The use of spect/ct in the evaluation of heterotopic ossification in para/tetraplegics

Objective:To evaluate the stage of maturation and the metabolism of neurogenic heterotopic ossification by using SPECT/CT.Methods:A total of 12 medical records of patients with spinal cord injury, all of them classified according to the ASIA protocol (disability scale from the American Spinal Injury Association) in complete lesion (A) and partial lesions (B, C and D) and registered at the Laboratory of Biomechanics and Rehabilitation of the Locomotor System, were submitted to SPECT/CT evaluation.Results:Sixteen hips with heterotopic ossification observed in X-ray were studied and only two (12.5%) had high osteoblastic activity. Five hips showed medium activity, three (18.75%) low activity and six (37.5%) did not present any activity detected by SPECT/CT.Conclusion:SPECT/CT helps to determinate which patients have a greater risk of relapse after surgical resection, proving to be a useful imaging study in preoperative evaluation that can be used to determinate the postoperative prognosis of these patients. Level of Evidence III, Investigating a Diagnostic Test.121

Treatment Of Bone Pain Secondary To Metastases Using Samarium-153-edtmp.

More than 50% of patients with prostate, breast or lung cancer will develop painful bone metastases. The purpose of treating bone metastases is to relieve pain, reduce the use of steroids and to maintain motion. To evaluate the use of samarium-153-EDTMP (153Sm-EDTMP) for the treatment of bone pain secondary to metastases that is refractory to clinical management. Retrospective. Division of Nuclear Medicine, Universidade Estadual de Campinas (Unicamp). Fifty-eight patients were studied (34 males) with mean age 62 years; 31 patients had prostate cancer, 20 had breast cancer, three had lung cancer, one had lung hemangioendothelioma, one had parathyroid adenocarcinoma, one had osteosarcoma and one had an unknown primary tumor. All patients had multiple bone metastases demonstrated by bone scintigraphy using 99mTc-MDP,and were treated with 153Sm-EDTMP. Response to treatment was graded as good (pain reduction of 50-100%), intermediate (25-49%) and poor (0-24%). All patients showed good uptake of 153Sm-EDTMP by bone metastases. Among the patients with prostate cancer, intermediate or good response to therapy occurred in 80.6% (25 patients) and poor response in 19.4% (6). Among the patients with breast cancer, 85% (17) showed intermediate or good response to therapy while 15% (3) showed poor response. All three patients with lung cancer showed poor response to treatment. The lung hemangioendothelioma and unknown primary lesion patients showed intermediate response to treatment; the osteosarcoma and parathyroid adenocarcinoma patients showed good response to treatment. No significant myelotoxicity occurred. Pain control is important for improving the quality of life of patients with advanced cancers. The mechanism by which pain is relieved with the use of radionuclides is still not yet completely understood, however, the treatment is simple and provides a low risk of mielotoxicity. Treatment with 153Sm-EDTMP can control the pain secondary to bone metastases effectively in most patients with breast and prostate cancer without significant side effects.122208-1

Pesquisa de corpo inteiro com gálio-67 em uma paciente com paracoccidioidomicose: relato de caso

A 26 year-old female was admitted with abdominal pain, fever and weight loss. The clinical and laboratory investigations led to the diagnosis of paracoccidioidomycosis. Gallium-67 whole body images correlated well with the clinical course of the disease and with the patient's prognosis.Paciente do sexo feminino de 26 anos foi internada com dor abdominal, febre e emagrecimento. A investigação clínico-laboratorial estabeleceu o diagnóstico de paracoccidioidomicose. Os achados cintilográficos com citrato de gálio-67 correlacionaram-se com o curso clínico da paciente

Functional Electrical Stimulation Improves Brain Perfusion In Cranial Trauma Patients.

Demonstrate brain perfusion changes due to neuronal activation after functional electrical stimulation (FES). It was studied 14 patients with hemiplegia who were submitted to a program with FES during fourteen weeks. Brain perfusion SPECT was performed before and after FES therapy. These patients were further separated into 2 groups according to the hemiplegia cause: cranial trauma and major vascular insults. All SPECT images were analyzed using SPM. There was a significant statistical difference between the two groups related to patient's ages and extent of hypoperfusion in the SPECT. Patients with cranial trauma had a reduction in the hypoperfused area and patients with major vascular insult had an increase in the hypoperfused area after FES therapy. FES therapy can result in brain perfusion improvement in patients with brain lesions due to cranial trauma but probably not in patients with major vascular insults with large infarct area.69682-

SPECT cerebral na doença de Huntington antes e após terapia com olanzapina: relato de caso

Olanzapine, an atypical antipsychotic drug, was administered to a patient with Huntington's disease (HD) with marked choreiform movements. Brain SPECT with 99mTc-HMPAO was performed before and after treatment. Brain SPECT imaging has been performed in patients with HD in order to determine the status of basal ganglia perfusion. The use of brain SPECT with 99mTc-HMPAO before and after treatment in patients with HD has not been yet reported. The marked hypoperfusion of the basal ganglia on brain SPECT performed before therapy with olanzapine improved significantly after treatment.Olanzapina, um antipsicótico atípico, foi administrada a uma paciente com doença de Huntington (DH) com acentuados movimentos coreicos. O SPECT cerebral com HMPAO-99mTc foi realizado antes da paciente iniciar qualquer tratamento e após tratamento com olanzapina. O SPECT cerebral tem sido realizado em pacientes com DH para avaliar a perfusão dos núcleos da base. O uso do SPECT cerebral com HMPAO-99mTc antes e após terapia em pacientes com DH ainda não foi relatado. A acentuada hipoperfusão observada nos núcleos da base na imagem de SPECT cerebral, obtida antes da terapia com olanzapina, melhorou de forma significativa após o tratamento.86386

(18)f-fluoride Pet/ct In Clinical Practice.

48VII-VII

Calculo da fração de ejeção do ventriculo esquerdo utilizando contagens radioativas miocardicas

Orientador : Edwaldo E. CamargoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias MedicasResumo: A análise da função cardíaca em conjilllto com o estudo da perfusão miocárdica pode ter grande importânciano tratamento, acompanhamentoe avaliação prognóstica dos pacientes portadores de coronariopatia crônica. Várias técnicas foram descritas para a medida da fração de ejeção do ventrículo esquerdo (FEVE) utilizando imagens sincronizadasplanas e tomográficas de sestamibi-99mTc. A grande maioria dessas técnicas utiliza métodos geométricospara o cálculo da fração de ejeção (FE) a partir da delimitação anatômica das paredes do ventrículo esquerdo (VE)...Observação: O resumo, na integra, podera ser visualizado no texto completo da tese digitalAbstract: The simultaneous assessment of myocardial perfusion and function may be of great importance for prognosticationand management decision making in patients with coronary artery disease. Several techniques have been described for measuring left ventricular ejection fraction (LVEF) using planar and tomographic 9mTc-sestamibi images. The majority of these techniques is based on geometric methods for ejection fraction (EF) calculation and uses different techniques for the anatomical delineationof the endocardial borders of the left ventricle (LV)...Note: The complete abstract is available with the full electronic digital thesis or dissertationsDoutoradoDoutor em Ciências Médica