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Biomedical subjects

F Scopinaro

Publications and source records attributed to F Scopinaro.

At least 55 records · Page 3Linked to original sources
PubMed1997

Scintigraphic imaging of hepatic epithelioid hemangioendothelioma.

The epithelioid hemangioendothelioma of the liver has been recently characterized as a rare tumor with distinctive pathological features affecting young adults. Our report describes a case of histologically confirmed primary epithelioid hemangioendothelioma of the liver, diagnosed by clinical examination as well as radiological (CT/MR) and scintigraphic imaging (labelled red cells/ phytate-SPECT). This case highlights the usefulness of nuclear medicine techniques during the diagnostic of this rare tumor. Further it stresses the possibility of employing an easy and noninvasive method to adequately follow-up those patients who cannot be considered as disease-free even after orthotopic liver transplantation because of the recurrence of the disease in the transplanted liver.

Diagnostic Imaging↗
PubMed1997

Somatostatin receptor scintigraphy of malignant somatostatinoma with indium-111-pentetreotide.

This article describes the visualization of a pancreatic somatostatinoma and liver metastases using 111In-pentetreotide imaging in a patient with somatostatinoma syndrome. A 61-yr-old woman with gallbladder stones, diabetes, weight loss, diarrhea and steatorrhea, immunohistochemical diagnosis of somatostatinoma (liver biopsy) and high plasma values of somatostatin was studied by somatostatin receptor scintigraphy. Six sites of focal abnormal 111In-pentetreotide hyperfixation were found: three in the liver and three in the pancreatic area. This case report demonstrates that in vivo detection of somatostatinoma with somatostatin receptor imaging is possible in the presence of high levels of circulating somatostatin, suggesting that receptor downregulation has not occurred.

Female↗
PubMed1997

99Tcm-sestamibi scintimammography in patients with suspicious breast lesions: comparison of SPET and planar images in the detection of primary tumours and axillary lymph node involvement.

Planar scintimammography with 99Tcm-sestamibi (99Tcm-MIBI) has been shown to be useful in diagnosing breast carcinoma. The aim of this study was to compare single photon emission tomography (SPET) and planar imaging for scintimammography with 99Tcm-MIBI in the detection of primary breast cancer and axillary lymph node involvement. Sixty-three females with mammographically suspicious lesions and 12 controls were evaluated. Dynamic images were acquired commencing immediately after the injection of the radiopharmaceutical, followed by multiple planar images in the supine and prone positions plus SPET supine imaging. A final histopathological diagnosis was achieved after surgery. A total of 66 breast lesions were considered. No focal uptake of 99Tcm-MIBI was observed in the breasts or axillas of the controls. In the patients with breast cancer, the sensitivity was 92.9% (39/42) for SPET, 71.4% (30/42) for supine and 85.7% (36/42) for prone planar imaging, respectively; the specificity was 87.5% for SPET and 91.6% for the planar scans. Metastatic axillary lymph node involvement was seen in 19 patients: the sensitivity was 84.2% (16/19) for SPET and 63.2% (12/19) for planar images; the specificity was 91.3% and 95.7% respectively. Our results confirm the high diagnostic accuracy of 99Tcm scintimammography in the diagnosis of breast cancer, and suggest that SPET is more sensitive than planar images, especially in detecting axillary lymph node involvement.

Adult↗
PubMed1997

Noninvasive assessment of myocardial involvement in patients with systemic sclerosis: role of signal averaged electrocardiography.

OBJECTIVE: To assess the role of late ventricular potentials (LVP) in detecting early myocardial involvement in patients with systemic sclerosis (SSc). METHODS: Seventy-seven patients with SSc (68 women, 9 men, mean age 50 +/- 13 yrs) and 33 control subjects (18 women, 15 men, mean age 46 +/- 10 yrs) underwent resting electrocardiogram (ECG), 24 h Holter monitoring, complete echocardiographic and Doppler echocardiographic examination, and signal averaged ECG at high pass setting of 40 Hz, with the low pass fixed at 250 Hz. Patients with SSc underwent resting myocardial scintigraphy and radionuclide angioventriculography. RESULTS: The prevalence of LVP at 40 Hz was 20.5%. Compared to control subjects, patients with SSc showed higher prevalence of septal infarction pattern (p = 0.05), complex ventricular arrhythmias (p = 0.03), pulmonary arterial hypertension (p < 0.001), and LVP (p = 0.02). Forty-four patients with SSc (57.1%) had resting perfusion defects by myocardial scintigraphy. Fourteen of 15 patients with LVP showed perfusion defects compared to 29 of 58 without LVP (p = 0.002). Linear regression analysis showed that myocardial perfusion defect score was significantly correlated to either the filtered QRS duration, or the duration of low amplitude signals < 40 microV of the terminal QRS, or the root mean square voltage of the last 40 ms of the QRS complex. After a mean followup period of 20 months, 8 patients died. In 2 patients who died suddenly, LVP were present. CONCLUSION: Signal averaged ECG is a sensitive and inexpensive technique in the clinical assessment and followup of patients with SSc.

Adult↗
PubMed1997

99mTc anti-D-dimer MoAb detects venous thrombi in man.

Authors' work is based on the ability of a 99mTc labelled antibody (MoAb) against D-Dimer (D-D) to visualize thrombi in man. D-Dimer is a specific epitope created during the cross-linking process of fibrin strains. Five normal volunteers and 5 patients with leg varices were given 10 mCi of 99mTc anti-D-Dimer MoAb (research approved by our Ethical Committee). Each patient gave his informed consent. Scintigraphic images were taken at 5, 60, 180 min. No adverse reaction was observed. Two patients underwent saphenous stripping 3 hrs after injection, in the other 4 patients scintigraphic images were acquired at 6 and 8 hrs. Twelve hot spots were visualized. Of these, 5 were localized during operation with a pencil-like probe and exsected. Specific activity of exsected thrombi, saphenal walls and blood samples was measured. Thrombus to vein wall ratio of 2.2 +/- 0.6 and a thrombus to blood of 3.1 +/- 0.8 was measured. In non operated patients the best scintigraphic images were obtained between 60 and 180 min. 99mTc anti-D-Dimer MoAb is a promising agent for localization of thrombi.

Antibodies, Monoclonal↗
PubMed1996

Somatostatin receptor localization of pancreatic endocrine tumors.

Gastroenteropancreatic endocrine tumors are difficult to localize. At the same time the tumor is localized, though, there is an opportunity for cure or to remove tumor tissue. In this study we have prospectively examined the ability of 111In-octreotide scintigraphy, magnetic resonance imaging (MRI), and computed tomography (CT) to localize tumor lesions in 24 patients with a biochemical or histologic diagnosis of neuroendocrine tumor. In eight patients a surgical assessment of the imaging results was prospectively performed. Planar and abdominal single-photon emission tomography (SPET) images acquired 4 and 24 hours after 180 to 220 MBq of 111In-octreotide injection were evaluated and compared with conventional imaging techniques. SPET scintigraphy visualized more presumed tumor lesions (n = 39) than conventional imaging studies (MRI,n = 25; CT,n = 13); 23 of 24 patients had positive octreotide scintigraphy, 17 of 24 had positive MRI-scans, and 12 of 24 patients had positive CT scans. It was concluded that 111In-octreotide scintigraphy combined with conventional imaging improves the preoperative localization of presumably tumorous lesions in patients with gastroenterohepatic endocrine tumors.

Adenoma, Islet Cell↗
PubMed1996

Inhaled nitric oxide in patients with severe heart failure: changes in lung perfusion and ventilation detected using scintigraphy.

Inhaled nitric oxide (NO) is a selective pulmonary vasodilator in patients with end-stage cardiac failure. Preoperative high pulmonary vascular resistance could modify early and late results after heart transplantation generally due to right-ventricular failure. Aim of this study was to assess pulmonary vascular resistance variability following inhalation of NO by using a scintigraphic method. Our preliminary results suggest that inhaled NO in patients with end-stage heart failure redistributes blood away from apical regions and towards more basal and posterior segments, probably dilating blood vessels in ventilated but nonperfused zones. NO may represent a simple and reliable method to evaluate dynamic response of pulmonary vasculature.

Administration, Inhalation↗
PubMed1996

Preliminary evaluation of the usefulness of Tc-99m (V) DMSA in pancreatic neuroendocrine tumors.

The authors describe the possible application of Tc-99m (V) DMSA scintigraphy in pancreatic neuroendocrine tumors. In consideration of the common embryonic origin of these tumors and other neoplastic diseases (medullary thyroid carcinoma, pheocromocytoma, neuroblastoma) that have been well studied with radionuclide imaging, five cases of pancreatic neuroendocrine tumors (two insulinomas, one vipoma, and two unclassified neuroendocrine tumors) were successfully visualized with Tc-99m (V) DMSA scintigraphy, thus giving an overall "imaging confirmation" of the histologic and/or cytologic results in terms of primary and metastatic localization. The authors point out the importance of their results, obtained in a simple and repeatable manner, and suggest a real comparison in this setting between this approach and octreotide scintigraphy.

Female↗
PubMed1996

Muscular uptake of Tc-99m MIBI and TI-201 in Duchenne muscular dystrophy.

Lack of dystrophin, a protein localized to the inner surface of the sarcolemma of the muscle fiber, is the cause of Duchenne type muscular dystrophy. Plasma membrane damage of the muscular fiber occurs, followed by Ca++ influx into the fibers. There is severe mitochondrial damage in dystrophic but still viable fibers. Five children aged 5-7 years were studied with MRI, TI-201, and Tc-99m sestamibi scintigraphy of the thighs. These three methods showed that the sartorius is the least damaged muscle in Duchenne type muscular dystrophy. MRI showed mild damage of adductors and quadriceps; TI-201 scintigraphy showed a marked reduction of radioactivity in the same muscles; Tc-99m sestamibi uptake occurred only in the sartorius muscle; the quadriceps was not imaged and adductors showed a faint image. A decrease of water in muscular fibers as well as fatty fibrous substitution, occurs after death of the fibers, whereas plasma membrane and mitochondrial damage reduced the uptake of tracers when the fiber is still viable. The interesting mismatch between sestamibi and TI-201 can be explained by considering that the cellular mechanism of uptake and retention of Tc-99m sestamibi involves both plasma membrane and mitochondria, whereas the uptake of TI-201 is only affected by plasma membrane damage.

Child↗
PubMed1996

Nitroglycerin-induced changes in myocardial sestamibi uptake to detect tissue viability: radionuclide comparison before and after revascularization.

BACKGROUND: Nitroglycerin (NTG) is known to increase the blood supply to the myocardium, and would thus increase the delivery of a perfusional tracer such as sestamibi (MIBI) to the tissue. The latter, in turn, would take up and concentrate the tracer to a greater extent than in basal conditions only if energy-dependent mechanisms were still available-that is, only if the cells were still viable. METHODS: We evaluated the changes that intravenous administration of NTG induced on the uptake of MIBI by akinetic myocardial areas, using tomographic perfusional imaging in 23 patients with previously ascertained anterior myocardial infarction who were undergoing myocardial revascularization procedures. Changes in uptake were compared with echocardiographic and perfusional changes occurring after operation. RESULTS: The improvement of MIBI uptake after NTG correctly identified 12 of the 16 patients (75%) showing postoperative wall motion improvement; they comprised 12 of the 14 (86%) patients with NTG-induced increase in MIBI uptake who showed improved wall motion after operation. A close correlation (r = 0.88, P < 0.001) was found between the increase in myocardial MIBI uptake induced by NTG infusion and that induced by revascularization. The presence of collaterals to the akinetic area was associated with a significantly (P < 0.01) greater increase in MIBI uptake both during NTG infusion and after operation. CONCLUSIONS: The results of this study suggest that MIBI perfusional myocardial scintigraphy during infusion of NTG is capable of detecting viable but chronically hypoperfused myocardium, predicting postoperative wall motion and perfusional improvement, and reflecting the postoperative pattern of perfusion. The best results were achieved in patients with evidence of collateral circulation supplying the infarcted area.

Cardiac Catheterization↗
PubMed1996

[Breast scintigraphy with technetium 99m sestamibi, as support to radiologic methods in the study of breast lesions].

Our study was aimed at investigating the efficacy of scintigraphy with 99mTc-Sestamibi (MIBI) as a support to mammography and US in the diagnosis and staging of breast cancer. Twenty-seven women with breast lesions were examined: the masses, detected at mammography and US, ranged in diameter 0.7 to 2.5 cm; mass features suggested a benign lesion in 5 patients, a malignant lesion in 9 patients and a questionable diagnosis in 13 patients. 99mTc-MIBI scintigraphic images were analyzed blind by two observers and the pattern was considered positive when tracer uptake was demonstrated at the lesion. In neoplastic lesions, tracer uptake was looked for also in the axilla. All the patients were submitted to surgery and, in case of malignancy, lymphadenectomy was also performed. MIBI scintigraphy was negative in 14/16 benign lesions and positive in 9/11 malignant lesions. Tracer uptake in the axilla was observed in 3 of 5 patients with nodal involvement. Scintigraphy had 82% sensitivity, 87% specificity and 85% accuracy in the diagnosis of breast cancers.

Adult↗
PubMed1996

[Biliary scintigraphy vs. ultrasonography in the etiological diagnosis of acute pancreatitis].

Etiology of acute pancreatitis has important implications in the treatment of the disease as gallstones pancreatitis requires the correction of the underlying biliary disease. The usefulness of ultrasonography in the detection of stones in emergency has been questioned, and HIDA biliscintigraphy has been reported to be a possible indicator of biliary pancreatitis. This study compares the value of HIDA colesscintigraphy and ultrasonography in the etiologic diagnosis of 35 patients admitted and treated for acute pancreatitis in our Institution. All patients underwent ERCP for the confirmation of the findings. Cholescintigraphy showed no visualisation of the gallbladder, suggesting biliary tract stones, in 25 patients. In all of them ERCP confirmed the presence of gallbladder and/or common bile duct stones, and endoscopic sphincterotomy and later elective cholescystectomy was performed. Ultrasonography failed to demonstrate biliary stones in 11 of those patients. HIDA cholescintigraphy showed a sensitivity and a negative predictive value of 1 vs 0.56 and 0.45 for ultrasonography. From the results of our study it can be concluded that HIDA biliscintigraphy is more reliable than ultrasonography in the discrimination of biliary vs non-biliary acute pancreatitis in emergency.

Acute Disease↗
PubMed1996

SPECT improves accuracy of somatostatin receptor scintigraphy in abdominal carcinoid tumors.

UNLABELLED: Abdominal carcinoid tumors are often small and difficult to localize. Somatostatin receptors have been detected in carcinoids, thus enabling their in vivo visualization by scintigraphy with 111In pentetreotide, a radiolabeled somatostatin analog. The aim of this study was to determine the value of 111In-pentetreotide SPECT in the detection of abdominal carcinoids and to compare these results with the outcomes from planar scans and conventional imaging techniques. METHODS: Eighteen patients with a present, or previously operated, abdominal carcinoid were evaluated. Abdominal SPECT scans were acquired 4 hr postinjection of 111In-pentetreotide and multiple planar views were performed at 4, 24, and 48 hr. RESULTS: No adverse reactions were observed after radiopharmaceutical injection. In 13 of 18 patients, abnormal sites of uptake were found by SPECT, which localized 9 abdominal extrahepatic lesions (in 7 patients) and 33 hepatic lesions (in 10 patients). No pathologic accumulation was seen in the five patients considered in complete remission after surgery. Planar scans visualized 5 abdominal extrahepatic sites (in 4 patients) and 21 liver tumor sites (in 7 patients), while conventional procedures detected 3 abdominal extrahepatic lesions (in 2 patients) and 30 hepatic lesions (in 7 patients). CONCLUSION: Indium-111-pentetreotide scintigraphy is a safe and practical procedure. SPECT appears to be more sensitive than planar scintigraphy and conventional methods to detect abdominal carcinoids; it can increase the number of visualized tumor sites and that of patients with positive findings and may therefore have a role not only in the mapping of tumor spread but also in therapeutic decisions.

Abdominal Neoplasms↗
PubMed1996

99mTc-sestamibi and 201-Thallium at rest: dual scintigraphic mapping of myocardial injury in infarcted patients.

UNLABELLED: 201-Thallium (Tl) and (99m)Tc-sestamibi (SM) present different biological properties and kinetics, suggesting a complementary evaluation of mitochondrial and cell membrane functions with subsequent implications regarding myocardial injury mapping. To verify the usefulness of a dual isotopic approach in Q infarcted patients, 30 subjects were submitted at rest, within 5 days, to SM imaging, 4h-delayed Tl scans and echocardiography (ECHO). Left ventricle segmental uptake and wall motion were graded on a 3 points scale (0=absent to 2=normal) and compared on the basis of an 11 segments model. RESULTS AND DISCUSSION: 1) The analysis of SM normal segments demonstrated a strong concordance (97%) with Tl and ECHO, suggesting that both mitochondrial and cell membrane functions are preserved; 2) 49% of SM graded 0 segments were scored 1 by Tl and ECHO, suggesting a worse impairment of mitochondrial function with respect to cell membrane function; 3) approximately 55% of segments showing a reduced MIBI uptake were found normal using Tl, then an impaired mitochondrial but a normal cell membrane function could be hypothesized. 4) Tl provided a better estimation of the effective infarction size with respect to SM. CONCLUSIONS: The SM and Tl dual approach, allowing scintigraphic mapping of myocardial injury, seems to provide a useful tool for a complete evaluation of infarcted patients.

Echocardiography↗
PubMed1995

Myocardial scintigraphy with 99mTc-sestamibi in children with Kawasaki disease.

Kawasaki disease (KD) is a systemic vasculitis syndrome of early childhood. It involves particularly the coronary arteries and may cause aneurysms and thrombotic occlusions. Echocardiography is the most useful method of detecting coronary aneurysms. Nevertheless, obstructive lesions are difficult to evaluate and often need invasive coronary angiography. An important feature of this disease is the possibility of finding coronary pathology several years after the onset. This characteristic makes KD an important cause of coronary artery disease (CAD) in young adults. Thus patients with KD and previously diseased coronary arteries should be kept under long-term control. However, coronary angiography is invasive and cannot be performed repeatedly, especially in young patients. As an alternative, thallium 201 scintigraphy has been employed, but its low-energy photons are suboptimal for standard gamma-camera imaging, particularly in children aged less than three years. To verify the usefulness of a noninvasive assessment of myocardial perfusion, the authors used rest and dipyridamole 99mTc-Sestamibi scan in 15 children (ranging from one to six years of age) with Kawasaki's cardiac involvement. Coronary aneurysms have been demonstrated by echocardiography in 12 patients; 8 patients were also submitted to cardiac catheterization. The sensitivity of 99mTc-Sestamibi imaging for detection of overall coronary lesions was 88% and the specificity was 93%. These data suggest that rest/dipyridamole 99mTc-Sestamibi scintigraphy is an accurate and noninvasive method for the detection and follow-up of Kawasaki's cardiac damage even in patients aged one year.

Child↗