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Article ; Online: Lung clearance of inhaled aerosol of Tc-99m-methoxyisobutyl isonitrile: relationships with cigarette smoking, age and gender.

Mohan, Hosahalli K / Livieratos, Lefteris / Peters, A Michael

Clinical physiology and functional imaging

2019 Volume 39, Issue 4, Page(s) 236–239

Abstract: Tc-99m-methoxyisobutyl isonitrile (Tc-99m-MIBI) is a radiolabelled xenobiotic, the disappearance rate of which from lungs following inhalation as a radioaerosol correlates inversely with bronchopulmonary multidrug resistance protein 1 (MRP1) expression. ... ...

Abstract	Tc-99m-methoxyisobutyl isonitrile (Tc-99m-MIBI) is a radiolabelled xenobiotic, the disappearance rate of which from lungs following inhalation as a radioaerosol correlates inversely with bronchopulmonary multidrug resistance protein 1 (MRP1) expression. Tc-99m-MIBI clearance has previously been shown to be delayed in cigarette smokers. The aim of the current study was to determine whether smoking correlates with bronchopulmonary MRP1 expression, to confirm that Tc-99m-MIBI disappearance rate from the lungs following inhalation is delayed in smokers, and to determine the effects of gender and age on disappearance rate. Participants underwent dynamic imaging for 40 min over the lungs following inhalation of Tc-99m-MIBI using a double-headed gamma camera. The half-time of clearance was obtained from geometric mean of anterior and posterior counts and averaged between the two lungs. Paraffin-embedded tissue obtained from healthy lung during surgery in 13 patients was graded immunohistochemically for MRP1 as negative (0), weak (1), moderate (2) or strong (3). In 4 non-smokers, grading was 1 in three and 0 in one. In 9 smokers, in contrast, expression was graded 2-3 in 8 and 1 in one (P<0·02). Mean clearance half-time in smokers (142 ± 29 min; n = 17) was longer than in non-smokers (91 ± 14 min; n = 18; P<0·0001). In non-smokers, half-times were not significantly different between men (96 ± 16; n = 6) min and women (88 ± 12 min; P = 0·2). Combining genders into one group, half-time correlated with participant age (P = 0·0005). We conclude that smoking upregulates MRP1 and delays clearance of inhaled Tc-99m-MIBI. There is no significant gender difference in non-smokers but ageing is associated with longer clearance half-times.
MeSH term(s)	Adolescent ; Adult ; Aerosols ; Age Factors ; Cigarette Smoking/adverse effects ; Cigarette Smoking/metabolism ; Cigarette Smoking/physiopathology ; Female ; Half-Life ; Humans ; Inhalation Exposure ; Lung/diagnostic imaging ; Lung/metabolism ; Lung/physiopathology ; Male ; Metabolic Clearance Rate ; Middle Aged ; Multidrug Resistance-Associated Proteins/metabolism ; Non-Smokers ; Organotechnetium Compounds/administration & dosage ; Organotechnetium Compounds/pharmacokinetics ; Predictive Value of Tests ; Radionuclide Imaging ; Radiopharmaceuticals/administration & dosage ; Radiopharmaceuticals/pharmacokinetics ; Sex Factors ; Smokers ; Young Adult
Chemical Substances	Aerosols ; Multidrug Resistance-Associated Proteins ; Organotechnetium Compounds ; Radiopharmaceuticals ; technetium 99m methoxyisobutylisonitrile ; multidrug resistance-associated protein 1 (Y49M64GZ4Q)
Language	English
Publishing date	2019-02-07
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2071203-0
ISSN	1475-097X ; 1475-0961
ISSN (online)	1475-097X
ISSN	1475-0961
DOI	10.1111/cpf.12562
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Article: Clinical Utility of SPECT/CT Imaging Post-Radioiodine Therapy: Does It Enhance Patient Management in Thyroid Cancer?

Hassan, Fahim U / Mohan, Hosahalli K

European thyroid journal

2015 Volume 4, Issue 4, Page(s) 239–245

Abstract: Background: The aim of this study was to evaluate post-therapy iodine-131 single-photon emission computed tomography/computed tomography ((131)I-SPECT/CT) imaging in comparison to conventional planar (131)I whole-body imaging, and to assess its clinical ...

Abstract	Background: The aim of this study was to evaluate post-therapy iodine-131 single-photon emission computed tomography/computed tomography ((131)I-SPECT/CT) imaging in comparison to conventional planar (131)I whole-body imaging, and to assess its clinical impact on the management of patients. Methods: We retrospectively reviewed planar (131)I whole-body and (131)I-SPECT/CT imaging findings in 67 patients who underwent (131)I therapy for thyroid cancer. Two nuclear medicine physicians reviewed the scans independently. The foci of increased tracer uptake were identified in the neck, thorax and elsewhere. Within the neck, the foci of (131)I-increased uptake were graded qualitatively as probable or definite uptake in thyroid remnants and probable or definite uptake in the lymph nodes. Serum thyroglobulin level, histopathology and other imaging findings served as the reference standard. Results: Of the 67 patients, 57 (85%) had radioiodine avid disease and 10 (15%) demonstrated non-radioiodine avid disease. Overall, post-therapy (131)I-SPECT/CT downstaged lymph node staging in 10 patients and upstaged it in 4 patients. This translated into a change of management for 9/57 (16%) patients with radioiodine avid disease. A change of management was observed in 5/10 patients with non-radioiodine avid disease confirmed in the post-(131)I-SPECT/CT study. Additionally, clinically significant findings such as incidental lung cancer, symptomatic pleural effusion and consolidation were also diagnosed in both groups of patients. Conclusion: In patients with thyroid cancer, (131)I-SPECT/CT is a valuable addition to standard post-therapy planar imaging. SPECT/CT also improved diagnostic confidence and provided crucial clinical information leading to change of management for a significant number of these patients.
Language	English
Publishing date	2015-07-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2659767-6
ISSN	2235-0802 ; 2235-0640
ISSN (online)	2235-0802
ISSN	2235-0640
DOI	10.1159/000435836
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Article ; Online: Synthesis, characterization, and radiosynthesis of fluorine-18-AVT-011 as a Pgp chemoresistance imaging marker.

Kumar, Pardeep / Thakur, Riptee / Acharya, Pratap Chandra / Mohan, Hosahalli K / Pallavi, U N / Maheshwari, Divya / Mohammed K M, Afsal / Kumar, Aishwarya / Goud Nerella, Sridhar / Joshi, Raman Kumar / Kumar, Manoj / Nagaraj, Chandana

Scientific reports

2022 Volume 12, Issue 1, Page(s) 18584

Abstract: P-glycoprotein (Pgp) is the most studied ATP-binding cassette (ABC) efflux transporter and contributes to chemoresistance. A few tracers have been developed to detect the in-vivo status of chemoresistance using positron emission tomography (PET) imaging. ...

Abstract	P-glycoprotein (Pgp) is the most studied ATP-binding cassette (ABC) efflux transporter and contributes to chemoresistance. A few tracers have been developed to detect the in-vivo status of chemoresistance using positron emission tomography (PET) imaging. In our study, we have synthesized labeled AVT-011 with fluorine-18 (
MeSH term(s)	Animals ; Mice ; Positron Emission Tomography Computed Tomography ; Tissue Distribution ; Drug Resistance, Neoplasm ; Fluorine Radioisotopes/chemistry ; Positron-Emission Tomography/methods ; Radiopharmaceuticals ; ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism ; ATP-Binding Cassette Transporters/metabolism
Chemical Substances	Fluorine-18 (GZ5I74KB8G) ; Fluorine Radioisotopes ; Radiopharmaceuticals ; ATP Binding Cassette Transporter, Subfamily B, Member 1 ; ATP-Binding Cassette Transporters
Language	English
Publishing date	2022-11-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-22930-6
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Article ; Online: Synthesis, characterization, and radiosynthesis of fluorine-18-AVT-011 as a Pgp chemoresistance imaging marker

Pardeep Kumar / Riptee Thakur / Pratap Chandra Acharya / Hosahalli K. Mohan / U. N. Pallavi / Divya Maheshwari / Afsal Mohammed K M / Aishwarya Kumar / Sridhar Goud Nerella / Raman Kumar Joshi / Manoj Kumar / Chandana Nagaraj

Scientific Reports, Vol 12, Iss 1, Pp 1-

2022 Volume 11

Abstract: Abstract P-glycoprotein (Pgp) is the most studied ATP-binding cassette (ABC) efflux transporter and contributes to chemoresistance. A few tracers have been developed to detect the in-vivo status of chemoresistance using positron emission tomography (PET) ...

Abstract	Abstract P-glycoprotein (Pgp) is the most studied ATP-binding cassette (ABC) efflux transporter and contributes to chemoresistance. A few tracers have been developed to detect the in-vivo status of chemoresistance using positron emission tomography (PET) imaging. In our study, we have synthesized labeled AVT-011 with fluorine-18 (18F) followed by in-vitro and in-vivo analysis. Tosylate AVT-011 precursor was synthesized and characterized by 1H-NMR and 13C-NMR. AVT-011 was labeled with 18F using the nucleophilic substitution method, and a standard set of quality control was performed. The specificity for Pgp was tested in U87MG cells with and without an inhibitor (tariquidar). The biodistribution and in-vivo stability were tested in the small animals (mice). The biodistribution data of [18F]-AVT-011 was extracted from the PET-CT imaging of breast cancer patients (n = 6). The precursor was synthesized with 36 ± 4% yield and 97 ± 2% purity. The labeling was more than 95% with a 42 ± 2% yield, as evaluated by Radio-HPLC. The cell-binding assay showed a specificity of the tracer for Pgp as the uptake increased by twice after blocking the Pgp receptors. The radiotracer showed a hepatorenal excretion pathway for clearance in an animal study. The uptake was higher in the liver, lungs, spleen, and heart at 15 min and decreased at 60 min. The patients' distribution showed similar uptake patterns as observed in the small animals. [18F]AVT-011 was characterized successfully with high radiochemical purity and yield. The in-vitro and in-vivo studies proved its specificity for Pgp and safe for patient use.
Keywords	Medicine ; R ; Science ; Q
Subject code	570
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Clinical Utility of SPECT/CT Imaging Post-Radioiodine Therapy: Does It Enhance Patient Management in Thyroid Cancer?

Hassan, Fahim U. / Mohan, Hosahalli K.

European Thyroid Journal

2015 Volume 4, Issue 4, Page(s) 239–245

Abstract: Background: The aim of this study was to evaluate post-therapy iodine-131 single-photon emission computed tomography/computed tomography (131I-SPECT/CT) imaging in comparison to conventional planar 131I whole-body imaging, and to assess its clinical ... ...

Institution	Nuclear Medicine Department, Borough Wing, Guy's Hospital, London, UK
Abstract	Background: The aim of this study was to evaluate post-therapy iodine-131 single-photon emission computed tomography/computed tomography (131I-SPECT/CT) imaging in comparison to conventional planar 131I whole-body imaging, and to assess its clinical impact on the management of patients. Methods: We retrospectively reviewed planar 131I whole-body and 131I-SPECT/CT imaging findings in 67 patients who underwent 131I therapy for thyroid cancer. Two nuclear medicine physicians reviewed the scans independently. The foci of increased tracer uptake were identified in the neck, thorax and elsewhere. Within the neck, the foci of 131I-increased uptake were graded qualitatively as probable or definite uptake in thyroid remnants and probable or definite uptake in the lymph nodes. Serum thyroglobulin level, histopathology and other imaging findings served as the reference standard. Results: Of the 67 patients, 57 (85%) had radioiodine avid disease and 10 (15%) demonstrated non-radioiodine avid disease. Overall, post-therapy 131I-SPECT/CT downstaged lymph node staging in 10 patients and upstaged it in 4 patients. This translated into a change of management for 9/57 (16%) patients with radioiodine avid disease. A change of management was observed in 5/10 patients with non-radioiodine avid disease confirmed in the post-131I-SPECT/CT study. Additionally, clinically significant findings such as incidental lung cancer, symptomatic pleural effusion and consolidation were also diagnosed in both groups of patients. Conclusion: In patients with thyroid cancer, 131I-SPECT/CT is a valuable addition to standard post-therapy planar imaging. SPECT/CT also improved diagnostic confidence and provided crucial clinical information leading to change of management for a significant number of these patients.
Keywords	Thyroid cancer ; Radioiodine ; Single-photon emission computed tomography/computed tomography
Language	English
Publishing date	2015-07-31
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Clinical Thyroidology / Original Paper
ZDB-ID	2659767-6
ISSN	2235-0802 ; 2235-0640
ISSN (online)	2235-0802
ISSN	2235-0640
DOI	10.1159/000435836
Database	Karger publisher's database

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Article: Cost-effectiveness of 99mTc-sestamibi in predicting response to chemotherapy in patients with lung cancer: systematic review and meta-analysis.

Mohan, Hosahalli K / Miles, Kenneth A

Journal of nuclear medicine : official publication, Society of Nuclear Medicine

2009 Volume 50, Issue 3, Page(s) 376–381

Abstract: Unlabelled: Multidrug resistance (MDR) is a major problem in lung cancer. (99m)Tc-methoxyisobutylisonitrile ((99m)Tc-MIBI) has been demonstrated to be a noninvasive marker for the diagnosis of MDR-related P glycoprotein and MDR-associated protein ... ...

Abstract	Unlabelled: Multidrug resistance (MDR) is a major problem in lung cancer. (99m)Tc-methoxyisobutylisonitrile ((99m)Tc-MIBI) has been demonstrated to be a noninvasive marker for the diagnosis of MDR-related P glycoprotein and MDR-associated protein expression in various solid tumors. Studies have shown that (99m)Tc-MIBI could play a significant role in the management of lung cancer; for example, it could be used in the selection of patients for chemotherapy or radiotherapy or in combined protocols before the start of treatment. Accurate selection of chemosensitive patients with (99m)Tc-MIBI would result not only in effective treatment of patients but also in significant cost savings for health care providers. There is increasing pressure on health care providers to consider costs in medical decision making, particularly in the last decade, as several economic evaluations have appeared in the medical literature. The aims of this study were to undertake a systematic review of the performance of (99m)Tc-MIBI imaging in the assessment of treatment resistance in lung cancer and to use the findings of the review in a decision tree analysis of the potential cost-effectiveness of (99m)Tc-MIBI imaging in selecting lung cancer patients for chemotherapy. Methods: This study included a systematic review of the literature and a meta-analysis together with a cost-effectiveness analysis of studies with a decision tree analysis model. Results: Analysis of the studies revealed that the overall sensitivity of (99m)Tc-MIBI in identifying responders to chemotherapy was 94%, the specificity was 90%, and the accuracy was 92%. The sensitivity analysis revealed an incremental cost-effectiveness ratio of greater than pound30,000 ( approximately $42,900) for the strategy of treating all patients to recover the small loss of life expectancy (7.5 d) associated with the use of (99m)Tc-MIBI to preselect patients for chemotherapy. Conclusion: (99m)Tc-MIBI SPECT can accurately predict which patients with lung cancer will respond to chemotherapy. The use of (99m)Tc-MIBI to preselect patients for chemotherapy has the potential to yield significant cost savings in the health care system without a significant loss of life expectancy for patients.
MeSH term(s)	Cost-Benefit Analysis ; Decision Trees ; Drug Resistance, Neoplasm ; Humans ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/drug therapy ; Lung Neoplasms/economics ; Radiopharmaceuticals/economics ; Technetium Tc 99m Sestamibi/economics ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome
Chemical Substances	Radiopharmaceuticals ; Technetium Tc 99m Sestamibi (971Z4W1S09)
Language	English
Publishing date	2009-03
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	80272-4
ISSN	1535-5667 ; 0161-5505 ; 0097-9058 ; 0022-3123
ISSN (online)	1535-5667
ISSN	0161-5505 ; 0097-9058 ; 0022-3123
DOI	10.2967/jnumed.108.055988
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Article ; Online: Does the Clearance of Inhaled (99m)Tc-Sestamibi Correlate with Multidrug Resistance Protein 1 Expression in the Human Lung?

Mohan, Hosahalli K / Routledge, Thomas / Cane, Paul / Livieratos, Lefteris / Ballinger, James R / Peters, Adrien M

Radiology

2016 Volume 280, Issue 3, Page(s) 924–930

Abstract: Purpose To examine the relation between the lung elimination rate of inhaled technetium 99m ((99m)Tc)-sestamibi and immunohistochemical expression of bronchopulmonary multidrug resistance protein 1 (MRP1) and permeability glycoprotein (P-gp) and assess ... ...

Abstract	Purpose To examine the relation between the lung elimination rate of inhaled technetium 99m ((99m)Tc)-sestamibi and immunohistochemical expression of bronchopulmonary multidrug resistance protein 1 (MRP1) and permeability glycoprotein (P-gp) and assess the repeatability of the inhaled (99m)Tc-sestamibi clearance technique. Materials and Methods (99m)Tc-sestamibi is a known substrate for P-gp and MRP1, which are established cellular drug efflux transporters. The elimination rate of (99m)Tc-sestamibi from the lungs after inhalation as an aerosol has been hypothesized to be regulated by expression of these transporters. Institutional ethics committee approval was received for this prospective study. Written informed consent was obtained from all participants. The clearance of inhaled (99m)Tc-sestamibi from the lungs of 13 patients due to undergo surgery for primary lung cancer (five of 13) or spontaneous pneumothorax (eight of 13) was estimated after dynamic imaging of the lungs during a period of 40 minutes. The time taken to clear 50% of inhaled sestamibi (T1/2) was compared with a semiquantitative immunohistochemical assessment (grade 0-3) of MRP1 and P-gp expression in the lung by using parametric and nonparametric tests. The study was repeated in five participants to assess the repeatability of the technique by using a Bland Altman analysis method. Results MRP1 expression was seen in 12 of 13 patients, while P-gp expression was seen in only two. The mean (99m)Tc-sestamibi elimination rate was faster in patients (n = 6) with low levels of MRP1 expression (grade 0-1) and mean T1/2 of 105 minutes ± 20 (standard deviation), compared with those with higher levels of MRP1 expression (grade 2-3, n = 7) and mean T1/2 of 149 minutes ± 28 (P = .008). Bland-Altman analysis revealed excellent agreement between test and retest values. Conclusion Inhaled (99m)Tc-sestamibi clearance study is a repeatable technique demonstrating significant correlation with MRP1 expression in the lungs. (©) RSNA, 2016.
MeSH term(s)	ATP-Binding Cassette, Sub-Family B, Member 1/metabolism ; Administration, Inhalation ; Adult ; Aged ; Humans ; Immunohistochemistry ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/metabolism ; Middle Aged ; Multidrug Resistance-Associated Proteins/metabolism ; Pneumothorax/diagnostic imaging ; Pneumothorax/metabolism ; Prospective Studies ; Radiopharmaceuticals/administration & dosage ; Radiopharmaceuticals/pharmacokinetics ; Reproducibility of Results ; Technetium Tc 99m Sestamibi/administration & dosage ; Technetium Tc 99m Sestamibi/pharmacokinetics
Chemical Substances	ATP-Binding Cassette, Sub-Family B, Member 1 ; Multidrug Resistance-Associated Proteins ; Radiopharmaceuticals ; Technetium Tc 99m Sestamibi (971Z4W1S09) ; multidrug resistance-associated protein 1 (Y49M64GZ4Q)
Language	English
Publishing date	2016-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.16151389
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Article ; Online: SPECT/CT in imaging foot and ankle pathology-the demise of other coregistration techniques.

Mohan, Hosahalli K / Gnanasegaran, Gopinath / Vijayanathan, Sanjay / Fogelman, Ignac

Seminars in nuclear medicine

2010 Volume 40, Issue 1, Page(s) 41–51

Abstract: Disorders of the ankle and foot are common and given the complex anatomy and function of the foot, they present a significant clinical challenge. Imaging plays a crucial role in the management of these patients, with multiple imaging options available to ...

Abstract	Disorders of the ankle and foot are common and given the complex anatomy and function of the foot, they present a significant clinical challenge. Imaging plays a crucial role in the management of these patients, with multiple imaging options available to the clinician. The American College of radiology has set the appropriateness criteria for the use of the available investigating modalities in the management of foot and ankle pathologies. These are broadly classified into anatomical and functional imaging modalities. Recently, single-photon emission computed tomography and/or computed tomography scanners, which can elegantly combine functional and anatomical images have been introduced, promising an exciting and important development. This review describes our clinical experience with single-photon emission computed tomography and/or computed tomography and discusses potential applications of these techniques.
MeSH term(s)	Ankle/diagnostic imaging ; Ankle/pathology ; Foot Diseases/diagnostic imaging ; Humans ; Image Processing, Computer-Assisted/methods ; Tomography, Emission-Computed, Single-Photon/methods ; Tomography, X-Ray Computed/methods ; Ultrasonography
Language	English
Publishing date	2010-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	120248-0
ISSN	1558-4623 ; 0001-2998
ISSN (online)	1558-4623
ISSN	0001-2998
DOI	10.1053/j.semnuclmed.2009.08.004
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Article: Detection of finger clubbing and primary lung tumor on Tc-99 MDP bone scintigraphy in a patient with a scaphoid fracture.

Mohan, Hosahalli K / Groves, Ashley M / Clarke, Susan E M

Clinical nuclear medicine

2004 Volume 29, Issue 7, Page(s) 450–451

MeSH term(s)	Fractures, Bone/diagnostic imaging ; Humans ; Lung Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Osteoarthropathy, Secondary Hypertrophic/diagnostic imaging ; Radionuclide Imaging ; Scaphoid Bone/diagnostic imaging ; Scaphoid Bone/injuries ; Technetium Tc 99m Medronate ; Whole-Body Counting
Chemical Substances	Technetium Tc 99m Medronate (X89XV46R07)
Language	English
Publishing date	2004-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	197628-x
ISSN	1536-0229 ; 0363-9762
ISSN (online)	1536-0229
ISSN	0363-9762
DOI	10.1097/01.rlu.0000129131.31329.56
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Article ; Online: Value of lateral blood pool imaging in patients with suspected stress fractures of the tibia.

Mohan, Hosahalli K / Clarke, Susan E M / Centenara, Martin / Lucarelli, Amanda / Baron, Daniel / Fogelman, Ignac

Clinical nuclear medicine

2011 Volume 36, Issue 3, Page(s) 173–177

Abstract: Aim: To critically evaluate the use of lateral blood pool imaging in athletes with lower limb pain and with a clinical suspicion of stress fracture.: Methods: Two experienced nuclear medicine physicians evaluated 3-phase bone scans using 99mTc- ... ...

Abstract	Aim: To critically evaluate the use of lateral blood pool imaging in athletes with lower limb pain and with a clinical suspicion of stress fracture. Methods: Two experienced nuclear medicine physicians evaluated 3-phase bone scans using 99mTc-methylene diphosphonate performed in 50 consecutive patients referred from a specialist sports injury clinic for suspected tibial stress fracture. The vascularity to the tibia as seen on the blood pool (second phase) images in the anterior/posterior views was compared with the lateral/medial view assessments. Stress fractures were presumed to be present when on the delayed images (third phase) there was a focal or fusiform area of increased tracer uptake involving the tibial cortex. Shin splints which are a recognized cause of lower limb pain in athletes mimicking stress fracture were diagnosed if increased tracer uptake was seen extending along the posterior tibial surface with no significant focal or fusiform area of uptake within this. Inter-reviewer agreement for the assessment of vascularity was also assessed using Cohen's Kappa scores. Results: Twenty-four stress fractures in 24 patients and 66 shin splints in 40 patients were diagnosed. In 18 patients stress fracture and shin splints coexisted. In 10 patients no tibial pathology was identified. Of the 24 patients diagnosed with stress fractures, lateral/medial blood pool imaging was superior in the assessment of blood pool activity (P < 0.001) identifying increased vascularity in 21 cases compared with the anterior/posterior views positive in only 11 cases. The inter-reviewer agreement was near perfect for lateral/medial views, κ = 0.86 while very good for anterior/posterior views, κ = 0.68. Conclusion: In patients with suspected tibial stress fractures, lateral views of the tibia provide the optimal method for evaluation of vascularity. Prospective studies with quantitative or semi-quantitative assessment of skeletal vascularity could provide supplementary information relating to the pathophysiology of stress fractures, for example, the time scale of vascular changes after a tibial stress fracture, and potentially could have clinical relevance as to the assessment of the severity of stress fractures and their prognosis.
MeSH term(s)	Adult ; Athletes ; Female ; Fractures, Stress/diagnostic imaging ; Gated Blood-Pool Imaging/methods ; Humans ; Male ; Radionuclide Imaging/methods ; Tibia/blood supply ; Tibia/diagnostic imaging ; Tibial Fractures/diagnostic imaging ; Young Adult
Language	English
Publishing date	2011-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	197628-x
ISSN	1536-0229 ; 0363-9762
ISSN (online)	1536-0229
ISSN	0363-9762
DOI	10.1097/RLU.0b013e318208ef88
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