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Sample records for gated spect evaluation

  1. Clinical evaluation of the Tl-201 ECG-gated myocardial SPECT

    International Nuclear Information System (INIS)

    Mochizuki, Teruhito

    1989-01-01

    In order to evaluate the clinical usefulness of the Tl-201 ECG-gated myocardial single photon emission computed tomography (SPECT), we compared the wall motion and the grade of the Tl-201 uptake of the ECG-gated myocardial SPECT with the wall motion of the ECG-gated blood pool SPECT. Materials were 87 patients of 50 old myocardial infarctions (OMIs), 19 hypertrophic cardiomyopathies (HCMs), 2 dilated cardiomyopathies (DCMs) and 16 others. After intravenous injection of 111-185 MBq (3-5 mCi) of Tl-201 at rest, the projection data were acquired using a rotating gamma-camera through 180deg, from RAO 45deg in 24 directions, each of which consisted of 80-100 beats. For the reconstruction of ED, ES and non-gated images, R-R interval was divided into about 20 (18-22) fractions. In 348 regions of interest (anterior, septal, lateral and inferior wall) in 87 cases, wall motion and the Tl-201 uptake were evaluated to three grades (normal, hypokinesis and akinesis; normal, low and defect, respectively), which were compared with the wall motion of the ECG-gated blood pool SPECT. The wall motion and the grade of the Tl-201 uptake of the ECG-gated myocardial SPECT correlated well with the wall motion of the ECG-gated blood pool SPECT (96.6% and 87.9%, respectively). In conclusion, the ECG-gated myocardial SPECT can provide clear perfusion images and is a very useful diagnostic strategy to evaluate the regional wall motion and perfusion simultaneously. (author)

  2. Evaluation of left ventricular function using electrocardiographically gated myocardial SPECT with (123)I-labeled fatty acid analog.

    Science.gov (United States)

    Nanasato, M; Ando, A; Isobe, S; Nonokawa, M; Hirayama, H; Tsuboi, N; Ito, T; Hirai, M; Yokota, M; Saito, H

    2001-12-01

    Electrocardiographically (ECG) gated myocardial SPECT with (99m)Tc-tetrofosmin has been used widely to assess left ventricular (LV) function. However, the accuracy of variables using ECG gated myocardial SPECT with beta-methyl-p-(123)I-iodophenylpentadecanoic acid (BMIPP) has not been well defined. Thirty-six patients (29 men, 7 women; mean age, 61.6 +/- 15.6 y) with ischemic heart disease underwent ECG gated myocardial SPECT with (123)I-BMIPP and with (99m)Tc-tetrofosmin and left ventriculography (LVG) within 1 wk. LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV) were determined on gated SPECT using commercially available software for automatic data analysis. These volume-related items on LVG were calculated with an area-length method and were estimated by 2 independent observers to evaluate interobserver validity. The regional wall motion with these methods was assessed visually. LVEF was 41.1% +/- 12.5% on gated SPECT with (123)I-BMIPP, 44.5% +/- 13.1% on gated SPECT with (99m)Tc-tetrofosmin, and 46.0% +/- 12.7% on LVG. Global LV function and regional wall motion between both gated SPECT procedures had excellent correlation (LVEF, r = 0.943; LVEDV, r = 0.934; LVESV, r = 0.952; regional wall motion, kappa = 0.92). However, the correlations of global LV function and regional wall motion between each gated SPECT and LVG were significantly lower. Gated SPECT with (123)I-BMIPP showed the same interobserver validity as gated SPECT with (99m)Tc-tetrofosmin. Gated SPECT with (123)I-BMIPP provides high accuracy with regard to LV function and is sufficiently applicable for use in clinical SPECT. This technique can simultaneously reveal myocardial fatty acid metabolism and LV function, which may be useful to evaluate various cardiac diseases.

  3. The usefulness of treatment evaluation of severe heart failure by ECG-gated myocardial SPECT

    International Nuclear Information System (INIS)

    Ohkoshi, Nobuyuki; Watanabe, Shingo; Matsumoto, Tooru

    2011-01-01

    Our purpose of study was to investigate the usefulness of treatment evaluation of severe heart failure by Electrocardiogram (ECG)-gated myocardial single photon emission computed tomography (SPECT). We evaluated the cardiac function in the case of severe heart failure by gated SPECT and compared it with the cardiac function obtained by left ventriculography (LVG), echocardiography, cardiac MRI, and B-type natriuretic peptide (BNP) values. We investigated the correlation of ejection fraction (EF), time lag of wall motion between the septal and lateral walls of the left ventricle for cardiac resynchronization therapy (CRT) and wall thickening (WT). We classified the left ventricular (LV) into basal, middle and apical areas for comparison of WT. We investigated the effect of a perfusion defect score in these comparisons. The gated SPECT results were correlated with comparative subjects in EF. The results were correlated with MRI on the middle area of the LV in the comparison of WT. We thought it was possible that there was an effect from a perfusion defect score in a time lag comparison of wall motion. Treatment evaluation of severe heart failure by gated SPECT is useful, because it is able to obtain three-dimensional cardiac function analysis, and it offers objectivity and reproducible quantitative evaluation. At the same time, perfusion SPECT is helpful for CRT and LV-plasty. (author)

  4. Evaluation of left ventricular ejection fraction using quantitative gated SPECT (QGS)

    International Nuclear Information System (INIS)

    Musa, M. A. A.

    2010-07-01

    Electrocardiographic ally gated myocardial perfusion SPECT (G SPECT) is a state-of the art technique for the combined evaluation of myocardial perfusion and left ventricular function within a single study. It is currently one of the most commonly performed cardiology procedures in a nuclear medicine department. Automation of the image processing and quantification has made this techniques highly reproducible, practical and user friendly in the clinical setting . In patients with coronary artery disease, gating enhances the diagnostic and prognostic capability of myocardial perfusion imaging provides incremental information over the the perfusion data, and has shown potentials for myocardial viability assessment and sequential follow-up after therapy. Evaluation of the left ventricular (L V) function is important in clinical cardiology. Quantifying the degree and extent of the L V functional abnormalities permits a systematic assessment of the disease process on the myocardial performance. The aim of this thesis is to evaluate left ventricular ejection fraction (LVEF) in patients with no evidence of ischemic response during the stress test. This investigation was carried out in view of the few reports concerning the findings ventricular function with gated SPECT in these situations in the normal population, which is relevant when considering the possibility of myocardial stunning. Method: We prospectively studied 30 selected patients, in difference age and gender. A one-day protocol was used, with injection 555 MBq - 1.11 MBq (15 - 30 mCi) of 99 mTc-M1 B1 at stress and rest. Gated perfusion SPECT was acquired 30 to 60 minutes after radiotracer injection in both condition and processed using QGSPECT software. Difference between stress and rest LVEF was calculated. Result and conclusion: rest LVEF was higher in the stress (exercise) group, A trend line was done in both groups and r-value was (0.9) and p=0.04 in acceptance value. Standard deviation of LVEF also was

  5. Rapid gated Thallium-201 perfusion SPECT - clinically feasible?

    International Nuclear Information System (INIS)

    Wadhwa, S.S.; Mansberg, R.; Fernandes, V.B.; Wilkinson, D.; Abatti, D.

    1998-01-01

    Full text: Standard dose energy window optimised Thallium-201 (Tl-201) SPECT has about half the counts of a standard dose from Technetium-99m Sestamibi (Tc99m-Mibi) gated perfusion SPECT. This study investigates the clinical feasibility of rapid energy window optimised Tl-201 gated perfusion SPECT (gated-TI) and compares quantitative left ventricular ejection fraction (LVEF) and visually assessed image quality for wall motion and thickening to analogous values obtained from Tc99m-Mibi gated perfusion SPECT (gated - mibi). Methods: We studied 60 patients with a rest gated Tl-201 SPECT (100 MBq, 77KeV peak, 34% window, 20 sec/projection) followed by a post stress gated Sestamibi SPECT (1GBq, 140KeV, 20% window, 20 sec/projection) separate dual isotope protocol. LVEF quantitation was performed using commercially available software (SPECTEF, General Electric). Visual grading of image quality for wall thickening and motion was performed using a three-point scale (excellent, good and poor). Results: LVEF for gated Tl-201 SPECT was 59.6 ± 12.0% (Mean ± SD). LVEF for gated Sestamibi SPECT was 60.4 ±11.4% (Mean ± SD). These were not significantly different (P=0.27, T-Test). There was good correlation (r=0.9) between gated-TI and gated-mibi LVEF values. The quality of gated-Tl images was ranked as excellent, good and poor in 12, 50 and 38% of the patients respectively. Image quality was better in gated-mibi SPECT, with ratings of 12, 62 and 26% respectively. Conclusion: Rapid gated Thallium-201 acquisition with energy window optimisation can be effectively performed on majority of patients and offers the opportunity to assess not only myocardial perfusion and function, as with Technetium based agents, but also viability using a single day one isotope protocol

  6. 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)

    Berk, Fatma; Isgoren, S.; Demir, H.; Kozdag, G.; Ural, D.; Komsuoglu, B.

    2005-01-01

    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<0.01) for the assessment of LVEF. The correlation for EDV and ESV were also good, but with wider limits of agreement (r=0.72, P<0.01 and r=0.73, P<0.01, respectively) and significantly higher values were obtained with gated SPECT (P<0.01). Gated SPECT and 2D-echocardiography correlate well for the assessment of LV function and LV volumes. Like 2D-echocardiography, gated SPECT provides reliable information about LV function and dimension with the additional advantage of perfusion data. (author)

  7. Evaluation and reduction of respiratory motion artifacts in small animal SPECT with GATE

    International Nuclear Information System (INIS)

    Lee, C.-L.; Park, S.-J.; Kim, H.-J.

    2015-01-01

    The degradation of image quality caused by respiration is a major impediment to accurate lesion detection in single photon emission computed tomography (SPECT) imaging. This study was performed to evaluate the effects of lung motion on image quantification. A small animal SPECT system with NaI(Tl) was modeled in the Geant4 application for tomographic emission (GATE) simulation for a lung lesion using a 4D mouse whole-body phantom. SPECT images were obtained using 120 projection views acquired from 0 o to 360 o with a 3 o step. Slices were reconstructed using ordered subsets expectation maximization (OS-EM) without attenuation correction with five iterations and four subsets. Image quality was compared between the static mode without respiratory motion, and dynamic mode with respiratory motion in terms of spatial resolution was measured by the full width at half maximum (FWHM), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The FWHM of the non-gated image and the respiratory gated image were also compared. Spatial resolution improved as activity increased and lesion diameter decreased in the static and dynamic modes. The SNR and CNR increased significantly as lesion activity increased and lesion diameter decreased. Our results show that respiratory motion leads to reduced contrast and quantitative accuracy and that image quantification depends on both the amplitude and the pattern of the respiratory motion. We verified that respiratory motion can have a major effect on the accuracy of measurement of lung lesions and that respiratory gating can reduce activity smearing on SPECT images

  8. Pharmacologic stress-induced stunning: evaluation with quantitative gated SPECT

    International Nuclear Information System (INIS)

    Chun, K. A.; Cho, I. H.; Won, K. J.; Lee, H. W.

    2000-01-01

    The after-effect of pharmacologic stress (adenosine) on left ventricular (LV) function, end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were evaluated after pharmacologic stress with Tl-201 and 99m Tc-MIBI SPECT using an automated program in 153 subjects. The subjects were grouped as follows: 1) Tl-201 group (n=35, male 18, female 17, mean age: 58 years); normal scan (n=24), ischemia (n=8) and infarction (n=3). 2) 99m Tc-MIBI group (n=118, male 60, female 58, mean age: 62 years); normal scan (n=73), ischemia (n=20) and infarction (n=25) based on the interpretation of perfusion images. All patients were in sinus rhythm during the study. 1)Tl-201 group; In patients with ischemia (the mean time interval between injection and acquisition is 12.3 min), post-stress LVEF was significantly depressed after adenosine infusion (51.2 ± 6.3% vs 59.8± 8.2%, p 99m Tc-MIBI group; In patients with ischemia (the mean time interval between injection and acquisition is 80 min), post-stress LVEF was significantly depressed after adenosine infusion (p<0.001) and ΔLVEF was 5.1%. Eight patients (40%) showed an increase in LVEF greater than 5% from poststress to rest. Poststress ESV (37.1±17.3 ml) was significantly higher than ESV (31.3±15.5 ml, p<0.001) at rest, but no significant difference in EDV. These results showed that pharmacologic stress induced stunning is well noted in the early quantitative gated SPECT in ischemic patients and also observed in the delayed gated SPECT, even though the rate of stunning is less than the early SPECT

  9. Utility of QGS for 201Tl electrocardiogram-gated SPECT in cardiac function evaluations

    International Nuclear Information System (INIS)

    Shimazaki, Hiroshi; Oono, Ryuichi

    2001-01-01

    QGS (quantitative gated SPECT) was applied to 201 Tl SPECT, whose images are inferior to those of Tc SPECT, and its utility was evaluated. More specifically, the cardiac function index was calculated by QGS, and local wall motion was evaluated visually. Accuracy was assessed by comparison with left ventriculography. The subjects were 29 patients (21 males, 8 females; 6 with myocardial infarction, 18 with stenocardia, 2 with pericardial disease, 3 with other heart diseases) who had undergone myocardial scintigraphy and left ventriculography between February and May, 2000. 201 Tl (74 or 111 MBq) was administered to all patients. The resting image was obtained 10 minutes later, and the delayed image during loading was obtained 4 hours later. The conditions for acquiring the images were as follows. Two detectors were arranged at a 90-degree angle in the form of an L. The 180 degrees from 45 degrees right anterior oblique (RAO) to 45 degrees left posterior oblique (LPO) were divided into 30 sections at 6-degree intervals, and the image in each section was acquired for 60 seconds. The matrix was 64 x 64. As a cardiac function index, the left ventricular ejection function (LVEF) obtained by electrocardiogram-gated SPECT (QGS-EF) at the rest (14 cases) and the QGS-EF on the delayed images (15 cases) were compared with the LVEF determined by left ventriculography (LVG-EF). There was an excellent positive correlation between the data obtained by two methods, with a correlation coefficient of r=0.93 (y=1.04x-0.04). Most of the difference between the values fell within two standard deviations, and the error was in the clinically allowable range. There was no significant difference between the correlation coefficient at rest and during loading or between the cases that showed an obvious defect on the image and those that did not. The local wall motion of the left ventricle was visually evaluated in five stages in two directions (RAO, 30 degrees, and LAO, 60 degrees). The motion

  10. Reference Range of Functional Data of Gated Myocardial Perfusion SPECT by Quantitative Gated SPECT of Cedars-Sinai and 4D-MSPECT of Michigan University

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    Kang, Do Young; Kim, Moo Hyun; Kim, Young Dae [College of Medicine, Univ. of Donga, Pusan (Korea, Republic of)

    2003-07-01

    Various programs have been developed for gating of myocardial perfusion SPECT. Among the those program, the most popular program is the Quantitative Gated SPECT (QGS)? developed by Cedars-Sinai hospital and most recently released program is 4D-MSPECT? developed by university of Michigan. It is important to know the reference range of the functional data of gated myocardial perfusion SPECT because it is necessary to determine abnormality of individual patient and echocardiographic data is different from those of gated SPECT. Tc-99m MIBI gated myocardial perfusion SPECT image was reconstructed by dual head gamma camera (Siemens, BCAM, esoft) as routine procedure and analyzed using QGS? and 4D-MSPECT? program. All patients (M: F=9: 18, Age 69{+-}9 yrs) showed normal myocardial perfusion. The patients with following characteristics were excluded: previous angina or MI history, ECG change with Q wave or ST-T change, diabetes melitius, hypercholesterolemia, typical chest pain, hypertension and cardiomyopathy. Pre-test likelihood of all patients was low. (1) In stress gated SPECT by QGS?, EDV was 73{+-}25 ml, ESV 25{+-}14 ml, EF 67{+-}11 % and area of first frame of gating 106.4{+-}21cm{sup 2}. In rest gated SPECT, EDV was 76{+-}26 ml, ESV 27{+-}15 ml, EF 66{+-}12 and area of first frame of gating 108{+-}20cm{sup 2}. (2) In stress gated SPECT by 4D-MSPECT?, EDV was 76{+-}28 ml, ESV 23{+-}16 ml, EF 72{+-}11 %, mass 115{+-}24 g and ungated volume 42{+-}15 ml. In rest gated SPECT, EDV was 75{+-}27 ml, ESV 23{+-}12 ml, EF 71{+-}9%, mass 113{+-}25g and ungate dvolume 42{+-}15 ml, (3) s-EDV, s-EF, r-ESV and r-EF were significantly different between QGS? and 4D-MSPECT? (each p=0.016, p<0.001. p=0.003 and p=0.001). We determined the normal reference range of functional parameters by QGS? and 4D-MSPECT? program to diagnose individually the abnormality of patients. And the reference ranges have to adopted to be patients by each specific gating program.

  11. Methods of gated-blood-pool-spect data processing

    International Nuclear Information System (INIS)

    Kosa, I.; Mester, J.; Tanaka, M.; Csernay, L.; Mate, E.; Szasz, K.

    1991-01-01

    Three techniques of gated SPECT were evaluated. The methods of Integral SPECT (ISPECT), enddyastole-endsystole SPECT (ED-ES SPECT) and Fourier SPECT were adapted and developed on the Hungarian nuclear medicine data processing system microSEGAMS. The methods are based on data reduction before back projection which results in processing times acceptable for the clinical routine. The clinical performance of the introduced techniques was tested in 10 patients with old posterior myocardial infarction and in 5 patients without cardiac disease. The left ventricular ejection faction determined by ISPECT correlated well with the planar values. The correlation coefficient was 0.89. The correlation coefficient of EF values determined by ED-ES SPECT and planar radionuclide ventriculography was lower (0.70). For the identification of left ventricular wall motion abnormalities ED-ES SPECT and Fourier SPECT exhibited a favourable performance, but ISPECT only moderate suitability. In the detection of regional phase delay Fourier-SPECT demonstrated higher sensitivity than the planar radionuclide ventriculography. (author) 4 refs.; 3 figs.; 2 tabs

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

    International Nuclear Information System (INIS)

    Toba, Masahiro; Ishida, Yoshio; Fukuchi, Kazuki; Fukushima, Kazuhito; Katafuchi, Tetsurou; Hayashida, Kohei; Oka, Hisashi; Takamiya, Makoto

    1999-01-01

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

  13. Implementation of angular response function modeling in SPECT simulations with GATE

    International Nuclear Information System (INIS)

    Descourt, P; Visvikis, D; Carlier, T; Bardies, M; Du, Y; Song, X; Frey, E C; Tsui, B M W; Buvat, I

    2010-01-01

    Among Monte Carlo simulation codes in medical imaging, the GATE simulation platform is widely used today given its flexibility and accuracy, despite long run times, which in SPECT simulations are mostly spent in tracking photons through the collimators. In this work, a tabulated model of the collimator/detector response was implemented within the GATE framework to significantly reduce the simulation times in SPECT. This implementation uses the angular response function (ARF) model. The performance of the implemented ARF approach has been compared to standard SPECT GATE simulations in terms of the ARF tables' accuracy, overall SPECT system performance and run times. Considering the simulation of the Siemens Symbia T SPECT system using high-energy collimators, differences of less than 1% were measured between the ARF-based and the standard GATE-based simulations, while considering the same noise level in the projections, acceleration factors of up to 180 were obtained when simulating a planar 364 keV source seen with the same SPECT system. The ARF-based and the standard GATE simulation results also agreed very well when considering a four-head SPECT simulation of a realistic Jaszczak phantom filled with iodine-131, with a resulting acceleration factor of 100. In conclusion, the implementation of an ARF-based model of collimator/detector response for SPECT simulations within GATE significantly reduces the simulation run times without compromising accuracy. (note)

  14. Implementation of angular response function modeling in SPECT simulations with GATE

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    Descourt, P; Visvikis, D [INSERM, U650, LaTIM, IFR SclnBioS, Universite de Brest, CHU Brest, Brest, F-29200 (France); Carlier, T; Bardies, M [CRCNA INSERM U892, Nantes (France); Du, Y; Song, X; Frey, E C; Tsui, B M W [Department of Radiology, J Hopkins University, Baltimore, MD (United States); Buvat, I, E-mail: dimitris@univ-brest.f [IMNC-UMR 8165 CNRS Universites Paris 7 et Paris 11, Orsay (France)

    2010-05-07

    Among Monte Carlo simulation codes in medical imaging, the GATE simulation platform is widely used today given its flexibility and accuracy, despite long run times, which in SPECT simulations are mostly spent in tracking photons through the collimators. In this work, a tabulated model of the collimator/detector response was implemented within the GATE framework to significantly reduce the simulation times in SPECT. This implementation uses the angular response function (ARF) model. The performance of the implemented ARF approach has been compared to standard SPECT GATE simulations in terms of the ARF tables' accuracy, overall SPECT system performance and run times. Considering the simulation of the Siemens Symbia T SPECT system using high-energy collimators, differences of less than 1% were measured between the ARF-based and the standard GATE-based simulations, while considering the same noise level in the projections, acceleration factors of up to 180 were obtained when simulating a planar 364 keV source seen with the same SPECT system. The ARF-based and the standard GATE simulation results also agreed very well when considering a four-head SPECT simulation of a realistic Jaszczak phantom filled with iodine-131, with a resulting acceleration factor of 100. In conclusion, the implementation of an ARF-based model of collimator/detector response for SPECT simulations within GATE significantly reduces the simulation run times without compromising accuracy. (note)

  15. Assessment of sistemic ventricle function in corrected transposition of great arteries with Gated SPECT: comparison with radionuclide ventriculography

    International Nuclear Information System (INIS)

    Alexanderson, E.; Espinola, N.; Duenas, D.; Fermon, S.; Acevedo, C.; Martinez, C.

    2002-01-01

    Corrected trasposition of great arteries is a uncommon congenital heart disease where the right ventricle works as the sistemic one. QGS Gated SPECT program was designed to recognize the contours of left ventricle being a good method to evaluate left ventricle ejection fraction. The purpose of this study was to evaluate the right ventricle ejection fraction (RVEF) by gated SPECT using Tc-99mSestaMIBI in comparison with radionuclide ventriculography (RVG) in patients with corrected trasposition of great arteries. Methods: We performed gated SPECT and radionuclide ventriculography within 15 days of each other in 7 adults consecutive patients with the diagnosis of corrected trasposition of great arteries (5 men, 2 women; mean age 47 y). Gated tomographic data, including ventricular volumes and ejection fraction, were processed using QGS automatic algorithm, whereas equilibrium radionuclide ventriculography used standard techniques. Results: We found a good correlation between right ventricle ejection fraction obtained with Gated SPECT compared with equilibrium radionuclide ventriculography. The mean of the RVEF with Gated SPECT was 41.2% compared with 44.2% of RVEF with equilibrium radionuclide ventriculography. Both methods recognized abnormal RVEF in 5 patients ( 50%) with Gated SPECT and abnormal with RVG meanwhile another patient had normal RVEF with RVG and abnormal with Gated SPECT. Conclusion: Quantitative gated tomography, using Tc 99mSestaMIBI, has a good correlation with radionuclide ventriculography for the assessment of right ventricle ejection fraction in patients with corrected trasposition of great arteries. These results support the clinical use of this technique among these patients

  16. GATED SPECT TO EVALUATE LEFT VENTRICULAR MYOCARDIAL PERFUSION, FUNCTION AND DYSSYNCHRONY FOR RESYNCHRONIZATION THERAPY

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    E.N. Ostroumov

    2009-01-01

    Full Text Available The study included 15 consecutive patients with heart failure and substantial LV dyssynchrony undergoing CRT. Clinical and phase analysis of gated myocardial perfusion SPECT assessed at baseline, after 2–3 days and after 3–4 months of CRT. The results demonstrated inversely relationship between the response to CRT and the nonviable myocardium. Evaluation of myocardial viability is necessary to considered in the selection process for CRT.

  17. Assessment of poststress left ventricular ejection fraction by gated SPECT: comparison with equilibrium radionuclide angiocardiography

    International Nuclear Information System (INIS)

    Acampa, Wanda; Liuzzi, Raffaele; De Luca, Serena; Capasso, Enza; Luongo, Luca; Cuocolo, Alberto; Caprio, Maria Grazia; Nicolai, Emanuele; Petretta, Mario

    2010-01-01

    We compared left ventricular (LV) ejection fraction obtained by gated SPECT with that obtained by equilibrium radionuclide angiocardiography in a large cohort of patients. Within 1 week, 514 subjects with suspected or known coronary artery disease underwent same-day stress-rest 99m Tc-sestamibi gated SPECT and radionuclide angiocardiography. For both studies, data were acquired 30 min after completion of exercise and after 3 h rest. In the overall study population, a good correlation between ejection fraction measured by gated SPECT and by radionuclide angiocardiography was observed at rest (r=0.82, p<0.0001) and after stress (r=0.83, p<0.0001). In Bland-Altman analysis, the mean differences in ejection fraction (radionuclide angiocardiography minus gated SPECT) were -0.6% at rest and 1.7% after stress. In subjects with normal perfusion (n=362), a good correlation between ejection fraction measured by gated SPECT and by radionuclide angiocardiography was observed at rest (r=0.72, p<0.0001) and after stress (r=0.70, p<0.0001) and the mean differences in ejection fraction were -0.9% at rest and 1.4% after stress. Also in patients with abnormal perfusion (n=152), a good correlation between the two techniques was observed both at rest (r=0.89, p<0.0001) and after stress (r=0.90, p<0.0001) and the mean differences in ejection fraction were 0.1% at rest and 2.5% after stress. In a large study population, a good agreement was observed in the evaluation of LV ejection fraction between gated SPECT and radionuclide angiocardiography. However, in patients with perfusion abnormalities, a slight underestimation in poststress LV ejection fraction was observed using gated SPECT as compared to equilibrium radionuclide angiocardiography. (orig.)

  18. Benefits of quantitative gated SPECT in evaluation of perioperative cardiac risk in noncardiac surgery

    International Nuclear Information System (INIS)

    Watanabe, Koji; Ohsumi, Yukio; Abe, Hirohiko; Hattori, Masahito; Minatoguchi, Shinya; Fujiwara, Hisayoshi

    2007-01-01

    Gated single-photon emission computed tomography (G-SPECT) was used to evaluate cardiac risk associated with noncardiac surgery and determine the benefits and indications of this technique for this type of surgery. Patients scheduled to undergo noncardiac surgery under the supervision of anesthesiologists and subjected to preoperative cardiac evaluation using G-SPECT during the 26-month period between June 2000 and August 2002 were followed for the presence/absence of cardiac events (id est (i.e.), cardiac death, myocardial infarction, unstable angina, congestive heart failure, or fatal arrhythmia) during surgery and the postoperative period until discharged. Relationships between the occurrence of cardiac events and preoperative G-SPECT findings were evaluated. A total of 39 patients underwent G-SPECT; 6 of the 39 exhibited abnormal ejection fraction (left ventricular ejection fraction, left ventricular ejection fraction (LVEF)≤50%) and end-systolic volume (end-systolic volume (ESV)≥50 ml). Surgery was suspended for three of these six patients and cardiac events developed in the remaining three patients. Both abnormal perfusion images (PI) and abnormal wall thickening (WT) were observed in all six patients. All six patients exhibited abnormal LVEF and/or ESV. Three patients had either abnormal PI or WT, and a cardiac event occurred in one of them. Of the five patients who experienced cardiac events during or after surgery, two exhibited a short run of ventricular tachycardia requiring a continuous administering of antiarrhythmic drugs, whereas the remaining three patients exhibited cardiac failure requiring inotropic support following surgery. The results of this study indicate that the occurrence of perioperative cardiac events can be predicted by considering the severity of expected surgical stress and preoperative G-SPECT findings for LVEF, PI, and WT. We conclude that G-SPECT is quite useful for cardiac risk assessment in patients undergoing noncardiac

  19. Evaluation of global and regional left ventricular function obtained by quantitative gated SPECT using {sup 99m}Tc-tetrofosmin for left ventricular dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Ban, Kazunobu; Nakajima, Tohru; Iseki, Harukazu; Abe, Sumihisa; Handa, Shunnosuke; Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

    2000-08-01

    The quantitative gated SPECT (QGS) software is able to calculate LV volumes and visualize LV wall motion and perfusion throughout the cardiac cycle using an automatic edge detection algorithm of the left ventricle. We evaluated the reliability of global and regional LV function assessment derived from QGS by comparing it with the results from left ventriculo-cineangiography (LVG). In 20 patients with left ventricular dysfunction who underwent ECG gated {sup 99m}Tc-tetrofosmin SPECT, the end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. The QGS-assessed regional wall motion was determined using the cinematic display. QGS-derived EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). There was a good correlation between wall motion score (WMS) derived from the QGS and the LVG (r=0.40, p<0.05). In some patients with extensive myocardial infarction, there was a discrepancy in the regional wall motion results between QGS and LVG. The ECG-gated SPECT using QGS is useful to evaluate global and regional LV functions in left ventricular dysfunction. (author)

  20. Quantification of left ventricular function by gated myocardial perfusion SPECT using multidimTM

    International Nuclear Information System (INIS)

    Huang Jin; Song Wenzhong; Chen Mingxi

    2004-01-01

    Objective: To evaluate the accuracy of left ventricular function by gated SPECT using the software Multidim TM . Methods: Rest gated SPECT was performed on 42 cases involved 26 normal subjects and 16 patients with myocardial infarct (MI). All cases underwent rest equilibrium radionuclide angiocardiography (ERNA) within 1 w. Results: (1)End diastolic volume (EDV), end systolic volume (ESV) and left ventricular ejection fraction(LVEF)were calculated using the software MultidimtMand ERNA. The correlation coefficient between the two Methods was 0.90,0.89,0.92 respectively(P TM , but the EDV and ESV value measured by this software maybe high with small heart. (authors)

  1. Functional assessment of the right ventricle with gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Wadhwa, S.S.; Abbati, D.; Carolan, M.

    2002-01-01

    Full text: Evaluation of right ventricular function can provide valuable information in a variety of cardiac and non-cardiac conditions. Functional assessment of the right ventricle is difficult owing to its anatomy and geometry. We describe a method of assessing right ventricular function using gated myocardial perfusion SPECT. In 20 patients right and left ventricular ejection fractions (RVEF, LVEF) were determined using gated blood pool (GBPS) and gated myocardial perfusion SPECT (GSPECT). To avoid contamination with right atrial activity the two frame method was adopted for gated blood pool data when measuring RVEF. In 9 patients with normal right ventricles, an index of wall thickening for the right ventricle was derived from the peak systolic and diastolic counts in the free wall. There was good linear correlation between the two methods adopted for calculation of LVEF and RVEF. Bland - Airman analysis demonstrated good agreement between the two methods with no specific bias. The mean LVEF was 47.9 +/-12% (GBPS) and 47.3 +/- 12.4 (GSPECT). The mean RVEF was 43.2 +/- 9.6% (GBPS) and 44.2 +/- 8.5% (GSPECT). In both cases the values were significantly different. The mean wall motion index was 35%. There was no correlation between the wall thickness index and ejection fraction however the index was greater in patients with normal right ventricle than in those with reduced RVER Gated SPECT offers an alternative to GBPS for the functional assessment of the right ventricle. Utilising GSPECT will allow the simultaneous assessment of both the right and left ventricles. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  2. Paradoxical motion of interventricular septum on Tc-99m MIBI gated SPECT study

    International Nuclear Information System (INIS)

    Ergun, E.L.; Erbas, B.; Beylergil, V.; Demirturk, O.S.; Pasaoglu, I.

    2004-01-01

    After uncomplicated cardiac surgery, abnormal motion of the interventricular septum is frequently observed. The interventricular septum has often been found to display dyskinetic, or paradoxical motion by echocardiographic studies. This study was undertaken to describe instances of paradoxical motion of interventricular septum on Tc-99m MIBI gated SPECT studies in patients after coronary artery by pass graft surgery. Tc-99m MIBI gated SPECT in conjunction with stress myocardial perfusion SPECT was performed in 18 patients who had history of cardiac bypass graft surgery. Paradoxical motion of the interventricular septum was defined visually from Tc-99m MIBI gated SPECT. Perfusion of the interventricular septum was examined from myocardial perfusion images in the same study. Paradoxical motion of the interventricular septum was observed in 4 patients (22%). The interventricular septum was normally perfused in all patients. It was concluded that paradoxical motion of the interventricular septum in patients who had a history of cardiac by-pass graft surgery is not an uncommon finding and it can be observed with gated SPECT. The exact mechanism of this phenomenon is not well-known. A normal perfusion in interventricular wall helps to discriminate this situation from a real abnormality. (author)

  3. Gated myocardial SPECT using spatial and temporal filtering

    International Nuclear Information System (INIS)

    Hatton, R.L.; Hutton, B.F.; Kyme, A.Z.; Larcos, G.

    2002-01-01

    Full text: Standard protocols for examining myocardial perfusion and motion defects involve the use of gated SPECT images, and a composite of the gated frames. This study examines the usefulness of extracting one or a combination of frames from the gated image to assess perfusion, and whether the addition of a temporal filter to the gated image improves signal to noise. Choice of the most appropriate frame was also considered. Sixteen and eight frame gated SPECT studies were simulated using the dynamic NURBS-based cardiac torso (NCAT) phantom. Variously sized perfusion defects were included in the inferior wall to assess contrast to normal tissue. Scatter and attenuation were not included. Butterworth spatial cutoff frequencies were varied to establish the most appropriate combination of temporal/spatial filters to reduce noise and retain contrast in the images. The 16 frame data produced higher ejection fraction across all spatial filter cutoffs, and generally was unaffected by temporal filtering. Temporal filtering reduced the noise in a uniform liver region in the gated images to within 25% of the composite image noise. The lesion extent and contrast were greater in the end-diastolic frames compared to end-systolic and mid-cycle frames. In conclusion, by using a temporally filtered end-diastolic image from the gated sequence, a favourable balance between noise and contrast can be achieved. Work is progress to confirm these findings in the clinical situation. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  4. 'Motion frozen' quantification and display of myocardial perfusion gated SPECT

    International Nuclear Information System (INIS)

    Slomka, P.J.; Hurwitz, G.A.; Baddredine, M.; Baranowski, J.; Aladl, U.E.

    2002-01-01

    Aim: Gated SPECT imaging incorporates both functional and perfusion information of the left ventricle (LV). However perfusion data is confounded by the effect of ventricular motion. Most existing quantification paradigms simply add all gated frames and then proceed to extract the perfusion information from static images, discarding the effects of cardiac motion. In an attempt to improve the reliability and accuracy of cardiac SPECT quantification we propose to eliminate the LV motion prior to the perfusion quantification via automated image warping algorithm. Methods: A pilot series of 14 male and 11 female gated stress SPECT images acquired with 8 time bins have been co-registered to the coordinates of the 3D normal templates. Subsequently the LV endo and epi-cardial 3D points (300-500) were identified on end-systolic (ES) and end-diastolic (ED) frames, defining the ES-ED motion vectors. The nonlinear image warping algorithm (thin-plate-spline) was then applied to warp end-systolic frame was onto the end-diastolic frames using the corresponding ES-ED motion vectors. The remaining 6 intermediate frames were also transformed to the ED coordinates using fractions of the motion vectors. Such warped images were then summed to provide the LV perfusion image in the ED phase but with counts from the full cycle. Results: The identification of the ED/ES corresponding points was successful in all cases. The corrected displacement between ED and ES images was up to 25 mm. The summed images had the appearance of the ED frames but have been much less noisy since all the counts have been used. The spatial resolution of such images appeared higher than that of summed gated images, especially in the female scans. These 'motion frozen' images could be displayed and quantified as regular non-gated tomograms including polar map paradigm. Conclusions: This image processing technique may improve the effective image resolution of summed gated myocardial perfusion images used for

  5. Evaluation of left ventricular ejection fraction from radial long-axis tomography. A new reconstruction algorithm for ECG-gated technetium-99m Sestamibi SPECT

    International Nuclear Information System (INIS)

    Tsujimura, Eiichiro; Kusuoka, Hideo; Uehara, Toshiisa

    1997-01-01

    Radial long-axis tomography can provide views similar to contrast left ventriculography (LVG) including the basal and apical areas of the left ventricle, not possible in routine short-axis tomography. We applied this method to ECG-gated Tc-99m Sestamibi (MIBI) myocardial SPECT images to estimate the left ventricular ejection fraction (LVEF). ECG-gated Tc-99m MIBI SPECT was performed with a temporal resolution of 10 frames per R-R interval. LVEF was calculated on the basis of left ventricular volume estimates at end diastole (ED) and end systole (ES) with using an ellipsoid body model. To validate this method, LVEF's derived from ECG-gated Tc-99m MIBI SPECT were compared with those from LVG in 11 patients with coronary artery disease. There was a close linear correlation between LVEF values calculated from Tc-99m MIBI SPECT and those from LVG (r=0.89, p<0.001), although the gated SPECT underestimated LVEF compared to LVG. The technique showed excellent reproducibility (intra-observer variability, r=0.96, p<0.001; inter-observer variability, r=0.71, p<0.005). The radial long-axis tomography technique gives a good estimate of LVEF, in agreement with estimates based on LVG. ECG-gated Tc-99m MIBI SPECT can, therefore, be applicable to assess myocardial perfusion and ventricular function at the same time. (author)

  6. Evaluation of left ventricular ejection fraction from radial long-axis tomography. A new reconstruction algorithm for ECG-gated technetium-99m Sestamibi SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tsujimura, Eiichiro; Kusuoka, Hideo; Uehara, Toshiisa [Osaka Univ. (Japan). Faculty of Medicine] [and others

    1997-08-01

    Radial long-axis tomography can provide views similar to contrast left ventriculography (LVG) including the basal and apical areas of the left ventricle, not possible in routine short-axis tomography. We applied this method to ECG-gated Tc-99m Sestamibi (MIBI) myocardial SPECT images to estimate the left ventricular ejection fraction (LVEF). ECG-gated Tc-99m MIBI SPECT was performed with a temporal resolution of 10 frames per R-R interval. LVEF was calculated on the basis of left ventricular volume estimates at end diastole (ED) and end systole (ES) with using an ellipsoid body model. To validate this method, LVEF`s derived from ECG-gated Tc-99m MIBI SPECT were compared with those from LVG in 11 patients with coronary artery disease. There was a close linear correlation between LVEF values calculated from Tc-99m MIBI SPECT and those from LVG (r=0.89, p<0.001), although the gated SPECT underestimated LVEF compared to LVG. The technique showed excellent reproducibility (intra-observer variability, r=0.96, p<0.001; inter-observer variability, r=0.71, p<0.005). The radial long-axis tomography technique gives a good estimate of LVEF, in agreement with estimates based on LVG. ECG-gated Tc-99m MIBI SPECT can, therefore, be applicable to assess myocardial perfusion and ventricular function at the same time. (author)

  7. Reproducibility of the assessment of myocardial function using gated Tc-99m-MIBI SPECT and quantitative software

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Cheon, Gi Jeong; Ahn, Ji Young; Jeong, Joon Ki; Lee, Myung Chul

    1998-01-01

    We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT. We used 16 frames per cycle for the gating of sequential Tc-99m-MIBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF). Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. Enddiastolic volumes (EDV) ranged from 58 ml to 248 ml (122 ml +/-42 ml), endsystolic volumes (ESV) from 20 ml to 174 ml (65 ml+/-39 ml), and EF from 20% to 68% (51%+/-14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval: 0.83-0.90) for assessment of wall thickening. We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect

  8. LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Chen, Chun; Li, Dianfu; Miao, Changqing; Zhou, Yanli; Cao, Kejiang; Feng, Jianlin; Lloyd, Michael S.; Chen, Ji

    2012-01-01

    The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2-3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA. Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4 %) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p < 0.05). RFA improved LV synchrony in the entire cohort and in the patients with septal APs (p < 0.01). Phase analysis of gated SPECT MPI demonstrated that LV mechanical dyssynchrony can be present in patients with WPW syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI. (orig.)

  9. LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chun; Li, Dianfu; Miao, Changqing; Zhou, Yanli; Cao, Kejiang [First Affiliated Hospital of Nanjing Medical University, Department of Cardiology, Nanjing, Jiangsu (China); Feng, Jianlin [First Affiliated Hospital of Nanjing Medical University, Department of Nuclear Medicine, Nanjing, Jiangsu (China); Lloyd, Michael S. [Emory University School of Medicine, Division of Cardiology, Atlanta, GA (United States); Chen, Ji [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, GA (United States)

    2012-07-15

    The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2-3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA. Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4 %) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p < 0.05). RFA improved LV synchrony in the entire cohort and in the patients with septal APs (p < 0.01). Phase analysis of gated SPECT MPI demonstrated that LV mechanical dyssynchrony can be present in patients with WPW syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI. (orig.)

  10. End-expiration respiratory gating for a high-resolution stationary cardiac SPECT system

    International Nuclear Information System (INIS)

    Chan, Chung; Sinusas, Albert J; Liu, Chi; Harris, Mark; Le, Max; Biondi, James; Grobshtein, Yariv; Liu, Yi-Hwa

    2014-01-01

    Respiratory and cardiac motions can degrade myocardial perfusion SPECT (MPS) image quality and reduce defect detection and quantitative accuracy. In this study, we developed a dual respiratory and cardiac gating system for a high-resolution fully stationary cardiac SPECT scanner in order to improve the image quality and defect detection. Respiratory motion was monitored using a compressive sensor pillow connected to a dual respiratory–cardiac gating box, which sends cardiac triggers only during end-expiration phases to the single cardiac trigger input on the SPECT scanners. The listmode data were rebinned retrospectively into end-expiration frames for respiratory motion reduction or eight cardiac gates only during end-expiration phases to compensate for both respiratory and cardiac motions. The proposed method was first validated on a motion phantom in the presence and absence of multiple perfusion defects, and then applied on 11 patient studies with and without perfusion defects. In the normal phantom studies, the end-expiration gated SPECT (EXG-SPECT) reduced respiratory motion blur and increased myocardium to blood pool contrast by 51.2% as compared to the ungated images. The proposed method also yielded an average of 11.2% increase in myocardium to defect contrast as compared to the ungated images in the phantom studies with perfusion defects. In the patient studies, EXG-SPECT significantly improved the myocardium to blood pool contrast (p < 0.005) by 24% on average as compared to the ungated images, and led to improved perfusion uniformity across segments on polar maps for normal patients. For a patient with defect, EXG-SPECT improved the defect contrast and definition. The dual respiratory–cardiac gating further reduced the blurring effect, increased the myocardium to blood pool contrast significantly by 36% (p < 0.05) compared to EXG-SPECT, and further improved defect characteristics and visualization of fine structures at the expense of increased

  11. LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Chen, Chun; Li, Dianfu; Miao, Changqing; Feng, Jianlin; Zhou, Yanli; Cao, Kejiang; Lloyd, Michael S; Chen, Ji

    2012-07-01

    The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2-3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA. Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4%) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI.

  12. Left ventricular ejection fraction determined by gated Tl-201 perfusion SPECT and quantitative software

    International Nuclear Information System (INIS)

    Hyun, In Young; Kim, Sung Eun; Seo, Jeong Kee; Hong, Eui Soo; Kwan, Jun; Park, Keum Soo; Lee, Woo Hyung

    2000-01-01

    We compared estimates of ejection fraction (EF) determined by gated Tl-201 perfusion SPECT (g-Tl-SPECT) with those by gated blood pool (GBP) scan. Eighteen subjects underwent g-Tl-SPECT and GBP scan. After reconstruction of g-Tl-SPECT, we measured EF with Cedars software. The comparison of the EF with g-Tl-SPECT and GBP scan was assessed by correlation analysis and Bland Altman plot. The estimates of EF were significantly different (p<0.05) with g-Tl-SPECT (40%±14%) and GBP scan (43%±14%). There was an excellent correlation of EF between g-Tl-SPECT and GBP scan (r=3D0.94, p<0.001). The mean difference of EF between GBP scan and g-Tl-SPECT was +3.2%. Ninety-five percent limits of agreement were ±9.8%. EF between g-Tl-SPECT and GBP scan were in poor agreement. The estimates of EF by g-Tl-SPECT was well correlated with those by GBP scan. However, EF of g-Tl-SPECT doesn't agree with EF of GBP scan. EF of g-Tl-SPECT can't be used interchangeably with EF of GBP scan.=20

  13. Diagnosis of severe and extensive coronary artery disease using gated myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Ihn Ho; Lee, Hyoung Woo; Won, Kyu Chang; Park, Jong Sun; Sin, Dog Gu; Kim, Young Jo; Shim, Bong Sub [College of Medicine, Yeungnam Univ., Taegu (Korea, Republic of)

    1999-07-01

    Left ventricular volumes and ejection fractions constitute important informations in the diagnosis and prognosis of cardiac disease. Aim of the study is to verify if the assessment of left ventricular function and perfusion together by gated myocardial perfusion SPECT is useful for diagnosing severe and extensive CAD. We examined 27 consecutive patients (17 males and 10 females, mean age : 60.1 years) who underwent two day rest/stress Tc-99m MIBI gated SPECT. Stress was done with adenosine. Post-stress gated SPECT was done at 1 hour after an injection of Tc-99m MIBI (740 MBq). All patients underwent coronary angiography after gated SPECT within 1 month. We divided them three groups with single vessel disease, double vessel disease and triple vessel disease or severe proximal left coronary artery stenosis. Extent of Defect (ED), Reversibility of Extent (RE), Severity of Defect (SD) and Severity of Reversibility (SR) were calculated by CEqual program. Post-stress LVEF, Rest LVEF, End-diastolic volume(EDV), End-systolic volume(ESV), Transient Ischemic Dilation (TID) of left ventricle (Post-stress EDV/Rest EDV) were calculated using gated SPECT quantification program. Left ventricle is divided with 18 segments and wall motion was scored (normal=0, mild hypokinesia =1, severe hypokinesia =2, akinesia =3 and dyskinesia =4), and then post-stress summed wall motion score was calculated. Post-stress summed wall motion score and post-stress LVEF were significant differences between three groups ( P <0.01). Extent of defect, Extent of reversibility, Severity of defect and severity of reversibility in Polar map were significant differences between three groups ( P <0.01). Post-stress Transient left ventricular dilatation and test LVEF were not significant differences between three groups ( P > 0.05). The gated SPECT pattern (low post-stress LVEF and post-stress summed wall motion score) add important diagnostic information over ungated perfusion data (high ED, ER and SR and

  14. Assessment of left ventricular function by thallium-201 quantitative gated cardiac SPECT

    International Nuclear Information System (INIS)

    Baba, Akira; Hano, Takuzo; Ohmori, Hisashi; Ibata, Masayo; Kawabe, Tetsuya; Kubo, Takashi; Kimura, Keizo; Nishio, Ichiro

    2002-01-01

    Present study was designed to evaluate the accuracy of the measurement of left ventricular volume by quantitative gated SPECT (QGS) software using 201 Tl and the effect of cutoff frequency of Butterworth prereconstruction filter on the calculation of volume. The RH-2 type cardiac phantom and 20 patients with ischemic heart disease were studied. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were calculated by the QGS software using the various frequency of Butterworth filter. These parameters were evaluated by Simpson's method using left ventriculography (LVG). The volume of the phantom calculated by QGS was under-estimated by 14%. In the clinical study, EDV and ESV measured by QGS were smaller than those obtained from LVG by 10%. When the cutoff frequency of Butterworth filter was 0.43 cycles/cm, the values measured by QGS were best correlated with those by LVG (EDV: r=0.80, p 201 Tl quantitative gated cardiac SPECT can estimate myocardial ischemia and left ventricular function simultaneously. (author)

  15. Global and regional left ventricular function: a comparison between gated SPECT, 2D echocardiography and multi-slice computed tomography

    International Nuclear Information System (INIS)

    Henneman, Maureen M.; Bax, Jeroen J.; Holman, Eduard R.; Schuijf, Joanne D.; Jukema, J.W.; Wall, Ernst E. van der; Stokkel, Marcel P.M.; Lamb, Hildo J.; Roos, Albert de

    2006-01-01

    Global and regional left ventricular (LV) function are important indicators of the cardiac status in patients with coronary artery disease (CAD). Therapy and prognosis are to a large extent dependent on LV function. Multi-slice computed tomography (MSCT) has already earned its place as an imaging modality for non-invasive assessment of the coronary arteries, but since retrospective gating to the patient's ECG is performed, information on LV function can be derived. In 49 patients with known or suspected CAD, coronary angiography with MSCT imaging was performed, in addition to gated SPECT and 2D echocardiography. LV end-diastolic and LV end-systolic volumes and LV ejection fraction were analysed with dedicated software (CMR Analytical Software System, Medis, Leiden, The Netherlands for MSCT; gated SPECT by QGS, Cedars-Sinai Medical Center, Los Angeles, CA, USA), and by the biplane Simpson's rule for 2D echocardiography. Regional wall motion was evaluated according to a 17-segment model and a three-point score system. Correlations were fairly good between gated SPECT and MSCT (LVEDV: r=0.65; LVESV: r=0.63; LVEF: r=0.60), and excellent between 2D echocardiography and MSCT (LVEDV: r=0.92; LVESV: r=0.93; LVEF: r=0.80). Agreement for regional wall motion was 95% (κ=0.66) between gated SPECT and MSCT, and 96% (κ=0.73) between 2D echocardiography and MSCT. Global and regional LV function and LV volumes can be adequately assessed with MSCT. Correlations with 2D echocardiography are stronger than with gated SPECT. (orig.)

  16. Impact of attenuation correction and gated acquisition in SPECT myocardial perfusion imaging: results of the multicentre SPAG (SPECT Attenuation Correction vs Gated) study

    International Nuclear Information System (INIS)

    Genovesi, Dario; Giorgetti, Assuero; Gimelli, Alessia; Kusch, Annette; D'Aragona Tagliavia, Irene; Casagranda, Mirta; Marzullo, Paolo; Cannizzaro, Giorgio; Giubbini, Raffaele; Bertagna, Francesco; Fagioli, Giorgio; Rossi, Massimiliano; Romeo, Annadina; Bertolaccini, Pietro; Bonini, Rita

    2011-01-01

    In clinical myocardial single photon emission computed tomography (SPECT), attenuation artefacts may cause a loss of specificity in the identification of diseased vessels that can be corrected by means of gated SPECT (GSPECT) acquisition or CT attenuation correction (AC). The purpose of this multicentre study was to assess the impact of GSPECT and AC on the diagnostic performance of myocardial scintigraphy, according to patient's sex, body mass index (BMI) and site of coronary artery disease (CAD). We studied a group of 104 patients who underwent coronary angiography within 1 month before or after the SPECT study. Patients with a BMI > 27 were considered ''overweight''. Attenuation-corrected and standard GSPECT early images were randomly interpreted by three readers blinded to the clinical data. In the whole group, GSPECT and AC showed a diagnostic accuracy of 86.5% (sensitivity 82%, specificity 93%) and 77% (sensitivity 75.4%, specificity 81.4%), respectively (p < 0.05). In women, when anterior ischaemia was matched with CAD, AC failed to show any increase in specificity (AC 63.6% vs GSPECT 63.6%) with evident loss of sensitivity (AC 72.7% vs GSPECT 90.9%). AC significantly improved SPECT specificity in the identification of right CAD in overweight men (AC 100% vs GSPECT 66.7%, p <0.05). AC improved specificity in the evaluation of right CAD in overweight men. In the other evaluable subgroups specificity was not significantly affected while sensitivity was frequently reduced. (orig.)

  17. Impact of attenuation correction and gated acquisition in SPECT myocardial perfusion imaging: results of the multicentre SPAG (SPECT Attenuation Correction vs Gated) study

    Energy Technology Data Exchange (ETDEWEB)

    Genovesi, Dario; Giorgetti, Assuero; Gimelli, Alessia; Kusch, Annette; D' Aragona Tagliavia, Irene; Casagranda, Mirta; Marzullo, Paolo [Fondazione CNR-Regione Toscana ' ' G. Monasterio' ' , Nuclear Medicine, Pisa (Italy); Cannizzaro, Giorgio [A.O.V. Cervello, Nuclear Medicine, Palermo (Italy); Giubbini, Raffaele; Bertagna, Francesco [Spedali Civili, Nuclear Medicine, Brescia (Italy); Fagioli, Giorgio; Rossi, Massimiliano; Romeo, Annadina [Ospedale Maggiore, Nuclear Medicine, Bologna (Italy); Bertolaccini, Pietro; Bonini, Rita [Ospedale SS Giacomo e Cristoforo, Nuclear Medicine, Massa (Italy)

    2011-10-15

    In clinical myocardial single photon emission computed tomography (SPECT), attenuation artefacts may cause a loss of specificity in the identification of diseased vessels that can be corrected by means of gated SPECT (GSPECT) acquisition or CT attenuation correction (AC). The purpose of this multicentre study was to assess the impact of GSPECT and AC on the diagnostic performance of myocardial scintigraphy, according to patient's sex, body mass index (BMI) and site of coronary artery disease (CAD). We studied a group of 104 patients who underwent coronary angiography within 1 month before or after the SPECT study. Patients with a BMI > 27 were considered ''overweight''. Attenuation-corrected and standard GSPECT early images were randomly interpreted by three readers blinded to the clinical data. In the whole group, GSPECT and AC showed a diagnostic accuracy of 86.5% (sensitivity 82%, specificity 93%) and 77% (sensitivity 75.4%, specificity 81.4%), respectively (p < 0.05). In women, when anterior ischaemia was matched with CAD, AC failed to show any increase in specificity (AC 63.6% vs GSPECT 63.6%) with evident loss of sensitivity (AC 72.7% vs GSPECT 90.9%). AC significantly improved SPECT specificity in the identification of right CAD in overweight men (AC 100% vs GSPECT 66.7%, p <0.05). AC improved specificity in the evaluation of right CAD in overweight men. In the other evaluable subgroups specificity was not significantly affected while sensitivity was frequently reduced. (orig.)

  18. Development of 4D mathematical observer models for the task-based evaluation of gated myocardial perfusion SPECT

    Science.gov (United States)

    Lee, Taek-Soo; Frey, Eric C.; Tsui, Benjamin M. W.

    2015-04-01

    performance of human observers in detecting regional motion defects in 4D gated MP SPECT images. The result supports the use of the observer model in the optimization and evaluation of 4D image reconstruction and compensation methods for improving the detection of motion abnormalities in 4D gated MP SPECT images.

  19. Development of 4D mathematical observer models for the task-based evaluation of gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Lee, Taek-Soo; Frey, Eric C; Tsui, Benjamin M W

    2015-01-01

    performance of human observers in detecting regional motion defects in 4D gated MP SPECT images. The result supports the use of the observer model in the optimization and evaluation of 4D image reconstruction and compensation methods for improving the detection of motion abnormalities in 4D gated MP SPECT images. (paper)

  20. The additive prognostic value of perfusion and functional data assessed by quantitative gated SPECT in women

    NARCIS (Netherlands)

    Y.G.C.J. America (Yves); J.J. Bax (Jeroen); H. Boersma (Eric); M. Stokkel (Marcel); E.E. van der Wall (Ernst)

    2009-01-01

    textabstractBackground: The aim of this study was to assess the prognostic value of technetium-99m tetrofosmin gated SPECT imaging in women using quantitative gated single photon emission computed tomography (SPECT) imaging. Methods: We followed 453 consecutive female patients. Average follow-up was

  1. Comparison of myocardial function between post-menopausal and pre-menopausal women: evaluation by gated myocardial SPECT

    International Nuclear Information System (INIS)

    Hwang, K. H.; Choa, Won Sick; Yoon, Min Ki

    2005-01-01

    In addition to inhibiting coronary atherosclerosis, estrogen is expected to have protective effects on cardiac myocytes. We investigated the difference in myocardial functional parameters evaluated by gated myocardial SPECT after adenosine-stress between post-menopausal and pre-menopausal healthy women. This study included 22 healthy post-menopausal women (mean age: 53.0 yr) and 20 pre-menopausal women (mean age: 43.0 yr) who performed Tc-99m tetrofosmin gated myocardial SPECT after adenosine-stress. Measured hemodynamic parameters, EDV, ESV, stroke volume, EF, cardiac output and cardiac index were compared between the two groups. For comparison, similar-aged two male groups with matched numbers were also studied. There was no significant difference in hemodynamic parameters. EDV, ESV, stroke volume, EF, or cardiac output between the post-menopausal and pre-menopausal women. However, post-menopausal women have a smaller cardiac index (mean: 1.95 L/min/m2 vs 2.20 L/min/m2; p=0.045) and adenosine-induced HR increase (mean : 80.5/min vs 89.7/min ; p=0.03), compared to the pre-menopausal women. On the contrary, the two male groups of the same age range and numbers with the women groups showed no significant difference in any myocardial parameters. These results suggest that menopause may be correlated with reduced increase in cardiac index and HR increase after adenosine-stress

  2. Comparison of myocardial function between post-menopausal and pre-menopausal women: evaluation by gated myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, K. H.; Choa, Won Sick; Yoon, Min Ki [Gachon Medical School, Gil Hospital, Incheon (Korea, Republic of)

    2005-07-01

    In addition to inhibiting coronary atherosclerosis, estrogen is expected to have protective effects on cardiac myocytes. We investigated the difference in myocardial functional parameters evaluated by gated myocardial SPECT after adenosine-stress between post-menopausal and pre-menopausal healthy women. This study included 22 healthy post-menopausal women (mean age: 53.0 yr) and 20 pre-menopausal women (mean age: 43.0 yr) who performed Tc-99m tetrofosmin gated myocardial SPECT after adenosine-stress. Measured hemodynamic parameters, EDV, ESV, stroke volume, EF, cardiac output and cardiac index were compared between the two groups. For comparison, similar-aged two male groups with matched numbers were also studied. There was no significant difference in hemodynamic parameters. EDV, ESV, stroke volume, EF, or cardiac output between the post-menopausal and pre-menopausal women. However, post-menopausal women have a smaller cardiac index (mean: 1.95 L/min/m2 vs 2.20 L/min/m2; p=0.045) and adenosine-induced HR increase (mean : 80.5/min vs 89.7/min ; p=0.03), compared to the pre-menopausal women. On the contrary, the two male groups of the same age range and numbers with the women groups showed no significant difference in any myocardial parameters. These results suggest that menopause may be correlated with reduced increase in cardiac index and HR increase after adenosine-stress.

  3. A priori motion models for four-dimensional reconstruction in gated cardiac SPECT

    International Nuclear Information System (INIS)

    Lalush, D.S.; Tsui, B.M.W.; Cui, Lin

    1996-01-01

    We investigate the benefit of incorporating a priori assumptions about cardiac motion in a fully four-dimensional (4D) reconstruction algorithm for gated cardiac SPECT. Previous work has shown that non-motion-specific 4D Gibbs priors enforcing smoothing in time and space can control noise while preserving resolution. In this paper, we evaluate methods for incorporating known heart motion in the Gibbs prior model. The new model is derived by assigning motion vectors to each 4D voxel, defining the movement of that volume of activity into the neighboring time frames. Weights for the Gibbs cliques are computed based on these open-quotes most likelyclose quotes motion vectors. To evaluate, we employ the mathematical cardiac-torso (MCAT) phantom with a new dynamic heart model that simulates the beating and twisting motion of the heart. Sixteen realistically-simulated gated datasets were generated, with noise simulated to emulate a real Tl-201 gated SPECT study. Reconstructions were performed using several different reconstruction algorithms, all modeling nonuniform attenuation and three-dimensional detector response. These include ML-EM with 4D filtering, 4D MAP-EM without prior motion assumption, and 4D MAP-EM with prior motion assumptions. The prior motion assumptions included both the correct motion model and incorrect models. Results show that reconstructions using the 4D prior model can smooth noise and preserve time-domain resolution more effectively than 4D linear filters. We conclude that modeling of motion in 4D reconstruction algorithms can be a powerful tool for smoothing noise and preserving temporal resolution in gated cardiac studies

  4. Assessment of left ventricular function by thallium-201 quantitative gated cardiac SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Baba, Akira; Hano, Takuzo; Ohmori, Hisashi; Ibata, Masayo; Kawabe, Tetsuya; Kubo, Takashi; Kimura, Keizo; Nishio, Ichiro [Wakayama Medical Coll. (Japan)

    2002-02-01

    Present study was designed to evaluate the accuracy of the measurement of left ventricular volume by quantitative gated SPECT (QGS) software using {sup 201}Tl and the effect of cutoff frequency of Butterworth prereconstruction filter on the calculation of volume. The RH-2 type cardiac phantom and 20 patients with ischemic heart disease were studied. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were calculated by the QGS software using the various frequency of Butterworth filter. These parameters were evaluated by Simpson's method using left ventriculography (LVG). The volume of the phantom calculated by QGS was under-estimated by 14%. In the clinical study, EDV and ESV measured by QGS were smaller than those obtained from LVG by 10%. When the cutoff frequency of Butterworth filter was 0.43 cycles/cm, the values measured by QGS were best correlated with those by LVG (EDV: r=0.80, p<0.001; ESV: r=0.86, p<0.001; EF: r=0.80, p<0.001). These data suggest that {sup 201}Tl quantitative gated cardiac SPECT can estimate myocardial ischemia and left ventricular function simultaneously. (author)

  5. Gated spect myocardial perfusion scintigraphy for identifying septal perfusion artifacts in left bundle branch block

    International Nuclear Information System (INIS)

    Afzal, M.S.; Imran, M.B.; Akhtar, M.S.; Muhammand, K.; Nadeem, A.; Aslam, N.; Khurshid, S.J.; Farooq, U.I.; Sohaib, M.

    2006-01-01

    To determine the role of gated Single Photon Emission Computed Tomography (SPECT) for accurate assessment of myocardial perfusion scintigraphy (MPS) of patients with left bundle branch block (LBBB). MPS data of patients with LBBB was analyzed. Resting gated SPECT MPS was performed after an injection of 740 MBq 99mTc-MIBI in 10 normal and 25 subjects with LBBB (with low probability of coronary artery disease). Visual and quantitative analyses were done on non-gated (NG), end diastolic (ED), end systolic (ES) images. Calculations included septal to lateral wall ratio (SLR), myocardial thickening (MT=% increase in counts during systole) at end systolic phase and myocardial thickening at peak level (% peak MT). Septal hypoperfusion was noted in 19 (76%) patients on NG images and in only 1 (4%) patient on gated SPECT ED images. On NG images of LBBB group, SLR was lower than in controls (0.68 +- 0.07 vs. 0.87 +- 0.05, p<0.001). SLR of LBBB patients approached to that of control group in gated SPECT ED data (0.86 +- 0.06 vs 0.88 +- 0.06, p=ns). Myocardial thickening at ES for septum was markedly lower in LBBB group than in controls (21.83% +- 10.86 vs. 66.32% +- 20.15, p<0.001). (author)

  6. Reversible wall motion abnormality on adenosine stress/rest thallium-201 gated myocardial SPECT is an independent predictor of coronary artery disease

    International Nuclear Information System (INIS)

    Park, Eun Kyung; Lee, Won Woo; So, Young; Eo, Jae Seon; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun; Kim, Cheol Ho; Lee, Sang Woo

    2004-01-01

    As early as 10 minutes after adenosine stress, immediate post-stress wall motion (ipsWM) can be evaluated on adenosine stress/rest TI-201 gated SPECT (gSPECT). To widen application of TI-201 in gated SPECT, we investigated image quality, LV parameters (EF, EDV, and ESV) reproducibility, and diagnostic competency of gSPECT regarding ipsWM evaluation Myocardial perfusion and wall motion were evaluated by 5-point scoring system in 20-segment model. Image quality was assessed using weighted Kappa (Kw) for inter-and intra-observer agreements of wall motion scores (n=49). Reproducibility was examined through repeated acquisition (n=31). Diagnostic competency was evaluated versus coronary angiography (CAG) and multivariate logistic regression analysis was performed to identify significant predictors of coronary artery disease (CAD) among stress abnormal perfusion (SSSp), stress abnormal wall motion (SSSwm), and reversible abnormal wall motion (SDSwm) (n=60). Kw for ipsWM was significantly better than that for rest regarding inter- (0.717 vs 0.489) and intra-observer agreements (0.792 vs 0.688) (p<0.05). 2SD for ipsWM was smaller than that for rest at EF (8.6% vs 10.7%) and ESV (6.0ml vs 8.4ml). Sensitivities of SSSp, SSSwm, and SDSwm were 63.3% (19/30), 63.3% (19/30), and 43.3% (13/30) and specificities 83.3% (25/30), 83.3% (25/30), and 86.7% (26/30), respectively. By multivariate analysis, SSSp (p=0.013) and SDSwm (p=0.039) remained significant predictors. Additionally, SSSwm or SDSwm could find undetected CAD in 54.5% (6/11) of patients with normal perfusion. TI-201 can be successfully applied to gated SPECT for ipsWM evaluation. Moreover, reversible wall motion abnormality on gSPECT is an independent predictor of significant CAD

  7. Agreement of left ventricular ejection fraction and volumes between adenosine stress TL-201 gated SPECT and echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Pai, M. S. [College of Medicine, Univ. of Ewha, Seoul (Korea, Republic of); Moon, D. H.; Kim, H. M.; Yang, Y. J.; Kang, D. H. [Asan Medical Center, Seoul (Korea, Republic of)

    2003-07-01

    Electrocardiogram-gated TI-201 SPECT measurements of left ventricular ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV) have shown high correlation with conventional methods. However, how much these parameters measured by TI-201 gated SPECT differ from those by echocardiography has not been assessed. Adenosine stress (Ad-G) and redistribution TI-201 gated SPECT (Re-G) and resting echocardiography were conducted in 337 patients (184 male, 153 female). EDV, ESV and LVEF measured by QGS software were compared with the results by echocardiography. Patients with arrhythmia (atrial fibrillation or frequent premature contractions) or evidence of fixed or reversible perfusion defects on TI-201 SPECT were excluded. EF, EDV and ESV measured by Ad-G (63.3{+-}9.8,73.8{+-}30.2,29.1{+-}20.1) and Re-G (65.2{+-}11.6,69.1{+-}30.1,26.5{+-}20.3) correlated well with those by Echo (61.4{+-}7.9,78.3{+-}2.7, 30.7{+-} 17.5 ; r of Ad-G=0.547, 0.850, 0.827, p<0.001 ; r of Re-G=0.585, 0.838, 0.819, p<0.001). However the difference (mean, SD, SEE of Echo - gated SPECT) was statistically significant (EF: Ad-G=1.71, 8.92, 0.48, Re-G=3.59, 10.39, 0.56, p<0.001 ; EDV: Ad-G=4.75, 16.21, 0.88, Re-G=9.53, 16.77, 0.91, p<0.001 ; ESV: Ad-G=1.75, 11.35, 0.61, p<0.05, Re-G=4.29, 11.7, 0.63, p<0.001). Bland-Altman plots showed that the difference of EDV and ESV did not vary in any systematic way over the range of measurement, whereas the difference of EF increased with increasing average EF by Echo and gated-SPECT. The difference of EF, EDV, and ESV between Ad-G and Echo was significantly smaller than those between Re-G and Echo (p<0.001). Gated TI-201 SPECT underestimates EDV and ESV over a wide range of volume. As a result, EF by gated TI-201 SPECT is overestimated especially in patients with small LV volume. Ad-G is preferable to Re-G in assessing left ventricular ejection fraction and volume in place of Echo because of smaller bias.

  8. Comparison of automatic quantification software for the measurement of ventricular volume and ejection fraction in gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Van Staden, J.A.; Herbst, C.P.; Du Raan, H.; Lotter, M.G.; Otto, A.C.

    2004-01-01

    Full text: Introduction: Gated myocardial perfusion SPECT has been used to calculate left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV) and has correlated well with conventional methods. However, the comparative accuracy of and correlations across various types of gated SPECT software are not well understood. Materials and methods: Twelve patients participated in a radionuclide gated blood-pool (GBP) study in addition to undergoing 99m Tc-sestamibi gated SPECT. Three different software algorithms, Quantitative Gated SPECT (QGS) from Cedars-Sinai, MultiDim from Stanford University Medical School and GQUANT from Alfa Nuclear were used to compute LVEF and LVEDV. These software algorithms operate in 3-dimensional space, two dependent on surface detection and the other on statistical parameters. The LVEF as calculated from gated SPECT myocardial perfusion images were compared with LVEF calculated from the GBP studies in the same patients to assess accuracy of the three software algorithms. Results: The software success-rate was 92% (11/12 pts) for MultiDim and 100% for the QGS and GQUANT. Agreement between LVEF measured with MultiDim and QGS, MultiDim and GQUANT and QGS and GQUANT were excellent (LVEF-MuItidim 0.80 LVEF QGS +5.02, r = 0.93, LVEF GQUANT = 1.10 LVEF MuItidim -1.33, r 0.90 and LVEF GQUANT = 1.02 LVEF QGS -1.40, r = 0.96). The correlation coefficient for LVEF between gated SPECT and the GBP study was 0.95, 0.95 and 0.97, for MultiDim, GQUANT and QGS, respectively. Conclusion: All 3 software programs showed good correlation between LVEF for gated SPECT and the GBP study. Good agreement for LVEF was observed also between the three software algorithms. However, because each method has unique characteristics that depend on its specific algorithm and thus behaves differently in the various patients, the methods should not be used interchangeably. (author)

  9. Myocardial viability assessment with gated SPECT Tc-99m tetrofosmin % wall thickening. Comparison with F-18 FDG-PET

    International Nuclear Information System (INIS)

    Maruyama, Atsushi; Hasegawa, Shinji; Paul, A.K.; Xiuli, M.; Yoshioka, Jun; Maruyama, Kaoru; Hori, Masatsugu; Nishimura, Tsunehiko

    2002-01-01

    This study was designed to assess the value of gated SPECT Tc-99m-tetrofosmin (TF) wall thickening (WT) in addition to TF exercise (Ex)/rest myocardial SPECT, in comparison with F-18 fluorodeoxyglucose (FDG)-PET. The study population consisted of 33 patients with old myocardial infarction (27 men and 6 women; mean age, 62±8 years old). All patients underwent Ex/rest TF SPECT and glucose loading FDG-PET. Polar map images of Ex/rest TF were generated and divided into 24 segments for further analysis. We classified LV segments according to the exercise-rest perfusion scintigraphy. LV segments with less than 70% of the maximum TF activity on the exercise image were defined as stress-induced defects. Among these, the segments whose TF acitvity increased by 10% from exercise to rest images or exceeded 70% of the maximum uptake were defined as reversible (viable) defects. The remaining defects on the rest image were irreversible (non-viable) defect segments, and were considered for viability study on the basis of %WT. %WT was calculated according to the standard method: {(counts ES-counts ED)/ counts ED} x 100. A viable segment on gated SPECT was defined as a segment whose %WT exceeded the lower limit of the normal value (mean-SD). PET viability was defined as FDG uptake exceeding 50% of the maximum count. Among the 792 segments evaluated in the 33 patients studied, there were 689 PET viable segments. Of the 689 segments analyzed, 198 (29%) were identified as having defects on Ex images. Among these defects, 55 (8%) were reversible or partially reversible, as evidenced by rest images, and 143 (21%) were irreversible. Of the irreversible segments on Ex/rest images, 106 (15%) demonstrated no apparent WT by gated TF SPECT, whereas 37 (6%) segments with irreversible defects did have apparent WT. Overall, the sensitivity of Ex/rest TF perfusion imaging was 79%. Sensitivity was improved from 79% to 85% by combining %WT and perfusion data, but specificity was reduced from 70

  10. Normal value of functional parameters in gated myocardial perfusion SPECT in patients with low risk of coronary artery disease: emory cardiac tool box program

    Energy Technology Data Exchange (ETDEWEB)

    Kang, D. Y.; Kim, M. H.; Kim, Y. D.; Kim, D. K. [Donga University College of Medicine, Busan (Korea, Republic of)

    2002-07-01

    Absolute value of the functional data of gated myocardial perfusion SPECT is necessary to determine that individual patient is normal or not. Tc-99m MIBI gated myocardial perfusion SPECT was performed using emory cardiac tool box program. All patients (M:F=15:36, age 64{+-}10 yrs) showed normal myocardial perfusion. The patients with following characteristics were excluded; previous angina or MI, ECG change with Q wave or ST-T change, diabetes mellitus, hypercholesterolemia, typical chest pain and hypertension. In all patients, myocardial mass is 117{+-}23 g in stress gated SPECT, 106{+-}22 g in stress ungated SPECT and 102{+-}21 g in rest ungated SPECT. EDV is 90{+-}28 ml, ESV 26{+-}20 ml, SV 66{+-}21 ml, EF 73{+-}10 % and TID 1.06{+-}0.14. Myocardial mass in rest ungated SPECT is significantly different between men and women (p=0.025). Myocardial mass is significantly different between stress gated SPECT and stress ungated SPECT (p=0.000), and between stress ungated SPECT and rest ungated SPECT (p=0.003). We provide normal value of functional parameters to determine the abnormality of individual patients in patients with low risk of coronary artery disease.

  11. Prognostic value of Tc-99m tetrofosmin myocardial perfusion gated SPECT in patients with diabetes mellitus and suspected coronary artery disease

    International Nuclear Information System (INIS)

    Santos, Marcia Maria Sales dos; Pantoja, Mauricio da Rocha; Cwajg, Eduardo

    2008-01-01

    Background: The cardiovascular disease is the main cause of death among diabetic patients, which makes it crucial to identify the individuals at higher risk of cardiovascular events. Objective: To evaluate the prognostic value of scintigraphy with gated single photon emission computed tomography (SPECT) in patients with diabetes mellitus (DM) and suspected coronary artery disease. Methods: Retrospective study with 232 diabetic patients submitted to scintigraphy with gated SPECT. Perfusion Gated SPECT (scores and number of altered segments) as well as ventricular function parameters (ejection fraction, left ventricle volume and contractility) were evaluated. Cardiac death, acute ischemic coronary syndrome, revascularization procedures or encephalic vascular accident were considered future cardiovascular events. The uni- and multivariate analyses were carried out by the multiple logistic regression model (p< 0.05). Results: At the univariate analysis, age (p=0.02), chest angina (p=0.01), insulin therapy (p=0.02), myocardial perfusion abnormalities (p<0.0001), the number of segments involved (p=0.0001), the perfusion scores (p=0.0001), the ejection fraction (p=0.004), the final systolic volume (p=0.03) and the finding of segmental alteration at the LV contractility (p<0.0001) were associated with future events at the univariate analysis. At the multivariate analysis, the male sex (p=0.007), age (p=0.03), angina (p=0.001), insulin therapy (p=0.007) and the SDS ≥ 3 (p=0.0001), and the number of altered segments ≥ 3 (p=0.0001) were predictors of cardiovascular events. Conclusion: The myocardial scintigraphy with gated SPECT adds independent information to the stratification of the risk of future cardiovascular events in patients with DM and suspected coronary artery disease. (author)

  12. Prognostic value of Tc-99m tetrofosmin myocardial perfusion gated SPECT in patients with diabetes mellitus and suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcia Maria Sales dos; Pantoja, Mauricio da Rocha; Cwajg, Eduardo [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil); CINTILAB, Rio de Janeiro, RJ (Brazil); E-mail: mmsales@oi.com.br

    2008-01-15

    Background: The cardiovascular disease is the main cause of death among diabetic patients, which makes it crucial to identify the individuals at higher risk of cardiovascular events. Objective: To evaluate the prognostic value of scintigraphy with gated single photon emission computed tomography (SPECT) in patients with diabetes mellitus (DM) and suspected coronary artery disease. Methods: Retrospective study with 232 diabetic patients submitted to scintigraphy with gated SPECT. Perfusion Gated SPECT (scores and number of altered segments) as well as ventricular function parameters (ejection fraction, left ventricle volume and contractility) were evaluated. Cardiac death, acute ischemic coronary syndrome, revascularization procedures or encephalic vascular accident were considered future cardiovascular events. The uni- and multivariate analyses were carried out by the multiple logistic regression model (p< 0.05). Results: At the univariate analysis, age (p=0.02), chest angina (p=0.01), insulin therapy (p=0.02), myocardial perfusion abnormalities (p<0.0001), the number of segments involved (p=0.0001), the perfusion scores (p=0.0001), the ejection fraction (p=0.004), the final systolic volume (p=0.03) and the finding of segmental alteration at the LV contractility (p<0.0001) were associated with future events at the univariate analysis. At the multivariate analysis, the male sex (p=0.007), age (p=0.03), angina (p=0.001), insulin therapy (p=0.007) and the SDS {>=} 3 (p=0.0001), and the number of altered segments {>=} 3 (p=0.0001) were predictors of cardiovascular events. Conclusion: The myocardial scintigraphy with gated SPECT adds independent information to the stratification of the risk of future cardiovascular events in patients with DM and suspected coronary artery disease. (author)

  13. Pulse wave as an alternate signal for data synchronization during gated myocardial perfusion SPECT imaging.

    Science.gov (United States)

    Lang, Otto; Trojanova, Helena; Balon, Helena R; Kunikova, Ivana; Bilwachs, Milos; Penicka, Martin; Kaminek, Milan; Myslivecek, Miroslav

    2011-09-01

    Proper identification of the cardiac cycle is essential for gated SPECT myocardial perfusion imaging. We have developed an alternate method of ECG for gating, that is, using the peripheral pulse wave (PW) as the triggering signal for gated SPECT acquisition. The aim of this study is to compare the use of this method of gating with the standard ECG trigger. We tested the PW triggering by comparing it with the ECG trigger. We evaluated 33 patients (25 males, 8 females), average age of 61 years (39-80) referred for stress myocardial perfusion imaging. Data from all patients were acquired twice and were processed by CEqual and QGS software. We compared the left ventricular ejection fraction (LVEF), end-diastolic and end-systolic volumes (EDV, ESV). Paired t test and Pearson correlation coefficient were used for comparison. The mean LVEF, EDV, and ESV calculated with the ECG trigger were 0.52, 120, and 64, respectively, those with the pulse-wave trigger were 0.48, 126, and 71, respectively. Mean paired difference for LVEF was -0.034 (P<0.001), for EDV 5.9 (P=0.012), and for ESV 7.9 (P<0.001). Pearson correlation coefficient for LVEF was 0.955, for EDV 0.987, and for ESV 0.991 (P<0.001 for all correlations). Triggering of gated-data acquisition by the PW is feasible. Quantitative parameters of cardiac function correlate highly with those obtained from the ECG trigger and the absolute differences are not clinically significant across a wide range of values.

  14. Comparison of Nitrate-augmented resting gated 99mTc-Sestamibi imaging with Low Dose Dobutamine SPECT for the detection of Myocardial Viability

    International Nuclear Information System (INIS)

    Parameswaran, R.V.; Dash, P.K.; Barooah, B.; Guruprasad, H.P.; Purantharan, N.

    2002-01-01

    Background: Dobutamine Echocardiography and Radionuclide imaging with Tl-201 and Technetium agents are two of the most established techniques available for the detection of viable myocardium. The purpose of this study was to evaluate the utility of Low dose Dobutamine gated Myocardial SPECT in identifying additional areas of dysfunctional, but viable myocardium when compared to nitrate-augmented rest gated SPECT with SestaMIBI. Materials and Methods: 20 patients (19 males and 1 female, with an age range of 40- 65 yrs and a mean of 52.75yrs) all with history of MI or severe LV dysfunction were included in this study. Patients with LBBB, recent revascularisation, arrhythmias etc were excluded from the study. A routine stress-rest study was initially performed on them with 99mTc-SestaMIBI and both the stress as well as resting studies was gated and the resting study was augmented with 10mg of sublingual nitrate. After the resting study was over, the patient was infused with Low dose Dobutamine(5μg/kg/min), at which time the gated acquisition was started and the infusion was continued till the acquisition got completed. In the perfusion study with SestaMIBI, all infarct segments which have uptake less than 50% as compared to the maximally perfused area was deemed non-viable Results: A 17-segment Myocardial model was used for both perfusion as well as quantification of wall motion and wall thickening. 110 akinetic/dyskinetic segments were taken up for analysis. 93 of these segments were non-viable and improvement in wall motion was seen in 17 segments (15.4%) in the nitrate-augmented SPECT. Dobutamine study showed improvement in totally in 27 segments (24.5%), 10 of which were additional segments which were non-viable in Nitrate SPECT study, apart from the 17 segments which showed improvement in the Nitrate study. In Dobutamine study, there was also improvement in wall thickening in 10 (10.7%) out of 93 segments which had showed less than 50% of MIBI uptake. Conclusion

  15. Reproducibility of non-invasive measurement for left ventricular contractility using gated myocardial SPECT

    International Nuclear Information System (INIS)

    Kim, Kyeon Min; Lee, Dong Soo; Kim, Yu Kyeong; Cheon, Gi Jeong; Kim, Seok Ki; Chung, June Key; Lee, Myung Chul

    2001-01-01

    We tried to establish the reproducibility of the measurement of maximal elastance (Emax) and to compare the degree of the reproducibility of two estimation methods: single pressure-volume loop method and parameter optimization method. In 47 patients (42 males and 5 females, 53 ± 10 years old) with suspected coronary artery disease (ejection fraction; 22-68%), gated Tc-99m MIBI myocardial SPECT and arterial tonometry were acquired, In 11 patients among these 47 patients, gated SPECT and tonometry were performed twice consecutively with patients in situ. Emax and void volume (Vo) were estimated using single pressure-volume loop method of Lee and parameter optimization method based on linear approximation of Yoshizawa. Correlation between the consecutive measurements by each method and correlation between the two estimation methods were compared. Reproducibility of Emax (r=0.96) and Vo (r=0.99) by single pressure-volume method was better than the reporducibility of Emax (r=0.89) and Vo (r=0.64) by parameter optimization method. Correlations of Emax and Vo were fair between the two methods. The correlation of Emax (r=0.77) was better thn that of Vo (r=0.65). Reproducibiity of Emax measurement by single pressure-volume loop method using gated myocardial SPECT and arterial tonometry was excellent. Reproducibility by parameter optimization method was also but was less than that achieved by single pressure-volume method

  16. Respiratory lung motion analysis using a nonlinear motion correction technique for respiratory-gated lung perfusion SPECT images

    International Nuclear Information System (INIS)

    Ue, Hidenori; Haneishi, Hideaki; Iwanaga, Hideyuki; Suga, Kazuyoshi

    2007-01-01

    This study evaluated the respiratory motion of lungs using a nonlinear motion correction technique for respiratory-gated single photon emission computed tomography (SPECT) images. The motion correction technique corrects the respiratory motion of the lungs nonlinearly between two-phase images obtained by respiratory-gated SPECT. The displacement vectors resulting from respiration can be computed at every location of the lungs. Respiratory lung motion analysis is carried out by calculating the mean value of the body axis component of the displacement vector in each of the 12 small regions into which the lungs were divided. In order to enable inter-patient comparison, the 12 mean values were normalized by the length of the lung region along the direction of the body axis. This method was applied to 25 Technetium (Tc)-99m-macroaggregated albumin (MAA) perfusion SPECT images, and motion analysis results were compared with the diagnostic results. It was confirmed that the respiratory lung motion reflects the ventilation function. A statistically significant difference in the amount of the respiratory lung motion was observed between the obstructive pulmonary diseases and other conditions, based on an unpaired Student's t test (P<0.0001). A difference in the motion between normal lungs and lungs with a ventilation obstruction was detected by the proposed method. This method is effective for evaluating obstructive pulmonary diseases such as pulmonary emphysema and diffuse panbronchiolitis. (author)

  17. Automated quantitative coronary computed tomography correlates of myocardial ischaemia on gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Graaf, Michiel A. de; Boogers, Mark J.; Veltman, Caroline E.; El-Naggar, Heba M.; Bax, Jeroen J.; Delgado, Victoria; Broersen, Alexander; Kitslaar, Pieter H.; Dijkstra, Jouke; Kroft, Lucia J.; Younis, Imad Al; Reiber, Johan H.; Scholte, Arthur J.

    2013-01-01

    Automated software tools have permitted more comprehensive, robust and reproducible quantification of coronary stenosis, plaque burden and plaque location of coronary computed tomography angiography (CTA) data. The association between these quantitative CTA (QCT) parameters and the presence of myocardial ischaemia has not been explored. The aim of the present investigation was to evaluate the association between QCT parameters of coronary artery lesions and the presence of myocardial ischaemia on gated myocardial perfusion single-photon emission CT (SPECT). Included in the study were 40 patients (mean age 58.2 ± 10.9 years, 27 men) with known or suspected coronary artery disease (CAD) who had undergone multidetector row CTA and gated myocardial perfusion SPECT within 6 months. From the CTA datasets, vessel-based and lesion-based visual analyses were performed. Consecutively, lesion-based QCT was performed to assess plaque length, plaque burden, percentage lumen area stenosis and remodelling index. Subsequently, the presence of myocardial ischaemia was assessed using the summed difference score (SDS ≥2) on gated myocardial perfusion SPECT. Myocardial ischaemia was seen in 25 patients (62.5 %) in 37 vascular territories. Quantitatively assessed significant stenosis and quantitatively assessed lesion length were independently associated with myocardial ischaemia (OR 7.72, 95 % CI 2.41-24.7, p 2 = 20.7) and lesion length (χ 2 = 26.0) to the clinical variables and the visual assessment (χ 2 = 5.9) had incremental value in the association with myocardial ischaemia. Coronary lesion length and quantitatively assessed significant stenosis were independently associated with myocardial ischaemia. Both quantitative parameters have incremental value over baseline variables and visually assessed significant stenosis. Potentially, QCT can refine assessment of CAD, which may be of potential use for identification of patients with myocardial ischaemia. (orig.)

  18. Is 16-frame really superior to 8-frame gated SPECT for the assessment of left ventricular volumes and ejection fraction? Comparison of two simultaneously acquired gated SPECT studies

    International Nuclear Information System (INIS)

    Montelatici, Giulia; Sciagra, Roberto; Passeri, Alessandro; Dona, Manjola; Pupi, Alberto

    2008-01-01

    Conflicting data exist about the difference between 8- and 16-frame gated single-photon emission computed tomography (SPECT) left ventricular volumes and ejection fraction (EF); moreover, the influence of framing on detection of stress-induced functional changes is unknown. In 133 patients, two separate gated SPECT studies, one with 8 and one with 16 frames, were simultaneously acquired during a single gantry orbit using dedicated software. In 33 of 133 patients, two additional studies (with 8 and 16 frames, respectively) were acquired using arrhythmia rejection. Left ventricular EF and volumes were calculated using the QGS software. Stress-induced ischemia was identified on summed perfusion images. Arrhythmia-rejection did not influence volumes and EF independently of framing rate. Using data without arrhythmia-rejection, there was a significant difference in volumes and EF between 8 and 16 frames both in resting and post-stress gated SPECT. However, the difference was small: 2.6% for resting and 2.8% for post-stress EF. Both using 8 and 16 frames, there were significantly larger volumes and lower EF in patients with than without stress-induced ischemia. A stress-induced decrease >5 EF units was observed in 26 of 133 patients using 8 and in 23 of 133 using 16 frames, respectively, with finding agreement in 19 patients. Comparing two simultaneously acquired studies, the use of 16 instead of 8 frames has minor and predictable influence on functional data. Furthermore, there are no differences in the detection of stress-induced functional changes. The advantage of 16 over 8 frames in the daily clinical practice appears questionable. (orig.)

  19. Normal LVEF measurements are significantly higher in females asassessed by post-stress resting Tc-99m sestamibi gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Kim, Jong Ho; Shin, Eak Kyun

    1999-01-01

    Volume-LVEF relationship is one of the most important factors of automatic EF quantification algorithm from gated myocardial perfusion SPECT(gMPS) (Germano et al. JNM, 1995). Gender difference whereby normal LVEF measurements are higher in females assessed by gMPS (Yao et al. JNM 1997). To validate true physiologic value of LVEF vs sampling or measured error, various parameters were evaluated statistically in both gender and age matched 200 subjects (mean age= 58.41±15.01) with normal LVEF more than 50%, and a low likelihood of coronary artery disease. Correlation between LVEDVi(ml/m2) and LVEF was highly significant (r=-0.62, p<0.0001) with similar correlations noted in both male (r=-0.45, p<0.0001) and female (r=-0.67, p<0.0001) subgroups. By multivariate analysis, LV volume and stroke volume was the most significant factor influencing LVEF in male and female, respectively. In conclusion, there is a significant negative correlation between LV volume and LVEF as measured by Tc-99m gated SPECT. Higher normal LVEF value should be applied to females as assessed by post-stress resting Tc-99m Sestamibi gated myocardial perfusion SPECT

  20. Left ventricular functional parameters by gated SPECT myocardial perfusion imaging in a Latin American country.

    Science.gov (United States)

    Kapitan, Miguel; Beltran, Alvaro; Beretta, Mario; Mut, Fernando

    2018-04-01

    There is paucity of data on left ventricular (LV) functional parameters using gated SPECT myocardial perfusion imaging (MPI) from the Latin American region. This study provides detailed information in low-risk patients both at rest and during exercise. We studied 90 patients (50 men) with a very low likelihood of coronary artery disease. Gated-SPECT MPI was performed with Tc-99m MIBI using a 2-day protocol, with 16 frames/R-R cycle. The LV ejection fraction and volumes were not different between the rest and post-stress images. LVEF was 68 ± 7% post-stress and 70 ± 7% at rest in women, and 62 ± 7% and 63 ± 7%, respectively, in men (P = .19, .26). LV volumes were larger in men than women (P stress. Transient ischemic dilatation was similar, with upper limits of 1.20 and 1.19 in women and men, respectively (P = NS). These data could prove helpful for the interpretation of gated SPECT MPI data in Latin America using identical protocol as used in this study.

  1. Comparison of Gated SPECT Myocardial Perfusion Imaging with Echocardiography for the Measurement of Left Ventricular Volumes and Ejection Fraction in Patients With Severe Heart Failure

    Science.gov (United States)

    Shojaeifard, Maryam; Ghaedian, Tahereh; Yaghoobi, Nahid; Malek, Hadi; Firoozabadi, Hasan; Bitarafan-Rajabi, Ahmad; Haghjoo, Majid; Amin, Ahmad; Azizian, Nasrin; Rastgou, Feridoon

    2015-01-01

    Background: Gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is known as a feasible tool for the measurement of left ventricular ejection fraction (EF) and volumes, which are of great importance in the management and follow-up of patients with coronary artery diseases. However, considering the technical shortcomings of SPECT in the presence of perfusion defect, the accuracy of this method in heart failure patients is still controversial. Objectives: The aim of the present study was to compare the results from gated SPECT MPI with those from echocardiography in heart failure patients to compare echocardiographically-derived left ventricular dimension and function data to those from gated SPECT MPI in heart failure patients. Patients and Methods: Forty-one patients with severely reduced left ventricular systolic function (EF ≤ 35%) who were referred for gated SPECT MPI were prospectively enrolled. Quantification of EF, end-diastolic volume (EDV), and end-systolic volume (ESV) was performed by using quantitative gated spect (QGS) (QGS, version 0.4, May 2009) and emory cardiac toolbox (ECTb) (ECTb, revision 1.0, copyright 2007) software packages. EF, EDV, and ESV were also measured with two-dimensional echocardiography within 3 days after MPI. Results: A good correlation was found between echocardiographically-derived EF, EDV, and ESV and the values derived using QGS (r = 0.67, r = 0.78, and r = 0.80 for EF, EDV, and ESV, respectively; P echocardiography. ECTb-derived EDV was also significantly higher than the EDV measured with echocardiography and QGS. The highest correlation between echocardiography and gated SPECT MPI was found for mean values of ESV different. Conclusions: Gated SPECT MPI has a good correlation with echocardiography for the measurement of left ventricular EF, EDV, and ESV in patients with severe heart failure. However, the absolute values of these functional parameters from echocardiography and gated

  2. [Influence of the professional experience of the clinical cardiologist on the adequacy of the clinical indications of myocardial perfusion gated-SPECT].

    Science.gov (United States)

    Dominguez-Rodriguez, Alberto; Avanzas, Pablo; Abreu-Gonzalez, Pedro; Sanchez Grande-Flecha, Alejandro; García-Baute, María Del Carmen; Gómez, María Ángeles

    2017-11-30

    During cardiology training, the cardiology fellow has to be trained in all things related to the indication, interpretation, and performing of nuclear cardiology studies using single photon emission computed tomography (SPECT). The aim of the present study was to analyse the relationship between the adequacy of indications of myocardial perfusion gated-SPECT and the years of experience since the completion of cardiology training. A descriptive, retrospective analysis was performed on a single-centre register, in which the indications (adequate or inadequate use) were recorded according to myocardial perfusion gated-SPECT guidelines, prescribed by cardiologists of a university hospital. A total of 950 gated-SPECT tests were analysed according to the appropriate or inadequate indication. The sample of study was distributed in quartiles (years) since the cardiologist finished the residency. Cardiologists with less than 10 years of clinical experience reported a higher proportion of gated-SPECT tests compared to the more experienced cardiologists (87.6 vs. 9.3%, P<.001). After adjusting for age, gender, and cardiovascular risk factors, the multivariate analysis showed that, for each year of experience after completion of cardiology training, the probability of adequately indicating the test (OR: 1.33, 95% CI: 1.29-1.38, P<.001) was statistically significant. The professional experience of the clinical cardiologist is the most important factor to perform an appropriate indication of gated-SPECT myocardial perfusion. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  3. Automated quantitative coronary computed tomography correlates of myocardial ischaemia on gated myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Michiel A. de; Boogers, Mark J.; Veltman, Caroline E. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); The Interuniversity Cardiology Institute of The Netherlands, Utrecht (Netherlands); El-Naggar, Heba M.; Bax, Jeroen J.; Delgado, Victoria [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Broersen, Alexander; Kitslaar, Pieter H.; Dijkstra, Jouke [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Kroft, Lucia J. [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Younis, Imad Al [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands); Reiber, Johan H. [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Medis medical imaging systems B.V., Leiden (Netherlands); Scholte, Arthur J. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands)

    2013-08-15

    Automated software tools have permitted more comprehensive, robust and reproducible quantification of coronary stenosis, plaque burden and plaque location of coronary computed tomography angiography (CTA) data. The association between these quantitative CTA (QCT) parameters and the presence of myocardial ischaemia has not been explored. The aim of the present investigation was to evaluate the association between QCT parameters of coronary artery lesions and the presence of myocardial ischaemia on gated myocardial perfusion single-photon emission CT (SPECT). Included in the study were 40 patients (mean age 58.2 {+-} 10.9 years, 27 men) with known or suspected coronary artery disease (CAD) who had undergone multidetector row CTA and gated myocardial perfusion SPECT within 6 months. From the CTA datasets, vessel-based and lesion-based visual analyses were performed. Consecutively, lesion-based QCT was performed to assess plaque length, plaque burden, percentage lumen area stenosis and remodelling index. Subsequently, the presence of myocardial ischaemia was assessed using the summed difference score (SDS {>=}2) on gated myocardial perfusion SPECT. Myocardial ischaemia was seen in 25 patients (62.5 %) in 37 vascular territories. Quantitatively assessed significant stenosis and quantitatively assessed lesion length were independently associated with myocardial ischaemia (OR 7.72, 95 % CI 2.41-24.7, p < 0.001, and OR 1.07, 95 % CI 1.00-1.45, p = 0.032, respectively) after correcting for clinical variables and visually assessed significant stenosis. The addition of quantitatively assessed significant stenosis ({chi} {sup 2} = 20.7) and lesion length ({chi} {sup 2} = 26.0) to the clinical variables and the visual assessment ({chi} {sup 2} = 5.9) had incremental value in the association with myocardial ischaemia. Coronary lesion length and quantitatively assessed significant stenosis were independently associated with myocardial ischaemia. Both quantitative parameters have

  4. Serial assessment of left ventricular function in various patient groups with Tl-201 gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Wei Lingge; Kadoya, Masumi; Momose, Mitsuhiro; Kurozumi, Masahiro; Matsushita, Tsuyoshi; Yamada, Akira

    2007-01-01

    The present study was performed to assess stress-related left ventricular (LV) function variations in various patient groups and to determine if they were affected by sex or the type of stress experienced. We used thallium (Tl)-201 gated myocardial perfusion single-photon emission computed tomography (SPECT) for the analysis. A total of 270 patients were examined by electrocardiography-gated myocardial perfusion SPECT imaging to assess LV function. After injection of Tl-201 at a dose of 111 MBq at peak stress, SPECT scans were acquired at 10 min (after stress) and 3 h (rest) after injection on a three-headed camera. In the normal perfusion group, the mean LV ejection fraction (LVEF) was significantly higher, and both the end-diastolic volume index (EDVI) and end-systolic volume index (ESVI) were significantly lower in women than in men (P<0.05). Poststress stunning occurred in 29 of 98 patients (30.0%) in the ischemia group and in 42 of 90 patients (46.7%) in the fixed group. There was a significant difference in poststress stunning between bicycle ergometer stress and dipyridamole stress (P<0.05). In patients with normal perfusion, LVEF, EDVI, and ESVI determined by gated Tl-201 SPECT should be corrected for sex. In addition, the influence of the type of stress should be considered when assessing stress-related LV function variations. (author)

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

    International Nuclear Information System (INIS)

    Li Zicheng; Chen Xiaoming; Xu Hao

    2006-01-01

    Objective: To study the prognostic value of gated 201 Tl 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 201 Tl 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 (P 201 Tl 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)

  6. Physics process level discrimination of detections for GATE: assessment of contamination in SPECT and spurious activity in PET.

    Science.gov (United States)

    De Beenhouwer, Jan; Staelens, Steven; Vandenberghe, Stefaan; Verhaeghe, Jeroen; Van Holen, Roel; Rault, Erwann; Lemahieu, Ignace

    2009-04-01

    The GEANT4 application for tomographic emission (GATE) is one of the most detailed Monte Carlo simulation tools for SPECT and PET. It allows for realistic phantoms, complex decay schemes, and a large variety of detector geometries. However, only a fraction of the information in each particle history is available for postprocessing. In order to extend the analysis capabilities of GATE, a flexible framework was developed. This framework allows all detected events to be subdivided according to their type: In PET, true coincidences from others, and in SPECT, geometrically collimated photons from others. The framework of the authors can be applied to any isotope, phantom, and detector geometry available in GATE. It is designed to enhance the usability of GATE for the study of contamination and for the investigation of the properties of current and future prototype detectors. The authors apply the framework to a case study of Bexxar, first assuming labeling with 124I, then with 131I. It is shown that with 124I PET, results with an optimized window improve upon those with the standard window but achieve less than half of the ideal improvement. Nevertheless, 124I PET shows improved resolution compared to 131I SPECT with triple-energy-window scatter correction.

  7. Improved accuracy in estimation of left ventricular function parameters from QGS software with Tc-99m tetrofosmin gated-SPECT. A multivariate analysis

    International Nuclear Information System (INIS)

    Okizaki, Atsutaka; Shuke, Noriyuki; Sato, Junichi; Ishikawa, Yukio; Yamamoto, Wakako; Kikuchi, Kenjiro; Aburano, Tamio

    2003-01-01

    The purpose of this study was to verify whether the accuracy of left ventricular parameters related to left ventricular function from gated-SPECT improved or not, using multivariate analysis. Ninety-six patients with cardiovascular diseases were studied. Gated-SPECT with the quantitative gated SPECT (QGS) software and left ventriculography (LVG) were performed to obtain left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV). Then, multivariate analyses were performed to determine empirical formulas for predicting these parameters. The calculated values of left ventricular parameters were compared with those obtained directly from the QGS software and LVG. Multivariate analyses were able to improve accuracy in estimation of LVEF, EDV and ESV. Statistically significant improvement was seen in LVEF (from r=0.6965 to r=0.8093, p<0.05). Although not statistically significant, improvements in correlation coefficients were seen in EDV (from r=0.7199 to r=0.7595, p=0.2750) and ESV (from r=0.5694 to r=0.5871, p=0.4281). The empirical equations with multivariate analysis improved the accuracy in estimating LVEF from gated-SPECT with the QGS software. (author)

  8. Limited diagnostic accuracy of gated myocardial perfusion SPECT for wall motion analysis in patients with asymmetric septal hypertrophy

    International Nuclear Information System (INIS)

    Seo, J.H.; Ahn, B.C.; Bae, J.H.; Jeong, S.Y.; Lee, J.; Lee, K.B.

    2004-01-01

    Objective: Although gated SPECT(G-SPECT) using Tc-99m MIBI is well-known diagnostic modality in the evaluation of myocardial perfusion and wall motion analysis, there were limited reports for subjects with asymmetric septal hypertrophy (ASH). This study was performed to evaluate the clinical usefulness of G-SPECT for assessments of myocardial perfusion and wall motion analysis in patients with ASH on 2D-echocardiography(Echo). Methods: Thirty patients (male 18, 59 12 years) with ASH on Echo (septal wall thickness 13 mm and 1.3 times as thick as that of posterior wall) underwent Tc-99m MIBI G-SPECT. Two studies were performed within one month. No patient had experienced any significant cardiac event, nor had changed medical and surgical therapy during the studies. Functional parameters of the left ventricle were acquired with QGS software(AutoQUANTTM). Three experts performed visual interpretation for the presence of septal thickening and perfusion abnormalities on G-SPECT and two experienced cardiologists measured dimension, thickness and wall motion of the left ventricle on Echo. Results: Mean septum thickness measured by Echo was 1.90 0.50 cm, and the septum/posterior wall thickness ratio was 1.85 0.51. On visual SPECT analysis, 14 patients (46.7%) were interpreted as with thickened septum and 17 patients (57%) as with abnormal perfusion. All 3 patients who underwent coronary angiography showed significant luminal stenosis and also had perfusion abnormalities on SPECT. On Echo, only one patient showed septal hypokinesia, who showed anteroseptal infarction on SPECT, and the others showed normal septal wall motion. But 13 patients (54%) among 24 patients showed septal hypokinesia on G-SPECT. Patients with thickened septum on SPECT had thicker septum (2.3 vs 1.6 cm) and higher septum/posterior wall thickness ratio (2.2 vs 1.6) on Echo, compared with patients without septal thickening on SPECT. Conclusions: Although G-SPECT could proffer diagnostic accuracy for

  9. Prognostic study of risk stratification among Japanese patients with ischemic heart disease using gated myocardial perfusion SPECT: J-ACCESS study

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Nakajima, Kenichi; Kusuoka, Hideo; Yamashina, Akira; Nishimura, Shigeyuki

    2008-01-01

    Although the prognostic value of myocardial perfusion imaging using gated single photon emission computed tomography (SPECT) for predicting major cardiac events has been evaluated, little is known about the relevance of this procedure to the Japanese population. A total of 4,031 consecutive Japanese patients with suspected or confirmed ischemic heart diseases were registered at 117 hospitals in the Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT investigation. Gated stress/rest myocardial perfusion SPECT was performed and the patients were followed up for 3 years. Segmental perfusion scores and quantitative gated SPECT results were calculated. Major cardiac events were defined as cardiac death, nonfatal myocardial infarction, and severe heart failure. During the 3-year follow-up, cardiac death (n = 57) and nonfatal myocardial infarction (n = 39) occurred in 96 patients (2.4%/3 years) when hard events were the endpoints. When severe heart failure was included as an endpoint, major cardiac events that developed in 175 patients (4.3%/3 years) comprised cardiac death (n = 45), nonfatal myocardial infarction (n = 37), and severe heart failure (n = 93). Normal and severely abnormal summed stress score values were associated with low (2.31%/3 years) and high (9.21%/3 years) rates of major cardiac events, respectively. Rates of major cardiac events were significantly higher in patients with ejection fraction (EF) <45% than in those with EF 45% or higher (16.55 vs 2.94%/3 years; P < 0.001). The incidence of major cardiac events within 3 years was also significantly higher among patients with high end-systolic volumes. The major event rates were similar among nondiabetic patients with and diabetic patients without prior myocardial infarction at 5.06% and 5.73%/3 years, respectively. Cardiac event rates were significantly lower in the Japanese than in the USA and European populations. However, large myocardial perfusion defects and

  10. Effect of streptozotocin-induced diabetes on left ventricular function in adult rats: an in vivo Pinhole Gated SPECT study

    Directory of Open Access Journals (Sweden)

    Weytjens Caroline

    2007-10-01

    Full Text Available Abstract Background Recent studies have suggested that diabetes mellitus (DM may cause left ventricular (LV dysfunction directly resulting in increased susceptibility to heart failure. Using pinhole collimators and advances in data processing, gated SPECT was recently adapted to image the rat heart. The present study was aimed to assess this new imaging technique for quantifying LV function and remodeling from the Streptozotocin (STZ rat model compared to controls. Methods Twenty one rats were randomly assigned to control or diabetic group. Six months after the induction of diabetes by STZ, Pinhole 99 m Tc-sestamibi gated SPECT was performed for determining rat LV volumes and function. Post-mortem histopathologic analysis was performed to evaluate the determinant of LV remodeling in this model. Results After six months, the normalized to body weight LV End-systolic volume was significantly different in diabetic rats compared to controls (0.46 ± 0.02 vs 0.33 ± 0.03 μL/g; p = 0.01. The normalized LV End-diastolic volume was also different in both groups (1.51 ± 0.03 vs 0.88 ± 0.05 μL/g; p = 0.001 and the normalized stroke volume was significantly higher in STZ-rats (1.05 ± 0.02 vs 0.54 ± 0.06 μL/g; p = 0.001. The muscular fibers were thinner at histology in the diabetic rats (0.44 ± 0.07 vs 0.32 ± 0.06 AU; p = 0.01. Conclusion Pinhole 99 m Tc-sestamibi gated SPECT can successfully be applied for the evaluation of cardiac function and remodeling in STZ-induced diabetic rats. In this model, LV volumes were significantly changed compared to a control population, leading to a LV dysfunction. These findings were consistent with the histopathological abnormalities. Finally, these data further suggest the presence of diabetes cardiomyopathy.

  11. Assessment of left ventricular performance by ECG-gated SPECT. Comparison with magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tadamura, Eiji; Inubushi, Masayuki; Kubo, Shigeto; Matsumoto, Keiichi; Yokoyama, Hiroshi; Fujita, Toru; Konishi, Junji [Kyoto Univ. (Japan). Faculty of Medicine

    1999-10-01

    In the measurement of a left ventricular volume, MIBI-QGS was compared with MRI. Because it became clear by the experiment using phantom that a volume calculated with QGS was smaller than the actual volume, data of clinical study were corrected. Subjects were 20 patients with coronary artery disease. Fourteen patients had anamnesis of myocardial infarct. ECG-gated SPECT was performed one hour after intravenous injection of MIBI (600 MBq) in rest. End diastolic volume (EDV), end systolic volume (ESV) and ejection fraction (EF) were calculated using QGS. Cine-MR image was obtained by using MR system of 1.5 Tesla within 1 week after SPECT. A condition was as follows; segmented k-space gradient echo with view sharing, TR=11 ms, TE=1.4 ms, flip angle 20 degree, field of view 32 cm, matrix 256 x 196, 8 lines per segment. LVEF, ESV and EF were analysed by Bland-Altman method, and the difference between MIBI-gated-SPECT and MRI was no problem. Horizontal dislocation image and vertical major axis dislocation image were provided. Minor axis crossing images of 10-12 slice were also filmed in order to cover all left ventricles. As a result, availability of MIBI-QGS became clear. Some factors which produces the measurement error are examined. (K.H.)

  12. Electrocardiographic-gated dual-isotope simultaneous acquisition SPECT using 18F-FDG and 99mTc-sestamibi to assess myocardial viability and function in a single study

    International Nuclear Information System (INIS)

    Matsunari, Ichiro; Matsudaira, Masamichi; Hisada, Kinichi; Kanayama, Sugako; Yoneyama, Tatsuya; Nakajima, Kenichi; Taki, Junichi; Tonami, Norihisa; Nekolla, Stephan G.

    2005-01-01

    Dual-isotope simultaneous acquisition single-photon emission computed tomography (DISA SPECT) with 18 F-fluorodeoxyglucose (FDG) and 99m Tc-sestamibi appears attractive for the detection of viable myocardium because it permits simultaneous assessment of glucose utilisation and perfusion. Another potential benefit of this approach is that the measurement of left ventricular (LV) function may be possible by ECG gating. The aim of this study was to test the hypothesis that both myocardial viability and LV function can be assessed by a single ECG-gated 18 F-FDG/ 99m Tc-sestamibi DISA SPECT study, based on comparison with 18 F-FDG/ 13 N-ammonia positron emission tomography (PET) and magnetic resonance imaging (MRI) as reference techniques. Thirty-three patients with prior myocardial infarction underwent ECG-gated 18 F-FDG/ 99m Tc-sestamibi DISA SPECT and 18 F-FDG/ 13 N-ammonia PET on a single day. Of these, 25 patients also underwent cine-MRI to assess LV function. The LV myocardium was divided into nine regions, and each region was classified as viable or scar using a semiquantitative visual scoring system as well as quantitative analysis. The global and regional LV function measured by gated SPECT was compared with the results of MRI. There was good agreement in respect of viability (90-96%, κ0.74-0.85) between DISA SPECT and PET by either visual or quantitative analysis. Furthermore, although both global and regional LV function measured by gated SPECT agreed with those by MRI, 99m Tc-sestamibi showed a closer correlation with MRI than did 18 F-FDG. In conclusion, ECG-gated DISA SPECT provides information on myocardial viability, as well as global and regional LV function, similar to that obtained by PET and MRI. (orig.)

  13. GATE simulation of a LYSO-based SPECT imager: Validation and detector optimization

    International Nuclear Information System (INIS)

    Li, Suying; Zhang, Qiushi; Xie, Zhaoheng; Liu, Qi; Xu, Baixuan; Yang, Kun; Li, Changhui; Ren, Qiushi

    2015-01-01

    This paper presents a small animal SPECT system that is based on cerium doped lutetium–yttrium oxyorthosilicate (LYSO) scintillation crystal, position sensitive photomultiplier tubes (PSPMTs) and parallel hole collimator. Spatial resolution test and animal experiment were performed to demonstrate the imaging performance of the detector. Preliminary results indicated a spatial resolution of 2.5 mm at FWHM that cannot meet our design requirement. Therefore, we simulated this gamma camera using GATE (GEANT 4 Application for Tomographic Emission) aiming to make detector spatial resolution less than 2 mm. First, the GATE simulation process was validated through comparison between simulated and experimental data. This also indicates the accuracy and effectiveness of GATE simulation for LYSO-based gamma camera. Then the different detector sampling methods (crystal size with 1.5, and 1 mm) and collimator design (collimator height with 30, 34.8, 38, and 43 mm) were studied to figure out an optimized parameter set. Detector sensitivity changes were also focused on with different parameters set that generated different spatial resolution results. Tradeoff curves of spatial resolution and sensitivity were plotted to determine the optimal collimator height with different sampling methods. Simulation results show that scintillation crystal size of 1 mm and collimator height of 38 mm, which can generate a spatial resolution of ∼1.8 mm and sensitivity of ∼0.065 cps/kBq, can be an ideal configuration for our SPECT imager design

  14. Value of gated SPECT in the analysis of regional wall motion of the interventricular septum after coronary artery bypass grafting

    International Nuclear Information System (INIS)

    Giubbini, Raffaele; Rossini, Pierluigi; Bertagna, Francesco; Bosio, Giovanni; Paghera, Barbara; Pizzocaro, Claudio; Canclini, Silvana; Terzi, Arturo; Germano, Guido

    2004-01-01

    The aim of this study was the evaluation of septal wall motion, perfusion and wall thickening after CABG in two groups of consecutive patients, one with grafted left anterior coronary artery and no history of myocardial infarction, and the other with previous anteroseptal myocardial infarction and impaired septal motion before surgery. The issue addressed was the ability of gated SPECT to differentiate between true paradoxical septal motion, characterised by paradoxical wall motion, depressed ejection fraction (EF), poor viability and compromised wall thickening, and pseudo-paradoxical motion, characterised by abnormal wall motion and regional EF but preserved perfusion and wall thickening. One hundred and thirty-two patients with previous anterior myocardial infarction, 82 patients with left anterior descending coronary disease and no history of myocardial infarction and 27 normal subjects underwent rest gated SPECT after 99m Tc-sestamibi injection, according to the standard QGS protocol. Quantitative regional EF, regional perfusion, regional wall motion and regional wall thickening were determined using a 20-segment model. Despite the presence of similar regional wall motion impairment in patients with and patients without septal infarction, in terms of regional EF (2.5%±3% vs 1.9%±4.9% p=NS) and inward septal motion (3±4.9 mm vs 2.3±6.1 mm p=NS), significant differences were observed in both perfusion (74.7%±6.2% vs 63.3%±13%, p>0.0001) and regional wall thickening (17.2%±7.4% vs 12.6%±7.2%, p>0.0001). Gated SPECT with perfusion tracers can reliably differentiate pseudo-paradoxical from true paradoxical septal motion in patients with previous CABG, and it may be the method of choice for evaluating left ventricular performance in this patient population. (orig.)

  15. Value of gated SPECT in the analysis of regional wall motion of the interventricular septum after coronary artery bypass grafting.

    Science.gov (United States)

    Giubbini, Raffaele; Rossini, Pierluigi; Bertagna, Francesco; Bosio, Giovanni; Paghera, Barbara; Pizzocaro, Claudio; Canclini, Silvana; Terzi, Arturo; Germano, Guido

    2004-10-01

    The aim of this study was the evaluation of septal wall motion, perfusion and wall thickening after CABG in two groups of consecutive patients, one with grafted left anterior coronary artery and no history of myocardial infarction, and the other with previous anteroseptal myocardial infarction and impaired septal motion before surgery. The issue addressed was the ability of gated SPECT to differentiate between true paradoxical septal motion, characterised by paradoxical wall motion, depressed ejection fraction (EF), poor viability and compromised wall thickening, and pseudo-paradoxical motion, characterised by abnormal wall motion and regional EF but preserved perfusion and wall thickening. One hundred and thirty-two patients with previous anterior myocardial infarction, 82 patients with left anterior descending coronary disease and no history of myocardial infarction and 27 normal subjects underwent rest gated SPECT after 99mTc-sestamibi injection, according to the standard QGS protocol. Quantitative regional EF, regional perfusion, regional wall motion and regional wall thickening were determined using a 20-segment model. Despite the presence of similar regional wall motion impairment in patients with and patients without septal infarction, in terms of regional EF (2.5%+/-3% vs 1.9%+/-4.9% p=NS) and inward septal motion (3+/-4.9 mm vs 2.3+/-6.1 mm p=NS), significant differences were observed in both perfusion (74.7%+/-6.2% vs 63.3%+/-13%, p>0.0001) and regional wall thickening (17.2%+/-7.4% vs 12.6%+/-7.2%, p>0.0001). Gated SPECT with perfusion tracers can reliably differentiate pseudo-paradoxical from true paradoxical septal motion in patients with previous CABG, and it may be the method of choice for evaluating left ventricular performance in this patient population.

  16. Value of gated SPECT in the analysis of regional wall motion of the interventricular septum after coronary artery bypass grafting

    Energy Technology Data Exchange (ETDEWEB)

    Giubbini, Raffaele; Rossini, Pierluigi; Bertagna, Francesco; Bosio, Giovanni; Paghera, Barbara; Pizzocaro, Claudio; Canclini, Silvana; Terzi, Arturo [Spedali Civili di Brescia, Department of Nuclear Medicine, Brescia (Italy); Germano, Guido [Cedars-Sinai Medical Center, Artificial Intelligence Program, Department of Medicine, Los Angeles, CA (United States)

    2004-10-01

    The aim of this study was the evaluation of septal wall motion, perfusion and wall thickening after CABG in two groups of consecutive patients, one with grafted left anterior coronary artery and no history of myocardial infarction, and the other with previous anteroseptal myocardial infarction and impaired septal motion before surgery. The issue addressed was the ability of gated SPECT to differentiate between true paradoxical septal motion, characterised by paradoxical wall motion, depressed ejection fraction (EF), poor viability and compromised wall thickening, and pseudo-paradoxical motion, characterised by abnormal wall motion and regional EF but preserved perfusion and wall thickening. One hundred and thirty-two patients with previous anterior myocardial infarction, 82 patients with left anterior descending coronary disease and no history of myocardial infarction and 27 normal subjects underwent rest gated SPECT after {sup 99m}Tc-sestamibi injection, according to the standard QGS protocol. Quantitative regional EF, regional perfusion, regional wall motion and regional wall thickening were determined using a 20-segment model. Despite the presence of similar regional wall motion impairment in patients with and patients without septal infarction, in terms of regional EF (2.5%{+-}3% vs 1.9%{+-}4.9% p=NS) and inward septal motion (3{+-}4.9 mm vs 2.3{+-}6.1 mm p=NS), significant differences were observed in both perfusion (74.7%{+-}6.2% vs 63.3%{+-}13%, p>0.0001) and regional wall thickening (17.2%{+-}7.4% vs 12.6%{+-}7.2%, p>0.0001). Gated SPECT with perfusion tracers can reliably differentiate pseudo-paradoxical from true paradoxical septal motion in patients with previous CABG, and it may be the method of choice for evaluating left ventricular performance in this patient population. (orig.)

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

    International Nuclear Information System (INIS)

    Lau, W.F.E.; Kelly, M.J.; O'Donnell, M.; Kalff, V.; Van Every, B.

    2000-01-01

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

  18. Diagnosis of silent myocardial ischemia in type 2 diabetic patients by electrocardiogram, ergometry and Gated-SPECT

    International Nuclear Information System (INIS)

    Penna Quian, Yamile; Fernandez-Britto Rodriguez, Jose; Bacallao Gallestey, Jorge; Batista Cuellar, Juan Felipe; Coca Perez, Marco Antonio; Toirac Garcia, Noresma; Penna Coego, Andria

    2008-01-01

    31 asymptomatic type 2 diabetic patients were studied by lab tests, electrocardiogram, ergometry, Gated-SPECT and coronariography to determine the relation between the atherosclerotic risk factors and the silent myocardial ischemia. Patients were classified into two groups: positive SPECT and negative SPECT. Association tests were made for each variable and ROC curves were constructed to identify risk markers. In 35.5% of the patients silent myocardial ischemia was detected with a good angiographic correlation. A significant association was evidenced between positive SPECT and the atherosclerotic risk factors, namely, low values of HDLc, family pathological history of ischemic heart disease and peripheral vascular disease. The logistic regression models showed that low values of HDLc together with family pathological history of ischemic heart disease may be strong predictors of silent myocardial ischemia in asymptomatic type 2 diabetic patients

  19. Myocardial perfusion SPECT for assessment of left ventricular function and volume- comparison with echocardiography

    International Nuclear Information System (INIS)

    Cheng Xu; Huang Gang

    2004-01-01

    Objective: The purpose of this study was to evaluate left ventricular volume and function by gated SPECT and comparison of the results with echocardiography. Methods: 65 Consecutive patients (49 male, 16 female; mean age 61+11 years) who underwent both gated 99m Tc-MIBI myocardial perfusion SPECT and echocardiography within a 15 days period were included in the study. Exclusion criteria were any change in clinical status between acquisition of the gated SPECT and echocardiography studies, acute myocardial infarction occurring less than 7 days before study, and surgical procedures occurring within 30 days of the study. The clinical diagnosis of each patient was not considered, as this was not relevant to the purpose of the study. The diagnoses were as follows: coronary artery disease (n=46), hypertensive heart disease (n=8), old myocardial infarction (n=5), myocarditis (n=2), and routine medical examination(n=4). A dose of 740 MBq of 99 Tc m -sestamibi was administered in resting condition. Gated SPECT images were obtained with ADAC Vertex MCD-AC SPECT system. The raw projection images were reconstructed with filtered back-projection (ramp filter), without attenuation correction. The data, including left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), end-systolic volume (ESV) were obtained using AUTOQUANT software (ADAC corporation). The echocardiography study used its standard techniques. Two nuclear medicine physicians processed the raw images respectively to evaluate internal reproducibility of gated SPECT. In order to compare the results of gated SPECT with echocardiography on different left ventricular volumes, all patients were divided into two groups (EDV 90 ml, n=34) based by EDV measurements in echocardiography. Results: The correlation coefficient of LVEF, EDV, ESV between SPECT and echocardiography were 0.77, 0.86 and 0.90 respectively. P 0.07). The reproducibility of gated SPECT was excellent. There were no significant differences in

  20. Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Tamaki, Nagara; Kuwabara, Yoichi; Kawano, Masaya; Matsunari, Ichiro; Taki, Junichi; Nishimura, Shigeyuki; Yamashina, Akira; Ishida, Yoshio; Tomoike, Hitonobu

    2008-01-01

    Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies. A total of 252 patients with recent myocardial infarction (n = 74) and old myocardial infarction (n = 175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99m Tc-hexakis-2-methoxy-isobutyl isonitrile (MIBI) and repeated the study after revascularization after an average follow-up period of 132 ± 81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5,040 segments. Non-gated segmental percent uptake and end-systolic (ES) percent uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66 ± 17% and 55 ± 18%, p 99m Tc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES percent uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study. (orig.)

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

    International Nuclear Information System (INIS)

    Nishikubo, Naotsugu; Tamai, Hiroyuki

    2013-01-01

    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). 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. 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. SPECT analysis has the same quantity as that of obtained from CT for evaluation of left ventricular wall motion. (author)

  2. Calculation of left ventricular volume and ejection fraction from ECG-gated myocardial SPECT. Automatic detection of endocardial borders by threshold method

    International Nuclear Information System (INIS)

    Fukushi, Shoji; Teraoka, Satomi.

    1997-01-01

    A new method which calculate end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) of the left ventricle from myocardial short axis images of ECG-gated SPECT using 99m Tc myocardial perfusion tracer has been designed. Eight frames per cardiac cycle ECG-gated 180 degrees SPECT was performed. Threshold method was used to detect myocardial borders automatically. The optimal threshold was 45% by myocardial SPECT phantom. To determine if EDV, ESV and LVEF can also be calculated by this method, 12 patients were correlated ventriculography (LVG) for 10 days each. The correlation coefficient with LVG was 0.918 (EDV), 0.935 (ESV) and 0.900 (LVEF). This method is excellent at objectivity and reproductivity because of the automatic detection of myocardial borders. It also provides useful information on heart function in addition to myocardial perfusion. (author)

  3. Two dimensional polar display of cardiac blood pool SPECT

    International Nuclear Information System (INIS)

    Honda, Norinari; Machida, Kikuo; Mamiya, Toshio; Takahashi, Taku; Takishima, Teruo; Hasegawa, Noriko; Hashimoto, Masanori; Ohno, Ken

    1989-01-01

    A new method of ECG gated cardiac blood pool SPECT to illustrate the left ventricular (LV) wall motion in a single static image, two dimensional polar display (2DPD), was described. Circumferential profiles of the difference between end diastolic and end systolic short axis images of the LV were displayed in a similar way to the bull's eye plot of 201 Tl myocardial SPECT. The diagnoses by 2DPDs agreed with those by cinematic displays of ECG gated blood pool SPECT in 74 out of 84 segments (85.5%) of abnormal motion, and 155 out of 168 segments (80.3%) of normal motion. It is concluded that 2DPD can evaluate regional wall motion by a single static image in a significant number of patients, and is also useful in comparing with the bull's eye image of 201 Tl myorcardial SPECT. (orig.)

  4. DIAGNOSTIC VALUE of Tc-99m TETROFOSMİN GATED SPECT IN MYOCARDIAL VIABILITY INVESTIGATION AFTER ADMINISTRATION TRIMETAZIDINE and NITRATE IN THE PATIENTS WITH MYOCARDIAL INFARCTION

    OpenAIRE

    TURHAL, Özgül; TUTUŞ, Ahmet; KULA, Mustafa

    2018-01-01

    ABSTRACT Aim: With the aim of investigating of the myocardial viability on the patients with MI, the results obtained from Tc-99m-tetrofosmin gated SPECT following the nitrate infusion and acute TMZ were compared.Method: For this study, 30 patients who had MI and were be planned of revascularization process were taken. The patients were applied Tc-99m-tetrofosmin gated SPECT basally and following nitrate infusion and acute TMZ separately each day. The data from perfusion were quantitatively e...

  5. Prediction of functional recovery after primary PCI using the estimate of myocardial salvage in gated SPECT early after acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Calabretta, Raffaella; Castello, Angelo; Linguanti, Flavia; Tutino, Francesca; Ciaccio, Alfonso; Sciagra, Roberto [University of Florence, Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences ' ' Mario Serio' ' , Florence (Italy); Giglioli, Cristina [Careggi University Hospital, Cardiothoracovascular Department, Florence (Italy)

    2018-04-15

    Primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) aims to achieve myocardial salvage (MS). Because the reference method for measuring MS requires myocardial perfusion imaging (MPI) after tracer injection before PCI, alternative approaches have been proposed, but none has gained wide acceptance. Gated SPECT MPI can assess infarct size (IS), but can also show myocardial stunning. Thus, we compared functional and perfusion abnormalities early after AMI to estimate MS, and to predict left ventricular ejection fraction (LVEF) recovery at follow-up. We studied 120 patients with AMI. Gated SPECT MPI was performed early (before hospital discharge) and at 6 months after AMI to measure IS, MS and functional outcome. MS was defined as the difference between the number of segments with abnormal thickening (i.e. the stunned area or area at risk) and the number of segments with abnormal perfusion (i.e. the final IS), expressed as a percentage of the total number of segments in the AHA model. LVEF was calculated using quantitative gated SPECT. The area at risk was 40 ± 25%, IS was 17.3 ± 16% and MS was 22 ± 19%. Early LVEF was 46.6 ± 11.6% and late LVEF was 51.4 ± 11.6%, with 54 patients showing at least an increase in LVEF of more than 5 units. ROC analysis showed that MS was able to predict LVEF recovery with an area under the curve (AUC) of 0.79 (p < 0.0001), and using a cut off >23% detected LVEF recovery with 74% sensitivity and 71% specificity. Conversely, IS was associated with an AUC 0.53 (not significant). MS assessed by a single early gated SPECT MPI study can accurately predict LVEF evolution after primary PCI for AMI. (orig.)

  6. Evaluation of exercise-induced myocardial stunning by means of immediate post-exercise Tc-99m sestamibi gated SPECT

    International Nuclear Information System (INIS)

    Ouvrier, M.J.; Hitzel, A.; Vera, P.; Manrique, A.; Bernard, M.; Manrique, A.

    2009-01-01

    Aim: Repeated episodes of myocardial stunning may lead to chronic ventricular dysfunction. We attempted to assess the parameters related to post-exercise stunning in patients undergoing gated SPECT. Methods: Six hundred patients undergoing a one-day stress/rest 99m Tc-sestamibi gated SPECT were studied. Stress imaging was acquired within 15 minutes after injection. Summed perfusion scores (S.S.S., S.R.S. and S.D.S.) were calculated using Q.P.S., and L.V. function assessed using Q.G.S.. Stunning was defined as the association of ischemia (S.S.S. = 4 and SDS > 0) and a minimum of 5% decrease in post-stress E.F.. Results: Ischemia was found in 225 (37.5%) patients. Among these, 67 (30%) showed myocardial stunning. Patients with stunning had a lower rest E.S.V. (47 ± 24 ml vs 65 ± 52 ml, p < 0.0003) and E.D.V. (108± 35 ml vs 122 ± 66 ml, p 0.03), an increased rest L.V.E.F. (58 ± 10% vs 52 ± 13%, p < 0.0001) and a decreased post-stress L.V.E.F. (49 ± 10% vs 53 ± 13%, p < 0.02) compared to patients with no stunning. The number of myocardial segments showing reversible perfusion defects was increased in patients with stunning (2.7 ± 2.6 vs 1.7 ± 2.1, p < 0.02). On logistic regression, an extent of ischemia greater than two segments and a rest E.F. greater than 45% were independent predictors of the occurrence of myocardial stunning in patients with ischemia. Conclusions: In patients with ischemia, exercise-induced stunning was associated with an increased extent of ischemia but also preserved rest ventricular function. (authors)

  7. Influence of magnification on the calculated value of left ventricular ejection fraction and volumes using quantitative gated perfusion SPECT

    International Nuclear Information System (INIS)

    Nunez, M.; Beretta, M.; Alonso, O.; Alvarez, B.; Canepa, J.; Mut, F.

    2002-01-01

    Aim: To compare left ventricular ejection fraction (LVEF), end-diastolic volumes (EDV) and end-systolic volumes (ESV) measured by quantitative gated SPECT (QGSPECT) in studies acquired with and without magnification factor (zoom). Material and Methods: We studied 30 consecutive patients (17 men, ages 61±14 years) referred for myocardial perfusion evaluation with a 2-day protocol. Studies were performed after injection of 925 MBq (25 mCi) of 99mTc-MIBI in the resting state. Gated SPECT was first acquired using a x2 zoom factor and immediately repeated with x1 zoom (no magnification), using a 64x64 matrix and 8 frames/cardiac cycle. Patients with arrhythmia were not included in the investigation. According to the median EDV calculated with the x2 zoom acquisition, the population was further divided in two sub-groups regarding the size of the LV cavity. Average LVEF, EDV, ESV and difference between values (delta) were then calculated for the total population and for each sub-group (a and b). Results: For the total population, results are expressed.Pearson correlation showed r=0.954 between LVEF with and without zoom (p<0.0001), but linear regression analysis did not fit a specific model (p=0.18). Median EDV with zoom was 92.5 ml, allowing to separate 15 cases with EDV above (a) and 15 below that value (b). Results for both sub-groups are presented. Conclusion: Calculated LVEF is higher with no zoom, at the expense of decreasing both EDV and ESV. Although differences were very significant for all parameters, ESV changes were specially relevant with no zoom, particularly in patients with smaller hearts. Although good correlation was found between LVEF with and without zoom, no specific correction factor was found to convert one value into the other. Magnification factor should be kept constant in gated SPECT if calculated LVEF values QGSPECT are expected to be reliable, and validation of the method using different zoom factors should be considered

  8. The value of regional wall motion abnormalities on 99Tcm-MIBI gated cardiac SPECT in predicting angiographic stenoses of coronary artery

    International Nuclear Information System (INIS)

    Li Dianfu; Huang Jun; Zhu Tiebing; Wang Liansheng; Yang Zhijian; Feng Jianlin; Li Jianhua; Chen Jianwei; Chang Guojun

    2004-01-01

    Objective: To determine the magnitude of angiographic stenoses of coronary artery in reversible regional wall motion abnormalities (RWMA) present in exercise stress 99 Tc m -methoxyisobutylisonitrile (MIBI) gated SPECT myocardial perfusion imaging (MPI). Methods: One hundred and sixteen patients undergoing coronary angiography two weeks before and after the exercise stress 99 Tc m -MIBI gated SPECT MPI. Images were acquired 15 to 20 min after stress. A five grades and twenty segments marking system was introduced to assess the RWMA and thickening of left ventricles. Results: The sensitivity of reversible RWMA for detecting ≥75% angiographic stenoses was 65%, with a specificity of 97%. Reversible RWMA has a high positive predictive value (98%) for stratification between severe angiographic stenoses of 75% and non-severe stenoses (less than 75%). Multivariate analysis showed that the post-stress wall motion (SSSWM), exercise wall motion differentiation value (SDSWM) and summed stress score (SSS) were the independent risk factor of coronary artery jeopardy score. Conclusions: Reversible RWMA, as shown by exercise stress 99 Tc m -MIBI gated SPECT MPI, is a significant predictor of angiographic disease with very high specificity and positive predictive values. Exercise reversible RWMA can rise the assessment value of angiographic severity in MPI

  9. Variability of left ventricular ejection fraction and volumes with quantitative gated SPECT: influence of algorithm, pixel size and reconstruction parameters in small and normal-sized hearts

    International Nuclear Information System (INIS)

    Hambye, Anne-Sophie; Vervaet, Ann; Dobbeleir, Andre

    2004-01-01

    Several software packages are commercially available for quantification of left ventricular ejection fraction (LVEF) and volumes from myocardial gated single-photon emission computed tomography (SPECT), all of which display a high reproducibility. However, their accuracy has been questioned in patients with a small heart. This study aimed to evaluate the performances of different software and the influence of modifications in acquisition or reconstruction parameters on LVEF and volume measurements, depending on the heart size. In 31 patients referred for gated SPECT, 64 2 and 128 2 matrix acquisitions were consecutively obtained. After reconstruction by filtered back-projection (Butterworth, 0.4, 0.5 or 0.6 cycles/cm cut-off, order 6), LVEF and volumes were computed with different software [three versions of Quantitative Gated SPECT (QGS), the Emory Cardiac Toolbox (ECT) and the Stanford University (SU-Segami) Medical School algorithm] and processing workstations. Depending upon their end-systolic volume (ESV), patients were classified into two groups: group I (ESV>30 ml, n=14) and group II (ESV 2 to 128 2 were associated with significantly larger volumes as well as lower LVEF values. Increasing the filter cut-off frequency had the same effect. With SU-Segami, a larger matrix was associated with larger end-diastolic volumes and smaller ESVs, resulting in a highly significant increase in LVEF. Increasing the filter sharpness, on the other hand, had no influence on LVEF though the measured volumes were significantly larger. (orig.)

  10. Evaluating low pass filters on SPECT reconstructed cardiac orientation estimation

    Science.gov (United States)

    Dwivedi, Shekhar

    2009-02-01

    Low pass filters can affect the quality of clinical SPECT images by smoothing. Appropriate filter and parameter selection leads to optimum smoothing that leads to a better quantification followed by correct diagnosis and accurate interpretation by the physician. This study aims at evaluating the low pass filters on SPECT reconstruction algorithms. Criteria for evaluating the filters are estimating the SPECT reconstructed cardiac azimuth and elevation angle. Low pass filters studied are butterworth, gaussian, hamming, hanning and parzen. Experiments are conducted using three reconstruction algorithms, FBP (filtered back projection), MLEM (maximum likelihood expectation maximization) and OSEM (ordered subsets expectation maximization), on four gated cardiac patient projections (two patients with stress and rest projections). Each filter is applied with varying cutoff and order for each reconstruction algorithm (only butterworth used for MLEM and OSEM). The azimuth and elevation angles are calculated from the reconstructed volume and the variation observed in the angles with varying filter parameters is reported. Our results demonstrate that behavior of hamming, hanning and parzen filter (used with FBP) with varying cutoff is similar for all the datasets. Butterworth filter (cutoff > 0.4) behaves in a similar fashion for all the datasets using all the algorithms whereas with OSEM for a cutoff < 0.4, it fails to generate cardiac orientation due to oversmoothing, and gives an unstable response with FBP and MLEM. This study on evaluating effect of low pass filter cutoff and order on cardiac orientation using three different reconstruction algorithms provides an interesting insight into optimal selection of filter parameters.

  11. Reproducibility of an automatic quantitation of regional myocardial wall motion and systolic thickening on gated Tc-99m-MIBI myocardial SPECT

    International Nuclear Information System (INIS)

    Paeng, Jin Chul; Lee, Dong Soo; Cheon, Gi Jeong; Kim, Yu Kyeong; Chung, June Key; Lee, Myung Chul

    2000-01-01

    The aim of this study is to investigate the reproducibility of the quantitative assessment of segmental wall motion and systolic thickening provided by an automatic quantitation algorithm. Tc-99m-MIBI gated myocardial SPECT with dipyridamole stress was performed in 31 patients with known or suspected coronary artery disease (4 with single, 6 with two, 11 with triple vessel disease; ejection fraction 51±14%) twice consecutively in the same position. Myocardium was divided into 20 segments. Segmental wall motion and systolic thickening were calculated and expressed in mm and % increase respectively, using AutoQUANT TM software. The reproducibility of this quantitative measurement of wall motion and thickening was tested. Correlations between repeated measurements on consecutive gated SPECT were excellent for wall motion (r=0.95) and systolic thickening (r=0.88). On Bland-Altman analysis, two standard deviation was 2 mm for repeated measurement of segmental wall motion, and 20% for that of systolic thickening. The weighted kappa values of repeated measurements were 0.807 for wall motion and 0.708 for systolic thickening. Sex, perfusion, or segmental location had no influence on reproducibility. Segmental wall motion and systolic thickening quantified using AutoQUANT TM software on gated myocardial SPECT offers good reproducibility and is significantly different when the change is more than 2 mm for wall motion and more than 20% for systolic thickening

  12. Factors affecting accuracy of ventricular volume and ejection fraction measured by gated Tl-201 myocardial perfusion single photon emission computed tomography

    International Nuclear Information System (INIS)

    Pai, Moon Sun; Yang, You Jung; Im, Ki Chun; Hong, Il Ki; Yun, Sung Cheol; Kang, Duk Hyun; Song, Jae Kwan; Moon, Dae Hyuk

    2005-01-01

    Systemic errors in the gated single photon emission computed tomography (SPECT) measurement of left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) may occur. We evaluated whether patient-related factors affected the accuracy of EDV, ESV, and EF measured by electrocardiogram-gated Tl-201 SPECT. A total of 518 patients without perfusion defects on Tl-201 SPECT or coronary artery disease were studied. EDV, ESV, and EF were measured from echocardiography and adenosine stress/redistribution gated Tl-201 SPECT using commercially available software packages (QGS and 4D-MSPECT). We identified factors affecting the accuracy of gated SPECT via multiple linear regression analysis of the differences between echocardiography and gated SPECT. Gated SPECT analyzed with QGS underestimated EDV and ESV, and overestimated EF, but 4D-MSPECT overestimated all those values (p<0.001). Independent variables that increased the difference in EDV between echocardiography and gated SPECT were decreasing LV end-diastolic wall thickness, decreasing body surface area, female sex and increasing EDV (p< 0.001). Those for ESV were decreasing LV end-systolic wall thickness, female sex, and decreasing ESV (p<0.001). Increasing end-systolic wall thickness, male sex and decreasing age were independent determinants associated with an increased difference in EF (p< 0.001). Adenosine stress SPECT showed significantly higher EDV and ESV values and a lower EF than did redistribution SPECT (p< 0.001). In determination of EF, QGS demonstrated a smaller bias than did 4D-MSPECT. However, in men with LV hypertrophy, 4D-MSPECT was superior to QGS. Systemic error by gated Tl-201 SPECT is determined by individual patient-characteristics

  13. Comparison of myocardial fatty acid metabolism with left ventricular function and perfusion in cardiomyopathies. By 123I-BMIPP SPECT and 99mTc-tetrofosmin electrocardiographically gated SPECT

    International Nuclear Information System (INIS)

    Zhao, Chunlei; Shuke, Noriyuki; Okizaki, Atsutaka

    2003-01-01

    The objective of this study was to investigate myocardial fatty acid metabolism and its relationship with left ventricular (LV) function and perfusion in hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM). Thirty-nine patients with cardiomyopathies (58±14 y), comprising 15 DCM and 24 HCM, and 9 age-matched healthy controls were studied with 123 I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) and 99m Tc-tetrofosmin (TF) electrocardiographically gated SPECT. As parameters of myocardial fatty acid metabolism, the heart-to-mediastinum ratio (H/M) and global washout of BMIPP were calculated from early and delayed planar images, while regional BMIPP uptake and washout were calculated from SPECT. In TF study, the H/M (H/M-TF) and LV ejection fraction (LVEF) were calculated as global parameters of perfusion and function, while regional TF uptake and wall thickening index were calculated as regional parameters of perfusion and function using the Quantitative Gated SPECT software. The differences in the parameters and the correlations between the parameters from the 2 studies were investigated by one-way ANOVA and multiple linear regression analysis. BMIPP uptake was decreased (p 0.05), but showed a significant correlation with H/M-TF (p 0.05) but had a significant correlation with regional perfusion (p<0.0001) in DCM. In HCM, regional BMIPP parameters showed significant multiple linear correlations with both regional function (p<0.005) and perfusion (p<0.0001). According to the partial correlation coefficients, delayed regional BMIPP uptake was the most significant factor for predicting regional function in HCM, while early regional BMIPP uptake was the only or the most significant factor for predicting regional perfusion in DCM and HCM, respectively. In DCM, BMIPP uptake and washout could not reflect LV function. In HCM, regional delayed BMIPP uptake might be useful for evaluating regional function. In DCM and HCM, early BMIPP uptake might be

  14. A newly developed maneuver, field change conversion (FCC), improved evaluation of the left ventricular volume more accurately on quantitative gated SPECT (QGS) analysis

    International Nuclear Information System (INIS)

    Tajima, Osamu; Shibasaki, Masaki; Hoshi, Toshiko; Imai, Kamon

    2002-01-01

    The purpose of this study was to investigate whether a newly developed maneuver that reduces the reconstruction area by a half more accurately evaluates left ventricular (LV) volume on quantitative gated SPECT (QGS) analysis. The subjects were 38 patients who underwent left ventricular angiography (LVG) followed by G-SPECT within 2 weeks. Acquisition was performed with a general purpose collimator and a 64 x 64 matrix. On QGS analysis, the field magnification was 34 cm in original image (Original: ORI), and furthermore it was changed from 34 cm to 17 cm to enlarge the re-constructed image (Field Change Conversion: FCC). End-diastolic volume (EDV) and end-systolic volume (ESV) of the left ventricle were also obtained using LVG. EDV was 71±19 ml, 83±20 ml and 98±23 ml for ORI, FCC and LVG, respectively (p<0.001: ORI versus LVG, p<0.001: ORI versus FCC, p<0.001: FCC versus LVG). ESV was 28±12 ml, 34±13 ml and 41±14 ml for ORI, FCC and LVG, respectively (p<0.001: ORI versus LVG, p<0.001: ORI versus FCC, p<0.001: FCC versus LVG). FCC was better than ORI for calculating LV volume in clinical cases. Furthermore, FCC is a useful method for accurately measuring the LV volume on QGS analysis. (author)

  15. Performance of Thallium-201 Electrocardiography-gated Myocardial Perfusion Single Photon Emission Computed Tomography to Assess Left Ventricular Function

    Directory of Open Access Journals (Sweden)

    Guang-Uei Hung

    2005-05-01

    Full Text Available This study evaluated the performance of gated single photon emission computed tomography (SPECT with thallium-201 (201Tl in assessing left ventricular ejection fraction (LVEF, end-diastolic volume (EDV, and end-systolic volume (ESV in Taiwanese by determining repeatability and correlation with two-dimensional (2D echocardiography. A total of 18 patients underwent two sequential gated SPECT acquisitions within 30 minutes in the resting state to assess repeatability. Another 28 patients who underwent gated SPECT and 2D echocardiography within 7 days were included for comparison. The two sequential measurements were well correlated with respect to LVEF, EDV, and ESV (r = 0.97, 0.95, and 0.97, respectively, all p < 0.0001. Bland-Altman analysis revealed that two standard deviations of the absolute difference between the two sequential measurements for LVEF, EDV, and ESV were 6.4%, 16.8 mL, and 8.6 mL, respectively. For LVEF, EDV, and ESV, correlations between redistribution 201Tl-gated SPECT and echocardiography were also excellent (all r = 0.83, p < 0.0001. LVEF was similar with 201Tl-gated SPECT and echocardiography, but EDV and ESV were significantly higher with echocardiography (p < 0.05. Our study revealed that 201Tl-gated SPECT has high repeatability and excellent correlation with echocardiography for the assessment of LVEF and volumes in Taiwanese. These results support the clinical application of gated SPECT in routine 201Tl myocardial perfusion imaging in Taiwanese.

  16. Prognostic Value of Normal Perfusion but Impaired Left Ventricular Function in the Diabetic Heart on Quantitative Gated Myocardial Perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hwanjeong; Choi, Sehun; Han, Yeonhee [Research Institute of Chonbuk National Univ. Medical School and Hospitial, Jeonju (Korea, Republic of); Lee, Dong Soo; Lee, Hoyoung; Chung, Junekey [Seoul National Univ., Seoul (Korea, Republic of)

    2013-09-15

    This study aimed at identifying the predictive parameters on quantitative gated myocardial perfusion single-photon emission computed tomography (QG-SPECT) in diabetic patients with normal perfusion but impaired function. Methods Among the 533 consecutive diabetic patients, 379 patients with normal perfusion on rest Tl-201/dipyridamole-stress Tc-{sup 99m} sestamibi Gated SPECT were enrolled. Patients were grouped into those with normal post-stress left ventricular function (Group I) and those with impaired function (EF <50 or impaired regional wall motion, Group II). We investigated cardiac events and cause of death by chart review and telephone interview. Survival analysis and Cox proportional hazard model analysis were performed. Between the Group I and II, cardiac events as well as chest pain symptoms, smoking, diabetic complications were significantly different (P<0.05). On survival analysis, event free survival rate in Group II was significantly lower than in Group I (P=0.016). In univariate Cox proportional hazard analysis on overall cardiac event, Group (II over I), diabetic nephropathy, summed motion score (SMS), summed systolic thickening score (STS), numbers of abnormal segmental wall motion and systolic thickening predicted more cardiac events (P<0.05). Multivariate analysis showed that STS was the only independent predictor cardiac event. The functional parameter, especially summed systolic thickening score on QG-SPECT had prognostic values, despite normal perfusion, in predicting cardiac events in diabetic patients, and QG-SPECT provides clinically useful risk stratification in diabetic patients with normal perfusion.

  17. SPECT acquisition using dynamic projections: a novel approach for data-driven respiratory gating

    International Nuclear Information System (INIS)

    Hutton, B.F.; Hatton, R.L.; Yip, N.

    2002-01-01

    Full text: Movement of the heart due to respiration has been previously demonstrated to produce potentially serious artefacts. On-line respiratory gating is difficult, as it requires a high level of patient cooperation. We demonstrate that use of dynamic acquisition of projections permits identification of the respiratory dynamics, allowing retrospective selection of data corresponding to a fixed point in the respiratory cycle. To demonstrate the feasibility of the technique a dynamic study was acquired just prior to myocardial per-fusion SPECT acquisition, using 5 frames/sec for 20 seconds (64*64 matrix) in anterior and lateral projections (using a dual-head right-angled configuration). The dynamic was processed a) by compressing frames in the transverse direction so as to illustrate time dependence, b) by plotting the centre of mass in the axial direction as a function of time. Respiratory motion was enhanced by use of temporal smoothing and intensity thresholding. In ten patients studied the cyclic pattern of motion due to respiratory dynamics was clearly visible in nine. Respiration typically resulted in around 1cm axial translation but in some individuals, movements as large as 3 cm were identified. The respiration rate ranged from 12-18 /min in agreement with independent observation of the patient's breathing pattern. These results suggest that retrospective respiratory gating is feasible without the need for any external respiratory monitoring device, provide that dynamic acquisition of SPECT projections is implemented. Correction for respiratory motion may also be feasible using this technique. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  18. Evaluation of left ventricular function and volume with multidetector-row computed tomography. Comparison with electrocardiogram-gated single photon emission computed tomography

    International Nuclear Information System (INIS)

    Suzuki, Takeya; Yamashina, Shohei; Nanjou, Shuji; Yamazaki, Junichi

    2007-01-01

    This study compared left ventricular systolic function and volume determined by multidetector-row computed tomography (MDCT) and electrocardiogram-gated single photon emission computed tomography (G-SPECT) Thirty-seven patients with coronary artery disease and non-cardiovascular disease underwent MDCT. In this study, left ventricular ejection fraction (EF), left ventricular end-diastolic volume (EDV) and left ventricular end-systolic volume (ESV) were calculated using only two-phase imaging with MDCT. Left ventricular function and volume were compared using measurements from G-SPECT. We conducted MDCT and G-SPECT virtually simultaneously. Both the EF and ESV evaluated by MDCT closely correlated with G-SPECT (r=0.763, P 65 bpm) during MDCT significantly influenced the difference in EF calculated from MDCT and G-SPECT (P<0.05). Left ventricular function can be measured with MDCT as well as G-SPECT. However, a heart rate over 65 bpm during MDCT negatively affects the EF correlation between MDCT and G-SPECT. (author)

  19. Feasibility of one-eighth time gated myocardial perfusion SPECT functional imaging using IQ-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Caobelli, Federico; Thackeray, James T.; Bengel, Frank M. [Medizinische Hochschule Hannover, Klinik fuer Nuklearmedizin, Hannover (Germany); Soffientini, Alberto; Pizzocaro, Claudio; Guerra, Ugo Paolo [Fondazione Poliambulanza, Department of Nuclear Medicine, Brescia (Italy)

    2015-11-15

    IQ-SPECT, an add-on to general purpose cameras based on multifocal collimation, can reduce myocardial perfusion imaging (MPI) acquisition times to one-fourth that of standard procedures (to 12 s/view). In a phantom study, a reduction of the acquisition time to one-eighth of the standard time (to 6 s/view) was demonstrated as feasible. It remains unclear whether such a reduction could be extended to clinical practice. Fifty patients with suspected or diagnosed CAD underwent a 2-day stress-rest {sup 99m}Tc-sestamibi MPI protocol. Two consecutive SPECT acquisitions (6 and 12 s/view) were performed. Electrocardiogram-gated images were reconstructed with and without attenuation correction (AC). Polar maps were generated and visually scored by two blinded observers for image quality and perfusion in 17 segments. Global and regional summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) were determined. Left ventricular volumes and ejection fraction were calculated based on automated contour detection. Image quality was scored higher with the 12 s/view acquisition, both with and without AC. Summed scores were statistically comparable between the 6 s/view and the 12 s/view acquisition, both globally and in individual coronary territories (e.g. in images with AC, SSS were 6.6 ± 8.3 and 6.2 ± 8.2 with 6 s and 12 s/view, respectively, p = 0.10; SRS were 3.9 ± 5.6 and 3.5 ± 5.3, respectively, p = 0.19; and SDS were 2.8 ± 5.7 and 2.6 ± 5.7, respectively, p = 0.59). Both acquisitions allowed MPI-based diagnosis of CAD in 25 of the 50 patients (with AC). Calculated end-diastolic volume (EDV) and end-systolic volume (ESV) were modestly higher with the 6 s/view acquisition than with the 12 s/view acquisition (EDV +4.8 ml at rest and +3.7 ml after stress, p = 0.003; ESV +4.1 ml at rest and +2.6 ml after stress, p = 0.01), whereas the ejection fraction did not differ (-1.2 % at rest, p = 0.20, and -0.9 % after stress, p = 0.27). Image quality and

  20. Assessment of left ventricular function by gated myocardial perfusion and gated blood-pool SPECT. Can we use the same reference database?

    Energy Technology Data Exchange (ETDEWEB)

    Paul, A.K.; Hasegawa, Shinji; Yoshioka, Jun; Yamaguchi, Hitoshi; Tsujimura, Eiichiro; Nishimura, Tsunehiko [Osaka Univ., Suita (Japan). Graduate School of Medicine

    2000-04-01

    The purpose of this study was to compare left ventricular (LV) volume and ejection fraction (LVEF) measurements obtained with electrocardiographic gated single-photon emission computed tomographic (SPECT) myocardial perfusion imaging (GS-MPI) with those obtained with gated SPECT cardiac blood-pool imaging (GS-pool). Fifteen patients underwent GS-MPI with technetium-99m tetrofosmin and GS-pool with technetium-99m-erythrocyte, within a mean interval of 8{+-}3 days. Eight patients had suspected dilated cardiomyopathy and seven patients had angiographically significant coronary artery disease. End-diastolic volume (EDV), end-systolic volume (ESV) and LVEF measurements were estimated from GS-MPI images by means of Cedars-Sinai automatic quantitative program and from GS-pool images by the threshold technique. Mean differences between GS-MPI and GS-pool in EDV, ESV and LVEF measurements were -2.8{+-}10.5 ml [95% confidence interval (CI): -8.6{+-}3.0 ml], 2.6{+-}7.3 ml (CI: -1.4-6.6 ml) and -2.3{+-}5.1% (CI: -5.1-0.6%), respectively. No significant difference in the mean differences from 0 was found for EDV, ESV or LVEF measurements. Bland-Altman plots revealed no trend over the measured LV volumes and LVEF. For all parameters, regression lines approximated lines of identity. The excellent agreement between GS-MPI and GS-pool measurements suggests that, for estimation of LV volumes and LVEF, these two techniques may be used interchangeably and measurements by one method can serve as a reference for the other. (author)

  1. Prediction of improvement of myocardial wall motion after coronary artery bypass surgery using rest Tl-201/dipyridamole stress gated Tc-99m-MIBI/24 hour delay Tl-201 SPECT

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Lee, Won Woo; Yeo, Jeong Yeo; Kim, Seok Ki; Kim, Ki Bong; Chung, June Key; Lee, Myung Chul

    1998-01-01

    Using rest Tl-201/ dipyridamole stress gated Tc-99m-MIBI/24 hour delay Tl-201 SPECT, we investigated the predictive values of the markers of the stress-rest reversibility (Rev), Tl-201 rest perfusion (Rest), Tl-201 24 hour redistribution (Del) and Tc-99m-MIBI gated systolic thickening (Thk) for wall motion improvement after coronary artery bypass surgery. In 39 patients (M:F=34:5, age 58±8), preoperative and postoperative (3 months) SPECT were compared. 24 hour delayed SPECT was done in 16 patients having perfusion defects at rest. Perfusion or wall motion was scored from 0 to 3 (0: normal to 3: defect or dyskinesia). Wall motion was abnormal in 142 segments among 585 segments of 99 artery territories which were surgically revascularized. After bypass surgery, ejection fraction increased from 37.8±9.0% to 45.5±12.3% in 22 patients who had decreased ejectin fraction preoperatively. Wall motion improved in 103 (72.5%) segments among 142 dysfunctional segments. Positive predictive values (PPV) of Rev, Rest, Del, and Thk were 83%, 76%, 43%, and 69% respectively. Negative predictive values (NPV) of Rev, Rest, Del, and Thk were 48%, 44%, 58%, and 21%, respectively. Rest/gated stress/delay SPECT had PPV of 74% and NPV of 46%. Through univariate logistic regression analysis revealed Rev( p=0.0008) and Rest (p=0.024) as significant predictors, stepwise multivariate test found Rev as the only good predictor (p=0.0008). Among independent predictors obtained by rest Tl-201/stress gated Tc-99m-MIBI/delayed Tl-201 myocardial SPECT for wall motion improvement after bypass surgery, stress-rest reversibility was the single most useful predictor

  2. Clinical evaluation of SPECT in cerebrovascular disease

    International Nuclear Information System (INIS)

    Oshibuchi, Masao; Satoh, Mitsutaka; Kanda, Tetsuro; Nishi, Fumiaki; Yamane, Kanji; Fujimatsu, Masahiko; Edamitsu, Satoshi; Anno, Yasuro; Ohtake, Hisashi.

    1989-01-01

    In 131 patients with cerebrovascular disease, regional cerebral blood flow were determined by 123 I-IMP (N-isopropyl ( 123 I)-iodoamphetamine) or 99m Tc-HM-PAO ( 99m Tc (d, 1)-hexamethyl propyleneamine oxime) SPECT and findings were compared with those of X-CT or MRI. The perfusion deficit detected by SPECT was larger than the deficit by X-CT or MRI in every case. The perfusion deficit area was more clearly demonstrated by SPECT than by X-CT or MRI in patients with acute cerebral infarction. The hypoperfusion area determined by 123 I-IMP SPECT was wider than that by 99m Tc-HM-PAO SPECT. The crossed cerebellar diaschisis was observed in 56 out of 131 cases (43%). The results of operation were quantitatively evaluated by 123 I-IMP SPECT in 25 patients. (author)

  3. SPECT Myocardial Blood Flow Quantitation Concludes Equivocal Myocardial Perfusion SPECT Studies to Increase Diagnostic Benefits.

    Science.gov (United States)

    Chen, Lung-Ching; Lin, Chih-Yuan; Chen, Ing-Jou; Ku, Chi-Tai; Chen, Yen-Kung; Hsu, Bailing

    2016-01-01

    Recently, myocardial blood flow quantitation with dynamic SPECT/CT has been reported to enhance the detection of coronary artery disease in human. This advance has created important clinical applications to coronary artery disease diagnosis and management for areas where myocardial perfusion PET tracers are not available. We present 2 clinical cases that undergone a combined test of 1-day rest/dipyridamole-stress dynamic SPECT and ECG-gated myocardial perfusion SPECT scans using an integrated imaging protocol and demonstrate that flow parameters are capable to conclude equivocal myocardial perfusion SPECT studies, therefore increasing diagnostic benefits to add value in making clinical decisions.

  4. Gated single photon emission computer tomography for the detection of silent myocardial ischemia

    International Nuclear Information System (INIS)

    Pena Q, Yamile; Coca P, Marco Antonio; Batista C, Juan Felipe; Fernandez-Britto, Jose; Quesada P, Rodobaldo; Pena C; Andria

    2009-01-01

    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. All subjects were 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, specificity, 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

  5. Assessment of left ventricular function by electrocardiogram-gated myocardial single photon emission computed tomography using quantitative gated single photon emission computed tomography software

    International Nuclear Information System (INIS)

    Morita, Koichi; Adachi, Itaru; Konno, Masanori

    1999-01-01

    Electrocardiogram (ECG)-gated myocardial single photon emission computed tomography (SPECT) can assess left ventricular (LV) perfusion and function easily using quantitative gated SPECT (QGS) software. ECG-gated SPECT was performed in 44 patients with coronary artery disease under post-stress and resting conditions to assess the values of LV functional parameters, by comparison to LV ejection fraction derived from gated blood pool scan and myocardial characteristics. A good correlation was obtained between ejection fraction using QGS and that using cardiac blood pool scan (r=0.812). Some patients with myocardial ischemia had lower ejection fraction under post-stress compared to resting conditions, indicating post-stress LV dysfunction. LV wall motion and wall thickening were significantly impaired in ischemic and infarcted myocardium, and the degree of abnormality in the infarcted areas was greater than in the ischemia area. LV functional parameters derived using QGS were useful to assess post-stress LV dysfunction and myocardial viability. In conclusion, ECG-gated myocardial SPECT permits simultaneous quantitative assessment of myocardial perfusion and function. (author)

  6. Gated SPECT evaluation of left ventricular function using a CZT camera and a fast low-dose clinical protocol: comparison to cardiac magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Giorgetti, Assuero; Masci, Pier Giorgio; Marras, Gavino; Gimelli, Alessia; Genovesi, Dario; Lombardi, Massimo [Fondazione CNR/Regione Toscana ' ' G. Monasterio' ' , Pisa (Italy); Rustamova, Yasmine K. [Azerbaijan Medical University, Department of internal medicine Central Customs Hospital, Baku (Azerbaijan); Marzullo, Paolo [Istituto di Fisiologia Clinica del CNR, Pisa (Italy)

    2013-12-15

    CZT technology allows ultrafast low-dose myocardial scintigraphy but its accuracy in assessing left ventricular function is still to be defined. The study group comprised 55 patients (23 women, mean age 63 {+-} 9 years) referred for myocardial perfusion scintigraphy. The patients were studied at rest using a CZT camera (Discovery NM530c; GE Healthcare) and a low-dose {sup 99m}Tc-tetrofosmin clinical protocol (mean dose 264 {+-} 38 MBq). Gated SPECT imaging was performed as a 6-min list-mode acquisition, 15 min after radiotracer injection. Images were reformatted (8-frame to 16-frame) using Lister software on a Xeleris workstation (GE Healthcare) and then reconstructed with a dedicated iterative algorithm. Analysis was performed using Quantitative Gated SPECT (QGS) software. Within 2 weeks patients underwent cardiac magnetic resonance imaging (cMRI, 1.5-T unit CVi; GE Healthcare) using a 30-frame acquisition protocol and dedicated software for analysis (MASS 6.1; Medis). The ventricular volumes obtained with 8-frame QGS showed excellent correlations with the cMRI volumes (end-diastolic volume (EDV), r = 0.90; end-systolic volume (ESV), r = 0.94; p < 0.001). However, QGS significantly underestimated the ventricular volumes (mean differences: EDV, -39.5 {+-} 29 mL; ESV, -15.4 {+-} 22 mL; p < 0.001). Similarly, the ventricular volumes obtained with 16-frame QGS showed an excellent correlations with the cMRI volumes (EDV, r = 0.92; ESV, r = 0.95; p < 0.001) but with significant underestimations (mean differences: EDV, -33.2 {+-} 26 mL; ESV, -17.9 {+-} 20 mL; p < 0.001). Despite significantly lower values (47.9 {+-} 16 % vs. 51.2 {+-} 15 %, p < 0.008), 8-frame QGS mean ejection fraction (EF) was closely correlated with the cMRI values (r = 0.84, p < 0.001). The mean EF with 16-frame QGS showed the best correlation with the cMRI values (r = 0.91, p < 0.001) and was similar to the mean cMRI value (49.6 {+-} 16 %, p not significant). Regional analysis showed a good

  7. Combination of physical exercise and adenosine improves accuracy of automatic calculation of stress LVEF in gated SPECT using QGS software

    International Nuclear Information System (INIS)

    Tehranipour, N.; AL-Nahhas, A.; Towey, D.

    2005-01-01

    Combining exercise and adenosine during the stress phase of myocardial perfusion imaging (MPI) is known to reduce adverse effects and improve image quality. The aim of this study was to assess whether it can also improve the automatic calculation of left ventricular ejection fraction (LVEF) by QGS software package, during the stress phase of Gated SPECT. One hundred patients who had stress Gated SPECT were retrospectively included in this study. Gated data of those who had adenosine only (50 patients = group A) was compared with those obtained in another group of 50 patients who had added bicycle exercise (Group B). All had identical image acquisition protocol using 99mT c-tetrofosmine. Clinical adverse effects, changes in blood pressure (BP), heart rate (HR), and ECG were monitored. Visual assessment of subdiaphragmatic uptake and accuracy of automatic regions of interest (ROI's) drawn by the software were noted. Regions of interest that involved sub-diaphragmatic uptake and resulting in low LVEF were manually adjusted to include the left ventricle only, and the frequency of manual adjustment was noted. No significant difference was noted in age, sex, baseline BP and HR between groups A and B. Adverse effects occurred less often in group B compared to group A (12% vs. 24%, p = 0.118). Maximum HR and BP achieved during stress were significantly higher in group B compared to group A (p 0.025, p = 0.001 respectively). The number of patients who had faulty ROI's and low LVEF, who needed manual adjustment of ROI.s, were higher in group A compared to group B (16% vs. 6%, p = 0.025). The values of LVEF showed significant improvement following manual adjustment of ROI's, increasing from a mean of 19.63 ± 15.96 to 62.13 ± 7.55 (p = 0.0001) and from 17.33 ± 9.5 to 49.67 ± 7.7 (p = 0.0014) in groups A and B respectively. The addition of exercise to adenosine significantly improves the automatic calculation of LVEF by QGS software during Gated SPECT and reduces the need

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-09-15

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

  9. Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology

    Science.gov (United States)

    Erlandsson, Kjell; Kacperski, Krzysztof; van Gramberg, Dean; Hutton, Brian F.

    2009-05-01

    D-SPECT (Spectrum Dynamics, Israel) is a novel SPECT system for cardiac perfusion studies. Based on CZT detectors, region-centric scanning, high-sensitivity collimators and resolution recovery, it offers potential advantages over conventional systems. A series of measurements were made on a β-version D-SPECT system in order to evaluate its performance in terms of energy resolution, scatter fraction, sensitivity, count rate capability and resolution. Corresponding measurements were also done on a conventional SPECT system (CS) for comparison. The energy resolution of the D-SPECT system at 140 keV was 5.5% (CS: 9.25%), the scatter fraction 30% (CS: 34%), the planar sensitivity 398 s-1 MBq-1 per head (99mTc, 10 cm) (CS: 72 s-1 MBq-1), and the tomographic sensitivity in the heart region was in the range 647-1107 s-1 MBq-1 (CS: 141 s-1 MBq-1). The count rate increased linearly with increasing activity up to 1.44 M s-1. The intrinsic resolution was equal to the pixel size, 2.46 mm (CS: 3.8 mm). The average reconstructed resolution using the standard clinical filter was 12.5 mm (CS: 13.7 mm). The D-SPECT has superior sensitivity to that of a conventional system with similar spatial resolution. It also has excellent energy resolution and count rate characteristics, which should prove useful in dynamic and dual radionuclide studies.

  10. Evaluation of usefulness of bone SPECT for lumbar spondylolysis

    International Nuclear Information System (INIS)

    Watanabe, Osamu; Hashimoto, Manabu; Tomura, Noriaki; Watarai, Jiro

    2002-01-01

    The purpose of this study was to evaluate the usefulness of 99m Tc-MDP SPECT (bone SPECT) for lumbar spondylolysis. We analyzed 11 cases with 17 lesions. All cases were compared using plain radiography, computed tomography (CT), planar bone scintigraphy (PBS), and bone SPECT. Four lesions that showed a wide defect on CT were negative on bone SPECT and may have been chronic lesions. Thirteen lesions that were positive on bone SPECT were narrow or showed no defect on CT and may have been early lesions. Two cases showed no defect on CT but were positive on bone SPECT, and one of them progressed to bilateral spondylolysis after one year. This may have been a very early lesion. Thus bone SPECT is useful for the diagnosis of lumbar spondylolysis, especially in its early stage. (author)

  11. Evaluation of usefulness of bone SPECT for lumbar spondylolysis

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Osamu; Hashimoto, Manabu; Tomura, Noriaki; Watarai, Jiro [Akita Univ. (Japan). School of Medicine

    2002-07-01

    The purpose of this study was to evaluate the usefulness of {sup 99m}Tc-MDP SPECT (bone SPECT) for lumbar spondylolysis. We analyzed 11 cases with 17 lesions. All cases were compared using plain radiography, computed tomography (CT), planar bone scintigraphy (PBS), and bone SPECT. Four lesions that showed a wide defect on CT were negative on bone SPECT and may have been chronic lesions. Thirteen lesions that were positive on bone SPECT were narrow or showed no defect on CT and may have been early lesions. Two cases showed no defect on CT but were positive on bone SPECT, and one of them progressed to bilateral spondylolysis after one year. This may have been a very early lesion. Thus bone SPECT is useful for the diagnosis of lumbar spondylolysis, especially in its early stage. (author)

  12. [Image fusion of gated-SPECT and CT angiography in coronary artery disease. Importance of anatomic-functional correlation].

    Science.gov (United States)

    Nazarena Pizzi, M; Aguadé Bruix, S; Cuéllar Calabria, H; Aliaga, V; Candell Riera, J

    2010-01-01

    A 77-year old patient was admitted for acute coronary syndrome without ST elevation. His risk was stratified using the myocardial perfusion gated SPECT, mild inferior ischemia being observed. Thus, medical therapy was optimized and the patient was discharged. He continued with exertional dyspnea so a coronary CT angiography was performed. It revealed severe lesions in the proximal RCA. SPECT-CT fusion images correlated the myocardial perfusion defect with a posterior descending artery from the RCA, in a co-dominant coronary area. Subsequently, cardiac catheterism was indicated for his treatment. The current use of image fusion studies is limited to patients in whom it is difficult to attribute a perfusion defect to a specific coronary artery. In our patient, the fusion images helped to distinguish between the RCA and the circumflex artery as the culprit artery of ischemia. Copyright © 2010 Elsevier España, S.L. y SEMNIM. All rights reserved.

  13. Gated-SPECT myocardial scintigraphy in left bundle branch block: A study in patients with and without coronary artery disease

    International Nuclear Information System (INIS)

    Falcao, A.M.; Moffa, P.J.; Chalela, W.A.; Soares, J.; Oliveira, C.G.; Kreling, J.C.; Ferreira, B.A.; Uchida, A.H.; Meneghetti, J.C.

    2002-01-01

    Introduction: Myocardial perfusion scintigraphy (MPS) is a non-invasive method helpful for evaluating coronary heart disease. In left bundle branch block (LBBB), the myocardial scintigraphy frequently reveals septal abnormalities in the absence of coronary artery disease (CAD) and gives rise to 'false-positive' results in patients (pts) with suspected CAD. The purpose of this study was to assess the diagnostic role of ECG-gated SPECT in pts with complete LBBB, with and without known CAD. Methods. This study included 46 pts, 29 women (63%), with mean age 63.8 ± 11.6yr, divided into two groups: Group 1 (n=21 pts) with LBBB and CAD angiographically confirmed and Group 2 (n=25 pts) with LBBB and normal coronangiography. All pts underwent MPS at rest and two stress tests - dipyridamole (DIP) and treadmill exercise test (ET) with Bruce protocol. Myocardial perfusion, wall motility and wall thickening were analyzed qualitatively by consensus of two observers in anterior, septal, inferior, lateral and apical myocardial segments. Scores were attributed to: perfusion as normal, reversible or fixed defects; motility as normal, hypokinesia, akinesia or dyskinesia and thickening if present or absent. The left ventricle ejection fraction (LVEF) was automatically calculated from the ECG-gated SPECT. Results: The comparative analysis between groups 1 and 2 for both stresses (DIP and ET) for the parameters analyzed in the myocardial segments are presented: LVEF at rest, ET and DIP show statistically significant differences between groups 1 and 2 (p<0.0001). Conclusion: In the anterior and septal segments, only septal thickening was capable of differentiating between LBBB with and without CAD, independent of the kind of stress. In the other segments there was no influence of disturbance conduction for the perfusion analysis

  14. GATE V6: a major enhancement of the GATE simulation platform enabling modelling of CT and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Jan, S; Becheva, E [DSV/I2BM/SHFJ, Commissariat a l' Energie Atomique, Orsay (France); Benoit, D; Rehfeld, N; Stute, S; Buvat, I [IMNC-UMR 8165 CNRS-Paris 7 and Paris 11 Universities, 15 rue Georges Clemenceau, 91406 Orsay Cedex (France); Carlier, T [INSERM U892-Cancer Research Center, University of Nantes, Nantes (France); Cassol, F; Morel, C [Centre de physique des particules de Marseille, CNRS-IN2P3 and Universite de la Mediterranee, Aix-Marseille II, 163, avenue de Luminy, 13288 Marseille Cedex 09 (France); Descourt, P; Visvikis, D [INSERM, U650, Laboratoire du Traitement de l' Information Medicale (LaTIM), CHU Morvan, Brest (France); Frisson, T; Grevillot, L; Guigues, L; Sarrut, D; Zahra, N [Universite de Lyon, CREATIS, CNRS UMR5220, Inserm U630, INSA-Lyon, Universite Lyon 1, Centre Leon Berard (France); Maigne, L; Perrot, Y [Laboratoire de Physique Corpusculaire, 24 Avenue des Landais, 63177 Aubiere Cedex (France); Schaart, D R [Delft University of Technology, Radiation Detection and Medical Imaging, Mekelweg 15, 2629 JB Delft (Netherlands); Pietrzyk, U, E-mail: buvat@imnc.in2p3.fr [Reseach Center Juelich, Institute of Neurosciences and Medicine and Department of Physics, University of Wuppertal (Germany)

    2011-02-21

    GATE (Geant4 Application for Emission Tomography) is a Monte Carlo simulation platform developed by the OpenGATE collaboration since 2001 and first publicly released in 2004. Dedicated to the modelling of planar scintigraphy, single photon emission computed tomography (SPECT) and positron emission tomography (PET) acquisitions, this platform is widely used to assist PET and SPECT research. A recent extension of this platform, released by the OpenGATE collaboration as GATE V6, now also enables modelling of x-ray computed tomography and radiation therapy experiments. This paper presents an overview of the main additions and improvements implemented in GATE since the publication of the initial GATE paper (Jan et al 2004 Phys. Med. Biol. 49 4543-61). This includes new models available in GATE to simulate optical and hadronic processes, novelties in modelling tracer, organ or detector motion, new options for speeding up GATE simulations, examples illustrating the use of GATE V6 in radiotherapy applications and CT simulations, and preliminary results regarding the validation of GATE V6 for radiation therapy applications. Upon completion of extensive validation studies, GATE is expected to become a valuable tool for simulations involving both radiotherapy and imaging.

  15. Automatic construction of 3D-ASM intensity models by simulating image acquisition: application to myocardial gated SPECT studies.

    Science.gov (United States)

    Tobon-Gomez, Catalina; Butakoff, Constantine; Aguade, Santiago; Sukno, Federico; Moragas, Gloria; Frangi, Alejandro F

    2008-11-01

    Active shape models bear a great promise for model-based medical image analysis. Their practical use, though, is undermined due to the need to train such models on large image databases. Automatic building of point distribution models (PDMs) has been successfully addressed and a number of autolandmarking techniques are currently available. However, the need for strategies to automatically build intensity models around each landmark has been largely overlooked in the literature. This work demonstrates the potential of creating intensity models automatically by simulating image generation. We show that it is possible to reuse a 3D PDM built from computed tomography (CT) to segment gated single photon emission computed tomography (gSPECT) studies. Training is performed on a realistic virtual population where image acquisition and formation have been modeled using the SIMIND Monte Carlo simulator and ASPIRE image reconstruction software, respectively. The dataset comprised 208 digital phantoms (4D-NCAT) and 20 clinical studies. The evaluation is accomplished by comparing point-to-surface and volume errors against a proper gold standard. Results show that gSPECT studies can be successfully segmented by models trained under this scheme with subvoxel accuracy. The accuracy in estimated LV function parameters, such as end diastolic volume, end systolic volume, and ejection fraction, ranged from 90.0% to 94.5% for the virtual population and from 87.0% to 89.5% for the clinical population.

  16. Brain SPECT using dipyridamole for evaluation of vascular reserve

    International Nuclear Information System (INIS)

    Kim, Su Zy; Park, Chan Hee; Yoon, Soo Hwan; Pai, Moon Sun; Yoon, Suk Nam; Cho, Kyung Kee

    1997-01-01

    Baseline and stress brain SPECT studies using CO 2 inhalation, acetazolamide (Diamox R ) and adenosine administrations have been used in the evaluation of cerebral vascular reserve. Recently dipyridamole (Persantine R ) which is one of the pharmacologic myocardial perfusion SPECT agents as a potent vasodilator is suggested as another cerebral vasodilator. IV Diamox R is not available in Korea. Therefore, the purpose of our study was to evaluate dipyridamole in stress brain SPECT in patients with Moya Moya disease. Eight patients with angiographically proven Moya Moya disease were studied. Their ages ranged from 7 to 62 year old. There were 4 males and 4 females. Each patient had a baseline and persantine brain SPECT studies with 1 to 3 days' interval. Dipyridamole was given intravenously at a dose of 0.56 mg/kg over 4 minutes while watching vital signs such as blood pressure, heart rate, and electrocardiogram. Three minutes after the completion of the infusion, 99mTc-ECD (0.2 mCi/Ib body weight) was injected. Brain SPECT was performed 30 minutes later using a tripple head gamma camera equipped with LEHR collimators. A total of 128 projections with an acquisition time of 30 second per projection was obtained and reconstructed by filtered back projections without attenuation correction. The difference between the baseline and persantine studies was analysed by visual and semiquantitavely. During the infusion of persantine, heart rate, blood pressure and side effects such as headache, chest discomfort were similar to the persantine myocardial SPECT studies. Five of eight patients showed a significant decrease in rCBF on persantine brain SPECT in comparison to the baseline study. The remaining three revealed no significant change in rCBF. Our study suggests that the dipyridamole stress brain SPECT is feasible and useful in assessing cerebral blood flow reserve. However we need to evaluate more number of patients in the future

  17. GATE simulation of a new design of pinhole SPECT system for small animal brain imaging

    International Nuclear Information System (INIS)

    Ozsahin, D. Uzun; Bläckberg, L.; Fakhri, G. El; Sabet, H.

    2017-01-01

    Small animal SPECT imaging has gained an increased interest over the past decade since it is an excellent tool for developing new drugs and tracers. Therefore, there is a huge effort on the development of cost-effective SPECT detectors with high capabilities. The aim of this study is to simulate the performance characteristics of new designs for a cost effective, stationary SPECT system dedicated to small animal imaging with a focus on mice brain. The conceptual design of this SPECT system platform, Stationary Small Animal SSA-SPECT, is to use many pixelated CsI:TI detector modules with 0.4 mm × 0.4 mm pixels in order to achieve excellent intrinsic detector resolution where each module is backed by a single pinhole collimator with 0.3 mm hole diameter. In this work, we present the simulation results of four variations of the SSA-SPECT platform where the number of detector modules and FOV size is varied while keeping the detector size and collimator hole size constant. Using the NEMA NU-4 protocol, we performed spatial resolution, sensitivity, image quality simulations followed by a Derenzo-like phantom evaluation. The results suggest that all four SSA-SPECT systems can provide better than 0.063% system sensitivity and < 1.5 mm FWHM spatial resolution without resolution recovery or other correction techniques. Specifically, SSA-SPECT-1 showed a system sensitivity of 0.09% in combination with 1.1 mm FWHM spatial resolution.

  18. Role of myocardial perfusion SPECT in asymptomatic diabetic patients

    International Nuclear Information System (INIS)

    Cho, I.; Chun, K.; Won, K.; Lee, H.; Park, J.; Shin, D.; Kim, Y.; Shim, B.; Lee, J.

    2002-01-01

    Purpose: It is important that early diagnosis and treatment of coronary artery disease in diabetic patients, but there are few reports on the prevalence of stress-induced myocardial perfusion abnormalities and the rates of cardiac event in patients with type 2 diabetes. We evaluated the scan findings on gated myocardial perfusion SPECT in asymptomatic diabetic patients. Methods: We performed pharmacological stress test and gated perfusion SPECT in 69 diabetic patients without cardiovascular symptom (mean age: 65 year, male 31 and female 38). Patients underwent two-day imaging protocol and stress study was performed injection of Tc-99m MIBI during adenosine infusion. We followed up these patients by reviewing medical records. Results: Fifty-two of 69 patients (74.5%) showed normal scan findings and 17 patients (24.6%) showed reversible or fixed perfusion defects. Three of 52 patients with normal scan findings showed decreased LV ejection fraction and decreased wall motion. Twenty-three patients with normal scan findings were possible to follow up for more than 1yr (mean time: 18.3±3.3 mo.) and they all had no cardiac event. Three patients with reversible perfusion defects were performed coronary angioplasty. Conclusion: Myocardial perfusion SPECT is a noninvasive method and maybe useful in early diagnosis and predicting prognosis in diabetic patients

  19. A methodology for generating normal and pathological brain perfusion SPECT images for evaluation of MRI/SPECT fusion methods: application in epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Grova, C [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France); Jannin, P [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France); Biraben, A [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France); Buvat, I [INSERM U494, CHU Pitie Salpetriere, Paris (France); Benali, H [INSERM U494, CHU Pitie Salpetriere, Paris (France); Bernard, A M [Service de Medecine Nucleaire, Centre Eugene Marquis, Rennes (France); Scarabin, J M [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France); Gibaud, B [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France)

    2003-12-21

    Quantitative evaluation of brain MRI/SPECT fusion methods for normal and in particular pathological datasets is difficult, due to the frequent lack of relevant ground truth. We propose a methodology to generate MRI and SPECT datasets dedicated to the evaluation of MRI/SPECT fusion methods and illustrate the method when dealing with ictal SPECT. The method consists in generating normal or pathological SPECT data perfectly aligned with a high-resolution 3D T1-weighted MRI using realistic Monte Carlo simulations that closely reproduce the response of a SPECT imaging system. Anatomical input data for the SPECT simulations are obtained from this 3D T1-weighted MRI, while functional input data result from an inter-individual analysis of anatomically standardized SPECT data. The method makes it possible to control the 'brain perfusion' function by proposing a theoretical model of brain perfusion from measurements performed on real SPECT images. Our method provides an absolute gold standard for assessing MRI/SPECT registration method accuracy since, by construction, the SPECT data are perfectly registered with the MRI data. The proposed methodology has been applied to create a theoretical model of normal brain perfusion and ictal brain perfusion characteristic of mesial temporal lobe epilepsy. To approach realistic and unbiased perfusion models, real SPECT data were corrected for uniform attenuation, scatter and partial volume effect. An anatomic standardization was used to account for anatomic variability between subjects. Realistic simulations of normal and ictal SPECT deduced from these perfusion models are presented. The comparison of real and simulated SPECT images showed relative differences in regional activity concentration of less than 20% in most anatomical structures, for both normal and ictal data, suggesting realistic models of perfusion distributions for evaluation purposes. Inter-hemispheric asymmetry coefficients measured on simulated data were

  20. Impact of endothelial dysfunction on left ventricular remodeling after successful primary coronary angioplasty for acute myocardial infarction. Analysis by quantitative ECG-gated SPECT

    International Nuclear Information System (INIS)

    Matsuo, Shinro; Nakae, Ichiro; Matsumoto, Tetsuya; Horie, Minoru

    2006-01-01

    We hypothesized that endothelial cell integrity in the risk area would influence left ventricular remodeling after acute myocardial infarction. Twenty patients (61±8 y.o.) with acute myocardial infarction underwent 99m Tc-tetrofosmin imaging in the sub-acute phase and three months after successful primary angioplasty due to myocardial infarction. All patients were administered angiotensin-converting enzyme inhibitor after revascularization. Cardiac scintigraphies with quantitative gated SPECT were performed at the sub-acute stage and again 3 months after revascularization to evaluate left ventricular (LV) remodeling. The left ventricular ejection fraction (EF) and end-systolic and end-diastolic volume (ESV, EDV) were determined using a quantitative gated SPECT (QGS) program. Three months after myocardial infarction, all patients underwent cardiac catheterization examination with coronary endothelial function testing. Bradykinin (BK) (0.2, 0.6, 2.0 μg/min) was administered via the left coronary artery in a stepwise manner. Coronary blood flow was evaluated by Doppler flow velocity measurement. Patients were divided into two groups by BK-response: a preserved endothelial function group (n=10) and endothelial dysfunction group (n=10). At baseline, both global function and LV systolic and diastolic volumes were similar in both groups. However, LV ejection fraction was significantly improved in the preserved-endothelial function group, compared with that in the endothelial dysfunction group (42±10% to 48±9%, versus 41±4% to 42±13%, p<0.05). LV volumes progressively increased in the endothelial dysfunction group compared to the preserved-endothelial function group (123±45 ml to 128±43 ml, versus 111±47 ml to 109±49 ml, p<0.05). In re-perfused acute myocardial infarction, endothelial function within the risk area plays an important role with left ventricular remodeling after myocardial infarction. (author)

  1. Asymmetrically thickened posterior wall is associated with decline of ejection fraction after stress on adenosine stress/rest thallium-201 gated myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bom Sahn; Lee, Won Woo; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2004-07-01

    LV parameters (LVEF. ESVI and EDVI) on adenosine stress/rest thallium-201 gated myocardial SPECT (gSPECT) are various from stress to rest. We investigated the reason why they were various in patients without coronary artery disease. Seventy-one patients(M:F=32:39, age 58.1{+-}9.7yrs), who underwent gSPECT and coronary angiography (CAG) due to chest pain or preoperative evaluation were included. CAG results were normal or insignificant. Exclusion criteria were atrial fibrillation, thyroid disease, primary cardiomyopathy, myocardial bridge, LBBB, MI, and valvular heart disease. Patients were calssified into 3 groups by EF difference ({delta}EF=rest-stress EF) on gSPECT : group1 ({delta}EF{>=}10), group2 (0 {<=}{delta}EF<10), and group3 ({delta}EF<0). LV parameters on gSPECT and thicknesses of IVS (interventricular septum) and LVPW (left ventricular posterior wall) on echocardiography were compared among the 3 groups. Myocardial perfusion status were normal or mild reversible/persistent perfusion defect in 76.1% (54/71). LVEFs at stress were not different among all 3 groups : 59.3{+-}8.54% in group 1 (61.3{+-}10.22% in group 2 and 64.8{+-}7.58% in group 3 (p>0.05). But LVEF at rest was smaller in group 3 (58.7{+-}8.38%) than the other groups (72.5{+-}8.77% in group1 and 66.7{+-}10.6% in group2) (p<0.01). EDVIs and ESVI at stress were larger than those at rest in all groups (p<0.05) except ESVI in group 3 (16.2{+-}6.21ml at stress and 17.5{+-}6.41ml at rest, p<0.01), and that was attributed to EF<0 in group 3. In echocardiographical analysis, group 3 had significantly increased wall thickness of LVPW (10.7{+-}1.2mm versus 9.4{+-}1.6mm, p=0.01) and decreased wall thickness ratio of IVS/LVPW (0.963{+-}0.102 versus 1.048{+-}0.104, p=0.035) than group 1. In patients without coronary artery disease, LVEF, EDVI and ESVI on gSPECT were various and decline of LVEF from stress to rest was caused by unnormalized ESVI . Asymmetrically thickened LVPW may play a crucial role and

  2. Cluster computing software for GATE simulations

    International Nuclear Information System (INIS)

    Beenhouwer, Jan de; Staelens, Steven; Kruecker, Dirk; Ferrer, Ludovic; D'Asseler, Yves; Lemahieu, Ignace; Rannou, Fernando R.

    2007-01-01

    Geometry and tracking (GEANT4) is a Monte Carlo package designed for high energy physics experiments. It is used as the basis layer for Monte Carlo simulations of nuclear medicine acquisition systems in GEANT4 Application for Tomographic Emission (GATE). GATE allows the user to realistically model experiments using accurate physics models and time synchronization for detector movement through a script language contained in a macro file. The downside of this high accuracy is long computation time. This paper describes a platform independent computing approach for running GATE simulations on a cluster of computers in order to reduce the overall simulation time. Our software automatically creates fully resolved, nonparametrized macros accompanied with an on-the-fly generated cluster specific submit file used to launch the simulations. The scalability of GATE simulations on a cluster is investigated for two imaging modalities, positron emission tomography (PET) and single photon emission computed tomography (SPECT). Due to a higher sensitivity, PET simulations are characterized by relatively high data output rates that create rather large output files. SPECT simulations, on the other hand, have lower data output rates but require a long collimator setup time. Both of these characteristics hamper scalability as a function of the number of CPUs. The scalability of PET simulations is improved here by the development of a fast output merger. The scalability of SPECT simulations is improved by greatly reducing the collimator setup time. Accordingly, these two new developments result in higher scalability for both PET and SPECT simulations and reduce the computation time to more practical values

  3. Four-dimensional MAP-RBI-EM image reconstruction method with a 4D motion prior for 4D gated myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taek-Soo; Tsui, Benjamin M.W. [Johns Hopkins Univ., Baltimore, MD (United States). Dept. of Radiology; Gullberg, Grant T. [Lawrence Berkeley National Laboratory, Berkeley, CA (United States)

    2011-07-01

    We evaluated and proposed here a 4D maximum a posteriori rescaled-block iterative (MAP-RBI)-EM image reconstruction method with a motion prior to improve the accuracy of 4D gated myocardial perfusion (GMP) SPECT images. We hypothesized that a 4D motion prior which resembles the global motion of the true 4D motion of the heart will improve the accuracy of the reconstructed images with regional myocardial motion defect. Normal heart model in the 4D XCAT (eXtended CArdiac-Torso) phantom is used as the prior in the 4D MAP-RBI-EM algorithm where a Gaussian-shaped distribution is used as the derivative of potential function (DPF) that determines the smoothing strength and range of the prior in the algorithm. The mean and width of the DPF equal to the expected difference between the reconstructed image and the motion prior, and smoothing range, respectively. To evaluate the algorithm, we used simulated projection data from a typical clinical {sup 99m}Tc Sestamibi GMP SPECT study using the 4D XCAT phantom. The noise-free projection data were generated using an analytical projector that included the effects of attenuation, collimator-detector response and scatter (ADS) and Poisson noise was added to generated noisy projection data. The projection datasets were reconstructed using the modified 4D MAP-RBI-EM with various iterations, prior weights, and sigma values as well as with ADS correction. The results showed that the 4D reconstructed image estimates looked more like the motion prior with sharper edges as the weight of prior increased. It also demonstrated that edge preservation of the myocardium in the GMP SPECT images could be controlled by a proper motion prior. The Gaussian-shaped DPF allowed stronger and weaker smoothing force for smaller and larger difference of neighboring voxel values, respectively, depending on its parameter values. We concluded the 4D MAP-RBI-EM algorithm with the general motion prior can be used to provide 4D GMP SPECT images with improved

  4. Prognostic significance of stress myocardial gated SPECT among Japanese patients referred for coronary angiography: A study of data from the J-ACCESS database

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuru [Tokyo Women' s Medical University, Department of Radiology, Tokyo (Japan); Nakajima, Kenichi [Kanazawa University Hospital, Department of Nuclear Medicine, Kanazawa (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2009-08-15

    The J-ACCESS [Japanese investigation of prognosis based on gated single photon emission computed tomography (SPECT)] study found that quantitative gated myocardial SPECT (QGS) is valuable for predicting the prognosis of Japanese patients with known or suspected ischaemic heart disease. The present study evaluates the incremental prognostic value of myocardial perfusion imaging (MPI) with QGS among patients referred for coronary angiography (CAG). Among 4,031 Japanese patients registered at 117 hospitals for the J-ACCESS study, we selected 1,011 who underwent CAG within 3 months before or after MPI with QGS. Summed stress, rest and difference scores (SSS, SRS and SDS) were generated from myocardial perfusion images using a 20-segment scoring system. Myocardial ischaemia was judged visually. End-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were determined by QGS. Numbers of diseased (> 75% stenosis) coronary vessels (CDV) were assessed by CAG. All patients were followed up for 3 years to determine cardiac events (CE) including cardiac death, non-fatal myocardial infarction and severe heart failure. Univariate and multivariate analyses of prognostic ability included age, cardiac risk factors (hypertension, hyperlipidaemia, diabetes mellitus and prior myocardial infarction), angiographic findings and the QGS parameters as independent variables. Cardiac events occurred more frequently with increasing numbers of coronary vessel lesions (p=0.0016). Cox univariate analysis revealed that diabetes, CDV, SSS, SDS, EDV, ESV and EF were significant predictors (Wald {chi}{sup 2}=5.99, 12.9, 8.39, 9.11, 35.5, 42.1 and 31.1, respectively), whereas multivariate analysis selected only ESV and SDS as significant predictors (Wald {chi}{sup 2}=36.4, 8.4; p = 0.0038, p < 0.001). MPI with QGS, especially with gated functional data, has incremental prognostic value in addition to angiographic findings. MPI with QGS findings predominantly contribute to the

  5. Influence of Respiratory Gating, Image Filtering, and Animal Positioning on High-Resolution Electrocardiography-Gated Murine Cardiac Single-Photon Emission Computed Tomography

    Directory of Open Access Journals (Sweden)

    Chao Wu

    2015-01-01

    Full Text Available Cardiac parameters obtained from single-photon emission computed tomographic (SPECT images can be affected by respiratory motion, image filtering, and animal positioning. We investigated the influence of these factors on ultra-high-resolution murine myocardial perfusion SPECT. Five mice were injected with 99m technetium (99mTc-tetrofosmin, and each was scanned in supine and prone positions in a U-SPECT-II scanner with respiratory and electrocardiographic (ECG gating. ECG-gated SPECT images were created without applying respiratory motion correction or with two different respiratory motion correction strategies. The images were filtered with a range of three-dimensional gaussian kernels, after which end-diastolic volumes (EDVs, end-systolic volumes (ESVs, and left ventricular ejection fractions were calculated. No significant differences in the measured cardiac parameters were detected when any strategy to reduce or correct for respiratory motion was applied, whereas big differences (> 5% in EDV and ESV were found with regard to different positioning of animals. A linear relationship (p < .001 was found between the EDV or ESV and the kernel size of the gaussian filter. In short, respiratory gating did not significantly affect the cardiac parameters of mice obtained with ultra-high-resolution SPECT, whereas the position of the animals and the image filters should be the same in a comparative study with multiple scans to avoid systematic differences in measured cardiac parameters.

  6. Evaluation of Tl-201 SPECT imaging findings in prostate cancer

    Directory of Open Access Journals (Sweden)

    Sinem Ozyurt

    2015-07-01

    Full Text Available Objectives: To compare with histopathological findings the findings of prostate cancer imaging by SPECT method using Tl-201 as a tumor seeking agent. Methods: The study comprised 59 patients (age range 51-79 years, mean age 65.3 ± 6.8 years who were planned to have transrectal ultrasonography (TRUS-guided biopsies due to suspicion of prostate cancer between April 2011 and September 2011. Early planar, late planar and SPECT images were obtained for all patients. Scintigraphic evaluation was made in relation to uptake presence and patterns in the visual assessment and to Tumor/Background (T/Bg ratios for both planar and SPECT images in the quantitative assessment. Histopathological findings were compatible with benign etiology in 36 (61% patients and malign etiology in 23 (39% patients. Additionally, comparisons were made to evaluate the relationships between uptake patterns,total PSA values and Gleason scores. Results: A statistically significant difference was found between the benign and malignant groups in terms of uptake in planar and SPECT images and T/Bg ratios and PSA values. No statistically significant difference was found between uptake patterns of planar and SPECT images and Gleason scores in the malignant group. Conclusions: SPECT images were superior to planar images in the comparative assessment. Tl-201 SPECT imaging can provide an additional contribution to clinical practice in the diagnosis of prostate cancer and it can be used in selected patients.

  7. Segmented slant hole collimator for stationary cardiac SPECT: Monte Carlo simulations.

    Science.gov (United States)

    Mao, Yanfei; Yu, Zhicong; Zeng, Gengsheng L

    2015-09-01

    This work is a preliminary study of a stationary cardiac SPECT system. The goal of this research is to propose a stationary cardiac SPECT system using segmented slant-hole collimators and to perform computer simulations to test the feasibility. Compared to the rotational SPECT, a stationary system has a benefit of acquiring temporally consistent projections. The most challenging issue in building a stationary system is to provide sufficient projection view-angles. A GATE (GEANT4 application for tomographic emission) Monte Carlo model was developed to simulate a two-detector stationary cardiac SPECT that uses segmented slant-hole collimators. Each detector contains seven segmented slant-hole sections that slant to a common volume at the rotation center. Consequently, 14 view-angles over 180° were acquired without any gantry rotation. The NCAT phantom was used for data generation and a tailored maximum-likelihood expectation-maximization algorithm was used for image reconstruction. Effects of limited number of view-angles and data truncation were carefully evaluated in the paper. Simulation results indicated that the proposed segmented slant-hole stationary cardiac SPECT system is able to acquire sufficient data for cardiac imaging without a loss of image quality, even when the uptakes in the liver and kidneys are high. Seven views are acquired simultaneously at each detector, leading to 5-fold sensitivity gain over the conventional dual-head system at the same total acquisition time, which in turn increases the signal-to-noise ratio by 19%. The segmented slant-hole SPECT system also showed a good performance in lesion detection. In our prototype system, a short hole-length was used to reduce the dead zone between neighboring collimator segments. The measured sensitivity gain is about 17-fold over the conventional dual-head system. The gate Monte Carlo simulations confirm the feasibility of the proposed stationary cardiac SPECT system with segmented slant

  8. Segmented slant hole collimator for stationary cardiac SPECT: Monte Carlo simulations

    Energy Technology Data Exchange (ETDEWEB)

    Mao, Yanfei, E-mail: ymao@ucair.med.utah.edu [Department of Radiology, Utah Center for Advanced Imaging Research (UCAIR), University of Utah, Salt Lake City, Utah 84108 and Department of Bioengineering, University of Utah, Salt Lake City, Utah 84112 (United States); Yu, Zhicong [Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905 (United States); Zeng, Gengsheng L. [Department of Radiology, Utah Center for Advanced Imaging Research (UCAIR), University of Utah, Salt Lake City, Utah 84108 and Department of Engineering, Weber State University, Ogden, Utah 84408 (United States)

    2015-09-15

    Purpose: This work is a preliminary study of a stationary cardiac SPECT system. The goal of this research is to propose a stationary cardiac SPECT system using segmented slant-hole collimators and to perform computer simulations to test the feasibility. Compared to the rotational SPECT, a stationary system has a benefit of acquiring temporally consistent projections. The most challenging issue in building a stationary system is to provide sufficient projection view-angles. Methods: A GATE (GEANT4 application for tomographic emission) Monte Carlo model was developed to simulate a two-detector stationary cardiac SPECT that uses segmented slant-hole collimators. Each detector contains seven segmented slant-hole sections that slant to a common volume at the rotation center. Consequently, 14 view-angles over 180° were acquired without any gantry rotation. The NCAT phantom was used for data generation and a tailored maximum-likelihood expectation-maximization algorithm was used for image reconstruction. Effects of limited number of view-angles and data truncation were carefully evaluated in the paper. Results: Simulation results indicated that the proposed segmented slant-hole stationary cardiac SPECT system is able to acquire sufficient data for cardiac imaging without a loss of image quality, even when the uptakes in the liver and kidneys are high. Seven views are acquired simultaneously at each detector, leading to 5-fold sensitivity gain over the conventional dual-head system at the same total acquisition time, which in turn increases the signal-to-noise ratio by 19%. The segmented slant-hole SPECT system also showed a good performance in lesion detection. In our prototype system, a short hole-length was used to reduce the dead zone between neighboring collimator segments. The measured sensitivity gain is about 17-fold over the conventional dual-head system. Conclusions: The GATE Monte Carlo simulations confirm the feasibility of the proposed stationary cardiac

  9. Left ventricular synchrony assessed by phase analysis of gated myocardial perfusion SPECT imaging in healthy subjects

    International Nuclear Information System (INIS)

    Wang Yuetao; Wang Jianfeng; Yang Minfu; Niu Rong

    2013-01-01

    Objective: To investigate the value of Cedars-Sinai quantitative gated SPECT (QGS) phase analysis for left ventricular synchrony assessment in healthy subjects. Methods: Seventy-four healthy subjects (41 males, 33 females,average age: (60±13) years) underwent both rest and exercise 99 Tc m -MIBI G-MPI. QGS software was used to analyze the reconstructed rest gated SPECT images automatically, and then the parameters of left ventricular synchrony including phase bandwidth (BW) and phase standard deviation (SD) were obtained. The influences of gender and age (age<60 years, n=36; age ≥ 60 years, n=38) on left ventricular systolic synchronicity were analyzed. The phase angle for original segmental contraction was measured to determine the onset of the ventricular contraction using 17-segment model. Forty healthy subjects were selected by simple random sampling method to evaluate the intra-observer and interobserver repeatability of QGS phase analysis software. Two-sample t test and linear correlation analysis were used to analyze the data. Results: The BW and SD of left ventricular in healthy subjects were (37.22 ±11.71)°, (11.84±5.39)° respectively. Comparisons between male and female for BW and SD yielded no statistical significance (BW: (36.00±9.70)°, (38.73±13.84)°; SD: (11.88±5.56)°, (11.79±5.26)°; t=0.96 and-0.07, both P>0.05); whereas the older subjects (age≥60 years) had larger BW than the others (age<60 years ; (39.95± 12.65)°, (34.33± 10.00)°; t=-2.11, P<0.05) and no statistical significance was shown for SD between the two age groups ((11.18±4.31)°, (12.54±6.33)°; t=1.08, P>0.05). Of the 74 subjects, the mechanical activation started from the ventricular base to apex in 54 subjects (73%), and from apex to base in only 20 subjects (27%). High repeatability of phase analysis was observed for both intra-observer and inter-observer (r=0.867-0.906, all P<0.001). Conclusions: Good left ventricular segmental synchrony is shown in healthy

  10. Serial cerebral hemodynamic change after extracranial-intracranial (EC-IC) bypass surgery: evaluated by acetazolamide stress brain perfusion SPECT(acz-SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Im, Ki Chun; Kim, Euy Nyong; Mun, Dae Hyeog [Asan Medical Center, Seoul (Korea, Republic of)

    2005-07-01

    We evaluated serial cerebral hemodynamic changes after EC-IC bypass surgery in symptomatic pts with atherosclerotic occlusion of internal carotid (lCA) or mid-cerebral artery (MCA) using Acz-SPECT. 25 symptomatic pts (M/F 19/6, 53{+-}10 y) with ICA and MCA occlusion (16 uni - and 9 bilateral) prospectively underwent Acz-SPECT using Tc-99m ECD before and 1 week after EC-IC bypass surgery. Of these, 16 underwent additional f/u Acz-SPECT 5 mo later. Cerebral perfusion and perfusion reserve of MCA territory were evaluated visually and SPECT findings were classified into 4 groups: N/N; R/N; N/R; and R/R (perfusion/perfusion reserve: N = normal, R = reduced). For semiquantitative analysis, all SPECT images were normalized to MNI template and mean counts of MCA territory and cerebellum were obtained by AAL. Cerebral perfusion index (PI =C{sub region}/C{sub cere}) and perfusion reserve index (RI = (PI{sub Acz} - PI{sub basal}) /Pl{sub basal}) were calculated. Preop SPECT findings of ipsilateral MCA in 25 pts were R/N (4%), N/R (12%), and R/R (84% ). Early postop SPECT showed improvement of perfusion (26%) and/or reserve (68%) in ipsilateral MCA. Of 16 pts with 5mo f/u SPECT, 6 (38%) showed further improvement of perfusion or reserve. However, 4 (25%) showed aggravation of perfusion and one of these underwent revision surgery. Preop PI (1.1{+-}0.1) and RI (0.11{+-}0.07) of ipsilateral MCA were significantly lower than those of contralateral hemispheres (p<0.05). After surgery, PIs of bilateral MCA did not change at early postop period but improved in ipsilateral MCA at 5mo. Rls of ipsilateral MCA increased significantly (68%) at early postop period (P<0.001) and then did not changed. Cerebral perfusion and perfusion reserve changed with different manner during 5 mo after bypass surgery and perfusion reserve changed more dramatically than perfusion. Acz-SPECT is a feasible method for evaluating cerebral hemodynamic change after EC-IC bypass surgery.

  11. Differential effects comparing exercise and pharmacologic stress on left ventricular function using gated Tc-99m sestamibi SPECT

    International Nuclear Information System (INIS)

    Ohtaki, Yuka; Chikamori, Taishiro; Igarashi, Yuko; Hida, Satoshi; Tanaka, Hirokazu; Hatano, Tsuguhisa; Usui, Yasuhiro; Miyagi, Manabu; Yamashina, Akira

    2008-01-01

    Although post-ischemic stunning has emerged as an important marker for severe coronary artery disease (CAD), differences in stress methods may have different effects on left ventricular (LV) volumes and function. To assess differential effects comparing exercise and pharmacologic stress on the LV measurements, 99m Tc-sestamibi gated single-photon emission computed tomography (SPECT) acquired more than 30 min after stress and at rest was evaluated in 38 patients undergoing adenosine triphosphate (ATP) stress (ATP group) and 38 age- and sex-matched patients subjected to exercise stress (Ex group) among 268 patients with normal SPECT findings. Coronary risk factors and LV volumetric measurements at baseline were similar in the two groups. Compared with volumetric measurements at rest, end-diastolic volume (EDV) increased (72±21 ml to 74±21 ml; P=0.01), end-systolic volume increased (25±12 ml to 28±13 ml; P=0.001), and ejection fraction (EF) decreased after stress (66%±8% to 63%±9%; P<0.002) in the ATP group. In the Ex group, by contrast, no such change was observed. In addition, changes in EDV (3±6 vs. -1±5 ml; P=0.01) and the stress-to-rest ratio of EDV (1.04±0.09 vs. 0.99±0.08; P<0.02) after stress were greater in the ATP than in the Ex group. Differential effects of stress methods on LV volumes persist more than 30 min after the stress. These findings should be kept in mind when interpreting post-ischemic stunning. (author)

  12. Time course evaluation of myocardial perfusion after reperfusion therapy by 99mTc-tetrofosmin SPECT in patients with acute myocardial infarction.

    Science.gov (United States)

    Tanaka, R; Nakamura, T

    2001-09-01

    Myocardial perfusion imaging with 99mTc-labeled agents immediately after reperfusion therapy can underestimate myocardial salvage. It is also conceivable that delayed imaging is useful for assessing the risk area. However, to our knowledge, very few studies have sequentially evaluated these image changes. We conducted 99mTc-tetrofosmin (TF) and 123I-beta-methyl-p-iodophenylpentadecanoic acid (BMIPP) SPECT before and after reperfusion to treat acute myocardial infarction and quantified changes in TF myocardial accumulation and reverse redistribution. Seventeen patients with a first myocardial infarction underwent successful reperfusion. We examined SPECT images obtained at the onset (preimage), those acquired 30 min (early image) and 6 h (delayed image) after TF injection, and images acquired 1, 4, 7, and 20 d after reperfusion (post-1-d, post-4-d, post-7-d, and post-20-d image, respectively). We also examined BMIPP SPECT images after 7 +/- 1.8 d (BMIPP image). Polar maps were divided into 48 segments to calculate percentage uptake, and time course changes in segment numbers below 60% were observed as abnormal area. Moreover, cardiac function was analyzed by gated TF SPECT on 1 and 20 d after reperfusion. In reference to the abnormal area on the early images, the post-1-d image was significantly improved compared with the preimage (P < 0.01) as was the post-7-d image compared with the post-1-d and post-4-d images (P < 0.05, respectively). However, post-20-d and post-7-d images did not significantly differ. Therefore, the improvement in myocardial accumulation reached a plateau 7 d after reperfusion. On the other hand, the abnormal area on the delayed images was significantly greater (P < 0.01) compared with that on the early images from 4 to 20 d after reperfusion, as the value was essentially constant. The correlations of the abnormal area between the preimage and the post-7-d delayed image, the preimage and the BMIPP image, and the post-7-d delayed image and the

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

    International Nuclear Information System (INIS)

    Mendoza V, R.

    2004-01-01

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

  14. Performance of Myocardial Perfusion Imaging Using Multi-focus Fan Beam Collimator with Resolution Recovery Reconstruction in a Comparison with Conventional SPECT

    International Nuclear Information System (INIS)

    Matsutomo, Norikazu; Nagaki, Akio; Sasaki, Masayuki

    2014-01-01

    IQ-SPECT is an advanced high-speed SPECT modality for myocardial perfusion imaging (MPI), which uses a multi-focus fan beam collimator with resolution recovery reconstruction. The aim of this study was to compare IQ-SPECT with conventional SPECT in terms of performance, based on standard clinical protocols. In addition, we examined the concordance between conventional and IQ-SPECT in patients with coronary artery disease (CAD). Fifty-three patients, undergoing rest-gated MPI for the evaluation of known or suspected CAD, were enrolled in this study. In each patient, conventional SPECT ( 99m Tc-tetrofosmin, 9.6 min and 201 Tl, 12.9 min) was performed, immediately followed by IQ-SPECT, using a short acquisition time (4.3 min for 99m Tc-tetrofosmin and 6.2 min for 201 Tl). A quantitative analysis was performed on an MPI polar map, using a 20-segment model of the left ventricle. An automated analysis by gated SPECT was carried out to determine the left ventricular volume and function including end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF). The degree of concordance between conventional SPECT and IQ-SPECT images was evaluated according to linear regression and Bland-Altman analyses. The segmental percent uptake exhibited a significant correlation between IQ-SPECT and conventional SPECT (P<0.05). The mean differences in 99m Tc-tetrofosmin studies were 1.1±6.6% (apex), 2.8±5.7% (anterior wall), 2.9±6.2% (septal wall), 4.9±6.7% (lateral wall), and 1.8±5.6% (inferior wall). Meanwhile, regarding the 201 Tl-SPECT studies, these values were 1.6±6.9%, 2.0±6.6%, 2.1±5.9%, 3.3±7.2%, and 2.4±5.8%, respectively. Although the mean LVEF in IQ-SPECT tended to be higher than that observed in conventional SPECT (conventional SPECT=64.8±11.8% and IQ-SPECT=68.3±12.1% for 99m Tc-tetrofosmin; conventional SPECT= 56.0±11.7% and IQ-SPECT=61.5±12.2% for 201 Tl), quantitative parameters were not significantly different between

  15. Validation of Left Ventricular Ejection Fraction with the IQ•SPECT System in Small-Heart Patients.

    Science.gov (United States)

    Yoneyama, Hiroto; Shibutani, Takayuki; Konishi, Takahiro; Mizutani, Asuka; Hashimoto, Ryosuke; Onoguchi, Masahisa; Okuda, Koichi; Matsuo, Shinro; Nakajima, Kenichi; Kinuya, Seigo

    2017-09-01

    The IQ•SPECT system, which is equipped with multifocal collimators ( SMART ZOOM) and uses ordered-subset conjugate gradient minimization as the reconstruction algorithm, reduces the acquisition time of myocardial perfusion imaging compared with conventional SPECT systems equipped with low-energy high-resolution collimators. We compared the IQ•SPECT system with a conventional SPECT system for estimating left ventricular ejection fraction (LVEF) in patients with a small heart (end-systolic volume IQ•SPECT. End-systolic volume, end-diastolic volume, and LVEF were calculated using quantitative gated SPECT (QGS) and cardioREPO software. We compared the LVEF from gated myocardial perfusion SPECT to that from echocardiographic measurements. Results: End-diastolic volume, end-systolic volume, and LVEF as obtained from conventional SPECT, IQ•SPECT, and echocardiography showed a good to excellent correlation regardless of whether they were calculated using QGS or using cardioREPO. Although LVEF calculated using QGS significantly differed between conventional SPECT and IQ•SPECT (65.4% ± 13.8% vs. 68.4% ± 15.2%) ( P = 0.0002), LVEF calculated using cardioREPO did not (69.5% ± 10.6% vs. 69.5% ± 11.0%). Likewise, although LVEF calculated using QGS significantly differed between conventional SPECT and IQ•SPECT (75.0 ± 9.6 vs. 79.5 ± 8.3) ( P = 0.0005), LVEF calculated using cardioREPO did not (72.3% ± 9.0% vs. 74.3% ± 8.3%). Conclusion: In small-heart patients, the difference in LVEF between IQ•SPECT and conventional SPECT was less when calculated using cardioREPO than when calculated using QGS. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

  17. Detection of myocardial viability by means of Single Proton Emission Computed Tomography (Perfused SPECT) dual {sup 201} Tl (rest of 15 minutes, 24 late hours and 24 hours reinjection) and gated-SPECT {sup 99m} Tc-SESTAMIBI in effort or stimulation of the coronary reserves; Deteccion de viabilidad miocardica mediante tomografia por emision de foton unico (SPECT perfusorio) dual {sup 201} Talio (Reposo de 15 minutos, 24 horas tardio y 24 horas reinyeccion) y gated-SPECT {sup 99m} Tc-SESTAMIBI en esfuerzo o estimulo de reserva coronaria

    Energy Technology Data Exchange (ETDEWEB)

    Mendoza V, R

    2004-07-01

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

  18. Feasibility and diagnostic accuracy of Ecg-gated SPECT myocardial perfusion imaging by a two-hour protocol: The Myofast study;Faisabilite et precision diagnostique d'un protocole de scintigraphie myocardique synchronisee a l'ECG en deux heures: l'etude Myofast

    Energy Technology Data Exchange (ETDEWEB)

    Dunet, V.; Costo, S.; Sabatier, R.; Grollier, G.; Bouvard, G.; Agostini, D. [CHU Cote-de-Nacre, Service de medecine nucleaire, 14 - Caen (France)

    2010-04-15

    Aim of the study: To assess the feasibility of early stress and rest myocardial perfusion and function study using a fast {sup 99m}Tc-tetrofosmin gated-SPECT protocol in patients with known coronary artery disease. Materials and methods: Forty-three patients (pts) (37 M, 6 F, mean age 63.8 +- 9.8 years) underwent a {sup 99m}Tc-Tetrofosmin gated-SPECT (Axis Picker-Philips) myocardial study and a coronary angiography (C.A.) within 3 months. Images were acquired (LEHR, eight bins, 40 sec per image) after injection of {sup 99m}Tc-tetrofosmin (200 to 380 MBq) early (15 min) post-stress (36 dipyridamole, two dobutamine and five ergo-metric stress), and at rest after {sup 99m}Tc-tetrofosmin reinjection (600 to 1150 MBq), in a total time not exceeding 2 hours. Processing was performed with Q.G.S. software using the 17-segment model. Pathological study was defined as a summed difference score (SDS) greater than or equal to 4 4, a fixed defect with summed rest score greater than or equal to 4 and/or L.V. dysfunction defined as myocardial stunning (variation between stress and rest L.V.E.F. greater than or equal to 4 5%), stress L.V.E.F. less than or equal to 45% or rest L.V.E.F. less than or equal to 40%. Results were compared with C.A., and stenosis greater than or equal to 4 50% was considered as significant. Results: For 100% the quality of SPECT imaging was good or excellent. For six patients gating was impossible because of arrhythmia. The overall sensitivity, specificity and accuracy were 95%, 50%, and 91%, respectively. The concordance between gated SPECT and C.A. was moderate (kappa = 0.45, S.E. = 0.15). Interestingly, early-gated acquisition permitted to underline left ventricular dysfunction in 11 cases (30%), of whom eight had poly vascular disease. Stunning was detected in six of 37 cases (16%), of whom six had poly vascular disease. Conclusion: A one-day two-hour {sup 99m}Tc-tetrofosmin gated-SPECT protocol to assess left ventricular perfusion and function is

  19. Implementation and Evaluation of Pinhole SPECT

    International Nuclear Information System (INIS)

    MacArtain Anne Marie

    2002-08-01

    The aim of this work was to implement Pinhole SPECT into a working Nuclear Medicine department. It has been reported that pinhole SPECT has been successfully performed to visualise pathology in ankle bones using gamma camera and the images were constructed using a standard filtered back-projection algorithm (Bahk YW, 1998). The objective of this study was to produce and evaluate this technique with the equipment available in the nuclear medicine department. The system performance was assessed using both the low-energy high resolution and the pinhole collimators. Phantoms constructed using capillary tubes, filled with technetium 99m (pertechnetate) were imaged in different arrays to identify possible limitations in the reconstruction software. A thyroid phantom with hot and cold inserts was also imaged. Data was acquired in ''tep-and-shoot'' mode as the camera was rotated 180 degrees or 360 degrees around the phantom. Images were reconstructed using standard parallel back-projection algorithm and a weighted backprojection algorithm (Nowak). An attempt was made to process images of the phantom in Matlab using the Iradon function modified by application of a cone-beam type algorithm (Feldkamp L, 1984). Visual comparison of static images between the pinhole and the LEHR collimators showed the expected improved spatial resolution of the pinhole images. Pinhole SPECT images should be reconstructed using the appropriate cone beam algorithm. However, it was established that reconstructing pinhole SPECT images using a standard parallel backprojection algorithm yielded results which were deemed to be clinically useful. The Nowak algorithm results were a distinct improvement on those achieved with the parallel backprojection algorithm. Likewise the results from the cone beam algorithm were better than the former but not as good as those obtained from the Nowak algorithm. This was due to the fact that the cone beam algorithm did not include a weighting factor. Implementation

  20. Clinical evaluation of 123I-IMP SPECT in patients with various neurological diseases

    International Nuclear Information System (INIS)

    Yoneda, Naoto

    1993-01-01

    Single photon emission computed tomography with N-isopropyl-p-[ 123 I] iodoamphetamine ( 123 I-IMP SPECT) was performed in 57 patients with various neurological disease, and compared with the findings of brain CT, MRI, and EEG. The author also evaluated the relationship between the findings on 123 I-IMP SPECT and the condition of the control of the attack after treatment with antiepileptic drugs in idiopathic epileptic patients. Abnormality of accumulation of 123 I-IMP SPECT was observed in 62.3% of all cases. Focal abnormality was detected in 28.3% of all cases by brain CT and 54.1% by MRI. The detectability of focal abnormality in brain CT and MRI was found to be lower than that of 123 I-TMP SPECT. There was very little significance in detectability between 123 I-IMP SPECT and EEG. But it infers that 123 I-IMP SPECT can detect the subictal state in epileptic patients. One comparative study of the relationship between the findings on 123 I-IMP SPECT and the condition of the control of the attack by antiepileptic drugs in patients with idiopathic epilepsy, abnormality of 123 I-IMP SPECT findings was found to be higher in patients who were not controlled sufficiently than in patients who were controlled sufficiently, and a significant difference is found by X 2 test. 123 I-IMP SPECT is useful for the evaluation of treatment in patients with epilepsy. (author)

  1. The clinical use of myocardial gated SPECT imaging with 99TcmN-NOEt

    International Nuclear Information System (INIS)

    Li Sijin; Hu Guang; Liu Jianzhong; Tian Mei; Li Xianfeng; Zhang Wanchun; Wang Jin

    2002-01-01

    Objective: To evaluate the clinical value of 99 Tc m N-NOEt myocardial perfusion imaging comparing with 99 Tc m -MIBI. Methods: Twenty patients (pts) were divided into 2 groups. Group 1 (G1), left ventricular ejection fraction (LVEF) ≥ 50%, 13 pts, the mean age was (49.9 +- 14.7) years. Group 2 (G2), LVEF 0.05 vs G1). All the pst underwent gated SPECT imaging at 30 and 120 min after injection of 925 MBq 99 Tc m N-NOEt at rest, and the heart to lung (H/L) activity ratio was calculated. Of the 6 pts in G2 and 1 pt in G1 underwent the 99 Tc m -MIBI imaging within 3 days to the former imaging at 120 min after 99 Tc m -MIBI injection under the same condition as at 99 Tc m N-NOEt imaging. The left ventricles of the 7 pts were divided into 63 segments with 9 segments for each, and the four-point scoring system was used to evaluate the tracer uptake in the segments. Results: The H/L ratio was 1.47 +- 0.47 and 1.59 +- 0.53 (P > 0.50) respectively in G1 and was 0.72 +- 0.11 and 0.89 +- 0.11 (P 99 Tc m N-NOEt and 99 Tc m -MIBI for the presence of defects was 93.65%, Kappa +- s = 0.87 +- 0.12. The mean score was 2.0 +- 0.84 (MIBI) and 2.38 +- 0.84 (NOEt) respectively (P > 0.05). Conclusions: 1) If the lung uptake of 99 Tc m N-NOET showed higher, it suggested that the left ventricular function was poor. 2) The results of LVEF, EDV and ESV were accordant between MIBI and NOEt. 3) The extent and intensity of myocardial defect with NOEt imaging was more severe than that with MIBI

  2. Evaluation of role of brain SPECT in diagnosis of post stroke dementia

    International Nuclear Information System (INIS)

    Yousepour, G.; Alavi, M.

    2003-01-01

    Post stroke dementia is one of the most common complications of stroke that is preventable and relatively treatable too. The purpose of the study is comparison between the positive findings in the brain CT scan and brain perfusion SPECT. 15 patients who were complicated by dementia after cerebrovascular accident and also 5 patients as a control group enrolled in this study. Brain CT scan and brain SPECT were performed during at most one week after stroke. Abnormal findings in both brain CT scan and SPECT were seen in 46% of patients. Brain CT scan disclosed more abnormal findings compared to brain SPECT (33.3%). While brain SPECT findings were more information than brain CT scan (20%) this study is indicating that brain CT scan and the brain SPECT concomitantly for each other in better diagnosis of post stroke dementia. We did not find any specific diagnostic pattern in brain SPECT of patients suffering from post stroke dementia. The low quality of brain SPECT in spite of uniformity of gamma camera may be suggestive of low quality of Iran produced ECD kit that needs further evaluation

  3. The role of quantitative Tc-99m-MIBI gated SPECT/F-18-FDG PET imaging in the monitoring of intracoronary bone marrow cell transplantation

    International Nuclear Information System (INIS)

    Kaminek, M.; Myslivecek, M.

    2006-01-01

    A lot of unresolved questions still exist concerning the exact mechanism of the beneficial effects of bone marrow cell (BMC) transplantation for myocardial regeneration. The aim of this communication is to report the cases of patients with and without post-transplantation left ventricular function improvement. To this study we included consecutive patients with irreversible damage after a first acute ST-elevation myocardial infarction treated by coronary angioplasty with stent implantation. The irreversible damage was identified by dobutamine echocardiography and confirmed by rest gated Tc-99m-MIBI gated SPECT and in the majority of patients by F-18-FDG PET imaging as well. Using 4D-MSPECT software, we quantified MIBI/FDG uptake and gated SPECT left ventricular ejection fraction, end-diastolic/end-systolic volumes (LVEF, EDV/ESV) before BMC therapy and 3 months later. The results obtained in the initial group of patients in this study (27 patients in the BMC treated group, 16 patients in the control group) have been published previously [Eur J Nucl Med 2005; 32 (Suppl 1 ): S46]. Among the BMC group, we identified 13 responders to therapy with average LVEF improvement from 43.3%± 11% to 51.4%± 10.4% and EDV/ESV improvement from 145 ml/84 ml to 133 ml/67 ml. The remaining 14 patients were non-responders to therapy with no significant change in LVEF (39.1%±8.1% versus 39.8% ± 7.4%), the EDV/ESV increased from 166 ml/105 ml to 188 ml/116 ml. Responders to the cell therapy had prevailing MIBI uptake in the range of 31-50% of maximum in the infarction territory. On the other hand, non-responders to BMC therapy had prevailing MIBI uptake in the range of 0-30% of maximum. Two cases are presented in this report. Further studies with a larger cohort of patients would be helpful to evaluate our findings. We observed strong interindividual differences in the effectiveness of the cell therapy. Prevailing residual MIBI uptake in the range of 31-50% of maximum was in the

  4. Assessment of left ventricular function by gated cardiac blood-pool emission computed tomography using a rotating gamma camera

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa; Honda, Minoru

    1991-01-01

    To elucidate the usefulness of gated cardiac blood-pool single photon emission CT (SPECT) with Tc-99m for the evaluation of left ventricular (LV) global and regional functions, 18 patients with coronary artery disease were studied. Thirty-two gated projection images were obtained over 360-degree at 16 frames per cardiac cycle. As LV volume was calculated by integrating the numbers of voxels which constituted LV and multiplying by the volume of a single voxel (0.1143 ml), we performed phantom studies to determine the appropriate cut-off level to detect LV outline. These cut-off levels were affected by the background activity and organ volume itself. So we constructed Volume-Cut-Level-Curve at each background activity. In clinical studies, short axis images which constituted LV were selected and provisional LV volumes were calculated at the cut-off levels of 45, 50 and 55%. These volumes were plotted on the Volume-Cut-Level-Curve and the true cut-off levels were obtained to calculate LV end-diastolic or end-systolic volume (EDV, ESV). The cut-off levels were different at every patient and ED or ES. EDV, ESV and LV ejection fraction obtained by SPECT were correlatd well with those obtained by contrast ventriculography (LVG) (r=0.89, 0.94, 0.94 each, p<0.01). For the LV wall motion analysis, LVGs obtained at two projections were compared with SPECT or gated cardiac blood-pool planar imaging (Planar) in 5 segments. In addition to visual comparison, wall motion scores (WMS) based on the degree of wall motion abnormality were calculated in each segment. Correlation of WMS between LVG and SPECT (r=0.84) was significantly (p<0.01) superior to that between LVG and Planar (r=0.62). Especially in SPECT, wall motion analyses at septal and infero-posterior segments were superior to those in Planar. Although gated SPECT requires relatively long time to perform, it is a useful method to detect LV global and regional functions. (author)

  5. Development of a new statistical evaluation method for brain SPECT images

    International Nuclear Information System (INIS)

    Kawashima, Ryuta; Sato, Kazunori; Ito, Hiroshi; Koyama, Masamichi; Goto, Ryoui; Yoshioka, Seiro; Ono, Shuichi; Sato, Tachio; Fukuda, Hiroshi

    1996-01-01

    The purpose of this study was to develop a new statistical evaluation method for brain SPECT images. First, we made normal brain image databases using 99m Tc-ECD and SPECT in 10 normal subjects as described previously. Each SPECT images were globally normalized and anatomically standardized to the standard brain shape using Human Brain Atlas (HBA) of Roland et al. and each subject's X-CT. Then, mean and SD images were calculated voxel by voxel. For the next step, 99m Tc-ECD SPECT images of a patient were obtained, and global normalization and anatomical standardization were performed as the same way. Then, a statistical map was calculated as following voxel by voxel; (P-Mean)/SDx10+50, where P, mean and SD indicate voxel value of patient, mean and SD images of normal databases, respectively. We found this statistical map was helpful for clinical diagnosis of brain SPECT studies. (author)

  6. Influences of reconstruction and attenuation correction in brain SPECT images obtained by the hybrid SPECT/CT device: evaluation with a 3-dimensional brain phantom

    International Nuclear Information System (INIS)

    Akamatsu, Mana; Yamashita, Yasuo; Akamatsu, Go; Tsutsui, Yuji; Ohya, Nobuyoshi; Nakamura, Yasuhiko; Sasaki, Masayuki

    2014-01-01

    The aim of this study was to evaluate the influences of reconstruction and attenuation correction on the differences in the radioactivity distributions in 123 I brain SPECT obtained by the hybrid SPECT/CT device. We used the 3-dimensional (3D) brain phantom, which imitates the precise structure of gray matter, white matter and bone regions. It was filled with 123 I solution (20.1 kBq/mL) in the gray matter region and with K 2 HPO 4 in the bone region. The SPECT/CT data were acquired by the hybrid SPECT/CT device. SPECT images were reconstructed by using filtered back projection with uniform attenuation correction (FBP-uAC), 3D ordered-subsets expectation-maximization with uniform AC (3D-OSEM-uAC) and 3D OSEM with CT-based non-uniform AC (3D-OSEM-CTAC). We evaluated the differences in the radioactivity distributions among these reconstruction methods using a 3D digital phantom, which was developed from CT images of the 3D brain phantom, as a reference. The normalized mean square error (NMSE) and regional radioactivity were calculated to evaluate the similarity of SPECT images to the 3D digital phantom. The NMSE values were 0.0811 in FBP-uAC, 0.0914 in 3D-OSEM-uAC and 0.0766 in 3D-OSEM-CTAC. The regional radioactivity of FBP-uAC was 11.5% lower in the middle cerebral artery territory, and that of 3D-OSEM-uAC was 5.8% higher in the anterior cerebral artery territory, compared with the digital phantom. On the other hand, that of 3D-OSEM-CTAC was 1.8% lower in all brain areas. By using the hybrid SPECT/CT device, the brain SPECT reconstructed by 3D-OSEM with CT attenuation correction can provide an accurate assessment of the distribution of brain radioactivity

  7. Gated 99mTc-MIBI single-photon emission computed tomography for the evaluation of left ventricular ejection fraction. Comparison with three-dimensional echocardiography

    International Nuclear Information System (INIS)

    Lipiec, P.; Wejner-Mik, P.; Krzeminska-Pakula, M.; Kapusta, A.; Kasprzak, J.D.; Kusmierek, J.; Plachcinska, A.; Szuminski, R.

    2008-01-01

    Parameters of left ventricular systolic function directly influence the management of patients with suspected coronary artery disease (CAD). Quantitative gated single-photon emission computed tomography (QGS; Cedars-Sinai Medical Center, Los Angeles, CA, USA) allows the computation of left ventricular ejection fraction (LVEF) from myocardial perfusion imaging studies which are frequently performed on patients with suspected CAD. Three-dimensional (3D) echocardiography is considered to be the echocardiographic ''gold standard'' for the quantification of LVEF. We sought to compare QGS with 3D echocardiography in the evaluation of EF in patients with suspected CAD. Ninety-one consecutive patients with suspected CAD, scheduled for coronary angiography, underwent rest electrocardiographic-gated technetium-99m methoxyisobutylisonitrile SPECT (G-SPECT) with measurement of LVEF by QGS and transthoracic 3D echocardiography with off-line measurement of LVEF (Tomtec 4D LV Analysis 1.1). The diagnosis of CAD was based on coronary angiography, performed on every patient. Nine patients were excluded from the analysis owing to unsuitability for 3D echocardiography (8 patients) or G-SPECT (1 patient). In the remaining group of 82 patients, 71 (87%) had significant CAD, 34 (42%) had a history of myocardial infarction, and 50 (61%) had perfusion defects at rest G-SPECT images. The mean LVEF measured by QGS and 3D echocardiography was 53±13% and 53±10%, respectively. The mean difference in LVEF between 3D echocardiography and QGS was 0.1±6.0% (P=0.87), and the correlation between the values obtained by both methods was high (r=0.88, P< 0.001). The largest discrepancies were observed in patients with small ventricular volumes. In patients undergoing diagnostic work-up for CAD, the measurement of LVEF by QGS algorithm provides high correlation and satisfactory agreement with the results of reference ultrasound method- 3D echocardiography. (author)

  8. Assessment of global and regional LV function obtained by quantitative gated SPECT using {sup 99m}Tc-tetrofosmin. Comparison with left ventricular cineangiography and echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Ban, Kazunobu; Nakajima, Toru; Aoki, Naoto; Abe, Sumihisa; Handa, Shunnosuke; Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

    1998-11-01

    The quantitative gated SPECT (QGS) software that has automatic edge detection algorithm of the left ventricle, is able to calculate LV volumes and visualize LV wall motion with perfusion throughout the cardiac cycle. We evaluated the reliability of global and regional LV function derived from QGS using {sup 99m}Tc-tetrofosmin by comparing with left ventricular cineangiography (LVG) and echocardiography (ECHO). In 22 cardiac patients, end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. Using cinematic display, regional LV wall motion were scored on a 3-point scale (1=normal, 2=hypokinesis, 3=akinesis; WMS). EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). Correlation between WMS derived from QGS and ECHO was high (r=0.85, p<0.001). There was an inverse correlation between WMS and LVEF (r=0.77, p<0.001). In conclusion, QGS is useful to evaluate global LV function. Regional wall motion evaluated by QGS is good enough for clinical application. (author)

  9. Potential value of serial cerebral SPECT scanning in the evaluation of psychiatric illness

    International Nuclear Information System (INIS)

    Notardonato, H.; Gonzalez-Avilez, A.; Van Heertum, R.L.; O'Connell, R.A.; Yudd, A.P.

    1989-01-01

    Cerebral SPECT imaging has the potential to make an important contribution to clinical psychiatry. Cerebral SPECT scanning, stimulated by the work with PET, is readily available and much less expensive than PET. This paper reports a case demonstrating the potential value of cerebral SPECT scanning with I-123 IMP, specifically in the serial evaluation of a schizophrenic patient with auditory hallucinations. The initial scan revealed focal areas of increased uptake in the caudate nuclei of the basal ganglia, and in the right temporal lobe. After pharmacological treatment with clinical improvement, the follow-up SPECT scan demonstrated significant improvement in the distribution of the radiopharmaceutical

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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)

  11. Evaluation of attenuation and scatter correction requirements in small animal PET and SPECT imaging

    Science.gov (United States)

    Konik, Arda Bekir

    Positron emission tomography (PET) and single photon emission tomography (SPECT) are two nuclear emission-imaging modalities that rely on the detection of high-energy photons emitted from radiotracers administered to the subject. The majority of these photons are attenuated (absorbed or scattered) in the body, resulting in count losses or deviations from true detection, which in turn degrades the accuracy of images. In clinical emission tomography, sophisticated correction methods are often required employing additional x-ray CT or radionuclide transmission scans. Having proven their potential in both clinical and research areas, both PET and SPECT are being adapted for small animal imaging. However, despite the growing interest in small animal emission tomography, little scientific information exists about the accuracy of these correction methods on smaller size objects, and what level of correction is required. The purpose of this work is to determine the role of attenuation and scatter corrections as a function of object size through simulations. The simulations were performed using Interactive Data Language (IDL) and a Monte Carlo based package, Geant4 application for emission tomography (GATE). In IDL simulations, PET and SPECT data acquisition were modeled in the presence of attenuation. A mathematical emission and attenuation phantom approximating a thorax slice and slices from real PET/CT data were scaled to 5 different sizes (i.e., human, dog, rabbit, rat and mouse). The simulated emission data collected from these objects were reconstructed. The reconstructed images, with and without attenuation correction, were compared to the ideal (i.e., non-attenuated) reconstruction. Next, using GATE, scatter fraction values (the ratio of the scatter counts to the total counts) of PET and SPECT scanners were measured for various sizes of NEMA (cylindrical phantoms representing small animals and human), MOBY (realistic mouse/rat model) and XCAT (realistic human model

  12. Tc-99m-MDP/Ga-67 SPECT in the evaluation of otitis externa

    International Nuclear Information System (INIS)

    Tumeh, S.S.; Hamdan, U.; Desisto, W.; English, R.J.

    1988-01-01

    Four patients with otitis externa were studied with Tc-99m MDP and Ga-67 single photon emission computed tomography (SPECT). In addition to the abnormal uptake in the external ear seen with planar imaging, SPECT demonstrated mastoid uptake (proved clinically) that was not appreciated with planar imaging in three patients, one of whom had negative x-ray computed tomographic (CT) findings. In one patient, SPECT demonstrated midline uptake in the skull base that was not depicted by x-ray CF.No false-positive results were seen. The authors conclude that Tc-99m MDP/Ga-67 SPECT is superior to planar imaging and should be used in the evaluation of otitis externa

  13. Noninvasive evaluation of ischemic stroke with SPECT

    International Nuclear Information System (INIS)

    Gomez, C.R.; Malik, M.M.; Gomez, S.M.; Wingkun, E.C.

    1988-01-01

    Technetium Tc 99m DTPA single photon emission computerized tomography (SPECT) brain scans of 20 patients with acute ischemic stroke were reviewed retrospectively and compared with clinical and radiologic (CT) data. Fourteen of the patients had abnormal SPECT studies. The abnormal findings were demonstrated by static views in eight patients, by the flow study in one patient, and by both sets of images in the other five patients. All abnormalities correlated with the clinical syndrome of presentation, and only two of the patients had no corresponding lesions on CT. Of the six patients with normal SPECT scans, two had abnormal CT studies, and in the other four, no lesions were shown at all. The ability of /sup 99m/Tc DTPA SPECT to display cerebral infarctions appears to be, at best, comparable to that of CT. SPECT also provides qualitative information regarding flow dynamics in the affected hemisphere of some patients (6/20 in our review). This, we believe, represents the objective demonstration of the preexisting insufficient collateral flow in the hemisphere at risk for ischemic stroke

  14. Evaluation of the diagnostic performance of SPECT coupled to tomodensitometry (SPECT-CT) in the daily practice of bone scintigraphy at the Nuclear Medical station of Nancy

    International Nuclear Information System (INIS)

    Netter, F.; Journo, A.; Mayer, J.C.; Grandpierre, S.; Daragon, N.; Karcher, G.; Olivier, P.; Scigliano, S.

    2008-01-01

    Objective: The purpose of our study was to evaluate the diagnostic performance of SPECT coupled to computed axial tomography (SPECT- CT) in our daily practice of bone scintigraphy. Subjects and methods: SPECT- CT obtained as a complement to the planar bone scintigraphy in 39 patients were studied. Each type of image was retrospectively read by two different observers: a nuclear medicine physician who was unaware of SPECT- CT results analysed planar bone scintigraphy, a second one who was unaware of planar bone scintigraphy results analysed SPECT- CT images. In this population of patients, 17 patients were addressed in an oncologic setting. The 22 other patients were addressed for pain of indeterminate origin without neoplastic context. Results: In 13% of the cases, SPECT- CT specified the precise location of increased uptake foci seen on planar bone scintigraphy. In 38% of cases, SPECT- CT confirmed a diagnosis suspected by the planar bone scintigraphy. In 10% of cases, SPECT- CT established a diagnosis that was uncertain with planar bone scintigraphy. In 26% of cases, SPECT- CT brought no additional information. Finally in 3% of cases, SPECT- CT proved to be more sensitive than planar images. Conclusion: Our study demonstrates the utility of SPECT- CT in the daily practice of bone scintigraphy, this complementary imaging study benefited to 74% of our patients. (authors)

  15. Clinical evaluation of stress thallium spect in ischemic heart disease

    International Nuclear Information System (INIS)

    Sui, Osamu; Kimura, Nazuna; Soeki; Takeshi; Takeichi, Naoki; Shinohara, Hisanori; Tamura, Yoshiyuki; Fukuda, Nobuo

    1997-01-01

    Thallium SPECT was performed in patients with significant coronary artery stenosis, 67 cases were after maximal exercise and 74 cases were during coronary vasodilation induced by ATP (adenosine triphosphate) infusion. In patients suspected of angina pectoris, the sensitivity, specificity and predictive accuracy for detection of coronary artery disease (CAD) were 88%, 78% and 82% for exercise SPECT, and 100%, 72% and 84% for ATP SPECT studies, respectively. In patients with old myocardial infarction, these were 73%, 100% and 88% for exercise SPECT and 71%, 100% and 81% for ATP SPECT. These were 75%, 49% and 60% for treadmill exercise test in the patient group including both angina and myocardial infarction. For detection of diseased vessels, the diagnostic accuracy for left anterior descending artery and right coronary artery lesions was almost equal for ATP and exercise SPECT study, but ATP SPECT study was more sensitive than exercise SPECT study in detection of left circumflex artery lesions. ATP as well as exercise SPECT studies occasionally gave false positive results in patients with single-vessel disease. ATP as well as exercise SPECT studies underestimated the severity of multi-vessel disease. In general, the results of ATP SPECT imaging were highly concordant with the results of exercise SPECT imaging. ATP stress thallium SPECT imaging provided a safe and highly accurate diagnostic tool for detection of CAD. (author)

  16. Amplitude-based data selection for optimal retrospective reconstruction in micro-SPECT

    Science.gov (United States)

    Breuilly, M.; Malandain, G.; Guglielmi, J.; Marsault, R.; Pourcher, T.; Franken, P. R.; Darcourt, J.

    2013-04-01

    Respiratory motion can blur the tomographic reconstruction of positron emission tomography or single-photon emission computed tomography (SPECT) images, which subsequently impair quantitative measurements, e.g. in the upper abdomen area. Respiratory signal phase-based gated reconstruction addresses this problem, but deteriorates the signal-to-noise ratio (SNR) and other intensity-based quality measures. This paper proposes a 3D reconstruction method dedicated to micro-SPECT imaging of mice. From a 4D acquisition, the phase images exhibiting motion are identified and the associated list-mode data are discarded, which enables the reconstruction of a 3D image without respiratory artefacts. The proposed method allows a motion-free reconstruction exhibiting both satisfactory count statistics and accuracy of measures. With respect to standard 3D reconstruction (non-gated 3D reconstruction) without breathing motion correction, an increase of 14.6% of the mean standardized uptake value has been observed, while, with respect to a gated 4D reconstruction, up to 60% less noise and an increase of up to 124% of the SNR have been demonstrated.

  17. GATE: Improving the computational efficiency

    International Nuclear Information System (INIS)

    Staelens, S.; De Beenhouwer, J.; Kruecker, D.; Maigne, L.; Rannou, F.; Ferrer, L.; D'Asseler, Y.; Buvat, I.; Lemahieu, I.

    2006-01-01

    GATE is a software dedicated to Monte Carlo simulations in Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET). An important disadvantage of those simulations is the fundamental burden of computation time. This manuscript describes three different techniques in order to improve the efficiency of those simulations. Firstly, the implementation of variance reduction techniques (VRTs), more specifically the incorporation of geometrical importance sampling, is discussed. After this, the newly designed cluster version of the GATE software is described. The experiments have shown that GATE simulations scale very well on a cluster of homogeneous computers. Finally, an elaboration on the deployment of GATE on the Enabling Grids for E-Science in Europe (EGEE) grid will conclude the description of efficiency enhancement efforts. The three aforementioned methods improve the efficiency of GATE to a large extent and make realistic patient-specific overnight Monte Carlo simulations achievable

  18. Optimal left ventricular lead position assessed with phase analysis on gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Boogers, Mark J.; Chen, Ji; Garcia, Ernest V.; Bommel, Rutger J. van; Borleffs, C.J.W.; Schalij, Martin J.; Wall, Ernst E. van der; Bax, Jeroen J.; Dibbets-Schneider, Petra; Hiel, Bernies van der; Younis, Imad Al

    2011-01-01

    The aim of the current study was to evaluate the relationship between the site of latest mechanical activation as assessed with gated myocardial perfusion SPECT (GMPS), left ventricular (LV) lead position and response to cardiac resynchronization therapy (CRT). The patient population consisted of consecutive patients with advanced heart failure in whom CRT was currently indicated. Before implantation, 2-D echocardiography and GMPS were performed. The echocardiography was performed to assess LV end-systolic volume (LVESV), LV end-diastolic volume (LVEDV) and LV ejection fraction (LVEF). The site of latest mechanical activation was assessed by phase analysis of GMPS studies and related to LV lead position on fluoroscopy. Echocardiography was repeated after 6 months of CRT. CRT response was defined as a decrease of ≥15% in LVESV. Enrolled in the study were 90 patients (72% men, 67±10 years) with advanced heart failure. In 52 patients (58%), the LV lead was positioned at the site of latest mechanical activation (concordant), and in 38 patients (42%) the LV lead was positioned outside the site of latest mechanical activation (discordant). CRT response was significantly more often documented in patients with a concordant LV lead position than in patients with a discordant LV lead position (79% vs. 26%, p<0.01). After 6 months, patients with a concordant LV lead position showed significant improvement in LVEF, LVESV and LVEDV (p<0.05), whereas patients with a discordant LV lead position showed no significant improvement in these variables. Patients with a concordant LV lead position showed significant improvement in LV volumes and LV systolic function, whereas patients with a discordant LV lead position showed no significant improvements. (orig.)

  19. SVD-Based Evaluation of Multiplexing in Multipinhole SPECT Systems

    Directory of Open Access Journals (Sweden)

    Aaron K. Jorgensen

    2008-01-01

    Full Text Available Multipinhole SPECT system design is largely a trial-and-error process. General principles can give system designers a general idea of how a system with certain characteristics will perform. However, the specific performance of any particular system is unknown before the system is tested. The development of an objective evaluation method that is not based on experimentation would facilitate the optimization of multipinhole systems. We derive a figure of merit for prediction of SPECT system performance based on the entire singular value spectrum of the system. This figure of merit contains significantly more information than the condition number of the system, and is therefore more revealing of system performance. This figure is then compared with simulated results of several SPECT systems and is shown to correlate well to the results of the simulations. The proposed figure of merit is useful for predicting system performance, but additional steps could be taken to improve its accuracy and applicability. The limits of the proposed method are discussed, and possible improvements to it are proposed.

  20. 201Thallium SPECT, accuracy in astrocytoma diagnosis and treatment evaluation

    International Nuclear Information System (INIS)

    Kaellen, K.

    1999-10-01

    The aims of the studies included in this thesis were: - to investigate the reliability of 201 Thallium single photon emission computed tomography. Tl SPECT for preoperative diagnosis and histological staging of malignant astrocytomas in comparison with CT; - to develop a method for quantification of cerebral thallium uptake, and to evaluate the quantitative measurement in comparison with CT, for astrocytoma treatment follow-up purposes; - to compare quantitative Tl SPECT and proton magnetic resonance spectroscopy (H-MRS) with conventional MR imaging for astrocytoma monitoring, and to evaluate associations between change of morphological tumour characteristics during treatment and changes of cerebral thallium uptake and metabolic ratios. Results and conclusions: - High TI-index, calculated as a ratio comparing tumour uptake to uptake in the contralateral hemisphere, is an indicator of highly malignant astrocytoma. Differentiation between the high-grade astrocytomas, the low-grade astrocytomas, and infectious lesions is only partial, with an overlap of Tl-indexes between these groups. High-grade astrocytomas that do not show contrast enhancement on CT, and astrocytomas with central necrosis and moderate ring-enhancement, tend to be underestimated when evaluated by Tl-index calculation. Tl SPECT is not a reliable method for non-invasive tumour staging among the group of highly malignant astrocytomas. - Quantification of cerebral TI-uptake, defining the volume of viable tumour tissue, is a new method for astrocytoma chemotherapy monitoring. Results suggest that the method provides prognostic information, and information of treatment efficacy, at an earlier stage than CT. - We did not find a higher accuracy of quantitative Tl SPECT than of MR for monitoring purposes and our results indicated that treatment induced MR changes were interrelated with TI-uptake variations. - Multi-voxel H-MRS was difficult to apply for astrocytoma treatment monitoring, due to the anatomical

  1. The current status of SPECT or SPECT/CT in South Korea

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Ik Dong; Choi, Eun Kyung; Chung, Yong An [Dept. of Radiology, Incheon Saint Mary' s HospitalThe Catholic University of Korea, Incheon (Korea, Republic of)

    2017-06-15

    The first step to nuclear medicine in Korea started with introduction of the gamma camera in 1969. Although planar images with the gamma camera give important functional information, they have the limitations that result from 2-dimensional images. Single-photon emission computed tomography (SPECT) due to its 3-dimensional image acquisition is superior to earlier planar gamma imaging in image resolution and diagnostic accuracy. As demand for a hybrid functional and anatomical imaging device has increased, integrated SPECT/CT systems have been used. In Korea, SPECT/CT was for the first time installed in 2003. SPECT/CT can eliminate many possible pitfalls on SPECT-alone images, making better attenuation correction and thereby improving image quality. Therefore, SPECT/CT is clinically preferred in many hospitals in various aspects. More recently, additional SPECT/CT images taken from the region with equivocal uptake on planar images have been helpful in making precise interpretation as part of their clinical workup in postoperative thyroid cancer patients. SPECT and SPECT/CT have various advantages, but its clinical application has gradually decreased in recent few years. While some researchers investigated the myocardial blood flow with cardiac PET using F-18 FDG or N-13 ammonia, myocardial perfusion SPECT is, at present, the radionuclide imaging study of choice for the risk stratification and guiding therapy in the coronary artery disease patients in Korea. New diagnostic radiopharmaceuticals for AD have received increasing attention; nevertheless, brain SPECT will remain the most reliable modality evaluating cerebral perfusion.

  2. Effect of bypass on the motor activation SPECT compared to the acetazolamide SPECT

    International Nuclear Information System (INIS)

    Kawaguchi, Shoichiro; Iwahashi, Hideaki; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime

    2002-01-01

    The authors evaluated and analyzed motor activation single photon emission computed tomography (M-SPECT) in ischemic cerebrovascular disease compared to resting and acetazolamide (ACZ) activated SPECT studies. Seventeen cases with STA-MCA bypass performed for ischemic cerebrovascular disease were examined. The SPECT studies consisting of resting, ACZ activation, and motor activation stages were performed before bypass, at 1 month, and 3 months after bypass. The result of the M-SPECT was expressed as negative or positive. Before bypass: In all 17 cases, SPECT studies of the affected side showed reduction of resting cerebral blood flow (CBF) and reduction of cerebrovascular reserve capacity (CVRC). Eight cases were positive in the M-SPECT study. One week after bypass: The resting CBF increased in seven cases. Four showed preoperative positive M-SPECT. Eight cases showed improvement of the CVRC. Twelve cases were positive in M-SPECT, and two were negative in the preoperative M-SPECT. Three months after bypass: Thirteen cases showed improvement in the resting CBF, and fourteen cases showed improvement of the CVRC. Fourteen cases were positive in the M-SPECT, and among these, 6 were negative in the preoperative M-SPECT. There was a discrepancy between the improvement in CVRC and M-SPECT. M-SPECT study can provide information about the degree of hemodynamic compromise and effect of bypass surgery. (author)

  3. Effect of bypass on the motor activation SPECT compared to the acetazolamide SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Shoichiro; Iwahashi, Hideaki; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

    2002-03-01

    The authors evaluated and analyzed motor activation single photon emission computed tomography (M-SPECT) in ischemic cerebrovascular disease compared to resting and acetazolamide (ACZ) activated SPECT studies. Seventeen cases with STA-MCA bypass performed for ischemic cerebrovascular disease were examined. The SPECT studies consisting of resting, ACZ activation, and motor activation stages were performed before bypass, at 1 month, and 3 months after bypass. The result of the M-SPECT was expressed as negative or positive. Before bypass: In all 17 cases, SPECT studies of the affected side showed reduction of resting cerebral blood flow (CBF) and reduction of cerebrovascular reserve capacity (CVRC). Eight cases were positive in the M-SPECT study. One week after bypass: The resting CBF increased in seven cases. Four showed preoperative positive M-SPECT. Eight cases showed improvement of the CVRC. Twelve cases were positive in M-SPECT, and two were negative in the preoperative M-SPECT. Three months after bypass: Thirteen cases showed improvement in the resting CBF, and fourteen cases showed improvement of the CVRC. Fourteen cases were positive in the M-SPECT, and among these, 6 were negative in the preoperative M-SPECT. There was a discrepancy between the improvement in CVRC and M-SPECT. M-SPECT study can provide information about the degree of hemodynamic compromise and effect of bypass surgery. (author)

  4. Combined use of 64-slice computed tomography angiography and gated myocardial perfusion SPECT for the detection of functionally relevant coronary artery stenoses. First results in a clinical setting concerning patients with stable angina

    International Nuclear Information System (INIS)

    Hacker, M.; Hack, N.; Tiling, R.; Jakobs, T.; Nikolaou, K.; Becker, C.; Ziegler, F. von; Knez, A.; Koenig, A.; Klauss, V.

    2007-01-01

    Aim: In patients with stable angina pectoris both morphological and functional information about the coronary artery tree should be present before revascularization therapy is performed. High accuracy was shown for spiral computed tomography (MDCT) angiography acquired with a 64-slice CT scanner compared to invasive coronary angiography (ICA) in detecting obstructive'' coronary artery disease (CAD). Gated myocardial SPECT (MPI) is an established method for the noninvasive assessment of functional significance of coronary stenoses. Aim of the study was to evaluate the combination of 64-slice CT angiography plus MPI in comparison to ICA plus MPI in the detection of hemodynamically relevant coronary artery stenoses in a clinical setting. Patients, methods: 30 patients (63 ± 10.8 years, 23 men) with stable angina (21 with suspected, 9 with known CAD) were investigated. MPI, 64-slice CT angiography and ICA were performed, reversible and fixed perfusion defects were allocated to determining lesions separately for MDCT angiography and ICA. The combination of MDCT angiography plus MPI was compared to the results of ICA plus MPI. Results: Sensitivity, specificity, negative and positive predictive value for the combination of MDCT angiography plus MPI was 85%, 97%, 98% and 79%, respectively, on a vessel-based and 93%, 87%, 93% and 88%, respectively, on a patient-based level. 19 coronary arteries with stenoses =50% in both ICA and MDCT angiography showed no ischemia in MPI. Conclusion: The combination of 64-slice CT angiography and gated myocardial SPECT enabled a comprehensive non-invasive view of the anatomical and functional status of the coronary artery tree. (orig.)

  5. Combined use of 64-slice computed tomography angiography and gated myocardial perfusion SPECT for the detection of functionally relevant coronary artery stenoses. First results in a clinical setting concerning patients with stable angina

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, M.; Hack, N.; Tiling, R. [Klinikum Grosshadern (Germany). Dept. of Nuclear Medicine; Jakobs, T.; Nikolaou, K.; Becker, C. [Klinikum Grosshadern (Germany). Dept. of Clinical Radiology; Ziegler, F. von; Knez, A. [Klinikum Grosshadern (Germany). Dept. of Cardiology; Koenig, A.; Klauss, V. [Medizinische Poliklinik-Innenstadt, Univ. of Munich (Germany). Dept. of Cardiology

    2007-07-01

    Aim: In patients with stable angina pectoris both morphological and functional information about the coronary artery tree should be present before revascularization therapy is performed. High accuracy was shown for spiral computed tomography (MDCT) angiography acquired with a 64-slice CT scanner compared to invasive coronary angiography (ICA) in detecting ''obstructive'' coronary artery disease (CAD). Gated myocardial SPECT (MPI) is an established method for the noninvasive assessment of functional significance of coronary stenoses. Aim of the study was to evaluate the combination of 64-slice CT angiography plus MPI in comparison to ICA plus MPI in the detection of hemodynamically relevant coronary artery stenoses in a clinical setting. Patients, methods: 30 patients (63 {+-} 10.8 years, 23 men) with stable angina (21 with suspected, 9 with known CAD) were investigated. MPI, 64-slice CT angiography and ICA were performed, reversible and fixed perfusion defects were allocated to determining lesions separately for MDCT angiography and ICA. The combination of MDCT angiography plus MPI was compared to the results of ICA plus MPI. Results: Sensitivity, specificity, negative and positive predictive value for the combination of MDCT angiography plus MPI was 85%, 97%, 98% and 79%, respectively, on a vessel-based and 93%, 87%, 93% and 88%, respectively, on a patient-based level. 19 coronary arteries with stenoses =50% in both ICA and MDCT angiography showed no ischemia in MPI. Conclusion: The combination of 64-slice CT angiography and gated myocardial SPECT enabled a comprehensive non-invasive view of the anatomical and functional status of the coronary artery tree. (orig.)

  6. Postoperative Functional Outcome After Off-Pump Versus On-Pump Coronary Artery Bypass Grafting Using Gated Myocardial SPECT: A Comparison by Propensity Score Analysis

    International Nuclear Information System (INIS)

    Lee, Jong Jin; Paeng, Jin Chul; Lee, Dong Soo; Kim, Ki Bong; Chung, June Key; Lee, Myung Chul; Kang, Won Jun

    2010-01-01

    We evaluated the short-term and mid-term differences in perfusion and function after off-pump and on-pump coronary artery bypass grafting (CABG) using gated myocardial single photon emission computed tomography. A total of 70 patients with coronary artery disease who underwent CABG were included based on the propensity score matching results from 165 patients. Thirty-five patients underwent off-pump and 35 patients on-pump CABG. Rest 201 TI/dipyridamole stress 99m Tc-methoxyisobutylisonitrile gated single photon emission computed thermographs were performed preoperatively and postoperatively at short-term (103±23 days after surgery) and mid-term follow-up (502±111 days after surgery). Changes in left ventricular ejection fraction, end systolic volume, stress and rest segmental perfusion, and segmental wall thickening were compared between the two groups. The segments with preoperative rest 201 T1 uptake under 60% of maximum uptake were included in the segmental analysis. Left ventricular ejection fraction (P=0.001) and end systolic volume (P=0.008) showed significant improvement in both groups. There were no significant short-term and mid-term differences between the two groups in terms of left ventricular ejection fraction (P=0.309) and end systolic volume (P=0.938). Likewise, segmental rest (P=0.178) and stress perfusion (P=0.071), and systolic wall thickening (P=0.241) showed significant improvement in both groups with similar time courses. Off-pump CABG resulted in significant improvements in left ventricular ejection fraction, end systolic volume, and regional myocardial perfusion and function that are comparable to on-pump CABG at short-term and mid-term. Gated myocardial SPECT successfully revealed that off-pump CABG is as good as on-pump CABG from the viewpoint of myocardial perfusion and function.

  7. A new automated method for analysis of gated-SPECT images based on a three-dimensional heart shaped model

    DEFF Research Database (Denmark)

    Lomsky, Milan; Richter, Jens; Johansson, Lena

    2005-01-01

    A new automated method for quantification of left ventricular function from gated-single photon emission computed tomography (SPECT) images has been developed. The method for quantification of cardiac function (CAFU) is based on a heart shaped model and the active shape algorithm. The model....... The maximal differences between the CAFU estimations and the true left ventricular volumes of the digital phantoms were 11 ml for the end-diastolic volume (EDV), 3 ml for the end-systolic volume (ESV) and 3% for the ejection fraction (EF). The largest differences were seen in the smallest heart....... In the patient group the EDV calculated using QGS and CAFU showed good agreement for large hearts and higher CAFU values compared with QGS for the smaller hearts. In the larger hearts, ESV was much larger for QGS than for CAFU both in the phantom and patient studies. In the smallest hearts there was good...

  8. Detection of myocardial stunning with gated SPECT and its relationship with location, extension and severity of perfusion defects induced by exercise or pharmacologic stress

    International Nuclear Information System (INIS)

    Mut, F.; Beretta, M.; Vidal, I.; Rener, A.; Alonso, O.

    2002-01-01

    Aim: To investigate the relationship between transient ventricular dysfunction detected by gated SPECT with the location, extension and severity of ischemic areas in patients with reversible perfusion defects. Material and Methods: We retrospectively studied 83 patients (61±11 yrs., 61 men, 27 with previous MI) submitted for coronary artery disease (CAD) evaluation with 99mTc-MIBI gated SPECT using a 2-day protocol whose perfusion imaging pattern had been reported positive for myocardial ischemia. Stress test was exercise in 54 cases, dipyridamole in 28 and dobutamine in 1. Previous work from our group demonstrated up to 12% change in LVEF from rest to post-stress in a population with low likelihood of CAD and a normal perfusion pattern. Thus, according to % variation of left ventricular ejection fraction (LVEF) from rest to post-stress we further divided the population into 2 subgroups, (A) with less than 12% change in LVEF (n=56) and (B) with more than 12% negative variation (n=27). For evaluation of perfusion, a simplified 7-segment division of the myocardium was used and a combined ischemic score was obtained by multiplying the number of segments with reversible defects by the 1-4 assigned severity score. Results: There was no significant difference between the two groups regarding age, gender, stress result (clinical or ECG), number of fixed perfusion defects or rest LVEF. Dipyridamole test was more frequent among patients of group B. Post-stress LVEF was 49±14% for group A and 41±15% for group B, p=0.0125. Combined ischemic score was 6.82±6.5 vs. 11.96±12 respectively, p=0.014. In patients of group A, defects corresponding to the right coronary territory were more frequent, while the left descending artery territory was more commonly affected in group B patients, however this was not statistically significant. Left circumflex territory was equally affected in both groups. Conclusion: Transient ventricular dysfunction after a stress test can be

  9. Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome

    Energy Technology Data Exchange (ETDEWEB)

    Lalonde, Michel, E-mail: mlalonde15@rogers.com; Wassenaar, Richard [Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada); Wells, R. Glenn; Birnie, David; Ruddy, Terrence D. [Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7 (Canada)

    2014-07-15

    Purpose: Phase analysis of single photon emission computed tomography (SPECT) radionuclide angiography (RNA) has been investigated for its potential to predict the outcome of cardiac resynchronization therapy (CRT). However, phase analysis may be limited in its potential at predicting CRT outcome as valuable information may be lost by assuming that time-activity curves (TAC) follow a simple sinusoidal shape. A new method, cluster analysis, is proposed which directly evaluates the TACs and may lead to a better understanding of dyssynchrony patterns and CRT outcome. Cluster analysis algorithms were developed and optimized to maximize their ability to predict CRT response. Methods: About 49 patients (N = 27 ischemic etiology) received a SPECT RNA scan as well as positron emission tomography (PET) perfusion and viability scans prior to undergoing CRT. A semiautomated algorithm sampled the left ventricle wall to produce 568 TACs from SPECT RNA data. The TACs were then subjected to two different cluster analysis techniques, K-means, and normal average, where several input metrics were also varied to determine the optimal settings for the prediction of CRT outcome. Each TAC was assigned to a cluster group based on the comparison criteria and global and segmental cluster size and scores were used as measures of dyssynchrony and used to predict response to CRT. A repeated random twofold cross-validation technique was used to train and validate the cluster algorithm. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and compare results to those obtained for SPECT RNA phase analysis and PET scar size analysis methods. Results: Using the normal average cluster analysis approach, the septal wall produced statistically significant results for predicting CRT results in the ischemic population (ROC AUC = 0.73;p < 0.05 vs. equal chance ROC AUC = 0.50) with an optimal operating point of 71% sensitivity and 60% specificity. Cluster

  10. Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome

    International Nuclear Information System (INIS)

    Lalonde, Michel; Wassenaar, Richard; Wells, R. Glenn; Birnie, David; Ruddy, Terrence D.

    2014-01-01

    Purpose: Phase analysis of single photon emission computed tomography (SPECT) radionuclide angiography (RNA) has been investigated for its potential to predict the outcome of cardiac resynchronization therapy (CRT). However, phase analysis may be limited in its potential at predicting CRT outcome as valuable information may be lost by assuming that time-activity curves (TAC) follow a simple sinusoidal shape. A new method, cluster analysis, is proposed which directly evaluates the TACs and may lead to a better understanding of dyssynchrony patterns and CRT outcome. Cluster analysis algorithms were developed and optimized to maximize their ability to predict CRT response. Methods: About 49 patients (N = 27 ischemic etiology) received a SPECT RNA scan as well as positron emission tomography (PET) perfusion and viability scans prior to undergoing CRT. A semiautomated algorithm sampled the left ventricle wall to produce 568 TACs from SPECT RNA data. The TACs were then subjected to two different cluster analysis techniques, K-means, and normal average, where several input metrics were also varied to determine the optimal settings for the prediction of CRT outcome. Each TAC was assigned to a cluster group based on the comparison criteria and global and segmental cluster size and scores were used as measures of dyssynchrony and used to predict response to CRT. A repeated random twofold cross-validation technique was used to train and validate the cluster algorithm. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and compare results to those obtained for SPECT RNA phase analysis and PET scar size analysis methods. Results: Using the normal average cluster analysis approach, the septal wall produced statistically significant results for predicting CRT results in the ischemic population (ROC AUC = 0.73;p < 0.05 vs. equal chance ROC AUC = 0.50) with an optimal operating point of 71% sensitivity and 60% specificity. Cluster

  11. Molecular imaging agents for SPECT (and SPECT/CT)

    International Nuclear Information System (INIS)

    Gnanasegaran, Gopinath; Ballinger, James R.

    2014-01-01

    The development of hybrid single photon emission computed tomography/computed tomography (SPECT/CT) cameras has increased the diagnostic value of many existing single photon radiopharmaceuticals. Precise anatomical localization of lesions greatly increases diagnostic confidence in bone imaging of the extremities, infection imaging, sentinel lymph node localization, and imaging in other areas. Accurate anatomical localization is particularly important prior to surgery, especially involving the parathyroid glands and sentinel lymph node procedures. SPECT/CT plays a role in characterization of lesions, particularly in bone scintigraphy and radioiodine imaging of metastatic thyroid cancer. In the development of novel tracers, SPECT/CT is particularly important in monitoring response to therapies that do not result in an early change in lesion size. Preclinical SPECT/CT devices, which actually have spatial resolution superior to PET/CT devices, have become essential in characterization of the biodistribution and tissue kinetics of novel tracers, allowing coregistration of serial studies within the same animals, which serves both to reduce biological variability and reduce the number of animals required. In conclusion, SPECT/CT increases the utility of existing radiopharmaceuticals and plays a pivotal role in the evaluation of novel tracers. (orig.)

  12. Molecular imaging agents for SPECT (and SPECT/CT)

    Energy Technology Data Exchange (ETDEWEB)

    Gnanasegaran, Gopinath [Guy' s and St Thomas' NHS Foundation Trust, Department of Nuclear Medicine, London (United Kingdom); Ballinger, James R. [Guy' s and St Thomas' NHS Foundation Trust, Department of Nuclear Medicine, London (United Kingdom); King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom)

    2014-05-15

    The development of hybrid single photon emission computed tomography/computed tomography (SPECT/CT) cameras has increased the diagnostic value of many existing single photon radiopharmaceuticals. Precise anatomical localization of lesions greatly increases diagnostic confidence in bone imaging of the extremities, infection imaging, sentinel lymph node localization, and imaging in other areas. Accurate anatomical localization is particularly important prior to surgery, especially involving the parathyroid glands and sentinel lymph node procedures. SPECT/CT plays a role in characterization of lesions, particularly in bone scintigraphy and radioiodine imaging of metastatic thyroid cancer. In the development of novel tracers, SPECT/CT is particularly important in monitoring response to therapies that do not result in an early change in lesion size. Preclinical SPECT/CT devices, which actually have spatial resolution superior to PET/CT devices, have become essential in characterization of the biodistribution and tissue kinetics of novel tracers, allowing coregistration of serial studies within the same animals, which serves both to reduce biological variability and reduce the number of animals required. In conclusion, SPECT/CT increases the utility of existing radiopharmaceuticals and plays a pivotal role in the evaluation of novel tracers. (orig.)

  13. Brain spect in the pre-surgical evaluation of epileptic patients preliminary results

    Directory of Open Access Journals (Sweden)

    Carlos A. Buchpiguel

    1992-03-01

    Full Text Available Pre-surgical evaluation of epileptic patients consists of neurological examination, intensive electroencephalographic (EEG monitoring and anatomical studies (CT and MRI. Functional methods such as PET and SPECT imaging are now used more frequently. We have studied pre-operatively 15 adult epileptic patients (8 female, 7 male using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99mTc_HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas. In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions. Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hyperperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: (a in 4, SPECT findings correlated well with the anatomical findings; (b in 5 instances, SPECT was able to disclose additional functional deficits; (c in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10 SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and hete-rogenicity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic patients who are candidates for epilepsy surgery.

  14. SPECT/CT with radiolabeled somatostatin analogues in the evaluation of systemic granulomatous infections.

    Science.gov (United States)

    Monteiro, Paulo Henrique Silva; de Souza, Thiago Ferreira; Moretti, Maria Luiza; Resende, Mariangela Ribeiro; Mengatti, Jair; de Lima, Mariana da Cunha Lopes; Santos, Allan Oliveira; Ramos, Celso Darío

    2017-01-01

    To evaluate SPECT/CT with radiolabeled somatostatin analogues (RSAs) in systemic granulomatous infections in comparison with gallium-67 ( 67 Ga) citrate scintigraphy. We studied 28 patients with active systemic granulomatous infections, including tuberculosis, paracoccidioidomycosis, pneumocystosis, cryptococcosis, aspergillosis, leishmaniasis, infectious vasculitis, and an unspecified opportunistic infection. Of the 28 patients, 23 had started specific treatment before the study outset. All patients underwent whole-body SPECT/CT imaging: 7 after injection of 99m Tc-EDDA-HYNIC-TOC, and 21 after injection of 111 In-DTPA-octreotide. All patients also underwent 67 Ga citrate imaging, except for one patient who died before the 67 Ga was available. In 20 of the 27 patients who underwent imaging with both tracers, 27 sites of active disease were detected by 67 Ga citrate imaging and by SPECT/CT with an RSA. Both tracers had negative results in the other 7 patients. RSA uptake was visually lower than 67 Ga uptake in 11 of the 20 patients with positive images and similar to 67 Ga uptake in the other 9 patients. The only patient who did not undergo 67 Ga scintigraphy underwent 99m Tc-EDDA-HYNIC-TOC SPECT/CT-guided biopsy of a lung cavity with focal RSA uptake, which turned to be positive for aspergillosis. SPECT/CT with 99m Tc-EDDA-HYNIC-TOC or 111 In-DTPA-octreotide seems to be a good alternative to 67 Ga citrate imaging for the evaluation of patients with systemic granulomatous disease.

  15. Cortical damage following traumatic brain injury evaluated by iomazenil SPECT and in vivo microdialysis.

    Science.gov (United States)

    Koizumi, Hiroyasu; Fujisawa, Hirosuke; Suehiro, Eiichi; Iwanaga, Hideyuki; Nakagawara, Jyoji; Suzuki, Michiyasu

    2013-01-01

    [(123)I] iomazenil (IMZ) single photon emission computed tomography (SPECT) has been reported to be a useful marker of neuronal integrity. We evaluated cortical damage following traumatic brain injury (TBI) with IMZ SPECT at the acute stage. After conventional therapy for a cranial trauma, an IMZ SPECT re-evaluation was performed at the chronic stage. A reduction in IMZ uptake in the location of cerebral contusions was observed during the TBI acute phase; however, images of IMZ SPECT obtained during the chronic phase showed that areas with decreased IMZ distribution were remarkably reduced compared with those obtained during the acute phase. As a result of in vivo microdialysis study, the extracellular levels of glutamate in the cortex, where decreased IMZ distribution was shown during the acute phase, were increased during the 168-h monitoring period. During the chronic phase, IMZ uptake in the region with the microdialysis probes was recovered. The results suggest that this reduction in IMZ uptake might not be a sign of irreversible tissue damage in TBI.

  16. Evaluation of newborns with brain disease using 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Oshima, Motoo; Yasukochi, Hiroshi; Suzuki, Chizuko; Sasaki, Junko; Kitoh, Osamu.

    1993-01-01

    Eleven newborns with suspected cerebral disease were evaluated using 123 I-IMP SPECT. In a normal subject, high uptake was shown in the sensorimotor cortex, thalamus, midbrain-brainstem, and cerebellar vermis. Decreased perfusion was also noted in the frontal lobe. In hypoxic ischemic encephalopathy (HIE), diffuse decreased uptake which showed no redistribution in the white matter was seen in two patients. These two patients had a poor prognosis. In one of the other 4 patients with HIE, persistent defect in parasagittal area was recognized and the patient also had a poor prognosis. In one of two patients with tuberous sclerosis, 123 I-IMP SPECT showed high uptake in the area of increased density shown in CT. Thus, 123 I-IMP SPECT of newborn has characteristic findings different from the adult. This tracer also might have a prognostic value of clinical improvement following HIE. (author)

  17. Design and evaluation of two multi-pinhole collimators for brain SPECT.

    Science.gov (United States)

    Chen, Ling; Tsui, Benjamin M W; Mok, Greta S P

    2017-10-01

    SPECT is a powerful tool for diagnosing or staging brain diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD) but is limited by its inferior resolution and sensitivity. At the same time, pinhole SPECT provides superior resolution and detection efficiency trade-off as compared to the conventional parallel-hole collimator for imaging small field-of-view (FOV), which fits for the case of brain imaging. In this study, we propose to develop and evaluate two multi-pinhole (MPH) collimator designs to improve the imaging of cerebral blood flow and striatum. We set the target resolutions to be 12 and 8 mm, respectively, and the FOV at 200 mm which is large enough to cover the whole brain. The constraints for system optimization include maximum and minimum detector-to-center-of-FOV (CFOV) distances of 344 and 294 mm, respectively, and minimal radius-of-rotation (ROR) of 135 mm to accommodate patients' shoulder. According to the targeted FOV, resolutions, and constraints, we determined the pinhole number, ROR, focal length, aperture acceptance angle, and aperture diameter which maximized the system sensitivity. We then assessed the imaging performance of the proposed MPH and standard low-energy high-resolution (LEHR) collimators using analytical simulations of a digital NCAT brain phantom with 99m Tc-HMPAO/ 99m Tc-TRODAT-1 distributions; Monte Carlo simulations of a hot-rod phantom; and a Defrise phantom using GATE v6.1. Projections were generated over 360° and reconstructed using the 3D MPH/LEHR OS-EM methods with up to 720 updates. The normalized mean square error (NMSE) was calculated over the cerebral and striatal regions extracted from the reconstructed images for 99m Tc-HMPAO and 99m Tc-TRODAT-1 simulations, respectively, and average normalized standard deviation (NSD) based on 20 noise realizations was assessed on selected uniform 3D regions as the noise index. Visual assessment and image profiles were applied to the results of Monte Carlo

  18. {sup 201}Thallium SPECT, accuracy in astrocytoma diagnosis and treatment evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kaellen, K

    1999-10-01

    The aims of the studies included in this thesis were: - to investigate the reliability of {sup 201}Thallium single photon emission computed tomography. Tl SPECT for preoperative diagnosis and histological staging of malignant astrocytomas in comparison with CT; - to develop a method for quantification of cerebral thallium uptake, and to evaluate the quantitative measurement in comparison with CT, for astrocytoma treatment follow-up purposes; - to compare quantitative Tl SPECT and proton magnetic resonance spectroscopy (H-MRS) with conventional MR imagingfor astrocytoma monitoring, and to evaluate associations between change of morphological tumour characteristics during treatment and changes of cerebral thallium uptake and metabolic ratios. Results and conclusions: - High TI-index, calculated as a ratio comparing tumour uptake to uptake in the contralateral hemisphere, is an indicator of highly malignant astrocytoma. Differentiation between the high-grade astrocytomas, the low-grade astrocytomas, and infectious lesions is only partial, with an overlap of Tl-indexes between these groups. High-grade astrocytomas that do not show contrast enhancement on CT, and astrocytomas with central necrosis and moderate ring-enhancement, tend to be underestimated when evaluated by Tl-index calculation. Tl SPECT is not a reliable method for non-invasive tumour staging among the group of highly malignant astrocytomas. - Quantification of cerebral TI-uptake, defining the volume of viable tumour tissue, is a new method for astrocytoma chemotherapy monitoring. Results suggest that the method provides prognostic information, and information of treatment efficacy, at an earlier stage than CT. - We did not find a higher accuracy of quantitative Tl SPECT than of MR for monitoring purposes and our results indicated that treatment induced MR changes were interrelated with TI-uptake variations. - Multi-voxel H-MRS was difficult to apply for astrocytoma treatment monitoring, due to the

  19. Quantitative assessment of 201TlCl myocardial SPECT

    International Nuclear Information System (INIS)

    Uehara, Toshiisa

    1987-01-01

    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)

  20. Evaluation of pulmonary emphysema by the fused image of CT image and ventilation SPECT image

    International Nuclear Information System (INIS)

    Okuda, Ituko; Maruno, Hiromasa; Mori, Kazuaki; Kohno, Tadashi; Kokubo, Takashi

    2007-01-01

    We evaluated pulmonary emphysema using a diagnostic device that could obtain a CT image, a ventilation single photon emission computed tomography (SPECT) image and a lung perfusion SPECT image in one examination. The fused image made from the CT image and SPECT image had very little position gap between images, and the precision was high. From the fused image, we were able to detect the areas in which emphysematous change was the most marked in the CT image, while the accumulation decrease was most remarkable in the ventilation SPECT image. Thus it was possible to obtain an accurate status of pulmonary emphysema, and our method was regarded as a useful technique. (author)

  1. The usefulness of myocardial SPECT for the preoperative cardiac risk evaluation in noncardiac surgery

    International Nuclear Information System (INIS)

    Lim, Seok Tae; Lee, Dong Soo; Kang, Won Jon; Chung, June Key; Lee, Myung Chul

    1999-01-01

    We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. 118 patients ( M: F=66: 52, 62.7±10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest Tl-201/ stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heat failure and unstable angina) were surveyed through perioperative periods (14.6±5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery

  2. Property of electrocardiogram gated single photon emission tomography by 99mTc-methoxy isobutyl isonitrile

    International Nuclear Information System (INIS)

    Imai, Kamon; Nishio, Yukari; Araki, Yasushi; Saito, Satoshi; Ozawa, Yukio; Yasugi, Tadao; Hagiwara, Kazuo; Kamata, Rikisaburo

    1992-01-01

    99m Tc-methoxy isobutyl isonitrile (MIBI) is a new developed myocardial perfusion imaging agent. Because this compound has higher photon energy than thallium (Tl), electrocardiogram gated single photon emission tomography (SPECT): end-diastolic (ED) and end-systolic (ES) short axis (SA) images could be taken. To investigate property of gated MIBI SPECT, MIBI myocardial scintigraphy, Tl scintigraphy (TMS) and analysis of left ventricular wall motion were performed in 6 patients with myocardial infarction. Left ventricule was divided into 8 segments. Perfusion defect (PD) was scored: '0' (normal), '1' (hypo-perfusion), '2' (defect). Wall motion abnormality (WMA) was also scored: '0' (normo-kinesis), '1' (hypo-kinesis), '2' (a-, dys-kinesis). Severity and extent of PD and WMA were calculated. Severity of WMA was 3.0±2.0 (M±SD), severity of PD was 3.3±1.7 in TMS, 3.7±1.3 in no-gated MIBI, 5.0±0.6 in ES-MIBI, 7.3±2.0 in ED-MIBI. Extent of WMA was 2.3±1.0. Extent of PD was 2.5±1.3 in TMS, 3.0±1.6 in no-gated MIBI, 3.5±0.8 in ES-MIBI, 4.8±1.0 in ED-MIBI. Compared with wall motion abnormality, severity and extent of PD in ED-MIBI was larger. From our data, it is concluded that perfusion defect in ED-MIBI was overestimated significantly. When we evaluate gated MIBI image, we must consider this property. (author)

  3. Validation of use of the low energies library in the GATE program: assessment of the effective mass attenuation coefficient

    International Nuclear Information System (INIS)

    Argenta, J.; Brambilla, C.R.; Marques da Silva, A.M.; Hoff, G.

    2009-01-01

    GATE (Geant4 Application for Emission Tomography) is a versatile tool kit for nuclear medicine simulations of SPECT and PET studies. GATE takes advantage of well-validated libraries of physics processes models, geometry description, tracking of particles through materials, response of detector and visualization tools offered by Geant4. One package available to simulate electromagnetic interactions is LEP (Low Energy Electromagnetic Processes). The purpose of this work was to evaluate the LEP package used by GATE 4 for nuclear medicine shielding simulations. Several simulations were made involving a mono directional and 140 keV monoenergetic point source beam, passing through barriers of variable thickness of water and lead. The results showed good agreement with the theoretical model, indicating that GATE 4 uses correctly the LEP package. (author)

  4. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?

    International Nuclear Information System (INIS)

    Sharma, Punit; Kumar, Rakesh; Singh, Harmandeep; Bal, Chandrasekhar; Malhotra, Arun; Julka, Pramod Kumar; Thulkar, Sanjay

    2012-01-01

    The objective of the present study was to compare the role of single photon emission computed tomography (SPECT), computed tomography (CT) and SPECT-CT of selected volume in lung cancer patients with indeterminate lesions on planar bone scintigraphy (BS). The data of 50 lung cancer patients (53 ± 10.3 years; range 30-75; male/female 38/12) with 65 indeterminate lesions on planar BS (January 2010 to November 2010) were retrospectively evaluated. All of them underwent SPECT-CT of a selected volume. SPECT, CT and SPECT-CT images were independently evaluated by two experienced readers (experience in musculoskeletal imaging, including CT: 5 and 7 years) in separate sessions. A scoring scale of 1 to 5 was used, in which 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each modality, taking a score ≤2 as metastatic. With receiver operating characteristic (ROC) curve analysis, areas under the curve (AUC) were calculated for each modality and compared. Clinical and imaging follow-up and/or histopathology were taken as reference standard. For both readers SPECT was inferior to CT (P = 0.004, P = 0.022) and SPECT-CT (P = 0.003, P = 0.037). However, no significant difference was found between CT and SPECT-CT for reader 1 (P = 0.847) and reader 2 (P = 0.592). The findings were similar for lytic as well as sclerotic lesions. Moderate inter-observer agreement was seen for SPECT images (κ = 0.426), while almost perfect agreement was seen for CT (κ = 0.834) and SPECT-CT (κ = 0.971). CT alone and SPECT-CT are better than SPECT for accurate characterisation of indeterminate lesions on planar BS in lung cancer patients. CT alone is not inferior to SPECT-CT for this purpose and might be preferred because of shorter acquisition time and wider availability. (orig.)

  5. Extraosseous accumulation of bone scanning agents in malignant brain tumors. Comparison to semi-quantitative evaluation with 99mTc SPECT/201Tl SPECT and histological findings

    International Nuclear Information System (INIS)

    Suzuki, Aya

    2003-01-01

    Although 201 Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99m Tc-MDP or 99m Tc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation. (author)

  6. SPECT/CT with radiolabeled somatostatin analogues in the evaluation of systemic granulomatous infections

    International Nuclear Information System (INIS)

    Monteiro, Paulo Henrique Silva; Souza, Thiago Ferreira de; Moretti, Maria Luiza; Resende, Mariangela Ribeiro; Lima, Mariana da Cunha Lopes de; Santos, Allan Oliveira; Ramos, Celso Darío

    2017-01-01

    Objective: To evaluate SPECT/CT with radiolabeled somatostatin analogues (RSAs) in systemic granulomatous infections in comparison with gallium-67 ( 67 Ga) citrate scintigraphy. Materials And Methods: We studied 28 patients with active systemic granulomatous infections, including tuberculosis, paracoccidioidomycosis, pneumocystosis, cryptococcosis, aspergillosis, leishmaniasis, infectious vasculitis, and an unspecified opportunistic infection. Of the 28 patients, 23 had started specific treatment before the study outset. All patients underwent whole-body SPECT/CT imaging: 7 after injection of 99m Tc-EDDA-HYNIC-TOC, and 21 after injection of 111 In-DTPA-octreotide. All patients also underwent 67 Ga citrate imaging, except for one patient who died before the 67 Ga was available. Results: In 20 of the 27 patients who underwent imaging with both tracers, 27 sites of active disease were detected by 67 Ga citrate imaging and by SPECT/CT with an RSA. Both tracers had negative results in the other 7 patients. RSA uptake was visually lower than 67 Ga uptake in 11 of the 20 patients with positive images and similar to 67 Ga uptake in the other 9 patients. The only patient who did not undergo 67 Ga scintigraphy underwent 99m Tc-EDDA-HYNIC-TOC SPECT/CT-guided biopsy of a lung cavity with focal RSA uptake, which turned to be positive for aspergillosis. Conclusion: SPECT/CT with 99m Tc-EDDA-HYNIC-TOC or 111 In-DTPA-octreotide seems to be a good alternative to 67 Ga citrate imaging for the evaluation of patients with systemic granulomatous disease. (author)

  7. SPECT/CT with radiolabeled somatostatin analogues in the evaluation of systemic granulomatous infections

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Silva Monteiro

    2017-10-01

    Full Text Available Abstract Objective: To evaluate SPECT/CT with radiolabeled somatostatin analogues (RSAs in systemic granulomatous infections in comparison with gallium-67 (67Ga citrate scintigraphy. Materials and Methods: We studied 28 patients with active systemic granulomatous infections, including tuberculosis, paracoccidioidomycosis, pneumocystosis, cryptococcosis, aspergillosis, leishmaniasis, infectious vasculitis, and an unspecified opportunistic infection. Of the 28 patients, 23 had started specific treatment before the study outset. All patients underwent whole-body SPECT/CT imaging: 7 after injection of 99mTc-EDDA-HYNIC-TOC, and 21 after injection of 111In-DTPA-octreotide. All patients also underwent 67Ga citrate imaging, except for one patient who died before the 67Ga was available. Results: In 20 of the 27 patients who underwent imaging with both tracers, 27 sites of active disease were detected by 67Ga citrate imaging and by SPECT/CT with an RSA. Both tracers had negative results in the other 7 patients. RSA uptake was visually lower than 67Ga uptake in 11 of the 20 patients with positive images and similar to 67Ga uptake in the other 9 patients. The only patient who did not undergo 67Ga scintigraphy underwent 99mTc-EDDA-HYNIC-TOC SPECT/CT-guided biopsy of a lung cavity with focal RSA uptake, which turned to be positive for aspergillosis. Conclusion: SPECT/CT with 99mTc-EDDA-HYNIC-TOC or 111In-DTPA-octreotide seems to be a good alternative to 67Ga citrate imaging for the evaluation of patients with systemic granulomatous disease.

  8. Radionuclide arthrogram with SPECT/CT for the evaluation of mechanical loosening of hip and knee prostheses

    International Nuclear Information System (INIS)

    Chew, C.G.; Lewis, P.; Middleton, F.; Wijngaard, R. van den; Deshaies, A.

    2010-01-01

    The Objective of this study was to evaluate the value of single photon emission computed tomography (SPECT)/CT in radionuclide arthrogram (RNA) for the assessment of mechanical loosening of hip and knee prostheses. A retrospective audit of 117 RNA SPECT/CTs evaluated by a single reader- 40 hips, (1 hemiarthroplasty) and 77 knees (12 unicompartmental). The detection of any radiotracer within the bone/prosthetic interface was deemed positive for loosening. The operative assessment of 29 hip and 44 knee prosthetic joints was known and used as the gold standard. A subsequent blinded reassessment of the planar images was performed and compared with the SPECT/CT results for 26 of the 29 hip and 42 of the 44 knee prostheses. The respective SPECT/CT versus planar results were as follows: hips- acetabular cup: sensitivity: 73 versus 0%; specificity: 71 versus 100%; positive predictive value: 62% versus indeterminate; negative predictive value: 80% versus 72% (p=0.0044). Hips- femoral component: sensitivity: 78 versus 63%; specificity: 90 versus 94%; positive predictive value: 78 versus 83%; negative predictive value: 90 versus 85% (p=0.2482). Knees- femoral component: sensitivity: 75 versus 17%; specificity 63 versus 97%; positive predictive value: 43 versus 67%; negative predictive value: 87 versus 74% (p=0.0001). Knees- tibial component: sensitivity: 86 versus 63%; specificity: 86 versus 76%; positive predictive value: 55 versus 38%; negative predictive value: 97 versus 90% (p=0.6831). For evaluation of mechanical loosening of the hip prosthesis SPECT/CT was significantly better than planar scanning for the acetabular cup, but not for the femoral stem. For evaluation of the knee prosthesis, a significant improvement was noted using SPECT/CT for the femoral component, and although superior results were also noted for the tibial component, statistical significance was not reached. Taking into account the limitations of this retrospective audit, the value of using RNA SPECT

  9. Quantification of left ventricular regional functions using ECG-gated myocardial perfusion SPECT. Validation of left ventricular systolic functions

    International Nuclear Information System (INIS)

    Yamamoto, Akira; Takahashi, Naoto; Iwahara, Shin-ichiro; Munakata, Kazuo; Hosoya, Tetsuo

    2006-01-01

    We have developed a program to quantify regional left ventricular (LV) function and wall motion synchrony using electrocardiogram (ECG)-gated myocardial perfusion SPECT (MPS). This preliminary study was undertaken to validate the use of this program for estimating regional LV systolic function. Patients were subjected to MPS by 99m Tc-sestamibi at rest. The study included 20 patients who were confirmed to have a low probability of coronary artery disease (LPG; low probability group), 19 heart disease patients who were examined by MPS and equilibrium radionuclide angiography (ERNA) (ERG; ERNA group), and 24 patients who were examined by MPS and 2-dimensional echocardiography (2DE) (2DEG; 2DE group). The values of the ejection fraction (EF) and peak ejection rate (PER) were estimated. The global functions evaluated by this program were compared with those obtained by ERNA in the ERG. For regional assessment, the reference values of the functional indices were obtained for 17 LV segments in LPG. The Z score, (reference average value of the segment-patient's value of the segment)/reference standard deviation of the segment, was used for the evaluation of regional functions; a score equal to or greater than 2 was defined as abnormal. Semiquantitative visual interpretation of 2DE was used as the standard to assess wall motion. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these criteria and the relationship between 2DE grading and Z scoring were validated in 2DEG. The values of the global EF and PER evaluated by this program correlated with those determined by ERNA (r=0.76 and 0.58, respectively; p -10 ). The potential of this program to quantify the regional systolic function was validated. (author)

  10. Evaluating performance of a pixel array semiconductor SPECT system for small animal imaging

    International Nuclear Information System (INIS)

    Kubo, Naoki; Zhao, Songji; Fujiki, Yutaka

    2005-01-01

    Small animal imaging has recently been focused on basic nuclear medicine. We have designed and built a small animal SPECT imaging system using a semiconductor camera and a newly designed collimator. We assess the performance of this system for small object imaging. We employed an MGC 1500 (Acrorad Co.) camera including a CdTe semiconductor. The pixel size was 1.4 mm/pixel. We designed and produced a parallel-hole collimator with 20-mm hole length. Our SPECT system consisted of a semiconductor camera with the subject holder set on an electric rotating stage controlled by a computer. We compared this system with a conventional small animal SPECT system comprising a SPECT-2000H scanner with four Anger type cameras and pinhole collimators. The count rate linearity for estimation of the scatter was evaluated for a pie-chart phantom containing different concentrations of 99m Tc. We measured the full width half maximum (FWHM) of the 99m Tc SPECT line source along with scatter. The system volume sensitivity was examined using a flood source phantom which was 35 mm long with a 32-mm inside diameter. Additionally, an in vivo myocardial perfusion SPECT study was performed with a rat. With regards to energy resolution, the semiconductor camera (5.6%) was superior to the conventional Anger type camera (9.8%). In the count rate linearity evaluation, the regression lines of the SPECT values were y=0.019x+0.031 (r 2 =0.999) for our system and y=0.018x+0.060 (r 2 =0.997) for the conventional system. Thus, the scatter count using the semiconductor camera was less than that using the conventional camera. FWHMs of our system and the conventional system were 2.9±0.1 and 2.0±0.1 mm, respectively. Moreover, the system volume sensitivity of our system [0.51 kcps/(MBq/ml)/cm] was superior to that of the conventional system [0.44 kcps/(MBq/ml)/cm]. Our system provided clear images of the rat myocardium, sufficient for practical use in small animal imaging. Our SPECT system, utilizing a

  11. Evolution of the GATE project: new results and developments

    Energy Technology Data Exchange (ETDEWEB)

    Santin, G. [ESA-ESTEC, Keplerlaan 1, 2200 AG Noordwijk (Netherlands); Staelens, S. [ELIS Department, Ghent University, B-9000 Ghent (Belgium); Taschereau, R. [CRUMP Institute for Molecular Imaging, University of California Los Angeles, 700 Westwood Plaza A438, Los Angeles, CA 90095-1770 (United States); Descourt, P. [U650 INSERM, LaTIM, Brest (France); Schmidtlein, C.R. [Memorial Sloan-Kettering Cancer Center, New York, New York, US (United States); Simon, L. [Department of Radiation Oncology, Institut Curie, Paris (France); Visvikis, D. [U650 INSERM, LaTIM, Brest (France); Jan, S. [Service Hospitalier Frederic Joliot (SHFJ), CEA-Orsay, Orsay (France); Buvat, I. [U678 INSERM, CHU Pitie-Salpetriere, Paris (France)

    2007-10-15

    We present the status of the Geant4 Application for Emission Tomography (GATE) project, a Monte Carlo simulator for Single Photon Emission Computed Tomography (SPECT) and Positron annihilation Emission Tomography (PET). Its main features are reminded, including modelling of time dependent phenomena and versatile, user-friendly scripting interface. The focus of this manuscript will be on new developments introduced in the past 4 years. New results have been achieved in the fields of validation on real medical and research PET and SPECT systems, voxel geometries, digitisation, distributed computing and dosimetry.

  12. Evolution of the GATE project: new results and developments

    International Nuclear Information System (INIS)

    Santin, G.; Staelens, S.; Taschereau, R.; Descourt, P.; Schmidtlein, C.R.; Simon, L.; Visvikis, D.; Jan, S.; Buvat, I.

    2007-01-01

    We present the status of the Geant4 Application for Emission Tomography (GATE) project, a Monte Carlo simulator for Single Photon Emission Computed Tomography (SPECT) and Positron annihilation Emission Tomography (PET). Its main features are reminded, including modelling of time dependent phenomena and versatile, user-friendly scripting interface. The focus of this manuscript will be on new developments introduced in the past 4 years. New results have been achieved in the fields of validation on real medical and research PET and SPECT systems, voxel geometries, digitisation, distributed computing and dosimetry

  13. Objective evaluation of reconstruction methods for quantitative SPECT imaging in the absence of ground truth.

    Science.gov (United States)

    Jha, Abhinav K; Song, Na; Caffo, Brian; Frey, Eric C

    2015-04-13

    Quantitative single-photon emission computed tomography (SPECT) imaging is emerging as an important tool in clinical studies and biomedical research. There is thus a need for optimization and evaluation of systems and algorithms that are being developed for quantitative SPECT imaging. An appropriate objective method to evaluate these systems is by comparing their performance in the end task that is required in quantitative SPECT imaging, such as estimating the mean activity concentration in a volume of interest (VOI) in a patient image. This objective evaluation can be performed if the true value of the estimated parameter is known, i.e. we have a gold standard. However, very rarely is this gold standard known in human studies. Thus, no-gold-standard techniques to optimize and evaluate systems and algorithms in the absence of gold standard are required. In this work, we developed a no-gold-standard technique to objectively evaluate reconstruction methods used in quantitative SPECT when the parameter to be estimated is the mean activity concentration in a VOI. We studied the performance of the technique with realistic simulated image data generated from an object database consisting of five phantom anatomies with all possible combinations of five sets of organ uptakes, where each anatomy consisted of eight different organ VOIs. Results indicate that the method provided accurate ranking of the reconstruction methods. We also demonstrated the application of consistency checks to test the no-gold-standard output.

  14. SPECT/CT with radiolabeled somatostatin analogues in the evaluation of systemic granulomatous infections

    Energy Technology Data Exchange (ETDEWEB)

    Monteiro, Paulo Henrique Silva; Souza, Thiago Ferreira de; Moretti, Maria Luiza; Resende, Mariangela Ribeiro; Lima, Mariana da Cunha Lopes de; Santos, Allan Oliveira; Ramos, Celso Darío, E-mail: paulohsm42@gmail.com [Universidade de Campinas (UNICAMP), SP (Brazil). Escola de Medicina; Mengatti Jair [Instituto de Pesquisas Energéticas e Nucleares (IPEN/CNEN-SP), São Paulo, SP (Brazil)

    2017-11-15

    Objective: To evaluate SPECT/CT with radiolabeled somatostatin analogues (RSAs) in systemic granulomatous infections in comparison with gallium-67 ({sup 67}Ga) citrate scintigraphy. Materials And Methods: We studied 28 patients with active systemic granulomatous infections, including tuberculosis, paracoccidioidomycosis, pneumocystosis, cryptococcosis, aspergillosis, leishmaniasis, infectious vasculitis, and an unspecified opportunistic infection. Of the 28 patients, 23 had started specific treatment before the study outset. All patients underwent whole-body SPECT/CT imaging: 7 after injection of {sup 99m}Tc-EDDA-HYNIC-TOC, and 21 after injection of {sup 111}In-DTPA-octreotide. All patients also underwent {sup 67}Ga citrate imaging, except for one patient who died before the {sup 67}Ga was available. Results: In 20 of the 27 patients who underwent imaging with both tracers, 27 sites of active disease were detected by {sup 67}Ga citrate imaging and by SPECT/CT with an RSA. Both tracers had negative results in the other 7 patients. RSA uptake was visually lower than {sup 67}Ga uptake in 11 of the 20 patients with positive images and similar to {sup 67}Ga uptake in the other 9 patients. The only patient who did not undergo {sup 67}Ga scintigraphy underwent {sup 99m}Tc-EDDA-HYNIC-TOC SPECT/CT-guided biopsy of a lung cavity with focal RSA uptake, which turned to be positive for aspergillosis. Conclusion: SPECT/CT with {sup 99m}Tc-EDDA-HYNIC-TOC or {sup 111}In-DTPA-octreotide seems to be a good alternative to {sup 67}Ga citrate imaging for the evaluation of patients with systemic granulomatous disease. (author)

  15. Myocardial Perfusion SPECT 2015 in Germany

    Science.gov (United States)

    Burchert, Wolfgang; Schäfer, Wolfgang; Hacker, Marcus

    2016-01-01

    Summary Aim The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine presents the results of the 7th survey of myocardial perfusion SPECT (MPS) of the reporting year 2015. Method 268 questionnaires (173 practices [PR], 67 hospitals [HO], 28 university hospitals [UH]) were evaluated. Results of the last survey from 2012 are set in squared brackets. Results MPS of 121 939 [105 941] patients were reported. 98 % [95 %] of all MPS were performed with Tc-99m radiopharmaceuticals and 2 % [5 %] with Tl-201. 78 % [79 %] of all patients were studied in PR, 14 % [15 %] in HO, and 8 % [6 %] in UH. A pharmacological stress test was performed in 43 % [39 %] (22 % [24 %] adenosine, 20 % [9 %] regadenoson, 1% [6 %] dipyridamole or dobutamine). Attenuation correction was applied in 25 % [2009: 10 %] of MPS. Gated SPECT was performed in 78 % [70 %] of all rest MPS, in 80 % [73 %] of all stress and in 76 % [67 %] of all stress and rest MPS. 53 % [33 %] of all nuclear medicine departments performed MPS scoring by default, whereas 24 % [41 %] did not apply any quantification. 31 % [26 %] of all departments noticed an increase in their counted MPS and 29 % [29 %] no changes. Data from 89 departments which participated in all surveys showed an increase in MPS count of 11.1 % (PR: 12.2 %, HO: 4.8 %, UH: 18.4 %). 70 % [60 %] of the MPS were requested by ambulatory care cardiologists. Conclusion The 2015 MPS survey reveals a high-grade adherence of routine MPS practice to current guidelines. The positive trend in MPS performance and number of MPS already observed in 2012 continues. Educational training remains necessary in the field of SPECT scoring. PMID:27909712

  16. Evaluation of newborns with brain disease using [sup 123]I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Oshima, Motoo; Yasukochi, Hiroshi (Teikyo Univ., Tokyo (Japan). Faculty of Medicine); Suzuki, Chizuko; Sasaki, Junko; Kitoh, Osamu

    1993-07-01

    Eleven newborns with suspected cerebral disease were evaluated using [sup 123]I-IMP SPECT. In a normal subject, high uptake was shown in the sensorimotor cortex, thalamus, midbrain-brainstem, and cerebellar vermis. Decreased perfusion was also noted in the frontal lobe. In hypoxic ischemic encephalopathy (HIE), diffuse decreased uptake which showed no redistribution in the white matter was seen in two patients. These two patients had a poor prognosis. In one of the other 4 patients with HIE, persistent defect in parasagittal area was recognized and the patient also had a poor prognosis. In one of two patients with tuberous sclerosis, [sup 123]I-IMP SPECT showed high uptake in the area of increased density shown in CT. Thus, [sup 123]I-IMP SPECT of newborn has characteristic findings different from the adult. This tracer also might have a prognostic value of clinical improvement following HIE. (author).

  17. Quantitative gated SPECT- a comparative study of two algorithms for parameters of perfusion and LV function

    International Nuclear Information System (INIS)

    Ali, A.Z.

    2007-01-01

    Full text: Aim: To compare the perfusion and LV function parameters as quantified by 4D-MSPECT and ECT in the same patient group and a qualitative comparison of the reconstructed slices by two different experts. Materials and methods: Thirty-one consecutive patients underwent gated myocardial perfusion SPECT using a two-day protocol. The gated and ungated data were reconstructed by back projection method. Quantitative analysis was performed on the same set of reconstructed slices by 4D-MSPECT and Emory Cardiac Tool Box. The reconstructed slices were read qualitatively by two different experts on their respective systems. Polar map and functional analysis was performed in both softwares and the results were compared. Results: The concordance between the two experts qualitatively was seen in 78/93(84%) coronary territories. The polar map defects were comparable in LAD (r-value of 0.87) and LCX (r-value of 0.76) territories whereas RCA defects (r-value of 0.04) were not at all correlating. The defect severity showed concordance in 68/93 (73%) coronary territories. There was concordance between 4DMSPECT and the qualitative interpretation in 84/93 (90%) coronary territories whereas ECT showed concordance in only 70/93(75%) coronary territories. The overall sensitivity is marginally higher for ECT (100% vs. 96%) but the overall specificity is much higher with 4 DMSPECT (88% vs. 65%). ESV showed good correlation(r=0.94) of the two softwares with no significant difference in means. EDV and LVEF although had good correlation(r = 0.96 and 0.89) showed high difference in means (p<0.01). Conclusion: Between 4D-MSPECT and ECT, 4D-MSPECT is marginally superior to ECT with reference to qualitative interpretation in view of better specificity. The LVEF values between the two softwares should also not be used interchangeably. (author)

  18. Prepulse inhibition is associated with attention, processing speed, and 123I-FP-CIT SPECT in Parkinson's disease

    DEFF Research Database (Denmark)

    Zoetmulder, Marielle; Biernat, Heidi B; Nikolic, Miki

    2014-01-01

    BACKGROUND: Prepulse inhibition is a measure of sensorimotor gating, which reflects the ability to filter or 'gate' irrelevant information. Prepulse inhibition is dramatically altered in basal ganglia disorders associated with dysfunction in the midbrain dopaminergic system, and corresponding......'s disease have been extensively studied in relation to motor function, less is known about the potential role of sensorimotor processes in cognitive function. OBJECTIVE: We investigated the relationship between prepulse inhibition, cognition and nigrostriatal dysfunction, as measured with 123I......-FP-CIT-SPECT scanning, in patients with Parkinson's disease. METHODS: 38 Parkinson patients were assessed with prepulse inhibition, neuropsychological tests, and neurological investigation. A subset of these patients underwent 123I-FP-CIT-SPECT scanning. RESULTS: Patients with a higher level of prepulse inhibition...

  19. Validation of use of the low energies library in the GATE program: assessment of the effective mass attenuation coefficient

    International Nuclear Information System (INIS)

    Argenta, Jackson; Brambilla, Claudia R.; Silva, Ana Maria Marques da; Hoff, Gabriela

    2010-01-01

    Geant4 Application for Emission Tomography program (GATE) is a versatile toolkit for nuclear medicine simulations of SPECT and PET studies. GATE takes advantage of well-validated libraries of physics processes models, geometry description, tracking of particles through materials, response of detector and visualization tools offered by Geant4 (version 4.0). One package available to simulate electromagnetic interactions is low energy electromagnetic processes (LEP). The purpose of this work was to evaluate the LEP package used by GATE 4 for nuclear medicine shielding simulations. Several simulations were made involving a monodirectional and 140 keV monoenergetic point source beam, passing through barriers of variable thickness of water and lead. The results showed good agreement with the theoretical model, indicating that GATE 4 uses correctly the LEP package. (author)

  20. Evaluation of cerebral vasoreactivity by SPECT and transcranial doppler sonography using the acetazolamide test

    Energy Technology Data Exchange (ETDEWEB)

    Pavics, L. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Gruenwald, F. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Barzo, P. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Ambrus, E. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Menzel, C. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Schomburg, A. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Borda, L. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Mate, E. [Laszlo Kalmar Kibernetic Lab., Attila Jozsef Univ., Szeged (Hungary); Bodosi, M. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Csernay, L. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Biersack, H.J. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin

    1994-12-01

    rCBF SPECT with {sup 99m}Tc-HMPAO was performed prospectively in 29 patients (3 controls and 26 stroke patients) as well as TCD studies in 20 patients (3 controls and 17 stroke patients) before and after 1 g i.v. acetazolamide. The sensitivity of rCBF SPECT increased from 62% to 77% after acetazolamide provocation in stroke patients. In patients with a reversible neurological deficit, the sensitivity under resting conditions was 50% which increased to 71%, while in cases with a permanent deficit it increased from 75% to 83%. In the evaluation of the cerebrovascular reserve capacity the results of rCBF SPECT and TCD coincided in 91% of the hemispheres. The correlation was statistically significant. (orig.) [Deutsch] Bei 29 Patienten (3 Kontrollpersonen, 26 Patienten mit zerebrovaskulaerer Erkrankung) wurde prospektiv die Hirn-SPECT mit {sup 99m}TC-HMPAO und bei 20 Patienten (3 Kontrollpersonen, 17 Patienten mit ZVK) die transkranielle Dopplersonographie (TCD) vor und nach i.v. Gabe von Azetazolamid durchgefuehrt. Die Sensitivitaet der Hirn-SPECT erhoehte sich mit Azetazolamid von 62% auf 77%. Bei Patienten mit reversiblem neurologischem Defizit wurde eine Verbesserung von 50% auf 71%, bei Patienten mit persistierendem Defizit von 75% auf 83% beobachtet. Die Ergebnisse der Hirn-SPECT und der TCD stimmten in der Beurteilung der zerebrovaskulaeren Reservekapazitaet in 91% der Hemisphaeren ueberein. Die Korrelation zwischen den beiden Methoden war statistisch signifikant. (orig.)

  1. The role of SPECT in the evaluation of skeletal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Murray, I P.C. [Prince of Wales Hospital, Randwick (Australia)

    1993-02-01

    Single photon emission computed tomography (SPECT) has, in the last decade, established a critical role in routine diagnosis. Skeletal scintigraphy exemplifies the impact in improving detection of lesions by delineation of their site and size. The advantage of minimizing the superimposed radioactivity from overlying and underlying structures is typified by the readiness with which avascular necrosis of the femoral head can be identified by removal of the surrounding hyperaemia which masks the classical photopaenia. However, the ability to achieve an accurate image at a plane at a prescribed depth is most characteristically shown by the study of a vertebra, a bone of irregular contour and subject to a variety of pathological disorders at different sites within it. The various focal abnormalities resulting from these can be localized exactly, readily distinguishing, for example, those in the body from those in the natural arch. In particular, the alterations resulting from trauma, such as pars interarticularis stress fracture, are readily seen. Consequently SPECT has an indispensable role in the investigation and management of low back pain. However, the ability of SPECT to delineate abnormal accumulation has provided a new approach to the evaluation of knee pain, especially when acute such as that resulting from athletic injury, since the identification of the presence or absence of focal abnormalities can be critical to patient management. The frequency of these various disorders in which SPECT is so useful explains why the procedure has become such a routine high-volume examination in so many departments. (author).

  2. 201Tl/99mTc-MIBI SPECT to evaluate therapy effect of BNCT with BSH and BPA for malignant brain tumor

    International Nuclear Information System (INIS)

    Shibata, Yasushi; Katayama, Wataru; Yamamoto, Tetsuya; Nakai, Kei; Endo, Kiyoshi; Matsuda, Masahide; Matsushita, Akira; Matsumura, Akira

    2006-01-01

    201 Tl/ 99m Tc-MIBI SPECT are imaging modalities to evaluate the malignancy and viability of brain tumor. We reviewed these SPECT findings before and after BNCT, and evaluated the usefulness of SPECT. The study includes total 11 patients admitted in our hospital between 1999 and 2005, 8 with glioblastoma, 2 with anaplastic astrocytoma and 2 with anaplastic oligodendroglioma. SPECT was taken with multidetector SPECT at 15 minutes and 3 hours after intravenous injection of Tl 74 MBq or MIBI 740 MBq. Region of interests were set on tumor and contralateral white matter and radioactivity ratios were calculated as Tl, MIBI indexes. For patients with no residual tumor in MRI, Tl/MIBI indexes were low. For patients with large residual tumor the indexes were high. For the patients with recurrent tumor the indexes were very high. Tl/MIBI indexes before BNCT correlated with survival and progression-free period after BNCT. SPECT indexes decreased after BNCT. For 8 patients with recurrent tumor, the indexes increased. Tl and MIBI SPECT are valuable to evaluate malignancy, viability, survival and recurrence of malignant glioma in BNCT. (author)

  3. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  4. [Follow-up of patients with good exercise capacity in stress test with myocardial single-photon emission computed tomography (SPECT)].

    Science.gov (United States)

    González, Javiera; Prat, Hernán; Swett, Eduardo; Berrocal, Isabel; Fernández, René; Zhindon, Juan Pablo; Castro, Ariel; Massardo, Teresa

    2015-11-01

    The evaluation of coronary artery disease (CAD) can be performed with stress test and myocardial SPECT tomography. To assess the predictive value of myocardial SPECT using stress test for cardiovascular events in patients with good exercise capacity. We included 102 males aged 56 ± 10 years and 19 females aged 52 ± 10 years, all able to achieve 10 METs and ≥ 85% of the theoretical maximum heart rate and at least 8 min in their stress test with gated 99mTc-sestamibi SPECT. Eighty two percent of patients were followed clinically for 33 ± 17 months. Sixty seven percent of patients were studied for CAD screening and the rest for known disease assessment. Treadmill stress test was negative in 75.4%; 37% of patients with moderate to severe Duke Score presented ischemia. Normal myocardial perfusion SPECT was observed in 70.2%. Reversible defects appeared in 24.8% of cases, which were of moderate or severe degree (> 10% left ventricular extension) in 56.6%. Only seven cases had coronary events after the SPECT. Two major (myocardial infarction and emergency coronary revascularization) and 5 minor events (elective revascularization) ere observed in the follow-up. In a multivariate analysis, SPECT ischemia was the only statistically significant parameter that increased the probability of having a major or minor event. Nearly a quarter of our patients with good exercise capacity demonstrated reversible defects in their myocardial perfusion SPECT. In the intermediate-term follow-up, a low rate of cardiac events was observed, being the isotopic ischemia the only significant predictive parameter.

  5. Determination of Three-Dimensional Left Ventricle Motion to Analyze Ventricular Dyssyncrony in SPECT Images

    DEFF Research Database (Denmark)

    de Sá Rebelo, Marina; Aarre, Ann Kirstine Hummelgaard; Clemmesen, Karen-Louise

    2010-01-01

    A method to compute three-dimension (3D) left ventricle (LV) motion and its color coded visualization scheme for the qualitative analysis in SPECT images is proposed. It is used to investigate some aspects of Cardiac Resynchronization Therapy (CRT). The method was applied to 3D gated-SPECT images...... sets from normal subjects and patients with severe Idiopathic Heart Failure, before and after CRT. Color coded visualization maps representing the LV regional motion showed significant difference between patients and normal subjects. Moreover, they indicated a difference between the two groups...

  6. Performance evaluation of Siemens E.Cam® Spect System at Korle ...

    African Journals Online (AJOL)

    Performance evaluation of Siemens E.Cam® Spect System at Korle-Bu Teaching Hospital (Ghana. ... The tests were performed according to National Electrical Manufac-turers Association protocols, and different measuring instruments and phantoms containing 99m-Tc were used. Extrinsic uniformity, System energy ...

  7. SPECT for smokers brain perfusion evaluation; SPECT para avaliacao da perfusao cerebral em fumantes

    Energy Technology Data Exchange (ETDEWEB)

    Maliska, C.M.; Martins, E.F.; Barros, D.S.; Lopes, M.M.S.; Lourenco, C.; Goncalves, S.; Goncalves, M.B.; Miranda, M.M.B.G.; Neto, L.M.; Penque, E.; Antonucci, J.B. [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil)

    2002-07-01

    Cigarette smoking increases brain stroke risk, however,five to fifteen years after ceasing this habit, brain perfusion recovers normal pattern. We propose to compare brain perfusion patterns performing brain SPECT scans of smokers and non-smokers. Thirteen volunteers age range 20-30 years old) composed of six non-smokers and seven smokers were studied by brain scans (SPECT).We used ECD- {sup 99m} Tc radiolabelled as recommended by the manufacturer. All patients received 740 MBq of the radiopharmaceutical through intravenous injection, with their eyes opened and their ears unplugged, in a quiet room. We used a one head SPECT camera ( General Electric/ StarCam 4000 and Siemens/ E.Cam) with low-energy ultrahigh resolution collimator. Imaging begin 40 minutes after tracer injection. For reconstruction we used a Butterworth filter.The preliminary results showed brain perfusion deficit areas on five of the smokers while all non- smokers had normal brain perfusion scans. We believe that smoking increases the possibility of brain perfusion deficits. (author)

  8. Brain SPECT. SPECT in der Gehirndiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Feistel, H. (Erlangen-Nuernberg Univ., Erlangen (Germany). Nuklearmedizinische Klinik mit Poliklinik)

    1991-12-01

    Brain SPECT investigations have gained broad acceptance since the introduction of the lipophilic tracer Tc-99m-HMPAO. Depending on equipment and objectives in different departments, the examinations can be divided into three groups: 1. Under normal conditions and standardised patient preparation the 'rest' SPECT can be performed in every department with a tomographic camera. In cerebrovascular disease there is a demand for determination of either the perfusion reserve in reversible ischemia or prognostic values in completed stroke. In cases of dementia, SPECT may yield useful results according to differential diagnosis. Central cerebral system involvement in immunologic disease may be estimated with higher sensitivity than in conventional brain imaging procedures. In psychiatric diseases there is only a relative indication for brain SPECT, since results during recent years have been contradictory and may be derived only in interventional manner. In brain tumor diagnostics SPECT with Tl-201 possibly permits grading. In inflammatory disease, especially in viral encephalitis, SPECT may be used to obtain early diagnosis. Normal pressure hydrocephalus can be distinguished from other forms of dementia and, consequently, the necessity for shunting surgery can be recognised. 2. In departments equipped for emergency cases an 'acute' SPECT can be performed in illnesses with rapid changing symptoms such as different forms of migraine, transient global amnesia, epileptic seizures (so-called 'ictal SPECT') or urgent forms like trauma. 3. In cooperation with several departments brain SPECT can be practised as an interventional procedure in clinical and in scientific studies. (orig./MG).

  9. Gated SPECT evaluation of myocardial perfusion defects and left ventricular function in chronic atrial fibrillation (CAF) patients - a prevalence study between a General Hospital (GH) and a referral Cardiology Hospital (CH)

    International Nuclear Information System (INIS)

    Rocha, G.; Guimaraes, M.; Marroni, B.; Zagoury, E.; Sprinz, C.; Andrea, S.; Louzada, A.; Ludwig, R.; Graef, C.

    2002-01-01

    Aims: to evaluate myocardial perfusion defects (MPD) prevalence and left ventricular function in CAF patients from a distinct referral basis (a GH and CH populations). Materials and Methods: a retrospective cross-sectional survey including 171 CAF (43 from GH and 128 from CH) and 5415 control patients (2222 from GH and 3193 from CH) submitted to rest/stress myocardial perfusion gated SPECT with Tc99m-MIBI. The following items were collected from CAF patients: the percentage of patients with MPD, the type (fixed, reversible or mixed) and number of segments with MPD and left ventricular ejection fraction (LVEF). The control patients percentage of MPD, their type and number were also collected. Results: CAF from GH and CH were not significantly different in the number of patients with MPD, mean number of segments affected, and LVEF. In GH patients, the CAF group had more segments with MPD (2,4x1,6 p<0,01) and lower LVEF (37%x52% p<0,01) than control group. CAF patients from CH also showed lower LVEF (40%x58% p<0,01) and more fixed MPD (40%x18% p<0,01) than their control group population. Conclusion: our data showed similar prevalence of MPD and reduced LVEF values between CAF patients from a GH and referral CH. The CAF group from CH seemed to have more fixed MPD perhaps reflecting more severe coronary artery disease population or referral bias. The data appears to support the evaluation of myocardial ischemia as a part of CAF possible etiologies. Caution is advised in LVEF evaluation of CAF patients due to increased variability of R-R interval

  10. Left ventricular diastolic dyssynchrony assessed with phase analysis of gated myocardial perfusion SPECT: a comparison with tissue Doppler imaging

    International Nuclear Information System (INIS)

    Boogers, Mark J.; Veltman, Caroline E.; Chen, Ji; Garcia, Ernest V.; Bommel, Rutger J. van; Mooyaart, Eline A.Q.; Wall, Ernst E. van der; Schalij, Martin J.; Bax, Jeroen J.; Delgado, Victoria; Younis, Imad Al; Hiel, Bernies van der; Dibbets-Schneider, Petra

    2011-01-01

    The aim of the current study was to evaluate the feasibility of phase analysis on gated myocardial perfusion SPECT (GMPS) for the assessment of left ventricular (LV) diastolic dyssynchrony in a head-to-head comparison with tissue Doppler imaging (TDI). The population consisted of patients with end-stage heart failure of New York Heart Association functional class III or IV with a reduced LV ejection fraction of ≤35%. LV diastolic dyssynchrony was calculated using TDI as the maximal time delay between early peak diastolic velocities of two opposing left ventricle walls (diastolic mechanical delay). Significant LV diastolic dyssynchrony was defined as a diastolic mechanical delay of >55 ms on TDI. Furthermore, phase analysis on GMPS was performed to evaluate LV diastolic dyssynchrony; diastolic phase standard deviation (SD) and histogram bandwidth (HBW) were used as markers of LV diastolic dyssynchrony. A total of 150 patients (114 men, mean age 66.0 ± 10.4 years) with end-stage heart failure were enrolled. Both diastolic phase SD (r = 0.81, p 55 ms) showed significantly larger diastolic phase SD (68.1 ± 13.4 vs. 40.7 ± 14.0 , p < 0.01) and diastolic HBW (230.6 ± 54.3 vs. 129.0 ± 55.6 , p < 0.01) as compared to patients without LV diastolic dyssynchrony on TDI (≤55 ms). Finally, phase analysis on GMPS showed a good intra- and interobserver reproducibility for the determination of diastolic phase SD (ICC 0.97 and 0.88) and diastolic HBW (ICC 0.98 and 0.93). Phase analysis on GMPS showed good correlations with TDI for the assessment of LV diastolic dyssynchrony. (orig.)

  11. Simulation Study of PET System Using GATE%基于GATE的PET系统仿真研究

    Institute of Scientific and Technical Information of China (English)

    刘豪佳; 张斌

    2014-01-01

    PET and SPECT is the most advanced nuclear medical imaging technology .GATE is a dedicated Monte Carlo simulation platform for PET and SPECT .This study validates two GATE models of Simens ECAT EXACT HR+PET scanner and Simens PET/CT Biograph 2.After the simulation of PET systems completed , testing and performance evaluation of simulation systems were proceeded according to NEMA 2001 performance protocols , including spatial resolution , scatter fraction and sensitivity .Test results show that , performances of GATE simulation systems agree well with the experimental values .%PET和SPECT是现代核医学最高水平的影像技术,GATE是专用于PET和SPECT的蒙特卡罗仿真工具。研究以西门子公司的PET扫描仪 ECAT EXACT HR+和PET/CT Biograph2为原型,分别使用GATE实现其系统的完整仿真。依据NEMA 2001标准,对仿真系统的空间分辨率、散射分数和灵敏度分别进行测试与评估。测试结果表明,仿真系统性能参数和实验结果之间具有良好的一致性。

  12. Pre-evaluation study in SPECT images using a phantom

    International Nuclear Information System (INIS)

    Rebelo, Marina de Sa; Furuie, Sergio Shiguemi; Abe, Rubens; Moura, Lincoln

    1996-01-01

    An alternative solution for the reconstruction of SPECT images using a Poisson Noise Model is presented. The proposed algorithm was applied on a real phantom and compared to the standard clinical procedures. Results have shown that the proposed method improves the quality of the SPECT images

  13. A new dynamic myocardial phantom for evaluation of SPECT and PET quantitation in systolic and diastolic conditions

    International Nuclear Information System (INIS)

    Dreuille, O. de; Bendriem, B.; Riddell, C.

    1996-01-01

    We present a new dynamic myocardial phantom designed to evaluate SPECT and PET imaging in systolic and diastolic conditions. The phantom includes a thoracic attenuating media and the myocardial wall thickness varying during the scan can be performed. In this study the phantom was used with three different wall thickness characteristic of a systolic, end-diastolic and pathologic end-diastolic condition. The myocardium was filled with 99m Tc, 18 F and Gd and imaged by SPECT, PET and MRI. SPECT attenuation correction was performed using a modified PET transmission. A bull's eyes image was obtained for all data and wall ROI were then drawn for analysis. Using MRI as a reference, error from PET, SPECT and attenuation corrected SPECT were calculated. Systolic PET performances agree with MRI. Quantitation loss due to wall thickness reduction compared to the systole. Attenuation correction in SPECT leads to significant decrease of the error both in systole (from 29% to 14%) and diastole (35% to 22%). This is particularly sensitive for septum and inferior walls. SPECT residual errors (14% in systole and 22% in pathologic end-diastole) are likely caused by scatter, noise and depth dependent resolution effect. The results obtained with this dynamical phantom demonstrate the quantitation improvement achieved in SPECT with attenuation correction and also reinforce the need for variable resolution correction in addition to attenuation correction

  14. Design and evaluation of corn starch-bonded Rhizophora spp. particleboard phantoms for SPECT/CT imaging

    Science.gov (United States)

    Hamid, Puteri Nor Khatijah Abd; Yusof, Mohd Fahmi Mohd; Aziz Tajuddin, Abd; Hashim, Rokiah; Zainon, Rafidah

    2018-01-01

    The aim of this study was to design and evaluate of corn starch-bonded Rhizophora spp. particleboards as phantom for SPECT/CT imaging. The phantom was designed according to the Jaszczak phantom commonly used in SPECT imaging with dimension of 22 cm diameter and 18 cm length. Six inserts with different diameter were made for insertion of vials filled with 1.6 µCi/ml of 99mTc unsealed source. The particleboard phantom was scanned using SPECT/CT imaging protocol. The contrast of each vial for particleboards phantom were calculated based on the ratio of counts in radionuclide volume and phantom background and compared to Perspex® and water phantom. The results showed that contrast values for each vial in particleboard phantomis near to 1.0 and in good agreement with Perspex® and water phantoms as common phantom materials for SPECT/CT. The paired sample t-test result showed no significant difference of contrast values between images in particleboard phantoms and that in water. The overall results showed the potential of corn starch-bonded Rhizophora spp. as phantom for quality control and dosimetry works in SPECT/CT imaging.

  15. Motor activation SPECT for the neurosurgical diseases. Clinical application

    International Nuclear Information System (INIS)

    Noguchi, Hiroshi; Kawaguchi, Shoichiro; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime

    1999-01-01

    We evaluated and analyzed the motor activation single photon emission computed tomography (M-SPECT) findings on patients with ischemic cerebrovascular diseases (CVD). The M-SPECT studies were carried out on 91 patients with ischemic cerebrovascular diseases. The M-SPECT study was performed using the finger opposition task in each case. The SPECT images were superimposed on the magnetic resonance images (MRIs) for each case using Image Fusion Software. The result of the M-SPECT was expressed as positive or negative. The cases with a marked increase of blood flow in the sensorio-motor cortex after the finger opposition task were categorized as positive, and those cases showing no marked increase of blood flow were categorized as negative. Among the 91 cases examined, 53 (58%) were categorized as positive in the M-SPECT study. Among the negative M-SPECT cases treated with revascularization surgery, there were some cases showing positive M-SPECT results postoperatively. The cases without any revascularization surgery did not change the M-SPECT findings in each during the follow-up period. The M-SPECT procedure for examining intracranial lesions could provide the cortical localization of the motor function. The M-SPECT procedure in the ischemic CVDs contributes to knowledge about the choices of treatment and the evaluation of the treatment result. (author)

  16. Motor activation SPECT for the neurosurgical diseases. Clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Hiroshi; Kawaguchi, Shoichiro; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

    1999-08-01

    We evaluated and analyzed the motor activation single photon emission computed tomography (M-SPECT) findings on patients with ischemic cerebrovascular diseases (CVD). The M-SPECT studies were carried out on 91 patients with ischemic cerebrovascular diseases. The M-SPECT study was performed using the finger opposition task in each case. The SPECT images were superimposed on the magnetic resonance images (MRIs) for each case using Image Fusion Software. The result of the M-SPECT was expressed as positive or negative. The cases with a marked increase of blood flow in the sensorio-motor cortex after the finger opposition task were categorized as positive, and those cases showing no marked increase of blood flow were categorized as negative. Among the 91 cases examined, 53 (58%) were categorized as positive in the M-SPECT study. Among the negative M-SPECT cases treated with revascularization surgery, there were some cases showing positive M-SPECT results postoperatively. The cases without any revascularization surgery did not change the M-SPECT findings in each during the follow-up period. The M-SPECT procedure for examining intracranial lesions could provide the cortical localization of the motor function. The M-SPECT procedure in the ischemic CVDs contributes to knowledge about the choices of treatment and the evaluation of the treatment result. (author)

  17. Incremental value of 99mTc-HYNIC-TOC SPECT/CT over whole-body planar scintigraphy and SPECT in patients with neuroendocrine tumours.

    Science.gov (United States)

    Trogrlic, Mate; Težak, Stanko

    2017-06-12

    The aim of this study was to evaluate the additional value of 99m Tc-HYNIC-TOC SPECT/CT over planar whole-body (WB) scintigraphy and SPECT alone in the detection and accurate localisation of neuroendocrine tumour (NET) lesions. This study included 65 patients with a definitive histological diagnosis of NET prior to scintigraphy. Planar WB scintigraphy, SPECT, and SPECT/CT images were acquired at 4 h post-administration of 670 MBq 99m Tc-HYNIC-TOC. Additional SPECT images at 10 min after tracer administration were also acquired. Clinical and imaging follow-up findings were considered as the reference standards (minimum follow-up period, 15 months). Patient and lesion-based analyses of the efficacies of the imaging modalities were performed. While 38 patients exhibited metastasis of NETs, 27 presented no evidence of metastasis. Upon patient-based analysis, the sensitivity and specificity of SPECT/CT were found to be 88.9 and 79.3 %, respectively. The diagnostic accuracies of WB scintigraphy, 4h-SPECT, and SPECT/CT were 72.3, 73.8, and 84.6 %, respectively. The area under curve (AUC) value for SPECT/CT (0.84) was the highest, followed by those for 4h-SPECT (0.75) and WB scintigraphy (0.74). The accuracy and AUC values of SPECT/CT were significantly better compared to those of WB scintigraphy (p < 0.001), 10 min-SPECT (p < 0.001), and 4 h-SPECT (p = 0.001). The findings of SPECT/CT led to the change in treatment plan of 11 patients (16.9 %). The sensitivity and diagnostic accuracy of SPECT/CT in the evaluation of NET lesions outperforms planar WB imaging or SPECT alone.

  18. Brain SPECT in the pre-surgical evaluation of epileptic patients

    International Nuclear Information System (INIS)

    Buchpiguel, C.A.; Cukiert, A.; Hironaka, F.H.; Cerri, G.G.; Magalhaes, A.E.A.; Marino Junior, R.

    1992-01-01

    Fifteen adult epileptic patients were studied pre-operatively using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99 m Tc-HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas). In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions). Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hypoperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: in 4, SPECT findings correlated well with the anatomical findings; in 5 instances, SPECT was able to disclose additional functional deficits; in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10) SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and heterogeneity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic who are candidates for epilepsy surgery. (author)

  19. 99mTc-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI / CT and EEG

    International Nuclear Information System (INIS)

    Yang, Hyung In; Im, Ju Hyuk; Choi, Chang Woon; Lee, Dong Soo; Chung, June Key; No, Jae Kyu; Lee, Myung Chul; Koh, Chang Soon

    1994-01-01

    We studied 115 patients with seizure who had been performed brain SPECT brain MRI of CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction ultiple sclerosis, AV-malformation. granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions. 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4. temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

  20. Evaluation of bone viability in patients after girdlestone arthroplasty: comparison of bone SPECT/CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Diederichs, G.; Collettini, F.; Hamm, B.; Makowski, M.R. [Department of Radiology, Berlin (Germany); Hoppe, P.; Brenner, W. [Department of Nuclear Medicine, Berlin (Germany); Wassilew, G. [Department of Orthopedic Surgery, Berlin (Germany)

    2017-09-15

    To test the diagnostic performance of bone SPECT/CT and MRI for the evaluation of bone viability in patients after girdlestone-arthroplasty with histopathology used as gold standard. In this cross-sectional study, patients after girdlestone-arthroplasty were imaged with single-photon-emission-computed-tomography/computed-tomography (SPECT/CT) bone-scans using 99mTc-DPD. Additionally, 1.5 T MRI was performed with turbo-inversion-recovery-magnitude (TIRM), contrast-enhanced T1-fat sat (FS) and T1-mapping. All imaging was performed within 24 h prior to revision total-hip-arthroplasty in patients with a girdlestone-arthroplasty. In each patient, four standardized bone-tissue-biopsies (14 patients) were taken intraoperatively at the remaining acetabulum superior/inferior and trochanter major/minor. Histopathological evaluation of bone samples regarding bone viability was used as gold standard. A total of 56 bone-segments were analysed and classified as vital (n = 39) or nonvital (n = 17) by histopathology. Mineral/late-phase SPECT/CT showed a high sensitivity (90%) and specificity (94%) to distinguish viable and nonviable bone tissue. TIRM (sensitivity 87%, specificity 88%) and contrast-enhanced T1-FS (sensitivity 90%, specificity 88%) also achieved a high sensitivity and specificity. T1-mapping achieved the lowest values (sensitivity 82%, specificity 82%). False positive results in SPECT/CT and MRI resulted from small bone fragments close to metal artefacts. Both bone SPECT/CT and MRI allow a reliable differentiation between viable and nonviable bone tissue in patients after girdlestone arthroplasty. The findings of this study could also be relevant for the evaluation of bone viability in the context of avascular bone necrosis. (orig.)

  1. Evaluation of bone viability in patients after girdlestone arthroplasty: comparison of bone SPECT/CT and MRI

    International Nuclear Information System (INIS)

    Diederichs, G.; Collettini, F.; Hamm, B.; Makowski, M.R.; Hoppe, P.; Brenner, W.; Wassilew, G.

    2017-01-01

    To test the diagnostic performance of bone SPECT/CT and MRI for the evaluation of bone viability in patients after girdlestone-arthroplasty with histopathology used as gold standard. In this cross-sectional study, patients after girdlestone-arthroplasty were imaged with single-photon-emission-computed-tomography/computed-tomography (SPECT/CT) bone-scans using 99mTc-DPD. Additionally, 1.5 T MRI was performed with turbo-inversion-recovery-magnitude (TIRM), contrast-enhanced T1-fat sat (FS) and T1-mapping. All imaging was performed within 24 h prior to revision total-hip-arthroplasty in patients with a girdlestone-arthroplasty. In each patient, four standardized bone-tissue-biopsies (14 patients) were taken intraoperatively at the remaining acetabulum superior/inferior and trochanter major/minor. Histopathological evaluation of bone samples regarding bone viability was used as gold standard. A total of 56 bone-segments were analysed and classified as vital (n = 39) or nonvital (n = 17) by histopathology. Mineral/late-phase SPECT/CT showed a high sensitivity (90%) and specificity (94%) to distinguish viable and nonviable bone tissue. TIRM (sensitivity 87%, specificity 88%) and contrast-enhanced T1-FS (sensitivity 90%, specificity 88%) also achieved a high sensitivity and specificity. T1-mapping achieved the lowest values (sensitivity 82%, specificity 82%). False positive results in SPECT/CT and MRI resulted from small bone fragments close to metal artefacts. Both bone SPECT/CT and MRI allow a reliable differentiation between viable and nonviable bone tissue in patients after girdlestone arthroplasty. The findings of this study could also be relevant for the evaluation of bone viability in the context of avascular bone necrosis. (orig.)

  2. Effects of perfusion detect on the measurement of left ventricular mass, ventricular volume and post-stress left ventricular ejection fraction in gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Ahn, Byeong Cheol; Bae, Sun Keun; Lee, Sang Woo; Jeong, Sin Young; Lee, Jae Tae; Lee, Kyu Bo

    2002-01-01

    The presence of perfusion defect may influence the left ventricular mass (LVM) measurement by quantitative gated myocardial perfusion SPECT (QGS), and ischemic myocardium, usually showing perfusion defect may produce post-stress LV dysfunction. This study was aimed to evaluated the effects of extent and reversibility of perfusion defect on the automatic measurement of LVM by QGS and to investigate the effect of reversibility of perfusion defect on post-stress LV dysfunction. Forty-six patients (male/female=34:12, mean age=64 years) with perfusion defect on myocardial perfusion SPECT underwent rest and post-stress QGS. Forty patients (87%) showed reversible defect. End-diastolic volume (EDV), end-systolic volume (ESV), LV ejection fraction (EF), and LV myocardial volume were obtained from QGS by autoquant program, and LVM was calculated by multiplying the LV myocardial volume by the specific gravity of myocardium. LVMs measured at rest and post-stress QGS showed good correlation, and higher correlation was founded in the subjects with fixed perfusion defect and with small defect (smaller than 20%). There were no significant differences in EDVs, ESVs and EFs between obtained by rest and post-stress QGS in patients with fixed myocardial defect. Whereas, EF obtained by post-stress QGS was lower than that by rest QGS in patients with reversible defect and 10 (25%) of them showed decreases in EF more than 5% in post-stress QGS, as compared to that of rest QGS. Excellent correlations of EDVs, ESVs, EFs between rest and post-stress QGS were noted. Patients with fixed defect had higher correlation between defect can affect LVM measurement by QGS and patients with reversible defect shows post-stress LV dysfunction more frequently than patients with fixed perfusion defect

  3. The origins of SPECT and SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Hutton, Brian F. [University College London, Institute of Nuclear Medicine, London (United Kingdom); University of Wollongong, Centre for Medical Radiation Physics, Wollongong, NSW (Australia)

    2014-05-15

    Single photon emission computed tomography (SPECT) has a long history of development since its initial demonstration by Kuhl and Edwards in 1963. Although clinical utility has been dominated by the rotating gamma camera, there have been many technological innovations with the recent popularity of organ-specific dedicated SPECT systems. The combination of SPECT and CT evolved from early transmission techniques used for attenuation correction with the initial commercial systems predating the release of PET/CT. The development and acceptance of SPECT/CT has been relatively slow with continuing debate as to what cost/performance ratio is justified. Increasingly, fully diagnostic CT is combined with SPECT so as to facilitate optimal clinical utility. (orig.)

  4. Importance of SPECT/CT for knee and hip joint prostheses; Stellenwert der SPECT/CT bei Knie- und Hueftgelenkprothesen

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, K.; Steurer-Dober, I.; Huellner, M.W.; Veit-Haibach, P.; Allgayer, B. [Luzerner Kantonsspital (Switzerland). Institut fuer Nuklearmedizin und Roentgendiagnostik

    2012-07-15

    Complications, such as loosening or infections are common problems after hip or knee arthroplasty. If conventional X-rays are equivocal bone scintigraphy is the classical second-line imaging modality. Single photon emission computed tomography/computed tomography (SPECT/CT) offers metabolic and morphologic information in one imaging step and is becoming increasingly more available in larger hospitals. The SPECT/CT procedure is a promising method and is increasingly being used in daily routine to evaluate joint arthroplasty. The additional benefit compared with classical conventional bone scintigraphy has to be evaluated in further prospective studies. In our hospital SPECT/CT regularly gives important additional information regarding prosthetic joint complications. SPECT/CT is increasingly being used as the second step imaging standard modality if conventional X-rays are equivocal. (orig.) [German] Komplikationen wie Lockerung und Infekt stellen ein haeufiges Problem nach Hueft- und Kniegelenkprothesen dar. Wenn die konventionelle Roentgenaufnahme nicht zum Ziel fuehrt, ist die klassische konventionelle Skelettszintigraphie die am haeufigsten verwendete ''Second-line''-Bildgebung. Die ''single photon emission computed tomography''/CT (SPECT/CT) bietet metabolische und morphologische Informationen bzgl. Prothesenkomplikationen in einem Untersuchungsgang und ist zunehmend in groesseren Kliniken verfuegbar. Die SPECT/CT ist eine viel versprechende Methode und wird im klinischen Alltag bei der Evaluation von Gelenkprothesen zunehmend eingesetzt. Es sind noch mehr prospektive Studien noetig, um die Leistungsfaehigkeit und den Zusatznutzen gegenueber der klassischen Szintigraphie zu evaluieren. In unserer Klinik wird die Knochenszintigraphie bei der Abklaerung von Prothesenkomplikationen zumeist mit einer SPECT/CT kombiniert und liefert regelmaessig wichtige Zusatzinformationen. Die SPECT/CT entwickelt sich zunehmend zum Standard

  5. The role of Tc-99m HMPAO brain perfusion SPECT in the psychiatric disability evaluation of patients with chronic traumatic brain injury

    Energy Technology Data Exchange (ETDEWEB)

    So, Young [Nuclear Medicne, Seoul National Univ., Seoul (Korea, Republic of); Lee, Kang Wook; Lee, Sun Woo; Ghi, Lek Sung; Song, Chang June [College of Medicine, Chungnam National Univ., Taejon (Korea, Republic of)

    2002-08-01

    We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Sixty-nine patients (M:F=58:11, age 39 {+-} 14 years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were performed 6 {approx} 61 months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SEPCT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

  6. The role of Tc-99m HMPAO brain perfusion SPECT in the psychiatric disability evaluation of patients with chronic traumatic brain injury

    International Nuclear Information System (INIS)

    So, Young; Lee, Kang Wook; Lee, Sun Woo; Ghi, Lek Sung; Song, Chang June

    2002-01-01

    We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Sixty-nine patients (M:F=58:11, age 39 ± 14 years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were performed 6 ∼ 61 months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SEPCT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI

  7. Wide beam reconstruction for half-dose or half-time cardiac gated SPECT acquisitions: optimization of resources and reduction in radiation exposure

    International Nuclear Information System (INIS)

    Marcassa, Claudio; Campini, Riccardo; Zoccarato, Orazio; Calza, Paolo

    2011-01-01

    A new iterative reconstruction algorithm (WBR trademark) has been recently proposed for cardiac single photon emission computed tomography (SPECT). The WBR trademark technology is designed to reduce noise, improving lesion identification without affecting the image resolution, allowing SPECT studies with reduced count statistic. This allows for either half-time (HT) or half-dose (HD) cardiac SPECT, with image quality and quantitative data comparable to standard-time (ST) or standard-dose (SD) SPECT. Few data exist on the comparison between conventional filtered backprojection (FBP) and this new algorithm in a clinical setting. The aim of this study was to compare the performance of FBP and WBR trademark. Phantoms studies were performed to compare spatial resolution and contrast recovery with FBP, ordered subset expectation maximization (OSEM) and WBR trademark. A group of 92 patients, with different cardiac pathology, scheduled for a stress-rest SPECT were studied: 52 patients (group A) were injected with a SD of tracer and underwent both ST and HT SPECT; 40 patients (group B) were injected with a half dose of tracer and underwent ST SPECT and immediately after an additional SPECT at double time/projection (DT), to compensate for the low count statistic. A 2-day 99m Tc-sestamibi protocol was used in all patients. SD/ST and HD/DT SPECT were reconstructed with a conventional FBP; SD/HT and HD/ST SPECT were reconstructed with WBR trademark. The summed stress score (SSS) and summed rest score (SRS) were calculated; the left ventricular ejection fraction (LVEF) was automatically derived. In group A (SD), no significant differences were observed between ST FBP SPECT and HT WBR trademark in SSS (11.1 and 11.7, respectively) and SRS (9.4 and 10.3, respectively, NS). LVEF on rest acquisitions was also comparable (50% on ST SPECT and 49% on HT SPECT, NS); LVEF on post-stress studies in HT SPECT (46%) was lower than ST SPECT (50%), although not statistically significant. In

  8. Wide beam reconstruction for half-dose or half-time cardiac gated SPECT acquisitions: optimization of resources and reduction in radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Marcassa, Claudio [S. Maugeri Fnd, IRCCS, Scientific Institute of Veruno, Cardiology Department (Italy); Campini, Riccardo; Zoccarato, Orazio; Calza, Paolo [S. Maugeri Fnd, IRCCS, Scientific Institute of Veruno, Nuclear Medicine Department (Italy)

    2011-03-15

    A new iterative reconstruction algorithm (WBR trademark) has been recently proposed for cardiac single photon emission computed tomography (SPECT). The WBR trademark technology is designed to reduce noise, improving lesion identification without affecting the image resolution, allowing SPECT studies with reduced count statistic. This allows for either half-time (HT) or half-dose (HD) cardiac SPECT, with image quality and quantitative data comparable to standard-time (ST) or standard-dose (SD) SPECT. Few data exist on the comparison between conventional filtered backprojection (FBP) and this new algorithm in a clinical setting. The aim of this study was to compare the performance of FBP and WBR trademark. Phantoms studies were performed to compare spatial resolution and contrast recovery with FBP, ordered subset expectation maximization (OSEM) and WBR trademark. A group of 92 patients, with different cardiac pathology, scheduled for a stress-rest SPECT were studied: 52 patients (group A) were injected with a SD of tracer and underwent both ST and HT SPECT; 40 patients (group B) were injected with a half dose of tracer and underwent ST SPECT and immediately after an additional SPECT at double time/projection (DT), to compensate for the low count statistic. A 2-day {sup 99m}Tc-sestamibi protocol was used in all patients. SD/ST and HD/DT SPECT were reconstructed with a conventional FBP; SD/HT and HD/ST SPECT were reconstructed with WBR trademark. The summed stress score (SSS) and summed rest score (SRS) were calculated; the left ventricular ejection fraction (LVEF) was automatically derived. In group A (SD), no significant differences were observed between ST FBP SPECT and HT WBR trademark in SSS (11.1 and 11.7, respectively) and SRS (9.4 and 10.3, respectively, NS). LVEF on rest acquisitions was also comparable (50% on ST SPECT and 49% on HT SPECT, NS); LVEF on post-stress studies in HT SPECT (46%) was lower than ST SPECT (50%), although not statistically significant

  9. Ventilation/perfusion SPECT or SPECT/CT for lung function imaging in patients with pulmonary emphysema?

    Science.gov (United States)

    Froeling, Vera; Heimann, Uwe; Huebner, Ralf-Harto; Kroencke, Thomas J; Maurer, Martin H; Doellinger, Felix; Geisel, Dominik; Hamm, Bernd; Brenner, Winfried; Schreiter, Nils F

    2015-07-01

    To evaluate the utility of attenuation correction (AC) of V/P SPECT images for patients with pulmonary emphysema. Twenty-one patients (mean age 67.6 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. AC/non-AC V/P SPECT images were compared visually and semiquantitatively. Visual comparison of AC/non-AC images was based on a 5-point likert scale. Semiquantitative comparison assessed absolute counts per lung (aCpLu) and lung lobe (aCpLo) for AC/non-AC images using software-based analysis; percentage counts (PC = (aCpLo/aCpLu) × 100) were calculated. Correlation between AC/non-AC V/P SPECT images was analyzed using Spearman's rho correlation coefficient; differences were tested for significance with the Wilcoxon rank sum test. Visual analysis revealed high conformity for AC and non-AC V/P SPECT images. Semiquantitative analysis of PC in AC/non-AC images had an excellent correlation and showed no significant differences in perfusion (ρ = 0.986) or ventilation (ρ = 0.979, p = 0.809) SPECT/CT images. AC of V/P SPECT images for lung lobe-based function imaging in patients with pulmonary emphysema do not improve visual or semiquantitative image analysis.

  10. Scatter and cross-talk correction for one-day acquisition of 123I-BMIPP and 99mtc-tetrofosmin myocardial SPECT.

    Science.gov (United States)

    Kaneta, Tomohiro; Kurihara, Hideyuki; Hakamatsuka, Takashi; Ito, Hiroshi; Maruoka, Shin; Fukuda, Hiroshi; Takahashi, Shoki; Yamada, Shogo

    2004-12-01

    123I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) and 99mTc-tetrofosmin (TET) are widely used for evaluation of myocardial fatty acid metabolism and perfusion, respectively. ECG-gated TET SPECT is also used for evaluation of myocardial wall motion. These tests are often performed on the same day to minimize both the time required and inconvenience to patients and medical staff. However, as 123I and 99mTc have similar emission energies (159 keV and 140 keV, respectively), it is necessary to consider not only scattered photons, but also primary photons of each radionuclide detected in the wrong window (cross-talk). In this study, we developed and evaluated the effectiveness of a new scatter and cross-talk correction imaging protocol. Fourteen patients with ischemic heart disease or heart failure (8 men and 6 women with a mean age of 69.4 yr, ranging from 45 to 94 yr) were enrolled in this study. In the routine one-day acquisition protocol, BMIPP SPECT was performed in the morning, with TET SPECT performed 4 h later. An additional SPECT was performed just before injection of TET with the energy window for 99mTc. These data correspond to the scatter and cross-talk factor of the next TET SPECT. The correction was performed by subtraction of the scatter and cross-talk factor from TET SPECT. Data are presented as means +/- S.E. Statistical analyses were performed using Wilcoxon's matched-pairs signed-ranks test, and p corrected total count was 26.0 +/- 5.3%. EDV and ESV after correction were significantly greater than those before correction (p = 0.019 and 0.016, respectively). After correction, EF was smaller than that before correction, but the difference was not significant. Perfusion scores (17 segments per heart) were significantly lower after as compared with those before correction (p correction revealed significant differences in EDV, ESV, and perfusion scores. These observations indicate that scatter and cross-talk correction is required for one

  11. EEG, MRI, and SPECT in epilepsy. Relative contributions to preoperative evaluation

    International Nuclear Information System (INIS)

    Seki, Gaku; Hoshida, Tohru; Goda, Kazuo; Hashimoto, Hiroshi; Nakase, Hiroyuki; Hirabayashi, Hidehiro; Kawaguchi, Shoichiro; Morimoto, Tetsuya; Sakaki, Toshisuke

    1998-01-01

    We comparatively assessed detection of epileptogenic areas on preoperative evaluation in 33 patients with intractable partial epilepsy using scalp interictal and ictal electroencephalography (EEG), magnetic resonance imaging (MRI), and interictal single photon emission computed tomography (SPECT). There are 22 temporal and 11 extratemporal lobe epilepsies. All or almost of their seizures have stopped after resective surgery for more than 12 months follow-up period, averaged 43 months. MRI studies demonstrated 21 organic lesions, 11 mesial temporal sclerosis and one patient showed normal brain tissue. Scalp EEG could correctly identify the focus in 14 of 33 cases (42%), interictal SPECT in 18 of 26 (69%), MRI in 29 of 33 (88%), interictal scalp EEG-video monitoring in 17 of 24 (71%), and ictal scalp EEG-video monitoring in 15 of 22 (68%). Although neuroimaging studies, especially MRI, are useful to detect not only localization of epileptic lesions but also epileptogenic focus, for example, mesial temporal sclerosis, the exact localization of epileptogenic areas could be done by comprehensive evaluation including ictal scalp EEG-video monitoring. (author)

  12. EEG, MRI, and SPECT in epilepsy. Relative contributions to preoperative evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Gaku [Luoyang Medical Coll. Associated Hospital (China); Hoshida, Tohru; Goda, Kazuo; Hashimoto, Hiroshi; Nakase, Hiroyuki; Hirabayashi, Hidehiro; Kawaguchi, Shoichiro; Morimoto, Tetsuya; Sakaki, Toshisuke

    1998-07-01

    We comparatively assessed detection of epileptogenic areas on preoperative evaluation in 33 patients with intractable partial epilepsy using scalp interictal and ictal electroencephalography (EEG), magnetic resonance imaging (MRI), and interictal single photon emission computed tomography (SPECT). There are 22 temporal and 11 extratemporal lobe epilepsies. All or almost of their seizures have stopped after resective surgery for more than 12 months follow-up period, averaged 43 months. MRI studies demonstrated 21 organic lesions, 11 mesial temporal sclerosis and one patient showed normal brain tissue. Scalp EEG could correctly identify the focus in 14 of 33 cases (42%), interictal SPECT in 18 of 26 (69%), MRI in 29 of 33 (88%), interictal scalp EEG-video monitoring in 17 of 24 (71%), and ictal scalp EEG-video monitoring in 15 of 22 (68%). Although neuroimaging studies, especially MRI, are useful to detect not only localization of epileptic lesions but also epileptogenic focus, for example, mesial temporal sclerosis, the exact localization of epileptogenic areas could be done by comprehensive evaluation including ictal scalp EEG-video monitoring. (author)

  13. SPECT and PET imaging in epilepsy

    International Nuclear Information System (INIS)

    Semah, F.

    2007-01-01

    Positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging are very useful for the management of patients with medically refractory partial epilepsy. Presurgical evaluation of patients with medically refractory partial epilepsy often included PET imaging using FDG. The use of SPECT in these patients adds some more information and gives the clinicians the possibility of having ictal imaging. Furthermore, PET and SPECT imaging are performed to better understand the pathophysiology of epilepsy. (authors)

  14. {sup 99m}Tc-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI / CT and EEG

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hyung In [Kyunghee University Hospital, Seoul (Korea, Republic of); Im, Ju Hyuk; Choi, Chang Woon; Lee, Dong Soo; Chung, June Key; No, Jae Kyu; Lee, Myung Chul; Koh, Chang Soon [Seoul National University Hospital, Seoul (Korea, Republic of)

    1994-03-15

    We studied 115 patients with seizure who had been performed brain SPECT brain MRI of CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction ultiple sclerosis, AV-malformation. granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions. 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4. temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

  15. Evaluation of using 99Tcm-MDP SPECT/CT for differentiating malignancy from benignancy in femoral diseases

    International Nuclear Information System (INIS)

    Ou Xiaohong; Huang Rui; Su Minggang; Zhou Li'na; Fan Qiuping

    2010-01-01

    Objective: To evaluate the value of SPECT/CT in assessment of femoral foci of abnormal bone metabolism classified as intermediated on bone scanning using 99Tcm-methylene diphosphonate (MDP). Methods: There were 94 patients with solitary femoral abnormal uptake in bone scanning included. SPECT was accompanied by inline CT over the femoral region. All of the images were blindly interpreted independently by two experienced board-certified radiologists. The reference standard was follow-up over half a year of MRI, CT, SPECT, or pathology. Diagnosis which consist with reference were counted as accurate. Diagnosis which either not consist with reference or undetermined were counted as false. Results: Of the 94 patients, 78 patients (male 42 , female 36, mean age 62 yrs) have the definite diagnosis of their femoral foci. 19 were proved to be metastasis and the other 59 were benign diseases. The diagnostic accuracy by bone SPECT, bone CT and fusion imaging were 58.9%, 87.2%, 96.2% respectively. Conclusions: Most of the solitary femoral foci caused by benign diseases. SPECT/CT using 99 Tc m -MDP has additional valuable in differentiating malignancy from benignancy in femoral foci . (authors)

  16. Performance evaluation of a compact PET/SPECT/CT tri-modality system for small animal imaging applications

    International Nuclear Information System (INIS)

    Wei, Qingyang; Wang, Shi; Ma, Tianyu; Wu, Jing; Liu, Hui; Xu, Tianpeng; Xia, Yan; Fan, Peng; Lyu, Zhenlei; Liu, Yaqiang

    2015-01-01

    PET, SPECT and CT imaging techniques are widely used in preclinical small animal imaging applications. In this paper, we present a compact small animal PET/SPECT/CT tri-modality system. A dual-functional, shared detector design is implemented which enables PET and SPECT imaging with a same LYSO ring detector. A multi-pinhole collimator is mounted on the system and inserted into the detector ring in SPECT imaging mode. A cone-beam CT consisting of a micro focus X-ray tube and a CMOS detector is implemented. The detailed design and the performance evaluations are reported in this paper. In PET imaging mode, the measured NEMA based spatial resolution is 2.12 mm (FWHM), and the sensitivity at the central field of view (CFOV) is 3.2%. The FOV size is 50 mm (∅)×100 mm (L). The SPECT has a spatial resolution of 1.32 mm (FWHM) and an average sensitivity of 0.031% at the center axial, and a 30 mm (∅)×90 mm (L) FOV. The CT spatial resolution is 8.32 lp/mm @10%MTF, and the contrast discrimination function value is 2.06% with 1.5 mm size cubic box object. In conclusion, a compact, tri-modality PET/SPECT/CT system was successfully built with low cost and high performance

  17. Efficacy of SPECT over planar bone scan in the diagnosis of solitary vertebral lesions in patients with low back pain

    International Nuclear Information System (INIS)

    Sudhakar, Pushpalatha; Bhushan, Shanti M.; Ranadhir, G.; Prabhakar Rao, V.V.S.; Sharma, Anshu Rajnish; Narsimuhulu, G.

    2010-01-01

    The purpose of our study has been to evaluate the efficacy of single photon emission computed tomography (SPECT) over planar bone scan in identifying solitary vertebral lesions in patients with low backache and its ability to differentiate various pathologies according to the uptake pattern. Materials and Methods: The study included twenty patients out of whom six patients presented with known carcinoma and fourteen patients with low back pain. SPECT was done in all following planar skeletal survey. Benign and malignant lesions were identified according to the uptake pattern in vertebral elements, based on Gary F. Gates observations. Final diagnosis was obtained by means of biopsy or correlation with radiograph or computed tomography (CT) or magnetic resonance imaging (MRI), and/or follow up. Results: SPECT detected additional 30% of solitary vertebral lesions that were obscured on planar scan. Seven out of twenty were localized in anterior vertebral body and were diagnosed as benign ostophytes in six and osteoma in one substantiating the previous observations. Out of six cases of known carcinoma, three were having solitary metastases and showed posterior vertebral body uptake with pedicle involvement. SPECT could localize specific lesions as source of pain in eleven patients with low back pain (78%) and identified various etiologies including benign tumors (osteoid osteoma and osteoma), facet arthritis, discitis, transverse process fractures and spondylolysis. Conclusion: Our study highlighted the higher diagnostic value of SPECT over planar skeletal scintigraphy in localizing solitary vertebral lesions in low backache patients. Based on SPECT pattern, malignant and benign lesions could be differentiated in the given clinical context. (author)

  18. Quantitation of myocardial blood flow and myocardial flow reserve with 99mTc-sestamibi dynamic SPECT/CT to enhance detection of coronary artery disease

    International Nuclear Information System (INIS)

    Hsu, Bailing; Chen, Fu-Chung; Chen, Chien-Cheng; Wu, Tao-Cheng; Huang, Wen-Sheng; Hou, Po-Nien; Hung, Guang-Uei

    2014-01-01

    Conventional dual-head single photon emission computed tomography (SPECT)/CT systems capable of fast dynamic SPECT (DySPECT) imaging have a potential for flow quantitation. This study introduced a new method to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR) with DySPECT scan and evaluated the diagnostic performance of detecting coronary artery disease (CAD) compared with perfusion using invasive coronary angiography (CAG) as the reference standard. This study included 21 patients with suspected or known CAD who had received DySPECT, ECG-gated SPECT (GSPECT), and CAG (13 with ≥50 % stenosis in any vessel; non-CAD group: 8 with patent arteries or 99m Tc-sestamibi (MIBI) tracer at rest or dipyridamole-stress stages. DySPECT images were reconstructed with full physical corrections and converted to the physical unit of becquerels per milliliter. Stress MBF (SMBF), rest MBF (RMBF), and MFR were quantified by a one-tissue compartment flow model using time-activity curves derived from DySPECT images. Perfusion images were processed for GSPECT scan and interpreted to obtain summed stress score (SSS) and summed difference score (SDS). Receiver-operating characteristic (ROC) analyses were conducted to evaluate the diagnostic performance of flow and perfusion. Using the criteria of ≥50 % stenosis as positive CAD, areas under the ROC curve (AUCs) of flow assessment were overall significantly greater than those of perfusion. For patient-based analysis, AUCs for MFR, SMBF, SSS, and SDS were 0.91 ± 0.07, 0.86 ± 0.09, 0.64 ± 0.12, and 0.59 ± 0.13. For vessel-based analysis, AUCs for MFR, SMBF, SSS, and SDS were 0.81 ± 0.05, 0.76 ± 0.06, 0.62 ± 0.07, and 0.56 ± 0.08, respectively. The preliminary data suggest that MBF quantitation with a conventional SPECT/CT system and the flow quantitation method is a clinically effective approach to enhance CAD detection. (orig.)

  19. An accurate projection algorithm for array processor based SPECT systems

    International Nuclear Information System (INIS)

    King, M.A.; Schwinger, R.B.; Cool, S.L.

    1985-01-01

    A data re-projection algorithm has been developed for use in single photon emission computed tomography (SPECT) on an array processor based computer system. The algorithm makes use of an accurate representation of pixel activity (uniform square pixel model of intensity distribution), and is rapidly performed due to the efficient handling of an array based algorithm and the Fast Fourier Transform (FFT) on parallel processing hardware. The algorithm consists of using a pixel driven nearest neighbour projection operation to an array of subdivided projection bins. This result is then convolved with the projected uniform square pixel distribution before being compressed to original bin size. This distribution varies with projection angle and is explicitly calculated. The FFT combined with a frequency space multiplication is used instead of a spatial convolution for more rapid execution. The new algorithm was tested against other commonly used projection algorithms by comparing the accuracy of projections of a simulated transverse section of the abdomen against analytically determined projections of that transverse section. The new algorithm was found to yield comparable or better standard error and yet result in easier and more efficient implementation on parallel hardware. Applications of the algorithm include iterative reconstruction and attenuation correction schemes and evaluation of regions of interest in dynamic and gated SPECT

  20. Validation and the limits of SPECT for patients suffering from cerebrovascular accidents. Evaluations based on simultaneous PET and SPECT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Mizukawa, Norihiko; Yano, Ichiro; Tenjin, Hiroshi (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1989-02-01

    Contemporaneous single photon emission computed tomography (SPECT) and positron emission tomography (PET) were performed in 10 patients with cerebrovascular accidents (CVA), whose ages ranged from 11 to 67 years. I-123-isopropyl-iodoamphetamine (IMP) and/or Tc-99m hexamethylpropyleneamine oxime (HM-PAO) were used for SPECT. Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate for oxygen (CMRO{sub 2}) were measured by an O-15 labelled gas continuous-inhalation method. SPECT images were quite similar to CBF and CMRO{sub 2} during the chronic stage of CVA. Two patietns with vasospasm during the subacute stage had apparently low CBF and CMRO{sub 2} on PET, but did not have low perfusion on SPECT. Luxury perfusion areas were detected in 4 subacute stage patients and one chronic stage patient. A redistribution of IMP was detected in two patients with infarction during subacute stage. CMRO{sub 2} value in such an area was 2.0 ml/100 g/min. Low CBF and/or CMRO{sub 2} areas were well visualized by IMP rather than by HM-PAO SPECT. (N.K.).

  1. Quantitation of myocardial blood flow and myocardial flow reserve with {sup 99m}Tc-sestamibi dynamic SPECT/CT to enhance detection of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Bailing [University of Missouri-Columbia, Nuclear Science and Engineering Institute, Columbia, MO (United States); Chen, Fu-Chung; Chen, Chien-Cheng [Show Chwan Memorial Hospital, Section of Cardiology, Department of Internal Medicine, Changhua (China); Wu, Tao-Cheng [Taipei Veterans General Hospital, Section of Cardiology, Department of Internal Medicine, Taipei (China); Huang, Wen-Sheng [Changhua Christian Hospital, Department of Medical Research and Department of Nuclear Medicine, Changhua (China); Hou, Po-Nien [Chang Bing Show Chwan Memorial Hospital, Department of Nuclear Medicine, Lukong Town, Changhua Shien (China); Hung, Guang-Uei [Chang Bing Show Chwan Memorial Hospital, Department of Nuclear Medicine, Lukong Town, Changhua Shien (China); Central Taiwan University of Science and Technology, Department of Medical Imaging and Radiological Science, Taichung (China); China Medical University, Department of Biomedical Imaging and Radiological Science, Taichung (China)

    2014-12-15

    Conventional dual-head single photon emission computed tomography (SPECT)/CT systems capable of fast dynamic SPECT (DySPECT) imaging have a potential for flow quantitation. This study introduced a new method to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR) with DySPECT scan and evaluated the diagnostic performance of detecting coronary artery disease (CAD) compared with perfusion using invasive coronary angiography (CAG) as the reference standard. This study included 21 patients with suspected or known CAD who had received DySPECT, ECG-gated SPECT (GSPECT), and CAG (13 with ≥50 % stenosis in any vessel; non-CAD group: 8 with patent arteries or <50 % stenosis). DySPECT and GSPECT scans were performed on a widely used dual-head SPECT/CT scanner. The DySPECT imaging protocol utilized 12-min multiple back-and-forth gantry rotations during injections of {sup 99m}Tc-sestamibi (MIBI) tracer at rest or dipyridamole-stress stages. DySPECT images were reconstructed with full physical corrections and converted to the physical unit of becquerels per milliliter. Stress MBF (SMBF), rest MBF (RMBF), and MFR were quantified by a one-tissue compartment flow model using time-activity curves derived from DySPECT images. Perfusion images were processed for GSPECT scan and interpreted to obtain summed stress score (SSS) and summed difference score (SDS). Receiver-operating characteristic (ROC) analyses were conducted to evaluate the diagnostic performance of flow and perfusion. Using the criteria of ≥50 % stenosis as positive CAD, areas under the ROC curve (AUCs) of flow assessment were overall significantly greater than those of perfusion. For patient-based analysis, AUCs for MFR, SMBF, SSS, and SDS were 0.91 ± 0.07, 0.86 ± 0.09, 0.64 ± 0.12, and 0.59 ± 0.13. For vessel-based analysis, AUCs for MFR, SMBF, SSS, and SDS were 0.81 ± 0.05, 0.76 ± 0.06, 0.62 ± 0.07, and 0.56 ± 0.08, respectively. The preliminary data suggest that MBF quantitation with a

  2. The role of bone SPECT/CT in the evaluation of lumbar spinal fusion with metallic fixation devices

    DEFF Research Database (Denmark)

    Damgaard, Morten; Nimb, Lars; Madsen, Jan L

    2010-01-01

    PURPOSE: It is difficult to evaluate the stability of the lumbar spondylodesis with metallic fixation devices by conventional imaging methods such as radiography or magnetic resonance imaging. It is unknown whether single photon emission computed tomography/computed tomography (SPECT/CT) may......, whereas in 1 case loose pedicle screws were detected at a wrong vertebral level. CONCLUSION: SPECT/CT may be useful to detect a lack of fixation of the metallic implants, and hence instability of the spondylodesis by evaluating the focal bone mineralization activity in relation to the pedicle screws....

  3. Ejection fraction in myocardial perfusion imaging assessed with a dynamic phantom: comparison between IQ-SPECT and LEHR.

    Science.gov (United States)

    Hippeläinen, Eero; Mäkelä, Teemu; Kaasalainen, Touko; Kaleva, Erna

    2017-12-01

    Developments in single photon emission tomography instrumentation and reconstruction methods present a potential for decreasing acquisition times. One of such recent options for myocardial perfusion imaging (MPI) is IQ-SPECT. This study was motivated by the inconsistency in the reported ejection fraction (EF) and left ventricular (LV) volume results between IQ-SPECT and more conventional low-energy high-resolution (LEHR) collimation protocols. IQ-SPECT and LEHR quantitative results were compared while the equivalent number of iterations (EI) was varied. The end-diastolic (EDV) and end-systolic volumes (ESV) and the derived EF values were investigated. A dynamic heart phantom was used to produce repeatable ESVs, EDVs and EFs. Phantom performance was verified by comparing the set EF values to those measured from a gated multi-slice X-ray computed tomography (CT) scan (EF True ). The phantom with an EF setting of 45, 55, 65 and 70% was imaged with both IQ-SPECT and LEHR protocols. The data were reconstructed with different EI, and two commonly used clinical myocardium delineation software were used to evaluate the LV volumes. The CT verification showed that the phantom EF settings were repeatable and accurate with the EF True being within 1% point from the manufacture's nominal value. Depending on EI both MPI protocols can be made to produce correct EF estimates, but IQ-SPECT protocol produced on average 41 and 42% smaller EDV and ESV when compared to the phantom's volumes, while LEHR protocol underestimated volumes by 24 and 21%, respectively. The volume results were largely similar between the delineation methods used. The reconstruction parameters can greatly affect the volume estimates obtained from perfusion studies. IQ-SPECT produces systematically smaller LV volumes than the conventional LEHR MPI protocol. The volume estimates are also software dependent.

  4. Interictal SPECT in the pre surgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis

    International Nuclear Information System (INIS)

    Marques, Lucia H.N.; Ferraz-Filho, Jose R.L.; Lins-Filho, Mario L.M.

    2009-01-01

    The aim of this study was to evaluate the sensitivity of interictal compared to ictal SPECT in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (TLE) patients that present with normal magnetic resonance imaging (MRI) or bilateral mesial temporal sclerosis (MTS). Thirty patients with TLE, for whom MRI examinations were normal or who presented with bilateral MTS, were retrospectively studied. Using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal SPECTs. In conclusion the interictal SPECT is only useful when associated with the ictal SPECT and does not substitute it in the localization of epileptogenic areas in patients with normal MRI or bilateral MTS. (author)

  5. Interictal SPECT in the pre surgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Lucia H.N. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Neurologia. Centro Cirurgico de Epilepsia; Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil); Ferraz-Filho, Jose R.L. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil); Lins-Filho, Mario L.M. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Radiologia; Maciel, Marina G.; Yoshitake, Rafael; Filetti, Sarah V. [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil)

    2009-07-01

    The aim of this study was to evaluate the sensitivity of interictal compared to ictal SPECT in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (TLE) patients that present with normal magnetic resonance imaging (MRI) or bilateral mesial temporal sclerosis (MTS). Thirty patients with TLE, for whom MRI examinations were normal or who presented with bilateral MTS, were retrospectively studied. Using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal SPECTs. In conclusion the interictal SPECT is only useful when associated with the ictal SPECT and does not substitute it in the localization of epileptogenic areas in patients with normal MRI or bilateral MTS. (author)

  6. A combined static-dynamic single-dose imaging protocol to compare quantitative dynamic SPECT with static conventional SPECT.

    Science.gov (United States)

    Sciammarella, Maria; Shrestha, Uttam M; Seo, Youngho; Gullberg, Grant T; Botvinick, Elias H

    2017-08-03

    SPECT myocardial perfusion imaging (MPI) is a clinical mainstay that is typically performed with static imaging protocols and visually or semi-quantitatively assessed for perfusion defects based upon the relative intensity of myocardial regions. Dynamic cardiac SPECT presents a new imaging technique based on time-varying information of radiotracer distribution, which permits the evaluation of regional myocardial blood flow (MBF) and coronary flow reserve (CFR). In this work, a preliminary feasibility study was conducted in a small patient sample designed to implement a unique combined static-dynamic single-dose one-day visit imaging protocol to compare quantitative dynamic SPECT with static conventional SPECT for improving the diagnosis of coronary artery disease (CAD). Fifteen patients (11 males, four females, mean age 71 ± 9 years) were enrolled for a combined dynamic and static SPECT (Infinia Hawkeye 4, GE Healthcare) imaging protocol with a single dose of 99m Tc-tetrofosmin administered at rest and a single dose administered at stress in a one-day visit. Out of 15 patients, eleven had selective coronary angiography (SCA), 8 within 6 months and the rest within 24 months of SPECT imaging, without intervening symptoms or interventions. The extent and severity of perfusion defects in each myocardial region was graded visually. Dynamically acquired data were also used to estimate the MBF and CFR. Both visually graded images and estimated CFR were tested against SCA as a reference to evaluate the validity of the methods. Overall, conventional static SPECT was normal in ten patients and abnormal in five patients, dynamic SPECT was normal in 12 patients and abnormal in three patients, and CFR from dynamic SPECT was normal in nine patients and abnormal in six patients. Among those 11 patients with SCA, conventional SPECT was normal in 5, 3 with documented CAD on SCA with an overall accuracy of 64%, sensitivity of 40% and specificity of 83%. Dynamic SPECT image

  7. Evaluation of Gilles de la Tourette syndrome with [99mTc] HMPAO Brain SPECT

    International Nuclear Information System (INIS)

    Carreira, LCTF; Santos, A. O; Juarez, B. A; Leite, H. A; Lima, M. C. L; Ramos, C. D; Camargo, E. E

    2002-01-01

    Gilles de la Tourette syndrome (GLTS) is a disorder characterized by tics and several behavioral disturbances. Although GLTS is a relatively common disorder, little is known about its pathophysiology. Previous studies with SPECT and PET were performed in a small number of patients and have shown some discordant data. The aim of this study is to evaluate brain perfusion abnormalities in patients with GLTS and to correlate them with the clinical manifestations of the syndrome. Twenty-eight patients were submitted to brain [99mTc]-HMPAO SPECT. 82 percent of the patients had abnormal studies. The most frequent finding was perfusion abnormalities in the thalami in 16 patients (57 percent) and 85 percent of patients with hyperperfusion of one or both thalami had complex motor tics. This investigation has demonstrated that brain perfusion SPECT is able to identify cortical perfusion abnormalities, associated with clinical symptoms in patients with GLTS. These abnormalities involve the pre-frontal-striatal-thalamic-cortical pathways (Au)

  8. Design and evaluation of a mobile bedside PET/SPECT imaging system

    Science.gov (United States)

    Studenski, Matthew Thomas

    Patients confined to an intensive care unit, the emergency room, or a surgical suite are managed without nuclear medicine procedures such as positron emission tomography (PET) or single photon emission computed tomography (SPECT). These studies have diagnostic value which can greatly benefit the physician's treatment of the patient but require that the patient is moved to a scanner. This dissertation examines the feasibility of an economical PET/SPECT system that can be brought to the bedside of an immobile patient for imaging. We chose to focus on cardiac SPECT imaging including perfusion imaging using 99mTc tracers and viability imaging using 18F tracers first because of problems arising from positioning a detector beneath a patient's bed, a requirement for the opposed detector orientation in PET imaging. Second, SPECT imaging acquiring over the anterior 180 degrees of the patient results in reduced attenuation effects due to the heart's location in the anterior portion of the body. Four studies were done to assess the clinical feasibility of the mobile system; 1) the performance of the system was evaluated in SPECT mode at both 140 keV (99mTc tracers) and 511 keV (positron emitting tracers), 2) a dynamic cardiac phantom was used to develop and test image acquisition and processing methods for the system at both energies, 3) a high energy pinhole collimator was designed to reduce the effects of high energy photon penetration through the parallel hole collimator, and 4) we estimated the radiation dose to persons that would be in the vicinity of a patient to ensure that the effective dose is below the regulatory limit. With these studies, we show that the mobile system provides an economical means of bringing nuclear medicine to an immobile patient while staying below the regulatory dose limit to other persons. The system performed well at both 140 keV and 511 keV and provided viable images of a phantom myocardium at both energies. The system does not achieve the

  9. Evaluation of pelvic ring injuries using SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Scheyerer, Max J. [University Hospital Zurich, Division of Trauma Surgery, Department of Surgery, Zurich (Switzerland); University Medical Center, Centre for Orthopaedic and Trauma Surgery, Cologne (Germany); Huellner, Martin; Pietsch, Carsten [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Werner, Clement M.L. [University Hospital Zurich, Division of Trauma Surgery, Department of Surgery, Zurich (Switzerland); Veit-Haibach, Patrick [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); University Hospital Zurich, Diagnostic and Interventional Radiology, Department of Medical Radiology, Zurich (Switzerland)

    2014-08-12

    The incidence of pelvic fractures is relatively low compared with other fracture locations. The low incidence is in great contrast to the high morbidity and mortality. Particularly in the elderly, with apparently isolated fractures of the pubic rami, these observations are believed to be due to additional occult lesions of the posterior pelvic ring. In these cases diagnosis cannot be established by conventional imaging alone and SPECT/CT is considered as a diagnostic adjunct. The aim of this study was to assess concomitant bony or soft tissue lesions within the pelvic ring in a population of patients with fractures of the anterior elements. In all patients with no obvious lesions of the posterior pelvic ring on X-rays and CT or with suspicious but inconclusive findings on CT an additional SPECT/CT was carried out in a non-acute setting within 3 days of the trauma. In all cases additional lesions within the pelvic ring were found. Most lesions were vertical sacral fractures, followed by transverse fractures, one non-dislocated fracture of the acetabulum on the side of the pubic rami fracture, and one post-traumatic dilatation of the sacroiliac joint with increased tracer uptake. According to our results after SPECT/CT all patients with pubic rami fracture suffered additional lesions, none detectable previously by X-ray or CT, within the pelvic ring. In this context SPECT/CT has proved to be very helpful in the clinical routine to visualize occult fractures and instability within the sacroiliac joint. (orig.)

  10. Evaluation of both perfusion and atrophy in multiple system atrophy of the cerebellar type using brain SPECT alone

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi; Imabayashi, Etsuko; Kuji, Ichiei; Seto, Akira; Ito, Kimiteru; Kikuta, Daisuke; Yamada, Minoru; Shimano, Yasumasa; Sato, Noriko

    2010-01-01

    Partial volume effects in atrophied areas should be taken into account when interpreting brain perfusion single photon emission computed tomography (SPECT) images of neurodegenerative diseases. To evaluate both perfusion and atrophy using brain SPECT alone, we developed a new technique applying tensor-based morphometry (TBM) to SPECT. After linear spatial normalization of brain perfusion SPECT using 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD) to a Talairach space, high-dimension-warping was done using an original 99m Tc-ECD template. Contraction map images calculated from Jacobian determinants and spatially normalized SPECT images using this high-dimension-warping were compared using statistical parametric mapping (SPM2) between two groups of 16 multiple system atrophy of the cerebellar type (MSA-C) patients and 73 age-matched normal controls. This comparison was also performed in conventionally warped SPECT images. SPM2 demonstrated statistically significant contraction indicating local atrophy and decreased perfusion in the whole cerebellum and pons of MSA-C patients as compared to normal controls. Higher significance for decreased perfusion in these areas was obtained in high-dimension-warping than in conventional warping, possibly due to sufficient spatial normalization to a 99m Tc-ECD template in high-dimensional warping of severely atrophied cerebellum and pons. In the present high-dimension-warping, modification of tracer activity remained within 3% of the original tracer distribution. The present new technique applying TBM to brain SPECT provides information on both perfusion and atrophy at the same time thereby enhancing the role of brain perfusion SPECT

  11. Evaluation of both perfusion and atrophy in multiple system atrophy of the cerebellar type using brain SPECT alone

    Directory of Open Access Journals (Sweden)

    Matsuda Hiroshi

    2010-08-01

    Full Text Available Abstract Background Partial volume effects in atrophied areas should be taken into account when interpreting brain perfusion single photon emission computed tomography (SPECT images of neurodegenerative diseases. To evaluate both perfusion and atrophy using brain SPECT alone, we developed a new technique applying tensor-based morphometry (TBM to SPECT. Methods After linear spatial normalization of brain perfusion SPECT using 99mTc-ethyl cysteinate dimer (99mTc-ECD to a Talairach space, high-dimension-warping was done using an original 99mTc-ECD template. Contraction map images calculated from Jacobian determinants and spatially normalized SPECT images using this high-dimension-warping were compared using statistical parametric mapping (SPM2 between two groups of 16 multiple system atrophy of the cerebellar type (MSA-C patients and 73 age-matched normal controls. This comparison was also performed in conventionally warped SPECT images. Results SPM2 demonstrated statistically significant contraction indicating local atrophy and decreased perfusion in the whole cerebellum and pons of MSA-C patients as compared to normal controls. Higher significance for decreased perfusion in these areas was obtained in high-dimension-warping than in conventional warping, possibly due to sufficient spatial normalization to a 99mTc-ECD template in high-dimensional warping of severely atrophied cerebellum and pons. In the present high-dimension-warping, modification of tracer activity remained within 3% of the original tracer distribution. Conclusions The present new technique applying TBM to brain SPECT provides information on both perfusion and atrophy at the same time thereby enhancing the role of brain perfusion SPECT

  12. Evaluation on effects of isradipine on renal protection by SPECT

    International Nuclear Information System (INIS)

    Xu Fengpo; Dong Shenan; Zhang Wei; Wu Xinghong; Lu Guoyuan

    1999-01-01

    The protective effects of isradipine on renal function were evaluated in a study on 40 patients with mild-moderate essential hypertension. Isradipine was administered at ado-sage of 2.5 mg twice daily for 4 weeks after receiving placebo for one week. SPECT were used for detecting renal function. The results of these evaluation indicated that there was significantly increasing in ERPF and GFR (P<0.01) and significant decreasing in resistance of renal vessel (P<0.01), and FF remained unchanged. It suggests that isradipine has a protective effect on renal function and it is beneficial for the long-term therapy

  13. Diagnostic impact of SPECT-CT in the assessment of endocrine tumors

    International Nuclear Information System (INIS)

    El Badaoui, A.; Clermont, H. de; Valli, N.; Caignon, J.M.; Fernandez, P.; Allard, M.; Barat, J.L.; Ducassou, D.; Clermont, H. de; Valli, N.; Caignon, J.M.; Fernandez, P.; Allard, M.; Barat, J.L.; Ducassou, D.; Clermont, H. de; Allard, M.

    2008-01-01

    Image fusion using single photon emission computed tomography - computed tomography (SPECT - CT) associates functional and morphological images. This study evaluates the added value of SPECT- CT, obtained with a hybrid SPECT- CT gamma camera, on anatomic localization and diagnostic impact in assessment of endocrine tumours and pheochromocytomas. Method: Six months prospective study was undertaken including 33 consecutive exams encompassing 20 Somatostatin Receptor Scintigraphies (S.R.S.) and 13 123 I-meta-iodo-benzyl-guanidine (Mibg) scans. Two experienced nuclear medicine physicians independently analysed independently planar and SPECT images in a first time, then, SPECT- CT fused images in a second time. They evaluated two parameters: SPECT- CT impact on anatomic localization (L.A.) and its diagnostic impact (I.D.). Each parameter was scored according three levels of evaluation. Results: An added value of SPECT- CT images was evidenced in 55% of cases on the anatomic localization and in 41% of the patients on the diagnostic impact. Therefore, a more important benefit was noted when SPECT was positive (L.A.: 90%; I.D.: 70%) than when it was negative (L.A.: 15%; I.D.: 8%). Furthermore, the added value proved higher for the S;R.S. compared to Mibg scans. Conclusion: SPECT- CT fusion images obtained by a hybrid system is more relevant to determine anatomic localization and more accurate than SPECT alone, particularly in the assessment of endocrine tumours. The added value of SPECT- CT seems to be lower for Mibg scans in the assessment of pheochromocytomas. (authors)

  14. Brain SPECT

    International Nuclear Information System (INIS)

    Feistel, H.

    1991-01-01

    Brain SPECT investigations have gained broad acceptance since the introduction of the lipophilic tracer Tc-99m-HMPAO. Depending on equipment and objectives in different departments, the examinations can be divided into three groups: 1. Under normal conditions and standardised patient preparation the 'rest' SPECT can be performed in every department with a tomographic camera. In cerebrovascular disease there is a demand for determination of either the perfusion reserve in reversible ischemia or prognostic values in completed stroke. In cases of dementia, SPECT may yield useful results according to differential diagnosis. Central cerebral system involvement in immunologic disease may be estimated with higher sensitivity than in conventional brain imaging procedures. In psychiatric diseases there is only a relative indication for brain SPECT, since results during recent years have been contradictory and may be derived only in interventional manner. In brain tumor diagnostics SPECT with Tl-201 possibly permits grading. In inflammatory disease, especially in viral encephalitis, SPECT may be used to obtain early diagnosis. Normal pressure hydrocephalus can be distinguished from other forms of dementia and, consequently, the necessity for shunting surgery can be recognised. 2. In departments equipped for emergency cases an 'acute' SPECT can be performed in illnesses with rapid changing symptoms such as different forms of migraine, transient global amnesia, epileptic seizures (so-called 'ictal SPECT') or urgent forms like trauma. 3. In cooperation with several departments brain SPECT can be practised as an interventional procedure in clinical and in scientific studies. (orig./MG) [de

  15. Clinical evaluation of Parkinson's disease using 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Hayashi, Hiroko; Odano, Ikuo; Nishihara, Mamiko; Higuchi, Shouichi; Sakai, Kunio; Ishikawa, Atsushi.

    1989-01-01

    N-isopropyl-p[ 123 I]iodoamphetamine ( 123 I-IMP) SPECT and regional cerebral blood flow (rCBF) studies were performed in 20 patients with Parkinson's disease (PD) and 8 normal subjects. RCBF was measured by the arterial blood sampling method which used the microsphere model. We analized seven factors which might be related to the rCBF in PD, i.e., age, stage, duration of the disease, cerebral atrophy, severity of dementia, laterality of symptoms and motor disability score (MDS; the degree of akinesia, rigidity, tremor, gait disturbance, freezing and pulsion sign). Compared with normal subjects, global CBF (supratentorial mean rCBF) was reduced by 21.8% in PD. In particular, rCBF in the basal ganglia and that of frontal cortex were reduced by 25.3% and 24.8%, respectively. Distribution patterns of rCBF in PD were almost as same as those in normals except for cerebellum. The reduction of both rCBFs in the basal ganglia and parietal cortex significantly correlated with MDS (p 123 I-IMP SPECT study is a useful method for clinical evaluation of PD. (author)

  16. Functional neuroimaging in epilepsy: FDG-PET and SPECT

    International Nuclear Information System (INIS)

    Lee, Sang Kun; Lee, Dong Soo

    2003-01-01

    Finding epileptogenic zone is the most important step for the successful epilepsy surgery. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and single photon emission computed tomography (SPECT) can be used in the localization of epileptogenic foci. In medial temporal lobe epilepsy, the diagnostic sensitivity of FDG-PET and ictal SPECT is excellent. However, detection of hippocampal sclerosis by MRI is so certain that use of FDG-PET and ictal SPECT in medial temporal lobe epilepsy is limited for some occasions. In neocortical epilepsy, the sensitivities of FDG-PET or ictal SPECT are fair. However, FDG-PET and ictal SPECT can have a crucial role in the localization of epileptogenic foci for non-lesional neocortical epilepsy. Interpretation of FDG-PET has been recently advanced by voxel-based analysis and automatic volume of interest analysis based on a population template. Both analytical methods can aid the objective diagnosis of epileptogenic foci. lctal SPECT was analyzed using subtraction methods and voxel-based analysis. Rapidity of injection of tracers, ictal EEG findings during injection of tracer, and repeated ictal SPECT were important technical issues of ictal SPECT. SPECT can also be used in the evaluation of validity of Wada test

  17. Functional neuroimaging in epilepsy: FDG-PET and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Kun; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2003-02-01

    Finding epileptogenic zone is the most important step for the successful epilepsy surgery. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and single photon emission computed tomography (SPECT) can be used in the localization of epileptogenic foci. In medial temporal lobe epilepsy, the diagnostic sensitivity of FDG-PET and ictal SPECT is excellent. However, detection of hippocampal sclerosis by MRI is so certain that use of FDG-PET and ictal SPECT in medial temporal lobe epilepsy is limited for some occasions. In neocortical epilepsy, the sensitivities of FDG-PET or ictal SPECT are fair. However, FDG-PET and ictal SPECT can have a crucial role in the localization of epileptogenic foci for non-lesional neocortical epilepsy. Interpretation of FDG-PET has been recently advanced by voxel-based analysis and automatic volume of interest analysis based on a population template. Both analytical methods can aid the objective diagnosis of epileptogenic foci. lctal SPECT was analyzed using subtraction methods and voxel-based analysis. Rapidity of injection of tracers, ictal EEG findings during injection of tracer, and repeated ictal SPECT were important technical issues of ictal SPECT. SPECT can also be used in the evaluation of validity of Wada test.

  18. Chilaiditi's syndrome demonstrated by SPECT/CT

    Directory of Open Access Journals (Sweden)

    Nalini S Perumal

    2009-11-01

    Full Text Available Purpose: Chilaiditi’s syndrome is a rare condition commonly diagnosed as an incidental radiological finding. The aim of this report is to show the role of SPECT-CT in this syndrome and state the functional and anatomical role of this hybrid imaging modality. Materials and Methods: A case report. Results: A 49-year-old female patient was referred for gallium-67 citrate for a possible granulomatous myositis and underwent SPECT-CT of the abdomen to assess the area of decreased gallium uptake on planar images of the liver. The combined SPECT and CT modality demonstrated findings consistent with the clinical evidence of Chilaiditi’s syndrome. The anatomical part of this hybrid modality made it easier to evaluate the area of gallium lack of uptake which was due to air in the colon. Conclusion: This case does not only show the role of SPECT-CT in this syndrome but also suggest that the use of such modality should be considered whenever available in the evaluation of patients in whom the localization of active disease becomes imperative.

  19. Role of adenosine 99MTc sestamibi myocardial perfusion spect in evaluation of symptomatic hypertensives with recent onset left bundle branch block

    International Nuclear Information System (INIS)

    Padma, S.; Sundaram, P.S.; Zachariah, M.; Hariads, K.K.

    2004-01-01

    Objectives: Adenosine pharmacological stress Myocardial Perfusion Imaging (AMPI) is the preferred imaging modality for IHD evaluation in pts with Left Bundle Branch Block (LBBB). Good prognosis has been reported in recent onset LBBB pts with normal MPI. Our aim was to evaluate the utility and analyze the predictive value of SestaMIBI AMPI in symptomatic recent onset LBBB hypertensives for coronary artery disease evaluation. Methods: 29 hypertensive pts, age range 36-72yrs, mean 54+ 6 yrs, M:F- 21:8 with recent onset complete LBBB, under evaluation for typical/atypical angina who had AMPI between Nov 02-Nov 03, were retrospectively analyzed. LBBB was diagnosed ECG wise if there is prolonged QRS complex i.e. 0.125sec or more in sinus/supraventricular rhythm, a QS or rS complex in lead 1, and an R-wave peak time of 0.06sec in leads 1, V5 or V6 with no Q wave in same lead. Pts with prior Myocardial Infarct / revasularisation, pacemaker induced LBBB were excluded. Single day 6 min. Adenosine infusion Stress-rest 99m Tc MIBI gated MPI was performed with a dual head variable angle Gamma Camera at 76-degree angle. Coronary Angiogram (CAG) correlation was available in 24 pts. Results: Myocardial perfusion SPECT images were assessed visually and by a 20-segment model. Location, extent and severity of the LV perfusion defects were evaluated. 6/29 pts (20.7%) had normal stress-rest perfusion in all LV segments.12 (41.4%) had isolated septal fixed defect with normal perfusion in rest of the segments.3 pts (10.3%)showed isolated reversible septal defects while 8(27.6%) had reversible septal defects with reversible defects in other LV segments also. Pts with fixed septal perfusion defect showed moderate to good septal wall thickening in gated SPECT images. While all pts with multiple reversible perfusion defects had angiographically proven coronary artery disease (i.e. 3pts had LAD lesion, 2 had Triple vessel and 3 showed double vessel lesions), 1 out of 3 pts with isolated

  20. Spatiotemporal processing of gated cardiac SPECT images using deformable mesh modeling

    International Nuclear Information System (INIS)

    Brankov, Jovan G.; Yang Yongyi; Wernick, Miles N.

    2005-01-01

    In this paper we present a spatiotemporal processing approach, based on deformable mesh modeling, for noise reduction in gated cardiac single-photon emission computed tomography images. Because of the partial volume effect (PVE), clinical cardiac-gated perfusion images exhibit a phenomenon known as brightening--the myocardium appears to become brighter as the heart wall thickens. Although brightening is an artifact, it serves as an important diagnostic feature for assessment of wall thickening in clinical practice. Our proposed processing algorithm aims to preserve this important diagnostic feature while reducing the noise level in the images. The proposed algorithm is based on the use of a deformable mesh for modeling the cardiac motion in a gated cardiac sequence, based on which the images are processed by smoothing along space-time trajectories of object points while taking into account the PVE. Our experiments demonstrate that the proposed algorithm can yield significantly more-accurate results than several existing methods

  1. Clinical application of heart rate-synchronized myocardial SPECT with {sup 99m}Tc-labeled imaging agents for myocardial blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Tsunehiko; Uehara, Toshiisa; Fukuchi, Kazuki; Tsujimura, Eiichiro; Hasegawa, Shinji; Ito, Yasushi; Hashimoto, Katsuji; Matsuda, Shinichi; Yutani, Kenji [Osaka Univ., Suita (Japan). Biomedical Research Center

    1996-11-01

    Application of gated SPECT to assess multiple heart functions simultaneously in authors` facility was reported. The myocardial SPECT at rest was performed 1 hr after intravenous administration of 740 MBq of {sup 99m}Tc-sestamibi with Toshiba 3-detector type gamma camera GCA9300/HG. R wave monitored by ECG was used as a trigger to record images of 360deg direction (90 sec/6deg direction, 20 directions x 3). Data were processed by Toshiba GMS-5500A or Hitachi-Medico RW3000. Percent CI (count increase at a myocardial region) was calculated by =(ES-ED)=/ED x 100, where ES and ED were computed by circumferential profile analysis of reconstruction images at the end-systole and end-diastole stages, respectively. Left ventricular ejection fraction was calculated from %AC (area change between areas of left ventricle at end-systolic and -diasystolic stages). Ventricular wall-motion was assessed by bullet display of the gated SPECT images. The present procedure is expected to be widely used as a routine test of the myocardial functions and is beneficial from a viewpoint of cost/performance. (K.H.)

  2. Dosimetric evaluation of the interplay effect in respiratory-gated RapidArc radiation therapy

    International Nuclear Information System (INIS)

    Riley, Craig; Yang, Yong; Li, Tianfang; Zhang, Yongqian; Heron, Dwight E.; Huq, M. Saiful

    2014-01-01

    Purpose: Volumetric modulated arc therapy (VMAT) with gating capability has had increasing adoption in many clinics in the United States. In this new technique, dose rate, gantry rotation speed, and the leaf motion speed of multileaf collimators (MLCs) are modulated dynamically during gated beam delivery to achieve highly conformal dose coverage of the target and normal tissue sparing. Compared with the traditional gated intensity-modulated radiation therapy technique, this complicated beam delivery technique may result in larger dose errors due to the intrafraction tumor motion. The purpose of this work is to evaluate the dosimetric influence of the interplay effect for the respiration-gated VMAT technique (RapidArc, Varian Medical Systems, Palo Alto, CA). Our work consisted of two parts: (1) Investigate the interplay effect for different target residual errors during gated RapidArc delivery using a one-dimensional moving phantom capable of producing stable sinusoidal movement; (2) Evaluate the dosimetric influence in ten clinical patients’ treatment plans using a moving phantom driven with a patient-specific respiratory curve. Methods: For the first part of this study, four plans were created with a spherical target for varying residual motion of 0.25, 0.5, 0.75, and 1.0 cm. Appropriate gating windows were applied for each. The dosimetric effect was evaluated using EDR2 film by comparing the gated delivery with static delivery. For the second part of the project, ten gated lung stereotactic body radiotherapy cases were selected and reoptimized to be delivered by the gated RapidArc technique. These plans were delivered to a phantom, and again the gated treatments were compared to static deliveries by the same methods. Results: For regular sinusoidal motion, the dose delivered to the target was not substantially affected by the gating windows when evaluated with the gamma statistics, suggesting the interplay effect has a small role in respiratory-gated Rapid

  3. Dosimetric evaluation of the interplay effect in respiratory-gated RapidArc radiation therapy.

    Science.gov (United States)

    Riley, Craig; Yang, Yong; Li, Tianfang; Zhang, Yongqian; Heron, Dwight E; Huq, M Saiful

    2014-01-01

    Volumetric modulated arc therapy (VMAT) with gating capability has had increasing adoption in many clinics in the United States. In this new technique, dose rate, gantry rotation speed, and the leaf motion speed of multileaf collimators (MLCs) are modulated dynamically during gated beam delivery to achieve highly conformal dose coverage of the target and normal tissue sparing. Compared with the traditional gated intensity-modulated radiation therapy technique, this complicated beam delivery technique may result in larger dose errors due to the intrafraction tumor motion. The purpose of this work is to evaluate the dosimetric influence of the interplay effect for the respiration-gated VMAT technique (RapidArc, Varian Medical Systems, Palo Alto, CA). Our work consisted of two parts: (1) Investigate the interplay effect for different target residual errors during gated RapidArc delivery using a one-dimensional moving phantom capable of producing stable sinusoidal movement; (2) Evaluate the dosimetric influence in ten clinical patients' treatment plans using a moving phantom driven with a patient-specific respiratory curve. For the first part of this study, four plans were created with a spherical target for varying residual motion of 0.25, 0.5, 0.75, and 1.0 cm. Appropriate gating windows were applied for each. The dosimetric effect was evaluated using EDR2 film by comparing the gated delivery with static delivery. For the second part of the project, ten gated lung stereotactic body radiotherapy cases were selected and reoptimized to be delivered by the gated RapidArc technique. These plans were delivered to a phantom, and again the gated treatments were compared to static deliveries by the same methods. For regular sinusoidal motion, the dose delivered to the target was not substantially affected by the gating windows when evaluated with the gamma statistics, suggesting the interplay effect has a small role in respiratory-gated RapidArc therapy. Varied results were

  4. Evaluation of peripheral pulmonary perfusion decrease of 99m-Tc MAA scintigraphy using SPECT/CT

    International Nuclear Information System (INIS)

    Yoneyama, Tatsuya; Kamisaki, Yuichi; Kameda, Keisuke; Seto, Hikaru

    2012-01-01

    We often experienced non-segmented peripheral patchy decrease (NSPPD) in 99m Tc-macro-aggregated albumin (MAA) pulmonary perfusion scan using single photon emission computed tomography (SPECT)/CT. Seventy cases were evaluated by 99m Tc-MAA SPECT/CT. NSPPD was seen in 22 cases (31.4%), of which 17 were assessed for pulmonary hypertension. Pulmonary hypertension was diagnosed in 11 cases, which consisted of 3 chronic thromboembolic pulmonary hypertension, 2 idiopathic pulmonary arterial hypertension, 2 systemic lupus eryhthematosus and 4 left ventricular heart disease. We suggest that NSPPD may indicate the early stage of pulmonary hypertension (PH). (author)

  5. SPECT and 3D display quantitative evaluation in renal DMSA scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lyra, M; Skouroliakou, K; Emmanouilides, I; Stratis, I [Univerisity of Athens, Department of Radiology and Department of Mathematics, Athens (Greece)

    1999-12-31

    The evaluation of cortical damage to the kidneys, especially in children, is currently performed by means of Tc99m-DMSA renal scan. The routine involves the acquisition of planar images and their qualitative and quantitative evaluation. Many studies have dealt with the possible advantage that SPECT could possess on qualitative criteria. This study attempts to quantitatively deal with the issue by the calculation of an index. The results exhibit a clear advantage of tomographic and 3D reconstructed images over the conventional planar ones. (authors) 14 refs., 3 figs., 1 tabs.

  6. Prospective Evaluation of (99m)Tc-sestamibi SPECT/CT for the Diagnosis of Renal Oncocytomas and Hybrid Oncocytic/Chromophobe Tumors.

    Science.gov (United States)

    Gorin, Michael A; Rowe, Steven P; Baras, Alexander S; Solnes, Lilja B; Ball, Mark W; Pierorazio, Phillip M; Pavlovich, Christian P; Epstein, Jonathan I; Javadi, Mehrbod S; Allaf, Mohamad E

    2016-03-01

    Nuclear imaging offers a potential noninvasive means of determining the histology of renal tumors. The aim of this study was to evaluate the accuracy of technetium-99m ((99m)Tc)-sestamibi single-photon emission computed tomography/x-ray computed tomography (SPECT/CT) for the differentiation of oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) from other renal tumor histologies. In total, 50 patients with a solid clinical T1 renal mass were imaged with (99m)Tc-sestamibi SPECT/CT prior to surgical resection. Preoperative SPECT/CT scans were reviewed by two blinded readers, and their results were compared with centrally reviewed surgical pathology data. Following surgery, 6 (12%) tumors were classified as renal oncocytomas and 2 (4%) as HOCTs. With the exception of 1 (2%) angiomyolipoma, all other tumors were renal cell carcinomas (82%). (99m)Tc-sestamibi SPECT/CT correctly identified 5 of 6 (83.3%) oncocytomas and 2 of 2 (100%) HOCTs, resulting in an overall sensitivity of 87.5% (95% confidence interval [CI], 47.4-99.7%). Only two tumors were falsely positive on SPECT/CT, resulting in a specificity of 95.2% (95% CI, 83.8-99.4%). In summary, (99m)Tc-sestamibi SPECT/CT is a promising imaging test for the noninvasive diagnosis of renal oncocytomas and HOCTs. We found that the imaging test (99m)Tc-sestamibi SPECT/CT can be used to accurately diagnose two types of benign kidney tumors. This test may be eventually used to help better evaluate patients diagnosed with a renal tumor. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  7. Evaluation of Tourette's syndrome by 99Tcm-TRODAT-1 SPECT imaging

    International Nuclear Information System (INIS)

    Dong Feng; Liu Hong; Meng Zhaowei; Tan Jian; Zhang Benshu

    2011-01-01

    Objective: To observe dopamine transporter (DAT) binding capacity using 99 Tc m -TRODAT-1 in drug-naive patients with Tourette's syndrome (TS) on SPECT imaging, and explore possible correlations between 99 Tc m -TRODAT-1 uptake ratio and TS patient's age, disease duration, and tic severity. Methods: Eighteen drug-naive TS patients, male 14, female 4, as well as 8 age- and gender-matched healthy subjects were recruited. Brain SPECT imaging was performed 2. 5 h after intravenous injection of 11.1 - 14.8 MBq/kg 99 Tc m -TRODAT-1. ROI was drawn on the striatum including its sub-regions of caudate and putamen, with cerebellum as the background. Striatum/cerebellum ratio was calculated. Comparisons of the ratios between TS patients and controls were carried out by independent-sample t-test. Pearson correlation analysis was performed between DAT uptake ratios of striatum and patients' age, disease duration, tic severity. Results: Compared with the control, higher symmetrically striatum uptake of 99 Tc m -TRODAT-1 in TS patients was observed (2.17±0.23 vs 1.87±0.24, t=2.957, P 0.05)and tic severity(r=0.345, P>0.05) scores were not significantly correlated with specific uptake ratios measured in the striatum. But there was significant negative correlation between disease duration and the specific uptake ratios (r=-0.483, P 99 Tc m -TRODAT-1 SPECT imaging may play an adjuvant role for initial evaluation of untreated TS. (authors)

  8. Evaluation of usefulness of thallium-201-SPECT and CT images in differential diagnosis between organizing pneumonia and primary lung cancer

    International Nuclear Information System (INIS)

    Nakamura, Kazuhiko; Fujiwara, Yoshio; Ogawa, Hirofumi; Nakano, Kenji; Ogawa, Toshihide

    2007-01-01

    We tried differential diagnosis between organizing pneumonia and primary lung cancer using CT and 201 Tl single photon emission computed tomography (SPECT) images. CT images were estimated margin, air space consolidation, air bronchogram, ground-glass attenuation, spicula and indentation of the lesions. 201 Tl SPECT images were evaluated early and delayed lesion-to-normal contralateral lung uptake ratio (ER and DR) and retention index (RI). Clearness of margin and ground-glass attenuation of CT images of organizing pneumonia were significant different from those of primary lung cancer. On the other hand, DR and RI of organizing pneumonia were significant lower than those of primary lung cancer. We emphasized that 201 Tl SPECT was useful to evaluate differential diagnosis between organizing pneumonia and primary lung cancer. (author)

  9. Implementation and application of simulation platform of PET based on GATE

    International Nuclear Information System (INIS)

    Zhang Bin; Zhao Shujun; Zhang Shixun; Liu Haojia

    2010-01-01

    Positron emission tomography (PET) is a tool for obtaining functional image in vivo and GATE is a dedicated software for PET/SPECT simulation based on Mentor Carlo Method. It encapsulates the Geant4 libraries to achieve a modular and provides a number of new characteristics. In practice, a simulation platform of PET has been builded employing GATE based on Ubuntu operating system, including many keys and skills in the process. We have exploited benchmark PET, a testing example in GATE, and implemented PET scanner simulation in the end. Through analyzing the simulation data, the result demonstrate that predictive goal has been reached. The work provides the foundation for investigating PET scanner and optimizing the algorithm of tomograph image reconstruction. (authors)

  10. Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty- a new dimension of diagnostics?

    OpenAIRE

    Hirschmann, Michael T; Konala, Praveen; Iranpour, Farhad; Kerner, Anna; Rasch, Helmut; Friederich, Niklaus F

    2011-01-01

    Abstract Background The purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA). Methods Twenty-three painful knees in patients following primary TKA were assessed using Tc-99m-HDP-SPECT/CT. Rotational, sagittal and coronal position of the TKA was assessed on 3D-CT reconstructions. The level of the SPECT-tracer uptake (0-10) and its anatomical distribution was mapped using a validated localization sch...

  11. Quantitative evaluation of renal dynamic scan with 99mTc-MAG3 assessment of interoposterior myocardial infarction using ECG gated SPECT with 99mTc-MIBI

    International Nuclear Information System (INIS)

    Cho, Keiichi; Kumita, Shinichiro; Mizumura, Sunao

    1997-01-01

    Simultaneous assessment of regional myocardial perfusion and local contraction ability of interoposterior myocardial infarction was examined by ECG gated SPECT. In thirteen cases of acute interoposterior myocardial infarction, the above-mentioned data were obtained by 180deg data acquisition method using L-shaped 2 detecting element type gamma camera. Mean and standard deviation of %Uptake and wall thickening (WT) in inferior wall were as follows: Infarction case; 57±9.2%/23±11.3%, normal case; 71±8.2%/61±10.2%. The significant depression (p<0.01/p<0.001) of both data were found in the infarction case. The both data in posterior wall were as follows: Infarction case; 55±10.7%/16±8.9%, normal case; 64±9.7%/41±15.0%. The significant depression (p<0.05/p<0.001) were also found in the infarction case. In both inferior wall and posterior wall, the AUC of ROC curve of WT was greater than that of %Uptake, and diagnostic ability of this method was favorable. The best sensitivity/specificity rate and the threshold were as follows: %Uptake of inferior wall 77/65, -0.5SD, WT of inferior wall 100/100, -2SD, %Uptake of posterior wall 62/82, -1SD, WT of posterior wall 85/88, -4SD. Accordingly, in diagnosis of interoposterior myocardial infarction, assessment of focus cardiac function, for example WT, is necessary as well as %Uptake. (K.H.)

  12. Qualitative and quantitative evaluation of renal parenchymal damage by 99mTc-DMSA planar and SPECT scintigraphy

    International Nuclear Information System (INIS)

    Itoh, Kazuo; Yamashita, Tetsufumi; Tsukamoto, Eriko; Nonomura, Katsuya; Furudate, Masayori; Koyanagi, Tomohiko

    1995-01-01

    The initial 99m Tc-DMSA studies carried out over a four year period in 229 patients with various heterogenic causes of lower urinary tract abnormalities were reviewed. Anatomical damage to the renal parenchyma was graded by means of planar and SPECT studies into a six group classification proposed by Monsour et al.: grade 0 (normal), I (equivocal), II (single defect), III (more than 2 defects), IV (contracted or small) and V (no visualization). Parenchymal uptake of 99m Tc-DMSA was quantitated from planar images at 2 hours postinjection by a computer assisted gamma camera method. SPECT studies could enhance the pick-up rate for parenchymal uptake defects by a factor of 1.5 in comparison with planar imaging. The incidence of anatomical damage to the renal parenchyma increased with a high radiological grade for VUR, and renal uptake per injection dose of 99m Tc-DMSA by the individual kidney significantly decreased in grades III and IV of the anatomical classification. These data revealed that 99m Tc-DMSA planar is still useful for evaluating gross structural damage and for quantitative evaluation of the kidney with computer assistance. SPECT scintigraphy is more effective in disclosing anatomical damage to the renal parenchyma than planar, although it needs further discussion as to whether SPECT may increase sensitivity with minimal or no adverse affect on specificity. (author)

  13. Prognostic implications of post-stress ejection fraction decrease detected by gated SPECT in the absence of stress-induced perfusion abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Dona, Manjola; Massi, Lucia; Settimo, Leonardo; Bartolini, Matteo; Gianni, Gianluca; Pupi, Alberto; Sciagra, Roberto [University of Florence, Nuclear Medicine Unit, Department of Clinical Physiopathology, Florence (Italy)

    2011-03-15

    The prognostic meaning of a post-stress ejection fraction (EF) decrease detected by perfusion gated SPECT is still unclear. We therefore followed up patients with post-stress EF decrease in the absence of stress-induced perfusion abnormalities. We prospectively enrolled 57 consecutive patients with post-stress EF drop {>=} 5 EF units and summed difference score (SDS) {<=} 1. They were followed up for more than 1 year and their outcome was compared with a group of sex- and age-matched controls with the same SDS but without EF decrease. During follow-up there were 13 events (1 cardiac death, 1 non-fatal myocardial infarction, 1 congestive heart failure and 10 late revascularizations). In the control group we registered six events. There was a significant difference (p < 0.0001) between the event-free survival curves of the two groups. The event rate of patients with post-stress EF decrease {>=} 5 EF units is relatively high and is significantly worse than that of a control group of patients with similarly normal SDS but without EF changes. Therefore, a post-stress EF decrease without stress-induced perfusion abnormalities should be cautiously interpreted. (orig.)

  14. SPECT data acquisition and image reconstruction in a stationary small animal SPECT/MRI system

    Science.gov (United States)

    Xu, Jingyan; Chen, Si; Yu, Jianhua; Meier, Dirk; Wagenaar, Douglas J.; Patt, Bradley E.; Tsui, Benjamin M. W.

    2010-04-01

    The goal of the study was to investigate data acquisition strategies and image reconstruction methods for a stationary SPECT insert that can operate inside an MRI scanner with a 12 cm bore diameter for simultaneous SPECT/MRI imaging of small animals. The SPECT insert consists of 3 octagonal rings of 8 MR-compatible CZT detectors per ring surrounding a multi-pinhole (MPH) collimator sleeve. Each pinhole is constructed to project the field-of-view (FOV) to one CZT detector. All 24 pinholes are focused to a cylindrical FOV of 25 mm in diameter and 34 mm in length. The data acquisition strategies we evaluated were optional collimator rotations to improve tomographic sampling; and the image reconstruction methods were iterative ML-EM with and without compensation for the geometric response function (GRF) of the MPH collimator. For this purpose, we developed an analytic simulator that calculates the system matrix with the GRF models of the MPH collimator. The simulator was used to generate projection data of a digital rod phantom with pinhole aperture sizes of 1 mm and 2 mm and with different collimator rotation patterns. Iterative ML-EM reconstruction with and without GRF compensation were used to reconstruct the projection data from the central ring of 8 detectors only, and from all 24 detectors. Our results indicated that without GRF compensation and at the default design of 24 projection views, the reconstructed images had significant artifacts. Accurate GRF compensation substantially improved the reconstructed image resolution and reduced image artifacts. With accurate GRF compensation, useful reconstructed images can be obtained using 24 projection views only. This last finding potentially enables dynamic SPECT (and/or MRI) studies in small animals, one of many possible application areas of the SPECT/MRI system. Further research efforts are warranted including experimentally measuring the system matrix for improved geometrical accuracy, incorporating the co

  15. Radionuclide cisternography: SPECT and 3D-rendering. Radionuklidzisternographie: SPECT- und 3D-Technik

    Energy Technology Data Exchange (ETDEWEB)

    Henkes, H; Huber, G; Piepgras, U [Universitaet des Saarlandes, Homburg/Saar (Germany, F.R.). Abt. fuer Neuroradiologie; Hierholzer, J [Freie Univ. Berlin (Germany, F.R.). Strahlenklinik und Poliklinik; Cordes, M [British Columbia Univ., Vancouver, BC (Canada). Belzberg Lab. of Neuroscience

    1991-10-01

    Radionuclide cisternography is indicated in the clinical work-up for hydrocephalus, when searching for CSF leaks, and when testing whether or not intracranial cystic lesions are communicating with the adjacent subarachnoid space. This paper demonstrates the feasibility and diagnostic value of SPECT and subsequent 3D surface rendering in addition to conventional rectilinear CSF imaging in eight patients. Planar images allowed the evaluation of CSF circulation and the detection of CSF fistula. They were advantageous in examinations 48 h after application of {sup 111}In-DTPA. SPECT scans, generated 4-24 h after tracer application, were superior in the delineation of basal cisterns, especially in early scans; this was helpful in patients with pooling due to CSF fistula and in cystic lesions near the skull base. A major drawback was the limited image quality of delayed scans, when the SPECT data were degraded by a low count rate. 3D surface rendering was easily feasible from SPECT data and yielded high quality images. The presentation of the spatial distribution of nuclide-contaminated CSF proved especially helpful in the area of the basal cisterns. (orig.).

  16. Evaluation of cardiomyopathy in Duchenne muscular dystrophy by Tl-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Jinnouchi, Seishi; Asai, Junko; Inoue, Kenjirou; Hoshi, Hiroaki; Watanabe, Katsushi.

    1985-01-01

    Clinical evaluation of Tl-201 myocardial SPECT in patients with cardiomyopathy of Duchenne type progressive muscular dystrophy (DMD) was reported. Cases subjected to study were 14 DMD and 8 normal. Using a rotating gamma camera system (ZLC7500 and Scintipac 70A), SPECT data were collected for 16 minutes (32 angles x 30 sec/angle, 180 0 ). The hypoperfusion areas of the left ventricular muscle were observed in 10 patients (71 %), which was in posterior wall (71 %), inferior wall (57 %), lateral and anterior wall (43 %) in the order of frequency. The hypoperfusion area became wider with age and stage, exept for some patients. It was suggested that myocardial degeneration in DMD started in posterior wall and then spread in other areas. For the purpose of quantitative evaluation of myocardial damage, Tl-201 myocardial uptake ratio (MUR) and left ventricular muscle volume (LVMV) were calculated using the results obtained by phantom studies. MUR and LVMV were higher in DMD than those of normal individuals (3.6 +- 1.0 %: 2.7 +- 0.3 %, p < 0.05, 190.2 +- 67.5 ml: 157.8 +- 21.5 ml, n.s., respectively). (author)

  17. 123I-iomazenil brain receptor SPECT in focal epilepsy. In comparison with 99mTc-HMPAO brain SPECT, MRI and Video/EEG monitoring

    International Nuclear Information System (INIS)

    Xu Hao; Wang Tongge; Huang Li; Michael Cordes

    1998-01-01

    Purpose: To evaluate the clinical value of 123 I-Iomazenil brain receptor SPECT in diagnosis of focal epilepsy in comparison with 99m Tc-HMPAO brain SPECT, MRI and Video/EEG monitoring. Methods 123 I-Iomazenil brain receptor SPECT was performed on 40 patients with focal epilepsy. The results were compared with those obtained by 99m Tc-HMPAO brain SPECT, MRI and Video/EEG monitoring. Results: In 40 patients, the sensitivity of Video/EEG monitoring for localization of epileptogenic area was 95% (38/40). The sensitivity of 123 I-iomazenil brain receptor SPECT, 99m Tc-HMPAO brain SPECT and MRI for localization of epileptogenic area compared with Video/EEG monitoring ('gold standard') was 65.8%(25/38), 55.3%(21/38) and 47.4%(18/38), respectively. The localization of epileptogenic area with 123 I-Iomazenil brain receptor SPECT was in concordance with Video/EEG monitoring in 20 patients, 99m Tc-HMPAO brain SPECT in 15 patients and MRI in 16 patients, respectively. The sensitivity of 123 I-Iomazenil brain receptor SPECT combined with MRI for localization of epileptogenic area was 84.2%(32/38). Conclusions: 123 I-Iomazenil brain receptor SPECT is a useful method in detecting and localizing epileptogenic area. The combination of 123 I-Iomazenil brain receptor SPECT and MRI has a high sensitivity for detecting epileptogenic area

  18. Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI

    International Nuclear Information System (INIS)

    Campbell, R.S.D.; Grainger, A.J.; Hide, I.G.; Papastefanou, S.; Greenough, C.G.

    2005-01-01

    To evaluate whether MRI correlates with CT and SPECT imaging for the diagnosis of juvenile spondylolysis, and to determine whether MRI can be used as an exclusive image modality. Juveniles and young adults with a history of extension low back pain were evaluated by MRI, CT and SPECT imaging. All images were reviewed blindly. Correlative analyses included CT vs MRI for morphological grading and SPECT vs MRI for functional grading. Finally, an overall grading system compared MRI vs CT and SPECT combined. Statistical analysis was performed using the kappa statistic. Seventy-two patients (mean age 16 years) were recruited. Forty pars defects were identified in 22 patients (31%), of which 25 were chronic non-union, five acute complete defects and ten acute incomplete fractures. Kappa scores demonstrated a high level of agreement for all comparative analyses. MRI vs SPECT (kappa: 0.794), MRI vs CT (kappa: 0.829) and MRI vs CT/SPECT (kappa: 0.786). The main causes of discrepancy were between MRI and SPECT for the diagnosis of stress reaction in the absence of overt fracture, and distinguishing incomplete fractures from intact pars or complete defects. MRI can be used as an effective and reliable first-line image modality for diagnosis of juvenile spondylolysis. However, localised CT is recommended as a supplementary examination in selected cases as a baseline for assessment of healing and for evaluation of indeterminate cases. (orig.)

  19. Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, R.S.D. [Royal Liverpool University Hospital, Department of Radiology, Liverpool (United Kingdom); Grainger, A.J. [Leeds General Infirmary, Department of Radiology, Leeds (United Kingdom); Hide, I.G. [Freeman Hospital, Department of Radiology, Newcastle upon Tyne (United Kingdom); Papastefanou, S. [James Cook University Hospital, Department Radiology, Middlesbrough (United Kingdom); Greenough, C.G. [James Cook University Hospital, Department of Trauma and Orthopaedics, Middlesbrough (United Kingdom)

    2005-02-01

    To evaluate whether MRI correlates with CT and SPECT imaging for the diagnosis of juvenile spondylolysis, and to determine whether MRI can be used as an exclusive image modality. Juveniles and young adults with a history of extension low back pain were evaluated by MRI, CT and SPECT imaging. All images were reviewed blindly. Correlative analyses included CT vs MRI for morphological grading and SPECT vs MRI for functional grading. Finally, an overall grading system compared MRI vs CT and SPECT combined. Statistical analysis was performed using the kappa statistic. Seventy-two patients (mean age 16 years) were recruited. Forty pars defects were identified in 22 patients (31%), of which 25 were chronic non-union, five acute complete defects and ten acute incomplete fractures. Kappa scores demonstrated a high level of agreement for all comparative analyses. MRI vs SPECT (kappa: 0.794), MRI vs CT (kappa: 0.829) and MRI vs CT/SPECT (kappa: 0.786). The main causes of discrepancy were between MRI and SPECT for the diagnosis of stress reaction in the absence of overt fracture, and distinguishing incomplete fractures from intact pars or complete defects. MRI can be used as an effective and reliable first-line image modality for diagnosis of juvenile spondylolysis. However, localised CT is recommended as a supplementary examination in selected cases as a baseline for assessment of healing and for evaluation of indeterminate cases. (orig.)

  20. Quantitative gated SPECT: the effect of reconstruction filter on calculated left ventricular ejection fractions and volumes

    International Nuclear Information System (INIS)

    Wright, Graham A.; McDade, Mark; Martin, William; Hutton, William

    2002-01-01

    Gated SPECT (GSPECT) offers the possibility of obtaining additional functional information from perfusion studies, including calculation of left ventricular ejection fraction (LVEF). The calculation of LVEF relies upon the identification of the endocardial surface, which will be affected by the spatial resolution and statistical noise in the reconstructed images. The aim of this study was to compare LVEFs and ventricular volumes calculated from GSPECT using six reconstruction filters. GSPECT and radionuclide ventriculography (RNVG) were performed on 40 patients; filtered back projection was used to reconstruct the datasets with each filter. LVEFs and volumes were calculated using the Cedars-Sinai QGS package. The correlation coefficient between RNVG and GSPECT ranged from 0.81 to 0.86 with higher correlations for smoother filters. The narrowest prediction interval was 11±2%. There was a trend towards higher LVEF values with smoother filters, the ramp filter yielding LVEFs 2.55±3.10% (p<0.001) lower than the Hann filter. There was an overall fall in ventricular volumes with smoother filters with a mean difference of 13.98±10.15 ml (p<0.001) in EDV between the Butterworth-0.5 and Butterworth-0.3 filters. In conclusion, smoother reconstruction filters lead to lower volumes and higher ejection fractions with the QGS algorithm, with the Butterworth-0.4 filter giving the highest correlation with LVEFs from RNVG. Even if the optimal filter is chosen the uncertainty in the measured ejection fractions is still too great to be clinically acceptable. (author)

  1. Analysis of the diagnostic value of the Gated-SPECT study of myocardial perfusion in the diagnosis of coronary disease in users seen at the Hospital Rafael Angel Calderon Guardia

    International Nuclear Information System (INIS)

    Calvo Montero, Karla; Coto Rodriguez, Maria Fernanda

    2011-01-01

    An analysis of the diagnostic value of the Gated-SPECT study of myocardial perfusion with Sestamibi marked with 99m Tc for the diagnosis of Coronary Disease was performed at the Hospital Rafael Angel Calderon Guardia. 13 patients with nuclear study and coronary angiography performed, were selected for the investigation. An estimate of the sensitivity, specificity and predictive values of the myocardial perfusion study was performed for the detection of the disease. Then, these values were related to socio-demographic and clinical characteristics of the patients submitted to the diagnosis. The need to use appropriate criteria to request this type of study was evidenced when determining that most of the patients presented risk factors compared to 26% of patients who did not present any factor [es

  2. Cerebral blood flow and metabolism of the patients with a carotid stenosis evaluated by SPECT and 1H-MRS

    International Nuclear Information System (INIS)

    Uno, Masaaki; Nishi, Kyouko; Shinno, Kiyohito; Nagahiro, Shinji; Ohtsuka, Hideki; Harada, Masafumi

    1998-01-01

    We examined cerebral blood flow (CBF) and metabolic states in patients with a severe carotid stenosis by SPECT and proton MRS ( 1 H-MRS). SPECT using 99m Tc-HMPAO and 1 H-MRS were performed in twenty five patients with over 70% carotid stenosis. Moreover, 10 patients were evaluated by these methods after carotid endarterectomy (CEA). N-acetyl-aspartate (NAA) on the ipsilateral side was reduced in 17 patients (Group A) while NAA of other 8 patients was not reduced (Group B). In Group A, although regional CBF was reduced in only 4 of 17 patients, 11 patients showed decline of cerebral vasoreactivity evaluated by acetazolamide injection. Concentration of NAA and regional CBF showed significant correlations. After CEA, ipsilateral NAA was increased significantly compared to preoperative NAA level. In 6 of 7 patients in Group A, cerebral vasoreactivity also improved postoperatively. These results indicated that ipsilatereal NAA metabolism and cerebral vasoreactivity can be improved after CEA. SPECT and 1 H-MRS were useful to evaluate CBF and metabolism in patients with carotid stenosis. (author)

  3. Skeletal scintigraphy and SPECT/CT in orthopedic imaging; Knochenszintigrafie und SPECT/CT bei orthopaedischen Fragestellungen

    Energy Technology Data Exchange (ETDEWEB)

    Klaeser, B.; Walter, M.; Krause, T. [Inselspital Bern (Switzerland). Universitaetsklinik fuer Nuklearmedizin

    2011-03-15

    Multi-modality imaging with SPECT-CT in orthopaedics combines the excellent sensitivity of scintigraphy with the morphological information of CT as a key for specific interpretation of findings in bone scans. The result is an imaging modality with the clear potential to prove of value even in a competitive setting dominated by MRI, and to significantly add to diagnostic imaging in orthopaedics. SPECT-CT is of great value in the diagnostic evaluation after fractures, and - in contrast to MRI - it is well suited for imaging in patients with osteosyntheses and metallic implants. In sports medicine, SPECT-CT allows for a sensitive and specific detection of osseous stress reactions before morphological changes become detectable by CT or MRI. In patients with osseous pain syndromes, actively evolving degenerative changes as a cause of pain can be identified and accurately localized. Further, particularly prospective diagnostic studies providing comparative data are needed to strengthen the position of nuclear imaging in orthopaedics and sports medicine and to help implementing SPECT/CT in diagnostic algorithms. (orig.)

  4. Accuracy evaluation of fusion of CT, MR, and SPECT images using commercially available software packages (SRS PLATO and IFS)

    International Nuclear Information System (INIS)

    Mongioj, Valeria; Brusa, Anna; Loi, Gianfranco; Pignoli, Emanuele; Gramaglia, Alberto; Scorsetti, Marta; Bombardieri, Emilio; Marchesini, Renato

    1999-01-01

    Purpose: A problem for clinicians is to mentally integrate information from multiple diagnostic sources, such as computed tomography (CT), magnetic resonance (MR), and single photon emission computed tomography (SPECT), whose images give anatomic and metabolic information. Methods and Materials: To combine this different imaging procedure information, and to overlay correspondent slices, we used commercially available software packages (SRS PLATO and IFS). The algorithms utilize a fiducial-based coordinate system (or frame) with 3 N-shaped markers, which allows coordinate transformation of a clinical examination data set (9 spots for each transaxial section) to a stereotactic coordinate system. The N-shaped markers were filled with fluids visible in each modality (gadolinium for MR, calcium chloride for CT, and 99m Tc for SPECT). The frame is relocatable, in the different acquisition modalities, by means of a head holder to which a face mask is fixed so as to immobilize the patient. Position errors due to the algorithms were obtained by evaluating the stereotactic coordinates of five sources detectable in each modality. Results: SPECT and MR position errors due to the algorithms were evaluated with respect to CT: Δx was ≤ 0.9 mm for MR and ≤ 1.4 mm for SPECT, Δy was ≤ 1 mm and ≤ 3 mm for MR and SPECT, respectively. Maximal differences in distance between estimated and actual fiducial centers (geometric mismatch) were in the order of the pixel size (0.8 mm for CT, 1.4 mm for MR, and 1.8 mm for SPECT). In an attempt to distinguish necrosis from residual disease, the image fusion protocol was studied in 35 primary or metastatic brain tumor patients. Conclusions: The image fusion technique has a good degree of accuracy as well as the potential to improve the specificity of tissue identification and the precision of the subsequent treatment planning

  5. SPECT I-123 iodoamphetamine brain imaging

    International Nuclear Information System (INIS)

    Tikofsky, R.S.; Liebman, A.; Hellman, R.S.; Collier, B.D.; Voslar, A.M.

    1988-01-01

    SPECT/IMP studies of 100 patients with a presumptive diagnosis of dementia were performed with a rotating gamma camera 15-20 minutes after intravenous injection of 3.5 mCi of IMP. Of these studies, 43 were interpreted as normal for age; 28 demonstrated decreased but not absent activity bilaterally in posterior parietal/occipital regions (consistent with Alzheimer-type dementia); 28 showed unilateral abnormalities in regional cerebral blood flow consistent with cerebrovascular disease; and one had mixed findings. Based on SPECT/IMP results, further diagnostic testing and/or management would be altered for 72% of patients, suggesting that SPECT/IMP provides valuable data, not available on clinical examination, to guide the evaluation and management of demented patients

  6. Evaluation of image reconstruction methods for 123I-MIBG-SPECT. A rank-order study

    International Nuclear Information System (INIS)

    Soederberg, Marcus; Mattsson, Soeren; Oddstig, Jenny; Uusijaervi-Lizana, Helena; Leide-Svegborn, Sigrid; Valind, Sven; Thorsson, Ola; Garpered, Sabine; Prautzsch, Tilmann; Tischenko, Oleg

    2012-01-01

    Background: There is an opportunity to improve the image quality and lesion detectability in single photon emission computed tomography (SPECT) by choosing an appropriate reconstruction method and optimal parameters for the reconstruction. Purpose: To optimize the use of the Flash 3D reconstruction algorithm in terms of equivalent iteration (EI) number (number of subsets times the number of iterations) and to compare with two recently developed reconstruction algorithms ReSPECT and orthogonal polynomial expansion on disc (OPED) for application on 123 I-metaiodobenzylguanidine (MIBG)-SPECT. Material and Methods: Eleven adult patients underwent SPECT 4 h and 14 patients 24 h after injection of approximately 200 MBq 123 I-MIBG using a Siemens Symbia T6 SPECT/CT. Images were reconstructed from raw data using the Flash 3D algorithm at eight different EI numbers. The images were ranked by three experienced nuclear medicine physicians according to their overall impression of the image quality. The obtained optimal images were then compared in one further visual comparison with images reconstructed using the ReSPECT and OPED algorithms. Results: The optimal EI number for Flash 3D was determined to be 32 for acquisition 4 h and 24 h after injection. The average rank order (best first) for the different reconstructions for acquisition after 4 h was: Flash 3D 32 > ReSPECT > Flash 3D 64 > OPED, and after 24 h: Flash 3D 16 > ReSPECT > Flash 3D 32 > OPED. A fair level of inter-observer agreement concerning optimal EI number and reconstruction algorithm was obtained, which may be explained by the different individual preferences of what is appropriate image quality. Conclusion: Using Siemens Symbia T6 SPECT/CT and specified acquisition parameters, Flash 3D 32 (4 h) and Flash 3D 16 (24 h), followed by ReSPECT, were assessed to be the preferable reconstruction algorithms in visual assessment of 123 I-MIBG images

  7. Complexity and accuracy of image registration methods in SPECT-guided radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yin, L S; Duzenli, C; Moiseenko, V [Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC, V6T 1Z1 (Canada); Tang, L; Hamarneh, G [Computing Science, Simon Fraser University, 9400 TASC1, Burnaby, BC, V5A 1S6 (Canada); Gill, B [Medical Physics, Vancouver Cancer Centre, BC Cancer Agency, 600 West 10th Ave, Vancouver, BC, V5Z 4E6 (Canada); Celler, A; Shcherbinin, S [Department of Radiology, University of British Columbia, 828 West 10th Ave, Vancouver, BC, V5Z 1L8 (Canada); Fua, T F; Thompson, A; Sheehan, F [Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, 600 West 10th Ave, Vancouver, BC, V5Z 4E6 (Canada); Liu, M [Radiation Oncology, Fraser Valley Cancer Centre, BC Cancer Agency, 13750 9th Ave, Surrey, BC, V3V 1Z2 (Canada)], E-mail: lyin@bccancer.bc.ca

    2010-01-07

    The use of functional imaging in radiotherapy treatment (RT) planning requires accurate co-registration of functional imaging scans to CT scans. We evaluated six methods of image registration for use in SPECT-guided radiotherapy treatment planning. Methods varied in complexity from 3D affine transform based on control points to diffeomorphic demons and level set non-rigid registration. Ten lung cancer patients underwent perfusion SPECT-scans prior to their radiotherapy. CT images from a hybrid SPECT/CT scanner were registered to a planning CT, and then the same transformation was applied to the SPECT images. According to registration evaluation measures computed based on the intensity difference between the registered CT images or based on target registration error, non-rigid registrations provided a higher degree of accuracy than rigid methods. However, due to the irregularities in some of the obtained deformation fields, warping the SPECT using these fields may result in unacceptable changes to the SPECT intensity distribution that would preclude use in RT planning. Moreover, the differences between intensity histograms in the original and registered SPECT image sets were the largest for diffeomorphic demons and level set methods. In conclusion, the use of intensity-based validation measures alone is not sufficient for SPECT/CT registration for RTTP. It was also found that the proper evaluation of image registration requires the use of several accuracy metrics.

  8. Effects of Piecewise Spatial Smoothing in 4-D SPECT Reconstruction

    Science.gov (United States)

    Qi, Wenyuan; Yang, Yongyi; King, Michael A.

    2014-02-01

    In nuclear medicine, cardiac gated SPECT images are known to suffer from significantly increased noise owing to limited data counts. Consequently, spatial (and temporal) smoothing has been indispensable for suppressing the noise artifacts in SPECT reconstruction. However, recently we demonstrated that the benefit of spatial processing in motion-compensated reconstruction of gated SPECT (aka 4-D) could be outweighed by its adverse effects on the myocardium, which included degraded wall motion and perfusion defect detectability. In this work, we investigate whether we can alleviate these adverse effects by exploiting an alternative spatial smoothing prior in 4-D based on image total variation (TV). TV based prior is known to induce piecewise smoothing which can preserve edge features (such as boundaries of the heart wall) in reconstruction. However, it is not clear whether such a property would necessarily be beneficial for improving the accuracy of the myocardium in 4-D reconstruction. In particular, it is unknown whether it would adversely affect the detectability of perfusion defects that are small in size or low in contrast. In our evaluation study, we first use Monte Carlo simulated imaging with 4-D NURBS-based cardiac-torso (NCAT) phantom wherein the ground truth is known for quantitative comparison. We evaluated the accuracy of the reconstructed myocardium using a number of metrics, including regional and overall accuracy of the myocardium, accuracy of the phase activity curve (PAC) of the LV wall for wall motion, uniformity and spatial resolution of the LV wall, and detectability of perfusion defects using a channelized Hotelling observer (CHO). For lesion detection, we simulated perfusion defects with different sizes and contrast levels with the focus being on perfusion defects that are subtle. As a preliminary demonstration, we also tested on three sets of clinical acquisitions. From the quantitative results, it was demonstrated that TV smoothing could

  9. SPECT/CT imaging in children with papillary thyroid carcinoma

    International Nuclear Information System (INIS)

    Kim, Hwa-Young; Gelfand, Michael J.; Sharp, Susan E.

    2011-01-01

    SPECT/CT improves localization of single photon-emitting radiopharmaceuticals. To determine the utility of SPECT/CT in children with papillary thyroid carcinoma. 20 SPECT/CT and planar studies were reviewed in 13 children with papillary thyroid carcinoma after total thyroidectomy. Seven studies used I-123 and 13 used I-131, after elevating TSH by T4 deprivation or intramuscular thyrotropin alfa. Eight children had one study and five children had two to four studies. Studies were performed at initial post-total thyroidectomy evaluation, follow-up and after I-131 treatment doses. SPECT/CT was performed with a diagnostic-quality CT unit in 13 studies and a localization-only CT unit in 7. Stimulated thyroglobulin was measured (except in 2 cases with anti-thyroglobulin antibodies). In 13 studies, neck activity was present but poorly localized on planar imaging; all foci of uptake were precisely localized by SPECT/CT. Two additional foci of neck uptake were found on SPECT/CT. SPECT/CT differentiated high neck uptake from facial activity. In six studies (four children), neck uptake was identified as benign by SPECT/CT (three thyroglossal duct remnants, one skin contamination, two by precise anatomical CT localization). In two children, SPECT/CT supported a decision not to treat with I-131. When SPECT/CT was unable to identify focal uptake as benign, stimulated thyroglobulin measurements were valuable. In three of 13 studies with neck uptake, SPECT/CT provided no useful additional information. SPECT/CT precisely localizes neck iodine uptake. In small numbers of patients, treatment is affected. SPECT/CT should be used when available in thyroid carcinoma patients. (orig.)

  10. Electrocardiograph-gated single photon emission computed tomography radionuclide angiography presents good interstudy reproducibility for the quantification of global systolic right ventricular function.

    Science.gov (United States)

    Daou, Doumit; Coaguila, Carlos; Vilain, Didier

    2007-05-01

    Electrocardiograph-gated single photon emission computed tomography (SPECT) radionuclide angiography provides accurate measurement of right ventricular ejection fraction and end-diastolic and end-systolic volumes. In this study, we report the interstudy precision and reliability of SPECT radionuclide angiography for the measurement of global systolic right ventricular function using two, three-dimensional volume processing methods (SPECT-QBS, SPECT-35%). These were compared with equilibrium planar radionuclide angiography. Ten patients with chronic coronary artery disease having two SPECT and planar radionuclide angiography acquisitions were included. For the right ventricular ejection fraction, end-diastolic volume and end-systolic volume, the interstudy precision and reliability were better with SPECT-35% than with SPECT-QBS. The sample sizes needed to objectify a change in right ventricular volumes or ejection fraction were lower with SPECT-35% than with SPECT-QBS. The interstudy precision and reliability of SPECT-35% and SPECT-QBS for the right ventricle were better than those of equilibrium planar radionuclide angiography, but poorer than those previously reported for the left ventricle with SPECT radionuclide angiography on the same population. SPECT-35% and SPECT-QBS present good interstudy precision and reliability for right ventricular function, with the results favouring the use of SPECT-35%. The results are better than those of equilibrium planar radionuclide angiography, but poorer than those previously reported for the left ventricle with SPECT radionuclide angiography. They need to be confirmed in a larger population.

  11. Methods of evaluating SPECT images. The usefulness of the Matsuda`s method by the Patlak plot method in children

    Energy Technology Data Exchange (ETDEWEB)

    Takaishi, Yasuko [Nippon Medical School, Tokyo (Japan); Hashimoto, Kiyoshi; Fujino, Osamu [and others

    1998-11-01

    Single photon emission computed tomography (SPECT) is a tool to study cerebral blood flow (CBF) kinetics. There are three methods of evaluating SPECT images: visual, semi-quantitative (evaluation of the radioactivity ratio of the cerebral region to the cerebellum (R/CE) or to the thalamus (R/TH)) and quantitative (Matsuda`s method by Patlak plot method using {sup 99m}Tc-hexamethylpropylene amine oxime radionuclide angiography). We evaluated SPECT images by the quantitative method in 14 patients with neurological disorders and examined the correlation of the results to those obtained by the semi-quantitative method. There was no significant correlation between the R/CE or R/TH ratio and regional CBF except two regions. The evaluation by the semi-quantitative method may have been inappropriate, probably because the cerebellar or thalamic blood flow was not constant in each case. Evaluation by the quantitative method, on the other hand, seemed to be useful not only for the comparison of CBF among normal subjects, but also in the demonstration of progressive changes of CBF in the same case. The Matsuda`s method by the Patlak plot method is suitable for examination of children, since it dose not require aortic blood sampling. (author)

  12. Ventilation-perfused studies using SPECT

    International Nuclear Information System (INIS)

    Zwijnenburg, A.

    1989-01-01

    A method for the quantitative analysis of ventilation-perfusion SPECT studies is decribed and an effort is made to evaluate its usefullness. The technical details of the emthod are described. In the the transaxial reconstructions of the tomographic studies the contour of the lungs is detected and regional values of lung volume, ventilation, perfusion and ventilation-perfusion ratios are calculated. The method is operator independent. The lung volume calculations from the SPECT studies are validated by comparing them with lung volume measurements using the helium dilution technique. A good correlation (r=0.91) was found between the two volumes. SPECT volume was greater than the volume measured with helium dilution, which was attributed to non-gas-containing structures in the. lungs. The use of ventilation-perfusion ratio SPECT is described to evaluate the effect of ionizing radiation on the lungs in patients treated with mantle field irradiation for Hodgkin's disease. Perfusion changes appear as early as 2 months after the start of irradiation. Ventilation changes appear later and relatively minor. No changes are seen outside the radiation portals. The ventilation-perfusion inequality in pulmonary sarcoidosis is treated. It is suggested that the decrease D LCO in these patients may be partly due to an even distribution of ventilation perfusion ratios. An effort is made to establish the properties of a new tracer used for the assessment of the metabolic function of the pulmonary endothelium. The lung uptake of I-123 IMP mimics the distribution of a perfusion tracer and it is suggested that this tracer may be useful for the early detection of pulmonary vascular damage, even when blood flow is still intact. Some aspects of the use of Kr-81m as a ventilation tracer are discussed as well as the effect of noise on Kr-81m SPECT reconstructions. (author). 146 refs.; 39 figs.; 8 tabs

  13. Clinical evaluation of 99mTc-Technegas SPECT in thoracoscopic lung volume reduction surgery in patients with pulmonary emphysema

    International Nuclear Information System (INIS)

    Imai, Teruhiko; Sasaki, Yoshiaki; Shinkai, Takayuki

    2000-01-01

    99m Tc-Technegas (Tcgas) SPECT is useful for evaluating the patency of the airway and highly sensitive in detecting regional pulmonary function in pulmonary emphysema. The aim of this study is to evaluate regional ventilation impairment by this method pre and post thoracoscopic lung volume reduction surgery (LVRS) in patients with pulmonary emphysema. There were 11 patients with pulmonary emphysema. The mean age of patients was 64.1 years. All patients were males. LVRS was performed bilaterally in 8 patients and unilaterally in 3 patients. Post inhalation of Tcgas in the sitting position, the subjects were placed in the supine position and SPECT was performed. Distribution of Tcgas on axial images was classified into 4 types, homogeneous, inhomogeneous, hot spot, and defect. Three slices of axial SPECT images, the upper, middle and lower fields were selected, and changes in deposition patterns post LVRS were scored (Tcgas score). Post LVRS, dyspnea on exertion and pulmonary function tests were improved. Pre LVRS, inhomogeneous distribution, hot spots and defects were observed in all patients. Post LVRS, improvement in distribution was obtained not only in the surgical field and other fields, but also in the contralateral lung of unilaterally operated patients. In 5 patients some fields showed deterioration. The Tcgas score correlated with improvements in FEV 1.0 , FEV 1.0 % and %FEV 1.0 . Tcgas SPECT is useful for evaluating changes in regional pulmonary function post LVRS. (author)

  14. SPECT in psychiatry. SPECT in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Barocka, A. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Feistel, H. (Nuklearmedizinische Klinik, Erlangen (Germany)); Ebert, D. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Lungershausen, E. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany))

    1993-08-13

    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D[sub 2] and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.)

  15. Utility of Electrocardiography (ECG)-Gated Computed Tomography (CT) for Preoperative Evaluations of Thymic Epithelial Tumors.

    Science.gov (United States)

    Ozawa, Yoshiyuki; Hara, Masaki; Nakagawa, Motoo; Shibamoto, Yuta

    2016-01-01

    Preoperative evaluation of invasion to the adjacent organs is important for the thymic epithelial tumors on CT. The purpose of our study was to evaluate the utility of electrocardiography (ECG)-gated CT for assessing thymic epithelial tumors with regard to the motion artifacts produced and the preoperative diagnostic accuracy of the technique. Forty thymic epithelial tumors (36 thymomas and 4 thymic carcinomas) were examined with ECG-gated contrast-enhanced CT using a dual source scanner. The scan delay after the contrast media injection was 30 s for the non-ECG-gated CT and 100 s for the ECG-gated CT. Two radiologists blindly evaluated both the non-ECG-gated and ECG-gated CT images for motion artifacts and determined whether the tumors had invaded adjacent structures (mediastinal fat, superior vena cava, brachiocephalic veins, aorta, pulmonary artery, pericardium, or lungs) on each image. Motion artifacts were evaluated using a 3-grade scale. Surgical and pathological findings were used as a reference standard for tumor invasion. Motion artifacts were significantly reduced for all structures by ECG gating ( p =0.0089 for the lungs and p ECG-gated CT and ECG-gated CT demonstrated 79% and 95% accuracy, respectively, during assessments of pericardial invasion ( p =0.03). ECG-gated CT reduced the severity of motion artifacts and might be useful for preoperative assessment whether thymic epithelial tumors have invaded adjacent structures.

  16. Fusion of SPECT/TC images: Usefulness and benefits in degenerative spinal cord pathology

    International Nuclear Information System (INIS)

    Ocampo, Monica; Ucros, Gonzalo; Bermudez, Sonia; Morillo, Anibal; Rodriguez, Andres

    2005-01-01

    The objectives are to compare CT and SPECT bone scintigraphy evaluated independently with SPECT-CT fusion images in patients with known degenerative spinal pathology. To demonstrate the clinical usefulness of CT and SPECT fusion images. Materials and methods: Thirty-one patients with suspected degenerative spinal disease were evaluated with thin-slice, non-angled helical CT and bone scintigrams with single photon emission computed tomography (SPECT), both with multiplanar reconstructions within a 24-hour period After independent evaluation by a nuclear medicine specialist and a radiologist, multimodality image fusion software was used to merge the CT and SPECT studies and a final consensus interpretation of the combined images was obtained. Results: Thirty-two SPECT bone scintigraphy images, helical CT studies and SPECT-CT fusion images were obtained for 31 patients with degenerative spinal disease. The results of the bone scintigraphy and CT scans were in agreement in 17 pairs of studies (53.12%). In these studies image fusion did not provide additional information on the location or extension of the lesions. In 11 of the study pairs (34.2%), the information obtained was not in agreement between scintigraphy and CT studies: CT images demonstrated several abnormalities, whereas the SPECT images showed only one dominant lesion, or the SPECT images did not provide enough information for anatomical localization. In these cases image fusion helped establish the precise localization of the most clinically significant lesion, which matched the lesion with the greatest uptake. In 4 studies (12.5%) the CT and SPECT images were not in agreement: CT and SPECT images showed different information (normal scintigraphy, abnormal CT), thus leading to inconclusive fusion images. Conclusion: The use of CT-SPECT fusion images in degenerative spinal disease allows for the integration of anatomic detail with physiologic and functional information. CT-SPECT fusion improves the

  17. 111In-Pentetreotide SPECT/CT in Pulmonary Carcinoid.

    Science.gov (United States)

    Chiaravalloti, Agostino; Spanu, Angela; Danieli, Roberta; Dore, Francesca; Piras, Bastiana; Falchi, Antonio; Tavolozza, Mario; Madeddu, Giuseppe; Schillaci, Orazio

    2015-07-01

    We evaluated somatostatin receptor scintigraphy (SRS) with (111)In-pentetreotide incremental value in pulmonary carcinoid (PC) diagnosis compared to contrast enhanced Computed Tomography (ceCT). We enrolled 81 patients with ascertained PC, 39 at initial staging and 42 in follow-up; the primary tumor had already been excised in 68 cases. Single Photon emission Computed Tomography (SPECT) images were reconstructed with the iterative method and fused with non-enhanced Computed tomography (CT) images. Primary PC or metastatic lesions were ascertained in 55/81 patients and SPECT/CT was positive in 50/55 cases, while ceCT was positive in 44/55. Comparing SPECT/CT with ceCT results, we found a sensitivity of 96 vs. 87.5%, and specificity of 92% vs. 97% for the detection of primary lesion or recurrent disease. A total of 198 lesions were ascertained at SPECT/CT, while 161 at ceCT, with values of sensitivity and specificity of 85.5% and 84.6% for SRS and 75.2% and 90.5% respectively. (111)In-Pentetreotide SPECT/CT proved to be more sensitive and accurate than ceCT, thus enhancing its role in evaluating patients with PC. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  18. Clinical application of SPECT and PET in cerebrovascular disease

    International Nuclear Information System (INIS)

    Ra, Young Shin

    2003-01-01

    Single photon emission computed tomography(SPECT) and positron emission tomography(PET) are modern imaging techniques that allow for both qualitative are quantitative assessment of hemodynamic changes in cerebrovascular diseases. SPECT has been becoming an indispensable method to investigate regional cerebral blood flow because equipment and isotope are easily available in most general hospitals. Acetazolamide stress SPECT has also been proved to be useful to evaluate the cerebrovascular reserve of occlusive cerebrovascular diseases and to select surgical candidate. PET has gained wide spread clinical use in the evaluation of the hemodynamic and metabolic consequences of extracranial or intracranial arterial obstructive disease despite its complexity and limited availability. PET has been established as an invaluable tool in the pathophysilogy investigation of acute ischemic stroke. The potentials, limitations, and clinical applications of SPECT and PET in various cerebrovascular diseases will be discussed in this article with reviews of literatures

  19. Clinical application of SPECT and PET in cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Ra, Young Shin [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2003-02-01

    Single photon emission computed tomography(SPECT) and positron emission tomography(PET) are modern imaging techniques that allow for both qualitative are quantitative assessment of hemodynamic changes in cerebrovascular diseases. SPECT has been becoming an indispensable method to investigate regional cerebral blood flow because equipment and isotope are easily available in most general hospitals. Acetazolamide stress SPECT has also been proved to be useful to evaluate the cerebrovascular reserve of occlusive cerebrovascular diseases and to select surgical candidate. PET has gained wide spread clinical use in the evaluation of the hemodynamic and metabolic consequences of extracranial or intracranial arterial obstructive disease despite its complexity and limited availability. PET has been established as an invaluable tool in the pathophysilogy investigation of acute ischemic stroke. The potentials, limitations, and clinical applications of SPECT and PET in various cerebrovascular diseases will be discussed in this article with reviews of literatures.

  20. Evaluation of seizure propagation on ictal brain SPECT using statistical parametric mapping in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Jeon, Tae Joo; Lee, Jong Doo; Kim, Hee Joung; Lee, Byung In; Kim, Ok Joon; Kim, Min Jung; Jeon, Jeong Dong

    1999-01-01

    Ictal brain SPECT has a high diagnostic sensitivity exceeding 90 % in the localization of seizure focus, however, it often shows increased uptake within the extratemporal areas due to early propagation of seizure discharge. This study aimed to evaluate seizure propagation on ictal brian SPECT in patients with temporal lobe epilepsy (TLE) by statistical parametric mapping (SPM). Twenty-one patients (age 27.14 5.79 y) with temporal lobe epilepsy (right in 8, left in 13) who had successful seizure outcome after surgery and nine normal control were included. The data of ictal and interictal brain SPECT of the patients and baseline SPECT of normal control group were analyzed using automatic image registration and SPM96 softwares. The statistical analysis was performed to compare the mean SPECT image of normal group with individual ictal SPECT, and each mean image of the interictal groups of the right or left TLE with individual ictal scans. The t statistic SPM [t] was transformed to SPM [Z] with a threshold of 1.64. The statistical results were displayed and rendered on the reference 3 dimensional MRI images with P value of 0.05 and uncorrected extent threshold p value of 0.5 for SPM [Z]. SPM data demonstrated increased uptake within the epileptic lesion in 19 patients (90.4 %), among them, localized increased uptake confined to the epileptogenic lesion was seen in only 4 (19%) but 15 patients (71.4%) showed hyperperfusion within propagation sites. Bi-temporal hyperperfusion was observed in 11 out of 19 patients (57.9%, 5 in the right and 6 in the left); higher uptake within the lesion than contralateral side in 9, similar activity in 1 and higher uptake within contralateral lobe in one. Extra-temporal hyperperfusion was observed in 8 (2 in the right, 3 in the left, 3 in bilateral); unilateral hyperperfusion within the epileptogenic temporal lobe and extra-temporal area in 4, bi-temporal with extra-temporal hyperperfusion in remaining 4. Ictal brain SPECT is highly

  1. Usefulness of brain SPECT

    International Nuclear Information System (INIS)

    Raynaud, C.; Rancurel, G.; Kieffer, E.; Ricard, S.; Askienazy, S.; Moretti, J.L.; Bourdoiseau, M.; Rapin, J.; Soussaline, F.

    1983-01-01

    Brain SPECT was not effectively exploited until I-123 isopropyl amphetamine (IAMP), indicator able to penetrate the blood brain barrier, became available. Although the experience of research teams working with IAMP is quite restricted due to the high cost of the indicator, some applications now appear to be worth the cost and in some cases provide data which cannot be obtained with routine techniques, especially in cerebrovascular patients, in epilepsy and some cases of tumor. Brain SPECT appears as an atraumatic test which is useful to establish a functional evaluation of the cerebral parenchyma, and which is a complement to arteriography, X-ray scan and regional cerebral blood flow measurement

  2. Influence of void on image quality of industrial SPECT

    International Nuclear Information System (INIS)

    Park, J G; Jung, S H; Kim, J B; Moon, J; Kim, C H

    2013-01-01

    Industrial single photon emission computed tomography (SPECT) is a promising technique to determine the dynamic behavior of industrial process media and has been developed in the Korea Atomic Energy Research Institute. The present study evaluated the influence of a void, which is presence in multiphase reactors of industrial process, on the image quality of an industrial SPECT. The results are very encouraging; that is, the performance of the industrial SPECT system is little influenced by the presence of a void, which means that industrial SPECT is an appropriate tool to estimate the dynamic characteristics of the process media in a water-air phase bubble column with a static gas sparger

  3. 123I-amphetamine-SPECT in the diagnosis of neurological disorders

    International Nuclear Information System (INIS)

    Biersack, H.J.; Kreiten, K.; Hartmann, A.; Friedrich, G.; Linck, H.A.; Winkler, C.; Bonn Univ.; Rheinische Landesklinik, Bonn

    1985-01-01

    In contrast to conventional brain scintigraphy with sup(99m)Tc-pertechnetate, SPECT with 123 I-IMP enables visualization of the brain tissue itself. The relevance of this imaging technique was evaluated in 54 patients with cerebral disorders. SPECT of the brain was performed with a rotating gamma camera. In 6 of 24 epileptic patients, SPECT revealed foci consistent with EEG-findings which were, however, not detected by CCT. In 4 of 25 patients with cerebrovascular disease, hypoperfused areas were detected by SPECT despite negative results obtained with CCT. In 50% (10/20) of the patients with cerebrovascular disease, SPECT showed a greater functional extent of the lesions than CCT. In 3 patients with migraine and normal CCT, regional perfusion disturbancers were found. SPECT with 123 I-labeled amphetamines, therefore, enables diagnosis of functional perfusion disorders and metabolic disturbances that are not revealed by CCT. In addition, SPECT can be used to exactly demonstrate the functional extent of lesions detected by CCT. (orig.) [de

  4. 99mTc-ECD SPECT study in dementia and aphasia

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo; Ichiya, Yuichi; Otsuka, Makoto; Sasaki, Masayuki; Akashi, Yuko; Fukumura, Toshimitsu; Yoshida, Tsuyoshi; Masuda, Kouji; Ichimiya, Atsushi

    1993-01-01

    We studied clinical significance of 99m Tc-L,L,-ethyl cysteine dimer ( 99m Tc-ECD) SPECT study in dementia and aphasia, and compared it with 99m Tc-HMPAO SPECT study. The subjects consisted of 13 patients, including 10 patients with dementia and 3 patients with aphasia. Hypoperfusion areas were detected in 5 out of 10 patients with dementia and 2 out of 3 patients with aphasia in 99m Tc-ECD SPECT, and in 4 out of 10 patients with dementia and all of 3 patients with aphasia in 99m Tc-HMPAO SPECT. The count rate ratios in 99m Tc-ECD and 99m Tc-HMPAO SPECT were correlated well with each other, and the contrast of the 99m Tc-ECD SPECT image was equivalent or slightly higher as compared with 99m Tc-HMPAO. Therefore, 99m Tc-ECD SPECT study was considered to be useful for the evaluation of cerebral perfusion in dementia and aphasia. (author)

  5. Small-animal SPECT and SPECT/CT: application in cardiovascular research

    Energy Technology Data Exchange (ETDEWEB)

    Golestani, Reza; Dierckx, Rudi A.J.O. [University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Wu, Chao [University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); University Medical Center Utrecht, Image Sciences Institute and Rudolf Magnus Institute of Neurosciences, Utrecht (Netherlands); Tio, Rene A. [University Medical Center Groningen, Thorax Center, Department of Cardiology, Groningen (Netherlands); University Medical Center Groningen, Cardiovascular Imaging Group, P.O. Box 30001, Groningen (Netherlands); Zeebregts, Clark J. [University Medical Center Groningen, Department of Surgery, Division of Vascular Surgery, Groningen (Netherlands); University Medical Center Groningen, Cardiovascular Imaging Group, P.O. Box 30001, Groningen (Netherlands); Petrov, Artiom D. [University of California, Irvine, Division of Cardiology, School of Medicine, Irvine, California (United States); Beekman, Freek J. [University Medical Center Utrecht, Image Sciences Institute and Rudolf Magnus Institute of Neurosciences, Utrecht (Netherlands); Delft University of Technology, Faculty of Applied Sciences, Section Radiation Detection and Medical Imaging, Delft (Netherlands); MILabs, Utrecht (Netherlands); Boersma, Hendrikus H. [University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); University Medical Center Groningen, Department of Clinical and Hospital Pharmacy, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); University Medical Center Groningen, Cardiovascular Imaging Group, P.O. Box 30001, Groningen (Netherlands); Slart, Riemer H.J.A. [University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); University Medical Center Groningen, Cardiovascular Imaging Group, P.O. Box 30001, Groningen (Netherlands)

    2010-09-15

    Preclinical cardiovascular research using noninvasive radionuclide and hybrid imaging systems has been extensively developed in recent years. Single photon emission computed tomography (SPECT) is based on the molecular tracer principle and is an established tool in noninvasive imaging. SPECT uses gamma cameras and collimators to form projection data that are used to estimate (dynamic) 3-D tracer distributions in vivo. Recent developments in multipinhole collimation and advanced image reconstruction have led to sub-millimetre and sub-half-millimetre resolution SPECT in rats and mice, respectively. In this article we review applications of microSPECT in cardiovascular research in which information about the function and pathology of the myocardium, vessels and neurons is obtained. We give examples on how diagnostic tracers, new therapeutic interventions, pre- and postcardiovascular event prognosis, and functional and pathophysiological heart conditions can be explored by microSPECT, using small-animal models of cardiovascular disease. (orig.)

  6. Small-animal SPECT and SPECT/CT: application in cardiovascular research

    International Nuclear Information System (INIS)

    Golestani, Reza; Dierckx, Rudi A.J.O.; Wu, Chao; Tio, Rene A.; Zeebregts, Clark J.; Petrov, Artiom D.; Beekman, Freek J.; Boersma, Hendrikus H.; Slart, Riemer H.J.A.

    2010-01-01

    Preclinical cardiovascular research using noninvasive radionuclide and hybrid imaging systems has been extensively developed in recent years. Single photon emission computed tomography (SPECT) is based on the molecular tracer principle and is an established tool in noninvasive imaging. SPECT uses gamma cameras and collimators to form projection data that are used to estimate (dynamic) 3-D tracer distributions in vivo. Recent developments in multipinhole collimation and advanced image reconstruction have led to sub-millimetre and sub-half-millimetre resolution SPECT in rats and mice, respectively. In this article we review applications of microSPECT in cardiovascular research in which information about the function and pathology of the myocardium, vessels and neurons is obtained. We give examples on how diagnostic tracers, new therapeutic interventions, pre- and postcardiovascular event prognosis, and functional and pathophysiological heart conditions can be explored by microSPECT, using small-animal models of cardiovascular disease. (orig.)

  7. Contralateral thalamic hypoperfusion on brain perfusion SPECT

    International Nuclear Information System (INIS)

    Lee, Seok Mo; Bae, Sang Kyun; Yoo, Kyung Moo; Yum, Ha Yong

    2000-01-01

    Brain perfusion single photon emission computed tomography (SPECT) is useful for the localization of cerebrovascular lesion and sometimes reveals more definite lesion than radiologic imaging modality such as CT or MRI does. The purpose of this study was to evaluate the diagnostic usefulness of brain perfusion SPECT in patients with hemisensory impairment. Thirteen consecutive patients (M:F= 8:5, mean age = 48) who has hemisensory impairment were included. Brain perfusion SPECT was performed after intravenous injection of 1110 MBq of Tc-99m ECD. The images were obtained using a dual-head gamma camera with ultra-high resolution collimator. Semiquantitative analysis was performed after placing multiple ROIs on cerebral cortex, basal ganglia, thalamus and cerebellum. There were 10 patients with left hemisensory impairment and 3 patients with right-sided symptom. Only 2 patients revealed abnormal signal change in the thalamus on MRI. But brain perfusion SPECT showed decreased perfusion in the thalamus in 9 patients. Six patients among 10 patients with left hemisensory impairment revealed decreased perfusion in the contralateral thalamus on brain SPECT. The other 4 patients revealed no abnormality. Two patients among 3 patients with right hemisensory impairment also showed decreased perfusion in the contralateral thalamus on brain SPECT. One patients with right hemisensory impairment showed ipsilateral perfusion decrease. Two patients who had follow-up brain perfusion SEPCT after treatment revealed normalization of perfusion in the thalamus. Brain perfusion SPECT might be a useful tool in diagnosing patients with hemisensory impairment

  8. Evaluation of brain tumors by simultaneous dual isotope SPECT with 201Tl-chloride and 99mTc-MIBI

    International Nuclear Information System (INIS)

    Nagai, Hidemasa; Yamasaki, Toshiki; Yamamoto, Yoshiaki; Takada, Daikei; Miyazaki, Takeshi; Sugimoto, Keiji; Matsumoto, Yoshifumi; Akiyama, Yasuhiko; Moritake, Kouzo

    2004-01-01

    Single photon emission computed tomography (SPECT) is useful for detecting brain tumors. In this study, we evaluated the utility of simultaneous dual SPECT with 201 Tl-Chloride (Tl) and 99m Tc-MIBI (MIBI) for diagnosis of brain tumors. We evaluated 20 cases, including 2 glioblastomas, 7 anaplastic astrocytomas, 2 oligodendrogliomas, 2 anaplastic ependymomas, 2 medulloblastomas, 2 meningiomas, 1 malignant meningioma, 1 pituitary adenoma, and 1 craniopharyngioma. We analyzed the uptake ratio (T/N ratio) of tracers in both Tl and MIBI at max counts/pixels ratio in the region of interest. The T/N ratios in early and delayed images were described as early ratios (ER) and delay ratios (DR), respectively. The retention index (RI) was calculated as the DR/ER ratio. Significant correlations were found between ER and DR for both Tl (DR=0.797 x ER+0.359, r=0.871), and MIBI (DR=0.961 x ER-0.191, r=0.784). Next, we analyzed the correlations between Tl and MIBI SPECT, for ER, DR, and RI. ER values for the two were strongly correlated (r=0.791), DR values were weakly correlated (r=0.556), and RI exhibited no correlation between them (r=0.328). There were no correlations between tumor volume and T/N ratio for the two (ER-Tl; r=0.0095, DR-Tl; r=0.0050, ER-MIBI; r=0.036, DR-MIBI; r=0.254). Lastly no correlation was found between RI-Tl and RI-MIBI (r=0.328). We discuss the difference in the mechanism of accumulation of two tracers and the significance of simultaneous dual SPECT using them for the differential diagnosis of pituitary tumors, regrowth of oligodendrogliomas, and multi-drug resistance of chemotherapy. Dual SPECT with Tl and MIBI appears to be useful for the diagnosis of brain tumor. (author)

  9. Diagnostic evaluation of brain SPECT imaging in diseases of nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Yongsheng, Jiang; Chengmo, Zhu; Jixian, Zhang; Weijia, Tian [Shanghai Second Medical Univ. (China). Ruijing Hospital

    1992-11-01

    The dynamic distributions of home made ECD and the Amersham brain SPECT imaging agent 'Ceretec' in normal person as well as their diagnostic use in diseases of nervous system were investigated. Semi-quantitative analysis combined with direct observation was more accurate for the diagnosis. Aside from cerebrovascular diseases, SPECT brain imaging has its unique value for the diagnosis of transient ischemic attack, Alzheimer disease, multiple ischemic dementia and epilepsy etc.

  10. Pre and post operative evaluation of the perfusion reserve by acetazolamide 99mTc-HMPAO SPECT in patients with chronic occlusive cerebral arteries. A comparative study with PET

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo; Ichiya, Yuichi; Sasaki, Masayuki; Akashi, Yuko; Yoshida, Tsuyoshi; Fukumura, Toshimitsu; Masuda, Kouji; Fujii, Kiyotaka; Fukui, Masashi

    1994-01-01

    We studied the pre and post-operative perfusion reserve using Diamox 99m Tc-HMPAO SPECT in 7 patients with chronic occlusive cerebral arteries and then compared the results with PET. STAMCA anastomosis was performed on 5 patients, while a carotid endarterectomy was done on 2 patients. The cerebral blood flow, the vascular response to CO 2 or Diamox, the oxygen extraction fraction and transit time (CBV/CBF) were measured by PET. In the pre-operative state, the visual evaluations for hypoperfusion area at rest agreed in 5 out of 7 patients in HMPAO SPECT and PET studies. In the remaining 2 patients, hypoperfusion areas were only detected in the PET study. The pre-operative evaluation of perfusion reserve agreed in 2 patients. In the remaining 5 patients, 3 patients showed definite positive (++) in PET and positive (+) in HMPAO SPECT, and one patient showed positive (+) in PET and negative (-) in HMPAO SPECT. The post-operative change of hypoperfusion areas well agreed in HMPAO SPECT and PET studies. However, the change of perfusion reserve was underestimated in HMPAO SPECT compared with PET. In the semiquantitative and quantitative analyses, the count rate ratios (affected/unaffected side) in HMPAO SPECT were apparently higher than those of CBF in PET. The postoperative change of the count rate ratios in HMPAO SPECT were smaller than those of CBF in PET. There was no significant correlation between the change in the ratio of the HMPAO SPECT after the administration of Diamox and the oxygen extraction fraction, and it was thus thought to be impossible to predict the areas with an increased oxygen extraction fraction. Thus, Diamox HMPAO SPECT may underestimate the areas of hypoperfusion or decrease in perfusion reserve when compared with PET. We should consider these limitations in the evaluation of pre and post operative cerebral hemodynamics. (author)

  11. Evaluation of regional wall motion in myocardial infarction using animation ECG gated cardiac computed tomography

    International Nuclear Information System (INIS)

    Shimizu, Takahiko; Hyodo, Haruo; Hayashi, Terumi; Yamamoto, Hideo; Yagi, Shigeru

    1984-01-01

    Regional wall motion of the left ventricle was evaluated in 21 patients with myocardial infarction using an animation system of gated cardiac computed tomographic (CT) images (animation gated CCT). The results obtained were compared with data by two-dimensional echocardiography (2-DE). 1. Evaluation of the asynergic area by animation gated CCT and 2-DE: Animation gated CCT detected the following specific regions with asynergy established by 2-DE; 10/10 cases (100%) at the anterior wall of the left ventricle, 14/14 cases (100%) at the interventricular septum, and 9/11 cases (81.8%) at the infero-posterior wall. In addition, one false positive case and one negative case were observed at the lateral wall and the apex, respectively. Of 37 instances with asynergic areas established by 2-DE, 21 cases or 89.2% were detected by animation gated CCT; the sensitivity was 91.9%. 2. Evaluation of severity of asynergy by animation gated CCT and 2-DE: The degree of asynergy evaluated by both methods was compared with each other, and the agreement was as follows: 10/10 cases (100%) at the left-ventricular anterior wall, 13/13 cases (100%) at the interventricular septum, and 7/9 cases (77.8%) at the infero-posterior wall. 3. Evaluation of the asynergic area by nonanimation gated CCT and 2-DE: Nonanimation gated CCT detected asynergic areas ascertained by 2-DE at the following areas; 8/10 cases (80%) at the left-ventricular anterior wall, 12/14 cases (85.7%) at the interventricular septum, and 4/11 cases (36.4%) at the infero-posterior wall. The difference between animation and nonanimation gated CCT was statistically significant (p<0.05). The severity of asynergy could not be evaluated by nonanimation gated CCT. (J.P.N.)

  12. Generation of complete electronic nuclear medicine reports including static, dynamic and gated images

    International Nuclear Information System (INIS)

    Beretta, M.; Pilon, R.; Mut, F.

    2002-01-01

    Aim: To develop a procedure for the creation of nuclear medicine reports containing static and dynamic images. The reason for implementing this technique is the lack of adequate solutions for an electronic format of nuclear medicine results allowing for rapid transmission via e-mail, specially in the case of dynamic and gated SPECT studies, since functional data is best presented in dynamic mode. Material and Methods: Clinical images were acquired in static, whole body, dynamic and gated mode, corresponding to bone studies, diuretic renogram, radionuclide cystography and gated perfusion SPECT, as well as respective time-activity curves. Image files were imported from a dedicated nuclear medicine computer system (Elscint XPert) to a Windows-based PC through a standard ethernet network with TCP-IP communications protocol, using a software developed by us which permits the conversion from the manufacturer's original format into a bitmap format (.bmp) compatible with commercially available PC software. For cardiac perfusion studies, background was subtracted prior to transferring to reduce the amount of information in the file; this was not done for other type of studies because useful data could be eliminated. Dynamic images were then processed using commercial software to create animated files and stored in .gif format. Static images were re-sized and stored in .jpg format. Original color or gray scale was always preserved. All the graphic material was then merged with a previously prepared report text using HTML format. The report also contained reference diagrams to facilitate interpretation. The whole report was then compressed into a self-extractable file, ready to be sent by electronic mail. Reception of the material was visually checked for data integrity including image quality by two experienced nuclear medicine physicians. Results: The report presented allows for simultaneous visualization of the text, diagrams and images either static, dynamic, gated or

  13. Evaluation of reconstruction techniques in regional cerebral blood flow SPECT using trade-off plots: a Monte Carlo study.

    Science.gov (United States)

    Olsson, Anna; Arlig, Asa; Carlsson, Gudrun Alm; Gustafsson, Agnetha

    2007-09-01

    The image quality of single photon emission computed tomography (SPECT) depends on the reconstruction algorithm used. The purpose of the present study was to evaluate parameters in ordered subset expectation maximization (OSEM) and to compare systematically with filtered back-projection (FBP) for reconstruction of regional cerebral blood flow (rCBF) SPECT, incorporating attenuation and scatter correction. The evaluation was based on the trade-off between contrast recovery and statistical noise using different sizes of subsets, number of iterations and filter parameters. Monte Carlo simulated SPECT studies of a digital human brain phantom were used. The contrast recovery was calculated as measured contrast divided by true contrast. Statistical noise in the reconstructed images was calculated as the coefficient of variation in pixel values. A constant contrast level was reached above 195 equivalent maximum likelihood expectation maximization iterations. The choice of subset size was not crucial as long as there were > or = 2 projections per subset. The OSEM reconstruction was found to give 5-14% higher contrast recovery than FBP for all clinically relevant noise levels in rCBF SPECT. The Butterworth filter, power 6, achieved the highest stable contrast recovery level at all clinically relevant noise levels. The cut-off frequency should be chosen according to the noise level accepted in the image. Trade-off plots are shown to be a practical way of deciding the number of iterations and subset size for the OSEM reconstruction and can be used for other examination types in nuclear medicine.

  14. The consequences of a new software package for the quantification of gated-SPECT myocardial perfusion studies

    International Nuclear Information System (INIS)

    Veen, Berlinda J. van der; Dibbets-Schneider, Petra; Stokkel, Marcel P.M.; Scholte, Arthur J.

    2010-01-01

    Semiquantitative analysis of myocardial perfusion scintigraphy (MPS) has reduced inter- and intraobserver variability, and enables researchers to compare parameters in the same patient over time, or between groups of patients. There are several software packages available that are designed to process MPS data and quantify parameters. In this study the performances of two systems, quantitative gated SPECT (QGS) and 4D-MSPECT, in the processing of clinical patient data and phantom data were compared. The clinical MPS data of 148 consecutive patients were analysed using QGS and 4D-MSPECT to determine the end-diastolic volume, end-systolic volume and left ventricular ejection fraction. Patients were divided into groups based on gender, body mass index, heart size, stressor type and defect type. The AGATE dynamic heart phantom was used to provide reference values for the left ventricular ejection fraction. Although the correlations were excellent (correlation coefficients 0.886 to 0.980) for all parameters, significant differences (p < 0.001) were found between the systems. Bland-Altman plots indicated that 4D-MSPECT provided overall higher values of all parameters than QGS. These differences between the systems were not significant in patients with a small heart (end-diastolic volume <70 ml). Other clinical factors had no direct influence on the relationship. Additionally, the phantom data indicated good linear responses of both systems. The discrepancies between these software packages were clinically relevant, and influenced by heart size. The possibility of such discrepancies should be taken into account when a new quantitative software system is introduced, or when multiple software systems are used in the same institution. (orig.)

  15. Principle of cerebral hemodynamic perfusion in SPECT and new evaluation method of hemodynamic reserve capacity using {sup 99m}Tc tracer

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Masaaki; Mukai, Hironobu; Tada, Motoyuki; Miyazaki, Yoshiharu; Takimoto, Masamori; Shiozaki, Jun; Inoue, Hisashi [Noto General Hospital, Nanao, Ishikawa (Japan)

    2002-07-01

    We performed quantitative measurements of cerebral blood flow (CBF) using {sup 99m}Tc tracer by the Patlak Plot method with reference to normal aging and cerebrovascular reserve (CVR) capacity and then investigated a new evaluation method of CVR. Aging and decrease of ADL were significantly associated with reduction of the mean hemispheric CBF. In the acetazolamide (ACZ) stress test, these retrospective data showed some overlap in each ischemic grade on the relationship between rCBF and CVR response for the predictability of EC/IC bypass surgery. In these controversial problems, we must reconfirm the principle of cerebral hemodynamic perfusion in SPECT. First, retention tracer is distributed via the microcirculatory system to brain tissue. Second, therefore, we should understand not only the circulation of major vessels, but also the dynamics and rheology in parenchymal microcirculation to determine brain SPECT and CVR capacity. In the next step, we approached the new evaluation method of CVR capacity using {sup 99m}Tc tracer by a serial dynamic SPECT with a slip-ring rotational gamma camera. These preliminally findings suggest that a serial dynamic SPECT may be more useful for analyzing the pathophysiology on brain circulation and CVR than conventional approaches. (author)

  16. Preoperative evaluation of brain lesion with 201TI brain SPECT: is it useful to differentiate benign and malignant lesions?

    International Nuclear Information System (INIS)

    Sohn, Hyung Sun; Kim, Euy Neyng; Kim, Sung Hoon; Chung, Yong An; Chung, Soo Kyo; Hong, Yong Gil; Lee, Youn Soo

    2000-01-01

    Thallium-201 ( 201 TI) brain SPECT, which can represent cellular activity of brain lesions, may provide more useful information in differentiating between benign and malignant brain lesions more so than CT or MRI, that merely represents anatomic changes or breakdown of blood brain barrier. We used 201 TI brain SPECT prospectively to evaluate the utility of 201 TI-indices as an indicator of benign or malignant lesions. We studied 28 patients. There were 13 cases of benign lesions (3: nonspecific benign lesion, 3: meningioma, 2: low grade glioma, 1: tuberculoma, central neurocytoma, hemangioblastoma, radiation necrosis, and choroid plexus papilloma) and 15 cases of malignant lesions (6: glioblastoma multiforme, 5: anaplastic glioma, 2: medulloblastoma, 1: metastasis and lymphoma). In all patients, CT and/or MRI were obtained and then 201 TI brain SPECT was obtained with measuring mean 201 TI index and peak 201 TI index. An unpaired t-test was performed to compare the 201 TI-indices and pathologic diagnoses to evaluate the utility of 201 TI-indices as an indicator of benign or malignant lesions. There were no statistically significant difference in 201 TI-indices between benign and malignant brain lesions (P>0.05). These results demonstrated that we could not use 201 TI indices on brain SPECT alone as an indicator of benign or malignant brain lesions

  17. Single photon emission computed tomography (SPECT) in neurocysticercosis

    International Nuclear Information System (INIS)

    Braga, Francisco Jose H. N; Santos, Antonio C; Takanayagui, Oswaldo M; Agapejev, Svetlana; Maes, A

    2002-01-01

    Neurocysticercosis (NC) is a parasitic infectious disease caused by Taenia solium eggs that set in the brain. Its incidence is increasing both in the developing and the developed world, as a result of low economical and hygiene levels and immigration, respectively. Clinical manifestation of disease varies from no symptoms to epilepsy, increased intra-cranial pressure, arachnoiditis and dementia. In order to evaluate function (perfusion) of affected brains, we studied 40 patients (21 females and 19 males, 19-71 yo) by means of SPECT (ECD, ethyl cysteinate dimer, labelled with 99mTc) and with and without contrast CT. SPECT studies were all abnormal. No difference was noted between active and inactive disease. Two SPECT patterns were noted: a) several areas of focally reduced uptake, resulting from coalescent and big lesions and large destruction of brain tissue (small, isolated and symmetric cysts seen in CT were missed by SPECT); b) diffuse atrophy with reduction of the tracer uptake, associated with ventricle dilatation, corresponding to the cases where ventricular NC was important. Interestingly, we noted diffuse hypoperfusion, with the scintigraphic pattern of atrophy in 5 cases of massive parenchymal infection; in such cases, CT signs of atrophy were clearly less prominent. The first scintigraphic aspect can be explained by the destruction of large areas of brain, which produces focal absence of perfusion; generalised vasculitis and the destruction of large portions of brain tissue could explain the difference noted between the SPECT and the CT aspects in the 5 cases of massive parenchimal infection, and this may be interesting for prognosis. Dilatation of ventricles and Sylvian fissures were interestingly prominent in SPECT. SPECT may be of great value to evaluate brain perfusion in NC (Au)

  18. Validation of the Gate simulation platform in single photon emission computed tomography and application to the development of a complete 3-dimensional reconstruction algorithm; Validation de la plate-forme de simulation GATE en tomographie a emission monophotonique et application au developpement d'un algorithme de reconstruction 3D complete

    Energy Technology Data Exchange (ETDEWEB)

    Lazaro, D

    2003-10-01

    Monte Carlo simulations are currently considered in nuclear medical imaging as a powerful tool to design and optimize detection systems, and also to assess reconstruction algorithms and correction methods for degrading physical effects. Among the many simulators available, none of them is considered as a standard in nuclear medical imaging: this fact has motivated the development of a new generic Monte Carlo simulation platform (GATE), based on GEANT4 and dedicated to SPECT/PET (single photo emission computed tomography / positron emission tomography) applications. We participated during this thesis to the development of the GATE platform within an international collaboration. GATE was validated in SPECT by modeling two gamma cameras characterized by a different geometry, one dedicated to small animal imaging and the other used in a clinical context (Philips AXIS), and by comparing the results obtained with GATE simulations with experimental data. The simulation results reproduce accurately the measured performances of both gamma cameras. The GATE platform was then used to develop a new 3-dimensional reconstruction method: F3DMC (fully 3-dimension Monte-Carlo) which consists in computing with Monte Carlo simulation the transition matrix used in an iterative reconstruction algorithm (in this case, ML-EM), including within the transition matrix the main physical effects degrading the image formation process. The results obtained with the F3DMC method were compared to the results obtained with three other more conventional methods (FBP, MLEM, MLEMC) for different phantoms. The results of this study show that F3DMC allows to improve the reconstruction efficiency, the spatial resolution and the signal to noise ratio with a satisfactory quantification of the images. These results should be confirmed by performing clinical experiments and open the door to a unified reconstruction method, which could be applied in SPECT but also in PET. (author)

  19. Noise suppressed partial volume correction for cardiac SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Chung; Liu, Chi, E-mail: chi.liu@yale.edu [Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut 06520 (United States); Liu, Hui [Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut 06520 and Key Laboratory of Particle and Radiation Imaging (Tsinghua University), Ministry of Education, Beijing 100084 (China); Grobshtein, Yariv [GE Healthcare, Haifa 3910101 (Israel); Stacy, Mitchel R. [Department of Internal Medicine, Yale University, New Haven, Connecticut 06520 (United States); Sinusas, Albert J. [Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut 06520 and Department of Internal Medicine, Yale University, New Haven, Connecticut 06520 (United States)

    2016-09-15

    Purpose: Partial volume correction (PVC) methods typically improve quantification at the expense of increased image noise and reduced reproducibility. In this study, the authors developed a novel voxel-based PVC method that incorporates anatomical knowledge to improve quantification while suppressing noise for cardiac SPECT/CT imaging. Methods: In the proposed method, the SPECT images were first reconstructed using anatomical-based maximum a posteriori (AMAP) with Bowsher’s prior to penalize noise while preserving boundaries. A sequential voxel-by-voxel PVC approach (Yang’s method) was then applied on the AMAP reconstruction using a template response. This template response was obtained by forward projecting a template derived from a contrast-enhanced CT image, and then reconstructed using AMAP to model the partial volume effects (PVEs) introduced by both the system resolution and the smoothing applied during reconstruction. To evaluate the proposed noise suppressed PVC (NS-PVC), the authors first simulated two types of cardiac SPECT studies: a {sup 99m}Tc-tetrofosmin myocardial perfusion scan and a {sup 99m}Tc-labeled red blood cell (RBC) scan on a dedicated cardiac multiple pinhole SPECT/CT at both high and low count levels. The authors then applied the proposed method on a canine equilibrium blood pool study following injection with {sup 99m}Tc-RBCs at different count levels by rebinning the list-mode data into shorter acquisitions. The proposed method was compared to MLEM reconstruction without PVC, two conventional PVC methods, including Yang’s method and multitarget correction (MTC) applied on the MLEM reconstruction, and AMAP reconstruction without PVC. Results: The results showed that the Yang’s method improved quantification, however, yielded increased noise and reduced reproducibility in the regions with higher activity. MTC corrected for PVE on high count data with amplified noise, although yielded the worst performance among all the methods

  20. Evaluation of image reconstruction methods for {sup 123}I-MIBG-SPECT. A rank-order study

    Energy Technology Data Exchange (ETDEWEB)

    Soederberg, Marcus; Mattsson, Soeren; Oddstig, Jenny; Uusijaervi-Lizana, Helena; Leide-Svegborn, Sigrid [Medical Radiation Physics, Dept. of Clinical Sciences Malmoe, Lund Univ., Skaane Univ. Hospital, Malmoe (Sweden)], e-mail: marcus.soderberg@med.lu.se; Valind, Sven; Thorsson, Ola; Garpered, Sabine [Dept. of Clinical Physiology, Skaane Univ. Hospital, Malmoe (Sweden); Prautzsch, Tilmann [Scivis wissenschaftlice Bildverarbeitung GmbH, Goettingen (Germany); Tischenko, Oleg [Research Unit Medical Radiation Physics and Diagnostics (AMSD), Helmholtz Zentrum Muenchen (Germany); German Research Center for Environmental Health, Neuherberg (Germany)

    2012-09-15

    Background: There is an opportunity to improve the image quality and lesion detectability in single photon emission computed tomography (SPECT) by choosing an appropriate reconstruction method and optimal parameters for the reconstruction. Purpose: To optimize the use of the Flash 3D reconstruction algorithm in terms of equivalent iteration (EI) number (number of subsets times the number of iterations) and to compare with two recently developed reconstruction algorithms ReSPECT and orthogonal polynomial expansion on disc (OPED) for application on {sup 123}I-metaiodobenzylguanidine (MIBG)-SPECT. Material and Methods: Eleven adult patients underwent SPECT 4 h and 14 patients 24 h after injection of approximately 200 MBq {sup 123}I-MIBG using a Siemens Symbia T6 SPECT/CT. Images were reconstructed from raw data using the Flash 3D algorithm at eight different EI numbers. The images were ranked by three experienced nuclear medicine physicians according to their overall impression of the image quality. The obtained optimal images were then compared in one further visual comparison with images reconstructed using the ReSPECT and OPED algorithms. Results: The optimal EI number for Flash 3D was determined to be 32 for acquisition 4 h and 24 h after injection. The average rank order (best first) for the different reconstructions for acquisition after 4 h was: Flash 3D{sub 32} > ReSPECT > Flash 3D{sub 64} > OPED, and after 24 h: Flash 3D{sub 16} > ReSPECT > Flash 3D{sub 32} > OPED. A fair level of inter-observer agreement concerning optimal EI number and reconstruction algorithm was obtained, which may be explained by the different individual preferences of what is appropriate image quality. Conclusion: Using Siemens Symbia T6 SPECT/CT and specified acquisition parameters, Flash 3D{sub 32} (4 h) and Flash 3D{sub 16} (24 h), followed by ReSPECT, were assessed to be the preferable reconstruction algorithms in visual assessment of {sup 123}I-MIBG images.

  1. Study on SPECT image for children with cerebral infarction

    International Nuclear Information System (INIS)

    Xie Wenhuang; Xie Zhichun; Chen Yucai; Lin Haoxue; Zheng Aidong; Xie Hui

    1998-01-01

    To explore the diagnostic value of SPECT image for children with cerebral infarction (CCI), comparative research was made on 26 cases undergoing regional cerebral perfusion (rCP) image between SPECT imaging and CT scanning. The results showed that the rCP in the infarct and its distant area was decreased. The positive rate of SPECT and CT were 92.3% (24/26) and 84.5% (22/26) respectively. The difference was not significant (P = 0.67, P>0.05). But, the positive rate of SPECT image 2 days after onset in 9 CCI was 100% (9/9), significantly higher than 55.6% (5/9) in CT scanning (P = 0.04, P<0.05). These findings suggested that the SPECT imaging is a sensitive method for the early diagnosis of CCI, and also helpful for observation of the therapeutic effect and evaluation of the prognosis

  2. Brain SPECT in severs traumatic head injury

    International Nuclear Information System (INIS)

    Beaulieu, F.; Eder, V.; Pottier, J.M.; Baulieu, J.L.; Fournier, P.; Legros, B.; Chiaroni, P.; Dalonneau, M.

    2000-01-01

    The aim of this work was to compare the results of the early brain scintigraphy in traumatic brain injury to the long term neuropsychological behavior. Twenty four patients had an ECD-Tc99m SPECT, within one month after the trauma; scintigraphic abnormalities were evaluated according to a semi-quantitative analysis. The neuropsychological clinical investigation was interpreted by a synthetic approach to evaluate abnormalities related to residual motor deficit, frontal behavior, memory and language disorders. Fourteen patients (58%) had sequela symptoms. SPECT revealed 80 abnormalities and CT scan only 31. Statistical analysis of uptake values showed significantly lower uptake in left basal ganglia and brain stem in patients with sequela memory disorders. We conclude that the brain perfusion scintigraphy is able to detect more lesions than CT and that it could really help to predict the neuropsychological behavior after severe head injury. Traumatology could become in the future a widely accepted indication of perfusion SPECT. (authors)

  3. /sup 123/I-amphetamine-SPECT in the diagnosis of neurological disorders

    Energy Technology Data Exchange (ETDEWEB)

    Biersack, H.J.; Kreiten, K.; Hartmann, A.; Friedrich, G.; Linck, H.A.; Winkler, C.

    1985-03-01

    In contrast to conventional brain scintigraphy with sup(99m)Tc-pertechnetate, SPECT with /sup 123/I-IMP enables visualization of the brain tissue itself. The relevance of this imaging technique was evaluated in 54 patients with cerebral disorders. SPECT of the brain was performed with a rotating gamma camera. In 6 of 24 epileptic patients, SPECT revealed foci consistent with EEG-findings which were, however, not detected by CCT. In 4 of 25 patients with cerebrovascular disease, hypoperfused areas were detected by SPECT despite negative results obtained with CCT. In 50% (10/20) of the patients with cerebrovascular disease, SPECT showed a greater functional extent of the lesions than CCT. In 3 patients with migraine and normal CCT, regional perfusion disturbancers were found. SPECT with /sup 123/I-labeled amphetamines, therefore, enables diagnosis of functional perfusion disorders and metabolic disturbances that are not revealed by CCT. In addition, SPECT can be used to exactly demonstrate the functional extent of lesions detected by CCT.

  4. Validation of the Gate simulation platform in single photon emission computed tomography and application to the development of a complete 3-dimensional reconstruction algorithm

    International Nuclear Information System (INIS)

    Lazaro, D.

    2003-10-01

    Monte Carlo simulations are currently considered in nuclear medical imaging as a powerful tool to design and optimize detection systems, and also to assess reconstruction algorithms and correction methods for degrading physical effects. Among the many simulators available, none of them is considered as a standard in nuclear medical imaging: this fact has motivated the development of a new generic Monte Carlo simulation platform (GATE), based on GEANT4 and dedicated to SPECT/PET (single photo emission computed tomography / positron emission tomography) applications. We participated during this thesis to the development of the GATE platform within an international collaboration. GATE was validated in SPECT by modeling two gamma cameras characterized by a different geometry, one dedicated to small animal imaging and the other used in a clinical context (Philips AXIS), and by comparing the results obtained with GATE simulations with experimental data. The simulation results reproduce accurately the measured performances of both gamma cameras. The GATE platform was then used to develop a new 3-dimensional reconstruction method: F3DMC (fully 3-dimension Monte-Carlo) which consists in computing with Monte Carlo simulation the transition matrix used in an iterative reconstruction algorithm (in this case, ML-EM), including within the transition matrix the main physical effects degrading the image formation process. The results obtained with the F3DMC method were compared to the results obtained with three other more conventional methods (FBP, MLEM, MLEMC) for different phantoms. The results of this study show that F3DMC allows to improve the reconstruction efficiency, the spatial resolution and the signal to noise ratio with a satisfactory quantification of the images. These results should be confirmed by performing clinical experiments and open the door to a unified reconstruction method, which could be applied in SPECT but also in PET. (author)

  5. Clinical applications of SPECT/CT in imaging the extremities

    International Nuclear Information System (INIS)

    Huellner, Martin W.; Strobel, Klaus

    2014-01-01

    Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insufficient, if MR image quality is impaired due to metal implants or in patients with contraindications to MR. In complex joints such as those in the foot and wrist, SPECT/CT provides exact anatomical correlation of pathological uptake. In many cases SPECT increases the sensitivity and CT the specificity of the study, increasing confidence in the final diagnosis compared to planar images alone. The CT protocol should be adapted to the clinical question and may vary from very low-dose (e.g. attenuation correction only), to low-dose for anatomical correlation, to normal-dose protocols enabling precise anatomical resolution. The aim of this review is to give an overview of SPECT/CT imaging of the extremities with a focus on the hand and wrist, knee and foot, and for evaluation of patients after joint arthroplasty. (orig.)

  6. Clinical applications of SPECT/CT in imaging the extremities

    Energy Technology Data Exchange (ETDEWEB)

    Huellner, Martin W. [University Hospital Zurich, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Strobel, Klaus [Lucerne Cantonal Hospital, Department of Nuclear Medicine and Radiology, Lucerne (Switzerland)

    2014-05-15

    Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insufficient, if MR image quality is impaired due to metal implants or in patients with contraindications to MR. In complex joints such as those in the foot and wrist, SPECT/CT provides exact anatomical correlation of pathological uptake. In many cases SPECT increases the sensitivity and CT the specificity of the study, increasing confidence in the final diagnosis compared to planar images alone. The CT protocol should be adapted to the clinical question and may vary from very low-dose (e.g. attenuation correction only), to low-dose for anatomical correlation, to normal-dose protocols enabling precise anatomical resolution. The aim of this review is to give an overview of SPECT/CT imaging of the extremities with a focus on the hand and wrist, knee and foot, and for evaluation of patients after joint arthroplasty. (orig.)

  7. High-resolution brain SPECT imaging by combination of parallel and tilted detector heads.

    Science.gov (United States)

    Suzuki, Atsuro; Takeuchi, Wataru; Ishitsu, Takafumi; Morimoto, Yuichi; Kobashi, Keiji; Ueno, Yuichiro

    2015-10-01

    To improve the spatial resolution of brain single-photon emission computed tomography (SPECT), we propose a new brain SPECT system in which the detector heads are tilted towards the rotation axis so that they are closer to the brain. In addition, parallel detector heads are used to obtain the complete projection data set. We evaluated this parallel and tilted detector head system (PT-SPECT) in simulations. In the simulation study, the tilt angle of the detector heads relative to the axis was 45°. The distance from the collimator surface of the parallel detector heads to the axis was 130 mm. The distance from the collimator surface of the tilted detector heads to the origin on the axis was 110 mm. A CdTe semiconductor panel with a 1.4 mm detector pitch and a parallel-hole collimator were employed in both types of detector head. A line source phantom, cold-rod brain-shaped phantom, and cerebral blood flow phantom were evaluated. The projection data were generated by forward-projection of the phantom images using physics models, and Poisson noise at clinical levels was applied to the projection data. The ordered-subsets expectation maximization algorithm with physics models was used. We also evaluated conventional SPECT using four parallel detector heads for the sake of comparison. The evaluation of the line source phantom showed that the transaxial FWHM in the central slice for conventional SPECT ranged from 6.1 to 8.5 mm, while that for PT-SPECT ranged from 5.3 to 6.9 mm. The cold-rod brain-shaped phantom image showed that conventional SPECT could visualize up to 8-mm-diameter rods. By contrast, PT-SPECT could visualize up to 6-mm-diameter rods in upper slices of a cerebrum. The cerebral blood flow phantom image showed that the PT-SPECT system provided higher resolution at the thalamus and caudate nucleus as well as at the longitudinal fissure of the cerebrum compared with conventional SPECT. PT-SPECT provides improved image resolution at not only upper but also at

  8. SPECT in psychiatry; Die Bedeutung der Hirn-SPECT in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Kasper, S [Universitaetsklinik fuer Psychiatrie, Wien (Austria); Gruenwald, F [Bonn Univ. (Germany). Klinik fuer Nuklearmedizin; Danos, P [Psychiatrische Universitaetsklinik, Bonn (Germany); Walter, H [Universitaetsklinik fuer Psychiatrie, Wien (Austria); Klemm, E [Bonn Univ. (Germany). Klinik fuer Nuklearmedizin; Bruecke, T [Universitaetsklinik fuer Neurologie, Wien (Austria); Podreka, I [Universitaetsklinik fuer Neurologie, Wien (Austria); Biersack, H J [Bonn Univ. (Germany). Klinik fuer Nuklearmedizin

    1994-10-01

    In the last fifteen years different attempts have been undertaken to understand the biological basis of major psychiatric disorders. One important tool to determine patterns of brain dysfunction is single emission computed tomography (SPECT). Whereas SPECT investigations are already a valuable diagnostic instrument for the diagnosis of dementia of the Alzheimer Type (DAT) there have not been consistent findings that can be referred to as specific for any other particular psychiatric diagnostic entity. Nevertheless, SPECT studies have been able to demonstrate evidence of brain dysfunction in patients with schizophrenia, depression, anxiety disorders, and substance abuse in which other methods showed no clear abnormality of brain function. Our manuscript reviews the data which are currently available in the literature and stresses the need for further studies, especially for prediction and monitoring psychiatric treatment modalities. (orig.) [Deutsch] In den vergangenen 15 Jahren wurde durch verschiedene methodologische Ansaetze versucht, die biologischen Ursachen psychiatrischer Erkrankungen naeher zu erforschen. Als eine bedeutende Methode hat sich dabei die Single-Photonen-Emissions-Computertomographie (SPECT) herausgestellt. Waehrend die SPECT-Untersuchungen bereits Eingang in die Routinediagnostik bei Demenzen vom Alzheimer-Typ gefunden haben, konnten fuer weitere psychiatrische Erkrankungen noch keine eindeutigen Befunde etabliert werden. Mit der SPECT-Methode ist es jedoch gelungen, funktionelle Veraenderungen des Gehirns von psychiatrischen Erkrankungen darzustellen, wie z.B. Schizophrenie, Depression, Angsterkrankungen bzw. Substanzmissbrauch. In Forschungsprotokollen wird durch die SPECT-Methode versucht, abzuklaeren, inwieweit es moeglich ist, innerhalb der Erkrankungsentitaeten psychiatrischer Erkrankungen oder auch diese uebergreifend eine Subklassifizierung zu finden und evtl. Gehirnsysteme ausfindig zu machen, die mit einer spezifischen

  9. Brain SPECT in psychiatry: Delusion or reality?

    International Nuclear Information System (INIS)

    Pavel, D.G.; Davis, G.; Epstein, P.; Kohn, R.; Antonino, F.; Devore-Best, S.; Craita, I.; Liu, P.

    2002-01-01

    Aim: The need for functional information is becoming increasingly evident for proper therapeutic approaches to the treatment and follow up of psychiatric diseases. While data on this subject already exists, there is a general lack of consensus about the use of brain SPECT in this domain and also a considerable negative prejudice due to a number of factors including poor quality imaging and unrealistic expectations. Based on a large group of brain SPECT-s performed over the past 3 years we attempted to sort and refine the indications for SPECT in psychiatry. Materials and Methods: High resolution brain SPECT was performed with triple head gamma camera, super-high resolution fan beam collimator and Tc-HMPAO. A comprehensive semiquantitative color, 3D surface as well as multi-thresholded volume display was routinely used and supplemented by automatic realignment in case of longitudinal follow-up. Results: 470 brain SPECT-s done on 432 patients were all referred by psychiatrists or neuro-psychiatrists for a wide spectrum of psychiatric diseases and ranged in age from 7 to 88 years. The most common primary reasons for referral were : attention deficit hyperactive disorder (ADHD); anxiety; obsessive-compulsive disease, depression (refractory, chronic, bipolar ), impulse control problems; oppositional defiance, post traumatic brain injury; seizures, learning difficulties, pervasive development disorders, memory loss and differential of dementia. Among common denominators were long duration of the disease, unresponsiveness to treatment, worsening of clinical status, and presence of multiple conditions at the same time. The multiparametric display used enabled a comprehensive evaluation of the brain volume which included the hemispheric surfaces; the basal ganglia (striatum) and the thalamus, several components of the limbic and paralimbic systems: anterior and posterior cingulate and their respective subdivisions, insula-s and their subdivisions, apical and mesial

  10. Dynamic gating window for compensation of baseline shift in respiratory-gated radiation therapy

    International Nuclear Information System (INIS)

    Pepin, Eric W.; Wu Huanmei; Shirato, Hiroki

    2011-01-01

    Purpose: To analyze and evaluate the necessity and use of dynamic gating techniques for compensation of baseline shift during respiratory-gated radiation therapy of lung tumors. Methods: Motion tracking data from 30 lung tumors over 592 treatment fractions were analyzed for baseline shift. The finite state model (FSM) was used to identify the end-of-exhale (EOE) breathing phase throughout each treatment fraction. Using duty cycle as an evaluation metric, several methods of end-of-exhale dynamic gating were compared: An a posteriori ideal gating window, a predictive trend-line-based gating window, and a predictive weighted point-based gating window. These methods were evaluated for each of several gating window types: Superior/inferior (SI) gating, anterior/posterior beam, lateral beam, and 3D gating. Results: In the absence of dynamic gating techniques, SI gating gave a 39.6% duty cycle. The ideal SI gating window yielded a 41.5% duty cycle. The weight-based method of dynamic SI gating yielded a duty cycle of 36.2%. The trend-line-based method yielded a duty cycle of 34.0%. Conclusions: Dynamic gating was not broadly beneficial due to a breakdown of the FSM's ability to identify the EOE phase. When the EOE phase was well defined, dynamic gating showed an improvement over static-window gating.

  11. Longitudinal evaluation of early dementia of Alzheimer type using brain perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kogure, Daiji; Matsuda, Hiroshi; Ohnishi, Takashi; Kunihiro, Toshiyuki; Uno, Masataka; Asada, Takashi [National Center Hospital for Mental, Nervous, and Muscular Disorders, Kodaira, Tokyo (Japan); Takasaki, Masaru

    1999-02-01

    Regional cerebral blood flow (rCBF) measurements using a Patlak plot method of {sup 99m}Tc-ECD were performed in early dementia of Alzheimer type (DAT) with both HDS-R and MMSE of over 20 to investigate initial abnormality and longitudinal changes of rCBF. A fusion technique of MRI and SPECT images was developed for MRI-guided analysis of regions of interest in hippocampal areas and statistical parametric mapping (SPM) was used for automated and objective approach to analysis of SPECT image data. Seventeen patients with clinically diagnosed early DAT and age-matched 32 normal control subjects were studied. At the first SPECT studies, the mean cerebral blood flow (mCBF) of 38.6{+-}4.7 ml/100 g/min (mean{+-}SD) for early DAT did not show significant reduction as compared with the normal control value of 42.0{+-}3.8, whereas the rCBF values in the bilateral hippocampi (right; 26.8{+-}4.7, left; 26.7{+-}5.2) showed significant reduction (p<0.05) as compared with the normal control values (right; 38.3{+-}4.2, left; 38.4{+-}3.8). The SPM analysis (voxel height; p<0.001, Bonferroni correction; p<0.05) of the first SPECT images revealed significant selective decrease of relative rCBF in the bilateral posterior cingulate gyri. At the second SPECT studies after 1.4 year on the average from the first studies, mCBF for early DAT showed a slight decrease by 1.7{+-}3.8 ml/100 g/min/year. Bilateral hippocampi showed a greater decrease with slight left side dominance by 3.8{+-}3.3 on the right and 4.4{+-}3.2 on the left side. The SPM analysis demonstrated significant decrease of relative rCBF in the basal forebrain area, the left hippocampus, the left amygdala, and the left parahippocampal area. These results suggest that the MRI-guided ROI analysis of rCBF values in the hippocampus and the SPM analysis of SPECT images are quite useful for early diagnosis and follow-up of DAT. (author)

  12. A small-animal imaging system capable of multipinhole circular/helical SPECT and parallel-hole SPECT

    International Nuclear Information System (INIS)

    Qian Jianguo; Bradley, Eric L.; Majewski, Stan; Popov, Vladimir; Saha, Margaret S.; Smith, Mark F.; Weisenberger, Andrew G.; Welsh, Robert E.

    2008-01-01

    We have designed and built a small-animal single-photon emission computed tomography (SPECT) imaging system equipped with parallel-hole and multipinhole collimators and capable of circular or helical SPECT. Copper-beryllium parallel-hole collimators suitable for imaging the ∼35 keV photons from the decay of 125 I have been built and installed to achieve useful spatial resolution over a range of object-detector distances and to reduce imaging time on our dual-detector array. To address the resolution limitations in the parallel-hole SPECT and the sensitivity and limited field of view of single-pinhole SPECT, we have incorporated multipinhole circular and helical SPECT in addition to expanding the parallel-hole SPECT capabilities. The pinhole SPECT system is based on a 110 mm diameter circular detector equipped with a pixellated NaI(Tl) scintillator array (1x1x5 mm 3 /pixel). The helical trajectory is accomplished by two stepping motors controlling the rotation of the detector-support gantry and displacement of the animal bed along the axis of rotation of the gantry. Results obtained in SPECT studies of various phantoms show an enlarged field of view, very good resolution and improved sensitivity using multipinhole circular or helical SPECT. Collimators with one, three and five, 1-mm-diameter pinholes have been implemented and compared in these tests. Our objective is to develop a system on which one may readily select a suitable mode of either parallel-hole SPECT or pinhole circular or helical SPECT for a variety of small animal imaging applications

  13. Filters in 2D and 3D Cardiac SPECT Image Processing

    Directory of Open Access Journals (Sweden)

    Maria Lyra

    2014-01-01

    Full Text Available Nuclear cardiac imaging is a noninvasive, sensitive method providing information on cardiac structure and physiology. Single photon emission tomography (SPECT evaluates myocardial perfusion, viability, and function and is widely used in clinical routine. The quality of the tomographic image is a key for accurate diagnosis. Image filtering, a mathematical processing, compensates for loss of detail in an image while reducing image noise, and it can improve the image resolution and limit the degradation of the image. SPECT images are then reconstructed, either by filter back projection (FBP analytical technique or iteratively, by algebraic methods. The aim of this study is to review filters in cardiac 2D, 3D, and 4D SPECT applications and how these affect the image quality mirroring the diagnostic accuracy of SPECT images. Several filters, including the Hanning, Butterworth, and Parzen filters, were evaluated in combination with the two reconstruction methods as well as with a specified MatLab program. Results showed that for both 3D and 4D cardiac SPECT the Butterworth filter, for different critical frequencies and orders, produced the best results. Between the two reconstruction methods, the iterative one might be more appropriate for cardiac SPECT, since it improves lesion detectability due to the significant improvement of image contrast.

  14. An evaluation of the cerebral hemodynamics in moyamoya disease with acetazolamide (Diamox) 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Qin-Yi, Gao; Kuwabara, Yasuo; Ichiya, Yuichi

    1994-01-01

    We studied the cerebral hemodynamics using Diamox 99m Tc-HMPAO SPECT in 9 patients with moyamoya disease, consisting of 4 children and 5 adults. Diamox 99m Tc-HMPO SPECT studies were performed by the double injection method. Hypoperfusion areas were scored by a visual inspection as follows: ++, definite positive; +, probable positive; -, negative. Diamox test was interpreted as positive when the score increased over one degree. In the resting state, 6 out of 9 patients showed definite or probable positive hypoperfusion, while all of 9 patients showed a similar finding after Diamox injection. The Diamox test was positive in 6 out of 9 patients. It was positive in all 3 patients who showed a negative hypoperfusion in the resting state. The regional cerebrovascular response to Diamox was most severely impaired in the frontal region. However, it was relatively well preserved in the cerebellum and thalamus according to the semiquantiative analysis. Thus, the Diamox HOPAO SPECT was considered to be useful in evaluating the hemodynamics in patients with moyamoya disease. (author)

  15. The Performance of Ictal Brain SPECT for Localizing Epileptogenic Foci in Temporal Lobe epilepsies

    International Nuclear Information System (INIS)

    Kim, Eun Sil; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Chang, Kee Hyun; Lee, Sang Kun; Chung, Chun Kee

    1995-01-01

    Anterior temporal lobectomy has become a widely used respective surgery in patients with medically intractable temporal lobe epilepsies. Prerequisites of this resection include the accurate localization of the epileptogenic focus and the determination that the proposed resection would not result in unacceptable postoperative memory or language deficits. The purpose of this study was to evaluate the performance of ictal SPECT compared to MRI findings for localization of epileptogenic foci in this group of patients. 11 patients who had been anterior temporal oral lobectomy were evaluated with ictal 99m Tc-HMPAO SPECT and MRI. MRI showed 8/11(73%) concordant lesion to the side of surgery and ictal SPECT also showed 8/11(73%) concordant hyperperfusion. In 3 cases with incorrect or nonlocalizing findings of MRI, ictal SPECT showed concordant hyperperfusion. In 2 cases confirmed by pre-resectional invasive EEG, MRI showed bilateral and contralateral lesion but ictal SPECT showed concordant hyperperfusion. 3 delayed injection of ictal SPECT showed discordant hyperperfusion. Thus, ictal SPECT was a useful method for localizing epileptogenic foci in temporal lobe epilepsies and appeared complementay to MRI.

  16. Diagnostic pathway of integrated SPECT/CT for coronary artery disease

    International Nuclear Information System (INIS)

    Slart, Riemer H.J.A.; Tio, Rene A.; Zijlstra, Felix; Dierckx, Rudi A.

    2009-01-01

    Treatment strategy in patients with suspected coronary artery disease (CAD) is driven by symptomatology in combination with diagnostic evaluation of the extent and/or severity of atherosclerosis in the coronary arteries and ischemia in the myocardium, i.e., the anatomic and functional correlates of CAD. Whereas multislice row computed tomography (MSCT) has the advantage of detecting coronary atherosclerosis at its earliest stages, thereby allowing initiation of appropriate therapeutic measures well before development of obstructive CAD, myocardial perfusion imaging (MPI) SPECT can clarify the hemodynamic consequences of the anatomic findings on MSCT based on a functional assessment of myocardial blood flow. There is a lack of correlation between coronary artery calcium (CAC), coronary artery stenosis, and MPI SPECT. Therefore CAC scoring and stress MPI should be thus considered complementary approaches rather than exclusionary in the evaluation of the patient at risk for CAD. The integration of anatomic and functional information may provide additional information for the clinician by the improved risk stratification and diagnostic accuracy of integrated techniques. The majority of previous studies are based on a sequential flowchart, starting with either SPECT or CAC scoring that finally directs the therapeutic strategy. Patients at low risk for CAD can be selected for primary prevention, and patients at high risk for CAD can be directly selected for coronary angiography (CAG). The remaining group of patients at intermediate risk for CAD can be substratified into lower- and higher-risk categories based on the presence or absence of stress-induced ischemia on MPI SPECT and CAC scoring. An integration of SPECT and CAC as a starting point for CAD detection in symptomatic patients at intermediate risk for CAD may facilitate a tailored diagnostic as well as therapeutic approach. Finally, using SPECT/CT, MPI SPECT, and CAC findings may be completed with CT angiography

  17. The role of bone SPECT/CT in the evaluation of lumbar spinal fusion with metallic fixation devices

    DEFF Research Database (Denmark)

    Damgaard, Morten; Nimb, Lars; Madsen, Jan L

    2010-01-01

    PURPOSE: It is difficult to evaluate the stability of the lumbar spondylodesis with metallic fixation devices by conventional imaging methods such as radiography or magnetic resonance imaging. It is unknown whether single photon emission computed tomography/computed tomography (SPECT/CT) may be u...

  18. Prognostic value of myocardial perfusion SPECT images in combination with the maximal heart rate at exercise testing in Japanese patients with suspected ischemic heart disease. A sub-analysis of J-ACCESS

    International Nuclear Information System (INIS)

    Ueshima, Kenji; Usami, Satoru; Yasuno, Shinji; Nakao, Kazuwa; Yamashina, Akira; Nishiyama, Osamu; Yamazaki, Takuya; Nishimura, Tsunehiko

    2009-01-01

    We assessed whether a combination of summed stress scores (SSS) using exercise myocardial perfusion single photon emission computed tomography (SPECT) (Ex-SPECT) and maximal heart rate accurately predicts cardiac events through a sub-analysis of J-ACCESS (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT) which was conducted to evaluate the prognosis of Japanese patients with suspected ischemic heart disease. In J-ACCESS, 2,373 patients with suspected coronary artery disease not receiving beta-blocker treatment underwent Ex-SPECT. These patients were categorized into the following four groups: Group A [achieved target heart rate (THR) and SSS<4: n=631], B (did not achieve THR and SSS<4: n=612), C (achieved THR and SSS≥4: n=570), and D (did not achieve THR and SSS≥4: n=560). We evaluated the incidence rate of cardiac events including cardiac death, myocardial infarction, and heart failure requiring hospital admission during a 3-year period. In Group A, B, C, and D, 9 of 631 (1.4%), 15 of 612 (2.4%), 23 of 570 (4.0%) and 30 of 560 (5.4%) patients experienced cardiac events, respectively. Although the hazard ratio of the SSS≥4 was 2.45 (p<0.001) and that of the attained THR was 0.69 (p=0.10) in the multiple Cox regression analysis, Kaplan-Meier curves showed that the cardiac events rate was lower in the order of A, B, C, and D (p<0.001). The combination of SSS using Ex-SPECT and the maximal heart rate is a useful predictor of cardiac events in patients with suspected coronary artery disease. (author)

  19. Impaired coronary flow reserve is the most important marker of viable myocardium in the myocardial segment-based analysis of dual-isotope gated myocardial perfusion single-photon emission computed tomography

    International Nuclear Information System (INIS)

    Lee, Won Woo; So, Young; Kim, Ki Bong; Lee, Dong Soo

    2014-01-01

    The aim of this study was to investigate the most robust predictor of myocardial viability among stress/rest reversibility (coronary flow reserve [CFR] impairment), 201 Tl perfusion status at rest, 201 Tl 24 hours redistribution and systolic wall thickening of 99m Tc-methoxyisobutylisonitrile using a dual isotope gated myocardial perfusion single-photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) who were re-vascularized with a coronary artery bypass graft (CABG) surgery. A total of 39 patients with CAD was enrolled (34 men and 5 women), aged between 36 and 72 years (mean 58 ± 8 standard in years) who underwent both pre- and 3 months post-CABG myocardial SPECT. We analyzed 17 myocardial segments per patient. Perfusion status and wall motion were semi-quantitatively evaluated using a 4-point grading system. Viable myocardium was defined as dysfunctional myocardium which showed wall motion improvement after CABG. The left ventricular ejection fraction (LVEF) significantly increased from 37.8 ± 9.0% to 45.5 ± 12.3% (p 201 Tl rest perfusion status (p = 0.024) were significant predictors of wall motion improvement. However, in multiple logistic regression analysis, stress/rest reversibility alone was a significant predictor for post-CABG wall motion improvement (p < 0.001). Stress/rest reversibility (impaired CFR) during dual-isotope gated myocardial perfusion SPECT was the single most important predictor of wall motion improvement after CABG.

  20. Evaluation of the parameters of SPECT images for yttrium-90 in radiosinoviorthesis; Avaliação dos parâmetros de aquisição de imagens SPECT para ítrio-90 em radiosinoviortese

    Energy Technology Data Exchange (ETDEWEB)

    Toledo, B.C. de; Sáa, L.V. de, E-mail: bruce.de.toledo@gmail.com [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Física Médica; Ramos, S.M.; Coelho, F.A.; Thomas, S.; Souza, S.A. de; Pinheiro, M.A. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Hospital Universitário Clementino Fraga Filho

    2017-07-01

    Introduction: the evaluation of the distribution of radioactive material in the articulation by SPECT images after radiosinoviorthesis (RSO) can guarantee the efficacy of this therapy. However, Bremsstrahlung image quality has major limitations, necessitating studies on SPECT image acquisition parameters and yttrium-90 image reconstruction methods. Methods: SPECT images were obtained from an acrylic simulator containing four cylindrical inserts to simulate capturing lesions. The images were obtained with collimators of high, medium and low (HEGP, MEGP and LEHR) energy; 130 keV power window, 70% width and 64 x 64 matrix. The reconstruction methods used were: FBP and OSEM with different filters. Results: 45 results found. The images obtained with the MEGP and HEGP collimators presented better results than those obtained with the LEHR collimator. The OSEM reconstructions were superior when the MEGP and HEGP collimators were used. Conclusions: The acquisition of yttrium-90 SPECT images with MEGP collimators showed higher sensitivity, whereas those obtained with HEPG collimators presented lower noise. The image reconstruction methods have relevant importance in the image quality, showing a significant difference between the FBP and OSEM reconstructions and between the filters used.

  1. Usefulness of {sup 99m}Tc-HMPAO SPECT in Patients with Subarachnoid Hemorrhage due to Ruptured Intracranial Aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Choi, C. W.; Lee, K. H.; Kim, J. H.; Kwark, C. E.; Lee, D. S.; Chung, J. K.; Lee, M. C.; Han, D. H.; Koh, C. S. [Seoul National University Hospital, Seoul (Korea, Republic of)

    1993-07-15

    We evaluated the usefulness of {sup 99m}Tc-HMPAO SPECT in 21 Patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm and in 3 patients with unruptured intracranial aneurysm. SPECT study could detect the bilaterally hypoperfused cases in 10 patients(48%), but CT/MRI showed the bilateral abnormalities in only 3 patients(14%). The number of abnormal lesions were 56 in SPECT and 25 in CT/MRI. The lesions found in SPECT were well correlated with the neurological signs of the patients such as aphasia or hemiplegia. SPECT study during Matas test was helpful in evaluating the risk for carotid artery occlusion therapy. We thought that {sup 99m}Tc-HMPAO brain SPECT is helpful in evaluating the functional changes in patients with subarachnoid hemorrhage.

  2. [sup 99m]Tc-ECD SPECT study in dementia and aphasia

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo; Ichiya, Yuichi; Otsuka, Makoto; Sasaki, Masayuki; Akashi, Yuko; Fukumura, Toshimitsu; Yoshida, Tsuyoshi; Masuda, Kouji; Ichimiya, Atsushi (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine)

    1993-09-01

    We studied clinical significance of [sup 99m]Tc-L,L,-ethyl cysteine dimer ([sup 99m]Tc-ECD) SPECT study in dementia and aphasia, and compared it with [sup 99m]Tc-HMPAO SPECT study. The subjects consisted of 13 patients, including 10 patients with dementia and 3 patients with aphasia. Hypoperfusion areas were detected in 5 out of 10 patients with dementia and 2 out of 3 patients with aphasia in [sup 99m]Tc-ECD SPECT, and in 4 out of 10 patients with dementia and all of 3 patients with aphasia in [sup 99m]Tc-HMPAO SPECT. The count rate ratios in [sup 99m]Tc-ECD and [sup 99m]Tc-HMPAO SPECT were correlated well with each other, and the contrast of the [sup 99m]Tc-ECD SPECT image was equivalent or slightly higher as compared with [sup 99m]Tc-HMPAO. Therefore, [sup 99m]Tc-ECD SPECT study was considered to be useful for the evaluation of cerebral perfusion in dementia and aphasia. (author).

  3. 99mTc-MIBI-SPECT-studies in the evaluation of brain tumors

    International Nuclear Information System (INIS)

    Ambrus, E.; Pavics, L.; Gruenwald, F.; Barath, B.; Tiszlavicz, L.; Bender, H.; Menzel, C.; Almasi, L.; Lang, J.; Bodosi, M.; Biersack, H.J.; Csernay, L.

    1994-01-01

    Brain SPECT studies were performed 5 and 60 minutes after 99m Tc-MIBI administration in 41 patients with brain tumors confirmed by CT and surgical removal (13 meningeomas, 8 astrocytomas grades I-III, 10 glioblastomas, 10 metastases). 99m Tc-MIBI uptake was found in 32 out of 41 brain tumors. According to the semiquantitative SPECT analysis, the tumor/non tumor radios revealed a statistically significant difference in the early tracer uptake between meningeomas and astrocytomas (+4.73±2.91 vs -1.75±0.75, p 99m Tc-MIBI uptake and its changes with time. We concluded that the combination of an early and late 99m Tc-MIBI brain SPECT may be helpful in the non invasive histological classification of brain tumors and the determination of the grade of theirs malignancy. (orig.) [de

  4. SPECT assay of radiolabeled monoclonal antibodies. Final performance report, March 1992--November 1995

    Energy Technology Data Exchange (ETDEWEB)

    Jaszczak, R.J.

    1995-12-01

    Research is described in the following areas: development and evaluation quantitatively of reconstruction algorithms with improved compensations for attenuation, scatter, and geometric collimator response; evaluation of single photon emission computed tomography (SPECT) quantification of iodine 123 and astatine 211; and the development and evaluation of SPECT pinhole imaging for low and medium energy photons.

  5. SPECT assay of radiolabeled monoclonal antibodies. Final performance report, March 1992--November 1995

    International Nuclear Information System (INIS)

    Jaszczak, R.J.

    1995-12-01

    Research is described in the following areas: development and evaluation quantitatively of reconstruction algorithms with improved compensations for attenuation, scatter, and geometric collimator response; evaluation of single photon emission computed tomography (SPECT) quantification of iodine 123 and astatine 211; and the development and evaluation of SPECT pinhole imaging for low and medium energy photons

  6. Usefulness of hyperventilation myocardial SPECT for diagnosing vasospastic angina pectoris

    International Nuclear Information System (INIS)

    Tahara, Yorio; Shimoyama, Katsuya; Nishimura, Tooru; Sasaki, Akira; Taya, Makoto; Mizuno, Haruyoshi; Ono, Akifumi; Tsuya, Tsuneo; Ishikawa, Kyozo

    1990-01-01

    We evaluated the usefulness of hyperventilation myocardial scintigraphy (HV-SPECT) for diagnosing vasospastic angina pectoris. The subjects consisted of 11 patients with rest angina and 13 with rest and exertional angina in whom coronary spasm was demonstrated by coronary angiography, and 6 with exertional angina in whom a significant stenotic lesion was observed by coronary angiography. Hyperventilation was performed at a rate of 40/min for 5 minutes in all the patients. Ischemia was considered to be present when defect and redistribution were observed by SPECT. HV-SPECT revealed positive findings in 8 patients with rest angina (73%) and 9 with exertional and rest angina (69%) but only in 1 with exertional angina (17%). Ischemic ST changes on monitor ECG were observed in 13 of the 30 patients (43%); ST was enhanced in 4 patients and depressed in 9 patients. In the patients with rest angina, HV-SPECT induced ischemic findings more frequently than exercise SPECT (73% vs 55%). HV-SPECT seems to be useful as a non-invasive method for diagnosing angina pectoris resulting from coronary spasm. (author)

  7. Development of the new phantom for evaluation of SPECT performance

    International Nuclear Information System (INIS)

    Fukukita, H.; Oyamada, H.; Nagaiwa, K.; Kawai, H.; Terui, S.

    1984-01-01

    The authors developed a new Phantom designed to evaluate the SPECT system performances of rotational gamma cameras. This phantom is composed of 5 parts, and each of them has its own purpose; such as measurements of 1) spatial resolution 2) slice thickness, 3) dose linearity, 4) uniformity, and 5) image distortion. These parts are made of Acrylic (0.8 cm in thickness) and each of them has the same disc-shape, measuring 28.4 cm in inner diameter and 7 cm in inner length. For the large field of view cameras, it is possible to set up-to 4 parts together if necessary. Therefore, 4 different parameters can be obtained at one rotation. The phantom was filled with Tc-99m solution, and SPET data were obtained as follows: for the determination of spatial resolution and slice thickness, 128 linear sampling with every 5 0 angular rotation was performed, and 64 linear sampling with every 10 0 angular rotation for dose linearity uniformity, and image distortion. The values obtained with the phantom were FWHM of 19.1 mm for spatial resolution, FWHM of 19.9 mm for slice thickness, and integral uniformity of 36.4%. For dose linearity a good correlating (r=0.99) was obtained. For image distortion it was easy to detect the misalignment of the electrical and mechanical axes. The authors found that this phantom was a suitable tool as a routine quality control and daily maintenance of SPECT system

  8. Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina

    International Nuclear Information System (INIS)

    Hacker, Marcus; Hack, Nicolas; Hahn, Klaus; Tiling, Reinhold; Jakobs, Tobias; Nikolaou, Konstantin; Becker, Christoph; Reiser, Maximilian; Ziegler, Franz von; Knez, Andreas; Koenig, Andreas; Klauss, Volker

    2007-01-01

    The aim of this study was to evaluate spiral multidetector computed tomography (MDCT) angiography using 64-slice technique in the detection of functionally relevant coronary artery stenoses (CAS). Thirty-eight patients (62±11 years, 28 men) with stable angina (26 with suspected and 12 with known coronary artery disease) were investigated using 64-slice MDCT angiography and gated myocardial perfusion SPECT (gated SPECT); a subgroup of 30 patients had additional invasive coronary angiography (ICA). Stenoses with luminal narrowing of ≥50% were defined as ''significant'' in MDCT angiography and ICA. MDCT angiography was compared with gated SPECT and the combination of gated SPECT plus ICA with respect to the detection of functionally relevant CAS. The sensitivity, specificity and negative and positive predictive values of MDCT angiography in detecting reversible perfusion defects on gated SPECT were 63%, 80%, 94% and 32%, respectively, in vessel-based analysis and 71%, 62%, 72% and 60%, respectively, in patient-based analysis. If only reversible perfusion defects on gated SPECT with CAS ≥50% on ICA were considered, the sensitivity, specificity and negative and positive predictive values were, respectively, 85%, 79%, 98% and 33% for vessel-based analysis and 85%, 59%, 83% and 61% for patient-based analysis. Sixty-four slice MDCT angiography failed to predict the functional relevance of CAS, but had a high negative predictive value in the exclusion of functionally relevant CAS in symptomatic patients. (orig.)

  9. Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, Marcus; Hack, Nicolas; Hahn, Klaus; Tiling, Reinhold [Ludwig-Maximilians-University, Department of Nuclear Medicine, Munich (Germany); Jakobs, Tobias; Nikolaou, Konstantin; Becker, Christoph; Reiser, Maximilian [Ludwig-Maximilians-University, Department of Clinical Radiology, Munich (Germany); Ziegler, Franz von; Knez, Andreas [Ludwig-Maximilians-University, Department of Cardiology, Klinikum Grosshadern, Munich (Germany); Koenig, Andreas; Klauss, Volker [Ludwig-Maximilians-University, Department of Cardiology, Medizinische Poliklinik-Innenstadt, Munich (Germany)

    2007-01-15

    The aim of this study was to evaluate spiral multidetector computed tomography (MDCT) angiography using 64-slice technique in the detection of functionally relevant coronary artery stenoses (CAS). Thirty-eight patients (62{+-}11 years, 28 men) with stable angina (26 with suspected and 12 with known coronary artery disease) were investigated using 64-slice MDCT angiography and gated myocardial perfusion SPECT (gated SPECT); a subgroup of 30 patients had additional invasive coronary angiography (ICA). Stenoses with luminal narrowing of {>=}50% were defined as ''significant'' in MDCT angiography and ICA. MDCT angiography was compared with gated SPECT and the combination of gated SPECT plus ICA with respect to the detection of functionally relevant CAS. The sensitivity, specificity and negative and positive predictive values of MDCT angiography in detecting reversible perfusion defects on gated SPECT were 63%, 80%, 94% and 32%, respectively, in vessel-based analysis and 71%, 62%, 72% and 60%, respectively, in patient-based analysis. If only reversible perfusion defects on gated SPECT with CAS {>=}50% on ICA were considered, the sensitivity, specificity and negative and positive predictive values were, respectively, 85%, 79%, 98% and 33% for vessel-based analysis and 85%, 59%, 83% and 61% for patient-based analysis. Sixty-four slice MDCT angiography failed to predict the functional relevance of CAS, but had a high negative predictive value in the exclusion of functionally relevant CAS in symptomatic patients. (orig.)

  10. Evaluation of the diagnosis for hypertrophic cardiomyopathy (HCM) with SPECT

    International Nuclear Information System (INIS)

    Li Jiaxiu

    1992-01-01

    A heart phantom-7070 was used to measure the wall thickness of cardiac chambers. Two methods were employed: (1) profile curve measurement, (2) calculation of the thickness of cardiac walls. 9 normal cases and 13 patients with hypertrophic cardiomyopathy were studied using 99m Tc-CDI SPECT. 4 patterns were obtained: (1) Local hypertrophy of ventricular septum; (2) The predominant hypertrophy localized in left ventricular lateral wall; (3) Markedly hypertrophied septum and also involving left ventricular walls, especially the apical region; (4) Markedly hypertrophied papillary muscles with perfusion defects in the left wall and septum. These results suggest that myocardial SPECT is a promising and noninvasive method for the diagnosis of HCM

  11. Initial validation of 4D-model for a clinical PET scanner using the Monte Carlo code gate

    International Nuclear Information System (INIS)

    Vieira, Igor F.; Lima, Fernando R.A.; Gomes, Marcelo S.; Vieira, Jose W.; Pacheco, Ludimila M.; Chaves, Rosa M.

    2011-01-01

    Building exposure computational models (ECM) of emission tomography (PET and SPECT) currently has several dedicated computing tools based on Monte Carlo techniques (SimSET, SORTEO, SIMIND, GATE). This paper is divided into two steps: (1) using the dedicated code GATE (Geant4 Application for Tomographic Emission) to build a 4D model (where the fourth dimension is the time) of a clinical PET scanner from General Electric, GE ADVANCE, simulating the geometric and electronic structures suitable for this scanner, as well as some phenomena 4D, for example, rotating gantry; (2) the next step is to evaluate the performance of the model built here in the reproduction of test noise equivalent count rate (NEC) based on the NEMA Standards Publication NU protocols 2-2007 for this tomography. The results for steps (1) and (2) will be compared with experimental and theoretical values of the literature showing actual state of art of validation. (author)

  12. Initial validation of 4D-model for a clinical PET scanner using the Monte Carlo code gate

    Energy Technology Data Exchange (ETDEWEB)

    Vieira, Igor F.; Lima, Fernando R.A.; Gomes, Marcelo S., E-mail: falima@cnen.gov.b [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil); Vieira, Jose W.; Pacheco, Ludimila M. [Instituto Federal de Educacao, Ciencia e Tecnologia (IFPE), Recife, PE (Brazil); Chaves, Rosa M. [Instituto de Radium e Supervoltagem Ivo Roesler, Recife, PE (Brazil)

    2011-07-01

    Building exposure computational models (ECM) of emission tomography (PET and SPECT) currently has several dedicated computing tools based on Monte Carlo techniques (SimSET, SORTEO, SIMIND, GATE). This paper is divided into two steps: (1) using the dedicated code GATE (Geant4 Application for Tomographic Emission) to build a 4D model (where the fourth dimension is the time) of a clinical PET scanner from General Electric, GE ADVANCE, simulating the geometric and electronic structures suitable for this scanner, as well as some phenomena 4D, for example, rotating gantry; (2) the next step is to evaluate the performance of the model built here in the reproduction of test noise equivalent count rate (NEC) based on the NEMA Standards Publication NU protocols 2-2007 for this tomography. The results for steps (1) and (2) will be compared with experimental and theoretical values of the literature showing actual state of art of validation. (author)

  13. Tc-99m ECD brain SPECT in MELAS syndrome: comparison with MR finding

    International Nuclear Information System (INIS)

    Park, Sang Joon; Ryu, Young Hoon; Yoon, Pyeong Ho; Jeon, Tae Joo; Kim, Jai Keun; Nam, Ji Eun; Lee, Jong Doo; Lee, Byung Hee; Shin, Hyung Cheol

    1998-01-01

    The purpose of this study was to evaluate SPECT findings of MELAS syndrome and mitochondrial myopathy and correlate them with MR findings in search of specific imaging features and to assess the role of SPECT in MELAS syndrome. Five patients (four females and one male; age range, 1 to 25 years) who presented with repeated stroke-like episodes or seizures or developmental delay or were asymptomatic but had elevated lactic acid in CSF and serum were evaluated with conventional noncontrast MR imaging and SPECT. MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly on the parietal (4/5) and occipital lobes (4/5) and in the basal ganglias (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased uptake of Tc-99m ECD on parietal (5/5) and occipital (4/5) and temporal (2/5) and frontal (1/5) lobe and basal ganglia (2/5) and thalami (2/5). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion is noted on left parietal area and bilateral thalami. Comparison of the numbers of abnormal findings revealed that decreased perfusion seen on SPECT were more numerous than anatomical abnormalities seen on MRI. SPECT may be a sensitive method for pathophysiological study of metabolic disturbances in MELAS. Moreover, in patients with mitochondrial myopathy without clinical encephalopathy, SPECT may play a role in evaluating subclinical encephalopathy even with normal conventional MR findings

  14. Memory-provoked rCBF-SPECT as a diagnostic tool in Alzheimer's disease?

    International Nuclear Information System (INIS)

    Sundstroem, Torbjoern; Riklund, Katrine Aa.; Elgh, Eva; Naesman, Birgitta; Larsson, Anne; Nyberg, Lars

    2006-01-01

    Alzheimer's disease (AD) is a primary degenerative disease that progressively affects all brain functions, with devastating consequences for the patient, the patient's family and society. Rest regional cerebral blood flow (rCBF) could have a strategic role in differentiating between AD patients and normal controls, but its use for this purpose has a low discriminatory capacity. The purpose of this study was to evaluate whether the diagnostic sensitivity of rCBF single-photon emission computed tomography (SPECT) could be increased by using an episodic memory task provocation, i.e. memory-provoked rCBF-SPECT (MP-SPECT). Eighteen persons (73.2±4.8 years) with mild AD and 18 healthy elderly (69.4±3.9 years) were included in the study. The subjects were injected with 99m Tc-hexamethylpropylene amine oxime (HMPAO) during memory provocation with faces and names, followed by an rCBF-SPECT study. The rCBF 99m Tc-HMPAO SPECT images were analysed using statistical parametric mapping (SPM2). Peaks with a false discovery rate corrected value of 0.05 were considered significant. On MP-SPECT, the AD group showed a significant rCBF reduction in the left parietal cortex in comparison with healthy elderly. At rest, no significant group differences were seen. Memory provocation increased the sensitivity of rCBF-SPECT for the detection of AD-related blood flow changes in the brain at the group level. Further studies are needed to evaluate MP-SPECT as a diagnostic tool at the individual level. If a higher sensitivity for AD at the individual level is verified in future studies, a single MP-SPECT study might be sufficient in the clinical setting. (orig.)

  15. Pinhole SPECT: high resolution imaging of brain tumours in small laboratory animals

    International Nuclear Information System (INIS)

    Franceschim, M.; Bokulic, T.; Kusic, Z.; Strand, S.E.; Erlandsson, K.

    1994-01-01

    The performance properties of pinhole SPECT and the application of this technology to evaluate radionuclide uptake in brain in small laboratory animals were investigated. System sensitivity and spatial resolution measurements of a rotating scintillation camera system were made for a low energy pinhole collimator equipped with 2.0 mm aperture pinhole insert. Projection data were acquired at 4 degree increments over 360 degrees in the step and shoot mode using a 4.5 cm radius of rotation. Pinhole planar and SPECT imaging were obtained to evaluate regional uptake of Tl-201, Tc-99m-MIBI, Tc-99m-HMPAO and Tc-99m-DTPA in tumor and control regions of the brain in a primary brain tumor model in Fisher 344 rats. Pinhole SPECT images were reconstructed using a modified cone- beam algorithm developed from a two dimensional fan-beam filtered backprojection algorithm. The reconstructed transaxial resolution of 2.8 FWHM and system sensitivity of 0.086 c/s/kBq with the 2.0 mm pinhole collimator aperture were measured. Tumor to non-tumor uptake ratios at 19-28 days post tumor cell inoculation varied by a factor > 20:1 on SPECT images. Pinhole SPECT provides an important new approach for performing high resolution imaging: the resolution properties of pinhole SPECT are superior to those which have been achieved with conventional SPECT or PET imaging technologies. (author)

  16. SPECT of aged backache patients

    International Nuclear Information System (INIS)

    Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki

    1995-01-01

    Single photon emission computed tomography (SPECT) using 99m Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. 99m Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.)

  17. Labeled receptor ligands for spect

    International Nuclear Information System (INIS)

    Kung, H.F.

    1989-01-01

    Receptor specific imaging agents for single photon emission computed tomography (SPECT) can potentially be useful in the understanding of basic biochemistry and pharmacology of receptors. SPECT images may also provide tools for evaluation of density and binding kinetics of a specific receptor, information important for diagnosis and patient management. Basic requirements for receptor imaging agents are: (a) they are labeled with short-lived isotopes, (b) they show high selectivity and specific uptake, (c) they exhibit high target/background ratio, and (d) they can be modeled to obtain quantitative information. Several good examples of CNS receptor specific ligands labeled with I-123 have been developed, including iodoQNB, iodoestrogen iodobenzadiazepine, iodobenazepine, iodobenzamides for muscarinic, estrogen benzadiazepine, D-1 and D-2 dopamine receptors. With the advent of newer and faster SPECT imaging devices, it may be feasible to quantitate the receptor density by in vivo imaging techniques. These new brain imaging agents can provide unique diagnostic information, which may not be available through other imaging modalities, such as CT and MRI

  18. Tc-99m MAG3 SPECT on transplanted kidney

    International Nuclear Information System (INIS)

    Ryu, Jong Gul; Kim, Soon; Zeon, Seok Kil

    1999-01-01

    This study was designed to evaluate the usefulness of a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) single photon emission computed tomography (SPECT) performed on transplanted kidney. Thirty renal transplant patients were included in this study. Planar scan was performed for 30 minutes using 555 MBq Tc-99m MAG3. A post-voiding SPECT scan was acquired on the third, seventh, fourteenth and twenty eighth day after transplantation. SPECT scan showed interpretable image quality in 26 of 30 patients (86.7%) and 84 in 120 scans (70%). Fourteen of 26 patients with interpretable SPECT image showed decreased or increased radioactivity, but only 5 had abnormal findings on the planar scan. Focal SPECT defects were seen in allografts with normal function (n=3), acute tubular necrosis (n=3), and acute rejection (n=2). The defects are thought to reflect focally underperfused renal parenchyme or, in normal allografts, an artifact from uneven radioactivity distribution. Four of 10 paints with renal arterial variation showed focally decreased radioactivity and SPECT helped guide further studies that confirmed the exact cause. Five of 10 patients with acute tubular necrosis or acute rejection showed focally decreased radioactivity, but its relation to the patients' clinical course was not clear. Focally increased radioactivity was observed in 5 allografts with normal function and 1 with double ureter in which local clearance delay was observed. Tc-99m MAG3 SPECT renal scan can detect additional focal abnormalities compared to planar scan. Further study is necessary to elucidate the exact clinical significance of the SPECT findings

  19. Performance characterization of the Inveon preclinical small-animal PET/SPECT/CT system for multimodality imaging

    International Nuclear Information System (INIS)

    Magota, Keiichi; Kubo, Naoki; Kuge, Yuji; Nishijima, Ken-ichi; Zhao, Songji; Tamaki, Nagara

    2011-01-01

    We investigated the performance of the Inveon small-animal PET/SPECT/CT system and compared the imaging capabilities of the SPECT and PET components. For SPECT, the energy resolution, tomographic spatial resolution and system sensitivity were evaluated with a 99m Tc solution using a single pinhole collimator. For PET, the spatial resolution, absolute sensitivity, scatter fraction and peak noise equivalent count were evaluated. Phantoms and a normal rat were scanned to compare the imaging capabilities of SPECT and PET. The SPECT spatial resolution was 0.84 mm full-width at half-maximum (FWHM) at a radius of rotation of 25 mm using a 0.5-mm pinhole aperture collimator, while the PET spatial resolution was 1.63 mm FWHM at the centre. The SPECT system sensitivity at a radius of rotation of 25 mm was 35.3 cps/MBq (4 x 10 -3 %) using the 0.5-mm pinhole aperture, while the PET absolute sensitivity was 3.2% for 350-650 keV and 3.432 ns. Accordingly, the volume sensitivity of PET was three orders of magnitude higher than that of SPECT. This integrated PET/SPECT/CT system showed high performance with excellent spatial resolution for SPECT and sensitivity for PET. Based on the tracer availability and system performance, SPECT and PET have complementary roles in multimodality small-animal imaging. (orig.)

  20. Ventilation/perfusion SPECT/CT in patients with pulmonary emphysema. Evaluation of software-based analysing.

    Science.gov (United States)

    Schreiter, V; Steffen, I; Huebner, H; Bredow, J; Heimann, U; Kroencke, T J; Poellinger, A; Doellinger, F; Buchert, R; Hamm, B; Brenner, W; Schreiter, N F

    2015-01-01

    The purpose of this study was to evaluate the reproducibility of a new software based analysing system for ventilation/perfusion single-photon emission computed tomography/computed tomography (V/P SPECT/CT) in patients with pulmonary emphysema and to compare it to the visual interpretation. 19 patients (mean age: 68.1 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. Data were analysed by two independent observers in visual interpretation (VI) and by software based analysis system (SBAS). SBAS PMOD version 3.4 (Technologies Ltd, Zurich, Switzerland) was used to assess counts and volume per lung lobe/per lung and to calculate the count density per lung, lobe ratio of counts and ratio of count density. VI was performed using a visual scale to assess the mean counts per lung lobe. Interobserver variability and association for SBAS and VI were analysed using Spearman's rho correlation coefficient. Interobserver agreement correlated highly in perfusion (rho: 0.982, 0.957, 0.90, 0.979) and ventilation (rho: 0.972, 0.924, 0.941, 0.936) for count/count density per lobe and ratio of counts/count density in SBAS. Interobserver agreement correlated clearly for perfusion (rho: 0.655) and weakly for ventilation (rho: 0.458) in VI. SBAS provides more reproducible measures than VI for the relative tracer uptake in V/P SPECT/CTs in patients with pulmonary emphysema. However, SBAS has to be improved for routine clinical use.

  1. Longitudinal evaluation of early dementia of Alzheimer type using brain perfusion SPECT

    International Nuclear Information System (INIS)

    Kogure, Daiji; Matsuda, Hiroshi; Ohnishi, Takashi; Kunihiro, Toshiyuki; Uno, Masataka; Asada, Takashi; Takasaki, Masaru

    1999-01-01

    Regional cerebral blood flow (rCBF) measurements using a Patlak plot method of 99m Tc-ECD were performed in early dementia of Alzheimer type (DAT) with both HDS-R and MMSE of over 20 to investigate initial abnormality and longitudinal changes of rCBF. A fusion technique of MRI and SPECT images was developed for MRI-guided analysis of regions of interest in hippocampal areas and statistical parametric mapping (SPM) was used for automated and objective approach to analysis of SPECT image data. Seventeen patients with clinically diagnosed early DAT and age-matched 32 normal control subjects were studied. At the first SPECT studies, the mean cerebral blood flow (mCBF) of 38.6±4.7 ml/100 g/min (mean±SD) for early DAT did not show significant reduction as compared with the normal control value of 42.0±3.8, whereas the rCBF values in the bilateral hippocampi (right; 26.8±4.7, left; 26.7±5.2) showed significant reduction (p<0.05) as compared with the normal control values (right; 38.3±4.2, left; 38.4±3.8). The SPM analysis (voxel height; p<0.001, Bonferroni correction; p<0.05) of the first SPECT images revealed significant selective decrease of relative rCBF in the bilateral posterior cingulate gyri. At the second SPECT studies after 1.4 year on the average from the first studies, mCBF for early DAT showed a slight decrease by 1.7±3.8 ml/100 g/min/year. Bilateral hippocampi showed a greater decrease with slight left side dominance by 3.8±3.3 on the right and 4.4±3.2 on the left side. The SPM analysis demonstrated significant decrease of relative rCBF in the basal forebrain area, the left hippocampus, the left amygdala, and the left parahippocampal area. These results suggest that the MRI-guided ROI analysis of rCBF values in the hippocampus and the SPM analysis of SPECT images are quite useful for early diagnosis and follow-up of DAT. (author)

  2. Single-Photon Emission Computed Tomography (SPECT) in childhood epilepsy

    International Nuclear Information System (INIS)

    Gulati, Sheffali; Kalra, Veena; Bal, C.S.

    2000-01-01

    The success of epilepsy surgery is determined strongly by the precise location of the epileptogenic focus. The information from clinical electrophysiological data needs to be strengthened by functional neuroimaging techniques. Single photon emission computed tomography (SPECT) available locally has proved useful as a localising investigation. It evaluates the regional cerebral blood flow and the comparison between ictal and interictal blood flow on SPECT has proved to be a sensitive nuclear marker for the site of seizure onset. Many studies justify the utility of SPECT in localising lesions to possess greater precision than interictal scalp EEG or anatomic neuroimaging. SPECT is of definitive value in temporal lobe epilepsy. Its role in extratemporal lobe epilepsy is less clearly defined. It is useful in various other generalized and partial seizure disorders including epileptic syndromes and helps in differentiating pseudoseizures from true seizures. The need for newer radiopharmaceutical agents with specific neurochemical properties and longer shelf life are under investigation. Subtraction ictal SPECT co-registered to MRI is a promising new modality. (author)

  3. Evaluation of SPECT with N-isopropyl[I-123]-p-iodoamphetamine (IMP) in epileptic patients

    International Nuclear Information System (INIS)

    Nambu, Toshikazu; Itoh, Kazuo; Sumi, Tetsuo; Furudate, Masayori; Irie, Goro

    1988-01-01

    Brain SPECT scintigrams with N-Isopropyl[I-123]-p-Iodoamphetamine (IMP) were reviewed and compared with the EEG findings in 21 epileptic patients (22 SPECT images) with normal CT. Thirteen of 22 SPECT images showed abnormal low uptake and 7 of them corresponded to the EEG focus. In order to obtain the quantitative analysis, the count ratio of the focus side to the opposite I-123 content in fixed ROI was measured for each case, but no statistically significant correlation for the frequency or the duration of epilepsy was found. EEG is not considered to be favorite standard for localizing epileptic foci, especially in deep cerebral region, and that may be one of the main reason for the incomplete correlation. In the qualitative study, however, the cases with frequent epileptic attack were more likely to show abnormal findings. I-123 IMP SPECT can now be considered as having a significant clinical role for the diagnosis and management of patients with epilepsy. (author)

  4. Qualitative evaluation of Chang method of attenuation correction on heart SPECT by using custom made heart phantom

    International Nuclear Information System (INIS)

    Takavar, A.; Eftekhari, M.; Beiki, D.; Saghari, M.; Mostaghim, N.; Sohrabi, M.

    2003-01-01

    SPECT detects γ- rays from administrated radiopharmaceutical within the patient body. γ-rays pass through different tissues before reaching detectors and are attenuated. Attenuation can cause artifacts; therefore different and used to minimize attenuation effects. In our study efficacy of Chang method was evaluated for attenuation purpose, using a custom made heart phantom. Due to different tissues surrounding heart, evaluation is not uniform more over activity distribution around heart is also non- uniform. In Chang method distribution of radioactivity and attenuation due to the surrounding tissue is considered uniform. Our phantom is a piece of plastic producing similar SPECT image as left ventricle. A dual head, ADAC system was used in our study. Images were taken by 180 d ig C (limited angle) and 360 d ig C (total rotation). Images are compared with and without attenuation correction. Our results indicate that Chang attenuation correction method is not capable of eliminating attenuation artifact completely in particular attenuation effects caused by breast

  5. Single-photon emission tomography (SPECT) with 123I-amphetamine in cerebral ischemia

    International Nuclear Information System (INIS)

    Koenig, B.; Donis, J.; Mostbeck, A.; Koehn, H.

    1987-01-01

    The uptake of 123 I-amphetamine (IMP) in brain mainly corresponds to regional perfusion. Distribution of IMP can be visualized in tomographic slices by single-photon emission computed tomography (SPECT). For better evaluation and comparison in follow-up studies, right/left ratios were computed and an asymmetry index calculated. The most sensitive asymmetry index was achieved by 120 average circumferential profiles. In 52 patients with stroke and 16 controls the respective sensitivities of IMP-SPECT, computed tomography (CT), static and dynamic brain scanning and angiography were evaluated. In patients with TIA and PRIND the IMP-SPECT had the highest sensitivity of all non-invasive methods. In patients with completed stroke, the sensitivity of IMP-SPECT was comparable with that of CT (90 vs. 93%). There was a significant correlation between the IMP asymmetry index and the clinical and social score (p [de

  6. Usefulness of additional SPECT/CT identifying lymphatico-renal shunt in a patient with chyluria

    International Nuclear Information System (INIS)

    Suh, Min Seok; Cheon, Gi Jeong; Seo, Hyo Jung; KIm, Hyeon Hoe; Lee, Dong Soo

    2015-01-01

    Lymphoscintigraphy is known to be a useful and non-invasive modality for the evaluation of lymphatic abnormality. However, lymphoscintigraphy has limitations in evaluating chyluria because of its lack of anatomical information. Additional single-photon emission computed tomography (SPECT) combined with computed tomography (CT) was considered to be potentially helpful in detecting the abnormal lymphatico-renal communication. A 20-year-old male patient was referred to our hospital for evaluation of recurrent chyluria. During the third recurrence of chyluria, additional SPECT/CT along with lymphoscintigraphy was performed for evaluation. From the combined SPECT/CT images, lymphatic drainage of radiotracers to the kidney was well visualized, helping diagnosis of a patient with chyluria

  7. Usefulness of additional SPECT/CT identifying lymphatico-renal shunt in a patient with chyluria

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Min Seok; Cheon, Gi Jeong; Seo, Hyo Jung; KIm, Hyeon Hoe; Lee, Dong Soo [Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-03-15

    Lymphoscintigraphy is known to be a useful and non-invasive modality for the evaluation of lymphatic abnormality. However, lymphoscintigraphy has limitations in evaluating chyluria because of its lack of anatomical information. Additional single-photon emission computed tomography (SPECT) combined with computed tomography (CT) was considered to be potentially helpful in detecting the abnormal lymphatico-renal communication. A 20-year-old male patient was referred to our hospital for evaluation of recurrent chyluria. During the third recurrence of chyluria, additional SPECT/CT along with lymphoscintigraphy was performed for evaluation. From the combined SPECT/CT images, lymphatic drainage of radiotracers to the kidney was well visualized, helping diagnosis of a patient with chyluria.

  8. High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: preliminary clinical results

    International Nuclear Information System (INIS)

    Gimelli, Alessia; Genovesi, Dario; Giorgetti, Assuero; Marzullo, Paolo; Bottai, Matteo; Di Martino, Fabio

    2012-01-01

    Appropriate use of SPECT imaging is regulated by evidence-based guidelines and appropriateness criteria in an effort to limit the burden of radiation administered to patients. We aimed at establishing whether the use of a low dose for stress-rest single-day nuclear myocardial perfusion imaging on an ultrafast (UF) cardiac gamma camera using cadmium-zinc-telluride solid-state detectors could be used routinely with the same accuracy obtained with standard doses and conventional cameras. To this purpose, 137 consecutive patients (mean age 61 ± 8 years) with known or suspected coronary artery disease (CAD) were enrolled. They underwent single-day low-dose stress-rest myocardial perfusion imaging using UF SPECT and invasive coronary angiography. Patients underwent the first scan with a 7-min acquisition time 10 min after the end of the stress protocol (dose range 185 to 222 MBq of 99m Tc-tetrofosmin). The rest scan (dose range 370 to 444 MBq of 99m Tc-tetrofosmin) was acquired with a 6-min acquisition time. The mean summed stress scores (SSS) and mean summed rest scores (SRS) were obtained semiquantitatively. Coronary angiograms showed significant epicardial CAD in 83% of patients. Mean SSS and SRS were 10 ± 5 and 3 ± 3, respectively. Overall the area under the ROC curve for the SSS values was 0.904, while the areas under the ROC curves for each vascular territory were 0.982 for the left anterior descending artery, 0.931 for the left circumflex artery and 0.889 for the right coronary artery. This pilot study demonstrated the feasibility of a low-dose single-day stress-rest fasting protocol performed using UF SPECT, with good sensitivity and specificity in detecting CAD at low patient exposure, opening new perspectives in the use of myocardial perfusion in ischaemic patients. (orig.)

  9. High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: preliminary clinical results

    Energy Technology Data Exchange (ETDEWEB)

    Gimelli, Alessia; Genovesi, Dario; Giorgetti, Assuero; Marzullo, Paolo [CNR, Fondazione Toscana Gabriele Monasterio, Pisa (Italy); Bottai, Matteo [University of South Carolina, Division of Biostatistics, Columbia, SC (United States); Karolinska Institutet, Division of Biostatistics, Stockholm (Sweden); Di Martino, Fabio [AOUP, UO Fisica Sanitaria, Pisa (Italy)

    2012-01-15

    Appropriate use of SPECT imaging is regulated by evidence-based guidelines and appropriateness criteria in an effort to limit the burden of radiation administered to patients. We aimed at establishing whether the use of a low dose for stress-rest single-day nuclear myocardial perfusion imaging on an ultrafast (UF) cardiac gamma camera using cadmium-zinc-telluride solid-state detectors could be used routinely with the same accuracy obtained with standard doses and conventional cameras. To this purpose, 137 consecutive patients (mean age 61 {+-} 8 years) with known or suspected coronary artery disease (CAD) were enrolled. They underwent single-day low-dose stress-rest myocardial perfusion imaging using UF SPECT and invasive coronary angiography. Patients underwent the first scan with a 7-min acquisition time 10 min after the end of the stress protocol (dose range 185 to 222 MBq of {sup 99m}Tc-tetrofosmin). The rest scan (dose range 370 to 444 MBq of {sup 99m}Tc-tetrofosmin) was acquired with a 6-min acquisition time. The mean summed stress scores (SSS) and mean summed rest scores (SRS) were obtained semiquantitatively. Coronary angiograms showed significant epicardial CAD in 83% of patients. Mean SSS and SRS were 10 {+-} 5 and 3 {+-} 3, respectively. Overall the area under the ROC curve for the SSS values was 0.904, while the areas under the ROC curves for each vascular territory were 0.982 for the left anterior descending artery, 0.931 for the left circumflex artery and 0.889 for the right coronary artery. This pilot study demonstrated the feasibility of a low-dose single-day stress-rest fasting protocol performed using UF SPECT, with good sensitivity and specificity in detecting CAD at low patient exposure, opening new perspectives in the use of myocardial perfusion in ischaemic patients. (orig.)

  10. Parallel Implementation of the Multi-Dimensional Spectral Code SPECT3D on large 3D grids.

    Science.gov (United States)

    Golovkin, Igor E.; Macfarlane, Joseph J.; Woodruff, Pamela R.; Pereyra, Nicolas A.

    2006-10-01

    The multi-dimensional collisional-radiative, spectral analysis code SPECT3D can be used to study radiation from complex plasmas. SPECT3D can generate instantaneous and time-gated images and spectra, space-resolved and streaked spectra, which makes it a valuable tool for post-processing hydrodynamics calculations and direct comparison between simulations and experimental data. On large three dimensional grids, transporting radiation along lines of sight (LOS) requires substantial memory and CPU resources. Currently, the parallel option in SPECT3D is based on parallelization over photon frequencies and allows for a nearly linear speed-up for a variety of problems. In addition, we are introducing a new parallel mechanism that will greatly reduce memory requirements. In the new implementation, spatial domain decomposition will be utilized allowing transport along a LOS to be performed only on the mesh cells the LOS crosses. The ability to operate on a fraction of the grid is crucial for post-processing the results of large-scale three-dimensional hydrodynamics simulations. We will present a parallel implementation of the code and provide a scalability study performed on a Linux cluster.

  11. Usefulness of MRI and SPECT studies in evaluating the lesion of aphasia

    Energy Technology Data Exchange (ETDEWEB)

    Hanyu, Haruo; Kobayashi, Yasutaka; Arai, Hisayuki; Hatano, Nobuyoshi; Yamaguchi, Katsuhiko; Katsunuma, Hideyo (Tokyo Medical Coll. (Japan))

    1990-06-01

    Since the introduction of CT scanning, correlations between neuropsychological findings and anatomical lesions have been studied. Anatomical studies by CT scans may, however, be misleading in delineating the extent of lesions in aphasia. We have carried out MRI (magnetic resonance imaging) and SPECT (single photon emission CT) examinations in 15 aphasic patients with cerebrovascular disease and discussed the usefulness of these studies. Compared to CT scan, MRI or SPECT studies were considered to be very useful in 8 of 15 patients. The useful points of these studies were: (1) easy detection of lesions with undetectable damages on CT, (2) demonstration of functional abnormalities in areas adjacent or distant from cerebrovascular lesions, and (3) precise definition of topographical abnormalities because of the three-dimensional imaging capability of MRI. As MRI or SPECT may define the actual extent of lesions and show areas of functional abnormality, these studies are useful and necessary in the assessment of lesions causing aphasia. (author).

  12. Usefulness of MRI and SPECT studies in evaluating the lesion of aphasia

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Kobayashi, Yasutaka; Arai, Hisayuki; Hatano, Nobuyoshi; Yamaguchi, Katsuhiko; Katsunuma, Hideyo

    1990-01-01

    Since the introduction of CT scanning, correlations between neuropsychological findings and anatomical lesions have been studied. Anatomical studies by CT scans may, however, be misleading in delineating the extent of lesions in aphasia. We have carried out MRI (magnetic resonance imaging) and SPECT (single photon emission CT) examinations in 15 aphasic patients with cerebrovascular disease and discussed the usefulness of these studies. Compared to CT scan, MRI or SPECT studies were considered to be very useful in 8 of 15 patients. The useful points of these studies were: 1) easy detection of lesions with undetectable damages on CT, 2) demonstration of functional abnormalities in areas adjacent or distant from cerebrovascular lesions, and 3) precise definition of topographical abnormalities because of the three-dimensional imaging capability of MRI. As MRI or SPECT may define the actual extent of lesions and show areas of functional abnormality, these studies are useful and necessary in the assessment of lesions causing aphasia. (author)

  13. 99mTc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia

    International Nuclear Information System (INIS)

    Guedj, Eric; Taieb, David; Cammilleri, Serge; Lussato, David; Laforte, Catherine de; Mundler, Olivier; Niboyet, Jean

    2007-01-01

    Neuro-imaging studies with 99m Tc-HMPAO SPECT in fibromyalgia (FM) patients have reported only limited subcortical hypoperfusion. 99m Tc-ECD SPECT is known to provide better evaluation of areas of high cerebral blood flow and regional metabolic rate. We evaluated a homogeneous group of hyperalgesic patients with FM using 99m Tc-ECD SPECT. The aim of this study was to investigate brain processing associated with spontaneous pain in FM patients. Eighteen hyperalgesic FM women (mean age 49 years, range 25-63 years; American College of Rheumatology criteria) and ten healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). Visual Analogue Scale score for pain was 82±4 at the time of the SPECT study. Compared with control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis, with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. In the present study, performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in the sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective-attentional dimension. As current pharmacological and non-pharmacological therapies act differently on the two components of pain, we hypothesise that SPECT could be a valuable and readily available tool to guide individual therapeutic strategy and provide objective follow-up of pain processing recovery under treatment. (orig.)

  14. SPECT/CT and pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, Jann [Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); The Faroese National Hospital, Department of Medicine, Torshavn (Faroe Islands); Gutte, Henrik [Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Herlev Hospital, Copenhagen University Hospital, Department of Radiology, Copenhagen (Denmark); University of Copenhagen, Cluster for Molecular Imaging, Faculty of Health Sciences, Copenhagen (Denmark)

    2014-05-15

    Acute pulmonary embolism (PE) is diagnosed either by ventilation/perfusion (V/P) scintigraphy or pulmonary CT angiography (CTPA). In recent years both techniques have improved. Many nuclear medicine centres have adopted the single photon emission CT (SPECT) technique as opposed to the planar technique for diagnosing PE. SPECT has been shown to have fewer indeterminate results and a higher diagnostic value. The latest improvement is the combination of a low-dose CT scan with a V/P SPECT scan in a hybrid tomograph. In a study comparing CTPA, planar scintigraphy and SPECT alone, SPECT/CT had the best diagnostic accuracy for PE. In addition, recent developments in the CTPA technique have made it possible to image the pulmonary arteries of the lungs in one breath-hold. This development is based on the change from a single-detector to multidetector CT technology with an increase in volume coverage per rotation and faster rotation. Furthermore, the dual energy CT technique is a promising modality that can provide functional imaging in combination with anatomical information. Newer high-end CT scanners and SPECT systems are able to visualize smaller subsegmental emboli. However, consensus is lacking regarding the clinical impact and treatment. In the present review, SPECT and SPECT in combination with low-dose CT, CTPA and dual energy CT are discussed in the context of diagnosing PE. (orig.)

  15. Use of the GATE Monte Carlo package for dosimetry applications

    Energy Technology Data Exchange (ETDEWEB)

    Visvikis, D. [INSERM U650, LaTIM, University Hospital Medical School, F 29609 Brest (France)]. E-mail: Visvikis.Dimitris@univ-brest.fr; Bardies, M. [INSERM U601, CHU Nantes, F 44093 Nantes (France); Chiavassa, S. [INSERM U601, CHU Nantes, F 44093 Nantes (France); Danford, C. [Department of Medical Physics, MSKCC, New York (United States); Kirov, A. [Department of Medical Physics, MSKCC, New York (United States); Lamare, F. [INSERM U650, LaTIM, University Hospital Medical School, F 29609 Brest (France); Maigne, L. [Departement de Curietherapie-Radiotherapie, Centre Jean Perrin, F 63000 Clemont-Ferrand (France); Staelens, S. [UGent-ELIS, St-Pietersnieuwstraat, 41, B 9000 Gent (Belgium); Taschereau, R. [CRUMP Institute for Molecular Imaging, UCLA, Los Angeles (United States)

    2006-12-20

    One of the roles for Monte Carlo (MC) simulation studies is in the area of dosimetry. A number of different codes dedicated to dosimetry applications are available and widely used today, such as MCNP, EGSnrc and PTRAN. However, such codes do not easily facilitate the description of complicated 3D sources or emission tomography systems and associated data flow, which may be useful in different dosimetry application domains. Such problems can be overcome by the use of specific MC codes such as GATE (GEANT4 Application to Tomographic Emission), which is based on Geant4 libraries, providing a scripting interface with a number of advantages for the simulation of SPECT and PET systems. Despite this potential, its major disadvantage is in terms of efficiency involving long execution times for applications such as dosimetry. The strong points and disadvantages of GATE in comparison to other dosimetry specific codes are discussed and illustrated in terms of accuracy, efficiency and flexibility. A number of features, such as the use of voxelised and moving sources, as well as developments such as advanced visualization tools and the development of dose estimation maps allowing GATE to be used for dosimetry applications are presented. In addition, different examples from dosimetry applications with GATE are given. Finally, future directions with respect to the use of GATE for dosimetry applications are outlined.

  16. Radionuclide cisternography: SPECT and 3D-rendering

    International Nuclear Information System (INIS)

    Henkes, H.; Huber, G.; Piepgras, U.; Hierholzer, J.; Cordes, M.

    1991-01-01

    Radionuclide cisternography is indicated in the clinical work-up for hydrocephalus, when searching for CSF leaks, and when testing whether or not intracranial cystic lesions are communicating with the adjacent subarachnoid space. This paper demonstrates the feasibility and diagnostic value of SPECT and subsequent 3D surface rendering in addition to conventional rectilinear CSF imaging in eight patients. Planar images allowed the evaluation of CSF circulation and the detection of CSF fistula. They were advantageous in examinations 48 h after application of 111 In-DTPA. SPECT scans, generated 4-24 h after tracer application, were superior in the delineation of basal cisterns, especially in early scans; this was helpful in patients with pooling due to CSF fistula and in cystic lesions near the skull base. A major drawback was the limited image quality of delayed scans, when the SPECT data were degraded by a low count rate. 3D surface rendering was easily feasible from SPECT data and yielded high quality images. The presentation of the spatial distribution of nuclide-contaminated CSF proved especially helpful in the area of the basal cisterns. (orig.) [de

  17. Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty- a new dimension of diagnostics?

    Directory of Open Access Journals (Sweden)

    Rasch Helmut

    2011-02-01

    Full Text Available Abstract Background The purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA. Methods Twenty-three painful knees in patients following primary TKA were assessed using Tc-99m-HDP-SPECT/CT. Rotational, sagittal and coronal position of the TKA was assessed on 3D-CT reconstructions. The level of the SPECT-tracer uptake (0-10 and its anatomical distribution was mapped using a validated localization scheme. Univariate analysis (Wilcoxon-Mann-Whitney, Spearmean`s-rho test, p Results SPECT/CT imaging changed the suspected diagnosis and the proposed treatment in 19/23 (83% knees. Progression of patellofemoral OA (n = 11, loosening of the tibial (n = 3 and loosening of the femoral component (n = 2 were identified as the leading causes of pain after TKA. Patients with externally rotated tibial trays showed higher tracer uptake in the medial patellar facet (p = 0.049 and in the femur (p = 0.051. Patients with knee pain due to patellofemoral OA showed significantly higher tracer uptake in the patella than others (p Conclusions SPECT/CT was very helpful in establishing the diagnosis and guiding subsequent management in patients with painful knees after TKA, particularly in patients with patellofemoral problems and malpositioned or loose TKA.

  18. Interactions of collimation, sampling and filtering on spect spatial resolution

    International Nuclear Information System (INIS)

    Tsui, B.M.W.; Jaszczak, R.J.

    1984-01-01

    The major factors which affect the spatial resolution of single-photon emission computer tomography (SPECT) include collimation, sampling and filtering. A theoretical formulation is presented to describe the relationship between these factors and their effects on the projection data. Numerical calculations were made using commercially available SPECT systems and imaging parameters. The results provide an important guide for proper selection of the collimator-detector design, the imaging and the reconstruction parameters to avoid unnecessary spatial resolution degradation and aliasing artifacts in the reconstructed image. In addition, the understanding will help in the fair evaluation of different SPECT systems under specific imaging conditions

  19. Usefulness of CT based SPECT Fusion Image in the lung Disease : Preliminary Study

    International Nuclear Information System (INIS)

    Park, Hoon Hee; Lyu, Kwang Yeul; Kim, Tae Hyung; Shin, Ji Yun

    2012-01-01

    Recently, SPECT/CT system has been applied to many diseases, however, the application is not extensively applied at pulmonary disease. Especially, in case that, the pulmonary embolisms suspect at the CT images, SPECT is performed. For the accurate diagnosis, SPECT/CT tests are subsequently undergoing. However, without SPECT/CT, there are some limitations to apply these procedures. With SPECT/CT, although, most of the examination performed after CT. Moreover, such a test procedures generate unnecessary dual irradiation problem to the patient. In this study, we evaluated the amount of unnecessary irradiation, and the usefulness of fusion images of pulmonary disease, which independently acquired from SPECT and CT. Using NEMA PhantomTM (NU2-2001), SPECT and CT scan were performed for fusion images. From June 2011 to September 2010, 10 patients who didn't have other personal history, except lung disease were selected (male: 7, female: 3, mean age: 65.3±12.7). In both clinical patient and phantom data, the fusion images scored higher than SPECT and CT images. The fusion images, which is combined with pulmonary vessel images from CT and functional images from SPECT, can increase the detection possibility in detecting pulmonary embolism in the resin of lung parenchyma. It is sure that performing SPECT and CT in integral SPECT/CT system were better. However, we believe this protocol can give more informative data to have more accurate diagnosis in the hospital without integral SPECT/CT system.

  20. Effect of STA-MCA bypass based on the motor activation SPECT

    International Nuclear Information System (INIS)

    Kawaguchi, Shoichiro; Uranishi, Ryunosuke; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime

    1999-01-01

    The effect of STA-MCA bypass for ischemic cerebrovascular diseases (CVDs) on pure motor function using motor activation SPECT was evaluated and analyzed, and this effect with the resting cerebral blood flow and reserved capacity was compared. Motor activation SPECT were carried out on 22 cases with STA-MCA bypass for symptomatic ischemic CVDs. All motors activation SPECT using the finger opposition task on the affected side were performed before bypass, at 1 month, and 3 months after the bypass. Visual inspection was used to determine whether the result of the motor activation SPECT was as negative or positive. The activated region was detected anatomically precisely by superimposing the SPECT on the MRI. Before this study, the same examination was performed on normal controls. In controls, 91% showed the activated area on the sensorimotor cortex after the finger opposition tasks. Before bypass, the resting SPECT revealed reduction of cerebral blood flow (CBF) on the affected side in all cases. All cases also showed a disturbed response to acetazolamide (ACZ). Nine cases were positive in the motor activation SPECT. One month after bypass, the resting CBF increased in 11 cases. Seven showed preoperative positive motor activation. Fifteen cases were positive in the motor activation SPECT. Three months after bypass, 20 cases showed improvement in the resting CBF, and 19 cases were positive in the motor activation SPECT. Ten cases were negative in the preoperative motor activation SPECT. At one month after surgery, ACZ activation SPECT was performed in 12 cases. Five showed improvement of the response to ACZ. At 3 months after surgery, 8 of 12 cases treated with ACZ activation SPECT showed improved response to ACZ. In most of the cases, improved response to ACZ could be seen after response to motor activation improved. STA-MCA bypass is useful not only for resting CBF but also for pure motor function based on motor activation SPECT. (K.H.)

  1. Effect of STA-MCA bypass based on the motor activation SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Shoichiro; Uranishi, Ryunosuke; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

    1999-07-01

    The effect of STA-MCA bypass for ischemic cerebrovascular diseases (CVDs) on pure motor function using motor activation SPECT was evaluated and analyzed, and this effect with the resting cerebral blood flow and reserved capacity was compared. Motor activation SPECT were carried out on 22 cases with STA-MCA bypass for symptomatic ischemic CVDs. All motors activation SPECT using the finger opposition task on the affected side were performed before bypass, at 1 month, and 3 months after the bypass. Visual inspection was used to determine whether the result of the motor activation SPECT was as negative or positive. The activated region was detected anatomically precisely by superimposing the SPECT on the MRI. Before this study, the same examination was performed on normal controls. In controls, 91% showed the activated area on the sensorimotor cortex after the finger opposition tasks. Before bypass, the resting SPECT revealed reduction of cerebral blood flow (CBF) on the affected side in all cases. All cases also showed a disturbed response to acetazolamide (ACZ). Nine cases were positive in the motor activation SPECT. One month after bypass, the resting CBF increased in 11 cases. Seven showed preoperative positive motor activation. Fifteen cases were positive in the motor activation SPECT. Three months after bypass, 20 cases showed improvement in the resting CBF, and 19 cases were positive in the motor activation SPECT. Ten cases were negative in the preoperative motor activation SPECT. At one month after surgery, ACZ activation SPECT was performed in 12 cases. Five showed improvement of the response to ACZ. At 3 months after surgery, 8 of 12 cases treated with ACZ activation SPECT showed improved response to ACZ. In most of the cases, improved response to ACZ could be seen after response to motor activation improved. STA-MCA bypass is useful not only for resting CBF but also for pure motor function based on motor activation SPECT. (K.H.)

  2. SPECT versus planar bone radionuclide imaging in the detection of spondylolysis

    International Nuclear Information System (INIS)

    Whitten, C.G.; El-Khoury, G.Y.; Chang, P.J.; Seabold, J.E.; Found, E.M.; Renfrew, D.L.

    1991-01-01

    This paper evaluates the relative performance and ease of interpretation of SPECT versus planar radionuclide bone imaging in the detection of spondylolysis. The authors studied all patients presenting with back pain suggestive of spondylolysis from November 1989 to January 1991 who underwent bone scanning; patients underwent both planar and SPECT imaging. The planar and SPECT images were randomly mixed and independently interpreted by four observers for presence or absence of spondylolysis and ease of interpretation for each scan. Receiver operating characteristic (ROC) and analysis of variance (ANOVA) were used. Of 72 patients, 19 had confirmed spondylolysis, and 53 did not. While ROC analysis showed that SPECT performed slightly better than planar imaging for all four observers, the difference was not statistically significant. ANOVA results suggest that planar imaging was significantly easier to use than SPECT and that ease of use was strongly correlated with the observer's confidence in the diagnosis

  3. Serial SPECT in children with partial epilepsy

    International Nuclear Information System (INIS)

    Hosoya, Machiko; Ushiku, Hideo

    1995-01-01

    We performed serial single-photon emission CT (SPECT) with N-isopropyl-p-( 123 I)-Iodoamphetamine to measure the regional cerebral blood flow (rCBF) in 15 children with partial epilepsy. SPECT showed focal changes in 14 cases. Ten cases had abnormalities in the initial SPECT and another four cases in the second test. The cases with normal rCBF in initial SPECT had been tested in an early phase after the onset, and then decreased rCBF were observed in the second SPECT. The cases with both abnormal rCBF in the initial SPECT and improved rCBF in the second SPECT showed good prognosis in clinico-electrophysiological evolutions. In cases with abnormal changes of rCBF in the second SPECT, clinical prognosis was found to be not so good. These findings suggest that serial SPECT may be used to follow the course of epilepsy. (author)

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

    International Nuclear Information System (INIS)

    Watanabe, Shigeyuki; Ajisaka, Ryuichi; Masuoka, Takeshi

    1990-01-01

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

  5. Thallium brain SPECT and MRI correlation in the evaluation of tumour recurrence versus radiation necrosis

    International Nuclear Information System (INIS)

    Robins, P.D.; Mahoney, D.S.; Mullan, B.P.

    2000-01-01

    Full text: This study compares different methods of determining thallium tumour uptake indices. Correlation with MR was performed to evaluate features that may affect the thallium index (TI) and to improve specificity for differentiation of recurrent tumor from radiation necrosis. 23 patients who had received radiotherapy for a brain neoplasm were included. The TI was determined using three different methods including large and small regions-of-interest (ROI). The concordance between the thallium SPECT and MRI was assessed. The effect of central necrosis on the different thallium indices derived was evaluated. 18 patients were determined to have recurrent tumor and five had inactive disease. The optimal TI cut-off values was statistically delivered and sensitivity and specificity was 78-94% and 80% respectively for cut-off values between 2.0 and 2.6 depending on the method used to calculate the TI. When compared with MRI, the majority of SPECT abnormalities correlated well with location and degree of uptake and enhancement. Seven cases showed central necrosis and the degree of necrosis had less effect on the TI when a small ROI was used in these cases. In conclusion thallium brain SPECT is a sensitive technique for detecting recurrent tumour. When performing semi-quantitative assessment of thallium uptake, a smaller ROI over the most intense area of uptake will reduce the underestimation of the TI in the presence of necrosis and a Tl cut-off value of 2.6 gave optimal accuracy using this method. Correlation with MRI aids in localization, particularly where there is anatomic distortion and enables more accurate analysis of these lesions by avoiding areas of necrosis. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  6. The implementation of quality controls of gamma camera functioning and simulation of tomography techniques by Gate and GEANT4

    International Nuclear Information System (INIS)

    Ben Ameur, Narjes

    2011-01-01

    The reliability of medical devices is directly linked to the services quality offered to the patient. For this reason, quality control tests should be regularly conducted in every nuclear medicine service according to international norms. Our approach consists on realizing different quality control tests recommended by the Nema norm on a gamma-camera in order to evaluate its performance. The obtained data allowed us to study the different physical phenomena happening during a SPECT exam. It also allowed us to identify those affecting the image quality based on the simulation programmes: GEANT 4 and Gate. The obtained results of the quality control showed that the Gamma-camera has a high performance in terms of spatial resolution, linearity, uniformity and rotational center. The establishment of a model for a gamma-camera Symbia E (Siemens) using a Gate platform confirms the reliability of this platform in the conception and the optimization of the detectors.

  7. Skeletal scintigraphy and SPECT/CT in orthopedic imaging

    International Nuclear Information System (INIS)

    Klaeser, B.; Walter, M.; Krause, T.

    2011-01-01

    Multi-modality imaging with SPECT-CT in orthopaedics combines the excellent sensitivity of scintigraphy with the morphological information of CT as a key for specific interpretation of findings in bone scans. The result is an imaging modality with the clear potential to prove of value even in a competitive setting dominated by MRI, and to significantly add to diagnostic imaging in orthopaedics. SPECT-CT is of great value in the diagnostic evaluation after fractures, and - in contrast to MRI - it is well suited for imaging in patients with osteosyntheses and metallic implants. In sports medicine, SPECT-CT allows for a sensitive and specific detection of osseous stress reactions before morphological changes become detectable by CT or MRI. In patients with osseous pain syndromes, actively evolving degenerative changes as a cause of pain can be identified and accurately localized. Further, particularly prospective diagnostic studies providing comparative data are needed to strengthen the position of nuclear imaging in orthopaedics and sports medicine and to help implementing SPECT/CT in diagnostic algorithms. (orig.)

  8. Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

    Energy Technology Data Exchange (ETDEWEB)

    Joegi, Jonas; Bajc, Marika [Lund University, Skaane University Hospital, Department of Clinical Physiology, Institution of Clinical Sciences, Lund (Sweden); Ekberg, Marie [Lund University, Skaane University Hospital, Department of Respiratory Medicine and Allergology, Institution of Clinical Sciences, Lund (Sweden); Jonson, Bjoern [Lund University, Department of Clinical Physiology, Institution of Clinical Sciences, Lund (Sweden); Bozovic, Gracijela [Lund University, Skaane University Hospital, Department of Radiology, Institution of Clinical Sciences, Lund (Sweden)

    2011-07-15

    Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV{sub 1}). FEV{sub 1} does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV{sub 1}, symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilation/perfusion single photon emission tomography (V/P SPECT)] visualizes regional V and P. In COPD, relations between V/P SPECT, spirometry, high-resolution computed tomography (HRCT) and symptoms have been insufficiently studied. The aim of this study was to investigate how lung function imaging and obstructive disease grading undertaken using V/P SPECT correlate with symptoms, spirometric lung function and degree of emphysema assessed with HRCT in patients with COPD. Thirty patients with stable COPD were evaluated with the Medical Research Council dyspnoea questionnaire (MRC) and the clinical COPD questionnaire (CCQ). Spirometry was performed. The extent of emphysema was assessed using HRCT. V/P SPECT was used to assess V/P patterns, total reduction in lung function and degree of obstructive disease. The total reduction in lung function and degree of obstructive disease, assessed with V/P SPECT, significantly correlated with emphysema extent (r = 0.66-0.69, p < 0.0001) and spirometric lung function (r = 0.62-0.74, p < 0.0005). The correlation between emphysema extent and spirometric lung function was weaker. No correlation between MRC, CCQ and objective measurements was found. V/P SPECT is sensitive to early changes in COPD. V/P SPECT also has the possibility to identify comorbid disease. V/P SPECT findings show a significant correlation with emphysema extent and spirometric lung function. We therefore recommend that scintigraphic signs of COPD, whenever found, should be

  9. Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

    International Nuclear Information System (INIS)

    Joegi, Jonas; Bajc, Marika; Ekberg, Marie; Jonson, Bjoern; Bozovic, Gracijela

    2011-01-01

    Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV 1 ). FEV 1 does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV 1 , symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilation/perfusion single photon emission tomography (V/P SPECT)] visualizes regional V and P. In COPD, relations between V/P SPECT, spirometry, high-resolution computed tomography (HRCT) and symptoms have been insufficiently studied. The aim of this study was to investigate how lung function imaging and obstructive disease grading undertaken using V/P SPECT correlate with symptoms, spirometric lung function and degree of emphysema assessed with HRCT in patients with COPD. Thirty patients with stable COPD were evaluated with the Medical Research Council dyspnoea questionnaire (MRC) and the clinical COPD questionnaire (CCQ). Spirometry was performed. The extent of emphysema was assessed using HRCT. V/P SPECT was used to assess V/P patterns, total reduction in lung function and degree of obstructive disease. The total reduction in lung function and degree of obstructive disease, assessed with V/P SPECT, significantly correlated with emphysema extent (r = 0.66-0.69, p < 0.0001) and spirometric lung function (r = 0.62-0.74, p < 0.0005). The correlation between emphysema extent and spirometric lung function was weaker. No correlation between MRC, CCQ and objective measurements was found. V/P SPECT is sensitive to early changes in COPD. V/P SPECT also has the possibility to identify comorbid disease. V/P SPECT findings show a significant correlation with emphysema extent and spirometric lung function. We therefore recommend that scintigraphic signs of COPD, whenever found, should be reported. V

  10. SPECT of aged backache patients

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki [Prefectural Tajimi Hospital, Gifu (Japan)

    1995-12-01

    Single photon emission computed tomography (SPECT) using {sup 99m}Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. {sup 99m}Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.).

  11. Clinical applications of SPECT-CT

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadzadehfar, Hojjat; Biersack, Hans-Juergen (eds.) [University Hospital Bonn (Germany). Dept. of Nuclear Medicine

    2014-06-01

    Covers the full spectrum of clinical applications of SPECT/CT in diagnosis of benign and malignant diseases. Includes chapters on the use of SPECT/CT for dosimetry and for therapy planning. Completely up to date. Many helpful illustrations. SPECT/CT cameras have considerably improved diagnostic accuracy in recent years. Such cameras allow direct correlation of anatomic and functional information, resulting in better localization and definition of scintigraphic findings. In addition to this anatomic referencing, CT coregistration provides superior quantification of radiotracer uptake based on the attenuation correction capabilities of CT. Useful applications of SPECT/CT have been identified not only in oncology but also in other specialties such as orthopedics and cardiology. This book covers the full spectrum of clinical applications of SPECT/CT in diagnosis and therapy planning of benign and malignant diseases. Opening chapters discuss the technology and physics of SPECT/CT and its use for dosimetry. The role of SPECT/CT in the imaging of a range of pathologic conditions is then addressed in detail. Applications covered include, among others, imaging of the thyroid, bone, and lungs, imaging of neuroendocrine tumors, cardiac scintigraphy, and sentinel node scintigraphy. Individual chapters are also devoted to therapy planning in selective internal radiation therapy of liver tumors and bremsstrahlung SPECT/CT. Readers will find this book to be an essential and up-to-date source of information on this invaluable hybrid imaging technique.

  12. Myocardial perfusion SPECT 2015 in Germany. Results of the 7th survey.

    Science.gov (United States)

    Lindner, Oliver; Burchert, Wolfgang; Schäfer, Wolfgang; Hacker, Marcus

    2017-02-14

    The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine presents the results of the 7th survey of myocardial perfusion SPECT (MPS) of the reporting year 2015. 268 questionnaires (173 practices [PR], 67 hospitals [HO], 28 university hospitals [UH]) were evaluated. Results of the last survey from 2012 are set in squared brackets. MPS of 121 939 [105 941] patients were reported. 98 % [95 %] of all MPS were performed with Tc-99m radiopharmaceuticals and 2 % [5 %] with Tl-201. 78 % [79 %] of all patients were studied in PR, 14 % [15 %] in HO, and 8 % [6 %] in UH. A pharmacological stress test was performed in 43 % [39 %] (22 % [24 %] adenosine, 20 % [9 %] regadenoson, 1 % [6 %] dipyridamole or dobutamine). Attenuation correction was applied in 25 % [2009: 10 %] of MPS. Gated SPECT was performed in 78 % [70 %] of all rest MPS, in 80 % [73 %] of all stress and in 76 % [67 %] of all stress and rest MPS. 53 % [33 %] of all nuclear medicine departments performed MPS scoring by default, whereas 24 % [41 %] did not apply any quantification. 31 % [26 %] of all departments noticed an increase in their counted MPS and 29 % [29 %] no changes. Data from 89 departments which participated in all surveys showed an increase in MPS count of 11.1 % (PR: 12.2 %, HO: 4.8 %, UH: 18.4 %). 70 % [60 %] of the MPS were requested by ambulatory care cardiologists. The 2015 MPS survey reveals a high-grade adherence of routine MPS practice to current guidelines. The positive trend in MPS performance and number of MPS already observed in 2012 continues. Educational training remains necessary in the field of SPECT scoring.

  13. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy; SPECT cerebral interictal em pacientes com epilepsia do lobo temporal de dificil controle

    Energy Technology Data Exchange (ETDEWEB)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  14. Optimization of detector size and collimator for PG-SPECT

    International Nuclear Information System (INIS)

    Ishikawa, M.; Kobayashi, T.; Kanda, K.

    2000-01-01

    A current absorbed dose evaluation method in a Boron Neutron Capture Therapy demands boron reaction rate from a boron concentration of an affected part supposed from a neutron flux and a boron concentration in blood measured by an activation method of a gold wire indirectly and converts it into an absorbed dose. So we devised a PG-SEPCT (Prompt Gamma-ray Single Photon Emission Computed Tomography) system to evaluate an absorbed dose directly by measuring prompt gamma-rays. Ordinary SPECT system uses a big NaI scintillator for detector so that measurement is done in low background gamma-ray environment. However, a conventional detector and collimator system cannot be just applied to PG-SPECT system because a background radiation coexists abundantly (PG-SPECT system is set in irradiation room). Accordingly PG-SPECT system requires a dedicated detector and collimator system. In order to reduce efficiency for background gamma-rays, we arranged detectors in a collimator to shield from background gamma-rays. We examined the most suitable collimator shape. The optimization condition of a dedicated collimator system is as follows: 1) the smallest particle size that can be distinguished is 1 cm. 2) necessary counts at measurement target center is not less than 10,000. (author)

  15. SPECT in psychiatry

    International Nuclear Information System (INIS)

    Barocka, A.; Feistel, H.; Ebert, D.; Lungershausen, E.

    1993-01-01

    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D 2 and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.) [de

  16. Brain SPECT in children

    International Nuclear Information System (INIS)

    Guyot, M.; Baulieu, J.L.

    1996-01-01

    Brain SPECT in child involves specific trends regarding the patient cooperation, irradiation, resolution and especially interpretation because of the rapid scintigraphic modifications related to the brain maturation. In a general nuclear medicine department, child brain SPECT represents about 2 % of the activity. The choice indications are the perfusion children: thallium and MIBI in brain tumours, pharmacological and neuropsychological interventions. In the future, brain dedicated detectors and new radiopharmaceuticals will promote the development of brain SPECT in children. (author)

  17. Avaliação da perfusão e função miocárdicas em vítimas de escorpionismo utilizando o Gated-SPECT Evaluación de la perfusión y función miocárdicas en víctimas de escorpionismo utilizando el Gated-SPECT Assessment of myocardial perfusion and function in victims of scorpion envenomation using Gated-SPECT

    Directory of Open Access Journals (Sweden)

    Alexandre Baldini de Figueiredo

    2010-04-01

    Full Text Available FUNDAMENTO: O choque cardiogênico e o edema agudo de pulmão são as principais causas de óbito em pacientes com escorpionismo, cujo mecanismo fisiopatológico ainda é controverso. OBJETIVOS: Investigar a correlação entre os distúrbios da perfusão miocárdica e a função contrátil do ventrículo esquerdo, em vítimas de escorpionismo. MÉTODOS: Quinze pacientes submeteram-se à cintilografia de perfusão miocárdica sincronizada com ECG (Gated SPECT, dentro de 72 horas e 15 dias após o acidente escorpiônico. As imagens foram analisadas visualmente por escore semiquantitativo de perfusão (0 = normal, 4 = ausente e mobilidade (0 = normal, 4 = acinético, utilizando modelo de 17 segmentos. Para cada paciente foram calculados escores somados de perfusão (ESP e mobilidade (ESM. A fração de ejeção (FEVE foi calculada por software comercialmente disponível. RESULTADOS: Na avaliação inicial, 12 dos 15 pacientes apresentaram alterações da contratilidade e da perfusão miocárdica. O ESP foi de 12,5 ± 7,3, o ESM de 17,0 ± 12, 8 e a FEVE de 44,6 ± 16,0%. Houve correlação positiva entre o ESP e o ESM (r = 0,68; p = 0,005 e negativa entre o ESP e a FEVE (r = -0,75; p = 0,0021. Os estudos de seguimento mostraram recuperação da contratilidade global (FEVE de 68,9 ± 9,5, p = 0,0002, segmentar (ESM 2,6 ± 3,1, p = 0,0009 e da perfusão (ESP 3,7 ± 3,3, p = 0,0003. A melhora da FEVE correlacionou-se positivamente com a melhora do ESP (r = 0,72; p = 0,0035. CONCLUSÕES: Alterações perfusionais miocárdicas são comuns no envenenamento escorpiônico e correlacionam-se topograficamente com a disfunção contrátil. A recuperação da contratilidade correlaciona-se com a reversibilidade dos defeitos perfusionais. Estes achados sugerem a participação de alterações perfusionais miocárdicas na fisiopatologia desta forma de insuficiência ventricular aguda. (Arq Bras Cardiol 2010;94(4: 444-451FUNDAMENTO: El shock cardiog

  18. Clinical evaluation of left ventricular wall thickness by combined technique with gated planer 201Tl image and gated cardiac pool image

    International Nuclear Information System (INIS)

    Nakai, Kenji; Katsuragawa, Shigehiko; Takahashi, Tsuneo; Matsushita, Kazuo; Kawamura, Akiyoshi

    1983-01-01

    To evaluate the left ventricular (LV) wall thickness, combined technique with gated planer 201-Thallium image and gated cardiac pool image was applied to 6 patients with hypertrophic cardiomyopathy (HCM) and 4 patients with secondary hypertrophy due to hypertension (HHD) proven by electrocardiography and ultrasonic-echocardiography. Scintigraphic pattern of hypertrophy on reconstructed planer 201 Tl image showed diffuse or asymmetrical apical hypertrophy in HHD, asymmetrical septal hypertrophy in HCM. It was very interesting that abnormal perfusion was shown in 201 Tl image, despite symmetrical hypertrophy in echocardiography. This techniques provided useful information for evaluating the LV wall thickness and cardiac performance. (author)

  19. Brain SPECT in childhood

    International Nuclear Information System (INIS)

    Tranquart, F.; Saliba, E.; Prunier, C.; Baulieu, F.; Besnard, J.C.; Guilloteau, D.; Baulieu, J.L.

    2001-01-01

    The modalities and the indications of perfusion and neurotransmission SPECT in childhood are presented. The perfusion as well as neurotransmission tracers have not yet authorization for use in children; they have to be used by prescription of magistral preparation or in research protocols. The radioprotection rules have to be strictly respected. The most frequent indication of perfusion SPECT is pharmacologically resistant epilepsy; the ictal SPECT before surgery allows the localization of the epileptogenic focus. Other indications are relevant in the prognosis of neonatal anoxia and encephalitis. In psychiatric disorders, especially in autism, the interest is the physiopathological approach of the brain dysfunctions. The neurotransmission SPECT is emerging as a consequence of the development of new radiotracer, as the dopaminergic system ligands. The decrease of the dopamine D2 receptors in the striatum can be imaged and quantified in the neonate. The lesions of dopamine system seem to be a consequence of the neonatal hypoxia-ischemia and it is predictive of motor sequelae. Brain SPECT should become a routine examination in child neurologic and psychiatric disorders. (authors)

  20. SPECT/CT imaging in general orthopedic practice.

    Science.gov (United States)

    Scharf, Stephen

    2009-09-01

    The availability of hybrid devices that combine the latest single-photon emission computed tomography (SPECT) imaging technology with multislice computed tomography (CT) scanning has allowed us to detect subtle, nonspecific abnormalities on bone scans and interpret them as specific focal areas of pathology. Abnormalities in the spine can be separated into those caused by pars fractures, facet joint arthritis, or osteophyte formation on vertebral bodies. Compression fractures can be distinguished from severe degenerative disease, both of which can cause intense activity across the spine on either planar or SPECT imaging. Localizing activity in patients who have had spinal fusion can provide tremendous insight into the causes of therapeutic failures. Infections of the spine now can be diagnosed with gallium SPECT/CT, despite the fact that gallium has long been abandoned because of its failure to detect spine infection on either planar or SPECT imaging. Small focal abnormalities in the feet and ankles can be localized well enough to make specific orthopedic diagnoses on the basis of their location. Moreover, when radiographic imaging provides equivocal or inadequate information, SPECT/CT can provide a road map for further diagnostic studies and has been invaluable in planning surgery. Our ability to localize activity within a bone or at an articular surface has allowed us to distinguish between fractures and joint disease. Increased activity associated with congenital anomalies, such as tarsal coalition and Bertolotti's syndrome have allowed us to understand the pathophysiology of these conditions, to confirm them as the cause of the patient's symptoms, and to provide information that is useful in determining appropriate clinical management. As our experience broadens, SPECT/CT will undoubtedly become an important tool in the evaluation and management of a wider variety of orthopedic patients.

  1. Anatomically standardized statistical mapping of 123I-IMP SPECT in brain tumors

    International Nuclear Information System (INIS)

    Shibata, Yasushi; Akimoto, Manabu; Matsushita, Akira; Yamamoto, Tetsuya; Takano, Shingo; Matsumura, Akira

    2010-01-01

    123 I-iodoamphetamine Single Photon Emission Computed Tomography (IMP SPECT) is used to evaluate cerebral blood flow. However, application of IMP SPECT to patients with brain tumors has been rarely reported. Primary central nervous system lymphoma (PCNSL) is a rare tumor that shows delayed IMP uptake. The relatively low spatial resolution of SPECT is a clinical problem in diagnosing brain tumors. We examined anatomically standardized statistical mapping of IMP SPECT in patients with brain lesions. This study included 49 IMP SPECT images for 49 patients with brain lesions: 20 PCNSL, 1 Burkitt's lymphoma, 14 glioma, 4 other tumor, 7 inflammatory disease and 3 without any pathological diagnosis but a clinical diagnosis of PCNSL. After intravenous injection of 222 MBq of 123 I-IMP, early (15 minutes) and delayed (4 hours) images were acquired using a multi-detector SPECT machine. All SPECT data were transferred to a newly developed software program iNeurostat+ (Nihon Medi-physics). SPECT data were anatomically standardized on normal brain images. Regions of increased uptake of IMP were statistically mapped on the tomographic images of normal brain. Eighteen patients showed high uptake in the delayed IMP SPECT images (16 PCNSL, 2 unknown). Other tumor or diseases did not show high uptake of delayed IMP SPECT, so there were no false positives. Four patients with pathologically proven PCNSL showed no uptake in original IMP SPECT. These tumors were too small to detect in IMP SPECT. However, statistical mapping revealed IMP uptake in 18 of 20 pathologically verified PCNSL patients. A heterogeneous IMP uptake was seen in homogenous tumors in MRI. For patients with a hot IMP uptake, statistical mapping showed clearer uptake. IMP SPECT is a sensitive test to diagnose of PCNSL, although it produced false negative results for small posterior fossa tumor. Anatomically standardized statistical mapping is therefore considered to be a useful method for improving the diagnostic

  2. Bone SPECT/CT in the postoperative spine: a focus on spinal fusion

    Energy Technology Data Exchange (ETDEWEB)

    Al-Riyami, Khulood; Bomanji, Jamshed [University College London Hospitals, Institute of Nuclear Medicine, London (United Kingdom); Gnanasegaran, Gopinath [Royal Free Hospital, Department of Nuclear Medicine, London (United Kingdom); Wyngaert, Tim van den [Antwerp University Hospital, Department of Nuclear Medicine, Edegem (Belgium); University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk (Belgium)

    2017-11-15

    Low back pain is a global problem affecting one in 10 people. The management of low back pain varies from conservative to more invasive methods with a spectacular increase in the number of patients undergoing spinal fusion surgery during the last decade. Conventional radiological and radionuclide studies are often used in the assessment of persistent or recurring pain after spinal surgery with several advantages and limitations related to each technique. This article reviews the key contribution of integrated bone SPECT/CT in evaluating patients with persistent or recurring pain after spinal surgery, focusing on spinal fusion. Current literature supports the use of bone SPECT/CT as an adjunct imaging modality and problem-solving tool in evaluating patients with suspicion of pseudarthrosis, adjacent segment degeneration, and hardware failure. The role of bone SPECT/CT in post-operative orthopaedic scenarios is evolving, and this review highlights the need for further research on the role of bone SPECT/CT in these patients. (orig.)

  3. Presurgical evaluation of cerebral perfusion reserve in patients for cardiovascular surgery using {sup 99m}Tc-ECD SPECT with diamox enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kaname; Nakashima, Hiromichi; Tanaka, Kuniyoshi; Kitano, Tokio; Murashima, Shuichi; Takeda, Kan; Yuasa, Hiroshi; Yada, Isao; Nakagawa, Tsuyoshi [Mie Univ., Tsu (Japan). School of Medicine

    1996-03-01

    Cerebrovascular stroke is one of the major complications in cardiovascular surgery with cardiopulmonary bypass. The purpose of this study was to evaluate the usefulness of preoperative {sup 99m}Tc-ethyl cysteinate dimer (ECD) SPECT and acetazolamide (diamox) enhancement to predict neurological complications in cardiovascular surgery. Eighteen patients with coronary disease, valvular disease or aortic aneurysm were studied before the operations. Regional cerebral blood flow and perfusion reserve were evaluated using ECD SPECT before and after the intravenous administration of diamox (1 g). Three cases with moderate to severe baseline abnormalities and poor perfusion reserve had cerebral infarction postoperatively. Twelve cases with good to fair perfusion reserve had no neurological complication. Three cases having poor perfusion reserve had the operations with more intensive brain protection, in which higher perfusion pressure to the brain was maintained during cardiopulmonary bypass, and no neurological complication was observed. In conclusion, patients who have moderately or markedly abnormal baseline flow with poor perfusion reserve may have some risk of neurological complications in cardiovascular surgery. ECD SPECT with diamox enhancement may give information useful for selection of operation procedures. (author).

  4. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A R; Hansen, B A; Høgenhaven, H

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the "Engel score", was at least 3 years. The data were analyzed in a blinded...... set-up, first visually and subsequently quantitatively by an automatic regional analysis. By visual analysis 95% of the patients were considered abnormal in one part of the brain, of whom 27% were abnormal on CT, 45% on MRI and 98% on scalp EEG. Using a quantitative regional analysis subdividing each...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation....

  5. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A.R.; Hansen, B.A.; Hogenhaven, H

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the 'Engel score', was at least 3 years. The data were analyzed in a blinded...... set-up, first visually and subsequently quantitatively by an automatic regional analysis. By visual analysis 95% of the patients were considered abnormal in one part of the brain, of whom 27% were abnormal on CT, 45% on MRI and 98% on scalp EEG. Using a quantitative regional analysis subdividing each...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation...

  6. Brain perfusion SPECT in dementia syndromes

    International Nuclear Information System (INIS)

    Libus, P.; Stupalova, J.; Kuzelka, I.; Konrad, J.

    2002-01-01

    Aim: Brain perfusion SPECT is used in differential diagnostics of dementia syndromes. First of all the aim is to distinguish vascular dementia from degenerative dementia and to differentiate dementia from delirium, psychiatric syndromes, depression and secondary dementia, which is important in relation to therapy. The purpose of our study was to detect significance of BP SPECT and include it into the diagnostic process in dementia syndromes. Materials and methods: 51 women and 63 men aged 55 - 88 were evaluated in the study. The patients correspond to the general criteria of dementia diagnosis. They were sent to the examination by neurological, internal and psychiatric departments and out-patient departments. All patients were examined by 99mTc ECD SPECT using a double head camera PRISM 200 VP with LEHR collimator. The scintigraphic data were evaluated by the visual and semiquantitative analysis. Results: It was established that most patients in our group had vascular dementia, while Alzheimer's disease was second. In other groups we found out dementia at strategic infarct location, e.g. in gyrus angularis in the dominant hemisphere, frontal temporal lobe dementia and alcoholic dementia. Twenty-four patients had a normal diagnosis. Fifteen of them had a somatic reason of the delirious state and were re-classified into pseudodementia. Nine patients were not diagnostically included and the examination will repeated in four months time. Conclusion: We have found out a good applicability of brain perfusion SPECT in dementia syndromes diagnosis in our work. The best diagnosticable and most specific were the findings in multi-infarct dementia, Alzheimer's disease and frontal temporal lobe dementia. When vascular dementia is concerned we can even distinguish dementia at strategic infarction location, e.g. in thalamus, basal frontal telencefalon, in gyrus angularis of the dominant hemisphere, etc

  7. Recovered neuronal viability revealed by Iodine-123-iomazenil SPECT following traumatic brain injury

    OpenAIRE

    Koizumi, Hiroyasu; Fujisawa, Hirosuke; Kurokawa, Tetsu; Suehiro, Eiichi; Iwanaga, Hideyuki; Nakagawara, Jyoji; Suzuki, Michiyasu

    2010-01-01

    We evaluated cortical damages following traumatic brain injury (TBI) in the acute phase with [123I] iomazenil (IMZ) single photon emission computed tomography (SPECT). In all, 12 patients with cerebral contusion following TBI were recruited. All patients underwent IMZ SPECT within 1 week after TBI. To investigate the changes in distribution of IMZ in the cortex in the chronic phase, after conventional treatment, patients underwent IMZ SPECT again. A decrease in the accumulation of radioligand...

  8. Frequencies and implications of discordant findings of interictal SPECT and itcal SPECT in patients with intractable epilepsy

    International Nuclear Information System (INIS)

    Lee, D. S.; Lee, S. K.; Jeong, J. K.; Lee, M. C.; Ko, C. S.

    1997-01-01

    Interictal SPECT could be used at best as a reference image to ictal SPECT, and cause sometimes confusion if it had given unexplained discordant findings from ictal SPECT. We investigated implications of discordant findings which occurred in 26 among 268 which found their epileptogenic zones using ictal EEG and/or operative outcome. Sensitivity of interictal SPECT was only 36%. Among these 268, 69 patients had no structural lesions on MR, 14 of whom had decreased perfusion on interictal SPECT (8 trues and 6 falses (adjacent or contralateral)). Structural lesion were found in 199 on MR, 103 of whom had decreased perfusion (89 trues and 14 falses). Among 26 having discordant cases, 10 interictal SPECT were proved wrong after operation and/or invasive EEG and the other 16 were on speculation using PET and ictal EEG. Ictal hyperperfusion was observed in 14 patients in these interictal SPECT. Six ictal studies were found postictal accompanied by contralateral propagation or not. Two patients had dual pathology, and the remaining 2 unknown. Interictal SPECT was done on the 2nd day after ictal study(24), the 3rd day (18), the 4th day(16), the 5th day (23). Four among 24 interictal studies (17%) of the 2nd day and the other 4 among 57 of 3rd to 5th day revealed ictal hyperperfusion on interictal SPECT. Six interictal studies (2.7% among 221) acquired on the indifferent day showed also ictal hyperperfusion. We could suggest that the next day is not desirable for interictal SPECT after ictal study, as ictal hyperperfusion on interictal study confounded more than postictal findings of ictal SPECT in the discrete localization than reassuring ictal study

  9. Frequencies and implications of discordant findings of interictal SPECT and itcal SPECT in patients with intractable epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D S; Lee, S K; Jeong, J K; Lee, M C; Ko, C S [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1997-07-01

    Interictal SPECT could be used at best as a reference image to ictal SPECT, and cause sometimes confusion if it had given unexplained discordant findings from ictal SPECT. We investigated implications of discordant findings which occurred in 26 among 268 which found their epileptogenic zones using ictal EEG and/or operative outcome. Sensitivity of interictal SPECT was only 36%. Among these 268, 69 patients had no structural lesions on MR, 14 of whom had decreased perfusion on interictal SPECT (8 trues and 6 falses (adjacent or contralateral)). Structural lesion were found in 199 on MR, 103 of whom had decreased perfusion (89 trues and 14 falses). Among 26 having discordant cases, 10 interictal SPECT were proved wrong after operation and/or invasive EEG and the other 16 were on speculation using PET and ictal EEG. Ictal hyperperfusion was observed in 14 patients in these interictal SPECT. Six ictal studies were found postictal accompanied by contralateral propagation or not. Two patients had dual pathology, and the remaining 2 unknown. Interictal SPECT was done on the 2nd day after ictal study(24), the 3rd day (18), the 4th day(16), the 5th day (23). Four among 24 interictal studies (17%) of the 2nd day and the other 4 among 57 of 3rd to 5th day revealed ictal hyperperfusion on interictal SPECT. Six interictal studies (2.7% among 221) acquired on the indifferent day showed also ictal hyperperfusion. We could suggest that the next day is not desirable for interictal SPECT after ictal study, as ictal hyperperfusion on interictal study confounded more than postictal findings of ictal SPECT in the discrete localization than reassuring ictal study.

  10. Technetium-99m-HMPAO SPECT, CT and MRI in the evaluation of patients with chronic traumatic brain injury: a correlation with neuropsychological performance.

    Science.gov (United States)

    Ichise, M; Chung, D G; Wang, P; Wortzman, G; Gray, B G; Franks, W

    1994-02-01

    The purposes of this study were: (1) to compare 99mTc-hexamethylpropyleneamineoxime (HMPAO) SPECT with CT and MRI in chronic traumatic brain injury (TBI) patients and (2) to correlate both functional and structural neuroimaging measurements of brain damage with neuropsychological (NP) performance. Twenty-nine patients (minor TBI, n = 15 and major TBI, n = 14) and 17 normal controls (NC) underwent HMPAO SPECT, CT, MRI and NP testing. Imaging data were analyzed both visually and quantitatively. Nineteen (66%) patients showed 42 abnormalities on SPECT images, whereas 13 (45%) and 10 (34%) patients showed 29 abnormalities on MRI and 24 abnormalities on CT. SPECT detected relatively more abnormalities than CT or MRI in the minor TBI subgroup. The TBI group showed impairment on 11 tests for memory, attention and executive function. Of these, the anterior-posterior ratio (APR) correlated with six tests, whereas the ventricle-to-brain ratio (VBR), a known structural index of a poor NP outcome, correlated with only two tests. In evaluating chronic TBI patients, HMPAO SPECT, as a complement to CT or MRI, may play a useful role by demonstrating brain dysfunction in morphologically intact brain regions and providing objective evidence for some of the impaired NP performance.

  11. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other factors; KIHD perspective

    International Nuclear Information System (INIS)

    Maseeh-uz-Zaman; Fatima, N.; Samad, A.; Rasheed, S.Z.; Ishaq, M.; Rehman, K.; Wali, A.

    2009-01-01

    The objective of the present study was to assess the prevalence of coronary artery disease (CAD) among diabetic (DM) and nondiabetic (NDM) women using Gated SPECT (GSPECT) and to study the impact of other. risk factors like hypertension (HTN), dyslipidemia, family history and menopause. This is a prospective cross-sectional study on a consecutive sample of 287 women referred to Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD) for GSPECT for evaluation of known or suspected CAD (from January 2009 till June 2009). Women with a history of DM diagnosed less than 5 years were excluded. Same day (reststress) GSPECT study was conducted and fixed or reversible perfusion defects were considered positive GSPECT for CAD. GSPECT was positive for CAD in 41/115 (36%, P 0.002) diabetic women and 37/172 (21 %, P 0.005) non-diabetic cohort. In diabetic cohort, GSPECT was positive in 5/9 (56%, P 0.013) women with diabetes only, 17/35 (48%, P 0.02) DM with HTN, 12/15 (80%, P value 0.02) DM with dyslipidemia and 11/43 (26%, P 0.001) DM with >2 risk factors. GSPECT was normal in all 3 diabetic women with positive family history for CAD. In nondiabetic cohort, GSPECT was positive in 9/32 (28%, P value 0.739) women with no risk factor, 5/58 (26%, P 0.866) HTN only, 2/5 (40%, P value 0.655) only dyslipidemic women, 1/12. (8%, P 0.004) with family history only and 4/23 (17%, P value 0.166) non-diabetic with >2 risk factors. Interestingly, 35/93 post-menopausal diabetic (38%, p value 0.017) had positive GSPECT while 33/123 non-diabetic postmenopausal women (27%, p 0.03) had positive perfusion scans. GSPECT was positive in 6/26 (23%, P 0.006) and 4/49 (8%, P 0.05) in diabetic and non-diabetic pre-menopausal women. The prevalence of CAD in our diabetic women is as high as internationally reported and diabetes is a strong risk factor for CAD. Dyslipidemia with diabetes is a major contributor to CAD than HTN and F/H. Diabetes erases the protective effect of estrogen

  12. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other factors; KIHD perspective

    Energy Technology Data Exchange (ETDEWEB)

    Maseeh-uz-Zaman,; Fatima, N; Samad, A; Rasheed, S Z; Ishaq, M; Rehman, K; Wali, A [Karachi, Inst. of Heart Diseases, Karachi (Pakistan)

    2009-07-15

    The objective of the present study was to assess the prevalence of coronary artery disease (CAD) among diabetic (DM) and nondiabetic (NDM) women using Gated SPECT (GSPECT) and to study the impact of other. risk factors like hypertension (HTN), dyslipidemia, family history and menopause. This is a prospective cross-sectional study on a consecutive sample of 287 women referred to Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD) for GSPECT for evaluation of known or suspected CAD (from January 2009 till June 2009). Women with a history of DM diagnosed less than 5 years were excluded. Same day (reststress) GSPECT study was conducted and fixed or reversible perfusion defects were considered positive GSPECT for CAD. GSPECT was positive for CAD in 41/115 (36%, P 0.002) diabetic women and 37/172 (21 %, P 0.005) non-diabetic cohort. In diabetic cohort, GSPECT was positive in 5/9 (56%, P 0.013) women with diabetes only, 17/35 (48%, P 0.02) DM with HTN, 12/15 (80%, P value 0.02) DM with dyslipidemia and 11/43 (26%, P 0.001) DM with >2 risk factors. GSPECT was normal in all 3 diabetic women with positive family history for CAD. In nondiabetic cohort, GSPECT was positive in 9/32 (28%, P value 0.739) women with no risk factor, 5/58 (26%, P 0.866) HTN only, 2/5 (40%, P value 0.655) only dyslipidemic women, 1/12. (8%, P 0.004) with family history only and 4/23 (17%, P value 0.166) non-diabetic with >2 risk factors. Interestingly, 35/93 post-menopausal diabetic (38%, p value 0.017) had positive GSPECT while 33/123 non-diabetic postmenopausal women (27%, p 0.03) had positive perfusion scans. GSPECT was positive in 6/26 (23%, P 0.006) and 4/49 (8%, P 0.05) in diabetic and non-diabetic pre-menopausal women. The prevalence of CAD in our diabetic women is as high as internationally reported and diabetes is a strong risk factor for CAD. Dyslipidemia with diabetes is a major contributor to CAD than HTN and F/H. Diabetes erases the protective effect of estrogen

  13. Clinical applications of SPECT/CT: New hybrid nuclear medicine imaging system

    International Nuclear Information System (INIS)

    2008-08-01

    Interest in multimodality imaging shows no sign of subsiding. New tracers are spreading out the spectrum of clinical applications and innovative technological solutions are preparing the way for yet more modality marriages: hybrid imaging. Single photon emission computed tomography (SPECT) has enabled the evaluation of disease processes based on functional and metabolic information of organs and cells. Integration of X ray computed tomography (CT) into SPECT has recently emerged as a brilliant diagnostic tool in medical imaging, where anatomical details may delineate functional and metabolic information. SPECT/CT has proven to be valuable in oncology. For example, in the case of a patient with metastatic thyroid cancer, neither SPECT nor CT alone could identify the site of malignancy. SPECT/CT, a hybrid image, precisely identified where the surgeon should operate. However SPECT/CT is not just advantageous in oncology. It may also be used as a one-stop-shop for various diseases. Clinical applications with SPECT/CT have started and expanded in developed countries. It has been reported that moving from SPECT alone to SPECT/CT could change diagnoses in 30% of cases. Large numbers of people could therefore benefit from this shift all over the world. This report presents an overview of clinical applications of SPECT/CT and a relevant source of information for nuclear medicine physicians, radiologists and clinical practitioners. This information may also be useful for decision making when allocating resources dedicated to the health care system, a critical issue that is especially important for the development of nuclear medicine in developing countries. In this regard, the IAEA may be heavily involved in the promotion of programmes aimed at the IAEA's coordinated research projects and Technical Cooperation projects

  14. Preliminary application of brain perfusion SPECT imaging in schizophrenia

    International Nuclear Information System (INIS)

    Wu Zhixing; Guo Chanliu; Li Xingbao; Liang Rongxiang; Zhao Jun; Yan Tingxiu

    1996-01-01

    The clinical value of 99m Tc-ECD brain perfusion SPECT imaging was evaluated in patients with schizophrenia. 32 patients with schizophrenia and 21 normal controls were analyzed with 99m Tc-ECD SPECT. 93.8% (30/32) of the patients showed decreased regional cerebral blood flow (rCBF). There was normal rCBF in controls. In the patient group rCBF decreased significantly in bilateral frontal lobes, left temporal lobe and right basal ganglion. The rCBF of left temporal lobe was significantly lower than that of right temporal lobe. The decreasing rCBF was not significantly related to previous treatment and duration of illness. 99m Tc-ECD SPECT is useful for the study and diagnosis of patients with schizophrenia

  15. Applicability of myocardial perfusion scintigraphy in the evaluation of cardiac synchronization

    Energy Technology Data Exchange (ETDEWEB)

    Reis, Christiane Cigagna Wiefels; Nascimento, Erivelton Alessandro do; Dias, Fernanda Baptista Ribeiro; Ribeiro, Mario Luiz; Wanderley, Annelise Passos Bispo; Batista, Layanara Albino; Nunes, Thais Helena Peixoto; Mesquita, Claudio Tinoco, E-mail: chriswreis@gmail.com [Universidade Federal Fluminense (UFF), Niterói, RJ (Brazil). Hospital Universitário Antônio Pedro

    2017-07-15

    To systematically assess the literature on the applicability of myocardial perfusion scintigraphy with phase analysis in the investigation of cardiac dyssynchrony and in the selection of patients for cardiac resynchronization therapy (CRT), manuscripts published on the PubMed database over the past five years have been reviewed. The following MeSH terms were used: heart failure, left ventricular, dyssynchrony, gated-SPECT, phase analysis and resynchronization therapy. Altogether, 99 manuscripts were included for discussion. Speckle-tracking echocardiography is still widely used in the evaluation of dyssynchrony, but the advent of myocardial perfusion scintigraphy with the phase analysis technique has been gaining ground, as besides being operator independent, it can evaluate myocardial viability in the same test. Its use became more widespread in patients with left bundle branch block, with recommendation of CRT. Phase analysis also allows evaluating, in a highly reproducible way, the last ventricular segment to contract, hence allowing the best positioning of the CRT electrode. Knowing that the presence, location and extent of fibrosis in the left ventricle, associated with dyssynchrony are determinants of response to resynchronization therapy, GATED- SPECT can provide this information in a single test and in a reproducible and accurate way. Phase histogram offers several parameters that provide greater sensitivity and specificity to the method. It seems that the technique is able to add value both in the selection and in the evaluation of response of patients eligible to CRT. Further studies are being conducted to demonstrate its clinical applicability. (author)

  16. Pre-operative evaluation of medically intractable partial seizures using [sup 123]I-Iomazenil SPECT. Comparison with Video/EEG-monitoring and post-operative results. Praeoperative Bewertung pharmakoresistenter fokaler Epilepsien mit der [sup 123]J-Iomazenil-SPECT. Vergleich mit dem Video/EEG-Monitoring und postoperativen Ergebnissen

    Energy Technology Data Exchange (ETDEWEB)

    Venz, S [Strahlenklinik und Poliklinik und Neurologische Klinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, FU Berlin (Germany); Cordes, M [Strahlenklinik und Poliklinik und Neurologische Klinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, FU Berlin (Germany); Straub, H B [Strahlenklinik und Poliklinik und Neurologische Klinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, FU Berlin (Germany); Hierholzer, J [Strahlenklinik und Poliklinik und Neurologische Klinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, FU Berlin (Germany); Schroeder, R [Strahlenklinik und Poliklinik und Neurologische Klinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, FU Berlin (Germany); Richter, W [Strahlenklinik und Poliklinik und Neurologische Klinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, FU Berlin (Germany); Schmitz, B [Strahlenklinik und Poliklinik und Neurologische Klinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, FU Ber

    1994-10-01

    SPECT with the benzodiazepine receptor antagonist [sup 123]I-Iomazenil was performed in 33 patients with intractable partial seizures for pre-operative evaluation. The results combined with MRI and [sup 99m]Tc-HMPAO-SPECT findings were compared with the video-assisted EEG monitoring (gold standard'') which localised the focus in 25 patients. 11 patients underwent surgical resection of the epileptogenic area and became seizure-free for a period up to 13 months. The lomazenil SPECT had a significantly higher sensitivity compared to [sup 99m]Tc-HMPAO in the visualization of an epileptogenic area and should be regularly used in the diagnostic of medically intractable partial seizures. (orig.)

  17. Evaluation of respiratory pattern during respiratory-gated radiotherapy

    International Nuclear Information System (INIS)

    Dobashi, Suguru; Mori, Shinichiro

    2014-01-01

    The respiratory cycle is not strictly regular, and generally varies in amplitude and period from one cycle to the next. We evaluated the characteristics of respiratory patterns acquired during respiratory gating treatment in more than 300 patients. A total 331 patients treated with respiratory-gated carbon-ion beam therapy were selected from a group of patients with thoracic and abdominal conditions. Respiratory data were acquired for a total of 3,171 fractions using an external respiratory sensing monitor and evaluated for respiratory cycle, duty cycle, magnitude of baseline drift, and intrafractional/interfractional peak inhalation/exhalation positional variation. Results for the treated anatomical sites and patient positioning were compared. Mean ± SD respiratory cycle averaged over all patients was 4.1 ± 1.3 s. Mean ± SD duty cycle averaged over all patients was 36.5 ± 7.3 %. Two types of baseline drift were seen, the first decremental and the second incremental. For respiratory peak variation, the mean intrafractional variation in peak-inhalation position relative to the amplitude in the first respiratory cycle (15.5 ± 9.3 %) was significantly larger than that in exhalation (7.5 ± 4.6 %). Interfractional variations in inhalation (17.2 ± 18.5 %) were also significantly greater than those in exhalation (9.4 ± 10.0 %). Statistically significant differences were observed between patients in the supine position and those in the prone position in mean respiratory cycle, duty cycle, and intra-/interfractional variations. We quantified the characteristics of the respiratory curve based on a large number of respiratory data obtained during treatment. These results might be useful in improving the accuracy of respiratory-gated treatment.

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

    International Nuclear Information System (INIS)

    Kato, Hiroshi; Misawa, Toshihiro; Kutsumi, Yasunori

    1991-01-01

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

  19. Feasibility study of a novel general purpose CZT-based digital SPECT camera: initial clinical results.

    Science.gov (United States)

    Goshen, Elinor; Beilin, Leonid; Stern, Eli; Kenig, Tal; Goldkorn, Ronen; Ben-Haim, Simona

    2018-03-14

    The performance of a prototype novel digital single-photon emission computed tomography (SPECT) camera with multiple pixelated CZT detectors and high sensitivity collimators (Digital SPECT; Valiance X12 prototype, Molecular Dynamics) was evaluated in various clinical settings. Images obtained in the prototype system were compared to images from an analog camera fitted with high-resolution collimators. Clinical feasibility, image quality, and diagnostic performance of the prototype were evaluated in 36 SPECT studies in 35 patients including bone (n = 21), brain (n = 5), lung perfusion (n = 3), and parathyroid (n = 3) and one study each of sentinel node and labeled white blood cells. Images were graded on a scale of 1-4 for sharpness, contrast, overall quality, and diagnostic confidence. Digital CZT SPECT provided a statistically significant improvement in sharpness and contrast in clinical cases (mean score of 3.79 ± 0.61 vs. 3.26 ± 0.50 and 3.92 ± 0.29 vs. 3.34 ± 0.47 respectively, p < 0.001 for both). Overall image quality was slightly higher for the digital SPECT but not statistically significant (3.74 vs. 3.66). CZT SPECT provided significantly improved image sharpness and contrast compared to the analog system in the clinical settings evaluated. Further studies will evaluate the diagnostic performance of the system in large patient cohorts in additional clinical settings.

  20. HMPAO-SPECT in cerebral seizures

    International Nuclear Information System (INIS)

    Gruenwald, F.; Bockisch, A.; Reichmann, K.; Ammari, B.; Hotze, A.; Biersack, H.J.; Durwen, H.; Buelau, P.; Elger, C.E.; Rohde, A.; Penin, H.

    1988-01-01

    In nine patients with suspected psychogenic seizures and in three patients with proven epileptic seizures HMPAO-SPECT was performed prior to and during seizure. In the patients with lateron-proven psychogenic seizures no, or only slight, changes of regional cerebral blood flow were found. Patients with proven epilepsy revealed partly normal findings interictally but during seizure a markedly increased circumscript blood flow was found in all patients. Even though PET is superior to SPECT with respect to spatial resolution, in the diagnosis of seizures HMPAO-SPECT has the advantage of enabling injection of the tracer during the seizure and the performance of the SPECT study subsequently. (orig.) [de

  1. Efficient simulation of voxelized phantom in GATE with embedded SimSET multiple photon history generator

    Science.gov (United States)

    Lin, Hsin-Hon; Chuang, Keh-Shih; Lin, Yi-Hsing; Ni, Yu-Ching; Wu, Jay; Jan, Meei-Ling

    2014-10-01

    GEANT4 Application for Tomographic Emission (GATE) is a powerful Monte Carlo simulator that combines the advantages of the general-purpose GEANT4 simulation code and the specific software tool implementations dedicated to emission tomography. However, the detailed physical modelling of GEANT4 is highly computationally demanding, especially when tracking particles through voxelized phantoms. To circumvent the relatively slow simulation of voxelized phantoms in GATE, another efficient Monte Carlo code can be used to simulate photon interactions and transport inside a voxelized phantom. The simulation system for emission tomography (SimSET), a dedicated Monte Carlo code for PET/SPECT systems, is well-known for its efficiency in simulation of voxel-based objects. An efficient Monte Carlo workflow integrating GATE and SimSET for simulating pinhole SPECT has been proposed to improve voxelized phantom simulation. Although the workflow achieves a desirable increase in speed, it sacrifices the ability to simulate decaying radioactive sources such as non-pure positron emitters or multiple emission isotopes with complex decay schemes and lacks the modelling of time-dependent processes due to the inherent limitations of the SimSET photon history generator (PHG). Moreover, a large volume of disk storage is needed to store the huge temporal photon history file produced by SimSET that must be transported to GATE. In this work, we developed a multiple photon emission history generator (MPHG) based on SimSET/PHG to support a majority of the medically important positron emitters. We incorporated the new generator codes inside GATE to improve the simulation efficiency of voxelized phantoms in GATE, while eliminating the need for the temporal photon history file. The validation of this new code based on a MicroPET R4 system was conducted for 124I and 18F with mouse-like and rat-like phantoms. Comparison of GATE/MPHG with GATE/GEANT4 indicated there is a slight difference in energy

  2. Can perfusion SPECT aid CTPA interpretation?

    International Nuclear Information System (INIS)

    Gradinscak, D. J.; Roach, P.; Bailey, E.; Kueh, S.

    2009-01-01

    Full text:Objective: To determine whether fusion of perfusion SPECT and CTPA improves the diagnostic accuracy of CTPA. Methods: 35 patients with suspected PE who underwent both CTPA and SPECT V/Q within 48 hours were included. Of these, the majority (n=30) had PE as determined by the V/Q SPECT scan and the others (n=5) were negative for PE. The clinical reports of CTPA were reviewed and pulmonary emboli tabulated based on anatomical location. A second radiologist, blinded to the results of the clinical read and the V/Q SPECT scan, reviewed the CTPA with and without perfusion SPECT fusion for assistance. Results: A total 57 PE were reported on the clinical reports and 60 PE identified on the blinded read. Fused CTPA/perfursion SPECT images identified a further 5 PE not identified on the clinical read (8% increase) and 2 PE not identified on the blinded read (3% increase). The additional emboli detected resulted in a change in final diagnosis from PE negative to PE positive in 2 patients (6%) compared with the clinical read and 1 patient (3%) compared with the blinded read without SPECT fusion. Conclusion: Fused CTPA-SPECT perfusion improves the sensitivity of CTPA for the detection of PE in a small number of patients. Fused data may help guide the radiologist to identify sites of PE on CTPA.

  3. Evaluation of performance quality of SPECT camera in Sharyati Hospital of Tehran University of Medical Sciences

    International Nuclear Information System (INIS)

    Takavar, A.

    2001-01-01

    In nuclear medicine, there are two methods of imaging, planar and tomography. Single photon emission computerized tomography (SPECT) shows better image details and therefore is influenced more by image parameters such as resolution, uniformity, sensitivity, etc. Manufacturers provide customers with data which are obtained by complicated and sometimes secret methods. Marketing companies test and verify these data and buyers perform acceptance testing on installation of system. Since acceptance testing is not usually done in our country, follow up of system performance and therefore setting up of a comprehensive quality control program faces difficulty. In this research which was done sometimes after installation, evaluation of SPECT system was carried out and data obtained were compared with those of manufacturer catalogue. It was found that in most cases our figures do not correspond to those of manufacturer catalogue, therefore acceptance testing using standard and precision devices being carried out by trained personnel is strongly recommended

  4. Diagnostic role of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for early and atypical bone metastases.

    Science.gov (United States)

    Chen, Xiao-Liang; Li, Qian; Cao, Lin; Jiang, Shi-Xi

    2014-01-01

    The bone metastasis appeared early before the bone imaging for most of the above patients. (99)Tc(m)-MDP ((99)Tc(m) marked methylene diphosphonate) bone imaging could diagnosis the bone metastasis with highly sensitivity, but with lower specificity. The aim of this study is to explore the diagnostic value of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for the early period atypical bone metastases. 15 to 30 mCi (99)Tc(m)-MDP was intravenously injected to the 34 malignant patients diagnosed as doubtful early bone metastases. SPECT, CT and SPECT/CT images were captured and analyzed consequently. For the patients diagnosed as early period atypical bone metastases by SPECT/CT, combining the SPECT/CT and MRI together as the SPECT/MRI integrated image. The obtained SPECT/MRI image was analyzed and compared with the pathogenic results of patients. The results indicated that 34 early period doubtful metastatic focus, including 34 SPECT positive focus, 17 focus without special changes by using CT method, 11 bone metastases focus by using SPECT/CT method, 23 doubtful bone metastases focus, 8 doubtful bone metastases focus, 14 doubtful bone metastases focus and 2 focus without clear image. Totally, SPECT/CT combined with SPECT/MRI method diagnosed 30 bone metastatic focus and 4 doubtfully metastatic focus. In conclusion, (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging shows a higher diagnostic value for the early period bone metastases, which also enhances the diagnostic accuracy rate.

  5. Technetium-99m-HMPAO SPECT in the evaluation of patients with a remote history of traumatic brain injury: a comparison with x-ray computed tomography.

    Science.gov (United States)

    Gray, B G; Ichise, M; Chung, D G; Kirsh, J C; Franks, W

    1992-01-01

    The functional imaging modality has potential for demonstrating parenchymal abnormalities not detectable by traditional morphological imaging. Fifty-three patients with a remote history of traumatic brain injury (TBI) were studied with SPECT using 99mTc-hexamethylpropyleneamineoxime (HMPAO) and x-ray computed tomography (CT). Overall, 42 patients (80%) showed regional cerebral blood flow (rCBF) deficits by HMPAO SPECT, whereas 29 patients (55%) showed morphological abnormalities by CT. Out of 20 patients with minor head injury, 12 patients (60%) showed rCBF deficits and 5 patients (25%) showed CT abnormalities. Of 33 patients with major head injury, 30 patients (90%) showed rCBF deficits and 24 patients (72%) showed CT abnormalities. Thus, HMPAO SPECT was more sensitive than CT in detecting abnormalities in patients with a history of TBI, particularly in the minor head injury group. In the major head injury group, three patients showed localized cortical atrophy by CT and normal rCBF by HMPAO SPECT. In the evaluation of TBI patients, HMPAO SPECT is a useful technique to demonstrate regional brain dysfunction in the presence of morphological integrity as assessed by CT.

  6. Proceedings of clinical SPECT (single photon emission computed tomography) symposium

    Energy Technology Data Exchange (ETDEWEB)

    1986-09-01

    It has been five years since the last in-depth American College of Nuclear Physicians/Society of Nuclear Medicine Symposium on the subject of single photon emission computed tomography (SPECT) was held. Because this subject was nominated as the single most desired topic we have selected SPECT imaging as the basis for this year's program. The objectives of this symposium are to survey the progress of SPECT clinical applications that have taken place over the last five years and to provide practical and timely guidelines to users of SPECT so that this exciting imaging modality can be fully integrated into the evaluation of pathologic processes. The first half was devoted to a consideration of technical factors important in SPECT acquisition and the second half was devoted to those organ systems about which sufficient clinical SPECT imaging data are available. With respect to the technical aspect of the program we have selected the key areas which demand awareness and attention in order to make SPECT operational in clinical practice. These include selection of equipment, details of uniformity correction, utilization of phantoms for equipment acceptance and quality assurance, the major aspect of algorithms, an understanding of filtered back projection and appropriate choice of filters and an awareness of the most commonly generated artifacts and how to recognize them. With respect to the acquisition and interpretation of organ images, the faculty will present information on the major aspects of hepatic, brain, cardiac, skeletal, and immunologic imaging techniques. Individual papers are processed separately for the data base. (TEM)

  7. Proceedings of clinical SPECT [single photon emission computed tomography] symposium

    International Nuclear Information System (INIS)

    1986-09-01

    It has been five years since the last in-depth American College of Nuclear Physicians/Society of Nuclear Medicine Symposium on the subject of single photon emission computed tomography (SPECT) was held. Because this subject was nominated as the single most desired topic we have selected SPECT imaging as the basis for this year's program. The objectives of this symposium are to survey the progress of SPECT clinical applications that have taken place over the last five years and to provide practical and timely guidelines to users of SPECT so that this exciting imaging modality can be fully integrated into the evaluation of pathologic processes. The first half was devoted to a consideration of technical factors important in SPECT acquisition and the second half was devoted to those organ systems about which sufficient clinical SPECT imaging data are available. With respect to the technical aspect of the program we have selected the key areas which demand awareness and attention in order to make SPECT operational in clinical practice. These include selection of equipment, details of uniformity correction, utilization of phantoms for equipment acceptance and quality assurance, the major aspect of algorithms, an understanding of filtered back projection and appropriate choice of filters and an awareness of the most commonly generated artifacts and how to recognize them. With respect to the acquisition and interpretation of organ images, the faculty will present information on the major aspects of hepatic, brain, cardiac, skeletal, and immunologic imaging techniques. Individual papers are processed separately for the data base

  8. SPECT-CT in the diagnosis of coronary artery disease; SPECT-CT in der Diagnostik der koronaren Herzerkrankung

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, M. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Univ. Muenchen (Germany)

    2006-09-15

    SPECT have a very low risk of death or fatal myocardial infarction (MI), therefore no intervention is required for these patients. According to the current guidelines for management of patients with chronic stable angina, both morphological and functional information about the coronary artery tree should be present before revascularization therapy is performed. The combination of 64-slice CT angiography plus gated myocardial SPECT could provide both non-invasive three-dimensional anatomical and functional information of the coronary artery tree. (orig.)

  9. Sequential SPECT/CT imaging starting with stress SPECT in patients with left bundle branch block suspected for coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Engbers, Elsemiek M.; Mouden, Mohamed [Isala, Department of Cardiology, Zwolle (Netherlands); Isala, Department of Nuclear Medicine, Zwolle (Netherlands); Timmer, Jorik R.; Ottervanger, Jan Paul [Isala, Department of Cardiology, Zwolle (Netherlands); Knollema, Siert; Jager, Pieter L. [Isala, Department of Nuclear Medicine, Zwolle (Netherlands)

    2017-01-15

    To investigate the impact of left bundle branch block (LBBB) on sequential single photon emission computed tomography (SPECT)/ CT imaging starting with stress-first SPECT. Consecutive symptomatic low- to intermediate-risk patients without a history of coronary artery disease (CAD) referred for SPECT/CT were included from an observational registry. If stress SPECT was abnormal, additional rest SPECT and, if feasible, coronary CT angiography (CCTA) were acquired. Of the 5,018 patients, 218 (4.3 %) demonstrated LBBB. Patients with LBBB were slightly older than patients without LBBB (65±12 vs. 61±11 years, p<0.001). Stress SPECT was more frequently abnormal in patients with LBBB (82 % vs. 46 %, p<0.001). After reviewing stress and rest images, SPECT was normal in 43 % of the patients with LBBB, compared to 77 % of the patients without LBBB (p<0.001). Sixty-four of the 124 patients with LBBB and abnormal stress-rest SPECT underwent CCTA (52 %), which could exclude obstructive CAD in 46 of the patients (72 %). Sequential SPECT/CT imaging starting with stress SPECT is not the optimal imaging protocol in patients with LBBB, as the majority of these patients have potentially false-positive stress SPECT. First-line testing using CCTA may be more appropriate in low- to intermediate-risk patients with LBBB. (orig.)

  10. Memory-provoked rCBF-SPECT as a diagnostic tool in Alzheimer's disease?

    Energy Technology Data Exchange (ETDEWEB)

    Sundstroem, Torbjoern; Riklund, Katrine Aa. [Umeaa University, Umeaa University Hospital, Department of Radiation Sciences, Diagnostic Radiology, Umeaa (Sweden); Elgh, Eva; Naesman, Birgitta [Umeaa University, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeaa (Sweden); Larsson, Anne [Umeaa University, Department of Radiation Sciences, Radiation Physics, Umeaa (Sweden); Nyberg, Lars [Umeaa University, Department of Psychology, Umeaa (Sweden)

    2006-01-01

    Alzheimer's disease (AD) is a primary degenerative disease that progressively affects all brain functions, with devastating consequences for the patient, the patient's family and society. Rest regional cerebral blood flow (rCBF) could have a strategic role in differentiating between AD patients and normal controls, but its use for this purpose has a low discriminatory capacity. The purpose of this study was to evaluate whether the diagnostic sensitivity of rCBF single-photon emission computed tomography (SPECT) could be increased by using an episodic memory task provocation, i.e. memory-provoked rCBF-SPECT (MP-SPECT). Eighteen persons (73.2{+-}4.8 years) with mild AD and 18 healthy elderly (69.4{+-}3.9 years) were included in the study. The subjects were injected with{sup 99m}Tc-hexamethylpropylene amine oxime (HMPAO) during memory provocation with faces and names, followed by an rCBF-SPECT study. The rCBF{sup 99m}Tc-HMPAO SPECT images were analysed using statistical parametric mapping (SPM2). Peaks with a false discovery rate corrected value of 0.05 were considered significant. On MP-SPECT, the AD group showed a significant rCBF reduction in the left parietal cortex in comparison with healthy elderly. At rest, no significant group differences were seen. Memory provocation increased the sensitivity of rCBF-SPECT for the detection of AD-related blood flow changes in the brain at the group level. Further studies are needed to evaluate MP-SPECT as a diagnostic tool at the individual level. If a higher sensitivity for AD at the individual level is verified in future studies, a single MP-SPECT study might be sufficient in the clinical setting. (orig.)

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

    International Nuclear Information System (INIS)

    Fujinaga, Tsuyoshi; Yamazaki, Sayaka; Hara, Masatada; Umezawa, Chiaki; Okamura, Tetsuo; Murata, Hajime; Maruno, Hirotaka; Onoguchi, Masahisa.

    1993-01-01

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

  12. {sup 99m}Tc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric; Taieb, David; Cammilleri, Serge; Lussato, David; Laforte, Catherine de; Mundler, Olivier [Assistance Publique des Hopitaux de Marseille, Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 05 (France); Niboyet, Jean [Clinique La Phoceanne, Unite d' Etude et de Traitement de la Douleur, Marseille (France)

    2007-01-15

    Neuro-imaging studies with {sup 99m}Tc-HMPAO SPECT in fibromyalgia (FM) patients have reported only limited subcortical hypoperfusion. {sup 99m}Tc-ECD SPECT is known to provide better evaluation of areas of high cerebral blood flow and regional metabolic rate. We evaluated a homogeneous group of hyperalgesic patients with FM using {sup 99m}Tc-ECD SPECT. The aim of this study was to investigate brain processing associated with spontaneous pain in FM patients. Eighteen hyperalgesic FM women (mean age 49 years, range 25-63 years; American College of Rheumatology criteria) and ten healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). Visual Analogue Scale score for pain was 82{+-}4 at the time of the SPECT study. Compared with control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis, with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. In the present study, performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in the sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective-attentional dimension. As current pharmacological and non-pharmacological therapies act differently on the two components of pain, we hypothesise that SPECT could be a valuable and readily available tool to guide individual therapeutic strategy and provide objective follow-up of pain processing recovery under treatment. (orig.)

  13. Usefulness of change ratio map in 99mTc-HMPAO SPECT with acetazolamide enhancement

    International Nuclear Information System (INIS)

    Yamamoto, Naoyuki

    1996-01-01

    Although a sequential 99m Tc-HMPAO SPECT technique with Diamox test (seq-SPECT) is a simple and time-saving procedure to assess brain perfusion reserve, the influence of the first dose of the tracer on the second one is not negligible. Therefore, a subtraction of the rest-SPECT from the 2nd SPECT is widely-used. However, subtracted SPECT images not only need to be corrected for the injected dose and the radiochemical purity due to inherent instability of HMPAO but also are usually degraded in quality. This study was undertaken to resolve these problems utilizing a change ratio (CR) map. The CR map was obtained by dividing 2nd SPECT by rest-SPECT. Prior to subtraction, the 2nd SPECT was normalized with the ratio of the mean whole brain counts between both SPECTs. To validate CR map, 7 patients were studied with both seq-SPECT and 133 Xe inhalation CBF measurement (Xe-CBF). The right to left count ratio obtained from the ROIs placed on MCA territory of CR map correlated well with that from Xe-CBF (r=0.89, p<0.01). Fifty-three patients with stroke underwent the seq-SPECT which was compared with the cerebral angiography (CAG) and classified into 4 groups according to the CR map. In 25 patients, all of the rest-, the subtracted-SPECT and the CR map did not show any difference between the affected side and the contralateral normal side. Seven patients with normal rest-SPECT showed decreased subtracted-SPECT counts and CR on the affected side. Three of them showed more than 75% stenosis on CAG. Four patients with the decreased counts both at the rest-and the subtracted-SPECT revealed no difference on the CR map suggesting the matched decrease of both blood flow and metabolism in the affected side. In conclusion, the CR map was a simple and useful method to evaluate the brain perfusion reserve with the seq-SPECT. (author)

  14. Evaluation of respiratory movement during gated radiotherapy using film and electronic portal imaging

    International Nuclear Information System (INIS)

    Ford, E.C.; Mageras, G.S.; Yorke, E.; Rosenzweig, K.E.; Wagman, R.; Ling, C.C.

    2002-01-01

    Purpose: To evaluate the effectiveness of a commercial system in reducing respiration-induced treatment uncertainty by gating the radiation delivery. Methods and Materials: The gating system considered here measures respiration from the position of a reflective marker on the patient's chest. Respiration-triggered planning CT scans were obtained for 8 patients (4 lung, 4 liver) at the intended phase of respiration (6 at end expiration and 2 at end inspiration). In addition, fluoroscopic movies were recorded simultaneously with the respiratory waveform. During the treatment sessions, gated localization films were used to measure the position of the diaphragm relative to the vertebral bodies, which was compared to the reference digitally reconstructed radiograph derived from the respiration-triggered planning CT. Variability was quantified by the standard deviation about the mean position. We also assessed the interfraction variability of soft tissue structures during gated treatment in 2 patients using an amorphous silicon electronic portal imaging device. Results: The gated localization films revealed an interfraction patient-averaged diaphragm variability of 2.8±1.0 mm (error bars indicate standard deviation in the patient population). The fluoroscopic data yielded a patient-averaged intrafraction diaphragm variability of 2.6±1.7 mm. With no gating, this intrafraction excursion became 6.9±2.1 mm. In gated localization films, the patient-averaged mean displacement of the diaphragm from the planning position was 0.0±3.9 mm. However, in 4 of the 8 patients, the mean (over localization films) displacement was >4 mm, indicating a systematic displacement in treatment position from the planned one. The position of soft tissue features observed in portal images during gated treatments over several fractions showed a mean variability between 2.6 and 5.7 mm. The intrafraction variability, however, was between 0.6 and 1.4 mm, indicating that most of the variability was

  15. Implications of CT noise and artifacts for quantitative 99mTc SPECT/CT imaging

    International Nuclear Information System (INIS)

    Hulme, K. W.; Kappadath, S. C.

    2014-01-01

    Purpose: This paper evaluates the effects of computed tomography (CT) image noise and artifacts on quantitative single-photon emission computed-tomography (SPECT) imaging, with the aim of establishing an appropriate range of CT acquisition parameters for low-dose protocols with respect to accurate SPECT attenuation correction (AC). Methods: SPECT images of two geometric and one anthropomorphic phantom were reconstructed iteratively using CT scans acquired at a range of dose levels (CTDI vol = 0.4 to 46 mGy). Resultant SPECT image quality was evaluated by comparing mean signal, background noise, and artifacts to SPECT images reconstructed using the highest dose CT for AC. Noise injection was performed on linear-attenuation (μ) maps to determine the CT noise threshold for accurate AC. Results: High levels of CT noise (σ ∼ 200–400 HU) resulted in low μ-maps noise (σ ∼ 1%–3%). Noise levels greater than ∼10% in 140 keV μ-maps were required to produce visibly perceptible increases of ∼15% in 99m Tc SPECT images. These noise levels would be achieved at low CT dose levels (CTDI vol = 4 μGy) that are over 2 orders of magnitude lower than the minimum dose for diagnostic CT scanners. CT noise could also lower (bias) the expected μ values. The relative error in reconstructed SPECT signal trended linearly with the relative shift in μ. SPECT signal was, on average, underestimated in regions corresponding with beam-hardening artifacts in CT images. Any process that has the potential to change the CT number of a region by ∼100 HU (e.g., misregistration between CT images and SPECT images due to motion, the presence of contrast in CT images) could introduce errors in μ 140 keV on the order of 10%, that in turn, could introduce errors on the order of ∼10% into the reconstructed 99m Tc SPECT image. Conclusions: The impact of CT noise on SPECT noise was demonstrated to be negligible for clinically achievable CT parameters. Because CT dose levels that affect

  16. Preoperative evaluation of malignancy of glioma by thallium-201 SPECT, proton MRS and 18F-fluorodeoxy-glucose PET

    International Nuclear Information System (INIS)

    Ito, Tamio; Nakagawara, Jyoji; Sasaki, Takehiko; Nakamura, Hirohiko; Tsukamoto, Eriko

    2005-01-01

    We studied preoperative malignancy evaluation of glioma by thallium-201 SPECT (T1-SPECT), proton MRS (MRS) and 18F-fluorodeoxy-glucose PET (FDG-PET). Twenty-seven patients with astrocytic tumors (diffuse astrocytoma (A): 8, anaplastic astrocytoma (AA): 10, glioblastoma (GB): 9) were retrospectively studied. FDG-PET was assessed as the visual metabolic grading scale (MG Scale) in 9 cases. The Tl index was expressed as the count rate of the tumor site to the count rate over the contralateral normal region in 25 cases. MRS was evaluated as the metabolite ratios of choline/creatine (Cho/Cr) and Cho/N-acetylaspartate (NAA), and as the presence of lactate and lipid metabolites in 23 cases. As the malignancy grade of the glioma rises, so too did the MG Scale of FDG-PET and Tl index (PET MG Scale (A: Grade (Gr). 1; 2 cases, Gr.2; 2 cases, AA: Gr.1; 1 case, Gr.2; 1 case, GB: Gr.2; 2 cases, Gr.3; 1 case), Tl index: A:129±0.22, AA: 1.97±0.44, GB: 342±1.38). Metabolite ratios of Cho/Cr and Cho/NAA in the high-grade gliomas were higher than those in the low-grade gliomas, however, those of GB were lower than those of AA, maybe due to difficulty in the spectroscopic voxel selection (Cho/Cr: A:1.86, AA: 2.96, GB: 2.73, Cho/NAA: A: 2.90, AA: 6.37, GB: 5.57). Both lactate and lipids presented in the high-grade glioma cases. Proliferative potential as measured by MIB-1 index mostly correlated with the Tl index significantly (p=0.0002). We were able to evaluate the malignancy grade of gliomas preoperatively by using FDG-PET, Tl-SPECT and MRS, however, we also need to understand the pitfalls of each of these examinations respectively (author)

  17. Evaluation of segmental left ventricular wall motion by equilibrium gated radionuclide ventriculography.

    Science.gov (United States)

    Van Nostrand, D; Janowitz, W R; Holmes, D R; Cohen, H A

    1979-01-01

    The ability of equilibrium gated radionuclide ventriculography to detect segmental left ventricular (LV) wall motion abnormalities was determined in 26 patients undergoing cardiac catheterization. Multiple gated studies obtained in 30 degrees right anterior oblique and 45 degrees left anterior oblique projections, played back in a movie format, were compared to the corresponding LV ventriculograms. The LV wall in the two projections was divided into eight segments. Each segment was graded as normal, hypokinetic, akinetic, dyskinetic, or indeterminate. Thirteen percent of the segments in the gated images were indeterminate; 24 out of 27 of these were proximal or distal inferior wall segments. There was exact agreement in 86% of the remaining segments. The sensitivity of the radionuclide technique for detecting normal versus any abnormal wall motion was 71%, with a specificity of 99%. Equilibrium gated ventriculography is an excellent noninvasive technique for evaluating segmental LV wall motion. It is least reliable in assessing the proximal inferior wall and interventricular septum.

  18. SPM analysis of cerebrovascular reserve capacity after stimulation with acetazolamide measured by Tc-99m ECD SPECT in normal brain MRI patient

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M. H.; Yoon, S. N.; Yoon, J. K.; Cho, C. W. [College of Medicine, Univ. of Ajou, Suwon (Korea, Republic of)

    2003-07-01

    This study was undertaken to evaluate normal response of acetazolamide in normal individuals, whose brain MRI is normal, using SPM99. In total, 10 Tc- 99m ECD brain SPECT were evaluated retrospectively. The half of the patients were male. Their mean age was 47.1 years old with a range of 33-61 years. They all visited our neurology department to evaluate stroke symptom. Their brain MRI was normal. Rest/acetazolamide brain SPECT was perfomed using Tc-99m ECD and the sequential injection and subtraction method. SPECT was acquired using fanbeam collimators and triple-head gamma camera (MultiSPECT III, Siemens medical systems, Inc. Hoffman Estates, III, USA). Chang's attenuation correction was applied their brain SPECT revealed normal rCBF pattern in visual analysis by two nuclear physician and they were diagnosed clinically normal. Using SPM method, we compared rest brain SPECT images with those of acetazolamide brain SPECT and measured the extent of the area with significant perfusion change (P<0.05) in predefined 34 cerebral regions. Acetazolamide brain SPECT showed no significant decreased region in comparison to rest brain SPECT. Only small portion of left mid temporal gyrus revealed increased rCBF on acetazolamide brain SPECT in comparison to rest brain SPECT. It apperas that there is no significant change in rCBF between rest and acetazolamide brain SPECT using Tc-99m ECD. The small number of this study is limitation of our study.

  19. Multi-centre evaluation of accuracy and reproducibility of planar and SPECT image quantification. An IAEA phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, Brian E. [National Institute of Standards and Technology, Gaithersburg, MD (United States); Grosev, Darko [Univ. Hospital Centre Zagreb (Croatia); Buvat, Irene [Service Hospitalier Frederic Joliot, Paris (France); and others

    2017-08-01

    Accurate quantitation of activity provides the basis for internal dosimetry of targeted radionuclide therapies. This study investigated quantitative imaging capabilities at sites with a variety of experience and equipment and assessed levels of errors in activity quantitation in Single-Photon Emission Computed Tomography (SPECT) and planar imaging. Participants from 9 countries took part in a comparison in which planar, SPECT and SPECT with X ray computed tomography (SPECT-CT) imaging were used to quantify activities of four epoxy-filled cylinders containing {sup 133}Ba, which was chosen as a surrogate for {sup 131}I. The sources, with nominal volumes of 2, 4, 6 and 23 mL, were calibrated for {sup 133}Ba activity by the National Institute of Standards and Technology, but the activity was initially unknown to the participants. Imaging was performed in a cylindrical phantom filled with water. Two trials were carried out in which the participants first estimated the activities using their local standard protocols, and then repeated the measurements using a standardized acquisition and analysis protocol. Finally, processing of the imaging data from the second trial was repeated by a single centre using a fixed protocol. In the first trial, the activities were underestimated by about 15% with planar imaging. SPECT with Chang's first order attenuation correction (Chang-AC) and SPECT-CT overestimated the activity by about 10%. The second trial showed moderate improvements in accuracy and variability. Planar imaging was subject to methodological errors, e.g., in the use of a transmission scan for attenuation correction. The use of Chang-AC was subject to variability from the definition of phantom contours. The project demonstrated the need for training and standardized protocols to achieve good levels of quantitative accuracy and precision in a multicentre setting. Absolute quantification of simple objects with no background was possible with the strictest protocol to

  20. SPECT in psychiatry

    International Nuclear Information System (INIS)

    Kasper, S.; Gruenwald, F.; Walter, H.; Klemm, E.; Podreka, I.; Biersack, H.J.

    1994-01-01

    In the last fifteen years different attempts have been undertaken to understand the biological basis of major psychiatric disorders. One important tool to determine patterns of brain dysfunction is single emission computed tomography (SPECT). Whereas SPECT investigations are already a valuable diagnostic instrument for the diagnosis of dementia of the Alzheimer Type (DAT) there have not been consistent findings that can be referred to as specific for any other particular psychiatric diagnostic entity. Nevertheless, SPECT studies have been able to demonstrate evidence of brain dysfunction in patients with schizophrenia, depression, anxiety disorders, and substance abuse in which other methods showed no clear abnormality of brain function. Our manuscript reviews the data which are currently available in the literature and stresses the need for further studies, especially for prediction and monitoring psychiatric treatment modalities. (orig.) [de

  1. Superimposed dual-isotope SPECT using 99mTc-hydroxymethylene diphosphonate and 201Tl-chloride to assess cartilage invasion in laryngohypopharyngeal cancer

    International Nuclear Information System (INIS)

    Nishiyama, Yoshihiro; Yamamoto, Yuka; Yokoe, Koiku; Miyabe, Kazunori; Iwasaki, Takanobu; Toyama, Yoshihiro; Satoh, Katashi; Ohkawa, Motoomi

    2004-01-01

    Cartilage invasion in laryngohypopharyngeal cancer has a significant impact on the choice of treatment modality and outcome of the disease. We examined invasion of cartilage in laryngohypopharyngeal cancer by simultaneous bone and tumor dual-isotope SPECT using 99m Tc-hydroxymethylene diphosphonate and 201 Tl-chloride. Early and delayed simultaneous bone and tumor dual-isotope SPECT were performed on 19 patients with laryngohypopharyngeal cancer. Dual-isotope SPECT images were superimposed to project tumor location from tumor SPECT onto the osseous structures shown by bone SPECT. The presence or absence of cartilage invasion was evaluated histopathologically or by radiological studies such as CT and/or MRI. Histopathological or radiological examination of the cartilage revealed invasion in 5 patients and no invasion in 14 patients. The results of both early and delayed dual-isotope SPECT were exactly the same. Using dual-isotope SPECT, the sensitivity, specificity, and accuracy in detecting cartilage invasion by laryngohypopharyngeal cancer were: 80% (4/5), 92.9% (13/14), and 89.5% (17/19), respectively. Results of the present study suggest that superimposed early bone and tumor dual-isotope SPECT images may be sufficient for the diagnostic evaluation of cartilage invasion by laryngohypopharyngeal cancer. Superimposed dual-isotope SPECT imaging is a useful technique in the evaluation of cartilage invasion in laryngohypopharyngeal cancer. (author)

  2. SPECT/CT: main applications in nuclear medicine

    International Nuclear Information System (INIS)

    Perera Pintado, Alejandro; Torres Aroche, Leonel A.; Vergara Gil, Alex; Batista Cuéllar, Juan F.; Prats Capote, Anaís

    2017-01-01

    SPECT/CT has represented not only the possibility of acquiring anatomical and functional images in one single study, but also a revolution for the clinical management of several diseases, taking the better of each one of these imaging modalities. The present work is aimed at presenting an overview of the most important applications of the SPECT/CT in the field of oncology, cardiology and neurology. New technological advances in the design of innovative solid state detectors and related equipment have had a positive effect on the performance of this kind of dual modality. This hybrid technique improves the sensitivity and the specificity of gammagraphic studies, as well as shortens the acquisition times and gives attenuation correction of co-registered images, which, in turn, makes their analysis easier. Some of the main applications for the study of oncological diseases are the following: localization and follow-up of different kinds of tumors, their metastasis and relapses, as well as the optimization of radiotherapy doses. This technique has been useful to evaluate the coronary artery disease allowing an adequate attenuation correction of images, the determination of calcium score, and performing angio-CT studies, according to the CT quality. SPECT/CT has also gained ground in the assessment of some neurological diseases. Conclusions: The introduction of new technological advances and radiopharmaceuticals thus predicting a more relevant place for SPECT/CT in clinical practice. (author)

  3. Clinical usefulness of Tc-99m hexakis 2-methoxybutyl isonitrile gated SPECT in patients with dilated cardiomyopathy: retrospective analysis

    International Nuclear Information System (INIS)

    Khan, Z.R.; Khan, A.Z.

    2010-01-01

    Background: In Dilated cardiomyopathy the heart is enlarged and ventricles are dilated. Gated myocardial perfusion single photon emission computed tomography is considered state of the art for myocardial perfusion imaging. A retrospective analysis was conducted to evaluate patients with dilated cardiomyopathy with Tc-99m sestamibi gated myocardial perfusion single photon emission computed tomography to evaluate its clinical utility. Methods: A 10 year retrospective medical record review was done from 1991 to 2001 at Wake Forest University, North Carolina, USA. Eligibility criteria included a diagnosis of dilated cardiomyopathy and availability of coronary angiography and Tc-99m sestamibi cardiac imaging results. 26 cases were selected for the final review and inclusion in the study. The study was done with standard protocols for cardiac sestamibi imaging. Results: A total of 26 cases were included in the final analysis. Cases were divided into two main groups. Group-A included 16 patients with no correlation between Tc-99m sestamibi and cardiac catheterisation reports. Group-B included 10 patients with good correlation between the above tests. There were no significant differences between the left ventricular ejection fraction, angina history, sex distribution and diabetic status between the two groups. We applied Wilcoxon Signed Rank Test and z-test to quantify the difference between the two groups. Data was tabulated and z-test was performed. The calculated p value was <0.0001. This is significantly less than the tabulated p-value at 5% level of significance, i.e., 1.96. Significant differences exist between Group-A and Group-B. Conclusion: Tc-99m sestamibi is an excellent agent for investigating myocardial perfusion in dilated cardiomyopathy. The reversible and fixed perfusion defects (small to medium sized) seen in dilated cardiomyopathy after performance of Tc-99m sestamibi gated single photon emission computed tomography imaging may not be due to coronary

  4. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  5. Evaluation of the effects of methylprednisolone pulse therapy in patients with systemic lupus erythematosus with brain involvement by Tc-99m HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sun, S.S.; Kao, C.H. [Department of Nuclear Medicine, China Medical University Hospital, Taichung (Taiwan); Huang, W.S. [Department of Nuclear Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei (Taiwan); Chen, J.J.H. [Section of Rheumatology, Department of Internal Medicine, China Medicine University Hospital, Taichung (Taiwan); Chang, C.P. [Division of Allergy, Immunology and Rheumatology, Changhua Christian Hospital, Changhua (Taiwan); Wang, J.J. [Department of Medical Research, Chi-Mei Medical Center, Tainan (Taiwan)

    2004-07-01

    Methylprednisolone pulse therapy (MPT) was introduced to avoid life-threatening complications in patients with systemic lupus erythematosus (SLE) with brain manifestations; however, the efficacy of MPT in SLE patients with brain involvement is still uncertain and needs to be objectively evaluated. We enrolled 15 female SLE patients with neuropsychiatric manifestations in this study. All patients had normal brain MRI and abnormal brain HMPAO-SPECT findings. Follow-up HMPAO-SPECT studies were conducted 2 weeks after MPT. Serum levels of anticardiolipin antibodies (ACA) and anti-ribosomal P antibodies (anti-P) were measured before and after MPT. Before MPT, 7 patients were positive for ACA and 7 patients were positive for anti-P. After MPT, none of the 15 patients demonstrated positive serologic findings or neuropsychiatric manifestations. Based on the follow up brain HMPAO-SPECT images following MPT, 13 patients showed disappearance of the perfusion defects and 2 patients showed partial recovery of rCBF. Brain HMPAO-SPECT imaging is a logical and objective tool for measuring the effects of MPT in SLE patients with brain involvement by determining of changes in rCBF. (orig.)

  6. Clinical evaluation of left ventricular wall thickness by combined technique with gated planer /sup 201/Tl image and gated cardiac pool image

    Energy Technology Data Exchange (ETDEWEB)

    Nakai, Kenji; Katsuragawa, Shigehiko; Takahashi, Tsuneo; Matsushita, Kazuo; Kawamura, Akiyoshi

    1983-11-01

    To evaluate the left ventricular (LV) wall thickness, a combined technique with gated planer 201-thallium image and gated cardiac pool image was applied to 6 patients with hypertrophic cardiomyopathy (HCM) and 4 patients with secondary hypertrophy due to hypertension (HHD) proven by electrocardiography and ultrasonic-echocardiography. Scintigraphic pattern of hypertrophy on reconstructed planer /sup 201/Tl image showed diffuse or asymmetrical apical hypertrophy in HHD, asymmetrical septal hypertrophy in HCM. It was very interesting that abnormal perfusion was shown in /sup 201/Tl image, despite symmetrical hypertrophy in echocardiography. This techniques provided useful information for evaluating the LV wall thickness and cardiac performance.

  7. Normal anatomy of lung perfusion SPECT scintigraphy

    International Nuclear Information System (INIS)

    Moskowitz, G.W.; Levy, L.M.

    1987-01-01

    Ten patients studies for possible pulmonary embolic disease had normal lung perfusion planar and SPECT scintigraphy. A computer program was developed to superimpose the CT scans on corresponding SPECT images. Superimposition of CT scans on corresponding SPECT transaxial cross-sectional images, when available, provides the needed definition and relationships of adjacent organs. SPECT transaxial sections provide clear anatomic definition of perfusion defects without foreground and background lung tissue superimposed. The location, shape, and size of the perfusion defects can be readily assessed by SPECT. An algorithm was developed for the differentiation of abnormal pulmonary perfusion patterns from normal structures on variation

  8. Optimization of SPECT calibration for quantification of images applied to dosimetry with iodine-131

    International Nuclear Information System (INIS)

    Carvalho, Samira Marques de

    2018-01-01

    SPECT systems calibration plays an essential role in the accuracy of the quantification of images. In this work, in its first stage, an optimized SPECT calibration method was proposed for 131 I studies, considering the partial volume effect (PVE) and the position of the calibration source. In the second stage, the study aimed to investigate the impact of count density and reconstruction parameters on the determination of the calibration factor and the quantification of the image in dosimetry studies, considering the reality of clinical practice in Brazil. In the final step, the study aimed evaluating the influence of several factors in the calibration for absorbed dose calculation using Monte Carlo simulations (MC) GATE code. Calibration was performed by determining a calibration curve (sensitivity versus volume) obtained by applying different thresholds. Then, the calibration factors were determined with an exponential function adjustment. Images were performed with high and low counts densities for several source positions within the simulator. To validate the calibration method, the calibration factors were used for absolute quantification of the total reference activities. The images were reconstructed adopting two approaches of different parameters, usually used in patient images. The methodology developed for the calibration of the tomographic system was easier and faster to implement than other procedures suggested to improve the accuracy of the results. The study also revealed the influence of the location of the calibration source, demonstrating better precision in the absolute quantification considering the location of the target region during the calibration of the system. The study applied in the Brazilian thyroid protocol suggests the revision of the calibration of the SPECT system, including different positions for the reference source, besides acquisitions considering the Signal to Noise Ratio (SNR) of the images. Finally, the doses obtained with the

  9. Clinical Significance of Brain SPECT in Zipeprol Abusers

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Dai Ok; Kim, Jae Phil; Kim, Deog Yoon; Yang, Hyung In; Koh, Eun Mi; Kim, Kwang Won; Choi, Young Kil [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    1993-03-15

    Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of Tc-99m- HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction induced by zipeprol abuse.

  10. SPECT and MRI in the diagnosis of epilepsy

    International Nuclear Information System (INIS)

    Gruenwald, F.; Biersack, H.J.; Bockisch, A.; Elger, C.E.; Durwen, H.F.; Penin, H.

    1989-01-01

    This study presents the results obtained using SPECT and MRI in epilepsy - mainly based on presurgical investigation in therapy-resistant cases of temporal lobe epilepsy. MRI was positive in 61% of 102 examined patients, SPECT was positive in 84%. In 46 patients with temporal lobe epilepsy subjected to partial temporal lobectomy was performed later on there was agreement of the results obtained with regard to the lateralisation in 74%. Although MRI, due to its sensitivity is superior to CT in diagnosis of epilepsy, CT should be performed in any case because some morphological changes - especially small arteriovenous malformations - are only seen in CT. MRI and SPECT should be considered as two complementary methods in epilepsy diagnosis, serving to evaluate morphology and function. A definite statement as to the predictive value of both methods remains to be made depending on a comparison of the results with the postoperative outcome referring to seizure frequency and cognitive function. (orig.) [de

  11. Clinical Significance of Brain SPECT in Zipeprol Abusers

    International Nuclear Information System (INIS)

    Cho, Dai Ok; Kim, Jae Phil; Kim, Deog Yoon; Yang, Hyung In; Koh, Eun Mi; Kim, Kwang Won; Choi, Young Kil

    1993-01-01

    Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of Tc-99m- HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction induced by zipeprol abuse.

  12. Evaluation of (99m)Tc-HYNIC-TMTP1 as a tumor-homing imaging agent targeting metastasis with SPECT.

    Science.gov (United States)

    Li, Fei; Cheng, Teng; Dong, Qingjian; Wei, Rui; Zhang, Zhenzhong; Luo, Danfeng; Ma, Xiangyi; Wang, Shixuan; Gao, Qinglei; Ma, Ding; Zhu, Xiaohua; Xi, Ling

    2015-03-01

    TMTP1 (NVVRQ) is a novel tumor-homing peptide, which specifically targets tumor metastases, even at the early stage of occult metastasis foci. Fusing TMTP1 to therapeutic peptides or proteins can increase its anti-cancer efficacy both in vivo and in vitro. Here, we labeled TMTP1 with (99m)Tc to evaluate its targeting properties in an ovarian cancer xenograft tumor mouse model and a gastric cancer xenograft mouse model. The invasion ability of SKOV3 and highly metastatic SKOV3.ip cell lines were performed by the Transwell Invasion Assays, and then Rhodamine-TMTP1 was used to detect its affinity to these two cells. Using the co-ligand ethylenediamine-N, N'-diacetic acid (EDDA) and the bifunctional chelator 6-hydrazinonicotinic acid (HYNIC), the TMTP1 peptide was labeled with (99m)Tc. A cell-binding assay was performed by incubating cancer cells with (99m)Tc-HYNIC-TMTP1 with or without an excess dose of cold HYNIC-TMTP1. To evaluate the probe in vivo, nude mice bearing SKOV3, SKOV3.ip and MNK-45 tumor cells were established and subjected to SPECT imaging after injection with (99m)Tc-HYNIC-TMTP1. Ex vivo γ-counting of dissected tissues from the mice was used to evaluate its biodistribution. (99m)Tc-HYNIC-TMTP1 was successfully synthesized. The radiotracer also exhibited high hydrophilicity and excellent stability in vitro and in vivo. It has strong affinity to highly metastatic cancer cell lines but not to poorly metastatic cell lines. After mice were injected with (99m)Tc-HYNIC-TMTP1, non-invasive SPECT imaging detected SKOV3.ip and MNK-45 xenograft tumors but not SKOV3 xenograft tumors. This result can be inhibited by excess HYNIC-TMTP1. The uptake of (99m)Tc-HYNIC-TMTP1 in SKOV3.ip xenograft tumors was 0.182±0.017% ID/g at 2h p.i. with high renal uptake (74.32±15.05% ID/g at 2h p.i.). (99m)Tc-HYNIC-TMTP1 biodistribution and SPECT imaging demonstrated its ability to target highly metastatic tumors. Therefore, metastasis can be non-invasively investigated by SPECT

  13. Dobutamine stress tetrofosmin SPECT. Evaluation of short rest-stress protocol and head to head comparison with MIBI in detection of coronary artery disease

    International Nuclear Information System (INIS)

    Turgut, B.; Unlu, M.; Cengel, A.

    2005-01-01

    The purpose of the present study was to evaluate the feasibility and diagnostic accuracy of same day short rest-dobutamine stress Tetrofosmin (TF) SPECT imaging protocol and to compare TF SPECT results with methoxyisobutyl isonitrile (MIBI) SPECT in the same subjects who were unable to perform treadmill exercise or were unsuitable for pharmacological vasodilator stress. The study group consisted of 19 patients (2 female and 17 male, with a mean age of 53.8±7.9 yrs) in whom coronary artery disease (CAD) had been proven or excluded at coronary angiography (CA). MIBI SPECT imaging was performed first. TF SPECT images were obtained one week after MIBI imaging. Immediately after the rest SPECT imaging in both of the MIBI and TF studies, patients underwent dobutamine stress tests. Rest-stress radiotracer doses and dobutamine doses were the same for both TF and MIBI studies. While 60 min waiting periods were applied for MIBI study, only 30 min waiting periods were applied for TF study after the rest and stress injections. Images were evaluated by visual and quantitative analysis. Dobutamine stress parameters were similar for both studies. Although in TF study, the time between radiopharmaceutical injection and imaging was shorter than in MIBI study, there was no significant difference between heart-to-liver (H/Li) and heart-to-lung (H/Lu) ratios. According to CA results, diagnostic accuracy was similar for TF and MIBI. While sensitivity, specificity and accuracy for TF study were calculated as 82%, 84% and 82%, respectively, the corresponding values for MIBI were 82%, 88% and 84%, respectively. This clinical study has shown comparable diagnostic performance for the detection of CAD between MIBI and TF. Good correlation was found between segmental analysis for both studies. MIBI and TF showed similar perfusion defects and good segmental correlation during dobutamine stress with the same quality images. Both radiopharmaceuticals may be acceptable with this imaging protocol

  14. Evaluation of diastolic phase by left ventricular volume curve using s2-gated equilibrium method among radioisotope angiography

    International Nuclear Information System (INIS)

    Watanabe, Yoshirou; Sakai, Akira; Inada, Mitsuo; Shiraishi, Tomokuni; Kobayashi, Akitoshi

    1982-01-01

    S2-gated (the second heart sound) method was designed by authors. In 6 normal subjects and 16 patients (old myocardial infarction 12 cases, hypertension 2 cases and aortic regurgitation 2 cases), radioisotope (RI) angiography using S2-gated equilibrium method was performed. In RI angiography, sup(99m)Tc-human serum albumin (HSA) 555MBq (15mCi) as tracer, PDP11/34 as minicomputer and PCG/ECG symchromizer (Metro Inst.) were used. Then left ventricular (LV) volume curve by S2-gated and electrocardiogram (ECG) R wave-gated method were obtained. Using LV volume curve, left ventricular ejection fraction (EF), mean ejection rate (mER, s -1 ), mean filling rate (mFR, -1 ) and rapid filling fraction (RFF) were calculated. mFR indicated mean filling rate during rapid filling phase. RFF was defined as the filling fraction during rapid filling phase among stroke volume. S2-gated method was reliable in evaluation of early diastolic phase, compared with ECG-gated method. There was the difference between RFF in normal group and myocardial infarction (MI) group (p < 0.005). RFF in 2 groups were correlated with EF (r = 0.82, p < 0.01). RFF was useful in evaluating MI cases who had normal EF values. The comparison with mER by ECG-gated and mFR by S2-gated was useful in evaluating MI cases who had normal mER values. mFR was remarkably lower than mER in MI group, but was equal to mER in normal group approximately. In conclusion, the evaluation using RFF and mFR by S2-gated method was useful in MI cases who had normal systolic phase indices. (author)

  15. Accuracy of bone SPECT/CT for identifying hardware loosening in patients who underwent lumbar fusion with pedicle screws

    Energy Technology Data Exchange (ETDEWEB)

    Hudyana, Hendrah; Maes, Alex [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Hospital Leuven, Department of Morphology and Medical Imaging, Leuven (Belgium); Vandenberghe, Thierry; Fidlers, Luc [AZ Groeninge, Department of Neurosurgery, Kortrijk (Belgium); Sathekge, Mike [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Nicolai, Daniel [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Wiele, Christophe van de [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Ghent, Department of Radiology and Nuclear Medicine, Ghent (Belgium)

    2016-02-15

    The aim of this retrospective study was to evaluate the accuracy of bone SPECT (single photon emission computed tomography)/CT (computed tomography) in diagnosing loosening of fixation material in patients with recurrent or persistent back pain that underwent lumbar arthrodesis with pedicle screws using surgery and clinical follow-up as gold standard A total of 48 patients (median age 49 years, range 21-81 years; 17 men) who had undergone lumbar spinal arthrodesis were included in this retrospective analysis. SPECT/CT results were compared to the gold standard of surgical evaluation or clinical follow-up. Positive SPECT/CT results were considered true positives if findings were confirmed by surgery or if clinical and other examinations were completely consistent with the positive SPECT/CT finding. They were considered false positives if surgical evaluation did not find any loose pedicle screws or if symptoms subsided with non-surgical therapy. Negative SPECT/CT scans were considered true negatives if symptoms either improved without surgical intervention or remained stable over a minimum follow-up period of 6 months. Negative SPECT/CT scans were determined to be false negatives if surgery was still required and loosening of material was found. The median length of time from primary surgery to bone SPECT/CT referral was 29.5 months (range 12-192 months). Median follow-up was 18 months (range 6-57) for subjects who did not undergo surgery. Thirteen of the 48 patients were found to be positive for loosening on bone SPECT/CT. Surgical evaluation (8 patients) and clinical follow-up (5 patients) showed that bone SPECT/CT correctly predicted loosening in 9 of 13 patients, while it falsely diagnosed loosening in 4 patients. Of 35 negative bone SPECT/CT scans, 12 were surgically confirmed. In 18 patients, bone SPECT/CT revealed lesions that could provide an alternative explanation for the symptoms of pain (active facet degeneration in 14 patients, and disc and sacroiliac

  16. Evaluation of myocardial damage in Duchenne's muscular dystrophy with thallium-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Tamura, Takuhisa; Shibuya, Noritoshi; Hashiba, Kunitake; Oku, Yasuhiko; Mori, Hideki; Yano, Katsusuke.

    1993-01-01

    Myocardial damage and cardiopulmonary functions in patients with Duchenne's muscular dystrophy (DMD) were assessed using thallium-201 myocardial single-photon emission computed tomography (SPECT) and technetium-99m multigated radionuclide angiography. Twenty-five patients with DMD were divided into 4 groups according to percent of perfusion defect (%PD) calculated by the bull's-eye method and age. PD was detected in 24 (96.0%) of 25 patients with DMD, and it spread from the left ventricular lateral wall to the anterior wall and/or interventricular septum. PD was detected even in a 6-year-old DMD boy. Patients in Group I (%PD≥10% and age<15 years old) were shown to have a higher risk of left-sided heart failure without respiratory failure. Patients in Group II (%PD≥10 and age≥15) showed decreased pulmonary function and worsened arterial blood gas values as compared with Group IV (%PD<10 and age≥15). There was no significant difference in cardiac function among the 4 groups. It is postulated that myocardial damage in Group II patients is dependent primarily on a deficiency of dystrophin and on chronic respiratory failure, and that some of them are at risk of cardiopulmonary failure. It is concluded that myocardial SPECT is useful for the early diagnosis of myocardial damage and evaluation of cardiopulmonary function in DMD patients. (author)

  17. Perfusion differences on SPECT and PWI in patients with acute ischemic stroke

    International Nuclear Information System (INIS)

    Nuutinen, Juho; Liu, Yawu; Laakso, Mikko P.; Karonen, Jari O.; Vanninen, Esko J.; Kuikka, Jyrki T.; Aronen, Hannu J.; Vanninen, Ritva L.

    2009-01-01

    The purposes of the present study were to compare the flow defect volumes on perfusion-weighted magnetic resonance imaging (PWI) and 99m Tc-labeled ethylcysteinate dimer ( 99m Tc-ECD) single photon emission computed tomography (SPECT) at acute and subacute stages of ischemic stroke and to analyze the relationship between the detected flow defects on the two methods and neurological status and clinical outcomes. Perfusion defects on PWI and SPECT were measured within 48 h and on day 8 of the onset of stroke from 22 patients with their first-ever acute supratentorial ischemic stroke. The primary neurological status was evaluated prior to the imaging. Clinical outcome was assessed at 3 months after the onset of the stroke. The volumes of cerebral blood flow (CBF) defects did not differ between SPECT and PWI within the 48-h examinations. However, the volume of CBF defect was significantly larger on SPECT than on PWI on day 8 (p = 0.03). Within the 48-h examinations, the CBF defect volumes on SPECT and PWI were comparably related to the neurological status. On day 8, the CBF defect volume on SPECT showed higher correlation to the neurological status and more precisely predicted the clinical outcomes at 3 months than PWI. 99m TC-ECD-SPECT and PWI both have ability to detect cerebral hypoperfusion in patients with ischemic stroke but with some differences. The value of SPECT is more accurate in terms of the delayed outcome, such as prognosis and rehabilitation planning. (orig.)

  18. Perfusion differences on SPECT and PWI in patients with acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Nuutinen, Juho [Kuopio University Hospital, University of Kuopio, Department of Neurology, Kuopio (Finland); Liu, Yawu; Laakso, Mikko P. [Kuopio University Hospital, University of Kuopio, Department of Neurology, Kuopio (Finland); Kuopio University Hospital, University of Kuopio, Department of Clinical Radiology, P. O. Box 1777, Kuopio (Finland); Karonen, Jari O. [Mikkeli Central Hospital, Department of Radiology, Mikkeli (Finland); Vanninen, Esko J. [Kuopio University Hospital, University of Kuopio, Department of Clinical Physiology and Nuclear Medicine, Kuopio (Finland); Kuikka, Jyrki T. [Kuopio University Hospital, University of Kuopio, Department of Clinical Physiology and Nuclear Medicine, Kuopio (Finland); Niuvanniemi Hospital, Kuopio (Finland); Aronen, Hannu J. [University of Turku, Department of Radiology, Turku (Finland); Vanninen, Ritva L. [Kuopio University Hospital, University of Kuopio, Department of Clinical Radiology, P. O. Box 1777, Kuopio (Finland)

    2009-10-15

    The purposes of the present study were to compare the flow defect volumes on perfusion-weighted magnetic resonance imaging (PWI) and {sup 99m}Tc-labeled ethylcysteinate dimer ({sup 99m}Tc-ECD) single photon emission computed tomography (SPECT) at acute and subacute stages of ischemic stroke and to analyze the relationship between the detected flow defects on the two methods and neurological status and clinical outcomes. Perfusion defects on PWI and SPECT were measured within 48 h and on day 8 of the onset of stroke from 22 patients with their first-ever acute supratentorial ischemic stroke. The primary neurological status was evaluated prior to the imaging. Clinical outcome was assessed at 3 months after the onset of the stroke. The volumes of cerebral blood flow (CBF) defects did not differ between SPECT and PWI within the 48-h examinations. However, the volume of CBF defect was significantly larger on SPECT than on PWI on day 8 (p = 0.03). Within the 48-h examinations, the CBF defect volumes on SPECT and PWI were comparably related to the neurological status. On day 8, the CBF defect volume on SPECT showed higher correlation to the neurological status and more precisely predicted the clinical outcomes at 3 months than PWI. {sup 99m}TC-ECD-SPECT and PWI both have ability to detect cerebral hypoperfusion in patients with ischemic stroke but with some differences. The value of SPECT is more accurate in terms of the delayed outcome, such as prognosis and rehabilitation planning. (orig.)

  19. Global scaling for semi-quantitative analysis in FP-CIT SPECT.

    Science.gov (United States)

    Kupitz, D; Apostolova, I; Lange, C; Ulrich, G; Amthauer, H; Brenner, W; Buchert, R

    2014-01-01

    Semi-quantitative characterization of dopamine transporter availability from single photon emission computed tomography (SPECT) with 123I-ioflupane (FP-CIT) is based on uptake ratios relative to a reference region. The aim of this study was to evaluate the whole brain as reference region for semi-quantitative analysis of FP-CIT SPECT. The rationale was that this might reduce statistical noise associated with the estimation of non-displaceable FP-CIT uptake. 150 FP-CIT SPECTs were categorized as neurodegenerative or non-neurodegenerative by an expert. Semi-quantitative analysis of specific binding ratios (SBR) was performed with a custom-made tool based on the Statistical Parametric Mapping software package using predefined regions of interest (ROIs) in the anatomical space of the Montreal Neurological Institute. The following reference regions were compared: predefined ROIs for frontal and occipital lobe and whole brain (without striata, thalamus and brainstem). Tracer uptake in the reference region was characterized by the mean, median or 75th percentile of its voxel intensities. The area (AUC) under the receiver operating characteristic curve was used as performance measure. The highest AUC of 0.973 was achieved by the SBR of the putamen with the 75th percentile in the whole brain as reference. The lowest AUC for the putamen SBR of 0.937 was obtained with the mean in the frontal lobe as reference. We recommend the 75th percentile in the whole brain as reference for semi-quantitative analysis in FP-CIT SPECT. This combination provided the best agreement of the semi-quantitative analysis with visual evaluation of the SPECT images by an expert and, therefore, is appropriate to support less experienced physicians.

  20. Incremental Diagnostic Performance of Combined Parameters in the Detection of Severe Coronary Artery Disease Using Exercise Gated Myocardial Perfusion Imaging.

    Directory of Open Access Journals (Sweden)

    Chia-Ju Liu

    Full Text Available Myocardial perfusion imaging (MPI using gated single-photon emission tomography (gSPECT may underestimate the severity of coronary artery disease (CAD. This study aimed to evaluate the significance of combined parameters derived from gSPECT, as well as treadmill stress test parameters, in the detection of severe CAD.A total of 211 consecutive patients referred for exercise MPI between June 2011 and June 2013 (who received invasive coronary angiography within six months after MPI were retrospectively reviewed. Exercise MPI was performed with Bruce protocol and 201Tl injected at peak exercise. Gated SPECT was performed using a cadmium-zinc-telluride camera and processed by QPS/QGS software. Perfusion defect abnormalities such as sum stress score (SSS; sum difference score, algorithm-derived total perfusion deficits, transient ischemic dilatation ratios of end-diastolic volumes and end-systolic volumes, post-stress changes in ejection fraction, and lung/heart ratio (LHR were calculated. Treadmill parameters, including ST depression (STD at the 1st and 3rd minutes of recovery stage (1'STD and 3'STD, maximal STD corrected by heart rate increment (ST/HR, heart rate decline in 1st and 3rd minutes of recovery stage, recovery heart rate ratio (HR ratio, systolic and mean blood pressure ratios (SBP ratio and MAP ratio during recovery phase were recorded. Diagnostic performances of these parameters were analyzed with receiver operating characteristic (ROC analysis and logistic regression for detection of left main (≥ 50% or 3-vessel disease (all ≥ 70% luminal stenosis on invasive angiography.Among various MPI and treadmill parameters used for detection of severe CAD, SSS and ST/HR had the highest AUC (0.78, 0.73, p = NS and best cut-off values (SSS > 6, ST/HR > 17.39 10-2mV/bpm, respectively. By univariate logistic regression, all parameters except 1'HRR, 3'HRR, SBP and MAP ratios increased the odds ratio of severe CAD. Only increased L/H ratio, 3'STD

  1. An analytical simulation technique for cone-beam CT and pinhole SPECT

    International Nuclear Information System (INIS)

    Zhang Xuezhu; Qi Yujin

    2011-01-01

    This study was aimed at developing an efficient simulation technique with an ordinary PC. The work involved derivation of mathematical operators, analytic phantom generations, and effective analytical projectors developing for cone-beam CT and pinhole SPECT imaging. The computer simulations based on the analytical projectors were developed by ray-tracing method for cone-beam CT and voxel-driven method for pinhole SPECT of degrading blurring. The 3D Shepp-Logan, Jaszczak and Defrise phantoms were used for simulation evaluations and image reconstructions. The reconstructed phantom images were of good accuracy with the phantoms. The results showed that the analytical simulation technique is an efficient tool for studying cone-beam CT and pinhole SPECT imaging. (authors)

  2. Diagnostic value of rest and stress gated 82Rb PET myocardial perfusion imaging using quantitative software

    International Nuclear Information System (INIS)

    Shi Hongcheng; Gu Yusen; Liu Wenguan; Zhu Weimin; Halkar, R.K.; Santana, C.A.; Feng Yusheng

    2008-01-01

    Objective: Gated myocardial perfusion imaging (MPI) is regularly performed using SPECT. More recently, gated 82 Rb MPI has been used to assess left ventricular myocardial perfusion and function with new generation PET scanners. The objective of this study was to evaluate the value of rest and stress gated 82 Rb PET myocardial perfusion imaging and to determine whether the quantitative technique in- creased the confidence level of the interpreters. Methods: Thirty-two patients underwent rest and adenosine stress gated 82 Pb PET MPI. Emory Cardiac Toolbox quantitative software was used for processing and inter-predation. Left ventricular ejection fraction (LVEF), end-diastolic, end-systolic and transient ischemia dilation ratio were automatically generated. Three interpreters (nuclear medicine doctors) independently reviewed the studies. Visual scoring (1-5 scales: excellent, good, unsure, poor, uninterpretable) was used to assess the overall quality of the gated images and the added confidence level of interpretation. Visual assessment of the LVEF was compared to the automatically generated LVEF. Comparison between the visual assessment and software generated was graded on a 1- 5 scales (helpful, probably helpful, unsure, probably not helpful, definitely not helpful). The analysed items were divided into two groups (favorable group and negative group). The percentage and 95% confidence intervals of each group were calculated. Results: A total of 192 gated studies were evaluated (64 gated x 3 interpreters ). The overall quality of the gated images was good [excellent 40.1% (77/192), good 43.2% (83/192), unsure 3.1% (6/192), poor 13.6% (26/192), uninterpretable 0]. The 95% confidence intervals of good and excellent quality range from 78.1% to 88.6%. The interpreter's agreed with the automated LVEF on 85.4% of the gated images [agree 76.6% (147/192), probably agree 8.8% (17/192), unsure 3.1% (6/192), probably disagree 8.8% (17/192), disagree 2.6% (5/192)]. And its 95

  3. Viewing the functional consequences of traumatic brain injury by using brain SPECT.

    Science.gov (United States)

    Pavel, D; Jobe, T; Devore-Best, S; Davis, G; Epstein, P; Sinha, S; Kohn, R; Craita, I; Liu, P; Chang, Y

    2006-03-01

    High-resolution brain SPECT is increasingly benefiting from improved image processing software and multiple complementary display capabilities. This enables detailed functional mapping of the disturbances in relative perfusion occurring after TBI. The patient population consisted of 26 cases (ages 8-61 years)between 3 months and 6 years after traumatic brain injury.A very strong case can be made for the routine use of Brain SPECT in TBI. Indeed it can provide a detailed evaluation of multiple functional consequences after TBI and is thus capable of supplementing the clinical evaluation and tailoring the therapeutic strategies needed. In so doing it also provides significant additional information beyond that available from MRI/CT. The critical factor for Brain SPECT's clinical relevance is a carefully designed technical protocol, including displays which should enable a comprehensive description of the patterns found, in a user friendly mode.

  4. Clinical evaluation of Parkinson's disease using sup 123 I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Hiroko; Odano, Ikuo; Nishihara, Mamiko; Higuchi, Shouichi; Sakai, Kunio [Niigata Univ. (Japan). School of Medicine; Ishikawa, Atsushi

    1989-11-01

    N-isopropyl-p({sup 123}I)iodoamphetamine ({sup 123}I-IMP) SPECT and regional cerebral blood flow (rCBF) studies were performed in 20 patients with Parkinson's disease (PD) and 8 normal subjects. RCBF was measured by the arterial blood sampling method which used the microsphere model. We analized seven factors which might be related to the rCBF in PD, i.e., age, stage, duration of the disease, cerebral atrophy, severity of dementia, laterality of symptoms and motor disability score (MDS; the degree of akinesia, rigidity, tremor, gait disturbance, freezing and pulsion sign). Compared with normal subjects, global CBF (supratentorial mean rCBF) was reduced by 21.8% in PD. In particular, rCBF in the basal ganglia and that of frontal cortex were reduced by 25.3% and 24.8%, respectively. Distribution patterns of rCBF in PD were almost as same as those in normals except for cerebellum. The reduction of both rCBFs in the basal ganglia and parietal cortex significantly correlated with MDS (p<0.05, respectively). Especially, akinesia was closely correlated to the reduction of rCBF in the parietal cortex (p<0.02). Moreover, we observed a significant relationship between cerebral atrophy and reduction of rCBF in each region except for cerebellum. However, there was no significant correlation between the severity of dementia and reduction of rCBF, even in the frontal cortex or parietal cortex. These data show that the severity of dementia in PD may be connected with other factors except for rCBF. {sup 123}I-IMP SPECT study is a useful method for clinical evaluation of PD. (author).

  5. A limitation of the split-dose method for evaluating rCBF changes using 99mTc-ECD and SPECT

    International Nuclear Information System (INIS)

    Odano, Ikuo; Takahashi, Makoto; Noguchi, Eikichi; Ohtaki, Hiro; Shibaki, Mitsurou; Kasahara, Tosifumi; Hatano, Masayoshi; Ohkubo, Masaki.

    1997-01-01

    The purpose of the study is to validate the split-dose method corrected with dose ratio of 99m Tc-ECD for brain perfusion scan. A dose of 600 MBq of 99m Tc-ECD was divided into two with various dose ratios from 1 : 1 to 1 : 4, and injected to eleven patients with various cerebral diseases. A lesser dose of 99m Tc-ECD was injected under a control state for the first SPECT scan, and 15 min SPECT scan was performed 10 min after injection with a triple-head high resolution gamma camera. After the scan, the other dose of 99m Tc-ECD was injected under the same control state and the second SPECT scan was performed as same as above. A ratio of the activity of the first scan to the net activity of the second scan corrected by dose ratio, defined as K, was measured in brain regions of each subject. Expected value of K was 1, but the value was distributed with large variations in each subject. The mean % error of the K value was 10.4±4.9%. Hence it is considered that activity changes by more than 20% from the control values should be required to detect a significant rCBF change in an activation SPECT study. Then, we proposed a new method in which the activity of both two SPECT scans was normalized by cerebellar or occipital activity and compared. The ratio obtained by the proposed method came closer to 1 with less variations and with less mean % error in comparison with those of K value obtained by the dose-correction method. Although the proposed method has a limitation in the use of an activation study loaded with Diamox, it may be useful to evaluate an alteration of rCBF in the study such as postural testing or finger-moving test. (author)

  6. Brain perfusion SPECT imaging before and during the acetazolamide test using sup 99m Tc-HMPAO

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi; Higashi, Sotaro; Kinuya, Keiko; Tsuji, Shiro; Sumiya, Hisashi; Hisada, Kinichi; Yamashita, Junkoh (Kanazawa Univ. (Japan). School of Medicine)

    1990-05-01

    A new method using brain perfusion {sup 99m}Tc-HMPAO SPECT imaging was developed for evaluating cerebral perfusion reserve by the acetazolamide test with a short period. The first SPECT study was carried out for 13.5 min to obtain SPECT images at the resting state after 3 min postinjection of 555 MBq (15 mCi) of {sup 99m}Tc-HMPAO. At the same time as the start of the first SPECT study, 1 g of acetazolamide was intravenously injected. Immediately after the stop of the 1st SPECT study, 925 MBq (25 mCi) of {sup 99m}Tc-HMPAO from the same vial as in the first study was additionally injected. Three minutes later the second SPECT study was carried out for 10 min. After reconstruction the tomographic images in the first study were subtracted from the images in the second study to obtain those during the acetazolamide test after correction of the time differences in data acquisition between the two studies. This subtraction technique gives independent brain perfusion SPECT images before and during the acetazolamide test. Besides, the regional flow changes during the test were quantitatively analyzed. In conclusion this method seems to be practically useful for evaluating regional brain perfusion before and during drug treatments as a consecutive study with a short period of approximately 30 min. (author).

  7. Automated voxel-based analysis of brain perfusion SPECT for vasospasm after subarachnoid haemorrhage

    International Nuclear Information System (INIS)

    Iwabuchi, S.; Yokouchi, T.; Hayashi, M.; Kimura, H.; Tomiyama, A.; Hirata, Y.; Saito, N.; Harashina, J.; Nakayama, H.; Sato, K.; Aoki, K.; Samejima, H.; Ueda, M.; Terada, H.; Hamazaki, K.

    2008-01-01

    We evaluated regional cerebral blood flow (rCBF) during vasospasm after subarachnoid haemorrhage ISAH) using automated voxel-based analysis of brain perfusion single-photon emission computed tomography (SPELT). Brain perfusion SPECT was performed 7 to 10 days after onset of SAH. Automated voxel-based analysis of SPECT used a Z-score map that was calculated by comparing the patients data with a control database. In cases where computed tomography (CT) scans detected an ischemic region due to vasospasm, automated voxel-based analysis of brain perfusion SPECT revealed dramatically reduced rCBF (Z-score ≤ -4). No patients with mildly or moderately diminished rCBF (Z-score > -3) progressed to cerebral infarction. Some patients with a Z-score < -4 did not progress to cerebral infarction after active treatment with a angioplasty. Three-dimensional images provided detailed anatomical information and helped us to distinguish surgical sequelae from vasospasm. In conclusion, automated voxel-based analysis of brain perfusion SPECT using a Z-score map is helpful in evaluating decreased rCBF due to vasospasm. (author)

  8. Onboard functional and molecular imaging: A design investigation for robotic multipinhole SPECT

    International Nuclear Information System (INIS)

    Bowsher, James; Giles, William; Yin, Fang-Fang; Yan, Susu; Roper, Justin

    2014-01-01

    Purpose: Onboard imaging—currently performed primarily by x-ray transmission modalities—is essential in modern radiation therapy. As radiation therapy moves toward personalized medicine, molecular imaging, which views individual gene expression, may also be important onboard. Nuclear medicine methods, such as single photon emission computed tomography (SPECT), are premier modalities for molecular imaging. The purpose of this study is to investigate a robotic multipinhole approach to onboard SPECT. Methods: Computer-aided design (CAD) studies were performed to assess the feasibility of maneuvering a robotic SPECT system about a patient in position for radiation therapy. In order to obtain fast, high-quality SPECT images, a 49-pinhole SPECT camera was designed which provides high sensitivity to photons emitted from an imaging region of interest. This multipinhole system was investigated by computer-simulation studies. Seventeen hot spots 10 and 7 mm in diameter were placed in the breast region of a supine female phantom. Hot spot activity concentration was six times that of background. For the 49-pinhole camera and a reference, more conventional, broad field-of-view (FOV) SPECT system, projection data were computer simulated for 4-min scans and SPECT images were reconstructed. Hot-spot localization was evaluated using a nonprewhitening forced-choice numerical observer. Results: The CAD simulation studies found that robots could maneuver SPECT cameras about patients in position for radiation therapy. In the imaging studies, most hot spots were apparent in the 49-pinhole images. Average localization errors for 10-mm- and 7-mm-diameter hot spots were 0.4 and 1.7 mm, respectively, for the 49-pinhole system, and 3.1 and 5.7 mm, respectively, for the reference broad-FOV system. Conclusions: A robot could maneuver a multipinhole SPECT system about a patient in position for radiation therapy. The system could provide onboard functional and molecular imaging with 4-min

  9. Onboard functional and molecular imaging: A design investigation for robotic multipinhole SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Bowsher, James, E-mail: james.bowsher@duke.edu; Giles, William; Yin, Fang-Fang [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 and Medical Physics Graduate Program, Duke University, Durham, North Carolina 27710 (United States); Yan, Susu [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27710 (United States); Roper, Justin [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 (United States)

    2014-01-15

    Purpose: Onboard imaging—currently performed primarily by x-ray transmission modalities—is essential in modern radiation therapy. As radiation therapy moves toward personalized medicine, molecular imaging, which views individual gene expression, may also be important onboard. Nuclear medicine methods, such as single photon emission computed tomography (SPECT), are premier modalities for molecular imaging. The purpose of this study is to investigate a robotic multipinhole approach to onboard SPECT. Methods: Computer-aided design (CAD) studies were performed to assess the feasibility of maneuvering a robotic SPECT system about a patient in position for radiation therapy. In order to obtain fast, high-quality SPECT images, a 49-pinhole SPECT camera was designed which provides high sensitivity to photons emitted from an imaging region of interest. This multipinhole system was investigated by computer-simulation studies. Seventeen hot spots 10 and 7 mm in diameter were placed in the breast region of a supine female phantom. Hot spot activity concentration was six times that of background. For the 49-pinhole camera and a reference, more conventional, broad field-of-view (FOV) SPECT system, projection data were computer simulated for 4-min scans and SPECT images were reconstructed. Hot-spot localization was evaluated using a nonprewhitening forced-choice numerical observer. Results: The CAD simulation studies found that robots could maneuver SPECT cameras about patients in position for radiation therapy. In the imaging studies, most hot spots were apparent in the 49-pinhole images. Average localization errors for 10-mm- and 7-mm-diameter hot spots were 0.4 and 1.7 mm, respectively, for the 49-pinhole system, and 3.1 and 5.7 mm, respectively, for the reference broad-FOV system. Conclusions: A robot could maneuver a multipinhole SPECT system about a patient in position for radiation therapy. The system could provide onboard functional and molecular imaging with 4-min

  10. Evaluation of linear registration algorithms for brain SPECT and the errors due to hypoperfusion lesions

    International Nuclear Information System (INIS)

    Radau, Perry E.; Slomka, Piotr J.; Julin, Per; Svensson, Leif; Wahlund, Lars-Olof

    2001-01-01

    The semiquantitative analysis of perfusion single-photon emission computed tomography (SPECT) images requires a reproducible, objective method. Automated spatial standardization (registration) of images is a prerequisite to this goal. A source of registration error is the presence of hypoperfusion defects, which was evaluated in this study with simulated lesions. The brain perfusion images measured by 99m Tc-HMPAO SPECT from 21 patients with probable Alzheimer's disease and 35 control subjects were retrospectively analyzed. An automatic segmentation method was developed to remove external activity. Three registration methods, robust least squares, normalized mutual information (NMI), and count difference were implemented and the effects of simulated defects were compared. The tested registration methods required segmentation of the cerebrum from external activity, and the automatic and manual methods differed by a three-dimensional displacement of 1.4±1.1 mm. NMI registration proved to be least adversely effected by simulated defects with 3 mm average displacement caused by severe defects. The error in quantifying the patient-template parietal ratio due to misregistration was 2.0% for large defects (70% hypoperfusion) and 0.5% for smaller defects (85% hypoperfusion)

  11. SP-ECT imaging and its physical study

    International Nuclear Information System (INIS)

    Kinoshita, Fujimi

    1983-01-01

    Recently, more than a hundred hospitals are provided with SPECT system for clinical examination in Japan. However, a standardization of measuring method and performance test of the systems is ont yet made. We have been studying some basic problems of SPECT system with special phantoms originaly designed by ourselves. We got a conclusion that a standardized phantom is necessary for comparing performances between SPECT systems. In clinical experiences with 3,332 cases, we think that SPECT image combined with conventional image presents much more informations for accurate diagnosis, especially in brain, bone and tumor imagings. Synthesized image of SPECT and XCT, double tracer image and transmission image are useful to visualize the body contour and the clinical diagnosis. (author)

  12. DMSA SPECT imaging using oblique reconstruction in a paediatric population - benefits and technical considerations

    International Nuclear Information System (INIS)

    Parsons, G.; Ford, M.; Crisp, J.; Bernard, E.; Howman-Giles, R.

    1997-01-01

    Full text: DMSA renal scans are frequently requested for the diagnosis and follow-up of acute pyelonephritis and cortical scarring. This study was designed to:- 1. evaluate oblique reconstruction of DMSA SPECT over standard plane reconstruction and planar imaging; and 2. report on the technical aspects important in obtaining high quality DMSA SPECT, particularly in neonates. Over seven months, 210/231 (91 %) of DMSA scans were performed with SPECT on children from age nine days to 16 years, the median age being 2.5 years. 65 patients (31 %) were under one year and 39 (18%) were under six months. Planar and SPECT imaging with standard plane reconstruction and oblique reorientation was performed on the Siemens triple-headed gamma camera. High quality SPECT images were obtained on the smallest babies using a paediatric palette, and were of comparable quality to those of older children. At the time of reporting, the nuclear medicine physician assessed the diagnostic value of the three types of date presented: (1) planar images; (2) standard plane SPECT reconstruction; and (3) oblique SPECT reconstruction. Cortical defects were identified separately for upper, middle and lower poles. Three physicians concluded that high quality SPECT is superior to planar images when assessing the renal cortex. In addition, oblique reorientation is superior to standard reconstruction, particularly at the upper and lower poles. SPECT is now performed routinely on patients of all ages, and the oblique sagittal and coronal reorientation is now used in place of the standard reconstruction

  13. The accuracy of myocardial perfusion SPECT imaging in the evaluation of coronary artery disease in women and men

    International Nuclear Information System (INIS)

    Kaminek, M.; Myslivecek, M.; Huyak, V.; Koranda, P.; Skvarilova, M.; Ostransky, J.

    2001-01-01

    The purpose of this study is to compare sensitivity, specificity and accuracy of myocardial perfusion SPECT for the detection of coronary artery disease (CAD) in women and men. 588 patients (455 males and 133 females, 273 after a previous myocardial infarction) underwent stress myocardial perfusion SPECT. The accuracy of myocardial perfusion SPECT was proved by coronary angiography (stenosis >50% was considered as a CAD). The sensitivity of SPECT was slightly higher, but statistically not significant, in men than in women (94% versus 91%, p > 0.05). The specificity was higher in women than in men (93% versus 82%), but this difference was not statistically significant either (p > 0.05). The accuracy of SPECT was the same for both sexes (92%). In angiographically verified group of patients the selection bias was obvious - patients with CAD dominated (74%) and the fraction of patients with CAD in men's group (83%) was significantly higher than in women's group (50%), p < 0.05. No significant difference was revealed in the accuracy of myocardial perfusion SPECT in men and women. Our results are in accordance with the prevailing opinion in literature that discovered differences in sensitivity, specificity and diagnostic accuracy are usually not statistically significant or that they can be explained by the selection bias of patients in angiographically verified groups (significantly higher fraction of patients with CAD in men's group). (author)

  14. Clinical application of SPECT in adrenal imaging with iodine-131 6 beta-iodomethyl-19-norcholesterol

    International Nuclear Information System (INIS)

    Ishimura, J.; Kawanaka, M.; Fukuchi, M.

    1989-01-01

    Forty-one patients with or without adrenocortical disorders were studied to evaluate the clinical usefulness of SPECT in adrenal imaging with I-131 Adosterol. In the SPECT images from this study, all glands with either normally functioning or hyperfunctioning adrenal cortices could be detected, while those glands with hypofunctioning adrenal cortices could not be detected. Particularly in transaxial and sagittal slices, the adrenal gland was identified posteriorly and was clearly distinguished from the gallbladder. In preliminary results using SPECT by a standard method, uptake in 68 detectable glands ranged from 1.7% to 4.9% in four glands with Cushing's syndrome, from 1.1% to 1.3% in seven glands with primary aldosteronism, and were distributed below 1.0% in the remaining glands with normally functioning adrenal cortices. These data show that it is possible to evaluate the adrenocortical functioning status simply by analyzing the SPECT images of the adrenal

  15. An evaluation of gating window size, delivery method, and composite field dosimetry of respiratory-gated IMRT

    International Nuclear Information System (INIS)

    Hugo, Geoffrey D.; Agazaryan, Nzhde; Solberg, Timothy D.

    2002-01-01

    A respiratory gating system has been developed based on a commercial patient positioning system. The purpose of this study is to investigate the ability of the gating system to reproduce normal, nongated IMRT operation and to quantify the errors produced by delivering a nongated IMRT treatment onto a moving target. A moving phantom capable of simultaneous two-dimensional motion was built, and an analytical liver motion function was used to drive the phantom. Studies were performed to assess the effect of gating window size and choice of delivery method (segmented and dynamic multileaf collimation). Additionally, two multiple field IMRT cases were delivered to quantify the error in gated and nongated IMRT with motion. Dosimetric error between nonmoving and moving deliveries is related to gating window size. By reducing the window size, the error can be reduced. Delivery error can be reduced for both dynamic and segmented delivery with gating. For the implementation of dynamic IMRT delivery in this study, dynamic delivery was found to generate larger delivery errors than segmented delivery in most cases studied. For multiple field IMRT delivery, the largest errors were generated in regions where high field modulation was present parallel to the axis of motion. Gating was found to reduce these large errors to clinically acceptable levels

  16. Precise fusion of MRI and dual energy 111In WBC/99mTc HDP SPECT/CT in the diabetic foot using companion CT: an example of SPECT/MRI imaging

    International Nuclear Information System (INIS)

    Knešaurek, K.; Heiba, S.; Kolker, D.; Vatti, S.

    2015-01-01

    The purpose of our study was to correctly fuse MRI and SPECT 111 In WBC and 99m Tc HDP images using companion CT images. The fused images could be used to assess proper surgical approach in treatment of the diabetic foot. Nine patients who had dual energy 111 In WBC/ 99 m Tc HDP SPECT/CT and MRI studies within a week were investigated in an ongoing project. A GE Infinia SPECT/CT camera and Siemens MAGNETOM 1.5T MR system were used in this study. First, the MRI and corresponding CT images were coregistrated using a transformation based on normalized mutual information. The transformation was saved and used for MRI and 111 In WBC/ 99 m Tc HDP SPECT fusion. A Jaszczak phantom study was also performed in order to estimate accuracy of MRI/ SPECT fusion. The Jaszczak phantom study with 3.7 MBq 111 In hot sphere showed that MRI/SPECT alignment using the approach described above produced registration with 0.7±0.4 mm accuracy in all three dimensions (3D). The nine clinical cases were visually evaluated and showed 1-2 mm 3D fusion accuracy. MRI provides almost perfect anatomy of soft tissue and bony structures but it may exaggerate the extent of infection. 111 In WBC/ 99 m Tc HDP SPECT imaging is more accurate for infection detection but lacks anatomical reference. Combination of these images proved an essential adjunct to diagnosis. A clinical utility of the approach is illustrated in two clinical examples. In conclusion, the CT in dual energy 111 In WBC/ 99 m Tc HDP SPECT/CT studies can be used to accurately fuse and compare 111 In WBC/ 99 m Tc HDP SPECT and MRI images of the diabetic foot. This can significantly help in conservative treatment planning and limb salvage procedures in treatment of diabetic foot infections.

  17. Diagnosis of Alzheimer's disease using brain perfusion SPECT and MR imaging: which modality achieves better diagnostic accuracy?

    International Nuclear Information System (INIS)

    Kubota, Takao; Ushijima, Yo; Yamada, Kei; Okuyama, Chio; Kizu, Osamu; Nishimura, Tsunehiko

    2005-01-01

    The purpose of this study was to compare the accuracy of MR imaging and brain perfusion single-photon emission tomography (SPECT) in diagnosing Alzheimer's disease (AD). The transaxial section display of brain perfusion SPECT, three-dimensional stereotactic surface projection (3D-SSP) SPECT image sets, thin-section MR imaging of the hippocampus and perfusion MR imaging were evaluated in 66 subjects comprising 35 AD patients and 31 subjects without AD. SPECT and MR imaging were visually interpreted by two experts and two novices, and the diagnostic ability of each modality was evaluated by receiver operating characteristic (ROC) analysis. In the experts' interpretations, there was no significant difference in the area under the ROC curve (A z ) between 3D-SSP and thin-section MR imaging, whereas the A z of transaxial SPECT display was significantly lower than that of 3D-SSP (3D-SSP: 0.97, thin-section MR imaging: 0.96, transaxial SPECT: 0.91), and the A z of perfusion MR imaging was lowest (0.63). The sensitivity and specificity of each modality were, respectively, 80.0% and 96.8% for 3D-SSP, 77.1% and 96.8% for thin-section MR imaging, 60.0% and 93.5% for transaxial SPECT display and 34.3% and 100% for perfusion MR imaging. In the novices' interpretations, the A z , sensitivity and specificity of 3D-SSP were superior to those of thin-section MR imaging. Thin-section hippocampal MR imaging and 3D-SSP image sets had potentially equivalent value for the diagnosis of AD, and they were superior to transaxial SPECT display and perfusion MR imaging. For avoidance of the effect of interpreters' experience on image evaluation, 3D-SSP appears to be optimal. (orig.)

  18. Reproducibility of Lobar Perfusion and Ventilation Quantification Using SPECT/CT Segmentation Software in Lung Cancer Patients.

    Science.gov (United States)

    Provost, Karine; Leblond, Antoine; Gauthier-Lemire, Annie; Filion, Édith; Bahig, Houda; Lord, Martin

    2017-09-01

    Planar perfusion scintigraphy with 99m Tc-labeled macroaggregated albumin is often used for pretherapy quantification of regional lung perfusion in lung cancer patients, particularly those with poor respiratory function. However, subdividing lung parenchyma into rectangular regions of interest, as done on planar images, is a poor reflection of true lobar anatomy. New tridimensional methods using SPECT and SPECT/CT have been introduced, including semiautomatic lung segmentation software. The present study evaluated inter- and intraobserver agreement on quantification using SPECT/CT software and compared the results for regional lung contribution obtained with SPECT/CT and planar scintigraphy. Methods: Thirty lung cancer patients underwent ventilation-perfusion scintigraphy with 99m Tc-macroaggregated albumin and 99m Tc-Technegas. The regional lung contribution to perfusion and ventilation was measured on both planar scintigraphy and SPECT/CT using semiautomatic lung segmentation software by 2 observers. Interobserver and intraobserver agreement for the SPECT/CT software was assessed using the intraclass correlation coefficient, Bland-Altman plots, and absolute differences in measurements. Measurements from planar and tridimensional methods were compared using the paired-sample t test and mean absolute differences. Results: Intraclass correlation coefficients were in the excellent range (above 0.9) for both interobserver and intraobserver agreement using the SPECT/CT software. Bland-Altman analyses showed very narrow limits of agreement. Absolute differences were below 2.0% in 96% of both interobserver and intraobserver measurements. There was a statistically significant difference between planar and SPECT/CT methods ( P software is highly reproducible. This tridimensional method yields statistically significant differences in measurements for right lung lobes when compared with planar scintigraphy. We recommend that SPECT/CT-based quantification be used for all lung

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-01-01

    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.).

  20. Evaluation of the quality of picture in studies of sect brain acquired with various collimators; Evaluacion de la calidad de imagen en estudios de spect cerebral adquiridos con distintos colimadores

    Energy Technology Data Exchange (ETDEWEB)

    Moran Velasco, V.; Prieto Azcarete, E.; Barbes Fernandez, B.; Sancho rodriguez, L.; Ribelles Segura, M. J.; Richter echevarria, J. A.; Arbizu Lostao, J.; Marti-Climent, J. M.

    2015-07-01

    On the practice clinic , the performance of the systems SPECT depends on in large measurement of the quality of image. The goal of East study was evaluate how affect the parameters of reconstruction of studies SPECT of perfusion brain acquired with a collimator of holes parallel (LEHR) and other of holes in fan (Fan-Beam). (Author)

  1. HMPAO-SPECT during epileptic seizures: Early and late images

    International Nuclear Information System (INIS)

    Overbeck, B.; Gruenwald, F.; Bockisch, A.; Biersack, H.J.; Reinke, U.; Gratz, K.F.

    1990-01-01

    For presurgical evaluation of epilepsy a 44-year old patient with complex-partial seizures underwent HMPAO-SPECT. The morphology of the seizures, the MRI-scan, psychometry and ictal as well as interictal EEGs showed a left temporal origin of the seizures. Early images were obtained 20 min and late images 24 h following injection. On both scans a marked hyperperfusion was observed in the left temporal area. A crossed cerebellar diaschisis was also seen on both SPECTs. It could be shown that during ictal examinations there is no bloodflow-dependent wash-out from brain tissue. (orig.) [de

  2. Radiopharmaceuticals for SPECT cancer detection

    Energy Technology Data Exchange (ETDEWEB)

    Chernov, V. I., E-mail: chernov@oncology.tomsk.ru; Medvedeva, A. A., E-mail: tickayaAA@oncology.tomsk.ru; Zelchan, R. V., E-mail: r.zelchan@yandex.ru; Sinilkin, I. G., E-mail: sinilkinig@oncology.tomsk.ru [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation); Stasyuk, E. S.; Larionova, L. A. [Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation); Slonimskaya, E. M.; Choynzonov, E. L. [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation)

    2016-08-02

    The purpose of the study was to assess the efficacy of single photon emission computed tomography (SPECT) with {sup 199}Tl and {sup 99}mTc-MIBI in the detection of breast, laryngeal and hypopharyngeal cancers. A total of 220 patients were included into the study: 120 patients with breast lesions (100 patients with breast cancer and 20 patients with benign breast tumors) and 100 patients with laryngeal/hypopharyngeal diseases (80 patients with laryngeal/hypopharyngeal cancer and 20 patients with benign laryngeal/hypopharyngeal lesions). No abnormal {sup 199}Tl uptake was seen in all patients with benign breast and laryngeal lesions, indicating a 100% specificity of {sup 199}Tl SPECT. In the breast cancer patients, the increased {sup 199}Tl uptake in the breast was visualized in 94.8% patients, {sup 99m}Tc-MIBI—in 93.4% patients. The increased {sup 199}Tl uptake in axillary lymph nodes was detected in 60% patients, and {sup 99m}Tc-MIBI—in 93.1% patients. In patients with laryngeal/hypopharyngeal cancer, the sensitivity of SPECT with {sup 199}Tl and {sup 99m}Tc-MIBI was 95%. The {sup 199}Tl SPECT sensitivity in identification of regional lymph node metastases in the patients with laryngeal/hypopharyngeal cancer was 75% and the {sup 99m}Tc-MIBI SPECT sensitivity was 17%. The data obtained showed that SPECT with {sup 199}Tl and {sup 99m}Tc-MIBI can be used as one of the additional imaging methods in detection of tumors.

  3. The utility of segmental analysis in cardiac I-123 MIBG SPECT in Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Soo Hyun; Yoon, Joon Kee; Yoon, Jung Han; Lee, Su Jin; Jo, Kyung Soo; Lee, Dong Hyun; An, Young Sil [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2015-12-15

    Cardiac images using I-123 metaiodobenzylguanidine (MIBG) are widely used to evaluate cardiac sympathetic denervation in Parkinson’s disease (PD). The aim of this study was to evaluate the utility of segmental analysis on cardiac MIBG SPECT in PD patients. In total, 36 patients with PD (n = 26) or essential tremor (ET, n = 10) who underwent MIBG cardiac SPECT were enrolled. The heart-to-mediastinum (H/M) ratios of MIBG uptake were acquired on planar images. For the segmental analysis of SPECT images, we evaluated the summed defect score (SDS) using a 17-segment model. The diagnostic abilities of H/M ratios and segmental parameters on MIBG SPECT were assessed by ROC curve analysis. The H/M ratios were significantly lower in PD than in ET patients (p < 0.05). On segmental analysis, SDS was significantly higher in PD patients than in the ET group (7.04 ± 4.09 vs. 2.90 ± 2.80; p = 0.006). The defect score of the anteroseptal region showed a significant difference between the groups (p = 0.002). The ROC analysis suggested only SDS (AUC = 0.785, p = 0.0003) and defect scores in the anteroseptal (AUC = 0.800, p < 0.0001) and inferior (AUC = 0.667, p = 0.013) regions showed significant diagnostic ability to differentiate PD from ET. Segmental parameters from cardiac MIBG SPECT images can provide additional information to differentiate PD from ET patients. Beyond H/M ratios from planar images, we recommend an MIBG SPECT study to evaluate sympathetic denervation in PD.

  4. Imaging fusion (SPECT/CT) in degenerative disease of spine

    International Nuclear Information System (INIS)

    Bernal, P.; Ucros, G.; Bermudez, S.; Ocampo, M.

    2007-01-01

    Full text: Objective: To determine the utility of Fusion Imaging SPECT/CT in degenerative pathology of the spine and to establish the impact of the use of fusion imaging in spinal pain due to degenerative changes of the spine. Materials and methods: 44 Patients (M=21, F=23) average age of 63 years and with degenerative pathology of spine were sent to Diagnosis Imaging department in FSFB. Bone scintigraphy (SPECT), CT of spine (cervical: 30%, Lumbar 70%) and fusion imaging were performed in all of them. Bone scintigraphy was carried out in a gamma camera Siemens Diacam double head attached to ESOFT computer. The images were acquired in matrix 128 x 128, 20 seg/imag, 64 images. CT of spine was performed same day or two days after in Helycoidal Siemens somatom emotion CT. The fusion was done in a Dicom workstation in sagital, axial and coronal reconstruction. The findings were evaluated by 2 Nuclear Medicine physicians and 2 radiologists of the staff of FSFB in an independent way. Results: Bone scan (SPECT) and CT of 44 patients were evaluated. CT showed facet joint osteoarthrities in 27 (61.3%) patients, uncovertebral joint arthrosis in 7 (15.9%), bulging disc in 9(20.4%), spinal nucleus lesion in 7(15.9%), osteophytes in 9 (20.4%), spinal foraminal stenosis in 7 (15.9%), spondylolysis/spondylolisthesis in 4 (9%). Bone scan showed facet joint osteoarthrities in 29 (65.9%), uncovertebral joint arthrosis in 4 (9%), osteophytes in 9 (20.4%) and normal 3 (6.8%). The imaging fusion showed coincidence findings (main lesion in CT with high uptake in scintigraphy) in 34 patients (77.2%) and no coincidence in 10 (22.8%). In 15 (34.09%) patients the fusion provided additional information. The analysis of the findings of CT and SPECT showed similar results in most of the cases and the fusion didn't provide additional information but it allowed to confirm the findings but when the findings didn't match where the CT showed several findings and SPECT only one area with high uptake

  5. Prediction of sentinel lymph node status using single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging of breast cancer.

    Science.gov (United States)

    Tomiguchi, Mai; Yamamoto-Ibusuki, Mutsuko; Yamamoto, Yutaka; Fujisue, Mamiko; Shiraishi, Shinya; Inao, Touko; Murakami, Kei-ichi; Honda, Yumi; Yamashita, Yasuyuki; Iyama, Ken-ichi; Iwase, Hirotaka

    2016-02-01

    Single-photon emission computed tomography (SPECT)/computed tomography (CT) improves the anatomical identification of sentinel lymph nodes (SNs). We aimed to evaluate the possibility of predicting the SN status using SPECT/CT. SN mapping using a SPECT/CT system was performed in 381 cases of clinically node-negative, operable invasive breast cancer. We evaluated and compared the values of SN mapping on SPECT/CT, the findings of other modalities and clinicopathological factors in predicting the SN status. Patients with SNs located in the Level I area were evaluated. Of the 355 lesions (94.8 %) assessed, six cases (1.6 %) were not detected using any imaging method. According to the final histological diagnosis, 298 lesions (78.2 %) were node negative and 83 lesions (21.7 %) were node positive. The univariate analysis showed that SN status was significantly correlated with the number of SNs detected on SPECT/CT in the Level I area (P = 0.0048), total number of SNs detected on SPECT/CT (P = 0.011), findings of planar lymphoscintigraphy (P = 0.011) and findings of a handheld gamma probe during surgery (P = 0.012). According to the multivariate analysis, the detection of multiple SNs on SPECT/CT imaging helped to predict SN metastasis. The number of SNs located in the Level I area detected using the SPECT/CT system may be a predictive factor for SN metastasis.

  6. Clinical application of SPECT in adrenal imaging with iodine-131 6 beta-iodomethyl-19-norcholesterol

    Energy Technology Data Exchange (ETDEWEB)

    Ishimura, J.; Kawanaka, M.; Fukuchi, M.

    1989-04-01

    Forty-one patients with or without adrenocortical disorders were studied to evaluate the clinical usefulness of SPECT in adrenal imaging with I-131 Adosterol. In the SPECT images from this study, all glands with either normally functioning or hyperfunctioning adrenal cortices could be detected, while those glands with hypofunctioning adrenal cortices could not be detected. Particularly in transaxial and sagittal slices, the adrenal gland was identified posteriorly and was clearly distinguished from the gallbladder. In preliminary results using SPECT by a standard method, uptake in 68 detectable glands ranged from 1.7% to 4.9% in four glands with Cushing's syndrome, from 1.1% to 1.3% in seven glands with primary aldosteronism, and were distributed below 1.0% in the remaining glands with normally functioning adrenal cortices. These data show that it is possible to evaluate the adrenocortical functioning status simply by analyzing the SPECT images of the adrenal.

  7. SPECT of the brain: Present and future

    International Nuclear Information System (INIS)

    Fazio, F.; Lenzi, G.L.

    1986-01-01

    In both PET and SPECT, most of the studies and the models have been addressed to two organs: brain and heart. So far, brain has certainly been investigated more. The several comparisons between planar scintigraphy and SPECT, between X-ray TCT and SPECT, and also between PET and SPECT, have tended to consider SPECT a cheap but scarcely useful tool for a nuclear medicine section. Again the authors feel that this is due to the fact that SPECT is really a ''physiological tomography'', with little known about its physiology or how it is measured. Thus the present state of the art of SPECT of the brain is characterized by a collection of data and reports on brain imaging and by a slowly growing basic understanding of the utilized modes. The introduction of a new brain-imaging radiopharmaceutical is immediately signaled by its ''first clinical application'' without parallel studies on the kinetics, the metabolic degradation, and the real suitability of the molecule as a tracer for measurement of regional CBF. Only a few attempts seek to narrow this discussion between clinic and biology, and the authors like to emphasize the need for nuclear medicine people to dedicate more time and effort

  8. The significance of 123I-BMIPP myocardial SPECT on the evaluation of angina pectoris

    International Nuclear Information System (INIS)

    Kurosawa, Kazuhiko; Ohtani, Hiroshi; Saitou, Tomiyoshi; Maruyama, Yukio; Katohno, Eiichi; Ohwada, Kenji

    1998-01-01

    Some patients of ischemic heart disease have low uptake in 123 I-labeled beta methyl-iodophenyl pentadecanoic acid (BMIPP) SPECT in spite of normal uptake in thallium-201 (Tl) SPECT. To investigate their clinical significance, we performed both Tl and BMIPP myocardial SPECT in 26 cases with stable angina (n=16) and unstable angina (n=10), and compared with clinical backgrounds electrocardiogram (ECG) and left ventriculography (LVG). In 11 patients of them, the uptake of BMIPP was moderately reduced. We divided 26 cases into two groups according to uptake of BMIPP (normal/reduced). The two groups had no differences in length of angina attack and duration of disease, but they had a significant difference in the abnormality of either ECG or LVG. Three to six months after PTCA, we examined LVG in 18 cases, 12 of 16 cases with the abnormality of LVG showed the improvement of wall motion. We concluded the reduced uptake of BMIPP with normal uptake of Tl was related to more severe ischemia in cases with unstable angina. (author)

  9. 99mTc-HMPAO Brain SPECT in Patients with Post-Traumatic Organic Mental Disorder

    International Nuclear Information System (INIS)

    Lee, Kang Wook; Lee, Dong Jin; Shong, Min Ho; Kang, Min Hee; Ghi, Ick Sung; Shin, Young Tai; Ro, Heung Kyu

    1994-01-01

    It is well known that 99m Tc-HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of 99m Tc-HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD). We included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of 99m Tc-HMPAO SPECT with those of MRI, EEG and MINI mental status examination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on 99m Tc-HMPAO SPECT. 2) Most frequent lesion on brain 99m Tc-HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain 99m Tc-HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain 99m Tc-HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain 99m Tc-HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that 99m Tc-HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.

  10. Evaluation of joints in the lower limbs in adults and children using bone SPECT: Technical aspects and results; Valoracion de articulaciones de miembros inferiores mediante SPECT oseo en el adulto y en el nino: Aspectos tecnicos e indicaciones

    Energy Technology Data Exchange (ETDEWEB)

    Gaudiano, J; Dalenz, R; Hermida, J C; Olivera, C; Rodriguez, S; Paolino, A [Hospital de Clinicas, Montevideo (Uruguay). Centro de Medicina Nuclear; Figueredo, M [Hospital Pereira Rossell, Montevideo (Uruguay). Catedra de Ortopedia Infantil; Prodanov, A [Instituto Nacional de Reumatologia, Montevideo (Uruguay). Catedra de Reumatologia

    1996-06-01

    Optimization procedures for and results of single photon emission computed tomography (SPECT) bone scintigraphy scans of the lower limbs are discussed. A group of patients was selected comprising 12 adults with chronic knee pain and 11 children with disorders which might affect growth cartilage. For the latter, it was proposed to evaluate the global and localized activity of the physics using SPECT with post-processing in three dimensions. These results are important in that they may directly influence the decision whether or not to proceed with orthopedic treatment or surgery, the aim being to prevent or predict dysmetrias and secondary deformities caused by various pathologies. (author). 3 refs, 3 figs, 3 tabs.

  11. Longitudinal in vivo evaluation of bone regeneration by combined measurement of multi-pinhole SPECT and micro-CT for tissue engineering

    Science.gov (United States)

    Lienemann, Philipp S.; Metzger, Stéphanie; Kiveliö, Anna-Sofia; Blanc, Alain; Papageorgiou, Panagiota; Astolfo, Alberto; Pinzer, Bernd R.; Cinelli, Paolo; Weber, Franz E.; Schibli, Roger; Béhé, Martin; Ehrbar, Martin

    2015-05-01

    Over the last decades, great strides were made in the development of novel implants for the treatment of bone defects. The increasing versatility and complexity of these implant designs request for concurrent advances in means to assess in vivo the course of induced bone formation in preclinical models. Since its discovery, micro-computed tomography (micro-CT) has excelled as powerful high-resolution technique for non-invasive assessment of newly formed bone tissue. However, micro-CT fails to provide spatiotemporal information on biological processes ongoing during bone regeneration. Conversely, due to the versatile applicability and cost-effectiveness, single photon emission computed tomography (SPECT) would be an ideal technique for assessing such biological processes with high sensitivity and for nuclear imaging comparably high resolution (designed poly(ethylene glycol)-based hydrogels that release bone morphogenetic protein to guide the healing of critical sized calvarial bone defects. By combined in vivo longitudinal multi-pinhole SPECT and micro-CT evaluations we determine the spatiotemporal course of bone formation and remodeling within this synthetic hydrogel implant. End point evaluations by high resolution micro-CT and histological evaluation confirm the value of this approach to follow and optimize bone-inducing biomaterials.

  12. Clinical utility of spatially normalized PET and SPECT to evaluate patients with memory and cognitive impairments

    International Nuclear Information System (INIS)

    Okumura, Ayumi; Nakayama, Noriyuki; Soeda, Akio; Miwa, Kazuhiro; Shinoda, Jun; Iwama, Toru

    2004-01-01

    We assessed cerebral metabolism and blood flow in patients with memory and other cognitive impairment using the easy Z score imaging system (eZIS) and statistical parametric mapping (SPM) of FDG-PET and SPECT scans. Twenty patients with dementia (12 Alzheimer's disease (AD), 3 diffuse Lewy body disease (DLB), and 2 frontotemporal dementia (FTD)) and twenty with diffuse axonal injury (DAI) and cognitive impairments were studied with FDG-PET and ECD-SPECT. All images were analyzed using eZIS with the same processing procedures, including smoothing, normalization, and z-transformation, and compared to a database of normals. Z score maps were super-imposed on 3D MRI brain images. Group analyses were performed using SPM. Age-related declines in cerebral metabolism and blood flow were observed in the anterior cingulate association area. In contrast, reductions in these cerebral functions correlated best with severity of AD in the posterior cingulate association areas. In DLB and FTD, eZIS analysis of PET and SPECT revealed reductions of cerebral functions in specific areas. DAI showed low metabolism and blood flow in mesiofrontal cortex including the anterior cingulate association area. Dysfunction of the anterior cingulate association area in DAI, which resembled age-related cognitive decline, may be responsible for cognitive impairments. Overall, PET and SPECT scans showed significant correlations according to the type of dementia. Spatially normalized maps contributed to PET and SPECT image interpretation for patients with memory and cognitive impairments because better 3D visualization allowed more objective and systematic investigations. (author)

  13. Usefulness of corregistration and post-processing of MR and interictal SPECT images for localization of epileptogenic focus in children – preliminary report

    International Nuclear Information System (INIS)

    Miśko, Jolanta; Jurkiewicz, Elżbieta; Bekiesińska-Figatowska, Monika; Kamińska, Anna; Bachański, Zbigniew; Chełstowska, Sylwia; Walecki, Jerzy

    2011-01-01

    Children with focal epilepsy unresponsive to anticonvulsant therapy may become surgical candidates. Inter-ictal SPECT (SPECT-IN) studies demonstrate an area of hypoperfusion within the seizure focus in up to 50% of patients. The goal of this study was to evaluate the usefulness of corregistration of MR and SPECT-IN images for localization of the epileptogenic focus. Brain MRI and SPECT-IN were performed in 20 children (mean age 9.5). We found multifocal (3–6 perfusion deficits in 10 patients) or diffuse perfusion deficits (lobar) in all patients. In fused MR and SPECT images we evaluated average activity in volumes-of-interest (VOIs) outlined in each gray matter region with deficits. Average VOI activity below average total brain activity with at least 15% difference to the mirror VOI in the brain cortex on the opposite side of was considered as “true” perfusion deficit (TPD). In all children from our group, MRI and SPECT-IN image fusion and evaluation of TPD allowed to verify most of multifocal or diffuse deficits: in each of 12 patients we found 1 TPD, in each of 6 patients 2 TPD and in each of 2 patients 3 TPD. In 8 patients with 2 or 3 TPD we used scalp EEG or ictal SPECT for identification of one probable location of epileptogenic focus. In children with refractory focal epilepsy, image fusion of MRI and SPECT-IN with evaluation of TPD has potential clinical utility in localization of epileptogenic focus

  14. (123I)-IMP SPECT findings in Machado-Joseph disease

    International Nuclear Information System (INIS)

    Suzuki, Masahiko

    1997-01-01

    Single photon emission computed tomography (SPECT) with N-isopropyl-p-( 123 I)iodoamphetamine (IMP) was used to study the dynamics of cerebellar and brainstem metabolic function in patients with Mochado-Joseph disease (MJD), the diagnosis of which was confirmed with genetic analysis. The SPECT data obtained was analyzed semiquantitatively. In patients with MJD, ( 123 I)-IMP accumulation in the cerebellum and brainstem was decreased, and the degree of decrease reflected the clinical severity of MJD. When MJD was mild, the decrease in ( 123 I)-IMP accumulation was much greater in the brainstem than in the cerebellum. However, the decrease in ( 123 I)-IMP accumulation in the cerebellum and brainstem was not correlated with the severity of atrophy or with the number of CAG repeats. ( 123 I)-IMP SPECT was useful for evaluating the decrease in cerebellum and brainstem function in patients with MJD. Results of this study suggest that the functional decrease in MJD may begin in the brainstem. (author)

  15. Brain Perfusion SPECT Imaging in Sturge - Weber Syndrome : Comparison with MR Imaging

    International Nuclear Information System (INIS)

    Ryu, Jin Sook; Choi, Yun Young; Moon, Dae Hyuk; Yang, Seoung Oh; Ko, Tae Sung; Yoo, Shi Joon; Lee, Hee Kyung

    1996-01-01

    The purpose of this study was evaluate the characteristic perfusion changes in patients with Sturge-Weber syndrome by comparison of the findings of brain MR images and perfusion SPECT images. 99m Tc-HMPAO or 99m Tc-ECD interictal brain SPECTs were performed on 5 pediatric patients with Struge-Weber syndrome within 2 weeks after MR imaging. Brain SPECTs of three patients without calcification showed diminished perfusion in the affected area on MR image. A 3 month-old patient without brain atrophy or calcification demonstrated paradoxical hyperperfusion in the affected hemisphere, and follow-up perfusion SPECT revealed decreased perfusion in the same area. The other patient with advanced calcified lesion and atrophy on MR image showed diffusely decreased perfusion in the affected hemisphere, but a focal area of increased perfusion was also noted in the ipsilateral temporal lobe on SPECT. In conclusion, brain perfusion of the affected area of Sturge-Weber syndrome patients was usually diminished, but early or advanced patients may show paradoxical diffuse or focal hyperperfusion in the affected hemisphere. Further studies are needed for better understanding of these perfusion changes and pathophysiology of Struge-Weber syndrome.

  16. Clinical value of SPECT/CT imaging in the diagnosis of bone metastasis

    International Nuclear Information System (INIS)

    Wang Xinhua; Zhao Yanping; Lu Haijian; Dong Zhanfei

    2010-01-01

    Objective: To evaluate the clinical value of 99 Tc m -methylene diphosphonic acid (MDP) SPECT/CT imaging for the diagnosis of bone metastasis. Methods: Patients suspected for bone metastasis and with bone pain of unknown origin were included in this study (n=237). All cases underwent SPECT and CT imaging at 180 min after 99 Tc m -MDP injection. Diagnosis was confirmed by pathology (n=21), more than 2 kinds of radiologieal imaging (MRI, CT, X-ray) (n=106), and clinical follow up in 2 years (n=110). χ 2 -test was used to compare the results of planar and SPECT/CT imaging using SAS 6.12 software. Results: In 237 patients, planar imaging of 142 cases matched the final diagnosis in which 72 had benign lesions and 70 had bone metastases. The definite coincidence rate was 95.30% (142/149). SPECT/CT imaging of 224 cases matched the final diagnosis in which 104 had benign lesions and 120 cases diagnosed as bone metastases. The coincidence and definite coincidence rates were 94.51% (224/237), and 99.48% (192/193). Difference in the definite coincidence rate between planar and SPECT/CT imaging was statistically significant (χ 2 = 5.37, P=0.024). Conclusion: SPECT/CT imaging is valuable for accurate localization of osseous pathology and for improvement of diagnosing bone metastasis. (authors)

  17. Silicon Detectors for PET and SPECT

    Science.gov (United States)

    Cochran, Eric R.

    Silicon detectors use state-of-the-art electronics to take advantage of the semiconductor properties of silicon to produce very high resolution radiation detectors. These detectors have been a fundamental part of high energy, nuclear, and astroparticle physics experiments for decades, and they hold great potential for significant gains in both PET and SPECT applications. Two separate prototype nuclear medicine imaging systems have been developed to explore this potential. Both devices take advantage of the unique properties of high resolution pixelated silicon detectors, designed and developed as part of the CIMA collaboration and built at The Ohio State University. The first prototype is a Compton SPECT imaging system. Compton SPECT, also referred to as electronic collimation, is a fundamentally different approach to single photon imaging from standard gamma cameras. It removes the inherent coupling of spatial resolution and sensitivity in mechanically collimated systems and provides improved performance at higher energies. As a result, Compton SPECT creates opportunities for the development of new radiopharmaceuticals based on higher energy isotopes as well as opportunities to expand the use of current isotopes such as 131I due to the increased resolution and sensitivity. The Compton SPECT prototype consists of a single high resolution silicon detector, configured in a 2D geometry, in coincidence with a standard NaI scintillator detector. Images of point sources have been taken for 99mTc (140 keV), 131I (364keV), and 22Na (511 keV), demonstrating the performance of high resolution silicon detectors in a Compton SPECT system. Filtered back projection image resolutions of 10 mm, 7.5 mm, and 6.7 mm were achieved for the three different sources respectively. The results compare well with typical SPECT resolutions of 5-15 mm and validate the claims of improved performance in Compton SPECT imaging devices at higher source energies. They also support the potential of

  18. Mnemonic activation by SPECT

    International Nuclear Information System (INIS)

    Migneco, O.; Darcourt, J.; Benoit, M; Malandain, G.; Thirion, J.P.; Robert, Ph.; Vidal, R.; Desvignes, Ph.; Benoliel, J.; Ayache, N.; Bussiere, F.

    1997-01-01

    Data of literature show that SPECT is able to detect cerebral activations induced by sensory-motor stimuli. The facts are not clearly established in what concerns the cognitive activations the amplitude of which is lower. We have studied an activation paradigm such as the Grober and Bruschke test which implies the long term explicit memory. It comprises a visual presentation of words followed by their indexed recall. By using a two-day protocol, 2 SPECTs were achieved in 4 healthy right-handed voluntaries as follows: one of activation (A) and one of control (B). The fifth subject benefited by a SPECT B and of an MRI. The injection for the examination A has been done during the indexed recall stage and for the examination B at the moment when the patient repeated several times the same 3 words. The SPECT data were collected 1 hour after the injection of 370 MBq of ECD making use of a 3-head camera equipped with UHR fan collimators and ending by a LMH on the reconstructed images of 8 mm. The MRI has been achieved by means of a Signa 1.5 Tesla magnet. The SPECT A and B of the subjects 1 to 4 were matched elastically to that of the subject 5 and that of the subject 5 was rigidly matched on its MRI. In this way the individual activation cards of the 4 subjects could be averaged and superimposed on the MRI of the 5. subject. One observes an internal temporal activation (maximal activation of left tonsil, +25% and right uncus, +23%) and a right cingulum activation (maximal activation, +25%), in agreement with the neuro-physiological data. The elastic matching makes possible the inter-subject averaging, what increases the signal-to-noise ratio of activation. The inter-modality rigid matching facilitates the anatomical localisation of the activation site. With these adapted tools, the cognitive activation is thus possible by SPECT and opens perspectives for early diagnosis of neurological troubles, namely of Alzheimer's disease

  19. SPECT quantification of regional radionuclide distributions

    International Nuclear Information System (INIS)

    Jaszczak, R.J.; Greer, K.L.; Coleman, R.E.

    1986-01-01

    SPECT quantification of regional radionuclide activities within the human body is affected by several physical and instrumental factors including attenuation of photons within the patient, Compton scattered events, the system's finite spatial resolution and object size, finite number of detected events, partial volume effects, the radiopharmaceutical biokinetics, and patient and/or organ motion. Furthermore, other instrumentation factors such as calibration of the center-of-rotation, sampling, and detector nonuniformities will affect the SPECT measurement process. These factors are described, together with examples of compensation methods that are currently available for improving SPECT quantification. SPECT offers the potential to improve in vivo estimates of absorbed dose, provided the acquisition, reconstruction, and compensation procedures are adequately implemented and utilized. 53 references, 2 figures

  20. Bull's-eye map of myocardial perfusion MR imaging. Comparison with SPECT

    International Nuclear Information System (INIS)

    Nomura, Yukihiro; Nanjo, Shuji; Yamazaki, Junichi; Yoshikawa, Kohki; Inoue, Yusuke

    2003-01-01

    When diagnosing heart disease, chest roentgenograms, ultrasonography, single-photon emission computed tomography (SPECT), and coronary arteriography are usually performed. Magnetic resonance (MR) imaging is not widely used for evaluating heart disease. Recent technological progress has allowed high quality images of the heart to be reliably obtained. A routine MR study taking about 30-40 minutes can provide a large amount of diagnostic information, such as cardiac structure, function, perfusion, and myocardial viability. The analysis software that can offer Bull's-eye maps from myocardial perfusion images has recently become commercially available. In this study, the characteristics of Bull's-eye mapping of MR imaging is compared with that of Bull's-eye mapping of SPECT using the same heart phantom. The difference in the image quality of the Bull's-eye maps was evaluated among the receiver coils of MR imaging. On Bull's-eye maps from both MR imaging and SPECT, decreased signal intensity was noted in the posterolateral wall. The degree of decrease in the signal of the MR imaging was more prominent than of SPECT. The decrease was severe for the general-purpose receive-only flexible (GPFLEX) coil, moderate for the cardiac and TORSO coil, and slight for the body coil. In the selection of a coil, it is necessary to take into consideration the trade-off between the distribution of signal intensity and the signal-to-noise ratio (SNR). (author)