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López DF, Castro MA, Muñoz JM, Cárdenas-Perilla R. Reference values of mandibular condyles metabolic activity: A study using 99m Tc-MDP single-photon emission computed tomography. Orthod Craniofac Res 2020; 24:328-334. [PMID: 33090651 DOI: 10.1111/ocr.12434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/13/2020] [Accepted: 10/15/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the condylar bone metabolic activity in patients with temporomandibular joint health by measuring 99m Tc-MDP uptake using a single-photon emission computed tomography (SPECT) to establish reference values of the uptake difference between condyles and the ratio with respect to the clivus. SETTING AND SAMPLE POPULATION Eighty consecutive patients of both sexes who were admitted to a Nuclear Medicine Centre between 2017 and 2019 were included in the study. METHOD This was an observational cross-sectional study in patients with SPECT indications to evaluate pathologies other than those of the temporomandibular joint. The values of the total and normalized counts in a fixed region of interest of five trans-axial slides were obtained to assess the percentage difference between the sides and the uptake ratio. The reference values are expressed as median and 5th and 95th percentiles. RESULTS The sample included 53 women (66.25%) and 27 men (33.75%) aged 15-55 years. The percentage of uptake difference between condyles was 5.04% (0.46-14.78) for men and 5.17% (0.27-13.21) for women (difference not significant, P = .9). The uptake difference was below 10% in 85% of the subjects (n = 68). The ratio values for total counts in women (0.87, 0.46-1.33) were significantly different (P = .0030) from those in men (1.08, 0.61-2.09). No significant correlation with age was found. CONCLUSIONS These new reference ranges are applicable to the diagnosis of unilateral and bilateral condylar hyperplasia.
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Affiliation(s)
- Diego Fernando López
- Orthodontics Graduate Program, School of Dentistry, Universidad del Valle, Cali, Colombia
| | - María Angélica Castro
- Orthodontics Graduate Program, School of Dentistry, Universidad del Valle, Cali, Colombia
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Scintigraphy of the Liver, Spleen, and Biliary Tree. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Modern radiotherapy techniques have enabled high focal doses of radiation to be delivered to patients with primary and secondary malignancies of the liver. The current clinical practice of radiation oncology has benefitted from decades of research that have informed how to achieve excellent local control and survival outcomes with minimal toxicities. Still, one of the most devastating consequences of radiation to the liver remains a challenge: radiation-induced liver disease (RILD). Here, we will review the current understanding of classic and nonclassic RILD from a clinical perspective, the evaluation and management of patients who are at risk of developing RILD, methods to reduce the likelihood of RILD using modern radiation techniques, and the diagnosis and treatment of radiation-related liver toxicities.
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Everson GT, Hoefs JC, Niemann CU, Olthoff KM, Dupuis R, Lauriski S, Herman A, Milne N, Gillespie BW, Goodrich NP, Everhart JE. Functional elements associated with hepatic regeneration in living donors after right hepatic lobectomy. Liver Transpl 2013; 19:292-304. [PMID: 23239552 PMCID: PMC3600052 DOI: 10.1002/lt.23592] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 11/06/2012] [Indexed: 12/12/2022]
Abstract
We quantified the rates of hepatic regeneration and functional recovery for 6 months after right hepatic lobectomy in living donors for liver transplantation. Twelve donors were studied pre-donation (baseline); 8 were retested at a mean ± SD of 11±3 days after donation (T1), 10 were retested at a mean of 91±9 days after donation (T2), and 10 were retested at a mean of 185±17 days after donation (T3). Liver and spleen volumes were measured with computed tomography (CT) and single-photon emission computed tomography (SPECT). Hepatic metabolism was assessed with caffeine and erythromycin, and hepatic blood flow (HBF) was assessed with cholates, galactose, and the perfused hepatic mass (PHM) by SPECT. The regeneration rates (mL kg(-1) of body weight day(-1)) by CT were 0.60±0.22 mL from the baseline to T1, 0.05±0.02 mL from T1 to T2, and 0.01±0.01 from T2 to T3; by SPECT they were 0.54±0.20, 0.04±0.01, and 0.01±0.02, respectively. At T3, the liver volumes were 84%±7% of the baseline according to CT and 92%±13% of the baseline according to SPECT. Changes in the hepatic metabolism did not achieve statistical significance. At T1, the unadjusted clearance ratios with respect to the baseline were 0.75±0.07 for intravenous cholate (P<0.001), 0.88±0.15 for galactose (P=0.07), 0.84±0.08 for PHM (P=0.002), and 0.83±0.19 for the estimated HBF (P=0.06). At T1, these ratios adjusted per liter of liver were up to 50% greater than the baseline values, suggesting recruitment of HBF by the regenerating liver. Increased cholate shunt, increased spleen volume, and decreased platelet count, were consistent with an altered portal circulation. In conclusion, initial hepatic regeneration is rapid, accounts for nearly two-thirds of total regeneration, and is associated with increases in HBF and cholate uptake. Right lobe donation alters the portal circulation of living donors, but the long-term clinical consequences, if there are any, are unknown.
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Affiliation(s)
- Gregory T. Everson
- Section of Hepatology, Division of Gastroenterology and Hepatology, University of Colorado Denver, Aurora, CO
| | - John C. Hoefs
- Division of Radiological Sciences, University of California – Irvine, Irvine, CA
| | - Claus U. Niemann
- Department of Anesthesia & Perioperative Care, University of California San Francisco, San Francisco, CA, Department of Surgery, Division of Transplantation, University of California San Francisco, San Francisco, CA
| | - Kim M Olthoff
- Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Robert Dupuis
- School of Pharmacy, University of North Carolina, Chapel Hill, NC
| | - Shannon Lauriski
- Section of Hepatology, Division of Gastroenterology and Hepatology, University of Colorado Denver, Aurora, CO
| | - Andrea Herman
- Section of Hepatology, Division of Gastroenterology and Hepatology, University of Colorado Denver, Aurora, CO
| | - Norah Milne
- Division of Radiological Sciences, University of California – Irvine, Irvine, CA
| | | | | | - James E. Everhart
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
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Zuckier LS, Freeman LM. Liver, Spleen and Biliary Tree. Clin Nucl Med 2008. [DOI: 10.1007/978-3-540-28026-2_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
In assessing the severity of chronic liver disease, one measures either the fibrotic structure of the liver or liver function. This article reviews the methods for evaluating the severity of liver disease noninvasively by estimating function or structure.
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Affiliation(s)
- John Carl Hoefs
- Department of Medicine, University of California-Irvine University of California Medical Center, 101 City Drive, South Orange, CA 92668, USA.
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