RESUMO
An autopsy was performed on a patient who died after receiving 89Sr-chloride for treatment of bone pain from metastatic prostate carcinoma. Coordination between nuclear medicine physicians, radiation safety division personnel and pathologists resulted in minimal radiation exposure and the acquisition of dosimetry data.
Assuntos
Autopsia , Monitoramento Ambiental , Exposição Ocupacional , Radioisótopos de Estrôncio/análise , Estrôncio/análise , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/secundário , Evolução Fatal , Humanos , Masculino , Neoplasias da Próstata/patologia , Neoplasias da Próstata/radioterapia , Roupa de Proteção , Estrôncio/uso terapêutico , Radioisótopos de Estrôncio/uso terapêutico , Contagem Corporal TotalRESUMO
The U.S. Food and Drug Administration regulates the manufacture and distribution of 18F-FDG. Acquisition and use of this radiopharmaceutical for myocardial imaging at our institution required approval by our Institutional Review Board. Our initial objective was to present a scientific validation for use of this radiopharmaceutical in adjudicating the "viable versus scarred myocardium question," using either a PET scanner or a gamma camera equipped with 511-keV collimators. We believe that our nuclear medicine colleagues who find themselves in a similar business/legal situation regarding the acquisition and use of 18F-FDG will find this review useful. We reviewed the literature to document the efficacy of 18F-FDG, in general, in assessing myocardial viability. We then did a literature-based comparison of PET scanner methodology versus modified gamma camera methodology for imaging 18F-FDG emissions. Imaging 18F-FDG with a modified gamma camera appears to be an effective alternative to imaging with a standard PET camera for assessing myocardial viability.
Assuntos
Radioisótopos de Flúor , Fluordesoxiglucose F18 , Coração/diagnóstico por imagem , Isquemia Miocárdica/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada de Emissão , Câmaras gama , HumanosRESUMO
A 53-year-old man presented for evaluation of nocturnal chest pain, consistent with angina pectoris. An exercise stress test reproduced his symptoms, however, exercise electrocardiograms were nondiagnostic. An exercise-thallium perfusion study confirmed vasospasm as the cause. This knowledge guided subsequent successful medical therapy.
Assuntos
Angina Pectoris Variante/diagnóstico por imagem , Teste de Esforço , Radioisótopos de Tálio , Angina Pectoris Variante/tratamento farmacológico , Angina Pectoris Variante/fisiopatologia , Circulação Coronária , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
PURPOSE: Renovascular hypertension is an unusual cause of elevated mean arterial pressure in children. When suspected, angiotensin-converting enzyme inhibitor-enhanced renal scintigraphy is usually one of the initial studies done to evaluate patients. The accuracy of this test depends not only on patient selection but also on technical factors involved in performing the study. We report a case of a false-positive angiotensin-converting enzyme inhibitor-enhanced radionuclide renogram in a 5-year-old boy with hypertension. METHODS: Angiotensin-converting enzyme inhibitor-enhanced renal scintigraphy was performed and the result was interpreted as positive for bilateral renovascular disease. A review of the anesthesia record from the study revealed that the patient was hypotensive. A repeated study with adequate hydration and blood pressure stability was then done. RESULTS: The result of the second examination was interpreted as normal, without evidence of abnormal renovascular physiology. CONCLUSIONS: The cause of the initial false-positive result was determined to be dehydration with secondary hypotension. Dehydration, with secondary hypotension, can cause a diminished glomerular filtration rate and mimic bilateral renovascular physiology on angiotensin-converting enzyme inhibitor-enhanced renal scans.