Nuclear medicine communications
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Comparative Study
A clinical comparison between traditional planar V/Q images and planar images generated from SPECT V/Q scintigraphy.
To compare interpretation of traditional planar ventilation-perfusion lung scan images with planar images reformatted from single photon emission computed tomography (SPECT) data using two different techniques. ⋯ Angular summed planar images result in a perceived decreased likelihood of pulmonary embolism compared with true planar images. In contrast, while reprojected planar images result in an increased number of matched defects compared to true planar scans, there was no change in the clinical interpretation. Caution should be exercised when interpreting SPECT derived angular summed planar images in isolation.
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Minimal-to-low grade fluorodeoxyglucose (FDG) uptake in the parotid glands is regarded as a normal variant in a whole-body survey with FDG-PET. Not frequently, however, a relatively intense or asymmetric FDG uptake is encountered in the parotid glands. The aim of this study was to determine the causes and characteristics of this 'FDG accumulation of uncertain significance' in the parotid glands in patients without any known or suspected pathologies at the time of whole-body FDG-PET. In addition, we also examined patients in whom there was no documented evidence of parotid pathology before FDG-PET scan and a suspicion of disease involvement was first raised in the reports in view of focal uptake in the FDG-PET images. ⋯ Both the pattern and intensity of FDG uptake have important implications for differential diagnosis in the salivary glands in whole-body FDG-PET. A bilaterally symmetrical increased uptake is usually physiological. An asymmetrical uptake, especially when focal, would warrant further radiological and histopathological correlation to rule out disease involvement. At times, this can lead to the detection of an asymptomatic hitherto unknown etiology, which would have been otherwise interpreted as a metastatic disease in the background of an existing malignancy in these patients; this is noteworthy as it may have a bearing on the subsequent management of these patients.
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Comparative Study
Hypoxia imaging of patients with acute myocardial infarction by using dual isotopes of 201Tl and 99mTc-HL91.
To evaluate the myocardial ischaemia/viability in patients with acute myocardial infarction (AMI) using the ischaemia-avid agent (99m)Tc-HL91. ⋯ Myocardial uptake of (99m)Tc-HL91 is perfusion-dependent as well as ischaemia dependent. (99m)Tc-HL91 hypoxia imaging alone is not sufficient to identify ischaemic/viable myocardium. Dual-isotope imaging with (201)Tl and (99m)Tc-HL91 can characterize the myocardium into normal, ischaemic/viable and necrotic (scarred) myocardium.
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Quantifying hemispheric cerebral blood flow (CBF) may improve diagnostic accuracy when combined with perfusion SPECT. ⋯ Routine quantification of mean CBF by HMPAO-RNA is a simple and reproducible method which can be easily added to the standard brain perfusion SPECT without additional cost or increasing patient's radiation burden. Combined with regional perfusion it provides an additional tool for the aetiological classification of dementia.
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Oesophageal carcinoma is a relatively rare form of cancer. However, it is also one of the most deadly forms of cancer, with a 5-year survival rate of only 3% for patients with nodal disease, and 42% for those without nodal disease. ⋯ The literature is reviewed in the context of our recent experience. A retrospective review of 129 patients with oesophageal carcinoma, who underwent PET or PET-CT scanning over a 24-month period confirmed the incremental value of PET and PET-CT scanning in the staging of oesophageal carcinoma.