Carcinoma ; Humans ; Male ; Middle Aged ; Parathyroid Neoplasms

Objective To compare the tracing effects of radionuclide and barium sulfate on lactulose hydrogen breath test (LHBT), and to explore the value of LHBT combined with radionuclide imaging in the diagnosis of small intestinal bacterial overgrowth (SIBO) in patients with irritable bowel syndrome (IBS).Methods From November 2010 to November 2012, 89 patients (47 males, 42 females;mean age (45.7±12.9) years) with IBS and 13 healthy volunteers (9 males, 4 females;mean age (43.3±8.6) years) were enrolled in this prospective study.All the subjects underwent LHBT combined with radionuclide imaging.Recording the time when the increment of H2 value >0.005‰ and the OCTT of the radionuclide.Four healthy volunteers also underwent LHBT combined with barium sulfate 1 week after radionuclide imaging.The location of barium sulfate was recorded when H2 value increment >0.020‰.Patients with SIBO received rifaximin treatment, and the effect was observed.χ2 test, Pearson correlation analysis and Wilcoxon rank sum test were used to analyze the data.Results (1)In LHBT combined with barium sulfate test, barium sulfate was found still stagnating in small intestine by abdominal X-ray when H2 value increment >0.020‰ in 4 healthy volunteers, and barium sulfate didn′t reach the colon in delayed imaging in 1 patient.(2) The rates of SIBO detected by LHBT in IBS patients and healthy volunteers were significantly different (43.8%(39/89) vs 5/13;χ2=0.133, P=0.716), and those detected by LHBT combined with radionuclide imaging were also significantly different (39.3%(35/89) vs 1/13;χ2=4.970, P=0.026).(3)The time of H2 value increased >0.005‰ correlated well with OCTT in 13 healthy volunteers ((73±31) and (50±19) min;r=0.871, P<0.001) and 54 IBS patients without SIBO ((83±34) and (66±28) min;r=0.735, P<0.001), but there was no correlation in 35 IBS patients with SIBO ((36±30) and (75±30) min;r=0.304, P=0.076).(4)A total of 34 SIBO-positive patients received a rifaximin treatment, with a significant improvement in the frequency of abdominal pain and abdominal distension after the treatment according to Rome Ⅲ diagnostic criteria: 5(4, 6) vs 4(3, 5), 4(1, 6) vs 0(0, 4)(z values:-4.842 and-5.388, both P<0.001).Conclusion LHBT alone is not a valid test for SIBO, and LHBT combined with radionuclide imaging is a good candidate for SIBO diagnosis.

Objective To explore the prevalence of sialorrhea and its clinical correlation with dysphagia in Chinese patients with Parkinson′s disease ( PD ).Methods One hundred and sixteen consecutive patients with a clinical diagnosis of PD were selected.Demographic data included sex , age, years of education, age at onset of PD, clinical genotype, disease duration, treatment, Hoehn and Yahr (H&Y) stage.Sialorrhea was assessed using the Unified Parkinson′s Disease Rating Scale (UPDRS) Ⅱitem number 6.All patients were studied with videofluoroscopic study of swallowing ( VFSS).Results The prevalence rate of sialorrhea in PD was 59.5% (69/116, 95% CI 50.6%-68.4%).Males were more likely to develop sialorrhea than females (47/70 vs 22/46,χ2 =4.298, P=0.038).PD patients′sialorrhea correlated with oral dysphagia:with food leaking from the mouth ( liquid r=0.229, P=0.014; juice r=0.197, P=0.034;pudding viscosities r=0.231, P=0.013;solid food r=0.255, P=0.006), with more than 1 ml of oral food residues (liquid r=0.319, P<0.01;solid food r=0.185, P=0.047), with delay in food transfer to the root of the tongue (liquid r=0.279, P=0.002; juice r=0.209, P=0.024), and delayed swallow transfer ( pudding viscosities r=0.257, P=0.005).Sialorrhea score was not related to H&Y stage, clinical course and levodopa equivalent doses (LED).The prevalence rate of dysphagia in PD was 87.1%(95% CI 81.0% -93.2%).Liquid was more likely to cause pharyngeal dysphagia ( P=0.03).With the increase in H&Y stage , so did the oral and pharyngeal stages of dysphagia.Late and mid-course was more likely to develop oral and pharyngeal dysphagia than those with early clinical course .Conclusions Sialorrhea and dysphagia are common non-motor symptoms in PD patients.Sialorrhea is more prevalent in males and correlates with oral phase of dysphagia.Liquid is more likely to cause pharyngeal dysphagia.With increase in H&Y stage , so did oral and pharyngeal dysphagia.Even though late clinical course is more likely to develop oral and pharyngeal dysphagia than early clinical course , the comparison between late and intermediate clinical courses does not reach statistical significance .

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In 2003, JCI certification was introduced to create our new hospital quality management system. Our department imaging facilities management level and service quality markedly improved through JCI certification and re-evaluation. It played an important role in improving the efficiency and extending the life of medical facilities, reducing maintenance costs.
Certification ; organization & administration ; Hospital Administration ; Nuclear Medicine ; instrumentation ; Quality Assurance, Health Care ; methods ; organization & administration

OBJECTIVETo study intra-operative radionuclide lymphatic mapping in sentinel lymph node (SLN) biopsy of breast cancer.

METHODSForty-two breast cancer (diameter 98%, size of colloid granule 100 approximately 200 nm) was injected into the mammary tissue around the tumor or biopsy site at four points. SLN in breast cancer was detected and dissected with the help of lymphoscintigraphy and intra-operative gamma probe. Routine lymph node dissection was performed for all patients.

RESULTSThe detection rate was 88.1% in lymphoscintigraphy and 97.6% in intra-operative gamma probe detection for SLN in breast cancer. The sensitivity, accuracy, false negative and specificity of SLN biopsy were 93.3% (14 in 15), 97.6% (40 in 41), 6.7% (1 in 15) and 100% (26 in 26).

CONCLUSIONSentinel lymph node in breast cancer, detected by preoperative lymphoscintigraphy combined with intra-operative gamma probe, is able to predict regional lymph node metastasis. The successful rate of SLN biopsy can be raised by improvement in the quality of nuclear imaging agent, technic of injection and method of measurement.

Adult ; Aged ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Lymph Nodes ; diagnostic imaging ; Middle Aged ; Radionuclide Imaging ; Sentinel Lymph Node Biopsy ; Technetium Tc 99m Sulfur Colloid

OBJECTIVETo evaluate the clinical value of (89)SrCl(2) (Ke xing Inc, Shanghai) as a palliative therapy modality for cancer patients with bone metastasis.

METHODSIn 504 cancer patients with painful limitation of movement due to bony metastasis, a dose of 1.48-2.22 MBq/kg (40-60 uCi/kg) iv infusion of (89)SrCl(2) was given.

RESULTSIn 97 patients (19.2%) there was no improvement in pain and life quality, 298 patients (59.1%) showed mild to moderate improvement (moderately effective), 109 patients (21.6%) became free of pain and were subsequently fully ambulatory (markedly effective). The pain relief appeared from D1-D46 after (89)SrCl(2) administration, most frequently from D5-D14. The palliative effect could last for about 56 days to 13 months. Repeated bone scans of some patients showed that the metastatic foci in the bone became smaller or even disappeared gradually after the administration of (89)SrCl(2). Approximately 55% of patients experienced grade I approximately III bone marrow depression attributable to (89)SrCl(2), which would return to the pre-treatment level within 3 approximately 9 months.

CONCLUSION(89)SrCl(2) is effective and safe for the relief of bone pain and improvement of quality of life in cancer patients with painful bony metastasis.

Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; complications ; radiotherapy ; secondary ; Breast Neoplasms ; pathology ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Pain Measurement ; Pain, Intractable ; etiology ; radiotherapy ; Quality of Life ; Strontium Radioisotopes ; therapeutic use

Adult ; Brain ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the application of ²⁰¹TI and (99m)Tc-MIBI scintigraphy in assessment of neoadjuvant chemotherapy for osteosarcoma.

METHODSTwenty-two patients with osteosarcoma underwent both ²⁰¹TI and (99m)Tc-MIBI scintigraphy. According to tumor necrosis rate (TNR), 22 patients were classified into three groups: Group 1(necrosis less than 50%), Group 2(50% ≊ 89% necrosis) and Group 3(necrosis greater than 90%). The uptake ratio(UR) was obtained in images before and after chemotherapy. The alteration ratio(AR) and tumor necrosis ratio (TNR) were calculated.

RESULTSIn ²⁰¹Tl images,UR(pre) and UR(post) (mean ± s.d.) of Group 1 were 2.14 ± 0.67, 2.07 ± 0.71 (P>0.05); UR(pre) and UR(post)of Group 2 were 3.45 ± 1.57 and 2.02 ± 0.97 (P<0.01); UR(pre) and UR(post) of Group 3 were 3.57 ± 0.67 and 1.36 ± 0.20 (P<0.01). In (99m)Tc-MIBI images, UR(pre)and UR(post) of Group 1 were 1.66 ± 0.42 and 1.85 ± 0.70 (P>0.05); UR(pre) and UR(post) of Group 2 were 2.39 ± 1.41 and 1.68 ± 0.72 (P<0.05);UR(pre) and UR(post) of Group 3 were 2.56 ± 0.60 and 1.19 ± 0.14 (P<0.01). The AR value in (201)Tl scintigraphy was -0.03-0.72, the liner regression analysis of AR versus TNR showed a highly significant positive correlation (r=0.95). The AR value in (99m)Tc-MIBI scintigraphy was -1.21-0.64, the liner regression analysis of AR versus TNR showed a highly significant positive correlation (r=0.71). The liner regression analysis of AR in ²⁰¹TI scintigraphy versus AR in (99m)Tc-MIBI scintigraphy showed a highly significant positive correlation (r=0.70).

CONCLUSIONThe AR changes significantly after neoadjuvant chemotherapy and is positively correlated with TNR, which indicates that ²⁰¹TI- and (99m)Tc-MIBI scintigraphy can be used for evaluation of neoadjuvant chemotherapy.

Adolescent ; Adult ; Bone Neoplasms ; diagnostic imaging ; drug therapy ; Child ; Female ; Humans ; Male ; Neoadjuvant Therapy ; Osteosarcoma ; diagnostic imaging ; drug therapy ; Preoperative Care ; Radionuclide Imaging ; Technetium Tc 99m Sestamibi ; Thallium Radioisotopes ; Young Adult

OBJECTIVETo investigate the value of(99m)Tc-MIBI/(18)F-FDG-dual-isotope simultaneous acquisition (DISA) in diagnosis and treatment of patients with myocardial infarction.

METHODSSixty-three patients with myocardial infarction who underwent DISA before and after treatment were enrolled in the study. All cases were divided into subgroups based on different treatment and myocardial viability: Group A1 (n = 16) with coronary revascularization and viable myocardium, A2 (n = 9) same as A1 but no viable myocardium; B1 (n = 6) with coronary revascularization + stem cell transplantation and viable myocardium, B2 (n = 7) same as B1 but no vital myocardium; C1 (n = 8) with stem cell transplantation and viable myocardium, C2 (n = 17) same as C1 but on viable myocardium. The changes of uptake rate of (99m)Tc-MIBI/(18)F-FDG before and after treatment were analyzed with SPSS 13.0 software.

RESULTThere were statistical significances in DF value of (99m)Tc-MIBI or (18)F-FDG imaging before and after treatment in all groups (P <0.05), except Group A2 (P>0.05). The improvement of blood perfusion and metabolism in cardiac survival groups was more marked than that in non-cardiac survival groups after treatment (P<0.05). Furthermore, Group B1 was superior to Groups A1 and C1; Group B2 was superior to Group A2 and Group C2 (P<0.05 or<0.01).

CONCLUSION(99m)Tc-MIBI/(18)F-FDG DISA can detect myocardial viability and is of value for patients with myocardial infarction to choose appropriate therapeutic strategies. The degree of cardiac improvement after treatment can be evaluated by DISA.

Aged ; Female ; Fluorodeoxyglucose F18 ; Heart ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; therapy ; Radionuclide Imaging ; Retrospective Studies ; Technetium Tc 99m Sestamibi ; Treatment Outcome