technetium-tc-99m-exametazime and Lymphoma

A total of 17 patients with histologically proven diagnoses of low-grade astrocytoma (n = 4), high-grade astrocytoma (n = 8), lymphoma (n = 3), and meningioma (n = 2) were examined by using EPISTAR MR imaging. Meningiomas had the highest EPISTAR tumor/white matter contrast and low-grade astrocytomas and lymphomas the lowest. High-grade astrocytomas demonstrated elevated EPISTAR signal with marked regional heterogeneity. There was agreement between tumor vascularity by SPECT and EPISTAR in the five cases where both were done. Our results show that tumor vascularity can be assessed qualitatively by using EPISTAR without the need for contrast medium injection.

Topics: Adult; Aged; Astrocytoma; Brain Neoplasms; Cerebrovascular Circulation; Contrast Media; Echo-Planar Imaging; Female; Glioblastoma; Humans; Image Enhancement; Lymphoma; Magnetic Resonance Imaging; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Topics: Adult; Aged; Brain; Brain Neoplasms; Humans; Lymphoma; Male; Middle Aged; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

The purpose of the presented study was to determine the diagnostic value of correlated EEG and SPECT findings in patients with CNS-manifestations of AIDS. Ten HIV 1 infected patients had been examined. Diagnoses: meningitis (2 x), lymphoma (2 x), necrotizing encephalitis (1 x), toxoplasmosis (7 x) (Some patients had more than one diagnosis). Unenhanced and Gd-DTPA enhanced MR, 99mTc-HM-PAO SPECT and clinical EEG were compared. In 9/10 patients MR demonstrated intracranial lesions. In one patient with necrotizing encephalitis (not detected by MR), SPECT revealed an inhomogeneous cerebral perfusion. Only lymphoma was hyperperfused. Toxoplasmic lesions-when detectable by SPECT-were hypoperfused. Reduced rCBF was also seen in brain regions not affected directly, but functionally associated to altered areas. EEG revealed diffuse signs such as slowing in patients with brain atrophy, but also in those patients with lesions of basal ganglia and thalamus. Focal signs in the EEG were in concordance with imaging findings in only 2/10 patients. In 4/10 patients foci even adjacent to the cortex - as shown by MR - remained undetected by EEG. One patient with an active toxoplasmosis had sharp waves over the affected region. The parallel application of the three methods as suggested in this paper appears useful not only for scientific purposes. In most cases, this procedure provides relevant diagnostic information. It is recommended for AIDS-patients with CNS manifestations of unknown etiology.

Topics: Acquired Immunodeficiency Syndrome; Adult; Brain; Brain Diseases; Brain Neoplasms; Electroencephalography; Encephalitis; HIV-1; Humans; Lymphoma; Magnetic Resonance Imaging; Male; Meningitis; Middle Aged; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Toxoplasmosis

Topics: Adult; Aged; Aged, 80 and over; Brain Neoplasms; Cerebrovascular Circulation; Female; Glioma; Humans; Iodobenzenes; Lymphoma; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Organotechnetium Compounds; Oximes; Regional Blood Flow; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Forty-three patients with suspected benign, inflammatory, or infectious diseases were imaged with [99mTc]HM-PAO-labeled leukocytes and [67Ga]citrate. Technetium-99m leukocytes showed 22 true-positive, no false-positive, 19 true-negative, and two false-negative findings and [67Ga]citrate 23, 7, 12 and 1, respectively. The sensitivity, specificity, and accuracy values with 99mTc leukocytes were 92%, 100%, and 95%, and with [67Ga]citrate 96%, 63%, and 81%. Technetium-99m leukocyte scintigraphy has a promising future in comparison with [67Ga]citrate because of the ready availability of [99mTc]HM-PAO, the good image quality, more rapid results (within few hours), and the lower radiation exposure to the patient with 99mTc leukocytes. The usefulness of 99mTc leukocytes in chronic osteomyelitis needs further evaluation.

Topics: Abdomen; Abscess; Adult; Aged; Blood Vessel Prosthesis; Bone Neoplasms; Citrates; Citric Acid; Female; Hip Prosthesis; Humans; Ilium; Infections; Inflammation; Leukocytes; Lymphoma; Male; Middle Aged; Organometallic Compounds; Oximes; Radionuclide Imaging; Technetium; Technetium Tc 99m Exametazime