European journal of nuclear medicine and molecular imaging
-
Eur. J. Nucl. Med. Mol. Imaging · Jun 2002
Comparative Study Clinical TrialOvarian cancer recurrence: role of whole-body positron emission tomography using 2-[fluorine-18]-fluoro-2-deoxy- D-glucose.
This study was designed to assess the value of whole-body positron emission tomography (PET) using 2-[fluorine-18]-fluoro-2-deoxy- D-glucose (FDG) for the diagnosis of recurrent ovarian cancer. Twenty-five patients who had previously undergone surgery for ovarian cancer were imaged using whole-body FDG-PET. During the 4 weeks preceding the PET study, conventional imaging, comprising computed tomography (CT) and magnetic resonance (MR) imaging of the abdomen and/or pelvis, was performed and serum CA125 levels were measured. ⋯ The CA125 results showed a sensitivity of 75% (15/20), a specificity of 100% (5/5) and an accuracy of 80% accuracy (20/25). Among the 15 patients with true-positive CA125 results, PET correctly detected abnormal foci of recurrence in 13 patients (86.7%) whereas conventional imaging showed recurrent lesions in only eight patients (53.3%). In conclusion, our preliminary study demonstrates that FDG-PET may be accurate and useful for the detection of tumour recurrence when conventional imaging is inconclusive or negative, especially in patients with abnormal CA125 levels.
-
Eur. J. Nucl. Med. Mol. Imaging · Jun 2002
Comparative StudySensitivity of 123I whole-body scan and thyroglobulin in the detection of metastases or recurrent differentiated thyroid cancer.
Primary treatment of differentiated thyroid carcinoma consists of total thyroidectomy followed by ablation of thyroid tissue remnants and possible metastases by means of radioactive iodine. After complete destruction of remnants, metastases or recurrence can be detected by measurement of the serum thyroglobulin level as well as by radionuclide methods. Here we report on the sensitivity of diagnostic 123I scintigraphy and serum thyroglobulin measurement for tumour detection in patients with proven recurrence or metastases. ⋯ Early treatment of distant metastases or tumour remnants of differentiated thyroid carcinoma is favoured and 131I treatment should also be considered in patients with a negative WBS but positive serum Tg level. The finding of a positive Tg-off level, which is clearly above the corresponding Tg-on value, is sufficient to make this decision. Additional diagnostic 123I WBS will not improve sensitivity.
-
Eur. J. Nucl. Med. Mol. Imaging · May 2002
Comparative Study Clinical Trial Controlled Clinical TrialA comparison of (99m)Tc-HMPAO SPET changes in dementia with Lewy bodies and Alzheimer's disease using statistical parametric mapping.
Differences in regional cerebral blood flow (rCBF) between subjects with Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and healthy volunteers were investigated using statistical parametric mapping (SPM99). Forty-eight AD, 23 DLB and 20 age-matched control subjects participated. Technetium-99m hexamethylpropylene amine oxime (HMPAO) brain single-photon emission tomography (SPET) scans were acquired for each subject using a single-headed rotating gamma camera (IGE CamStar XR/T). ⋯ Abnormalities in these areas, which included visual cortex and several areas involved in higher visual processing and visuospatial function, may be important in understanding the visual hallucinations and visuospatial deficits which are characteristic of DLB. Covariate analysis indicated group differences between AD and DLB in terms of a positive correlation between cognitive test score and temporoparietal blood flow. In conclusion, we found evidence of frontal and parietal hypoperfusion in both AD and DLB, while temporal perfusion deficits were observed exclusively in AD and parieto-occipital deficits in DLB.
-
Eur. J. Nucl. Med. Mol. Imaging · Apr 2002
Clinical TrialThe usefulness of hepatobiliary scintigraphy in the diagnosis of complications after adult-to-adult living donor liver transplantation.
Living donor liver transplantation has become an accepted procedure to overcome the shortage of adult donor organs. The aim of this study was to evaluate the usefulness of hepatobiliary scintigraphy in the diagnosis of complications after adult-to-adult living donor liver transplantation. We analysed 82 hepatobiliary scintigraphy studies performed using technetium-99m DISIDA in 60 adult patients (44 males, 16 females) who had been transplanted with a living donor's hepatic lobe (right lobe, 32; left lobe, 28). ⋯ The diagnostic sensitivity and specificity of scintigraphy for biliary obstruction in the 54 patients with abnormal symptoms or liver function tests were 93% (100% for segmental, 83% for total) and 88% (35/40), respectively. The sensitivity and specificity were each 100% (15/15, 13/13) for bile leak in the 28 patients with suspected bile leak or biloma. Hepatobiliary scintigraphy is an accurate diagnostic modality in the evaluation of biliary complications after adult-to-adult living donor liver transplantation, although it has limitations as a means of differential diagnosis of non-biliary complications.
-
Eur. J. Nucl. Med. Mol. Imaging · Feb 2002
Diagnosis, characterisation and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study.
No large prospective study is available on use of a radionuclide method to assess frostbite and its response to conservative treatment. Recently, a large retrospective study using two-phase bone scintigraphy suggested that non-uptake (or low uptake) in frostbite lesions in the blood pool or bone phase had a strong correlation with the subsequent need for amputation. In the present study, we performed early blood pool scintigraphy with technetium-99m pertechnetate in 20 patients (10-180 days after frostbite injury; 71 clinical lesions) referred for a topical treatment protocol for mild to moderately severe frostbite, and in 22 asymptomatic controls. ⋯ In contrast to the previous findings that non-uptake on a scan performed 2 or more weeks after exposure correlates with the need for amputation, none of the 80 ischaemic lesions in our series required amputation while 60% showed improvement or normalisation in microvascular blood flow even though they were 10-180 days old. Our findings suggest that moderate to severe frostbite lesion can be classified as having infarcted, ischaemic or hibernating (viable) tissue, similar to the classification employed when using myocardial scintigraphy. Absence of uptake even after the initial 10 days does not necessarily indicate infarction and the need for amputation as many such lesions retain potential for vasodilation and recovery.