Displaying publications 1 - 20 of 27 in total

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  1. Fulltext Use of gallium-67 in the assessment of response to antibiotic therapy in malignant otitis externa--a case report
    Paramsothy M, Khanijow V, Ong TO
    Singapore Med J, 1997 Aug;38(8):347-9.
    PMID: 9364890
    Malignant Otitis Externa (MOE) can cause considerable morbidity and mortality in affected individuals. The outlook is now much improved with the use of ciprofloxacin, but it is important to ascertain that the infection has been completely eradicated before stopping treatment, as undertreatment may lead to a recurrence which is usually more resistant than the initial infection. Gallium-67 Single Photon Emmision Computerised Tomography (SPECT) is a sensitive and cost effective tool in monitoring the disease activity of MOE, and should be used in the assessment of the response to antibiotic therapy.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon*
  2. The role of 67gallium scintigraphy and high resolution computed tomography as predictors of disease activity in sputum smear-negative pulmonary tuberculosis
    Lai FM, Liam CK, Paramsothy M, George J
    Int J Tuberc Lung Dis, 1997 Dec;1(6):563-9.
    PMID: 9487455
    University Hospital, Kuala Lumpur, Malaysia.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  3. Relapsed and late-onset Nipah encephalitis
    Tan CT, Goh KJ, Wong KT, Sarji SA, Chua KB, Chew NK, et al.
    Ann Neurol, 2002 Jun;51(6):703-8.
    PMID: 12112075
    An outbreak of infection with the Nipah virus, a novel paramyxovirus, occurred among pig farmers between September 1998 and June 1999 in Malaysia, involving 265 patients with 105 fatalities. This is a follow-up study 24 months after the outbreak. Twelve survivors (7.5%) of acute encephalitis had recurrent neurological disease (relapsed encephalitis). Of those who initially had acute nonencephalitic or asymptomatic infection, 10 patients (3.4%) had late-onset encephalitis. The mean interval between the first neurological episode and the time of initial infection was 8.4 months. Three patients had a second neurological episode. The onset of the relapsed or late-onset encephalitis was usually acute. Common clinical features were fever, headache, seizures, and focal neurological signs. Four of the 22 relapsed and late-onset encephalitis patients (18%) died. Magnetic resonance imaging typically showed patchy areas of confluent cortical lesions. Serial single-photon emission computed tomography showed the evolution of focal hyperperfusion to hypoperfusion in the corresponding areas. Necropsy of 2 patients showed changes of focal encephalitis with positive immunolocalization for Nipah virus antigens but no evidence of perivenous demyelination. We concluded that a unique relapsing and remitting encephalitis or late-onset encephalitis may result as a complication of persistent Nipah virus infection in the central nervous system.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  4. Analysis of pediatric subdural empyema outcome in relation to computerized tomography brain scan
    Md Ralib AR, Ariff AR, Shuaib IL, Naing NN, George PJ, Abdullah JM
    Southeast Asian J. Trop. Med. Public Health, 2004 Jun;35(2):434-44.
    PMID: 15691152
    A cross-sectional study was conducted to predict the outcome in patients with subdural empyema, using initial and post-treatment CT scan brain parameters. Data collection was done on those children who were diagnosed to have subdural empyema by CT scan of the brain with contrast, who underwent burrhole evacuation, from February 2000 until April 2002. Numerous factors, such as coma or loss of unconsciousness at diagnosis, age, types of antibiotic, microbiology, extension of empyema, associated cerebral infarction and ventriculitis, were analyzed. Poor prognosis was associated with loss of consciousness, and hypodensity by CT scan at presentation (p < 0.005). Patients with an extensive subdural empyema will have a good outcome if they are treated early and aggressively with antibiotics and burrhole evacuation.
    Matched MeSH terms: Tomography, Emission-Computed
  5. Therapeutic angiogenesis for severe ischemic heart diseases by autologous bone marrow cells transplantation
    Hattori R, Matsubara H
    Mol Cell Biochem, 2004 Sep;264(1-2):151-5.
    PMID: 15544044
    Conventional therapies for severe ischemic heart disease are limited in applicability. While several angiogenesis researches have shown novel efficacy, safety and feasibility for clinical use, recently we have started the clinical trial of a sole cell therapy using autologous bone marrow mononuclear cells transplantation targeted into ischemic hibernating myocardium. Here, we review the background of bone marrow cell research and introduce therapeutic angiogenesis for severe ischemic heart disease by autologous bone marrow cells transplantation.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  6. Fulltext Neuroimaging features of tuberculous meningitis
    Sobri M, Merican JS, Nordiyana M, Valarmathi S, Ai-Edrus SA
    Med J Malaysia, 2006 Mar;61(1):36-40.
    PMID: 16708732 MyJurnal
    Tuberculous meningitis leads to a high mortality rate. However, it responds well to chemotherapy if the treatment is started early. Neuroimaging is one of the most important initial investigations. There were 42 patients diagnosed with tuberculous meningitis in Kuala Lumpur Hospital based on clinical criteria, cerebrospinal fluid analysis and response to anti-tuberculous treatment over a 7 year period. Relevant information was obtained from patients' medical case notes and neuroimaging findings were evaluated. Male to female ratio was 3:1. The three major ethnics and the immigrant groups in Malaysia were represented in this study. The majority of the cases involved the Malays followed by immigrants, Chinese and Indians. The patients' age ranged from 18 to 62 years old with the mean age of 34.4 years. There were 95.2% (n = 40) of patients who presented with various neuroimaging abnormalities and only 2 (4.8%) patients had normal neuroimaging findings. Hydrocephalus and meningeal enhancement were the two commonest neuroimaging features. Other features include infarction, enhancing lesion, tuberculoma, abcess, oedema and calcification. Contrasted CT scan is an adequate neuroimaging tool to unmask abnormal findings in tuberculous meningitis.
    Matched MeSH terms: Tomography, Emission-Computed
  7. Fulltext Computed tomography perfusion of ischaemic stroke patients in a rural Malaysian tertiary referral centre
    Man K, Kareem AM, Ahmad Alias NA, Shuaib IL, Tharakan J, Abdullah JM, et al.
    Singapore Med J, 2006 Mar;47(3):194-7.
    PMID: 16518552
    Computed tomography (CT) perfusion is a new method to diagnose ischaemic stroke especially in developing countries. It identifies the area and is useful to predict the size of final infarction. The aim of this study was to assess cerebral ischaemia with CT perfusion (CTP) among patients with acute ischaemic stroke in Hospital Universiti Sains Malaysia, a tertiary referral centre in a rural setting.
    Matched MeSH terms: Tomography, Emission-Computed*
  8. Fulltext Femoral overgrowth following plate fixation of the fractured femur in children
    Sulaiman AR, Joehaimy J, Iskandar MA, Anwar Hau M, Ezane AM, Faisham WI
    Singapore Med J, 2006 Aug;47(8):684-7.
    PMID: 16865208
    The purpose of this study is to determine the overgrowth phenomenon of the affected femur following plate fixation of femoral fractures in children.
    Matched MeSH terms: Tomography, Emission-Computed
  9. Fulltext The prognostic value of early follow-up computerized tomography of the brain in adult traumatic brain injury
    Kiflie A, Alias NA, Abdul-Kareem MM, Mar W, Abdullah J, Naing NN
    Med J Malaysia, 2006 Oct;61(4):466-73.
    PMID: 17243525 MyJurnal
    A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic hydrocephalus, gliosis and site of gliosis in the follow-up CT scan. There was no direct correlation between the significant predictors on the first CT scan and the follow-up CT scan of the brain.
    Matched MeSH terms: Tomography, Emission-Computed*
  10. A low-cost phantom for simple routine testing of single photon emission computed tomography (SPECT) cameras
    Ng AH, Ng KH, Dharmendra H, Perkins AC
    Appl Radiat Isot, 2009 Oct;67(10):1864-8.
    PMID: 19049851 DOI: 10.1016/j.apradiso.2008.10.010
    A simple sphere test phantom has been developed for routine performance testing of SPECT systems in situations where expensive commercial phantoms may not be available. The phantom was based on a design with six universal syringe hubs set in the frame to support a circular array of six glass blown spheres of different sizes. The frame was then placed into a water-filled CT abdomen phantom and scanned with a triple head camera system (Philips IRIX, USA). Comparison was made with a commercially available phantom (Deluxe Jaszczak phantom). Whereas the commercial phantom demonstrates cold spot resolution, an important advantage of the sphere test phantom was that hot spot resolution could be easily measured using almost half (370MBq) of the activity recommended for use in the commercial phantom. Results showed that the contrast increased non-linearly with sphere volume and radionuclide concentration. The phantom was found to be suitable as an inexpensive option for daily performance tests.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon/instrumentation*; Tomography, Emission-Computed, Single-Photon/methods
  11. Fulltext An Incidental Detection of Popliteal Vein Aneurysm during Labeled Leukocyte Scintigraphy
    Hassan HA, Nazri M, Azman RR
    World J Nucl Med, 2012 May;11(2):81-3.
    PMID: 23372443 DOI: 10.4103/1450-1147.103421
    Technetium (99mTc) exametazime (hexamethylpropyleneamine oxime, HMPAO) labeled leukocyte scintigraphy is mainly used to exclude occult infection in our institution. On review of previously published article, no case of popliteal venous aneurysm was ever diagnosed and detected on labeled leukocyte scintigraphy. We present a rare case of popliteal venous aneurysm which was detected on labeled leukocyte scintigraphy and was further confirmed with single-photon emission computed tomography and computed tomography fusion.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  12. Periodic lateralized epileptiform discharges (PLEDs) in cerebral lupus correlated with white-matter lesions in brain MRI and reduced cerebral blood flow in SPECT
    Aye SM, Lim KS, Ramli NM, Tan CT
    Lupus, 2013 Apr;22(5):510-4.
    PMID: 23358870 DOI: 10.1177/0961203312474705
    This is a case report on an uncommon correlation between periodic lateralized epileptiform discharges (PLEDs) and white-matter lesions in cerebral lupus, and with a reduced cerebral blood flow (CBF) in single-photon emission computed tomography (SPECT). A 47-year-old woman with a long-term history of systemic lupus erythematosus (SLE) presented with a seizure followed by frontal lobe dysfunction clinically. An electroencephalogram (EEG) showed bilateral independent PLEDs in the frontal region. A magnetic resonance image of the brain showed white-matter changes in the frontal periventricular region. Cerebral angiogram did not reveal any evidence of vasculitis. A cerebral SPECT with tracer injected during the EEG showing PLEDs showed a reduction in CBF in the frontal regions. Clinical recovery was observed with intravenous immunoglobulin. This case shows that PLEDs can be seen with white-matter changes in SLE.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  13. Fusion of gamma scintigraphic and magnetic resonance images improves the anatomical delineation of radiotracer for the assessment of gastrointestinal transit
    Yeong CH, Abdullah BJ, Ng KH, Chung LY, Goh KL, Perkins AC
    Nucl Med Commun, 2013 Jul;34(7):645-51.
    PMID: 23612704 DOI: 10.1097/MNM.0b013e32836141e4
    This paper describes the use of gamma scintigraphic and magnetic resonance (MR) fusion images for improving the anatomical delineation of orally administered radiotracers used in gastrointestinal (GI) transit investigations.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon*
  14. Fulltext Extracorporeal shockwave myocardial therapy is efficacious in improving symptoms in patients with refractory angina pectoris--a multicenter study
    Prasad M, Wan Ahmad WA, Sukmawan R, Magsombol EB, Cassar A, Vinshtok Y, et al.
    Coron Artery Dis, 2015 May;26(3):194-200.
    PMID: 25734606 DOI: 10.1097/MCA.0000000000000218
    OBJECTIVE: Medically refractory angina remains a significant health concern despite major advances in revascularization techniques and emerging medical therapies. We aimed to determine the safety and efficacy of extracorporeal shockwave myocardial therapy (ESMT) in managing angina pectoris.

    METHODS: A single-arm multicenter prospective study was designed aiming to determine the safety and efficacy of ESMT. Patients of functional Canadian Cardiovascular Society class II-IV, despite stable and optimal medical management, with documented myocardial segments with reversible ischemia and/or hibernation on the basis of echocardiography/single-photon emission computerized tomography (SPECT) were enrolled from 2010 to 2012. A total of 111 patients were enrolled, 33 from Indonesia, 21 from Malaysia, and 57 from Philippines. Patients underwent nine cycles of ESMT over 9 weeks. Patients were followed up for 3-6 months after ESMT treatment. During follow-up, patients were subjected to clinical evaluation, the Seattle Angina Questionnaire, assessment of nitrate intake, the 6-min walk test, echocardiography, and SPECT.

    RESULTS: The mean age of the population was 62.9±10.9 years. The summed difference score on pharmacologically induced stress SPECT improved from 9.53±17.87 at baseline to 7.77±11.83 at follow-up (P=0.0086). Improvement in the total Seattle Angina Questionnaire score was seen in 83% of patients (P<0.0001). Sublingual nitroglycerin use significantly decreased (1.14±1.01 tablets per week at baseline to 0.52±0.68 tablets per week at follow-up; P=0.0215). There were no changes in left ventricular function on echocardiography (0.33±9.97, P=0.93). The Canadian Cardiovascular Society score improved in 74.1% of patients.

    CONCLUSION: This multicenter prospective trial demonstrated that ESMT is both a safe and an efficacious means of managing medically refractory angina.

    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  15. Uptake and clearance analysis of Technetium99m labelled iron oxide nanoparticles in a rabbit brain
    Nadeem M, Ahmad M, Saeed MA, Shaari A, Riaz S, Naseem S, et al.
    IET Nanobiotechnol, 2015 Jun;9(3):136-41.
    PMID: 26023157 DOI: 10.1049/iet-nbt.2014.0012
    Nanoparticles as solid colloidal particles are extensively studied and used as anticancer drug delivery agents because of their physical properties. This current research aims to prepare water base suspension of uncoated iron oxide nanoparticles and their biodistribution study to different organs, especially the brain, by using a single photon emission computed tomography gamma camera. The water-based suspension of iron oxide nanoparticles was synthesised by a reformed version of the co-precipitation method and labelled with Tc99m for intravenous injection. The nanoparticles were injected without surface modification. X-ray diffraction (XRD), energy dispersive spectrometry (EDS) and transmission electron microscope (TEM) techniques were used for characterisation. Peaks of XRD and EDS indicate that the particles are magnetite and exist in aqueous suspension. The average diameter of iron oxide nanoparticles without any surface coating determined by TEM is 10 nm. These particles are capable of evading the reticuloendothelial system and can cross the blood-brain barrier in the rabbit. The labelling efficiency of iron oxide nanoparticles labelled with Tc99m is 85%, which is good for the biodistribution study. The sufficient amount of iron oxide nanoparticles concentration in the brain as compared with the surrounding soft tissues and their long blood retention time indicates that the water-based suspension of iron oxide nanoparticles may be an option for drug delivery into the brain.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  16. Neuroimaging in refractory epilepsy. Current practice and evolving trends
    Ramli N, Rahmat K, Lim KS, Tan CT
    Eur J Radiol, 2015 Sep;84(9):1791-800.
    PMID: 26187861 DOI: 10.1016/j.ejrad.2015.03.024
    Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  17. Fulltext Gamma scintigraphic study of the hydrodynamically balanced matrix tablets of Metformin HCl in rabbits
    Razavi M, Karimian H, Yeong CH, Sarji SA, Chung LY, Nyamathulla S, et al.
    Drug Des Devel Ther, 2015;9:3125-39.
    PMID: 26124637 DOI: 10.2147/DDDT.S82935
    The purpose of this study is to evaluate the in vitro and in vivo performance of gastro-retentive matrix tablets having Metformin HCl as model drug and combination of natural polymers. A total of 16 formulations were prepared by a wet granulation method using xanthan, tamarind seed powder, tamarind kernel powder and salep as the gel-forming agents and sodium bicarbonate as a gas-forming agent. All the formulations were evaluated for compendial and non-compendial tests and in vitro study was carried out on a USP-II dissolution apparatus at a paddle speed of 50 rpm. MOX2 formulation, composed of salep and xanthan in the ratio of 4:1 with 96.9% release, was considered as the optimum formulation with more than 90% release in 12 hours and short floating lag time. In vivo study was carried out using gamma scintigraphy in New Zealand White rabbits, optimized formulation was incorporated with 10 mg of (153)Sm for labeling MOX2 formulation. The radioactive samarium oxide was used as the marker to trace transit of the tablets in the gastrointestinal tract. The in vivo data also supported retention of MOX2 formulation in the gastric region for 12 hours and were different from the control formulation without a gas and gel forming agent. It was concluded that the prepared floating gastro-retentive matrix tablets had a sustained-release effect in vitro and in vivo, gamma scintigraphy played an important role in locating the oral transit and the drug-release pattern.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon*
  18. Fulltext Incremental Value of Single-photon Emission Computed Tomography-computed Tomography for Characterization of Skeletal Lesions in Breast Cancer Patients
    Mahaletchumy T, AbAziz A
    World J Nucl Med, 2017 Oct-Dec;16(4):303-310.
    PMID: 29033679 DOI: 10.4103/1450-1147.215496
    The incremental value of single-photon emission computed tomography-computed tomography (SPECT-CT) over planar bone scintigraphy and SPECT in detecting skeletal lesions in breast cancer patients and its effect on patient management is assessed in this study. This is a prospective study which was conducted over 1-year duration. Whole-body planar scintigraphy, SPECT, and SPECT-CT were performed in 85 breast cancer patients with total of 128 lesions. Correlative imaging and clinical follow-up was used as the reference standard. McNemar's multistep analysis was performed for each patient and each lesion. On patient-wise analysis, 47 patients had equivocal diagnosis on planar bone scintigraphy, 28 on SPECT, and eight on SPECT-CT. On lesion-wise analysis, there were 72 equivocal lesions on planar bone scintigraphy, 48 on SPECT, and 15 on SPECT-CT. Overall, SPECT-CT resulted in a significant reduction in the proportion of equivocal diagnosis on both patient-wise (P < 0.004) and lesion-wise basis (P < 0.004), irrespective of the skeletal region involved. The sensitivity on a per-patient basis was 43%, 58%, and 78% for planar bone scintigraphy, SPECT, and SPECT-CT, respectively. Similarly, the specificity was 85%, 92%, and 94% for planar bone scintigraphy, SPECT, and SPECT-CT, respectively. Patient management was correctly altered in 32% of the patients based on SPECT-CT interpretation. Our data suggest that adding SPECT-CT to whole-body imaging significantly improves sensitivity and specificity in diagnosing bone metastases and significantly reduces the proportion of equivocal diagnosis in all regions of the skeleton. The most important outcome is derived from the accurate alteration in patient management clinically by down- and up-staging of patients and a more precise identification of metastatic extent.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  19. The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease
    Suppiah S, Ching SM, Nordin AJ, Vinjamuri S
    Med J Malaysia, 2018 06;73(3):141-146.
    PMID: 29962497
    BACKGROUND: Imaging such as Tc99m-HMPAO single photon emission computed tomography (SPECT), and positron emission tomography/ computed tomography (PET/CT) amyloid scans are used to aid the diagnosis of Alzheimer's disease (AD).

    OBJECTIVE: We aimed to correlate the ability of these modalities to differentiate Probable AD and Possible AD using the clinical diagnosis as a gold standard. We also investigated the correlation of severity of amyloid deposit in the brain with the diagnosis of AD.

    METHODS: A retrospective study of 47 subjects (17 Probable AD and 30 Possible AD) who were referred for PET/CT amyloid scans to our centre was conducted. Hypoperfusion in the temporo-parietal lobes on Tc99m-HMPAO SPECT and loss of grey-white matter contrast in cortical regions on PET/CT Amyloid scans indicating the presence of amyloid β deposit were qualitatively interpreted as positive for AD. SPECT and PET/CT were also read in combination (Combo reading). The severity of amyloid β deposit was semiquantitatively assessed in a visual binary method using a scale of Grade 0-4. The severity of amyloid β deposit was assessed in a visual binary method and a semi-quantitative method using a scale of Grade 0-4.

    RESULTS: There was significant correlation of Tc99m-HMPAO SPECT, PET/CT amyloid findings and Combo reading with AD. The sensitivity, specificity, PPV and NPV were 87.5%, 73.7%, 58.3% and 93.3% (SPECT); 62.5%, 77.4%, 58.8% and 80.0% (PET/CT) and 87.5%, 84.2%, 70.0% and 30.0% (Combo reading) respectively. The grade of amyloid deposition was not significantly correlated with AD (Spearman's correlation, p=0.687).

    CONCLUSION: There is an incremental benefit in utilizing PET/CT amyloid imaging in cases with atypical presentation and indeterminate findings on conventional imaging of Alzheimer's disease.

    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
  20. Fulltext Positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging of macrophages in large vessel vasculitis: Current status and future prospects
    Jiemy WF, Heeringa P, Kamps JAAM, van der Laken CJ, Slart RHJA, Brouwer E
    Autoimmun Rev, 2018 Jul;17(7):715-726.
    PMID: 29729443 DOI: 10.1016/j.autrev.2018.02.006
    Macrophages are key players in the pathogenesis of large-vessel vasculitis (LVV) and may serve as a target for diagnostic imaging of LVV. The radiotracer, 18F-FDG has proven to be useful in the diagnosis of giant cell arteritis (GCA), a form of LVV. Although uptake of 18F-FDG is high in activated macrophages, it is not a specific radiotracer as its uptake is high in any proliferating cell and other activated immune cells resulting in high non-specific background radioactivity especially in aging and atherosclerotic vessels which dramatically lowers the diagnostic accuracy. Evidence also exists that the sensitivity of 18F-FDG PET drops in patients upon glucocorticoid treatment. Therefore, there is a clinical need for more specific radiotracers in imaging GCA to improve diagnostic accuracy. Numerous clinically established and newly developed macrophage targeted radiotracers for oncological and inflammatory diseases can potentially be utilized for LVV imaging. These tracers are more target specific and therefore may provide lower background radioactivity, higher diagnostic accuracy and the ability to assess treatment effectiveness. However, current knowledge regarding macrophage subsets in LVV lesions is limited. Further understanding regarding macrophage subsets in vasculitis lesion is needed for better selection of tracers and new targets for tracer development. This review summarizes the development of macrophage targeted tracers in the last decade and the potential application of macrophage targeted tracers currently used in other inflammatory diseases in imaging LVV.
    Matched MeSH terms: Tomography, Emission-Computed, Single-Photon
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