Spectrum of 99m-Tc-IDA cholescintigraphic patterns in acute cholecystitis.

Weissmann, Heidi S.; Badia, John; Sugarman, Leroy A.; Kluger, L; Rosenblatt, Ruth; Freeman, Leonărd M.

doi:10.1148/radiology.138.1.7192874

Cited by 98 publications

(9 citation statements)

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“…In summary, we conclude the following: (1) high initial serum transaminase levels may be found in acute biliary tract obstruction more frequently than commonly appreci¬ ated; (2) regardless of initial transaminase levels, sequen¬ tial transaminase measurements may provide a diagnostic clue in acute biliary obstruction; (3) absence of visualization of biliary tract and bowel during cholescintigraphy is a feature of biliary tract obstruction; and (4) the above findings taken together may be virtually diagnostic of acute biliary tract obstruction. Awareness of these features would avoid delay in therapeutic decompression of the biliary tract.…”

Section: Resultsmentioning

confidence: 76%

Serum Transaminase Levels and Cholescintigraphic Abnormalities in Acute Biliary Tract Obstruction

Patwardhan¹,

Smith²,

Farmelant³

1987

Arch Intern Med

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Section: Resultsmentioning

confidence: 76%

Serum Transaminase Levels and Cholescintigraphic Abnormalities in Acute Biliary Tract Obstruction

Patwardhan¹,

Smith²,

Farmelant³

1987

Arch Intern Med

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“…A test that establishes the presence of the obstruction of the cystic duct in the clinical setting of acute cholecystitis is, therefore, very reliable for diagnosis (34). The overall accuracy of 99"Tc-IDA scintigraphy in the detection of acute calculous cholecystitis is 97.6%, with a false-negative rate of 4.8% (35). When the gallbladder is visualized, the diagnosis of acute cholecystitis can be excluded within 10 to 20 min of imaging ( Fig.…”

Section: Part 11: 8emt~-ida Clinical Applicationsmentioning

confidence: 99%

Technetium-99m-iminodiacetic acid organic anions: Review of biokinetics and clinical application in hepatology

Krishnamurthy

1989

Hepatology

104

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Technetium-99m-labeled iminodiacetic acid analogs are a new class of organic anions, taken up and secreted by hepatocyte into hepatic bile by a carrier-mediated organic anion pathway. They provide a new dimension in the assessment of pathophysiology and morphology of the hepatobiliary system. The amount of uptake and the rapidity of its elimination from the liver is dependent upon the structural configuration of the agent as well as the functional integrity of the hepatocyte and the patency of the biliary system. The clinical areas for application are wide and include most of the hepatobiliary diseases. Technetium-99m-iminodiacetic acid, an agent well suited for both planar and single photon tomographic scintigraphy, is ideal for early diagnosis prior to anatomical changes in the hepatobiliary system. The data collection directly from the liver provides quantitation of both regional and global liver diseases. The count-based method for measuring gallbladder emptying overcomes the theoretical disadvantages of geometric tests. Biokinetics and current clinical application of six of the 99mTc-iminodiacetic acid agents are reviewed, and the potential future clinical and research areas of application are indicated.

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“…As the gallbladder relaxes after contraction, a negative pressure within it relative to the biliary ducts results in preferential flow via the cystic duct to the gallbladder rather than through the common duct and into the intestines. Delayed biliary-to-bowel transit is also seen in patients with chronic cholecystitis (13). The reason is uncertain but may be due to an ampullitis caused by recurrent passage of small stones.…”

Section: Partialmentioning

confidence: 99%

Hepatobiliary Scintigraphy in 2014

Ziessman

2014

J Nucl Med

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CE Credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than December 2017. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test. Participants who have already taken the exam using JNM and passed cannot retake the exam.Cholescintigraphy with 99m Tc-hepatobiliary radiopharmaceuticals has been an important, clinically useful diagnostic imaging study for almost 4 decades. It continues to be in much clinical demand; however, the indications, methodology, and interpretative criteria have evolved over the years. This review will emphasize state-of-the-art methodology and diagnostic criteria for various clinical indications, including acute cholecystitis, chronic acalculous gallbladder disease, high-grade and partial biliary obstruction, and the postcholecystectomy pain syndrome, including sphincter-of-Oddi dysfunction and biliary atresia. The review will also emphasize the use of diagnostic pharmacologic interventions, particularly sincalide. Now almost 4 decades old, 99m Tc cholescintigraphy continues to be a radionuclide imaging study in much clinical demand. Its strength lies in the fact that the diagnostic information provided defines pathophysiology rather than anatomy.123 I-and 123 I-rose bengal were the first clinically useful cholescintigraphic agents; however, image quality was relatively poor (Fig. 1). 99m Tc-hepatobiliary radiopharmaceuticals began to be widely used by the early 1980s.The discovery of 99m Tc-hepatobiliary (HIDA) radiopharmaceuticals was by chance. During investigation for a cardiac imaging radiopharmaceutical, it was found that 99m Tclabeled lidocaine was not a good cardiac imaging agent but cleared through the hepatobiliary system. With chemical modification, 99m Tc-HIDA imaging agents were born. Loberg et al. reported on this in 1976 (1). Its structure is simply that of 2 lidocaine analogs bichelated to 99m Tc by iminodiacetic acid (IDA) (Fig. 2). HIDA (hepatoiminodiacetic acid) has long been used as a generic term for cholescintigraphy.Modifications of the benzene ring of the lidocaine analogs resulted in an alphabet soup of hepatobiliary radiopharmaceuticals (PIPIDA, BIDA, EIDA, DIDA, DISIDA, etc.), each with different rates of hepatic uptake and clearance. The first 99m Tc-HIDA radiopharmaceutical was approved for clinical use by the Food and Drug Administration in 1982. Dimethyl IDA (lidofenin [Technescan; Mallinckrodt]) was a major advance, but image quality and diagnostic utility were suboptimal in patients with seru...

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Spectrum of 99m-Tc-IDA cholescintigraphic patterns in acute cholecystitis.

Cited by 98 publications

References 0 publications

Serum Transaminase Levels and Cholescintigraphic Abnormalities in Acute Biliary Tract Obstruction

Serum Transaminase Levels and Cholescintigraphic Abnormalities in Acute Biliary Tract Obstruction

Technetium-99m-iminodiacetic acid organic anions: Review of biokinetics and clinical application in hepatology

Hepatobiliary Scintigraphy in 2014

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