The value of positron emission tomography (PET) and magnetic resonance (MR) imaging in differentiating recurrent rectal cancer and scar was investigated. PET with fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) and MR imaging were performed in 15 patients with suspected recurrence. FDG accumulation in the mass was measured by means of the differential absorption ratio (DAR). All 11 patients with confirmed recurrent rectal cancer had increased accumulation of FDG in the mass (DAR = 4.73 +/- 2.28). Low FDG accumulation in the mass (DAR = 0.97 +/- 0.15) was noted in the remaining four patients, in whom the presence of a scar was proved by means of follow-up observation with or without biopsy. On the MR images, the recurrent tumor could be differentiated from scar in all but one case. The lesion-muscle signal intensity ratios on the T2-weighted images for the recurrent tumor and scar were 2.18 +/- 0.55 and 0.89 +/- 0.30, respectively. PET and MR imaging complement each other in the differential diagnosis between recurrent rectal cancer and scar. PET may also permit the evaluation of the effect of therapy.
The ring opening of alkylidenecyclopropanone acetal under acidic conditions produces the 1-alkylidene-2-oxyallyl cation as an intermediate, which reacts with furan to give the [3 + 2] and [4 + 3] cycloadducts as well as an electrophilic substitution product. The product distribution is controlled by the oxy substituents of the cation and by the solvent employed.
99mTc-sestamibi was the best localization test. mdr1 and mrp were associated with 99Tc-sestamibi washout, but their role in the parathyroid remains unclear.
3D-SSP enhanced performance of the nuclear medicine physicians inspecting SPECT. Performance of the automated diagnosis exceeded that of the physicians inspecting SPECT with and without 3D-SSP.
The sensitivity of the commonly used stress tests for the diagnosis of coronary artery disease was analyzed in 46 patients with significant occlusion (greater than or equal to 70% luminal diameter obstruction) of only one major coronary artery and no prior myocardial infarction. In all patients, thallium-201 perfusion imaging (both planar and seven-pinhole tomographic) and 12 lead electrocardiography were performed during the same graded treadmill exercise test and radionuclide angiography was performed during upright bicycle exercise. Exercise rate-pressure (double) product was 22,307 +/- 6,750 on the treadmill compared with 22,995 +/- 5,622 on the bicycle (p = NS). Exercise electrocardiograms were unequivocally abnormal in 24 patients (52%). Qualitative planar thallium images were abnormal in 42 patients (91%). Quantitative analysis of the tomographic thallium images were abnormal in 41 patients (89%). An exercise ejection fraction of less than 0.56 or a new wall motion abnormality was seen in 30 patients (65%). Results were similar for the right (n = 11) and left anterior descending (n = 28) coronary arteries while all tests but the planar thallium imaging showed a lower sensitivity for isolated circumflex artery disease (n = 7). The specificity of the tests was 72, 83, 89 and 72% for electrocardiography, planar thallium imaging, tomographic thallium imaging and radionuclide angiography, respectively. The results suggest that exercise thallium-201 perfusion imaging is the most sensitive noninvasive stress test for the diagnosis of single vessel coronary artery disease.
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