Biomedical subjects
Publications and source records attributed to E W Fordham.
Patients undergoing brain scintigraphy with pertechnetate are frequently premedicated with oral perchlorate. However, the oral route is difficult to employ in unconscious or uncooperative patients or when oral intake is restricted. In such situations, rectal administration of sodium perchlorate dissolved in water is an effective alternative to oral administration.
A new method of obtaining scintigraphic images of the cardiac blood pool for the study of ventricular wall motion is described. The method, which is based upon an inexpensive modification of a commercial multiformat imaging device, yields a set of serial gated images covering the entire cardiac cycle. These images may be converted into a film loop to yield a continuous motion picture of the mechanical cycle of the heart.
Extensively irradiated patients were studied from 0 to 73 months after irradiation by 52Fe bone marrow scanning. Marrow regeneration was observed in most patients after intervals of 12 months or longer. The degree of recovery was not dose-related and the marrow ablative dose was not defined with doses of 4000-5000 rads. Degree of recovery depended more upon the antomic region and/or sequence of fields treated; the last field treated invariably showed poorer regeneration when recovery was uneven. Active erythropoisis expanded into distal inactive erthropoietic sites from 3-12 months after irradiation and then decreased thereafter. Blood count cytopenias were almost always restricted to the first year after irradiation.
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One hundred and one patients (43 abnormal, 58 normal) were re-examined with a commercial prototype of the Anger multiplane tomographic scanner after brain scintigraphy. The studies were interpreted independently by four observers of varying experience. Observer performance, in terms of ROC curves, was substantially better when interpreting the tomographic brain scans and camera scintigrams together or the tomographic scans alone than when interpreting the camera images alone. Re-examination with the scanner increases the accuracy of brain scintigraphy (observer performance) in cases in which there is difficulty distinguishing intracranial lesions from superficial foci of activity by camera scintigraphy alone.
A commercial prototype of the Anger multiplane tomographic scanner was compared with a scintillation camera, in terms of observer performance, as a primary instrument for brain scintigraphy. Observer performance (diagnostic accuracy), expressed as ROC curves, was slightly better when reading the tomographic scans than when reading the camera images. In brain scintigraphy of a general population, the scanner has a small advantage over the scintillation camera. This advantage is directly proportional to the fraction of cases in which there is difficulty differentiating intracranial lesions from superficial foci of activity on the camera image.
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A simple and inexpensive electrical modification of the pulse-height analyzers of the Ohio-Nuclear Model 84FD rectilinear scanner, which allows the use of wide pulse-height intervals, is described. The modified instrument is applied to 67Ga scanning, in which the increase acceptance of gamma rays produces scans of increased count density and improved image quality.
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An osteosarcoma, primary in the right ventricular epicardium, produced pericardial constriction. Intense activity on technetium-99m bone scintigraphy led to a correct preoperative diagnosis. Biopsy of unrepresentative tissue clouded the diagnosis, and autopsy resolved the issue. Several clinicopathologic correlations are presented. Major therapeutic advances mandate early recognition of extraskeletal osteosarcoma, and the topic is reviewed in regard to cardiac cancers in general. The need to biopsy both hard and fleshy areas of unusual tumors is reviewed.