Prediction of 2-year major adverse cardiac events from myocardial perfusion scintigraphy and clinical risk factors.

Background: We developed CRAX2MACE, a new tool derived from clinical and SPECT myocardial perfusion imaging (MPI) variables, to predict 2-year probability of major adverse cardiac event (MACE) comprising death, hospitalized acute myocardial infarction or coronary revascularization.

Methods: Consecutive individuals with SPECT MPI 2001-2008 had two-year MACE determined from population-based health services data. CRAX2MACE included age, sex, diabetes, recent cardiac hospitalization, pharmacologic stress, stress total perfusion deficit (TPD), ischemic (stress-rest) TPD, left ventricular ejection fraction and transient ischemic dilation ratio.

Reassessment Intervals for Transition From Low to High Fracture Risk Among Adults Older Than 50 Years.

Importance: Fracture risk scores are used to identify individuals at high risk of major osteoporotic fracture or hip fracture for antiosteoporosis treatment. For those not meeting treatment thresholds at baseline, the optimal interval for reassessing fracture risk is uncertain.

Objective: To examine reassessment intervals for transition from low to high fracture risk under guidelines-defined treatment thresholds.

Vertebral Fracture Assessment Increases Use of Pharmacologic Therapy for Fracture Prevention in Clinical Practice.

The impact of vertebral fracture assessment (VFA) on lateral spine images in clinical practice on subsequent patient use of fracture prevention medication is unknown. Our objective was to determine the association of prevalent vertebral fracture identified on bone density lateral spine images (positive VFA) with subsequent use of fracture prevention therapy in usual clinical practice, using the Manitoba Bone Density Program database prospective observational cohort. Since 2010, targeted VFA imaging has been done at the time of bone densitometry in Manitoba for 21% of women and men meeting criteria based on age, bone mineral density (BMD), height loss, and glucocorticoid use.

Association of Bone Density Monitoring in Routine Clinical Practice With Anti-Osteoporosis Medication Use and Incident Fractures: A Matched Cohort Study.

Routine bone mineral density (BMD) monitoring of individuals during the initial 5 years of anti-osteoporosis treatment is controversial. Using a registry-based cohort from the Province of Manitoba, Canada, we compared anti-osteoporosis medication use and fracture outcomes in women with versus without BMD monitoring receiving anti-osteoporosis medication. We identified 4559 women aged 40 years and older receiving anti-osteoporosis therapy with serial BMD testing (monitoring) within 5 years (mean interval 3.

Factors Associated With Bone Density Monitoring While on Antiosteoporosis Treatment in Routine Clinical Practice: A Registry-Based Cohort Study.

The role for bone mineral density (BMD) monitoring while on antiosteoporosis therapy remains controversial. The current study used population-based registries to identify factors associated with BMD monitoring in women within 5 yr of receiving antiosteoporosis treatment vs treatment without monitoring in routine clinical practice. The analytical dataset consisted of women age 40 yr and older at baseline receiving antiosteoporosis therapy: 6877 with BMD monitoring (mean interval 3.

Prevalent vertebral fracture on bone density lateral spine (VFA) images in routine clinical practice predict incident fractures.

Purpose: The predictive validity of vertebral fracture assessment (VFA) on bone density lateral spine images to identify prevalent vertebral fractures in routine clinical practice has not been established. Our objective was to estimate the associations of prevalent vertebral fracture identified on VFA images in routine practice with incident hip, all non-vertebral, major osteoporotic, and clinical vertebral fractures, using the Manitoba Bone Density database.

Methods: From 2010 onward, 9972 men and women (mean age [SD] 76 [6.

Neurolymphomatosis of the Brachial Plexus and its Branches: Case Series and Literature Review.

Background: Neurolymphomatosis is a process of neoplastic endoneurial invasion, most strongly associated with non-Hodgkin's lymphoma. It must be distinguished from paraneoplastic, metabolic, nutritional and treatment-related causes of neuropathy that are common in this patient population.

Methods: This brief case series illustrates the protean manifestations of neurolymphomatosis of the brachial plexus, ranging from focal distal mononeuropathy to multifocal brachial plexopathy, either as the index manifestation of lymphoma or as a complication of relapsing disease.

Acute obstruction of a chronic organoaxial gastric volvulus detected on blood pool imaging of a bone scan.

Acute obstruction of a chronic gastric volvulus was incidentally detected on blood pool imaging of a total body bone scan performed for an elevated prostate-specific antigen level. The patient had been diagnosed with an organoaxial gastric volvulus within a paraesophageal hernia 4.5 years previously, with no evidence for obstruction.

Cardiac metastases of neuroendocrine tumors treated with 177Lu DOTATATE peptide receptor radionuclide therapy or 131I-MIBG therapy.

Neuroendocrine tumors have a propensity to metastasize to the heart, although the reason for this remains unknown. A review of 251 neuroendocrine tumor patients treated with Lu DOTATATE peptide receptor radionuclide therapy or I-MIBG therapy at our institution since 2003 revealed 2 patients with cardiac metastases (incidence, 0.8%), one treated with Lu DOTATATE and one with I-MIBG.

Pseudomyogenic Hemangioendothelioma Mimicking Multiple Myeloma on 18F-FDG PET/CT, Followed by Spontaneous Regression.

Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma is a rare, recently described vascular neoplasm that occurs predominantly in the distal extremities of young to middle aged adult males. In this report, we describe a patient who presented with numerous lytic bone lesions which were intensely ¹⁸F-FDG avid on PET/CT and presumed to be metastatic. Pathology revealed pseudomyogenic hemangioendothelioma.