Henry P. Pendergrass

Comparison of Enzyme, Clinical, Radiographic, and Radionuclide Methods of Detecting Bone Metastases from Carcinoma of the Prostate

Patients (219) with prostatic adenocarcinoma were classified on the basis of whether or not their bone scans were positive for metastasis. Acid and alkaline phosphatase determinations and clinical evaluations for bone metastases were reviewed. Of those with proved metastases, 43% had no bone pain, 39% had normal acid phosphatase levels, 23% normal alkaline phosphatase levels, 19% normal levels of both enzymes, and 15% normal enzyme levels without bone pain. Twenty-four per cent of the patients with normal enzyme levels and clinically unsuspected bone metastases had bone scans which proved positive for metastasis; 62% of these had normal radiographs.

The Clinical Use of 99mTc-Diphosphonate (HEDSPA)

Clinical experience in over 500 patients scanned with 99mTc-diphosphonate is discussed. In comparison with 18F scans and roentgen studies, 99mTc-diphosphonate has produced similar or better studies. Frequently, the diphosphonate scan is more sensitive, especially in the detection of metastases to bone. In addition, calcific soft-tissue deposits and urinary tract pathology have been visualized on 99mTc-diphosphonate scans. Scanning with 99mTc-diphosphonate is considered to be the most effective imaging modality available for determining the presence and extent of skeletal metastases.

99mTc-Diphosphonate Concentration in Primary Breast Carcinoma

In two patients with breast carcinoma images of the skeleton were obtained with 99mTc-diphosphonate. In both cases there was increased uptake of the scanning agent in the area of the breast mass.

Relative efficacy of radionuclide imaging and computed tomography of the brain.

Computed tomography (CT) with the EMI scanner has been demonstrated to possess a wide spectrum of capabilities in the diagnosis of suspected intracranial disease. This review of 418 dual CT and radionuclide (RN) brain images indicates that RN and CT are complementary in the diagnosis of cerebral infarction, but that CT has a greater capability in brain tumor detection. The classical RN static brain image does not detect cerebral atrophy, hydrocephalus or intraventricular hemorrhage; these conditions are clearly defined by CT.

Lung Perfusion Pattern Associated with Widespread Occlusion of the Pulmonary Vessels and Lymphatics

A case is reported of unusual lung perfusion changes in a patient with overwhelming occlusion of the pulmonary vessels and lymphatics. In addition to peripherally radiating irregular and linear perfusion defects, there are clearly demonstrated “fissure” hypoperfusion defects. Three major pathological processes appear to be important: fibrotic obliteration of the peripheral lung vessels, tumor microemboli, and Iyrnphangitic spread of tumor.

Certificate-of-Need in an Antitrust Context

Recent cases such as National Gerimedical Hospital and Gerontology Center v. Blue Cross of Kansas City have found that certificate-of-need (CON) legislation did not intend to remove antitrust considerations. This note discusses the exemptions from antitrust provided by the state action doctrine of Parker v. Brown as well as the Noerr-Pennington doctrine, both of which appear to protect provider input into the CON process. Providing information that assists decision-making must be carefully distinguished from providing data that serve the interests of physicians and hospitals.

Certain Legal Considerations As Applied To Diagnostic Medical Imaging: Emphasis Upon New Technology

The application of biomedical techniques developed in physics, chemistry, engineering and computer sciences has been the subject of this symposium. In general, these provide exciting new opportunities for participants in the health care field but they also represent challenges. This communication will discuss the basic principles of the laws of agency and evidence and how these might be applied to the specific technology discussed in this symposium. Since the resources necessary for these imaging devices and other improvements in data acquisition, information transmission and archiving are of such magnitude, public policies have been enacted to assure both public access to and protection from inappropriate acquisition and distribution of this technology. We will consider the combined effects of these initiative in relation to the present social changes providing the environment in which these policies will be enacted.

Legal Implications Associated With New Medical Imaging Technology

The application of biomedical engineering advances to health care delivery has provided both opportunities and challenges. One of these has been considerations of resource acquisition and distribution. Guidelines, agencies, modalities and devices have become increasingly apparent. Applications of the laws of agency and concepts of vicarious responsibility are particularly relevant. Certificate of Need legislation has led to antitrust considerations that are exceedingly complex. This presentation will attempt to evaluate some of the legal aspects resulting from the acquisition, allocation, and application of the many exciting technologies that are the subject of this symposium.

Annual oration, 1978: a tribute to Albert Soiland, M.D. Introduction of the Annual Orator, William J. Tuddenham, M.D.

The 1978 Annual Oration of the Radiological Society of North America is in honor of Dr. Albert Soiland, one of the early presidents of this society. Our Annual Orator this afternoon is a superb clinical radiologist and a medical scientist of the first order. William J. Tuddenham, currently professor of radiology at the University of Pennsylvania and director of the Department of Radiology at the Pennsylvania Hospital in Philadelphia, had his premedical education in the public schools in Salt Lake City and at the University of Utah where he graduated with a Bachelor of Arts degree in 1943. His graduate study at the California Institute of Technology was interrupted by active duty with the United States Navy during World War II. Upon his return to civilian life, Dr. Tuddenham went east to the University of Pennsylvania and graduated from its School of Medicine in 1950. His rotating internship and radiology residency took place at the University Hospital; during and following his residency training he attend...

The Scientific Exhibit in Radiology

Abstract The authors present practical details on choice and preparation of radiology exhibits. The space requirements and materials available both in the exhibitors department and in the exhibit hall are named, and suggestions are made for their most advantageous use. The exhibit should always be designed to stand alone, but it can at the same time be planned so as to supplement or reinforce ideas or concepts presented in a scientific paper.