The primary objectives of this retrospective study were to determine the cancer detection rate of PET/CT in this institution and to compare the sensitivity and specificity of low-dose PET/CT to that of PET with high-dose CT. Three hundred sixty-seven (367) patients with unremarkable history, family history of cancer, symptoms or abnormal diagnostic tests, and with follow-up studies were included. PET/CT and histopathology results were noted. Individual and overall cancer detection rates, as well as sensitivities and specificities for each subgroup, were computed. Overall cancer detection rates was 22.3%, for low-dose PET/CT was 17.9%, and for high-dose PET/CT was 24.4%. Using the chi squared test of independence, no statistically significant difference was found between the calculated sensitivities and specificities of low- and high-dose PET/CT across all patient groups. Using the Mantel-Haeaszel chi squared test, a statistically significant association between the subindication for malignancy screening and PET/CT results was established with subindications pointing to a higher suspicion for malignancy having a higher probability of detecting a malignancy. Therefore, high-dose PET/CT as a screening test would be advised for high-risk patients and low-dose PET/CT would be recommended because of its similar accuracy but lower radiation exposure.

Human ; Male ; Female ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Positron-Emission Tomography ; Tomography Scanners, X-Ray Computed ; neoplasms-diagnosis ; False Positive Reactions ; False Negative Reactions

This is a case report of a 65-year-old female with lumbar vertebral lesions secondary to an unknown primary malignancy. 99mTc-methylene diphosphonate bone scintigraphy showed multiple bone metastases as well as focal extraosseous uptake in the area above the right supraclavicular area. Further imaging with SPECT/CT localized the calcified extraosseous uptake to the right thyroid bed. These findings narrowed down the primary malignancy to a thyroidal origin, which was eventually proven as such through immunohistologic studies of the lumbar lesions. Different pathophysiologic mechanisms of extraosseous uptake in bone scintigraphy and how SPECT/CT can increase the diagnostic value of a standard nuclear medicine procedure are highlighted in this paper.

Human ; Female ; Aged ; Thyroid Neoplasms ; Thyroid cancer, papillary ; Tomography, Emission-Computed, Single-Photon ; Low Back Pain

Technetium-99m dimercaptosuccinic acid (99mTc-DMSA) scan is performed when there is a need to visualize the renal cortex and not the ureters or the bladder as the latter two are not effectively imaged. Less than twenty cases of tracer accumulation in a dilated ureter during a 99mTc-DMSA scan have been reported worldwide. There is no published case of ureter visualization in a 99mTc-DMSA scan done in the Philippines. In the case at hand, visualization of the ureters prompted further investigation. The present study pointed to a consideration of obstructive hydroureter, which was eventually supported by VCUG findings. Ureteral visualization in a 99mTc-DMSA scan should therefore prompt the inclusion of megaureter in the differential diagnosis.

Human ; Male ; Child ; Vesico-Ureteral Reflux ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ureter ; diagnosis

?Iodine-131 (I-131) whole body scan is a procedure routinely done after radioactive iodine therapy. It helps detect presence of functioning thyroid tissue remnants in the neck, as well as distant metastases. However, not all that take up I-131 are of thyroidal origin. Our patient is a 74-year-old woman with recurrent papillary thyroid carcinoma, who underwent a repeat radioactive iodine therapy (RAIT). Her post-RAIT whole body scan showed an unusual iodine-avid focus in the transverse colon which was later confirmed to be another primary malignancy of colonic origin through colonoscopy with biopsy, as well as post-surgical histopathology. This case report distinctively demonstrates uptake of I-131 in extra-thyroidal malignancy. It also emphasizes the importance of evaluating carefully any irregular-looking focal iodine uptake in areas with seemingly physiologic activity on a routine I-131 whole body-scan.

Human ; Female ; Aged ; Whole Body Imaging ; Thyroid cancer, papillary-Recurrence ; Carcinoma

Glomerular Filtration Rate has conventionally been indexed to Body Surface Area (BSA). The Du Bois and Mosteller formulae are used in calculating BSA. Recently, the methodologies in GFR determination have been cited as possible sources of discrepancies. This study was done to determine if a statistically significant difference exists in the GFRs obtained using the BSA calculated by the Du Bois and the Mosteller formulae; if such differences are related to age, sex, height, weight, and BMI. A review of the GFR results obtained in our institution was done. A total of of 186 subjects were included. GFR results were normalized to BSA using the two formulae. The difference between the resulting GFRs were caculated and subjected to appropriate statistical methods to determine their relationship to age, sex, height, weight, and BMI. They were then classified into different CKD stages and observed for any shifts in classification when the formula was changed. No correlation was observed between the differences and sex (P value = 0.70). Negative correlation was noted between the differences and age, height, and weight. Individuals with normal BMIs had the smallest differences. Those that were underweight showed the biggest differences. Of the 186 subjects, 9 patients had a shift in CKD classification when the GFRs using the Du Bois formula was compared to those using the Mosteller formula. The differences between the surface-area-normalized GFRs obtained using the two formulae are statistically significant and may affect clinical decision-making, patient management, and long-term outcome.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; Body Mass Index ; Body Surface Area ; Body Weight ; Clinical Decision-making ; Glomerular Filtration Rate ; Health Facilities ; Renal Insufficiency, Chronic ; Thinness

A treatment option for early stage breast cancer is nodal evaluation by axillary lymph node dissection (ALND). An alternative to ALND is sentinel lymph node (SLN) biopsy employing radionuclide SLN mapping. This study was designed to investigate the relationship between malignancy spread to the SLN and primary tumor size by reviewing the clinical profile of 20 female breast cancer patients who underwent radionuclide SLN mapping procedure, sentinel lymph node and primary tumor biopsy, as well as axillary lymph node dissection. The accuracy of radionuclide mapping in the identifying the sentinel node and determining the status of the axillary lymph nodes was reviewed. Among the mapped sentinel nodes, 15% were positive for metastatic lymphadenopathy and 85% without malignant spread. The malignant sentinel nodes had a mean size of 5.5 ± 0.87 cm and the negative sentinel nodes had a mean size of 2.95 ±2.2 cm. The SLN identified by radionuclide mapping truly represented the status of the rest of the axillary nodes for the presence or absence of metastatic lymphadenopathy. Primary tumor size is a prognostic factor for cancer spread to the sentinel node. However, the combination of primary tumor histology and tumor size may prove to be a stronger prognostic indicator malignancy spread to the sentinel lymph node.

Human ; Female ; Axilla ; Breast Neoplasms ; Lymph Node Excision ; Lymph Nodes ; Lymphadenopathy ; Prognosis ; Radioisotopes ; Sentinel Lymph Node ; Sentinel Lymph Node Biopsy

This paper presents a clinical situation in which a Technetium 99m sestamibi myocardial perfusion scintigraphy (MPS) with dipyridamole was used as part of the preoperative evaluation in a 15 year old female with Tetralogy of Fallot. MPS revealed no evident inducible myocardial ischemia, depressed LV wall function and RVH but with good RV function. There are many different techniques for imaging and studying patients with Tetralogy of Fallot (TOF). Echocardiography, ventriculography and invasive angiography remain the mainstay in its evaluation. However, the presence of coronary anomalies in these patients is very common and has negative effect on myocardial perfusion, either preoperatively or postoperatively. Hence, MPS plays an essential role in providing complete assessment in this group of patients.

Human ; Female ; Adolescent ; Angiography ; Cerebral Ventriculography ; Dipyridamole ; Echocardiography ; Heart Defects, Congenital ; Myocardial Ischemia ; Perfusion Imaging ; Technetium Tc 99m Sestamibi ; Tetralogy Of Fallot ; Tomography, X-ray Computed ; ; ; ;

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac disease with serious complications. This is a case of a three-year-old female who was initially diagnosed and managed as a case of dilated cardiomyopathy. A 2-D echocardiogram showed the left main coronary artery to be coming from the pulmonary artery. The patient was referred for myocardial perfusion scintigraphy (MPS) to determine viability prior to surgical revascularization. MPS showed absent myocardial perfusion in the apex and apical anterior segments and thinned-out perfused myocardium in the midventricular to basal anterior segment and apical to basal inferior and lateral walls. This is consistent with markedly reduced perfusion in the segments supplied by the anomalous left coronary artery distribution. While echo cardiography and angiography are used to diagnose ALCAPA, the roles of MPS are to provide information regarding the viability of the areas supplied by the anomalous left coronary artery and to assess postoperative myocardial perfusion.

Human ; Female ; Child Preschool ; Angiography ; Bland White Garland Syndrome ; Cardiomyopathy, Dilated ; Echocardiography ; Heart Defects, Congenital ; Myocardium ; Perfusion Imaging ; Pulmonary Artery ; Tomography, X-ray Computed

Primary anterior mediastinal neoplasms account for 50% of all mediastinal masses with thymomas being the most common. These tumors demonstrate T1-20 1, Tc-99m sestamibi, and Tcc99m tetrofosmin uptake during SPECT myocardial scintigraphy A 60-year-old Filipino with hypertension, dyslipidemia and prior history of ischemic stroke underwent Tc-99m sestamibi SPECT dipyridamole stress. Inhomogeneous tracer uptake of the left ventricle in the inferior and inferolateral region was noted which was attributed to diaphragmatic attenuation. Gated SPECT showed normal myocardial thickening and wall motion. Extracardiac mediastinal activity was visualized on both the resting and stress images. Computed tomography scan demonstrated two (2) well-defined homogeneously enhancing lesions in the left anterior mediastinum most likely a thymoma. Specialists who interpret myocardial scintigrams should be aware of the causes of non-cardiac uptake so that unanticipated focal extracardiac accumulation during myocardial scintigraphy will lead to further investigation to establish the diagnosis of mediastinal tumors.

Human ; Male ; Middle Aged ; Dipyridamole ; Dyslipidemias ; Heart Ventricles ; Hypertension ; Mediastinal Neoplasms ; Mediastinum ; Myocardial Perfusion Imaging ; Myocardium ; Specialization ; Stroke ; Technetium Tc 99m Sestamibi ; Thymoma ; Tomography, Emission-computed, Single-photon ; Tomography, X-ray Computed

Biliary atresia is a significant cause of neonatal jaundice that needs differentiation from neonatal hepatitis. Early identification of biliary atresia is important as surgical intervention is required. A hepatobiliary scan can help in the diagnosis of biliary atresia. Scintigraphic findings in a rare type of biliary atresia are described here to serve as a guide to other nuclear medicine physicians. Type 7 biliary atresia, which has an atretic common bile duct only, appears as persistent radiotracer activity in the gallbladder with no tracer activity in the intestines.

Human ; Female ; Infant ; Biliary Atresia ; Common Bile Duct ; Gallbladder ; Hepatitis ; Infant, Newborn ; Intestines ; Jaundice, Neonatal ; Nuclear Medicine ; Radionuclide Imaging