Aim: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymp... more Aim: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) identification in patients with breast cancer.
The aim of this study was to evaluate adverse and therapeutic effects of applicated holmium-boro-... more The aim of this study was to evaluate adverse and therapeutic effects of applicated holmium-boro-macroaggregates (HBMAs) in the radiosynoviorthesis (RSO) of knees in patients suffering from chronic synovitis. We started RSO of the knees by means of a new radiopharmaceutical (RF) HBMA in patients with gonarthrosis, rheumatoid arthritis, chronic synovitis, psoriatic arthritis, and gout arthropathy. Seventeen (17) intra-articular injections were performed in 15 patients who were receiving a mean activity of 972 MBq (range, 904-1057) of 166 Ho-HBMA. Patient inclusion to the study followed a series of inclusion and exclusion criterions. The patients were hospitalized for 3 days. Side-effects were evaluated during their hospital stay and again after 6-8 weeks. Static scintigraphy of knee joints and measurements of blood radioactivity were performed. Therapeutic effects were evaluated after 6-8 weeks and at 6 months. In 2 hours and 2 days following the application, we proved, by means of knee and inguinal scintigraphy, only insignificant radiopharmaceutical leakage from the joint cavity to the inguinal lymph nodes in 4 patients. In the treated patients, no serious adverse effects occurred. Nine (9) patients were without complaints, 4 patients had slight knee exudation, and 2 patients had great exudation. Therapeutic effects were as follows: 2 patients were without pain, 9 were with lower pain, 3 were with the same pain, and 1 patient was with increased pain. Joint motion was improved in 7 patients, remained the same in 7 patients, and was impaired in 1 patient. Analgesics consumption was lower in 5 patients, the same in 9 patients, and greater in 1 patient. Knee exudation was absent in 2 patients, lower in 4 patients, the same in 6 patients, and greater in 3 patients. In 3 patients it was necessary to do surgical RSO. This RF can extend the range of clinically used radiopharmaceuticals for RSO and to supplement space between 90 Y with high energy and 186 Re with 169 Er with lower beta energy. The energy of 166 Ho is suitable for great and medium joints (i.e., knees, hips, shoulders, elbows, wrists, and ankles).
Technological advancement in hardware and software development in myocardial perfusion imaging (M... more Technological advancement in hardware and software development in myocardial perfusion imaging (MPI) leads to the shortening of acquisition time and reduction of the radiation burden to patients. We compared semiquantitative perfusion results and functional parameters of the left ventricle between new dedicated cardiac system with astigmatic collimators called IQ-SPECT (Siemens Medical Solutions, USA) and conventional single photon emission tomography (SPET) system equipped with standard low energy high resolution collimators. A group of randomly selected 81 patients underwent consecutively the MPI procedure on IQ-SPECT and on conventional SPET systen, both without attenuation correction. The summed scores and the values of the functional parameters of the left ventricle: ejection fraction (EF), end-systolic and end-diastolic volumes (ESV, EDV) received from the automatic analysis software were compared and statistically analyzed. Our results showed that summed scores values were si...
Our aim was to describe and evaluate our experience in the treatment of radiosynoviorthesis (RSO)... more Our aim was to describe and evaluate our experience in the treatment of radiosynoviorthesis (RSO) of small and middle-sized joints in patients with rheumatoid arthritis (RA). Eighty six patients with RA enrolled in the study. The criterion for enrolment was destructive process of the joint detected by X-rays and classified as a stage II-III according to Larsen. Seventy-six middle-sized joints were treated each with 74MBq or rhenium-186 sulphate and other 80 small joints with 10-40MBq of erbium-169 citrate each. The effect of treatment was evaluated at 6 and 12 months following the RSO treatment. The obtained values were compared with those of the initial state. The inflammatory and structural changes in activity were assessed according to the results of ultrasound examination, regression of pain, swelling of the joint and the improvement in mobility. The data obtained were statistically processed with the Chi-square test. Our results showed that RSO significantly decreased pain of t...
Nuclear medicine review. Central & Eastern Europe, 2006
The aim of this paper is a description of our experience with scintigraphic detection of brain de... more The aim of this paper is a description of our experience with scintigraphic detection of brain death. Thirty-four patients were studied from February 2003 to June 2006. We performed brain scintigraphic examination utilising (99m)Tc-HMPAO and a two-headed SPECT camera E.CAM. We used LEHR collimators. 15% energy window was centred around 140 keV. 650-750 MBq of radiopharmaceutical was injected as a bolus. Then dynamic scintigraphy of the head and neck was done in an anterior projection--2 s per frame for 60 s. Then static scintigraphy of the head in four projections followed (anterior, both lateral and posterior views), for 4 minutes per view. A typical picture of brain death on planar dynamic and static scintigrams showed an absence of perfusion and radiopharmaceutical accumulation in both cereberal and cerebral hemispheres and brain stem. Radioactivity in the area of the scalp and face could be present. Borderline findings, which demanded careful interpretation, were the cases with ...
A male patient had undergone total thyroidectomy for thyroid papillary carcinoma. He was administ... more A male patient had undergone total thyroidectomy for thyroid papillary carcinoma. He was administered thyroablation activity of radioiodine. Whole body imaging after diagnostic activity of 131-I demonstrated intense radioiodine uptake in the right side of the upper abdominal region. The serum thyroglobulin level was low. Ultrasonography demonstrated a large irregular anechoic structure in the centre of the right kidney -a cyst in the parapelvic region. Renal cysts can lead to erroneous interpretation of radioiodine scintigraphy.
Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentine... more Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) detection in patients with gynecologic tumours. Material and Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years): 36 pts with cervical cancer (Group A), 21 pts with endometrial cancer (Group B), 7 pts with vulvar carcinoma (Group C). Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared. Results: Planar scintigraphy did not image SLN in 7 patients (10.9%), SPECT/CT was negative in 4 patients (6.3%). In 35 (54.7%) patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05). Three foci of uptake (1.7% from totally visible 177 foci on planar images) in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. Conclusion: In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs. (MIRT 2012;21:47-55) Özet Amaç: Jinekolojik tümörü olan hastalarda sentinel lenf nodunun (SLN) saptanmasında planar lenfosintigrafi ve SPECT/BT füzyon görüntülemesinin rolünü değerlendirmek. Gereç ve Yöntemler: Jinekolojik tümörü olan 64 ardışık kadın hastaya planar sintigrafi ve hibrid SPECT/BT uygulandı (ortalama yaş 53,6, aralık 30-77 yıl): 36 hasta serviks kanseri (Grup A), 21 hasta endometriyal kanser (Grup B), 7 hasta vulvar karsinom (Grup C) idi. Planar ve SPECT/BT görüntüler iki ayrı nükleer tıp uzmanı tarafından yorumlandı. SLN görüntülemesi açısından her iki tekniğin etkinliği karşılaştırıldı. Bulgular: Planar sintigrafi 7 hastada (%10,9) SLN'nu görüntüleyemedi. Dört (%6,3) hastada SPECT/BT negatifti. Otuz beş hastada (%54,7) SPECT/BT ile yakalanan SLN sayısı planar görüntülemeye göre daha fazla idi. 64 hastanın tümü bir grup olarak ele alındığında, SLN saptama açısından planar ve SPECT/BT görüntüleme arasındaki farklılık istatistiksel olarak anlamlıydı (p>0,05). İki hastada, planar görüntülerde sıcak LN olarak yorumlanan üç uptake odağı (planar görüntülerde görülebilir 177 odağın %1,7'si) daha sonra SPECT/BT ile değerlendirildiğinde yalancı pozitif non-nodal uptake odağı olarak kabul edildi. SPECT/BT, vizüalize edilen tüm sentinel lenf nodlarının kesin anatomik lokalizasyonunu gösterdi. Sonuç: SPECT/BT, jinekolojik kanserleri olan bazı hastalarda sentinel lenf nodlarının saptanma sıklığını arttırır. Planar sintigrafide görülemeyen lenf nodlarını görüntüleyebilir, yalancı negatif uptake'i dışlayabilir ve pelvik/paraaortal SLN'nu kesin olarak lokalize edebilir. SLN'larının anatomik lokalizasyonlarını kolaylaştırır. (MIRT 2012;21:47-55) Anahtar kelimeler: Sentinel lenf nodu biyopsisi, jinekolojik tümörler, sintigrafi, gama kamera görüntüleme, SPEKT, tomografi, X-ray bilgisayarlı
To describe the case history and new histopathological findings of a young woman suffering from m... more To describe the case history and new histopathological findings of a young woman suffering from moyamoya disease. The patient underwent brain computed tomography, magnetic resonance imaging and brain angiography. Vessel samples of a. temporalis superficialis were processed by standard histopathological and immunohistochemical methods by analysis of VEGF, VEGFR and nestin expression. Brain angiography revealed both internal carotid artery stenoses and stenoses of the anterior cerebral arteries. Stenotic parts of vessels were accompanied by coiled and elongated vessels with a picture of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;smoke puffs carried away by breeze&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; after contrast medium application. Histological examination showed: obstruction of lumen, fibrocellular intimal thickening, tortuosity and disruption of internal elastic lamina. Imunohistochemistry confirmed a defect of the internal elastic membrane of the muscular arteria and progressive intimal thickening accompanied by abnormal smooth muscle cells and, VEGF/VEGFR expression in intima. Nestin positivity in endothelium of arteria indicated that endothelial cells are activated. We found that the endothelium of affected vessels is nestin positive. This, together with the finding of VEGF/VEGFR expression, might suggest an active angiogenetic process We present a new conception of pathogenesis but further studies with higher number of patients are necessary to elucidate the role of these growth factors in the moyamoya disease.
Aim: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymp... more Aim: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) identification in patients with breast cancer.
The aim of this study was to evaluate adverse and therapeutic effects of applicated holmium-boro-... more The aim of this study was to evaluate adverse and therapeutic effects of applicated holmium-boro-macroaggregates (HBMAs) in the radiosynoviorthesis (RSO) of knees in patients suffering from chronic synovitis. We started RSO of the knees by means of a new radiopharmaceutical (RF) HBMA in patients with gonarthrosis, rheumatoid arthritis, chronic synovitis, psoriatic arthritis, and gout arthropathy. Seventeen (17) intra-articular injections were performed in 15 patients who were receiving a mean activity of 972 MBq (range, 904-1057) of 166 Ho-HBMA. Patient inclusion to the study followed a series of inclusion and exclusion criterions. The patients were hospitalized for 3 days. Side-effects were evaluated during their hospital stay and again after 6-8 weeks. Static scintigraphy of knee joints and measurements of blood radioactivity were performed. Therapeutic effects were evaluated after 6-8 weeks and at 6 months. In 2 hours and 2 days following the application, we proved, by means of knee and inguinal scintigraphy, only insignificant radiopharmaceutical leakage from the joint cavity to the inguinal lymph nodes in 4 patients. In the treated patients, no serious adverse effects occurred. Nine (9) patients were without complaints, 4 patients had slight knee exudation, and 2 patients had great exudation. Therapeutic effects were as follows: 2 patients were without pain, 9 were with lower pain, 3 were with the same pain, and 1 patient was with increased pain. Joint motion was improved in 7 patients, remained the same in 7 patients, and was impaired in 1 patient. Analgesics consumption was lower in 5 patients, the same in 9 patients, and greater in 1 patient. Knee exudation was absent in 2 patients, lower in 4 patients, the same in 6 patients, and greater in 3 patients. In 3 patients it was necessary to do surgical RSO. This RF can extend the range of clinically used radiopharmaceuticals for RSO and to supplement space between 90 Y with high energy and 186 Re with 169 Er with lower beta energy. The energy of 166 Ho is suitable for great and medium joints (i.e., knees, hips, shoulders, elbows, wrists, and ankles).
Technological advancement in hardware and software development in myocardial perfusion imaging (M... more Technological advancement in hardware and software development in myocardial perfusion imaging (MPI) leads to the shortening of acquisition time and reduction of the radiation burden to patients. We compared semiquantitative perfusion results and functional parameters of the left ventricle between new dedicated cardiac system with astigmatic collimators called IQ-SPECT (Siemens Medical Solutions, USA) and conventional single photon emission tomography (SPET) system equipped with standard low energy high resolution collimators. A group of randomly selected 81 patients underwent consecutively the MPI procedure on IQ-SPECT and on conventional SPET systen, both without attenuation correction. The summed scores and the values of the functional parameters of the left ventricle: ejection fraction (EF), end-systolic and end-diastolic volumes (ESV, EDV) received from the automatic analysis software were compared and statistically analyzed. Our results showed that summed scores values were si...
Our aim was to describe and evaluate our experience in the treatment of radiosynoviorthesis (RSO)... more Our aim was to describe and evaluate our experience in the treatment of radiosynoviorthesis (RSO) of small and middle-sized joints in patients with rheumatoid arthritis (RA). Eighty six patients with RA enrolled in the study. The criterion for enrolment was destructive process of the joint detected by X-rays and classified as a stage II-III according to Larsen. Seventy-six middle-sized joints were treated each with 74MBq or rhenium-186 sulphate and other 80 small joints with 10-40MBq of erbium-169 citrate each. The effect of treatment was evaluated at 6 and 12 months following the RSO treatment. The obtained values were compared with those of the initial state. The inflammatory and structural changes in activity were assessed according to the results of ultrasound examination, regression of pain, swelling of the joint and the improvement in mobility. The data obtained were statistically processed with the Chi-square test. Our results showed that RSO significantly decreased pain of t...
Nuclear medicine review. Central & Eastern Europe, 2006
The aim of this paper is a description of our experience with scintigraphic detection of brain de... more The aim of this paper is a description of our experience with scintigraphic detection of brain death. Thirty-four patients were studied from February 2003 to June 2006. We performed brain scintigraphic examination utilising (99m)Tc-HMPAO and a two-headed SPECT camera E.CAM. We used LEHR collimators. 15% energy window was centred around 140 keV. 650-750 MBq of radiopharmaceutical was injected as a bolus. Then dynamic scintigraphy of the head and neck was done in an anterior projection--2 s per frame for 60 s. Then static scintigraphy of the head in four projections followed (anterior, both lateral and posterior views), for 4 minutes per view. A typical picture of brain death on planar dynamic and static scintigrams showed an absence of perfusion and radiopharmaceutical accumulation in both cereberal and cerebral hemispheres and brain stem. Radioactivity in the area of the scalp and face could be present. Borderline findings, which demanded careful interpretation, were the cases with ...
A male patient had undergone total thyroidectomy for thyroid papillary carcinoma. He was administ... more A male patient had undergone total thyroidectomy for thyroid papillary carcinoma. He was administered thyroablation activity of radioiodine. Whole body imaging after diagnostic activity of 131-I demonstrated intense radioiodine uptake in the right side of the upper abdominal region. The serum thyroglobulin level was low. Ultrasonography demonstrated a large irregular anechoic structure in the centre of the right kidney -a cyst in the parapelvic region. Renal cysts can lead to erroneous interpretation of radioiodine scintigraphy.
Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentine... more Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) detection in patients with gynecologic tumours. Material and Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years): 36 pts with cervical cancer (Group A), 21 pts with endometrial cancer (Group B), 7 pts with vulvar carcinoma (Group C). Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared. Results: Planar scintigraphy did not image SLN in 7 patients (10.9%), SPECT/CT was negative in 4 patients (6.3%). In 35 (54.7%) patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05). Three foci of uptake (1.7% from totally visible 177 foci on planar images) in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. Conclusion: In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs. (MIRT 2012;21:47-55) Özet Amaç: Jinekolojik tümörü olan hastalarda sentinel lenf nodunun (SLN) saptanmasında planar lenfosintigrafi ve SPECT/BT füzyon görüntülemesinin rolünü değerlendirmek. Gereç ve Yöntemler: Jinekolojik tümörü olan 64 ardışık kadın hastaya planar sintigrafi ve hibrid SPECT/BT uygulandı (ortalama yaş 53,6, aralık 30-77 yıl): 36 hasta serviks kanseri (Grup A), 21 hasta endometriyal kanser (Grup B), 7 hasta vulvar karsinom (Grup C) idi. Planar ve SPECT/BT görüntüler iki ayrı nükleer tıp uzmanı tarafından yorumlandı. SLN görüntülemesi açısından her iki tekniğin etkinliği karşılaştırıldı. Bulgular: Planar sintigrafi 7 hastada (%10,9) SLN'nu görüntüleyemedi. Dört (%6,3) hastada SPECT/BT negatifti. Otuz beş hastada (%54,7) SPECT/BT ile yakalanan SLN sayısı planar görüntülemeye göre daha fazla idi. 64 hastanın tümü bir grup olarak ele alındığında, SLN saptama açısından planar ve SPECT/BT görüntüleme arasındaki farklılık istatistiksel olarak anlamlıydı (p>0,05). İki hastada, planar görüntülerde sıcak LN olarak yorumlanan üç uptake odağı (planar görüntülerde görülebilir 177 odağın %1,7'si) daha sonra SPECT/BT ile değerlendirildiğinde yalancı pozitif non-nodal uptake odağı olarak kabul edildi. SPECT/BT, vizüalize edilen tüm sentinel lenf nodlarının kesin anatomik lokalizasyonunu gösterdi. Sonuç: SPECT/BT, jinekolojik kanserleri olan bazı hastalarda sentinel lenf nodlarının saptanma sıklığını arttırır. Planar sintigrafide görülemeyen lenf nodlarını görüntüleyebilir, yalancı negatif uptake'i dışlayabilir ve pelvik/paraaortal SLN'nu kesin olarak lokalize edebilir. SLN'larının anatomik lokalizasyonlarını kolaylaştırır. (MIRT 2012;21:47-55) Anahtar kelimeler: Sentinel lenf nodu biyopsisi, jinekolojik tümörler, sintigrafi, gama kamera görüntüleme, SPEKT, tomografi, X-ray bilgisayarlı
To describe the case history and new histopathological findings of a young woman suffering from m... more To describe the case history and new histopathological findings of a young woman suffering from moyamoya disease. The patient underwent brain computed tomography, magnetic resonance imaging and brain angiography. Vessel samples of a. temporalis superficialis were processed by standard histopathological and immunohistochemical methods by analysis of VEGF, VEGFR and nestin expression. Brain angiography revealed both internal carotid artery stenoses and stenoses of the anterior cerebral arteries. Stenotic parts of vessels were accompanied by coiled and elongated vessels with a picture of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;smoke puffs carried away by breeze&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; after contrast medium application. Histological examination showed: obstruction of lumen, fibrocellular intimal thickening, tortuosity and disruption of internal elastic lamina. Imunohistochemistry confirmed a defect of the internal elastic membrane of the muscular arteria and progressive intimal thickening accompanied by abnormal smooth muscle cells and, VEGF/VEGFR expression in intima. Nestin positivity in endothelium of arteria indicated that endothelial cells are activated. We found that the endothelium of affected vessels is nestin positive. This, together with the finding of VEGF/VEGFR expression, might suggest an active angiogenetic process We present a new conception of pathogenesis but further studies with higher number of patients are necessary to elucidate the role of these growth factors in the moyamoya disease.
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