Hepatobiliary scintigraphy with SPET in the diagnosis of bronchobiliary fistula due to a hydatid cyst

In this report, we present the application of hepatobiliary scintigraphy using Tc-99m mebrofenin in the diagnosis of bronchobiliary fistula caused by a liver hydatid cyst, which penetrated the diaphragm. Hepatobiliary scintigraphy noticeably depicted the leakage of the tracer from the biliary system of the liver to the bronchial tree. Hepatobiliary scintigraphy stands as a robust modality in the accurate diagnosis and treatment planning of bronchobiliary fistulas. © 2015, P.Ziti and Co. All rights reserved

Sternal nonunion on bone scintigraphy: A case report

Sternal non-union is a severe complication of sternotomy closure following open heart surgeries. Healing problems typically occur in 0.3% to 5% of patients. Technetium-99m methylene diphosphonate (99mTc-MDP) bone scintigraphy has been used to assess bone nonunion to predict the healing response for proper management. In this report, we present the case of a marked sternal nonunion following coronary artery bypass graft (CABG), using radionuclide bone scintigraphy

99mTc-MIBI Lung Scintigraphy in the Assessment of Pulmonary Involvement in Interstitial Lung Disease and Its Comparison With Pulmonary Function Tests and High-Resolution Computed Tomography: A Preliminary Study

The differentiation of active inflammatory processes from an inactive form of the disease is of great value in the management of interstitial lung disease (ILD). The aim of this investigation was to assess the efficacy of 99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI) scans in distinguishing the severity of the disease compared to radiological and clinical parameters.In total, 19 known cases of ILD were included in this study and were followed up for 1 year. Five patients without lung disease were considered as the control group. The patients underwent pulmonary function tests (PFTs) and high-resolution computed tomography scans, followed by 99mTc-MIBI scanning. The 99mTc-MIBI scans were analyzed either qualitatively (subjectively) or semiquantitatively.All 19 ILD patients demonstrated a strong increase in 99mTc-MIBI uptake in the lungs compared to the control group. The 99mTc-MIBI scan scores were higher in the patient group in both the early phase (0.240.19-0.31 vs 0.110.10-0.15, P 0.14). The 99mTc-MIBI scan scores were not significantly correlated with the PFT findings (P > 0.05). In total, 5 patients died and 14 patients were still alive over the 1-year follow-up period. There was also a significant difference between the uptake intensity of 99mTc-MIBI and the outcome in the early phase (dead: 0.320.29-0.43 vs alive: 0.210.18-0.24, P < 0.05) and delayed phase (dead: 0.270.22-0.28 vs alive: 0.100.07-0.19, P < 0.05).The washout rate was ~40 min starting from 20 min up to 60 min and this rate was significantly different in our 2 study groups (ILD: 46.6115.61-50.39 vs NL: 70.9127.09-116.36, P = 0.04).The present study demonstrated that 99mTc-MIBI lung scans might distinguish the severity of pulmonary involvement in early views, which were well correlated with HRCT findings. These results also revealed that 99mTc-MIBI lung scans might be used as a complement to other diagnostic and clinical examinations in terms of functional information in ILD; however, further investigations are strongly required

The effect of an iodine restricted including no sea foods diet, on technetium-99m thyroid scintigraphy: A neglected issue in nuclear medicine practice

Although it is recommended to patients to avoid sea food and iodine-containing medications prior to iodine-131 ( 131I) scanning, the efficacy of this diet as for technetium-99m pertechnetate ( 99mTc-P) thyroid scintigraphy is not well addressed in the literature. We evaluated a self-managed, outpatients, iodine restricted diet (IRD) designed to reduce total body iodine in preparation for such a scan. We have studied 39 patients who referred to our Department for multinodular goiter, 30 females and 9 males, aged: 14-54 years and their 99mTc-P thyroid scintigraphy showed poor visualization of the thyroid gland. These patiens were living in regions with high consumption of sea foods went underwent a two-weeks iodine restriction including restriction of sea food diet for the reduction of iodine body content. These patients were called for a repeated scan after going on a IRD for at least two weeks. The two scans were compared visually, and by semiquantitative analysis. Semiquantitative analysis was applied in 8 regions of interest (ROI) by using Wilcoxon signed rank test. Thirty-six subjects had better quality scintigraphy images in the post IRD thyroid scan, as was visually assessed by two nuclear medicine physicians. Semiquantitatetively, there was a significant difference in the mean counts of ROI of the right and the left thyroid lobes in favor of the post IRD scans (P&lt;0.05). In conclusion, this study suggests that in patients with multinodular goiter, living in regions with high consumption of sea foods a two-weeks diet for the reduction of iodine body content induces in most of the cases a slightly better diagnostic thyroid 99mTc-P scan

Relation between clinical features and gastric emptying time in diabetic patients

BACKGROUND: Gastroparesis is characterized by delayed gastric emptying. This pathology is usually observed in patients with diabetes. One standard approach to quantitative assessment of gastric emptying is scintigraphic study. The aim of present study was to perform scintigraphic study of gastric emptying time in patient with diabetes and to find its correlation with patients' characteristics. MATERIALS AND METHODS: Gastric emptying was assessed in 19 patients with type 2 diabetes (mean age of 61.04 ± 6.09 years) and 6 healthy volunteers. Characteristics of the patients were sex, age, duration of diabetes, blood sugar and serum HbA1c level. RESULTS: Results of present study revealed that gastric emptying half time was significantly larger in patients with type 2 diabetes as compared with healthy volunteers (P-value < 0.05). While correlation of sex, age, duration of diabetes and blood sugar with gastric emptying time was not statistically significant, HbA1c level had significant effect on gastric emptying time. CONCLUSION: Results of this prospective study indicated that level of serum HbA1c is an effecting factor on gastric emptying time in patients with type 2 diabetes; however, these preliminary findings should be validated in larger and well-designed studies. Copyright © 2015 Via Medica

Radiation exposure from diagnostic nuclear medicine examinations in golestan province

Introduction: The aim of present study was to estimate effective dose from most common procedures performed in nuclear medicine departments of Golestan province. Methods: Data of nuclear medicine procedures performed in 2 nuclear medicine departments in Golestan province were collected during 4 years. Effective dose, collective effective dose and effective dose per examination were calculated using standard dosimetry tables. Results: Based on the data of this study, results of 10437 nuclear medicine procedures performed during 4 years have lead to 3.97 mSv as average effective dose per examination and 10.37 human-Sv as mean collective effective dose. It was also revealed that Tc-99m was the main source of effective dose (98.3%), bone scan was the most common procedure (25.9%) and cardiac scan (MIBI-rest) has the highest collective effective dose (33.5%) during 4 years. Conclusion: Beside the cardiac scan which was the most common nuclear medicine procedure and the main contributor of effective dose in patients, due to geographical condition of the northeast of Iran, bone scan was the highest performed nuclear medicine examination in the Golestan province

The role of 99mTc-Ubiquicidin (UBI) and 99mTc-IgG scintigraphies in diagnosis of acute appendicitis: A preliminary result

Introduction: Appendicitis is one of the most common surgical emergencies. In spite of the relatively high rate of negative appendectomy, as a result of miss diagnosis, uncertainty of diagnosis still continues to challenge physicians. The objective of this prospective study was to investigate the role of 99mTc-Ubiquicidin (UBI) scintigraphy in the diagnosis of acute appendicitis and to compare 99mTc-UBI scintigraphy with 99mTc-IgG scintigraphy. Methods: Twelve patients with right lower quadrant pain and suspicious of acute appendicitis were referred to the nuclear medicine imaging center. Radionuclide imaging was performed with 99mTc-UBI in 8 and 99mTc-IgG in 4 patients. Ultrasonography, Alvarado scoring and histopathological examinations were also performed as additional diagnostic tests. Results: Reports from 99mTc-IgG and 99mTc-UBI scintigraphies of all patients were negative. Conclusion: This study may conclude that 99mTc-IgG scintigraphy and 99mTc-UBI scintigraphy in the detection of appendicitis do not have adequate efficacy. However, in order to better evaluate 99mTc-IgG and 99mTc-UBI scintigraphy, a comprehensive study on a large number of patients with clinical suspicious of acute appendicitis would be more helpful

Comparison of technetium-99m IgG with technetium-99m red blood cells labeling in cardiac blood-pool scintigraphy: A preliminary study

This first clinical prospective study was conducted to use of technetium-99m immunoglobulin G (99mTc-IgG) as compared with autologous 99mTc-red blood cells (RBC) in gated blood pool ventriculography. We studied 12 patients who referred to us for a possible diagnosis of liver hemangioma or infection. Six patients underwent gated planar blood pool (GPBP) acquisition using 99mTc-RBC and 6 GPBP acquisition using 99mTc-IgG. The use of 99mTc-IgG in cardiac blood pool studies provided comparable images to 99mTc-RBC. In conclusion, 99mTc-IgG, which is readily available and needs only a single injection, may be an attractive alternative to 99mTc-RBC for the estimation of various cardiac function parameters like left ventricular function

The association of increased stomach wall radiotracer uptake with prolonged use of Omeprazole capsules on myocardial perfusion imaging (MPI) using 99mTc-sestamibi SPECT

Myocardial perfusion imaging (MPI) is widely used in routine practice for diagnosis and risk stratification of coronary artery disease (CAD). Intense curvilinear activity in the stomach wall of a patient was seen on MPI raw data. This phenomenon was completely dissimilar to the familiar intraluminal gastric reflux of sestamibi. This observed activity could have resulted in false-positive or false-negative artifacts - and inaccurate diagnosis - of the inferior wall of the left ventricle after MPI processing. On further exploration, the current researchers found that the patient had a history of 10-year Omeprazole capsule consumption. The authors present this infrequent case of intense stomach uptake to stress the related clinical and diagnostic implications with the aim to stimulate acute awareness of possible, unexpected infringements on image quality that could potentially interfere with accurate interpretation of the data. Copyright © 2013 Via Medica

Developing a Finite Element Model to Investigate Second Metatarsal Stress During Running

This is the author accepted manuscript. The final version is available from UKACM via the link in this recordSecond metatarsal (2MT) stress fracture is a common and burdensome injury amongst runners, however understanding of the risk factors leading to injury is limited. Finite Element (FE) modelling represents a viable biorealistic alternative to invasive studies and simple beam theory models. This study shows the design and validation of a simple subject-specific FE model of the 2MT incorporating geometrically accurate soft tissue and loading. Results show a good comparison with both recent models and bone staple strain gauge data.Engineering and Physical Sciences Research Council (EPSRC