• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.413-421
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• 1999

Purpose: This study was performed to evaluate the usefulness of $^{99m}Tc$-HMPAO-labelled leucocyte scintigraphy for diagnosing prosthetic infection after total knee replacement arthroplasty without the aid of following bone marrow scintigraphy Materials and Methods: The study subjects were 25 prostheses of 17 patients (one man and 16 women, mean age. 65 years) who had total knee replacement arthroplasty. After injection of $^{99m}Tc$-HMPAO-labelled leucocyte, the whole body planar and knee SPECT images were obtained in all patients. The subjects were classified into three groups according to clinical suspicion of prosthetic infection. Group A (n=11) with high suspicion of infection; Group B (n=6) with equivocal suspicion of infection, and Group C (n=8) with asymptomatic contralateral prostheses. Final diagnosis of infection was based on surgical, histological and bacteriological data and clinical follow-up. Results: Infection was confirmed in 13 prostheses (11 in Group A and 2 in Group B). All prostheses in Group A were true positive. There were two true positives, one false positive and three true negatives in Group B, and six true negatives and two false positives in Group C. Overall sensitivity, specificity, and accuracy for diagnosis of the infected knee prosthesis were 100%, 75% and 88%, respectively Conclusion: $^{99m}Tc$-HMPAO-labelled leucocyte scintigraphy is a sensitive method for the diagnosis of infected knee prosthesis. However, false positive uptakes even in asymptomatic prosthesis suggest that bone marrow scintigraphy may be needed to achieve improved specificity.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.333-337
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• 1992

In order to establish the clinical significance of pubic bone uptake of radionuclide on $^{99m}Tc-MDP$ bone scintigraphs, we analyzed uptake patterns of normal adult pubic bone in 300 randomly sampled subjects. Bone scintigraphy was performed in each patient for the reasons other than pubic or pelvic problems. One-hundred-fifty-four were men and 146 women. The age ranged from 8 to 78 years. The pubic uptake was graded arbitrarily into 4 grades by comparing the pubic uptake density with that of L5 vertebra. Thus, grade I was defined as the L5 density greater than the pubic density, grade II as the L5 density equals to the pubic density, grade III as the L5 density less than the pubic cdensity, and grade IV as the L5 density much less than the pubic density. Statistical analysis revealed negative trend in the pubic uptake from grade IV to grade I with age. There was no sexual difference in the pubic uptake. The women in the 3rd and 4th decades disclosed higher pubic uptake (grades III, IV) probably due to pregnancy and labor.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.2
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• pp.98-104
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• 1997

We carried out a prospective study of the effectiveness of a diagnostic strategy in thirty consecutively seen patients who had skeletal metastasis. The diagnostic strategy consisted of the recording of a medical history, physical examination, routine laboratory analysis, plain radiography of the involved bone and chest, whole-body technetium-99m-phosphonate bone scintigraphy, abdominal ultrasound, computed tomography of the chest, abdomen and pelvis, fiberbronchoscopy and fibergastroscopy. After this evaluation, a biopsy of the most accessible osseous lesion was done in twenty four patients. On the basis of the our diagnostic strategy, we were able to identify the primary site of the malignant tumor in nineteen patients(63%). The laboratory values were non-specific in all patients. The history and physical examination revealed the occult primary site of the malignant tumor in one patient(3.3%) who had carcinoma of the breast. Plain radiographs of the chest established the diagnosis of carcinoma of the lung in three patients(9.9%). Computed tomography of the chest identified an additional three primary carcinoma of the lung(9.9%). Fiberbronchoscopy identified an additional one primary carcinoma of the lung(3.3%). Abdominal ultrasound established the diagnosis in three patients(9.9%). Computed tomography of the abdomen and pelvis established the diagnosis in four patients(13.2%). Fibergastroscopy established the diagnosis in two patients(6.6%). Examination of the biopsy tissue established the diagnosis in one patient(3.3%). So we recommend to perform plain radiographs of chest, abdominal ultrasound, chest C-T, abdomino-pelvic C-T, fiber-bronchoscopy, fibergastroscopy sequentially.

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.256-260
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• 1993

Thirteen patients received a coralline hydroxyapatite sphere as a buried integrated ocular implant after enucleation surgery. The implant was modified by multiple drillings, 1 mm in diameter, to the center of the sphere to allow more rapid host tissue ingrowth. $^{99m}Tc$-MDP planar and tomographic bone scintigraphies were performed at various intervals after implantation (from 100 to 742 days after operation) to assess vascularization of the implant. All patients showed hot uptakes in the implants. These patients underwent a secondary drilling for the final motility peg application. The confirmation of vascular ingrowth was done by inspection of bleeding at the time of bleeding at the time of drilling from the center of the implant. Bleeding from the drilled implant was noted in all patients. In cnclusion, hot uptake in the implanted ocular hydroxyapatite implant accurately reflect vascular ingrowth into the implant.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.81-86
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• 2011

Background: Facet joint disease plays a major role in axial low-back pain. Few diagnostic tests and imaging methods for identifying this condition exist. Single photon emission computed tomography (SPECT) is reported that it has a high sensitivity and specificity in diagnosing facet disease. We prospectively evaluated the use of bone scintigraphy with SPECT for the identification of patients with low back pain who would benefit from medial branch block. Methods: SPECT was performed on 33 patients clinically suspected of facet joint disease. After SPECT, an ultrasound guided medial branch block was performed on all patients. On 28 SPECT-positive patients, medial branch block was performed based on the SPECT findings. On 5 negative patients, medial branch block was performed based on clinical findings. For one month, we evaluated the patients using the visual analogue scale (VAS) and Oswestry disability index. SigmaStat and paired t-tests were used to analyze patient data and compare results. Results: Of the 33 patients, the ones who showed more than 50% reduction in VAS score were assigned 'responders'. SPECT positive patients showed a better response to medial branch blocks than negative patients, but no changes in the Oswestry disability index were seen. Conclusions: SPECT is a sensitive tool for the identification of facet joint disease and predicting the response to medial branch block.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.76-82
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• 2011

Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.47-50
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• 2013

There has been an increase in the number of reports of atypical manifestations of Graves' disease (GD), such as jaundice, anemia, thrombocytopenia and leukopenia. Pancytopenia also rarely occurs in GD. In this paper, a case of pancytopenia with GD that was successfully treated with an anti-thyroid drug is reported. In this case, a 69-year-old woman showed pancytopenia with a normal peripheral blood smear, bone marrow aspiration smear and bone marrow biopsy. Her thyroid function test and thyroid scintigraphy confirmed her hyperthyroid status. Her laboratory abnormality and clinical condition improved after she was treated with an anti-thyroid drug. This is a rare case of pancytopenia associated with GD.

• The Korean Journal of Nuclear Medicine
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• v.24 no.2
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• pp.337-342
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• 1990

A case of a 39-year-old man with granulocytic sarcoma documented by positive Ga-67 scan is described and brief review of literature was performed. He was diagnosed as acute myelogenous leukemia and got complete remission with antileukemic chemotherapy for 7 months. On admission, picture of his bone marrow and peripheral blood showed remission state of leukemia. Radiologic examinations were performed for evaluation of lesions in head and chest, and findings of granulocytic sarcoma were suspected. So we got $^{67}Ga-citrate$ scan and pleural biopsy for identification of causes of intractable pleural effusion and skin lesion. Myeloblastomas (or granular sarcomas) proved by pleural biopsy were correctly identified by $^{67}Ga-citrate$ scan, and disease extent was clearly delineated. We believe that $^{67}Ga-scintigraphy$ is very helpful in localizing and follow-up evaluation of granulocytic sarcoma.

• The Korean Journal of Nuclear Medicine
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• v.18 no.1
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• pp.67-69
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• 1984

A patient with multiple myeloma, hypercalcemia, and renal failure was found to have diffuse uptake of $^{99m}Tc-MDP$ in his both lungs and stomach. This finding appears to have been due to metastatic calcification of these organs.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.155-159
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• 1992

Sternocostoclavicular hyperostosis (SCCH) is a chronic, nonsuppurative inflammatory disease involving sternum, clavicle, upper ribs and its adjacent soft tissue. It is a relatively newly described syndrome, characterized by ossification in the region between the clavicle and the first rib, and hyperostosis of the medial end of the clavicle with simultaneous involvement of the sternum and juxtasternal ribs. We experienced one case of sternocostoclavicular hyperostosis, diagnosed by pinhole bone scintigraphy. This paper describes characteristic pinhole scintigraphic findings of SCCH, with comparative study with radiographic and pathologic findings.