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Biomedical subjects

A G Kettle

Publications and source records attributed to A G Kettle.

24 records · Page 2Linked to original sources

Radiation dose rates from adult patients receiving 131I therapy for thyrotoxicosis.

Recommendations for restricting the exposure to radiation of members of the public coming into contact with thyrotoxic patients treated with 131I are currently based on the activity retained by the patient, and not on the doses likely to be received by such individuals. In order to examine whether these current implications of a reduction in this limit to 1 mSv, measurements were made of the dose rates at distances of 0.1, 0.5 and 1.0 m from 60 patients just before they left the nuclear medicine department. These measurements were repeated 1, 3, 6, 8 and 10 days after administration for 30 patients, and the radioactivity in samples of saliva taken on each of these days and secreted in sweat over the first 24 h were also measured. Doses were estimated for administered activities of approximately 200-600 MBq, assuming appropriate values for the times and distances spent near other individuals while travelling, at work, at home and near to young children considered in three age groups (< 2, 2-5 and 5-11 years). Periods of restriction were derived which would reduce these doses to 5 or 1 mSv. For a dose limit of 5 mSv, there is no need to restrict private travel, public transport journeys can last up to 7 h, a patient can return to work immediately, but sleeping with a partner will have to be restricted even for the minimum activity of 200 MBq.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

123I-methylene blue: an unsatisfactory parathyroid imaging agent.

This study was designed to examine the possible use of 123I-labelled methylene blue as a parathyroid imaging agent. Five patients were studied, all of whom had parathyroid adenomas which were successfully localized preoperatively with 201Tl and 99Tcm-sestamibi, and which were subsequently proven at surgery. The 123I-labelled methylene blue localized only one of these adenomas, was negative in two and had equivocal uptake in the remaining two patients. It is therefore concluded that compared to other radionuclide methods for localizing parathyroid adenomas this agent is unsatisfactory.

Adenoma↗

Parathyroid imaging with technetium-99m-sestamibi: preoperative localization and tissue uptake studies.

The accepted radionuclide method for imaging abnormal parathyroid tissue has been the combined use of [99mTc]pertechnetate 201Tl-chloride. Various problems with this approach, however, have suggested the need for an improved parathyroid imaging agent. This study examined the use of 99mTc-sestamibi as a parathyroid imaging agent compared with 201Tl-chloride. Fifty-seven patients were scanned with both 99mTc-sestamibi and 201Tl preoperatively. There were 40 adenomas, of which 37 were localized with 201Tl and 39 with sestamibi. Fifteen patients had hyperplastic glands, of which 29 glands were localized with 201Tl and 32 with sestamibi. Possible differences in uptake of the two agents by thyroid and parathyroid tissue were examined by administering 10 MBq of each agent to patients undergoing surgical exploration and biopsy. Preoperatively 20 patients were studied (13 adenomas and 7 with hyperplasia). Thallium-201 uptake was higher in both the parathyroid and thyroid tissue than sestamibi. However, the uptake per gram of parathyroid tissue of sestamibi was higher than the uptake per gram of thyroid tissue. This was not true for 201Tl. Technetium-99m-sestamibi was at least as effective as 201Tl in parathyroid localization. This may be partly due to a higher target-to-background ratio, but also to the superior physical characteristics of 99mTc.

Adenoma↗

Comparison of technetium-99m-HM-PAO leukocytes with indium-111-oxine leukocytes for localizing intraabdominal sepsis.

Technetium-99m-HM-PAO [( 99mTc]HM-PAO) leukocyte and indium-111-oxine (111In-oxine) leukocyte scanning were carried out simultaneously in 41 patients at 4 hr and 24 hr after reinjection to determine whether the 4-hr 99mTc scan could replace the 24-hr 111In scan for detecting intraabdominal sepsis. Abdominal infection was confirmed in 12 cases. The 4-hr 99Tc-leukocyte scan, the 4-hr 111In-leukocyte scan, and the 24-hr 111In-leukocyte scan yielded a sensitivity of 100%, 67%, and 100%, respectively, and a specificity of 62%, 90%, and 86%, respectively. The 24-hr 99mTc-leukocyte scan also produced a sensitivity of 100%, but it was falsely positive in all 29 cases without infection due to physiologic bowel uptake. False-positive 4-hr 99mTc-leukocyte scans were also produced by physiologic bowel uptake in seven cases all of whom had true-negative 4-hr and 24-hr 111In-leukocyte scans. Because of the high incidence of false-positive 4-hr [99mTc]HM-PAO leukocyte scans, it was concluded that they could not replace 24-hr 111In-leukocyte scans for detecting intraabdominal sepsis, and that serial 99mTc leukocyte scans starting earlier than 4 hr after reinjection must be evaluated.

Abdomen↗

99Tcm sestamibi--a new agent for parathyroid imaging.

Parathyroid imaging using 99Tcm sestamibi has been carried out prior to surgery in five patients with hyperparathyroidism and the results compared with a standard preoperative localization technique using 201Tl (thallous chloride). The 99Tcm sestamibi correctly localized all abnormal glands and showed higher parathyroid to thyroid uptake in three of four parathyroid adenomas. Both agents showed localization in a thyroid adenoma. The higher uptake of sestambi and better imaging properties of its 99Tcm radiolabel means that the agent may replace thallium for routine preoperative parathyroid localization.

Drug Evaluation↗