Journal of nuclear medicine : official publication, Society of Nuclear Medicine
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Strontium-89 has been used for the treatment of painful bony metastases in patients suffering from disseminated adenocarcinoma of the prostate, with a variable proportion of patients obtaining clinically significant reductions in analgesic requirements. Based on data revealing enhancement of continuous low-dose rate irradiation by low-dose cisplatin in murine models, a protocol using 148 MBq (4 mCi) of 89Sr and 35 mg/m2 of cisplatin infused over 2 days, 1 and 4 wk after administration of the radioisotope was undertaken. Preliminary data suggest good pain relief with 55% of 18 patients entered thus far obtaining at least a 50% reduction in analgesic requirements. ⋯ In particular, myelosuppression after one course of treatment was modest, but retreatments in two patients has resulted in grade 3 hematologic toxicity. Two patients developed a "pain flare" after administration of cisplatin. Further accrual to this study will allow more accurate determination of pain response rate, and improved evaluation of parameters of objective response.
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There is little information about gastric emptying of extracellular fat. A marker for liquid fat, 99mTc-(V)-thiocyanate, was used to compare gastric emptying and intragastric distribution of oil to that of aqueous liquid and solid meal components. Eight volunteers consumed 60 ml of 99mTc-labeled oil and 290 ml of 113m-In-labeled soup (total 505 kcal) on one day and 280 g 113mIn-minced beef (500 kcal), 60 ml 99mTc-labeled oil and 290 ml nonlabeled soup (505 kcal) on another day. ⋯ The emptying rate of oil in the oil/soup meal was about twice that for oil consumed in the other meal. There was no difference between the two meals in the number of calories emptied in the first 180 min. These results demonstrate major differences in the intragastric distribution of oil compared to solid and aqueous liquid meals.
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It is widely known that narcotics, such as morphine, cause spasm of the sphincter of Oddi, increasing pressure in the common bile duct. This pharmacologic effect has been applied to hepatobiliary scintigraphy in patients with chronic cholecystitis or cholestasis to reducing the time required for a diagnostic study. However, this feature of narcotics could result in delayed or nonvisualization of the small bowel, simulating a distal common bile duct obstruction, in patients requiring parenteral narcotic analgesics who must undergo hepatobiliary scintigraphy. We report on three patients where administration of intravenous naloxone hydrochloride (Narcan), a narcotic antagonist, was helpful in distinguishing narcotic-induced spasm of the sphincter of Oddi from true obstruction of the common bile duct.
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Global and regional mucociliary clearance and transport in the lungs was studied in 20 patients with bronchiectasis by radioaerosol inhalation lung cine-scintigraphy and the quantitative analysis following inhalation of ultrasonically-generated 99mTc-tagged human serum albumin aerosol (mass median diameter; 1.93 microns with geometric s.d. of 1.52). In bronchiectatic lung regions, deposition of inhaled aerosol was diminished or inhomogeneous. ⋯ When coughs occurred, regurgitation and stray became more marked in the bronchiectatic regions. These regional abnormalities in mucociliary transport seem to be responsible for the development of infections and hemoptysis in the bronchiectatic regions.
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To provide optimal image quality, digital filters should account for both the count level and the object imaged. That is, they should be image-dependent. By using the constraint equation of constrained least-squares (CLS) restoration to determine one parameter of the Metz filter, a filter which adapts to the image has been developed. ⋯ The designed filter was tested for its ability to adapt to other objects with images from each of three different test objects. When the values of the Metz filter parameters for these images determined by the CLS-Metz filter were compared by a regression analysis to those which minimized the NMSE for each image, a correlation coefficient of 0.98, a slope of 0.95, and a zero intercept of 0.1 were obtained. With clinical images, the CLS-Metz filter has been shown to provide consistently good image quality with images as diverse as heart perfusion images and bone studies.