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Biomedical subjects

B C Lentle

Publications and source records attributed to B C Lentle.

At least 73 records · Page 4Linked to original sources

Iatrogenic alterations in radionuclide biodistributions.

The biodistribution of radiotracers used in diagnostic imaging is grossly and recognizably altered by a wide variety of drugs and other treatment modalities, such as surgery and radiotherapy. Knowledge of such altered biodistribution is important both in making diagnostic inferences from scans and in dosimetric considerations.

Anesthetics↗

Vertebral sclerosis in adults.

Narrowing of the intervertebral disc space with sclerosis of the adjacent vertebral bodies may occur as a consequence of infection, neoplasia, trauma, or rheumatic disease. Some patients have been described with backache and these radiological appearances without any primary cause being apparent. The lesions were almost always of 1 or, at most, 2 vertebrae and most frequently involved the inferior margin of L4. We describe 3 patients with far more extensive vertebral involvement and present the clinical, radiological, scintiscan, and histological findings. The only patient we have seen with the better known, isolated L4/5 lesion was shown on biopsy to have staphylococcal osteomyelitis. For this reason we would still recommend a biopsy of all such sclerotic vertebral lesions if they occur in the absence of other rheumatic disease.

Adult↗

Sacroiliitis detected by bone scintiscanning: a clinical, radiological, and scintigraphic follow-up study.

Twenty-four patients had abnormal sacroiliac joints detected by quantitative sacroiliac scintigraphy but no radiological evidence of sacroiliitis on original investigation. We studied them again after intervals of 12 to 36 months. Four patients developed radiological change. Two young, HLA B27-positive men had undoubted ankylosing spondylitis, and a young woman had possible ankylosing spondylitis. A middle-aged man had changes that could be attributed to post-traumatic osteoarthrosis. Of the remaining 20 cases 15 had symptoms and signs suggestive of inflammatory disease of the axial skeleton (and peripheral arthropathy in 5 cases). The sexes were affected equally (8 females, 7 males), and only 2 of the 15 were B27-positive. The response to anti-inflammatory medication was generally good to excellent, and scintiscans tended to improve. Of the remaining 5 patients, 3 had mechanical or traumatic problems, and in 2 there was no explanation for the abnormal sacroiliac scintiscan. We conclude that quantitative sacroiliac scintigraphy may detect ankylosing spondylitis prior to the develpment of radiological change and that it can identify an organic basis for backache in patients with a spondylitis-like syndrome. The clinical circumstances must be taken into account, as scintigraphic abnormalities are not diagnostic of any specific disease entity.

Adult↗

Urinoma diagnosed on a bone scan.

A case of urinoma diagnosed on a bone scan is described. The administration of radiotracers excreted by the kidney is a useful, non-invasive, uncomplicated diagnostic procedure when leakage from the urinary tract is suspected.

Adult↗

Correction for out-of-focal-plane blurring in a simulated multiplane tomographic scanner.

A technique has been developed to remove out-of-focal-plane blurring from coronal and axial images made using a multiplane tomographic scanner. The technique uses a combined smoothing and differential operator that is applied to the axial images. It has been tested using computer-simulated images, with favorable results. The usefulness of the technique in a real system has yet to be determined.

Computers↗

Evidence for sacroiliac disease as a common cause of low backache in women.

99M Tc stannous pyrophosphate bone scanning with quantitative sacroiliac scintigraphy (Q.S.S.) has been used in 50 females with low backache and in 66 symptomless female controls. Mean uptake of radionuclide at the sacroiliac joints was significantly increased in the patients when compared with controls. Q.S.S. gave objective evidence of unilateral sacroiliac disease in 2 of the 66 controls compared with that of unilateral and bilateral sacroiliac disease in 8 and 14 of the 50 patients respectively. Of the 22 patients with abnormal scans, 20 had normal radiographs. An abnormal scan did not correlate with the presence of HLA B27. It is concluded that sacroiliac disease is a common cause of low backache in women, and that it can be objectively diagnosed by Q.S.S. when radiographs are normal.

Adult↗

Quantitative sacroiliac scintigraphy in patients with Crohn's disease.

Sixty patients with Crohn's disease have been assessed radiologically and by quantitative sacroiliac scintigraphy for evidence of sacroilitis and/or ankylosing spondylitis. The incidence of radiologic sacroiliitis (11%) and ankylosing spondylitis (5%) was no greater in our series than previously reported. However, the incidence of increased uptake of radiotracer at the sacroiliac joints was 52%. There was no correlation in the group as a whole between radiologic and/or scintigraphic evidence of sacroiliitis and the tissue antigen HLA-B27.

Adolescent↗

Scintilymphangiography with 99 mTc-antimony sulfide colloid in hereditary lymphedema (Nonne-Milroy diseases).

A family of four patients suffering from Nonne-Milroy disease has been examined by pedal scintilymphangiography. Lower limb edema was present in three patients and was bilateral in two instances. Scintilymphangiographic abnormality was invariably present, ranging from almost total obstruction of lymphatic flow to lymphatic pooling. The inguinal, iliac and para-aortic nodes on the affected sides were also noted to be small and few in number. The examination is safe and simple and may be used to distinguish Nonne-Milroy edema from edema due to other causes.

Adult↗

How many views to a liver scan?

In a prospective study of 500 consecutive patients, the addition of oblique scans increased the accuracy of the colloid liver scans used to detect metastases. The oblique views changed the interpretation in 12 (2.4%) patients; objective evidence to support this change was obtained in 11 of the 12. The addition of at least a right anterior oblique scan should, on this evidence, form part of the radiocolloid evaluation of the liver for the presence of metastatic disease.

Colloids↗

Gallium-67 scintigraphy in multisystem malignant melanoma.

In a prospective study of the value of gallium-67 scintigraphy in cases of multisystem malignant melanoma, 69 scans were obtained for 36 patients. No abnormality was found in 18 scans; in only 3 was there other evidence of disease. Of 54 sites of disease demonstrated by scintigraphy, 40 were correlated with other investigations: biopsy (5), surgery (7), autopsy (7), radiographic (13), or clinical (8). Metastatic melanoma was found in 37 (69%) of the sites; no such disease was found in 3 (5.7%). The life expectancy of patients with an abnormal scan was shorter than that of patients with a normal scan. Gallium studies reliably indicated the extent of multisystem melanoma, and are of value in clinical management.

Aged↗

The scintigraphic investigation of sacroiliac disease.

Bone scintigraphs obtained with both Technetium-99m polyphosphate and Technetium-99m pyrophosphate have been abnormal at the sacroiliac joints of 44 patients with definite ankylosing spondylitis (AS). Because of the normal registration of the sacroiliac joints on bone scintigraphy, it has been necessary to develop a profile-scan technique to quantify the abnormality that proves to be significantly different from the normal finding. In 17 patients with a strong clinical suspicion of AS but normal radiographs, the sacroiliac joints have frequently been abnormal. This finding is meaningful because there is a common occurence in this group of the histocompatibility antigen HL A-B27, known to be a marker of AS. We also note the frequency of abnormal sacroiliac scinitigrams in 26 patients with rheumatoid arthritis and in a group of other diseases-Crohn's disease, uveitis, psoriasis, ulcerative colitis, and Reiter's disease-all of which share some of the manifestations of AS.

Adult↗