Technetium-99m human immunoglobulin imaging in patients with subacromial impingement or adhesive capsulitis.

Although recognised as useful in detecting soft-tissue inflammation and infection, technetium-99m human immunoglobulin (Tc-99m HIG) has not been widely studied in evaluating regional inflammatory musculoskeletal conditions. Tc-99m HIG scintigraphy was undertaken for consecutive patients referred to a rheumatology clinic with unilateral shoulder pain, diagnosed with either subacromial impingement (n = 12) or adhesive capsulitis (n = 4) from clinical examination, radiographic, and in some cases arthrographic findings. In all patients there were no differences in Tc-99m HIG images between symptomatic and asymptomatic shoulders.

Iodine-131-MIBG therapy of a patient with carcinoid liver metastases.

Unlabelled: Iodine-13I-metaiodobenzylguanidine (MIBG) is highly concentrated by >60% of carcinoid metastases and thus provides a therapeutic opportunity.

Methods: A symptomatic patient with carcinoid liver metastases, unresponsive to chemotherapy combined with interferon-alpha, was subsequently treated with 131I-MIBG.

Results: Radionuclide therapy, which was without significant side effects, resulted in symptomatic improvement and reduced urinary 5-hydroxyindoleacetic acid levels.

Foot pain: specific indications for scintigraphy.

Bone scintigraphy is requested as part of the investigation of foot pain, but its contribution to clinical management has not been comprehensively documented. Previously published data are limited; the most comprehensive series identified scintigraphic abnormalities in patients with primarily orthopaedic problems and a control group was not included (Maurice HD et al. J Bone Joint Surg 1987;69B:448 52).

Recurrent follicular carcinoma-oxyphilic cell type (Hürthle cell carcinoma) of the thyroid, imaging with iodine-131 and technetium-99m tetrofosmin before and after radiotherapy.

A 68-year-old male with recurrence of malignant follicular carcinoma-oxyphilic cell type of the thyroid after surgery underwent whole body scintigraphy with 131I-sodium iodide and 99Tcm-tetrofosmin (Myoview). 131I scanning demonstrated local uptake most likely to be in the normal remnant, but 99Tcm-Myoview images delineated recurrence of the carcinoma in the neck, with more extensive involvement. We believe that a combination of 131I and 99Tcm-tetrofosmin imaging may be useful to assess the extent of disease in patients with recurrent Hürthle cell type carcinoma of the thyroid.

Biodistribution of a radiolabelled monoclonal antibody NY3D11 recognizing the neural cell adhesion molecule in tumour xenografts and patients with small-cell lung cancer.

The neural cell adhesion molecule (NCAM) is highly expressed on the surface of small-cell-lung cancer (SCLC) cells. We have produced a monoclonal antibody, NY3D11, that binds to NCAM to investigate whether this antigen could be used to develop antibody-directed therapy for SCLC. 125I-labelled IgG and F(ab')2 fragments of NY3D11 localized selectively in human SCLC xenografts grown in nude mice.

Technetium-99m-MDP patterns in patients with painful shoulder lesions.

Unlabelled: There is no consensus on the optimum mode of imaging in patients with painful shoulder lesions. There is a particular paucity of scintigraphic data. As a result, the strengths and weaknesses of scintigraphy cannot be adequately compared to other imaging techniques used in shoulder imaging.

Clinical evaluation of technetium-99m-L,L-ethylenedicysteine in patients with chronic renal failure.

Unlabelled: Technetium-99m-L,L-ethylenedicysteine (99mTc-L,L-EC), a new renal radiopharmaceutical, has been shown to have similar excretion characteristics but a higher plasma clearance than 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) in normal volunteers and patients with obstructive nephropathy. This study evaluated 99mTc-L,L-EC in patients with chronic renal failure.

Methods: The clearance of 99mTc-L,L-EC was compared with that of 125l-hippuran in 26 patients with varying degrees of chronic renal impairment (serum creatine 168-1163 mumol/liter).

Clinical evaluation of technetium-99m infecton for the localisation of bacterial infection.

The aim of the study was to distinguish infection from inflammation in patients with suspected infection using technetium-99m Infecton. Ninety-nine patients (102 studies) referred for infection evaluation underwent imaging with 400 MBq 99mTc-Infecton at 1 and 4 h. Most patients had appropriate microbiological tests and about half (56) had radiolabelled white cell scans as well.

Effect of attenuation correction on myocardial thallium-201 distribution in patients with a low likelihood of coronary artery disease.

Regional variation of tracer distribution is seen in uncorrected thallium-201 images of normal hearts. This study evaluates the effect of attenuation correction on myocardial 201T1 distribution in patients with low risk of coronary artery disease. An L-shaped dual-detector single-photon emission tomographic system equipped with a pair gadolinium-153 scanning line sources was used for sequential emission/transmission imaging in 36 patients (14 men and 22 women) with less than 5% risk for coronary artery disease.

Transmission scanning for attenuation correction of myocardial 201Tl images in obese patients.

For attenuation correction (AC) of 201Tl myocardial perfusion images, an accurate attenuation map is required. This study assessed whether prolonged transmission scanning is required in obese compared to normal-sized patients. Twenty-nine obese patients (mean body mass index 33 kg m-2) underwent sequential emission/transmission imaging for AC using an L-shaped, dual-headed gamma camera fitted with two 153Gd scanning line sources.

Contrast nephrotoxicity and the role of radionuclide renal scan.

Radiographic contrast media-induced nephrotoxicity is an important cause of acute renal failure. The indications of using contrast are usually unavoidable, compelling and continue to expand, especially in the vascular field. When acute renal failure follows such a procedure, it becomes important to establish the presence of contrast nephrotoxicity or an acute occlusive event which may have precipitated the failure.

Myocardial perfusion scintigraphy in patients undergoing major non-vascular abdominal surgery.

The prognostic value of myocardial perfusion scintigraphy is beginning to be recognised in patients undergoing cardiovascular surgery. The aim of this prospective study was to assess the predictive value of scintigraphy in elderly patients undergoing major non-vascular abdominal surgery. Adenosine stress thallium-201 (201Tl) single-photon emission tomography (SPET) was employed for imaging using a standard protocol.

Slow bolus injection of ribose in the identification of thallium-201 redistribution following combined adenosine/dynamic exercise stress.

Aim: A simple stress/redistribution thallium-201 myocardial perfusion imaging protocol may underestimate the degree of thallium redistribution in a defect identified on the stress images. We sought to investigate whether a slow-bolus injection of D-ribose improves the identification of thallium redistribution following combined adenosine/dynamic exercise stress.

Materials And Methods: Fifteen patients (10 males, five female, median age 63 years, range 50-75) were enrolled in the study.

Inter-observer agreement in the reporting of 99Tcm-DMSA renal studies.

The early identification of renal cortical scarring secondary to urinary reflux and/or renal infection is important in the management of patients with recurrent disease. Scintigraphic imaging of the renal cortex using 99Tcm-dimercaptosuccinic acid (DMSA) is often considered the standard method for the diagnosis of renal scars in both adults and children. Consistent reporting of 99Tcm-DMSA is nevertheless essential in ensuring that the clinician can act on the data reported.

Sonographic abnormalities of the thyroid gland following radiotherapy in survivors of childhood Hodgkin's disease.

The aims of this study were as follows. (1) To demonstrate the spectrum, frequency and changes on follow-up of sonographic abnormalities in the thyroid gland of survivors of Hodgkin's disease who had received radiotherapy to the neck in childhood. (2) To compare the sonographic findings with clinical examination and radionuclide imaging.

Gallium-67 imaging of pericardial lymphoma in AIDS.

A 33-yr-old homosexual man with acquired immune deficiency syndrome (AIDS) and Mycobacterium avium intracellulare (MAI) infection presented with fever, sweats, lethargy and dyspnea. A chest radiograph showed cardiomegaly and an echocardiograph revealed a large pericardial effusion. After pericardial aspiration, which confirmed T cell non-Hodgkin's lymphoma, he remained dyspneic.

Comparison of 99mTc infecton imaging with radiolabelled white-cell imaging in the evaluation of bacterial infection.

Background: Bacterial infection can pose a substantial diagnostic dilemma. Techniques involving radiolabelled leucocytes can pinpoint the site of inflammation. However, previous radiolabelling techniques have failed to distinguish between bacterial-mediated infection and non-bacterial inflammation.

Immunoscintigraphy with a 99Tcm-labelled anti-granulocyte monoclonal antibody in patients with human immunodeficiency virus infection and AIDS.

The value of immunoscintigraphy with technetium-99m (99Tcm) labelled anti-granulocyte monoclonal antibody (BW250/183) was studied prospectively in human immunodeficiency virus (HIV-1) antibody-positive patients presenting with fever without localizing symptoms or signs. Twenty-three studies were performed in 23 patients and the results of 99Tcm-anti-granulocyte imaging were compared with the definitive microbiological or cytological diagnosis. Twenty-one patients had an infective cause of pyrexia, one patient had disseminated lymphoma and one Kaposi sarcoma.

Tumour imaging.

This review looks at the nuclear medicine scanning techniques that are available for tumour imaging. It aims to promote an understanding of the specific value of this imaging modality, and thereby help to conserve resources, save time, and assist clinicians in providing optimal care.

Technetium-99m-L,L-ethylenedicysteine scintigraphy in patients with renal disorders.

Technetium-99m-L,L-ethylenedicysteine (99mTc-L,L-EC), a new renal imaging agent, was introduced as an alternative to 99mTc-mercaptoacetyltriglycine (MAG3). This radiopharmaceutical can be easily labelled at room temperature and has high radiochemical purity and long stability. The aim of this study was to gain clinical experience in using 99mTc-L,L-EC in normal volunteers and patients.

Combined rest thallium-201/stress technetium-99m-tetrofosmin SPECT: feasibility and diagnostic accuracy of a 90-minute protocol.

Unlabelled: Technetium-99m tetrofosmin is a recently developed compound that clears from background organs rapidly. Tetrofosmin has a good correlation with 201Tl. This study assesses the feasibility and diagnostic accuracy of a combined protocol involving rest 201Tl SPECT and stress imaging with 99mTc-tetrofosmin.