Our study demonstrated that the images obtained by (68)Ga-DOTATATE and (68)Ga-DOTANOC have comparable diagnostic accuracy. However, (68)Ga-DOTATATE seems to have a higher lesion uptake and may have a potential advantage.
A comparative prospective study of technetium-99m methoxyisobutylisonitrile (MIBI) and thallium-201 with early (15 min) and delayed (90 min for MIBI, 3 h for 201Tl) imaging in the differentiation of thyroid lesions is presented. Forty patients with cold thyroid nodules visualised on 99mTc-pertechnetate scan and with dyskaryotic or atypical epithelial cells verified by fine needle aspiration biopsy underwent MIBI and 201Tl scintigraphy at 3-day intervals. Subsequent thyroidectomies were carried out in all patients. Semiquantitative analysis was performed using a lesion to non-lesion ratio on early (ER) and delayed images (DR). Additionally, a retention index (RI) was calculated using the formula RI=(DR-ER) x 100/ER. The reproducibility of the method for the early and delayed measurements was tested by analysing intra- and inter-observer variability and repeatability coefficients. Histopathologically, the nodules were found to be well-differentiated thyroid cancer in 21 patients and benign in 19 patients. There was no significant difference in the ER between malignant and benign lesions for either 201Tl or MIBI (P>0.05). However, for both agents significant differences were found between malignant and benign lesions with regard to DR (P<0.01 for 201Tl and P<0.001 for MIBI) and RI (P<0.001 for both agents). Statistical comparison of the two agents showed no significant differences (P>0.05) except with regard to DR and RI in malignant nodules (P<0.05). A receiver operating characteristic analysis was performed to determine threshold levels for the differentiation of malignant from benign nodules. Following this analysis, ER, DR and RI levels of 1.03, 1.54 and 2 for MIBI and < or =1.42, 1.24 and 5 for 201Tl were selected. Using these threshold levels, the sensitivity, specificity and accuracy of the study were 90.5%, 36.8% and 65% for ER MIBI, 61.9%, 94.7% and 77.5% for DR MIBI, 95.2%, 89.4% and 92.5% for RI MIBI, 85.7%, 47.3% and 67.5% for ER 201Tl, 80.9%, 73.6% and 77.5% for DR 201Tl, and 90.5%, 94.7% and 92.5% for RI 201Tl. In conclusion, the DR for MIBI and 201Tl is superior to the ER in detecting malignant nodules, and the RI for both MIBI and 201Tl is more valuable than the DR in differentiating malignant from benign thyroid nodules.
The purposes of the present study are to measure the total radiation doses for the radiation workers and for the accompanying person to the patients in positron emission tomography (PET)/computed tomography (CT) imaging. Urines samples from the patients were collected at 43, 62, 87, 117, 238, 362 min after the 555-MBq (18)flour-fluorodeoxyglucose ((18)F-FDG) injection and activities were measured. Dose rates were recorded using a Geiger-Muller counter and the total radiation doses were measured with using an electronic personnel dosemeter. According to the results here, 18.4 % of (18)F-FDG was excreted in the urine in 117 min after injection. At 117th min after injection, dose rates were determined as 345, 220, 140, 50 and 15 µSv h(-1), at proposed distances. The radiation doses after 117 min were measured as 3.92 mSv at 0.1 m, 2.11 mSv at 0.25 m and 1.08 mSv at 0.5 m. In conclusion, radiation protection will be sufficient within 2 h after (18)F-FDG injection for PET/CT imaging in daily practice.
CAC is highly prevalent in renal transplant recipients; it is associated with symptoms of coronary ischaemia. Time on transplantation is an independent determinant of CAC. Future studies to evaluate the prognostic significance of CAC in these patients are necessary.
Whole-body FDG PET is an important tool for imaging of cancer, including skeletal metastases. However, false-positive results can occur in benign diseases such as insufficiency fractures. We report a case of sacral insufficiency fracture in which increased FDG uptake was detected. Correlative CT images obtained by a combined PET/CT scanner excluded a possible false-positive interpretation by revealing the fracture lines at the site of increased FDG uptake.
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