(99m)Tc sestamibi breast imaging for the examination of patients with dense and fatty breasts: multicenter study.

Purpose: To evaluate the accuracy of scintimammography as an adjunct to physical examination and mammography in the detection of breast cancer in women with dense and fatty breasts.

Materials And Methods: A total of 558 women were prospectively enrolled from 42 centers in North America. Images were interpreted by readers blinded to the subjects' clinical history, mammographic findings, and other test results.

Combined corrections for attenuation, depth-dependent blur, and motion in cardiac SPECT: a multicenter trial.

Background: The diagnostic accuracy of cardiac single photon emission computed tomography (SPECT) is limited by image-degrading factors, such as heart or subject motion, depth-dependent blurring caused by the collimator, and photon scatter and attenuation. We developed correction approaches for motion, depth-dependent blur, and attenuation and performed a multicenter validation.

Methods And Results: Motion was corrected both transversely and axially with a cross-correlation technique.

Functioning liver metastases on an I-131 whole-body scan: a case of malignant struma ovarii.

A 46-year-old women was examined for severe constipation. Pelvic examination revealed a large pelvic mass extending to the level of the umbilicus. Computed tomography showed a large multicystic, septated mass in the pelvis and a small amount of fluid in the cul de sac.

Radiotherapy treatment planning using lymphoscintigraphy.

A method for the three dimensional location of lymph nodes with respect to the skin surface is described. The technique is based on the reconstruction of surface shape using isocentric radiographs taken with metal chains draped on the patient. Registration of the radiographic study to the lymphoscintigraphic study is accomplished automatically by matching the location of four radiopaque and radioisotope markers.

Perioperative ischemic injury after coronary bypass graft surgery.

Two hundred twelve patients who underwent isolated coronary bypass graft surgery were prospectively evaluated for perioperative ischemic injury. All patients underwent preoperative and postoperative testing with technetium 99m pyrophosphate first-pass ventriculography combined with myocardial uptake scans, 12-lead electrocardiography, and serial creatinine phosphokinase MB determination. Fifteen percent of the patients had ischemic injury with at least two test results positive, but only 4 percent had positive results of all three tests.

Effect of obesity on esophageal transit.

Esophageal transit time as measured by radionuclide scintigraphy using a swallowed technetium sulfur colloid bolus was measured in obese patients with gastroesophageal reflux, lean patients with reflux, and lean volunteers without reflux. The esophageal transit time was significantly prolonged in the obese group compared with both lean groups (p less than 0.001).

Factor analysis in left ventricular first-pass radionuclide angiography: value of the ventricular factor to measure ejection fraction.

Factor analysis theoretically generates the time-activity curves of the various physiological compartments, or factors, which are superimposed in a dynamic series of scintigraphic frames. An image of the spatial distribution of each of these factors is also displayed. We tested the ability of one of these, the ventricular factor, to measure the left ventricular ejection fraction (LVEF) in first-pass radionuclide angiography (FPRA).

Localization of abnormal parathyroid glands using thallium-201.

Ectopically located parathyroid adenomas may be difficult to find during initial neck exploration. They account for over 70 percent of missed adenomas found at reexploration. Preoperative localization of parathyroid adenomas would reduce unnecessary dissection and possibly reduce the number of negative results of initial neck exploration.

Colon polyps, sebaceous cysts, gastric polyps, and malignant brain tumor in a family.

A unique family with a distinct syndrome of adenomatous colonic polyps and sebaceous cysts without osseous or soft tissue abnormalities is presented. One member had benign gastric polyps limited to the upper half of the stomach and another had a medulloblastoma of the cerebellum. A histologic feature in the colon of the propositus was the presence of atypical epithelium in flat mucosa as well as in the colonic polyps.

Yersinia colitis.

A 2-year-old child with a febrile, non-bloody diarrheal illness of acute onset with repeatedly negative stool and blood cultures for pathogenic bacteria is presented. Sigmoidoscopic and roentgenographic studies revealed an inflammatory colitis. Unfortunately, diagnostic perserverance and a high index of suspicion resulted in a positive stool culture for Yersinia enterocolitica.

Occult malignant tumors in dermatologic disease. The futility of radiological search.

Analysis of 102 patients with dermatomyositis, polymyositis, bullous pemphigoid, and dermatitis herpetiformis was undertaken to determine: (a) the incidence of occult malignant tumors in these diseases, and (b) the value of radiological screening to detect unsuspected malignant neoplasms. The incidence of internal malignant disease was no higher than that encountered in a control population. Radiological screening procedures routinely performed for patients with these disorders failed to disclose any occult neoplasms.

Lymphangioma of the pancreas exhibiting an unusual pattern of calcification.

A case of calcified lymphangioma of the pancreas is presented. The pattern of calcification evolved through three distinct phases over a 15-year period, suggesting at first a lymphangioma or hemangioma and later a cystadenoma.

Bacteremia and the barium enema.

To investigate the possible association of bacteremia with barium enema examinations, blood samples were obtained from 42 patients before and at 5, 10, and 20 min after administration of the enema. Patients with fever or symptoms suggestive of inflammatory bowel disease were not included in the study; neither were patients who had received antimicrobiotic medication during the preceding 3 months. Pour-plate blood cultures showed no bacteremia due to enteric organism in the 42 patients-a result at variance with previously published reports.

Invasion of the duodenum by carcinoma of the stomach.

It has frequently been stated that extension to the duodenum occurs commonly in patients with gastric lymphoma but almost never in those with carcinoma of the stomach. We found radiographically detectable invasion of the duodenum in six of 111 consecutive patients (5%) with gastric carcinoma. The duodenum was involved microscopically in 18%.

Chiba percutaneous transhepatic cholangiography. A valuable method for visualizing the nondilated biliary tract.

Percutaneous transhepatic cholangiography with the Chiba needle has had remarkable results in cannulating small bile ducts. We have roentgenographically visualized a nondilated biliary system in the first five out of seven cases attempted. Including our series, there have been 71 successful Chiba studies in 107 nondilated or presumed normal biliary tracts with only one questionable major complication.

[Radiologic approaches to gastric cancer (author's transl)].

Radiologic study of patients continues to be of major importance in the detection of gastric malignant neoplasms and often provides the stimulus for further diagnostic procedures. The conventional roentgenographic procedure for this disease comprises a careful fluoroscopic examination of gastric peristalsis and distensibility, and views obtained with graded compression, mucosal relief, double-contrast technique, and barium filling. No single method has the ability to disclose all pathognomonic signs of a gastric tumor.

Roentgenographic features of mushroom (Amanita) poisoning.

The clinical and roentgenographic features of six cases of Amanita mushroom poisoning were reviewed. The roentgenographic manifestations included adynamic ileus (three patients) and small, irregularly shaped kidneys secondary to the healing process of acute tubular necrosis (one patient). Intestinal pseudo-obstruction can result from many medical problems and mushroom poisoning should be considered in its differential diagnosis.

Liver scan "hot spot" in hepatic veno-occlusive disease.

A focal "hot spot" seen on liver scan in an unusual case of hepatic veno-occlusive disease bore striking similarities to scanning patterns in superior vena cava syndrome. The findings are also compared to those reported in Budd-Chiari syndrome.