technetium-tc-99m-medronate and Coronary-Disease

Erdheim-Chester's disease is a form of histiocytic granulomatosis afflicting the skeletal system and various inner organs. Apart from incidental findings of involvement of various structures and tissues, a complete diagnostic workup to evaluate afflicted bodily parts is not known. The authors we present several specific isotope-diagnostic techniques of a case to support the identification of this rare multisystem infiltrative disease.

Topics: Bone and Bones; Coronary Disease; Erdheim-Chester Disease; Heart; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Orbital Diseases; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Whole Body Imaging

Amyloidosis is characterized by the soft-tissue deposition of amyloid protein. It may occur as a primary disorder but more often is seen as a manifestation of chronic illness. Scattered reports of the affinity of amyloid for bone scanning agents have appeared over many years. Isolated cardiac uptake of Tc-99m HDP is described in a patient with biopsy-proved cardiac amyloidosis on a background of tuberculosis, prostate cancer, and coronary artery disease.

Topics: Aged; Aged, 80 and over; Amyloidosis; Bone and Bones; Cardiomyopathies; Coronary Disease; Heart; Humans; Male; Prostatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Serial determination of radionuclide left ventricular ejection fraction and volumes require a label that remains highly stable after introduction into the human circulation. We have evaluated the in vivo stability of 99Tcm-red blood cells (99Tcm-RBC) labelled in vitro by preparation with small amounts of a stannous agent in 19 patients with coronary artery disease. The distribution volume of 99Tcm-RBC was virtually identical to that of RBC labelled with 51Cr. Labelling efficiency expressed as the cell bound/total activity was more than 95% and remained high throughout 1 h after injection of the label. The effective in vivo half-times (T1/2) calculated from venous blood activity and externally recorded left ventricular end-diastolic frame activity were 342 +/- 103 min (mean +/- S.D.) and 306 +/- 92 min, respectively. A significant correlation, r = 0.86 (p less than 0.01) was found between the T1/2 values calculated from the two methods. Thus, a high in vivo stability of the label was demonstrated with considerable inter-patient variation. The labelling procedure seems suitable for serial performance of radionuclide cardiography within an hour after injection of 99Tcm-RBC. However, serial volume determination necessitates individual calculation of in vivo tracer decay from either venous blood or externally recorded activity in the left ventricular area during steady conditions.

Topics: Aged; Coronary Disease; Erythrocytes; Half-Life; Humans; Isotope Labeling; Middle Aged; Radionuclide Imaging; Stroke Volume; Technetium Tc 99m Medronate; Time Factors

A miniature solid-state mercuric iodide (HgI2) nuclear probe detector has been developed in conjunction with a computerized nuclear probe (Nuclear Stethoscope) to enable continuous non-invasive monitoring of left ventricular function using 99Tc-labelled equilibrium blood pool techniques. Left ventricular ejection fraction was measured in 54 patients undergoing radionuclide angiography with a gamma-camera and with the Nuclear Stethoscope and a good correlation was obtained between both techniques (r = 0.94, n = 54, P less than 0.001). The prototype mercuric iodide detector was compared with the sodium iodide detector of the Nuclear Stethoscope and a study in 41 consecutive patients demonstrated a good correlation for the measurement of ejection fraction, ejection rate, peak filling rate and time to peak filling rate (r = 0.94, 0.89, 0.90 and 0.78 respectively). It may be possible to adapt the mercuric iodide detector for continuous non-invasive monitoring of left ventricular performance in critically ill patients and during physiological or pharmacological interventions.

Topics: Adult; Aged; Cardiac Output; Coronary Disease; Diphosphonates; Female; Heart; Heart Function Tests; Heart Ventricles; Humans; Iodides; Male; Mercury; Mercury Compounds; Middle Aged; Monitoring, Physiologic; Radionuclide Imaging; Stroke Volume; Technetium; Technetium Tc 99m Medronate

Topics: Aged; Carcinoma; Coronary Disease; Diphosphonates; Etidronic Acid; Follow-Up Studies; Heart; Heart Failure; Humans; Male; Organotechnetium Compounds; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate