Validation and impact of a new technique for assessment of glomerular filtration rate in patients with liver disease.

Objectives: Previously we have proposed a technique for the measurement of plasma clearance in patients with ascites. The impact of using the technique was assessed and the results compared with those from a reference technique in 111 patients having glomerular filtration rate measurements as part of their workup for liver transplantation.

Methods: Results of calculations using the new technique were compared with plasma clearance measurements obtained using a conventional slope-intercept technique and with clearance measurements based on urine collection.

Development of a modified sampling and calculation method for isotope plasma clearance assessment of the glomerular filtration rate in patients with cirrhosis and ascites.

Aim: The aim of this study was to identify a practical sampling regimen and calculation method that could be used to measure the glomerular filtration rate in patients with ascites using plasma sampling.

Patients And Methods: Thirteen potential liver transplant patients with cirrhosis and ascites were injected with Cr-51 ethylenediaminetetraacetic acid, and plasma samples were obtained at up to 16 time points for each patient. Reference clearance values were calculated using the area under the plasma clearance curve, which was calculated using all the available data points.

Clinical governance improves the quality of nuclear medicine reporting.

Objective: To assess the quality of nuclear medicine reporting, within a private UK hospital, of five physicians from four different National Health Service trusts and compare it with a similar previous clinical governance exercise.

Methods: Reports (n=140) were shown anonymously to all five physicians, including the one who produced the report. Each physician ranked them on a scale of 1-5, with 1 and 5 corresponding to complete disagreement and complete agreement, respectively.

Technetium-99m-labelled sulesomab (LeukoScan) in the evaluation of soft tissue infections.

Objective: To perform a retrospective review of all patients receiving technetium-99m ((99m)Tc)-labelled sulesomab over a 4-year period to determine if soft tissue infections can be accurately identified.

Methods And Materials: We reviewed the results of 124 (99m)Tc-sulesomab studies performed over a 4-year period. Of these, 34 were performed for undiagnosed fever in which soft tissue infection was suspected to be the main cause.

Gallium citrate uptake is a marker of breast malignancy: true or false?

A 34-year old lady had a (67)Gallium citrate scan and demonstrated uptake by both of her breasts--diffuse in the right breast, but focal in the left breast at the "9 o'clock position". Core biopsy from both breasts showed fibroadenoma and no malignant cells were found. Though uptake of (67)Gallium citrate is normally associated with malignancy or infection there may be other causes of uptake and follow-up biopsy should be performed.

Late recurrent urinary tract infections may produce renal allograft scarring even in the absence of symptoms or vesicoureteric reflux.

Background: The significance of late urinary tract infections (UTIs) after renal transplantation and their association with scarring and graft dysfunction remains controversial. We sought to define the prevalence of renal scarring in allograft recipients with a history of late recurrent UTIs, to determine whether the presence of vesicoureteric reflux (VUR) confers an increased risk of scarring and to establish whether scarring correlates with graft dysfunction.

Methods: Among 307 renal allograft recipients, we identified 56 (18%) with late recurrent UTIs (> or =3/year).

Massive gastrointestinal haemorrhage in isolated intestinal Henoch-Schonlein purpura with response to intravenous immunoglobulin infusion.

There is increasing recognition that Henoch-Schonlein purpura may present in an atypical form in which gastrointestinal symptoms may predominate, and classic cutaneous changes may be delayed or absent. This may lead to significant diagnostic delay. We report the case of a 9-year-old girl who presented acutely with life-threatening gastrointestinal haemorrhage from multiple intestinal sites, with no skin rash and only mild evidence of renal involvement.

Intertumoural variability in functional imaging within patients suffering from neuroendocrine tumours. An observational, cross-sectional study.

(123)I mIBG (meta-iodobenzylguanidine) and (111)In pentetreotide scintigraphy imaging modalities are useful in demonstrating neuroendocrine tumours. Although (111)In pentetreotide is generally held to be a more superior imaging agent than (123)I mIBG for neuroendocrine tumours, we noted a differential uptake of the two agents by different tumour sites within individual patients. In some cases, the two tracers appeared to demonstrate different lesions within the same patient.

Diagnostic imaging of carcinoid metastases to the abdomen and pelvis.

Background: Functional and anatomical imaging methods are currently the standard approach to the evaluation of carcinoid tumor extent. Due to the nature of carcinoid tumors ,there is not a single imaging procedure that is sufficient to detect the malignancy. The aim of the study was to compare the value of CT, MR and functional imaging study with(111) In-Octreotide (SRS) in carcinoid detection and evaluation of its extent as well as to work out the imaging studies diagnostic algorithm that could enhance diagnostic efficacy.

Long-term efficacy of low activity meta-[131I]iodobenzylguanidine therapy in patients with disseminated neuroendocrine tumours depends on initial response.

Background: meta-[131I]Iodobenzylguanidine (131I-MIBG) has been used to treat patients with disseminated neuroendocrine tumours (NET). However, so far there is limited information related to the efficacy of this agent beyond the normal 6-month assessment period. Before we can assume that such treatment would be beneficial to patients with these tumours the outcome of the patients over a longer time course should be determined.

Clinical audit in nuclear medicine.

Background And Aim: Clinical governance is important. Clinical audit is part of clinical governance. The aim of this study was to perform a clinical governance exercise, and the reporting arrangements at an independent hospital provided the opportunity to do this over two phases between 1999 and 2002.

Prediction of clinical outcome in treated neuroendocrine tumours of carcinoid type using functional volumes on 111In-pentetreotide SPECT imaging.

The quantification of the tumour volume is essential for the assessment of therapy-induced changes. Traditional methods of assessing the response of neuroendocrine tumours using radiological methods yield poor results, particularly within the liver. The aim of this study was to establish whether it would be possible to identify a method using functional volumes to predict the response of tumours to various therapies.

[Evaluation of scintimammography as an additional test to conventional mammography in detection of breast cancer].

Objectives And Design: Scintimammography using Tc-99m MIBI is becoming established as a second line diagnostic test for the detection of breast cancer in patients with suspected primary disease. Though most published clinical studies compare scintimammography (SMM) with mammography (XMM), in clinical practice they are likely to be used sequentially with the scintimammography following the mammography.

Materials And Methods: To determine the possible accuracy of such an approach, receiver operator characteristic (ROC) curves were produced for SMM, XMM and a combination of both studies performed over 2 years period on 162 suspicious lesions in 154 patients with no previous history of breast cancer.

Long-term efficacy of high-activity 111in-pentetreotide therapy in patients with disseminated neuroendocrine tumors.

Unlabelled: High-activity (111)In-pentetreotide has been used to treat patients with disseminated neuroendocrine tumors. There is, however, little information related to the efficacy of this agent beyond the normal 6-mo assessment period. Before we can assume that such treatment would be beneficial to patients with neuroendocrine tumors the outcome of the patients over a longer time course should be determined.