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Biomedical subjects

A T Isitman

Publications and source records attributed to A T Isitman.

At least 55 records · Page 3Linked to original sources
PubMed1988

False-negative bone imaging due to etidronate disodium therapy.

A 77-year-old man with prostate cancer was serially evaluated for bone metastases using Tc-99m methylene disphosphonate (Tc-99m MDP) both on and off treatment with etidronate disodium (EHDP). While the patient was receiving the medication only minimal bony uptake of the tracer was seen with the majority remaining in the soft tissues. The similarly structured EHDP probably saturated the binding sites that the radioactive MDP usually adheres to. Physicians should be aware of this interaction and may have to wait until the EHDP has been discontinued for several months before performing bone imaging on these patients.

Aged↗
PubMed1988

Unusual stress fracture of the scapula in a jogger.

A case of fracture of the right scapula in the superomedial portion with no history of direct trauma is presented. It is most likely due to jogging with weights in both hands. A brief review of scapular fractures is also reported.

Adult↗
PubMed1988

Accurate diagnosis of renal transplant rejection by indium-111 platelet imaging despite postoperative cyclosporin therapy.

Previous reports indicate that In-111 platelet scintigraphy (IPS) is a reliable test for the early diagnosis of acute post-operative renal transplant rejection (TR). However, the recent introduction of cyclosporin for post-transplantation immunosuppression requires that the diagnostic efficacy of IPS once again be established. Therefore, a prospective IPS study of 73 post-operative renal transplant recipients was conducted. Fourty-nine patients received cyclosporin and 24 patients did not receive this drug. Between these two patient groups, there were no significant differences in the diagnostic sensitivities (0.86 vs 0.80) and specificities (0.93 vs 0.84) with which TR was identified. We conclude that during the first two weeks following renal transplantation the cyclosporin treatment regimen used at our institution does not limit the reliability of IPS as a test for TR.

Adult↗
PubMed1988

Dipyridamole thallium-201 myocardial imaging. Complications associated with oral and intravenous routes of administration.

Previous reports have shown that TI-201 myocardial imaging with either an oral or intravenous administration of dipyridamole is a suitable diagnostic examination for patients at risk for coronary artery disease who cannot perform treadmill exercise. To compare the incidence of complications associated with these two routes of drug administration, the records of 78 oral and 97 intravenous dipyridamole TI-201 imaging studies were reviewed. The oral administration is associated with a significantly higher incidence of nausea (15% vs. 4%). Despite the higher incidence of nausea, the percentage of patients having one or more dipyridamole-induced symptoms was no greater for the oral (29%) than for the intravenous (37%) administration. Intravenous administration produced both a significantly higher incidence of atypical angina (14% vs. 4%) and a significantly greater increase in heart rate (16.6 vs. 10.2 beats per minute). No patient in either the oral or intravenous dipyridamole protocols had life-threatening arrhythmias or myocardial infarctions. In clinical practice, the difference in complications associated with the oral and intravenous administration of dipyridamole for TI-201 imaging is not significant.

Administration, Oral↗
PubMed1988

Comparison of technetium-99m pyrophosphate and technetium-99m DTPA aerosols for SPECT ventilation lung imaging.

Although [99mTc] diethylenetriaminepentaacetic acid (DTPA) is currently the most widely used radioaerosol, rapid alveolar clearance limits its usefulness for single photon emission computed tomography (SPECT) ventilation lung imaging. Previous research has shown that [99mTc]phosphate compounds have high alveolar deposition and slow clearance and thus provide suitable aerosols for pulmonary ventilation studies. We have compared the pulmonary retention and blood levels of [99mTc]pyrophosphate (PYP) and [99mTc]DTPA in eight normal nonsmoking male volunteers. These two radioaerosols have comparable pulmonary deposition. Technetium-99m PYP, however, has a much slower pulmonary clearance which allows sufficient time (20 or more minutes) for SPECT data acquisition using a single-headed rotating gamma camera. While the radiation absorbed dose to the lungs for [99mTc]PYP (0.31 rad/mCi) is greater than for [99mTc]DTPA (0.11 rad/mCi), it is at a clinically acceptable and safe level.

Administration, Inhalation↗
PubMed1987

Painful pseudarthrosis following lumbar spinal fusion: detection by combined SPECT and planar bone scintigraphy.

Twenty-six adult patients more than 6-months post-lumbar spinal fusion were studied. Flexion and extension radiographs showing motion or bone scintigrams showing focal areas of increased activity within the fusion mass were considered positive for pseudarthrosis. Patients were classified as either symptomatic or asymptomatic. Among the 15 symptomatic patients, scintigraphy had a sensitivity of 0.78 and a specificity of 0.83 which was superior to the 0.43 sensitivity and 0.50 specificity of radiography. Six of the 11 asymptomatic patients had focal areas of increased activity in the bony fusion mass, possibly reflecting painless pseudarthrosis. Planar imaging was substantially enhanced by SPECT in 14 of the 26 cases. It is concluded that for the patient who remains symptomatic after lumbar spinal fusion, bone scintigraphy with SPECT is of significant value in detecting painful pseudarthrosis.

Adult↗
PubMed1987

Comparison of high-resolution MRI and SPECT bone scintigraphy for noninvasive imaging of the temporomandibular joint.

Prospective evaluation by magnetic resonance imaging (MRI) and both single photon emission computed tomography (SPECT) and planar bone scintigraphy was undertaken in 31 temporomandibular joints (TMJs) of 21 symptomatic patients. When compared with the results of subsequent arthrography, MRI (0.88) was more sensitive than SPECT (0.76) or planar (0.56) scintigraphy for detection of internal derangement of the TMJ. A diagnostic sensitivity of 0.96 was achieved when the results of either MRI or SPECT was considered evidence of internal joint derangement. Five symptomatic TMJs, clinically thought to be abnormal, were positive on SPECT but showed no evidence of anterior disk displacement at the time of arthrography. In such instances, SPECT may be detecting functionally significant altered joint mechanics that are not evident on anatomic imaging of the TMJ.

Adolescent↗
PubMed1986

Effect of Sn(II) ion concentration and heparin on technetium-99m red blood cell labeling.

While convenience and economy favor the use of in vivo methods for labeling red blood cells (RBCs) with [99mTc]pertechnetate, previous reports suggested that patient medication such as heparin might interfere and thus result in inferior quality images. In this study, using a canine model, the role of stannous Sn(II) ion in in vivo and in vitro labeling of RBCs both in the presence and absence of a therapeutic dose of heparin was investigated. Our results showed that Sn(II) ion concentration of 20 micrograms/kg body weight levels provided better than 80% in vivo labeling efficiency enabling high quality blood-pool images even in the presence of therapeutic doses of heparin.

Animals↗
PubMed1986

Early diagnosis of acute postoperative renal transplant rejection by indium-111-labeled platelet scintigraphy.

A prospective evaluation of 111In-labeled platelet scintigraphy (IPS) for the early diagnosis of acute postoperative renal transplant rejection (TR) was undertaken. The results of IPS were compared with in vitro biochemical tests, the clinical finding of graft tenderness, and combined [99mTc]DTPA and [131I]orthoiodohippurate scintigraphy. With a sensitivity of 0.93 and a specificity of 0.95, IPS provided otherwise unavailable diagnostic information. Furthermore, postoperative IPS was a good predictor of long-term allograft survival.

Acute Disease↗
PubMed1985

Painful spondylolysis or spondylolisthesis studied by radiography and single-photon emission computed tomography.

Planar bone scintigraphy (PBS) and single-photon emission computed tomography (SPECT) were compared in 19 adults with radiographic evidence of spondylolysis and/or spondylolisthesis. SPECT was more sensitive than PBS when used to identify symptomatic patients and sites of "painful" defects in the pars interarticularis. In addition, SPECT allowed more accurate localization than PBS. In 6 patients, spondylolysis or spondylolisthesis was unrelated to low back pain, and SPECT images of the posterior neural arch were normal. The authors conclude that when spondylolysis or spondylolisthesis is the cause of low back pain, pars defects are frequently heralded by increased scintigraphic activity which is best detected and localized by SPECT.

Adolescent↗
PubMed1985

Chronic knee pain assessed by SPECT: comparison with other modalities.

Twenty-seven patients with chronic knee pain were examined prospectively using conventional radiography, radionuclide angiography, planar bone scintigraphy, and single-photon emission computed tomographic (SPECT) bone scintigraphy. When the results of subsequent arthroscopic examination of all three compartments of the knee were correlated with those of the noninvasive methods, SPECT bone scintigraphy was found to be most sensitive for evaluating the extent of osteoarthritis. Differences in detection sensitivity for articular cartilage damage and synovitis were greatest in the patellofemoral compartment. The frequency with which hyperemia was present in association with cartilage damage and synovitis indicates that osteoarthritis of the knee is capable of producing hyperemia and further implies that increased perfusion cannot be used to distinguish with confidence between osteoarthritis and septic processes involving the knee. SPECT (1.00) and planar (0.91) bone scintigraphy were highly sensitive indicators of torn menisci in a subgroup of 14 patients, each having a prearthroscopic clinical diagnosis of a torn meniscus. This result suggests that for patients with chronic knee pain and clinical suggestion of a torn meniscus, bone scintigraphy has significant potential as a high-sensitivity, prearthroscopic screening examination.

Adolescent↗
PubMed1985

Double osteotomy operation in the surgical treatment of coxa plana disease.

During the years 1975 to 1982, what was named the double osteotomy--which is a combination of pelvic osteotomy together with subtrochanteric varus, extension and derotation osteotomy--was applied to 26 cases suffering from coxa plana (Perthes-Calvé-Legg disease). The postoperative follow up averages a period of three years and five months and was undertaken at the Department of Orthopedics and Traumatology of the Faculty of Medicine, University of Ankara, Turkey.

Acetabulum↗
PubMed1985

Photon deficient bone metastasis of hepatocellular carcinoma with avid gallium-67 uptake.

While bone metastases producing photon deficient defects on bone scintigraphy have previously been reported, this finding has not been emphasized for hepatocellular carcinoma (HCC). Furthermore, "filling-in" of such photon deficient defects with 67Ga at skeletal sites of metastatic HCC has not been described. In this case report, the combination of a photon deficient defect on bone scintigraphy and avid accumulation of 67Ga in this same area was of value in confirming the diagnosis of metastatic HCC.

Adult↗