neoplasias Gástricas/patologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Corantes , Feminino , Gastrectomia/métodos , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Azul de Metileno , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Quebeque , Compostos Radiofarmacêuticos , Linfonodo Sentinela/cirurgia , Neoplasias Gástricas/cirurgia , Coloide de Enxofre Marcado com Tecnécio Tc 99m
17.
Clin Nucl Med ; 44(7): 585-586, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30829873

RESUMO

A 34-year-old woman with history of bilateral saline implants, invasive ductal carcinoma of the right breast, and suspicious left breast calcifications was referred for left breast lymphoscintigraphy before bilateral mastectomy. A total of 3.2 mCi of Tc-filtered sulfur colloid was administered with 3 subdermal injections in the superior, lateral, and inferior periareolar left breast in the late afternoon preceding the day of surgery. Imaging identified radiotracer uptake within a dense, circular area deep to the injection sites within the left breast, compatible with implant puncture and radiotracer administration within the indwelling breast implant.


Assuntos
Implantes de Mama/efeitos adversos , Neoplasias da Mama/diagnóstico por imagem , Carcinoma Ductal/diagnóstico por imagem , Linfocintigrafia , Adulto , Neoplasias da Mama/patologia , Carcinoma Ductal/patologia , Feminino , Humanos , Compostos Radiofarmacêuticos/farmacocinética , Coloide de Enxofre Marcado com Tecnécio Tc 99m/farmacocinética
18.
BMC Gastroenterol ; 19(1): 26, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30744574

RESUMO

BACKGROUND: In adults, there is a consensus for standards to diagnose gastroparesis utilizing a gastric emptying study as the key diagnostic modality but there is no consensus for a standard in pediatrics. Additionally, some cost savings might be achieved if symptoms could be utilized to predict patients with gastroparesis. The aims of the current study were to confirm the sensitivity of a 4 h study in the pediatric population and to assess whether the severity of symptoms were predictive of delayed gastric emptying. STUDY: This was a single site, two part study. In the first part, results were reviewed for all patients who had completed a 4-h, solid gastric emptying study over the course of a 3 year period. In the second portion of the study, participants scheduled for a gastric emptying study, completed a modified GCSI questionnaire. RESULTS: Out of a total of 109 participants, at 2 h, 14 participants (12.8%) had abnormal studies as compared to 26 (23.85%) participants who had abnormal studies at 4 h (p = .0027). Of the 95 participants with normal studies at 2 h, 15% (14/95) were abnormal at 4 h. There were no differences in symptom severity scores between those with slow and those with normal emptying at either 2 h or 4 h. CONCLUSIONS: Our study adds independent confirmation that extending studies from 2 to 4 h increases the diagnostic yield and should be the standard in children and adolescents as it is in adults.


Assuntos
Esvaziamento Gástrico , Gastroparesia/diagnóstico por imagem , Gastroparesia/fisiopatologia , Adolescente , Criança , Pré-Escolar , Redução de Custos , Feminino , Humanos , Masculino , Estudos Prospectivos , Cintilografia/economia , Compostos Radiofarmacêuticos , Inquéritos e Questionários , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Fatores de Tempo
19.
J Surg Res ; 233: 149-153, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30502241

RESUMO

BACKGROUND: Sentinel lymph node biopsy (SLNB) is an important adjunct in the staging of patients with melanoma. Preoperative lymphoscintigraphy with radiolabeled isotopes is essential to localize sentinel nodes for removal. Our study compared the effectiveness of Lymphoseek to standard sulfur colloids in patients with melanoma undergoing SLNB. METHODS: We queried our IRB-approved melanoma database to identify 370 consecutive patients who underwent SLNB from 2012 to 2016 with at least 1 y of follow-up. There were 185 patients in each group. Data points included characteristics of the primary melanoma lymphoscintigraphy and SLNB. Student's t-test and chi-square were used to analyze the data with a P value of <0.05 being considered significant. RESULTS: Patients were equally matched in regard to age, sex, and primary characteristics of their melanoma. In comparison to sulfur colloid, Lymphoseek required lower radiation dosages (P < 0.001), shorter mapping times (P = 0.008), and decreased number of sentinel nodes removed (P = 0.03). There was no difference in the number of patients with positive nodes (P = 0.5). In addition, there were no statistical differences between the two radioactive tracers in regard to the number of patients with false-negative SLNB. CONCLUSION: Lymphoseek has the potential to decrease radioactivity and mapping time in patients who need SLNB. With a decrease in the number of nodes removed without loss of sensitivity, there is a potential to avoid unnecessary node removal and thus complications such as lymphedema. Longer follow-up will help to determine if there is any increase in false-negative rates despite fewer nodes removed.


Assuntos
Metástase Linfática/diagnóstico por imagem , Melanoma/patologia , Compostos Radiofarmacêuticos/administração & dosagem , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dextranos/administração & dosagem , Feminino , Seguimentos , Humanos , Metástase Linfática/patologia , Linfedema/etiologia , Linfedema/prevenção & controle , Linfocintigrafia/métodos , Masculino , Mananas/administração & dosagem , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Biópsia de Linfonodo Sentinela/efeitos adversos , Pentetato de Tecnécio Tc 99m/administração & dosagem , Pentetato de Tecnécio Tc 99m/análogos & derivados , Coloide de Enxofre Marcado com Tecnécio Tc 99m/administração & dosagem , Adulto Jovem
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