Von Hippel-Lindau (VHL) syndrome is a rare neoplastic disorder characterized by central nervous system (CNS) and visceral tumors. We here present 68Ga-labelled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-Nal3-Octreotide positron emission tomography computed tomography findings in a 52 year old female with VHL syndrome, demonstrating both CNS and visceral tumors.
Brain Diseases/radionuclide imaging ; Female ; Humans ; Kidney Diseases/radionuclide imaging ; Liver Diseases/radionuclide imaging ; Middle Aged ; Multimodal Imaging/*methods ; Organometallic Compounds/diagnostic use ; Pancreatic Diseases/radionuclide imaging ; Positron-Emission Tomography/*methods ; Tomography, X-Ray Computed/*methods ; von Hippel-Lindau Disease/*radionuclide imaging

No abstract available.
Amyloidosis/*radionuclide imaging ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Liver Diseases/*radionuclide imaging ; Multiple Myeloma/*complications ; *Positron-Emission Tomography and Computed Tomography ; Radiopharmaceuticals/*diagnostic use

No abstract available.
Adult ; Carcinoma, Hepatocellular/radiography/radionuclide imaging/ultrasonography ; Granuloma, Plasma Cell/pathology/*radiography/radionuclide imaging ; Humans ; Liver Diseases/pathology/*radiography/radionuclide imaging ; Liver Neoplasms/radiography/radionuclide imaging/ultrasonography ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

We report here on a rare case of primary AL hepatic amyloidosis associated with multiple myeloma in a 64-year-old woman. The patient was referred for evaluating her progressive jaundice and right upper quadrant pain. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) showed diffusely and markedly increased 18F-FDG uptake in the liver. Although there have been several case studies showing positive 18F-FDG uptake in pulmonary amyloidosis, to the best of our knowledge, the 18F-FDG PET/CT findings of hepatic amyloidosis or primary hepatic amyloidosis associated with multiple myeloma have not been reported previously.
Amyloidosis/complications/pathology/*radionuclide imaging ; Biopsy, Needle ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Liver/pathology ; Liver Diseases/complications/pathology/*radionuclide imaging ; Middle Aged ; Multiple Myeloma/*complications ; *Positron-Emission Tomography and Computed Tomography ; Radiopharmaceuticals/*diagnostic use

OBJECTIVETo identify the uptake and biological distribution of technetium galactosyl human serum albumin diethylenetriamine pentaacetic acid injection (99mTc-GSA) in three mouse models with different degrees of hepatic injuries.

METHODSThree mouse models including hepatic fibrosis, hepatic cholestasis, and liver cancer were established. Hepatic fibrosis model was established by intraperitoneal injection of carbon tetrachloride, 0.4 ml 10%, every 48 hours for 48 days. Hepatic cholestasis model was set up by ligature of the common bile duct for 72 hours, and liver cancer model by implantation of H22 tumor cells underneath liver capsule for 10 days. On measurement, each mouse in different models and normal controls was injected with 0.1 ml (0.37 MBq)99mTc-GSA (2 microg) into vena caudalis, and 5 minutes later sacrificed by decapitation. Important organs and tissues including liver, heart, lungs, kidney, spleen, stomach, blood, bones, muscles, and intestines were taken and their different radio countings were measured. The hepatic injuries were evaluated with serum and pathological examinations.

RESULTS99mTc-GSA was concentrated in the liver in all three models and the control mice ( >40% ID x g(-1)). Compared with the control mice (90.05 +/- 10.55)% ID x g(-1), the density of 99mTc-GSA was significantly lower in the models with hepatic injuries (P < 0.001). The liver function test indicated that the injury in hepatic fibrosis model was less serious than those in the other two models. However, the concentration of 99mTc-GSA in hepatic fibrosis model [(72.20 +/- 2.13)% ID x g(-1)] was significantly higher than those in the models with cholestasis [(56.72 +/- 5.92)% ID x g(-1)] and liver cancer [(42.80 +/- 6.05)% ID x g(-1)] (P < 0.001).

CONCLUSIONS99mTc-GSA may well concentrate in liver and its concentration degree is adversely correlated with hepatic injuries. Therefore 99mTc-GSA may be clinically used as liver imaging agent. When combined with three-dimensional scanning technique, it may facilitate constructing a new three-dimensional imaging method to demonstrate the function of designed liver segments.

Animals ; Disease Models, Animal ; Female ; Humans ; Liver ; diagnostic imaging ; drug effects ; injuries ; Liver Diseases ; diagnosis ; diagnostic imaging ; Mice ; Mice, Inbred BALB C ; Radiography ; Radionuclide Imaging ; Radiopharmaceuticals ; administration & dosage ; pharmacokinetics ; Random Allocation ; Technetium Tc 99m Aggregated Albumin ; administration & dosage ; pharmacokinetics ; Technetium Tc 99m Pentetate ; administration & dosage ; pharmacokinetics

Dry mouth is a common symptom in over middle- aged women. Xerostomia itself can be caused by multifactorial etiolgy. Dry mouth may occur with the use of medications, as a complication of connective tissue and autoimmune disease, such as Sjogren's syndrome or sicca syndrome, with radiation therapy to the head and neck or diabetes mellitus, or with a number of other condition. Even stress and anxiety can lead to a dry mouth. Also, Abnormal liver function is associated with drugs, viral infection, alcohol, obesity, autoimmne disease and a number of other disease. A 41-year-old women complaining of xerostomia and known abnormal liver fuction since 1 year was admitted to our medical examination center. In this case, Final diagnosis was systemic lupus erythematosus with autoimmune hepatitis and secondary Sjogren's syndrome through characteristic clinical finding, liver biopsy, positive Schirmer's test, salivary gland biopsy, and salivary scintigraphy. The various immunosuppresant medication has taken and then liver function indices and clinical symptoms were improved.
Adult ; Anxiety ; Autoimmune Diseases ; Biopsy ; Connective Tissue ; Diabetes Mellitus ; Diagnosis ; Female ; Head ; Hepatitis, Autoimmune ; Humans ; Liver* ; Lupus Erythematosus, Systemic* ; Mouth ; Neck ; Obesity ; Radionuclide Imaging ; Salivary Glands ; Sjogren's Syndrome ; Xerostomia*

BACKGROUND/AIMS: Liver scintigraphy is a useful tool in evaluating the chronic liver disease, even though it is less sensitive to detect a mass lesion in the liver than ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI). We evaluate the clinical usefulness of liver scintigraphy in patients with liver cirrhosis by comparing with the clinical and biochemical indices. METHODS: Liver scintigraphy was taken beginning 20 minutes after the intravenous injection of 370 MBq of Tc-99m phytate. Images were obtained in multiple views with a gamma camera (Basicam(R), Siemens). The size of the liver, left lobe enlargement, inhomogeneity of radioactivity, the size of the spleen, the extrahepatic uptake were evaluated on liver scintigraphy. The compared clinical indices were serum albumin level, serum bilirubin level, INR (international normalized ratio) for prothrombin time, the presence of hepatic coma, and esophageal varix. RESULTS: Forty four patients (M:F=24:20) were included. The extrahepatic uptake such as bone marrow and splenic uptake was positively correlated with the level of serum bilirubin and negatively correlated with the level of serum albumin. The size of the spleen, inhomogenous liver uptake, hypertrophy of left lobe was positively correlated with the degree of esophageal varix. The size of the liver was negatively correlated with that of esophageal varix. CONCLUSION: We suggest that scintigraphic findings in liver scintigraphy could be used in the evaluation of patients with liver cirrhosis not only to diagnose cirrhosis but also to know the severity of cirrhosis.
Bilirubin ; Bone Marrow ; Esophageal and Gastric Varices ; Fibrosis ; Gamma Cameras ; Hepatic Encephalopathy ; Humans ; Hypertrophy ; Injections, Intravenous ; International Normalized Ratio ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Magnetic Resonance Imaging ; Phytic Acid ; Prothrombin Time ; Radioactivity ; Radionuclide Imaging* ; Serum Albumin ; Spleen ; Ultrasonography

BACKGROUND/AIMS: [18F]FDG-PET is a functional imaging modality reflecting cellular glucose metabolism. In most malignant cells, accumulation and trapping of [18F]FDG allows the visualization of increased uptake compared with normal cells. The aim of this study was to assess the value of PET in differentiating benign from malignant hepatic lesions and to determine in which types of hepatic tumors PET can help evaluate stage, monitor response to therapy, and detect recurrence. METHODS: Eighty patients with liver lesions were enrolled (hepatocellular carcinoma 34, cholangiocarcinoma 8, metastatic liver cancer 25, hemangioma 6, liver abscess 7). Liver metastases were 22 adenocarcinoma, 2 lymphoma, 2 squamous cell carcinoma. The PET images of these patients were analyzed. SUV and lesion-to-normal liver background SUV ratio were obtained and compared among the disease groups. RESULTS: All liver metastases and all cholangiocarcinomas had increased uptake value, with SUV ratios greater than 2. Hepatocellular carcinoma had SUV ratios greater than 2 in 20 of 34 patients (59%). All hemangiomas had poor uptake, a SUV ratio of less than 2. All liver abscesses showed definite uptake. CONCLUSIONS: The PET technique using FDG static imaging was useful in differentiating malignant from benign lesions of the liver in limited situations. Limitations included false negative results in some patients with hepatocellular carcinoma. Liver abscesses raised problems in differential diagnosis from malignant liver tumors. The findings of this study suggest that the PET technique might be applied in tumor staging and the detection of recurrence, as well as monitoring responses to therapy for all adenocarcinomas and some hepatocelluar carcinomas.
Adult ; Aged ; Diagnosis, Differential ; English Abstract ; Female ; Fludeoxyglucose F 18/diagnostic use ; Human ; Liver Diseases/*radionuclide imaging ; Liver Neoplasms/radionuclide imaging ; Male ; Middle Aged ; Radiopharmaceuticals/diagnostic use ; *Tomography, Emission-Computed

BACKGROUND: The disturbances of portal circulation in chronic liver disease may cause hepatic failure, hepatic encephalopathy and variceal bleeding. The measure of porto-systemic shunt plays a significant role in the management and prognosis of the patients. So we have evaluated the relationship between the shunt index of thallium-201 liver scan and the histological grade and stage of chronic liver disease. METHODS: The thallium-201 scintigraphy per rectum was evaluated in 159 patients with chronic liver disease, which were proven with percutaneous liver biopsy. We used the heart to liver activity ratio at 20 minute as shunt index, representing portal-systemic shunt. The two pathologists scored independently hepatitis activity (lobular and porto-periportal activity) and stage (fibrosis). RESULTS: A significant difference was noted between the shunt index and the scores of fibrosis (p< 0.001) although this correlation was statistically weak (r=0.26, p=0.008). In cumulative logistic regression test, the shunt index had a effect on the fibrosis (p< 0.001) but not on the lobular and porto-periportal activity. Fibrosis was predicted as less than 2 if shunt index was less than 0.24, 3 if more than 0.24 but less than 0.46, 4 if more than 0.46. CONCLUSION: The shunt index of thallium-201 liver scintigraphy correlated only with fibrosis not with lobular and porto-periportal activity. As the fibrosis progresses in chronic liver disease, portal hypertension becomes more severe and the shunt index increases. Thallium-201 liver scan may be useful for evaluation of hepatic fibrosis instead of invasive liver biopsy in predicting the histological stage (fibrosis) of advanced chronic liver disease.
Biopsy* ; Esophageal and Gastric Varices ; Fibrosis ; Heart ; Hepatic Encephalopathy ; Hepatitis ; Humans ; Hypertension, Portal ; Liver Diseases* ; Liver Failure ; Liver* ; Logistic Models ; Prognosis ; Radionuclide Imaging* ; Rectum

PURPOSE: Heart to liver ratio on T1-201 per rectal scintigraphy (shunt index) is known to be useful in the assessment of portal systemic shunt. We assessed T1-201 uptake pattern and early liver/heart uptake rate of T1-201 and correlated with shunt index in patients with chronic active hepatitis (CAH) and liver cirrhosis (LC). MATERIALS AND METHODS: Fifty eight patients with biopsy-proven chronic liver disease (35 with CAH, 23 with LC) underwent T1-201 per rectum scintigraphy after instillation of 18.5 MBq of T1-201 into the upper rectum. We evaluated hepatic uptake (type 1: homogeneous, 2: inhomogeneous segmental, 3: inhomogeneous nonsegmental) and extrahepatic uptake of spleen, heart and kidney (grade 0: no uptake, 1: less than liver, 2: equal to liver, 3: greater than liver). We measured the early liver/heart uptake rate (the slope of the liver to heart uptake ratio for 10 min) and shunt index (heart to liver uptake ratio). T1-201 uptake pattern and early liver/heart uptake rate of T1-201 was correlated with the pathologic diagnosis and shunt index. RESULTS: Hepatic uptake patterns of type 1 and 2 were dominant in CAH (CAH: 27/35, LC: 8/23), and type 3 in LC (CAH: 8/35, LC: 15/23) (p<0.005). The grades of extrahepatic uptake were higher in LC than in CAH (spleen: p<0.001, other soft tissue: p<0.005). The early liver/heart uptake rate of CAH (0.110+/-0.111) was significantly higher than that of LC (0.014+/-0.090) (p<0.001). The sensitivity and specificity of the early liver/heart uptake rate were 77.7% and 67.7% in differentiating LC from CAH. There was negative correlation between early liver/heart uptake rate and shunt index (r=-0.3347, p<0.01). CONCLUSION: Hepatic and extrahepatic uptake pattern and early liver/heart uptake rate on T1-201 per rectum scintigraphy are useful in the assessment of portal systemic shunt in patients with chronic liver disease.
Diagnosis ; Heart ; Hepatitis, Chronic ; Humans ; Kidney ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Portal System ; Radionuclide Imaging* ; Rectum* ; Sensitivity and Specificity ; Spleen