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<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

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 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

Wall slope effects on the vertical pull-out capacity of tapered suction caissons

AbstractSuction caissons offer certain advantages over other underwater foundation systems by virtue of large bearing capacity, ease of installation, and efficiency. They are typically built with upright walls. The behaviour of upright suction caissons in regard to their applications, installation, load-bearing, etc. has already been investigated by a number of researchers. However, the performance of tapered suction caissons has not been formerly studied. This paper addresses the pull-out capacity of tapered suction caissons under vertical pull-out loads. A numerical approach was used. The finite element model was first calibrated against available test results on upright suction caissons and then used to simulate the pull-out of tapered caissons. It is admitted, however, that further validation of the model against experimental results on tapered suction caissons will increase the acceptability of the results. It was observed that positive wall slopes may noticeably improve the pull-out capacity. A change from local to global failure modes was postulated as the main reason for this improved resistance. With negative wall slopes, however, the pull-out capacity slightly decreased. In addition, effects from the caisson wall slope were investigated for a number of caisson geometries, drainage conditions and soil properties

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

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

The role of gated myocardial perfusion scintigraphy (GMPS) in myocarditis: A case report and review of the literature

Acute myocarditis is one of the most challenging diagnoses and treatments in cardiology. The acute viral myocarditis diagnosis is usually based on high suspicion, history taking, and physical examination. Likewise, the use of chest radiography, electrocardiography (ECG), and echocardiography is helpful in making a final diagnosis, but all are non-specific. In addition, in imaging query, magnetic resonance imaging (MRI) depicts some degree of cardiac inflammation in the course of myocarditis. Myocardial perfusion imaging (MPI) has also been shown to be useful in diagnosis, and this noninvasive technique diminishes the need for myocardial biopsy. The current study presents the diagnostic and prognostic role of MPI in a 25-year-old patient with suspected myocarditis. The patient underwent gated-technetium-99m-lablled, methoxyisobutyl isonitrile, single photon emission computed tomography (Gated 99mTc-MIBI SPECT) that showed nonheterogeneous absorption with remarkable decreased radiotracer uptake in the myocardium in both stress and rest phases. In addition, the gated mode demonstrated decreased wall motion and thickening of the myocardium with a sum motion score (SMS) of 28, a sum thickening score (STS) of 15, and a measured LVEF of 34%. The study concludes that 99mTC-MIBI SPECT imaging is a useful modality in the preparation of supplementary diagnostic and prognostic information in viral myocarditis. Copyright © 2011 Via Medica