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1

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

International Nuclear Information System (INIS)

[en] 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  

Energy Technology Data Exchange (ETDEWEB)

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

Assessment of left ventricular function using (201)Tl electrocardiogram-gated myocardial single photon emission computed tomography.  

UK PubMed Central (United Kingdom)

PURPOSE: Advances in computed tomography (CT) technology make it possible to obtain left ventricular wall motion using 3D reconstruction. In this study, we compared the images obtained from CT and (201)Tl electrocardiogram (ECG) gated single photon emission computed tomography (SPECT). METHODS: In 20 patients with ischemic heart disease, we performed (201)Tl ECG gated SPECT (GE Healthcare Millennium VG) and ECG gated CT (Philips Medical Systems Brilliance iCT) to evaluate of left ventricular wall motion during the resting phase. In SPECT, left ventricular images were reconstructed using quantitative gated SPECT (QGS) software. In CT, the images were reconstructed using Virtual Place (AZE Software). The left ventricle was classified into five regions (anterior, lateral, inferior, septal, and apical). The amplitude of the wall motion was classified into five grades according to AHA classification. The values of the wall motion were separately checked by two radiographers. RESULTS: Assessment of left ventricular function myocardial wall movement using the three-dimensional movie display with ECG gated myocardial SPECT data was in agreement with the evaluation by cardiac CT inspection, and corresponded with wall motion in 88 of all 100 segments. CONCLUSIONS: SPECT analysis has the same quantity as that of obtained from CT for evaluation of left ventricular wall motion.

Nishikubo N; Tamai H

2013-07-01

4

Evaluation of acute myocardial infarction by 201Tl single-photon emission computed tomography using scoring system  

International Nuclear Information System (INIS)

In 36 patients with acute myocardial infarction (AMI) 201Tl single photon emission computed tomography (SPECT) examinations were performed in a relatively early phase of AMI. The short and long axis views of the left ventricle (LV) were divided into 6 segments. Images of each segment were assigned scores (segmental scores) based on a visual evaluation of the extent of 201Tl accumulations. SPECT scores were compared with max GOT, max LDT, max CPK and max CK-MB, Killip classification and Forrester hemodynamic subset on admission, and LV ejection fraction (LVEF). Segmental scores were compared with LV wall motion evaluated by left ventriculography. The results are as follows: There were significant correlations between SPECT scores and max GOT, max LDH, max CPK and max CK-MB. SPECT scores in patients with Killip group III were significantly higher than in patients with Killip group I+II. However, no significant differences in max GOT, max LDH, max CPK and max CK-MB were observed between patients with Killip group III and those with Killip group I+II. SPECT scores were significantly higher in patients with Forrester group III+IV than in patients with Forrester group I+II. Segmental scores in segments evaluated as akinesis, dyskinesis and aneurysm by left ventriculography were significantly higher than those evaluated as hypokinesis or normal. Segmental scores in segments evaluated as hypokinesis were significantly high in comparison with normal segments. Significant correlations were observed between LVEF and SPECT scores. However, LVEF correlated poorly with max GOT, max LDH and max CPK, and no significant correlation was observed between LVEF and max CK-MB. SPECT examinations were performed in 11 patients in both the acute and chronic phase of AMI. SPECT scores in the chronic phase did not change in 4 patients, decreased in 5, increased in 2. These results suggest that SPECT scores and segmental scores can be useful indices in the evaluation of AMI. (J.P.N.).

1991-01-01

5

Evaluation of acute myocardial infarction by sup 201 Tl single-photon emission computed tomography using scoring system  

Energy Technology Data Exchange (ETDEWEB)

In 36 patients with acute myocardial infarction (AMI) {sup 201}Tl single photon emission computed tomography (SPECT) examinations were performed in a relatively early phase of AMI. The short and long axis views of the left ventricle (LV) were divided into 6 segments. Images of each segment were assigned scores (segmental scores) based on a visual evaluation of the extent of {sup 201}Tl accumulations. SPECT scores were compared with max GOT, max LDT, max CPK and max CK-MB, Killip classification and Forrester hemodynamic subset on admission, and LV ejection fraction (LVEF). Segmental scores were compared with LV wall motion evaluated by left ventriculography. The results are as follows: There were significant correlations between SPECT scores and max GOT, max LDH, max CPK and max CK-MB. SPECT scores in patients with Killip group III were significantly higher than in patients with Killip group I+II. However, no significant differences in max GOT, max LDH, max CPK and max CK-MB were observed between patients with Killip group III and those with Killip group I+II. SPECT scores were significantly higher in patients with Forrester group III+IV than in patients with Forrester group I+II. Segmental scores in segments evaluated as akinesis, dyskinesis and aneurysm by left ventriculography were significantly higher than those evaluated as hypokinesis or normal. Segmental scores in segments evaluated as hypokinesis were significantly high in comparison with normal segments. Significant correlations were observed between LVEF and SPECT scores. However, LVEF correlated poorly with max GOT, max LDH and max CPK, and no significant correlation was observed between LVEF and max CK-MB. SPECT examinations were performed in 11 patients in both the acute and chronic phase of AMI. SPECT scores in the chronic phase did not change in 4 patients, decreased in 5, increased in 2. These results suggest that SPECT scores and segmental scores can be useful indices in the evaluation of AMI.

Setsuta, Koichi (Nippon Medical School, Tokyo (Japan))

1991-10-01

6

Usefulness of sup 99m Tc-methoxy isobutyl isonitrile myocardial single photon emission computed tomography; A comparison with sup 201 Tl in effort angina pectoris with only left anterior descending coronary artery stenosis  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the usefulness of a new radiotracer, {sup 99m}Tc methoxy isobutyl isonitrille ({sup 99m}Tc-MIBI), rest and stress {sup 99m}Tc-MIBI myocardial single photon emission computed tomography (SPECT) were compared with stress {sup 201}Tl myocardial SPECT in the same 10 effort angina pectoris patients with only left anterior descending artery (LAD) stenosis. In the stress scan, the number and the severity of abnormal segments in LAD territories were higher by {sup 201}Tl than those by {sup 99m}Tc-MIBI. Sensitivity in the detection of abnormality by {sup 99m}Tc-MIBI was as high as that by {sup 201}Tl (90% vs. 100%). However, specificity by {sup 99m}Tc-MIBI tended to be higher than that by {sup 201}Tl (70% vs. 55%), because the more false-positive segments were observed in {sup 201}Tl SPECT. In comparison of images between rest scan by {sup 99m}Tc-MIBI and delayed scan by {sup 201}Tl, the rate and degree of normalization in {sup 99m}Tc-MIBI SPECT was higher than those of redistribution in {sup 201}Tl SPECT. Thus, our results indicate that {sup 99m}Tc-MIBI myocardial SPECT was more reliable than {sup 201}Tl for the evaluation of the extent of ischemic lesion or viable tissue in the ischemic heart disease. (author).

Takao, Yuji; Murata, Hajime; Onoguchi, Masahisa; Ohtake, Eiji; Katoh, Kenichi (Toranomon Hospital, Tokyo (Japan))

1991-08-01

7

Single photon emission computed tomography using rotating dual gamma-camera for /sup 201/Tl myocardial imaging in patients with ischemic heart disease  

Energy Technology Data Exchange (ETDEWEB)

Exercise /sup 201/Tl myocardial scintigraphy was performed for comparison between single photon emission computed tomography (SPECT) and the conventional planar method. The detection rate for ischemic heart diseases was 98% by SPECT and 86% by the planar method. The detection rate of transient ischemia in the myocardial infarction group was 70% by SPECT, 34% by the planar method and 40% by ECG (ST depression). In segmental analysis the sensitivity for the left anterior descending artery, left circumflex artery and right coronary artery was 86%, 68% and 83%, respectively, by SPECT and 61%, 60% and 57% by the planar method. SPECT thus elevated the sensitivity in ischemic heart diseases and allowed estimation of coronary artery diseases.

Futagami, Yasuo; Hamada, Masayuki; Ichikawa, Takehiko; Konishi, Tokuji; Nakano, Takeshi (Mie Univ., Tsu (Japan). School of Medicine)

1983-08-01

8

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

International Nuclear Information System (INIS)

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 201Tl 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 201Tl uptake index (SPECT) generally corresponded well, 2DE was thought to be a useful method for evaluating myocardial infarct zone. (J.P.N.).

1987-01-01

9

Clinical use of 201Tl myocardial scintigraphy  

International Nuclear Information System (INIS)

Myocardial imaging with 201Tl and scinticamera was studied experimentally using specially designed phantoms and clinically in 23 patients with myocardial infarction or other heart disease. In the phantom experiment, quality of image, accumulative count rate, and detectability of the defect were compared to obtain the best technique for their detection, using four different collimators, i.e., converging, pin-hole, 4000-hole, and 140 keV high-resolution, at two photopeak levels of 201Tl of 75 and 167 keV, and combining a radiation absorber. In patient examination, myocardial images taken at different periods after injection, different detecting conditions of the scinticamera, and various detecting projections were compared. Images of the converging collimator at the 75 keV photopeak revealed considerably higher accumulative counts and relatively higher quality than those of other detecting conditions. It was necessary to take as many images as possible in various projections, in order to detect the location and size of the myocardial ischemic lesion because the lesion was demonstrated as a clear defect only in profile. It became evident that images taken between about 25 and 90 min delineated the myocardium more clearly than those taken in other periods. Normal images taken in 8 patients without ischemic heart disease appeared in the shape of a doughnut of horseshoe, demonstrating mainly the left venticular myocardium. The image was faint in the region of the aortic or mitral valve and thin in the region of the apical wall. A faint image of the right ventricular myocardium was sometimes seen. In 3 patients with valvular heart disease, findings suggested changes in the thickness of myocardium and the distribution of coronary blood flow. In 11 of 12 patients with old myocardial infarction, the location and size of the lesion was detected. (Evans, J.)

1977-01-01

10

Myocardial scintigraphy with 201Tl in angiosarcoma of the heart  

International Nuclear Information System (INIS)

The appearance of angiosarcoma of the heart in the myocardial image with 201Tl is described on hand of an casuistic example. This diagnostic procedure may be important for follow-up of therapeutic effects. (orig.)

1979-01-01

11

Quantitative analysis of 201Tl-myocardial imaging  

International Nuclear Information System (INIS)

[en] 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

12

Left ventricular ejection fraction derived from resting sup 201 Tl myocardial images  

Energy Technology Data Exchange (ETDEWEB)

To determine if resting {sup 201}Tl myocardial scintigraphy (rest-Tl) provides the information on left ventricular function, we compared preliminarily the parameters derived from rest-Tl with left ventricular ejection fraction (LVEF) derived from left ventriculography; while the parameters included Extent Score (ES), Severity Score (SS), Percent Uptake (PU), and Area Index (AI). AI was derived from the averaging of {l brace}(A/B)x100{r brace} in three or four central slices of short axis view on single photon emission computed tomography (A; area surrounded by inner edge of {sup 201}Tl myocardial image, B; area surrounded by outer edge of {sup 201}Tl myocardial image). The patients were comprised of 38 males and 16 females with a mean age of 53 years old (range 15-70) and classified into two groups; patients with myocardial infarction (n=28, Group I), and patients with miscellaneous disease but without myocardial infarction (n=26, Group II). In Group I, ES, SS and AI correlated with LVEF. If ES was less than 0.30, SS was less than 26.2, or AI was less than 19.8, LVEF was suggested more than 60% with an accuracy of 92%, 85% and 85%, respectively. In Group II, these did not correlate with LVEF. If there were areas with PU <70% in the region perfused by left anterior descending artery or left circumflex artery, LVEF was less than 60% with an accuracy of 78%. In conclusion, rest-Tl images provide some information on left ventricular function in some patients. (author).

Matsuo, Takeshi; Nagatomo, Yoshitatsu; Imamura, Takuroh; Koiwaya, Yasushi; Tanaka, Kenjiro (Miyazaki Medical Coll., Kiyotake (Japan))

1990-08-01

13

Myocardial perfusion SPET imaging with 99mTc-MIBI in the detection and localization of coronary artery disease: A comparison with 201Tl  

International Nuclear Information System (INIS)

99mTc-MIBI (methoxy isobutyl isonitrile) is a new radiopharmaceutical with advantageous characteristics over 201Tl for the study of myocardial perfusion and single photon emission tomography (SPET). In order to compare its diagnostic accuracy with that of 201Tl, SPET studies were performed in 29 patients with angiographically confirmed coronary artery disease (CAD) and 4 normal healthy volunteers. Stress (bycicle ergometer) and rest SPET investigations were carried out after the intravenous administration of a single dose (74 MBq) of 201Tl, always at peak stress exercise, and 99mTc-MIBI (370 MBq) at peak stress, repeated when the patient was at rest (24 or more hours later). Reconstructed images were visually analysed in order to detect perfusion defects and assess their reversibility (reversible myocardial ischaemia). Results were compared with those from coronary angiography. Both 99mTc-MIBI and 201Tl showed a high sensitivity (96% and 90% respectively) for the detection of CAD. In a segment by segment comparison, the sensitivity, specificity and diagnostic accuracy were similar for 99mTc-MIBI and 201Tl. 156 or 165 (95%) myocardial segments showed complete agreement between the two myocardial perfusion imaging tracers. The effect of therapeutic interventions (angioplasty or coronary bypass surgery) was accurately demonstrated (compared with coronary angiography). Myocardial perfusion SPET imaging with 99mTc-MIBI demonstrates high diagnostic accuracy, comparable to 201Tl, to detect myocardial ischaemia and assess myocardial perfusion of patients with CAD. (author).

1990-01-01

14

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

International Nuclear Information System (INIS)

[en] 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

2004-01-01

15

201Tl in myocardial diagnosis: studies on the influence of dipyridamole, dobutamine ergometer exercise and background subtraction on the 201Tl myocadial scintiscam  

International Nuclear Information System (INIS)

[en] Changes in 201Tl myocardial scintiscans upon administration of dipyridamole or dobutamine and upon ergometer exercise relative to scintiscans at rest were investigated as well as the influence of myocardial background subtraction on scintiscan quality and information. A total of 90 201Tl examinations were carried out in 59 patients. 18 patients had no myocardial disease, 30 patients had a coronary disease, 5 patients suffered from cardiomyopathy and 6 from left ventricular hypertrophy. The findings are discussed in detail. (orig.)

1979-01-01

16

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

Energy Technology Data Exchange (ETDEWEB)

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

17

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)

[en] 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)

2003-01-01

18

Quantitative assessment of 201TlCl myocardial SPECT  

International Nuclear Information System (INIS)

[en] 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

19

The value of myocardial 201Tl scintigraphy for the diagnosis of coronary heart disease  

International Nuclear Information System (INIS)

The results of ECG, bicycle ergometry (BEM) and myocardial 201Tl scintigraphy at rest and during BEM exercise were evaluated in 78 male and 24 female coronary patients as well as 18 normal controls. Scintigraphy during the BEM test is shown to be capable of detecting areas of transient myocardial ischemia. The sensitivity of the BEM test and myocardial scintigraphy was 83 and 91 %, respectively, in detecting transient myocardial ischemia. Myocardial 201Tl scintigraphy should be conducted where other investigations, used for the diagnosis of coronary disease, yield little information: in patients with angiographically-intact coronary arteries and in cases of atypical clinical appearance of coronary heart disease

1988-01-01

20

Degradation of myocardial perfusion SPECT images caused by contaminants in thallous (201Tl) chloride  

International Nuclear Information System (INIS)

Thallous (201Tl) chloride is a single-photon emission computed tomography (SPECT) tracer mainly used for assessing perfusion and viability of myocardial tissue. 201Tl emits X-rays around 72 keV and gammas at 167 keV, and has a half-life of 73 h. Regulations allow an intrinsic contamination up to 3-5%, which is mainly caused by 200Tl (368 keV; 26 h) and by 202Tl (439 keV; 12.2 days). Contra-intuitive to the low-level percentages in which these contaminants are present, their impact may be significant because of much higher gamma camera sensitivity for these high-energy photon emissions. Therefore, we investigate the effects of the contaminants in terms of detected fractions of photons in projections and contrast degradation in reconstructed images. Acquisitions of a digital thorax phantom filled with thallous (201Tl) chloride were simulated with a validated Monte Carlo tool, thereby, modelling 1% of contamination by 200Tl and 202Tl each. In addition, measurements of a thorax phantom on a dual-headed gamma camera were performed. The product used was contaminated by 0.17% of 200Tl and 0.24% of 202Tl at activity reference time (ART). This ART is specified by the manufacturer, thereby, accounting for the difference in half-lives of 201Tl and its contaminants. These measurements were repeated at different dates associated with various contamination levels. Simulations showed that, with 1% of 200Tl and 202Tl, the total contamination in the 72 keV window can rise up to one out of three detected photons. For the 167keV window, the contamination is even more pronounced: more than four out of five detections in this photopeak window originate from contaminants. Measurements indicate that cold lesion contrast in myocardial perfusion SPECT imaging is at maximum close to ART. In addition to a higher noise level, relative contrast decreases 15% 2 days early to ART, which is explained by an increase in 200Tl contamination. After ART, contrast decreased by 16% when the 202Tl contamination increased to the maximal allowed limit. Contra-intuitive to the low-level percentages in which they are typically present, penetration and downscatter of high-energy photons from 200Tl and 202Tl significantly contribute to thallous (201Tl) chloride images, thereby, reducing contrast and adding noise. These findings may prompt for improved production methods, for updated policies with regard to timing of usage, and they also render the usefulness of adding the high photopeak window (167 keV) questionable. A window-based correction method for this contamination is advisable. (orig.)

2008-01-01

 
 
 
 
21

[Single-photon emission computed tomography with 201Tl in the diagnosis of ischemic heart disease  

UK PubMed Central (United Kingdom)

One hundred and thirty-six patients with CHD were examined by plane scintigraphy and single-photon emission computer-aided tomography (SPECT). The control group comprised 26 healthy persons. Two SPECT techniques were compared (gamma-chamber rotation at 360 and 180 degrees). In acute myocardial infarction, focal defects of perfusion were detected by SPECT in 36 out of 39 patients, those by plane scintigraphy in 30 patients. In angina pectoris patients, perfusion alterations were detected by SPECT and scintigraphy in 91.6 and 75% of cases, respectively. During tomographic examination of patients with postinfarction cardiosclerosis, the perfusion defects were revealed in 38 out of 42 patients, whereas during plane scintigraphy, such alterations were detected but in 31 patients. The advantages of SPECT and its high importance for diagnosing different patterns of CHD are discussed. It is recommended that SPECT and plane scintigraphy can be used combined in clinical practice.

Sergienko VB; Shcherbatkin DD; Borisenko AP

1985-01-01

22

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

Energy Technology Data Exchange (ETDEWEB)

The objective of the present study was to characterize the production of {sup 201}Tl myocardial perfusion defects, the relation between the {sup 201}Tl multiple small defects and the myocardial damage indicated by myocardial fibrosis shown histopathologically in patients with dilated cardiomyopathy (DCM). Rest {sup 201}Tl scintigraphy was performed in thirty-seven patients. {sup 201}Tl 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. {sup 201}Tl uptake, defect regions (DR), and coefficient of variation % (CV%) were also quantified by Bull`s eye quantification in nineteen patients. {sup 201}Tl 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 {sup 201}Tl findings, and 21 (62.2%) had myocardial fibrosis in stage 1. Clinically, the correlation between the grades of the IPD, % {sup 201}Tl 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; % {sup 201}Tl uptake vs. fibrosis: r=-0.6542; DR vs. fibrosis: r=0.7027; CV% vs. fibrosis: r=0.6985). The {sup 201}Tl 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 {sup 201}Tl 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 {sup 201}Tl 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)

Li, Lin-xue; Nohara, Ryuji; Okuda, Kazumi [Kyoto Univ. (Japan). Hospital] [and others

1996-08-01

23

Detectability of diagonal branch disease by [sup 201]TlCl exercised myocardial scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

The detectability of diagonal branch disease in 10 patients (five with angina pectoris, five with myocardial infarction) with isolated diagonal branch lesions (more than 75% luminal stenosis in coronary angiography) was reviewed. In exercised [sup 201]TlCl myocardial scintigraphy, chest pain occurred in four of 10 patients, electrocardiographic change indicating myocardial ischemia was seen in four, and diagonal branch lesion was detected in only four patients by planar images. In contrast, diagonal branch lesions were detected in 10 of 10 patients by single photon emision computed tomography (SPECT). In planar images, perfusion defects appeared high in the anterolateral, posterolateral, and anterior walls of the left ventricle. In SPECT images they appeared high in the anterior to anterolateral wall. The extent of diagonal branch lesions could be quantitatively evaluated by coronary territory maps developed from unfolded maps of exercised SPECT. The mean ratio of the extent of diagonal branch lesion to left anterior descending branch territory was 24.7%, and the extent of myocardial infarction was significantly larger than that of angina pectoris (p<0.05). In conclusion, SPECT is useful for detecting diagonal branch lesions and can quantitatively show the extent of these lesions by coronary territory map. (author).

Hirose, Yoshiaki; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Shimonagata, Tsuyoshi; Hamada, Seiki (National Cardiovascular Center, Suita, Osaka (Japan))

1992-09-01

24

Evaluation of 201Tl myocardial tomography in detecting coronary heart disease  

International Nuclear Information System (INIS)

The diagnostic value of 201Tl myocardial tomographic imaging in coronary heart diseases were studied in 31 cases of coronary heart disease and 15 normal subjects, compared with coronary angiography. The sensitivity and specificity of myocardial tomography were 97% and 80% respectively. The sensitivity in identifying one-vessel, two-vessels and three-vessels of coronary artery stenosis were 100%, 83% and 44% respectively. The detectability of LAD, RCA and LCX lesions were 95%, 93% and 59% respectively. It is concluded that 201Tl myocardial tomography is a valuable procedure for the early diagnosis and localization of coronary stenosis

1992-01-01

25

Prognostic value of gated 201Tl myocardial perfusion SPECT imaging in patients with coronary artery disease  

International Nuclear Information System (INIS)

[en] Objective: To study the prognostic value of gated 201Tl myocardial perfusion SPECT imaging in patients with coronary artery disease and assessment of therapy strategy for the individual patient. Methods: Eighty-four patients underwent rest and exercise stress 201Tl gated myocardial perfusion SPECT imaging and were followed up for (32.92 ± 16.77) months. Images were studied using 17 segments and 1 to 4 scoring. Global summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS=SSS-SRS) were also calculated. Post-stress and rest ejection fraction (EF) were automatically measured. Results: Nine cardiac events occurred (3.90% per year). SSS, SDS, SRS and EF were the independent predictors of cardiac events (P201Tl myocardial perfusion SPECT imaging can provide prognostic assessment for the patients with coronary artery disease and guide in selection of therapeutic strategy. Among all of the indices SSS is the best predictors of cardiac events. (authors)

2006-01-01

26

Usefulness of 99mTc-methoxy isobutyl isonitrile myocardial single photon emission computed tomography  

International Nuclear Information System (INIS)

[en] To evaluate the usefulness of a new radiotracer, 99mTc methoxy isobutyl isonitrille (99mTc-MIBI), rest and stress 99mTc-MIBI myocardial single photon emission computed tomography (SPECT) were compared with stress 201Tl myocardial SPECT in the same 10 effort angina pectoris patients with only left anterior descending artery (LAD) stenosis. In the stress scan, the number and the severity of abnormal segments in LAD territories were higher by 201Tl than those by 99mTc-MIBI. Sensitivity in the detection of abnormality by 99mTc-MIBI was as high as that by 201Tl (90% vs. 100%). However, specificity by 99mTc-MIBI tended to be higher than that by 201Tl (70% vs. 55%), because the more false-positive segments were observed in 201Tl SPECT. In comparison of images between rest scan by 99mTc-MIBI and delayed scan by 201Tl, the rate and degree of normalization in 99mTc-MIBI SPECT was higher than those of redistribution in 201Tl SPECT. Thus, our results indicate that 99mTc-MIBI myocardial SPECT was more reliable than 201Tl for the evaluation of the extent of ischemic lesion or viable tissue in the ischemic heart disease. (author)

1991-01-01

27

/sup 201/Tl myocard scintigraphy - a specialized non-invasive method in evaluating myocardial function  

Energy Technology Data Exchange (ETDEWEB)

In 216 patients with ischemic heart disease (IHK) or with angina pectoris symptoms and suspected IHK the results of resting electrocardiograms were compared with those of /sup 201/Tl scintigraphy under conditions of rest and exercise, resp. /sup 201/Tl scintigraphy proved to be superior in sensitivity and specifity to the electrocardiograms of rest and under exercise as to the detection of coronary heart disease, the localization and assessment of the severity of coronary heart disease, and the evidence of load ischemia. Conclusions are drawn for a program of consecutive diagnostic steps in suspected IHK as well as for the evaluation of myocardial function in known IHK.

Birke, S.; Deckart, H.; Mischke, W.; Schulz, J.; Koblitz, E. (Staedtisches Klinikum Berlin-Buch (German Democratic Republic). Nuklearmedizinische Klinik)

1985-01-01

28

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

International Nuclear Information System (INIS)

[en] 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

29

Potentialities of using 201Tl-chloride in the differential diagnosis of coronarogenic and extraconarogenic myocardial lesions in menopausal females  

International Nuclear Information System (INIS)

[en] 76 menopausal females were subjected to general clinical examination: biochemical investigation of carbohydrate, protein and lipid metabolism; radioimmunoassay of hormones; myocardial scintigraphy with 201Tl-chloride to diagnose coronarogenic and extracoronarogenic myocardial lesions. It is shown that the application of myocardial scintigraphy with 201Tl-chloride in menopausal females has followed to clarify the degree of distrophic changes in the myocardium of the left ventricle and to differentiate dyshormonal dystrophy and myocardial ischemia

1991-01-01

30

Quantitative assessment of myocardial blood flow by measurement of fractional myocardial uptake of /sup 201/Tl  

Energy Technology Data Exchange (ETDEWEB)

Fractional Myocardial uptake of /sup 201/Tl was measured for the quantitative assessment of myocardial blood flow in coronary artery disease (CAD). 10 normals and 28 CAD, 7 of which have less than 50% stenosis (CAD I) and 21 of which have more than 50% stenosis (CAD II) in the proximal portion of coronary arteries, were studied at rest and with submaximal exercise loading by bicycle ergometer. After intravenous injection of /sup 201/Tl, its rapid transport process was recorded during the initial 5 minutes by a scintillation camera and a minicomputer. Total injected dosage (T) was obtained from the counts of the entire chest region during the initial passage of the tracer through the heart and lung. Myocardial uptake (M) was counted with the same geometry from the subsequent accumulation within the myocardial region with subtraction of the background activities in the upper mediastinal region (B). The fractional myocardial uptake of /sup 201/Tl ((M-B)/T) is assumed to be proportional to the fractional myocardial blood flow to cardiac output (MBF/CO) according to the indicator fractionation principle. The average value of MBF/CO at rest in CAD (4.11 +- 1.12%) was significantly greater than in normals (3.36 +- 0.49%), which may be caused by an increased left ventricular mass in CAD. Change rate of MBF/CO on the exercise loading was significantly less in CAD I (1.36 +- 0.14) and in CAD II (1.11 +- 0.21) than in normals (1.75 +- 0.11). MBF/CO increased proportionally to the increment of the double product of heart rate and systolic blood pressure by exercise loading in normals, whereas it didn't in CAD. The sensitivity of this method was superior to the stress electrocardiogram and the stress myocardial perfusion imaging, not only in CAD II but also in CAD I. This result indicated that this type of global assessment of the myocardial reserve capacity is valuable in addition to the simple stress myocardial perfusion imaging.

Yonekura, Y.; Ishii, Y.; Torizuka, K.; Kadota, K.; Kambara, H. (Kyoto Univ. (Japan). Faculty of Medicine)

1980-12-01

31

Evaluation of role of 201Tl myocardial perfusion scintigraphy in patients with left ventricular dysfunction  

International Nuclear Information System (INIS)

A study was undertaken to determine prognostic value of thallium-201 myocardial perfusion SPECT study in patients with low left ventricular dysfunction (LVEF) to predict future adverse cardiac outcome. The study shows that in patients with low LVEF the infarct size and pulmonary uptake of 201Tl are the most important prognostic indicators. Patients with mild to moderate infarct size and absent pulmonary uptake may benefit from a non invasive strategy and may not require invasive management

1998-01-01

32

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

33

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

International Nuclear Information System (INIS)

[en] 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)

1996-01-01

34

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

35

Characteristics of [sup 201]Tl myocardial SPECT and left ventriculography in patients with acute diagonal branch myocardial infarction  

Energy Technology Data Exchange (ETDEWEB)

Characteristics of [sup 201]Tl myocardial SPECT and ventriculography were studied in 13 patients with acute diagonal branch myocardial infarction. Rest [sup 201]Tl myocardial SPECT and left ventriculography were underwent in chronic phase. In 5 patients electrocardiogram (ECG) changes in acute phase were not definite. In 6 patients it was difficult to identify the obstructed coronary artery with coronary angiography in acute phase. Mean value of maximum creatine phosphokinese (CPK) was 854 (458-1,774) U/l. It seemed to be difficult to diagnose acute diagonal branch myocardial infarction with ECG and/or coronary angiography. In all patients defects were noted on [sup 201]Tl SPECT. Defects were small and noted in the central anterior wall and not in the septum. In 2 patients defects were noted at apex. In left ventriculography dyskinetic motion was noted in 10 patients; one patient showed apical aneurysm and 3 patients showed anterior wall aneurysm. In 3 patients anterior wall showed akinesis. It was concluded that [sup 201]Tl myocardial SPECT were useful for detecting diagonal branch lesion. In case of diagonal branch myocardial infarction size of defects were small and defects were not noted in the septum, however aneurysmal motion was frequently noted. (author).

Tanaka, Takeshi; Aizawa, Tadanori; Katou, Kazuzo; Ogasawara, Ken; Kirigaya, Hajime (Cardiovascular Inst., Tokyo (Japan))

1993-10-01

36

/sup 201/Tl chloride scintiscanning in myocardial infarction - correlation with ECG findings - diagnostic potential  

Energy Technology Data Exchange (ETDEWEB)

The author intended to find out in how far myocardial scintiscanning with /sup 201/Tl chloride is a necessary auxiliary investigation in diagnosing acute myocardial infarction and whether there are correlations between ECG, increase of enzyme levels, and pressure measured in the lesser circulatory system. The scintiscans were evaluated by a new method: Defect sizes were determined using a transparent template and recorded in angular degrees. Also the reduced activity was considered. Especially posterior myocardial infarctions can be localized more easily and clearly by means of myocardial scintiscanning at rest, and also infarction sizes can be judged more easily. For a diagnosis of small myocardial infarctions or in patients with a block in their ECG picture, scintiscanning is a necessary part of the diagnostic spectrum. The findings of myocardial scintiscanning correspond well with those of other methods. As for the pressure increase in the lesser circulatory system, it is well correlated with the defect size shown by the scintiscan. /sup 201/Tl scintiscanning offers a good diagnostic possibility in those myocardial infarctions where ECG findings are ambiguous.

Kostka, I.

1980-10-17

37

201Tl myocardial SPECT and ?-endorphin levels in patients with suspected silent ischemia  

International Nuclear Information System (INIS)

[en] Today silent myocardial ischemia (SMI) is a well-recognized phenomenon. Treadmill exercise according to the Bruce protocol, 201Tl myocardial SPECT and coronary angiography were performed in a total of 106 patients with suspected SMI. In group I (high probability of ischemia; n=46), reversible defects detected by SPECT correlated well with significant stenoses and irreversible defects with subtotal stenoses or complete occlusions. SPECT sensitivity in the detection of ischemia was 91%, its specificity 96%. In group II (low probability of ischemia; n=60), SPECT sensitivity was as high as in group I (94%) but due to a high number of false-positive results (e.g. cardiomyopathy) specificity was only 75%. However, SPECT was superior to exercise ECG (sensitivity 70%; specificity 56%) in the detection of SMI. In addition, ?-endorphin levels were determined in 180 healthy subjects, 37 patients with symptomatic CAD and in 34 patients with SMI before and during maximum exercise. Exercise values in patients with SMI were significantly higher than in healthy subjects or in patients with symptomatic CAD. (orig./MG)[de] Fuer die asymptomatische Form der koronaren Herzkrankheit (KHK) ist heute der Begriff der stummen Myokardischaemie (SMI) etabliert. Bei 106 Patienten mit fraglicher SMI wurde neben einem Belastungs-EKG (Protokoll nach Bruce) eine 201Tl-Myokard-SPECT und eine Koronarangiographie durchgefuehrt. In Gruppe I (hohe Praetestwahrscheinlichkeit, n=46) bestand eine gute Korrelation zwischen reversiblen 201Tl-Defekten und signifikanten Koronarstenosen einerseits sowie irreversiblen 201Tl-Defekten und subtotalen Stenosen bzw. Koronarverschluessen andererseits. Die Sensitivitaet der SPECT betrug 91%, ihre Spezifitaet 96%. In Gruppe II (niedrige Praetestwahrscheinlichkeit, n=60) war die Sensitivitaet der SPECT aehnlich hoch wie in Gruppe I (94%), die Spezifitaet lag aber auf Grund mehrerer falsch-positiver Befunde (Kardiomyopathie etc.) deutlich niedriger (75%). Insgesamt war die SPECT in der Diagnose der stummen Myokardischaemie dem Belastungs-EKG (Sensitivitaet 70%; Spezifitaet 56%) deutlich ueberlegen. Zusaetzlich wurden in dieser Studie ?-Endorphin-Spiegel vor und waehrend ergometrischer Belastung bei 180 Koronargesunden, bei 37 Patienten mit symptomatischer KHK und bei 34 Patienten mit SMI bestimmt. Die Belastungswerte lagen bei Patienten mit SMI signifikant hoeher als bei Koronargesunden oder Patienten mit symptomatischer KHK. (orig./MG)

1990-01-01

38

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)

2000-01-01

39

Correlation of myocardial uptake of 201Tl with local perfusion in the dog heart  

International Nuclear Information System (INIS)

[en] 34 anesthetized and thoracotomized dogs are studied. The local myocardial blood flow is measured with sup(99m)Tc human albumin microsphere. The intramyocardial distribution of 201Tl in relation to local blood flow is studied in basal conditions (24 dogs), after experimental infarction (4 dogs) and postischemic reactive hyperhemia (6 dogs). We conclude that during basal conditions, after infarction and hyperhemia the 201Tl myocardial distribution reflect with damping the variations of blood flow[fr] 34 chiens anesthesies et thoracotomises sont etudies. Le debit sanguin myocardique local est mesure avec des microspheres d'albumine humaine marquees au technetium-99m. La repartition intramyocardique du thallium-201 en fonction du debit sanguin local est etudiee dans les conditions basales (24 chiens), apres creation d'un infarctus (4 chiens) et au cours de l'hyperhemie reactionnelle postischemique (6 chiens). On conlue que dans les conditions basales, apres infarctus et au cours de l'hyperhemie la fixation du thallium-201 reflete les variations du debit sanguin local en les amortissant

1980-01-01

40

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

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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

 
 
 
 
41

Myocardial imaging with 201Tl at rest and during exercise. Comparison with coronary arteriography and resting and stress electrocardiography  

International Nuclear Information System (INIS)

[en] Myocardial imaging with intravenous thallium-201 (201Tl) was performed at rest and following maximal treadmill exercise in 101 patients with suspected coronary artery disease. Results were interpreted from Polaroid scintiphotos by three independent observers with complete interobserver agreement in 79%. Of 25 patients with no or insignificant coronary artery disease (201Tl image defect, one (4%) had an exercise 201Tl defect, none had an ECG Q wave, and four (16%) had exercise ST-segment depression. Among 76 patients with coronary artery disease (greater than or equal to 50% diameter stenosis), 58 (76%) had a defect on either the rest or exercise 201Tl image. The proportion of patients with an exercise image defect (50/76, 66%) was greater than the proportion with exercise ST depression alone (34/76, 45%; P 201Tl is easily accomplished with readily available imaging equipment. The image data enhanced the diagnostic sensitivity of stress electrocardiography, and provided spatial identification of the abnormal segment(s) of myocardium

1977-01-01

42

Myocardial scintigraphy with 201Tl in combination with pharmacological tests in the diagnosis of coronary heart diseases  

International Nuclear Information System (INIS)

[en] The paper presents the results from examination of 67 patients with coronary heart disease verified by a bicycle ergometric tests, 48 underwent 201Tl myocardial scintigraphy along with a dipyridamole test, 19, the scintigraphy in combination with an isoproterenol test. The feasibilities of employing the procedures in the diagnosis of coronary heart disease were compared by statistic analysis

1989-01-01

43

201Tl myocardial scintigraphy correlation with TMT and coronary angiography - a preliminary report  

International Nuclear Information System (INIS)

Full text: This study analyses 60 patients of suspected ischemic heart disease who underwent myocardial perfusion studies with 201Tl SPECT from June 1998 - September 1998. Thirty six patients were tested positive on TMT, thallium scintigraphy was positive in 21 (58%) patients and negative in 15 (41%) cases. Coronary angiography results were available in 35 patients, of which there were 5 cases with LBBB where TMT was not done due to high unpredictability. The 5 cases were tested negative, both angiographically and stress thallium showing 100% correlation. Out of remaining 30 patients, angiography was positive in 22 patients. Stress thallium was positive in 19 patients (87%). Of the 8 cases which showed normal coronary angiography, stress thallium was positive in 3 cases (13%) and negative in 5 patients (87%). Statistical analysis of this small group showed a sensitivity of 86%, specificity of 63%, false negative rate 14% and false positive rate of 37%. Overall accuracy is 80%

1998-01-01

44

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

International Nuclear Information System (INIS)

[en] 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

2001-01-01

45

Evaluation of scanning condition and early organ accumulation with large field of view gamma camera in 201Tl myocardial scan  

International Nuclear Information System (INIS)

The authors evaluated 201Tl as a myocardial scanning agent and studied its scanning condition and early accumulation in organs up to 10 minutes after intravenous injection in order to obtain basic information for 201Tl myocardial scans. The study with a liver slice phantom showed the best results in 80 keV photopeak with 20% window width in a low energy collimator. Normal myocardium (NM) and lung activity decreased rapidly to reach a plateau within 3 minutes after injection. Activity in NM and liver changed little after 5 minutes postinjection, but infarcted myocardium (MI) and lung activity still continued to decrease. In each case Ml always showed low activity compared to the normal area of the myocardium, and mean Ml/NM ratio distributed from 0.74 to 0.80 up to 10 minutes after the injection. Disappearance of 201Tl from the blood was two exponential: 2.5 minutes (rapid phase) and 54.7 minutes (slow phase). Effective half life of 201Tl in the whole body measured by linear scan was 2.22 +- 0.46 days, and the whole body radiation dose was thought to be about 160 mrads/mCi. 201Tl myocardial scan beginning at 5 minutes after injection delineated Ml as a cleararea of decreased activity. The kidney showed the highest activity, and NM showed the same as or slightly greater than liver and spleen activity. Mediastinal activity always showed the lowest activity, resulting in a good contrast myocardial scan. From these results, the time to begin myocardial scan could be as early as 5 minutes after injection. (Evans, J.)

1976-01-01

46

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

1996-01-01

47

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

48

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

Energy Technology Data Exchange (ETDEWEB)

To determine quantitatively the discriminant and characteristics of cor pulmonale, {sup 201}Tl 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 (PaCO{sub 2}), while it was inversely correlated with arterial oxygen tension (PaO{sub 2}). However, there was no significant correlation between Tl-score and mPAP, TPR, PaCO{sub 2}, and PaO{sub 2} 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 {sup 201}Tl 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.).

Kato, Hiroshi; Misawa, Toshihiro; Kutsumi, Yasunori (Fukui Medical School, Matsuoka (Japan)) (and others)

1991-01-01

49

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

50

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

Energy Technology Data Exchange (ETDEWEB)

The effect of cardiac rehabilitation (mean 70{+-}48 months) on myocardial perfusion was assessed using thallium-201 ({sup 201}Tl) 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 {sup 201}Tl 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%) (p<0.01). Peak double products increased from 203.4{+-}72 x 10{sup 2} to 269.8{+-}58 x 10{sup 2} in the Rh group and decreased from 218.7{+-}40 x 10{sup 2} to 216.6{+-}76 x 10{sup 2} (p<0.01) in the Ct group. {sup 201}Tl 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%, p<0.01). {sup 201}Tl 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)

Li, Linxue; Nohara, Ryuji; Makita, Shigeru [Kyoto Univ. (Japan). Hospital] [and others

1996-07-01

51

Effect of verapamil on myocardial ischemia in patients with hypertrophic cardiomyopathy; Evaluation by exercise [sup 201]Tl SPECT  

Energy Technology Data Exchange (ETDEWEB)

Effect of verapamil on myocardial ischemia in patients with hypertrophic cardiomyopathy (HCM) was evaluated by exercise stress myocardial [sup 201]Tl SPECT (EX-Tl). EX-Tl was performed before and after 8.8 weeks of oral verapamil (240 mg/day) in 12 patients with HCM who showed transient [sup 201]Tl perfusion defects under control conditions. [sup 201]Tl perfusion defect was visually scored and judged for 4 grades as normal (0), mild defect (1), moderate defect (2), and severe defect (3). Transient dilation index (TDI) was calculated as an index of subendocardial ischemia. Improvements of defect score were demonstrated in 10 patients after administration of verapamil. Two patients showed no change of defect score. Mean defect score decreased significantly from 5.50 to 3.03 (p<0.001). Although 11 of 12 patients showed abnormal TDI under control conditions, 10 of these revealed improvements of TDI and 7 of the 10 disclosed normal TDI after verapamil. Mean TDI decreased from 1.263 to 1.090 significantly (p<0.01). In conclusion, verapamil may improve myocardial ischemia in patients with HCM. (author).

Taniguchi, Yoko; Sugihara, Hiroki; Ootsuki, Katsuichi (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

1993-01-01

52

Noninvasive estimation of site of lesion of left anterior descending artery with stress 201Tl myocardial SPECT images  

International Nuclear Information System (INIS)

[en] Noninvasive estimation of site of lesion of left anterior descending artery (LAD) is important because of high morbidity of LAD lesion. Utility of stress 201Tl myocardial SPECT images for predicting site of LAD lesion characteristics of ischemic region induced by LAD lesion in the basal coronal image were studied in 53 patients with localized significant LAD lesion. Right margin of ischemic region at basal plane of SPECT images was determined by circumferential maximum count profile analysis of stress 201Tl myocardial images. Right margin of ischemic region induced by the just proximal lesion was 21±11deg, that by proximal lesion was -6±10deg and that by mid portion was -36±17deg. Sensitivity of right margin of ischemic region 0 for just proximal lesion was 100% (20/20) and that of right margin of ischemic region 0 for mid portion lesion was 100% (18/18). These results showed the possibility of detecting site of LAD lesion by stress 201Tl myocardial SPECT images. (author)

1992-01-01

53

Noninvasive estimation of site of lesion of left anterior descending artery with stress sup 201 Tl myocardial SPECT images  

Energy Technology Data Exchange (ETDEWEB)

Noninvasive estimation of site of lesion of left anterior descending artery (LAD) is important because of high morbidity of LAD lesion. Utility of stress {sup 201}Tl myocardial SPECT images for predicting site of LAD lesion characteristics of ischemic region induced by LAD lesion in the basal coronal image were studied in 53 patients with localized significant LAD lesion. Right margin of ischemic region at basal plane of SPECT images was determined by circumferential maximum count profile analysis of stress {sup 201}Tl myocardial images. Right margin of ischemic region induced by the just proximal lesion was 21{+-}11deg, that by proximal lesion was -6{+-}10deg and that by mid portion was -36{+-}17deg. Sensitivity of right margin of ischemic region 0 for just proximal lesion was 100% (20/20) and that of right margin of ischemic region 0 for mid portion lesion was 100% (18/18). These results showed the possibility of detecting site of LAD lesion by stress {sup 201}Tl myocardial SPECT images. (author).

Tanaka, Takeshi; Aizawa, Tadanori; Kato, Kazuzo; Ogasawara, Ken; Kirigaya, Hajime; Okamoto, Kiyoshi; Hosoi, Hiromitsu (Cardiovascular Inst., Tokyo (Japan))

1992-03-01

54

Scintigraphic appearance in stress 201Tl myocardial SPECT of midportion lesion in left anterior descending artery  

International Nuclear Information System (INIS)

[en] Scintigraphic appearance of left anterior descending artery (LAD) lesion in stress 201Tl myocardial SPECT was studied in 43 patients with midportion lesion in LAD confirmed by coronary angiography. Right margin of ischemic region in the basal short axial image was -36±17deg and left margin was -128±75deg. In 28 of 43 patients left margin lied beyond -120deg. From the results it was concluded that in most cases basal inferior wall was perfused by septal branches from LAD. In 6 patients with midportion lesion situated proximal to the first diagonal branch and in 12 patients with midportion lesion situated proximal to the second diagonal branch ischemic region in the apical portion was noted at both septum and anterolateral wall. Critical short axial image, in which right margin of ischemic region shifted from plus to minus area, was the 3.2th short axial image in the former group and the 5.2th in the latter group (p

1993-01-01

55

Dipiramidole test and 201-Tl myocardial scintigraphy in the diagnosis of ischemic heart disease  

International Nuclear Information System (INIS)

19 conscutive subjects affected by effort angina have been studied using following tests: ecg stress test, stress 201-Tl scan, coronary arteriography; 201-Tl scan, coronary arteriography, hemodynamic, echo 2 D, ecographyc monitoring on coronary arteriography results we divided patients; in the group A (10 patients with significant stenoses ?50%) stress ecg and scintigraphy were positive in 9 patients; Dipyridamole test induced angor and ecographyc changes in 5 patients and in 4 left ventricle wall motion disorders, 201-Tl scan was positive in all 9 patients tested. In the group B (9 subjects with no significant stenosis) ecographyc changes were observed in 2 subjects and 201 Tl scan was positive in 6 subjects; D induced in 2 cases angor, in 1 case ecographyc changes, in 1 case left ventricle wall motion disorders and the same 201-Tl defects in 6 previously individualized patients. In both groups at coronary arteriography have been observed during D identical findings in comparison with the immediately before performed. In experience D infusion is confirmed as provocative test of ischemia. The same ischemic pattern observed at strees and Dipyridamole scintygraphy in patients with no significant coronary stenosis suggests as pathogenetic mechanism the regional lack of dilatory reserve.

1987-01-01

56

Evaluation of myocardial perfusion and left ventricular function by /sup 201/Tl scintigraphy after dipyridamole  

Energy Technology Data Exchange (ETDEWEB)

/sup 201/Tl myocardial imaging was performed at rest and after dipyridamole (0.44 mg/kg) on 50 patients with known or suspected ischemic heart disease. The dipyridamole had no effect in 14 patients (group Dip.0). In 17 patients (group Dip +-) it significantly modified the contrast of the rest image (by increasing or decreasing a rest perfusion defect). In 19 patients (group Dip - Steal) the drug induced a paradoxical response interpreted as a coronary steal effect (an active region at rest becomes hypoactive after dipyridamole while an underperfused region at rest improves). All patients underwent coronary arteriography and left monoplane ventriculography; results were interpreted in relation to these angiographic data. The mean percentage of stenoses (per patient) was about the same in the three groups but it was found that, despite these stenoses, the patients of the group Dip - Steal had a good left ventricular function (EF = 0.62 +- 0.12). On the other hand, the ejection fraction was very poor in the two other groups (0.50 +- 0.17 and 0.48 +- 0.17). Moreover it was found that: (1) the frequency of high grade or even complete obstruction was notably less in group Dip - Steal (P < 0.05); (2) the frequency of angiographically visible collaterals was higher in group Dip - Steal (P < 0.05); (3) the left anterior descending artery was less diseased than the right coronary artery in group Dip - Steal (P < 0.05). These results have a real prognostic value for the assessment of the preserved cardiac performance in Dip - Steal patients despite severe stenoses, and are discussed in terms of compensatory collateral circulation and preservation of the coronary-flow reserve in the myocardium distal to a critical stenosis.

Demangeat, J.L.; Constantinesco, A.; Chambron, J.; Mossard, J.M.; Voegtlin, R.

1981-11-01

57

Serial assessment of denervated but viable myocardium following acute myocardial infarction in dogs using iodine-123 metaiodobenzylguanidine and thallium-201 chloride myocardial single photon emission tomography  

International Nuclear Information System (INIS)

Iodine-123 metaiodobenzylguanidine (mIBG) is taken up by sympathetic nerve endings, allowing scintigraphic imaging of myocardial sympathetic innervation. We investigated the denervated but viable canine myocardium after acute myocardial infarction by serial mIBG and thallium-201 chloride (201TlCl) single photon emission tomography (SPET). In 12 dogs, acute myocardial infarction was produced by ligation of the left circumflex coronary artery. Images of mIBG and thallium SPET were obtained 6 h, 1, 4 and 6 weeks later. The defect size was calculated in percentage points from short axial views, and the 123I-mIBG/201TlCl ratio was determined. The uptake ratio was high at 1 week but gradually decreased. Three dogs were killed at each time point, and tissue samples were obtained from infarcted (both 201TlCl and 123I-mIBG defects), peri-infarcted (123I-mIBG defect and 201TlCl normal) and normal myocardium (both mIBG and 201TlCl normal). The changes in tissue content of noradrenaline in these lesions were measured. Noradrenaline tissue content gradually recovered in the pre-infarcted area. However, no recovery was noted in the infarcted area at 6 weeks. We conclude that sympathetic denervation and re-innervation occur following acute myocardial infarction, and the denervated but viable myocardium could be detected non-invasively by combined mIBG and thallium SPET. (orig.)

1992-01-01

58

Serial assessment of denervated but viable myocardium following acute myocardial infarction in dogs using iodine-123 metaiodobenzylguanidine and thallium-201 chloride myocardial single photon emission tomography  

Energy Technology Data Exchange (ETDEWEB)

Iodine-123 metaiodobenzylguanidine (mIBG) is taken up by sympathetic nerve endings, allowing scintigraphic imaging of myocardial sympathetic innervation. We investigated the denervated but viable canine myocardium after acute myocardial infarction by serial mIBG and thallium-201 chloride ({sup 201}TlCl) single photon emission tomography (SPET). In 12 dogs, acute myocardial infarction was produced by ligation of the left circumflex coronary artery. Images of mIBG and thallium SPET were obtained 6 h, 1, 4 and 6 weeks later. The defect size was calculated in percentage points from short axial views, and the {sup 123}I-mIBG/{sup 201}TlCl ratio was determined. The uptake ratio was high at 1 week but gradually decreased. Three dogs were killed at each time point, and tissue samples were obtained from infarcted (both {sup 201}TlCl and {sup 123}I-mIBG defects), peri-infarcted ({sup 123}I-mIBG defect and {sup 201}TlCl normal) and normal myocardium (both mIBG and {sup 201}TlCl normal). The changes in tissue content of noradrenaline in these lesions were measured. Noradrenaline tissue content gradually recovered in the pre-infarcted area. However, no recovery was noted in the infarcted area at 6 weeks. We conclude that sympathetic denervation and re-innervation occur following acute myocardial infarction, and the denervated but viable myocardium could be detected non-invasively by combined mIBG and thallium SPET. (orig.).

Nishimura, Tsunehiko; Oka, Hisashi; Sago, Masatsugu; Matsuo, Takeshi; Uehara, Toshiisa; Noda, Hiroyuki (National Cardiovascular Center, Suita, Osaka (Japan). Dept. of Radiology); Takano, Hisateru (National Cardiovascular Center, Suita, Osaka (Japan). Dept. of Artificial Organs)

1992-01-01

59

Accuracy of serial myocardial perfusion scintigraphy with /sup 201/Tl for prediction of graft patency early and late after coronary artery bypass surgery. A controlled prospective study  

Energy Technology Data Exchange (ETDEWEB)

To assess the accuracy of serial myocardial perfusion scintigraphy with /sup 201/Tl to predict graft patency early and late coronary artery bypass surgery, rest and exercise /sup 201/Tl 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 /sup 201/Tl 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 /sup 201/Tl scintigraphy in 61%. Postoperative apical /sup 201/Tl 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 /sup 201/Tl defects in addition to typical or atypical angina provided a high probability of graft occlusion, while in the absence of new /sup 201/Tl 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 /sup 201/Tl 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.

Pfisterer, M.; Emmenegger, H.; Schmitt, H.E.; Mueller-Brand, J.; Hasse, J.; Graedel, E.; Laver, M.B.; Burckhardt, D.; Burkart, F.

1982-11-01

60

Accuracy of serial myocardial perfusion scintigraphy with 201Tl 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 201Tl to predict graft patency early and late coronary artery bypass surgery, rest and exercise 201Tl 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 201Tl 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 201Tl scintigraphy in 61%. Postoperative apical 201Tl 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 201Tl defects in addition to typical or atypical angina provided a high probability of graft occlusion, while in the absence of new 201Tl 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 201Tl 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

 
 
 
 
61

Low-dose single acquisition rest (99m)Tc/stress (201)Tl myocardial perfusion SPECT protocol: phantom studies and clinical validation.  

UK PubMed Central (United Kingdom)

PURPOSE: We developed and tested a single acquisition rest (99m)Tc-sestamibi/stress (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). METHODS: 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 (99m)Tc and rest (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. RESULTS: 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 (201)Tl dose of 74 MBq was insufficient for clinical assessment. In answer to this the (201)Tl dose was adapted for obese patients in the rest of the study. In 31 patients, SDI and (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 (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. CONCLUSION: 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.

Dey T; Backus BE; Romijn RL; Wieczorek H; Verzijlbergen JF

2013-09-01

62

Myocardial scintigraphic studies with 123I-MIBG, 201Tl and 99mTc-PYP in patients with cardiac amyloidosis  

International Nuclear Information System (INIS)

[en] Myocardial scintigraphic studies, using 123I-metaiodobenzylguanidine (MIBG), 99mTc-pyrophosphate (PYP) and 201Tl were performed in 4 patients with cardiac amyloidosis. In MIBG myocardial images, 2 patients with familial amyloid polyneuropathy (FAP) showed complete or partial defect and the other 2 with primary amyloidosis had normal myocardial uptake of MIBG. In PYP myocardial images, diffuse myocardial uptake of PYP was mild in 2 patients with FAP and moderate in the other 2. 201Tl myocardial images revealed normal myocardial uptake of 201Tl in 2 patients with FAP and 1 with primary amyloidosis, and intense myocardial uptake in the other one with primary amyloidosis. These results suggest that myocardial scintigraphies with PYP and 201Tl may be useful for the detection of cardiac amyloidosis and estimation of its pathophysiology. And MIBG myocardial scintigraphy may provide useful information about sympathetic nerve abnormalities which vary with type of the fibril protein, clinical syndromes and disease process of cardiac amyloidosis. (author)

1997-01-01

63

Scintigraphically determined myocardial blood flow by means of /sup 201/Tl in single and multiple vascular lesions  

Energy Technology Data Exchange (ETDEWEB)

100 patients with suspected coronary heart disease were examined for local storage defects in Tl scintigram in order to determine the clinical importance of /sup 201/Tl myocardial scintigraphy in comparison to heart catheterization. As to the sensitivity Tl scintigraphy proved to be superior to exercise electrocardiography with 89.3% to 63.6%. Tl scintigraphy was 100% sensitive in cases with 1 or 2 vessels affected compared to ECG with 47.0% and 58.8% resp. In patients with 3 vessels affected the sensitivity of both the methods was nearly equal. The myocardial scintigraphy, however, revealed more false positive results than ergometry. In spite of the diagnostic advantage, myocardial scintigraphy is not suited for screening tests. The range of indication of Tl scintigraphy in suspected as well as in established coronary heart disease is discussed.

Foerster, A.; Reisinger, I.; Strangfeld, D.; Ritter, A.; Romaniuk, P.; Frenzel, R.; Geissler, W. (Humboldt-Universitaet, Berlin (German Democratic Republic). Bereich Medizin (Charite))

1983-06-01

64

Coronary flow reserve evaluated by {sup 201}Tl myocardial perfusion SPECT after coronary artery bypass grafting (CABG) for angina pectoris  

Energy Technology Data Exchange (ETDEWEB)

We compared the flow reserves of the coronary bypass vessels between arterial and venous grafts by {sup 201}Tl myocardial perfusion SPECT on the patients with angina pectoris who had no past history of myocardial infarction or intervention therapy such as PTCA. Thirty two patients had undergone a total of 70 bypass grafts and 66 of them were proved to be patent at postoperative CAG. Reversible defects were observed in 6 of 40 segments (15.0%) covered by patent venous grafts, and in 11 of 26 segments (42.3%) by patent arterial grafts. The rate of postoperative reversible defects was higher in the areas grafted by artery but this had no relation with the severity of coronary artery stenosis before CABG. This reversible defect is most likely to be caused by the character of artery graft itself and this should not be considered to highly suggest the restenosis or occlusion of the graft vessel. (author)

Ishino, Yoichi; Nakata, Hajime [Univ. of Occupational and Environmental Health, Kitakyusyu, Fukuoka (Japan)

2000-11-01

65

Coronary flow reserve evaluated by 201Tl myocardial perfusion SPECT after coronary artery bypass grafting (CABG) for angina pectoris  

International Nuclear Information System (INIS)

[en] We compared the flow reserves of the coronary bypass vessels between arterial and venous grafts by 201Tl myocardial perfusion SPECT on the patients with angina pectoris who had no past history of myocardial infarction or intervention therapy such as PTCA. Thirty two patients had undergone a total of 70 bypass grafts and 66 of them were proved to be patent at postoperative CAG. Reversible defects were observed in 6 of 40 segments (15.0%) covered by patent venous grafts, and in 11 of 26 segments (42.3%) by patent arterial grafts. The rate of postoperative reversible defects was higher in the areas grafted by artery but this had no relation with the severity of coronary artery stenosis before CABG. This reversible defect is most likely to be caused by the character of artery graft itself and this should not be considered to highly suggest the restenosis or occlusion of the graft vessel. (author)

2000-01-01

66

Double myocardial scintigraphy with thallium 201 (Tl) and technetium containing pyrophosphate (PYP) in acute thrombosis  

International Nuclear Information System (INIS)

[en] Tests were carried out with thallium 201 (Tl) and technetium containing pyrophosphate (PYP) to compare their diagnostic sensitivity and estimate their possibilities for thrombosis size determinations. The study shows that double scintigraphy (Tl+PYP) supplies information on the size of the necrosis and promises more precise quantification, an important point considering the relationship which exists between the size of a thrombosis and the clinical prospects. PYP appears more sensitive than Tl, especially for non-transmural necroses and small thromboses. The diagnostic value of PYP is greater than that of Tl during the subacute phase[fr] On a utilise le thallium 201 (Tl) et le pyrophosphate technetie (PYP) afin de comparer leur sensibilite diagnostic et d'evaluer leur possibilite de determiner la taille de l'infarctus. L'etude confirme que la double scintigraphie (Tl et PYP) apporte des indications sur la taille de la necrose, et autorise l'espoir d'une quantification plus precise. Ce point et particulierement important quand on sait la relation existant entre la taille de l'infarctus et le pronostic clinique. La sensibilite du PYP parait superieure a celle du Tl surtout pour les necroses non transmurales et les infarctus de petite taille. La valeur diagnostique du PYP est superieure au Tl pendant la phase subaigue

1977-06-12

67

Evaluation of clinical usefulness of myocardial perfusion imaging with tetrofosmin in patients with ischemic heart disease. Comparison with [sup 201]Tl SPECT  

Energy Technology Data Exchange (ETDEWEB)

We evaluated the clinical usefulness of [sup 99m]Tc-1, 2-bis[bis(2-ethoxyethyl)phosphino]ethane (tetrofosmin) and compared it with [sup 201]Tl. The subjects consisted of 12 patients including 8 patients with old myocardial infarction (OMI), 2 with effort angina, one with stable angina and one with myocarditis. The tetrofosmin SPECT images were obtained during exercise and at rest. The quality of tetrofosmin SPECT images was equal or slightly superior to that of [sup 201]Tl. And the sensitivity, specificity and accuracy of tetrofosmin for the detection of coronary stenosis and/or obstruction were equal to that of [sup 201]Tl. We conclude that tetrofosmin is useful in the diagnosis of ischemic heart disease. (author).

Yoshida, Tsuyoshi; Sasaki, Masayuki; Ichiya, Yuichi (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine) (and others)

1994-09-01

68

Noninvasive detection and localization of coronary stenoses in patients: comparison of resting dipyridamole and exercise /sup 201/Tl myocardial perfusion imaging  

Energy Technology Data Exchange (ETDEWEB)

Two noninvasive tests to detect and localize coronary stenoses were compared in a fully blinded protocol. /sup 201/Tl myocardial perfusion imaging (MPI) following maximal treadmill exercise and pharmacologic coronary vasodilation with intravenous dipyridamole (DP) was performed in 33 patients. /sup 201/Tl imaging defects in six myocardial perfusion regions were correlated with stenoses in their respective vascular distributions. Disease severity was determined with coronary arteriograms using a computer-assisted method. 198 myocardial regions were evaluated; 101 were supplied by at least one major artery with a greater than or equal to 50% stenosis (luminal diameter narrowing). The sensitivity and specificity for detecting a greater than or equal to 50% stenosis were 85% and 64% (p less than 0.005), respectively, for DP and 84% and 68% (p less than 0.005) for exercise-/sup 201/Tl imaging. A particular combination of anterior and septal imaging defects was useful in detecting left anterior descending artery stenoses proximal to its first septal branch. DP administration was safe in this group of patients; however, 42% experienced transient chest pain. Although the overall sensitivity and specificity of the two methods were not significantly different, DP-MPI appeared more sensitive than exercise-MPI (70% vs 52%, p less than 0.01) in detecting coronary stenoses in the 40% to 60% range. DP-/sup 201/Tl MPI provides a useful alternative test for potential coronary disease patients unable to perform maximal exercise.

Josephson, M.A.; Brown, B.G.; Hecht, H.S.; Hopkins, J.; Pierce, C.D.; Petersen, R.B.

1982-06-01

69

Estimation of infarct size by myocardial emission computed tomography with /sup 201/Tl and its relation to creatine kinase-MB release after myocardial infarction in man  

Energy Technology Data Exchange (ETDEWEB)

We evaluated emission computed tomography (ECT) /sup 201/Tl myocardial imaging in estimating infarct size (IS). In 18 patients in whom IS was estimated enzymatically at the time of the acute episode, planar /sup 201/Tl perfusion scintigraphy and ECT with a rotating gamma camera were performed 4 weeks after the first myocardial infarction. From the size of /sup 201/Tl 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.

Tamaki, S.; Nakajima, H.; Murakami, T.

1982-11-01

70

Estimation of infarct size by myocardial emission computed tomography with 201Tl and its relation to creatine kinase-MB release after myocardial infarction in man  

International Nuclear Information System (INIS)

[en] We evaluated emission computed tomography (ECT) 201Tl myocardial imaging in estimating infarct size (IS). In 18 patients in whom IS was estimated enzymatically at the time of the acute episode, planar 201Tl perfusion scintigraphy and ECT with a rotating gamma camera were performed 4 weeks after the first myocardial infarction. From the size of 201Tl 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

71

Assessment of infarct volume in acute myocardial infarction using {sup 99m}Tc-pyrophosphate SPECT. Comparison with {sup 201}Tl defect, CPK and LVEF  

Energy Technology Data Exchange (ETDEWEB)

We measured infarct size (volume) in 15 patients with acute myocardial infarction (AMI) using {sup 99m}Tc-pyrophosphate and single photon emission computed tomography (SPECT) (PYP-SPECT). PYP-SPECT was performed between the 2nd and 6th days after the onset of AMI. The infarct size (PYP infarct size) was calculated by summing up the pixels with counts over a certain cut-off level in the transaxial and short axial images obtained by PYP-SPECT, and was compared with the relative infarct size obtained by {sup 201}Tl myocardial SPECT (%Tl infarct size), peak CPK, {Sigma}CPK and left ventricular ejection fraction (LVEF) measured by {sup 99m}Tc blood pool study. In addition to the measurement of the PYP infarct size, we calculated the relative infarct size (%PYP infarct size) from the defect length in the long axial image and the defect angle in the short axial image. Both the transaxial and short axial images were almost equally useful for the measurement of the PYP infarct size. The PYP infarct size and %PYP infarct size correlated well with %Tl infarct size (r = 0.7 - 0.8 and r=0.953, respectively). They also correlated with peak CPK (r = 0.6 - 0.65) and {Sigma}CPK (r = 0.8 - O.9). However. there was not a good correlation between the PYP infarct size and LVEF (r = -0.4 - -0.5). We conclude that PYP-SPECT is a very useful and reliable procedure that can delineate infarct size in AMI patients. (author)

Mochizuki, Teruhito [Ehime Imabari Hospital (Japan); Murase, Kenya; Fujiwara, Yasushi; Miyagawa, Masao; Tanada, Shuji; Ikezoe, Junpei

1997-12-01

72

Assessment of infarct volume in acute myocardial infarction using 99mTc-pyrophosphate SPECT. Comparison with 201Tl defect, CPK and LVEF  

International Nuclear Information System (INIS)

We measured infarct size (volume) in 15 patients with acute myocardial infarction (AMI) using 99mTc-pyrophosphate and single photon emission computed tomography (SPECT) (PYP-SPECT). PYP-SPECT was performed between the 2nd and 6th days after the onset of AMI. The infarct size (PYP infarct size) was calculated by summing up the pixels with counts over a certain cut-off level in the transaxial and short axial images obtained by PYP-SPECT, and was compared with the relative infarct size obtained by 201Tl myocardial SPECT (%Tl infarct size), peak CPK, ?CPK and left ventricular ejection fraction (LVEF) measured by 99mTc blood pool study. In addition to the measurement of the PYP infarct size, we calculated the relative infarct size (%PYP infarct size) from the defect length in the long axial image and the defect angle in the short axial image. Both the transaxial and short axial images were almost equally useful for the measurement of the PYP infarct size. The PYP infarct size and %PYP infarct size correlated well with %Tl infarct size (r = 0.7 - 0.8 and r=0.953, respectively). They also correlated with peak CPK (r = 0.6 - 0.65) and ?CPK (r = 0.8 - O.9). However. there was not a good correlation between the PYP infarct size and LVEF (r = -0.4 - -0.5). We conclude that PYP-SPECT is a very useful and reliable procedure that can delineate infarct size in AMI patients. (author).

1997-01-01

73

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

International Nuclear Information System (INIS)

[en] 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

2007-01-01

74

Double-nuclide study of the myocardium using /sup 201/Tl and /sup 123/I-labeled fatty acids in non-ischemic myocardial diseases  

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Metabolic impairment and perfusion abnormalities are known to occur in hypertensive heart disease (HHD) and in cardiomyopathies. Free fatty acid (FFA) extraction is severely inhibited in a number of pathobiochemical reactions. This parameter was assessed using the radiolabeled FFA analogue /sup 123/I-(p-iodo-phenyl-)-pentadecanoic acid (IPPA) and /sup 201/Tl as perfusion marker, both of them injected at maximal physical workload. The regional extraction fraction of IPPA (IPPA-EF) was estimated by relating the regional IPPA and /sup 201/Tl uptake to each other. In HHD (normal coronary arteries) with posterior wall thickness less than or equal to12 mm IPPA-EF was 77 +- 18% (SD) in septum and 92 +- 17% in the posterolateral wall (N = 13), with thickness of >12 mm 60 +- 23% in septum and 61 +- 20% in the posterolateral wall (N = 8) when compared with IPPA-EF in normal subjects (= 100%, N = 9). In hypertrophic cardiomyopathy (HCM) IPPA-EF averaged 51 +- 20% in septum and 87 +- 10% in the posterolateral wall (N = 11). In these patient groups no systematic regional changes in /sup 201/Tl uptake were observed. In dilated cardiomyopathy (DCM) both IPPA-EF and /sup 201/Tl uptake showed distinct regional variations and a great interindividual variability with a mean IPPA-EF reduction of 12% (N = 9). Thus, IPPA uptake in primarily non-ischemic myocardial disease may already be compromised when /sup 201/Tl uptake is unchanged. The double-nuclide method for IPPA-EF determination allows to eliminate the influence of flow in FFA imaging and enhances the potential of scintigraphy in the differential diagnosis of HHD versus coronary artery disease.

Knapp, W.H.; Vyska, K.; Notohamiprodjo, G.; Schmidt, U.; Machulla, H.J.; Knust, E.J.; Gleichmann, U.

1988-06-01

75

sup(99m)Tc-pyrophosphate and 201Tl myocardial scintigrams in a patient with myocarditis  

International Nuclear Information System (INIS)

Myocardial necrosis in acute myocarditis was investigated by scintigraphy. sup(99m)Tc-pyrophosphate (PYP) and 201TI myocardial scintigrams were obtained on a patient with acute myocarditis due to mycoplasma infection. sup(99m)Tc-PYP myocardial scintigrams in the acute stage demonstrated grade 2+ findings, which remained until the chronic stage. 201TI myocardial scintigrams in the acute stage revealed impaired perfusion restricted to the posterolateral wall, and this decrease continued through the chronic stage. It was concluded that both of sup(99m)Tc-PYP and 201TI myocardial scintigrams can reveal abnormality of acute myocarditis. (Ueda, J.)

1981-01-01

76

Quantification of myocardial infarct size by technetium-99m pyrophosphate single photon emission computed tomography  

International Nuclear Information System (INIS)

Myocardial infarct size in 41 patients with the first attack of acute transmural myocardial infarction (MI) was assessed by technetium-99m pyrophosphate single photon emission computed tomography (99mTcPYP-SPECT). A ratio of the number of voxels of 99mTcPYP uptake into the infarct area to that into the thorax was calculated as a parameter of MI size. The ratio was positively correlated with both peak CPK activity (r=0.53, p201Tl-SPECT (r=0.70, p99mTcPYP-SPECT was a useful method to evaluate MI size and to predict prognosis of cardiac function in patients with anterior MI but not in patients with inferior MI. (author).

1989-01-01

77

Aspects of recovery from regional wall motion abnormalities after exercise in patients with ischemic heart disease using 201Tl myocardial dynamic SPECT  

International Nuclear Information System (INIS)

Using 201Tl myocardial dynamic SPECT (dynamic SPECT), we studied various aspects of the recovery from exercise-induced ischemia, particularly the mechanism of delayed recovery from wall motion abnormality. The subjects were 23 patients with ischemic heart disease who underwent coronary angiography, exercise stress two-dimensional echocardiography (ESE), and dynamic SPECT. Using a 3-head SPECT system, dynamic SPECT was performed for 33 min consecutively from 5 min after the intravenous injection of 201TlCl (Tl). The regional early washout rate (early WR) was determined at 20, 29, and 38 min after Tl injection, and the delayed washout rate (delayed WR) was determined at 240 min. From the duration of regional wall motion abnormalities on ESE, the patients were divided into Group A (wall motion abnormalities persisting for ?20 min, n=8) and Group B (

1994-01-01

78

Myocardial scintigraphy with /sup 201/Tl. Pt. 2. Clinical applications (coronary heart disease)  

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This review article deals with the clinical application of myocardial scintigraphy, its originally proposed and modified strategies, and the indications such as the selection of high risk patients, prognostic evaluations, therapy control, silent myocardial ischemia and heart transplantation problems. The sensitivity and specificity of the method is described considering various problems of a suspected coronary heart disease in comparison to documented coronary heart disease. Comparative evaluations are made between nuclear cardiology and other medical diagnostic examinations. The authors consider positron emission tomography the most applicable method for myocardial scintigraphy in the future and the study of myocardial metabolism to be in the stage of routine clinical applicability.

Hoer, G.; Klepzig, H. Jr.

1987-08-01

79

Myocardial perfusion scintigraphy with 201Tl in patients with abnormal left coronary artery branch from the pulmonary trunk: clinical and anatomical comparisons  

International Nuclear Information System (INIS)

The clinical significance of 201Tl myocardial perfusion scintigraphy was studied in 7 patients with abnormal branch of the left coronary artery from the pulmonary trunk and in 1 patient with that of the anterior interventricular artery from the pulmonary trunk. Radiological cryteria for the defect were established on the data of myocardial scintigraphy with those of electrocardiographic, coronary angiography and anatomic examinations. It was shoun that myocardial scintigraphy permited to make a differential diagnosis between abnormal left coronary artery branch and dilated cardiomyopathy, and that the technique was of value for comparative assessment of the efficiency of various types of surgical treatment for abnormal left coronary artery branch from the pulmonary trunk

1989-01-01

80

Double-nuclide study of the myocardium using 201Tl and 123I-labeled fatty acids in non-ischemic myocardial diseases  

International Nuclear Information System (INIS)

[en] Metabolic impairment and perfusion abnormalities are known to occur in hypertensive heart disease (HHD) and in cardiomyopathies. Free fatty acid (FFA) extraction is severely inhibited in a number of pathobiochemical reactions. This parameter was assessed using the radiolabeled FFA analogue 123I-(p-iodo-phenyl-)-pentadecanoic acid (IPPA) and 201Tl as perfusion marker, both of them injected at maximal physical workload. The regional extraction fraction of IPPA (IPPA-EF) was estimated by relating the regional IPPA and 201Tl uptake to each other. In HHD (normal coronary arteries) with posterior wall thickness ?12 mm IPPA-EF was 77 ± 18% (SD) in septum and 92 ± 17% in the posterolateral wall (N = 13), with thickness of >12 mm 60 ± 23% in septum and 61 ± 20% in the posterolateral wall (N = 8) when compared with IPPA-EF in normal subjects (= 100%, N = 9). In hypertrophic cardiomyopathy (HCM) IPPA-EF averaged 51 ± 20% in septum and 87 ± 10% in the posterolateral wall (N = 11). In these patient groups no systematic regional changes in 201Tl uptake were observed. In dilated cardiomyopathy (DCM) both IPPA-EF and 201Tl uptake showed distinct regional variations and a great interindividual variability with a mean IPPA-EF reduction of 12% (N = 9). Thus, IPPA uptake in primarily non-ischemic myocardial disease may already be compromised when 201Tl uptake is unchanged. The double-nuclide method for IPPA-EF determination allows to eliminate the influence of flow in FFA imaging and enhances the potential of scintigraphy in the differential diagnosis of HHD versus coronary artery disease. (orig.)[de] Stoerungen des myokardialen Stoffwechsels und der Perfusion sind bekannte pathophysiologische Gegebenheiten bei hypertensiver Herzkrankheit (HHD) und bei Kardiomyopathien. Verschiedene pathobiochemische Reaktionen fuehren zu einer drastischen Hemmung der Extraktion freier Fettsaeuren (FFA). Dieser Parameter wurde unter Verwendung des markierten FFA-Analogs 123J-(p-Jod-Phenyl-)Pentadekansaeure (IPPA) und von 201Tl als Perfusionsindikator untersucht. Beide Substanzen wurden simultan unter maximaler Ergometerbelastung injiziert. Die regionale IPPA-Extraktionsfraktion (IPPA-EF) wurde bestimmt, indem die regionale IPPA- und 201Tl-Aufnahme miteinander verglichen wurden. Bei Patienten mit HHD (normale Koronarien) und einer Hinterwanddicke ? 12mm betrug die IPPA-EF 77 ± 18% (SD) im Septum und 92 ± 17% (N = 13) in der Posterolateralwand gegenueber dem mittleren Normalwert (= 100%), bei Patienten mit einer Wanddicke > 12mm 60 ± 23% bzw. 61 ± 20% (N = 8). Bei hypertrophischen Kardiomyopathien (HCM) betrug die mittlere IPPA-EF 51 ± 20% im Septum und 87 ± 10% in der Posterolateralwand (N = 11). Bei den genannten Patientengruppen wurde keine systematische Veraenderung der regionalen 201Tl-Aufnahme beobachtet. Bei dilatativen Kardiomyopathien (DCM) war die regionale Aufnahme beider Indikatoren deutlich veraendert, wobei die IPPA-EF ein interindividuell sehr unterschiedliches Verhalten mit einer durchschnittlichen Abnahme von 12% zeigte (N = 9). Insgesamt wird gefolgert, dass die IPPA-Aufnahme bei primaer nichtischaemischen Myokarderkrankungen bereits vermindert sein kann, wenn die 201Tl-Aufnahme (noch) normal ist. Die Doppelnuklidmethode zur IPPA-EF-Bestimmung ist in der Lage, den Faktor Perfusion aus der Fettsaeureszintigraphie zu eliminieren und die differentialdiagnostischen Moeglichkeiten der Szintigraphie im Hinblick auf die Fragestellung HHD oder KHK zu verbessern. (orig.)

1988-01-01

 
 
 
 
81

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

82

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

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The usefulness of various non-invasive methods such as electrocardiography, echocardiography and /sup 201/Tl 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.

Inoh, T.; Nakashima, Y.; Hayakawa, M. (Kobe Univ. (Japan). School of Medicine)

1981-12-01

83

/sup 201/Tl myocardial imaging in a cardiac rejection episode. Case report  

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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.).

Richter, J.; Serena, A.; Charvet, M.A.; Honorato, J.; Herreros, J.; Arcas, R.; Pardo, J.; Azanza, J.R.

1986-01-01

84

Scintigraphic appearance in stress [sup 201]Tl myocardial SPECT of midportion lesion in left anterior descending artery  

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Scintigraphic appearance of left anterior descending artery (LAD) lesion in stress [sup 201]Tl myocardial SPECT was studied in 43 patients with midportion lesion in LAD confirmed by coronary angiography. Right margin of ischemic region in the basal short axial image was -36[+-]17deg and left margin was -128[+-]75deg. In 28 of 43 patients left margin lied beyond -120deg. From the results it was concluded that in most cases basal inferior wall was perfused by septal branches from LAD. In 6 patients with midportion lesion situated proximal to the first diagonal branch and in 12 patients with midportion lesion situated proximal to the second diagonal branch ischemic region in the apical portion was noted at both septum and anterolateral wall. Critical short axial image, in which right margin of ischemic region shifted from plus to minus area, was the 3.2th short axial image in the former group and the 5.2th in the latter group (p<0.01). In 10 patients with midportion lesion situated distal to the large first diagonal branch, ischemic region was noted in septal wall and not in anterolateral wall. It was concluded that right margin of ischemic region in the basal coronal image was the most useful sign for predicting midportion lesion and left margin for dominancy between LAD and right coronary artery and that apical anterolateral ischemia was sign for LAD lesion involving diagonal branch. Critical short axial image was useful for determining whether the lesion was situated proximal or distal to the first diagonal branch and whether the lesion was situated proximal to the second diagonal branch. (author).

Tanaka, Takeshi; Aizawa, Tadanori; Katou, Kazuzo; Ogasawara, Ken; Kirigaya, Hajime; Satou, Hiroshi; Okamoto, Kiyoshi; Hosoi, Hiromitsu (The Cardiovascular Institute, Tokyo (Japan))

1993-03-01

85

The evaluation of left ventricular eccentric hypertrophy by 201Tl-myocardial scintigraphy  

International Nuclear Information System (INIS)

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

1989-01-01

86

Diagnosis of effort angina pectoris using 201Tl stress myocardial imaging  

International Nuclear Information System (INIS)

[en] 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

87

Quantitative analysis of sup 201 Tl myocardial scintigraphy in ischemic heart disease  

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Seventy two patients with myocardial infarction (MI), 13 with angina pectoris (AP), and 10 without ischemic heart disease were investigated by the quantitative analysis of Tl-201 myocardial scintigraphy. In the group of MI patients, defects of Tl-201 uptake was observed in 89.7% on planar images and 91.2% on SPECT images. Patients without Tl defect had no evidence of abnormal Q wave. For 62 patients undergoing coronary angiography and left ventriculography, defect size was well consistent with culprit lesions, particularly in the left anterior descending artery. Both extent score (ES) and severity score (SS), obtained by planar images and bull's-eye SPECT images, were significantly correlated with peak creatine phosphokinase (CPK) in plasma and ejection fraction. Redistribution magnitudes of Tl-201 uptake ({Delta}ES and {Delta}SS) 3 hr after exercise were much greater in patients with exercise-induced ST depression than those with either unchanged or elevated ST segments. Some of the patients with no evidence of ST depression had high {Delta}ES and {Delta}SS. Similarly, these indices were high in patients with residual stenosis of culprit coronary artery. Six MI patients treated with percutaneous transluminal coronary angioplasty (PTCA) were found to have the decrease in both {Delta}ES and {Delta}SS. Decreased % Tl-201 uptake and % washout rate were also improved by PTCA. Similar improvement in these indices was seen in 15 AP patients successfully treated with PTCA. Reverse redistribution (RR) was seen in 5 patients with no significant stenosis of culprit coronary artery. Three other MI patients had also RR after PTCA. Areas corresponding to RR had higher washout rate than the other areas. In conclusion, quantitative analysis of Tl-201 myocardial scintigraphy seems to be useful in estimating infarction size and viable myocardium, as well as in evaluating the improvement of myocardial ischemia after PTCA. (N.K.).

Ohta, Akihiro (Wakayama Medical Coll. (Japan))

1991-08-01

88

Quantitative analysis of 201Tl myocardial scintigraphy in ischemic heart disease  

International Nuclear Information System (INIS)

Seventy two patients with myocardial infarction (MI), 13 with angina pectoris (AP), and 10 without ischemic heart disease were investigated by the quantitative analysis of Tl-201 myocardial scintigraphy. In the group of MI patients, defects of Tl-201 uptake was observed in 89.7% on planar images and 91.2% on SPECT images. Patients without Tl defect had no evidence of abnormal Q wave. For 62 patients undergoing coronary angiography and left ventriculography, defect size was well consistent with culprit lesions, particularly in the left anterior descending artery. Both extent score (ES) and severity score (SS), obtained by planar images and bull's-eye SPECT images, were significantly correlated with peak creatine phosphokinase (CPK) in plasma and ejection fraction. Redistribution magnitudes of Tl-201 uptake (?ES and ?SS) 3 hr after exercise were much greater in patients with exercise-induced ST depression than those with either unchanged or elevated ST segments. Some of the patients with no evidence of ST depression had high ?ES and ?SS. Similarly, these indices were high in patients with residual stenosis of culprit coronary artery. Six MI patients treated with percutaneous transluminal coronary angioplasty (PTCA) were found to have the decrease in both ?ES and ?SS. Decreased % Tl-201 uptake and % washout rate were also improved by PTCA. Similar improvement in these indices was seen in 15 AP patients successfully treated with PTCA. Reverse redistribution (RR) was seen in 5 patients with no significant stenosis of culprit coronary artery. Three other MI patients had also RR after PTCA. Areas corresponding to RR had higher washout rate than the other areas. In conclusion, quantitative analysis of Tl-201 myocardial scintigraphy seems to be useful in estimating infarction size and viable myocardium, as well as in evaluating the improvement of myocardial ischemia after PTCA. (N.K.).

1991-01-01

89

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

90

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)

[en] 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)

1994-01-01

91

sup 99m Tc-Isonitrile ('MIBI'): Chances to improve myocardial scintigraphy or substitute for sup 201 Tl. sup 99m Tc-Isonitril ('MIBI'): Chancen zur Verbesserung der Myokardszintigraphie oder Ersatz fuer sup 201 Tl  

Energy Technology Data Exchange (ETDEWEB)

{sup 99m}Tc-MIBI has used to examine 22 patients for a qualitative and quantitative comparison to {sup 201}Tl myocardial scintigraphy and {sup 99m}Tc-Erythrocytes- radionuclide ventriculography (=RNV) in patients with previous anterior (AWMI) and posterior wall myocardial infarction (PWMI). (1) Planar gated amplitude scintigrams (GAMS, MIBI) and planar amplitudes (RNV, Ery) correlated in AWMI (r=0.87), to minor degree in PWMI (r=0.76) pointing to a superiority of GAMS in PWMI. (2) Correlation of global EF ({sup 99m}Tc-MIBI vs. {sup 99m}Tc-Ery) was good (r=0.75). (3) Perfusion and function are derivable by {sup 99m}Tc-MIBI in a one-step procedure ('radionuclide myocardial ventriculography = RMV'). Thus MIBI may be suited to replace {sup 201}Tl and {sup 99m}Tc-erythrocytes. However extensive clinical studies have to be carried out - similar to those available now for {sup 201}Tl - before the recommendation to replace {sup 201}Tl by MIBI would be justified. (orig.).

Hoer, G.; Bittner, G.; Standke, R.; Maul, F.D.; Klepzig, H. Jr.; Baum, R.P. (Frankfurt Univ. (Germany, F.R.). Abt. fuer Nuklearmedizin; Frankfurt Univ. (Germany, F.R.). Abt. fuer Kardiologie)

1989-04-01

92

Quantitative evaluation of myocardial stressrest /sup 201/Tl SPECT: Results of a ROI-based method in 108 patients with CHD  

Energy Technology Data Exchange (ETDEWEB)

ROI-based polar maps (33 ROIs) were employed to evaluate quantitatively stressrest myocardial /sup 201/Tl SPECT in 108 patients with angiographically proven coronary heart disease (CHD) in comparison with 30 controls. Sensitivity in detecting a CHD with stenoses of > 50% of luminal diameter was determined versus normal regional values (+- 2.5 SD) employing vitality (VI) and wash-out corrected redistribution (RD). The method was evaluated referring to the severity of the disease, to the number of ROIs displaying changes (a) 1 ROI, (b) > 2 ROIs, to validity of VI, RD or a combination thereof, and for specificity. Wash-out values were found to depend on degree of stress individually achieved and thus were not used as a threshold criterion. Sensitivity in supply areas with old myocardial infarctions was 95% (a) and 86% (b), resp. With no infarction, it was 96% (a) and 79% (b), resp. VI in stenosis > 75% was more sensitive than RD. However, combined evaluation of VI and RD yielded sensitivities from 91-100% (a) and 77-94% (b), resp. for different main supply areas. In stenosis < 50% with normal VI, RD was positive in 18-31%. Specificity turned out to be 91% (a) and 97% (b), resp. We conclude that the method presented is reliable to quantify numerically /sup 201/Tl kinetics in myocardial SPECT, aimed at detecting and describing CHD.

Buell, U.; Stirner, H.; Kleinhans, E.; Biedermann, M.; Grosse, W.; Vom Dahl, J.; Uebis, R.; Simon, H.J.

1987-12-01

93

Quantitative evaluation of myocardial stress/rest 201Tl SPECT: Results of a ROI-based method in 108 patients with CHD  

International Nuclear Information System (INIS)

ROI-based polar maps (33 ROIs) were employed to evaluate quantitatively stress/rest myocardial 201Tl SPECT in 108 patients with angiographically proven coronary heart disease (CHD) in comparison with 30 controls. Sensitivity in detecting a CHD with stenoses of > 50% of luminal diameter was determined versus normal regional values (± 2.5 SD) employing vitality (VI) and wash-out corrected redistribution (RD). The method was evaluated referring to the severity of the disease, to the number of ROIs displaying changes (a) 1 ROI, (b) > 2 ROIs, to validity of VI, RD or a combination thereof, and for specificity. Wash-out values were found to depend on degree of stress individually achieved and thus were not used as a threshold criterion. Sensitivity in supply areas with old myocardial infarctions was 95% (a) and 86% (b), resp. With no infarction, it was 96% (a) and 79% (b), resp. VI in stenosis > 75% was more sensitive than RD. However, combined evaluation of VI and RD yielded sensitivities from 91-100% (a) and 77-94% (b), resp. for different main supply areas. In stenosis 201Tl kinetics in myocardial SPECT, aimed at detecting and describing CHD. (orig.)

1987-01-01

94

Assessment of myocardial damage and metabolic disorder in the left ventricle in patients with mitral stenosis using {sup 201}Tl and {sup 123}I-BMIPP myocardial SPECT  

Energy Technology Data Exchange (ETDEWEB)

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 <1.5 cm{sup 2}) included 6 patients, mildly stenostic group (1.5 cm{sup 2}{<=} valve area <2.5 cm{sup 2}) included 9. A 111 MBq of {sup 123}I-BMIPP was intravenously injected at rest, SPECT images were obtained at 15 min and 3 hours after injection. A 111 MBq of {sup 201}Tl was intravenously injected at rest, and SPECT images were obtained at 15 min after injection. Washout rate (WR) of {sup 123}I-BMIPP from the whole left ventricle was obtained using polar maps. The concentration of norepinephrine (NE: pg/ml) in the blood at rest was measured. The mean values of pulmonary artery pressure was measured in ten patients using Swan-Ganz catheter. {sup 123}I-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<0.05). NE values were 480{+-}69 and 743{+-}295 in the mildly and severely stenotic groups, respectively. NE value was increased in severely stenotic group (p<0.05). Twelve patients showed normal uptake on both {sup 201}Tl and {sup 123}I-BMIPP myocardial SPECT. Three patients showed slightly reduced uptake on both {sup 201}Tl and {sup 123}I-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. (author)

Ito, Kazuki; Tanabe, Takuji; Yuba, Tatsuya; Doue, Tomoki; Adachi, Yoshihiko; Katoh, Shuuji [Asahi Univ., Gifu (Japan). Murakami Memorial Hospital; Sugihara, Hiroki; Azuma, Akihiro; Nakagawa, Masao

2001-07-01

95

[Aspects of recovery from regional wall motion abnormalities after exercise in patients with ischemic heart disease using 201Tl myocardial dynamic SPECT  

UK PubMed Central (United Kingdom)

Using 201Tl myocardial dynamic SPECT (dynamic SPECT), we studied various aspects of the recovery from exercise-induced ischemia, particularly the mechanism of delayed recovery from wall motion abnormality. The subjects were 23 patients with ischemic heart disease who underwent coronary angiography, exercise stress two-dimensional echocardiography (ESE), and dynamic SPECT. Using a 3-head SPECT system, dynamic SPECT was performed for 33 min consecutively from 5 min after the intravenous injection of 201TlCl (Tl). The regional early washout rate (early WR) was determined at 20, 29, and 38 min after Tl injection, and the delayed washout rate (delayed WR) was determined at 240 min. From the duration of regional wall motion abnormalities on ESE, the patients were divided into Group A (wall motion abnormalities persisting for > or = 20 min, n = 8) and Group B (< 20 min, n = 15). At each point of assessment, early WR was significantly lower in Group A than in the control group (5 healthy subjects) and Group B (p < 0.01). In addition, the early WR at 20 min was negative in all Group A patients. The present study suggests that a persistent relative and reduction in myocardial blood flow is one factor responsible for prolonged abnormal regional wall motion.

Ishiguro S

1994-06-01

96

[Evaluation of myocardial viability with 201Tl/18F-FDG DISA-SPECT technique in patients with acute myocardial infarction after emergent intracoronary autologous bone marrow mononuclear cells transplantation].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the myocardial viability with (201)Tl/(18)F-FDG DISA-SPECT technique in patients with acute myocardial infarction underwent emergent intracoronary autologous bone marrow mononuclear cells (BM-MNC) transplantation. METHODS: Patients with first acute myocardial infarction underwent emergent percutaneous coronary intervention (PCI) were randomized in a 1:1 ratio to either intracoronary transplantation of autologous BM-MNC (n = 20) or to sodium chloride concluding heparin (control, n = 20) via a micro infusion catheter group immediately after PCI. Change in global left ventricular function (LVEF measured by echocardiography) and the myocardial viability detected by (201)Tl/(18)F-FDG DISA-SPECT from baseline and 6-months post transplantation were analyzed. RESULTS: Left ventricular ejection fraction (LVEF) was improved in both groups and the absolute increase (DeltaLVEF) in BM-MNC group was significantly higher than that in control group (7.6% +/- 2.8% vs. 3.0% +/- 2.8%, P < 0.001). In addition, the absolute decrease of myocardial infusion defect detected by (201)Tl SPECT was more significant in BM-MNC group than that in control group (6.7% +/- 3.0% vs. 2.6% +/- 2.6%, P < 0.001) and the number of mismatched segments (indicating viable myocardium) detected by (18)F-FDG SPECT in border zone was also significantly higher in BM-MNC group than that in control group. CONCLUSION: Improved myocardial viability and reduced myocardial infusion defect post emergent intracoronary transplantation of autologous BM-MNC in patients with acute myocardial infarction could be detected by (201)Tl/(18)F-FDG DISA-SPECT technique.

Huang RC; Yao K; Qian JY; Niu YH; Ge L; Chen SG; Shi HC; Zhang YQ; Sun AJ; Wang KQ; Zou YZ; Ge JB

2007-06-01

97

Study of washout rate in patients with chronic renal failure by dipyridamole [sup 201]Tl myocardial scintigraphy; Comparison with hypertrophic cardiomyopathy  

Energy Technology Data Exchange (ETDEWEB)

Fourteen patients with chronic renal failure (CRF) were studied by dipyridamole [sup 201]Tl myocardial scintigraphy. In this study, patients with coronary heart disease were excluded by clinical findings. [sup 201]Tl SPECT was performed at 8 min after injection of dipyridamole (0.56 mg/kg) and at a 3-hr delayed interval, and washout rates (WR) were calculated. Because UCG showed left ventricular hypertrophy (thickness; 13[+-]2 mm) in CRF, the WR values were compared with those of hypertrophic cardiomyopathy (HCM)(n=9). In CRF, an average WR was 54.2[+-]6.8% and was significantly higher than that in normal (46.2[+-]9.1%, p<0.05, n=9), though WR in HCM was significantly low (26.9[+-]11.4%, p<0.01). Hematocrit value was 24.5[+-]3.2% in CRF and was significantly lower than that in normal (37.8[+-]3.6%, p<0.001). On the other hand, hemoconcentration was observed in HCM (hematocrit; 44.6[+-]3.6%, p<0.001). WR in CRF, HCM and normal had significant correlation with hematocrit values (r=-0.796, p<0.001). These results suggest that anemia or hemoconcentration may affect coronary blood flow and WR, and this should be considered when diagnosing coronary heart disease in CRF or HCM. (author).

Matsumura, Kaname; Nakagawa, Tsuyoshi (Mie Univ., Tsu (Japan). School of Medicine); Senda, Yutaka; Ito, Tsunao; Mizutani, Yasuhide; Yoshida, Nobutaka; Yasuda, Ryuichi; Takagi, Isao

1993-11-01

98

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

Energy Technology Data Exchange (ETDEWEB)

After a 4-minute i.v. dipyridamole infusion, 0.14 mg/kg/min, serial /sup 201/Tl 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 /sup 201/Tl 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.

Leppo, J.; Boucher, C.A.; Okada, R.D.; Newell, J.B.; Strauss, H.W.; Pohost, G.M.

1982-09-01

99

Precision of electrocardiographic diagnosis of myocardial infarction in the ventricular septal area. Comparison with 201-TlCl scintigraphy and coronary angiography  

International Nuclear Information System (INIS)

The purpose of this study was to clarify the diagnostic accuracy of 3 electrocardiographic (ECG) indexes including Q waves in V1[QV1(+)], Q waves in V1 and V2 [QV1V2(+)], and absence of septal q waves in V6 [qV6(-)] for prediction of myocardial infarction (MI) in the interventricular septal area (IVS) using 201-TlCl myocardial scintigraphy. In addition, we also evaluated the relationship between these ECG indexes and the site of the culprit lesions in the left anterior descending artery (LAD). This study consisted of 115 patients (100 males; mean age, 60 years) with anteroseptal MI who underwent 201-TlCl myocardial scintigraphy in our hospital between January 1994 and December 1997. One hundred six of them also underwent coronary angiography (CAG). On extent maps obtained from SPECT images of 201-TlCl scintigraphy, the area of MI occupying the IVS area, using the proportion of the defect area in the IVS, was expressed as % defect area (%DA). Three patterns of %DA were defined as follows. A: 50%?%DA?100%; B: 70%?%DA?100%; and C: 90%?%DA?100%. On scintigraphic evaluations, %DA in patients with each of the 3 ECG indexes was significantly larger than %DA in patients without them (p=0.0002, p=0.0008, and p=0.0008, respectively). QV1(+) and qV6(-) showed good sensitivities only for pattern C (79% and 75%, respectively), but all ECG indexes showed low sensitivities for patterns A and B. Regarding specificity, QV1V2(+) showed the best values (76% for pattern A, 68% for pattern B, and 68% for pattern C) among the 3 ECG indexes. For prediction of the culprit lesions located proximal to the origin of the first septal branch, qV6(-) showed a relatively good sensitivity (67%) and specificity (67%). For prediction of MI in the IVS area, QV1(+) and qV6(-) showed good sensitivities when the MI was sufficiently large in size. QV1V2(+) showed relatively good specificities irrespective of the MI size. qV6(-) was the best predictive index for the culprit lesions located in the proximal site of the LAD. (author)

1997-12-00

100

Precision of electrocardiographic diagnosis of myocardial infarction in the ventricular septal area. Comparison with 201-TlCl scintigraphy and coronary angiography  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to clarify the diagnostic accuracy of 3 electrocardiographic (ECG) indexes including Q waves in V{sub 1}[QV{sub 1}(+)], Q waves in V{sub 1} and V{sub 2} [QV{sub 1}V{sub 2}(+)], and absence of septal q waves in V{sub 6} [qV{sub 6}(-)] for prediction of myocardial infarction (MI) in the interventricular septal area (IVS) using 201-TlCl myocardial scintigraphy. In addition, we also evaluated the relationship between these ECG indexes and the site of the culprit lesions in the left anterior descending artery (LAD). This study consisted of 115 patients (100 males; mean age, 60 years) with anteroseptal MI who underwent 201-TlCl myocardial scintigraphy in our hospital between January 1994 and December 1997. One hundred six of them also underwent coronary angiography (CAG). On extent maps obtained from SPECT images of 201-TlCl scintigraphy, the area of MI occupying the IVS area, using the proportion of the defect area in the IVS, was expressed as % defect area (%DA). Three patterns of %DA were defined as follows. A: 50%{<=}%DA{<=}100%; B: 70%{<=}%DA{<=}100%; and C: 90%{<=}%DA{<=}100%. On scintigraphic evaluations, %DA in patients with each of the 3 ECG indexes was significantly larger than %DA in patients without them (p=0.0002, p=0.0008, and p=0.0008, respectively). QV{sub 1}(+) and qV{sub 6}(-) showed good sensitivities only for pattern C (79% and 75%, respectively), but all ECG indexes showed low sensitivities for patterns A and B. Regarding specificity, QV{sub 1}V{sub 2}(+) showed the best values (76% for pattern A, 68% for pattern B, and 68% for pattern C) among the 3 ECG indexes. For prediction of the culprit lesions located proximal to the origin of the first septal branch, qV{sub 6}(-) showed a relatively good sensitivity (67%) and specificity (67%). For prediction of MI in the IVS area, QV{sub 1}(+) and qV{sub 6}(-) showed good sensitivities when the MI was sufficiently large in size. QV{sub 1}V{sub 2}(+) showed relatively good specificities irrespective of the MI size. qV{sub 6}(-) was the best predictive index for the culprit lesions located in the proximal site of the LAD. (author)

Miyano, Shoko; Fujioka, Haruto; Sumiyoshi, Masataka [Juntendo Univ., Tokyo (Japan). School of Medicine

2000-03-01

 
 
 
 
101

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)

2008-01-01

102

Thallium-201 right lung/heart ratio during exercise in patients with coronary artery disease: relation to thallium-201 myocardial single-photon emission tomography, rest and exercise left ventricular function and coronary angiography  

International Nuclear Information System (INIS)

The aim of this study was to correlate lung thallium-201 uptake on exercise with 201Tl single-photon emission tomography (SPET) myocardial perfusion imaging, rest and exercise equilibrium radionuclide angiographic and coronary angiographic findings in patients with coronary artery disease (CAD) using a simple, reproducible lung/heart (L/H) ratio that would be easy to use in clinical practice. L/H ratio was defined on the anterior planar image obtained during exercise 201Tl SPET acquisition as the mean counts per pixel in an entire right lung field region of interest divided by the mean counts per pixel in the hottest myocardial wall region of interest. We studied 103 patients. Fifty-nine patients (group I) with 201Tl SPET, radionuclide angiographic and coronary angiographic variables. The group I L/H ratio of 0.35±0.05 (mean ±1 SD) was significantly lower (P0.45 (mean+2 SD in group I) was considered abnormal. In group II, L/H ratio showed a significant correlation with stress and rest 201Tl perfusion defect size (r=0.39 and r=0.42, P

1999-01-01

103

Quantification of myocardial infarct size by technetium-99m pyrophosphate single photon emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

Myocardial infarct size in 41 patients with the first attack of acute transmural myocardial infarction (MI) was assessed by technetium-99m pyrophosphate single photon emission computed tomography (/sup 99m/TcPYP-SPECT). A ratio of the number of voxels of /sup 99m/TcPYP uptake into the infarct area to that into the thorax was calculated as a parameter of MI size. The ratio was positively correlated with both peak CPK activity (r=0.53, p<0.005, n=24) and extent score in /sup 201/Tl-SPECT (r=0.70, p<0.005, n=14) significantly in patients with anterior MI but not in patients with inferior MI. There was also significant negative correlation between the ratio and the left ventricular ejection fraction (LVEF) measured by RI angiography in both acute (r=-0.67, p<0.005, n=18) and chronic (r=-0.75, p<0.005, n=25) phases in patients with anterior MI. Recovery in LVEF at chronic phase was noted in patients with small anterior MI but not with large anterior MI. Eight of 14 patients with inferior MI had right ventricular MI, that might have affected evaluation of MI size and resulted in no correlation between variables. It was suggested that /sup 99m/TcPYP-SPECT was a useful method to evaluate MI size and to predict prognosis of cardiac function in patients with anterior MI but not in patients with inferior MI. (author).

Yamamoto, Hiromichi; Fukuyama, Takaya; Aoki, Makoto; Inou, Tetsuji; Ashihara, Toshiaki; Nabeyama, Shyohzou; Yamamoto, Yuhsuke

1989-04-01

104

201Tl labelled myocardium tomoscanning  

International Nuclear Information System (INIS)

[en] A new device, the J and P Tomoscanner, enables us to obtain the transverse scintigraphic section of any organ labelled by a single photon emitting radionuclide. For the time being, this technique has been used mainly for brain and liver studies. This work explores the ability of this tomograph to furnish sections of the 201Tl labelled myocardium by comparing them with the scintillation gamma-camera images. Towards this aim, witnesses and patients with documented anterior or lateral infarctus have been studied. Our actual results show a high correlation between the two explorations. But, by means of the section, both the site and size of the necrosis are visualized. However, only a single tomographic image was obtained in each patient because of the time necessary for its retranscription on paper. In the near future, when it will be possible to perform routinely several sections, a better size estimation will be possible[fr] Un nouvel appareil, le J et P Tomoscanner, pouvant realiser la coupe scintigraphique transverse de tout organe marque par un des traceurs monophotoniques utilises couramment en Medecine Nucleaire a ete recemment commercialise. Ses principales applications ont concerne jusqu'a present l'etude du cerveau et du foie. Nous nous sommes proposes d'explorer ses possibilites de visualisation du myocarde marque par 201Tl, en les comparant avec les donnees des images de la camera a scintillation. Dans ce but, des temoins et des malades porteurs d'un infarctus anterieur ou lateral de diagnostic certain ont ete etudies. Notre experience actuelle permet de conclure a une bonne concordance entre les resultats de l'examen scintigraphique a la camera a scintillation et l'image tomoscintigraphique. La coupe apporte par ailleurs une information supplementaire en visualisant clairement a la fois la localisation et l'etendue de l'atteinte necrotique. Toutefois, la lenteur de retranscription de l'image ne nous a pas permis d'effectuer des sections etagees chez chaque malade, ce qui autoriserait pourtant une estimation plus precise de la surface infarcie. L'amelioration prochaine de l'appareillage devrait pallier cet inconvenient

1978-12-09

105

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)

[en] 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

1993-01-01

106

Studies on thallium-201 myocardial single photon emission computed tomography (SPECT) using treadmill exercise test  

Energy Technology Data Exchange (ETDEWEB)

A comparative study was made of 24 patients who underwent treadmill exercise test (TET group), and another 24 patients who underwent bicycle ergometer exercise test (Ergo group) for wall-motion abnormalities by {sup 201}Tl myocardial single photon emission computer tomography (SPECT), in contrast to the findings of coronary angiograms performed concurrently. Both visual and washout rate (WOR) methods were used for the evaluation of the SPECT findings. For the visual evaluation short axis, sagittal and horizontal views were used, and analyses were made by left anterior descending (LAD), left circumflex (LCx) and right coronary artery (RCA) regions. WORs of short axis (at the apical, middle and basal levels) were defined as positive when the WOR was lower than the normal lower limit and evaluated by LAD, LCx and RCA. The following results were obtained. The sensitivity and specificity for visual evaluation (TET group) were 77.8% and 95.8% respectively, 78.2% and 85.7% for WOR (TET group), 77.2% and 88.9% for visual evaluation (Ergo group), 62.5% and 92.1% for WOR (Ergo group). (author).

Tanaka, Tsutomu; Boku, Eishin; Kumabe, Toshitsugu; Shiono, Noritsugu; Lee, Mineo; Matsuzaki, Hideo; Ukai, Kyosuke; Abe, Yoshihisa (Kanagawa Byoin National Sanatorium, Hadano (Japan))

1990-08-01

107

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

Energy Technology Data Exchange (ETDEWEB)

[sup 123]I-MIBG (MIBG) regional defects in myocardial regions with preserved [sup 201]Tl (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 ([Delta]TDS). TDS was not different between Gps A and B in both Tl and MIBG images. However, [Delta]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).

Maeno, Masakazu; Ishida, Yoshio; Shimonagata, Tsuyoshi (National Cardiovascular Center, Suita, Osaka (Japan)) (and others)

1993-10-01

108

201Tl-myocardial scintigraphy: Current status in coronary artery disease, results of sensitivity/specificity in 3092 patients and clinical recommendations  

International Nuclear Information System (INIS)

This review is concerned with qualitative and quantitative sectorial 201Tl-redistribution analysis of exercise myocardial scintigraphy (EMS). In 3092 cases the sensitivity (specificity) was on average 83(90)%, the average CAD prevalence scintigraphy (EMS). In 3092 cases the sensitivity (specificity) was in average 83(90)%, the average CAD prevalence being 71%. Sensitivity (Se) for EMS (ExECG) increased from 73(43)% in single vessel disease through 83(69)% in double vessel to 90(77)% in triple disease (n = 879); average Se was 77% for LAD-, 79% for RCA- and 65% for LCX-stenosis. Se for detection of the real extension of CAD conversely decreased from 59% in SVD through 41% in DVD down to 33% in TVD. Clinical recommendations for EMS and rest scans are outlined in CAD (atypical angina, follow-up after bypass-surgery, percutaneous transluminal angioplasty), in non-coronary artery diseae (non-ischemic cardiomyopathies, right ventricular hypertrophy) and in pediatric cardiology. (orig.)

1981-01-01

109

sup(99m)Tc-pyrophosphate and /sup 201/Tl myocardial scintigrams in a patient with myocarditis  

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Myocardial necrosis in acute myocarditis was investigated by scintigraphy. sup(99m)Tc-pyrophosphate (PYP) and /sup 201/TI myocardial scintigrams were obtained on a patient with acute myocarditis due to mycoplasma infection. sup(99m)Tc-PYP myocardial scintigrams in the acute stage demonstrated grade 2+ findings, which remained until the chronic stage. /sup 201/TI myocardial scintigrams in the acute stage revealed impaired perfusion restricted to the posterolateral wall, and this decrease continued through the chronic stage. It was concluded that both of sup(99m)Tc-PYP and /sup 201/TI myocardial scintigrams can reveal abnormality of acute myocarditis.

Kondo, M.; Nishimura, T.; Shimoto, Y.; Fuzioka, S.; Kobayashi, K. (Shimada City Hospital, Shizuoka (Japan))

1981-09-01

110

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

International Nuclear Information System (INIS)

[en] 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)

2004-01-01

111

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

1997-01-01

112

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

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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

113

Quantitative analysis of acute myocardial infarction using single photon emission computed tomography using technetium-99m pyrophosphate  

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The usefulness of single photon emission computed tomography (SPECT) using technetium-99m pyrophosphate (/sup 99m/Tc-PPi) was evaluated in 15 patients with acute myocardial infarction. SPECT was performed with a rotating gamma camera after conventional planar images were made. Infarct size was measured from transaxial images of myocardial pyrophosphate uptakes. In each slice, the boundary was defined by subtracting 70 percent of the maximal counts and the number of voxels automatically counted. This subtraction rate was determined by phantom study and by compraing SPECT using /sup 99m/Tc-PPi with thallium-201-gated myocardial scintigraphy (/sup 201/Tl gated SPECT). The planar images showed diffuse uptakes in two of the 15 patients, and in these cases it was difficult to detect the infarct site. In contrast, SPECT images clearly imaged the infarct site consistent with the electrocardiographic findings, and they were definitely separated from the uptakes in the bones in all cases. Infarct size, ranging from 3.4 ml to 78.3 ml, correlated well with cumulative creatine kinase release (r = 0.84, p < 0.01, y = 772x + 13900). Correlation of infarct size with peak serum creatine kinase level was also significant (r = 0.66, p < 0.01, y = 10.6x + 693). In conclusion, SPECT with /sup 99m/Tc-PPi is a useful means of investigating the spatial distribution of pyrophosphate uptake and of evaluating the size of myocardial infarction.

Fujiwara, Yasushi; Kokubu, Tatsuo; Murase, Kenya; Hamamoto, Ken; Itoh, Taketoshi; Doiuchi, Junji; Ochi, Takaaki

1986-09-01

114

Diagnosis of effort angina pectoris using /sup 201/Tl stress myocardial imaging. Utility of predicted washout rate for quantitative assessment  

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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).

Abe, Masahiro; Watanabe, Takeshi; Miyashita, Takeo; Taya, Kouichi; Honda, Noribumi; Kiyomi, Sadamichi; Nagai, Yoshikazu; Yamasawa, Ikuhiro (Tokyo Medical Coll. (Japan))

1989-03-01

115

Diagnosis of acute myocardial infarction using dual SPECT (99mTc PYP and 201Tl Cl) method  

International Nuclear Information System (INIS)

We investigated the usefulness of the dual SPECT method with the Tc-99m and Tl-201 in comparison with the conventional Tc-99m planar method. Myocardial scintigraphy was performed in 57 patients with acute myocardial infarction; 30 were assessed by the conventional planar method and 27 by the dual SPECT method. The accumulation ratio of Tc-99m (%Tc) by the dual SPECT method was calculated from the coronal image and was compared with the serum values of total CPK, peak CPK, total CPK-MB, and peak CPK-MB obtained from serial sampling and the LVEF obtained by a left ventriculography a month later. The sensitivity for diagnosis of myocardial infarction was 73.3% by the planar method and 88.9% by the dual SPECT method. The infarct sites were identified in 61.5% of the antero-septal lesion, in 35.7% of the infero-posterior lesion and in 66.7% of the lateral lesion using the planar method, while using the dual SPECT method were 100% identification for both antero-septal and lateral lesions, and 75% for the infero-posterior lesion. The highest correlation, with a rate of 0.854, was between the %Tc and the total CPK. The %Tc also showed a positive correlation with peak CPK (r=0.798), with total CPK-MB (r=0.792) and with peak CPK-MB (r=0.751) (p

1991-01-01

116

Influence of myocardial mass and /sup 201/Tl perfusion defect on left ventricular function in hypertrophic cardiomyopathy  

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Factors influencing left ventricular function were examined in cases of hypertrophic cardiomyopathy (HCM). Seventeen HCM patients were classified as having either no perfusion defect (Group I, n = 12) or perfusion defect (Group II, n = 5) on Tl-201 emission computed tomography. Left ventricular myocardial mass (m) and left ventricular chamber volume (v) were obtained by X-ray CT. 1/3 filling fraction (1/3FF) and ejection fraction (EF) were obtained by gated blood pool scanning. In Group I, m/v was correlated well with both 1/3FF and EF. In Group II, although similar correlation was seen between m/v and EF, 1/3FF was lower than that in Group I. Myocardial biopsy revealed a tendency toward higher % fibrosis in Group II than Group I. The results indicate that left ventricular function was remarkably lower than indicated by m and v when HCM is associated with perfusion defects on Tl-201 scans, suggesting the presence of myocardial lesions. (Namekawa, K.).

Mori, Takao; Yamabe, Hiroshi; Yokota, Yoshiyuki; Maeda, Kazumi; Fukuzaki, Hisashi

1988-03-01

117

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

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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

118

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.

2011-01-01

119

Clinical assessment of effects of nitroglycerin ointment in patients with angina pectoris by quantitative stress 201Tl myocardial scintigraphy  

International Nuclear Information System (INIS)

[en] 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

120

Myocardial imaging using emission computed tomography  

International Nuclear Information System (INIS)

Single-photon emission computed tomography (ECT) was evaluated during myocardial studies in dogs. Acute anterior and posterior infarcts were imaged following injection of /sup 99m/Tc-pyrophosphate or 201Tl. In most cases, tomographic delineation of infarct location and extent correlated with tissue sections. The /sup 99m/Tc images were far superior to the 201Tl images. ECT improves delineation of tracer within the myocardium

1978-01-01

 
 
 
 
121

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)

[en] 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)

1994-01-01

122

Myocardial infarction in rats: High-resolution single-photon emission tomographic imaging with a pinhole collimator  

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The purpose of this study was to evaluate the accuracy of myocardial imaging by means of high-resolution single-photon emission tomography (SPET) with a pinhole collimator in rats with experimental infarction. Myocardial infarctions were induced in male Wistar rats by ligation of the left coronary artery for 30 min, followed by reperfusion. Two days after the reperfusion, pinhole SPET was performed after the intravenous administration of 111 MBq of thallium-201 chloride, using a rotating gamma camera equipped with a pinhole insert (2.0-mm aperature) in a low-energy pinhole collimator. SPET projection data were collected at 6 increments over 360 using a 4-cm radius of rotation to reconstruct the short- and long-axis images. Projection data were acquired in 15 or 30 s, the SPET imaging being accomplished within 40 min after the injection of {sup 201}Tl. After SPET, the rats were sacrificed to remove the hearts for autoradiography (ARG) and nitroblue tetrazolium (NBT) staining as a visual correlative study. Quantitative correlative studies between pinhole SPET and ARG were performed with linear regression analysis for infarct size and distribution properties (relative counts on SPET images and relative density on autoradiographs) on the short-axis sections. All infarcts (4 mm in minimum diameter) in seven rats were detected by pinhole SPET. The SPET images in rats with or without myocardial infarction were consistent within the findings of ARG and NBT staining. There were significant correlations between pinhole SPET and ARG with respect to the infarct size (r=0.933, P<0.001; n=15) and the relative radiotracer distribution (r=0.931, P<0.001; n=68). This study therefore confirmed the accuracy of myocardial pinhole SPET imaging in rats with myocardial infarction. This method may partially substitute for ARG and prove useful for assessing new myocardial imaging agents in vivo in small laboratory animals. (orig.)

Yukihiro, Masashi [Dept. of Nuclear Medicine, Gunma Univ. School of Medicine (Japan); Inoue, Tomio [Dept. of Nuclear Medicine, Gunma Univ. School of Medicine (Japan); Iwasaki, Tsutomu [Second Dept. of Internal Medicine, Gunma Univ. School of Medicine (Japan); Tomiyoshi, Katsumi [Dept. of Nuclear Medicine, Gunma Univ. School of Medicine (Japan); Erlandsson, K. [Radiation Physics Dept., Lund Univ. (Sweden); Endo, Keigo [Dept. of Nuclear Medicine, Gunma Univ. School of Medicine (Japan)

1996-08-01

123

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

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.).

1994-01-01

124

Comparative study of [sup 201]Tl-scintigraphic image and endomyocardial biopsy findings in patients with dilated cardiomyopathy  

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[sup 201]Tl-SPECT image was compared with the findings of endomyocardial biopsy in patients with dilated cardiomyopathies (DCM), and diagnostic value of [sup 201]Tl pathy pattern image for fibrosis with DCM was evaluated. Serial 22 patients diagnosed as DCM with endomyocardial biopsy findings were selected for this study (age: 50[+-]17 y.o., male/female=17/5). Patchy pattern of [sup 201]Tl-SPECT image was visually classified into 4 stages according to the severity of inhomogeneous defect, and pathologic findings of fibrosis was also classified into 4 according to the severity of fibrosis (0: none, 1: mild, 2: moderate, 3: severe). Ejection fraction calculated from left ventriculography and end-diastolic dimension by echocardiography were also compared with [sup 201]Tl-SPECT image. Out of 22 patients, 21 patients (95%) showed fibrosis, and 18 patients (82%) showed patchy pattern with [sup 201]Tl-SPECT. Severity of patchy pattern was not in good relation to that of fibrosis (r=0.374). [sup 201]Tl image was not related to the function nor dimension. Four autopsy studies revealed a good relation of macroscopic severity, spatial distribution of fibrosis and inhomogeneous [sup 201]Tl-defect pattern before death. Patchy pattern of [sup 201]Tl-SPECT image will show the myocardial fibrosis in patients with DCM, and is independent of the function. [sup 201]Tl-SPECT may show more clinically useful findings of spatial distribution and severity of fibrosis with focal myocardial biopsy. (author).

Li, Linxue; Nohara, Ryuji (Kyoto Univ. (Japan). Faculty of Medicine); Ono, Shinji (and others)

1994-03-01

125

Comparative study of 201Tl-scintigraphic image and endomyocardial biopsy findings in patients with dilated cardiomyopathy  

International Nuclear Information System (INIS)

201Tl-SPECT image was compared with the findings of endomyocardial biopsy in patients with dilated cardiomyopathies (DCM), and diagnostic value of 201Tl pathy pattern image for fibrosis with DCM was evaluated. Serial 22 patients diagnosed as DCM with endomyocardial biopsy findings were selected for this study (age: 50±17 y.o., male/female=17/5). Patchy pattern of 201Tl-SPECT image was visually classified into 4 stages according to the severity of inhomogeneous defect, and pathologic findings of fibrosis was also classified into 4 according to the severity of fibrosis (0: none, 1: mild, 2: moderate, 3: severe). Ejection fraction calculated from left ventriculography and end-diastolic dimension by echocardiography were also compared with 201Tl-SPECT image. Out of 22 patients, 21 patients (95%) showed fibrosis, and 18 patients (82%) showed patchy pattern with 201Tl-SPECT. Severity of patchy pattern was not in good relation to that of fibrosis (r=0.374). 201Tl image was not related to the function nor dimension. Four autopsy studies revealed a good relation of macroscopic severity, spatial distribution of fibrosis and inhomogeneous 201Tl-defect pattern before death. Patchy pattern of 201Tl-SPECT image will show the myocardial fibrosis in patients with DCM, and is independent of the function. 201Tl-SPECT may show more clinically useful findings of spatial distribution and severity of fibrosis with focal myocardial biopsy. (author).

1994-01-01

126

Myocardial infarction in rats: High-resolution single-photon emission tomographic imaging with a pinhole collimator  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the accuracy of myocardial imaging by means of high-resolution single-photon emission tomography (SPET) with a pinhole collimator in rats with experimental infarction. Myocardial infarctions were induced in male Wistar rats by ligation of the left coronary artery for 30 min, followed by reperfusion. Two days after the reperfusion, pinhole SPET was performed after the intravenous administration of 111 MBq of thallium-201 chloride, using a rotating gamma camera equipped with a pinhole insert (2.0-mm aperature) in a low-energy pinhole collimator. SPET projection data were collected at 6 increments over 360 using a 4-cm radius of rotation to reconstruct the short- and long-axis images. Projection data were acquired in 15 or 30 s, the SPET imaging being accomplished within 40 min after the injection of 201Tl. After SPET, the rats were sacrificed to remove the hearts for autoradiography (ARG) and nitroblue tetrazolium (NBT) staining as a visual correlative study. Quantitative correlative studies between pinhole SPET and ARG were performed with linear regression analysis for infarct size and distribution properties (relative counts on SPET images and relative density on autoradiographs) on the short-axis sections. All infarcts (4 mm in minimum diameter) in seven rats were detected by pinhole SPET. The SPET images in rats with or without myocardial infarction were consistent within the findings of ARG and NBT staining. There were significant correlations between pinhole SPET and ARG with respect to the infarct size (r=0.933, P

1996-01-01

127

Assessment of coronary hemodynamics and myocardial perfusion in patients with syndrome X by digital subtraction angiography and 201Tl-myocardial scintigraphy  

International Nuclear Information System (INIS)

To evaluate coronary hemodynamics and myocardial perfusion, left coronary digital subtraction angiography (DSA) and Tl-201 myocardial scintigraphy were performed in patients with syndrome X. The coronary circulation time (CCT) was significantly prolonged after the injection of isosorbide dinitrate and contrast medium i.c. Apical T1/2 was also prolonged on ergonovine malate provocation test. We suspected that the vascular response of the coronary peripheral artery was impaired, and microvascular spasm probably existed in patients with syndrome X. The prevalence of abnormal myocardial perfusion defect on exercise Tl-201 SPECT in syndrome X was very high, and coronary hemodynamics was significantly disturbed in the group of syndrome X with abnormal Tl-201 SPECT. Tl-201 lung/heart count ratio significantly increased in syndrome X on treadmill test. Because of this, exercise induced left ventricular dysfunction was suspected. We concluded that the main pathophysiological finding of impaired coronary circulation in syndrome X was microvascular spasm. (author).

1992-01-01

128

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

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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

129

Myocardial imaging in acute myocardial infarction using. beta. -methyl-p-( sup 123 I)-iodophenylpentadecanoic acid; Comparison with sup 201 Tl imaging and wall motion  

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Myocardial imaging using {beta}-methyl-p-({sup 123}I)-iodophenylpentadecanoic acid (BMIPP) was performed in 11 patients with acute myocardial infarction. The left ventricular images were divided into 12 segments, and myocardial images with BMIPP were compared with coronary angiography (CAG), thallium-201 myocardial scintigraphy (Tl) and wall motion obtained by two-dimensional echocardiography (WM). When the culprit lesion was at the proximal point of the left anterior descending artery (LAD), all segments showed depressed uptake. In 3 cases with single vessel disease of the LAD, inferior wall of the basis showed reduced uptake of BMIPP despite the location of the culprit lesion. In cases with discordant uptake between the two tracers, BMIPP frequently showed more severely depressed uptake than Tl in the subacute phase, although the uptake of BMIPP correlated with that of Tl ({tau}=0.82, p<0.001). In such cases, the discordance was related to the improvement in WM from the acute phase to the convalescent phase. BMIPP uptake correlated with WM in the subacute phase ({tau}=0.50, p<0.001). BMIPP showed more severely depressed uptake while WM showed mild asynergy in most cases in which discordance was found between the BMIPP and WM findings. However, there was no correlation between the change in WM from the acute to subacute phases, or the uptakes of BMIPP and Tl alone. We concluded that the myocardial condition can be evaluated in detail in acute myocardial infarction by comparing the findings of BMIPP with those of Tl and WM. (author).

Naruse, Hitoshi; Itano, Midoriko; Kondo, Tomohiro (Hyogo College of Medicine, Nishinomiya (Japan)) (and others)

1992-01-01

130

Multimodality MRI in determination of myocardial viability: comparison with positron emission tomography and single photon emission computed tomography  

International Nuclear Information System (INIS)

Objective: To evaluate the diagnostic value for myocardial viability by using various imaging methods. Methods: Chronic myocardial ischemia animal model in 10 pigs were established and underwent multi-modality MR imaging, PET(positron emission tomography) and 201Tl SPECT(single photon emission computed tomography) before and after 1 to 2 month modeling respectively. The size of myocardial ischemia and necrosis was judged and compared with pathological findings to assess the sensitivity and specificity of various methods. Results: 7 pigs completed all examination successfully. At rest-cine MRI, 10 (8.93%) segments were akinetic, 4 (3.57%) segments were mild hypokinetic and 2 (1.78%) segments were severely hypokinetic. During dobutamine infusion, 10 (8.93% ) segments were akinetic. Perfusion was abnormal in 34 (30.36%) segments. Delayed hyper enhancement was observed in 12 (10.71%) segments. PET showed 17 (15.18%) segments of myocardial necrosis. SPECT showed 9 (8.04%) segments of myocardial necrosis. Triphenyl tetrazolium chloride (TTC) determined 14 (12.50%) segments of pale necrosis. Necrosis segments determined by PET significantly higher than contrast-enhanced MR imaging (?2=5, P=0.0253, Kappa=0.8028) and cine MRI (?2=7, P=0.0082, Kappa=0.7079), it was also higher than TTC (?2=3, P=0.0833, Kappa=0.8879), but had no significant statistic difference. Necrosis segments determined by SPECT was significantly lower than TTC (?2=5, P=0.0253, Kappa=0.7590). Necrosis segments determined by cine MR was significantly lower than TTC (?2=4, P=0.0455, Kappa=0.8100). Necrosis segments determined by contrast-enhanced MRI had no significant statistic difference with TTC (?2=2, P=0.1573, Kappa=0.9130). Using TTC as the gold standard, the sensitivity and specificity of cine MRI, contrast-enhanced MRI, PET and SPECT in the determination of unviable myocardium were 71.43%, 100.00%; 85.71%, 100.00%; 100.00%, 96.94% and 64.29%, 100%, respectively. Conclusion: Cardiac MRI can provide information of morphology, function and perfusion for determining viable myocardium, delineate the location and degree of necrosis myocardium clearly, demonstrate wall motion of left ventricular directly which is cheaper than PET. PET slightly overestimates extent of necrosis myocardium and can't distinguish transmural necrosis from subendocardial necrosis. MRI has high consistency with PET and pathology result. (authors)

2005-01-01

131

Determination of [{sup 201}Tl]Tl(III) in [{sup 201}Tl]TlCl solutions using HPLC  

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A high-performance liquid chromatography technique has been presented to measure the [{sup 201}Tl]TlCl{sub 3} impurity in [{sup 201}Tl]TlCl radiopharmaceutical for precise determination of radiochemical purity. Diethylene tetraamine pentaacetic acid (DTPA) has been used for complete complexation of [{sup 201}Tl]Tl(III). [{sup 201}Tl]Tl(III)-DTPA was analyzed in the presence of [{sup 201}Tl]Tl(I) using a cation exchange HPLC column.

Akhlaghi, M. [Nuclear Medicine Group, Agriculture, Medicine and Industrial Research School (AMIRS), Nuclear Science and Technology Research Institute, Moazzen Blvd., Rajaeeshahr, P.O. Box 31485-498, Karaj (Iran, Islamic Republic of)], E-mail: makhlaghi@nrcam.org; Kamalidehghan, M.; Jalilian, A.R.; Shadanpoor, N. [Nuclear Medicine Group, Agriculture, Medicine and Industrial Research School (AMIRS), Nuclear Science and Technology Research Institute, Moazzen Blvd., Rajaeeshahr, P.O. Box 31485-498, Karaj (Iran, Islamic Republic of)

2008-04-15

132

Motion detection and correction using multi-rotation 180 single-photon emission tomography for thallium myocardial imaging  

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Patient and organ motion is a potentially limiting factor in gamma camera single-photon emission tomography (SPET) imaging, as highlighted in stress thallium myocardial SPET, where the heart may exhibit a systematic axial motion (cardiac creep) following stress. Multi-rotation SPET has previously been described as a means of obtaining better raw data for motion detection and correction. This study describes the validation of a computerised motion detection algorithm applied to multi-rotation SPET, and reports measured motions in thallium myocardial stress SPET studies from a single-headed gamma camera. Forty-two patients underwent pharmacological stress (dipyridamole) with leg raising, with injection of 75 MBq thallium-201 and imaging after a 10-min delay to detect or evaluate coronary artery disease. Multi-rotation gamma camera SPET was performed with a single-headed gamma camera, with five sequential rapid (4.5 min) continuous SPET mode rotations over 180 . A one-dimensional cross-correlation alignment technique was applied to the projection images to perform motion detection and correction in the axial direction prior to combining the five data sets for tomographic reconstruction. Validation of the cross-correlation alignment analysis was carried out by performing imaging with measured whole-body axial motions in nine subjects, and by reproducibility measurements on multi-rotation data sets. The effect of the applied motion correction was evaluated by calculating mean differences between image pairs before and after shifting, and the general reliability of the automatic motion detection was checked to within one pixel by visual assessment of 160 image pairs. Validation measurements of the cross-correlation technique gave a mean absolute error of 1.5{+-}0.4 mm (0.24{+-}0.06pixels) with a maximum error of 3.7 mm (0.6 pixels). In 40 subjects undergoing pharmacological stress {sup 201}Tl myocardial SPET imaging, the mean cardiac axial creep movement was calculated as 3.1{+-}0.7 mm (0.49{+-}0.11 pixels), with 13 out of 40 (32%) having a calculated motion of 1 pixel (6.3 mm) or more. The automatic image shift was visually judged to be within 1 pixel in all 160 image pair analyses, and the mean pixel value difference between image pairs was reduced following image shifting. It is concluded that multi-rotation 180 SPET imaging provides raw data which allow objective and accurate motion detection of cardiac motion in thallium stress myocardial imaging, whilst the one-dimensional cross-correlation technique demonstrates adequate accuracy and reliability to be applied as an automatic motion screening technique on these data. (orig.) With 7 figs., 16 refs.

Britten, A.J.; Jamali, F. [Department of Medical Physics, St. George`s Hospital, Tooting, London (United Kingdom); Gane, J.N.; Joseph, A.E.A. [Department of Nuclear Medicine, St. George`s Hospital, Tooting, London (United Kingdom)

1998-11-01

133

Motion detection and correction using multi-rotation 180 single-photon emission tomography for thallium myocardial imaging  

International Nuclear Information System (INIS)

[en] Patient and organ motion is a potentially limiting factor in gamma camera single-photon emission tomography (SPET) imaging, as highlighted in stress thallium myocardial SPET, where the heart may exhibit a systematic axial motion (cardiac creep) following stress. Multi-rotation SPET has previously been described as a means of obtaining better raw data for motion detection and correction. This study describes the validation of a computerised motion detection algorithm applied to multi-rotation SPET, and reports measured motions in thallium myocardial stress SPET studies from a single-headed gamma camera. Forty-two patients underwent pharmacological stress (dipyridamole) with leg raising, with injection of 75 MBq thallium-201 and imaging after a 10-min delay to detect or evaluate coronary artery disease. Multi-rotation gamma camera SPET was performed with a single-headed gamma camera, with five sequential rapid (4.5 min) continuous SPET mode rotations over 180 . A one-dimensional cross-correlation alignment technique was applied to the projection images to perform motion detection and correction in the axial direction prior to combining the five data sets for tomographic reconstruction. Validation of the cross-correlation alignment analysis was carried out by performing imaging with measured whole-body axial motions in nine subjects, and by reproducibility measurements on multi-rotation data sets. The effect of the applied motion correction was evaluated by calculating mean differences between image pairs before and after shifting, and the general reliability of the automatic motion detection was checked to within one pixel by visual assessment of 160 image pairs. Validation measurements of the cross-correlation technique gave a mean absolute error of 1.5±0.4 mm (0.24±0.06pixels) with a maximum error of 3.7 mm (0.6 pixels). In 40 subjects undergoing pharmacological stress 201Tl myocardial SPET imaging, the mean cardiac axial creep movement was calculated as 3.1±0.7 mm (0.49±0.11 pixels), with 13 out of 40 (32%) having a calculated motion of 1 pixel (6.3 mm) or more. The automatic image shift was visually judged to be within 1 pixel in all 160 image pair analyses, and the mean pixel value difference between image pairs was reduced following image shifting. It is concluded that multi-rotation 180 SPET imaging provides raw data which allow objective and accurate motion detection of cardiac motion in thallium stress myocardial imaging, whilst the one-dimensional cross-correlation technique demonstrates adequate accuracy and reliability to be applied as an automatic motion screening technique on these data. (orig.)

1998-01-01

134

Thallium-201 single photon emission computed tomography in patients with symptoms of heart disease and non-significant coronary artery lesions  

International Nuclear Information System (INIS)

[en] Polar presentations of coronary angiograms and myocardial 201Tl SPECT were compared in 44 patients without significant coronary artery disease (201Tl SPECT overlap but are not congruent. Coronary angiography describes morphology of large coronary vessels, whereas 201Tl SPECT contains information of large and small vessel perfusion as well as membrane transport of 201Tl ions. (orig.)

1990-01-01

135

Hemodynamic significance of diffuse lung uptake of /sup 201/Tl in heart diseases  

Energy Technology Data Exchange (ETDEWEB)

Clinical significance of diffuse lung uptake of /sup 201/Tl was studied in 244 cases of various heart diseases. The grade of lung uptake of /sup 201/Tl was assessed by total lung uptake ratio (L/T), maximal lung uptake ratio (Max/T), lung to myocardium or mediastinum counts ratio (M/H or M/Med) and visual grade. L/T, Max/T, M/H and M/Med were directly correlated with pulmonary arterial pressure (PCW), and inversely correlated with cardiac output (CO) and cardiac index (CI). Among them, L/T was the best index to assess PCW, that was correlated with PCW (r=0.65), CO (r=-0.53) and CI (r=-0.45). The visual grade of /sup 201/Tl lung uptake was correlated with L/T, and the increased lung uptake was associated with a higher PCW and a lower CO as well as a lower CI. Diffuse increased lung uptake of /sup 201/Tl was observed in 29 of 41 cases (70.7%) with myocardial infarction, 25 of 29 cases (86.2%) with mitral valvular diseases and 9 of 10 cases (90.0%) with combined valvular diseases, in addition, in most cases with left heart failure and cases of NYHA 3 and 4, but that was not rarely observed in cases of NYHA 2 and without left heart failure. In heart diseases, /sup 201/Tl myocardial scintigraphy seems to be valuable for detection of left heart failure including pulmonary congestion and interstitial pulmonary edema. Total lung uptake ratio (L/T) may be useful for estimation of PCW, and the visual grade of /sup 201/Tl lung uptake may be applicable as routine index for grading of lung uptake of /sup 201/Tl. (author).

Fujii, Tadashige; Kanai, Hisakata; Tanaka, Masao and others

1989-05-01

136

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

International Nuclear Information System (INIS)

[en] 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)

2004-01-01

137

Diagnosis of acute myocardial infarction using dual SPECT ( sup 99m Tc PYP and sup 201 Tl Cl) method; Diagnostic availability and quantitative assessment of infarct area  

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We investigated the usefulness of the dual SPECT method with the Tc-99m and Tl-201 in comparison with the conventional Tc-99m planar method. Myocardial scintigraphy was performed in 57 patients with acute myocardial infarction; 30 were assessed by the conventional planar method and 27 by the dual SPECT method. The accumulation ratio of Tc-99m (%Tc) by the dual SPECT method was calculated from the coronal image and was compared with the serum values of total CPK, peak CPK, total CPK-MB, and peak CPK-MB obtained from serial sampling and the LVEF obtained by a left ventriculography a month later. The sensitivity for diagnosis of myocardial infarction was 73.3% by the planar method and 88.9% by the dual SPECT method. The infarct sites were identified in 61.5% of the antero-septal lesion, in 35.7% of the infero-posterior lesion and in 66.7% of the lateral lesion using the planar method, while using the dual SPECT method were 100% identification for both antero-septal and lateral lesions, and 75% for the infero-posterior lesion. The highest correlation, with a rate of 0.854, was between the %Tc and the total CPK. The %Tc also showed a positive correlation with peak CPK (r=0.798), with total CPK-MB (r=0.792) and with peak CPK-MB (r=0.751) (p<0.01). The LVEF had a tendency to decrease as %Tc exceeded 30%. The dual SPECT method was superior to the conventional planar method in detecting, in identifying the site and in evaluating the size of myocardial infarction. It also showed a high correlation between the %Tc and the LVEF at chronic stage of myocardial infarction. (author).

Honda, Noribumi; Abe, Masahiro; Taya, Kouichi; Takata, Yoshifumi; Ogawa, Takashi; Inuzuka, Hiroshi; Abe, Toshihiro; Nagai, Yoshikazu (Tokyo Medical Coll. (Japan))

1991-09-01

138

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

International Nuclear Information System (INIS)

[en] 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

1996-01-01

139

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

140

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

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Nineteen patients suffering from DSS, diagnosed by echocardiography, heart catheterization and angiography were further evaluated by radionuclide studies including ECG-gated {sup 201}TI-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.).

Garty, I.; Shem-Tov, A.A. (Central Emek Hospital, Afula (Israel). Dept. of Nuclear Medicine Chaim-Sheba Medical Center, Tel-Hashomer (Israel))

1991-08-01

 
 
 
 
141

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)

2006-01-01

142

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

143

Myocardial single photon emission computed tomography (SPECT) in syndrome X  

International Nuclear Information System (INIS)

[en] Compared with the usual planar scintigraphy of the myocardium the single photon emission computer tomography (SPECT) has essential advantages. By means of the SPECT a three-dimensional reconstruction of the intersection image is possible which allows a judgment of the myocardium in the transversal, sagittal and coronary planes of section. The scans of the SPECT are richer in contrast and freer from overshadowings of normally or disturbedly perfused areas of the myocardium. 43 patients with angina pectoris complaints in angiographically normal coronary arteries (syndrome X) were examined by means of the SPECT under bicycle ergometer load and at rest. As radionuclide thallium-201 was used. 28 out of 43 patients (65%) showed disturbances of the perfusion, in which cases 21 patients with reversible ischaemias and 7 ones with cicatrised changes and an ischaemia of the marginal zone were conspicuous. Previous own investigations with the planar Tl-201 scintigraphy of the myocardium showed pathological findings in 66% of the cases with a syndrome X. The nearly identical results speak for the high reliability of the scintigraphy of the myocardium, but against the increased sensitivity of the SPECT in contrast to the planar scintigraphy of the myocardium. (author)

1990-09-01

144

Effects of ouabain on 201Tl and 99mTc MIBI kinetics in rat myocardium  

International Nuclear Information System (INIS)

The aim of this study was to investigate the effect of ouabain (inhibitor of Na-K ATPase) in the myocardial uptake and clearance of 201Tl and 99mTc MIBI using rats. Time activity curves of three groups were measured by CsI miniature detector for 15 min after the administration of each radiopharmaceutical. Groups were divided as follows: 1) control group (CON group), 2) early phase 15 min after the administration of ouabain (OU15 group), and 3) late phase 120 min after the administration of ouabain (OU120 group). Main organs of rats including myocardium were resected at 1 min and 15 min after the administration of 201Tl or 99mTc MIBI under the anesthesia of pentobarbital sodium. The uptake (%ID/g) of 201Tl or 99mTc MIBI was measured by well type scintillation counter. The uptake of 201Tl of OU15 group was significantly higher than CON group (OU15: 10.81±1.90, CON: 1.86±0.42) and cleared more rapidly. On the contrary, OU120 group showed lower uptake (1.70±0.21) and slower clearance than OU15 group. Time activity curve of OU15 group indicated the accelerated washout compared with CON group. However, OU120 group showed significantly the reduced washout (CON group: 19%, OU15 group: 22%, OU120 group: 9%). On the other hand, the uptake and time activity curves of 99mTc MIBI were not influenced by ouabain administration. In conclusion, myocardial uptake and clearance of 99mTc MIBI were not related to Na-K ATPase activity, while those of 201Tl were markedly influenced by Na-K ATPase. (author).

1992-01-01

145

Myocardial stunning in hypertrophic cardiomyopathy: recovery predicted by single photon emission computed tomographic thallium-201 scintigraphy  

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A young woman with hypertrophic cardiomyopathy confirmed by echocardiography and cardiac catheterization presented with chest pain and features of a large left ventricular aneurysm. The initial diagnosis was myocardial ischemia with either an evolving or an ancient myocardial infarction. Subsequently, verapamil therapy was associated with complete resolution of the extensive left ventricular wall motion abnormalities, normalization of left ventricular ejection fraction and a minimal myocardial infarction. Normal thallium uptake on single photon emission computed tomographic scintigraphy early in the hospital course predicted myocardial viability in the region of the aneurysm. Thus, orally administered verapamil may reverse spontaneous extensive myocardial ischemia in hypertrophic cardiomyopathy and possibly limit the extent of myocardial infarction in such circumstances.

Fine, D.G.; Clements, I.P.; Callahan, M.J.

1989-05-01

146

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

Energy Technology Data Exchange (ETDEWEB)

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 {sup 201}Tl 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 {sup 201}Tl 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 {sup 201}Tl 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 {sup 201}Tl SPECT is useful for evaluating myocardial ischemia even in the elderly, but exercise electrocardiography has limitations such as lower specificity in the elderly than {sup 201}Tl SPECT. (author)

Kurata, Chinori; Uehara, Akihiko; Sugi, Toshihiko; Yamazaki, Keisuke [Hamamatsu Univ. School of Medicine, Shizuoka (Japan); Tawarahara, Kei; Mikami, Tadashi; Matoh, Fumitaka; Odagiri, Keiichi

2000-06-01

147

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

International Nuclear Information System (INIS)

[en] 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)

2000-01-01

148

Abnormal /sup 201/Tl limb scan due to unilateral tremor  

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A abnormal intra- and interextremity distribution pattern on /sup 201/Tl was observed on the limb scan of a patient with a unilateral tremor. This is ascribed to the increased blood flow in the muscles responsible for the tremor. The suggestion is made that the existence of tremor should be considered as a possible explanation for unexpected abnormalities on /sup 201/Tl limb scintigrams.

Simons, M.; Schelstraete, K.; Bratzlavsky, M.

1982-12-01

149

Prevalence of myocardial viability assessed by single photon emission computed tomography in patients with chronic ischaemic left ventricular dysfunction  

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OBJECTIVE: To assess the prevalence of myocardial viability by technetium-99m (Tc-99m)-tetrofosmin/fluorine-18-fluorodeoxyglucose (FDG) single photon emission computed tomography (SPECT) in patients with ischaemic cardiomyopathy. DESIGN: A retrospective observational study. S...

Schinkel, A.F.; Bax, J.J.; Sozzi, F.A.M.A.; Valkema, R.; Elhendy, A.A.; Poldermans, D.; Roelandt, J.R.T.C.; Boersma, H.

150

201Tl scintigraphy after surgical repair of hemodynamically significant primary coronary artery anomalies  

International Nuclear Information System (INIS)

[en] Nine patients with hemodynamically significant congenital coronary artery anomalies underwent surgical repair at our institution during the period 1960 to 1979. Four received diagnoses of anomalous left coronary artery arising from the pulmonary artery, while five patients had coronary artery fistulae. Stress 201Tl scintigraphy was performed on these patients 0.5 to 18 years after surgical correction as a means of assessing the adequacy of myocardial perfusion. No perfusion defects were visualized on any of the thallium studies. The surgical procedure used did not appear to influence the results of 201Tl stress imaging. Thus, these nine patients with surgically corrected primary coronary artery anomalies had no evidence of ischemia as assessed by stress thallium scintigraphy. Serial preoperative and postoperative thallium studies are now indicated to determine the role of this procedure in the management of hemodynamically significant congenital coronary artery anomalies

1982-01-01

151

/sup 201/Tl scintigraphy after surgical repair of hemodynamically significant primary coronary artery anomalies  

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Nine patients with hemodynamically significant congenital coronary artery anomalies underwent surgical repair at our institution during the period 1960 to 1979. Four received diagnoses of anomalous left coronary artery arising from the pulmonary artery, while five patients had coronary artery fistulae. Stress /sup 201/Tl scintigraphy was performed on these patients 0.5 to 18 years after surgical correction as a means of assessing the adequacy of myocardial perfusion. No perfusion defects were visualized on any of the thallium studies. The surgical procedure used did not appear to influence the results of /sup 201/Tl stress imaging. Thus, these nine patients with surgically corrected primary coronary artery anomalies had no evidence of ischemia as assessed by stress thallium scintigraphy. Serial preoperative and postoperative thallium studies are now indicated to determine the role of this procedure in the management of hemodynamically significant congenital coronary artery anomalies.

Rajfer, S.I.; Oetgen, W.J.; Weeks, K.D. Jr.; Kaminski, R.J.; Rocchini, A.P.

1982-06-01

152

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

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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](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 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](III)VAN 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](III)vancomycin, 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; M. Amin Hosseini; A. Karimian; M. Kamali Dehghan; M. Sadeghi; F. Saddadi; S. Moradkhani; S. Daneshvari; F. Motamedi-sede

2006-01-01

153

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

154

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)

2004-01-01

155

Usefulness of dynamic 201TlCl SPECT for differential diagnosis of ring-enhancing brain lesions  

International Nuclear Information System (INIS)

[en] Glioblastoma (GB), metastatic brain tumor (ME), and brain abscess (AB) show ring enhancement on imaging, and their differentiation is difficult. We performed dynamic 201TlCl SPECT in patients with these 3 diseases, and investigated the diagnostic usefulness of differences in their accumulation dynamics. The subjects were 41, 37, and 11 patients with GB, ME, and AB, respectively, who underwent single photon emission tomography (SPECT). Dynamic scan every minute for 15 minutes was initiated immediately after the administration of 201TlCl. All data for the 15 minutes were added up and designated as static data, and the thallium index (TL index) was calculated from the ratio of uptake in the tumorous region to that in the contralateral normal brain region. Data per minute were summed every 3 minutes and designated as dynamic data, and the time-activity ratio curve (TARC) was drawn using the tumor/contralateral normal brain uptake ratio. The TARC was approximated to a linear function, and its slope was compared between the 3 disease groups. The TL index was 5.16±1.95 (mean±standard deviation (SD)) in GB, 3.63±1.71 in ME, and 2.60±1.52 in AB, showing a greater uptake in GB than in ME and AB (p201TlCl uptake in GB (p201TlCl uptake in tumors by dynamic 201TlCl SPECT may be a simple, useful evaluation method for the differential diagnosis of ring-enhancing brain lesions. (author)

2009-01-01

156

Myocardial infarct quantification in the dog by single photon emission computed tomography  

International Nuclear Information System (INIS)

Radionuclide techniques for sizing acute myocardial infarction have been hampered by the intrinsic limitations of the scintillation camera. Emission computed tomography can overcome these limitations. Single photon emission computed tomograms of the distribution of technetium-99m pyrophosphate in acute anterior and posterior infarcts were obtained in 16 dogs after death. Tomograms were also obtained in 10 dogs during life without gating. The size of the infarcts was determined by staining gross sections of the heart with nitro blue tetrazolium, dissecting out the infarcted tissue and weighing it. Infarct sizes were determined from the tomographic images and compared with the measured infarct sizes. Good images showing the location and three-dimensional extent of the infarcts were obtained in all dogs. The measured and calculated infarct sizes correlated well (r = 0.85). Comparison of the calculated sizes in the living (non-gated) and dead (physiologically gated) animals showed reasonable agreement (r = 0.87). Single photon emission computed tomography is a feasible and useful technique for localizing and sizing acute myocardial infarctions

1978-01-01

157

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.).

1994-01-01

158

The most suitable parameter to distinguish brain tumor using 201Tl-chloride and SPECT  

International Nuclear Information System (INIS)

We performed 201Tl single photon emission CT (SPECT) studies on 62 patients with brain tumors prior to any therapy for the tumor. Ten lesions of ope-scar and 17 patients without brain tumor were also studied. The SPECT imaging was initiated 5 min (early image) and 4 hour (delayed image) after injection with 74 MBq of 201Tl-chloride. For a semi-quantitative analysis, we used the ratio of delayed count density to the early count density of the tumor (Td/Te), the ratio of tumor to normal brain tissue (Te/Te) on the early SPECT and the index of T/B ((Td/Te)/(Bd/Be)). Delay to early ratio of 34 normal brain tissue (Bd/Be) was 1.22±0.15 and tended to decrease with the age. The Td/Te ratio of meningioma and region of operation scar was about 0.75 which was less than that of normal brain tissue. In 31 patients with astrocytic tumor, Td/Te ratio was clearly higher in poorly differentiated tumor than in well differentiated one. The index of Td/Te ratio was superior to Te/Be or T/B ratio for differentiating brain tumor and grading astrocytic tumor. (author).

1993-01-01

159

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

160

Evaluation of 201Tl SPECT in patients with glioma  

International Nuclear Information System (INIS)

[en] The purpose of this study is to clarify the usefulness of 201Tl brain SPECT in the prediction of clinical degree of malignancy. Quantitative evaluation of 201Tl uptake in the tumor was expressed as count ratio of tumor site over contralateral normal region (D/C ratio) on 201Tl SPECT image. Fourteen patients with gliomas received an intravenous administration of bromodeoxyuridine (BUdR) at surgery to label tumor cells in the DNA synthesis phase. BUdR-positive cells in excised tumor specimen were stained with anti-BUdR monoclonal antibody by indirect immunoperoxydase staining. Percentage of labeled cells in relation to the total number of tumor cells in microscopic fields was defined as labeling index (BUdR-LI). D/C ratio in patients with grade IV glioma (198.7±31.7) was higher than that in patients with grade III glioma (138.3±33.9) or more low-grade gliomas (94.2±11.9, p201Tl uptake in the tumor may provide non-invasive prediction of malignancy grade of gliomas and accurate estimation of efficacy of the therapy and early detection of recurrence or malignant transformation of the tumors, by delineating viable tumor tissue in patients with gliomas. (author)

1991-01-01

 
 
 
 
161

Assessment of myocardial perfusion and viability with technetium-99m methoxyisobutylisonitrile and thallium-201 rest redistribution in chronic coronary artery disease  

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We compare thallium-201 rest redistribution and fluorine-18 fluorodeoxyglucose ([{sup 18}F]FDG) for the assessment of myocardial viability within technetium-99m methoxyisobutylisonitrile (MIBI) perfusion defects in 27 patients with chronic stable coronary artery disease. The following studies were performed: (1) stress {sup 99m}Tc-MIBI, (2) rest {sup 99m}Tc-MIBI, (3) {sup 201}Tl rest-redistribution single-photon emission tomography, (4) [{sup 18}F]FDG positron emission tomography. The left ventricle was devided into 11 segments on matched tomographic images. The segment with the highest activity at stress was taken as the reference (activity = 100%). Perfusion defects at {sup 99m}Tc-MIBI rest were classified as severe (activity < 50%), moderate (activity 50%-60%) or mild (activity 60%-85%). Uptakes of [{sup 18}F]FDG and rest-redistributed {sup 201}Tl were recognized as significant if they exceeded 50% of that in the reference segment. Among the 33 segments with severe {sup 99m}Tc-MIBI rest perfusion defects, 21 had significant [{sup 18}F]FDG and 10 significant rest-redistributed {sup 201}Tl uptake. As regards the 37 segments with moderate defects, [{sup 18}F]FDG was present in 29 and {sup 201}Tl in 31, while of the 134 segments with mild defects, 128 showed [{sup 18}F]FDG uptake, and 131, {sup 201}Tl uptake. In conclusion, there is an inverse relationship between the severity of {sup 99m}Tc-MIBI perfusion defects and the uptake of rest-redistributed {sup 201}Tl and [{sup 18}F]FDG. Both tracers are adequate markers of viability in mild and moderate defects; in severe defects {sup 201}Tl might underestimate the presence of viability as assessed by [{sup 18}F]FDG. (orig.)

Rosetti, C. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Landoni, C. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Lucignani, G. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Huang, G. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Bartorelli, A.L. [Institute of Cardiology, University of Milan, CNR, `I. Monzino` Foundation (Italy); Guazzi, M.D. [Institute of Cardiology, University of Milan, CNR, `I. Monzino` Foundation (Italy); Margonato, A. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Chierchia, S. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Galli, L. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Savi, A. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Fazio, F. [INB-CNR, University of Milan, Institute H San Raffaele (Italy)

1995-11-01

162

Comparison of 11C-methionine PET and 201Tl SPECT in the detection of lymph node metastases from lung cancer  

International Nuclear Information System (INIS)

[en] A comparative study of positron emission tomography (PET) using 11C-methionine and single photon emission tomography (SPECT) of thallium chloride-201Tl was performed to detect hilar and mediastinal lymph node metastasis from non-small cell lung cancer. 11C-methionine PET and 201Tl SPECT were used in 22 patients with primary lung cancer before surgery. The findings of two modalities were compared with the pathologic findings. PET was judged, using tumor/muscle radioactivity ratio (TMR), by semiquantitative analysis. SPECT was judged visually. The sensitivity of 11C-methionine PET in detecting lymph node metastasis was 79.2%, specificity 91.5% and accuracy 87.3%. Comparative figures for 201Tl SPECT were 62.5%, 89.3% and 79.5% respectively. PET actually detected four of five metastatic lymph nodes, the size of which ranged from 7 mm to 9 mm in the short axis and were judged as negative by CT. This indicates that PET can detect even small metastatic lymph nodes. PET distinguishes adjacent metastatic nodes as separate nodes because of its high resolution, and enables us to evaluate each lymph node by semiquantitative analysis. The sensitivity of 11C-methionine PET was superior to that of 201Tl SPECT. (author)

1997-01-01

163

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

International Nuclear Information System (INIS)

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

2002-01-01

164

Selection of methods for determining radiochemical purity of (201Tl) thallous chloride  

International Nuclear Information System (INIS)

[en] Different kinds of chromatographic and electrophoretic methods for determining (201Tl) thallous chloride and thallic chloride were compared in a same batch of samples. It was found that mono-valent and tri-valent 201Tl ions could be separated by using cellulose acetate-electrophoresis, paper electrophoresis, pre-saturation paper chromatography and non-saturation paper chromatography. Very close results for the amount of mono-valent 201Tl were obtained when (201Tl) thallous chloride samples were used for the determination. However, it was not consistent for tri-valent 201Tl using the four methods described above. The amount of tri-valent 201Tl was determined effectively by the ascending presaturation paper chromatography method using Na2HPO4-acetone (10:90) as developing agent. The method, with advantages of good reproducibility and small error, is there fore recommended for the determination of radiochemical purity of (201Tl) thallous chloride

1990-01-01

165

Transverse CAT of the myocardium with 201 Tl  

International Nuclear Information System (INIS)

[en] A new computerized axial tomographic (CAT) scanner (J and P Tomoscanner) which enables the transverse section viewing of any organ labelled by one of the monophotonic gamma-ray emitting tracers commonly used in Nuclear Medicine, has been recently commercialized. Its abilities in visualing the 201 Tl labelled myocardium are evaluated with normal hearts and patients with documented infarctions. Positive results have been obtained, allowing an interesting approach to the estimation of the anatomical extent of necrosis. (orig.) 891 MG/orig. 892 MBE[de] Vor kurzem kam ein neuer, axialer Computertomographscanner (CAT) von J und P Tomoscanner auf den Markt, der Schraegschnittabbildungen beliebiger mit in der Nuklearmedizin ueblichen, monophotonen Gammatracern markierter Organe ermoeglicht. Die Abbildungsleistung dieses Geraets wird erprobt in Versuchen zur Abbildung des mit 201 Tl markierten Myokards von gesunden Personen und von Patienten nach Herzinfarkten. Die Resultate sind durchwegs positiv, so dass hiermit ein interessantes neues Verfahren zur anatomischen Beurteilung einer Nekrose zur Verfuegung steht. (orig.)

1979-01-01

166

Attenuation correction in pulmonary and myocardial single photon emission computed tomography  

International Nuclear Information System (INIS)

[en] 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

167

The most suitable parameter to distinguish brain tumor using [sup 201]Tl-chloride and SPECT  

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We performed [sup 201]Tl single photon emission CT (SPECT) studies on 62 patients with brain tumors prior to any therapy for the tumor. Ten lesions of ope-scar and 17 patients without brain tumor were also studied. The SPECT imaging was initiated 5 min (early image) and 4 hour (delayed image) after injection with 74 MBq of [sup 201]Tl-chloride. For a semi-quantitative analysis, we used the ratio of delayed count density to the early count density of the tumor (T[sub d]/T[sub e]), the ratio of tumor to normal brain tissue (T[sub e]/T[sub e]) on the early SPECT and the index of T/B ((T[sub d]/T[sub e])/(B[sub d]/B[sub e])). Delay to early ratio of 34 normal brain tissue (B[sub d]/B[sub e]) was 1.22[+-]0.15 and tended to decrease with the age. The T[sub d]/T[sub e] ratio of meningioma and region of operation scar was about 0.75 which was less than that of normal brain tissue. In 31 patients with astrocytic tumor, T[sub d]/T[sub e] ratio was clearly higher in poorly differentiated tumor than in well differentiated one. The index of T[sub d]/T[sub e] ratio was superior to T[sub e]/B[sub e] or T/B ratio for differentiating brain tumor and grading astrocytic tumor. (author).

Komatani, Akio; Akutsu, Tooru; Yamaguchi, Koichi (Yamagata Univ. (Japan). School of Medicine)

1993-11-01

168

Clinical significance of 201Tl reverse redistribution in patients with aorto-coronary bypass surgery  

International Nuclear Information System (INIS)

[en] Detection of myocardial ischemia by the stress thallium scan has traditionally been performed using transient defect analysis on exercise, followed by redistribution studies. Worsening of the 201Tl myocardial image from exercise to redistribution is referred to as reverse redistribution. In this study, we found reverse redistribution in 10 (21%) of 48 angina pectoris patients who had undergone aortocoronary bypass surgery. The clinical significance of this phenomenon in these patients was investigated in relation to angiographic and surgical findings. Reverse redistribution was found to occur in regions which were supplied by bypass grafts. These areas showed increased coronary blood flow and rapid thallium washout. Our results indicate that a perfusion defect in the bypass region of the redistribution image might be caused by relatively rapid washout in the bypass graft region compared to the adjacent normal myocardium. These results should be considered in the clinical interpretation of stress thallium scans. (orig.)

1987-01-01

169

Clinical significance of /sup 201/Tl reverse redistribution in patients with aorto-coronary bypass surgery  

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Detection of myocardial ischemia by the stress thallium scan has traditionally been performed using transient defect analysis on exercise, followed by redistribution studies. Worsening of the /sup 201/Tl myocardial image from exercise to redistribution is referred to as reverse redistribution. In this study, we found reverse redistribution in 10 (21%) of 48 angina pectoris patients who had undergone aortocoronary bypass surgery. The clinical significance of this phenomenon in these patients was investigated in relation to angiographic and surgical findings. Reverse redistribution was found to occur in regions which were supplied by bypass grafts. These areas showed increased coronary blood flow and rapid thallium washout. Our results indicate that a perfusion defect in the bypass region of the redistribution image might be caused by relatively rapid washout in the bypass graft region compared to the adjacent normal myocardium. These results should be considered in the clinical interpretation of stress thallium scans.

Nishimura, Tsunehiko; Uehara, Tashiisa; Hayashida, Kohei; Kozuka, Takahira

1987-06-01

170

Comparison of positron tomography and scintigraphy with 201Tl for delineation of the myocardium  

International Nuclear Information System (INIS)

[en] Recent advances in nuclear medicine instrumentation have led to the development of improved positron-imaging systems which exceed in performance the earlier systems which were limited mainly by low count rate capability. This has led to renewed interest in positron imaging in general, primarily because such devices offer better resolution and higher sensitivity than conventional, mechanically collimated gamma cameras, as well as tomographic capability which may provide additional and more accurate information for the clinician. Furthermore, the unique capabilities of positrons for use in reconstructive imaging are beginning to be exploited. In the present report, results are presented from a preliminary study in which longitudinal tomographic myocardial images, produced with 81Rb as the positron-emitting label using the double camera coincidence system are compared with conventional myocardial images obtained with 201Tl and a gamma camera

1976-01-12

171

In vitro uptake and release of 201Tl and 99mTc-MIBI in HeLa cell  

International Nuclear Information System (INIS)

201Tl is useful in the diagnosis of tumor malignancy determined by the grade of washout rate to the normal tissue especially in lung tumors and thyroid tumors. 99mTc-MIBI, a tracer of myocardial blood flow is also a tumor tracer. We determined whether the growth of the tumor cell is related to the uptake and release of these tracers in cultured cells (HeLa cell). Cultured HeLa cells were incubated for 1 hr with 10 kBq of either tracer for the kinetic study of cellular uptake and additionally incubated for 90 min with cold medium for the kinetic study of cellular release. These cells cultured with various concentrations of actinomycin D (ACD) were used to examine the correlation between cellular growth and kinetics of these tracers. The uptake in the cell reached a plateau at about 60 min and the uptake at 60 min correlated with the number of the cells and was identified for specific accumulation in the cell. The uptake of 201Tl and 99mTc-MIBI at 60 min was 5.17% and 1.32% respectively of the given dose. The release for 90 min showed almost the same tendency for these tracers. The cellular release of 201Tl with the addition of ACD was increased in association with the concentration of ACD. On the other hand, the cellular release of 99mTc-MIBI showed no change by the addition of ACD. In conclusion, 201Tl showed slower washout in high growth cells than in low growth cells, and could act as an indicator of tumor malignancy by assessment of its washout by the tumor. (author)

1995-01-01

172

Comparison of flow capacities of arterial and venous grafts for coronary artery bypass grafting: evaluation with exercise thallium-201 single-photon emission tomography  

International Nuclear Information System (INIS)

[en] Stress thallium-201 tomography was performed to compare the flow capacities of arterial and saphenous vein grafts in patients with coronary artery bypass grafting (CABG). One hundred and seven consecutive patients (95 male and 12 female; mean age 58±9.1 years) underwent exercise-redistribution 201Tl myocardial single-photon emission tomography 4-5 weeks after CABG. When a reversible perfusion defect was present in the area covered by a patent bypass graft, the flow capacity of the graft was defined as insufficient. Of all 285 grafts, 211 were considered as complete bypass. Reversible perfusion defects were present in 29 (27%) of 108 myocardial areas supplied by patent arterial grafts but in only 5 (5%) of 103 myocardial areas supplied by patent saphenous vein grafts (P

1997-01-01

173

Effects of ouabain on [sup 201]Tl and [sup 99m]Tc MIBI kinetics in rat myocardium; In vivo study using miniature CsI detector  

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The aim of this study was to investigate the effect of ouabain (inhibitor of Na-K ATPase) in the myocardial uptake and clearance of [sup 201]Tl and [sup 99m]Tc MIBI using rats. Time activity curves of three groups were measured by CsI miniature detector for 15 min after the administration of each radiopharmaceutical. Groups were divided as follows: (1) control group (CON group), (2) early phase 15 min after the administration of ouabain (OU15 group), and (3) late phase 120 min after the administration of ouabain (OU120 group). Main organs of rats including myocardium were resected at 1 min and 15 min after the administration of [sup 201]Tl or [sup 99m]Tc MIBI under the anesthesia of pentobarbital sodium. The uptake (%ID/g) of [sup 201]Tl or [sup 99m]Tc MIBI was measured by well type scintillation counter. The uptake of [sup 201]Tl of OU15 group was significantly higher than CON group (OU15: 10.81[+-]1.90, CON: 1.86[+-]0.42) and cleared more rapidly. On the contrary, OU120 group showed lower uptake (1.70[+-]0.21) and slower clearance than OU15 group. Time activity curve of OU15 group indicated the accelerated washout compared with CON group. However, OU120 group showed significantly the reduced washout (CON group: 19%, OU15 group: 22%, OU120 group: 9%). On the other hand, the uptake and time activity curves of [sup 99m]Tc MIBI were not influenced by ouabain administration. In conclusion, myocardial uptake and clearance of [sup 99m]Tc MIBI were not related to Na-K ATPase activity, while those of [sup 201]Tl were markedly influenced by Na-K ATPase. (author).

Tange, Shoichi (Tokyo Women' s Medical Coll. (Japan))

1992-08-01

174

Different thallium-201 single-photon emission tomographic patterns in benign and aggressive meningiomas  

International Nuclear Information System (INIS)

To evaluate the possibility of preoperatively obtaining an index of aggressiveness for intracranial meningiomas, we prospectively studied 22 patients with computed tomographic or magnetic resonance imaging evidence of meningeal tumour, using single-photon emission tomography (SPET) of the brain and thallium-201 (201Tl). On a brain-dedicated SPET scanner, a rapid acquisition protocol with early, short scans was started simultaneously with the intravenous administration of 111 MBq 201Tl, covering the initial intratumoral distribution of the tracer. Twenty minutes post injection, a delayed SPET scan was also obtained. On the reconstructed and attenuation-corrected images we calculated the 201Tl concentration in tumour and normal contralateral brain tissue, and compared intratumoral tracer concentration in the initial and the final part of the rapid acquisition protocol. Benign and malignant meningiomas were classified as such based on histological examination. In malignant lesions, the ratio of the 201Tl concentration at 2-4 min post injection to that at 14-16 min was found to be significantly higher than in non-aggressive neoplasms (mean±1 SD: 1.14±0.31 and 0.56±0.13, respectively, P 201Tl concentration values at 2-4 and at 14-16 min. Our findings suggest that the comparative assessment of intratumoral 201Tl concentration at 2-4 and at 14-16 min post injection could provide a fast, simple method to differentiate preoperatively intracranial meningiomas with different biological behaviour. (orig.). With 3 figs., 1 tab.

1996-01-01

175

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

176

Role of myocardial perfusion single photon emission computed tomography in pediatric cardiology practice  

Directory of Open Access Journals (Sweden)

Full Text Available Diagnostic and prognostic power of myocardial perfusion imaging in patients with coronary artery disease has been demonstrated with planar imaging which was further improvised with addition of gated SPECT and newer Technetium labeled myocardial perfusion tracers like SestaMIBI, Tetrofosmin. Myocardial perfusion abnormalities at rest and after stress are considered to be the best predictors of cardiac event-free survival in adults with ischemic heart disease. This article highlights various myocardial perfusion imaging (MPI)radiopharmaceuticals, exercise procedures, pharmacological stress protocols, indications for MPI and myocardial perfusion patterns in children with some of the common congenital and acquired heart diseases.

Sundaram P; Padma S

2009-01-01

177

High spin structure of 200,201Tl isotopes  

International Nuclear Information System (INIS)

The heavy Tl isotopes in mass 190-200 region with one proton hole and a few neutron holes in Z = 82 and N = 126 shells are expected to show various structural changes as a function of angular momentum due to the strong interplay of single particle and collective degrees of freedom. Thus, the high spin states of Tl isotopes are fertile testing ground for different nuclear models and the underlying angular momentum coupling schemes. There is also a prediction of Chiral partner bands in mass 190 region. The aim of the present experiment was to extend the known yrast band structures to higher spin states and search for other non-yrast side bands to carry out complete spectroscopy of 200,201Tl

2011-01-01

178

[sup 201]Tl-labelled TlCl dosimetry revisited  

Energy Technology Data Exchange (ETDEWEB)

A review of the literature pertaining to the human dosimetry of [sup 201]Tl-labelled thallous chloride provides a spectrum of organ absorbed doses associated with this radiopharmaceutical. A more recent article details human quantitative studies up to 216h postadministration. This multiorgan radiopharmacological study, however, reports the kidney dosimetry to be significantly lower than previous values; 0.0647 mGy MBq[sup -1] (0.238 rad mCi[sup -1]) compared to 0.326 mGy MBq[sup -1] (1.2 rad mC[sup -1]). Because of the latter discrepancy, the dosimetry was recalculated using the reported pharmacodynamic data. This recalculation resulted in a kidney radiation dose comparable to previously published reports of 0.514 mGy MBq[sup -1] (1.89 rad mCi[sup -1]). Also, revised absorbed doses to the various segments of the gastrointestinal tract (GIT) were significantly higher. (author).

Castronovo, F.P. Jr. (Brigham Young Univ., Provo, UT (United States) Harvard Medical School, Boston, MA (United States))

1993-02-01

179

201Tl-labelled TlCl dosimetry revisited  

International Nuclear Information System (INIS)

[en] A review of the literature pertaining to the human dosimetry of 201Tl-labelled thallous chloride provides a spectrum of organ absorbed doses associated with this radiopharmaceutical. A more recent article details human quantitative studies up to 216h postadministration. This multiorgan radiopharmacological study, however, reports the kidney dosimetry to be significantly lower than previous values; 0.0647 mGy MBq-1 (0.238 rad mCi-1) compared to 0.326 mGy MBq-1 (1.2 rad mC-1). Because of the latter discrepancy, the dosimetry was recalculated using the reported pharmacodynamic data. This recalculation resulted in a kidney radiation dose comparable to previously published reports of 0.514 mGy MBq-1 (1.89 rad mCi-1). Also, revised absorbed doses to the various segments of the gastrointestinal tract (GIT) were significantly higher. (author)

1993-01-01

180

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

Energy Technology Data Exchange (ETDEWEB)

{sup 123}I-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 {sup 201}Tl in hypertrophic myocardium. The present study was therefore undertaken to determine whether or not {sup 123}I-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 {sup 123}I-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 higher than that in the remaining HCM patients. The BMIPP SS for the survivors was significantly lower than that for the non-survivors. 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 the BMIPP SS is useful in evaluating the severity of HCM. We conclude that {sup 123}I-BMIPP is a valuable metabolic tracer in predicting the outcome of HCM. (author).

Nishimura, Tsunehiko; Uehara, Toshiisa [Osaka Univ., Suita (Japan). Medical School; Nagata, Seiki [and others

1996-02-01

 
 
 
 
181

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

182

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

International Nuclear Information System (INIS)

[en] 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.)

1999-01-01

183

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

184

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

185

Myocardial metabolic imaging by means of fluorine-18 deoxyglucose/technetium-99m sestamibi dual-isotope single-photon emission tomography  

International Nuclear Information System (INIS)

[en] It was the aim of the present work to develop and test FDG single-photon emission tomography (SPET) with the means of conventional nuclear medicine. The perfusion marker sestamibi (MIBI) was used together with the metabolic tracer FDG in dual-isotope acquisition. A conventional SPET camera was equipped with a 511-keV collimator and designed to operate with simultaneous four-channel acquisition. In this way, the scatter of 18F into the technetium-99m energy window could be taken into account by a novel method of scatter correction. Thirty patients with regional wall motion abnormalities at rest were investigated. The results of visual wall motion analysis by contrast cine-ventriculography in nine segments/heart were compared with the results of quantitative scintigraphy. The scintigraphic patterns of MIBI and FDG tracer accumulation were defined as normal, matched defects and perfusion-metabolism mismatches. Spatial resolution of the system was satisfactory, with a full width at half maximum (FWHM) of 15.2 mm for 18F and 14.0 mm for 99mTc, as measured by planar imaging in air at 5 cm distance from the collimator. Image quality allowed interpretation in all 30 patients. 88% of segments without relevant wall motion abnormalities presented normal scintigraphic results. Seventy-five akinetic segments showed mismatches in 27%, matched defects in 44% and normal perfusion in 29%. We conclude that FDG-MIBI dual-isotope SPET is technically feasible with the means of conventional nuclear medicine. Thus, the method is potentially available for widespread application in patient care and may represent an alternative to the 201Tl reinjection technique. (orig.)

1994-01-01

186

Myocardial metabolic imaging by means of fluorine-18 deoxyglucose/technetium-99m sestamibi dual-isotope single-photon emission tomography  

Energy Technology Data Exchange (ETDEWEB)

It was the aim of the present work to develop and test FDG single-photon emission tomography (SPET) with the means of conventional nuclear medicine. The perfusion marker sestamibi (MIBI) was used together with the metabolic tracer FDG in dual-isotope acquisition. A conventional SPET camera was equipped with a 511-keV collimator and designed to operate with simultaneous four-channel acquisition. In this way, the scatter of [sup 18]F into the technetium-99m energy window could be taken into account by a novel method of scatter correction. Thirty patients with regional wall motion abnormalities at rest were investigated. The results of visual wall motion analysis by contrast cine-ventriculography in nine segments/heart were compared with the results of quantitative scintigraphy. The scintigraphic patterns of MIBI and FDG tracer accumulation were defined as normal, matched defects and perfusion-metabolism mismatches. Spatial resolution of the system was satisfactory, with a full width at half maximum (FWHM) of 15.2 mm for [sup 18]F and 14.0 mm for [sup 99m]Tc, as measured by planar imaging in air at 5 cm distance from the collimator. Image quality allowed interpretation in all 30 patients. 88% of segments without relevant wall motion abnormalities presented normal scintigraphic results. Seventy-five akinetic segments showed mismatches in 27%, matched defects in 44% and normal perfusion in 29%. We conclude that FDG-MIBI dual-isotope SPET is technically feasible with the means of conventional nuclear medicine. Thus, the method is potentially available for widespread application in patient care and may represent an alternative to the [sup 201]Tl reinjection technique. (orig.)

Stoll, H.P. (Medizinische Universitaetsklinik und Poliklinik, Innere Medizin 3 (Kardiologie), Univ. des Saarlandes, Homburg/Saar (Germany)); Hellwig, N. (Medizinische Universitaetsklinik und Poliklinik, Innere Medizin 3 (Kardiologie), Univ. des Saarlandes, Homburg/Saar (Germany)); Alexander, C. (Abt. fuer Nuklearmedizin der Radiologischen Universitaetsklinik, Univ. des Saarlandes, Homburg/Saar (Germany)); Oezbek, C. (Medizinische Universitaetsklinik und Poliklinik, Innere Medizin 3 (Kardiologie), Univ. des Saarlandes, Homburg/Saar (Germany)); Schieffer, H. (Medizinische Universitaetsklinik und Poliklinik, Innere Medizin 3 (Kardiologie), Univ. des Saarlandes, Homburg/Saar (Germany)); Oberhausen, E. (Abt. fuer Nuklearmedizin der Radiologischen Universitaetsklinik, Univ. des Saarlandes, Homburg/Saar (Germany))

1994-10-01

187

The evaluation of 201TlCl and delayed scan for thyroid imaging agent  

International Nuclear Information System (INIS)

The results of 189 patients with nodular goiter by imaging with 201TlCl following with sup(99m)TcO4- was presented. Accumulation of 201TlCl to the corresponding area was observed in 85.5% of cancer, 62.2% of adenoma, 42.5% of adenomatous goiter, and the usefulness of 201TlCl (early scan) for thyroid imaging agent was recognized. On the other hand, delayed scan for purpose of differentiation from benign to malignant was also performed. However, no significant differences were obtained. (author)

1982-01-01

188

Evaluation of /sup 201/TlCl and delayed scan for thyroid imaging agent  

Energy Technology Data Exchange (ETDEWEB)

The results of 189 patients with nodular goiter by imaging with /sup 201/TlCl following with sup(99m)TcO/sub 4//sup -/ was presented. Accumulation of /sup 201/TlCl to the corresponding area was observed in 85.5% of cancer, 62.2% of adenoma, 42.5% of adenomatous goiter, and the usefulness of /sup 201/TlCl (early scan) for thyroid imaging agent was recognized. On the other hand, delayed scan for purpose of differentiation from benign to malignant was also performed. However, no significant differences were obtained.

Taniguchi, Tatsuyoshi; Harada, Taneichi; Takahashi, Tatsuo; Senoo, Tsuneaki; Ohtsuka, Nobuaki; Ito, Yasuhiko (Kawasaki Medical School, Kurashiki, Okayama (Japan))

1982-11-01

189

[Stress myocardial perfusion single photon emission computed tomography imaging in the detection of coronary artery disease in woman].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the diagnostic efficacy of stress myocardial perfusion imaging (MPI) in female coronary artery disease (CAD) patients. METHODS: Two hundred and fifty-nine consecutive female patients, aged 60 +/- 8, underwent stress myocardial perfusion single photon emission computed tomography (SPECT) imaging and coronary angiography with an interval of < 60 days. Among them, 227 patients underwent exercise MPI, injected intravenously with (99m)Tc-methoxyisobutyl isonitrile (MIBI) 740 - 925 MBq when the exercise end point was reached, and 32 patients underwent pharmacologic stress MPI, injected intravenously with persantine or adenosine and then (99m)Tc-MIBI. RESULTS: Among the 227 patients undergoing exercise MPI 79 had significant coronary artery stenosis with the overall sensitivity and specificity for detecting coronary artery disease of 63% and 97% respectively. According to the exercise heart rate, the 227 patients were divided into two groups: group 1 (n = 137) the patients of which achieved adequate exercise end points, and group 2 (n = 90) the patients of which only reached submaximal exercise. The sensitivity of exercise MPI for detecting CAD was 86% in the group 1 and 38% in the group 2. Among the 32 patients who underwent pharmacologic stress MPI 13 had significant CAD with the sensitivity and specificity of 85% and 84% respectively. CONCLUSION: Stress MPI is an efficient protocol for the detection of CAD in women, and pharmacologic stress MPI is more suitable for the women with decreased exercise capacity and advanced age.

Zhang WC; Tian YQ; Yang MF; Guo XH; He ZX

2007-10-01

190

Quantitative assessment of myocardial viability following coronary artery bypass grafting using exercise thallium-201 myocardial single photon emission computed tomography and left ventricular regional wall motion  

International Nuclear Information System (INIS)

Using exercise thallium-201 myocardial single photon emission computed tomography (SPECT) and % radial shortening (%RS), 58 patients were evaluated before and after coronary artery bypass grafting (CABG) to quantitatively assess myocardial viability and the effect of CABG. The patient was classified, according to redistribution pattern, as group I with only complete redistribution (20 cases) and group II with including incomplete redistribution (22 cases) and group III with no redistribution (16 cases). Group I was expected complete improvement of ischemic myocardium after CABG but regional left ventricular wall motion was unchanged (?i%RS: 142.5±54.7?138.4±39.6, ?a%RS: 201.2±51.1?238.2±68.2). Group II was expected to diminish ischemic size after CABG and left ventricular regional wall motion was significantly improved (?i%RS: 68.8±25.9?154.9±42.6 p

1989-01-01

191

Impact of appropriate use on the prognostic value of single-photon emission computed tomography myocardial perfusion imaging.  

UK PubMed Central (United Kingdom)

BACKGROUND: Appropriate use criteria (AUC) have been developed to aid in the optimal use of single-photon emission computed tomography (SPECT)-myocardial perfusion imaging (MPI), a technique that is a mainstay of risk assessment for ischemic heart disease. The impact of appropriate use on the prognostic value of SPECT-MPI is unknown. METHODS AND RESULTS: A prospective cohort study of 1511 consecutive patients undergoing outpatient, community-based SPECT-MPI was conducted. Subjects were stratified on the basis of the 2009 AUC for SPECT-MPI into an appropriate or uncertain appropriateness group and an inappropriate group. Patients were prospectively followed up for 27±10 months for major adverse cardiac events of death, death or myocardial infarction, and cardiac death or myocardial infarction. In the entire cohort, the 167 subjects (11%) with an abnormal scan experienced significantly higher rates of major adverse cardiac events and coronary revascularization than those with normal MPI. Among the 823 subjects (54.5%) whose MPIs were classified as appropriate (779, 51.6%) or uncertain (44, 2.9%), an abnormal scan predicted a multifold increase in the rates of death (9.2% versus 2.6%; hazard ratio, 3.1; P=0.004), death or myocardial infarction (11.8% versus 3.3%; hazard ratio, 3.3; P=0.001), cardiac death or myocardial infarction (6.7% versus 1.7%; hazard ratio, 3.7; P=0.006), and revascularization (24.7% versus 2.7%; hazard ratio, 11.4; P<0.001). Among the 688 subjects (45.5%) with MPI classified as inappropriate, an abnormal MPI failed to predict major adverse cardiac events, although it was associated with a high revascularization rate. Furthermore, appropriate MPI use provided incremental prognostic value beyond myocardial perfusion and ejection fraction data. CONCLUSIONS: When performed for appropriate indications, SPECT-MPI continues to demonstrate high prognostic value. However, inappropriate use lacks effectiveness for risk stratification, further emphasizing the need for optimal patient selection for cardiac testing.

Doukky R; Hayes K; Frogge N; Balakrishnan G; Dontaraju VS; Rangel MO; Golzar Y; Garcia-Sayan E; Hendel RC

2013-10-01

192

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

International Nuclear Information System (INIS)

[en] 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

193

Evaluation of diffuse lung uptake of sup 201 Tl in bronchopulmonary diseases  

Energy Technology Data Exchange (ETDEWEB)

{sup 201}Tl scintigraphy was performed in various bronchopulmonary diseases. Applying semiquantitative and visual assessments of grade of {sup 201}Tl lung uptake, clinical aspects of diffuse lung uptake of {sup 201}Tl was studied. Diffuse lung uptake of {sup 201}Tl 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 {sup 201}Tl 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 {plus minus} 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 {sup 201}Tl was 1.5 {plus minus} 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 {sup 201}Tl was diffuse, homogenous and marked in diffuse interstitial pneumonia and hypersensitivity pneumonitis, while it was scattered and slight in chronic obstructive lung diseases. {sup 201}Tl 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).

Fujii, Tadashige; Tanaka, Masao; Hirose, Yoshiki; Kusama, Yasumasa; Hirayama, Jiro; Kobayashi, Toshio; Handa, Kenjiro (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

1990-03-01

194

Detection of moderate and severe coronary artery stenosis with technetium-99m tetrofosmin myocardial single-photon emission tomography  

International Nuclear Information System (INIS)

[en] The aim of this study was to determine the diagnostic accuracy of technetium-99m tetrofosmin myocardial imaging for the localization of coronary artery stenoses of different degrees of severity. Stress-rest single-photon emission tomography (SPET) was performed on separate days in 80 patients (64 males, 16 females; mean age 61 years; 43 patients with previous myocardial infarction; 18 patients with pharmacological stress), within 6 months of coronary angiography. Scintigraphic images were blindly and independently evaluated by three observers. Coronary stenosis was defined as a >50% narrowing in luminal diameter; severe stenosis was defined as a proximal stenosis of >75% or a peripheral stenosis of >90%. Coronary angiography revealed normal coronary arteries or insignificant coronary stenosis in 13 patients and significant coronary stenoses in 67 patients. The sensitivity and specificity of 99mTc-tetrofosmin SPET in respect of severely stenosed vessels were, respectively, 80% and 65% for the left anterior descending artery (LAD), 100% and 46% for the right coronary artery (RCA) and 58 and 78% for the left circumflex artery (LCx) territories. Considering all the significantly stenosed vessels, a significant decrease in sensitivity was observed for LAD territories (to 59%, P=0.05), and a nonsignificant decrease for RCA (88%) and LCx (47%) territories while specificity values remained essentially unchanged. No significant changes in sensitivity or specificity were observed when regions with previous myocardial infarction were excluded. In conclusion, the sensitivity of 99mTc-tetrofosmin SPET for the localization of individual stenosed vessels is only moderate when all significant stenoses are considered, but the ability of this technique to predict the location of severe coronary artery stenoses seems satisfactory, with the exception of the low specificity in respect of RCA territories. (orig.)

1997-01-01

195

Comparison of {sup 201}Tl-SPECT and MRI using Gd-DTPA for glioma  

Energy Technology Data Exchange (ETDEWEB)

{sup 201}Tl-SPECT was performed in 25 patients with a pathological diagnosis of glioma. The lesion-to-normal (L/N) ratio of the glioblastoma group (n=7) was found to be higher than that of the low-grade glioma group (n=7; Mann-Whitney U-test, p<0.0167). {sup 201}Tl accumulation in the tumor corresponded to contrast enhancement on MRI in 95% of cases. An insufficient blood-brain barrier was considered to be the primary contributor to {sup 201}Tl accumulation. In five cases, there was a discrepancy between the extent of {sup 201}Tl accumulation and the Gd-DTPA enhanced area. In these cases, the area of {sup 201}Tl accumulation was larger than the area of Gd-DTPA enhancement. This may result from damage to the blood-brain barrier that is not severe enough to be detected with Gd-DTPA or from additional factors other than change in the blood-brain barrier. {sup 201}Tl-SPECT is able to demonstrate the extent of glioma more accurately than contrast-enhanced MRI. (author)

Yamada, Takayuki; Maruoka, Shin; Yamada, Shogo [Tohoku Univ., Sendai (Japan). School of Medicine; Sonobe, Makoto

1999-07-01

196

Relationship between availability of the collateral circulation and ischemic time for myocardial viability in patients with acute myocardial infarction. Assessment by technetium-99m tetrofosmin single photon emission computed tomography  

International Nuclear Information System (INIS)

Myocardial accumulation before reperfusion therapy of a radioactive tracer in the completely occluded region, conceivably reflects the viability of myocytes and degree of collateral circulation. To confirm this, the present study examined the relationship in the title. Subjects were 33 patients (F 7, M 26; average age 65 y) of the first 1-branch acute myocardial infarction and of TIMI (thrombolysis in myocardial infarction trial) grade 0 who recovered to TIMI 3 within 12 hr after attack: 99mTc-tetrofosmin, 740 MBq, was intravenously injected before reperfusion and just after which, SPECT imaging (TF-SPECT) was conducted with Toshiba E. CAM, and regional severity score index (RSSI) (0-3) was calculated. About 1 week later, to see the myocardial viability in the chronic phase, GITl (Glucose-Insulin-201Tl) (111 MBq) SPECT was performed 30 min after its injection to calculate RSSI as above, and the echocardiography with ALOKA Pro Sound SSD-4000 or SIEMENS Acuson SEQUOIA C256 was done to calculate the regional wall motion score index (RWMSI) (0-4). RWMSI was found significantly correlated with TF-RSSI, the group with the better collateral circulation (TF-RSSI, 1.9 or less) exhibited significantly lower GITl-RSSI and RWMSI, and correlation between the ischemic time and neither TF-RSSI, GITl-RSSI nor RWMSI was found. Thus under these conditions, the development of collateral vessels was found to have potential protective effects on myocardium independently on the ischemic time. (T.I.)

2007-01-01

197

Adenosine myocardial perfusion single photon emission computed tomographic stress testing 24-72 h after uncomplicated myocardial infarction.  

Science.gov (United States)

Safety of performing adenosine myocardial perfusion stress testing as early as 24 h after acute uncomplicated myocardial infarction is not known. We evaluated 31(14 females and 17 males, average age 72, range 46-89 years) consecutive patients with uncomplicated myocardial infarction, who underwent adenosine myocardial perfusion stress imaging, 24-72 h after infarction for risk stratification. Adenosine was infused at a rate of 140 microg/kg/min for 6 min. Twenty patients were presented with non-ST-elevation myocardial infarction. Eleven patients were admitted with acute ST-elevation myocardial infarction. Patients were monitored for signs of complication during and immediately after the stress test. The average time from admission to performance of stress tests was 51 +/- 19 h, ranging from the minimum of 24 h to maximum 72 h. No complications related to adenosine infusion were detected. In conclusion, our data suggest that a further large study of early adenosine myocardial perfusion SPECT imaging may be safe in a carefully selected group of patients after uncomplicated myocardial infarction. PMID:12123319

Kulhanek, Jan; Sorrell, Vincent L; Ershadi, Reza E; Cabarrus, Brian R; Short, Douglas B; Movahed, Assad

2002-08-01

198

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

International Nuclear Information System (INIS)

[en] 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.)[de] Es wurden die Ergebnisse der Standardtechnik Stress-Redistribution, (R1) mit jenen nach Reinjektion von 37 MBq sofort nach der ersten Spaetafunahme und Bilddokumentation nach 15 min (R2), mit jenen einer Spaetaufnahme nach 24 h (R3) und mit jenen, die mit einer zeitlich verstetzten Ruheinjektion (R4) gemacht wurden, bei 24 Patienten mit vorangegangenem Herzinfarkt verglichen. Die in drei Projektionsebenen angefertigten planaren Bilder wurden in 216 Segmente unterteilt. Die Anreicherung des 201Tl mittles eines subjektiven Scores bzw. semiquntitativer Analyse der Flaechen, die aus dem Circumferenzprofil gewonnen wurden, bewertet. Ein Speicherungsdefekt wurde unter Belastung in 127 Segmenten bestaetigt (58,7%); die visuelle Analyse konnte eine verbesserte Anreicherung in R1 (32,3%), in R2 (41,7%), in R3 (33%) und in R4 (49,6%) feststellen. Die semiquantitative Bewertung hat nur mit der R1-Methode (62% der Faelle) eine Verbesserung erbracht. Es wurde bei 6 Patienten (25% der Faelle) vitales Myokard nachgewiesen, welches nicht mit der konventionellen Analyse identifiziert werden konnte. (orig.)

1993-01-01

199

99mTc perfusion myocardial Cardiolite scintigraphy by means of SPECT  

International Nuclear Information System (INIS)

The semicircular (RAO 45 deg - LPO 45 deg) data acquisition in 201Tl perfusion myocardial Single Photon Emission Computer Tomograph (SPECT) examination is generally accepted. After the administration of 99mTc which has numerous favourable character, the question is raised whether the 180 degree data acquisition technique is suitable. 360 deg and simulated 180 deg projectional SPECT images of 11 patients before coronaria surgery were compared with the coronarograms. Data acquisition derived from 180 deg rotation is satisfactory according to the authors. This technique is recommended for clinical examination because of its short examination time. (author) 12 refs.; 2 tabs.

1989-01-01

200

Diagnosis of left ventricular aneurysm by exercise thallium-201 myocardial single photon emission computed tomography  

International Nuclear Information System (INIS)

Seventy nine patients with acute myocardial infarction underwent exercise thallium-201 myocardial SPECT combined with selective coronary angiography and left ventriculography to determine post-infarction left ventricular (LV) aneurysm. Ventricular wall morphology on either horizontal or vertical long-axis images was visually classified as convergent (C), parallel (P), or divergent (D) wall. According to morphological types from poststress to delayed images, the patients were also divided into five groups: Group A (n=36) having C-C, Group B (n=8) having P-C, Group C (n=7) having P-P, Group D (n=5) having D-P, and Group E (n=23) having D-D. The highest incidence of LV aneurysm was seen in Group E (21/23), followed by Group D (3/5), and Group C (3/7). When patients in Groups D or E, all of whom had anterior infarction, were defined as positive for LV aneurysm, the diagnostic sensitivity, specificity, and accuracy of SPECT were 89%, 92%, and 86%, respectively. Two of three patients with false negative diagnosis had only apical involvement. Groups D and E had significantly larger defect scores, as calculated by polar maps, than the other three groups. When patients with anterior infarction with defect scores of 200 or greater were defined positive, the sensitivity, specificity, and accuracy of SPECT in determining LV aneurysm were 96%, 75%, and 86%, respectively. One false negative case was apical infarction, and one of the two false positive cases was extensive anteroseptal infarction involving the apex. These results suggest that LV aneurysm could be diagnosed only by exercise SPECT, and that it could be characterized by extensive and severe aplicoanterior infarction and a divergent-type ventricular wall arrangement on a poststress SPECT images. (N.K.)

1991-01-01

 
 
 
 
201

Diagnosis of left ventricular aneurysm by exercise thallium-201 myocardial single photon emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

Seventy nine patients with acute myocardial infarction underwent exercise thallium-201 myocardial SPECT combined with selective coronary angiography and left ventriculography to determine post-infarction left ventricular (LV) aneurysm. Ventricular wall morphology on either horizontal or vertical long-axis images was visually classified as convergent (C), parallel (P), or divergent (D) wall. According to morphological types from poststress to delayed images, the patients were also divided into five groups: Group A (n=36) having C-C, Group B (n=8) having P-C, Group C (n=7) having P-P, Group D (n=5) having D-P, and Group E (n=23) having D-D. The highest incidence of LV aneurysm was seen in Group E (21/23), followed by Group D (3/5), and Group C (3/7). When patients in Groups D or E, all of whom had anterior infarction, were defined as positive for LV aneurysm, the diagnostic sensitivity, specificity, and accuracy of SPECT were 89%, 92%, and 86%, respectively. Two of three patients with false negative diagnosis had only apical involvement. Groups D and E had significantly larger defect scores, as calculated by polar maps, than the other three groups. When patients with anterior infarction with defect scores of 200 or greater were defined positive, the sensitivity, specificity, and accuracy of SPECT in determining LV aneurysm were 96%, 75%, and 86%, respectively. One false negative case was apical infarction, and one of the two false positive cases was extensive anteroseptal infarction involving the apex. These results suggest that LV aneurysm could be diagnosed only by exercise SPECT, and that it could be characterized by extensive and severe aplicoanterior infarction and a divergent-type ventricular wall arrangement on a poststress SPECT images. (N.K.).

Okano, Mitsuji; Ohsuzu, Fumitaka; Katsushika, Shuuichi; Yanagida, Shigeki; Senoo, Masao; Aosaki, Noboru; Nakamura, Haruo (National Defense Medical Coll., Tokorozawa, Saitama (Japan))

1991-01-01

202

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

Energy Technology Data Exchange (ETDEWEB)

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)

Lin, Jen-Jhy; Hsu, Hsiu-Bao; Sun, Shung-Shung; Kao, Chia-Hung [China Medical Coll., Taichung, Taiwan (China). Hospital; Wang, Jhi-Joung [Chi-Mei Medical Center, Tainan, Taiwan (China); Ho, Shung-Tai [National Defense Medical Center, Taipei, Taiwan (China). School of Medicine

2003-01-01

203

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)

[en] 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

204

In vitro uptake and release of {sup 201}Tl and {sup 99m}Tc-MIBI in HeLa cell  

Energy Technology Data Exchange (ETDEWEB)

{sup 201}Tl is useful in the diagnosis of tumor malignancy determined by the grade of washout rate to the normal tissue especially in lung tumors and thyroid tumors. {sup 99m}Tc-MIBI, a tracer of myocardial blood flow is also a tumor tracer. We determined whether the growth of the tumor cell is related to the uptake and release of these tracers in cultured cells (HeLa cell). Cultured HeLa cells were incubated for 1 hr with 10 kBq of either tracer for the kinetic study of cellular uptake and additionally incubated for 90 min with cold medium for the kinetic study of cellular release. These cells cultured with various concentrations of actinomycin D (ACD) were used to examine the correlation between cellular growth and kinetics of these tracers. The uptake in the cell reached a plateau at about 60 min and the uptake at 60 min correlated with the number of the cells and was identified for specific accumulation in the cell. The uptake of {sup 201}Tl and {sup 99m}Tc-MIBI at 60 min was 5.17% and 1.32% respectively of the given dose. The release for 90 min showed almost the same tendency for these tracers. The cellular release of {sup 201}Tl with the addition of ACD was increased in association with the concentration of ACD. On the other hand, the cellular release of {sup 99m}Tc-MIBI showed no change by the addition of ACD. In conclusion, {sup 201}Tl showed slower washout in high growth cells than in low growth cells, and could act as an indicator of tumor malignancy by assessment of its washout by the tumor. (author).

Komori, Tsuyoshi; Matsui, Ritsuo; Adachi, Itaru; Shimizu, Tadafumi; Sueyoshi, Kozo; Narabayashi, Isamu [Osaka Medical Coll., Takatsuki (Japan)

1995-07-01

205

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.

1997-01-01

206

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

2001-01-01

207

Stress thallium-201 myocardial single photon emission computed tomography for the detection of multivessel disease in patients with previous myocardial infarction  

Energy Technology Data Exchange (ETDEWEB)

The value of stress Thallium-201 myocardial single photon emission computed tomography (SPECT) for detection of multivessel disease was analyzed in 93 patients with previous myocardial infarction. The sensitivities for detecting coronary arterial narrowing greater than 51 % in multivessel disease and three-vessel disease were 61 % and 63 %, respectively. Excluded in this study were the two-vessel disease groups of left circumflex and right coronary arteries. In patients with previous anterior infarction, concomitant right coronary or left circumflex artery lesion was detected in 36 %, whereas in those with previous inferior both anterior and inferior infarction, the sensitivity for left anterior descending arterial lesion was 69 % and 100 %, respectively. The existence of stress-induced ischemia which appeared in the peri-infarction area, and ventricular aneurysm inhibited the detection of other coronary arterial lesions. Thus, we concluded that stress SPECT is a useful technique for detection of multivessel disease (especially left anterior descending artery lesion) and three-vessel disease; however, there is a limit in detection of multivessel disease in patients with previous anterior myocardial infarction.

Hamada, Masayuki; Futagami, Yasuo; Aoki, Toshikazu; Yada, Takashi; Koyama, Takao; Konishi, Tokuji; Nakano, Takeshi; Maeda, Hisato

1988-08-01

208

Recovery of impaired left ventriculary function in patients with acute myocardial infarction is predicted by the discordance in defect sise on {sup 123}I-BMIPP and {sup 201}TI SPET images  

Energy Technology Data Exchange (ETDEWEB)

A discrepancy between myocardial perfusion defect and wall motion abnormalities is frequently found early after coronary reperfusion in patients with acute myocardial infarction. The purpose of this study was to assess recovery of impaired left ventricular function by reference to the discordance in defect size between myocardial fatty acid uptake and myocardial perfusion using combined single-photon emission tomographic (SPET) imaging early after coronary perfusion therapy. In 37 patients with acute myocardial infarction, iodine-123 15-(p-iodophenyl)-3(R, S)-methylpentadecanoic acid (BMIPP) and thallium-201 SPET scans were performed early after coronary reperfusion. A severity score was determined from the extent of the imaging defect with each tracer. Left ventricular wall motion score (WMS) and injection fraction (EF) were obtained at admission and at 4 weeks after the onset of infarction. In 32 of the 37 patients, discordance in defect sizes delineated with the two SPET studies was found during the acute stage. The severity score for BMIPP was larger than that for {sup 201}Tl during the acute stage (7.7{+-}2.4 vs 4.4{+-}2.5, P<0.001). There was a fair correlation between the severity score for BMIPP and WMS (r=0.82, P<0.0001), but a poor correlation between that for {sup 201}Tl and WMS. The extent of discordance in severity scores between BMIPP and {sup 201}Tl during the acute stage correlated well with the extent of the improvement in WMS (r=0.86, P<0.0001) and that of EF (r=0.85, P<0.0001). We conclude that the discordance in defect size on BMIPP and {sup 201}Tl SPET images during the acute stage of infarction is an early predictor of the viability of the myocardium at risk of infarction. (orig.)

Ito, Tatsuo [Osaka Rosai Hospital, Sakai (Japan). Div. of Cardiology; Tanouchi, Jun [Osaka Rosai Hospital, Sakai (Japan). Div. of Cardiology; Kato, Junji [Osaka Rosai Hospital, Sakai (Japan). Div. of Cardiology; Morioka, Tashikazu [Osaka Rosai Hospital, Sakai (Japan). Div. of Cardiology; Nishino, Masami [Osaka Rosai Hospital, Sakai (Japan). Div. of Cardiology; Iwai, Kunimitsu [Osaka Rosai Hospital, Sakai (Japan). Div. of Cardiology; Tanahashi, Hideo [Osaka Rosai Hospital, Sakai (Japan). Div. of Cardiology; Yamada, Yoshio [Osaka Rosai Hospital, Sakai (Japan). Div. of Cardiology; Hori, Masatsugu [Osaka Univ. School of Medicine, Suita (Japan). First Dept. of Medicine; Kamada, Takenobu [Osaka Univ. School of Medicine, Suita (Japan). First Dept. of Medicine

1996-08-01

209

[Comparative assessment of resting myocardial perfusion in patients with postinfarct cardiosclerosis by electron-beam tomography and 99mTc-MIBI myocardial single-photon tomography  

UK PubMed Central (United Kingdom)

The purpose of the study was to compare myocardial perfusion assessed by electron beam computed tomography (EBCT) with that obtained by 99mTc-sestamibi single photon emission computed tomography (SPECT) in patients with old myocardial infarction and control subjects at rest. A total of 42 patients with suspected and known ischaemic heart disease (IHD) were included in the study. 20 pts had a history of Q-wave myocardial infarction (MI), 12 pts had an old non-Q-wave MI and 10 served as controls (without perfusion defects on SPECT images at rest). Assessment of the myocardial perfusion by EBCT was performed using the short axis view and multislice mode (MSM) during injection of 50 ml of the nonionic contrast medium at 4 ml/s via cubital vein. Perfusion defects were localized by SPECT according to 6-segment model of the LV (septal, anterior, lateral, posterior, inferior and apical). Overall concordance between EBCT and SPECT was 67% for normal versus abnormal perfusion. Agreement between the 2 methods for each of the 6 segments was 81% (K = 0.62) for the anterior segment, 71% (K = 0.42) for the septal segment, 71% (K = 0.43) for the apical, 69% (K = 0.3) for the lateral segment, 48% (K = 0.13) for the posterior segment and 60% (K = -0.13) for the inferior segment. Discrepancies between the two of techniques were most notable in the posterior region. Beam hardening during passage of the contrast medium through the heart chambers and descending aorta is possible explanation of the artifacts on EBCT images. This study demonstrates that nowadays EBCT is not yet alternative to SPECT in the assessment of the myocardial perfusion in patients and further improvements of scanning techniques are necessary.

Sinitsyn VE; Gramovich VV; Khodareva EN; Mikha?lov DV; Veselova TN; Sergienko VB; Ternovo? SK; Chazov EI

2002-07-01

210

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

International Nuclear Information System (INIS)

The purpose was to evaluate cardiac sympathetic reinnervation and hemodynamic changes after orthotopic heart transplantation (TPL). We performed 24 serial or followup cardiac 123I-MIBG imaging and rest 201Tl/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS) in 15 patients (M:F=10:5;mean ages=34.5±13.0 yr; idiopathic:rheumatic=14:1; one heart lung TPL)(10.80 ±11.88 (1-48) mo) after TPL 123I-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 heart to mediastinal MIBG uptake (HMR) Compared to HMR on 15 min images (1.48 ± 0.28), neither four nor 24 hour delayed images (1.26 ± 0.23 vs. 1.06 ± 0.26: p

2000-01-01

211

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

Energy Technology Data Exchange (ETDEWEB)

The thyroid scintigraphy with /sup 123/I and /sup 201/Tl-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 /sup 201/Tl early scintigram performed within 15 minutes after intravenous injection demonstrated homogeneous high activity in the whole thyroid gland and in the /sup 201/Tl delayed scintigram performed 3 hours after the injection, the accumulation of /sup 201/Tl 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 /sup 123/I scintigram was discussed. We believe that /sup 201/Tl-early and delayed scintigrams could be one of useful non-invasive methods to diagnose chronic thyroiditis.

Okamura, Terue; Fukuda, Teruo; Sawa, Hisashi; Inoue, Yuichi; Nakazima, Hideyuki (Osaka City Univ. (Japan). Faculty of Medicine)

1982-07-01

212

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

International Nuclear Information System (INIS)

[en] 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

213

Visual and semi-quantitative assessment of brain tumors using (201)Tl-SPECT.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the usefulness of (201)Tl-SPECT in differentiating benign from malignant brain tumors. METHODS AND MATERIALS: Eighty-eight patients (44 males and 44 females) with 58 high-grade (WHO grade III-IV) and 30 low-grade (WHO grade I-II) tumors were evaluated with (201)Tl-SPECT. (1) Visual assessment was performed by board-certificated radiologists using (201)Tl-SPECT. Tumors were classified in two groups (Tl-positive and Tl-negative) and scored using the five grade evaluation system. Receiver operating characteristic (ROC) analysis was performed in the Tl-positive group. (2) Semi-quantitative assessment involved measurement of early and delayed (201)Tl uptake, and the retention index (RI) was applied as follows: RI=delayed uptake ratio/early uptake ratio. Three combinations of RI using mean and maximum values of the region of interest were calculated. RESULTS: (1) Seventy-four Tl-positive and 14 Tl-negative tumors. The area under the ROC curve (AUC) estimated by three radiologists exceeded a value of 0.7. The value was greater when estimated by the more experienced radiologist. (2) In all RIs, the difference of RI between high-grade tumors and low-grade tumors was statistically significant. CONCLUSION: A visual and semi-quantitative assessment using (201)Tl-SPECT was found to be useful for differentiating benign from malignant brain tumors.

Nose A; Otsuka H; Nose H; Otomi Y; Terazawa K; Harada M

2013-01-01

214

99mTc-MIBI and 201Tl imaging of thyroid with cold nodule  

International Nuclear Information System (INIS)

Objective: To investigate clinical value of 99mTc-MIBI and 201Tl imaging of thyroid with cold nodule. Methods: 87 patients with cold thyroid nodule were imaged with 99mTc-MIBI (early 15 min, delayed 60 min) and 201Tl (early 15 min, delayed 120 min). Results of interest (ROIs) were generated over the cold nodule and normal tissue on each image by semi-quantification method. The semi-quantitative analysis was performed by using a lesion to non-lesion ratio of early (ER) and delayed (DR) images. Retention index (RI) was calculated by dividing delayed-early subtraction to product ER. Results: there was significant difference in the ER, DR and RI between malignant and benign lesions for 99mTc-MIBI and 201Tl (p0.05), but there was significant difference between carcinoma and cystic adenoma for 201Tl imaging (p99mTc-MIBI and 201Tl imaging of thyroid cold nodule using ER, DR and RI have good clinical application value

2001-01-01

215

The usefulness of 201TlCl scintigraphy for the diagnosis of breast tumor  

International Nuclear Information System (INIS)

The usefulness of 201TlCl SPECT (Tl SPECT) for the diagnosis of breast cancer was evaluated in 14 patients with various breast tumors (9 with invasive ductal carcinoma, 2 with fibroadenoma and 3 with benign process). These tumors ranged in size from 1.5 cm x 1.5 cm to 15.0 cm x 14.0 cm. Tl SPECT was carried out 2 hours after the intravenous injection of 201TlCl (185 MBq). For quantitative study, ROIs were set in the tumor (T), normal tissue of the opposite breast (B) and myocardium (M). Count ratios of T/B and T/M were calculated. Eight patients with breast cancer and a case of fibroadenoma showed intense accumulation of 201TlCl in the tumors. The T/B ratio was 1.20±0.68 and the T/M ratio was 0.68±0.31 in the 9 cases. Lymph node metastasis was detected in 2 of 6 cases that were confirmed at operation. No remarkable accumulation of 201TlCl was seen in 4 patients with benign process. One patient with benign tumor showed a false positive result. The rates of accuracy of mammography and ultrasonography for the same subjects were 82% and 84%, respectively. The results suggest that 201TlCl SPECT might be useful to assess breast cancer in cases in which the findings of other modalities are equivocal. (author).

1994-01-01

216

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

International Nuclear Information System (INIS)

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.).

1997-01-01

217

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

218

Correlation of MIB-1 staining index and 201Tl-SPECT retention index in preoperative evaluation of malignancy of brain tumors  

International Nuclear Information System (INIS)

MIB-1 staining provides a useful index of the malignancy of brain tumors. However, because of the difficulty of evaluating malignancy based on the preoperative imaging findings, we investigated the correlation between the 201Tl-single photon emission computed tomography (SPECT) retention index (RI) and MIB-1 staining index (MIB-1 SI) to determine the usefulness of RI for preoperative evaluation of the malignancy of brain tumors. The subjects of this study were 47 patients who underwent tumor removal surgery at our hospital in 2006 and 2007. The tumors consisted of 16 intraaxial tumors (all gliomas: 9 glioblastomas, 2 anaplastic astrocytomas, 2 anaplastic oligoastrocytomas, 1 oligodendroglioma, and 2 ependymomas), 8 other malignant brain tumors, and 23 extraaxial tumors (10 meningiomas, 7 pituitary adenomas, and 6 schwannomas). The mean RI and mean MIB-1 SI of the intraaxial tumors were 0.628% and 32.0%, respectively, and after MIB-1 SI was converted to the natural logarithm (log MIB-1 SI), Pearson's coefficient for the correlation between them was significant (r=0.752, P201Tl-SPECT RI values were useful as an index of malignancy. RI values may also be useful for evaluating apparently benign extraaxial tumors for possible malignancy. (author)

2010-01-01

219

99mTc myocardial perfusion imaging.  

UK PubMed Central (United Kingdom)

For more than 15 years, 201Tl has been used for measuring myocardial perfusion and viability although its physical characteristics, which include a photon energy of 68 to 80 keV and a physical half-life of 73 hours, are far from ideal. In early 1991, 99mTc tracers from the group of compounds known as isonitriles and boronic acid adducts of technetium dioximes (BATO) compounds were made available for general use in the United States, with approval by the Food and Drug Administration in late 1990. The uptake of these agents in the myocardium is proportional to regional blood flow. Because these tracers have 99mTc as the radiolabel, they have better physical characteristics--a gamma photon energy of 140 keV and a half-life of 6 hours--than 201Tl. The isonitrile with the best properties for myocardial imaging is 99mTc-hexakis-2-methoxyisobutyl isonitrile (MIBI) (Cardiolite, DuPont, Wilmington, DE). It has transient hepatic uptake and little or no myocardial redistribution, making it an ideal single-photon emission CT tracer. The commercially developed agent of the BATO group is 99mTc-teboroxime (Cardiotec, Squibb, Princeton, NJ). Its extraction fraction by the myocardium is higher than that of 201Tl and 99mTc-MIBI but its washout is very rapid and flow related. Because of the lack of redistribution with 99mTc-MIBI and the rapid washout with 99mTc-teboroxime, two separate injections are necessary for these new tracers to enable them to distinguish ischemia from scar tissue. It is recommended to perform the rest study first, and then to do the exercise study if a 1-day protocol is being used.(ABSTRACT TRUNCATED AT 250 WORDS)

Braat SH

1991-12-01

220

Diagnosis of intracranial malignant lymphoma by 67Ga and 201Tl SPECT  

International Nuclear Information System (INIS)

Six patients with malignant lymphoma of the brain underwent 67Ga and 201Tl brain SPECT. For the quantitative analysis, count ratios of a lesion to the normal brain (L/N) were calculated. In 201Tl SPECT studies, an L/N ratios ranged from 2.3 to 3.2, with a mean of 2.9±0.4. In 67Ga SPECT studies, an L/N ratios ranged from 4.4 to 6.6 with a mean of 5.7±0.8. 67Ga SPECT showed much more intense tracer uptake than 201Tl SPECT and the degree of 67Ga accumulation seems to be in proportion to the viability of malignant lymphoma. We came to the conclusion that quantitative 67Ga SPECT appears to be useful in detecting and managing malignant lymphoma in the brain. (author)

1995-01-01

 
 
 
 
221

Experimental investigation of [sup 201]TlCl-scintigraphy in evaluating therapeutic effect of hyperthermia  

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We investigated the usefulness of 201Tl-scintigraphy in the evaluation of therapeutic effect of hyperthermia. Satoh's experimental lung cancer tumors implanted in the right thighs of donryu rats were treated with hyperthermia using water bath. Tumors were heated at 44degC or 46degC for 15 min. [sup 201]Tl-scintigraphy was obtained before, immediately after and 24 hrs after treatment. Counts ratio of the tumor of the normal muscle (T/N ratio) was measured by gamma camera. We examined blood flow of the tumor, and relative tumor growth rate, and performed autoradiogram and histopathological examination of the tumor after [sup 201]Tl-scintigraphy. Immediately after hyperthermia, T/N ratio and blood flow of the tumor significantly decreased (p<0.05). Autoradiogram showed that the accumulation of [sup 201]TlCl in the tumor decreased diffusely. Histopathological finding showed congestion, thrombosis, and swelling of endothelial cells. These results suggest that the decrease in T/N ratio may be caused by the vascular damage due to hyperthermia. The T/N ratio recovered 24 hrs after hyperthermia but was still lower than that for the control. Autoradiogram showed that [sup 201]TlCl greatly accumulated in viable tumor tissue but was hardly seen in the necrotic tumor tissue. These results suggest that the decrease in T/N ratio may be caused by increase of necrotic areas. The T/N ratio 24 hrs after hyperthermia correlated (r=0.83) with relative tumor growth rate on 7th day after hyperthermia and, therefore, can be used as an indicator of relative tumor growth rate. [sup 201]Tl-scintigraphy can be useful for prediction of therapeutic effect of hyperthermia. (author).

Nishiyama, Yoshihiro; Takashima, Hitoshi; Kawasaki, Yukiko; Ohkawa, Motoomi; Tanabe, Masatada; Kobayashi, Shoji (Kagawa Medical School, Miki (Japan))

1994-06-01

222

Experimental investigation of 201TlCl-scintigraphy in evaluating therapeutic effect of hyperthermia  

International Nuclear Information System (INIS)

We investigated the usefulness of 201Tl-scintigraphy in the evaluation of therapeutic effect of hyperthermia. Satoh's experimental lung cancer tumors implanted in the right thighs of donryu rats were treated with hyperthermia using water bath. Tumors were heated at 44degC or 46degC for 15 min. 201Tl-scintigraphy was obtained before, immediately after and 24 hrs after treatment. Counts ratio of the tumor of the normal muscle (T/N ratio) was measured by gamma camera. We examined blood flow of the tumor, and relative tumor growth rate, and performed autoradiogram and histopathological examination of the tumor after 201Tl-scintigraphy. Immediately after hyperthermia, T/N ratio and blood flow of the tumor significantly decreased (p201TlCl in the tumor decreased diffusely. Histopathological finding showed congestion, thrombosis, and swelling of endothelial cells. These results suggest that the decrease in T/N ratio may be caused by the vascular damage due to hyperthermia. The T/N ratio recovered 24 hrs after hyperthermia but was still lower than that for the control. Autoradiogram showed that 201TlCl greatly accumulated in viable tumor tissue but was hardly seen in the necrotic tumor tissue. These results suggest that the decrease in T/N ratio may be caused by increase of necrotic areas. The T/N ratio 24 hrs after hyperthermia correlated (r=0.83) with relative tumor growth rate on 7th day after hyperthermia and, therefore, can be used as an indicator of relative tumor growth rate. 201Tl-scintigraphy can be useful for prediction of therapeutic effect of hyperthermia. (author)

1994-01-01

223

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

International Nuclear Information System (INIS)

[en] 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)

2005-01-01

224

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

225

Postoperative myocardial infarction documented by technetium pyrophosphate scan using single-photon emission computed tomography: Significance of intraoperative myocardial ischemia and hemodynamic control  

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The aim of this prospective study was to document postoperative myocardial infarction (PMI) by technetium pyrophosphate scan using single-photon emission computed tomography (TcPPi-SPECT) in 28 patients undergoing elective coronary bypass grafting (CABG). The relationships of intraoperative electrocardiographic myocardial ischemia, hemodynamic responses, and pharmacological requirements to this incidence of PMI were correlated. Radionuclide cardioangiography and TcPPi-SPECT were performed 24 h preoperatively and 48 h postoperatively. A standard high-dose fentanyl anesthetic protocol was used. Twenty-five percent of elective CABG patients were complicated with PMI, as documented by TcPPi-SPECT with an infarcted mass of 38.0 +/- 5.5 g. No significant difference in demographic, preoperative right and left ventricular function, number of coronary vessels grafted, or aortic cross-clamp time was observed between the PMI and non-PMI groups. The distribution of patients using preoperative beta-adrenergic blocking drugs or calcium channel blocking drugs was found to have no correlation with the outcome of PMI. As well, no significant differences in hemodynamic changes or pharmacological requirements were observed in the PMI and non-PMI groups during prebypass or postbypass periods, indicating careful intraoperative control of hemodynamic indices did not prevent the outcome of PMI in these patients. However, the incidence of prebypass ischemia was 39.3% and significantly correlated with the outcome of positive TcPPi-SPECT, denoting a 3.9-fold increased risk of developing PMI. Prebypass ischemic changes in leads II and V5 were shown to correlate with increased CPK-MB release (P less than 0.05) and tends to occur more frequently with lateral myocardial infarction.

Cheng, D.C.; Chung, F.; Burns, R.J.; Houston, P.L.; Feindel, C.M. (Toronto Hospital, Ontario (Canada))

1989-12-01

226

Diagnostic merits of current and potential applications of single photon and positron imaging: a perspective  

International Nuclear Information System (INIS)

A brief review of the limitations of medical radionuclide imaging techniques in competition with x-ray CAT scanning and ultrasound suggest that the emphasis in this are should be on measurement of the physiologic uptake of tracer materials. Tomography greatly improves the possibilities of quantitation of this uptake - examples using positron and single photon techniques are presented for 13NH3 and 201Tl in the heart

1978-10-20

227

The role of {sup 201}Tl scintigraphy in evaluating proliferative activity in thyroid neoplasms  

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To identify the relationship between the uptake of {sup 201}Tl and the proliferative activity in thyroid neoplasms, {sup 201}Tl scintigraphy was performed in 57 patients with thyroid neoplasms. {sup 201}Tl uptake ratio was calculated in both the early and the delayed images and then compared with factors representing cellular or practical proliferative activity of the lesions. The labeling index (LI) for proliferating cell nuclear antigen (PCNA) was determined quantitatively by flow cytometry. There was a significant correlation between the uptake ratio and LI for PCNA. The correlation coefficient for the delayed ratio (DR) vs. LI was better than that for the early ratio (ER) vs. LI. As parameters for practical proliferation, the surgical stage in primary thyroid carcinoma or {sup 131}I uptake in recurrent thyroid carcinoma was focused on. DR was strongly related to these parameters, regardless of the histopathological features or size of the lesions. Our results suggest that {sup 201}Tl uptake in delayed thyroid scan is useful in assessing proliferative activity in thyroid neoplasms. (author).

Nakada, Kunihiro; Katoh, Chietsugu; Kanegae, Kakuko; Tsukamoto, Eriko; Itoh, Kazuo; Furudate, Masayori; Tamaki, Nagara [Hokkaido Univ., Sapporo (Japan). School of Medicine

1996-02-01

228

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

229

Studies on portal systemic circulation by oral administration of 201Tl enclosed enteric coated capsule  

International Nuclear Information System (INIS)

Thallium-201 enclosed enteric coated capsule was prepared and administered orally to evaluate portal systemic circulation in 11 control subjects and 31 patients with various liver diseases by investigating scintigraphic appearance and the heart-to-liver uptake ratio (H/L ratio). In 10 patients with liver cirrhosis and one with chronic hepatitis, the results of H/L ratio were compared to those obtained by 201Tl per-rectal administration. 1. It was fundamentally confirmed that 201Tl enclosed enteric coated capsule was not broken down in the artificial gastric juice, but nearly completely melted 15 minutes after soaking in the artificial intestinal juice. 2. Clinical study was successfully completed in 36 out of 42 cases (86 %). Unsuccessful cases were found in 2 with capsule collapse in the stomach and 4 with its poor moving to the duodenum. 3. In control subjects the liver was clearly visualized and the mean value of H/L ratio was 0.32 which is lower than that of 201Tl per-rectal administration previously reported. H/L ratio in patients with chronic and acute hepatitis was nearly equal to that in control subjects. H/L ratio in patients with liver cirrhosis was slightly higher than that in control subjects, but there was no significant difference between them. In cases with esophageal varices, H/L ratio was not so high compared to that in control subjects. Out of 7 patients showing high H/L ratio more than 0.8 in 201Tl per-rectal administration, only one showed similar high ratio (1.07) in oral administration of 201Tl enclosed enteric coated capsule. In this case the shunting from superior mesenteric vein to inferior vena cava connection was confirmed. From these results, it was considered that the shunting volume of superior mesenteric vein through esophageal varices is small. 4. A possibility of a new administration of radioisotope with enteric coated capsule was emphasized. (author).

1986-01-01

230

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; Cwajg Eduardo; Pantoja Mauricio da Rocha

2003-01-01

231

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)

[en] 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

232

Dipyridamole-loading scintigraphy in patients with subendocardial infarction using single photon emission computed tomography  

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To detect myocardial lesions in patients with subendocardial (nontransmural) infarction, myocardial perfusion images of thallium-201 (Tl-201), using single photon emission computed tomography, were obtained in 17 patients during and three hours after coronary vasodilatation induced by the administration of dipyridamole. Controls consisted of 28 patients with transmural infarction and 11 with angina pectoris. Dipyridamole was infused intravenously at a rate of 0.142 mg/kg per min for four min, and the washout rate of Tl-201 was calculated by the segmental ROI method. Many patients with nontransmural infarction exhibited various Tl-201 myocardial perfusion images. The prevalence of redistribution among patients with nontransmural infarction was 88.2% (15 of 17), and its reverse redistribution was 64.7% (11 of 17). Every subject exhibited a number of abnormal Tl-201 myocardial perfusion images. In patients with nontransmural infarction the occurence of reverse redistribution images was significantly higher (64.7%) compared to those with transmural infarction (10.7%), and the occurrence of redistribution images was significantly higher (88.2%) compared to those with angina pectoris (45.5%). The abnormal perfusion images most frequently present in the areas corresponding to the sites of ST-T changes on ECG were reverse redistribution (26.7%), redistribution (17.3%), and fixed defect (6.7%) in order. The phenomenon of reverse redistribution images was found irrespective of stenotic coronary artery lesions on selective coronary angiography. Most areas corresponding to the sites of reverse redistribution showed ST-T changes on ECG and high washout rates of Tl-201. (J.P.N.).

Mori, Kiyoo; Masuda, Masanosuke (Hoju Memorial Hospital, Tatsunokuchi, Ishikawa (Japan)); Bunkou, Hisashi

1988-12-01

233

Effect of collateral circulation on myocardial protection in patients with acute myocardial infarction. Comparison of technetium-99m-tetrofosmin myocardial single photon emission computed tomography and coronary angiography  

International Nuclear Information System (INIS)

Evaluation of myocardial blood flow from collateral vessels into the infarct area has been estimated by coronary angiography. In patients with acute myocardial infarction with Thrombolysis in Myocardial Infarction (TIMI) 0 flow, myocardial tracer uptake on single photon emission computed tomography (SPECT) images can predict the collateral blood flow in the infarct area if technetium (Tc)-99m-tetrofosmin was administered before recanalization. The present study investigated whether collateral blood flow evaluated by myocardial scintigraphy is a good predictor of myocardial salvage in patients with acute myocardial infarction. The study group consisted of 30 patients (mean age 65±14 years, 23 males, 7 females) with first acute myocardial infarction and coronary angiography evidence of total occlusion (TIMI 0) within 12 hr after the onset. All patients had one vessel disease related to infarction and TIMI 3 flow after percutaneous coronary intervention (PCI). Tc-99m-tetrofosmin was injected intravenously before the PCI. The regional severity score index (RSSI) was obtained from SPECT using the 17 segment method with the four-point scoring system. Myocardial viability was evaluated by the RSSI obtained from thallium-glucose-insulin infusion SPECT after 1 week and regional wall motion score index obtained from echocardiography during the chronic phase. The patients were divided into two groups according to the angiographic collateral finding. There were no differences in RSSI on thallium-glucose-insulin SPECT and regional wall motion score between the good collateral group (n=8) and poor collateral group (n=22). Myocardial Tc-99m-tetrofosmin RSSI was similar in these groups. On the other hand, the patients were divided according to Tc-99m-tetrofosmin scintigraphic evaluation before PCI. RSSI on thallium-glucose-insulin SPECT was significantly greater (0.7±0.5 vs 1.5±0.4, p

2006-01-01

234

Left ventricular function assessed with gated single photon emission tomography (GSPET) in patients with acute myocardial infarction subjected to primary PTCA  

International Nuclear Information System (INIS)

The aim of the study is to assess the impact of primary percutaneous transluminal coronary angioplasty (pPTCA) on left ventricular function measured with gated single photon computed tomography (GSPET) with Tc-99m MIBI. Primary PTCA was performed in 20 patients with first acute myocardial infarction. The GSPET studies were acquired 4 times. After 5 days from onset of symptoms the resting study was obtained and 10 days after PTCA the study was performed after submaximal stress. After 6 months the whole sequence was repeated both at rest and after stress. Both in the early acquired studies and after 6 months the left ventricular ejection fraction (LVEF) was greater after stress, while the end-diastolic and end-systolic left ventricular volumes (LVED and LVES) were significantly smaller. In the correlation test the LVET both at resting state and after stress increased significantly after 6 months (p ? 0.001). The correlation coefficient (r=0.9) confirmed full correlation between early and later obtained LVEF values. LVES and LVED volumes both post-stress and at rest decreased significantly within the six months period. The gated single photon emission tomography (GSPET) with Tc-99m MIBI allows the assessment of left ventricular function both at rest and after stress in patients with acute myocardial infarction subjected to primary PTCA. The left ventricular ejection fraction significantly increases with time and the end-diastolic and end-systolic volumes decreased significantly after 6 months. (author)

2003-01-01

235

Effect of diltiazem on myocardial infarct size estimated by enzyme release, serial thallium-201 single-photon emission computed tomography and radionuclide angiography  

International Nuclear Information System (INIS)

[en] Diltiazem is a calcium antagonist with demonstrated experimental cardioprotective effects. Its effects on myocardial infarct size were studied in 34 patients admitted within 6 hours after the first symptoms of acute myocardial infarction. These patients were randomized, double-blind to placebo or diltiazem (10-mg intravenous bolus followed by 15 mg/hr intravenous infusion during 72 hours, followed by 4 X 60 mg during 21 days). Myocardial infarct size was assessed by plasma creatine kinase and creatine kinase-MB indexes, perfusion defect scores using single-photon emission computed tomography with thallium-201 and left ventricular ejection fraction measured by radionuclide angiography. Tomographic and angiographic scanning was performed serially before randomization, after 48 hours and 21 days later. Groups were comparable in terms of age, sex, inclusion time and baseline infarct location and size. Results showed no difference in creatine kinase and creatine kinase-MB data between controls and treated patients, a significant decrease in the perfusion defect scores in the diltiazem group (+0.1 +/- 3.0 placebo vs -2.2 +/- 1.9 diltiazem, p less than 0.02) and a better ejection fraction recovery in the diltiazem group (-4.2 +/- 7.4 placebo vs +7.7 +/- 11.2 diltiazem, p less than 0.05). Myocardial infarct size estimates from perfusion defect scores and enzyme data were closely correlated. These preliminary results suggest that diltiazem may reduce ischemic injury in acute myocardial infarction

1988-06-01

236

Effect of diltiazem on myocardial infarct size estimated by enzyme release, serial thallium-201 single-photon emission computed tomography and radionuclide angiography  

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Diltiazem is a calcium antagonist with demonstrated experimental cardioprotective effects. Its effects on myocardial infarct size were studied in 34 patients admitted within 6 hours after the first symptoms of acute myocardial infarction. These patients were randomized, double-blind to placebo or diltiazem (10-mg intravenous bolus followed by 15 mg/hr intravenous infusion during 72 hours, followed by 4 X 60 mg during 21 days). Myocardial infarct size was assessed by plasma creatine kinase and creatine kinase-MB indexes, perfusion defect scores using single-photon emission computed tomography with thallium-201 and left ventricular ejection fraction measured by radionuclide angiography. Tomographic and angiographic scanning was performed serially before randomization, after 48 hours and 21 days later. Groups were comparable in terms of age, sex, inclusion time and baseline infarct location and size. Results showed no difference in creatine kinase and creatine kinase-MB data between controls and treated patients, a significant decrease in the perfusion defect scores in the diltiazem group (+0.1 +/- 3.0 placebo vs -2.2 +/- 1.9 diltiazem, p less than 0.02) and a better ejection fraction recovery in the diltiazem group (-4.2 +/- 7.4 placebo vs +7.7 +/- 11.2 diltiazem, p less than 0.05). Myocardial infarct size estimates from perfusion defect scores and enzyme data were closely correlated. These preliminary results suggest that diltiazem may reduce ischemic injury in acute myocardial infarction.

Zannad, F.; Amor, M.; Karcher, G.; Maurin, P.; Ethevenot, G.; Sebag, C.; Bertrand, A.; Pernot, C.; Gilgenkrantz, J.M.

1988-06-01

237

Indium-111 antimyosin antibody imaging and thallium-201 imaging. A comparative myocardial scintigraphic study using single-photon emission computed tomography in patients with myocarditis and dilated cardiomyopathy  

International Nuclear Information System (INIS)

[en] Indium-111 antimyosin antibody imaging (a tracer of myocardial necrosis) and thallium-201 imaging (a tracer of myocardial perfusion) were compared in patients with myocarditis and dilated cardiomyopathy. The distribution of each tracer and antimyosin/thallium-201 overlapping were evaluated with single-photon emission computed tomography (SPECT). Scintigraphic data were classified into 5 patterns according to the distribution of both images and were compared with histologic findings of endomyocardial biopsy: AM-D, intense and diffuse antimyosin uptake and no perfusion abnormality (active myocarditis); AM-L, localized antimyosin uptake and no perfusion abnormality (active myocarditis); HM, no antimyosin uptake with or without perfusion abnormality (healed myocarditis); DCM-NH, diffuse antimyosin uptake and inhomogeneous thallium-201 uptake (dilated cardiomyopathy); DCM-PD, diffuse or localized antimyosin uptake and myocardial perfusion defect(s) (dilated cardiomyopathy). Patients with dilated-phase hypertrophic cardiomyopathy were frequently found in the DCM-PD group. Taken together, comparative antimyosin/thallium-201 SPECT images are useful for evaluating the activity of myocarditis and ongoing myocardial damage even in areas with no perfusion in patients with dilated cardiomyopathy. (author)

1997-01-01

238

Indium-111 antimyosin antibody imaging and thallium-201 imaging. A comparative myocardial scintigraphic study using single-photon emission computed tomography in patients with myocarditis and dilated cardiomyopathy  

Energy Technology Data Exchange (ETDEWEB)

Indium-111 antimyosin antibody imaging (a tracer of myocardial necrosis) and thallium-201 imaging (a tracer of myocardial perfusion) were compared in patients with myocarditis and dilated cardiomyopathy. The distribution of each tracer and antimyosin/thallium-201 overlapping were evaluated with single-photon emission computed tomography (SPECT). Scintigraphic data were classified into 5 patterns according to the distribution of both images and were compared with histologic findings of endomyocardial biopsy: AM-D, intense and diffuse antimyosin uptake and no perfusion abnormality (active myocarditis); AM-L, localized antimyosin uptake and no perfusion abnormality (active myocarditis); HM, no antimyosin uptake with or without perfusion abnormality (healed myocarditis); DCM-NH, diffuse antimyosin uptake and inhomogeneous thallium-201 uptake (dilated cardiomyopathy); DCM-PD, diffuse or localized antimyosin uptake and myocardial perfusion defect(s) (dilated cardiomyopathy). Patients with dilated-phase hypertrophic cardiomyopathy were frequently found in the DCM-PD group. Taken together, comparative antimyosin/thallium-201 SPECT images are useful for evaluating the activity of myocarditis and ongoing myocardial damage even in areas with no perfusion in patients with dilated cardiomyopathy. (author)

Yamada, Takehiko; Matsumori, Akira; Nohara, Ryuji; Konishi, Junji; Sasayama, Shigetake [Kyoto Univ. (Japan). Faculty of Medicine; Tamaki, Nagara

1997-10-01

239

Sodium bicarbonate-augmented stress thallium myocardial scintigraphy.  

Science.gov (United States)

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 (201)Tl 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 (201)Tl. 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. PMID:14673543

Sarin, Badal; Chugh, Pradeep Kumar; Kaushal, Dinesh; Soni, Nakse Lal; Sawroop, Kishan; Mondal, Anupam; Bhatnagar, Aseem

2003-12-12

240

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.)

2004-01-01

 
 
 
 
241

Sodium bicarbonate-augmented stress thallium myocardial scintigraphy  

Energy Technology Data Exchange (ETDEWEB)

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 {sup 201}Tl 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 {sup 201}Tl. 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.)

Sarin, Badal; Chugh, Pradeep Kumar; Kaushal, Dinesh; Soni, Nakse Lal; Sawroop, Kishan; Mondal, Anupam; Bhatnagar, Aseem [Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, Brig. S. K. Mazumdar Road, 110054, Delhi (India)

2004-04-01

242

Differential diagnosis between recurrence of brain tumor and radiation necrosis by sup 201 Tl SPECT  

Energy Technology Data Exchange (ETDEWEB)

In order to differentiate recurrence of brain tumor from radiation necrosis, we performed {sup 201}Tl brain SPECT in 16 post-operative patients. Five of them had residual anaplastic astrocytoma. Final diagnosis of the other 11 patients was recurrent astrocytoma (n=6), cerebral radiation necrosis (n=5), based on re-operation (n=9) and more than one year follow-up findings (n=2). Early and delayed images were obtained at 10{similar to}15 min. and 4 hrs. after i.v. injection of 111 MBq of {sup 201}Tl chroride. Counts ratio of a lesion to the normal brain (L/N) was calculated by creating rectangular ROI over each area. All of the patients with recurrent or residual tumor showed L/N ratios of more than 2.5 on the early images (mean 4.70 +- 2.65). On the other hand, L/N ratios on the early images were less than 2.5 in patients with radiation necrosis (mean 2.05 +- 0.25, p<0.001). In conclusion, a quantitative assessment using {sup 201}Tl brain SPECT may be useful in differentiating recurrence of brain tumor from radiation necrosis. (author).

Kosuda, Shigeru; Shioyama, Yasukazu; Kamata, Noriko; Suzuki, Kenzo; Tanaka, Yoshiaki; Nakamura, Osamu; Matsutani, Masao (Tokyo Metropolitan Komagome Hospital (Japan))

1991-04-01

243

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

244

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

245

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

246

Myocardial perfusion abnormality and effects of Ca channel blockers on myocardial ischemia in patients with hypertrophic cardiomyopathy  

International Nuclear Information System (INIS)

The purpose of this study was to investigate the frequency of myocardial ischemia and characteristic regions of myocardial hypoperfusion during stress in patients with hypertrophic cardiomyopathy. Furthermore, the effects of Ca channel blocker (verapamil, diltiazem) on myocardial ischemia were studied. One hundred patients with hypertrophic cardiomyopathy underwent exercise 201Tl SPECT. Sixty-eight patients had one or more 201Tl abnormalities. Of the 68 patients with 201Tl abnormalities, 56 had reversible 201Tl abnormalities and 12 had fixed defect. 201Tl abnormalities were frequently distributed in the anterior and posterior areas of junction between the ventricular septum and the free wall and the apex. Of the 56 patients with reversible 201Tl abnormalities, 40 patients underwent one more exercise 201Tl SPECT after 8 weeks of oral administration of verapamil or diltiazem. The 201Tl defect was visually scored as the defect score. Transient dilation index was calculated as an index of subendocardial ischemia. The mean defect score decreased significantly from 9.80±4.35 to 5.50±4.63 after verapamil and from 9.90±5.17 to 5.50±4.89 after diltiazem. Mean transient dilation index decreased from 1.20±0.12 to 1.08±0.09 after treatment with verapamil and from 1.16±0.10 to 1.02±0.09 after treatment with diltiazem. (K.H.)

1997-01-01

247

Myocardial perfusion abnormality and effects of Ca channel blockers on myocardial ischemia in patients with hypertrophic cardiomyopathy  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to investigate the frequency of myocardial ischemia and characteristic regions of myocardial hypoperfusion during stress in patients with hypertrophic cardiomyopathy. Furthermore, the effects of Ca channel blocker (verapamil, diltiazem) on myocardial ischemia were studied. One hundred patients with hypertrophic cardiomyopathy underwent exercise {sup 201}Tl SPECT. Sixty-eight patients had one or more {sup 201}Tl abnormalities. Of the 68 patients with {sup 201}Tl abnormalities, 56 had reversible {sup 201}Tl abnormalities and 12 had fixed defect. {sup 201}Tl abnormalities were frequently distributed in the anterior and posterior areas of junction between the ventricular septum and the free wall and the apex. Of the 56 patients with reversible {sup 201}Tl abnormalities, 40 patients underwent one more exercise {sup 201}Tl SPECT after 8 weeks of oral administration of verapamil or diltiazem. The {sup 201}Tl defect was visually scored as the defect score. Transient dilation index was calculated as an index of subendocardial ischemia. The mean defect score decreased significantly from 9.80{+-}4.35 to 5.50{+-}4.63 after verapamil and from 9.90{+-}5.17 to 5.50{+-}4.89 after diltiazem. Mean transient dilation index decreased from 1.20{+-}0.12 to 1.08{+-}0.09 after treatment with verapamil and from 1.16{+-}0.10 to 1.02{+-}0.09 after treatment with diltiazem. (K.H.)

Taniguchi, Yoko [Kyoto Prefectural Univ. of Medicine (Japan)

1997-03-01

248

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  

Energy Technology Data Exchange (ETDEWEB)

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

249

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

250

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

251

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)

[en] 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

252

The usefulness of preoperative exercise stress myocardial single photon emission CT with thallium-201 to predict the responses to coronary revascularization  

International Nuclear Information System (INIS)

To evaluate the usefulness of preoperative exercise stress (Ex) myocardial single photon emission CT (SPECT) with thallium-201 to predict the responses to coronary revascularization (CRV), Ex-SPECT's were obtained in 42 patients with coronary artery disease (CAD). In 34 patients angioplasty was performed and in 18 patients coronary bypass surgery was undergone. Before and after CVR, Ex-SPECT's were obtained both at immediately after Ex (Initial) and 3 hours later (RD) by the rotating gamma camera. Initial images before CRV showed definite perfusion defects (+3) in 76 myocardial segments. Perfusion abnormalities at RD images were graded into (+3 to 0) by visual interpretation. '+3' indicated fixed defect and '0' indicated no perfusion abnormality. At RD images 17 segments showed fixed defect and 59 segments showed improved perfusion more than one grade. After CRV, all 59 segments with improved perfusion at RD images showed improvement of perfusion in comparison with initial images before CRV. Out of 17 segments with fixed defect before CRV, 14 segments showed perfusion defect with +3, while 3 segments showed improved perfusion after CRV. These 3 segments had ECG evidence of myocardial infarction. In these 3 segments, Ex-SPECT's before CRV showed abnormally low myocardial Tl washout rate (WOR) despite they indicated fixed defect visually. On the contrary, other 14 segments with fixed defect showed normal WOR before CRV. In conclusion, visually interpreted Ex-SPECT's before CRV predict the myocardial perfusion after CRV in most of cases. In a small number (especially infarction segments) Ex-SPECT's before CRV cannot predict the improvement of myocardial perfusion after CRV by visual inspection, but WOR abnormality before CRV is useful to prospect their results. (author).

1989-01-01

253

Calcified occlusion of the right coronary artery in Kawasaki disease: evidence of myocardial ischaemia using cardiac technetium-99m-tetrofosmin perfusion single-photon emission computed tomography.  

Science.gov (United States)

We report the case of a 14-year-old boy who developed Kawasaki disease at 5 months of age. The patient developed severe aneurysmal disease of both the left and right coronary arteries. He eventually developed total calcified occlusion of the right coronary artery despite long-term treatment with aspirin. Catheterisation showed no antegrade flow into the right coronary artery, with retrograde flow from the left coronary system into the right coronary. At the most recent follow-up he was asymptomatic, with normal exercise tolerance and a negative exercise stress test. Single-photon emission computed tomography (SPECT) myocardial perfusion imaging was carried out during stress and at rest using intravenous persantine (dipyridamole) and technetium-99m tetrofosmin. During stress, there were prominent left ventricular apical and anteroseptal defects, which normalised at rest. SPECT during stress and at rest may detect subclinical ischaemia and influence further management options in such patients. PMID:17056866

Beamish, J; O'Connell, M J; El Khuffash, A; Duff, D F; McMahon, C J

2006-11-01

254

Calcified occlusion of the right coronary artery in Kawasaki disease: evidence of myocardial ischaemia using cardiac technetium-99m-tetrofosmin perfusion single-photon emission computed tomography.  

UK PubMed Central (United Kingdom)

We report the case of a 14-year-old boy who developed Kawasaki disease at 5 months of age. The patient developed severe aneurysmal disease of both the left and right coronary arteries. He eventually developed total calcified occlusion of the right coronary artery despite long-term treatment with aspirin. Catheterisation showed no antegrade flow into the right coronary artery, with retrograde flow from the left coronary system into the right coronary. At the most recent follow-up he was asymptomatic, with normal exercise tolerance and a negative exercise stress test. Single-photon emission computed tomography (SPECT) myocardial perfusion imaging was carried out during stress and at rest using intravenous persantine (dipyridamole) and technetium-99m tetrofosmin. During stress, there were prominent left ventricular apical and anteroseptal defects, which normalised at rest. SPECT during stress and at rest may detect subclinical ischaemia and influence further management options in such patients.

Beamish J; O'Connell MJ; El Khuffash A; Duff DF; McMahon CJ

2006-11-01

255

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

256

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

257

Clinical application of indium-111 antimyosin antibody and thallium-201 dual nuclide single photon emission computed tomography in acute myocardial infarction  

Energy Technology Data Exchange (ETDEWEB)

The significance of indium-111 antimyosin antibody and thallium-201 dual nuclide single photon emission computed tomography (SPECT) was evaluated in 7 patients with acute myocardial infarction (AMI) who underwent emergency coronary angiography with successful revascularization by intracoronary thrombolysis. Indium-111 antimyosin antibody and thallium-201 dual nuclide SPECT was performed 11 to 36 days after the onset of AMI. Antimyosin SPECT images delineated areas of myocardial necrosis in all 7 patients (100%), but planar images detected necrotic areas in only 4 of 7 patients (57%). Peak CPK-MBs of the 3 patients in whom no necrotic area was detected by indium-111 planar image showed a tendency to be smaller. Indium-111 antimyosin antibody/thallium 201 overlap was observed in all patients. The area of overlap was at the center of necrosis in 4 patients (2 anterior infarction, 1 inferior infarction, 1 inferolateral infarction) and at the peripheral portion in 3 patients (all 3 had inferior infarction). Indium-111 antimyosin antibody and thallium-201 dual nuclide SPECT is useful in identifying the localization of myocardial infarction and the overlap of these tracers might reflect the presence of salvaged myocardium adjacent to the necrotic myocardium. (author).

Yoshida, Hiroshi; Mochizuki, Mamoru; Kainouchi, Mari (Shizuoka General Hospital (Japan)) (and others)

1991-03-01

258

Clinical application of indium-111 antimyosin antibody and thallium-201 dual nuclide single photon emission computed tomography in acute myocardial infarction  

International Nuclear Information System (INIS)

The significance of indium-111 antimyosin antibody and thallium-201 dual nuclide single photon emission computed tomography (SPECT) was evaluated in 7 patients with acute myocardial infarction (AMI) who underwent emergency coronary angiography with successful revascularization by intracoronary thrombolysis. Indium-111 antimyosin antibody and thallium-201 dual nuclide SPECT was performed 11 to 36 days after the onset of AMI. Antimyosin SPECT images delineated areas of myocardial necrosis in all 7 patients (100%), but planar images detected necrotic areas in only 4 of 7 patients (57%). Peak CPK-MBs of the 3 patients in whom no necrotic area was detected by indium-111 planar image showed a tendency to be smaller. Indium-111 antimyosin antibody/thallium 201 overlap was observed in all patients. The area of overlap was at the center of necrosis in 4 patients (2 anterior infarction, 1 inferior infarction, 1 inferolateral infarction) and at the peripheral portion in 3 patients (all 3 had inferior infarction). Indium-111 antimyosin antibody and thallium-201 dual nuclide SPECT is useful in identifying the localization of myocardial infarction and the overlap of these tracers might reflect the presence of salvaged myocardium adjacent to the necrotic myocardium. (author)

1991-01-01

259

Time course of thallium-201 redistribution after transient myocardial ischemia  

Energy Technology Data Exchange (ETDEWEB)

The mechanism and time course of thallium-201 (/sup 201/Tl) redistribution after transient myocardial ischemia was investigated in 27 anesthetized dogs given 1.5 mCi of /sup 201/Tl intravenously 10 minutes after occlusion of the left anterior descending coronary artery. Coronary reperfusion (RP) was accomplished 10 minutes after /sup 201/Tl administration. Transmural myocardial biopsies were obtained in situ from normal (N) and ischemic (IS) regions during occlusion and 5 minutes (four dogs), 20 minutes (eight dogs), 90 minutes (six dogs), 4 hours (five dogs) and 6 hours (four dogs) after RP. There was a twofold rise in /sup 201/Tl activity (counts/10 min/mg) in the IS region after only 5 minutes of reflow with as yet no detectable change in /sup 201/Tl concentration in the N zone. In dogs undergoing 90 minutes of RP, /sup 201/Tl activity was 700 +- 150 (SEM) in the IS zone during occlusion and markedly increased (p < 0.001) to 3200 +- 100 at 90 minutes of reflow. During this period /sup 201/T1 activity in the N region decreased only slightly, from 7000 +- 800 to 6000 +- 450 (NS). In dogs that underwent 6 hours of RP, /sup 201/Tl activity in the IS zone increased from 1700 +- 500 during occlusion to 3300 +- 200 (p < 0.001) after RP. In this group, bbaTl activity in the N zone +- 1200 to 3900 +- 400 over the 6 hours of reflow, reflecting the magnitude of thallium washout after ischemia. This near-equalization of /sup 201/Tl activity between N and IS zones was already apparent by 4 hours of RP. These data indicate that /sup 201/Tl redistribution after transient myocardial ischemia is related to both delayed accumulation of /sup 201/Tl into ischemic myocardial segments and to a more rapid washout of the radionuclide from normal segments.

Beller, G.A.; Watson, D.D.; Ackell, P.; Pohost, G.M.

1980-04-01

260

Evaluation of non-uniform attenuation correction using simultaneous transmission and emission computed tomography. Basic analysis with myocardial phantom  

Energy Technology Data Exchange (ETDEWEB)

Simultaneous transmission emission protocol (STEP), developed for the non-uniform attenuation correction of single photon emission computed tomography (SPECT) was evaluated using the cardiac phantom prepared with and without a myocardial wall defect. Emission computed tomography (ECT) of the cardiac phantom using {sup 201}Tl was acquired. Transmission data (TCT) were taken using a line source of {sup 99m}Tc. Myocardial images with STEP method were superior in the homogeneity of intramyocardial radioactivity and spatial resolution to the conventional SPECT images. This is an excellent method because of the accurate matching position between TCT and ECT images and shortening the examination time by simultaneous data acquisition. It would be clinically useful for diagnosing various myocardial diseases. (author).

Otake, Hidenori; Yukihiro, Masashi; Fukushima, Yumi [Gunma Univ., Maebashi (Japan). School of Medicine] [and others

1996-03-01

 
 
 
 
261

A comparison of resting images from two myocardial perfusion tracers  

International Nuclear Information System (INIS)

We have compared stress-redistribution and delayed rest thallium-201 with rest technetium-99m methoxyisobutylisonitrile (MIBI) tomograms in order to compare the tracers for the assessment of myocardial viability and to validate a rapid protocol combining the two tracers. We studied 30 consecutive patients with known or suspected coronary artery disease [group 1: 16 with normal left ventricular function, mean left ventricular ejection fraction (LVEF) 55%, SD 6%; group 2: 14 with abnormal function, mean LVEF 28%, SD 8%]. 201Tl was injected during infusion of adenosine followed by acquisition of conventional stress and redistribution tomograms. On a separate day, 201Tl was injected at rest with imaging 4 h later. 99mTc-MIBI was then given at rest and imaging was performed. Three images were compared: redistribution 201Tl, rest 201Tl, and rest 99mTc-MIBI. Tracer activity was classified visually and quantitatively in nine segments and segments with>50% activity were defined as containing clinically significant viable myocardium. Mean global tracer uptake as a percentage of maximum was similar in group 1 (rest 201Tl 69%±12%, redistribution 201Tl 69%±15%, rest 99mTc-MIBI 70%±13%), but in group 2 mean tracer uptake was significantly greater in the rest 201Tl images (59%±16%) than in redistribution 201Tl images (53%±17%) or rest 99mTc-MIBI images (53%±19%). Overall agreement for regional uptake score was excellent (? from 0.79 to 0.84), although there were a significant number of segments with less uptake shown by redistribution 201Tl and by rest 99mTc-MIBI than by rest 201Tl in group 2. The number of segments with significant viable myocardium in group 1 was very similar between the three images but in group 2 rest 201Tl identified significantly more segments as viable than the other images. (orig./MG) (orig.). With 1 fig., 7 tabs.

1995-01-01

262

[The examination of attenuation correction using one computed tomography scan in myocardial perfusion stress-rest single photon emission computed tomography].  

UK PubMed Central (United Kingdom)

Attenuation correction (AC) of myocardial perfusion stress-rest single photon emission computed tomography (SPECT) with hybrid SPECT/computed tomography (CT) is effective. But because CT scan is done two times, the radiation exposure of patients increases. Therefore, we suggested a new method of AC that can correct attenuation of SPECT images acquired during a rest examination by using the CT scan during a stress examination. AC was done using one CT scan and we evaluated the clinical appropriateness of using this method. Matters of this study were (1) positional reproducibility of data analysis machine (Xeleris) (2) phantom study: accuracy of registration by manual and repetition reproducibility (3) clinical study using (99m)Tc-tetrofosmin. Comparison methods were analyzed by calculating the difference perfusion (Dp) with 17-segments model of American Heart Association and visual evaluation of three axis images in the myocardium. In the phantom study, because most of the score of 17-segments accord (Dp?1), it was considered that the shift on SPECT/CT's bed was reproduced by the shift on Xeleris. And it is shown that AC with CT scan on deference point was accuracy. In the clinical study, there were a few differences in Dp (Dp?4) and approximately equal evaluation on visual evaluation was provided, which compared with conventional methods. Because AC of myocardial perfusion stress-rest SPECT by one CT scan showed that it was approximately equal in evaluation compared with conventional methods, we expect to be able to use this method in clinical cases.

Sasaki M; Kawase S; Miyazaki Y; Fujimoto T; Higashimura K

2012-01-01

263

Evaluation of 201TlCl per rectum scintigraphy in biliary atresia  

International Nuclear Information System (INIS)

[en] To study whether or not 201TlCl per rectum scintigraphy is clinically useful for evaluating portosystemic shunt in biliary atresia (BA), we reviewed 13 patients with biliary atresia already in the postoperative state. The patients' details were as follows: age, 4 years 6 months-18 years 7 months (mean: 12 years 7 months); male, 3 cases; females, 10 cases; type III BA, 11 cases; type I-cyst BA, 2 cases. A radioisotope (RI) of 201TlCl (18.5 or 37.0 MBq) was administered via the rectum. Heart and liver counts per area were calculated respectively 30-60 minutes after RI administration, and the ratio of heart and liver (H/L ratio) was adopted as a indicator of portosystemic shunt. There was no correlation between the H/L ratio and laboratory examinations (total bilirubin, alanine aminotransferase, cholinesterase, white blood cell and platelet). There was positive correlation between the H/L ratio and splenomegaly. Splenomegaly was evaluated using gray-scale ultrasonography. There was a positive correlation between the H/L ratio and existence of esophageal varices. Esophageal varices were evaluated using barium meal upper gastrointestinal examination. There was a remarkable positive correlation between the H/L ratio and the patient's age. This group of patients was restricted to that in which the laboratory liver function test was abnormal. The use of 201TlCl via rectum scintigraphy and quantitatively conducted H/L ratio are clinically useful for evaluating the portosystemic shunt in biliary atresia. The portosystemic shunt might gradually increase with patients' age independently of the liver function, which should support our daily clinical observations. (author)

2003-01-01

264

Parathyroid localizlation by 201Tl-99mTc subtraction scintigraphy  

International Nuclear Information System (INIS)

Subtraction scintigraphy with 201Tl and 99mTc for parathyroid localization was performed preoperatively in 13 patients with chronic renal failure and secondary hyperparathyroidism. Twenty of the 37 examined pathological glands were predicted correctly (sensitivity 54%). In 3 patients with recurrent hyperparathyroidism after surgery all pathological glands found at second operation had been detected correctly by subtraction scintigraphy. We conclude that this localization method has a limited value when used prior to first neck exploration in secondary hyperparathyroidism. In persistent hyperparathyroidism after surgery it may play a useful role in localizing missed and ectopic glands. (author).

1990-01-01

265

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

International Nuclear Information System (INIS)

[en] 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.)

1998-01-01

266

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

Energy Technology Data Exchange (ETDEWEB)

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 {sup 99m}Tc 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 {sup 99m}Tc external source may not produce truncation in TCT images and is cost-effective and easy to prepare in clinical situations. (orig.) With 10 figs., 1 tab., 30 refs.

Hashimoto, Jun; Kubo, Atsushi [Department of Radiology, School of Medicine, Keio University, Tokyo (Japan); Ogawa, Koichi [Department of Electronic Informatics, College of Engineering, Hosei University, Tokyo (Japan); Ichihara, Takashi; Motomura, Nobutoku; Takayama, Takuzo [Toshiba Medical Engineering Laboratory, Tochigi (Japan); Iwanaga, Shiro; Mitamura, Hideo; Ogawa, Satoshi [Department of Internal Medicine, School of Medicine, Keio University, Tokyo (Japan)

1998-02-01

267

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

International Nuclear Information System (INIS)

[en] 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.)

1998-01-01

268

Myocardial perfusion imaging is feasible for infarct size quantification in mice using a clinical single-photon emission computed tomography system equipped with pinhole collimators.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The aim of this study is to evaluate a non-invasive method for measuring myocardial perfusion defect size in mice using a clinical single-photon emission computed tomography system equipped with pinhole collimators (pinhole SPECT). MATERIALS AND METHODS: Thirty days after ligation of the left anterior descending coronary artery, 13 mice (C57BL/6J) were imaged following intravenous injection of 370 MBq [99mTc]sestamibi. Eight control mice without myocardial infarction were likewise investigated. Image quality optimization had been achieved by repeated scanning of a multiple point phantom, with varying zoom factors, number of projection angles, and pinhole diameter. Volumetric sampling was used to generate polar maps, in which intensity was normalized to that of a standard septal region of interest (ROI), which was set at 100%. Receiver operating characteristic analyses were performed to define an optimal threshold as compared to histologically measured defect sizes, which were considered as gold standard. RESULTS: A spatial resolution of 1.9 mm was achieved using a pinhole diameter of 0.5 mm, a zoom factor of 2, and 6 degrees projection angles. Histological results were best reproduced by a 60% threshold relative to the septal reference ROI. By applying this threshold, SPECT perfusion defect sizes revealed very high correlation to the histological results (R(2) = 0.867) with excellent intra- and interobserver reproducibility (intraclass correlation coefficients of 0.84 and 0.82). CONCLUSIONS: We achieved a spatial resolution of 1.9 mm in myocardial perfusion imaging in mice using a clinical SPECT system mounted with pinhole collimators. Compared to a histological gold standard, the infarct sizes were accurately estimated, indicating that this method shows promise to monitor experimental cardiac interventions in mice.

Wollenweber T; Zach C; Rischpler C; Fischer R; Nowak S; Nekolla SG; Gröbner M; Ubleis C; Assmann G; Müller-Höcker J; La Fougére C; Böning G; Cumming P; Franz WM; Hacker M

2010-08-01

269

Evaluation of cellular viability by quantitative autoradiographic study of myocardial uptake of a fatty acid analogue in isoproterenol-induced focal rat heart necrosis  

International Nuclear Information System (INIS)

Previous studies led us to hypothesize that a fatty acid analogue, 15-p-iodophenyl-?-methyl pentadecanoic acid (IMPPA or BMIPP), which is taken up but not quickly metabolized by heart cells, would be a more suitable tracer of cellular viability that 201Tl. Biodistribution studies of 1-14C-IMPPA in conscious, freely moving rats showed that the concentration ratio of radioactivity in the heart with respect to the blood was about 8 for at least 60 min after intravenous administration, permitting its use as a putative tracer in these conscious, freely moving rats. Thereafter, the myocardial uptake of 14C-IMPPA was studied in isoproterenol-treated rats (daily treatment for 10 days in order to induce cardiac hypertrophy and necrotic foci) with respect to control ones. Comparison of myocardial localizations by quantitative autoradiography of the uptake of 201Tl and 14C-IMPPA with that of triphenyltetrazolium chloride (TTC) staining enabled comparative evaluation of nutritional blood flow, localization and uptake of 14C-IMPPA and necrotic foci size. Distributions of 14C-IMPPA and 201Tl in control rats' hearts were homogenous, like TTC staining. In infarcted hearts, areas of decreased 14C-IMPPA uptake were nearly the same (100%±5%) as those unstained by TTC. These areas were larger than those showing a decrease in thallium uptake (about 70%±5% of the total scar size). Therefore, IMPPA seems to be a more accurate and sensitive indicator of necrosis localization compared with thallium. It may be a useful agent for assessment of myocardial viability by single photon emission tomography (SPET) imaging. (orig.).

1991-01-01

270

SPECT imaging of hypertrophic cardiomyopathy with 201Tl and 123I-MIBG  

International Nuclear Information System (INIS)

Objective: The aim of this study is to clarify whether there are differences in sympathetic nerve activities between hypertrophied and non-hypertrophied myocardium in patients with hypertrophic cardiomyopathy (HCM). Methods:18 patients with HCM diagnosed with symptomatology and echocardiography and six normal subjects underwent two-dimensional and M-mode echocardiography, and SPECT with 201Tl and 123I-MIBG. The HCM group included 5 of apical type (APM), 7 of asymmetrical septal hypertrophy (ASH) and 6 of defused type (DPM). The average age of HCM group was (56.8 +-8.8) years, and normal group, 49.0 +- 5.4. Results: In 201Tl study, there was no difference between HCM and normal group. In 123I-MIBG study, HCM group showed low radioactivities compared with normal group (P123I-MIBG scanning in HCM group, APM and DPM type showed low activities in anterior (P123I-MIBG activities, mild hypertrophy group showed low activities as well as marked hypertrophy group did (P

2000-01-01

271

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

International Nuclear Information System (INIS)

[en] 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

272

Studies on muscle metabolism in peripheral vascular disease using 201Tl  

International Nuclear Information System (INIS)

Thallium 201 has been used mostly in cardiology, for the detection of ischemic ''areas'' and infarcted zones in cardiac muscle. This isotope has been chosen, because of its great metabolic similarity to Potassium. But less interest has been shown in the transit and localization of Thallium in the limbs. We have been working on a method based upon the study of muscle metabolism using 201Tl which could possibly detect the condition before the onset of clinical symptoms. As a preliminary investigation, we have studied the distribution of this isotope, in rats after effort, or in resting state. We have observed an important increase in the muscle uptake of 201Tl during the period of effort compared to the uptake in a resting state. The ratio of this increased uptake is about two to three times more important. In vitro studies of fibroblast cell cultures reveal a competition between potassium and thallium, the fixation of thallium being diminished in the presence of an excess of potassium and increased when the concentration of potassium is low, in the culture medium

1982-09-02

273

Reversible myocardial ischaemia or irreversible myocardial fibrosis  

International Nuclear Information System (INIS)

[en] The results of biphasis 201thallium (201Tl) scanning were compared with those of coronary arteriography, left ventricular angiography and stress ECG in 56 patients with coronary artery disease and six with no evidence of heart disease. There were 104 201Tl defects, 50 of them reversible. The defects were always located in the area supplied by a critically stenotic coronary artery. Correlation of regional wall motion with 201Tl activity demonstrated that in all forms of abnormal wall motion there was either ischaemia or fibrosis. The resting LV angiogram thus does not make it possible to distinguish between myocardial ischaemia and fibrosis. Taking the LV angiogram as a standard, the rate of false-positive 201Tl scintigrams was 5%, that of false-negative ones 23%. The biphasic 201Tl scintigram was more sensitive than the stress ECG in detecting myocardial ischaemia. It furthermore made it possible to localize the ischaemic (or fibrotic) region within the LV and to estimate its size. (orig.)[de] Bei 56 Patienten mit Koronarstenosen und sechs Patienten ohne nachweisbare Herzerkrankung wurde das biphasische 201-Thallium-(201Tl-)-Szintigramm mit den Befunden der Koronarographie, Laevokardiographie und des Belastungs-EKG verglichen. Szintigraphisch fanden sich 104 Myokarddefekte, davon 50 nur unter Belastung (reversible Myokardischaemie) und 54 auch in Ruhe (irreversible Myokardfibrose). Die Defekte lagen stets im Versorgungsgebiet einer stenosierten Koronararterie. Die Korrelation zur regionalen linksventrikulaeren Wandbewegung ergab, dass den verschiedenen Formen einer gestoerten Wandbewegung ein reversibler oder auch ein irreversibler Myokardschaden zugrunde liegen kann. Anhand des Laevokardiogramms kann somit nicht zwischen einer Myokardischaemie und einer Myokardfibrose unterschieden werden. Bezogen auf nachgewiesene regionale Stoerungen der Wandbewegung ergab die Myokardszintigraphie 5% falsch-positive und 23% falsch-negative Befunde. Gegenueber dem Belastungs-EKG erwies sich das biphasiche 201-Tl-Szintigramm beim Nachweis einer Myokardischaemie als ueberlegen. Zudem gestattete das Szintigramm, den ischaemischen (oder fibrotischen) Bezirk innerhalb des linken Ventrikels zu lokalisieren und seine Ausdehnung abzuschaetzen. (orig.)

1978-01-01

274

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

275

Discrimination capabilities of fine- needle aspiration combined with serum thyroglobulin and 201Tl scintigraphy of thyroid nodules  

International Nuclear Information System (INIS)

The sensitivity and N.P.V. by 201Tl scintigraphy which nodular uptake was higher and equal to normal thyroid tissue on early scan without quantitative washout were higher than those of FNA combined with the serum thyroglobulin level (sensitivity; 96.9%, 53.1-75.0%, N.P.V. 96.3%, 72.2-80.5%, respectively p201Tl scintigraphy is more useful for discrimination of benign and malignant thyroid nodules than fine- needle aspiration combined with serum thyroglobulin. (author)

2001-01-01

276

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

Energy Technology Data Exchange (ETDEWEB)

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.

Burns, R.J.; Galligan, L.; Wright, L.M.; Lawand, S.; Burke, R.J.; Gladstone, P.J. (Toronto Hospital, Ontario (Canada))

1991-08-15

277

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.

1991-01-01

278

[The examination of attenuation correction using one computed tomography scan in myocardial perfusion stress-rest single photon emission computed tomography].  

Science.gov (United States)

Attenuation correction (AC) of myocardial perfusion stress-rest single photon emission computed tomography (SPECT) with hybrid SPECT/computed tomography (CT) is effective. But because CT scan is done two times, the radiation exposure of patients increases. Therefore, we suggested a new method of AC that can correct attenuation of SPECT images acquired during a rest examination by using the CT scan during a stress examination. AC was done using one CT scan and we evaluated the clinical appropriateness of using this method. Matters of this study were (1) positional reproducibility of data analysis machine (Xeleris) (2) phantom study: accuracy of registration by manual and repetition reproducibility (3) clinical study using (99m)Tc-tetrofosmin. Comparison methods were analyzed by calculating the difference perfusion (Dp) with 17-segments model of American Heart Association and visual evaluation of three axis images in the myocardium. In the phantom study, because most of the score of 17-segments accord (Dp?1), it was considered that the shift on SPECT/CT's bed was reproduced by the shift on Xeleris. And it is shown that AC with CT scan on deference point was accuracy. In the clinical study, there were a few differences in Dp (Dp?4) and approximately equal evaluation on visual evaluation was provided, which compared with conventional methods. Because AC of myocardial perfusion stress-rest SPECT by one CT scan showed that it was approximately equal in evaluation compared with conventional methods, we expect to be able to use this method in clinical cases. PMID:22975698

Sasaki, Makoto; Kawase, Shigeto; Miyazaki, Yoshihiro; Fujimoto, Takahiro; Higashimura, Kyouji

2012-01-01

279

Myocardial infarction determined by technetium-99m pyrophosphate single-photon tomography complicating elective coronary artery bypass grafting for angina pectoris  

Energy Technology Data Exchange (ETDEWEB)

The incidence of acute myocardial infarction (AMI) complicating coronary artery bypass grafting (CABG) has previously been based on concordance of electrocardiographic, enzymatic and scintigraphic criteria. Technetium-99m pyrophosphate (Tc-PPi) single-photon emission computed tomography now enables detection of AMI with high sensitivity and specificity. Using this technique, perioperative AMI was detected in 12 of 58 patients (21%) undergoing successful elective CABG for stable angina pectoris. Stepwise multivariate logistic regression analysis was performed to compare the predictive value of preoperative (New York Heart Association class, left ventricular ejection fraction and use of beta blockers) and intraoperative (number of grafts constructed, use of internal mammary anastomoses, use of sequential saphenous vein grafts, smallest grafted distal vessel lumen caliber and aortic cross-clamp time) variables. Preoperative New York Association class (p = 0.04) and smallest grafted distal vessel lumen caliber (p = 0.03) were significant multivariate predictors of perioperative AMI. Only 1 perioperative patient with AMI (and 1 pyrophosphate-negative patient) developed new Q waves. Serum creatine kinase-MB was higher in patients with AMI by repeated measures analysis of variance (p = 0.0003). Five AMIs occurred in myocardial segments revascularized using sequential saphenous vein grafts, and 7 in segments perfused by significantly stenosed epicardial vessels with distal lumen diameter and perfusion territory considered too small to warrant CABG. At 6-month follow-up, the mean left ventricular ejection fraction increased from 0.61 to 0.65 in Tc-PPI-negative patients (p = 0.01), but not in perioperative patients with AMI.

Burns, R.J.; Gladstone, P.J.; Tremblay, P.C.; Feindel, C.M.; Salter, D.R.; Lipton, I.H.; Ogilvie, R.R.; David, T.E.

1989-06-15

280

Myocardial infarction determined by technetium-99m pyrophosphate single-photon tomography complicating elective coronary artery bypass grafting for angina pectoris  

International Nuclear Information System (INIS)

[en] The incidence of acute myocardial infarction (AMI) complicating coronary artery bypass grafting (CABG) has previously been based on concordance of electrocardiographic, enzymatic and scintigraphic criteria. Technetium-99m pyrophosphate (Tc-PPi) single-photon emission computed tomography now enables detection of AMI with high sensitivity and specificity. Using this technique, perioperative AMI was detected in 12 of 58 patients (21%) undergoing successful elective CABG for stable angina pectoris. Stepwise multivariate logistic regression analysis was performed to compare the predictive value of preoperative (New York Heart Association class, left ventricular ejection fraction and use of beta blockers) and intraoperative (number of grafts constructed, use of internal mammary anastomoses, use of sequential saphenous vein grafts, smallest grafted distal vessel lumen caliber and aortic cross-clamp time) variables. Preoperative New York Association class (p = 0.04) and smallest grafted distal vessel lumen caliber (p = 0.03) were significant multivariate predictors of perioperative AMI. Only 1 perioperative patient with AMI (and 1 pyrophosphate-negative patient) developed new Q waves. Serum creatine kinase-MB was higher in patients with AMI by repeated measures analysis of variance (p = 0.0003). Five AMIs occurred in myocardial segments revascularized using sequential saphenous vein grafts, and 7 in segments perfused by significantly stenosed epicardial vessels with distal lumen diameter and perfusion territory considered too small to warrant CABG. At 6-month follow-up, the mean left ventricular ejection fraction increased from 0.61 to 0.65 in Tc-PPI-negative patients (p = 0.01), but not in perioperative patients with AMI

1989-06-15

 
 
 
 
281

A multicenter evaluation of the appropriate use of single-photon emission tomography myocardial perfusion imaging in Greece.  

UK PubMed Central (United Kingdom)

BACKGROUND: This study evaluates the appropriate use of myocardial perfusion imaging (MPI) and determines patterns and variables associated with inappropriate testing. METHODS: Over a 10-month period data were collected prospectively from consecutive patients referred for MPI in four academic departments and an appropriate use grade was assigned (appropriate, uncertain, inappropriate, and unclassifiable scans) according to established criteria. RESULTS: Among 3,032 referrals appropriate MPI had 72.8% of patients and 19.2% of studies were inappropriate, the remaining being uncertain (7.2%) or unclassifiable (0.8%). In multivariate analysis the asymptomatic status (odds ratio 10.7, P < .001), good functional capacity (odds ratio 1.9, P < .001), an interpretable resting electrocardiogram (odds ratio 1.8, P = .004), an age <65 years (odds ratio 1.5, P = .001) and the absence of diabetes (odds ratio 1.7, P < .001) or dyslipidemia (odds ratio 1.3, P = .014) were independent predictors of inappropriate scintigraphy. The most common indication for inappropriate testing was the assessment of asymptomatic patients <2 years after percutaneous coronary intervention (PCI) (38.9%). CONCLUSIONS: The appropriate use of MPI is relatively high, but a considerable proportion of inappropriate scans is noted which is associated with markers of lower risk. The most common source of inappropriate testing is the assessment of asymptomatic patients <2 years after PCI.

Moralidis E; Papadimitriou N; Stathaki M; Xourgia X; Spyridonidis T; Fotopoulos A; Apostolopoulos D; Karkavitsas N; Gotzamani-Psarrakou A

2013-04-01

282

Measurement of regional wash out rate in stress thallium-201 myocardial scintigraphy using single photon emission computed tomography  

International Nuclear Information System (INIS)

Wash out rate (WR) of thallium-201 was analysed in 40 cases, including 10 normal cases and 30 cases with angiographically proved coronary artery disease (CAD), by using emission computed tomography (ECT). WR of normal segment (N) was 45.5+-7.8% (n=40), WR of nonischemic segment of CAD (IN) was 38.3+-10.2% (n=71), WR of ischemic segment (AP) was 28.6+-10.5% (n=64), WR of all myocardial infarctional segment (MI (all)) was 32.3+-12.2% (n=38), and WR of ischemic segment by coronary spasm (SP) was -5.3+-12.5% (n=7). WR of SP was remarkably lower than other segments and it was interesting that its value was minus. WR of infarctional segment (IS) without transient ischemia(TI) of one-vessel disease (1VD) or two-vessel disease (2VD)(MI (st)) was 39.6+-8.8% (n=21), WR of IS without TI of three-vessel disease (3VD)(MI (3)) was 26.2+-5.9% (n=9), and WR of IS with TI (MI (P)) was 19.9+-11.3% (n=8). WR of N was significantly higher than IN, AP, SP, MI(all), MI(st), MI(3), and MI(P) (p

1985-01-01

283

Significance of exercise-induced ST segment depression in patients with myocardial infarction involving the left circumflex artery. Evaluation by exercise thallium-201 myocardial single photon emission computed tomography  

Energy Technology Data Exchange (ETDEWEB)

The significance of exercise-induced ST segment depression in patients with left circumflex artery involvement was investigated by comparing exercise electrocardiography with exercise thallium-201 single photon emission computed tomography (Tl-SPECT) and the wall motion estimated by left ventriculography. Tl-SPECT and exercise electrocardiography were simultaneously performed in 51 patients with left circumflex artery involvement (angina pectoris 30, myocardial infarction 21). In patients with myocardial infarction, exercise-induced ST depression was frequently found in the V{sub 2}, V{sub 3} and V{sub 4} leads. In patients with angina pectoris, ST depression was frequently found in the II, III, aV{sub F}, V{sub 5} and V{sub 6} leads. There was no obvious difference in the leads of ST depression in patients with myocardial infarction with ischemia and without ischemia on Tl-SPECT images. In patients with myocardial infarction, the lateral wall motion of the infarcted area evaluated by left ventriculography was more significantly impaired in the patients with ST depression than without ST depression (p<0.01). Exercise-induced ST depression in the precordial leads possibly reflects wall motion abnormality rather than ischemia in the lateral infarcted myocardium. (author)

Koitabashi, Norimichi; Toyama, Takuji; Hoshizaki, Hiroshi [Gunma Prefectural Cardiovascular Center, Maebashi (Japan)] [and others

2000-04-01

284

Significance of exercise-induced ST segment depression in patients with myocardial infarction involving the left circumflex artery. Evaluation by exercise thallium-201 myocardial single photon emission computed tomography  

International Nuclear Information System (INIS)

[en] The significance of exercise-induced ST segment depression in patients with left circumflex artery involvement was investigated by comparing exercise electrocardiography with exercise thallium-201 single photon emission computed tomography (Tl-SPECT) and the wall motion estimated by left ventriculography. Tl-SPECT and exercise electrocardiography were simultaneously performed in 51 patients with left circumflex artery involvement (angina pectoris 30, myocardial infarction 21). In patients with myocardial infarction, exercise-induced ST depression was frequently found in the V2, V3 and V4 leads. In patients with angina pectoris, ST depression was frequently found in the II, III, aVF, V5 and V6 leads. There was no obvious difference in the leads of ST depression in patients with myocardial infarction with ischemia and without ischemia on Tl-SPECT images. In patients with myocardial infarction, the lateral wall motion of the infarcted area evaluated by left ventriculography was more significantly impaired in the patients with ST depression than without ST depression (p

2000-01-01

285

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

UK PubMed Central (United Kingdom)

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Neill J; Prvulovich EM; Fish MB; Berman DS; Slomka PJ; Sharir T; Martin WH; DiCarli MF; Ziffer JA; Bomanji JB; Shiti D; Ben-Haim S

2013-07-01

286

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

International Nuclear Information System (INIS)

[en] 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 100 cm 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 5 cm 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)

2008-01-01

287

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

Energy Technology Data Exchange (ETDEWEB)

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 {beta}{sub 2}-microglobulin amyloid ({beta}{sub 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, {sup 67}Ga and {sup 201}Tl whole-body and SPET images were then acquired. If any {sup 67}Ga and/or {sup 201}Tl uptake was observed, a CT-guided biopsy was done. In those patients who had articular and/or peri-articular uptake of {sup 99m}Tc MDP, {sup 67}Ga and/or {sup 201}Tl and who were pathologically proven to have {beta}{sub 2}-MA, {sup 99m}Tc MDP, {sup 67}Ga and {sup 201}Tl 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 {sup 99m}Tc MDP uptake. Among these eight, six had intense {sup 99m}Tc MDP, {sup 67}Ga and {sup 201}Tl 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 {sup 67}Ga and {sup 201}Tl scans but less obvious changes in uptake of {sup 99m}Tc-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 {sup 67}Ga and {sup 201}Tl 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 {sup 99m}Tc-MDP whole-body bone scan can both detect active and pre-existing inactive deposits of {beta}{sub 2}-MA. {sup 67}Ga and {sup 201}Tl scans are helpful to differentiate active from inactive deposits of {beta}{sub 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.)

Yen Tzuchen; Tzen Kaiyuan [Dept. of Nuclear Medicine, Chang Gung Memorial Hospital, Taipei Medical Center and School of Medicine, Chang Gung University (Taiwan); Chen Kuosu; Tsai Chijuen [Dept. of Nephrology, Chang Gung Memorial Hospital at Keelung (Taiwan)

2000-01-01

288

Clinical evaluation of myocardial SPECT using 99mTc-tetrofosmin (PPN 1011) in patients with ischemic heart disease  

International Nuclear Information System (INIS)

Myocardial SPECT was performed in seven patients with ischemic disease using 99mTc-tetrofosmin (PPN 1011) and 201Tl. A comparison of findings between 99mTc-tatrofosmin and 201Tl on each segment by segmental analysis showed concordance in 70% of total segments and showed discordance in 45% of posterior-inferior segments. Positive predictive value of 99mTc-tetrofosmin was superior to that of 201Tl in the infero-posterior segments. 99mTc-Tetrofosmin was considered to be a useful agent for evaluation of myocardial perfusion in the ischemic heart disease, especially in infero-posterior myocardial wall of the left ventricle. (author)

1994-01-01

289

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

International Nuclear Information System (INIS)

[en] 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

1999-01-01

290

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)

[en] 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

291

A myocardial perfusion imaging agent: 99Tcm-N-NOET  

International Nuclear Information System (INIS)

Bis [N-ethoxy, N-ethyl (dithiocarbamato)] nitride Tc(V) (99Tcm-N-NOET) is a neutral lipophilic technetium agent of myocardial perfusion presenting the high first-pass myocardial uptake and long myocardial retention. The location of 99Tcm-N-NOET myocardial uptake is on cell membranes, and its myocardial uptake is not energy-dependent, which is affected by L-type calcium channel inhibitor. 99Tcm-N-NOET not only has a myocardial redistribution equivalent to 201Tl, the sensitivity and specificity of its myocardial perfusion imaging in detecting coronary artery disease but also are similar to 201Tl

2001-01-01

292

Single photon emission tomography  

Energy Technology Data Exchange (ETDEWEB)

The principle of single photon emission tomography is briefly described, and various image reconstruction methods are explained. The diagnostic advantages provided by this technique are illustrated by two examples.

Scheuerlein, H.

1982-01-01

293

201Tl SPECT for evaluation of brain tumors as compared with 123I-IMP SPECT and 18F-FDG PET  

International Nuclear Information System (INIS)

[en] Clinical usefulness of 201Tl SPECT for evaluation of brain tumors was studied in comparison with 123I-IMP SPECT and 18F-FDG PET. 201Tl SPECT and 123IMP SPECT were performed in 73 patients with brain neoplasm (group 1) and 15 patients with non-tumor cerebral diseases (group 2). Among them, 31 patients in group 1 and 5 patients in group 2 received 18F-FDG PET. SPECT was done with a ring type machine (HEADTOME SET011) and PET with a neuro PET (PCT H1). Forty-eight of 73 (65.8%) patients in group 1 showed increased accumulation of 201Tl in tumor site, whereas only 9 (12.3%) patients showed increased radioactivity of 123I-IMP in the lesion. Eighteen of 31 (58.1%) patients with neoplasm demonstrated increased regional cerebral metabolic rate of glucose (rCMRgl) in the lesion. Only two out of 15 (13.3%) patients with non-tumor lesion demonstrated increased accumulation of 201Tl. None of them showed accumulation of 123I-IMP or increased rCMRgl. Patients with malignant neoplasm demonstrated higher uptake of 201Tl in the lesion than those with benign neoplasm or non-tumor lesions. Post-therapeutic patients with glioblastoma or metastatic tumors showed lower 201Tl uptake than before therapy. Superimposed images of both 201Tl and 123I-IMP resemble rCMRgl functional images, suggesting increased 201Tl radioactivity in viable tumor tissue with decreased radioactivity in surrounding areas. 201Tl SPECT is useful for diagnosis of brain tumors and evaluation of effectiveness of therapy or evidence of residual tumor tissue. It may differentiate malignant tumors from benign tumors or non-tumor intracranial diseases including radiation injury and detect tumor recurrence earlier. (author)

1991-01-01

294

Effect of thallium-201 blood levels on reversible myocardial defects  

Energy Technology Data Exchange (ETDEWEB)

To determine if /sup 201/Tl plasma blood levels correlate with the presence of reversible myocardial defects during exercise testing, 14 patients with stable coronary artery disease underwent two separate exercise /sup 201/Tl stress tests. Between initial and delayed imaging, on one test the patients drank an instant breakfast drink (eating) and on the other they drank an equivalent volume of water as a control (H/sub 2/O). Thallium-201 imaging was performed immediately postexercise, immediately after eating/H/sub 2/O and 210 min after eating/H/sub 2/O. Between initial and immediate post eating/H/sub 2/O images 201Tl reversible defects occurred in 27/38 regions in the H/sub 2/O test versus 15/38 regions in the eating test (p = 0.02). Over this early time period, plasma /sup 201/Tl activity was significantly higher in the H/sub 2/O test than eating test (p less than 0.05). In conclusion, early reversal of /sup 201/Tl defects may, in part, be the result of higher plasma /sup 201/Tl activity early after initial postexercise /sup 201/Tl imaging.

Nelson, C.W.; Wilson, R.A.; Angello, D.A.; Palac, R.T.

1989-07-01

295

Effect of thallium-201 blood levels on reversible myocardial defects  

International Nuclear Information System (INIS)

[en] To determine if 201Tl plasma blood levels correlate with the presence of reversible myocardial defects during exercise testing, 14 patients with stable coronary artery disease underwent two separate exercise 201Tl stress tests. Between initial and delayed imaging, on one test the patients drank an instant breakfast drink (eating) and on the other they drank an equivalent volume of water as a control (H2O). Thallium-201 imaging was performed immediately postexercise, immediately after eating/H2O and 210 min after eating/H2O. Between initial and immediate post eating/H2O images 201Tl reversible defects occurred in 27/38 regions in the H2O test versus 15/38 regions in the eating test (p = 0.02). Over this early time period, plasma 201Tl activity was significantly higher in the H2O test than eating test (p less than 0.05). In conclusion, early reversal of 201Tl defects may, in part, be the result of higher plasma 201Tl activity early after initial postexercise 201Tl imaging

1989-01-01

296

Assessment of the myocardial sympathic nerve function in patients of acute myocardial infarction by 123I-MIBG (metaiodobenzylguanidine)  

International Nuclear Information System (INIS)

Metaiodobenzylguanidine (MIBG) functions as an analog of norepinephrine, the sympathic neurotransmitter. MIBG concentrates in sympathic nerve terminals. Therefore 123I-MIBG scintigraphy can detect sympathic nerve distribution in the heart. Dual myocardial SPECT procedure with 123I-MIBG and 201TlCl were performed in 24 patients with acute myocardial infarction (AMI), including 3 patients after percutaneous transluminal coronary recanalization (PTCR). There was a difference between 123I-MIBG SPECT and 201TlCl SPECT. Perfusion defects of 123I-MIBG SPECT were generally larger than those of 201TlCl SPECT. And this difference was remarkable in AMI after PTCR. Small myocardial infarcts which were not able to be detected by 201TlCl SPECT could be detected as defects by 123I-MIBG SPECT. We compared 123I-MIBG SPECT with crosstalk correction (201Tl?123I: 15%, 123I?201Tl: 0%) and without crosstalk correction in 1 case. Defects of 123I-MIBG SPECT without correction were smaller than with correction. In conclusion 123I-MIBG could evaluate sympathic nerve denervation in patients with acute myocardial infarction. (author).

1991-01-01

297

Phase II safety and clinical comparison with single-photon emission computed tomography myocardial perfusion imaging for detection of coronary artery disease: flurpiridaz F 18 positron emission tomography.  

UK PubMed Central (United Kingdom)

OBJECTIVES: This was a phase II trial to assess flurpiridaz F 18 for safety and compare its diagnostic performance for positron emission tomography (PET) myocardial perfusion imaging (MPI) with Tc-99m single-photon emission computed tomography (SPECT) MPI with regard to image quality, interpretative certainty, defect magnitude, and detection of coronary artery disease (CAD) (?50% stenosis) on invasive coronary angiography (ICA). BACKGROUND: In pre-clinical and phase I studies, flurpiridaz F 18 has shown characteristics of an essentially ideal MPI tracer. METHODS: One hundred forty-three patients from 21 centers underwent rest-stress PET and Tc-99m SPECT MPI. Eighty-six patients underwent ICA, and 39 had low-likelihood of CAD. Images were scored by 3 independent, blinded readers. RESULTS: A higher percentage of images were rated as excellent/good on PET versus SPECT on stress (99.2% vs. 88.5%, p < 0.01) and rest (96.9% vs. 66.4, p < 0.01) images. Diagnostic certainty of interpretation (percentage of cases with definitely abnormal/normal interpretation) was higher for PET versus SPECT (90.8% vs. 70.9%, p < 0.01). In 86 patients who underwent ICA, sensitivity of PET was higher than SPECT (78.8% vs. 61.5%, respectively, p = 0.02). Specificity was not significantly different (PET: 76.5% vs. SPECT: 73.5%). Receiver-operating characteristic curve area was 0.82 ± 0.05 for PET and 0.70 ± 0.06 for SPECT (p = 0.04). Normalcy rate was 89.7% with PET and 97.4% with SPECT (p = NS). In patients with CAD on ICA, the magnitude of reversible defects was greater with PET than SPECT (p = 0.008). Extensive safety assessment revealed that flurpiridaz F 18 was safe in this cohort. CONCLUSIONS: In this phase 2 trial, PET MPI with flurpiridaz F 18 was safe and superior to SPECT MPI for image quality, interpretative certainty, and overall CAD diagnosis.

Berman DS; Maddahi J; Tamarappoo BK; Czernin J; Taillefer R; Udelson JE; Gibson CM; Devine M; Lazewatsky J; Bhat G; Washburn D

2013-01-01

298

Value of myocardial defect size measured by thallium-201 SPECT: results of a multicenter trial comparing heparin and a new fibrinolytic agent  

International Nuclear Information System (INIS)

[en] In a multicenter randomized double-blind trial comparing heparin and a new fibrinolytic agent, anisoylated plasminogen streptokinase activator complex (APSAC), 231 patients presenting with a less than 5 hr acute myocardial infarction underwent a contrast angiography (CA) before the end of the first week of admission, and radionuclide cardiac blood-pool imaging and a 201Tl single photon emission computed tomography (SPECT) study before the end of the third week. Left ventricular ejection fraction (LVEF) and a wall motion score (WM) were calculated from CA. LVEF was also obtained from cardiac blood-pool imaging, and defect size (DS) from 201Tl SPECT. Results demonstrated that all parameters were significantly improved in patients treated with APSAC versus heparin (contrast LVEF 53 +/- 13 vs. 47 +/- 14 p less than 0.01, WM 9.8 +/- 6.5 vs. 13.3 +/- 7.9 p less than 0.001, radionuclide LVEF 43 +/- 12 vs. 40 +/- 13 p less than 0.05, DS 14 +/- 12 vs. 18 +/- 14 p less than 0.05). When the patients were divided according to infarct site and infarct-related coronary artery patency, it was demonstrated with all four parameters that the beneficial effect of APSAC can be largely explained by the lower incidence of vessel obstruction in this group (37% vs. 77% in the heparin group, p less than 0.001). It is concluded that (a) when compared with heparin and in the conditions of the trial, APSAC significantly improves the cardiac function and decreases the DS and (b) DS measured by 201Tl SPECT is as valuable a quantitative parameter of therapeutic evaluation as are LVEF and WM

1988-01-01

299

Single-photon imaging  

International Nuclear Information System (INIS)

The acquisition and interpretation of images is a central capability in almost all scientific and technological domains. In particular, the acquisition of electromagnetic radiation, in the form of visible light, UV, infrared, X-ray, etc. is of enormous practical importance. The ultimate sensitivity in electronic imaging is the detection of individual photons. With this book, the first comprehensive review of all aspects of single-photon electronic imaging has been created. Topics include theoretical basics, semiconductor fabrication, single-photon detection principles, imager design and applications of different spectral domains. Today, the solid-state fabrication capabilities for several types of image sensors has advanced to a point, where uncooled single-photon electronic imaging will soon become a consumer product. This book is giving a specialist's view from different domains to the forthcoming ''single-photon imaging'' revolution. The various aspects of single-photon imaging are treated by internationally renowned, leading scientists and technologists who have all pioneered their respective fields. (orig.)

2011-01-01

300

Examination of the findings on 201Tl, 123I-BMIPP dual cardiac SPECT in acute phase of Kawasaki disease  

International Nuclear Information System (INIS)

[en] In 42 cases with acute phase of Kawasaki disease (3-27 days since pathopoiesis), 201Tl, 123I-BMIPP dual cardiac SPECT was performed and the reduction of the isotope-uptake was macroscopically assessed. On cardiac SPECT, 28 of 42 cases (67%), and 19 of 30 cases (63%) who were normal on electrocardiogram, echocardiogram and blood CK levels showed abnormal images. In a part of cases showing abnormal cardiac SPECT, coronary arteriography was performed, and constrictive lesions with more than 25% were not observed. In acute phase of Kawasaki disease, the risk of cardiac complication was thought to be low. But these results suggest that there are cardiac complications detectable by 201Tl, 123I-BMIPP dual cardiac SPECT. This cardiac lesions were thought to be intramyocardinal microangiitis or abnormal coronary micro circulation cased by myocarditis associating microangiitis. (K.H.)

1999-01-01

 
 
 
 
301

Single-photon optomechanics.  

UK PubMed Central (United Kingdom)

Optomechanics experiments are rapidly approaching the regime where the radiation pressure of a single photon displaces the mechanical oscillator by more than its zero-point uncertainty. We show that in this limit the power spectrum has multiple sidebands and that the cavity response has several resonances in the resolved-sideband limit. Using master-equation simulations, we also study the crossover from the weak-coupling many-photon to the single-photon strong-coupling regime. Finally, we find non-Gaussian steady states of the mechanical oscillator when multiphoton transitions are resonant. Our study provides the tools to detect and take advantage of this novel regime of optomechanics.

Nunnenkamp A; Børkje K; Girvin SM

2011-08-01

302

Diagnostic accuracy of 201Tl SPECT·MRI in brain diseases and inter-reader variance of diagnostic performance  

International Nuclear Information System (INIS)

[en] Fifteen-four studies of 201Tl brain tumor SPECT were independently interpreted by 9 nuclear medicine physicians with and without reference magnetic resonance images in 2 separate sessions to define an effect of referring images, and inter-observer variations. The physicians were requested to detect foci of abnormal deposits, and to discriminate whether they were malignant or not according to 5-grade scaling of subjective diagnostic confidence. Receiver-operating characteristics (ROC) analysis was performed. Mean sensitivity for presence of lesions (SFP), and sensitivity and specificity for malignancy of 201Tl SPECT were 84, and 53 and 55%, which were changed to 94 and 74 and 55% after referring to the MR images. The SFP was significantly improved (p201Tl brain tumor SPECT has moderate sensitivity and specificity for malignancy, which is not improved by addition of anatomical reference images, that additional MR images reduce inter-observer variation of confidence on lesion presence, and that SPECT localization of lesions has great inter-observer variations. (author)

1996-01-01

303

Adsorption kinetics of 201Tl and migration of 99mTc in natural soils  

International Nuclear Information System (INIS)

The safety is very important in facilities where radioactive wastes are stored. One of the necessary characteristics of the site where these wastes will be disposed is the soil permeability, since a waterproof terrain avoids the diffusion and radionuclide transport in the leakages case. The objective of this work is to study the adsorption kinetics of 201Tl and the migration of 99mTc in natural soil samples. The adsorption kinetics was determined starting from the obtaining of the retention coefficient of the thallium (static method) at different contact times. The technetium diffusion was studied by means of the dynamic method with different soil particles sizes. The results showed that the thallium is totally adsorbed starting from 20 h of contact among this and the mean. On the other hand, the technetium is very mobile in the soil, since it was possible to extract the majority of the tracer with little solvent. Also, it was found that for each soil gram the double water will be needed to leach the technetium almost in its entirety. Moreover, influence exists of the particle size in the migration velocity from the radiotracer to the most mobile being in major sizes than 2 mm that in minor size. (Author)

2012-08-01

304

Development of [201Tl](III)Oxinate complex for cell labeling  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Due to interesting physical properties and wide availability of thallium-201 as a SPECT radionuclide, the incorporation of this nuclide into 8-hydroxyquinoline for cell labeling was targeted. Methods: Thallium-201 (T1/2=3.04 d) in Tl+ form was converted to Tl3+ cation in presence of O3/6M HCl and di-isopropyl ether, controlled by RTLC/gel electrophoresis The final evaporated activity reacted with ethanolic 8-hydroxy-quinoline (oxine) solution in normal saline to yield [201Tl](III)oxinate at room temperature after 0.5 h, followed by solid phase extraction/purification using C18 Sep-Pak column Results: A radiochemical yield of more than 95% was obtained. Radiochemical purity of 92% was obtained using RTLC (>90% using HPLC) with specific activity of about 820 GBq/mmol. The tracer was stable in the final product and in presence of human serum at 37°C up to 6h. The partition coefficient of lopP=5.5 was obtained. The labeled compound was used in red blood cell (RBC) labeling. The cell uptake ratio was determined at 37°C up to 3 hours. Conclusion: The radiolabeled compound used in this study is a very inexpensive agent for use in cell labeling studies in biology, medicine and various research areas.  

Amir Hakimi; Amir Reza Jalilian; Javad Garousi; Mehdi Kamali Dehghan; Gholamreza Aslani

2010-01-01

305

Quantitative 201Tl scintigraphy of the lower limbs in peripheral artery disease  

International Nuclear Information System (INIS)

201Tl scintigraphy is useful in evaluating the hemodynamic consequences of arterial stenoses in arterial occlusive disease. The aim of the present study was to determine normal values for absolute Tl uptake in the lower leg, for the quotient between left and right lower leg uptake as well as for the redistribution pattern after bicycle exercise. We examined as reference 49 patients without clinical evidence of peripheral or coronary artery disease: absolute Tl uptake in the lower leg in anterior scintigraphy (acquisition time: 120 sec) was 5.02±1.70 counts/pixel (left) 5.21±1,53 counts/pixel (right), the quotient between right and left lower leg was 0.85±0.09 and the redistribution pattern (quotient of the mean activity exercise/rest) 0.82±0.17 (left) and 0.83±0.15 (right). The arithmetic mean minus 2 standard deviations was regarded as the lower limit of normal. In 8 patients with mechanical compression of the left femoral artery before injection at least two scintigraphic parameters were abnormal, in 7 patients with angiographically proven peripheral artery disease at least one scintigraphic parameter was below normal. Quantification of Tl redistribution offers diagnostic advantages in bilateral peripheral artery disease. (orig.).

1993-01-01

306

Accumulation of radioisotopes with tumor affinity. II. Comparison of the tumor accumulation of 67Ga-citrate and 201Tl-chloride in vitro.  

Directory of Open Access Journals (Sweden)

Full Text Available The kinetics in tumor cells and various factors affecting the tumor accumulation of 67Ga-citrate and 201Tl-chloride were studied in vitro. 67Ga was taken up gradually by tumor cells and its excretion from the cells decreased with time. 201Tl was taken up rapidly by tumor cells. Its excretion was very rapid, indicating that the two nuclides had entirely different kinetics in tumor cells. The uptake of 201Tl by culture cells correlated with that of 42KCl and was inhibited by Ouabain. 201Tl was hardly taken up by nonviable tumor cells. These facts indicate that active transport involving Na-K ATPase is involved in the tumor accumulation of 201Tl. The uptake of 67Ga and 201Tl by tumor cells was not affected by the administration of anticancer agents. The uptake of 67Ga by tumor cells was dependent upon the concentration of transferrin in the medium, which apparently plays a role as one of the pathways of tumor accumulation of 67Ga.

Muranaka,Akira

1981-01-01

307

Leg {sup 201}Tl-SPECT in chronic exertional compartment syndrome; Tomoscintigraphie des jambes au thallium 201 dans le diagnostic du syndrome de loge chronique  

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Leg {sup 201}Tl-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 {sup 201}Tl-SPECT for patients with suspicion of compartment syndrome. Patients and methods: 51 leg {sup 201}Tl-SPECT exams were performed (exercise - and rest without reinjection) in 49 patients; 28 had compartment syndrome confirmed by pressure measurement. About 100 MBq of {sup 201}Tl 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 {sup 201}Tl level uptake between compartments with and without compartment syndrome and a significant correlation between muscular pressure measurement and rest level uptake. Conclusion: {sup 201}Tl-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)

Elkadri, N.; Slim, I.; Blondet, C.; Choquet, Ph.; Constantinesco, A. [Hopital Hautepierre, Service de Biophysique et Medecine Nucleaire, 67 - Strasbourg (France); Lecocq, J. [Hopital Hautepierre, Service de Medecine Physique et Readaptation, 67 - Strasbourg (France)

2004-06-01

308

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

International Nuclear Information System (INIS)

Gated single-photon emission computed tomography (SPECT) imaging of myocardium by 99mTc and 201Tl 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 99mTc-labelled tracers than in 201Tl. 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.)

2008-01-01

309

The usefulness of dipyridamole thallium-201 single photon emission computed tomography for predicting perioperative cardiac events in patients undergoing non-cardiac vascular surgery  

International Nuclear Information System (INIS)

The aim of this study was to evaluate the usefulness of dipyridamole Tl-201 myocardium single photon emission computed tomography (201Tl-SPECT) for predicting perioperative cardiac events in patients with arteriosclerosis obliterans (ASO) and abdominal aortic aneurysm (AAA) undergoing non-cardiac vascular surgery. Methods: Preoperative dipyridamole 201Tl-SPECT imaging in association with clinical risk assessment was performed in 224 consecutive patients (97 ASO and 127 AAA). Results: The patients were classified into three groups, including low-risk (n=173, 77%), intermediate-risk (n=39, 18%), and high-risk (n=12, 5%) groups according to the clinical risk stratification. The prevalence of reversible Tl-201 defect was significantly higher in the high-risk group than that in the low-risk group (83% vs. 14%, p

2004-01-01

310

Slowing down single photons  

Science.gov (United States)

Single photons emitted from a quantum dot can be slowed down using a hybrid semiconductor-atomic interface. Nika Akopian from Delft University of Technology in The Netherlands explained to Nature Photonics how this non-classical light storage system works.

2011-04-01

311

Single photon emission tomography  

International Nuclear Information System (INIS)

[en] The principle of single photon emission tomography is briefly described, and various image reconstruction methods are explained. The diagnostic advantages provided by this technique are illustrated by two examples. (MG)[de] Das Prinzip der Einzelphotonen-Emissionstomographie wird kurz erlaeutert. Verschiedene Verfahren zur Bildrekonstruktion werden aufgezeigt. Der diagnostische Vorteil wird anhand von 2 Beispielen demonstriert. (MG)

1982-01-01

312

Single photon emission computed tomography (SPECT) in nuclear cardiology  

International Nuclear Information System (INIS)

This article reviews single photon emission computed tomography (SPECT) in nuclear cardiology. The described methods are multidetector scanning system, pinhole tomography and rotating gamma camera system. Myocardial SPECT with fatty acids is discussed. (Auth.).

1985-01-01

313

Improved detection of fill-in using sublingual nitroglycerin in technetium-99m tetrofosmin exercise/rest single photon emission computed tomography one day protocol for old myocardial infarction  

International Nuclear Information System (INIS)

[en] Twenty-one patients with old myocardial infarction underwent repeated 99mTc-tetrofosmin (99mTc) exercise/rest same day protocols with and without the administration of sublingual nitroglycerin (NTG) 5 min before the second injection of 99mTc for rest SPECT. Twelve of these patients also underwent ordinary exercise/redistribution 201Tl SPECT. The control study protocol images showed decreased uptake of 99mTc on exercise in 157 of 420 segments and the presence of fill-in at rest in 58 segments. Images obtained with administration of NTG showed decreased uptake of 99mTc on exercise in 163 of 420 segments and fill-in in 74 segments at rest. The frequency of fill-in was greater in the NTG protocol than in the control protocol. The segments were scored as different grades according to 99mTc uptake between 2 protocols. Fill-in was only present or more remarkable in 31 segments in the NTG protocol than in the control protocol. Fill-in was only present or more remarkable in 10 segments in the control protocol than in the NTG protocol. In the NTG protocol, the mean defect score of the exercise images, calculated from the bull's eye image automatically, was higher than that of the rest images. The mean severity score of the exercise images, also calculated from the bull's eye image automatically, was likewise higher than that of the rest images, whereas the mean severity score of the stress images and rest images in the control protocol was not significantly different. Moreover, the mean defect score and severity score of the rest images from the NTG protocol were significantly lower than those obtained from the control protocol. Sublingual NTG administration before the injection of 99mTc-tetrofosmin at the rest study in the one day exercise/rest studies enhanced fill-in, so may enhance the detection of viable myocardium, allowing more informed decisions regarding cardiac revascularization in patients with chronic coronary artery disease. (K.H.)

1999-01-01

314

Combined assessment of myocardial perfusion and function by ECG-gated myocardial perfusion single-photon emission computed tomography for the prediction of future cardiac events in patients with type 2 diabetes mellitus  

International Nuclear Information System (INIS)

[en] The mid-term prognostic significance of electrocardiogram (ECG)-gated single-photon emission computed tomography (SPECT) remains unclear in Japanese patients with type 2 diabetes mellitus (DM). In the present study rates of future cardiac events (nonfatal acute myocardial infarction (AMI), cardiac death (CD) and severe heart failure (HF) requiring hospitalization) were compared in patients with and without DM. 1,810 patients (563 DM and 1,247 non-DM) we followed for a mean of 26.3±15.5 months. Summed stress score (SSS), summed difference score (SDS), poststress ejection fraction (EF) and resting end-diastolic volume (EDV) were calculated. In total, 20 cases of AMI (9 in DM (1.59%) and 11 in non-DM (0.88%)), 20 of CD (7 in DM patients (1.24%) and 13 in non-DM (1.04%)) and 54 of severe HF (31 in DM (5.5%) and 23 in non-DM (1.84%)) occurred. Univariate Cox analysis showed that, in DM patients, predictors of total cardiac events were poststress EF (Wald 60.4; P1c value (Wald 4.30; P

2011-01-01

315

Differential diagnosis between recurrence of gliomas and radiation necrosis by 201TlCl SPECT  

International Nuclear Information System (INIS)

We studied the value of quantitative 201thallium chloride brain SPECT (Tl SPECT) in the differentiation between glioma recurrence and radiation necrosis. A total of 44 patients -26 patients with recurrent malignant glioma, 10 patients with low grade glioma and 8 patients with radiation necrosis- underwent Tl SPECT. The patients had early SPECT images taken 15 minutes after intravenous injection of 3mCi of 201TlCl and also had delayed SPECT images taken 4 hours after injection. Count ratios of a lesion to normal brain (L/N) were calculated from the rectangular ROI for the quantitative analysis. Count ratios of the lesion seen on the delayed image to that on the early image (D/E) were also calculated. In 26 patients with recurrent malignant gliomas, L/N ratio ranged from 2.6 to 12.6 with a mean of 4.4±2.3 on early images. All patients had L/N ratios greater than 2.5. However, in 8 patients with cerebral radiation necrosis, L/N ratios ranged from 1.5 to 2.4 with a mean of 2.0±0.3 on early image. L/N ratios were always 2.5 or less. In 8 patients with cerebral radiation necrosis, there were little differences between the L/N ratios for early and delayed images. D/E ratios ranged from 1.0 to 1.3 with a mean of 1.2±0.1. These results confirmed the validity of Tl SPECT in differentiating cerebral radiation necrosis from recurrent malignant gliomas. In 10 patients with low grade astrocytoma there was a subtle uptake or no uptake of Tl and the ratios of these patients were rated at 1.0. Tl SPECT was also useful in discriminating low grade astrocytoma from malignant glioma or radiation necrosis. (author)

1994-01-01

316

Simultaneous dual myocardial imaging with iodine-123-?-methyl iodophenyl-pentadecanoic acid (BMIPP) and thallium-201 in patients with coronary heart disease  

International Nuclear Information System (INIS)

To assess the clinical value of simultaneous dual myocardial imaging with iodine-123-?-methyl-iodophenyl-pentadecanoic acid (123I-BMIPP) and thallium-201 (201TL), myocardial imaging was performed at rest and during execise in seven patients with coronary heart disease. When 123I-BMIPP and 201Tl images were compared, the initial exercise and resting images agreed 87% and 64%, respectively. In the initial resting images, the regional uptake of 123I-BMIPP was frequently less than that of 201Tl. The incidence of exercise-induced reversible defects by 201Tl in the Tl>BMIPP regions was significantly higher than that in the Tl=BMIPP regions (57% vs 4%, pBMIPP regions was also significantly higher than that in the Tl=BMIPP regions (91% vs 38%, pBMIPP) was found more frequently in regions with abnormal wall motion than in regions with normal wall motion (hypokinetic regions; 68%, severe hypokinetic or akinetic regions; 50%, vs normokinetic regions; 4%, p123I-BMIPP correlated closely with that of 201Tl in normal myocardium and the uptake of both 123I-BMIPP and 201Tl was severely reduced in myocardium with severe ischemia during exercise and prior infarction. These results indicate that dual myocardial imaging with 123I-BMIPP and 201Tl may provide a unique means of identifying patients with metabolically disturbed myocardium, such as hibernating and stunned myocardium. (author)

1994-01-01

317

Imaging of Receptors for Advanced Glycation End Products in Experimental Myocardial Ischemia and Reperfusion Injury  

Science.gov (United States)

OBJECTIVES The aim of this study was to image expression of receptor for advanced glycation end products (RAGE) in a mouse model of myocardial reperfusion injury. BACKGROUND RAGE and its ligands are implicated in the pathogenesis of ischemia/reperfusion injury and infarction. We hypothesized that RAGE-directed quantitative imaging of myocardial uptake of technetium-99m (99mTc)-anti-RAGE F(ab?)2 in a mouse model of myocardial ischemic injury can detect RAGE expression and show quantitative differences between early (18 to 20 h) and later times (48 h) after reperfusion. METHODS Twenty-five wild-type (WT) mice underwent left anterior descending coronary artery occlusion for 30 min. Mice were injected with 19.98 ± 1.78 MBq of 99mTc anti-RAGE F(ab?)2 at 2 time points after reperfusion (at 18 to 20 h [n = 8] and at 48 h [n = 12]) and 5 h later with 6.14 ± 2.0 MBq of thallium-201 (201Tl). Five WT mice were injected with nonspecific F(ab?)2 and 201Tl 18 to 20 h after reperfusion. Six WT mice underwent sham operation without coronary intervention. After injection with 201Tl, all mice immediately underwent dual isotope single-photon emission computed tomography/computed tomography. At completion of imaging, hearts were counted and sectioned. RESULTS The uptake of 99mTc-anti-RAGE F(ab?)2 in the ischemic zone from the scans as mean percentage injected dose was significantly greater at 18 to 20 h (5.7 ± 2.1 × 10?3%) as compared with at 48 h (1.4 ± 1.1 × 10?3%; p < 0.001) after reperfusion. Disease and antibody controls showed no focal uptake in the infarct. Gamma well counting of the myocardium supported the quantitative scan data. By immunohistochemical staining there was greater caspase-3 and RAGE staining at 18 to 20 h versus at 48 h (p = 0.04 and p = 0.01, respectively). On dual immunofluorescence, RAGE colocalized mainly with injured cardiomyocytes undergoing apoptosis. CONCLUSIONS RAGE expression in myocardial ischemic injury can be imaged in vivo using a novel 99mTc-anti-RAGE F(ab?)2. RAGE plays a role in several cardiovascular diseases and is a potential target for clinical imaging.

Tekabe, Yared; Luma, Joane; Li, Qing; Schmidt, Ann Marie; Ramasamy, Ravichandran; Johnson, Lynne L.

2013-01-01

318

The correlation between 99mTc-MIBI uptake and MIB-1 as a nuclear proliferation marker in glioma - a comparative study with 201Tl  

International Nuclear Information System (INIS)

[en] Technetium-99m methoxy-isobutylisonitrile (MIBI), like thallium-201 (201Tl), is a highly efficient agent for the diagnosis and monitoring of glioma tumors. Although 201Tl uptake is known to be partly associated with proliferative activity, little is known about the correlation between MIBI uptake and proliferation activity in gliomas. The current study was performed to assess the correlation between MIBI uptake and proliferative activities in gliomas, estimated by the monoclonal antibody to Ki-67 antigen (MIB-1) staining method. By comparing the results with those of 201Tl, we determined which tracer would be suitable for estimating proliferative activities. Twenty-four presurgical glioma patients (six with low-grade gliomas, five with anaplastic astrocytomas, and 13 with glioblastomas) were given MIBI and 201Tl SPECT. Early (10 min after injection) and delayed images (3 h after injection) were obtained for both MIBI and 201Tl scintigraphy. SPECT parameters, early ratio (ER), delayed ratio (DR), and retention index (RI) were obtained in both radiopharmaceuticals. All patients underwent subsequent surgical excision, and the specimens were immunostained for MIB-1. The proliferative activity was measured as a percentage positive nuclear area for MIB-1 (MI; MIB-1 index). To evaluate the relationship between the proliferative activity and SPECT parameters, we performed a correlation analysis. MI correlated with the MIBI uptake ratio (r=0.75 for ER, and r=0.7 for DR). Both DR and RI of 201Tl also correlated with MI, but weakly (r=0.6 for DR, and r=0.59 for RI). There was no significant correlation between the MIB-1 index and the other parameters. MIBI-uptake parameters demonstrated a stronger positive correlation with the MIB-1 index than that of 201Tl. With the use of MIBI SPECT, we can estimate the proliferative activity of glioma non-invasively. (orig.)

2001-01-01

319

Evaluation of bone and soft tissue lesion using 99mTc-MIBI. Comparison with 201Tl and the relation to chemotherapeutic effect  

International Nuclear Information System (INIS)

Thirty-five patients with bone and soft tissue lesions were studied with 99mTc-MIBI and 201Tl to compare the uptake of two tracers. Planar images were obtained 15 min (early image) and 3 hr (delayed image) after the injection of both tracers. Images were evaluated visually and quantitatively using uptake ratio (lesion/background). In visual analysis, 23 of 35 patients showed similar uptake of both tracers, 9 showed more intense uptake of 99mTc-MIBI than 201Tl, and 3 showed more intense uptake of 201Tl than 99mTc-MIBI on early images. On delayed images, 21 of 32 patients showed similar uptake of both tracers, 3 showed more intense uptake of 99mTc-MIBI than 201Tl, and 8 showed more intense uptake of 201Tl than 99mTc-MIBI. In quantitative analysis, similar 201Tl and 99mTc-MIBI uptake ratios were obtained on early images. On delayed images, 99mTc-MIBI uptake ratios are less than that of 201Tl, but the difference was not significant. In some cases, 99mTc-MIBI accumulation was washed out on delayed images, therefore the early image is essential to evaluate 99mTc-MIBI accumulation. In all cases with the uptake ratios less than 1.20 on delayed 99mTc-MIBI images, chemotherapy was not effective. In malignant tumors, decreased uptake of 99mTc-MIBI accumulation on delayed images may indicate that chemotherapy is not effective. Delayed 99mTc-MIBI image may be a potential marker predicting chemotherapeutic effect in malignant bone and soft tissue tumors. (author).

1997-01-01

320

Study on localization of hyperfunctioning parathyroid glands by /sup 201/Tl - sup(99m)Tc subtraction scintigraphy  

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/sup 201/Tl-sup(99m)Tc subtraction parathyroid scintigraphy assisted by computer (CASPS) was performed in 59 patients with suspected hyperparathyroidism (HPT). There were 32 patients operated on and 40 hyperfunctioning parathyroid glands histologically proven on 33 surgical explorations. Positive rate of scintigrams in surgically explored patients was preoperatively 66% (21/32) and retrospectively 78% (25/32). In seven of surgically explored patients, ten hyperfunctioning parathyroid glands could not be recognizable retrospectively. True positive rate of preoperative and retrospective localization as to each hyperfunctioning parathyroid glands were 53% (21/40) and 75% (30/40), respectively. There was a close but not statistically significant correlation between scintigraphic localization and weight of the hyperfuctioning parathyroid glands. However, visualization of hyperfunctioning parathyroid glands was statistically significant (p < 0.05) in kai /sup 2/-test in correlation between ones of less and more than 0.500 g in weight. Plain /sup 201/Tl-image delineated only one of 15 hyperfunctioning parathyroid glands which were less than 0.500 g in weight and subtraction image six. This result was also statistically significant (p < 0.05) in kai /sup 2/-test. Subtraction technique was proved to be essential for delineating hyperfunctioning parathyroid glands which were especially less than 0.500 g in weight. There are two adenoma which concentrated sup(99m)Tc-pertchnetate rather than /sup 201/Tl chloride. Subtraction images of these cases was not useful for positive delineation and showed an area of a decreased radioactive distribution corresponding to the presence of adenoma located at the left anterior mediastinum.

Itoh, Kazuo (Hokkaido Univ., Sapporo (Japan). School of Medicine)

1984-11-01

 
 
 
 
321

Study on different imaging time of late 201Tl thyroid imaging to differentiate malignant from benign thyroid nodules  

International Nuclear Information System (INIS)

[en] This study was undertaken to clarify better time to initiate the late 201Tl thyroid imaging to differentiate malignant thyroid nodules from benign ones. Thyroid images were obtained at 5 min, 1 and 3 hr after i.v. injection of 74 MBq of 201Tl chloride. The early (5 min) and late (1 or 3 hr) 201Tl images were compared in pathologically proven 38 malignant and 48 benign nodules of 83 patients. The lesion activity (LA) on the early image was visually graded as no uptake (-), slight uptake less than the surrounding thyroid tissue uptake (SITU) (±), uptake equal to the STTU (+), and uptake more than the STTU (++). The change of LA relative to the STTU from the early image to the late image was visually graded as decreasing (D), unchanged (U) or increasing (I) pattern when the LA was (±) to (++). The benign or malignant possibility at 1 hr and 3 hr in each lesion pattern was as follows: When the LA was (-) or D, the benign possibility was 95% (35/37) and 85% (39/46). When the LA was I, the malignant possibility was 96% (27/28) and 91% (21/23). When the LA is U, the diagnosis was equivocal: malignancy; 43% (9/21) at 1 hr and 59% (10/17) at 3 hr. The positive LA had a tendency to decrease with time irrespective of tumor character. The 1 hr image was statistically better than the 3 hr image as a late image. Comparative diagnosis of 5 min and 1 hr images with the criteria of I and U lesions being malignant and others being benign seems to be the best not to overlook malignant nodules: negative predictive value of 95% and sensitivity 95%. (author)

1995-01-01

322

Differences between accumulation of {sup 99m}Tc-MIBI and {sup 201}Tl-Thallous Chloride in tumour cells: Role of P-glycoprotein  

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Both {sup 99m}Tc-MIBI and {sup 201}Tl have been used for tumour imaging. It has recently been reported that {sup 99m}Tc-MIBI is a substrate for P-glycoprotein (Pgp), a membrane pump which mediates multidrug resistance. It has been evaluated the role of Pgp in the cellular accumulation of {sup 201}TI by using sensitive and resistant strains of Chinese hamster ovary (CHO) fibroblasts (AuxB1 and CH{sup R}C5, respectively) grown in suspension culture. {sup 201}Tl accumulation was the same in sensitive and resistant cells, whereas {sup 99m}Tc-MIBI accumulation was much lower in resistant cells than in sensitive ones. Down-modulation of Pgp with 100 {mu}M verapamil did not alter cellular accumulation of {sup 201}Tl while it significantly increased {sup 99m}Tc-MIBI accumulation in both types of cell. Similarly, 10 {mu}M verapamil did not affect the rate of washout of {sup 201}Tl from preloaded cells, while {sup 99m}Tc-MIBI washout was greatly reduced in the presence of verapamil. These results suggest that {sup 201}Tl will accumulate in both sensitive and resistant tumour cells, whereas {sup 99m}Tc-MIBI will be extruded from resistant cells and therefore may be less useful for tumour detection when the tumour cells express high Pgp levels.

Ballinger, J.R.; Boxen, I.; Erlichman, C.; Ling, V. [Ontario Cancer Inst., Toronto, ON (Canada)]|[Toronto Univ., ON (Canada); Sheldon, K.M. [Ontario Cancer Inst., Toronto, ON (Canada)

1995-06-01

323

Differences between accumulation of 99mTc-MIBI and 201Tl-Thallous Chloride in tumour cells: Role of P-glycoprotein  

International Nuclear Information System (INIS)

Both 99mTc-MIBI and 201Tl have been used for tumour imaging. It has recently been reported that 99mTc-MIBI is a substrate for P-glycoprotein (Pgp), a membrane pump which mediates multidrug resistance. It has been evaluated the role of Pgp in the cellular accumulation of 201TI by using sensitive and resistant strains of Chinese hamster ovary (CHO) fibroblasts (AuxB1 and CHRC5, respectively) grown in suspension culture. 201Tl accumulation was the same in sensitive and resistant cells, whereas 99mTc-MIBI accumulation was much lower in resistant cells than in sensitive ones. Down-modulation of Pgp with 100 ?M verapamil did not alter cellular accumulation of 201Tl while it significantly increased 99mTc-MIBI accumulation in both types of cell. Similarly, 10 ?M verapamil did not affect the rate of washout of 201Tl from preloaded cells, while 99mTc-MIBI washout was greatly reduced in the presence of verapamil. These results suggest that 201Tl will accumulate in both sensitive and resistant tumour cells, whereas 99mTc-MIBI will be extruded from resistant cells and therefore may be less useful for tumour detection when the tumour cells express high Pgp levels

1995-01-01

324

Assessment of resistance to paclitaxel of murine tumors by 99mTc-MIBI/201Tl dual-radionuclide imaging  

International Nuclear Information System (INIS)

This study investigated P-glycoprotein (Pgp) expression by murine tumors with and without resistance to paclitaxel and the role of 99mTc-2-methoxyisobutylisonitrile (MIBI)/201Tl imaging in predicting the effect of paclitaxel. Antitumor effect of paclitaxel and biodistribution of the radiopharmaceuticals were evaluated in mice bearing four tumor types. Pgp expression did not correlate with the antitumor efficacy of paclitaxel. Although the absolute uptake of 99mTc-MIBI did not correlate with Pgp expression, 99mTc-MIBI could predict paclitaxel sensitivity by its higher uptake.

2000-01-01

325

Evaluation of myocardial viability using sequential dual-isotope single photon emission tomography imaging with rest Tl-201/stress Tc-99m tetrofosmin in the prediction of wall motion recovery after revascularization  

Energy Technology Data Exchange (ETDEWEB)

In patients with coronary artery disease (CAD), differentiation between severely ischemic but potentially viable myocardium and irreversibly infarcted tissue is clinically important, particularly when revascularization procedures are considered. Although thallium (Tl) cardiac imaging has been shown to be a good tool for investigating myocardial viability in CAD, this tracer shows physical limitations, such as a low photon energy and long half-life. We assessed the results of a rest Tl-201/stress Tc-99m tetrofosmin protocol in subjects with prior anterior myocardial infarction. All of the patients had an akinetic or dyskinetic area and more than 75% stenosis in the left anterior descending artery. All of the patients underwent revascularization after the examination. We evaluated the improvement in wall motion after revascularization using the centerline method with contrast left ventricular angiography. Fourteen patients showed reversible defects with the rest Tl-201/stress Tc-99m tetrofosmin protocol or in additional Tl-201 24 h redistribution images. All 14 patients showed a significant improvement in wall motion after revascularization. Dual-isotope rest Tl-201/stress Tc-99m tetrofosmin single photon emission tomography data, acquired separately, may give fast and complete information about myocardial perfusion during stress and at rest, and on about myocardial viability. (author)

Fukuzawa, Shigeru; Inagaki, Masayuki; Morooka, Shigeru; Inoue, Toshihisa; Matsumoto, Yasunori; Yokoyama, Kenichi; Ozawa, Shun [Funabashi Municipal Medical Center, Chiba (Japan)

1997-06-01

326

Utilidad de la tomografía computarizada de emisión de fotón único sincronizada con el electrocardiograma para la detección de isquemia miocárdica silente en diabéticos tipo 2/ Gated single photon emission computer tomography for the detection of silent myocardial ischemia  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Background: Asymptomatic patients with severe coronary atherosclerosis may have a normal resting electrocardiogram and stress test. Aim: To assess the yield of Gated Single Photon Emission Computer Tomography (SPECT) for the screening of silent myocardial ischemia in type 2 diabetic patients. Material and methods: Electrocardiogram, stress test and gated-SPECT were performed on 102 type 2 diabetic patients aged 60 ± 8 years without cardiovascular symptoms. AH subjects we (more) re also subjected to a coronary angiography whose results were used as gold standard. Results: Gated-SPECT showed myocardial ischemia on 26.5% of studied patients. The sensibility, specifity accuracy, positive predictive value and negative predictive value were 92.3%, 96%, 95%, 88.8%, 97.3%, respectively. In four and six patients ischemia was detected on resting electrocardiogram and stress test, respectively. Eighty percent of patients with doubtful resting electrocardiogram results and 70% with a doubtful stress test had a silent myocardial ischemia detected by gated-SPECT There was a good agreement between the results of gated-SPECT and coronary angiography (k =0.873). Conclusions: Gated-SPECT was an useful tool for the screening of silent myocardial ischemia.

Peña Q, Yamilé; Coca P, Marco Antonio; Batista C, Juan Felipe; Fernández-Britto R, José; Quesada P, Rodobaldo; Peña C, Andria

2009-08-01

327

Evaluation of brain tumor by 99mTc-MIBI. Comparison study with 201Tl and predictivity of therapeutic effect  

International Nuclear Information System (INIS)

We compared the detectability of 99mTc-MIBI and 201Tl-chloride for brain tumor in relationship with histopathology. We also evaluated correlation between therapeutic effect using ACNU, Cisplatine and the degree of MIBI tumor uptake. The subjects were 31 brain tumor histologically confirmed by operation or biopsy. Dual-isotope SPECT technique was performed at both 20 min and 180 min after tracer injection. A tumor to normal lung ratio on both early (ER) and delayed image (DR) and retention index (RI) were calculated. The positive rates of 99mTc-MIBI (90.3% and 77.4%) were comparable to that of 201Tl (90.3% and 80.6%). In the relationship with histopathology, both MIBI and Tl accumulated in 100% of glioblastoma (GBM), metastasis (meta), anaplastic astrocytoma and 25% of low grade astrocytoma on both early and delayed images. On semiquantitative analysis, there were no statistical significance among GBM, meta and anaplastic astrocytoma of ER, DR, RI in the both radiopharmaceuticals. However, both ER and DR in GBM tended to be higher than those of anaplastic astrocytoma. In spite of intense MIBI uptake, GBM patients died within six months except one patient. We concluded that MIBI can be helpful in detecting brain tumor as Tl. MIBI also might be useful in estimating the degree of malignancy in glioma. However intense MIBI uptake did not mean favorable therapeutic effect in patients with GBM treated with ACNU and Cisplatine. (author)

1998-01-01

328

Experimental study of hypoxic preconditioning on 99Tcm-MIBI and 201Tl kinetics in cultured neonatal rat cardio-myocytes  

International Nuclear Information System (INIS)

Objective: To study the effect of hypoxic preconditioning (HPC) on 99Tcm-MIBI and 201Tl kinetics in cultured neonatal rat cardio-myocytes. Methods: The protection of HPC was assayed on the model of hypoxia/reoxygenation (H/R) of cultured neonatal rat cardio-myocytes and the Trypan blue exclusion method was used to assess cell viability. Normal, hypoxic preconditioning and hypoxia/reoxygenation cardio-myocytes groups were studied. By measuring the diffused and released radioactivity of myocytes in different time intervals, the effect of HPC on 99Tcm-MIBI and 201Tl uptake and clearance kinetics in the myocytes was observed in various conditions. Results: Compared with H/R, the number of viable cells after HPC [(75.31 +- 3.45)% vs (55.50 +- 3.13)%, P 99Tcm-MIBI and 201Tl to a plateau level with a half-time of 12.8 min and 6.5 min, respectively. HPC caused a significant increase in uptake of 99Tcm-MIBI [normal control, (4852 +- 491) counts?min-1?mg-1 protein to HPC group, (6103 +- 170) counts?min-1?mg-1 protein; P 201Tl uptake [normal control, (3190 +- 183) counts?min-1?mg-1 protein to HPC group, (2120 +- 202) counts?min-1?mg-1 protein; P 99Tcm-MIBI and 201Tl were both retarded. Conclusions: These results suggested that the neonatal rat cardio-myocytes after HPC offered more capacity to tolerate the H/R damage and HPC could influence the 99Tcm-MIBI and 201Tl uptake and clearance

1999-01-01

329

Evaluation of left ventricular function and volume in patients with dilated cardiomyopathy: Gated myocardial single-photon emission tomography (SPECT) versus echocardiography  

International Nuclear Information System (INIS)

[en] Left ventricular function, volumes and regional wall motion provide valuable diagnostic information and are of long-term prognostic importance in patients with dilated cardiomyopathy (DCM). This study was designed to compare the effectiveness of 2D-echocardiography and gated single-photon emission tomography (SPECT) for evaluation of these parameters in patients with DCM. Gated SPECT and 2D-echocardiography were performed in 33 patients having DCM. Gated SPECT data, including left ventricular ejection fraction (LVEF), were processed using an automated algorithm. Standard technique was used for 2D-echocardiography. Regional wall motion was evaluated using both modalities and was scored by two independent observers using a 16-sement model with a 5-point scoring system. The overall agreement between the two imaging modalities for the assessment of regional wall motion was 56% (298/528 segments). With gated SPECT, LEVF, end-diastolic volume (EDV), and end-diastolic volume (EDV), and end-systolic volume (ESV) were 27+-9%, 217+-73mL, respectively, and 30.8%, 195+-58mL and, 137+-48 mL with echocardiography. The correlation between gated SPECT and 2-D-echocardiography was good (r=0.76, P

2005-01-01

330

Myocardium at risk can be determined by ex vivo T2-weighted magnetic resonance imaging even in the presence of gadolinium: comparison to myocardial perfusion single photon emission computed tomography.  

UK PubMed Central (United Kingdom)

AIMS: Determination of the myocardium at risk (MaR) and final infarct size by cardiac magnetic resonance imaging (CMR) enables calculation of salvaged myocardium in acute infarction. T2-weighted imaging is performed prior to the administration of gadolinium, since gadolinium affects T2 tissue properties. This is, however, difficult in an ex vivo model since gadolinium must be administered for determination of infarct size by CMR. We aimed to test the ability of ex vivo T2-weighted imaging to assess MaR using myocardial perfusion single photon emission computed tomography (SPECT) as reference and to investigate whether MaR could be assessed by ex vivo T2-weighted imaging after injection of gadolinium. Materials and methods In 18 domestic pigs, the left anterior descending artery was occluded for either 30 or 40 min, followed by 4 h of reperfusion. After explantation of the hearts, myocardial perfusion SPECT and T2-weighted imaging were performed for determination of MaR, either with or without gadolinium. Infarct size was determined by T1-weighted imaging and by triphenyl tetrazolium chloride (TTC) staining. RESULTS: T2-weighted imaging agreed with myocardial perfusion SPECT, both with and without gadolinium (r(2)= 0.70, P < 0.01) with a bias of 2.6 ± 5.1% (P = 0.04). Infarct size was 15.4 ± 5.3 and 22.1 ± 5.6% with TTC and T1-weighted imaging, respectively (P = 0.008) in nine pigs who had both infarct measures. CONCLUSION: T2-weighted CMR imaging can be used to determine MaR in an ex vivo experimental model, both with and without the presence of gadolinium. Thus, CMR alone can be used to assess myocardial salvage in experimental studies.

Ubachs JF; Engblom H; Koul S; Kanski M; Andersson P; van der Pals J; Carlsson M; Erlinge D; Arheden H

2013-03-01

331

Approaches to Single Photon Detection  

CERN Document Server

We present recent results on our development of single photon detectors, including: gated and free-running InGaAs/InP avalanche photodiodes; hybrid detection systems based on sum-frequency generation and Si APDs; and SSPDs (superconducting single photon detectors), for telecom wavelengths; as well as SiPM (Silicon photomultiplier) detectors operating in the visible regime.

Thew, R T; Eraerds, P; Walenta, N; Gautier, J-D; Koller, E; Zhang, J; Gisin, N; Zbinden, H

2008-01-01

332

Evaluation of {sup 99m}Tc-ECD SPECT for the detection of brain tumor. Comparison with {sup 201}Tl SPECT  

Energy Technology Data Exchange (ETDEWEB)

For the evaluation of brain tumor (n=15), we performed both dynamic and static {sup 99m}Tc-ECD (ECD) SPECT studies. {sup 201}Tl SPECT was also used for comparison with the results of ECD SPECT. Dynamic ECD SPECT was obtained following the injection of 600 MBq of ECD. Five min after the injection of ECD, static ECD SPECT was performed. {sup 201}Tl SPECT was obtained 10 min after the injection of 74 MBq. Abnormal uptake was recognized in 7 of 15 tumors with dynamic ECD; 5 of 7 meningiomas, 1 of 1 glioblastoma and 1 of 1 astrocytoma. However, no abnormal uptake was seen in 3 of 3 benign tumors (1 low grade astrocytoma, 1 hemangioma, 1 craniopharyngioma) and in 2 of 2 brain metastases. In contrast abnormal uptake was seen in 11 of 15 tumors with {sup 201}Tl; 7 of 7 meningiomas, 2 of 2 brain metastases, 1 of 1 glioblastoma and 1 of 1 craniopharyngioma. No abnormal uptake was seen in 3 of 3 benign tumors (1 hemangioma and 2 low grade astrocytomas). Equivocal uptake was seen in 1 low grade astrocytoma with dynamic ECD and {sup 201}Tl. The mechanism of the accumulation of dynamic ECD to brain tumor is unclear. However, it may reflect not only blood flow, but also metabolism. (author)

Oshima, Motoo; Sasaki, Yasushi; Kikuchi, Yoshirou; Kaminaga, Tatsuro; Furui, Shigeru [Teikyo Univ., Tokyo (Japan). Faculty of Medicine; Konoeda, Kouichi; Karigome, Masato; Yoshida, Katsuhiko

1997-01-01

333

Improved Diagnostic Performance of Thallium-201 Myocardial Perfusion Scintigraphy in Coronary Artery Disease: from Planar to Single Photon Emission Computed Tomography Imaging  

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Full Text Available Background: This study was performed to compare Tl-201 myocardial perfusion singlephoton emission computed tomography (SPECT) with planar scintigraphy inthe diagnosis of coronary artery disease (CAD).Methods: Retrospectively, 240 of 3262 patients, with exercise-redistribution Tl-201myocardial perfusion scintigraphy performed between January 1990 andOctober 1997, were analyzed to compare Tl-201 scintigraphy and coronaryarteriography. Within 30 days, all 240 patients underwent both coronaryarteriography and exercise-redistribution Tl-201 myocardial perfusionscintigraphy with 86 SPECT and 154 planar images acquired.Results: The sensitivities of Tl-201 myocardial perfusion scintigraphy in individualcoronary arteries including left anterior descending (LAD) artery, left circumflex(LCX) artery, and right coronary artery (RCA), were 77%/72%,31%/30%, and 77%/50% in the SPECT/planar study groups, respectively.The sensitivities of CAD detection in patients with single-vessel, double-vessel,and triple-vessel diseases were 96%/82%, 91%/85%, and 96%/90% inthe SPECT/planar study groups, respectively.Conclusion: SPECT images provide greater advantages over planar images for betterdetection of the number, location, and extent of CAD. Cardiac SPECT doesimprove the accurate interpretation in abnormal Tl-201 distributions due tothe higher contrast resolution and better separation of overlapping myocardialregions.

Ming-Fong Tsai; Pan-Fu Kao; Kai-Yuan Tzen

2002-01-01

334

Regional myocardial wall thickening and global ejection fraction in patients with low angiographic left ventricular ejection fraction assessed by visual and quantitative resting ECG-gated 99mTc-tetrofosmin single-photon emission tomography and magnetic resonance imaging  

International Nuclear Information System (INIS)

[en] We investigated the use of visual and quantitative technetium 99m tetrofosmin ECG-gated single-photon emission tomography (SPET) for the assessment of regional myocardial wall thickening (WT) and left ventricular (LV) ejection fraction (EF) in comparison with gated magnetic resonance imaging (MRI) in patients with a low angiographic LVEF. Gated SPET using 99mTc-labelled flow tracers offers potential for simultaneous assessment of myocardial perfusion and LV function. Few data are available on the use of visual and quantitative gated SPET in patients with low LVEF. In this study 21 patients with low angiographic LVEF (mean 37%±5%) were studied. Resting gated 99mTc-tetrofosmin SPET and gated MRI were performed within 48 h. WT was assessed by visual interpretation (five point score) and quantitative analysis based on count increase. There was good agreement for EF measurements by MRI and gated SPET (mean EF: 33%±12% vs 35%±11%, r = 0.86, P

1998-01-01

335

Iodine-123 phenylpentadecanoic acid: detection of acute myocardial infarction and injury in dogs using an iodinated fatty acid and single-photon emission tomography  

Energy Technology Data Exchange (ETDEWEB)

The ability of an iodinated fatty acid, iodine-123 phenylpentadecanoic acid (1-123 PPA), and single-photon emission computed tomography (SPECT) to detect myocardium injured by temporary or permanent coronary arterial occlusion was evaluated. In 5 control dogs, 11 dogs that underwent 90 to 120 minutes of fixed left anterior descending coronary artery (LAD) occlusion, and 8 dogs that underwent 90 minutes of temporary LAD occlusion and up to 90 minutes of reflow, 2 to 6 mCi of I-123 PPA were injected and the dogs were imaged with SPECT. Control dogs showed relatively uniform uptake and clearance of I-123 PPA in similar left ventricular (LV) regions. Dogs with permanent LAD occlusion were identified by computer algorithm as having regions of decreased I-123 PPA uptake in the infarct-related area and a reduced rate of I-123 PPA clearance (-9.4% in infarct sectors (washin), +3.7% in sectors adjacent to the area of infarction, and +15.4% in control LV sectors (p less than 0.01)). Dogs with temporary LAD occlusion and reperfusion had decreased clearance of I-123 PPA from the regions with infarction; I-123 PPA clearance was -5.2 +/- 16.4% in infarct sectors, 12.7 +/- 7.4% in periinfarct zones, and 30.4 +/- 12% in control LV regions. These data demonstrate that tomographic analysis of I-123 PPA uptake and clearance permits the relatively noninvasive detection of LV myocardium injured by permanent or temporary LAD occlusion and reperfusion.

Rellas, J.S.; Corbett, J.R.; Kulkarni, P.; Morgan, C.; Devous, M.D. Sr.; Buja, L.M.; Bush, L.; Parkey, R.W.; Willerson, J.T.; Lewis, S.E.

1983-12-01

336

Influence of mode of stress and coronary risk factor burden upon long-term mortality following normal stress myocardial perfusion single-photon emission computed tomographic imaging.  

UK PubMed Central (United Kingdom)

In patients with normal results on stress single-photon emission computed tomographic (SPECT) studies, coronary artery disease risk factors (RFs) and the mode of testing can influence the trajectory of long-term outcomes. Nevertheless, the combined prognostic impact of these commonly assessed factors has heretofore not been considered. In this study, all-cause mortality rates were assessed in 5,762 patients with normal results on stress SPECT studies. Patients were divided according to mode of stress testing, exercise or pharmacologic, and by number of coronary artery disease RFs. Patients were followed for a mean of 8 ± 4.2 years for all-cause mortality. There were 1,051 deaths (18%), with an annualized mortality rate of 2.2% per year. The RF-adjusted event rate was significantly higher for pharmacologic versus exercise SPECT studies (3.6% per year vs 1.2% per year, p <0.0001) and for patients with increasing numbers of coronary artery disease RFs (p <0.0001). Kaplan-Meier survival analysis revealed wide heterogeneity in all-cause mortality rates when RF burden and performance of exercise versus pharmacologic testing were considered, ranging from only 0.8% per year in exercise patients with no RFs to 4.2% per year in pharmacologic patients with ?2 RFs. Mortality rates in exercise patients with ?2 RFs were comparable to those in pharmacologic patients with no RFs. In conclusion, long-term outcomes after cardiac stress testing are synergistically and strongly influenced by RF burden and inability to exercise. Given these findings, prospective study is indicated to determine whether enhanced risk categorization that combines the consideration of these 2 factors improves patient counseling and physician risk management among patients manifesting normal results on stress SPECT studies.

Supariwala A; Uretsky S; Depuey EG; Thotakura G; Kanneganti S; Guriginjakunta N; Vala R; Kuruba M; Rozanski A

2013-03-01

337

Myocardial perfusion in patients with left bundle branch block and without coronary artery disease  

International Nuclear Information System (INIS)

For the evaluation of myocardial perfusion in patients with left bundle branch block (LBBB), we performed exercise stress (Ex)-redistribution (RD) myocardial tomography with thallium-201 (201Tl) in 23 patients with LBBB and without coronary artery disease (CAD). Myocardial images in patients with LBBB were compared with those of 9 patients with CAD who showed Ex induced transient septal defect. Bull'-eye maps (201Tl distribution maps at Ex and RD and 201Tl washout rate [WOR] map) were made from myocardial tomograms. In 23 patients with LBBB, 15 patients (65%) developed myocardial perfusion abnormality. In 10 (67%) of these 15 patients, transient perfusion defect appeared in the entire septum (diffuse type). On the other hand in 5 patients (33%), localized fixed perfusion defect developed at the boundary between septum and anterior wall (focal type). In focal type, every patient had other disease such as hypertension, aortic stenosis or sick sinus syndrome. While in patients with diffuse type, other diseases were observed in 30% (p201Tl WOR and 201Tl uptake ratio of septum to lateral wall indicated that exercise induced septal defect was slighter in diffuse type than CAD. These points might be useful to differentiate whether CAD participates in the septal defect or not in patients with LBBB. (author).

1992-01-01

338

Duke treadmill score (DTS) and gated single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) in chest pain patient initial experience  

International Nuclear Information System (INIS)

Background: Risk stratification of the patient with suspected or known coronary artery disease(CAD)by means of non-invasive testing are highly relevant in clinical cardiology for the selection of patient who require further diagnostic or therapeutic investigation. Aim: To predict severity of myocardial ischaemia by exercise tolerance test (ETT) determined duke treadmill score (DTS) and myocardial perfusion study. Material and methods: A total of 108 (92-men) patients presenting with Canadian cardiovascular society (CCS) class Mil severity of chest pain, mean age 49.88+8.44 yrs, were studied during October 2002-march 2003. All patient underwent ETT and SPECT-MPI scan using Tc-99m-tetrofosmin in one-day stress and rest protocol. Coronary angiogram (CAG) was done within six months of the perfusion study. After performing ETT, patients were categorized by DTS, myocardial perfusion studies were also stratified according to severity of perfusion defect. The angiographic findings (significant>50% stenosis) and perfusion defects in MPI were compared with the severity of DTS. Result: In high DTS group 91.66% patients had perfusion defect, whereas in intermediate and low risk group it was 60% and 40.90% respectively. In high DTS group 91.66% of patient had angiographically proven CAD, 58.33% of them had triple vessel disease (TVD) while in intermediate and low risk group angiographically proven CAD were 65% and 22.27% of whom TVD only in 15% and 0% respectively. Conclusion: The results of ETT using DTS score satisfactorily correlate with SPECT-MPI scanning in high DTS subsets of patients .So it is suggested that patient of high risk DTS could undergo CAG for further evaluation without radio-nuclide perfusion study. Intermediate and low risk needs myocardial perfusion imaging study to guide for further evaluation. (authors)

2004-01-01

339

Sympathetic reinnervation in cardiac transplants: {sup 123}I-MIBG and {sup 201}Tl/{sup 99m}Tc-MIBI scintigraphy  

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The purpose was to evaluate cardiac sympathetic reinnervation and hemodynamic changes after orthotopic heart transplantation (TPL). We performed 24 serial or followup cardiac 123I-MIBG imaging and rest 201Tl/99mTc-MIBI dipyridamole stress gated myocardial perfusion SPECT (g-MPS) in 15 patients (M:F=10:5;mean ages=34.5{+-}13.0 yr; idiopathic:rheumatic=14:1; one heart lung TPL)(10.80 {+-}11.88 (1-48) mo) after TPL 123I-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 heart to mediastinal MIBG uptake (HMR) Compared to HMR on 15 min images (1.48 {+-} 0.28), neither four nor 24 hour delayed images (1.26 {+-} 0.23 vs. 1.06 {+-} 0.26: p<0.05, respectively, ANOVA) showed definite delayed localization of MIBG. 12 subjects with <13 (4.9 {+-}3.7) months after TPL had no visible 123I-MIBG uptake on early 15 min imaging however, 12 subjects with 13 to 48(28.6{+-}12.8) months had visible cardiac 123I-MIBG uptake (HMR: 1.65{+-}0.21 vs. 1.32{+-}0.26; p=0.002). One-year followup 123I-MIBG scintigraphy in nine pts showed significantly increased HMR(1.40{+-}0.31 to 1.61{+-}0.16, p<0.05) but a plateau was reached at HMR value of 2.0, which was still lower than 3.0 in normal controls. Plasma NE was increased according to I-123 MIBG myocardial uptake. Annual G-MPS detected an allograft atherosclerosis in one pt and showed progressive normalization of tachycardia and significant deterioration of LVEF and cardiac indices according to severity of rejection. To dipyridamole stress, transplant heats showed significant subnormal hemodynamic responses. Partial sympathetic l