The aim of the study was estimation of the relation between the gallbladder (GB) motility function and the presence and quantity of enterogastric reflux (EGR). We investigated 172 patients with: ...physiological GB function (filling and emptying)(FGB), impaired GB function (prolonged filling and ejection fraction < 45%) and afunctional gallbladder (AGB)(without visualization). The study was performed during 90 min (1 f/min) after i.v. application of 185 MB 99mTc-dietil IDA. After 30 min. test meal was given while at the end stomach was marked. According to the parameters from time activity curves over stomach and hepatobiliary system, the index of ERG was calculated, while GB filling and ejection fraction were estimated from the GB time/activity curve. We can conclude that EGR occurs more frequently in the patients with afunctional GB in comparison to those with functional and decreased motor function. Also, EGR quantity is in correlation with the impairment of the GB function.
Helicobacter pylori infection is supposed to be one of the major causes of digestive and other diseases. Among a lot of invasive and non-invasive methods for its detection, none is ideal. The aim is ...an assessment of the Helicobacter pylori infection in the stomach using breath test and comparison to other diagnostic methods, as well as following up the effects of therapy. In 17 patients with digestive discomfort, breath test, rapid urease test and histology were performed, while in 47 patients with proven HP infection the effect of therapy was followed up using breath test and clinical findings. Breath test was performed after per oral administration of the capsule of (14)C urea (37 kBq). Findings of the breath and urease tests were in accordance in 14/17 patients (83%) while breath test and histology in 16/17 patients (94%). During follow-up of the therapeutic effects, breath test and clinical findings were in accordance in 43/47 patients (98%). Breath test can be useful in diagnosis but is a method of choice in following up the patients after therapy for H. pylori infection, because it is non-invasive, fast and precise.
Color Doppler sonography and angioscintigraphy in hepatic Hodgkin＇s lymphoma Mirjana V Stojkovic Vera M Artiko Irena B Radoman Slavko J Knezevic Snezana M Lukic Mirko D Kerkez Nebojsa S Lekic Andrija A Antic Marinko M Zuvela Vitomir I Rankovic Milorad N Petrovic Dragana P Sobic Vladimir B Obradovic
World journal of gastroenterology : WJG,
2009
26
Journal Article
AIM： To estimate the characteristics of Color Doppler findings and the results of hepatic radionuclide angiography （HRA） in secondary Hodgkin＇s hepatic lymphoma.
METHODS： The research included ...patients with a diagnosis of Hodgkin＇s lymphoma with metastatic focal lesions in the liver and controls. Morphologic characteristics of focal liver lesions and hemodynamic parameters were examined by pulsed and Color Doppler in the portal, hepatic and splenic veins were examined. Hepatic perfusion index （HPI） estimated by HRA was calculated. was observed. Lesions were mostly hypoechoic and mixed, solitary or multiple. Some of the patients presented with dilated splenic veins and hepatofugal blood flow. A pulse wave was registered in the centre and at the margins of lymphoma. The average velocity of the pulse wave was higher at the margins （P 〉 0.05）. A continuous venous wave was found only at the margins of lymphoma. There was no linear correlation between lymphoma size and velocity of pulse and continuous wave （r = 390, P 〈 0.01）. HPI was significantly lower in patients with lymphomas than in controls （P 〈 0.05）, pointing out increased arterial perfusion in comparison to portal perfusion.
CONCLUSION： Color Doppler ultrasonography is a sensitive method for the detection of neovascularization in Hodgkin＇s hepatic lymphoma and estimation of its intensity. Hepatic radionuclide angiography can additionally help in the assesment of vascularisation of liver lesions.
The aim of the study is evaluation of the clinical validity of the chosen and modified own model of the nuclear medicine method for the detection and quantification of enterogastric reflux (EGR), as ...well as evaluation of its clinical validity. The study was performed in 172 patients: with gastric and duodenal ulcer, after Billroth I and Billroth II gastrectomy, with gastroesophageal reflux, after cholecystectomy, with chronic cholecystitis and chronic duodenal disease. Acquisition was performed with gamma camera, during 90 minutes after intravenous application of 185 MBq 99m-Tc-Dietil IDA. Test meal was given in 30th minute, while gastric region was marked at the end of the study. On the basis of the radioactivity changes in the regions of the stomach and hepatobiliary system, presence of enterogastric reflux is determined and its index calculated. In all the groups of patients, values are significantly different from physiological. The most frequent occurrence and the largest quantity of reflux is present in patients after Billroth II gastrectomy with significantly different values from other groups of patients. The obtained results approve clinical value of the chosen and modified scintigraphy of EGR as a non-invasive and physiological method, which provides data about its presence and quantity.
We evaluated possibilities of bone scintigraphy with 99mTc-methylendiphosphonate (99mTc-MDP) and magnetic resonance imaging (MRI) in follow-up and prediction of effect in patients with extensive bone ...metastatic disease treated with betha-emitter 89SrCl2. 24 patients with prostate cancer and extensive metastatic involvement of skeleton were referred for the study. 89SrCl2 was injected as single injection of 150 MBq (4 mCi), in eighteen from Amersham plc., England, as Metastron, in six--from Medradiopreparat, Russia). In all patients bone scintigraphy with 99mTc-MDP and MRI study of metastatic regions were performed before and in 3 months after 89SrCl2 injection. Patients treated with Metsatron were also studied in 6 months after injection. Quantitative analysis of data comprised count and anatomic dimensions of metastatic areas and calculation of indices metastasis/intact bone both for scintillation count of 99mTc-MDP bone scans and signal intensity of T1-weighted MRI scan. Henceforth, we conclude the data of bone scanning with 99mTc-MDP and of MRI give evidencies for significant regress of bone metastases in patients treated with 89SrCl2 besides symptomatic suppression of pain syndrome. 99mTc-MDP bone scanning is also of predictive value for the prognosis of therapeutic effect of systemic radiotherapy with 89SrCl2 in prostate cancer.
We developed an image Acquisition Systems (IAS) for Anger camera that uses a general-purpose workstation and high quality interface to the appropriate sensors. This IAS comprises intuitive and easy ...to use interface, and real-time visual monitoring during the image generation. The IAS supports DICOM standards, allows open integration to wider Picture Archiving and Communication Systems (PACS) and Hospital information Systems (HIS). The IAS consists of off-the-shelf PC computer with high quality analog to digital card, and state of the art software with two modules: 1) module for data acquisition and image generation capable in generating static, dynamic and gated studies; and 2) module for image reviewing and exporting in desired formats. Both modules comprise interface to the electronic patient record. The prototype IAS was evaluated in the Nuclear Medicine Institute of the Clinical Centre of Serbia in Belgrade. Evaluation proved that overall system's linearity and spatial resolution fulfil CEN standards for clinical use of Anger camera. Blinded clinical evaluation compared 159 static and dynamic studies simultaneously made by the new IAS and the conventional Siemens system that was originally supplied with the camera. Results show that the new IAS was diagnostically more efficient in 91 percent of analysed studies compared with the conventional system. The novel IAS facilitates diagnostics and greatly improves the performance to cost ratio; thereby, it is well suited for the Serbian health care system being under reorganization and development. (4 pages)
Estimation of the gallbladder (GB) motility disorders after gastric surgery has not yet been assessed because of the shortage of the reliable diagnostic methods. The aim of the study is introduction, ...modification and establishment of the infusion cholescintigraphy into clinical practice and its performance in the groups of patients with gastric resection (RVBI i RVBII), total gastrectomy and patients after gastroplasty. Obtained data produced information about motility disorders caused by billateral truncal vagotomy, lack of the food transit through duodenum and if the motility disorders are the same in different time periods after operation. In groups of patients without truncal vagotomy (RVBI and RVBII), minor motility disorders are registered in comparison to the groups after truncal vagotomy. In the period of 6 months after surgery, higher motility disorders are registered in the group of patients with total gastrectomy, while after 9-12 months GB motility completely recovers. Groups with preserved transit of food through duodenum (RVBI and gastroplasty), has minor motility disorders in comparison to the group without transit of food through duodenum (RVBII and total gastrectomy). By introducing infusion cholescintigraphy, reliable method for the GB motility assessment is obtained.
The aim of investigation was to assess the role of somatostatin receptor
scintigraphy in diagnosis and follow-up of pancreatic neuroendocrine
neoplasms. Somatostatin receptor scintigraphy was ...performed with 740 MBq
99mTc-EDDA/HYNIC TOC for diagnosis of primary tumors and follow-up after
the therapy. There were 63 true positive, 24 true negative, 4 false
positive, and 6 false negative findings. Sensitivity was 91.3 %, specificity
85.7 %, positive predictive value 94.0 %, negative predictive value 80.0 %,
accuracy 89.7 %. The SPECT contributed diagnosis in 28 true positive
findings. In 32 patients (33 %) somatostatin receptor scintigraphy
significantly changed the management of the patients (10 had surgery, in 17
somatostatin analogues, and in 5 peptide receptor radionuclide therapy was
introduced). Mean Ki-67 index in true positive patients was 13.8 ?5.0 %
while in true negative 7.1 ? 3.4% which is significantly lower at p < 0.05. There
was significantly (p < 0.01) higher number of increased chromogranin A
values in true positive than in true negative patients (p = 0.000857). Our
results confirmed the value of SRS in the diagnosis and follow-up of the patients with pancreatic neuroendocrine neoplasms PanNEN if primary tumors, recurrences or metastases are suspected, as well as for appropriate
choice of the therapy.
PURPOSEThis study aimed to compare baseline to follow-up F-FDG PET/CT findings after treatment for active chronic sarcoidosis and to correlate changes on F-FDG PET/CT with changes in clinical status.
...PATIENTS AND METHODSThe sample included 66 patients with chronic sarcoidosis and evidence of active inflammation on baseline F-FDG PET/CT for which they received therapy. Of these 66 patients, 30 returned for the follow-up F-FDG PET/CT after 12 (5) months to evaluate response to treatment. They were also asked to indicate changes in clinical status. Baseline characteristics of patients who did and did not return for the follow-up were compared to assess selection bias.
RESULTSSUVmax was significantly decreased at the follow-up compared with baseline F-FDG PET/CT (8.46 3.52 vs 4.90 0.96; P = 0.006), primarily in the mediastinum. Inflammatory activity appeared absent in 9 patients, decreased in 12 patients, and increased in 9 patients, with the corresponding changes in SUVmax of −80%, −41%, and +54%, respectively. The changes on F-FDG PET/CT were in agreement with self-perceived changes in clinical symptoms (P = 0.019). The angiotensin-converting enzyme at the follow-up was not significantly different from baseline (49.80 19.25 vs 46.35 25.58, P = 0.522). There was no difference in baseline characteristics of patients who did and did not return for the follow-up.
CONCLUSIONSF-FDG PET/CT is able to detect clinically meaningful changes in magnitude and extent of inflammatory activity in patients receiving treatment for active chronic sarcoidosis. Thus, F-FDG PET/CT is a valuable adjunct to clinical evaluation for monitoring the response to treatment in these patients.
PURPOSE:The aim of our study was to assess diagnostic accuracy of Tc-99m depreotide and Tc-99m-EDDA/HYNIC-TOC scintigraphy for evaluation of pulmonary lesions that appeared ambiguous on computed ...tomography (CT).
MATERIAL AND METHODS:Forty-nine consecutive patients (37 men and 12 women; mean age, 60 ± 11 years) with 60 pulmonary lesions on chest radiography and CT were referred for nuclear imaging. They were prospectively allocated to undergo whole-body scintigraphy (WBS) and single photon emission computed tomography (SPECT) using either Tc-99m depreotide (26 patients, group 1) or Tc-99m-EDDA/HYNIC-TOC imaging (23 patients, group 2). Histologic findings after tissue biopsy served as a gold standard for determining diagnostic accuracy of the 2 somatostatin analogs. Visual assessment was complemented by semiquantitative analysis based on target to background ratio.
RESULTS:Among the 32 pulmonary lesions scanned with Tc-99m depreotide, focal uptake was increased in 22 of 25 malignancies, whereas no uptake was found in 6 of 7 benign lesions (88% sensitivity, 85% specificity, and 88% accuracy) on both WBS and SPECT. Imaging of 28 pulmonary lesions with Tc-99m-EDDA/HYNIC-TOC had a similar diagnostic yield (sensitivity 87%, specificity 84%, and accuracy 86%). Overall, target to background ratios were higher on SPECT than WBS but not significantly different between groups 1 and 2 (SPECT 2.72 ± 0.70 vs. 2.71 ± 0.50, WBS 1.61 ± 0.32 vs. 1.62 ± 0.28, respectively).
CONCLUSION:This study demonstrates that Tc-99m depreotide and Tc-99m-EDDA/HYNIC-TOC have similar diagnostic value for characterizing pulmonary lesions that appear ambiguous on CT.
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