Deteksi Karakteristik Peluruhan Radionuklida Medis 99Mo Untuk Memperoleh 99mTc Menggunakan Spektrometer Gamma dengan Sumber Standar Cair Campuran 133Ba dan 152Eu

Technetium-99m (99mTc) is a subsidiary of metastable 99Mo with a half-life of 6 hours. The relatively short half-life, causing 99mTc widely used for diagnostic purposes in nuclear medicine, especially in bone scanning for a faster decay. This research aims to determine the optimal time to product formation of 99mTc until elution profiles have detected 99Mo energy. The instrument used is the 99Mo/99mTc generator with standard sources 133Ba and 152Eu liquid mixture. The results obtained showed that 99mTc radioisotope production is still good until the third day elution 99Mo, whereas in the fourth to ninth day 99Mo energy detected on the decline, so that the activity of the 99mTc resulting product cannot be used for diagnosis.

Value of antigranulocyte scintigraphy with Tc-99m-sulesomab in diagnosing combat-related infections of the musculoskeletal system

AimCombat-related extremity injuries are regularly associated with long-term complications such as chronic infection, especially osteomyelitis. Clinical examination and laboratory parameters do not usually allow reliable diagnosis. In contrast, imaging techniques enable constructive assertions to be made about the location and extent of an infection of the peripheral musculoskeletal system. The aim of this study was therefore to determine the diagnostic reliability of three-phase bone scanning and antigranulocyte scintigraphy using Tc-99m-sulesomab (Leukoscan) in the diagnostic clarification of infections associated with combat-related extremity injuries.MethodsTwenty-seven male patients (mean age 33.9 years) with suspected combat-associated infections of the extremities were included in this retrospective analysis. All patients underwent three-phase bone scanning using Tc-99m-HDP followed by antigranulocyte scintigraphy with Tc-99m-sulesomab. In 26 of the 27 patients, a CT scan of affected limb was obtained, where the secondary fusion with single photon emission CT data set was possible. The diagnostic reliability of imaging techniques was validated against microbiological samples obtained during surgery and used as gold standard.ResultsThree-phase bone scanning yielded a positive result in all patients, with 18 scans classified as true positive (TP) and nine scans as false positive (FP). This produced a sensitivity of 100%, a specificity of 0% and a positive predictive value (PPV) of 67%. Antigranulocyte scintigraphy recognised 13 patients as TP, 1 patient as FP, 8 patients as true negative (TN) and 5 patients as false negative (FN), which gave a sensitivity of 72%, a specificity of 88%, a PPV of 93%, a negative predictive value (NPV) of 62% and an accuracy of 78%. CT recognised in 7 cases a TP result, in 3 cases an FP, in 5 cases a TN and in 11 cases an FN result. This produced a sensitivity of 39%, a specificity of 63%, a PPV of 70%, an NPV of 31% and an accuracy of 46%.ConclusionsThree-phase bone scanning did not deliver any diagnostic benefit, since no result was able to differentiate unequivocally between infection-related and reactive changes. Antigranulocyte scintigraphy using Tc-99m-sulesomab represented a highly suitable technique for diagnostically clarifying combat-related infections of the extremities. It is superior to CT in sensitivity, specificity, PPV, NPV and accuracy.

ADRENOMEDULIN DI KARSINOMA PAYUDARA DENGAN METASTASIS

Metastasis is the leading cause of mortality in patients with breast cancer. The molecular biology behind the metastasis is verycomplex and may require changes in the regulation of the cell cycle, protein that promotes autocrine growth loop, and the protein thatcauses epithelial to mesenchymal transition. More complex, it is clear that the biology of metastasis is partly governed by the non-tumourcells, including fibroblasts, endothelial cells and myoepithelial cells. Adrenomedullin is an autocrine growth factor produced by the renalcarcinoma cells. However, previous studies indicated that adrenomedullin can be secreted in various carcinoma tissue and carcinoma cells.Adrenomedullin may mediate immunosuppression, antiapoptosis, angiogenesis and proliferation, thus it is an important tumour cellsurvival factor underlying human carcinoma genesis. The role of adrenomedullin in the carcinoma genesis, invasion and metastasis hasbeen greatly focused. The aim of this study was to determine the concentration of adrenomedullin in patients with metastatic breast cancer.A total of 64 patients with breast cancer aged 21–90 years (63 women and 1 man) in Jakarta has been participated in this study aftersigning informed consent. Metastasis was confirmed by examination of bone scanning. Concentrations of adrenomedullin were measuredby EnzymeLinked Immunosorbent Assay (ELISA) using a commercial kit. Based on examination of bone scanning, there were 24 (37.5%)subjects with metastasis and 40 (62.5%) nonmetastasis. Mean of the concentrations of adrenomedullin in the subjects with metastasiswas 252.5 (205.0–299.9) pg/mL, while in the nonmetastasis was 203.1 (178.7–227.5) pg/mL. The concentrations of adrenomedullinwere significantly higher in subjects with metastasis than nonmetastasis (p=0.041). High concentration of adrenomedullin in the subjectswith metastasis suggests that adrenomedullin may be more likely to be involved in metastasis.