Clinical nuclear medicine
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The utility of Fluorine-18 fluorodeoxyglucose positron emission tomography/CT in identifying the causal source was assessed in this retrospective study. A total of 68 patients (33 men, 35 women; age range, 23-91 years) with fever of unknown origin (FUO) underwent a positron emission tomography/computed tomography (PET/CT) scan. PET/CT was considered helpful when abnormal results allowed an accurate diagnosis, based on histopathology, microbiologic assays, or clinical and imaging follow-up. ⋯ Overall 56% of the F-18 FDG PET/CT studies contributed in the identification of the source in patients with FUO, and elevated erythrocyte sedimentation rate and C-reactive protein (positive predictive value 93%). When systemic diseases are excluded F18-FDG PET/CT has a high negative predictive value for focal etiologies of FUO (negative predictive value 100%).
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Clinical nuclear medicine · Nov 2009
Patterns of three-phase bone scintigraphy according to the time course of complex regional pain syndrome type I after a stroke or traumatic brain injury.
We have proposed to evaluate different patterns represented on 3-phase bone scintigraphy (TPBS) according to the time course of complex regional pain syndrome (CRPS) type I (CRPS-I) after a stroke or traumatic brain injury. TPBS was performed in 50 consecutive patients for the evaluation of CRPS. We divided the patients into CRPS and non-CPRS groups based on the use of International Association for the Study of Pain criteria. ⋯ In the late stage of more than 21 weeks, there was no distinct difference in uptake between the 2 groups. A sequential change during the time course for the CPRS-I group was statistically significant (P < 0.05). Therefore, performance of follow-up TPBS may be useful to diagnose CPRS-I in uncertain cases of the early acute stage after a stroke or traumatic brain injury.
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Clinical nuclear medicine · Sep 2009
Unexpected accumulation of F-18 FDG in the urinary bladder after bladder irrigation and retrograde filling with sterile saline: a possible pitfall in PET examination.
: Bladder irrigation and retrograde filling technique has been used to reduce urinary F-18 FDG (FDG) activity for better image interpretation in patients with pelvic tumors. Despite the zealous use of this technique, FDG accumulation in the urinary bladder has been reported and might cause false-positive or false-negative results. In this study, we analyzed the pattern and estimated the incidence of the unexpected accumulation of urinary FDG activity after bladder irrigation and retrograde filling with sterile saline. ⋯ : Unexpected FDG activity in the urinary bladder, either focal or diffuse, may occur after bladder irrigation and retrograde filling and interfere with pelvic image interpretation. Great caution is required to avoid misdiagnosis: focal FDG accumulation may mimic tumor uptake of FDG whereas diffuse FDG activity may obliterate a FDG-avid pelvic lesion. Repeated bladder irrigation and retrograde filling, and prone-position imaging are useful techniques to ascertain the nature of the FDG accumulation.
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Clinical nuclear medicine · Jul 2009
Comparative StudyComparison of lung scintigraphy with multi-slice spiral computed tomography in the diagnosis of pulmonary embolism.
To compare the diagnostic efficacy of lung perfusion scans combined with ventilation (V/Q) scans and/or chest radiography (CR) with contrast-enhanced multislice spiral CT pulmonary angiography (CTPA) in diagnosing pulmonary embolism (PE). ⋯ V/Q scan, perfusion scan combined with CR and CTPA all show high efficacy in diagnosing PE. V/Q scan or perfusion scan combined with CR is as accurate as CTPA.