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Öğe 99mTc-dextran scintigraphy to detect disease activity in patients with rheumatoid arthritis(Lippincott Williams & Wilkins, 2004) Kaya, M; Tuna, H; Firat, MF; Tuna, F; Seren, G; Yigitbasi, ÖNAim To test the applicability of Tc-99m-dextran joint scintigraphy in the assessment of disease activity in patients with rheumatoid arthritis (RA), and to compare it with the clinical disease activity scores and laboratory parameters. Methods Twenty-seven patients with RA were investigated using Tc-99m-dextran joint scintigraphy. The images were evaluated semi-quantitatively and the regional uptakes of the radiopharmaceutical were calculated for the knee, wrist and ankle joints. The clinical and laboratory parameters were collected and fully analysed. An articular Ritchie index (a tender joint score), the number of swollen joints (Sw), the number of tender joints, the morning stiffness h, the total Ritchie articular index (R), the visual analogue scale (VAS) and the Disease Activity Score (DAS) were determined for all patients. Results Compared with controls, patients with RA had significantly higher regional Tc-99m-dextran uptake in the knee, wrist and ankle joints (P=0.001). The regional 99mTc-dextran uptake showed no correlation with the patient's age, gender, duration of disease, number of swollen joints (Sw), number of tender joints, morning stiffness (h), VAS, total Ritchie articular index and DAS, or any laboratory parameters. There was a significant correlation between the regional Tc-99m-dextran uptake for individual joints and the articular Ritchie index of the right and left wrist (r=0.42, P=0.03; r=0.45, P=0.02), right and left knee (r=0.66, P<0.0001; r=0.80, P<0.0001) and right and left ankle (r=0.47, P=0.014; r=0.76, P<0.0001), respectively. Conclusions This study demonstrates that 99mTc-dextran scintigraphy is a sensitive method to detect active joint inflammation and could be useful in the management of patients with RA. (C) 2004 Lippincott Williams Wilkins.Öğe Assessment of digital ischaemia and evaluation of response to therapy by 99mTc sestamibi limb scintigraphy after local cooling of the hands in patients with vasospastic Raynaud's syndrome(Lippincott Williams & Wilkins, 2004) Sarikaya, A; Ege, T; Firat, MF; Duran, EAim Cold induced arteriolar constriction in patients with vasospastic Raynaud's syndrome (VRS) produces temporary digital ischaemia. The aim of this study was to ascertain whether Tc-99m sestamibi scintigraphy is useful in the diagnosis and the monitoring of treatment in VRS. Methods Fifteen patients with VRS and 20 matched normal controls underwent examination. Twelve patients with VRS received therapy. For each patient one hand was immersed in iced water for 30s while the other hand served as a control. Ten minutes after cooling, Tc-99m sestamibi was injected and imaging was performed 60 min later. The per cent decrease of the perfusion (%DP) was calculated by semiquantitative analysis to determine the severity of hypoperfusion. Results In all patients with VRS, moderate or marked hypoperfusion were seen in (TC)-T-99m sestamibi images after exposure to the iced water, while there was minimal or mild hypoperfusion in the control groups. Values for %DP were 46.86 +/- 19.04 and 7.85 +/- 4.53 for the VRS group and normal subjects, respectively. The difference between both groups was statistically significant (P = 0.0000). In 12 treated patients with VRS, pre-treatment and post-treatment %DP values were 51.16 +/- 18.42 and 33.58 +/- 17.83, respectively, and a significant difference was seen between both values (P = 0.001). However, there was still a statistically significant difference between control subjects and post-therapy values (7.85 +/- 4.53 vs. 33.58 +/- 17.83, P = 0.0000). The +/- 95% confidence interval of DIP for control subjects was 5.7-10% (chi-squared, P = 0.000). When a DIP of 10% was used as a cut-off point, sensitivity, specificity and diagnostic accuracy were 100%, 70% and 83%, respectively, for the Tc-99m sestamibi scan. There was also a strong correlation between %DP and the duration of the disease (r = 0.80, P = 0.0003). Conclusion The results of this study indicate that a Tc-99m sestamibi scan is a valuable imaging method for the determination of digital ischaemia in vasospastic Raynaud's syndrome, and may play a role in evaluating the response to therapy. (C) 2004 Lippincott Williams Wilkins.Öğe Assessment of Tc-99m sestamibi tumor tissue uptake under the influence of increased arterial oxygen saturation(Elsevier Science Inc, 2005) Cermik, TF; Altiay, G; Firat, MF; Hatipoglu, ON; Berkarda, SThe aim of this study is to investigate the potential effect of increased arterial saturation of oxygen in the magnitude of technetium-99m-hexakis-isobutyl-isonitrile ((99)mTc-MIBI) uptake in tumor tissue and to compare the results with those of conventional Tc-99m-MIBI tumor imaging in the same patient with lung cancer. A total of 26 lung cancer patients underwent initial SPECT (I-SPECT) and after oxygen inhalation SPECT (O-2-SPECT). The early (ER) and delayed ratios (DR) Of O-2-SPECT mean +/- S.D. were significantly higher than those of I-SPECT mean +/- S.D. (2.07 +/- 0.57 vs. 1.90 +/- 0.48 and 2.02 +/- 0.45 vs. 1.83 +/- 0.39, respectively). There are increased rates for the relative tumor uptake of Tc-99m-MIBI by 9% for ER and 10% for DR on the O-2-SPECT compared to I-SPECT. We found that 99mTc-MIBI uptake increased significantly in the tumor tissue with O-2-SPECT compared to I-SPECT. In conclusion, 99mTc-MIBI scintigraphy is one of the main methods for differentiating viable and nonviable tissue fractions in tumors. We consider that 99mTc-MIBI uptake increase after oxygen inhalation is an indicator of positive acute cellular response of the tumor tissue to the rising tissue oxygen level. (c) 2005 Elsevier Inc. All rights reserved.Öğe Comparison of regional cerebral blood flow in early and late onset alcoholic patients(Springer, 2004) Vardar, E; Durmus-Altun, G; Erdogan, E; Firat, MF; Tuglu, C; Caliyurt, O; Abay, E[Abstract Not Available]Öğe Determination of scintigraphic parameters in normal population according to age and gender by using quantitative salivary gland scintigraphy summary(Springer, 2004) Firat, MF; Sarikaya, A; Cermik, TF; Berkarda, S[Abstract Not Available]Öğe Evaluation of maxillary sinus after treatment of midfacial fractures [Meeting Abstract](Springer, 2004) Top, H; Aygit, AC; Sarikaya, A; Karaman, D; Firat, MF[Abstract Not Available]Öğe Evaluation of the factors effecting uptake of Tc-99m MIBI in hyperparathyroidism(Springer, 2004) Cermik, TF; Puyan, FO; Sezer, A; Firat, MF; Berkarda, S[Abstract Not Available]Öğe The fate of intramuscularly injected fat autografts: An experimental study in rabbits(Springer, 2004) Aygit, AC; Sarikaya, A; Doganay, L; Top, H; Cakir, B; Firat, MFAn experimental study was designed to assess the viability and revascularization of intramuscularly injected fat autografts. For the study, 18 rabbits were divided into two groups. In the first group, fat was injected intramuscularly (12 rabbits). Autologous fat was obtained from the inguinal area and subsequently injected into the thigh muscle. In the second group, physiologic saline was injected intramuscularly to determine the effects of cannulation and pressure on muscle tissue (6 rabbits). Fat autografts were performed on the right side of the animal, and the left side was used as the control. Scintigraphic imaging and histopathologic examination of the limbs were performed after injection of adipose tissue on days 15, 30, 45, 60, 90. and 120. On the technetium-99m (Tc-99m) hexamethylpropylene amine oxime scintigraphy, whereas similar activity distribution was observed between the left and right thigh on days 15, 30, and 45, there was increased uptake at the right thigh on days 60, 90, and 120. This increased uptake indicates that there is viable fat tissue in this region. Histopathologic evaluation showed that microcysts resulting from degeneration of some adipocytes and inflammatory changes on day 15 additionally increased vascularity and fibrosis in some animals on day 30, as well as fibrosis, microcysties, and focal calcification areas in adipose tissue on day 45 and later. It was observed that adipose tissue survived in more than 50% of the graft area in all the animals. These findings show that fat autografts can survive in muscle tissue with less than 50% fibrotic change.Öğe Idiopathic osteonecrosis of the second metacarpal head detected on bone scintigraphy(Lippincott Williams & Wilkins, 2004) Cermik, TF; Firat, MFA 29-year-old woman had pain and limited range of motion in the metacarpophalangeal joint of the left second finger for 3 months. The patient had no previous trauma, and there were no factors that could be the cause of her disease. Examination revealed tenderness over the second metacarpophalangeal joint. For the evaluation of pain, x-ray and 3-phase bone scintigraphy were performed. X-rays showed an osteolytic lesion in the head of the left second metacarpal, and a bone scan showed increased activity at the same site. It was determined to be osteonecrosis.Öğe Irbesartan has a masking effect on dipyridamole stress induced myocardial perfusion defects(Lippincott Williams & Wilkins, 2004) Altun, GD; Altun, A; Yildiz, M; Firat, MF; Hacimahmutoglu, S; Berkarda, SBackground and aim The angiotensin 11 type 1 (AT(1)) receptor antagonist irbesartan is used for the treatment of hypertension, but its anti-ischaemic effect is not yet known. Our aim was to assess the effect of irbesartan administration on the diagnostic yield of Tc-99m sestamibi single photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) after dipyridamole stress. Methods Our study group consisted of 13 patients (11 men and two women; mean age, 53.3 +/- 10.6 years; body mass index, 26.9 +/- 3.3 kg.m(-2)) with angiographically documented CAD. All patients underwent Tc-9m sestamibi SPECT studies at rest, before (STRESS-1) and 2 weeks after irbesartan (150 mg daily) administration (STRESS-2) at dipyridamole stress. The extent and severity of defects were analysed by using visual and quantitative Tc-99m sestamibi SPECT. Results The mean summed stress score was significantly higher during the STRESS-1 study than the STRESS-2 study (13.2 +/- 7.4 vs. 11 +/- 74, P=0.003). The mean size of perfusion defects at stress was significantly larger for the STRESS-1 group than the STRESS-2 group (17.8% +/- 2.85% vs. 15.3% +/- 2.95%, P=0.01). Conclusion Our study showed that the AT(1) receptor blocker irbesartan reduces the extent and severity of Tc-99m sestamibi perfusion defects after dipyridamole stress in patients with CAD. Irbesartan may alter coronary blood flow reserve. The continued use of irbesartan before stress myocardial perfusion SPECT has a masking effect on stress induced myocardial perfusion defects. For this reason AT(1) receptor blockers must be stopped before stress myocardial perfusion scintigraphic examinations. (C) 2004 Lippincott Williams Wilkins.Öğe Relation between Tc-99m sestamibi uptake and biological factors in hyperparathyroidism(Japanese Society Nuclear Medicine, 2005) Cermik, TF; Puyan, FO; Sezer, A; Firat, MF; Berkarda, SThe aim of this study was to evaluate the relation between uptake ratios of Tc-99m sestamibi (MIBI) and tumor volume, serum biochemical values (i-PTH, Ca, P) and oxyphil cell content. Materials and Methods: The study population consisted of 19 patients (2 M, 17 F; mean +/- SD: 47 +/- 12 y). Anterior planar images of the neck and chest were acquired early (15 min) and triple late phase (1, 2 and 3-4 h) after intravenous injections of 740 MBq MIBI. Each of the surgical materials was reviewed retrospectively. The percentage of cell type (chief, oxyphil and clear cells) in the tumors was calculated by light microscopy. Results: The uptake ratio obtained from L I (1 hour) phase was found to be higher than the uptake ratio obtained from early phase, and the difference was statistically significant (1.57 +/- 0.34 and 1.43 +/- 0.29, p = 0.004, respectively). There was no significant correlation between uptake ratios that were obtained from 4 different imaging phases and lesion volumes, i-PTH levels and calcium levels (p > 0.05). However, there was a significant adverse correlation between L2 and L3 uptake ratios and serum phosphorus values (r = -0.44, p = 0.04 and r = -0.46, p = 0.04, respectively). Additionally, no significant correlation between MIBI uptake ratios of each imaging phase and the laboratory data, volume of lesion or oxyphil percentage volume was found after the multiple regression analysis (E: p = 0.46, r = 0.49; L1: p = 0.24, r = 0.58; L2: p = 0.27, r = 0.57; L3: p = 0.32, r = 0.55, respectively. There was no correlation between gland oxyphil percentage volume and MIBI uptake ratios (p > 0.05). Conclusion: The results of our study show that the optimal imaging times after intravenous injection of MIBI are 15 minutes and I hour because of the shorter examination time without loss of diagnostic ability. In the present study, there was no significant correlation between MIBI uptake ratios and increased gland volume, or serum Ca and i-PTH levels. Besides, we think that oxyphil cell content may not have a main effect on MIBI uptake and retention. The fact of an adverse relation between phosphorus and MIBI retention in our study suggests that phosphorus level should be considered prior to MIBI imaging.Öğe Tc-99m HMPAO brain SPECT findings in epileptic patients with hypoxic ischemic encephalopathy in the neonatal period(Springer, 2004) Cermik, TF; Oner, N; Alpay, M; Turan, C; Firat, MF; Aladag, N[Abstract Not Available]Öğe Tc-99m MDP bone scintigraphy in a patient with multicentric osteosarcoma(Lippincott Williams & Wilkins, 2003) Çermik, TR; Salan, A; Firat, MF; Berkarda, S[Abstract Not Available]Öğe Technetium-99m sestamibi limb scintigraphy in post-traumatic reflex sympathetic dystrophy: preliminary results(Springer, 2001) Sarikaya, A; Sarikaya, I; Pekindil, G; Firat, MF; Pekindil, YJReflex sympathetic dystrophy (RSD) has widely variable clinical manifestations. Its pathogenesis remains partially unexplained. RSD is commonly divided into three stages; these stages are not always clearly separable. but staging remains important for correct treatment. Since the disease involves soft tissue alterations as well as bone changes, we decided to investigate whether technetium-99m sestamibi limb imaging can be used to evaluate the soft tissue appearance. Fifteen patients (seven females and eight males; age range 12-68 years) with clinically significant post-fracture RSD were evaluated with both three-phase bone scan (TPBS) and Tc-99m-sestamibi limb scintigraphy. Although, in general, patients with similar duration of disease, clinical stage and TPBS activity tended to have similar patterns of sestamibi uptake, discordant uptake patterns were observed in some patients with clinical stage 1. Thus, of 12 patients with stage I disease, eight had increased Tc-99m-sestamibi activity in the distal part of the affected limb, while three had normal activity and one had decreased activity. All three patients with stage II disease showed normal Tc-99m-sestamibi uptake. Although most of the patients with increased Tc-99m-sestamibi uptake had increased activity on all three phases of the bone scan, there were discordant results between the scan patterns in other patients. On the basis of these findings, we suggest that Tc-99m-sestamibi imaging may contribute to the differentiation between clinical stages and may permit evaluation of the disease course and selection of appropriate therapy. Tc-99m-sestamibi imaging is not, however, a primary diagnostic procedure for RSD.
