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1

Evaluation of dilated cardiomyopathy by 201Tl myocardial single photon emission computed tomography  

International Nuclear Information System (INIS)

To estimate dilated cardiomyopathy (DCM)morphologically and quantitatively, 201Tl myocardial single photon emission computed tomography (SPECT) was performed in 14 DCM and 5 normal cases. Using a rotating dual-gamma camera system, resting SPECT data were collected for 6 minutes. Quantitative analysis of clinical cases was based on phantom studies. (I) Morphological features Marked spherical left ventricular (LV) dilatation (14/14), localized-diffuse low uptake or defect (12/14), and right ventricular visualization (6/14) were characteristic features in DCM. Differentiation of DCM from ischemic heart disease by SPECT was possible through the feature indicating disproportionately large LV cavity to defect size or degree. (II) Quantitative analysis When DCM was compared with normal control (n-5), following 3 features were impressive; 1) DCM was significantly higher in LV myocardial 201Tl uptake ratio and LV volume than normal control. (4.8+-1.3%: 3.3+-0.2%, p201Tl uptake ratio of unit volume (1 ml) than normal control. 3) DCM was significantly lower in mean myocardial count/mean lung count.ratio than normal control. Thus we concluded that 201Tl myocardial SPECT was useful non-invasive technique for diagnosis of DCM and was with fairly well correlation between morphology and quantitative estimations. Furthermore, this quantitative method appears to be applicable for estimation of other cardiac disease. (author)

1984-01-01

2

Evaluation of dilated cardiomyopathy by /sup 201/Tl myocardial single photon emission computed tomography. Morphological and quantitative analysis  

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To estimate dilated cardiomyopathy (DCM)morphologically and quantitatively, /sup 201/Tl myocardial single photon emission computed tomography (SPECT) was performed in 14 DCM and 5 normal cases. Using a rotating dual-gamma camera system, resting SPECT data were collected for 6 minutes. Quantitative analysis of clinical cases was based on phantom studies. Marked spherical left ventricular (LV) dilatation (14/14), localized-diffuse low uptake or defect (12/14), and right ventricular visualization (6/14) were characteristic features in DCM. Differentiation of DCM from ischemic heart disease by SPECT was possible through the feature indicating disproportionately large LV cavity to defect size or degree. Quantitative analysis When DCM was compared with normal control (n-5), following 3 features were impressive: DCM was significantly higher in LV myocardial /sup 201/Tl uptake ratio and LV volume than normal control; DCM was significantly lower in LV myocardial /sup 201/Tl uptake ratio of unit volume (1 ml) than normal control; DCM was significantly lower in mean myocardial count/mean lung count.ratio than normal control.

Futagami, Yasuo; Makino, Katsutoshi; Ichikawa, Takehiko

1984-08-01

3

Relationship between the mismatch of 123I-BMIPP and 201Tl myocardial single-photon emission computed tomography and autonomic nervous system activity in patients with acute myocardial infarction  

International Nuclear Information System (INIS)

The purpose of this study was to elucidate the relationship between the mismatch of thallium-201 (Tl) and iodine-123-beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) myocardial single-photon emission computed tomography (SPECT) and autonomic nervous system activity in myocardial infarction (MI) patients. The subjects were 40 patients (34 males, 6 females) who underwent examinations by 123I-BMIPP and 201Tl myocardial SPECT imaging and 24-hour Holter monitoring within a 3-day period 3 weeks after the onset of their first MI. R-R intervals were analyzed every hour over a period of 24 hours by fast Fourier transformation (FFT). High frequency (HF) and low frequency (LF) were defined as markers of cardiac vagal activity in the former and the LF/HF ratio as sympathetic activity. Greater or more extensive decreases in the BMIPP image than that in the Tl image were defined as a positive mismatch. Patients were divided into positive and negative mismatch groups of 20 patients each. There were no significant differences between the 2 groups in age, sex, site of infarction, max CK (creatine kinase), max CK-MB, or left ventricular ejection fraction. The incidences of clinical signs suggesting residual myocardial ischemia were significantly greater in the positive than in the negative mismatch group (P123I-BMIPP and 201Tl myocardial SPECT 3 weeks after a first acute myocardial infarction with uncomplicated moderate or severe heart failure and decreased heart rate variability are related to residual myocardial ischemia. A combined assessment of heart rate variability in 24 hour Holter electrocardiogram (ECG) monitoring and perfusion-metabolism mismatch in 123I-BMIPP and 201Tl myocardial SPECT is useful for determining residual myocardial ischemia in the follow-up of those with acute myocardial infarction. (author)

2006-03-01

4

Comparison of two-dimensional echocardiography with /sup 201/Tl-single photon emission computed tomography for evaluating the myocardial infarct zone  

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The reliability of measuring the myocardial infarct zone by two-dimensional echocardiography (2DE) was compared with that by regional myocardial blood flow as evaluated by single photon emission computed tomography (SPECT) in 47 patients with old myocardial infarction, with ventricular aneurysm (An group ; n = 15), and without ventricular aneurysm (Non-An group ; n = 32). Short-axis images of the left ventricle at the level of the mitral valve, the papillary muscles, and the apex were obtained both by 2DE and SPECT. The left ventricular wall was divided into 36 segments in 2DE and 40 segments in SPECT with reference points at the posterior end of the right side of the interventricular septum. Wall motion abnormalities on 2DE and hypoperfusion on SPECT showed a correspondence of 81 % in the An group and 78 % in the Non-An group at the level of the mitral valve, and 78 % in the An group and 76 % in the Non-An group at the papillary muscle level. However, a better correspondence was observed in the An group (84 %) as compared to the Non-An group (64 %) at the level of the apex. Apical movement assessed by cineangiography showed more extensive changes in the Non-An group than in the An group (2.3 +- 0.9 mm vs 4.1 +- 1.7 mm in the RAO view, 2.4 +- 1.9 mm vs 5.3 +- 2.1 mm in the LAO view). From these observations, it was suspected that the cause of disparity between radial shortening and the /sup 201/Tl uptake index at the level of the apex is related to the cardiac movement of the apex toward the base during systole. Since wall motion abnormalities demonstrated by radial shortening (2DE) and hypoperfusion indicated by the /sup 201/Tl uptake index (SPECT) generally corresponded well, 2DE was thought to be a useful method for evaluating myocardial infarct zone. (J.P.N.).

Konishiike, Atsushi; Mihata, Senri; Matsumori, Yoshiko and others

1987-12-01

5

Practical assessment of myocardial viability with a positron coincidence gamma camera using 18F-fluorodeoxyglucose in acute myocardial infarction. Comparison with dedicated positron emission tomography and 201Tl single photon emission computed tomography  

International Nuclear Information System (INIS)

2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) began to be supplied commercially to our hospital, which does not have a cyclotron, in autumn of 2005. The purpose of this study was to compare the utility of a dual-head positron coincidence detection (PCD) gamma camera in the detection of myocardial viability using 18F-FDG with that of dedicated positron emission tomography (PET) and with that of thallium-201 (201Tl) single photon emission computed tomography (SPECT). A total of 15 patients (14 men and 1 woman, mean age: 60±7 years, range: 46-73) with a large acute myocardial infarction (AMI) underwent 18F-FDG PET, 18F-FDG PCD imaging after oral glucose loading (75 g) and 201Tl SPECT imaging. We divided the SPECT and PET images into a total of 20 segments, and semiquantitative visual analysis was performed by assessing regional tracer activities on a 4-point scoring system (DS): 0=normal uptake, 1=mildly reduced uptake, 2=severely reduced uptake, and 3=no uptake. We summed the DS in each patient as the total DS (TDS). The TDS of the 18F-FDG PET image was 14.4±7.7. The TDS of the 18F-FDG PCD image was 18.7±7.7. The TDS of the 201Tl SPECT image was 24.1±11.5. The TDS of the 18F-FDG PET image was significantly smaller than that of the 18F-FDG PCD image. The TDS of the 18F-FDG PET image was significantly smaller than that of the 201Tl SPECT image. The TDS of the 18F-FDG PCD image was significantly smaller than that of the 201Tl SPECT image. The findings of the project suggest that 18F-FDG PCD is a good modality based on its accuracy, convenience, and cost-performance for detecting myocardial viability in hospitals that do not have a PET system. (author)

2009-04-01

6

Evaluation of Agreement between 64-slice Computed Tomography Angiography and 201-Tl Single Photon Emission Computed Tomography-myocardial Perfusion Imaging in the Diagnosis of Significant Coronary Artery Disease  

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To compare coronary computed tomography angiography (CTA) with single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) for the detection of physiologically significant coronary artery disease (CAD). We evaluated 202 patients undergoing 64-slice coronary CTA and 201-Tl SPECT-MPI within a 3-month time interval. In addition, 68 patients underwent invasive coronary angiography (ICA). Coronary artery stenoses with luminal narrowing {>=} 50% were defined as 'significant' on CTA and ICA. All myocardial segments were classified as reversible or fixed perfusion defects and normal segments on 201-Tl SPECT-MPI, and were allocated to the corresponding coronary vessels. Agreement and diagnostic performance between each imaging modality for physiologically significant CAD was calculated using the kappa ({kappa}) statistic and receiver operating characteristic analysis, respectively. The sensitivity and specificity of CTA for the detection of physiologically significant CAD were 88% and 86% by patient-based analysis, and 84% and 91% by vessel-based analysis as compared to 201-Tl SPECT-MPI, respectively. The agreement between CTA and SPECTMPI was good ({kappa} = 0.647) and moderate ({kappa} = 0.558) by patientand vessel-based analyses, respectively. The accuracy of CTA for predicting perfusion defects on SPECT-MPI was comparable (area under the curve; 0.814 vs. 0.819, p=0.902 on patient-based analysis, and 0.808 vs. 0.749, p=0.197 on vessel-based analysis) to ICA. Coronary stenosis {>=} 50% on coronary CTA shows good agreement with perfusion defects in SPECT-MPI.

Ma, Jee Hyun; Kang, Doo Kyoung [Dept. of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Lee, Su Jin; An, Young Sil [Dept. of Nuclear Medicine, Ajou University School of Medicine, Suwon (Korea, Republic of); Lim, Hong Seok [Dept. of Cardiology, Ajou University School of Medicine, Suwon (Korea, Republic of)

2011-06-15

7

Limitations of 201Tl myocardial perfusion scintigrams  

International Nuclear Information System (INIS)

The reliability of myocardial perfusion scintigrams with thallium-201 (201Tl) for detecting areas of hypoperfusion was assessed in 16 closed-chest dogs. Variable areas of ischemia were produced either by occluding or stenosing the left anterior descending coronary artery. Cardiac scintigrams taken in four projections were compared with regional myocardial perfusion maps. Segmental concentrations and segmental perfusions were quantitated by counting the emissions from 201Tl and the microspheres in each of 96 segments of the left ventricle. In addition, studies with a phantom were performed. The results indicate: (1) The emissions from 201Tl and from microspheres correlated well in ischemic segments (r = 0.93 +- SE 0.02). (2) Seven of twelve ischemic hearts had definitely abnormal scintigrams and in each of these the hypoperfused zone was greater than 4.9 grams and perfusion was decreased by more than 45 percent. (3) In the phantom, abnormal scintigrams could be detected in the presence of lesser deficits than in the dogs. The limitation of the thallium perfusion scintigrams will be the inconsistent detection of small perfusion deficits

1976-01-01

8

Usefulness and limitation of stress /sup 201/Tl myocardial single photon emission computed tomography (SPECT) for diagnosis of ischemic heart disease  

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Stress 201-T1-myocardial single photon emission computed tomography (SPECT) proved to have significantly higher sensitivity than planar scintigraphy for the detection of ischemic heart disease (IHD), each affected artery, multi-vessel disease and three-vessel disease. It also permitted the detection of ventricular aneurysm. Diagnostic accuracy was influenced by the presence and severity of infarction, the number of affected vessels, and infarct site. Transient ischemia in the infarct site and ventricular aneurysm seemed to make it difficult to detect multi-vessel disease in cases of infarction. These results indicated that SPECT is a noninvasive useful technique for detecting IHD, each affected artery, multi-vessel disease (especially, postero-inferior myocardial infarction), three-vessel disease, and ventricular aneurysm. However, SPECT seemed to have the limitation for detecting multi-vessel disease accompanied by anterior myocardial infarction and angina pectoris.

Futagami, Yasuo (Mie Univ., Tsu (Japan). School of Medicine)

1984-11-01

9

Assessment of myocardial viability by resting 201Tl SPECT image  

International Nuclear Information System (INIS)

The aim of this study was to assess whether resting 201Tl scintigraphy is superior in detecting viable myocardium to previous conventional methods. We performed not only stress 201Tl SPECT but also resting 201Tl SPECT within one month in 65 patients with coronary artery disease. Resting 201Tl images were quantitatively compared with 4 hour late images of stress study using a polar map. In stress study, redistribution was recognized on 83% (25/30) of non-MI SEGs with perfusion defect in the stress 201Tl images, and on 39% (18/46) of infarcted SEGs. The agreement of resting 201Tl study with 4 hour late images of stress study was shown on 93% (28/30) of non-MI SEGs and on 52% (24/46) of MI SEGs. The increased uptake of 201Tl in resting study, however, was found on 13 (46%) of 28 MI SEGs showing fixed defects in stress study. In stress delayed image with fixed defect, the %Tl uptake of improved SEGs was higher than that of unchanged SEGs (59±10% vs 48±11%,; p>0.05). There was no viable myocardium which had %Tl uptake less than 40% at stress delayed image. In conclusion, the resting 201Tl imaging will give an important information as for the myocardial viability showing fixed defects, if more than 40% Tl uptake is observed. (author)

1990-01-01

10

Quantitative analysis of 201Tl-myocardial imaging  

International Nuclear Information System (INIS)

Effects of vasodilators, NTG, Dipyridamole, and Nifedipine, were evaluated by 201Tl-myocardial scintigraphy. Dipyridamole and Nifedipine significantly increased the heart rate, and NTG and Nifedipine slightly decreased the blood pressure. A significantly decreased back ground ratio of the lung field was noted after administration of Nifedipine. In normal myocardial area, measured uptake counts which were significantly higher than predicted uptake counts were obtained after administration of NTG, Dipyridamole, Nifedipine. In ischemic myocardial area, with administration of NTG and Nifedipine, measured 201Tl-uptake counts became significantly higher than predicted uptake counts. The difference between normal and ischemic myocardial areas increased by the administration of Dipyridamole. These results suggested that these three kinds of vasodilators increase 201Tl-uptake. (Ueda, J.)

1982-01-01

11

201Tl myocardial scintigraphy at rest and during exercise  

International Nuclear Information System (INIS)

64 patients (38 after myocardial infarction, 23 with angina pectoris, 3 controls) were examined by different methods of 201Tl myocardial scintigraphy: scintigraphy during exercise and redistribution scintigraphy, seaprate scintigraphy at rest and during exercise, and scintigraphy at rest followed by scintigraphy during exercise, resp. The scintigraphy during exercise and redistribution scintigraphy proved to be most effective in ischemic and dicatricial myocardium. The scintigraphy during exercise should be performed rapidly since the redistribution begins immediately after ischemia

1981-05-01

12

Multi-center study for the evaluation of clinical usefulness of attenuation and scatter correction on 201Tl myocardial SPECT  

International Nuclear Information System (INIS)

The aim of this study was to evaluate the clinical usefulness of attenuation and scatter correction (AC, SC) on a 201Tl myocardial single-photon emission computed tomography (201Tl SPECT) as a multi-center trial. With a dual-detector and a triple-detector SPECT systems with a 99mTc transmission source, simultaneous transmission/emission tomography (TCT/ECT) was performed on 38 patients with angiographically coronary heart disease (CHD) and 26 patients without evidence of CHD. Stress and delayed attenuation and scatter corrected images (SAC) and uncorrected images (NC) were reconstructed. On NC images of normal cases, influence of attenuation was greater in male than female. In comparison of 201Tl distribution between male and female, significant decrease in 201Tl activity was observed in the inferoposterior wall in male and that was observed in the anterobasal wall of the left myocardium in female. Such a difference in 201Tl distribution between male and female disappeared on SAC images. On the diagnostic performance for the identification of CHD, SAC images demonstrated improved specificity and accuracy values in the right coronary arterial territory (RCA) with visual analysis statistically. Sensitivity value in the RCA was also improved, but it was not statistically significant. Sensitivity value in the left circumflex arterial territory (LCX) increased without decrease in specificity value on SAC images. In the left anterior descending arterial territory (LAD), sensitivity value increased on SAC images. Although specificity value decreased on SAC images in LAD territory, it was not statistically significant. The difference in 201Tl distribution between male and female is improved in normal cases by attenuation and scatter correction on 201Tl myocardial SPECT. Diagnostic performance of CHD is also improved by attenuation and scatter correction, especially in territories of which specificity in assessing the absence of disease have been suboptimal. In conclusion, attenuation and scatter correction on 201Tl myocardial SPECT is considered to be clinically useful. (author)

2002-02-01

13

Limitations of /sup 201/Tl myocardial perfusion scintigrams  

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The reliability of myocardial perfusion scintigrams with thallium-201 (201Tl) for detecting areas of hypoperfusion was assessed in 16 closed-chest dogs. Variable areas of ischemia were produced either by occluding or stenosing the left anterior descending coronary artery. Cardiac scintigrams taken in four projections were compared with regional myocardial perfusion maps. Segmental concentrations and segmental perfusions were quantitated by counting the emissions from /sup 201/Tl and the microspheres in each of 96 segments of the left ventricle. In addition, studies with a phantom were performed. The results indicate: (1) The emissions from /sup 201/Tl and from microspheres correlated well in ischemic segments (r = 0.93 +- SE 0.02). (2) Seven of twelve ischemic hearts had definitely abnormal scintigrams and in each of these the hypoperfused zone was greater than 4.9 grams and perfusion was decreased by more than 45 percent. (3) In the phantom, abnormal scintigrams could be detected in the presence of lesser deficits than in the dogs. The limitation of the thallium perfusion scintigrams will be the inconsistent detection of small perfusion deficits.

Mueller, T.M.; Marcus, M.L.; Ehrhardt, J.C.; Chaudhuri, T.; Abboud, F.M.

1976-10-01

14

Radiation exposure around patients after 201Tl-myocardial scintigraphy  

International Nuclear Information System (INIS)

Aim: It was the aim of the study to assess the additional radiation exposure to patients, attendents and nurses by patients who are undergoing nuclear medicine investigations (myocardial scintigraphy) with 201Tl-chloride (201Tl-Cl). Methode: In 16 cases the dose rates at 0.5, 1 and 2 m distance from patients were measured at 0.5, 1.5, 3-4 and 24, in some cases until 370 h after administration of 100±10 MBq 201Tl-Cl. From the time courses of the dose rates around the patients the possible radiation exposure of other persons were estimated. Results: The initial values of the dose rate were 3.82 ?Sv/h at 0.5 m, 1.18 ?Sv/h at 1 m and 0.30 ?Sv/h at 2 m distance from the patients respectively. The dose rates were decreasing following a monoexponential course with an effective half-life of 60 h. The maximum doses to other persons at 1 m distance from the patients were determined by considering three scenarios. The values were 13 ?Sv in the waiting room, 26 ?Sv for nurses working in the ward and 105 ?Sv for persons living in the same household. Conclusion: Even at very restrictive assumptions the doses were far below the maximum permissible dose to non-radiation workers set by radiation protection regulations (1.5 mSv per year). (orig.)

1997-01-01

15

Reverse 201Tl myocardial redistribution induced by coronary artery spasm  

International Nuclear Information System (INIS)

Objective: To investigate the mechanism of reverse redistribution (RR) on dipyridamole 201Tl myocardial perfusion studies in the patients with coronary artery spasm. Methods: Twenty-six patients with coronary artery spasm and presented as RR on dipyridamole 201Tl myocardial perfusion studies were enlisted as RR group, while other 16 patients with no coronary artery stenosis nor RR were enlisted as control group. Dipyridamole test was repeated during coronary angiography. Corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) and TIMI myocardial perfusion grade (TMPG) were measured at RR related and non-RR related coronary arteries before and after dipyridamole infusion respectively. All of the data were analyzed by Student's t-test or ?2-test and correlation analysis. Results: Coronary artery angiography showed slower blood flow and lower myocardial perfusion in RR related vessels when compared with non-RR related vessels in RR group, but there was no significant difference among the main coronary arteries in control group. The perfusion defects of RR area at rest were positively related to slower blood velocity at corresponding coronary arteries (r = 0.79, t =10.18, P0.05). Conclusion: RR is related to the decreased blood flow and myocardial perfusion induced by coronary artery spasm at rest, which may be improved by stress test such as intravenous dipyridamole infusion. (authors)

2010-10-01

16

Spontaneous changes in _2_0_1Tl myocardial perfusion imaging after myocardial infarction  

International Nuclear Information System (INIS)

To examine regional myocardial perfusion after myocardial infarction, 26 patients underwent exercise electrocardiographic testing with _2_0_1Tl myocardial perfusion imaging 3 weeks and 3 months after infarction. At 3 weeks, 9 of 26 patients (35%) had myocardial ischemia by exercise electrocardiographic testing, whereas 18 of 26 (69%) had ischemia by _2_0_1Tl imaging. The _2_0_1Tl scintigrams were scored by dividing each image, in 3 views, into 5 segments, using a 5-point scoring scheme. The exercise _2_0_1Tl score was 44.3 +/- 1.2 and increased to 47.3 +/- 1.2 in the redistribution study (p less than 0.001). Three months after infarction, although there was a significantly greater rate-pressure product which would predict a larger ischemic defect and a decrease in the stress _2_0_1Tl score, the stress score was improved (48.3 +/- 1.1, p less than 0.001). The redistribution score was similar, that is, 48.9 +/- 1.0. The improvement in _2_0_1Tl myocardial perfusion was associated with a loss of stress-induced ischemia in 8 patients (30%). These results indicate that spontaneous improvements in _2_0_1Tl myocardial perfusion imaging may occur after myocardial infarction

1982-01-01

17

Effects of smoking on lung uptake of 201Tl during exercise myocardial perfusion imaging  

International Nuclear Information System (INIS)

Objective: To investigate the influence of smoking on lung uptake of 201Tl during myocardial perfusion imaging. Methods: Ninety-two healthy subjects, with normal 201Tl myocardial perfusion imaging findings but no evidence of left ventricular hypertrophy and pulmonary disease, were divided into three groups, smoker, nonsmoker and quitted smoker groups. Exercise/delay 201Tl myocardial perfusion imaging was performed on all subjects included. Lung/heart ratio was defined on the anterior planar image obtained during exercise tomography. Results: Both the lung/heart ratios during exercise in smoker (0.40 ± 0.07, F=10.635, P201Tl lung/heart ratios in smokers are higher than in nonsmokers and this must be kept in mind when 201Tl lung/heart ratios are used clinically, even in quitted smokers

2004-06-01

18

Dipyridamole 201Tl scintigraphy in the evaluation of prognosis after myocardial infarction  

International Nuclear Information System (INIS)

Dipyridamole 201Tl imaging has been proposed as an alternative to exercise ECG testing for the prehospital discharge evaluation of patients recovering from myocardial infarction. The rationale is that many postinfarction patients with exercise-induced ischemia experience later cardiac events, and the sensitivity of predischarge exercise ECG testing in patients with multivessel disease ranges from only 45% to 62%. In addition, several groups of investigators have shown the sensitivity of submaximum exercise 201Tl imaging to be less than ideal. This report summarizes the current status of dipyridamole 201Tl imaging in the period of 1-13 days after myocardial infarction. Although the number of studies performed to date is limited, the following conclusions can be drawn: dipyridamole 201Tl imaging after myocardial infarction was associated with no serious side effects, and those present could be quickly reversed with aminophylline; redistribution with dipyridamole 201Tl images definitely correlates with prognosis after uncomplicated myocardial infarction; dipyridamole 201Tl imaging is definitely useful in patients unable to exercise for a variety of reasons; and future studies are definitely indicated to further define the role of dipyridamole 201Tl imaging for assessing prognosis, especially in those patients undergoing interventional therapy after acute myocardial infarction

1991-01-01

19

Dipyridamole 201Tl scintigraphy in the evaluation of prognosis after myocardial infarction  

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Dipyridamole 201Tl imaging has been proposed as an alternative to exercise ECG testing for the prehospital discharge evaluation of patients recovering from myocardial infarction. The rationale is that many postinfarction patients with exercise-induced ischemia experience later cardiac events, and the sensitivity of predischarge exercise ECG testing in patients with multivessel disease ranges from only 45% to 62%. In addition, several groups of investigators have shown the sensitivity of submaximum exercise 201Tl imaging to be less than ideal. This report summarizes the current status of dipyridamole 201Tl imaging in the period of 1-13 days after myocardial infarction. Although the number of studies performed to date is limited, the following conclusions can be drawn: dipyridamole 201Tl imaging after myocardial infarction was associated with no serious side effects, and those present could be quickly reversed with aminophylline; redistribution with dipyridamole 201Tl images definitely correlates with prognosis after uncomplicated myocardial infarction; dipyridamole 201Tl imaging is definitely useful in patients unable to exercise for a variety of reasons; and future studies are definitely indicated to further define the role of dipyridamole 201Tl imaging for assessing prognosis, especially in those patients undergoing interventional therapy after acute myocardial infarction.

Okada, R.D.; Glover, D.K.; Leppo, J.A. (Saint Francis Hospital Medical Research Institute, University of Oklahoma Health Sciences Center, Tulsa (United States))

1991-09-01

20

Quantitative analysis of /sup 201/Tl-myocardial imaging. Effect of vasodilators, glycerin trinitrate, dipyridamole and nifedipine on /sup 201/Tl-myocardial uptake  

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Effects of vasodilators, NTG, Dipyridamole, and Nifedipine, were evaluated by /sup 201/Tl-myocardial scintigraphy. Dipyridamole and Nifedipine significantly increased the heart rate, and NTG and Nifedipine slightly decreased the blood pressure. A significantly decreased background ratio of the lung field was noted after administration of Nifedipine. In normal myocardial area, measured uptake counts which were significantly higher than predicted uptake counts were obtained after administration of NTG, Dipyridamole, Nifedipine. In ischemic myocardial area, with administration of NTG and Nifedipine, measured /sup 201/Tl-uptake counts became significantly higher than predicted uptake counts. The difference between normal and ischemic myocardial areas increased by the administration of Dipyridamole. These results suggested that these three kinds of vasodilators increase /sup 201/Tl-uptake.

Aizawa, Yoshifusa; Kimura, Michio; Tsuda, Takashi; Shibata, Akira (Niigata Univ. (Japan). School of Medicine); Kamei, Kiyomitsu

1982-12-01

 
 
 
 
21

Myocardial 201Tl washout after combined dipyridamole submaximal exercise stress: Reference values from different patient groups  

International Nuclear Information System (INIS)

Dipyridamole stress is favorable in patients unable to exercise maximally for 201Tl myocardial scintigraphy. Aside from an analysis of uptake defects, proper washout analysis can be limited by heart rate variations when isolated dipyridamole stress is used. Heart rate standardized 201Tl washout kinetics after a combined dipyridamole and submaximal exercise stress protocol (CDSE), feasible in elderly patients as well as in patients with peripheral artery disease, were therefore studied to investigate the 201Tl washout after CDSE in differently defined patient groups: Group I comprised 19 patients with documented heart disease and angiographically excluded coronary artery disease (CAD); group II contained 17 patients with a very low likelihood of CAD determined by both normal exercise radionuclide ventriculography and normal 201Tl uptake. Group III comprised 56 patients with a 50% pretest likelihood of CAD but normal 201Tl uptake. Mean washout values were nearly identical in all groups. Despite similar uptake patterns, however, washout standardized by CDSE was significantly lower than the normal washout values after maximal treadmill exercise. Thus an obviously lower 201Tl washout after CDSE than after maximal treadmill exercise must be considered if washout analysis criteria after dipyridamole are applied to evaluate ischemic heart disease. Nevertheless, heart rate elevation achieved by additional submaximal exercise stress seems necessary, adequate and clinically safe for standardisation of washout analysis in dipyridamole 201Tl scintigraphy. (orig.)

1989-01-01

22

Impact of diabetes mellitus on worsening of the left ventricular ejection fraction in exercise-gated 201Tl myocardial single photon emission computed tomography in patients with coronary artery disease  

International Nuclear Information System (INIS)

It remains uncertain whether factors other than the severity of coronary artery disease (CAD) are associated with the worsening of the left ventricular ejection fraction (LVEF) by exercise. In the present study the impact of coronary risk factors on the worsening of LVEF by exercise was investigated in 391 patients with known or suspected CAD using exercise-gated 201Tl scanning to calculate the LVEF. Significant worsening of the LVEF by exercise was defined as >4.7% (mean plus 1 SD of the value in 116 patients without CAD). Multivariate analysis revealed that diabetes mellitus (DM) was an independent risk factor for the worsening of LVEF by exercise in patients with multivessel (2- or 3-vessel) CAD with an odds ratio (95% confidence interval) of 2.2 (1.1-4.5, p=0.037). In 157 patients with 2- or 3-vessel CAD, 20 (23.5%) of 85 nondiabetic patients and 31 (43.1%, p=0.009 vs nondiabetic patients) of 72 diabetic patients showed significant worsening of LVEF by exercise. In patients with 2- or 3-vessel CAD, there was no significant difference in Gensini score or reversibility of perfusion defects between nondiabetic and diabetic patients. Thus, DM is a risk factor for worsening LVEF by exercise in addition to the severity of CAD. (author)

2003-10-01

23

Single photon tomography imaging of a standard heart phantom with 201Tl: A gamma camera based system  

International Nuclear Information System (INIS)

A standard heart phantom (University of lowa design), inlcuding discrete myocardial walls, a central blood pool, and a 24-cc transmural cold defect, was studied with both planar and transverse tomographic imaging. The heart phantom was filled with 201Tl and placed within a cylindrical tank containing water and 201Tl to simulae nonmyocardial background activity from the thorax. The tomographic imaging system used was a commercially available, rotating, large field-of-view gamma camera. Image reconstruction from 64 sampling angles was performed in a nuclear medicine minicomputer system. The percentage activity in the region of the defect (actual activity of 0) contrasted to the normal wall was compared between planar and 1.25-cm transaxial tomographic slices. Defect activity fell to between 65% and 85% of that of the opposing normal wall in planar images, whereas it fell to between 26% and 49% of that of the normal wall in the tomographic images. In most cases, tomographic defect activity was half or less than that in the planar image. The geographic extent of the defect was seen in an appropriate number of tomographic slices: i.e., the geographic 3.2-cm defect length was predominantly seen in three 1.25-cm transverse slices. We conclude that camera-based tomographic systems show promise for improved 201Tl myocardial defect detection and quantitation over conventional planar images. (orig.)

1982-01-01

24

Dipyridamole 201Tl myocardial SPECT imaging in patients with dilated cardiomyopathy  

International Nuclear Information System (INIS)

Objective: To explore the characteristics of dipyridamole 201Tl myocardial perfusion imaging (MPI) SPECT in patients with dilated cardiomyopathy. Methods: Thirty patients with dilated cardiomyopathy underwent pharmacological stress 201Tl MPI SPECT after intravenous infusion of dipyridamole (0.56 mg/kg) for 4 min. The early and delayed SPECT images were acquired respectively at 10 and 240 min after 201Tl injection. The images were analyzed and reported by two or three experienced nuclear medicine physicians. Results: All patients were found to have abnormal perfusion patterns at delay imaging, however 90.00% (27/30) were also abnormal at early images. Six patients had reverse redistribution. Conclusion: Dipyridamole 201Tl MPI SPECT imaging may be of some value for the assessment of patients with dilated cardiomyopathy. (authors)

2011-04-01

25

Comparative study of 201Tl-scintigraphic image and myocardial pathologic findings in patients with dilated cardiomyopathy  

International Nuclear Information System (INIS)

The objective of the present study was to characterize the production of 201Tl myocardial perfusion defects, the relation between the 201Tl multiple small defects and the myocardial damage indicated by myocardial fibrosis shown histopathologically in patients with dilated cardiomyopathy (DCM). Rest 201Tl scintigraphy was performed in thirty-seven patients. 201Tl myocardial SPECT images were visually classified into 4 grades according to the severity of inhomogeneous perfusion defects (IPD), 0: none, 1: slight, 2: moderate, 3: severe. 201Tl uptake, defect regions (DR), and coefficient of variation % (CV%) were also quantified by Bull's eye quantification in nineteen patients. 201Tl perfusion defects were observed in 35 (94.6%) patients, of whom 29 (78.4%) showed inhomogeneous perfusion defects. Twenty-four (64.9%) showed Stage 0 and 1 201Tl findings, and 21 (62.2%) had myocardial fibrosis in stage 1. Clinically, the correlation between the grades of the IPD, % 201Tl uptake, DR and CV% of myocardial uptake, which were calculated semiquantitatively by Bull's eye image, and the histological grades of fibrosis were also good (IPD vs. fibrosis: r=0.7014; % 201Tl uptake vs. fibrosis: r=-0.6542; DR vs. fibrosis: r=0.7027; CV% vs. fibrosis: r=0.6985). The 201Tl SPECT findings were in close agreement with the severity of myocardial fibrosis confirmed by autopsy, but the grading of the IPD was not related to the ejection fraction or left ventricular diameter. It showed a higher rate of inhomogeneous 201Tl myocardial perfusion defects (78.4%) in patients with DCM. This result may contribute to the clinical evaluation of DCM or differentiation from other diseases. Furthermore, the grading of 201Tl inhomogeneous perfusion defects related to the myocardial fibrosis of left ventricular myocardium may contribute to speculation of the myocardial degenerative stage in clinical settings. (author)

1996-08-01

26

Sequential change of cardiomyopathy of Duchenne muscular dystrophy by 201Tl myocardial SPECT  

International Nuclear Information System (INIS)

201Tl myocardial SPECT were performed to evaluate of cardiomyopathy in Duchenne type of progressive muscular dystrophy (DMD). Follow up SPECT images of the same patients were also obtained about 1 year after the first scan. Cases subjected to study were 10 DMD. At the first study the hypoperfusion area of the left ventricular muscle were observed in 6 cases (60%) out of 10. At the second study the hypoperfusion areas became wider and lower in 4 out of 6 cases (66.7%). The new hypoperfusion area which was not demonstrated at the first study was observed at the second study in one case of these cases. These results suggested that the positive rate of cardiomyopathy in DMD by 201Tl myocardial SPECT was high, and 201Tl myocardial SPECT is a useful examination to detect the change of myocardial damage in DMD. (author)

1989-01-01

27

Sequential change of cardiomyopathy of Duchenne muscular dystrophy by /sup 201/Tl myocardial SPECT  

Energy Technology Data Exchange (ETDEWEB)

/sup 201/Tl myocardial SPECT were performed to evaluate of cardiomyopathy in Duchenne type of progressive muscular dystrophy (DMD). Follow up SPECT images of the same patients were also obtained about 1 year after the first scan. Cases subjected to study were 10 DMD. At the first study the hypoperfusion area of the left ventricular muscle were observed in 6 cases (60%) out of 10. At the second study the hypoperfusion areas became wider and lower in 4 out of 6 cases (66.7%). The new hypoperfusion area which was not demonstrated at the first study was observed at the second study in one case of these cases. These results suggested that the positive rate of cardiomyopathy in DMD by /sup 201/Tl myocardial SPECT was high, and /sup 201/Tl myocardial SPECT is a useful examination to detect the change of myocardial damage in DMD. (author).

Ono, Seiji; Sugimoto, Seiichirou; Inoue, Kenjirou; Jinnouchi, Seishi; Hoshi, Hiroaki; Watanabe, Katsushi.

1989-03-01

28

Value of planar 201Tl imaging in risk stratification of patients recovering from acute myocardial infarction  

Energy Technology Data Exchange (ETDEWEB)

Although exercise ECG testing has been shown to have important prognostic value after acute myocardial infarction, exercise 201Tl scintigraphy offers several potential advantages, including: (1) increased sensitivity for detecting residual myocardial ischemia; (2) the ability to localize ischemia to a specific area or areas subtended by a specific coronary artery; (3) the ability to identify exercise-induced left ventricular dysfunction, which is manifested by increased lung uptake or transient left ventricular dilation; and (4) more reliable risk stratification of individual patients. The more optimal prognostic efficiency of 201Tl scintigraphy partially results from the fact that the error rate in falsely classifying patients as low risk is significantly smaller with 201Tl scintigraphy than with stress ECG. Because of these substantial advantages, there seems to be adequate rationale for recommending exercise perfusion imaging rather than exercise ECG alone as the preferred method for evaluating mortality and morbidity risks after acute myocardial infarction.

Gibson, R.S.; Watson, D.D. (Medical Center, University of Virginia Health Sciences Center, Charlottesville (United States))

1991-09-01

29

Scintigraphy of the heart with the aid of 201Tl in diagnosis of acute myocardial infarction  

International Nuclear Information System (INIS)

In patients with acute myocardial infarction of different localization by the method of heart scitigraphy using 201Tl irradiation doses, extraction factors in myocardium, 201Tl distribution in the heart are considered. A good correlation between ECG data and scintigraphy as to myocardium localization is pointed out. Advantages (availability, acceptable radiation doses, high sensitivity for the first 12-24 hours after the appearence of first symptoms etc.) and disadvantages (impossibility of the differentiating of acute, developing or ''chronic'' infarction) of the method are shown

1980-01-01

30

Myocardial imaging with dipyridamole - comparison of the sensitivity and specificity of /sup 201/Tl versus MUGA  

Energy Technology Data Exchange (ETDEWEB)

Myocardial imaging was performed at rest and after dipyridamole infusion using /sup 201/Tl and sup(99m)Tc-gated blood pool studies (MUGA). Of 38 patients studied, 21 had coronary artery disease (CAD) and 17 were normal. With /sup 201/Tl imaging, 19 of 21 patients with CAD (sensitivity 88%) showed perfusion defects during dipyridamole. Of 17 normals 6 (specificity 65%) showed clear perfusion defects during dipyridamole. With MUGA, 2 of 15 patients with CAD (sensitivity 13%) developed abnormal wall motion during dipyridamole; both patients developed ST depression > 1 mm. Of 10 normals none developed abnormal wall motion. Twenty six of 38 patients developed angina during dipyridamole, which was reversed by aminophylline in 24 of 26. We suggest that dipyridamole infusion is effective for /sup 201/Tl-perfusion imaging, and easily performed, but is not suitable for MUGA studies where ischaemia is the required endpoint.

Harris, D.; Taylor, D.; Condon, B.; Ackery, D.; Conway, N.

1982-01-01

31

Assessment of left ventricular function by {sup 201}Tl FCG-gated myocardial SPECT  

Energy Technology Data Exchange (ETDEWEB)

We applied the QGS program for LV function analysis (described by Germano, 1995) to a {sup 201}Tl SPECT study at rest, and estimated its accuracy. We performed {sup 201}Tl ECG-gated myocardial SPECT in 25 patients with ischemic heart disease under an acquisition time used in the routine {sup 99m}Tc ECG-gated SPECT study. The quality of the gated images was visually assessed with a 4-point grading system. LVEDV, LVESV, LVEF determined by the QGS program were compared with those by Simpson`s method on biplane LVG in 25 patients. Regional wall motion scores in 7 myocardial segments were assessed on the three-dimensional display created by the QGS program and the cine display of biplane LVG with a 5-point grading system. Wall motion scores obtained by the QGS program were compared with those by LVG. Although 72.0% of {sup 201}Tl ECG-gated SPECT images were fair or poor in image quality, there were good correlations between the values obtained by the QGS program and LVG (LVEDV: r=0.82, LVESV: r=0.88, LVEF: r=0.89). In addition, wall motion scores by the QGS program were correspondent to those by LVG in 77.1% of all 175 myocardial segments. We conclude that the QGS program provides high accuracy in evaluating left ventricular function even from {sup 201}Tl ECG-gated myocardial SPECT data. (author)

Toba, Masahiro; Ishida, Yoshio; Fukuchi, Kazuki; Fukushima, Kazuhito; Katafuchi, Tetsurou; Hayashida, Kohei; Oka, Hisashi; Takamiya, Makoto [National Cardiovascular Center, Suita, Osaka (Japan)

1999-01-01

32

Assessment of left ventricular function by 201Tl FCG-gated myocardial SPECT  

International Nuclear Information System (INIS)

We applied the QGS program for LV function analysis (described by Germano, 1995) to a 201Tl SPECT study at rest, and estimated its accuracy. We performed 201Tl ECG-gated myocardial SPECT in 25 patients with ischemic heart disease under an acquisition time used in the routine 99mTc ECG-gated SPECT study. The quality of the gated images was visually assessed with a 4-point grading system. LVEDV, LVESV, LVEF determined by the QGS program were compared with those by Simpson's method on biplane LVG in 25 patients. Regional wall motion scores in 7 myocardial segments were assessed on the three-dimensional display created by the QGS program and the cine display of biplane LVG with a 5-point grading system. Wall motion scores obtained by the QGS program were compared with those by LVG. Although 72.0% of 201Tl ECG-gated SPECT images were fair or poor in image quality, there were good correlations between the values obtained by the QGS program and LVG (LVEDV: r=0.82, LVESV: r=0.88, LVEF: r=0.89). In addition, wall motion scores by the QGS program were correspondent to those by LVG in 77.1% of all 175 myocardial segments. We conclude that the QGS program provides high accuracy in evaluating left ventricular function even from 201Tl ECG-gated myocardial SPECT data. (author)

1999-01-01

33

Planar imaging of left ventricular 201Tl myocardial SPECT-scintigrams  

International Nuclear Information System (INIS)

A new method of processing SPECT of 201Tl myocardial images is demonstrated based on the idea that 3-dimensional myocardium might be a curved area which can be presented in an unfolded form as a single planar image. An example of the procedure including parametric pictures is demonstrated. (orig.)

1985-02-01

34

[Usefulness of 201Tl/123I-BMIPP myocardial SPECT to evaluate myocardial viability and area at risk in acute myocardial infarction--comparison with 201Tl/99mTc-PYP dual SPECT].  

Science.gov (United States)

To evaluate the area at risk and the myocardial viability of acute myocardial infarction (AMI), we compared rest 123I-beta-methyl iodophenyl pentadecanoic acid (123I-BMIPP) and 201Tl myocardial SPECT with 201Tl/99mTc-PYP dual SPECT (D-SPECT) in 65 patients (mean age 64 +/- 11 years) with AMI. D-SPECT was performed in 3 to 5 days, 123I-BMIPP myocardial SPECT in 5 to 7 days, and left ventriculography on 1 month after onset of AMI. Furthermore, 201Tl/123I-BMIPP myocardial SPECT and left ventriculography were performed on 4 months after onset of AMI. The area which showed the reduced 123I-BMIPP uptake was larger than that showed the accumulation of 99mTc-PYP. The improvement of regional wall motion on 4 months after onset of AMI tended to be more closely correlated with the existence of discrepancy zone between 201Tl and 123I-BMIPP uptake than that of overlap zone between 201Tl and 99mTc-PYP uptake in acute period. We conclude that 201Tl/123I-BMIPP myocardial SPECT is more useful to evaluate the area at risk and myocardial viability of AMI than D-SPECT. PMID:9183144

Isobe, N; Toyama, T; Hoshizaki, H; Oshima, S; Taniguchi, K

1997-04-01

35

Quantitative evaluation of coronary artery disease by 201Tl myocardial emission computed tomography  

International Nuclear Information System (INIS)

The purpose of this study is to investigate the value of quantitative evaluation by circumferential profile analysis of stress-redistribution myocardial 201Tl distribution and myocardial 201Tl washout to diagnose coronary artery disease in comparison with qualitative evaluation by visual segmental analysis, using emission computed tomography (ECT). In 14 normal cases and 57 cases with angiographically defined coronary artery disease, stress and redistribution ECT were performed. ECT data were acquired in a 64 x 64 matrix format from 90 projections over 360 degrees using an ECT system with dual opposed large-field gamma cameras. A total acquisition time was 6 minutes. Tomographic sections oriented perpendicular and parallel to the long axis of left ventricule were reconstructed. For qualitative evaluation, ECT myocardial images were divided into 8 segments and segmental analysis was made by visual interpretation. For quantitative evaluation, circumferential profile curves for stress-redistribution myocardial 201Tl distribution and myocardial 201Tl washout were generated and evaluated by comparing with normal limits, which were obtained from 14 normal cases. Quantitative evaluation showed superior diagnostic accuracies to qualitative evaluation in left anterior descending artery (from 82 % to 89 %), right coronary artery (from 79 % to 86 %) and left circumflex artery (from 79 % to 87 %) lesions. Moreover, the number of diseased coronary arteries was more accurately predicted by quantitative evaluation. Especially in patients with three-vessel disease, 80 % of the patients was detected accurately by the quantitative evaluation, while only 30 % by the qualitative evaluation. We conclude that this quantitative evaluation for 201Tl myocardial ECT produces a remarkable improvement for predicting individual coronary artery disease and number of diseased coronary arteries. (author)

1986-01-01

36

Multi-center study for the evaluation of clinical usefulness of attenuation and scatter correction on {sup 201}Tl myocardial SPECT  

Energy Technology Data Exchange (ETDEWEB)

The aim of this study was to evaluate the clinical usefulness of attenuation and scatter correction (AC, SC) on a {sup 201}Tl myocardial single-photon emission computed tomography ({sup 201}Tl SPECT) as a multi-center trial. With a dual-detecter and a triple-detector SPECT systems with a {sup 99m}Tc transmission source, simultaneous transmission/emission tomography (TCT/ECT) was performed on 38 patients with angiographically coronary heart disease (CHD) and 26 patients without evidence of CHD. Stress and delayed attenuation and scatter corrected images (SAC) and uncorrected images (NC) were reconstructed. On NC images of normal cases, influence of attenuation was greater in male than female. In comparison of {sup 201}Tl distribution between male and female, significant decrease in {sup 201}Tl activity was observed in the inferoposterior wall in male and that was observed in the anterobasal wall of the left myocardium in female. Such a difference in {sup 201}Tl distribution between male and female disappeared on SAC images. On the diagnostic performance for the identification of CHD, SAC images demonstrated improved specificity and accuracy values in the right coronary arterial territory (RCA) with visual analysis statistically. Sensitivity value in the RCA was also improved, but it was not statistically significant. Sensitivity value in the left circumflex arterial territory (LCX) increased without decrease in specificity value on SAC images. In the left anterior descending arterial territory (LAD), sensitivity value increased on SAC images. Although specificity value decreased on SAC images in LAD territory, it was not statistically significant. The difference in {sup 201}Tl distribution between male and female is improved in normal cases by attenuation and scatter correction on {sup 201}Tl myocardial SPECT. Diagnostic performance of CHD is also improved by attenuation and scatter correction, especially in territories of which specificity in assessing the absence of disease have been suboptimal. In conclusion, attenuation and scatter correction on {sup 201}Tl myocardial SPECT is considered to be clinically useful. (author)

Tomiguchi, Seiji [Kumamoto Univ. (Japan). Hospital; Kumita, Shin-ichiro [Nippon Medical School, Tokyo (Japan); Hashimoto, Jun [Keio Univ., Tokyo (Japan). School of Medicine; Inoue, Tomio [Gunma Univ., Maebashi (Japan). School of Medicine; Nomura, Yoshiyuki [Mie Univ., Tsu (Japan). School of Medicine; Emoto, Junichi [Handa Municipal Hospital, Aichi (Japan); Nakajima, Kenichi [Kanazawa Univ. (Japan). School of Medicine; Nishimura, Tunehiko [Kyoto Prefectural Univ. of Medicine (Japan)

2002-02-01

37

Detection of coronary artery stenosis in children with Kawasaki disease. Usefulness of pharmacologic stress sup 201 Tl myocardial tomography  

Energy Technology Data Exchange (ETDEWEB)

This study determined the feasibility and accuracy of quantitative 201Tl myocardial single-photon emission computed tomography (SPECT) after dipyridamole infusion to detect coronary obstructive lesions in children with Kawasaki disease. 201Tl distribution after dipyridamole infusion was measured in 23 normal children, and with these normal values, quantitative analysis of SPECT was performed in 49 patients. Thirty-four patients had coronary stenosis 90% or greater on angiograms. Side effects resulting from systemic vasodilation were observed in about 70%. Angina pectoris and ischemic ST changes were observed only in patients with coronary stenosis. These symptoms disappeared after aminophylline infusion. Results of visual and quantitative analysis of SPECT were compared. SPECT data were shown on two-dimensional polar maps, and the extent and severity scores were calculated. The sensitivity of SPECT for detection of overall coronary stenosis was 91% (visual analysis) and 88% (quantitative analysis). The specificity of SPECT was 60% visually and 93% quantitatively. The sensitivity of quantitative analysis to detect individual coronary stenosis was similar to that of visual analysis. However, the specificity of visual analysis to detect individual coronary artery stenosis was significantly less than that of quantitative analysis. From these data, we conclude that quantitative analysis of myocardial SPECT after dipyridamole infusion is a safe and accurate diagnostic method for identifying coronary stenosis in children with Kawasaki disease.

Kondo, C.; Hiroe, M.; Nakanishi, T.; Takao, A. (Tokyo Women' s Medical College (Japan))

1989-09-01

38

Detection of coronary artery stenosis in children with Kawasaki disease. Usefulness of pharmacologic stress 201Tl myocardial tomography  

International Nuclear Information System (INIS)

This study determined the feasibility and accuracy of quantitative 201Tl myocardial single-photon emission computed tomography (SPECT) after dipyridamole infusion to detect coronary obstructive lesions in children with Kawasaki disease. 201Tl distribution after dipyridamole infusion was measured in 23 normal children, and with these normal values, quantitative analysis of SPECT was performed in 49 patients. Thirty-four patients had coronary stenosis 90% or greater on angiograms. Side effects resulting from systemic vasodilation were observed in about 70%. Angina pectoris and ischemic ST changes were observed only in patients with coronary stenosis. These symptoms disappeared after aminophylline infusion. Results of visual and quantitative analysis of SPECT were compared. SPECT data were shown on two-dimensional polar maps, and the extent and severity scores were calculated. The sensitivity of SPECT for detection of overall coronary stenosis was 91% (visual analysis) and 88% (quantitative analysis). The specificity of SPECT was 60% visually and 93% quantitatively. The sensitivity of quantitative analysis to detect individual coronary stenosis was similar to that of visual analysis. However, the specificity of visual analysis to detect individual coronary artery stenosis was significantly less than that of quantitative analysis. From these data, we conclude that quantitative analysis of myocardial SPECT after dipyridamole infusion is a safe and accurate diagnostic method for identifying coronary stenosis in children with Kawasaki disease

1989-01-01

39

ATP-loading 201Tl myocardial SPECT for the detection of ischemic heart disease  

International Nuclear Information System (INIS)

To evaluate the usefulness for the detection of ischemic heart disease, ATP myocrdial SPECT was performed in 35 patients (mean; 59±9.4 years) with angina pectoris or old myocardial infarction. Coronary angiography (CAG) was performed in all patients. The ultra-short half-life of ATP required a continuous infusion for its use. ATP was infused intravenously at a rate of 0.16 mg/kg/min for 5 min, with 201Tl injection taking place at 3 min. Myocardial SPECT imaging was begun 5 min and 4 hr later after the end of ATP infusion. ATP caused a significant decrease in arterial blood pressure (p201Tl myocardial SPECT for the detection of coronary artery disease (CAD) was evaluated using CAG as a golden standard. The sensitivity and specificity for CAD detection were 82% and 90%, respectively. ATP myocardial SPECT is a promising new test for the detection of ischemic heart disease. (author)

1993-03-01

40

Is the cardiac function improvement after PTCA predictable by the quantitative indices from exercise stress 201Tl myocardial SPECT, in patients with old myocardial infarction?  

International Nuclear Information System (INIS)

We examined whether the improvement of left ventricular function after percutaneous transluminal coronary angioplasty (PTCA) in patients with one diseased vessel can be predicted by the quantitative indices from exercise stress 201Tl single photon emission computed tomography (SPECT) and radionuclide angiography (RNA) before PTCA. Exercise stress 201Tl myocardial SPECT and RNA were performed before and after PTCA in 28 patients with old myocardial infarction (OMI). The patients were divided into two groups according to the results of coronary angiogram performed at 3 to 6 months after PTCA; patency was confirmed in 22 patients (Group P) and restenosis was observed in the remaining 6 patients (Group S). In Group P, the count ratios defined as 201Tl uptake in the PTCA region divided by the uptake in the normal region were significantly improved at 1 week and 3 to 6 months after PTCA in the initial image. 201Tl washout rates in the normal regions were significantly increased at 1 week after PTCA in Group S, and these rates in the PTCA regions were significantly increased at 1 week after PTCA in Group P. Left ventricular ejection fractions (LVEF) obtained from RNA were significantly improved 1 week and 3 to 6 months after PTCA in Group P. The changes of LVEF between pre-PTCA and 3 to 6 months after PTCA (?LVEF) were significantly correlated with the count ratios of both initial and delayed SPECT images in Group P (r=0.652; p<0.01, r=0.645; p<0.01 respectively). From the multiple regression analysis using stepwise methods, the count ratio in delayed image and the LVEF before PTCA were selected as independent predictive variables for ?LVEF (multiple correlation coefficient=0.776). Thus, the improvement of LVEF after PTCA may be predictable by the count ratio in the delayed SPECT image and LVEF before PTCA when the treated vessel is persistently patent. (author)

2000-03-01

 
 
 
 
41

Clinical evaluation of efonidipine hydrochloride in angina pectoris. Evaluation in exercise {sup 201}Tl myocardial scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

Clinical usefulness of once-daily administration of 20 to 60 mg of efonidipine hydrochloride and coronary hemodynamics during exercise {sup 201}Tl myocardial scintigraphy were investigated in patients with angina pectoris. Out of 11 patients enrolled in this study, 9 patients were included in the evaluation of patients` impression, in improvement rating in subjective symptoms, in the analysis of the exercise test, in the improvement rating of images on {sup 201}Tl myocardial scintigraphy, and in the global improvement rating, while 10 patients were included in the overall safety rating. Four patients in improvement rating in subjective symptoms, 2 in improving rating in the exercise test, and 5 in the global improvement rating were rated `improved` or better. In the improvement rating on the exercise {sup 201}Tl myocardial scintigraphy image, reduction of the image was observed in 5 patients, 3 out of which were evaluated as `improved` or better. A distinctive reduction of ischemic regions was observed in 2 patients out of the 3. A significant decrease in the number of angina pectoris events and a decreasing tendency in consumption of fast-acting nitrates were observed in spite of the low number of the patients studied. An adverse effect was observed in 1 patient and abnormal laboratory values were observed in 2 patients which were improved promptly after withdrawal of the drug. It was in 7 patients evaluated as `no problem`, while in 4 patients it was evaluated as `useful` or more. (author)

Hori, Masatsugu; Nishimura, Tsunehiko [Osaka Univ., Suita (Japan). Medical School

1996-12-01

42

Clinical evaluation of efonidipine hydrochloride in angina pectoris. Evaluation in exercise 201Tl myocardial scintigraphy  

International Nuclear Information System (INIS)

Clinical usefulness of once-daily administration of 20 to 60 mg of efonidipine hydrochloride and coronary hemodynamics during exercise 201Tl myocardial scintigraphy were investigated in patients with angina pectoris. Out of 11 patients enrolled in this study, 9 patients were included in the evaluation of patients' impression, in improvement rating in subjective symptoms, in the analysis of the exercise test, in the improvement rating of images on 201Tl myocardial scintigraphy, and in the global improvement rating, while 10 patients were included in the overall safety rating. Four patients in improvement rating in subjective symptoms, 2 in improving rating in the exercise test, and 5 in the global improvement rating were rated 'improved' or better. In the improvement rating on the exercise 201Tl myocardial scintigraphy image, reduction of the image was observed in 5 patients, 3 out of which were evaluated as 'improved' or better. A distinctive reduction of ischemic regions was observed in 2 patients out of the 3. A significant decrease in the number of angina pectoris events and a decreasing tendency in consumption of fast-acting nitrates were observed in spite of the low number of the patients studied. An adverse effect was observed in 1 patient and abnormal laboratory values were observed in 2 patients which were improved promptly after withdrawal of the drug. It was in 7 patients evaluated as 'no problem', while in 4 patients it was evaluated as 'useful' or more. (author)

1996-12-01

43

Contamination of clothing and other items by sweat during exercise 201Tl myocardial perfusion scintigraphy  

International Nuclear Information System (INIS)

We measured the radioactivity on patient's upper and lower garments, towels, broad sashes for the bust, and electrodes contaminated by sweat due to exercise 201Tl myocardial perfusion scintigraphy. In measuring activity, a scintillation survey meter adjusted to the energy of 201Tl was used. In measuring the radioactivity of clothing, more than 4 Bq/cm2 was considered to be a significant level of contamination. We detected contamination in 30% of upper garments and towels, 19% of broad sashes, 8% of lower garments and 4% of electrodes. Among these materials, several items of clothing and other items showed contamination exceeding 40 Bq/cm2. Towels were remarkably contaminated, with one towel showing a maximum contamination level of 420 Bq/cm2. Examinations done by exercise 201Tl myocardial perfusion scintigraphy often result in the contamination of clothing and other items through sweating. This contamination is especially common in summer, particularly in upper garments and towels. The contamination ratio for towels was over 50%. The contamination ratio increased as the level of exercise became more difficult. When the exercise load was more than 100 W, the contamination ratio was 50%. In cases of extreme contamination, images of contaminated upper garments could be obtained by the scintigraphy camera. The areas of high activity on the images seemed to correspond to areas of the body where sweating was profuse. Based on these results, we should pay close attention to the handling of clothing and other items used in exercise testing by 201Tl myocardial perfusion scintigraphy and the points used in measuring contaminated clothing and other items after testing. (author)

1999-05-01

44

Contamination of clothing and other items by sweat during exercise {sup 201}Tl myocardial perfusion scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

We measured the radioactivity on patient`s upper and lower garments, towels, broad sashes for the bust, and electrodes contaminated by sweat due to exercise {sup 201}Tl myocardial perfusion scintigraphy. In measuring activity, a scintillation survey meter adjusted to the energy of {sup 201}Tl was used. In measuring the radioactivity of clothing, more than 4 Bq/cm{sup 2} was considered to be a significant level of contamination. We detected contamination in 30% of upper garments and towels, 19% of broad sashes, 8% of lower garments and 4% of electrodes. Among these materials, several items of clothing and other items showed contamination exceeding 40 Bq/cm{sup 2}. Towels were remarkably contaminated, with one towel showing a maximum contamination level of 420 Bq/cm{sup 2}. Examinations done by exercise {sup 201}Tl myocardial perfusion scintigraphy often result in the contamination of clothing and other items through sweating. This contamination is especially common in summer, particularly in upper garments and towels. The contamination ratio for towels was over 50%. The contamination ratio increased as the level of exercise became more difficult. When the exercise load was more than 100 W, the contamination ratio was 50%. In cases of extreme contamination, images of contaminated upper garments could be obtained by the scintigraphy camera. The areas of high activity on the images seemed to correspond to areas of the body where sweating was profuse. Based on these results, we should pay close attention to the handling of clothing and other items used in exercise testing by {sup 201}Tl myocardial perfusion scintigraphy and the points used in measuring contaminated clothing and other items after testing. (author)

Yokoo, Shigeki; Niio, Yasuo; Yamamoto, Tomoaki; Miyashita, Makoto [Showa Univ., Yokohama (Japan). Fujigaoka Hospital

1999-05-01

45

Evaluation of bedside myocardial scintigraphy with "2"0"1TL in acute myocardial infarction  

International Nuclear Information System (INIS)

Bedside myocardial scintigraphy was performed on 149 patients admitted to the Coronary Care Unit (CCU), after IV injection of 74 MBq "2"0"1Tl, using a mobile gamma camera (Dynamo). The study was displayed on Polaroid pictures, without any image treatment, and read by two independent readers. Clinical history, findings, and final diagnosis were assessed by an independent clinician. The following conclusions were reached: 1) The sensitivity of the study for the detection of a recent myocardial infarction (MI) was 0.84 with a specificity of 0.87. 2) There was a good correlation between scintigraphic and ECG localization. 3) No firm correaltion was found between scintigraphic and enzymatic estimates of infarct size. 4) Abnormal visualization of the right ventricle was probably associated with more extensive infarction. (orig.)

1982-01-01

46

Evaluation of myocardial viability following acute myocardial infarction using 201Tl SPECT after thallium-glucose-insulin infusion. Comparison with 18F-FDG positron emission tomography  

International Nuclear Information System (INIS)

The aim of this study was to evaluate myocardial viability in patients after acute myocardial infarction (AMI). We compared 201Tl SPECT after 201Tl with GIK (10% glucose 250 ml, insulin 5 U and KCI 10 mEq) infusion (GIK-201Tl) with resting 201Tl and 99mTc-pyrophosphate (PYP) dual SPECT, positron emission computed tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) in 21 patients with their first AMI, who all underwent successful reperfusion. GIK-201Tl SPECT, 201Tl and 99mTc-PYP dual SPECT were done within 10 days after admission and 18F-FDG-PET was performed at 3 weeks. GIK-201Tl SPECT was obtained after 30 min of GIK-201Tl infusion. 18F-FDG (370 MBq) was injected intravenously after oral glucose (1 g/kg) loading, and then PET was obtained. PET and SPECT images were divided into 20 segments. Regional tracer uptake was scored using a 4-point scoring system (3=normal to 0=defect), and summed to a regional uptake score (RUS). Regional area means the infarcted area in which 99mTc-PYP accumulated. The number of decreased uptake segments (ES) was then determined. The infarcted area was defined as the area of 99mTc-PYP uptake. The ESs for the GIK-201Tl and 18F-FDG-PET images were significantly lower than the number of 99mTc-PYP uptake segments. The RUS for GIK-201Tl was higher than that for resting-201Tl imaging and similar to those for 18F-FDG-PET. In the detection of myocardial viability following AMI, GIK-201Tl imaging is useful with findings similar to those of 18F-FDG-PET. (author)

2004-09-01

47

Gamma radiation measurements and Monte Carlo computations following myocardial perfusion imaging with 201Tl.  

Science.gov (United States)

In the current study, the time-dependent retention of (201)Tl-thallous chloride (111 MBq) was measured in a 56-y-old man undergoing myocardial perfusion imaging. For 23 d following the (201)Tl injection, total-body retained activity was measured by (i) in situ gamma spectrometry using a portable high-purity germanium (HPGe) detector and (ii) ex vivo urine radioassay using a shielded HPGe detector. The time-dependent decrease in total-body activity followed a monoexponential function, exp(-0.011 t), with an excellent correlation (R(2)=0.9988) between the experimental data and the fitted values. The effective half-life, Teff, of (201)Tl (physical half-life, Tph: 72.9 h) was therefore 63 h and the biological half-life, Tb, 463 h=19.3 d, identical to those measured in the same patient in 1997 (i.e. 14 y ago). The time-dependent decrease in the urine activity concentration, which followed a monoexponential function, exp(-0.0115 t), corroborated the foregoing results. The correlation (R(2)=0.9939) between the experimental data and the fitted values was again excellent. The effective half-life, Teff, was 60.26 h and the biological half-life, Tb, 348 h=14.5 d. Monte Carlo simulation using a simple model of the patient as a unit-density cylinder filled with water and containing a uniform distribution of (201)Tl yielded photon flux results in reasonable agreement with the measured data. PMID:22611205

Clouvas, A; Xanthos, S

2012-12-01

48

Gamma radiation measurements and Monte Carlo computations following myocardial perfusion imaging with 201Tl  

International Nuclear Information System (INIS)

In the current study, the time-dependent retention of 201Tl-thallous chloride (111 MBq) was measured in a 56-y-old man undergoing myocardial perfusion imaging. For 23 d following the 201Tl injection, total-body retained activity was measured by (i) in situ gamma spectrometry using a portable high-purity germanium (HPGe) detector and (ii) ex vivo urine radioassay using a shielded HPGe detector. The time-dependent decrease in total-body activity followed a monoexponential function, exp(-0.011 t), with an excellent correlation (R2=0.9988) between the experimental data and the fitted values. The effective half-life, Teff, of 201Tl (physical half-life, Tph: 72.9 h) was therefore 63 h and the biological half-life, Tb, 463 h=19.3 d, identical to those measured in the same patient in 1997 (i.e. 14 y ago). The time-dependent decrease in the urine activity concentration, which followed a monoexponential function, exp(-0.0115 t), corroborated the foregoing results. The correlation (R2=0.9939) between the experimental data and the fitted values was again excellent. The effective half-life, Teff, was 60.26 h and the biological half-life, Tb, 348 h = 14.5 d. Monte Carlo simulation using a simple model of the patient as a unit-density cylinder filled with water and containing a uniform distribution of 201Tl yielded photon flux results in reasonable agreement with the measured data. (authors)

2012-01-01

49

Usefulness and safety of ATP 201Tl myocardial scintigraphy for the detection of coronary artery disease  

International Nuclear Information System (INIS)

To evaluate the usefulness and safety for the detection of coronary artery disease (CAD). adenosine triphosphate (ATP) 201Tl myocardial scintigraphy was performed in 42 patients (mean: 60.0±10.4 years) with angina pectoris or old myocardial infarction. Coronary angiography (CAG) was performed by the conventional method in all patients. The ultra-short half-life of ATP required a continuous infusion for its use. To estimate the safe and suitable dose of ATP, the patients were divided to 4 groups according to infusion dose of ATP, 0.18 mg/kg/min in fifteen patients (group A), 0.16 mg/kg/min in fifteen patients (group B), 0.14 mg/kg/min in ten patients (group C), and 0.10 mg/kg/min in two patients (group D). ATP caused a significant decrease (pB). No significant hemodynamic changes were observed in groups C and D. Chest pain was observed in 53% of patients in group A, 27% in group B, 20% in group C, and 0% in group D during ATP infusion. However, due to ATP's ultra-short half-life, administration of aminophylline was not required. No serious complications were observed with ATP 201Tl scintigraphy. Usefulness of ATP 201Tl scintigraphy for the detection of CAD was evaluated using CAG as a golden standard. The sensitivity and specificity were 81% and 92%, respectively, in group A, and 84% and 92% in group B. The sensitivity in group C was 67% which was lower than that of groups A and B. Nevertheless patients with CAD, perfusion defect was not seen in group D. ATP 201Tl scintigraphy showed high sensitivity and specificity for the detection of CAD, comparable with those of exercise, dipyridamole and adenosine methods in groups A and B. The dose of group B (0.16 mg/kg/min) was the most suitable, considering usefulness and safety. ATP 201Tl scintigraphy is a promising new test for the detection of CAD. (author)

1992-12-01

50

Reverse redistribution of thallium-201 myocardial single photon emission tomography and contractile reserve  

International Nuclear Information System (INIS)

The present study investigated the contractile reserve of myocardium exhibiting reverse redistribution (RRD) of thallium-201 (201Tl) after acute myocardial infarction. Forty patients experiencing their first acute myocardial infarction underwent resting 201Tl single-photon emission computed tomography (SPECT) and low-dose (5-10 ?g·kg-1·min-1) dobutamine stress echocardiography (DSE) within 4 weeks after the onset of infarction. The left ventricle was divided into 13 segments for analysis. The severity of defects in 201Tl SPECT and the extent of wall motion abnormality in DSE were visually assessed and scored. The sum of each defect score and wall motion score of infarct-related segments were defined as total defect score (TDS) and total wall motion score (TWM), respectively. Quantitative analysis of 201Tl uptake was also performed. Resting 201Tl SPECT revealed RRD in 16 patients (group RRD), fixed defect (FIX) in 23 patients (group FIX), and redistribution in one. There was a significant difference in improvement of TWM between rest and stress in TWM in both the RRD and FIX groups (p201Tl SPECT in patients with acute myocardial infarction has greater contractile reserve than that exhibiting a fixed defect. (author)

2000-05-01

51

ATP-loading [sup 201]Tl myocardial SPECT for the detection of ischemic heart disease  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the usefulness for the detection of ischemic heart disease, ATP myocrdial SPECT was performed in 35 patients (mean; 59[+-]9.4 years) with angina pectoris or old myocardial infarction. Coronary angiography (CAG) was performed in all patients. The ultra-short half-life of ATP required a continuous infusion for its use. ATP was infused intravenously at a rate of 0.16 mg/kg/min for 5 min, with [sup 201]Tl injection taking place at 3 min. Myocardial SPECT imaging was begun 5 min and 4 hr later after the end of ATP infusion. ATP caused a significant decrease in arterial blood pressure (p<0.01) and reflex increase in heart rate (p<0.01). Double product increased slightly (from 8394[+-]2452 to 9581[+-]1856). The side effects were generally mild, transient, and no need for administration of aminophylline. The most frequent side effects include chest pain (26%), flushing, warmth (14%), headache (11%), palpitation (3%), dyspnea (3%), and arm discomfort (3%). The second degree AV block was observed in 6% and ST depression was observed in 9% of patients. Usefulness of ATP [sup 201]Tl myocardial SPECT for the detection of coronary artery disease (CAD) was evaluated using CAG as a golden standard. The sensitivity and specificity for CAD detection were 82% and 90%, respectively. ATP myocardial SPECT is a promising new test for the detection of ischemic heart disease. (author).

Fujinaga, Tsuyoshi; Yamazaki, Sayaka; Hara, Masatada; Umezawa, Chiaki; Okamura, Tetsuo (Jikei Univ., Tokyo (Japan). School of Medicine); Murata, Hajime; Maruno, Hirotaka; Onoguchi, Masahisa

1993-03-01

52

Two dimensional polar coordinate representation (bulls-eye view) method of the "2"0"1Tl myocardial SPECT  

International Nuclear Information System (INIS)

Two dimensional polar coordinate representation (bulls-eye view) method was applied to the "2"0"1Tl myocardial imaging by single photon emission CT (SPECT) and this method was compared with a conventional SPECT image for the ability to detect the abnormalities. We examined 5 normals and 15 patients (10 angina pectolis and 5 myocardial infarction), whose diagnosis were confirmed by coronary angiography. Diagnostic efficacy of two methods was evaluated in two groupes of radiologists by means of ROC (receiver operating characteristic) curve. Radiologists in A group have three years experience or more in nuclear medicine and those in B group have less than one year experience. As a result, diagnostic accuracy of conventional method was 93 % in a group and 55 % in B group. The accuracy by the two polar coordinate representation was increased from 55 % to 86 % in B group, although no remarkable improvement was seen in the accuracy (90 %) of A group. The consuming time for diagnosis was shortend by using the two dimensional polar coordinate representation method, especially in B group. This result suggests that the two dimensional polar coordinate representation method is useful for reading the myocardial imaging in not-well trained radiologists as well as in the well trained. (author)

1987-01-01

53

Delayed cerebral radionecrosis with a high uptake of 11C-methionine on positron emission tomography and 201Tl-chloride on single-photon emission computed tomography  

International Nuclear Information System (INIS)

A 47-year-old woman, who 2.5 years previously had undergone resection of a malignant astrocytoma of the left temporal lobe followed by radiotherapy, was found to have a mass in the left frontal lobe. This showed high uptake of thallium-201 (201Tl) on single-photon emission computed tomography and 11C-methionine on positron-emission tomography, suggesting recurrent tumour. Histological examination of the resected lesion, however, revealed it to be radionecrosis. This case thus illustrates a diagnostic pitfall in the use of these investigations for distinguishing radionecrosis from recurrent malignant glioma. (orig.)

1998-07-01

54

Absolute quantitation of myocardial blood flow with 201Tl and dynamic SPECT in canine: optimisation and validation of kinetic modelling  

International Nuclear Information System (INIS)

201Tl has been extensively used for myocardial perfusion and viability assessment. Unlike 99mTc-labelled agents, such as 99mTc-sestamibi and 99mTc-tetrofosmine, the regional concentration of 201Tl varies with time. This study is intended to validate a kinetic modelling approach for in vivo quantitative estimation of regional myocardial blood flow (MBF) and volume of distribution of 201Tl using dynamic SPECT. Dynamic SPECT was carried out on 20 normal canines after the intravenous administration of 201Tl using a commercial SPECT system. Seven animals were studied at rest, nine during adenosine infusion, and four after beta-blocker administration. Quantitative images were reconstructed with a previously validated technique, employing OS-EM with attenuation-correction, and transmission-dependent convolution subtraction scatter correction. Measured regional time-activity curves in myocardial segments were fitted to two- and three-compartment models. Regional MBF was defined as the influx rate constant (K1) with corrections for the partial volume effect, haematocrit and limited first-pass extraction fraction, and was compared with that determined from radio-labelled microspheres experiments. Regional time-activity curves responded well to pharmacological stress. Quantitative MBF values were higher with adenosine and decreased after beta-blocker compared to a resting condition. MBFs obtained with SPECT (MBFSPECT) correlated well with the MBF values obtained by the radio-labelled microspheres (MBFMS) (MBFSPECT = -0.067 + 1.042 x MBFMS, p 201Tl and dynamic SPECT. (orig.)

2008-05-01

55

The quantitative analysis of "2"0"1Tl myocardial emission computed tomography in patients with old myocardial infarction  

International Nuclear Information System (INIS)

Circumferential profiles for "2"0"1Tl two-dimensional myocardial planar images and "2"0"1Tl myocardial emission computed tomography (ECT) images at rest were generated from 52 patients with old myocardial infarction undergoing left ventriculography (LVG). Normal profile curves were obtained from the ECT images in normal volunteers. Infarct areas were estimated based on the profile curves: Findings obtained coincided well with abnormal wall motion in LVG. Qualitative analysis of ECT images was superior to that of two-dimensional planar images in the diagnostic sensitivity and specificity. There was a significant positive correlation between the ratio of infarct size to the total left ventricular volume, which was obtained from shortaxial ECT images, and percent abnormally contracting segment with r = 0.74 (p < 0.0001). A significant negative correlation was observed between infarct size and left ventricular ejection fraction obtained by LVG with r = -0.53 (p < 0.0001). These results led to a conclusion that circumferential profile analysis of "2"0"1Tl myocardial ECT images is an objective, reliable, and non-invasive method in the diagnosis of location and size of old myocardial infarction. (Namekawa, K.)

1985-01-01

56

Comparison of correction techniques for simultaneous 201Tl/99mTc myocardial perfusion SPECT imaging: a dog study  

International Nuclear Information System (INIS)

We compared two correction methods for simultaneous 201Tl/99mTc dual-isotope single-photon emission computed tomography (SPECT). Both approaches use the information from the third energy window placed between the photopeak windows of the 201Tl and 99mTc. The first approach, described by Moore et al, corrects only for the contribution of the 99mTc to the 201Tl primary 70 keV window. We developed the three-window transformation dual-isotope correction method, which is a simultaneous cross-talk correction. The two correction methods were compared in a simultaneous 201Tl/99mTc sestamibi cardiac dog study. Three separate acquisitions were performed in this dog study: two single-isotope and one dual-isotope acquisition. The 201Tl single-isotope images were used as references. The total number of counts, and the contrast between the left ventricular cavity (LVC) and the myocardium, were used in 70 keV short-axis slices as parameters for evaluating the results of the dual-isotope correction methods. Three consecutive short-axis slices were used to calculate averaged contrast and the averaged total number of counts. The total number of the counts was 667 000 ± 500 and 414 500 ± 400 counts for the dual-isotope (201Tl + 99mTc) and single-isotope (201Tl-only) 70 keV images, respectively. The corrected dual-isotope images had 514 700 ± 700 and 368 000 ± 600 counts for Moore's correction and our approach, respectively. Moore's method improved contrast in the dual-isotope 70 keV image to 0.14 ± 0.03 from 0.11 ± 0.02, which was the value in the 70 keV non-corrected dual-isotope image. Our method improved the same contrast to 0.22 ± 0.03. The contrast in the 201Tl single-isotope 70 keV image was 0.28 ± 0.02. Both methods improved the 70 keV dual-isotope images. However, our approach provided slightly better images than Moore's correction when compared with 201Tl-only 70 keV images. (author)

2000-11-01

57

NOTE: Comparison of correction techniques for simultaneous 201Tl/99mTc myocardial perfusion SPECT imaging: a dog study  

Science.gov (United States)

We compared two correction methods for simultaneous 201Tl/99mTc dual-isotope single-photon emission computed tomography (SPECT). Both approaches use the information from the third energy window placed between the photopeak windows of the 201Tl and 99mTc. The first approach, described by Moore et al, corrects only for the contribution of the 99mTc to the 201Tl primary 70 keV window. We developed the three-window transformation dual-isotope correction method, which is a simultaneous cross-talk correction. The two correction methods were compared in a simultaneous 201Tl/99mTc sestamibi cardiac dog study. Three separate acquisitions were performed in this dog study: two single-isotope and one dual-isotope acquisition. The 201Tl single-isotope images were used as references. The total number of counts, and the contrast between the left ventricular cavity (LVC) and the myocardium, were used in 70 keV short-axis slices as parameters for evaluating the results of the dual-isotope correction methods. Three consecutive short-axis slices were used to calculate averaged contrast and the averaged total number of counts. The total number of the counts was 667 000 ± 500 and 414 500 ± 400 counts for the dual-isotope (201Tl + 99mTc) and single-isotope (201Tl-only) 70 keV images, respectively. The corrected dual-isotope images had 514 700 ± 700 and 368 000 ± 600 counts for Moore's correction and our approach, respectively. Moore's method improved contrast in the dual-isotope 70 keV image to 0.14 ± 0.03 from 0.11 ± 0.02, which was the value in the 70 keV non-corrected dual-isotope image. Our method improved the same contrast to 0.22 ± 0.03. The contrast in the 201Tl single-isotope 70 keV image was 0.28 ± 0.02. Both methods improved the 70 keV dual-isotope images. However, our approach provided slightly better images than Moore's correction when compared with 201Tl-only 70 keV images.

Knesaurek, Karin; Machac, Josef

2000-11-01

58

Limited performance of quantitative assessment of myocardial function by thallium-201 gated myocardial single-photon emission tomography  

International Nuclear Information System (INIS)

We investigated the reproducibility between thallium-201 and technetium-99m methoxyisobutylisonitrile (MIBI) gated single-photon emission tomography (SPET) for the assessment of indices of myocardial function such as end-diastolic and end-systolic volume (EDV, ESV), ejection fraction (EF) and wall motion. Rest 201Tl (111 MBq) gated SPET was sequentially performed twice in 20 patients. Rest 201Tl gated SPET and rest 99mTc-MIBI (370 MBq) gated SPET were performed 24 h apart in 40 patients. Wall motion was graded using the surface display of the Cedars quantitative gated SPET (QGS) software. EDV, ESV and EF were also measured using the QGS software. The reproducibility of functional assessment on rest 201Tl gated SPET was compared with that on 99mTc-MIBI gated SPET, and also with that between 201Tl gated SPET and 99mTc-MIBI gated SPET performed on the next day. The two standard deviation (2 SD) values for EDV, ESV and EF on the Bland-Altman plot were 29 ml, 19 ml and 12%, respectively, on repeated 201Tl gated SPET, compared with 14 ml, 11 ml and 5.3% on repeated 99mTc-MIBI gated SPET. The correlations were good (r=0.96, 0.97 and 0.87) between the two measurements of EDV, ESV and EF on repeated rest studies with 201Tl and 99mTc-MIBI gated SPET. However, Bland-Altman analysis revealed that the 2 SD values between the two measurements were 31 ml, 23 ml and 12%. We were able to score the wall motion in all cases using the 3D surface display of the QGS on 201Tl gated SPET. The kappa value of the wall motion grade on the repeated 201Tl study was 0.35, while that of the wall motion grade on the repeated 99mTc-MIBI study was 0.76. The kappa value was 0.49 for grading of wall motion on repeated rest studies with 201Tl and 99mTc-MIBI. In conclusion, QGS helped determine EDV, ESV, EF and wall motion on 201Tl gated SPET. Because the EDV, ESV and EF were less reproducible on repeated 201Tl gated SPET or on 201Tl gated SPET and 99mTc-MIBI gated SPET on the next day than on repeated 99mTc-MIBI gated SPET, functional measurement on 201Tl gated SPET did not seem to be interchangeable with that on 99mTc-MIBI gated SPET. (orig.)

2000-02-01

59

Influence of increased 201Tl lung uptake on the myocardial viability of the patients with dilated cardiomyopathy under congestive heart failure  

International Nuclear Information System (INIS)

Influence of increased 201Tl lung uptake on the myocardial viability was studied in 15 patients with dilated cardiomyopathy under congestive heart failure. Rest and 4 hours delayed 201Tl SPECT were obtained. At the same time anterior planar images were collected. In 10 patients of 15 patients 201Tl lung heart ratio in SPECT (LHR) was larger than that in planar images. Maximal 201Tl lung uptake was noted at the lower left lung adjacent to the heart. In the delayed images 201Tl lung uptake diminished. In 10 patients the value of LHR in the delayed images was less than 0.5. By comparing initial images with delayed images it was proved to be difficult to determine the myocardial margin adjacent to the increased 201Tl lung uptake. In 2 patients lateral defects were concealed by the increased 201Tl lung uptake. In the remaining patients lateral wall was similar to the hypertrophic myocardium. The effect of scatter due to the increased 201Tl lung uptake was noted in the neighboring myocardium. In most cases %201Tl uptake in the septum was relatively depressed by increased %201Tl uptake in the lateral wall. In the delayed images pseudo-redistribution was noted in the septum. Mean value of differences in %201Tl uptake between initial and delayed images was 8(2-15)%. It was concluded that in case of increased 201Tl lung uptake SPECT could not accurately estimate myocardial viability by initial images and delayed images were necessary for precise estimation. (author)

1992-11-01

60

Influence of increased [sup 201]Tl lung uptake on the myocardial viability of the patients with dilated cardiomyopathy under congestive heart failure  

Energy Technology Data Exchange (ETDEWEB)

Influence of increased [sup 201]Tl lung uptake on the myocardial viability was studied in 15 patients with dilated cardiomyopathy under congestive heart failure. Rest and 4 hours delayed [sup 201]Tl SPECT were obtained. At the same time anterior planar images were collected. In 10 patients of 15 patients [sup 201]Tl lung heart ratio in SPECT (LHR) was larger than that in planar images. Maximal [sup 201]Tl lung uptake was noted at the lower left lung adjacent to the heart. In the delayed images [sup 201]Tl lung uptake diminished. In 10 patients the value of LHR in the delayed images was less than 0.5. By comparing initial images with delayed images it was proved to be difficult to determine the myocardial margin adjacent to the increased [sup 201]Tl lung uptake. In 2 patients lateral defects were concealed by the increased [sup 201]Tl lung uptake. In the remaining patients lateral wall was similar to the hypertrophic myocardium. The effect of scatter due to the increased [sup 201]Tl lung uptake was noted in the neighboring myocardium. In most cases %[sup 201]Tl uptake in the septum was relatively depressed by increased %[sup 201]Tl uptake in the lateral wall. In the delayed images pseudo-redistribution was noted in the septum. Mean value of differences in %[sup 201]Tl uptake between initial and delayed images was 8(2-15)%. It was concluded that in case of increased [sup 201]Tl lung uptake SPECT could not accurately estimate myocardial viability by initial images and delayed images were necessary for precise estimation. (author).

Tanaka, Takeshi; Nakano, Hajime; Katoh, Kazuzo (Cardiovascular Inst., Tokyo (Japan))

1992-11-01

 
 
 
 
61

Myocardial imaging in dogs treated with grisorixin: relationship between "2"0"1Tl uptake and coronary blood flow  

International Nuclear Information System (INIS)

"2"0"1Tl myocardial imaging was performed in dogs after pretreatment with grisorixin, which appeared to increase the myocardial uptake of "2"0"1Tl. This effect of grisorixin was found to be dose dependent, with an optimal dose of 60 microgram/kg. The myocardial-to-background ratio, which was 1.92 in the control dogs, rose to 4.45. The increase in the absolute myocardial uptake was demonstrated in guinea pigs that received "2"0"1Tl after similar pretreatment with grisorixin. In the animals treated with 500 microgram/kg, the uptake of "2"0"1Tl by the heart was 35% over the control value. With 60 microgram/kg grisorixin, the coronary blood flow increased from 40 to 176 ml/min 5 min after the injection. This dose, optimal for imaging, induced the maximum vasodilator effect with only a very slight concomitant increase in the left-ventricular pressure and myocardial contractility. Above 60 microgram/kg, grisorixin appeared to be a potent inotropic agent, whereas below this dose it showed only coronary vasodilator properties. Some evidence for an ionophore effect of this compound was found in dogs pretreated with 60 microgram/kg. In these the radionuclide was injected when the coronary vasodilatation had become insignificant, but a significant improvement of the M/B ratio was still evident

1982-01-01

62

Myocardial imaging in dogs treated with grisorixin: relationship between /sup 201/Tl uptake and coronary blood flow  

Energy Technology Data Exchange (ETDEWEB)

/sup 201/Tl myocardial imaging was performed in dogs after pretreatment with grisorixin, which appeared to increase the myocardial uptake of /sup 201/Tl. This effect of grisorixin was found to be dose dependent, with an optimal dose of 60 microgram/kg. The myocardial-to-background ratio, which was 1.92 in the control dogs, rose to 4.45. The increase in the absolute myocardial uptake was demonstrated in guinea pigs that received /sup 201/Tl after similar pretreatment with grisorixin. In the animals treated with 500 microgram/kg, the uptake of /sup 201/Tl by the heart was 35% over the control value. With 60 microgram/kg grisorixin, the coronary blood flow increased from 40 to 176 ml/min 5 min after the injection. This dose, optimal for imaging, induced the maximum vasodilator effect with only a very slight concomitant increase in the left-ventricular pressure and myocardial contractility. Above 60 microgram/kg, grisorixin appeared to be a potent inotropic agent, whereas below this dose it showed only coronary vasodilator properties. Some evidence for an ionophore effect of this compound was found in dogs pretreated with 60 microgram/kg. In these the radionuclide was injected when the coronary vasodilatation had become insignificant, but a significant improvement of the M/B ratio was still evident.

Moins, N.; Gachon, P.; Maublant, J.

1982-04-01

63

Myocardial imaging with dipyridamole - comparison of the sensitivity and specificity of "2"0"1Tl versus MUGA  

International Nuclear Information System (INIS)

Myocardial imaging was performed at rest and after dipyridamole infusion using "2"0"1Tl and sup(99m)Tc-gated blood pool studies (MUGA). Of 38 patients studied, 21 had coronary artery disease (CAD) and 17 were normal. With "2"0"1Tl imaging, 19 of 21 patients with CAD (sensitivity 88%) showed perfusion defects during dipyridamole. Of 17 normals 6 (specificity 65%) showed clear perfusion defects during dipyridamole. With MUGA, 2 of 15 patients with CAD (sensitivity 13%) developed abnormal wall motion during dipyridamole; both patients developed ST depression > 1 mm. Of 10 normals none developed abnormal wall motion. Twenty six of 38 patients developed angina during dipyridamole, which was reversed by aminophylline in 24 of 26. We suggest that dipyridamole infusion is effective for "2"0"1Tl-perfusion imaging, and easily performed, but is not suitable for MUGA studies where ischaemia is the required endpoint. (orig.)

1982-01-01

64

Variability of 201Tl-myocardial image reading by different observers  

International Nuclear Information System (INIS)

In reference to 201Tl-myocardial multiplanar images (PL) and seven-pinhole tomography (7P); interobserver variability, diagnostic difference due to methods, and circumferential profile (CEP) by 7P quantitative evaluation were investigated. No significant difference in the sensitivity by the two methods was found between studies and staff (St), and between St and freshman (Fr). In the St group, results of twice reading were consistent, showing high reproducibility; and the rate of inconsistent diagnosis was very low. Similer results were obtained by the two method. Although there was no significant difference between the two groups, the St group had higher accuracy for positive decision and for localization of lesions consistently by both PL and 7P. Higher accuracy in reading was given by 7P, and 7P and PL than by PL by itself. CFP was useful as a method to correct instability of visual evaluation. (Ueda, J.)

1982-01-01

65

Quantitative evaluation of right ventricular overload in cor pulmonale using 201Tl myocardial SPECT  

International Nuclear Information System (INIS)

To determine quantitatively the discriminant and characteristics of cor pulmonale, 201Tl myocardial perfusion SPECT was performed in 16 patients with chronic obstructive pulmonary disease (COPD) and 7 with restrictive pulmonary disease (RPD). One section of the short-axis SPECT image in which the right ventricle was most clearly visualized was selected. Tl-score was defined as the ratio of the sum of counts in the region of interest (ROI) at the anterior, mid, and posterior regions of the right ventricular free wall to the sum of counts in ROI at the posterior, lateral, and anterior walls of the left ventricle, and the anterior and posterior regions of the interventricular septum. In the group of COPD patients, Tl-score was positively correlated with mean pulmonary arterial pressure (mPAP), total pulmonary vascular resistance (TPR), and arterial carbon dioxide tension (PaCO2), while it was inversely correlated with arterial oxygen tension (PaO2). However, there was no significant correlation between Tl-score and mPAP, TPR, PaCO2, and PaO2 in the group of RPD patients. In assessing pulmonary hypertension as defined by mPAP over 20 mmHg, a Tl-score greater than 0.25 was useful with a sensitivity of 69% and a specificity of 90%. The occurrence of cor pulmonale is a major factor in determining the prognosis of COPD patients. It was concluded that 201Tl myocardial SPECT is useful for evaluating right ventricular overload quantitatively, as well as for assessing core pulmonale, especially in COPD patients, since the ratio of Tl counts in the right and left ventricles was significantly correlated with right cardiopulmonary hemodynamic parameters. (N.K.)

1991-01-01

66

Crosstalk analysis of simultaneously acquired dual-isotope 201tl myocardial perfusion SPECT and 99Tcm-RBC equilibrium ventricle imaging  

International Nuclear Information System (INIS)

Objective: To analysis the crosstalk between the 20'1Tl and 99Tcm while the myocardial SPECT imaging with 201Tl and the equilibrium ventricle imaging with 99Tcm-RBC are simultaneously acquired, and to search after a method to reduce the down scatter of 99Tcm in the 201Tl window. Methods: Myocardial perfusion images were acquired using a cardiac phantom, which can present various levels of ischemia. The pulse height analysis was performed before the SPECT acquisition. The down scatter ratio of different 201Tl doses was calculated on each project with variable acquisition energy window. After the raw data were reconstructed with Butterworth filter, the defect-to-myocardium count ratios from different 201Tl acquisition window and variable defect levels were compared. Results: During the dual-isotope acquisition with 201Tl and 99Tcm the main crosstalk was the down scatter of 99Tcm in 201Tl window, which was considerably reduced while using higher dosage of 201Tl. The down scatter was also inhibited by applying more specific energy window of 201Tl. The defect-to-myocardium ratio analysis showed that only the data acquired under 15% energy window were affected on the contrast of the defects in short axis slice. The window of 201Tl and the extent of the ischemia influenced the defect-to-myocardium ratios of mimic ischemia segments differently. The completely defect group appeared insensible to the change of acquisition window. Between the defect-to-myocardium ratio of 33% filled group and the 66% filled group considerable difference was demonstrated while the acquisition window of 20% was used. Conclusions: The down scatter of 99Tcm is the major factor which influences the simultaneous dual-isotope acquisition. The stain can be reduced either using more specific 201Tl energy acquisition window or applying higher dosage of 201Tl. But due to the long half-life of 201Tl, the authors can not increase the dosage discretionarily. As the more specific window of 201Tl can avoid the influence of the judgement of defect, and provide higher resolution of images, the authors recommend +-10% 201Tl energy window for 201Tl/99Tcm simultaneous acquisition

2001-10-01

67

Effects of metabolically ischemic, but viable, myocardium on QT dispersion in patients with acute myocardial infarction. A study with resting I-123-BMIPP/thallium-201 myocardial single-photon emission computed tomography  

International Nuclear Information System (INIS)

In chronic Q-wave myocardial infarction, QT dispersion is closely correlated with infarct size, but this correlation has not been evaluated for acute myocardial infarction (AMI). The effects of abnormal fatty acid metabolism on QT dispersion were examined in 123 patients with AMI who underwent resting iodine-123-15-iodophenyl 3-methyl pentadecanoic acid (BMIPP)/thallium-201 (201Tl) myocardial single photon emission computed tomography (SPECT) and electrocardiographic analysis in the subacute phase. The relationship between BMIPP and 201Tl was defined as match when the total defect score for BMIPP was equal to or smaller than that for 201Tl, and as mismatch when the total defect score for BMIPP was larger than that for 201Tl. Twenty-six patients (21%) demonstrated BMIPP-201Tl match and 97 (79%) demonstrated mismatch. Infarct size was closely correlated with QT dispersion (r=0.67, p201Tl match, but weakly correlated (r=0.30, p201Tl mismatch. For small infarctions, QT dispersion was significantly larger in patients with BMIPP-201Tl mismatch than in those with BMIPP-201Tl match (62±24 ms vs 41±18 ms, p=0.03), but did not differ between the 2 groups for large infarctions. This study shows that QT dispersion is influenced by infarct size and by the presence of metabolically ischemic but viable myocardium in patients with AMI. (author)

2000-08-01

68

Noninvasive detection of regional myocardial perfusion abnormality with 201Tl and 81Rb  

International Nuclear Information System (INIS)

Myocardial scintigrams were performed at rest and during exercise using 201Tl and 81Rb. Patients underwent graded ergometer exercise stress tests. In normals, myocardial images were horse-shoe of O-shaped and concentration of radionuclide was relatively uniform throughout the myocardium. In 13 patients with old myocardial infarctions, and abnormal Q waves, regional myocardial perfusion defects (cold area) were detected. Their locations correlated with sites of the abnormal Q waves. Two patients had no abnormal Q waves at the examination, but their scintigrams showed cold areas, the locations of which coincided with coronary angiographic findings. Exercise stress Ecg and stress scintigrams were performed. Myocardial perfusion defects, which developed from exercise stress, were detected in 9 of 10 positive exercise Ecg patients, 2 of 4 equivocal exercise Ecg patients, and 2 of 10 negative exercise Ecg patients. These 2 patients (exercise Ecg (-), stress scintigram (+)) had typical angina. Findings of exercise stress scintigrams coincided better with clinical findings than did those of exercise Ecg. These scintigraphic methods appear to be excellent for detection of noninvasive coronary heart disease noninvasively. (Evans, J.)

1977-01-01

69

Myocardial scintigraphy using 99m-Tc-methoxyisobutylisonitrile (Tc-MIBI): A full substitution of 201-Tl?  

International Nuclear Information System (INIS)

The results of selective coronary angiography, myocardial 201-Tl scintigraphy (stress and redistribution) and after 99m-Tc-methoxyisobutylisonitrile stress and rest injections (Tc-MIBI, Cardiolite, DuPont de Nemours, USA) were compared in 19 patients with manifest ischemic heart disease in identical three projections and after same ergometric load. 16 patients had significant stenoses of 1-3 main coronary arteries inclusive of left coronary artery main stem, insignificant stenoses (<50%) were present in the remaining 3 patients. Scintigraphic localizations of accumulation defects in both Tc-MIBI and 201-Tl stress scintigraphy were in agreement in 70.6% of evaluated left ventricular wall segments. A positive 201-Tl redistribution and rest-stress Tc-MIBI scintigraphic difference agreed in 52.6% of images of all three projections with verified accumulation defects. The sensitivity of ischemic area detection in reference to coronary angiography was nearly identical in 201-Tl (75%) and Tc-MIBI scintigraphy (81.2%). Better physical properties of 99m-Tc from the point of view of a gamma camera detection, a possibility to get markedly higher counting rate and sufficient accumulation of the radiopharmaceutical in the perfused myocardium enable to reach scintigraphic pictures with a high contrast after labelled Tc-MIBI injection, even in case of sequential impulse summation during heart cycle (gating). (author) 1 tab., 1 fig., 14 refs

1991-01-01

70

Comparison of myocardial 201Tl clearance after maximal and submaximal exercise: implications for diagnosis of coronary disease: concise communication  

International Nuclear Information System (INIS)

Recently the quantitation of regional 201Tl clearance has been shown to increase the sensitivity of the scintigraphic detection of coronary disease. Although 201Tl clearance rates might be expected to vary with the degree of exercise, this relationship has not been explored. We therefore evaluated the rate of decrease in myocardial 201Tl activity following maximal and submaximal stress in seven normal subjects and 21 patients with chest pain, using the seven-pinhole tomographic reconstruction technique. In normals, the mean 201Tl clearance rate declined from 41% +/- 7 over a 3-hr period with maximal exercise to 25% +/- 5 after 3 hr at a submaximal level (p less than 0.001). Similar differences in clearance rates were found in the normally perfused regions of the left ventricle in patients with chest pain, depending on whether or not a maximal end point (defined as either the appearance of ischemia or reaching 85% of age-predicted heart rate) was achieved. In five patients who did not reach these end points, 3-hr clearance rates in uninvolved regions averaged 25% +/- 2, in contrast to a mean of 38% +/- 5 for such regions in 15 patients who exercised to ischemia or an adequate heart rate. These findings indicate that clearance criteria derived from normals can be applied to patients who are stressed maximally, even if the duration of exercise is limited, but that caution must be used in interpreting clearance rates in those who do not exercise to an accepted end point

1982-01-01

71

Localization of post-infarction myocardial ischemia by /sup 201/Tl emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

In 41 patients with a history of a single myocardial infarction, the location of myocardial ischemia was studied by /sup 201/Tl emission computed tomography immediately and 3 h after intravenous dipyridamole. Peri-infarctional ischemia without distant ischemia was observed in 15 patients. The occurrence of distant ischemia was found to be dependent on the severity of stenosis in non-infarct coronary vessels. Twelve (86%) of 14 patients with non-infarct stenosis of 75% or greater had distant ischemia, but only 1 (4%) of 27 patients with non-infarct stenosis of less than 75%. In the presence of distant ischemia, peri-infarctional ischemia was in 11 patients (85%) associated with collaterals supplying the infarct zone, whereas in 13 (87%) of the patients with peri-infarctional ischemia only, incomplete obstruction of the infarct vessel was observed. It is concluded that, by the distinction between peri-infarctional and distant ischemia, the presence of significant stenosis in non-infarct vessels can be non-invasively predicted from tomographic thallium scintigraphy with dipyridamole.

Spielmann, R.P.; Heinemann, H.; Montz, R.; Nienaber, C.A.

1985-12-01

72

Localization of post-infarction myocardial ischemia by "2"0"1Tl emission computed tomography  

International Nuclear Information System (INIS)

In 41 patients with a history of a single myocardial infarction, the location of myocardial ischemia was studied by "2"0"1Tl emission computed tomography immediately and 3 h after intravenous dipyridamole. Peri-infarctional ischemia without distant ischemia was observed in 15 patients. The occurrence of distant ischemia was found to be dependent on the severity of stenosis in non-infarct coronary vessels. Twelve (86%) of 14 patients with non-infarct stenosis of 75% or greater had distant ischemia, but only 1 (4%) of 27 patients with non-infarct stenosis of less than 75%. In the presence of distant ischemia, peri-infarctional ischemia was in 11 patients (85%) associated with collaterals supplying the infarct zone, whereas in 13 (87%) of the patients with peri-infarctional ischemia only, incomplete obstruction of the infarct vessel was observed. It is concluded that, by the distinction between peri-infarctional and distant ischemia, the presence of significant stenosis in non-infarct vessels can be non-invasively predicted from tomographic thallium scintigraphy with dipyridamole. (orig./MG)

1985-01-01

73

Coronary artery disease detected noninvasively by dipyridamole-loading 201Tl myocardial scintigraphy in elderly patients  

International Nuclear Information System (INIS)

To evaluate the usefulness in diagnosing coronary artery disease (CAD), dipyridamole-loading 201Tl myocardial scintigraphy was performed for 52 elderly patients (65 - 92 years, mean: 72 years), and the results were compared with data from the treadmill exercise tests. 1. Thirty-five patients could not tolerate adequate exercise tests. Seven of them had reversible defects; six, fixed (irreversible) ones. Dipyridamole scintigraphy is therefore applicable in detecting CAD among patients with suspected CAD who are unable to perform adequate exercise tests. 2. Four of 16 patients with positive exercise tests had no reversible defects; the exercise results in three were regarded as false positives. 3. Seventeen patients experienced chest pain; 12 had ST depression during dipyridamole loading. There were no serious complications, but seven patients required aminophylline. 4. We demonstrated previously that the sensitivity and specificity of dipyridamole scintigraphy in detecting CAD were 90 % and 92 %, respectively, in patients with chest pain undergoing coronary angiography. These results were superior to those of conventional exercise myocardial scintigraphy. Therefore, dipyridamole scintigraphy is regarded as a safe and useful method for detecting CAD, particulary in elderly patients who have ST and T wave abnormalities but cannot tolerate exercise test adequately. (author)

1986-01-01

74

Effect of wall thickness of left ventricle on {sup 201}Tl myocardial SPECT images. Myocardial phantom study  

Energy Technology Data Exchange (ETDEWEB)

{sup 201}Tl myocardial SPECT is known for better sensitivity, specificity, and accuracy than planar images in detecting coronary artery disease and diagnosing myocardial viability. SPECT images arc also superior to planar images in diagnostic sensitivity and anatomical orientation. However, as limitation of the spatial resolution of the machine, we often encounter poor SPECT plower image quality in patients with decreased wall thickness. To test the accuracy of SPECT images in patients with marked thinning of the left ventricular wall, as occurs in dilated cardiomyopathy, we performed a experimental study using myocardial phantom with 7 mm wall thickness. Tomographic image of the phantom images were rather heterogeneous, though no artificial defect was located Dilated cardiomyopathy is thought to be characterized by patchy defects in the left ventricle. Careful attention should be given to elucidating myocardial perfusion in patients with a thin left ventricle wall, as there are technical limitations in addition to clinical features. (author)

Koto, Masanobu; Kawase, Osami [Kobe Univ. (Japan). Hospital; Namura, Hiroyuki; Yamasaki, Katsuhito; Kono, Michio

1996-07-01

75

Value of myocardial 201Tl scintigraphy for the diagnosis of coronary heart disease in patients with blocked left peduncle of His' bundle  

International Nuclear Information System (INIS)

Possible use of loading myocardial 201Tl scintigraphy is considered for patients with blocked left peduncle of His' bundle. The procedure is shown to be of considerable value for the prognosis of coronary heart disease in such patients

1987-01-01

76

Improvement of myocardial perfusion detected by 201Tl scintigraphy on cardiac rehabilitation for patients with coronary artery disease  

International Nuclear Information System (INIS)

The effect of cardiac rehabilitation (mean 70±48 months) on myocardial perfusion was assessed using thallium-201 (201Tl) exercise study in 63 patients with coronary artery disease (CAD). Subjects were those in a rehabilitation group (Rh=42) participating in supervised sports training two to three times per week and the control group (Ct=21) not taking active daily exercise. The interval between two 201Tl SPECT studies was 19±16 months. After physical training, total duration of the exercise test increased from 443±112 to 536±121 seconds (+19%) in the Rh group, and from 484±129 to 432±115 seconds in the Ct group (-10.7%) (p2 to 269.8±58 x 102 in the Rh group and decreased from 218.7±40 x 102 to 216.6±76 x 102 (p201Tl myocardial perfusion defect on exercise improved more in 54.8% (stress 59.5%, rest 35.7%) in the Rh group than in the Ct group (9.5%, p201Tl perfusion defect decreased from 68 (23.1%) to 49 regions (16.7%) of 294 total myocardial regions in the Rh group on exercise. However. it increased from 39 (26.5%) to 44 (29.9%) regions of 147 regions in the Ct group (p<0.01). Thus, cardiac rehabilitation increases exercise tolerance with improvement of myocardial perfusion. suggesting that cardiac rehabilitation is an advisable and effective treatment for patients with ischemic heart disease. (author)

1996-07-01

77

Prognostic investigations after myocardial infarction: A comparison of radionuclide angiography and "2"0"1Tl scintigraphy  

International Nuclear Information System (INIS)

The ability of pre-discharge thallium Tl201 scintigraphy and radionuclide angiography (RNA) to predict subsequent cardiac events was investigated in 46 apparently low-risk survivors of a first acute myocardial infarction. All patients underwent selective coronary arteriography at 3 months post-discharge. At the time of the initial investigation, half were beta-blocked, and thereafter, all patients were given prophylactic beta-blockade. During a mean follow-up period of 12+-4 months, 14 patients (30%) experienced cardiac events, i.e. recurrent myocardial infarction (3 patients), angina pectoris (13 patients) and coronary surgery (8 patients). No patient died during the follow-up period. Of the 14 with subsequent cardiac events, 11 were identified by the presence of a reversible perfusion defect at "2"0"1Tl scintigraphy, while 7 exhibited abnormal left ventricular exercise reserve on RNA. The predictive accuracy of "2"0"1Tl (85%) for subsequent cardiac events exceeded that of RNA (56%; P<0.01) and of arteriographic multi-vessel disease (65%; P<0.05). The sensitivity of the non-invasive techniques was not influenced by beta-blockade at the time of investigation. Thus, "2"0"1Tl scintigraphy appears to be the more accurate technique for the assessment of the prognosis of apparently low-risk patients following myocardial infarction. The accuracy of the technique was not reduced by beta-adrenergic blockade. (orig.)

1986-01-01

78

Serial assessment of denervated but viable myocardium following acute myocardial infarction by using 123I-MIBG and 201TlCl myocardial SPECT  

International Nuclear Information System (INIS)

123I-MIBG is taken up by sympathetic nerve ending and provides a scintigraphic image of myocardial sympathetic innervation. We investigated the scingigraphic detection of denervated but viable myocardium following acute myocardial infarction by serial 123I-MIBG and 201TlCl myocardial SPECT. Fourteen patients were studied at acute (10±2 days) and chronic stage (86±10 days). Simultaneous dual SPECT was carried out after IV administration of 111 MBq (3 mCi) of 201TlCl and 123I-MIBG. The defect size of 123I-MIBG and 201TlCl were compared visually by using Bull's eye display generated from each myocardial SPECT. In all patients, 123I-MIBG defect showed larger compared to 201TlCl defect at acute stage, which suggest the existence of denervated but viable myocardium. Of these patients, seven showed significant improvement of both defects, though 123I-MIBG defect showed slightly larger compared to 201TlCl defect, even at chronic stage. These patients had exercise induced thallium transient defect at infarcted area. The remaining 7 patients had no improvement of both defects at chronic stage, which suggest the complete scar at infarcted area. In addition to above study, 4 patients of old myocardial infarction demonstrated larger 123I-MIBG defect compared to 201TlCl defect even at old stage, which thought to be pathogenesis of ventricular tachycardia. In conclusion, 123I-MIBG could evaluate sympathetic denervation and reinnervation noninvasively in the patients with acute myocardial infarction. (author)

1990-01-01

79

Quantitative assessment of "2"0"1TlCl myocardial SPECT  

International Nuclear Information System (INIS)

Clinical evaluation of the quantitative analysis of Tl-201 myocardial tomography by SPECT (Single Photon Emission Computed Tomography) was performed in comparison with visual evaluation. The method of quantitative analysis has been already reported in our previous paper. In this study, the program of re-standardization in the case of lateral myocardial infarction was added. This program was useful mainly for the evaluation of lesions in the left circumflex coronary artery. Regarding the degree of diagnostic accuracy of myocardial infarction in general, quantitative evaluation of myocardial SPECT images was highest followed by visual evaluation of myocardial SPECT images, and visual evaluation of myocardial planar images. However, in the case of anterior myocardial infarction, visual evaluation of myocardial SPECT images has almost the same detectability as quantitative evaluation of myocardial SPECT images. In the case of infero-posterior myocardial infarction, quantitative evaluation was superior to visual evaluation. As for specificity, quantitative evaluation of SPECT images was slightly inferior to visual evaluation of SPECT images. An infarction map was made by quantitative analysis and this enabled us to determine the infarction site, extent and degree according to easily recognizable patterns. As a result, the responsible coronary artery lesion could be inferred correctly and the calculated infarction score could be correlated with the residual left ventricular function after myocardial infarction. (author)

1987-01-01

80

Usefulness and safety of ATP [sup 201]Tl myocardial scintigraphy for the detection of coronary artery disease  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the usefulness and safety for the detection of coronary artery disease (CAD). adenosine triphosphate (ATP) [sup 201]Tl myocardial scintigraphy was performed in 42 patients (mean: 60.0[+-]10.4 years) with angina pectoris or old myocardial infarction. Coronary angiography (CAG) was performed by the conventional method in all patients. The ultra-short half-life of ATP required a continuous infusion for its use. To estimate the safe and suitable dose of ATP, the patients were divided to 4 groups according to infusion dose of ATP, 0.18 mg/kg/min in fifteen patients (group A), 0.16 mg/kg/min in fifteen patients (group B), 0.14 mg/kg/min in ten patients (group C), and 0.10 mg/kg/min in two patients (group D). ATP caused a significant decrease (p<0.01) in arterial blood pressure and increase in heart rate in groups A and B (potency: A>B). No significant hemodynamic changes were observed in groups C and D. Chest pain was observed in 53% of patients in group A, 27% in group B, 20% in group C, and 0% in group D during ATP infusion. However, due to ATP's ultra-short half-life, administration of aminophylline was not required. No serious complications were observed with ATP [sup 201]Tl scintigraphy. Usefulness of ATP [sup 201]Tl scintigraphy for the detection of CAD was evaluated using CAG as a golden standard. The sensitivity and specificity were 81% and 92%, respectively, in group A, and 84% and 92% in group B. The sensitivity in group C was 67% which was lower than that of groups A and B. Nevertheless patients with CAD, perfusion defect was not seen in group D. ATP [sup 201]Tl scintigraphy showed high sensitivity and specificity for the detection of CAD, comparable with those of exercise, dipyridamole and adenosine methods in groups A and B. The dose of group B (0.16 mg/kg/min) was the most suitable, considering usefulness and safety. ATP [sup 201]Tl scintigraphy is a promising new test for the detection of CAD. (author).

Fujinaga, Takeshi (Jikei Univ., Tokyo (Japan). School of Medicine)

1992-12-01

 
 
 
 
81

Cold pressor 201Tl myocardial scintigraphy in the diagnosis of coronary artery disease  

International Nuclear Information System (INIS)

ams. Coronary cineangiography performed during cold pressor stimulation in 6 patients who had positive cold pressor and exercise 201Tl scintigrams did not show coronary spasm. Our data indicate that cold pressor thallium-201 scintigraphy offers promise as a noninvasive test in the diagnosis of coronary artery disease and may be used in patients in whom exercise testing is not feasible

1982-01-01

82

Diagnostic reliability of 201Tl myocardial emission computed tomography and Frank vectorcardiography for evaluation of myocardial infarct sites  

International Nuclear Information System (INIS)

Diagnostic reliability of 201Tl emission computed tomography (ECT) and vectorcardiography (VCG) for evaluation of myocardial infarction (MI) was studied comparatively in 64 patients with prior myocardial infarction (group I) and 41 noninfarction patients with electrocardiographic abnormalities simulating infarction (group II). The left ventricular wall was divided into anterior, septal, lateral, inferior, and posterior segments in the left ventriculogram. Based on the number of its akinetic segments, group I was divided into two subgroups, solitary infarct group (I-a; n = 48) and multiple infarct group (I-b; n = 16). In group I-a, both ECT and VCG showed a good diagnostic accuracy for every LV segment. In group I-b, ECT showed high sensitivity for all LV segments, whereas VCG showed lower one for the posterior and inferior than for the septal, anterior and lateral segments. In group II, 25 patients satisfied VCG criteria for myocardial infarctions, whereas only two met ECT criteria for myocardial infarction. The latter revealed malrotation of cardiac axis in 13 cases (32 %). Low sensitivity of VCG for multiple infarcts may be best explained by cancellation effects of multiple, reciprocal infarction vectors. Either cardiac malrotation and/or malposition may cause VCG findings simulating myocardial infarction. (author)

1986-01-01

83

Evaluation of myocardial disorders in patients with dilated cardiomyopathy and left ventricular eccentric hypertrophy; By sup 201 Tl myocardial SPECT  

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{sup 201}Tl myocardial SPECT was performed in cases of dilated cardiomyopathy and valvular heart disease with left ventricular eccentric hypertrophy, and the two groups were compared from the standpoint of the mechanism of onset of myocardial disorders. Significant coefficients of correlation were seen between the Tl score and LVDd (r=0.792, r=0.785) and Tl score and LVEF (r=-0.634, r=-0.555) in both dilated cardiomyopathy and valvular heart disease. In cases of valvular heart disease, significant correlation coefficients (r=-0.756, r=-0.720) between LVDd and r-WR (relative-washout rate), and Tl score and r-WR were observed, but no such correlation was seen in dilated cardiomyopathy. In valvular heart disease, a decrease in myocardial perfusion associated with enlargement of the left ventricle appeared, while in dilated cardiomyopathy, there was a marked decrease in LVEF in proportion to the thallium defect. Therefore, it was assumed that left ventricular wall disorders occur due to myocardial metabolic disorders and coronary microcirculation disorders. (author).

Yamazaki, Junichi; Ohsawa, Hidefumi; Uchi, Takashi (Toho Univ., Tokyo (Japan). School of Medicine) (and others)

1992-03-01

84

Low-dose single acquisition rest 99mTc/stress 201Tl myocardial perfusion SPECT protocol: phantom studies and clinical validation  

International Nuclear Information System (INIS)

We developed and tested a single acquisition rest 99mTc-sestamibi/stress 201Tl dual isotope protocol (SDI) with the intention of improving the clinical workflow and patient comfort of myocardial perfusion single photon emission computed tomography (SPECT). The technical feasibility of SDI was evaluated by a series of anthropomorphic phantom studies on a standard SPECT camera. The attenuation map was created by a moving transmission line source. Iterative reconstruction including attenuation correction, resolution recovery and Monte Carlo simulation of scatter was used for simultaneous reconstruction of dual tracer distribution. For clinical evaluation, patient studies were compared to stress 99mTc and rest 99mTc reference images acquired in a 2-day protocol. Clinical follow-up examinations like coronary angiography (CAG) and fractional flow reserve (FFR) were included in the assessment if available. Phantom studies demonstrated the technical feasibility of SDI. Artificial lesions inserted in the phantom mimicking ischaemia could be clearly identified. In 51/53 patients, the image quality was adequate for clinical evaluation. For the remaining two obese patients with body mass index > 32 the injected 201Tl dose of 74 MBq was insufficient for clinical assessment. In answer to this the 201Tl dose was adapted for obese patients in the rest of the study. In 31 patients, SDI and 99mTc reference images resulted in equivalent clinical assessment. Significant differences were found in 20 patients. In 18 of these 20 patients additional examinations were available. In 15 patients the diagnosis based on the SDI images was confirmed by the results of CAG or FFR. In these patients the SDI images were more accurate than the 99mTc reference study. In three patients minor ischaemic lesions were detected by SDI but were not confirmed by CAG. In one of these cases this was probably caused by pronounced apical thinning. For two patients no relevant clinical follow-up information was available for evaluation. The proposed SDI protocol has the potential to improve clinical workflow and patient comfort and suggests improved accuracy as demonstrated in the clinical feasibility study. (orig.)

2014-03-01

85

Low-dose single acquisition rest {sup 99m}Tc/stress {sup 201}Tl myocardial perfusion SPECT protocol: phantom studies and clinical validation  

Energy Technology Data Exchange (ETDEWEB)

We developed and tested a single acquisition rest {sup 99m}Tc-sestamibi/stress {sup 201}Tl dual isotope protocol (SDI) with the intention of improving the clinical workflow and patient comfort of myocardial perfusion single photon emission computed tomography (SPECT). The technical feasibility of SDI was evaluated by a series of anthropomorphic phantom studies on a standard SPECT camera. The attenuation map was created by a moving transmission line source. Iterative reconstruction including attenuation correction, resolution recovery and Monte Carlo simulation of scatter was used for simultaneous reconstruction of dual tracer distribution. For clinical evaluation, patient studies were compared to stress {sup 99m}Tc and rest {sup 99m}Tc reference images acquired in a 2-day protocol. Clinical follow-up examinations like coronary angiography (CAG) and fractional flow reserve (FFR) were included in the assessment if available. Phantom studies demonstrated the technical feasibility of SDI. Artificial lesions inserted in the phantom mimicking ischaemia could be clearly identified. In 51/53 patients, the image quality was adequate for clinical evaluation. For the remaining two obese patients with body mass index > 32 the injected {sup 201}Tl dose of 74 MBq was insufficient for clinical assessment. In answer to this the {sup 201}Tl dose was adapted for obese patients in the rest of the study. In 31 patients, SDI and {sup 99m}Tc reference images resulted in equivalent clinical assessment. Significant differences were found in 20 patients. In 18 of these 20 patients additional examinations were available. In 15 patients the diagnosis based on the SDI images was confirmed by the results of CAG or FFR. In these patients the SDI images were more accurate than the {sup 99m}Tc reference study. In three patients minor ischaemic lesions were detected by SDI but were not confirmed by CAG. In one of these cases this was probably caused by pronounced apical thinning. For two patients no relevant clinical follow-up information was available for evaluation. The proposed SDI protocol has the potential to improve clinical workflow and patient comfort and suggests improved accuracy as demonstrated in the clinical feasibility study. (orig.)

Dey, Thomas [RWTH Aachen University, Institute of Imaging and Computer Vision, Aachen (Germany); Backus, Barbra E.; Romijn, R.Leo [St. Antonius Hospital, Department of Nuclear Medicine, Nieuwegein (Netherlands); Wieczorek, Herfried [Philips Research, Eindhoven (Netherlands); Verzijlbergen, J.F. [St. Antonius Hospital, Department of Nuclear Medicine, Nieuwegein (Netherlands); Erasmus Medical Center, Department of Nuclear Medicine, Rotterdam (Netherlands)

2014-03-15

86

Limited performance of quantitative assessment of myocardial function by thallium-201 gated myocardial single-photon emission tomography  

Energy Technology Data Exchange (ETDEWEB)

We investigated the reproducibility between thallium-201 and technetium-99m methoxyisobutylisonitrile (MIBI) gated single-photon emission tomography (SPET) for the assessment of indices of myocardial function such as end-diastolic and end-systolic volume (EDV, ESV), ejection fraction (EF) and wall motion. Rest {sup 201}Tl (111 MBq) gated SPET was sequentially performed twice in 20 patients. Rest {sup 201}Tl gated SPET and rest {sup 99m}Tc-MIBI (370 MBq) gated SPET were performed 24 h apart in 40 patients. Wall motion was graded using the surface display of the Cedars quantitative gated SPET (QGS) software. EDV, ESV and EF were also measured using the QGS software. The reproducibility of functional assessment on rest {sup 201}Tl gated SPET was compared with that on {sup 99m}Tc-MIBI gated SPET, and also with that between {sup 201}Tl gated SPET and {sup 99m}Tc-MIBI gated SPET performed on the next day. The two standard deviation (2 SD) values for EDV, ESV and EF on the Bland-Altman plot were 29 ml, 19 ml and 12%, respectively, on repeated {sup 201}Tl gated SPET, compared with 14 ml, 11 ml and 5.3% on repeated {sup 99m}Tc-MIBI gated SPET. The correlations were good (r=0.96, 0.97 and 0.87) between the two measurements of EDV, ESV and EF on repeated rest studies with {sup 201}Tl and {sup 99m}Tc-MIBI gated SPET. However, Bland-Altman analysis revealed that the 2 SD values between the two measurements were 31 ml, 23 ml and 12%. We were able to score the wall motion in all cases using the 3D surface display of the QGS on {sup 201}Tl gated SPET. The kappa value of the wall motion grade on the repeated {sup 201}Tl study was 0.35, while that of the wall motion grade on the repeated {sup 99m}Tc-MIBI study was 0.76. The kappa value was 0.49 for grading of wall motion on repeated rest studies with {sup 201}Tl and {sup 99m}Tc-MIBI. In conclusion, QGS helped determine EDV, ESV, EF and wall motion on {sup 201}Tl gated SPET. Because the EDV, ESV and EF were less reproducible on repeated {sup 201}Tl gated SPET or on {sup 201}Tl gated SPET and {sup 99m}Tc-MIBI gated SPET on the next day than on repeated {sup 99m}Tc-MIBI gated SPET, functional measurement on {sup 201}Tl gated SPET did not seem to be interchangeable with that on {sup 99m}Tc-MIBI gated SPET. (orig.)

Lee, D.S.; Chung, J.-K. [Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul (Korea); Heart Institute, Seoul National University Medical Research Center, Seoul (Korea); Ahn, J.Y. [Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea); Kim, S.K. [Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul (Korea); Oh, B.H.; Seo, J.D. [Department of Internal Medicine, Seoul National University College of Medicine, Seoul (Korea); Lee, M.C. [Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul (Korea); Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea)

2000-02-01

87

Radionuclide diagnosis of dilated cardiomyopathy: a new approach to evaluate myocardial perfusion from 201Tl scintigraphic findings at rest and during dipyridamole test  

International Nuclear Information System (INIS)

A method for quantitative determination of the percentage of left ventricular myocardial 201Tl isotope uptake at rest and during dipyridamole test was first used in patients with dilated cardiomyopathy and coronary heart disease complicated by circulatory insufficiency or chronic myocarditis. This method makes it possible to judge the level of myocardial blood flow and perfusion reserve in these diseases

1992-07-01

88

Diagnosis of myocardial infarction using single photon emission computed tomography  

International Nuclear Information System (INIS)

For diagnosing myocardial infarction by myocardial scintigraphy using "2"0"1TlCl, the following two items were compared: 1) The diagnostic accuracy of visual evaluation of myocardial planar images versus that of single photon emission computed tomography (SPECT) images. 2) The diagnostic accuracy of qualitative and quantitative evaluations of SPECT images. The planar and SPECT methods were performed for 81 subjects consisting of 41 patients having myocardial infarction and 40 normal persons. Receiver operator characteristic (ROC) analysis, which is most objective in evaluation of visual diagnosis, was also used. To analyze quantitative diagnosis by ROC analysis, the normal range of circumferential profile analysis of myocardial short-axial tomography was determined by assessing five step divisions (less than 1SD, 1-1.7SD, 1.7-2.3SD, 2.3-3SD, and more than 3SD) from 10 normal cases. Four physicians and three laboratory technicians familiar with myocardial images diagnosed the myocardial planar images and SPECT images individually. The results were analyzed and the ROC curves were constructed. The results indicated that image diagnosis by SPECT was superior to that by the visual planar method for all persons. The physicians who had more experience in diagnosing myocardial images made more accurate diagnosis. However, quantitative SPECT image diagnosis was superior to visual SPECT image diagnosis. Thus, with the input of data of the normal range of quantitative SPECT image diagnosis into the computer, the prospects of accurate computer assessments of myocardial infarctions were posed. Furthermore, an area of low myocardial perfusion, less than 2 standard deviations of the normal range, showed the degree and extent of infarction, which facilitated pinpointing the site, extent and degree of the myocardial infarction in a three-dimensional concept, and the location of the corresponding coronary artery lesion, as well. (author)

1984-01-01

89

Effects of metabolically ischemic, but viable, myocardium on QT dispersion in patients with acute myocardial infarction. A study with resting I-123-BMIPP/thallium-201 myocardial single-photon emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

In chronic Q-wave myocardial infarction, QT dispersion is closely correlated with infarct size, but this correlation has not been evaluated for acute myocardial infarction (AMI). The effects of abnormal fatty acid metabolism on QT dispersion were examined in 123 patients with AMI who underwent resting iodine-123-15-iodophenyl 3-methyl pentadecanoic acid (BMIPP)/thallium-201 ({sup 201}Tl) myocardial single photon emission computed tomography (SPECT) and electrocardiographic analysis in the subacute phase. The relationship between BMIPP and {sup 201}Tl was defined as match when the total defect score for BMIPP was equal to or smaller than that for {sup 201}Tl, and as mismatch when the total defect score for BMIPP was larger than that for {sup 201}Tl. Twenty-six patients (21%) demonstrated BMIPP-{sup 201}Tl match and 97 (79%) demonstrated mismatch. Infarct size was closely correlated with QT dispersion (r=0.67, p<0.001) in patients with BMIPP-{sup 201}Tl match, but weakly correlated (r=0.30, p<0.005) in patients with BMIPP-{sup 201}Tl mismatch. For small infarctions, QT dispersion was significantly larger in patients with BMIPP-{sup 201}Tl mismatch than in those with BMIPP-{sup 201}Tl match (62{+-}24 ms vs 41{+-}18 ms, p=0.03), but did not differ between the 2 groups for large infarctions. This study shows that QT dispersion is influenced by infarct size and by the presence of metabolically ischemic but viable myocardium in patients with AMI. (author)

Yamagishi, Hiroyuki; Toda, Iku; Akioka, Kaname; Hirata, Kumiko; Yoshiyama, Minoru; Teragaki, Masakazu; Takeuchi, Kazuhide; Yoshikawa, Junichi; Ochi, Hironobu [Osaka City Univ. (Japan). Medical School

2000-08-01

90

Serial 201Tl myocardial imaging after dipyridamole infusion: diagnostic utility in detecting coronary stenoses and relationship to regional wall motion  

International Nuclear Information System (INIS)

After a 4-minute i.v. dipyridamole infusion, 0.14 mg/kg/min, serial 201Tl scans were obtained in 60 patients undergoing cardiac catheterization. Forty patients had significant (greater than or equal to 50% stenosis) coronary artery disease (CAD), and 20 patients had normal coronary arteries or trivial lesions. The images were graded qualitatively for thallium activity by three observers. Sensitivity was 93% (37 of 40) and specificity was 80% (16 of 20). The sensitivity and specificity of the 201Tl study were not affected by the extent of CAD, the presence of Q waves, or propranolol therapy. Twenty-seven of 37 patients who had initial defects (73%) had complete thallium redistribution of one or more defects. Patient-by-patient analysis using a regression model of all patients showed that the fate of a segmental thallium defect predicted abnormal wall motion by angiography better than ECG Q waves. The presence of propranolol therapy or collaterals did not significantly affect the thallium redistribution results. We conclude that qualitative interpretation by multiple observers of thallium images after dipyridamole infusion is a highly sensitive and specific test for CAD. After dipyridamole, as with exercise stress, the extent of thallium redistribution is related to the degree of myocardial wall motion abnormality

1982-01-01

91

123I-MIBG myocardial scintigraphy in diabetic patients. Relationship with 201Tl uptake and cardiac autonomic function  

International Nuclear Information System (INIS)

The purpose of this paper is to investigate the influence of diabetic myocardial damage (suspected myocardial damage; SMD) diagnosed by 201Tl-SPECT and diabetic cardiac autonomic neuropathy (AN) on myocardial MIBG uptake in patients with NIDDM. Eighty-seven diabetic patients divided into four subgroups: 23 with SMD (+) AN (+); 19 with SMD (+) AN (-); 27 with SMD (-) AN (+); 18 with SMD (-) AN (-), and 10 controls were studied. Both planar and SPECT images were taken at 30 minutes (early) and 3 hours (delayed) after 123I-MIBG injection. The heart to mediastinum uptake ratio (H/M) and washout ratio of 123I-MIBG (WR) were obtained from both planar images. Similarly, the difference between the 201Tl image and the 123I-MIBG image in the total uptake score (TUS) was taken as the difference in the total uptake score (?TUS) representing cardiac sympathetic denervation without SMD. On both early and delayed planar images, the mean H/M value in the subgroups of diabetic patients was significantly lower in the SMD (+) AN (+) group than in the control group, but among those subgroups, there was statistically significant difference between the SMD (+) AN (+) and SMD (-) AN (-) groups only on the delayed images. Regarding the WR value, there was no statistically significant difference among subjects. On SPECT image analysis, the diabetic subgroup with AN or SMD had statistically significant lower values for TUS than those of the control group. Among diabetics, there was a statistically significant differences between SMD [+] AN [+] and SMD [-] AN [-] on both early and delayed images. Similarly, the SMD [+] AN [-] group also had significantly lower values than those of SMD [-] AN [-] on early images. Regarding ?TUS, there was a statistically significant differences between AN [+] subgroups and controls. Similarly, the mean value for ?TUS was much higher in AN [+] subgroups than in AN [-] subgroups with or without SMD in diabetes mellitus. (K.H.)

1998-12-01

92

{sup 123}I-MIBG myocardial scintigraphy in diabetic patients. Relationship with {sup 201}Tl uptake and cardiac autonomic function  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this paper is to investigate the influence of diabetic myocardial damage (suspected myocardial damage; SMD) diagnosed by {sup 201}Tl-SPECT and diabetic cardiac autonomic neuropathy (AN) on myocardial MIBG uptake in patients with NIDDM. Eighty-seven diabetic patients divided into four subgroups: 23 with SMD (+) AN (+); 19 with SMD (+) AN (-); 27 with SMD (-) AN (+); 18 with SMD (-) AN (-), and 10 controls were studied. Both planar and SPECT images were taken at 30 minutes (early) and 3 hours (delayed) after {sup 123}I-MIBG injection. The heart to mediastinum uptake ratio (H/M) and washout ratio of {sup 123}I-MIBG (WR) were obtained from both planar images. Similarly, the difference between the {sup 201}Tl image and the {sup 123}I-MIBG image in the total uptake score (TUS) was taken as the difference in the total uptake score ({Delta}TUS) representing cardiac sympathetic denervation without SMD. On both early and delayed planar images, the mean H/M value in the subgroups of diabetic patients was significantly lower in the SMD (+) AN (+) group than in the control group, but among those subgroups, there was statistically significant difference between the SMD (+) AN (+) and SMD (-) AN (-) groups only on the delayed images. Regarding the WR value, there was no statistically significant difference among subjects. On SPECT image analysis, the diabetic subgroup with AN or SMD had statistically significant lower values for TUS than those of the control group. Among diabetics, there was a statistically significant differences between SMD [+] AN [+] and SMD [-] AN [-] on both early and delayed images. Similarly, the SMD [+] AN [-] group also had significantly lower values than those of SMD [-] AN [-] on early images. Regarding {Delta}TUS, there was a statistically significant differences between AN [+] subgroups and controls. Similarly, the mean value for {Delta}TUS was much higher in AN [+] subgroups than in AN [-] subgroups with or without SMD in diabetes mellitus. (K.H.)

Nagamachi, Shigeki; Jinnouchi, Seishi; Kurose, Takeshi; Ohnishi, Takashi; Flores, L.G. II; Nakahara, Hiroshi; Futami, Shigemi; Tamura, Shozo; Matsukura, Shigeru [Miyazaki Medical Coll., Kiyotake (Japan)

1998-12-01

93

[sup 123]I-MIBG myocardial scintigraphy in diabetic patients. Relationship with [sup 201]Tl uptake and cardiac autonomic function  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this paper is to investigate the influence of diabetic myocardial damage (suspected myocardial damage; SMD) diagnosed by [sup 201]Tl-SPECT and diabetic cardiac autonomic neuropathy (AN) on myocardial MIBG uptake in patients with NIDDM. Eighty-seven diabetic patients divided into four subgroups: 23 with SMD (+) AN (+); 19 with SMD (+) AN (-); 27 with SMD (-) AN (+); 18 with SMD (-) AN (-), and 10 controls were studied. Both planar and SPECT images were taken at 30 minutes (early) and 3 hours (delayed) after [sup 123]I-MIBG injection. The heart to mediastinum uptake ratio (H/M) and washout ratio of [sup 123]I-MIBG (WR) were obtained from both planar images. Similarly, the difference between the [sup 201]Tl image and the [sup 123]I-MIBG image in the total uptake score (TUS) was taken as the difference in the total uptake score ([Delta]TUS) representing cardiac sympathetic denervation without SMD. On both early and delayed planar images, the mean H/M value in the subgroups of diabetic patients was significantly lower in the SMD (+) AN (+) group than in the control group, but among those subgroups, there was statistically significant difference between the SMD (+) AN (+) and SMD (-) AN (-) groups only on the delayed images. Regarding the WR value, there was no statistically significant difference among subjects. On SPECT image analysis, the diabetic subgroup with AN or SMD had statistically significant lower values for TUS than those of the control group. Among diabetics, there was a statistically significant differences between SMD [+] AN [+] and SMD [-] AN [-] on both early and delayed images. Similarly, the SMD [+] AN [-] group also had significantly lower values than those of SMD [-] AN [-] on early images. Regarding [Delta]TUS, there was a statistically significant differences between AN [+] subgroups and controls. Similarly, the mean value for [Delta]TUS was much higher in AN [+] subgroups than in AN [-] subgroups with or without SMD in diabetes mellitus. (K.H.)

Nagamachi, Shigeki; Jinnouchi, Seishi; Kurose, Takeshi; Ohnishi, Takashi; Flores, L.G. II; Nakahara, Hiroshi; Futami, Shigemi; Tamura, Shozo; Matsukura, Shigeru (Miyazaki Medical Coll., Kiyotake (Japan))

1998-12-01

94

Delayed cerebral radionecrosis with a high uptake of {sup 11}C-methionine on positron emission tomography and {sup 201}Tl-chloride on single-photon emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

A 47-year-old woman, who 2.5 years previously had undergone resection of a malignant astrocytoma of the left temporal lobe followed by radiotherapy, was found to have a mass in the left frontal lobe. This showed high uptake of thallium-201 ({sup 201}Tl) on single-photon emission computed tomography and {sup 11}C-methionine on positron-emission tomography, suggesting recurrent tumour. Histological examination of the resected lesion, however, revealed it to be radionecrosis. This case thus illustrates a diagnostic pitfall in the use of these investigations for distinguishing radionecrosis from recurrent malignant glioma. (orig.) With 2 figs., 21 refs.

Tashima, T.; Hachisuga, S. [Department of Neurosurgery, Hachisuga Hospital, Munakata (Japan); Morioka, T.; Nishio, S.; Fukui, M. [Department of Neurosurgery, Faculty of Medicine, Kyushu University, Fukuoka (Japan); Sasaki, M. [Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka (Japan)

1998-07-01

95

assessment of the clinical role of simultaneous 99mTc-MIBI and 201Tl dual-isotopic myocardial perfusion SPECT imaging in the patients wit hypertension  

International Nuclear Information System (INIS)

Objective: To study the clinical role of Simultaneous rest technetium-99m sestamibi (99mTc-MIBI) and stress thallium-201 (201Tl) Dual-isotopic myocardial perfusion SPECT imaging in the patients with hypertension. Methods: 116 patients with high blood pressure underwent simultaneous dual-isotopic myocardial perfusion SPECT imaging with 99mTc-MIBI and 201Tl. 99mTc-MIBI was injected at rest, 15 min later dobutamine was instilled into vein begin with 5 mg/kg/min, before and after instilling the base ECG, blood pressure, heart rate was recorded. when the maximal dose of Dobutamine was achieved, thallium-201 was injected, the dual-isotopic simultaneously SPECT imagine was performed. The stress and rest imagine was obtained. After tomographic reconstruction, the images were interpreted by two experienced observers without previous knowledge of results of other studies. Coronary angiography was performed in two weeks. All of 116 patients were found normal. Results: (1) All of 116 patients with high blood pressure were divided as three group by the course of disease: A group (20 year), 15. The heart/lung ratios of A, B, C group were 2.651±0.246, 2.546±0.231, 2.490±0.36 (mean±SD)respectively, no significant difference was noted among three group. Normal heart/lung ratios is 2.50±0.28 among of control group of 20. (2) The overall sensitivity for the dual-isotopic simultaneously myocardial SPECT imagine of high blood pressure was 46.55%(54/116). (3) Anterior, lateral, inferior, apex, interventricular septal segment were regarded as a whole segment, 111 segments display abnormal 201Tl uptake. 63, 30, 18 segments were in A, B, C group respectively, and no significant difference was noted among three group. 4 85 segments reveal reduced stressing 201Tl uptake and no typical redistribution was observed in the delay 201Tl imagines. 20, 24, 14, 12, 15 segments were in anterior, lateral, inferior, apex, interventricular septal segment respectively. 26 segments display inverse 201Tl redistribution, 2, 14, 3, 3, 4 segments were m anterior, lateral, inferior, apex, interventricular septal segment respectively. 5 all rest 99mTc-MIBI imagines display normal uptake. Conclusion: Simultaneous rest 99mTc-MIBI and stress 201Tl dual-isotopic myocardial perfusion SPECT imaging is an effective auxiliary method in the detection of hypertension and identification of Coronary Artery Disease. (authors)

2004-10-09

96

Stress-induced myocardial ischemia is associated with early post-stress left ventricular mechanical dyssynchrony as assessed by phase analysis of 201Tl gated SPECT myocardial perfusion imaging  

International Nuclear Information System (INIS)

In 201Tl SPECT myocardial perfusion imaging (MPI) data are acquired shortly after the stress injection to assess early post-stress left ventricle (LV) function. The purpose of this study was to use 201Tl SPECT MPI to investigate whether stress-induced myocardial ischemia is associated with LV mechanical dyssynchrony. Enrolled in the study were 75 patients who were referred for dipyridamole stress and rest 201Tl gated SPECT MPI. The early post-stress scan was started 5 min after injection, and followed by the rest scan 4 h later. The patients were divided into three groups: ischemia group (N = 25, summed stress score, SSS, ?5, summed rest score, SRS, 201Tl gated SPECT MPI. (orig.)

2012-12-01

97

Absolute quantitation of myocardial blood flow with {sup 201}Tl and dynamic SPECT in canine: optimisation and validation of kinetic modelling  

Energy Technology Data Exchange (ETDEWEB)

{sup 201}Tl has been extensively used for myocardial perfusion and viability assessment. Unlike {sup 99m}Tc-labelled agents, such as {sup 99m}Tc-sestamibi and {sup 99m}Tc-tetrofosmine, the regional concentration of {sup 201}Tl varies with time. This study is intended to validate a kinetic modelling approach for in vivo quantitative estimation of regional myocardial blood flow (MBF) and volume of distribution of {sup 201}Tl using dynamic SPECT. Dynamic SPECT was carried out on 20 normal canines after the intravenous administration of {sup 201}Tl using a commercial SPECT system. Seven animals were studied at rest, nine during adenosine infusion, and four after beta-blocker administration. Quantitative images were reconstructed with a previously validated technique, employing OS-EM with attenuation-correction, and transmission-dependent convolution subtraction scatter correction. Measured regional time-activity curves in myocardial segments were fitted to two- and three-compartment models. Regional MBF was defined as the influx rate constant (K{sub 1}) with corrections for the partial volume effect, haematocrit and limited first-pass extraction fraction, and was compared with that determined from radio-labelled microspheres experiments. Regional time-activity curves responded well to pharmacological stress. Quantitative MBF values were higher with adenosine and decreased after beta-blocker compared to a resting condition. MBFs obtained with SPECT (MBF{sub SPECT}) correlated well with the MBF values obtained by the radio-labelled microspheres (MBF{sub MS}) (MBF{sub SPECT} = -0.067 + 1.042 x MBF{sub MS}, p < 0.001). The three-compartment model provided better fit than the two-compartment model, but the difference in MBF values between the two methods was small and could be accounted for with a simple linear regression. Absolute quantitation of regional MBF, for a wide physiological flow range, appears to be feasible using {sup 201}Tl and dynamic SPECT. (orig.)

Iida, Hidehiro; Kim, Kyeong-Min; Nakazawa, Mayumi; Sohlberg, Antti; Zeniya, Tsutomu; Hayashi, Takuya; Watabe, Hiroshi [National Cardiovascular Center Research Institute, Department of Investigative Radiology, Suita City, Osaka (Japan); Eberl, Stefan [National Cardiovascular Center Research Institute, Department of Investigative Radiology, Suita City, Osaka (Japan); Royal Prince Alfred Hospital, PET and Nuclear Medicine Department, Camperdown, NSW (Australia); Tamura, Yoshikazu [Akita Kumiai General Hospital, Department of Cardiology, Akita City (Japan); Ono, Yukihiko [Akita Research Institute of Brain, Akita City (Japan)

2008-05-15

98

Prediction of cardiac events in patients with dilated cardiomyopathy using 123I-BMIPP and 201Tl myocardial scintigraphy  

International Nuclear Information System (INIS)

Various clinical trials for dilated cardiomyopathy (DCM) have demonstrated that the prognosis as well as cardiac function is improved by the administration of beta-blocker therapy. On the other hand, 123I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) reflects myocardial fatty acid metabolism and is considered to be a more sensitive tracer than perfusion tracers. In this study, the efficacy of DCM for the evaluation of myocardial damage and the prediction of cardiac events was studied using 123I-BMIPP and 201Tl (Tl) myocardial scintigraphy. Study subjects comprised 33 DCM patients, divided into a cardiac event group (event, n=9) and an event-free group (event free, n=24). An extent score (ES) and severity score (SS) were calculated for each BMIPP image. BMIPP and Tl images were divided into 17 segments, and total defect scores (TDS) were calculated for each. The TDS of the BMIPP and Tl images were compared with score differences greater than or equal to 4 and less than 4 defined as mismatch and non-mismatch, respectively. The TDS of BMIPP was significantly higher in the event group than in the event-free group (P2 test; P<0.01). The ES of BMIPP was a significant predictor of cardiac events in the multivariate analysis (P<0.01). These results suggest that the ES for BMIPP is useful as a predictor of cardiac events in DCM. (author)

2007-09-01

99

[The relationship between discrepant areas on 201TlCl/123I-BMIPP myocardial scintigraphy, local wall motion, and glucose metabolism in patients with myocardial infarction].  

Science.gov (United States)

In order to clarify the significance of the discrepancy between myocardial blood flow and fatty acid metabolism on 201TlCl/123I-BMIPP SPECT after acute myocardial infarction, we examined 52 patients (278 segments) with their first acute myocardial infarction using two-dimensional echocardiography and FDG-PET. Patients with Tl/BMIPP discrepancy in the acute stage showed higher FDG accumulation than those without Tl/BMIPP discrepancy. In the chronic stage, however, there was no significant difference between both groups. Patients with Tl/BMIPP discrepancy in the chronic stage had lower wall motion scores than those without Tl/BMIPP discrepancy. Significant improvement of the wall motion score was recognized in patients who showed Tl/BMIPP discrepancy in the acute stage. Patients were classified into stenosis and non-stenosis groups by the presence of significant stenosis on coronary angiography in the chronic stage. In the stenosis group, the Tl/BMIPP discrepancy did not show much change from the acute to chronic stage, but there was a significant decrease in the non-stenosis group. It was concluded that 201TlCl/123I-BMIPP myocardial SPECT is useful for predicting future improvement of wall motion and determining the residual ischemia in the chronic stage based on the presence or absence of this discrepancy. PMID:9916402

Tanaka, A

1998-11-01

100

Evaluation of prognosis in patients with old myocardial infarction; Using sup 201 Tl myocardial scintigraphy and sup 99m Tc cardiac scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the prognosis in 57 patients with old myocardial infarction, {sup 201}Tl myocardial scintigraphy and {sup 99m}Tc-HSA gated blood pool scan had been done as a 5-year follow up study. We subdivided into two groups; group I (over 60 years) and group II (under 60 years). Cardiac index (CI) and right ventricular ejection fraction (RVEF) did not change significantly, however left ventricular ejection fraction (LVEF) changed significantly (p<0.05). Correlationship between CAG score and {delta}LVEF by handgrip exercise test was y=-1.34x+3.61 (n=44, r=-0.400, p<0.01). Otherwise, Tl defect ratio between first and final examination did not show the significant change in two groups. In conclusion, nuclear examination (cardiac function and myocardial blood flow) is significant to evaluate the prognosis in patients with myocardial infarction. (author).

Aoki, Riuko; Kawamura, Yasuaki (Toho Univ., Tokyo (Japan). School of Medicine)

1990-08-01

 
 
 
 
101

Processing of "2"0"1Tl serial images for the assessment of myocardial clearance and redistribution  

International Nuclear Information System (INIS)

Regional activity changes over the myocardium after IV injection of "2"0"1Tl were assessed in 90 patients by applying a superposition algorithm for paired images. The kinetics were expressed as quotients C_1/C_2 of the initial divided by the delayed count rate within an myocardial segment. Regarding the total left ventricular myocardium, normal subjects showed count rate ratios (Csub(30 min)/C_4sub(h)) of 1.75 +- 0.075 (SD, n = 19) when the nuclide was injected under submaximal (80% of maximum) exercise. In patients with triple-vessel disease (n = 21) the corresponding values were 1.46 +- 0.05, in single-vessel (n = 14) disease the quotients averaged 1.62 +- 0.12. Average quotients in poststenotic myocardial segments increased from 1.46 before to 1.73 following bypass surgery in cases of graft patency (n = 8), while a decrease was observed in a patient with occlusion of the bypass graft. In small-vessel disease and in congestive cardiomyopathy, global values of 1.50 +- 0.07 (n = 7) and 1.53 +- 0.12 (n = 19) were obtained. The display of C_1/C_2 matrices provided typical patterns in uptake defects caused by ischemic heart disease and by congestive cardiomyopathy. The procedure described may provide diagnostic information in addition to conventional myocardial scintigrphy in triple-vessel disease, in patients with angina who fail to demonstrate hemodynamically significant coronary artery stenoses, and in patients with inhomogeneous Tl-scintigrams. (orig.)

1982-01-01

102

Quantified myocardial SPECT: Comparative evaluation of 201Tl-chloride and 99mTc-hexakis-(2-methoxy-isobutyl-nitrile) (RP 30) in coronary multivascular disorder  

International Nuclear Information System (INIS)

Ten patients with multivascular coronary disorder were selected for the comparative SPECT examinations using 99mTc-RP 30 or 201Tl-chloride, under stress and at rest. Good agreement of myocardial uptake of the two substances was observed under stress, but there were deviations from the computed redistribution indexes of both substances. The redistribution index of myocardial regions supplied by stenosed coronary arteries was above 40 p.c. The results obtained so far show an equal, if not superior sensitivity of 99mTc-RP 30 SPECT as compared to the thallium compound, for detection of myocardial stress-induced ischemia. (orig./MG)

1988-01-01

103

Dual-isotope SPET"2"0"1Tl rest/"9"9Tc-MIBI stress: One-day protocol for pre-operative myocardial imaging?  

International Nuclear Information System (INIS)

We compared the results of a rest "2"0"1Tl/stress "9"9"mTc-MIBI protocol, both by means of separate single isotope and simultaneous dual isotope acquisition, with a standard stress/rest "9"9"mTc-MIBI 2-day protocol in 11 patients with low probability of CAD and 14 patients with chronic CAD. In patients with CAD 406 segments (sgs) were analysed. In the standard protocol 119 sgs were classified as pathological of which 50.4% were fixed and 49.6% reversible defects. With the MIBI-stress/Tl-rest single 33% of 119 pathological sgs were fixed and 67% reversible defects. With the MIBI-stress/Tl-rest dual only 20% were fixed and 80% reversible defects. The reversibility of 59 MIBI-stress/MIBI-rest reversible defects was quantified: MIBI-stress/MIBI-rest 35 ± 16% MIBI-stress/Tl-rest single 50 ± 26% and MIBI-stress/Tl-rest dual 48 ± 22%. The results of "9"9"mTc-MIBI rest and "2"0"1Tl rest studies in patients with chronic CAD are not the same. Dual-isotope 1-day "2"0"1Tl-rest/"9"9"mTc-MIBI-stress SPET data, acquired separately, may give fast and complete information on myocardial perfusion at stress and rest, respectively, and on myocardial viability. (orig.)

1994-04-01

104

Differential diagnosis of idiopathic congestive cardiomyopathy and ischemic heart disease by echocardiography and 201Tl-myocardial scintigraphy  

International Nuclear Information System (INIS)

The usefulness of various non-invasive methods such as electrocardiography, echocardiography and 201Tl myocardial scintigraphy in the differential diagnosis of idiopathic congestive cardiomyopathy (CCM) and ischemic heart disease (IHD) were evaluated. Eighteen cases with CCM and 9 cases with IHD were subjected. For this study patients with IHD showing dilated cavity (LVDd over 66 mm) and diffuse hypokinesis of the left ventricle in the echocardiogram were selected. Cardiothoracic ratio of CCM and IHD were 59.6 +- 6.3% and 58.3 +- 6.3% in average, respectively. In CCM, mean LVDd was 76.0 +- 5.6 mm and mean LVDs was 63.4 +- 7.3 mm. In IHD, mean LVDd was 74.7 +- 8.1 mm and mean LVds was 63.2 +- 4.6 mm. Both cardiothoracic ratios and echocardiographic findings showed no difference between CCM and IHD. Incidence of an abnormal Q wave in ECG was higher in IHD (2.72 leads per a case) than that in CCM (1.33 leads per a case). An abnormal Q wave in aVL was frequently (28%) observed in CCM but none in IHD. However, these ECG findings did not seem to be contributory to the differential diagnosis. Myocardial scintigraphic study revealed that 10 of 18 cases with CCM showed no perfusion defect or sparse uptake and others showed small and isolated defect in the apex or postero-lateral wall of the left ventricle, while 7 of 9 cases with IHD showed large perfusion defect over 15% in the anterior and inferior areas. However, small localized defects less than 14% in the apex were observed in both groups, 5 cases (27.8%) with CCM, and 2 cases (22.2%) with IHD, suggesting limitation of this method for the differential diagnosis. (J.P.N.)

1981-01-01

105

"2"0"1Tl myocardial imaging in a cardiac rejection episode. Case report  

International Nuclear Information System (INIS)

Serial myocardial imaging using thallium Tl 207 was performed in the early follow-up of two patients with orthotopic cardiac transplantation. In one patient, non-homogeneous uptake, small defects and an irregular myocardial edge were observed during a moderately acute rejection crisis revealed by endomyocardial biopsy. The abnormal gammagraphic findings and histological changes were coincident and exhibited a parallel reversal. We emphasize the connection between these two events. The mechanisms which could explain these phenomena are discussed. (orig.)

1986-01-01

106

Quantitative analysis of exercise 201Tl myocardial emission CT in patients with coronary artery disease  

International Nuclear Information System (INIS)

The clinical usefulness of quantitative analysis of exercise thallium-201 myocardial emission computed tomography (ECT) was evaluated in coronary artery disease (CAD). The subjects consisted of 20 CAD patients and five normal controls. All CAD patients underwent coronary angiography. Tomographic thallium-201 myocardial imaging was performed with a rotating gamma camera, and long-axial and short-axial myocardial images of the left ventricle were reconstructed. The tomographic images were interpreted quantitatively using circumferential profile analysis. Based on features of regional myocardial thallium-201 kinetics, two types of abnormalities were studied: (1) diminished initial distribution (stress defect) and (2) slow washout of thallium-201, as evidenced by patients' initial thallium-201 uptake and 3-hour washout rate profiles which fell below the normal limits, respectively. Two diagnostic criteria including the stress defect and a combination of the stress defect and slow washout were used to detect coronary artery lesions of significance (>=75 % luminal narrowing). The ischemic volumes were also evaluated by quantitative analysis using thallium-201 ECT. The diagnostic accuracy of the stress defect criterion was 95 % for left anterior descending, 90 % for right, and 70 % for left circumflex coronary artery lesions. The combined criteria of the stress defect and slow washout increased detection sensitivity with a moderate loss of specificity for identifying individual coronary artery lesion. A relatively high diagnostic accuracy was obtained using the stress defect criterion for multiple vessel disease (75 %). Ischemic myocardial volume was significantly larger in triple vessel than in single vessel disease (p < 0.05) using the combined criteria. It was concluded that quantitative analysis of exercise thallium-201 myocardial ECT images proves useful for evaluating coronary artery lesions. (author)

1984-01-01

107

Measurement of myocardial uptake rate and method of dual energy data acquisition in myocardial scintigraphy with 123I-metaiodobenzylguanidine and 201Tl-chloride, 2  

International Nuclear Information System (INIS)

Myocardial scintigraphy was performed on 24 patients with hypertrophic cardiomyopathy (HCM), 5 with essential hypertension (EHT) and 7 normal controls at rest by means of simultaneous dual energy data acquisition following an intravenous injection of 123I-metaiodobenzylguanidine (MIGB) and 201Tl-chloride (Tl). The myocardial uptake rates of both tracers were measured in the planar images by taking into account the myocardial and pulmonary attenuation. The regional myocardial distributions of the tracers were also studied in the SPECT images. In planar images, the rate of loss of 123I-MIBG from the myocardium of HCM subjects was significantly higher than of control subjects 15 min to 3 hr after injection. No significant difference was observed from 3 hr to 5 hr and from the 5 hr to 21 hr periods. In the SPECT images, the rate of loss of 123I-MIBG from the myocardium of HCM subjects was significantly higher than of control subjects in all segments of myocardium through a 15 min to 5 hr observation period. The results suggested that the uptake-release mechanism of 123I-MIBG in the neuronal vesicles was impaired in HCM subjects in two different ways: (1) normal release in delayed phase associated with low uptake in early phase or (2) accelerated release in early phase. Moreover, the sympathetic dysfunction may spread through the all segments of myocardium of HCM subjects. The apical lesion showed an extremely high rate of loss up to 5 hr after injection in SPECT images. This was quite different from that of the septal lesion. This indicated that the apical lesion of HCM subjects may have a different sympathetic abnormality. In EHT subjects, no abnormal regional distribution of 123I-MIBG was observed. This suggested that the sympathetic innervation was maintained although an abnormal distribution of blood flow was frequently observed in 201Tl scintigraphy. (author)

1991-01-01

108

Diagnosis of effort angina pectoris using 201Tl stress myocardial imaging  

International Nuclear Information System (INIS)

Tl-201 stress myocardial SPECT images were obtained from 42 patients with effort angina pectoris and 40 healthy volunteers. Predicted washout rate (WR) was calculated from the regression equation of the maximum heart rate in normal volunteers. In determining ischemic areas, the sensitivity and specificity of predicted WR were 69%-81% and was 86%, respectively, for the left anterior descending artery; 54%-79% and 84%-92% for the right coronary artery; and 60%-68% and 86%-91% for the left circumflex artery. In evaluating the number of diseased coronary arteries, the accuracy of predicted WR was significantly higher than that of conventional mean WR (78% vs 50% for single vessel disease; 60% vs 46% for two-vessel disease). For three-vessel disease, predicted WR had the same accuracy as mean WR (57%). The results indicate the validity of using predicted WR in the quantitative evaluation of stress myocardial SPECT images. (Namekawa, K)

1989-01-01

109

Assessment of myocardial perfusion and cardiac sympathetic nerve dysfunction in patients with sick sinus syndrome. Evaluation of coronary hemodynamics and 201TlCl/123I-MIBG myocardial SPECT  

International Nuclear Information System (INIS)

To clarify the coronary hemodynamics, myocardial perfusion and cardiac sympathetic nerve function in patients with sick sinus syndrome (SSS), we performed left coronary digital subtraction angiography (DSA) in 41 patients, exercise 201TlCl-myocardial scintigraphy (planar and SPECT) in 69 patients, and 201TlCl/123I-MIBG myocardial dual SPECT in 13 patients without significant organic coronary stenosis. Coronary artery spasm was documented on coronary angiography in 25/43 (58%) patients with SSS by ergonovine provocation test. Compared with normals, patients with SSS demonstrated prolongation of left coronary circulation time (CCT) on own heart beats and right atrial pacing. We suspected that prolonged CCT may be induced by increased peripheral coronary vascular resistance and impaired coronary micro-circulation in patients with SSS. Forty-two patients (60.9%) developed exercise-induced 201Tl-myocardial perfusion defect on SPECT images. On myocardial dual SPECT images, 11/13 (85%) patients showed localized myocardial low uptake in 123I-MIBG-SPECT images. In eight patients with normal findings on 201Tl-SPECT, six patients showed abnormality on 123I-MIBG-SPECT. We suspected that coronary vasospasm, impaired coronary micro-circulation and cardiac sympathetic nerve dysfunction are taken a part of pathophysiology in SSS (decreased ?-adrenergic receptor of peripheral coronary arteries?). (author)

1994-11-01

110

Assessment of myocardial perfusion and cardiac sympathetic nerve dysfunction in patients with sick sinus syndrome. Evaluation of coronary hemodynamics and [sup 201]TlCl/[sup 123]I-MIBG myocardial SPECT  

Energy Technology Data Exchange (ETDEWEB)

To clarify the coronary hemodynamics, myocardial perfusion and cardiac sympathetic nerve function in patients with sick sinus syndrome (SSS), we performed left coronary digital subtraction angiography (DSA) in 41 patients, exercise [sup 201]TlCl-myocardial scintigraphy (planar and SPECT) in 69 patients, and [sup 201]TlCl/[sup 123]I-MIBG myocardial dual SPECT in 13 patients without significant organic coronary stenosis. Coronary artery spasm was documented on coronary angiography in 25/43 (58%) patients with SSS by ergonovine provocation test. Compared with normals, patients with SSS demonstrated prolongation of left coronary circulation time (CCT) on own heart beats and right atrial pacing. We suspected that prolonged CCT may be induced by increased peripheral coronary vascular resistance and impaired coronary micro-circulation in patients with SSS. Forty-two patients (60.9%) developed exercise-induced [sup 201]Tl-myocardial perfusion defect on SPECT images. On myocardial dual SPECT images, 11/13 (85%) patients showed localized myocardial low uptake in [sup 123]I-MIBG-SPECT images. In eight patients with normal findings on [sup 201]Tl-SPECT, six patients showed abnormality on [sup 123]I-MIBG-SPECT. We suspected that coronary vasospasm, impaired coronary micro-circulation and cardiac sympathetic nerve dysfunction are taken a part of pathophysiology in SSS (decreased [beta]-adrenergic receptor of peripheral coronary arteries ). (author).

Matsumura, Kentaro; Nakase, Emiko; Saito, Takayuki; Kikkawa, Nobutada; Haiyama, Tohru (Kyoto Minami Hospital (Japan))

1994-11-01

111

Clinical investigation of large perfusion defect cases with {sup 201}Tl exercise myocardial scintigraphy  

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We investigated retrospectively the clinical significance of large perfusion defect on {sup 201}Thallium myocardial scintigraphy from the records of 833 patients during the past 3 years from 1991 to 1994. The patients were divided into 3 groups according to the extent of perfusion defect; cases with normal perfusion (n=561), with small perfusion defect (n=211) and with large perfusion defect (n=61). We found that the proportions of cases with large perfusion defect was significantly larger than that of cases with small perfusion defect in myocardial disease (MD; hypertrophic cardiomyopathy, dilated cardiomyopathy, and post myocarditis combined) (P<0.001). Analyzing patients with ischemic heart disease (IHD; angina pectoris and myocardial infarction) according to the severity of coronary artery lesion, the proportion of cases with large perfusion defect was significantly larger than that of cases with small perfusion defect in 3 vessel disease (P<0.001). Incidence of diabetes mellitus was significantly higher in patients with IHD than in those with MD in large perfusion defect group (P<0.01). As for symptoms in large perfusion defect group, the incidences of chest pain, chest oppression, and chest discomfort were significantly higher in patients with IHD than in those with MD (P<0.001), whereas the incidences of palpitation and shortness of breath were significantly higher in patients with MD (P<0.001). These results suggest that IHD with multiple artery lesions and MD underlie large perfusion defect on {sup 201}Thallium myocardial scintigraphy and that complication of diabetes mellitus and clinical symptoms may be useful in differentiating IHD from MD. (author)

Morota, Motoi; Kobayashi, Yasuhiko [Tokyo Medical Coll. (Japan)

1999-02-01

112

Evaluation of left ventricular eccentric hypertrophy by /sup 201/Tl-myocardial scintigraphy  

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In order to elucidate the mechanism of left ventricular eccentric hypertrophy in conditions of volume overload, Tl-201 myocardial scintigraphy was performed in patients with aortic valve regurgitation and mitral valve regurgitation. There was a good relationship between the severity of Tl-defects, as determined by Tl-201 myocardial scintigraphy, and the changes in the T wave on the ECG on the one hand and the NYHA functional classification of heart diseases. In 17 of 18 patients where LVDd increased with increasing severity of Tl-defects and the defects were moderate to severe, LVDd was 65 mm or larger. There was a significant negative correlation between the washout rate for the whole circumference of the left ventricle, as determined by exercise Tl-201 SPECT, and LVDd (r=-0.603, p<0.01). The phenomenon of redistribution as determined by exercise Tl-201 myocardial scintigraphy was observed relatively early. Our results suggest that mechanical volume overload and ischemic changes are involved in left ventricular wall damage in left ventricular eccentric hypertrophy. For patients with moderate to severe Tl-defects valve replacement is indicated, no matter whether they may have heart failure or arrhythmia.

Yamazaki, Junichi; Kawamura, Yasuaki; Okuzumi, Ichio; Morishita, Takeshi; Koyama, Nobuya; Komatsu, Hisashi; Ohsawa, Hidefumi; Yabe, Yoshimasa

1989-03-01

113

Evaluation of myocardial perfusion by differentiating planar scintigraphy at rest and at stress, respectively using the sup 201 Tl and the sup 99m Tc SestaMIBI. Evaluation de la perfusion myocardique par scintigraphies planaires au repos et a l'effort realisees respectivement au sup 201 Tl et au sup 99m Tc SestaMIBI  

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The differentiating planar scintigraphy at rest and at stress, respectively using {sup 201}Tl and {sup 99m}Tc SestaMIBI, within strict spectrometric conditions, allow two distinct images to be obtained for the same views which permits calculation of the importance of the ischemic defects at stress and evaluation of myocardial vitality, when analyzed by computer-assisted techniques.

Vernejoul, P. de; Albarede, P.; Etienne, D.; Richardot, G.; Vacheron, A. (Hopital Necker-Enfants Malades, 75 - Paris (FR). Service de Biophysique et Medecine Nucleaire)

1991-11-07

114

Defect of {sup 18}F-FDG Uptake Observed in Infarcted Myocardium Showing Reverse Redistribution on Rest / 24-Hour Delayed {sup 201}Tl Myocardial SPECT after Acute Myocardial Infarction  

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Reverse redistribution is frequently observed after revascularization in acute myocardial infarction, and usually regarded as a predictor of viable myocardium on stress/rest and 2- to 4-hour redistribution {sup 201}Tl SPECT. However, there is not enough report of reverse redistribution in case of 24-hour delayed SPECT, which is commonly used for viability assessment. In this report, a case of reverse redistribution on rest and 24-hour delayed {sup 201}Tl SPECT is reported with use of automatic segmental quantitative analysis. The myocardium of reverse redistribution was dysfunctional on gated SPECT, and diagnosed as non-viable on {sup 18}F-FDG PET.

Lee, Ho Young; Paeng, Jin Chul; Oh, So Won; Kim, Ji Yeong; Chung, Woo Young [Seoul national University College of Medicine, Seoul (Korea, Republic of)

2008-12-15

115

Application of 201Tl scanning for bone diseases  

International Nuclear Information System (INIS)

Recently 201Tl chloride is used for myocardial imaging, renal medullary imaging and tumor detection, but there is little information on the 201Tl scanning in patients with bone disease. A comparative study of the efficacy of 201Tl and sup(99m)Tc-MDP bone scanning in detecting bone disease was performed 25 patients with bone disease, who had abnormal radiographic findings, were studied by bone scanning with 201Tl and were compared to sup(99m)Tc-MDP in 24 lesions (11 benign and 13 malignant lesions). The result on these patients showed that, (1) 201Tl and sup(99m)Tc-MDP bone images were in agreement with each other in 4 of 11 lesions with benign disease and 5 of 13 lesions with malignant disease, (2) positive images with 201Tl were obtained in 11 of 13 malignant lesions, whereas only 3 of 11 benign lesions showed positive images with 201Tl, on the other hand, positive ratio of sup(99m)Tc-MDP scanning was 10/11 for benign and 7/13 for malignant lesions, (3) all of 4 cold lesions with malignant disease on sup(99m)Tc-MDP images were positively delineated with 201Tl. From these observations, some promise is offered by the use of 201Tl in allowing differentiation between malignant and benign bone disease. It is also suggestive that bone images with 201Tl could delineate the cold lesion in sup(99m)Tc-MDP bone scanning. (author)

1979-01-01

116

Importance of 201Tl scintigraphy during exercise for diagnosis of silent myocardial ischemia  

International Nuclear Information System (INIS)

Using thallium scintigraphy during exercise (TSE), suspect silent myocardial ischemia (SIM) was diagnosed in subjects without angina pectoris. 21 active pilots with suspect SIM were examined after previous exercise ECG as well as 33 patients with diabetes type I and II. In six pilots (28.6%) TSE showed accumulation defects suggesting ischemic disorders of the large coronary arteries. Five pilots showed obvious depressions of the ST segment in ECG during submaximal exercise TSE. In another group of five pilots small depressions of the ST segment were associated with normal TSE. Twelve diabetic patients (36.4%) had minor accumulation defects on TSE. Only two showed a ST depression under 2 mm in ECG during TSE. Based on data in the literature suggesting higher sensitivity and specificity of exercise thallium scintigraphy as compared with exercise ECG and the possibility of a false positive diagnosis of SIM from exercise ECG alone, it is recommended to also use TSE. A more detailed diagnosis of SIM is essential not only with regard to the assessment of work capacity but also for a long-term follow-up of patients with SIM for assessment of its incidence, impact and prognosis in the population. (author). 4 figs., 4 tabs., 25 refs

1990-03-30

117

The predictive value of 201Tl rest-redistribution and 18F-fluorodeoxyglucose SPECT for wall motion recovery after recent reperfused myocardial infarction.  

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201Tl and 18F-FDG are useful for acute myocardial infarction (MI) assessment. The goal of this study was to compare their predictive value for wall motion recovery in the culprit area after a recent reperfused MI using SPECT technique. METHODS: Forty-one patients (mean age: 56 +/- 12 years) were included, 81% of them male; all were studied within 1-24 days post MI. They underwent angioplasty in 27 cases (12 primary); bypass grafting in 10 cases and successful thrombolysis in 4. SPECT 201T...

2004-01-01

118

Accuracy of serial myocardial perfusion scintigraphy with _2_0_1Tl for prediction of graft patency early and late after coronary artery bypass surgery. A controlled prospective study  

International Nuclear Information System (INIS)

To assess the accuracy of serial myocardial perfusion scintigraphy with _2_0_1Tl to predict graft patency early and late coronary artery bypass surgery, rest and exercise _2_0_1Tl and coronary arteriography were performed preoperatively and 2 weeks and 1 year after operation. The scintigraphic results were compared with graft patency, symptoms, left ventricular function and physical work capacity in a consecutive series of 55 patients with a total of 154 grafts. Serial _2_0_1Tl had an 80% sensitivity, 88% specificity and 86% overall accuracy in detecting or excluding graft occlusion, which was predicted by reversible ischemia as well as persistent new scar segments. Occluded grafts were correctly localized by _2_0_1Tl scintigraphy in 61%. Postoperative apical _2_0_1Tl defects were frequent (two-thirds of cases), and were the result of intraoperative transapical venting of the left ventricle. After coronary bypass graft surgery, ejection fraction at rest was unchanged. Left ventricular end-diastolic pressure and physical work capacity improved significantly. In the presence of new perfusion defects detected postoperatively, physical work capacity was reduced significantly. New _2_0_1Tl defects in addition to typical or atypical angina provided a high probability of graft occlusion, while in the absence of new _2_0_1Tl defects all grafts were patent in more than 90% of patients, all of whom had no or only atypical chest pain. We conclude that serial _2_0_1Tl imaging after coronary artery bypass surgery is an accurate noninvasive method that can be used routinely to assess graft function, to localize spatially occluded grafts and to identify patients with a high likelihood of graft occlusion who may need invasive studies

1982-01-01

119

Mismatched regional myocardial uptake between [sup 123]I-BMIPP and [sup 201]Tl SPECT; Comparison between hypertrophic myocardium and dilated myocardium  

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The distribution of a new myocardial fatty acid metabolic agent [sup 123]I-BMIPP was compared in 6 each patients with hypertrophic myocardium (4 cases of hypertensive heart disease and 2 of hypertrophic cardiomyopathy) and dilated myocardium (4 of dilated type of valvular heart disease and 2 of dilated cardiomyopathy) with that of [sup 201]Tl. Mismatched regional myocardial uptake between [sup 123]I-BMIPP and [sup 201]Tl SPECT was observed in all of the hypertrophic myocardium, however no but one in the dilated myocardium. Relative increase or decrease in regional BMIPP from the images of 20 min and to those of 4 h was observed in 3 cases of the hypertrophic myocardium. FDG-PET was performed in 2 cases of the hypertrophic myocardium. The distribution of FDG was different from neither those of BMIPP nor Tl in a hypertrophic cardiomyopathy case with the reserved distribution of BMIPP and Tl. Although more investigations are necessary, we concluded that [sup 123]I-BMIPP is a promising radiopharmaceutical for evaluating myocardial fatty acid metabolism in hypertrophic myocardium. (author).

Otsuka, Makoto; Ichiya, Yuichi; Kuwabara, Yasuo; Sasaki, Masayuki; Fukumura, Toshimitsu; Masuda, Kouji; Ejima, Junichi; Tsuda, Yasuo (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine)

1992-07-01

120

Cost-effectiveness of exercise {sup 201}Tl myocardial SPECT in patients with chest pain assessed by decision-tree analysis  

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To evaluate the potential cost-effectiveness of exercise {sup 201}Tl myocardial SPECT in outpatients with angina-like chest pain, we developed a decision-tree model which comprises three 1000-patients groups, i.e., a coronary arteriography (CAG) group, a follow-up group, and a SPECT group, and total cost and cardiac events, including cardiac deaths, were calculated. Variables used for the decision-tree analysis were obtained from references and the data available at out hospital. The sensitivity and specificity of {sup 201}Tl SPECT for diagnosing angina pectoris, and its prevalence were assumed to be 95%, 85%, and 33%, respectively. The mean costs were 84.9 x 10{sup 4} yen/patient in the CAG group, 30.2 x 10{sup 4} yen/patient in the follow-up group, and 71.0 x 10{sup 4} yen/patient in the SPECT group. The numbers of cardiac events and cardiac deaths were 56 and 15, respectively in the CAG group, 264 and 81 in the follow-up group, and 65 and 17 in the SPECT group. SPECT increases cardiac events and cardiac deaths by 0.9% and 0.2%, but it reduces the number of CAG studies by 50.3%, and saves 13.8 x 10{sup 4} yen/patient, as compared to the CAG group. In conclusion, the exercise {sup 201}Tl myocardial SPECT strategy for patients with chest pain has the potential to reduce health care costs in Japan. (author)

Kosuda, Shigeru; Momiyama, Yukihiko; Ohsuzu, Fumitaka; Kusano, Shoichi [National Defense Medical Coll., Tokorozawa, Saitama (Japan); Ichihara, Kiyoshi

1999-09-01

 
 
 
 
121

Comparative study of dobutamine stress echocardiography and dual single-photon emission computed tomography (Thallium-201 and I-123 BMIPP) for assessing myocardial viability after acute myocardial infarction  

International Nuclear Information System (INIS)

Discordance between the 123I-labelled 15-iodophenyl-3-R, S-methyl pentadecanoic acid (BMIPP) and 201Tl findings may indicate myocardial viability (MV). This study compared dobutamine stress echocardiography (DSE) and single-photon emission computed tomography (SPECT) using the dual tracers for assessment of MV and prediction of functional recovery after acute myocardial infarction (AMI). DSE and dual SPECT were studied in 35 patients after AMI, of whom 28 underwent percutaneous coronary intervention in the acute stage. Dual SPECT was performed to compare the defect score of BMIPP and 201Tl. The left ventricular wall motion score (WMS) was estimated during DSE and 6 months later to assess functional recovery of the infarct area. The rate of agreement of MV between dual SPECT and DSE was 89% (p201Tl were significantly smaller in patients with functional recovery than in those without. Assessment of MV using DSE concords with the results of dual SPECT in the early stage of AMI. DSE may have a higher predictive value for long-term functional recovery at the infarct area. However, a finding of positive MV by dual SPECT, without functional recovery, may indicate residual stenosis of the infarct-related artery, although the number of cases was small. Combined assessment by dual SPECT and DSE may be useful for detecting MV and jeopardized myocardium. Furthermore, the results suggest that functional recovery of dysfunctional myocardium may depend on the size of the infarct and risk area. (author)

2002-12-01

122

Dual myocardial scintigraphic imaging using 123I-BMIPP and 201Tl in patients with Duchenne's progressive muscular dystrophy  

International Nuclear Information System (INIS)

Dual single photon emission computed tomography (SPECT) was performed in 30 patients with Duchenne's muscular dystrophy (DMD) using 201 thallium (Tl) for myocardial perfusion 123I-?-methyl-p-iodophenylpentadecanoic acid (BMIPP) for myocardial fatty acid metabolism scintigraphy. The left ventricle was divided into 9 regions, and accumulation of the radiotracers was assessed visually for each region to calculate defect score for each tracer. There was some degree of decrease in the myocardial accumulation of both tracers in all DMD patients. Reduced accumulation was most common at the apex (BMIPP, 70%; Tl, 63%), followed by the posterior wall, lateral wall, and anterior wall. It was less common on the apical side of the ventricular septum for both tracers (BMIPP, 3%; Tl, 17%). Accumulation of Tl was lower than BMIPP in 18/30 patients (60%) and higher in 9 (30%), while both tracers showed equal accumulation in 3 (10%). BMIPP showed higher accumulation than Tl in all regions but the septum. A significant negative correlation was found between the defect scores for both tracers and the left ventricular ejection fraction (LVEF) (r=-0.629 for Tl; r=-0.567 for BMIPP). The strongest negative correlation was that between the sum of the Tl and BMIPP defect scores and the LVEF (r=-0.681). Dual SPECT myocardial scintigraphy with Tl and BMIPP provided an accurate evaluation of the progression of cardiac lesions in DMD by detecting abnormalities of the myocardial metabolism of each substance thereby enabling the assessment of left ventricular function. (author)

1996-03-01

123

Exercise and rest myocardial scintigraphy with 201TlCl/99mTc-MIBI dual energy acquisition using triple-energy window scatter correction  

International Nuclear Information System (INIS)

We carried out dual 201Tl/99mTc-MIBI imaging to reduce the time required for exercise myocardial scintigraphy. We investigated 4 different protocols. In protocol (A), Tl was injected at rest followed by the injection of MIBI at peak exercise. Dual SPECT images were obtained by 201Tl/99mTc simultaneous acquisition. Protocol (B) means reverse either, in which MIBI was injected at rest followed by the administration of Tl at peak exercise. In protocol (C), exercise was performed first with MIBI-injection, and then Tl was injected at rest one hour later. Simultaneous acquisition was also performed. In protocol (D), after the rest Tl-imaging, MIBI was injected at peak exercise, and then the MIBI-imaging was done. In protocol (A), (B) and (C), simultaneous acquisition was performed using TEW (Triple-Energy Window) scatter correction. Thanks to using dual isotopes, all procedures could be completed within 1-2 hours, which was much shorter than the conventional myocardial perfusion imaging. Scatter correction was useful for accurate diagnoses, when the simultaneous imaging is performed. (author)

1994-11-01

124

Evaluation of mandibular invasion by head and neck cancers using 99mTc-methylene diphosphonate or 99mTc-hydroxymethylene diphosphonate and 201Tl chloride dual isotope single photon emission computed tomography  

International Nuclear Information System (INIS)

Whether a patient with head and neck cancer has mandibular invasion or not is important in determining the method of resection surgery. But, no modality is adequately reliable when used alone in the evaluation of mandibular invasion. Therefore, to more accurately diagnose mandibular invasion in head and neck cancer, we used a new modality, namely, 99mTc methylene diphosphonate (MDP) or 99mTc hydroxymethylene diphosphonate (HMDP) and 201Tl chloride dual isotope single photon emission computed tomography (Tc/Tl SPECT). The aim of this study is to disclose the usefulness of Tc/Tl SPECT in the assessment of mandibular invasion by head and neck cancers. 99mTc-MDP or -HMDP SPECT (Tc SPECT)s and 201Tl chloride SPECT (Tl SPECT)s were performed in 34 patients with suspected mandibular involvement of head and neck cancer. Thirty of 34 cases underwent both Tc/Tl SPECT and CT examination. Tc/Tl SPECT fusion images were obtained using the Automatic Registration Tool (ART, TOSHIBA, Japan) system. In the diagnosis of mandibular invasion on Tc/Tl SPECT fusion images, a problem was that the range of Tc and Tl uptake was changed by the condition of display used in the reconstruction and expression of the images. Then, prior to clinical evaluation, to reveal the most appropriate upper window level for display, a phantom study was performed. In a clinical study, the upper window level was set at 40 or 50%, which were verified to be the proper values in the preliminary study. The diagnostic accuracy obtained using Tc SPECT, Tc/Tl SPECT and CT was compared with the histopathological findings. Tc/Tl SPECT at 40 and 50% upper window level had higher specificity, accuracy, and positive predictive value (73.3%, 85.3%, 81.8%) than Tc SPECT alone (21.4%, 67.6%, 64.5%) and higher sensitivity and negative predictive value (94.7%, 91.7%) than CT (70.6%, 72.2%) for detecting mandibular invasion. Tc/Tl SPECT was a useful diagnostic procedure for the assessment of mandibular invasion by head and neck cancers. (author)

2004-07-01

125

[Assessment of myocardial damage and metabolic disorder in the left ventricle in patients with mitral stenosis using 201Tl and 123I-BMIPP myocardial SPECT].  

Science.gov (United States)

This study was designed to evaluate the myocardial damage and metabolic disorder of the left ventricle in patients with mitral stenosis. We studied 15 patients with mitral stenosis. Their grade of chronic heart failure using New York Heart Association classification were class I: 5 patients, class II: 5, class III: 3, class IV: 2, respectively. The severely stenotic group (valve area 123I-BMIPP myocardial SPECT and measurement of NE were reexamined in 5 patients after mitral valvuloplasty. NE values were 476 +/- 72 and 793 +/- 286 in classes I + II and III + IV, respectively. NE values was increased in the severe heart failure group (p 123I-BMIPP myocardial SPECT. Three patients showed slightly reduced uptake on both 201Tl and 123I-BMIPP myocardial SPECT. WR was 27.2 +/- 4.8% and 44.3 +/- 6.7% in class I + II and class III + IV, respectively. WR was increased in severe heart failure group (p < 0.05). WR was 27.8 +/- 6.0% and 41.3 +/- 9.4% in the mildly and severely stenotic group, respectively. WR was increased in the severely stenotic group (p < 0.05). NE was correlated with WR (p < 0.001). In patients with mitral valvuloplasty, WR was 44.3 +/- 6.7% and 31.4 +/- 4.7% before and after mitral valvuloplasty, respectively. NE values were 857 +/- 266 and 574 +/- 165, respectively. Both WR and NE were decreased after mitral valvuloplasty (p < 0.01). In patients with mitral stenosis, WR was increased in the severe heart failure group and severely stenotic group without apparent myocardial damage. Myocardial metabolism in the left ventricle might be influenced by right heart failure through, for example, NE and neurohormonal factors. PMID:11530379

Ito, K; Sugihara, H; Tanabe, T; Yuba, T; Doue, T; Adachi, Y; Katoh, S; Azuma, A; Nakagawa, M

2001-07-01

126

Effect of long-term cholesterol-lowering treatment with HMG-CoA reductase inhibitor (Simvastatin) of myocardial perfusion evaluated by thallium-201 single photon emission computed tomography  

International Nuclear Information System (INIS)

Fifteen patients with either angina pectoris or old myocardial infarction, who had positive 201Tl single photon emission computed tomography (SPECT) imaging and coronary sclerosis of more than 50%, were treated with an HMG-CoA reductase inhibitor (simvastatin) for more than 1 year. They were compared with an untreated control group (n=25). Total cholesterol decreased 22% and high-density lipoprotein (HDL) increased 9% with simvastatin; both changes were significantly different from those in controls. Long-term simvastatin induced improvement of myocardial perfusion on 201Tl SPECT images both during exercise and at rest, which was also significantly different from controls. In addition, the improvement of myocardial perfusion on 201Tl SPECT images was clearly related to the improvements in cholesterol values, especially nonHDL cholesterol. Thus, the greater the decrease in nonHDL cholesterol, the greater the improvement in myocardial perfusion at rest or during exercise with long-term treatment using an HMG-CoA reductase inhibitor. These findings indicate that the improvements in cholesterol values caused by HMG-CoA reductase inhibitor therapy are related to improvements of myocardial perfusion seen on 201Tl SPECT images. (author)

2000-03-01

127

Effect of long-term cholesterol-lowering treatment with HMG-CoA reductase inhibitor (Simvastatin) of myocardial perfusion evaluated by thallium-201 single photon emission computed tomography  

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Fifteen patients with either angina pectoris or old myocardial infarction, who had positive {sup 201}Tl single photon emission computed tomography (SPECT) imaging and coronary sclerosis of more than 50%, were treated with an HMG-CoA reductase inhibitor (simvastatin) for more than 1 year. They were compared with an untreated control group (n=25). Total cholesterol decreased 22% and high-density lipoprotein (HDL) increased 9% with simvastatin; both changes were significantly different from those in controls. Long-term simvastatin induced improvement of myocardial perfusion on {sup 201}Tl SPECT images both during exercise and at rest, which was also significantly different from controls. In addition, the improvement of myocardial perfusion on {sup 201}Tl SPECT images was clearly related to the improvements in cholesterol values, especially nonHDL cholesterol. Thus, the greater the decrease in nonHDL cholesterol, the greater the improvement in myocardial perfusion at rest or during exercise with long-term treatment using an HMG-CoA reductase inhibitor. These findings indicate that the improvements in cholesterol values caused by HMG-CoA reductase inhibitor therapy are related to improvements of myocardial perfusion seen on {sup 201}Tl SPECT images. (author)

Hosokawa, Ryohei; Nohara, Ryuji; Linxue, Li; Sasayama, Shigetake [Kyoto Univ. (Japan). Graduate School of Medicine; Tamaki, Shunichi; Hashimoto, Tetsuo; Tanaka, Masahiro; Miki, Shinji

2000-03-01

128

Comparison of thallium-201 single-photon emission tomography after rest injection and fluorodeoxyglucose positron emission tomography for assessment of myocardial viability in patients with chronic coronary artery disease  

International Nuclear Information System (INIS)

This prospective study in 42 patients with chronic coronary artery disease and severe wall motion abnormalities (sWMA) on cineventriculography (24 patients with previous myocardial infarction; ejection fraction, 45%±13%) was designed to compare myocardial thallium-201 uptake after rest injection and normalized fluorodeoxyglucose ("1"8FDG) uptake (after oral glucose load) for assessment of a rest "2"0"1Tl protocol to evaluate myocardial viability. The left ventricle was divided into the supply territory of the left anterior descending coronary artery (LAD) and the lateral wall and posterior territory (inferior, posterior and posteroseptal segments) because of the high variability of left circumflex and right coronary artery supply territories. Segmental "2"0"1Tl uptake in single-photon emission tomography (SPET) and segmental normalized "1"8FDG uptake (13 segments per patient) showed a close linear relationship in the LAD territory and in the lateral wall, while the correlation in the posterior territory was considerably lower. "2"0"1Tl/"1"8FDG concordance was defined as an "1"8FDG uptake exceeding "2"0"1Tl uptake by < 20%. Discordance was assumed if "1"8FDG exceeded "2"0"1Tl uptake by at least 20%. Concordant results were shown by 81% of segments. In segments with severe "2"0"1Tl reduction discordance was observed in 10% of segments in the LAD territory and lateral wall and in 44% of segments in the posterior territory. In segments with moderate "2"0"1Tl reduction discordance occurred in 12% or 46% of segments, respectively. Severe defects were defined as the entire area with "2"0"1Tl uptake ?50% within a defined territory. Discordance was observed in 6/43 of these. Of 90 areas with sWMA on cineventriculography, 12 showed discordant results. Ten of these 12 discordant areas affected septum or posterior wall. In areas with normal wall motion or only mild hypokinesis, discordance occurred in the septum or posterior wall in 22% whereas the figure for the anterior or lateral wall was only 2%. These results point to a significant role of photon attenuation in "2"0"1Tl SPET imaging in the septum and posterior wall. (orig.)

1994-01-01

129

Diagnosis of ischemic lesion by {sup 201}Tl myocardial three-dimensional polar map. Comparison between before and after administration of Amlodipine  

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In order to apply the three-dimensional polar map using the Application Visualization System-Medical viewer (AVS-MV) in clinical cases, we have conducted the {sup 201}Tl myocardial SPECT studies before and after the pharmacotherapy of Amlodipine to thirteen cases with old myocardial infarction. We have visually evaluated the three-dimensional polar maps, and the improvement of the myocardial perfusion of infarct area was observed after administration of Amlodipine in nine out of thirteen cases (69%). Significant improvements of severity score in the entire area of left ventricle were indicated on stress images and delayed images (p<0.05). Significant improvements were also demonstrated in the %Tl uptake and washout rate of infarct areas (p<0.05). With the administration of Amlodipine, improvement of myocardial perfusion was indicated on the exercise stress test. With the use of AVS-MV, the three-dimensional polar map was easy to operate and improved form of myocardial perfusion was observed in the infarct area before and after the administration of Amlodipine on three-dimensional image, although we used the myocardial phantom as the basic image. (author)

Yamazaki, Junichi; Muto, Hiroshi; Ishida, Shuichi; Uno, Nariaki; Saisho, Kenichiro; Morishita, Takeshi [Toho Univ., Tokyo (Japan). School of Medicine

1996-11-01

130

Diagnosis of ischemic lesion by 201Tl myocardial three-dimensional polar map. Comparison between before and after administration of Amlodipine  

International Nuclear Information System (INIS)

In order to apply the three-dimensional polar map using the Application Visualization System-Medical viewer (AVS-MV) in clinical cases, we have conducted the 201Tl myocardial SPECT studies before and after the pharmacotherapy of Amlodipine to thirteen cases with old myocardial infarction. We have visually evaluated the three-dimensional polar maps, and the improvement of the myocardial perfusion of infarct area was observed after administration of Amlodipine in nine out of thirteen cases (69%). Significant improvements of severity score in the entire area of left ventricle were indicated on stress images and delayed images (p<0.05). Significant improvements were also demonstrated in the %Tl uptake and washout rate of infarct areas (p<0.05). With the administration of Amlodipine, improvement of myocardial perfusion was indicated on the exercise stress test. With the use of AVS-MV, the three-dimensional polar map was easy to operate and improved form of myocardial perfusion was observed in the infarct area before and after the administration of Amlodipine on three-dimensional image, although we used the myocardial phantom as the basic image. (author)

1996-11-01

131

Clinical significance of diffuse slow washout pattern (DSWO) on the exercise stress 201Tl SPECT myocardial imaging: Correlative study with influencing factors  

International Nuclear Information System (INIS)

DSWO shown on the Bull's eye images was found in 98 of 1234 patients suspected of having coronary artery disease and examined with 201Tl myocardial SPECT imaging. 48 of these 98 patients underwent coronary arteriography. Comparison studies were performed between Bull's eye SPECT image, coronary arteriography and laboratory data. DSWO was found in 11 cases with single vessel disease (1VD), 18 cases with double vessel disease (2VD) and 21 cases with triple vessel disease (3VD). Three of 58 cases with stenosis of a cardiomyopathy. In the CAD group, DSWO appeared frequently accompanying hypertension, hyperlipemia and diabetes mellitus. These complications tended to increase in patients with 1VD and the stenosis less than 75%

1994-08-01

132

The value of "2"0"1Tl myocardial scintigraphy and of computed tomography for predicting the effectiveness of coronary artery bypass surgery  

International Nuclear Information System (INIS)

50 male patients with stenosing coronary artery sclerosis and an indication for coronary artery bypass surgery were subjected to pre- and postsurgical "2"0"1Tl scintigraphy and postsurgical computed tomography. Control by angiography was carried out in six cases. Scintigraphy revealed an improved myocardial perfusion in 30 patients, whereas it was unchanged in 15 and deteriorated in 5 patients. Angiography exhibited two cases of graft occlusion, one case of bad run off, and two cases of progressing arteriosclerosis under intact graft. Computed tomography showed that 83 bypasses of the 50 patients were occluded in 6 cases, which was confirmed by angiography in 3 cases. The investigation demonstrates the high value of the two non-invasive methods for the control of bypass patency. (author)

1986-01-01

133

Stress-induced myocardial ischemia is associated with early post-stress left ventricular mechanical dyssynchrony as assessed by phase analysis of {sup 201}Tl gated SPECT myocardial perfusion imaging  

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In {sup 201}Tl SPECT myocardial perfusion imaging (MPI) data are acquired shortly after the stress injection to assess early post-stress left ventricle (LV) function. The purpose of this study was to use {sup 201}Tl SPECT MPI to investigate whether stress-induced myocardial ischemia is associated with LV mechanical dyssynchrony. Enrolled in the study were 75 patients who were referred for dipyridamole stress and rest {sup 201}Tl gated SPECT MPI. The early post-stress scan was started 5 min after injection, and followed by the rest scan 4 h later. The patients were divided into three groups: ischemia group (N = 25, summed stress score, SSS, {>=}5, summed rest score, SRS, <5), infarct group (N = 16, SSS {>=}5, SRS {>=}5) and normal group (N = 34, SSS <5, SRS <5). LV dyssynchrony parameters were calculated by phase analysis, and compared between the stress and rest images. In the ischemia group, LV dyssynchrony was significantly larger during stress than during rest. On the contrary, LV dyssynchrony during stress was significantly smaller than during rest in the normal and infarct groups. LV dyssynchrony during rest was significantly larger in the infarct group than in the normal and ischemia groups. There were no significant differences in LV dyssynchrony during rest between the normal and ischemia groups. Stress-induced myocardial ischemia caused dyssynchronous contraction in the ischemic region, leading to a deterioration in LV synchrony. Normal myocardium had more synchronous contraction during stress. The different dyssynchrony pattern between ischemic and normal myocardium early post-stress may aid the diagnosis of coronary artery disease using {sup 201}Tl gated SPECT MPI. (orig.)

Chen, Chien-Cheng; Shen, Thau-Yun [Show Chwan Memorial Hospital, Department of Cardiology, Changhua (China); Chang, Ming-Che [Changhua Christian Hospital, Department of Nuclear Medicine, Changhua (China); Hung, Guang-Uei [Chang Bing Show Chwan Memorial Hospital, Department of Nuclear Medicine, Changhua (China); China Medical University, Department of Biomedical Imaging and Radiological Science, Taichung (China); Chen, Wan-Chen [Chang Bing Show Chwan Memorial Hospital, Department of Nuclear Medicine, Changhua (China); Kao, Chia-Hung [China Medical University, Department of Biomedical Imaging and Radiological Science, Taichung (China); Chen, Ji [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, GA (United States)

2012-12-15

134

Estimation of infarct size by myocardial emission computed tomography with _2_0_1Tl and its relation to creatine kinase-MB release after myocardial infarction in man  

International Nuclear Information System (INIS)

We evaluated emission computed tomography (ECT) _2_0_1Tl myocardial imaging in estimating infarct size (IS). In 18 patients in whom IS was estimated enzymatically at the time of the acute episode, planar _2_0_1Tl perfusion scintigraphy and ECT with a rotating gamma camera were performed 4 weeks after the first myocardial infarction. From the size of _2_0_1Tl perfusion defects, the infarct area in planar images and the infarct volume in reconstructed ECT images were measured by computerized planimetry. When scintigraphic IS was compared with the accumulated creatine kinase-MB isoenzyme release (CK-MBr), infarct volume determined from ECT correlated closely with CK-MBr (r . 0.89), whereas infarct area measured from planar images correlated less satisfactorily with the enzymatic IS (for an average infarct area from three views, r . 0.69; for the largest infarct area, r . 0.73). Although conventional scintigraphic evaluation is useful for detecting and localizing infarction, quantification of ischemic injury with this two-dimensional technique has a significant inherent limitation. The ECT approach can provide a more accurate three-dimensional quantitative estimate of infarction, and can corroborate the enzymatic estimate of IS

1982-01-01

135

Usefulness of 201Tl myocardial perfusion SPECT in prediction of left ventricular remodeling following an acute myocardial infarction  

International Nuclear Information System (INIS)

We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial linfarction (AMI). We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 6 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index(PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB,Q wave, LVEF and revascularization were analysed using multivariate analysis. Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.=20

2000-02-01

136

Clinical significance of 201Tl lung uptake in heart disease  

International Nuclear Information System (INIS)

In order to evaluate the clinical significance of 201Tl lung uptake, 201Tl myocardial scintigraphy was performed in 675 cases with various cardiac diseases. The lung uptake ratio of 201Tl (L/T) was calculated by ratio of the total radioactivity of the unilateral lung to the injected dose of 201Tl in 69 cases. Using both 201Tl scintigraphy and cardiac pool scintigraphy with 99mTc-human serum albumin, images of 201Tl of the intravascular space and extravascular space were obtained in 14 cases. The image of 201Tl of the extravascular space was almost the same as the original 201Tl image as regards the pattern of 201Tl-distribution, and the lung uptake ratio of the former was 95.7 ± 2.8% of that of the latter. The mean values of L/T of the right and left lungs were 1.5 ± 0.9%, 1.2 ± 0.6% in the healthy lungs, 2.8 ± 1.4% and 1.4 ± 0.7% in heart diseases without left heart failure, and 4.4 ± 1.8% and 2.6 ± 1.2% in those with left heart failure, respectively. Increased lung uptake ratio of 201Tl, which was related to post-capillary pulmonary hypertension, prolonged pulmonary circulation time and findings of left heart failure, was observed more frequently in mitral valvular diseases (72.2%) and dilated cardiomyopathies (60.0%). Increased lung uptake of 201Tl was associated with normal or increased pulmonary perfusion in many cases or areas, but with pulmonary hypoperfusion in some cases with post-capillary pulmonary hypertension, in whom both increased lung uptake of 201Tl and pulmonary hypoperfusion were shown in the lower lung fields. In conclusion, increased lung uptake of 201Tl suggests increased pulmonary extravascular space and calculation of the lung uptake ratio of 201Tl seems to be useful for the evaluation of left ventricular dysfunction. (author)

1990-01-01

137

Quantitative assessment of /sup 201/TlCl myocardial SPECT. Including the comparison with visual diagnosis of myocardial SPECT and planar images  

Energy Technology Data Exchange (ETDEWEB)

Clinical evaluation of the quantitative analysis of Tl-201 myocardial tomography by SPECT (Single Photon Emission Computed Tomography) was performed in comparison with visual evaluation. The method of quantitative analysis has been already reported in our previous paper. In this study, the program of re-standardization in the case of lateral myocardial infarction was added. This program was useful mainly for the evaluation of lesions in the left circumflex coronary artery. Regarding the degree of diagnostic accuracy of myocardial infarction in general, quantitative evaluation of myocardial SPECT images was highest followed by visual evaluation of myocardial SPECT images, and visual evaluation of myocardial planar images. However, in the case of anterior myocardial infarction, visual evaluation of myocardial SPECT images has almost the same detectability as quantitative evaluation of myocardial SPECT images. In the case of infero-posterior myocardial infarction, quantitative evaluation was superior to visual evaluation. As for specificity, quantitative evaluation of SPECT images was slightly inferior to visual evaluation of SPECT images. An infarction map was made by quantitative analysis and this enabled us to determine the infarction site, extent and degree according to easily recognizable patterns. As a result, the responsible coronary artery lesion could be inferred correctly and the calculated infarction score could be correlated with the residual left ventricular function after myocardial infarction.

Uehara, Toshiisa

1987-02-01

138

Diagnostic accuracy of supine and prone thallium-201 stress myocardial perfusion single-photon emission computed tomography to detect coronary artery disease in inferior wall of left ventricle  

International Nuclear Information System (INIS)

Prone thallium-201 (201Tl) myocardial perfusion single-photon emission computed tomography (SPECT) reduces false-positive rates when evaluating inferior wall abnormalities by minimizing diaphragmatic attenuation. The present study investigates the diagnostic validity of prone 201Tl stress myocardial perfusion SPECT for detecting coronary artery disease in the inferior wall of the left ventricle in Japanese patients. Of the 104 consecutive patients who underwent 201Tl stress myocardial perfusion SPECT to diagnose coronary artery disease, we evaluated 46 who underwent image acquisition in both the supine and prone positions, and coronary angiography within 3 months thereafter. Images were acquired in the routine supine position immediately following 201Tl (111 MBq) injection and 4 h following early acquisition. Images were acquired in the prone position only during the early phase following supine acquisition. We evaluated the SPECT images of the inferior half segments of the left ventricle using a five-point defect scoring system. According to the coronary angiographic findings, we investigated the diagnostic accuracy of stress-rest supine, stress supine, stress prone, and combined supine-prone images. Reduced uptake in the stress supine image of the combined images was considered as attenuation when uptake was normal in the prone image. The sensitivity of the stress-rest supine, stress supine, stress prone, and stress-combined supine-prone images was 77%, 86%, 55%, and 55%, and the specificity was 71%, 54%, 79%, and 83%, respectively. Diagnostic accuracy was the highest in stress-rest supine images. Prone images tended to improve the specificity of detecting coronary artery disease in the inferior wall, but not diagnostic accuracy compared with stress-rest supine images because of decreased sensitivity. (author)

2008-05-01

139

Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile. A direct comparison in normal individuals and patients with coronary artery disease  

International Nuclear Information System (INIS)

We tested the hypothesis that 99mTc 2-methoxy-isobutyl-isonitrile (99mTc MIBI), a new radiopharmaceutical for myocardial perfusion imaging, provides accurate noninvasive detection of coronary artery disease (CAD). Imaging in patients after exercise and at rest with 99mTc MIBI was compared with imaging after exercise and redistribution with 201Tl in 12 normal subjects and 38 patients with angiographic documentation of CAD (greater than or equal to 50% diameter stenosis). We used single-photon emission computed tomography (SPECT) and computer quantitation of regional tracer distribution. The quality of reconstructed images with 99mTc MIBI judged visually was superior to that of 201Tl in 88% of all studies performed and was comparable in the others. With the limits of normal as 2.5 SD below the mean of gender-matched normal volunteers, 201Tl SPECT identified 32 and 99mTc MIBI identified 36 patients with CAD (p = 0.2). 201Tl SPECT identified 45 of 75 (60%) and 99mTc MIBI identified 59 of 75 (79%) stenosed coronary arteries (p less than 0.05). The quantitative severity of perfusion defects was similar for the two tracers. 201Tl SPECT identified 104 reversibly ischemic myocardial segments compared with 134 with 99mTc MIBI (p less than 0.05). Thus, SPECT myocardial perfusion imaging with 99mTc MIBI and computer quantitation provides an accurate method for the noninvasive detection of significant coronary artery disease. Furthermore, image quality is generally superior to 201Tl, and reversibly ischemic myocardial segments may be better identified with 99mTc MIBI

1989-01-01

140

The significance of 201Tl/123I MIBG (metaiodobenzylguanidine) mismatched myocardial regions for predicting ventricular tachycardia in patients with idiopathic dilated cardiomyopathy  

International Nuclear Information System (INIS)

123I-MIBG (MIBG) regional defects in myocardial regions with preserved 201Tl (Tl) uptake have been observed in patients with idiopathic dilated cardiomyopathy (DCM). To evaluate whether the presence of Tl/MIBG mismatched regions is related to the occurrence of ventricular tachycardia (VT), we performed myocardial dual SPECT imaging with Tl (111 MBq) and MIBG (111 MBq) in 17 patients with DCM, 11 (Gp A) with and 6 (Gp B) without VT. Myocardial dual SPECT imaging was performed at 15 minutes after and 4 hours after the tracer injection. The regional tracer uptake was scored visually in 6 segments of the basal, middle, and apical short-axial images and in 2 apical segments of the midventricular vertical long-axial image by a four-point scoring system (0=normal, 1=moderate, 2=severe and 3=complete defect). Then, the severity of tracer maldistributions was assessed by the difference between total defect scores (TDSs) of Tl and MIBG (?TDS). TDS was not different between Gps A and B in both Tl and MIBG images. However, ?TDS was larger in Gp A than in Gp B (13.5±6.5 vs. 5.8±3.0, p<0.05). Also, the number of segments with the mismatched tracer uptake was larger in Gp A than in Gp B (12.5±3.0 vs. 8.3±1.5, p<0.01). In the electrophysiologic study, we found that the fractionated area corresponded to the mismatched region in 3 of 5 patients in Gp A. These results suggest that regional sympathetic denervation is a possible factor which provocates VT, and myocardial dual SPECT imaging with Tl and MIBG is a useful method for predicting VT in patients with DCM. (author)

1993-10-01

 
 
 
 
141

Relation between myocardial damage and disease activity in patients with systemic lupus erythematosus by exercise 201Tl scintigraphy  

International Nuclear Information System (INIS)

Myocardial damage in patients with systemic lupus erythematosus (SLE) was evaluated using exercise thallium-201 myocardial scintigraphy, and the relationship between myocardial damage and disease activity of SLE was examined. Twenty-seven patients (26 women and 1 man, mean age 43 years), in whom extramural coronary artery lesions were excluded by coronary angiogram or presumed to be excluded by exercise electrocardiogram, were enrolled in this study. The mean duration of disease and the mean duration of corticosteroid therapy in these patients were 94 and 77 months, respectively. Exercise thallium-201 scintigraphy was performed twice (mean interval, 30 months) to evaluate the progression of myocardial damage. Myocardial ischemia as an index of myocardial damage was evaluated by visual analysis and ischemic score (IS). The changes in myocardial ischemia were categorized into 3 groups: improved, unchanged or worsened. The disease activity of SLE was determined by the SLE Disease Activity Index (SLEDAI), and the changes in this index were classified into the same three categories, as evaluated every six months between the two scintigraphic examinations. Disease activity was significantly correlated with myocardial ischemia (p<0.05), and with myocardial ischemia as diagnosed by ?IS (difference in ischemic score between the first and second thallium-201 scintigrams: p<0.005). But neither the duration of disease nor the duration of corticosteroid therapy was correlated with IS at the first scintigraphy. These results indicate that control of SLE disease activity may be critical in the treatment of myocardial damage resulting from vascular lesions, especially intramyocardial small-artery disease, in patients with SLE. (author)

1997-08-01

142

Relation between myocardial damage and disease activity in patients with systemic lupus erythematosus by exercise {sup 201}Tl scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

Myocardial damage in patients with systemic lupus erythematosus (SLE) was evaluated using exercise thallium-201 myocardial scintigraphy, and the relationship between myocardial damage and disease activity of SLE was examined. Twenty-seven patients (26 women and 1 man, mean age 43 years), in whom extramural coronary artery lesions were excluded by coronary angiogram or presumed to be excluded by exercise electrocardiogram, were enrolled in this study. The mean duration of disease and the mean duration of corticosteroid therapy in these patients were 94 and 77 months, respectively. Exercise thallium-201 scintigraphy was performed twice (mean interval, 30 months) to evaluate the progression of myocardial damage. Myocardial ischemia as an index of myocardial damage was evaluated by visual analysis and ischemic score (IS). The changes in myocardial ischemia were categorized into 3 groups: improved, unchanged or worsened. The disease activity of SLE was determined by the SLE Disease Activity Index (SLEDAI), and the changes in this index were classified into the same three categories, as evaluated every six months between the two scintigraphic examinations. Disease activity was significantly correlated with myocardial ischemia (p<0.05), and with myocardial ischemia as diagnosed by {Delta}IS (difference in ischemic score between the first and second thallium-201 scintigrams: p<0.005). But neither the duration of disease nor the duration of corticosteroid therapy was correlated with IS at the first scintigraphy. These results indicate that control of SLE disease activity may be critical in the treatment of myocardial damage resulting from vascular lesions, especially intramyocardial small-artery disease, in patients with SLE. (author)

Kuzumoto, Masayuki [Nara Medical Univ. (Japan)

1997-08-01

143

Evaluation of myocardial viability and efficacy of reperfusion therapy by dual-SPECT using "9"9"mTc-PYP and "2"0"1Tl in acute myocardial infarction  

International Nuclear Information System (INIS)

Dual SPECT using "9"9"mTc-PYP and "2"0"1Tl was performed in 70 patients with acute myocardial infarction, and the ratio of overlap zone between "2"0"1Tl and "9"9"mTc-PYP uptake in the infarcted area was determined (the Y-ratio). The Y-ratio was significantly higher in the group with redistribution in the infarcted area on exercise thallium myocardial scintigraphy in the chronic stage of infarction, as well as in the group with normal left ventricular wall motion. Thus, the Y-ratio value was apparently useful in the evaluation of myocardial viability. Patients from 60% of the Y-ratio upward are suggested that myocardial viability had been survived. When the Y-ratio was determined in 30 patients who underwent early reperfusion therapy (ICT or direct-PTCA), no significant difference was found between the ICT group and the direct-PTCA group. However, the Y-ratio was significantly higher when reperfusion was performed within 6 hours than when it was performed after 6 hours, and a significant positive correlation (r=0.63, p<0.01), was found between reperfusion time from cardiac event within 9 hours and the value of (100- the Y-ratio). In conclusion, the Y-ratio grateful appeared to be useful for the quantitative evaluation of myocardial viability in the acute stage of myocardial infarction. In addition, it appears to be important to perform reperfusion as soon as possible to improve myocardial salvage. (author)

1994-10-01

144

The use of dual phase 201Tl SPECT for differentiating pulmonary malignancies from benign lesions  

International Nuclear Information System (INIS)

This study examines the usefulness of thallium-201 single photon emission computed tomography (201Tl SPECT) in differentiating pulmonary malignancies from benign lesions by using dual phase 201Tl scintigraphy. One hundred and six patients with thoracic lesions and confirmed diagnoses were assessed by 201Tl chest SPECT examinations; of these 106 enrolled thoracic lesions, 59 were malignancies and 47 were benign lesions. Dual phase 201Tl SPECT was performed with an early image acquired at 10-20 min and a delayed image at 2-3 h after intravenous injection of 2-3 mCi of 201Tl. The results of 201Tl SPECT images were classified as either malignant or benign lesions by visual interpretation: the lesion was interpreted as positive for malignancy if the uptake of 201Tl in the lung lesion in the delayed phase was increased or persistent as compared with that in the early phase image; otherwise, it was considered as a benign lesion. Simultaneously, the traditional method of retention index (RI) was also calculated to help in the differential diagnosis of pulmonary lesions. Then, both methods of dual phase 201Tl SPECT, visual reading and traditional RI, were compared to differentiate pulmonary malignancies from benign lesions. Analyzing the image results, we found that dual phase 201Tl SPECT could differentiate pulmonary malignancies from benign lesions with a sensitivity of 83%, a specificity of 91% and an accuracy of 87%. Moreover, by using the traditional RI method of 201Tl SPECT, it could differentiate pulmonary malignancy from benign lesions with a sensitivity of 79.3%, a specificity of 80.8% and an accuracy of 80%. We conclude that using dual phase 201Tl SPECT with visual interpretation is a simpler and potentially more effective method for differentiating pulmonary malignancies from benign lesions, with results compatible with the traditional RI method of 201Tl SPECT. (author)

2004-08-01

145

A case of myotonic dystrophy presenting an acute inversion of T wave and positive findings in 201Tl and 99mTc-PYP myocardial scintigram  

International Nuclear Information System (INIS)

In a 66-year-old man with myotonic dystrophy, ECG showed repeated occurrence of Mobitz II type second degree of atrioventricular block and acute inversion of T wave. Thallium-201 myocardial single photon emission computed tomography (SPECT) showed defect images corresponding to hypokinesis in the anterolateral wall and apex that were detected on left ventriculography. Tc-99m PYP myocardial SPECT showed abnormal uptake in the posteroinferior wall. Positive findings on myocardial SPECT seemed to indicate myocardial degeneration associated with myotonic dystrophy because there was histological evidence of myocardial degeneration despite the lack of abnormal findings on coronary arteriography. ECG findings are also worthy to note because T waves became deteriorated in a short time. (Namekawa, K)

1988-01-01

146

Case of myotonic dystrophy presenting an acute inversion of T wave and positive findings in /sup 201/Tl and /sup 99m/Tc-PYP myocardial scintigram  

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In a 66-year-old man with myotonic dystrophy, ECG showed repeated occurrence of Mobitz II type second degree of atrioventricular block and acute inversion of T wave. Thallium-201 myocardial single photon emission computed tomography (SPECT) showed defect images corresponding to hypokinesis in the anterolateral wall and apex that were detected on left ventriculography. Tc-99m PYP myocardial SPECT showed abnormal uptake in the posteroinferior wall. Positive findings on myocardial SPECT seemed to indicate myocardial degeneration associated with myotonic dystrophy because there was histological evidence of myocardial degeneration despite the lack of abnormal findings on coronary arteriography. ECG findings are also worthy to note because T waves became deteriorated in a short time. (Namekawa, K).

Horimoto, Masashi; Takeda, Hiroki; Funayama, Naoki; Igarashi, Takeki; Horata, Katsumi; Sekine, Mitsuo.

1988-02-01

147

[Clinical evaluation of 123I-BMIPP myocardial SPECT in patients with hypertensive heart disease and hypertrophic cardiomyopathy: comparison with the findings of 201Tl SPECT and Gd enhanced magnetic resonance imaging].  

Science.gov (United States)

123I-BMIPP SPECT (123I-BMIPP), 201Tl SPECT (201Tl), and Gd-DTPA enhanced magnetic resonance myocardial imaging (MR) were performed in patient groups with hypertensive heart disease (HHD), apical hypertrophic cardiomyopathy (APH), and hypertrophic cardiomyopathy without APH(HCM). SPECT was divided into 20 segments and each segment was scored as one of 4 grades (0 = normal; 1 = mildly decreased; 2 = severely decreased; and 3 = defect) according to the RI uptake. Gd enhancement in MR was interpreted visually. A decreased in the uptake of 123I-BMIPP showed in 54 of 141 hypertrophic (> 13 mm, measured by ultrasonic cardiography) segments in HHD, in 32 of 66 in APH and in 103 of 207 in HCM respectively. Whereas 201Tl SPECT showed decreased uptake in 18 of 141 hypertrophic segments, in 18 of 66 in APH, and in 27 of 207 in HCM, respectively. 123I-BMIPP showed a higher incidence of these scintigraphic abnormalities than did 201Tl in the hypertrophic segments. And also in the hypertrophic segments, decreased in the uptake of 123I-BMIPP occurred more frequently in HCM than in HHD. In HCM, decreased 123I-BMIPP uptake appeared more frequently in segments 1, 2, 9, and 10 (antero-septal junction) than in other segments, but in APH, such decreases occurred more often in segments 17, 18, 19, and 20 (apex). Enhanced signal intensity with Gd-DTPA appeared in more segments in the HCM group than in the APH or HHD groups. We concluded that HCM had the most extensive and severe structural changes--including metabolic and ischemic changes--among three groups, and that the combination of these three examinations was useful for evaluating the characteristics of hypertrophic myocardium. PMID:9095571

Miyanaga, H; Kawasaki, S; Yoneyama, S; Hyougo, T; Kamitani, T; Takahashi, T; Kunishige, H

1997-02-01

148

The value and limitation of resting 201Tl reinjection after stress-redistribution imaging for the assessment of myocardial viability  

International Nuclear Information System (INIS)

Clinical value and limitation of resting reinjection of small dose of thallium (37 MBq) for the assessment of myocardial viability were evaluated. The results were compared with the degree of wall motion improvement by revascularization to infarcted myocardium supplied by chronic total vessels in 12 patients with old myocardial infarction. Thallium uptake was visually scored and judged as normal, reversible defect (Group 1), new fill in after reinjection (Group 2A), and no fill in even after reinjection (Group 2B). Among 53 segments with initial perfusion abnormality, 21 segments reverted to almost normal, while 32 segments remained abnormal on redistribution images. New fill in after reinjection was observed in 11 segments of 32 segments showing persisting defect on stress and delayed image (37%). Wall motion score index of Group 2A improved significantly higher than Group 2B (p<0.01) and almost equal to Group 1, suggesting the utility of reinjection for the assessment of tissue viability which may be underestimated by conventional imaging. But significant wall motion improvement (?0.6 mean SD/chords) was observed in 6 segments (29%) of 21 segments showing neither redistribution nor fill in after reinjection. These data indicate that small dose of thallium reinjection may enhance detection of viable but jeopardized myocardium, although some underestimation of viability remained to be resolved. (author)

1992-01-01

149

Measurement of myocardial uptake rate and method of dual energy data acquisition in myocardial scintigraphy with sup 123 I-metaiodobenzylguanidine and sup 201 Tl-chloride, 2; Clinical studies in hypertrophic cardiomyopathy and hypertensive cardiomegaly  

Energy Technology Data Exchange (ETDEWEB)

Myocardial scintigraphy was performed on 24 patients with hypertrophic cardiomyopathy (HCM), 5 with essential hypertension (EHT) and 7 normal controls at rest by means of simultaneous dual energy data acquisition following an intravenous injection of {sup 123}I-metaiodobenzylguanidine (MIGB) and {sup 201}Tl-chloride (Tl). The myocardial uptake rates of both tracers were measured in the planar images by taking into account the myocardial and pulmonary attenuation. The regional myocardial distributions of the tracers were also studied in the SPECT images. In planar images, the rate of loss of {sup 123}I-MIBG from the myocardium of HCM subjects was significantly higher than of control subjects 15 min to 3 hr after injection. No significant difference was observed from 3 hr to 5 hr and from the 5 hr to 21 hr periods. In the SPECT images, the rate of loss of {sup 123}I-MIBG from the myocardium of HCM subjects was significantly higher than of control subjects in all segments of myocardium through a 15 min to 5 hr observation period. The results suggested that the uptake-release mechanism of {sup 123}I-MIBG in the neuronal vesicles was impaired in HCM subjects in two different ways: (1) normal release in delayed phase associated with low uptake in early phase or (2) accelerated release in early phase. Moreover, the sympathetic dysfunction may spread through the all segments of myocardium of HCM subjects. The apical lesion showed an extremely high rate of loss up to 5 hr after injection in SPECT images. This was quite different from that of the septal lesion. This indicated that the apical lesion of HCM subjects may have a different sympathetic abnormality. In EHT subjects, no abnormal regional distribution of {sup 123}I-MIBG was observed. This suggested that the sympathetic innervation was maintained although an abnormal distribution of blood flow was frequently observed in {sup 201}Tl scintigraphy. (author).

Higashino, Hiroshi (Ehime Univ., Shigenobu (Japan). School of Medicine)

1991-06-01

150

Synthesis and in vivo evaluation of 201Tl(III)-DOTA complexes for applications in SPECT imaging  

International Nuclear Information System (INIS)

Introduction: The aim of this study was to assess the use of 201thallium3+ (201Tl3+) as a radiolabel for nuclear imaging tracers. Methods for labeling of 1,4,7,10-tetraazacyclododecane-N,N',N'',N''' tetraacetic acid (DOTA) and diethylenetriaminepentaacetic acid (DTPA) chelators with 201Tl3+ were investigated, and the levels of stability of these chelates were tested in vitro and in vivo. Methods: 201Tl(I)Cl was treated with hydrochloric acid and ozone to form 201Tl(III)Cl3. The procedure for labeling of DOTA and DTPA was optimized, testing different buffer solutions and pH values. The stability levels of 201Tl(III)-DOTA and 201Tl(III)-DTPA were assessed in buffer, mouse serum and human serum (1:1, v/v) at a temperature of 310 K for 48 h. Subsequently, in vivo stability studies with 201Tl(III)-DOTA were performed, comparing the biodistribution of 201Tl(III)-DOTA with that of 201Tl(I)Cl in a single-isotope study and with that of 177Lu(III)-DOTA in a dual-isotope single photon emission computed tomography study. Results: 201Tl(III)-DTPA, 201Tl(III)-DOTA and 177Lu(III)-DOTA were prepared with >95% radiochemical purity. While 201Tl(III)-DOTA showed a prolonged level of stability in buffer and serum, 201Tl was quickly released from DTPA in serum. Apart from some urinary excretion, the biodistribution of DOTA-chelated 201Tl3+ was similar to that of free (ionic) 201Tl+ and did not match the biodistribution of 177Lu(III)-DOTA. This indicated a limited stability of 201Tl(III)-DOTA complexes in vivo. Conclusion: Despite promising results on the labeling and in vitro stability of 201Tl(III)-DOTA, our in vivo results indicate that the integrity of 201Tl(III)-DOTA decreases to 201Tl3+ as a radiolabel for tracer imaging.

2011-05-01

151

Synthesis and in vivo evaluation of {sup 201}Tl(III)-DOTA complexes for applications in SPECT imaging  

Energy Technology Data Exchange (ETDEWEB)

Introduction: The aim of this study was to assess the use of {sup 201}thallium{sup 3+} ({sup 201}Tl{sup 3+}) as a radiolabel for nuclear imaging tracers. Methods for labeling of 1,4,7,10-tetraazacyclododecane-N,N',N'',N''' tetraacetic acid (DOTA) and diethylenetriaminepentaacetic acid (DTPA) chelators with {sup 201}Tl{sup 3+} were investigated, and the levels of stability of these chelates were tested in vitro and in vivo. Methods: {sup 201}Tl(I)Cl was treated with hydrochloric acid and ozone to form {sup 201}Tl(III)Cl{sub 3}. The procedure for labeling of DOTA and DTPA was optimized, testing different buffer solutions and pH values. The stability levels of {sup 201}Tl(III)-DOTA and {sup 201}Tl(III)-DTPA were assessed in buffer, mouse serum and human serum (1:1, v/v) at a temperature of 310 K for 48 h. Subsequently, in vivo stability studies with {sup 201}Tl(III)-DOTA were performed, comparing the biodistribution of {sup 201}Tl(III)-DOTA with that of {sup 201}Tl(I)Cl in a single-isotope study and with that of {sup 177}Lu(III)-DOTA in a dual-isotope single photon emission computed tomography study. Results: {sup 201}Tl(III)-DTPA, {sup 201}Tl(III)-DOTA and {sup 177}Lu(III)-DOTA were prepared with >95% radiochemical purity. While {sup 201}Tl(III)-DOTA showed a prolonged level of stability in buffer and serum, {sup 201}Tl was quickly released from DTPA in serum. Apart from some urinary excretion, the biodistribution of DOTA-chelated {sup 201}Tl{sup 3+} was similar to that of free (ionic) {sup 201}Tl{sup +} and did not match the biodistribution of {sup 177}Lu(III)-DOTA. This indicated a limited stability of {sup 201}Tl(III)-DOTA complexes in vivo. Conclusion: Despite promising results on the labeling and in vitro stability of {sup 201}Tl(III)-DOTA, our in vivo results indicate that the integrity of {sup 201}Tl(III)-DOTA decreases to <20% during the time required for urinary excretion, thereby limiting the use of {sup 201}Tl{sup 3+} as a radiolabel for tracer imaging.

Hijnen, Nicole M.; Vries, Anke de [Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven (Netherlands); Blange, Roy [Department of Biomolecular Engineering, Antwerp University, 2610 Antwerp (Belgium); Burdinski, Dirk [Department of Biomolecular Engineering, Philips Research, 5656 AE Eindhoven (Netherlands); Gruell, Holger, E-mail: h.gruell@tue.n [Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven (Netherlands); Department of Biomolecular Engineering, Philips Research, 5656 AE Eindhoven (Netherlands)

2011-05-15

152

Evaluation of left ventricular perfusion and regional wall motion in myocardial infarction. Using 201Tl myocardial SPECT and 99mTc-HSAD multigated cardiac blood pool emission computed tomography  

International Nuclear Information System (INIS)

In order to evaluate left ventricular regional wall motion and regional myocardial perfusion, 99mTc-HSAD multigated cardiac blood pool emission computed tomography (cardiac pool SPECT) and 201Tl myocardial SPECT (Tl) were performed on 12 patients with acute myocardial infarction (AMI), 6 patients had treated with only thrombolysis in group I and 6 patients had treated with thrombolysis and selective PTCA in group II, 17 patients with old myocardial infarction (OMI) in group III and 5 normal volunteers (controls). The relationship between left ventricular regional wall motion and regional myocardial perfusion was estimated. The relationship between % length shortening (%LS) by cardiac pool SPECT and %Tl uptake (%TU) was good (r=0.820) in group III. The value for %TU in segments of akinesia was low (35%) and in those of severe hypokinesia was higher (48%). In all phases, two groups showed significant relationships between %LS and %TU in groups I and II. The %TU was unchanged in the akinetic segment, the %LS changed to 30% in group I and the %LS changed to 49% in group II. If the %TU is more than 50% (AMI) or 40% (OMI), we would observe viable muscle. The combination of Tl and cardiac pool SPECT are useful for evaluating myocardial viability in the patients with AMI. (author)

1994-09-01

153

Dual myocardial scintigraphic imaging using {sup 123}I-BMIPP and {sup 201}Tl in patients with Duchenne`s progressive muscular dystrophy  

Energy Technology Data Exchange (ETDEWEB)

Dual single photon emission computed tomography (SPECT) was performed in 30 patients with Duchenne`s muscular dystrophy (DMD) using {sup 201} thallium (Tl) for myocardial perfusion {sup 123}I-{beta}-methyl-p-iodophenylpentadecanoic acid (BMIPP) for myocardial fatty acid metabolism scintigraphy. The left ventricle was divided into 9 regions, and accumulation of the radiotracers was assessed visually for each region to calculate defect score for each tracer. There was some degree of decrease in the myocardial accumulation of both tracers in all DMD patients. Reduced accumulation was most common at the apex (BMIPP, 70%; Tl, 63%), followed by the posterior wall, lateral wall, and anterior wall. It was less common on the apical side of the ventricular septum for both tracers (BMIPP, 3%; Tl, 17%). Accumulation of Tl was lower than BMIPP in 18/30 patients (60%) and higher in 9 (30%), while both tracers showed equal accumulation in 3 (10%). BMIPP showed higher accumulation than Tl in all regions but the septum. A significant negative correlation was found between the defect scores for both tracers and the left ventricular ejection fraction (LVEF) (r=-0.629 for Tl; r=-0.567 for BMIPP). The strongest negative correlation was that between the sum of the Tl and BMIPP defect scores and the LVEF (r=-0.681). Dual SPECT myocardial scintigraphy with Tl and BMIPP provided an accurate evaluation of the progression of cardiac lesions in DMD by detecting abnormalities of the myocardial metabolism of each substance thereby enabling the assessment of left ventricular function. (author).

Sasaki, Akira [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

1996-03-01

154

Serial change of defect size after injection of [sup 123]I-MIBG in patients with acute myocardial infarction as compared with [sup 201]TlCl  

Energy Technology Data Exchange (ETDEWEB)

Eight patients with acute myocardial infarction underwent dual energy single photon emission computed tomography (SPECT) with I-123 metaiodobenzylguanidine (I-123 MIBG) and Tl-201 chloride 15 min after iv injection of these radionuclides at rest. Furthermore, myocardial SPECT with I-123 MIBG was undertaken 60 and 240 min after iv injection. According to SPECT images and Bull's eye color map, tracer uptake was expressed by defect scores; defect scores were compared on 15, 60, and 240 min I-123 MIBG images and on 15 min Tl-201 images. Defect scores on all serial phases of I-123 MIBG images were significantly higher than those on 15 min Tl-201 images. Changes of defect size became larger with time. The quality of 240 min I-123 MIBG images was poor, which made it difficult to interpret images in many patients. Serial changes in defect size between I-123 MIBG images and Tl-201 images were dependent upon the time of I-123 MIGB scanning. In comparing I-123 MIBG and Tl-201 scintigraphies, I-123 MIBG scans, obtained 15 min after iv injection, were the appropriate, although these scans seemed to underestimate the denervated but viable myocardium. (N.K.).

Yoshida, Naoki; Takeuchi, Masaaki; Ishino, Yoichi; Kuriyama, Masami; Nandate, Hidekazu; Oka, Yuichi; Kondo, Shoichi; Nakashima, Yasuhide; Kuroiwa, Akio (University of Occupational and Environmental Health, Kitakyushu, Fukuoka (Japan))

1994-06-01

155

Single photon Rb-82 imaging of remote myocardial infarction  

International Nuclear Information System (INIS)

Rb-82, a short-lived (t 1/2 = 75 sec) positron emitting tracer which accumulates in the myocardium, is available from a long lived (t 1/2 = 25d) Sr-82 generator. Using a Pho-IV gamma camera and a rotating tungsten collimator, the authors have previously demonstrated the feasibility of single photon imaging of the myocardium with Rb-82 in subjects without myocardial defects on Tl-201 scans. To evaluate myocardial lesion detection with this technique the authors selected 10 patients with documented remote (>3 months) myocardial infarctions (MI) and imaged them at rest with both Tl-201 and Rb-82. After injection of 1.2 mCi Tl-201, 3 views (Ant, LAO 40, LAO 70) were obtained with a portable camera (LEM-Siemens). Subsequently, 2 views were chosen for Rb-82 imaging using 40 mCi i.v. per view. Images were accumulated from 2-7 minutes and compared to the Tl-201 images. In general, contrast was good with Rb-82 and interference from liver activity was minimal. In 1 patient the Tl-201 and Rb-82 images were normal. In 4 patients with inferior wall MI, the lesion site was abnormal in 4 with Tl-201 and in 3 with Rb-82. Both studies showed decreased activity at the site of the lesion in 5 patients with an MI in the LAD distribution. Although lesion detection was similar with both tracers, the defects in some cases were more visible with Rb-82 than Tl-201 and vice versa. Single photon imaging with Rb-82 provided lesion detection comparable with Tl-201 imaging in these patients with remote MI. Rb-82 imaging should prove especially useful in clinical situations such as acute MI in which rapid sequential myocardial perfusion imaging is desirable

1984-06-05

156

Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of 201Tl  

International Nuclear Information System (INIS)

Myocardial 201Tl uptake and regional blood flow by the microsphere technique were determined in anesthetized dogs undergoing either 20 min of coronary occlusion and 100 min of reperfusion (N = 10) or 120 min of occlusion (N = 4). In both groups, 201Tl was injected intravenously after 10 min of occlusion. In transiently occluded dogs, regional flow at the time of 201Tl administration was reduced to 8 +- 3 percent of normal flow in endocardial layers of the central ischemic zone. After 100 min of reperfusion, flow values were not significantly different from normal. 201Tl activity after reperfusion rose to 56 +- 5 percent of normal, demonstrating that redistribution of the radionuclide occurred during the reflow period. In animals with persistent occlusion, there was a significant relationship between 201Tl uptake and flow (r = 0.95) and no evidence of redistribution of 201Tl during the two hour occlusion period. In another five dogs receiving 201Tl, serial gamma camera images obtained during reperfusion showed increasing uptake of the tracer in apical defects which returned to normal by 4 hours of reflow. Thirteen patients with stable angina received 2 mCi of 201Tl intravenously at peak exercise, and multiple gamma camera images obtained serially. All demonstrated zones of diminished 201Tl uptake 10 min after exercise. Defects which disappeared within 1-6 hours postexercise corresponded to areas supplied by coronary arteries with significant stenoses. Persistent defects were present in regions of old myocardial infarction. Six patients with acute myocardial infarction demonstrated 201Tl myocardial defects which showed no significant change over 6 hours. Redistribution of 201Tl into ischemic myocardium was demonstrated during transient coronary occlusion in dogs and after exercise stress in man

1977-01-01

157

Mechanism of 201Tl uptake in tumours  

International Nuclear Information System (INIS)

We have studied the mechanism of tumour uptake of 201Tl by in vivo and in vitro studies. In a series of patients with breast cancer (n=26), lung cancer (n=56) and lymphoma (n=15), the time course of tumour uptake of 201Tl paralleled that in the myocardium with almost identical times of peak uptake being obtained in tumours and myocardium. In a patient with hepatic metastases from colonic cancer undergoing laparotomy, 99mTc labelled microspheres and 201Tl were injected into the hepatic artery and biopsies of metastatic and normal liver tissue obtained. The tumour to normal liver activity ratios for 201Tl were one tenth of those for 99mTc microspheres. In the final part of the study, cells from a lung cancer tissue culture line were incubated for 30 min with 201Tl with and without the addition of cardiac glycoside, which acts a sodium potassium pump blocker. The cells exposed to the cardiac glycoside showed markedly decreased uptake of 201Tl compared to the cells not so exposed (0.6%±0.1% vs 11.8±0.7% of the administered dose). The mechanism of 201Tl uptake of tumours is similar to that in the myocardium. Sodium potassium pump activity appears to be more important than tumour blood flow. 201Tl uptake may provide a useful means of studying tumour viability. (orig.)

1989-01-01

158

Evaluation of SPECT with /sup 67/Ga and /sup 201/Tl in patients with primary lung cancer  

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To evaluate the effectiveness of single photon emission CT (SPECT) for estimation of primary lesion, hilar, and mediastinal nodal involvement of primary lung cancer using /sup 67/Ga and /sup 201/Tl, both planar and SPECT imagings were performed. All 8 patients had peripheral well differentiated adenocarcinoma, and postsurgical T1N0. The SPECT study comprised 64 views over a 360 transaxial rotation. After planar imaging was performed 15 minutes after intravenous administration of 6 mCi /sup 201/Tl, SPECT imaging was taken. /sup 67/Ga planar and SPECT imagings were performed 72 hours after intravenous administration of 3 mCi /sup 67/Ga. /sup 67/Ga and /sup 201/Tl studies were done with 8 and 5 patients respectively. When accumulations of these radiopharmaceuticals were noted in the primary lesion, hilar and mediastinal regions, the results were considered positive. The accuracy of primary lesion accumulation on /sup 67/Ga scintigraphy was 16 % with planar and 38 % with SPECT, and on /sup 201/Tl accuracy was 25 % with planar and 100 % with SPECT. For detection of hilar nodal involvement, /sup 67/Ga SPECT yielded 25 % accuracy, and /sup 201/Tl SPECT showed 100 % accuracy. In mediastinal staging, /sup 67/Ga SPECT had 75 % accuracy and /sup 201/Tl SPECT had 100 % accuracy. For evaluation of the primary lesion and lymphnode metastasis, /sup 201/Tl SPECT proved superior to /sup 201/Tl planar, /sup 67/Ga planar and /sup 67/Ga SPECT.

Tanabe, Masatada; Matsuno, Shinsuke; Satoh, Katashi and others

1988-11-01

159

The new method of evaluation for the regional myocardial function using the regional wall thickening curve obtained by ECG-gated 201Tl planar myocardial scintigraphy  

International Nuclear Information System (INIS)

A new method was developed for obtaining an increase rate of regional myocardial systolic wall thickness (%WT) in ECG-gated Tl-201 myocardial scintigraphy. Its value was assessed in the clinical setting in comparison with %WT obtained by echocardiography. The subjects were a total of 18 patients with cardiac diseases, including angina pectoris (7), hypertension (3), dilated cardiomyopathy (4), aortic valve stenosis (2), aortic valve regurgitation (one) and sick sinus syndrome (one). Left ventricular septal and posterolateral segments were defined as regions of interest (ROI) on LAO 45deg planar images to correspond to the sites on echocardiographic left ventricular short axial M mode images. In addition, rectangular ROI, which directly crossed the ventricular wall, was assigned to determine changes in myocardial wall thickness, whereby time-activity curve (TAC) was prepared. TAC obtained so far was analogous to that obtained by ultrasound crystal method in an animal experiment. Thus the TAC was supposed to reflect changes in regional myocardial wall thickness. Furthermore, enddiastolic count (EDC) and endsystolic count (ESC) were obtained. %WT was obtained by a formula of (ESC - EDC)/EDC*100. %WT obtained in this way correlated positively with that obtained by echocardiography, for both septal segment (r=0.78) and posterolateral segment (r=0.77). These findings suggested that the regional wall thickening curve can be used in the clinical setting. (N.K.)

1994-01-01

160

The new method of evaluation for the regional myocardial function using the regional wall thickening curve obtained by ECG-gated [sup 201]Tl planar myocardial scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

A new method was developed for obtaining an increase rate of regional myocardial systolic wall thickness (%WT) in ECG-gated Tl-201 myocardial scintigraphy. Its value was assessed in the clinical setting in comparison with %WT obtained by echocardiography. The subjects were a total of 18 patients with cardiac diseases, including angina pectoris (7), hypertension (3), dilated cardiomyopathy (4), aortic valve stenosis (2), aortic valve regurgitation (one) and sick sinus syndrome (one). Left ventricular septal and posterolateral segments were defined as regions of interest (ROI) on LAO 45deg planar images to correspond to the sites on echocardiographic left ventricular short axial M mode images. In addition, rectangular ROI, which directly crossed the ventricular wall, was assigned to determine changes in myocardial wall thickness, whereby time-activity curve (TAC) was prepared. TAC obtained so far was analogous to that obtained by ultrasound crystal method in an animal experiment. Thus the TAC was supposed to reflect changes in regional myocardial wall thickness. Furthermore, enddiastolic count (EDC) and endsystolic count (ESC) were obtained. %WT was obtained by a formula of (ESC - EDC)/EDC*100. %WT obtained in this way correlated positively with that obtained by echocardiography, for both septal segment (r=0.78) and posterolateral segment (r=0.77). These findings suggested that the regional wall thickening curve can be used in the clinical setting. (N.K.).

Harada, Masahiko; Ozaki, Masaharu; Furutani, Yuhji; Saiki, Atsushi; Matsuzaki, Masanori (Yamaguchi Univ., Ube (Japan). School of Medicine); Takahashi, Yohjiro

1994-01-01

 
 
 
 
161

Clinical evaluation of the ipsilateral lung uptake of /sup 201/TlCl in spontaneous pneumothorax  

Energy Technology Data Exchange (ETDEWEB)

A case of re-expansion pulmonary edema following the treatment of spontaneous pneumothorax was reported, and in 3 other cases of this disease, perfusion lung scintigraphy with sup(99m)Tc-MAA and myocardial scintigraphy with /sup 201/TlCl were performed in order to evaluate the regional pulmonary arterial perfusion and lung uptake of /sup 201/Tl. The perfusion decrease and the marked uptake of /sup 201/Tl were observed in the ipsilateral lung of 2 cases. In a previous study, we reported that diffuse bilateral lung uptake of /sup 201/Tl, which was distributed in more than 90% of the extravascular space of the lung, was observed in various cases with heart disease, diffuse interstitial pneumonia etc. Therefore, it seems that ipsilateral lung in cases with spontaneous pneumothorax may be accompanied with a subclinical increased vascular permeability and abnormal accumulation of interstitial fluid. Thus patients with spontaneous pneumothorax will be predisposed to re-expansion pulmonary edema.

Fujii, T.; Hirayama, J.; Kanai, H.; Kanbayashi, T.; Mimura, N.; Amamiya, H. (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

1982-08-01

162

["2"0"1Tl]thallous chloride injection for cardiological applications  

International Nuclear Information System (INIS)

The "2"0"1TlCl injection is a modern and highly effective radiopharmaceutical for the assessment of myocardial defects. The suitable physical characteristics of "2"0"1Tl allow commercial production of the injection and its regular supply. At the Nuclear Research Institute, Rez, production of "2"0"1Tl has been developed by irradiation of an about 900 mg/cm"2 thick thallium metal target with 30 MeV protons. For the production of "2"0"1TlCl injections a method of chemical separation has been worked out, based on the different coprecipitation of Tl"+ and Pb"2"+ with Fe(OH)_3 and different extraction of Pb"2"+, Tl"3"+ and Fe"3"+ chlorocomplexes with diisopropylether from 8 mol/l HCl. (author)

1984-01-01

163

A comparison between terminally radioiodinated hexadecenoic acid (sup(*)I-HA) and 201Tl-thallium chloride in the dog heart  

International Nuclear Information System (INIS)

The regional myocardial distribution of 131I-16-iodo-9-hexadecenoic acid (131I-HA) and 201Tl-thallium chloride (201TlCl) was determined in normal dogs and after occlusion of a coronary artery. The uptake of 131I-HA was about 20% lower than that of 201TlCl but the ratio 201Tl/131I was the same for the whole myocardium within narrow limit for normal as well as infarcted tissue. The potential of 123I-HA as a radiopharmaceutical for diagnosis of myocardial defects is discussed. (orig.)

1980-01-01

164

Clinical validation of simultaneous dual-isotope myocardial scintigraphy  

International Nuclear Information System (INIS)

Simultaneous dual-isotope (rest thallium-201/stress technetium-99m sestamibi) myocardial single-photon emission tomography (SPET) would be an ideal procedure; however, 99mTc cross-talk on the 201Tl window hampers its routine use. Photon energy recovery (PER) is a spectral deconvolution technique validated for scatter and cross-talk removal in phantom studies and a limited series of patients. In this study we aimed to validate the technique in 295 patients within a context of clinical routine practice. Conventional separate rest 201Tl myocardial SPET data sets were visually compared with simultaneous dual-isotope data sets corrected by PER. Conventional separate rest 201Tl data sets were identical to dual PER-corrected 201Tl data sets in 173 (58.6%) patients. As dual PER 201Tl data sets are corrected for 99mTc cross-talk but also for 201Tl scatter, they were compared with separate rest 201Tl data sets corrected by PER in the 122 discordant patients. No difference was found in 77 (26.1%) patients. In 26 (8.8%) patients, the difference consisted in the presence of a defect on dual PER 201Tl data sets only, mirroring an ischaemic defect on 99mTc-sestamibi data sets. This difference can be attributed to the influence of stress on the kinetics of 201Tl injected at rest. In the remaining 19 (6.4%) patients, the difference between separate and simultaneous PER-corrected data sets was scored as mild in 11 and moderate in eight patients and seemed to be related to multiple methodological factors. It is concluded that PER correctly removes 99mTc cross-talk. With the addition of an appropriate attenuation correction, the PER technique may allow the routine use of simultaneous dual-isotope myocardial scintigraphy in the near future. (orig.)

2003-01-01

165

201Tl scintigraphy in primary lung cancer  

International Nuclear Information System (INIS)

Tumor scintigraphy with 201Tl chloride was studied in 153 cases with primary lung cancer, the findings were compared with these of various other respiratory diseases, and some attempts to improve scintigraphic diagnosis were made. Positive results were obtained in not only malignant conditions such as primary lung cancer, metastatic lung tumor and malignant mediastinal tumor, but also benign conditions such as benign thymoma, pneumonia, pulmonary tuberculosis and so on. In primary lung cancer, 139 of 153 cases (90.8 %) had positive results, demonstrating the presence of a primary focus in cases of pleural effusion or atelectasis, and metastatic foci in the hilum and mediastinum. The ratio of the maximal count in primary focus to the upper mediastinum ranged from 0.5 to 4.2 with a mean value ± S.D. of 1.8 ± 0.6, and the ratio of total counts of the primary focus to the administered dose of 201Tl (uptake ratio) ranged from 0.02 % to 0.98 % with a mean value ± S.D. of 0.27 ± 0.18 %. The degree of 201Tl uptake in primary focus correlated with bronchial blood flow and it was higher in cases of T2 and T3 than T1, but no correlation with histological type was found. Joint use of 201Tl scintigraphy and perfusion lung scintigraphy was valuable to improve the anatomical orientation of the image and to assess the significance of the distribution of both radiotracers. Radionuclide angiocardiography with 201Tl contributed to demonstrate vena cava superior syndrome and impairment of the pulmonary perfusion, and to calculate the uptake ratio of 201Tl in various regions including tumor. 201Tl scintigraphy seems to be useful in detecting right ventricular hypertrophy, pericardial effusion, bleomycin pneumonitis and other cardio-pulmonary complications as well as the presence and extent of primary lung cancer. (author)

1988-01-01

166

Comparison between unstable angina pectoris and stable effort angina pectoris by using 123I-BMIPP and 201Tl myocardial SPECT  

International Nuclear Information System (INIS)

We performed BMIPP myocardial SPECT and Tl myocardial SPECT in patients with unstable angina (UAP) and stable effort angina (SAP), and compared the results for the two groups. Our subjects were 30 patients with the UAP and 25 patients with the SAP. The early and delayed images of the BMIPP were obtained with patients at rest. The early image of the Tl alone was obtained with patients at rest. We calculated severity score (SS) using the polar map based on SPECT short-axis image on the both myocardial SPECT. And, we calculated % uptake of the responsible coronary lesion and regional washout rate (WR) on myocardial SPECT with BMIPP. On coronary angiogram, no difference in % diameter stenosis was seen between the two groups. On myocardial SPECT with Tl, no difference in the SS was seen between the two groups. However, on myocardial SPECT with BMIPP, the SS was significantly higher score in the UAP group than in the SAP group. And, on myocardial SPECT with BMIPP, the % uptake and the WR were significant lower values in the UAP group than in the SAP group. Even if the two groups have almost the same level of myocardial perfusion disorder, the UAP group may have severer myocardial fatty-acid metabolic disorder than the SAP group, because the defects in BMIPP were significantly severer in the UAP group. (author)

2004-02-01

167

Determination of impurities in 201TlCl injected and 203PbCl aqueous solution by ICP-AES  

International Nuclear Information System (INIS)

201TlCl is a useful radiopharmaceutical. It is widely used to diagnose myocardial disease. An inductively coupled plasma (ICP) emission spectrometrical method for determining impurities in 201TlCl injection and 203PbCl solution is described. 201Tl in physiological saline and 203Pb in aqueous solution were checked for Al, Ca, Cd, Co, Cr, Cu, Fe, Mg, Mn, Ni, Pb, Sn, Tl and Zn with a sensitivities of 0.001 ?g/ml to 0.010 ?g/ml and relative standard deviations < 10%

1987-01-01

168

Thyroid scanning with 201Tl-chloride  

International Nuclear Information System (INIS)

Thyroid scanning with 201Tl-chloride was performed on 32 cases of thyroid pathology, comparing with that with sup(99m)Tc, 3 cases of follicular adenocarcinoma, 10 cases of papillary adenocarcinoma, 2 cases of mixed type of follicular and papillary adenocarcinoma, a case of poorly differentiated squamous carcinoma, a case of Huerthle cell carcinoma, 8 cases of follicular adenoma, 5 cases of chronic thyroiditis, a case of subacute thyroiditis and a case of Basedow's disease. The most important evidence of thyroid scanning with 201Tl-chloride is the hot nodule in primary malignant tumor and also metastasis in the mediastinal area. (auth.)

1978-01-01

169

Phantom evaluation of scatter and attenuation correction in thallium-201/technetium-99m acquisition in myocardial perfusion single-photon emission computed tomography  

International Nuclear Information System (INIS)

This phantom study was carried out to evaluate the usefulness of scatter correction combined with transmission-based attenuation correction in separate and simultaneous 201Tl/99mTc myocardial SPECT. An anthropomorphic torso phantom was used in this study. We used the triple-energy-window (TEW) method for scatter correction and transmission computed tomography (TCT) images for attenuation correction. Images without corrections (UC) and images with corrections (SAC) for scatter and attenuation were reconstructed for the evaluation. The differences in defect size between 99mTc and 201Tl UC images led to interpretation errors in separate (separate protocol) and simultaneous dual-isotope studies (simultaneous protocol). These errors were more prominent in the infero-posterior wall in the simultaneous protocol. Improvement for overestimation in object size and underestimation in defect contrast was visually obtained, and increased contrast was also shown by the myocardium-to-defect count (MD) ratios on SAC images in the separate and simultaneous protocols. However, 201Tl SAC images in the simultaneous protocol still had less defect contrast than the corresponding 201Tl SAC images in the separate protocol. From the results of our phantom experiment, separate rest 201Tl/ stress 99mTc-sestamibi acquisitions may be recommended in clinical practice. Further clinical and phantom studies will be needed to validate the method using scatter correction combined with transmission-based attenuation correction. (author)

2001-01-01

170

SPECT (201Tl) of the myocardium after experimental infarction  

International Nuclear Information System (INIS)

On the basis of an experimental model the extent was studied to which even small intramural myocardial ischemia can be demonstrated by SPECT. For this purpose ligature of the Ramus interventricularis anterior (n = 10) or of the Ramus circumflexus (n = 2) of the left coronary artery was performed in 12 dogs to produce myocardial lesions of the anterior and posterior wall. Transmission computed tomography (TCAT) served as a control method in 10 dogs showing that 6 lesions were transmural and 4 intramural. All infarctions could be detected by SPECT with a rotating gamma camera (TCAT: 9/10). TCAT after contrast media enhancement with its morphological advantages (high resolution) should, however, not be used in the acute phase of myocardial infarction because of its hemodynamic side effects. Thus, SPECT wit 201Tl remains the method of choice even for the proof of minor intramural (acute) ischemic lesions. (orig.)

1982-12-01

171

Clinical assessment of effects of nitroglycerin ointment in patients with angina pectoris by quantitative stress "2"0"1Tl myocardial scintigraphy  

International Nuclear Information System (INIS)

The effects of nitroglycerin ointment (NGO) on angina pectoris (AP), especially the increase in regional coronary blood flow were clinically examined using stress Tl-201 myocardial scintigraphy in 26 patients with AP. Scintigraphic findings included: (1) an improvement of perfusion defect due to an increased Tl-201 uptake in ischemic areas, (2) an improvement of defect in spite of unchanged uptake in ischemic areas, and (3) no improvement of defect. From these findings, two mechanisms of NGO action are considered in the presence or absence of the coronary artery response (spasm or an increased coronary artery tonus) which plays an important role in the occurrence of AP. That is, there seems to be an increased regional coronary blood flow resulting from the dilatation of the coronary artery, or the lowered pre- or post-cardiac load. (Namekawa, K.)

1985-01-01

172

Discrete subaortic stenosis (DSS): New diagnostic and pathogenic parameters gained by gated 201Tl myocardial scintigraphy (TMS) and multigated acquisition blood-pool ventriculography (MUGA)  

International Nuclear Information System (INIS)

Nineteen patients suffering from DSS, diagnosed by echocardiography, heart catheterization and angiography were further evaluated by radionuclide studies including ECG-gated 201TI-myocardial scintigraphy (TMS) and multigated (MUGA) acquisition blood pool ventriculography. The results of these patients were further compared with results obtained in an earlier study of 20 patients suffering from Idiopathic Hypertrophic Subaortic Stenosis (IHSS), and with a group of 28 disease-free patients all of whom were studied by the same methods. All four parameters characteristic of IHSS were demonstrated in 100% of the patients with DSS as well. The close similarity of DSS and IHSS as introduced by the results of this study, serves as an additional proof supporting our previously expressed hypothesis that most of the cases of DSS involve dynamic features similar to those obstructive cardiomyopathy. Accordingly, TMS and MUGA studies seem to provide an additional sensitive tool for the early diagnosis and evaluation of DSS patients, in a similar manner to that of IHSS patients. The value of this method for the postsurgical follow-up of DSS patients is currently investigated. (orig.)

1991-01-01

173

Comparison in regard to myocardial sympathetic denervation between 123I-MIBG and 201Tl in patients with vasospastic angina pectoris  

International Nuclear Information System (INIS)

Of the patients who were diagnosed as having vasospastic angina (VSA) with coronary spasm proven by acetylcholine (Ach) on coronary angiograms were used as the subjects. There were 39 males and 15 females. MIBG and Tl were administered to all of the 54 cases before coronary angiography. MIBG in a dose of 111 Mbq was injected intravenously at rest. A photograph was taken after 3 hours for a delayed image. Tl myocardial blood flow image was taken immediately after exercise loading and a redistribution image 3 hours later. Results of administration of MIBG and Tl were restudied 3 to 6 months after inception of the treatment in 14 out of 54 cases. The proportion of positive cases was significantly high with MIBG, with 52 (97%) out of 54 cases found positive with MIBG and 10 (19%) out of 54 cases with Tl (p<0.05). The number of cases which were positive with both MIBG and Tl was 10 (19%) but there was no positive case with Tl alone. 42 (78%) out of 54 cases were found positive with MIBG alone, which was significantly high compared with the Tl positive cases (P<0.01). The sensitivity of MIBG tended to be higher than that of Tl, with the sensitivity 19.6% and specificity 42.8% with Tl against the sensitivity 74.4% and specificity 36.8% with MIBG (P<0.1). A significant improvement (P<0.01) was noted with MIBG, with the defect score after treatment being -8.9±6.0 against -13.5±7.7 before treatment. With Tl no significant difference was found, with -5.2±2.3 after treatment against -8.2±4.3 before administration. In VSA, the frequency of the decline in accumulation was higher with MIBG than with Tl. MIBG is thought to sharply reflect past ischemia. With MIBG, a significant improvement in the defect score was seen before and after treatment. So MIBG considered useful for judging the therapeutic effect as well. (K.H.)

1996-06-01

174

Comparison in regard to myocardial sympathetic denervation between {sup 123}I-MIBG and {sup 201}Tl in patients with vasospastic angina pectoris  

Energy Technology Data Exchange (ETDEWEB)

Of the patients who were diagnosed as having vasospastic angina (VSA) with coronary spasm proven by acetylcholine (Ach) on coronary angiograms were used as the subjects. There were 39 males and 15 females. MIBG and Tl were administered to all of the 54 cases before coronary angiography. MIBG in a dose of 111 Mbq was injected intravenously at rest. A photograph was taken after 3 hours for a delayed image. Tl myocardial blood flow image was taken immediately after exercise loading and a redistribution image 3 hours later. Results of administration of MIBG and Tl were restudied 3 to 6 months after inception of the treatment in 14 out of 54 cases. The proportion of positive cases was significantly high with MIBG, with 52 (97%) out of 54 cases found positive with MIBG and 10 (19%) out of 54 cases with Tl (p<0.05). The number of cases which were positive with both MIBG and Tl was 10 (19%) but there was no positive case with Tl alone. 42 (78%) out of 54 cases were found positive with MIBG alone, which was significantly high compared with the Tl positive cases (P<0.01). The sensitivity of MIBG tended to be higher than that of Tl, with the sensitivity 19.6% and specificity 42.8% with Tl against the sensitivity 74.4% and specificity 36.8% with MIBG (P<0.1). A significant improvement (P<0.01) was noted with MIBG, with the defect score after treatment being -8.9{+-}6.0 against -13.5{+-}7.7 before treatment. With Tl no significant difference was found, with -5.2{+-}2.3 after treatment against -8.2{+-}4.3 before administration. In VSA, the frequency of the decline in accumulation was higher with MIBG than with Tl. MIBG is thought to sharply reflect past ischemia. With MIBG, a significant improvement in the defect score was seen before and after treatment. So MIBG considered useful for judging the therapeutic effect as well. (K.H.)

Ohta, Katsuhisa [Kanazawa Medical Univ., Uchinada (Japan)

1996-06-01

175

Diagnostic significance of positive I-123 BMIPP despite negative stress Tl-201 myocardial imaging in patients with suspected coronary artery disease  

International Nuclear Information System (INIS)

There is frequently discordance in the interpretation of myocardial single-photon emission computed tomography images using both rest iodine-123 15-(p-iodophenyl)-3-(R, S) methylpentadecanoic acid (BMIPP) and stress thallium-201 (201Tl); that is, negative BMIPP vs positive 201Tl studies. However, little attention has been paid to reverse discordance (ie, positive BMIPP despite negative stress 201Tl). In the present study 105 consecutive patients with suspected coronary artery disease (CAD) who underwent both rest BMIPP and stress 201Tl imaging were evaluated. No patient with previous myocardial infarction was included. Scintigraphic studies revealed that BMIPP was in concordance with 201Tl in 71 patients: both were positive in 38 and negative in 33, whereas both were discordant in 20 and reverse discordant in 14. In patients with reverse discordance, the pattern of BMIPP abnormality was segmental in 8 and spotty in 6; the former was related to coronary territory. Based on the BMIPP findings and clinical symptoms, 7 patients with positive BMIPP despite negative 201Tl underwent coronary angiography: 3-vessel CAD was found in 3 patients, 2-vessel CAD in 1, coronary spasm in 2, and insignificant lesions in 1. In the remaining 7 patients, no cardiac event was observed during 2-year follow-up. In patients showing positive BMIPP despite negative 201Tl, a segmental BMIPP perfusion abnormality indicates a high likelihood for CAD, despite normal stress 201Tl imaging. Thus, adding BMIPP to 201Tl imaging may help to better identify patients with significant CAD, including multivessel disease. (author)

2006-02-01

176

201Tl-redistribution analysis in early and delayed myocordial scintigrams of patients with coronary heart disease (CHD)  

International Nuclear Information System (INIS)

Scans were performed on 8 healthy subjects and 25 with coronary heart disease proven by angiography and ventriculography including 6 with previous myocardial infarction at rest, exercise, and 1 and 2 h after exercise. Data were collected by a gamma camera interfaced to a data collection system. In healthy subjects 201Tl distribution was homogeneous at rest and after exercise, the count rate ranging between 100% - as set in the region of maximum - and 80% over other regions of myocardium. In 19 patients with coronary heart disease it was uniform only at rest; 6 patients with previous myocardial infarction had locally diminished 201Tl uptake even at rest. In patients with coronary heart disease without previous myocardial infarction, scans made immediately after exercise showed significant 201Tl hypofixation in region of minimum, the count rate of which was less than 80% of the count rate as determined over region of maximum, 201Tl uptake. Scans made 1 and 2 h after exercise had filling-in of 201Tl within the region of minimum the count rate of which returned to the normal range of at least 80% of the count rate measured over region of maximum uptake. This return to resting distribution was called 201Tl redistribution. Six patients with coronary heart disease and previous myocardial infarction had 201Tl defects larger after exercise than at rest, without redistribution being observed. Redistribution in late postexercise scans is a sign of reversible ischemia in coronary heart disease. Scans at rest may be omitted in coronary heart disease, because transient ischemia is undetectable, unless spontaneous angina occurs during scan procedure. (orig.)

1979-01-01

177

Clinical usefulness of thallium-201 myocardial single photon emission CT in cases of acute myocardial infarction  

International Nuclear Information System (INIS)

Clarification of the clinical usefulness of Single Photon Emission Computed Tomography (SPECT) compared to conventional planar Thallium-201 chloride myocardial scintigraphy in terms of its relationship to other clinical examinations was investigated. Patients consisted of 27 acute myocardial infarctions, 25 male and 2 female. Their average age was 61.2. For 25 patients it was their first attack of acute myocardial infarction, and 2 had suffered previous myocardial infarction. The following results were obtained: 1) In the apex, the scores were remarkably higher with SPECT than those with the planar image. However, in the anterior portion or septum, the scores were almost the same. In the inferior, lateral or posterior portions the scores were slightly higher on SPECT than those with the planar image. 2) Eleven out of 27 cases showed a high correspondence between the planar image and SPECT, but the other 16 were different in the identification of infarct sites. In 11 out of 16, SPECT was more accurate, but in another 3 out of 16, the planar image was more accurate because of overdiagnosis by SPECT. 3) The defects of apex might be overdiagnosed by SPECT. 4) SPECT scores showed a good correlation with the severity of wall motion disturbance. 5) Patients with severe broad defects on anteroseptal or anteroseptolateral identified by SPECT showed significantly lower ejection fraction than others. 6) The total SPECT score was inversely well correlated with ejection fraction. (J.P.N.)

1986-01-01

178

Quantification of the extent and severity of myocardial ischemia in single-vessel disease using stress-redistribution thallium-201 single-photon emission computerized tomography  

International Nuclear Information System (INIS)

Single-vessel coronary artery (CA) disease (SVD) is not uniformly benign: long-term prognosis is likely to be related to the extent (E) and severity (S) of myocardial ischemia (isch). To assess the ability of stress thalium-201 (Tl) single photon emission computerized tomography (SPECT) to quantify E and S of isch, the authors studied 15 patients (pts) without myocardial infarction who had SVD (8 LAD, 4 RCA, and 3 LCX). SPECT cuts were analyzed using maximum count circumferential profiles (CPs) which were compared with previously established normal (nl) limits derived from 20 nl pts. E of isch was defined as the % of the CP points falling below nl, S and depth (D) of ischemia respectively expressed the total and the mean % by which the abnormal points fell below normal limits. Although all pts had SVD, the range of E, S and D of isch was wide (0 to 48% and 0 to 38% and 0 to 20% respectively). CA scores (CS) were derived using a 15-point system accounting for the distribution of the diseased CA, location, and degree of stenosis, and collateral supply. CS varied from 1.2 to 8. E and S significantly correlated with CS (r=.74,p=.001, and r=.78, p=.000, respectively). The 6 pts with a D ? .1 had 75% CA stenosis whereas 5 of the 9 pts with D <.1 had only 50-75% stenosis. Thus, the authors conclude that: 1) pts with SVD have highly differing degrees of isch; 2) E, S and D scores from Tl SPECT correlate favorably with the angiographic extent and severity of disease; and 3) SPECT offers potential for quantification of the magnitude of isch and may become a useful, noninvasive prognostic indicator

1984-06-05

179

Evaluation of the ischemic myocardium in acute coronary syndromes using 123I-MIBG and 201TlCl SPECT imaging  

International Nuclear Information System (INIS)

Images from myocardial I-123-meta-iodobenzylguanidine (MIBG) single photon emission computed tomography (SPECT) and Tl-201 SPECT were reviewed in 20 patients with acute coronary syndromes, including 6 with unstable angina and 7 with non-transmural myocardial infarction. Myocardial SPECT imaging was undertaken 90 min after iv injection of I-123 MIBG, followed by myocardial perfusion SPECT imaging 15 min after iv injection of 201TlCl. One week later, coronary arteriography was performed. Of 7 patients with non-transmural myocardial infarction, 3 were not recognized as having hypoperfusion or defect on Tl-201 images, but were found to have defects in culprit vessels on I-123 MIBG images. In 3 of 6 patients with unstable angina, I-123 MIBG imaging clearly visualized defects in culprit vessels, although there were no abnormal findings in serum creatinine kinase or Tl-201 myocardial imaging. Thus I-123 MIBG myocardial imaging was found to visualize ischemic zones, not detected by the other imaging methods, especially in non-transmural myocardial infarction and unstable angina. (N.K.)

1994-01-01

180

Evaluation of the ischemic myocardium in acute coronary syndromes using [sup 123]I-MIBG and [sup 201]TlCl SPECT imaging  

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Images from myocardial I-123-meta-iodobenzylguanidine (MIBG) single photon emission computed tomography (SPECT) and Tl-201 SPECT were reviewed in 20 patients with acute coronary syndromes, including 6 with unstable angina and 7 with non-transmural myocardial infarction. Myocardial SPECT imaging was undertaken 90 min after iv injection of I-123 MIBG, followed by myocardial perfusion SPECT imaging 15 min after iv injection of [sup 201]TlCl. One week later, coronary arteriography was performed. Of 7 patients with non-transmural myocardial infarction, 3 were not recognized as having hypoperfusion or defect on Tl-201 images, but were found to have defects in culprit vessels on I-123 MIBG images. In 3 of 6 patients with unstable angina, I-123 MIBG imaging clearly visualized defects in culprit vessels, although there were no abnormal findings in serum creatinine kinase or Tl-201 myocardial imaging. Thus I-123 MIBG myocardial imaging was found to visualize ischemic zones, not detected by the other imaging methods, especially in non-transmural myocardial infarction and unstable angina. (N.K.).

Tomoda, Haruo; Takigawa, Osamu; Morimoto, Hiroshi (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine) (and others)

1994-01-01

 
 
 
 
181

Exercise myocardial perfusion scintigraphy is useful for evaluating myocardial ischemia even in the elderly  

International Nuclear Information System (INIS)

Pharmacologic stress testing is recommended to elderly patients as a valuable alternative to exercise testing. We examined whether exercise testing is as useful for evaluating myocardial ischemia in the elderly as in the young. The consecutive 1,508 patients who underwent exercise 201Tl single-photon emission computed tomography (SPECT) were divided into six age groups: 6-29 years (n=56), 30-44 (n=143), 45-54 (n=311), 55-64 (n=498), 65-74 (n=402), and 75-88 (n=98). Both heart rate and rate-pressure product at peak exercise were significantly lower in patients aged 75-88 than in the other five groups. The frequency of ischemic ST depression was higher in patients aged 75-88 than in those aged 6-74, although the difference was not significant. Moreover, the frequency of 201Tl transient defect was significantly higher in patients aged 75-88 than in those aged 6-74. On the other hand, the sensitivity of ischemic ST depression for 201Tl transient defect was similar among the six groups, but the specificity was significantly lower in patients aged 75-88 than in those aged 6-74. In conclusion, exercise 201Tl SPECT is useful for evaluating myocardial ischemia even in the elderly, but exercise electrocardiography has limitations such as lower specificity in the elderly than 201Tl SPECT. (author)

2000-06-01

182

Detection of the viable myocardium. A perfusion scintigraphic study, before and after coronary bypass surgery in myocardial infarction patients  

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Full Text Available OBJECTIVE: To compare single-photon-emission computed tomography (SPECT imaging scans using 201Tl and 99mTc-MIBI in detection of viable myocardium, in regions compromised by infarction. METHODS: Thirty-two (59.3±9.8 years old and 87% male myocardial infarction patients were studied. All had Q waves on the ECG and left ventricle ejection fraction of <50%. They underwent coronary and left ventricle angiographies and SPECT before (including 201Tl reinjection and after coronary artery bypass surgery (CABG. Improvement in perfusion observed after surgery was considered the gold standard for myocardial viability. RESULTS: Among 102 studied regions of the heart, there were 40 (39.2% areas of transient perfusion defects in the conventional protocol with 201Tl and 52 (51.0% after reinjection. Therefore, 12/62 (19.4% more viable regions were identified by reinjection. Using 99mTc-MIBI, only 14 (13.7% regions with transient defects were identified, all of which were seen also in 201Tl protocols. After surgery, 49 of a total of 93 regions analyzed (52.7% were viable. Sensitivity, specificity, accuracy, positive and negative prediction values were, respectively, 201Tl SPECT scans - 65.3%, 90.9%, 77.4%, 88.9% and 70.2%, reinjection protocol with 201Tl scans - 81.6%, 81.8%, 81.7%, 83.3% and 80.0%; 99mTc-MIBI SPECT scans - 20.4%, 90.9%, 53.8%, 71.4% and 50.6%. Logistic regression demonstrated that the reinjection protocol with 201Tl was the best predictor of viability (P<0.001. CONCLUSION: Our data suggest the election of 201Tl for viability studies, especially when using the reinjection protocol.

Chalela Willliam A.

1999-01-01

183

{sup 201}Tl SPECT for evaluating head and neck cancer  

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Thallium-201 ({sup 201}Tl) has come to be widely used in the diagnosis of several kinds of malignant tumor, but its usefulness in diagnosing head and neck cancer has not been established. This study investigated the usefulness of {sup 201}Tl SPECT imaging in patients with head and neck cancer histologically confirmed. Eighteen patients with histologically proven head and neck cancer were studied. {sup 201}Tl SPECT images were obtained both 15 min and 4 hours after intravenous injection of 148 MBq of {sup 201}Tl-chloride. {sup 201}Tl-indices were calculated semiquantitatively to assess the tracer uptake in relation to tumor size and histological type. High {sup 201}Tl uptake was noted in all primary tumors and metastatic lymph nodes on the both early and delayed images, but {sup 201}Tl-indices did not show any correlation with tumor size or histological type. Primary head and neck cancer and lymph node metastasis can be effectively visualized with {sup 201}Tl SPECT. It may provide information in addition to morphological changes and may be a supplemental method to use in the evaluation of head and neck cancer. (author).

Nagamachi, Shigeki; Hoshi, Hiroaki; Jinnouchi, Seishi; Ohnishi, Takashi; Flores, L.G. II; Futami, Shigemi; Nakahara, Hiroshi; Watanabe, Katsushi [Miyazaki Medical Coll., Kiyotake (Japan)

1996-02-01

184

Mechanism of /sup 201/Tl uptake in tumours  

Energy Technology Data Exchange (ETDEWEB)

We have studied the mechanism of tumour uptake of /sup 201/Tl by in vivo and in vitro studies. In a series of patients with breast cancer (n=26), lung cancer (n=56) and lymphoma (n=15), the time course of tumour uptake of /sup 201/Tl paralleled that in the myocardium with almost identical times of peak uptake being obtained in tumours and myocardium. In a patient with hepatic metastases from colonic cancer undergoing laparotomy, /sup 99m/Tc labelled microspheres and /sup 201/Tl were injected into the hepatic artery and biopsies of metastatic and normal liver tissue obtained. The tumour to normal liver activity ratios for /sup 201/Tl were one tenth of those for /sup 99m/Tc microspheres. In the final part of the study, cells from a lung cancer tissue culture line were incubated for 30 min with /sup 201/Tl with and without the addition of cardiac glycoside, which acts a sodium potassium pump blocker. The cells exposed to the cardiac glycoside showed markedly decreased uptake of /sup 201/Tl compared to the cells not so exposed (0.6%+-0.1% vs 11.8+-0.7% of the administered dose). The mechanism of /sup 201/Tl uptake of tumours is similar to that in the myocardium. Sodium potassium pump activity appears to be more important than tumour blood flow. /sup 201/Tl uptake may provide a useful means of studying tumour viability.

Sehweil, A.M.; Omar, Y.T.; McKillop, J.H.; Milroy, R.; Wilson, R.; Abdel-Dayem, H.M.

1989-07-01

185

{sup 201}Tl-SPECT in low-grade gliomas: diagnostic accuracy in differential diagnosis between tumour recurrence and radionecrosis  

Energy Technology Data Exchange (ETDEWEB)

The aim of this work was to describe the usefulness of a simple {sup 201}Tl single-photon emission computed tomography (SPECT) technique in the differential diagnosis between tumour recurrence and radionecrosis during the follow-up of patients treated for low-grade gliomas. The study population comprised 84 patients treated for low-grade gliomas who showed suspicion of tumour recurrence during their follow-up. All patients were examined by neuro-anatomical imaging procedures (CT, MRI) and {sup 201}Tl-SPECT. {sup 201}Tl-SPECT images were assessed by visual analysis based only on the information on the prescription form and by estimation of the uptake index (ratio of mean counts in the lesion to those in the contralateral mirror area). Examiners were blinded to the results of other tests. Under these conditions, the neuro-anatomical procedures yielded 26.2% inconclusive reports, with a global diagnostic accuracy of 0.61, a sensitivity of 0.63 and a specificity of 0.59. The global diagnostic accuracy for {sup 201}Tl-SPECT was 0.83, with a sensitivity of 0.88 and a specificity of 0.76. Diagnostic pitfalls were observed in regions with physiological {sup 201}Tl uptake, i.e. the posterior cranial fossa, diencephalon, lateral ventricles and cavernous and longitudinal venous sinuses. An uptake index cut-off value of 1.25 showed a sensitivity of 0.90 and specificity of 0.80 for detection of tumour activity. {sup 201}Tl-SPECT has adequate diagnostic accuracy to be part of routine algorithms in the follow-up of patients with low-grade glioma suspected of tumour recurrence, as an alternative to neuro-anatomical procedures and not solely as a complementary test. (orig.)

Gomez-Rio, Manuel; Martinez del Valle Torres, Dolores; Rodriguez-Fernandez, Antonio; Llamas-Elvira, Jose Manuel; Lozano, Simeon Ortega; Font, Carlos Ramos [Department of Nuclear Medicine, ' ' Virgen de las Nieves' ' University Hospital, Ada. Fuerzas Armadas 2, 18014, Granada (Spain); Lopez Ramirez, Escarlata [Department of Radiotherapeutic Oncology, ' ' Virgen de las Nieves' ' University Hospital, Granada (Spain); Katati, Majed [Department of Neurosurgery, ' ' Virgen de las Nieves' ' University Hospital, Granada (Spain)

2004-09-01

186

201Tl-SPECT in low-grade gliomas: diagnostic accuracy in differential diagnosis between tumour recurrence and radionecrosis  

International Nuclear Information System (INIS)

The aim of this work was to describe the usefulness of a simple 201Tl single-photon emission computed tomography (SPECT) technique in the differential diagnosis between tumour recurrence and radionecrosis during the follow-up of patients treated for low-grade gliomas. The study population comprised 84 patients treated for low-grade gliomas who showed suspicion of tumour recurrence during their follow-up. All patients were examined by neuro-anatomical imaging procedures (CT, MRI) and 201Tl-SPECT. 201Tl-SPECT images were assessed by visual analysis based only on the information on the prescription form and by estimation of the uptake index (ratio of mean counts in the lesion to those in the contralateral mirror area). Examiners were blinded to the results of other tests. Under these conditions, the neuro-anatomical procedures yielded 26.2% inconclusive reports, with a global diagnostic accuracy of 0.61, a sensitivity of 0.63 and a specificity of 0.59. The global diagnostic accuracy for 201Tl-SPECT was 0.83, with a sensitivity of 0.88 and a specificity of 0.76. Diagnostic pitfalls were observed in regions with physiological 201Tl uptake, i.e. the posterior cranial fossa, diencephalon, lateral ventricles and cavernous and longitudinal venous sinuses. An uptake index cut-off value of 1.25 showed a sensitivity of 0.90 and specificity of 0.80 for detection of tumour activity. 201Tl-SPECT has adequate diagnostic accuracy to be part of routine algorithms in the follow-up of patients with low-grade glioma suspected of tumour recurrence, as an alternative to neuro-anatomical procedures and not solely as a complementary test. (orig.)

2004-09-01

187

Serial change of defect size after injection of "1"2"3I-MIBG in patients with acute myocardial infarction as compared with "2"0"1TlCl  

International Nuclear Information System (INIS)

Eight patients with acute myocardial infarction underwent dual energy single photon emission computed tomography (SPECT) with I-123 metaiodobenzylguanidine (I-123 MIBG) and Tl-201 chloride 15 min after iv injection of these radionuclides at rest. Furthermore, myocardial SPECT with I-123 MIBG was undertaken 60 and 240 min after iv injection. According to SPECT images and Bull's eye color map, tracer uptake was expressed by defect scores; defect scores were compared on 15, 60, and 240 min I-123 MIBG images and on 15 min Tl-201 images. Defect scores on all serial phases of I-123 MIBG images were significantly higher than those on 15 min Tl-201 images. Changes of defect size became larger with time. The quality of 240 min I-123 MIBG images was poor, which made it difficult to interpret images in many patients. Serial changes in defect size between I-123 MIBG images and Tl-201 images were dependent upon the time of I-123 MIGB scanning. In comparing I-123 MIBG and Tl-201 scintigraphies, I-123 MIBG scans, obtained 15 min after iv injection, were the appropriate, although these scans seemed to underestimate the denervated but viable myocardium. (N.K.)

1994-06-01

188

Evaluation of [201Tl](III) Vancomycin in normal rats  

International Nuclear Information System (INIS)

Tl-201 has potential in the preparation of radiolabelled compounds similar to its homologues, like In-111 and radiogallium. In this paper, recently prepared [20'1Tl](III) vancomycin complex ([201Tl](III)VAN) has been evaluated for its biological properties. [20'1Tl](III)VAN was prepared according to the optimized conditions followed by biodistribution studies in normal rats for up to 52 h. The Staphylococcus aurous specific binding was checked in vitro. The complex was finally injected to normal rats. Tracer SPECT images were obtained in normal animals and compared to those of 67 Ga-citrate. Freshly-prepared [201Tl](III)VAN batches (radiochemical yield ? 99%, radiochemical purity ? 98%, specific activity = 1.2 Ci/mmol) showed a similar biodistribution to that of unlabeled vancomycin. The microorganism binding ratios were 3 and 9 for tracer 201Tl3+ and tracer 201Tl(III)DTPA, respectively, suggesting the preservation of the tracer bioactivity. As a nonspecific cell penetrating tracer, [201Tl](III)DTPA was used. (authors)

2008-01-01

189

The optimum technique for 201Tl tomography of myocardium: an investigation using phantoms  

International Nuclear Information System (INIS)

Rotating gamma-camera tomography is used for 201Tl perfusion imaging to detect myocardial ischaemia or infarction. Variables which can affect the utility of the images include acquisition time, collimator sensitivity and resolution, spatial filtering, reconstruction matrix and display parameters. An 'Iowa' design myocardial phantom containing 201Tl, with a defect representing an unperfused area, was used to study the effect of these variables. Receiver operator characteristic (ROC) curves and contrast ratios indicated that filtering the acquisition data with a count-dependent (Metz) filter before reconstruction and using a narrow slice width gave best results. No single collimator was superior for all four defect locations investigated but low-energy general purpose and high-resolution collimators were preferred to those with greater sensitivity. Reducing acquisition time by a factor of four compared with that for routine patient imaging affected contrast ratio, uniformity and area under ROC curves insignificantly, provided the optimum reconstruction was used. Displaying tomographic sections in colour gave no improvement in ROC curves over monochrome images. Data acquisition time or administered 201Tl radioactivity might therefore be reduced below the 25 min and 80 MBq often used for patient studies. (author)

1987-01-01

190

Identification of viable myocardium using 99mTc-tetrofosmin scintigraphy. Comparison with 201Tl redistribution-reinjection images  

International Nuclear Information System (INIS)

The purpose of this study was to clarify the diagnostic value of identifying viable myocardium using 99mTc-Tetrofosmin scintigraphy. Twenty-one patients with chronic coronary artery disease were studied using 201Tl exercise myocardial scintigraphy with reinjection and 99mTc-Tetrofosmin exercise myocardial scintigraphy. All patients had a history of old myocardial infarction. For 99mTc-Tetrofosmin scintigraphy, 222 MBq of 99mTc-Tetrofosmin was injected during exercise, and exercise images were obtained 20 min thereafter. Three hours later, 666 MBq of 99mTc-Tetrofosmin was injected at rest, and images were obtained 40 min and 220 min later. Myocardial viability in the 99mTc-Tetrofosmin scintigraphy was estimated as fill-in findings (FF) or over 50% of %RI uptake (%TF) in the rest image. Myocardial viability in the 201Tl scintigraphy was estimated as redistribution (RD), full-in findings in the reinjection image (FR) or over 50% of %RI uptake in the reinjection image (%TL). Sixteen of the 21 patients (76%) who underwent 201Tl scintigraphy (RD 10, FR 3, %TL 3 cases) and 15 of the 21 patients (71%) who underwent 99mTc-Tetrofosmin scintigraphy (FF 11, %TF 4 cases) had viable myocardium in the infarcted area. A comparison between the 99mTc-Tetrofosmin rest images obtained 40 min after the injection and that of 220 min revealed no redistribution findings. The %RI uptake of the infarcted area in the resting 99mTc-Tetrofosmin image (47±16%) was slightly lower than that in the 201Tl reinjection image (52±16%). In conclusion, viable myocardium was as clearly identified by 99mTc-Tetrofosmin, as by 201Tl scintigraphy. (author)

1995-04-01

191

Preparation and biodistribution of [201Tl](III vancomycin complex in normal rats  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: Thallium-201 (T1/2=3.04d has been used in clinical nuclear cardiology and oncology for 3 decades. The development of [201Tl](IIIradiopharmaceuticals could provide many advantages: the chemistry of [201Tl](IIIcomplexation molecule is simple and the complexation constant for most of Tl(III complexes are among the highest. A wide variety of radiopharmaceuticals have been proposed for the scintigraphic detection of inflammatory and infectious disease. [67Ga]Citrate, being the most primitive radiotracer for this purpose, has a high sensitivity for both acute and chronic infections and noninfectious inflammation. Based on our previous experiences on the production and biological evaluation of radiolabelled glycopeptide antibiotics and vast clinical application of vancomycin for therapeutic purposes, we were interested in preparation of radiolabelled vancomycin as a possible infection imaging agent. Methods: Thallium-201 (T1/2=3.04 d in Tl+ form was converted to Tl3+ cation in presence of O3 in 6M HCl controlled by RTLC/gel electrophoresis methods. The final evaporated activity was reacted with vancomycin (VAN in water to yield [201Tl](IIIVAN after mixing the reactants followed by SPE purification using Si Sep-Pak. Radiochemical purity and stability of 201Tl-VAN in the preparation and in presence of human serum was determined up to 5.5 d. Biodistribution study of 201Tl(III-vancomycin in normal rats was performed up to 52 h. Results: The best results were obtained at room temperature in water after 30min with a radiochemical yield>99%, The studies showed that thallic ion is mostly incorporated into vancomycin with a radiochemical purity of more than 98?1% by RTLC. A specific activity of about 1.2 Ci/mmol was obtained. This pattern was also observed after IV injection to the normal rats at the same time intervals. Conclusion: [201Tl](IIIvancomycin, can be SPECT radiotracer with a rather long half life, meeting radiopharmaceutical standards for use in remote nuclear medicine centers. There are lots of opportunities for radiopharmacists and interested nuclear medicine students to look at Tl-201 not only as a myocardial tracer but as a new radionulclide for kit formulations.

A.R. Jalilian

2006-06-01

192

Development of [201Tl](III-DTPA-human polyclonal antibody complex for inflammation detection  

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Full Text Available Objectives: There are a couple of radiotracers used in the detection of inflammation and infection in human, but just a few of them have been widely used in routine clinical trials. 111In-labeled HIG has been extensively tested in a large number of clinical studies. Due to interesting physical properties and wide availability of thallium-201 as a SPECT radionuclide, the idea of incorporation of this nuclide into human polyclonal immunoglubin (HIgG was targeted. Methods:Thallium-201 (T1/2=3.04 d in Tl+ form was converted to Tl3+ cation in presence of O3 in 6M HCl controlled by RTLC/gel electrophoresis methods. Human polyclonal antibody (HIgG was successively labeled with 201Tl-thallium chloride after residulation with freshly prepared cyclic DTPA-dianhydride. The best results of the conjugation were obtained by the addition of 1 ml of a HIgG pharmaceutical solution (5 mg/ml, in phosphate buffer, pH=8 to a glass tube pre-coated with DTPA-dianhydride (0.01 mg at 25?C with continuous mild stirring for 30 min. Preliminary in vivo studies in turpentine-oil induced inflammation in rat model was performed to determine complex distribution of the radioimmunoconjugate. Results: Total labeling and formulation of [201Tl](III-DTPA-HIgG took about 60 minutes, with a yield of 99%. A suitable specific activity product was formed via insertion of 201Tl cation. No unlabelled and/or labeled conjugates were observed upon RTLC analysis of the final preparations. The radio-labeled complex was stable in mice serum for at least 24 hours and no significant amount of free 201Tl as well as 201Tl-DTPA was observed. Trace amounts of 201Tl-thallium chloride (?1% were detected by TLC (radiochemical yield of >99%, specific activity =38 TBq/mM, radiochemical purity?98%. The preliminary SPECT at the 33.8 degree shows the absorbtion of the immunoconjugate in the dorsal inflammed lesion. The target/skin and target/blood ratio was 3 after 28h, showing the high selectivity of the radiopharmaceutical for the inflammatory lesions. The final preparation was administered to normal rats and biodistribution of the radiopharmaceutical was checked 1 and 6 hours later by scarification. Conclusion: there are lots of upportunities for radiopharmacist and interested nuclear medicine students to look at Tl-201 not only as a myocardial tracer but as a new radionulclide for kit formulations.

A.R. Jalilian

2006-06-01

193

Diagnosis of intracranial meningiomas by /sup 201/Tl-chlorine  

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Results are presented of a study of the use of /sup 201/Tl-chloride in the diagnosis of intracranial meningiomas. The meningiomas uniformly presented an intense /sup 201/Tl-chloride uptake. Factors such as vascularization increased and abnormal capillaries might play an important role in the tumoral fixation mechanisms. It was concluded that /sup 201/Tl-chloride imaging could be of particular interest in the diagnosis of intracranial meningiomas, especially in those cases that present a basal or infratentorial localization. It may also be useful as a post-surgery control method in the early detection of meningioma recurrence. The disadvantages of /sup 201/Tl-chloride are that it is an expensive radiopharmaceutical and its half-life limits the dose to be administered, thus not allowing the IBAS to be obtained.

Banzo, J.; Abos, M.D.; Casanova, C.; Teijeiro, J. (Hospital Universitario, Zaragoza (Spain))

1981-06-01

194

Leg 201Tl-SPECT in chronic exertional compartment syndrome  

International Nuclear Information System (INIS)

Leg 201Tl-SPECT in chronic exertional compartment syndrome Background: The chronic exertional compartment syndrome is one of the most frequent origins regarding leg pain due to sport training. The diagnosis can be established by invasive compartment pressure measurement. The aim of this study is to evaluate the role that could have 201Tl-SPECT for patients with suspicion of compartment syndrome. Patients and methods: 51 leg 201Tl-SPECT exams were performed (exercise - and rest without reinjection) in 49 patients; 28 had compartment syndrome confirmed by pressure measurement. About 100 MBq of 201Tl were injected during exercise, when pain appeared or at least after 25 minutes exercise. We studied mean percentages of level uptake for each compartment, referred to the maximal uptake of both legs. Results: 47 compartments were concerned by compartment syndrome and 361 compartments were not. Scintigraphic patterns in compartments are reversible ischaemia (45%), uptake stability (36%) or reverse redistribution (19%); these patterns are not linked to compartment syndrome. However, there is a significant difference of rest 201Tl level uptake between compartments with and without compartment syndrome and a significant correlation between muscular pressure measurement and rest level uptake. Conclusion: 201Tl-SPECT shows that only ischaemia does not explain compartment syndrome. Moreover, it allows to predict pressure variation during exercise but it does not offer any interest in order to select patients for muscular invasive pressure measurement. (author)

2004-06-01

195

Significance of single photon emission computed tomography with Tc-99m pyrophosphate in acute myocardial infarction  

International Nuclear Information System (INIS)

To examine the value of single photon emission computed tomography with Tc-99m pyrophosphate (PYP-SPECT) in delineating myocardial infarts, 38 patients with documented acute myocardial infarction were studied. Planar imaging (PI) had sufficient ability to detect transmural infarcts; and SPECT requiring much more time for examination is unlikely necessary. In contrast, PYP-SPECT significantly improved sensitivity for delineating subendocardial infarcts (SEI) compared with PI (84 % versus 46 %). Patients with diffuse accumulation of PYP on PI tended to show SEI or inferoposterior infarcts (IPI) on ECG, or merely had blood pool images. Right ventricular accumulation of PYP was visualized in 11 patients on PYP-SPECT, in 2 patients on PI, and in 3 patients on ECG and blood circulation examination; this suggests the usefulness of PYP-SPECT in detecting subclinical right ventricular infarcts (RVI). The results indicate that PYP-SPECT is of value in delineating SEI, IPI, and RVI. (Namekawa, K.)

1985-01-01

196

Clinical significance of improved persistent defect by thallium-201 reinjection imaging in the subacute phase of myocardial infarction  

International Nuclear Information System (INIS)

The clinical significance of new fill-in observed by thallium-201 (201Tl) reinjection in myocardial segments with persistent defect in the subacute phase of myocardial infarction was investigated. Seventy-five patients with subacute phase (mean 20th day) of first myocardial infarction underwent stress-redistribution-reinjection 201Tl single photon emission computed tomography (SPECT) imaging. Percentage 201Tl uptake was calculated and classified as persistent defect without fill-in even after reinjection (PD group, n=26, 35%), persistent defect with new fill-in after reinjection (REINJ(+) group, n=19, 25%) and reversible defect (RD(+) group, n=24, 32%). The clinical features and angiographic findings were assessed in the same phase in each group. Diameter stenosis of the infarction-related arteries by coronary angiography was 68±34% in the PD group, 31±23% in the REINJ(+) group and 83±27% in the RD(+) group (p201Tl reinjection has been considered to indicate severe myocardial ischemia in chronic coronary disease, these results indicate that this phenomenon in viable myocardium in patients with subacute phase of myocardial infarction is not always related to residual ischemia in the infarcted myocardial area. (author)

1999-02-01

197

Clinical evaluation of single-photon emission computed tomography for Tl-201 myocardial imaging. Clinical efficacy for myocardial infarction  

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Single-photon emission computed tomography (SPECT) for Tl-201 myocardial imaging using a rotating gamma camera was evaluated for clinical diagnostic efficacy of myocardial infarction. Thirty-three cases with prior myocardial infarction and 28 cases without myocardial infarction were injected with 2 - 4 mCi of Tl-201 at rest. Planar imaging was performed for 5 views (ANT, LAO-30, 45, 60, L-LAT) and followed by SPECT. Overall time of the studies was within one hour. Results were as follows: (1) Sensitivity, specificity and overall accuracy for myocardial infarction diagnosis of SPECT system showed 96.9%, 78.6% and 88.5% respectively. In comparison with planar imaging, SPECT significantly improved sensitivity, however decreased specificity and slightly improved accuracy. (2) Overall interpretation of transaxial, coronal and sagittal images were required for the detection of myocardial infarction. (3) SPECT images showed more clearly findings of infarction than planar imaging and extension of myocardial infarction on SPECT images showed relatively well correlation with ECG diagnosis.

Inoue, T.; Ishihara, T.; Yamakawa, M.; Tamaki, Y.; Nozaki, M.; Nagai, T. (Gunma Univ., Maebashi (Japan). School of Medicine)

1982-09-01

198

The characteristics of syndrome X based on {sup 201}Tl-SPECT, {sup 18} FDG-PET and histopathologic findings  

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Syndrome X is a microvascular disease. However, the relationship between microvascular ischemia and histopathological findings remains unknown. The present study was performed to evaluate the myocardial perfusion and metabolism of patients with Syndrome X using {sup 201}Tl-SPECT and {sup 18}FDG-PET, and to clarify the morphological characteristics with a ventricular myocardial biopsy. We examined 24 patients with Syndrome X and 5 patients with myocarditis as a control group. In the study using {sup 201}Tl-SPECT and {sup 18}FDG-PET, we evaluated the presence or absence of myocardial ischemia. We calculated the Standardized Uptake Value (SUV) (%dose/ml) of {sup 18}FDG, and analyzed quantitatively the degree of ischemia. For histopathologic study on coronary microcirculation, we performed a right ventricular myocardial biopsy. The biopsies were examined light and electron microscopically. The semithin sections, stained with toluidine blue, were projected onto a screen. Microvessels were counted and the ratio of microvascular luminal narrowing and the number of microvessels per unit area were determined. The study using {sup 201}Tl-SPECT and {sup 18}FDG-PET showed that hypoperfusion of {sup 201}Tl was found in 17 of 24 (71%) patients during {sup 201}Tl-loaded myocardial scanning together with redistribution of {sup 201}Tl at the same regions; {sup 18}FDG-uptake were found in all 24 patients during {sup 18}FDG-PET performed under resting and fasting conditions; the SUV of {sup 18}FDG in the Syndrome X group (0.025{+-}0.039 %dose/ml) was significantly different from that of the control group (0.003{+-}0.002 %dose/ml) (p<0.01). Histopathological observations under the both light and electron microscope showed that an increment in number of the endothelial cells with swelling, a marked luminal narrowing due to the hypertrophy of the arteriolar media and the capillary walls, and a compression of the capillaries were shown in all the patients; the ratio of luminal narrowing of microvessels in the Syndrome X group was significantly higher than the control group (56.2{+-}16.2% VS 12.2{+-}2.9%, p<0.001); the number of microvessels in the Syndrome X group was more decreased than the control group (14.6{+-}7.8 VS 21.5{+-}10.0, p=0.124). Our results suggest that the characteristics of Syndrome X may be myocardial ischemia due to narrowness of microvessels with morphological abnormalities. (author)

Satake, Osamichi [Kanazawa Medical Univ. (Japan)

1999-03-01

199

Study of 201Tl uptake by bone and bone marrow on 201Tl scintigraphy  

International Nuclear Information System (INIS)

Thallium-201 (Tl-201) uptake in the bone and bone marrow was examined in a total of 93 patients with various diseases. Sternal uptake of Tl-201 was observed when patients had bone marrow abnormality especially associated with hematopoietic disease. It was associated with proliferation of immature cells and of various types of bone marrow cells, especially erythroblastic and plasma cells. Whole-body Tl-201 scanning showed a high uptake (82%) in the sternum, chest, lumbar vertebrae, and pelvis. Thallium-201 was definitively taken up by the sternum in polycythemia (5/41), hemolytic anemia (2/2), iron deficiency anemia (2/2), and multiple myeloma (2/5). For leukemia, Tl-201 uptake was slight or negative. Thallium-201 scanning proved useful in visualizing bone marrow abnormality, although careful interpretation of bone and bone marrow uptake is required. (Namekawa, K)

1989-01-01

200

Sympathetic reinnervation following heart transplantation: a double-tracer study with 123I-MIBG and 201Tl  

International Nuclear Information System (INIS)

Sympathetic reinnervation was evaluated in 15 patients 2-69 months after heart transplantation using a double-tracer technique with 123I-MIBG and 201Tl. Since MIBG is accumulated in the same manner as norepinephrine it may serve as a tracer of the integrity and function of the sympathetic nervous system. 201Tl was used for landmarking. Planar anterior imaging was performed 15 min and 4 h after i.v. injection of 220 MBq 123I-MIBG and 37 MBq 201Tl. Image quantitation was based on the ratio of myocardial to mediastinal MIBG-uptake. Cardiac regions of interest were defined according to the 201Tl uptake. There was no evidence of sympathetic reinnervation in 8 patients 2-34 months after transplantation. Increased MIBG-uptake could be observed in the anterior basal region in 6 long-term cardiac transplants (37-69 months). One patient with a 59-month-old transplanted heart did not reinnervate. Increased MIBG-uptake in the anterior basal region indicating partial sympathetic reinnervation could be shown in 40% of the investigated patients with an average organ age of 51 months. (orig.)

1994-06-01

 
 
 
 
201

Clinical evaluation of the ipsilateral lung uptake of _2_0_1TlCl in spontaneous pneumothorax  

International Nuclear Information System (INIS)

A case of re-expansion pulmonary edema following the treatment of spontaneous pneumothorax was reported, and in 3 other cases of this disease, perfusion lung scintigraphy with sup(99m)Tc-MAA and myocardial scintigraphy with _2_0_1TlCl were performed in order to evaluate the regional pulmonary arterial perfusion and lung uptake of _2_0_1Tl. The perfusion decrease and the marked uptake of _2_0_1Tl were observed in the ipsilateral lung of 2 cases. In a previous study, we reported that diffuse bilateral lung uptake of _2_0_1Tl, which was distributed in more than 90% of the extravascular space of the lung, was observed in various cases with heart disease, diffuse interstitial pneumonia etc. Therefore, it seems that ipsilateral lung in cases with spontaneous pneumothorax may be accompanied with a subclinical increased vascular permeability and abnormal accumulation of interstitial fluid. Thus patients with spontaneous pneumothorax will be predisposed to re-expansion pulmonary edema. (author)

1982-01-01

202

Clinical study of sarcoidosis with special reference to significance and diagnostic value of /sup 201/Tl scintigraphy and /sup 99m/Tc perfusion lung scintigraphy  

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Both /sup 201/Tl scintigraphy and /sup 99m/Tc-MAA perfusion lung scintigraphy were performed in 31 patients with sarcoidosis and the perfusion lung scintigraphy only was performed in additional 11 patients. In order to evaluate the diagnostic usefullness and the significance of these methods, the scintigraphic findings were compared with other clinical findings such as chest roentgenographic findings, pathological changes on the biopsy specimen, levels of serum angiotensin converting enzyme (ACE), pulmonary function data and so on. From the present study, the results were summarized as follow : 1) Diffuse /sup 201/Tl lung uptake was observed in 23 cases (74.2 %), but its intensity was mild or moderate in most cases. 2) The intensity of /sup 201/Tl lung uptake had a tendency to be related to the quantity of abnormal lung shadows on the chest x-ray film, the frequency of epithelioid granuloma on the biopsy specimen, levels of serum ACE and serum lysozyme. However, no good relationship was obtained between the intensity of /sup 201/Tl lung uptake and pulmonary function data or the intensity of alveolitis on the biopsy specimen. 3) There was close relationship between /sup 201/Tl uptake of hilar or mediastinal lymphnodes and chest roentgenographic findings of lymphadenopathy. In mediastinal lymphnodes, however, about half of roentgenographically negative cases showed /sup 201/Tl uptake. 4) In the /sup 201/Tl myocardial image, visualization of the right ventricle and the myocardial perfusion defect were revealed in 17 and 9 cases, respectively. 5) In the perfusion lung scintigraphy, perfusion abnormalities were observed in 41 of 42 cases. They were more frequently observed in the upper andor middle fields and peripheral areas of the lung.

Hirose, Yoshiki

1987-11-01

203

Prediction of left ventricular dilatation with thallium-201 SPET imaging after primary angioplasty in patients with acute myocardial infarction  

International Nuclear Information System (INIS)

Progressive ventricular dilatation is an important prognostic factor in patients with acute myocardial infarction. We evaluated clinical, angiographic, echocardiographic and thallium-201 single-photon emission tomography (SPET) imaging variables predictive of the change in left ventricular volume during a 7-month follow-up period after primary angioplasty in patients with acute myocardial infarction. Thirty-six patients with first acute myocardial infarction treated with primary angioplasty within 12 h of onset underwent 201Tl SPET imaging (5.8±2.1 days after angioplasty). Changes in left ventricular volume were assessed over the 7-month period. The left ventricle dilated significantly after angioplasty (P201Tl uptake 2=0.41, P201Tl uptake 2 with positive and negative predictive values of 85% (17/20) and 75% (12/16), respectively. It is concluded that, following primary angioplasty in patients with acute myocardial infarction, the extent of myocardial infarction assessed by 201Tl SPET can identify those who will develop ventricular dilatation during the subsequent 7 months. (orig.)

2002-06-01

204

Prediction of left ventricular dilatation with thallium-201 SPET imaging after primary angioplasty in patients with acute myocardial infarction  

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Progressive ventricular dilatation is an important prognostic factor in patients with acute myocardial infarction. We evaluated clinical, angiographic, echocardiographic and thallium-201 single-photon emission tomography (SPET) imaging variables predictive of the change in left ventricular volume during a 7-month follow-up period after primary angioplasty in patients with acute myocardial infarction. Thirty-six patients with first acute myocardial infarction treated with primary angioplasty within 12 h of onset underwent {sup 201}Tl SPET imaging (5.8{+-}2.1 days after angioplasty). Changes in left ventricular volume were assessed over the 7-month period. The left ventricle dilated significantly after angioplasty (P<0.001). Multivariate analysis revealed that the number of segments with {sup 201}Tl uptake <40% of peak activity was a single independent predictor of increase in end-diastolic volume index between 1 week and 7 months (R{sup 2}=0.41, P< 0.001). The presence of two or more segments with {sup 201}Tl uptake <40% predicted an increase in end-diastolic volume index of {>=}6 ml/m{sup 2} with positive and negative predictive values of 85% (17/20) and 75% (12/16), respectively. It is concluded that, following primary angioplasty in patients with acute myocardial infarction, the extent of myocardial infarction assessed by {sup 201}Tl SPET can identify those who will develop ventricular dilatation during the subsequent 7 months. (orig.)

Choi, Joon Young; Moon, Dae Hyuk; Shin, Jung Woo; Lee, Hee Kyung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea); Lee, Cheol Whan; Park, Seong-Wook; Hong, Myeong-Ki; Song, Jae-Kwan; Park, Seung-Jung [Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea)

2002-06-01

205

Value of 123I-BMIPP scintigraphy in patients with ischemic heart disease. Comparison with exercise 201Tl SPECT  

International Nuclear Information System (INIS)

To evaluate 123I labeled beta-methyl-branched fatty acid (BMIPP) myocardial uptake at rest in the segment with and without stress induced ischemia in patients with coronary artery disease, 123I-beta-methyl-branched fatty acid myocardial scintigraphy was performed at rest and was compared with the findings of stress-reinjection 201Tl myocardial scintigraphy in 31 patients with coronary artery disease. In 159 ischemic myocardial segments, equally decreased uptake on both reinjection 201Tl and fatty acid images was observed in 64 segments, more severely decreased uptake of fatty acid in 76 segments, and more severely decreased uptake of reinjection thallium in 19 segments. On the other hand, in 53 non-reversible defects, each patterns was observed in 41, 3, and 9 segments respectively. When comparing the ischemic segments with more reduced uptake of fatty acid than reinjection thallium (Group 1) and the ischemic segments with equally or less reduced fatty acid uptake than reinjection thallium (Group 2), wall motion was more severely impaired in Group 1 than in Group 2 (severe hypo- to dyskinesis was present in 32 of 54 segments in group 1 and in 21 of 75 segments in group 2, p201Tl in the segments with stress induced ischemia and wall motion was more impaired in these segments. BMIPP myocardial imaging may provide information on metabolic alterations at rest independent of perfusion abnormalities in patients with coronary artery disease. (author)

1995-04-01

206

Production of 'no-carrier-added' 201Tl  

International Nuclear Information System (INIS)

A procedure has been developed for producing a radiopharmaceutically pure ''no-carrier-added'' 201Tl. The procedure is based on irradiating enriched metallic thallium (> 96% 203Tl) targets with approx. 30 Mev protons, separating 201Pb by co-precipitation with SrSO4 from sulphuric acid solution, and extracting 201Tl (after its in-growth) with butyl acetate from a hydrochloric solution. The average overall yield of 201Tl is approx. 92%. The radioactive concentration of the product exceeds 2 mCi/mL; radionuclide impurities-200Tl 202Tl 203Pb <= 0.02%; inactive impurities (?g/mL)-Tl < 2, Sr < 1, Fe < 0.25, Cu < 0.05; pH within the range 5-8. The product is sterile, apyrogenic, and suitable for clinical application. (author)

1984-01-01

207

Identification of viable myocardium by [sup 201]Tl scintigraphy: a comparison of methods. Identifizierung des vitalen Myokards mit der [sup 201]Tl-Szintigraphie: Ein Vergleich der Methoden  

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The present study was undertaken to compare four different imaging approaches to evaluate uptake defect reversibility. 24 infracted patients underwent standard stress/redistribution [sup 201]Tl imaging (R1). Then, after reinjection of 37 MBq of [sup 20]1Tl, patients were re-imaged either after 15 min (R2) 24 h later (R3). A separate rest study (R4) following a new tracer injection was done within 2-3 days. Planar images were obtained in the standard three views and subdivided into 216 segments for qualitative analysis based on a visual score. A semiquantitative analysis based upon circumferential profiles was also applied. A stress defect was found in 127 sements (58.7%). By visual inspection reperfusion was considered to occur in 32.3%, 41.7%, 33.0% and 49.6% of the cases with R1, R2, R3, and R4, respectively. The semiquantitative method showed a high reperfusion only with R1 (62%), while the other procedures proved less effective. No improvement was found with R4. Six patients (25%) showed myocardial viability that was not detected with the early reinjection technique. (orig.)

Dondi, M. (Servizio di Medicina Nucleare, Osp. degli Infermi, Faenza (Italy)); Tartagni, F. (Ist. di Cardiologia dell' Univ. degli Studi, Bologna (Italy)); Osele, L. (Servizio di Medicina Nucleare, Bolzano (Italy)); Fanti, S. (Servizio di Medicina Nucleare, Policlinico S. Orsola-Malpighi, Bologna (Italy)); Monetti, N. (Servizio di Medicina Nucleare, Policlinico S. Orsola-Malpighi, Bologna (Italy)); Antonioli, P. (Servizio di Medicina Nucleare, Policlinico S. Orsola-Malpighi, Bologna (Italy)); De Tommaso, I. (Servizio di Medicina Nucleare, Policlinico S. Orsola-Malpighi, Bologna (Italy)); Franchi, R. (Servizio di Medicina Nucleare, Osp. degli Infermi, Faenza (Italy)); Di Niro, M.R. (Servizio di Medicina Nucleare, Policlinico S. Orsola-Malpighi, Bologna (Italy)); Magnani, B. (Servizio di Medicina Nucleare, Policlinico S. Orsola-Malpighi, Bologna (Italy)); Zheng, Q.F. (People' s Liberation Army Hospital, Beijing (China))

1993-08-01

208

Venous uptake of /sup 201/Tl as thallous chloride  

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Thallium-201, injected as thallous chloride, has been found to adhere to or be taken up by the vein into which it is injected, permitting images to be obtained of human veins up to 4 h following injection. A digoxin-insensitive rat vein model also retained /sup 201/Tl but for shorter periods of time. /sup 201/Tl uptake is independent of the solution into which it is introduced, whether 5% dextrose or 0.9% sodium chloride. This technique permits multiple delayed views of normal veins to be obtained but is of uncertain value in the evaluation of thrombophlebitis of the calf because of rather poor resolution and high cost.

Silberstein, E.B.; Thomas, S.R. (Cincinnati Univ., OH (USA). Coll. of Medicine); Robbins, P.J.; Fortman, D.L. (Office of Science and Technology, Cincinnati, OH (USA). Food and Drug Administration, Nuclear Medicine Lab.); Sill, P.

1984-05-01

209

Experimental considerations of myocardial single photon emission CT image with a cardiac phantom  

International Nuclear Information System (INIS)

We studied the quantity of thallium-201 myocardial single photon emission CT (SPECT) image with a cardiac phantom. The myocardial SPECT image is influenced by several causes, i.e., the absorption of gamma rays, collimator aperture, statistical noise and limited angle of rotation in data acquisition. The attenuation correction under the assumption of uniform distribution is not sufficient, so we have to consider the actual distribution of absorption. The effects of the nonuniform attenuation are most prominently appeared when we evaluate the quantity by the integral method. The aperture characteristics of a collimator are decided by the distance between the rotational center of the gamma camera and the collimator surface. Simultaneously scattered gamma rays affect the reconstructed image in the low frequency component, so the effective attenuation coefficient varies gradually. The statistical noise intermixed in the projection data generate artifacts like as lumpshaped pattern. The noise are clearly appeared in the spatial frequency upper than 0.25 cycle, so the low-pass filter are required with that of cut-off frequency. Moreover to enhance the details of the radionuclide distribution of cardiac muscle, the Wiener filter should be applied. The scan area also affects the appearance of the artifact in the myocardial SPECT image. The 180-degree scan usually generates false defects just nearby the center of reconstructed cross section. And the positions are changed with the conditions of gamma ray absorber and its relative position to the myocardial area. The 360-degree scan should be used from the standpoint of reconstructing more quantitative image. (author)

1987-01-01

210

Detection of the viable myocardium. A perfusion scintigraphic study, before and after coronary bypass surgery in myocardial infarction patients  

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Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To compare single-photon-emission computed tomography (SPECT) imaging scans using 201Tl and 99mTc-MIBI in detection of viable myocardium, in regions compromised by infarction. METHODS: Thirty-two (59.3±9.8 years old and 87% male) myocardial infarction patients were studied. All had Q wave [...] s on the ECG and left ventricle ejection fraction of

Willliam A., Chalela; Paulo J., Moffa; José A. F., Ramires; Aguinaldo P., Moraes; José, Soares Jr; José C., Meneghetti.

211

Evaluation of exercise thallium-201 myocardial single photon emission computed tomography in silent myocardial ischemia  

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To evaluate the diagnostic significance of exercise Tl-201 myocardial SPECT in silent myocardial ischemia, 41 patients with angiographically-proven coronary artery disease (27 effort angina, 14 postinfarction angina) were tested using this method. Double product (blood pressure x heart rate) during exercise was used as a hemodynamic parameter. Thirty-two projections were obtained throughout 180 degrees by a rotating gamma camera, immediately, and four hours after exercise. Myocardial Tl-201 washout rate of the entire left ventricle was presented in two-dimensional polar function maps. Normal lower limit of myocardial Tl-201 washout rate was defined as mean-2SD of normals, and the region with a washout rate lower than normal was defined as an ischemic region. The location of myocardial ischemia was visually determined using a Bull's eye polar map. The ischemic size was quantified by the defect volume ratio (ratio of the ischemic myocardium to total myocardium). Coronary lesions were quantitatively assessed by the Pujadas score using coronary angiography. Results were as follows: There was no significant difference between painful myocardial ischemia and silent myocardial ischemia according to double product and the Pujadas scores. In most silent ischemia, the region of the reduced washout rate was in the inferior or lateral area of the Bull's eye polar map, whereas it was in the anterior area in painful ischemia . The defect volume ratio indicating the extent of ischemia was smaller in silent ischemia than in painful ischemia. In conclusion, the ischemic location and size may be contributing factors in silent myocardial ischemia. (author).

Miyakawa, Tomohisa; Miura, Shuetsu; Ichikawa, Takashi; Motegi, Itaru; Kato, Masataka; Nakai, Kenji; Takahashi, Tsuneo; Yanagisawa, Tohru (Iwate Medical Coll., Morioka (Japan))

1989-12-01

212

How reliable is myocardial imaging in the diagnosis of acute myocardial infarction  

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Myocardial scintigraphic techniques available presently allow a sensitive and relatively specific diagnosis of acute myocardial infarction when they are used correctly, although every technique has definite limitations. Small myocardial infarcts (less than 3 gm.) may be missed, and there are temporal limitations in the usefulness of the scintigraphic techniques. The development of tomographic methodology that may be used with single-photon radionuclide emitters (including technetium and /sup 201/Tl will allow the detection of relatively small abnormalities in myocardial perfusion and regions of myocardial infarction and will help to provide a more objective interpretation of the myocardial scintigrams. The use of overlay techniques allowing simultaneous assessment of myocardial perfusion, infarct-avid imaging, and radionuclide ventriculograms will provide insight into the relevant aspects of the extent of myocardial damage, the relationship of damage to myocardial perfusion, and the functional impact of myocardial infarction on ventricular performance.

Willerson, J.T.

1983-01-01

213

Dosimetric consequences of interstitial extravasation following i.v. administration of {sup 201}Tl  

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There is a slight possibility that radiopharmaceutical administrations are infiltrated to the subcutaneous tissue at intravenous administration. {sup 201}Tl has a long effective half life at subcutaneous tissue. It thus appears that there is some risk for radiation dermatitis when {sup 201}Tl is injected subcutaneously. To estimate radiation dose from extravasated {sup 201}Tl chloride, we created simple models. An absorbed dose to the basal cell layer of skin because of an inadvertent intravenous injection of {sup 201}Tl chloride was calculated from these models. The result indicated that extravasated {sup 201}Tl chloride may cause radiation burdens at high specific activity. (author)

Yamaguchi, Ichiro [National Inst. of Public Health, Tokyo (Japan); Togashi, Atsuhiko [Niigata Univ. (Japan). School of Medicine

2002-03-01

214

Usefulness of isoproterenol stress thallium-201 myocardial single photon emission computed tomography (SPECT)  

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Twenty patients complaining of chest pain were referred for isoproterenol stress thallium-201 myocardial single photon emission computed tomography (ISO-SPECT). The findings were compared with those obtained from isoproterenol stress ECG testing (ISO-ECG) and exercise SPECT (EX-SPECT). Isoproterenol was iv injected in a dose of 0.02 {mu}g/kg/min. The amount was continuously increased until limited by chest pain, ST depression, and/or determined heart rate criteria. The patients were scanned immediately and three hours after giving isoproterenol. Transient hypoperfusion was regarded as myocardial ischemia. Washout rate, obtained from circumferential profile analysis on the short axis SPECT images, was expressed by Bull's eye display. Fifteen patients with angiographically significant stenosis of 75% or greater were diagnosed as having coronary artery disease (CAD). The other five patients had normal coronary artery (NC). In diagnosing CAD, ISO-ECG and ISO-SPECT had a sensitivity of 80% and 92%, respectively. Because the NC group had negative findings for redistribution on ISO-SPECT, the specificy of ISO-SPECT seemed to be high. For multi-vessel disease, redistribution on ISO-SPECT tended to underestimate coronary lesions. The underestimation was, however, corrected by calculating washout rate. For evaluable 11 patients undergoing concurrent EX-SPECT, ISP-SPECT was equivalent or superior to EX-SPECT in diagnostic sensitivity. None of the patients had severe side effects of isoproterenol, except for some having arrhythmia. The results indicated that ISO-SPECT is a safe, high sensitive diagnostic approach that is comparable to Ex-SPECT. (N.K.).

Watanabe, Shigeyuki; Ajisaka, Ryuichi; Masuoka, Takeshi (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine) (and others)

1990-02-01

215

Cardiac phase-synchronized myocardial thallium-201 single-photon emission tomography using list mode data acquisition and iterative tomographic reconstruction  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to determine whether data acquisition in the list mode and iterative tomographic reconstruction would render feasible cardiac phase-synchronized thallium-201 single-photon emission tomography (SPET) of the myocardium under routine conditions without modifications in tracer dose, acquisition time, or number of steps of the a gamma camera. Seventy non-selected patients underwent {sup 201}Tl SPET imaging according to a routine protocol (74 MBq/2 mCi {sup 201}Tl, 180 rotation of the gamma camera, 32 steps, 30 min). Gamma camera data, ECG, and a time signal were recorded in list mode. The cardiac cycle was divided into eight phases, the end-diastolic phase encompassing the QRS complex, and the end-systolic phase the T wave. Both phase- and non-phase-synchronized tomograms based on the same list mode data were reconstructed iteratively. Phase-synchronized and non-synchronized images were compared. Patients were divided into two groups depending on whether or not coronary artery disease had been definitely diagnosed prior to SPET imaging. The numbers of patients in both groups demonstrating defects visible on the phase-synchronized but not on the non-synchronized images were compared. It was found that both postexercise and redistribution phase tomograms were suited for interpretation. The changes from end-diastolic to end-systolic images allowed a comparative assessment of regional wall motility and tracer uptake. End-diastolic tomograms provided the best definition of defects. Additional defects not apparent on non-synchronized images were visible in 40 patients, six of whom did not show any defect on the non-synchronized images. (orig./VHE)

Vemmer, T. [Abt. Nuklearmedizin, Klinikum der Univ. Goettingen (Germany); Steinbuechel, C. [Abt. Nuklearmedizin, Klinikum der Univ. Goettingen (Germany); Bertram, J. [Abt. Nuklearmedizin, Klinikum der Univ. Goettingen (Germany); Eschner, W. [Abt. Nuklearmedizin, Klinikum der Univ. Goettingen (Germany); Koegler, A. [Abt. Nuklearmedizin, Klinikum der Univ. Goettingen (Germany); Luig, H. [Abt. Nuklearmedizin, Klinikum der Univ. Goettingen (Germany)

1997-03-01

216

Serial evaluation of 123I-BMIPP/201Tl myocardial single-proton emission computed tomography after coronary stent implantation in ischemic heart disease. Association with recovery of left ventricular function  

International Nuclear Information System (INIS)

Coronary stent implantation is often used to treat ischemic heart disease. However, few studies have evaluated myocardial viability with single-proton emission computed tomography (SPECT) and both thallium and ?-methyl-iodophenyl-pentadecanoic acid (BMIPP) after coronary stent implantation. Forty patients (30 men and 10 women, 64.8±9.3 years old) who had undergone successful stent implantation were enrolled. Twenty-two patients had angina pectoris (AP) and 18 patients had acute myocardial infarction (AMI). We performed BMIPP and thallium SPECT immediately after coronary stent implantation and at 3 months follow-up and compared the results with left ventriculograms. Myocardial SPECT images were divided into 17 segments, after which defect scores (1 to 5) were assigned to each segment and summed to obtain a total defect score (TDS). Left ventriculograms were divided into 9 segments, each of which was given a wall motion score (WMS; 1 to 5). In patients with either AP or AMI, the TDS of BMIPP and thallium SPECT images were significantly better at 3 months follow-up than immediately after stent implantation. In patients with AP, improvements in TDS on BMIPP and thallium SPECT were not associated with improvements in WMS. In patients with AMI, improvements in TDS on BMIPP SPECT were correlated with improvements in WMS (r=0.69, p<0.01) and in left ventricular ejection fraction (r=0.70, p<0.01), and improvements in TDS on thallium SPECT were correlated with improvements in WMS (r=0.64, p<0.01) but were not associated with improvements in left ventricular ejection fraction. In conclusion, a decrease in BMIPP myocardial uptake in patients with AP suggests previous episodes of severe myocardial ischemia. Improvements in BMIPP uptake in patients with AMI may indicate recovery of left ventricular function. Coronary stent implantation for severe myocardial ischemia contributes to improvements in myocardial viability. (author)

2000-11-01

217

Serial evaluation of {sup 123}I-BMIPP/{sup 201}Tl myocardial single-proton emission computed tomography after coronary stent implantation in ischemic heart disease. Association with recovery of left ventricular function  

Energy Technology Data Exchange (ETDEWEB)

Coronary stent implantation is often used to treat ischemic heart disease. However, few studies have evaluated myocardial viability with single-proton emission computed tomography (SPECT) and both thallium and {beta}-methyl-iodophenyl-pentadecanoic acid (BMIPP) after coronary stent implantation. Forty patients (30 men and 10 women, 64.8{+-}9.3 years old) who had undergone successful stent implantation were enrolled. Twenty-two patients had angina pectoris (AP) and 18 patients had acute myocardial infarction (AMI). We performed BMIPP and thallium SPECT immediately after coronary stent implantation and at 3 months follow-up and compared the results with left ventriculograms. Myocardial SPECT images were divided into 17 segments, after which defect scores (1 to 5) were assigned to each segment and summed to obtain a total defect score (TDS). Left ventriculograms were divided into 9 segments, each of which was given a wall motion score (WMS; 1 to 5). In patients with either AP or AMI, the TDS of BMIPP and thallium SPECT images were significantly better at 3 months follow-up than immediately after stent implantation. In patients with AP, improvements in TDS on BMIPP and thallium SPECT were not associated with improvements in WMS. In patients with AMI, improvements in TDS on BMIPP SPECT were correlated with improvements in WMS (r=0.69, p<0.01) and in left ventricular ejection fraction (r=0.70, p<0.01), and improvements in TDS on thallium SPECT were correlated with improvements in WMS (r=0.64, p<0.01) but were not associated with improvements in left ventricular ejection fraction. In conclusion, a decrease in BMIPP myocardial uptake in patients with AP suggests previous episodes of severe myocardial ischemia. Improvements in BMIPP uptake in patients with AMI may indicate recovery of left ventricular function. Coronary stent implantation for severe myocardial ischemia contributes to improvements in myocardial viability. (author)

Shimazu, Yoshihisa; Taniguchi, Ikuo; Wagatsuma, Kenji; Yamazaki, Tatsuo [Jikei Univ., Tokyo (Japan). School of Medicine

2000-11-01

218

Advanced quantitative 201-Tl gated SPECT (QGS-A) images for the assessment of left ventricular function and volumes. Comparison with two-dimensional echocardiography  

International Nuclear Information System (INIS)

The aim of this study was to assess the clinical significance and validity of the advanced quantitative 201-Tl and 99m-Tc gated SPECT (QGS-A) methods. We studied 79 patients (48 men, 31 women; mean age 70±14 yr) with cardiomyopathy (n=4) and ischemic (n=57) or congestive heart disease (n=18). All subjects were investigated as to the correlation between values with QGS-A and UCG. Either 201-Tl (n=51) or 99m-Tc (n=28) gated SPECT was performed at rest (n=48) or stress (n=31) stage followed by UCG within one month. Gated SPECT data, including EDV, ESV, and LVEF, were quantified by using an automatic algorithm as QGS-A, whereas UCG data (EDV, ESV, and LVEF) were determined by the standard technique. A significant correlation was found between 201-Tl or 99m-Tc QGS-A and UCG with respect to EDV, ESV, and LVEF (201-Tl: r=0.761, 0.882, 0.819; 99m-Tc: r=0.515, 0.765, 0.695, respectively, all p values <0.01), regardless of the use of rest images. The mean values of EDV, ESV, and LVEF calculated by QGS-A were significantly lower than those of UCG (all p values <0.01). LV volumes and LVEF calculated by both 201-Tl and 99m-Tc QGS-A were significantly correlated with those obtained by UCG. These findings support the clinical significance and validity of 201-Tl and 99m-Tc QGS-A for simultaneously assessing both LV function and myocardial perfusion imaging. (author)

2001-11-01

219

Advanced quantitative 201-Tl gated SPECT (QGS-A) images for the assessment of left ventricular function and volumes. Comparison with two-dimensional echocardiography  

Energy Technology Data Exchange (ETDEWEB)

The aim of this study was to assess the clinical significance and validity of the advanced quantitative 201-Tl and 99m-Tc gated SPECT (QGS-A) methods. We studied 79 patients (48 men, 31 women; mean age 70{+-}14 yr) with cardiomyopathy (n=4) and ischemic (n=57) or congestive heart disease (n=18). All subjects were investigated as to the correlation between values with QGS-A and UCG. Either 201-Tl (n=51) or 99m-Tc (n=28) gated SPECT was performed at rest (n=48) or stress (n=31) stage followed by UCG within one month. Gated SPECT data, including EDV, ESV, and LVEF, were quantified by using an automatic algorithm as QGS-A, whereas UCG data (EDV, ESV, and LVEF) were determined by the standard technique. A significant correlation was found between 201-Tl or 99m-Tc QGS-A and UCG with respect to EDV, ESV, and LVEF (201-Tl: r=0.761, 0.882, 0.819; 99m-Tc: r=0.515, 0.765, 0.695, respectively, all p values <0.01), regardless of the use of rest images. The mean values of EDV, ESV, and LVEF calculated by QGS-A were significantly lower than those of UCG (all p values <0.01). LV volumes and LVEF calculated by both 201-Tl and 99m-Tc QGS-A were significantly correlated with those obtained by UCG. These findings support the clinical significance and validity of 201-Tl and 99m-Tc QGS-A for simultaneously assessing both LV function and myocardial perfusion imaging. (author)

Kameyama, Yasunobu; Mitsue, Noriko; Sato, Shigehiko; Kato, Kimihiko; Saito, Masaya [Seki Chuo Hospital, Gifu (Japan)

2001-11-01

220

Attenuation correction in pulmonary and myocardial single photon emission computed tomography  

International Nuclear Information System (INIS)

The objective was to develop and validate methods for single photon emission computed tomography, SPECT, allowing quantitative physiologic and diagnostic studies of lung and heart. A method for correction of variable attenuation in SPECT, based on transmission measurements before administration of an isotope to the subject, was developed and evaluated. A protocol based upon geometrically well defined phantoms was developed. In a mosaic pattern phantom count rates were corrected from 39-43% to 101-110% of reference. In healthy subjects non-gravitational pulmonary perfusion gradients observed without attenuation correction were artefacts caused by attenuation. Pulmonary density in centre of right lung, obtained from the transmission measurement, was 0.28 ± 0.03 g/ml in normal subjects. Mean density was lower in large lungs compared to smaller ones. We also showed that regional ventilation/perfusion ratios could be measured with SPECT, using the readily available tracer 133Xe. Because of the low energy of 133Xe this relies heavily upon attenuation correction. A commercially available system for attenuation correction with simultaneous emission and transmission, considered to improve myocardial SPECT, performed erroneously. This could lead to clinical misjudgement. We considered that manufacturer-independent pre-clinical tests are required. In a test of two other commercial systems, based on different principles, an adapted variant of our initial protocol was proven useful. Only one of the systems provided correct emission count rates independently on phantom configuration. Errors in the other system were related to inadequate compensation of the influence of emission activity on the transmission study

2000-01-01

 
 
 
 
221

Attenuation correction in pulmonary and myocardial single photon emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

The objective was to develop and validate methods for single photon emission computed tomography, SPECT, allowing quantitative physiologic and diagnostic studies of lung and heart. A method for correction of variable attenuation in SPECT, based on transmission measurements before administration of an isotope to the subject, was developed and evaluated. A protocol based upon geometrically well defined phantoms was developed. In a mosaic pattern phantom count rates were corrected from 39-43% to 101-110% of reference. In healthy subjects non-gravitational pulmonary perfusion gradients observed without attenuation correctionwere artefacts caused by attenuation. Pulmonary density in centre of right lung, obtained from the transmission measurement, was 0.28 {+-} 0.03 g/ml in normal subjects. Mean density was lower in large lungs compared to smaller ones. We also showed that regional ventilation/perfusion ratios could be measured with SPECT, using the readily available tracer {sup 133}Xe. Because of the low energy of {sup 133}Xe this relies heavily upon attenuation correction. A commercially available system for attenuation correction with simultaneous emission and transmission, considered to improve myocardial SPECT, performed erroneously. This could lead to clinical misjudgement. We considered that manufacturer-independent pre-clinical tests are required. In a test of two other commercial systems, based on different principles, an adapted variant of our initial protocol was proven useful. Only one of the systems provided correct emission count rates independently on phantom configuration. Errors in the other system were related to inadequate compensation of the influence of emission activity on the transmission study.

Almquist, H

2000-01-01

222

Transmission-based scatter correction of 180 degrees myocardial single-photon emission tomographic studies.  

Science.gov (United States)

Meaningful comparison of single-photon emission tomographic (SPET) reconstructions for data acquired over 180 degrees or 360 degrees can only be performed if both attenuation and scatter correction are applied. Convolution subtraction has appeal as a practical method for scatter correction; however, it is limited to data acquired over 360 degrees. A new algorithm is proposed which can be applied equally well to data acquired over 180 degrees or 360 degrees. The method involves estimating scatter based on knowledge of reconstructed transmission data in combination with a reconstructed estimate of the activity distribution, obtained using attenuation correction with broad beam attenuation coefficients. Processing is implemented for planes of activity parallel to the projection images for which a simplified model for the scatter distribution may be applied, based on the measured attenuation. The appropriate broad beam (effective) attenuation coefficients were determined by considering the scatter buildup equation. It was demonstrated that narrow beam attenuation coefficients should be scaled by 0.75 and 0.65 to provide broad beam attenuation coefficients for technetium-99m and thallium-201 respectively. Using a thorax phantom, quantitative accuracy of the new algorithm was compared with conventional transmission-based convolution subtraction (TDCS) for 360 degrees data. Similar heart to lung contrasts were achieved and correction of 180 degrees data yielded a 10.4% error for cardiac activity compared to 5.2% for TDCS. Contrast for myocardium to ventricular cavity was similarly good for scatter-corrected 180 degrees and 360 degrees data, in contrast to attenuation-corrected data, where contrast was significantly reduced. The new algorithm provides a practical method for correction of scatter applicable to 180 degrees myocardial SPET. PMID:8781133

Hutton, B F; Osiecki, A; Meikle, S R

1996-10-01

223

Evaluating image denoising methods in myocardial perfusion single photon emission computed tomography (SPECT) imaging  

Science.gov (United States)

The statistical nature of single photon emission computed tomography (SPECT) imaging, due to the Poisson noise effect, results in the degradation of image quality, especially in the case of lesions of low signal-to-noise ratio (SNR). A variety of well-established single-scale denoising methods applied on projection raw images have been incorporated in SPECT imaging applications, while multi-scale denoising methods with promising performance have been proposed. In this paper, a comparative evaluation study is performed between a multi-scale platelet denoising method and the well-established Butterworth filter applied as a pre- and post-processing step on images reconstructed without and/or with attenuation correction. Quantitative evaluation was carried out employing (i) a cardiac phantom containing two different size cold defects, utilized in two experiments conducted to simulate conditions without and with photon attenuation from myocardial surrounding tissue and (ii) a pilot-verified clinical dataset of 15 patients with ischemic defects. Image noise, defect contrast, SNR and defect contrast-to-noise ratio (CNR) metrics were computed for both phantom and patient defects. In addition, an observer preference study was carried out for the clinical dataset, based on rankings from two nuclear medicine clinicians. Without photon attenuation conditions, denoising by platelet and Butterworth post-processing methods outperformed Butterworth pre-processing for large size defects, while for small size defects, as well as with photon attenuation conditions, all methods have demonstrated similar denoising performance. Under both attenuation conditions, the platelet method showed improved performance with respect to defect contrast, SNR and defect CNR in the case of images reconstructed without attenuation correction, however not statistically significant (p > 0.05). Quantitative as well as preference results obtained from clinical data showed similar performance of the denoising methods studied. In conclusion, the multi-scale platelet denoising method applied on raw projection images provides more efficient noise reduction while preserving image quality in a myocardial phantom SPECT imaging as compared to the Butterworth filter applied either on projection or reconstructed images. However, this trend in favour of the platelet denoising method was not observed on clinical data reconstructed either without or with attenuation correction.

Skiadopoulos, S.; Karatrantou, A.; Korfiatis, P.; Costaridou, L.; Vassilakos, P.; Apostolopoulos, D.; Panayiotakis, G.

2009-10-01

224

Evaluating image denoising methods in myocardial perfusion single photon emission computed tomography (SPECT) imaging  

International Nuclear Information System (INIS)

The statistical nature of single photon emission computed tomography (SPECT) imaging, due to the Poisson noise effect, results in the degradation of image quality, especially in the case of lesions of low signal-to-noise ratio (SNR). A variety of well-established single-scale denoising methods applied on projection raw images have been incorporated in SPECT imaging applications, while multi-scale denoising methods with promising performance have been proposed. In this paper, a comparative evaluation study is performed between a multi-scale platelet denoising method and the well-established Butterworth filter applied as a pre- and post-processing step on images reconstructed without and/or with attenuation correction. Quantitative evaluation was carried out employing (i) a cardiac phantom containing two different size cold defects, utilized in two experiments conducted to simulate conditions without and with photon attenuation from myocardial surrounding tissue and (ii) a pilot-verified clinical dataset of 15 patients with ischemic defects. Image noise, defect contrast, SNR and defect contrast-to-noise ratio (CNR) metrics were computed for both phantom and patient defects. In addition, an observer preference study was carried out for the clinical dataset, based on rankings from two nuclear medicine clinicians. Without photon attenuation conditions, denoising by platelet and Butterworth post-processing methods outperformed Butterworth pre-processing for large size defects, while for small size defects, as well as with photon attenuation conditions, all methods have demonstrated similar denoising performance. Under both attenuation conditions, the platelet method showed improved performance with respect to defect contrast, SNR and defect CNR in the case of images reconstructed without attenuation correction, however not statistically significant (p > 0.05). Quantitative as well as preference results obtained from clinical data showed similar performance of the denoising methods studied. In conclusion, the multi-scale platelet denoising method applied on raw projection images provides more efficient noise reduction while preserving image quality in a myocardial phantom SPECT imaging as compared to the Butterworth filter applied either on projection or reconstructed images. However, this trend in favour of the platelet denoising method was not observed on clinical data reconstructed either without or with attenuation correction

2009-10-01

225

Semi-quantitative assessment of oral cavity squamous cell carcinoma using 201Tl SPECT for evaluating effectiveness of preoperative radiotherapy  

International Nuclear Information System (INIS)

The aim of this study is to reveal the usefulness of semi-quantitative assessment using 201Tl chloride (Tl) single photon emission computed tomography (SPECT) (Tl SPECT) to evaluate the effectiveness of radiotherapy in 15 patients with oral cavity squamous cell carcinoma (SCC). Fifteen patients were diagnosed with SCC by biopsy. All 15 patients enrolled in this study were planned to undergo preoperative radiotherapy with or without chemotherapy using carboplatin (CBDCA) and received reduction operation. Tl SPECTs were performed 15 minutes after intravenous administration of 111 MBq 201Tl chloride. Regions of interest (ROI) were set up around tumor (T), and non-lesion (N) at the part of contralateral scalp at the height of the cerebellum. The ratios of mean counts in ROI of the tumor to those in non-lesion were measured as pre- and post-treatment T/N ratios (pre T/N, post T/N). Furthermore, reduction rate (RR) was obtained by calculating [(pre T/N - post T/N)/(pre T/N)] x 100%. Each parameter (pre T/N, post T/N, and RR) was compared to histopathological grade of surgical specimen based on the Oboshi and Shimosato classification (grade I-IV). RR showed significantly higher values in grade III and IV than in grade I and II (p=0.0008). In conclusion, semiquantitative assessment using Tl SPECT, especially calculating RR, is useful to evaluate the effectiveness of preoperative radiotherapy. (author)

2004-07-01

226

Evaluation of diffuse lung uptake of 201Tl in bronchopulmonary diseases  

International Nuclear Information System (INIS)

201Tl scintigraphy was performed in various bronchopulmonary diseases. Applying semiquantitative and visual assessments of grade of 201Tl lung uptake, clinical aspects of diffuse lung uptake of 201Tl was studied. Diffuse lung uptake of 201Tl was observed in various broncho-pulmonary diseases with multiple or numerous abnormal shadows in the lung fields, and obvious lung uptake was also shown even in some cases with few or no abnormal shadows. Positive results of moderate (++) and marked (+++) lung uptake of 201Tl more than 60.0% were obtained in diffuse interstitial pneumonia, hypersensitivity pneumonitis, silicosis, the disseminated type of pulmonary tuberculosis and primary lung cancer. The ratio of radioactivity of the lung (maximum) to the upper mediastinum was 1.04 ± 0.24 in healthy controls, and more than 2.0 in diffuse interstitial pneumonia, hypersensitivity pneumonitis and silicosis. The ratio of radioactivity of the right lung to the administered dose of 201Tl was 1.5 ± 0.9% in healthy controls, and more than 3.0% in diffuse interstitial pneumonia, silicosis, the disseminated type of pulmonary tuberculosis and primary lung cancer. Lung uptake of 201Tl was diffuse, homogenous and marked in diffuse interstitial pneumonia and hypersensitivity pneumonitis, while it was scattered and slight in chronic obstructive lung diseases. 201Tl scintigraphy seems to be useful for detecting interstitial disorders of the lung including edema, inflammatory and granulomatous changes, especially in cases with slightly abnormal or normal chest X-ray films. (author)

1990-01-01

227

"2"0"1Tl-thallium chloride injections for cardiological applications  

International Nuclear Information System (INIS)

The production is being prepared by the Nuclear Research Institute at Rez of the cardiovascular diagnostic agent, "2"0"1Tl-thallium chloride. The "2"0"1Tl radionuclide will be produced by irradiating a thallium target in the U-120 M cyclotron at Rez. For this purpose, the "2"0"1Tl production rate was measured in the proton energy range of 27 to 31 MeV, and the production conditions were optimized with respect to parasitic production of radionuclide contaminants "2"0"0Tl and "2"0"2Tl. A method was developed of chemically separating "2"0"1Tl from the irradiated target. This will allow the production of "2"0"1Tl-thallium chloride injections in the required quality. (author)

1985-06-06

228

Clinical application of [sup 201]Tl SPECT to local recurrence of rectal carcinoma  

Energy Technology Data Exchange (ETDEWEB)

Recently [sup 201]Tl SPECT technique has been used for tumor imaging in some neoplasms including thyroid cancer and lung cancer. But there were a few reports on the diagnosis of digestive cancers using [sup 201]Tl SPECT. In this study usefulness of [sup 201]Tl SPECT was evaluated in 22 patients who had gone surgical treatment for rectal carcinomas. The group consisted of 6 recurrences and 16 without recurrence, the results were as follows: 5 true positive and 15 true negative. This technique was used in the follow-up of 2 recurrences after several courses of therapy. There was obvious decrease uptake of [sup 201]Tl in the 2 patients who clinically got good response to the treatments. We conclude that [sup 201]Tl SPECT is expected to be a useful diagnostic tool for investigation recurrence of rectal carcinoma. (author).

Yamada, Shigeru; Watanabe, Satoshi; Fujita, Yoshihiro (Chiba Cancer Center Hospital (Japan)) (and others)

1994-04-01

229

Use of ECG-gated single-photon emission tomography to assess the evolution of perfusion after acute myocardial infarction  

Energy Technology Data Exchange (ETDEWEB)

Serial improvement in myocardial perfusion images from the acute or subacute to the chronic stage of acute myocardial infarction (AMI) has been attributed to improved coronary microcirculation or cell function after acute ischaemia and reperfusion. However, conventionally used non-gated imaging cannot eliminate the effect of improved regional contraction. We studied the possibility that such scintigraphic improvement reflects the functional recovery by using ECG-gated myocardial perfusion imaging with technetium-99m sestamibi. Nineteen AMI patients who received acute reperfusion therapy underwent ECG-gated myocardial single-photon emission tomography (SPET) in the subacute and chronic stages. Serial changes in regional image count distributions were analysed on the non-gated, end-diastolic (ED) and end-systolic (ES) images by using segmental mean percent peak activity (MPA) and {delta}MPA (MPA in chronic stage - MPA in subacute stage) on bull's-eye polar maps. These changes were compared with those in regional wall motion on biplane left ventriculography (LVG) from the acute (just after reperfusion) to the chronic stage. During the follow-up, regional wall motion remained the same in 42 (group A) but improved in 17 (group B) of the 59 ischaemically compromised segments. MPA showed no improvement in group A but significant improvement in group B on the non-gated and ES images (P<0.0001 and P<0.001, respectively). However, MPA on the ED images showed no improvement in either group. In the follow-up study of AMI, the scintigraphic improvement documented on the non-gated myocardial images appears to be mainly related to the recovery of wall thickening and not to a real improvement in myocardial perfusion. Therefore, ECG-gated myocardial imaging, which enables simultaneous assessment of changes in perfusion and contraction, is preferable to conventional non-gated imaging for follow-up of AMI. (orig.)

Toba, Masahiro; Ishida, Yoshio; Fukuchi, Kazuki; Takamiya, Makoto [Dept. of Radiology, National Cardiovascular Center, Osaka (Japan); Noguchi, Teruo; Itoh, Akira; Nonogi, Hiroshi [Div. of Cardiology, National Cardiovascular Center, Osaka (Japan)

2000-05-01

230

Leg arteritis exploration by quantitative muscle scintigraphy with 201Tl  

International Nuclear Information System (INIS)

Detection and localization of peripheral arterial disease was evaluated by an intravenous injection of 201Tl at peak exercise in 18 subjects and at rest in 6 patients. Images of the skull (S), thighs (T), knees (K), calves (C) and feet (F) were obtained at rest or after exercise and stored in a computer. Intraleg (T/K, T/C, T/F), and left to right interleg (TL/TR,...) count ratios were calculated. In addition, all patients were submitted to routine functional tests (walk perimeter, serial local arterial blood pressure measurement, Strandness test, venous occlusion plethysmography). Correlations between functional tests and the intra and interleg ratios were calculated. After exercise, there is a medium correlation between the tissular blood flow under hyperemia at the calf level and the T/C and C/K ratios. At the calf level a good correlation is obtained for CL/CR and the flux under hyperemia (r = 0.81, P 0.001). A ratio between the counting rates of limb segments after exercise and those of skull was established. The ratios T/S and C/S compared with the systolic pressure index of the most affected limb after a Strandness test give a correlation of 0.72 (P 0.02) for the thigh and of 0.86 (P 0.001) for the calf. For hyperemic flux, the correlation are 0.58 (P 0.005) with T/S and 0.75 (P 0.001) with C/S. In order to find the best quantitative scintigraphic index of the arterial illness, we compared the different ratio values with the distance walked. For T/S we found a relationship very close to a linear one and for C/S a less significant exponential one. Thus, quantitative scintigraphy using 201Tl appears as an accurate method to measure local muscular perfusion deficit in the cases of lower limb arterial disease

1984-01-01

231

Leg arteritis exploration by quantitative muscle scintigraphy with 201Tl  

Energy Technology Data Exchange (ETDEWEB)

Detection and localization of peripheral arterial disease was evaluated by an intravenous injection of 201Tl at peak exercise in 18 subjects and at rest in 6 patients. Images of the skull (S), thighs (T), knees (K), calves (C) and feet (F) were obtained at rest or after exercise and stored in a computer. Intraleg (T/K, T/C, T/F), and left to right interleg (TL/TR,...) count ratios were calculated. In addition, all patients were submitted to routine functional tests (walk perimeter, serial local arterial blood pressure measurement, Strandness test, venous occlusion plethysmography). Correlations between functional tests and the intra and interleg ratios were calculated. After exercise, there is a medium correlation between the tissular blood flow under hyperemia at the calf level and the T/C and C/K ratios. At the calf level a good correlation is obtained for CL/CR and the flux under hyperemia (r = 0.81, P 0.001). A ratio between the counting rates of limb segments after exercise and those of skull was established. The ratios T/S and C/S compared with the systolic pressure index of the most affected limb after a Strandness test give a correlation of 0.72 (P 0.02) for the thigh and of 0.86 (P 0.001) for the calf. For hyperemic flux, the correlation are 0.58 (P 0.005) with T/S and 0.75 (P 0.001) with C/S. In order to find the best quantitative scintigraphic index of the arterial illness, we compared the different ratio values with the distance walked. For T/S we found a relationship very close to a linear one and for C/S a less significant exponential one. Thus, quantitative scintigraphy using 201Tl appears as an accurate method to measure local muscular perfusion deficit in the cases of lower limb arterial disease.

Robert, J.; Thouvenot, P.; Schmidt, C.; Escanye, J.M.; Schmitt, J.

1984-10-01

232

The quantitative evaluation of _2_0_1Tl-uptake in the pulmonary extravascular space  

International Nuclear Information System (INIS)

_2_0_1TlCl chest scintigraphy was performed in 10 patients with various heart and lung diseases, and _2_0_1Tl clearances of blood and lung were studied too. Soon after the injection of _2_0_1Tl, serial images of the whole chest were recorded in the supine position using a scintillation camera with a small digital computer. Total injected dose (T) was obtained from the maximum radioactivity in the serial images, and that in both lungs (L) was calculated from the anterior image on which the iso-count map of the perfusion lung scintigram was superimposed. Then the lung uptake ratio (%) was calculated by ratio of L/T. Using both scintigrams with _2_0_1Tl and sup(99m)Tc-human serum albumin, the image of _2_0_1Tl in the extravascular space was obtained, and subtracting this image from the original image of _2_0_1Tl, the one in the pulmonary extravascular space was obtained. Following results were obtained; 1) The disappearance of _2_0_1Tl from the blood was rapid, and 15 minutes after the injection only 10-15% of the radioactivity after 1 minute was present. 2) The lung activity of _2_0_1Tl on the time activity curve decreased rapidly to reach near plateau within 100-150 seconds after the injection, but slight and gradual decrease of it continued for 30 minutes. 3) The image of _2_0_1Tl in the extravascular space was almost the same as the original image of _2_0_1Tl as regard to the pattern of _2_0_1Tl-distribution. 4) The lung uptake ratio of _2_0_1Tl in the pulmonary extravascular space and original image were 9.8+-5.2% and 10.1+-5.3% as mean +-SD, respectively. So the former was 96.8+-2.4% of the latter. 5) The grade of lung uptake of _2_0_1Tl was seemed to be a useful index showing the disease process in the pulmonary extravascular space of cardiorespiratory diseases. (author)

1982-01-01

233

Prognosis of hypertrophic cardiomyopathy: assessment by 123I-BMIPP (beta-methyl-p-(123I)iodophenyl pentadecanoic acid) myocardial single photon emission computed tomography.  

Science.gov (United States)

123I-BMIPP (beta-methyl-iodophenyl pentadecanoic acid) has shown unique properties for potential use in assessing myocardial metabolism. Previous basic and clinical studies demonstrated that the disturbances of myocardial metabolism precede the occurrence of myocardial perfusion abnormalities by using 201Tl in hypertrophic myocardium. The present study was therefore undertaken to determine whether or not 123I-BMIPP myocardial SPECT is useful in predicting the prognosis of hypertrophic cardiomyopathy (HCM) in 65 patients in 6 facilities. There were 33 patients with non-obstructive HCM, 12 with obstructive HCM, 12 with apical HCM and 8 with dilated-phase HCM. Fasted patients at rest received an intravenous injection of 111 MBq of 123I-BMIPP. Twenty to thirty minutes later, myocardial SPECT was carried out. The BMIPP severity score (BMIPP SS) was evaluated semiquantitatively by using representative short axial SPECT images. We followed up the incidence of cardiac events for a mean period of 3.0 +/- 0.6 years. Cardiac events occurred in 13 patients. Of these, 11 developed heart failure and 6 died (4 from heart failure and 2 from sudden death). The BMIPP SS in the dilated-phase HCM was significantly lower than that for the nonsurvivors. The BMIPP SS was particularly high in patients with fatal heart failure. Furthermore, there was a close negative correlation between the BMIPP SS and percent fractional shortening measured by echocardiography (r = -0.49). Finally, the mortality over the three years increased according to the extent of the BMIPP SS. In conclusion, these results indicate that BMIPP SS is useful in evaluating the severity of HCM. We conclude that 123I-BMIPP is a valuable metabolic tracer in predicting the outcome of HCM. PMID:8814730

Nishimura, T; Nagata, S; Uehara, T; Morozumi, T; Ishida, Y; Nakata, T; Iimura, O; Kurata, C; Wakabayashi, Y; Sugihara, H; Otsuki, K; Wada, T; Koga, Y

1996-02-01

234

Single-photon emission computerized tomography for the determination of a site and extent of acute myocardial infarction  

International Nuclear Information System (INIS)

Results of plane santigraphy of myocardium (PSM) and single-photon emission computerized tomography (SPECT) of heart with 99mTc-pyrophosphate are compared to study diagnostic value of the latter in the determination of focal changes in myocardium, ascertaining localization and propagation of the disease focus in patients with myocardial infarction (MI). 40 patients have been examined. Localization and propagation of the process were determined by the inclusion of RP in necrosis focus at a certain number of sections. It is ascertained that SPECT permits to determine IM localization and its propagation more precisely than PSM. For IM of front localization (according to SPECT data) sections in all orthogonal planes proved to be informative, for IM of lower localization-saggital and frontal ones, and for the lateral IM - axial and frontal sections

1990-01-01

235

Quantitative myocardial thallium single-photon emission computed tomography in normal women: demonstration of age-related differences  

International Nuclear Information System (INIS)

The aim of this study is the development of a database of normal women for quantitative analysis of exercise and reinjection myocardial single-photon emission computed tomography (SPET). We studied 101 subjects (40 males and 61 females) with less than 5% likelihood of coronary artery disease. All patients underwent stress and rest thallium-201 myocardial SPET. Myocardial stress was induced by bicycle exercise test (n=51), dipyridamole infusion (n=27) or a combined test (n=23). Multivariate ANOVA showed that the type of stress did not influence the percentage of thallium uptake for each region. Significant differences between men and women were found for the percentage of uptake in the inferior and the anterior wall. The most original finding of this study is the correlation between age and thallium uptake in the three regions of the anterior wall, showing an increase in measured thallium uptake with age for women. Consequently, two groups of women, those under and those over 55 years old, were separated, with a significantly lower tracer uptake in the anterior wall in the younger age group. (orig./MG)

1996-01-01

236

Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus  

International Nuclear Information System (INIS)

In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death. However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET). Twenty-eight patients without overt cardiac involvement and risk factors were studied with 99mTc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which normalized on dipyridamole images (''reverse redistribution pattern''). Coronary angiography was performed in eight patients with positive 99mTc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that 99mTc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion, rest/dipyridamole 99mTc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus, and patients potentially at risk of later cardiac events. (orig.)

1999-07-01

237

Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus  

Energy Technology Data Exchange (ETDEWEB)

In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death. However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET). Twenty-eight patients without overt cardiac involvement and risk factors were studied with {sup 99m}Tc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which normalized on dipyridamole images (``reverse redistribution pattern``). Coronary angiography was performed in eight patients with positive {sup 99m}Tc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that {sup 99m}Tc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion, rest/dipyridamole {sup 99m}Tc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus, and patients potentially at risk of later cardiac events. (orig.) With 2 figs., 2 tabs., 21 refs.

Schillaci, O. [Nuclear Medicine, University of l`Aquila (Italy); Lagana, B.; Gentile, R.; Tubani, L.; Baratta, L. [Department of Clinical Medicine, University ``La Sapienza``, Rome (Italy); Danieli, R.; Scopinaro, F. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy)

1999-07-01

238

Clinical usefulness of 201Tl-chloride scintigraphy for the diagnosis of bone metastases  

International Nuclear Information System (INIS)

Fifty-five patients with bone lesions underwent 201Tl-chloride (201Tl) scintigraphy to evaluate its findings and usefulness for the diagnosis of bone metastases. 201Tl scintigraphy was performed 15 minutes (early scan) and 2 hour (delayed scan) after iv injection of 5.55 MBq/kg of 201Tl-chloride. To evaluate the degree of tracer retention at the lesions, we calculated retention index after setting regions of interest in each lesion demonstrated tracer uptake in both early and delayed scans. Among 118 pathologically and/or clinically comfirmed bone metastases, 201Tl planar images disclosed 90 (76.3%) and 88 (74.6%) lesions on early and delayed scans, respectively. SPECT images were preferable for the evaluation of the lesions in the spine, thoracic cage and pelvis. Correlation of tumor size with findings on 201Tl images demonstrated 90.5% sensitivity for the metastases more than 7 cm3. No correlational difference was seen in the sensitivity depending on primary cancers. The overall retention index of bone metastases was -21.4±47.1. Bone metastases of pulmonary adenocarcinomas and small cell carcinomas demonstrated higher retention index than pulmonary squamous cell carcinomas and breast cancers. On 201Tl images, no abnormal tracer uptake was seen in benign lesions detected by 99mTc-hydroxymethylene diphosphonate (99mTc-HMDP) images except 5 lesions. The retention index of the benign lesions demonstrated abnormal uptakes of -48.3±15.9 on 201Tl images, showing no significant difference between that of metastases. For vertebral compression fractures, abnormal tracer uptakes were demonstrated in 9 of the 12 pathologic fractures against 2 of the 10 benign ones. Those 2 benign fractures proved to be vertebral tuberculosis. The results suggest 201Tl scintigraphy can find out false positive lesions of 99mTc-HMDP scintigraphy and contribute to diagnosis of bone metastases with combination of other images. (author)

1995-01-01

239

Single photon emission computed tomography (SPECT)  

International Nuclear Information System (INIS)

Methods, instrumentation, performance data, clinical use and results of SPECT are presented. Since SPECT is yielding functional tomograms, morphological data are not the major concern with this method. Essentially sup(99m)Tc labeled radiopharmaceuticals, _2_0_1Tl chloride or _1_3_3Xe gas are in current use. SPECT may be considered as a supplement to ultrasound in detecting space-occupying lesions of the liver (combined accuracy 95%). Cranial SPECT already allows quantification of regional cerebral blood flow following inhalation of _1_3_3Xe gas. The sensitivity of myocardial SPECT with _2_0_1Tl (three-dimensional reconstruction) at rest in patients with severe coronary artery disease was higher than 90%. To further develop SPECT as a functionally oriented supplementary method to other radiodiagnostic procedures, further improvements are required as to performance, reconstruction algorithms and radiopharmaceuticals. (orig.)

1983-04-01

240

Quantification of the extent of myocardial infarction by thallium-201 single photon emission computed tomography  

International Nuclear Information System (INIS)

The diagnostic capability of a circumferential profile analysis with a two-dimensional representation of Tl-201 myocardial SPECT depends on the normal range of thallium distribution. The present study was thus to determine the lower normal limits useful for assessing the precise extent of myocardial infarction (MI). The quantitative analysis of Tl-201 myocardial SPECT was correlated with pathological findings of the heart in 50 autopsy cases (28 with MI; 22 without MI). The lower normal limits were 2.5 standard deviations below the mean values calculated using profiles normalized to the maximum pixel count observed in each profile. Using this lower normal limit, the sensitivity was 63.8%; specificity was 87.4%; and accuracy was 80.7% for determining the extent of ischemic lesions. However, for detecting MI, the sensitivity by quantitative analysis was 97%, which was higher than that by visual analysis. Non-transmural infarction 2.5 cm in size, undetectable by visual analysis, was detected by two-dimensional polar representation. However, the specificity of detecting MI was low (59%). The detectability of MI extent varied from site to site; false negative lesions were frequent in the septal region, and false positive lesions in the posterolateral region of the dilated hypertrophic heart. In conclusion, Tl-201 myocardial SPECT is useful for evaluating MI automatically, although possible false positive diagnosis must be taken into accounts in cases of dilated hypertrophic heart. (N.K.)

1991-01-01

 
 
 
 
241

Diagnosis of intracranial meningiomas by "2"0"1Tl-chlorine  

International Nuclear Information System (INIS)

Results are presented of a study of the use of "2"0"1Tl-chloride in the diagnosis of intracranial meningiomas. The meningiomas uniformly presented an intense "2"0"1Tl-chloride uptake. Factors such as vascularization increased and abnormal capillaries might play an important role in the tumoral fixation mechanisms. It was concluded that "2"0"1Tl-chloride imaging could be of particular interest in the diagnosis of intracranial meningiomas, especially in those cases that present a basal or infratentorial localization. It may also be useful as a post-surgery control method in the early detection of meningioma recurrence. The disadvantages of "2"0"1Tl-chloride are that it is an expensive radiopharmaceutical and its half-life limits the dose to be administered, thus not allowing the IBAS to be obtained. (U.K.)

1981-01-01

242

A technique of quantifying lung uptake of _2_0_1Tl on the scintigram with _2_0_1TlCl  

International Nuclear Information System (INIS)

On intravenous administration of _2_0_1TlCl (74 MBq (2 mCi)), initial transit of it through the heart as well as subsequent uptake by the chest were recorded in the supine position using a scintillation camera coupling to a small digital computer, and remaining the patient in the same position perfusion scintigram with sup(99m)Tc-macroaggregated albumin (MAA) or transmi ssion scintigram with a point source of sup(99m)TcO"4"- too. The radioactivity of total injected dose of _2_0_1Tl (T) was calculated from the entire region on the initial transit of the tracer bolus through the heart, and that of unilateral lung (L) was done from the anterior image of _2_0_1Tl on which isocount map of the perfusion image or transmission one was superimposed. By these procedures, the lung uptake ratio of _2_0_1Tl was calculated by ratio of L/T, and expressed as percentage per entire unilateral lung and mean value (%) per pixel. The average values of the lung uptake ratio in circulatory diseases were 4.0 +- 1.2% in the right lung, 2.7 +- 1.2% in the left lung, and in respiratory diseases 4.5 +- 2.1% and 2.3 +- 1.0%, respectively. This technique is useful to quantify the lung uptake of _2_0_1Tl on the lung scintigram with _2_0_1TlCl. (author)

1982-01-01

243

Clinical evaluation of "2"0"1Tl-chloride scintigraphy for breast tumors  

International Nuclear Information System (INIS)

Fifty-two patients with breast tumors were scintigraphed with "2"0"1Tl-chloride. Each one was given a histological diagnosis after surgery or excisional biopsy. In 39 cases of primary breast cancer, 27 cases (69.2 %) showed a positive figure by "2"0"1Tl-chloride scintigraphy. In five cases of local recurrent breast cancer, four cases (80 %) showed a positive figure. In examining each histological type of primary breast cancer, in 10 cases of papillotubular carcinoma, seven (70 %) were positive with "2"0"1Tl-chloride. In 20 patients with medullary tubular carcinoma, 17 cases (85 %) revealed a positive figure. In nine cases of scirrhous carcinoma, only three cases (33.3 %) were positive. Some cases showed an accumulation in the metastatic lymph nodes of the axilla with "2"0"1Tl-chloride. In three cases of phyllodes tumor, two cases (66.7 %) were positive. On the other hand, all cases of benign breast tumors showed a negative figure by "2"0"1Tl-chloride scintigraphy. As to the uptake ratio of "2"0"1Tl-chloride into the breast carcinoma tissue, it was observed that papillotubular carcinoma absorbed 5.8 times as much as normal mammary gland tissue, medullary tubular carcinoma absorbed 4.7 times as much, scirrhous carcinoma absorbed 3.3 times as much as normal mammary gland tissue. In recurrent breast cancer, "2"0"1Tl-chloride scintigraphy is a useful procedure in determining the malignant area and in judging the effect of treatment. From the above mentioned results, it was concluded that "2"0"1Tl-chloride has specific affinity for malignant breast tumors and it is also very useful tumor-seeking agent to detect the early recurrent breast cancer. (author)

1985-01-01

244

Evaluation of dilated cardiomyopathy by stress Tl-201 myocardial single photon emission computed tomography (SPECT)  

International Nuclear Information System (INIS)

Stress Tl-201 myocardial SPECT was performed in 20 dilated cardiomyopathy (DCM) and 23 old myocardial infarction (OMI: ED volume ? 200 ml by left ventriculography = LVG) for non-invasive diagnosis of DCM. We assessed the perfusion abnormality of 5 segments (anterior-anterolateral, septal, apical, posterolateral, postero-inferior) in SPECT images in grades as follows; 0: normal, 1: mild low uptake, 2: severe low uptake, 3: complete defect. Thus, we defined the abnormal perfusion score (APS) as the summation of the grades in 5 segments. 1) Perfusion abnormality was found 85 % in DCM and 100 % in OMI by stress SPECT images. 2) Rare complete defect, abnormal perfusion segments under 3 and APS under 7 were characteristic findings in DCM, and could finally distinguish DCM from OMI with the finding of APS under 7 (18/20: 90 %) in stress images. 3) The perfusion abnormality in delayed images had a good relation with wall motion abnormality in OMI, but not DCM. 4) Redistribution was found only 3 cases with DCM (15 %) and 9 cases with OMI (39 %), but mild without 2 cases with OMI. 5) Inspite of exercise induced severe symptom and arrhythmia in some DCM cases, stress SPECT was efficient especially to rule out ischemic heart disease. Thus, we conclude that stress Tl-201 myocardial SPECT is useful method for the non-invasive differential diagnosis of DCM from ischemic heart disease, but wall motion abnormality has no good relation with perfusion abnormality. (author)

1986-01-01

245

Studies on the diagnosis of uterine body cancer using "2"0"1Tl-chloride  

International Nuclear Information System (INIS)

"2"0"1Tl scintigraphy was performed in 18 patients with cancer of uterine body, and the results were compared with histopathological findings. With six patients, "2"0"1Tl distribution in the pelvic cavity was registered in the minicomputer, and the time activity curve was plotted. Analysis of "2"0"1Tl distribution using ROI revealed that the radioactivity in the uterus was approximately 1.47 times as high as that in background. In the removed uterus, the radioactivity in the cancer was calculated to be approximately 1.9 times as high as that in the myometrium. In all 13 patients with Stage Ib or higher cancer, obvious activity in the uterus coinciding with the lesion was obtained shortly after the intravenous administration of "2"0"1Tl-Cl. Though accumulation of activity in the uterus was obtained in three of five patients with Stage Ia cancer, it was interpreted as false-positive, because myoma or adenomyosis was present in addition to cancer in these three patients, and such a complication seemed responsible for the positive result. The sensitivity, specificity and accuracy of "2"0"1Tl scintigraphy in diagnosing cancer of the uterine body were 86.7, 0 and 72.2%, respectively. These results suggest that "2"0"1Tl scintigraphy is a promising diagnostic aid for cancer of the uterine body. (author)

1985-01-01

246

Identification of viable myocardium by 201Tl scintigraphy: a comparison of methods  

International Nuclear Information System (INIS)

The present study was undertaken to compare four different imaging approaches to evaluate uptake defect reversibility. 24 infracted patients underwent standard stress/redistribution 201Tl imaging (R1). Then, after (R2) 24 h later (R3). A separate rest study (R4) following a new tracer injection was done within 2-3 days. Planar images were obtained in the standard three views and subdivided into 216 segments for qualitative analysis based on a visual score. A semiquantitative analysis based upon circumferential profiles was also applied. A stress defect was found in 127 sements (58.7%). By visual inspection reperfusion was considered to occur in 32.3%, 41.7%, 33.0% and 49.6% of the cases with R1, R2, R3, and R4, respectively. The semiquantitative method showed a high reperfusion only with R1 (62%), while the other procedures proved less effective. No improvement was found with R4. Six patients (25%) showed myocardial viability that was not detected with the early reinjection technique. (orig.)

1993-08-01

247

Comparison of left ventricular ejection fraction by 201Tl gated SPECT and gated blood pool scan  

International Nuclear Information System (INIS)

Full text: The aim of this study was to evaluate left ventricular ejection fraction (LVEF) determination by the Germano 201Tl gated-SPECT myocardial perfusion (TLGSMP) method using gated blood pool scintigraphy (GBPS) as a reference. 21 patients underwent both TLGSMP and GBPS within eight days of each other from June 1997 to Jan 2000. Acquisition of TLGSMP was performed on a GE Optima NX dual head camera using Tl-201 dose of 1.5MBq/Kg and imaging time of 45 cardiac cycles/step with 16 steps/90 Deg of rotation per detector. All LVEF results were determined using a GE Genie workstation. GBPS results were compared with TLGSMP results for LVEF obtained from the reinjection images using automated Germano processing, and from the stress images using automatic and manual processing. Duplicate automatic analysis by a second observer produced identical mean TLGSMP LVEF results (r = 0.99). Stress TLGSMP LVEF by the automatic and manual processing correlate well (r = 0.99) but the manual LVEF is significantly lower. In conclusion LVEF determination using TLGSMP is highly reproducible and is also accurate when applied to reinjection data. Both manual processing and the use of stress data lead to underestimation of LVEF. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

2000-09-01

248

Single photon emission computed tomography of technetium-99m tetrofosmin myocardial perfusion imaging in patients with systemic lupus erythematosus-A preliminary report  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the utility of single-photon emission computed tomography (SPECT) of technetium-99m tetrofosmin (Tc-99m TF) myocardial perfusion imaging to detect myocardial involvement in patients with systemic lupus erythematosus (SLE). Three groups of subjects-group 1: 25 SLE female patients with non-specific cardiac symptoms and signs, group 2: 25 female SLE patients without any cardiac symptoms and signs, and group 3: 25 female healthy controls-were evaluated by comparing rest and dipyridamole-stress Tc-99m TF myocardial perfusion SPECT. Tc-99m TF myocardial perfusion SPECT revealed perfusion defects in 88% and 40% of the cases in groups 1 and 2, respectively. However, no cases in group 3 demonstrated myocardial perfusion defects. Tc-99m TF myocardial perfusion SPECT is a useful noninvasive imaging modality to detect cardiac involvement in SLE patients with or without cardiac symptoms and signs. (author)

2003-01-01

249

Value of {sup 123}I-BMIPP scintigraphy in patients with ischemic heart disease. Comparison with exercise {sup 201}Tl SPECT  

Energy Technology Data Exchange (ETDEWEB)

To evaluate {sup 123}I labeled beta-methyl-branched fatty acid (BMIPP) myocardial uptake at rest in the segment with and without stress induced ischemia in patients with coronary artery disease, {sup 123}I-beta-methyl-branched fatty acid myocardial scintigraphy was performed at rest and was compared with the findings of stress-reinjection {sup 201}Tl myocardial scintigraphy in 31 patients with coronary artery disease. In 159 ischemic myocardial segments, equally decreased uptake on both reinjection {sup 201}Tl and fatty acid images was observed in 64 segments, more severely decreased uptake of fatty acid in 76 segments, and more severely decreased uptake of reinjection thallium in 19 segments. On the other hand, in 53 non-reversible defects, each patterns was observed in 41, 3, and 9 segments respectively. When comparing the ischemic segments with more reduced uptake of fatty acid than reinjection thallium (Group 1) and the ischemic segments with equally or less reduced fatty acid uptake than reinjection thallium (Group 2), wall motion was more severely impaired in Group 1 than in Group 2 (severe hypo- to dyskinesis was present in 32 of 54 segments in group 1 and in 21 of 75 segments in group 2, p<0.005). In conclusion, in patients with coronary artery disease, resting fatty acid uptake was frequently more reduced than reinjection {sup 201}Tl in the segments with stress induced ischemia and wall motion was more impaired in these segments. BMIPP myocardial imaging may provide information on metabolic alterations at rest independent of perfusion abnormalities in patients with coronary artery disease. (author).

Taki, Junichi; Nakajima, Kenichi; Matsunari, Ichiro; Bunko, Hisashi; Takada, Shigeo; Muramori, Akira; Tonami, Norihisa; Hisada, Kinichi [Kanazawa Univ. (Japan). School of Medicine

1995-04-01

250

The dobutamine stress Tl-201 myocardial single photon emission computed tomography for coronary artery stenosis caused by Kawasaki disease  

International Nuclear Information System (INIS)

Noninvasive cardiac imaging with pharmacologic stress Tl-201 single photon emission computed tomography (SPECT) as an alternative to exercise test is now getting popular for patients with Kawasaki disease. Dobutamine infusion produces hemodynamic change which is quite similar to exercise induced hemodynamic change. Material consisted of 17 patients (13 males, 4 females) with coronary occlusion or significant coronary stenosis (?75% diameter stenosis) caused by Kawasaki disease. After step-wise infusion of dobutamine up to 40 ?g/kg/min., quantitative analysis of Tl-201 SPECT was obtained. No patient had a symptomatic arrhythmia or severely stress-induced ischemia. The sensitivity and specificity of dobutamine induced perfusion defects were 65% (11 to 17) and 92% (1 of 13) respectively. The sensitivity was 87% (7 of 8) in patients with the left coronary artery lesions and 46% (6 of 13) in patients with the right coronary artery lesions. We conclude that a quantitative analysis of Tl-201 SPECT after step-wise infusion of dobutamine is a safe and clinically useful method for detection of stress-induced myocardial ischemia in coronary artery stenosis caused by Kawasaki disease. (author)

1994-05-01

251

Myocardial sestamibi single-photon emission tomography: variations in reference values with gender, age and rest versus stress?  

International Nuclear Information System (INIS)

Reference data files support the evaluation of myocardial perfusion single-photon emission tomography (SPET). The aim of this study was to create a large reference data base for technetium-99m sestamibi SPET, age and gender matched to the general patient population. One hundred and twenty-eight healthy volunteers (76 males and 52 females) with a likelihood of coronary artery disease of less than 5% underwent rest and maximal exercise 99mTc-sestamibi SPET with a 2-day protocol and 180 elliptical rotation. The normalized activity values of 99mTc-sestamibi in the inferior wall differed significantly between men and women. Age variations were found for men in the anterior wall. Normalized activity values in all four walls were strikingly similar during rest and stress. Our results suggest that the use of reference files in 99mTc-sestamibi SPET requires a gender- and, for males, possibly an age-matched reference population. Different reference files at rest and during stress might not be necessary. (orig.). With 3 figs., 3 tabs

1997-04-01

252

Evaluation of "2"0"1Tl-accumulation in lung  

International Nuclear Information System (INIS)

In order to evaluate "2"0"1Tl-accumulation in lung, "2"0"1Tl imaging was performed using a scintillation camera coupling to a small digital computer, and blood clearance of it was examined. After the injection of 74MBq(2mCi) of "2"0"1Tl-chloride, the serial images and static images were obtained. In order to obtain the image of "2"0"1Tl in the extravascular space [T sub(E)(x, y)], a subtraction technique was performed as follows; after 2 anterior views of "2"0"1Tl were obtained using a 20% window centered at 80 keV[T_0(x, y)] and 140 keV[T_1_4_0(x, y)] respectively, and blood sample was taken, radionuclide angiocardiography with 185 MBq(5mCi) of sup(99m)Tc-human serum albumin and it's static image were done in the same supine position and blood sample was taken too. The radioactivity of "2"0"1Tl(T) and sup(99m)Tc(H sub(B)) in the blood was counted by a autogamma scintillation counter. Then the image of T sub(E)(x, y) was obtained by the following formula; T sub(E)(x, y) = T_0(x, y) - [H(x, y) - T_1_4_0(x, y)]T sub(B)/H sub(B). Following results were obtained; (1) The disappearance of "2"0"1Tl from the blood was rapid and 15 min after the injection only 10 -- 15% of the activity after 1 min was present in the blood. (2) The lung activity in the time activity curve decreased rapidly to reach plateau within 100 -- 150 sec after the injection. (3) The image of "2"0"1Tl in the extravascular space was nearly equal to the original one as regard to the radioactivity of "2"0"1Tl in lung. (author)

1982-01-01

253

Clinical usefulness of the 201Tl-chloride scintigraphy in the chronic thyroiditis  

International Nuclear Information System (INIS)

The thyroid scintigraphy with 123I and 201Tl-Chloride was performed for 32 patients with clinically proven chronic thyroiditis. Iodine-123 scintigrams showed varicus appearances, which were diffusely enlarged, mottled, cold nodullar and non visualizing patterns. The mottled pattern was the most common and seen in 16 out of 32 patients (50%). On the other hand, the 201Tl early scintigram performed within 15 minutes after intravenous injection demonstrated homogeneous high activity in the whole thyroid gland and in the 201Tl delayed scintigram performed 3 hours after the injection, the accumulation of 201Tl remained in the whole thyroid gland relatively strong compared to the background activity. The possibility to detect coexisting thyroid carcinoma in the chronic thyroiditis was described. Differential points between chronic thyroiditis and analplastic carcinoma involving whole thyroid gland in which thyroid gland was not visualized with 123I scintigram was discussed. We believe that 201Tl-early and delayed scintigrams could be one of useful non-invasive methods to diagnose chronic thyroiditis. (author)

1982-01-01

254

Production of 201Tl and 203Pb via proton induced nuclear reactions on natural thallium  

International Nuclear Information System (INIS)

Excitation functions for the formation of sup(204m)Pb, 203Pb, sup(202m)Pb, 201Pb, 200Pb, 199Pb, 202Tl and 201Tl in the interactions of natural thallium with protons have been measured by the stacked-foil technique within the energy range of 8-45 Mev. For the production of both the medically important radioisotopes 201Tl and 203Pb in a high radionuclide purity, the optimum incident proton energy was found to be 28 MeV and, theoretically, thick target yields of 0.50 mCi ?Ah-1 and 3.5 mCi ?Ah-1, respectively, were achieved. The whole-body radiation dose due to the 200Tl contaminant is five times higher than that due to 201Tl. A target system for the production of 201Tl and 203Pb in a high current compact cyclotron is described. Some observations of the radiochemical separation of lead and thallium are discussed. A procedure for the carrier-free separation of 203Pb and 201Tl activities, employing anion-exchange chromatography, as well as methods for the analytical quality control of the final products are described. (author)

1979-01-01

255

Detection of impaired fatty acid metabolism in right ventricular hypertrophy. Assessment by I-123 {beta}-methyl iodophenyl pentadecanoic acid (BMIPP) myocardial single-photon emission computed tomography  

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The subjects consisted of 6 patients with chronic obstructive pulmonary disease, 4 with primary pulmonary hypertension, 2 each with refractory pulmonary tuberculosis, tricuspid insufficiency, pulmonary embolism, 1 each with atrial septal defect, ventricular septal defect (Eisenmenger complex), Ebstein anomaly, and endocardial defect, and 7 healthy controls. SPECT imaging with Tl-201 (Tl) and I-123 BMIPP, and Tc-99m RBC first pass and gated blood pool scintigraphy were performed. Based on Tl planar images, the subjects were classified into 3 groups: 7 patients with no RV visualization (Group A), 11 with moderate RV visualization (Group B) and 9 with marked RV visualization (Group C). As a semi-quantitative evaluation by a myocardial SPECT, 3 regions in 3 representative short axial images were divided into 9 segments, each of which was graded from 0 to +3, and their sum was calculated as the RV score. The right ventricular ejection fraction (RVEF) and the left ventricular ejection fraction were obtained by Tc-99m RBC cardiac scintigraphy. The groups with marked visualization of the right ventricle had lower RVEF, and there was a good correlation between the RVEF and the RV score with both a and BMIPP. Although a good correlation was demonstrated between the RV score with Tl and BMIPP in Groups A and B, in Group C, in which there was marked RV Tl visualization, the RV score with BMIPP was significantly smaller than with Tl. These findings suggest that impaired fatty acid metabolism may exist in severely hypertrophic right ventricle due to RV overload. (K.H.)

Kim, Yong-ih; Goto, Hideki; Kobayashi, Katsuhiro; Sawada, Yoshihiro; Miyake, Yoshitaka; Fujiwara, Go [Nishiyodo Hospital, Osaka (Japan); Chiba, Hiroshi; Okada, Tomoya; Nishimura, Tsunehiko

1997-08-01

256

Genotoxicity of thallium-201 in patients with angina pectoris undergoing myocardial perfusion study  

International Nuclear Information System (INIS)

Thallium-201 (201Tl) has been widely used as a nuclear reagent for myocardial blood flow imaging. The purpose of this study was to investigate genotoxic effects of 201Tl in patients with angina pectoris (n=21), who had undergone myocardial perfusion imaging. Lymphocytes were isolated from each patient before, and 3, 30 and 90 days after 201Tl administration (111 MBq, 3 mCi) and were analyzed for chromosomal aberrations, sister chromatid exchanges, mitotic index and replicative index. There were significant increases in chromosomal aberrations and sister chromatid exchanges 3 days after 201Tl administration (p0.05). Moreover, decreased mitotic index and replicative index were noted after 3 days of 201Tl administration (p201Tl for myocardial blood flow imaging may induce genetic damage. (author)

2005-08-01

257

Clinical evaluation of 99mTc-CPI myocardial perfusion single photon emission computerized tomography in the diagnosis of coronary heart disease  

International Nuclear Information System (INIS)

Two normal subjects, 5 patients with old myocardial infarction (OMI) and 4 patients with angina pectoris were examined by rest single photon emission computerized tomography revealed that the right ventricular was not imaged, the left ventricular was well exposed in the normal subjects. All the 9 patients had defects in the left ventricle. comparison of SPECT with 99mTc-CPI with selective coronary arteriography (SCA), echocardiography (UCG), dynamic electrocardiography (DCG) and electrocardiographic (ECG)-exercise test in the diagnosis of myocardial ischemia or necrosis has demonstrated the former to be more significantly sensitive than the latter four. Good agreement between SPECT and SCA has been confirmed

1991-04-01

258

Statistical indices of "2"0"1Tl distribution in the myocardium in various diseases  

International Nuclear Information System (INIS)

A study was made of the diagnostic potentialities of a histogram analysis of scintillation counting distribution on myocardium scans using "2"0"1Tl in 9 patients with dilatational cardiomyopathy, 12 patients with coronary heart disease and 6 patients with primary pulmonary hypertension. Scans were recorded 10 min., 4 and 24 h after a single administration of "2"0"1Tl at rest in the front-forward, 45 deg left forward oblique and left lateral projections. The author showed a possibility of group distinction by scintillation counting distribution in the heart area on myocardium scans using "2"0"1Tl, the distinguishing information being within the interval of 41-80% of maximum intensity in this area

1987-01-01

259

Removal of 99mTc and 201Tl by means of Lemna Gibba  

International Nuclear Information System (INIS)

In this work the capacity of the water macrophyte Lemna gibba coming from San Pedro Tultepec in the Mexico State was studied to remove the radioisotopes 99mTc and 201Tl, in order to show the capacity of this macrophyte for to treat some radioactive waste flowing that could contain this radioisotopes type. The removal capacity of 99mTc and 201Tl of the macrophyte Lemna gibba was determined using the batch method. In accordance with the values of the obtained Kd, the Lemna gibba with a size of particle diameter among 1mm - 300 ?m presents a better adsorption of 99mTc. The 201Tl is adsorbed better in the bioadsorbent when it has a size of particle diameter <150?m. (Author)

2012-08-01

260

Production of 'no-carrier-added' /sup 201/Tl  

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A procedure has been developed for producing a radiopharmaceutically pure ''no-carrier-added'' /sup 201/Tl. The procedure is based on irradiating enriched metallic thallium (> 96% /sup 203/Tl) targets with approx. 30 Mev protons, separating /sup 201/Pb by co-precipitation with SrSO/sub 4/ from sulphuric acid solution, and extracting /sup 201/Tl (after its in-growth) with butyl acetate from a hydrochloric solution. The average overall yield of /sup 201/Tl is approx. 92%. The radioactive concentration of the product exceeds 2 mCi/mL; radionuclide impurities-/sup 200/Tl <= 0.5%; /sup 202/Tl <= 0.1%; /sup 203/Pb <= 0.02%; inactive impurities (..mu..g/mL)-Tl < 2, Sr < 1, Fe < 0.25, Cu < 0.05; pH within the range 5-8. The product is sterile, apyrogenic, and suitable for clinical application.

Malinin, A.B.; Kozlova, M.D.; Sevastyanova, A.S. (Ministry of Health, Moscow (USSR). Inst. of Biophysics)

1984-07-01

 
 
 
 
261

Myocardial imaging with thallium-201 for assessment of regional myocardial perfusion and viability after intracoronary thrombolytic therapy  

International Nuclear Information System (INIS)

Whereas coronary arteriography demonstrates success of reflow or recanalization after intracoronary thrombolysis, myocardial perfusion imaging with thallium-201 (201Tl) permits assessment of viability of reperfused myocytes. The initial distribution of 201Tl in the myocardium immediately after intravenous injection is the result of both blood flow delivery of the radionuclide to the heart and the extraction fraction for 201Tl. If 201Tl is administered during a period of coronary occlusion, a scintigraphic defect will be observed in the territory of the occluded vessel. If, subsequently, blood flow is restored, as with reperfusion, and cellular kinetics transport of 201Tl returns to normal, myocardial regions initially deprived of 201Tl will demonstrate delayed redistribution and the defect will tend to normalize within several hours. In a sustained coronary occlusion, the defect will persist after 201Tl injection. Specific imaging protocols that have been or can be used to assess thrombolytic therapy are reviewed. If intracoronary streptokinase infusion is associated with a substantial enhancement of perfusion and preservation of cellular integrity in the ischemic zone, delayed 201Tl images obtained several hours after intravenous injection of the radionuclide will demonstrate significantly more 201Tl activity than the images before reflow. Direct intracoronary injections of 201Tl down the infarct vessel have also been used to evaluate the benefit of thrombolytic therapy by the demonstration of increased 201Tl uptake after reperfusion in the ischemic zone. Finally, computer methods for subtracting serial images obtained after two separate intravenous 201Tl injections administered before and after streptokinase infusion might be used to derive a ''functional image'' of the ischemic region that would quantitatively be proportional to the amount of myocardial salvage achieved

1983-01-01

262

201Tl brain SPECT in differentiating central nervous system lymphoma from toxoplasmosis in AIDS patients  

International Nuclear Information System (INIS)

In AIDS patients, toxoplasmosis and lymphoma are the leading causes of CNS mass lesions. It is important to make the correct diagnosis expeditiously, since the two diseases require markedly different treatments and have different prognoses. In general, CT and MR imaging have failed to provide specific distinguishing characteristics to differentiate CNS lymphoma from toxoplasmosis, and it is difficult to differentiate these entities clinically. We performed 201Tl brain SPECT in order to differentiate two diseases. Counts ratio of a lesion to the normal brain (L/N ratio) was elevated in patients of lymphoma compared in patients of toxoplasmosis. 201Tl brain SPECT is useful to differentiate CNS lymphoma from toxoplasmosis. (author)

1997-11-01

263

Preparation and biodistribution of [201Tl](III) vancomycin complex in normal rats  

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Objectives: Thallium-201 (T1/2=3.04d) has been used in clinical nuclear cardiology and oncology for 3 decades. The development of [201Tl](III)radiopharmaceuticals could provide many advantages: the chemistry of [201Tl](III)complexation molecule is simple and the complexation constant for most of Tl(III) complexes are among the highest. A wide variety of radiopharmaceuticals have been proposed for the scintigraphic detection of inflammatory and infectious disease. [67Ga]Citrate, being the most...

2006-01-01

264

201Tl-SPECT, 1H-MRS, and MIB-1 labeling index of central neurocytomas: three case reports  

International Nuclear Information System (INIS)

Background: The proliferative activity and metabolic features of three central neurocytomas were investigated using the findings of thallium-201 single photon emission computed tomography (201Tl-SPECT) and proton magnetic resonance spectroscopy (1H-MRS), and the MIB-1 labeling index (MIB-1 LI). Method: The early and delayed 201TI indices were calculated as the ratio of tumor to normal brain tissue uptake by 201TI-SPECT. In vivo single-voxel 1H-MRS was performed with echo time of 272 msec to evaluate the metabolites including choline (Cho), N-acetyl aspartate (NAA) and creatine/phosphocreatine (Cre). An external standard reference was used to semiquantitate each metabolite. MIB-1 LI was determined in the surgical specimens. Findings: The MIB-l LI was 0.5 %, 1.2 %, and 7.5 % in an atypical central neurocytoma without intraventricular extension. Significant 201TI uptake was observed on delayed images in all three central neurocytomas. 1H-MRS showed the high Cho peaks relative to the NAA and Cre peak. The signal at 3.55 ppm, which may be due to inositol or glycine, was observed in one central neurocytoma. Interpretation: Both 201TI-SPECT and 1H-MRS did not reflect the proliferative potential of central neurocytomas. (author)

2002-01-01

265

Comparison of post-exercise and post-vasodilator stress myocardial stunning as assessed by electrocardiogram-gated single-photon emission computed tomography  

International Nuclear Information System (INIS)

Exercise gated single-photon emission computed tomography (SPECT) using technetium-99m (99mTc)-sestamibi evaluates both myocardial perfusion during stress and wall motion >30 min after the stress, which has the potential to assess not only exercise-induced myocardial ischemia but also the development of myocardial stunning. To evaluate the incidence of post-stress myocardial stunning, as well as comparing the effects of different stress methods on the development of stunning, 179 consecutive patients with known or suspected coronary artery disease (CAD) underwent 99mTc-sestamibi SPECT with either exercise (n=135) or adenosine triphosphate disodium (ATP) (n=44). Electrocardiogram-gated SPECT images were acquired >30 min after the stress and again 4 h later, and perfusion and wall motion were evaluated. Post-stress myocardial stunning occurred in 24 patients (13%): 22 after exercise and 2 after ATP stress. The magnitude of the transient wall motion abnormality after exercise was greater in patients with severe ischemia, compared with those with mild-to-moderate ischemia (p99mTc-sestamibi gated SPECT, myocardial stunning is frequently observed after exercise and correlates with the severity of myocardial ischemia, but this does not occur with ATP, which is regarded as a specific marker for severe CAD. (author)

2005-11-01

266

Quantitative evaluation of thallium-201 myocardial scintigram in coronary artery diseases  

International Nuclear Information System (INIS)

Quantitative indices from circumferential profile curves of thallium-201 (201Tl) myocardial scintigram were evaluated for diagnostic utility in coronary artery diseases (CAD). Myocardial 201Tl scintigrams with single photon emission computed tomography (SPECT) were obtained 5 minutes (early) and 4 hours (delayed) after exercise in 20 normal subjects and 66 cases of CAD, of which 20 were angina pectoris without myocardial infarction (AP), 14 were subendocardial infarction (non-QMI) and 32 were Q-wave infarction (QMI). Tl counts, %Tl uptake and washout ratio (WR) were measured in 81 segments (9 apical segments of the slice from the longitudinal axis and all 72 segments of two slices from the short axis). A mean early defect (MED), a mean delayed defect (MDD), a mean delta washout rate (MDR), and a ? delayed defect (?DD) were calculated from the areas which were below the two standard deviations of the mean %Tl uptake in normal subjects. A mean filling-in (MFI) was calculated from the difference of the %Tl uptake between early and delayed curves in each patient. In patients with CAD, the MED and MFI were higher, but MDW was lower with a more severe coronary stenosis, indicating that these indices were useful to detect myocardial hypo-perfuion. In severely stenotic regions, the MDD was higher in QMI than in AP and non-QMI, indicating that the ratio of infarct to the myocardium in the region was higher in QMI. In QMI, ?DD correlated well (r=0.723) with Total Wall Motion Scores with two-dimentional echocardiography which was directly related with infarct size. Further, MED, MFI and MDW were improved after aortocoronary bypass only in patients with patent graft. It is concluded that this quantitative evaluation with 201Tl-SPECT can provide an objective and quantitative estimate of regional myocardial ischemia and infarct. (author)

1992-11-01

267

Technetium-99m pyrophosphate/thallium-201 dual-isotope SPECT imaging predicts reperfusion injury in patients with acute myocardial infarction after reperfusion  

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Microcirculatory failure after reperfusion is clinically indicated to cause reperfusion injury whereas excessive intracellular calcium ion overload is experimentally proved as a key mechanism of reperfusion injury. We hypothesized that technetium-99m ({sup 99m}Tc) pyrophosphate (Tc-PYP) uptake in injured but viable infarct-related myocardium with preserved myocardial perfusion after reperfusion estimated by thallium-201 ({sup 201}Tl) uptake would be associated with final functional recovery. Dual-isotope Tc-PYP/{sup 201}Tl single-photon emission computed tomography (SPECT) was performed 2 days after successful reperfusion therapy in patients with first acute myocardial infarction, and 50 patients (63 {+-} 13 years old, female 22%) with preserved {sup 201}Tl uptakes of {>=}50% in reperfused myocardium was followed for 1 month. Tc-PYP uptake was assessed as the heart-to-sternum (H/S) ratio. Two-dimensional echocardiography was also performed 2 days and 1 month after reperfusion to evaluate functional recovery. High Tc-PYP uptake, defined as the H/S ratio {>=}0.81, was predictive of chronic phase no functional recovery (73.7% in 14 of 19 patients with high uptake vs 16.1% in five of 31 patients without those, p < 0.0001). After adjustment for potential confounding variables, including electrocardiographic persistent ST segment elevation at 1 h after reperfusion, high Tc-PYP uptake remained independently predictive of no functional recovery with odds ratio of 8.7 (95% confidential interval = 2 to 38.7; p = 0.005). High Tc-PYP uptake in reperfused but viable infarct-related myocardium was a powerful predictor of no functional recovery, which may reflect excessive intracellular calcium ion overload caused by reperfusion injury. Tc-PYP/{sup 201}Tl dual-isotope SPECT imaging can provide prognostic information after reperfusion. (orig.)

Akutsu, Yasushi; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Nishimura, Hideki; Hamazaki, Yuji; Kobayashi, Youichi [Showa University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo (Japan); Suyama, Jumpei; Shinozuka, Akira; Gokan, Takehiko [Showa University School of Medicine, Department of Radiology, Tokyo (Japan)

2009-02-15

268

Diagnostic potentialities of scintigraphy of the myocardium with 201Tl chloride  

International Nuclear Information System (INIS)

Application of standard methods of collection, processing and interpretation of scintigraphy results, obtained with the use of 201Tl enables to answer a series of diagnostic questions concerning morphological and functional state of the left ventricle and heart on the whole, extends the method far beyond the scope of traditional perfused scintigraphy and is a good assistance in cardiological practice

1989-01-01

269

Transient QT interval prolongation with inverted T waves indicates myocardial salvage on dual radionuclide single-photon emission computed tomography in acute anterior myocardial infarction  

International Nuclear Information System (INIS)

In patients with acute myocardial infarction (AMI), transient QT interval prolongation with a prominent negative T wave is frequently observed in cases of early spontaneous reperfusion and often indicates a good prognosis. Additionally, in nuclear cardiac imaging, technetium-99m/thallium-201 overlap on dual single-photon emission computed tomography (dual SPECT) in AMI patients indicates the presence of viable myocardium and early recanalization. To elucidate the clinical significance of this transient QT interval prolongation, 34 patients (64±8 years) admitted within 24 h of the onset of anterior AMI were enrolled and classified into 2 groups according to the presence (group A, n=24) or absence (group B, n=10) of scintigraphic overlap on simultaneous dual SPECT imaging. The maximal QTc interval was 0.59±0.06 s in group A and 0.52±0.06 s in group B (p<0.01). The peak creatine kinase was lower in group A (2650±2160 IU/L) than in group B (3490±2060 IU/L). The left ventricular ejection fraction (LVEF) at discharge was 62±11% in group A and 49±14% in group B (p<0.01). The scintigraphic overlap group had a smaller infarct and better LVEF, which suggests that the QT interval prolongation that appears transiently in the acute phase of AMI indicates scintigraphically the presence of salvaged myocardium. (author)

2001-01-01

270

Transient QT interval prolongation with inverted T waves indicates myocardial salvage on dual radionuclide single-photon emission computed tomography in acute anterior myocardial infarction  

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In patients with acute myocardial infarction (AMI), transient QT interval prolongation with a prominent negative T wave is frequently observed in cases of early spontaneous reperfusion and often indicates a good prognosis. Additionally, in nuclear cardiac imaging, technetium-99m/thallium-201 overlap on dual single-photon emission computed tomography (dual SPECT) in AMI patients indicates the presence of viable myocardium and early recanalization. To elucidate the clinical significance of this transient QT interval prolongation, 34 patients (64{+-}8 years) admitted within 24 h of the onset of anterior AMI were enrolled and classified into 2 groups according to the presence (group A, n=24) or absence (group B, n=10) of scintigraphic overlap on simultaneous dual SPECT imaging. The maximal QTc interval was 0.59{+-}0.06 s in group A and 0.52{+-}0.06 s in group B (p<0.01). The peak creatine kinase was lower in group A (2650{+-}2160 IU/L) than in group B (3490{+-}2060 IU/L). The left ventricular ejection fraction (LVEF) at discharge was 62{+-}11% in group A and 49{+-}14% in group B (p<0.01). The scintigraphic overlap group had a smaller infarct and better LVEF, which suggests that the QT interval prolongation that appears transiently in the acute phase of AMI indicates scintigraphically the presence of salvaged myocardium. (author)

Obayashi, Tohru; Tokunaga, Takeshi; Iiizumi, Tomohiro; Shiigai, Tatsuo [Toride Kyodo General Hospital, Ibaraki (Japan); Hiroe, Michiaki; Marumo, Fumiaki

2001-01-01

271

Gallium-67 myocardial imaging for the detection of myocarditis in the acute phase of Kawasaki disease (mucocutaneous lymph node syndrome): the usefulness of single photon emission computed tomography.  

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Myocardial imaging with gallium-67 citrate was used to detect myocarditis in 46 consecutive infants and children (31 boys and 15 girls, mean age 21 months) with Kawasaki disease. In all of them planar imaging (group A) was performed at 6 hours and at 48 or 72 hours after the intravenous administration of a mean (SD) dose of gallium-67 citrate (0.07 (0.02) mCi/kg). Thirty four patients (24 boys and 10 girls, mean age 21 months) also had single photon emission computed tomography imaging (group...

1987-01-01

272

Effect of ribose on thallium-201 myocardial redistribution  

International Nuclear Information System (INIS)

Myocardial 201Tl redistribution after transient ischemia may be too slow to allow identification of a reversible myocardial defect within the routine 201Tl imaging period. To determine whether 201Tl redistribution could be affected by a metabolic intervention, intravenous ribose was administered postischemia. Seventeen domestic swine were subjected to a 10-min ischemic period followed by either a 30-min i.v. ribose (n = 8) or saline (n = 9) infusion. Thallium-201 was injected during ischemia and myocardial 201Tl activity was continuously monitored in ischemic and nonischemic regions with miniature CdTe radiation detection probes. Coronary flow in the ischemic region was reduced to 25% of that in the nonischemic regions in both saline and ribose groups. The 201Tl time-activity curves demonstrated a significant enhancement of % 201Tl redistribution in the ribose-treated animals at the end of ribose infusion: Ribose (48 +/- 11%), Saline (20 +/- 4%), p less than 0.05. Alteration of 201Tl kinetics by ribose may permit earlier recognition of 201Tl myocardial redistribution after transient ischemia

1988-01-01

273

Prognostic value of technetium-99m-labeled single-photon emission computerized tomography in the follow-up of patients after their first myocardial revascularization surgery  

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Full Text Available OBJECTIVE: To assess the prognostic value of Technetium-99m-labeled single-photon emission computerized tomography (SPECT in the follow-up of patients who had undergone their first myocardial revascularization. METHODS: We carried out a retrospective study of 280 revascularized patients undergoing myocardial scintigraphy under stress (exercise or pharmacological stress with dipyridamole and at rest according to a 2-day protocol. A set of clinical, stress electrocardiographic and scintigraphic variables was assessed. Cardiac events were classified as "major" (death, infarction, unstable angina and "any" (major event or coronary angioplasty or new myocardial revascularization surgery. RESULTS: Thirty-six major events occurred as follows: 3 deaths, 11 infarctions, and 22 unstable anginas. In regard to any event, 22 angioplasties and 7 new surgeries occurred in addition to major events, resulting a total of 65 events. The sensitivity of scintigraphy in prognosticating a major event or any event was, respectively, 55% and 58%, showing a negative predictive value of 90% and 83%, respectively. Diabetes mellitus, inconclusive stress electrocardiography, and a scintigraphic visualization of left ventricular enlargement were significant variables for the occurrence of a major event. On multivariate analysis, abnormal myocardial scintigraphy was a predictor of any event. CONCLUSION: Myocardial perfusion tomography with Technetium-99m may be used to identify high-risk patients after their first myocardial revascularization surgery.

Santos Márcia Maria Sales dos

2003-01-01

274

Autoradiography with 201Tl and our clinical experience  

International Nuclear Information System (INIS)

Thallium-201 has been suggested as a useful diagnostic agent for myocardial scanning. We report herewith the clinical usefulness of Tl-201 as a result of our animal studies with rats as well as clinical trial for human being. After intravenous injection, we killed rats at regular intervals, then measured the activity in each anatomized organ by ?-well counter and observed the internal distribution and examined autoradiograms with the naked eye. As a result, the accumulation of Tl-201 in the myocardium observed in 5 min after injection, reaching the maximum level in 30 min and gradually decreased hereafter. We performed 22 myocardial clinical scans. In adults we could clearly detect the lesion of myocardial infarction, but in children found it difficult to obtain fully sufficient information due to small heart size and high pulse rate. Judging from the foregoing we think it possible to obtain much clearer images by using a data analyzer. (auth.)

1977-01-01

275

Quantification of myocardial infarction: a comparison of single photon-emission computed tomography with pyrophosphate to serial plasma MB-creatine kinase measurements  

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Single photon-emission computed tomography (SPECT) with /sup 99m/Tc-pyrophosphate (PPi) has been shown to estimate size of myocardial infarction accurately in animals. The authors tested the hypothesis that SPECT with /sup /sup 99m//Tc-PPi and blood pool subtraction can provide prompt and accurate estimates of size of myocardial infarction in patients. SPECT estimates are potentially available early after the onset of infarction and should correlate with estimates of infarct size calculated from serial measurements of plasma MB-creatine kinase (CK) activity. Thirty-three patients with acute myocardial infarction and 16 control patients without acute myocardial infarction were studied. Eleven of the patients had transmural anterior myocardial infarction, 16 had transmural inferior myocardial infarction, and six had nontransmural myocardial infarction. SPECT was performed with a commercially available rotating gamma camera. Identical projection images of the distribution of 99mTc-PPi and the ungated cardiac blood pool were acquired sequentially over 180 degrees. Reconstructed sections were color coded and superimposed for purposes of localization of infarct. Areas of increased PPi uptake within myocardial infarcts were thresholded at 65% of peak activity. The blood pool was thresholded at 50% and subtracted to determine the endocardial border for the left ventricle. Myocardial infarcts ranged in size from 1 to 126 gram equivalents (geq) MB-CK. The correlation of MB-CK estimates of size of infarct with size determined by SPECT (both in geq) was good (r = .89 with a regression line of y = 13.1 + 1.5x).

Jansen, D.E.; Corbett, J.R.; Wolfe, C.L.; Lewis, S.E.; Gabliani, G.; Filipchuk, N.; Redish, G.; Parkey, R.W.; Buja, L.M.; Jaffe, A.S.

1985-08-01

276

Quantification of myocardial infarction: a comparison of single photon-emission computed tomography with pyrophosphate to serial plasma MB-creatine kinase measurements  

International Nuclear Information System (INIS)

Single photon-emission computed tomography (SPECT) with /sup 99m/Tc-pyrophosphate (PPi) has been shown to estimate size of myocardial infarction accurately in animals. The authors tested the hypothesis that SPECT with /sup /sup 99m//Tc-PPi and blood pool subtraction can provide prompt and accurate estimates of size of myocardial infarction in patients. SPECT estimates are potentially available early after the onset of infarction and should correlate with estimates of infarct size calculated from serial measurements of plasma MB-creatine kinase (CK) activity. Thirty-three patients with acute myocardial infarction and 16 control patients without acute myocardial infarction were studied. Eleven of the patients had transmural anterior myocardial infarction, 16 had transmural inferior myocardial infarction, and six had nontransmural myocardial infarction. SPECT was performed with a commercially available rotating gamma camera. Identical projection images of the distribution of 99mTc-PPi and the ungated cardiac blood pool were acquired sequentially over 180 degrees. Reconstructed sections were color coded and superimposed for purposes of localization of infarct. Areas of increased PPi uptake within myocardial infarcts were thresholded at 65% of peak activity. The blood pool was thresholded at 50% and subtracted to determine the endocardial border for the left ventricle. Myocardial infarcts ranged in size from 1 to 126 gram equivalents (geq) MB-CK. The correlation of MB-CK estimates of size of infarct with size determined by SPECT (both in geq) was good (r = .89 with a regression line of y = 13.1 + 1.5x)

1985-01-01

277

"2"0"1Tl perfusion study of ''ischemic'' ulcers of the leg: prognostic ability compared with Doppler ultrasound  

International Nuclear Information System (INIS)

Thallium 201 perfusion analysis was compared with Doppler ultrasound as a means of determining the healing potential of an ischemic ulcer of the leg in 27 patients. The degree of hyperemia was determined by comparative point counting of the "2"0"1Tl distribution in and about the ulcer. Using established Doppler criteria and a hyperemia ratio greater than 1.5:1, ultrasound alone correctly predicted healing in 15 out of 23 cases and "2"0"1Tl in 20 out of 23. Ultrasound correctly predicted non-healing in 3 out of 6 cases, compared with 5 out of 6 for "2"0"1Tl. The positive predictive value of the "2"0"1Tl study was 63%, versus 27% for ultrasound, and the negative predictive value was 95% for "2"0"1Tl and 83% for ultrasound. The accuracy of "2"0"1Tl and ultrasound was 86% and 62%, respectively. This limited study suggests that "2"0"1Tl perfusion scanning is a useful noninvasive test of ulcer healing potential and may be more sensitive than Doppler ultrasound

1982-01-01

278

Sodium bicarbonate-augmented stress thallium myocardial scintigraphy  

International Nuclear Information System (INIS)

It is well known that sodium bicarbonate in pharmacological doses induces transient alkalosis, causing intracellular transport of serum potassium. The aims of this study were (a) to investigate whether, in humans, myocardial thallium-201 uptake can be augmented by pretreatment with a single bolus of sodium bicarbonate at a pharmacological dose, (b) to verify general safety aspects of the intervention and (c) to evaluate the clinical implications of augmentation of 201Tl uptake, if any. Routine exercise myocardial scintigraphy was performed twice in eight adult volunteers (five normal and three abnormal), once without intervention and the second time (within a week) following intravenous administration of sodium bicarbonate (88 mEq in 50 ml) as a slow bolus 1 h prior to the injection of 201Tl. Conventional myocardial thallium study was compared with sodium bicarbonate interventional myocardial scintigraphy with respect to myocardial uptake (counts per minute per mCi injected dose), washout patterns in normal and abnormal myocardial segments, and overall clinical interpretation based on planar and single-photon emission tomographic (SPET) images. All patients remained asymptomatic after the intervention. A mean increase of 53% in myocardial uptake of thallium was noted in post-exercise acquisitions after the intervention, confirming uptake of the tracer via the potassium-hydrogen pump and its augmentation by transient alkalosis. The washout pattern remained unchanged. The visual quality of planar and SPET images improved significantly after the intervention. Out of the five abnormal myocardial segments identified in three cases, four showed significant filling-in after the intervention, causing the diagnosis to be upgraded from ''partial scar'' to ''ischaemia'', or from ''ischaemia'' to ''normal''. The overall scan impression changed in two out of three such cases. Sodium bicarbonate augmentation may have significant implications for stress-thallium scintigraphy and may be a new parameter for defining myocardial viability. (orig.)

2004-04-01

279

Myocardial imaging with thallium-201  

International Nuclear Information System (INIS)

The dual radioisotope techniques with 201TlCl and sup(99m)TcO4- were performed in 30 cases inclusive of various heart and lung diseases, using a scintillation camera coupling to a small digital computer. The scintigraphic procedures were started about 5 minutes after intravenous injection of 201TlCl. The myocardial images such as anterior, 600 left anterior oblique, and left lateral view, were obtained. Next, 300 left anterior oblique view was taken and radionuclide angiogram with sup(99m)TcO4- was done in the same position too. This joint use of the myocardial imaging and radionuclide angiography could increase diagnostic reliability. Superimposing the image as iso-count map extracted out of radionuclide angiogram to the brightness image of 201TlCl, the anatomic orientation of the image of 201TlCl was improved. Subtracting the blood pool image with sup(99m)TcO4- or radionuclide angiogram, which showed visualization of the right ventricle, lungs and left ventricle, from the image of 201TlCl, the subtraction image was obtained. The right ventricle was visualized more clearly on this subtraction image than the original image of 201TlCl. Good visualization of the right ventricle was shown in 25 cases on the subtraction image, and in 17 cases on the original image of 201TlCl. (author)

1979-01-01

280

Dual myocardial single photon emission computed tomography (SPECT) using thallium-201 and I-123-?-methyl-i-pentadecanoic acid in patients with Duchenne's progressive muscular dystrophy  

International Nuclear Information System (INIS)

Dual single photon emission computed tomography (SPECT) was performed in 31 patients with Duchenne's progressive muscular dystrophy (DMD) using 123I-?-methyl pentadecanoic acid (BMIPP) for myocardial fatty acid metabolism and 201thallium (Tl)-chloride for myocardial perfusion. The left ventricle was divided into 9 segments, and accumulation of the radiotracers was assessed visually for each segment to calculate defect score for each tracer. There was some degree of decrease in myocardial accumulation of both tracers in all DMD patients. Reduced accumulation was most common at the apex (BMIPP: 67%, Tl: 63%), followed by the posterior wall, lateral wall, and anterior wall. On the other hand, reduced accumulation was less common at the septum. BMIPP showed a higher accumulation than Tl in all segments but the septum. When BMIPP defect score was larger than Tl defect score, BMIPP defect score tended to increase during 4 years follow-up (p Tl defect score revealed a slight fibrosis or normal myocardium. It can be concluded that the dual SPECT myocardial scintigraphy using BMIPP and Tl provides accurate information about disease progression of the heart in patients with DMD by detecting abnormalities of the myocardial metabolism of each substance, thereby enabling the assessment of left ventricular function. (author)

1999-10-01

 
 
 
 
281

Acute and reperfused myocardial infarction: relations between `reverse redistribution` of {sup 201}Tl at rest, micro-perfusion and myocardial viability; Infarctus du myocard aigu et reperfuse: relations entre `reverse redistribution` du Tl{sup 201} au repos, microperfusion et viabilite myocardique  

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The mechanism of `reverse redistribution` (RR) of thallium after myocardial infarction remains obscure. In fact, the fixation of thallium depends on the coronary flow rate, microcirculation and cellular viability. We have studied the RR in 18 patients with normal coronary flow rate after reperfusion of artery of acute phase infarction but with a large range of micro-circulation alteration (evaluated by intracoronary contrast echography (ICCE)) and necrosis size. A thallium rest-redistribution achieved at the eighth day (8D) and 42D was compared with a perfusion score established by ICCE and analyses of the echographic regional kinetics achieved at 0D, 8D and 42D. At 8D a RR was observed in 16/18 patients with a 15 minute average defect of 25 {+-} 15% of myocardium extended up to 34 {+-} 13% at 4 hours. At 42D only 6/18 patients retained a RR while the average changes in the size of defect were not significant. The defect measured at 8D on the 15 min. image alone showed to be significantly correlated with the perfusion score while the patients with bad micro-perfusion had defects significantly larger than the others. On the other side the size of the same defect at 15 min. showed to be correlated to that of redistribution at 42D as well as the number of the akinetic segments at 42D. In conclusion, a large a RR is present at 8D after acute reperfusion of a myocardial infarction and tends to vanish at 42D. The 15 minute images reflect essentially the micro-perfusion. The last one being a necessary condition of myocardial salvation, the size of the 15 minute defect is also correlated to the viability indices evaluated at 42D

Faraggi, M.; Sarda, L.; Karila-Cohen, D.; Lebtahi, R.; Czitrom, D.; Delahaye, N.; Brochet, E.; Steg, P.G.; Le Guludec, D. [Hopital Bichat, Paris (France)

1997-12-31

282

Myocardial metabolic, hemodynamic, and electrocardiographic significance of reversible thallium-201 abnormalities in hypertrophic cardiomyopathy  

International Nuclear Information System (INIS)

Exercise-induced abnormalities during thallium-201 scintigraphy that normalize at rest frequently occur in patients with hypertrophic cardiomyopathy. However, it is not known whether these abnormalities are indicative of myocardial ischemia. Fifty patients with hypertrophic cardiomyopathy underwent exercise 201Tl scintigraphy and, during the same week, measurement of myocardial lactate metabolism and hemodynamics during pacing stress. Thirty-seven patients (74%) had one or more 201Tl abnormalities that completely normalized after 3 hours of rest; 26 had regional myocardial 201Tl defects, and 26 had apparent left ventricular cavity dilatation with exercise, with 15 having coexistence of these abnormal findings. Of the 37 patients with reversible 201Tl abnormalities, 27 (73%) had metabolic evidence of myocardial ischemia during rapid atrial pacing compared with four of 13 patients (31%) with normal 201Tl scans (p less than 0.01). Eleven patients had apparent cavity dilatation as their only 201Tl abnormality; their mean postpacing left ventricular end-diastolic pressure was significantly higher than that of the 13 patients with normal 201Tl studies (33 +/- 5 versus 21 +/- 10 mm Hg, p less than 0.001). There was no correlation between the angiographic presence of systolic septal or epicardial coronary arterial compression and the presence or distribution of 201Tl abnormalities. Patients with ischemic ST segment responses to exercise had an 80% prevalence rate of reversible 201Tl abnormalities and a 70% prevalence rate of pacing-induced ischemia. However, 69% of patients with nonischemic ST segment responses had reversible 201Tl abnormalities, and 55% had pacing-induced ischemia. Reversible 201Tl abnormalities during exercise stress are markers of myocardial ischemia in hypertrophic cardiomyopathy and most likely identify relatively underperfused myocardium

1991-01-01

283

Predicting chemotherapeutic response to small-cell lung cancer of platinum compounds by thallium-201 single-photon emission computerized tomography.  

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Thallium-201 single-photon emission computerized tomography (SPECT) was used to clarify the relationship between 201Tl uptake and the response in chemotherapy to platinum compounds in 21 patients with small-cell lung cancer. 201Tl-SPECT scans were obtained twice: at 15 min (early scan) and 120 min (delayed scan) after an intravenous injection of 111 MBq (3 mCi) of thallium-201 chloride. We obtained the uptake ratio from each scan and calculated the retention index:uptake ratio = region of int...

Tokuchi, Y.; Isobe, H.; Takekawa, H.; Hanada, T.; Ishida, T.; Ogura, S.; Itoh, K.; Furudate, M.; Saito, K.; Kawakami, Y.

1998-01-01

284

Does myocardial thallium-201 SPECT combined with electron beam computed tomography improve the detectability of coronary artery disease? Comparative study of diagnostic accuracy  

Energy Technology Data Exchange (ETDEWEB)

The aim of this study is to evaluate the diagnostic accuracy of myocardial {sup 201}Tl SPECT combined with EBT for detecting CAD. The study was based on 34 patients with suspected CAD, who had EBT and myocardial {sup 201}Tl SPECT. The CAD was diagnosed by the findings of coronary arteriography. Sensitivity, specificity and accuracy of EBT, myocardial {sup 201}Tl SPECT and the combined diagnosis on a per vessel basis and a per-patient basis were studied. The sensitivity for detecting CAD of myocardial {sup 201}Tl SPECT, EBT and the combined diagnosis was 85%, 77%, and 62%, respectively. No significant difference in the accuracy of myocardial {sup 201}Tl SPECT, EBT and the combined diagnosis was observed on a patient basis and per vessel basis. In the over 70 yr age subgroup, the sensitivity and accuracy of EBT for detecting LAD lesion were significantly superior to those of myocardial {sup 201}Tl SPECT. Regardless of age-based subgroups and gender, the combined diagnosis did not contribute to an improvement in diagnostic accuracy. Although the sensitivity of EBT for detecting LAD lesion in patients over 70 yr of age was significantly higher than that of myocardial {sup 201}Tl SPECT, in the detectability of CAD, combined use of myocardial {sup 201}Tl SPECT and EBT offers no improvement. (author)

Aoyagi, Keiko; Inoue, Tomio; Yamauchi, Yasuhiko; Iwasaki, Tsutomu; Endo, Keigo [Gunma Univ., Maebashi (Japan). School of Medicine

1998-08-01

285

Does myocardial thallium-201 SPECT combined with electron beam computed tomography improve the detectability of coronary artery disease? Comparative study of diagnostic accuracy  

International Nuclear Information System (INIS)

The aim of this study is to evaluate the diagnostic accuracy of myocardial 201Tl SPECT combined with EBT for detecting CAD. The study was based on 34 patients with suspected CAD, who had EBT and myocardial 201Tl SPECT. The CAD was diagnosed by the findings of coronary arteriography. Sensitivity, specificity and accuracy of EBT, myocardial 201Tl SPECT and the combined diagnosis on a per vessel basis and a per-patient basis were studied. The sensitivity for detecting CAD of myocardial 201Tl SPECT, EBT and the combined diagnosis was 85%, 77%, and 62%, respectively. No significant difference in the accuracy of myocardial 201Tl SPECT, EBT and the combined diagnosis was observed on a patient basis and per vessel basis. In the over 70 yr age subgroup, the sensitivity and accuracy of EBT for detecting LAD lesion were significantly superior to those of myocardial 201Tl SPECT. Regardless of age-based subgroups and gender, the combined diagnosis did not contribute to an improvement in diagnostic accuracy. Although the sensitivity of EBT for detecting LAD lesion in patients over 70 yr of age was significantly higher than that of myocardial 201Tl SPECT, in the detectability of CAD, combined use of myocardial 201Tl SPECT and EBT offers no improvement. (author)

1998-08-01

286

Contamination and radiation exposure from 201Tl in patients undergoing dialysis after a nuclear medicine study  

International Nuclear Information System (INIS)

Our institution is a major kidney research and transplant center. Hemodialysis patients that are scheduled for renal transplant are given a 201Tl stress test. Possible radiation exposure and contamination are of concern to attending personnel. We investigated this situation and found measurable activity in the effluent of patients receiving dialysis but no significant contamination of equipment. We determined that dialysis personnel received minimal radiation exposure

1991-01-01

287

"2"0"1Tl scintigraphic evaluation of tumor mass and viability of bone and soft-tissue tumors  

International Nuclear Information System (INIS)

To characterize "2"0"1Tl uptake in patients with bone and soft-tissue tumor, we studied 49 patients with surgically proven tumors and one patient with a tumor diagnosed arteriographically. In 37 of our 50 patients, the tumor was evaluated with "2"0"1Tl and arteriography. Moreover, in 14 of patients with pre-operative chemotherapy, pathologic changes were graded on the basis of percent tumor necrosis as defined histologically. The percent tumor necrosis histologically was compared with changes in the scintigraphic and conventional angiographic studies. Radiologic comparisons demonstrated a high degree of correlation with images of "2"0"1Tl and both arterial and blood pool phase of "9"9"mTc-HMDP. Ninety-six percent of 28 malignant tumors had positive "2"0"1Tl uptake. None of the patients showed any thallium accumulation in the soft tissues or skeleton adjacent to the lesion. Activity of "2"0"1Tl was mainly dependent upon a tumor blood flow and a vascular density. In of 14 cases with the preoperative chemotherapeutic treatment, "2"0"1Tl scintigraphic changes showed concordance with % tumor necrosis. Thallium-201 was superior to "9"9"mTc-HMDP in predicting tumor response to chemotherapy. Interestingly, delayed images of "9"9"mTc-HMDP of 5 responders with >90% tumor necrosis showed decreased uptake in the adjacent bone to the tumor mass lesions. It seems to be quite all right to consider that a major determinant of "2"0"1Tl uptake is intratumoral angiogenecity, which is closely connected with tumor viability. Therefore, "2"0"1Tl is a sensitive radiopharmaceutical for detection of vascular rich bone and soft-tissue tumors, and appears to be a simple and an accurate test for evaluating the response to specific therapeutic regimens of malignant bone and soft-tissue tumors. (author)

1994-12-01

288

Diagnostic significance of diffuse lung uptake of /sup 201/Tl chloride in diffuse interstitial pneumonia  

Energy Technology Data Exchange (ETDEWEB)

Scintigraphy with /sup 201/TlCl and /sup 197/HgCl/sub 2/ was performed in 323 patients with various respiratory diseases. Diffuse, marked bilateral lung uptake of /sup 201/Tl or /sup 197/Hg was demonstrated in 2 of 3 cases with hypersensitivity pneumonitis, 26 of 29 cases with silicosis and 28 of 29 cases with diffuse interstitial pneumonia, but in diffuse panbronchiolitis, chronic bronchitis and pulmonary emphysema, only slight lung uptake or negative results were obtained in most cases. In diffuse interstitial pneumonia, no close correlation was observed between the grade of the lung uptake and the various clinical findings such as fever, cough, rales, ESR, S-LDH, ..cap alpha../sub 1/-globulin, %VC, PaO/sub 2/ and so on. With regard to roentgenological findings, marked lung uptake was observed in cases not only with reticulonodular shadows but also those with ring shadows and those without any shadows. Concerning the microscopic findings of lung biopsy specimens, marked uptake was observed in cases with slight interstitial fibrosis as well as infiltration of mononuclear cells. The right ventricle was visualized in 13 of 19 cases (68.4%) with diffuse interstitial pneumonia. Lung scintigraphy with /sup 201/Tl chloride is non-invasive and seems a more sensitive indicator of diffuse intersitial changes such as inflammatory disorders than the clinical findings, chest X-ray and so on.

Fujii, Tadashige; Hirayama, Jiro; Kanai, Hisakata (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

1982-09-01

289

The diagnostic significance of diffuse lung uptake of 201Tl chloride in diffuse interstitial pneumonia  

International Nuclear Information System (INIS)

Scintigraphy with 201TlCl and 197HgCl2 was performed in 323 patients with various respiratory diseases. Diffuse, marked bilateral lung uptake of 201Tl or 197Hg was demonstrated in 2 of 3 cases with hypersensitivity pneumonitis, 26 of 29 cases with silicosis and 28 of 29 cases with diffuse interstitial pneumonia, but in diffuse panbronchiolitis, chronic bronchitis and pulmonary emphysema, only slight lung uptake or negative results were obtained in most cases. In diffuse interstitial pneumonia, no close correlation was observed between the grade of the lung uptake and the various clinical findings such as fever, cough, rales, ESR, S-LDH, ?1-globulin, %VC, PaO2 and so on. With regard to roentgenological findings, marked lung uptake was observed in cases not only with reticulonodular shadows but also those with ring shadows and those without any shadows. Concerning the microscopic findings of lung biopsy specimens, marked uptake was observed in cases with slight interstitial fibrosis as well as infiltration of mononuclear cells. The right ventricle was visualized in 13 of 19 cases (68.4%) with diffuse interstitial pneumonia. Lung scintigraphy with 201Tl chloride is non-invasive and seems a more sensitive indicator of diffuse intersitial changes such as inflammatory disorders than the clinical findings, chest X-ray and so on. (author)

1982-01-01

290

Computerized study with /sup 201/Tl of the cold thyroid node  

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Because of its physical and potassium-metabolic characteristics /sup 201/Tl is more suitable than /sup 131/Cs for radioisotopic studies of the cold thyroid nodule, with the further diagnostic possibility of quantitatively assessing intranodular behaviour for a specific differentiation among different kinds of neoformations. Using a gamma-camera on line with a computer data processing device, sequential scintiscans were recorded for the first 20-30 min after i.v. administration of 15-20 ..mu..Ci/kg of radiothallium; delayed sequences were taken at 40-60 min if intranodular uptake appeared. A quantitative appraisal was made of the differential /sup 201/Tl uptake-ratio between nodule and healthy thyroid tissue (density-index) and the multiparameter analysis of thyroid time/activity curves generated on the relative regions of interest (ROIs). This computerized study, in 120 out of 293 patients submitted to this radiothallium test, has shown a) diagnostic agreement between clinical-histological and radioisotopic findings in 76 out of 79 colloid-cystic or degenerative neoformations, in all 16 malignant and in 23 out of 25 hyperplastic benign nodules; b) significant statistical difference of the density-index in solid versus cystic but not between benign and malignant nodules; c) different /sup 201/Tl kinetics behaviour in different kinds of solid thyroid lesions with a satisfactory statistical difference of the radiothallium nodular dissappearance-index.

Palermo, F.; Saitta, B.; Coghetto, F.; Tiberio, M.; Caldato, L.

1982-02-01

291

Computerized study with "2"0"1Tl of the gold thyroid node  

International Nuclear Information System (INIS)

Because of its physical and potassium-metabolic characteristics "2"0"1Tl is more suitable than "1"3"1Cs for radioisotopic studies of the cold thyroid nodule, with the further diagnostic possibility of quantitatively assessing intranodular behaviour for a specific differentiation among different kinds of neoformations. Using a gamma-camera on line with a computer data processing device, sequential scintiscans were recorded for the first 20-30 min after i.v. administration of 15-20 ?Ci/kg of radiothallium; delayed sequences were taken at 40-60 min if intranodular uptake appeared. A quantitative appraisal was made of the differential "2"0"1Tl uptake-ratio between nodule and healthy thyroid tissue (density-index) and the multiparameter analysis of thyroid time/activity curves generated on the relative regions of interest (ROIs). This computerized study, in 120 out of 293 patients submitted to this radiothallium test, has shown a) diagnostic agreement between clinical-histological and radioisotopic findings in 76 out of 79 colloid-cystic or degenerative neoformations, in all 16 malignant and in 23 out of 25 hyperplastic benign nodules; b) significant statistical difference of the density-index in solid versus cystic but not between benign and malignant nodules; c) different "2"0"1Tl kinetics behaviour in different kinds of solid thyroid lesions with a satisfactory statistical difference of the radiothallium nodular dissappearance-index. (orig.)

1982-01-01

292

Preparation and biodistribution of [201Tl](III)vancomycin complex in normal rats  

International Nuclear Information System (INIS)

Thallium-201 (T1/2 = 3.04 days) in Tl+ form was converted to Tl3+ cation in presence of O3 in 6 M HCl controlled by RTLC/gel electrophoresis methods. The final evaporated activity was reacted with vancomycin (VAN) in water to yield [201Tl](III)VAN. The best results were obtained at room temperature in water after 30 min with a radiochemical yield >99%, after mixing the reactants followed by SPE purification using Si Sep-Pak. The studies showed that thallic ion is mostly incorporated into vancomycin with a radiochemical purity of more than 98 ± 1% by RTLC. A specific activity of about 4.14·1010 Bq/mmol was obtained. Radiochemical purity and stability of 201Tl-VAN in the preparation and in presence of human serum was determined up to 5.5 days. Biodistribution study of 201Tl(III)-vancomycin in normal rats was performed up to 52 h. (authors)

2006-01-01

293

Clinical relevance of 201Tl-chloride SPET in the differential diagnosis of brain tumours.  

Science.gov (United States)

Magnetic resonance imaging (MRI) and computed tomography (CT) may not be reliable in the differential diagnosis of tumour necrosis, scar and recurrent tumour. We compared 201Tl-chloride SPET with CT and MRI for the differential diagnosis of these cerebral lesions. Brain SPET was performed in 40 patients after the intravenous injection of 201Tl-chloride. All 40 patients also had a CT or MRI scan, and a histological diagnosis was available for 27 of the patients. For each patient, the ratio of counts in the lesion region of interest (ROI) to counts in the contralateral ROI was calculated and found to be between 0.58 and 9.60. The ratios for high-grade gliomas, metastases and meningiomas were high (> 2.7), especially in tumours with good vascularization. A low ratio (< 1.7) was noted in patients with low-grade astrocytoma, necrosis or ischaemic lesions. There were two exceptional cases of ischaemic lesions in the luxury perfusion stage (ratios of 3.61 and 3.87), as verified by HMPAO-SPET. We found that 201Tl-chloride SPET helps to differentiate between malignant tumours, poorly vascularized benign lesions and necrosis. Differentiation between low-grade astrocytoma and non-malignant lesions was not possible, but there was a trend towards differentiating between low-grade astrocytoma and ischaemic infarction. The timing of the investigation is important to avoid false-positive results in hyperperfused ischaemic tissue. PMID:9853323

Staffen, W; Hondl, N; Trinka, E; Iglseder, B; Unterrainer, J; Ladurner, G

1998-04-01

294

Diagnosis of pancreatic cancer using sup 201 Tl-chloride and a three-head rotating gamma camera SPECT system  

Energy Technology Data Exchange (ETDEWEB)

{sup 201}Tl SPECT was performed on 17 patients with pancreatic cancer or chronic pancreatitis using a three-head rotating gamma camera SPECT system. In 7 of 10 patients with pancreatic cancer, the lesions were clearly delineated by {sup 201}Tl SPECT. Whereas the lesion of 30 mm in diameter was visualized, a large tumor of 80 mm in diameter could not be visualized. Namely, it was thought that {sup 201}Tl uptake by pancreatic cancer might be well correlated with tumor blood flow and/or its histological subtype rather than with tumor size. In 5 of 7 patients with chronic pancreatitis, no uptake by the pancreas was shown. The sensitivity, specificity, and accuracy in diagnosing pancreatic cancer by {sup 201}Tl SPECT were 70%, 71%, and 71%, respectively. The present results obtained by {sup 201}Tl SPECT were thought satisfactory enough to evaluate pancreatic cancer under the present conditions where there was no useful imaging agent for visualizing pancreatic cancer by SPECT. {sup 201}Tl SPECT is expected to be a new diagnostic tool for investigation of pancreatic tumorous lesion. (author).

Togawa, Takashi; Yui, Nobuharu; Kinoshita, Fujimi; Koakutsu, Masaki; Ryu, Munemasa (Chiba Cancer Center (Japan)); Yamazaki, Masato

1991-12-01

295

Diagnosis of pancreatic cancer using 201Tl-chloride and a three-head rotating gamma camera SPECT system  

International Nuclear Information System (INIS)

201Tl SPECT was performed on 17 patients with pancreatic cancer or chronic pancreatitis using a three-head rotating gamma camera SPECT system. In 7 of 10 patients with pancreatic cancer, the lesions were clearly delineated by 201Tl SPECT. Whereas the lesion of 30 mm in diameter was visualized, a large tumor of 80 mm in diameter could not be visualized. Namely, it was thought that 201Tl uptake by pancreatic cancer might be well correlated with tumor blood flow and/or its histological subtype rather than with tumor size. In 5 of 7 patients with chronic pancreatitis, no uptake by the pancreas was shown. The sensitivity, specificity, and accuracy in diagnosing pancreatic cancer by 201Tl SPECT were 70%, 71%, and 71%, respectively. The present results obtained by 201Tl SPECT were thought satisfactory enough to evaluate pancreatic cancer under the present conditions where there was no useful imaging agent for visualizing pancreatic cancer by SPECT. 201Tl SPECT is expected to be a new diagnostic tool for investigation of pancreatic tumorous lesion. (author)

1991-01-01

296

Comparison of Myocardial perfusion by ECG-gated myocardial perfusion single photon emission computed tomography method with coronary angiography in all of the coronary vessels and individual coronary vessels in patients with suspected or known coronary artery disease  

International Nuclear Information System (INIS)

In order to compare myocardial perfusion using 99mTc Tetrofosmin ECG gated myocardial perfusion single photon emission computed tomography (ECG gated MP-SPECT) with coronary angiography, this descriptive study was performed in 47 patients. Sensitivity and specificity of myocardial perfusion scan with coronary angiography were calculated in all of the coronary vessels and individual coronary vessel. The sensitivity of perfusion scan of myocardium in case of LAD was 94.28% and the specificity was 91.66%. For LCX these figures were 82.35% and 90% and for RCA, 95.83% and 78.26% Respectively The overall sensitivity and specificity of myocardial perfusion scan in all of the coronary vessels was 91.66% and 81.81 % respectively. Our findings are consistent with other published studies. (author)

2009-01-01

297

Functional significance of myocardial perfusion defects induced by dipyridamole using thallium-201 single-photon emission computed tomography and two-dimensional echocardiography  

International Nuclear Information System (INIS)

The mechanisms responsible for inhomogeneous myocardial blood flow after oral administration of a large dose (300 mg) of dipyridamole were assessed in 27 patients with serial thallium-201 single-photon emission computed tomography (SPECT) and simultaneous 2-dimensional echocardiograms. Myocardial tomographic images were obtained 50 minutes and 3 to 4 hours after administration of dipyridamole. Two-dimensional echocardiograms were recorded at baseline and then every 15 minutes for 60 minutes. Dipyridamole caused only a mild reduction in blood pressure (from 129 +/- 18 to 126 +/- 16 mm Hg) and a mild increase in heart rate (from 69 +/- 15 to 73 +/- 4 beats/min). Sixteen patients had perfusion defects after dipyridamole by SPECT, which underwent partial or total filling-in. Fourteen of these patients (87.5%) had either a new abnormality or further deterioration of a preexisting wall motion abnormality by 2-dimensional echocardiography, and thus were considered to have developed transient ischemia during dipyridamole administration. Ten of 11 patients (91%) with normal perfusion or fixed defects by SPECT had no further deterioration in wall motion after oral dipyridamole, and were thus considered to have no evidence of myocardial ischemia. In conclusion, most patients with transient thallium-201 defects after dipyridamole develop transient worsening of resting wall motion by 2-dimensional echocardiography, suggestive of true myocardial ischemia. Because myocardial oxygen demand, as indicated by the heart rate-blood pressure product, did not change significantly, the mechanism of myocardial ischemia in these patients is likely to be diminished regional blood flow related to a subendocardial steal induced by dipyridamole

1990-10-01

298

Reverse redistribution in dipyridamole-loading thallium-201 images using single photon emission computed tomography  

International Nuclear Information System (INIS)

Dipyridamole was infused intravenously at a rate of 0.142 mg/kg per min for four min, and a stress image was obtained 10 min after the injection of two mCi "2"0"1Tl. The myocardial image of Tl was analyzed by single photon emission computed tomography and its washout rate was calculated by the segmental ROI method. Myocardial function and the motion of the left ventricular wall were analyzed by "9"9"mTc-RBC-gated cardiac pool imaging. Reverse redistribution was noted in 27 (21.6 %) of 125 consecutive Tl dipyridamole and redistribution myocardial imaging studies. The stress image demonstrated normal perfusion (group 1) and reduced perfusion (group 2) of Tl. Group 1 consisted of 17 patients with diabetes mellitus, supraventricular arrhythmias, hypertension, and others. Group 2 consisted of 10 patients with subendocardial infarction, diabetes mellitus, and hypertension, and others. The percentage prevalence of reverse redistribution among patients with supraventricular arrhythmia was 62.5 % (five of eight patients), with subendocardial infarction 60.0 % (three of five), with hypertension 42.8 % (six of 14), and with diabetes mellitus 40.0 % (eight of 20), while in those with transmyocardial infarction and angina pectoris no reverse redistribution percentage was found. The washout rate of Tl in normal perfusion areas was 44.0 ± 12.8 %, the reverse redistribution of group 1 was 47.4 ± 12.8 %, and of group 2 was 51.2 ± 8.2 %. The washout rate of the reverse redistribution of group 2 was significantly greater than that of the normal areas. In gated cardiac pool imaging, patients in group 2 had significantly larger areas showing abnormal contraction of the left ventricular wall and significantly lower ejection fraction than did group 1. In the electrocardiogram ST segment depression was noted more frequently in group 2 than group 1. No Q wave was present in the corresponding reverse redistribution area. (J.P.N.)

1986-01-01

299

Sympathetic reinnervation in cardiac transplants : preliminary results 123I-MIBG and 201Tl/99mTc-MIBI scintigraphy  

International Nuclear Information System (INIS)

Iodine-123 metaiodobenzylguanidine (123I-MIBG) is a norepinephrine (NE) analogue. To determine whether cardiac sympathetic reinnervation occurs after orthotopic heart transplantation (TPL). Nine patients (M : F=7 :2; mean ages=34±24.1 yr; idiopathic:rheumatic = 8: 1) within 197.±14.3 (4-36) months after TPL performed both 123I-MIBG scintigraphy and 201Tl/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS). 23I-MIBG imagings were performed in anterior position 15 minutes, 4 and 24 hours after i.v. injection of 148 MBq 123I MIBG. Image quantitation was based on the ratio of hear to mediastinal MIBG uptake (HMR). Six subjects with 123I-MIBG uptake on early 15. min imaging however, three subjects with 26 to 36(32.0±5.3) months had visible cardiac 123I-MIBG uptake (HMR:1.24±0.09 vs. 1.8±0.2). Correlation was found between plasma NE concentration and HMR(r=0.80: p1 years after TPL, as assessed by 123I-MIBG imaging

1997-11-21

300

Study of the predictors and lesion characteristics of ischemic heart disease patients with false negative results in stress myocardial perfusion single-photon emission tomography  

International Nuclear Information System (INIS)

The predictors and lesion morphology of patients with ischemic heart disease testing false negative results in stress myocardial perfusion single-photon emission computed tomography (SPECT) was investigated. Subjects were 58 consecutive patients who underwent coronary angiography (CAG), even though they showed normal findings in stress myocardial perfusion SPECT. Age, gender, methods of stress, perfusion agent, coronary risk factors, angina symptoms, and electrocardiographic changes were investigated as predictors by multivariate analysis. For lesion morphology, significant stenotic lesions were studied for morphological characteristics and reference diameter (RD), percentage diameter stenosis (%DS), minimum lumen diameter (MLD), and lesion length (LL) were measured. CAG revealed 30 significant stenotic lesions in 18 patients. Logistic regression analysis revealed significant predictors to be age (odds ratio (OR) 1.118, p<0.05), typical anginal pain (OR 21.09, p<0.01), and hypertension (OR 8.336, p<0.05). For lesion morphology, there were only 2 diffuse lesions and the mean RD, %DS, MLD, and LL were 3.03±0.9 mm, 63.1±9.3%, 1.13±0.49 mm, and 13.2±7.0 mm, respectively. Sufficient caution is believed necessary in the interpretation of normal findings of stress myocardial perfusion SPECT when the patient is elderly, complains of typical anginal pain, or has hypertension. In regard to characteristics of lesion morphology, there were hardly any diffuse lesions. (author)

2006-03-01

 
 
 
 
301

Evaluation of malignancy and viability of brain tumors by "2"0"1Tl SPECT. The correlation between "2"0"1Tl SPECT and pathology, clinical progress and the intensity of enhancement on CT images  

International Nuclear Information System (INIS)

Thallium-201 ("2"0"1Tl) SPECT was performed 48 times in 26 patients to clarify its usefulness in the evaluation of malignancy and viability of brain tumors. The early counts ratio (ER) and delayed counts ratio (DR) of a lesion compared with normal brain were obtained 10-15 minutes and 3 hours, respectively, after intravenous administration of 185 MBq of "2"0"1Tl chloride. Untreated high grade malignant tumors and recurrent tumors did not always show high ER and DR, and they were widely distributed. High grade malignant tumors that showed low ER and DR were not well enhanced on CT or MRI. In low grade malignant tumors, such as pituitary adenoma which was well enhanced on CT, ER and DR were as high as in high grade malignant tumor. Whether a tumor recurred within three months after radiotherapy or not was retrospectively predicted as accuracy rates of 93.8% and 87.5% with cut-off points of 4.0 for ER and 3.5 for DR. Cerebral radiation necrosis showed ring-like increased uptake of "2"0"1Tl in proportion to the progress of necrosis and intensity of enhancement on MRI. In conclusion "2"0"1Tl SPECT is considered to be less useful for lesions that are well enhanced on CT, because they show high uptake of "2"0"1Tl regardless of their malignancy and viability. On the other hand, in tumors that are not well enhanced on CT, "2"0"1Tl shows good accumulation in viable and high grade malignant lesions. "2"0"1Tl SPECT should be performed on such cases. (author)

1994-12-01

302

/sup 99m/Tc-pyrophosphate imaging in patients with acute myocardial infarction: Comparison of planar imaging with single-photon tomography with and without blood pool overlay  

International Nuclear Information System (INIS)

To test the hypothesis that single-photon emission computed tomography (SPECT) of /sup 99m/Tc-pyrophosphate (/sup 99m/Tc-PPi) with and without the overlay of tomographic blood pool scintigrams might detect small infarcts not identified by planar imaging, 52 patients were studied 3.2 +/- 2.0(SD) days after hospital admission for suspected acute myocardial infarction. Patients were chosen prospectively for tomographic study primarily, but not exclusively, because planar four-view imaging with /sup 99m/Tc-PPi was either negative or equivocal. SPECT was performed with a commercial rotating detector system immediately after planar imaging on one occasion. Corresponding /sup 99m/Tc-PPi and blood pool sections were mapped into opposite halves of a bichromic color table and displayed as an overlay. Planar images, SPECT and SPECT with blood pool overlay were interpreted separately and in random order without knowledge of clinical data. Seventeen patients had transmural infarcts (four anterior, 13 inferior), 19 had nontransmural infarcts, and 16 patients did not have acute myocardial infarction. The sensitivity of SPECT with blood pool overlay was significantly better than planar imaging for the entire group with myocardial infarction (97% vs 78%; p less than .025); this was primarily due to increased sensitivity in the detection of nontransmural myocardial infarction (95% vs 67%; p less than .05), although in one additional patient inferior transmural myocardial infarction was also detected by the SPECT overlay technique. The specificities of the SPECT overlay technique and planar imaging were not significantly different; however, receiver operating characteristic analysis showed enhanced observer confidence with the tomographic method. SPECT without overlay was intermediate in sensitivity and specificity

1984-01-01

303

Effects of exercise training on myocardial fatty acid metabolism in rats with depressed cardiac function induced by transient ischemia  

International Nuclear Information System (INIS)

The effects of exercise training on metabolic and functional recovery after myocardial transient ischemia were investigated in a rat model. Male Wistar Kyoto rats were subjected either to a 30-min left coronary artery occlusion followed by reperfusion or to a sham operation. At 4 weeks after operation, the rats were randomly assigned either to sedentary conditions or to exercise training for 6 weeks. In the ischemic rats, pinhole SPECT (single photon emission computed tomography) imaging with thallium-201 (201Tl) and 123I-(?-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) showed a reduction of both myocardial perfusion and fatty acid metabolism in the risk zone of the left ventricle (LV). The LV was dilated and the ejection fraction was decreased after ischemic injury. The severity score showed a significant decrease on both 201Tl and BMIPP (201Tl, from 19.9±2.7 to 17.0±2.2, p<0.05; BMIPP, from 21.5±2.4 to 18.6±1.9, p<0.05) after exercise training in the ischemic trained rats, but did not change significantly in their sedentary counterparts. Plasma levels of free fatty acids normalized in the ischemic trained rats, but elevated in the ischemic sedentary rats (0.53±0.05 vs 0.73±0.06 mmol/L, p<0.05). Furthermore, the trained rats had a significant increase in LV stroke volume (0.25±0.02 vs 0.21±0.01 ml/beat, p<0.05) and adaptive cardiac hypertrophy. These findings demonstrate that adaptive improvements in myocardial perfusion, fatty-acid metabolism and LV function were induced by exercise training after transient ischemia. (author)

2001-06-01

304

Study of /sup 201/Tl uptake by bone and bone marrow on /sup 201/Tl scintigraphy. With special reference to bone marrow abnormalities  

Energy Technology Data Exchange (ETDEWEB)

Thallium-201 (Tl-201) uptake in the bone and bone marrow was examined in a total of 93 patients with various diseases. Sternal uptake of Tl-201 was observed when patients had bone marrow abnormality especially associated with hematopoietic disease. It was associated with proliferation of immature cells and of various types of bone marrow cells, especially erythroblastic and plasma cells. Whole-body Tl-201 scanning showed a high uptake (82%) in the sternum, chest, lumbar vertebrae, and pelvis. Thallium-201 was definitively taken up by the sternum in polycythemia (5/41), hemolytic anemia (2/2), iron deficiency anemia (2/2), and multiple myeloma (2/5). For leukemia, Tl-201 uptake was slight or negative. Thallium-201 scanning proved useful in visualizing bone marrow abnormality, although careful interpretation of bone and bone marrow uptake is required. (Namekawa, K).

Fujii, Tadashige; Tanaka, Masao; Hirose, Yoshiki; Hirayama, Jiro; Handa, Kenjiro; Nakanishi, Fumiko; Yano, Kesato; Ueda, Hitoshi

1989-04-01

305

Removal of {sup 99m}Tc and {sup 201}Tl by means of Lemna Gibba; Remocion de {sup 99m}Tc y {sup 201}Tl mediante Lemna Gibba  

Energy Technology Data Exchange (ETDEWEB)

In this work the capacity of the water macrophyte Lemna gibba coming from San Pedro Tultepec in the Mexico State was studied to remove the radioisotopes {sup 99m}Tc and {sup 201}Tl, in order to show the capacity of this macrophyte for to treat some radioactive waste flowing that could contain this radioisotopes type. The removal capacity of {sup 99m}Tc and {sup 201}Tl of the macrophyte Lemna gibba was determined using the batch method. In accordance with the values of the obtained K{sub d}, the Lemna gibba with a size of particle diameter among 1mm - 300 {mu}m presents a better adsorption of {sup 99m}Tc. The {sup 201}Tl is adsorbed better in the bioadsorbent when it has a size of particle diameter <150{mu}m. (Author)

Fernandez R, E.; Carreno de L, M. C.; Cuevas S, J. C.; Hernadez T, U. O. [Instituto Tecnologico de Toluca, Av. Tecnologico s/n, Fraccionamiento La Virgen, 52149 Metepec, Estado de Mexico (Mexico); Monroy G, F., E-mail: edelmiraf@yahoo.com [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

2012-10-15

306

Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography  

Science.gov (United States)

Objective Coronary artery disease (CAD) is associated with abdominal obesity and metabolic syndrome. Adipocytes secrete adipokines, including the newly discovered adipocyte fatty acid binding protein (A-FABP) and chemerin. Adipokines contribute to the pathogenesis of CAD. In patients with CAD, the presence of significant ischemia predicts adverse outcomes. It is unknown whether adipokines can be better predictors of the presence of significant myocardial ischemia than conventional risk factors. This study aimed to compare adipokines with clinical risk factors and abdominal obesity as predictive factors for significant myocardial ischemia. Methods One hundred and ninety-six adults with suspected, but unproven, CAD were consecutively enrolled. The main measures were clinical and biochemical parameters and stress myocardial perfusion imaging with gated myocardial perfusion single-photon emission computed tomography (SPECT), with computed tomography (CT) attenuation correction. The abdominal visceral fat area was examined using a hybrid SPECT/CT scanner. Serum levels of high-sensitivity C-reactive protein (hs-CRP) and adipokines (adiponectin, A-FABP, and chemerin) were evaluated. Results A-FABP levels correlated significantly with adiponectin, hs-CRP, body mass index, waist circumference, and visceral fat area. A-FABP was significantly associated with metabolic syndrome (OR 3.2, 95% CI 1.6–6.4, p?=?0.001), significant myocardial ischemia (OR 1.9, 95% CI 1.0–3.4, p?=?0.05), and stress lung-to-heart ratio (??=?0.03, p?=?0.03) on SPECT. Chemerin was significantly associated with serum triglyceride levels but not with metabolic syndrome, significant ischemia, or stress lung-to-heart ratio on SPECT. A-FABP was better at detecting significant inducible ischemia than other biomarkers, although this was a modest improvement (area under ROC curve 0.579, 95% CI 0.46–0.69). Conclusions Serum A-FABP concentrations correlate significantly with visceral fat area, metabolic syndrome, and predicted significant myocardial ischemia on SPECT. This may help to more accurately assess CAD risk, especially in patients with metabolic syndrome.

Hung, Chi-Sheng; Wu, Yen-Wen; Huang, Jei-Yie; Hsu, Pei-Ying; Chen, Ming-Fong

2014-01-01

307

Application of transmission scan-based attenuation compensation to scatter-corrected thallium-201 myocardial single-photon emission tomographic images.  

Science.gov (United States)

A practical method for scatter and attenuation compensation was employed in thallium-201 myocardial single-photon emission tomography (SPET or ECT) with the triple-energy-window (TEW) technique and an iterative attenuation correction method by using a measured attenuation map. The map was reconstructed from technetium-99m transmission CT (TCT) data. A dual-headed SPET gamma camera system equipped with parallel-hole collimators was used for ECT/TCT data acquisition and a new type of external source named "sheet line source" was designed for TCT data acquisition. This sheet line source was composed of a narrow long fluoroplastic tube embedded in a rectangular acrylic board. After injection of 99mTc solution into the tube by an automatic injector, the board was attached in front of the collimator surface of one of the two detectors. After acquiring emission and transmission data separately or simultaneously, we eliminated scattered photons in the transmission and emission data with the TEW method, and reconstructed both images. Then, the effect of attenuation in the scatter-corrected ECT images was compensated with Chang's iterative method by using measured attenuation maps. Our method was validated by several phantom studies and clinical cardiac studies. The method offered improved homogeneity in distribution of myocardial activity and accurate measurements of myocardial tracer uptake. We conclude that the above correction method is feasible because a new type of 99mTc external source may not produce truncation in TCT images and is cost-effective and easy to prepare in clinical situations. PMID:9473258

Hashimoto, J; Ogawa, K; Kubo, A; Ichihara, T; Motomura, N; Takayama, T; Iwanaga, S; Mitamura, H; Ogawa, S

1998-02-01

308

Application of transmission scan-based attenuation compensation to scatter-corrected thallium-201 myocardial single-photon emission tomographic images  

International Nuclear Information System (INIS)

A practical method for scatter and attenuation compensation was employed in thallium-201 myocardial single-photon emission tomography (SPET or ECT) with the triple-energy-window (TEW) technique and an iterative attenuation correction method by using a measured attenuation map. The map was reconstructed from technetium-99m transmission CT (TCT) data. A dual-headed SPET gamma camera system equipped with parallel-hole collimators was used for ECT/TCT data acquisition and a new type of external source named ''sheet line source'' was designed for TCT data acquisition. This sheet line source was composed of a narrow long fluoroplastic tube embedded in a rectangular acrylic board. After injection of 99mTc solution into the tube by an automatic injector, the board was attached in front of the collimator surface of one of the two detectors. After acquiring emission and transmission data separately or simultaneously, we eliminated scattered photons in the transmission and emission data with the TEW method, and reconstructed both images. Then, the effect of attenuation in the scatter-corrected ECT images was compensated with Chang's iterative method by using measured attenuation maps. Our method was validated by several phantom studies and clinical cardiac studies. The method offered improved homogeneity in distribution of myocardial activity and accurate measurements of myocardial tracer uptake. We conclude that the above correction method is feasible because a new type of 99mTc external source may not produce truncation in TCT images and is cost-effective and easy to prepare in clinical situations. (orig.)

1998-02-01

309

False-positive defects in technetium-99m sestamibi myocardial single-photon emission tomography in healthy athletes with left ventricular hypertrophy  

International Nuclear Information System (INIS)

Exercise ECG and myocardial single-photon emission tomography (SPET) are fundamental in the non-invasive evaluation of patients suspected of having coronary artery disease (CAD). The purpose of the present study was to investigate the influence of physiological left ventricular hypertrophy (LVH) on myocardial sestamibi SPET in healthy young and old athletes. Eighteen young male elite athletes (ten rowers, five power/weight lifters and three triathletes) and 14 well-trained elderly rowers were studied. All underwent a bicycle test as part of a 2-day sestamibi SPET protocol. Attenuation correction was not performed. The studies were evaluated visually and quantitatively analysed by the CEqual program with its reference files and with a file from a local non-athletic age-matched population. Echocardiographic LVH was an inclusion criterion in the young athletes. Exercise ECG was normal in all subjects. In at least three of the young athletes a reversible defect was observed by visual analysis. On quantitative analysis one-third of the young athletes had ''significant'' (>10 pixels) defects compared with both the local reference base and the CEqual reference population. Nearly all defects were found in the anterior or inferior wall. The remaining subjects, including all old rowers, had normal SPET findings. Anterior and inferior wall defects are so common in healthy athletes with physiological LVH that the specificity of myocardial SPET, in contrast to exercise ECG, seems to be too low for evaluation of chest pain in this group. The mechanism of anterior and inferior defects may be related to hot spots (papillary muscles?) in the lateral wall. The specificity of SPET is maintained in athletes without LVH. (orig.)

1998-09-01

310

201-Tl production for medical use by (p,xn) nuclear reactions on Tl and Hg natural and enriched targets  

International Nuclear Information System (INIS)

High-specific activity 201-Tl for biomedical uses might be produced by proton activation on: a) Hg targets by direct (p,xn) nuclear reactions, b) Tl targets via its parent radionuclide 201-Pb, c) Pb targets via its parent radionuclides 201-Bi and 201-Pb. With the Milan University AVF Cyclotron (maximum proton energy 45 MeV) the only nuclear reactions, which can be used for its production are the 203-Tl(p,3n), 201-Pb ? 201-Tl and the Hg(p,n/p,2n/p,4n)201-Tl ones. So, thin-target excitation function measurements and thick-target-yield calculations have been carried out in the proton energy range available, for the (p,xn) nuclear reactions on nat-Tl, 81% enriched 203-Tl, nat-Hg and 98.6% enriched 202-Hg targets. The yields and contaminations obtainable with the various methods are discussed in some detail. (Auth.)

1983-01-01

311

Computer simulation of temperature distribution on a solid target for 201Tl production  

International Nuclear Information System (INIS)

Thallium-201 is of great interest in nuclear medicine for diagnostic purposes. It is produced by the 203Tl(p,3n)201Pb nuclear reaction. Since the target for 201Tl production is a solid target and the maximum beam current for the irradiation has a direct relation with its temperature surface, therefore, the control of temperature during the irradiation is essential. Designing a proper cooling system is one of the important and determining parameters in radionuclide production efficiency. Non-controlled temperature would cause melting and consequently loss of target materials that could be very costly especially when an isotopically enriched material is used. In this study, the heat transfer and temperature distribution on the target has been simulated based on a computational fluid dynamics (CDF) code for the thermal behavior of the target during the irradiation and under the different beam currents, cooling flow rates and target designing. The results on the routinely used target for the production of 201Tl in AMIRS, showed that there was a good linearity between proton beam currents (in the range of 100-350 ?A) and maximum temperature on the thallium target (345-458 K). The results also showed that the flow rate of the cooling water can be brought down (from routinely used 45 L/min) to 15 L/min without any risk of melting of target material. (authors)

2011-01-01

312

Study of myocardial viability using thallium-201 in patients with a history of infarctions: Is reinjection necessary?  

International Nuclear Information System (INIS)

An analysis was performed of 84 patients with a history of myocardial infarction using the thallium-single photon emission computed tomography (SPECT) test and employing the technique of reinjection of the radioisotope 201Tl at rest. A study was conducted during the period of maximum stress, four hours and one hour after reinjection of 37 MBq of 201Tl. The presence and extent of reperfusion was determined. In addition, the incidence of ischaemia was correlated with four clinical parameters which might influence its occurrence: development period of the infarction (greater or less than 30 days), Q wave in the electrocardiogram, prior use of streptokinase, and angina. Twenty-seven patients exhibited partial reperfusion at rest which increased significantly in 14 of the patients after thallium reinjection. Moreover, 22 patients only exhibited reperfusion with reinjection. There was no relation between the clinical parameters evaluated and the incidence of ischaemia. In conclusion, with thallium reinjection 43% more patients can be detected with viable areas of myocardium which are not evident at rest. The clinical parameters evaluated are no help in predicting ischaemia with thallium. The routine use of reinjection is recommended to evaluate myocardial viability in patients with a history of infarction. (author). 14 refs, 2 figs

1996-06-01

313

Evaluation of efficacy of the therapy with proton MR spectroscopy and {sup 201}Tl SPECT in patient with brain tumor  

Energy Technology Data Exchange (ETDEWEB)

Twenty-two patients with brain tumor were examined by {sup 1}H-MRS and 25 patients were by {sup 201}Tl SPECT. Decrease of NAA/Cho ratio after irradiation indicates both efficacy of the therapy and damage of the brain tissue by radiotherapy, however follow-up {sup 1}H-MRS studies detected recurrent tumor. It is suggested that follow up {sup 1}H-MRS study may be useful for early detection of recurrence of tumor as well as {sup 201}Tl SPECT. (author)

Tanouchi, Miki; Harada, Masashi; Bandou, Kazuhiko; Kannuki, Seiji; Nishitani, Hiroshi [Tokushima Univ. (Japan). School of Medicine; Miyoshi, Hirokazu

1996-07-01

314

Tumour affinity of 203Pb-chloride: comparison with 67Ga-citrate and 201Tl-chloride  

International Nuclear Information System (INIS)

203Pb-chloride is a promising imaging agent for tumour scanning because of the large retention value for tumour tissue and the small value for normal organs, but the large value for the kidneys and bone is a shortcoming. The retention value of 203Pb in tumour tissue is larger than that of 201Tl and smaller than that of 67Ga. The tumour/inflammatory lesion retention ratio for 203Pb is very large in comparison with those for 67Ga and 201Tl. 203Pb accumulates to a large extent in viable tumour tissue, and less in necrotic tumour tissue and in inflammatory lesion. (author)

1994-01-01

315

Assessment of right ventricular function using gated blood pool single photon emission computed tomography in inferior myocardial infarction with or without hemodynamically significant right ventricular infarction  

Energy Technology Data Exchange (ETDEWEB)

Right ventricular function was assessed using gated blood pool single photon emission computed tomography (GSPECT) in 10 normal subjects and 14 patients with inferior myocardial infarction. Three-dimensional backbround subtraction was achieved by applying an optimal cut off level. The patient group consisted of 6 patients with definite hemodynamic abnormalities indicative of right ventricular infarction (RVI) and 8 other patients with significant obstructive lesion at the proximal portion of right coronary artery without obvious hemodynamic signs of RVI. Right ventricular regional wall motion abnormalities were demonstrated on GSPECT functional images and the indices of right ventricular function (i.e the right ventricular ejection fraction (RVEF), the right ventricular peak ejection rate (RVPER) and the right ventricular peak filling rate (RVPFR)) were significantly reduced in the patient group, not only in the patients with definite RVI but also in those without hemodynamic signs of RVI, even in the absence of definite hemodynamic signs, when the proximal portion of right coronary artery is obstructed. It is concluded that GSPECT is reliable for the assessment of right ventricular function and regional wall motion, and is also useful for the diagnosis of RVI. (author).

Takahashi, Masaharu (Gunma Univ., Maebashi (Japan). School of Medicine)

1992-02-01

316

Improved specificity of myocardial thallium-201 single-photon emission computed tomography in patients with left bundle branch block by dipyridamole  

International Nuclear Information System (INIS)

Reduced septal uptake of thallium-201 during exercise is frequently observed in patients with left bundle branch block (LBBB) and normal coronary arteries. This may reflect normal coronary autoregulation in response to lower septal oxygen demand; thus, dipyridamole, which uniformly exploits flow reserve, would be more accurate for diagnosis of coronary artery disease (CAD). Sixteen patients with LBBB underwent exercise and dipyridamole thallium-201 single-photon emission computed tomography and coronary angiography within 3 months. Sensitivity for detection of left anterior descending CAD (greater than 50% stenosis) was 0.83 for exercise and 1.00 for dipyridamole. Specificity was 0.30 (visual) or 0.20 (quantitative analysis) for exercise and 0.80 (visual) or 0.90 (quantitative) for dipyridamole (p less than 0.05). Dipyridamole combined with quantitative analysis also improved specificity of CAD detection overall (p less than 0.01). These data demonstrate that pharmacologic vasodilation is more accurate than exercise when diagnosing CAD by myocardial perfusion scintigraphy in patients with LBBB

1991-08-15

317

Iodine-123 N-methyl-4-iododexetimide: a new radioligand for single-photon emission tomographic imaging of myocardial muscarinic receptors  

International Nuclear Information System (INIS)

Cardiac muscarinic receptor ligands suitable for positron emission tomography have previously been characterised. Attempts to develop radioligands of these receptors suitable for single-photon emission tomographic (SPET) imaging have not been successful due to high lung retention and high non-specific binding of previously investigated potential tracers. The purpose of this study was to evaluate the biodistribution and in vivo imaging characteristics of a new radiopharmaceutical, [123I]N-methyl-4-iododexetimide. Biodistribution studies performed in rats showed high cardiac uptake (2.4% ID/g) 10 min after injection with a heart to lung activity ratio of 5:1. Specificity and stereoselectivity of cardiac binding were demonstrated using blocking experiments in rats. Dynamic imaging studies in anaesthetised greyhounds demonstrated rapid and high myocardial uptake and low lung binding with stable heart to lung activity ratios of >2.5:1 between 10 and 30 min, making SPET imaging feasible. Administration of an excess of an unlabelled muscarinic antagonist, methyl-quinuclidinyl benzylate rapidly displaced myocardial activity to background levels and the pharmacologically inactive enantiomer, [123I]N-methyl-4-iodolevetimide, had no detectable cardiac uptake, indicating specific and stereoselective muscarinic receptor binding. SPET revealed higher activity in the inferior than in the anterior wall, this being consistent with previously described regional variation of cardiac parasympathetic innervation. [123I]N-methyl-4-iododexetimide shows promise as an imaging agent for muscarinic receptor distribution in the heart and may be helpful in evaluating diverse cardiac diseases associated with altered muscarinic receptor function, including heart failure and diabetic heart disease. (orig.)

1995-04-01

318

Study to prepare 201Tl by irradiation of mercury with protons. Application of extraction chromatography technique in separation of thallium and mercury  

International Nuclear Information System (INIS)

The extraction chromatography technique was used for the lig and 201Tl separation. It was used glass columns of 5,0 cm height and 1,0 cm diameter filled with Voltalef powder impregnated with TBP/cyclohexane. By the Voltalef columns solutions of 203Hg2+, 201Tl1+ and 201Te3 were separately percolated in a nitric environment of 4 to 8 M concentration and in a hydrochloridric environment of 0,5 to 4 M. The separation of Hg and 201Tl was obtained by the retention of 201Tl3+ in the column during the elution of all the Hg with HCl 2 M. The 201Tl3+ was eluted from the column after its reduction with a hot hydrazine dichloride solution. (Author)

1986-03-17

319

Myocardial scintigraphy and radionuclide ventriculography in myocardial infarction  

International Nuclear Information System (INIS)

149 patients with acute (n = 75) myocardial infarction and 74 postinfarctions, angiographically confirmed, were investigated by "2"0"1Tl myocardial scintigraphy and subsequent radionuclide ventriculography. Quantitative evaluation of the scintigram showed "2"0"1Tl storage defects in 92% in the acute stage and in 79% in the later stage. The sensitivity of identification of the posterior wall infarction was consistently markedly less than for anterior wall infarctions and could not be increased by additional application of "9"9sup(m)Tc methylene disphosphonate. By the combined application of myocardial scintigraphy and radionuclide ventriculography the functional effects of the infarction can be described non-invasively. (orig.)

1980-11-14

320

Detection of myocardial viability by means of Single Proton Emission Computed Tomography (Perfused SPECT) dual 201 Tl (rest of 15 minutes, 24 late hours and 24 hours reinjection) and gated-SPECT 99m Tc-SESTAMIBI in effort or stimulation of the coronary reserves  

International Nuclear Information System (INIS)

The objective of this work was to determine if the images of SPECT 201 TI in rest of 15 minutes, 24 late hours and Gated-SPECT 99m Tc-SESTAMIBI in effort or stimulation of coronary reservation correlate with the study of 24 hours post reinjection of 201TI to determine the presence of having knitted viable myocardium. Material and methods: 29 patients were studied with coronary arterial illness (EAC) to who are carried out SPECT 201 TI in rest with images of 15 minutes, 24 late hours and 24 hours reinjection, by means of the administration of 201TI to dose of 130 MBq and reinjection with 37 MBq. and Gated-SPECT 99mTc-SESTAMIBI in effort or stimulation of coronary reservation, later to the administration of 1110 MBq. Results: 29 patients were included according to inclusion approaches and exclusion, of those which 22 (75.86%) they correspond at the masculine sex and 7 (24.13%) to the feminine one, with an average of 62.1 year-old age, 2320 segments myocardial were analysed so much it is phase post-effort as rest; they were diagnosed a total of 264 segments with heart attack, of which viability myocardium was observed in 174 segments. The statistical tests are analysis of frequencies. The non parametric test of Wilcoxon and Mann-Whitney. Conclusions: the viability myocardial at the 24 late hours and 24 hours reinjection was similar; significant difference exists between the study of 15 minutes and 24 hours reinjection, ischemic illness was also demonstrated in territories different to the heart attack area in the studies of 15 minutes, late 24 hours and 24 hours reinjection. (Author)

2004-01-01

 
 
 
 
321

Diagnostic value of myocardial tomographic imaging with 123I labelled BMIPP for exercise-induced angina pectoris  

International Nuclear Information System (INIS)

Objective: To evaluate the diagnostic value of resting myocardial tomographic imaging with 123I labelled BMIPP (123I-BMIPP SPECT) for exercise-induced angina pectoris by comparison with stress myocardial tomographic imaging with 201Tl(201Tl SPECT). Methods: 123I-BMIPP SPECT and 201Tl SPECT were performed in 32 patients with exercise-induced angina pectoris and 12 normal controls. Left ventricle was divided into nine segments and uptake of 201TL and 123I-BMIPP was evaluated by four classes score method (defect score, DS). Results: In the patients with angina pectoris, segments of 201Tl distribution abnormality were more than that of 123I-BMIPP. Concordant rate between DS of the 20'1Tl SPECT for detecting coronary artery stenosis were 62%, 92% and 70%, respectively, and 201Tl SPECT were 84%, 83% and 84%, respectively. Sensitivity of 123I-BMIPP SPECT was significantly lower than that of 201Tl SPECT (P 123I-BMIPP SPECT will be. Conclusions: The results indicated that to a certain extent, resting 123I-BMIPP SPECT may has practical clinical value for detection of coronary artery stenosis, and determination of stenotic degree in the patients with exercise-induced angina pectoris

1999-08-01

322

Absorbed radiation to the nuclear medicine nurses from patients administered 201Tl and 99mTc- MIBI  

International Nuclear Information System (INIS)

People who have administrated radiopharmaceuticals could be a source of radiation to their relatives, medical nurses, and people who have contact them. In this study, the dose rates at various distances of 5, 10,50 and 100cm from 70 patients, who were administered diagnostic amounts of 201Tl-Chloride and 99mTc-MIBI, was measured using an ionization chamber. For determination of external radiation dose to the nurses the radiations in three deferent interval times have measured. The maximum values of external dose rates of 201Tl and 99mTc- MIBI were 11.2?Sv/h ±2.3 and 43.1?Sv/h ±11.9 respectively at 5cm from the patients. Significant exposure from patients after injection of 99mTc-MIBI was limited on the day of administration. Departure doses rate of 201Tl fell gradually so by 3 days after administration was significant. Maximum and average absorbed dose of nuclear medicine staff for one 201Tl scan was 4.6 and 2.7?Sv/h, and for 99mTc-MIBI was 18.1 and 9.8?Sv/h in a working day. (author)

2010-05-01

323

Initial multicentre experience of high-speed myocardial perfusion imaging: comparison between high-speed and conventional single-photon emission computed tomography with angiographic validation  

International Nuclear Information System (INIS)

High-speed (HS) single-photon emission computed tomography (SPECT) with a recently developed solid-state camera shows comparable myocardial perfusion abnormalities to those seen in conventional SPECT. We aimed to compare HS and conventional SPECT images from multiple centres with coronary angiographic findings. The study included 50 patients who had sequential conventional SPECT and HS SPECT myocardial perfusion studies and coronary angiography within 3 months. Stress and rest perfusion images were visually analysed and scored semiquantitatively using a 17-segment model by two experienced blinded readers. Global and coronary territorial summed stress scores (SSS) and summed rest scores (SRS) were calculated. Global SSS ?3 or coronary territorial SSS ?2 was considered abnormal. In addition the total perfusion deficit (TPD) was automatically derived. TPD >5 % and coronary territorial TPD ?3 % were defined as abnormal. Coronary angiograms were analysed for site and severity of coronary stenosis; ?50 % was considered significant. Of the 50 patients, 13 (26 %) had no stenosis, 22 (44 %) had single-vessel disease, 6 (12 %) had double-vessel disease and 9 (18 %) had triple-vessel disease. There was a good linear correlation between the visual global SSS and SRS (Spearman's ? 0.897 and 0.866, respectively; p < 0.001). In relation to coronary angiography, the sensitivities, specificities and accuracies of HS SPECT and conventional SPECT by visual assessment were 92 % (35/38), 83 % (10/12) and 90 % (45/50) vs. 84 % (32/38), 50 % (6/12) and 76 % (38/50), respectively (p < 0.001). The sensitivities, specificities and accuracies of HS SPECT and conventional SPECT in relation to automated TPD assessment were 89 % (31/35), 57 % (8/14) and 80 % (39/49) vs. 86 % (31/36), 77 % (10/13) and 84 % (41/49), respectively. HS SPECT allows fast acquisition of myocardial perfusion images that correlate well with angiographic findings with overall accuracy by visual assessment better than conventional SPECT. Further assessment in a larger patient population may be needed to confirm this observation. (orig.)

2013-07-01

324

Initial multicentre experience of high-speed myocardial perfusion imaging: comparison between high-speed and conventional single-photon emission computed tomography with angiographic validation  

Energy Technology Data Exchange (ETDEWEB)

High-speed (HS) single-photon emission computed tomography (SPECT) with a recently developed solid-state camera shows comparable myocardial perfusion abnormalities to those seen in conventional SPECT. We aimed to compare HS and conventional SPECT images from multiple centres with coronary angiographic findings. The study included 50 patients who had sequential conventional SPECT and HS SPECT myocardial perfusion studies and coronary angiography within 3 months. Stress and rest perfusion images were visually analysed and scored semiquantitatively using a 17-segment model by two experienced blinded readers. Global and coronary territorial summed stress scores (SSS) and summed rest scores (SRS) were calculated. Global SSS {>=}3 or coronary territorial SSS {>=}2 was considered abnormal. In addition the total perfusion deficit (TPD) was automatically derived. TPD >5 % and coronary territorial TPD {>=}3 % were defined as abnormal. Coronary angiograms were analysed for site and severity of coronary stenosis; {>=}50 % was considered significant. Of the 50 patients, 13 (26 %) had no stenosis, 22 (44 %) had single-vessel disease, 6 (12 %) had double-vessel disease and 9 (18 %) had triple-vessel disease. There was a good linear correlation between the visual global SSS and SRS (Spearman's {rho} 0.897 and 0.866, respectively; p < 0.001). In relation to coronary angiography, the sensitivities, specificities and accuracies of HS SPECT and conventional SPECT by visual assessment were 92 % (35/38), 83 % (10/12) and 90 % (45/50) vs. 84 % (32/38), 50 % (6/12) and 76 % (38/50), respectively (p < 0.001). The sensitivities, specificities and accuracies of HS SPECT and conventional SPECT in relation to automated TPD assessment were 89 % (31/35), 57 % (8/14) and 80 % (39/49) vs. 86 % (31/36), 77 % (10/13) and 84 % (41/49), respectively. HS SPECT allows fast acquisition of myocardial perfusion images that correlate well with angiographic findings with overall accuracy by visual assessment better than conventional SPECT. Further assessment in a larger patient population may be needed to confirm this observation. (orig.)

Neill, Johanne [University College London Hospital, Institute of Nuclear Medicine, London (United Kingdom); The Prince Charles Hospital, Brisbane (Australia); Prvulovich, Elizabeth M.; Bomanji, Jamshed B. [University College London Hospital, Institute of Nuclear Medicine, London (United Kingdom); Fish, Matthews B. [Sacred Heart Medical Center (SHMC), Springfield, OR (United States); Berman, Daniel S.; Slomka, Piotr J. [Cedars-Sinai Medical Center, Los Angeles, CA (United States); Sharir, Tali [Procardia Maccabi Healthcare Services (PMHS), Tel Aviv (Israel); Martin, William H. [Vanderbilt University Medical Center (VUMC), Nashville, TN (United States); DiCarli, Marcelo F. [Brigham and Women' s Hospital (BWH), Boston, MA (United States); Ziffer, Jack A. [Baptist Hospital of Miami (BHM), Miami, FL (United States); Shiti, Dalia [Spectrum-Dynamics, Caesarea (Israel); Ben-Haim, Simona [University College London Hospital, Institute of Nuclear Medicine, London (United Kingdom); Chaim Sheba Medical Center, Department of Nuclear Medicine, Tel-Hashomer (Israel)

2013-07-15

325

Thallium-201 myocardial SPECT findings at rest in sarcoidosis  

International Nuclear Information System (INIS)

In 41 patients with sarcoidosis (diagnosed according to criteria recommended by the Committee on Diffuse Pulmonary Disease, Ministry of Health and Welfare, Japan 1988), thallium-201 (201Tl) myocardial SPECT was performed to investigate: the ability of 201Tl SPECT to detect cardiac involvement of sarcoidosis with images recorded at rest and 2 hours later, and the relationships between 201Tl myocardial SPECT findings and the activity of sarcoidosis or endomyocardial biopsy findings. As to the abnormal findings in 201Tl myocardial SPECT, a low density area was seen in 13 of 41 cases (31.7%) and non-uniform uptake was found in 17 cases (41.5%), the mean washout ratio (n=39) was 16.5±7.4%, which is significantly lower than that found in normal subjects, 23.9±7.5% (n=10). Of the 19 patients judged visually to be normal, 5 patients had a reduced mean washout ratio less than 12%. Thus, the incidence of abnormal findings including all types of abnormality in sarcoidosis was 63.4% (26/41 cases). As measured by the serum ACE (angiotensin converting enzyme) or lysozyme level, or the presence of more than 30% symphocyte fraction in BALF (broncho-alveolar lavage fluid), 20 (80%) of 25 cases with 201Tl abnormality were judged to be active sarcoidosis, while only 6 (37.5%) of 16 cases with normal findings on 201Tl SPECT were judged to be active. This suggest that there is a significant relationship between the presence or absence of an abnormal finding on 201Tl myocardial SPECT and the activity of sarcoidosis. Among 13 patients examined by endomyocardial biopsy, 10 patients had abnormal findings on 201Tl myocardial SPECT and 7 of these 10 patients had no histological evidence of cardiac sarcoidosis. In all of these 7 patients, however, sarcoidosis was judged to be active. This suggest that endomyocardial biopsy is of limited value in the diagnosis of cardiac sarcoidosis. (author)

1993-05-01

326

Indications and evaluation of coronary artery bypass grafting with myocardial single photon emission tomography using 123I-BMIPP. A new tracer of myocardial metabolism of fatty acid  

Energy Technology Data Exchange (ETDEWEB)

To evaluate viability and severity of ischemically damaged myocardium,myocardal single emission tomography (SPECT) using 123I-BMIPP (BMIPP), a new tracer of myocardial metabolism of fatty acid, was performed before and after coronary artery bypass grafting (CABG). 201TI myocardial SPECT (TI) and left ventriculography (LVG) were also used.Thirty-three revascularized areas in eight patients were investigated. Areas showing good redistribution on TI and normal uptake on BMIPP indicated good viability and simple ischemic myocardium. Postoperative uptake of both tracers returned to normal levels. Areas showing good redistribution on TI and severely decreased uptake on BMIPP indicated jeopardized myocardium with severe ischemia. All such areas were seen in patients with unstable angina.Postoperative uptake of both tracers returned to normal levels. Areas showing poor redistribution or severely decreased uptake on TI and slight uptake on BMIPP indicating hibernating areas. Postoperative uptake became normal or better than preoperative uptake on TI necrosis. However on BMIPP, the uptake was unchanged or recovered slightly. Areas showing complete defect in TI and BMIPP indicated necrosis and had no viabilty. Postoperatively the defect in both tracers were unchanged. Therefore, these areas required no revascularization. The ischemic state of myocardium could be assessed by evaluation of uptake patterns of BMIPP and TI using myocardial SPECT. Therefore, using this new tracer of myocardial fatty acid metabolism BMIPP is useful for deciding culprit and viable lesions requiring coronary revascularization and evaluating therapeutical effects.

Nemoto, Shintaro; Oshitomi, Takashi; Endo, Masahiro; Koyanagi, Hitoshi [Tokyo Women`s Medical Coll. (Japan). Heart Inst. and Hospital; Harada, Masanori

1996-03-01

327

Altered myocardial perfusion in patients with angina pectoris or silent ischemia during exercise as assessed by quantitative thallium-201 single-photon emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

The extent of abnormally perfused myocardium was compared in patients with and without chest pain during treadmill exercise from a large, relatively low-risk consecutive patient population (n = 356) referred for quantitative thallium-201 single-photon emission computed tomography (SPECT). All patients had concurrent coronary angiography. Patients were excluded if they had prior coronary angioplasty or bypass surgery. Tomographic images were assessed visually and from computer-generated polar maps. Chest pain during exercise was as frequent in patients with normal coronary arteries (12%) as in those with significant (greater than 50% stenosis) coronary artery disease (CAD) (14%). In the 219 patients with significant CAD, silent ischemia was fivefold more common than symptomatic ischemia (83% versus 17%, p = 0.0001). However, there were no differences in the extent, severity, or distribution of coronary stenoses in patients with silent or symptomatic ischemia. Our major observation was that the extent of quantified SPECT perfusion defects was nearly identical in patients with (20.9 +/- 15.9%) and without (20.5 +/- 15.6%) exertional chest pain. The sensitivity for detecting the presence of CAD was significantly improved with quantitative SPECT compared with stress electrocardiography (87% versus 65%, p = 0.0001). Although scintigraphic and electrocardiographic evidence of exercise-induced ischemia were comparable in patients with chest pain (67% versus 73%, respectively; p = NS), SPECT was superior to stress electrocardiography for detecting silent myocardial ischemia. The majority of patients in this study with CAD who developed ischemia during exercise testing were asymptomatic, although they exhibited an angiographic profile and extent of abnormally perfused myocardium similar to those of patients with symptomatic ischemia.

Mahmarian, J.J.; Pratt, C.M.; Cocanougher, M.K.; Verani, M.S. (Baylor College of Medicine, Houston, TX (USA))

1990-10-01

328

Altered myocardial perfusion in patients with angina pectoris or silent ischemia during exercise as assessed by quantitative thallium-201 single-photon emission computed tomography  

International Nuclear Information System (INIS)

The extent of abnormally perfused myocardium was compared in patients with and without chest pain during treadmill exercise from a large, relatively low-risk consecutive patient population (n = 356) referred for quantitative thallium-201 single-photon emission computed tomography (SPECT). All patients had concurrent coronary angiography. Patients were excluded if they had prior coronary angioplasty or bypass surgery. Tomographic images were assessed visually and from computer-generated polar maps. Chest pain during exercise was as frequent in patients with normal coronary arteries (12%) as in those with significant (greater than 50% stenosis) coronary artery disease (CAD) (14%). In the 219 patients with significant CAD, silent ischemia was fivefold more common than symptomatic ischemia (83% versus 17%, p = 0.0001). However, there were no differences in the extent, severity, or distribution of coronary stenoses in patients with silent or symptomatic ischemia. Our major observation was that the extent of quantified SPECT perfusion defects was nearly identical in patients with (20.9 +/- 15.9%) and without (20.5 +/- 15.6%) exertional chest pain. The sensitivity for detecting the presence of CAD was significantly improved with quantitative SPECT compared with stress electrocardiography (87% versus 65%, p = 0.0001). Although scintigraphic and electrocardiographic evidence of exercise-induced ischemia were comparable in patients with chest pain (67% versus 73%, respectively; p = NS), SPECT was superior to stress electrocardiography for detecting silent myocardial ischemia. The majority of patients in this study with CAD who developed ischemia during exercise testing were asymptomatic, although they exhibited an angiographic profile and extent of abnormally perfused myocardium similar to those of patients with symptomatic ischemia

1990-01-01

329

/sup 201/Tl perfusion study of ''ischemic'' ulcers of the leg: prognostic ability compared with Doppler ultrasound  

Energy Technology Data Exchange (ETDEWEB)

Thallium 201 perfusion analysis was compared with Doppler ultrasound as a means of determining the healing potential of an ischemic ulcer of the leg in 27 patients. The degree of hyperemia was determined by comparative point counting of the /sup 201/Tl distribution in and about the ulcer. Using established Doppler criteria and a hyperemia ratio greater than 1.5:1, ultrasound alone correctly predicted healing in 15 out of 23 cases and /sup 201/Tl in 20 out of 23. Ultrasound correctly predicted non-healing in 3 out of 6 cases, compared with 5 out of 6 for /sup 201/Tl. The positive predictive value of the /sup 201/Tl study was 63%, versus 27% for ultrasound, and the negative predictive value was 95% for /sup 201/Tl and 83% for ultrasound. The accuracy of /sup 201/Tl and ultrasound was 86% and 62%, respectively. This limited study suggests that /sup 201/Tl perfusion scanning is a useful noninvasive test of ulcer healing potential and may be more sensitive than Doppler ultrasound.

Siegel, M.E. (Univ. of Southern California, Los Angeles); Stewart, C.A.; Kwong, P.; Sakimura, I.

1982-04-01

330

The value of gallium-67 and thallium-201 whole-body and single-photon emission tomography images in dialysis-related ?2-microglobulin amyloid  

International Nuclear Information System (INIS)

The aim of this study was to investigate the value of gallium-67 and thallium-201 whole-body and single-photon emission tomography (SPET) images in long-term dialysis patients in whom dialysis-related ?2-microglobulin amyloid (?2-MA) was clinically suspected. Twenty-three patients who had received dialysis for at least 10 years were included in the study. A technetium-99m methylene diphosphonate (MDP) whole-body scan was performed in all of the patients. If there was any MDP accumulation in the articular and/or peri-articular region, 67Ga and 201Tl whole-body and SPET images were then acquired. If any 67Ga and/or 201Tl uptake was observed, a CT-guided biopsy was done. In those patients who had articular and/or peri-articular uptake of 99mTc MDP, 67Ga and/or 201Tl and who were pathologically proven to have ?2-MA, 99mTc MDP, 67Ga and 201Tl whole-body scans and SPET were carried out again, both 3 months and 1 year after initiation of treatment. This served to evaluate the therapeutic effect and allowed comparison with the clinical findings. Of the 23 patients, eight had abnormal 99mTc MDP uptake. Among these eight, six had intense 99mTc MDP, 67Ga and 201Tl uptake in the articular and peri-articular regions before medication. Three months after the start of treatment, there were very marked decreases in uptake on both the 67Ga and 201Tl scans but less obvious changes in uptake of 99mTc-MDP. In comparison with the other clinical manifestations such as limitation in range of motion, the more the painful disability improved, the less was the uptake on both 67Ga and 201Tl scans. There were virtually no differences in uptake pattern between the three scans of each radiopharmaceutical obtained for each patient in both 3 months and 1 year after initial of treatment. It is concluded that 99mTc-MDP whole-body bone scan can both detect active and pre-existing inactive deposits of ?2-MA. 67Ga and 201Tl scans are helpful to differentiate active from inactive deposits of ?2-MA and to evaluate the therapeutic effect on these patients. SPET images are usually needed to distinguish articular and peri-articular lesions from bone lesions. (orig.)

2000-01-01

331

Non-invasive evaluation of myocardial reperfusion by transthoracic Doppler echocardiography and single-photon emission computed tomography in patients with anterior acute myocardial infarction  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background The study was designed to evaluate whether the preserved coronary flow reserve (CFR) 72 hours after reperfused acute myocardial infarction (AMI) is associated with less microvascular dysfunction and is predictive of left ventricular (LV) functional recovery and the final infarct size at follow-up. Methods In our study, CFR was assessed by transthoracic Doppler echocardiography (TDE) in 44 patients after the successful percutaneous coronary in...

Sadauskiene Egle; Zakarkaite Diana; Ryliskyte Ligita; Celutkiene Jelena; Rudys Alfredas; Aidietiene Sigita; Laucevicius Aleksandras

2011-01-01

332

Production of carrier-free 201Tl from enriched 204Pb targets bombarded by 32-60 MeV protons  

International Nuclear Information System (INIS)

Yields of 200Tl, 201Tl, and 202Tl in targets of enriched 204Pb bombarded by 32-60 MeV protons in a Y-240 synchronous cyclotron are determined. It is demonstrated that 201Tl is produced in (6.1 ± 0.9)·107 Bq/?A·h yield with a radionuclidic purity of 98% in a 204Pb (56%) target of thickness 0.9 g/cm2 bombarded with 44 ± 0.5 MeV protons. Isolation of 201Tl from the bombarded Pb targets by extraction chromatography is proposed

1992-11-01

333

Regional wall thickening in gated myocardial perfusion SPECT in a Japanese population: effect of sex, radiotracer, rotation angles and frame rates  

Energy Technology Data Exchange (ETDEWEB)

Gated single-photon emission computed tomography (SPECT) imaging of myocardium by {sup 99m}Tc and {sup 201}Tl is used extensively to measure quantitative cardiac functional parameters. However, factors affecting normal values for myocardial functional parameters and population-specific standards have not yet been established. The aim of the study was to determine the effect of sex, radiotracer, rotation angles and frame rates on resting myocardial wall thickening (WT) and to develop a Japanese standard of normal values for WT. Data from a total of 202 patients with low possibility of having cardiac problems were collected from nine hospitals throughout Japan. Patients were divided into five groups according to study protocol, and WT was evaluated according to the 17-segment and four-region (basal, mid and apical regions and the apex) polar map distribution. WT was generally higher in women than in men irrespective of the use of radiotracers, rotation angles or frame rates, and the difference was highly significant in the mid and apical regions. In any protocol used, resting myocardial thickening in the apex was higher than in the mid and apical regions, and thickening was lowest in the basal region, suggesting heterogeneous regional myocardial thickening (%) in normal subjects. Different rotation angles showed no significant change on WT, but different frame rates and tracers showed significant WT change in both sexes. Percent thickening of the myocardium was significantly higher in imaging by {sup 99m}Tc-labelled tracers than in {sup 201}Tl. Sex, radiotracers and frame rates had a significant effect on myocardial thickening, and the importance of population-specific standards should be emphasized. A normal database can serve as a standard for gated SPECT evaluation of myocardial thickening in a Japanese population and might be applicable to Asian populations having a similar physique. (orig.)

Akhter, Nasima; Nakajima, Kenichi; Okuda, Koichi; Matsuo, Shinro; Yoneyama, Tatsuya; Taki, Junichi; Kinuya, Seigo [Kanazawa University Hospital, Department of Nuclear Medicine, Kanazawa, Ishikawa (Japan)

2008-09-15

334

A rapid improved method for gamma-spectrometric determination of 202Tl impurities in [201Tl]-labelled radiopharmaceuticals.  

Science.gov (United States)

Despite the cyclotron production method and the efficiency of the radiochemical procedures adopted, the long-lived radio-isotopic impurity 202Tl is always present in [201Tl]-labelled radio-pharmaceuticals, together with other short-lived impurities like, 200Tl. Rapid determination of the 202Tl impurity, can be achieved using HPGe gamma spectrometry and a detector shielded by a 5 mm thick envelope of lead. In this way, dead-time correction errors, Compton and X-ray background, are very efficiently avoided and suppressed. The same method could be applied routinely in nuclear medicine, to determine the radioisotopic purity of 201Tl by means of an ionisation chamber dose calibrator. PMID:12433038

Bonardi, Mauro; Groppi, Flavia; Birattari, Claudio

2002-11-01

335

Single photon quantum cryptography.  

Science.gov (United States)

We report the full implementation of a quantum cryptography protocol using a stream of single photon pulses generated by a stable and efficient source operating at room temperature. The single photon pulses are emitted on demand by a single nitrogen-vacancy color center in a diamond nanocrystal. The quantum bit error rate is less that 4.6% and the secure bit rate is 7700 bits/s. The overall performances of our system reaches a domain where single photons have a measurable advantage over an equivalent system based on attenuated light pulses. PMID:12398636

Beveratos, Alexios; Brouri, Rosa; Gacoin, Thierry; Villing, André; Poizat, Jean-Philippe; Grangier, Philippe

2002-10-28

336

Separation of 201Tl by anion exchange chromatography on AG1-X4 after proton bombardment of a lead cyclotron target  

International Nuclear Information System (INIS)

A method is described for the separation of 201Tl from lead cyclotron target material bombarded with 66 MeV protons. After bombardment the lead target material is dissolved in nitric acid and the bismuth radioisotopes are separated from the lead by anion exchange chromatography on AG1-X4 in a nitric acid-hydrobromic acid mixture. Nitric acid is then eluted with a hydrobromic acid-ascorbic acid mixture, and the column set aside for 36 h in order to let the 201Bi decay via 201Pb to 201Tl