• Title/Summary/Keyword: Bone scintigraphy

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Management of Recurrent Thyroid Carcinoma with Negative Diagnostic Radioiodine Whole-Body Scan (진단적 방사성옥소 전신스캔이 음성인 갑상선 재발암의 진료)

  • Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.117-124
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    • 2001
  • Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

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Scintigraphic Evaluation of Dogs with Experimentally Transected Cranial Cruciate Ligaments Treated Using Tibial Plateau Leveling Osteotomy (실험적으로 전십자 인대를 단열한 개에서 TPLO의 핵의학적 평가)

  • Lee Jae yeong;Kim Joong-hyun;Lee Won guk;Kang Seong soo;Bae Chun sik;Choi Seok hwa
    • Journal of Veterinary Clinics
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    • v.22 no.1
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    • pp.21-25
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    • 2005
  • This study was performed to assess therapeutic effect of the tibial plateau leveling osteotomy (TPLO) in dogs with experimentally transected cranial cruciate ligaments (CrCL). Nine healthy adult Beagle dogs were transected left CrCL under general anesthesia. The dogs were assigned to TPLO and non-TPLO control groups. The TPLO procedures for correcting the CrCL rupture in the left stifle of dogs were performed under sterile conditions. Before TPLO procedures, all dogs were screened by orthopedic and radiographic examinations. Dogs were lameness free for the previous three months, and when examined at the walk and trot on a hard surface, in a straight line and on a circle. Lateral and craniocaudal radiographs were done to confirm the soundness of the both knee joint in dogs and not detectable lesions were diagnosed. The dogs were intravenously injected with a 10 mci/kg of 99mTechnetium-methylene diphosphonate (99mTc-MDP) under general anesthesia. Scintigraphs were obtained using a large field of view gamma camera equipped a parallel-hole, low-energy about 3 hours after intravenous injection of 99mTc-MDP. Before CrCL transection and 4, 8, and 12 weeks after the procedures, scintigraphy were conducted. Bone uptake of the left stifle joint increased after the procedures in all dogs. When the bone uptake from the TPLO procedure was compared with that of the control, there was a significant difference (p < 0.05). At 12 weeks after the TPLO procedure, the dogs showed normal anatomical posture and gait. It is concluded that TPLO procedure was effective in reconstruct of the stifle joint in dogs with CrCL rupture.

Performance Evaluation of a Pinhole Collimator According to the Aperture Diameter (핀홀 콜리메이터 초점의 직경 크기 별 성능비교 및 평가)

  • Lee, Kwang Hun;An, Byung Ho;Kim, Soo Young;Choi, Sung Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.104-109
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    • 2014
  • Purpose: Conventional pinhole scintigraphy offers a high resolution and generally use for thyroid scan or bone scintigraphy. the aim of this study is to evaluate performance of each aperture according to the diameter size. Materials and Methods: In this study 2 mm, 4 mm, 6 mm, 8 mm diameter pinhole collimators were mounted on Siemens E.CAM systems. In order to evaluate performance evaluation of each aperture, we acquired projection image by using SPECT for evaluating FWHM, resolution test and static image for evaluating thyroid phantom test. Results: As a result of FWHM showed 2.2 mm FWHM, 3.2 mm FWHM, 5.4 mm FWHM, 7.5 mm FWHM per each aperture in the resolution test. SNR, uniformity, contrast were acquired result from thyroid phantom test comparing general image and delayed image. as a result of SNR showed 6.55, 8.47, 6.2, 5.23 in case of general image and 5.25, 5.01, 5.38, 5.82 in case of delayed image per each aperture. as a result of uniformity showed 0.152, 0.118, 0.161, 0.19 in case of general image and 0.19, 0.199, 0.185, 0.171 in case of delayed image per each aperture. as a result of contrast showed 1.31, 1.19, 1.15, 1.01 in case of general image and 1.09, 1.08, 1.04, 1 in case of delayed image per each aperture. Conclusion: Resolution and sensitivity were heavily influenced by aperture size. and also we found advantage of delayed image as a result of thyroid phantom test.

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Osteoid Osteoma Around the Hip Joint (고관절 주위에 발생한 유골 골종)

  • Kim, Tai-Seung;Kim, Jong-Heon;Lee, Bong-Gun;Kim, Soon-Myung
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.168-174
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    • 2005
  • Purpose: We experienced 8 cases of osteoid osteoma arising around hip joint which had some characteristics that differ from those arising on long bone. we reports the characteristics of osteoid osteoma arising around the hip joint. Materials and Methods: 8 cases of osteoid osteoma were diagnosed during 1985 to 2004 at hanyang university hospital. all cases were comfirmed patholgically. 6 cases were male, 2 cases were female patients. The mean age was 17 years old (ranged from 8 to 29). They occurred in intertrochanteric area (4 cases), subtrochanteric area (2 cases), acetabulum (1 case) and femoral neck (1 case). We used radiologic tools including magnetic resonance image, computed tomography, bone scintigraphy. clinicopathologic test including erythrocyte sedimentation rate and Creactive protein. Results: The patients expressed various symptoms including thigh pain, knee pain, low back pain and radiating pain respectively. 2 patients had experienced operation on knee joint. 3 patients showed limping gait. Aspirin relieved the pain in 3 patients. The difference in circumference was 1cm between both thighs in 2 cases. Conclusion: Patients with osteoid osteoma arising around hip joint which have various symptoms such as severe knee pain and claudication, differ from infectious disease by clinicopathologic test including erythrocyte sedimentation rate and C- reactive protein and had better diagnostic result in computed tomography.

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The Effect of Sympathectomy on Bone: -Evaluation with Quantitative Bone Scintigraphy- (흰쥐에서 교감신경절제술이 골에 미치는 영향 : -정량적 골스캔을 이용한 평가-)

  • Kim, Hak-Hee;Yang, Woo-Jin;Lee, Seong-Yong;Chung, Soo-Kyo;Park, Jang-Sang;Yim, Jung-Ik;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.85-88
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    • 1994
  • 근래 골조직에 있어서 자율신경의 기능에 대하여 많은 연구가 이루어지고 있으며, 골내의 자율신경의 해부학적 분포는 많이 알려져 있다. 그러나 임상적으로 반사적 교감신경 이상이나 레이노드 현상등과 같은 교감신경의 기능이상증에서나, 버거씨병 등의 치료 목적으로 시행되고 있는 교감신경 절제술 후, 자율신경기능의 변화가 사지골의 혈류나 골대사에 미치는 영향에 대하여는 아직도 논란의 여지가 있다. 저자들은 교감신경절제술 후 시간 경과에 따른 골에 미치는 영향을 알아보기 위하여 흰쥐에서 골대사와 혈류상태를 비교적 충실히 반영하는 정량적 골스캔을 시행하였다. 체중 $300{\sim}400g$의 수컷 흰쥐 10마리에서 복강을 통한 편측 요추부 교감신경절제술을 시행하였고, 수술 전과 후 1일, 3일, 1주, 2주, 3주, 4주에 양측 하지에서 각각 골스캔을 시행하고 교감신경 절제측 하지와 정상 하지에 대칭적으로 관심구역을 정하여 양측의 골스캔상 섭취계수를 비교하였다. 측정부위는 각 하지의 대퇴골간, 경골간 및 중족골로 하였다. 교감신경 절제술을 시행한 하지에서는 골스캔 소견상 수술 후 1일 또는 3일부터 동위원소 집적이 유의하게 증가되었으며 원위부로 갈수록 더욱 증가되었다. 그러나 3주 이후에는 정상측 수준으로 환원되었다. 교감신경절제술 후 골스캔상 동위원소집적이 증가되는 것은 골자체의 혈류가 증가되기 때문이며 이차적으로 골의 흡수를 유발하여 골밀도가 감소하는 것으로 생각되는데 이러한 변화는 시술 후 1일 째부터 관찰되어 사지골이 교감신경 절제에 매우 민감하게 반응하는 것을 알 수 있었다.9m}Tc$-MAA를 이용한 간 동맥 혈류 검사는 간암에서 색전술의 효과를 정확히 평가할 수 있는 유용한 검사법으로 이용될 수 있으리라 생각한다. 활성화 과정을 알아볼 수 있었으며 위상영상히스토그램을 통하여 이를 정량화하여 심실내 전기적 활성의 비동시성 여부를 추적관찰 할 수 있는 비관혈적검사임을 확인하였다.며, 3. $^{99m}Tc$으로 표지된 avidin과 streptavidin은 먼저 간으로 흡수된 후 대사된 다음 신장으로 배설된다는 사실을 알았다.damole에 의한 부작용은 흉통, 두통, 복통 등의 순이었고 전예에서 호전되었으며 생명에 위험을 초래할 수 있는 정도의 심장마비나 심부정맥은 한 예에서도 없었다. 결론적으로 dipyridamole은 약물부하 심근 SPECT 검사에 안전하게 사용할 수 있는 약물로 사료된다. 미소핵 빈도수가 증가하는 경향을 보였으나, 각 군간에 통계학적으로 유의한 차이는 없었다(p>0.05). 결론 : 임상적으로 치료를 중단하게 되는 1000mCi/60 Kg(16.67 mCi/Kg)를 투여한 군에서도 생쥐 골수내 미소핵이 발현되지 않는 것으로 보아, 방사성옥소는 비교적 안심하고 치료에 사용할 수 있는 제제로 사료되었다.반드시 비례하지만은 않아서 시간경과에 따른 추후 검사가 필요하리라 생각된다. 또한 방광요관역류가 있는 환아에서 DMSA 섭취율로 신기능을 평가할 때, 특히 영유아에서 연령에 따른 고려가 있어야 할 것으로 보인다.었다. 4) $^{99m}Tc-DISIDA$ hepatobiliary scintigram 음성율을

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The nuclear medicinal study on degenerative arthritis of knee joint using traditional acupuncture (퇴행성 슬관절염에 대한 핵의학적 고찰)

  • Kim, Young-Gue;Park, So-Young;Koh, Kang-Hoon;Yoon, Min-Young;Jin, Kyong-Sun;Chang, Byoung-Sun;Oh, Hee-Hong;Kim, Sung-Chul;Hwang, Woo-Jun;Song, Ho-Chun;Ahn, Soo-Gi
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.127-134
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    • 2002
  • Background and Purpose : Now, a lot of people are suffering from arthritis of knee joint. Western and oriental medicine, all of them are trying various methods to cure this disease, but generally the grade or level of repairing has been decided by the subjective estimation of the patients and doctors. So, we suggest the new standard for estimating the level of repair in this disease using nuclear medicine. Objective : To evalute the difference of the blood pool and delayed images in the correlation with clinical symptoms in patients with arthritis of knee joint by using acupuncture. Methods : Eight patients with arthritis of knee joint included in this study. Using Thermograph (D.I.T.I) and Radionuclide, we obtained the results. In Bone scan Tc-99m MDP, and MIBI scan was obtained at 1 minute and 3 hour after injection of 1,110 MBq Tc-99m MDP and MIBI. The analysis was carried out hurted area of joint. The Joint-to-background(J/B) ratios were obtained exclusively in the joints regions. Clinical symptoms were evaluated as pain and swelling graded from 0(no) to 5(severe) in the same joints, respectively. Results : J/B ratios on the delayed scans were higher than those on blood pool images. There was significant correlation between clinical symptoms and J/B on blood pool image in the joints =0.03). Conclusion : The results demonstrate that blood pool images of Tc-99m MDP scintigraphy correlates with clinical symptoms more than delayed images in patients with arthritis Joint.

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