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Sample records for thallium-201 scintigraphic markers

  1. Comparative analysis of the diagnostic and prognostic value of exercise ECG and thallium-201 scintigraphic markers of myocardial ischemia in asymptomatic and symptomatic patients

    International Nuclear Information System (INIS)

    Gibson, R.S.

    1989-01-01

    A considerable amount of data now exists that indicates that exercise ECG--due to its suboptimal sensitivity and specificity--has limited diagnostic and prognostic value in asymptomatic subjects, patients with chest pain of unclear etiology or those with chronic stable angina pectoris, and in patients recovering from acute myocardial infarction. Because of this and the well-recognized advantages of thallium-201 scintigraphy, there appears to be a strong rationale for recommending exercise perfusion imaging, rather than exercise ECG alone, as the preferred method for detecting CAD and staging its severity. This recommendation seems justified given the fact that (1) thallium-201 scintigraphy is far more sensitive and specific in detecting myocardial ischemia than exercise testing; (2) unlike stress ECG, thallium-201 scintigraphy can localize ischemia to a specific area of areas subtended by a specific coronary artery; and (3) thallium-201 scintigraphy has been shown to be more reliable to risk stratification of individual patients than exercise testing alone. The more optimal prognostic efficiency of thallium-201 scintigraphy is due, in part, to the fact that the error rate in falsely classifying patients as low-risk is substantially and significantly smaller with thallium-201 scintigraphy than with stress ECG. 52 references

  2. Biventricular function in sickle-cell anemia: radionuclide angiographic and thallium-201 scintigraphic evaluation

    International Nuclear Information System (INIS)

    Manno, B.V.; Burka, E.R.; Hakki, A.H.; Manno, C.S.; Iskandrian, A.S.; Noone, A.M.

    1983-01-01

    Left ventricular (LV) and right ventricular (RV) function were evaluated at rest and during exercise using radionuclide ventriculography in 10 patients, aged 19-53 years, with sickle-cell anemia (SCA). Seven patients were in New York Heart Association functional class I and 3 were in class II. The resting LV ejection fraction (EF) was normal in 9 patients and the resting RVEF was normal in 4. LV dilation and high cardiac output were observed in 6 patients at rest. The LVEF during exercise was normal in all 10 patients, whereas only 2 patients had normal RVEF at rest and during exercise. The LVEF was lower in patients with SCA at rest (54 +/- 4% versus 61 +/- 6%, p less than 0.001) and exercise (66 +/- 4% versus 74 +/- 6%, p less than 0.001) than in 42 age-matched normal subjects. Rest thallium-201 images from 9 patients showed abnormal RV uptake in 8 and normal LV uptake in 8. Thus, in adult patients with SCA, LV function was normal during exercise in all patients and at rest in all but 1 patient. The LVEF, however, was lower than that in age-matched normal subjects. RV function was abnormal in most patients at rest and during exercise. RV thallium-201 uptake suggested pressure or volume overload (or both), most likely due to pulmonary vaso-occlusive complications of the disease

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-10-01

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

  4. Thallium 201 Scintigraphy

    OpenAIRE

    McKillop, James H.

    1980-01-01

    The radioactive isotope thallium 201 behaves physiologically as a potassium analog, and when injected intravenously accumulates rapidly within the cells of many organs. Uptake of the isotope reflects both regional perfusion and sodium-potassium pump activity. The radionuclide emits 80 keV x-rays which are suitable for scintillation camera imaging.

  5. Mechanisms of thallium-201 accumulation to thyroid gland

    International Nuclear Information System (INIS)

    Kishida, Toshihiro

    1987-01-01

    In this study 91 patients with goiter were scintigraphed for the duration of 84 minutes after intravenous administration of thallium-201 by digital γ camera lined to computer data system. Regions of interest (ROIs) were assigned for thyroid tumor, normal thyroid and back ground, and time-activity curves (TACs) were generated from these ROIs. Na + , K + -ATPase activity of microsome fraction from thyroid tumor and the normal thyroid glands was determined. The first 15 minutes accumulation of each ROI was determined as the early accumulation of thallium-201 for tumor and the normal thyroid glands. Papillary and follicular carcinomas, showing the high accumulation of thallium-201, had high activity of Na + , K + -ATPase. Microfollicular adenomas had high activity of Na + , K + -ATPase and demonstrated intense accumulation of thallium-201. However, colloid adenoma had a similar level of Na + , K + -ATPase activity to that of the normal thyroid glands and did not demonstrate radionuclide accumulation. Consequently, radionuclide accumulation in thallium-201 thyroid scintigraphy was closely correlated to Na + , K + -ATPase activity of thyroid tumor. Thyroid blood flow was measured by hydrogen gas clearance method. Thyroid blood flow of papillary carcinoma was smaller, as compared with normal thyroid blood flow. TAC of papillary carcinoma showed flattening. Thallium-201 accumulation in early image was also found to correspond to thyroid blood flow. From this study we can conclude that mechanisms of thallium-201 accumulation in a thyroid tumor depends on Na + , K + -ATPase activity and thyroid blood flow. Washout of TAC in thallium-201 scintigraphy appears dependent on blood flow of a thyroid nodule. (author)

  6. Contribution to the study of thallium 201 myocardium scintigraphy

    International Nuclear Information System (INIS)

    Annweiler, Marc.

    1976-01-01

    In this work a new isotope was tested in the field of myocardium scintigraphy: thallium 201. The different radioisotopes used so far in myocardium scintigraphy are reviewed to begin with. The main biological and physical characteristics of thallium and the scintillation camera used for this work are described next. In our opinion thallium 201 owing to its biological behavior similar to that of potassium and to its physical characteristics, appears as one of the better -if not the best- known tracer suitable for use in myocardium scintigraphy. Its properties are suited to the use of a scintillation camera, which considerably shortens the examination time and thus allows an isotopic exploration of the myocardium from several incidences. The only disadvantage of this cyclotron-produced isotope seems to be its high price which will probably limit its use on a large scale. Fifty thallium 201 myocardium scintigraphs were practised on forty-eight coronary thrombosis patients. From this was established a precise topographic correlation between the electrocardiographic diagnosis and the scintigraph. The two corresponded in 47 cases out of 50. The few disagreements between ECG and scintigraphic results seem to be due either to poor-quality images or to an overall myocardium hypofixation connected with a very extensive necrosis. This means that thallium 201 myocardium scintigraphy is a reliable method of examination in the great majority of cases, giving a direct picture of the heart muscle and its necrotic lesions [fr

  7. Quantitative evaluation of right ventricular overload with thallium-201 myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Watanabe, Toshiya; Miyakoda, Hiroyuki; Koike, Yoshihiro; Itatsu, Hidetaka; Kawai, Naoki; Sotobata, Iwao.

    1983-01-01

    Thallium-201 myocardial perfusion scintigraphy and right-heart catheterization were performed on patients with right ventricular pressure overload (RVPO) or right ventricular volume overload (RVVO). In 18 patients with RVPO, right ventricular systolic pressure correlated significantly both with the RV/LV wall thallium-201 uptake ratios (r=0.54, p<0.02) and the RV wall/background thallium-201 uptake ratios (r=0.70, p<0.01). RV/LV work ratios also significantly correlated with RV/LV wall thallium-201 uptake ratios (r=0.57, p<0.02). In 19 patients with RVVO, Qp/Qs and RV/LV work ratios both significantly correlated with RV/LV wall thallium-201 uptake ratios (r=0.78 and 0.87, respectively; p<0.001 for both) and RV wall/background thallium-201 uptake ratios (r=0.69, p<0.01 for both parameters). Right ventricular systolic pressure also correlated with RV/LV wall thallium-201 uptake ratios (r=0.57, p<0.02). Feasibility of the differentiation between RVPO and RVVO was suggested with use of ''transitional view angle'' and RV/LV diameter ratios obtained from the scintigram. In patients who underwent cardiac surgery, post-operative alleviations of the right ventricular overload were evaluated. There was a significant decrease in RV/LV wall thallium-201 uptake ratios, but no significant decrease in RV wall/background thallium-201 uptake ratios in patients with RVPO. On the other hand, there was a significant decrease both in RV/LV wall thallium-201 uptake ratios and RV wall/background thallium-201 uptake ratios in patients with RVVO. No significant changes were observed between the scintigraphic measurements obtained 1 month and 1 year after the surgery, irrespective of the type of right ventricular overloading. (J.P.N.)

  8. Thallium 201 scintigraphy

    International Nuclear Information System (INIS)

    Thallium-201 behaves physiologically as a potassium analog, and when injected intravenously accumulates rapidly within the cells of many organs. Uptake of the isotope reflects both regional perfusion and sodium-potassium pump activity. The main clinical application of 201 Tl scintigraphy has been in myocardial imaging. Abnormalities due to ischemia usually are seen only on the stress image whereas fixed defects in both rest and stress studies usually indicate areas of infarction or scarring. The sensitivity of stress imaging for detecting significant coronary disease is of the order of 80 to 95% though computer processing of the images may be necessary to achieve the higher figure. The main clinical value of 201 Tl myocardial imaging is likely to be in the noninvasive screening of patients with atypical chest pain or with ambiguous findings on stress electrocardiographic tests. It has also proved useful in studying patients with variant angina or following a coronary bypass operation. It is doubtful whether the technique is clinically helpful in most patients with suspected or established acute myocardial infarction. Imaging of organs other than the heart with 201 Tl has received much less attention but has been reported in patients with peripheral vascular disease and various primary and secondary neoplasms

  9. Thallium 201 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    McKillop, J.H.

    1980-07-01

    Thallium-201 behaves physiologically as a potassium analog, and when injected intravenously accumulates rapidly within the cells of many organs. Uptake of the isotope reflects both regional perfusion and sodium-potassium pump activity. The main clinical application of /sup 201/Tl scintigraphy has been in myocardial imaging. Abnormalities due to ischemia usually are seen only on the stress image whereas fixed defects in both rest and stress studies usually indicate areas of infarction or scarring. The sensitivity of stress imaging for detecting significant coronary disease is of the order of 80 to 95% though computer processing of the images may be necessary to achieve the higher figure. The main clinical value of /sup 201/Tl myocardial imaging is likely to be in the noninvasive screening of patients with atypical chest pain or with ambiguous findings on stress electrocardiographic tests. It has also proved useful in studying patients with variant angina or following a coronary bypass operation. It is doubtful whether the technique is clinically helpful in most patients with suspected or established acute myocardial infarction. Imaging of organs other than the heart with /sup 201/Tl has received much less attention but has been reported in patients with peripheral vascular disease and various primary and secondary neoplasms.

  10. Thallium-201 scintigraphy for bone and soft tissue tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tokuumi, Yuji; Tsuchiya, Hiroyuki; Sunayama, Chiaki; Matsuda, Eizo; Asada, Naohiro; Taki, Junichi; Sumiya, Hisashi; Miyauchi, Tsutomu; Tomita, Katsuro [Kanazawa Univ. (Japan). School of Medicine

    1995-05-01

    This study was undertaken to assess the usefulness of thallium-201 scintigraphy in bone and soft tissue tumors. Pre-therapy scintigraphy was undertaken in a total of 136 patients with histologically confirmed diagnosis, consisting of 74 with malignant bone and soft tissue tumors, 39 with benign ones, 12 with diseases analogous to tumors, and 11 others. Thallium activity was graded on a scale of 0-4: 0=background activity, 1=equivocal activity, 2=definitive activity, but less than myocardium, 3=definite activity equal to myocardium, and 4=activity greater than myocardium. In the group of malignant tumors, thallium-201 uptake was found in 80%, although it was low for chondrosarcoma (2/8) and malignant Schwannoma (one/3). The group of benign tumors, however, showed it in only 41%, being restricted to those with giant cell tumors, chondroblastoma, fibromatosis, and osteoid osteoma. Thallium-201 uptake was also found in all 8 patients with metastatic tumors. In 23 patients undergoing thallium imaging before and after chemotherapy, scintigraphic findings revealed a high correlation with histopathological findings. Thus, thallium-201 scintigraphy may be potentially used to distinguish malignant from benign bone and soft tissue tumors, except for a few histopathological cases, as well as to determine loco-regional metastases and response to chemotherapy. (N.K.).

  11. Thallium-201 scintigraphy for bone and soft tissue tumors

    International Nuclear Information System (INIS)

    Tokuumi, Yuji; Tsuchiya, Hiroyuki; Sunayama, Chiaki; Matsuda, Eizo; Asada, Naohiro; Taki, Junichi; Sumiya, Hisashi; Miyauchi, Tsutomu; Tomita, Katsuro

    1995-01-01

    This study was undertaken to assess the usefulness of thallium-201 scintigraphy in bone and soft tissue tumors. Pre-therapy scintigraphy was undertaken in a total of 136 patients with histologically confirmed diagnosis, consisting of 74 with malignant bone and soft tissue tumors, 39 with benign ones, 12 with diseases analogous to tumors, and 11 others. Thallium activity was graded on a scale of 0-4: 0=background activity, 1=equivocal activity, 2=definitive activity, but less than myocardium, 3=definite activity equal to myocardium, and 4=activity greater than myocardium. In the group of malignant tumors, thallium-201 uptake was found in 80%, although it was low for chondrosarcoma (2/8) and malignant Schwannoma (one/3). The group of benign tumors, however, showed it in only 41%, being restricted to those with giant cell tumors, chondroblastoma, fibromatosis, and osteoid osteoma. Thallium-201 uptake was also found in all 8 patients with metastatic tumors. In 23 patients undergoing thallium imaging before and after chemotherapy, scintigraphic findings revealed a high correlation with histopathological findings. Thus, thallium-201 scintigraphy may be potentially used to distinguish malignant from benign bone and soft tissue tumors, except for a few histopathological cases, as well as to determine loco-regional metastases and response to chemotherapy. (N.K.)

  12. Thallium 201 Scintigraphy

    Science.gov (United States)

    McKillop, James H.

    1980-01-01

    The radioactive isotope thallium 201 behaves physiologically as a potassium analog, and when injected intravenously accumulates rapidly within the cells of many organs. Uptake of the isotope reflects both regional perfusion and sodium-potassium pump activity. The radionuclide emits 80 keV x-rays which are suitable for scintillation camera imaging. The main clinical application of 201TI scintigraphy has been in myocardial imaging. Abnormal uptake of the isotope results in a cold spot on the myocardial image. In patients with coronary artery disease, the differentiation of ischemic and infarcted myocardium is made by comparing images obtained after injecting the radionuclide at the peak of a maximal exercise test with those obtained after injection at rest. Abnormalities due to ischemia usually are seen only on the stress image whereas fixed defects in both rest and stress studies usually indicate areas of infarction or scarring. Some investigators believe that redistribution images obtained four to six hours after stress injection (without administering further 201TI) give the same information as a separate rest study. The sensitivity of stress imaging for detecting significant coronary disease is of the order of 80 percent to 95 percent, though computer processing of the images may be necessary to achieve the higher figure. The prediction of the extent of coronary disease from 201TI images is less reliable. An abnormal 201TI image is not entirely specific for coronary artery disease and the likelihood of an abnormal image being due to this diagnosis varies according to the clinical circumstances. The main clinical value of 201TI myocardial imaging is likely to be in the noninvasive screening of patients with atypical chest pain or with ambiguous findings on stress electrocardiographic tests. It has also proved useful in studying patients with variant angina or following a coronary bypass operation. It is doubtful whether the technique is clinically helpful in most

  13. Submaximal exercise thallium-201 SPECT for assessment of interventional therapy in patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Stewart, R.E.; Kander, N.; Juni, J.E.; Ellis, S.G.; O'Neill, W.W.; Schork, M.A.; Topol, E.J.; Schwaiger, M.

    1991-01-01

    Submaximal thallium-201 stress testing has been shown to provide important diagnostic and prognostic information in patients with acute myocardial infarction. The purpose of this investigation was to evaluate the diagnostic value of early submaximal stress testing and thallium-201 single photon emission computed tomography (SPECT) after interventional therapy. Scintigraphic results from 56 patients with infarctions, who underwent acute thrombolytic therapy, angioplasty, or both, were compared with late (6 weeks) functional outcome as assessed by radionuclide ventriculography and with results of discharge coronary angiography. A linear correlation was found between the extent of thallium-201 SPECT perfusion defect and late ventricular function (r = 0.74, p less than 0.01). Forty-two percent of patients with large SPECT perfusion defects had normal left ventricular ejection fractions, suggesting an overestimation of infarct size by early imaging. Sensitivity and specificity of thallium-201 SPECT for detection of coronary artery stenosis in noninfarct territories was 57% and 46%, respectively, indicating limited diagnostic definition of extent of underlying coronary artery disease. Results of follow-up coronary angiography showed a significant relationship between the size of the initial perfusion defect and early restenosis or reocclusion of the infarct artery. Thus the extent of early thallium-201 perfusion defects correlates with late functional outcome but appears to overestimate the degree of injury. Submaximal thallium-201 stress testing allows only limited characterization of underlying coronary artery disease. Early assessment of infarct size may identify a patient population at high risk for reocclusion of the infarct artery

  14. Prevalence and correlates of increased lung/heart ratio of thallium-201 during dipyridamole stress imaging for suspected coronary artery disease

    International Nuclear Information System (INIS)

    Villanueva, F.S.; Kaul, S.; Smith, W.H.; Watson, D.D.; Varma, S.K.; Beller, G.A.

    1990-01-01

    There is little information concerning the prevalence and clinical correlates of increased pulmonary thallium-201 uptake during dipyridamole thallium-201 stress imaging. Accordingly, the clinical characteristics and quantitative thallium-201 findings were correlated with quantitative lung/heart thallium-201 ratio in 87 patients undergoing dipyridamole thallium-201 stress testing. Nineteen patients (22%) had an elevated ratio (greater than 0.51). These patients were more likely to have had an infarction, to be taking beta blockers, and have a lower rate-pressure product after dipyridamole administration than those with a normal ratio (p less than 0.03). An elevated ratio was associated with a greater likelihood of initial, redistribution and persistent defects, as well as left ventricular cavity dilatation on thallium-201 imaging (p less than 0.05). In addition, the number of myocardial segments demonstrating initial, redistribution and persistent defects was also greater in patients with increased ratios (p less than 0.03). Multivariate analysis demonstrated that the presence of redistribution and left ventricular cavity dilatation were the most significant correlates of lung/heart thallium-201 ratio. It is concluded that the prevalence of increased lung/heart thallium-201 ratio with dipyridamole thallium-201 stress imaging is similar to that seen with exercise stress imaging. As with exercise thallium-201 imaging, increased pulmonary thallium-201 uptake may be a marker of functionally more significant coronary artery disease

  15. Comparison of thallium perfusion and electrocardiographic findings at exercise thallium-201 scintigraphy with coronary arteriographic findings

    International Nuclear Information System (INIS)

    Matsuo, Takeshi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Chiba, Hiroshi; Mitani, Isao; Yamagami, Hidetoshi; Sumiyoshi, Tetsuya; Haze, Kazuo

    1989-01-01

    Findings of thallium-201 perfusion (Tl) and exercise electrocardiography (ECG) at exercise thallium-201 scintigraphy were compared with coronary arteriographic findings (CAG) in 283 patients. We classified these cases into four groups by Tl and ECG; [A] Tl(+)·ECG(+), [B] Tl(+)·ECG(-), [C] Tl(-)·ECG(+), [D] Tl(-)·ECG(-). Redistribution of thallium-201 was evaluated by qualitative (visual) analysis. Three percent of group A consisted of the patients with normal coronary artery, and thirty-eight percent of group D consisted of the patients with coronary artery disease. On exercise thallium-201 scintigraphic imagings, most of patients with normal coronary artery showed redistribution of inferior (24%) and septum (45%). On exercise electrocardiographic findings, most of patients with normal coronary artery showed ST-segment depression in II, III, aV F , V 5 and V 6 . In patients with coronary artery diseases, single vessel disease in group B was larger than that in group C (62% vs. 33%, p<0.05), and triple vessel disease and left main truncus disease in group C was larger than that in group B (37% vs. 10%, p<0.05). On exercise thallium-201 scintigraphic imagings, most of false negative in patients with coronary artery disease changed to true positive by quantitative analysis. The patients with less than 90% coronary stenosis in group C was larger than that in group B (65% vs. 100%). (author)

  16. Commercial production of thallium-201 chloride

    International Nuclear Information System (INIS)

    Sokolov, S.V.; Volkova, N.M.; Skokov, V.S.

    1989-01-01

    Thallium-201 chloride pharmaceuticals production practice at the Medradiopreparat factory under USSR Ministry of Public Health is described. The factory is carried out series-produced supplies of the compound prepared according to a new practice from September, 1985. Thallium-201 extraction from cyclotron targets irradiated is carried out by the extraction method

  17. Clinical significance of normal exercise thallium-201 myocardial scintigraphy in subjects with abnormal exercise electrocardiographic findings

    International Nuclear Information System (INIS)

    Matsuo, Takeshi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Chiba, Hiroshi; Mitani, Isao; Saito, Muneyasu; Sumiyoshi, Tetsuya

    1988-01-01

    The relationship between exercise thallium-201 scintigraphic findings and clinical features (chest pain, risk factors, resting electrocardiography, exercise electrocardiography and prognosis) was studied in the 234 patients with profound ST-segment depression (J 80 ≥ -2 mm) or negative U wave in exercise electrocardiography. We classified these cases into two groups by exercise thallium perfusion; (I) normal thallium-201 perfusion (n = 24), (II) abnormal thallium-201 perfusion (n = 210). The incidence of female in group I was larger than that in group II. In resting electrocardiography, left ventricular hypertrophy was found more frequent in group I. In exercise electrocardiography, most of ST-segment depression in group I revealed up-slope type and a rapid recovery to baseline. Group I had lower incidence of cardiac events (cardiac death, nonfatal myocardial infarction, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting). In conclusion, normal thallium-201 perfusion in exercise thallium-201 scintigraphy was more useful indicator for prognosis, even if the patients had the findings of profound ST-segment depression or negative U wave in exercise electrocardiography. (author)

  18. Value of thyroid scintigraphy using thallium 201

    International Nuclear Information System (INIS)

    Hermans, J.; Parmentier, S.; Beauduin, M.; Schmitz, A.; Therasse, G.

    1986-01-01

    The value of thallium-201 scintigraphy in the differential diagnosis of cold thyroid nodules demonstrated on the thyroid scan with technetium-99m was emphasized. From the clinical results it can be deduced that if a cold nodule is positive with thallium-201 the lesion has a high percentage of being a high risk of malignancy. This information might be quite valuable in selecting patients for operation [fr

  19. Thallium-201 stress imaging in hypertensive patients

    International Nuclear Information System (INIS)

    Schulman, D.S.; Francis, C.K.; Black, H.R.; Wackers, F.J.

    1987-01-01

    To assess the potential effect of hypertension on the results of thallium-201 stress imaging in patients with chest pain, 272 thallium-201 stress tests performed in 133 hypertensive patients and 139 normotensive patients over a 1-year period were reviewed. Normotensive and hypertensive patients were similar in age, gender distribution, prevalence of cardiac risk factors (tobacco smoking, hyperlipidemia, and diabetes mellitus), medications, and clinical symptoms of coronary disease. Electrocardiographic criteria for left ventricular hypertrophy were present in 16 hypertensive patients. Stepwise probability analysis was used to determine the likelihood of coronary artery disease for each patient. In patients with mid to high likelihood of coronary disease (greater than 25% probability), abnormal thallium-201 stress images were present in 54 of 60 (90%) hypertensive patients compared with 51 of 64 (80%) normotensive patients. However, in 73 patients with a low likelihood of coronary disease (less than or equal to 25% probability), abnormal thallium-201 stress images were present in 21 patients (29%) of the hypertensive group compared with only 5 of 75 (7%) of the normotensive patients (p less than 0.001). These findings suggest that in patients with a mid to high likelihood of coronary artery disease, coexistent hypertension does not affect the results of thallium-201 exercise stress testing. However, in patients with a low likelihood of coronary artery disease, abnormal thallium-201 stress images are obtained more frequently in hypertensive patients than in normotensive patients

  20. Experimental Study of Thallium 201 Redistribution in Transient Myocardial Ischemia

    Science.gov (United States)

    Tanaka, Toshiyuki; Mandal, Ashis K.; Wong, Dennis Q.

    1982-01-01

    The influence of differential washout on the redistribution phenomenon of thallium 201 chloride deposited in ischemic myocardium was investigated. Two groups of dogs had serial scintigraphic images and tissue counting performed. The first group had ischemia produced prior to the injection of the thallium and, following the control image after production of ischemia, the occlusion was released and serial images obtained over a three-hour period. The second group received thallium initially and after a control scintigraph was taken, ischemia was created and maintained for three hours via transthoracic ligature. Activity distribution was followed by serial images. Thallium content of ischemic areas was compared to the normal area by computer assisted data analysis. Tissues from the ischemic and normal areas from both groups were obtained after the serial images and counted. In the first group, prompt redistribution of activity into the ischemic areas was seen within 30 minutes of releasing the occlusion and was verified by tissue counting. Neither scintigraphic image changes nor tissue uptake differences were observed in the second group. The restoration of blood flow and consequently increased avidity for thallium probably accounted for the redistribution seen in the first group as there appeared to be no differential washout of activity in the second group from either the ischemic or normal areas to contribute to the redistribution phenomenon. ImagesFigure 1Figure 2 PMID:7120444

  1. Thallium-201 exercise myocardial imaging to evaluate myocardial perfusion after coronary artery bypass surgery

    International Nuclear Information System (INIS)

    Hirzel, H.O.; Nuesch, K.; Sialer, G.; Horst, W.; Krayenbuehl, H.P.

    1980-01-01

    To assess the usefulness of thallium-201 exercise scintigraphy in evaluating myocardial perfusion after coronary artery bypass surgery, imaging was performed after submaximal bicycle ergometry and at rest in 54 patients before and within 24 +- 10 (SD) weeks after operation. Scintigraphy identified 8 out of 20 patients who were symptom free after operation and showed normal exercise electrocardiograms as still having exercise-induced ischaemia and thus as having not truly benefited from the surgical intervention. In contrast, improvement in perfusion was documented in 17 out of 31 patients despite further complaints of chest pain and persistence of a pathological exercise electrocardiogram in 6 of them. Bypass graft patency rate paralleled the scintigraphic findings in the 35 patients who were restudied arteriographically. It was concluded that thallium-201 exercise scintigraphy is a useful technique to document changes in regional perfusion after surgery and is definitely superior to the clinical evaluation of patients including the exercise electrocardiogram. (author)

  2. Thallium-201 myocardial imaging in children.

    Science.gov (United States)

    Sty, J R; Starshak, R J

    1985-01-01

    The clinical applications of thallium-201 scintigraphy are less well defined in children than in adults. However, the published data indicate several potential applications including assessment of: 1) deficit in left ventricular myocardial perfusion, 2) early right ventricular volume or pressure overload, or both, and 3) the right ventricle in both cyanotic and acyanotic congenital heart disease. In this report, the applications of thallium imaging to pediatric diseases are described and the advantages and disadvantages of the procedure are enumerated.

  3. Assessment of chest pain in hypertrophic cardiomyopathy using exercise thallium-201 myocardial scintigraphy

    International Nuclear Information System (INIS)

    Pitcher, D.; Wainwright, R.; Maisey, M.; Curry, P.; Sowton, E.

    1980-01-01

    Exercise thallium-201 myocardial scintigraphy was performed in 23 patients with hypertrophic cardiomyopathy. Eighteen patients presented with chest pain which was a persistent symptom in 11. Selective coronary arteriography was performed in 16 patients and showed normal coronary arteries in 15 and insignificant luminal irregularities in one patient. Eighteen patients had abnormal scintigrams. Three had an abnormal distribution of tracer entirely attributable to asymmetric septal hypertrophy, whereas 15 had discrete tracer uptake defects which could not be explained solely by myocardial hypertrophy. In this latter group of patients three scintigraphic patterns were identified: (1) in 10 patients defects were seen in scintigrams immediately after exercise but not in delayed images obtained four to six hours later. Eight of these patients had chest pain. (2) Four patients had uptake defects seen in both initial and delayed images. One patient had chest pain. (3) In three patients, one of whom had chest pain, tracer defects were seen only in delayed images and were not apparent in the initial scintigrams. Chest pain occurred in eight out of 10 patients with scintigraphic evidence of myocardial ischaemia but was present in only three out of 13 patients with non-ischaemic scintigrams. The value of exercise thallium-201 myocardial imaging as a diagnostic technique in hypertrophic cardiomyopathy appears limited. Scintigraphic evidence of regional myocardial ischaemia in the absence of significant coronary artery disease, however, contributes to an understanding of the mechanism of angina production in patients with hypertrophic cardiomyopathy. (author)

  4. Evaluation of myocardial involvement in Duchenne progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Kawai, Naoki; Yamamoto, Shuhei; Okada, Mitsuhiro

    1983-01-01

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. The qualitative analysis was performed in anterior, 3 left anterior oblique and left lateral projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in LV posterolateral or posterior walls (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle changes or thoracic deformities assessed by transmission computed tomography. Slightly increased thallium-201 activity in RV free wall and lungs was shown in nine and one patient, respectively. The extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. The myocardial scintigraphic changes were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies in 2 to 3 years. It was concluded that the thallium myocardial perfusion imaging was a useful clinical technique to evaluate the cardiomyopathy in Duchenne progressive muscular dystrophy. (author)

  5. Evaluation of myocardial involvement in Duchenne's progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Kawai, Naoki; Sotobata, Iwao; Okada, Mitsuhiro

    1985-01-01

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. A qualitative analysis was performed from five projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in the LV posterolateral or posterior wall (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle involvements or thoracic deformities assessed by transmission computed tomography. Extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. Progression of the myocardial scintigraphic abnormalities were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies over 2 to 3 years. It was concluded that thallium myocardial perfusion imaging is a useful clinical technique to assess myocardial involvement in Duchenne's progressive muscular dystrophy. (author)

  6. Thallium-201 for oncological imaging in children.

    Science.gov (United States)

    Nadel, H R

    1993-07-01

    Many pediatric centers are beginning to accumulate a large experience in the use of thallium-201 (201Tl) imaging with 201Tl requires a state-of-the-art high-resolution gamma camera computer system with single photon emission computed tomography (SPECT) capability and a physician-directed tailored examination. Tumor imaging with 201Tl, with its multifactorial localization mechanisms that are different from those for gallium-67, offers a distinct advantage over gallium tumor imaging with a short total imaging time. Tumors are variable in avidity and intensity of thallium uptake. Primary and metastatic disease can be detected with 201Tl scintigraphy. Baseline pretreatment determination of thallium avidity is crucial to its efficacy in therapeutic response assessment. Adjunctive SPECT imaging provides greater sensitivity for lesion detection and direct comparison of physiology (thallium uptake) with anatomy (computed tomography and magnetic resonance imaging). The sensitivity and specificity for detection of pediatric brain tumors has been reported as 77% and 93%, respectively. Thallium-201 brain SPECT also provides a less expensive and more readily available alternative to positron emission tomography for assessing the functional state of pediatric brain tumors. Extremity osteogenic sarcoma and Ewing's sarcoma have 100% sensitivity for 201Tl uptake pretreatment. Early results confirm an association between 201Tl uptake and histological tumor response. The determination of residual/recurrent disease versus thymic rebound and other nonneoplastic change in thallium-avid lymphoma, rhabdomyosarcoma, and germ cell tumors that involve the thorax can be confirmed with a 201Tl SPECT examination. Soft-tissue tumors elsewhere in the body may be detected with 201Tl scintigraphy. Thallium-201 does not exhibit 100% specificity for tumors. False-positive 201Tl uptake has been seen in histiocytosis X, benign bone tumors, stress fractures, and inflammation.

  7. Noninvasive external cardiac pacing for thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Feldman, M.D.; Warren, S.E.; Gervino, E.V.

    1988-01-01

    Improvements in noninvasive external cardiac pacing have led to a technique with reliable electrical capture and tolerable patient discomfort. To assess the use of this modality of pacing in combination with thallium scintigraphy as a noninvasive pacing stress test, we applied simultaneous noninvasive cardiac pacing, hemodynamic monitoring, and thallium-201 scintigraphy in 14 patients undergoing cardiac catheterization for chest pain syndromes. Two patients had normal coronary arteries, while the remaining 12 had significant coronary artery disease. Thallium scintigraphic responses to pacing were compared to routine exercise thallium stress testing in nine of these 14 patients. All patients were noninvasively paced to more than 85% of the age-predicted maximum heart rate. Twelve patients demonstrated reversible thallium defects, which corresponded in 11 cases to significant lesions seen on coronary angiography. Of nine patients who underwent both pacing and exercise thallium stress tests, comparable maximal rate-pressure products were achieved. Moreover, thallium imaging at peak pacing and during delayed views did not differ significantly from exercise thallium scintigraphy. A limiting factor associated with the technique was local patient discomfort, which occurred to some degree in all patients. We conclude that noninvasive external cardiac pacing together with thallium scintigraphy is capable of detecting significant coronary artery disease and may be comparable to routine exercise thallium stress testing. This new modality of stress testing could be useful in patients unable to undergo the exercise required for standard exercise tolerance testing, particularly if improvements in the technology can be found to reduce further the local discomfort

  8. Thallium-201 scintigraphy in diagnosis of coronary stenosis

    International Nuclear Information System (INIS)

    Corne, R.A.; Gotsman, M.S.; Weiss, A.; Enlander, D.; Samuels, L.D.; Salomon, J.A.; Warshaw, B.; Atlan, H.

    1979-01-01

    The sensitivity of rest and exercise thallium-201 scintigraphy for the detection of significant coronary artery disease and myocardial ischaemia was compared with rest and exercise electrocardiography in 46 patients with chest pain. Of 26 patients with greater that 70 per cent coronary stenosis, 16 had abnormal rest thallium-201 scintigrams and 13 had Q waves. Myocardial perfusion defects in the resting scintigram correlated very well with evidence of previous myocardial infarction (16 of 17 patients, 94%) significant Q waves were present in 13 of these 17 patients (76%). After exercise, abnormal thallium-201 scintigrams consistent with ischaemia were found in 21 patients (81%). Abnormal exercise electrocardiograms were present in 15 patients (58%). The combination of abnormal exercise thallium-201 scintigrams or exercise electrocardiograms (23/26, 88%) exceeded abnormal exercise electrocardiograms alone (15/26, 58%). The two procedures were thus complementary. Abnormal rest or exercise thallium-201 scintigrams were obtained in 25/26 patients (96%) compared with abnormal rest or exercise electrocardiograms in 21/26 patients (84%). Twenty patients with less than 50 per cent coronary stenosis had normal rest thallium-201 scintigrams and no Q waves. Two had abnormal exercise thallium-201 scintigrams and 7 had abnormal exercise electrocardiograms. Thus,exercise thallium scintigraphy has higher sensitivity than exercise electrocardiography in detecting exercise induced ischaemia and is more specific. Scintigraphy appears to have a higher sensitivity than electrocardiography in detecting coronary artery disease. (author)

  9. Quantitative analysis of thallium-201 myocardial scintigraphy

    International Nuclear Information System (INIS)

    Kanemoto, Nariaki; Hoer, G.; Johost, S.; Maul, F.-D.; Standke, R.

    1981-01-01

    The method of quantitative analysis of thallium-201 myocardial scintigraphy using computer assisted technique was described. Calculated indices are washout factor, vitality index and redistribution factor. Washout factor is the ratio of counts at certain period of time after exercise and immediately after exercise. This value is neccessary for the evaluation of redistribution to the ischemic areas in serial imagings to correct the Tl-201 washout from the myocardium under the assumption that the washout is constant in the whole myocardium. Vitality index is the ratio between the Tl-201 uptake in the region of interest and that of the maximum. Redistribution factor is the ratio of the redistribution in the region of interest in serial imagings after exercise to that of immediately after exercise. Four examples of exercise Tl-201 myocardial scintigrams and the quantitative analyses before and after the percutaneous transluminal coronary angioplasty were presented. (author)

  10. Mechanisms of thallium-201 myocardial accumulation

    International Nuclear Information System (INIS)

    Wackers, F.J.Th.; Samson, G.

    1980-01-01

    The practical advantages of 201 Tl over other suitable myocardial imaging agents such as potassium-43 ( 43 K), rubidium-81 ( 81 Rb), and cesium-129 ( 129 Cs), are its relatively low energy photons which makes it possible to employ high-resolution low-energy collimators and its physical half-life of 73 hr which provides sufficiently long shelf-life for practical clinical imaging. Toxicological considerations do not play a role using 201 Tl as thallous chloride. The concentration of thallous chloride in a dose of 2 mCi of 201 Tl is less than 4μg. The LD 50 of thallous chloride is a factor 10 4 more. The minimal lethal dose in man is reported to be 12 mg/kg. The kinetics of 201 Tl, its tissue distributions and radiation doses are assessed, and the effect of cardiac drugs on thallium-201 uptake are discussed. (Auth.)

  11. Effect of stenosed and occluded coronary arteries on immediate and late myocardial uptake of thallium-201.

    Science.gov (United States)

    Clitsakis, D; Layton, C A; Battersby, W; Johns, M; Stockley, A V

    1981-01-01

    Exercise and redistribution myocardial scintigraphy using thallium-201 was compared with the left ventricular angiogram and with the presence of stenosis or occlusion of coronary arteries on angiography. Irreversible scintigraphic defects representing areas of myocardial infarction were found in all patients with occlusion of the left anterior descending artery but nearly one-third of patients with stenosis of that artery also showed evidence of infarction. For the right coronary or circumflex arteries the incidence of infarction was 82% with vessel occlusion and 57% with vessel stenosis. Of abnormally contracting segments on the left ventricular angiogram, 95% showed irreversible scintigraphic defects but 33% of normally contracting segments supplied by a diseased artery also showed this. Myocardial infarction is not uncommon in patients with angina even in the absence of coronary occlusion. The incidence is underestimated by the left ventricular angiogram. These findings are of importance in the assessment of patients with coronary disease and their evaluation before coronary artery surgery. PMID:7272129

  12. Clinical implications of diffuse slow washout of thallium-201 in exercise stress myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa; Honda, Minoru (Sumitomo Hospital, Osaka (Japan))

    1991-07-01

    Clinical implications of diffuse slow washout of thallium-201 (DSWO) in exercise-redistribution myocardial SPECT were studied. Thallium-201 washout rate was calculated by Bull's-eye method. DSWO was defined as having abnormal thallium-201 washout rate (<30% per 3 hours) in more than two thirds of each coronary artery (CA) area. Of 974 patients whose exercise heart rate exceeded 120/min, 51 (5.2%) showed DSWO and coronary angiography was performed in 43. Twenty-three patients (53%) showed triple vessel disease (3VD), 8 (19%) showed single or double vessel disease (1VD/2VD) and 12 (28%) showed normal CA. Patients with normal CA consisted of 6 patients with hypertrophic cardiomyopathy (HCM), 5 with hypertension (HT) and one with electrocardiographic abnormality only. The cause of DSWO were assessed from the history of effort angina (EA) and congestive heart failure (CHF), delayed fill-in of the perfusion defect and the ratio of lung to heart thallium-201 activity (L/M) at exercise as an indicator of the left ventricular (LV) function. High prevalence of EA (74%), high incidence of scintigraphic delayed fill-in (83%) and normal L/M suggested diffuse LV ischemia as the cause of DSWO in 3VD. On the other hand in patients with 1VD/2VD, LV dysfunction at exercise was considered as the cause of DSWO because of low prevalence of EA (13%) and scintigraphic delayed fill-in (13%)(p<0.01, p<0.005 each vs 3VD), and high L/M (p<0.001 vs 3VD) and high prevalence of CHF (38%, NS). In patients with HCM LV ischemia at small vessel levels was assumed as the cause of DSWO from the high incidence of EA (83%) and delayed fill-in (50%), low L/M and normal CA. In cases of HTLV dysfunction and/or LV ischemia at the small vessel levels were considered as the cause of DSWO. Thus, it was concluded that DSWO is a noteworthy finding in exercise stress myocardial imaging. (author).

  13. Methods of thallium-201 preparation from proton irradiated thallium targets

    International Nuclear Information System (INIS)

    Kozlova, M.D.; Sevast'yanova, A.S.; Malinin, A.B.; Kurenkov, N.V.

    1989-01-01

    Two methods of thallium-201 preparation from Tl-targets irradiated by protons: oxidation-extraction (1) and extraction (2) - are developed. At first radioactive lead is separated from the target material - thallium macroquantities during ∼32 hours, then thallium-201 was separated from residual activity of lead radioisotopes and transformed it into the necessary chemical formula. The 1st and 2nd methods differ from each other by the 1st stage of target retreatment; only extraction was used to separate radioactive lead in the 2nd method. The target was solved in H 2 SO 4 . The 1st method permits to separate thallium-201 with chemical yield not less than 90 %, the 2nd one - higher than 95 %. Volumetric activity of thallium-201 prepared is more than 55 MBq/ml. 5 refs

  14. A method for the production of thallium-201

    International Nuclear Information System (INIS)

    Ageev, V.A.; Kljuchnikov, A.A.; Linev, A.F.; Khalkin, V.A.; Zaitseva, N.G.

    1987-01-01

    For the production of thallium-201 a target of at least 95% enriched pure lead-206 is irradiated by a proton beam of an energy of between 50 and 70 MeV. During irradiation the reaction 206 Pb(p,6n) 201 Bi takes place. The target is kept sufficiently long for the transition 201 Bi- 201 Pb- 201 Tl to take place. The target is then dissolved in acid. The thallium-201 contained in the acid is oxidized to the trivalent state followed by precipitation of the lead. Lead traces remaining in solution are separated from the thallium-201 through cation exchange following which the thallium-201 is eluted using hydrochloric acid

  15. The thallium-201 myocardial scintigraphy, its possibilities and limitations

    International Nuclear Information System (INIS)

    Adam, W.; Meindl, S.; Schmitz, A.; Utech, C.; Boettcher, D.

    1983-01-01

    The Thallium-201 Myocardial Scintigraphy, its Possibilities and limitations: The Thallium-201 myocardial scintigraphy is a simple non-invasive procedure to detect hypo- and non-perfused myocardial regions. In the he last years it was demonstrated to be a helpful method in the diagnostic strategy for the cardiologist. It can not replace the coronary angiogram, but in many cases it appears to be useful in selecting patients for coronary angiography. (orig.) [de

  16. Clinical usefulness of thallium-201 myocardial scintigraphy for the diagnosis of chronic cor pulmonale

    Energy Technology Data Exchange (ETDEWEB)

    Hirayama, Jiro

    1987-06-01

    In order to evaluate right ventricular overloading(RVO) and hypertrophy, thallium-201 myocardial scintigraphy applying a new quantitative method was performed on 17 patients with chronic respiratory diseases, 13 autopsy cases and 30 normal subjects. Thallium-201 uptake ratio of left and right ventricular myocardium to the administered dose (LT, RT) were measured scintigraphically, and RT and LT/RT ratio were compared with pulmonary hemodynamic findings and with heart weight measured at autopsy. Mean pulmonary arterial pressure (MPAP) in 17 patients was significantly correlated both with RT (r = 0.78, p < 0.001) and with LT/RT ratio (r = -0.87, p < 0.001). Based on the results of investigations on 30 normal subjects, these patients could be divided into two groups as follows : RVO group (RT greater than or equal to 1.1 and/or LT/RT less than or equal to 2.7) and non-RVO group (RT < 1.1 and LT/RT > 2.7). The patients in the RVO group showed a significantly higher MPAP than those in the non-RVO group (p < 0.01). The efficiency of this method for the diagnosis of pulmonary hypertension (MPAP greater than or equal to 20 mmHg) was eighty-eight percent. In addition, there were significant correlations between RT and the weight of right cardiac mass (r = 0.97, p < 0.001) as well as between LT/RT ratio and the ratio of the weight of left to right cardiac mass (r = 0.94, p < 0.001) in 13 autopsy cases. Thallium-201 myocardial scintigraphy using this quantitative method may be useful for the estimation of right ventricular overloading and hypertrophy in chronic respiratory diseases.

  17. Gated intracoronary thallium-201 scintigraphy: feasibility and potential clinical advantages

    International Nuclear Information System (INIS)

    Siegel, M.E.; Chen, D.C.; Lee, K.; Rasmussen, D.; Colletti, P.; Thom, P.; Rahimtoola, S.H.

    1989-01-01

    Visualization of ventricular walls with true global motion and myocardial thickening is not possible with use of present scintigraphic techniques. When thallium 201 (201TI) is injected intravenously (IV), only about 5% reaches the myocardium. However, if 201TI is injected intracoronarily, 100% reaches, and approximately 88% localizes in, the myocardium, which results in higher count rates than when given IV, permitting acceptable acquisition times for gated true wall motion studies. The authors describe a new technique using intracoronary (IC) 201TI to acquire high count rate, high contrast, and short acquisition time in gated true wall motion studies. Thirteen patients were studied at rest with gated IC thallium. Six of these patients also had resting IV 201TI myocardial studies. After routine coronary angiography, 0.75 mCi of 201TI was injected into each coronary artery. Multiple sequential one-minute gated studies were obtained in LAO and RAO projections, followed by sequential five-minute images for two hours to determine 201TI redistribution kinetics. Regions of interest over segments of left and right ventricles and background permitted definition of temporal and spatial distributions. Three one-minute gated studies were summed with a total count of 2,100 K for a three-minute acquisition. Myocardium-to-background ratios were as high as 13:1 with a mean of 11.4:1 in the IC study compared with 2.3:1 in the IV studies. Washout half-time in normal myocardium was 95 +/- 5 min. The detectability and size of perfusion defects were different on gated diastolic and systolic, nongated, and IV studies. Questionable defects seen on nongated studies or after IV administration were easily noted on gated diastolic images

  18. Myocardial viability in cases with persistent perfusion defects on the dipyridamole thallium-201 scintigram. A comparative study with autopsy findings

    International Nuclear Information System (INIS)

    Nakayama, Masafumi; Mashima, Saburo; Ohkawa, Shin-ichiro; Tanno, Munehiko; Yamada, Hideo.

    1996-01-01

    The aim of this study was to assess the incidence of myocardial infarction among persistent perfusion defects in dipyridamole-stress thallium scintigraphy by inspecting autopsied hearts and to evaluate whether the regional thallium activity of a scintigraphic defect can predict the presence of infarction. Autopsied hearts were compared with dipyridamole myocardial scintigrams undertaken during life in 27 patients (mean age 85±8 years). The time interval from stress testing until death was 428±351 days. Regional thallium uptake of delayed perfusion defect was calculated on the short axis images. The grade of regional myocardial fibrosis in autopsy specimens was also quantified to correlate with the corresponding regional thallium uptake. In 6 of 15 (40%) regions with persistent defects on the scintigram, myocardial infarction was not found at autopsy. Regional thallium-201 uptake of delayed defects < 50% diagnosed infarction with a sensitivity of 82% and a specificity of 80%. A linear correlation (r=-0.67) was observed between percent thallium-201 uptake and the degree of myocardial fibrosis. In conclusion, perfusion defects at 4-hour imaging in dipyridamole-stress testing may overestimate the presence of myocardial infarction and regional thallium-201 activity is helpful in distinguishing between defects with and without infarction. (author)

  19. Exercise and redistribution myocardial scintigraphy with thallium-201 in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Ruzyllo, W.; Letowski, A.; Wroblewska, M.; Stepinska, J.

    1980-01-01

    Exercise and redistribution myocardial scintigraphy using thallium-201 was performed in 23 patients with clinically typical coronary artery disease or with suspected coronary disease. Coronarographic findings were compared with the results of scintigraphic examination and exercise test. New defect appearance or enlargement of the pre-existing defect in exercise scintigram in comparison to redistribution scintigram was found in 12 out of 15 patients with at least 50% stenosis of at least one of three main coronary arteries. In this group electrocardiographic effort tolerance test was positive in 9 cases. In 2 patients with clinical suspicion of coronary arterial disease but normal ventriculography and coronarography the myocardial pattern was normal during exercise scintigraphy, while the result of the effort tolerance test was positive in one case. Myocardial scintigraphy using one dose of thallium-201 connected with effort tolerance test is a non-invasive method for determination of local disturbances in myocardial perfusion and may serve as a screening test for coronarographic investigations. (author)

  20. Is thallium-201 of use in the measurement of total exchangeable potassium in man?

    Science.gov (United States)

    MacKay, A; Davies, D L; Horton, P W

    1978-08-01

    Simultaneous measurements of exchangeable potassium were made in seven normal male subjects using potassium-43 and thallium-201. Exchangeable potassium values obtained using the 'thallium-201 space' were unreliable.

  1. Serial Myocardial Imaging after a Single Dose of Thallium-201

    Directory of Open Access Journals (Sweden)

    Takahiko Kamata

    2014-10-01

    Full Text Available Although thallium-201 exercise scintigraphy has been established for the detection of myocardial ischemia and viability, little is known regarding the myocardial thallium-201 kinetics during angioplasty. Herein, we report a 77-year old man with angina pectoris, in whom serial myocardial imaging after a single dose of thallium-201 was helpful in identifying not only the culprit lesion and myocardial viability, but also the dynamic changes in myocardial perfusion during angioplasty. Thallium-201 images after exercise showed a perfusion defect in the inferior wall, with a trivial redistribution 3 hours after the exercise and a marked improvement 24 hours later. Coronary angiography, performed 27 hours after exercise scintigraphy, showed severe stenosis in the right coronary artery. Guidewire crossing of the lesion interrupted the antegrade flow, which was restored after balloon dilation and stent implantation. Thallium-201 images, 2 hours after angioplasty (i.e., 30 hours after exercise, showed a decreased tracer uptake in the inferior wall, which improved the next day (i.e., 48 hours after exercise. Cardiac biomarkers were negative in the clinical course.

  2. Thallium-201 production at the National Medical Cyclotron

    International Nuclear Information System (INIS)

    Wood, N.R.

    1993-01-01

    The National Medical Cyclotron (NMC) began commercial production of thallium-201 chloride radiochemical solution in May 1993. This material is supplied to the laboratories of Australian Radioisotopes (ARI) at Lucas Heights where it is the active ingredient in the manufacture of the radiopharmaceutical thallous ( 201 Tl) chloride injection BP. Complete substitution of imported material will not occur immediately but should take place gradually over the next 12 months or so. The nuclear medicine community in Australia has shown an interest in such issues as price, availability and full Australian manufacturing capability of thallium-201 owing to its large-scale usage. This brief article explains how thallium-201 is generally made and how NMC production should evolve as experience in cyclotron production of radioisotopes begins to be accumulated in Australia

  3. Exercise thallium-201 scintigraphy in evaluating aortocoronary bypass surgery

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Haaz, W.; Segal, B.L.; Kane, S.A.

    1981-01-01

    Thirty patients with recurrent symptoms after aortocoronary bypass graft surgery underwent angiography as well as exercise thallium 201 imaging. Exercise imaging has been shown to be highly specific (100 percent in our study) in evaluating patients after bypass surgery. Patients with complete revascularization have normal thallium 201 images. Similarly, exercise-induced defects are seen only in the presence of incomplete revascularization. There are patients, however, with incomplete revascularization with normal exercise images, but these generally limited to the right coronary artery or the diagonal vessels or their grafts

  4. Visualization of atrial myocardium with thallium-201: case report

    International Nuclear Information System (INIS)

    Cowley, M.J.; Coghlan, H.C.; Logic, J.R.

    1977-01-01

    An adult patient evaluated for cyanotic congenital heart disease was found to have pulmonary atresia with intact ventricular septum, hypoplastic right ventricle, and right atrial enlargement. Thallium-201 myocardial imaging before surgical correction showed thallium activity in the right atrium. Following the establishment of a conduit from the right atrium to pulmonary artery, the right-atrial thallium uptake was even more prominent

  5. Exercise thallium-201 myocardial scintigraphy in left main coronary artery disease

    International Nuclear Information System (INIS)

    Kihara, Koichi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Sumiyoshi, Tetsuya; Saito, Muneyasu

    1987-01-01

    To detect left main (LM) coronary artery disease (CAD), exercise thallium-201 myocardial scintigraphy was analyzed in 24 patients (LM stenosis > 50 %) without myocardial infarction and 10 normal controls. A high risk myocardial scintigraphy was defined as follows; (1) a LMCAD scintigraphic pattern reported by Dash, (2) nonuniform diffuse slow washout, (3) increased lung thallium uptake on the initial anterior image. Twenty-three (96 %) patients had an abnormal scintigraphic findings. The LMCAD scintigraphic pattern was found in seven (29 %) patients, all of whom had LM stenosis more than 90 %. Remaining 17 patients with LM stenosis less than 90 % didn't show this pattern. In the 10 LMCAD patients without right coronary artery (RCA) lesion, four (40 %) patients showed this pattern. But in the 14 LMCAD patients with RCA lesion, three (21 %) patients showed this pattern. In this study, a high risk exercise electrocardiography was also defined as follows; (1) > 2 mm ST depression, (2) appearance of ST depression at 50 watt or less exercise load, (3) 10 mmHg or more decrease in systolic blood pressure during exercise. Detection of high risk CAD with exercise electrocardiography, exercise thallium scintigraphy and either were 46, 67, 83 %, respectively. (author)

  6. Prevalence of ischemia by quantitative thallium-201 scintigraphy in patients with ventricular tachycardia or fibrillation inducible by programmed stimulation

    International Nuclear Information System (INIS)

    Sellers, T.D.; Beller, G.A.; Gibson, R.S.; Watson, D.D.; DiMarco, J.P.

    1987-01-01

    The prevalence of exercise-induced ischemia was determined by thallium-201 (TI-201) scintigraphic criteria in patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) inducible by programmed electrical stimulation. Thirty-eight patients (age 57 +/- 19 years), of whom 87% had angiographic coronary artery disease, underwent quantitative TI-201 exercise scintigraphy within 14 days of invasive electrophysiologic testing. The mean rest ejection fraction was 38 +/- 9%. Eighty percent of patients had 1 or more regions with akinetic or dyskinetic wall motion. Thallium-201 scan segments were scored as normal or containing redistribution defects or mild or severe persistent defects. Only 4 patients (10%) had only redistribution defects and 9 (24%) had both redistribution defects and persistent defects; 32 of 38 patients (84%) had 1 or more persistent defects, of which 26 had at least 1 severe, persistent defect (more than 50% reduction in TI-201 activity). Patients with and without exercise-induced VT had a similar prevalence of redistribution. Redistribution defect prevalence was similar in patients with polymorphic VT (3 of 13) and monomorphic VT (10 of 25) during programmed electrical stimulation (difference not significant). Thus, patients with VT or VF induced by programmed ventricular stimulation have extensive TI-201 scintigraphic abnormalities on exercise scintigrams, predominantly those suggesting scar, with associated severe regional wall motion abnormalities at rest

  7. Scintigraphic evidence of the no reflow phenomenon in human beings after coronary thrombolysis

    International Nuclear Information System (INIS)

    Schofer, J.; Montz, R.; Mathey, D.G.

    1985-01-01

    To assess whether the absence of new thallium-201 uptake after successful intracoronary thrombolysis reflects a disturbance of myocardial cell function or lack of capillary reperfusion, dual isotope scintigraphic studies with thallium-201 and technetium-99m micro-albumin aggregates were performed in 16 patients with acute anterior myocardial infarction. Intracoronary thallium-201 and technetium-99m scintigraphy performed before intracoronary thrombolysis in 12 of the 16 patients resulted in identical thallium-201 and technetium-99m defect sizes. Immediately after intracoronary thrombolysis, thallium-201 and technetium-99m scintigraphy was repeated in 11 of the 12 patients. In 4 of the 11, the initial thallium and technetium scintigraphic defects were significantly reduced, and in 6 of the 11, they were only slightly reduced; there was no difference in the size of the residual defect as assessed with both radionuclides in all 10 of the 11 patients. In the eleventh patient, there was a significant reduction of the initial technetium-99m scintigraphic defect but no change in the size of the thallium-201 defect. In four other patients, scintigrams were obtained only after intracoronary thrombolysis; these revealed no difference in thallium-201 and technetium-99m defect size. In seven of eight patients restudied 2 to 4 weeks after intracoronary thrombolysis, thallium-201 and technetium-99m defect sizes were identical with those immediately after intracoronary thrombolysis; in the eighth patient there was no difference in thallium-201 and technetium-99m defect size, although such a difference had been present immediately after intracoronary thrombolysis

  8. Usefulness of thallium-201 myocardial perfusion scintigraphy in the diagnosis of chronic cor pulmonale

    Energy Technology Data Exchange (ETDEWEB)

    Kawai, S.; Tanaka, N.; Sawada, M.; Sakaguchi, K.; Fujita, K. (Osaka Prefectural Habikino Hospital, Osaka (Japan))

    1981-09-01

    To open up the possibility of exact clinical diagnoses of chronic cor pulmonale, we performed thallium-201 myocardial perfusion scintigraphy on patients with chronic pulmonary disease. From the thallium activity in the left ventricle (plus ventricular septum) and right ventricle counted scintigraphically, we determined the thallium activity ratio of left to right ventricle (TAR). The intra- and inter-observer variations of this ratio were negligible. We compared TAR with pulmonary hemodynamic findings and with left to right ventricular mass ratio measured at autopsy, and obtained the following results. 1) Left to right ventricular mass ratio determined in 11 autopsied patients by the method of Fulton et al. was closely correlated with TAR values (r = 0.90, p < 0.001). 2) In patients with chronic pulmonary disease, there were highly significant exponential inverse correlations between TAR and pulmonary arterial mean pressure, total pulmonary vascular resistance and right ventricular systolic pressure with the coefficients of -0.75, -0.72 or -0.77, respectively (p < 0.001). These results suggested the possibility that the severity of pulmonary circulatory disturbance may be ascertained non-invasively by TAR measurement. Thus, thallium-201 myocardial perfusion scintigraphy is able to reveal non-invasively right ventricular hypertrophy in patients with chronic pulmonary disease, and it might be a useful means of clinically diagnosing chronic cor pulmonale. If TAR obtained from scintigrams is smaller than 2, the patient concerned may possibly have right ventricular hypertrophy and he or she may be diagnosed as having chronic cor pulmonale.

  9. Evaluation of thallium-201 exercise scintigraphy in coronary heart disease

    International Nuclear Information System (INIS)

    Murray, R.G.; McKillop, J.H.; Bessent, R.G.; Turner, J.G.; Lorimer, A.R.; Hutton, I.; Greig, W.R.; Lawrie, T.D.V.

    1979-01-01

    Thallium-201 myocardial imaging provides a non-invasive technique in the investigation of patients with suspected coronary heart disease. This study was designed to evaluate thallium-201 ( 201 Tl) scintigraphy in predicting the presence or absence of coronary heart disease in 50 patients presenting with chest pain. The results suggest that computer analysed 201 Tl exercise scintigraphy is a valuable technique for identifying patients with significant coronary artery disease. 201 Tl image data were highly sensitive for detecting the presence of coronary artery disease though accuracy in predicting the extent of disease was limited in patients with multiple vessel disease. The data provides further justification for the use of exercise 201 Tl scintigraphy especially in conjunction with exercise electrocardiography in the investigation of patients with chest pain. (author)

  10. Computed tomography of the heart using thallium-201 in children.

    Science.gov (United States)

    Treves, S; Hill, T C; VanPraagh, R; Holman, B L

    1979-09-01

    Thallium-201 emission computed tomography (ECT) was performed in 3 pediatric patients in whom conventional scintigraphy was normal but there was a strong clinical suspicion of myocardial disease. Abnormalities in the distribution of myocardial perfusion appeared sharply. Single photon ECT provides a three dimensional reconstruction which results in greater enhancement since activity in overlying structures does not interfere. Its widespread use is limited only by the cost of the imaging device.

  11. Computed tomography of the heart using thallium-201 in children

    International Nuclear Information System (INIS)

    Treves, S.; Hill, T.C.; VanPraagh, R.; Holman, B.L.

    1979-01-01

    Thallium-201 emission computed tomography (ECT) was performed in 3 pediatric patients in whom conventional scintigraphy was normal but there was a strong clinical suspicion of myocardial disease. Abnormalities in the distribution of myocardial perfusion appeared sharply delineated with ECT compared to normal conventional gamma camera scintigraphy. Single photon ECT provides a three dimensional reconstruction which results in greater enhancement since activity in overlying structures does not interfere. Its widespread use is limited only by the cost of the imaging device

  12. Normal results of post-race thallium-201 myocardial perfusion imaging in marathon runners with elevated serum MB creatine kinase levels

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    Siegel, A.J.; Silverman, L.M.; Holman, B.L.

    1985-10-01

    Elevated cardiac enzyme values in asymptomatic marathon runners after competition can arise from skeletal muscle through exertional rhabdomyolysis, silent injury to the myocardium, or a combined tissue source. Peak post-race levels of the MB isoenzyme of creatine kinase are similar to values in patients with acute myocardial infarction. Previously reported normal results of infarct-avid myocardial scintigraphy with technetium 99m pyrophosphate in runners after competition suggest a non-cardiac source but cannot exclude silent injury to the myocardium. Therefore, thallium 201 myocardial perfusion imaging was performed in runners immediately after competition together with determination of sequential cardiac enzyme levels. Among 15 runners tested, the average peak in serum MB creatine kinase 24 hours after the race was 128 IU/liter with a cumulative MB creatine kinase release of 117 IU/liter; these values are comparable to those in patients with acute transmural myocardial infarction. Thallium 201 myocardial scintigraphic results were normal in five runners randomly selected from those who volunteered for determination of sequential blood levels. It is concluded that elevations of serum MB creatine kinase in marathon runners arise from a skeletal muscle source and that thallium 201 myocardial scintigraphy is useful to assess runners for myocardial injury when clinical questions arise.

  13. Normal results of post-race thallium-201 myocardial perfusion imaging in marathon runners with elevated serum MB creatine kinase levels

    International Nuclear Information System (INIS)

    Siegel, A.J.; Silverman, L.M.; Holman, B.L.

    1985-01-01

    Elevated cardiac enzyme values in asymptomatic marathon runners after competition can arise from skeletal muscle through exertional rhabdomyolysis, silent injury to the myocardium, or a combined tissue source. Peak post-race levels of the MB isoenzyme of creatine kinase are similar to values in patients with acute myocardial infarction. Previously reported normal results of infarct-avid myocardial scintigraphy with technetium 99m pyrophosphate in runners after competition suggest a non-cardiac source but cannot exclude silent injury to the myocardium. Therefore, thallium 201 myocardial perfusion imaging was performed in runners immediately after competition together with determination of sequential cardiac enzyme levels. Among 15 runners tested, the average peak in serum MB creatine kinase 24 hours after the race was 128 IU/liter with a cumulative MB creatine kinase release of 117 IU/liter; these values are comparable to those in patients with acute transmural myocardial infarction. Thallium 201 myocardial scintigraphic results were normal in five runners randomly selected from those who volunteered for determination of sequential blood levels. It is concluded that elevations of serum MB creatine kinase in marathon runners arise from a skeletal muscle source and that thallium 201 myocardial scintigraphy is useful to assess runners for myocardial injury when clinical questions arise

  14. Bayesian analysis of stress thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    The variation of the diagnostic value of stress T1-201 scintigraphy with prevalence of coronary heart disease (CHD) in the population has been investigated using Bayesian reasoning. From scintigraphic and arteriographic data obtained in 100 consecutive patients presenting with chest pain, the sensitivity of stress T1-201 scintigraphy for the detection of significant CHD was 90% and the specificity was 88%. From Bayes' Theorem, the posterior probability of having CHD for a given test result was calculated for prevalences of CHD ranging from 1% to 99%. the discriminant value of stress T1-201 scintigraphy was best when the prevalence of CHD lay between 30% and 70% and maximum for a prevalence of 52%. Thus, stress T1-201 scintigraphy would be an unsuitable diagnostic test where the prior probability of CHD is low, e.g., population screening programmes, and would add little where the clinical probability of having CHD is intermediate stress T1-201 scintigraphy may provide valuable diagnostic information. (orig.)

  15. Myocardial thallium-201 kinetics in normal and ischemic myocardium

    International Nuclear Information System (INIS)

    Grunwald, A.M.; Watson, D.D.; Holzgrefe, H.H. Jr.; Irving, J.F.; Beller, G.A.

    1981-01-01

    The net myocardial accumulation of thallium-201 after injection depends upon the net balance between continuing myocardial extraction from low levels of recirculating thallium in the blood compartment and the net rate of efflux of thallium from the myocardium into the extracardiac blood pool. These experiments were designed to measure separately the myocardial extraction and intrinsic myocardial efflux of thallium-201 at normal and at reduced rates of myocardial blood flow. The average myocardial extraction fraction at normal blood flow in 10 anesthetized dogs was 82 +/- 6% (+/- SD) at normal coronary arterial perfusion pressures and increased insignificantly, to 85 +/- 7%, at coronary perfusion pressures of 10--35 mm Hg. At normal coronary arterial perfusion pressures in 12 additional dogs, the intrinsic thallium washout in the absence of systemic recirculation had a half-time (T 1/2) of 54 +/- 7 minutes. The intrinsic cellular washout rate began to increase as distal perfusion pressures fell below 60 mm Hg and increased markedly to a T 1/2 of 300 minutes at perfusion pressures of 25--30 mm Hg. A second, more rapid component of intrinsic thallium washout (T 1/2 2.5 minutes) representing approximately 7% of the total initially extracted myocardial thallium was observed. The faster washout component is presumed to be due to washout of interstitial thallium unextracted by myocardial cells, whereas the slower component is presumed due to intracellular washout. The net clearance time of thallium measured after i.v. injection is much longer than the intrinsic myocardial cellular washout rate because of continuous replacement of myocardial thallium from systemic recirculation. Myocardial redistribution of thallium-201 in states of chronically reduced perfusion cannot be the result of increased myocardial extraction efficiency, but rather, is the result of the slower intrinsic cellular washout rate at reduced perfusion levels

  16. Exercise-induced silent myocardial ischemia: Evaluation by thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Kurata, C.; Sakata, K.; Taguchi, T.; Kobayashi, A.; Yamazaki, N.

    1990-01-01

    Factors associated with silent myocardial ischemia (SMI) during exercise testing were studied by means of thallium-201 emission computed tomography (ECT) in 471 patients. Coronary angiography was done in 290, of whom 167 were found to have significant coronary artery disease (CAD). Exercise-induced ischemia and its severity were defined with ECT. During exercise 108 (62%) of 173 patients with ischemia and 57 (50%) of 115 with ischemia and angiographically documented CAD had no chest pain. One third of the patients showed an inconsistency between scintigraphic ischemia and ischemia ST depression. Age, sex, prior myocardial infarction, and diabetes mellitus were not related to SMI. Patients with SMI had less severe ischemia despite a higher peak double product compared to those with painful ischemia. Among 91 with prior myocardial infarction and exercise-induced ischemia, 51 with periinfarction ischemia had a higher frequency of SMI than did 14 with ischemia remote from the prior infarct zone despite similarities in the severity of ischemia. In conclusion, factors localized within ischemic myocardium such as less severe ischemia or adjacency to a prior infarct made SMI more prevalent

  17. Thallium-201 myocardial scintigram in primary pulmonary hypertension

    International Nuclear Information System (INIS)

    Fujii, Isao; Handa, Shunnosuke; Yamazaki, Hajime; Nakamura, Yoshiro

    1984-01-01

    Right heart catheterization is needed for the diagnosis of pulmonary hypertension in patients with primary pulmonary hypertension (PPH), though the procedure was reported to have an unusually high risk. We examined the usefulness of thallium-201 myocardial scintigraphy for the evaluation of right ventricular overloading in patients with PPH. This study includes 5 patients with PPH, diagnosed by the clinical criteria of research committee of PPH in the Ministry of Health and Welfare in Japan (1976). Autopsy was done and diagnosis was confirmed in 4 cases. The right ventricular (RV) free wall was visualized in all cases. They were divided into 2 groups by the degree of visualization. The cases with heavier visualization had a higher pulmonary arterial resistence. The shape of the interventricular septum was deformed in all cases. It was straight in 3 cases and convex to the left ventricle (LV) in 3. In the later group, a systolic LV-RV pressure difference was less than 25 mmHg. One of these 3 cases showed reversed pressure difference. We concluded that thallium-201 myocardial scintigraphy could non-invasively assess the degree of RV overloading in PPH. (author)

  18. Risk-benefit of dipyridamole loading thallium-201 myocardial scintigraphy

    International Nuclear Information System (INIS)

    Ueshima, Kenji; Ogiu, Naonori; Musha, Takehiko; Moriai, Naoki; Miyakawa, Tomohisa; Nakai, Kenji; Hiramori, Katsuhiko

    1995-01-01

    This study assessed the accuracy of dipyridamole-stressed thallium-201 scintigraphy in the detection of myocardial ischemia, as well as the associated complications and their background factors. Fifty consecutive patients (33 men and 17 women; a mean age of 67 years) unable to undergo exercise thallium imaging were examined. R waves on resting ECG, the occurrence of ischemic changes on exercise ECG, asynergy on left ventriculography and dobutamine-stressed two-dimensional echocardiography, uptake of FEG on PET, and coronary angiographic findings were comprehensively assessed to determine the accuracy of the present scintigraphy. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 60.4%, 94.2%, 89.7%, 83.0%, and 82.9%, respectively. These findings yielded satisfactory detectability of dipyridamole-stressed thallium-201 scintigraphy for myocardial ischemia. The present scintigraphy had a high sensitivity and specificity for the left anterior descending artery; however, it had a high specificity but low sensitivity for the other arteries. A majority of complications during the scintigraphy was transient, mild decrease in blood pressure, which was found especially when ischemia was present in the left circumflex artery and chest pain occurred during dipyridamole stress. Dipyridamole stress is considered to be contraindicated for patients with unstable angina. (N.K.)

  19. Evaluation of hibernating myocardium with exercise thallium-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Hashimoto, Yasunori; Yamabe, Hiroshi; Yasaka, Yoshinori; Namura, Hiroyuki; Maeda, Kazumi; Yokoyama, Mitsuhiro

    1991-01-01

    Seven patients with left ventricular wall motion abnormality underwent exercise thallium-201 myocardial SPECT before and after percutaneous transluminal coronary angioplasty (PTCA) for the infarct-related artery. Both redistribution (Rd) images and %Tl uptake were examined to evaluate the capability of SPECT to diagnose pre-PTCA hibernation of the myocardium. Of 7 patients (18 segments), 5 (13 segments) were found to have an improvement of wall motion abnormality on left ventricular cineangiogram, leading to a diagnosis of hibernating myocardium. For all of the 5 patients, delayed SPECT images showed complete Rd in one patient (2 segments) and incomplete Rd in 4 patients (11 segments). In addition, %Tl uptake on early images was 54.3±19.4% before PTCA and 78.8±19.2% after PTCA. These results indicated that exercise thallium-201 myocardial SPECT may be useful for diagnosis of hibernating myocardium. It should, however, be noted that of 13 segments diagnosed with hibernation, 6 had Rd on post-PTCA SPECT in spite of the absence of restenosis. (N.K.)

  20. The clinical role of thallium-201 scintigraphy in the management and prognosis of coronary artery disease

    International Nuclear Information System (INIS)

    Gammage, M.D.; Murray, D.P.; Rafiqi, E.; Murray, R.G.

    1984-01-01

    To determine the clinical impact of thallium-201 scintigraphy in coronary artery disease, the indications, diagnostic yield and contribution to patient management were reviewed retrospectively in 103 patients referred for routine investigations. Exercise and redistribution image data were collected in multiple projections and interpreted by visual and semi-quantitative means. A segmental image defect was accepted as indicating the presence of coronary artery disease. Thallium-201 scintigraphy was performed as a diagnostic procedure in 71 patients (69%) who had equivocal evidence of coronary artery disease. In 57 (80%) of these patients, thallium-201 scintigraphy was normal and 53 (75%) were spared diagnostic coronary arteriography. Despite normal thallium-201 scintigrams, arteriography was performed in 4 patients with persisting symptoms and demonstrated normal vessels in 2 patients and single vessel disease in 2 patients. Conversely, arteriography was normal in 2 of 14 patients (14%) with unequivocal image defects. Thallium-201 scintigraphy was performed as a functional complement to coronary arteriography in 32 patients, influencing the decision for coronary surgery in 10, for angioplasty in 4 and against surgery in 2. Myocardial ischaemia was confirmed in 8 and refuted in 8 patients with questionable arteriographic coronary disease. Positive management decisions were taken as a result of thallium-201 scintigraphy in 80 of these 103 patients (78%). These data confirm the vital role of thallium-201 scintigraphy in the evaluation and management of patients with suspected and proven coronary artery disease. (orig.)

  1. Prognostic significance of large perfusion defects on thallium-201 myocardial scintigraphy in dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Takata, Jun; Doi, Yoshinori; Chikamori, Taishiro; Yonezawa, Yoshihiro; Hamashige, Naohisa; Kuzume, Osamu; Ozawa, Toshio

    1989-01-01

    To evaluate the prognostic significance of perfusion abnormalities, particularly large defects, in dilated cardiomyopathy (DCM), we performed thallium-201 myocardial scintigraphy and 24-hour ambulatory ECG monitoring in 27 patients. The abnormal scintigraphic patterns and the presence of ventricular tachycardia (VT) were correlated with causes of death during a follow-up period of 30.0±19.4 months. Eight patients had large defects (LD), 11 had multiple small defects (MSD), and eight had no defects (NL). The patients with LD had extensive ventricular akinesis in the region of the perfusion defect, significantly elevated LVEDP (LD 20.6±7.4 mmHg, MSD 15.5±7.6 mmHg, NL 10.3±2.3 mmHg: LD vs NL; p<0.01, MSD vs NL; p<0.05), and reduced ejection fraction (LD 23.9±9.1%, MSD 32.7±7.2%, NL 40.3±7.7%: LD vs MSD; p<0.05, MSD vs NL; p<0.01). VT was detected in 11 patients; among whom three had LD, six had MSD, and two had no defects. Among seven patients who died during follow-up (five of heart failure, one sudden death, and one non-cardiac death), five had LD and two had MSD. There were no deaths among patients without defects. Among 11 patients with VT, only one died suddenly. In conclusion, large scintigraphic defects correlated well with severe LV dysfunction, and this is an important variable in predicting outcomes in DCM. (author)

  2. Coronary-to-pulmonary artery fistula in adults: Evaluation with thallium-201 myocardial perfusion SPECT.

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    Seul Ki Lee

    Full Text Available With the increasing use of multi-detector CT, the number of detected cases with coronary-to-pulmonary artery fistula (CPAF has increased. Several previous studies reported severe cases of angina, but no appropriate tests to evaluate myocardial perfusion for patients with CPAF have been established. We evaluated the hemodynamic characteristics of CPAF using thallium-201 (Tl-201 single photon emission computed tomography (SPECT.Tl-201 SPECT was performed in 17 patients with CPAF, but without evidence of coronary artery disease on coronary computed tomography angiography (CCTA (age, 58.5±13.3 years; 8 men. Quantitative analysis of scintigraphic data was performed. Additionally, perfusion abnormalities were compared with CCTA findings. Medical records were obtained to define clinical data, diagnostic findings, symptoms, management, follow-up data, and major adverse cardiac events (MACE.Six patients (35.2% showed perfusion abnormalities on SPECT studies and could be classified as follows: 3 patients, no reversible ischemia (3/17, 17.6%; 1 patient, mild ischemia (1/17, 5.8%; and 2 patients, moderate ischemia (2/17, 11.7%. During the follow-up, ten patients (58.8% improved under medical management and 5 patients (29.4% underwent surgical ligation for CPAF with symptomatic improvement in 4 patients. Seven patients performed follow-up myocardial perfusion SPECT, and symptomatic improvement correlated well with scintigraphic perfusion improvement in 6 patients No MACE was observed.Tl-201 myocardial perfusion SPECT might be useful for determining the hemodynamic status and for risk stratification in patients with CPAF.

  3. Preparation of thallium 201 from enriched thallium targets using U-240 cyclotron

    International Nuclear Information System (INIS)

    Klyuchnikov, A.A.; Ageev, V.A.; Sazhenyuk, A.D.; Odintsov, A.A.; Demekhin, V.L.

    1989-01-01

    Possibility of thallium-201 preparation from enriched thallium targets (thallium-203 and 205) under proton irradiation at isochronous cyclotron U-240 is studied. Excitation functions of nuclear reactions, on which commercial method of thallium-201 preparation is based, are determined experimentally for the given conditions of irardiation. Perspectivity of multilayer targets application under proton irradiation in the energy range from 20 to 55 MeV is shown. Experimental thallium-201 quantities have been prepared by target set irradiation, consisting of lead-206, thallium-205 and thallium-203 with further extracting separation of a product

  4. Diagnostic advantages of the association of electrocardiograms and thallium 201 exercise scintigraphy in detecting coronary disease

    International Nuclear Information System (INIS)

    Tubau, J.F.; Chaitman, B.R.; Dupras, G.; Waters, D.D.; Bourassa, M.G.

    1979-01-01

    Thallium 201 exercise scintigraphy combined with 14-lead exercise electrocardiography detects coronary artery disease in 95-96 percent of the patients, whether men or women. When both tests were positive, 93 percent of the men and 100 percent of the women had coronary artery disease. In women, thallium 201 seems to do better than 14-lead exercise electrocardiogram, detecting the presence of coronary artery disease in 72 percent and its absence in 83 percent of the cases. In approximately 50 percent of the cases, the results of thallium 201 and multiple-lead exercise testing were discordant; in these cases, an accurate clinical history is helpful. (author) [fr

  5. Enhanced detection of proximal right coronary artery stenosis with the additional analysis of right ventricular thallium-201 uptake in stress scintigrams

    International Nuclear Information System (INIS)

    Gutman, J.; Brachman, M.; Rozanski, A.; Maddahi, J.; Waxman, A.; Berman, D.S.

    1983-01-01

    The value of right ventricular thallium-201 analysis in detecting proximal right coronary artery stenosis in exercise myocardial scintigraphy was analyzed in 52 patients, 27 with and 25 without proximal right coronary artery stenosis. For the detection of proximal right coronary artery stenosis, the sensitivity and specificity of thallium scintigraphic analysis were 59 and 88% for a right ventricular abnormality, 67 and 68% for a left ventricular inferior wall abnormality, and 93 and 56% for an abnormality of either. When both right and left ventricular thallium images were abnormal, all 9 patients had proximal right coronary artery stenoses, and when both were normal, 26 of 28 patients had a normal proximal right coronary artery. The sensitivity and specificity of blood pool scintigraphic variables during exercise (right ventricular ejection fraction and left ventricular inferior wall motion) were not significantly different for detection of proximal right coronary artery stenosis. Thus, the additional analysis of the right ventricle on thallium-201 stress scintigrams can improve the detection of proximal right coronary artery stenosis. When both right ventricular and left ventricular thallium scintigrams are abnormal (or normal), the ability to predict the presence (or absence) of proximal right coronary artery stenosis is very high

  6. Thallium-201 myocardial imaging in acute-myocardial infarction

    International Nuclear Information System (INIS)

    Wackers, F.J.Th.; Lie, K.I.; Sokole, E.B.; Wellens, H.J.J.; Samson, G.; Schoot, J.B. van der

    1980-01-01

    Thallium-201 scintigraphy has proven to be an early and highly sensitive technique to detect myocardial perfusion abnormalities in patients with acute myocardial infarction. During the early phase of acute myocardial infarction, patients may be hemodynamically and electrically unstable. Therefore, scintigraphy is performed preferably at the bed side in the Coronary Care Unit using a mobile gamma camera. Additionally, in order to shorten imaging time in these often critically ill patients, the authors recommend injecting no less than 2 mCi of 201 Tl. Using this dosage, the imaging time per view will be approximately five minutes. Routinely, three views are taken: the first view is a supine 45 0 left-anterior-oblique view, followed by a supine anterior view and finally a left-lateral view, the latter with the patient turned on the right side. (Auth.)

  7. AIDS-related Kaposi sarcoma: findings on thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Lee, V.W.; Rosen, M.P.; Baum, A.; Cohen, S.E.; Cooley, T.P.; Liebman, H.A.

    1988-01-01

    No simple, noninvasive method is available for evaluating extracutaneous Kaposi sarcoma in AIDS patients or for following the tumor's response to treatment. We report our preliminary experience with thallium-201 scintigraphy in nine AIDS patients with proved Kaposi sarcoma. Eight of the nine had abnormal uptake of the radionuclide in skin, lymph nodes, oral cavity, vagina, and lungs. Only four of the nine had cutaneous Kaposi sarcoma at the time of scanning. All cutaneous and mucosal lesions were thallium avid. Two of the six patients with thallium-avid nodes underwent nodal biopsy. Both biopsies confirmed the diagnosis of Kaposi sarcoma. Cutaneous Kaposi sarcoma developed later in one of these patients, showing the efficacy of thallium scintigraphy for the early detection of extracutaneous lesions. These preliminary results show thallium avidity in Kaposi sarcoma involving the skin and various extracutaneous sites (lymph nodes, lung, mucosa, and vagina). Thallium scintigraphy is a potentially useful procedure for detecting extracutaneous Kaposi sarcoma in AIDS patients

  8. Clinical indications for Thallium-201 myocardial perfusion scanning

    International Nuclear Information System (INIS)

    Dunn, R.J.; Kelly, D.T.

    1982-01-01

    Thallium-201 myocardial perfusion scanning can assess regional myocardial perfusion non-invasively. As it is both time-consuming and expensive its use should be restricted to specific diagnostic problems. The clinical indications in known or suspected coronary artery disease are reviewed. In suspected coronary artery disease thallium scanning is most useful in patients with chest pain when the exercise ECG is uninterpretable, in men with probable angina but a negative exercise ECG, or conversely a positive exercise ECG without typical angina, and in women with probable angina and either a positive or a negative exercise ECG. In known coronary artery disease, thallium scanning may help determine the functional significance of a coronary obstruction found at angiography and may determine the site of myocardial ischaemia when multiple obstructions are present

  9. 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

  10. Value of noninvasive assessment of patients with atypical chest pain and suspected coronary spasm using ergonovine infusion and thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    DiCarlo, L.A. Jr.; Botvinick, E.H.; Canhasi, B.S.; Schwartz, A.S.; Chatterjee, K.

    1984-01-01

    Twenty-six patients with known benign coronary anatomic characteristics and atypical chest pain syndromes were evaluated for the possibility of coronary spasm. Incremental intravenous ergonovine maleate infusions were administered, and thallium-201 scintigraphy was performed at the peak dosage and during recovery in the coronary care unit. With ergonovine therapy, 4 patients (16%) had chest pain associated with electrocardiographic (ECG) or scintigraphic changes. Nine patients (35%) had chest pain without associated ECG or scintigraphic changes, and 13 patients did not have chest pain in response to ergonovine administration, although 2 (8%) had ergonovine-induced scintigraphic defects. All 4 patients with ergonovine-induced chest pain and associated ECG or scintigraphic abnormalities had resolution or reduction of chest pain after medical treatment. However, 7 of the 9 patients with ergonovine-induced chest pain in the absence of ECG or scintigraphic abnormalities continued to have symptoms despite medical treatment a mean of 18 months later. In this limited study of a select group, bedside ergonovine provocation appeared safe. Many patients had chest pain, but few showed ECG or scintigraphic evidence of ischemia. Perfusion scintigraphy appears to have potential complementary value for the identification of an ischemic cardiac cause of atypical chest pain and provides a rationale for appropriate therapy

  11. Simultaneous multivessel coronary artery spasm demonstrated by quantitative analysis of thallium-201 single photon emission computed tomography

    International Nuclear Information System (INIS)

    Kugiyama, K.; Yasue, H.; Okumura, K.; Minoda, K.; Takaoka, K.; Matsuyama, K.; Kojima, A.; Koga, Y.; Takahashi, M.

    1987-01-01

    Thallium-201 myocardial scintigraphy with quantitative analysis of emission computed tomography was performed during episodes of angina in 19 patients with variant angina and nearly normal coronary arteriographic findings. Eleven patients (group I) were shown by arteriography to have spasm in 2 or more large coronary arteries. Eight patients (group II) had spasm in only 1 coronary artery. In 7 patients in group I, significant diffuse perfusion defects simultaneously appeared in multiple coronary artery regions on the scintigram (group IA). The extent and severity of the perfusion defect as measured by thallium-201 tomography were significantly greater in group IA than in group II (p less than 0.001 and p less than 0.01, respectively). The duration of transient ST-segment elevation during the attack in group IA was significantly longer than in group II (p less than 0.001). The incidence of ventricular arrhythmias, including ventricular tachycardia, or complete atrioventricular block during the anginal attack was significantly higher (p less than 0.05) in group IA than in group II. In all study patients, neither attack nor scintigraphic perfusion defect appeared on the repeat test after oral administration of nifedipine. In conclusion, multivessel coronary artery spasm simultaneously appears and causes the attack in many patients with variant angina and nearly normal coronary arteriographic findings, and myocardial ischemia due to simultaneous multivessel coronary spasm is likely to be more extensive and severe, persist longer and have a higher frequency of potentially dangerous arrhythmias than that due to spasm of only 1 coronary artery

  12. Usefulness of thallium-201 SPECT imaging for the evaluation of local recurrence of colorectal cancer

    International Nuclear Information System (INIS)

    Sumi, Yukiharu; Ozaki, Yutaka; Shindoh, Noboru; Kyogoku, Shinsuke; Katayama, Hitoshi

    1998-01-01

    To clarify the accumulation of thallium-201 in recurrent tumors in patients who had undergone resection of colorectal cancer and to evaluate the usefulness of thallium-201 single photon emission computed tomography (SPECT) images for distinguishing recurrent tumors from postoperative changes. Thallium-201 SPECT images and CT images of 22 consecutive patients suspected to have local recurrence of colorectal cancer based on clinical symptoms and signs were reviewed. CT was performed on all patients. In nine of the 11 patients who had local recurrence, SPECT images showed positive thallium uptake, but in 10 of the 11 patients confirmed to have no recurrence, SPECT images showed negative thallium uptake. Sensitivity was 81.8% (9/11), specificity was 90.9% (10/11), and accuracy was 86.4% (19/22). There were five patients in whom CT results were inconclusive. All of them had rectal cancer and had undergone Miles' operation, and all were correctly diagnosed by thallium-201 SPECT. Thallium-201 exhibited intense uptake in recurrent colorectal cancer. Thallium-201 SPECT is considered to be a useful diagnostic tool for the detection of recurrence of colorectal cancer, particularly in patients with inconclusive CT results. (author)

  13. A model to predict multivessel coronary artery disease from the exercise thallium-201 stress test

    International Nuclear Information System (INIS)

    Pollock, S.G.; Abbott, R.D.; Boucher, C.A.; Watson, D.D.; Kaul, S.

    1991-01-01

    The aim of this study was to (1) determine whether nonimaging variables add to the diagnostic information available from exercise thallium-201 images for the detection of multivessel coronary artery disease; and (2) to develop a model based on the exercise thallium-201 stress test to predict the presence of multivessel disease. The study populations included 383 patients referred to the University of Virginia and 325 patients referred to the Massachusetts General Hospital for evaluation of chest pain. All patients underwent both cardiac catheterization and exercise thallium-201 stress testing between 1978 and 1981. In the University of Virginia cohort, at each level of thallium-201 abnormality (no defects, one defect, more than one defect), ST depression and patient age added significantly in the detection of multivessel disease. Logistic regression analysis using data from these patients identified three independent predictors of multivessel disease: initial thallium-201 defects, ST depression, and age. A model was developed to predict multivessel disease based on these variables. As might be expected, the risk of multivessel disease predicted by the model was similar to that actually observed in the University of Virginia population. More importantly, however, the model was accurate in predicting the occurrence of multivessel disease in the unrelated population studied at the Massachusetts General Hospital. It is, therefore, concluded that (1) nonimaging variables (age and exercise-induced ST depression) add independent information to thallium-201 imaging data in the detection of multivessel disease; and (2) a model has been developed based on the exercise thallium-201 stress test that can accurately predict the probability of multivessel disease in other populations

  14. Serial thallium-201 imaging after dipyridamole for coronary disease detection: quantitative analysis using myocardial clearance

    International Nuclear Information System (INIS)

    Okada, R.D.; Dai, Y.H.; Boucher, C.A.; Pohost, G.M.

    1984-01-01

    After dipyridamole, canine studies have demonstrated a slower rate of myocardial thallium-201 clearance from zones distal to a coronary artery stenosis compared to normal zones. To determine if criteria based on canine myocardial thallium-201 clearance rates could be applied clinically, 40 patients with and 26 patients without coronary artery disease (CAD) had serial thallium-201 images obtained for 2 to 5 hours after dipyridamole. Regions of interest were manually placed over six left ventricular segments in two projections for each of three imaging times. The myocardial thallium-201 clearance rate was calculated for each of the six segments and, using the clearance rate criterion found in canine studies, was considered abnormal if less than 6.5%/hr. Using this criterion alone, 22 of 26 patients (85%) without CAD had normal and 30 of 40 patients (75%) with CAD had abnormal myocardial thallium-201 clearance rates. A quantitative analysis of regional inhomogeneity in tracer distribution (normal was greater than or equal to 25% difference between segments) was negative in 24 of 26 patients (92%) without CAD and positive in 20 of 40 patients (50%) with CAD. When both clearance rate and regional inhomogeneity were considered, 21 of 26 patients (81%) without CAD had negative and 36 of 40 patients (90%) with CAD had positive results. Thus, post-dipyridamole myocardial clearance rate criteria derived from canine studies can be applied to clinical thallium imaging. Quantitative analysis of serial thallium-201 images after dipyridamole is optimized by using myocardial thallium-201 clearance rates. Such an approach is independent of regional inhomogeneities in tracer distribution

  15. Detection of Myocardial Sarcoidosis by Thallium 201 Imaging

    Science.gov (United States)

    Haywood, L. Julian; Sharma, Om P.; Siegel, Michael E.; Siegel, Robert J.; Gottlieb, Stephen L.; Caldwell, John; Siemsen, Jan K.

    1982-01-01

    Thallium 201 myocardial perfusion scanning revealed focal left ventricular defects at rest in four of 30 patients (13 percent) with systemic sarcoidosis. All the defects decreased in size during thallium stress imaging, a finding opposite of that usually seen in myocardial ischemia. Nine patients had abnormal right ventricular visualization at rest. Thus, 11 of 30 (37 percent) had abnormal resting myocardial scand. Two of the four patients with left ventricular defects were studied serially for up to 1.5 years to evaluate response to corticosteroid therapy. The myocardial defect diminished in one patient, whereas the second patient, maintained for 2 years on low doses of steroids, had no resolution. In patients suspected of focal myocardial involvement by sarcoidosis on thallium scanning dynamic changes in scan defects can occur during exercise which are the reverse of those usually seen in coronary artery disease. These defects probably represent myocardial sarcoid. Right ventricular uptake generally appears to correlate with the severity of pulmonary involvement by sarcoidosis, yet does not appear to be a specific finding. ImagesFigure 1Figure 2 PMID:7143469

  16. Dependence of quality of Thallium-201 on irradiation data

    International Nuclear Information System (INIS)

    Sattari, I.; Aslani, G.; Dehghan, M. K.; Shirazi, B.; Shafie, M.; Shadanpour, N.; Winkel, P. V.

    2003-01-01

    Background: Thallium-201 is produced through 203 Tl (p,3 n) 201 pb 201 Tl reaction by cyclotron. This radioisotope has known as one of the cyclotron radioisotopes which is used for myocardial perfusion in the coronary artery disease, Ti-201 after chemical purification and quality control in the form of 201 Tl-chloride is ready to send the hospitals. Materials and methods: In this work the effect of the proton energy on quality of a Ti-201, was studied. Radionuclidic purity was determined by high purity Ge (H P Ge) detector Gamma spectrometer, in production time and after one half-life (73 h). The targets were coated with Enriched Thallium-203 (97%). Results: The variation of thickness of targets was 18.3±1.3μm. The different energies of bombardment on quality of Tl-201 and Tl-200, Tl-202, and Pb-203 (as impurity) were studied. The results have been that optimum energy for proton was 28.5 MeV. Conclusion: The variation energy of bombardment can change the purity of Tl-201 but all results were in standard range according to the United States Pharmacopoeia (USP) and European Pharmacopoeia

  17. Effect of thallium-201 blood levels on reversible myocardial defects

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  18. Thallium-201 myocardial imaging for evaluation of pulmonary hypertension

    International Nuclear Information System (INIS)

    Ikuno, Yoshiyasu

    1979-01-01

    Thallium-201 ( 201 Tl) myocardial scintigraphy (TMS) was performed in 54 patients. The images were analysed semi-quantitatively by measuring the extent of radioisotope concentration in the right ventricular free wall and the size of the right ventricular cavity. The extent of radioisotope concentration (four degrees) was expressed as the right ventricular activity score (RVAS) and the size of the right ventricular cavity (three degrees) was expressed as the right ventricular cavity score (RVCS). The scores were added for a right ventricular total score (RVTS). To establish criteria for the diagnosis of pulmonary hypertension (PH) by means of TMS, these scores were compared with the values of pulmonary arterial mean pressure (PAMP). The criteria were evaluated by comparing them with conventional criteria for electrocardiographic diagnosis of right ventricular hypertrophy. Patients with a 2-point RVAS had a significantly higher PAMP than those with a 0 or 1-point RVAS (p 201 Tl myocardial scintigrams is a useful non-invasive method for evaluating PH and its severity. (J.P.N.)

  19. Role of exercise thallium 201 imaging in decision making

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Segal, B.L.; Frankl, W.S.; Kane-Marsch, S.; Unger, J.

    1986-01-01

    This prospective study examined the impact of results of exercise thallium 201 imaging on the estimation of probability of coronary artery disease (CAD) and patient management among cardiologists and internists in our institution. Before exercise testing, the probability of CAD in the 100 patients enrolled in this study was considered low in 31, intermediate in 28, and high in 41 patients. The probability of CAD after exercise thallium imaging was different in four patients (10%) in the high group, 22 patients (79%) in the intermediate group, and three patients (10%) in the low group. Further, the results of exercise testing resulted in changes in patient management in 29 patients (71%) in the high group, 26 patients (93%) in the intermediate group, and 16 patients (52%) in the low group. Overall, the management changed in 71% of the patients. This change included changes in medications, physical activity, frequency of office visits, need for cardiac catheterization, and need for coronary arterial bypass grafting. Thus, exercise thallium imaging is useful in clinical decision making: the diagnostic certainty is improved in patients with intermediate pretest probability of CAD; and some degree of change in patient management is observed, even in patients in whom the probability of CAD is not altered

  20. Exercise-induced thallium-201 myocardial perfusion defects in angina pectoris without significant coronary artery stenosis

    International Nuclear Information System (INIS)

    Nakazato, Masayasu; Maruoka, Yuji; Sunagawa, Osahiko; Kinjo, Kunihiko; Tomori, Masayuki; Fukiyama, Koshiro

    1990-01-01

    We performed exercise thallium-201 myocardial scintigraphy in 32 patients with angina pectoris to study the incidence of perfusion defects, who had no significant organic stenosis on coronary angiography. None of them had myocardial infarction or cardiomyopathy. Thallium-201 myocardial scintigraphy and 12-lead ECG recording were performed during supine bicycle ergometer exercise. Perfusion defects in thallium-201 scintigrams in SPECT images were assessed during visual analysis by two observers. In the coronary angiograms obtained during intravenous infusion of nitroglycerin, the luminal diameter of 75% stenosis or less in the AHA classification was regarded as an insignificant organic stenosis. Myocardial perfusion defects in the thallium-201 scintigrams were detected in eight (25%) of the 32 patients. Six of these eight patients had variant angina documented during spontaneous attacks with ST elevations in standard 12-lead ECGs. Perfusion defects were demonstrated at the inferior or infero-posterior regions in six patients, one of whom had concomitant anteroseptal defect. The defects were not always accompanied by chest pain. All but one patient demonstrating inferior or inferoposterior defects showed ST depression in leads II, III and aV F on their ECGs, corresponding to inferior wall ischemia. The exception was a case with right bundle branch block. Thus, 25% of the patients with angina pectoris, who had no evidence of significant organic stenosis on their coronary angiograms, exhibited exercise-induced perfusion defects in their thallium-201 scintigrams. Coronary spasms might have caused myocardial ischemia in these patients. (author)

  1. Atrial pacing and thallium 201 scintigraphy: combined use for diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Stratmann, H.G.; Mark, A.L.; Walter, K.E.; Fletcher, J.W.; Williams, G.A.

    1987-01-01

    To evaluate the presence of coronary artery disease (CAD), atrial pacing and thallium 201 scintigraphy were performed in 36 patients with stable angina pectoris who were unable to perform an adequate exercise stress test. All patients underwent cardiac catheterization. Nine patients had previously undergone coronary artery bypass surgery. Significant CAD (one or more lesions greater than or equal to 50%) was present in 33 patients. Atrial pacing produced ischemic ST segment depression (greater than or equal to 1 mm) in 18 (55%) patients with CAD, and angina in 20 patients (61%). As the number of vessels with CAD increased, there was no significant change in the sensitivities of pacing-induced angina or ST segment depression for detecting CAD. In the 3 patients without CAD, ST segment depression occurred in 1 patient and angina in none. Thallium 201 scintigraphy demonstrated perfusion defects in 27 (82%) patients with CAD, with fixed defects seen in 13 studies (39%) and reversible defects in 15 (45%). In the 3 patients without CAD, no perfusion defects were seen. The thallium 201 scan successfully predicted the presence of CAD in patients with single-vessel disease but usually underestimated the number of vessels involved in patients with multivessel disease. Combined sensitivity of pacing-induced ST segment depression and an abnormal thallium 201 scan finding for detecting CAD was 91%. The authors conclude that combined atrial pacing and thallium 201 scintigraphy is a useful test for detecting CAD in patients unable to perform an adequate exercise stress test

  2. Exercise-induced thallium-201 myocardial perfusion defects in angina pectoris without significant coronary artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Nakazato, Masayasu; Maruoka, Yuji; Sunagawa, Osahiko; Kinjo, Kunihiko; Tomori, Masayuki; Fukiyama, Koshiro (Ryukyu Univ., Nishihara, Okinawa (Japan). School of Medicine)

    1990-01-01

    We performed exercise thallium-201 myocardial scintigraphy in 32 patients with angina pectoris to study the incidence of perfusion defects, who had no significant organic stenosis on coronary angiography. None of them had myocardial infarction or cardiomyopathy. Thallium-201 myocardial scintigraphy and 12-lead ECG recording were performed during supine bicycle ergometer exercise. Perfusion defects in thallium-201 scintigrams in SPECT images were assessed during visual analysis by two observers. In the coronary angiograms obtained during intravenous infusion of nitroglycerin, the luminal diameter of 75% stenosis or less in the AHA classification was regarded as an insignificant organic stenosis. Myocardial perfusion defects in the thallium-201 scintigrams were detected in eight (25%) of the 32 patients. Six of these eight patients had variant angina documented during spontaneous attacks with ST elevations in standard 12-lead ECGs. Perfusion defects were demonstrated at the inferior or infero-posterior regions in six patients, one of whom had concomitant anteroseptal defect. The defects were not always accompanied by chest pain. All but one patient demonstrating inferior or inferoposterior defects showed ST depression in leads II, III and aV{sub F} on their ECGs, corresponding to inferior wall ischemia. The exception was a case with right bundle branch block. Thus, 25% of the patients with angina pectoris, who had no evidence of significant organic stenosis on their coronary angiograms, exhibited exercise-induced perfusion defects in their thallium-201 scintigrams. Coronary spasms might have caused myocardial ischemia in these patients. (author).

  3. Evaluation of muscular lesions in connective tissue diseases: thallium 201 muscular scans

    International Nuclear Information System (INIS)

    Guillet, G.; Guillet, J.; Sanciaume, C.; Maleville, J.; Geniaux, M.; Morin, P.

    1988-01-01

    We performed thallium 201 muscle scans to assess muscular involvement in 40 patients with different connective tissue diseases (7 with dermatomyositis, 7 with systemic lupus erythematosus, 12 with progressive systemic scleroderma, 2 with calcinosis, Raynaud's phenomenon, esophageal involvement, sclerodactyly, and telangiectasia (CREST) syndrome, 3 with monomelic scleroderma, 6 with morphea, and 3 with Raynaud's disease). Only 12 of these patients complained of fatigability and/or myalgia. Electromyography was performed and serum levels of muscle enzymes were measured in all patients. Comparison of thallium 201 exercise recording with the other tests revealed that scan sensitivity is greater than electromyographic and serum muscle enzymes levels. Thallium 201 scans showed abnormal findings in 32 patients and revealed subclinical lesions in 18 patients, while electromyography findings were abnormal in 25 of these 32 patients. Serum enzyme levels were raised in only 8 patients. Thallium 201 scanning proved to be a useful guide for modifying therapy when laboratory data were conflicting. It was useful to evaluate treatment efficacy. Because our data indicate a 100% positive predictive value, we believe that thallium 201 scanning should be advised for severe systemic connective tissue diseases with discordant test results

  4. Evaluation of muscular lesions in connective tissue diseases: thallium 201 muscular scans

    Energy Technology Data Exchange (ETDEWEB)

    Guillet, G.; Guillet, J.; Sanciaume, C.; Maleville, J.; Geniaux, M.; Morin, P.

    1988-04-01

    We performed thallium 201 muscle scans to assess muscular involvement in 40 patients with different connective tissue diseases (7 with dermatomyositis, 7 with systemic lupus erythematosus, 12 with progressive systemic scleroderma, 2 with calcinosis, Raynaud's phenomenon, esophageal involvement, sclerodactyly, and telangiectasia (CREST) syndrome, 3 with monomelic scleroderma, 6 with morphea, and 3 with Raynaud's disease). Only 12 of these patients complained of fatigability and/or myalgia. Electromyography was performed and serum levels of muscle enzymes were measured in all patients. Comparison of thallium 201 exercise recording with the other tests revealed that scan sensitivity is greater than electromyographic and serum muscle enzymes levels. Thallium 201 scans showed abnormal findings in 32 patients and revealed subclinical lesions in 18 patients, while electromyography findings were abnormal in 25 of these 32 patients. Serum enzyme levels were raised in only 8 patients. Thallium 201 scanning proved to be a useful guide for modifying therapy when laboratory data were conflicting. It was useful to evaluate treatment efficacy. Because our data indicate a 100% positive predictive value, we believe that thallium 201 scanning should be advised for severe systemic connective tissue diseases with discordant test results.

  5. Relationship between cancer cell proliferation and thallium-201 uptake in lung cancer

    International Nuclear Information System (INIS)

    Ishibashi, Masatoshi; Fujii, Teruhiko; Yamana, Hideaki; Fujimoto, Kiminori; Rikimaru, Toru; Hayashi, Akihiro; Kurata, Seiji; Hayabuchi, Naofumi

    2000-01-01

    Although thallium-201 ( 201 Tl) uptake is related to perfusion in many normal tissues, the biologic rationale for 201 Tl uptake in tumors is uncertain. To determine if tumor uptake is related to cell proliferation, we correlated the relative retention of 201 Tl in lung tumors with expression of Ki-67, an indicator of cell proliferation. Sixty patients with lung tumors, included small cell carcinoma (n=8) and non-small cell carcinoma (n=52), underwent 201 Tl single photon emission computed tomography (SPECT) imaging. The 201 Tl lesion uptake was determined on early and delayed images and the radiotracer retention index (RI) was calculated. Tumor specimens were obtained at surgery or bronchoscopy. The cell proliferation ratio was estimated with MIB-1, a monoclonal antibody that recognized the nuclear antigen Ki-67. The average 201 Tl index was 2.13±0.61 (early) and 2.46±0.83 (delayed). The average RI was 17.44±35.01. Overall, the 201 Tl index (delayed) and the cancer cell proliferation were correlated (r=0.70, p 201 Tl index on delayed images and the cell proliferation ratio in patients with small cell but not non-small cell lung carcinoma. The 201 Tl index (delayed) was significantly higher (p 201 Tl imaging appears to be useful for evaluating patients with small cell lung carcinoma but not non-small lung carcinoma, and is correlated with the monoclonal antibody MIB-1, marker of cell proliferation. (author)

  6. Predicting the extent and location of coronary artery disease during the early postinfarction period by quantitative thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Gibson, R.S.; Taylor, G.J.; Watson, D.D.; Stebbins, P.T.; Martin, R.P.; Crampton, R.S.; Beller, G.A.

    1981-01-01

    The ability of quantitative thallium-201 scintigraphy to predict the extent and location of coronary artery disease before hospital discharge after acute myocardial infarction was evaluated in 52 patients. All patients underwent coronary angiography and serial thallium-201 imaging either at rest (10 patients) or after submaximal exercise stress (42 patients; target heart rate 120 beats/min). Two or three vessel disease was designated if abnormal thallium-201 uptake or washout patterns, or both, were seen in two or three vascular segments, respectively. Thus, 2 weeks after myocardial infarction, exercise thallium-201 scintigraphy is useful for predicting the extent and location of coronary artery disease, particularly stenoses in the left anterior descending and right coronary arteries. Moreover, thallium-201 imaging at rest is reliable in assessing the extent of coronary disease in hospitalized patients who cannot undergo exercise testing because of unstable angina, uncompensated heart failure, poorly controlled arrhythmias or physical limitations

  7. Thallium-201 myocardial imaging with single photon emission CT in Kawasaki disease

    International Nuclear Information System (INIS)

    Matsumoto, Syuhei

    1992-01-01

    Seventy-five patients with Kawasaki disease underwent single photon emission computed tomography (SPECT) and planar imaging with thallium-201 after dipyridamole in order to evaluate the usefulness of detecting the complication of coronary artery disease (CAD). The results of SPECT with a three reconstruction imaging study (short axis, vertical long axis, horizontal long axis) and of planar imaging study with thallium-201 were compared with coronary angiography. The overall sensitivity of detecting CAD was 86.7% with SPECT and 66.7% with planar imaging. The sensitivity in identifying individual vessels was 76.0% with SPECT and 44.0% with planar imaging. SPECT was especially superior to planar imaging in detecting localized stenosis. (53.8% vs 15.4%) The specificity of SPECT did not differ from the planar imaging study. Dipyridamole thallium-201 SPECT is a useful non-invasive method to detect CAD due to Kawasaki disease. (author)

  8. Chest Pain with Normal Thallium-201 Myocardial Perfusion Image – Is It Really Normal?

    Science.gov (United States)

    Liu, Pang-Yen; Lin, Wen-Yu; Lin, Li-Fan; Lin, Chin-Sheng; Lin, Wei-Shiang; Cheng, Shu-Meng; Yang, Shih-Ping; Liou, Jun-Ting

    2016-01-01

    Background Thallium-201 myocardial perfusion image (MPI) is commonly used to detect coronary artery disease in patients with chest pain. Although a normal thallium-201 MPI result is generally considered to be a good prognosis and further coronary angiogram is not recommended, there are still a few patients who suffer from unexpected acute coronary events. The aim of this study was to investigate the clinical prognosis in patients with normal thallium-201 MPI. Methods From January 2006 to August 2012, a total 22,003 patients undergoing thallium-201 MPI in one tertiary center were screened. Of these, 8092 patients had normal results and were investigated retrospectively. During follow-up, 54 patients underwent coronary angiogram because of refractory typical angina pectoris or unexpected acute coronary events. These 54 patients were divided into 2 groups: group I consisted of 26 (48.1%) patients with angiography-proven significant coronary artery stenosis, and group II consisted of 28 (51.9%) patients without significant stenosis. Results Patients in group I had a higher prevalence of prior coronary stenting and electrocardiographic features of ST depression compared with patients in group II. The multivariate analysis demonstrated that both prior coronary stenting and ST depression were risk predictors of unexpected acute coronary events in the patients with normal thallium-201 MPI [odds ratio (OR), 5.93; 95% confidence interval (CI): 1.03-34.06, p = 0.05 and OR, 7.10; 95% CI: 1.28-39.51, p = 0.03,respectively]. Conclusions Although there is a low incidence of unexpected acute coronary events in patients with chest pain and normal thallium-201 MPI, physicians should be aware of the potentials risk in certain patients in this specific population. PMID:27274174

  9. Prognostic implications of normal exercise thallium-201 images

    International Nuclear Information System (INIS)

    Wahl, J.; Hakki, A.H.; Iskandrian, A.S.; Kay, H.

    1984-01-01

    The usefulness of exercise-thallium-201 imaging (ETI) in the evaluation of patients (pts) with suspected coronary heart disease (CHD) is well established. A more far-reaching use of the method is, however, in risk stratification. The purpose of this study was to determine the prognosis of pts with normal ETI results. The study group consisted of 432 pts (218 men and 214 women with a mean age of 51 years) who underwent ETI for suspected CHD. Of those, 305 (71%) had typical or atypical angina pectoris and 65% achieved ≥85% of maximum predicted heart rate. The exercise ECG was positive in 65 pts (15%), inconclusive in 153 (35%) and negative in 214 (50%). At a mean follow-up of 13.5 mos (range 4 to 44), 6 pts had cardiac events: 1 had fatal myocardial infarction (MI) and 5 had non-fatal MI's, (one pt with non-fatal MI had spasm by coronary angiography). Two other pts had coronary artery bypass grafting. Of the 6 pts with events, none had positive exercise ECG's, 2 had typical angina, 2 had atypical angina, and 2 had non-anginal chest pain. The authors conclude the following: (1) normal ETI results identify pts at a very low risk for future cardiac events (death: 0.2%, MI: 1.2%) which is comparable to that reported in pts with chest pain and angiographically normal coronary angiograms, (2) pts with positive exercise ECG's but normal ETI results have good prognosis, none of the 65 pts in this study had cardiac events, and, (3) ETI is a far better prognostic indicator than exercise ECG, because of the high incidence of inconclusive exercise ECG results (35%) and the good prognosis in pts with positive results

  10. Thallium-201 scintigraphy in complete left bundle branch block

    Energy Technology Data Exchange (ETDEWEB)

    Hirzel, H.O.; Senn, M.; Nuesch, K.; Buettner, C.; Pfeiffer, A.; Hess, O.M.; Krayenbuehl, H.P.

    1984-03-01

    Nineteen symptomatic patients with left bundle branch block (LBBB) were examined by thallium-201 (TI-201) exercise scintigraphy and selective coronary arteriography. All elicited significant anteroseptal perfusion defects in the exercise scintigrams, but in only 4 was coronary artery disease (CAD) involving the left anterior descending coronary artery present. To further elucidate the effect of LBBB on septal TI-201 uptake in the absence of CAD, TI-201 scintigrams combined with regional myocardial blood flow measurements using radioactive microspheres were carried out in 7 dogs during right atrial and right ventricular pacing (LBBB in the ECG) at similar heart rates. During right atrial pacing, TI-201 uptake was homogeneous in the entire left ventricle, as were tissue flows. During right ventricular pacing, TI-201 activity was reduced to 69% of maximal TI-201 activity within the septum, whereas it averaged 90% in the lateral wall (p less than 0.05) in 6 dogs. Correspondingly, regional myocardial blood flow was lower within the septum as compared with that in the lateral wall, averaging 89 and 120 ml/min/100 g, respectively (p less than 0.005). In 1 dog, normal TI-201 distribution and tissue flows were found in both studies. Thus, symptomatic patients with LBBB may elicit abnormal TI-201 exercise scintigrams, suggesting anteroseptal ischemia despite normal coronary arteries. The electrical induction of LBBB in dogs results, in most instances, in a comparable reduction in septal TI-201 uptake associated with diminished septal blood flow. Therefore, exercise-induced septal perfusion defects in the presence of LBBB do not necessarily indicate CAD even in symptomatic patients, but may reflect functional ischemia due to asynchronous septal contraction.

  11. Clinical value of delayed thallium-201 myocardial imaging in suspected acute myocardial infarction.

    Science.gov (United States)

    McKillop, J H; Turner, J G; Gray, H W; Bessent, R G; Greig, W R

    1978-01-01

    Fifty patients with acute chest pain had thallium-201 myocardial imaging performed three to six days after emergency admission to hospital. The image was abnormal in 20 out of 22 patients with acute transmural myocardial infarcts but in only 1 of 5 with acute subendocardial infarcts. Indistinguishable scan abnormalities caused by old infarcts were seen in 7 patients, and caused by myocardial ischaemia in 1 patient. A single thallium-201 myocardial scan some days after the onset of symptoms appears to be of little value in the clinical assessment of patients with suspected acute myocardial infarction. Images PMID:687488

  12. Quantitative comparison of technetium-99m tetrofosmin and thallium-201 images of the thyroid and abnormal parathyroid glands

    International Nuclear Information System (INIS)

    Giordano, A.; Meduri, G.; Calcagni, M.L.; Marozzi, P.; Ficola, U.; Vaccaro, A.; Rubini, G.; Attard, M.; Li Puma, M.; Ricci, R.; Corsello, S.

    1999-01-01

    The aim of the study was to quantitatively compare the scintigraphic images of the thyroid and abnormal parathyroid glands obtained with technetium-99m tetrofosmin and thallium-201 in patients with hyperparathyroidism. Forty-six patients with hyperparathyroidism underwent 201 Tl (74 MBq), 99m Tc-pertechnetate (74 MBq) and 99m Tc-tetrofosmin (555-740 MBq) scintigraphy in a single session. Image analysis included the computation of the thyroid/background ratio in the whole study population and the parathyroid/background ratio, parathyroid/thyroid ratio and diagnostic sensitivity in 17 patients who underwent parathyroid surgery. The pertechnetate subtraction technique was used. 201 Tl and 99m Tc-tetrofosmin showed a similar thyroid/background ratio (1.79±0.41 and 1.81±0.47, respectively, P=NS); however, 99m Tc-tetrofosmin showed a higher parathyroid/background ratio than 201 Tl (2.06±0.54 vs 1.79± 0.50, P=0.007). Despite the superior quality of 99m Tc-tetrofosmin images, both tracers showed identical sensitivity in detecting enlarged parathyroid glands in patients with primary hyperparathyroidism (89%) and in those with secondary hyperparathyroidism (50%). (orig.)

  13. New CZT cardiac cameras and myocardial perfusion imaging with thallium 201; Nouvelles cameras cardiaques a semi-conducteur cadmium -zinc- telluride (CZT) et scintigraphies myocardiques au thallium 201

    Energy Technology Data Exchange (ETDEWEB)

    Songy, B. [Service de medecine et imagerie nucleaire, centre cardiologique du Nord (CCN), 93 - Saint-Denis (France)

    2010-08-15

    Myocardial perfusion imaging is widely used for management of coronary artery disease. However, it suffers from technical limitations. New cardiac cameras using CZT detectors are now available and increase spatial (x2) and energy (x2) resolutions and photons sensitivity (x5). We describe here the General Electric Discovery NM 530c new camera and summarize the validation studies with technetium agents and with thallium 201, protocols to reduce doses, ultrafast protocols and perspectives offered with this new technology. (author)

  14. Significance of dipyridamole-induced transient dilation of the left ventricle during thallium-201 scintigraphy in suspected coronary artery disease

    International Nuclear Information System (INIS)

    Chouraqui, P.; Rodrigues, E.A.; Berman, D.S.; Maddahi, J.

    1990-01-01

    The occurrence and significance of transient dilation of the left ventricle during dipyridamole stress-redistribution thallium-201 scintigraphy was studied in 73 patients who underwent both dipyridamole thallium-201 study and coronary angiography. Transient dilation ratio was calculated from planar anterior images by dividing the computer-derived left ventricular area on the initial image by that of the 4-hour image. In 11 patients with normal coronary arteriograms or less than 50% coronary stenosis, the transient dilation ratio was 0.98 +/- 0.046. An abnormal transient dilation ratio was defined as greater than or equal to 1.12, representing greater than or equal to 3 standard deviations above the mean normal value. When the 15 patients with an abnormal ratio were compared with the 58 with a normal ratio, the former group had a significantly higher frequency of 3 critical (greater than or equal to 90%) coronary stenoses (33 vs 5%), higher prevalence of collaterals (67 vs 24%), more extensive myocardial reversible defects by planar (71 vs 10%) or by single-photon emission computed tomography (87.5 vs 35%) imaging and a higher incidence of dipyridamole-induced anginal chest pain (53 vs 22%). No significant difference between the 2 groups was noted with respect to age, gender, prior myocardial infarction, single or double critical coronary stenosis, dipyridamole-induced ischemic electrocardiographic response and increased lung uptake. An abnormal transient dilation ratio of greater than or equal to 1.12 was a specific marker of multivessel (87%) or 3-vessel (85%) critical coronary artery disease

  15. Clinical features and applications of thallium-201. With reference to scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Tadashige

    1988-12-01

    Thallium-201 is not only used widely in myocardial imaging but also has a great potential in other various nuclear medicine imaging studies. This paper presents clinical features and applications of thallium-201, focusing on clinical trials with thallium-201 at the Shinshu University School of Medicine. Thallium-201 myocardial scintigraphy offers information on (1) ventricular position and morphology, (2) hypertrophy or dilatation of the left ventricle, (3) hypertrophy or dilatation of the right ventricle, (4) site and extent of myocardial ischemia and infarct, (5) myocardial blood flow, (6) pulmonary congestion or interstitial pulmonary edema, and (7) pericardial effusion. It can be used in the following evaluation or diagnosis: (1) acute or old myocardial infarction, (2) angina pectoris, (3) treatment strategy or prognosis of ischemic heart disease, (4) treatment strategy or observation of bypass graft or drug therapy, (5) hypertrophic or dilated idiopathic cardiomyopathy, (6) myocardial lesions induced by sarcoidosis, collagen disease, and neuro-muscular disease, (7) ventricular hypertrophy and pulmonary edema, and (9) pericarditis, pericardial effusion, and systolic pericarditis associated with underlying disease. The significance of tumor, liver, bone marrow scintigraphies is also referred to. (Namekawa, K) 69 refs.

  16. Thallium-201 imaging of brain tumors using single photon emission CT

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Yuzo; Imao, Yukinori; Hirata, Toshifumi; Andoh, Takashi; Sakai, Noboru; Yamada, Hiromu (Gifu Univ. (Japan). Faculty of Medicine)

    1989-11-01

    Single photon emission CT using thallium-201 chloride, injected intravenously, was performed on 28 cases of cerebral lesions, among which were 16 gliomas, 2 meningiomas, 5 other brain tumors, 3 metastatic brain tumors and 2 cerebral radiation necroses. The degree of thallium-201 accumulation was evaluated by a new method called the thallium index (TLI); that is, TLI was expressed as (T-C)/C (T and C indicate relative counts in a pixel of a lesion and in non-affected normal brain tissue, respectively). Thallium-201 accumulation occurred in 86% (24) of the evaluated cases. In general, there was a tendency in high-grade or recurrent gliomas, as well as in metastatic brain tumors for the TLI values to be high. Moreover, high TLI values were noticed in cases of meningioma, radiation necrosis of cerebellum and in cases involving subacute stages of cerebral infarction. It is particularly noteworthy that the meningioma TLI values were about two times higher than those of the glioblastomas. The CT contrast-enhancement of lesions was clearly correlated with the TLI values, and the relationship between the TLI values and the number of vessels observed microscopically in the specimen was statistically significant. From the above results, it was concluded that thallium-201 accumulation in lesions might be strongly influenced by the development of vascularity in lesions, and/or the interference with the blood brain barrier due to the tumor itself. However, this malignancy diagnostic method is probably limited to the diagnosis of glioma. (author).

  17. Quantitative thallium-201 myocardial exercise scintigraphy in normal subjects and patients with normal coronary arteries

    International Nuclear Information System (INIS)

    Niemeyer, M.G.; St. Antonius Hospital Nieuwegein; Laarman, G.J.; Lelbach, S.; Cramer, M.J.; Ascoop, C.A.P.L.; Verzijlbergen, J.F.; Wall, E.E. van der; Zwinderman, A.H.; Pauwels, E.K.J.

    1990-01-01

    Quantitative thallium-201 myocardial exercise scintigraphy was tested in two patient populations representing alternative standards for cardiac normality: group I comprised 18 male uncatherized patients with a low likelihood of coronary artery disease (CAD); group II contained 41 patients with normal coronary arteriograms. Group I patients were younger, they achieved a higher rate-pressure product than group II patients; all had normal findings by phisical examination and electrocardiography at rest and exercise. Group II patients comprised 21 females, 11 patients showed abnormal electrocardiography at rest, and five patients showed ischemic ST depression during exercise. Twelve patients had sign of minimal CAD. Twelve patients revealed abnormal visual and quantitative thallium findings, three of these patients had minimal CAD. Profiles of uptake and washout of thallium-201 were derived from both patient groups, and compared with normal limits developed by Maddahi et al. Furthermore, low likelihood and angiographically normal patients may differ substantially, and both sets of normal patients should be considered when establishing criteria of abnormality in exercise thallium imaging. When commercial software containing normal limits for quantitative analysis of exercise thallium-201 imaging is used in clinical practice, it is mandatory to compare these with normal limits of uptake and washout of thallium-201, derived from the less heterogeneous group of low-likelihood subjects, which should be used in selecting a normal population to define normality. (author). 37 refs.; 3 figs; 1 tab

  18. Frequency of late reversibility in stress-redistribution thallium-201 SPECT using an early reinjection protocol

    International Nuclear Information System (INIS)

    Kiat, H.; Friedman, J.D.; Wang, F.P.; Van Train, K.F.; Maddahi, J.; Takemoto, K.; Berman, D.S.

    1991-01-01

    To assess the efficacy of an early thallium-201 reinjection protocol for reducing the need for late redistribution imaging, the frequency of thallium-201 late reversibility was prospectively assessed in 62 patients who had stress-redistribution thallium-201 studies by single-photon emission computerized tomography (SPECT), and who received 1 mCi of thallium-201 reinjection immediately following stress tomographic acquisition. These patients also demonstrated greater than or equal to 2 segments with nonreversible defects at 4-hour imaging and underwent late (18-to 72-hour) redistribution imaging. When the criterion of late reversibility was defined as greater than or equal to 1 segment with a 4-hour nonreversible defect demonstrating late reversibility, late reversibility was present in 36 (58%) of the 62 patients and in 88 (24%) of 368 SPECT segments. When the criterion of greater than or equal to 2 segments was used, late reversibility was found in 21 (34%) of the 62 patients and in 73 (20%) of the 368 segments. Of the 21 patients who had greater than or equal to 2 late reversible segments, 12 (57%) exhibited late reversibility in greater than or equal to 3 segments. The frequency of detected reversible defects increased from 32% by 4-hour imaging to 48% by combined 4-hour and late imaging (p less than 0.0001). The patients who demonstrated late reversibility could not be distinguished from those who had only late nonreversible defects by analysis of the clinical, exercise, and electrocardiographic (ECG) variables

  19. SPECT thallium-201 scintigraphy for the detection of left-ventricular aneurysm

    International Nuclear Information System (INIS)

    Morton, K.A.; Alazraki, N.P.; Taylor, A.T.; Datz, F.L.

    1987-01-01

    We have noted that the presence of left ventricular anterior/apical aneurysm on contrast ventriculography or echocardiography correlates well with the finding of failure of convergence of the left ventricular walls toward the apex on single photon emission computed tomography (SPECT) thallium-201 images. To assess this observation, we analyzed the SPECT thallium scans of 74 sequential patients who had SPECT thallium scintigraphy and contrast ventriculography and/or echocardiography for evaluation of coronary artery disease. Immediate post-stress and 4-hr redistribution thallium-201 SPECT images, obtained following i.v. administration of 2 mCi of thallium-201, were reconstructed with no attenuation correction using three-dimensional linear and nonlinear filters and displayed in short, vertical-long, and horizontal-long axes. Of the 74 patients, contrast ventriculography and/or echocardiography showed anterior/apical aneurysms in 15 and a posterolateral aneurysm in one. SPECT thallium scans detected 14 of the 16 aneurysms, based on the criterion of failure of convergence of the ventricular walls toward the apex. There were two false-positives. Thus SPECT thallium-201 scintigraphy for the detection of left-ventricular aneurysm in this series had a sensitivity of 94%, a specificity of 97%, and an accuracy of 96%

  20. Radiometric measurement of lead-201 and thallium-201 activity in industrial production of thallium chlorides

    International Nuclear Information System (INIS)

    Skokov, V.S.; Azbel', G.A.

    1989-01-01

    The spectrometric methods and equipment for 201 Pb and 201 Tl activity control in the prepared thallium chloride in industrial production are described. Estimation of thallium-201 activity is carried out in accord with the square of summary photopeak caused by γ-quanta at 167 keV energy. Attenuation is paid to spectrometer calibration. 5 refs.; 2 figs.; 2 tabs

  1. Thallium-201 per rectum for the diagnosis of cirrhosis in patients with asymptomatic chronic hepatitis

    Energy Technology Data Exchange (ETDEWEB)

    D' Arienzo, A.; Celentano, L.; Scuotto, A.; Di Siervi, P.; Lombardi, V.; Squame, G.; Mazzacca, G.

    1988-07-01

    In normal subjects, thallium-201, administered per rectum, is taken up mainly by the liver (heart/liver ratio in normal subjects: 0.04 to 0.12). It has been claimed that an increased heart/liver ratio is suggestive of portal-caval shunting and portal hypertension. To evaluate the possibility of using thallium-201 as a test to diagnose cirrhosis, we administered this substance per rectum to 33 patients with biochemical evidence, but no clinical symptoms, of liver disease. Laparoscopy and liver biopsy revealed chronic active hepatitis without cirrhosis in 18 patients, and chronic active hepatitis with cirrhosis in the others. The results of conventional liver function tests were similar in both groups. A significant difference, however, was found between the means of fasting serum bile acid concentrations (9.8 +/- 3.2 and 18.3 +/- 4.2 microM per liter) in chronic active hepatitis without cirrhosis and cirrhotic patients, and between the means of the heart/liver ratios 20 min after thallium-201 administration (heart/liver: 0.09 +/- 0.03 and 0.54 +/- 0.13, respectively). Unlike the serum bile acid concentration which gave some overlapping values, the thallium-201 test clearly distinguished the chronic active hepatitis without cirrhosis group from the cirrhotics. In the cirrhotic group, there was a significant correlation between the heart/liver ratio and signs of portal hypertension such as esophageal varices, increased diameter of the vena porta and hypersplenism. The thallium-201 test is therefore useful in discriminating between chronic active hepatitis with and without cirrhosis in clinically asymptomatic subjects with biochemical evidence of moderate liver function impairment. A heart/liver uptake ratio much higher than normal (above 0.30) strongly suggests the development of hepatic cirrhosis.

  2. Usefulness of thallium-201 SPECT in the evaluation of tumor natures in intracranial meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, Tetsuji; Nakano, Takahiro; Asano, Kenichiroh; Shimamura, Norihito; Ohkuma, Hiroki [Hirosaki University Graduate School of Medicine, Department of Neurosurgery, Hirosaki (Japan)

    2011-11-15

    Although intracranial meningiomas are regarded as benign tumors, some of them behave clinically as malignant tumors. Past reports suggest that MIB 1 and vascular endothelial growth factor (VEGF) in postoperative tumor specimens correlate with the aggressive nature of tumors, but preoperative prediction of such a nature is more useful for therapeutic planning for the tumor. The purpose of this study was to assess the usefulness of preoperative thallium-201 chloride single-photon emission computed tomography (Tl SPECT) to evaluate biological behavior in intracranial meningiomas. Tl SPECT was performed on 39 patients with intracranial meningioma and Tl uptake indices were calculated. The difference in the Tl uptake index between atypical meningiomas and other pathological types of meningioma was evaluated. Moreover, correlation of Tl uptake indices with the MIB1 labeling index was estimated. Tl uptake indices were also compared between VEGF strongly positive and weakly positive meningiomas. The delayed index of atypical meningioma was significantly higher than that of the other pathological types (p = 0.036). Significant correlation was found between the Tl uptake index in the delayed image and MIB1 labeling index (p < 0.0001, R{sup 2} = 0.36). Moreover, VEGF strongly positive meningiomas exhibited a significantly higher Tl uptake index compared to VEGF weakly positive meningiomas in both the early image and the delayed image (p = 0.029, 0.023, respectively). Tl uptake index may be a possible preoperative surrogate marker of MIB1 and VEGF that is useful in detecting aggressive natures in intracranial meningiomas. (orig.)

  3. Lung uptake of thallium-201 on resting myocardial imaging in assessment of pulmonary edema

    Energy Technology Data Exchange (ETDEWEB)

    Tamaki, N.; Yonekura, Y.; Yamamoto, K. (Kyoto Univ. (Japan). Hospital)

    1981-03-01

    We have noted increased lung uptake of thallium-201 on resting myocardial images in patients with congestive heart failure. To evaluate this phenomenon, lung uptake of thallium on resting myocardial imaging was examined in 328 patients with various cardiovascular diseases. Increased lung uptake was observed in 117 cases (78%) with myocardial infarction, 32 (37%) with angina pectoris, 6 (27%) with hypertensive heart disease, 7 (30%) with hypertrophic cardiomyopathy, 6 (100%) with congestive cardiomyopathy, 11 (100%) with valvular heart disease, and 7 (71%) with congenital heart disease, however, only one (5%) of normal subjects revealed increased uptake. Left ventricular ejection fraction was evaluated in 32 cases with ischemic heart disease on the same day and it was significantly decreased as the lung uptake of thallium increased. Increased thallium activity in the lung seemed to be another noninvasive marker of lift heart failure in ischemic heart disease. Lung uptake of thallium was compared with pulmonary congestive signs on chest X-ray in 29 cases. The uptake was well correlated with the degree of pulmonary edema, and thallium myocardial image revealed remarkably increased lung uptake in all the patients accompanied with pulmonary interstitial edema on chest X-ray. Therefore, this phenomenon will demonstrate pulmonary edema, since thallium may be extracted to the increased interstitial distribution space of the lung as well as the myocardium in a patient with pulmonary edema. We conclude that thallium myocardial scintigraphy is useful not only in identification and localization of myocardial ischemia or infarction, but also in evaluation of pulmonary edema at the same time.

  4. Lung uptake of thallium-201 on resting myocardial imaging in assessment of pulmonary edema

    International Nuclear Information System (INIS)

    Tamaki, Nagara; Yonekura, Yoshiharu; Yamamoto, Kazutaka

    1981-01-01

    We have noted increased lung uptake of thallium-201 on resting myocardial images in patients with congestive heart failure. To evaluate this phenomenon, lung uptake of thallium on resting myocardial imaging was examined in 328 patients with various cardiovascular diseases. Increased lung uptake was observed in 117 cases (78%) with myocardial infarction, 32 (37%) with angina pectoris, 6 (27%) with hypertensive heart disease, 7 (30%) with hypertrophic cardiomyopathy, 6 (100%) with congestive cardiomyopathy, 11 (100%) with valvular heart disease, and 7 (71%) with congenital heart disease, however, only one (5%) of normal subjects revealed increased uptake. Left ventricular ejection fraction was evaluated in 32 cases with ischemic heart disease on the same day and it was significantly decreased as the lung uptake of thallium increased. Increased thallium activity in the lung seemed to be another noninvasive marker of lift heart failure in ischemic heart disease. Lung uptake of thallium was compared with pulmonary congestive signs on chest X-ray in 29 cases. The uptake was well correlated with the degree of pulmonary edema, and thallium myocardial image revealed remarkably increased lung uptake in all the patients accompanied with pulmonary interstitial edema on chest X-ray. Therefore, this phenomenon will demonstrate pulmonary edema, since thallium may be extracted to the increased interstitial distribution space of the lung as well as the myocardium in a patient with pulmonary edema. We conclude that thallium myocardial scintigraphy is useful not only in identification and localization of myocardial ischemia or infarction, but also in evaluation of pulmonary edema at the same time. (author)

  5. Evaluation of myocardial and skeletal muscular involvement with thallium-201 myocardial emission computed tomography and whole body scintigraphy

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Matsushima, Hideo; Sotobata, Iwao; Suzuki, Akio; Indo, Toshikatsu; Matsuoka, Yukihiko

    1986-01-01

    Thallium-201 (Tl-201) myocardial emission computed tomography and whole body scintigraphy were performed using a rotating gamma camera in 64 patients with neurologic disease and 14 normal subjects. Thallium-201 myocardial perfusion defects were seen in 40 % of the muscular involvement in 47 patients with muscular dystrophy (MD), in whom morphological abnormality of the heart was common. There was strong relationship between the degree of left ventricular perfusion defects and the degree of pulmonary uptake of Tl-201. Thallium-201 whole body scintigraphy showed homogeneous distribution of Tl-201 in the extremities in normal subjects, and perfusion defects in 73 % of the muscular lesions in MD patients. Muscular and skeletal lesions for MD appear to progress independently. Thallium-201 imaging seems to be of clinical value in assessing the muscular and skeletal lesions. (Namekawa, K.)

  6. Evaluation of initial uptake and redistribution on stress thallium-201 myocardial perfusion images in patients with myocardial infarction

    International Nuclear Information System (INIS)

    Watanabe, Yoshihiko; Tonooka, Ichiroh; Kanaya, Tohru; Tsuiki, Kai; Yasui, Shouji.

    1984-01-01

    Stress thallium-201 myocardial perfusion imaging was performed on 29 patients with previous myocardial infarction and 29 patients with angina pectoris at exercise to evaluate thallium-201 kinetics in ischemic heart disease. Four views of thallium-201 images (right anterior oblique, antero-posterior, left anterior oblique and left lateral views) were obtained at 5 min after treadmill exercise with administration of 2 mCi of thallium-201 chloride (initial image) and at 3 hours later (delayed image). Myocardial images were divided into 6 segments (anterior, lateral, inferior, posterior, apical and septal segments) and initial uptake (IU) and redistribution index (RDI, the ratio of the maximal washout rate to a washout rate in each segment) were calculated in order to assess the relations of thallium-201 kinetics to wall motion abnormality and coronary artery stenosis. In myocardial infarction, IU and RDI were decreased in proportion to the severity of wall motion abnormality and coronary artery stenosis. Contrarily, in angina pectoris, IU was decreased but RDI was increased proportionally to the severity of coronary arterial stenosis. In conclusion, IU and redistribution of thallium-201 were affected essentially by both the grade of coronary arterial stenosis and the amount of residual viable heart muscle in patients with ischemic myocardial disease. (author)

  7. Relationship between segmental thallium-201 uptake and regional myocardial blood flow in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Nichols, A.B.; Weiss, M.B.; Sciacca, R.R.; Cannon, P.J.; Blood, D.K.

    1983-01-01

    The relationship between the spatial distribution of thallium-201 in myocardial perfusion scintigrams and the distribution of left ventricular regional myocardial blood flow was examined in 25 patients undergoing coronary arteriography. Thallium-201 myocardial scintigrams were obtained after symptom-limited exercise and after a 4 hr delay. Regional myocardial blood flow was measured by the xenon-133 clearance method in patients at rest and during rapid atrial pacing to a double product comparable with that achieved during exercise stress testing. Patterns of regional thallium-201 activity and regional myocardial blood flow, recorded in similar left anterior oblique projections, were compared for left ventricular segments supplied by the left anterior descending (LAD) and left circumflex (CIRC) arteries. In 11 patients without significant lesions of the left coronary artery (group 1), thallium-201 was homogeneously distributed in the LAD and CIRC distributions in scintigrams taken during peak exercise; these scintigrams correspond to homogeneous regional myocardial blood flow in the LAD and CIRC regions during pacing-induced stress. In 14 patients with significant lesions of the left coronary artery (group 2), ratios of regional thallium-201 activity in the LAD and CIRC distributions of exercise scintigrams correlated well (r . .84) with ratios of regional myocardial blood flow measured during rapid pacing. Background subtraction altered the relationship between relative thallium-201 uptake and regional myocardial blood flow, causing overestimation of the magnitude of flow reduction on exercise scintigrams

  8. Estimation of right ventricular pressure in children by thallium-201 myocardial imaging using single-photon emission computed tomography.

    Science.gov (United States)

    Akiba, T; Yoshikawa, M; Otaki, S; Nakasato, M; Suzuki, H; Sato, S; Sato, T

    1992-03-01

    Thallium-201 myocardial imaging using single-photon emission computed tomography was performed to estimate right ventricular (RV) systolic pressure in 34 children (aged 4.1 to 16.1 years, mean 7.9 +/- 2.9). Acquisition of the images was performed using a semicircular arc of 180 degrees. On a short-axis slice, a line drawn perpendicular to the ventricular septum so as to cross the RV free wall showing maximum uptake was defined as the region of interest. Thallium-201 counts in regions of interest over both RV and left ventricular (LV) free walls were measured. The ratio of RV-to-LV peak thallium-201 counts was compared with RV peak systolic pressure and the ratio of RV-to-LV peak systolic pressure measured at cardiac catheterization. Both RV peak systolic pressure and the ratio of RV-to-LV peak systolic pressure correlated well with the ratio of RV-to-LV peak thallium-201 counts (r = 0.95 and 0.96, respectively). The ratio of RV-to-LV peak thallium-201 counts greater than or equal to 0.45 could predict RV pressure overloading with a sensitivity of 92%, and a specificity of 88%. Thus, the quantitative analysis of thallium-201 myocardial imaging using single-photon emission computed tomography permits the noninvasive and accurate estimation of RV systolic pressure in children.

  9. The use of thallium-201 scintigraphy in the assessment and management of bone and soft tissue tumours

    International Nuclear Information System (INIS)

    Jong, I.; Schlicht, S.M.; Smith, P.; J Slavin; Powell, G.; Choong, P.F.M.

    2004-01-01

    Introduction: Thallium-201 scintigraphy is routinely performed on all patients presenting to the bone and soft tissue sarcoma service at St. Vincent's Hospital Melbourne. Methods: As part of the multimodality approach to patients presenting to the service, Thallium-201 planar images are obtained at 30 minutes following a resting injection of tracer with delayed planar and where possible SPECT images at 4 hours. Uptake is qualitatively assessed using adjacent muscle uptake at the time of the scan. All thallium-201 scans are read in conjunction with the correlative structural images performed. Results: High grade bone and soft tissue sarcomas typically show significant retention of tracer relative to background activity and adjacent anatomically structures. Benign lesions may show early activity but typically washout on the delayed images. However, some lesions may show marked thallium-201 activity which will be discussed. At our institution the thallium-201 scans are used for assessment of metabolic activity and tumour grade, planning of image guided pre-treatment biopsies and monitoring of treatment response particularly following radiotherapy. Conclusion: Thallium-201 scintigraphy plays a vital role in assessment and management of bone and soft tissue tumours at our institution. (authors)

  10. Noninvasive ergonovine maleate provocative testing for coronary artery spasm: the need for routine thallium-201 imaging

    International Nuclear Information System (INIS)

    Shanes, J.G.; Krone, R.J.; Fisher, K.; Shah, B.; Eisenkramer, G.; Humphrey, J.R.

    1983-01-01

    We administered ergonovine and used both electrocardiographic monitoring and thallium- 201 [ 201 Tl] imaging to detect reversible ischemia in 100 patients. Patients already established as having coronary artery spasm and those with nonbypassed, proximal, high-grade coronary artery stenosis were excluded. No complication occurred in any patient. The use of thallium imaging in addition to electrocardiographic monitoring resulted in a higher degree of sensitivity than did ECG monitoring alone. Fourteen patients demonstrated evidence of coronary artery spasm as documented by 201 Tl imaging but of the 14, significant ECG changes occurred in only 50%, and classic ST segment elevation in 21%. Thus, in carefully selected patients the noninvasive provocation of coronary spasm can be accomplished safely, but ECG monitoring must be combined with thallium- 201 imaging to achieve an acceptable degree of sensitivity

  11. Reliability of stress thallium-201 scanning in the clinical evaluation of coronary artery disease

    International Nuclear Information System (INIS)

    Stolzenbert, J.; London, R.

    1979-01-01

    Stress thallium-201 scanning proved to be a highly sensitive and specific screening procedure for myocardial ischemia in 52 consecutive cases with coronary arteriograms. Stress thallium-201 scanning was considerably more accurate and more specific than the exercise electrocardiogram (ECG) as evidenced by a sensitivity of 83% compared to 55%, and a specificity of 94% compared to 82%. When submaximal stress tests were excluded, improved sensitivity of thallium scan to exercise ECG was 95% to 64% with no change in specificity. Factors producing negative thallium scans in the presence of coronary artery disease were: delay in obtaining the first post-exercise scan, positioning and observing variability, severe three-vessel disease uniformly affecting all myocardial segments, and failure to achieve maximal stress testing due to attenuation of the heart-rate response by propranolol or somatic complaints

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

    International Nuclear Information System (INIS)

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

    1982-01-01

    Emission computed tomography (ECT) for thallium-201 ( 201 Tl) myocardial imaging was evaluated in estimating infarct size (IS). In 18 patients in whom IS was estimated enzymatically at the time of the acute episode, planar 201 Tl perfusion scintigraphy and ECT with a rotating gamma camera were performed 4 weeks after the first myocardial infarction. From the size of 201 Tl perfusion defects, the infarct area in planar images and the infarct volume in reconsturcted ECT images were measured by computerized planimetry. When scintigraphic IS was compared with the accumulated creatine kinase-MB isoenzyme release (CK-MBr), infarct volume determined from ECT correlated closely with CK-MBr (r=0.89), whereas infarct area measured from planar images correlated less satisfactorily with the enzymatic IS (for an average infarct area from three views, r=0.69; for the largest infarct area, r=0.73). Although conventional scintigraphic evaluation is useful for detecting and localizing infarction, quantification of ischemic injury with this two-dimensional technique has a significant inherent limitation. The ECT approach can provide a more accurate three-dimensional quantitative estimate of infarction, and can corroborate the enzymatic estimate of IS

  13. Disease stage classification in hypertrophic cardiomyopathy by dual analysis of iodine-123-labeled metaiodobenzylguanidine and thallium-201 myocardial scintigraphies

    Energy Technology Data Exchange (ETDEWEB)

    Hiasa, Go [Ehime Univ., Matsuyama (Japan). School of Medicine

    2001-08-01

    Many patients with hypertrophic cardiomyopathy (HCM) gradually changes from typical myocardial hypertrophy to dilated cardiomyopathy-like features. However, it is difficult to estimate the disease stage in HCM. To determine the disease stage, dual analysis of iodine-123-labeled metaiodobenzylguanidine ({sup 123}I-MIBG) and thallium-201 ({sup 201}Tl) myocardial scintigraphies were performed in 108 HCM patients. According to the scintigraphic distribution patterns, patients were divided into three groups. Group A (n=15): normal distributions of both {sup 123}I-MIBG and {sup 201}Tl, group B (n=71): normal {sup 201}Tl and low {sup 123}I-MIBG patterns, group C (n=22): low distributions of both scintigraphies. The decrease in {sup 201}Tl uptake was observed in only group C. Concerning {sup 123}I-MIBG, heart-to-mediastinum ratio (H/M) and washout rate (WOR) had good correlations with left ventricular systolic functions. H/M was decreased and WOR was increased in order of C, B and A groups. Left ventricular diastolic function reflected by isovolumic relaxation time was longer in group B than in group A. Attenuated left ventricular hypertrophy, enlarged left ventricular volumes, impaired left ventricular functions and serious clinical symptoms were observed in only group C. Myocardial sympathetic abnormalities in group B may be mainly due to myocardial hypertrophy, and those in group C may be due to myocardial injury. Dual analysis of {sup 123}I-MIBG and {sup 201}Tl scintigraphies may be useful to classify disease stages of HCM. (author)

  14. Dipyridamole-thallium-201 tomography documenting improved myocardial perfusion with therapy in Kawasaki disease

    International Nuclear Information System (INIS)

    Nienaber, C.A.; Spielmann, R.P.; Hausdorf, G.

    1988-01-01

    Thallium-201 tomographic perfusion studies after pharmacologic vasodilation were performed in seven children (aged 2 years 8 months to 8 years 7 months), 3 to 20 months after the acute stage of the disease. In all patients coronary aneurysms were seen on cross-sectional echocardiograms. The scintigrams of six children showed no significant regional reduction of myocardial thallium-201 uptake. These children had remained asymptomatic in the follow-up period after the acute inflammatory stage of Kawasaki disease. Persistent and transient thallium defects were present in one child with acute posterolateral myocardial infarction; obstruction of two coronary vessels supplying the defect zones was confirmed by contrast angiography. After 8 months of treatment a follow-up nuclear scan showed marked reduction in the size of the defect and almost complete abolishment of the ischemic reaction. Thus tomographic thallium-201 perfusion scintigraphy in conjunction with vasodilation stress is useful to assess myocardial perfusion in children with Kawasaki disease and demonstrates marked improvement in regional perfusion after adequate medical therapy

  15. Non-invasive assessment of coronary artery disease with stress thallium-201 myocardial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Yoshio; Hirose, Yoshiaki; Hamada, Seiki; Maeno, Masakazu; Takahashi, Nobukazu; Hayashida, Kohei; Takamiya, Makoto; Miyazaki, Shun-ich; Nonogi, Hiroshi [National Cardiovascular Center, Suita, Osaka (Japan)

    1995-02-01

    Recent studies have reported a low specificity of stress thallium-201 myocardial imaging in the diagnosis of coronary artery disease. Thus this study was undertaken to reassess the ability of stress thallium-201 myocardial imaging to detect deseased coronary vessels. The subjects were 469 patients, who consisted of 397 with a significant {>=}75% stenosis and the other 72 with normal coronary vessels on coronary arteriography done within 6 months before and after thallium imaging. Using the coronary arteriogram as the arbiter, the sensitivity and specificity of stress thallium imaging were 91% and 43%, respectively. Forty-one patients with no angiographic evidence of coronary stenosis were assessed as having coronary stenosis on thallium imaging (false-positive cases). All the 41 patients had cardiovascular diseases or symptoms, such as hypertrophic cardiomyopathy, complete left bundle branch block, chest pain of unknown etiology, and abnormalities on stress ECG. This suggested the possibility that dysfunctional segments may be manifested by exercise stress even though these are not shown on coronary arteriography at rest. Thus the low specificity of stress thallium-201 myocardial imaging in the diagnosis of coronary artery disease may not contribute to the essential disadvantage of thallium imaging, but may reflect dysfunctional segments that are not shown by morphological manifestation of coronary arteriography. (N.K.).

  16. A serial changes of thallium-201 myocardial images in a patient with nontransmural myocardial infarction

    International Nuclear Information System (INIS)

    Tanaka, Takeshi; Itoh, Yukiyoshi; Takayama, Yasuo

    1986-01-01

    A 66 year old man had suffered from inferior myocardial infarction one year ago and then suffered from effort angina. Recently rest angina attack frequently occurred and he was admitted because of angina attack refractory to TNG. The patient was diagnosed as broad nontransmural infarction. A serial thallium-201 myocardial imagings at rest and thallium-201 lung uptake imagings were performed and some interesting findings were obtained as followings. Myocardial imagings on 3rd day after admission showed no significant deffect, however EF was 34 %. Immediately after severe ischemic attack marked defect was noted at posterolateral region and ECG showed prominent precordial ST depression without accompanying significant ST change in II, III, aVF. On 3rd day after severe attack under hemodynamically and electrocardiographically stable state posterolateral defect improved, though still persisted. EF was 28 %. On 3rd day postop no marked defects were noted in myocardial imagings, so posterolateral defect at rest after severe ischemic attack was proved to be transient defect. In this case thallium-201 lung uptake was not noted before attack. Immediately after severe attack thallium lung uptake increased and maximal uptake was noted at basal zone of lung, however in chest X-P typical butterfly shadow was noted at upper zone of lung. On 3rd day after severe attack hemodynamics improved and butterfly shadow ceased, though thallium lung uptake increased and noted at upper zone of lung. After operation thallium lung uptake improved. (J.P.N.)

  17. Evaluation of skeletal muscular involvement in neuromuscular disorders with thallium-201 whole body scintigraphy

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Sotobata, Iwao; Indo, Toshikatsu; Matsuoka, Yukihiko; Matsushima, Hideo; Suzuki, Akio; Abe, Tetsutaro; Sakuma, Sadayuki

    1986-01-01

    The extent as well as severity of pathologic changes of skeletal muscles were analyzed with thallium-201 whole body scintigraphy (WBS) in 29 cases of various types of neuromuscular diseases (18 cases of myogenic and 11 cases of neurogenic muscular diseases) and 14 cases of normal controls. After intravenous injection of 2 mCi of thallium-201 chloride, WBS was performed for 15 minutes using a gamma camera with twin-opposed large rectangular detectors. Counts at brachia, forearms, thighs, and calves were assessed after reconstruction of the scintigram of the whole body by taking the geometric mean of the anterior and posterior data. WBS showed uniform tracer activities in the 4 extremities in 12 cases among 14 controls. Laterality in distribution of counts of both legs and arms was noted in the remaining 2 controls. WBS revealed decrease of perfusion in the extremities with muscular atrophy and/or weakness in neuromuscular diseases. The overall diagnostic accuracy of WBS for evaluation of skeletal muscle involvement was 75 to 80 % except for the bilateral brachia for which it decreased to 65 %. All of the three cases of muscular dystrophy with pseudohypertrophy of the calves or thighs showed unequivocal decrease of perfusion of those regions in WBS. In conclusion, thallium-201 WBS was considered to be a useful clinical means in evaluating the extent and severity of muscular involvement of various types of neuromuscular disorders. (author)

  18. Detection of human collateral circulation by vasodilation-thallium-201 tomography

    International Nuclear Information System (INIS)

    Nienaber, C.A.; Salge, D.; Spielmann, R.P.; Montz, R.; Bleifeld, W.

    1990-01-01

    Coronary arteriolar vasodilation may provoke redistribution of flow to collateral-dependent jeopardized myocardium. To assess the physiologic significance of collaterals, 80 consecutive post-infarction patients (age 58 +/- 8 years) underwent vasodilation-redistribution thallium-201 tomographic imaging after administration of 0.56 mg of intravenous dipyridamole/kg body weight. Circumferential profile analysis of thallium-201 uptake and redistribution in representative left ventricular tomograms provided quantitative assessment of transient and fixed defects and separation between periinfarctional and distant inducible hypoperfusion. Tomographic perfusion data were correlated to wall motion and collateral circulation between distinct anatomic perfusion territories. Patients were grouped according to presence (59%) or absence (41%) of angiographically visible collateral channels to jeopardized myocardium. In the presence of collaterals, distant reversible defects were larger than in absence of collaterals (p less than 0.05); the extent of combined periinfarctional and distant redistribution was also larger in collateralized patients (p less than 0.025), whereas the size of the persistent perfusion defect was similar in both groups. By prospective analysis the tomographic perfusion pattern of combined periinfarctional and distant redistribution revealed a sensitivity of 85% and a specificity of 78% for the detection of significant collateral circulation in this group of patients. Thus, using the exhausted flow reserve as a diagnostic tool, vasodilation-thallium-201 tomography has the potential to identify and quantitate collateralized myocardium in post-infarction patients and may guide diagnostic and therapeutic decision-making

  19. Thallium-201 myocardial perfusion imaging during transient coronary occlusion at the time of PTCA

    International Nuclear Information System (INIS)

    Nakagawa, Tatsuya; Sugihara, Hiroki; Inagaki, Suetsugu

    1989-01-01

    To evaluate myocardial perfusion during transient coronary arterial occlusion, thallium-201 was administered intravenously during percutaneous transluminall coronary angioplasty (PTCA) in 12 patients with effort angina, and the resulting perfusion images were compared with those of exercise stress obtained before PTCA. Thallium-201 was injected at the last inflation of an angioplastic baloon and occlusion was maintained for 60 to 90 sec. Three projections of planar images were obtained immediately after PTCA, using a portable gamma camera in an angiography room. These perfusion images obtained during PTCA and exercise were visually interpreted and compared. Myocardial perfusion defects due to the responsible vessel occlusion were observed at early imaging after PTCA, and were fully redistributed three hrs post injection. In 10 patients without angiographically imaged collateral vessels, there were no significatn differences in perfusion between images during PTCA and during exercise. Two patients whose collaterals were observed during coronary angiography before PTCA had higher perfusion scores during PTCA than during exercise. We concluded that intravenous injection of thallium-201 during PTCA is a useful means for assessing alteration of myocardial perfusion due to transient coronary occlusion without increasing the risk of angioplastic procedures, and that it provides more precise information about the jeopardized myocardium, perfused by antegrade blood flow. (author)

  20. Non-invasive assessment of coronary artery disease with stress thallium-201 myocardial imaging

    International Nuclear Information System (INIS)

    Ishida, Yoshio; Hirose, Yoshiaki; Hamada, Seiki; Maeno, Masakazu; Takahashi, Nobukazu; Hayashida, Kohei; Takamiya, Makoto; Miyazaki, Shun-ich; Nonogi, Hiroshi

    1995-01-01

    Recent studies have reported a low specificity of stress thallium-201 myocardial imaging in the diagnosis of coronary artery disease. Thus this study was undertaken to reassess the ability of stress thallium-201 myocardial imaging to detect deseased coronary vessels. The subjects were 469 patients, who consisted of 397 with a significant ≥75% stenosis and the other 72 with normal coronary vessels on coronary arteriography done within 6 months before and after thallium imaging. Using the coronary arteriogram as the arbiter, the sensitivity and specificity of stress thallium imaging were 91% and 43%, respectively. Forty-one patients with no angiographic evidence of coronary stenosis were assessed as having coronary stenosis on thallium imaging (false-positive cases). All the 41 patients had cardiovascular diseases or symptoms, such as hypertrophic cardiomyopathy, complete left bundle branch block, chest pain of unknown etiology, and abnormalities on stress ECG. This suggested the possibility that dysfunctional segments may be manifested by exercise stress even though these are not shown on coronary arteriography at rest. Thus the low specificity of stress thallium-201 myocardial imaging in the diagnosis of coronary artery disease may not contribute to the essential disadvantage of thallium imaging, but may reflect dysfunctional segments that are not shown by morphological manifestation of coronary arteriography. (N.K.)

  1. Effect of ischemia and postischemic dysfunction on myocardial uptake of technetium-99m-labeled methoxyisobutyl isonitrile and thallium-201

    International Nuclear Information System (INIS)

    Sinusas, A.J.; Watson, D.D.; Cannon, J.M. Jr.; Beller, G.A.

    1989-01-01

    The myocardial uptake of a new technetium-99m-labeled myocardial perfusion agent, methoxyisobutyl isonitrile (Tc-99m MIBI), and thallium-201 was correlated with microsphere flow in an open chest canine model of low coronary flow and postischemic dysfunction. Eighteen dogs were given an injection of thallium-201 (0.5 mCi) and Tc-99m MIBI (5 mCi) either after 40 min of partial left anterior descending artery occlusion (Group I, 10 dogs) or during reperfusion after 15 min of left anterior descending artery occlusion (Group II, 8 dogs). Regional dysfunction was documented during injection in both groups by quantitative two-dimensional echocardiography. Regional blood flow was assessed by radiolabeled microspheres. The heart was excised 15 min after radionuclide injection and the left ventricle divided into 96 segments for gamma well counting. Among Group I dogs, central ischemic thallium-201 and Tc-99m MIBI activity (expressed as a percent of the activity in the corresponding nonischemic zone) was comparable, respectively, for endocardial (54 +/- 17% and 52 +/- 17%), mid-wall (71 +/- 20% and 69 +/- 17%) and epicardial (89 +/- 13% and 94 +/- 9%) segments and increased proportionally with flow. There was a good linear correlation among these endocardial segments between flow and both thallium-201 (r = 0.78) and Tc-99m MIBI (r = 0.85) activity. Among Group II dogs, central ischemic endocardial flow (59 +/- 14%) was comparable to thallium-201 (70 +/- 18%) and Tc-99m MIBI (74 +/- 12%) activity. Similarly, relative endocardial flow in the intermediate ischemic region (71 +/- 11%) was comparable to thallium-201 (77 +/- 11%) and Tc-99m MIBI (81 +/- 10%) activity. Thus, myocardial uptake of Tc-99m MIBI and thallium-201 is comparable under conditions of low coronary flow and postischemic dysfunction and closely parallels flow alterations

  2. Relation of immediate and delayed thallium-201 distribution to localization of iodine-125 antimyosin antibody in acute experimental myocardial infarction

    International Nuclear Information System (INIS)

    Khaw, B.A.; Strauss, H.W.; Pohost, G.M.; Fallon, J.T.; Katus, H.A.; Haber, E.

    1983-01-01

    Thallium-201 (TI-201) distribution in acute experimental myocardial infarction (MI) (n . 18) was compared with cardiac-specific antimyosin Fab (AM-Fab) uptake, a specific marker for myocardial necrosis. When antimyosin was injected 4 hours after ligation with TI-201 administered 23 hours 55 minutes later and measurement of myocardial distribution determined 5 minutes after intravenous administration of TI-201, (1) TI-201 distribution closely correlated with microsphere regional blood flow, and (2) an inverse exponential relation to iodine-125 (I-125) AM-Fab uptake was apparent. In another group of 4 animals, TI-201 and AM-Fab were administered intravenously 4 hours after MI, and 36 hours later myocardial distribution was measured. This delayed TI-201 distribution had a close inverse linear correlation with I-125 AM-Fab uptake. This inverse linear relation also was apparent in 28-hour-old MIs in dogs (n . 4) where collateral circulation had been established. TI-201 was administered intravenously at 27 hours after MI, and TI-201 distribution was determined 1 hour later. The present study demonstrated that whereas immediate TI-201 distribution is flow-limited, delayed TI-201 distribution is a marker of cell viability which, due to prolonged circulation time and redistribution, is not flow-limited

  3. Study and development recuperation of Thallium-203 from bombarded targets of this metal in production of Thallium-201 via addition of Thallium-201 radioisotope as a tracer

    International Nuclear Information System (INIS)

    Shirazi, B.

    2006-01-01

    Thallium-203 is the main material for 201 TlCl 3 radiopharmaceutical. It is very important to recover the remaining enriched Thallium-203 in every stage of the process to be reused in the production loop. In this research, the recuperation of Thallium-203 was studied with Dowex 50 WΧ8 ion exchange resin and Thallium-201 as a tracer. The results based on filling of ( 1 8 X 1.5) cm columns with this resin showed that the best flow rate of eluent is 2 ml/min. Also the most suitable volumes are 200 mL (HNO 3 0.05 M), 400 mL (solution of Thallium-203), 100 mL (H 2 O), 500 mL (Citric acid), 100 mL (H 2 0), 100 mL (EDTA 0.5 M and pH∼12.5). 60 mL (H 2 0), respectively

  4. Thallium-201 SPECT imaging of recurrent brain tumors. Analysis of 8 cases

    Energy Technology Data Exchange (ETDEWEB)

    Sano, Tetsuro; Seki, Yojiro; Aiba, Tadashi; Teramoto, Akira; Ohtake, Eiji; Murata, Hajime (Toranomon Hospital, Tokyo (Japan))

    1994-06-01

    With post-irradiated brain tumors, it is sometimes difficult to distinguish between tumor recurrence and late radiation necrosis, because both conditions are similar by conventional neuroimaging and the length of the latent period following initial treatment. Thallium-201 SPECT was performed in 8 cases. The mean time elapsed after post-operative radiation therapy was 3 years and one month. The patients were of 4 adult males and 4 adult females, ranging in age from 29 to 66 with a mean age of 47.5 years at the first surgery. All cases were histologically verified: 3 low grade gliomas; 3 malignant gliomas; 1 malignant lymphoma, and 1 giant invasive pituitary adenoma. Five minutes after the intravenous injection of approximately 111 MBq of thallium-201, a ring-typed head scanner, SET-050 (Shimadzu), was used to acquire SPECT images. To evaluate objectively, we set up an ROI (region of interest) of 16 pixels at the tumor site (T), the contralateral cerebrum (C), the contralateral cerebellum (C'), and the scalp (S), and then calculated the ratios of T/C, T/C' and T/S. All patients underwent second surgical interventions, such as a craniotomy or a stereotactic biopsy. In the end, seven cases were diagnosed as recurrent and the remaining one was determined to have radiation necrosis. Of the 7 recurrent tumors, 2 low grade gliomas had turned malignant. On the SPECT images, the 7 recurrent cases showed an abnormally strong accumulation at the tumor site, whereas the case of late radiation necrosis revealed no abnormal deposit, suggesting that thallium-201 SPECT might be useful in the differential diagnosis between recurrence and late radiation necrosis. Among the various quantitative methods of evaluating SPECT images, the T/S ratio seemed to be the most useful since it had the smallest standard deviation. (author).

  5. Predicting the extent and location of coronary artery disease during the early postinfarction period by quantitative thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Gibson, R.S.; Taylor, G.J.; Watson, D.D.; Stebbins, P.T.; Martin, R.P.; Crampton, R.S.; Beller, G.A.

    1981-01-01

    The ability of quantitative thallium-201 scintigraphy to predict the extent and location of coronary artery disease before hospital discharge after acute myocardial infarction was evaluated in 52 patients. All patients underwent coronary angiography and serial thallium-201 imaging either at rest or after submaximal exercise stress. Two or three vessel disease was designated if abnormal thallium-201 uptake or washout patterns, or both, were seen in two or three vascular segments, respectively. Of 156 vessels analyzed in the 52 patients, 91 stenoses of 70 percent or greater were found by angiography. Seventy-four of these were predicted by scintigraphy. The specificity of scintigraphy for identifying vessel stenoses was 92 percent. Sensitivity for detecting and localizing stenoses supplying an infarct zone was 96 percent compared with 62 percent for stenoses supplying myocardium remote from the acute infarct. Perfusion abnormalities were more frequently seen in the distribution of vessels with severe stenoses than in those with moderate stenoses. Scintigraphy detected a greater proportion of left anterior descending and right coronary arterial stenoses than circumflex stenoses. In the 42 patients who underwent submaximal exercise testing, multivariate analysis of 23 clinical and laboratory variables identified multiple thallium-201 defects as the best predictor of multivessel disease. The predictive accuracy of exercise-induced S-T segment depression was only 45 percent compared with 88 percent for thallium-201 scintigraphy. Thallium-201 imaging at rest is reliable in assessing the extent of coronary disease in hospitalized patients who cannot undergo exercise testing because of unstable angina, uncompensated heart failure, poorly controlled arrhythmias or physical limitations

  6. Validation with the thallium 201 of a cadmium-zinc-telluride semiconductor camera (C.Z.T.); Validation avec le thallium 201 d'une camera a semi-conducteur cadmium-zinc-telluride (CZT)

    Energy Technology Data Exchange (ETDEWEB)

    Songy, B.; Guernou, M.; Geronazzo, R.; Lussato, D. [Centre cardiologique du Nord, 93 - Saint-Denis (France)

    2010-07-01

    With thallium-201 ({sup 201}Tl), the cadmium-zinc-telluride (C.Z.T.) NM530c discovery camera allows acquisition of 5 min with enhanced imaging quality and reliable diagnosis, in the prone or supine position. (N.C.)

  7. Qualitative evaluation of coronary flow during anesthetic induction using thallium-201 perfusion scans

    International Nuclear Information System (INIS)

    Kleinman, B.; Henkin, R.E.; Glisson, S.N.; el-Etr, A.A.; Bakhos, M.; Sullivan, H.J.; Montoya, A.; Pifarre, R.

    1986-01-01

    Qualitative distribution of coronary flow using thallium-201 perfusion scans immediately postintubation was studied in 22 patients scheduled for elective coronary artery bypass surgery. Ten patients received a thiopental (4 mg/kg) and halothane induction. Twelve patients received a fentanyl (100 micrograms/kg) induction. Baseline thallium-201 perfusion scans were performed 24 h prior to surgery. These scans were compared with the scans performed postintubation. A thallium-positive scan was accepted as evidence of relative hypoperfusion. Baseline hemodynamic and ECG data were obtained prior to induction of anesthesia. These data were compared with the data obtained postintubation. Ten patients developed postintubation thallium-perfusion scan defects (thallium-positive scan), even though there was no statistical difference between their baseline hemodynamics and hemodynamics at the time of intubation. There was no difference in the incidence of thallium-positive scans between those patients anesthetized by fentanyl and those patients anesthetized with thiopental-halothane. The authors conclude that relative hypoperfusion, and possibly ischemia, occurred in 45% of patients studied, despite stable hemodynamics, and that the incidence of these events was the same with two different anesthetic techniques

  8. Qualitative evaluation of coronary flow during anesthetic induction using thallium-201 perfusion scans

    Energy Technology Data Exchange (ETDEWEB)

    Kleinman, B.; Henkin, R.E.; Glisson, S.N.; el-Etr, A.A.; Bakhos, M.; Sullivan, H.J.; Montoya, A.; Pifarre, R.

    1986-02-01

    Qualitative distribution of coronary flow using thallium-201 perfusion scans immediately postintubation was studied in 22 patients scheduled for elective coronary artery bypass surgery. Ten patients received a thiopental (4 mg/kg) and halothane induction. Twelve patients received a fentanyl (100 micrograms/kg) induction. Baseline thallium-201 perfusion scans were performed 24 h prior to surgery. These scans were compared with the scans performed postintubation. A thallium-positive scan was accepted as evidence of relative hypoperfusion. Baseline hemodynamic and ECG data were obtained prior to induction of anesthesia. These data were compared with the data obtained postintubation. Ten patients developed postintubation thallium-perfusion scan defects (thallium-positive scan), even though there was no statistical difference between their baseline hemodynamics and hemodynamics at the time of intubation. There was no difference in the incidence of thallium-positive scans between those patients anesthetized by fentanyl and those patients anesthetized with thiopental-halothane. The authors conclude that relative hypoperfusion, and possibly ischemia, occurred in 45% of patients studied, despite stable hemodynamics, and that the incidence of these events was the same with two different anesthetic techniques.

  9. Exercise thallium-201 scintigraphy in men with nondiagnostic exercise electrocardiograms. Prognostic implications

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Kane-Marsch, S.

    1986-01-01

    We studied the prognostic value of exercise thallium-201 imaging in 196 men with suspected or known coronary artery disease who had nondiagnostic exercise electrocardiograms. The perfusion images in each of three projections were divided into three segments; each segment was assessed for perfusion defects (fixed or reversible). There were 12 cardiac events at a mean follow-up of 15 months (range, one to 66 months). Of those, five patients died of cardiac causes and seven had nonfatal acute myocardial infarctions (MIs). Only the number of perfusion defects significantly predicted cardiac events; clinical presentation, history of MI, presence of Q-wave MI, exercise duration, and exercise heart rate and double product did not predict cardiac events or add to information provided by the number of defects. Furthermore, actuarial life-table analysis showed that patients with three or more perfusion defects had significantly worse prognoses than patients with fewer than three defects. Exercise thallium-201 imaging helps in risk stratification of men with nondiagnostic exercise electrocardiograms

  10. Assessment of the significance of coronary collateral vessel by using thallium-201 myocardial imaging

    International Nuclear Information System (INIS)

    Kanoh, Yasushi; Shiotani, Hideyuki; Fukuzaki, Hisashi; Maeda, Kazumi.

    1988-01-01

    For functional assessment of coronary collateral vessels, twenty-three patients with effort angina pectoris who had total coronary obstruction were studied. The patients were divided depending on the degree of development of collateral vessels into two groups, i.e. good collateral group I (n = 13) and poor collateral group II (n = 10). Thallium-201 scan was performed immediately (Ex-1 image), 20 minutes (Ex-2 image) after exercise and after nitroglycerin administration (NTG image) respectively. In all images, the relative percent activity of thallium-201 in the collateral-dependent ischemic area to the normal myocardium were calculated and were compaired between two groups. Relative percent activities in group I and II were as follows : Ex-1 image ; 75.8 ± 3.5 % vs. 77.2 ± 2.9 % (NS), Ex-2 images ; 85.3 ± 4.5 % vs. 79.3 ± 3.9 % (p < 0.005), NTG image ; 97.3 ± 3.1 % vs. 96.4 ± 5.2 % (NS). From these results, it was elucidated that good collateral induced early partial redistribution in its perfusion area, suggesting that good collateral circulation may provide rapid recovery from myocardial ischemia. (author)

  11. Cardiac morphology in left ventricular hypertrophy using thallium-201 myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Torii, Yukio; Adachi, Haruhiko; Katsume, Hiroshi; Ochiai, Masakazu; Ijichi, Hamao

    1985-06-01

    To evaluate cardiac morphology in the patients with various cases of hypertrophy, we measured left ventricular (LV) size using thallium-201 myocardial scintigraphy in 29 normal subjects and in 90 patients. Cardiac shape and dimension were assessed by measuring the wall thickness and external length in the short and long axis of LV image in LAO projection. In aortic stenosis and hypertensive heart disease the shape was spherical and the wall was thickened. In both mitral (MR) and aortic (AR) regurgitations, LV dilatation were shown; spherical shape in chronic MR but ellipsoid shape in acute MR and AR. Decreased LV size but normal shape was observed in mitral stenosis and cor pulmonale. In hypertrophic cardiomyopathy the LV wall was asymmetrically hypertrophied, while in congestive cardiomyopathy the wall is thin with marked LV dilatation and the shape was spherical. We concluded that the heart had characteristic configuration which might reflect cardiac performance or compensate for the load to the heart, and that thallium-201 myocardial scintigraphy is useful in the evaluation of cardiac morphology as well as in diagnosis of myocardial ischemia. (author).

  12. Wiener filtering improves quantification of regional myocardial perfusion with thallium-201 SPECT

    International Nuclear Information System (INIS)

    Links, J.M.; Jeremy, R.W.; Dyer, S.M.; Frank, T.L.; Becker, L.C.

    1990-01-01

    Quantitation of myocardial perfusion with thallium-201 (201Tl) SPECT is limited by finite resolution and image noise. This study examined whether Wiener filtering could improve quantitation of the severity of myocardial perfusion deficits. In 19 anesthetized dogs, adjustable stenoses were placed on the left anterior descending (LAD, n = 12) or circumflex (LCx, n = 7) arteries. Thallium-201 SPECT images were acquired during maximal coronary vasodilation with dipyridamole, and simultaneous measurements of myocardial blood flow were made with microspheres. The relationship between SPECT and microsphere flow deficits in the LAD region was significantly better (p less than 0.05) with Wiener filtering (Y = 0.90X + 0.03, r = 0.78) than with conventional Hanning filtering (Y = 0.66X + 0.34, r = 0.61). Similarly, in the LCx region the relationship between SPECT and microsphere perfusion deficits was better (p less than 0.01) with the Wiener filter (Y = 0.91X + 0.07, r = 0.66) than with the Hanning filter (Y = 0.36X + 0.50, r = 0.40). Wiener filtering improves quantitation of the severity of regional myocardial perfusion deficits, allowing better assessment of the functional significance of coronary artery stenoses

  13. Prognostic value of exercise thallium-201 imaging in patients presenting for evaluation of chest pain

    International Nuclear Information System (INIS)

    Brown, K.A.; Boucher, C.A.; Okada, R.D.; Guiney, T.E.; Newell, J.B.; Strauss, H.W.; Pohost, G.M.

    1983-01-01

    Accurate prognostic information is important in determining optimal management of patients presenting for evaluation of chest pain. In this study, the ability of exercise thallium-201 myocardial imaging to predict future cardiac events (cardiovascular death or nonfatal myocardial infarction) was correlated with clinical, coronary and left ventricular angiographic and exercise electrocardiographic data in 139 consecutive, nonsurgically managed patients followed-up over a 3 to 5 year period (mean follow-up, 3.7 +/- 0.9), using a logistic regression analysis. Among patients without prior myocardial infarction (100 of 139), the number of myocardial segments with transient thallium-201 defects was the only statistically significant predictor of future cardiac events when all patient variables were evaluated. Among patients with myocardial infarction before evaluation (39 of 139), angiographic ejection fraction was the only significant predictor of future cardiac events when all variables were considered. This study suggests an approach to evaluate the risk of future cardiac events in patients with possible ischemic heart disease

  14. Correlation of exercise thallium-201 myocardial scan with coronary arteriograms and the maximal exercise test

    International Nuclear Information System (INIS)

    Carrillo, A.P.; Marks, D.S.; Pickard, S.D.; Khaja, F.; Goldstein, S.

    1978-01-01

    Myocardial scans obtained by injecting radioactive thallium-201 during exercise were corrlated with electrocardiograms obtained at rest and during exercise, with coronary arteriographic abnormalities, and with left ventriculograms in 55 patients suspected of having coronary arterial disease. Thirty-nine patients had significant coronary arterial disease, 34 of whom had abnormal myocardial scans after exercise and 21 of whom had abnormal ECGs during exercise. The myocardial scan after exercise was most frequently abnormal in the presence of significant abnormalities in the Q wave or localized left ventricullar asynergy and when ST-segment depression persisted for longer than ten minutes after exercise. All patients with single-vessel disease had abnormal myocardial scans after exercise, whereas five of 29 patients with two or more abnormal vessels had normal scans. Patients with coronary arterial disease were more likely to have a normal myocardial scan after exercise when the resting ECG and left ventriculogram were normal and when exercise-induced ST-segment depression persisted for less than ten minutes. The combination of the myocardial scan after exercise and the ECG during maximal exercise had a sensitivity of 98 percent. The mycardial scan after exercise alone had a specificity of 100 percent. These observations indicate that the myocardial scan obtained by injecting thallium-201 during exercise is an important diagnostic adjunct in the identification of patients with coronary arterial disease

  15. Thallium-201 imaging in children with osteogenic sarcoma

    International Nuclear Information System (INIS)

    Parker, M.K.; Koutsiofi, M.; Rossleigh, M.A.

    2003-01-01

    Full text: Thallium(Tl)-201 scintigraphy has been utilised in the imaging of a variety of tumours. This study evaluates its usefulness in children with osteogenic sarcoma. Five patients (3 male, 2 female) whose ages ranged from 11 to 15 years were investigated. Each child underwent a baseline 201 Tl study at diagnosis to determine the initial avidity of the tumour and a follow up study following chemotherapy, just prior to surgical excision, to assess tumour response to chemotherapy. This tumour response was confirmed by histopathological examination of the operative specimen. 201 Tl scintigraphy was undertaken 20 minutes following the intravenous administration of a weight adjusted dose of 201 Tl (minimum dose 20 MBq, adult dose 120 MBq). Whole body studies as well as planar images of the primary tumour were performed. All primary tumours were thallium avid on the baseline study. On the follow-up examination after therapy, a variety of patterns of uptake were seen and these correlated with the pathological findings. In one patient, complete loss of thallium accumulation following treatment corresponded to 100% tumour necrosis histologically. In another patient, persistent thallium uptake in the tumour following chemotherapy correlated with viable tumour cells on pathology and this patient died of his disease. In the other 3 patients, intermediate grade thallium appearances were demonstrated. In conclusion, 201 Tl scintigraphy is an excellent marker of osteogenic sarcoma and follow-up studies after chemotherapy accurately reflect residual tumour activity when correlated with histology. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  16. The interference of uptake of thallium-201 in cultured rat myocardial cells with existence of potassium related pharmaceuticals--a preliminary report.

    Science.gov (United States)

    Chen, Y W; Yeh, J L; Huang, Y C; Chen, I J; Huang, Y F; Liu, G C

    2000-03-01

    Thallium-201 myocardial perfusion imaging is wildly used to detect and assess the extent of jeopardized myocardial ischemia in the coronary artery disease and the viability of myocardium post infarction. In recent years, there has been a great deal of pharmacological development of blockers and openers of potassium channel. In this study, we will discuss the interference of uptake of thallium-201 ion in cultured neonatal rat myocytes with existence of a variety of pharmacological agents. The cultures of neonatal rat myocardial cells were incubated with different agents such as potassium chloride, sodium-potassium ATPase pump inhibitor (ouabain), cesium compound, variable potassium channel blockers (4 AP, TEA and glibenclamide) and their openers (minoxidil, and cromakalim). The radioactivity of intracellular thallium-201 that could enter rat myocardial cells was detected by gamma counter sixty minutes after thallium-201 was added. In this study we found that thallium and potassium ions behave in an analogous manner in cultured rat myocardial cells. Both 2.5 mM and 5 mM concentration of extracellular potassium ion significantly result in reduction of thallium-201 ion influx in rat myocardial cells. 0.5 mM ouabain, an inhibitor of sodium-potassium ATPase pump, reduced about 40% of influx of thallium-201 ion in cultured rat myocardial cells via active transport. Combination of both potassium ion and ouabain inhibit most of thallium-201 ions influx in myocardial cells, but it is not completely inhibited. Cesium, a potassium antagonist, also interferes with the uptake of thallium-201 in cultured rat myocytes in our study. The most interesting finding in our investigation is that potassium channel blockers such as TEA and glibenclamide, inhibit the influx of thallium-201 in myocytes. However, potassium channel openers have no overt effect on influx of thallium-201 in cultured rat myocytes. We indirectly observe about 60% of influx of thallium-201 ion into cultured rat

  17. Comparison of chest pain, electrocardiographic changes and thallium-201 scintigraphy during varying exercise intensities in men with stable angina pectoris

    International Nuclear Information System (INIS)

    Heller, G.V.; Ahmed, I.; Tilkemeier, P.L.; Barbour, M.M.; Garber, C.E.

    1991-01-01

    This study was performed to evaluate the presence of angina pectoris, electrocardiographic changes and reversible thallium-201 defects resulting from 2 different levels of exercise in 19 patients with known coronary artery disease and evidence of exercise-induced ischemia. The exercise protocols consisted of a symptom-limited incremental exercise test (Bruce protocol) followed within 3 to 14 days by a submaximal, steady-state exercise test performed at 70% of the maximal heart rate achieved during the Bruce protocol. The presence and time of onset of angina and electrocardiographic changes (greater than or equal to 0.1 mV ST-segment depression) as well as oxygen uptake, exercise duration and pressure-rate product were recorded. Thallium-201 (2.5 to 3.0 mCi) was injected during the last minute of exercise during both protocols, and the images were analyzed using both computer-assisted quantitation and visual interpretations. Incremental exercise resulted in anginal symptoms in 84% of patients, and electrocardiographic changes and reversible thallium-201 defects in all patients. In contrast, submaximal exercise produced anginal symptoms in only 26% (p less than 0.01) and electrocardiographic changes in only 47% (p less than 0.05), but resulted in thallium-201 defects in 89% of patients (p = not significant). The locations of the thallium-201 defects, when present, were not different between the 2 exercise protocols. These findings confirm the sequence of the ischemic cascade using 2 levels of exercise and demonstrate that the cascade theory is applicable during varying ischemic intensities in the same patient

  18. Usefulness of semiquantitative analysis of dipyridamole-thallium-201 redistribution for improving risk stratification before vascular surgery

    International Nuclear Information System (INIS)

    Levinson, J.R.; Boucher, C.A.; Coley, C.M.; Guiney, T.E.; Strauss, H.W.; Eagle, K.A.

    1990-01-01

    Preoperative dipyridamole-thallium-201 scanning is sensitive in identifying patients prone to ischemic cardiac complications after vascular surgery, but most patients with redistribution do not have an event after surgery. Therefore, its positive predictive value is limited. To determine which patients with thallium redistribution are at highest risk, dipyridamole-thallium-201 images were interpreted semiquantitatively. Sixty-two consecutive patients with redistribution on preoperative dipyridamole-thallium-201 planar imaging studies were identified. Each thallium scan was then analyzed independently by 2 observers for the number of myocardial segments out of 15, the number of thallium views out of 3 and the number of coronary artery territories with redistribution. Seventeen patients (27%) had postoperative ischemic events, including unstable angina pectoris, ischemic pulmonary edema, myocardial infarction and cardiac death. Thallium predictors of ischemic operative complications included thallium redistribution greater than or equal to 4 myocardial segments (p = 0.03), greater than or equal to 2 of the 3 planar views (p = 0.005) and greater than or equal to 2 coronary territories (p = 0.007). No patient with redistribution in only 1 view had an ischemic event (0 of 15). Thus, determining the extent of redistribution by dipyridamole-thallium-201 scanning improves risk stratification before vascular surgery. Patients with greater numbers of myocardial segments and greater numbers of coronary territories showing thallium-201 redistribution are at higher risk for ischemic cardiac complications. In contrast, when the extent of thallium redistribution is limited, there is a lower risk despite the presence of redistribution

  19. Can the extent of coronary artery disease be predicted from thallium-201 myocardial images

    Energy Technology Data Exchange (ETDEWEB)

    McKillop, J.H.; Murray, R.G.; Turner, J.G.; Bessent, R.G.; Lorimer, A.R.; Greig, W.R.

    1979-07-01

    The accuracy with which the extent of coronary artery disease can be predicted from stress thallium-201 myocardial images has been assessed in 81 patients with chest pain. Whereas the appearance of the myocaridal images was both a sensitive means of detecting coronary artery disease (images abnormal in 43 of 47 patients with abnormal coronary arteriograms) and specific in excluding it (images normal in 31 of 34 patients with normal arteriograms), there was poor correlation between the extent of disease predicted from the Tl-201 images and the findings at arteriography. It is concluded that although stress Tl-201 myocardial imaging is a useful method for the noninvasive diagnosis of coronary artery disease, it cannot be relied upon to predict the number of abnormal vessels.

  20. Can the extent of coronary artery disease be predicted from thallium-201 myocardial images

    International Nuclear Information System (INIS)

    The accuracy with which the extent of coronary artery disease can be predicted from stress thallium-201 myocardial images has been assessed in 81 patients with chest pain. Whereas the appearance of the myocaridal images was both a sensitive means of detecting coronary artery disease (images abnormal in 43 of 47 patients with abnormal coronary arteriograms) and specific in excluding it (images normal in 31 of 34 patients with normal arteriograms), there was poor correlation between the extent of disease predicted from the Tl-201 images and the findings at arteriography. It is concluded that although stress Tl-201 myocardial imaging is a useful method for the noninvasive diagnosis of coronary artery disease, it cannot be relied upon to predict the number of abnormal vessels

  1. The effect of steroid on thallium-201 uptake by malignant gliomas

    International Nuclear Information System (INIS)

    Namba, Hiroki; Togawa, Takashi; Yui, Nobuharu; Yanagisawa, Masamichi; Kinoshita, Fujimi; Iwadate, Yasuo; Ohsato, Katsunobu; Sueyoshi, Kanji

    1996-01-01

    In order to assess the effect of steroid on thallium-201 uptake by glioma, 201 Tl single-photon emission tomography was performed before and after steroid administration in four patients with recurrent malignant glioma. After steroid administration the 201 Tl index, expressed as the ratio of 201 Tl uptake in the tumour to that in the contralateral cerebral hemisphere, was 0.77±0.11 of the value before steroid (mean±SD: P 201 Tl index has been used as a possible indicator for the differentiation of malignant gliomas from relatively benign tumours or radiation necrosis. The present results indicate that the effect of steroid has to be taken into account when semi-quantitative analysis, e.g. by means of the 201 Tl index, is used in patients with brain tumours. (orig.)

  2. Quantitative planar thallium-201 stress scintigraphy: A critical evaluation of the method

    International Nuclear Information System (INIS)

    Wackers, F.J.; Fetterman, R.C.; Mattera, J.A.; Clements, J.P.

    1985-01-01

    The results of quantitative analysis of planar thallium- 201 stress scintigraphy are superior to those of visual analysis. The increased sensitivity for detection of coronary artery disease is associated with maintenance of specificity. Consequently, the authors believe that quantitative analysis is the state-of-the-art for planar 201 Tl stress scintigraphy. They emphasize that for reliable and reproducible results, rigorous quality control and strict adherence to a standardized imaging protocol are necessary. An important feature is clarity of display of computer data. In this experience, the most important feature for making quantitative analysis reliable and accessible for a broader user market is simultaneous display of the lower limits of normal with processed patient data. This provides a simple visual impression of the degree and extent of abnormal 201 Tl distribution and kinetics relative to the lower limit of normal

  3. Myocardial involvement in muscular dystrophy evaluated by thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Matsushima, Hideo; Kawai, Naoki; Sotobata, Iwao

    1986-01-01

    The clinical usefulness of thallium-201 myocardial emission computed tomography (ECT) for evaluating left ventricular myocardial fibrosis was assessed in 47 patients with Duchenne (MD), facio-scapulo-humeral (FSH), limb-girdle (LG) and myotonic (MT) dystrophy. 1. Trans-, long- and short-axial images were interpreted quantitatively by circumferential profile analysis, and the extent of fibrotic tissue (%FIB) was estimated by integrating hypoperfused areas in six to eight consecutive short-axial slices. Lung/mediastinum count ratio (L/M ratio), LV cavity dilatation, aneurysm formation and cardiac malrotation were also assessed with ECT. 2. Distinct ECT defects were demonstrated in 95 of a total of 235 LV segments (40 %) and in 37 of 47 cases (85 % of DMD, 71 % of FSH, 50 % of MT and 60 % of LG). They were observed specifically in the posterior wall (82 %) and the apex (65 %) in DMD, and were scattered in all LV wall segments in FSH, LG, and MT. 3. There was a significant correlation between %FIB and the L/M ratio (r = 0.79, p < 0.001), and the L/M ratio was significantly higher in DMD than in MT (0.67 ± 0.36 vs 0.34 ± 0.25, p < 0.05). 4. ECT showed marked LV dilatation in seven (15 %), apical aneurysm in five (11 %) and vertical heart in 12 (26 %) of the 47 patients. 5. There were no significant correlations between age or clinical stage scores and numbers of defect segments or %FIB in each group. 6. During the one-year follow-up period of these patients, a DMD boy with the largest %FIB (54 %) and the highest L/M ratio (1.4) together with LV dilatation had complications of refractory heart failure and he died eight months following the ECT examination. 7. Thallium-201 planar imaging and standard 12-lead ECG underestimated the perfusion defects which were evaluated with ECT. (author)

  4. Evaluation of myocardial abnormalities in patients with collagen diseases by thallium-201 myocardial scintigram

    Energy Technology Data Exchange (ETDEWEB)

    Yamano, Shigeru (Nara Medical Univ., Kashihara (Japan))

    1992-08-01

    This study was performed to evaluate myocardial lesions in patients with collagen diseases by rest and exercise thallium-201 myocardial scintigraphies. A total of 76 patients without ischemic ECG changes, consisting of 27 cases of systemic lupus erythematosus (SLE), 17 cases of polymyositis or dermatomyositis (PM[center dot]DM), 11 cases of progressive systemic sclerosis (PSS), and 21 cases of Sjoegren's syndrome (SjS), were enrolled in this study. Reversible exercise-induced defects suggesting myocardial ischemia were noted in 12 cases of SLE, 5 cases of PM[center dot]DM, 3 cases of PSS, and 3 cases of SjS. Of the 23 patients who had exercise-induced defects, 9 patients showed normal coronary angiograms by cardiac catheterization. Fixed hypoperfusion areas were observed in 5 cases of SLE, 6 cases of PM[center dot]DM, 4 cases of PSS and 3 cases of SjS. Rest thallium-201 myocardial scintigraphy disclosed hypoperfusion areas, which were not induced by exercise, in 1 case of SLE, 4 cases of PM[center dot]DM, 1 case of PSS and 5 cases of SjS. Endomyocardial biopsy was performed on 20 patients. Myocardial lesions in PM[center dot]DM and PSS were more severe and wide spread than in SLE. Ejection fraction and fractional shortening evaluated by echocardiography had no significant differences between each disease group and the healthy control group. These findings suggest that patients with collagen diseases show the presence of abnormalities of coronary circulation at the level of the intramyocardial vasculature in the stage before impairment of cardiac function, myocardial fibrosis and functional abnormalities of the cell membrane level that were not dependent on myocardial ischemia. (author).

  5. Impact of thallium-201 imaging on clinical assessment and management of patients with chest pain

    International Nuclear Information System (INIS)

    Schmoliner, R.; Dudczak, R.; Kronik, G.; Moesslacher, H.; Zangeneh, M.; Pollak, C.; Schurz, B.; Schoberwalter, A.

    1984-01-01

    The histories, rest, and exercise ECG results of 60 patients without myocardial infarction complaining of chest pain were submitted to 6 physicians (3 cardiologists and 3 noncardiologists) who were unaware of the angiographic findings. The physicians were requested to estimate the probability of coronary artery disease present in percentages and to assess the need for coronary angiography on a five-point scale (1 . definitely not indicated, 5 . definitely indicated). After obtaining the results of thallium-201 imaging following dipyridamole (0.50 mg/kg intravenously) administration, the physicians were again requested to estimate probability and need for angiography. In the 43 patients with coronary artery disease the judgment of probability was increased significantly after 201 Tl from 75.6 +/- 20.2% to 82.9 +/- 23.2% (p less than 0.001) and the need for angiography from 4.3 +/- 0.9% to 4.5 +/- 0.9% (p less than 0.001). In the subgroup of patients with atypical angina the relative change in probability was higher than in other subgroups of patients with coronary artery disease. In the 17 patients with normal coronary arteries the probability estimation fell after 201 Tl from 36.7 +/- 22.0% to 24.8 +/- 21.0% (p less than 0.001), the need for angiography was decreased from 2.7 +/- 1.1% to 2.2 +/- 1.2% (p less than 0.001). With the 201 Tl information, cardiologists performed a better diagnostic differentiation of patients with and without coronary artery disease than noncardiologists. The study demonstrates the improvement of clinical diagnosis in patients with chest pain by thallium-201 imaging and confirms the favorable influence of the method on the management of the patients in terms of indications for coronary angiography

  6. Noninvasive diagnosis of coronary arterial lesions by exercise thallium-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Kawai, Naoki; Okada, Mitsuhiro; Miyakoda, Hiroyuki

    1983-01-01

    The value of exercise thallium-201 myocardial perfusion imaging (Ex MPI) for identifying diseased coronary arteries was evaluated in 57 effort angina patients without previous myocardial infarction. The territory of the individual major coronary artery on myocardial images was determined by analysis of the site of perfusion defects in 29 patients with single vessel or isolated left main disease. The anteroseptal wall was considered as the territory of the left anterior descending artery (LAD). The inferior and the posterolateral walls were assumed to be supplied by the right coronary (RCA) and the left circumflex (LCX) arteries, respectively. Ex MPI was sensitive for identifying the diseased artery in single vessel disease, the sensitivity being 86% for LAD, 66% for LCX and 71% for RCA. However, the sensitivity tended to decrease as the number of diseased vessels increased. An improved sensitivity was observed by analysis of the regional myocardial washout rate of thallium-201 in patients with triple vessel disease, in which the criterion of Tl-201 perfusion defect was not sensitive. Ex MPI was highly specific for individual coronary artery disease. Several factors supposed to affect the sensitivity of Ex MPI for detection of individual lesions were analysed. The sensitivity increased, in general, with the severity of stenosis and it was lower for a less severely diseased artery in multiple vessel disease. The presence or absence of coronary collaterals seemed not to affect the sensitivity of Ex MPI. In conclusion, Ex MPI was considered to be a useful noninvasive technique to detect the diseased coronary arteries in patients with single vessel disease or the most severely diseased artery in patients with multiple vessel disease

  7. Noninvasive identification of left main and triple vessel coronary artery disease: improved accuracy using quantitative analysis of regional myocardial stress distribution and washout of thallium-201

    International Nuclear Information System (INIS)

    Maddahi, J.; Abdulla, A.; Garcia, E.V.; Swan, H.J.; Berman, D.S.

    1986-01-01

    The capabilities of visual and quantitative analysis of stress redistribution thallium-201 scintigrams, exercise electrocardiography and exercise blood pressure response were compared for correct identification of extensive coronary disease, defined as left main or triple vessel coronary artery disease, or both (50% or more luminal diameter coronary narrowing), in 105 consecutive patients with suspected coronary artery disease. Extensive disease was present in 56 patients and the remaining 49 had either less extensive coronary artery disease (n = 34) or normal coronary arteriograms (n = 15). Although exercise blood pressure response, exercise electrocardiography and visual thallium-201 analysis were highly specific (98, 88 and 96%, respectively), they were insensitive for identification of patients with extensive disease (14, 45 and 16%, respectively). Quantitative thallium-201 analysis significantly improved the sensitivity of visual thallium-201 analysis for identification of patients with extensive disease (from 16 to 63%, p less than 0.001) without a significant loss of specificity (96 versus 86%, p = NS). Eighteen (64%) of the 28 patients who were misclassified by visual analysis as having less extensive disease were correctly classified as having extensive disease by virtue of quantitative analysis of regional myocardial thallium-201 washout. When the results of quantitative thallium-201 analysis were combined with those of blood pressure and electrocardiographic response to exercise, the sensitivity and specificity for identification of patients with extensive disease was 86 and 76%, respectively, and the highest overall accuracy (0.82) was obtained

  8. Thallium-201 myocardial perfusion imaging in infants and children. Value in distinguishing anomalous left coronary artery from congestive cardiomyopathy.

    Science.gov (United States)

    Gutgesell, H P; Pinsky, W W; DePuey, E G

    1980-03-01

    In infants and children, anomalous origin of the left coronary artery (ALCA) from the pulmonary artery may be difficult to distinguish from congestive cardiomyopathy (CCM) of other causes. We performed thallium-201 myocardial perfusion imaging in seven children with ALCA and in nine with CCM to study the usefulness of this technique in distinguishing between these lesions. Localized abnormalities of thallium uptake were present in each of the seven patients with ALCA, including two asymptomatic 4-year-old children. Thallium distribution was normal in five patients with CCM, diffusely irregular in three, and was absent in the lateral and posterobasal portions of the left ventricle in one patient. We conclude that thallium-201 imaging is a sensitive noninvasive method of detecting ALCA. However, perfusion abnormalities are not limited to patients with coronary artery abnormalities, and may be present in patients with myocardial ischemia or infarction of other causes.

  9. Diagnostic value of exercise thallium-201 scintigraphy for ischemic heart disease in patients with chronic renal failure

    International Nuclear Information System (INIS)

    Sato, Shigeaki; Ohta, Makoto; Soejima, Michimasa

    1991-01-01

    Recently, it has been reported that there are considerable difficulties in diagnosing ischemic heart disease by ECG alone in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). This study was designed to evaluate the diagnostic value of exercise thollium-201 myocardial scintigraphy as compared with ECG examination alone in patients with chronic renal failure. The subjects were 26 patients with chronic renal failure, including patients being treated with HD and CAPD, and 7 normal persons who served as controls. Exercise thallium-201 myocardial scintigraphy was performed according to a multistage bicycle ergometer exercise test. Exercise duration times were shorter (p<0.001) and maximum attained heart rates lower (p<0.05) in the HD group than in controls. Since exercise capacities were reduced in the dialysis patients, there were considerable difficulties in diagnosing ischemic heart disease by ECG alone. In our 26 patients, 15 cases (57.7%) had left ventricular hypertrophy, 5 cases (19.2%) had manifestations of ischemic heart disease, and 4 cases with abnormal ECGs had no abnormal findings on exercise thallium-201 myocardial scintigraphy. Thallium washout rates were higher (p<0.001) in the chronic renal failure group than in the control group, and a significant negative correlation (r=-0.70, p<0.001) was found between thallium washout rates and hematocrit values. Exercise thallium-201 myocardial scitigraphy was more accurate than ECG examination and also could be performed repeatedly without invasion. These results indicate that exercise thallium-201 myocardial scintigraphy is a valuable diagnostic method for ischemic heart disease in patients with chronic renal failure. (author)

  10. Diagnostic value of exercise thallium-201 scintigraphy for ischemic heart disease in patients with chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Shigeaki; Ohta, Makoto; Soejima, Michimasa (Jikei Univ., Tokyo (Japan). School of Medicine) (and others)

    1991-11-01

    Recently, it has been reported that there are considerable difficulties in diagnosing ischemic heart disease by ECG alone in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). This study was designed to evaluate the diagnostic value of exercise thollium-201 myocardial scintigraphy as compared with ECG examination alone in patients with chronic renal failure. The subjects were 26 patients with chronic renal failure, including patients being treated with HD and CAPD, and 7 normal persons who served as controls. Exercise thallium-201 myocardial scintigraphy was performed according to a multistage bicycle ergometer exercise test. Exercise duration times were shorter (p<0.001) and maximum attained heart rates lower (p<0.05) in the HD group than in controls. Since exercise capacities were reduced in the dialysis patients, there were considerable difficulties in diagnosing ischemic heart disease by ECG alone. In our 26 patients, 15 cases (57.7%) had left ventricular hypertrophy, 5 cases (19.2%) had manifestations of ischemic heart disease, and 4 cases with abnormal ECGs had no abnormal findings on exercise thallium-201 myocardial scintigraphy. Thallium washout rates were higher (p<0.001) in the chronic renal failure group than in the control group, and a significant negative correlation (r=-0.70, p<0.001) was found between thallium washout rates and hematocrit values. Exercise thallium-201 myocardial scitigraphy was more accurate than ECG examination and also could be performed repeatedly without invasion. These results indicate that exercise thallium-201 myocardial scintigraphy is a valuable diagnostic method for ischemic heart disease in patients with chronic renal failure. (author).

  11. Prognostic utility of the exercise thallium-201 test in ambulatory patients with chest pain: comparison with cardiac catheterization

    International Nuclear Information System (INIS)

    Kaul, S.; Lilly, D.R.; Gascho, J.A.; Watson, D.D.; Gibson, R.S.; Oliner, C.A.; Ryan, J.M.; Beller, G.A.

    1988-01-01

    The goal of this study was to determine the prognostic utility of the exercise thallium-201 stress test in ambulatory patients with chest pain who were also referred for cardiac catheterization. Accordingly, 4 to 8 year (mean +/- 1SD, 4.6 +/- 2.6 years) follow-up data were obtained for all but one of 383 patients who underwent both exercise thallium-201 stress testing and cardiac catheterization from 1978 to 1981. Eighty-three patients had a revascularization procedure performed within 3 months of testing and were excluded from analysis. Of the remaining 299 patients, 210 had no events and 89 had events (41 deaths, nine nonfatal myocardial infarctions, and 39 revascularization procedures greater than or equal to 3 months after testing). When all clinical, exercise, thallium-201, and catheterization variables were analyzed by Cox regression analysis, the number of diseased vessels (when defined as greater than or equal to 50% luminal diameter narrowing) was the single most important predictor of future cardiac events (chi 2 = 38.1) followed by the number of segments demonstrating redistribution on delayed thallium-201 images (chi 2 = 16.3), except in the case of nonfatal myocardial infarction, for which redistribution was the most important predictor of future events. When coronary artery disease was defined as 70% or greater luminal diameter narrowing, the number of diseased vessels significantly (p less than .01) lost its power to predict events (chi 2 = 14.5). Other variables found to independently predict future events included change in heart rate from rest to exercise (chi 2 = 13.0), ST segment depression on exercise (chi 2 = 13.0), occurrence of ventricular arrhythmias on exercise (chi 2 = 5.9), and beta-blocker therapy (chi 2 = 4.3)

  12. Linear relationship between in distribution of thallium-201 and blood flow in ischemic and nonischemic myocardium during exercise

    International Nuclear Information System (INIS)

    Nielsen, A.P.; Morris, K.G.; Murdock, R.; Bruno, F.P.; Cobb, F.R.

    1980-01-01

    The purpose of this study was to compare the myocardial distribution of thallium-201 and regional myocrdial blood flow during ischemia and the physiologic stress of exercise. Studies were carried out in six dogs with chronically implanted catheters in the atrium and aorta and a snare on the circumflex coronary artery distal to the first marginal branch. Regional myocardial blood flow was measured during quiet, resting conditions using 7 to 10 ] of radioisotope-labeled microspheres. Each dog was then exercised on a treadmill at speeds of 5 to 9 mph at a 5/sup o/ incline. (After 1 minute of exercise the cirumflex coronary artery was occluded and thallium-201 and a second label of microspheres were injected. Exercise was continued for 5 minutes. The dogs were then sacrificed and the left ventricle was sectioned into approximately 80 1-2-g samples to compare thallium-201 activity and regional myocardial blood flow. The maximum increase in blood flow ranged from 3.3 to 7.2 times resting control values. Each dog had myocardial samples in which blood flow was markedly reduced, to less than 0.10 ml/min/g. In each dog there was a close linear relationship between thallium-201 distribution and direct measurements of regional myocardial blood flow. Linear regression analyses demonstrated a correlation coefficient of 0.98 or greater in each dog. These data indicate that during the physiologic stress of exercise, the myocardial distribution of thallium activity is linearly related to regional myocardial blood flow in both the ischemic and nonischemic regions

  13. Quantitative thallium-201 scintigraphy in childhood osteosarcoma: Comparison with technetuim-99m MDP and magnetic resonance imaging in the evaluation of chemotherapeutic response.

    Science.gov (United States)

    Ilhan, Inci Ergurhan; Vural, Gülin; Berberoglu, Semha; Kapucuoglu, Nilgun; Cila, Aysenur; Eke, Sefa

    2005-03-01

    The aim of this study was to assess early (15 min) and late 2 h) thallium-201 (201Tl) uptake in children with osteosarcoma and to compare these findings with magnetic resonance imaging (MRI) and technetium-99m methylenediphosphonate (99mTc MDP), with emphasis on evaluating tumor viability before and after chemotherapy. Fifteen patients with biopsy-proven osteosarcoma received standard preoperative chemotherapy with a combination of cisplatin, Adriamycin, and high-dose methotrexate. Their ages ranged between 7 and 18 years (median 14.5 years). All patients had 201Tl, 99mTc MDP, and MRI studies. Thallium scintigraphy was performed at 15 min and 2 h after IV injection of 92 MBq of thallium. Thallium uptake ratio was calculated by dividing the count density of the lesion (L) by that of the controlateral normal (N) area. The percent reduction of 201Tl uptake ratio (alteration ratio) was calculated by [100x(prechemotherapy L/N-postchemotherapy L/N)/prechemotherapy L/N]. Pathologic changes were graded on the basis of % tumor necrosis as defined histologically. Scintigraphic comparisons demonstrated a high-degree of correlation with late 201Tl alteration ration and poor correlation with both early 201Tl and 99mTc MDP alteration ratios. Late 201Tl images were superior to early 201Tl, 99mTc MDP, and MRI in predicting tumor response to chemotherapy as determined by % tumor necrosis (p<.01). The authors found that late 201Tl was an accurate test for evaluating the response to specific therapeutic regimens and it can be useful planning surgery or choosing alternative chemotherapeutic regimens.

  14. Study on thallium-201 myocardial perfusion scanning for detection of right ventricular hypertrophy in chronic pulmonary disease

    International Nuclear Information System (INIS)

    Kawai, Seiki

    1980-01-01

    Thallium-201 myocardial perfusion scanning was performed in 34 patients with chronic pulmonary disease for the purpose of detecting right ventricular hypertrophy. Thallium-201 activity ratio of left ventricle plus ventricular septum/right ventricle (TAR) was significantly correlated with hemodynamic findings such as pulmonary arterial mean pressure (r = -0.75, p 2 (p < 0.001). Assuming that TAR < 2 or TAR = 2 would indicate pulmonary hypertension, sensitivity was 95%, specificity 79%, validity score 75%, false positive 14% and false negative was 8%. TAR was compared with left to right ventricular mass ratio using Fulton's method in 6 autopsied patients in whom thallium-201 myocardial perfusion scanning were performed within three months before death. TAR closely correlated with left to right ventricular mass ratio (r = 0.978, p < 0.001). The comparison of validity of TAR with those of electrocardiographic interpretation according to WHO, Sasamoto, Roman or Milnor for the detection of right ventricular hypertrophy revealed the former was much superior to all of latters. From the results obtained, it may be inferred that TAR reflects the degree of pulmonary hypertension and anatomical right ventricular hypertrophy and is a useful non-invasive method to detect right ventricular hypertrophy in chronic pulmonary disease. (J.P.N.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Morel, O.; Pezard, P.; Le Jeune, J.J.; Denizot, B.; Jallet, P. [Department of Nuclear Medicine, University Hospital, Angers (France); Furber, A. [Department of Cardiology, University Hospital, Angers (France); Vielle, B. [Department of Biostatistics, University Hospital, Angers (France)

    1999-06-01

    The aim of this study was to correlate lung thallium-201 uptake on exercise with {sup 201}Tl single-photon emission tomography (SPET) myocardial perfusion imaging, rest and exercise equilibrium radionuclide angiographic and coronary angiographic findings in patients with coronary artery disease (CAD) using a simple, reproducible lung/heart (L/H) ratio that would be easy to use in clinical practice. L/H ratio was defined on the anterior planar image obtained during exercise {sup 201}Tl SPET acquisition as the mean counts per pixel in an entire right lung field region of interest divided by the mean counts per pixel in the hottest myocardial wall region of interest. We studied 103 patients. Fifty-nine patients (group I) with <5% likelihood of CAD were used as a reference group. In 44 CAD patients (group II), L/H ratio was compared with {sup 201}Tl SPET, radionuclide angiographic and coronary angiographic variables. The group I L/H ratio of 0.35{+-}0.05 (mean {+-}1 SD) was significantly lower (P<0.001) than the group II L/H ratio of 0.45{+-}0.10. An L/H ratio >0.45 (mean+2 SD in group I) was considered abnormal. In group II, L/H ratio showed a significant correlation with stress and rest {sup 201}Tl perfusion defect size (r=0.39 and r=0.42, P<0.01, respectively), but not with extent of ischaemic myocardium. The mean L/H ratio was 0.41{+-}0.10 in patients with one-vessel disease (n=15), 0.46{+-}0.08 in those with two-vessel disease (n=17) and 0.47{+-}0.12 in those with three-vessel disease (n=12), but no significant difference was found between the three subgroups. L/H ratio showed a significant inverse relation with rest and exercise left ventricular ejection fraction (r=-0.37 and r=-0.50, P<0.05 and P<0.001, respectively). Using stepwise multiple regression analysis, exercise left ventricular ejection fraction and previous history of hypertension were the sole two variables independently predictive of the L/H ratio. In conclusion, although lung thallium uptake is

  16. Quantitative estimation of myocardial infarct area from infarction map by thallium 201 myocardial SPECT

    International Nuclear Information System (INIS)

    Sekiai, Yasuhiro; Mikuniya, Atsushi; Sawai, Michihiko

    1988-01-01

    To define clearly the infarct in patients with myocardial infarction, we developed a device of infarction map using thallium 201 myocardial SPECT and compared the results from infarction map with coronary angiographic and electrocardiographic (ECG) findings. The subjects consisted of 10 healthy persons (7 males, 3 females, average 47 aged) and 30 patients with myocardial infarction, including 16 patients with the left anterior descending (LAD), 6 with the left circumflex (LCX), and 8 with the right coronary artery (RCA) lesions. The patients with the LAD proximal lesion to the first diagonal branch were found in an infarction map to have a large anterior infarct area from the base over the apex of heart, which corresponded well to the ECG findings of abnormal Q waves in leads I, V 1 and V 2 through V 5 . The patients with the LAD distal lesion showed less infarct area than that of proximal lesion, restricted in anterior region in the middle but extending almost to all surroundings in the apex. The range of abnormal Q waves detected in ECG was narrow. Abnormal Q waves of ECG in the patients with the RCA lesion were seen in leads II, III, and aV f , and the infarct area was detected inferiorly from the base over the apex like an island in a steady width. In some of the patients with the LCX lengion, however, abnormal Q waves were observed not only in leads II, III, aV f but also in I and aV 1 . The infarct area existed limitedly in the lateral region from the base to middle of heart. We conclude that standard 12 leads ECG is useful for detection of left anterior infarction and infarct area of relatively large size, but may mislead in detecting inferior or posterior infarction and in small-sized infarct area as well. The infarction map drawn from thallium 201 myocardial SPECT clearly defines the infarct noninvasively, and can be used for quantitative estimation of infarction area. (author)

  17. Relationship between regional myocardial blood flow and thallium-201 distribution in the presence of coronary artery stenosis and dipyridamole-induced vasodilation.

    Science.gov (United States)

    Mays, A E; Cobb, F R

    1984-01-01

    This study assesses the relationship between the distribution of thallium-201 and myocardial blood flow during coronary vasodilation induced by intravenous dipyridamole in canine models of partial and complete coronary artery stenosis. 10 dogs were chronically instrumented with catheters in the left atrium and aorta and with a balloon occluder and electromagnetic flow probe on the proximal left circumflex coronary artery. Regional myocardial blood flow was measured during control conditions with radioisotope-labeled microspheres, and the phasic reactive hyperemic response to a 20-s transient occlusion was then recorded. Dipyridamole was then infused intravenously until phasic coronary blood flow increased to match peak hyperemic values. The left circumflex coronary artery was either partially occluded to reduce phasic blood flow to control values (group 1) or it was completely occluded (group 2), and thallium-201 and a second microsphere label were injected. 5 min later, the animals were sacrificed, the left ventricle was sectioned into 1-2-g samples, and thallium-201 activity and regional myocardial blood flow were measured. Curvilinear regression analyses between thallium-201 localization and myocardial blood flow during dipyridamole infusion demonstrated a slightly better fit to a second- as compared with a first-order model, indicating a slight roll-off of thallium activity as myocardial blood flow increases. During the dipyridamole infusion, the increases in phasic blood flow, the distributions of regional myocardial blood flow, and the relationships between thallium-201 localization and regional blood flow were comparable to values previously observed in exercising dogs with similar occlusions. These data provide basic validation that supports the use of intravenous dipyridamole and thallium-201 as an alternative to exercise stress and thallium-201 for evaluating the effects of coronary occlusive lesions on the distribution of regional myocardial blood flow

  18. Detection of hibernating myocardium in patients with myocardial infarction by low-dose dobutamine echocardiography. Comparison with thallium-201 scintigraphy with reinjection

    International Nuclear Information System (INIS)

    Takagi, Tsutomu; Yoshikawa, Junichi; Yoshida, Kiyoshi; Akasaka, Takashi; Honda, Yasuhiro; Yonezawa, Yoshihiro; Shakudo, Masahiro

    1995-01-01

    The identification of hibernating myocardium is important for selecting patients who will benefit from coronary revascularization. The relationship between echocardiographic and radioisotopic markers of hibernating myocardium and postrevascularization recovery of myocardial function was investigated in 21 patients who underwent successful revascularization. Each patient underwent low-dose dobutamine stress echocardiography and thallium-201 ( 201 Tl) scintigraphy with reinjection before revascularization. The presence of contractile reserve in dobutamine stress echocardiography and Tl uptake in 201 Tl scintigraphy with reinjection were defined as markers of hibernating myocardium. Follow-up echocardiograms were evaluated for improved regional wall motion in all patients at a mean of 8.6 months after revascularization. Sensitivity, specificity, and positive and negative predictive values of low-dose dobutamine stress echocardiography for indicating recovery of function after revascularization were 75.0%, 77.8%, 81.8%, and 70.0%, respectively. Sensitivity, specificity, and positive and negative predictive values of 201 Tl scintigraphy with reinjection for indicating recovery of function after revascularization were 91.7%, 55.6%, 73.3%, and 83.3%, respectively. There were no statistical differences between low-dose dobutamine echocardiography and 201 Tl scintigraphy in predicting postrevascularization recovery of function in patients with hibernating myocardium. (author)

  19. Clinical evaluation of exercise thallium-201 whole body scintigraphy in ischemic heart disease

    International Nuclear Information System (INIS)

    Kaneko, Kenzo; Watanabe, Yoshihiko; Kondo, Takeshi

    1985-01-01

    To evaluate whole body distribution and kinetics of Thallium-201 at exercise and redistribution, whole body scintigraphy (WB-S) was performed on 12 normal subjects (N), 19 patients with angina pectoris (AP) and 18 patients with old myocardial infarction (MI). WB-S was obtained using a gamma camera OMEGA 500 and analized by ADAC System IV. We estimated the following parameters from WB-S; 1) %Distribution (%D): the ratio of whole body counts to organ counts 2) washout rate (WR) in each organ. %D of the heart in N, AP and MI was similar at rest and exercise. At exercise, %D of the lung and the liver decreased and %D of thighs increased remarkably than at rest. At supine exercise, the lung indicated high %D and thinghs indicated low %D compared with at upright exercise. WR of the heart in AP and MI was significantly lower than in N (p<0.005, p<0.01) and further decreased proportionally to the number of stenotic coronary arteries and related to the ischemic ST depression of exercise ECG. WR of the heart was not correlation with pressure rate product and this finding suggested that WR of the heart was not prescribed by the tolerance of exercise but related to coronary flow at exercise a certain degree. WR of the lung in MI was significantly higher (p<0.025) and WR of thighs in AP and MI was significantly lower (p<0.025, p<0.05) compared with N. (author)

  20. A comparison of maximal exercise and dipyridamole thallium-201 planar gated scintigraphy

    International Nuclear Information System (INIS)

    Martin, W.; Tweddel, A.C.; Main, G.; Hutton, I.

    1992-01-01

    Both symptom-limited maximal exercise and intravenously given dipyridamole stress (0.56 mg/kg over 4 min with a 2 min walk) gated thallium scans were performed in 22 patients undergoing coronary arteriography for the assessment of chest pain. All scans were acquired gated to the electrocardiogram in 3 projections and were reported for the presence and extent of defects in 5 myocardial segments in each view. In addition, left and right ventricular myocardial uptake and estimates of right and left lung and liver to left ventricular uptake were assessed relative to the injected dose of thallium-201. Overall, 190/310 segments were abnormal with exercise compared with 169/310 with dipyridamole. Segments were scored greater in extent in 90/310 cases with exercise, compared with 46/310 in which the defect was more extensive with dipyridamole. Non-attenuation corrected percentage myocardial thallium uptakes were similar for both stresses. Left and right lung and liver to left ventricle ratios were all significantly higher with dipyridamole than with exercise. High right and left lung uptakes with dipyridamole were strongly correlated with high exercise values. The liver uptake was weakly correlated between the 2 different stress tests. These results demonstrate that dipyridamole induces fewer and less extensive thallium perfusion defects than maximal exercise, and that liver and lung to myocardial ratios are higher with dipyridamole than with exercise. (orig./MG)

  1. Myocardial perfusion imaging with thallium-201: correlation with coronary arteriography and electrocardiography

    Science.gov (United States)

    Sternberg, Leonard; Wald, Robert W.; Feiglin, David H.I.; Morch, John E.

    1978-01-01

    Myocardial perfusion imaging with thallium-201 and electrocardiography with the subject at rest and undergoing submaximal treadmill exercise were performed in 19 men and 3 women. Selective coronary arteriography and left ventriculography showed that 7 had normal coronary arteries and 15 had coronary artery disease. The 11 persons with electrocardiographic evidence of an old myocardial infarct (q waves) had a perfusion defect at rest in the area of the infarct and a segmental abnormality of wall motion apparent on the left ventriculogram corresponding to the perfusion defect. Myocardial perfusion imaging and electrocardiography were equally sensitive in detecting coronary artery disease in exercising individuals: perfusion defects were noted in 7 of the 15 persons with coronary artery disease, and diagnostic ST-segment depression was present in 8 of the 15. Combination of the results of the two tests with exercise permitted the identification of 11 of the 15 persons and improved the sensitivity. Combination of the results of rest and exercise imaging and electrocardiography permitted the identification of 94% of the patients with coronary artery disease. Myocardial perfusion imaging with 201TI in the subject at rest is a sensitive indicator of previous myocardial infarction. Imaging after the subject has exercised is a useful adjunct to conventional exercise electrocardiography, especially in those whose exercise electrocardiogram is non-interpretable. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5 PMID:630487

  2. Time sequential single photon emission computed tomography studies in brain tumour using thallium-201

    International Nuclear Information System (INIS)

    Ueda, Takashi; Kaji, Yasuhiro; Wakisaka, Shinichiro; Watanabe, Katsushi; Hoshi, Hiroaki; Jinnouchi, Seishi; Futami, Shigemi

    1993-01-01

    Time sequential single photon emission computed tomography (SPECT) studies using thallium-201 were performed in 25 patients with brain tumours to evaluate the kinetics of thallium in the tumour and the biological malignancy grade preoperatively. After acquisition and reconstruction of SPECT data from 1 min post injection to 48 h (1, 2, 3, 4, 5, 6, 7, 8, 9, 10 and 15-20 min, followed by 4-6, 24 and 48 h), the thallium uptake ratio in the tumour versus the homologous contralateral area of the brain was calculated and compared with findings of X-ray CT, magnetic resonance imaging, cerebral angiography and histological investigations. Early uptake of thallium in tumours was related to tumour vascularity and the disruption of the blood-brain barrier. High and rapid uptake and slow reduction of thallium indicated a hypervascular malignant tumour; however, high and rapid uptake but rapid reduction of thallium indicated a hypervascular benign tumour, such as meningioma. Hypovascular and benign tumours tended to show low uptake and slow reduction of thallium. Long-lasting retention or uptake of thallium indicates tumour malignancy. (orig.)

  3. Evaluation of myocardial involvement in muscular dystrophy with thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Sotobata, Iwao; Indo, Toshikatsu; Matsuoka, Yukihiko; Kawai, Naoki; Matsushima, Hideo; Suzuki, Akio; Abe, Tetsutaro; Sakuma, Sadayuki

    1986-01-01

    The clinical usefulness of thallium-201 myocardial perfusion scanning with emission computed tomography (ECT) for evaluation of left ventricular myocardial fibrosis was assessed on 47 patients with Duchenne (DMD), facioscapulohumeral (FSH), limb-girdle (LG) and myotonic (MT) dystrophy. Trans-, long- and short-axial images were interpreted quantitatively by circumferential profile analysis, and the fibrotic tissue size (%FIB) was estimated by integration of hypoperfused areas in 6 to 8 consecutive short-axial slices. Lung/mediastinum count ratios (L/M ratio), LV cavity dilatation, aneurysm formation and cardiac malrotations were also assessed with ECT. Distinct ECT perfusion defect was observed in 26 of 29 DMDs, and in 11 of 18 patients with other types. Perfusion defect was demonstrated in 95 of total 235 segments, and was observed specifically in the posterior wall (82 %) and the apex (65 %) in DMD, and was scattered in all LV wall segments in FSH, LG, and MT. Percent FIB correlated significantly with L/M ratio (r = 0.82, p < 0.01), and did not with age or clinical stage score. ECT showed marked LV dilatation in 7, apical aneurysm in 5 and cardiac malrotation in 23 of the 47 patients. In conclusion, ECT was considered to be a useful clinical means of evaluating myocardial involvement in patients with muscular dystrophy. (author)

  4. Evaluation of myocardial involvement in muscular dystrophy with Thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Yamamoto, S.; Kawai, N.; Matsushima, H.; Okada, M.; Yamauchi, K.; Yokota, M.; Hayashi, H.; Sotobata, I.; Sakuma, S.

    1985-01-01

    The clinical usefulness of quantitative analysis of thallium-201 emission computed tomography (ECT) for evaluation of left ventricular myocardial fibrosis was assessed on 45 patients with Duchenne(D), facioscapulohumeral(FSH), limbgirdle(LG) and myotonic(M) dystrophy. Trans-,long- and short-axial images were interpreted quantitatively using circumferential profile analysis, and the fibrotic tissue size (%FIB) was estimated by integration of hypoperfused areas in 6 to 8 consecutive short-axial slices. Lung/mediastinum count ratios (L/M ratio) were also assessed. Distinct ECT defects were found in 42 patients (all cases of D, FSH and LG, and 2 of 5 MTs). ECT defects were observed specifically in the posterolateral wall (71%) and apex (58%) in D, and were scattered in all LV walls in FSHG, LG and MT. ECG and VCG underestimated the extent of myocardial fibrosis in 17 patients (40%). Percent FIBs coincided with fibrotic tissue sizes proven by autopsy. Body-surface ECG should be influenced by cardiac position and rotation in the thorax, which were often observed in these disease entities. These factors were also assessed with ECT. The authors conclude; ECT to be useful for non-invasive evaluation of myocardial fibrosis in patients with various types of muscular dystrophy

  5. Functional significance of coronary collateral circulation during dynamic exercise evaluated by thallium-201 myocardial scintigraphy

    International Nuclear Information System (INIS)

    Wainwright, R.J.; Maisey, M.N.; Edwards, A.C.; Sowton, E.

    1980-01-01

    Sixty-five patients with angiographically documented coronary artery disease were investigated by thallium-201 ( 201 Tl) scintigraphy to determine the role of the collateral circulation during dynamic exercise. Fifty-three patients had complete proximal occlusion of at least one major coronary artery. One patient had total occlusion of all three major coronary arteries. Sixty-four collateral channels were identified, graded, and compared with corresponding regions of the myocardial scintigram. Tracer uptake was also graded and classified as various degrees of protection from ischaemia. A significant correlation between good collaterals with complete protection and poor or absent collaterals with no protection was noted. Seventeen patients (20 occluded vessels) had total coronary occlusion without myocardial infarction. Collaterals conferred protection in 9/15 occlusions whereas no protection was seen in five occlusions without collaterals. There was no difference in the protective role of homocoronary and heterocoronary collateral vessels. Hypertrophy of the first septal left anterior descending perforator conferred significant protection from ischaemia in contrast to bridging collaterals and ghosting. During exercise the right coronary bed is preferentially protected from ischaemia, in contrast to the left anterior descending territory. This probably reflects the direction of a transmural flow gradient between left and right ventricles during exercise. (author)

  6. Dipyridamole thallium-201 single-photon emission tomography in aortic stenosis: gender differences

    International Nuclear Information System (INIS)

    Rask, L.P.; Karp, K.H.; Eriksson, N.P.; Mooe, T.

    1995-01-01

    This study was undertaken to establish the gender-specific normal limits of thallium-201 distribution in patients with aortic stenosis and to apply these normal limits in a larger group of patients with aortic stenosis to obtain the sensitivity and specificity for coexisting CAD. A low-dose dipyridamole protocol was used (0.56 mg/kg during 4 min). Thallium was injected 2 min later and tomographic imaging was performed. Following image reconstruction a basal, a mid-ventricular and an apical short-axis slice were selected. The highest activity in each 6 segment was normalised to the maximal activity of each slice. The normal uptake for patients with aortic stenosis was obtained from ten men and ten women with aortic stenosis and a normal coronary angiography. Eighty-nine patients were prospectively evaluated. An area reduction of at least 75% in a coronary artery was considered to be a significant coronary lesion and was found in 57 (64%) patients. With gender-specific curves (-2.5 SD) sensitivity for detecting CAD was 100% and specificity was 75% in men, while sensitivity was 61% and specificity 64% in women. It is concluded that the gender-specific normal distribution of 201 Tl uptake in patients with aortic stenosis, using dipyridamole SPET, yields a high sensitivity and specificity for coronary artery lesions in men but a lower sensitivity and specificity in women with aortic stenosis. (orig./MG)

  7. Evaluation of myocardial damage in Duchenne's muscular dystrophy with thallium-201 myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Takuhisa; Shibuya, Noritoshi (Kawatana National Hospital, Nagasaki (Japan)); 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).

  8. 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)

  9. Incomplete revascularization in multivessel percutaneous transluminal coronary angioplasty: the role for stress thallium-201 imaging

    International Nuclear Information System (INIS)

    Breisblatt, W.M.; Barnes, J.V.; Weiland, F.; Spaccavento, L.J.

    1988-01-01

    Evaluation of patients with multivessel coronary disease for percutaneous transluminal coronary angioplasty raises the question: Is incomplete revascularization an acceptable procedure in these patients, or does complete revascularization need to be performed, as in coronary artery bypass grafting? To provide an answer the present study utilized exercise thallium imaging as a guide to the performance of angioplasty in 85 patients with multivessel coronary disease. Preangioplasty exercise thallium imaging helped to identify the primary stenosis (culprit lesion) in 93% of patients. Two weeks to 1 month after dilation of this lesion, repeat thallium imaging identified two patient groups: Group 1, 47 patients with no evidence of ischemia in a second vascular distribution and Group 2, 38 patients with evidence of further angioplasty. In Group 2 47% of patients had angioplasty of a second vessel and 79% required multivessel angioplasty at 1 year follow-up. In contrast, only six Group 1 patients (13%) required angioplasty of a second vessel at 1 year. Thus, incomplete revascularization may be an acceptable approach in many patients with multivessel coronary disease. Stress thallium-201 imaging may be a useful technique in the evaluation and management of these patients

  10. Thallium-201 scintigraphy of neuroblastoma: different results for primary tumors and skeletal lesions.

    Science.gov (United States)

    Okuyama, C; Ushuima, Y; Nakamura, T; Kikkawa, M; Nishimura, T

    2001-04-01

    Thallium-201 scintigraphy was performed in 8 children with neuroblastoma, and uptake by the tumors was evaluated in comparison with the results of 123I-MIBG scintigraphy. No primary tumors or metastatic lymph nodes showed 201Tl accumulation, but in 4 cases of bone marrow metastases accompanied by focal cortical invasion, the metastatic lesion was demonstrated more clearly on the early image than on the delayed image. In another case of bone metastases infiltrating cortical bone revealed by 123I-MIBG scintigraphy and biopsy before treatment, 201Tl scintigraphy performed after chemotherapy showed abnormal accumulation in the tibia, but the second 123I-MIBG scintigraphy performed 1 week after the 201Tl scintigraphy showed no abnormal uptake. 201Tl does not appear to have good affinity for neuroblastoma, but it accumulates in metastatic skeletal lesions. A reactive hypermetabolic bone marrow, and/or inflammatory process and periosteal reaction due to the presence of metastatic foci may have induced the 201Tl accumulation. It seems that 201Tl is not useful for the diagnosis. Nevertheless, the discordance between 201Tl uptake in primary tumors and skeletal lesions allows speculation on the mechanism of 201Tl accumulation in skeletons.

  11. Myocardial involvement in diabetic patients evaluated by exercise thallium-201 scintigraphy and cardiac catheterization

    International Nuclear Information System (INIS)

    Mizuno, Sumio; Genda, Akira; Nakayama, Akira; Igarashi, Yutaka; Takeda, Ryoyu

    1985-01-01

    To evaluate myocardial involvement in diabetes mellitus, we studied 39 patients with negative double-Master's test and without hypertension by exercise thallium-201 (Tl-201) myocardial scintigraphy using a bicycle ergometer. Among the 39 patients, 12 (30.8 %) showed filling defects in the scintigrams (positive cases), including eight with stress-induced defects and four with fixed defects. The positive cases had higher scores of diabetic complications (3.6 +- 2.4 vs 2.1 +- 1.8; p < 0.05) and longer durations of diabetes as compared with those of the negative cases. The frequency of insulin therapy was also greater in the positive cases. Eleven patients (5 positive and 6 negative cases) who underwent cardiac catheterization had no significant stenotic lesions of their coronary arteries. However, all of the positive cases showed abnormal wall motion, mainly hypokinesis, by left ventriculography (LVG). The abnormalities of the LVG corresponded to the findings of the scintigrams (i.e. filling defects and decrease in washout ratios by circumferential profile analysis). These results suggest that in some diabetics myocardial involvement exists in the early stage without overt cardiac disease and exercise Tl-201 scintigraphy is useful in detecting pre-clinical cardiomyopathy. Cardiomyopathy in diabetics seems to be due to disturbances of the myocardial microcirculation. (author)

  12. Significance of repeated exercise testing with thallium-201 scanning in asymptomatic diabetic males

    International Nuclear Information System (INIS)

    Rubler, S.; Fisher, V.J.

    1985-01-01

    This study was conducted with asymptomatic middle-aged male subjects with diabetes mellitus to detect latent cardiac disease using noninvasive techniques. One group of 38 diabetic males (mean age 50.5 +/- 10.2 years) and a group of 15 normal males (mean age 46.9 +/- 10.0 years) participated in the initial trial; 13 diabetic patients and 7 control subjects were restudied 1-2 years later. Maximal treadmill exercise with a Bruce protocol and myocardial scintigraphy with thallium-201(201Tl) were used. Diabetic subjects on initial examination and retesting achieved a lower maximal heart rate and duration of exercise than control subjects. Abnormal electrocardiographic changes, thallium defects, or both were observed in 23/38 diabetic males (60.5%) on the first study and only one 65-year-old control subject had such findings. On retesting, the control subjects had no abnormalities while 76.9% of diabetic subjects had either 201Tl defects or ECG changes. We conclude that despite the fact that none of diabetic males had any clinical evidence or symptoms of heart disease, this high-risk group demonstrated abnormalities on exercise testing that merit careful subsequent evaluation and followup and could be an effective method of detecting early cardiac disease

  13. Incidental detection of an invasive thymoma during thallium-201 imaging for coronary artery disease.

    Science.gov (United States)

    Tseng, Jo-Chi; Hua, Chung-Ching; Tsai, Ming-Fong; Chang, Liang-Che

    2004-02-01

    Thallium-201 (Tl-201) is widely used for myocardial perfusion imaging, but is also reported to have potential tumor-seeking properties. Tl-201 uptake has been described in various malignant diseases, including thymic tumors. Thymomas are the most frequent tumors of the anterior mediastinum, and chest pain is one of the major presentation symptoms. Sometimes, a thymoma may be overlooked on chest plain film. We report on a case of a 63-year-old man who had a history of hypertension and suffered from intermittent chest pain for several weeks. He underwent a Tl-201 stress test to evaluate the presence of coronary artery disease, and during the test, abnormal uptake over focal extracardiac activity in the left upper mediastinum was incidentally revealed. Furthermore, chest computed tomography identified a 6-cm left anterior mediastinal mass. Mediastinal tumor resection was carried out, and the pathological examination demonstrated an invasive epithelial-type thymoma, which had invaded the left innominate vein. Subsequently, the patient received postoperative radiotherapy and thenceforth responded well to treatment. A Tl-201 scan has the potential to play a part in tumor detection and clinical assessment of therapeutic effects.

  14. Thallium-201 single-photon emission tomography in the treatment follow-up of nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Togawa, Takashi [Chiba Cancer Center Hospital (Japan). Div. of Nuclear Medicine; Yui, Nobuharu [Chiba Cancer Center Hospital (Japan). Div. of Nuclear Medicine; Kinoshita, Fujimi [Chiba Cancer Center Hospital (Japan). Div. of Nuclear Medicine; Yanagisawa, Masamichi [Chiba Cancer Center Hospital (Japan). Div. of Nuclear Medicine; Hatano, Kazuo [Chiba Cancer Center Hospital (Japan). Div. of Radiotherapy; Sekiya, Yuichi [Chiba Cancer Center Hospital (Japan). Div. of Radiotherapy; Shimada, Fumiyuki [Chiba Cancer Center Hospital (Japan). Div. of Head and Neck Surgery; Omura, Ken [Chiba Cancer Center Hospital (Japan). Div. of Head and Neck Surgery; Takeuchi, Yousuke [Chiba Cancer Center Hospital (Japan). Div. of Head and Neck Surgery; Katahashi, Tatsuaki [Dept. of Otorhinolaryngology, School of Medicine, Chiba Univ. (Japan)

    1997-03-01

    In order to assess the usefulness of thallium-201 single-photon emission tomography (SPET) in the treatment follow-up of nasopharyngeal carcinoma (NPC), a total of 75 {sup 201}Tl SPET studies were performed in 18 patients with histologically proven NPC. The findings were compared with those of magnetic resonance imaging (MRI) before and after therapy. Four patients received radiotherapy alone while the other 14 received concurrent chemo-radiotherapy. Treatment response was classified as complete (CR) or partial (PR) based on the findings of MRI and {sup 201}Tl SPET. Intense {sup 201}Tl uptake by the tumour was seen in all 18 patients before treatment. After treatment, MRI showed seven CRs and 11 PRs, whereas {sup 201}Tl SPET showed 13 CRs and five PRs. In 12 patients, the results of {sup 201}Tl SPET were in agreement with those of MRI. In six patients MRI showed PR but {sup 201}Tl showed CR. Follow-up (mean 10.6 months) MRI and {sup 201}Tl SPET studies of these six patients revealed that tumour gradually decreased and finally vanished in three patients. This preliminary study indicates that {sup 201}Tl SPET has potential in the assessment of early response to treatment of patients with NPC when compared with MRI. (orig.)

  15. Pseudonormalization of transmitral flow pattern during exercise thallium-201 imaging in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Shiota, Takahiro; Sakamoto, Tsuguya; Takenaka, Katsu; Amano, Keiko; Amano, Wataru; Igarashi, Tsutomu; Otake, Takeshi; Sugimoto, Tsuneaki

    1993-01-01

    This study was undertaken to assess the usefulness of Doppler parameters and transmitral blood velocity for detecting abnormalities of left ventricular diastolic function during low-level exercise thallium-201 imaging. The study population consisted of 16 thallium perfusion defect patients with coronary artery disease (mean 61±8 years) and 21 age-matched control subjects (mean 55±5 years) without any thallium perfusion defect. Of the 16 thallium perfusion defect patients, 12 were examined by coronary arteriography, of whom single vessel coronary artery disease was seen in 2 and multivessel coronary artery disease in 10. Patients with mitral regurgitant murmurs were excluded from the study. Peak mitral blood flow velocity was measured in early diastole (E) and during atrial systole (A) and the A/E ratio was calculated. The changes in blood pressure and heart rate after low-level exercise were not significantly different between control and thallium perfusion defect groups. The A/E ratio increased slightly in control subjects from 93±14% at baseline to 100±15% during low-level exercise (p<0.05), whereas in patients with thallium perfusion defect, it decreased significantly from 119±33% at baseline to 92±23% during low-level exercise (p<0.01). Thus pseudonormalization of the A/E ratio during low-level exercise may be valuable in the evaluation of patients with severe or multivessel coronary artery disease. (author)

  16. Segmental quantitative analysis of digital thallium-201 myocardial scintigrams in diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Wainwright, R.J.; Maisey, M.N.; Sowton, E.

    1981-01-01

    One hundred and forty-nine patients with suspected ischaemic heart disease were evaluated by exercise thallium-201 myocardial scintigraphy ( 201 Tl SMS), single lead exercise electrocardiography, and coronary arteriography. Myocardial distribution of tracer was assessed semi-quantitatively from digital 201 Tl scintigrams and compared with tracer distribution in subjects with normal hearts. Fifty-two of 54 (96%) patients with normal coronary arteries had normal myocardial scintigrams whereas three patients had a positive ischaemic exercise electrocardiogram and were scan normal. Conversely, 36 of 95 (38%) patients with coronary artery disease had a positive ischaemic electrocardiogram compared with 94 of 95 (99%) patients who had a positive myocardial scintigram. Disease was predicted correctly in 76 out of 80 (95%) of left anterior descending coronary stenoses, in 48 out of 64 (75%) of right coronary artery stenoses, and in 55 out of 64 (85%) of left circumflex coronary artery stenoses, despite the presence of infarcted myocardium in other territories. 201 Tl SMS with segmental quantitative analysis is a highly sensitive and specific technique in the diagnosis of coronary artery disease and may be a useful screening procedure to select patients for further investigation, particularly those with evidence of life-threatening severe left coronary artery disease. (author)

  17. Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary artery disease

    International Nuclear Information System (INIS)

    Kotler, T.S.; Diamond, G.A.

    1990-01-01

    The objective of this study is to determine the discriminant accuracy of exercise thallium-201 myocardial perfusion scintigraphy for the diagnosis and prognosis of patients with known or suspected coronary artery disease. This is a survey of the National Library of Medicine MEDLINE database. The key medical subject headings used were coronary disease, myocardial infarction, radionuclide imaging, and thallium. A total of 122 retrieved studies were considered relevant and were reviewed in depth. Only studies reporting both the sensitivity and specificity of thallium scintigraphy were analyzed. Discriminant accuracy for diagnosis and prognosis was summarized in terms of pooled sensitivity and specificity. Exercise thallium scintigraphy is useful in the noninvasive diagnosis of coronary artery disease, especially in patients with abnormal resting electrocardiograms, restricted exercise tolerance, and intermediate probability of having disease at the time of testing as well as of defining the prognosis of patients with known or suspected coronary artery disease, especially in those with previous myocardial infarction. Because of various shortcomings in the published record, however, the marginal discriminant accuracy and cost effectiveness of thallium scintigraphy compared with conventional clinical assessment and exercise electrocardiography remain controversial. 193 references

  18. Comparison of resting {beta}-methyl-iodophenyl pentadecanoic acid (BMIPP) and thallium-201 tomography using quantitative polar maps in patients with unstable angina

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Akio; Takada, Yasuo; Nagasaka, Makoto; Kato, Rinya; Watanabe, Toshiya; Shimokata, Keiko; Yasui, Shoji [Nagoya National Hospital, Aichi (Japan)

    1997-02-01

    We compared resting {beta}-methyl-iodophenyl pentadecanoic acid (BMIPP) tomography with resting thallium-201 tomography in 28 patients with unstable angina. Tracer distribution was displayed on a polar map and compared with a normal standard deviation map obtained from a group of 12 normal subjects. The extent scores and severity scores obtained by BMIPP were significantly greater than those obtained by thallium-201. Confirmation by coronary angiography revealed the sensitivity of the methods in identifying patients to be 89% for BMIPP and 54% for thallium-201. There were significant differences between BMIPP and thallium-201 in the sensitivities of detecting postischemic jeopardized myocardium in the area supplied by the right coronary artery (RCA; 53% vs 18%, p<0.05), left circumflex artery (LCX; 78% vs 39%, p<0.025) and all 3 vessels combined (71% vs 35%, p<0.001) but no significant differences in specificity (RCA: 82% vs 64%; LCX: 70% vs 90%; and total 3 vessels combined: 75% vs 79%). In conclusion, resting BMIPP tomography is more sensitive than resting thallium-201 tomography in detecting postischemic myocardial damage in patients with unstable angina. (author)

  19. Transthoracic Doppler assessment of coronary flow velocity reserve in children with Kawasaki disease: comparison with coronary angiography and thallium-201 imaging.

    Science.gov (United States)

    Hiraishi, Satoshi; Hirota, Hamao; Horiguchi, Yasunori; Takeda, Nobuhiro; Fujino, Nobuyuki; Ogawa, Natsuko; Nakahata, Yayoi

    2002-11-20

    The purpose of this study was to determine the feasibility of coronary flow velocity reserve (CFVR) measurement by transthoracic Doppler echocardiography (TTDE) in children with Kawasaki disease (KD). Doppler-derived CFVR is a reliable marker predicting the presence of myocardial ischemia. We studied 49 patients (median age 11 years) with KD. The CFVR was calculated as the ratio of hyperemic to basal peak (peak CFVR) and mean (mean CFVR) diastolic flow velocities in the posterior descending coronary artery (PD) and left anterior descending coronary artery (LAD). The CFVR measurements by TTDE were compared with the results of coronary angiography, thallium-201 (Tl-201) single-photon emission computed tomography (SPECT), and intracoronary Doppler study. The CFVR measurements by TTDE were obtained in 92 (94%) of 98 vessels of the PD and LAD in 49 study patients. Both peak and mean CFVRs for 21 stenotic vessels were significantly smaller than those for 35 normal vessels and for 20 vessels with aneurysmal lesions (p children with KD.

  20. Myocardial uptake and clearance of thallium-201 in normal subjects: comparison of dipyridamole-induced hyperemia with exercise stress

    International Nuclear Information System (INIS)

    Ruddy, T.D.; Gill, J.B.; Finkelstein, D.M.; Strauss, H.W.; McKusick, K.A.; Okada, R.D.; Boucher, C.A.

    1987-01-01

    Thallium-201 uptake and clearance after dipyridamole infusion may differ from that after exercise stress because the hemodynamic effects of these two interventions are different. In this study of normal volunteers, thallium kinetics after dipyridamole (n = 13) were determined from three serial image sets (early, intermediate and delayed) and from serial blood samples and compared with thallium kinetics after exercise (n = 15). Absolute myocardial thallium uptake was greater after dipyridamole compared with exercise (p less than 0.0001), although the relative myocardial distribution was similar. The myocardial clearance (%/h) of thallium was slower after dipyridamole than it was after exercise. Comparing dipyridamole and exercise, the differences in clearance were large from the early to the intermediate image (anterior, -11 +/- 17 versus 24 +/- 5, p = 0.0005; 50 degrees left anterior oblique, -7 +/- 11 versus 15 +/- 8, p = 0.004; 70 degrees left anterior oblique, 3 +/- 9 versus 21 +/- 6, p = 0.001). In contrast, the differences in clearance were small from the intermediate to the delayed image (anterior, 15 +/- 4 versus 20 +/- 2, p = 0.025; 50 degrees left anterior oblique, 15 +/- 4 versus 19 +/- 3, p = 0.13; 70 degrees left anterior oblique, 15 +/- 3 versus 18 +/- 2, p = 0.047). Thallium uptake and clearance in the liver, splanchnic region and spleen were greater after dipyridamole (p less than 0.001). Blood thallium levels were greater after dipyridamole (p less than 0.05) and cleared more slowly (p = 0.07). Thus, myocardial thallium-201 uptake and clearance after dipyridamole infusion differ from thallium kinetics after exercise. This difference is, in part, related to associated differences in extracardiac and blood kinetics. Diagnostic criteria for the detection of abnormal thallium-201 clearance must be specific for the type of intervention

  1. The value and throughput of rest Thallium-201/stress Technetium -99m sestamibi dual-isotope myocardial SPECT.

    Science.gov (United States)

    Okudan, Berna; Smitherman, Thomas C

    2004-06-01

    Myocardial perfusion scintigraphy is an established method in cardiology for the diagnosis and evaluation of coronary artery disease (CAD). Thallium-201 and Tc-99m sestamibi myocardial perfusion imaging has been widely accepted as non-invasive diagnostic procedure for detection of CAD, risk stratification and myocardial viability assessment. But, standard Tl-201 redistribution and same day or 2-day rest/stress Tc-99m sestamibi protocols are time-consuming. Hence, the dual isotope rest thallium-201/stress technetium-99m sestamibi gated single-photon emission tomography protocol has gained increasing popularity for these applications. Combining the use of thallium-201 with technetium-99m agents permits optimal image resolution and simultaneous assessment of viability. Dual-isotope imaging may be separate or simultaneous acquisition set-up. The more rapid completion of these studies is appreciated as an advantage by patients, technologists, interpreting and referring physicians, nurses and hospital management. Simultaneous imaging has the potential advantages of precise pixel registration and artifacts, if present, are identical in both thallium and sestamibi, and require only one set of imaging. Also, there are some disadvantages of spillover of activity from the Tc-99m to the Tl-201 window. Fortunately, despite this problem it can be overcome. Separate acquisition dual isotope also has some disadvantages. Difference in defect resolution in attenuation and scatter between T-201 and Tc-99m sestamibi potentially results in interpretation problems. But, studies about cost-effectiveness of dual isotope imaging showed that some selective elimination of the rest studies may decrease the cost of the nuclear procedures and should be considered in the current care health system.

  2. Dipyridamole-induced ST segment depression during thallium-201 imaging in patients with coronary artery disease: angiographic and hemodynamic determinants

    International Nuclear Information System (INIS)

    Chambers, C.E.; Brown, K.A.

    1988-01-01

    To examine the angiographic and hemodynamic determinants of dipyridamole-induced ST segment depression in patients with coronary artery disease, 41 patients with angiographically documented coronary disease who underwent dipyridamole-thallium-201 myocardial scintigraphy were studied. Dipyridamole-induced ST depression occurred in 14 (34%) of the 41 patients. Stepwise multivariate logistic regression was performed to compare the predictive value of angiographic findings (good coronary collateral vessels, jeopardized collateral vessels, multivessel disease), hemodynamic changes (changes in heart rate, systolic pressure, diastolic pressure and rate-pressure product), thallium-201 results (perfusion defect, thallium-201 redistribution) and demographic data (age, gender, medications). Only the presence of good coronary collateral vessels (p less than 0.02) and increases in rate-pressure product after dipyridamole infusion (p less than 0.02) were significant multivariate predictors of dipyridamole-induced ST depression. Good collateral vessels were more common in the group with ST depression (11 [79%] of 14) than they were in the group without ST depression (6 [22%] of 27; p less than 0.001). Rate-pressure product increased 2,835 +/- 1,648 beats/min.mm Hg in the group with ST depression compared with 1,179 +/- 1,417 beats/min.mm Hg in patients without ST depression (p less than 0.005). In conclusion, dipyridamole-induced ST segment depression in patients with coronary artery disease appears to be related to 1) the presence of good coronary collateral vessels, which may act by facilitating coronary steal, and 2) increases in rate-pressure product, reflecting increased myocardial oxygen demand. These observations may explain the lack of prognostic value of dipyridamole-induced ST segment depression described in previous reports

  3. Effect of eating on thallium-201 myocardial redistribution after myocardial ischemia

    International Nuclear Information System (INIS)

    Angello, D.A.; Wilson, R.A.; Palac, R.T.

    1987-01-01

    To determine whether eating a high-carbohydrate meal between initial and delayed postexercise thallium-201 (Tl-201) imaging affects detection of Tl-201 redistribution during exercise stress testing, 16 patients with stable angina performed 2 Tl-201 treadmill exercise stress tests within a 14-day interval. Immediately after initial postexercise imaging, patients either drank a commercially available instant breakfast preparation for the intervention test or drank an equivalent volume of water for the control test. Comparable exercise workloads were achieved by exercising patients to the same heart rate for both tests. The order of the 2 (intervention and control) tests were randomized. All patients had at least 1 region of Tl-201 myocardial redistribution on either their eating or control test scans, although only 7 of the 16 had positive treadmill exercise test responses. Forty-six regions showing Tl-201 myocardial redistribution were identified in all 144 regions examined. Significantly more of these regions were identified on control test scans than on eating test scans: 11 of 46 on both test scans, 6 of 46 only on eating test scans and 29 of 46 only on control scans (p less than 0.001). Consistent with results of the quantitative regional analysis, the percentage of Tl-201 clearance over 4 hours in the 46 Tl-201 myocardial redistribution regions was 39 +/- 8% for the eating tests and 29 +/- 8% for control tests (mean +/- standard deviation, p less than 0.003). In 4 patients diagnosis of transient ischemia would have been missed because their 14 Tl-201 myocardial redistribution regions were detected only on the control test scans

  4. Phantom evaluation of simultaneous thallium-201/technetium-99m acquisition in single-photon emission tomography

    International Nuclear Information System (INIS)

    Cao Zongjian; Chen, C.C.; Maunoury, C.; Holder, L.E.; Abraham, T.C.; Tehan, A.

    1996-01-01

    This study investigated downscatter effects in cardiac single-photon emission tomographic studies with simultaneous thallium-201/technetium-99m acquisition, and evaluated a previously proposed subtraction technique for downscatter compensation. Ten studies were carried out with different defect sizes and locations and varying activity distributions using four energy windows: 70±10% keV, 140±10% keV, 100±10% KeV, and 103±16% keV. The subtraction technique used the 100- or 103-keV data to remove scattered 99m Tc counts from the 70-keV data. The size and contrast of infarcts in the dual-isotope 70-keV image were artificially decreased compared to those in the 140-keV image, caused by scattered 99m Tc counts that were comparable to the primary 201 Tl counts in the 70-keV window. The subtraction technique produced larger defects and more heterogeneous activity in the myocardial wall in dual-isotope 70-keV images compared to the corresponding 201 Tl-only images. These artifacts were caused by the markedly different spatial distributions of scattered 99m Tc counts in the 100-keV (or 103-keV) window as compared with the 70-keV window. It is concluded that scattered 99m Tc photons may cause overestimation of ischemia and myocardial viability in simultaneous dual-isotope patient studies. The proposed subtraction technique was inaccurate and produced image artifacts. Adequate downscatter compensation methods must be developed before applying simultaneous 201 Tl/ 99m Tc acquisition in clinical practice. (orig.). With 6 figs., 3 tabs

  5. Significance of positive or negative thallium-201 scintigraphy in hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    von Dohlen, T.W.; Prisant, L.M.; Frank, M.J. (Medical College of Georgia, Augusta (USA))

    1989-09-01

    Myocardial ischemia, fibrosis and infarction may occur in patients with hypertrophic cardiomyopathy (HC) in the absence of epicardial coronary artery disease. To determine their prevalence and relation with common characteristics, stress thallium-201 scintigraphy was performed in 28 patients. Eleven (39%) had positive scans despite normal epicardial coronary arteries (7 patients) or a pretest risk of coronary disease less than or equal to 5% (4 patients). There was no relation between thallium defects and age, sex, chest pain or outflow tract gradients at rest. However, the mean left ventricular ejection fraction was significantly lower in those with perfusion abnormalities compared with those without (64 +/- 15 vs 75 +/- 11%, respectively, p less than 0.05). Also, the mean ventricular septal thickness was greater in patients with positive scans (27 +/- 7 vs 21 +/- 6 mm, p less than 0.05), and there was a nonparametric relation between increasing septal thickness and the frequency of positive scans (p less than 0.025). Seven of 11 patients with positive scans had ventricular tachycardia compared with none among those who had negative scans (p less than 0.001), and 5 of these 11 patients had conduction system disease requiring permanent pacemaker insertion compared with 1 of 17 with negative scans (p less than 0.025). It is concluded that thallium perfusion abnormalities are common in patients with HC in the absence of epicardial coronary disease, and are strongly associated with potentially lethal arrhythmias. Thallium scintigraphy appears to identify a subset of patients with HC at increased risk for sudden death, who therefore require closer follow-up.

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

    International Nuclear Information System (INIS)

    Tedeschi, E.; Soricelli, A.; Brunetti, A.; Romano, M.; Bucciero, A.; Iaconetta, G.; Alfieri, A.; Postiglione, A.; Salvatore, M.

    1996-01-01

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

  7. Kinetics of thallium-201 in reperfused canine myocardium after coronary artery occlusion

    International Nuclear Information System (INIS)

    Okada, R.D.

    1984-01-01

    To study the kinetics of thallium-201 in nonsalvaged acutely infarcted myocardium and salvaged myocardium, the tracer was administered after experimental left anterior descending coronary artery reperfusion 2 hours after occlusion. In 19 dogs, thallium activity was then monitored for 4 hours in the reperfused anterior wall and normal posterior wall using miniature cadmium telluride radiation detectors. After sacrifice, 13 of the dogs were found to have an infarcted anterior wall by triphenyltetrazolium-chloride staining. In these dogs, mean (+/- standard deviation) fractional 4 hour thallium clearance was 0.33 +/- 0.08 for the infarct zone and 0.15 +/- 0.06 for the normal control zone (p less than 0.001). When computer-modeled, the clearance curve from the infarct zone was biexponential. The second exponential clearance curve from the infarct zone began 19.1 +/- 3.2 minutes after tracer administration, and was indistinguishable from the monoexponential clearance curve from the normal control zone. Thallium clearance from the blood pool was triexponential, the final exponential clearance curve being indistinguishable from the normal control zone clearance curve. Six dogs were found to have a salvaged noninfarcted anterior wall by triphenyltetrazolium-chloride staining. In these dogs, mean fractional 4 hour thallium clearance was 0.20 +/- 0.07 for the reperfused zone, and 0.19 +/- 0.08 for the normal control zone (p . NS). When computer-modeled, clearance curves for the reperfused and control zones were monoexponential. The monoexponential clearance curve for the salvaged reperfused zone was indistinguishable from the monoexponential clearance curve for normal myocardium

  8. Clinical studies on the thallium-201 myocardial scintiphotography in patient with ischemic heart disease

    International Nuclear Information System (INIS)

    Owada, Kenji

    1980-01-01

    Thallium-201 myocardial scintiphotography was performed in 41 patients with myocardial infarction, 13 with angina pectoris and 12 without coronary artery disease. 1) In patients with congestive heart failure, blood clearance of 201 Tl was delayed and radioactivity on the lung area increased compared with normal cases. 2) The scintillation camera image on a globular model containing 0.5 mCi of 201 Tl was recorded in a magnetic disk as 64 * 64 matrix. Myocardial area was estimated as an area where the count showed more than 55% of maximum counts of myocardium. On the myocardial area, cold area due to infarction was defined as an area where the count showed less than 70% of the maximum. 3) The infarct size (%) was calculated as an ratio of the number of matrix in cold area against to myocardial area on the images of ANT, LAO, and LAT view. The mean infarct size (%) was larger in the patient with cardiomegaly (CTR >= 55%) than those without it, and it was larger in the patients with high values of serum CPK or LDH than in those with low values of them. 4) The correlation coefficient between the mean infarct size (%) and direction of QRS vector at the maximum, 20 msec and 40 msec were r = 0.780, 0.672 and 0.766, respectively. 5) Mean values of MBF/CO (%) ratio were showing significant low in myocardial infarction and in angina pectoris. 6) The mean value of Myocardial blood flow (MBF) was showing significant low in myocardial infarction and in angina pectoris. MBF (ml/min/m 2 ) value expressed the states of coronary blood flow better than MBF/CO (%). (J.P.N.)

  9. Cardiac inotropic reserve examined by postextrasystolic potentiation and redistribution of exercise thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Sugihara, Hiroki; Adachi, Haruhiko; Nakagawa, Hiroaki

    1986-01-01

    Evaluation of regional contractile reserve and the viability of an infarcted segment of the myocardium is very important in determining the indications for aorto-coronary bypass after myocardial infarction and in predicting the prognosis. Regional wall motion of the left ventricle after postextrasystolic potentiation (PESP) was studied in 18 patients with old myocardial infarction, and compared with indices of redistribution of thallium after exercise. Equilibrium radionuclide angiocardiography (RNA) using Tc 99m HSA was performed at rest and after PESP produced by a programmable cardiac stimulator via a right ventricular catheter. Regional ejection fractions (REF) were determined, and wall motion was observed visually. The relative thallium activity (RTA) and washout rate (WOR) were obtained from exercise myocardial scintigraphy performed 10 minutes, and 3 hours after thallium-201 injections. Wall motion improved in 12 of 23 infarcted segments after PESP. Regional ejection fraction and relative thallium activity (in three hours, or the difference between the activities of the initial and three hours after exercise) in the improved segments were significantly higher (p < 0.001) than in the unchanged segments. Washout rate was lower (p < 0.02) in the improved segments. Significant correlation was observed between the change in regional ejection fraction and relative thallium activity (3 hours after exercise) (r = 0.654, p < 0.05). Thus, the wall motion of some infarcted regions of the myocardium improved after PESP, and thallium was redistributed during three hours after exercise. It is concluded that contractility and viability might be preserved even in the infarcted site following myocardial infarction, and that these results are indications for aorto-coronary bypass surgery in cases of old myocardial infarction. Both PESP assessed by equilibrium radionuclide angiography and exercise thallium scintigraphy are useful means for these evaluations. (author)

  10. Thallium-201 for cardiac stress tests: residual radioactivity worries patients and security.

    Science.gov (United States)

    Geraci, Matthew J; Brown, Norman; Murray, David

    2012-12-01

    A 47-year-old man presented to the Emergency Department (ED) in duress and stated he was "highly radioactive." There were no reports of nuclear disasters, spills, or mishaps in the local area. This report discusses the potential for thallium-201 (Tl-201) patients to activate passive radiation alarms days to weeks after nuclear stress tests, even while shielded inside industrial vehicles away from sensors. Characteristics of Tl-201, as used for medical imaging, are described. This patient was twice detained by Homeland Security Agents and searched after he activated radiation detectors at a seaport security checkpoint. Security agents deemed him not to be a threat, but they expressed concern regarding his health and level of personal radioactivity. The patient was subsequently barred from his job and sent to the hospital. Tl-201 is a widely used radioisotope for medical imaging. The radioactive half-life of Tl-201 is 73.1h, however, reported periods of extended personal radiation have been seen as far out as 61 days post-administration. This case describes an anxious, but otherwise asymptomatic patient presenting to the ED with detection of low-level personal radiation. Documentation should be provided to and carried by individuals receiving radionuclides for a minimum of five to six half-lives of the longest-lasting isotope provided. Patients receiving Tl-201 should understand the potential for security issues; reducing probable tense moments, confusion, and anxiety to themselves, their employers, security officials, and ED staff. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. The clinical impact of thallium-201 reinjection for the detection of myocardial hibernation

    International Nuclear Information System (INIS)

    Schaefers, M.; Matheja, P.; Hasfeld, M.; Bartenstein, P.; Lerch, H.; Breithardt, G.; Scheld, H.; Schober, O.

    1996-01-01

    Thallium-201 reinjection improves detection of hibernating myocardium in about 30%-50% of persisting defects. The main goal of cardiac revascularization techniques is amelioration of clinical symptoms such as angina and dyspnoea; however, improvement in regional and global pump function is an additional and important target. The aim of this study was to investigate whether fill-in in the reinjection study is correlated with improved contractile function after treatment (percutaneous transluminal coronary angioplasty/aortocoronary bypass surgery). We studied 32 patients with coronary heart disease and impaired regional wall motion (RWM). RWM and ejection fraction (EF) were assessed by analysing ventriculographic images using the centreline method (values in standard deviations from mean values found in a healthy control group). Three 201 Tl single-photon emission tomographic studies (stress, redistribution and reinjection) were performed prior to revascularization and analysed using a bull's-eye scheme. Patients were divided into two groups (group FI-=no fill-in, n=16; group FI+=fill-in, n=16). Fifty-six percent of all patients showed persisting defects, and 56% of these defects showed fill-in after reinjection. Fill-in in our patient group was independent of the size of the persisting defects. After revascularization RWM increased significantly in group FI+ (from -1.9 to 0.0 SD, P 201 Tl reinjection image can predict recovery of RWM and EF after revascularization and should be used in all patients with impaired RWM and persisting defects independent of their extent. (orig.). With 7 figs., 2 tabs

  12. Exercise thallium-201 myocardial imaging in left main coronary artery disease: sensitive but not specific

    International Nuclear Information System (INIS)

    Rehn, T.; Griffith, L.S.; Achuff, S.C.; Bailey, I.K.; Bulkley, B.H.; Burow, R.; Pitt, B.; Becker, L.C.

    1981-01-01

    To determine the usefulness of thallium-201 scintigraphy for identifying left main coronary artery disease, the results of scintigraphy at rest and during exercise were compared in 24 patients with 50 percent or greater narrowing of the left main coronary artery and 80 patients with 50 percent or greater narrowing of one or more of the major coronary arteries but without left main coronary involvement. By segmental analysis of the scintigrams, perfusion defects were assigned to the left anterior descending, left circumflex or right coronary artery, singly or in combination, and the pattern of simultaneous left anterior descending and circumflex arterial defects was used to identify left main coronary artery disease. Of the 24 patients with left main coronary artery disease, 22 (92 percent) had abnormal exercise scintigrams. Despite this high sensitivity, the pattern of perfusion defects was not specific; the ''left main pattern'' was found in 3 patients (13 percent) with left main coronary artery disease but also in 3 (33 percent) of 9 patients with combined left anterior descending and left circumflex arterial disease, 4 (19 percent) of 21 patients with three vessel disease and 3 (6 percent) of 50 patients with one or two vessel disease but excluding the group with left anterior descending plus left circumflex arterial disease. The pattern of perfusion defects in the patients with left main coronary artery disease was determined by the location and severity of narrowings in the coronary arteries downstream from the left main arterial lesion. Concomitant lesions in other arteries were found in all patients with left main coronary disease (one vessel in 1 patient, two vessels in 7 patients and three vessels in 16). For this reason, it is unlikely that even with improvements in radiopharmaceutical agents and imaging techniques, myocardial perfusion scintigraphy will be sufficiently specific for definitive identification of left main coronary artery disease

  13. Localization of coronary artery disease with exercise electrocardiography: correlation with thallium-201 myocardial perfusion scanning

    International Nuclear Information System (INIS)

    Dunn, R.F.; Freedman, B.; Bailey, I.K.; Uren, R.F.; Kelly, D.T.

    1981-01-01

    In 61 patients with single vessel coronary artery disease (70 percent or greater obstruction of luminal diameter in only one vessel) and no previous myocardial infarction, the sites of ischemic changes on 12 lead exercise electrocardiography and on thallium-201 myocardial perfusion scanning were related to the obstructed coronary artery. The site of exercise-induced S-T segment depression did not identify which coronary artery was obstructed. In the 37 patients with left anterior descending coronary artery disease S-T depression was most often seen in the inferior leads and leads V4 to V6, and in the 18 patients with right coronary artery disease and in the 6 patients with left circumflex artery disease S-T depression was most often seen in leads V5 and V6. Although S-T segment elevation was uncommon in most leads, it occurred in lead V1 or a VL, or both, in 51 percent of the patients with left anterior descending coronary artery disease. A reversible anterior defect on exercise thallium scanning correlated with left anterior descending coronary artery disease (probability [p] less than 0.0001) and a reversible inferior thallium defect correlated with right coronary or left circumflex artery disease (p less than 0.0001). In patients with single vessel disease, the site of S-T segment depression does not identify the obstructed coronary artery; S-T segment elevation in lead V1 or aVL, or both, identifies left anterior descending coronary artery disease; and the site of reversible perfusion defect on thallium scanning identifies the site of myocardial ischemia and the obstructed coronary artery

  14. Comparison of visual and semiquantitative analysis of stress thallium-201 myocardial images in patients with suspected ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    McKillop, J.H.; Murray, R.G.; Turner, J.G.; Bessent, R.G.

    1980-07-01

    Three methods of analyzing stress thallium-201 myocardial images were performed on 79 patients with suspected coronary artery disease. The results of visual analysis of unprocessed Polaroid images, background subtracted and contrast enhanced computer generated color television images, and a semiquantitative regions-of-interest method were each compared to the coronary arteriographic findings in all patients. Analysis by the semiquantitative method achieved the highest accuracy for the classification of patients as either having or not having coronary artery disease. This method of interpreting myocardial images appears worthy of further study.

  15. Comparison of visual and semiquantitative analysis of stress thallium-201 myocardial images in patients with suspected ischemic heart disease

    International Nuclear Information System (INIS)

    Three methods of analyzing stress thallium-201 myocardial images were performed on 79 patients with suspected coronary artery disease. The results of visual analysis of unprocessed Polaroid images, background subtracted and contrast enhanced computer generated color television images, and a semiquantitative regions-of-interest method were each compared to the coronary arteriographic findings in all patients. Analysis by the semiquantitative method achieved the highest accuracy for the classification of patients as either having or not having coronary artery disease. This method of interpreting myocardial images appears worthy of further study

  16. Biphasic thallium 201 SPECT-imaging for the noninvasive diagnosis of myocardial perfusion abnormalities in a child with Kawasaki disease--a case report

    International Nuclear Information System (INIS)

    Hausdorf, G.; Nienaber, C.A.; Spielman, R.P.

    1988-01-01

    The mucocutaneous lymph node syndrome (Kawasaki disease) is of increasing importance for the pediatric cardiologist, for coronary aneurysms with the potential of thrombosis and subsequent stenosis can develop in the course of the disease. The authors report a 2 1/2-year-old female child in whom, fourteen months after the acute phase of Kawasaki disease, myocardial infarction occurred. Biphasic thallium 201 SPECT-imaging using dipyridamole depicted anterior wall ischemia and inferolateral infarction. This case demonstrates that noninvasive vasodilation-redistribution thallium 201 SPECT-imaging has the potential to predict reversible myocardial perfusion defects and myocardial necrosis, even in small infants with Kawasaki disease

  17. Intracoronary thallium-201 assessment of thrombolysis in acute myocardial infarction. Validation of the method of imaging before and after therapy

    International Nuclear Information System (INIS)

    Parker, J.A.; Heller, G.V.; Silverman, K.J.; Campbell, C.C.; Markis, J.E.; Royal, H.D.; Paulin, S.; Kolodny, G.M.

    1985-01-01

    In order to study acute changes in perfusion with intracoronary thrombolytic therapy, the authors have used ten times the pretherapy intracoronary thallium-201 dose for the posttherapy study. Because of the larger posttherapy dose, the posttherapy images had ten times as many counts as the pretherapy images. Since the change in image quality between the pretherapy and posttherapy studies might affect interpretation, they studied the effect of image statistics on interpretation of perfusion scintigraphy. The pretherapy and posttherapy images were scored on a four-point scale in five segments on each of three views. In 31 patients, Poisson-distributed pseudorandom noise was added to the posttherapy study in order to match the statistical accuracy of the pretherapy study. A blinded interpretation of the pretherapy and posttherapy noise-added images was performed in the same way as the initial unblinded interpretation. The mean difference between the unblinded pretherapy and posttherapy scores (the improvement in thallium distribution with therapy) was 2.5 +/- 0.8 (standard error) compared with the difference between the blinded pretherapy and posttherapy noise-added scores which was 2.6 +/- 1.0. The correlation between readings of similar pairs of data was higher than the correlation between pretherapy and posttherapy studies. Thus, the difference in statistic quality of the pretherapy and posttherapy studies did not affect the interpretation of these studies. Therefore, the evaluation of pretherapy and posttherapy studies using a ten-fold increase in thallium-201 dosage is valid

  18. Diagnostic accuracy of exercise thallium-201 single-photon emission computed tomography in patients with left bundle branch block

    International Nuclear Information System (INIS)

    Larcos, G.; Gibbons, R.J.; Brown, M.L.

    1991-01-01

    Recent reports have proposed that abnormal apical or anterior wall perfusion with exercise thallium-201 imaging may increase diagnostic accuracy for disease of the left anterior descending artery in patients with left bundle branch block (LBBB). To evaluate these suggestions, 83 patients with LBBB who underwent thallium-201 single-photon emission computed tomography and coronary angiography within an interval of 3 months were retrospectively reviewed. There were 59 men and 24 women aged 33 to 84 years (mean 65). Myocardial perfusion to the apex, anterior wall and anterior septum were scored qualitatively by consensus of 2 experienced observers and by quantitative analysis in comparison with a normal data base. The sensitivity, specificity and accuracy of perfusion defects in these segments were then expressed according to angiographic findings. Significant stenosis of vessels within the left anterior descending artery territory was present in 38 patients. By receiver-operator characteristic analysis, a fixed or reversible defect within the apex by the qualitative method was the best criterion for coronary artery disease. However, although highly sensitive (79 and 85% by the qualitative and quantitative methods, respectively), an apical defect was neither specific (38 and 16%, respectively), nor accurate (57 and 46%, respectively). Perfusion abnormalities in the anterior wall and septum were also of limited diagnostic accuracy. Thus, modified interpretative criteria in patients with LBBB are not clinically useful in the assessment of left anterior descending artery disease

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

    International Nuclear Information System (INIS)

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

    1982-01-01

    After a 4-minute i.v. dipyridamole infusion, 0.14 mg/kg/min, serial thallium-201 scans were obtained in 60 patients undergoing cardia catheterization. Forty patients had significant (greater than or equal to50% stenosis) coronary artery disease (CAD), and 20 patients had normal coronary arteries or trivial lesions. The images were graded qualitatively for thallium activity by three observers. Sensitivity was 93% (37 of 40) and specificity was 80% (16 of 20). The sensitivity and specificity of the thallium-201 study were not affected by the extent of CAD, the presence of Q waves, or propranolol therapy. Twenty-seven of 37 patients who had initial defects (73%) had complete thallium redistribution of one or more defects. Patient-by-patient anlaysis using a regression model of all patients showed that the fate of a segmental thallium defect predicted abnormal wall motion by angiography better than ECG Q waves. The presence of propranolol therapy or collaterals did not significantly affect the thallium redistribution results. It is concluded that qualitative interpretation by multiple observers of thallium images after dipyridamole infusion is a highly sensitive and specific test for CAD. After dipyridamole, as with exercise stress, the extent of thallium redistribution is related to the degree of myocardial wall motion abnormality

  20. Assessment of single vessel coronary artery disease: results of exercise electrocardiography, thallium-201 myocardial perfusion imaging and radionuclide angiography

    International Nuclear Information System (INIS)

    Port, S.C.; Oshima, M.; Ray, G.; McNamee, P.; Schmidt, D.H.

    1985-01-01

    The sensitivity of the commonly used stress tests for the diagnosis of coronary artery disease was analyzed in 46 patients with significant occlusion (greater than or equal to 70% luminal diameter obstruction) of only one major coronary artery and no prior myocardial infarction. In all patients, thallium-201 perfusion imaging (both planar and seven-pinhole tomographic) and 12 lead electrocardiography were performed during the same graded treadmill exercise test and radionuclide angiography was performed during upright bicycle exercise. Exercise rate-pressure (double) product was 22,307 +/- 6,750 on the treadmill compared with 22,995 +/- 5,622 on the bicycle (p = NS). Exercise electrocardiograms were unequivocally abnormal in 24 patients (52%). Qualitative planar thallium images were abnormal in 42 patients (91%). Quantitative analysis of the tomographic thallium images were abnormal in 41 patients (89%). An exercise ejection fraction of less than 0.56 or a new wall motion abnormality was seen in 30 patients (65%). Results were similar for the right (n = 11) and left anterior descending (n = 28) coronary arteries while all tests but the planar thallium imaging showed a lower sensitivity for isolated circumflex artery disease (n = 7). The specificity of the tests was 72, 83, 89 and 72% for electrocardiography, planar thallium imaging, tomographic thallium imaging and radionuclide angiography, respectively. The results suggest that exercise thallium-201 perfusion imaging is the most sensitive noninvasive stress test for the diagnosis of single vessel coronary artery disease

  1. Thallium-201 scintigraphy after intravenous infusion of adenosine compared with exercise thallium testing in the diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Coyne, E.P.; Belvedere, D.A.; Vande Streek, P.R.; Weiland, F.L.; Evans, R.B.; Spaccavento, L.J.

    1991-01-01

    Adenosine is an endogenously produced compound that has significant effects as a coronary and systemic vasodilator. Previous studies suggest that intravenous infusion of adenosine, coupled with thallium-201 scintigraphy, may have specific value as a noninvasive means of evaluating coronary artery disease. The purpose of this study was to compare the diagnostic value of adenosine thallium testing with that of standard exercise thallium testing. One hundred subjects were studied with exercise thallium imaging and thallium imaging after adenosine infusion, including 47 with angiographically proved coronary artery disease and 53 control subjects. The overall sensitivity of the thallium procedures was 81% for the exercise study and 83% for the adenosine study (p = NS); the specificity was 74% for the exercise study and 75% for the adenosine study (p = NS). The diagnostic accuracy of the exercise study was 77% and that of the adenosine study was 79%. Ninety-four percent of subjects had an adverse effect due to the adenosine infusion; however, most of these effects were mild and well tolerated. All adverse effects abated within 30 to 45 s of the termination of the study, consistent with the very brief half-life of the agent. Thus, thallium-201 scintigraphy after intravenous infusion of adenosine has a diagnostic value similar to that of exercise thallium testing for evaluation of coronary artery disease. Adenosine thallium testing may be particularly useful in evaluating patients unable to perform treadmill exercise testing

  2. Comparison of arbutamine stress and treadmill exercise thallium-201 SPECT: Hemodynamics, safety profile and diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Kiat, H.; Berman, D.S. [Cedars-Sinai Medical Centre, Los Angeles, California, LA (United States)

    1998-02-01

    Full text: Arbutamine (ARB), a new pharmacologic stress agent with enhanced chronotropic property compared to dobutamine, was compared with treadmill (TM) exercise testing (Ex) in a multicenter study using thallium-201 (Tl) SPECT. Of the total of 184 patients who underwent ARB, 69 also had TM stress and quantitative coronary angiography. Fifty-eight patients with a low pretest likelihood of CAD also underwent ARB study for evaluation of test specificity (normalcy rate). Tl scans were scored by a central laboratory using a 20 segment (seg)/scan visual analysis (5 point system: 0=normal, 4-absent uptake). Maximum heart rate (HR) by ARB and Ex was 122 vs 141 bpm (p<0.05). Mean %HR change from baseline was similar (79% vs 82%, respectively, p=ns). Maximum systolic BP for ARB and Ex was 173 vs 175 mmHg, and mean % change from baseline was 24% vs 28% (p=ns). Sensitivity for detecting CAD (270% stenosis) by ARB Tl was 94% and 97% by Ex Tl (p=ns). Stress Tl SPECT segmental agreement for presence of defect between ARB and Ex was 92% (kappa=0.8, p<0.001). Exact segmental stress Tl score (0-4 grading) agreement was 83 % (kappa=0.7, p<0.001). Among 346 segs with stress defects by both ARB and Ex defect reversibility agreement was 86% (kappa=0.7, p<0.001). The normalcy rate for ARB TI-SPECT among patients with a low likelihood of CAD was 90%. Adverse events were mostly mild (tremor: 23%, flushing: 10%, headache: 10%, paraesthesia: 8%, dizziness: 8%, hot flushes: 4%). Arrhythimia of clinical concern occurred in 8% (10/122) of ARB patients who had cardiac catheterisation and in 1.4% (1/69) of patients who had stress Tl. Of all 184 patients with ARB stress, ARB was discontinued due to arrhythmia in 7(5%) and 1 patient had IV Metoprolol for frequent ventricular couplets. Sustained arrhythmias were not observed

  3. Tc99m-Tetrofosmin and Thallium-201 SPECT imaging of pituitary tumors: Preliminary results

    International Nuclear Information System (INIS)

    Yarman, S.; Mudun, A.

    2002-01-01

    Aim: It has been reported that pituitary adenomas accumulate Thallium -201(Tl-201), Tc99m-sestamibi and In111-Octreotide. These agents maybe useful in the diagnosis and follow-up of pituitary adenomas. Tc99m-tetrofosmin also has been shown as an tumor seeking agent in various tumors. The aim of this study is to evaluate the accumulation of Tc99m-tetrofosmin in pituitary adenomas and compare the results to Tl-201 SPECT. Methods: We performed Tc99m-Tetrofosmin and Tl-201 SPECT imaging on 5 patients (pts) with pituitary tumors, 3 patients with acromegaly, 1 patient with macro prolactinoma, and 1 patient with nonfunctional tumor (1 female, 4 male, age range: 26-50). SPECT imaging of cranium were obtained 20 min after intravenous injection of 111 MBq Tl-201 and 555 MBq Tc99m-Tetrofosmin on different days with a dual head gamma camera. All but one patient had surgical therapy. One patient had medical treatment. One patient had post surgical imaging with both Tetrofosmin and Tl-201 and 2 pts had only with Thallium. Semiquantitative analysis were performed by calculating tumor to background ratio from the mean counts of the created ROI's. Results: All adenomas showed prominent uptake with both Thallium and Tetrofosmin. The mean tumor to background ratios were 2.3 (range: 1.2-4.29) with Thallium and 3.57 (range: 1.6-6.86) with Tetrofosmin. Post therapy images showed no significant uptake in pituitary region with both agents in 2 patients. Post therapy mean Thallium uptake ratio in 3 pts was 1.64. One patient with acromegaly showed no decrease in thallium uptake, but showed some decrease in tetrofosmin uptake. Conclusion: Although our patient number is limited, these preliminary results indicate that Tc99m-tetrofosmin has also strong affinity for pituitary adenomas as does Thallium, either the adenoma is functioning or non-functioning. It may have a potential value to evaluate the response to therapy

  4. IQ-SPECT for thallium-201 myocardial perfusion imaging: effect of normal databases on quantification.

    Science.gov (United States)

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

    2017-07-01

    Although IQ-single-photon emission computed tomography (SPECT) provides rapid acquisition and attenuation-corrected images, the unique technology may create characteristic distribution different from the conventional imaging. This study aimed to compare the diagnostic performance of IQ-SPECT using Japanese normal databases (NDBs) with that of the conventional SPECT for thallium-201 ( 201 Tl) myocardial perfusion imaging (MPI). A total of 36 patients underwent 1-day 201 Tl adenosine stress-rest MPI. Images were acquired with IQ-SPECT at approximately one-quarter of the standard time of conventional SPECT. Projection data acquired with the IQ-SPECT system were reconstructed via an ordered subset conjugate gradient minimizer method with or without scatter and attenuation correction (SCAC). Projection data obtained using the conventional SPECT were reconstructed via a filtered back projection method without SCAC. The summed stress score (SSS) was calculated using NDBs created by the Japanese Society of Nuclear Medicine working group, and scores were compared between IQ-SPECT and conventional SPECT using the acquisition condition-matched NDBs. The diagnostic performance of the methods for the detection of coronary artery disease was also compared. SSSs were 6.6 ± 8.2 for the conventional SPECT, 6.6 ± 9.4 for IQ-SPECT without SCAC, and 6.5 ± 9.7 for IQ-SPECT with SCAC (p = n.s. for each comparison). The SSS showed a strong positive correlation between conventional SPECT and IQ-SPECT (r = 0.921 and p IQ-SPECT with and without SCAC was also good (r = 0.907 and p IQ-SPECT without SCAC; and 88.5, 86.8, and 87.3%, respectively, for IQ-SPECT with SCAC, respectively. The area under the curve obtained via receiver operating characteristic analysis were 0.77, 0.80, and 0.86 for conventional SPECT, IQ-SPECT without SCAC, and IQ-SPECT with SCAC, respectively (p = n.s. for each comparison). When appropriate NDBs were used, the diagnostic performance of 201 Tl IQ

  5. The clinical value and limitation of exercise electrocardiography and exercise thallium-201 myocardial scintigraphy in the diagnosis of coronary artery disease, with special reference to single vessel disease

    International Nuclear Information System (INIS)

    Fujioka, Tatsuo; Shibata, Nitaro; Shimizu, Yoichi; Itoh, Yukiyoshi; Abe, Mitsuki; Tanaka, Toshihide; Matsuda, Mitsukazu; Obunai, Yoshio

    1984-01-01

    The clinical value and limitation of exercise electrocardiography and exercise thallium-201 myocardial scintigraphy were studied in 40 patients with no previous history of myocardial infarction. Coronary angiography was performed on all the patients. Compared with thallium-201 myocardial scintigraphy, treadmill exercise electrocardiography showed greater sensitivity (84% versus 63%) in diagnosing coronary stenosis of more than 50%. In patients with single vessel discase, the results of sensitivities were similar (75% to 65%). However, the specificity of thallium-201 myocardial scintigraphy was higher than that of exercise electrocardiography (100% compared to 63%). Nine patients with evidence of significant lesions using coronary angiography, showed normal conditions using exercise electrocardiography and thallium myocardial scintigraphy examinations as well. All these patients had a history of chest pain, and 4 of them experienced chest pain during exercise. In cases with false negative exercise tests, the clinical symptoms and exercise-induced chest pain seem to be important diagnostic signs when evaluating patients with coronary artery disease. In 15 patients with isolated single vessel coronary artery disease (more than 75% stenosis of luminal diameter in only one vessel), the site of ST segment depression did not coincide with the stenotic lesion. The site of reversible perfusion defect on thallium-201 myocardial scintigraphy did, however, coincide with the site of myocardial ishemia and the stenotic lesion in most cases. (author)

  6. Clinical usefulness of Thallium-201 chloride scintigraphy for evaluation of oral malignant tumors. Relationship between retention index, histological type and tumor involvement

    International Nuclear Information System (INIS)

    Sato, Tsuyoshi; Nagai, Koyu; Morita, Yasuhiko; Indo, Hiroko; Kawano, Kazunori; Noikura, Takenori

    1999-01-01

    In this report we assessed retrospectively the usefulness of Thallium-201 chloride scintigraphy for diagnosing malignant tumors of the maxillofacial region. Thallium-201 chloride scintigraphy was performed on 74 patients with malignant tumors and 8 patients with benign tumors, and a retention index was calculated from the early and delayed scintigrams (delayed accumulation ratio/ early accumulation ratio). This retention index depended on the blood flow of tumors and the affinity of tumors with Thallium-201 chloride. The retention index was large for malignant tumors (avg.: 1.05) and small for benign tumors (avg.: 0.78). Concerning the degree of malignancy (the histological type and the degree of tumor involvement), the retention index was higher in highly malignant tumors (1.20 for poorly-differentiated tumors and 1.19 for aggressive-involvement-type tumors) and lower for tumors of low malignancy (1.02 for well-differentiated tumors and 0.98 for low involvement-type tumors). Thus, our results indicated that the retention index of Thallium-201 chloride is useful for the qualitative diagnosis of malignant tumors. (author)

  7. Thallium-201 myocardial imaging in anomalous left coronary artery arising from the pulmonary artery. Applications before and after medical and surgical treatment.

    Science.gov (United States)

    Finley, J P; Howman-Giles, R; Gilday, D L; Olley, P M; Rowe, R D

    1978-10-01

    Thallium-201 myocardial imaging was performed on six patients with an anomalous left coronary artery arising from the pulmonary artery. Initial images in three children (aged 4 months, 12 months and 2 1/2 years, respectively) demonstrated anterolateral perfusion defects in agreement with the electrocardiographic localization of infarction. Repeat imaging in two patients 2 to 3 months later, after clinical improvement with anticongestive therapy, demonstrated a reduction in the perfusion defect. In 3 other patients (aged 16, 16 and 20 years, respectively) thallium-201 scans performed during exercise stress demonstrated normal myocardial perfusion 7 to 15 years after operation (ligation of anomalous left coronary in two, ligation plus bypass graft in one). Thallium-201 imaging appears to be helpful in monitoring changes in myocardial perfusion before and after medical or surgical treatment of an anomalous left coronary artery, and may shed light on the pathophysiology of the defect. A possible practical limitation of thallium-201 imaging in this condition is the difficulty of imaging subendocardial infarction.

  8. Occult primary tumors of the head and neck: accuracy of thallium 201 single-photon emission computed tomography and computed tomography and/or magnetic resonance imaging

    NARCIS (Netherlands)

    van Veen, S. A.; Balm, A. J.; Valdés Olmos, R. A.; Hoefnagel, C. A.; Hilgers, F. J.; Tan, I. B.; Pameijer, F. A.

    2001-01-01

    To determine the accuracy of thallium 201 single-photon emission computed tomography (thallium SPECT) and computed tomography and/or magnetic resonance imaging (CT/MRI) in the detection of occult primary tumors of the head and neck. Study of diagnostic tests. National Cancer Institute, Amsterdam,

  9. Is quantitative analysis superior to visual analysis of planar thallium 201 myocardial exercise scintigraphy in the evaluation of coronary artery disease? - Analysis of a prospective clinical study

    NARCIS (Netherlands)

    M.G. Niemeyer (Menco); G-J. Laarman (GertJan); E.E. van der Wall (Ernst); M.-J. Cramer (Maarten-Jan); J.F. Verzijlbergen (Fred); A.H. Zwindermans (Aelko); C.A.P.L. Ascoop (Carl); E.K.J. Pauwels (Ernest K.J)

    1990-01-01

    textabstractQuantitative analysis of myocardial exercise scintigraphy has been previously reported to be superior to visual image interpretation for detection of the presence and extent of coronary artery disease. Computer analysis of perfusion defects and washout rate of thallium 201 was performed

  10. Superiority of quantitative exercise thallium-201 variables in determining long-term prognosis in ambulatory patients with chest pain: a comparison with cardiac catheterization

    International Nuclear Information System (INIS)

    Kaul, S.; Finkelstein, D.M.; Homma, S.; Leavitt, M.; Okada, R.D.; Boucher, C.A.

    1988-01-01

    The purpose of this study was to determine the prognostic utility of quantitative exercise thallium-201 imaging and compare it with that of cardiac catheterization in ambulatory patients. Accordingly, long-term (4 to 9 years) follow-up was obtained in 293 patients who underwent both tests for the evaluation of chest pain: 89 had undergone coronary artery bypass graft surgery within 3 months of testing and were excluded from analysis, 119 experienced no cardiac events and 91 had an event (death in 20, nonfatal myocardial infarction in 21 and coronary artery bypass operations performed greater than 3 months after cardiac catheterization in 50). When all variables were analyzed using Cox regression analysis, the quantitatively assessed lung/heart ratio of thallium-201 activity was the most important predictor of a future cardiac event (chi 2 = 40.21). Other significant predictors were the number of diseased vessels (chi 2 = 17.11), patient gender (chi 2 = 9.43) and change in heart rate from rest to exercise (chi 2 = 4.19). Whereas the number of diseased vessels was an important independent predictor of cardiac events, it did not add significantly to the overall ability of the exercise thallium-201 test to predict events. Furthermore, information obtained from thallium-201 imaging alone was marginally superior to that obtained from cardiac catheterization alone (p = 0.04) and significantly superior to that obtained from exercise testing alone (p = 0.02) in determining the occurrence of events. In addition, unlike the exercise thallium-201 test, which could predict the occurrence of all categories of events, catheterization data were not able to predict the occurrence of nonfatal myocardial infarction. The exclusion of bypass surgery and previous myocardial infarction did not alter the results

  11. Assessment of lower extremities ischemic disease by thallium 201 perfusion scintigraphy in patients with diabetic angiopathy

    Directory of Open Access Journals (Sweden)

    Čizmić Milica

    2011-01-01

    Full Text Available Background/Aim. Tibial perfusion in diabetic microangiopathy is considered to be a diagnostic problem. A special place in quantifying muscle microcirculatory perfusion belongs to thallium 201 muscle perfusion scintigraphy (201Tl PS. Thallium, showing the characteristics of potassium (K+, enters a cell by means of active cell transportation and follows erythrocyte up to the tissue. The aim of this study was to determine if 201Tl PS of lower extremities (LE is a good method for estimating muscle microcirculatory perfusion in diabetic microangiopathy. Methods. The study included 32 patients of an average age 66.1 ± 14.9 years with signs of LE ischemia befalling into III and IV stage of ischemic disease according to the Lariche-Fontain classification. Out of that number there were 27 of the patients with non-insulin-dependent diabetes mellitus (NIDDM, while 5 of the patients were with Burger's disease and Raynand's disorder. Lower extremities PS was performed after 3 min of tibial loading by the use of dorsoplantar foot flexion and intravenous 74 MBq 201Tl as a 10-minute dynamic study. A 10 minute static scintigraphy was carried out of the gluteal region, femurs, tibias and feet per a position and repeated after 3 h at rest in the same projections. The results were interpreted visually and by the semiquantitive method using a program for calculating the number of pulses per pixel in the corresponding region over 1-, 2- and 10-minute dynamic study, thus obtaining numerical data for estimating perfusion. Binding ratio in both legs was estimated visually as low (1, medium (2 and significant (3 difference in both legs. The results were compared with doppler hemodynamic indices (PI and RI. Results. Regardless the group, 201Tl binding intensity rising was significantly 2 min after application, as compared to 1 min, and the obtained level of binding was maintained even after 10 min. In the group Fontain III the majority of the patients showed a medium

  12. [Assesment of lower extremities ischemic disease by thallium 201 perfusion scintigraphy in patients with diabetic angiopathy].

    Science.gov (United States)

    Cizmić, Milica; Pucar, Dragan; Zoranović, Uros

    2011-02-01

    Tibial perfusion in diabetic microangiopathy is considered to be a diagnostic problem. A special place in quantifying muscle microcirculatory perfusion belongs to thallium 201 muscle perfusion scintigraphy (201T1 PS). Thallium, showing the characteristics of potassium (K+), enters a cell by means of active cell transportation and follows erythrocyte up to the tissue. The aim of this study was to determine if T1 PS of lower extremities (LE) is a good method for estimating muscle microcirculatory perfusion in diabetic microangiopathy. The study included 32 patients of an average age 66.1 +/- 14.9 years with signs of LE ischemia befalling into III and IV stage of ischemic disease according to the Lariche-Fontain classification. Out of that number there were 27 of the patients with non-insulin-dependent diabetes mellitus (NIDDM), while 5 of the patients were with Burger's disease and Raynand's disorder. Lower extremities PS was performed after 3 min of tibial loading by the use of dorsoplantar foot flexion and intravenous 74 MBq 201T1 as a 10-minute dynamic study. A 10 minute static scintigraphy was carried out of the gluteal region, femurs, tibias and feet per a position and repeated after 3 h at rest in the same projections. The results were interpreted visually and by the semiquantitive method using a program for calculating the number of pulses per pixel in the corresponding region over 1-, 2- and 10-minute dynamic study, thus obtaining numerical data for estimating perfusion. Binding ratio in both legs was estimated visually as low (1), medium (2) and significant (3) difference in both legs. The results were compared with doppler hemodynamic indices (PI and RI). Regardless the group, 201T1 binding intensity rising was significantly 2 min after application, as compared to 1 min, and the obtained level of binding was maintained even after 10 min. In the group Fontain III the majority of the patients showed a medium difference in binding 201T1 (2) in regard to the

  13. New technique for showing the relation of tomographic myocardial perfusion images obtained with thallium-201 to the coronary arteries.

    Science.gov (United States)

    Gibson, C J; Laird, E E; Williams, E D; Rajathurai, A; Mittra, B; Rankin, D

    1985-01-01

    A new technique has been developed for presenting myocardial tomograms that allows the observer to perceive the shape of the thallium-201 distribution directly. The surface of the myocardium was found by applying an interactive thresholding technique to a set of conventional transverse slices. Computer graphics techniques were used to display a shaded image of that surface on a television screen, showing the three dimensional shape of the myocardial surface from any chosen aspect. A set of normal preserved coronary arteries was digitised, and using scaling and transformation techniques these arteries were mapped on to the myocardial tomograms and a shaded surface image produced with superimposed coronary arteries. This provided a familiar anatomical framework for locating perfusion defects. Its value in identifying various diseased vessels was confirmed by a comparison of the tomographic findings with the angiographic findings in five individual cases. Images PMID:3876840

  14. Thallium-201 myocardial imaging in young adults with anomalous left coronary artery arising from the pulmonary artery

    International Nuclear Information System (INIS)

    Moodie, D.S.; Cook, S.A.; Gill, C.C.; Napoli, C.A.

    1980-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery (Bland-Garland-White syndrome) may produce myocardial ischemia, infarction, and frequently death in infancy. Some patients, however, develop satisfactory coronary artery collaterals and are relatively asymptomatic into adulthood. Very little is known about their myocardial perfusion patterns. We studied three young adults with this condition using stress thallium-201 myocardial imaging. Electrocardiograms in two patients demonstrated old arterolateral myocardial infarctions. Preoperative stress exercise tests were positive in all three patients. Marked perfusion abnormalities were found in the proximal anterolateral wall in all patients, and one patient also had a posterolateral defect. Postoperatively, all stress tests returned to normal. Thallium imaging demonstrated improvement in ischemic areas, but old scars persisted

  15. Clinical course of cor pulmonale investigated after an interval of one year by thallium-201 myocardial SPECT scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamaoka, Shimpachi; Nishimura, Kouichi; Kuno, Kenshi; Yonekura, Yoshiharu; Koide, Harutoshi.

    1988-06-01

    Cor pulmonale was evaluated in 13 patients with chronic lung disease by thallium-201 myocardial SPECT scintigraphy together with pulmonary function tests and right heart catheterization. One year later, we performed this scintigraphy again to investigate the clinical course of the cor pulmonale. In 6 of 13 patients with respiratory failure (Pao/sub 2/ less than 60 Torr), a remarkable progression in cor pulmonale was noted after one year, despite outpatient oxygen therapy. If the patients were admitted because of acute exacerbation of respiratory failure, the cor pulmonale was found to have worsened. In contrast, patients with acute exacerbation due to respiratory infection or causes other than respiratory failure, showed little change in cor pulmonale. Although patients with a marked progression of cor pulmonale tended to have poor pulmonary function data and elevated pulmonary arterial pressure, the clinical course of cor pulmonale could not be predicted from the initial pulmonary function tests or right heart catheterization.

  16. Prospective assessment of regional myocardial perfusion before and after coronary revascularization surgery by quantitative thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Gibson, R.S.; Watson, D.D.; Taylor, G.J.; Crosby, I.K.; Wellons, H.L.; Holt, N.D.; Beller, G.A.

    1983-01-01

    Because thallium-201 uptake relates directly to the amount of viable myocardium and nutrient blood flow, the potential for exercise scintigraphy to predict response to coronary revascularization surgery was investigated in 47 consecutive patients. All patients underwent thallium-201 scintigraphy and coronary angiography at a mean (+/- standard deviation) of 4.3 +/- 3.1 weeks before and 7.5 +/- 1.6 weeks after surgery. Thallium uptake and washout were computer-quantified and each of six segments was defined as normal, showing total or partial redistribution or a persistent defect. Persistent defects were further classified according to the percent reduction in regional thallium activity; PD25-50 denoted a 25 to 50% constant reduction in relative thallium activity and PD greater than 50 denoted a greater than 50% reduction. Of 82 segments with total redistribution before surgery, 76 (93%) showed normal thallium uptake and washout postoperatively, versus only 16 (73%) of 22 with partial redistribution (probability [p] . 0.01). Preoperative ventriculography revealed that 95% of the segments with total redistribution had preserved wall motion, versus only 74% of those with partial redistribution (p . 0.01). Of 42 persistent defects thought to represent myocardial scar before surgery, 19 (45%) demonstrated normal perfusion postoperatively. Of the persistent defects that showed improved thallium perfusion postoperatively, 75% had normal or hypokinetic wall motion before surgery, versus only 14% of those without improvement (p less than 0.001). Whereas 57% of the persistent defects that showed a 25 to 50% decrease in myocardial activity demonstrated normal thallium uptake and washout postoperatively, only 21% of the persistent defects with a decrease in myocardial activity greater than 50% demonstrated improved perfusion after surgery (p . 0.02)

  17. Quantitative exercise thallium-201 single photon emission computed tomography for the enhanced diagnosis of ischemic heart disease

    International Nuclear Information System (INIS)

    Mahmarian, J.J.; Boyce, T.M.; Goldberg, R.K.; Cocanougher, M.K.; Roberts, R.; Verani, M.S.

    1990-01-01

    The clinical utility of exercise thallium-201 single photon emission computed tomography was investigated in 360 consecutive patients who had concomitant coronary arteriography. Tomographic images were assessed visually and from computer-quantified polar maps. Sensitivity for detecting coronary artery disease was comparably high using quantitative and visual analysis, although specificity tended to improve using the former method (87% versus 76%, p = 0.09). Quantitative analysis was superior to the visual method for identifying left anterior descending (81% versus 68%, p less than 0.05) and circumflex coronary artery (77% versus 60%, p less than 0.05) stenoses and detected most patients (92%) with multivessel coronary artery disease. Multivessel involvement was correctly predicted in 65% of the patients with more than one critically stenosed vessel. Exercise variables in patients with significant coronary artery disease were similar whether the tomographic images were normal or abnormal. However, patients with coronary stenoses and normal versus abnormal tomograms had a trend toward more single vessel disease (79% versus 62%, p = 0.07) and moderate coronary stenosis (66% versus 28%, p less than 0.001), but had less proximal left anterior descending artery involvement (8% versus 34%, p = 0.05). Computer-quantified perfusion defect size was directly related to the extent of coronary artery disease. Intra- and interobserver agreement for quantifying defects were excellent (r = 0.98 and 0.97, respectively). In conclusion, quantitative thallium-201 tomography offers improved detection of coronary artery disease, localization of the anatomic site of coronary stenosis, prediction of multivessel involvement and accurate determination of perfusion defect size, while maintaining a high specificity

  18. [Diagnosis of myocardial ischemia in Kawasaki disease: thallium-201 myocardial imagings at rest, with exercise and with dipyridamole administration].

    Science.gov (United States)

    Mitomori, T; Ono, Y; Sugiyama, H; Suzuki, A; Kamiya, T; Nishimura, T; Kozuka, T

    1984-06-01

    Thallium-201 myocardial imaging was performed at rest in 131 children with coronary arterial lesions due to Kawasaki disease. The coronary arterial lesions were assessed by selective coronary angiography within a few days of the isotope study. Twenty-one children had occlusive lesions, and segmental stenotic lesions were seen in 16 children. Perfusion defects of the myocardial images were detected in nine of the former and in three of the latter. The locations of the perfusion defects coincided with the perfusion areas of the affected vessels on coronary angiography. Twelve patients with initial perfusion defects at rest had a follow-up study and the defects disappeared in five. These patients had re-establishment of coronary blood flow in the initially affected areas by either development of collateral vessels or recanalization. Myocardial imaging with exercise was performed in 27 patients including four with coronary arterial occlusion and two with segmental stenosis on coronary angiography. All with coronary artery lesions showed perfusion defects on the imaging with exercise, while the resting study showed the defects only in one patient, in whom more extensive perfusion defects were observed after exercise. Myocardial imaging following intravenous injection of dipyridamole was carried out in 43 patients. Perfusion defects after the injection were noted in 15 of 17 patients with coronary occlusion and in nine of 13 patients with segmental stenosis. In four patients with perfusion defects at rest, additional or more extensive defects were revealed by this drug in the areas of additional coronary arterial involvements. In 20 patients with perfusion defects only after dipyridamole injection, the perfusion defects coincided with the angiographic findings very well. A perfusion defect was documented following dipyridamole injection in one exceptional patient who had no stenotic lesions, but had three giant coronary aneurysms of the right coronary artery. Thus the

  19. Correlation between gadolinium-diethylenetriaminepentaacetic acid contrast enhancement and thallium-201 chloride uptake in pediatric brainstem glioma.

    Science.gov (United States)

    Maria, B L; Drane, W B; Quisling, R J; Hoang, K B

    1997-09-01

    We previously showed that thallium-201 (201Tl) chloride is accumulated in over 75% of brain tumors, including brainstem gliomas. The imaging of 201Tl with single photon emission computed tomography (SPECT) may require an abnormal increase in permeability of tumor vessels to allow penetration of the blood-brain barrier. To test this hypothesis, we evaluated the correlation between gadolinium enhancement and the degree of 201Tl uptake on SPECT and the contributions of either gadolinium enhancement or 201Tl uptake to the prognosis in children with brainstem gliomas. Forty-two sets of paired SPECT scans and magnetic resonance imaging (MRI) scans were obtained longitudinally in 13 cases. Altogether, 31 of 42 pairs (74%) of scans showed concordance between the presence of gadolinium enhancement and 201Tl uptake. There were no cases that demonstrated 201Tl uptake but lacked gadolinium enhancement. The results indicate that 201Tl SPECT is of value primarily when brainstem tumors have vessels that are demonstrably permeable to gadolinium, prior to or as a result of radiotherapy.

  20. Evaluation of left ventricular hypertrophy using thallium-201 myocardial scintigraphy, echocardiography and vectorcardiography. Comparison between pressure and volume overloading

    Energy Technology Data Exchange (ETDEWEB)

    Tsukahara, Yasunori; Owada, Kenji; Suzuki, Shigebumi

    1983-09-01

    Thallium-201 (/sup 201/Tl) myocardial scintigraphy was performed in 40 patients with left ventricular hypertrophy(LVH). Twelve out of 40 patients had pressure overloading (aortic stenosis: 5, hypertension: 7), 14 patients had volume overloading (aortic regurgitation: 9, mitral regurgitation: 5) and 14 had idiopathic cardiomyopathy (hypertrophic type (HCM): 8, congestive type (CCM): 6), respectively. LV area, LV uptake index and wall uptake ratio were calculated from left anterior oblique view of /sup 201/Tl myocardial images. These three indices of both pressure overloading and volume overloading were significantly higher than those of controls. The degree of LVH was indicated by both LV area and LV uptake index. LV area was significantly larger in volume overloading than in pressure overloading. In idiopathic cardiomyopathy, these three indices of HCM and LV area and LV uptake index of CCM were significantly increased compared with those of controls. LV area of CCM was significantly larger than that of HCM, while wall uptake ratio of HCM was significantly higher than that of CCM. LV uptake index and wall uptake ratio of HCM became higher according as left ventricular cavity became smaller. LV area of CCM became larger in proportion as left ventricular cavity became larger and as left ventricular wall thickness became thinner. (author).

  1. Detection and dosimetry of gamma ray emitted from thallium-201 and technetium-99m based on chemiluminescence technique

    Energy Technology Data Exchange (ETDEWEB)

    Shourian, Mostafa [Laboratory of Microanalysis, Institute of Biochemistry and Biophysics, University of Tehran, P.O. Box 13145-1384, Tehran (Iran, Islamic Republic of); Tavakoli, Hassan, E-mail: tavakoli@ibb.ut.ac.i [Faculty of Medicine, Department of Physiology and Biophysics, Faculty of Medicine, Baqiyatollah University of Medical Sciences, P.O. Box 19395-6558, Tehran (Iran, Islamic Republic of); Ghourchian, Hedayatollah, E-mail: hadi@ibb.ut.ac.i [Laboratory of Microanalysis, Institute of Biochemistry and Biophysics, University of Tehran, P.O. Box 13145-1384, Tehran (Iran, Islamic Republic of); Rafiee-Pour, Hossain-Ali [Laboratory of Microanalysis, Institute of Biochemistry and Biophysics, University of Tehran, P.O. Box 13145-1384, Tehran (Iran, Islamic Republic of)

    2010-09-15

    This report describes the detection and dosimetry of gamma ray emitted from Thallium-201 ({sup 201}Tl) and Technetium-99m ({sup 99m}Tc) based on chemiluminescence technique. H{sub 2}O{sub 2} produced by two gamma emitter radioisotopes of {sup 201}Tl and {sup 99m}Tc were quantitatively measured by chemiluminescence method. Upon producing H{sub 2}O{sub 2} in a luminol alkaline solution, in the presence of diperiodatocuprate, as catalyst a chemical reaction was accrued and consequently the emitted light was measured. The determined H{sub 2}O{sub 2} concentration was correlated with the gamma ray detection and dosimetry. The sensitivity of chemiluminescence technique for {sup 201}Tl and {sup 99m}Tc dosimetry was determined to be 0.20 and 0.08 MBq/l (Mega Becquerel per liter) respectively (R.S.D. = %5, N = 3). The plotted calibration curves showed detection limits of 3.24 and 1.76 MBq/l for {sup 201}Tl and {sup 99m}Tc, respectively.

  2. Resting technetium-99m methoxyisobutylisonitrile cardiac imaging in chronic coronary artery disease: comparison with rest-redistribution thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Cuocolo, A.; Maurea, S.; Pace, L.; Nicolai, E.; Nappi, A.; Imbriaco, M.; Trimarco, B.; Salvatore, M.

    1993-01-01

    We studied 19 patients with angiographically proven coronary artery disease and left ventricular dysfunction (ejection fraction 33%±8%) by resting technetium-99m methoxyisobutylisonitrile ( 99m Tc-MIBI) and rest-redistribution thallium-201 cardiac imaging. Thallium and 99m Tc-MIBI studies were visually analysed. Of 285 segments, 203 (71%) had normal thallium uptake, 48 (17%) showed reversible thallium defects and 34 (12%) showed irreversible thallium defects. Of these 34 irreversible thallium defects, 19 (56%) were moderate and 15 (44%) were severe. Of the corresponding 285 segments, 200 (70%) had normal 99m Tc-MIBI uptake, while 37 (13%) showed moderate and 48 (17%) showed severe reduction of MIBI uptake. Myocardial segmental agreement for regional uptake score between initial thallium and resting 99m Tc-MIBI images was 90% (κ=0.78). Segmental agreement between delayed thallium and resting 99m Tc-MIBI images was 77% (κ=0.44). In particular, in 26 (9%) segments 99m Tc-MIBI uptake was severely reduced while delayed thallium uptake was normal or only moderately reduced. These data suggest that although rest-redistribution thallium and resting 99m Tc-MIBI cardiac imaging provide concordant results in the majority of myocardial segments, some segments with severely reduced resting 99m Tc-MIBI uptake may contain viable but hypoperfused myocardium. Thus, conclusions on myocardial viability based on 99m Tc-MIBI uptake should be made with caution in chronic coronary artery disease. (orig.)

  3. Effects of reduced coronary flow on thallium-201 accumulation and release in an in vitro rat heart preparation.

    Science.gov (United States)

    Goldhaber, S Z; Newell, J B; Ingwall, J S; Pohost, G M; Alpert, N M; Fossel, E T

    1983-03-01

    To study the relation between myocardial thallium-201 (TI-201) uptake, TI-201 release, and reduced coronary flow, isolated Langendorff rat hearts (n = 8) were perfused for 3 hours at constant flows ranging from physiologic (12 ml/min) to severely ischemic (1.5 ml/min); thallium activity was monitored with a scintillation probe. Each heart was perfused for 1 hour with thallium buffer, followed by 2 hours with thallium-free buffer at the same flow rate. Accumulation curves for all 4 flows were monoexponential. However, release curves during the 2 hours of washout with thallium-free buffer demonstrated a biexponential configuration. The early fast release component decreased with reductions in coronary flow, and the later slow release component did not vary significantly with flow. These data show that thallium clearance has at least 2 components: a rapid (possibly extracellular) component related to coronary flow and a slow (possibly intracellular) component independent of coronary flow. These findings should be useful in providing a better understanding of thallium redistribution observed clinically.

  4. Thallium-201 single photon emission computed tomography (SPECT) in patients with Duchenne's progressive muscular dystrophy. A histopathologic correlation study

    International Nuclear Information System (INIS)

    Nishimura, Toru; Yanagisawa, Atsuo; Sakata, Konomi; Shimoyama, Katsuya; Yoshino, Hideaki; Ishikawa, Kyozo; Sakata, Hitomi; Ishihara, Tadayuki

    2001-01-01

    The pathomorphologic mechanism responsible for abnormal perfusion imaging during thallium-201 myocardial single photon emission computed tomography ( 201 Tl-SPECT) in patients with Duchenne's progressive muscular dystrophy (DMD) was investigated. Hearts from 7 patients with DMD were evaluated histopathologically at autopsy and the results correlated with findings on initial and delayed resting 201 Tl-SPECT images. The location of segments with perfusion defects correlated with the histopathologically abnormal segments in the hearts. Both the extent and degree of myocardial fibrosis were severe, especially in the posterolateral segment of the left ventricle. Severe transmural fibrosis and severe fatty infiltration were common in segments with perfusion defects. In areas of redistribution, the degree of fibrosis appeared to be greater than in areas of normal perfusion; and intermuscular edema was prominent. Thus, the degree and extent of perfusion defects detected by 201 Tl-SPECT were compatible with the histopathology. The presence of the redistribution phenomenon may indicate ongoing fibrosis. Initial and delayed resting 201 Tl-SPECT images can predict the site and progress of myocardial degeneration in patients with DMD. (author)

  5. The quantitative diagnosis of thallium-201 myocardial perfusion images and vectorcardiograms in myocardial infarction and hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Watanabe, Yoshihiko; Yasui, Shoji; Inagaki, Haruo; Kawai, Naoki; Sotobata, Iwao.

    1981-01-01

    Correlation studies were carried out between thallium-201 myocardial perfusion images and vectorcardiograms in 77 patients with myocardial infarction (48 anterior and 29 inferior infarctions) and 30 patients with hypertrophic cardiomyopathy. A quantitative method was developed; myocardial 201 Tl uptake index (a relative myocardial activity to background, MUI) and myocardial 201 Tl uptake ratio (a ratio of regional myocardial counts to maximal myocardial counts, MUR) were utilized to differentiate myocardial infarction from hypertrophic cardiomyopathy, and evaluate them. A fairly good agreement between left ventriculograms and myocardial perfusion images was obtained in myocardial infarction (diagnostic accuracy 95.1% in anterior and 75.6% in inferior infarction). In anterior infarction the linear relationship of r = -0.58 (p 201 Tl images (septal, apical and anterior, apical and septal, and anterior dominant types). Azimuth angles of instantaneous 10 msec vector were directed right-anteriorly (mean 114.5 degrees) in septal hypertrophy, and left-anteriorly (mean 84.9 degrees) in apical and anterior hypertrophy. Elevation angle of maximal T vector in apical hypertrophy was deviated superiorly (mean 102.6 degrees). There was a good correlation (r = 0.60, p < 0.001) between the magnitude of spatial maximal QRS vector and lateral wall MUR. (author)

  6. Correlative studies between Frank vectorcardiograms and thallium-201 myocardial perfusion images in patients with old anterior myocardial infarction

    International Nuclear Information System (INIS)

    Kawai, Naoki; Sotobata, Iwao; Inagaki, Haruo; Kondo, Teruo; Yamauchi, Kazunobu

    1982-01-01

    A correlative study was performed on 70 patients with old anterior myocardial infarction between each of the orthogonal components of instantaneous QRS vectors and the anterior-wall, lateral-wall and septal myocardial uptake ratios (A-MUR, L-MUR and S-MUR, respectively). These MURs were calculated from the thallium-201 myocardial perfusion images at 5 projections and used as the index of the infarct size of the respective LV wall. The Z components of the 14-msec and 24-msec instantaneous QRS vectors significantly correlated with the S-MUR (r = -0.51) and the A-MUR (r = -0.66) respectively. The X component of the 32-msec instantaneous QRS vector also showed a significant correlation with the L-MUR (r = 0.59). The regression equations obtained in the present study seemed also applicable to patients with complete right bundle branch block. It is concluded that the quantitative analysis of the Frank vectorcardiograms could afford valuable information as to the size as well as the site of myocardial infarctions. (author)

  7. Thallium-201 single photon emission tomography of myocardium. Additional information in reinjection studies is dependent on collateral circulation

    International Nuclear Information System (INIS)

    Bartenstein, P.; Schober, O.; Schaefers, M.; Matheja, P.; Hasfeld, M.; Breithardt, G.

    1992-01-01

    A second thallium-201 injection under resting conditions is able to improve the differentiation between myocardial scar and ischaemia when compared with simple redistribution imaging. The aim of this study was to evaluate the dependence of this improvement on the degree of stenosis and the presence of collaterals. Single photon emission tomography (SPET) studies under exercise, redistribution and reinjection conditions were performed on 84 patients with 181 stenotic vessels (70 left anterior descending, 47 left circumflex, 64 right coronary artery) and compared with angiography. An improvement of the 201 Tl uptake in the reinjection image was observed in 53% of the myocardial areas served by a coronary artery with a stenosis of over 90%. This is compared with 13% of the areas served by a vessel with a stenosis between 50% and 90%. Some 90% of the collateralized areas showed a fill-in effect, but only 7 of the 118 without angiographically visible collateralization (6%). The dependence of the fill-in effect, collateralization and >90% stenosis was highly significant (χ 2 test, P 90% narrowing. The fill-in effect was closely correlated to the presence of collaterals. In these cases, the fill-in may be an indication for hibernating myocardium. (orig.)

  8. Relationship between redistribution on exercise thallium-201 scintigraphy and repetitive ventricular premature beats in patients with recent myocardial infarction

    International Nuclear Information System (INIS)

    Tsuji, H.; Iwasaka, T.; Sugiura, T.; Shimada, T.; Nakamori, H.; Kimura, Y.; Inada, M.

    1991-01-01

    The relationship between myocardial ischemia detected by exercise thallium-201 scintigraphy and repetitive ventricular premature beats (VPBs) during ambulatory monitoring was evaluated in 57 patients with recent myocardial infarction. Multivariate analysis was performed to obtain the relatively important factor related to repetitive VPBs with the use of the following variables: age, redistribution, left ventricular ejection fraction, serum potassium and magnesium concentration, QRS score, left ventricular aneurysm, and the number of diseased vessels. Thirty-five patients had redistribution, but only three of them had repetitive VPBs during exercise testing. The average heart rate before 79% of 398 episodes of repetitive VPBs during ambulatory monitoring was in the range of 56 to 70/min. These data indicate that most of repetitive VPBs during ambulatory monitoring were not provoked by exercise-induced acute myocardial ischemia. However, redistribution was found to be an important factor associated with repetitive VPBs. The electrical abnormality relating to a substrate characterized by chronic reversible ischemia may explain the association between redistribution and repetitive VPBs

  9. Automatic detection of the left ventricular myocardium long axis and center in thallium-201 single photon emission computed tomography

    International Nuclear Information System (INIS)

    Cauvin, J.C.; Boire, J.Y.; Maubliant, J.C.; Bonny, J.M.; Zanca, M.; Veyre, A.

    1992-01-01

    A new method for centering and reorienting automatically the left ventricle in thallium-201 myocardial single photon emission tomography (SPECT) is proposed. The processing involves the following steps: (a) The transverse sections of the left ventricle are segmented, (b) the three-dimensional skeleton of the left ventricle is extracted using tools of mathematical morphology, (c) the skeleton is fitted to a quadratic surface by the least-squares method, (d) the left ventricle is reoriented and centered using the long axis and the coordinates of the centre of the quadratic surface. A series of 30 consecutive exercise and redistribution 201 Tl SPECT studies were centered and reoriented by two operators twice with this method, and twice manually. There was no significant difference in the mean realignment performed by the automatic and the manual methods while centering differed moderately in some instances. In all cases and for all parameters, the reproducibility of the automatic method was 1.00, while it ranged between 0.74 and 0.98 with the manual centering and reorientation. This automatic approach provides a fast and highly reproducible method for the reconstruction of short- and long-axis sections of the left ventricle in 201 Tl SPECT. (orig.)

  10. Effects of reduced coronary flow on thallium-201 accumulation and release in an in vitro rat heart preparation

    International Nuclear Information System (INIS)

    Goldhaber, S.Z.; Newell, J.B.; Ingwall, J.S.; Pohost, G.M.; Alpert, N.M.; Fossel, E.T.

    1983-01-01

    To study the relation between myocardial thallium-201 (TI-201) uptake, TI-201 release, and reduced coronary flow, isolated Langendorff rat hearts (n . 8) were perfused for 3 hours at constant flows ranging from physiologic (12 ml/min) to severely ischemic (1.5 ml/min); thallium activity was monitored with a scintillation probe. Each heart was perfused for 1 hour with thallium buffer, followed by 2 hours with thallium-free buffer at the same flow rate. Accumulation curves for all 4 flows were monoexponential. However, release curves during the 2 hours of washout with thallium-free buffer demonstrated a biexponential configuration. The early fast release component decreased with reductions in coronary flow, and the later slow release component did not vary significantly with flow. These data show that thallium clearance has at least 2 components: a rapid (possibly extracellular) component related to coronary flow and a slow (possibly intracellular) component independent of coronary flow. These findings should be useful in providing a better understanding of thallium redistribution observed clinically

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-06-01

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

  12. Thallium-201 myocardial perfusion imaging during adenosine-induced coronary vasodilation in patients with ischemic heart disease

    International Nuclear Information System (INIS)

    Takeishi, Yasuchika; Chiba, Junya; Abe, Shinya

    1992-01-01

    Thallium-201 ( 201 Tl) myocardial perfusion imaging during adenosine infusion was performed in consecutive 55 patients with suspected coronary artery disease. Adenosine was infused intravenously at a rate of 0.14 mg/kg/min for 6 minutes and a dose of 111 MBq of 201 Tl was administered in a separate vein at the end of third minutes of infusion. Myocardial SPECT imaging was begun 5 minutes and 3 hours after the end of adenosine infusion. For evaluating the presence of perfusion defects, 2 short axis images at the basal and spical levels and a vertical long axis image at the mid left ventricle were used. The regions with decreased 201 Tl uptake were assessed semi-quantitatively. Adenosine infusion caused a slight reduction in systolic blood pressure and an increase in heart rate. The rate pressure products increased slightly (9314±2377 vs. 10360±2148, p 201 Tl myocardial imaging during adenosine infusion was considered to be safe and useful for evaluating the patients with ischemic heart disease. (author)

  13. Validation of a low dose {sup 201}thallium protocol with a cadmium-zinc-telluride (C.Z.T.) semiconductor camera;Validation d'un protocole thallium 201 faible dose avec une camera a semi-conducteur cadmium-zinc-telluride (CZT)

    Energy Technology Data Exchange (ETDEWEB)

    Songy, B.; Geronazzo, R.; Guernou, M.; Queneau, M.; Lussato, D. [Centre cardiologique du Nord, 93 - Saint-Denis (France)

    2010-05-15

    The objective of the study was to reduce the dosimetry with thallium 201 in myocardium scintigraphy with the new cadmium-zinc-telluride (C.Z.T.) semi-conductors cameras. As results it appears with a low dose of thallium 201 ( less 30%) and then a reduced dosimetry, the C.Z.T. camera provides reliable and high quality images. (N.C.)

  14. Prediction of 6-year prognosis for cardiac event by thallium-201 single-photon emission computed tomography (SPECT) with treadmill exercise test

    International Nuclear Information System (INIS)

    Hayashi, Katsumi; Ohsuzu, Fumitaka; Kosuda, Shigeru; Nakamura, Haruo

    1997-01-01

    To examine thallium-201 single-photon emission computed tomography (SPECT) with a treadmill exercise test can predict the long-term prognosis of patients with coronary artery disease, 95 patients (71 men, 24 women) who underwent a treadmill exercise test with thallium-201 SPECT from April to December 1986 were followed for 6 years. Three short-axis slices at the apical, mid- and basal-level were selected, and each slice was divided into eight segments. Each segment count was assigned a score according to the count range in the slice (score 0, count range 76-100%; 1, 51-75%; 2, 26-50%; 3, 1-25%; 4, 0%) by evaluating the mean value of the slice. The total Tl defect score of each segment in 3 slices was summed (ΣTl defect score). The 'early ΣTl defect score' was the ΣTl defect score 5 min after treadmill exercise, and the 'late ΣTl defect score' was ΣTl defect score measured 4 h after treadmill exercise. Cardiac events occurred in 27 of the 95 patients: cardiac death 3; myocardial infarction 1; percutaneous transluminal angioplasty 16; coronary artery bypass graft 5; congestive heart failure 3. Univariate analysis showed that previous myocardial infarction (p<0.01), exercise work load (p<0.05), early ΣTl defect score (p<0.0l) and late ΣTl defect score (p<0.01) were independent predictors of the prognosis. These results suggest that thallium-201 SPECT with the treadmill exercise test could be applicable and useful to predict long term prognosis. (author)

  15. Influence of arm positioning on tomographic thallium-201 myocardial perfusion imaging and the effect of attenuation correction

    International Nuclear Information System (INIS)

    Prvulovich, E.M.; Jarritt, P.H.; Vorontsova, E.; Bomanji, J.B.; Ell, P.J.

    2000-01-01

    Lateral attenuation in single-photon emission tomography (SPET) myocardial perfusion imaging (MPI) has been attributed to the left arm if it is held by the patient's side during data acquisition. As a result MPI data are conventionally acquired with the arms held above the head. The aims of this study were to determine the effect of imaging arms down on reconstructed tomographic images depicting regional myocardial thallium-201 distribution and to assess whether attenuation-corrected (AC) myocardial perfusion images acquired arms down could replace uncorrected (NC) images acquired arms up for routine clinical service. Twenty-eight patients referred for routine MPI underwent sequential 180 emission/transmission imaging for attenuation correction using an L-shaped dual-headed gamma camera (GE Optima) fitted with two gadolinium-153 scanning line sources. Delay data were acquired twice: once supine with the arms up and then supine with the arms down. Detector radius of rotation (ROR) for arms up and arms-down studies was recorded. For each data set, count density was measured in 17 segments of a polar plot and segmental uptake expressed relative to study maximum. Oblique images were assessed qualitatively by two observers blinded to study type for tracer distribution and overall quality. Transmission maps were assessed for truncation. Mean detector ROR was 190 mm for arms-up studies and 232 mm for arms-down studies (P 201 Tl distribution, particularly anterolaterally. There is lateral undercorrection in approximately 10% of AC arms-down studies, possibly because of attenuation map truncation. Image quality is reduced in about one-third of AC arms-down studies compared with NC arms-up studies. These data suggest that this attenuation correction method is not sufficiently robust to allow routine acquisition of MPI data with the arms down. (orig.)

  16. 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.

  17. Comparison of electrocardiography and thallium-201 myocardial scintigraphy for the detection of ergonovine-induced coronary artery spasm: angiographic correlation

    International Nuclear Information System (INIS)

    Shanes, J.G.; Pavel, D.; Blend, M.

    1987-01-01

    This study was performed to determine the sensitivity of thallium imaging vs ECG monitoring for detecting coronary artery spasm noninvasively following intravenous ergonovine administration as compared to simultaneous coronary angiography. Thirty-two patients with insignificant coronary artery disease and chest pain underwent 12-lead ECG monitoring, thallium imaging, and coronary arteriography following the administration of 0.05, 0.1, 0.2, and 0.3 mg of ergonovine given 5 minutes apart or until chest pain occurred. One minute following the last dose of ergonovine, 2.5 mCi of thallium-201 was injected intravenously, and a final ECG was recorded and repeat coronary arteriography performed. Within 10 minutes following the injection of thallium, imaging was performed in the 40-degree and 70-degree left anterior oblique and anterior projections. The ECG, thallium study, and coronary arteriogram were read blindly and results were compared. The ECG, angiogram, and thallium study were read as positive if the following occurred, respectively: greater than or equal to 1 mm ST segment elevation, depression, or T wave reversal; greater than 50% vessel narrowing,; and reversible perfusion defect. Five patients were excluded from analysis because of either catheter-induced spasm, suboptimal thallium studies, or protocol violations. Of the 27 patients included for analysis, six had chest pain, five had a positive angiogram, five had a positive thallium study, and one had a positive ECG. The sensitivity of thallium vs ECG monitoring was 80% vs 25%, and the accuracy was 92% vs 80%. We conclude that thallium imaging greatly increases the noninvasive detection of ergonovine-induced coronary spasm as compared with the ECG with no loss of accuracy

  18. Preoperative evaluation of myocardial viability by thallium-201 imaging in patients with old myocardial infarction who underwent coronary revascularization

    International Nuclear Information System (INIS)

    Naruse, Hitoshi; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Miyamoto, Takashi; Fukuchi, Minoru

    1992-01-01

    The myocardial uptake and redistribution in thallium scintigraphy and the regional wall motion by echocardiography were evaluated by a semi-quantitative method in 42 patients who previously had myocardial infarction (50 target vessels) and underwent coronary revascularization. The aim of this study was to elucidate the significance of the initial image, delayed image and redistribution on thallium-201 scintigraphy for clinical diagnosis of the myocardial viability. As a semi-quantitative analysis, we used a bull's-eye display for thallium image and centerline method for echocardiographic wall motion, and compared the results before and after revascularization. As a result, the thallium grade improved postoperatively in all 17 areas which preoperatively had showed redistribution, and also in 11 of the 32 areas without preoperative redistribution. The sensitivity, specificity and accuracy of preoperative thallium redistribution for predicting myocardial viability were 61%, 100% and 78%, respectively, when the postoperative improvement in the thallium grade was used as the standard. The postoperative probability of improvement in the thallium grade increased in proportion to the preoperative grade (delayed image)(p<0.01). There was no correlation between the preoperative thallium delayed image and postoperative improvement in wall motion. Postoperative improvement in thallium image and wall motion could not be predicted from the preoperative wall motion. Thus, postoperative improvement in thallium images can be anticipated if redistribution is present on the preoperative thallium image, and the preoperative thallium delayed image is useful for predicting myocardial viability. Improvement in wall motion could not be predicted preoperatively by these methods. (author)

  19. Functional Significance of Angiographic Collaterals in Patients with Totally Occluded Right Coronary Artery: Intracoronary Thallium-201 Scintigraphy

    International Nuclear Information System (INIS)

    Lee, Do Yun; Lee, Jong Doo; Cho, Seung Yun; Shim, Won Heum; Ha, Jong Won; Kim, Han Soo; Kwon, Hyuk Moon; Jang, Yang Soo; Chung, Nam Sik; Kim, Sung Soon; Park, Chang Yun; Kim, Young Soo

    1993-01-01

    To compare the myocardial viability in patients suffering from total occlusion of the right coronary artery (RCA) with the angiographic collaterals, intracoronary injection of Thallium-201 (T1-201) was done to 14 coronary artery disease (CAD) patients (pts) with total occlusion of RCA and into four normal subjects for control. All 14 CAD pts had Grade 2 or 3 collateral circulations. There were 14 male and 4 females, and their ages ranged from 31 to 70 years. In nine pts, T1-201 was injected into left main coronary artery (LCA) (300 ∼ 350 μ Ci) to evaluate the myocardial viability of RCA territory through collateral circulations. The remaining five pts received T1-201 into RCA (200-250 μ Ci) because two had intraarterial bridging collaterals and three had previous successful PTCA. Planar and SPECT myocardial perfusion images were obtained 30 minutes, and four to five hours after T1-201 reinjection. Intravenous T1-201 reinjection (six pts) or 99m Tc-MIBI (two pts) were also performed in eight CAD pts. Intracoronary myocardial perfusion images were compared with intravenous T1-201(IV T1-201) images, EGG, and ventriculography. Intracoronary TI-201 images proved to be superior to that of IV T1-201 due to better myocardial to background uptake ratio and more effective in the detection of viable tissue. We also found that perfusion defects were smaller on intracoronary T1-201 images than those on the IV T1-201. All of the 14 CAD pts had either mostly viable myocardium (seven pts) or large area of T1-201 perfusion (seven pts) in RCA territory, however ventriculographic wall motion and ECG did not correlate well with intracoronary myocardial perfusion images. In conclusion, total RCA occlusion patients with well developed collateral circulation had large area of viable myocardial in the corresponding territory.

  20. Relation of global and regional left ventricular function to tomographic thallium-201 myocardial perfusion in patients with prior myocardial infarction

    International Nuclear Information System (INIS)

    Stratton, J.R.; Speck, S.M.; Caldwell, J.H.; Martin, G.V.; Cerqueira, M.; Maynard, C.; Davis, K.B.; Kennedy, J.W.; Ritchie, J.L.

    1988-01-01

    To determine the relation between regional myocardial perfusion and regional wall motion in humans, tomographic thallium-201 imaging and two-dimensional echocardiography at rest were performed on the same day in 83 patients 4 to 12 weeks after myocardial infarction. Myocardial perfusion and wall motion were assessed independently in five left ventricular regions (total 415 regions). Regional myocardial perfusion was quantitated as a percent of the region infarcted (range 0 to 100%) using a previously validated method. Wall motion was graded on a four point scale as 1 = normal (n = 266 regions), 2 = hypokinesia (n = 64), 3 = akinesia (n = 70), 4 = dyskinesia (n = 13) or not evaluable (n = 2). Regional wall motion correlated directly with the severity of the perfusion deficit (r = 0.68, p less than 0.0001). Among normally contracting regions, the mean perfusion defect score was only 2 +/- 4. Increasingly severe wall motion abnormalities were associated with larger perfusion defect scores (hypokinesia = 6 +/- 5, akinesia = 11 +/- 7 and dyskinesia = 18 +/- 5, all p less than 0.01 versus normal. Among regions with normal wall motion, only 3% had a perfusion defect score greater than or equal to 10. Conversely, among 68 regions with a large (greater than or equal to 10) perfusion defect, only 13% had normal motion whereas 87% had abnormal wall motion. The relation between perfusion and wall motion noted for the entire cohort was also present in subgroups of patients with anterior or inferior infarction. In patients with prior myocardial infarction, the severity of the tomographic thallium perfusion defect correlates directly with echocardiographically defined wall motion abnormalities, both globally and regionally

  1. Comparison of coronary angiography and early oral dipyridamole thallium-201 scintigraphy in patients receiving thrombolytic therapy for acute myocardial infarction

    International Nuclear Information System (INIS)

    Jain, A.; Hicks, R.R.; Myers, G.H.; McCarthy, J.J.; Perry, J.R.; Adams, K.F.

    1990-01-01

    We evaluated 50 consecutive patients who received thrombolytic therapy for acute myocardial infarction using thallium-201 single photon emission computed tomography in combination with oral dipyridamole to assess the frequency of residual myocardial ischemia. Thallium studies were performed early after myocardial infarction at a mean of 4.6 days. The time from the onset of chest pain to the administration of thrombolytic therapy was 2.6 hours (range 0.5 to 5.5). Q wave myocardial infarction was evident in 46 patients; four patients had a non-Q wave infarction (anterior infarction in 31 patients and inferior infarction in 19 patients). The serum mean peak creatinine kinase was 1503 IU/L (range 127 to 6500). Coronary angiography was performed in all patients at a mean of 3.1 days (range 2 to 10) and revealed the infarct-related vessel to be patent in 36 patients (72%). The ejection fraction was 48% (range 26% to 67%). After dipyridamole administration, 13 patients (26%) developed angina that was easily reversed with the administration of intravenous aminophylline. Systolic blood pressure decreased from 122 to 115 mm Hg (p less than 0.05) and the heart rate increased from 76 to 85 beats/min (p less than 0.05). None of the patients had significant hypotension, arrhythmias, or evidence of infarct extension. Perfusion abnormalities were present on the initial thallium images in 48 patients. Redistribution suggestive of ischemia was present in 36 patients (72%). Ischemia confined to the vascular distribution of the infarct vessel was evident in 22 patients. Seven patients had ischemia in the infarct zone as well as in a remote myocardial segment. Thus 29 patients (58%) had ischemia in the distribution of the infarct vessel. Ischemia in the infarct zone was evident in 19 of 36 patients with open infarct vessels and in 10 of 14 patients with occluded infarct vessels

  2. Sensitivity and specificity of thallium-201 perfusion scintigrams under exercise in the diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Verani, M.S.; Marcus, M.L.; Razzak, M.A.; Ehrhardt, J.C.

    1978-01-01

    The specificity and sensitivity of thallium-201 myocardial perfusion imaging (MPI), under exercise, in patients with suspected coronary-obstructive disease was compared with graded exercise ECG tests (GTX) in patients with angiographically normal (N = 34) and obstructed (N = 48) coronary arteries. Of the 34 patients with normal coronaries, only one had a perfusion defect on the MPI (specificity 97%). Of the 48 patients with coronary obstructive disease (>50% obstruction of at least one coronary vessel), MPI was positive in 38 (sensitivity 79%). In contrast, the GTX had a specificity of 62% and sensitivity of 88% if nondiagnostic GTX tests are excluded. When the MPI and the GTX were used in combination, however, the sensitivity of detecting patients with coronary obstructive disease was increased to 94% (p < 0.01). The MPI was particularly useful in the evaluation of the 26 patients with nondiagnostic GTX. In this group, 24 of the 26 patients were correctly identified by the MPI with respect to the presence or absence of coronary-obstructive disease. In the 14 patients with a history of classical angina but with normal coronaries, the MPI was negative in 13 and positive in one, thus suggesting that in the majority of these patients transient transmural myocardial ischemia probably does not occur during exercise. The presence or absence of angiographically demonstrable coronary collateral vessels did not seem to influence the exercise MPI in patients with coronary-obstructive disease. Thus, although the MPI does not correctly identify all patients with either coronary-obstructive disease or normal coronary arteries, it is helpful in patients who have a nondiagnostic GTX. Furthermore, when used in combination with the GTX, the MPI significantly increases the likelihood that significant coronary-obstructive disease is present when both tests are positive, and that coronary disease is absent when both tests are negative

  3. Clinical value of the thallium-201 stress test: sensitivity and specificity in the detection of coronary artery disease

    International Nuclear Information System (INIS)

    Okada, R.D.; Raessler, K.L.; Woolfenden, J.M.; Groves, B.M.; Patton, D.; Goldman, S.; Hager, W.D.

    1978-01-01

    Rest and exercise thallium-201 scintigraphy ( 201 Tl stress test), 90% submaximal treadmill exercise test (ECG stress test), and coronary angiography were performed on 49 patients with suspected coronary artery disease. When technically unsatisfactory and uninterpretable scintiphotos were excluded, the sensitivity (true positives/true positives + false negatives) of the 201 Tl stress test in detecting coronary artery stenosis >= 70% was 81%. The sensitivity of the 201 Tl stress test in detecting coronary artery stenosis >= 50% was 84%. However, when technically unsatisfactory and uninterpretable studies were considered as failures of the test to detect disease, the sensitivity of the 201 Tl stress test in detecting coronary artery stenosis >= 50% was 71%. The sensitivity of the ECG stress test was 92% in detecting stenosis >= 70% and 85% in detecting stenosis >= 50% when non-diagnostic tests were excluded. However, when 11 non-diagnostic ECG stress tests were considered as a failure of the test to detect disease, the sensitivity of the ECG stress test in detecting coronary artery stenosis >= 50% was 64%. The sensitivity of the combined stress test in detecting coronary artery stenosis >= 50% was high whether or not technically unsatisfactory and uninterpretable studies were (89%) or were not (94%) included in the analysis. The specificity (true negatives/true negatives + false positives) for >= 50% coronary artery stenosis was 90% for the 201 Tl stress test, 75% for the ECG stress test and 80% for the combined stress test. Combined ECG and 201 Tl stress testing detects a number of patients with significant coronary artery disease missed by ECG stress testing alone, primarily in those cases where the ECG stress test is non-diagnostic. (author)

  4. Nuclear cardiology. I - Radionuclide angiographic assessment of left ventricular contraction: uses, limitations and future directions. II - The role of myocardial perfusion imaging using thallium-201 in diagnosis of coronary heart disease

    International Nuclear Information System (INIS)

    Bodenheimer, M.M.; Banka, V.S.; Helfant, R.H.; Pennsylvania, University, Philadelphia, PA)

    1980-01-01

    The current status of radionuclide angiography is reviewed. First pass and gated equilibrium methods for determining left ventricular contraction are compared. Some clinical applications of radionuclide angiography are then examined, including the detection of discrete versus diffuse asynergy and the assessment of myocardial infarction. The second part of this work reviews the uses and limitations of thallium-201 perfusion imaging in the diagnosis of the acute and chronic manifestations of coronary heart disease. Theoretical and technical considerations of thallium-201 imaging are reviewed along with the clinical implications of the technique

  5. Quantification of pulmonary thallium-201 activity after upright exercise in normal persons: importance of peak heart rate and propranolol usage in defining normal values

    International Nuclear Information System (INIS)

    Brown, K.A.; Boucher, C.A.; Okada, R.D.; Strauss, H.W.; Pohost, G.M.

    1984-01-01

    Fifty-nine normal patients (34 angiographically normal and 25 clinically normal by Bayesian analysis) underwent thallium-201 imaging after maximal upright exercise. Lung activity was quantitated relative to myocardial activity and a lung/myocardial activity ratio was determined for each patient. Stepwise regression analysis was then used to examine the influence of patient clinical characteristics and exercise variables on the lung/myocardium ratio. Peak heart rate during exercise and propranolol usage both showed significant negative regression coefficients (p less than 0.001). No other patient data showed a significant relation. Using the regression equation and the estimated variance, a 95% confidence level upper limit of normal could be determined for a give peak heart rate and propranolol status. Sixty-one other patients were studied to validate the predicted upper limits of normal based on this model. None of the 27 patients without coronary artery disease had an elevated lung/myocardial ratio, compared with 1 of 8 with 1-vessel disease (difference not significant), 6 of 14 with 2-vessel disease (p less than 0.005), and 6 of 12 with 3-vessel disease (p less than 0.0001). Thus, lung activity on upright exercise thallium-201 studies can be quantitated relative to myocardial activity, and is inversely related to peak heart rate and propranolol use. Use of a regression analysis allows determination of a 95% confidence upper limit of normal to be anticipated in an individual patient

  6. Extracardiac Uptake of Thallium-201 during Myocardial Perfusion Imaging with Pharmacologic Vasodilation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Chung Il; Kwark, Dong Suk; Chung, Byung Cheon; Park, Moo Keun; Lee, Jae Tae; Lee, Kyu Bo [Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

    1992-03-15

    Myocardial perfusion imaging with {sup 201}T1-chloride following exercise or vasodilator-induced hyperemia has been effective in detecting the presence of coronary artery disease. An increased lung uptake of thallium has been reported as a sensitive marker of severe and extensive coronary artery disease and associated with poor prognosis. Thallium has also been noted to concentrate in a variety of malignant lesions. We report 5 cases of extracardiac uptake of thallium during myocardial perfusion scan with pharmacologic vasodilation. Accumulation of thallium was found in the lesions of a breast cancer, a lung cancer, a Castleman's disease and 2 cases of thymoma. We believe that the presence of focal extracardiac uptake of thallium during myocardial perfusion scan should suggest the need for further clinical evaluation to detect the tumor and must differentiate the increased lung uptake of thallium due to left ventricular dysfunction in coronary artery disease.

  7. Prediction of improvement in global left ventricular function in patients with chronic coronary artery disease and impaired left ventricular function: rest thallium-201 SPET versus low-dose dobutamine echocardiography

    International Nuclear Information System (INIS)

    Pace, L.; Salvatore, M.; Perrone-Filardi, P.; Dellegrottaglie, S.; Prastaro, M.; Crisci, T.; Ponticelli, M.P.; Piscione, F.; Chiariello, M.; Storto, G.; Della Morte, A.M.

    2000-01-01

    Accurate assessment of myocardial viability permits selection of patients who would benefit from myocardial revascularization. Currently, rest-redistribution thallium-201 scintigraphy and low-dose dobutamine echocardiography are among the most used techniques for the identification of viable myocardium. Thirty-one consecutive patients (all men, mean age 60±8 years) with chronic coronary artery disease and reduced left ventricular ejection fraction (31%±7%) were studied. Rest 201 Tl single-photon emission tomography (SPET), low-dose dobutamine echocardiography and radionuclide angiography were performed before revascularization. Radionuclide angiography and echocardiography were repeated after revascularization. An a/dyskinetic segment was considered viable on 201 Tl SPET when tracer uptake was >65%, while improvement on low-dose dobutamine echocardiography was considered a marker of viability. Increase in global ejection fraction was considered significant at ≥5%. In identifying viable segments, rest 201 Tl SPET showed higher sensitivity than low-dose dobutamine echocardiography (72% vs 53%, P 201 Tl SPET in group 1 than in group 2 (2.6±1.9 vs 0.6±1.2, P 201 Tl SPET and post-revascularization changes in ejection fraction (r=0.52, P 201 Tl SPET had a higher sensitivity (82% vs 53%, P=0.07) and showed a trend towards higher accuracy and specificity (77% vs 58%, and 71% vs 64%, respectively) as compared with low-dose dobutamine echocardiography. In conclusion, these findings suggest that when severely reduced global function is present, rest 201 Tl SPET evaluation of viability is more accurate than low-dose dobutamine echocardiography for the identification of patients who will benefit most from revascularization. (orig.)

  8. Correlation between thallium-201 myocardial perfusion defects and the functional severity of coronary artery stenosis as assessed by pressure-derived myocardial fractional flow reserve

    International Nuclear Information System (INIS)

    Yanagisawa, Hidefumi; Chikamori, Taishiro; Tanaka, Nobuhiro

    2002-01-01

    Although a relationship between the coronary pressure-derived fractional flow reserve (FFR) and the presence of myocardial ischemia as demonstrated by radionuclide imaging has been reported in a select group of patients, it remains to be established whether this relation also holds true in actual clinical settings with a heterogeneous group of patients. Accordingly, 194 coronary vessels and their supply territories were evaluated in 165 consecutive patients with suspected or known coronary artery disease. An FFR 201 Tl (p 201 Tl reversibility score (r=-0.62; p<0.0001). These results suggest that the FFR has a significant relationship with scintigraphic evidence of myocardial ischemia and can be regarded as a marker of its presence or absence in patients in actual clinical settings. (author)

  9. Quantitation of extent, depth, and severity of planar thallium defects in patients undergoing exercise thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Reisman, S.; Maddahi, J.; Van Train, K.; Garcia, E.; Berman, D.

    1986-01-01

    Previous quantitation of exercise-redistribution planar 201 TI scintigraphy has shown high sensitivity and specificity in the detection of coronary artery disease and improved detection of individual coronary stenoses over visual analysis. By using similar methodology based on the circumferential profile method, we studied 133 patients to quantitatively assess the extent, depth, and severity of thallium defects compared with consensus visual analysis. These quantitative measurements are objective, requiring only three operator interactions. In comparing quantitative and visual results, a close correlation was found for measurement of extent of thallium defect (r = 0.73) and severity of defect (r = 0.79). In detecting patients with the high-risk scintigraphic pattern of a severe stress thallium defect, a quantitative depth score of greater than or equal to 36 had an 81% sensitivity and an 82% specificity. Thus, this nearly automatic, computerized quantitative method allows objective determination of extent, severity, and depth of planar 201 TI defects

  10. Defect images in stress thallium-201 myocardial scintigraphy in patients with complete left bundle branch block. Comparison of exercise stress and pharmacological stress

    International Nuclear Information System (INIS)

    Sasaki, Hideki; Shimizu, Mitsuyuki; Ogawa, Kazuhiko; Okazaki, Fumiko; Mizokami, Tsuneo; Kusaka, Masafumi; Uehara, Yoshiki; Taniguchi, Ikuo; Mochizuki, Seibu

    2007-01-01

    Stress thallium-201 ( 201 Tl) myocardial scintigraphy can demonstrate perfusion abnormalities, especially in the septum in patients with complete left bundle branch block (CLBBB) even with angiographically normal coronary arteries. Differences in the images between exercise and pharmacological stress 201 Tl myocardial scintigraphy were evaluated in patients with CLBBB and normal coronary arteries. Forty-five patients with CLBBB underwent exercise stress using treadmill or pharmacological (adenosine triphosphate) stress 201 Tl myocardial scintigraphy from October 1997 to February 2003. Patients with myocardial diseases were excluded, such as cardiomyopathy and coronary artery diseases detected by echocardiography and/or cardiac catheterization. The myocardial segment was classified according to the American Heart Association style for coronary artery disease. Peak blood pressure levels and heart rates were significantly higher in the exercise stress group than in the pharmacological stress group (p 201 Tl myocardial scintigraphy according to the stress method. Moreover, defects also occurred in areas other than the septum. Blood pressure and heart rate were involved in the mechanisms of defects in left bundle branch block. (author)

  11. Assessment of congenital heart disease by a thallium-201 SPECT study in children; Accuracy of estimated right to left ventricular pressure ratio

    Energy Technology Data Exchange (ETDEWEB)

    Ishii, Iwao; Nakajima, Kenichi; Taki, Junichi; Taniguchi, Mitsuru; Bunko, Hisashi; Tonami, Norihisa; Hisada, Kinichi; Ohno, Takashi (Kanazawa Univ. (Japan). School of Medicine)

    1993-01-01

    The characteristics of correlation between the right-to-left ventricular systolic pressure ratios (RVp/LVp) and the thallium-201 right-to-left ventricular ([sup 201]Tl R/L) count ratios was investigated in children with various congenital heart diseases. High-resolution three-headed SPECT system equipped with either parallel-hole or fan-beam collimators was used. In a total of 102 patients, the correlation between RVp/LVp and [sup 201]Tl R/L average count ratios was good in both planar (r=0.89, p=0.0001) and SPECT studies (r=0.80, p=0.0001). Quantitative analysis of myocardial uptake by SPECT demonstrated the characteristic pattern of each disease as well as the differences in the right ventricular overload types. When the linear regression analysis was performed in each heart disease, ventricular septal defect showed most excellent correlation. Complex heart anomalies also showed positive correlation (r=0.51, p=0.05) with RVp/LVp, and it can be used to estimate right ventricular pressure. After surgical treatment of tetralogy of Fallot and pulmonary stenosis, the decrease of [sup 201]Tl R/L count ratio was in accordance with improvement of right ventricular overload. We conclude that [sup 201]Tl SPECT study can be a good indicator for estimation of right ventricular pressure. (author).

  12. Ventricular premature contraction in hypertrophic cardiomyopathy and essential hypertension with left ventricular hypertrophy; Comparison of Holter ECG, UCG and stress thallium-201 myocardial scintigraphy findings

    Energy Technology Data Exchange (ETDEWEB)

    Kobiki, Naoki (Okayama Univ. (Japan). School of Medicine)

    1989-10-01

    In order to investigate the relationship of different morbid states of the hypertrophied myocardium to the appearance of ventricular premature contraction (VPC), we compared the VPC findings from Holter ECG with those of UCG and stress thallium-201 myocardial SPECT scintigraphy (stress scinti) in 31 patients with hypertrophic cardiomyopathy (HCM) and 20 with essential hypertension (HT). The HCM patients consisted of 21 with asymmetric hypertrophy (ASH), 3 with symmetric hypertrophy (SH), and 7 with apical hypertrophy (APH). We recognized positive findings on the stress scinti such as fixed perfusion defect (FD) or reversible perfusion defect (RD) in 11 patients (ASH 10, APH 1) out of 31 patients with HCM (35%). Positive findings were observed in only one patient out of 20 with HT (5%). We recognized a high grade VPC (grade 4a and 4b of Lown's criteria) in 8 of 11 scinti positive patients with HCM (ASH 7, APH 1)(73%), while high grade VPC appeared in 5 (all of them are ASH) out of 20 scinti negative patients with HCM (25%). Therefore, these findings suggest that high grade VPCs in HCM occur in relation to a myocardial perfusion defect. (author).

  13. Thallium-201 is comparable to technetium-99m-sestamibi for estimating cardiac function in patients with abnormal myocardial perfusion imaging

    Directory of Open Access Journals (Sweden)

    Ming-Che Wu

    2015-11-01

    Full Text Available We analyzed the left-ventricular functional data obtained by cardiac-gated single-photon emission computed tomography myocardial perfusion imaging (MPI with thallium-201 (Tl-201 and technetium-99m-sestamibi (MIBI protocols in different groups of patients, and compared the data between Tl-201 and MIBI. Two hundred and seventy-two patients undergoing dipyridamole stress/redistribution Tl-201 MPI and 563 patients undergoing 1-day rest/dipyridamole stress MIBI MPI were included. Higher mean stress ejection fraction (EF, rest EF, and change in EF (ΔEF were noticed in the normal MPI groups by both Tl-201 and MIBI protocols. Higher mean EF was observed in the females with normal MPI results despite their higher mean age. Comparisons between the Tl-201 and MIBI groups suggested a significant difference in all functional parameters, except for the rest end diastolic volume/end systolic volume and ΔEF between groups with negative MPI results. For the positive MPI groups, there was no significant difference in all parameters, except for the change in end diastolic volume and change in end systolic volume after stress between both protocols. The Tl-201 provides comparable left-ventricular functional data to MIBI cardiac-gated single-photon emission computed tomography in patients with positive MPI results, and may therefore be undertaken routinely for incremental functional information that is especially valuable to this patient group.

  14. Retention index of thallium-201 single photon emission computerised tomography (SPECT) as an indicator of metastasis in adenocarcinoma of the lung.

    Science.gov (United States)

    Takekawa, H.; Itoh, K.; Abe, S.; Ogura, S.; Isobe, H.; Sukou, N.; Furudate, M.; Kawakami, Y.

    1994-01-01

    We examined the relationship between the retention of thallium-201 (201Tl) on a delayed scan and the metastatic potential of adenocarcinomas of the lung. We studied 43 patients with adenocarcinoma of the lung and divided them into two groups according to the presence or absence of lymph node metastasis. 201Tl single photon emission computerised tomography (SPECT) was conducted twice: 15 min (early scan) and 120 min (delayed scan) after intravenous injection of 3 mCi of 201Tl chloride. We calculated the retention index in order to evaluate the degree of 201Tl retention in the primary tumour. The retention indices were significantly higher in the group that was positive for lymph node metastasis than in the negative group. In adenocarcinomas with high metastatic potential, 201Tl SPECT demonstrated slow washout or increased retention on the delayed scan. The retention index of 201Tl SPECT is a useful indicator of metastatic potential, thereby facilitating the prediction of prognosis, and provides insight into the relationship between 201Tl uptake and malignancy. This is the first report demonstrating a significant relationship between the retention of 201Tl SPECT and lymph node metastasis. Images Figure 1 PMID:8054281

  15. Assessment of olfactory nerve by SPECT-MRI image with nasal thallium-201 administration in patients with olfactory impairments in comparison to healthy volunteers.

    Directory of Open Access Journals (Sweden)

    Hideaki Shiga

    Full Text Available PURPOSE: The aim of this study was to assess whether migration of thallium-201 ((201Tl to the olfactory bulb were reduced in patients with olfactory impairments in comparison to healthy volunteers after nasal administration of (201Tl. PROCEDURES: 10 healthy volunteers and 21 patients enrolled in the study (19 males and 12 females; 26-71 years old. The causes of olfactory dysfunction in the patients were head trauma (n = 7, upper respiratory tract infection (n = 7, and chronic rhinosinusitis (n = 7. (201TlCl was administered unilaterally to the olfactory cleft, and SPECT-CT was conducted 24 h later. Separate MRI images were merged with the SPECT images. (201Tl olfactory migration was also correlated with the volume of the olfactory bulb determined from MRI images, as well as with odor recognition thresholds measured by using T&T olfactometry. RESULTS: Nasal (201Tl migration to the olfactory bulb was significantly lower in the olfactory-impaired patients than in healthy volunteers. The migration of (201Tl to the olfactory bulb was significantly correlated with odor recognition thresholds obtained with T&T olfactometry and correlated with the volume of the olfactory bulb determined from MRI images when all subjects were included. CONCLUSIONS: Assessment of the (201Tl migration to the olfactory bulb was the new method for the evaluation of the olfactory nerve connectivity in patients with impaired olfaction.

  16. Imaging of brain tumors in AIDS patients by means of dual-isotope thallium-201 and technetium-99m sestamibi single-photon emission tomography

    International Nuclear Information System (INIS)

    De La Pena, R.C.; Ketonen, L.; Villanueva-Meyer, J.

    1998-01-01

    Our aim was to evaluate the use of dual-isotope thallium-201 (Tl) and technetium-99m sestamibi (sestamibi) simultaneous acquisition in brain single-photon emission tomography (SPET) for the differentiation between brain lymphoma and benign central nervous system (CNS) lesions in AIDS patients. Thirty-six consecutive patients with enhancing mass lesions on magnetic resonance (MR) imaging were included in the study. SPET of the brain was performed to obtain simultaneous Tl and sestamibi images. Regions-of-interest were drawn around the lesion and on the contralateral side to calculate uptake ratios. The final diagnosis was reached by pathologic findings in 17 patients and clinical and/or MR follow-up in 19 patients. Of the 36 patients, 11 had brain lymphoma, 1 glioblastoma multiforme, 15 toxoplasmosis and 9 other benign CNS lesions. Correlation between SPET and the final diagnosis revealed in 10 true-positive, 23 true-negative, 1 false-positive and 2 false-negative studies. All patients with toxoplasmosis had negative scans. A patient with a purulent infection had positive scans. Tl and sestamibi scans were concordant in every lesion. The same lesions that took up Tl were also visualized with sestamibi. However, sestamibi scans showed higher lesion-to-normal tissue uptake ratios (3.7±1.8) compared with those of Tl (2.3±0.8, P<0.002). Simultaneous acquisition of Tl and sestamibi can help differentiate CNS lymphoma from benign brain lesions in AIDS patients. (orig.)

  17. Dipyridamole thallium-201 single-photon emission computed tomography for prediction of perioperative cardiac events in patients with arteriosclerosis obliterans undergoing vascular surgery

    Energy Technology Data Exchange (ETDEWEB)

    Ziyang, Huang; Komori, Sadayoshi; Sawanobori, Takao [Yamanashi Medical Univ., Tamaho (Japan)] [and others

    1998-04-01

    The aim of the study was to determine whether or not dipyridamole thallium-201 single-photon emission computed tomography ({sup 201}Tl-SPECT) has significant additive value for predicting perioperative cardiac events in patients with arteriosclerosis obliterans (ASO) undergoing vascular surgery. Routine preoperative {sup 201}Tl-SPECT was performed in 106 consecutive patients with ASO (age 68{+-}8.9 years; 91 men and 15 women). The frequency of reversible defects in a clinical high-risk group (n=44) was significantly higher than in a low-risk group (n=62; 55% vs 24%, p<0.01). Perioperative cardiac events occurred in 9 patients, including 4 cardiac deaths, 1 non-fatal myocardial infarction, and 4 cases of unstable angina. Although clinical risk stratification was useful in predicting cardiac events (19% in the high-risk group vs 2% in the low-risk group, p<0.01), the positive predictive value was low. When considering a combination of 2 or more than 2 risk factors and a large reversible defect as a predictor, the positive predictive value and specificity increased from 19% to 47% and from 64% to 91%, respectively, whereas the sensitivity remained unchanged (89%). These results suggest that the addition of {sup 201}Tl-SPECT data to clinical risk-stratified patients with ASO allows better prediction of perioperative cardiac events. (author)

  18. p-Tertbutylcalix[4]arene nanoemulsion: preparation, characterization and comparative evaluation of its decontamination efficacy against Technetium-99m, Iodine-131 and Thallium-201.

    Science.gov (United States)

    Rana, Sudha; Sharma, Navneet; Ojha, Himanshu; Shivkumar, Hosakote Gurumalappa; Sultana, Sarwat; Sharma, Rakesh Kumar

    2014-05-01

    This study aimed to develop p-tertbutylcalix[4]arene o/w nanoemulsion for decontamination of radioisotopes from skin. Formulation was characterized using dynamic light scattering (DLS), transmission electron microscopy (TEM), multi-photon confocal microscopy techniques and in vitro dissolution studies. In vivo evaluation of nano-emulsion was done using nuclear medicine technique. Stability studies and dermal toxicity studies were also carried out. Comparative decontamination efficacy (DE) studies were performed on synthetic human tissue equivalent material and Sprague Dawley rat against three commonly used medical radioisotopes, i.e., Technetium-99m ((99m)Tc), Iodine-131 ((131)I) and Thallium-201 ((201)Tl). Decontamination was performed using cotton swabs soaked in nanoemulsion at different time intervals of contaminants exposure. Whole body imaging and static counts were recorded using gamma camera before and after each decontamination attempt data was analyzed using one way analysis of variance (ANOVA) and found to be statistically significant (panimals. Skin histopathology slides with and without API (Active pharmaceutical ingredients) also found to be comparable. p-Tertbutylcalix[4]arene loaded nanoemulsion shows great promise for skin decontamination against broad ranges of radiological contaminants besides being stable and safe. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Temporal Changes in Sequential Quantitative Thallium-201 Imaging Following Myocardial Infarction in Dogs: Comparison of Four and Twenty-Four Hour Infarct Images

    Science.gov (United States)

    Umbach, Richard E.; Lange, Robert C.; Lee, John C.; Zaret, Barry L.

    1978-01-01

    Thallium-201 (201T1) myocardial perfusion imaging allows definition of zones of myocardial infarction and ischemia. The temporal changes in sequential quantitative 201T1 infarct imaging was studied 4 and 24 hours in dogs subjected to closed-chest anterior wall myocardial infarction. A temporal decrease in 201T1 imaged infarct areas was noted in 10 of 13 animals. In no animal did the infarct area increase. The imaged infarct area decreased by an average of 30% from 12.9 ± 6.2 cm2 at 4 hours to 9.1 ± 5.1 cm2 at 24 hours (p < 0.001), and involved 34 ± 16% of the total 201T1 left ventricular distribution at 4 hours and 22 ± 14% at 24 hours (p < 0.001). The magnitude of temporal change in imaged infarct area was not predicted by initial image defect or final histopathologic infarct size. Thus, the results of 201T1 infarct imaging in the early period of infarction are clearly dependent upon the time at which the procedure is performed. ImagesFIG. 1 PMID:752198

  20. Comparative study of thallium-201 single-photon emission computed tomography and electrocardiography in Duchenne and other types of muscular dystrophy

    International Nuclear Information System (INIS)

    Yamamoto, S.; Matsushima, H.; Suzuki, A.; Sotobata, I.; Indo, T.; Matsuoka, Y.

    1988-01-01

    Single-photon emission computed tomography (SPECT) using thallium-201 was compared with 12-lead electrocardiography (ECG) in patients with Duchenne (29), facioscapulohumeral (7), limb-girdle (6) and myotonic (5) dystrophies, by dividing the left ventricular (LV) wall into 5 segments. SPECT showed thallium defects (37 patients, mostly in the posteroapical wall), malrotation (23), apical aneurysm (5) and dilatation (7). ECG showed abnormal QRS (36 patients), particularly as a posterolateral pattern (13). Both methods of assessment were normal in only 7 patients. The Duchenne type frequently showed both a thallium defect (particularly in the posteroapical wall) and an abnormal QRS (predominantly in the posterolateral wall); the 3 other types showed abnormalities over the 5 LV wall segments in both tests. The percent of agreement between the 2 tests was 64, 66, 70, 72 and 72 for the lateral, apical, anteroseptal, posterior and inferior walls, respectively. The 2 tests were discordant in 31% of the LV wall, with SPECT (+) but ECG (-) in 21% (mostly in the apicoinferior wall) and SPECT (-) but ECG (+) in 10% (mostly in the lateral wall). Some patients showed large SPECT hypoperfusion despite minimal electrocardiographic changes. ECG thus appeared to underestimate LV fibrosis and to reflect posteroapical rather than posterolateral dystrophy in its posterolateral QRS pattern. In this disease, extensive SPECT hypoperfusion was also shown, irrespective of clinical subtype and skeletal involvement

  1. Thallium-201 single photon emission computed tomography (SPECT) in patients with Duchenne's progressive muscular dystrophy. A histopathologic correlation study

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Toru; Yanagisawa, Atsuo; Sakata, Konomi; Shimoyama, Katsuya; Yoshino, Hideaki; Ishikawa, Kyozo [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine; Sakata, Hitomi; Ishihara, Tadayuki

    2001-02-01

    The pathomorphologic mechanism responsible for abnormal perfusion imaging during thallium-201 myocardial single photon emission computed tomography ({sup 201}Tl-SPECT) in patients with Duchenne's progressive muscular dystrophy (DMD) was investigated. Hearts from 7 patients with DMD were evaluated histopathologically at autopsy and the results correlated with findings on initial and delayed resting {sup 201}Tl-SPECT images. The location of segments with perfusion defects correlated with the histopathologically abnormal segments in the hearts. Both the extent and degree of myocardial fibrosis were severe, especially in the posterolateral segment of the left ventricle. Severe transmural fibrosis and severe fatty infiltration were common in segments with perfusion defects. In areas of redistribution, the degree of fibrosis appeared to be greater than in areas of normal perfusion; and intermuscular edema was prominent. Thus, the degree and extent of perfusion defects detected by {sup 201}Tl-SPECT were compatible with the histopathology. The presence of the redistribution phenomenon may indicate ongoing fibrosis. Initial and delayed resting {sup 201}Tl-SPECT images can predict the site and progress of myocardial degeneration in patients with DMD. (author)

  2. Early uptake and continuous accumulation of thallium-201 chloride in a benign mixed tumor of soft tissue: Case Report

    Directory of Open Access Journals (Sweden)

    Hamada Kenichiro

    2010-05-01

    Full Text Available Abstract A case of benign mixed tumor of the soft tissue in a 64-year-old Japanese male is presented. He noticed a painless, elastic hard mass sized 3 cm in the right knee, which gradually grew larger and harder in the last 5 years. Magnetic resonance imaging demonstrated a mass lesion embedded in the subcutaneous tissue with low and high signal intensity at T1- and T2-weighted images, respectively. Tl-201 scintigraphy showed an early uptake of Tl-201 within the lesion at 10 minutes after injection, which was slightly decreased but still continued at 2 hours later. The patient underwent a resection of tumor, and the pathological diagnosis was a benign mixed tumor of soft tissue without high vascularity, characterized by histological features similar to pleomorphic adenomas in the salivary glands. Immunohistochemical study proved expression of Na+/K+-ATPase of tumor cells. Overexpression of Na+/K+-ATPase of the tumor might be responsible for the early uptake of Tl-201, and poor vascular structure in this tumor might lead to continuous accumulation. The Tl-201 scintigraphic features of mixed tumor of soft tissue are assessed to resemble those of malignant soft tissue tumors.

  3. Correlation between thallium-201 myocardial perfusion defects and the functional severity of coronary artery stenosis as assessed by pressure-derived myocardial fractional flow reserve

    Energy Technology Data Exchange (ETDEWEB)

    Yanagisawa, Hidefumi; Chikamori, Taishiro; Tanaka, Nobuhiro [Tokyo Medical Coll. (Japan)] [and others

    2002-12-01

    Although a relationship between the coronary pressure-derived fractional flow reserve (FFR) and the presence of myocardial ischemia as demonstrated by radionuclide imaging has been reported in a select group of patients, it remains to be established whether this relation also holds true in actual clinical settings with a heterogeneous group of patients. Accordingly, 194 coronary vessels and their supply territories were evaluated in 165 consecutive patients with suspected or known coronary artery disease. An FFR <0.75, which is regarded as indicative of functionally important stenosis, showed a significant correlation with the redistribution of {sup 201}Tl (p<0.0001), with a sensitivity of 79% and specificity of 73%. In 70 infarct-related coronary arteries, the sensitivity and specificity were 79% and 75%, respectively, whereas in the 124 remaining vessels that were not related to the myocardial infarct, the sensitivity and specificity were 80% and 72%, respectively. In addition, the FFR exhibited a significant inverse correlation with the {sup 201}Tl reversibility score (r=-0.62; p<0.0001). These results suggest that the FFR has a significant relationship with scintigraphic evidence of myocardial ischemia and can be regarded as a marker of its presence or absence in patients in actual clinical settings. (author)

  4. The pacing stress test: thallium-201 myocardial imaging after atrial pacing. Diagnostic value in detecting coronary artery disease compared with exercise testing

    International Nuclear Information System (INIS)

    Heller, G.V.; Aroesty, J.M.; Parker, J.A.; McKay, R.G.; Silverman, K.J.; Als, A.V.; Come, P.C.; Kolodny, G.M.; Grossman, W.

    1984-01-01

    Many patients suspected of having coronary artery disease are unable to undergo adequate exercise testing. An alternate stress, pacing tachycardia, has been shown to produce electrocardiographic changes that are as sensitive and specific as those observed during exercise testing. To compare thallium-201 imaging after atrial pacing stress with thallium imaging after exercise stress, 22 patients undergoing cardiac catheterization were studied with both standard exercise thallium imaging and pacing thallium imaging. Positive ischemic electrocardiographic changes (greater than 1 mm ST segment depression) were noted in 11 of 16 patients with coronary artery disease during exercise, and in 15 of the 16 patients during atrial pacing. One of six patients with normal or trivial coronary artery disease had a positive electrocardiogram with each test. Exercise thallium imaging was positive in 13 of 16 patients with coronary artery disease compared with 15 of 16 patients during atrial pacing. Three of six patients without coronary artery disease had a positive scan with exercise testing, and two of these same patients developed a positive scan with atrial pacing. Of those patients with coronary artery disease and an abnormal scan, 85% showed redistribution with exercise testing compared with 87% during atrial pacing. Segment by segment comparison of thallium imaging after either atrial pacing or exercise showed that there was a good correlation of the location and severity of the thallium defects (r . 0.83, p . 0.0001, Spearman rank correlation). It is concluded that the location and presence of both fixed and transient thallium defects after atrial pacing are closely correlated with the findings after exercise testing

  5. Technetium-99m tetrofosmin imaging in thyroid diseases: comparison with Tc-99m-pertechnetate, thallium-201 and Tc-99m-methoxyisobutylisonitrile scans

    International Nuclear Information System (INIS)

    Klain, M.; Cuocolo, A.; Marzano, L.; Lombardi, G.; Salvatore, M.; Univ. di Napoli

    1996-01-01

    In this study, tetrofosmin whole-body scintigraphy was performed in 35 patients with evidence of thyroid diseases. All patients underwent laboratory evaluation of thyroid function as well as 99m Tc pertechnetate scan, thallium-201 99m Tc-methoxyisobutylisonitrile (MIBI) whole-body studies. Thyroid images were semi-quantitatively analysed by a 4-point score: 0=no significant uptake; 1=uptake increased but inferior to normal thyroid tissue; 2=uptake equal to normal thyroid tissue; 3=uptake superior to normal thyroid tissue. A total of 41 thyroid nodules were detected, of which 15 were goitre nodules, 13 adenomas and 13 malignant lesions. In goitre nodules, concordant results of tetrofosmin and pertechnetate uptake (score 1 or 0) were observed in the majority of lesions (87%). In function adenomas both tetrofosmin uptake and pertechnetate uptake were score 3. In non-function adenomas tetrofosmin uptake was score 3, while pertechnetate uptake was score 0. In six malignant lesions, tetrofosmin uptake was score 3, while pertechnetate uptake was score 0; in the other seven lesions, where a prevalence of goitre abnormalities was observed, results of tetrofosmin and pertechnetate uptake were similar (score 0 or 1). In (70%) patients with malignant nodules, whole-body tetrofosmin images showed increased abnormal uptake in a total of 28 extra-thyroid tumour sites, as subsequently confirmed by other techniques. When tetrofosmin images were compared to 201 Tl and 99m Tc-MIBI scans, concordant results were observed in all cases. In conclusion, tetrofosmin imaging may be particularly useful to characterize and stage patients with malignant thyroid nodules; it shows similar results to thallium but provides better image quality. Comparable findings were observed between tetrofosmin and MIBI studies. Thus, tetrofosmin may be an alternative to thallium and MIBI in the aforementioned patients. (orig.). With 4 figs., 3 tabs

  6. Prognostic value of dipyridamole thallium-201 screening to minimize perioperative cardiac complications in diabetics undergoing kidney or kidney-pancreas transplantation

    International Nuclear Information System (INIS)

    Mistry, B.M.; Solomon, H.; Hoff, J.; Aridge, D.L.; Lindsey, L.M.; Garvin, P.J.; Bastani, B.; Chaitman, B.R.

    1998-01-01

    To minimize perloperative cardiac events, we utilize a screening protocol consisting of intravenous dipyridamole thallium-201 myocardial imaging (DPT), with the selective use of coronary angiography based on the presence of reversible defect(s) on DPT test. A retrospective study was performed to determine the prognostic value of this protocol and to identify any clinical parameters predictive of an abnormal DPT test. To accomplish this, a detailed chart analysis of 176 consecutive kidney (n = 89) and kidney-pancreas (n = 87) transplant recipients who had undergone pre-transplant DPT testing was performed. The results of the DPT test were interpreted as normal in 111, fixed defect in 15, and reversible defect(s) in 50 patients. Forty-two of the 50 patients with reversible defect(s) underwent coronary angiography. Twelve of the 27 patients with significant coronary artery disease (CAD, > 50% stenosis in one or more coronary arteries) underwent pre-transplant revascularization and the remaining 15 were treated medically. Cardiac events (documented acute myocardial infarction or sudden cardiac death) within 6 wk of transplant were stratified by the results of this protocol. Also, various clinical parameters were compared between patients with normal and abnormal (fixed and reversible defect) DPT tests. Only one of the 111 (0.9%) transplant recipients with a normal DPT test had a perioperative cardiac event. None of the 15 (0%) patients with a fixed defect and none of the 15 (0%) patients with reversible defect(s), but a nonsignificant ( 50 yr was the only variable predictive of an abnormal DPT test. (au)

  7. Imaging of brain tumors in AIDS patients by means of dual-isotope thallium-201 and technetium-99m sestamibi single-photon emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    De La Pena, R.C.; Ketonen, L.; Villanueva-Meyer, J. [Dept. of Radiology, Univ. of Texas, Galveston (United States)

    1998-10-01

    Our aim was to evaluate the use of dual-isotope thallium-201 (Tl) and technetium-99m sestamibi (sestamibi) simultaneous acquisition in brain single-photon emission tomography (SPET) for the differentiation between brain lymphoma and benign central nervous system (CNS) lesions in AIDS patients. Thirty-six consecutive patients with enhancing mass lesions on magnetic resonance (MR) imaging were included in the study. SPET of the brain was performed to obtain simultaneous Tl and sestamibi images. Regions-of-interest were drawn around the lesion and on the contralateral side to calculate uptake ratios. The final diagnosis was reached by pathologic findings in 17 patients and clinical and/or MR follow-up in 19 patients. Of the 36 patients, 11 had brain lymphoma, 1 glioblastoma multiforme, 15 toxoplasmosis and 9 other benign CNS lesions. Correlation between SPET and the final diagnosis revealed in 10 true-positive, 23 true-negative, 1 false-positive and 2 false-negative studies. All patients with toxoplasmosis had negative scans. A patient with a purulent infection had positive scans. Tl and sestamibi scans were concordant in every lesion. The same lesions that took up Tl were also visualized with sestamibi. However, sestamibi scans showed higher lesion-to-normal tissue uptake ratios (3.7{+-}1.8) compared with those of Tl (2.3{+-}0.8, P<0.002). Simultaneous acquisition of Tl and sestamibi can help differentiate CNS lymphoma from benign brain lesions in AIDS patients. (orig.) With 2 figs., 2 tabs., 34 refs.

  8. Does supplementation of contrast MR imaging with thallium-201 brain SPECT improve differentiation between benign and malignant ring-like contrast-enhanced cerebral lesions?

    International Nuclear Information System (INIS)

    Kita, Tamotsu; Hayashi, Katsumi; Yamamoto, Masayoshi; Kawauchi, Toshio; Sakata, Ikuko; Iwasaki, Yoshie; Kosuda, Shigeru

    2007-01-01

    The objective of this study was to determine whether thallium-201 ( 201 Tl) brain single photon emission computed tomography (SPECT) could supplement magnetic resonance (MR) imaging diagnostic information by visual comparison of two separate data sets from patients with ring-like contrast-enhanced cerebral lesions. A combination of MR imaging and 201 Tl brain SPECT sets obtained from 13 patients (10 men, 3 women) ranging in age from 26 years to 86 years (mean 61.0 years) were retrospectively reviewed. A total of 12 patients had a solitary lesion, and the others had multiple lesions. All but two intracranial foci were pathologically confirmed. The final diagnoses were six glioblastomas, two cerebral metastases from lung cancer, and one each of abscess, resolving hematoma, primary central nervous system lymphoma, toxoplasmosis, and radiation necrosis. The two separate image formats (MR images and SPECT) were shown to ten readers with practical experience. All of the MR images for each patient were shown to each reader first. After interpreting them, the readers were shown the SPECT images. Images were scored in terms of how benign or malignant the foci were on a 5-point scale from ''definitely benign'' to ''definitely malignant.'' The improvement in the performance of all ten readers was from 67.7% to 93.8% in mean accuracy (P=0.0028) and from 0.730 to 0.971 in mean Az value (P=0.0069) after they were shown the 201 Tl brain SPECT images. 201 Tl brain SPECT should substantially increase confidence in the diagnosis of intracranial lesions with ring-like contrast enhancement when MR imaging does not permit differentiation between benign and malignant disease. (author)

  9. Noninvasive cardiac risk stratification of diabetic and nondiabetic uremic renal allograft candidates using dipyridamole-thallium-201 imaging and radionuclide ventriculography

    International Nuclear Information System (INIS)

    Brown, K.A.; Rimmer, J.; Haisch, C.

    1989-01-01

    The ability of noninvasive risk stratification using dipyridamole-thallium-201 (Tl-201) imaging and radionuclide ventriculography to predict perioperative and long-term cardiac events (myocardial infarction or cardiac death) was evaluated in 36 uremic diabetic and 29 nondiabetic candidates for renal allograft surgery. Of the 35 patients who underwent renal allograft surgery 8 +/- 7 months after the study, none had transient Tl-201 defects (although 13 had depressed left ventricular ejection fraction) and none developed perioperative cardiac events. During a mean follow-up of 23 +/- 11 months, 6 (9%) patients developed cardiac events. Logistic regression analysis was used to compare the predictive value of clinical data (including age, sex, diabetes, chest pain history, allograft recipient) and radionuclide data. Presence of transient Tl-201 defect and left ventricular ejection fraction were the only significant predictors of future cardiac events (p less than 0.01). No other patient variables, including diabetes or receiving a renal allograft, had either univariate or multivariate predictive value. All 3 patients with transient Tl-201 defects had cardiac events compared with only 3 of 62 (5%) patients without transient Tl-201 defect (p less than 0.0001). Mean left ventricular ejection fraction was lower in patients with cardiac events (44 +/- 13%) compared with patients without cardiac events (57 +/- 9%, p less than 0.005). Overall, 5 of 6 patients with cardiac events had either transient Tl-201 defects or depressed left ventricular ejection fraction. Dipyridamole-Tl-201 imaging and radionuclide ventriculography may be helpful in identifying uremic candidates for renal allograft surgery who are at low risk for perioperative and long-term cardiac events

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-02-15

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

  11. Myocardial scintigraphy with thallium-201 and technetium-99m-hexakis-methoxyisobutylisonitrile in left bundle branch block: a study in patients with and without coronary artery disease

    International Nuclear Information System (INIS)

    Knapp, W.H.; Bentrup, A.; Schmidt, U.; Ohlmeier, H.; Bochum Univ. Hospital, Bad Oeynhausen

    1993-01-01

    In left bundle branch block (LBBB) thallium-201 myocardial scintigraphy frequently reveals septal abnormalities in the absence of coronary artery disease (CAD) and gives rise to 'false-positive' results in patients with suspected CAD. It has not yet been clarified which pathophysiological mechanism is responsible for these perfusion abnormalities. A total of 66 patients with constant LBBB were investigated with 201 Tl or technetium-99m-hexakis-methoxyisobutylisonitrile (MIBI), 62 underwent coronary angiography. Of 12 patients without left anterior descending artery (LAD) or right coronary artery (RCA) stenoses, 11 had a reversible septal activity deficit after 201 Tl stress injection, whereas 20 of 22 patients without relevant CAD showed a constant stress/rest septal deficit using MIBI. Regarding patients with significant LAD and/or RCA stenoses, both radio-pharmaceuticals almost always showed a 'reversible' septal deficit: With 201 Tl in 15 of 16 individuals and with MIBI in 14 of 15. In 12 patients 201 Tl was reinjected at rest. In those who had LAD or RCA stenoses (n=5), early septal activity uptake after stress injection was poorer than that after rest injection; in the absence of CAD (n=7), septal stress uptake corresponded with that of rest injection. It is concluded that septal perfusion abnormalities in LBBB and the absence of CAD are characterized by an exercise-independent reduction of septal blood flow per mass of viable myocardium and that stress/rest injection protocols of myocardial perfusion tracers are able to differentiate between LBBB with and without CAD. (orig.)

  12. Comparison of conventional and cadmium-zinc-telluride single-photon emission computed tomography for analysis of thallium-201 myocardial perfusion imaging: an exploratory study in normal databases for different ethnicities.

    Science.gov (United States)

    Ishihara, Masaru; Onoguchi, Masahisa; Taniguchi, Yasuyo; Shibutani, Takayuki

    2017-12-01

    The aim of this study was to clarify the differences in thallium-201-chloride (thallium-201) myocardial perfusion imaging (MPI) scans evaluated by conventional anger-type single-photon emission computed tomography (conventional SPECT) versus cadmium-zinc-telluride SPECT (CZT SPECT) imaging in normal databases for different ethnic groups. MPI scans from 81 consecutive Japanese patients were examined using conventional SPECT and CZT SPECT and analyzed with the pre-installed quantitative perfusion SPECT (QPS) software. We compared the summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) for the two SPECT devices. For a normal MPI reference, we usually use Japanese databases for MPI created by the Japanese Society of Nuclear Medicine, which can be used with conventional SPECT but not with CZT SPECT. In this study, we used new Japanese normal databases constructed in our institution to compare conventional and CZT SPECT. Compared with conventional SPECT, CZT SPECT showed lower SSS (p < 0.001), SRS (p = 0.001), and SDS (p = 0.189) using the pre-installed SPECT database. In contrast, CZT SPECT showed no significant difference from conventional SPECT in QPS analysis using the normal databases from our institution. Myocardial perfusion analyses by CZT SPECT should be evaluated using normal databases based on the ethnic group being evaluated.

  13. Nuclear myocardial perfusion imaging using thallium-201 with a novel multifocal collimator SPECT/CT: IQ-SPECT versus conventional protocols in normal subjects.

    Science.gov (United States)

    Matsuo, Shinro; Nakajima, Kenichi; Onoguchi, Masahisa; Wakabayash, Hiroshi; Okuda, Koichi; Kinuya, Seigo

    2015-06-01

    A novel multifocal collimator, IQ-SPECT (Siemens) consists of SMARTZOOM, cardio-centric and 3D iterative SPECT reconstruction and makes it possible to perform MPI scans in a short time. The aims are to delineate the normal uptake in thallium-201 ((201)Tl) SPECT in each acquisition method and to compare the distribution between new and conventional protocol, especially in patients with normal imaging. Forty patients (eight women, mean age of 75 years) who underwent myocardial perfusion imaging were included in the study. All patients underwent one-day protocol perfusion scan after an adenosine-stress test and at rest after administering (201)Tl and showed normal results. Acquisition was performed on a Symbia T6 equipped with a conventional dual-headed gamma camera system (Siemens ECAM) and with a multifocal SMARTZOOM collimator. Imaging was performed with a conventional system followed by IQ-SPECT/computed tomography (CT). Reconstruction was performed with or without X-ray CT-derived attenuation correction (AC). Two nuclear physicians blinded to clinical information interpreted all myocardial perfusion images. A semi-quantitative myocardial perfusion was analyzed by a 17-segment model with a 5-point visual scoring. The uptake of each segment was measured and left ventricular functions were analyzed by QPS software. IQ-SPECT provided good or excellent image quality. The quality of IQ-SPECT images without AC was similar to those of conventional LEHR study. Mid-inferior defect score (0.3 ± 0.5) in the conventional LEHR study was increased significantly in IQ-SPECT with AC (0 ± 0). IQ-SPECT with AC improved the mid-inferior decreased perfusion shown in conventional images. The apical tracer count in IQ-SPECT with AC was decreased compared to that in LEHR (0.1 ± 0.3 vs. 0.5 ± 0.7, p IQ-SPECT was significantly higher than that from the LEHR collimator (p = 0.0009). The images of IQ-SPECT acquired in a short time are equivalent to that of conventional LEHR

  14. 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

  15. Dobutamine stress thallium-201 single-photon emission tomography versus echocardiography for evaluation of the extent and location of coronary artery disease late after myocardial infarction

    International Nuclear Information System (INIS)

    Elhendy, A.; Bax, J.J.; Domburg, R.T. van; Cornel, J.H.; Roelandt, J.R.T.C.; Valkema, R.; Reijs, A.E.M.; Krenning, E.P.

    1999-01-01

    Dobutamine stress echocardiography and thallium-201 myocardial perfusion scintigraphy are clinically useful methods for the evaluation of coronary artery disease (CAD). However, the relative merits of these imaging modalities in the evaluation of the extent of CAD after myocardial infarction have not been well studied. The aim of this study was to compare the accuracy of dobutamine stress echocardiography and simultaneous 201 Tl single-photon emission tomography (SPET) imaging for the diagnosis and localization of CAD late after acute myocardial infarction. Dobutamine (up to 40 μg kg -1 min -1 )-atropine (up to 1 mg) stress echocardiography in conjunction with stress-reinjection 201 Tl SPET was performed for the evaluation of myocardial ischaemia in 90 patients with previous myocardial infarction who underwent coronary angiography. Significant CAD was predicted on bases of myocardial ischemia (new or worsening wall motion abnormalities on echocardiography and reversible perfusion defects on 201 Tl SPET). Significant CAD (≥ 50% luminal diameter stenosis) was detected in 73 (81%) patients. The sensitivity, specificity and accuracy of echocardiography in detecting remote ischaemia for the diagnosis of remote CAD (present in 53 patients) were, respectively, 79% (CI 70%-88%), 85% (CI 77%-93%) and 81% (CI 73%-90%), while the corresponding figures for 201 Tl SPET were 75% (CI 66%-85%), 78% (CI 69%-87%) and 76% (CI 67%-86%) respectively (P = NS vs echocardiography). The sensitivity, specificity and accuracy of echocardiography in detecting peri-infarction ischaemia for the diagnosis of infarct-related artery stenosis (present in 70 patients) were, rspectively, 77% (CI 68%-86%), 85% (CI 78%-92%) and 79% (CI 70%-87%) while the corresponding figures for 201 Tl SPET were 73% (CI 64%-82%), 85% (CI 78%-92%) and 76% (CI 67%-84%) respectively (P = NS vs echocardiography). The agreement between the two methods for the diagnosis of peri-infarction and remote ischaemia was 70

  16. Extraction and retention of technetium-99m Q12, technetium-99m sestamibi, and thallium-201 in isolated rat heart during coronary acidemia.

    Science.gov (United States)

    McGoron, A J; Gerson, M C; Biniakiewicz, D S; Roszell, N J; Washburn, L C; Millard, R W

    1997-12-01

    Technetium-99m Q12 and 99mTc-sestamibi are cationic lipophilic myocardial perfusion imaging tracers. Because myocardium in areas of ischemia becomes acidotic, experiments were designed to differentiate the effects of myocardial perfusate pH on radiotracer extraction and retention independent of substrate availability. We hypothesized that 99mTc-Q12 and 99mTc-sestamibi single-pass uptake and retention would be unaffected by a modest reduction in coronary perfusate pH. Isolated rat hearts were perfused at constant flow with Krebs-Henseleit buffer enriched with bovine red blood cells (20%). The indicator dilution method was used to measure the maximum extraction (Emax) and net extraction (Enet) of thallium-201 and 99mTc-Q12 (n = 8) or 201Tl and 99mTc sestamibi (n = 7) during baseline perfusion (pH = 7.4), during acidemic (pH = 6.7) perfusion, and during a restitution period with normal perfusate (pH = 7.4). 201Tl Emax (0.71+/-0.03) was greater than either 99mTc-Q12 or 99mTc-sestamibi Emax (0.27+/-0.02 and 0.26+/-0.01 respectively, P<0.0001). Acidemia significantly reduced 201Tl Emax (0.65+/-0.03, P<0.02) but not 99mTc-Q12 or 99mTc-sestamibi Emax (0.25+/-0.02 and 0.24+/-0.02 respectively). During control perfusion Enet of 201Tl was greater than that of 99mTc-Q12 at 3 and 5 min and greater than that of 99mTc-sestamibi at 3 min. 99mTc-Q12 Enet was less than 99mTc-sestamibi Enet at 3, 5, and 10 min. Acidemia decreased 201Tl and 99mTc-sestamibi Enet at 3, 5, and 10 min but had no effect on 99mTc-Q12 Enet. It is concluded that Emax of 99mTc-Q12 is less than that of 201Tl but is not different from that of 99mTc-sestamibi. Enet of 99mTc-Q12 is less than that of 99mTc-sestamibi.

  17. Comparison of 8-frame and 16-frame thallium-201 gated myocardial perfusion SPECT for determining left ventricular systolic and diastolic parameters.

    Science.gov (United States)

    Kurisu, Satoshi; Sumimoto, Yoji; Ikenaga, Hiroki; Watanabe, Noriaki; Ishibashi, Ken; Dohi, Yoshihiro; Fukuda, Yukihiro; Kihara, Yasuki

    2017-07-01

    The myocardial perfusion single photon emission computed tomography synchronized with the electrocardiogram (gated SPECT) has been widely used for the assessment of left ventricular (LV) systolic and diastolic functions using Quantitative gated SPECT. The aim of this study was to compare the effects of 8-frame and 16-frame thallium-201 (Tl-201) gated SPECT for determining LV systolic and diastolic parameters. The study population included 42 patients with suspected coronary artery disease who underwent gated SPECT by clinical indication. LV systolic and diastolic parameters were assessed on 8-frame and 16-frame gated SPECT. There were good correlations in end-diastolic volume (r = 0.99, p < 0.001), end-systolic volume (ESV) (r = 0.97, p < 0.001) and ejection fraction (EF) (r = 0.95, p < 0.001) between 8-frame and 16-frame gated SPECT. Bland-Altman plot showed a significant negative slope of -0.08 in EDV indicating a larger difference for larger EDV. Eight-frame gated SPECT overestimated ESV by 2.3 ml, and underestimated EF by -4.2% than 16-frame gated SPECT. There were good correlations in peak filling rate (PFR) (r = 0.87, p < 0.001), one third mean filling rate (r = 0.87, p < 0.001) and time to PFR (r = 0.61, p < 0.001) between 8-frame and 16-frame gated SPECT. Eight-frame gated SPECT underestimated PFR by -0.22 than 16-frame gated SPECT. Eight-frame gated SPECT estimated as much MFR/3 and TPFR as 16-frame gated SPECT. According to the data, the study suggested that 8-frame Tl-201 gated SPECT could underestimate systolic and/or diastolic parameter when compared with 16-frame gated SPECT.

  18. Scintigraphic supervision of osteitis

    International Nuclear Information System (INIS)

    Manigault, L.; Sureau, B.; Wioland, M.; Perez, R.

    1975-01-01

    On the assumption that isotopic examinations of the bone metabolism and especially the scintigraphic method could give valuable results in the observation of osteitis patients treated with antibiotics, four cases of this disease were selected and followed regularly every three or four months for at least a year. Several bone scintigraphs were carried out with a scintillation camera after intraveinous injection of technetium-labelled pyrophosphate and the hyperfixation variations of the osteitis centre are given as a function of time. It is shown that bone scintigraphy gives an exact picture of the dimensions and morphology of lesions caused by an osteitis centre and above all, if repeated, enables the development of the infected region to be estimated. It seems that the healing of osteitis can be judged from scintigraphic evidence. Scintigraphy may be considered as a means to check the efficiency of an antibiotic treatment [fr

  19. Process for producing thallium-201

    International Nuclear Information System (INIS)

    Ageev, V.A.; Kljucnikov, A.A.; Linev, A.F.; Chalkin, V.A.; Zajceva, N.G.

    1985-01-01

    A storage plate of pure Pb-206 enriched up to 95% is irradiated with a 50 to 70 MeV proton beam. The plate is then dissolved in acid, and the Th-201 contained in the solution is oxydated and precipitated from the Pb solution. Traces of Pb retained in the solution are separated from the Th-201 by cation exchange, and the Th-201 is eluated using hydrochloric acid. (orig./PW) [de

  20. Characteristics of images of angiographically proven normal coronary arteries acquired by adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ[Symbol: see text]SPECT with CT attenuation correction changed stepwise.

    Science.gov (United States)

    Takahashi, Teruyuki; Tanaka, Haruki; Kozono, Nami; Tanakamaru, Yoshiki; Idei, Naomi; Ohashi, Norihiko; Ohtsubo, Hideki; Okada, Takenori; Yasunobu, Yuji; Kaseda, Shunichi

    2015-04-01

    Although several studies have shown the diagnostic and prognostic value of CT-based attenuation correction (AC) of single photon emission computed tomography (SPECT) images for diagnosing coronary artery disease (CAD), this issue remains a matter of debate. To clarify the characteristics of CT-AC SPECT images that might potentially improve diagnostic performance, we analyzed images acquired using adenosine-stress thallium-201 myocardial perfusion SPECT/CT equipped with IQ[Symbol: see text]SPECT (SPECT/CT-IQ[Symbol: see text]SPECT) from patients with angiographically proven normal coronary arteries after changing the CT attenuation correction (CT-AC) in a stepwise manner. We enrolled 72 patients (Male 36, Female 36) with normal coronary arteries according to findings of invasive coronary angiography or CT-angiography within three months after a SPECT/CT study. Projection images were reconstructed at CT-AC values of (-), 40, 60, 80 and 100 % using a CT number conversion program according to our definition and analyzed using polar maps according to sex. CT attenuation corrected segments were located from the mid- and apical-inferior spread through the mid- and apical-septal regions and finally to the basal-anterior and basal- and mid-lateral regions in males, and from the mid-inferior region through the mid-septal and mid-anterior, and mid-lateral regions in females as the CT-AC values increased. Segments with maximal mean counts shifted from the apical-anterior to mid-anterolateral region under both stress and rest conditions in males, whereas such segments shifted from the apical-septal to the mid-anteroseptal region under both stress and rest conditions in females. We clarified which part of the myocardium and to which degree CT-AC affects it in adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ[Symbol: see text]SPECT images by changing the CT-AC value stepwise. We also identified sex-specific shifts of segments with maximal mean counts that changed as

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-04-01

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

  2. Correlation of regional wall motion and fatty acid metabolism in coronary artery disease, hypertension, and hypertrophic cardiomyopathy; Assessment by dual-isotope SPECT with thallium-201 and iodine-123 [beta]-methyl fatty acid analogue

    Energy Technology Data Exchange (ETDEWEB)

    Hase, Mamoru; Nakata, Tomoaki; Yonekura, Shuji (Sapporo Medical Coll. (Japan)) (and others)

    1993-05-01

    In order to investigate the correlation between cardiac fatty acid metabolism and regional wall motion, dual-isotope tomography using thallium-201 and iodine-123 labeled 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP), was performed in 15 patients with coronary artery disease (CAD), hypertension, or hypertrophic cardiomyopathy (HCM). The uptake of thallium and BMIPP was scored and compared with left ventricular regional wall motion assessed by 2-dimensional echocardiography and radionuclide ventriculography. The incidence of a complete agreement of thallium and BMIPP scores was significantly higher in hypertension (64%) and CAD (63%) groups compared to HCM patients (24%), while a lower BMIPP uptake compared to that of thallium (mismatching) was observed more frequently in HCM (65%) than in hypertension (31%) or CAD (33%). Only 3 infarct patients had regional wall motion abnormality which was detected in 20 (95%) of 21 segments with a low BMIPP uptake. Furthermore, compared to thallium perfusion, decreased BMIPP uptake much more corresponded to reduced wall motion in 8 of 11 segments with mismatching. Thus, metabolic abnormality assessed by BMIPP is well associated with asynergy in CAD patients, whereas the discrepancy of fatty acid metabolism and contraction is more dominant in HCM, suggesting that the combined assessment of thallium perfusion, BMIPP uptake, and regional wall motion might contribute to better understanding of the pathogenesis of various cardiac disorders. (author).

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

    International Nuclear Information System (INIS)

    Koitabashi, Norimichi; Toyama, Takuji; Hoshizaki, Hiroshi

    2000-01-01

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

  4. Fatty acid metabolic and perfusion abnormalities in hypertrophied myocardium assessed by dual tracer tomography using thallium-201 and iodine-123-beta-methylpentadecanoic acid

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Hiroshi; Nakata, Tomoaki; Han, Shizui (Sapporo Medical Coll. (Japan)) (and others)

    Fatty acid and perfusion abnormalities associated with cardiac hypertrophy were investigated using dual tracer tomography with thallium and a cardiac metabolic tracer, 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP), in eight patients with hypertrophic cardiomyopathy (HCM) and in three with hypertension (HT). Thallium and BMIPP uptakes were scored and analyzed in 143 segments (13/heart) by comparison with the left ventricular wall thickness measured by two dimensional echocardiography. Complete agreement of both scores in HT patients was significantly higher than that in HCM patients (64% vs 24%, p<0.001), while a lower BMIPP uptake compared to that of thallium (mismatching) was observed more frequently in HCM than in HT patients (65% vs 31%, p<0.001). The wall thickness significantly (p<0.005) correlated with BMIPP uptake score. HCM patients showed a low BMIPP uptake in 22 hypertrophic segments (59%) and 15 non-hypertrophic segments (41%), and reduced BMIPP uptake in 29% hypertrophic segments, while HT patients showed just five segments with decreased BMIPP uptake of which 4 were non-hypertrophic and only one hypertrophic. The left ventricular ejection fraction assessed by radionuclide ventriculography was normal and no regional wall motion abnormality was detected in any patient by echocardiographic and scintigraphic studies. Metabolic abnormalities detected by the iodine-123-beta-methyl fatty acid analog in hypertrophic cardiomyopathy may be independent of thallium myocardial perfusion, regional wall motion, or the magnitude of cardiac hypertrophy, suggesting that fatty acid imaging may be useful in investigating the pathogenesis and subclinical abnormality of hypertrophic cardiomyopathy, and differentiation from secondary, induced cardiac hypertrophy. (author).

  5. Impact of metabolic syndrome and diabetes mellitus on cardiovascular events in coronary artery disease without ischemia on stress thallium-201 single photon emission computed tomography after percutaneous coronary intervention

    International Nuclear Information System (INIS)

    Mori, Takao; Ohashi, Yoshitaka; Ejiri, Junya; Takatsuki, Kiyonobu; Ichikawa, Shinobu; Awano, Kojiro

    2005-01-01

    The metabolic syndrome defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) is a predictor of cardiovascular events. However, the significance of metabolic syndrome for cardiovascular events has been not clarified in Japan. The impact of metabolic syndrome and diabetes mellitus on cardiovascular events was investigated, especially in the high risk group after percutaneous coronary intervention. We studied 456 patients (mean age 63±10 years, range 36-88 years) without ischemia on stress thallium-201 single photon emission computed tomography after percutaneous coronary intervention. The diagnosis of metabolic syndrome was made according to the modified NCEP ATP III criteria. Cardiovascular events were examined for mean 3.7±1.8 years (range 2.0-8.7 years). There were 196 patients without diabetes mellitus or metabolic syndrome (Group D-M-), 89 patients without diabetes mellitus but with metabolic syndrome (Group D-M+), 61 patients with diabetes mellitus but without metabolic syndrome (Group D+M-), and 110 patients with both diabetes mellitus and metabolic syndrome (Group D+M+). The event-free survival curve in Group D-M+ was significantly lower than that in Group D-M- (p<0.05), but not different from that in Group D+M-. The survival curve was markedly lower in Group D+M+ than that in Group D-M+ (p<0.005). The Cox proportional hazard model revealed that diabetes mellitus and metabolic syndrome were independent significant risk factors for events. The diagnosis of metabolic syndrome was helpful for identification of patients with high cardiovascular event rate even in patients after percutaneous coronary intervention. The combination of metabolic syndrome and diabetes mellitus markedly increases the risk for cardiovascular events. (author)

  6. Diagnosis of coronary artery disease by thallium-201 myocardial scintigraphy with intravenous infusion of SUNY4001 (adenosine) in effort angina pectoris. The clinical trial report at multi-center. Phase II

    International Nuclear Information System (INIS)

    Sakata, Yasushi; Kodama, Kazuhisa; Nishimura, Tsunehiko; Kajiya, Teishi; Kato, Kazuzo

    2004-01-01

    Forty-four patients with effort angina pectoris were evaluated with SUNY4001 (adenosine) thallium-201 ( 201 Tl) myocardial scintigraphy to detect coronary artery disease. These patients had single-vessel disease (≥American Heart Association (AHA) 90% stenosis) in either right coronary artery (RCA) or left anterior descending (LAD). Adenosine was infused at the rate of 120 or 140 μg/kg/min for six minutes. One hundred eleven MBq of 201 Tl was injected after three minutes of the start of the infusion. The early and delayed images were obtained by SPECT imaging. The sensitivity was 94.7% at 120 μg/kg/min and 84.2% at 140 μg/kg/min. Adenosine 201 Tl myocardial scintigraphy showed high accuracy for detecting significant coronary artery disease. Adverse reactions occurred in 77.3% of the patients. Regarding the rates of the adverse reactions, there was no significant difference between 120 and 140 μg/kg/min. Major adverse reactions were Chest pain/discomfort (52.3%) and Flushing/Feeling of warmth (27.3%). No serious complication was observed at any infusion rate. Most of adverse reactions disappeared shortly. Only two patients required treatment for moderate chest pain, which, however, disappeared in several minutes. One of the treatments was merely the termination of adenosine infusion, and the other was sublingual spray of nitroglycerin. Adenosine infusion caused slight decrease in blood pressure and increase in heart rate. The hemodynamic changes resolved within several minutes after the adenosine infusion. Decrease in systolic blood pressure of more than 20 mmHg from the base level occurred in 26.1% and 52.4% at 120 and 140 μg/kg/min infusion rate respectively. Therefore, the adenosine infusion at 120 μg/kg/min should be considered safe and useful for the diagnosis of coronary artery disease by pharmacologic stress imaging. (author)

  7. Identification of advanced coronary artery disease with exercise myocardial perfusion imaging: the clinical value of a novel approach for assessing lung thallium-201 uptake

    Energy Technology Data Exchange (ETDEWEB)

    Moralidis, Efstratios [Hippokration Hospital, Nuclear Medicine Department, Thessaloniki (Greece); Hippokration Medical Center, Larissa (Greece); Spyridonidis, Tryfon [Hippokration Medical Center, Larissa (Greece); Arsos, Georgios [Hippokration Hospital, Nuclear Medicine Department, Thessaloniki (Greece); Anagnostopoulos, Constantinos [Royal Brompton Hospital, Nuclear Medicine Department, London (United Kingdom)

    2007-04-15

    The precise clinical utility of lung{sup 201}Tl uptake in exercise SPECT myocardial perfusion imaging remains open to research. This study validates an optimal index for lung{sup 201}Tl uptake measurement and assesses its value in the prediction of higher-risk coronary artery disease (CAD). Three hundred and ninety-eight patients underwent exercise SPECT myocardial perfusion imaging. They were separated into derivation (n = 217) and validation (n = 186) groups, both including sub-populations of lower- and higher-risk CAD, according to coronary angiography. Another 56 individuals with a low probability of CAD comprised the control group. From a planar, anterior, post-exercise acquisition, the lung (L) to heart (H) maximal (L/H{sub max}), total (L/H{sub mean}) and background-subtracted total (L/H{sub net}) ratios were calculated. These were also adjusted for confounding variables, as assessed from the control group. ROC analysis was used to compare the L/H ratios and define thresholds of abnormality. The performance of the optimal index was assessed in the derivation group and was then tested in the validation population. Subsequently, it was compared with other scintigraphic, exercise electrocardiography and clinical variables. In the derivation group L/H{sub net} was a better discriminator for higher-risk CAD than both L/H{sub max} and L/H{sub mean}. Similarly, the adjusted L/H{sub net} was a better discriminator than both the adjusted L/H{sub max} and the adjusted L/H{sub mean}. No significant difference was attained between L/H{sub net} and the adjusted L/H{sub net}. At the upper defined threshold of abnormality, sensitivity and specificity of L/H{sub net} in the detection of higher-risk CAD in the derivation and the validation cohorts were 52% and 92% versus 47% and 94%, respectively (p = ns). The results were similar at other defined thresholds. Moreover, L/H{sub net} was found to be a significant predictor of higher-risk CAD, superior to myocardial perfusion

  8. Reflex sympathetic dystrophy in the hands: clinical and scintigraphic criteria

    Energy Technology Data Exchange (ETDEWEB)

    Holder, L.E.; Mackinnon, S.E.

    1984-08-01

    In an attempt to establish specific scintigraphic criteria for the reflex sympathetic dystrophy syndrome (RSD) as defined by a group of specialized hand surgeons, 145 consecutive patients, 23 of whom had clinical RSD, underwent three phase radionuclide bone scanning (TPBS). Specific patterns for positive radionuclide angiogram, blood pool, and delayed images were established. The delayed images were sensitive (96%), specific (97%), and had a valuable negative predictive value (99%). It was concluded that TPBS could provide an objective marker for RSD.

  9. The scintigraphic investigation of sacroiliac disease.

    Science.gov (United States)

    Lentle, B C; Russell, A S; Percy, J S; Jackson, F I

    1977-06-01

    Bone scintigraphs obtained with both Technetium-99m polyphosphate and Technetium-99m pyrophosphate have been abnormal at the sacroiliac joints of 44 patients with definite ankylosing spondylitis (AS). Because of the normal registration of the sacroiliac joints on bone scintigraphy, it has been necessary to develop a profile-scan technique to quantify the abnormality that proves to be significantly different from the normal finding. In 17 patients with a strong clinical suspicion of AS but normal radiographs, the sacroiliac joints have frequently been abnormal. This finding is meaningful because there is a common occurence in this group of the histocompatibility antigen HL A-B27, known to be a marker of AS. We also note the frequency of abnormal sacroiliac scinitigrams in 26 patients with rheumatoid arthritis and in a group of other diseases-Crohn's disease, uveitis, psoriasis, ulcerative colitis, and Reiter's disease-all of which share some of the manifestations of AS.

  10. Usefulness of lung and right ventricular thallium-201 uptake during single photon emission computed tomography in exercise testing of patients with coronary artery disease

    International Nuclear Information System (INIS)

    Matoh, Fumitaka; Tawarahara, Kei; Mikami, Naoshi

    2005-01-01

    Increased pulmonary or right ventricular 201 Tl uptake during the exercise test has been used as a marker of multivessel coronary artery disease. The most useful method for assessing the severity of coronary artery disease was evaluated among conventional evaluation of single photon emission computed tomography (SPECT), measurement of lung to heart uptake ratio (L/H), and right ventricular to left ventricular uptake ratio (RV/LV) on 201 Tl images during exercise testing. Regions-of-interest (4 x 4 pixels) were placed at the lung and the heart, and L/H was defined as mean lung uptake/mean heart uptake. Correspondingly, regions-of-interest (4 x 4 pixels) were placed at the RV and the LV, and RV/LV was defined as maximum RV uptake/maximum LV uptake. L/H and RV/LV on the initial image were analyzed in 216 patients (angiographically normal coronary arteries: 89, single-vessel disease: 82, multivessel disease: 45). The diagnostic value was evaluated using the receiver operating characteristic curve. All methods showed significantly higher values in patients with multivessel disease than in patients with no coronary artery disease or single-vessel disease. L/H was significantly higher in patients with prior myocardial infarction and RV/LV was significantly higher in patients without infarction. The sensitivity of only conventional SPECT evaluation for multivessel coronary artery disease was low (sensitivity 53%, specificity 94%). However, addition of evaluation of L/H and RV/LV to SPECT improved the sensitivity for multivessel coronary artery disease (sensitivity 93%, specificity 49%). The diagnostic sensitivity for multivessel coronary artery disease was improved by adding L/H and RV/LV to conventional evaluation of exercise 201 Tl SPECT. L/H and RV/LV during exercise 201 Tl imaging may provide additional information regarding the severity of coronary artery disease. (author)

  11. Scintigraphic assessment of double-chambered right ventricle

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei

    1987-01-01

    A double-chambered right ventricle is often clinically misdiagnosed and may be missed even during cardiac catheterization. We encountered a 56-year-old male who had abnormal right ventricular thallium-201 uptake and a photon deficient area in the right ventricle by radionuclide cardioangiography. These findings strongly suggested the existence of anomalous muscle band in the right ventricle. It was demonstrated by contrast angiography that the right ventricle was divided into two chambers by a hypertrophic muscular band; the pressure gradient in the right ventricle was 98 mmHg. (author)

  12. Production of Thallium 201 for medical applications

    International Nuclear Information System (INIS)

    Braghirolli, A.M.S.

    1981-12-01

    With the purpose of producing high purity carrier-free 201 Tl, for medical use, a production and separation method was developed using the CV-28 Cyclotron of the Nuclear Engineering Institute in Rio de Janeiro, Brazil. 201 Pb was produced by 24 MeV proton bombardment of natural Tl and allowed to decay to 201 Tl. In the separation process the target is dissolved in HNO 3 , the 201 Pb produced is separated by Fe(OH) 3 coprecipitation, and the Fe is latter separated by anion exchange. The 201 Pb is permited to decay during 32 hrs. 201 Tl is then separated from remaining Pb by anion exchange. The chemical separation is done in a remote processing cell using manipulators, tongs, electric and pneumatic systems. The thick target yield of 201 Pb is 1.7 mCi/μAhr. At the moment the production is restricted to 4 mCi of 201 Tl for each irradiation. (Author) [pt

  13. Production of thallium 201 for medical use

    International Nuclear Information System (INIS)

    Venikov, N.I.; Konyakhin, N.A.; Kozlova, M.D.; Volkova, N.M.

    1986-01-01

    An important product among the radiopharmaceuticals currently used in cardiology is T1 201 chloride, due to its nuclear-physical properties and its clinical value as a diagnostic tool. The authors explain and discuss the basic characteristics which determine the radiopharmaceutical quality of T1 201: its radiochemical purity and its chemical impurity content, which depend on the target-irradiation conditions - type of nuclear reaction, target material and design, particle energy, irradiation time - and the reprocessing technology. A production flow chart is presented which shows that ions are accelerated within a wide mass and energy range suitable for the production of T1 201 in different nuclear reactions. Cyclotron reconstruction for T1 201 production is discussed

  14. Scintigraphic findings in ankylosing spondylitis.

    Science.gov (United States)

    Lentle, B C; Russell, A S; Percy, J S; Jackson, F I

    1977-06-01

    A prospective study of bone scintigraphic findings has been carried out in 63 patients, firmly diagnosed as having ankylosing spondylitis. In addition to abnormal uptake of the radiotracer at the sacroiliac joints, a peripheral arthropathy has been a common finding, particularly in the proximal joints, occurring in up to 50% of patients. Increased uptake of radiotracer in the spine has also been found both diffusely and focally. Focal increases have been noted at the apophyseal joints in 40% of patients and in three patients with a sterile intervertebral diskitis, an unusual complication of this disease only diagnosed in two patients after bone scintigraphy.

  15. Scintigraphic evaluation of brain death

    International Nuclear Information System (INIS)

    Park, C. H.; Bai, M. S.; Cho, K. K.; Kim, S. J.; Yoon, S. N.; Cho, C. W.

    1997-01-01

    A law recognizing brain death is a life saving legal measure in patients suffering from badly diseased organs such as kidney, liver, heart, and lung. Such law is being discussed for legalization at the Korean National Assembly. There are various criteria used for brain death in western world and brain scintiscan is one of them. However, the scintiscan is not considered in establishing brain death in the draft of the law. The purpose of this report is to spread this technique in nuclear medicine society as well as in other medical societies. We evaluated 7 patients with clinical suspicion of brain death by various causes. The patient's age ranged from 5 to 39 years. We used 5-20mCi 99m Tc-HMPAO (d.1-hexamethyl propylene amine oxime) or ECD (Ethyl Cysteinate Dimer), lipophilic agents that cross BBB (blood brain barrier). A dynamic study followed by static or SPECT (single photon emission tomography) was performed. Interpretive criteria used for brain death were 1) no intracranial circulation 2) no brain uptake. The second criteria is heavily used. Five of 7 patients were scintigraphically brain dead and the remaining 2 had some brain uptake excluding the diagnosis of scintigraphic brain death. In conclusion, cerebral perfusion study using a lipophilic brain tracer offers a noninvasive, rapid, easy, accurate and reliable mean in the diagnosis of brain death. We believe that this modality should be included in the criteria of brain death in the draft of the proposed Korean law

  16. Scintigraphic imaging of endocrine organs

    International Nuclear Information System (INIS)

    Gross, M.D.; Shapiro, B.; Thrall, J.H.; Freitas, J.E.; Beierwaltes, W.H.

    1984-01-01

    The nuclear medicine approach to the portrayal of endocrine organs is unique; the scintigraphic images provide not only anatomic and localization information, but in many instances allow a quantitative assessment of organ function. The ability to image endocrine glands is based upon the design of radionuclides and radiopharmaceuticals with characteristics to take advantage of many unique and specific biochemical and advantage of many unique and specific biochemical and metabolic functions of these tissues. The recent introduction of new radiopharmaceutical and tracers has provided the consulting endocrinologist with imaging procedures that allow localization and functional characterization not available by other single, noninvasive diagnostic modalities. This review will serve as an update of the available techniques to image and quantitate the function of the endocrine glands using the nuclear medicine approach

  17. Scintigraphic And Ultrasonic Determinations of Thyroid Volume

    International Nuclear Information System (INIS)

    Sarsono; Ismanto; Kunto, W; Hayati, N; Irma, S H

    1996-01-01

    A study has been done on the determination of thyroid volume by scintigraphic method in comparison to ultrasonographic technique, which involved a healthy woman volunteer, 5 women patients and a man patient with thyroid diseases. Scintigraphic examination upon the patient's thyroid was performed using a gamma camera 20 minutes following the injection of 55.5 Mbq (1.5 mCi) Tc-99m pertechnetate. A computer, with a dedicated program, coupled to the gamma camera was employed in the calculation of thyroid volume based on the scintigraphic data. Subsequent to the scintigraphic study, ultrasonographic determination of thyroid volume was then carried out. Correlation test that was applied to the outcome of the two methods of thyroid volume determination resulted in an excellent coefficient of correlation, R, which was 0.99. This showed a very good correlation between these two different techniques of thyroid volume determination

  18. Scintigraphic appearance of the piriformis muscle syndrome

    International Nuclear Information System (INIS)

    Karl, R.D. Jr.; Yedinak, M.A.; Hartshorne, M.F.; Cawthon, M.A.; Bauman, J.M.; Howard, W.H.; Bunker, S.R.

    1985-01-01

    This is the first report in the nuclear medicine literature of the scintigraphic appearance of the piriformis muscle syndrome. This syndrome previously has been thought to be a purely clinical diagnosis and imaging modalities have been ignored. However, its confusing clinical presentation can lead to unnecessary surgical exploration. This case is presented to illustrate the characteristic scintigraphic pattern and suggest the role of nuclear medicine scanning in establishing the diagnosis

  19. Reversal of rest myocardial asynergy during exercise: a radionuclide scintigraphic study

    Energy Technology Data Exchange (ETDEWEB)

    Kimchi, A.; Rozanski, A.; Fletcher, C.; Maddahi, J.; Swan, H.J.; Berman, D.S.

    1985-11-01

    While exercise-induced segmental left ventricular wall motion abnormalities are well described, the phenomenon of improvement in certain asynergic segments during exercise in some patients remains a curiosity. To assess this unexpected finding, results were analyzed in 85 patients with wall motion abnormalities at rest who underwent two view exercise radionuclide ventriculography and exercise thallium-201 myocardial perfusion imaging. Wall motion was scored with a 5 point system; normalization or increase of 2 or more points with exercise signified improvement. Forty-eight patients (56%) had no change or further deterioration of wall motion at peak exercise, 15 (18%) showed both improvement of wall motion and deterioration and 22 (26%) showed only improvement of wall motion. Wall motion improvement during exercise was found in 57 (20%) of 279 segments with asynergy at rest. Of these 57 segments improving with exercise, 45 (79%) showed mild and 12 (21%) showed severe asynergy at rest. Only seven segments (12%) were associated with pathologic Q waves. Thallium-201 perfusion was normal in 44 segments (77%) while only 6 segments (11%) had reversible and only 7 (12%) had nonreversible thallium-201 defects. In conclusion segments with abnormal wall motion at rest that show improvement with exercise appear to represent viable nonischemic segments.

  20. [New techniques of scintigraphic imaging].

    Science.gov (United States)

    Chatal, J F

    1990-01-01

    The purpose of scintigraphic imaging is not to explore the morphology of an organ (or its abnormalities) but rather its functional and metabolic characteristics. It is thus important that a molecular structure (e.g., a hormonal receptor or an antigen) closely linked to the functional activity of an organ or tissue be targeted on its cell surface. Such diagnostic targeting requires the synthesis and labeling of a radiopharmaceutical substance specific for the receptor or antigen in question. It also requires a detection system adapted to count rates and signal-to-background ratios (generally moderate). The synthesis of new radiopharmaceutical agents, a critical stage for the future of nuclear medicine, is a long and often risky process in which success is difficult to foresee. Radiolabeling must be stable in vitro and in vivo, and the radiopharmaceutical must subsequently retain its capability of recognizing the targeted molecule. In endocrinology, the exemplary achievement in this direction has been the synthesis of 131I-6-iodomethylnorcholesterol and 131I-metaiodobenzylquanidine for functional scintigraphy of the adrenal cortex and medulla. Progress in detection equipment has been marked by the development of monophotonic tomoscintigraphy, using gamma cameras with a revolving head to obtain slices in different spatial planes showing the distribution in the organism of the injected radiopharmaceutical agent.

  1. Scintigraphic evaluation of pouch function in patients with ulcerative colitis

    DEFF Research Database (Denmark)

    Kjær, Mie Dilling; Simonsen, Jane Angel; Hvidsten, Svend

    scintigraphic intestinal transit time, scintigraphic defecography and any association with QoL, and pouch function. Method A cross-sectional study including 20 patients with ulcerative colitis and an IPAA. Scintigraphic transit time was determined after oral administration of a Tc-99m-labelled omelette...

  2. Scintigraphic Evaluation in Primary Hyperparathyroidism

    International Nuclear Information System (INIS)

    Ghita, S.; Mazilu, C.; Marinescu, G.; Mititelu, R.; Rambu, A.; Murgoci, P.; Codorean, I.

    2006-01-01

    corresponding to those found at bone scan (left femur, right humerus, patellae); another focal uptake in the right shoulder region, visible on the posterior image. Further investigations: US, IRM, CT confirm the presence of tumour and provide precise data regarding the morphology and localization: a tumour of 50/34/25 mm with solid and cystic components and benign features developed in the left anterior cervical space, between trachea, cervical vessels and SCM, in contact with the inferior pole of the left thyroid lobe. CT of right shoulder region confirms the presence of a tumour the right scapula with features consistent with the diagnosis of brown tumour. There is also a tumour developed on the posterior aspect of the right humerus. PTH 1248.0 pg/ml (N 15-65). Minimal surgical intervention tumour ablation, followed by normalization of calcium levels. Histopathology: parathyroid adenoma. Favourable evolution of clinical and laboratory parameters. Discussion. Clinical presentation was unspecific and misleading. Based on the 'metabolic' information, bone scan was able suggest the correct diagnosis and to reorient the entire management of this patient. However, we took into account all data available: benign aspect of bone lesions on Rx, the high number of giant cells of osteoclastic type in the previously assessed tumor were concordant with the diagnostic. The scintigraphic examination with 'metabolic' radiotracer was able to identify the presence of a parathyroid adenoma. Early whole body acquisitions revealed sites of osteitis fibrosa cystica/brown tumours with better accuracy than bone scan. Further investigations were necessary to confirm the presence of tumour and to provide useful data regarding the morphology and localization. Conclusions. Bone scan has to be mandatory in the evaluation of all bone tumours, being a simple diagnostic tool which provides data about the number and localization of bone lesions, but also regarding the metabolic status of the skeleton. The

  3. Markers

    Science.gov (United States)

    Healthy Schools Network, Inc., 2011

    2011-01-01

    Dry erase whiteboards come with toxic dry erase markers and toxic cleaning products. Dry erase markers labeled "nontoxic" are not free of toxic chemicals and can cause health problems. Children are especially vulnerable to environmental health hazards; moreover, schools commonly have problems with indoor air pollution, as they are more densely…

  4. Pharyngeal transit time measured by scintigraphic and biomagnetic method

    International Nuclear Information System (INIS)

    Miquelin, C.A.; Braga, F.J.H.N.; Baffa, O.

    1996-01-01

    A comparative evaluation between scintigraphic and biomagnetic method to measure the pharyngeal transit is presented. Three volunteers have been studied. The aliment (yogurt) was labeled with 9 9 m Technetium for the scintigraphic test and with ferrite for the biomagnetic one. The preliminary results indicate a difference between the values obtained, probably due to the biomagnetic detector resolution

  5. Scintigraphic measurement of regional gut transit in idiopathic constipation

    International Nuclear Information System (INIS)

    Stivland, T.; Camilleri, M.; Vassallo, M.; Proano, M.; Rath, D.; Brown, M.; Thomforde, G.; Pemberton, J.; Phillips, S.

    1991-01-01

    In this study, total gut transit and regional colonic transit in patients with idiopathic constipation were measured scintigraphically. Eight patients with severe constipation were studied, none of whom had evidence of abnormal function of the pelvic floor. 99mTc-radiolabeled Amberlite resin particles with a mixed meal were used to assess gastric emptying and small bowel transit; similar particles labeled with 111In were ingested in a coated capsule that dispersed in the ileocecal region. These were used to quantify colonic transit. Five healthy volunteers were also studied. Two patients showed delayed gastric emptying and two had slow small bowel transit. Seven of the eight patients had slow colonic transit. In five, delay affected the whole colon (pancolonic inertia); in two, transit in the ascending and transverse colon was normal, but solids moved through the left colon slowly. Mean colonic transit was also measured using radiopaque markers; this technique identified the patients with slow transit, as shown by measurements of overall colonic transit by simultaneous scintigraphy. However, estimated transit through the ascending and transverse colons was considerably shorter by the radiopaque marker technique. In conclusion, idiopathic constipation is characterized by either exaggerated reservoir functions of the ascending and transverse colons and/or impairment of propulsive function in the descending colon. Particle size may influence the result of regional colonic transit tests. Transit delays in other parts of the gut suggest that, in some patients, the condition may be a more generalized motor dysfunction

  6. Congenital vascular malformations in scintigraphic evaluation

    International Nuclear Information System (INIS)

    Pilecki, Stanisław; Gierach, Marcin; Gierach, Joanna; Świętaszczyk, Cyprian; Junik, Roman; Lasek, Władysław

    2014-01-01

    Congenital vascular malformations are tumour-like, non-neoplastic lesions caused by disorders of vascular tissue morphogenesis. They are characterised by a normal cell replacement cycle throughout all growth phases and do not undergo spontaneous involution. Here we present a scintigraphic image of familial congenital vascular malformations in two sisters. A 17-years-old young woman with a history of multiple hospitalisations for foci of vascular anomalies appearing progressively in the upper and lower right limbs, chest wall and spleen. A Parkes Weber syndrome was diagnosed based on the clinical picture. Due to the occurrence of new foci of malformations, a whole-body scintigraphic examination was performed. A 12-years-old girl reported a lump in the right lower limb present for approximately 2 years, which was clinically identified as a vascular lesion in the area of calcaneus and talus. Phleboscintigraphy visualized normal radiomarker outflow from the feet via the deep venous system, also observed in the superficial venous system once the tourniquets were released. In static and whole-body examinations vascular malformations were visualised in the area of the medial cuneiform, navicular and talus bones of the left foot, as well as in the projection of right calcaneus and above the right talocrural joint. People with undiagnosed disorders related to the presence of vascular malformations should undergo periodic follow-up to identify lesions that may be the cause of potentially serious complications and to assess the results of treatment. Presented scintigraphic methods may be used for both diagnosing and monitoring of disease progression

  7. Dynamic scintigraphic studies after oesophageal reconstruction

    International Nuclear Information System (INIS)

    Maliska, C.M.; Maliska, C.; Pinto, E.; Castro, L.; Fonseca, L.B.E; Miranda, M.

    1997-01-01

    Full text: We have studied the oesophageal transit and gastric emptying in the monitoring of the effect of oesophageal reconstruction surgery. Oncologic patients were evaluated after oesophageal reconstruction surgery with gastric (14 patients) or colonic (5 patients) tube and they were compared with 15 healthy volunteers, using scintigraphic method with liquid food (S-colloid-Tc99m). In the oesophageal transit studies there were no significant statistical differences among the three groups, when we have just considered to two superior (of the three) segments, as oesophagus, showing that the distal neo-tube works just like the stomach of normal volunteers

  8. Serendipity in scintigraphic gastrointestinal bleeding studies

    International Nuclear Information System (INIS)

    Goergen, T.G.

    1983-01-01

    A retrospective review of 80 scintigraphic bleeding studies performed with Tc-99m sulfur colloid or Tc-99m labeled red blood cells showed five cases where there were abnormal findings not related to bleeding. In some cases, the abnormalities were initially confused with bleeding or could obscure an area of bleeding, while in other cases, the abnormalities represented additional clinical information. These included bone marrow replacement related to tumor and radiation therapy, hyperemia related to a uterine leiomyoma and a diverticular abscess, and a dilated abdominal aorta (aneurysm). Recognition of such abnormalities should prevent an erroneous diagnosis and the additional information may be of clinical value

  9. Serendipity in scintigraphic gastrointestinal bleeding studies

    Energy Technology Data Exchange (ETDEWEB)

    Goergen, T.G.

    1983-09-01

    A retrospective review of 80 scintigraphic bleeding studies performed with Tc-99m sulfur colloid or Tc-99m labeled red blood cells showed five cases where there were abnormal findings not related to bleeding. In some cases, the abnormalities were initially confused with bleeding or could obscure an area of bleeding, while in other cases, the abnormalities represented additional clinical information. These included bone marrow replacement related to tumor and radiation therapy, hyperemia related to a uterine leiomyoma and a diverticular abscess, and a dilated abdominal aorta (aneurysm). Recognition of such abnormalities should prevent an erroneous diagnosis and the additional information may be of clinical value.

  10. Scintigraphic defecography in various anorectal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Ishii, Yuji; Oya, Masatoshi; Ishikawa, Hiroshi [Dokkyo Univ., School of Medicine, Saitama (Japan). Koshigaya Hospital

    1998-04-01

    Scintigraphic defecography was performed using {sup 99m}Tc-DATA to quantitatively evaluate defecation in 26 patients after low anterior resection of rectal cancer (LAP-group), 19 patients with chronic constipation (C-group), 11 patients with miscellaneous anal symptoms (AN-group), and 12 normal volunteers. After introducing semi-solid artificial stool containing {sup 99m}Tc-DTPA into the rectum, right lateral images of the anorectum were serially obtained during voluntary evacuation. From the time activity curve of the whole rectum, the half emptying time (T1/2) and the percentage of rectal evacuation (evacuation ratio) were calculated. Three abnormal patterns were identified: the flat type in which a temporary elevation of the RI activity, usually recorded in normal volunteers at the beginning of evacuation, was not recorded; the slow type in which T1/2 was over 20 seconds; and the poor evacuation type in which evacuation ratio was less than 80%. In the LAR-group, all the patients having very low anastomosis showed abnormal patterns irrespective of the type of reconstruction (straight or colonic J-pouch). In the C-group, 10 patients who had either slow pattern or poor evacuation pattern were suggested to have outlet obstruction. In the AN-group, the evacuation pattern differed from patient to patient. Scintigraphic defecography is useful in identifying abnormal evacuation in various anorectal disorders. (author)

  11. Scintigraphic defecography in various anorectal disorders

    International Nuclear Information System (INIS)

    Ishii, Yuji; Oya, Masatoshi; Ishikawa, Hiroshi

    1998-01-01

    Scintigraphic defecography was performed using 99m Tc-DATA to quantitatively evaluate defecation in 26 patients after low anterior resection of rectal cancer (LAP-group), 19 patients with chronic constipation (C-group), 11 patients with miscellaneous anal symptoms (AN-group), and 12 normal volunteers. After introducing semi-solid artificial stool containing 99m Tc-DTPA into the rectum, right lateral images of the anorectum were serially obtained during voluntary evacuation. From the time activity curve of the whole rectum, the half emptying time (T1/2) and the percentage of rectal evacuation (evacuation ratio) were calculated. Three abnormal patterns were identified: the flat type in which a temporary elevation of the RI activity, usually recorded in normal volunteers at the beginning of evacuation, was not recorded; the slow type in which T1/2 was over 20 seconds; and the poor evacuation type in which evacuation ratio was less than 80%. In the LAR-group, all the patients having very low anastomosis showed abnormal patterns irrespective of the type of reconstruction (straight or colonic J-pouch). In the C-group, 10 patients who had either slow pattern or poor evacuation pattern were suggested to have outlet obstruction. In the AN-group, the evacuation pattern differed from patient to patient. Scintigraphic defecography is useful in identifying abnormal evacuation in various anorectal disorders. (author)

  12. Scintigraphic determination of gastrointestinal transit times. A comparison with breath hydrogen and radiologic methods

    DEFF Research Database (Denmark)

    Madsen, J L; Larsen, N E; Hilsted, J

    1991-01-01

    A scintigraphic method for determination of gastrointestinal transit times was compared with the breath hydrogen test and a multiple-bolus, single-radiograph technique. A close temporal association was found between the caecal appearance of radioactivity and the onset of breath hydrogen excretion...... in eight healthy subjects. Neither mean small-intestinal nor mean orocaecal transit times of the radiolabelled marker were correlated with the magnitude of hydrogen peak, hydrogen peak time, or the area under hydrogen curve. No correlation was noted between whole-gut transit time of the radiolabelled...... marker and mean whole-gut transit time calculated from a 6-day administration of the radiopaque marker in 16 healthy subjects. The stool weight was inversely correlated with the mean colonic (r = -0.46, p = 0.009) and the mean whole-gut (r = -0.45, p = 0.011) transit times of the radiolabelled marker...

  13. Sequential scintigraphic staging of small cell carcinoma

    International Nuclear Information System (INIS)

    Bitran, J.D.; Bekerman, C.; Pinsky, S.

    1981-01-01

    Thirty patients with small cell carcinoma (SCC) of the lung were sequentially staged following a history and physical exam with liver, bran, bone, and gallium-67 citrate scans. Scintigraphic evaluation disclosed 7 of 30 patients (23%) with advanced disease, stage IIIM1. When Gallium-67 scans were used as the sole criteria for staging, they proved to be accurate and identified six of the seven patients with occult metastatic disease. Gallium-67 scans proved to be accurate in detecting thoracic and extrathoracic metastases in the 30 patients with SCC, especially within the liver and lymph node-bearing area. The diagnostic accuracy of gallium-67 fell in regions such as bone or brain. Despite the limitations of gallium-67 scanning, the authors conclude that these scans are useful in staging patients with SCC and should be the initial scans used in staging such patients

  14. Liver scintigraphic features associated with alcoholism

    International Nuclear Information System (INIS)

    Drum, D.E.; Beard, J.O.

    1978-01-01

    The relationships between scintigraphic features and clinical alcoholism were studied by review of 2406 liver scintiphotos. Two distinct patterns were significantly associated with alcoholism: heterogeneous distribution of radiocolloid in the liver, and jointly increased uptake of tracer by the spleen and vertebral bone marrow. A total of 13 overall patterns were found to distinguish, with considerable reliability, alcoholics from all other patients. This finding reflects the frequency with which alcohol abuse is associated with hepatic dysfunction in hospital patients. These observations indicate an important role for the nuclear medicine physician in detection of alcoholism among patients referred for liver-spleen imaging, and they form a basis for comparison with the diagnostic efficacy of other methods of evaluating diffuse liver diseases

  15. Unusual scintigraphic pattern in sickle cell patients

    Energy Technology Data Exchange (ETDEWEB)

    Glaser, A.M.; Chen, D.C.P.; Siegel, M.E.; Norris, S.L.; Haywood, L.J.

    1989-07-01

    We reviewed the nuclear medicine files of all patients enrolled in the sickle cell disease clinic who had had scans performed within the previous 5 years. We specifically looked for patterns of tracer uptake in these scans that would correlate with the severe anemia and consequent bone marrow hyperactivity of sickle cell patients. Thirty-three patients were included (21 men and 12 women) with a mean age of 26.8 years (range 17-48 years). The appearance of each of these patients' most recent scans was examined in the areas of the distal femurs, the proximal tibias and the distal tibias; a distinct triangular shaped pattern of increased activity was identified in these areas in a majority of patients. Thirty-three patients without sickle cell disease served as age-matched controls. This pattern was seen in 65.1% (95 out of 146 images) of the sickle cell patients' delayed images and 80.4% (82 out of 102 images) of their blood pool images. In contrast, the control patients demonstrated the triangular pattern in none of their blood pool studies (0%) and only 10.9% of their delayed bone images (P<0.001). The mean age of sickle cell patients with this pattern is 25.6 years which was significantly lower than that of those without this pattern (mean=37.5 years, P<0.05). Given the high prevalence of this unique scintigraphic pattern in a group of patients with known accelerated bone marrow function, these findings may be scintigraphic evidence of bone marrow expansion. The patient's age appears to be an important factor in visualization of this pattern.

  16. Thallium-201 accumulation in cerebral candidiasis: Unexpected finding on SPECT

    International Nuclear Information System (INIS)

    Tonami, N.; Matsuda, H.; Ooba, H.; Yokoyama, K.; Hisada, K.; Ikeda, K.; Yamashita, J.

    1990-01-01

    The authors present an unexpected finding of Tl-201 uptake in the intracerebral lesions due to candidiasis. SPECT demonstrated the extent of the lesions and a high target-to-background ratio. The regions where abnormal Tl-201 accumulation was seen were nearly consistent with CT scans of those enhanced by a contrast agent. After treatment, most of the abnormal Tl-201 accumulation disappeared

  17. Thallium-201 accumulation in cerebral candidiasis: Unexpected finding on SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tonami, N.; Matsuda, H.; Ooba, H.; Yokoyama, K.; Hisada, K.; Ikeda, K.; Yamashita, J. (Kanazawa Univ. (Japan))

    1990-06-01

    The authors present an unexpected finding of Tl-201 uptake in the intracerebral lesions due to candidiasis. SPECT demonstrated the extent of the lesions and a high target-to-background ratio. The regions where abnormal Tl-201 accumulation was seen were nearly consistent with CT scans of those enhanced by a contrast agent. After treatment, most of the abnormal Tl-201 accumulation disappeared.

  18. Clinical value of thallium 201 in a cardiology service

    International Nuclear Information System (INIS)

    Picard, J.-C.

    1979-01-01

    At present the most widely used element in isotopic cardiology is undoubtedly 201 Tl. In the few years since its appearance many publication testify to its growing use in the external detection of coronary thrombosis, the discovery of ischemia exertion, the non-traumatic observation of patients after an aortocoronary bridging operation, the diagnosis of coronary deficiency associated with another heart disease (aorta narrowing, mitral prolapsus, obstructive cardiomyopathy) and in combination with two other radioisotopic methods. The present work is intended as a modest contribution, still very recent, to the critical study of this new technique in all its present aspects. Part one presents the various characteristics responsible for the advantages and limits of 201 Tl, then describes the techniques and apparatus used. The production, dosimetry, toxicity and biological behaviour of 201 Tl are also discussed. A hundred and twenty-five examinations were performed in the Nuclear Medicine Service of the Limoges UHC between May 1977 and October 1978. The results are analysed in part two. This is followed by a discussion which attempts, in the light of our experience, to situate the place occupied by 201 Tl in the range of complementary examinations useful in declared or assumed coronary cases. We then propose an examination procedure and precise indications we believe to be justified, accounting for economic problems before considering the future prospects of myocardium scintigraphy [fr

  19. Effect of exercise supplementation on dipyridamole thallium-201 image quality

    International Nuclear Information System (INIS)

    Stern, S.; Greenberg, I.D.; Corne, R.

    1991-01-01

    To determine the effect of different types of exercise supplementation on dipyridamole thallium image quality, 78 patients were prospectively randomized to one of three protocols: dipyridamole infusion alone, dipyridamole supplemented with isometric handgrip, and dipyridamole with low-level treadmill exercise. Heart-to-lung, heart-to-liver, and heart-to-adjacent infradiaphragmatic activity ratios were generated from anterior images acquired immediately following the test. Additionally, heart-to-total infradiaphragmatic activity was graded semiquantitatively. Results showed a significantly higher ratio of heart to subdiaphragmatic activity in the treadmill group as compared with dipyridamole alone (p less than 0.001) and dipyridamole supplemented with isometric handgrip exercise (p less than 0.001). No significant difference was observed between patients receiving the dipyridamole infusion, and dipyridamole supplemented with isometric handgrip exercise. The authors conclude that low-level treadmill exercise supplementation of dipyridamole infusion is an effective means of improving image quality. Supplementation with isometric handgrip does not improve image quality over dipyridamole alone

  20. A comparison of the clinical relevance of thallium201 and ...

    African Journals Online (AJOL)

    The myocardial distribution of 201TI and 99mTc_MIBI was compared in a group of 20 patients, who underwent both 201TI single photon emission computed tomography and 99mTc_MIBI study as well as coronary angiography. The sensitivity for predicting a lesion ranged from 25% to 88% in different areas of the heart and ...

  1. Redistribution of thallium-201 into right ventricle through collateral circulation

    International Nuclear Information System (INIS)

    Kataoka, Hajime; Ohkubo, Toshitaka; Takaoka, Shigeru; Ohshige, Tamao; Miyahara, Kenkichi.

    1984-01-01

    The cases of reversible right ventricular ischemia, which demonstrated redistribution of thallium (Tl)-201 into the right ventricular free wall (RVFW) through collateral channels, were reported. Two cases with complete obstruction in the proximal right coronary artery accompanied by collateral channels (left coronary artery to distal right coronary artery) underwent submaximal exercise stress Tl-201 myocardial imaging. Although the RVFW was not visualized on immediate myocardial images in one or both of the 30 0 and 60 0 left anterior oblique views in each case, three-hour delayed myocardial images showed redistribution of Tl-201 into the RVFW. It was concluded that collateral circulation affects the occurrence of redistribution of Tl-201 into the RVFW. (author)

  2. Uptake of thallium-201 in enlarged thyroid glands. Concise communication

    International Nuclear Information System (INIS)

    Fukuchi, M.; Kido, A.; Hyodo, K.; Tachibana, K.; Onoue, K.; Morita, T.; Nagai, K.

    1979-01-01

    We have investigated the thyroid uptake of Tl-201 in 37 patients with various types of goiter, and in six with normal thyroids. Significant thallium uptake was found in all cases in which there was thyroid enlargement, including Graves' disease, toxic thyroid nodule, primary hypothyroidism, simple goiter, Hashimoto's disease, thyroid carcinoma, and thyroid adenoma. If goiter was absent, however, there was no demonstrable uptake - e.g., in secondary hypothyroidism, subacute thyroiditis, and the normal controls. Thallium uptake did not correlate with thyroid function tests such as BMR, T 3 -RU, T 3 , T 4 , TSH, antithyroid antibodies, or the 24-hr I-131 uptake. In 23 patients with diffuse goiter, on the other hand, maximum Tl-201 uptake correlated well with thyroid weight: r = 0.836 (p < 0.001); y = 0.02 x + 0.06

  3. Intravenous dipyridamole thallium-201 SPECT imaging methodology, applications, and interpretations

    International Nuclear Information System (INIS)

    Rockett, J.F.; Magill, H.L.; Loveless, V.S.; Murray, G.L.

    1990-01-01

    Dipyridamole TI-201 imaging is an ideal alternative to exercise TI-201 scintigraphy in patients who are unwilling or unable to perform maximum exercise stress. The use of intravenous dipyridamole, alone or in combination with exercise, has not been approved for clinical practice by the Food and Drug Administration. Once approval is granted, the test will become a widely used and important component of the cardiac work-up. The indications, methodology, side effects, and utility of dipyridamole cardiac imaging in the clinical setting are discussed and a variety of examples presented.59 references

  4. Detecting thyroid cancer: utopia or reality; possibilities for thallium 201

    International Nuclear Information System (INIS)

    Hermans, J.; Beauduin, M.; Gigot, J.F.; Schmitz, A.

    1986-01-01

    Faced with a diagnosis of cold thyroid nodule as evidenced by routine scintigraphy, the clinician has to determine whether this nodule is malignant or not. This is a serious problem since, according to literature, 7-20 per cent of cold thyroid nodules are malignant. In 1982 some Japanese authors demonstrated the possibility of using 201 T1 in diagnosing thyroid tumors. This study refers to 120 patients who underwent an operation for thyroid disorders characterized by the presence of one or several cold nodules (as evaluated with conventional scintigraphy) and enables a comparison between a thorough evaluation of the thyroidal status and the 201 T1 scintigrams. These were obtained with a gamma-camera using a pinhole collimator. If a cold nodule is positive with 201 T1, surgery is incontestably indicated, as such a finding correlates with the existence of a thyroid tumor (benign follicular adenoma or carcinoma) in 89.5 per cent of the observed cases. In the cancer group the sensibility of the Thallium test is of 85 per cent and its specificity 80 per cent. We may assert that there is a very low risk of Thallium negative (old) nodules being malignant. The pre-operative 201 T1 scintigraphy is easy to perform in any Nuclear Medicine department. Nowadays, the combination of aspiration cytology and 201 T1 scintigraphy should make it possible to make an accurate diagnosis in the vast majority of differentiated and undifferentiated thyroid cancers [fr

  5. The clinical value of planar thallium-201 myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Niemeyer, M.G.

    1989-01-01

    The clinical value of planar thalium-201 myocardial perfusion scintigraphy was examined, using visual and quantitative analysis, for the detection of presence, localization and extent of coronary disease, using coronary arteriography as gold standard. The indremental diagnostic yield of different noninvasive tests for the diagnosis and the severity of coronary artery disease was quantified by using multivariate discriminant analysis. (author). 284 refs.; 14 figs.; 37 tabs

  6. Normal SPECT thallium-201 bull's-eye display: gender differences

    International Nuclear Information System (INIS)

    Eisner, R.L.; Tamas, M.J.; Cloninger, K.

    1988-01-01

    The bull's-eye technique synthesizes three-dimensional information from single photon emission computed tomographic 201 TI images into two dimensions so that a patient's data can be compared quantitatively against a normal file. To characterize the normal database and to clarify differences between males and females, clinical data and exercise electrocardiography were used to identify 50 males and 50 females with less than 5% probability of coronary artery disease. Results show inhomogeneity of the 201 TI distributions at stress and delay: septal to lateral wall count ratios are less than 1.0 in both females and males; anterior to inferior wall count ratios are greater than 1.0 in males but are approximately equal to 1.0 in females. Washout rate is faster in females than males at the same peak exercise heart rate and systolic blood pressure, despite lower exercise time. These important differences suggest that quantitative analysis of single photon emission computed tomographic 201 TI images requires gender-matched normal files

  7. Quantitative analysis of normal thallium-201 tomographic studies

    International Nuclear Information System (INIS)

    Eisner, R.L.; Gober, A.; Cerqueira, M.

    1985-01-01

    To determine the normal (nl) distribution of Tl-201 uptake post exercise (EX) and at redistribution (RD) and nl washout, Tl-201 rotational tomographic (tomo) studies were performed in 40 subjects: 16 angiographic (angio) nls and 24 nl volunteers (12 from Emory and 12 from Yale). Oblique angle short axis slices were subjected to maximal count circumferential profile analysis. Data were displayed as a ''bullseye'' functional map with the apex at the center and base at the periphery. The bullseye was not uniform in all regions because of the variable effects of attenuation and resolution at different view angles. In all studies, the septum: lateral wall ratio was 1.0 in males and approximately equal to 1.0 in females. This occurred predominantly because of anterior defects due to breast soft tissue attenuation. EX and RD bullseyes were similar. Using a bi-exponential model for Tl kinetics, 4 hour normalized washout ranged 49-54% in each group and showed minimal variation between walls throughout the bullseye. Thus, there are well defined variations in Tl-201 uptake in the nl myocardium which must be taken into consideration when analyzing pt data. Because of these defects and the lack of adequate methods for attenuation correction, quantitative analysis of Tl-201 studies must include direct comparison with gender-matched nl data sets

  8. Myocardial uptake of thallium-201 augmented with bicarbonate: concise communication

    International Nuclear Information System (INIS)

    Hetzel, K.R.; Westerman, B.R.; Quinn, J.L. III; Meyers, S.; Barresi, V.

    1977-01-01

    Sodium bicarbonate was used to enhance the myocardial concentration of Tl-201 in rabbits and dogs. Organ distribution studies in rabbits and in vivo imaging in dogs showed a 1.5 to 2-fold increase in myocardial Tl-201 concentration in bicarbonate-treated animals as compared with matched controls. Image improvement was noted, with threefold enhancement of myocardium-to-liver ratios. The results suggest that a similar improvement may be possible for clinical myocardial imaging

  9. A comparison of the clinical relevance of thallium- 201 and ...

    African Journals Online (AJOL)

    1990-09-01

    Sep 1, 1990 ... A comparison of the clinical relevance of thallium- .... 99rnTc_MIBI scanning yielded a better value than 20lTl scanning ... P values of. <0,05 were considered significant. Coronary angiography. Coronary angiography was performed in multiple projections employing the transcutaneous femoral Seldinger ...

  10. Scintigraphical analyses of pulmonary function in dogs

    International Nuclear Information System (INIS)

    Clercx, C.

    1988-01-01

    The main goal of this study was to develop a quantitative analysis from 99mTc aerosol inhalation/perfusion (I/P) lung scintigrams. In particular attention was focused on both the regional I/P distribution, concerning the ratio of the mean I and P values in several lung regions, as well as on the local (intraregional) distribution of I/P, under a wide range of circumstances. In Ch. 2, the method and reference material are described. The distribution of the inhalation-to-perfusion ratios (I/P) is studied in anesthetized healthy dogs, with emphasis on inter-regional distribution and intra-regional dispersion of the I/P ratio. Moreover, it provides an insight into canine pulmonary physiology, frequently transposed from human lung physiology, what is not always correct. Ch. 3 deals with the possible methodological and physiological influences on the interpretation of scintigraphical measurements, such as age, posture and breed. Investigation of the effects of age and breed was pursued using qualitative studies of canine lung surfactant. The actual knowledge in this field lets prospect veterinary clinical meaning in the future. Finally in Ch. 4, the diagnostic value of the measurements was examined in experimental models of important lung disorders with different pathophysiological features, such as lobar and sublobar airway obstruction, and lung embolism. It also permits the investigation of the relative contribution of different compensating mechanisms upon the ventilation-to-perfusion ratio, such as collateral ventilation and hypoxic vasoconstriction. 218 refs.; 31 figs.; 14 tabs

  11. The new techniques of scintigraphic imaging

    International Nuclear Information System (INIS)

    Chatal, J.F.

    1990-01-01

    The purpose of scintigraphic imaging is not to explore the morphology of an organ (or its abnormalities) but rather its functional and metabolic characteristics. It is thus important that a molecular structure (e.g., a hormonal receptor or an antigen) closely linked to the functional activity of an organ or tissue be targeted on its cell surface. Such diagnostic targeting requires the synthesis and labeling of a radiopharmaceutical substance specific for the receptor or antigen in question. It also requires a detection system adapted to count rates and signal-to-background ratios (generally moderate). The synthesis of new radiopharmaceutical agents, a critical stage for the future of nuclear medicine, is a long and often risky process in which success is difficult to foresee. Radiolabeling must be stable in vitro and in vivo, and the radiopharmaceutical must subsequently retain its capability of recognizing the targeted molecule. In endocrinology, the exemplary achievement in this direction has been the synthesis of 131 I-6-iodomethylnorcholesterol and 131 I-metaiodobenzylguanidine for functional scintigraphy of the adrenal cortex and medulla. Progress in detection equipment has been marked by the development of monophotonic tomoscintigraphy, using gamma cameras with a revolving head to obtain slices in different spatial planes showing the distribution in the organism of the injected radiopharmaceutical agent [fr

  12. Scintigraphic instruments and techniques in nuclear medicine

    International Nuclear Information System (INIS)

    Bornand, B.; Soussaline, F.

    1977-03-01

    The development of new radiopharmaceuticals, cyclotron-produced radionuclides and improvement of detector, scanner and gamma camera characteristics have enable a remarkable recent progress in scintigraphic techniques for organ visualization and functional studies. Using a variety of techniques, positron cameras, section scanners, gamma holography, tomographic imaging appear to be playing an increasing important role. Data processing techniques, for example image processing and three dimensional reconstruction have significantly increased their impact. The principal research work and advances in technique achieved up to 1972 are summarized and the subjects which have been further exploited are outlined. The main section comprises references and abstracts of articles from scientific journals and conference proceedings (191 articles and 221 papers mentioned) for the period 1972-1975 to illustrate advances in this domain: Excerpta Medica (Nuclear Medicine) Abstract Journals and Nuclear Science Abstracts (1972-1975) were used as abstracting publications. This survey is completed with an index of authors and subject-matters. Eleven thesis are mentionned in an appendix [fr

  13. Scintigraphic assessment of cardiac adrenergic innervation in patients with essential hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, Y.; Hamada, M.; Shigematsu, Y.; Sumimoto, T.; Hamamoto, K.; Hiwada, K. (2nd Department of Internal Medicine, Ehime University School of Medicine (Japan))

    1991-01-01

    To assess the regional cardiac adrenergic innervation in patients with essential hypertension (EHT), simultaneous iodine-123 metaiodobenzylguanidine ((123I)MIBG) and thallium-201 (201Tl) myocardial imagings were performed in five patients with EHT, seven patients with hypertrophic cardiomyopathy (HCM), and seven normal subjects. Short axial images at rest were divided into five segments: anterior, septal, posterior, lateral, and apical segments. Percent regional uptake (%RU) of 201Tl except the septal segment in patients with EHT showed no significant difference. However, the %RU of (123I)MIBG at posterior, lateral, and apical segments was significantly lower than that at anterior and septal segments in EHT. This intraimage heterogeneity of (123I)MIBG was also observed in HCM. These results suggest that there is a difference in regional adrenergic innervation of the left ventricle with myocardial hypertrophy.

  14. Different scintigraphic findings in osseous metastases from organoid thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hotze, A.; Loew, A.; Mahlstedt, J.; Wolf, F.

    1983-02-01

    Scintigraphic results from investigations in two patients suffering from organoid thyroid carcinoma are presented using the tracers /sup 131/I, sup(99m)Tc-MDP and sup(99m)Tc-Microkolloid. Bone marrow scintigraphy with sup(99m)Tc-Microkolloid deserves the attention of the diagnostician in patients with metastasing diseases affecting bone marrow and/or skeleton.

  15. Scintigraphic analysis of thyroid diseases at the Lagos University ...

    African Journals Online (AJOL)

    This paper presents a retrospective analysis of randomly selected clinical scintigraphic records at the College of Medicine/Lagos University Teaching Hospital, Nigeria. Out of the 436 patients scanned for various thyroid abnormalities, 266 (61.0%) were used for the analysis due to insufficient data and parameters required ...

  16. Scintigraphic evaluation of the sacroiliac joints in anklylosing spondylitis

    International Nuclear Information System (INIS)

    Schoerner, W.

    1980-01-01

    The sedimentation of sup(99m)Tc-phosphate complexes into the sacroiliac joints was investigated in 94 patients with loin pains and suspected of ankylosing spondylitis (SpA) and a control group of 96 healthy patients. The investigation yields the following results: 1. the visual evaluation of the scintigrams does not allow a reliable diagnosis and should be replaced by a semi-quantitative technique, 2. the index ISC/sacrum does remarkably depend on age, 3rd even in young patients the scintigraphic examination appears to be useful to alidate the clinical suspicion of sacroilictis which is in contradiction to literature, 4th with increasing SpA the scintigraphic detectability of changes in the ISG decreases. 5th the floriditily of the ISG process determines the scintigraphic detectability of the process of the disease, 6th the scintigraphic finding is unspecific. Inflammatory states of the disease of different genesis and degenerative processes in the ISG equally yield pathological index values. (orig./MG) [de

  17. Scintigraphic pattern of small bowel bleeding

    International Nuclear Information System (INIS)

    Anshu Rajnish Sharma; Charan, S.; Silva, I.

    2004-01-01

    camera fitted with LEAP collimator. Delayed imaging up to 6 hours was optional and was undertaken only when first 90 minutes images did not reveal any site of bleeding. Two nuclear physicians reviewed the sequential static images for 1) First appearance of focus of activity in a particular quadrant/region of abdomen and 2) looking for its migration pattern. Scintigraphic results were prospectively compared with surgical outcome in 10 patients. Results: Tc-99m RBC Scan localized site of bleeding in 10 of 13 patient evaluated (77%). Ten scan positive patients underwent exploratory laprotomy. On surgical exploration, five culprit lesions were identified in jejunum and as many number of lesions were detected in ileum. Etiological lesions were mainly inflammatory or ulcerative (n=5) followed by neoplastic and vascular ectasias in 2 patients each. One patient showed diverticular disease of jejunum as the source of haemorrhage.Tc-99m RBC Scan was able to distinguish between proximal (jejunal) and distal (ileal) small bowel bleeding in 8 of 10 scan positive cases (80%). Scintigraphy correctly localized bleeding in jejunum and ileum in 3 and 5 patients respectively. In majority of patients (7/10, 70%), scan became positive within 3 hours. Six types of scan patterns were noticed in thirteen patients evaluated with Tc-99m RBCs scan. Five scintigraphic patterns were representative of small bowel bleeding. A serpentine appearance of bowel loops in mid abdomen, focal tracer appearance in right iliac region with subsequent outlining of ascending colon on delayed images, and a focus of activity showing distal extension in circular fashion on sequential static images were characteristic of ileal bleeding. Visualization of fixed loop in left flank region corroborated with jejunal lesion (Leiomyoma) in our series. An abnormal blush and early localization of diffuse activity in left upper quadrant followed by its centripetal extension/movement, was seen in patient with jejunitis

  18. Radiographic and scintigraphic evaluation of total knee arthroplasty

    International Nuclear Information System (INIS)

    Schneider, R.; Soudry, M.

    1986-01-01

    Various radiographic and scintigraphic methods are used to supplement clinical findings in the evaluation of total knee arthroplasty and its complications. Serial roentgenograms offer reliable information for diagnosing mechanical loosening. Wide and extensive radiolucency at the cement-bone interface and shift in position and alignment of prosthetic components can be seen in almost all cases by the time revision is necessary. Radiographic abnormalities are usually not present in acute infection, but are often present in chronic infection. Bone scanning has a high sensitivity for diagnosis of infection or loosening, but is nonspecific because increased uptake is often present around asymptomatic total knee arthroplasties with normal radiographs. Differential bone and Gallium scanning and scanning with Indium 111-labeled leukocytes have a greater specificity for diagnosis of infection than does bone or Gallium scanning alone. Routine radiographic and scintigraphic studies have shown a high incidence of deep vein thrombosis in the calf after total knee arthroplasty. Clinically significant pulmonary embolization is infrequent

  19. Scintigraphic demonstration of abscesses with radioactive gallium labeled leukocytes

    International Nuclear Information System (INIS)

    Burleson, R.L.; Holman, B.L.; Tow, D.E.

    1975-01-01

    Autologous peripheral blood leukocytes, labeled in vitro with 67 Ga citrate, have been studied in 20 patients as a radioactive carrier for the scintigraphic visualization of septic inflammatory areas. 67 Ga citrate was added to venous whole blood; following incubation, the blood was centrifuged, and the packed cells were reinfused. Scintiscans were obtained four and 24 hours later. The inflammatory process was demonstrated in nine of nine patients with confirmed sepsis. Eleven patients without sepsis had normal scans. There were no false-negative scans and one false-positive scan. The selective accumulation of the gallium labeled leukocytes in areas of septic inflammation was sufficient to allow scintigraphic demonstration of the inflammatory area

  20. Lymphedema after upper limb transplantation: scintigraphic study in 3 patients.

    Science.gov (United States)

    Cavadas, Pedro C; Thione, Alessandro; Carballeira, Alexo; Dominguez, Pablo Caro

    2013-07-01

    Lymphatic vasculature is known to spontaneously reconnect after hand replantation. Nonetheless, lymphatic outflow has not been specifically studied in hand transplantation.Lymphedema was studied clinically and scintigraphically in 3 bilateral upper limb transplants performed in Valencia, Spain, since 2006. Case 1 was a radiocarpal level, case 2 midforearm and proximal forearm, and case 3 was a transhumeral transplantation. Follow-up was 5, 4, and 3 years, respectively. Clinically, in case 1, there was a left-sided moderate lymphedema, case 2 was normal, and a right-sided moderate lymphedema was present in case 3. Lymphoscintigraphy results were consistent with the clinical findings. It was normal in the 4 nonedematous limbs. In the 2 affected limbs, there were scintigraphic findings of lymphatic block and lymphangiectasia.The study demonstrates objectively that lymphatic circulation can reconnect spontaneously in hand transplantations, although not in a homogeneously efficient way.

  1. Survey of 26 suprarenal scintigraphs on Cushing's syndrome patients

    International Nuclear Information System (INIS)

    Venot, A.; Luton, J.P.; Roucayrol, J.C.; Bricaire, H.

    On the basis of the results of 26 Cushing's syndrome examinations some new scintigraphic aspects are described, suprarenal scintigraphy is compared with retroperitoneal insufflation, its value in the observation of a medical treatment of Cushing's disease is demonstrated and finally some preliminary results are given on the application in the same pathological context, of 75 Se-6-selenocholesterol which was compared with 131 I-19-iodocholesterol [fr

  2. Bone scintigraphic changes in osteonecrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Bonnarens, F.; Hernandez, A.; D' Ambrosia, R.

    1985-10-01

    Bone scanning with /sup 99m/Tc will detect osteonecrosis of the femoral head before changes appear in conventional radiographs. There is no liner correlation between the intensity of the scintigraphic picture and the clinical stage of the disease. The /sup 99m/Tc labels newly formed hydroxyapatite crystals and may be helpful in detecting disease in a contralateral asymptomatic hip or confirming the diagnosis in the suspected hip.

  3. Bone scintigraphic changes in osteonecrosis of the femoral head

    International Nuclear Information System (INIS)

    Bonnarens, F.; Hernandez, A.; D'Ambrosia, R.

    1985-01-01

    Bone scanning with /sup 99m/Tc will detect osteonecrosis of the femoral head before changes appear in conventional radiographs. There is no liner correlation between the intensity of the scintigraphic picture and the clinical stage of the disease. The /sup 99m/Tc labels newly formed hydroxyapatite crystals and may be helpful in detecting disease in a contralateral asymptomatic hip or confirming the diagnosis in the suspected hip

  4. Supplementary remarks for interpretation of liver scintigraphic findings

    International Nuclear Information System (INIS)

    Karasawa, Masaaki

    1981-01-01

    The liver scintigraphy is nowadays widely accepted as one of the versatile techniques for figure out of the morbid morphology of the liver. However, it is important to note that the liver is one of the most well recognized visceral organs which reveals various anatomical dislocation and distorsion of the contour being effected by compression from adjacent visceral organs and tissues. Based on these facts, the diagnosis on the basis of the liver scintigraphy only sometimes leads to the misdiagnosis. For correcting this pitfall, the author has performed simultaneous application of (1) Plain X ray study, (2) Gastrointestinal study, (3) Angiographic study and (4) pneumo-peritoneography. The pneumo-peritoneography has performed in 43 cased. It is concluded the simultaneous application of the above-mentioned techniques as well as the scintigraphic study give much precised diagnostic results. Moreover, the application of the pneumo-peritoneography to the scintigraphic study gives much better results. The clinical importance of these supplementary methods in applying the scintigraphic study of the liver was described in this communication in full detail. (author)

  5. Post-exercise diastolic stunning detected by velocity vector imaging is a useful marker for induced ischemia in ischemic heart disease.

    Science.gov (United States)

    Kurosawa, Koji; Watanabe, Hiroyuki; Aikawa, Masaru; Mihara, Hirotsugu; Iguchi, Nobuo; Asano, Ryuta; Umemura, Jun; Kurabayashi, Masahiko; Sumiyoshi, Tetsuya

    2013-06-01

    Recently, post-exercise diastolic stunning (PES) has been reported as a new clinical marker of induced ischemia. Velocity vector imaging (VVI) has been developed to visualize regional wall motion abnormalities based on vectors detected by the tissue tracking technique, which has the potential to visualize PES. Thus, the aim of this study was to evaluate the usefulness of PES detection by VVI as an objective marker of ischemia compared to stress thallium-201 (Tl-201) single photon emission computed tomography (SPECT). We studied consecutive patients who were scheduled to undergo exercise stress Tl-201 SPECT for the diagnosis of ischemic heart disease. Transthoracic echocardiography was recorded digitally before and 20 min after exercise for Tl-201 SPECT, and the data were used subsequently for VVI analysis. We defined PES regions as those with new abnormal vectors observed during isovolumic relaxation. After excluding 14 patients with old myocardial infarction and/or atrial fibrillation, echocardiograms suitable for VVI analysis were obtained from 62 of 65 patients (feasibility, 95 %; 44 men; mean age, 64 ± 11 years). SPECT revealed induced ischemia in 20 patients, whereas VVI identified PES in 18 patients. VVI detected inducible ischemia with 85 % sensitivity and 98 % specificity compared to SPECT. VVI detection of PES is a new clinical tool for induced ischemia. Regional diastolic wall motion abnormalities following induced ischemia can be noninvasively detected by VVI.

  6. Scintigraphic calf perfusion symmetry after exercise and prediction of cardiovascular events: One stone to kill two birds?

    International Nuclear Information System (INIS)

    Tellier, Philippe; Lecouffe, Pascal; Zureik, Mahmoud

    2007-01-01

    Background: Peripheral arterial disease (PAD) is commonly associated with a high cardiovascular mortality and morbidity as a marker of plurifocal atherosclerosis. Whether exercise thallium perfusion muscular asymmetry in the legs associated with PAD has prognostic value is unknown. Such a hypothesis was evaluated in a prospective study which remains the gold standard in clinical research. Methods and results: Scintigraphic calf perfusion symmetry after exercise (SCPSE) was measured at the end of a maximal or symptom-limited treadmill exercise test in 358 patients with known or suspected coronary artery disease (CAD). During the follow-up period (mean 85.3±32.8 months), 93 cardiovascular events and deaths (incident cases) occurred. Among those incident cases, the percentage of subjects with higher SCPSE values (third tertile) was 45.2%, versus 29.1% in controls (lower tertiles) (p=0.005). In stepwise multivariate analysis performed with the Cox proportional hazards model, previous CAD and SCPSE were the only significant independent predictors of prognosis. The multivariate relative risk of cardiovascular death or event in subjects with higher values of SCPSE was 1.94 (95% CI: 1.15-3.21; p<0.01). Conclusions: Scintigraphic calf perfusion asymmetry after exercise was independently associated with incident cardiovascular events in high-risk subjects. This index, which is easily and quickly calculated, could be used for evaluation of cardiovascular risk

  7. Scintigraphic calf perfusion symmetry after exercise and prediction of cardiovascular events: One stone to kill two birds?

    Energy Technology Data Exchange (ETDEWEB)

    Tellier, Philippe [Centre de Medecine Nucleaire de l' Artois, Clinique Sainte Catherine, 62 223 Sainte Catherine Les Arras (France)]. E-mail: phtellier2@wanadoo.fr; Lecouffe, Pascal [Centre de Medecine Nucleaire de l' Artois, Clinique Sainte Catherine, 62 223 Sainte Catherine Les Arras (France); Zureik, Mahmoud [National Institute of Health and Medical Research (INSERM), Unit 508, Institut Pasteur de Lille (France)

    2007-02-01

    Background: Peripheral arterial disease (PAD) is commonly associated with a high cardiovascular mortality and morbidity as a marker of plurifocal atherosclerosis. Whether exercise thallium perfusion muscular asymmetry in the legs associated with PAD has prognostic value is unknown. Such a hypothesis was evaluated in a prospective study which remains the gold standard in clinical research. Methods and results: Scintigraphic calf perfusion symmetry after exercise (SCPSE) was measured at the end of a maximal or symptom-limited treadmill exercise test in 358 patients with known or suspected coronary artery disease (CAD). During the follow-up period (mean 85.3{+-}32.8 months), 93 cardiovascular events and deaths (incident cases) occurred. Among those incident cases, the percentage of subjects with higher SCPSE values (third tertile) was 45.2%, versus 29.1% in controls (lower tertiles) (p=0.005). In stepwise multivariate analysis performed with the Cox proportional hazards model, previous CAD and SCPSE were the only significant independent predictors of prognosis. The multivariate relative risk of cardiovascular death or event in subjects with higher values of SCPSE was 1.94 (95% CI: 1.15-3.21; p<0.01). Conclusions: Scintigraphic calf perfusion asymmetry after exercise was independently associated with incident cardiovascular events in high-risk subjects. This index, which is easily and quickly calculated, could be used for evaluation of cardiovascular risk.

  8. Differential diagnosis of scintigraphic brain centres by 75Se selenite

    International Nuclear Information System (INIS)

    Bestagno, M.; Garraffa, V.; Rembado, R.; Guerra, U.

    1975-01-01

    Since standard brain scintigraphy with sup(99m)Tc is not always adequate for a satisfactory differential diagnosis of the radioactive foci detected, the possibilities of 75 Se sodium selenite were investigated. It was observed that in centres due to a vascular lesion the selenite concentration is always low, rising steeply in neoplasmic foci. The 75 Se-selenite scintigraphic method is considered highly valid, complementing that of sup(99m)Tc when this latter is unsuitable for diagnosis of the nature of cerebral foci [fr

  9. Hyper-functioning Thyroid Nodule with Scintigraphic Owl's Eye Appearance

    International Nuclear Information System (INIS)

    Al-Kordi, R.S.; Elgazzar, A.H.

    2006-01-01

    Hyper-functioning thyroid nodules may produce various scintigraphic appearances on thyroid scans. Autonomously hyper functioning thyroid nodules invariably demonstrate degenerative changes. These changes may give rise to central or less commonly peripheral photopenic areas on a thyroid scan within otherwise a hot nodule. In this report we present a case of hyper functioning autonomous nodule with peripheral degeneration and residual central functioning tissue giving the appearance of an owl's eye. Although rare, this pattern can be seen in a variety of benign and malignant thyroid conditions. (author)

  10. Scintigraphic colonic transit study in children with chronic constipation

    International Nuclear Information System (INIS)

    Yano, Tsunehiro; Uemura, Sadashige; Nakaoka, Tatsuo; Nakagawa, Yoshikiyo; Tanimoto, Terutaka; Sone, Teruki

    2008-01-01

    Chronic constipation can be caused either by slow colonic transit or by functional fecal retention. The treatment strategy for chronic constipation should be based on its etiology. Scintigraphic colonic transit study (SCTS) is useful for dividing the cause of the constipation into slow colonic transit and functional fecal retention. SCTS is also useful for judging the therapeutic effect and postoperative intestinal motility of Hirschsprung's disease, anorectal molformation, and others. As SCTS is a safe, simple, and painless examination, it is one of the most important examinations in evaluating chronic constipation. (author)

  11. Scintigraphic study of gastric emptying with colloidal tin

    International Nuclear Information System (INIS)

    Rodríguez Paleo, Lester; Nuez Vilar, Maricela; Machado Lois, Marisel; López González, María Karla; Torres Leyva, Oscar; Izquierdo Izquierdo, Yimel; García González, Idelsy; Conesa Gonzalez, Ana Ibis

    2016-01-01

    Gastroparesis is defined as a delay in gastric emptying in the absence of mechanical obstruction, associated with symptoms such as nausea and / or vomiting, feeling of postprandial gastric fullness, early satiety or epigastric pain for more than 3 months. The gold standard in the diagnosis of delayed gastric emptying scintigraphy is gastric emptying and radiopharmaceutical has been used more 99m Tc-sulfur colloid not available in the country. In order to evaluate the usefulness of colloidal tin in the scintigraphic gastric emptying study, a descriptive study was conducted in 64 patients over 18 years using as radiopharmaceutical 99m Tc-Sn colloid. 31% of patients had symptoms. The emptying time was normal in 50 cases and the association of gastroparesis symptoms was observed in 20 (15 diabetic and 5 non-diabetic), 9 patients had a delayed emptying, but reported no symptoms. Gastroparesis was more frequent in women than in men (35% versus 21%). 21% of patients had a moderate delayed gastric emptying. Conclusions: The results obtained with 99m Tc-Sn colloid are comparable to those reported by other authors using 99m Tc-SC in the scintigraphic assessment of gastric emptying. (author)

  12. Scintigraphic portrayal of β receptors in the heart

    International Nuclear Information System (INIS)

    Sisson, J.C.; Wieland, D.M.; Koeppe, R.A.; Normolle, D.; Frey, K.A.; Bolgos, G.; Johnson, J.; Van Dort, M.E.; Gildersleeve, D.L.

    1991-01-01

    Myocardial β adrenergic receptors play important roles in physiology and disease, but the receptors have not before been portrayed. The β antagonist, iodocyanopindolol (ICYP), was used to develop a scintigraphic method for depicting the receptors in the living heart. Labeled with 125I, ICYP bound firmly to β receptors in the rat heart; the data conformed to a mathematical model. In vivo saturation kinetics indicated binding sites with two affinities. Inhibition of ICYP binding by beta antagonists of different potency and different selectivity for β-1 and β-2 receptors produced the expected pharmacologic effects. Inhibition by lipophilic and hydrophilic antagonists gave no evidence that ICYP was appreciably bound to internalized receptors. Fractional binding by tracer quantities of (-) ICYP and ± ICYP demonstrated stereospecificity. Labeled with 123I, ICYP bound to the hearts of intact dogs so that scintigraphic tomographs depicted ventricular myocardium. Small doses of beta antagonists selectively reduced the binding of ICYP to lung enabling better visualization of the heart. Thus, 123I-ICYP appears to portray the beta receptors in the living heart, and the characteristics of binding permit the development of mathematical models and lay the basis for quantifying this receptor binding

  13. Scintigraphic Demonstration of Trans-Diaphragmatic Migration of Ascites

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Heung Suk; Kang, Chong Myun; Cho, Suk Shin [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1987-03-15

    There are many disease in which pleural effusion develops without direct extension of the offending organism or cell into the thorax. They are intraabdominal or retroperitoneal in location and involve the transfer of fluid from below the diaphragm into the pleural space. Pleural involvement from subphrenic inflammation is easy to understand, but the precise mechanism of migration of noninflammatory ascites through diaphragm is not clear in the patients with liver cirrhosis, Meigs's syndrome or peritoneal dialysis. We report a case where trans-diaphragmatic migration of peritoneal fluid has been demonstrated in a patient with peritoneal dialysis by scintigraphic method, with a brief review of literatures about the possible mechanisms. Scintigraphic study can show the source of pleural effusion and can suggest the mechanism of migration of ascites in the patients with liver cirrhosis, Meigs' syndrome, and also in patients with peritoneal dialysis. And thus we can manage the patient properly by coping with possible situations if hydrothorax developed.

  14. Contribution to scintigraphic study of pulmonary ventilation using 133Xe

    International Nuclear Information System (INIS)

    Chareyron, R.P.

    1975-01-01

    A technique of regional lung function study, using 133 Xe, is described (instrumentation, procedure, results). A gamma-camera is used for this investigation, its main advantages are as follows. The picture is smaller than the one produced by a scanner, but is obtained more quickly. The gamma-camera equipped with a data processing unit is able to visualize areas of interest and to provide quantitative informations. Two parameters are studied. The first one is Xenon washout speed expressed in (ml/mn/cm 3 ) which gives an exact value of pulmonary ventilation. The latter is retention. This parameter is of interest because retention is more easy to evaluate than washout speed, and is able to quantify what is suggested by scintigraphic pictures. The technique has proven to be valuable in differentiating chronic bronchitis from post-bronchitic emphysema [fr

  15. Clinical, radiographic and scintigraphic aspects of the trapeziometacarpal osteoarthritis

    International Nuclear Information System (INIS)

    Kaziyama, Helena Hideko Seguchi

    1996-01-01

    Trapeziometacarpal osteoarthritis occurs mainly in women during the menopausal period. It is related to manual activities and is usually bilateral. The onset is insidious and the evolution is slow and progressive. It is characterized by of strength and pain in the basis of the thumb resulting in limitation of the use and function of the hand. The diagnosis of this condition is based on the physical examination. The manouver of compression axial-rotation of the trapezimetacarpal joint is a common positive finding. Typical findings of osteoarthritis are present in the radiological studies. Scintigraphic images have a predictive value. The early diagnosis is important to avoid the risk factors and to prevent disabilities of the hand. (author)

  16. Sjoegren's syndrome. A functional scintigraphic study of salivary glands

    International Nuclear Information System (INIS)

    Arrago, J.P.; Rain, J.D.; Rocher, F.; Vigneron, N.; Pecking, A.; Najean, Y.

    1984-01-01

    One-hundred and twenty patients with sicca syndrome, connective tissue disease or chronic graft-versus-host disease were investigated in the Saint-Louis Hospital Department of Nuclear Medicine. Technetium scanning of the salivary glands was performed in all patients. The results of the scintigraphic study were closely correlated with clinical and histological data in patients with Sjoegren's syndrome. This method, which accurately quantifies the salivary function without danger nor discomfort to the patients, has a number of advantages: (a) it is sensitive enough to detect minimal salivary gland dysfunction; (b) it differentiates between parotid gland and submandibular gland involvement demonstrates assymetry in pathological processes; (c) it helps in following up patients with Sjoegren's disease and in assessing the results of immunosuppressive or anti-inflammatory treatment [fr

  17. Scintigraphic measurement of colonic transit in patients with idiopathic constipation

    International Nuclear Information System (INIS)

    Yoon, K. H.; Kim, C. K.

    1999-01-01

    To evaluate usefulness of scintigraphic measurement of total and regional colonic transit in patients with idiopathic constipation. 25 patients who were complained chronic constipation underwent scintigraphic measurement of the total and regional colon transit. Of them 10 patients were diagnosed as idiopathic constipation, none of whom had evidence of abnormal function of the pelvic floor. Ten healthy volunteers were also studied. 67 Gallium-labelled Amberlite resin particles were ingested in a coated capsule with methacrylate that dispersed in the ileocecal region. Images were obtained using a gamma camera at regular intervals for the 2, 4, 8, 24, and 48 hours after the initial counting of the radioactivity in the cecum. We determined the geometric center in four regions of interest in the colon (ascending, transverse, descending, and rectosigmoid). Ten patients with colonic inertia showed significant retention of solid residue in the ascending and transverse colon over a 48-hour period. The median values for the healthy subjects at 2, 4, 8, and 24, and 48 hours were 1.44±0.2 (midway through ascending), 1.71±0.45 (midway through transverse), 2.64±0.95 (midway through descending), 3.94±0.89 (midway through rectosigmoid), and 4.52±0.76 (midway through the stool compartment). On the contrary, the values of ten patients with colonic inertia were 1.0±0.0 (midway through ascending), 1.0±0.0 (midway through ascending). 1.02 ±0.06 (midway through ascending), 1.70±0.36 (midway through transverse), and 2.33±0.31(midway through descending) at the same time (p<0.001). In patients with idiopathic constipation is characterized by exaggerated reservoir factions of the ascending and transverse colons. Scintigraphy using 67 Gallium-labelled pellets seems to be a useful tool to demonstrate the delayed colonic transit in patients with colonic inertia

  18. Scintigraphic visualization of bacterial translocation in experimental strangulated intestinal obstruction

    International Nuclear Information System (INIS)

    Galeev, Yu.M.; Popov, M.V.; Salato, O.V.; Lishmanov, Yu.B.; Grigorev, E.G.; Aparcin, K.A.

    2009-01-01

    The purpose of this study was to obtain scintigraphic images depicting translocation of 99m Tc-labelled Escherichia coli bacteria through the intestinal barrier and to quantify this process using methods of nuclear medicine. Thirty male Wistar rats (including 20 rats with modelled strangulated intestinal obstruction and 10 healthy rats) were used for bacterial scintigraphy. 99m Tc-labelled E. coli bacteria ( 99m Ts-E. coli) with an activity of 7.4-11.1 MBq were administered into a section of the small intestine. Scintigraphic visualization of bacterial translocation into organs and tissues of laboratory animals was recorded in dynamic (240 min) and static (15 min) modes. The number of labelled bacteria, which migrated through the intestinal barrier, was quantified by calculating the translocation index (TI). Control indicated no translocation of 99m Ts-E. coli administered into the intestine through the parietes of the small intestine's distal part in healthy animals. Animals with strangulated obstruction demonstrated different migration strength and routes of labelled bacteria from strangulated and superior to strangulation sections of the small intestine. 99m Ts-E. coli migrated from the strangulated loop into the peritoneal cavity later causing systemic bacteraemia through peritoneal resorption. The section of the small intestine, which was superior to the strangulation, demonstrated migration of labelled bacteria first into the portal and then into the systemic circulation. The strangulated section of the small intestine was the main source of bacteria dissemination since the number of labelled bacteria, which migrated from this section significantly, exceeded that of the area superior to the strangulation section of the small intestine (p = 0.0003). Bacterial scintigraphy demonstrated the possibility of visualizing migration routes of labelled bacteria and quantifying their translocation through the intestinal barrier. This approach to study bacterial

  19. Scintigraphic measurement of colonic transit in patients with idiopathic constipation

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, K. H.; Kim, C. K. [College of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

    1999-07-01

    To evaluate usefulness of scintigraphic measurement of total and regional colonic transit in patients with idiopathic constipation. 25 patients who were complained chronic constipation underwent scintigraphic measurement of the total and regional colon transit. Of them 10 patients were diagnosed as idiopathic constipation, none of whom had evidence of abnormal function of the pelvic floor. Ten healthy volunteers were also studied. 67 Gallium-labelled Amberlite resin particles were ingested in a coated capsule with methacrylate that dispersed in the ileocecal region. Images were obtained using a gamma camera at regular intervals for the 2, 4, 8, 24, and 48 hours after the initial counting of the radioactivity in the cecum. We determined the geometric center in four regions of interest in the colon (ascending, transverse, descending, and rectosigmoid). Ten patients with colonic inertia showed significant retention of solid residue in the ascending and transverse colon over a 48-hour period. The median values for the healthy subjects at 2, 4, 8, and 24, and 48 hours were 1.44{+-}0.2 (midway through ascending), 1.71{+-}0.45 (midway through transverse), 2.64{+-}0.95 (midway through descending), 3.94{+-}0.89 (midway through rectosigmoid), and 4.52{+-}0.76 (midway through the stool compartment). On the contrary, the values of ten patients with colonic inertia were 1.0{+-}0.0 (midway through ascending), 1.0{+-}0.0 (midway through ascending). 1.02 {+-}0.06 (midway through ascending), 1.70{+-}0.36 (midway through transverse), and 2.33{+-}0.31(midway through descending) at the same time (p<0.001). In patients with idiopathic constipation is characterized by exaggerated reservoir factions of the ascending and transverse colons. Scintigraphy using 67 Gallium-labelled pellets seems to be a useful tool to demonstrate the delayed colonic transit in patients with colonic inertia.

  20. An unusual scintigraphic pattern in sickle cell patients

    International Nuclear Information System (INIS)

    Glaser, A.M.; Chen, D.C.P.; Siegel, M.E.; Norris, S.L.; Haywood, L.J.

    1989-01-01

    We reviewed the nuclear medicine files of all patients enrolled in the sickle cell disease clinic who had had scans performed within the previous 5 years. We specifically looked for patterns of tracer uptake in these scans that would correlate with the severe anemia and consequent bone marrow hyperactivity of sickle cell patients. Thirty-three patients were included (21 men and 12 women) with a mean age of 26.8 years (range 17-48 years). The appearance of each of these patients' most recent scans was examined in the areas of the distal femurs, the proximal tibias and the distal tibias; a distinct triangular shaped pattern of increased activity was identified in these areas in a majority of patients. Thirty-three patients without sickle cell disease served as age-matched controls. This pattern was seen in 65.1% (95 out of 146 images) of the sickle cell patients' delayed images and 80.4% (82 out of 102 images) of their blood pool images. In contrast, the control patients demonstrated the triangular pattern in none of their blood pool studies (0%) and only 10.9% of their delayed bone images (P<0.001). The mean age of sickle cell patients with this pattern is 25.6 years which was significantly lower than that of those without this pattern (mean=37.5 years, P<0.05). Given the high prevalence of this unique scintigraphic pattern in a group of patients with known accelerated bone marrow function, these findings may be scintigraphic evidence of bone marrow expansion. The patient's age appears to be an important factor in visualization of this pattern. (orig.)

  1. Enhanced Diagnosis of Coronary Artery Disease in Women by Dobutamine Thallium-201 ST-Segment/Heart Rate Slope and Thallium-201 Myocardial SPECT

    Directory of Open Access Journals (Sweden)

    Dong-Feng Yeih

    2007-10-01

    Conclusion: Dobutamine ST/HR slope is less sensitive and less accurate than Tl-201 SPECT for detecting CAD in women. However, it adds diagnostic benefit to Tl-201 SPECT with only a little extra calculation.

  2. Association of bone scintigraphic abnormalities with knee malalignment and pain.

    Science.gov (United States)

    Kraus, V B; McDaniel, G; Worrell, T W; Feng, S; Vail, T P; Varju, G; Coleman, R E

    2009-11-01

    The information content of knee bone scintigraphy was evaluated, including pattern, localisation and intensity of retention relative to radiographic features of knee osteoarthritis, knee alignment and knee symptoms. A total of 308 knees (159 subjects) with symptomatic and radiographic knee osteoarthritis of at least one knee was assessed by late-phase (99m)Technetium methylene disphosphonate bone scintigraph, fixed-flexion knee radiograph, full limb radiograph for knee alignment and for self-reported knee symptom severity. Generalised linear models were used to control for within-subject correlation of knee data. The compartmental localisation (medial vs lateral) and intensity of knee bone scan retention were associated with the pattern (varus vs valgus) (p<0.001) and severity (p<0.001) of knee malalignment and localisation and severity of radiographic osteoarthritis (p<0.001). Bone scan agent retention in the tibiofemoral, but not patellofemoral, compartment was associated with severity of knee symptoms (p<0.001) and persisted after adjusting for radiographic osteoarthritis (p<0.001). To the authors' knowledge, this is the first study describing a relationship between knee malalignment, joint symptom severity and compartment-specific abnormalities by bone scintigraphy. This work demonstrates that bone scintigraphy is a sensitive and quantitative indicator of symptomatic knee osteoarthritis. Used selectively, bone scintigraphy is a dynamic imaging modality that holds great promise as a clinical trial screening tool and outcome measure.

  3. Scintigraphic evaluation of duodenogastric reflux. Problems, pitfalls, and technical review.

    Science.gov (United States)

    Drane, W E; Karvelis, K; Johnson, D A; Silverman, E D

    1987-05-01

    Bile reflux has been implicated in the pathogenesis of gastritis, gastric ulcer, and esophagitis. Radionuclide techniques provide the only non-invasive method to detect duodenogastric reflux. To analyze the problems that occur with attempts at quantitation, 55 patients were prospectively evaluated (45 patients with reflux esophagitis or Barrett's esophagus and ten patients with clinical symptoms of bile reflux, four of whom had Bilroth II surgery) with Tc-99m DISIDA, using a fasting technique with gallbladder stimulation by sincalide. Visual duodenogastric reflux occurred in 16 of 55 patients. Overlap of small bowel with the stomach is the major problem for accurate quantitation and occurred in 20 of 55 patients (36%). Overlap of left lobe of the liver occurred in 40 of 55 patients (73%), but its contribution to gastric activity was slight and could be easily subtracted. Reflux was intermittent in six of the 16 positive studies (38%), and continuous computer acquisition is needed to detect its maximum value. Primarily because of the problem of small bowel overlap, scintigraphic evaluation of duodenogastric reflux is only, at best, semi-quantitative. A review of the technical variables used in this examination, as well as potential problems that can occur, is provided.

  4. Scintigraphic method for evaluating reductions in local blood volumes in human extremities

    DEFF Research Database (Denmark)

    Blønd, L; Madsen, Jan Lysgård

    2000-01-01

    in the experiment. Evaluation of one versus two scintigraphic projections, trials for assessment of the reproducibility, a comparison of the scintigraphic method with a water-plethysmographic method and registration of the fractional reduction in blood volume caused by exsanguination as a result of simple elevation......% in the lower limb experiment and 6% in the upper limb experiment. We found a significant relation (r = 0.42, p = 0.018) between the results obtained by the scintigraphic method and the plethysmographic method. In fractions, a mean reduction in blood volume of 0.49+0.14 (2 SD) was found after 1 min of elevation......We introduce a new method for evaluating reductions in local blood volumes in extremities, based on the combined use of autologue injection of 99mTc-radiolabelled erythrocytes and clamping of the limb blood flow by the use of a tourniquet. Twenty-two healthy male volunteers participated...

  5. Unusual and subtle scintigraphic findings in the evaluation of the battered child

    International Nuclear Information System (INIS)

    Howard, J.L.; Barron, B.J.; Smith, G.G.

    1988-01-01

    Nuclear medicine imaging plays a key role in the evaluation of skeletal trauma. Recent findings in our department show that diagnoses other than skeletal trauma are often identified by means of subtle and unusual scintigraphic findings. The subject material will place strong emphasis on the less mentioned but often more important visceral and intracranial injury. Specific scintigraphic abnormalities to be demonstrated, with appropriate correlative radiographs, include (1) visceral and soft tissue (eg, duodenal hematoma, splenic laceration, renal contusion, hepatic hematoma, rhabdomyolysis and soft-tissue hematoma); (2) cranial (eg, intracranial bleeding, edema, and infarct, cephalohematoma, skull fracture, and widening of sutures; and (3) skeletal (various subtle abnormalities)

  6. A comparison of methods of assessment of scintigraphic colon transit.

    Science.gov (United States)

    Freedman, Patricia Noel; Goldberg, Paul A; Fataar, Abdul Basier; Mann, Michael M

    2006-06-01

    There is no standard method of analysis of scintigraphic colonic transit investigation. This study was designed to compare 4 techniques. Sixteen subjects (median age, 37.5 y; range, 21-61 y), who had sustained a spinal cord injury more than a year before the study, were given a pancake labeled with 10-18 MBq of (111)In bound to resin beads to eat. Anterior and posterior images were acquired with a gamma-camera 3 h after the meal and then 3 times a day for the next 4 d. Seven regions of interest, outlining the ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, rectosigmoid, and total abdominal activity at each time point, were drawn on the anterior and posterior images. The counts were decay corrected and the geometric mean (GM), for each region, at each time point calculated. The GM was used to calculate the percentage of the initial total abdominal activity in each region, at each time point. Colonic transit was assessed in 4 ways: (a) Three independent nuclear medicine physicians visually assessed transit on the analog images and classified subjects into 5 categories of colonic transit (rapid, intermediate, generalized delay, right-sided delay, or left-sided delay). (b) Parametric images were constructed from the percentage activity in each region at each time point. (c) The arrival and clearance times of the activity in the right and left colon were plotted as time-activity curves. (d) The geometric center of the distribution of the activity was calculated and plotted on a graph versus time. The results of these 4 methods were compared using an agreement matrix. Though simple to perform, the visual assessment was unreliable. The best agreement occurred between the parametric images and the arrival and clearance times of the activity in the right and left colon. The different methods of assessment do not produce uniform results. The best option for evaluating colonic transit appears to be a combination of the analog images

  7. Differentiated thyroid carcinoma in a scintigraphically hot nodule: diagnosis and interdisciplinary therapeutical approach

    International Nuclear Information System (INIS)

    Stahl, A.; Hess, U.; Langhammer, H.; Harms, J.; Zwicknagl, M.

    2002-01-01

    A hyperfunctioning differentiated thyroid carcinoma is a rare occurrence. Nevertheless, this diagnosis must be considered in a scintigraphically hot nodule if there is a clinical or sonographic suggestion of malignancy. The case of a 57-year old patient with hyperthyreosis and a scintigraphically hot thyroid nodule is presented. Further evaluation led to the diagnosis of a differentiated thyroid carcinoma with extensive lymph node and pulmonary metastases (pT2b, pN1b, pM1). The scintigraphically hot nodule corresponded to the primary tumor, whereas scintigraphic detection of the lymph node metastases was only possible postoperatively. Extensive resection of the lymph node metastases was achieved by the intraoperative application of a gamma probe (2nd operation). This allowed sufficient uptake of radioiodine in the pulmonary metastases for their detection and subsequent devitalization by radioiodine therapy. Complete elimination of all tumor tissue was documented at a control follow-up after six months. Gamma probe-guided surgery may allow for additional removement of non-palpable lymph node metastases. In selected cases this may optimize the surgical results and thereby facilitate the subsequent radioiodine elimination of advanced differentiated thyroid carcinomas. (author)

  8. The late prognostic value of acute scintigraphic measurement of myocardial infarction size

    International Nuclear Information System (INIS)

    Perez-Gonzalez, J.; Botvinick, E.H.; Dunn, R.; Rahimtoola, S.; Ports, T.; Chatterjee, K.; Parmley, W.W.

    1982-01-01

    Infarct, perfusion and blood pool scintigraphy were performed in 62 patients during hospitalization for acute myocardial infarction. The largest measured infarct or perfusion image defect and left ventricular ejection fraction were related to the late prognosis determined a mean of 16 months after the event. Breakpoint values for all scintigraphic variables could separate those who were asymptomatic on follow-up from those who died. The best indicators for selection of survivors and nonsurvivors were a scintigraphic infarct size greater than or equal to 25 cm 2 and a perfusion abnormality greater than or equal to 35% of the projected left ventricular area. Among patients with perfusion abnormalities above this limit, 61% died; 93% of those with small perfusion abnormalities survived. Scintigraphic measurements of relative myocardial perfusion and function best separated patients asymptomatic on follow-up from those who developed heart failure and also best identified those with an unfavorable evolution, who developed heart failure or died. Early scintigraphic parameters appeared more accurate than other clinical laboratory indicators for determining late prognosis and could be important in planning treatment after acute infarction

  9. The use of fast digital filters for the processing of scintigraphic pictures

    International Nuclear Information System (INIS)

    Grochulski, W.; Penczek, P.

    1982-01-01

    A brief review of typical methods applied in the development of digital filters for the processing of scintigraphic pictures is given. A simple parametrisation of such filters in the frequency domain is proposed and successfully applied in the case of mathematically simulated IAEA phantoms. The FFT algorithm is used. A possible application of the fast Walsh transform is pointed out. (author)

  10. Renal size in children with normal DMSA scintigraphy (DS): building a nomogram with scintigraphic data

    International Nuclear Information System (INIS)

    Lobo, G.; Ladron de Guevara, D.; Perez, A.; Donoso, G.; Jimenez, C.; Arnello, F.

    2002-01-01

    The aim of this was to evaluate the renal size in children with different ages, based in normal DMSA scintigraphic data. Material and Methods: We studied the length and width of kidneys measured from normal DMSA scans in children whose age varied from 1 month to 16 years old (91 men, 162 women, age average: 4.3 yr). We built nomograms of renal size vs age and a regression analysis of the data was done. We compared the distribution of scintigraphic data classified by sex and with published US data. Results: The scintigraphic distribution of the renal length vs age is presented. The best fitting regression equation for the whole data was y = 4.3349x 0.1456 with r:0.88. The lineal regression equation for 1 to 12 month was y = 0.1524x + 4.5668 and for 1-16 years was y = 0.0215x +6.3415. We did not find significant differences between boys and girls and between scintigraphic and published echographic data. Conclusion: 1) Our results support that renal DMSA scan size data are comparable with echographic renal size data. 2) Our data indicate that the growing rate of kidneys by month in the first year is similar to the growing rate by year later, without gender differences

  11. Is there a role for scintigraphic imaging of bone manifestations in Gaucher disease? A review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Mikosch, P. [State Hospital Klagenfurt (Austria). Dept. of Nuclear Medicine and Endocrinology, PET Center]|[State Hospital Klagenfurt (Austria). Dept. of Internal Medicine II; Kohlfuerst, S.; Gallowitsch, H.J.; Kresnik, E.; Lind, P. [State Hospital Klagenfurt (Austria). Dept. of Nuclear Medicine and Endocrinology, PET Center; Mehta, A.B.; Hughes, D.A. [Royal Free and University College Medical School, London (United Kingdom). Dept. of Academic Haematology

    2008-07-01

    Gaucher disease is the most prevalent inherited, lysosomal storage disease and is caused by deficient activity of the enzyme {beta}-glucocerebrosidase. Bone and bone marrow alterations are frequent in the most prevalent non-neuronopathic form of Gaucher disease. Imaging of bone manifestations in Gaucher disease is performed by a variety of imaging methods, conventional X-ray and MRI as the most frequently and most important ones. However, different modalities of scintigraphic imaging have also been used. This article gives an overview on scintigraphic imaging with respect to bone manifestations in Gaucher disease discussing the advantages and limitations of scintigraphic imaging in comparison to other imaging methods. (orig.)

  12. Diffuse lung uptake (DLU) on Ga-67 scintigraph: Clinical, radiologic and pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Sy, W.M.; Seo, I.S.; Vieira, J.; Zaman, M.

    1985-05-01

    Review, analysis and correlation (clinical, radiologic and pathologic) of 29 consecutive adults (16 drug addicts and/or homosexuals) with DLU on Ga-67 scintigraph were made. Diffuse increased uptake of at least 75% of both lungs was considered as DLU. WFOF cameras were used to obtain 24 to 96 hr. scintigraphs after IV injection of 3-5 mCi of Ga-67 citrate. In 26, tissue diagnosis established: pneumocystis carinii (PC) 15, miliary tuberculosis (TB) 3, sarcoidosis (SR) 3, drug-induced toxicity 2, and toxoplasmosis (TX), primary hyperparathyroidism and nonspecific lymphocytic pneumonia-one each. In two with breast and one with esophageal carcinomas, no lung tissue diagnosis was sought. Concurrent chest x-rays were negative in 16, but in 7/16, lung infiltrate was later documented. An average of 31 days elapsed before x-rays became positive in four with PC, 7 days in two with TB, and 22 days in one with TX. In 13, concurrent x-rays showed lung infiltrate, but in 6, only subtle, localized rather than diffuse infiltrate was noted. Fourteen of 29 had at least two Ga-67 studies. In 12 (7 PC, 2 TB, 3 SR) of 14 whose repeat studies showed significant to total disappearance of DLU, all did well clinically. In two whose initial studies were negative or equivocal, they became clinically worse when the repeat study showed DLU. In three others (2 PC, 1 TX) who died, their single studies recorded intense DLU. DLU on gallium scintigraph indicated a variety of pathology. In 55.2%, gallium scintigraph predated x-ray findings by a few days to weeks. In 20.3%, x-ray findings were only subtle or localized. Scintigraphic changes correlated well with the clinical courses in various diseases.

  13. Diffuse lung uptake (DLU) on Ga-67 scintigraph: Clinical, radiologic and pathologic correlation

    International Nuclear Information System (INIS)

    Sy, W.M.; Seo, I.S.; Vieira, J.; Zaman, M.

    1985-01-01

    Review, analysis and correlation (clinical, radiologic and pathologic) of 29 consecutive adults (16 drug addicts and/or homosexuals) with DLU on Ga-67 scintigraph were made. Diffuse increased uptake of at least 75% of both lungs was considered as DLU. WFOF cameras were used to obtain 24 to 96 hr. scintigraphs after IV injection of 3-5 mCi of Ga-67 citrate. In 26, tissue diagnosis established: pneumocystis carinii (PC) 15, miliary tuberculosis (TB) 3, sarcoidosis (SR) 3, drug-induced toxicity 2, and toxoplasmosis (TX), primary hyperparathyroidism and nonspecific lymphocytic pneumonia-one each. In two with breast and one with esophageal carcinomas, no lung tissue diagnosis was sought. Concurrent chest x-rays were negative in 16, but in 7/16, lung infiltrate was later documented. An average of 31 days elapsed before x-rays became positive in four with PC, 7 days in two with TB, and 22 days in one with TX. In 13, concurrent x-rays showed lung infiltrate, but in 6, only subtle, localized rather than diffuse infiltrate was noted. Fourteen of 29 had at least two Ga-67 studies. In 12 (7 PC, 2 TB, 3 SR) of 14 whose repeat studies showed significant to total disappearance of DLU, all did well clinically. In two whose initial studies were negative or equivocal, they became clinically worse when the repeat study showed DLU. In three others (2 PC, 1 TX) who died, their single studies recorded intense DLU. DLU on gallium scintigraph indicated a variety of pathology. In 55.2%, gallium scintigraph predated x-ray findings by a few days to weeks. In 20.3%, x-ray findings were only subtle or localized. Scintigraphic changes correlated well with the clinical courses in various diseases

  14. Scintigraphic calf perfusion symmetry after exercise and prediction of cardiovascular events: One stone to kill two birds?

    Science.gov (United States)

    Tellier, Philippe; Lecouffe, Pascal; Zureik, Mahmoud

    2007-02-01

    BackgroundPeripheral arterial disease (PAD) is commonly associated with a high cardiovascular mortality and morbidity as a marker of plurifocal atherosclerosis. Whether exercise thallium perfusion muscular asymmetry in the legs associated with PAD has prognostic value is unknown. Such a hypothesis was evaluated in a prospective study which remains the gold standard in clinical research. Methods and resultsScintigraphic calf perfusion symmetry after exercise (SCPSE) was measured at the end of a maximal or symptom-limited treadmill exercise test in 358 patients with known or suspected coronary artery disease (CAD). During the follow-up period (mean 85.3±32.8 months), 93 cardiovascular events and deaths (incident cases) occurred. Among those incident cases, the percentage of subjects with higher SCPSE values (third tertile) was 45.2%, versus 29.1% in controls (lower tertiles) ( p=0.005). In stepwise multivariate analysis performed with the Cox proportional hazards model, previous CAD and SCPSE were the only significant independent predictors of prognosis. The multivariate relative risk of cardiovascular death or event in subjects with higher values of SCPSE was 1.94 (95% CI: 1.15-3.21; pcardiovascular events in high-risk subjects. This index, which is easily and quickly calculated, could be used for evaluation of cardiovascular risk.

  15. Coronary blood flow and thallium 201 uptake in rejecting rat heart transplantations

    International Nuclear Information System (INIS)

    Bergsland, J.; Hwang, K.; Driscoll, R.; Carr, E.A.; Wright, J.R.; Curran-Everett, D.C.; Carroll, M.; Krasney, E.; Krasney, J.A.

    1989-01-01

    The effects of rejection on coronary flow (CAF) in heart allografts are unclear, although previous evidence with cardiac imaging agents indicates impaired flow during advanced rejection. The purpose of this study was to measure CAF in heterotopically placed heart grafts. Lewis rats (LEW) received grafts from either syngeneic Lewis rats (LEW/LEW group) or allogeneic ACI rats (ACI/LEW group). CAF was measured in both the transplanted and native hearts with radiolabeled microspheres. Rejection was measured histologically (grades 0 [absent] to 4+ [severe]). In addition systemic blood pressure and cardiac outputs of the native hearts were determined with microspheres. Different animals were studied during relatively early (4 days) and late (6 days) rejection. Among the 4-day animals a cyclosporine-treated group was included (ACI/LEW CyA). In 6-day rats CAF in allografts was lower (0.56 +/- .06 ml/gm/min) compared with syngeneic grafts (1.72 +/- 0.4 ml/gm/min) (p less than 0.05). The CAF in the native hearts did not differ significantly but was higher than in the grafts in both groups. Heart rates were reduced in allografts (p less than 0.05). It is interesting that arterial pressure and cardiac output were significantly lower in animals bearing allogeneic than syngeneic grafts. In rats studied at 4 days graft CAF was lower than in the native heart in both the LEW/LEW and ACI/LEW groups, but there was no significant difference in behavior between groups. The same was true for a cyclosporine-treated group. Graft heart rates were similar in all 4-day rats

  16. Quantitative thallium-201 scintigraphy after dipyridamole infusion combined with low level exercise in healthy volunteers

    International Nuclear Information System (INIS)

    Laarman, G.J.; Niemeyer, M.G.; Ascoop, C.A.P.L.; Bruschke, A.V.G.; Wall, E.E. van der; Verzijlbergen, F.J.; Liam Go, T.

    1989-01-01

    To establish test specific normal limits for quantitative analysis of uptake and washout of 201 Tl after dipyridamole infusion combined with low level exercise, 20 healthy volunteers were studied with low likelihood of coronary artery disease (CAD) assessed by a stepwise probability analysis based on age, sex, symptoms, resting electrocardiogram, and exercise electrocardiography. Likelihood of CAD in these volunteers was calculated as ≤ 1%. After dipyridamole infusion combined with low level exercise, one volunteer complained of headache; no other side effects were observed. There were no chest pain complaints. Maximal hemodynamic changes were achieved during the 6th and 7th min of the test. No ST segment depression was recorded. Visual analysis of the 201 Tl scintigrams was normal in all volunteers. Mean regional washout at 4 h was 44.37%±2.11%. The regional washout in the 70 0 LAO view (46.65%±1.10%) was significantly higher than in the anterior and 30 0 LAO views (43.44%±1.50% and 43.02%±1.45%, respectively). Profiles of uptake and washout of 201 Tl were different after dipyridamole infusion combined with low level exercise as compared to maximal exercise. Thus, in quantitative analysis of 201 Tl scintigraphy after dipyridamole infusion in conjunction with low level exercise as applied in the present study, it is mandatory to use normal limits of uptake and washout of 201 Tl derived from healthy volunteers who underwent the same combined protocol. (orig.)

  17. The importance of sex-specific quantitative criteria in thallium-201 myocardial scintigraphy

    International Nuclear Information System (INIS)

    Rabinovitch, M.A.; Suissa, S.; Elstein, J.; Turek, M.; Addas, A.; Burgess, J.H.; Rosenthall, L.

    1984-01-01

    Breast attenuation is an important cause of artifactual cold spots on visually interpreted TL-201 myocardial images. This study was undertaken to determine the need for sex-specific criteria in the quantitative analysis of exercise-redistribution TL-201 myocardial scintigraphy (SCINT). The studies of 13 normal females (F) and 12 normal males (M) were processed according to the method of a previous study. Significant sexual differences were found in 7/12 regional uptake (U) proportions, 9/11 regional washout (WO) percentages, 0/3 image redistribution indices, and 0/1 lung to heart ratio. The differences primarily reflected a proportionately decreased anterior and septal uptake in F, a proportionately decreased inferior and inferoapical U in M, and faster WO in F. Sex-specific and total population normal boundaries were set a +- 3SD of the mean for each parameter. Sex-specific boundaries were narrower, and, for 5 parameters (4U and 1WO), contained within the total population boundaries. It was estimated that these differences in boundaries would result in a 6 to 25% discrepancy in patient classification. These results predict that a subset of M and F with coronary artery stenoses could be misclassified as normal by total population criteria, while properly classified as abnormal by sex-specific criteria. The authors conclude that since important differences exist between M and F in the detected pattern of TL-201 myocardial U and WO, sex-specific cr4iteria may enhance the predictive accuracy of SCINT

  18. Correction for patient and organ movement in SPECT: application to exercise thallium-201 cardiac imaging

    International Nuclear Information System (INIS)

    Geckle, W.J.; Frank, T.L.; Links, J.M.; Becker, L.C.

    1988-01-01

    We describe a technique for correction of artifacts in exercise 201 Tl single photon emission computed tomography (SPECT) images arising from abrupt or gradual translational movement of the heart during acquisition. The procedure involves the tracking of the center of the heart in serial projection images using an algorithm which we call diverging squares. Each projection image is then realigned in the x-y plane so that the heart center conforms to the projected position of a fixed point in space. The shifted projections are reconstructed using the normal filtered backprojection algorithm. In validation studies, the motion correction procedure successfully eliminated movement artifacts in a heart phantom. Image quality was also improved in over one-half of 36 exercise thallium patient studies. The corrected images had smoother and more continuous left ventricular walls, greater clarity of the left ventricular cavity, and reduced streak artifacts. Rest injected or redistribution images, however, were often made worse, due to reduced heart to liver activity ratios and poor tracking of the heart center. Analysis of curves of heart position versus projection angle suggests that translation of the heart is common during imaging after exercise, and results from both abrupt patient movements, and a gradual upward shift of the heart. Our motion correction technique appears to represent a promising new approach for elimination of movement artifacts and enhancement of resolution in exercise 201 Tl cardiac SPECT images

  19. Quantitative analysis of stress thallium-201 myocardial scintigrams: a multicenter trial

    International Nuclear Information System (INIS)

    Van Train, K.F.; Berman, D.S.; Garcia, E.V.

    1986-01-01

    Previously we validated a method for quantification of 201 TI myocardial stress distribution and washout in which the patient's stress and washout circumferential profiles are compared with observed normal limits. The present study reports the results of a multicenter trial in which this method, utilizing normal limits from our institution, was employed to evaluate the presence, location, and extent of coronary artery disease (CAD). The normal limits utilized were generated from 49 patients having a low likelihood of CAD. The study population included 157 patients from four centers in the United States and Canada as well as a comparative prospective population from Cedars-Sinai Medical Center (CSMC) of 51 patients with CAD, 30 patients with normal coronary arteriograms, and 30 additional low-likelihood normals. The results in the combined centers regarding overall detection of CAD revealed a sensitivity of 84% and a frequency of test normality in the patients with low likelihood of CAD of 88%, compared to a sensitivity of 82% and true normalcy rate of 83% obtained in the prospective CSMC population. The sensitivity for detecting disease increased according to the extent of angiographic CAD in both the multicenter sites and the prospective CSMC group. Regarding localization of disease, similar sensitivities and specificities for detecting disease in individual coronary arteries were found in the multicenter sites and the prospective CSMC population. The results indicate that our method for quantifying 201TI stress-redistribution scintigrams utilizing standard normal limits can be applied at other institutions using a variety of scintillation cameras with similar accuracy to that currently obtained at our institution

  20. Quantitative measurement of membrane Na+-K+ ATPase activity using thallium-201: comparison with rubidium-86

    International Nuclear Information System (INIS)

    Lee, Jae Tae; Shon, Sang Kyun; Lee, Kyu Bo; Lee, In Kyu

    1998-01-01

    Na + -K + ATPase activity has been estimated by the degree of inhibition of cation transport by cardiac glycosides (ouabain) using Rb-86 as a substrate. The biological characteristics of Tl-201 is known to be similar to those of potassium as a transport substrate in the presence of glucose, insulin or phobol myristate acetate (PMA). The purpose of this study was to measure ouabain sensitive Na + -K + ATPase activity using Tl-201 and compare with that using Rb-86. Smooth muscle cells isolated from rat aorta or human placental umbilical artery were cultured, and used to measure cellular Na + -K + ATPase activity. Na + -K + ATPase activity was measured as a percentage decrease in cellular uptake of Tl-201 or Rb-86 by ouabain under the presence of glucose, insulin or PMA in media. Na + -K + ATPase activity measured with Tl-201, as a transport substrate, was not different from those measured with Rb-86 in rat or human smooth muscle cell preparation. Incubation with high concentration glucose resulted in about 30% decrease in enzyme activity. In contrast, insulin or PMA resulted in 50-70% or 28% increase from baseline activity, respectively. These results suggests that Tl-201 could replace Rb-86 in measurement of ouabain sensitive Na + -K + ATPase activity in vitro. High level of glucose concentration decreased cellular Na + -K + ATPase activity, but insulin or PMA increased it

  1. Myocardial imaging by direct injection of thallium-201 into coronary artery

    International Nuclear Information System (INIS)

    Sugihara, Hiroki; Inagaki, Suetsugu; Kubota, Yasushi

    1988-01-01

    Myocardial perfusion images were evaluated by direct injection of Thallium (Tl)-201 into coronary artery. Approximately 0.5 - 1 mCi of Tl-201 were instilled into the right coronary artery and/or the left coronary artery after coronary arteriography. Three images were obtained in the anterior, left anterior oblique and left lateral projections. Myocardial perfusion images of single photon emission computed tomography were also acquired in some patients. An image of supreme quality could be obtained in spite of small dose of Tl-201 since there was a lack of interference from background activity. Myocardial perfusion images corresponded to areas which were supplied by left or right coronary artery respectively. And the regional myocardial blood flow distribution of a coronary artery bypass graft could be revealed by instilling Tl-201 into the graft. Further, contribution of collateral channels to myocardial perfusion was showed. Not only left ventricle but also right ventricle was clearly visualized by injection of Tl-201 into right coronary artery. But in a case with arrhythmogenic right ventricular dysplasia, there was an area of decreased tracer uptake in the apex of the right ventricle which was identified as the site of dysplasia by electrophysiologic study. We conclude that direct injection of Tl-201 into coronary artery is an useful method to clarify the correlation between coronary anatomical findings and coronary perfusion and contribution of collaterals to myocardial perfusion, and also to detect the right ventricular myopathic site. (author)

  2. Comparison of rest and exercise thallium-201 kinetics in man and implications for quantitation

    International Nuclear Information System (INIS)

    Freeman, M.R.; Kanwar, N.; Armstrong, P.W.

    1989-01-01

    To develop a technique for quantitative analysis of resting thallium scintigrams, an understanding of thallium kinetics at rest is required. This study evaluates in normal man the thallium distribution and washout rates of thallium at rest and compares these findings to similar data obtained during exercise. The thallium half-life in normal resting myocardium is significantly longer than after exercise, 10.2 +/- 1.4 hours versus 3.9 +/- 0.3 hours (P less than .01). Differences in resting thallium half-life exist between the anterior, 45 degrees left anterior oblique (LAO), and 70 degrees LAO views and are 11.4 +/- 1.0, 10.6 +/- 1.0, 8.8 +/- 0.7 hours, respectively (all significantly different from each other by ANOVA, P less than or equal to .01); these differences are related to the imaging sequence. After exercise, the thallium half-life also varies according to imaging sequence, but in the opposite direction; i.e., anterior, 45 degrees LAO, and 70 degrees LAO views are 3.6 +/- 0.1, 3.9 +/- 0.3, 4.2 +/- 0.3 hours, respectively (P less than or equal to .01). Since imaging sequence and time of acquisition at rest and exercise were similar, this finding may be related to earlier maximal uptake of thallium after exercise as compared to rest. There are also significant segmental differences in thallium half-life at rest in the 45 degrees LAO view (9.8 +/- 0.9, septal vs. 11.0 +/- 0.9, posterolateral, P less than .01) and 70 degrees LAO view (8.3 +/- 0.4, anteroseptal vs. 9.2 +/- 0.6, inferior, P less than or equal to .01)

  3. Role of exercise thallium-201 myocardial perfusion scintigraphy in predicting prognosis in suspected coronary artery disease

    International Nuclear Information System (INIS)

    Koss, J.H.; Kobren, S.M.; Grunwald, A.M.; Bodenheimer, M.M.

    1987-01-01

    While exercise thallium imaging has improved sensitivity and specificity for detection of coronary artery disease (CAD), its predictive value for morbid cardiac events is unclear. Of 532 consecutive patients who underwent exercise thallium imaging, follow-up was complete in 515 (97%) after an average of 36 months (range 31 to 48). Two hundred six patients had an abnormal exercise thallium response and 309 had a normal response. Twenty morbid cardiac events occurred (13 deaths and 7 acute myocardial infarctions [AMI]). Of the 13 patients who died, 12 had abnormal thallium results. Overall, 5.8% of the patients with abnormal thallium results died, in contrast to 0.3% of patients with normal results. Of the 7 patients who had a nonfatal AMI, 3 had abnormal exercise thallium results. Moreover, similar proportions of patients (1.4% and 1.3%) with normal and abnormal exercise thallium results had nonfatal AMI. Presence or absence of pathologic Q waves and inclusion of exercise electrocardiographic results did not significantly alter the results. Thus, although a normal exercise thallium response significantly reduces the likelihood of cardiovascular death, its predictive value for nonfatal AMI is limited. Moreover, the relatively low event rate for patients with a positive exercise thallium response further limits its prognostic value

  4. Relationship between thallium-201 myocardial SPECT and findings of endomyocardial biopsy specimens in dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Motohiro; Gotoh, Kohshi; Nagashima, Kenshi [Gifu Univ. (Japan). School of Medicine] (and others)

    2001-02-01

    The purpose of this study was to clarify which myocardial histological findings associated with dilated cardiomyopathy (DCM) are reflected in quantitative {sup 201}Tl myocardial SPECT. We obtained studied SPECT images from 21 patients with DCM 10 minutes and 2 hours after they received an injection of 111 MBq {sup 201}Tl at rest. We calculated the percent coefficient of variation of myocardial {sup 201}Tl counts [%CV(Tl)], the washout rate (WR), standard deviation of WR [SD(WR)], extent score (ES) and severity score (SS). We used image analysis to measure % fibrosis, % myocytes, the ratio of fibrous tissue to myocyte tissue (F/My), myocyte size and standard deviation of myocyte size [SD(My)] in left ventricular endomyocardial biopsy specimens. The %CV(Tl) was correlated with % fibrosis and F/My. The ES and SS also correlated with F/My. The correlation between SD(WR) and SD(My) was significant. The present findings suggest that %CV(Tl), ES and SS of rest {sup 201}Tl SPECT reflect myocardial fibrosis and that the standard deviation of washout reflects the distribution of myocyte size. (author)

  5. Evaluation of thallium-201 myocardial emission computed tomography based on a comparison with postmortem findings

    International Nuclear Information System (INIS)

    Nagashima, Jun-ichi; Yamada, Hideo; Ohkawa, Shin-ichiro; Yonamine, Shigemichi; Nishino, Hideo; Yamagata, Atsushi; Suzuki, Yasuko; Tanno, Munehiko; Chiba, Kazuo

    1986-01-01

    The correlative study of myocardial perfusion assessed by 201 Tl myocardial ECT with the pathological finding of the heart was performed in 10 autopsied cases with mean age of 77 years old (range: 60 - 90 y). In 6 cases with myocardial infarction (MI) 7 perfusion defects were observed, that was, 3 in anteroseptal wall, 1 in anterolateral wall and 3 in posterior wall on the images of SPECT. Seven MIs were also found in postmortem examination. Six MIs were observed at autopsy corresponding to perfusion defect on SPECT images. In one myocardial perfusion defect at inferoposterior portion on SPECT, a non-transmural MI was found at anteroseptum. In one case with valvular disease a false positive result was obtained at posterior wall where neither myocardial necrosis nor fibrosis was observed at autopsy. This case had aortic stenosis due to bicuspid aortic valve by autopsy. The ventricle was devided into 16 segments in each of 4 short axial images to evaluate extent of MI. SPECT for extent of MI showed sensitivity of 81.9 %, specificity of 96.0 % and diagnostic accuracy of 92.5 %. False negative segment was apt to be observed at the surrounding of non-transmural MI or basal half of left ventricle (LV) with transmural MI, while false positive segment was at posterior portion of basal half of LV. It was concluded that myocardial ECT was useful for evaluation of the site and extent of MI. (author)

  6. Thallium-201 myocardial imaging in children with heart disease. Quantitative assessment of right ventricular pressure

    Energy Technology Data Exchange (ETDEWEB)

    Mitomori, Toshihiro; Ono, Yasuo; Kamiya, Tetsuro; Nishimura, Tsunehiko; Kozuka, Takahiro (National Cardiovascular Center, Suita, Osaka (Japan)); Kohata, Tohru; Tanimoto, Takeshi

    1985-02-01

    201-TlCl myocardial imaging studies were performed to evaluate systolic pressure of right ventricle on 107 patients including 89 patients with congenital cardiac disease, patients with primary pulmonary hypertension and 13 patients with history of MCLS with the age range of 2 months to 17 years. The congenital cardiac disease group included 30 patients with tetralogy of Fallot, 8 patients with pulmonary stenosis (included 1 patient with double chambered right ventricle), 20 patients with ventricular septal defect, 10 patients with patent ductus arteriosus, 9 patients with atrial septal defect and 12 patients with complete transposition of great arteries. None of the patients with history of MCLS had coronary involvement. 50 ..mu..Ci/kg of 201-TlCl was infused intravenously and after 15 minutes the images were obtained from 5 directions (anterior, LAO 30, LAO 45, LAO 60 and lateral). The angle was determined to demonstrate the intraventricular septum and ventricular free walls cleary separated. The image of end-diastolic phase was obtained with ECG synchronized gated method from that direction. The ROI (region of interest) was defined as a slice line by drawing two lines perpendicular to the septum and the counts of the left and right ventricular free wall (Cl and Cr) were analyzed to evaluate the pressure of right ventricle. The pressure of ventricles were obtained by cardiac catheterization performed at the same time with myocardial imaging. The ratio of Cl and Cr (Cr/Cl) had good correlation with the ratio of peak systolic pressure of left ventricle and right ventricle (regression equation Y=0.84X + 0.08, r=0.87). In each congenital heart disease group, very good correlation was also demonstrated (Y=1.46X - 0.30, r=0.96 in PS; Y=0.70X0.20, r=0.91 in VSD; Y=0.86X + 0.15, r=0.78 in ASD and Y=0.72X + 0.24, r=0.80 in PDA). Thus 201-TlCl myocardial imaging was useful method to evaluate right ventricular pressure noninvasively in congenital cardiac disease.

  7. SPET brain imaging with thallium 201 diethyldithiocarbamate in acute ischaemic stroke

    International Nuclear Information System (INIS)

    Bruine, J.F. de; Limburg, M.; Royen, E.A. van; Hijdra, A.; Hill, T.C.; Schoot, J.B. van der; Amsterdam Univ.; New England Deaconess Hospital, Boston, MA

    1990-01-01

    Thirty-five patients with acute ischaemic stroke were studied within 24 h after hospital admission with thallium diethyldithiocarbamate Tl 201 single photon emission tomography ( 201 Tl-DDC SPET) and X-ray computed tomography (CT). 201 Tl-DDC is a non-redistributing agent that allows postponed imaging after early administration and early therapeutic intervention. In 16 patients both investigations were performed within 24 h after stroke onset. The sensitivity of SPET was 94% and of CT 81% in the first 24 h, when hypodensity and obliteration of sulci were used as CT reading criteria. When only hypodensity was used as a criterion, the sensitivity of CT was 50% in this group. Sensitivity of CT compared with SPET became increasingly better in patients with older infarcts (1-18 days). In two-thirds of patients, the lesion demonstrated on SPET was larger than that on CT, and this was especially so with older infarcts. Crossed cerebellar diaschisis occurred in 69% of patients. The high sensitivity of 201 Tl-DDC SPET in the first 24 h after ischaemic stroke and the favourable properties of this radiopharmaceutical make it a method of interest in the assessment of initial perfusion defects in early experimental stroke therapies. (orig.)

  8. Subcutaneous injection of thallium-201 chloride and gallium-67 citrate at acupuncture point K-3

    International Nuclear Information System (INIS)

    Johg, Shiang-Bin; Wu, Chung-Chieng; Chen, Ming-Feng; Wu, Sheng-Nan

    1992-01-01

    Subcutaneous (SC) injection of 99m Tc pertechnetate ( 99m Tc) at acupuncture points K-3 is a new method of lower-limb radionuclide venography. To investigate the mechanism of absorption of 99m Tc from SC injected sites into vascular system, various radioisotopes such as 201 Tl chloride ( 201 Tl) and 67 Ga citrate ( 67 Ga) were SC injected at K-3 points in animal and human-beings experiments. It was found that 99m Tc and 201 Tl were absorbed rapidly from K-3 points through venous system and into whole body soft tissue. However, 67 Ga with a larger effective ionic radius than 201 Tl was not absorbed throughout the observation of 5 minutes. Furthermore, intravenous administration of digitalis, a Na + -K + pump blocker, did not inhibit the absorption of 99m Tc and 201 Tl after SC injection at K-3 points. These results suggest that absorption of radionuclides on SC injection at K-3 points is mainly through the passive pathway of diffusion rather than the active transport, and the effective ionic radius may be a major factor influencing the absorption rate of the radionuclides. (author)

  9. Effect of procainamide, lidocaine and diphenylhydantoin on thallium-201 chloride uptake

    Energy Technology Data Exchange (ETDEWEB)

    Schachner, E.R.; Oster, Z.H.; Sacker, D.F.; Som, P.; Atkins, H.L.

    1987-01-01

    The effect of procainamide, lidocaine and diphenylhydantoin on the organ distribution (particularly the heart) of /sup 201/Tl chloride in rats was studied. The results show that diphenylhydantoin significantly decreases the uptake of /sup 201/Tl chloride in several organs of rats previously treated with this drug. No statistically significant effects were noted with procainamide and lidocaine.

  10. Quantitation of postexercise lung thallium-201 uptake during single photon emission computed tomography

    International Nuclear Information System (INIS)

    Kahn, J.K.; Carry, M.M.; McGhie, I.; Pippin, J.J.; Akers, M.S.; Corbett, J.R.

    1989-01-01

    To test the hypothesis that analysis of lung thallium uptake measured during single photon emission computed tomography (SPECT) yields supplementary clinical information as reported for planar imaging, quantitative analysis of lung thallium uptake following maximal exercise was performed in 40 clinically normal subjects (Group 1) and 15 angiographically normal subjects (Group 2). Lung thallium uptake was measured from anterior projection images using a ratio of heart-to-lung activities. Seventy subjects with coronary artery disease (CAD) (Group 3) determined by angiography (greater than or equal to 70% luminal stenosis) underwent thallium perfusion SPECT. Thirty-nine percent of these subjects had multivessel and 61% had single vessel CAD. Lung thallium uptake was elevated in 47 of 70 (67%) Group 3 subjects. Group 3 subjects with elevated lung thallium uptake did not differ from Group 3 subjects with normal lung thallium uptake with respect to extent or distribution of coronary artery disease, left ventricular function, or severity of myocardial ischemia as determined by exercise and redistribution thallium SPECT. Thus, the measurement of thallium lung uptake from anterior projection images obtained during SPECT frequently identifies patients with CAD, but it may not provide supplementary information regarding the extent of myocardial ischemia or ventricular dysfunction

  11. Evaluation of thallium-201 scanning for detection of latent coronary artery disease

    Science.gov (United States)

    Johnson, P. C.; Leblanc, A.; Deboer, L.; Jhingran, S.

    1978-01-01

    The use of thallium imaging as a noninvasive method to accurately screen shuttle passengers for latent coronary artery disease was investigated. All radionuclide procedures were performed using an Anger type camera with a high resolution collimator. A minimum of 200,000 counts were collected for each image using a 20% window centered on the 69-83 keV X-rays. For the images obtained following injection with the patient at rest, the testing was begun 10 minutes after injection. Injections of TT during exercise were made at a point near the termination of the treadmill procedure as determined by either the appearance of ST segment changes on the electrocardiogram consistant with subendocardial ischemia, the appearance of angina-like chest pain in the patient or fatigue in the patient which required cessation of the test. The severity of heart disease was based on the medical history, physical exam, exercise electrocardiograms, chest X-rays and the coronary arteriogram.

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

    International Nuclear Information System (INIS)

    Mori, Kiyoo; Masuda, Masanosuke; Bunko, Hisashi.

    1986-01-01

    Dipyridamole was infused intravenously at a rate of 0.142 mg/kg per min for four min, and a stress image was obtained 10 min after the injection of two mCi 201 Tl. The myocardial image of Tl was analyzed by single photon emission computed tomography and its washout rate was calculated by the segmental ROI method. Myocardial function and the motion of the left ventricular wall were analyzed by 99m Tc-RBC-gated cardiac pool imaging. Reverse redistribution was noted in 27 (21.6 %) of 125 consecutive Tl dipyridamole and redistribution myocardial imaging studies. The stress image demonstrated normal perfusion (group 1) and reduced perfusion (group 2) of Tl. Group 1 consisted of 17 patients with diabetes mellitus, supraventricular arrhythmias, hypertension, and others. Group 2 consisted of 10 patients with subendocardial infarction, diabetes mellitus, and hypertension, and others. The percentage prevalence of reverse redistribution among patients with supraventricular arrhythmia was 62.5 % (five of eight patients), with subendocardial infarction 60.0 % (three of five), with hypertension 42.8 % (six of 14), and with diabetes mellitus 40.0 % (eight of 20), while in those with transmyocardial infarction and angina pectoris no reverse redistribution percentage was found. The washout rate of Tl in normal perfusion areas was 44.0 ± 12.8 %, the reverse redistribution of group 1 was 47.4 ± 12.8 %, and of group 2 was 51.2 ± 8.2 %. The washout rate of the reverse redistribution of group 2 was significantly greater than that of the normal areas. In gated cardiac pool imaging, patients in group 2 had significantly larger areas showing abnormal contraction of the left ventricular wall and significantly lower ejection fraction than did group 1. In the electrocardiogram ST segment depression was noted more frequently in group 2 than group 1. No Q wave was present in the corresponding reverse redistribution area. (J.P.N.)

  13. Intravenous dipyridamole thallium-201 SPECT imaging in patients with left bundle branch block

    International Nuclear Information System (INIS)

    Rockett, J.F.; Wood, W.C.; Moinuddin, M.; Loveless, V.; Parrish, B.

    1990-01-01

    Tl-201 exercise imaging in patients with left bundle branch block (LBBB) has proven to be indeterminate for significant left anterior descending (LAD) coronary artery stenosis because of the presence of immediate septal perfusion defects with redistribution on delayed images in almost all cases. Tl-201 redistribution occurs regardless of the presence or absence of LAD stenosis. Nineteen patients having LBBB were evaluated with dipyridamole Tl-201 SPECT. Fourteen of these subjects had normal dipyridamole Tl-201 SPECT imaging. Three patients had normal coronary angiograms. None of the remaining 11 patients with normal dipyridamole Tl-201 SPECT images was found to have clinical coronary artery disease in a 5-11 month follow-up period. Five patients had abnormal septal perfusion. Four underwent coronary angiography. One had a significant LAD stenosis. The single patient with septal redistribution who refused to undergo coronary angiography died shortly thereafter of clinical coronary artery disease. This preliminary work suggests that dipyridamole Tl-201 SPECT may be more useful for excluding LAD stenosis in patients with LBBB than Tl-201 exercise imaging

  14. Detecting thyroid cancer: utopia or reality? or Possibilities for thallium 201 in thyroid oncopathology

    International Nuclear Information System (INIS)

    Hermans, J.; Beauduin, M.; Gigot, J.F.; Schmitz, A.; Pluygers, E.

    1985-01-01

    201 Tl uptake by cold thyroid nodules, as evidenced by routine scintigraphy, was investigated in 119 patients. Results show strong correlation (89.5%) of existence of thyroid tumors (benign follicular adenoma and carcinoma) with 202 Tl uptake. (Auth.)

  15. Dipyridamole thallium-201 myocardial imaging. Complications associated with oral and intravenous routes of administration

    International Nuclear Information System (INIS)

    Aksut, S.V.; Port, S.; Collier, B.D.; Hoffmann, R.G.; Massardo, T.; Hellman, R.S.; Isitman, A.T.; Carnell, A.; Devich, E.C.

    1988-01-01

    Previous reports have shown that TI-201 myocardial imaging with either an oral or intravenous administration of dipyridamole is a suitable diagnostic examination for patients at risk for coronary artery disease who cannot perform treadmill exercise. To compare the incidence of complications associated with these two routes of drug administration, the records of 78 oral and 97 intravenous dipyridamole TI-201 imaging studies were reviewed. The oral administration is associated with a significantly higher incidence of nausea (15% vs. 4%). Despite the higher incidence of nausea, the percentage of patients having one or more dipyridamole-induced symptoms was no greater for the oral (29%) than for the intravenous (37%) administration. Intravenous administration produced both a significantly higher incidence of atypical angina (14% vs. 4%) and a significantly greater increase in heart rate (16.6 vs. 10.2 beats per minute). No patient in either the oral or intravenous dipyridamole protocols had life-threatening arrhythmias or myocardial infarctions. In clinical practice, the difference in complications associated with the oral and intravenous administration of dipyridamole for TI-201 imaging is not significant

  16. Correlates of lung/heart ratio of thallium-201 in coronary artery disease

    International Nuclear Information System (INIS)

    Homma, S.; Kaul, S.; Boucher, C.A.

    1987-01-01

    We studied 306 patients with chest pain (262 with coronary artery disease and 44 with no coronary artery disease) to determine which of 23 clinical, exercise, thallium, and angiographic variables best discriminate between patients with increased lung/heart ratios of thallium versus those with normal ratios. Normal lung/heart ratio values were defined using an additional 45 subjects with less than 1% probability of coronary artery disease. The number of diseased vessels was the best discriminator between patients with increased ratios versus those with normal ratios. Double product at peak exercise, number of segments with abnormal wall motion, patient gender, and duration of exercise were also significant discriminators. Using discriminant function analysis these variables could correctly identify 81% of cases with increased lung/heart ratios and 72% of cases with normal ratios. These results indicate that an increased lung/heart ratio of thallium reflects exercise-induced left ventricular dysfunction and affords a better understanding of why this thallium parameter is a powerful prognostic indicator in patients with chest pain

  17. The ECG component of Thallium-201 exercise testing impacts on cardiac intervention rates

    Energy Technology Data Exchange (ETDEWEB)

    Deague, J.; Salehi, N.; Grigg, L.; Lichtenstein, M.; Better, N. [Royal Melbourne Hospital, Parkville, VIC (Australia). Departments of Nuclear Medicine and Cardiology

    1998-06-01

    Full text: Thallium exercise testing (Tlex) offers superior sensitivity and specificity to exercise electrocardiography (ECG), but the value of the ECG data in Tlex remains poorly studied. While a normal Tlex is associated with an excellent prognosis, patients with a positive Tlex have a higher cardiac event rate. We aimed to see if a negative ECG Component of the Tlex (ECGTl) was associated with an improved outcome compared with a positive ECGTl, in those patients with a reversible Tlex defect. We followed 100 consecutive patients retrospectively with a reversible defect on Tlex (50 with negative and 50 with positive ECGTI) for 12 months. The ECG was reviewed as positive (1mm ST depression 0.08 seconds after J point or >2mm if on digoxin or prior ECG changes), negative, equivocal or uninterpretable. We excluded patients with pharmacological testing, and those with equivocal or uninterpretable ECGs. End-points included angiography, cardiac interventions and cardiac event rate (CER) incorporating unstable angina, acute myocardial infarction, and cardiac death. In conclusion 24% of patients with reversible defects on Tlex who had a negative ECGTI still proceeded to PTCA or CABG. Those with a positive ECGTI had a higher incidence of angiography and cardiac revascularisation, but this difference was only evident in patients with mild to moderate reversibility

  18. The ECG component of thallium-201 exercise testing significantly alters patient management

    Energy Technology Data Exchange (ETDEWEB)

    Deague, J.; Salehi, N.; Grigg, L.; Lichtenstein, M.; Better, N. [Royal Melbourne Hospital, Parkville, VIC (Australia). Departments Nuclear Medicine and Cardiology

    1998-02-01

    Full text: Thallium exercise testing (Tlex) offers superior sensitivity and specificity to exercise electrocardiography (ECG), but the value of the ECG data in Tlex remains poorly studied. While a normal Tlex is associated with an excellent prognosis, patients with a positive Tlex have a higher cardiac event rate. We aimed to see if a negative ECG component of the Tlex (ECGTI) was associated with an improved outcome compared with a positive ECGTI, in those patients with a reversible Tlex defect. We followed 100 consecutive patients retrospectively with a reversible defect on Tlex (50 with negative and 50 with positive ECGTI) for 12 months. The ECG was reviewed as positive (1 mm ST depression 0.08 seconds after J point or > 2 mm if on digoxin or prior ECG changes), negative, equivocal or uninterpretable. We excluded patients with pharmacological testing, and those with equivocal or uninterpretable ECGs. Over the ensuing 12 months no patients with negative ECGTl was admitted with unstable angina, myocardium infarction or had a cardiac death. It is concluded that in patients with reversible defects on Tlex, a negative ECGTl is associated with a low incidence of cardiac events and a decreased incidence of a cardiac intervention

  19. Intestinal absorption and excretion of thallium (201Tl) in the rat.

    Science.gov (United States)

    Sabbioni, E; Di Nucci, A; Edel, J; Gregotti, C; Marafante, E; Manzo, L

    1984-01-01

    The gastrointestinal transport of 201Tl-labelled monovalent thallium has been studied in normal and rats with cannulated bile ducts using an in vivo ligated loop technique. A marked difference in the Tl absorptive capacity among the various sections of the gut was observed. 201Tl was taken up more quickly from the colon than from any other segment and the uptake from the ileum and jejunum was higher than from the stomach. In addition, considerable amounts of the intravenously administered thallium were excreted into the intestinal lumen. The biliary excretion was very low compared with the direct transfer of 201Tl across the gastrointestinal wall that occurred against a tissue-to-plasma concentration gradient. In the rat, the large intestine seems to be the major area for the enteral reabsorption and recycling of thallium (I) ions.

  20. Thallium-201: Autoradiography in pigmented mice and melanin-binding in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Tjaelve, H.; Nilsson, M.; Larsson, B. (Uppsala Univ. (Sweden))

    1982-01-01

    Autoradiography with /sup 201/Tl/sup +/ in C57Bl mice showed a strong labelling of the eye melanin and of pigmented hair follicles. An analysis of the affinity of thallium for pigment from cow eyes indicated a binding to three groups of sites and showed a marked sensitivity to the addition of H/sup +/-ions. The results are consistent with the conception that a binding of thallium occurs to the free carboxyl groups of the melanin and that the structure of the polymer has a marked influence on the affinity. Similar results have previously been obtained with other cations. There was no indication that the strong in vivo affinity of thallium to melanin is due to a more firm binding than for other cations which do not localize on melanin in vivo. Instead, the ability of cations to pass the melanocyte membranes and reach the melanin granules is probably decisive for whether a melanin-binding will take place in vivo. Toxic effects on the eye and epilation are symptoms of thallium intoxication which may be related to its melanin-binding. The fate of /sup 201/Tl/sup +/ in some other tissues is also described and discussed.

  1. Effects of heart rate on myocardial thallium-201 uptake and clearance

    International Nuclear Information System (INIS)

    Nordrehaug, J.E.; Danielsen, R.; Vik-Mo, H.

    1989-01-01

    The effects of heart rate on the myocardial uptake and clearance of 201 Tl were studied prospectively in seven healthy men, mean age 43 +/- 7 (s.d.) yr. Initial and delayed (3 hr) thallium images were obtained in three views after three bicycle exercise tests: to maximal, 80% and 60% of predicted maximal heart rate. The mean of three views initial myocardial 201 Tl uptake was higher at maximal than at both 80% and 60% of predicted maximal heart rate, being 81% (p less than 0.01) and 60% (p less than 0.01) of maximal activity, respectively. The myocardial activity in the delayed images was identical. There was a linear relationship between heart rate and the initial myocardial activity, r = 0.86 (p less than 0.001). The mean (range) 201 Tl clearance was 58% (51-65), 47% (34-56), and 34% (22-49) (all differences p less than 0.01), respectively. Concordance among the three individual views in estimating clearance was best for the highest exercise level. There was a linear relationship between heart rate and clearance, r = 0.80 (p less than 0.001). Clearance was altered by only 1.67 x 10%/heart bpm (0.024 hr/heart beat). Clearance in the liver, spleen and lungs increased at submaximal exercise levels. Thus, a linear relationship between heart rate and clearance is the result of changes in the initial exercise myocardial 201 Tl activity. Submaximal exercise may reduce reproducibility of clearance estimation, and the change of myocardial clearance with heart rate seems less than previously suggested

  2. The effect of procainamide, lidocaine and diphenylhydantoin on thallium-201 chloride uptake

    International Nuclear Information System (INIS)

    Schachner, E.R.; Oster, Z.H.; Sacker, D.F.; Som, P.; Atkins, H.L.

    1987-01-01

    The effect of procainamide, lidocaine and diphenylhydantoin on the organ distribution (particularly the heart) of 201 Tl chloride in rats was studied. The results show that diphenylhydantoin significantly decreases the uptake of 201 Tl chloride in several organs of rats previously treated with this drug. No statistically significant effects were noted with procainamide and lidocaine. (UK)

  3. Peritoneal fluid causing inferior attenuation on SPECT thallium-201 myocardial imaging in women

    Energy Technology Data Exchange (ETDEWEB)

    Rab, S.T.; Alazraki, N.P.; Guertler-Krawczynska, E.

    1988-11-01

    On SPECT thallium images, myocardial left ventricular (LV) anterior wall attenuation due to breast tissue is common in women. In contrast, in men, inferior wall counts are normally decreased compared to anterior counts. The purpose of this report is to describe cases of inferior wall attenuation of counts in women caused by peritoneal fluid, not myocardial disease. Twelve consecutive SPECT thallium myocardial studies performed in women on peritoneal dialysis, being evaluated for kidney transplant, were included in this study. For all studies, 3.5 mCi 201Tl were injected intravenously. Thirty-two images were acquired over 180 degrees (45 degrees RAO progressing to 45 degrees LPO) at 40 sec per stop. SPECT images were reviewed in short axis, horizontal long and vertical long axes. Data were also displayed in bullseye format with quantitative comparison to gender-matched normal files. Ten of 12 female patients studied had inferior wall defects on images, confirmed by bullseye display. All patients had approximately 2 liters of peritoneal fluid. Review of planar rotational views showed diaphragm elevation and fluid margin attenuations affecting left ventricular inferior wall. Thus, peritoneal fluid is a cause of inferior attenuation on 201Tl cardiac imaging.

  4. Significance of collateral circulation on peri-infarct zone: assessment with stress thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Imamura, T.; Araki, H.; Fukuyama, T.; Maruoka, Y.; Ootsubo, H.; Nakamura, M.; Koiwaya, Y.; Tanaka, K.

    1986-01-01

    To evaluate the significance of collateral circulation on peri-infarct zone, stress myocardial scintigraphy and contrast left ventriculography (LVG) were performed in 38 patients with recent myocardial infarction (MI). All patients had at least one completely occluded coronary artery corresponding to the infarct area. In patients with good collaterals, stress induced transient enlargement of the perfusion defect, however, in those with poor or no collaterals the enlargement did not occur (p less than 0.05). Wall motion abnormality on LVG was significantly milder in the former patients than in the latter (p less than 0.001). Transient enlargement of the perfusion defect after stress and milder left ventricular asynergy were more frequently observed in patients with anterior MI and good collaterals. These observations indicate that good collaterals may keep some myocardium in the peri-infarct zone viable

  5. Thallium-201 myocardial imaging during coronary vasodilation induced by oral dipyridamole

    International Nuclear Information System (INIS)

    Gould, K.L.; Sorenson, S.G.; Albro, P.; Caldwell, J.H.; Chaudhuri, T.; Hamilton, G.W.

    1986-01-01

    Myocardial perfusion imaging of 201 TI injected during maximum exercise has been an important diagnostic tool for coronary artery disease. Pharmacologic coronary vasodilation by i.v. infusion of dipyridamole may be used in lieu of exercise stress for purposes of diagnostic perfusion imaging. However, i.v. dipyridamole is not currently available from commercial sources for widespread routine use. Accordingly, this study was carried out in order to determine whether high dose, oral dipyridamole would be useful as a coronary vasodilator for purposes of diagnostic perfusion imaging. Fifty-eight patients undergoing diagnostic coronary arteriography also had myocardial perfusion imaging with 201TI under conditions of rest, maximum exercise stress, and high dose oral dipyridamole. Of those patients who had a defect on exercise thallium images, 75% also had a perfusion defect on thallium images after high dose oral dipyridamole. These results indicate that oral dipyridamole causes sufficient coronary arteriolar vasodilation and increase of coronary flow in nonstenotic arteries to identify perfusion defects comparable to those seen on maximum exercise stress in at least 75% of cases. In 25% of patients with exercise defects, no perfusion defect was seen after oral dipyridamole. Thus, oral dipyridamole is a potent coronary vasodilator, comparable to exercise stress in most cases, but in a minority of patients may not be comparable to exercise stress

  6. False-negative dipyridamole-thallium-201 myocardial imaging after caffeine infusion

    International Nuclear Information System (INIS)

    Smits, P.; Corstens, F.H.; Aengevaeren, W.R.; Wackers, F.J.; Thien, T.

    1991-01-01

    The vasodilator effect of intravenously administered dipyridamole may be caused by an increase in endogenous plasma adenosine levels. The authors evaluated the effect of caffeine, an adenosine receptor antagonist, on the diagnostic results of dipyridamole-201Tl myocardial imaging in eight patients with coronary artery disease. Caffeine infusion significantly attenuated the dipyridamole-induced fall in blood pressure and the accompanied increase in heart rate. The infusion of dipyridamole alone resulted in chest pain and ST-segment depressions on the electrocardiogram in four patients, whereas none of these problems occurred when the tests were repeated after caffeine. In six of eight patients, caffeine was responsible for false-negative dipyridamole-201Tl tests. Semiquantitive scores of the dipyridamole-induced 201Tl perfusion defects were decreased by caffeine from 9.0 ± 0.9 to 2.0 ± 1.1 points (p less than 0.05). Computerized analysis revealed a caffeine-mediated reduction in the percent reversibility of the images from 46% ± 16% to 6% ± 10% (p less than 0.05). They conclude that the use of caffeinated products prior to dipyridamole-201Tl testing may be responsible for false-negative findings

  7. An attempt of thallium-201 myocardial perfusion imaging during transient coronary arterial occlusion by PTCA

    International Nuclear Information System (INIS)

    Nakagawa, Tatsuya; Sugihara, Hiroki; Katahira, Toshio

    1989-01-01

    To evaluate the myocardial perfusion during transient coronary occlusion, we attempted to obtain the myocardial scintigraphy during percutaneous transluminal coronary angioplasty (PTCA). Tl-201 was injected at the last inflation of angioplastic balloon and occlusion was kept on for 60 sec. Planar images or SPECT were obtained immediately after PTCA. With this protocol, myocardial perfusion defects were observed during PTCA and fully redistributed 3 hours after Tl injection. Extent of ischemic lesions were almost same as that observed during exercise in two cases without collateral vessels. In a case with well visualized collateral vessels, perfusion defect was smaller in PTCA images than that in exercise stressed images. We conclude that intravenous injection of Tl-201 during PTCA is useful to assess the alteration of myocardial perfusion due to transient coronary occlusion without increasing the risk of angioplastic procedure. (author)

  8. Sex-specific criteria for interpretation of thallium-201 myocardial uptake and washout studies

    International Nuclear Information System (INIS)

    Rabinovitch, M.; Suissa, S.; Elstein, J.

    1986-01-01

    A study was undertaken to determine the effect of gender on criteria for the quantitative analysis of exercise-redistribution 201 Tl myocardial scintigraphy. The studies of 26 normal females and 23 normal males were subjected to bilinear interpolative background subtraction and horizontal profile analysis. Significant sexual differences were found in both regional uptake ratios and washout rates. These differences primarily reflected a proportionately decreased anterior and upper septal uptake in females, and faster washout in females. Faster myocardial 201 Tl washout rates in females could not be clearly ascribed to either a physiological or artifactual explanation. It is concluded that since important differences exist between males and females in the detected pattern of 201 Tl myocardial uptake and washout, sex-specific criteria may enhance the predictive accuracy of exercise-redistribution 201 Tl myocardial scintigraphy

  9. Influence of peak exercise heart rate on normal thallium-201 myocardial clearance

    International Nuclear Information System (INIS)

    Kaul, S.; Chesler, D.A.; Pohost, G.M.; Strauss, H.W.; Okada, R.D.; Boucher, C.A.

    1986-01-01

    Measurement of myocardial clearance rates between initial and delayed images is a major justification for adding computer quantification to the interpretation of exercise 201 TI images. To clarify the range of normal thallium clearance and its relationship to the level of exercise achieved, exercise thallium images in 89 normal subjects were analyzed: 45 asymptomatic subjects with less than 1% probability of coronary artery disease (CAD) (Group I), and 44 patients with chest pain found to have no significant CAD on angiography (Group II). Mean initial regional thallium uptake was similar in the two groups, but myocardial thallium clearance (mean +/- 1 s.d.) was slower in Group II, expressed as a longer half-life in the myocardium (8.2 +/- 7.6 hr compared with 3.4 +/- 0.7 hr p less than 0.001). Analysis of variance using ten clinical and exercise variables as covariates showed that the slower clearance in Group II was related to a lower peak exercise heart rate (HR) (154 +/- 27 compared with 183 +/- 11, respectively, p less than 0.001). By linear regression analysis, a decrease in peak HR of 1 beat/min was associated with a slower thallium clearance (longer half-life) of 0.05 hr. Using this formula, the clearance value in each patient was then corrected for peak exercise heart rate by decreasing measured clearance by 0.05 hr multiplied by the amount peak exercise heart rate which was below 183 (the mean value in Group I). There were no differences in the corrected clearance between the two groups. We conclude that thallium myocardial clearance after exercise is related in part to factors other than the presence of CAD, being slower when peak exercise HR is lower. Therefore, thallium clearance rates alone uncorrected for peak exercise heart rate should be used with caution when diagnosing CAD

  10. Myocardial kinetics of thallium-201 after stress in normal and perfusion-reduced canine myocardium

    International Nuclear Information System (INIS)

    Okada, R.D.

    1985-01-01

    Despite the emerging use of quantitative computer programs for assessing myocardial thallium uptake and clearance after exercise, little is known about the kinetics of thallium after exercise stress. Accordingly, 11 mongrel dogs with experimental left anterior descending coronary stenoses were given thallium during norepinephrine infusion to simulate exercise. The infusion was discontinued and thallium activity was monitored regionally using miniature radiation detectors for 3 hours. Heart rate, arterial pressure and double product all increased significantly during norepinephrine infusion. The mean fractional myocardial thallium clearance was lower (0.47 +/- 0.03 [+/- standard error of the mean]) for the stenosis zone than for the no-stenosis zone (0.57 +/- 0.03) (p less than 0.0001). The stress blood flow ratio (stenosis/no-stenosis zone = 0.27 +/- 0.06) was significantly lower than the final thallium activity ratio (0.68 +/- 0.07) (p less than 0.001), consistent with thallium redistribution occurring over the 3-hour period. Myocardial thallium activity in the stenosis zone peaked in a mean of 2.2 minutes, then washed out biexponentially with a final decay constant of 0.0035 +/- 0.0005 min-1. Myocardial thallium activity in the no-stenosis zone peaked within 1 minute in all dogs, then washed out biexponentially, with a final decay constant of 0.0043 +/- 0.0003 (p less than 0.001 compared with stenosis zone). In conclusion, fractional clearance of thallium can differentiate myocardium distal to a coronary artery stenosis from that supplied by a normal coronary vessel

  11. Differences in Thallium-201 uptake in reperfused and nonreperfused myocardial infarction

    International Nuclear Information System (INIS)

    Melin, J.A.; Becker, L.C.; Bulkley, B.H.

    1983-01-01

    The respective importance of flow and cellular viability in determining initial myocardial thallium uptake was studied in reperfused and nonreperfused experimental myocardial infarction. Open-chest dogs were subjected to permanent coronary artery occlusion of 70-minute (n . 3) or 5-hour duration (n . 5), or to a 3-hour temporary occlusion followed by reflow (n . 14). Thallium uptake 10 minutes after intravenous injection was compared directly with radioactive microspheres in myocardial samples from excised hearts. Triphenyl tetrazolium chloride staining was used to differentiate necrotic and viable samples with confirmation by electron microscopy. In nonreperfused infarcts, thallium uptake occurred despite necrosis, and a close correlation was found between thallium uptake and regional myocardial blood flow. In reperfused infarcts, thallium uptake again occurred, but was reduced relative to flow in necrotic myocardium and, to a lesser extent, in reperfused viable areas. However, because of the high levels of reflow, actual thallium uptake was often more than 50% of normal in reperfused necrotic regions. This study demonstrates that the presence of thallium uptake is an unreliable indicator of myocardial injury and that reperfused necrotic tissue may have remarkably high levels of thallium uptake

  12. Experimental and clinical study of cardiac hypertrophy by thallium-201 myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Torii, Yukio (Kyoto Prefectural Univ. of Medicine (Japan))

    1983-09-01

    I studied experimentally the myocardial uptake of /sup 201/Tl in cardiac hypertrophy in rat, and clinically evaluated cardiac shape and dimension in the patients with various types of cardiac hypertrophy. Experimentally, both myocardial blood flow (MBF) and Tl uptake were increased with cardiac weight. There were negative correlations between the extraction fraction and MBF. Tl uptake in Hypertrophy is not always dependent on MBF and affected by the altered metabolism of hypertrophied myocardium. Clinical study was performed in 29 normal subjects and in 90 patients with heart disease. The measurements of left ventricular (LV) size by Tl scintigraphy were well correlated with them by echocardiography. Aortic stenosis and hypertensive heart disease showed thick wall and spherical shape. Both mitral (MR) and aortic (AR) regurgitation showed ventricular dilatation, spherical shape (in chronic MR) and ellipsoid shape (in acute MR and in AR). Decreased ventricular size but normal shape was observed in mitral stenosis and cor pulmonale. Hypertrophic cardiomyopathy showed thick wall with asymmetric septal hypertrophy, while congestive cardiomyopathy showed thin wall with marked ventricular dilatation and spherical shape. I conclude that heart disease has characteristic figures in dimension and shape which may be reflecting cardiac performance or compensating for the load to the heart, and that /sup 201/Tl scintigraphy is useful evaluating cardiac morphology as well as in diagnosing myocardial ischemia.

  13. Thallium-201 and technetium-99m pertechnetate subtraction scintigraphy in patients with hyperparathyroidism

    International Nuclear Information System (INIS)

    Kuwashima, Shigeko; Koizumi, Mitsuru; Goto, Masafumi; Nomura, Toshiharu; Fujioka, Mutsuhisa; Watari, Tsutomu

    1992-01-01

    A reliable technique for detecting and localizing abnormal parathyroid tissue has been a persistent problem. We evaluated thallium-technetium (Tl/Tc) subtraction scintigraphy in 16 patients with clinical biochemical evidence of hyperparathyroidism prior to other diagnostic methods and surgery. Seven patients had surgery and were confirmed to have parathyroid adenoma or hyperplasia. The other methods included ultrasonography (US) in 6 patients, computed tomography (CT) in 10 patients, magnetic resonance imaging (MRI) in 8 patients, and bone scintigraphy in 7 patients. In patients who had several imaging modalities, the detection rate was significantly better for Tl/Tc subtraction scan than for US, CT or MRI. Bote scintigraphy, though not so sensitive as Tl/Tc subtraction studies, was an important tool for evaluating metabolic bone disorder including hyperparathyroidism and renal osteodystrophy. Thus, Tl/Tc subtraction scan is more useful for diagnosis when hyperparathyroidism is suspected if both Tl/Tc subtraction scan and bone scan are performed. The detectability depended on the mass size, and detection of abnormal glands was greater for adenoma than for hyperplasia. The results suggest that Tl/Tc subtraction scan is a simple, non-invasive and useful tool for locating parathyroid abnormality even when compared with MRI. (author)

  14. Noninvasive detection of coronary artery disease by myocardial imaging with thallium-201

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Usami, Masahisa

    1981-01-01

    Dipyridamole-loading myocardial imaging was performed in 38 patients with coronary artery diseases(CAD). The diagnostic accuracy of this method was 66%. The combination of dipyridamole-loading and exercise stress myocardial imaging increased the diagnostic sensitivity of CAD from 71% (exercise stress imaging only) to 87%. In addition, dipyridamole-loading myocardial imaging was useful for the diagnosis of CAD in patients who could not perform exercise stree test. Chest pain and ST-segment depression were induced less often during dipyridamole administration than exercise stress test. Animal experiments showed that dipyridamole caused abnormalities in myocardial blood flow and myocardial Tl uptake distal to the critical coronary stenosis. And dipyridamole increased myocardial blood flow by 142% and myocardial Tl concentration by 62% in the normally perfused myocardial segments. Ergonovine-loading myocardial imaging was performed in 8 patients with resting angina and without significant coronary stenosis. And in all of them, ergonivine induced cold-spots on myocardial imaging with or without chest pain and ST-segment shift. Ergonovine-loading myocardial imaging was useful for the diagnosis of angina induced by coronary artery spasm. The combination of initial and delayed resting myocardial imaging was useful to differentiate the underperfused but viable myocardium from the scar. And by comparing with radionuclide angiography obtained before and after nitroglycerin(NTG) administration, ATG-loading myocardial imaging and electrocardiogram(ECG) findings in 20 patients with CAD, we demonstrated that the transient defective myocadial segments were underperfused but viable. (author)

  15. Scintigraphic small intestinal transit time and defaecography in patients with J-pouch

    DEFF Research Database (Denmark)

    Kjær, Mie Dilling; Simonsen, Jane Angel; Hvidsten, Svend

    2015-01-01

    Objective methods for examination of pouch function are warranted for a better understanding of the functional result and treatment of dysfunction. The objective of this study was to evaluate the results of scintigraphic intestinal transit time and defaecography compared to the results of pouch...... function, mucosal condition and a questionnaire on quality of life (QoL). This cross-sectional study included 21 patients. Scintigraphic transit time and defaecography was determined with the use of Tc-99m. Pouch function was assessed by number of bowel movements, pouch volume, and continence. Pouch...... mucosal condition was evaluated by endoscopy and histology. Median transit time was 189 min (105–365). Median ejection fraction at defaecography (EF) was 49% (3–77) and 62% (17–98) after first and second defecation. Median pouch volume was 223 mL (100–360). A median daily stool frequency of nine (4...

  16. Evaluation of radionuclide calibrators and scintigraphic cameras used in nuclear medicine in the Sergipe

    International Nuclear Information System (INIS)

    Lima Ferreira, F.C.; Nascimento Souza, D. do

    2008-01-01

    A quality control program to nuclear medicine services concerns the verification of the efficiency of equipment used to diagnosis and treatment, allow the professional improvement. In this study were assessed the performance of two radionuclide calibrators (activimeters) and of two scintigraphic cameras employed in nuclear medicine in the state of Sergipe, Brazil, according to regulation CNEN -NN-3.05. Additionally, to the radionuclide calibrators it was established a nd characterized an intercomparison of activities measured by different practitioners from standard samples of sealed radioactive sources of 133 Ba and 57 Co. The evaluation of this manufacture object was made thought quality control tests on scintigraphic cameras, such as: test of spatial resolution, tomographic resolution and linearity. The results of the quality control tests were satisfactory and they one can be used as parameter in future evaluations. (author)

  17. Studies on 201Th myocardial scintiscanning

    International Nuclear Information System (INIS)

    Buchner, U.

    1979-01-01

    The diagnostical evidence of myocardial scintiscanning with thallium-201 was tested on 98 patients with coronary heart disease. 2 mCi thallium-201 were injected into an arm vene and then scintigrams of the heart were registered partly with a scanner, partly with a gamma camera in several views. The healthy myocardium was found in the thallium-201-scintigram to be a rather homogeneous, horeshoe-shaped activity pattern with intramyocardial activity differences of up to 20% of the maximal thallium-201-activity above the myocard which can be declared to be physiological. In dependency on the local blood flow conditions, thallium-201 is stored only in the healthy, but not in the ischaemic or infarcted myocardium. In the scintigram, these regions are seen as regions with reduced radioactivity. A comparison of the localisation of the infarction in the scintigram with those in the electrocardiagram and coronary angiogram showed a good congrucucy. Scintigrams taken at different times after the infarction brought a decrease in the number of diagnosed storage failures, from 90% to 68% in infarctions older than 6 weeks. A scintigraphical differentiation between fresh and old infarctions was not possible. In cases of angiographically established coronary heart disease without infarction, pathological storage reductions were observed. By comparing the findings obtained by scintiscanning with the results of laevocardiography it was seen that hypokinetic regions in the thallium-201-myocardial scintigram showed in only 6% of the cases a pathological storage defect; akinetic, dyskinetic, and aneurysmatic regions, however, were seen in 65% of the cases as clear activity reductions or failures. (orig./MG) [de

  18. Scintigraphic Methods to Evaluate Alterations of Gastric and Esophageal Functions in Female Obesity

    Directory of Open Access Journals (Sweden)

    Özgür Ömür

    2014-02-01

    Full Text Available Objective: Altered gastrointestinal function has frequently been observed in obese patients. The aim of this study was to investigate the frequency of gastro-esophageal reflux (GER and to determine the alterations of gastric emptying and esophageal transit by scintigraphic methods in obese patients. Methods: Scintigraphic studies of 50 obese female non-diabetic patients who had not received any treatment for weight control were retrospectively reviewed. Mean Body Mass Index (BMI was 34.96±3.04 kg/m² (range:32-39 kg/m². All subjects were submitted to scintigraphic evaluation of esophageal transit, gastro-esophageal reflux, gastric emptying and presence of Helicobacter pylori infection. The data of obese patients were compared with those of sex-age matched 30 non-obese cases who were selected from our clinical archive. Results: In obese group, seventeen (34% patients were found to be GER positive scintigraphically; mean gastric emptying time (t½ was 59.18±30.8 min and the mean esophageal transit time was 8.9±7.2 s. Frequency of positive GER scintigraphy and the mean value of esophageal transit time were significantly higher in obese patients than non-obese control subjects. Gastric emptying time and esophageal transit time values were significantly longer in GER positive obese patients than GER negative ones. There was no statistically significant difference in the frequency of positive C14 urea breath test between obese and non-obese subjects and there were also no statistically significant correlations between BMI, GER, esophageal transit time and gastric emptying time. Conclusion: In our study, 42 of the 50 obese patients had esophago-gastric motility alterations. The significance of these alterations in obesity is not fully understood, but it is believed that these changes could be because of potential contributing factors in the development or maintenance of obesity or changes in eating habits

  19. Temporal contrast enhancement and parametric imaging for the visualisation of time patterns in dynamic scintigraphic imaging

    International Nuclear Information System (INIS)

    Deconinck, F.; Bossuyt, A.; Lepoudre, R.

    1982-01-01

    Image contrast, photon noise and sampling frequency limit the visual extraction of relevant temporal information in scintigraphic image series. When the Unitation is mainly due to low temporal contrast, temporal contrast enhancement will strongly improve the perceptibility of time patterns in the series. When the limitation is due to photon noise and limited temporal sampling, parametric imaging by means of the Hadamard transform can visualise temporal patterns. (WU)

  20. Evaluation of quatitative scintigraphic method in diagnosis of esophagic involvement of Progressive Systemic Sclerosis

    International Nuclear Information System (INIS)

    Von Muehlen, C.A.

    1985-01-01

    Twenty patients with Progressive Systemic Sclerosis are studied by scintigraphic methodology. The esophageal transit method is used for liquid and solid meals. The results are compared with the ones of a control group, without or not gastrintestinal problems but without autoimmune diasese. 99 sup(m)Tc-sulfurcolloid is used as labelling compound. The studies were done in supine and orthostatical position. (M.A.C.) [pt

  1. Experience based on 60 observations of scintigraphic bone exploration using pyrophosphates

    International Nuclear Information System (INIS)

    Mienville, J.-C.

    1975-01-01

    5 to 15 millicuries of technetium 99m-labelled pyrophosphates are injected intraveinously. 3 to 5 hours later, when the blood activity has dropped, the bone uptake is sufficient to give a good scintigraphic image of the skeleton. The skeleton may be explored one segment at a time, using a scanning scintigraph or a scintillation camera, or the whole skeleton front and back may be examined much more quickly with a 'whole-body' device. A study of 60 observations shows the large number of hyperfixations revealed by isotopic explorations in rheumatological diseases. A hyperfixation was observed in almost all bone localities of osteophilic cancers, osteonecrosis, Paget's disease, infections osteo-arthritis and algoneurodystrophy. On the other hand the isotopic test was found to be negative or inefficient in arthroses, osteoporosis and local bone manifestations of Kahler's or Hodgkin's disease. Finally inflammatory arthritis was detectable by scintigraphy in about half the cases studied. In reality a hyperfixation reflects a local rise in the metabolic activity of the bone at the moment of the examination. As a result the scintigraphic images lack specificity. This factor must therefore be accounted for in the patient's records and isotopic results compared with those of clinical and para-clinical examinations [fr

  2. Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction

    International Nuclear Information System (INIS)

    Kim, Sung Hoon; Chung, Soo Kyo; Byun, Jae Young; Lee, Sung Yong; Shinn, Kyung Sub; Kim, Choon Yul; Bahk, Yong Whee

    1988-01-01

    Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow. The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows: 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

  3. Scintigraphic Small Intestinal Transit Time and Defaecography in Patients with J-Pouch

    Directory of Open Access Journals (Sweden)

    Mie Dilling Kjaer

    2015-10-01

    Full Text Available Objective methods for examination of pouch function are warranted for a better understanding of the functional result and treatment of dysfunction. The objective of this study was to evaluate the results of scintigraphic intestinal transit time and defaecography compared to the results of pouch function, mucosal condition and a questionnaire on quality of life (QoL. This cross-sectional study included 21 patients. Scintigraphic transit time and defaecography was determined with the use of Tc-99m. Pouch function was assessed by number of bowel movements, pouch volume, and continence. Pouch mucosal condition was evaluated by endoscopy and histology. Median transit time was 189 min (105–365. Median ejection fraction at defaecography (EF was 49% (3–77 and 62% (17–98 after first and second defecation. Median pouch volume was 223 mL (100–360. A median daily stool frequency of nine (4–25 was reported and three (14% patients suffered from daytime incontinence. No patients had symptomatic or endoscopic pouchitis; however, the histology showed unspecific inflammation in 19 (90% patients. There was no correlation between transit time, evacuation fraction (EF and pouch function in univariate analysis. However, we found a high body mass index (BMI and a low bowel movement frequency to be associated with a longer transit time by multivariate analysis. Scintigraphic determination of transit time and defaecography are feasible methods in patients with ileal pouch anal anastomosis, but the clinical relevance is yet doubtful.

  4. Scintigraphic determination of the effect of metoclopramide and morphine on small intestinal transit time

    Energy Technology Data Exchange (ETDEWEB)

    Prokop, E.K.; Caride, V.J.; Winchenbach, K.; Troncale, F.J.; McCallum, R.W.

    1988-01-01

    To determine if a scintigraphic method could detect pharmacologic changes in small intestinal transit time (SITT), 10 male volunteers were studied at baseline and after intravenously administered metoclopramide (10 mg) and morphine (8 mg). Five of these volunteers were studied with the hydrogen breath test method for comparison. For each of the scintigraphic studies, the volunteers were positioned supine under a large-field-of-view gamma camera after ingesting an isosmotic lactulose solution containing 99mtechnetium-diethylenetriaminepentaacetic acid (DTPA). Data were collected and stored in a computer. Both gastric emptying and SITT were determined. SITT was 81 +/- 11 min (mean +/- S.E.M.; N = 10) during baseline studies, was decreased significantly to 50 +/- 6 min (N = 10; P less than 0.01) after metoclopramide, and was increased significantly to 161 +/- 15 min (N = 8; P less than 0.01) after morphine. Baseline mean values were 86.3 +/- 15 min (N = 15) for the hydrogen breath tests, 47 +/- 8 min (N = 5) for metoclopramide, and 183 +/- 16 min (N = 5) for morphine. For gastric emptying, there was no significant difference in percentage emptying at 1 hr for baseline and metochopramide (82 +/- 5% vs. 88 +/- 4%). Morphine prolonged gastric emptying at 1 hr to 63 +/- 8%. We conclude that the scintigraphic method for measuring SITT permits accurate investigation of the pharmacologic effects on intestinal motility and, in addition, may be a useful research and clinical method for SITT determination.

  5. Simplified scintigraphic methods for measuring gastrointestinal transit times

    DEFF Research Database (Denmark)

    Graff, J; Brinch, K; Madsen, Jan Lysgård

    2000-01-01

    To investigate whether simple transit measurements based on scintigraphy performed only 0, 2, 4 and 24 h after intake of a radiolabelled meal can be used to predict the mean transit time values for the stomach, the small intestine, and the colon, a study was conducted in 16 healthy volunteers...... intestinal and colonic mean transit times were calculated for both markers and compared with fractional gastric emptying at 2 h, fractional colonic filling at 4 h, and geometric centre of colonic content at 24 h, respectively. Highly significant correlations were found between gastric mean transit time...... and fractional gastric emptying at 2 h (111In: r=0.95, Ptransit time and fractional colonic filling at 4 h (111In: r=-0.97, Ptransit time and geometric centre of colonic content...

  6. Scintigraphic images of bacterial infection using aptamers directly labeled with 99mTc

    International Nuclear Information System (INIS)

    Santos, S.R.; Correa, C.R.; Andrade, A.S.R.; Barros, A.L.B.; Diniz, S.O.F.; Cardoso, V.N.

    2015-01-01

    Staphylococcus aureus is specie of great medical importance and is the most commonly agent found in infections of soft tissues, bone infections and bone prostheses. In this study, aptamers selected to S. aureus were labeled by the direct method with 99m Tc and used for bacterial infection identification by scintigraphy. The radiolabeled aptamers radiochemical purity and stability were assessed by thin-layer chromatography (TLC). Three groups of Swiss mice (n=6) were used for the scintigraphic imaging studies. The first group was infected intramuscularly in the right thigh with S. aureus, the second group with C. albicans and the third group received zymosan to induce aseptic inflammation. After 24 h, radiolabeled aptamers (18 MBq) were injected by the tail vein. Scintigraphic images were acquired at 1 h and 4 h postinjection. The radiolabeling yield with 99m Tc was over 90%. The radiolabeled aptamers were stable in 0.9% saline, plasma and cysteine excess. The scintigraphic image profiles showed high uptake in the kidneys and bladder in all groups, indicating a main renal excretion consistent with the hydrophilic nature of the molecule. No accumulation of radioactivity was observed in the thyroid, stomach, liver and spleen, indicating acceptable levels of radiochemical impurities. The group infected with S. aureus showed a visible uptake in the infected right thigh at 1 h post-injection. For the control groups (C. albicans and zymosan) visible differences between the right and left thighs were not observed. The radiolabeled aptamers were able to distinguish aseptic inflammation from bacterial infection and bacterial from fungal infection. (author)

  7. Evaluation by scintigraphic images of musculoskeletal infection with 99mTc ciprofloxacin

    International Nuclear Information System (INIS)

    Casacó, C.A.; Hernández, A.; Perera, A.; Prats, A.; Batista, J.F.; Torres, L.A.; Quesada, R.; Sánchez, Y.; Valladares, L.; Sánchez, E.L.; Marrero, L.O.; Mustelier, E.

    2016-01-01

    Introduction: Infectious diseases present high morbidity and mortality in all countries, especially in the third world. In Cuba between 2005 and 2014, approximately 1.3% of the total deaths were killed. Orthopedic infections are among the most common. The scintigraphic methods currently used are not able to discern between a septic focus and a sterile inflammation. Radiological methods detect a bone infection only when there is significant anatomical damage. Ciprofloxacin as a drug binds and inhibits topoisomerase II or bacterial gyrase DNA. Objective: to evaluate the efficacy of 99m Tc-ciprofloxacin in the detection of osteo-articular bacterial processes. Materials and Methods: An experimental, cross-sectional, cross-sectional study was conducted involving 258 patients with suspected osteoarticular infectious processes. The presence of the lesion and the quantification and intensity of uptake in the foci of infection in images with 99m Tc-MDP (3h post-administration) and 99m Tc-ciprofloxacin (1, 4 and 24h post-administration) were visually determined. Studies of 99m Tc-ciprofloxacin were compared with Culture / Biopsy results. Results: The germ that most frequently appears in infected osteo-articular sites is staphilococcusaureus. No adverse effects were detected in any of the subjects studied. Studies with 99m Tc-MDP allow delineating infected areas but are not specific. 99mTc-ciprofloxacin shows the sites of active osteo-articular bacterial infection and when it is fixed in a septic focus gives intense captures at both 4 and 24 hours. It exhibits a sensitivity similar to 99mTc-MDP, but a significantly higher specificity. Conclusions: Scintigraphic images with 99m Tc-ciprofloxacin show sites of active osteo-articular bacterial infection with a specificity significantly higher than 99m Tc-MDP. The microbiological and scintigraphic results were positive for sepsis in 122 patients out of 219 who were sampled.

  8. Role of intensity transformation function for enhancement of bone scintigraphic images.

    Science.gov (United States)

    Pandey, Anil Kumar; Dhiman, Vishali; Sharma, Akshima; ArunRaj, Sreedharan Thankarajan; Baghel, Vivek; Patel, Chetan; Sharma, Param Dev; Bal, Chandrasekhar; Kumar, Rakesh

    2018-03-29

    The bone scintigraphic image might exceed the dynamic range (the ratio between the highest and the lowest brightness a monitor is capable of displaying) of display monitor. In this case, a high intensity area, and loss of the details of other structures in the displayed image makes the clinical interpretation a challenging task. We have investigated the role of intensity transformation function for enhancement of these types of images. Methods: Forty high dynamic range bone scintigraphic images were processed using intensity transformation (IT) function. The IT function has two parameters: threshold and slope. Keeping the threshold equal to mean counts of the image, the value of slope was varied from 1 to 20. In-house application program written in MATLAB R2013b was used to process images. Twenty output images corresponding to one input image were visually inspected by two experienced nuclear medicine (NM) physicians to select diagnostic quality images, and from their selection the standardized slope (value of slope parameter) that produced maximum numbers of diagnostic images was determined. They also rated the image quality of input and output images (at standardized slope) on scale 1 to 5 [where 1 is for poor and 5 if for the excellent diagnostic quality]. Student's t-test was used to test the significance of difference between the mean image quality score assigned to input and processed images at significance level α = 0.05. Results: The application of IT functions with standardized parameters significantly improved the quality of high dynamic range bone scintigraphic images ( P enhancement. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  9. Scintigraphic images of bacterial infection using aptamers directly labeled with {sup 99m}Tc

    Energy Technology Data Exchange (ETDEWEB)

    Santos, S.R.; Correa, C.R.; Andrade, A.S.R., E-mail: sararoberta7@hotmail.com, E-mail: crisrcorrea@gmail.com, E-mail: antero@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Barros, A.L.B.; Diniz, S.O.F.; Cardoso, V.N., E-mail: brancodebarros@yahoo.com.br, E-mail: valbertcardoso@yahoo.com.br, E-mail: simoneodilia@yahoo.com.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Farmacia. Departamento de Analises Clinicas e Toxicologicas

    2015-07-01

    Staphylococcus aureus is specie of great medical importance and is the most commonly agent found in infections of soft tissues, bone infections and bone prostheses. In this study, aptamers selected to S. aureus were labeled by the direct method with {sup 99m}Tc and used for bacterial infection identification by scintigraphy. The radiolabeled aptamers radiochemical purity and stability were assessed by thin-layer chromatography (TLC). Three groups of Swiss mice (n=6) were used for the scintigraphic imaging studies. The first group was infected intramuscularly in the right thigh with S. aureus, the second group with C. albicans and the third group received zymosan to induce aseptic inflammation. After 24 h, radiolabeled aptamers (18 MBq) were injected by the tail vein. Scintigraphic images were acquired at 1 h and 4 h postinjection. The radiolabeling yield with {sup 99m}Tc was over 90%. The radiolabeled aptamers were stable in 0.9% saline, plasma and cysteine excess. The scintigraphic image profiles showed high uptake in the kidneys and bladder in all groups, indicating a main renal excretion consistent with the hydrophilic nature of the molecule. No accumulation of radioactivity was observed in the thyroid, stomach, liver and spleen, indicating acceptable levels of radiochemical impurities. The group infected with S. aureus showed a visible uptake in the infected right thigh at 1 h post-injection. For the control groups (C. albicans and zymosan) visible differences between the right and left thighs were not observed. The radiolabeled aptamers were able to distinguish aseptic inflammation from bacterial infection and bacterial from fungal infection. (author)

  10. Scintigraphic hepatobiliary function studies in newborn infants to diagnose biliary hypoplasia or atresia

    International Nuclear Information System (INIS)

    Askari-Sabi, Z.

    1987-01-01

    The results obtained from scintigraphic hepatobiliary function studies, intraoperative cholangiography and histological examinations in a total of 17 infants suspected of having biliary atresia were compared and analysed with reference to the clinical signs and symptoms observed. In most cases, the individual diagnostic procedures led to consistent findings, even though there were some variations in the clinical picture. Patient outcome is largely determined by the site of atresia, due to which fact surgical correction should be carried out as soon as possible, in any case before the 8th week post partum. (TRV) [de

  11. Scintigraphic and clinical findings in the Standardbred metatarsophalangeal joint: 114 cases (1993-1995)

    International Nuclear Information System (INIS)

    Ross, M.W.

    1998-01-01

    To correlate scintigraphic and clinical findings of the metatarsophalangeal joint (MTPJ) in Standardbreds, radiographic findings in horses with confirmed MTPJ lameness, and determine if stress reaction and more advanced bone remodelling occurred in the MTPJ, medical records of 114 Standardbreds admitted between September 1993 and April 1995 in which bone scintigraphy included standing lateral and plantar views of the metatarsophalangeal joint (MTPJ) were reviewed. Images obtained using a large field of view gamma camera were evaluated visually for location, definition and intensity of increased radioisotope uptake (IRU), which was graded as mild, moderate, or intense. Clinical history and lameness examination findings were recorded and, in horses with documented MTPJ lameness, radiographic examination included the 30 degree (down-angled) dorsolateral 45 degree plantaromedial view thought to be useful in evaluation of the plantarolateral condyle of the third metatarsal bone (MtIII). The most common abnormality, IRU of the plantarolateral aspect of MtIII, was seen in 67 horses, and horses were further classified according to scintigraphic and clinical findings. In 43 horses in which lameness was not localised to the MTPJ, mild (32 horses), moderate (10 horses), and intense (one horse) IRU of MtHII was found. In 24 horses with lameness localised to the MTPJ, moderate (18 horses) and intense (6 horses) IRU was found. Of 18 horses with moderate IRU of MtIII, 9 had radiographic evidence of abnormal bony remodelling of MtIII, whereas 5 of 6 horses with intense IRU had radiographic changes. In 12 horses with MTPJ lameness and radiographic evidence of bony remodelling without fracture, radiographic changes consisted of plantarolateral subchondral radiolucency and sclerosis (7 horses), radiolucency and osteochondrosis (one horse), and plantar MtIII sclerosis without radiolucency (4 horses). In 2 horses with moderate IRU and MTPJ lameness, radiographic evidence of

  12. Scintigraphic localization of a disseminated malignant pheochromocytoma with the use of 131I-meta-iodobenzylguanidine

    International Nuclear Information System (INIS)

    Troncone, L.; Maini, L.M.; Rufini, V.; Bonifazi, N.; De Rosa, G.; Corsello, S.M.; Mattei, O.

    1984-01-01

    Preliminary clinical studies with 131 I-meta-iodo-benzylguanidine, a newly synthesized radiopharmaceutical and guanethidine analog capable of imaging the adrenal medulla, have led to the identification, of a case of disseminated malignant pheochromocytoma with the localization of brain and bone metastases. The result is of particular interest as the symptomatology in this case appeared rather equivocal and various investigations had led to a completely different diagnosis. This new scintigraphic technique has proved to be safe, specific and noninvasive, and it may have a clinical application as a complementary or alternative technique to conventional diagnostic tests. (orig.)

  13. Scintigraphic study of blood perfusion of the pulmonary artery in pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Certain, D.A.; Brolio, R.; Salomon, G.C.; Carvalho, N.; Barbosa, Z.L.M.

    1972-01-01

    Blood perfusion in the pulmonary artery is studied by pulmonary scintigraphy with macroaggregated albumin 131 I, in 74 cases of pulmonary tuberculosis. Results shown by scintigraphy are compared to those observed in roentgenography and also correlated with the extension and degree of the lesions, and with the presence of associated tuberculosis, considered capable of changing the scintigraphic picture. The reduction of blood flow in the pulmonary artery are observed in cases of infiltrative, fibrotic of caseous lesions, as well as in cases of minor lesions [pt

  14. Scintigraphic measurement of the contractile activity of the gastric antrum using factor analysis

    International Nuclear Information System (INIS)

    Bergmann, H.; Hoebart, J.; Kugi, A.; Stacher, G.; Granser, G.V.

    1990-01-01

    The motor activity of the gastric antrum is difficult to record by manometric means and scintigraphic methods have proved unsatisfactory so far as no consistent relationship between antral contractile activity and gastric emptying rate could be detected. We investigated, using data recorded in 16 healthy human subjects after the ingestion of a semisolid standard meal, whether a newly developed method employing factor analysis would yield more meaningful and reproducible results. Factor analysis was applied to sequential scintigraphic images (3-s frame time) of gastric antrum. The computed factor images and the respective factor curves are representative of distinct dynamic structures of the antrum. From the more or less sinusoidal excursions of the factor curves, which exhibited the 3 cycles per minute frequency characteristic for the stomach, amplitude, frequency and propagation velocity of antral contractions can be calculated. The amplitudes of the factor curves were used to calculate a contraction index. This contraction index was found to be correlated significantly negatively with the gastric half-emptying time of the ingested meal. The employed factor analytical approach thus seems a promising tool to further investigate the role of antral contractility in the process of gastric emptying. (Authors)

  15. Scintigraphic test of the vitality and functional fitness of organs conserved for transplantation

    International Nuclear Information System (INIS)

    Bozduganov, A.; Marinov, V.

    1976-01-01

    Having reviewed critically present-day methods of testing the vitality of isolated perfused organs, the authors propose their own. It is founded in the principles of colour scintigraphy after introduction of short-lived nuclides. The method was applied in testing 57 isolated preserved organs (5 kidneys, 12 livers, 5 hearts and 4 spleens from dogs; 2 kidneys and 27 livers from rabbits; 1 kidney and 1 liver from young pigs). Moreover, compararive scintigraphic and biochemical investigations were conducted on 2 dogs and 4 young pigs (A. Bozduganov, E. Simeonov, N. Bogdanova). The techniques of isolation and perfusion of the organ have been given a detailed description. Sup(113m)In was used as tracer. Areas of radioactivity deposits were visualized more or less intensely, depending on the degree of vitality and functional fitness still present actually; else, blanks were seen. Orthotransplantation and heterotransplantation with subsequent scintigraphic examination in vivo served, in scattered instances, the purpose of confirming or of rejecting ambiguous vitality findings in preserved organs. Advantages of the method are a general and specified evaluation of the organ in all of its areas; anatomical integrity of the object under test; applicability to various organs; possibility of conducting dynamic tests; accurate reproduction of vitality and functional findings, etc

  16. Assessment of skeleton scintigraphic study in breast cancer patients (relative to 322 observations)

    International Nuclear Information System (INIS)

    Liechtmaneger, Nicole.

    1976-01-01

    The results of scintigraphic whole-skeleton examinations have recently been improved by the use of sup(99m)Tc labelled phosphorus compounds. An assessment was made of 368 explorations, most of which were carried out with pyrophosphates and a few, the most recent, with ethane hydroxy diphosphonate, both labelled with sup(99m)Tc. For pyrophosphates a 10 mCi intraveinous injection is followed by a latency time of about 3 hours before the scintigraphic examination. In the case of diphosphonates, which have only been used lately and on relatively few cases, the same 10 mCi intravenous injection is administered but the latency time before the examination is only half as long, i.e. about 1h30 min, which is a definite advantage. However the number of examinations carried out with the latter is too small to afford a significant comparison between the two products. The main object of this work is to count the hyperfixation centres and to estimate their specificity and their coexistence or otherwise with clinical or radiological signs [fr

  17. Scintigraphic assessment of ectopic splenic tissue localization and function following splenectomy for trauma

    Energy Technology Data Exchange (ETDEWEB)

    Zwas, S.T.; Samra, D.; Samra, Y.; Sibber, G.R.

    1986-07-01

    Twenty-three subjects who had a splenectomy as a result of trauma underwent scintigraphic evaluation with a sensitive heat-denatured sup(99m)Tc-labeled red blood cells (DRBC). This method enabled detection of ectopic splenic tissue foci (ESTF) as small as 1x1 cm in diameter. ESTF splenosis or accessory spleen was detected in 15 cases (65%), a higher incidence than previously reported. The size of the ESTF ranged from 1x1 to 5x10 cm (0.8-40 cm/sup 2/), and 53% were less than 2x2 cma (3 cm/sup 2/). A new multiparametric scintigraphic evaluating technique is described, which estimates the quantity of ESTF and its grade of activity, relative to that of the liver. The technique is a highly efficient assessor of ESTF function. Good correlation was found between the size and activity of the ESTF and the presence of Howell-Jolly bodies (HJB), but with a low sensitivity for detecting small ESTF. Correlation was low between residual splenic tissue and concentrations of IgM, IgA and IgG immunoglobulins. The sup(99m)Tc-DRBC method described is recommended for verification of ESTF existence, localization, and function.

  18. Scintigraphic assessment of ectopic splenic tissue localization and function following splenectomy for trauma

    International Nuclear Information System (INIS)

    Zwas, S.T.

    1986-01-01

    Twenty-three subjects who had a splenectomy as a result of trauma underwent scintigraphic evaluation with a sensitive heat-denatured sup(99m)Tc-labeled red blood cells (DRBC). This method enabled detection of ectopic splenic tissue foci (ESTF) as small as 1x1 cm in diameter. ESTF splenosis or accessory spleen was detected in 15 cases (65%), a higher incidence than previously reported. The size of the ESTF ranged from 1x1 to 5x10 cm (0.8-40 cm 2 ), and 53% were less than 2x2 cma (3 cm 2 ). A new multiparametric scintigraphic evaluating technique is described, which estimates the quantity of ESTF and its grade of activity, relative to that of the liver. The technique is a highly efficient assessor of ESTF function. Good correlation was found between the size and activity of the ESTF and the presence of Howell-Jolly bodies (HJB), but with a low sensitivity for detecting small ESTF. Correlation was low between residual splenic tissue and concentrations of IgM, IgA and IgG immunoglobulins. The sup(99m)Tc-DRBC method described is recommended for verification of ESTF existence, localization, and function. (orig.)

  19. Marker development

    Energy Technology Data Exchange (ETDEWEB)

    Adams, M.R.

    1987-05-01

    This report is to discuss the marker development for radioactive waste disposal sites. The markers must be designed to last 10,000 years, and place no undue burdens on the future generations. Barriers cannot be constructed that preclude human intrusion. Design specifications for surface markers will be discussed, also marker pictograms will also be covered.

  20. Targeting of macrophages for the scintigraphic evaluation of inflammatory lesions in a model of radio-induced inflammation in pigs

    International Nuclear Information System (INIS)

    Hoffschir, D.; Daburon, F.; Normier, G.; Binz, H.; Le Pape, A.

    1991-01-01

    For a new scintigraphic strategy based on the targeting of macrophages recruited by inflammatory lesions, a specific ligand able to interact with these cells both in vitro and in vivo has been developed. J001 is a 34 KDa acylated peptidopoly 1-3 galactoside isolated from proteoglycans of a non pathogenic strain of klebsiella. When labelled with 99mTc then administrated by aerosol, this agent has been demonstrated to be a potent tool for the scintigraphic imaging of inflammatory lymph nodes in experimental berylliosis and in patients with sarcoidosis, lung tumors and ganglionic metastases. An experimental model was developed in pigs using an acute and localized muscular γ irradiation in the limb and skin resection to prevent ulceration. Dynamic imaging was performed during two hours after intravenous injection of 1 mg J001 labelled with 370 MBq 99mTc in the presence of 0.125 mg stannous fluoride. The perfusion of the lesions was evaluated from scintigraphic data obtained both 15 min after IV injection of J001 or 99mTc 04-. The intensity of the fixation of J001 was quantified 2 hours after injection and expressed as a scintigraphic ratio: R2h = cpm in lesion / cpm in a defined healthy area in the same limb. After induction of irradiation, scintigraphic ratios exhibited a progressive increase to reach a maximum (R2h = 3.6) after 3 months. Then, they decreased to recover a normal value about 6 months after irradiation. At that time, histological controls and clinical observations exhibited a significant decrease in inflammatory reaction, macrophages recruitment and apparition of fibrosis. J001 fixation was very sensitive to corticosteroids that resulted in a complete clearing of the scintigraphic images 12 to 24 hours after treatment. Two weeks were then required for a complete recovery of the inflammatory reaction and J001 fixation. So, targeting of macrophages with J001 should offer a sensitive and specific tool for the scintigraphic assessment of inflammation and

  1. Comparative study of a therapeutic program of goldsalts v.s. D-Penicillamin controlled by scintigraphic, clinical and laboratory dates in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Doerwald, K.; Krebber, K.; Kriegel, W.

    1978-01-01

    The hand joints of 22 rheumatoid arthritis patients were examined by means of a scintigraphic investigation, introducing 99 mTc-pyrophosphate at the beginning of, and end of a sixth month period during which a therapy of goldsalts, respectively D-Penicillamine was given. To compare the chenges of activity, during therapy, we used a quantitative scintigraphic method of local tracer accumulation, conparing laboratory and clinical results. The quantitative analysis of the scintigraphic results correlated with the clinical findings, which allowed a measurable course of observation. Differences in the effect of this therapy did not arise. The MCP-joints of the finger were more frequently afflicted. (orig.) [de

  2. Analysis of stress fractures associated with lameness in Thoroughbred flat racehorses training on different track surfaces undergoing nuclear scintigraphic examination.

    Science.gov (United States)

    MacKinnon, M C; Bonder, D; Boston, R C; Ross, M W

    2015-05-01

    There is limited information regarding the impact of training track surface on the occurrence of stress fractures. To evaluate the impact of training track surface on the proportion of long bone and pelvic stress fractures associated with lameness in Thoroughbred horses in flat race training undergoing nuclear scintigraphic examination. Retrospective study. Scintigraphic examinations of Thoroughbred flat racehorses were evaluated from 2 hospitals (hospital A [Toronto Equine Hospital], 2003-2009, and hospital B [George D. Widener Hospital for Large Animals, School of Veterinary Medicine, University of Pennsylvania], 1994-2006). Horses admitted to hospital A trained at a single track, at which the main training surface changed from dirt to synthetic on 27 August 2006. Two distinct populations existed at hospital B: horses that trained on dirt (numerous trainers) and those that trained on turf (single trainer). All scintigraphic images were evaluated by a blinded reviewer. Fisher's exact test and logistic regression were used when appropriate, and significance was set at Pfractures detected in scintigraphic examinations from horses training on a synthetic surface (31.7%) in comparison to scintigraphic examinations from horses training on a dirt surface (23.0%) at an earlier point in time (P = 0.03). There was a greater proportion of hindlimb/pelvic and tibial stress fractures diagnosed in horses from the synthetic surface-trained group than from the dirt-trained group at hospital A (Pfractures diagnosed, but other factors, such as training philosophy, appear to be important. Future prospective investigations to fully elucidate the relationship between training track surface and the proportion of stress fractures and other nonfatal musculoskeletal injuries are warranted. © 2014 EVJ Ltd.

  3. Scintigraphic evaluation of the osteoblastic activity of rabbit tibial defects after HYAFF11 membrane application.

    Science.gov (United States)

    Mermerkaya, Musa Uğur; Doral, Mahmut Nedim; Karaaslan, Fatih; Huri, Gazi; Karacavuş, Seyhan; Kaymaz, Burak; Alkan, Erkan

    2016-05-03

    An unfavorable condition for bone healing is the presence of bone defects. Under such conditions, a material can play a role to cover fractured or defective bone. Technological advances now allow for the use of such material. Hyalonect(®) (Fidia Advanced Biopolymers SLR, Italy), a novel membrane comprising knitted fibers of esterified hyaluronan (HYAFF11) can be used to cover fractured or grafted bone and can also serve as a scaffold to keep osteoprogenitor cells in place. The aim of this study was to compare osteoblastic activity by the use of scintigraphic methods in defective rabbit tibias during early-phase bone healing with or without a hyaluronan-based mesh. Two groups (A and B) of New Zealand albino rabbits were used; each group included 10 animals. Operations on all rabbits were performed under general anesthesia. We also resected 10-mm bone segments from each animal's tibial diaphysis. After resection, tibias with defects were fixed using Kirschner wires. In group A, no hyaluronan-based mesh was used. In group B, tibial segmental defects were enclosed with a hyaluronan-based mesh. The rabbits were followed up for 4 weeks postoperatively, after which bone scintigraphic studies were performed on each animal to detect and compare osteoblastic activity. The mean count in the fracture side of the hyaluronan-based mesh group was significantly higher compared to that of the group A (p = 0.019). However, there was no significant difference between group B and control rabbits with respect to the mean count on the intact bone side (p = 0.437). The bone defect (fracture)/intact bone mean count ratio was significantly higher in group B compared to group A (p = 0.008). A hyaluronan-based mesh plays a role in promoting osteoblastic activity. Hyalonect(®) is suitable for restoring tissue continuity whenever the periosteal membrane is structurally impaired or inadequate. Our results demonstrated that, during early-phase bone healing, osteoblastic activity

  4. Scintigraphic imaging of focal hypoxic tissue: development and clinical applications of 123I-IAZA

    Directory of Open Access Journals (Sweden)

    Leonard I. Wiebe

    2002-09-01

    Full Text Available Affected tissues in a number of diseases, including cancer, stroke, cardiac infarction and diabetes, develop focal tissue hypoxia during their progression. The presence of hypoxic tissue may make the disease refractory to therapy, as in the case of solid tumor therapy using low LET ionizing radiation. In other pathologies, the detection of viable but hypoxic tissues may serve as a prodromal indicator of developing disease (e.g. diabetes,or as a prognostic indicator for management of the disease (e.g. stroke. Over the past two decades, a number of hypoxia radioimaging agents have been developed and tested clinically. Of these, 18F-Fmiso and 123I-IAZA are the most widely used radiotracers for PET and SPECT/planar imaging, respectively. IAZA and Fmiso are a 2-nitroimidazoles that chemically bind to subcellular components of viable hypoxic tissues. They sensitize hypoxic tumour to the killing effects of ionizing radiation via mechanisms that mimic the radiosensitizing effects of oxygen, and are therefore called oxygen mimetics. The oxygen mimetic effect is attributable in large part to the covalent binding of reductively-activated nitroimidazole intermediates to critical cellular macromolecules. Nitroimidazoles labelled with gamma-emitting radionuclides (e.g. 18F-Fmiso and 123I-IAZA have been used as scintigraphic markers of tumour hypoxia, based on the need to identify radioresistant hypoxic tumour cells as part of the radiotherapy planning process. Broader interest in non-invasive, imaging-based identification of focal hypoxia in a number of diseases has extended hypoxia studies to include peripheral vascular disease associated with diabetes, rheumatoid arthritis, stroke, myocardial ischaemia, brain trauma and oxidative stress. In this review, the current status of hypoxia-selective studies with 123I-IAZA , an experimental diagnostic radiopharmaceutical, is reviewed with respect to its pre-clinical development and clinical applications.Os tecidos

  5. Novel CT and scintigraphic findings of bone metastasis from invasive lobular breast cancer.

    Science.gov (United States)

    Al-Ogaili, Zeyad; Troedson, Russell

    2016-02-01

    The aim of this study is to identify and describe the computed tomography and scintigraphic imaging patterns of osseous metastasis from invasive lobular breast cancer (ILC). CT and skeletal scintigraphy (SS) studies of 23 patients with diagnosis of ILC and osseous metastasis on their initial presentation were reviewed. Osseous metastases in 14 patients (60.8%) appear as uniform small sclerotic lesions (USSL) on CT scan. The SS in these patients were interpreted as negative for metastasis (either normal or with some equivocal findings not typical for metastasis). Osseous metastasis from ILC can have a characteristic imaging pattern on CT and SS. The pattern of USSL on CT scan with negative SS is highly suggestive of osseous metastasis from ILC. © 2015 The Royal Australian and New Zealand College of Radiologists.

  6. Novel CT and scintigraphic findings of bone metastasis from invasive lobular breast cancer

    International Nuclear Information System (INIS)

    Al-Ogaili, Zeyad; Troedson, Russell

    2016-01-01

    The aim of this study is to identify and describe the computed tomography and scintigraphic imaging patterns of osseous metastasis from invasive lobular breast cancer (ILC). CT and skeletal scintigraphy (SS) studies of 23 patients with diagnosis of ILC and osseous metastasis on their initial presentation were reviewed.Osseous metastases in 14 patients (60.8%) appear as uniform small sclerotic lesions (USSL) on CT scan. The SS in these patients were interpreted as negative for metastasis (either normal or with some equivocal findings not typical for metastasis). Osseous metastasis from ILC can have a characteristic imaging pattern on CT and SS. The pattern of USSL on CT scan with negative SS is highly suggestive of osseous metastasis from ILC.

  7. Scintigraphic image contrast-enhancement techniques: global and local area histogram equalization.

    Science.gov (United States)

    Verdenet, J; Cardot, J C; Baud, M; Chervet, H; Duvernoy, J; Bidet, R

    1981-01-01

    This article develops two contrast-modification techniques for the display of scintigraphic images. Based on histogram-modification techniques, histogram equalization, where each level of gray is used to the same extent, gives maximum entropy. The first technique uses the application of histogram equalization in the whole image. To eliminate contrast attenuation small but important portion of the gray scale histogram, local area histogram equalization has been applied to images with differences in intensity. Both techniques were tested using a phantom with known characteristics. The global equalization technique is more suitable to bone scintigraphies, and some well-chosen boundaries improved the difference between two comparable areas. For liver scintigraphies, where intensity is quite equal in every pixel, a local area equalization was chosen that allowed detection of heterogeneous structures. The images resulting from histogram-equalization techniques improve the readability of data, but are often far from usual images and necessitate an apprenticeship for the physician.

  8. Scintigraphic localization of pheochromocytomas using 131 I-meta-iodobenzylguanidine. Comparison with computerized tomography

    International Nuclear Information System (INIS)

    Charbonnel, B.; Coornaert, S.; Tellier, J.L.; Peltier, P.; Chatal, J.F.

    1984-01-01

    Meta-iodobenzylguanidine was synthesized, radiolabelled with I 131 or I 123 and injected to 28 controls and 7 patients totalizing 13 foci of pheochromocytoma. The tumour was located in one adrenal gland in 3 cases, in both adrenal glands in 1 case, and between the aorta and the vena cava in 1 case; 2 were malignant with metastases. Scintigraphy was negative in all controls, whereas all pheochromocytomas were clearly demonstrated 24 h after injection, except one regarded as non functional due to necrosis. By comparison, CT readily showed the tumour in 7 cases, showed it only thanks to scintigraphic guidance in 4 cases and failed in 2 cases. It is concluded that scintigraphy with meta-iodo-benzylguanidine provides a safe and reliable means of locating a wide range of pheochromocytomas [fr

  9. Scintigraphic control of bone-fracture healing under ultrasonic stimulation: An animal experimental study

    International Nuclear Information System (INIS)

    Klug, W.; Franke, W.G.; Knoch, H.G.

    1986-01-01

    In a model of closed lower-leg fracture in rabbits and of secondary bone-fracture healing, scintigraphic control until biological healing was performed. Biological fracture healing was assumed for a region of interest (ROI)-activity ratio close to 1.0. After application of sup(99m)Tc-HEDP, 151 examinations were performed. ROI activity increased significantly until day 14 p.i. and reached the maximum value (Q=6.44) on day 14 postfracture. Sixty-one lower leg fractures were treated by ultrasound from days 14-28 postfractures. These stimulated fractures were biologically healed on day 168 postfracture. The fractures that were not treated by ultrasound could not be detected by scanning after day 203 postfracture. (orig.)

  10. Scintigraphic disagreement in the study of thyroid nodules using technetium 99m and iodine 131

    International Nuclear Information System (INIS)

    Planchon, C.A.

    1977-01-01

    116 patients with thyroid nodules, iso or hyperfixing, heterogeneous or scintigraphically indistinct after administration of pertechnetate 99mTc, were systematically re-examined with iodine 131. The results of this study are as follows: 1) 99mTc, while its advantages justify its extensive application, is an imperfect tracer and cannot replace iodine 131 altogether. In fact in 12% of the cases the results were conflicting. 2) The technological conditions may sometimes be to blame but the hypothesis of a special metabolic behavior of the nodule examined seems plausible in certain cases of disagreement (blocking of hormone synthesis and escape of non-hormonal iodine). 3) These observations correspond to no particular anatomo-clinical factors. The legitimate conclusion therefore is that the exclusive use of 99mTc could result in failure to recognise a non-functional nodule (1 case in about 10), a possibility not to be neglected because of the risk of cancer [fr

  11. Right ventricular function: methodologic and clinical considerations in noninvasive scintigraphic assessment

    International Nuclear Information System (INIS)

    Manno, B.V.; Iskandrian, A.S.; Hakki, A.H.

    1984-01-01

    Right ventricular function plays an important role in many cardiac disorders. Changes in left ventricular function, right ventricular afterload and preload, cardiac medications and ischemia may affect right ventricular function. Radionuclide ventriculography permits quantitative assessment of regional and global function of the right ventricle. This assessment can be made at rest, during exercise or after pharmacologic interventions. The overlap between right ventricle and right atrium is a major limitation for gated scintigraphic techniques. The use of imaging with newer short-lived radionuclides may permit more accurate and reproducible assessment of right ventricular function by means of the first pass method. Further work in areas related to improvement of techniques and the impact of right ventricular function on prognosis is needed

  12. Scintigraphic and Endoscopic Evaluation of Radiation-induced Acute Gastrointestinal Syndrome in Micro-pig Model

    International Nuclear Information System (INIS)

    Lee, Seung-Sook; Kim, Kyung-Min; Kim, Jin; Jang, Won-Suk; Lee, Jung-Eun; Kim, Noo-Ri; Lee, Sun-Joo; Kim, Mi-Sook; Ji, Young-Hoon; Cheon, Gi-Jeong; Lim, Sang-Moo

    2007-01-01

    Micro-pig model can be served as a proper substitute for humans in studying acute radiation syndrome following radiation-exposure accidents, especially showing similar clinico-pathologic response of hematopoietic and gastrointestinal (GI) syndrome to human. Among acute GI syndrome induced by radiation, GI motility disturbance has not been studied, however, it would be important in a viewpoint of affecting infectious progression from GI tract. Here, we employed scintigraphy of GI transit time and sequential endoscopic examination and tissue sampling in micropigs followed by abdominal radiation exposure. The specific aims of this study are to evaluate objective evidence of GI motility disturbance by scintigraphic evaluation and to find corresponding clinicoapthologic changes in radiation-induced acute GI syndrome

  13. Acute rhabdomyolysis of the soleus muscle induced by a lightning strike: magnetic resonance and scintigraphic findings

    International Nuclear Information System (INIS)

    Watanabe, Naofumi; Inaoka, Tsutomu; Shuke, Noriyuki; Takahashi, Koji; Aburano, Tamio; Chisato, Naoyuki; Go, Kazutomo; Nochi, Hitoshi

    2007-01-01

    Among natural disasters, a lightning strike is a rare but potentially life-threatening phenomenon. If victims survive a cardiac arrest due to instantaneous passage of an exceptionally high voltage electric charge through the whole body, they may be afflicted with various complications such as muscle necrosis resulting in acute renal failure. In this article, we report a case of a 54-year-old man with acute rhabdomyolysis of the left soleus muscle associated with a lightning strike. T2-weighted and short-tau inversion recovery MR images showed a high signal intensity in the left soleus muscle. A whole-body bone scintigram showed abnormal uptakes in the left soleus muscle and the dorsal aspect of the left foot. MR and scintigraphic evaluations were very useful in depicting the site and extent of muscle damage. Since the patient showed a surprisingly high level of serum creatine kinase, the added information was very valuable for determining the patient's management. (orig.)

  14. Scintigraphic data acquisition and processing unit HEWLETT-PACKARD 5407A

    International Nuclear Information System (INIS)

    Anon.

    A detailed description is devoted to the HP5407A scintigraphic analyser which offers, for the use of Nuclear Medicine and functional exploration services, possibilities of acquisition, analysis, visual display and storage of data supplied by a gamma camera. Its technical characteristics are as follows: choice between list (sequential) and histogram modes depending on the examination contemplated; ultrafast converter (dead time 3.3 μs) which conserves the counting statistics; 100 images/second and 82000 events/second in sequential; 20 images/second (64x64) and 30000 events/second in histogram; 7-bit coding in X and Y (128x128) which conserves the camera resolution; control board for speed of apprentireship and ease of operation; very extensive software which may be supplemented by programmes written in BASIC or FORTRAN. The system has been perfectly operational for more than a year and possesses numerous references [fr

  15. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

    Energy Technology Data Exchange (ETDEWEB)

    Williams, T.R. [Portsmouth Naval Medical Center, Radiology Department, Charette Health Care Center, Portsmouth, VA (United States); Puckett, M.L.; Shin, A.Y.; Gorman, J.D. [Naval Medical Center San Diego, Radiology Department, San Diego, CA (United States); Denison, G. [US Naval Hospital Guam (United States)

    2002-05-01

    Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

  16. Scintigraphic test of gastric emptying and motility: preliminary results in patients with chronic gastritis

    Energy Technology Data Exchange (ETDEWEB)

    Hausmann, T. [Abt. Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule Hannover (Germany); Mueller-Schauenburg, W. [Abt. Nuklearmedizin, Univ. Tuebingen (Germany); Goeke, M. [Abt. Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover (Germany); Luebeck, M. [Abt. Nuklearmedizin, Univ.-Krankenhaus Eppendorf, Hamburg (Germany); Gratz, K.F. [Abt. Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule Hannover (Germany); Meier, P. [Abt. Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover (Germany); Manns, M. [Abt. Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover (Germany); Hundeshagen, H. [Abt. Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule Hannover (Germany)

    1995-11-01

    To record gastric peristalsis using a conventional scintigraphic gastric emptying test the frame rate was increased to 1 frame per 3 s at 10, 30, and 50 min postprandially. The gastric contraction frequency was obtained from the first harmonic of a Fourier transform of a gastric region of interest (ROI) curve. The propagation of gastric contractions was better revealed from computed functional images of the phase and amplitude distribution as compared with the multiple scintigraphic images. The maximal count-rate changes per pixel were calculated as an estimate of the most prominent regional contractile activity of the gastric wall. Among 12 patients with chronic gastritis the group with more severe dyspeptic complaints (n = 6) had significantly higher count-rate changes per pixel when compared with the group with minor complaints (20.0, 21.1 and 14.2 vs 12.9, 12.0, and 10.4 counts/pixel X s at 10, 30, and 50 min. respectively; p < 0.05). The mean half-times of gastric emptying (61, SD 11 vs 54, SD 13 min) and the mean gastric contraction frequencies (2.99, SD 0.19; 3.09, SD 0.33; 3.07, SD 0.10 vs 3.15, SD 0.15; 3.17, SD 0.13; 3.23, SD 0.20 cycles/min at 10, 30, and 50 min, respectively) did not show significant differences between both groups. Our preliminary results agree with the hypothesis of the occurrence of more powerful, nonexpulsive gastric-wall contractions in patients with more severe dyspeptic complaints. Hence, additional quantification of gastric motility allowed a more detailed evaluation of gastric-motor-activity disorders that were for so long not accessible to conventional gastric-emptying tests. (orig.)

  17. Scintigraphic test of gastric emptying and motility: preliminary results in patients with chronic gastritis

    International Nuclear Information System (INIS)

    Hausmann, T.; Mueller-Schauenburg, W.; Goeke, M.; Luebeck, M.; Gratz, K.F.; Meier, P.; Manns, M.; Hundeshagen, H.

    1995-01-01

    To record gastric peristalsis using a conventional scintigraphic gastric emptying test the frame rate was increased to 1 frame per 3 s at 10, 30, and 50 min postprandially. The gastric contraction frequency was obtained from the first harmonic of a Fourier transform of a gastric region of interest (ROI) curve. The propagation of gastric contractions was better revealed from computed functional images of the phase and amplitude distribution as compared with the multiple scintigraphic images. The maximal count-rate changes per pixel were calculated as an estimate of the most prominent regional contractile activity of the gastric wall. Among 12 patients with chronic gastritis the group with more severe dyspeptic complaints (n = 6) had significantly higher count-rate changes per pixel when compared with the group with minor complaints (20.0, 21.1 and 14.2 vs 12.9, 12.0, and 10.4 counts/pixel X s at 10, 30, and 50 min. respectively; p < 0.05). The mean half-times of gastric emptying (61, SD 11 vs 54, SD 13 min) and the mean gastric contraction frequencies (2.99, SD 0.19; 3.09, SD 0.33; 3.07, SD 0.10 vs 3.15, SD 0.15; 3.17, SD 0.13; 3.23, SD 0.20 cycles/min at 10, 30, and 50 min, respectively) did not show significant differences between both groups. Our preliminary results agree with the hypothesis of the occurrence of more powerful, nonexpulsive gastric-wall contractions in patients with more severe dyspeptic complaints. Hence, additional quantification of gastric motility allowed a more detailed evaluation of gastric-motor-activity disorders that were for so long not accessible to conventional gastric-emptying tests. (orig.)

  18. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

    International Nuclear Information System (INIS)

    Williams, T.R.; Puckett, M.L.; Shin, A.Y.; Gorman, J.D.; Denison, G.

    2002-01-01

    Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

  19. Value of thallium-201 tomoscintigraphy for the evaluation of myocardial infarct size. Place de la tomoscintigraphie au Thallium-201 dans l'evaluation de la taille de l'infarctus du myocarde

    Energy Technology Data Exchange (ETDEWEB)

    Maublant, J.; Cauvin, J.C.; Mestas, D.; Boire, J.Y.; Peycelon, P.; Veyre, A. (Centre Jean Perrin, 63 - Clermont-Ferrand (FR)); Cassagnes, J.; Lusson, J.R. (Centre Hospitalier Universitaire Saint-Jacques, 63 - Clermont-Ferrand (FR))

    1990-01-01

    Infarct size remains difficult to be quantified although this parameter is strongly related to patient's prognosis. It has become increasingly needed since the advent of thrombolytic therapy in the acute phase of myocardial infarction. Myocardial tomoscintigraphy is the only method that provides a direct visualization of the ischemic area. The method that was developed and validated at Clermont-Ferrand is described and its limits are discussed. The other techniques are also reviewed.

  20. Evaluation of usefulness of scintigraphic imaging in diagnosis of intrathecal drug delivery system malfunction – a preliminary report

    International Nuclear Information System (INIS)

    Teodorczyk, Jacek; Szmuda, Tomasz; Siemiński, Mariusz; Lass, Piotr; Słoniewski, Paweł

    2013-01-01

    Implantable intrathecal drug delivery systems (IDDS) are basic tool enabling chronic intrathecal pharmacotherapy. Lack of expected clinical results of IDDS therapy necessitates search for the cause with the help of diagnostic imaging methods among other things. Beside radiological techniques, it is also possible to visually assess IDDS systems by nuclear medicine methods. In this study we assess utility of radioisotopic methods in differential diagnosis of failure of therapy with IDDS systems. Scintigraphic studies were performed in selected patients with neurological diseases associated with spasticity, who had IDDS system implanted and were unable to maintain satisfying clinical effect of inrathecally infused baclofen. After emptying the IDDS system of the drug, radiotracer (99mTc-DTPA) solution was injected into the pump reservoir. Subsequently, a series of scintigraphic images was registered, demonstrating passage and distribution of the infused radiotracer. In all investigated cases, scintigraphic study resulted in acquiring relevant additional diagnostic information. Normal or disrupted distribution of radiotracer in spinal canal allowed for a diagnosis drug resistance or demonstrated presence of arachnoid adhesions respectively. Early appearance of radiotracer in blood was considered a proof of leak. Our examinations had decisive influence on further patient treatment, allowing for diagnosis of drug resistance in one patient or complication related to IDDS system in three other cases including breakage of a catheter, pump malfunction and arachnoid adhesions. Scintigraphic methods carry significant amount of information facilitating final diagnosis of the cause of IDDS therapy failure. They should become an important element complementing the diagnostic strategy in patients with suspected failure of intrathecal drug administration systems. Interpretation of radioisotopic studies, since they are purely functional, must be performed in strict relation to

  1. Nontraumatic femoral head necrosis. Classification of bone scintigraphic findings and diagnostic value of SPECT following planar imaging

    International Nuclear Information System (INIS)

    Minoshima, Satoshi; Uchida, Yoshitaka; Anzai, Yoshimi; Uno, Kimiichi; Arimizu, Noboru

    1994-01-01

    This study was conducted to determine bone scintigraphic findings in nontraumatic femoral head avascular necrosis and diagnostic value of SPECT imaging following a conventional planar imaging. Forty-three femoral heads in twenty-six cases with idiopathic femoral head necrosis (n=2), systemic lupus erythematosus (n=22), aplastic anemia (n=1), and renal transplantation (n=1) were studied. The diagnosis for femoral head necrosis was based on magnetic resonance imaging as well as other diagnostic studies in all cases. Scintigraphic findings of planar and SPECT images were classified into six categories: normal (N); cold or decrease (C); partial increase with cold or decrease (PH+C); ring-like increase with a cold center (RH+C); partial increase (PH); diffuse and/or irregular increase (DH). Avascular necrosis was confirmed in twenty-four femoral heads, in which planar and SPECT images showed scintigraphic findings of N (n=3, 2), C (n=1, 3), PH+C (n=2, 8), RH+C (n=2, 3), PH (n=9, 2), and DH (n=7, 6), respectively. Femoral heads without avascular necrosis demonstrated planar and SPECT findings of N (n=16, 12), C (n=0, 6), and DH (n=3, 1), respectively. When considering C, PH+C, and RH+C as diagnostic findings for avascular necrosis, sensitivities of planar and SPECT images were 21% and 58%, and specificities were 100% and 68%, respectively. In nineteen femoral heads with normal planar findings (N), SPECT correctly identified avascular necrosis in two femoral heads and misidentified six normal femoral heads as avascular necrosis. In nineteen femoral heads with nondiagnostic abnormalities (PH, DH), SPECT correctly identified avascular necrosis in seven femoral heads and showed no false positive. Diagnostic planar findings in five femoral heads were concordant with SPECT diagnosis. These results indicate that SPECT imaging is most valuable when planar images show nondiagnostic abnormalities based on the proposed classification of scintigraphic findings. (author)

  2. Nontraumatic femoral head necrosis. Classification of bone scintigraphic findings and diagnostic value of SPECT following planar imaging

    Energy Technology Data Exchange (ETDEWEB)

    Minoshima, Satoshi; Uchida, Yoshitaka; Anzai, Yoshimi; Uno, Kimiichi; Arimizu, Noboru (Chiba Univ. (Japan). School of Medicine)

    1994-09-01

    This study was conducted to determine bone scintigraphic findings in nontraumatic femoral head avascular necrosis and diagnostic value of SPECT imaging following a conventional planar imaging. Forty-three femoral heads in twenty-six cases with idiopathic femoral head necrosis (n=2), systemic lupus erythematosus (n=22), aplastic anemia (n=1), and renal transplantation (n=1) were studied. The diagnosis for femoral head necrosis was based on magnetic resonance imaging as well as other diagnostic studies in all cases. Scintigraphic findings of planar and SPECT images were classified into six categories: normal (N); cold or decrease (C); partial increase with cold or decrease (PH+C); ring-like increase with a cold center (RH+C); partial increase (PH); diffuse and/or irregular increase (DH). Avascular necrosis was confirmed in twenty-four femoral heads, in which planar and SPECT images showed scintigraphic findings of N (n=3, 2), C (n=1, 3), PH+C (n=2, 8), RH+C (n=2, 3), PH (n=9, 2), and DH (n=7, 6), respectively. Femoral heads without avascular necrosis demonstrated planar and SPECT findings of N (n=16, 12), C (n=0, 6), and DH (n=3, 1), respectively. When considering C, PH+C, and RH+C as diagnostic findings for avascular necrosis, sensitivities of planar and SPECT images were 21% and 58%, and specificities were 100% and 68%, respectively. In nineteen femoral heads with normal planar findings (N), SPECT correctly identified avascular necrosis in t