Research Articles (Nuclear Medicine)

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Browsing Research Articles (Nuclear Medicine) by Author "Ellmann, A."

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    99mTc-MIBI stress-rest myocardial perfusion scintigraphy in patients with complete left bundle branch block
    (2001) Ellmann, A.; Van Heerden, P. D. R.; Van Heerden, B. B.; Klopper, J. F.
    Background. Patients with complete left bundle branch block (LBBB) often show a false-positive ischaemic pattern in the interventricular septum on thallium-201 (201Tl) stress-rest myocardial perfusion scintigraphy. Equivocal results have been reported with technetium-99m labelled hexakis-methoxyisobutyl isonitrile (99mTc-MIBI) in such patients. The aim of this retrospective study was to determine the effect of LBBB on the septal uptake of 99mTc-MIBI during stress-rest single photon emission computed tomography (SPECT) scintigraphy. Methods. We studied 75 consecutive patients with LBBB, referred for 99mTc-MIBI stress-rest SPECT. Studies were evaluated by visual analysis using a semi-quantitative grading technique. In all patients with abnormal septal segments, the presence or absence of ischaemic heart disease was confirmed either clinically or by means of angiographical examination. Results. Forty-three patients (57.3%) had completely normal studies. Only 15 (20%) had septal abnormalities (11 with reversible and 4 with fixed defects), while 17 patients (22.7%) had abnormal segments in areas other than the interventricular septum. Except for 1 patient lost to follow-up, ischaemic heart disease was confirmed in all the patients with septal changes. Conclusion. We conclude that 99mTc-MIBI is more specific than 201Tl for identifying ischaemic heart disease in the presence of LBBB.
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    A case for the provision of positron emission tomography (PET) in South African public hospitals
    (Health and Medical Publishing Group, 2006-07) Sathekge, M. M.; Warwick, James M.; Vangu, M. D. T.; Ellmann, A.; Mann, M.
    Nuclear medicine is expanding into new areas of clinical practice, of which positron emission tomography (PET) is an example. As in new treatments with labelled monoclonal antibodies, especially for lymphoma, the wide introduction of PET into health care in South Africa presents benefits and challenges to patients, doctors, and funders. PET is an imaging modality that has been available in specialised centres in the developed world since the 1970s. It was initially used as a research tool to image organ function in vivo. The development of the radiopharmaceutical F-18- fluorodeoxyglucose (FDG), a glucose analogue taken up avidly by the majority of tumours, has resulted in PET now being used routinely in the management of many cancer patients in centres with access to it. There has been rapid growth of PET in the developed world and it has also been introduced into developing countries, including Egypt. We welcome government initiatives to establish PET imaging in South Africa, as evidenced by the provision of cyclotrons in Gauteng and Cape Town.
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    The College of Nuclear Physicians of South Africa practice guidelines on peptide receptor radionuclide therapy in neuroendocrine tumours
    (Health and Medical Publishing Group, 2018) Lawal, I.; Louw, L.; Warwick, James M.; Nyakale, N.; Steyn, R.; Lengana, T.; Ellmann, A.; Kotze, T; Vangu, M.; Vorster, M.; Sathekge, M.
    Background: Peptide receptor radionuclide therapy (PRRT) for metastatic or inoperable neuroendocrine tumours (NETs) is a systemic therapy which targets somatostatin receptors overexpressed by differentiated NETs for endoradiotherapy. This guideline has been compiled by the College of Nuclear Physicians of the Colleges of Medicine of South Africa, with endorsement by the South African Society of Nuclear Medicine and the Association of Nuclear Physicians to guide Nuclear Medicine Physicians in its application during the management of these patients. Recommendations: Patients with well- to moderately-differentiated NETs should be comprehensively worked-up to determine their suitability for PRRT. Treatment should be administered by a Nuclear Medicine Physician in a licensed, appropriately equipped and fully staffed facility. Patient monitoring is mandatory during and after each therapy cycle to identify and treat therapy-related adverse events. Patients should also be followed-up after completion of therapy cycles for monitoring of long-term toxicities and response assessment. Conclusion: PRRT is a safe and effective therapy option in patients with differentiated NETs. Its use in appropriate patients is associated with a survival benefit.
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    Peptide receptor radionuclide therapy of neuroendocrine tumors : how important is internal dosimetry?
    (Health and Medical Publishing Group, 2019) Lawal, I.; Louw, L.; Warwick, James; Nyakale, N.; Steyn, R.; Lengana, T.; Ellmann, A.; Kotze, T.; Vangu, M.; Vorster, M.; Sathekge, M.
    No abstract available