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99mTc-HDP Labeling-A Non-Destructive Method for Real-Time Surveillance of the Osteogenic Differentiation Potential of hMSC during Ongoing Cell Cultures. Int J Mol Sci 2022; 23:ijms232415874. [PMID: 36555513 PMCID: PMC9785440 DOI: 10.3390/ijms232415874] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
99-Metastabil Technetium (99mTc) is a radiopharmaceutical widely used in skeletal scintigraphy. Recent publications show it can also be used to determine the osteogenic potential of human mesenchymal stem cells (hMSCs) by binding to hydroxyapatite formed during bone tissue engineering. This field lacks non-destructive methods to track live osteogenic differentiation of hMSCs. However, no data about the uptake kinetics of 99mTc and its effect on osteogenesis of hMSCs have been published yet. We therefore evaluated the saturation time of 99mTc by incubating hMSC cultures for different periods, and the saturation concentration by using different amounts of 99mTc activity for incubation. The influence of 99mTc on osteogenic potential of hMSCs was then evaluated by labeling a continuous hMSC culture three times over the course of 3 weeks, and comparing the findings to cultures labeled once. Our findings show that 99mTc saturation time is less than 0.25 h, and saturation concentration is between 750 and 1000 MBq. Repeated exposure to γ-radiation emitted by 99mTc had no negative effects on hMSC cultures. These new insights can be used to make this highly promising method broadly available to support researchers in the field of bone tissue engineering using this method to track and evaluate, in real-time, the osteogenic differentiation of hMSC, without any negative influence on the cell viability, or their osteogenic differentiation potential.
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Stowell JT, Walker CM, Chung JH, Bang TJ, Carter BW, Christensen JD, Donnelly EF, Hanna TN, Hobbs SB, Johnson BD, Kandathil A, Lo BM, Madan R, Majercik S, Moore WH, Kanne JP. ACR Appropriateness Criteria® Nontraumatic Chest Wall Pain. J Am Coll Radiol 2021; 18:S394-S405. [PMID: 34794596 DOI: 10.1016/j.jacr.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 10/19/2022]
Abstract
Chest pain is a common reason that patients may present for evaluation in both ambulatory and emergency department settings, and is often of musculoskeletal origin in the former. Chest wall syndrome collectively describes the various entities that can contribute to chest wall pain of musculoskeletal origin and may affect any chest wall structure. Various imaging modalities may be employed for the diagnosis of nontraumatic chest wall conditions, each with variable utility depending on the clinical scenario. We review the evidence for or against use of various imaging modalities for the diagnosis of nontraumatic chest wall pain. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | | | | | - Jonathan H Chung
- Panel Chair; and Vice-Chair, Quality and Section Chief, Chest Imaging, Department of Radiology, University of Chicago, Chicago, Illinois
| | - Tami J Bang
- Co-Director, Cardiothoracic Imaging Fellowship Committee, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado; Co-Chair, membership committee, NASCI; and Membership committee, ad-hoc online content committee, STR
| | - Brett W Carter
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jared D Christensen
- Vice-Chair, Department of Radiology, Duke University Medical Center, Durham, North Carolina; and Chair, Lung-RADS
| | - Edwin F Donnelly
- Chief, Thoracic Imaging, Ohio State University, Columbus, Ohio; Co-Chair Physics Module Committee, RSNA
| | - Tarek N Hanna
- Associate Director, Emergency and Trauma Imaging, Emory University, Atlanta, Georgia; and Director-at-Large, American Society of Emergency Radiology
| | - Stephen B Hobbs
- Vice-Chair, Informatics and Integrated Clinical Operations and Division Chief, Cardiovascular and Thoracic Radiology, University of Kentucky, Lexington, Kentucky
| | | | | | - Bruce M Lo
- Sentara Norfolk General/Eastern Virginia Medical School, Norfolk, Virginia; and Board Member, American College of Emergency Physicians
| | - Rachna Madan
- Associate Fellowship Director, Division of Thoracic Imaging, Brigham & Women's Hospital, Boston, Massachusetts
| | - Sarah Majercik
- Vice-Chair, Surgery for Research and Director, Trauma Research, Intermountain Medical Center, Salt Lake City, Utah; and American Association for the Surgery of Trauma
| | - William H Moore
- Associate Chair, Clinical Informatics and Chief, Thoracic Imaging, New York University Langone Medical Center, New York, New York
| | - Jeffrey P Kanne
- Specialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Srivastava MK, Pagala RM, Kendarla V, Nallapareddy K. Technetium-99m methylene diphosphonate bone scan in evaluation of insufficiency fractures - A pictorial assay and experience from South India. World J Nucl Med 2021; 20:355-360. [PMID: 35018150 PMCID: PMC8686751 DOI: 10.4103/wjnm.wjnm_155_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/21/2021] [Accepted: 06/17/2021] [Indexed: 11/04/2022] Open
Abstract
Insufficiency fractures (IFs) can be challenging to diagnose due to varied presentations, and sometimes, it changes the course of treatment, as in cancer patients in whom it has to be differentiated with metastatic disease. We present the role of Technetium 99m methylene diphosphonate (99mTc-MDP) bone scan, which is a low-cost, simple to perform, whole body diagnostic investigation in the diagnosis of IFs. This is a retrospective analysis of all patients who underwent a 99mTc-MDP bone scan in a tertiary care teaching hospital during 2013-2017 and were diagnosed as having an IF on bone scan. The bone scans were performed on a dual-head gamma camera using low-energy high-resolution collimators. Of all the bone scan performed during 2013-2017, a total of 138 patients with a mean age of 57.5 ± 14.7 years were diagnosed as having IFs based on bone scan and final clinical diagnosis. Among them, the most common complaint was regional bony pain in 62% of patients, while the most common cause was osteoporosis in 47% of patients, both postmenopausal and senile osteoporosis. In all, 265 sites of fractures were identified with a fracture average of 1.9/patient, the most common site being dorsolumbar vertebrae, followed by ribs and lower limb bones. Many unusual sites were also identified such as talus, sternum, clavicle, and scapula. 99mTc-MDP bone scan, being noninvasive whole-body imaging, is a useful investigation for evaluation of IFs and in correlation with biochemical analysis and other imaging can be used to determine the etiology of IF.
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Affiliation(s)
- Madhur Kumar Srivastava
- Department of Nuclear Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Ram Manohar Pagala
- Department of Nuclear Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Vinodh Kendarla
- Department of Nuclear Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Kavitha Nallapareddy
- Department of Nuclear Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
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Abstract
Radiolabeled bisphosphonates were developed in the 1970s for scintigraphic functional imaging of the skeleton in benign and malignant disease. Tracers such as 99mTc-methylene diphosphonate, that map focal or global changes in mineralization in the skeleton qualitatively and quantitatively, have been the backbone of nuclear medicine imaging for decades. While competing technologies are evolving, new indications and improvements in scanner hardware, in particular hybrid imaging (e.g. single photon emission computed tomography combined with computed tomography), have allowed improved diagnostic accuracy and a continued role for radiolabeled bisphosphonate imaging in current practice.
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Affiliation(s)
- Gary J R Cook
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
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Ghodasara N, Yi PH, Clark K, Fishman EK, Farshad M, Fritz J. Postoperative Spinal CT: What the Radiologist Needs to Know. Radiographics 2020; 39:1840-1861. [PMID: 31589573 DOI: 10.1148/rg.2019190050] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
During the past 2 decades, the number of spinal surgeries performed annually has been steadily increasing, and these procedures are being accompanied by a growing number of postoperative imaging studies to interpret. CT is accurate for identifying the location and integrity of implants, assessing the success of decompression and intervertebral arthrodesis procedures, and detecting and characterizing related complications. Although postoperative spinal CT is often limited owing to artifacts caused by metallic implants, parameter optimization and advanced metal artifact reduction techniques, including iterative reconstruction and monoenergetic extrapolation methods, can be used to reduce metal artifact severity and improve image quality substantially. Commonly used and recently available spinal implants and prostheses include screws and wires, static and extendable rods, bone grafts and biologic materials, interbody cages, and intervertebral disk prostheses. CT assessment and the spectrum of complications that can occur after spinal surgery and intervertebral arthroplasty include those related to the position and integrity of implants and prostheses, adjacent segment degeneration, collections, fistulas, pseudomeningoceles, cerebrospinal fluid leaks, and surgical site infections. Knowledge of the numerous spinal surgery techniques and devices aids in differentiating expected postoperative findings from complications. The various types of spinal surgery instrumentation and commonly used spinal implants are reviewed. The authors also describe and illustrate normal postoperative spine findings, signs of successful surgery, and the broad spectrum of postoperative complications that can aid radiologists in generating reports that address issues that the surgeon needs to know for optimal patient management.©RSNA, 2019.
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Affiliation(s)
- Nevil Ghodasara
- From the Russell H. Morgan Department of Radiology and Radiologic Science (N.G., P.H.Y., K.C.), Sections of Body CT (E.K.F.) and Musculoskeletal Radiology (J.F.), Johns Hopkins Hospital, 601 N Caroline St, Room 3014, Baltimore, MD 21287; and Spine Division, Department of Orthopedics, Balgrist University Hospital Zurich, Zurich, Switzerland (M.F.)
| | - Paul H Yi
- From the Russell H. Morgan Department of Radiology and Radiologic Science (N.G., P.H.Y., K.C.), Sections of Body CT (E.K.F.) and Musculoskeletal Radiology (J.F.), Johns Hopkins Hospital, 601 N Caroline St, Room 3014, Baltimore, MD 21287; and Spine Division, Department of Orthopedics, Balgrist University Hospital Zurich, Zurich, Switzerland (M.F.)
| | - Karen Clark
- From the Russell H. Morgan Department of Radiology and Radiologic Science (N.G., P.H.Y., K.C.), Sections of Body CT (E.K.F.) and Musculoskeletal Radiology (J.F.), Johns Hopkins Hospital, 601 N Caroline St, Room 3014, Baltimore, MD 21287; and Spine Division, Department of Orthopedics, Balgrist University Hospital Zurich, Zurich, Switzerland (M.F.)
| | - Elliot K Fishman
- From the Russell H. Morgan Department of Radiology and Radiologic Science (N.G., P.H.Y., K.C.), Sections of Body CT (E.K.F.) and Musculoskeletal Radiology (J.F.), Johns Hopkins Hospital, 601 N Caroline St, Room 3014, Baltimore, MD 21287; and Spine Division, Department of Orthopedics, Balgrist University Hospital Zurich, Zurich, Switzerland (M.F.)
| | - Mazda Farshad
- From the Russell H. Morgan Department of Radiology and Radiologic Science (N.G., P.H.Y., K.C.), Sections of Body CT (E.K.F.) and Musculoskeletal Radiology (J.F.), Johns Hopkins Hospital, 601 N Caroline St, Room 3014, Baltimore, MD 21287; and Spine Division, Department of Orthopedics, Balgrist University Hospital Zurich, Zurich, Switzerland (M.F.)
| | - Jan Fritz
- From the Russell H. Morgan Department of Radiology and Radiologic Science (N.G., P.H.Y., K.C.), Sections of Body CT (E.K.F.) and Musculoskeletal Radiology (J.F.), Johns Hopkins Hospital, 601 N Caroline St, Room 3014, Baltimore, MD 21287; and Spine Division, Department of Orthopedics, Balgrist University Hospital Zurich, Zurich, Switzerland (M.F.)
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Font MM. Clinical applications of nuclear medicine in the diagnosis and evaluation of musculoskeletal sports injuries. Rev Esp Med Nucl Imagen Mol 2020. [DOI: 10.1016/j.remnie.2019.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Minoves Font M. Clinical applications of nuclear medicine in the diagnosis and assessment of musculoskeletal sports injuries. Rev Esp Med Nucl Imagen Mol 2019; 39:112-134. [PMID: 31791886 DOI: 10.1016/j.remn.2019.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/15/2019] [Accepted: 09/21/2019] [Indexed: 11/17/2022]
Abstract
Increased participation in sports and physical exercise are widely promoted as an approach to a physically active lifestyle which has a positive effect on healthy aging, in patients and athletes of all ages, beginners and experts, including amateur athletes and professional athletes. Unfortunately, this has caused a higher incidence of sports-related injuries. In the sports context, the early and accurate diagnosis of injuries is of the utmost importance in order to enable early treatment to achieve a full recovery. Imaging techniques are increasingly important for the successful diagnosis and management of the patient. The nuclear medicine techniques with bone tracers provide physiological and metabolic information in the early phases of musculoskeletal injuries, which often precede anatomical changes and they reflect changes in bone turnover. This allows early diagnosis, along with evaluation of the activity and phase of the injury. In this article, the applications of nuclear medicine techniques, focusing on bone scintigraphy, alongside the important contribution of hybrid studies (SPECT/CT), in the diagnosis of bone and soft tissue sports injuries, will be described. In addition, we explain their usefulness in the expression of the pathophysiology of these lesions and their scintigraphic patterns. The article will also describe biomechanical and physiopathological aspects, injury mechanisms and clinical presentations of bone and joint sports injuries, knowledge of this is essential for the correct diagnostic assessment of imaging studies.
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Affiliation(s)
- Montse Minoves Font
- Cetir-Ascires, Barcelona, España; Vocal del Grupo de Patología Musculoesquelética de la SEMNIM, España.
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