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

We present a case of a 9-year-old mole whose follow-up DMSA renal scan showed increased background activity with radio tracer uptake in the liver, cardiac pool, and blood vessels. The possible causes of this unusual finding were discussed. With the patient's medical history, his recent laboratory work-ups and after excluding all other possible causes, we come to a conclusion that the multi-organ visualization in our patient's DMSA renal scan was a result of his medical condition of chronic kidney disease secondary to reflux nephropathy.

Human ; Male ; Child ; Kidney ; Liver ; Nevus ; Pyelonephritis ; Renal Insufficiency, Chronic ; Succimer

Human ; Radionuclide Imaging ; Nuclear Medicine

The use of 18F-fluoro-2-deoxy-D-glucose positron emission tomography with multiple slice spiral computed tomography scanners provides the opportunity to integrate morphologic information and functional information. It may allow the definition of new parameters for assessment of the treatment response of the tumor in one patient sitting. This will also facilitate the use of PET/CT in research studies as well as in clinical practice. This paper summarizes the results of recent studies with 18F-FDG PET/CT after chemotherapy or before and after surgery of metastatic colorectal carcinoma, and its impact on patient management. The purpose of this study was to evaluate the possible contribution of 18F-FDG PET/CT as compared to contrast-enhanced computerized tomography alone as a surrogate marker to evaluate liver metastases in vivo. Information retrieval for this review was through computerized literature search. Comparison of the results of each study was through statistical analysis. Results show that 18F-FDG PET/CT is better than CT as a diagnostic modality in the evaluation of the status of metastatic colorectal carcinoma. The review concludes with a position on how 18F-FDG-PET/CT could make a difference in drug development and clinical management for patients.

Human ; Biomarkers ; Colorectal Neoplasms ; Fluorodeoxyglucose F18 ; Glucose ; Information Storage And Retrieval ; Liver Neoplasms ; Positron Emission Tomography Computed ; Tomography, Spiral Computed ; Biopsy

This paper aims to discuss the sequential use of rituximab and 90Yttrium-ibritumomab tiuxetan, a novel treatment approach in the management of refractory follicular non-Hodgkin's lymphoma. Radioimmunotherapy (RIT), which combines the benefits of targeted radiation therapy and monoclonal antibody, has significantly increased the response rate well in excess of 50%. This is explained by the inherent radiosensitive nature of lymphoma cells. We present a case of a 56-year-old male with refractory follicular lymphoma. The patient was referred for RIT, the first case in the Philippines. The patient was pretreated with two doses of rituximab followed by an intravenous infusion of 90Y-ibritumomab tiuxetan (Zevalin). Hematologic nadir was reached six weeks following administration of the radioimmunotherapy. During this time, the patient developed melena. Hematologic recovery was noted after three weeks. Re-evaluation with computed tomography three months after treatment showed significant reduction in the tumor bulk and resolution of lymphadenopathies. This report underscores the importance and evolving role of radioimmunotherapy in the management of refractory non-Hodgkin's lymphoma.

Human ; Male ; Middle Aged ; Antibodies, Monoclonal ; Infusions, Intravenous ; Lymphadenopathy ; Lymphoma, Follicular ; Lymphoma, Non-hodgkin ; Melena ; Philippines ; Radioimmunotherapy ; Rituximab ; Tomography ; Yttrium Radioisotopes