The diagnostic value of pretreatment serum LDH in patients with limited disease small-cell lung carcinoma.

Background: In patients with limited disease SCLC, the overall survival is still poor. Therefore, a retrospective study was performed involving 48 patients with limited disease SCLC to select a parameter which can identify prognostic subgroups at the time of diagnosis.

Materials And Methods: Follow-up ranged from 3 to 96 months, during which period 38 patients died.

Pretreatment serum LDH as additional staging parameter in small-cell lung carcinoma.

Background: In patients with limited disease staged small-cell lung cancer (SCLC), overall survival is still poor. Therefore, a retrospective study was carried out of 48 patients with limited disease staged SCLC to select a parameter which can identify prognostic subgroups at the time of diagnosis.

Materials And Methods: Follow-up varied from 3 to 96 months during which 38 patients died.

Diagnostic nuclear medicine and risk for the fetus.

The possible detrimental effects on the developing embryo subsequent to irradiation are discussed. The doses to the embryo or fetus encountered for the most common procedures in diagnostic nuclear medicine are evaluated with respect to the threshold doses and the risks per cGy. The threshold dose for fatal and non-fatal malformations or other defects is, at the lowest estimate, 5-10 cGy.

Localization of a bacterial infection with 99Tcm-labelled human IgG: further improvement with enriched IgG subclass preparations.

The aim of this study was to determine the contribution of various IgG subclasses to the scintigraphic detection of a staphylococcal infection. An experimental thigh infection in mice was used to determine the accumulation of the various 99Tcm-labelled IgG preparations with enriched IgG1, IgG2 or IgG4 subclass. Multiple-regression analysis was used to investigate a relationship between the IgG subclasses and the time-dependent accumulation in infected sites.

Comparison of in vivo cardiac function with ex vivo cardiac performance of the rat heart after thoracic irradiation.

The aim of the study was to compare in vivo cardiac function with ex vivo cardiac performance after local heart irradiation in the same rat. Left ventricular ejection fraction (LVEF) was measured in vivo by radionuclide ventriculography in Sprague-Dawley rats up to 16 months after a single dose of 20 Gy. Four days after in vivo measurements, cardiac performance was determined ex vivo, using the isolated working rat heart preparation.

Detection of experimental infections with 99mTc-labeled monoclonal antibodies against TNF-alpha and interleukin-8.

This study was designed to assess monoclonal antibodies (MAbs) directed against tumor necrosis factor-alpha (TNF-alpha) (anti-TNF) or interleukin-8 (anti-IL-8) as radioactive agents for the detection of Staphylococcus aureus-or Klebsiella pneumoniae-infected thighs in mice. At 5 min (acute infection) or 20 h (established) post-infection, 20 micrograms of the 99mTc-labeled MAbs were injected. At various time intervals, the accumulation of the radiotracer in the infected thighs was assessed and expressed as a target-to-nontarget (T/NT) ratio.

Aspects of performance assessment of whole body imaging systems.

Regular quality control is one of the cornerstones of nuclear medicine and a prerequisite for adequate diagnostic imaging. Many papers have been published on quality control of planar and tomographic imaging systems. Up to now, however, only minor attention has been given to the assessment of the performance of whole body imaging systems.

The value of pretreatment clinical and biochemical parameters in patients with newly diagnosed untreated prostate carcinoma and no indications for bone metastases on the bone scintigram.

Between 10% and 25% of patients with newly diagnosed prostate cancer without bone metastases at the time of diagnosis will develop metastases during follow-up. To determine the value of clinical and biochemical parameters for assessment of prognosis at the time of diagnosis, a retrospective study was performed in 124 consecutive patients with newly diagnosed prostate cancer without bone metastases. The mean follow-up was 41 months, during which time 36 patients died and 15 patients developed metastases.

SPECT versus planar 99mTc-sestamibi myocardial scintigraphy: comparison of accuracy and impact on patient management in chronic ischemic heart disease.

A head-to-head comparison between 99mTc-sestamibi SPECT and planar myocardial imaging using dipyridamole low-level exercise stress was performed for the assessment of coronary artery disease (CAD) and for the impact on patient management in 78 patients (pts) who underwent coronary arteriography. Overall sensitivity and specificity for detection of CAD were 82% and 82% for SPECT, and 78% and 73% for planar imaging, respectively (both NS). Compared to planar imaging the sensitivity of SPECT imaging was significantly higher for detecting left anterior descending (p = 0.

Iodine-123 labelled radiopharmaceuticals and single-photon emission tomography: a natural liaison.

Most nuclear medicine departments possess one or more imaging apparatuses for single-photon emission tomography (SPET). Molecules of biological interest to assess metabolism and receptor function are often labelled with 123I, which allows proper SPET imaging. The various methods for radiolabelling are reviewed.

Inflammatory bowel disease activity assessment using technetium-99m-HMPAO leukocytes.

Aim of the study was to evaluate [99mTc]hexamethyl-propylamine-oxime (HMPAO) leukocyte scintigraphy for the assessment of disease activity and extent in inflammatory bowel disease patients. Results and scores of scintigraphy using [99mTc]HMPAO-labeled leukocytes were retrospectively compared with the activity index of van Hees, laboratory parameters, and gastroenterologists' assessment of disease using endoscopy, radiology, and histology plus clinical parameters in 136 patients with Crohn's disease (115) and ulcerative colitis (21) and in 29 controls. There were 114 positive and 22 negative [99mTc]HMPAO leukocyte scintigrams.

Myocardial SPET imaging with 99Tcm-tetrofosmin in clinical practice: comparison of a 1 day and a 2 day imaging protocol.

99Tcm-tetrofosmin is a new myocardial perfusion agent with the advantage that it can be reconstituted at room temperature. Because two separate injections are required for rest and stress images, a separate-day imaging protocol with one injection each day would be optimal in terms of image quality. From the logistical point of view, a 1 day protocol may be more convenient for the majority of those referred as outpatients.

The clinical role of immunoscintigraphy for the detection of ocular melanoma.

The value of immunoscintigraphy in the diagnosis of choroidal melanoma is discussed and compared with other diagnostic procedures with isotopes and diagnostic modalities like fluorescein angiography, standardized ultrasonography and magnetic resonance imaging. Consecutive studies with immunoscintigraphy in choroidal melanoma show a sensitivity of 41 to 49%, which can be improved by use of single photon emission computerized tomography (SPECT). Another technique which has improved the results of radio-immunoscintigraphy is the use of a three-step labelling procedure with biotinylated anti-tumor antibodies and avidin.

Potential for imaging cerebral amyloid deposits using 123I-labelled serum amyloid P component and SPET.

The systemic and cerebral accumulation of 123I-labelled serum amyloid P component (123I-SAP) was studied in patients with hereditary cerebral amyloid angiopathy-Dutch type (HCHWA-D) to determine the usefulness of 123I-SAP imaging in cerebral amyloidosis. Whole-body and SPET scintigraphic imaging was performed in two patients with HCHWA-D and four controls after the intraveous injection of 123I-SAP. Venous 123I-SAP clearance was also determined.

Quantitative analysis of defect reversibility after immediate and standard 201Tl reinjection.

Immediate reinjection of 201Tl after exercise imaging has been proposed as a time-saving approach for the accurate distinction between ischaemic and scarred myocardium. However, with this procedure, defect reversibility may be underestimated due to the high level of residual 201Tl activity in normally perfused myocardium at the time of reinjection. The aim of this study was to determine whether the detection of defect reversibility is hampered by a shortening of the time interval between exercise and reinjection.

Detection of coronary artery disease: comparison between technetium 99m-labeled sestamibi single-photon emission computed tomography and two-dimensional echocardiography with dipyridamole low-level exercise-stress.

Background: Myocardial perfusion imaging in conjunction with dipyridamole low-level exercise stress has proved its value in the evaluation of patients with coronary artery disease (CAD). Simultaneous wall motion analysis by two-dimensional (2D) echocardiography may provide additional information beyond that obtained by myocardial perfusion imaging alone. The purpose of this study was to compare 99mTc-labeled sestamibi single-photon emission computed tomography (SPECT) and 2D echocardiography for the evaluation of CAD according to a dipyridamole low-level bicycle exercise stress protocol.

Stress-reinjection 201Tl scintigraphy without redistribution imaging: prediction of the effect of coronary artery bypass grafting on regional myocardial 201Tl uptake.

Reinjection of thallium-201 (201Tl) improves the detection of myocardial ischaemia in approximately 50% of irreversible defects present on 3 h redistribution images. Additional reinjection studies, however, may limit the capacity of the nuclear laboratory and they are not patient-friendly Previous studies have suggested that only severe persistent defects with less than 50% of maximal 201Tl uptake are irreversibly damaged, with little chance of recovery following coronary artery bypass grafting (CABG). We examined the ability of a modified stress-reinjection protocol without redistribution imaging to predict subsequent improvement in myocardial perfusion post-CABG.

Comparison of technetium-99m sestamibi left ventricular wall motion and perfusion studies with thallium-201 perfusion imaging: in search of the combination of variables with the highest accuracy in predicting coronary artery disease.

Measurements of myocardial perfusion and ventricular function are expected to provide additional information in the detection of coronary artery disease (CAD). The purpose of this study was threefold: (1) to determine to what extent technetium-99m sestamibi wall motion yields different information compared with 99mTc-sestamibi and thallium-201 perfusion; (2) to test which information unique to either study is of value in diagnosing CAD; and (3) to assess the combination of variables with the highest diagnostic accuracy. Perfusion and wall motion scores (at rest and during exercise) obtained from visual and quantitative planar 201Tl and 99mTc-sestamibi scintigraphy of 60 patients with suspected CAD were compared with the angiographic results by means of a polytomous logistic regression model and the diagnostic values were compared with one another.

Role of 67Ga scintigraphy in localization of lymphoma.

This review deals with the applications of 67Gallium (Ga) scintigraphy for the initial staging and follow-up during and after treatment of patients with Hodgkin's or non-Hodgkin's lymphoma (NHL). During the last decade, the technique of visualization has been largely improved by using higher doses and additional tomography. Here, the indications for 67Ga scintigraphy in comparison with CT and MRI are discussed.

Defect reversibility using thallium-201 reinjection. Comparison of stress-redistribution-reinjection with stress-immediate reinjection.

Immediate poststress thallium-201 reinjection followed by imaging one hour later has been proposed as an alternative reinjection protocol. This procedure is patient-convenient and time-saving as it shortens the investigation time to maximally 2.5 hours.

Head-to-head comparison of 201Tl rest-redistribution scintigraphy and stress-immediate reinjection scintigraphy in the detection of myocardial viability.

Reinjection imaging with thallium-201 (201Tl) provides a reliable method of identifying viable myocardium. Reinjection of 201Tl immediately after completing the stress images followed by imaging 1 h after reinjection shortens the examination time to a maximum of 2.5 h and provides an alternative imaging approach in patients with coronary artery disease.

Nuclear medicine techniques and magnetic resonance imaging in coronary artery disease.

Primary modalities for non-invasive imaging of coronary artery disease (CAD) and related disorders include nuclear medicine techniques and magnetic resonance imaging (MRI). Nuclear medicine has contributed greatly to the diagnosis of CAD and the assessment of the extent of functional abnormalities. Thallium-201 has a long history as a perfusion agent and is currently also used to study myocardial viability.