Comparison of three with six regions of interest analyses in patients with idiopathic constipation undertaking colon transit scintigraphy using 67Ga-citrate

OBJECTIVE AND INTRODUCTION: Preparation of data from 6 geometric regions of interest in the colon is time consuming, and can become impractical in the environment of busy Nuclear Medicine Departments. Therefore, we have investigated and demonstrated an alternative method for obtaining the same diagnostic information from an analysis of patients with idiopathic constipation who underwent colon transit scintigraphy using 67Ga-citrate. Data analysis methods using three regions of interest are compared to the results obtained using the more time consuming 6 regions of interest method to analyze the data. MATERIALS AND METHODS: In this study, we report our results of the comparative reanalysis of data obtained by more traditional methods. We compare 3 regions of interest (ROI) which were taken from areas including the right colon, left colon and the rectosigmoid colon, with original work using our alternative 6 (ROI) diagnostic methodology. In addition, the proximal colonic emptying (PCE) was determined at 24 hr post ingestion among members of 3 identified subject groups. RESULTS: The distribution of activity as the ingested 67Ga-citrate passes through the colon constitutes an activity profile. The mean activity position in the colon can be determined from subsequent radiographic images and from this the mean clearance time can be calculated. In quantitative assessment, this represents the time at which half of activity was eliminated from colon (mean half clearance time - MCT) which did not appear different in the reanalysis. There is no significant difference in the current study in GMC 24h, GMC 48h and GMC 72h between two groups using the Man Whitney u test (p > 0.05), while in the previous work the results were statistically significant for the two later time periods GMC (GMC 48h and GMC 72h) (p = 0.016 and p = 0.027 respectively). The PCE in the group 1 was = 2.50 (0.37); group 2, 1.57 (0.47) and group 3, 2.97. The PCE was not different between the two groups (p = 0.21). CONCLUSIONS: This investigation demonstrated that the radionuclide colon transit study using 67Ga-citrate is a safe, physiologic, and quantitative method for evaluating the transit of fecal material from cecum to rectum. Although, the visual assessment of diagnosis of the subjects in the two analyses is the same, it was not completely supported by quantitative measurements. Therefore, further studies need to be done

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

Molecular epidemiology of hepatitis C virus genotypes in Bushehr province, Iran

Background and Objectives: Molecular epidemiology of hepatitis C virus (HCV) is very important for the treatment of hepatitis C infection. The aim of this study was to determine the distribution of HCV genotypes in Bushehr province (South West of Iran). Materials and Methods: A total of 100 patients who were detected as positive for HCV antibody (by using ELISA method and RIBA test) referred to Arya Virology Laboratory between 2007-2009 in order to molecular diagnosis and furthermore virus genotyping. After detection of HCV, RNA genotyping of virus was done by using genotype specific primers. Results: Genotype 1a was found in 49% of the patients and genotype 3a was found in 40% of the patients and 1b in 5% of patients, while the genotype of the virus could not be identified in 5% of the patients. Finally, in 1% of patients coinfection due to 1a-3a genotypes was identified. Conclusion: The dominant genotype of HCV in Bushehr province, Iran, was determined as 1a.with acute hepatitis C ultimately develop chronic infection1. Only a minority of cases of acute HCV recover completely, with spontaneous virus eradication. In most cases the acute infection progresses to chronicity. Chronic HCV infection is defined as an infection that persists for more than 6 months, with or without clinical manifestations of hepatic or extrahepatic disease. Chronic type of this infection can cause cirrhosis, liver failure, and liver cancer. HCV infection is a global health problem and it is estimated that 200 million people of the world population are infected5. The global spread of chronic HCV infection coincided with the widespread use of transfused blood and blood products and with the expansion of intravenous drug use but decreased prior to the wide implementation of anti-HCV screening6. There are at least six major genotypes designated by Arabic numerals and more than 50 subtypes of HCV identified by lower case letters. The different genotypes have different geographic distributions1,4. Genotype determination of HCV is one of the most important factors in order to prediction of the viral persistency, pathogenicity and resistancy to antivirals7. The success and the treatment period of interferon and ribavirin seems to be related to the genotype of virus8. Furthermore, HCV genotyping is a useful tool to determine its molecular epidemiology, as they are indicative of transmission route of infection9,10. There is no published data about the distribution of HCV genotypes from Bushehr province (South West of Iran). Prevalence of HCV genotypes in Bushehr is an issue that is not sufficiently investigated and there is a need, therefore, to study this in detail

Hepatopulmonary syndrome with right-to-left shunt in cirrhotic patients using macro-aggregated albumin lung perfusion scan: Comparison with contrast echocardiography and association with clinical data [Sirotik hastalardaki sağ-sol şant ile ilişkili hepatopulmoner sendromun tanısında makro-agregant albümin akciğer perfüzyon sintigrafisinin kontrast ekokardiyografi ile karşılaştırılması ve klinik veriler ile ilişkisi]

Objectives: The diagnosis of hepatopulmonary syndrome (HPS) which is a common complication in cirrhotic patients is still subject to debate. This study investigated the association of clinical findings with HPS in cirrhotic patients using macro-aggregated albumin lung perfusion scan (99mTc-MAA lung scintigraphy). In addition, comparison between99mTc-MAA lung scintigraphy and contrast echocardiography (CEE) in detection of HPS was also performed. Methods: In this study, 27 patients with cirrhosis underwent99mTc-MAA lung scintigraphy and contrast echocardiography comparison CEE and the frequency of HPS was assessed in them and also was compared across the other variables. Results: The99mTc-MAA lung scintigraphy showed HPS in 13 patients (48.1%) while CEE demonstrated HPS in 5 patients with cirrhosis (18.51%). HPS was mild in 40.74% (11/27) of the patients, and severe in only 2 patients. There was no relationship between gender, disease duration, having diagnosis of disease previously, pulmonary symptoms and Child-Pugh score variations and HPS (p>0.05). Comparison of hemodynamic indices, arterial blood gas analysis and laboratory indices between patients with and without HPS was also non-significant (p value >0.05). Among coagulation factors assessed in cirrhotic patients, we found only significant correlation between HPS and prothrombin time (p<0.05). Conclusion: HPS, particularly its mild form, is noted in a great number of patients with cirrhosis using 99mTc-MAA lung scintigraphy. Because of its technical ease, and possibility to obtain objective quantitative information,99mTc-MAA lung scintigraphy can be complementary to other diagnostic methods in the evaluation of HPS assessment, although additional studies are needed

Assessment of the prevalence of diabetic gastroparesis and validation of gastric emptying scintigraphy for diagnosis [Diyabetik Gastroparezi Prevalansı ve Tanısında Mide Boşalma Sintigrafisinin Geçerliliğinin Araştırılması]

Objective: Gastroparesis is defined as delayed gastric emptying and is a common medical condition in diabetic patients. Scintigraphy is commonly used as a standard diagnostic procedure for the quantitative assessment of gastroparesis. The aims of this study were to determine an optimum imaging time for the diagnosis of gastroparesis, to assess the prevalence of gastroparesis, to evaluate the correlation between endoscopy and scintigraphy findings as well as the correlation between gastric emptying with patient genders, blood glucose concentration, and functional dyspepsia. Methods: Gastric emptying was assessed in 50 diabetic patients with a mean age of 50.16 years. For evaluation of gastric emptying, a test meal containing 2 pieces of toast, 120 cc non-labeled water and fried egg labeled with 1 mCi of99mTc was given to each patient. The scintigraphy was performed immediately after ingestion and was repeated at 1, 1.5, 2 and 4 hours after ingestion. In some patients, an additional 90-minute dynamic scan was also acquired. Results: The prevalence of gastroparesis in this study population was determined as 64. Also, the results of this study revealed that a 4-hour scan after ingestion is more relevant than a 90-minute dynamic scan for the evaluation of delayed gastric emptying. There was no statistically significant difference between 1-hour and 2-hour scans, 1-hour and 90-minute scans, 2-hour and 90-minute scans, 2-hour and 4-hour scans. Likewise there was no significant correlation between blood glucose levels, gender and calculated values of gastric emptying time in all groups. Conclusion: According to our findings, it can be suggested that the prevalence of gastroparesis is higher than that mentioned in some previous studies. Also, this study indicates that a gastric emptying scintigraphy at 2 and 4 hours after meal ingestion might provide the anticipated clinical information in diabetic patients with dyspepsia without other evident reasons. © 2017 by Turkish Society of Nuclear Medicine

Topography of gastritis and its severity in 864 first degree relatives of gastric cancer patients

Objectives: Studies on gastric mucosal histological ndings among rst degree relatives (FDR) of gastric cancer (GC) patients are scarce. The aim is to evaluate the topography and the severity of gastritis among FDR of GC patients. Design: A total of 989 subjects who were FDR of GC patients, ages 40-65 years underwent gastroscopies. When no gross lesion was found, ve specimens were evaluated according to the Sydney Classication and one for urease testing in order to determine the type of gastritis and its severity. Results: Of the 989 subjects, 107 had signicant lesions, including two with GC and one with esophageal cancer. The 864 subjects who had complete morphological data taken from five gastric areas (two from the antrum and three from the corpus) comprised 419 males (mean age 48.5±7 years) and 445 females (mean age 47±6.4 years). The H. pylori rate was 76.6. Normal mucosa was seen in 6.9, antrum-restricted gastritis in 7.4, antrum-predominant gastritis in 63.5 and corpus-predominant gastritis in 20 (both had >80 H. pylori infection) and corpus-restricted gastritis in 2. More atrophy was seen in the antrum and corpus of FDR females than males. The severity did not differ between those with one or more GC patients' relatives. Forty-nine percent of FDR had atrophy and 9.4 intestinal metaplasia (IM) in the corpus. After the age of 40, there was progression of intestinal metaplasia from 12.2 to 27.3 in the antrum and from 6.7 to 26.2 in the corpus during two decades. No high grade dysplasia was found in this mid-age population. Conclusion: Only one-fifth of FDR have H. pylori-induced corpus-predominant gastritis who are at risk for cancer and suitable for eradication. Corpus-restricted gastritis is a rare disease in this area