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Background/Objective Management of thyroid disorders depends on accurate clinical assessment, appropriate investigations and radionuclide imaging, which plays an established important role either qualitatively or quantitatively. The aim of this study was to assess the utility of the thyroid/salivary ratio (TSR) as an alternative to technetium-99m (Tc99m) pertechnetate thyroid uptake (TcU) percentage in the evaluation of thyroid function and in the same time to establish reference range for the thyroid uptake of Tc99m-pertechnetate and TSR among Egyptian populations. Patients and methods This retrospective study enrolled 270 patients, out of which 250 with different thyroid disorders and 20 without thyroid diseases, as a control group who all underwent full clinical examination, thyroid function tests and Tc99m pertechnetate thyroid scintigraphy. The TcU percentage and TSR were calculated and then correlated to the thyroid hormonal profile. Results The normal reference ranges of TcU and TSR were 0.75–3.5% and 1.25–4.8%, respectively. The sensitivity and specificity of TSR to diagnose hyperthyroidism were slightly lower compared with TcU (84.5 and 92.3% vs. 86.2 and 98.3%, respectively) at TSR cutoff value of more than 4.8 and TcU cutoff value of more than 3.5. Meanwhile, they had comparable sensitivity and specificity to diagnose hypothyroidism (86.0 and 93.3% vs. 86.5 and 94.5%) at cutoff values <0.75 and <1.25, respectively. Conclusion The current study established a reference range for TcU and TSR in our institution. TSR is comparable to TcU in the evaluation of thyroid function among hyper-and hypothyroid patients and TSR can be used in doubtful cases of mal-thyroid function for confirmation of the diagnosis.

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Purpose: Coronary artery disease (CAD) and its related mortality differ between both sex. We study the sex difference in the occurrence of major adverse cardiac events (MACE) among patients undergoing MPI for the detection of CAD and the predictors of MACE among those populations.Methods: This is a prospective cohort study involving patients with known or suspected CAD undergoing MPI for ischemia evaluation from January 2018 to July 2020. All patients were subjected to resting and exercise stress ECG, Gated 99mTc-Sestamibi (MIBI) myocardial perfusion SPECT (GSPECT) using one day stress/rest protocol. All patients were followed up for 1 year or till the occurrence of cardiac event whichever was earlier.Results: one-hundred and sixty-eight patients were enrolled. The mean follow-up period was 13.8 ± 5.3 months. MACE occurred in 25 patients. There was significant difference between MACE & non-MACE groups regarding sex with more MACE among females. High SDS score, high SWTS score, DM and female sex were independent predictors for MACE.Conclusion: MACE is more among women, and female sex is an independent predictor of MACE in CAD patients. Abnormal MPI with higher SDS and SWTS scores are independent predictors for MACE. Females have different model in MACE prediction than males.

Background Bone scintigraphy is a highly sensitive diagnostic nuclear medicine imaging technique that uses a radiotracer to evaluate the distribution of active bone formation in the skeleton related to malignant and benign diseases, as well as physiological processes. Subjective increase of the radioactivity at the sacroiliac joint in cancer patients could indicate physiological, metastatic, or inflammatory (sacroiliitis) cause. In this single-center study, we aimed to settle the normal sacroiliac index (SII) in males and females and if it differs from side to other, as a more accurate quantitative method than qualitative one, and assess its validity in discriminating the cause in pathological increase. Results Sacroiliac index can differentiate physiological uptake at the SIJ from pathological uptake with a highly significant value (P < 0.001). Using SII at a cutoff value 1.17 had 100% sensitivity and specificity in differentiating between the two conditions. The normal SII in our institute ranged from 0.9 to 1.14 with no significant difference between right and left SIJs. The mean SII was 1.33 ± 0.11 in patients with ankylosing spondylitis (AS) and 1.38 ± 0.1 in metastatic cases with no significant difference in SII between the two diseased groups (P = 0.49). Conclusion Bone scintigraphy is widely used in our institute and qualitative assessment of SIJ uptake is sometimes confusing. In this study, we assessed the normal SII range in physiological uptake and assessed a cutoff value (which is lower than other races) above which any increase in SIJ uptake is considered pathological. We could not confirm a cutoff value to discriminate between AS and metastatic affection of SIJ.