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Biomedical subjects

B D Collier

Publications and source records attributed to B D Collier.

At least 91 records · Page 5Linked to original sources
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

Bone SPECT.

Single photon emission computed tomography (SPECT) is a valuable addition to bone scintigraphy. SPECT removes from the diagnostic image unwanted activity which originates from in front and behind the tomographic plane of medical interest. This tomographic procedure allows one to examine with greater contrast and anatomic clarity such structures as the spine, hips, knees, and temporomandibular joints (TMJ). Abnormalities also seen on planar bone scintigrams often are more convincingly identified and better localized by SPECT. SPECT may even detect skeletal abnormalities not evident on planar views. These advantages of SPECT must be weighed against the superior resolution of planar bone scintigraphy. For this reason, SPECT complements, but does not replace planar bone scintigraphy. Including SPECT as an additional component of the skeletal examination does not place excessive demands on either gamma camera use or technologist time. Those nuclear medicine facilities offering bone SPECT for the evaluation of back, hip, knee, and TMJ pain should anticipate a larger volume of patient referrals.

Bone Diseases↗
PubMed1987

Use of SPECT to distinguish recurrent brain tumor from persistent activity at a craniotomy site.

A 50-year-old male underwent extensive left frontal lobe resection for a Grade II astrocytoma. Resection margins were free of tumor, and the patient suffered no significant postoperative neurologic deficits. One month later the patient was referred to radiation therapy for further evaluation and possible treatment. Unenhanced and enhanced transmission computed tomograms (CT) were interpreted as suspicious for recurrent tumor. However, using CT, which is essentially an anatomic technique, may not allow one to distinguish between surgical changes and the morbid anatomic findings of recurrent tumor. Because Tc-99m DTPA will cross the blood-brain barrier at sites of active intercranial disease, brain scintigraphy frequently is of value in distinguishing between recurrent tumor with an unstable blood-brain barrier and healed surgical changes with a stabilized blood-brain barrier. Therefore, clinicians requested that a Tc-99m DTPA brain scintigram be performed so as to distinguish between active disease and healed surgical changes.

Brain Neoplasms↗
PubMed1987

Detection of exercise induced changes in left ventricular performance by Doppler echocardiography.

A study was performed to test the hypothesis that Doppler echocardiographic measurement of ascending aortic blood flow can detect exercise induced changes in left ventricular performance during exercise in patients suspected of having ischaemic heart disease. Acceleration and peak velocity of flow and stroke volume were determined by non-imaging Doppler echocardiography in the suprasternal notch in 38 patients as they underwent simultaneous exercise radionuclide ventriculography. The patients were divided into four groups: group 1 had resting ejection fractions greater than or equal to 50% and increased their ejection fractions greater than or equal to 5% during exercise; group 2 had resting ejection fractions of greater than or equal to 50% but the ejection fraction either fell or rose less than 5% during exercise; group 3 had resting ejection fractions less than 50% but the ejection fraction rose greater than or equal to 5% during exercise; and group 4 had resting ejection fractions less than 50% and the exercise ejection fraction either fell or rose less than 5% during exercise. Acceleration, velocity, and stroke volume all rose significantly during exercise in group 1. Acceleration also increased in group 2 but to a lesser extent; velocity and stroke volume did not increase. In group 3 acceleration and velocity increased but to a lesser extent than in group 1; stroke volume did not increase. In group 4 velocity increased slightly during exercise but acceleration and stroke volume were unchanged. Doppler echocardiography thus appears capable of detecting exercise induced changes in left ventricular performance and can identify normal and abnormal responses, as defined by radionuclide ventriculography.

Adult↗
PubMed1987

Enlarged parathyroid glands: high-resolution local coil MR imaging.

Twenty-two patients with primary hyperparathyroidism underwent high-resolution magnetic resonance (MR) imaging with local (surface) coils for preoperative localization of enlarged parathyroid glands. The MR studies were interpreted prospectively and the results compared with findings at surgery and the results of computed tomography (CT), ultrasonography (US), and thallium-technetium scintigraphy (TTS). The sensitivity and specificity of MR imaging were .74 and .88, respectively. The sensitivity/specificity for the other modalities were as follows: 74/.95 for CT, .59/.82 for US, and .82/.98 for TTS. Enlarged parathyroid glands displayed a medium-intensity signal on T1-weighted images and a marked increase in intensity on T2-weighted images, but the degree of increase varied considerably.

Adenoma↗
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

Comparison of single-photon emission computed tomography with [123I]iodoamphetamine and xenon-enhanced computed tomography for assessing regional cerebral blood flow.

Regional CBF (rCBF) images obtained from xenon-enhanced computed tomography (XeCT) and single-photon emission computed tomography (SPECT) with N-isopropyl-p-[123I]iodoamphetamine (IMP) done with a rotating gamma-camera were compared in nine patients. Both XeCT and SPECT/IMP demonstrated flow abnormalities at all sites of infarction identified by CT, while detecting reduced rCBF in areas normal by CT in eight of the nine patients. All areas that were abnormal on XeCT were abnormal on the comparable SPECT/IMP images. The major advantages of XeCT are its greater resolution and potential for noninvasive quantitation of rCBF, while the major advantage of SPECT/IMP is its visualization of the entire brain on transverse, coronal, and sagittal sections.

Amphetamines↗
PubMed1986

Evaluation of distance-weighted SPECT reconstruction for skeletal scintigraphy.

In 15 patients who had undergone skeletal scintigraphy for evaluation of low back pain, single-photon emission computed tomography (SPECT) reconstruction techniques of distance-weighted filtered backprojection (new method) and non-distance-weighted filtered backprojection (standard method) were compared. Mid-spine sagittal views differing only by reconstruction methods were evaluated by trained observers and by a quantitative profile technique. When asked to compare image quality, the observers demonstrated a clear preference for images reconstructed by the new method. Profile quantitation showed significantly greater contrast in more superficial structures with the new method.

Back Pain↗
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↗