The aim of this study was to compare the visualization of brain tumors with Iodine-123-Methyl Tyrosine (l-123-MT) and Indium-111-Octreotide (ln-111-Oc). We used l-123-MT (FZ-Seibersdorf), administering 222 MBq and planar images were performed 10min and 1hr after application. In 5 pts SPECT images were performed too. Not earlier than 48hrs 244 MBq In-111-Oc (OctreoScan{sup {reg_sign}}, Mallincrodt) were injected and planar images 4 and 24 hrs after application performed. In 9 pts SPECT images were performed (4hrs p.appl.). A digital Anger camera was used for data acquisition and processing (APEX 409A, Elscint). A total of 12 pts (8 male, 4 female age ranging from 45-71 yrs) were investigated. using a region of interest technique tumor-to-brain tissue rations (T/BT) were calculated. Diagnosis of tumor was established by neurosurgical procedures. 6 pts with glioblastoma showed a high uptake with in-111-Oc (T/BT 1.7 {plus_minus}0.5) and also with l-123-MT T/BT: 1.5{plus_minus}0.4 (10 {prime}) and 1.45 {plus_minus}0.45 (1h). In 2 menigiomas the images with ln-111-Oc were very good (T/BT: 3.1, 3.6 (4hr pl)) and were negative with l-123-MT. In 4 metastases we found a low uptake in 2 pts with l-123-MT T/BT (10{prime}): 1.3 and 1.25; T/BT (1h): 1.25 and 1.2 and ln-111-Oc (T/BT (4h pl): 1.6more » and 1.4). These were pts with brain metastases of adeno carcinoma. In two pts with brain metastases of small cell lung cancer we found good images with both substances I-123-MT T/BT: 1.6 and 1.7 (1h) and ln-111-Oc T/BT: 2.5 and 2.6 (4h pl). In summary, glioblastoma showed concordant images with both substances and also metastases, meningiomas showed discordant images. SPECT acquisition is possible with both substances and sometimes advisable.« less
Kroiss, A.; Böck, F.; Auinger, Ch.; Perneczky, G.; Angelberger, P.; Neumayr, A. Author Information
The aim of our study was to evaluate the clinical usefulness of a monoclonal antibody (MAB; BW 250/183; Behringwerke, Germany) in patients with suspected perioperative septic foci. The MAB is directed against the nonspecific crossreacting antigen (NCA 95) which has been found on the surface of human neutrophil granulocytes and which represents a murine immunoglobulin isotype of IgG1. Immunoscintigraphy was performed by labelling the MAB with 740 MBq (20mCi) Tc-99m. Data acquisition followed 4 and 18 to 24 hours after administration by a digital Anger camera (APEX 409A, Elscint). 53 patients were investigated (31 female, 22 male; average age 39 years), 4 patients were twice, 1 patient was 3 times evaluated, which results in a total of 59 studies. 45 patients experienced operation within 12 hours after our investigation, which resulted in 36 true positive, 5 true negative, 3 false negative, and 1 false positive findings. This means a sensitivity of 92%, and specificity of 83%. Immunoscintigraphy with granulocyte antibodies can be performed at any time, the preparation of the radiopharmaceutical is simple, the image quality is high; the obtained information concerning localization and size of perioperative septic infections permits the determination of the optimal point of time for surgical intervention. The accumulation of activity was visible as early as 4 hours post application. SPECT would enhance the diagnostic accuracy, but this technique cannot be applied in all such patients.
After the introduction of computed tomography intracerebral haemorrhage (ICH) was diagnosed more frequently. We discuss the role of surgical strategies for treatment of ICH of different aetiology. The main factors for surgical intervention for ICH (except vascular malformations) are: degree of midline shift, deformation of neurological deficit or consciousness-level and ventricular enlargement. In small hematomas surgical evacuation is of no benefit for final outcome.
We evaluated the monoclonal antibody MAb, BW 250/183, which is easy to label with Tc-99m, with respect to its clinical application for the detection of inflammatory processes in bone and joint diseases. This monoclonal antibody is a murine immunoglobulin (IgG1 isotype), directed against NCA 95 (nonspecific cross-reacting antigen), which is also present on the surface of neutrophil granulocytes. We investigated patients with acute (n = 9) and chronic (n = 3) osteomyelitis, with coxitis (n = 3) and coxarthrosis (n = 2), with septic hip prosthesis (n = 8) and loosening hip prosthesis (n = 14), with low back pain (n = 4), with spondylitis (n = 5) and with postoperative spondylodiscitis (n = 9). With reference to the total number of patients examined in this study we found 29 true positive results, 22 true negative results, 4 false negative results and 2 false positive results. This gives a sensitivity of 88% and a specificity of 92%. The lesions were already visualized within 4 to 6 hours, but 24 hour pictures are desirable. SPECT pictures are mandatory in patients with diseases of the hip or of the spine because sensitivity is considerably improved thereby.
We evaluated the monoclonal antibody MAb, BW 250/183, which is easy to label with Tc-99m, with respect to its clinical application for the detection of inflammatory processes in bone and joint diseases. This monoclonal antibody is a murine immunoglobulin (IgG1 isotype), directed against NCA95 (nonspecific cross-reacting antigen), which is also present on the surface of neutrophil granulocytes. We investigated patients with acute (n = 9) and chronic (n = 3) osteomyelitis, with coxitis (n = 3) and coxarthrosis (n = 2), with septic hip prosthesis (n = 8) and loosening hip prosthesis (n = 14), with low back pain (n = 4), with spondylitis (n = 5) and with postoperative spondylodiscitis (n = 9). With reference to the total number of patients examined in this study we found 29 true positive results, 22 true negative results, 4 false negative results and 2 false positive results. This gives a sensitivity of 88% and a specificity of 92%. The lesions were already visualized within 4 to 6 hours, but 24 hour pictures are desirable. SPECT pictures are mandatory in patients with diseases of the hip or of the spine because sensitivity is considerably improved thereby.
Von 1977 bis 1985 wurden 357 Patienten mit rupturiertem zerebralen Aneurysma operiert. In den letzten Jahren wurde die Akutoperation innerhalb von 3 Tagen nach dem Blutungsgeschehen angestrebt. Wir berichten von Änderungen im perioperativen Management und besprechen die wichtigsten intraund postoperativen Komplikationen.
Es wurden 200 Aneurysmen aus den Jahren 1983 bis 1985 retrospektiv überprüft. Für diese Untersuchung wurden Computertomographie (CT), Isotopenzisternographie und operative Ergebnisse herangezogen.
Die Autoren berichten über 2 Fälle von großen arteriovenösen Mißbildungen im Bereich der V. magna Galeni, bei denen durch alleinige Ligatur aller zuführender Arterien ohne Radikalexstirpation der Vene ein anhaltend guter operativer Effekt erzielt werden konnte.