Indian Journal of Nuclear Medicine
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  Citation statistics : Table of Contents
   2010| April-June  | Volume 25 | Issue 2  
    Online since November 24, 2010

 
 
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ORIGINAL ARTICLES
Estimation of effective half life of clearance of radioactive Iodine ( 131 I) in patients treated for hyperthyroidism and carcinoma thyroid
R Ravichandran, JP Binukumar, Amal Al Saadi
April-June 2010, 25(2):49-52
DOI:10.4103/0972-3919.72686  PMID:21188063
Background : In medical applications of radioisotopes, for calculations of whole body doses and radiation safety applications, there is a need to estimate radioactive body burden. Local recommendations in Oman stipulate the need for hospitalization of patients treated for radioactive-iodine ( 131 I) with activities above 400 MBq. Materials & Methods: A study of body burden estimation from sequentially measured exposure rates from patients treated for carcinoma thyroid and hyperthyroidism was undertaken. A digital auto-ranging beta gamma survey instrument calibrated for measurement of exposure rates is used in this study. Results: The mean measured exposure rates at 1 m in μSv/h immediately after administration and at 24 h intervals are used for estimation of effective half time of clearance of administered activity. For patients with post-operative thyroid carcinoma, the variation of body burden with time post-administration indicated tri-exponential clearance pattern, with T˝eff values 14.4 h, 22 h, and 41.3 h. For patients treated for thyrotoxicosis, the body burden showed slow delayed clearance with a T˝eff - 111.4 h, and exposure rates did not show appreciable fall off after 48 h.
  5 2,816 146
CASE REPORTS
Diffuse hepatic and splenic Tc-99m MDP tracer uptake in case of multiple myeloma
Ashwani Sood, Rajeev Kumar Seam, Sandeep Sethi, Manish Gupta
April-June 2010, 25(2):70-72
DOI:10.4103/0972-3919.72692  PMID:21188069
Tc-99m methylene diphosphonate (MDP) bone scintigraphy has long been used for the evaluation of benign as well as malignant skeletal conditions. However, non-osseous tracer uptake on a bone scan is an unusual finding. There is a need to understand the pathophysiological basis of the non-osseous uptake, which may have a clinical relevance or deteriorating effect on the quality of the bone scan. We describe a case of multiple myeloma, where extraosseous uptake in the form of diffuse hepatic and splenic uptake, with almost normal skeletal tracer distribution, has been seen on the bone scan.
  2 2,615 86
ORIGINAL ARTICLES
Efficacy of SPECT over planar bone scan in the diagnosis of solitary vertebral lesions in patients with low back pain
Pushpalatha Sudhakar, Anshu Rajnish Sharma, Shanti M Bhushan, G Ranadhir, G Narsimuhulu, V V.S Prabhakar Rao
April-June 2010, 25(2):44-48
DOI:10.4103/0972-3919.72685  PMID:21188062
Background : The purpose of our study has been to evaluate the efficacy of single photon emission computed tomography (SPECT) over planar bone scan in identifying solitary vertebral lesions in patients with low backache and its ability to differentiate various pathologies according to the uptake pattern. Materials and Methods : The study included twenty patients out of whom six patients presented with known carcinoma and fourteen patients with low back pain. SPECT was done in all following planar skeletal survey. Benign and malignant lesions were identified according to the uptake pattern in vertebral elements, based on Gary F. Gates observations. Final diagnosis was obtained by means of biopsy or correlation with radiograph or computed tomography (CT) or magnetic resonance imaging (MRI), and / or follow up. Results : SPECT detected additional 30% of solitary vertebral lesions that were obscured on planar scan. Seven out of twenty were localized in anterior vertebral body and were diagnosed as benign ostophytes in six and osteoma in one substantiating the previous observations. Out of six cases of known carcinoma, three were having solitary metastases and showed posterior vertebral body uptake with pedicle involvement. SPECT could localize specific lesions as source of pain in eleven patients with low back pain (78%) and identified various etiologies including benign tumors (osteoid osteoma and osteoma), facet arthritis, discitis, transverse process fractures and spondylolysis. Conclusion : Our study highlighted the higher diagnostic value of SPECT over planar skeletal scintigraphy in localizing solitary vertebral lesions in low backache patients. Based on SPECT pattern, malignant and benign lesions could be differentiated in the given clinical context.
  2 4,228 125
Does thyroxine suppression therapy help to rationalize surgery in benign euthyroid nodules?
Sujata Mitra, Mukesh Jha, KM Gandhi
April-June 2010, 25(2):57-61
DOI:10.4103/0972-3919.72688  PMID:21188065
Background : Nodular thyroid disease is a common endocrine problem. Most thyroid nodules are benign hyperplastic lesions, but 5-20% may be a true neoplasm. It is important to differentiate a benign from a malignant nodule early as the approach to treatment in the two is radically different. Early institution of medical management in a benign nodule may obviate the need for surgery. Purpose of the Study: The present work aims to study the efficacy of thyroxine suppression in the management of benign thyroid nodules. Materials and Methods: A prospective study on patients presenting with thyroid nodule was undertaken. The diagnostic work-up included a clinical evaluation, thyroid function tests, thyroid scintigraphy and fine needle aspiration cytology. Based on the investigations, patients were segregated in Group A (toxic nodular goiter), Group B (benign euthyroid nodule) and Group C (malignant nodule). Group A patients were managed with antithyroid drugs and radioiodine and Group C patients were managed surgically. Group B patients were put on thyroxine suppression. Patients who failed to show reduction in size of the nodule at 18 months were treated surgically. Conclusion: The response rate of benign euthyroid nodule to thyroxine suppression was 76% in the present study.
  2 2,261 72
CASE REPORTS
Successful removal of intrathyroidal parathyroid adenoma diagnosed and accurately located preoperatively by parathyroid scintigraphy (SPECT-CT)
Dinesh Kumar Kaushal, Atul Mishra, Naveen Mittal, Jayanta K Bordoloi
April-June 2010, 25(2):62-63
DOI:10.4103/0972-3919.72689  PMID:21188066
We describe the case of a large intrathyroidal parathyroid adenoma in a 46-year-old woman who had a history of recently diagnosed hypercalcaemia and a 2-year history of an asymptomatic enlargement of the right lobe of the thyroid. This rare case highlights the potential difficulties that can arise in the evaluation of hyperparathyroidism, especially in cases of multinodular goiter. In some cases, including this one, even a thorough preoperative evaluation that includes radiological studies (ultrasonography and computed tomography [CT]) may not allow for a definitive preoperative diagnosis due to limited sensitivity, especially in multinodular goiter. The overlapping histological features between thyroid and parathyroid lesions can also be problematic at the time of the intraoperative frozen-section evaluation. We present a case in which, with parathyroid scintigraphy and combination of structural and functional imaging (SPECT-CT), we could accurately locate the intrathyroidal parathyroid adenoma in a patient with multinodular goiter.
  1 2,693 57
Hot tongue on FDG PET scan in a patient of Hodgkin's lymphoma undergoing antipsychotic treatment
Alok S Pawaskar, Hrishikesh Aurangabadkar, M Indirani, S Shelley
April-June 2010, 25(2):64-66
DOI:10.4103/0972-3919.72690  PMID:21188067
Fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography (F-18 FDG PET-CT) is the modality of choice for the diagnosis, staging, and restaging of many malignancies. The importance of eliminating false positives cannot be underestimated because they can dramatically alter the clinical course. We present a case of benign uptake in the tongue secondary to tardive dyskinesia in a 53-year-old woman referred for therapy response evaluation of Hodgkin's lymphoma who was concurrently receiving oral antipsychotic therapy. This case emphasizes the importance of detailed clinical history and examination when concluding definite diagnosis.
  - 1,356 43
TC 99m MDP bone scan in evaluation of painful scoliosis
Sujit Nilegaonkar, Sameer Sonar, Ashish Ranade, Madhav Khadilkar
April-June 2010, 25(2):67-69
DOI:10.4103/0972-3919.72691  PMID:21188068
A 18-year-old male presented with low back ache. The patient was investigated and was diagnosed to have painful scoliosis. X-ray and other examinations could not reveal any diagnosis. The patient was referred to undergo bone scan on clinical suspicion of osteoid osteoma and to rule out stress fracture if any. Planar bone scan was performed, which showed a lesion in L3 vertebra and was further evaluated with SPECT (Single photon emission computed tomography) study to characterize the lesion. On SPECT examination, the classical features of osteoid osteoma, the double density sign (11), was noted in the pars interarticularis region. These findings were confirmed by a CT scan, which showed a sclerotic lesion in pars interarticularis of L3 vertebra. The patient was posted for operation and was relieved of symptoms in the postoperative follow-up.
  - 4,791 91
COMMENTARY
Regulatory requirements for designing PET-CT facility in India
Pankaj Tandon
April-June 2010, 25(2):39-43
DOI:10.4103/0972-3919.72684  PMID:21188061
  - 13,985 931
EDITORIAL
SPECT-CT: Technology trail
Anshu Rajnish Sharma
April-June 2010, 25(2):37-38
DOI:10.4103/0972-3919.72683  PMID:21188060
  - 1,240 79
ORIGINAL ARTICLES
Role of myocardial perfusion scintigraphy post invasive coronary angiography in patients with myocardial infarction
C.N.B Harisankar, Bhagwant Rai Mittal, KK Kamaleshwaran, Anish Bhattacharya, Baljinder Singh, Rajiv Mahajan
April-June 2010, 25(2):53-56
DOI:10.4103/0972-3919.72687  PMID:21188064
Background : The presence of severe hypokinesia or akinesia and near complete stenotic lesions on coronary angiography, in a patient with acute myocardial infarction raises a question of viability in the involved territory and its response to revascularization. The decision of revascularization can be effectively taken after myocardial perfusion scintigraphy (MPS). Aim: To evaluate the role of MPS in patients with acute or recent myocardial infarction after invasive coronary angiography. Materials and Methods: Thirty-five patients (27 Males, 8 Females; Mean age 54 years) with acute myocardial infarction, who underwent invasive angiography, were included prospectively. Invasive angiography was attempted during the episode of acute chest pain in 20 patients. Fifteen patients underwent angiography without MPS because of non-availability of MPS at the time of initial presentation in the referring hospital. Revascularization was deferred because of complete / near complete block of artery with hypokinesia / akinesia of the distal LV segments in 32 / 35 patients and 50 to 70% block in 3 / 35. These patients were subjected to MPS. Results: Twenty patients underwent stress MPS and 15 underwent nitrate-augmented rest re-distribution study (RR study). Imaging was performed using the hybrid SPECT / CT system. The average defect size of the perfusion defect was 34% (5 - 57% range). Sixteen patients (46%) had fixed perfusion defects. Reversible ischemia was present in 19 (54%). Ten patients had a < 10% reversible perfusion defect. Nine patients had reversible ischemia, > 10% of the LV myocardium, and underwent the invasive revascularization procedure. Conclusion: MPS is invaluable in patients who have total / near total occlusion of the coronary artery and distal segment hypokinesia or akinesia on invasive angiography. One in four patients, deemed to have non-viable myocardium, underwent an invasive revascularization after undergoing MPS.
  - 2,014 68
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