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1.
Heart Fail Clin ; 20(3): 307-316, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38844301

RESUMO

Cardiac amyloidosis (CA) is caused by the myocardial deposition of misfolded proteins, either amyloid transthyretin (ATTR) or immunoglobulin light chains (AL). The paradigm of this condition has transformed, since CA is increasingly recognized as a relatively prevalent cause of heart failure. Cardiac scintigraphy with bone tracers is the unique noninvasive technique able to confirm CA without performing tissue biopsy or advanced imaging tests. A moderate-to-intense myocardial uptake (Perugini grade ≥2) associated with the absence of a monoclonal component is greater than 99% specific for ATTR-CA, while AL-CA confirmation requires tissue biopsy.


Assuntos
Amiloidose , Cardiomiopatias , Compostos Radiofarmacêuticos , Humanos , Cardiomiopatias/diagnóstico por imagem , Cardiomiopatias/metabolismo , Amiloidose/diagnóstico por imagem , Amiloidose/metabolismo , Amiloidose/patologia , Cintilografia/métodos , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/metabolismo , Osso e Ossos/patologia , Miocárdio/patologia , Miocárdio/metabolismo , Neuropatias Amiloides Familiares/diagnóstico por imagem , Neuropatias Amiloides Familiares/metabolismo , Neuropatias Amiloides Familiares/patologia , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/metabolismo , Pré-Albumina/metabolismo
2.
Eur J Gastroenterol Hepatol ; 36(7): 845-849, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38829942

RESUMO

BACKGROUND: Meckel diverticulum (MD) is an important cause of gastrointestinal bleeding in children. Small bowel capsule endoscopy (SBCE) is a first-line examination method applied to patients with obscure gastrointestinal bleeding, but there are few studies on its application in children with MD. This article aims to provide evidence in favor of the auxiliary diagnosis of MD in children by analyzing its characteristics using SBCE. METHODS: We retrospectively collected the clinical data of patients with suspected MD. RESULTS: A total of 58 children were included in this study. All 58 children presented overt gastrointestinal bleeding (bloody stool or melena). Capsule endoscopy identified protruding lesions in 2 cases, double-lumen changes in 30 cases (all considered as MD), vascular lesions in 7 cases, intestinal mucosal inflammatory lesions in 3 cases, ulcers or erosion in 3 cases, and no obvious abnormalities in SBCE in 12 cases. Both SBCE and technetium-99 scans were performed for 24 cases, 22 of which were diagnosed MD by their combined results, giving a diagnostic coincidence rate of 91.7%. Eight cases were highly suspected as MD but were negative for the technetium-99 scan and positive for SBCE. CONCLUSION: SBCE has high accuracy in the diagnosis of MD in children, especially when performed in combination with a technetium-99 scan, which can greatly improve the diagnostic rate of MD in children.


Assuntos
Endoscopia por Cápsula , Hemorragia Gastrointestinal , Divertículo Ileal , Humanos , Divertículo Ileal/complicações , Divertículo Ileal/diagnóstico por imagem , Divertículo Ileal/diagnóstico , Endoscopia por Cápsula/métodos , Masculino , Feminino , Estudos Retrospectivos , Criança , Pré-Escolar , Hemorragia Gastrointestinal/etiologia , Adolescente , Lactente , Intestino Delgado/diagnóstico por imagem , Intestino Delgado/patologia , Valor Preditivo dos Testes , Cintilografia , Compostos Radiofarmacêuticos
3.
Artigo em Inglês | MEDLINE | ID: mdl-38758691

RESUMO

Charcot's neuroarthropathy and osteomyelitis can have similar initial presentations. The ability to differentiate between the two pathologic conditions is essential, as each requires different treatment. We present a case of a 53-year-old woman with pain, swelling, and warmth in her left first metatarsophalangeal joint and first tarsometatarsal joint. Radiographs showed comminuted fractures at the base of the first metatarsal. Osteomyelitis was suspected by the primary team based on physical findings and a history of previous first metatarsophalangeal joint arthrodesis. A triphasic bone scan and an indium white blood cell scan were positive for osteomyelitis. The podiatric medical team was suspicious for possible Charcot's neuroarthropathy based on physical findings and uncontrolled blood glucose levels at the time of her previous arthrodesis. A sulfur colloid scan was performed and compared with an indium scan, which showed no evidence of osteomyelitis. This case demonstrates the usefulness of sulfur colloid imaging compared with an indium white blood cell scan to differentiate osteomyelitis from Charcot's neuroarthropathy. This case also highlights the importance of using clinical judgment to make the correct diagnosis.


Assuntos
Artropatia Neurogênica , Osteomielite , Humanos , Osteomielite/diagnóstico por imagem , Osteomielite/diagnóstico , Feminino , Pessoa de Meia-Idade , Artropatia Neurogênica/diagnóstico por imagem , Artropatia Neurogênica/diagnóstico , Diagnóstico Diferencial , Cintilografia , Coloide de Enxofre Marcado com Tecnécio Tc 99m
4.
Arq Bras Cardiol ; 121(4): e20230216, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38775614

RESUMO

BACKGROUND: Transthyretin amyloidosis (ATTR) is an infiltrative disease caused by abnormal protein deposition mainly in the heart and peripheral nervous system. When it affects the heart, the disease presents as restrictive cardiomyopathy; when it affects the peripheral and autonomic nervous system, it manifests as polyneuropathy, and is called familial amyloid polyneuropathy (FAP). There are two ATTR subtypes: wild-type ATTR, where there is no mutation, and mutant ATTR (ATTRm), which is characterized by a mutation in the gene encoding the transthyretin protein (TTR). In both subtypes, cardiac involvement is the major marker of poor prognosis. OBJECTIVES: To assess the prevalence of subclinical cardiac involvement in a sample of patients with TTR gene mutation by using pyrophosphate scintigraphy and strain echocardiography; to compare scintigraphy and strain findings; to evaluate the association between neurological manifestations (FAP) and subclinical cardiac involvement; and to analyze whether there is an association between any specific mutation and cardiac involvement. METHODS: This is a cross-sectional study with carriers of the TTR gene mutation, without cardiovascular symptoms or changes in electrocardiographic or conventional echocardiographic parameters. All patients underwent pyrophosphate scintigraphy and strain echocardiography. Subclinical cardiac involvement was defined as a Perugini score ≥ 2, heart-to-contralateral lung (H/CL) ratio ≥ 1.5 at 1 h, H/CL ≥1.3 at 3 h, or global longitudinal strain (GLS) ≤ -17%. Descriptive and analytical analyses were performed and Fisher's exact test and Mann-Whitney test were applied. A value of p < 0.05 was considered significant. RESULTS: The 23 patients evaluated had a median age of 51 years (IQR 37-57 years), 15 (65.2%) were female, 12 (52.2%) were Pardo, nine (39.1%) had systemic arterial hypertension, and nine (39.1%) had a previous diagnosis of FAP. Of the nine patients with FAP, 8 (34.8%) were on tafamidis. The associated mutations were Val142IIe, Val50Met, and IIe127Val. The median GLS in the sample was -19% (-16% to -20%). Of the 23 patients, nine (39.1%; 95% CI = 29-49%) met criteria for cardiac involvement, six (26%) by the GLS-based criteria only. There was no association between having FAP and being an asymptomatic carrier, as assessed by strain echocardiography and pyrophosphate scintigraphy (p = 0.19). The prevalence of systemic arterial hypertension, diabetes mellitus, dyslipidemia, smoking, and reduced GLS did not differ between groups. Septal e' wave velocity was the only variable that significantly differed between individuals with and without reduced GLS, with an area under the ROC curve of 0.80 (95% CI = 0.61-0.98, p = 0.027). The best diagnostic accuracy was achieved with a septal e' velocity ≤ 8.5 cm/s. There was no association between mutation type and preclinical cardiac involvement, nor between tafamidis use and lower degree of cardiac involvement (37.5% versus 40.0%, p = 0.90). CONCLUSION: Subclinical cardiac involvement was common in a sample of TTR mutation carriers without cardiac involvement. Reduced left ventricular GLS was the most frequent finding. There was no association between the presence of amyloid polyneuropathy and subclinical cardiac involvement. Type of mutation was not associated with early cardiac involvement. In this sample, the use of tafamidis 20 mg/day was not associated with a lower prevalence of subclinical cardiac involvement.


FUNDAMENTO: A amiloidose por transtirretina (ATTR) é uma doença infiltrativa causada pela deposição anormal de proteína principalmente no coração e no sistema nervoso periférico. Quando acomete o coração, a doença manifesta-se como uma cardiomiopatia restritiva e, quando afeta o sistema nervoso periférico e autônomo, apresenta-se como uma polineuropatia, podendo ser chamada de Polineuropatia Amiloidótica Familiar (PAF). Existem dois subtipos de ATTR, a ATTR selvagem, em que não há variantes genéticas, e a ATTR hereditária, caracterizada por uma variante no gene que codifica a proteína transtirretina (T\TR). Em ambos os subtipos, o envolvimento cardíaco é o principal marcador prognóstico. OBJETIVOS: Avaliar a prevalência do envolvimento cardíaco subclínico em uma amostra de pacientes com variantes genéticas no gene TTR usando a cintilografia com pirofosfato e o ecocardiograma com strain; comparar os achados cintilográficos e as medidas de strain; avaliar a associação entre PAF e o envolvimento subclínico; e analisar se existe uma associação entre uma variante genética específica e o envolvimento cardíaco. MÉTODOS: Estudo transversal com carreadores de variantes no gene TTR sem sintomas cardiovasculares e sem alterações nos parâmetros da eletrocardiografia ou do ecocardiograma convencional. Todos os pacientes foram submetidos à cintilografia com pirofosfato e à ecocardiografia com análise de strain. O envolvimento cardíaco subclínico, definido como um escore de Perugini ≥ 2, razão Coração (C)/ Hemitórax Contralateral (CL) ≥ 1,5 em uma hora, C/CL ≥ 1,3 na terceira hora, ou um strain longitudinal global (SGL) ≤ −17%. Realizadas análises descritiva e analítica, e aplicados o teste exato de Fisher e o teste de Mann-Whitney. Um valor de p<0,05 foi considerado significativo. RESULTADOS: Os 23 pacientes avaliados apresentavam uma idade mediana de 51 (37-57) anos, 15 (65,2%) eram do sexo feminino, 12 (52,2%) eram pardos, nove (39,1%) apresentavam hipertensão arterial sistêmica, e nove (39,1%) tinham um diagnóstico prévio de PAF. Dos nove pacientes com PAF, oito (34,8%) usavam tafamidis. As variantes genéticas identificadas foram Val142IIe, Val50Met e IIe127Val. O valor mediano do SGL foi −19% (-16% ­ −20%). Dos 23 pacientes, nove (39,1%; 95% CI = 29­49%) preencheram os critérios de envolvimento cardíaco, seis (26%) somente pelo critério do SGL. Não houve associação entre PAF e um carreador assintomático avaliado por ecocardiograma com análise de strain e pela cintilografia com pirofostato (p=0,19). A prevalência de hipertensão arterial sistêmica, diabetes mellitus, dislipidemia, tabagismo e SGL reduzido não foi diferente entre os grupos. A velocidade da onda e' septal foi a única variável que apresentou diferença significativa entre os indivíduos com e sem SGL reduzido, com uma área sob a curva ROC de 0,80 (IC95% = 0,61­0,98, p = 0,027). A melhor acurácia diagnóstica foi alcançada com uma velocidade e' septal ≤ 8,5 cm/s. Não houve associação entre o tipo de variante genética e o envolvimento cardíaco pré-clínico, nem entre o uso de tafamidis e este mesmo envolvimento (37,5% versus 40,0%, p = 0,90). CONCLUSÃO: O envolvimento cardíaco subclínico foi frequente em uma amostra de carreadores da variante genética do gene TTR. Um valor do SGL reduzido foi o achado mais comum. Não houve associação entre a presença de polineuropatia amiloidótica e o envolvimento subclínico. O tipo de variante genética não foi associado com envolvimento cardíaco precoce. Nesta amostra, o uso de tafamidis (20mg/dia) não foi associado com uma menor prevalência de envolvimento cardíaco subclínico.


Assuntos
Neuropatias Amiloides Familiares , Ecocardiografia , Pré-Albumina , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuropatias Amiloides Familiares/genética , Neuropatias Amiloides Familiares/diagnóstico por imagem , Estudos Transversais , Pré-Albumina/genética , Cintilografia , Valores de Referência , Estatísticas não Paramétricas
5.
J Nippon Med Sch ; 91(2): 227-232, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38777783

RESUMO

BACKGROUND: Detective flow imaging (DFI) is a new imaging technology that displays low-velocity blood flow, which is difficult to visualize on conventional color Doppler ultrasonography (CDU). In this study, we compared the usefulness of DFI with that of CDU and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for detecting parathyroid adenoma (PA) in patients with primary hyperparathyroidism (PHPT). METHODS: From March 2021 to March 2023, 87 PHPT patients underwent surgery, and 66 had a single PA. We performed preoperative conventional ultrasonography with CDU, MIBI scintigraphy, and DFI for 42 patients (5 males and 37 females; mean age: 61.6 ± 15.4 years). RESULTS: MIBI scintigraphy detected PA in 85.7% (36/42) patients, and both CDU and DFI detected PA in all patients. The rates of vascularity in PA detected by CDU and DFI were 71.4% (30/42) and 85.7% (36/42), respectively. Vascularity was detected by DFI in 6 patients who were negative for vascularity on MIBI scintigraphy. Furthermore, DFI detected blood supply in 6 of the 12 patients with undetectable blood supply on CDU. Fisher's exact test revealed that high or low blood flow, as determined by DFI, was significantly associated with detection of feeding vessels in PA by CDU (P < 0.001). CONCLUSIONS: DFI was useful for preoperative detection of PA blood flow.


Assuntos
Adenoma , Hiperparatireoidismo Primário , Neoplasias das Paratireoides , Ultrassonografia Doppler em Cores , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/cirurgia , Neoplasias das Paratireoides/complicações , Hiperparatireoidismo Primário/diagnóstico por imagem , Hiperparatireoidismo Primário/cirurgia , Idoso , Ultrassonografia Doppler em Cores/métodos , Adenoma/diagnóstico por imagem , Cintilografia/métodos , Tecnécio Tc 99m Sestamibi , Adulto , Velocidade do Fluxo Sanguíneo
6.
Radiographics ; 44(6): e230127, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38814800

RESUMO

Various radiologic examinations and other diagnostic tools exist for evaluating gastrointestinal diseases. When symptoms of gastrointestinal disease persist and no underlying anatomic or structural abnormality is identified, the diagnosis of functional gastrointestinal disorder is frequently applied. Given its physiologic and quantitative nature, scintigraphy often plays a central role in the diagnosis and treatment of patients with suspected functional gastrointestinal disorder. Most frequently, after functional gallbladder disease is excluded, gastric emptying scintigraphy (GES) is considered the next step in evaluating patients with suspected gastric motility disorder who present with upper gastrointestinal symptoms such as dyspepsia or bloating. GES is the standard modality for detecting delayed gastric emptying (gastroparesis) and the less commonly encountered clinical entity, gastric dumping syndrome. Additionally, GES can be used to assess abnormalities of intragastric distribution, suggesting specific disorders such as impaired fundal accommodation or antral dysfunction, as well as to evaluate gastric emptying of liquid. More recently, scintigraphic examinations for evaluating small bowel and large bowel transit have been developed and validated for routine diagnostic use. These can be performed individually or as part of a comprehensive whole-gut transit evaluation. Such scintigraphic examinations are of particular importance because clinical assessment of suspected functional gastrointestinal disorder frequently fails to accurately localize the site of disease, and those patients may have motility disorders involving multiple portions of the gastrointestinal tract. The authors comprehensively review the current practice of gastrointestinal transit scintigraphy, with diseases and best imaging practices illustrated by means of case review. ©RSNA, 2024 See the invited commentary by Maurer and Parkman in this issue.


Assuntos
Gastroenteropatias , Trânsito Gastrointestinal , Cintilografia , Humanos , Cintilografia/métodos , Trânsito Gastrointestinal/fisiologia , Gastroenteropatias/diagnóstico por imagem , Motilidade Gastrointestinal/fisiologia , Adulto , Esvaziamento Gástrico/fisiologia
8.
Opt Express ; 32(7): 11934-11951, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38571030

RESUMO

Optical coherence tomography (OCT) can resolve biological three-dimensional tissue structures, but it is inevitably plagued by speckle noise that degrades image quality and obscures biological structure. Recently unsupervised deep learning methods are becoming more popular in OCT despeckling but they still have to use unpaired noisy-clean images or paired noisy-noisy images. To address the above problem, we propose what we believe to be a novel unsupervised deep learning method for OCT despeckling, termed Double-free Net, which eliminates the need for ground truth data and repeated scanning by sub-sampling noisy images and synthesizing noisier images. In comparison to existing unsupervised methods, Double-free Net obtains superior denoising performance when trained on datasets comprising retinal and human tissue images without clean images. The efficacy of Double-free Net in denoising holds significant promise for diagnostic applications in retinal pathologies and enhances the accuracy of retinal layer segmentation. Results demonstrate that Double-free Net outperforms state-of-the-art methods and exhibits strong convenience and adaptability across different OCT images.


Assuntos
Algoritmos , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Retina/diagnóstico por imagem , Cintilografia , Processamento de Imagem Assistida por Computador/métodos
9.
Clin Nucl Med ; 49(5): 451-453, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38557553

RESUMO

ABSTRACT: 131 I has been used effectively over the years in both diagnosis and therapy of differentiated thyroid cancer (DTC). Although whole-body scan with 131 I is a highly sensitive tool for detecting normal thyroid tissue and metastasis of DTC, it is not specific; therefore, false-positive images can be seen in clinical practice, and their recognition is critical for correct management. Evaluation of false-positive uptake is important because it may be confused with metastatic involvement. Here, we present a rare false-positive result of whole-body scan in a patient with DTC. To our knowledge, it is the first report on 131 I uptake of conjunctival concretions.


Assuntos
Adenocarcinoma , Neoplasias da Glândula Tireoide , Humanos , Imagem Corporal Total , Cintilografia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , Adenocarcinoma/tratamento farmacológico , Radioisótopos do Iodo/uso terapêutico
10.
Hell J Nucl Med ; 27(1): 55-57, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38629817

RESUMO

The hepatopulmonary syndrome (HPS) is characterized by arterial oxygenation defect induced by intrapulmonary vascular dilatations in the setting of liver disease. We report a 57-year-old woman with a history of liver cirrhosis presented with progressive cyanosis, exertional dyspnea and a dry cough. Oxyhemoglobin saturation was 88.5% on room air. Contrast transthoracic echocardiography (cTTE) and technetium-99m-macroaggregated albumin (99mTc-MAA) scintigraphy showed an intrapulmonary shunting and confirmed HPS.


Assuntos
Ecocardiografia , Síndrome Hepatopulmonar , Agregado de Albumina Marcado com Tecnécio Tc 99m , Humanos , Síndrome Hepatopulmonar/diagnóstico por imagem , Síndrome Hepatopulmonar/complicações , Feminino , Pessoa de Meia-Idade , Ecocardiografia/métodos , Cintilografia/métodos , Compostos Radiofarmacêuticos
11.
Hell J Nucl Med ; 27(1): 58-63, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38629818

RESUMO

Cerebrospinal fluid (CSF) shunting is an established long-term treatment option for hydrocephalus, and is one of the most commonly performed neurosurgical procedures in western countries.Despite advances in CSF shunt design and management, its failure rates remain high and is most commonly due to obstruction and infection.Cerebrospinal fluidshunt failure diagnosis should be prompt and accurate in establishing timely if its revision is appropriate. Radionuclide shuntography with technetium-99m-diethylenetriaminepetaacetic acid (99mTc-DTPA) is a useful technique for evaluation CSF shunts and management of patients presenting with shunt-related problems, in particular it can avoid unnecessary replacement interventions. Although its execution and interpretation require specific skills, we suggest its execution for the evaluation of device's patency. We here describe the radionuclide shuntography performed with recent hybrid multimodal technologies, with a procedure customized to a complicated patient with hydrocefalus and neoplastic disease. We suggest considering radionuclide shuntography in association with conventional imaging and strongly recommend the additional performance of single photon emission computed tomography/computed tomography (SPECT/CT) because it also provides valuable information to complete the interpretation of planar images.


Assuntos
Derivações do Líquido Cefalorraquidiano , Humanos , Derivações do Líquido Cefalorraquidiano/instrumentação , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/cirurgia , Imagem Multimodal/métodos , Pentetato de Tecnécio Tc 99m , Masculino , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Compostos Radiofarmacêuticos , Cintilografia
13.
Vet Rec ; 194(8): e4069, 2024 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-38578296

RESUMO

BACKGROUND: Data regarding the lesion detection ability of different radiotracers are lacking in equine bone scintigraphy. METHODS: In this prospective study, hydroxymethylene diphosphonate (HMDP) and methylene diphosphonate (MDP) were compared in horses with increased radiopharmaceutical uptake either in the caudal cervical region (CS group) or in the proximal metacarpal/metatarsal region (PMR group). Region of interest analysis was used to determine normal bone-to-soft tissue ratios, lesion-to-normal bone ratios and lesion-to-soft tissue ratios. Qualitative scoring and total count rates were recorded for each image. RESULTS: A total of 213 scintigrams were included. Within the PMR group, there were significantly higher lesion-to-normal bone ratios for MDP compared with HMDP (p = 0.02). In the CS group, normal bone-to-soft tissue ratios were significantly higher for HMDP (p = 0.01). The interobserver agreement with regard to the qualitative assessment of the scintigrams was poor. LIMITATION: Paired studies, comparing the different radiotracers in the same patient, were not feasible. CONCLUSION: This study revealed minor differences between the two radiotracers, although these have no practical implications. Both radiopharmaceuticals are well suited for detecting lesions at the investigated sites using equine bone scintigraphy.


Assuntos
Ossos Metacarpais , Ossos do Metatarso , Animais , Cavalos , Medronato de Tecnécio Tc 99m , Cintilografia , Ossos Metacarpais/diagnóstico por imagem , Estudos Prospectivos , Difosfonatos , Compostos Radiofarmacêuticos
14.
Nucl Med Commun ; 45(5): 420-461, 2024 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-38567438
16.
Clin Nucl Med ; 49(6): e301-e303, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38598541

RESUMO

ABSTRACT: Differentiated thyroid carcinoma constitutes over 90% of all thyroid cancers. The standard treatment approach involves total or near-total thyroidectomy with or without neck dissection followed by 131 I whole-body scintigraphy (WBS) to detect local or distant metastases. Radioiodine offers high sensitivity and specificity for detection of metastatic disease in well differentiated thyroid carcinoma. However, despite its high accuracy, 131 I WBS demonstrates false-positive results, mostly at inflammatory or infective site. These false-positive radioiodine accumulation can lead to misdiagnosis and unwarranted radioiodine treatment. This case presents localization of 131 I to the suture site granuloma leading to false-positive results on 131 I WBS.


Assuntos
Radioisótopos do Iodo , Metástase Linfática , Cintilografia , Imagem Corporal Total , Humanos , Diagnóstico Diferencial , Metástase Linfática/diagnóstico por imagem , Suturas/efeitos adversos , Granuloma/diagnóstico por imagem , Feminino , Pescoço/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Pessoa de Meia-Idade , Masculino , Transporte Biológico
17.
Nucl Med Commun ; 45(7): 573-580, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38618748

RESUMO

OBJECTIVE: We aimed to elucidate the factors underlying the difference between estimated glomerular filtration rate (eGFR) calculated from serum creatinine and Gate's GFR (gGFR) measured using technetium-99m diethylene triamine pentaacetic acid ( 99m Tc-DTPA) scintigraphy. METHODS: This study was based on consecutive patients who underwent 99m Tc-DTPA scintigraphy at our hospital between January 2021 and December 2022 and whose blood serum creatinine data were obtained on the same day as the 99m Tc-DTPA scintigraphy. Relationships between the ratio of gGFR and eGFR (gGFR/eGFR) and age, sex, BMI, visceral fat, psoas muscle index (PMI), serum blood urea nitrogen, and creatinine level were investigated based on 75 patients. Additionally, for 44 patients who had two or more follow-up DTPA studies, we compared gGFR values for studies that used iodine contrast media (ICM) for computed tomography before same-day 99m Tc-DTPA studies and those that did not in the same patients. RESULTS: Weak correlations were observed between gGFR/eGFR and PMI ( r  = 0.30), BMI ( r  = 0.24), and the visceral fat area ( r  = 0.33). Multi-regression analyses showed that gGFR/eGFR was correlated with PMI ( ß â€…= 0.34, P  < 0.01) and approached significance with the visceral fat area ( ß â€…= 0.24, P  = 0.05). A significant difference was observed in gGFR between patients who received ICM before the 99m Tc-DTPA renogram and those who did not ( P  < 0.001, eGFR 80.5 ±â€…19.0 vs. 91.7 ±â€…27.8 ml/min). CONCLUSION: ICM administration temporarily decreased gGFR, and increased muscle mass increased the difference between eGFR and gGFR values.


Assuntos
Meios de Contraste , Creatinina , Câmaras gama , Taxa de Filtração Glomerular , Iodo , Pentetato de Tecnécio Tc 99m , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Creatinina/sangue , Idoso , Adulto , Cintilografia , Idoso de 80 Anos ou mais , Estudos Retrospectivos
18.
Clin Radiol ; 79(7): e949-e956, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38641445

RESUMO

AIM: As a classic theranostic radiopharmaceutical, radioiodine (131I) has been utilized in the management of differentiated thyroid cancer (DTC) for more than 8 decades, and the refinement of its clinical practice has been raised recently. This study was conducted to evaluate the efficiency of a diagnostic (Dx) 131I scan in optimizing the indication of initial radioiodine oncolytic treatment (ROT) for metastatic DTC by predicting therapeutic outcomes. RESULTS: A total of 100 patients (Dx positive, n=29; Dx negative, n=71) were eligible for patient-based analysis. The matching rate was 83.0% between the Dx and the post-therapeutic scans (kappa = 0.648, P<0.001). The biochemical remission rate and structural shrinkage rate induced by the initial ROT in the Dx-positive group were, respectively, greater than those in the Dx-negative group (83.3% vs. 17.4%, P<0.001; 37.9% vs. 4.2%, P<0.001). Notably, the predictive values of positive Dx scans for ROT responsiveness and negative Dx scans for ROT nonresponsiveness reached up to 89.7% and 84.5%, respectively. CONCLUSION: This Dx scan approach seems viable in characterizing the 131I-avidity of metastatic DTC and plays a pivotal role in optimizing the indication of initial ROT for metastatic DTC.


Assuntos
Radioisótopos do Iodo , Neoplasias da Glândula Tireoide , Humanos , Radioisótopos do Iodo/uso terapêutico , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Compostos Radiofarmacêuticos/uso terapêutico , Idoso , Resultado do Tratamento , Estudos Retrospectivos , Cintilografia , Adulto Jovem
19.
Semin Nucl Med ; 54(3): 427-437, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38658301

RESUMO

Ventricular tachycardia (VT) is a life-threatening arrhythmia common in patients with structural heart disease or nonischemic cardiomyopathy. Many VTs originate from regions of fibrotic scar tissue, where delayed electrical signals exit scar and re-enter viable myocardium. Cardiac stereotactic body radiotherapy (SBRT) has emerged as a completely noninvasive alternative to catheter ablation for the treatment of recurrent or refractory ventricular tachycardia. While there is no common consensus on the ideal imaging workflow, therapy planning for cardiac SBRT often combines information from a plurality of imaging modalities including MRI, CT, electroanatomic mapping and nuclear imaging. MRI and CT provide detailed anatomic information, and late enhancement contrast imaging can indicate regions of fibrosis. Electroanatomic maps indicate regions of heterogenous conduction voltage or early activation which are indicative of arrhythmogenic tissue. Some early clinical adopters performing cardiac SBRT report the use of myocardial perfusion and viability nuclear imaging to identify regions of scar. Nuclear imaging of hibernating myocardium, inflammation and sympathetic innervation have been studied for ventricular arrhythmia prognosis and in research relating to catheter ablation of VT but have yet to be studied in their potential applications for cardiac SBRT. The integration of information from these many imaging modalities to identify a target for ablation can be challenging. Multimodality image registration and dedicated therapy planning tools may enable higher target accuracy, accelerate therapy planning workflows and improve patient outcomes. Understanding the pathophysiology of ventricular arrhythmias, and localizing the arrhythmogenic tissues, is vital for successful ablation with cardiac SBRT. Nuclear imaging provides an arsenal of imaging strategies to identify regional scar, hibernation, inflammation, and sympathetic denervation with some advantages over alternative imaging strategies.


Assuntos
Radiocirurgia , Taquicardia Ventricular , Humanos , Taquicardia Ventricular/diagnóstico por imagem , Taquicardia Ventricular/radioterapia , Taquicardia Ventricular/cirurgia , Radiocirurgia/métodos , Cintilografia
20.
Clin Nucl Med ; 49(5): 438-441, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38574255

RESUMO

ABSTRACT: 123I-meta-iodobenzylguanidine (123I-MIBG) is extensively used for initial staging and response evaluation in children with neuroblastoma. Physiological uptake of 123I-MIBG occurs in the salivary glands, liver, adrenal gland, myocardium, bowel, and thyroid gland. 123I-MIBG cannot cross an intact blood-brain barrier. We present the rare case of a 3-year-old boy with neuroblastoma and meningeal metastases who underwent an 123I-MIBG scan for disease restaging that showed abnormal brain uptake. Abnormal MIBG uptake in the brain can occur if there is disruption of the blood-brain barrier either secondary to metastases or after damage to blood-brain barrier.


Assuntos
Iodobenzenos , Neuroblastoma , Pré-Escolar , Humanos , Masculino , 3-Iodobenzilguanidina , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Neuroblastoma/diagnóstico por imagem , Neuroblastoma/patologia , Cintilografia
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