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The relationships of clinical diagnosis, the effect of blood chemistry, and the clinical implication of increased Ga-67 citrate uptake in the bone marrow of patients with signs and symptoms of fever of unknown origin were studied. Based on intensity of Ga-67 citrate uptake in bone marrow, patients were classified as follows: type 1 when there was no evidence or very faint bone marrow uptake in the vertebrae, type 2 when mild to moderate, type 3 when uptake was severe. The relationships of WBC count, hemoglobin, hematocrit, serum iron, and unsaturated iron-binding capacity with the occurrence of increased bone marrow uptake in the different groups were noted. Analysis of variance with Fisher's protected least significant difference was used. A P value of less than 0.05 was considered significant. The results showed significant differences between types 1 and 2 and between types 1 and 3 for WBC counts, hemoglobin, and hematocrit levels. Serum iron concentration and unsaturated iron-binding capacity, however, did not show any significant differences. Significant changes in WBC count, hemoglobin and hematocrit in patients with fever of unknown origin were accompanied by a varying intensity of Ga-67 citrate uptake in the bone marrow.

The authors performed both Tc-99m HMPAO and Tl-201 scintigraphy in 30 patients with thyroid tumors (21 papillary adenocarcinoma, three solid follicular adenoma, six adenomatous goiter with cystic degeneration). Increased accumulation of both Tc-99m HMPAO and Tl-201 was seen in 14 patients with papillary adenocarcinoma and three with solid follicular adenoma, whereas two patients with papillar adenocarcinoma had low accumulation of both tracers. Of the six patients with adenomatous goiter with cystic degeneration, four had low accumulation of both Tc-99m HMPAO and Tl-201, and one patient had low accumulation of Tc-99m HMPAO only. Iso accumulation (same accumulation as the normal thyroid) of Tc-99m HMPAO was seen in five patients with papillary adenocarcinoma and one with adenomatous goiter. The distribution of Tc-99m HMPAO in the thyroid tumors and normal thyroid tissue was independent of time from 2 to 120 minutes after injection. The results of dynamic studies using Tc-99m HMPAO suggested that the accumulation of Tc-99m HMPAO in thyroid tumors reflected mainly tumor blood flow. The resultant Tc-99m HMPAO images were essentially similar to the Tl-201 images obtained 10 minutes after injection. Tc-99m HMPAO imaging can be a suitable substitute for Tl-201 imaging, and it may possibly be used to estimate tumor blood flow in patients with thyroid tumors.

Myocardial dysfunction in 14 patients with Duchenne's muscular dystrophy (DMD) was evaluated by Tc-99m HSA multigated radionuclide ventriculography (MGRV). Follow-up studies were performed on eight patients for 5 years. Left ventricular ejection fraction and standard deviation of the phase angle were abnormal in all patients older than 15 years. Hypokinetic changes and phase delay were recognizable in most patients older than 17 years. Peak filling rate decreased in patients older than 17 years. MGRV was considered an effective method for evaluating serial changes in cardiomyopathy of patients with DMD.

A 32-year-old man had a giant pigmented nevus in general at birth in the head, face, chest, and back, and mental retardation and right hemiparesls (unknown cause) developed. A malignant melanoma was suspected on clinical evidence plus the images. At cranlotomy, an intracranial primary malignant melanoma was diagnosed that originated in the pia matter with neurocutaneous melanosis.