Iranian Journal of Nuclear Medicine
Volume:20 Issue: 2, Summer-Autumn 2012

Citation tracking is a bibliometrics method to analyze the scientific impact of journal articles which can be done through Scopus (SC), Google Scholar (GS), or ISI web of knowledge (WOS). In the current study, we analyzed the citations to 2006-2012 articles of Iranian Journal of Nuclear Medicine (IJNM) in the SC and GS. We retrieved the relevant data from SC and GS official websites. The search was done on 10/2012. Total number of citations, their overlap and unique citations of SC and GS were evaluated in detail. SC and GS covered 100% and 99% of articles and identified 53 and 62 citations to IJNM articles respectively with the overlap of 44 citations. Original articles were the main types of cited articles followed by review articles. Despite considerable overlap between GS and SC, they provide important unique citations to IJNM articles. Due to differences between citation analysis information in each database, authors should consider all the indexing databases when evaluating the scientific impact of the individual journal. Editors should consider original and review articles to increase long term visibility and hopefully impact factor of IJNM in the future.

Due to the cell labeling potentials of various metal-maltol complexes, the idea of developing a possible cell labeling imaging agent using single photon emission computed chromatography (SPECT) with[111In]-maltolate complex has been investigated. [111In] labeled 3-hydroxy-2-methyl-4H-pyran-4-onate ([111In]-maltolate) was prepared using freshly prepared [111In]InCl3 and 3-hydroxy-2-methyl-4H-pyran-4-onate in a sodium salt form in 25 min at 45°C. Stability of the complex was checked in final formulation and human serum for 48 h. The partition coefficient was calculated for the compound followed by biodistribution and imaging studies. [111In]-maltolate was successively used in the radiolabeling of red blood cells for diagnostic studies. The complex was prepared successfully (radiochemical purity: >98% ITLC, >98% HPLC, specific activity: 15-17 GBq/mmol, log P=0.278). The complex is mostly washed out from the circulation through kidneys in 24h. the cell labeling efficacy was significant at the time of experiment. [111In]-maltolate can be an interesting cell imaging agent due to stability and cell avidity of metal maltol complexes, however, further biodistribution studies in various cells as well as diagnostic protocols is necessary.

This study was conducted to evaluate prevalence and risk factors for diagnostic discordance for osteoporosis due to different T-scores of lumbar spine and femoral neck. In this cross sectional study demographic, anthropometric and risk factors for osteoporosis were derived from a database on 3,039 post-menopausal women who underwent bone densitometry for the first time in our department (Kurdistan Nuclear Medicine Center) from 2003 to 2010. DXA was performed on L2-L4 vertebrae and femoral neck for all cases. Major discordance (one site osteoporotic and the other normal) and minor discordance (difference between two site no more than one WHO diagnostic class) were determined. The association of related risk factors with discordance of interest was assessed. Prevalence of osteoporosis and osteopenia in these post-menopausal women with mean age of 58.5 ±8.7 years, menopausal period of 11.2+9.4 years and mean BMI of 28+4.5 were 37.7% and 50.7%, respectively. Frequencies of minor and major discordances were 40.0% and 1.8%, respectively. The minor discordance was a common finding; however, the major discordance is uncommon. The most important risk factors for major discordance were age, menopausal duration and BMI. There was no significant relationship between other risk factors (smoking and history of bone fracture) and diagnostic T-score discordances.

The aim of this study was to evaluate the effect of successful kidney transplantation (KT) on myocardial perfusion and left ventricular function by both qualitative (visual) interpretation and semiquantitative parameters, using myocardial perfusion scintigraphy with gated-single photon emission computed tomography (gated-SPECT) in patients suffering from end-stage renal disease. From a total of 38 patients who were candidates of KT, twenty-six patients (16 female, 10 male, mean age: 47.5 yr, range: 24-64 yr) who had successful KT were included. Myocardial perfusion scintigraphy was performed by Gated Single Photon Emission Computed Tomography (Gated-SPECT) method, before and after surgery (mean: 24 months). Perfusion and function status was evaluated by qualitative and semiquantitative parameters. Our data showed qualitative evidence of perfusion and functional abnormality in pre-transplant scans as follows: Abnormal perfusion in left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) territories in 42.5%, 53.8% and 65.4% of cases, respectively; dilation in 57.7% and inhomogenity of uptake in 53.8% of cases. However no statistically significant change was noted after transplantation, i.e. p value for all semiquantitative values including summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS), summed motion score (SMS), summed thickening score (STS), ejection fraction (EF), end diastolic volume (EDV), end systolic volume (ESV), and stroke volume (SV) was greater than 0.05. Renal transplantation may not have considerable long term effect on myocardial perfusion and function in patients with chronic renal failure. This could be due to either non-reversible myocardial changes or continuing effect of degrading factors on the myocardium.

Several radiotracers are being used for sentinel node mapping in patients with breast cancer. In the current study, we reported our experience with 99m-Tc Phytate for sentinel node mapping in Mashhad University of Medical Sciences. All breast cancer patients who underwent sentinel node mapping using 99m-Tc Phytate were included. All patients received intradermal peri-areolar injection of 0.5 mCi/0.1cc 99m-Tc Phytate. Lymphoscintiraphy was performed for 145 patients 5-10 minutes post-injection. The sentinel nodes were found during surgery using a hand-held gamma probe as well as blue dye technique. In total 165 patients were evaluated. Lymphoscintigraphy showed axillary sentinel nodes in 135 out of 145 patients (93%) following imaging. At least one sentinel node could be detected in all these 135 patients during surgery. In the remaining 10 patients with sentinel node non-visualization, 5 had sentinel node harvesting failure during surgery. Median number of sentinel nodes on the lymphoscintigraphy images was 1. Sentinel node detection rate was 95% (157/165). In the 8 patients with sentinel node harvesting failure, 7 had pathologically involved axilla. Median number of harvested sentinel nodes was 1. Mean sentinel node to background count ratio was 10±2. 99m-Tc Phytate is an effective and highly successful radiotracer for sentinel node mapping. Sentinel node can be visualized in a short time after 99m-Tc Phytate injection on the lymphoscintigraphy images. The sentinel to background count during surgery is high which results in more convenient sentinel node harvesting and high detection rate.

Congenital diaphragmatic hernia (CDH) is a rare anomaly with a reported incidence of 1 in 16,000 populations. It may be associated with herniation of stomach, intestinal loops, spleen, and kidney through a chest wall defect. We report a case of a 1 year old male child who presented with recurrent fever, occasional chills and rigor of 4 months duration. Left kidney was non visualised on ultrasound examination. Patient was referred for a 99mTc DTPA (Diethylenetriamine penta-acetic acid) renogram to look for the presence of an ectopic left kidney. An intrathoracic left kidney was identified that was normally functioning and PUJ (pelviureteric junction) non obstructed. A routine chest X-ray was performed to look for respiratory tract infection that showed bowel loops in left posterior thorax, raising a suspicion for CDH. The patient underwent thoracoscopic repair of CDH and the hernial contents were found to be left kidney, intestinal loops and spleen. Intrathoracic kidney is relatively rare and constitutes 5% of all ectopic kidneys and is invariably PUJ non obstructed.

Nuclear medicine imaging is routinely used for evaluation of perfusion and function of the transplanted kidneys. At present, the radiopharmaceutical of choice for this study in our center is Tc 99m-Ec. Complications of the kidney graft are demonstrable in the early and delayed images. One of these complications is vesicoureteral reflux to the graft or to the native kidneys. We present a 27 year old patient with elevated BUN and Cr ten days after kidney transplantation. He previously had failed renal transplantation due to rejection. Tc-99m EC renal scan revealed decreased perfusion and function suggesting acute rejection. In the late functional images (at 24 minute), vesicoureteral reflux to the previous non‑functioning graft was also noticed on the right side of the pelvis. We recommend considering vesicouretral reflux while interpreting renal transplant imaging since this can be easily mistaken with other complications such as urine leakage.