Journal of nuclear medicine : official publication, Society of Nuclear Medicine
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Comparative Study
Utility of technetium-99m-DTPA in determining regional ventilation.
The goal of this study was to determine the usefulness of radiolabeled aerosols in the assessment of regional ventilation in tracheotomized patients maintained on mechanical ventilation. ⋯ The lungs of patients maintained on mechanical ventilation can be imaged after the inhalation of 99mTc-DTPA from commercially available delivery kits, but the correlation between aerosol deposition and regional ventilation is poor. Better definition of ventilated lung segments is obtained when using a gas such as 81mKr because tracheal activity with the radiolabeled gas is minimized.
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Clinical Trial
Phase 1 study of rhenium-186-HEDP in patients with bone metastases originating from breast cancer.
Rhenium-186-1,1-hydroxyethylidene diphosphonate (186Re-HEDP) has been used for the palliative treatment of metastatic bone pain. A Phase 1 dosage escalation study was performed using 186Re-HEDP in patients with metastatic breast cancer. ⋯ The maximum tolerated administered activity of 186Re-HEDP in patients with metastatic breast cancer is 2405 MBq (65 mCi). Thrombocytopenia proved to be the dose-limiting toxicity, which could not be predicted adequately by the administered activity. Changes of alkaline phosphatase levels suggest anti-tumor effects of 186Re-HEDP.
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Rhenium-186(Sn)-1,1-hydroxyethylidene diphosphonate (186Re-HEDP) has been used for palliation of metastatic bone pain. The purpose of this study was to find a relationship between the bone marrow absorbed dose and the toxicity, expressed as the percentage decrease in the peripheral blood platelet count. ⋯ Although the function of normal bone marrow is affected by metastases in patients with metastatic bone disease, the MIRD model can be used to relate toxicity to the bone marrow absorbed dose after a therapeutic dosage of 186Re-HEDP.
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Comparative Study
Relationships between gastric emptying, intragastric meal distribution and blood glucose concentrations in diabetes mellitus.
The aim of this study was to evaluate the prevalence of disordered intragastric meal distribution and the relationships between gastric emptying, intragastric distribution, glycemic control and gastrointestinal symptoms in diabetes mellitus. ⋯ In patients with diabetes mellitus, there is poor relationship between solid and liquid gastric emptying and intragastric meal distribution is frequently abnormal. Interpretation of the results of gastric emptying measurements should consider meal composition and plasma glucose concentrations.
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Ischemia in the carotid artery territory due to atherosclerotic stenosis of the innominate artery is rare. We report a case in which transcranial Doppler ultrasonography (TCD) and SPECT with acetazolamide challenge proved the hemodynamic mechanism. The patient presented with three hypotensive TIAs in the right middle cerebral artery territory. ⋯ SPECT showed disturbed regional blood flow in the middle cerebral artery territory along with an exhausted perfusion reserve capacity. After angioplasty, flow velocities were normal and the perfusion reserve was restored. SPECT should be used to select patients at risk susceptible to benefit from angioplasty.