Technetium sulfur colloid imaging is widely regarded as a simple, accurate technique for the eval... more Technetium sulfur colloid imaging is widely regarded as a simple, accurate technique for the evaluation of liver size. Although numerous strategies have been proposed for standardizing measurements, none has considered the possibility of a variation depending on whether the patient is imaged erect or recumbent. We imaged several patients in both positions and observed an apparent increase in the vertical length of the liver from supine to upright. We confirmed this by demonstrating a significant increase in the vertical length of both the right and left lobes in a majority of 55 patients imaged in both positions. J NucÃ-Med 27:1632-1634,1986 a method of improving the sensitivity of radi-ocolloid scintigraphy for space-occupying disease, im aging in the upright position has been advocated since it allegedly reduces respiratory motion (7). The matter has been debated in the literature (2) and currently there is no standard practice (3). Standing, sitting, supine, prone, and even decub...
Information about reprints can be found online at: Reprints: document. Permissions and Rights Que... more Information about reprints can be found online at: Reprints: document. Permissions and Rights Question and Answer about this process is available in the located, click Request Permissions in the middle column of the Web page under Services. Further information Editorial Office. Once the online version of the published article for which permission is being requested is can be obtained via RightsLink, a service of the Copyright Clearance Center, not theCirculation Researchin Requests for permissions to reproduce figures, tables, or portions of articles originally publishedPermissions: by guest on April 21,
Timing of diuretic administration is not universally standard-ized in renography. Over the past y... more Timing of diuretic administration is not universally standard-ized in renography. Over the past year, our practice has changed from F-15 administration of furosemide to an F0 protocol. Therefore, we have retrospectively compared these 2 cohorts to assess if the shorter interval between diuretic administration and study completion in the F0 study results in a greater frequency of patients able to complete the sub-sequent 30-min dynamic acquisition without disruption due to voiding. Methods: We identified 108 diuretic 99mTc-mer-captoacetyltriglycine renograms performed in the previous 18-mo period. Three patients were given furosemide at 30 min after the radiopharmaceutical and were excluded. Twenty studies in children under 3 y of age were excluded from consideration because voiding is neither restricted in this age group nor does voiding into a diaper cause disrup-
Forty years after the publication of a landmark paper by the Ad Hoc Committee of the Harvard Medi... more Forty years after the publication of a landmark paper by the Ad Hoc Committee of the Harvard Medical School, the general concept of brain death has achieved widespread acceptance. In the United States, irreversible dysfunction of the brain and brainstem are required for the diagnosis of brain death. Although primarily based on clinical evaluation, confirmatory examinations, including radionuclide blood flow studies, play an important role in augmenting the physical examination in special situations when some of its specific components cannot be performed or reliably evaluated. The 2 main radionuclidic techniques used in evaluation of brain death are radionuclide angiography with nonlipophilic radiopharmaceuticals and parenchymal imaging with lipophilic agents. Specific technical guidelines for determination of brain death have been promulgated by professional medical societies. In the vast majority of cases, blood flow examinations are useful in confirming brain death. Nonetheless, ...
The purpose of this study is to evaluate a pulmonary embolism (PE) perfusion-only screening (POS)... more The purpose of this study is to evaluate a pulmonary embolism (PE) perfusion-only screening (POS) protocol, introduced during the pandemic surge. Subjects without dense parenchymal lung opacities were studied; those with <1 segmental perfusion defect were considered without PE while patients exhibiting ≥1 defects were indeterminate, mandating additional examinations to determine final diagnosis. Methods: We analyzed demographic information, clinical data, imaging findings and follow-up from electronic records in coronavirus disease, 2019 (COVID-19) patients who underwent lung scintigraphy during the 60-day study period. Results: 53 studies were performed in 17 COVID-19 positive and 36 COVID-19 negative patients. The POS protocol efficiently excluded PE in 79% of cases; the remaining 21%, indeterminate for PE, were generally referred for alternative testing or directly anticoagulated. In patients with negative POS studies there was a very low mortality prior to hospital discharge ...
Pertechnetate (as (99m)TcO(4)(-)), (123)I(-), and (131)I(-) have a long and successful history of... more Pertechnetate (as (99m)TcO(4)(-)), (123)I(-), and (131)I(-) have a long and successful history of use in the diagnosis and therapy of thyroid cancer, with uptake into thyroid tissue mediated by the sodium-iodide symporter (NIS). NIS has also emerged as a potential target for radiotherapy of nonthyroid malignancies that express the endogenous or transfected symporter. Perrhenates (as (188)ReO(4)(-) and (186)ReO(4)(-)) are promising therapeutic substrates of NIS, although less is known about their behavior in vivo. In this study, we endeavored to characterize the biologic behavior of perrhenate, especially in relation to iodide and pertechnetate, to better explore its possible therapeutic role.
The use of cardiac implantable electronic devices (CIED) is increasing, and their associated infe... more The use of cardiac implantable electronic devices (CIED) is increasing, and their associated infections result in significant morbidity and mortality. The introduction of better cardiac imaging techniques could be useful for diagnosing this condition and guiding therapy. Our objective was to systematically assess the diagnostic accuracy of Fluor-18-fluorodeoxyglucose positron emission tomography and computed tomography, labeled leukocyte scintigraphy (LS), and Gallium-67 citrate scintigraphy for the diagnosis of CIED infection. A systematic review of the literature and meta-analysis on the use of all 3 modalities in CIED infection were conducted. Pooled sensitivity, specificity, and summary receiver operating characteristic curves of each imaging modalities were determined. The literature search identified 2493 articles. A total of 13 articles (11 studies for (18)F-FDG PET-CT and 2 for LS), met the inclusion criteria. No studies for (67)Ga citrate scintigraphy met the inclusion crit...
Introduction. The purpose of this study is to assess referral patterns and the yield of ventilati... more Introduction. The purpose of this study is to assess referral patterns and the yield of ventilation-perfusion (V/Q) scintigraphy in patients referred for acute pulmonary embolism (PE). Methods. We retrospectively reviewed the charts of all patients who underwent V/Q studies between April 1, 2008, and March 31, 2010. Patients were subdivided into 4 groups based on their referral source: emergency department (ED), hospital inpatient ward, outpatient thrombosis clinic, and all other outpatient sources. Results. A total of 1008 patients underwent V/Q scintigraphy to exclude acute PE. The number of ED, inpatient, thrombosis clinic, and outpatient studies was 43 (4.3%), 288 (28.6%), 351 (34.8%), and 326 (32.3%). Proportion of patients with contrast contraindication varied significantly among the different groups. Of the 1,008 studies, 331 (32.8%) were interpreted as normal, 408 (40.5%) as low, 158 (15.7%) as intermediate, and 111 (11.0%) as high probability for PE. 68 (6.7%) patients unde...
Tuberculosis (TB) remains a major health problem, affecting approximately one-third of the world׳... more Tuberculosis (TB) remains a major health problem, affecting approximately one-third of the world׳s population. The tubercle bacillus can affect virtually any organ of the human body and if left untreated can lead to severe morbidity and death. Diagnosis of active TB is challenging, especially in children. As a "great imitator," the disease can mimic numerous other pathologies, both clinically and at imaging. Although recognition of active TB is crucial to initiate adequate treatment in a timely fashion, thereby preventing transmission of disease, differentiation of active and quiescent disease is not always straightforward. Since the first reports more than 20 years ago, FDG-PET/CT imaging has been shown to detect active disease with accuracy equal or superior to other conventional imaging modalities. The role of FDG-PET in evaluating patients with TB is rapidly expanding. FDG-PET/CT can effectively identify foci of intrathoracic and extrathoracic TB, assess disease activi...
Technetium sulfur colloid imaging is widely regarded as a simple, accurate technique for the eval... more Technetium sulfur colloid imaging is widely regarded as a simple, accurate technique for the evaluation of liver size. Although numerous strategies have been proposed for standardizing measurements, none has considered the possibility of a variation depending on whether the patient is imaged erect or recumbent. We imaged several patients in both positions and observed an apparent increase in the vertical length of the liver from supine to upright. We confirmed this by demonstrating a significant increase in the vertical length of both the right and left lobes in a majority of 55 patients imaged in both positions. J NucÃ-Med 27:1632-1634,1986 a method of improving the sensitivity of radi-ocolloid scintigraphy for space-occupying disease, im aging in the upright position has been advocated since it allegedly reduces respiratory motion (7). The matter has been debated in the literature (2) and currently there is no standard practice (3). Standing, sitting, supine, prone, and even decub...
Information about reprints can be found online at: Reprints: document. Permissions and Rights Que... more Information about reprints can be found online at: Reprints: document. Permissions and Rights Question and Answer about this process is available in the located, click Request Permissions in the middle column of the Web page under Services. Further information Editorial Office. Once the online version of the published article for which permission is being requested is can be obtained via RightsLink, a service of the Copyright Clearance Center, not theCirculation Researchin Requests for permissions to reproduce figures, tables, or portions of articles originally publishedPermissions: by guest on April 21,
Timing of diuretic administration is not universally standard-ized in renography. Over the past y... more Timing of diuretic administration is not universally standard-ized in renography. Over the past year, our practice has changed from F-15 administration of furosemide to an F0 protocol. Therefore, we have retrospectively compared these 2 cohorts to assess if the shorter interval between diuretic administration and study completion in the F0 study results in a greater frequency of patients able to complete the sub-sequent 30-min dynamic acquisition without disruption due to voiding. Methods: We identified 108 diuretic 99mTc-mer-captoacetyltriglycine renograms performed in the previous 18-mo period. Three patients were given furosemide at 30 min after the radiopharmaceutical and were excluded. Twenty studies in children under 3 y of age were excluded from consideration because voiding is neither restricted in this age group nor does voiding into a diaper cause disrup-
Forty years after the publication of a landmark paper by the Ad Hoc Committee of the Harvard Medi... more Forty years after the publication of a landmark paper by the Ad Hoc Committee of the Harvard Medical School, the general concept of brain death has achieved widespread acceptance. In the United States, irreversible dysfunction of the brain and brainstem are required for the diagnosis of brain death. Although primarily based on clinical evaluation, confirmatory examinations, including radionuclide blood flow studies, play an important role in augmenting the physical examination in special situations when some of its specific components cannot be performed or reliably evaluated. The 2 main radionuclidic techniques used in evaluation of brain death are radionuclide angiography with nonlipophilic radiopharmaceuticals and parenchymal imaging with lipophilic agents. Specific technical guidelines for determination of brain death have been promulgated by professional medical societies. In the vast majority of cases, blood flow examinations are useful in confirming brain death. Nonetheless, ...
The purpose of this study is to evaluate a pulmonary embolism (PE) perfusion-only screening (POS)... more The purpose of this study is to evaluate a pulmonary embolism (PE) perfusion-only screening (POS) protocol, introduced during the pandemic surge. Subjects without dense parenchymal lung opacities were studied; those with <1 segmental perfusion defect were considered without PE while patients exhibiting ≥1 defects were indeterminate, mandating additional examinations to determine final diagnosis. Methods: We analyzed demographic information, clinical data, imaging findings and follow-up from electronic records in coronavirus disease, 2019 (COVID-19) patients who underwent lung scintigraphy during the 60-day study period. Results: 53 studies were performed in 17 COVID-19 positive and 36 COVID-19 negative patients. The POS protocol efficiently excluded PE in 79% of cases; the remaining 21%, indeterminate for PE, were generally referred for alternative testing or directly anticoagulated. In patients with negative POS studies there was a very low mortality prior to hospital discharge ...
Pertechnetate (as (99m)TcO(4)(-)), (123)I(-), and (131)I(-) have a long and successful history of... more Pertechnetate (as (99m)TcO(4)(-)), (123)I(-), and (131)I(-) have a long and successful history of use in the diagnosis and therapy of thyroid cancer, with uptake into thyroid tissue mediated by the sodium-iodide symporter (NIS). NIS has also emerged as a potential target for radiotherapy of nonthyroid malignancies that express the endogenous or transfected symporter. Perrhenates (as (188)ReO(4)(-) and (186)ReO(4)(-)) are promising therapeutic substrates of NIS, although less is known about their behavior in vivo. In this study, we endeavored to characterize the biologic behavior of perrhenate, especially in relation to iodide and pertechnetate, to better explore its possible therapeutic role.
The use of cardiac implantable electronic devices (CIED) is increasing, and their associated infe... more The use of cardiac implantable electronic devices (CIED) is increasing, and their associated infections result in significant morbidity and mortality. The introduction of better cardiac imaging techniques could be useful for diagnosing this condition and guiding therapy. Our objective was to systematically assess the diagnostic accuracy of Fluor-18-fluorodeoxyglucose positron emission tomography and computed tomography, labeled leukocyte scintigraphy (LS), and Gallium-67 citrate scintigraphy for the diagnosis of CIED infection. A systematic review of the literature and meta-analysis on the use of all 3 modalities in CIED infection were conducted. Pooled sensitivity, specificity, and summary receiver operating characteristic curves of each imaging modalities were determined. The literature search identified 2493 articles. A total of 13 articles (11 studies for (18)F-FDG PET-CT and 2 for LS), met the inclusion criteria. No studies for (67)Ga citrate scintigraphy met the inclusion crit...
Introduction. The purpose of this study is to assess referral patterns and the yield of ventilati... more Introduction. The purpose of this study is to assess referral patterns and the yield of ventilation-perfusion (V/Q) scintigraphy in patients referred for acute pulmonary embolism (PE). Methods. We retrospectively reviewed the charts of all patients who underwent V/Q studies between April 1, 2008, and March 31, 2010. Patients were subdivided into 4 groups based on their referral source: emergency department (ED), hospital inpatient ward, outpatient thrombosis clinic, and all other outpatient sources. Results. A total of 1008 patients underwent V/Q scintigraphy to exclude acute PE. The number of ED, inpatient, thrombosis clinic, and outpatient studies was 43 (4.3%), 288 (28.6%), 351 (34.8%), and 326 (32.3%). Proportion of patients with contrast contraindication varied significantly among the different groups. Of the 1,008 studies, 331 (32.8%) were interpreted as normal, 408 (40.5%) as low, 158 (15.7%) as intermediate, and 111 (11.0%) as high probability for PE. 68 (6.7%) patients unde...
Tuberculosis (TB) remains a major health problem, affecting approximately one-third of the world׳... more Tuberculosis (TB) remains a major health problem, affecting approximately one-third of the world׳s population. The tubercle bacillus can affect virtually any organ of the human body and if left untreated can lead to severe morbidity and death. Diagnosis of active TB is challenging, especially in children. As a "great imitator," the disease can mimic numerous other pathologies, both clinically and at imaging. Although recognition of active TB is crucial to initiate adequate treatment in a timely fashion, thereby preventing transmission of disease, differentiation of active and quiescent disease is not always straightforward. Since the first reports more than 20 years ago, FDG-PET/CT imaging has been shown to detect active disease with accuracy equal or superior to other conventional imaging modalities. The role of FDG-PET in evaluating patients with TB is rapidly expanding. FDG-PET/CT can effectively identify foci of intrathoracic and extrathoracic TB, assess disease activi...
Uploads
Papers by lionel zuckier