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PubMed2004

Measurement of translymphatic fluid absorption using technetium-99m human serum albumin diethylenetriamine pentaacetic acid in continuous ambulatory peritoneal dialysis patients.

We have established a new method of measuring translymphatic fluid absorption (TLA) using technetium-99m ((99m)Tc) human serum albumin diethylenetriamine pentaacetic acid ((99m)Tc-HSAD) that can be used commonly in clinical practice. This new method was applied in 13 continuous ambulatory peritoneal dialysis patients (11 males and two females) who had various peritoneal permeability and capacities for peritoneal transport of water. (99m)Tc-HSAD 740MBq was injected in 2 L of peritoneal dialysis fluid with 2.5% glucose, mixed well, and administered intraperitoneally. The fluid was drained extraperitoneally after 4 h and TLA was determined by the in vivo loss of (99m)Tc-HSAD. TLA was 1.41 +/- 1.11 mL/min (mean +/- SD; range, 0.27-3.69 mL/min). The estimated reduction rate by TLA in trans-peritoneally removed fluid ranged from 14.2 to 84.4%, indicating that TLA could have an extremely significant negative effect in some cases on total drainage volume. The present study, using new tracer (99m)Tc-HSAD, could confirm a large individual difference in TLA, indicating TLA as an important contributing factor for fluid-removal failure in continuous ambulatory peritoneal dialysis patients.

Absorption↗
PubMed2000

Interpretation of Wada memory test for lateralization of seizure focus by use of (99m)technetium-HMPAO SPECT.

PURPOSE: Although the intracarotid amobarbital procedure (IAP) or Wada test is useful in lateralizing seizure focus in patients with temporal lobe epilepsy (TLE), the results of the IAP memory test are frequently nonlateralizing. An insufficient suppression of the medial temporal region contralateral to the seizure focus may contribute to the failure of lateralization. We tried to correlate IAP memory results with the functional changes in the contralateral medial temporal region as measured by single photon emission computed tomography (SPECT) during IAP. METHODS: We performed a (99m)technetium-(Tc) hexamethylene-propylene-amine-oxime (HMPAO) brain SPECT in 19 medial TLE patients during a contralateral IAP (sodium amobarbital injected contralateral to the seizure focus). Regional cerebral blood flow (rCBF) was measured in the contralateral medial temporal region. The amount of decrease in the rCBF was calculated by subtracting the previous measurement from the one obtained with the interictal SPECT. RESULTS: Ten (53%) patients passed and nine (47%) failed the contralateral IAP. The mean percentage decrease in rCBF was 5.3+/-5.3%. There was a significant negative correlation between a decrease in the rCBF and the IAP memory-retention score by Spearman correlation (p = -0.53: p<0.021). Patients with smaller decreases in rCBF (<5%) more frequently passed the contralateral IAP memory test than did those with larger decreases (80 vs. 22%; p<0.023). CONCLUSIONS: We suggest that an insufficient suppression of the contralateral medial temporal function is partly responsible for nonlateralizing IAP memory tests. An IAP-SPECT may be useful in interpreting IAP memory tests for the lateralization of seizure focus in TLE patients.

Adult↗
PubMed1992

Evaluation of leg perfusion during exercise using technetium 99m sestamibi. A new test for peripheral vascular disease.

Thirty patients with occlusive peripheral vascular disease underwent clinical examination, segmental blood pressure determinations, intra-arterial digital subtraction angiography, and treadmill stress testing with injection of technetium 99m sestamibi at peak exercise. Radionuclide images of the thighs, calves, and feet showed clear delineation of major muscle groups. Diminished radiotracer distribution was closely correlated with the presence of occlusive vascular disease on angiography and with the presence of claudication and reduced segmental blood pressure. A quantitative scheme based on pixel intensity was developed to compare areas of regional perfusion.

Arteriosclerosis↗
PubMed2001

Clinical value of technetium-99m-HMPAO-labeled leukocyte scintigraphy and spiral computed tomography in active Crohn's disease.

OBJECTIVES: The diagnostic accuracy of technetium-99m-HMPAO-labeled leukocyte scintigraphy (LS) and spiral CT for the detection of inflammatory activity was assessed; the extent of the inflammation and the complications were compared with the clinical and laboratory parameters and with the endoscopic and radiological findings in patients with clinically active Crohn's disease (CD). METHODS: Twenty-eight patients (13 men, 15 women, average age 32.5 yr, range: 18-59 yr) with an acute exacerbation of CD were enrolled in the study. The disease behavior type and the maximum extent of inflammation were established by means of endoscopy (jejunoscopy and colonoscopy) and enteroclysis. Nine patients with severe complications (abscess and stenosis) underwent operation. The GI tract was divided into five segments (small bowel, ascending colon, transverse colon, descending colon, and rectosigmoid), the LS, CT, endoscopic, and radiological pictures of all segments were graded (range: 0-3) and the scores were summed and compared. RESULTS: The investigations indicated that LS and CT had sensitivities of 76.1% and 71.8%, specificities of 91.0% and 83.5%, and accuracies of 82.6% and 77.5%, respectively, for detection of segmental inflammatory activity. With regard to the disease behavior type, the sensitivities of LS and CT were, respectively, 77% and 100% in the penetrating-fistulizing, 80% and 73% in the stricturing, and 68% and 64% in the inflammatory form of CD. CT detected all abdominal abscesses, whereas the diagnostic value of LS for the detection of the complications of CD was lower. The inflammatory activity scores measured by LS displayed a closer correlation than that of CT with the Best index (r = 0.71, p < 0.0005 vs r = 0.63, p < 0.001), the van Hees index (r = 0.61, p < 0.005 vs r = 0.59, p < 0.005), the serum fibrinogen level (r = 0.67, p < 0.005 vs r = 0.59, p < 0.005), or the C-reactive protein level (r = 0.64, p < 0.005 vs r = 0.51, p < 0.01). CONCLUSIONS: Both LS and CT are valuable noninvasive diagnostic methods in cases involving severe, active CD. LS seemed better for the detection of segmental inflammatory activity, whereas CT displayed excellent suitability for the recognition of complications: abdominal abscesses were diagnosed with 100% efficiency.

Abdominal Abscess↗
PubMed2006

A rapid mutant screening technique for detection of technetium [Tc(VII)] reduction-deficient mutants of Shewanella oneidensis MR-1.

Microbial metal reduction forms the basis of alternate bioremediation strategies for reductive precipitation and immobilization of toxic metals such as the radionuclide technetium [Tc(VII)]. A rapid mutant screening technique was developed to identify Shewanella oneidensis MR-1 respiratory mutants unable to reduce Tc(VII) as anaerobic electron acceptor. The Tc(VII) reduction-deficient (Tcr) mutant screening technique was based on the observation that wild-type S. oneidensis produced a black Tc(IV) precipitate on its colony surface during growth on Tc(VII)-amended agar, while colonies arising from mutagenized cells did not. Tcr mutants unable to produce the black precipitate were subsequently tested for anaerobic growth on an array of three electron donors and 13 alternate electron acceptors. The Tcr mutants displayed a broad spectrum of anaerobic growth deficiencies, including several that were unable to reduce Tc(VII) with hydrogen or lactate as electron donor, yet retained the ability to reduce Tc(VII) with formate. This report describes the development of a novel Tcr mutant screening technique and its application to identify the first set of Tcr mutants in a metal-reducing member of the genus Shewanella.

Anaerobiosis↗
PubMed2006

Technetium 99m-diethylene triamine penta-acetic acid aerosol clearance in the evaluation of pulmonary involvement in sickle cell disease.

BACKGROUND: Pulmonary clearance of inhaled technetium (Tc) 99m-labeled diethylene triamine penta-acetic acid (DTPA) aerosol is a sensitive non-invasive marker of alveolar permeability and patients with interstitial lung diseases show enhanced clearance. However, a previous study in adult patients with diabetes mellitus showed delayed clearance. OBJECTIVES: To investigate DTPA clearance in steady-state, otherwise healthy adult sickle cell disease (SCD) patients and correlate it with pulmonary function tests (PFTs), hematologic and clinical parameters. MATERIALS AND METHODS: The subjects were randomly selected from the Hematology Clinic of Mubarak Hospital, Kuwait. Hematologic and pulmonary function data were collected with standard methods. DTPA radio-aerosol clearance studies were performed using ultrafine nebulizer containing 35 mCi (1295 MBq) of Tc 99m-DTPA in its reservoir and t(1/2) clearance in minutes was determined. Average values for both lungs were calculated and compared with normal values for our population. RESULTS: Forty-three subjects (24 SS and 19 S-beta(0)thal) aged between 16 and 45 yr (mean of 27.1 +/- 9.7) were studied. Twenty-two subjects (51.2%) had delayed, while only 10 (23.3%) showed enhanced DTPA clearance. Patients with enhanced clearance showed better PFTs than those with normal or delayed clearance. There was significant negative correlation of DTPA clearance with forced expiratory volume in 1 s, forced vital capacity and total lung capacity and significant positive correlation with age. CONCLUSIONS: Majority of adult SCD patients have delayed DTPA clearance unlike in inflammatory lung diseases, but similar to diabetes mellitus. DTPA clearance may be a useful modality for monitoring pulmonary involvement in SCD.

Adolescent↗
PubMed1993

Typical technetium dimercaptosuccinic acid distribution patterns in acute pyelonephritis.

Technetium dimercaptosuccinic acid renal scintiscans in 37 children with clinical diagnosis of acute pyelonephritis were reviewed. In 18 children, follow-up scintigraphy was obtained after an interval ranging from 5 to 8 months. Uptake abnormalities were found in 89% of the children (74% of the kidneys). We were able to identify four typical pathological uptake patterns: (i) pole defect(s), usually wedge shaped (60%); (ii) lateral wedge shaped defect (4%); (ii) scattered multiple defects (21%); and (iv) swollen kidney without areas of diminished uptake (15%). Remaining pathology at follow-up was found in 52% of the kidneys. Vesicoureteric reflux was present in 33% of the children with scintigraphic signs of pyelonephritis. Frequencies of parenchymal changes in the acute phase and at follow-up were not significantly correlated to the presence of reflux.

Acute Disease↗
PubMed1979

Conjunctival transport of technetium-99m pertechnetate.

Using a gamma camera coupled to a computer and a tape unit the transport of pertechnetate (Tc99m) across the conjunctiva was determined by the 'region of interest' technique in human subjects. In 11 patients with their lacrimal sacs removed a fractional turnover rate of 0.021 min-1 was found. In 21 patients with inflammed conjunctiva due to chronic dacryocystitis a fractional turnover rate of 0.027 min-1 was found, whereas the value in 11 normal individuals was 0.015 min-1. Neglecting the relatively small transcorneal route of disappearance, the values found for technetium disappearance could be regarded as representative for the transconjunctival transport of the radioisotope. This assumption was confirmed by correlating the radioactivity in the blood with the fractional turnover rate.

Adolescent↗
PubMedDate not supplied

Technetium 99m sulfur colloid scintigraphy to evaluate reticuloendothelial system function in dogs with portasystemic shunts.

In a retrospective study, technetium 99m sulfur colloid scintigraphy was used to evaluate reticuloendothelial system function in 61 dogs with single congenital and 40 dogs with multiple acquired portasystemic shunts. Whole body reticuloendothelial function was measured by calculating the plasma clearance rate constant from a dynamic study of liver uptake of 99mTc sulfur colloid. Relative liver, spleen, and lung uptake, and a ratio of hepatic:extrahepatic uptake were measured on static equilibrium images. Results were compared with those of a group of 26 normal dogs. Compared with values for the group of normal dogs, the plasma clearance rate constant, relative liver uptake, and hepatic:extrahepatic uptake ratio were significantly decreased, and relative spleen and lung uptake were significantly increased in dogs with portasystemic shunts (P < .0001). The only significant difference between dogs with single congenital versus multiple acquired shunts was that the relative splenic uptake was higher in the former group (P < .0002). Based on these results, we concluded that dogs with portasystemic shunts have significantly impaired reticuloendothelial function. The primary cause of this dysfunction is likely a reduction in effective liver blood flow. Increases in spleen and lung reticuloendothelial activity did occur, but only partially compensated for the reduction of liver reticuloendothelial activity. Possible mechanisms for the increased spleen and lung uptake are discussed.

Animals↗
PubMed1973

Use of technetium ( 99m Tc) as a bacterial label in lung clearance studies.

The suitability of technetium ((99m)Tc), a gamma emitter, for labeling of Diplococcus pneumoniae in studies of lung bacterial clearance was examined. A killed bacterial slurry with high specific activity was obtained with a ferric ascorbate reducing system. Approximately 5.5% of radioactive counts dissociated from labeled bacteria in 6 h. Rats were exposed to a uniformly mixed aerosol of untagged, viable pneumococci and killed, (99m)Tc-tagged pneumococci. The aerodynamic behavior of labeled and unlabeled pneumococci was similar. Viable bacterial counts and radioactive counts were determined in lung homogenates at intervals following exposure, and rates of bacterial killing and disappearance of radioactive counts were plotted. Radioactive counts did not increase in the liver during the period of observation, suggesting that the decrease in lung radioactivity represents mucociliary clearance and not release of isotope to the systemic circulation. The use of (99m)Tc for bacterial labeling provides advantages of technical simplicity and personnel safety compared to the use of beta-emitting isotopes.

Aerosols↗
PubMed1978

Diagnostic value of sacroiliac joint scintigraphy with 99m technetium pyrophosphate in sacroiliitis.

Using a quantitative method, scintigraphy of SI joints was performed by means of 99m technetium pyrophosphate in 21 patients with definite ankylosing spondylitis, in 17 control patients, and in 26 patients 'at risk', i.e. patients with complaints of back pain of the inflammatory type where on clinical grounds there was a possibility of sacroiliitis developing but with normal x-ray findings of the SI joints. Radioisotope uptake was higher in the ankylosing spondylitis group than in the other two groups, although the difference was not statistically significant with regard to the group 'at risk'. The high variance in the three groups considerably reduces the diagnostic value of the examination. In the ankylosing spondylitis group no correlation was found between radioisotope uptake and age, duration of disease, erythrocyte sedimentation rate, or radiological stage of scaroiliitis. Since the specificity and sensitivity of scintiscanning are lower than that of clinical and radiological diagnosis of the disease, we conclude that scintigraphy is not very helpful in the early diagnosis of sacroiliitis, at least by the techniques used here.

Adult↗
PubMed1988

Intra-articular apatite deposition in mixed connective tissue disease: crystallographic and technetium scanning characteristics.

An acute arthritis in a patient with mixed connective tissue disease (MCTD) was found to be associated with intra-articular deposition of carbonated hydroxyapatite crystals. A technetium hydroxymethylene diphosphonate bone scan showed intense uptake in the delayed phase scan of the affected joints. Synovial fluid analysis demonstrated uptake of the radiopharmaceutical drug directly onto the crystals.

Adult↗
PubMed1989

Specific accumulation of technetium-99m radiolabelled, negative liposomes in the inflamed paws of rats with adjuvant induced arthritis: effect of liposome size.

Technetium-99m labelled, negatively charged liposomes accumulate in the inflamed tissue of rats with adjuvant induced arthritis. Up to 10 times more liposome accumulation was seen in inflamed paws than in paws of control rats, and this represented 5.3% of the injected liposome dose. The accumulation of liposomes in inflamed tissue was directly related to the liposome size, the maximal accumulation occurring with liposomes less than 100 nm in diameter.

Animals↗
PubMed1986

Technetium-99m autologous phagocyte scanning: a new imaging technique for inflammatory bowel disease.

A method to determine the extent of active inflammatory bowel disease using selective labelling of autologous neutrophils and monocytes by phagocytosis of a technetium-99m (99mTc) stannous oxide colloid is described. Unlike leucocyte scanning techniques using Indium-III (IIIIn), the 99mTc colloid scan uses a cheap, readily available isotope, which specifically labels phagocytes. Scan results in 20 patients with inflammatory bowel disease were compared with barium examinations and colonoscopic appearances. There was close agreement in 15 of 20 patients as to the extent of mucosal disease. In four cases the scan showed more extensive disease than was suggested by barium examination. The scan showed terminal ileal Crohn's disease in three patients in whom the barium studies of the ileum had been reported as normal. In four patients with inactive disease and normal barium examinations no activity was seen on the scans. The 99mTc phagocyte scan is a sensitive, reliable means of determining the extent of active inflammatory bowel disease and can be used to quantify disease activity.

Adolescent↗
PubMed1972

Technetium-99 m in the diagnosis of thyrotoxicosis.

The thyroid uptake at 20 minutes of intravenously administered Technetium-99(m) ((99m)Tc) was measured in 117 patients with a standard scintillation counter. Patients were divided into three groups on the basis of clinical assessment, four-hour (131)I uptake, triiodothyronine (T-3) resin uptake, and protein-bound iodine measurements.In 31 patients with no evidence of thyroid disease the mean (99m) Tc uptake was 1.8% +/-S.D. 1.1%. In 32 patients with thyroid enlargement who were euthyroid the mean uptake was 2.5% +/-S.D. 2.2%. In 54 thyrotoxic patients the mean uptake was 17.7% with a range of 4.1 to 44%, all cases having an uptake above the upper limit of normal (4.0%). These results agree closely with reported uptake studies using scanning techniques. In seven patients the extrathyroidal neck activity was measured by using a scanner, and the mean was 6.3% of the extrathyroidal total body radioactivity comparing favourably with an assumed 6% used in our calculations.We have shown that the measurement of the thyroid uptake of (99m)Tc with a scintillation counter is of value, and that it is not necessary to use scanning techniques in the diagnosis of thyrotoxicosis. Advantages of (99m) Tc are minimal radiation, reduction in patient and laboratory time, and low cost.

Female↗
PubMed1993

Technetium-99m hexamethyl propylene amine oxime granulocyte scintigraphy in Crohn's disease: diagnostic and clinical relevance.

Scintigraphy with autologous granulocytes labelled by technetium-99m hexamethyl, propylene amine oxime (99mTc-HMPAO) was performed in 103 Crohn's disease patients and 52 healthy controls. In 31 patients endoscopic and histologic activity was compared with scan activity index. In the 98 patients with a positive scan, the extent of Crohn's disease, assessed by scintigraphy, was compared with that evaluated by small bowel x ray or colonoscopy with biopsies. In 48 patients, Crohn's disease activity index, activity index, simple index, erythrocyte sedimentation rate, C-reactive protein were correlated with the scan results. In 16 patients the five parameters and scan were repeated after treatment with methyl-prednisolone (10 cases), enteral nutrition (3), and 5-acetylsalicylic acid (3). The results showed that 99mTc-HMPAO granulocyte scan had a 95% sensitivity and 100% specificity to detect active inflammation; it correctly showed an abscess or a fistula in all the 24 cases found. The correlation between histological inflammatory activity and scan activity index was highly significant (r = 0.85; p < 0.01), less significant (r = 0.65; p < 0.01) between endoscopy and scan activity index. The evaluation for the extent of Crohn's disease by scan was completely correct in the small bowel (100%) and 93% correct in the large bowel. No correlation was seen between the three clinical activity parameters and scanning; in more than 80% of the cases in remission on the basis of a clinical or laboratory index, scintigraphy remained positive. Medical treatment was effective on the clinical indices but not on the active inflammation in the ileum, whereas it led to a negative scan in 5/11 cases in the large intestine. Scintigraphy with 99mTc-HMPAO granulocyte plays an important part in Crohn's disease for the diagnosis of complications, for activity and assessment of the extent, and for the treatment results evaluation.

Abscess↗