Search PubMed⌕ Search

Biomedical subjects

M T Parisi

Publications and source records attributed to M T Parisi.

26 records · Page 2Linked to original sources

Efficacy of metaiodobenzylguanidine as a scintigraphic agent for the detection of neuroblastoma.

RATIONALE AND OBJECTIVES: Metaiodobenzylguanidine (MIBG) has been shown to be both sensitive and highly specific for the detection of neuroblastoma. However, controversy surrounds its sensitivity in detecting neuroblastoma when compared with radionuclide (technetium 99m-methylene diphosphonate [99mTc]-MDP) bone scans. Because a diagnostic test ideally should be easy to interpret in addition to being sensitive and specific, this study aims to determine the most efficacious scintigraphic agent for diagnostic use in neuroblastoma. METHODS: Twenty patients with neuroblastoma had a total of 26 paired MIBG and 99mTc-MDP bone scans obtained less than 4 weeks apart. Each study was evaluated independently of its counterpart by six separate observers (3 experienced and 3 inexperienced in MIBG scintigraphy) to determine the presence or absence of disease and the tumor burden. RESULTS: Inexperienced observers reported more confidence in their interpretations of 99mTc-MDP bone scans; however, seven false-positive bone scans were reported. Using MIBG, all true-positive and true-negative scans, as well as significantly more sites of both primary and metastatic disease, were identified by all observers. CONCLUSION: This study suggests that MIBG is the more efficacious agent for the scintigraphic evaluation of neuroblastoma.

3-Iodobenzylguanidine↗

Neuroblastoma: dose-related sensitivity of MIBG scanning in detection.

Iodine-131 metaiodobenzylguanidine (MIBG) has shown effectiveness as a systemic radiotherapeutic agent in neuroblastoma. The authors postulated a likely dose-related relationship of MIBG sensitivity when it was administered for neuroblastoma detection. They studied this relationship in neuroblastoma patients who underwent scanning after receiving diagnostic and therapeutic doses of MIBG in temporal proximity. Seven patients with stage IV disease received a total of 14 therapeutic administrations of I-131 MIBG (150-350 mCi [5,550-12,950 MBq]/m2 per treatment). Posttherapy scans were obtained at 3 and at 5-7 days. Diagnostic MIBG scans had been obtained no more than 4 weeks before the start of therapy. Use of diagnostic MIBG scanning led to underestimation of the tumor burden by 50% compared with use of posttherapy scanning. This difference may be an important consideration in selecting therapeutic strategies for individual patients. It further suggests that use of much larger diagnostic doses of MIBG is a rational strategy in histologically confirmed cases of advanced disease.

3-Iodobenzylguanidine↗

Unique scintigraphic findings of bile extravasation in the presence of ascites: a complication of hepatic transplantation.

A 99mTc-HIDA scan was performed on a 4-mo-old female, six days after hepatic transplantation. Gradually, a diffuse increase in activity was seen over the peritoneal region, consistent with a slow bile leak into ascitic fluid. Although the scintigraphic appearance of a bile leak has been previously described, it is usually seen as a focal area of extrabiliary activity. In this case, we report a pattern identified when the leak occurs in conjunction with ascites.

Anastomosis, Surgical↗

Duration of etidronate effect demonstrated by serial bone scintigraphy.

There have been several reports of etidronate disodium (EHDP) interference upon the biodistribution of 99mTc-methylene diphosphonate (MDP). With the increasing use of etidronate for the treatment of Paget's disease, hypercalcemia, and osteoporosis, nuclear physicians can expect to encounter increasing numbers of cases in which EHDP-induced artifacts impair the diagnostic utility of bone scans. The temporal duration of this effect is unknown yet obviously important. We report serial bone scintigraphy in a patient who received a single dose of EHDP for hypercalcemia. Normal biodistribution of 99mTc-MDP was noted at 15 days, suggesting that 2 wk are sufficient before performing a bone scan after a single intravenous dose of etidronate.

Aged↗

Pictorial review of the usual and unusual roentgen manifestations of childhood tuberculosis.

Despite advances in management of infectious diseases, tuberculosis remains a significant cause of morbidity and mortality in urban populations. In the pediatric age group, 65% of patients presenting with tuberculosis are asymptomatic. Recognition of the usual and unusual roentgen manifestations of this infectious disease often provides the only clue to the diagnosis.

Child↗

Complications of cancer therapy in children: a radiologist's guide.

As advances in cancer therapy improve the prognosis of patients with childhood malignancies, awareness of the consequences of treatment methods assumes increasing importance. All cancer treatment modalities are associated with toxic effects, and the spectrum of therapy-induced complications involves all organ systems. Radiologists have a pivotal role in detecting these sequelae, which can be categorized by the affected organ system and by whether they occur (a) at diagnosis or during initial therapy or (b) after the completion of treatment. The first group consists of oncologic emergencies, infectious complications, and irritant effects. Oncologic emergencies can be further categorized as space-occupying lesions (e.g., superior vena cava syndrome or spinal cord compression), vascular abnormalities (e.g., hyperleukocytosis, anemia, coagulopathy), and metabolic emergencies (e.g., tumor lysis syndrome). Common complications developing after completion of treatment include leukoencephalopathy and neurocognitive defects; cataract formation; cardiomyopathy and congestive heart failure; hepatic dysfunction, fibrosis, and cirrhosis; radiation enteritis; renal dysfunction or failure; scoliosis and short stature; hypothyroidism; gonadal dysfunction; graft-versus-host disease; and development of secondary malignancies. Physician awareness of these complications will permit more effective patient surveillance, which may afford patients the opportunity for earlier intervention in these situations and improved quality of life.

Adolescent↗