No adverse allergic reactions to iodine-131-metaiodobenzylguanidine ((131)I MIBG) at a diagnostic dose have been reported in the English literature. This report of a skin eruption in a 35-year-old man after an intravenous injection of (131)I MIBG strongly suggests an adverse allergic reaction, and is the first to address such a side effect of (131)I MIBG at a diagnostic dose. Erythematous maculopapular eruptions, some of which were contiguous, were seen in a symmetric disposition on the patient's chest walls, elbows, neck and face 18 h after the (131)I MIBG injection. Antiallergic treatment resolved the lesions completely. There were no possible causes of the exanthema other than the (131)I MIBG injection. Urticaria related to the (131)I MIBG injection and caused by type I allergic reaction was suspected, and these findings point to the possible risk of a hitherto unreported allergic skin reaction to (131)I MIBG. We would like to draw the attention of nuclear physicians to this possible drawback of (131)I MIBG.
Multidetector row computed tomography (MDCT) creates massive amounts of data, which can overload a picture archiving and communication system (PACS). To solve this problem, we designed a new data storage and image interpretation system in an existing PACS. Two MDCT image datasets, a thick- and a thin-section dataset, and a single-detector CT thick-section dataset were reconstructed. The thin-section dataset was archived in existing PACS disk space reserved for temporary storage, and the system overwrote the source data to preserve available disk space. The thick-section datasets were archived permanently. Multiplanar reformation (MPR) images were reconstructed from the stored thin-section datasets on the PACS workstation. In regular interpretations by eight radiologists during the same week, the volume of images and the times taken for interpretation of thick-section images with (246 CT examinations) or without (170 CT examinations) thin-section images were recorded, and the diagnostic usefulness of the thin-section images was evaluated. Thin-section datasets and MPR images were used in 79% and 18% of cases, respectively. The radiologists' assessments of this system were useful, though the volume of images and times taken to archive, retrieve, and interpret thick-section images together with thin-section images were significantly greater than the times taken without thin-section images. The limitations were compensated for by the usefulness of thin-section images. This data storage and image interpretation system improves the storage and availability of the thin-section datasets of MDCT and can prevent overloading problems in an existing PACS for the moment.
It is important to understand the definitive and stereotaxic vascular anatomy of the external carotid artery (ECA) in order to apply effective and safe transcatheter intraarterial infusion chemotherapy for head and neck cancer. We analyzed the branching patterns of the superior thyroid, lingual, facial, occipital and ascending pharyngeal arteries based on 105 digital subtraction external carotid arteriograms from patients with various head and neck cancers (82 males and 23 females; mean age, 65.8 years; age range, 26-88 years old ). The superior thyroid, lingual, facial, occipital or ascending pharyngeal arteries most often arose directly from the ECA in 46%, 67%, 72%, and 46% of subjects, respectively. The linguofacial, thyrolingual or thyrolinguofacial common trunks were more frequently noticed compared with previous reports. Branching of the superior thyroid artery toward the ventral direction was most often observed in 52% of the cases and the proximal portion of the artery showed obtuse, downward angulation in 58% of the cases. The occipital artery arose from between the facial and lingual arteries of the ECA in 50% of the cases. In the cases with linguofacial common trunk, the occipital artery arose from the distal portion of the common trunk branching in 73%. These angiographic analyses of the branching ECA are clinically useful to effectively and safely advance intra-arterial infusion chemotherapy for head and neck cancers.
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