Isotope scans in chronic subdural haematoma.
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Chronic Disease↗
Biomedical subjects
P J Ell
Publications and source records attributed to P J Ell.
Value of positive myocardial infarction imaging in coronary care units.
Positive myocardial imaging was undertaken on 120 unselected patients admitted to a coronary care unit with clinical suspicion of acute myocardial infarction. Multipurpose mobile gamma-cameras were used for serial imaging after administration of 99mtechnetium-labelled imidodiphosphonate, a low-cost radiopharmaceutical that is 97% specific for myocardial necrosis, with myocardial uptake and blood clearance most suitable for myocardial imaging. The sensitivty of detection was 94% for patients whose infarction was unequivocal on the ECG; when the presence of raised enzyme concentrations was also used as a criterion for myocardial necrosis, the overall sensitivity for all 120 patients remained 94%. In 73 patients (61%), whose ECGs were unhelpful or difficult to interpret, scintigraphy allowed infarction to be diagnosed in 11 (15%) and to be excluded in five (7%). In 32 (44%) of this group whose ECGs were totally uninterpretable due to previous myocardial damage or disorders of electrical activation, scintigraphy provided confirmation of a diagnosis that otherwise rested only on whether enzyme concentrations were raised. Myocardial imaging is thus a useful technique that permits more definite diagnosis in patients for whom ECG and enzyme data are uncertain.
Acute Disease↗
Is there a future for single photon emission tomography?
Emission tomography has the potential to be developed into a clinically useful technique. Its clinical applications, however, will be limited and not in the main stream of space occupying disease detection but in the definition of quantitative information particularly relevant in those disease processes where the metabolic component is the most important one. Special purpose designed instrumentation may prove to be the best of several possible compromises.
Elementary Particles↗
Mobile gamma cameras and 99mTc-labelled phosphates in acute myocardial infarction.
99mTc-labelled phosphates (PyP, IDP and MDP) were compared for their usefulness for the diagnosis of myocardial infarction. The results indicated the superiority of 99mTc-labelled imidodiphosphonate over the other 99mTc-labelled phosphates. At the same time, two mobile gamma cameras were compared with respect to their instrumental characteristics and clinical versalitity and their advantages and disadvantages are reported.
Diphosphates↗
A new transverse-section brain imager for single-gamma emitters.
Physical and clinical data on a new emission transverse-section scanner are given. Comparative data from an earlier tomoscanner and a rotating gamma-camera system yield the following information for the three imagers. Resolution at the center of the field is 9 mm for this tomoscanner, 18 mm for the earlier tomoscanner, and 11 mm for the rotating camera; sensitivity (cps/muCi-ml) 36K, 15.4K, 1.9K; crystal area (cm2) 3096, 619, 490, respectively. The quantification of images is discussed. Clinical emission section scans of the brain, liver, chest and skull are presented and discussed. Forty brain scans were analyzed in conjunction with x-ray transmission tomography. No false positives were found. From a total of 15 lesions seen by the CT x-ray scanner, 14 were detected by the emission tomographic scanner, 12 by standard gamma-camera imaging. One false negative case (cyst) was seen by the transmission x-ray scanner but not by the emission scanner.
Abdomen↗
Ventricular pseudo-aneurysm demonstrated by multiple gated cardiac imaging.
The use of multiple gated cardiac imaging in the diagnosis of left ventricular pseudo-aneurysm is reported and the clinical and therapeutic implications are discussed. Complemented with myocardial perfusion imaging, it is the method of choice for screening patients following infarction or chest trauma who may develop this potentially treatable complication of myocardial necrosis.
Heart Aneurysm↗
[Bone scans in the diagnosis of renal osteopathy].
Biochemical tests (serum calcium, inorganic phosphate and alkaline phosphatase), as well as clinical, radiological, scanning and histological investigations were undertaken in 24 patients in chronic renal failure. The frequency with which the diagnosis of renal osteopathy could be made depended in the method of investigation, the biochemical findings proving to be completely unreliable. There were positive radiological signs in ten patients and clinical signs in 12, predominantly in the progressive stages of osteopathy. A positive scan was obtained in 23 patients, typical histological bone changes in an equal number. Since it correlates so well with the histological findings, bone scan is suitable particularly in the early diagnosis of osteopathy. Since this test is easily performed and hardly stresses the patient, it should routinely be the initial one for the diagnosis of renal osteopathy.
Adult↗
Emission computerised tomography. A new diagnostic imaging technique.
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Adolescent↗
[Bone scan in the diagnosis of renal osteopathy (author's transl)].
Biochemical tests (serum calcium, inorganic phosphate and alkaline phosphatase), as well as clinical, radiological, scanning and histological investigations were undertaken in 24 patients in chronic renal failure. The frequency with which the diagnosis of renal osteopathy could be made depended in the method of investigation, the biochemical findings proving to be completely unreliable. There were positive radiological signs in ten patients and clinical signs in 12, predominantly in the progressive stages of osteopathy. A positive scan was obtained in 23 patients, typical histological bone changes in an equal number. Since it correlates so well with the histological findings, bone scan is suitable particularly in the early diagnosis of osteopathy. Since this test is easily performed and hardly stresses the patient, it should routinely be the initial one for the diagnosis of renal osteopathy.
Adolescent↗
Cardiovascular nuclear medicine and intensive care.
The clinical application of cardiovascular nuclear imaging techniques to intensive care medicine holds great promise for improved non-invasive assessment of the patient. With the development of new radiopharmaceutical agents and better instrument resolution, it is now possible to provide quantitative information concerning myocardial perfusion, acute myocardial ischaemia, left ventricular function, thromboembolic pulmonary disease and analysis of the patient's respiratory function. The patient can be studied during various phases of his disease, with these techniques furnishing objective guidelines of the therapy and prognosis.
Coronary Disease↗
The future of non-invasive medical imaging.
A variety of new non-invasive imaging techniques are now at the physicians' disposal for patients' management. However, the place of each new imaging modality within the general diagnostic armamentarium is far from established. Not only comparative assessments of these are needed but also pre-defined strategies for use are required for an intelligent approach to a difficult medical problem. The increasing cost of medicine and the decreasing resources available for development enhance the necessity for such an approach. This paper offers an initial solution to the problem.
Biliary Tract Diseases↗
Operating a nuclear medicine computer system with a remote mobile gamma camera.
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Analog-Digital Conversion↗
99mTc-imidodiphosphonate: a superior radio-pharmaceutical for in vivo positive myocardial infarct imaging. I: Experimental data.
99mTc-Imidodiphosphonate (99mTc-IDP) was investigated as an agent for nuclear medicine imaging of acute myocardial infarctions. For this purpose a suitable animal model was found. After coronary artery ligation reproducible myocardial infarcts were obtained with 80% of surviving animals. Scans of the myocardial infarcts were recorded with a high resolution gamma camera and good quality images were obtained. 99mTc-IDP ratios for normal and infarcted tissue were calculated and compared with similar data available from other 99mTc-labelled phosphates. With an infarct/normal ratio of 21:1, 99mTc-IDP is so far the best radiopharmaceutical for nuclear medicine imaging of necrosed heart muscle. Images of the myocardial infarcts have been recorded as early as 6 hours after infarction.
Animals↗
99mTc-imidodiphosphonate: a superior radio-pharmaceutical for in vivo positive myocardial infarct imaging. II: Clinical data.
99mTc-Imidodiphosphonate was investigated as a new myocardial infarct imaging agent. In the acute phase, 50 patients admitted to the coronary care unit were serially scanned over a period of 7 days. A mobile gamma camera linked on line to a remote data processor was used. Because of higher uptake in infarcted myocardium and faster blood clearance, superior images than those recorded with 99mTc-pyrophosphate were obtained. Its ease of preparation, low cost, and favourable dosimetry (because of its label with conventional 99mTc) transforms this agent into the present radiopharmaceutical of choice for acute infarct imaging in particular if sizing and follow-up is intended versus time and type of treatment. In this series, no false positive cases were seen. The sensitivity of the method in the detection of full thickness myocardial infarction was 95%. It dropped to 70% in the detection of subendocardial infarction. However, some of these apparent false negative cases may reflect severe ischaemia without infarction. It is postulated that this discrimination may not always be realistic.
Diphosphonates↗
Peroperative nuclear medicine: the portable gamma camera on-line to a computer, as a diagnostic service to the surgeon.
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Adolescent↗
Imaging: the clinical use of diagnostic imaging.
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Brain Neoplasms↗
Imaging: radioisotope imaging of bone.
Isotope bone scanning is here to stay: it is noninvasive, easy to perform, and economical (6 pounds per scan). The low radiation dose delivered to patients (0.03 rad/mCi to the skeleton) and the high sensitivity (less than 4 per cent of overall false positives) underline the value of this test as a screening procedure. When included in the patient's management protocol it reduces bed-occupancy time, changes the therapeutic approach to several illnesses, and substantiates general hopes that early diagnosis is the basis for progress in the treatment of benign or malignant disease.
Adenocarcinoma↗
A comparison of a new whole body scanner with a large crystal scanning camera in whole body imaging.
Physical parameters and the clinical experience obtained in one year with a new whole body scanning system are presented. Advantages and disadvantages of this system are described in comparison with a large crystal scanning camera. The whole body scanner has two detectors each an array of ten crystals with a large area (700 cm2 per head) able to scan a surface of 60 X 193 cm. The information is formed in a 160 by 512 point matrix and stored on a floppy disc. X-ray or polaroid film output is available. Whole body bone scans (both A.P. and P.A.) with excellent resolution are obtained in less than 25 min. The relative sensitivity and resolution of both imaging systems was studied using line and plane source phantoms and clinical material. Taking into account the different physical parameters of the systems an attempt at a practical comparison of scans is made in terms of time, sensitivity, resolution and image quality.
Adult↗