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How reliable is the lacrimal scintigraphy report? An interobserver agreement and reliability study

International Journal of Ophthalmology(English edition) 2019年第3期12卷 401-406页

作者： Mohsen Bahmani Kashkouli Navid Abolfathzadeh Parya Abdolalizadeh Nasser Karimi Raheleh Hedayati Samira Jafari Amirpooya Alemzadeh Eye Research Center Rassoul Akram Hospital Iran University of Medical Sciences Department of Nuclear Medicine Rassoul Akram Hospital Iran University of Medical Sciences

AIM: To assess the inter-observer agreement and reliability as well as intra-observer repeatability for lacrimal scintigraphy(LS) reports with and without considering the irrigation test results.METHODS: A prospective, observational, cross sectional study. Two masked clinicians(lacrimal surgeon and nuclear medicine specialist) independently reported 100 LS images(50 patients of >6 years of age with unilateral anophthalmic socket) in a university hospital. The lacrimal surgeon performed a diagnostic irrigation test and repeated the report of the same LS images 2 y after the first report(intra-observer agreement). A weighted Kappa analysis was performed to determine inter-observer agreement and reliability as well as intra-observer repeatability for the type(normal, partial and complete obstruction) and location(presac, preduct, and intraduct) of the obstruction. Subgroup analysis was also performed with consideration of irrigation test results. RESULTS: A significantly moderate agreement was found between lacrimal surgeon and nuclear medicine specialist for both the type(Kappa=0.55) and location(Kappa=0.48) of obstruction. Agreement values were higher for the type(Kappa=0.61 vs 0.41) and location(Kappa=0.56 vs 0.31) of obstruction in cases with normal than abnormal irrigation test. Strong and significant intraobserver(lacrimal surgeon) repeatability was found for both the type(Kappa=0.66) and location(Kappa=0.69) of obstruction. LS showed no to slight reliability based on irrigation test.CONCLUSION: A moderate agreement is found between lacrimal surgeon and nuclear medicine specialist regarding the interpretation of LS suggesting the importance ofconsensus groups among nuclear medicine specialists and lacrimal surgeons to create a common language for interpretation of LS. Intra-observer repeatability is strong for the lacrimal surgeon.

关键词： epiphora lacrimal drainage lacrimal scintigraphy reliability agreement

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Comparison of multichannel intraluminal impedance-pH monitoring and reflux scintigraphy in pediatric patients with suspected gastroesophageal reflux

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World Journal of Gastroenterology 2016年第43期22卷 9595-9603页

作者： Nuray Uslu Kizilkan Murat Fani Bozkurt Inci Nur Saltik Temizel Hülya Demir Aysel Yüce Biray Caner Hasan Ozen Division of Pediatric Gastroenterology Koc University Hospital Topkapi Istanbul 34010 Turkey Hacettepe University Faculty of Medicine Department of Nuclear Medicine Ankara 06100 Turkey Division of Gastroenterology Hepatology and Nutrition Unit Department of Pediatrics Hacettepe University Faculty of MedicineAnkara 06100 Turkey

AIM To evaluate the agreement of multichannel intraluminal impedance-p H monitoring(MII-p HM) and gastroesophageal reflux scintigraphy(GES) for the diagnosis of gastroesophageal reflux disease. METHODS Seventy-five consecutive patients with suspectedgastroesophageal reflux disease(GERD) underwent 24-h combined MII-p HM recording and one hour radionuclide scintigraphy during the course of the MIIpH M study. Catheters with 6 impedance channels and 1 p H sensor were placed transnasally. Impedance and p H data analysis were performed automatically and manually. For impedance monitoring, reflux was defined as a retrograde 50% drop in impedance, starting distally and propagating retrogradely to at least the next two more proximal measuring channels. Reflux index(RI, percentage of the entire record that esophageal p H is scintigraphy, 240 frames of 15 seconds duration were acquired in the supine position. Gastroesophageal reflux was defined as at least one reflux episode in the esophagus. After scintigraphic evaluation, impedance-pH recordings and scintigraphic images were evaluated together and agreement between tests were evaluated with Cohen's kappa.RESULTS Sufficient data was obtained from 60(80%) patients(34 male, 56.7%) with a mean age of 8.7 ± 3.7 years(range: 2.5-17.3 years; median: 8.5 years). Chronic cough, nausea, regurgitation and vomiting were the most frequent symptoms. The mean time for recording of MII-pH M was 22.8 ± 2.4 h(range: 16-30 h; median: 22.7 h). At least one test was positive in 57(95%) patients. According to diagnostic criteria, GERD was diagnosed in 34(57.7%), 44(73.3%), 47(78.3%) and 51(85%) patients by means of p HM, MII, GES and MII-p HM, respectively. The observed percentage agreements/κ values for GES and p HM, GES and MII, GES and MII-p HM, and MII and p HM are 48.3%/-0.118; 61.7%/-0.042; 73.3%/0.116 and 60%/0.147, respectively. There was no or slight agreem

关键词： Gastroesophageal 倒流疾病孩子多信道的 intraluminal 阻抗监视的食道的 pH scintigraphy

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Noninvasive imaging assessment of non-alcoholic fatty liver disease:focus on liver scintigraphy

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World Journal of Gastroenterology 2015年第15期21卷 4432-4439页

作者： Cristiane Valle Tovo Angelo Zambam de Mattos Gabriela Perdomo Coral Fernanda Schild Branco Eiji Suwa Angelo Alves de Mattos Department of Gastroenterology and Hepatology Universidade Federal de Ciências da Saúde de Porto Alegre

Noninvasive diagnoses of nonalcoholic fatty-liver disease(NAFLD) involve the use of serologic markers and imaging methods, such as conventional ultrasonography(US),computed tomography, and magnetic resonance imaging. Although these methods are reliable for the noninvasive detection of moderate to severe fatty changes in the liver, they are not reliable for detecting nonalcoholic steatohepatitis(NASH) and fibrosis. New imaging technologies, such as US-based transient elastography, acoustic radiation force impulse and magnetic resonancebased elastography, can reportedly be used to determine the severity of liver fibrosis associated with NASH. In this context, the field of nuclear medicine through liver scintigraphy has recently been proposed, and is being explored for use in the diagnosis of NASH. More importantly, nuclear medicine may contribute to the distinction between simple steatosis and NASH. For example, the enhanced release of cytokines and the decrease in the phagocytic activity of Kupffer cells play important roles in the pathogenesis of NASH. Removal of technetium-99 m colloid from circulation by Kupffer cell phagocytosis therefore provides a valuable imaging technique. Thus, nuclear medicine is poised to provide useful tools for the evaluation of patients with NAFLD. However, the evidence is still scarce, and more studies with larger samples are needed to identify their role before they are used in clinical practice.

关键词： Liver fibrosis Liver scintigraphy Nonalcoholicfatty-liver disease diagnosis Nonalcoholic steatohepatitis Noninvasive methods

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Primary hepatic neuroendocrine neoplasm diagnosed by somatostatin receptor scintigraphy:A case report

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World Journal of Clinical Cases 2022年第7期10卷 2222-2228页

作者： Miho Akabane Yuta Kobayashi Keiichi Kinowaki Satoshi Okubo Junichi Shindoh Masaji Hashimoto Division of Hepatobiliary-pancreatic Surgery Department of Gastroenterological SurgeryToranomon HospitalTokyo 105-8470Japan Department of Diagnostic Pathology Toranomon HospitalTokyo 105-8470Japan

BACKGROUND Primary hepatic neuroendocrine neoplasm(NEN)is a rare condition,and it is difficult to differentiate between primary and metastatic hepatic NENs.Herein,we report a case of primary hepatic NEN that initially mimicked a hemangioma but showed a gradual increase in size on long-term careful observation.CASE SUMMARY A 47-year-old woman was incidentally diagnosed with a 12-mm liver mass,suspected to be a hemangioma.Since then,regular follow-up had been carried out.Ten years later,she was referred to our institute due to the tumor(located in segment 4)having increased to 20 mm.Several imaging studies depicted no apparent extrahepatic lesion.Positron emission tomography(PET)/computed tomography exhibited significant accumulation in the mass lesion,which made us consider the possibility of malignancy.Left hepatectomy was performed.The histopathological diagnosis was neuroendocrine tumor grade 2,with somatostatin receptor 2 a/5 positivity.Postoperative somatostatin receptor scintigraphy(SRS)showed no other site,leading to the diagnosis of NEN of primary hepatic origin.The gradual growth of the hepatic NEN over 10 years suggested that it was likely to be a primary liver tumor.CONCLUSION In this case,positivity on PET and postoperative SRS may have helped determine whether the tumor was primary or metastatic.

关键词： Hepatic neoplasm scintigraphy Surgery Positron-emission tomography Clinical decision-making Case report

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Subclinical ankle joint tuberculous arthritis-The role of scintigraphy:A case series

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World Journal of Orthopedics 2023年第4期14卷 260-267页

作者： Raden Andri Primadhi Achmad Hussein Sundawa Kartamihardja Department Orthopaedics and Traumatology Universitas Padjadjaran/Hasan Sadikin HospitalBandung 40161Indonesia Departement of Nuclear Medicine and Molecular Imaging Universitas Padjadjaran/Hasan Sadikin HospitalBandung 40161Indonesia

BACKGROUND Tuberculosis remains a complicated problem.A lack of awareness accompanied by difficulty in diagnosis hinders the management of tuberculosis.Delayed management,particularly in osteoarticular regions,results in unnecessary procedures,including joint-sacrificing surgery.CASE SUMMARY Three cases of subclinical ankle joint tuberculosis without clear signs of tuberculosis were presented.The efficacy of technetium-99m-ethambutol scintigraphy in diagnosing early-stage tuberculous arthritis is reported.CONCLUSION The reports suggested that scintigraphy is recommended to diagnose subclinical tuberculous arthritis,especially in tuberculosis endemic regions.

关键词： Ankle Infectious arthritis Ethambutol scintigraphy Tuberculosis Case report

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Comparative evaluation of intragastric bile acids and hepatobiliary scintigraphy in the diagnosis of duodenogastric reflux

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World Journal of Gastroenterology 2013年第14期19卷 2187-2196页

作者： Teng-Fei Chen Praveen K Yadav Rui-Jin Wu Wei-Hua Yu Chang-Qin Liu Hui Lin Zhan-Ju Liu Department of Gastroenterology Shanghai Tenth People's HospitalTongji University

AIM:To assess the diagnostic value of a combination of intragastric bile acids and hepatobiliary scintigraphy in the detection of duodenogastric reflux(DGR).METHODS:The study contained 99 patients with DGR and 70 healthy volunteers who made up the control group.The diagnosis was based on the combination of several objective arguments:a long history of gastric symptoms(i.e.,nausea,epigastric pain,and/or bilious vomiting) poorly responsive to medical treatment,gastroesophageal reflux symptoms unresponsive to protonpump inhibitors,gastritis on upper gastrointestinal(GI) endoscopy and/or at histology,presence of a bilious gastric lake at > 1 upper GI endoscopy,pathologic 24-h intragastric bile monitoring with the Bilitec device.Gas-tric juice was aspirated in the GI endoscopy and total bile acid(TBA),total bilirubin(TBIL) and direct bilirubin(DBIL) were tested in the clinical laboratory.Continuous data of gastric juice were compared between each group using the independent-samples Mann-Whitney U-test and their relationship was analysed by Spearman's rank correlation test and Fisher's linear discriminant analysis.Histopathology of DGR patients and 23 patients with chronic atrophic gastritis was compared by clinical pathologists.Using the Independent-samples Mann-Whitney U-test,DGR index(DGRi) was calculated in 28 patients of DGR group and 19 persons of control group who were subjected to hepatobiliary scintigraphy.Receiver operating characteristic curve was made to determine the sensitivity and specificity of these two methods in the diagnosis of DGR.RESULTS:The group of patients with DGR showed a statistically higher prevalence of epigastric pain in comparison with control group.There was no significant difference between the histology of gastric mucosa with atrophic gastritis and duodenogastric reflux.The bile acid levels of DGR patients were significantly higher than the control values(Z:TBA:-8.916,DBIL:-3.914,TBIL:-6.197,all P < 0.001).Two of three in the DGR group have a significantly associated with each other(r

关键词： Duodenogastric reflux Diagnosis Intragastric bile acids Hepatobiliary scintigraphy

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The Clinical Usefulness of ^(99m)Tc-Tetrofosmin scintigraphy in the Diagnosis of Lung Neoplasmas and Mediastinal Lymphoid Node Involvement

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2008年第5期28卷 608-612页

作者：黄代娟赵峰张永学 Department of Nuclear Medicine Key Laboratory of Molecular Imaging of Hubei ProvinceUnion Hospital Tongji Medical College Huazhong University of Science and Technology Department of Thoracic Surgery Union Hospital Tongji Medical College Huazhong University of Science and Technology

In order to investigate the clinical significance of 99mTc-Tetrofosmin （TF） scintigraphy in the evaluation of lung cancer and mediastinal lymphoid node involvement, 33 patients with pulmo- nary neoplasmas were subjected to both 99mTc-TF scintigraphies and CT scans in one week before their operations or puncturations. All the images were judged visually and the emission images were analyzed with semi-quantitative methods in addition. The results of each group were compared. There was marked difference in target/non-target （T/N） ratio between the lung cancer group and the benign lesion group （P〈0.001）. Moreover, in the lung cancer group, T/N ratio in tomographies was signifi- cantly higher than that in planar images （P〈0.01）. The sensitivity and accuracy of semi-quantitative analysis in 99mTc-TF SPECT were significantly higher than those of CT in the diagnosis of pulmonary neoplasmas （P〈0.05 and P〈0.01 respectively）, so was the sensitivity of 99mTc-TF SPECT vs CT in the diagnosis of mediastinal lymphoid node metastasis （P〈0.05）. It was also found that epidermoid squamous cell carcinomas and adenocarcinomas had a higher T/N ratio than in small cell carcinomas （P〈0.05）, and 2 h washout rate （WR） of adenocarcinomas was higher than that of epidermoid squamous cell carcinomas （P〈0.05）. In conclusion, 99mTc-TF scintigraphy showed a favorable diag- nostic accuracy in appraising lung cancers and mediastinal lymph node metastases. Furthermore semi-quantitative technology can improve the accuracy, and is potential to offer some information about histological type of the cancer tissue. Therefore, 99mTc-TF scintigraphy will be a useful tool in the diagnosis and staging of lung cancer.

关键词： lung neoplasm mediastinum lymph node 99mTc-Tetrofosmin scintigraphy

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Contribution of Radioiodine Thyroid Uptake and scintigraphy to the Diagnosis of Hyperthyroidism

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World Journal of Nuclear Science and Technology 2018年第2期8卷 70-77页

作者： Md. Monirul Haque Alamin Md. Faruq Hossain Md. Sanowar Hossain Md. Selim Reza Department of Physics University of Rajshahi Rajshahi Bangladesh Institute of Nuclear Medicine and Allied Sciences (INMAS) BAEC Dhaka Bangladesh

In total 184 studies, which included thyroid uptake and scintigraphy, were performed in 68 hyperthyroid patients: 67% female and 33% male to investigate their thyroid conditions. The aim of the present study was to illustrate the role of uptake and scintigraphy tests in determining the thyroid status of hyperthyroid patients. The uptake study was performed by oral administration of 100 - 200 μCi of 131I as sodium-iodide and counting the radioactivity at 2 and 24 hrs, whereas thyroid scintigraphy was performed 20 minutes after an intravenous injection of 2 - 4 mCi of 99mTc-pertechnetate. The present results of thyroid uptake and scintigraphy successfully identified the thyroid condition in different states. The present results were also compared with some reported data and found to be fair in good agreement.

关键词： Radioiodine Uptake scintigraphy Hyperthyroidism

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Sensitivity of Esophageal scintigraphy (Milk Scans) in Detecting Gastro-Esophageal Reflux

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Open Journal of Medical Imaging 2015年第1期5卷 1-9页

作者： Saeed Bafaraj Awad Alzahrani Department of Diagnostic Radiology Faculty of Applied Medical Science King Abdulaziz University Jeddah Saudi Arabia

Gastro-esophageal scintigraphy (milk scan) is an accurate technique for detecting gastro-esophageal reflux that can be performed rapidly with minimal patient discomfort. A retrospective study was performed to find out to how much radionuclide milk scan is sensitive for detecting gastro-esophageal reflux (GER) for 89 patients who subjected to milk scan within Years 2010 to 2013. The study group age is ranging from one month old to four years old. Milk scan was performed using PHILIPS and SEIMENS machine. Tc 99-m sulfur colloid with milk administrated orally or through nasogastric tube to the patient. The highest frequency for milk scan study was in age group of 0 - 6 months old with 77% positive finding. Patients who suffer repeated vomiting represented the highest reason of examination for milk scan (46% of overall cases), while chocking attacks, pulmonary aspiration, and congenital heart disease, were 26%, 16%, 12% respectively of the overall cases. Seventy-nine percent of patients who prepared to be examine using nasogastric tube found with positive finding, 50% of GER patients have abnormal tracer activity in the mid of esophagus;on the other hand, 50% of GER patients divided equally between the lower and upper esophagus. The study show that infants especially in age of 0 - 6 months old and with repeated vomiting symptoms are strongly recommended to milk scan study rather than fluoroscopy to avoid unnecessary dose to the patients.

关键词： Gastro-Esophageal scintigraphy Milk Scan Gastro-Esophageal Reflux

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Differentiated Thyroid Cancer with Thyroglobulin Elevation and Negative Iodine scintigraphy (TENIS Syndrome)

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International Journal of Otolaryngology and Head & Neck Surgery 2014年第4期3卷 149-153页

作者： Raja Sfar Tarek Kamoun Manel Nouira Hamza Regaieg Nouha Ammar Hela Charfi Achraf Bahloul Maha Ben Fredj Kaouther Chatti Mohsen Guezguez Habib Essabbah Department of Nuclear Medicine Sahloul Hospital Sousse Tunisia Department of Nuclear Medicine Sahloul Hospital Sousse Tunisia Sousse University Sousse Tunisia University of Monastir Monastir Tunisia Department of Nuclear Medicine Sahloul Hospital Sousse Tunisia

Background and Objectives: Following the initial management, some patients with differentiated thyroid cancer (DTC) develop a state of high thyroglobulin (Tg) and Negative Iodine scintigraphy. The predisposing factors and outcome of this condition are unclear. In this study, our objectives were to analyze the characteristics of patients with high Tg level and negative Iodine scintigraphy and to determine the predictive factors for development of high Tg and negative scintigraphy. Patients and Methods: Retrospective study of 34 patients undergoing treatment for DTC, followed in the Nuclear Medicine department of the University Hospital—Sahloul Sousse between 1990 and 2006 and having a high Tg and negative Iodine scintigraphy. Fourteen patients had Tg between 2 and 10 ng/ml, 16 had Tg between 11 and 100 ng/ml and 4 patients had Tg more than 100 ng/ml. Results: There were 25 women and 9 men. The mean age was 51.65 years. In 94.1% of cases, the tumor was papillary carcinoma. Follicular tumors accounted for only 5.9%. The mean nodule size was3.26 cm. Capsular invasion was seen in 47.1% cases. The locoregional invasion was found in 35.3%. The lymph node extension was found in 84.8% of patients having lymph node surgery. Lymph node involvement was observed in 92.8% of patients with papillary cancer but it was found in 7.2% of patients with follicular cancers. Lymph node invasion was unilateral in 28.6% (N1a) and bilateral, contralateral or mediastinal in 71.4% (N1b). Initial level of Tg was as follows: 7 patients had Tg between 2 and 10 ng/ml, 14 patients had Tg between 11 and 100 ng/ml and 12 had Tg more than 100 ng/ml. The mean number of radioactive Iodine cure was 11.08 for patients with Tg more than 100 ng/ml with a significant difference (P = 0.001). Conclusion: Among epidemiological, pathological and clinical characteristics, lymph node invasion is the most frequent parameter found in patients with a DTC with high Tg level and negative Iodine scintigraphy.

关键词： Differentiated Thyroid Cancer Thyroglobulin Iodine scintigraphy TENIS Syndrome

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