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I Fogelman

Publications and source records attributed to I Fogelman.

306 records · Page 17Linked to original sources
PubMed1979

A clinical comparison of Tc-99m HEDP and Tc-99m MDP in the detection of bone metastases: concise communication.

We have compared bone scintigrams made with Tc-99m-tagged HEDP (1-hydroxyethylidene diphosphonate)and MDP (methylene diphosphonate), the former at 4 hr after injection, the latter at both 2 and 4 hr. In 17 patients with skeletal metastases, there was no significant difference in lesion count or scan quality between the 4-hr images. The tumor-to-bone ratio (T/B) was significantly higher with Tc-HEDP (p less than 0.02). Lesion detection rate and T/B ratios were both lower with Tc-MDP at 2 hr when compared with the 4-hr values for both Tc-HEDP (p less than 0.02, p less than 0.005) and Tc-MDP (p less than 0.02, p less than 0.01). The 4-hr Tc-MDP scan was of significantly higher quality than the 2 hr Tc-MDP scan (p less than 0.01). Although Tc-HEDP produces a higher T/B ratio at 4 hr, the present study does not suggest that either agent is superior in clinical practice.

Adult↗
PubMed1978

The prognostic and therapeutic implications of the positive radionuclide bone scan in clinically early breast cancer.

Seventy-five women with clinical stage I or stage II carcinoma of the breast have had radionuclide bone scans at the time of presentation and at 6-monthly intervals during a mean follow-up period of 39 months. Patients with evidence of metastases on bone scan, either at the time of presentation or during follow-up, had significantly higher mortality and morbidity rates than those with persistently negative scans. Whatever the clinical stage, breast cancer patients with a positive bone scan have a very poor short term prognosis and local therapy to the breast is inadequate. A plan is outlined which incorporates the patient's bone scan status into the decision to introduce endocrine therapy or chemotherapy.

Adult↗
PubMed1978

The use of whole-body retention of Tc-99m diphosphonate in the diagnosis of metabolic bone disease.

The limited role of bone scanning in the diagnosis of metabolic bone disease might be considerably improved by accurate quantification of skeletal uptake of the radiopharmaceutical. Using a standard shadow-shield whole-body monitor, we have measured whole-body retention (WBR) of Tc-99m HEDP up to 24 hr in 11 patients with renal osteodystrophy (mean WBR 88.6% at 24 hr); in ten patients with Paget's disease (mean 56.9%); in seven patients with osteomalacia (mean 40.7%); in five patients with primary hyperparathyroidism (mean 50.7%); in four patients with osteoporosis (mean 21.2%); and in 12 normals (mean 19.2%). The osteoporotic group could not be differentiated from the normal group, but the other groups were significantly different from the normal group at 24 hr (p less than 0.002), and each individual rest for the 24-hr WBR of Tc-99m HEDP in these groups lay outside our normal range. This test may, therefore, provide a sensitive means of detecting conditions with increased bone turnover. We obtained measurements of plasma activity of Tc-99m HEDP in these patients up to 24 hr, and 4-hr bone to soft-tissue ratios from bonescan images, but little additional information resulted.

Adolescent↗
PubMed1978

The role of bone scanning in osteomalacia.

The presence of eight "metabolic features" was assessed on the bone scintigrams of ten patients with osteomalacia. In all of these bone images, sufficient features were present to strongly suggest a metabolic disorder. There scintiphotos were included in a controlled blind study using 30 normal bone scans and 20 scans of metastatic disease. Nine of the ten metabolic bone images were correctly identified by two independent observers. Skeletal uptake of radiotracer, expressed as bone-to-soft tissue ratio, was significantly higher in the osteomalacic patients than in a group of 80 controls.

Adolescent↗
PubMed1977

1alpha-hydroxyvitamin D3 in primary hyperparathyroidism.

The surgical management of primary hyperparathyroidism with severe bone disease (and tertiary hyperparathyroidism) has frequently been complicated by severe and prolonged post-operative hypocalcaemia. In seven such cases a short-pre-operative course of 1alpha-hydroxyvitamin D3 has been found to abolish these adverse features virtually completely and even to diminish pre-operative symptoms where present. Exacerbation of hypercalcaemia has not occurred and this regimen is thus recommended as a routine measure.

Adult↗
PubMed1977

Bone scan findings in hypervitaminosis D: case report.

Bone scans in three patients showed generalized symmetrical increased uptake of radiopharmaceutical by the skeleton and absent or faint kidney images. It is thought that these appearances may be attributable to excess vitamin D, but other possible contributing factors, including the presence of renal osteodystrophy, are discussed.

Adolescent↗
PubMedDate not supplied

Successful repeat transcatheter ablation of a mediastinal parathyroid adenoma 6 years after alcohol embolization.

Recurrent hyperparathyroidism is rare following transcatheter ablation of mediastinal parathyroid adenomas. When it occurs it is usually early and resistant to further attempts at ablation. We present a patient with primary hyperparathyroidism in whom two surgical attempts at cure had been unsuccessful. Subsequently, a mediastinal adenoma was demonstrated angiographically and embolized with absolute alcohol. Hyperparathyroidism recurred 6 years later and the mediastinal adenoma was subsequently successfully ablated a second time by angiographic embolization with ionic contrast medium.

Adenoma↗
PubMedDate not supplied

A clinical profile of back pain and disability in patients with spinal osteoporosis.

This study investigated the pain and disability experienced by 85 consecutive postmenopausal Caucasian women, average age 64 years (range 50-82), with spinal osteoporosis, referred to a specialist bone clinic. Symptoms were related to the numbers and severity of vertebral deformities, and degree of kyphosis. Persistent back pain was experienced by 54 (63%) in the lumbar spine and 53 (62%) in the thoracic spine. The severity of thoracic but not lumbar back pain was significantly related by Kendall rank correlation to degree of kyphosis (R = 0.255, p < 0.01), numbers of collapsed vertebrae (R = 0.279, p < 0.01) and a summed score of the severity of collapse for all vertebrae (R = 0.253, p < 0.01). The severity and duration of thoracic back pain was also significantly related to numbers of collapsed vertebrae from T4-T8 alone. Sleep was disturbed in 60%, difficulty obtaining suitable clothes was found in 42% and difficulties with functional activities in 47%, although these were severe in only 10%. Significant associations were also found between scores of osteoporosis severity and sleep disturbance, difficulties with clothes and many functional activities. We conclude that in patients with spinal osteoporosis coming to medical attention, assessment and management of pain, disability, sleep pattern and difficulties with obtaining clothes are required for optimal care.

Activities of Daily Living↗
PubMedDate not supplied

Recent advances in imaging hepatocellular carcinoma: diagnosis, staging and response assessment: functional imaging.

Historically, nuclear medicine has had an important role in the differential diagnosis of liver tumors but has been largely superseded by other forms of conventional imaging, in particular computed tomographic portography. It remains helpful in difficult cases because it has characteristic features in both hepatocellular carcinoma (HCC) and benign conditions. 131I is an important therapeutic tool. FDG-PET is useful in certain cases, especially for finding metastases and monitoring response to therapy.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Dual energy x-ray absorptiometry: the effects of beam hardening on bone density measurements.

X-ray tubes have superseded radionuclide sources for dual photon absorptiometry of the spine and hip. However, the use of a polyenergetic spectrum is a potential source of error for x-ray absorptiometers since beam hardening may result in a nonlinear measurement scale for bone mineral density (BMD). A quantitative study of the effects of beam hardening on measurements made with a commercial dual energy x-ray scanner has been performed. Bone was represented by layers of aluminum of linearly increasing thickness which were scanned under water thicknesses ranging from 0 to 25 cm to represent different body thicknesses of soft tissue. Beam hardening had two effects on measured BMD: (i) at a constant true BMD, measured BMD varied with water thickness; (ii) at a constant water thickness, the BMD scale was not precisely linear. For conditions appropriate to spine and hip studies (BMD) values in the range 0.7 to 1.4 g/cm2 and body thickness between 15 and 25 cm) the maximum deviation of measured BMD from a linear scale was 0.023 g/cm2, while the root-mean-square deviation (0.01 g/cm2) was comparable to the measurement precision for a spine or femoral neck scan (about 1%). The largest departures from linearity were found to occur at the thinnest water thicknesses for BMD values in the range 0.2 to 0.6 g/cm2. The effect of scale nonlinearity on the results of longitudinal studies was examined: for a spine scan at 20-cm body thickness, measured changes in BMD slightly overestimated the true change and implied an error of 0.15%/year for a measurement of a true rate of loss of 3% year in a postmenopausal woman.

Absorptiometry, Photon↗
PubMedDate not supplied

Whole body retention of diphosphonate in rheumatoid arthritis.

The skeletal metabolism of patients with rheumatoid arthritis (RA) osteoarthritis (OA) and ankylosing spondylitis (AS) has been assessed by 24-h whole body retention of 99mTc diphosphonate (WBR). Values for RA and AS patients were significantly elevated but those of OA patients were not when compared to age and sex matched controls (27.0 +/- 8.6 vs 20.5 +/- 1.8%; 24.8 +/- 5.4 vs 19.4 +/- 1.5% greater than and 21.4 +/- 4.1 vs 21.2 +/- 1.4%, respectively). The WBR of patients taking steroids was greatly elevated and RA inpatients had higher values than outpatients, but the increased WBR could not be correlated with disease activity. The increased WBR in RA may represent an indirect effect possibly related to immobility.

Aged↗