Jong-Kang Lee

Expression of mediated P-glycoprotein multidrug resistance related to Tc-99m MIBI scintimammography results.

We prospectively studied a total of 24 patients with breast cancer to evaluate the relationship between the degree of accumulation of technetium-99m sestamibi (Tc-99m MIBI) and p-glycoprotein (Pgp) expression in tumor tissues. All 24 patients underwent Tc-99m MIBI scintimammography before surgery or biopsy. Immunohistochemical studies were performed on multiple non-consecutive sections of the same tumor using a Pgp specific monoclonal antibody, JSB-1. Planar images were started 10 min after injection of Tc-99m MIBI. Tumor to background (T/B) ratios calculated from the planar images were correlated with Pgp expression as determined by immunohistochemical studies. The T/B ratios were significantly lower for tumors in eight patients with positive Pgp expression (Group 1) than in 16 patients with negative expression (Group 2) (1.40+/-0.11 and 2.76+/-0.60, P<0. 05). Our data confirmed that Tc-99m MIBI scintimammography is useful for determination of the presence of multidrug resistance due to Pgp expression in patients with breast cancer.

Cytokeratin fragment 19 and squamous cell carcinoma antigen for early prediction of recurrence of squamous cell lung carcinoma.

Sixty patients with squamous cell carcinoma (SCC) of the lung, including 25 cases with recurrence and 35 cases without recurrence 1 year after operation, were enrolled in this study. The serial serum levels of cytokeratin fragment 19 (CYFRA 21-1) and SCC antigen were measured before operation and 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months after operation for early detection of recurrence. The results revealed that 1) mean serum values of CYFRA 21-1 were significantly higher at early and any times after operation in 25 patients with recurrent SCC when compared with 35 patients without recurrent SCC; and 2) mean serum values of SCC antigen were significantly higher until 9 and 12 months after operation, in 25 patients with recurrent SCC when compared with 35 patients without recurrent SCC. We conclude that CYFRA 21-1 is a better marker than SCC antigen for early prediction of SCC recurrence in the lung.

Using technetium-99m dimercaptosuccinic acid renal cortex scintigraphy to differentiate acute pyelonephritis from other causes of fever in patients with spinal cord injury

OBJECTIVES To differentiate acute pyelonephritis (APN) from fever due to other sources in patients with spinal cord injury by using technetium-99m dimercaptosuccinic acid (DMSA) renal cortex scintigraphy (DMSA scan). METHODS A total of 24 patients with spinal cord injury were admitted with fever. DMSA scans were performed on all patients. The final determination of the cause of the fever was based on the medical history, physical examination, laboratory evaluation, and imaging studies. RESULTS DMSA scan accurately diagnosed APN in 12 patients with inflammation on the DMSA scan. In 5 patients with scarred lesions on the DMSA scans and in 7 patients with negative DMSA scan, the fever was attributed to other causes. The sensitivity and specificity of the DMSA scan for detecting APN were both 100%. CONCLUSIONS The DMSA scan is a valuable adjunct in the evaluation of fever in patients with SCI.

Unexpected detection of colon lymphoma on a Tc-99m-labeled red blood cell abdominal scan.

A 60-year-old man was hospitalized because of intermittent tarry stools in association with right lower quadrant (RLQ) pain for 2 months. The Tc-99m-labeled RBC abdominal scan revealed abnormal RBC stasis in the RLQ of the abdomen. Colonoscopy indicated a tumor larger than 3 cm at the proximal portion of the ascending colon. After biopsy, a histopathologic diagnosis of large B-cell lymphoma was made. This unusual case of a large B-cell lymphoma in the ascending colon was detected incidentally on a Tc-99m-labeled RBC abdominal scan.

Skull meningioma demonstrated with Tc-99m tetrofosmin SPECT

A 47-year-old woman had a protruding mass in the left parietal region of the skull. The mass was clearly demonstrated by Tc-99m tetrofosmin skull SPECT. Craniotomy was performed and the pathologic examination revealed it to be an intraosseous meningioma.

Discrepancy between 24-hour I-131 and 30-minute Tc-99m tetrofosmin thyroid imaging in thyroiditis

1-131 and Tc-99m tetrofosmin thyroid imaging were performed in two patients with thyroiditis. One patient had subacute thyroiditis and the other had Hashimatos thyroiditis. 1-131 imaging showed no thyroid visualization in the patient with subacute thyroiditis and poor visualization in the patient with Hashimatos thyroiditis. Thyroid imaging with Tc-99m tetrofosmin was successful in both cases.

Detection of esophagitis by technetium 99m tetrofosmin chest SPECT

be reduced (1). In some cases blood transfusion may also be necessary (5). In this case, the patient remained symptom free, his activity was such that he did not need transfusions, and treatment was completed successfully without transfusions. This case illustrates that it is possible to treat chronic hepatitis C successfully in a patient with pre-existing hemolytic anemia and transfusion may not be required, although close monitoring is necessary.