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Biomedical subjects

F H DeLand

Publications and source records attributed to F H DeLand.

At least 55 records · Page 3Linked to original sources
PubMed1985

Photopenia of a hemithorax on technetium-99m HMDP bone scintigraphy resulting from massive pleural effusion.

Accumulation of Tc-99m labeled phosphonate bone scanning agent in a pleural effusion usually shows a mild and diffuse increase in radioactivity of the involved thorax. A malignant neoplasm was thought to account for this accumulation. The photon deficiency of the hemithorax on Tc-99m HMDP bone scintigraphy was shown in a case of massive pleural effusion, which was proved by autopsy to be due to metastatic breast carcinoma in the pleura. Two factors caused these scintigraphic findings: 1) a large amount of fluid in the pleural cavity caused photon attenuation; 2) the higher body background in the noninvolved hemithorax and other areas of the body was due to renal dysfunction resulting from chronic pyelonephritis. Whether the accumulation of the radiopharmaceutical agent in the pleural effusion was malignant or benign could not readily be distinguished.

Adult↗
PubMed1985

Simultaneous demonstration of pleural effusion and ascites by technetium-99m sulfur colloid liver-spleen scintigraphy.

Scintigraphic evidence of ascites has been observed in Tc-99m sulfur colloid studies of the liver and spleen, in Tc-99m HIDA hepatobiliary scans, in Ga-67 citrate scans, and in Tc-99m phosphonate bone images. Pleural effusion has been demonstrated in Tc-99m phosphonate bone scintigraphy. The case of a 48-year-old man whose Tc-99m sulfur colloid liver-spleen scintigram simultaneously demonstrated a right pleural effusion and ascites is presented.

Ascites↗
PubMed1985

Extrarenal abnormalities in Tc-99m-DTPA renal blood flow studies.

We observed extrarenal abnormalities during renal flow scintigraphy and retrospectively reviewed 90 patient studies to determine the types and frequencies of such abnormal findings. For each routine Tc-99m-DTPA renal flow study, we obtained nine 2-second sequential images, which included the heart, abdominal aorta, spleen and kidneys. Eighty abnormalities, observed in 62 patients, were divided into three categories: aortic, 37 cases (aneurysms, ectasia, thrombosis, tortuosity, and abruptly decreased flow); splenic, 40 cases (enlarged, small, or absent spleen); and miscellaneous, 3 cases (hepatic arterialization and very slow circulation). Other correlative studies including Tc-99m sulfur colloid-spleen scintigraphy, ultrasonography (US), CT, aortography, and surgical and/or autopsy findings were available for corroboration in 56 of 80 lesions.

Adult↗
PubMed1984

Adult polycystic disease of kidneys: a potential cause of false-positive 67Ga images.

A 56-year-old man with adult polycystic disease of the kidneys complicated by renal failure, hypertension, and bacteremia underwent bilateral nephrectomy because the enlarged kidneys compromised his gastrointestinal function and respiratory capacity. A scan using 99mTc-methylene diphosphonate demonstrated nonfunctioning kidneys, bilaterally. An unusual radioactivity pattern in the bowel in 67Ga scintigraphy was due to extreme renal enlargement and should be kept in mind to avoid misinterpretation.

Abscess↗
PubMed1984

Open rib biopsy guided by radionuclide technique.

When abnormally increased radioactivity is seen in a rib or ribs by bone imaging in a patient with suspected or known malignancy, it frequently is difficult to differentiate fracture from metastatic disease. Histological examination of the lesion is crucial for diagnosis, staging, and planning of therapy. To assess the value of external localization of the site or sites of abnormal uptake in a rib as a guide for open rib biopsy, 10 patients (7 men, 3 women; age range, 34 to 68 years) with known or suspected malignancy were studied. With reference to the oscilloscope image, a cobalt 57 marker was placed on the skin overlying the focus of increased uptake, and the area of increased activity was marked on the skin as a guide to surgical resection. Of ten resected ribs, four showed metastatic disease and five had fractures. (One patient underwent two external marking procedures and two surgical procedures.) Rib biopsy was not performed in 1 patient because prior to the surgical procedure, a small subcutaneous nodule adjacent to the skin marker was excised and confirmed to be carcinoma. Appropriate courses of management (operation, irradiation, chemotherapy) were taken after the biopsies. The surgeon responsible for the biopsy should be present during the skin-marking procedure, and the area beneath the scapula and the region adjacent to the spine should be avoided. Our results indicate that the technique is a very useful aid for approaching open rib biopsies more precisely.

Adenocarcinoma↗
PubMed1984

Pyogenic liver abscess presenting as a "warm" lesion in Ga-67 scintigram. A potential pitfall in interpretation.

In the Ga-67 scintigram, most pyogenic liver abscesses appear to be areas of high radiotracer concentration; rarely photon-deficient lesions may also occur. We present a 58-year-old man with sepsis and hepatic abscess, demonstrated by a Tc-99m BIDA study and a computerized tomogram of the body, showing homogenous radiogallium uptake throughout the liver in the Ga-67 images. To avoid missing such a "warm" lesion, it is emphasized that abdominal Ga-67 scintigrams for localization of a focal inflammatory lesion should be done along with Tc-99m sulfur colloid or Tc-99m BIDA scintigraphy.

Gallium Radioisotopes↗
PubMed1984

Demonstrating alcoholic cirrhosis of the liver by Tc-99m BIDA scintigram.

Six patients with decompensated cirrhosis of the liver underwent Tc-99m BIDA studies. All demonstrated 1) persistently high blood pool activity in the heart, lung, and soft tissue, 2) slow hepatic tracer uptake, 3) prolonged liver-to-bowel transit time, and 4) visualization of an enlarged spleen. Four of the six patients demonstrated evidence of ascites and in one patient there were visible collateral veins of the abdomen. These findings are due primarily to hepatic dysfunction and retaining Tc-99m BIDA in blood pool because of Tc-99m BIDA exclusively hepatic excretion and little or no alternative renal excretion. All six Tc-99m sulfur colloid studies were performed concomitantly. Except for bone marrow uptake and reversal of the normal liver-spleen ratio of radioactivity, the imaging abnormalities observed with Tc-99m BIDA were similar to those seen by Tc-99m SC. It is concluded that with Tc-99m BIDA studies, three of six abnormal findings, as described, suggest a decompensated stage of cirrhosis of the liver.

Humans↗
PubMed1984

Unusual persistence of Tc-99m MDP uptake in the incisional scar after thoracotomy.

Postoperative scar is one of the causes of extraosseous localization of Tc-99m phosphonate bone agents. Usually, an incisional scar will not be visualized in a Tc-99m phosphonate skeletal image two weeks after surgery. A case is reported with an unusually persistent localization of radiotracer in the scar of a thoracotomy seen in three consecutive bone images done beyond two weeks postoperatively. This patient suffered from "pulmonary insufficiency" before and after the thoracotomy. The abnormal radiotracer localization in the scar is presumably related to his pulmonary insufficiency, with resulting relatively delayed wound healing.

Aged↗
PubMed1984

Diagnostic imaging in mediastinal thyroid tumor.

Various diagnostic imagings in nine patients with mediastinal goiters were presented. The clinical manifestations of these patients were various, from totally asymptomatic to severe dyspnea. Six of the nine patients underwent surgical intervention, three were follicular adenomas and three were nodular goiters. A chest radiograph (positive in seven out of nine patients) provided the most valuable initial localization of a goiter mass to the anterior, middle, or posterior compartment. Esophagograms (performed in four patients) showed compression of esophagus by the mediastinal mass. I-131 scintigraphy (performed in seven patients) was capable of detection of functional (in three patients) vs nonfunctional status of thyroid status (in four patients). Angiography (performed in five patients), characterized by anatomic continuity with cervical thyroid gland, calcifications, well-defined border of masses and/or contrast enhancement, offered important roles to direct a diagnosis of intrathoracic goiter. The computed tomography becomes increasingly important because all mediastinal goiters are not radioiodine avid.

Adenoma↗
PubMed1984

Clinical studies of prostatic cancer imaging with radiolabeled antibodies against prostatic acid phosphatase.

Conventional antibodies against prostatic acid phosphatase, labeled with iodine-131, have been administered to patients with prostatic carcinoma for the external scintigraphic imaging of tumors containing prostatic acid phosphatase (radioimmunodetection). The method has been found to be safe and reliable for imaging of primary tumors and non-bone metastases, even differentiating between lung tumors of prostatic and pulmonary origin.

Acid Phosphatase↗
PubMed1984

Abdominal halo in Tc-99M DISIDA hepatobiliary scintigraphy: a sign of massive ascites.

An abdominal halo was demonstrated in a Tc-99m di-isopropyl imminodiacetic acid (DISIDA) hepatobiliary scintigram of a patient with a long history of alcohol abuse and liver disease complicated by massive ascites. This halo was not observed in the concurrent Tc-99m sulfur colloid study. Large amounts of ascitic fluid floated the liver, the bowel and the mesentery in the central abdomen forming an abdominal halo, a band-like clear zone around the abdominal organs. Severe hepatic dysfunction, resulting in prolongation of the blood pool phase in the Tc-99m DISIDA study, will cause exaggeration of this finding. When an abdominal halo is seen it should be considered a sign of massive ascites.

Abdomen↗
PubMed1983

Radioimmunodetection of prostatic cancer. In vivo use of radioactive antibodies against prostatic acid phosphatase for diagnosis and detection of prostatic cancer by nuclear imaging.

Radioimmunodetection (RAID) of prostatic cancer is done by injecting 131I-labeled rabbit antibody IgG against prostatic acid phosphatase (PAP) and performing total-body photoscans with a gamma scintillation camera. Of two patients tested, the PAP RAID scintiscans located the primary or recurrent prostatic cancers in both and showed no disease in the lungs of the patient shown subsequently to have lung cancer. The lung tumor nodules showing anti-PAP IgG accretion were assumed to be of prostatic cancer origin, since one of the original tumors removed from this patient's other lung a year earlier stained for PAP by immunohistochemistry. This study showed that PAP RAID can locate primary and metastatic tumors of prostatic origin.

Acid Phosphatase↗
PubMed1983

Sequential early and delayed myocardial 99mTc pyrophosphate scans: evaluation of diffuse myocardial uptake.

Of 114 pyrophosphate (PPi) myocardial studies, eleven were selected to assess the significance of diffuse uptake observed in the images obtained early (2-3 h) following injection and compared with delayed scintigrams at 6-24 h. From the results of the late studies the patients were divided into two groups; those with no or minimal residual activity in the delayed study (five cases) and those with approximately the same intensity of delayed scans as in the early study (six cases). No significant abnormalities in cardiac enzymes or the EKG (obtained within 24 h) were noted in the patients of the first group. Cardiac enzymes, EKG abnormalities, indicating myocardial damage, or decreased radionuclide LVEF dysfunction were found in the patients of second group. We concluded that a late image is required in a case of diffuse PPi myocardial uptake in the early image, and myocardial damage may be present if there is persistently diffuse uptake of PPi in the late image.

Diphosphates↗
PubMed1983

Massive splenomegaly with multiple defects in a chronic myelogenous leukemia demonstrated by 99mTc-sulfur colloid scintigraphy.

A 99mTc-sulfur colloid liver-spleen scintigram of a 78-year-old woman with a painful, large mass in the left upper quadrant of the abdomen revealed massive splenomegaly with multiple areas of absent radioactivity. Splenectomy was performed and the removed spleen, weighting 2,010 g, was confirmed to contain acute and old infarcts with leukemic cell and megakaryocyte infiltration.

Aged↗