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Sample records for tl myocardial spect

  1. Quantitative assessment of 201TlCl myocardial SPECT

    International Nuclear Information System (INIS)

    Uehara, Toshiisa

    1987-01-01

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

  2. Myocardial viability assessed by Tl-201 SPECT. Redistribution versus reinjection

    International Nuclear Information System (INIS)

    Chalela, William Azem; Pimentel, Flavio Ferrarini de Oliveira; Uchida, Augusto Hiroshi; Bottega, Augusto; Ramires, Jose Antonio Franchine; Izaki, Marisa; Moraes, Aguinaldo Pereira; Soares Junior, Jose; Giorgi, Maria C. Pinto; Moffa, Paulo Jorge; Bellotti, Giovanni; Giovanni Guido Cerri; Meneghetti, Jose Claudio

    1994-01-01

    The purpose of this study was to verify if a third series of images acquired by reinjection thallium-201, 24 h after conventional myocardial perfusion with the radioisotope, improves the identification of myocardial viability segments. The methods: we studied 30 patients, mean age 57.7 ±9.4 years, with old myocardial infarction using thallium (Tl)-201 SPECT, and we obtained three series of images (stress, redistribution after 4 h and reinjection after 24 h. Cardiac images were divided in 5 segments (apical, lateral, anterior, septal and inferior) and each one received a value by a score system according to the Tl-201 myocardial uptake (0=normal uptake; 1=mild hypoperfusion; 2=moderate hypoperfusion; 3=severe hypoperfusion or no myocardial uptake). We considered viable myocardium when the uptake of Tl-201 in the segment related to te myocardial infarction increases at least 1 point in two different axis of Tl-201 SPECT. The results: seven (23,3%) patients demonstrated increase of Tl-201 uptake only at reinjection images, showing a high efficacy of the method. Nine (30%) patients showed persistent hypoperfusion at all series of images suggesting only fibrosis in the are related to the infarction. Fourteen (46,7%) patients showed increase of Tl-201 concentration at redistribution images; among these patients, six showed improvement of myocardial uptake at reinjection. This condition was interpreted as regional chronic ischemic process: hibernating myocardium. The conclusion was that Tl-201 hypoperfusion at redistribution images without significant changes in relation to the stress images do not represent fibrosis at all. The reinjection technic was better than conventional redistribution in the detection of viable myocardium. This data allows a better therapeutic orientation. (author)

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

    International Nuclear Information System (INIS)

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

    1989-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-03-01

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

  5. Tl myocardial SPECT demonstrates importance of collateral circulation in patients with myocardial infarction

    International Nuclear Information System (INIS)

    Hattori, Fukunori

    1997-01-01

    The influence of collateral circulation on the preservation of myocardial viability and the efficacy of drug therapy and PTCA were evaluated by exercise 201 Tl myocardial SPECT before and after treatment. Thirty-five patients with a history of myocardial infarction resulting from total or subtotal obstruction of the responsible coronary artery were divided into four groups, according to the method of the treatment and the degree of collateral blood flow. Patients in groups A and B received drug therapy and displayed developed and undeveloped collateral circulation, respectively. Groups C and D received PTCA and displayed developed and undeveloped collateral circulation, respectively. Tl myocardial SPECT was performed before treatment to record the extent of redistribution to the occluded region, the degree of myocardial viability and the nature and extent of the ischemic lesion. In group A, myocardial perfusion improved, although redistribution remained in all cases, while in group B, 4 of 7 cases improved after drug therapy. In group C, myocardial perfusion improved in all cases, and redistribution disappeared in 7 of 12 cases. 5 of 6 cases improved in group D after PTCA. After drug therapy, the %Tl uptake in the infarcted region improved significantly in initial and delayed images of patients in group A. The differences in initial and delayed images in group B before and after drug therapy were not significant. In contrast, groups C and D both registered significant improvement in initial and delayed images after PTCA. The washout rate improved significantly in groups A, C and D after their respective treatments. These results suggest that developed collateral circulation helps to preserve myocardial viability in cases of myocardial infarction. Myocardial perfusion improved after drug therapy in cases with developed collateral circulation, and in patients with developed and undeveloped collateral circulation receiving PTCA. (K.H.)

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

    International Nuclear Information System (INIS)

    Fujinaga, Tsuyoshi; Yamazaki, Sayaka; Hara, Masatada; Umezawa, Chiaki; Okamura, Tetsuo; Murata, Hajime; Maruno, Hirotaka; Onoguchi, Masahisa.

    1993-01-01

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

  7. Value of dipyridamole stress 201Tl myocardial SPECT in detecting dysfunction of coronary microcirculation

    International Nuclear Information System (INIS)

    Lou Ying; Jiang Jinqi; Xie Wenhui; Yuan Fang; Wang Tong; Yang Yiqing

    2012-01-01

    Objective: To evaluate the value of dipyridamole stress 201 Tl myocardial SPECT in detecting dysfunction of coronary microcirculation. Methods: Forty-eight patients diagnosed with cardiac syndrome X underwent dipyridamole stress 201 Tl myocardial SPECT. Dipyridamole (0.56 mg/kg) was intravenously injected over 4 min followed by 201 Tl (111 MBq) injection at 2 min after dipyridamole administration. Image was acquired at 10 min and 240 min post-injection and co-analyzed by over two experienced doctors in nuclear medicine after three-dimensional reconstruction. The patients with 'reverse redistribution' underwent repeated dipyridamole stress 201 Tl SPECT after medical therapy for 2 weeks. The clinical symptoms and results of the treadmill exercise test pre-and post-therapy were compared. Results: Forty two patients (42/48, 87.50%) showed segmental defects: 'reverse redistribution' on delayed (240 min) 201 Tl images. After medical treatment, 36 cases of the 42 'reverse redistribution' patients had improvement in both clinical symptoms and treadmill exercise test. Post-treatment 201 Tl imaging showed improvement in 45/49 (91.84%) defect segments. Six of the 42 patients had no improvement in clinical symptoms and/or treadmill exercise test. Post-treatment 201 Tl imaging showed no improvement in all the 7 defect segments on the first scan. Conclusion: Dipyridamole stress 201 Tl myocardial SPECT may be valuable in evaluation of impaired coronary microcirculation associated with cardiac syndrome X. (authors)

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

    International Nuclear Information System (INIS)

    Li Zicheng; Chen Xiaoming; Xu Hao

    2006-01-01

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

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

    International Nuclear Information System (INIS)

    Mochizuki, Teruhito

    1989-01-01

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

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  11. Characteristics of 201Tl myocardial SPECT and left ventriculography in patients with acute diagonal branch myocardial infarction

    International Nuclear Information System (INIS)

    Tanaka, Takeshi; Aizawa, Tadanori; Katou, Kazuzo; Ogasawara, Ken; Kirigaya, Hajime

    1993-01-01

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

  12. Quantitative estimation of myocardial thickness by the wall thickness map with Tl-201 myocardial SPECT and its clinical use

    International Nuclear Information System (INIS)

    Sekiai, Yasuhiro; Sawai, Michihiko; Murayama, Susumu

    1988-01-01

    To estimate the wall thickness of left ventricular myocardium objectively and quantitatively, we adopted the device of wall thickness map (WTM) with Tl-201 myocardial SPECT. For validation on measuring left ventricular wall thickness with SPECT, fundamental studies were carried out with phantom models, and clinical studies were performed in 10 cases comparing the results from SPECT with those in echocardiography. To draw the WTM, left ventricular wall thickness was measured using the cut off method from SPECT images obtained at 5.6 mm intervals from the base and middle of left ventricle: short-axis image for the base and middle of left ventricle and vertical and horizontal long-axis images for the apical region. Wall thickness was defined from the number of pixel above the cut off level. Results of fundamental studies disclosed that it is impossible to evaluate the thickness of less than 10 mm by Tl-201 myocardial SPECT but possible to discriminate wall thickness of 10 mm, 15 mm, and 20 mm by Tl-201 myocardial SPECT. Echocardiographic results supported the validity of WTM, showing a good linear correlation (r = 0.96) between two methods on measuring wall thickness of left ventricle. We conclude that the WTM applied in this report may be useful for objective and quantitative estimation of myocardial hypertrophy. (author)

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

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

    1991-01-01

    To determine quantitatively the discriminant and characteristics of cor pulmonale, {sup 201}Tl myocardial perfusion SPECT was performed in 16 patients with chronic obstructive pulmonary disease (COPD) and 7 with restrictive pulmonary disease (RPD). One section of the short-axis SPECT image in which the right ventricle was most clearly visualized was selected. Tl-score was defined as the ratio of the sum of counts in the region of interest (ROI) at the anterior, mid, and posterior regions of the right ventricular free wall to the sum of counts in ROI at the posterior, lateral, and anterior walls of the left ventricle, and the anterior and posterior regions of the interventricular septum. In the group of COPD patients, Tl-score was positively correlated with mean pulmonary arterial pressure (mPAP), total pulmonary vascular resistance (TPR), and arterial carbon dioxide tension (PaCO{sub 2}), while it was inversely correlated with arterial oxygen tension (PaO{sub 2}). However, there was no significant correlation between Tl-score and mPAP, TPR, PaCO{sub 2}, and PaO{sub 2} in the group of RPD patients. In assessing pulmonary hypertension as defined by mPAP over 20 mmHg, a Tl-score greater than 0.25 was useful with a sensitivity of 69% and a specificity of 90%. The occurrence of cor pulmonale is a major factor in determining the prognosis of COPD patients. It was concluded that {sup 201}Tl myocardial SPECT is useful for evaluating right ventricular overload quantitatively, as well as for assessing core pulmonale, especially in COPD patients, since the ratio of Tl counts in the right and left ventricles was significantly correlated with right cardiopulmonary hemodynamic parameters. (N.K.).

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

    International Nuclear Information System (INIS)

    Kato, Hiroshi; Misawa, Toshihiro; Kutsumi, Yasunori

    1991-01-01

    To determine quantitatively the discriminant and characteristics of cor pulmonale, 201 Tl myocardial perfusion SPECT was performed in 16 patients with chronic obstructive pulmonary disease (COPD) and 7 with restrictive pulmonary disease (RPD). One section of the short-axis SPECT image in which the right ventricle was most clearly visualized was selected. Tl-score was defined as the ratio of the sum of counts in the region of interest (ROI) at the anterior, mid, and posterior regions of the right ventricular free wall to the sum of counts in ROI at the posterior, lateral, and anterior walls of the left ventricle, and the anterior and posterior regions of the interventricular septum. In the group of COPD patients, Tl-score was positively correlated with mean pulmonary arterial pressure (mPAP), total pulmonary vascular resistance (TPR), and arterial carbon dioxide tension (PaCO 2 ), while it was inversely correlated with arterial oxygen tension (PaO 2 ). However, there was no significant correlation between Tl-score and mPAP, TPR, PaCO 2 , and PaO 2 in the group of RPD patients. In assessing pulmonary hypertension as defined by mPAP over 20 mmHg, a Tl-score greater than 0.25 was useful with a sensitivity of 69% and a specificity of 90%. The occurrence of cor pulmonale is a major factor in determining the prognosis of COPD patients. It was concluded that 201 Tl myocardial SPECT is useful for evaluating right ventricular overload quantitatively, as well as for assessing core pulmonale, especially in COPD patients, since the ratio of Tl counts in the right and left ventricles was significantly correlated with right cardiopulmonary hemodynamic parameters. (N.K.)

  15. Normal 201Tl SPECT myocardial scintigram - a basis for quantification of tomographic data using 1800 rotation

    International Nuclear Information System (INIS)

    Bock, A.; Frenzel, R.; Meyer, M.; Pink, V.; Reisinger, I.; Strangfeld, D.

    1990-01-01

    Using 180 0 rotation for 201 Tl myocardial perfusion SPECT the influence of different myocardial wall thickness, depth-dependent resolution, attenuation and other facts is the reason for about 30% inhomogenity from anterolateral to posteroseptal myocardium in polar coordinate Bull's eye. It is very difficult for a visual observer to assess patients without knowledge of the corresponding normal distribution. We studied 25 normal males and calculated pixelwice vitality, washout rate between stress, 2-hr and 3.5-hr delay to obtain a normal Bull's eye reference databank. Before the patient's data can be analysed it is necessary to multiplicate them with the inverse normal Bull's eye. (author)

  16. 201Tl myocardial SPECT and β-endorphin levels in patients with suspected silent ischemia

    International Nuclear Information System (INIS)

    Lind, P.; Binter, G.; Koeltringer, P.; Eber, O.; Eber, B.; Klein, W.; Brandt, D.

    1990-01-01

    Today silent myocardial ischemia (SMI) is a well-recognized phenomenon. Treadmill exercise according to the Bruce protocol, 201 Tl myocardial SPECT and coronary angiography were performed in a total of 106 patients with suspected SMI. In group I (high probability of ischemia; n=46), reversible defects detected by SPECT correlated well with significant stenoses and irreversible defects with subtotal stenoses or complete occlusions. SPECT sensitivity in the detection of ischemia was 91%, its specificity 96%. In group II (low probability of ischemia; n=60), SPECT sensitivity was as high as in group I (94%) but due to a high number of false-positive results (e.g. cardiomyopathy) specificity was only 75%. However, SPECT was superior to exercise ECG (sensitivity 70%; specificity 56%) in the detection of SMI. In addition, β-endorphin levels were determined in 180 healthy subjects, 37 patients with symptomatic CAD and in 34 patients with SMI before and during maximum exercise. Exercise values in patients with SMI were significantly higher than in healthy subjects or in patients with symptomatic CAD. (orig./MG) [de

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

    International Nuclear Information System (INIS)

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

    1985-01-01

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

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

    International Nuclear Information System (INIS)

    Staelens, Steven G.; Wit, Tim C. de; Lemahieu, Ignace A.; Beekman, Freek J.

    2008-01-01

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

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

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

    1992-03-01

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

  20. Clinical evaluation of coronary territory map by using unfolded map of Tl-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Uehara, Toshiisa; Nishimura, Tsunehiko; Katafuchi, Tetsuro; Yamagami, Hidetoshi; Kumita, Shinichirou; Hayashida, Kohei; Hayashi, Makoto

    1990-01-01

    Coronary territory map was developed on unfolded map of exercise Tl-201 myocardial SPECT. Each coronary territory was determined by summing the each unfolded map of 54 cases of single vessel disease respectively, and standardizing with normal pattern obtained from normal patients. The diagnostic accuracy of coronary territory map to identify the diseased coronary artery was analyzed in 104 clinical cases and was compared with that of planar and SPECT visual diagnosis, simple unfolded map (raw map) and extent and severity map. The results were as follows. (1) Territory map showed excellent diagnostic accuracy in single or double vessel disease, especially in diagnosis of left circumflex coronary artery lesion. (2) In triple vessel disease, the diagnostic accuracy of territory map or other unfolded maps was 30% at best, and was inferior to planar or SPECT visual analysis. The cause of this inferiority seemed that the quantitatively analyzed map had no information about the degree of Tl-uptake into lung or myocardium, which give useful information in visual diagnosis. (3) The diagnostic agreement ratio in two observers was the highest in territory map diagnosis, so that the territory map diagnosis seemed to be the most objective one. (4) The unfolded map diagnosis with apical display obtained from long-axis tomogram was useful to diagnose left anteior descending coronary (LAD) lesion, which improve not only the sensitivity of LAD but also specificity of right coronary artery single vessel disease. (author)

  1. Tl-201 myocardial SPECT in patients with Duchenne's muscular dystrophy: A long-term follow-up

    International Nuclear Information System (INIS)

    Nagamachi, S.; Jinnouchi, S.; Ono, S.; Hoshi, H.; Inoue, K.; Watanabe, K.

    1989-01-01

    Tl-201 SPECT was used to evaluate myocardial involvement in 13 patients with Duchenne's muscular dystrophy. Serial studies of 9 patients were done at two-year intervals. The hypoperfused areas of the left ventricle became more prominent with age and severity

  2. Cost-effectiveness of exercise 201Tl myocardial SPECT in patients with chest pain assessed by decision-tree analysis

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Momiyama, Yukihiko; Ohsuzu, Fumitaka; Kusano, Shoichi; Ichihara, Kiyoshi

    1999-01-01

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

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

    International Nuclear Information System (INIS)

    Iida, Hidehiro; Kim, Kyeong-Min; Nakazawa, Mayumi; Sohlberg, Antti; Zeniya, Tsutomu; Hayashi, Takuya; Watabe, Hiroshi; Eberl, Stefan; Tamura, Yoshikazu; Ono, Yukihiko

    2008-01-01

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

  4. Exercise and rest Tl-201 myocardial SPECT, and low dose dobutamine echocardiography to assess myocardial viability in patients with myocardial infarction

    International Nuclear Information System (INIS)

    Toyama, Takuji; Ishida, Yoshio; Shimonagata, Tsuyoshi; Kawano, Shigeo; Beppu, Shintaro; Nishimura, Tsunehiko.

    1994-01-01

    To evaluate viability of infarcted myocardium, findings of Tl-201 myocardial SPECT were compared with those of low-dose dobutamine (DOB) echocardiography. The subjects were 19 patients with myocardial infarction (23 infarcted zones), consisting of 16 men and 3 women. Findings on myocardial SPECT were classified as evidence of myocardial viability (14 zones, Group A) and no evidence of myocardial viability (9 zones, Group B). For both groups, wall motion and regional % uptake (%UP) were obtained. DOB echocardiography revealed an improvement in 5 of 8 akinesis zones in Group A. In addition, one other zone was found improved by follow-up examination. Six hypokinesis zones were all found improved on DOB echocardiography. Out of a total of 14 akinesis or hypokinesis zones, 11 (79%) showed improvement on DOB echocardiography in Group A. In Group B, all akinesis zones remained unchanged on DOB echocardiography, although one zone was improved by follow-up examination. In 11 zones in which wall motion was improved on DOB echocardiography, %UT was increased by an average of 58% on 4 hr-delayed images and 70% on resting images. The corresponding figures for 12 zones which did not improve on DOB echocardiography were 49% and 50% on the average, respectively. In conclusion, low-dose DOB echocardiography appeared to reflect viability of severely infarcted myocardium, although it had a slightly lower sensitivity than convensional Tl-201 myocardial SPECT in its ability to detect. (N.K.)

  5. Usefulness of {sup 201}Tl myocardial perfusion SPECT in prediction of left ventricular remodeling following an acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam; Park, C. H.; Hwang, Kyung Hoon [Ajou Univ. College of Medicine, Suwon (Korea, Republic of)

    2000-02-01

    We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial linfarction (AMI). We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 6 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index(PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB,Q wave, LVEF and revascularization were analysed using multivariate analysis. Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable

  6. The diagnostic value of Tc-99m PYP, Tl-201 dual isotope SPECT to predict the viability of damaged myocardium in the acute phase of myocardial infarction

    International Nuclear Information System (INIS)

    Matsuo, Hitoshi; Watanabe, Sachiro; Arai, Masazumi

    1991-01-01

    To assess the diagnostic value of Tc-99m pyrophosphate (PYP), Tl-201 dual isotope SPECT for the evaluation of myocardial viability, segmental comparison between dual isotope SPECT and exercise, delayed, and reinjected Tl study were performed with 18 acute myocardial infarction (AMI) patients. Among 72 damaged myocardial segments, 48 segments (67%) were judged as viable by chronic phase Tl studies. The segments with severely reduced Tl uptake by dual SPECT showed significantly lower prevalence of viable myocardium than the segments with reduced and normal Tl uptake (p<0.001). The segments with PYP accumulation localized to the subendocardium represented the favorable outcome compared with the transmural accumulation (p<0.001). And overlap segments show better prognosis than the segments without overlap (p<0.05). Most importantly, we can get better predictive accuracy of myocardial scar by dual isotope SPECT than the judgement by Tl or PYP SPECT alone (83.3% vs 77.8%, 68.1%). Thus, we conclude that Tc-99m PYP, Tl-201 dual isotope SPECT is useful to assess the severity of myocardial damage in the acute phase of myocardial infarction. (author)

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

    International Nuclear Information System (INIS)

    Hisatake, Shinji; Yamashina, Shohei; Yamazaki, Junichi

    2004-01-01

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

  8. Intravenous streptokinase therapy in acute myocardial infarction: Assessment of therapy effects by quantitative 201Tl myocardial imaging (including SPECT) and radionuclide ventriculography

    International Nuclear Information System (INIS)

    Koehn, H.; Bialonczyk, C.; Mostbeck, A.; Frohner, K.; Unger, G.; Steinbach, K.

    1984-01-01

    To evaluate a potential beneficial effect of systemic streptokinase therapy in acute myocardial infarction, 36 patients treated with streptokinase intravenously were assessed by radionuclide ventriculography and quantitative 201 Tl myocardial imaging (including SPECT) in comparison with 18 conventionally treated patients. Patients after thrombolysis had significantly higher EF, PFR, and PER as well as fewer wall motion abnormalities compared with controls. These differences were also observed in the subset of patients with anterior wall infarction (AMI), but not in patients with inferior wall infarction (IMI). Quantitative 201 Tl imaging demonstrated significantly smaller percent myocardial defects and fewer pathological stress segments in patients with thrombolysis compared with controls. The same differences were also found in both AMI and IMI patients. Our data suggest a favorable effect of intravenous streptokinase on recovery of left ventricular function and myocardial salvage. Radionuclide ventriculography and quantitative 201 Tl myocardial imaging seem to be reliable tools for objective assessment of therapy effects. (orig.)

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  10. FDG F18/Rest Tl 201 SPECT patterns in recent myocardial infarction. Predictive value for regional function recovery

    Energy Technology Data Exchange (ETDEWEB)

    Massardo, Teresa [Universidad de Chile, Hospital Clinico. Centro de Medicina Nuclear, Santiago (Chile); Gonzalez, Patricio; Coll, Claudia; Yovanovich, Jorge; Jofre, M Josefina; Humeres, Pamela; Sierralta, Paulina; Chamorro, Hernan; Ramirez, Alfredo; Kunstmann, Sonia; Lopez, Hector; Aramburu, Ivonne; Bru, Solange [Universidad de Chile, Santiago (Chile). Hospital Clinico. Centros de Medicina Nuclear e Cardiovascular; Clinica Santa Maria, Santiago [Chile

    2003-04-01

    Background: detecting viability is important after recent myocardial infarction (MI). SPECT FDG/Tl flow-metabolism patterns for predicting functional recovery were analyzed in this setting. Method: forty-one patients were studied (56+-12 years; 80% males) with Tl 201 at rest and FDG F 18 SPECT at a mean of 8.9 days post MI (range:1-24). All had baseline and 3 month follow-up echocardiography (Echo) and initial coronary angiography. They were submitted to primary PTCA in 12 cases, late PTCA in 15 and bypass surgery in 10 and thrombolysis was performed in 4 patients as only procedure. A total of 345 culprit artery territory segments were interpreted by 3 nuclear independent observers. Analysis included segments with or without abnormal motion. Results: FDG/Tl 201 on patient basis, had: sensitivity 91%; specificity 56%; positive predictive value 88 %; negative predictive value (NPV) 63% and accuracy 83%. The analysis of segments with abnormal contractility showed values of 67%, 69%, 44%, 85% and 68%, respectively. Reverse mismatch with FDG/Tl appears to predict viability similarly to classical mismatch; severe or moderate match was highly associated with no functional recovery (NPV 85%). Conclusion: flow-perfusion patterns are variable in recent MI. FDG/Tl 201 SPECT has acceptable accuracy for predicting functional recovery and excellent NPV to further exclude viability (author)

  11. FDG F18/Rest Tl 201 SPECT patterns in recent myocardial infarction. Predictive value for regional function recovery

    International Nuclear Information System (INIS)

    Massardo, Teresa; Gonzalez, Patricio; Coll, Claudia; Yovanovich, Jorge; Jofre, M. Josefina; Humeres, Pamela; Sierralta, Paulina; Chamorro, Hernan; Ramirez, Alfredo; Kunstmann, Sonia; Lopez, Hector; Aramburu, Ivonne; Bru, Solange; Clinica Santa Maria, Santiago

    2003-01-01

    Background: detecting viability is important after recent myocardial infarction (MI). SPECT FDG/Tl flow-metabolism patterns for predicting functional recovery were analyzed in this setting. Method: forty-one patients were studied (56+-12 years; 80% males) with Tl 201 at rest and FDG F 18 SPECT at a mean of 8.9 days post MI (range:1-24). All had baseline and 3 month follow-up echocardiography (Echo) and initial coronary angiography. They were submitted to primary PTCA in 12 cases, late PTCA in 15 and bypass surgery in 10 and thrombolysis was performed in 4 patients as only procedure. A total of 345 culprit artery territory segments were interpreted by 3 nuclear independent observers. Analysis included segments with or without abnormal motion. Results: FDG/Tl 201 on patient basis, had: sensitivity 91%; specificity 56%; positive predictive value 88 %; negative predictive value (NPV) 63% and accuracy 83%. The analysis of segments with abnormal contractility showed values of 67%, 69%, 44%, 85% and 68%, respectively. Reverse mismatch with FDG/Tl appears to predict viability similarly to classical mismatch; severe or moderate match was highly associated with no functional recovery (NPV 85%). Conclusion: flow-perfusion patterns are variable in recent MI. FDG/Tl 201 SPECT has acceptable accuracy for predicting functional recovery and excellent NPV to further exclude viability (author)

  12. The causes and clinical significance of exercise-induced silent myocardial ischemia evaluated by ischemic range and intensity with exercise Tl-201 myocardial SPECT

    International Nuclear Information System (INIS)

    Moriai, Naoki; Nakai, Kenji; Hiramori, Katsuhiko

    1992-01-01

    We investigated the causes and long-term prognosis of exercise-induced silent myocardial ischemia (SMI) by means of exercise Tl-201 myocardial SPECT (Ex-SPECT) in 97 patients with effort angina or old myocardial infarction (OMI). These patients were proven to have significant stenosis by coronary angiography. The subjects were divided into three groups based on the presence or absence of Tl-201 redistribution (RD) or angina during exercise testing. Group one consisted of 34 patients who had RD on Ex-SPECT and angina during exercise testing: the painful myocardial ischemia (PMI) group. The second group consisted of 38 patients who had RD on Ex-SPECT, but no angina during exercise testing: the SMI group. The third group consisted of 25 patients who had no RD: the RD (-) group. The ischemic range and intensity were quantified by the defect volume ratio (DVR) and defect severity index (DSI), respectively. Comparison of the DVR and DSI values for the PMI and SMI groups revealed that the DVR and DSI values for the SMI group were lower than those of the PMI group. Also the prognosis of the SMI group tended to be worse than that of the RD (-) group. Thus, we concluded that the SMI and PMI groups should receive identical treatment. (author)

  13. Predictive values of early rest/24 hour delay Tl-201 perfusion SPECT for wall motion improvement in patients with acute myocardial infarction after reperfusion

    International Nuclear Information System (INIS)

    Hyun, In Young; Kwan, June

    1998-01-01

    We studied early rest/24 hour delay Tl-201 perfusion SPECT for prediction of wall motion improvement after reperfusion in patients with acute myocardial infarction. Among 17 patients (male/female=11/6, age: 59±13) with acute myocardial infarction, 15 patients were treated with percutaneous transcoronary angioplasty (direct:2, delay:11) and intravenous urokinase (2). Spontaneous resolution occurred in infarct related arteries of 2 patients. We confirmed TIMI 3 flow of infarct-related artery after reperfusion in all patients with coronary angiography. We performed rest Tl-201 perfusion SPECT less then 6 hours after reperfusion and delay Tl-201 perfusion SPECT next day. Tl-201 uptake was visually graded as 4 point score from normal (0) to severe defect (3). Rest Tl-201 uptake ≤2 or combination of rest Tl-201 uptake ≤2 or late reversibility were considered to be viable. Myocardial wall motion was graded as 5 point score from normal (1) to dyskinesia (5). Myocardial wall motion was considered to be improved when a segment showed an improvement ≥1 grade in follow up echo compared with the baseline values. Among 98 segments with wall motion abnormality, the severity of myocardial wall motion decrease was as follow: mild hypokinesia: 18/98 (18%), severe hypokinesia: 28/98 (29%), akinesia: 51/98 (52%), dyskinesia: 1/98 (1%). The wall motion improved in 85%. Redistribution (13%), and reverse redistribution (4%) were observed in 24 hour delay SPECT. Positive predictive value (PPV) and negative predictive value (NPV) of combination of late reversibility and rest Tl-201uptake were 99%, and 54%.PPV and NPV of rest Tl-201 uptake were 100% and 52% respectively. Predictive values of comibination of rest Tl-201 uptake and late reversibility were not significantly different compared with predictive values of rest Tl-201 uptake only. We conclude that early Tl-201 perfusion SPECT predict myocardial wall motion improvement with excellent positive but relatively low negative

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-05-15

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

  15. Quantitative assessment of the infarct size with the unfolded map method of sup 201 Tl myocardial SPECT in patient with acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kubota, Masahiro (Sapporo Medical Coll. (Japan))

    1992-03-01

    The unfolded map method of {sup 201}Tl single photon emission computed tomography (SPECT) was evaluated as to the ability to quantify and the clinical reliability in estimation of infarct size. The following results were obtained from basic experiments using a thoracic phantom. The defect area estimated by the unfolded map method was well correlated with the real defect area, in spite of overestimation of the defect area, when the defect area was determined by an isocount method (below 80% of maximum count) (y=1.941 + 2.292x, r=0.971). The defect volume estimated by short-axis images of {sup 201}Tl SPECT was closely correlated with real defect volume in spite of overestimation of defect volume (y=0.762 + 2.156x, r=0.982). When the defect area was estimated by division of the defect volume by the mean myocardial compartment thickness, it was closely correlated with real defect area (y=0.946 + 1.232x, r=0.990). When the volume was calculated from the summation of voxels in the regions districted by isocount threshold level at each section of the {sup 99m}Tc SPECT, the optimal isocount threshold level (percentage to maximum count) was 55%. Then, the clinical reliability of the unfolded map method as infarct sizing was evaluated in 26 patients with acute myocardial infarction by comparing it with enzymatic method, Bull's eye method, and {sup 99m}Tc pyrophosphate (PYP) SPECT method. In 14 first attack patients without right ventricular infarction, infarct area (IA) of the unfolded map method correlated most closely with the accumulated creatine kinase MB isoenzyme release (CK-MBr) (r=0.897), compared with the extent score (ES) (r=0.853) and the severity score (SS) (r=0.871) of Bull's eye method and the infarct volume (IV) (r=0.595) of {sup 99m}Tc PYP SPECT. In conclusion, although the unfolded map method of {sup 201}Tl SPECT has the tendency for overestimating infarct size, it is accurate and clinically reliable in estimating infarct size. (author).

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

    Science.gov (United States)

    González, Patricio; Massardo, Teresa; Coll, Claudia; Humeres, Pamela; Sierralta, Paulina; Jofré, M Josefina; Yovanovich, Jorge; Aramburu, Ivonne; Brugère, Solange; Chamorro, Hernán

    2004-04-01

    201Tl and 18F-FDG are useful for acute myocardial infarction (MI) assessment. The goal of this study was to compare their predictive value for wall motion recovery in the culprit area after a recent reperfused MI using SPECT technique. Forty-one patients (mean age: 56 +/- 12 years) were included, 81% of them male; all were studied within 1-24 days post MI. They underwent angioplasty in 27 cases (12 primary); bypass grafting in 10 cases and successful thrombolysis in 4. SPECT 201Tl injected at rest and redistribution (R-R) and also 18F-FDG, were performed on different days. Processed tomograms were interpreted blinded to clinical or angiographic data. Segmental wall motion assessed with echocardiography at baseline was compared with the 3 month follow up. Sensitivity [Confidence Interval] for 201Tl R-R was 74.6% [60.5-84.5], for FDG it was 82.1% [70.8-90.4]; specificities were 73% [64.3-80.5] and 54.8% [45.6-63.7], respectively. 18F-FDG tended to be more sensitive than 201Tl R-R, but the latter was more specific (p < 0.0004). Both 201Tl RR and 18F-FDG presented high negative predictive value (p: ns). In recent MI, SPECT 201Tl R-R is a valuable and widely available technique for viability detection, with similar sensitivity and significant better specificity than SPECT 18F-FDG.

  17. [Anomalous origin of the left coronary artery from the pulmonary trunk with myocardial infarction and severe left ventricular dysfunction in infancy--assessment of myocardial damage using SPECT studies with 201TlCl and 123I-BMIPP].

    Science.gov (United States)

    Miyamoto, T; Horigome, H; Sato, H; Yamada, M; Inai, K; Takeda, T; Ishikawa, N; Hoshino, H; Itai, Y

    1996-02-01

    A 4-month-old male infant with Bland-White-Garland (BWG) syndrome complicated myocardial infarction was reported. Signs included tachypnea, coughing, and failure to thrive. However, there was no sign of myocardial infarction. A chest radiograph revealed cardiomegaly (CTR = 65%) and electrocardiogram showed abnormal Q waves in I, aVL, V6 leads. Cardiac catheterization and angiography revealed marked dilatation of left ventricle (end-diastolic volume = 384 ml/m2) and extremely depressed ejection fraction (16%), confirming the diagnosis of BWG syndrome. A 201TlCl-myocardial SPECT demonstrated apical defect and hypoperfusion in the anterolateral, inferoposterior walls, whereas 123I-beta-methyl-p-iodophenylpentadecanoic-acid (123I-BMIPP) SPECT showed a wider defect area. SPECT studies with 201TlCl and 123I-BMIPP, are useful to assess myocardial viability more accurately in BWG syndrome.

  18. Microvascular obstruction on delayed enhancement cardiac magnetic resonance imaging after acute myocardial infarction, compared with myocardial {sup 201}Tl and {sup 123}I-BMIPP dual SPECT findings

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Hiroaki [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Department of Cardiology, Kainan Hospital, Yatomi (Japan); Isobe, Satoshi, E-mail: sisobe@med.nagoya-u.ac.jp [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Sakai, Shinichi [Department of Cardiology, Kainan Hospital, Yatomi (Japan); Yamada, Takashi [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Watanabe, Naoki; Miura, Manabu [Department of Cardiology, Kainan Hospital, Yatomi (Japan); Uchida, Yasuhiro; Kanashiro, Masaaki; Ichimiya, Satoshi [Department of Cardiology, Yokkaichi Municipal Hospital, Yokkaichi (Japan); Okumura, Takahiro; Murohara, Toyoaki [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan)

    2015-08-15

    Highlights: • The percentage infarct size (%IS) was significantly greater in the microvascular obstruction (MO) group than in the non-MO group. • The percentage mismatch score (%MMS) on dual scintigraphy significantly correlated with the %IS and the percentage MO. • The %MMS was significantly greater in the non-MO group than in the MO group, and was an independent predictor for MO. - Abstract: Background: The hypo-enhanced regions within the hyper-enhanced infarct areas detected by cardiac magnetic resonance (CMR) imaging reflect microvascular obstruction (MO) after acute myocardial infarction (AMI). The combined myocardial thallium-201 ({sup 201}Tl)/iodine-123-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid ({sup 123}I-BMIPP) dual single-photon emission computed tomography (SPECT) is a useful tool for detecting myocardial reversibility after AMI. We evaluated whether MO could be an early predictor of irreversible myocardial damage in comparison with {sup 201}Tl and {sup 123}I-BMIPP dual SPECT findings in AMI patients. Methods: Sixty-two patients with initial AMI who successfully underwent coronary revascularization were enrolled. MO was defined by CMR imaging. Patients were divided into 2 groups as follows: MO group (n = 32) and non-MO group (n = 30). Scintigraphic defect scores were calculated using a 17-segment model with a 5-point scoring system. The mismatch score (MMS) was calculated as follows: the total sum of (Σ) {sup 123}I-BMIPP defect score minus Σ{sup 201}Tl defect score. The percentage mismatch score (%MMS) was calculated as follows: MMS/(Σ{sup 123}I-BMIPP score) × 100 (%). Results: The percentage infarct size (%IS) was significantly greater in the MO group than in the non-MO group (32.2 ± 13.8% vs. 18.3 ± 12.1%, p < 0.001). The %MMS significantly correlated with the %IS and the percentage MO (r = −0.26, p = 0.03; r = −0.45, p < 0.001, respectively). The %MMS was significantly greater in the non-MO group than in the MO group (45.4

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

    International Nuclear Information System (INIS)

    Xie Wenhui; Zhang Lihua; Hu Shilong; Yang Shunfang; Zeng Jun

    2004-01-01

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

  20. Effect of post-myocardial infarction streptokinase (sk) therapy, on myocardial viability - evaluation with thallium-201 single photon emission computed tomography (TL-201 SPECT)

    International Nuclear Information System (INIS)

    Shaikh, M.S.; Raza, M.; Kayani, A.M.; Fazal, I.

    2011-01-01

    To evaluate the effect of post-myocardial infarction Streptokinase therapy on myocardial viability, employing Thallium-201 single photon emission computed tomography (TL-201 SPECT). Design: Retrospective, experimental study. Place and duration of study: The Nuclear Cardiology Department, Armed Forces Institute of Cardiology / National Institute of Heart Diseases, Rawalpindi, from 1 April, 2009 to 31 October, 2009. Patients and Methods: Male patients, who had suffered from acute myocardial infarction (AMI), in an area supplied by the left anterior descending (LAD) artery, had infarct-related electrocardiogram (ECG) changes and received or did not receive Streptokinase therapy, were included. Those with a normal ECG, or history of revascularisation, or non-ST elevation MI, or more than one MIs, were excluded. The patients were divided into groups 1 (who received Streptokinase) and 2 (who did not receive Streptokinase). Each group contained 42 patients and all underwent scintigraphic viability study through intravenous injection of 3.0 mCi (123 MBq) of TL-201, followed by rest-redistribution SPECT imaging on a dual head, dedicated cardiac gamma camera system (Philips Cardio MD). Emory's cardiac toolbox and AutoQUANT were used for data processing and quantitative estimation of viable myocardium. Empirical scores from 0 to 2 were assigned to each of the scans, in the order of increasing viability, and these were compared across the two groups. Result: Group 1 contained 42 patients (age range = 38 to 80 years, mean = 53.98 +- 11.26 years), in whom empirical viability scoring was done. Score 0 was seen in 2 patients, score 1 was seen in 15 patients and score 2 was seen in 25 patients form this group. Group 2 also contained 42 patients (age range = 38 to 80 years, mean = 56.71 +- 9.05 years), in whom viability score of 0 was seen in 3 patients, score 1 was seen in 11 patients and score 2 was seen in 28 patients form this group. Age difference between the two groups was

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-07-01

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

  3. Serial change of 123I-BMIPP SPECT imaging during recovery from stunned myocardium after acute myocardial infarction. Correlation with 201Tl and two-dimensional echocardiography

    International Nuclear Information System (INIS)

    Nakano, Akira; Kondo, Makoto; Tokunaga, Satoshi; Akiyama, Kiyozumi; Mori, Yoshihisa; Nosue, Yasuhiro; Makita, Toshinori; Tanio, Hitoshi; Shimono, Yukio

    1995-01-01

    Using 123 I-β-methyl iodophenyl pentadecanoic acid ( 123 I-BMIPP), we investigated changes in myocardial fatty acid metabolism at recovery from stunned myocardium after acute myocardial infarction (AMI), correlation with recovery of regional wall motion and thallium-201 ( 201 Tl) distribution in particular. The subjects were 15 patients who underwent successful reperfusion therapy after the first onset of AMI. None of the patients had multi-vessel disease or ischemic episode during their clinical course. Patients underwent 123 I-BMIPP scintigraphy, 201 Tl scintigraphy and two-dimensional echocardiography during the acute and chronic phases. Then, we compared regional wall motion with distribution of 123 I-BMIPP and 201 Tl. Regional wall motion and SPECT were evaluated by the established 16 segment model. In patients, showing serial improvement in regional wall motion, there was 80.0% (8/10) showed normal 201 Tl distribution during the acute phase or normalized during the chronic phase. However, distribution of 123 I-BMIPP normalized only in 10.0% (1/10) of this group. In examination of each segment that showed serial improvement in regional wall motion, 92.3% (24/26) of these segments showed normal distribution of 201 Tl during the acute phase or normalized distribution during chronic phase, despite distribution of 123 I-BMIPP improved in only 3.8% (1/26) of these segments. These indicate that, in the process of recovery from myocardial stunning after AMI, abnormal distribution of 123 I-BMIPP continued longer than abnormal distribution of 201 Tl. (author)

  4. New application of myocardial infarct map using a dual isotope single photon emission computed tomography (SPECT) of [99mTc]pyrophosphate and [201Tl]chloride in patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Hiroe, Michiaki; Muramatsu, Yasuji; Sugimoto, Keiichi; Tsujino, Motoyoshi; Maejima, Michihiro; Miyahara, Yasuhiro; Taniguchi, Koichi; Matsui, Susumu; Mizukawa, Katsumi.

    1988-01-01

    In 12 patients with acute myocardial infarction, a dual isotope SPECT was applied to describe a myocardial infarct map for detecting the site and the extent of the infarct. Threshold cut-off level was determined as 55 % for [ 99m Tc] and 35 % for [ 201 Tl] according to cardiac phantom studies. Multiple cardiac tomograms showed two different uptakes of the isotopes in indentical slices and regions. Then, color tomograms were described on the red and green image for [ 99m Tc] and for [ 201 Tl], respectively, and Bulls eye map was drawn in the two colored fashion as the myocardial infarct map. In all patients, the infarct map was successful to determine the exact site of the infarct and the overlapped area by the viable myocardium. In conclusion, this functional map of acute myocardial infarction may be useful for understanding three dimensional area of the infarct and the viable myocardium easily and exactly. (author)

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

    International Nuclear Information System (INIS)

    Wang Qian; Fumiko Nakanishi; Shusuke Sone

    1994-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

  7. Compensation of Cross-Contamination in Simultaneous 201Tl/99mTc Myocardial Perfusion SPECT Imaging

    Directory of Open Access Journals (Sweden)

    Faraz Kalantari

    2009-12-01

    Full Text Available Introduction: It is a common protocol to use 201Tl for the rest and 99mTc for the stress cardiac SPECT imaging. Theoretically, both types of imaging may be performed simultaneously using different energy windows for each radionuclide. However, a potential limitation is the cross-contamination of scattered photons from 99mTc and collimator X-rays into the 201Tl energy window. We used a middle energy window method to correct this cross-contamination. Material and Methods: Using NCAT, a typical software torso phantom was generated. An extremely thin line source of 99mTc activity was placed inside the cardiac region of the phantom and no activity in the other parts.  The SimSET Monte Carlo simulator was used to image the phantom in different energy windows. To find the relationship between projections in different energy windows, deconvolution theory was used. We investigated the ability of the suggested functions in three steps: Monte Carlo simulation, phantom experiment and clinical study. In the last step, SPECT images of eleven patients who had angiographic data were acquired in different energy windows. All of these images were compared by determining the contrast between a defect or left ventricle cavity and the myocardium. Results: We found a new 2D kernel which had an exponential pattern with a much higher center. This function was used for modeling 99mTc down scatter distribution from the middle window image. X-ray distribution in the 201Tl window was also modeled as the 99mTc photopeak image convolved by a Gaussian function. Significant improvements in the contrasts of the simultaneous dual 201Tl images were found in each step before and after reconstruction. In comparison with other similar methods, better results were acquired using our suggested functions. Conclusion: Our results showed contrast improvement in thallium images after correction, however, many other parameters should be evaluated for clinical approaches. There are many

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-15

    We developed and tested a single acquisition rest {sup 99m}Tc-sestamibi/stress {sup 201}Tl dual isotope protocol (SDI) with the intention of improving the clinical workflow and patient comfort of myocardial perfusion single photon emission computed tomography (SPECT). The technical feasibility of SDI was evaluated by a series of anthropomorphic phantom studies on a standard SPECT camera. The attenuation map was created by a moving transmission line source. Iterative reconstruction including attenuation correction, resolution recovery and Monte Carlo simulation of scatter was used for simultaneous reconstruction of dual tracer distribution. For clinical evaluation, patient studies were compared to stress {sup 99m}Tc and rest {sup 99m}Tc reference images acquired in a 2-day protocol. Clinical follow-up examinations like coronary angiography (CAG) and fractional flow reserve (FFR) were included in the assessment if available. Phantom studies demonstrated the technical feasibility of SDI. Artificial lesions inserted in the phantom mimicking ischaemia could be clearly identified. In 51/53 patients, the image quality was adequate for clinical evaluation. For the remaining two obese patients with body mass index > 32 the injected {sup 201}Tl dose of 74 MBq was insufficient for clinical assessment. In answer to this the {sup 201}Tl dose was adapted for obese patients in the rest of the study. In 31 patients, SDI and {sup 99m}Tc reference images resulted in equivalent clinical assessment. Significant differences were found in 20 patients. In 18 of these 20 patients additional examinations were available. In 15 patients the diagnosis based on the SDI images was confirmed by the results of CAG or FFR. In these patients the SDI images were more accurate than the {sup 99m}Tc reference study. In three patients minor ischaemic lesions were detected by SDI but were not confirmed by CAG. In one of these cases this was probably caused by pronounced apical thinning. For two patients

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

    International Nuclear Information System (INIS)

    Dey, Thomas; Backus, Barbra E.; Romijn, R.Leo; Wieczorek, Herfried; Verzijlbergen, J.F.

    2014-01-01

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

  10. A comparative study between TL-201 SPECT myocardial perfusion scintigraphy and dobutamine stress echocardiography in the detection of coronary artery disease at the Philippine Heart Center

    International Nuclear Information System (INIS)

    Ogbac, R.V.; Martinez, A.O.; Obaldo, J.M.; Monzon, O.P.; Torres, J.F.; Rondilla, L.W.S.; Yap, J.S.; Flores, V.B.; Santos, R.J.; Jara, R.D.

    1996-01-01

    Although thallium-201 SPECT myocardial perfusion scintigraphy (MPS) has shown considerable accuracy for the detection of coronary artery disease (CAD), dobutamine stress echocardiography (DSE), a relatively new method for the detection of CAD had been recently utilized at the Philippine Heart Center. To assess its diagnostic worth versus that of thallium-201 spect myocardial scintigraphy (MPS), we studied 18 patients who underwent both procedures. Coronary angiography (CA) was used as the gold standard. MPS was performed with maximal treadmill exercise or with dipyridamole (0.568 mg/kg over 4 minutes) and Tl-201 was injected at peak stress. DSE was performed by infusing dobutamine at an increment of 5 μg/kg/min up to a maximum of 40. Atropine (0.01%) was added when 85% of maximum predicted heart rate is not achieved. Significant stenosis (>70%) was found in 16 out of 18 patients by CA. The sensitivity for the presence of CAD was 88% (14/16) and 69% (11/16) for MPS and DSE respectively. Specificity was 100% (2/2) for both. PPV was 100% for both while NPV was 50% and 29% for MPS and DSE respectively. Diagnostic accuracies were 89% and 72% for MPS and DSE respectively (P>0.05). Sensitivity for detecting left anterior descending artery (LAD) lesion was 71% 64% for MPS and DSE respectively; specificity was 75% and 100% respectively. For the left circumplex artery (LCX) lesion, both MPS and DSE had a sensitivity of 62% and specificity of 60%. Likewise for the right coronary artery (RCA) lesion, both had a sensitivity of 66% and specificity of 50%. Diagnostic accuracies were equal for both tests at 72% for LAD; 61% for LCX; and 61% for RCA. Kappa tests for association shows ρ values of >0.05 for overall and individual CAD detection suggesting no significant difference between MPS and DSE. Although there is a trend showing better detection of CAD with MPS, this particular study shows that both tests are comparable with regards to detection of the presence of CAD and of

  11. Brain SPECT with Tl-201 DDC

    International Nuclear Information System (INIS)

    Bruine, J.F. de.

    1988-01-01

    The development, animal and human experiments and the first clinical results of a new blood flow tracer thallium-201 diethyldithiocarbamate (Tl-201 DDC) are discussed for functional brain imaging with single-photon emission computed tomography (SPECT). 325 refs.; 43 figs.; 22 tabs

  12. Effects of cross talk on dual energy SPECT imaging between [sup 123]I-BMIPP and [sup 201]Tl

    Energy Technology Data Exchange (ETDEWEB)

    Morita, Masato; Narita, Hitoshi; Yamamoto, Juro; Fukutake, Naoshige; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Fukuchi, Minoru (Hyogo College of Medicine, Nishinomiya (Japan))

    1994-01-01

    The study was undertaken to determine how much cross talk influences the visual assessment of dual energy single photon emission computed tomographic (SPECT) images with iodine 123 beta-methyl-p-iodophenylpentadecanoic acid (I-123 BMIPP) and thallium-201 in 15 patients with acute myocardial infarction. After single SPECT with I-123 BMIPP was undertaken, simultaneous dual SPECT with I-123 BMIPP and Tl-201 were undertaken in all patients. Three patients also underwent single SPECT with Tl-201. I-123 BMIPP and Tl-201 uptake was graded in four-score for the comparison between single and dual SPECT images. There was good correlation between dual energy SPECT and both single I-123 BMIPP SPECT (pS=0.97) and single Tl-201 SPECT (pS=0.59). Uptake scores were increased on dual energy SPECT, compared with single I-123 SPECT (8 out of 132 segments) and single Tl-201 SPECT (12 out of 36 segments). Overall, there was a comparatively well correlation between single SEPCT with either I-123 BMIPP or Tl-201 and dual energy SPECT images. However, one tracer uptake sometimes increased in the other tracer defect areas. This was noticeable when I-123 BMIPP exerted an effect on Tl-201. (N.K.).

  13. Effects of cross talk on dual energy SPECT imaging between 123I-BMIPP and 201Tl

    International Nuclear Information System (INIS)

    Morita, Masato; Narita, Hitoshi; Yamamoto, Juro; Fukutake, Naoshige; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Fukuchi, Minoru

    1994-01-01

    The study was undertaken to determine how much cross talk influences the visual assessment of dual energy single photon emission computed tomographic (SPECT) images with iodine 123 beta-methyl-p-iodophenylpentadecanoic acid (I-123 BMIPP) and thallium-201 in 15 patients with acute myocardial infarction. After single SPECT with I-123 BMIPP was undertaken, simultaneous dual SPECT with I-123 BMIPP and Tl-201 were undertaken in all patients. Three patients also underwent single SPECT with Tl-201. I-123 BMIPP and Tl-201 uptake was graded in four-score for the comparison between single and dual SPECT images. There was good correlation between dual energy SPECT and both single I-123 BMIPP SPECT (pS=0.97) and single Tl-201 SPECT (pS=0.59). Uptake scores were increased on dual energy SPECT, compared with single I-123 SPECT (8 out of 132 segments) and single Tl-201 SPECT (12 out of 36 segments). Overall, there was a comparatively well correlation between single SEPCT with either I-123 BMIPP or Tl-201 and dual energy SPECT images. However, one tracer uptake sometimes increased in the other tracer defect areas. This was noticeable when I-123 BMIPP exerted an effect on Tl-201. (N.K.)

  14. Radioimmunoassay of myosin heavy beta chains in human serum for the evaluation of the size of myocardial infarction: correlation with myocardial Tl-201 SPECT and cardiac angioscintigraphy

    International Nuclear Information System (INIS)

    Facello, A.; Gries, P.; Demangeat, C.; Brunot, B.; Roul, G.; Demangeat, J.L.; Moulichon, M.; Bareiss, P.; Sacrez, A.; Constantinesco, A.

    1990-01-01

    To determine the relationship between serum levels of myosin heavy beta chains assessed by an IRMA technique and other radionuclide and enzymatic parameters in the evaluation of the size of myocardial infarction, we studied 22 patients with acute myocardial infarction. Blood samples taken daily between 1st to 13th day of evolution allow the determination of peak and integral of myosine release that showed a good correlation (p [fr

  15. A study on crosstalk correction in dual energy acquisition of 123I-MIBG and 201TlCl in myocardial SPECT

    International Nuclear Information System (INIS)

    Onoguchi, Masahisa; Satoh, Keiko; Murata, Hajime; Takao, Yuji; Ohtake, Eiji; Katoh, Kenichi; Saitoh, Kyoko; Toyama, Hinako; Ueno, Takashi.

    1991-01-01

    In the simultaneous dual energy acquisition, energy spectrums of two radionuclides crosstalk each other and this phenomenon is a cause of the poor quality of images. In order to obtain the image of high quality in dual energy acquisition of 123 I-MIBG and 201 TlCl, a crosstalk correction method was originated. The crosstalk from 201 Tl to 123 I window (RI) and the crosstalk from 123 I to 201 Tl window (R2) were determined by the cardiac phantom studies. R1 and R2 showed almost constant value throughout the myocardial wall. The crosstalk correction was performed using R1 and R2. After the crosstalk correction, the defect region placed in the cardiac phantom was detected more clearly both in visual interpretation and in quantitative analysis. The crosstalk correction method with R1 and R2 was applied to some clinical cases. By the crosstalk correction, the quality of image was improved and a false defect caused by crosstalk disappeared in a clinical case. The crosstalk correction was considered to be useful for improving the quality of image on dual energy acquisition. (author)

  16. Myocardial SPECT in children with sickle cell disease

    International Nuclear Information System (INIS)

    Maunoury, C.; Hallaj, I.; Barritault, L.; Acar, P.; Montalembert, M. de

    2002-01-01

    Aim: While cerebral and bones strokes are well documented in children with sickle cell disease (SCD), impairment of myocardial perfusion is an unknown complication. Conventional techniques such as exercise testing and echocardiography have a low sensitivity and specificity to detect myocardial ischemia in patients with SCD. The aim of this prospective study was to assess myocardial perfusion with 201 Tl SPECT in children with SCD. Materials and Methods: Twenty-two patients, aged 12 ± 4 years, were included. Myocardial perfusion was assessed by 201 Tl SPECT after stress and 3 hours later after reinjection on a single head gammacamera equipped with a LEAP collimator (64x64 matrix size format, 30 projections over 180 0 , 30 seconds per step). Left ventricular ejection fraction (LVEF) was assessed by equilibrium radionuclide angiography at rest on the same day. Results: Myocardial perfusion was impaired in 13/22 patients: 8 had reversible defects and 5 had fixed defects. The left ventricular cavity was dilated in 13/22 patients. The mean LVEF was 63 ± 9%. There was no relationship between myocardial perfusion and left ventricular dilation or function. Conclusion: Myocardial perfusion is frequently impaired in children with SCD. Treatment with hydroxyurea should be considered in SCD patients with perfusion defects

  17. Myocardial perfusion SPECT imaging in patients with myocardial bridging

    International Nuclear Information System (INIS)

    Fang Wei; Qiu Hong; Yang Weixian; Wang Feng; He Zuoxiang

    2008-01-01

    Objective: Stress myocardial perfusion SPECT imaging was used to assess myocardial ischemia in patients with myocardial bridging. Methods: Ninety-six patients with myocardial bridging of the left anterior descending artery documented by coronary angiography were included in this study. All under- went exercise or pharmacological stress myocardial perfusion SPECT assessing myocardial ischemia. None had prior myocardial infarction. One year follow-up by telephone interview was performed in all patients. Results The mean stenotic severity of systolic phase on angiography was (65 ± 19)%. In the SPECT study, 20 of 96 (20.8%) patients showed abnormal perfusion. This percentage was significantly higher than that of stress electrocardiogram (ECG). The higher positive rate of SPECT perfusion images was showed in the group of patients with severe systolic narrowing (≥75%) than that with mild-to-moderate systolic narrowing (50% vs 6.3%, P<0.001). The prevalence of abnormal image was significantly higher in ELDERLY PEOPLE; patients with STT change on rest ECG than in those with normal rest ECG (54.2% vs 9.7%, P<0.001). During follow-up, one patient with abnormal SPECT perfusion image sustained angina and accepted percutaneous coronary intervention, and no cardiac event occurred in patients with normal images. Conclusions: Stress myocardial perfusion SPECT imaging can be used effectively for assessing myocardial ischemia and has potential prognostic value for patients with myocardial bridging. (authors)

  18. Myocardial Perfusion SPECT 2015 in Germany

    Science.gov (United States)

    Burchert, Wolfgang; Schäfer, Wolfgang; Hacker, Marcus

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Leg 201Tl-SPECT in chronic exertional compartment syndrome

    International Nuclear Information System (INIS)

    Elkadri, N.; Slim, I.; Blondet, C.; Choquet, Ph.; Constantinesco, A.; Lecocq, J.

    2004-01-01

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

  1. Evaluation of coronary hemodynamics and exercise 201Tl-myocardial scintigraphy in patients with vasospastic angina

    International Nuclear Information System (INIS)

    Matsumura, Kentaro; Nakase, Emiko; Haiyama, Tohru; Hasegawa, Akira; Saito, Takayuki

    1992-01-01

    To clarify the coronary hemodynamics and myocardial perfusion in patients with vasospastic angina, we performed exercise 201 Tl-myocardial scintigraphy (planar and SPECT) in 72 patients and left coronary digital subtraction angiography (DSA) in 37 patients without significant organic coronary artery stenosis. Coronary artery spasm was documented by coronary angiography in all patients. Fifty-four patients (75%) developed exercise-induced 201 Tl-myocardial perfusion defect on SPECT. 201 Tl pulmonary uptake (L/H) was significantly increased in patients with vasospastic angina. Especially, L/H was higher in patients with multiple small perfusion defect on 201 Tl-SPECT, so that exercise-induced left ventricular dysfunction existed in patients with vasospastic angina and especially in cases of multiple small perfusion defect on 201 Tl-SPECT. The left coronary circulation time (CCT) was prolonged in patients with vasospastic angina. The mechanism of prolonged CCT is still unknown, but we suspected that prolonged CCT was induced by increased peripheral coronary vascular resistance in patients with vasospastic angina. It was concluded that the peripheral coronary circulation was disturbed in patients with vasospastic angina, but its abnormal coronary circulation had no relation to location of spasm-induced vessels. We concluded that impaired coronary microcirculation was taken a part of pathophysiology in vasospastic angina. (author)

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sinem Ozyurt

    2015-07-01

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

  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-SPECT

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

    International Nuclear Information System (INIS)

    Sasaki, Akira

    1996-01-01

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

  6. Clinical use of 201Tl myocardial scintigraphy

    International Nuclear Information System (INIS)

    Senda, Kohei; Imaeda, Takeyoshi; Kato, Toshimitsu; Asada, Shuichi; Doi, Hidetaka

    1977-01-01

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

  7. Usefulness of BMIPP SPECT to evaluate myocardial viability, contractile reserve and coronary stenotic progression after reperfusion in acute myocardial infarction

    International Nuclear Information System (INIS)

    Katsunuma, Eita; Kurokawa, Shingo; Takahashi, Motoi; Fukuda, Naoto; Kurosawa, Toshiro; Izumi, Tohru

    2001-01-01

    Using combined 123 I-BMIPP (BMIPP), 201 Tl (Tl) and 99m Tc-PYP (PYP) myocardial SPECT imaging, risk areas of acute myocardial infarction were documented in the acute stage, and then these images were evaluated for how well they reflected muscle viability, contractile reserve and coronary stenotic progression subsequent to reperfusion therapy. Patients who only experienced a first attack of myocardial infarction were enrolled. In total, 36 cases who had had the occluded artery successfully reperfused were examined during the past year. They had no significant vessel disease except for the culprit single artery. The patients were comprised of 32 men and 4 women. The mean age was 59.5 years. All patients underwent coronary angiography and left ventricular (LV) angiography in the emergency room. BMIPP/Tl and PYP myocardial SPECT were conducted in the acute stage and chronic stage. In the chronic stage LV angiography was repeated to assess the improvement of LV wall motion. The response to postextrasystolic potentiation (PESP) testing was performed to estimate myocardial contractile reserve. The risk area of acute myocardial infarction (AMI) was documented by reduced BMIPP accumulation. The size of reduced BMIPP accumulation was larger than that of PYP accumulation. A BMIPP/Tl discrepancy and PYP accumulation were documented to assess myocardial viability. Both improvement in LV wall motion and augmentation of PESP response were more closely related to a BMIPP/Tl discrepancy in the presence or absence of PYP accumulation. Therefore, it would be possible to evaluate myocardial viability and contractile reserve by the BMIPP/Tl discrepancy. In patients with good viability, it is important to predict whether there is coronary stenotic progression or not. In this study, we demonstrated that most patients with improved BMIPP images had no significant progression at the site of intervention. Serial observation of BMIPP images from the acute stage to the chronic stage might

  8. Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various study protocols

    International Nuclear Information System (INIS)

    Verger, Antoine; Karcher, Gilles; Djaballah, Wassila; Fourquet, Nicolas; Rouzet, Francois; Le Guludec, Dominique; Koehl, Gregoire; Roch, Veronique; Imbert, Laetitia; Poussier, Sylvain; Fay, Renaud; Marie, Pierre-Yves

    2013-01-01

    The results of stress myocardial perfusion SPECT could be enhanced by new cadmium-zinc-telluride (CZT) cameras, although differences compared to the results with conventional Anger cameras remain poorly known for most study protocols. This study was aimed at comparing the results of CZT and Anger SPECT according to various study protocols while taking into account the influence of obesity. The study population, which was from three different institutions equipped with identical CZT cameras, comprised 276 patients referred for study using protocols involving 201 Tl (n = 120) or 99m Tc-sestamibi injected at low dose at stress ( 99m Tc-Low; stress/rest 1-day protocol; n = 110) or at high dose at stress ( 99m Tc-High; rest/stress 1-day or 2-day protocol; n = 46). Each Anger SPECT scan was followed by a high-speed CZT SPECT scan (2 to 4 min). Agreement rates between CZT and Anger SPECT were good irrespective of the study protocol (for abnormal SPECT, 201 Tl 92 %, 99m Tc-Low 86 %, 99m Tc-High 98 %), although quality scores were much higher for CZT SPECT with all study protocols. Overall correlations were high for the extent of myocardial infarction (r = 0.80) and a little lower for ischaemic areas (r = 0.72), the latter being larger on Anger SPECT (p 201 Tl or 99m Tc-Low group and in whom stress myocardial counts were particularly low with Anger SPECT (228 ± 101 kcounts) and dramatically enhanced with CZT SPECT (+279 ± 251 %). Concordance between the results of CZT and Anger SPECT is good regardless of study protocol and especially when excluding obese patients who have low-count Anger SPECT and for whom myocardial counts are dramatically enhanced on CZT SPECT. (orig.)

  9. Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various study protocols

    Energy Technology Data Exchange (ETDEWEB)

    Verger, Antoine; Karcher, Gilles [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Djaballah, Wassila [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947, Nancy (France); Fourquet, Nicolas [Clinique Pasteur, Toulouse (France); Rouzet, Francois; Le Guludec, Dominique [AP-HP, Hopital Bichat, Department of Nuclear Medicine, Paris (France); INSERM U 773 Inserm and Denis Diderot University, Paris (France); Koehl, Gregoire; Roch, Veronique [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Imbert, Laetitia [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Centre Alexis Vautrin, Department of Radiotherapy, Vandoeuvre (France); Poussier, Sylvain [INSERM U947, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Fay, Renaud [INSERM, Centre d' Investigation Clinique CIC-P 9501, Nancy (France); Marie, Pierre-Yves [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); INSERM U961, Nancy (France); Hopital de Brabois, CHU-Nancy, Medecine Nucleaire, Vandoeuvre-les-Nancy (France)

    2013-03-15

    The results of stress myocardial perfusion SPECT could be enhanced by new cadmium-zinc-telluride (CZT) cameras, although differences compared to the results with conventional Anger cameras remain poorly known for most study protocols. This study was aimed at comparing the results of CZT and Anger SPECT according to various study protocols while taking into account the influence of obesity. The study population, which was from three different institutions equipped with identical CZT cameras, comprised 276 patients referred for study using protocols involving {sup 201}Tl (n = 120) or {sup 99m}Tc-sestamibi injected at low dose at stress ({sup 99m}Tc-Low; stress/rest 1-day protocol; n = 110) or at high dose at stress ({sup 99m}Tc-High; rest/stress 1-day or 2-day protocol; n = 46). Each Anger SPECT scan was followed by a high-speed CZT SPECT scan (2 to 4 min). Agreement rates between CZT and Anger SPECT were good irrespective of the study protocol (for abnormal SPECT, {sup 201}Tl 92 %, {sup 99m}Tc-Low 86 %, {sup 99m}Tc-High 98 %), although quality scores were much higher for CZT SPECT with all study protocols. Overall correlations were high for the extent of myocardial infarction (r = 0.80) and a little lower for ischaemic areas (r = 0.72), the latter being larger on Anger SPECT (p < 0.001). This larger extent was mainly observed in 50 obese patients who were in the {sup 201}Tl or {sup 99m}Tc-Low group and in whom stress myocardial counts were particularly low with Anger SPECT (228 {+-} 101 kcounts) and dramatically enhanced with CZT SPECT (+279 {+-} 251 %). Concordance between the results of CZT and Anger SPECT is good regardless of study protocol and especially when excluding obese patients who have low-count Anger SPECT and for whom myocardial counts are dramatically enhanced on CZT SPECT. (orig.)

  10. Value of myocardial perfusion SPECT in pediatric population

    International Nuclear Information System (INIS)

    Massardo, T.; Coll, C.; Prat, H.; Gonzalez, P.; Doggenweiller, P.; Castillo, M.E.; Solis, A.

    2002-01-01

    Isotopic myocardial perfusion studies are less frequently used in children than in adults and their indications are also different. Our goal was to analyze retrospectively the experience with stress perfusion myocardial SPECT in pediatric population. Method: Since 1998 to 2001, ten studies were performed to 5 girls and 3 boys. Their mean age was 7±3 years ranging from 1-11. Three of them presented abnormal coronary arteries pre and post surgical intervention with or without coil; three had Kawasaki disease with coronary aneurysms and the other two, congenital cardiopathies (Cantrell pentalogy and great vessel transposition,both with posterior left ventricular hypokinesia post surgery). Stress was obtained using dipyridamole infusion (0.56 mg/kg) in 6 cases and treadmill exercise using Bruce protocol in 4. All those tests were well tolerated. Sestamibi Tc99m was selected in 80% of the cases and Tl 201 in the rest. Only 2 small children required anesthesia during SPECT acquisition. Results: Stress EKG did not demonstrated ischemia in any case. Coronary angiography was performed only in 50% of the patients, it was concordant with SPECT features in all, two of those patients presented transient perfusion defects (one Kawasaki and one abnormal coronary artery with a fistulae).The repaired pentalogy presented ischemia and septal infarction; in that patient echocardiographic hipokinesia was concordant with fixed hypoperfusion. One case with abnormal coronary plus mitral regurgitation (without isotopic ischemia) was submitted to embolization posteriorly, obtaining motion improvement. Clinical outcome was concordant with the presence or absence of isotopic ischemia in the rest of the patients. Conclusion: SPECT myocardial perfusion was helpful in the therapeutic approach and in prediction of outcome in children

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

    International Nuclear Information System (INIS)

    Shimazaki, Hiroshi; Oono, Ryuichi

    2001-01-01

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

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  13. Usefulness of rest-redistribution on thallium myocardial scintigraphy in patients with acute myocardial infarction by SPECT; Analysis by bull's eye and unfolded map images

    Energy Technology Data Exchange (ETDEWEB)

    Tahara, Yorio; Taya, Makoto; Sasaki, Akira; Nishimura, Tooru; Shimoyama, Katsuya; Mizuno, Haruyoshi; Ono, Akifumi; Okada, Michio; Ishikawa, Kyozo (Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine)

    1990-01-01

    The purpose of this study was to clarify the clinical significance of rest-redistribution in myocardial scintigraphy (SPECT) in acute myocardial infarction (AMI). 30 patients with AMI within one week after the onset of attack were studied. SPECT images were obtained 10 min and 3hrs after injection of {sup 201}Tl. Bull's eye images and unfolded map images were prepared. A {sup 201}Tl uptake was studied at the infarct and non-infarct sites. Exercise SPECT and radionuclide angiography were performed in all patients one month after the onset of AMI, and the findings were compared with clinical and coronary angiographic (CAG) findings. Redistribution of Tl at rest was observed at the infarct sites in 9 of the 30 patients. Redistribution at rest was observed at the non-infarct sites in 8 patients. Redistribution at rest was observed during exercise SPECT one month after the onset of AMI in patients with redistribution at rest in the acute phase. In patients with redistribution at rest at the infarct site, left ventricular ejection fraction (EF) improved one month after the onset of AMI ({Delta}EF>5%), but it decreased slightly during exercise. Wall motion at the infarct site was not much impaired in patients who showed redistribution at rest at the infarct site. Angina pectoris and recurrence of myocardial infarction were observed more frequently on SPECT, but no characteristic findings were obtained on CAG in those with redistribution at rest. In conclusion, cardiac function and wall motion at the infarct site are better preserved in patients with redistribution of Tl at rest on SPECT in the acute stage of myocardial infarction, as compared with patients having fixed defects, but the EF decrease slightly during exercise and the frequency of post-infarction angina is greater in those patients. Resting SPECT in AMI is considered to provide useful information for predicting cardiac function and the clinical course following myocardial infarction. (author).

  14. The characteristics of syndrome X based on 201Tl-SPECT, 18 FDG-PET and histopathologic findings

    International Nuclear Information System (INIS)

    Satake, Osamichi

    1999-01-01

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

  15. Methods, qualitative and quantitative evaluations of 201Tl myocardial scintiscans

    International Nuclear Information System (INIS)

    Buell, U.; Kleinhans, E.; Klepzig, M.; Seiderer, M.; Strauer, B.E.

    1981-01-01

    Exercise 201 Tl myocardial scintiscanning is a technique used to supplement exercise electrocardiography. The procedure employed should be identical to the standard procedure of electrocardiography. If the coronary disease has already been established by coronary angiography and kineventriculography, 201 Tl examinations should be carried out before surgery in order to determine the ''regional functional reserve''. Visual evaluations of the 201 Tl scintiscans should be supplemented by quantification methods. Quantification is also required between 201 Tl examination and surgery and to assure constant diagnostic accuracy in case of examination by different examiners. (orig./MG) [de

  16. A new method for quantification of pulmonary thallium uptake in myocardial SPECT studies

    International Nuclear Information System (INIS)

    Mannting, F.

    1990-01-01

    Quantified pulmonary thallium 201 (Tl) uptake was assessed in 32 normal people and 66 patients with suspected coronary artery disease (CAD) by a new method utilizing SPECT acquisition data. In 26 subjects pulmonary uptake was assessed with both SPECT and planar techniques. Pulmonary/myocardial (PM) ratios for the whole right lung (PM1) and for the upper left lung (PM2) were computed and compared with stress test, coronary angiography, radionuclide angiography (ERNA), and quantified Tl SPECT results. Excellent correlation between pulmonary uptake assessed by planar and SPECT technique was disclosed (r=0.92). The PM ratio (PM1/PM2) sensitivity and specificity in patients with CAD was 88%/92% and 60%/70%, for predicting perfusion abnormalities 90%/87% and 88%/88%, and an inverse correlation to LVEF was found (r=-0.40/r=-0.37, P<0.01). Significant correlations to coronary angiography findings (r=0.54/r=0.49, P<0.001) and to number of vessel territories with abnormal perfusion (r=0.70/r=0.69, P<0.001) were seen. Thus, pulmonary Tl uptake can be assessed in SPECT studies. The new method's discriminative ability seems higher than that of the standard planar technique currently employed. Positive correlations to coronary angiography findings and even stronger ones to perfusion abnormalities were observed. (orig.)

  17. Tl-201 and Tc-99m-DTPA neuro-SPECT in cerebral radiation necrosis

    International Nuclear Information System (INIS)

    Cleto, E.M. Jr.; Holmes, R.A.; Gumerlock, M.K.; Cabeen, M.; Logan, K.W.; Hoffman, T.J.

    1992-01-01

    The results in 3 cases of radiation necrosis demonstrate that by using both radionuclides Tl-201 and Tc-99m-DTPA, one can provide a semi-quantitative method to differentiate recurrent tumor from radiation necrosis. Focally increased cerebral Tl-201 activity in irradiated brain tumor patients is not specific for tumor recurrence, but when used in combination with DTPA, one is able to estimate the amount of Tl-201 activity resulting from increased blood-brain barrier permeability. If the average Tl-201 index is less than the average Tc-99m-DTPA index it suggests that the increased Tl-201 activity results primarily from blood-brain barrier breakdown. Tc-99m-DTPA SPECT, in addition to Tl-201 SPECT, or serial Tl-201 SPECT imaging may increase the accuracy of brain scintigraphy in differentiating radiation necrosis from tumor recurrence. To verify these preliminary findings, we are in the process of analyzing additional SPECT data on 9 more patients with malignant brain tumors. Using a slightly different method of quantifying Tl- 201/Tc-99m-DTPA ratios (computing the ratio of intralesional Tl-201 or Tc-99m-DTPA activity compared to adjacent scalp activity), patients with tumor recurrence have higher Tl-201/Tc-99m-DTPA ratios compared to those with radiation necrosis (verbal communication with Dr. Mary K. Gumerlock). (orig.) [de

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

    International Nuclear Information System (INIS)

    Nishikubo, Naotsugu; Tamai, Hiroyuki

    2013-01-01

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

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

    International Nuclear Information System (INIS)

    Yamanaka, Hiroyuki; Suzuki, Takeshi; Kishida, Hiroshi; Nagasawa, Koichi; Takano, Teruo

    2006-01-01

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

  20. Evaluation of viability of infarcted myocardium by low dose dobutamine stress echocardiography. Comparison with exercise stress 201Tl myocardial scintigraphy

    International Nuclear Information System (INIS)

    Nagahara, Toshihiro; Sakamoto, Kazunori; Sofue, Akira; Horiuchi, Toshimitsu; Yamazaki, Shigeki; Kuwako, Kenji

    1999-01-01

    Exercise stress 201 Tl myocardial single-photon emission computed tomography (SPECT) is recognized to be a excellent method for identifying viability after myocardial infarction, but it is expensive and needs a longer time for data acquisition than echocardiography. We therefore performed this study to evaluate the effectiveness of low dose (5-10 μg/kg/min) dobutamine stress echocardiography (DSE) in 30 patients (61±8 years old: 24 men and 6 women) within 4 weeks after myocardial infarction in identifying viable myocardium, compared to results obtained by SPECT. Defining an akinetic or dyskinetic segment obtained by rest echocardiography as a definite infarct area, altogether 96 segments out of 716 segments were shown to be infarct areas. Of these, 75 (78%) segments were identified as viable by DSE, and 77 (80%) by SPECT. Only 2 segments were shown to be discrepant on DSE and SPECT. Subsequently, the sensitivity, specificity and accuracy rates for DSE were 96%, 100% and 96%, respectively. In conclusion, DSE is as effective and useful as SPECT in the evaluation of viability after myocardial infarction. (author)

  1. When is 201Tl myocardial scintigraphy indicated?

    International Nuclear Information System (INIS)

    Klepzig, H. Jr.; Kaltenbach, M.

    1987-01-01

    Myocardial scintigraphy with thallium-201 has met with good acceptance in cardiology and has proven its value. The method implies only low risk and yields diagnostic results that allow verification or disqualification of suspected myocardial ischemia in those cases where there is only reduced accuracy of the exercise electrocardiogram. (TRV) [de

  2. Peritoneal fluid causing inferior attenuation on SPECT thallium-201 myocardial imaging in women

    International Nuclear Information System (INIS)

    Rab, S.T.; Alazraki, N.P.; Guertler-Krawczynska, E.

    1988-01-01

    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

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  4. Radioimmunoassay of myosin heavy beta chains in human serum for the evaluation of the size of myocardial infarction: correlation with myocardial Tl-201 SPECT and cardiac angioscintigraphy. Le dosage des chaines lourdes beta de la myosine serique dans l'approche de la taille de l'infarctus du myocarde: correlation avec la tomoscintigraphie myocardique au Tl-201 et l'angioscintigraphie cardiaque

    Energy Technology Data Exchange (ETDEWEB)

    Facello, A.; Gries, P.; Demangeat, C.; Brunot, B.; Roul, G.; Demangeat, J.L.; Moulichon, M.; Bareiss, P.; Sacrez, A.; Constantinesco, A. (Centre Hospitalier Universitaire Hautepierre, 67 - Strasbourg (FR))

    1990-01-01

    To determine the relationship between serum levels of myosin heavy beta chains assessed by an IRMA technique and other radionuclide and enzymatic parameters in the evaluation of the size of myocardial infarction, we studied 22 patients with acute myocardial infarction. Blood samples taken daily between 1st to 13th day of evolution allow the determination of peak and integral of myosine release that showed a good correlation (p<0.01) with myocardial underperfusion score in T1-201 SPECT, left ventricular ejection fractions at 1st day and at the pre-discharge study, just as CPK peak. This new assay is an interesting mean to evaluate the size of myocardial infarction.

  5. The effect of heart rate and contractility on the measurement of left ventricular mass by 201Tl SPECT

    International Nuclear Information System (INIS)

    Machac, J.; Vaquer, R.; Levin, H.; Horowitz, S.F.; Mount Sinai Medical Center, New York

    1987-01-01

    Left ventricular myocardial mass can be measured by 201 Tl SPECT, but the effects of changes in heart rate and contractility have not been determined. We constructed a dynamic computer model simulating the contracting left ventricle. Thirty two summed static views at each of 3 heart rates and 3 ejection fractions were manufactured to simulate a 180 0 acquisition. Each image set underwent tomographic reconstruction. Left ventricular mass was measured at a fixed percent threshold in each slice. The results show that left ventricular mass varied little with heart rate (4%) and only slightly more (8%) with ejection fraction. Thus, in the normal clinical setting, left ventricular mass measurements by SPECT are minimally affected by the dynamic state of the heart. (orig.)

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

    International Nuclear Information System (INIS)

    Mendoza V, R.

    2004-01-01

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

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

    International Nuclear Information System (INIS)

    Setsuta, Koichi

    1991-01-01

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

  8. Reverse 201Tl myocardial redistribution induced by coronary artery spasm

    International Nuclear Information System (INIS)

    Xiang Dingcheng; Yin Jilin; Gong Zhihua; Xie Zhenhong; Zhang Jinhe; Wen Yanfei; Yi Shaodong

    2010-01-01

    Objective: To investigate the mechanism of reverse redistribution (RR) on dipyridamole 201 Tl myocardial perfusion studies in the patients with coronary artery spasm. Methods: Twenty-six patients with coronary artery spasm and presented as RR on dipyridamole 201 Tl myocardial perfusion studies were enlisted as RR group, while other 16 patients with no coronary artery stenosis nor RR were enlisted as control group. Dipyridamole test was repeated during coronary angiography. Corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) and TIMI myocardial perfusion grade (TMPG) were measured at RR related and non-RR related coronary arteries before and after dipyridamole infusion respectively. All of the data were analyzed by Student's t-test or χ 2 -test and correlation analysis. Results: Coronary artery angiography showed slower blood flow and lower myocardial perfusion in RR related vessels when compared with non-RR related vessels in RR group, but there was no significant difference among the main coronary arteries in control group. The perfusion defects of RR area at rest were positively related to slower blood velocity at corresponding coronary arteries (r = 0.79, t =10.18, P 0.05). Conclusion: RR is related to the decreased blood flow and myocardial perfusion induced by coronary artery spasm at rest, which may be improved by stress test such as intravenous dipyridamole infusion. (authors)

  9. 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

  10. Simultaneous thallium-201/technetium-99m pyrophosphate tomography in patients with acute myocardial infarction: comparison of rotational SPECT and seven pinhole tomography

    International Nuclear Information System (INIS)

    Krause, T.; Schuemichen, C.; Beck, A.; Moser, E.; Zeiher, A.

    1992-01-01

    Simultaneous Tl-201/Tc-99m pyrophosphate (PPi) tomography was compared to Tc-99m PPi tomography and rotational SPECT (SPECT) was compared to seven pinhole tomography (9-PHT), respectively, in 19 patients with acute myocardial infarction (AMI). The results were correlated to electrocardiographic and angiographic findings. With Tl-201/Tc-99, PPi, all infarctions were detected and site of infarction was determined, independent of the tomographic technique used. There was no significant difference between the two acquisition techniques 7-PHT and SPECT concerning spatial extent of Tc-99m PPi accumulation and the uptake ratio. However, using only Tc-99m PPi without Tl-201 as anatomical marker, SPECT detected 15/19 infarctions. In 7 of these 15 cases infarction site was correctly determined. 7-PHT detected 11/19 and site was correctly determined in 9/11 infarctions. Myocardial infarctions which failed diagnosis using Tc-99m PPi alone showed significantly smaller spatial extent of Tc-99m PPi accumulation and necrosis to blood pool ratio was lower as assessed by Tl201/Tc-99m PPi tomography. In conclusions, tomography using simultaneous Tl-201/Tc-99m PPi imaging is a reliable technique for diagnosis and localization of AMI. For this reason, results obtained with SPECT and 7-PHT are comparable. Independent of the tomographic technique used, combined imaging is superior to Tc-99m PPi alone without Tl-201 as additional anatomical marker (orig./MG) [de

  11. The significance of 123I-BMIPP myocardial SPECT on the evaluation of angina pectoris

    International Nuclear Information System (INIS)

    Kurosawa, Kazuhiko; Ohtani, Hiroshi; Saitou, Tomiyoshi; Maruyama, Yukio; Katohno, Eiichi; Ohwada, Kenji

    1998-01-01

    Some patients of ischemic heart disease have low uptake in 123 I-labeled beta methyl-iodophenyl pentadecanoic acid (BMIPP) SPECT in spite of normal uptake in thallium-201 (Tl) SPECT. To investigate their clinical significance, we performed both Tl and BMIPP myocardial SPECT in 26 cases with stable angina (n=16) and unstable angina (n=10), and compared with clinical backgrounds electrocardiogram (ECG) and left ventriculography (LVG). In 11 patients of them, the uptake of BMIPP was moderately reduced. We divided 26 cases into two groups according to uptake of BMIPP (normal/reduced). The two groups had no differences in length of angina attack and duration of disease, but they had a significant difference in the abnormality of either ECG or LVG. Three to six months after PTCA, we examined LVG in 18 cases, 12 of 16 cases with the abnormality of LVG showed the improvement of wall motion. We concluded the reduced uptake of BMIPP with normal uptake of Tl was related to more severe ischemia in cases with unstable angina. (author)

  12. Attenuation correction of myocardial SPECT images with X-ray CT. Effects of registration errors between X-ray CT and SPECT

    International Nuclear Information System (INIS)

    Takahashi, Yasuyuki; Murase, Kenya; Mochizuki, Teruhito; Motomura, Nobutoku

    2002-01-01

    Attenuation correction with an X-ray CT image is a new method to correct attenuation on SPECT imaging, but the effect of the registration errors between CT and SPECT images is unclear. In this study, we investigated the effects of the registration errors on myocardial SPECT, analyzing data from a phantom and a human volunteer. Registerion (fusion) of the X-ray CT and SPECT images was done with standard packaged software in three dimensional fashion, by using linked transaxial, coronal and sagittal images. In the phantom study, and X-ray CT image was shifted 1 to 3 pixels on the x, y and z axes, and rotated 6 degrees clockwise. Attenuation correction maps generated from each misaligned X-ray CT image were used to reconstruct misaligned SPECT images of the phantom filled with 201 Tl. In a human volunteer, X-ray CT was acquired in different conditions (during inspiration vs. expiration). CT values were transferred to an attenuation constant by using straight lines; an attenuation constant of 0/cm in the air (CT value=-1,000 HU) and that of 0.150/cm in water (CT value=0 HU). For comparison, attenuation correction with transmission CT (TCT) data and an external γ-ray source ( 99m Tc) was also applied to reconstruct SPECT images. Simulated breast attenuation with a breast attachment, and inferior wall attenuation were properly corrected by means of the attenuation correction map generated from X-ray CT. As pixel shift increased, deviation of the SPECT images increased in misaligned images in the phantom study. In the human study, SPECT images were affected by the scan conditions of the X-ray CT. Attenuation correction of myocardial SPECT with an X-ray CT image is a simple and potentially beneficial method for clinical use, but accurate registration of the X-ray CT to SPECT image is essential for satisfactory attenuation correction. (author)

  13. Reproducibility of 201Tl myocardial imaging

    International Nuclear Information System (INIS)

    McLaughlin, P.R.; Martin, R.P.; Doherty, P.; Daspit, S.; Goris, M.; Haskell, W.; Lewis, S.; Kriss, J.P.; Harrison, D.C.

    1977-01-01

    Seventy-six thallium-201 myocardial perfusion studies were performed on twenty-five patients to assess their reproducibility and the effect of varying the level of exercise on the results of imaging. Each patient had a thallium-201 study at rest. Fourteen patients had studies on two occasions at maximum exercise, and twelve patients had studies both at light and at maximum exercise. Of 70 segments in the 14 patients assessed on each of two maximum exercise tests, 64 (91 percent) were reproducible. Only 53 percent (16/30) of the ischemic defects present at maximum exercise were seen in the light exercise study in the 12 patients assessed at two levels of exercise. Correlation of perfusion defects with arteriographically proven significant coronary stenosis was good for the left anterior descending and right coronary arteries, but not as good for circumflex artery disease. Thallium-201 myocardial imaging at maximum exercise is reproducible within acceptable limits, but careful attention to exercise technique is essential for valid comparative studies

  14. Abnormal perfusion on myocardial perfusion SPECT in patients with Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Kang, Do Young; Cha, Kwang Soo; Han, Seung Ho; Park, Tae Ho; Kim, Moo Hyun; Kim, Young Dae

    2005-01-01

    Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkison-White) syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECT with Fitzpatrick's algorithm of electrophysiologic study and radiofrequency catheter ablation. Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients(mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent (11.0 ± 8.5%, range:3 ∼ 35%) and mild to moderate severity (-71 ± 42.7%, range:-217 ∼ -39%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patients with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but if did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome

  15. Abnormal perfusion on myocardial perfusion SPECT in patients with Wolff-Parkinson-White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Cha, Kwang Soo; Han, Seung Ho; Park, Tae Ho; Kim, Moo Hyun; Kim, Young Dae [Donga University College of Medicine, Busan (Korea, Republic of)

    2005-02-15

    Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkison-White) syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECT with Fitzpatrick's algorithm of electrophysiologic study and radiofrequency catheter ablation. Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients(mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent (11.0 {+-} 8.5%, range:3 {approx} 35%) and mild to moderate severity (-71 {+-} 42.7%, range:-217 {approx} -39%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patients with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but if did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.

  16. 201Tl brain SPECT in differentiating central nervous system lymphoma from toxoplasmosis in AIDS patients

    International Nuclear Information System (INIS)

    Kamata, Noriko; Suzuki, Kenzo; Abe, Katsumi; Yokoyama, Yoshiaki; Ushimi, Hisashi; Terada, Kazushi

    1997-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-03-01

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

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

    International Nuclear Information System (INIS)

    Shimoyama, Katsuya

    1999-01-01

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

  19. Assessment of myocardial viability by exercise stress myocardial tomography with 201Tl

    International Nuclear Information System (INIS)

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

    1992-01-01

    Exercise stress (Ex) and redistribution (RD) myocardial tomography with Tl-201 has been widely used for evaluating myocardial viability. But recent studies have demonstrated that reinjection (ReI) study following RD study is necessary for detecting reversible ischemic myocardium. On the other hand, decreased myocardial washout of Tl-201 after Ex is an indicator of myocardial ischemia. So we have studied the usefulness of myocardial Tl-201 washout rate (WOR) for the evaluation of myocardial viability by comparing it with ReI images. Ex and RD myocardial tomographies were obtained immediately after Ex and 3 hours later. After RD study a small amount of Tl-201 was injected and ReI imaging was repeated. We studied 64 myocardial segments (in 58 patients with coronary artery disease) in which Ex-induced perfusion defects persisted in RD images. According to the changes of perfusion defects between Ex, RD and ReI images, they were classified into 3 types: Type I; perfusion defect on the RD image was identical to ReI image (75%). Type I was divided into 2 subgroups whether perfusion defect at Ex was unchanged (Ia, 42%) or improved (Ib, 33%) on the RD image. Type II; perfusion defect at Ex was reduced on the RD image and it improved furthermore at ReI image (17%). Type III; perfusion defect was the same at Ex and RD but it was reduced on the ReI image (8%). WOR less than 30% was defined as abnormal when Ex heart rate exceeded 120 bpm and lung-myocardial Tl-201 uptake ratio was less than 0.45. The differentiation between Type Ia and Type III is of great importance. History of myocardial infarction, effort angina and Ex induced ST depression could not differentiate these 2 groups. WOR abnormality was observed in all of Type III, but WOR was normal in Type Ia. In conclusion, WOR abnormality in Ex-RD myocardial imaging is useful for evaluating myocardial viability. ReI imaging is necessary for the precise evaluation of viable muscle mass and for inadequate Ex. (author)

  20. Automatic extraction of left ventricle in SPECT myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Liu Li; Zhao Shujun; Yao Zhiming; Wang Daoyu

    1999-01-01

    An automatic method of extracting left ventricle from SPECT myocardial perfusion data was introduced. This method was based on the least square analysis of the positions of all short-axis slices pixels from the half sphere-cylinder myocardial model, and used a iterative reconstruction technique to automatically cut off the non-left ventricular tissue from the perfusion images. Thereby, this technique provided the bases for further quantitative analysis

  1. Reproducibility and quantitativity of oblique-angle reconstruction in single photon emission computed tomography using Tl-201 myocardial phantom

    International Nuclear Information System (INIS)

    Bunko, Hisashi; Nanbu, Ichiro; Seki, Hiroyasu

    1984-01-01

    This study was carried out in order to evaluate reproducibility and quantitativity of oblique-angle reconstruction of myocardial phantom SPECT. Myocardial phantom with transmural and subendcardial defects, and off-axis phantom with wall thickness changing continuously from 0 to 23 mm were used. Sixty projection data in every 6 0 were aquired using dual-camera (ZLC) with high resolution collimators connected to Scintipac-2400 computer system. Oblique-angle reconstructed images were obtained by indicating the long axis of the phantom manually in the transaxial and vertical long axial tomograms. Reproducibility and quantitativity were evaluated by creating circumferential profile (CFP) of the finally reconstructed short axial images. Inter- and intra-operater reproducibility of relative counting ratio were less than 6.7% (C.V.) and 3.3% (C.V.), respectively. Both inter- and intraoperater reproducibility of absolute counts were better than that of counting ratio (less than 5.1% (C.V.) and 2.9% (C.V.), respectively). Variation of defect location in the reconstructed image and between the slices were less than 1 sampling interval of CFP (6 0 ) and 0.6 slice, respectively. Quantitativity of counts in the reconstructed images was poor in the transmulal defect, but was fair in the subendocardial defect. Counting ratio was greatly affected by wall thickness. Temporal quantitatibity or linearity of the counts in sequential SPECTs was good in non-defect area, especially when wall thickness was greater than 70% (16 mm) of maximum. In conclusion, three-dimensional oblique-angle reconstruction in Tl-201 myocardial SPECT could be applicable to relative and temporal quantitation of local myocardial activity other than defect area for the quantitative evaluation of Tl-201 myocardial wash-out. (J.P.N.)

  2. Clinical use of /sup 201/Tl myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Senda, K; Imaeda, T; Kato, T; Asada, S; Doi, H

    1977-04-01

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

  3. Triple vessel coronary artery disease presenting as a markedly positive stress electrocardiographic test and a negative SPECT-TL scintigram: a case of balanced Ischemia

    Directory of Open Access Journals (Sweden)

    Eyal Herzog

    2011-09-01

    Full Text Available The presence of false negative nuclear stress test in the settings of positive electrocardiographic changes is a very unusual phenomenon and is usually secondary to balanced ischemia of the myocardial segments evaluated by SPECT-TL. We present a case of an 81- year old post-menopausal female who presented to her primary care physician for evaluation of a 6-week dyspnea on exertion and was referred to our institution for exercise stress test with Thallium SPECT with the objective of ruling out coronary artery disease and identifying possible areas of myocardial ischemia. The resting electrocardiogram was unremarkable and stress test evaluation was made. The patient was admitted to the cardiac care unit and coronary artery bypass grafting was successfully performed. The presence of false negative nuclear stress test in the settings of positive electrocardiographic changes is a very unusual phenomenon and is usually secondary to balanced ischemia of the myocardial segments evaluated by SPECT-TL. Patients undergoing stress tests with these characteristics should undergo careful evaluation and a high level of suspicion should be adopted for further diagnostic assessment of coronary artery disease.

  4. Factors affecting the myocardial activity acquired during exercise SPECT with a high-sensitivity cardiac CZT camera as compared with conventional Anger camera

    International Nuclear Information System (INIS)

    Verger, Antoine; Karcher, Gilles; Imbert, Laetitia; Yagdigul, Yalcine; Roch, Veronique; Fay, Renaud; Djaballah, Wassila; Rouzet, Francois; Le Guludec, Dominique; Fourquet, Nicolas; Poussier, Sylvain; Marie, Pierre-Yves

    2014-01-01

    Injected doses are difficult to optimize for exercise SPECT since they depend on the myocardial fraction of injected activity (MFI) that is detected by the camera. The aim of this study was to analyse the factors affecting MFI determined using a cardiac CZT camera as compared with those determined using conventional Anger cameras. Factors affecting MFI were determined and compared in patients who had consecutive exercise SPECT acquisitions with 201 Tl (84 patients) or 99m Tc-sestamibi (87 patients) with an Anger or a CZT camera. A predictive model was validated in a group of patients routinely referred for 201 Tl (78 patients) or 99m Tc-sestamibi (80 patients) exercise CZT SPECT. The predictive model involved: (1) camera type, adjusted mean MFI being ninefold higher for CZT than for Anger SPECT, (2) tracer type, adjusted mean MFI being twofold higher for 201 Tl than for 99m Tc-sestamibi, and (3) logarithm of body weight. The CZT SPECT model led to a +1 ± 26 % error in the prediction of the actual MFI from the validation group. The mean MFI values estimated for CZT SPECT were more than twofold higher in patients with a body weight of 60 kg than in patients with a body weight of 120 kg (15.9 and 6.8 ppm for 99m Tc-sestamibi and 30.5 and 13.1ppm for 201 Tl, respectively), and for a 14-min acquisition of up to one million myocardial counts, the corresponding injected activities were only 80 and 186 MBq for 99m Tc-sestamibi and 39 and 91 MBq for 201 Tl, respectively. Myocardial activities acquired during exercise CZT SPECT are strongly influenced by body weight and tracer type, and are dramatically higher than those obtained using an Anger camera, allowing very low-dose protocols to be planned, especially for 99m Tc-sestamibi and in non-obese subjects. (orig.)

  5. Comparison of adenosine stress and exercise stress 201Tl myocardial perfusion imaging for diagnosis of coronary heart disease

    International Nuclear Information System (INIS)

    Chen Guibing; Wu Hua; Jiang Ningyi; Liu Sheng; Lu Xianping; Liang Jiugen; Zhang Hong

    2007-01-01

    Objective: The aim of this study was to compare the diagnostic values of adenosine and exercise stress 201 Tl myocardial perfusion imaging for detecting coronary heart disease (CHD). Methods: 41 patients with suspected CHD were randomly divided into two groups. In one group adenosine stress was submitted, the exercise stress myocardial SPECT was performed in another. Coronary angiography (CAG) was performed in each patient within 2 weeks before or after SPECT. The result of CAG was taken as 'gold standard of CHD. They compared the diagnostic value of two methods. Results: In adenosine group, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy are 92.86%, 57.14%, 81.25%, 80.00%, 80.95% respectively. In exercise stress group, are 100%, 60.0%, 71.43%, 100%, 80.00% respectively. Detection rates of coronary artery lesions were 66.67% and 72.22% in two groups respectively. Conclusion Adenosine stress testing and exercise stress testing 201 Tl myocardial perfusion imaging may provide similar value for detection of CHD. (authors)

  6. [Myokard-Perfusions-SPECT. Myocardial perfusion SPECT - Update S1 guideline].

    Science.gov (United States)

    Lindner, Oliver; Bengel, Frank; Burchert, Wolfgang; Dörr, Rolf; Hacker, Marcus; Schäfer, Wolfgang; Schäfers, Michael A; Schmidt, Matthias; Schwaiger, Markus; Vom Dahl, Jürgen; Zimmermann, Rainer

    2017-08-14

    The S1 guideline for myocardial perfusion SPECT has been published by the Association of the Scientific Medical Societies in Germany (AWMF) and is valid until 2/2022. This paper is a short summary with comments on all chapters and subchapters wich were modified and amended.

  7. Reduced dose measurement of absolute myocardial blood flow using dynamic SPECT imaging in a porcine model

    International Nuclear Information System (INIS)

    Timmins, Rachel; Klein, Ran; Petryk, Julia; Marvin, Brian; Kemp, Robert A. de; Ruddy, Terrence D.; Wells, R. Glenn; Wei, Lihui

    2015-01-01

    Purpose: Absolute myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements provide important additional information over traditional relative perfusion imaging. Recent advances in camera technology have made this possible with single-photon emission tomography (SPECT). Low dose protocols are desirable to reduce the patient radiation risk; however, increased noise may reduce the accuracy of MBF measurements. The authors studied the effect of reducing dose on the accuracy of dynamic SPECT MBF measurements. Methods: Nineteen 30–40 kg pigs were injected with 370 + 1110 MBq of Tc-99m sestamibi or tetrofosmin or 37 + 111 MBq of Tl-201 at rest + stress. Microspheres were injected simultaneously to measure MBF. The pigs were imaged in list-mode for 11 min starting at the time of injection using a Discovery NM 530c camera (GE Healthcare). Each list file was modified so that 3/4, 1/2, 1/4, 1/8, 1/16, and 1/32 of the original counts were included in the projections. Modified projections were reconstructed with CT-based attenuation correction and an energy window-based scatter correction and analyzed with FlowQuant kinetic modeling software using a 1-compartment model. A modified Renkin-Crone extraction function was used to convert the tracer uptake rate K1 to MBF values. The SPECT results were compared to those from microspheres. Results: Correlation between SPECT and microsphere MBF values for the full injected activity was r ≥ 0.75 for all 3 tracers and did not significantly degrade over all count levels. The mean MBF and MFR and the standard errors in the estimates were not significantly worse than the full-count data at 1/4-counts (Tc99m-tracers) and 1/2-counts (Tl-201). Conclusions: Dynamic SPECT measurement of MBF and MFR in pigs can be performed with 1/4 (Tc99m-tracers) or 1/2 (Tl-201) of the standard injected activity without significantly reducing accuracy and precision

  8. Reduced dose measurement of absolute myocardial blood flow using dynamic SPECT imaging in a porcine model

    Energy Technology Data Exchange (ETDEWEB)

    Timmins, Rachel; Klein, Ran; Petryk, Julia; Marvin, Brian; Kemp, Robert A. de; Ruddy, Terrence D.; Wells, R. Glenn, E-mail: gwells@ottawaheart.ca [Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario K1Y4W7 (Canada); Wei, Lihui [Nordion, Inc., Ottawa, Ontario K2K 1X8 (Canada)

    2015-09-15

    Purpose: Absolute myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements provide important additional information over traditional relative perfusion imaging. Recent advances in camera technology have made this possible with single-photon emission tomography (SPECT). Low dose protocols are desirable to reduce the patient radiation risk; however, increased noise may reduce the accuracy of MBF measurements. The authors studied the effect of reducing dose on the accuracy of dynamic SPECT MBF measurements. Methods: Nineteen 30–40 kg pigs were injected with 370 + 1110 MBq of Tc-99m sestamibi or tetrofosmin or 37 + 111 MBq of Tl-201 at rest + stress. Microspheres were injected simultaneously to measure MBF. The pigs were imaged in list-mode for 11 min starting at the time of injection using a Discovery NM 530c camera (GE Healthcare). Each list file was modified so that 3/4, 1/2, 1/4, 1/8, 1/16, and 1/32 of the original counts were included in the projections. Modified projections were reconstructed with CT-based attenuation correction and an energy window-based scatter correction and analyzed with FlowQuant kinetic modeling software using a 1-compartment model. A modified Renkin-Crone extraction function was used to convert the tracer uptake rate K1 to MBF values. The SPECT results were compared to those from microspheres. Results: Correlation between SPECT and microsphere MBF values for the full injected activity was r ≥ 0.75 for all 3 tracers and did not significantly degrade over all count levels. The mean MBF and MFR and the standard errors in the estimates were not significantly worse than the full-count data at 1/4-counts (Tc99m-tracers) and 1/2-counts (Tl-201). Conclusions: Dynamic SPECT measurement of MBF and MFR in pigs can be performed with 1/4 (Tc99m-tracers) or 1/2 (Tl-201) of the standard injected activity without significantly reducing accuracy and precision.

  9. Assessment of inferior wall in 123I-metaiodobenzylguanidine myocardial SPECT in diabetic patients

    International Nuclear Information System (INIS)

    Fukumoto, Yoshihiro; Kuroda, Yasuhisa; Ohta, Jun; Osono, Ken; Saitou, Miyoko; Suzuki, Mituaki; Nakajima, Toshiki

    1994-01-01

    A phantom experiment and a clinical assessment have been made with the purpose of investigating the causes of low accumulation and deficiency of the inferior wall in 123 I-metaiodobenzylguanidine (MIBG) myocardial SPECT and the method for its evaluation. By the phantom experiment, assessments were made regarding (1) influence of the liver positioned adjacently; and (2) involvement of absorption and attenuation of the inferior wall. For the clinical assessment, 84 patients with diabetes in whom no abnormality was observed by exercise myocardial SPECT ( 201 TlCl) and 5 cases of inferior myocardial infarction (OMI group) were adopted as subjects. The inferior walls were evaluated as visually deficient because of the adjacently-positioned liver, but no low value was exhibited by quantitative evaluation. By pulmonary mediastinal phantom (-), improvement of the inferior wall was observed visually and quantitatively, compared with pulmonary mediastinal phantom (+). By quantitative evaluation, the patients were classified into normal MIBG group (N group); segmentally deficient group (S group); and non-accumulated group (DH group). In addition, S group was classified by severity score into those from S 1 to S 4 groups. No significant difference was observed in Relative Regional Uptake (RRU) in the inferior wall between S 4 group and OMI group. To sum up, we considered the causes for low accumulation and deficiency of the inferior wall, (1) adjacently-positioned liver; (2) absorption and attenuation; and (3) the lesion itself. Visual evaluation is not sufficient as the evaluating method. Quantitative evaluation becomes necessary. (author)

  10. Usefulness of hyperventilation myocardial SPECT for diagnosing vasospastic angina pectoris

    International Nuclear Information System (INIS)

    Tahara, Yorio; Shimoyama, Katsuya; Nishimura, Tooru; Sasaki, Akira; Taya, Makoto; Mizuno, Haruyoshi; Ono, Akifumi; Tsuya, Tsuneo; Ishikawa, Kyozo

    1990-01-01

    We evaluated the usefulness of hyperventilation myocardial scintigraphy (HV-SPECT) for diagnosing vasospastic angina pectoris. The subjects consisted of 11 patients with rest angina and 13 with rest and exertional angina in whom coronary spasm was demonstrated by coronary angiography, and 6 with exertional angina in whom a significant stenotic lesion was observed by coronary angiography. Hyperventilation was performed at a rate of 40/min for 5 minutes in all the patients. Ischemia was considered to be present when defect and redistribution were observed by SPECT. HV-SPECT revealed positive findings in 8 patients with rest angina (73%) and 9 with exertional and rest angina (69%) but only in 1 with exertional angina (17%). Ischemic ST changes on monitor ECG were observed in 13 of the 30 patients (43%); ST was enhanced in 4 patients and depressed in 9 patients. In the patients with rest angina, HV-SPECT induced ischemic findings more frequently than exercise SPECT (73% vs 55%). HV-SPECT seems to be useful as a non-invasive method for diagnosing angina pectoris resulting from coronary spasm. (author)

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

    International Nuclear Information System (INIS)

    Suzuki, Aya

    2003-01-01

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

  12. Evaluation of latent cardiac disease in diabetic patients with Tl-201 exercise myocardial scintigram and blood pool scintigram

    International Nuclear Information System (INIS)

    Miyashita, Takeo; Kasai, Ryutaro; Ikebe, Nobuhiko; Nagai, Yoshikazu; Yamasawa, Ikuhiro; Ibukiyama, Chiharu; Notoya, Yoko

    1990-01-01

    To find latent heart disease in diabetic patients, 142 diabetic patients were divided into 4 groups: (1) no hypertension and normal ECG (DM group); (2) hypertension recognized clinically (HT group); (3) myocardial damage on ECG (MD group); (4) group associated with the previous 2 (HT+MD group). In all groups Tl-201 exercise myocardial scintigrams and blood pool scintigrams were taken for comparative analysis. Positive rates of SPECT were 27.7% (23/83) in the DM group, 30.0% (9/30) in the HT group, 50.0% (6/12) in the MD group, and 70.6% (12/17) in the HT+MD group. The rate in the HT+MD group was significantly higher than in that of the DM and HT groups (p<0.001, p<0.01). Blood pool scintigrams revealed that in the HT+MD group, as compared with the normal control group, both 1/3 FF and PFR were significantly depressed, in addition to significant TPF prolongation in the former (p<0.001, p<0.05, p<0.05). These findings suggest that in diabetic patients hypertension and myocardial damage would lead to a high incidence of abnormality in SPECT and left ventricular rapid filling dysfunction. This indicate a high incidence of latent cardiac disease which can be recognized in diabetic patients by stress myocardial and blood pool scintigrams. (author)

  13. Study of sympathetic nervous function under effort induced ischemia in patients with angina pectoris with I-123 metaiodobenzylguanidine (MIBG) myocardial SPECT images

    International Nuclear Information System (INIS)

    Tanaka, Takeshi; Aizawa, Tadanori; Kato, Kazuzo; Ogasawara, Ken; Sakuma, Toru; Kirigaya, Hajime; Hirosaka, Akira; Igarashi, Masaki

    1990-01-01

    I-123 metaiodobenzylguanidine (MIBG) is a norepinephrine analog, which can be used to study the sympathetic nervous function of the heart. With MIBG myocardial SPECT images sympathetic nervous function under effort induced ischemia were studied in 18 patients with significant coronary artery lesions. In 5 patients with effort induced ischemic region in stress Tl-201 myocardial images rest MIBG images were collected and then exercise stress test was performed. Patients continued exercising for 3 minutes after onset of symptom. Post-stress MIBG images were collected. Definite ischemic region was noted in stress Tl-201 myocardial images, however no differences were noted between rest and post-stress MIBG images. These results suggested that exercise induced ischemia did not enhance release of uptaken MIBG. In 13 patients with significant coronary artery lesions symptom-limited exercise stress test was performed MIBG and Tl-201 were simultaneously injected at onset of symptom and patients continued exercising for an additional one minute. In 6 cases (46%, 6/13) MIBG defects with Tl-201 uptake were noted. These results showed that exercise induced ischemia depressed net MIBG uptake and that sympathetic nervous function (MIBG images) may be more sensitive to ischemic damage than muscle (Tl-201 images). It is suggested that exercise induced ischemia depressed reuptake of norepinephrine at sympathetic nervous endings. MIBG myocardial SPECT images may be useful for evaluating sympathetic nervous function under ischemia. (author)

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

    International Nuclear Information System (INIS)

    Li, Linxue; Nohara, Ryuji; Makita, Shigeru

    1996-01-01

    The effect of cardiac rehabilitation (mean 70±48 months) on myocardial perfusion was assessed using thallium-201 ( 201 Tl) exercise study in 63 patients with coronary artery disease (CAD). Subjects were those in a rehabilitation group (Rh=42) participating in supervised sports training two to three times per week and the control group (Ct=21) not taking active daily exercise. The interval between two 201 Tl SPECT studies was 19±16 months. After physical training, total duration of the exercise test increased from 443±112 to 536±121 seconds (+19%) in the Rh group, and from 484±129 to 432±115 seconds in the Ct group (-10.7%) (p 2 to 269.8±58 x 10 2 in the Rh group and decreased from 218.7±40 x 10 2 to 216.6±76 x 10 2 (p 201 Tl myocardial perfusion defect on exercise improved more in 54.8% (stress 59.5%, rest 35.7%) in the Rh group than in the Ct group (9.5%, p 201 Tl perfusion defect decreased from 68 (23.1%) to 49 regions (16.7%) of 294 total myocardial regions in the Rh group on exercise. However. it increased from 39 (26.5%) to 44 (29.9%) regions of 147 regions in the Ct group (p<0.01). Thus, cardiac rehabilitation increases exercise tolerance with improvement of myocardial perfusion. suggesting that cardiac rehabilitation is an advisable and effective treatment for patients with ischemic heart disease. (author)

  15. Observer variability in the evaluation of dual-isotope Tl-201/Tc-99m sestamibi rest/stress myocardial perfusion SPECT in men and women with known or suspected stable angina pectoris

    DEFF Research Database (Denmark)

    Johansen, Allan; Høilund-Carlsen, Poul Flemming; Christensen, Henrik Wulff

    2004-01-01

    BACKGROUND: Observer variability of dual-isotope myocardial perfusion imaging (MPI) with single photon emission computed tomography has rarely been investigated. The aim of our study was to evaluate the interpretive reproducibility with this technique. METHODS AND RESULTS: We report on 507 patients...... rate of abnormal MPI was 49% (59% in men and 34% in women). The interobserver agreement for the whole group (kappa = 0.85) and for men and women separately (kappa = 0.86 and 0.82, respectively) was excellent with regard to the overall diagnosis (normal, reversible, or fixed defects) as well as left...... anterior descending and left circumflex artery vascular territories (kappa = 0.85 and 0.82, respectively). However, in the right coronary artery territory, agreement was excellent in men (kappa = 0.83) but moderate in women (kappa = 0.57). CONCLUSIONS: In a relatively large group of men and women...

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    International Nuclear Information System (INIS)

    Matsutomo, Norikazu; Nagaki, Akio; Sasaki, Masayuki

    2014-01-01

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

  18. Role of myocardial perfusion SPECT in asymptomatic diabetic patients

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  19. Radiation exposure around patients after 201Tl-myocardial scintigraphy

    International Nuclear Information System (INIS)

    Kurtaran, A.; Preitfellner, J.; Kohoutek, D.; Tousek, A.; Virgolini, I.; Havlik, E.

    1997-01-01

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

  20. Quantitative assessment of myocardial blood flow by measurement of fractional myocardial uptake of 201Tl

    International Nuclear Information System (INIS)

    Yonekura, Yoshiharu; Ishii, Yasushi; Torizuka, Kanji; Kadota, Kazunori; Kambara, Hirofumi

    1980-01-01

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

  1. The impact of exercise myocardial perfusion SPECT imaging on the selection of patients for coronary angiography

    International Nuclear Information System (INIS)

    Song Liping; He Zuoxiang; Liu Xiujie; Shi Rongfang; Liu Yunzhong; Tian Yueqin; Zhang Xiaoli; Qin Xuewen; Chen Jilin; Gao Runlin

    2001-01-01

    Objective: Exercise 99 Tc m -MIBI myocardial perfusion SPECT is accurate for the diagnosis of coronary artery disease (CAD). This study assessed the impact of exercise myocardial perfusion imaging on the selection of patients for coronary angiography. Methods: 2188 consecutive patients who underwent exercise myocardial perfusion SPECT in authors' department in 1999 were retrospectively analyzed. Among them, 1807 were men, 381 women (average age: 53.5 +- 7.2 years). Overall, exercise myocardial SPECT was normal in 1731 patients, abnormal in 359 cases, and equivocal in 98 patients. There were 141 patients who underwent CAG within 60 days after myocardial SPECT. Results: Overall, 12% of the patients with abnormal SPECT imaging underwent coronary angiography, but only 5% of the patients with a normal SPECT imaging did (P < 0.001). Among these 141 patients who underwent coronary angiography, significant coronary stenosis was present in 91% of the patients who had had an abnormal SPECT imaging, but only 8% of those who had had a normal SPECT imaging (P < 0.001). In those patients who underwent coronary angiography, revascularization rate was 25% for the patients with abnormal SPECT imaging, but only 1% for the patients with a normal SPECT imaging. Conclusion: The results of exercise myocardial perfusion SPECT have a significant impact on the selection of patients for coronary angiography and revascularization

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-01-01

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

  3. Usefulness of dual energy single photon emission computed tomography with 99mTc-pyrophosphate and 201TlCl in diagnosis of acute myocardial infarction

    International Nuclear Information System (INIS)

    Shohgase, Takashi; Okita, Kohichi; Sakai, Hiroto; Fukuda, Hiroyuki; Anzai, Teisuke; Yamaguchi, Masashi; Koseki, Yukio; Tsujita, Naoyuki; Itoh, Hideki

    1990-01-01

    The dual energy single photon emission computed tomography (D-SPECT) with 99m Tc-Pyrophosphate and 201 TlCl was evaluated, using Bull's Eye Map representation in 30 patients with acute myocardial infarction. D-SPECT imaging for infarct detection was 100% sensitive. The patients were divided into two groups. One group had an overlap of accumulation of 99m Tc and 201 TlCl in the infarct zone and the other had no overlap. Fifteen of 19 patients (78.9%) in whom reperfusion was successful showed an overlap. Ten of 11 patients in whom reperfusion was unsuccessful showed no overlap. In the patients with successful reperfusion, the group that showed an overlap had a shorter interval between the onset of acute myocardial infarction and the reperfusion of coronary artery than the group that showed no overlap. But one case showed that collateral circulation had an influence on the overlap. In conclusion, using Bull's Eye Map representation, D-SPECT was useful to detect infarct and the overlap of accumulation of 99m Tc and 201 TlCl might be used as an index of early recanalization. (author)

  4. Evaluation of brain tumors by simultaneous dual isotope SPECT with 201Tl-chloride and 99mTc-MIBI

    International Nuclear Information System (INIS)

    Nagai, Hidemasa; Yamasaki, Toshiki; Yamamoto, Yoshiaki; Takada, Daikei; Miyazaki, Takeshi; Sugimoto, Keiji; Matsumoto, Yoshifumi; Akiyama, Yasuhiko; Moritake, Kouzo

    2004-01-01

    Single photon emission computed tomography (SPECT) is useful for detecting brain tumors. In this study, we evaluated the utility of simultaneous dual SPECT with 201 Tl-Chloride (Tl) and 99m Tc-MIBI (MIBI) for diagnosis of brain tumors. We evaluated 20 cases, including 2 glioblastomas, 7 anaplastic astrocytomas, 2 oligodendrogliomas, 2 anaplastic ependymomas, 2 medulloblastomas, 2 meningiomas, 1 malignant meningioma, 1 pituitary adenoma, and 1 craniopharyngioma. We analyzed the uptake ratio (T/N ratio) of tracers in both Tl and MIBI at max counts/pixels ratio in the region of interest. The T/N ratios in early and delayed images were described as early ratios (ER) and delay ratios (DR), respectively. The retention index (RI) was calculated as the DR/ER ratio. Significant correlations were found between ER and DR for both Tl (DR=0.797 x ER+0.359, r=0.871), and MIBI (DR=0.961 x ER-0.191, r=0.784). Next, we analyzed the correlations between Tl and MIBI SPECT, for ER, DR, and RI. ER values for the two were strongly correlated (r=0.791), DR values were weakly correlated (r=0.556), and RI exhibited no correlation between them (r=0.328). There were no correlations between tumor volume and T/N ratio for the two (ER-Tl; r=0.0095, DR-Tl; r=0.0050, ER-MIBI; r=0.036, DR-MIBI; r=0.254). Lastly no correlation was found between RI-Tl and RI-MIBI (r=0.328). We discuss the difference in the mechanism of accumulation of two tracers and the significance of simultaneous dual SPECT using them for the differential diagnosis of pituitary tumors, regrowth of oligodendrogliomas, and multi-drug resistance of chemotherapy. Dual SPECT with Tl and MIBI appears to be useful for the diagnosis of brain tumor. (author)

  5. Clinical usefulness of the technetium-99m/thallium-201 overlap on simultaneous dual SPECT in reperfusion after thrombolytic therapy for acute myocardial infarction

    International Nuclear Information System (INIS)

    Suzuki, Kazuo

    2002-01-01

    In this study, the clinical usefulness of the technetium-99m/thallium-201 ( 99m Tc-PYP/ 201 Tl-Cl) overlap on simultaneous dual SPECT in reperfusion after thrombolytic therapy for acute myocardial infarction was evaluated. The subjects were 14 patients with acute myocardial infarction who had not had myocardial infarction. All patients had chest pain that persisted more than 1 hour and showed electrocardiographic ST elevation. Myocardial scintigraphy was performed on the 4th day of the attack, at 81±35 hours after reperfusion on average. Three hours 50 min after intravenous injection of 740 Mbq 99m Tc-PYP, 111 Mbq 201 Tl-Cl was intravenously injected, and simultaneous dual SPECT was performed after 10 min. In all short axis SPECT image which showed 99m Tc-PYP accumulation, the area of 99m Tc-PYP accumulation (Tc hot), the overlap area of 99m Tc-PYP and 201 Tl-Cl accumulation (overlap), and the total area of 99m Tc-PYP and 201 Tl-Cl accumulation in the short axis SPECT images were calculated. The relationships between these parameters and the peak creatinine kinase (CK), changes in wall motion abnormalities observed by M-mode echocardiography, and the 4-hour delayed image by 201 Tl-Cl exercise scintigraphy performed about one month after the attack were evaluated. The results were both parameters of overlap/Tc hot and overlap/total were negatively correlated with the peak CK, overlap/Tc hot and overlap/total were positively correlated with wall motion scores ratio (WMSR), and overlap/Tc hot was positively correlated with Tl uptake (d)/Tc hot, and the acute overlap region was evaluated to be viable cardiac muscles one month after the attack. These results demonstrated that the 99m Tc-PYP/ 201 Tl-Cl overlap on simultaneous dual SPECT in reperfusion after thrombolytic therapy for acute myocardial infarction indicates the presence of viable cardiac muscles, showing that this method is useful for judgment of the effects of reperfusion. (author)

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

    International Nuclear Information System (INIS)

    Ouyang Wei; He Guorong; Liu Jinhua

    2004-01-01

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

  7. Myocardial scintigraphy with /sup 201/Tl and quantitative assessment of myocardial blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Ishii, Y; Kanbara, H; Yonekura, Y; Kadota, K; Fujita, T [Kyoto Univ. (Japan). Faculty of Medicine

    1976-12-01

    A newly introduced radionuclide for myocardial imaging, /sup 201/Tl, was studied. Twenty-two subjects consisting of 7 normals, 12 with ischemic heart disease and 3 with hypertrophic cardiomyopathy (HCM) were selected. On intravenous administration of /sup 201/Tl(1.5 to 20. mCi), initial transit of the tracer through the heart, as well as subsequent uptake by the myocardium, were recorded by a scintillation camera. The later process showed the distribution of the myocardial blood flow (MBF). A normal myocardial scintigraphy revealed the left-sided myocardial mass predominantly, whereas the right side or the septum predominated in the case of tetralogy of fallot (T/F) or idiopathic hypertrophic subuaortic stenosis (IHSS). An ischemic or infarcted area of the myocardium in ischemic heart disease (IHD) was compatible with electrocardiographic findings, and revealed defects even in an equivocal case on ECG. Since the ratio of radioactivity taken up by the myocardium (U) to the total injected dosis (I) is assumed to be proportional to the fractional MBF of cardiac output (CO), MBF/CO is calculated by ratio of the radioactivity selected from myocardial region on the later recording to that from the entire region on the initial transit of the tracer bolus. The average MBF/CO of normals was 4.4 +- 0.5%, IHD 4.0 +- 0.8% and HCM 5.5 +- 1.2%. On exercise loading, a significant increase of this value was observed in normals, whereas no change was observed in IHD.

  8. Consideration of Normal Variation of Perfusion Measurements in the Quantitative Analysis of Myocardial Perfusion SPECT: Usefulness in Assessment of Viable Myocardium

    International Nuclear Information System (INIS)

    Paeng, Jin Chul; Lim, Il Han; Kim, Ki Bong; Lee, Dong Soo

    2008-01-01

    Although automatic quantification software of myocardial perfusion SPECT provides highly objective and reproducible quantitative measurements, there is still some limitation in the direct use of quantitative measurements. In this study we derived parameters using normal variation of perfusion measurements, and tried to test the usefulness of these parameters. In order to calculate normal variation of perfusion measurements on myocardial perfusion SPECT, 55 patients (M:F=28:27) of low-likelihood for coronary artery disease were enrolled and 201 Tl rest / 99m Tc-MIBI stress SPECT studies were performed. Using 20-segment model, mean (m) and standard deviation (SD) of perfusion were calculated in each segment. As a myocardial viability assessment group, another 48 patients with known coronary artery disease, who underwent coronary artery bypass graft surgery (CABG) were enrolled. 201 Tl rest / 99m Tc-MIBI stress / 201 Tl 24-hr delayed SPECT was performed before CABG and SPECT was followed up 3 months after CABG. From the preoperative 24-hr delayed SPECT, Q delay (perfusion measurement), Δ delay (Q delay .m) and Z delay ((Q delay .m)/SD) were defined and diagnostic performances of them for myocardial viability were evaluated using area under curve (AUC) on receiver operating characteristic (ROC) curve analysis. Segmental perfusion measurements showed considerable normal variations among segments. In men, the lowest segmental perfusion measurement was 51.8±6.5 and the highest segmental perfusion was 87.0±5.9, and they are 58.7±8.1 and 87.3±6.0, respectively in women. In the viability assessment, Q delay showed AUC of 0.633, while those for Δ delay and Z delay were 0.735 and 0.716, respectively. The AUCs of Δ delay and Z delay were significantly higher than that of Q delay (p=0.001 and 0.018, respectively). The diagnostic performance of Δ delay , which showed highest AUC, was 85% of sensitivity and 53% of specificity at the optimal cutoff of -24.7. On automatic

  9. Creation and characterization of Japanese standards for myocardial perfusion SPECT. Database from the Japanese Society of Nuclear Medicine Working Group

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Kumita, Shinichiro; Ishida, Yoshio

    2007-01-01

    Standards for myocardial single-photon emission computed tomography (SPECT) adapted for a Japanese population were not available. The purpose of this study was to create standard files approved by the Japanese Society of Nuclear Medicine and to make known the characteristics of the myocardial perfusion pattern of this population. With the collaboration of nine hospitals, a total of 326 sets of exercise-rest myocardial perfusion images were accumulated from subjects with a low likelihood of cardiac diseases. The normal database included a 99m Tc-methoxyisobutylisonitrile (MIBI)/tetrofosmin myocardial perfusion study with 360 deg (n=80) and 180 deg (n=56) rotations, 201 Tl study with 360 deg (n=115) and 180 deg rotations (n=54) and a dual-isotope study with 360 deg rotation (n=27). The projection images were transferred by digital imaging and communications in medicine (DICOM) format and reconstructed and analyzed with polar maps. The projection data from multiple centers were successfully transferred to a common format for SPECT reconstruction. When the average values were analyzed using a 17-segment model, myocardial counts in the septal segment differed significantly between 180 deg and 360 deg rotation acquisitions. Regional differences were observed between men and women in the inferior and anterior regions. A tracer difference between 99m Tc and 201 Tl was also observed in some segments. The attenuation patterns differed significantly between subjects from the United States and those from Japan. Myocardial perfusion data that were specific for the Japanese population were generated. The normal database can serve a standard for nuclear cardiology work conducted in Japan. (author)

  10. Scintigraphic detection of ischemic and other myocardial lesions using 201Tl

    International Nuclear Information System (INIS)

    Duska, F.; Novak, J.; Vizda, J.; Kubicek, J.; Kafka, P.

    1981-01-01

    Current knowledge of the myocardium scintiscanning using 201 Tl is briefly outlined. The principle is shown of 201 Tl cumulation in a healthy myocardium and the use of the radionuclide is justified. Heart scintiscanning after exercise or after administration of drugs increasing the blood flow through the coronaries allows detecting latent ischaemic heart disease. 201 Tl scintigraphy can also be used for diagnosing the myocardial infarction, angina pectoris and other heart diseases. (J.P.)

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

    International Nuclear Information System (INIS)

    Okada, R.D.; Glover, D.K.; Leppo, J.A.

    1991-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Mendoza V, R

    2004-07-01

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

  13. The Effect and Side Effect of Dipyridamole in Myocardial SPECT

    International Nuclear Information System (INIS)

    Yang, Hyung In; Lee, Dong Soo; Yeo, Jeong Suk; Bae, Sang Kyun; Choi, Chang Woon; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon

    1993-01-01

    Dipyridamole is an agent that may be used to noninvasively evaluate coronary artery disease. The effect of dipyridamole infusion its generally related to its induced peripheral vasodilatory effect. In normal person, heart rate is generally increased slightly while blood pressure decrease, but the achieved double product and related myocardial oxygen consumption have no significant change. The purpose of this study is to examine the effect and side effect of dipyridamole, and to compare different response to dipyridamole among the patients. We evaluated 847 patients who underwent dipyridamole stress myocardial SPECT. 93.6% of them had induced hypotension 0.9% showed no change of blood pressure, 5.5% had increased blood pressure 8.3% had no change of pulse rate more than 10% of basal pulse rate. Among diabetes, 16.9% was not change of pulse rate, 6.7% in non-diabetes. There was no significant correlation between age and rate pressure product rest(RPPr), in patients without perfusion defects on SPECT(y=7.1x+48.4r=0.13 p>0.01). As increasing age, RPPs/RPPr was declined(y=-11.6x+68.9 r=0.17 p<0.01), similar results were obtained in patients with perfusion defect. The size of perfusion defect on myocardial SPECT have no correlation between RPPr and RPPs/RPPr. The side effects of dipyridamole included chest pain and chest tightness, headache, abdominal pain, dizziness, nausea, and dyspnea. As increasing age, dipyridamole-induced cardiac work at rest was increased, cardiac response to dipyridamole was decreased.

  14. Coronary collateral circulation during exercise assessed with stress Tl-201 SPECT

    International Nuclear Information System (INIS)

    Tanaka, Takeshi; Aizawa, Tadanori

    1995-01-01

    Stree Tl-201 single photon emission computed tomography (SPECT) was undertaken in 25 patients with complete occlusion of the left anterior descending artery in which the major collateral circulation was septal segment supplied by the right posterior descending artery with no significant occlusion. The ratio of blood flow in ischemic area to that in normal area was quantitatively determined on Tl-201 images, and the degree of ischemia was expressed by Tl uptake ratio. Ischemia was found in 22 of the 25 patients. Of the 22 patients, 9 showed Tl uptake ratio of less than 50%. Tl uptake ratio in the inferior segment was 76.8±10.3%. In 11 patients, it was less than 75%. Redistribution images were acquired in 19 patients. Changes in Tl uptake ratio on the 90 degrees projection of the septum were less than 20%, with a lowest value of 59.1±11.3% in 14 patients; and these were 20% or more, with a lowest value of 45.2±11.1% in 8 patients. When coronary collateral circulation is not supplied by exercise, septal perfusion may be decreased. In cases of complete occlusion of the anteiror descending artery, ischemia may not uniform over the whole ischemic area and may be noticeable around the anterior descending artery. In cases of lesions in the anteior descending artery, however, collateral circulation supplied by the right coronary artery may occur by exercise when ischemia in the anterior segment was severer than in the septal segment. (N.K.)

  15. Impact of patient motion on myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Huang Kemin; Feng Yanlin; He Xiaohong; Wen Guanghua; Yu Fengwen; Liu Shusheng; Liu Dejun; Yuan Jianwei; Yang Ming

    2008-01-01

    Objective: It is well known that patient motion may cause artifacts in myocardial SPECT images and affect clinical diagnosis. The aim of the study was to evaluate the effects of motion on quality and semi-quantitative results of myocardial perfusion images. Methods: Six healthy volunteers un- derwent myocardial perfusion SPECT. The raw data in each case was manually shifted 1-6 frames and 1 4 pixels, respectively by using the motion correction software. The shifted raw data were then reconstructed. A semi-quantitative software was used to assess the myocardial perfusion of left ventricle. The quality and semi-quantitative results of the tomographic images reconstructed from the raw data with and without motion were compared and analyzed. SPSS 12.0 was used for data analysis. Results: There was no visible artifact and semi-quantitative difference on the data with 1 frame and (or) 1 pixel shift when compared with the original data without shift. The image artifacts became significantly deteriorated when the number of flame and (or) pixel shift was increased. In general, the image artifact of inferior and posterior wall was related to the upward shift, and that of anterior and infero-posterior wall was related to the downward shift, that of septal, anterior, infero-postefior wall and apex was related to right-ward shift, and the septal and infero-posterior wall was related to the left-ward shift. The differences along the x-axis shift were more prominent than that of the y-axis (t=2.848, P<0.01), and the differences in the downward and rightward shift were more severe than the upward and leftward shift (t=2.941, 6.598; all P<0.01), respectively. Conclusions: Image artifacts became significant when there was motion induced by manual shift of more than one flame and (or) one pixel. Different motion directions were closely related to different segments of left ventricle. (authors)

  16. Myocardial scintigraphy with 199Tl chloride for the assessment of antianginal effect of cardil

    International Nuclear Information System (INIS)

    Chernov, V.I.; Mordovin, V.F.; Vesnina, Zh.V.; Triss, S.V.; Bazilevich, I.A.; Lishmanov, Yu.B.

    1995-01-01

    The aim of this research was examination of myocardial perfusion in cardil therapy of twenty-two coronary patients and analysis of potentialities of load 199 Tl scintigraphy in assessment of the antianginal effect in the course of therapy of coronary patients. The findings evidence that due to short 199 Tl half life and low radiation load of the body because of this radionuclide load 199 Tl scintigraphy of the myocardium carried out in the course of therapy of coronary patients may be used as an objective test to assess myocardial perfusion under the effect of treatment. 8 refs

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-15

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

  18. 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.

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  20. 201Tl in myocardial diagnosis: studies on the influence of dipyridamole, dobutamine ergometer exercise and background subtraction on the 201Tl myocadial scintiscam

    International Nuclear Information System (INIS)

    Seiderer, M.

    1979-01-01

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

  1. 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).

  2. 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)

  3. Coronary flow reserve index corrected by exercise load using Tl-201 SPECT

    International Nuclear Information System (INIS)

    Kubota, Yasushi; Sugihara, Hiroki; Azuma, Akihiro

    1990-01-01

    For simple, non-invasive evaluation of coronary flow reserve during exercise, we investigated the coronary flow reserve index using the ratio of change of fractional distribution in the regional myocardium to oxygen demand. The subjects included 24 patients with effort angina pectoris and 11 normal volunteers. PTCA was peformed for 11 patients. Using the biological properties of Tl-201 single photon emission computed tomography (SPECT) was performed at submaximal exercise and at rest by two successive injections of Tl-201 within a short time interval (double dose method). The correlation between the fractional distribution in the myocardium (Δ-Fract) and the oxygen demand during exercise and at rest were evaluated. Δ-Fract correlated well with the rate of change of the pressure rate product (Δ-PRP), and Δ-Fract/Δ-PRP (CRI) was a good indicator of the coronary flow reserve index. CRI in the ischemic region correlated well with the percent area stenosis of the supplying coronary artery and improved with resolution of percent area stenosis of the target coronary artery after PTCA, but in some cases they were not above the normal range. CRI as obtained by exercise SPECT using the double dose method is useful for non-invasively estimating the coronary flow reserve during exercise, and it can be used for evaluating the effect before and after PTCA. (author)

  4. Clinical usefulness of technetium-99m pyrophosphate and Tl-201 myocardial imaging for the estimation of myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Akio; Sato, Akihiko; Miyakoda, Hiroyuki; Watanabe, Toshiya; Itatsu, Hidetaka; Ueda, Osamu; Sakurai, Kuniteru; Kawai, Naoki; Sotobata, Iwao

    1985-04-01

    A correlative study was performed between the infarct size estimated by either technetium-99 pyrophosphate (Tc-PYP) or Tl-201 myocardial imaging, and the cumulative total creatinine phosphokinase activity (..sigma..CPK) or left ventricular ejection fraction (LVEF) in 40 patients with acute myocardial infarction. Tc-PYP infarct area (TcIA) and mean Tl-201 uptake ratio (MUR) were calculated as indices of myocardial infarct size. LVEF was evaluated by first pass method using Tc-PYP in the acute phase of myocardial infraction. In 23 patients with anterior myocardial infarction, a significant correlation was shown between either TcIA or anterior-wall MUR and ..sigma..CPK (r=0.81 and r=-0.69, respectively) and also between either TcIA or anterior-wall MUR and LVEF (r=-0.84 and r=0.80, respectively). In 17 patients with inferior myocardial infarction without additional involvement of right ventricular wall, inferior-wall MUR correlated with ..sigma..CPK (r=-0.74). No statically significant correlation was shown between TcIA and ..sigma..CPK, and also between either TcIA or inferior-wall MUR and LVEF. In conclusion, the infarct size estimated with Tc-PYP or Tl-201 myocardial imaging could be a useful clinical indicator of the severity of acute myocardial infarction especially in anterior wall. (author).

  5. Effect of scatter correction on quantification of myocardial SPECT and application to dual-energy acquisition using triple-energy window method

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Matsudaira, Masamichi; Yamada, Masato; Taki, Junichi; Tonami, Norihisa; Hisada, Kinichi

    1995-01-01

    Triple-energy window (TEW) method is a simple and practical approach for correcting Compton scatter in single-photon emission tracer studies. The fraction of scatter correction, with a point source or 30 ml-syringe placed under the camera, was measured by the TEW method. The scatter fraction was 55% for 201 Tl, 29% for 99m Tc and 57% for 123 I. Composite energy spectra were generated and separated by the TEW method. Combination of 99m Tc and 201 Tl was well separated, and 201 Tl and 123 I were separated within an error of 10%; whereas asymmetric photopeak energy window was necessary for separating 123 I and 99m Tc. By applying this method to myocardial SPECT study, the effect of scatter elimination was investigated in each myocardial wall by polar map and profile curve analysis. The effect of scatter was higher in the septum and the inferior wall. The count ratio relative to the anterior wall including scatter was 9% higher in 123 I, 7-8% higher in 99m Tc and 6% higher in 201 Tl. Apparent count loss after scatter correction was 30% for 123 I, 13% for 99m Tc and 38% for 201 Tl. Image contrast, as defined myocardium-to-left ventricular cavity count ratio, improved by scatter correction. Since the influence of Compton scatter was significant in cardiac planar and SPECT studies; the degree of scatter fraction should be kept in mind both in quantification and visual interpretation. (author)

  6. Factors affecting the myocardial activity acquired during exercise SPECT with a high-sensitivity cardiac CZT camera as compared with conventional Anger camera

    Energy Technology Data Exchange (ETDEWEB)

    Verger, Antoine; Karcher, Gilles [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947 and Universite de Lorraine, Nancy (France); Nancyclotep experimental imaging platform, Nancy (France); Imbert, Laetitia [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep experimental imaging platform, Nancy (France); Centre Alexis Vautrin, Department of Radiotherapy, Vandoeuvre (France); Yagdigul, Yalcine; Roch, Veronique [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep experimental imaging platform, Nancy (France); Fay, Renaud [INSERM, Centre d' Investigation Clinique CIC-P 9501, Nancy (France); Djaballah, Wassila [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947 and Universite de Lorraine, Nancy (France); Rouzet, Francois; Le Guludec, Dominique [AP-HP, Hopital Bichat, Department of Nuclear Medicine, Paris (France); INSERM U 773 and Denis Diderot University, Paris (France); Fourquet, Nicolas [Clinique Pasteur, Toulouse (France); Poussier, Sylvain [INSERM U947 and Universite de Lorraine, Nancy (France); Nancyclotep experimental imaging platform, Nancy (France); Marie, Pierre-Yves [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep experimental imaging platform, Nancy (France); INSERM U1116 and Universite de Lorraine, Nancy (France); CHU-Nancy, Allee du Morvan, Medecine Nucleaire, Hopital de Brabois, Vandoeuvre-les-Nancy (France)

    2014-03-15

    Injected doses are difficult to optimize for exercise SPECT since they depend on the myocardial fraction of injected activity (MFI) that is detected by the camera. The aim of this study was to analyse the factors affecting MFI determined using a cardiac CZT camera as compared with those determined using conventional Anger cameras. Factors affecting MFI were determined and compared in patients who had consecutive exercise SPECT acquisitions with {sup 201}Tl (84 patients) or {sup 99m}Tc-sestamibi (87 patients) with an Anger or a CZT camera. A predictive model was validated in a group of patients routinely referred for {sup 201}Tl (78 patients) or {sup 99m}Tc-sestamibi (80 patients) exercise CZT SPECT. The predictive model involved: (1) camera type, adjusted mean MFI being ninefold higher for CZT than for Anger SPECT, (2) tracer type, adjusted mean MFI being twofold higher for {sup 201}Tl than for {sup 99m}Tc-sestamibi, and (3) logarithm of body weight. The CZT SPECT model led to a +1 ± 26 % error in the prediction of the actual MFI from the validation group. The mean MFI values estimated for CZT SPECT were more than twofold higher in patients with a body weight of 60 kg than in patients with a body weight of 120 kg (15.9 and 6.8 ppm for {sup 99m}Tc-sestamibi and 30.5 and 13.1ppm for {sup 201}Tl, respectively), and for a 14-min acquisition of up to one million myocardial counts, the corresponding injected activities were only 80 and 186 MBq for {sup 99m}Tc-sestamibi and 39 and 91 MBq for {sup 201}Tl, respectively. Myocardial activities acquired during exercise CZT SPECT are strongly influenced by body weight and tracer type, and are dramatically higher than those obtained using an Anger camera, allowing very low-dose protocols to be planned, especially for {sup 99m}Tc-sestamibi and in non-obese subjects. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Shimoyama, Katsuya [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    1999-10-01

    Dual single photon emission computed tomography (SPECT) was performed in 31 patients with Duchenne's progressive muscular dystrophy (DMD) using {sup 123}I-{beta}-methyl pentadecanoic acid (BMIPP) for myocardial fatty acid metabolism and {sup 201}thallium (Tl)-chloride for myocardial perfusion. The left ventricle was divided into 9 segments, and accumulation of the radiotracers was assessed visually for each segment to calculate defect score for each tracer. There was some degree of decrease in myocardial accumulation of both tracers in all DMD patients. Reduced accumulation was most common at the apex (BMIPP: 67%, Tl: 63%), followed by the posterior wall, lateral wall, and anterior wall. On the other hand, reduced accumulation was less common at the septum. BMIPP showed a higher accumulation than Tl in all segments but the septum. When BMIPP defect score was larger than Tl defect score, BMIPP defect score tended to increase during 4 years follow-up (p<0.042). However, when Tl defect score was larger than BMIPP defect score, an increase in Tl defect score was slight. A significant negative correlation was found between the sum of the BMIPP and Tl defect scores and the left ventricular ejection fraction (LVEF) (r=0.66, p<0.0001). According to the histo-pathological study of two autopsied hearts, severe myocardial fibrosis was seen in segments with fixed perfusion defect. In addition, the mismatched segments of BMIPP defect score > Tl defect score revealed a slight fibrosis or normal myocardium. It can be concluded that the dual SPECT myocardial scintigraphy using BMIPP and Tl provides accurate information about disease progression of the heart in patients with DMD by detecting abnormalities of the myocardial metabolism of each substance, thereby enabling the assessment of left ventricular function. (author)

  8. 201Tl-SPECT in low-grade gliomas: diagnostic accuracy in differential diagnosis between tumour recurrence and radionecrosis

    International Nuclear Information System (INIS)

    Gomez-Rio, Manuel; Martinez del Valle Torres, Dolores; Rodriguez-Fernandez, Antonio; Llamas-Elvira, Jose Manuel; Lozano, Simeon Ortega; Font, Carlos Ramos; Lopez Ramirez, Escarlata; Katati, Majed

    2004-01-01

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

  9. Determination of optimum filter in inferolateral view of myocardial SPECT

    International Nuclear Information System (INIS)

    Takavar; Eftekhari, M.; Fallahi, B.; Shamsipour, Gh.; Sohrabi, M.; Saghari, M.

    2004-01-01

    Background: In myocardial perfusion SPECT imaging, images are degraded by photon attenuation, distance-dependent collimator, detector response and photon scattering. As filters greatly affect quality of nuclear medicine images, in this study determination of optimum filter for inferolateral view is our prime objective. Materials and Methods: .A phantom simulating heart left ventricle was built. About 1mCi of 99m Tc, was injected into the phantom. Images were taken from this phantom. Parzen, Hamming, Hanning, Butter worth and Gaussian filters were exerted on the images obtained from the phantom.. By defining some criteria such as contrast, signal to noise ratio, and defect size delectability, the best filter was determined for our ADAC spect system at our nuclear medicine center. In this study, 27 patients who previously had undergone coronary angiography were chosen to be included. All of these patients revealed significant stenosis in the left circumflex artery. Myocardial SPECT images of these patients had inferolateral defect. The images of these patients were processed with 12 filters including the optimum filters obtained from phantom study and some other non-optimum filters. A nuclear medicine physician quantified the results by assigmng mark from 0 to 4. to every image. 0 mark for images that didn't show the defect properly and 4 for the best one. The data from patient study were analyzed with non-related, non -parametric Friedman test. Results: Nyquist frequency of 0.325 and 0.5 were obtained as the optimum cut-off frequencies for hamming and Hanning filters respectively. Order 11 and cut-off frequency of 0.45 and order 20. with cut-off frequency of 0.5 were found to be optimum for Butter worth and Gaussian filters. In patient studies it was found that, Butter worth filter with cut-off frequency of 0.45 and order of 11 produced the best quality images. Conclusion: In this study. Butter worth filter with cut-off frequency of 0.45 and order of 11 was the

  10. Myocardial perfusion SPECT 2015 in Germany. Results of the 7th survey.

    Science.gov (United States)

    Lindner, Oliver; Burchert, Wolfgang; Schäfer, Wolfgang; Hacker, Marcus

    2017-02-14

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-09-15

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

  12. MRS algorithm: a new method for searching myocardial region in SPECT myocardial perfusion images.

    Science.gov (United States)

    He, Yuan-Lie; Tian, Lian-Fang; Chen, Ping; Li, Bin; Mao, Zhong-Yuan

    2005-10-01

    First, the necessity of automatically segmenting myocardium from myocardial SPECT image is discussed in Section 1. To eliminate the influence of the background, the optimal threshold segmentation method modified for the MRS algorithm is explained in Section 2. Then, the image erosion structure is applied to identify the myocardium region and the liver region. The contour tracing method is introduced to extract the myocardial contour. To locate the centriod of the myocardium, the myocardial centriod searching method is developed. The protocol of the MRS algorithm is summarized in Section 6. The performance of the MRS algorithm is investigated and the conclusion is drawn in Section 7. Finally, the importance of the MRS algorithm and the improvement of the MRS algorithm are discussed.

  13. Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Feger, S.; Rief, M.; Zimmermann, E.; Richter, F.; Roehle, R. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Dewey, M. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Institut fuer Radiologie, Berlin (Germany); Schoenenberger, E. [Medizinische Hochschule Hannover, Department of Medicine, Hannover (Germany)

    2015-07-15

    To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), stress perfusion magnetic resonance imaging (MRI), coronary CT angiography (CTA) in combination with CT myocardial stress perfusion (CTP), and conventional coronary angiography (CCA). Intraindividual comparison of perception of 48 patients from the CORE320 multicentre multinational study who underwent rest and stress SPECT-MPI with a technetium-based tracer, combined CTA and CTP (both with contrast agent, CTP with adenosine), MRI, and CCA. The analysis was performed by using a validated questionnaire. Patients had significantly more concern prior to CCA than before CTA/CTP (p < 0.001). CTA/CTP was also rated as more comfortable than SPECT-MPI (p = 0.001). Overall satisfaction with CT was superior to that of MRI (p = 0.007). More patients preferred CT (46 %; p < 0.001) as a future diagnostic test. Regarding combined CTA/CTP, CTP was characterised by higher pain levels and an increased frequency of angina pectoris during the examination (p < 0.001). Subgroup analysis showed a higher degree of pain during SPECT-MPI with adenosine stress compared to physical exercise (p = 0.016). All noninvasive cardiac imaging tests are well accepted by patients, with CT being the preferred examination. (orig.)

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

    International Nuclear Information System (INIS)

    Voronin, V.A.; Nechaev, D.D.; Laskin, S.A.; Martynov, I.V.; Petukhova, G.S.

    1991-01-01

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

  15. Analysis of metabolic change by Tl-201 SPECT in brain tumors treated with stereotactic radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Sugo, Nobuo [Toho Univ., Tokyo (Japan). School of Medicine

    1996-03-01

    The time course for changes in Tl-201 uptake and tumor size was studied correlatively. A total of 24 cases of brain tumors was enrolled in the study. Three detector type scanner, PRISM 3000 was used. SPECT scanning was started 10 min after intravenous administration of 111 MBq of Tl-201, and sequentially repeated every 1 min for 16 min. Tl-201 radioactivity was counted in two regions of interest (ROI). One was an area encircling the tumor, and the other, an area in the contralateral hemisphere that served as control. Tl index (TI) was calculated by this formula: TI=T-C/C, where T is the count in the tumor and C, the count in the control area. The size of a given tumor was represented by its maximum diameter as determined by CT or MRI. The TI and the tumor size were compared before and after radiosurgery. In all cases, a decrease in TI was seen earlier than a reduction in tumor size. Among malignant tumors, the TI decrease took place as early as one week, and rapidly reached the lowest level. On the other hand, in benign tumors, it took as long as 6 to 12 months for the decrease of the TI to be evident; the subsequent was very slow. The difference between malignant and benign tumors of the brain is attributed to the fact that high dose irradiation of the malignant, radiosensitive tumors causes deep disturbances in cell metabolism that lead to cell death. By contrast, irradiation of a benign tumor with low radiosensitivity does not affect the cellular metabolism, but injures the vascular wall, leading to gradual stenosis or obliteration of the vessels in the tumor. These data strongly suggest that the rapid and marked decrease of malignant tumors after stereotactic radiosurgery is the result of a direct injury to the malignant cells, and that the rather slow and insufficient diminution of benign tumors can be attributed to diminished blood supply to the tumor. (author)

  16. Determination of optimum filter in myocardial SPECT: A phantom study

    International Nuclear Information System (INIS)

    Takavar, A.; Shamsipour, Gh.; Sohrabi, M.; Eftekhari, M.

    2004-01-01

    Background: In myocardial perfusion SPECT images are degraded by photon attenuation, the distance-dependent collimator, detector response and photons scatter. Filters greatly affect quality of nuclear medicine images. Materials and Methods: A phantom simulating heart left ventricle was built. About 1mCi of 99m Tc was injected into the phantom. Images was taken from this phantom. Some filters including Parzen, Hamming, Hanning, Butter worth and Gaussian were exerted on the phantom images. By defining some criteria such as contrast, signal to noise ratio, and defect size detectability, the best filter can be determined. Results: 0.325 Nyquist frequency and 0.5 nq was obtained as the optimum cut off frequencies respectively for hamming and handing filters. Order 11, cut off 0.45 Nq and order 20 cut off 0.5 Nq obtained optimum respectively for Butter worth and Gaussian filters. Conclusion: The optimum member of every filter's family was obtained

  17. Gated myocardial SPECT using spatial and temporal filtering

    International Nuclear Information System (INIS)

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

    Gibson, R.S.; Watson, D.D.

    1991-01-01

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

  19. Concordance between myocardial perfusion scan assessed by SPECT and fractional flow reserve findings for detection of significant ischemia

    Directory of Open Access Journals (Sweden)

    Morteza Safi

    2016-09-01

    Conclusion: FFR and MPI with SPECT techniques showed significant concordance for detection of myocardial ischemia, regardless of the type of diseased coronary arteries. In this context, SPECT has high sensitivity and NPV for detection of ischemia compared with FFR.

  20. Is attenuation correction of myocardial SPECT scans worth the effort?

    International Nuclear Information System (INIS)

    Bui, C.; Nguyen, D.; Dixson, H.; Saunders, C.; Cook, P.; Burnett, P.; Croll, F.; Dunn, R.; Hasche, E.; Kelleher, P.; Nasser, F.; Wilson, D.; Lee, K.

    2000-01-01

    Full text: Gated (GS), attenuation-corrected (AC) and non-attenuation-corrected (NAC) myocardial SPECT scans were performed after injection of 99 Tc m -Sestamibi (MIBI) at peak stress in 253 patients between September 1998 and March 1999. 60 patients have undergone cardiac catheterisation (37 males, 23 females, age range 34-80). For whole heart analysis, significant coronary disease was defined as 50% or greater diameter narrowing in any of the coronary arteries and/or documented myocardial infarction. For vascular territory analysis, significant coronary disease was defined as 50% or greater diameter narrowing of any artery in that territory. The three coronary artery territories were assigned as: left anterior descending (LAD), left circumflex (LCA) and right coronary (RCA). The septum, apex and anterior wall; the lateral wall; and the inferior wall were assigned to the LAD; LCA; and RCA territories respectively. In conclusion for this selected subgroup of patients with angiographic follow-up, NAC, AC and GS were of similar accuracy in the detection of significant CAD in both whole heart analysis and individual vascular territory analysis. AC and GS were of superior specificity when compared with NAC in both whole heart analysis and individual vascular territory analysis. AC and GS may be of additional diagnostic value in improving the specificity of NAC. Further outcome data will be presented. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  1. Risk assessment after coronary angioplasty with SPECT myocardial perfusion studies

    International Nuclear Information System (INIS)

    Camilletti, Jorge A.; Erriest, Juan; Mele, Anibal A.

    2007-01-01

    The chest pain can be use for stratifying the risk of the patients after coronary angioplasty. Nevertheless this strategy has shown to have a low accuracy in the detection of restenosis and myocardial ischemia. Aims: To establish the usefulness of the SPECT studies in the risk stratification after the coronary angioplasty. Evaluate the incidence of silent ischemia or symptomatic, and its impact on the prognosis. Method: There were included 107 patients (p) submitted to a gated SPECT between the year of the coronary angioplasty. The analysis of the images was performed according to different scores (SSS, SRS, SDS). These data was correlated with the symptoms of the patients. We define group 1 (G1) as the asymptomatic without ischemia (n 59p), group 2 (G2) as silent ischemia (n = 28p) and group 3 (G3) as symptomatic with ischemia (n = 20p). A clinical follow-up was done in search of events (target vessel revascularization, unstable angina, AMI and death). Results: Significant differences were not observed in the clinical variables between the different groups. The SSS was lower in the G1 compare with G2 and G3 (p 0.0001) and was similar between the last two, p = NS (SSS: G1: 2.2 ± 4.9; G2: 7.6 ± 5.9; G3: 9.5 ± 6.8). The SDS was greater in G3 vs. G1 and G2, p = 0.0001, and greater in G2 vs. G1, p = 0.0001 (SDS: G1: 0; G2: 4.8 ± 3.5; G3: 7.2 ± 6.5). No differences where observed in the SRS between the three groups. In the follow-up the total percentage of events was lesser when compare the G1 with the G2 and G3 (G1: 3.3%; G2 and G3: 18.7%; p 0.02). The percentage of annual events of the G3 symptomatic with ischemia (11.03%) and G2 silent ischemia (4.04%) did not present differences (p 0.7). When the events of the G2 (4.04%) were compared with the G1 (1.24%) we observed a trend to major frequency of events in the G2 (p = 0.6). Conclusions: The presence of myocardial ischemia after coronary angioplasty is a determinant of the prognosis. Nevertheless, the extension

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  3. Effects of ischemic-like insult on myocardial 201Tl accumulation

    International Nuclear Information System (INIS)

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

    1983-01-01

    Despite extensive clinical use of thallium-201 ( 201 Tl) for myocardial imaging, the effect of ischemia on myocardial accumulation and release of 201 Tl independent of flow has not been fully defined. Therefore, myocardial accumulation of 201 Tl in response to ischemic-like myocardial injury was assessed in vitro using the cultured fetal mouse heart preparation. Cultured fetal mouse hearts (n . 311) were subjected to injury simulating ischemia by deprivation of oxygen and oxidizable substrates for periods ranging from 15 minutes to 10 hours. The extent of irreversible injury was determined by the percentage of lactic dehydrogenase (LDH) lost from the hearts to the culture medium during recovery from injury. Injury was essentially reversible at 1 hour of insult. The fraction of 201 Tl content in injured compared with control hearts was not significantly lower after 1 hour of insult. By 3 hours of insult, irreversible injury as assessed by loss of LDH was detectable and the extent of injury increased progressively through 10 hours. During the 3-10-hour period of irreversible injury, 201 Tl accumulation within injured hearts compared with controls was related in a monotonically decreasing fashion to the loss of LDH as described by a mathematical kinetic model that fit the observations closely (R2 greater than 0.99). These results indicate that in this organ culture preparation, in which there is effectively an unlimited reservoir of 201 Tl and no confounding effects of perfusion, the time-dependent 201 Tl accumulation is determined by the extent of irreversible injury

  4. ECG-gated myocardial imaging with 201Tl

    International Nuclear Information System (INIS)

    Baehre, M.

    1980-01-01

    ECG-gated myocardial scintigraphy by means of 201 TI was performed in 11 patients. Good scintigrams could be gained by using long imaging times, but there was no additional information when compared with static images. Disadvantages were long imaging time, higher technical expenditure, and the smaller number of projections. Furthermore, there is no possibility of performing myocardial imaging under stress. (orig.) [de

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

    International Nuclear Information System (INIS)

    Watanabe, Shigeyuki; Ajisaka, Ryuichi; Masuoka, Takeshi

    1990-01-01

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

  6. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision

    International Nuclear Information System (INIS)

    Verberne, Hein J.; Eck-Smit, Berthe L.F. van; Wit, Tim C. de; Acampa, Wanda; Anagnostopoulos, Constantinos; Ballinger, Jim; Bengel, Frank; Bondt, Pieter De; Buechel, Ronny R.; Kaufmann, Philip A.; Cuocolo, Alberto; Flotats, Albert; Hacker, Marcus; Hindorf, Cecilia; Lindner, Oliver; Ljungberg, Michael; Lonsdale, Markus; Manrique, Alain; Minarik, David; Scholte, Arthur J.H.A.; Slart, Riemer H.J.A.; Traegaardh, Elin; Hesse, Birger

    2015-01-01

    Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/ publications/guidelines/2015 0 7 E ANM F INAL myocardial p erfusion g uideline.pdf. (orig.)

  7. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision

    Energy Technology Data Exchange (ETDEWEB)

    Verberne, Hein J.; Eck-Smit, Berthe L.F. van; Wit, Tim C. de [University of Amsterdam, Department of Nuclear Medicine, F2-238, Academic Medical Center, Amsterdam (Netherlands); Acampa, Wanda [National Council of Research, Institute of Biostructures and Bioimaging, Naples (Italy); Anagnostopoulos, Constantinos [Academy of Athens, Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Athens (Greece); Ballinger, Jim [Guy' s Hospital - Guy' s and St Thomas' Trust Foundation, Department of Nuclear Medicine, London (United Kingdom); Bengel, Frank [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Bondt, Pieter De [OLV Hospital, Department of Nuclear Medicine, Aalst (Belgium); Buechel, Ronny R.; Kaufmann, Philip A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Flotats, Albert [Universitat Autonoma de Barcelona, Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain); Hacker, Marcus [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Vienna (Austria); Hindorf, Cecilia [Skaane University Hospital, Department of Radiation Physics, Lund (Sweden); Lindner, Oliver [University Hospital of the Ruhr-University Bochum, Heart and Diabetes Center North Rhine-Westphalia, Institute for Radiology, Nuclear Medicine and Molecular Imaging, Bad Oeynhausen (Germany); Ljungberg, Michael [Lund University, Department of Medical Radiation Physics, Lund (Sweden); Lonsdale, Markus [Bispebjerg Hospital, Department of Clinical Physiology and Nuclear Medicine, Copenhagen (Denmark); Manrique, Alain [Caen University Hospital, Department of Nuclear Medicine, Service Commun Investigations chez l' Homme, GIP Cyceron, Caen (France); Minarik, David [Skaane University Hospital, Radiation Physics, Malmoe (Sweden); Scholte, Arthur J.H.A. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Slart, Riemer H.J.A. [University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Traegaardh, Elin [Skaane University Hospital and Lund University, Clinical Physiology and Nuclear Medicine, Malmoe (Sweden); Hesse, Birger [University Hospital of Copenhagen, Department of Clinical Physiology and Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark)

    2015-11-15

    Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/ publications/guidelines/2015{sub 0}7{sub E}ANM{sub F}INAL myocardial{sub p}erfusion{sub g}uideline.pdf. (orig.)

  8. [Performance of Thallium 201 rest-redistribution spect to predict viability in recent myocardial infarction].

    Science.gov (United States)

    Coll, Claudia; González, Patricio; Massardo, Teresa; Sierralta, Paulina; Humeres, Pamela; Jofré, Josefina; Yovanovich, Jorge; Aramburú, Ivonne; Brugère, Solange; Chamorro, Hernán; Ramírez, Alfredo; Kunstmann, Sonia; López, Héctor

    2002-03-01

    The detection of viability after acute myocardial infarction is primordial to select the most appropriate therapy, to decrease cardiac events and abnormal remodeling. Thallium201 SPECT is one of the radionuclide techniques used to detect viability. To evaluate the use of Thallium201 rest-redistribution SPECT to detect myocardial viability in reperfused patients after a recent myocardial infarction. Forty one patients with up to of 24 days of evolution of a myocardial infarction were studied. All had angiographically demonstrated coronary artery disease and were subjected to a successful thrombolysis, angioplasty or bypass grafting. SPECT Thallium201 images were acquired at rest and after 4 h of redistribution. These results were compared with variations in wall motion score, studied at baseline and after 3 or 4 months with echocardiography. The sensitivity of rest-redistribution Thallium201 SPECT, to predict recovery of wall motion was 91% when patient analysis was performed and 79% when segmental analysis was done in the culprit region. The figures for specificity were 56 and 73% respectively. Rest-distribution Thallium201 SPECT has an excellent sensitivity to predict myocardial viability in recent myocardial infarction. The data obtained in this study is similar to that reported for chronic coronary artery disease.

  9. Comparison of dobutamine-stress magnetic resonance imaging and dipyridamole-Tl-201-SPECT as alternative strategies for the detection of coronary artery disease in patients not suitable for stress-echocardiography

    International Nuclear Information System (INIS)

    Schmidt, M.; Theissen, P.; Voth, E.; Schicha, H.; Jochims, M.; Baer, F.M.; Crnac, J.; Schneider, C.A.; Erdmann, E.

    2001-01-01

    Aim: During the past decade stress-echocardiography has gained increasing popularity for detection of myocardial ischemia in patients with coronary artery disease. However, about 10% to 15% of the patients submitted for stress-echocardiography do not have an adequate acoustic window. The purpose of this study was to compare high-dose dobutamine-stress magnetic resonance imaging (dobutamine-MRI) with dipyridamole-Tl-201-SPECT (dipyridamole-SPECT) as alternative strategies for detection of myocardial ischemia in patients with inadequate image quality by stress-echocardiography. Patients and Methods: Of 296 patients which were consecutively submitted to stress-echo-cardiography 45 patients (15%) had two or more segments that could not be evaluated according to the 16-segment-model of the American Society of Echocardiography. They underwent dobutamine-MRI and dipyridamole-SPECT studies, which were evaluated using a 28-segment modell. Myocardial segments were attributed to perfusion territories of the coronary arteries. The results of ischemia detection were compared to the results of coronary angiography (stenosis ≥50%). Results: In comparison to coronary angiography dobutamine-MRI yielded a sensitivity of 87%, a specificity of 86%, a positive predictive value of 93%, a negative predictive value of 75% and a diagnostic accuracy of 86%. For dipyridamole-SPECT results were 90%, 86%, 93%, 80% and 89%, respectively. These values were not significantly different. Conclusions: In patients not suitable for stress-echocardiography, both dobutamine-MRI and dipyridamole-SPECT are reliable strategies for detection of myocardial ischemia. Selection is dependent on the patient criteria, technical considerations, local logistics and experience of the observer. (orig.) [de

  10. Evaluation of diagnostic efficiency of intelligence program for automatic diagnosis of circumferential profiles of myocardial short axial SPECT

    International Nuclear Information System (INIS)

    Bunko, Hisashi; Tada, Akira; Nakajima, Kenichi; Taki, Junichi; Kojima, Kazuhiko.

    1984-01-01

    Quantitative diagnosis using circumferential profile (CFP) is widely employed for Tl-201 myocardial imaging. However, its diagnostic efficiency is susceptible to the number and composition of the confirmed normal (CN) group. Intelligence program for CFP data file and automatic diagnosis (CAD), which was previously developed by us, was modified for creating universal data file (d-base) and evaluated its diagnostic efficiency for myocardial short axial images according to the number of CNs. CAD consists of following 3 major functions: (1) CFP data filing to d-base, (2) modification and correction of file data, and (3) automatic diagnosis of CFP. When function (1) or (2) is completed, new diagnostic criteria (mean-2 sd) are generated automatically using CN data in the d-base at that time. Because of this function, diagnostic criteria are changeable according to the number of CNs. Sensitivity (TP) and specificity (TN) of CAD program for Tl-201 7-pinhole images of 16 normals and 17 ischemic heart diseases (IHDs) were 100%, 44% (CN = 4), 88%, 94% (CN = 8 or 16) and 88%, 100% (CN = 12), respectively. Diagnostic efficiency reached plateau in more than 8 CNs. Although number of patients were limited (8 CNs and 6 IHDs), results of CAD for short axial SPECT showed consistent tendency with 7-pinhole images. In conclusion, intelligence program is necessary for automatic diagnosis using quantitative criteria under the clinical condition of daily increasing informations. Automatic diagnosis of CFP using CAD program is simple, effective and useful for interpretation of Tl-201 myocardial short axial images. CAD program is applicable to any quantitative distribution study using CFPs. (author)

  11. 201Tl myocardial imaging in patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Cohen, H.A.; Baird, M.G.; Rouleau, J.R.; Fuhrmann, C.F.; Bailey, I.K.; Summer, W.R.; Strauss, H.W.; Pitt, B.

    1976-01-01

    The appearance of the right ventricular myocardium on thallium 201 myocardial perfusion images was evaluated in patients with chronic pulmonary hypertension and compared to patients without pulmonary hypertension. Four groups of patients were studied: (1) eight normals, (2) five patients with angiographically documented coronary artery disease and normal pulmonary artery pressures, (3) ten patients with moderate to severe pulmonary parenchymal or vascular disease and documented pulmonary hypertension and (4) eight patients with chronic left ventricular dysfunction and pulmonary hypertension discovered during cardiac catheterization. The right ventricular free wall was visualized on the thallium 201 myocardial perfusion image in only one of eight normals (group 1) and in only one of the five patients with coronary artery disease (group 2) and measured 0.5 cm and 0.9 cm in thickness, respectively. In patients with documented pulmonary hypertension the right ventricle was visualized on low contrast thallium 201 myocardial perfusion image in all patients. The apparent right ventricular free wall thickness measured from the ungated thallium 201 myocardial perfusion images was 1.7 +- 0.3 cm in group 3 and 1.5 +- 0.2 cm in group 4. Right ventricular hypertrophy was detected by electrocardiography in only five of ten patients in group 3 and only one of eight patients in group 4. Thallium 201 myocardial perfusion imaging appears to be a useful technique for assessing the effects of chronic pulmonary hypertension on the right ventricular myocardium

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

    International Nuclear Information System (INIS)

    Fridrich, L.

    1989-01-01

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

  13. Usefulness of 201Tl myocardial scintigraphy after dipyridamole infusion in patients with atherosclerotic vascular disease

    International Nuclear Information System (INIS)

    Toyama, Takuji; Nishimura, Tsunehiko; Uehara, Toshiisa

    1992-01-01

    To determine the utility for detecting ischemic heart disease (IHD), dipyridamole thallium myocardial images (DIP-Tl) have been performed in 103 patients with atherosclerotic vascular disease who can't exercise fully. Of the 103 patients, there were 36 patients with arteriosclerosis obliterans (ASO), 31 patients with aneurysm of the abdominal aorta (AAA), 24 patients with aneurysm of the thoracic aorta (TAA) and 12 patients with dissecting aortic aneurysm (DAA). Clinical evidence of IHD was found in 20 patients with ASO, 10 with AAA, 7 with TAA and 4 with DAA. Positive evidence of DIP-Tl was identified in 66% of 41 patients who had clinical evidence of IHD, and particularly in the patients with AAA (80%) and ASO (65%). On the other hand, in the patients without clinical evidence of IHD, positive evidence of DIP-Tl was identified in 19% of 62 patients and particularly in the patients with AAA (39%). In all patients, the percentage of the positive DIP-Tl ratio was 38%. And, when the 38% patients of the positive DIP-Tl were added to the patients of the negative DIP-Tl who had clinical evidence of IHD, almost half patients (51%) were considered to be complicated with IHD. This study suggests that the atherosclerotic vascular disease is highly complicated with IHD and DIP-Tl is useful to detect IHD. (author)

  14. Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve

    Science.gov (United States)

    Tanaka, Haruki; Takahashi, Teruyuki; Ohashi, Norihiko; Tanaka, Koichi; Okada, Takenori; Kihara, Yasuki

    2017-01-01

    Abstract The aim of this study was to clarify the predictive value of fractional flow reserve (FFR) determined by myocardial perfusion imaging (MPI) using thallium (Tl)-201 IQ-SPECT without and with computed tomography-based attenuation correction (CT-AC) for patients with stable coronary artery disease (CAD). We assessed 212 angiographically identified diseased vessels using adenosine-stress Tl-201 MPI-IQ-SPECT/CT in 84 consecutive, prospectively identified patients with stable CAD. We compared the FFR in 136 of the 212 diseased vessels using visual semiquantitative interpretations of corresponding territories on MPI-IQ-SPECT images without and with CT-AC. FFR inversely correlated most accurately with regional summed difference scores (rSDS) in images without and with CT-AC (r = −0.584 and r = −0.568, respectively, both P system can predict FFR at an optimal cut-off of <0.80, and we propose a novel application of CT-AC to MPI-IQ-SPECT for predicting clinically significant and insignificant FFR even in nonobese patients. PMID:29390486

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-11-15

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

  16. Evaluation of myocardial damage and cardiac residual capacity by Tl-201 myocardial scintigraphy in valvular heart diseases

    International Nuclear Information System (INIS)

    Indo, Shunju

    1992-01-01

    This study was performed to clarify whether the extent-score (Ex-Score) calculated by Tl-201 myocardial scintigraphy is a reliable indicator of the severity of myocardial damage and cardiac residual capacity in valvular heart diseases. The subjects consisted of 38 patients (10 with aortic regurgitation (AR), 4 with aortic stenosis (AS), 13 with mitral regurgitation (MR) and 11 with mitral stenosis (MS)). Ex-Scores were significantly correlated with the severity of myocardial damage found in biopsied specimens obtained intraoperatively (correlation efficiency to Ex-Score with cell diameter in AR, % fibrosis in AR, cell diameter in AS, electron microscopic score in MR and % fibrosis in MS was 0.873, 0.734, 0.970, 0.913 and 0.659, respectively). Ex-Scores were also correlated with cardiac residual capacity determined by radioisotope angiography (correlation efficiency to Ex-Score with %Δ ejection fraction in AR, %Δ end-systolic volume in MR, %Δ end-diastolic volume in MS was -0.764, 0.790 and -0.763, respectively). These results suggest that the severity of myocardial damage and cardiac residual capacity can be estimated by Tl-201 myocardial scintigraphy (Ex-Score) in valvular heart diseases. (author)

  17. Measurement of the infarcted area by 201Tl myocardial emission CT

    International Nuclear Information System (INIS)

    Tamaki, Shunichi; Murakami, Tomoyuki; Kambara, Hirofumi

    1982-01-01

    201 Tl-ECT was performed in 28 cases 4 weeks after the onset of acute myocardial infarction to calculate the volume of infarction for comparison with the CK-MB infarction size obtained in the acute phase. The infarct area obtained by two-dimensional 201 Tl scintigraphy in 18 cases treated by the conventional method showed a positive correlation with the CK-MB infarct size, but the volume of infarction by 201 Tl-ECT produced a better correlation. In the group with successful thrombolysis, the serum CK-MB level reached a peak soon after the onset, accompanied by release of more CK-MB for a constant volume of infarction obtained by 201 Tl-ECT, as compared with the group with unsuccessful thrombolysis or conventional therapy. This suggests the involvement of washout phenomenon by reperfusion. Although there are some limitations, the three-dimensional detection of the distribution of myocardial blood flow by 201 Tl-ECT is useful, covering disadvantages of two-dimensional images. (Chiba, N.)

  18. Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve: A single-center prospective study.

    Science.gov (United States)

    Tanaka, Haruki; Takahashi, Teruyuki; Ohashi, Norihiko; Tanaka, Koichi; Okada, Takenori; Kihara, Yasuki

    2017-12-01

    The aim of this study was to clarify the predictive value of fractional flow reserve (FFR) determined by myocardial perfusion imaging (MPI) using thallium (Tl)-201 IQ-SPECT without and with computed tomography-based attenuation correction (CT-AC) for patients with stable coronary artery disease (CAD).We assessed 212 angiographically identified diseased vessels using adenosine-stress Tl-201 MPI-IQ-SPECT/CT in 84 consecutive, prospectively identified patients with stable CAD. We compared the FFR in 136 of the 212 diseased vessels using visual semiquantitative interpretations of corresponding territories on MPI-IQ-SPECT images without and with CT-AC.FFR inversely correlated most accurately with regional summed difference scores (rSDS) in images without and with CT-AC (r = -0.584 and r = -0.568, respectively, both P system can predict FFR at an optimal cut-off of reserved.

  19. Myocardial uptake of iodinated free fatty acids and 201Tl in experimental ischemia

    International Nuclear Information System (INIS)

    Westera, G.; Wall, E.E. van der; Visser, F.C.; Scholtalbers, A.S.; Eenige, M.J. van; Roos, J.P.

    1984-01-01

    In an experimental study, we evaluated the uptake of ( 131 I)-17-iodo heptadecanoic acid ( 131 I-HDA), ( 125 I)-15-4 (4-iodophenyl) pentadecanoic acid ( 125 I-PPA) and thallium-201 ( 201 Tl) in the dog heart. Twenty dogs were studied and divided into 3 groups: in group A, 10 dogs (4 normal, 6 with coronary artery occlusion) were studied with 131 I-HDA and 201 Tl; in group B, 5 dogs (with occlusion) received 125 I-PPA and 201 Tl; and in group C, 5 dogs (with occlusion) were studied with 125 I-PPA and 131 I-HDA. Two min after administration of the compounds the hearts were excised and stored in formaldehyde. After sectioning of the left ventricle, total uptake was counted and expressed in percentage of injected dose. Uptake in the normal myocardium (group A) was 4.2+-0.6% for 131 I-HDA and 4.6+-0.7% for 201 Tl; in the occluded dog hearts (group A) we measured values of 2.6+-0.4% for 131 I-HDA (p 201 Tl (p 131 I-HDA, 125 I-PPA and 201 Tl in groups B and C was not significantly different: group B, 125 I-PPA 2.8+-0.8% and 201 Tl 2.5+-0.5%; group C, 125 I-PPA 1.9+-0.7% and 131 I-HDA 1.6+-0.6%. Moreover, regional distribution of both iodinated fatty acids was quite comparable with the distribution of 201 Tl. We conclude that 131 I-HDA and 125 I-PPA show similar uptake as 201 Tl and are distributed according to coronary artery perfusion, which underscores their value as myocardial imaging agents. (orig.) [de

  20. Clinical significance of increased lung/heart ratio in 210Tl stress myocardial image

    International Nuclear Information System (INIS)

    Liu Zaoli; Chang Fengqin; Zhang Fengge; Wang Xiaoyuan; Liu Liuhua

    1990-01-01

    230 cases were studied with 201 Tl stress image. The results showed that the lung/heart ratio closely correlated with the presence and severity of coronary heart disease (CHD). Among them, 18 cases (7.8%) showed significantly elevated lung/heart ratio (> 0.50). It was confirmed that all of the 18 cases have severe CHD with left ventricular insufficiency. The author emphasizes that measurement of the lung/heart ratio during 201 Tl stress myocardial image may be useful for the assessment of the severity, evalation of the left ventricular function and judgement of prognosis in CHD

  1. 201Tl myocard scintigraphy - a specialized non-invasive method in evaluating myocardial function

    International Nuclear Information System (INIS)

    Birke, S.; Deckart, H.; Mischke, W.; Schulz, J.; Koblitz, E.

    1985-01-01

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

  2. Application of Three-Class ROC Analysis to Task-Based Image Quality Assessment of Simultaneous Dual-Isotope Myocardial Perfusion SPECT (MPS)

    OpenAIRE

    He, Xin; Song, Xiyun; Frey, Eric C.

    2008-01-01

    The diagnosis of cardiac disease using dual-isotope myocardial perfusion SPECT (MPS) is based on the defect status in both stress and rest images, and can be modeled as a three-class task of classifying patients as having no, reversible, or fixed perfusion defects. Simultaneous acquisition protocols for dual-isotope MPS imaging have gained much interest due to their advantages including perfect registration of the 201Tl and 99mTc images in space and time, increased patient comfort, and higher...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-09-15

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

  4. Prognostic value of stress 99Tcm-MIBI myocardial perfusion SPECT after acute myocardial infarction

    International Nuclear Information System (INIS)

    Sui Xutao; Chen Zhi; Gao Shenghai; Shen Li; Li Shang'ai

    2003-01-01

    Objective: To investigate relativity of acute myocardial infarction (AMI) with clinical, stress test and perfusion imaging parameters and to assess predictive value on hard events of cardiac death or recurrent nonfatal AMI. Methods: One hundred and one patients of AMI underwent stress 99 Tc m -MIBI SPECT before discharge. Hard and soft events were followed-up, relative factors with cardiac events were analyzed by statistical methods and predictive value on hard events were assessed. Results: Independent predictors by multivariate analysis for cardiac hard events or all cardiac events consisted of a history of prior AMI (RR=5.30, CI 2.17-12.98), a low exercise capacity (RR=6.28, CI 1.92-21.46) and left ventricular ejection fraction 99 Tc m -MIBI SPECT is a single test that can provide exercise parameter, cardiac perfusion imaging information and left ventricular function assessment to identify high-risk and estimate hard prognosis at discharge of AMI patients. These high-risk patients can be referred for early invasive evaluation and intervention

  5. Detection of myocardial ischemia with myocardial perfusion SPECT in patients with diabetes mellitus

    International Nuclear Information System (INIS)

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

    2004-01-01

    Diabetes mellitus(DM) is a critical disease associated with higher rates of cardiovascular morbidity and mortality. Atherosclerosis accounts for 65-80% of all deaths in diabetic patients and patients with DM are known to show high prevalence of coronary artery diseases(CAD). We evaluated the incidence of scintigraphic evidence of CAD in diabetic patients and results were compared with cardiovascular symptoms and clinical factors. 169 patients with DM(mean age 629years, 68 males) were referred for evaluation of CAD between Jan 2002 and Dec 2003. 101(60%) patients were with chest pain and 68(40%) were asymptomatic. Patients underwent exercise(n=6) or adenosine stress(n=163) SPECT myocardial perfusion imaging(MPI). Exclusion criteria included history of documented myocardial infarction, prior revascularization, clinically significant valvular heart disease, left-bundle branch block on rest ECG. We evaluated symptoms associated with cardiac problem and other clinical and laboratory data to reveal correlation with presence of CAD. MPI were assessed visually and semi-quantitatively with C-Equal program. Myocardial ischemia was detected in 52(31%) patients. Among them, 41 had 1-vessel and 9 had 2-vessel disease. In 52 patients with ischemia, 28(54%) were male and 24(46%) were female. 20/68(29%) asymptomatic and 32/101(32%) symptomatic patients had ischemia. Higher prevalence of neuropathy, hypertension, higher blood glucose level, HbA1c and CRP was noted in patients with myocardial ischemia. Serum levels of cholesterol and LDL was not significantly different between patients with ischemia and with normal MPI findings. Abnormal MPI findings were not related with gender and age. These results show a high prevalence of abnormal MPI results in diabetic patients regardless of symptoms. Screening stress MPI in diabetic patients should be indicated irrespective of symptoms, especially in patients with neuropathy, hypertension, higher level of blood glucose, or increased CRP

  6. Detection of myocardial ischemia with myocardial perfusion SPECT in patients with diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Seo, J. H.; Jeong, S. Y.; Bae, J. H.; Anh, B. C.; Lee, J.; Lee, K. B [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2004-07-01

    Diabetes mellitus(DM) is a critical disease associated with higher rates of cardiovascular morbidity and mortality. Atherosclerosis accounts for 65-80% of all deaths in diabetic patients and patients with DM are known to show high prevalence of coronary artery diseases(CAD). We evaluated the incidence of scintigraphic evidence of CAD in diabetic patients and results were compared with cardiovascular symptoms and clinical factors. 169 patients with DM(mean age 629years, 68 males) were referred for evaluation of CAD between Jan 2002 and Dec 2003. 101(60%) patients were with chest pain and 68(40%) were asymptomatic. Patients underwent exercise(n=6) or adenosine stress(n=163) SPECT myocardial perfusion imaging(MPI). Exclusion criteria included history of documented myocardial infarction, prior revascularization, clinically significant valvular heart disease, left-bundle branch block on rest ECG. We evaluated symptoms associated with cardiac problem and other clinical and laboratory data to reveal correlation with presence of CAD. MPI were assessed visually and semi-quantitatively with C-Equal program. Myocardial ischemia was detected in 52(31%) patients. Among them, 41 had 1-vessel and 9 had 2-vessel disease. In 52 patients with ischemia, 28(54%) were male and 24(46%) were female. 20/68(29%) asymptomatic and 32/101(32%) symptomatic patients had ischemia. Higher prevalence of neuropathy, hypertension, higher blood glucose level, HbA1c and CRP was noted in patients with myocardial ischemia. Serum levels of cholesterol and LDL was not significantly different between patients with ischemia and with normal MPI findings. Abnormal MPI findings were not related with gender and age. These results show a high prevalence of abnormal MPI results in diabetic patients regardless of symptoms. Screening stress MPI in diabetic patients should be indicated irrespective of symptoms, especially in patients with neuropathy, hypertension, higher level of blood glucose, or increased CRP.

  7. The clinical application of SPECT myocardial perfusion imaging with 99mTc-MIBI

    International Nuclear Information System (INIS)

    Dong Weiyu

    1992-01-01

    This paper reported 182 SPECT myocardial perfusion images with China made 99m Tc-MIBI and were compared with ECG and UCG. The sensitivity of SPECT in ischemic were 91.2% and was higher than ECG (74.9%)and UCG (61.8%) (P < 0.01). And its specificity, accuracy and positive predictive rate were 78.3%, 90% and 97% respectively. Besides 9 cases have reverse distribution after exercise and rest images. In some ICD patients had shown their SPECT images, the perfusion defects in exercise as well as in rest image

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

    International Nuclear Information System (INIS)

    Hori, Masatsugu; Nishimura, Tsunehiko

    1996-01-01

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

  9. Assessment of vascularity and permeability in brain tumor using SPECT and [sup 99m]Tc-DTPA-human serum albumin in relation to [sup 201]Tl SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji; Fukuoka, Seiji; Takahashi, Shuhei; Takahashi, Masaaki; Satoh, Katsuyasu; Suematsu, Katsumi; Nakamura, Jun-ichi (Nakamura Memorial Hospital, Sapporo (Japan))

    1994-02-01

    Single photon emission computed tomography (SPECT) using technetium-99m-DTPA-human serum albumin ([sup 99m]Tc-HSA-D) and thallium-201 chloride ([sup 201]Tl) was simultaneously performed on 25 patients with brain tumors; 10 with brain metastasis, 8 with astrocytoma (Gr. 3) and 7 with meningioma. The early image was obtained 10 minutes after [sup 99m]Tc-HSA-D (740 MBq) injection, and the delayed image was taken 5 hours after the injection. HSA-D index, based on the ratio of [sup 99m]Tc-HSA-D uptake in the tumor versus the cortical area, was calculated on each image, and compared with Tl index (tumor/contralateral cerebrum ratio). HSA-D delayed index was significantly greater than HSA-D early index in all tumor types (p<0.05 by the Wilcoxon ranked sign test). Linear correlation between HSA-D early index and HSA-D delayed index was significant in astrocytoma (GR. 3) (p<0.01) and meningioma (p<0.001), and a linear correlation between HSA-D delayed index and Tl index was significant in astrocytoma (Gr. 3) (p<0.05). It is concluded that HSA-D early index and delayed index could reflect tumor vascularity and permeability, respectively, and provide supplementary information for Tl index. (author).

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

    Directory of Open Access Journals (Sweden)

    E.N. Ostroumov

    2009-01-01

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

  11. Correlation of an abnormal rest /sup 201/Tl myocardial image: Pathological findings in cardiac transplant recipients

    Energy Technology Data Exchange (ETDEWEB)

    McKillop, J.H.; McDougall, I.R.; Billingham, M.; Schroeder, J.S.

    1982-06-01

    Rest myocardial /sup 201/Tl scintigraphy was undertaken in 15 males mean age 39 years (22-54) who had been accepted for cardiac transplantation. Complete pathological correlation was obtained in 14 after transplantation and in 1 who died before a suitable donor heart became available. The average time from scintigraphy to pathological evaluation was 42 days (9-103). All the /sup 201/Tl images were grossly abnormal and on the basis of these studies it was not possible to differentiate ischemic from idiopathic cardiomyopathy. Each of the three views of the /sup 201/Tl study was divided into three segments, therefore 135 areas were available for comparison (3 x 3 x 15). Eighty-eight of these were abnormal on scan and 78 of these were abnormal pathologically. The right ventricle was seen on all rest images but the degree of uptake bore no relationship to the measured thickness of the right ventricular wall. Structures such as the atrial wall and the enlarged papillary muscle were visualized in some patients. In two patients there was an improvement of the rest /sup 201/Tl image in delayed views and histologically these areas showed a mixture of muscle and fibrous tissue. The sensitivity of /sup 201/Tl imaging in this study was 89% and there was close correlation of the images with gross and microscopic pathological findings.

  12. Design of a digital phantom population for myocardial perfusion SPECT imaging research

    International Nuclear Information System (INIS)

    Ghaly, Michael; Du, Yong; Fung, George S K; Tsui, Benjamin M W; Frey, Eric; Links, Jonathan M

    2014-01-01

    Digital phantoms and Monte Carlo (MC) simulations have become important tools for optimizing and evaluating instrumentation, acquisition and processing methods for myocardial perfusion SPECT (MPS). In this work, we designed a new adult digital phantom population and generated corresponding Tc-99m and Tl-201 projections for use in MPS research. The population is based on the three-dimensional XCAT phantom with organ parameters sampled from the Emory PET Torso Model Database. Phantoms included three variations each in body size, heart size, and subcutaneous adipose tissue level, for a total of 27 phantoms of each gender. The SimSET MC code and angular response functions were used to model interactions in the body and the collimator-detector system, respectively. We divided each phantom into seven organs, each simulated separately, allowing use of post-simulation summing to efficiently model uptake variations. Also, we adapted and used a criterion based on the relative Poisson effective count level to determine the required number of simulated photons for each simulated organ. This technique provided a quantitative estimate of the true noise in the simulated projection data, including residual MC simulation noise. Projections were generated in 1 keV wide energy windows from 48–184 keV assuming perfect energy resolution to permit study of the effects of window width, energy resolution, and crosstalk in the context of dual isotope MPS. We have developed a comprehensive method for efficiently simulating realistic projections for a realistic population of phantoms in the context of MPS imaging. The new phantom population and realistic database of simulated projections will be useful in performing mathematical and human observer studies to evaluate various acquisition and processing methods such as optimizing the energy window width, investigating the effect of energy resolution on image quality and evaluating compensation methods for degrading factors such as

  13. Objective evaluation of Tl-201 image efficacy for detection of myocardial infarction

    International Nuclear Information System (INIS)

    Nagai, Teruo; Murata, Kazuhiko; Torizuka, Kanji

    1982-01-01

    As the 3rd report of the objective analysis of radioactive 201 Tl scintigraphy of myocardial infarction, detection of infarction and extent of the lesion was discussed. In 114 cases with relatively definite findings, their images were rereaded and evaluated by 2 physicians. Segmental analysis in each direction was employed for localization of perfusion defects. Comparison between the sites of myocardial infarction on ECG and that of perfusion defects by segmental analysis revealed that, in infarction of the anterior wall, many segments showed defects, and that the lesions of the posterior and lateral wall had a few segments showing defects. This standard of correlation was applied to other cases of myocardial infarction, and the result suggested possible improvement in detection of infarction. As regards the extent of the lesion, no significant correlation between number of segments with defect and ECG and/or the serum enzyme levels were seen. (Ueda, J.)

  14. Significance of 99mTc-MIBI myocardial SPECT imaging in diagnosis of syndrome X

    International Nuclear Information System (INIS)

    Tian Yueqing; Liu Xiujie; Jiao Shubin

    1996-01-01

    To assess the value of myocardial imaging in the diagnosis of syndrome X, the study was performed with 99m Tc-MIBI myocardial SPECT imaging in 64 patients. The patients were divided into three groups: group 1 had 21 patients diagnosed as syndrome X, group 2 had 17 patients with chest pain and normal coronary arteries without ST segment depression during exercise, group 3 had 26 patients with the angina pectoris and coronary stenoses≥50%. The myocardial SPECT imaging of the three groups was compared qualitatively and semi-quantitatively. Myocardial imaging identified 11 cases of myocardial ischemia from 21 patients with syndrome X. The ischemic score of myocardial imaging was 1.1 +- 0.3 for syndrome X and 1.8 +- 0.7 for patients with coronary heart disease (CHD) angina pectoris (t = 3.1746, P<0.01). Myocardial imaging may partly show myocardial ischemia in patients with syndrome X. The extent of ischemia in patients with syndrome X was significantly less than that in patients with CHD angina pectoris

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

    International Nuclear Information System (INIS)

    Yokoo, Shigeki; Niio, Yasuo; Yamamoto, Tomoaki; Miyashita, Makoto

    1999-01-01

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

  16. The quantitative evaluation of 201Tl myocardial scintigraphy using reinjection method

    International Nuclear Information System (INIS)

    Naruse, Hitoshi; Itano, Midoriko; Yamamoto, Juro; Morita, Masato; Fukutake, Naoshige; Kawamoto, Hideo; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Fukuchi, Minoru

    1993-01-01

    This study was designed to determine whether Tl-201 myocardial scintigraphy using reinjection method would improve the rate of redistribution (RD) and, if improved, which would contribute to RD improvement, extent or severity of ischemia shown by the bolls-eye view method. In 17 patients with ischemic heart disease, exercise Tl-201 myocardial images were acquired at 10 min (early images) and 180 min (delayed images) after intravenous injection of 74 MBq of TlCl. In addition, 37 MBq of TlCl was injected again after delayed imaging and then images were acquired (RI images). Among the 17 patients, 7 were judged as RD(+), 8 as RD(-), and 2 as undefined. In 8 RD(-) patients and 2 undefined patients, RD became (+) on RI images. Visual changes in extent and severity of ischemia from early to delayed images were 68±42 for RD(+) cases vs. 3±20 for RD(-) cases and 0.4±0.8 for RD(+) cases vs. 0.1±0.3 for RD(-) cases, respectively. The corresponding figures from delayed to RI images for extent and score of ischemia were 50±46 for RD(+) cases vs. 13±22 for RD(-) cases and 0.4±30.3 for RD(+) cases vs. 0.1±0.5 for RD(-) cases, respectively. For 5 patients undergoing coronary revascularization, extent was improved in all cases, but severity was improved in only some cases. In conclusion, when RD became (+) on RI images, myocardial viability seemed to have been underestimated. Quantitative evaluation revealed that RD improved from early to delayed images depended on extent and that RD improved from delayed to RI images depended on both extent and severity. In postoperative improvement of RD, extent of ischemia was mainly involved. RI imaging was found to compensate for the underestimation of RD. Quantitative evaluation was also useful in the observation of subtle changes of ischemia. (N.K.)

  17. Subendocardial versus transmural ischaemia in myocardial perfusion SPECT--a Monte Carlo study

    DEFF Research Database (Denmark)

    Bartosik, Jolanta; El-Ali, Henrik Hussein; Nilsson, Ulf

    2006-01-01

    Myocardial perfusion imaging with single-photon emission computed tomography (SPECT) is useful for the evaluation of patients with known or suspected coronary artery disease. Parameters of interest are the reduction in the blood perfusion (severity) and the lesion volume (extent). The aim of this...

  18. Minimizing Patient-Specific Tracer Dose in Myocardial Perfusion Imaging Using CZT SPECT

    NARCIS (Netherlands)

    van Dijk, Joris David; Jager, Pieter L.; Ottervanger, Jan Paul; Slump, Cornelis H.; de Boer, Jaep; Oostdijk, Adrianus H.J.; van Dalen, Jorn A.

    Myocardial perfusion imaging (MPI) with SPECT is widely adopted in clinical practice but is associated with a relatively high radiation dose. The aim of this study was to determine the minimum product of tracer dose and scan time that will maintain diagnostic value for cadmium zinc telluride (CZT)

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  20. Myocardial Infarction Area Quantification using High-Resolution SPECT Images in Rats

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Luciano Fonseca Lemos de [Divisão de Cardiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Mejia, Jorge [Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP (Brazil); Carvalho, Eduardo Elias Vieira de; Lataro, Renata Maria; Frassetto, Sarita Nasbine [Divisão de Cardiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Fazan, Rubens Jr.; Salgado, Hélio Cesar [Departamento de Fisiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Galvis-Alonso, Orfa Yineth [Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP (Brazil); Simões, Marcus Vinícius, E-mail: msimoes@fmrp.usp.br [Divisão de Cardiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2013-07-15

    Imaging techniques enable in vivo sequential assessment of the morphology and function of animal organs in experimental models. We developed a device for high-resolution single photon emission computed tomography (SPECT) imaging based on an adapted pinhole collimator. To determine the accuracy of this system for quantification of myocardial infarct area in rats. Thirteen male Wistar rats (250 g) underwent experimental myocardial infarction by occlusion of the left coronary artery. After 4 weeks, SPECT images were acquired 1.5 hours after intravenous injection of 555 MBq of 99mTc-Sestamibi. The tomographic reconstruction was performed by using specially developed software based on the Maximum Likelihood algorithm. The analysis of the data included the correlation between the area of perfusion defects detected by scintigraphy and extent of myocardial fibrosis assessed by histology. The images showed a high target organ/background ratio with adequate visualization of the left ventricular walls and cavity. All animals presenting infarction areas were correctly identified by the perfusion images. There was no difference of the infarct area as measured by SPECT (21.1 ± 21.2%) and by histology (21.7 ± 22.0%; p=0.45). There was a strong correlation between individual values of the area of infarction measured by these two methods. The developed system presented adequate spatial resolution and high accuracy for the detection and quantification of myocardial infarction areas, consisting in a low cost and versatile option for high-resolution SPECT imaging of small rodents.

  1. Myocardial CT perfusion imaging and SPECT for the diagnosis of coronary artery disease

    DEFF Research Database (Denmark)

    George, Richard T; Mehra, Vishal C; Chen, Marcus Y

    2014-01-01

    %, respectively, for SPECT. CONCLUSION: The overall performance of myocardial CT perfusion imaging in the diagnosis of anatomic CAD (stenosis ≥50%), as demonstrated with the Az, was higher than that of SPECT and was driven in part by the higher sensitivity for left main and multivessel disease.......PURPOSE: To compare the diagnostic performance of myocardial computed tomographic (CT) perfusion imaging and single photon emission computed tomography (SPECT) perfusion imaging in the diagnosis of anatomically significant coronary artery disease (CAD) as depicted at invasive coronary angiography....... MATERIALS AND METHODS: This study was approved by the institutional review board. Written informed consent was obtained from all patients. Sixteen centers enrolled 381 patients from November 2009 to July 2011. Patients underwent rest and adenosine stress CT perfusion imaging and rest and either exercise...

  2. Requirements of exercise myocardial scintigraphy (EMS) using Tl-201 prior and subsequent to coronary revascularisation, based on the example of transluminal angioplasty

    International Nuclear Information System (INIS)

    Maul, F.D.; Hoer, G.; Standke, R.; Kober, G.; Klepzig, H. Jr.; Doerr, G.; Baum, R.P.; Happ, J.; Kaltenbach, M.; Frankfurt Univ.

    1985-01-01

    Quantitative exercise myocardial scintigraphy (EMS) using Thallium-201 in planar technique was applied in 128 patients prior and subsequent to transluminal coronary angioplasty. The overall sensitivity was 92%, and 88% for multivessel disease. In contrast to previous reports, the sensitivity for lesions of the posterior wall proved not inferior to that for lesions of the anterior wall: RCA-stenoses 92%; LCX-stenoses 100% and RIA-stenoses 93%. The specificity was found to be 88%, and the accuracy 92%. Myocardial ischaemia, as detected by EMS and ex. ECG, amounted to 84% and 72%, respectively in single vessel disease. The degree of ischaemia, which was measured semiquantitatively in terms of score, paralleled that of stenosis. The accuracy for localisation of anterior or posterior wall lesions was 92%. In unsuccessfully treated patients the results were completely reproducible (100%) both in terms of the decision 'CAD yes or no', and regarding the localisation of a myocardial lesion. The reproducibility for detection of myocardial ischaemia was 82%. Conclusion: In comparison with SPECT the quantitative planar EMS procedure using Tl-201 is the method of choice for the detection and assessment of ischaemia prior and subsequent to revascularisation therapy. (orig.) [de

  3. Right ventricular visualization by Tl-201 myocardial scintigraphy in chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Tadashige; Tanaka, Masao; Takeda, Masashi; Matsuzawa, Yukinori; Handa, Kenjiro; Yoshimura, Kazuhiko [Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine

    1993-04-01

    Tl-201 myocardial scintigraphy was performed in 130 patients with chronic obstructive pulmonary disease (COPD) to evaluate right ventricular hypertrophy, and the clinical significance of this method was studied. Tl-201 uptake ratios of the right ventricle, which represents the ratio of total counts of the right ventricle to counts of the administered dose of Tl-201, was higher in COPD, especially in pulmonary emphysema and B type COPD by Burrows classification than in controls. The grade of visualization of the right ventricle by visual assessment (RVV) was marked (+++) in only a few cases and moderate (++) in many cases (more than 80%) in all diseases except bronchial asthma. The incidence of right ventricular hypertrophy by electrocardiogram, right-sided heart failure and marked dyspnea (Hugh-Jones 4[center dot]5) were very low in cases with RVV grade ++ and very high in cases with +++. The grade of RVV was related to the severity of pulmonary perfusion impairment, although in diffuse panbronchiolitis the RVV was relatively slight compared with the impairment of perfusion. May parameters of pulmonary function such as %VC, FEV1.0%, RV/TLC, V25, %DLCO, Raw, [Delta]N[sub 2] and PaO[sub 2] showed abnormal values in patients with RVV grade of (++) or (+++) in all diseases except bronchial asthma. In COPD, Tl-201 myocardial scintigraphy seems to be useful for assessment of right ventricular overloading, and for follow-up observation and differentiation between cor pulmonale and right ventricular hypertrophy secondary to cardiac diseases by observing Tl-201 uptake of the lung and left ventricle. (author).

  4. Right ventricular visualization by Tl-201 myocardial scintigraphy in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Fujii, Tadashige; Tanaka, Masao; Takeda, Masashi; Matsuzawa, Yukinori; Handa, Kenjiro; Yoshimura, Kazuhiko

    1993-01-01

    Tl-201 myocardial scintigraphy was performed in 130 patients with chronic obstructive pulmonary disease (COPD) to evaluate right ventricular hypertrophy, and the clinical significance of this method was studied. Tl-201 uptake ratios of the right ventricle, which represents the ratio of total counts of the right ventricle to counts of the administered dose of Tl-201, was higher in COPD, especially in pulmonary emphysema and B type COPD by Burrows classification than in controls. The grade of visualization of the right ventricle by visual assessment (RVV) was marked (+++) in only a few cases and moderate (++) in many cases (more than 80%) in all diseases except bronchial asthma. The incidence of right ventricular hypertrophy by electrocardiogram, right-sided heart failure and marked dyspnea (Hugh-Jones 4·5) were very low in cases with RVV grade ++ and very high in cases with +++. The grade of RVV was related to the severity of pulmonary perfusion impairment, although in diffuse panbronchiolitis the RVV was relatively slight compared with the impairment of perfusion. May parameters of pulmonary function such as %VC, FEV1.0%, RV/TLC, V25, %DLCO, Raw, ΔN 2 and PaO 2 showed abnormal values in patients with RVV grade of (++) or (+++) in all diseases except bronchial asthma. In COPD, Tl-201 myocardial scintigraphy seems to be useful for assessment of right ventricular overloading, and for follow-up observation and differentiation between cor pulmonale and right ventricular hypertrophy secondary to cardiac diseases by observing Tl-201 uptake of the lung and left ventricle. (author)

  5. Cardiac functional mapping for thallium-201 myocardial perfusion, washout, wall motion and phase using single-photon emission computed tomography (SPECT)

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Bunko, Hisashi; Taniguchi, Mitsuru; Taki, Junichi; Tonami, Norihisa; Hisada, Kinichi; Hirano, Takako; Wani, Hidenobu.

    1986-01-01

    A method for three-dimensional functional mapping of Tl-201 myocardial uptake, washout, wall motion and phase was developed using SPECT. Each parameter was mapped using polar display in the same format. Normal values were determined in Tl-201 exercise study in 16 patients. Myocardial counts were lower in the septum and inferior wall and the difference of counts between anterior and inferior walls were greater in man compared with the perfusion pattern in woman. Washout was slower at septum and inferior wall in man, and slightly slower at inferior wall in woman. In gated blood-pool tomography, length-based and count-based Fourier analyses were applied to calculate the parameters of contraction and phase. The results of both Fourier analyses generally agreed; however, the area of abnormality was slightly different. Phase maps were useful for the assessment of asynergy as well as in patients with conduction disorders. These cardiac functional maps using SPECT were considered to be effective for the understanding of three-dimensional informations of cardiac function. (author)

  6. Influence of the prevalence of coronary artery disease in patients with normal myocardial perfusion SPECT imaging. Cooperative study in South America

    International Nuclear Information System (INIS)

    Balestrini, V.R.; Arja, V.J.; Sandrin, A.L.; Sala, J.P.; Joekes, S.; Bier, G.; Precoma, D.; Yamada, A.

    2002-01-01

    An important feature of myocardial perfusion imaging is the ability to predict prognosis and identify high- and low-risk patients for coronary events. According to Bayes' theorem, the significance of test's results, relates not only the sensitivity and specificity of a test but also the prevalence of disease in the population under study. Aim: evaluate the relationship between pretest likelihood (PTL) and coronary events (CE) in patients with normal myocardial perfusion SPECT imaging during a long period of time. Material and Methods: The population included 709 patients (411 men and 298 women, mean age 58 years old) who underwent stress/rest myocardial perfusion SPECT imaging at nuclear cardiology laboratories in Argentina and Brazil, with scintigraphic images interpreted as normal. Analyzed variables: clinical, EKG and stress test. Perfusion agents: Tc-99m-tetrofosmin: 36.5%, Tc99m-sestamibi 5.8% and Tl-201 57.7%. Mean follow up: 919 days. CE: soft (unstable angina and need for revascularization) and hard (AMI and cardiac death). Results: Stress test: exercise stress test 72.2%, dipyridamole 25%, adenosine 1.7%, dobutamine 1.1%. PTL [ 9' (M/F): 59/11% (p 78%] 31 vs. 50%. Conclusions: 1) There was a relationship between PTL, events rate and time to event. 2) We found a low hard events rate (0.85%). 3) The results in this group of patients with normal myocardial perfusion SPECT imaging may suggest a guarantee period of low risk of coronary events between 2-3 years. 4) In spite of there is a low event rate in total population with normal myocardial perfusion imaging, patients with highest prevalence of coronary artery disease have more statistical probabilities of coronary events and therefore they have to be watched closely

  7. Comparison with myocardial perfusion MRI and myocardial perfusion SPECT in the diagnostic performance of coronary artery disease. A meta-analysis

    International Nuclear Information System (INIS)

    Iwata, Kunihiro; Kubota, Makoto; Ogasawara, Katsuhiko

    2008-01-01

    We compared the diagnostic abilities of stress myocardial perfusion MRI (myocardial perfusion MRI) and myocardial perfusion single photon emission computed tomography (SPECT), using a meta-analysis method. We investigated the diagnostic abilities of MRI and SPECT in similar subject groups in reports written in English or Japanese. The reports to be used for analysis were selected according to a ''screening standard,'' which was established in advance. After consolidating the data from the selected reports, we compared the integrated odds ratio, the point estimation values of sensibility/specificity, and the summary receiver operating characteristic (ROC) curve. For the analysis, six reports were selected (subjects: 153, coronary-artery target sites: 447). Meta-analysis revealed that the diagnostic ability of myocardial perfusion MRI was superior to that of myocardial perfusion SPECT regarding each of the parameters. This is considered to be supportive evidence of the usefulness of myocardial perfusion MRI. (author)

  8. Detecting culprit vessel of coronary artery disease with SPECT 99Tcm-MIBI myocardial imaging

    International Nuclear Information System (INIS)

    Luan Zhaosheng; Zhou Wen; Peng Yong; Su Yuwen; Tian Jianhe; Gai lue; Sun Zhijun

    2002-01-01

    Objective: To assess the value of detecting culprit vessel of coronary artery disease (CAD) with SPECT 99 Tc m -MIBI myocardial imaging. Methods: Forty-six patients with CAD were studied. Every patients had multiple-vessel lesion showed by coronary arteriography and was treated by revascularization as percutaneous transluminal angioplasty (PTCA), coronary artery bypass graft (CABG) or laser holing. Exercise (EX), rest (RE) and intravenous infusion of nitroglycerine (NTG) SPECT 99 Tc m -MIBI myocardial imagings were performed before revascularization. Exercise and rest images revealed the myocardial ischemia. NTG images revealed myocardial viability. Culprit vessels were detected according to the defects showed by above mentioned images. The veracity of detected culprit vessels was tested with the outcome of the reperfusion therapy. Results: In this group, the coronary arteriography revealed 107 lesioned coronary arteries. Myocardial imaging detected 46 culprit vessels including 23 left anterior descending (LAD), 19 left circumflex coronary artery (LCX) and 4 right coronary artery (RCA). All 46 culprit vessels underwent revascularization and had nice outcome. The veracity of 99 Tc m -MIBI myocardial imaging detected culprit vessels was high according to patients' outcome. Conclusion: Exercise, rest and NTG 99 Tc m -MIBI myocardial imaging is a great method for detecting culprit vessels in multivessel coronary disease

  9. Noninvasive detection of regional myocardial perfusion abnormality with /sup 201/Tl and /sup 81/Rb

    Energy Technology Data Exchange (ETDEWEB)

    Narita, M; Usami, M; Kurihara, T; Kawararadani, H; Kanao, K

    1977-05-01

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

  10. Relationship between coronary contrast-flow quantitative flow ratio and myocardial ischemia assessed by SPECT MPI

    Energy Technology Data Exchange (ETDEWEB)

    Smit, Jeff M.; Rosendael, Alexander R. van; Jukema, J.W.; Delgado, Victoria; Bax, Jeroen J.; Scholte, Arthur J. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Koning, Gerhard [Medis Medical Imaging Systems B.V., Leiden (Netherlands); Dibbets-Schneider, Petra [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands); Mertens, Bart J. [Leiden University Medical Center, Department of Medical Statistics, Leiden (Netherlands); Reiber, Johan H.C. [Medis Medical Imaging Systems B.V., Leiden (Netherlands); Leiden University Medical Center, Department of Radiology, Leiden (Netherlands)

    2017-10-15

    A new method has been developed to calculate fractional flow reserve (FFR) from invasive coronary angiography, the so-called ''contrast-flow quantitative flow ratio (cQFR)''. Recently, cQFR was compared to invasive FFR in intermediate coronary lesions showing an overall diagnostic accuracy of 85%. The purpose of this study was to investigate the relationship between cQFR and myocardial ischemia assessed by single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI). Patients who underwent SPECT MPI and coronary angiography within 3 months were included. The cQFR computation was performed offline, using dedicated software. The cQFR computation was based on 3-dimensional quantitative coronary angiography (QCA) and computational fluid dynamics. The standard 17-segment model was used to determine the vascular territories. Myocardial ischemia was defined as a summed difference score ≥2 in a vascular territory. A cQFR of ≤0.80 was considered abnormal. Two hundred and twenty-four coronary arteries were analysed in 85 patients. Overall accuracy of cQFR to detect ischemia on SPECT MPI was 90%. In multivariable analysis, cQFR was independently associated with ischemia on SPECT MPI (OR per 0.01 decrease of cQFR: 1.10; 95% CI 1.04-1.18, p = 0.002), whereas clinical and QCA parameters were not. Furthermore, cQFR showed incremental value for the detection of ischemia compared to clinical and QCA parameters (global chi square 48.7 to 62.6; p <0.001). A good relationship between cQFR and SPECT MPI was found. cQFR was independently associated with ischemia on SPECT MPI and showed incremental value to detect ischemia compared to clinical and QCA parameters. (orig.)

  11. Relationship Between Coronary Contrast-Flow Quantitative Flow Ratio and Myocardial Ischemia Assessed by SPECT MPI.

    Science.gov (United States)

    Smit, Jeff M; Koning, Gerhard; van Rosendael, Alexander R; Dibbets-Schneider, Petra; Mertens, Bart J; Jukema, J Wouter; Delgado, Victoria; Reiber, Johan H C; Bax, Jeroen J; Scholte, Arthur J

    2017-10-01

    A new method has been developed to calculate fractional flow reserve (FFR) from invasive coronary angiography, the so-called "contrast-flow quantitative flow ratio (cQFR)". Recently, cQFR was compared to invasive FFR in intermediate coronary lesions showing an overall diagnostic accuracy of 85%. The purpose of this study was to investigate the relationship between cQFR and myocardial ischemia assessed by single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI). Patients who underwent SPECT MPI and coronary angiography within 3 months were included. The cQFR computation was performed offline, using dedicated software. The cQFR computation was based on 3-dimensional quantitative coronary angiography (QCA) and computational fluid dynamics. The standard 17-segment model was used to determine the vascular territories. Myocardial ischemia was defined as a summed difference score ≥2 in a vascular territory. A cQFR of ≤0.80 was considered abnormal. Two hundred and twenty-four coronary arteries were analysed in 85 patients. Overall accuracy of cQFR to detect ischemia on SPECT MPI was 90%. In multivariable analysis, cQFR was independently associated with ischemia on SPECT MPI (OR per 0.01 decrease of cQFR: 1.10; 95% CI 1.04-1.18, p = 0.002), whereas clinical and QCA parameters were not. Furthermore, cQFR showed incremental value for the detection of ischemia compared to clinical and QCA parameters (global chi square 48.7 to 62.6; p relationship between cQFR and SPECT MPI was found. cQFR was independently associated with ischemia on SPECT MPI and showed incremental value to detect ischemia compared to clinical and QCA parameters.

  12. Clinical usefulness of 123I-MIBG myocardial spect in patients with cardiac sarcoidosis

    International Nuclear Information System (INIS)

    Kobayashi, Keiko; Hatsumi, Chie; Fujioka, Haruto

    1996-01-01

    This study was undertaken to assess whether 123 I-MIBG scintigraphy is useful to detect cardiac involvements of sarcoidosis. In 45 patients with sarcoidosis, dual SPECT with 123 I-MIBG and 201 Tl-Cl(Tl) were performed, and the findings were compared with electrocardiogram (ECG), 24 hour Holter ECG and ultrasound echocardiography. In order to evaluate cardiac involvements, Tl and MIBG extent score (E.S.) and severity score (S.S.) were calculated by a Bull's eye map in addition to visual evaluation. Abnormal findings were recognized in 8.9% of all subjects in echocardiography, in 22.2% of those in ECG and Holter ECG, in 40% of those in Tl scintigraphy, and in 64.4% of those in MIBG scintigraphy. All of the Tl and MIBG abnormalities were detected in left ventricles, especially at the basal septal wall. At the inferior wall, abnormalities were observed more frequently by MIBG than by Tl. Tl E.S., Tl S.S. and MIBG E.S. were significantly higher in 10 patients with abnormal ECG findings than in 35 patients with normal ECG findings. Also, all of 10 patients with abnormal ECG findings had abnormal MIBG image, but 3 of them showed normal Tl images. 11 of 35 patients with normal ECG findings showed abnormal Tl and MIBG images (group A), 8 of 35 patients showed normal Tl images and abnormal MIBG images (group B), and 16 of 35 patients showed normal Tl and MIBG images (group C). MIBG S.S. of group A (11.3±7.8) was significantly higher than that of group B (5.3±3.1) or group C (2.6±3.2). Furthermore, in group A, MIBG S.S. was significantly higher than Tl S.S. (5.5±2.8). In a case of normal ECG with abnormal MIBG images, we seriously suspect cardiac involvements and recommend repeated Holter ECG tests as necessary in order to detect critical arrythmia. MIBG scintigraphy appeared to be a sensitive and useful method for the early detection of cardiac sarcoidosis. (J.P.N.)

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

    Science.gov (United States)

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

    2001-12-01

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

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

    International Nuclear Information System (INIS)

    Huang Jin; Song Wenzhong; Chen Mingxi

    2004-01-01

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

  15. Noninvasive quantification of myocardial perfusion heterogeneity by Markovian analysis in SPECT nuclear imaging

    International Nuclear Information System (INIS)

    Pons, G.

    2011-01-01

    Cardiovascular diseases are the leading cause of mortality worldwide, and third of these deaths are caused by coronary artery disease and rupture of vulnerable atherosclerotic plaques. The heterogeneous alteration of the coronary microcirculation is an early phenomenon associated with many cardiovascular risk factors that can strongly predict the subsequent development of coronary artery disease, and lead to the appearance of myocardial perfusion heterogeneity. Nuclear medicine allows the study of myocardial perfusion in clinical routine through scintigraphic scans performed after injection of a radioactive tracer of coronary blood flow. Analysis of scintigraphic perfusion images currently allows the detection of myocardial ischemia, but the ability of the technique to measure the perfusion heterogeneity in apparently normally perfused areas is unknown. The first part of this thesis focuses on a retrospective clinical study to determine the feasibility of myocardial perfusion heterogeneity quantification measured by Thallium-201 single photon emission computed tomography (SPECT) in diabetic patients compared with healthy subjects. The clinical study has demonstrated the ability of routine thallium-201 SPECT imaging to quantify greater myocardial perfusion heterogeneity in diabetic patients compared with normal subjects. The second part of this thesis tests the hypothesis that the myocardial perfusion heterogeneity could be quantified in small animal SPECT imaging by Thallium-201 and/or Technetium-99m-MIBI in an experimental study using two animal models of diabetes, and is correlated with histological changes. The lack of difference in myocardial perfusion heterogeneity between control and diabetic animals suggests that animal models are poorly suited, or that the technology currently available does not seem satisfactory to obtain similar results as the clinical study. (author)

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

    International Nuclear Information System (INIS)

    Wang Lijuan; Kaname Akioka; Hiroyuki Yamagishi

    1999-01-01

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

  17. Myocardial perfusion SPECT in diabetic patients for detection of coronary artery disease

    International Nuclear Information System (INIS)

    Saeed, M.A.; Fatima, S.; Fatmi, S.; Kureshi, S.

    2003-01-01

    The aim of this study was to evaluate the efficacy of myocardial SPECT perfusion scan in the diagnosis of coronary artery disease in diabetic patients. A total number of thirty diabetic patients (21 males, 9 females) were included in the study. All the patients had strong risk-factors for coronary artery disease (strong family history, chronic smokers, hyperlipidemia, history of chest pain). All patients underwent coronary angiography and stress/rest myocardial perfusion SPECT scans with Tc-99m MIBI (two days protocol). Twenty two patients had significant coronary artery stenosis and 8 had normal coronary arteries. Myocardial perfusion scintigraphy (MPS) was positive in 19 subjects out of the 22 patients with significant stenosis (Sensitivity 86.4%) and negative (false negative) in only three. Out of 8 patients with normal angiography 7 had normal MPS (Specificity 87.5%) whereas only one patient revealed abnormality in the myocardial perfusion study. When compared with coronary angiography the positive predictive value and negative predictive value for Tc-99m MIBI myocardial perfusion scan was 86.4% and 87.5% respectively. In conclusion, Tc-99m MIBI myocardial perfusion scintigraphy is a useful screening modality for the detection of coronary artery disease in diabetic patients. (author)

  18. Objective evaluation of Tl-201 image efficacy for detection of myocardial infarction

    International Nuclear Information System (INIS)

    Nagai, Teruo; Murata, Kazuhiko; Torizuka, Kanji

    1982-01-01

    From 13 institutions, 343 cases were collected including 152 cases of myocardial infarction, 157 of heart diseases other than myocardial infarction, and 34 of undetermined heart diseases. Tl-201 image interpretation was conducted by 13 physicians specialized in nuclear medicine. They read twice with and without clinical information. In the reading without clinical information, sensitivity was 68.0 %; specificity, 86.3 %; accuracy, 78.0 %; in the reading with clinical information, these figures were 82.3 %, 91.5 %, and 84.7 %, respectively, showing an increase. Receiver operating characteristics analysis showed improved results in the reading with clinical information. Moreover, little variance among interpreters was suggested, but, much more effect of image quality on the results was demonstrated. (Ueda, J.)

  19. Superimposed dual-isotope SPECT using 99mTc-hydroxymethylene diphosphonate and 201Tl-chloride to assess cartilage invasion in laryngohypopharyngeal cancer

    International Nuclear Information System (INIS)

    Nishiyama, Yoshihiro; Yamamoto, Yuka; Yokoe, Koiku; Miyabe, Kazunori; Iwasaki, Takanobu; Toyama, Yoshihiro; Satoh, Katashi; Ohkawa, Motoomi

    2004-01-01

    Cartilage invasion in laryngohypopharyngeal cancer has a significant impact on the choice of treatment modality and outcome of the disease. We examined invasion of cartilage in laryngohypopharyngeal cancer by simultaneous bone and tumor dual-isotope SPECT using 99m Tc-hydroxymethylene diphosphonate and 201 Tl-chloride. Early and delayed simultaneous bone and tumor dual-isotope SPECT were performed on 19 patients with laryngohypopharyngeal cancer. Dual-isotope SPECT images were superimposed to project tumor location from tumor SPECT onto the osseous structures shown by bone SPECT. The presence or absence of cartilage invasion was evaluated histopathologically or by radiological studies such as CT and/or MRI. Histopathological or radiological examination of the cartilage revealed invasion in 5 patients and no invasion in 14 patients. The results of both early and delayed dual-isotope SPECT were exactly the same. Using dual-isotope SPECT, the sensitivity, specificity, and accuracy in detecting cartilage invasion by laryngohypopharyngeal cancer were: 80% (4/5), 92.9% (13/14), and 89.5% (17/19), respectively. Results of the present study suggest that superimposed early bone and tumor dual-isotope SPECT images may be sufficient for the diagnostic evaluation of cartilage invasion by laryngohypopharyngeal cancer. Superimposed dual-isotope SPECT imaging is a useful technique in the evaluation of cartilage invasion in laryngohypopharyngeal cancer. (author)

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-01

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

  2. Comparative study of 201Tl reinjection mycoardial imaging and late imaging after reinjection for detecting myocardial viability

    International Nuclear Information System (INIS)

    Lin Jinghui; Chai Xiaofeng; Zhu Mei

    1997-01-01

    PURPOSE: To compare 201 Tl reinjection imaging with late imaging in detecting myocardial viability. METHODS: 62 patients with myocardial infarction underwent 201 Tl exercise, 3∼5 hours redistribution, 16∼35 minutes and 12∼19 hours post 201 Tl reinjection mycoardial tomography imaging. After imaging, percutaneous transluminal coronary angioplasty (PTCA) were performed in 15 patients, and then exercise-redistribution myocardial imaging were repeated. RESULTS: 62 patients had 126 segments of irreversible defects on stress-redistribution imaging, 48 segments showed radioactive filling at 16∼35 minutes post-reinjection. The detecting rate of myocardial viability was 38.1% (48/126). 51 segments presented redistribution on 12∼19 hours late imaging, the detecting rate of myocardial viability was 40.5% (51/126). There were no significant difference in the detecting rate between them (x 2 0.16, P>0.05). But in combination of both methods, there were 62 segments refilling, thereby detecting rate was enhanced to 49.2% (62/126). In 15 patients who had PTCA, out of 17 segments were discovered to be viable before PTCA. After PTCA 12 segments had an improved perfusion of 201 Tl, the positive predictive accuracy was 70.6%. Out of 11 segments were discovered to be infarcted, 9 segments had non-improved 201 Tl perfusion after PTCA, the negative predictive accuracy was 81.8%. CONCLUSION: There were no significant difference in the detecting rate of myocardial viability between 2 '0 1 Tl reinjection and late imaging. In combination of both methods the detecting rate can be enhanced

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

    International Nuclear Information System (INIS)

    Cheng Xu; Huang Gang

    2004-01-01

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

  4. Evaluation of Parallel and Fan-Beam Data Acquisition Geometries and Strategies for Myocardial SPECT Imaging

    Science.gov (United States)

    Qi, Yujin; Tsui, B. M. W.; Gilland, K. L.; Frey, E. C.; Gullberg, G. T.

    2004-06-01

    This study evaluates myocardial SPECT images obtained from parallel-hole (PH) and fan-beam (FB) collimator geometries using both circular-orbit (CO) and noncircular-orbit (NCO) acquisitions. A newly developed 4-D NURBS-based cardiac-torso (NCAT) phantom was used to simulate the /sup 99m/Tc-sestamibi uptakes in human torso with myocardial defects in the left ventricular (LV) wall. Two phantoms were generated to simulate patients with thick and thin body builds. Projection data including the effects of attenuation, collimator-detector response and scatter were generated using SIMSET Monte Carlo simulations. A large number of photon histories were generated such that the projection data were close to noise free. Poisson noise fluctuations were then added to simulate the count densities found in clinical data. Noise-free and noisy projection data were reconstructed using the iterative OS-EM reconstruction algorithm with attenuation compensation. The reconstructed images from noisy projection data show that the noise levels are lower for the FB as compared to the PH collimator due to increase in detected counts. The NCO acquisition method provides slightly better resolution and small improvement in defect contrast as compared to the CO acquisition method in noise-free reconstructed images. Despite lower projection counts the NCO shows the same noise level as the CO in the attenuation corrected reconstruction images. The results from the channelized Hotelling observer (CHO) study show that FB collimator is superior to PH collimator in myocardial defect detection, but the NCO shows no statistical significant difference from the CO for either PH or FB collimator. In conclusion, our results indicate that data acquisition using NCO makes a very small improvement in the resolution over CO for myocardial SPECT imaging. This small improvement does not make a significant difference on myocardial defect detection. However, an FB collimator provides better defect detection than a

  5. Bull's-eye map of myocardial perfusion MR imaging. Comparison with SPECT

    International Nuclear Information System (INIS)

    Nomura, Yukihiro; Nanjo, Shuji; Yamazaki, Junichi; Yoshikawa, Kohki; Inoue, Yusuke

    2003-01-01

    When diagnosing heart disease, chest roentgenograms, ultrasonography, single-photon emission computed tomography (SPECT), and coronary arteriography are usually performed. Magnetic resonance (MR) imaging is not widely used for evaluating heart disease. Recent technological progress has allowed high quality images of the heart to be reliably obtained. A routine MR study taking about 30-40 minutes can provide a large amount of diagnostic information, such as cardiac structure, function, perfusion, and myocardial viability. The analysis software that can offer Bull's-eye maps from myocardial perfusion images has recently become commercially available. In this study, the characteristics of Bull's-eye mapping of MR imaging is compared with that of Bull's-eye mapping of SPECT using the same heart phantom. The difference in the image quality of the Bull's-eye maps was evaluated among the receiver coils of MR imaging. On Bull's-eye maps from both MR imaging and SPECT, decreased signal intensity was noted in the posterolateral wall. The degree of decrease in the signal of the MR imaging was more prominent than of SPECT. The decrease was severe for the general-purpose receive-only flexible (GPFLEX) coil, moderate for the cardiac and TORSO coil, and slight for the body coil. In the selection of a coil, it is necessary to take into consideration the trade-off between the distribution of signal intensity and the signal-to-noise ratio (SNR). (author)

  6. Supervising PTCA treatment with a scheme of steps combination SPECT 99Tcm-MIBI myocardial imaging

    International Nuclear Information System (INIS)

    Luan Zhaosheng; Tian Jiahe; Peng Yong; Zhou Wen; Gai Luyue; Sun Zhijun; Su Yuwen; Liu Xiaohu

    2001-01-01

    Objective: To set up a useful supervising method around PTCA treatment. Methods: A scheme of steps combination SPECT 99 Tc m -MIBI myocardial imaging was devised. 87 patients with coronary artery disease were selected into the study. 3-step imaging, exercise, rest and intravenous infusion of nitroglycerine (NTG) imaging, was performed at 1 week before PTCA. 2-step imaging, exercise and rest imaging, was performed 1-2 weeks after PTCA. All of the indexes obtained from steps combination imaging before and after PTCA were contrasted with each other in pairs. Results: 1) Compared with outcome of clinical assessing, the imaging after PTCA could correctly assess PTCA outcome. 2) The myocardial defects showed in 3-step imaging before PTCA appeared to be ameliorated after PTCA and the amelioration showed in exercise imaging was more evident than that in rest imaging. The myocardial perfusion state revealed by NTG imaging was similar to that revealed by rest imaging after PTCA. 3) The 3-step imaging findings correlated with PTCA outcome, the best correlation was found between indexes of myocardial defect changes showed by NTG and exercise imaging and indexes of PTCA outcome (r = 0.9470, P 99 Tc m -MIBI myocardial SPECT imaging scheme is a very useful supervising method around PTCA. 2-step imaging after PTCA could assess outcome correctly, and 3-step imaging before it could predict outcome correctly, too

  7. A new protocol of dual energy acquisition on stress 201Tl and rest 99mTc-tetrofosmin myocardial scintigraphy

    International Nuclear Information System (INIS)

    Maeno, Masakazu; Matsuo, Takeshi; Imamura, Takurou; Koiwaya, Yasushi; Eto, Tanenao; Nagamachi, Shigeki; Jinnouchi, Seishi

    2001-01-01

    We carried out stress 201 Tl (Tl) and rest 99m Tc-tetrofosmin (TF) myocardial scintigraphy with dual energy acquisition in 24 patients with suspected ischemic heart disease performed coronary arteriography and elucidated the sensitivity of this method. One hour after light meal eating, TF (555 MBq) was injected intravenously at rest and after 3 minutes from injection of TF exercise or pharmacologic stress was performed. During stress Tl (111 MBq) was injected intravenously before end-point or at adequate point of pharmacologic stress. Dual energy acquisition using triple energy windows (TEW) was started after 5 minutes (early) and 4 hours (delayed) from stress. The sensitivity (Sn), specificity (Sp) and accuracy (Ac) in diagnosis of non-infarcted branches by using Tl (early)-TF (rest) and Tl (early)-Tl (delayed) were 79% vs. 53% (Sn), 78% vs. 96% (Sp) and 79% vs. 71% (Ac) respectively. Accordance of uptake score of infarcted region between TF (rest) and Tl (delayed) was 70%. In conclusion, this protocol is seemed to be useful as usual protocol for detection of myocardial ischemia and viability during about only 1 hour. (author)

  8. The accuracy of myocardial perfusion SPECT imaging in the evaluation of coronary artery disease in women and men

    International Nuclear Information System (INIS)

    Kaminek, M.; Myslivecek, M.; Huyak, V.; Koranda, P.; Skvarilova, M.; Ostransky, J.

    2001-01-01

    The purpose of this study is to compare sensitivity, specificity and accuracy of myocardial perfusion SPECT for the detection of coronary artery disease (CAD) in women and men. 588 patients (455 males and 133 females, 273 after a previous myocardial infarction) underwent stress myocardial perfusion SPECT. The accuracy of myocardial perfusion SPECT was proved by coronary angiography (stenosis >50% was considered as a CAD). The sensitivity of SPECT was slightly higher, but statistically not significant, in men than in women (94% versus 91%, p > 0.05). The specificity was higher in women than in men (93% versus 82%), but this difference was not statistically significant either (p > 0.05). The accuracy of SPECT was the same for both sexes (92%). In angiographically verified group of patients the selection bias was obvious - patients with CAD dominated (74%) and the fraction of patients with CAD in men's group (83%) was significantly higher than in women's group (50%), p < 0.05. No significant difference was revealed in the accuracy of myocardial perfusion SPECT in men and women. Our results are in accordance with the prevailing opinion in literature that discovered differences in sensitivity, specificity and diagnostic accuracy are usually not statistically significant or that they can be explained by the selection bias of patients in angiographically verified groups (significantly higher fraction of patients with CAD in men's group). (author)

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    International Nuclear Information System (INIS)

    Ohkoshi, Nobuyuki; Watanabe, Shingo; Matsumoto, Tooru

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  12. Critical review-current status of Tl-201 myocardial scintigraphy in patients with ischemic heart disease

    International Nuclear Information System (INIS)

    Kanemoto, Nariaki; Hoer, G.

    1982-01-01

    Thallium-201 myocardial scintigraphy (TMS) is the most important, accurate and noninvasive diagnostic tool for the detection of regional myocardial perfusion. This agent is a potassium analog and the biologic half life in normal myocardium is 4 hours. Therefore, serial imaging after a single dose of Tl-201 at the peak of the exercise makes differential diagnosis possible between stress induced ischemia (transient perfusion defect with redistribution) and myocardial fibrosis or scar (permanent defect). The reproducibility is around 90%. The overall sensitivity in 4,094 patients reviewed from the literature was 83% with a specificity of 87%. The accuracy of TMS for the diagnosis of ischemic heart disease was 85%. Sensitivity increases in the order of visual (83%), computer analysis of standard scintigraphy (91%), and computer analysis of pinhole tomography (96%), but there is no significant difference in specificity among them. Also, sensitivity increases in the order of single (73%), double (83%) and triple (90%) vessel d isease. However, TMS does not indicate the correct number of vessels involved. In this paper, we discuss the current status of use and limitations of TMS in the diagnosis of ischemic heart disease. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-01-01

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

  14. [Myocardial imaging in acute myocardial infarction using beta-methyl-p-(123I)-iodophenylpentadecanoic acid: comparison with 201Tl imaging and wall motion].

    Science.gov (United States)

    Naruse, H; Itano, M; Kondo, T; Kogame, T; Yamamoto, J; Morita, M; Kawamoto, H; Fukutake, N; Ohyanagi, M; Iwasaki, T

    1992-01-01

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

  15. Attenuation correction of myocardial SPECT by scatter-photopeak window method in normal subjects

    International Nuclear Information System (INIS)

    Okuda, Koichi; Nakajima, Kenichi; Matsuo, Shinro; Kinuya, Seigo; Motomura, Nobutoku; Kubota, Masahiro; Yamaki, Noriyasu; Maeda, Hisato

    2009-01-01

    Segmentation with scatter and photopeak window data using attenuation correction (SSPAC) method can provide a patient-specific non-uniform attenuation coefficient map only by using photopeak and scatter images without X-ray computed tomography (CT). The purpose of this study is to evaluate the performance of attenuation correction (AC) by the SSPAC method on normal myocardial perfusion database. A total of 32 sets of exercise-rest myocardial images with Tc-99m-sestamibi were acquired in both photopeak (140 keV±10%) and scatter (7% of lower side of the photopeak window) energy windows. Myocardial perfusion databases by the SSPAC method and non-AC (NC) were created from 15 female and 17 male subjects with low likelihood of cardiac disease using quantitative perfusion SPECT software. Segmental myocardial counts of a 17-segment model from these databases were compared on the basis of paired t test. AC average myocardial perfusion count was significantly higher than that in NC in the septal and inferior regions (P<0.02). On the contrary, AC average count was significantly lower in the anterolateral and apical regions (P<0.01). Coefficient variation of the AC count in the mid, apical and apex regions was lower than that of NC. The SSPAC method can improve average myocardial perfusion uptake in the septal and inferior regions and provide uniform distribution of myocardial perfusion. The SSPAC method could be a practical method of attenuation correction without X-ray CT. (author)

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

    International Nuclear Information System (INIS)

    Tokareva, E.A.; Sergienko, V.B.; Sidorenko, B.A.

    1989-01-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  18. Specific perfusion pattern in stress 201Tl myocardial scintigraphy of left main coronary artery disease

    International Nuclear Information System (INIS)

    Wakasugi, Shigetoshi; Shibata, Nobuhiko; Kobayashi, Tohru; Fudemoto, Yoshiyuki; Hasegawa, Yoshihisa; Nakano, Shunichi

    1986-01-01

    The usefulness of stress 201 Tl myocardial scintigraphy for identifying left main coronary artery disease was evaluated with data from 23 patients with 50% or more narrowing of the left main coronary artery and 56 patients with 75% or more narrowing of the major coronary arteries but without left main coronary artery involvement (no left main coronary artery disease). Quantitative evaluation of stress perfusion scintigrams in all five patients with narrowing of the left main coronary artery of 90% or more showed a characteristic perfusion pattern (left main pattern) of extensive homogeneous defect over the whole anterolateral segment and simultaneous defects in all radii of the high anteroseptal and high posterolateral segments. On the other hand, such a perfusion pattern was noted in only 1 of 18 patients with less than 90% stenosis of the left main coronary artery and in only 1 of 56 patients with no left coronary artery disease. (orig.)

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  20. Emission computed tomography using rotating gamma cameras for stress 201Tl myocardial imaging

    International Nuclear Information System (INIS)

    Takeda, Kan; Maeda, Hisato; Nakagawa, Tsuyoshi; Yamaguchi, Nobuo; Taguchi, Mitsuo

    1983-01-01

    The purpose of this study is to evaluate the efficacy of emission computed tomography (ECT) for stress 201 Tl myocardial imaging to localize coronary artery disease (CAD) in comparison with planar (PL) images. In a series of 14 normal subjects and 53 patients with CAD proved coronary arteriography, ECT and PL imaging were performed successively. ECT data were collected for 90 projections in a 64 x 64 matrix form with a total aquisition time of 6 munutes over 180 0 of opposed dual cameras ratation and tomographic sections oriented perpendicular and parallel to the long axis of left ventricle were reconstructed. PL images were obtained for left lateral, left anterior oblique (30 0 and 45 0 ) and anterior projections. Both ECT and PL myocardial images were divided into 8 segments and segmental analysis was performed by visual interpretation. The ECT images remarkably increased sensitivity over the PL images in left anterior descending (LAD) artery (from 56% to 76%), right coronary artery (RCA) (from 50% to 96%), and circumflex artery (CX) (from 56% to 69%) lesions. The specificity for ECT images, as compared with PL images, was higher in LAD (88% against 85%) but slightly lower in RCA (70% ag ainst 72%) and CX (84% against 88%). Overall accuracy, therefore, was improved in LAD (from 67% to 81%) and RCA (from 64% to 79%) but equal in CX (81%). We conclude that stress 201 Tl ECT imaging result in a remarkable improvement in the localization of CAD, especially in patients with RCA lesions and multi-vessel disease. (author)

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-07-01

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

  3. Myocardial imaging with 201Tl: an analysis of clinical usefulness based on Bayes' theorem

    International Nuclear Information System (INIS)

    Hamilton, G.W.; Trobaugh, G.B.; Ritchie, J.L.; Gould, K.L.; DeRouen, T.A.; Williams, D.L.

    1978-01-01

    Rest-exercise thallium-201 ( 201 Tl) myocardial imaging and rest-exercise electrocardiography were performed in 137 patients with suspected coronary artery disease (CAD). The final diagnosis of coronary disease was made by arteriography. Sensitivity and specificity for the ECG and thallium studies alone or combined were then determined. Based on these data, the posttest probability of CAD with a normal or abnormal test was calculated using Bayes' theorem for disease prevalences ranging from 1% to 99%. The difference between the probability of disease with a normal test and the probability of disease with an abnormal test was also calculated for each prevalence range. The results demonstrate that 201 Tl imaging discriminates between disease absence or presence better than does the ECG. However, both the ECG and thallium studies provide rather poor discrimination between disease and no disease when the disease prevalence is low (less than 0.20) or high (greater than 0.70). Because of this characteristic, it is unlikely that screening tests for CAD will prove useful unless the disease prevalence in the group under study is in the moderate (0.20 to 0.70) range

  4. Quantification of 99mTc-MIBI lung uptake in myocardial SPECT studies

    International Nuclear Information System (INIS)

    Qu Wanying; Lu Zhenping; Zhou Ying; He Qin

    1996-01-01

    To assess the significance of 99m Tc-MIBI lung uptake during myocardial SPECT studies in the evaluation of left ventricular dysfunction. 42 control subjects and 65 patients with coronary artery disease (CAD) were investigated with 99m Tc-MIBI myocardial SPECT and radionuclide ventriculography (RNV) within 1 week. The lung-to-heart ratios (LHR) both at rest and exercise were calculated from the anterior projection of the SPECT image sets. The left ventricular ejection fraction (LVEF) was determined using RNV. In the control group, a significant decrease in LHR was observed during exercise (P<0.01). The CAD group showed significantly high LHR values both at rest and exercise. A negative correlation was observed between LHR values and LVEF at rest (r -0.6234, P<0.001) and exercise (r = -0.6113, P<0.001). LHR both at rest and exercise are significantly correlated with LVEF and may be useful in the evaluation of left ventricular function

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  6. Novel laser-processed CsI:Tl detector for SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sabet, H., E-mail: hsabet@mgh.harvard.edu; Uzun-Ozsahin, D.; El-Fakhri, G. [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02129 (United States); Bläckberg, L. [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02129 and Department of Physics and Astronomy, Uppsala University, Uppsala 75120 (Sweden)

    2016-05-15

    Purpose: The aim of this work is to demonstrate the feasibility of a novel technique for fabrication of high spatial resolution CsI:Tl scintillation detectors for single photon emission computed tomography systems. Methods: The scintillators are fabricated using laser-induced optical barriers technique to create optical microstructures (or optical barriers) inside the CsI:Tl crystal bulk. The laser-processed CsI:Tl crystals are 3, 5, and 10 mm in thickness. In this work, the authors focus on the simplest pattern of optical barriers in that the barriers are created in the crystal bulk to form pixel-like patterns resembling mechanically pixelated scintillators. The monolithic CsI:Tl scintillator samples are fabricated with optical barrier patterns with 1.0 × 1.0 mm{sup 2} and 0.625 × 0.625 mm{sup 2} pixels. Experiments were conducted to characterize the fabricated arrays in terms of pixel separation and energy resolution. A 4 × 4 array of multipixel photon counter was used to collect the scintillation light in all the experiments. Results: The process yield for fabricating the CsI:Tl arrays is 100% with processing time under 50 min. From the flood maps of the fabricated detectors exposed to 122 keV gammas, peak-to-valley (P/V) ratios of greater than 2.3 are calculated. The P/V values suggest that regardless of the crystal thickness, the pixels can be resolved. Conclusions: The results suggest that optical barriers can be considered as a robust alternative to mechanically pixelated arrays and can provide high spatial resolution while maintaining the sensitivity in a high-throughput and cost-effective manner.

  7. Novel laser-processed CsI:Tl detector for SPECT

    International Nuclear Information System (INIS)

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

    2016-01-01

    Purpose: The aim of this work is to demonstrate the feasibility of a novel technique for fabrication of high spatial resolution CsI:Tl scintillation detectors for single photon emission computed tomography systems. Methods: The scintillators are fabricated using laser-induced optical barriers technique to create optical microstructures (or optical barriers) inside the CsI:Tl crystal bulk. The laser-processed CsI:Tl crystals are 3, 5, and 10 mm in thickness. In this work, the authors focus on the simplest pattern of optical barriers in that the barriers are created in the crystal bulk to form pixel-like patterns resembling mechanically pixelated scintillators. The monolithic CsI:Tl scintillator samples are fabricated with optical barrier patterns with 1.0 × 1.0 mm"2 and 0.625 × 0.625 mm"2 pixels. Experiments were conducted to characterize the fabricated arrays in terms of pixel separation and energy resolution. A 4 × 4 array of multipixel photon counter was used to collect the scintillation light in all the experiments. Results: The process yield for fabricating the CsI:Tl arrays is 100% with processing time under 50 min. From the flood maps of the fabricated detectors exposed to 122 keV gammas, peak-to-valley (P/V) ratios of greater than 2.3 are calculated. The P/V values suggest that regardless of the crystal thickness, the pixels can be resolved. Conclusions: The results suggest that optical barriers can be considered as a robust alternative to mechanically pixelated arrays and can provide high spatial resolution while maintaining the sensitivity in a high-throughput and cost-effective manner.

  8. A new method for crosstalk correction in simultaneous dual-isotope myocardial imaging with Tl-201 and I-123

    International Nuclear Information System (INIS)

    Tsuji, Akinori; Kojima, Akihiro; Oyama, Yoichi; Tomiguchi, Seiji; Kira, Tomohiro; Takagi, Yoshikazu; Shimomura, Osamu; Takahashi, Mutsumasa; Matsumoto, Masanori

    1999-01-01

    We have developed a new method of crosstalk correction in simultaneous dual-isotope imaging with Tl-201 and I-123 by using crosstalk ratios and a blurring filter. Single isotope myocardial studies (10 for Tl-201 and 7 for I-123) were performed with a dual energy window acquisition mode and two low energy general-purpose collimators. Then two planar images acquired with dual energy windows for a Tl-201 line source and an I-123 line source were obtained to measure line spread functions (LSFs) and crosstalk ratios for each image. The line source experiments showed that the LSFs for the Tl-201 imaging window from the single Tl-201 source were very similar to those for the I-123 imaging window from the single Tl-201 source, but the LSFs for the Tl-201 imaging window from the single I-123 source had broad shapes which differed from those for the I-123 imaging window from the single I-123. To obtain accurate I-123 crosstalk images in the Tl-201 imaging window from the I-123 images in the I-123 imaging window, we designed a low-pass blurring filter. In 7 clinical I-123 MIBG studies, I-123 window images processed with this filter became very similar to the Tl-201 window image from the single I-123 source. The method proposed in this study can accurately correct the crosstalk in dual isotope studies with Tl-201 and I-123 and is easily applicable to conventional gamma camera systems with any dual energy window acquisition mode. (author)

  9. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT

    DEFF Research Database (Denmark)

    Verberne, Hein J; Acampa, Wanda; Anagnostopoulos, Constantinos

    2015-01-01

    Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated ...

  10. 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

  11. Interrelation of ST-segment depression during bicycle ergometry and extent of myocardial ischaemia by myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Muzzarelli, Stefano; Pfisterer, Matthias Emil; Zellweger, Michael Johannes [University Hospital Basel, Cardiology Department, Basel (Switzerland); Mueller-Brand, Jan [University Hospital Basel, Nuclear Medicine Department, Basel (Switzerland)

    2009-11-15

    The aim of this study was to compare ST-segment depression (STD) during bicycle ergometry and extent of myocardial ischaemia assessed by myocardial perfusion SPECT (MPS) in a large patient cohort. Consecutive patients (n = 955) referred for MPS with bicycle ergometry and interpretable stress ECG were evaluated with respect to ECG and MPS findings of ischaemia. The maximal STD was recorded and exercise ECG was considered ischaemic if STD was horizontal or downsloping ({>=}1 mm). MPS was interpreted using a 20-segment model with a scale of 0 to 4. A summed stress (SSS), summed rest (SRS) and summed difference score (SDS = SSS-SRS, e.g. extent of ischaemia) were derived. Ischaemia was defined as an SDS {>=} 2. An exercise-induced STD was present in 215 patients (22%) and myocardial ischaemia on MPS was present in 366 patients (38%). The extent of ST-segment depression and the number of ECG leads with significant STD were each strongly and significantly associated with increasing severity of ischaemia and the number of coronary territories involved (p < 0.01 for all correlations). These data demonstrate a strong correlation between the extent of STD, number of ischaemic leads and severity of myocardial ischaemia as assessed by MPS during bicycle ergometry. (orig.)

  12. Interrelation of ST-segment depression during bicycle ergometry and extent of myocardial ischaemia by myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Muzzarelli, Stefano; Pfisterer, Matthias Emil; Zellweger, Michael Johannes; Mueller-Brand, Jan

    2009-01-01

    The aim of this study was to compare ST-segment depression (STD) during bicycle ergometry and extent of myocardial ischaemia assessed by myocardial perfusion SPECT (MPS) in a large patient cohort. Consecutive patients (n = 955) referred for MPS with bicycle ergometry and interpretable stress ECG were evaluated with respect to ECG and MPS findings of ischaemia. The maximal STD was recorded and exercise ECG was considered ischaemic if STD was horizontal or downsloping (≥1 mm). MPS was interpreted using a 20-segment model with a scale of 0 to 4. A summed stress (SSS), summed rest (SRS) and summed difference score (SDS = SSS-SRS, e.g. extent of ischaemia) were derived. Ischaemia was defined as an SDS ≥ 2. An exercise-induced STD was present in 215 patients (22%) and myocardial ischaemia on MPS was present in 366 patients (38%). The extent of ST-segment depression and the number of ECG leads with significant STD were each strongly and significantly associated with increasing severity of ischaemia and the number of coronary territories involved (p < 0.01 for all correlations). These data demonstrate a strong correlation between the extent of STD, number of ischaemic leads and severity of myocardial ischaemia as assessed by MPS during bicycle ergometry. (orig.)

  13. Non invasive evaluation of the coronary atherosclerosis illness in patients with silent ischemia: utility of the SPECT of myocardial perfusion. Electric, angiographic and image correlation

    International Nuclear Information System (INIS)

    Puente B, A.; Roffe G, F.; Aceves C, J.; Gomez A, E.

    2005-01-01

    The objective of the work was to determine the utility of the SPECT (Single Photon Emission Computerized Tomography) of myocardial perfusion for the ischemia detection in asymptomatic patients with Coronary Atherosclerosis Illness. It was concluded that the SPECT of myocardial perfusion has a high sensitivity (97%) for the silent ischemia diagnosis

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

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

  15. Clinical usefulness of {sup 123}I-BMIPP myocardial SPECT in collagen disease

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kazuki; Zen, Kan [Asahi Univ., Gifu (Japan). Murakami Memorial Hospital; Sugihara, Hiroki (and others)

    2000-07-01

    This study was designed to evaluate the clinical usefulness of {sup 123}I-BMIPP myocardial SPECT for detecting cardiac involvement in patients with collagen disease. We studied 12 patients with systemic lupus erythematosus (SLE), 8 with progressive systemic sclerosis (PSS), 6 with polymyositis/dermatomyositis (PM/DM) and 3 with allergic granulomatosis and angiitis (AGA). A 111 MBq of {sup 123}I-BMIPP was intravenously injected at rest, and SPECT images were obtained at 15 min after the injection. Seven of 12 SLE, 6 of 8 PSS, 3 of 6 PM/DM and all 3 AGA patients showed an abnormal tracer uptake. The left ventricular ejection fraction was inversely correlated with a BMIPP abnormality. The regional wall motion abnormality was reduced in regions with reduced tracer uptake. These findings suggest that {sup 123}I-BMIPP imaging could be useful for assessment of cardiac involvement in patients with collagen disease. (author)

  16. Myocardial viability assessment with dynamic low-dose iodine-123-iodophenylpentadecanoic acid metabolic imaging: comparison with myocardial biopsy and reinjection SPECT thallium after myocardial infarction.

    Science.gov (United States)

    Murray, G L; Schad, N C; Magill, H L; Vander Zwaag, R

    1994-04-01

    Aggressive cardiac revascularization requires recognition of stunned and hibernating myocardium, and cost considerations may well govern the technique used. Dynamic low-dose (1 mCi) [123I]iodophenylpentadecanoic acid (IPPA) metabolic imaging is a potential alternative to PET using either 18FDG or 15O-water. Resting IPPA images were obtained from patients with severe ischemic cardiomyopathy, and transmural myocardial biopsies were obtained during coronary bypass surgery to confirm viability. Thirty-nine of 43 (91%) biopsies confirmed the results of the IPPA images with a sensitivity for viability of 33/36 (92%) and a specificity of 6/7 (86%). Postoperatively, wall motion improved in 80% of IPPA-viable, dysfunctional segments. Furthermore, when compared to reinjection thallium (SPECT-TI) scans after myocardial infarction, IPPA-SPECT-TI concordance occurred in 27/35 (77%) (K = 0.536, p = 0.0003). Similar to PET, IPPA demonstrated more viability than SPECT-TI, 26/35 (74%) versus 18/35 (51%) (p = 0.047). Metabolic IPPA cardiac viability imaging is a safe, inexpensive technique that may be a useful alternative to PET.

  17. Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yokota, Shu; Ottervanger, Jan Paul; Timmer, Jorik R. [Isala Hospital, Department of Cardiology, Zwolle (Netherlands); Mouden, Mohamed; Engbers, Elsemiek [Isala Hospital, Department of Cardiology, Zwolle (Netherlands); Isala Hospital, Department of Nuclear Medicine, Zwolle (Netherlands); Knollema, Siert; Jager, Pieter L. [Isala Hospital, Department of Nuclear Medicine, Zwolle (Netherlands)

    2016-02-15

    Single photon emission computed tomography (SPECT) myocardial perfusion imaging has proven to have prognostic importance in patients with suspected stable coronary artery disease (CAD). The recently introduced ultrafast cadmium zinc telluride (CZT)-based gamma cameras have been associated with less equivocal findings and more normal interpretations, allowing stress-only imaging to be performed more often. However, it is yet unclear whether normal stress-only CZT SPECT has comparable prognostic value as normally interpreted stress-only conventional SPECT. The study population consisted of 1,650 consecutive patients without known CAD with normal stress-only myocardial perfusion results with either conventional (n = 362) or CZT SPECT (n = 1,288). The incidence of major adverse cardiac events (MACE, all-cause death, non-fatal myocardial infarction and/or coronary revascularization) was compared between the conventional SPECT and CZT SPECT groups. Multivariable analyses using the Cox model were used to adjust for differences in baseline variables. Patients scanned with CZT were less often male (33 vs 39 %), had less often hypercholesterolaemia (41 vs 50 %) and had more often a family history of CAD (57 vs 49 %). At a median follow-up time of 37 months (interquartile range 28-45 months) MACE occurred in 68 patients. The incidence of MACE was 1.5 %/year in the CZT group, compared to 2.0 %/year in the conventional group (p = 0.08). After multivariate analyses, there was a trend to a lower incidence of MACE in the CZT SPECT group (hazard ratio 0.61, 95 % confidence interval 0.35-1.04, p = 0.07). The prognostic value of normal stress-only CZT SPECT is at least comparable and may be even better than that of normal conventional stress SPECT. (orig.)

  18. A clinical study of gated simultaneous rest 201Tl/stress 99Tcm-sestamibi dual isotope myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Tang Anwu; Qiao Shuixian; Luo Yaowu; Liang Xiaolin

    2002-01-01

    Objective: To investigate a modified gated radionuclide myocardial tomography in methodology for raising the sensitivity and efficiency of detecting myocardial ischemia. Methods: One hundred and three patients were involved and divided into two groups: coronary artery disease (CAD) patient 37, non-CAD patient 66. 201 Tl 111 MBq was injected intravenously 5 min before stress, the patient exercised with ergometer following the modified Bruce protocol, and was injected 99 Tc m -sestamibi at the peak of stress. 45 min later, the simultaneous dual energy peak gated acquisition was then performed. Stress ( 99 Tc m -sestamibi) and rest ( 201 Tl) images were reconstructed. Results: Positive findings were seen in 35/37 (94.6%) in CAD group and 7/66 (10.6%) in non-CAD, respectively; LVEF, EDV and ESV of two groups were (52.33+-16.26)%, (70.45+-28.12) mL, (33.35 +- 18.86) mL and (61.76 +- 9.38)%, (60.45 +- 18.18) mL, (23.30 +- 11.09) mL, respectively. Conclusion: The simultaneous stress ( 99 Tc m -sestamibi) and rest ( 201 Tl) gated myocardial imaging is an efficient and practical protocol for the study of myocardial perfusion and the diagnosis of ischemia

  19. Results of myocardial SPECT with fatty acids in coronary artery disease

    International Nuclear Information System (INIS)

    Reske, S.N.; Kropp, J.; Reichmann, K.; Winkler, C.; Knapp, F.F.; Nitsch, J.

    1986-01-01

    New developments in radiopharmacology of 123 I-labeled metabolic tracers and single-photon emission computerized tomography (SPECT) allow now-a-days the assessment of parameters of cardiac energy metabolism in well-defined areas of the heart muscle. This article will present a brief outline of the basic pathophysiological principles used in the application of 123 I-labeled phenyl fatty acids for the evaluation of CAD. First clinical results suggest an important application of cardiac fatty acid metabolic imaging to the detection, localisation and conceivable quantitation of myocardial ischemia, myocardial infarction and assessment of tissue viability. In addition to the diagnostic applications in CAD, cardiac fatty acid metabolic imaging may provide new perspectives to pathophysiological investigations of the coupling of local flow and substrate utilisation in vivo and the effect of therapeutic interventions. (orig.) [de

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

    Science.gov (United States)

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

    2018-04-01

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

  1. Myocardial multilayer strain does not provide additional value for detection of myocardial viability assessed by SPECT imaging over and beyond standard strain.

    Science.gov (United States)

    Orloff, Elisabeth; Fournier, Pauline; Bouisset, Frédéric; Moine, Thomas; Cournot, Maxime; Elbaz, Meyer; Carrié, Didier; Galinier, Michel; Lairez, Olivier; Cognet, Thomas

    2018-05-14

    The aim of this study was to evaluate the value of multilayer strain analysis to the assessment of myocardial viability (MV) through the comparison of both speckle tracking echocardiography and single-photon emission computed tomography (SPECT) imaging. We also intended to determine which segmental longitudinal strain (LS) cutoff value would be optimal to discriminate viable myocardium. We included 47 patients (average age: 61 ± 11 years) referred to our cardiac imaging center for MV evaluation. All patients underwent transthoracic echocardiography with measures of LS, SPECT, and coronary angiography. In all, 799 segments were analyzed. We correlated myocardial tracer uptake by SPECT with sub-endocardial, sub-epicardial, and mid-segmental LS values with r = .514 P Multilayer strain analysis does not evaluate MV with more accuracy than standard segmental LS analysis. © 2018 Wiley Periodicals, Inc.

  2. Effects of smoking on myocardial injury in patients with conservatively treated acute myocardial infarction. A study with resting {sup 123}I-15-iodophenyl 3-methyl pentadecanoic acid/{sup 201}Tl myocardial single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yamagishi, Hiroyuki; Akioka, Kaname; Shirai, Naoya; Yoshiyama, Minoru; Teragaki, Masakazu; Takeuchi, Kazuhide; Yoshikawa, Junichi; Ochi, Hironobu [Osaka City Univ. (Japan). Graduate School of Medicine

    2001-09-01

    Many reports have demonstrated that smokers who have suffered an acute myocardial infarction (AMI) have a better prognosis than nonsmokers. The present study investigated the effects of current smoking on myocardial injury with resting {sup 123}I-15-iodophenyl 3-methyl pentadecanoic acid (BMIPP)/{sup 201}Tl myocardial single photon emission computed tomography in 103 patients with conservatively treated AMI. The left ventricular myocardium was divided into 9 segments and BMIPP and {sup 201}Tl defects were scored using a 5-point grading system (0=normal and 4=no uptake). The sum of the defect scores was defined as the total defect score. There was no significant difference in either the baseline severity of the coronary artery discase or the total defect scores for BMIPP and {sup 201}Tl between the current smoker and nonsmoker groups. The difference between the total defect scores for BMIPP and {sup 201}Tl tended to be larger in the current smoker group than in the nonsmoker group (2.0{+-}1.9 vs 1.3{+-}1.6, p=0.056). Forty-one (53%) of 77 patients in the current smoker group exhibited a BMIPP/{sup 201}Tl mismatch, whereas only 8 (31%) of 26 patients in the nonsmoker group did (p=0.047). In conclusion, current smokers had more likelihood of salvageable myocardium in areas at risk, as demonstrated by BMIPP/{sup 201}Tl mismatch, in AMI than nonsmokers. (author)

  3. Effects of smoking on myocardial injury in patients with conservatively treated acute myocardial infarction. A study with resting 123I-15-iodophenyl 3-methyl pentadecanoic acid/201Tl myocardial single photon emission computed tomography

    International Nuclear Information System (INIS)

    Yamagishi, Hiroyuki; Akioka, Kaname; Shirai, Naoya; Yoshiyama, Minoru; Teragaki, Masakazu; Takeuchi, Kazuhide; Yoshikawa, Junichi; Ochi, Hironobu

    2001-01-01

    Many reports have demonstrated that smokers who have suffered an acute myocardial infarction (AMI) have a better prognosis than nonsmokers. The present study investigated the effects of current smoking on myocardial injury with resting 123 I-15-iodophenyl 3-methyl pentadecanoic acid (BMIPP)/ 201 Tl myocardial single photon emission computed tomography in 103 patients with conservatively treated AMI. The left ventricular myocardium was divided into 9 segments and BMIPP and 201 Tl defects were scored using a 5-point grading system (0=normal and 4=no uptake). The sum of the defect scores was defined as the total defect score. There was no significant difference in either the baseline severity of the coronary artery discase or the total defect scores for BMIPP and 201 Tl between the current smoker and nonsmoker groups. The difference between the total defect scores for BMIPP and 201 Tl tended to be larger in the current smoker group than in the nonsmoker group (2.0±1.9 vs 1.3±1.6, p=0.056). Forty-one (53%) of 77 patients in the current smoker group exhibited a BMIPP/ 201 Tl mismatch, whereas only 8 (31%) of 26 patients in the nonsmoker group did (p=0.047). In conclusion, current smokers had more likelihood of salvageable myocardium in areas at risk, as demonstrated by BMIPP/ 201 Tl mismatch, in AMI than nonsmokers. (author)

  4. Prone versus supine thallium myocardial SPECT: A method to decrease artifactual inferior wall defects

    International Nuclear Information System (INIS)

    Segall, G.M.; Davis, M.J.

    1989-01-01

    Artifactual inferior wall defects as a result of diaphragmatic attenuation of activity are a frequent source of error in thallium myocardial single photon emission computed tomography (SPECT) studies. Thirty-four patients and 11 clinically normal volunteers were studied prospectively to see if specificity of inferior wall defects for right coronary artery disease could be improved by scanning patients prone versus supine. All individuals were scanned both prone and supine, in random order, following symptom limited treadmill exercise. Images were acquired at 3 degrees steps, 25 sec per frame, in a 180 degrees elliptical orbit always beginning in the 45 degrees right anterior oblique position relative to the patient. Polar maps generated from the short axis slices were used to calculate the average regional activity. The prone studies showed consistently higher inferior wall activity compared to the supine studies on both the exercise (182 +/- 22 vs. 160 +/- 23, p less than or equal to 0.001) and 4-hr delay studies (183 +/- 20 vs. 175 +/- 21, p less than or equal to 0.001). Prone imaging resulted in a significantly higher specificity for RCA disease compared to supine imaging (90% vs. 66%, p less than 0.05) with an improvement in accuracy from 71% to 82%. Sensitivity, specificity, and accuracy for left anterior descending and left circumflex artery disease were not significantly affected by patient position during imaging. All patients having SPECT thallium myocardial perfusion studies should be imaged prone to minimize artifactual inferior wall defects and improve accuracy

  5. Evaluation of a method to determine the myocardial uptake from 123I-BMIPP myocardial SPECT and its significance

    International Nuclear Information System (INIS)

    Iwase, Mikio; Toriyama, Takayuki; Itou, Masato; Shimao, Ryuichiro; Ikeda, Koshiro; Suzuki, Takeshi; Nobuta, Takaaki; Iida, Akihiko.

    1996-01-01

    We examined methods of calculating myocardial uptake (TU) of 123 I-BMIPP by SPECT, and compared TU to heart function (ejection fraction (EF), cardiac output (CO), cardiac index (CI)) calculated by left ventriculography. Forty-two patients with acute myocardial infarction were classified into 5 groups; within 1 week (I), from 1 to 2 weeks (II), from 2 weeks to 1.5 months (III), from 1.5 to 3 months (IV) and more than 3 months (V) after percutaneous transluminal coronary angioplasty (PTCA). Chest depth (Tw) was calculated by measuring the thoracic absorption rate of 123 I. In calculating TU, the myocardial count was calculated from short-axis tomograms, and then absorption was corrected using Tw to calculate each value on early-phase image (E) and delay-phase image (D). The influence of lung uptake on myocardial count was only 1.76%. When TU was compared to heart function, there were correlations between group I and group V. Especially in group VD-TU was a significantly correlated with heart function. In heart function CI, but not EF nor CO, was significantly correlated with TU. It was suggested that the correlation between TU and heart function reflected the infarct condition before PTCA in group I, and that the individual difference in recovery of fatty acid metabolism in group V. The significant correlation between D-TU and CI suggests that D-TU reflects heart function and fatty acid metabolism, although TU is influenced by differences in physical status. (author)

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  7. Cost-effectiveness of myocardial perfusion SPECT for diagnosis of coronary artery disease in Korea: comparison with exercise ECG and coronary angiography

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Kang, Keon Wook; Cheon, Gi Jeong; Jang, Myung Jin; Lee, Myoung Mook; Chung, June Key; Lee, Myung Chul

    2000-01-01

    Cost-effectiveness of myocardial SPECT for the diagnosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (ΔQALY) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases. Cost/ΔQALY was calculated and compared between four different tactics according to pre-test probability. When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective. Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system

  8. Comparative study of adenosine and exercise 201Tl myocardial perfusion tomographic imaging for detection of coronary heart disease

    International Nuclear Information System (INIS)

    Wang Xiong

    1997-01-01

    To compare diagnostic accuracy of adenosine and exercise 201 Tl myocardial perfusion tomographic imaging for detection of coronary heart disease (CHD) in patients with a normal rest ECG and no history of myocardial infarction, 81 patients with CHD and 10 normal control subjects underwent adenosine myocardial perfusion imaging, exercise nuclide myocardial perfusion imaging was performed in 117 patients with CHD and 16 normal control subjects, two groups also had coronary arteriography. Both exercise and adenosine testing parameters were analysed. It is shown: 1) The sensitivity and specificity for detection of CHD were 79% vs 80% for adenosine group and 81% vs 81% for exercise myocardial perfusion imaging group respectively. There was no significant difference in comparison with two matched groups (χ 2 = 1.13, χ 2 = 0.18, χ 2 = 0.12, P>0.05). 2) Side effects induced by adenosine accounted for 89% of patients, all symptoms were mild and disappeared quickly after the termination of the study except in 2 cases withdrawal of infusion needed because of severe angina pectoris. Adenosine myocardial perfusion imaging is a safe and sensitive method for detection of CHD. The diagnostic value of adenosine test is similar to that of exercise myocardial perfusion imaging and particularly useful in evaluating patients unable to perform exercise test or achieve adequate level of exercise

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-07-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

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

    International Nuclear Information System (INIS)

    Ritchie, J.L.; Trobaugh, G.B.; Hamilton, G.W.; Gould, K.L.; Narahara, K.A.; Murray, J.A.; Williams, D.L.

    1977-01-01

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

  14. SPECT myocardial blood flow quantitation toward clinical use: a comparative study with {sup 13}N-Ammonia PET myocardial blood flow quantitation

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Bailing [University of Missouri-Columbia, Nuclear Science and Engineering Institute, Columbia, Missouri (United States); Hu, Lien-Hsin; Yang, Bang-Hung; Ting, Chien-Hsin; Huang, Wen-Sheng [Taipei Veterans General Hospital, Department of Nuclear Medicine, Taipei (China); Chen, Lung-Ching [Shin Kong Wu-Ho Su Memorial Hospital, Division of Cardiology, Taipei (China); Chen, Yen-Kung [Shin Kong Wu-Ho Su Memorial Hospital, Department of Nuclear Medicine, Taipei (China); Hung, Guang-Uei [Chang Bing Show Chwan Memorial Hospital, Department of Nuclear Medicine, Changhua (China); Wu, Tao-Cheng [National Yang-Ming University, Cardiovascular Research Center, Taipei (China)

    2017-01-15

    The aim of this study was to evaluate the accuracy of myocardial blood flow (MBF) quantitation of {sup 99m}Tc-Sestamibi (MIBI) single photon emission computed tomography (SPECT) compared with {sup 13}N-Ammonia (NH3) position emission tomography (PET) on the same cohorts. Recent advances of SPECT technologies have been applied to develop MBF quantitation as a promising tool to diagnose coronary artery disease (CAD) for areas where PET MBF quantitation is not available. However, whether the SPECT approach can achieve the same level of accuracy as the PET approach for clinical use still needs further investigations. Twelve healthy volunteers (HVT) and 16 clinical patients with CAD received both MIBI SPECT and NH3 PET flow scans. Dynamic SPECT images acquired with high temporary resolution were fully corrected for physical factors and processed to quantify K1 using the standard compartmental modeling. Human MIBI tracer extraction fraction (EF) was determined by comparing MIBI K1 and NH3 flow on the HVT group and then used to convert flow values from K1 for all subjects. MIBI and NH3 flow values were systematically compared to validate the SPECT approach. The human MIBI EF was determined as [1.0-0.816*exp(-0.267/MBF)]. Global and regional MBF and myocardial flow reserve (MFR) of MIBI SPECT and NH3 PET were highly correlated for all subjects (global R{sup 2}: MBF = 0.92, MFR = 0.78; regional R{sup 2}: MBF ≥ 0.88, MFR ≥ 0.71). No significant differences for rest flow, stress flow, and MFR between these two approaches were observed (All p ≥ 0.088). Bland-Altman plots overall revealed small bias between MIBI SPECT and NH3 PET (global: ΔMBF = -0.03Lml/min/g, ΔMFR = 0.07; regional: ΔMBF = -0.07 - 0.06, ΔMFR = -0.02 - 0.22). Quantitation with SPECT technologies can be accurate to measure myocardial blood flow as PET quantitation while comprehensive imaging factors of SPECT to derive the variability between these two approaches were fully addressed and corrected

  15. SPECT myocardial blood flow quantitation toward clinical use: a comparative study with "1"3N-Ammonia PET myocardial blood flow quantitation

    International Nuclear Information System (INIS)

    Hsu, Bailing; Hu, Lien-Hsin; Yang, Bang-Hung; Ting, Chien-Hsin; Huang, Wen-Sheng; Chen, Lung-Ching; Chen, Yen-Kung; Hung, Guang-Uei; Wu, Tao-Cheng

    2017-01-01

    The aim of this study was to evaluate the accuracy of myocardial blood flow (MBF) quantitation of "9"9"mTc-Sestamibi (MIBI) single photon emission computed tomography (SPECT) compared with "1"3N-Ammonia (NH3) position emission tomography (PET) on the same cohorts. Recent advances of SPECT technologies have been applied to develop MBF quantitation as a promising tool to diagnose coronary artery disease (CAD) for areas where PET MBF quantitation is not available. However, whether the SPECT approach can achieve the same level of accuracy as the PET approach for clinical use still needs further investigations. Twelve healthy volunteers (HVT) and 16 clinical patients with CAD received both MIBI SPECT and NH3 PET flow scans. Dynamic SPECT images acquired with high temporary resolution were fully corrected for physical factors and processed to quantify K1 using the standard compartmental modeling. Human MIBI tracer extraction fraction (EF) was determined by comparing MIBI K1 and NH3 flow on the HVT group and then used to convert flow values from K1 for all subjects. MIBI and NH3 flow values were systematically compared to validate the SPECT approach. The human MIBI EF was determined as [1.0-0.816*exp(-0.267/MBF)]. Global and regional MBF and myocardial flow reserve (MFR) of MIBI SPECT and NH3 PET were highly correlated for all subjects (global R"2: MBF = 0.92, MFR = 0.78; regional R"2: MBF ≥ 0.88, MFR ≥ 0.71). No significant differences for rest flow, stress flow, and MFR between these two approaches were observed (All p ≥ 0.088). Bland-Altman plots overall revealed small bias between MIBI SPECT and NH3 PET (global: ΔMBF = -0.03Lml/min/g, ΔMFR = 0.07; regional: ΔMBF = -0.07 - 0.06, ΔMFR = -0.02 - 0.22). Quantitation with SPECT technologies can be accurate to measure myocardial blood flow as PET quantitation while comprehensive imaging factors of SPECT to derive the variability between these two approaches were fully addressed and corrected. (orig.)

  16. Diagnostic value of myocardial perfusion SPECT in the prediction of restenosis after coronary artery bypass graft surgery

    International Nuclear Information System (INIS)

    Paeng, J. C.; Lee, D. S.; Kang, W. J.; Kim, K. B.; Chung, J. K.; Lee, M. C.

    2002-01-01

    Myocardial SPECT has been reported to be sensitive in the detection of restenosis after revascularization. However, the diagnostic value is not well established in bypass graft surgery (CABG), due to significant influences of characteristics of graft vessels and the time interval between CABG and the SPECT. In this study, we evaluated the diagnostic value of myocardial SPECT for the restenosis after CABG. A total of 160 patients with coronary artery disease (M:F=118:42, 60±8 yr) who had undergone CABG were included. Rest T1-201/ dipyridamole stress Tc-99m-MIBI SPECT was performed 3 months (103±16 days) after CABG. Segmental perfusion was quantified using a 20-segment model, and segments of reversible perfusion defect (REV) were defined. Follow-up coronary angiography was performed 1 year (397±104 days) after CABG. The segments of REV were compared between arterial and venous graft groups. And the diagnostic power of 3-month SPECT was evaluated for the prediction of restenosis. On the 3-month SPECT, 620 segments showed REV. The segments of REV were 37% of artery-grafted segments and 36% of vein-grafted segments (p=n.s.). On 1-year coronary angiography, 113 graft vessels (28%) showed restenosis. The overall sensitivity and specificity of REV on 3-month SPECT for the prediction of restenosis were 46% and 67%, respectively, but 52% and 68%, in artery-graft group. REV detected on 3-month SPECT has a predictive value, especially, high specificity for the prediction of restenosis after CABG, which was more definite in artery-graft group

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

    OpenAIRE

    TURHAL, Özgül; TUTUŞ, Ahmet; KULA, Mustafa

    2018-01-01

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

  18. Model-supported interpretation of Cedars-Sinai '201 Tl SPECT polar maps

    International Nuclear Information System (INIS)

    Petta, P.

    1994-10-01

    Cardiac scintigraphic imaging yields information about regional heart muscle perfusion distribution. The scintigraphic technique does not directly depict the coronary arteries. Inferring alterations of the supplying vessels from the characteristics of abnormally perfused areas of the myocardium is the difficult task in the interpretation of these image data. We investigate ways of applying model-based techniques to this end. Encoding of a model of myocardial perfusion as background knowledge supplied to a first-order inductive learner yielded classifiers capable of identifying presence of coronary artery disease down to the level of determination of affected vessels with an accuracy comparable to other diagnostic systems for this domain. We also identified criteria setting a limit to the performance obtainable by any single approach, such as machine learning or probabilistic techniques. This led to the realization of a model-supported diagnostic system, integrating an abductive perfusion model with heuristics embodying other domain knowledge, such as common variations of vessel anatomy and information related to the image-delivering process, including typical image artefacts. This system achieves excellent accuracy in the identification of diseased vessels and is additionally capable of locating stenosed vessel segments of affected arteries with satisfactory precision. (author)

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

    International Nuclear Information System (INIS)

    Fukushi, Shoji; Teraoka, Satomi.

    1997-01-01

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

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

    International Nuclear Information System (INIS)

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

    1982-01-01

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

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

    Science.gov (United States)

    Tanaka, R; Nakamura, T

    2001-09-01

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

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  3. Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and99mTc-tetrofosmin: Method and validation

    OpenAIRE

    Shrestha, U; Sciammarella, M; Alhassen, F; Yeghiazarians, Y; Ellin, J; Verdin, E; Boyle, A; Seo, Y; Botvinick, EH; Gullberg, GT

    2017-01-01

    © 2015, American Society of Nuclear Cardiology. Background: The objective of this study was to measure myocardial blood flow (MBF) in humans using 99m Tc-tetrofosmin and dynamic single-photon emission computed tomography (SPECT). Methods: Dynamic SPECT using 99m Tc-tetrofosmin and dynamic positron emission tomography (PET) was performed on a group of 16 patients. The SPECT data were reconstructed using a 4D-spatiotemporal iterative reconstruction method. The data corresponding to 9 patients w...

  4. Chocolate intake may reduce liver count in 99m-Tc-tetrofosmin myocardial SPECT

    International Nuclear Information System (INIS)

    Tsunekawa, Akikazu; Yasuda, Eisuke; Okuda, Seiji

    2005-01-01

    The accumulation of 99m-Tc-Tetrofosmin (TF) in the liver and intestine may often interfere the image quality of myocardial TF SPECT. Although milk intake before acquisition is recommended to reduce its accumulation by enhancing biliary excretion of TF, some patients cannot accept milk. To elucidate the efficacy of chocolate intake as a substitute for milk, we investigated 72 patients with coronary heart disease who underwent TF SPECT (stress imaging; n=36, rest imaging; n=36). Following injection of TF, the patients were randomly treated either with milk (n=24), or chocolate (n=24). The images were acquired before treatment, at 15 min, at 30 min, and 45 min after treatment. The ratio of liver to heart count (LHR) was calculated and was compared between the two groups. LHR in the stress imaging was not significantly different between the milk-treated and chocolate-treated groups: 1.86 vs 1.87 before treatment, 1.39 vs 1.39 at 30 min, and 1.02 vs 1.03 at 45 min. LHR in the rest imaging was also the same between the two groups: 1.43 vs 1.42 before treatment, 1.22 vs 1.21 at 15 min, and 0.95 vs. 0.95 at 30 min. Chocolate intake may be equally effective to milk intake in reducing the liver accumulation of TF. (author)

  5. Evaluation of attenuation correction, scatter correction and resolution recovery in myocardial Tc-99m MIBI SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Larcos, G.; Hutton, B.F.; Farlow, D.C.; Campbell- Rodgers, N.; Gruenewald, S.M.; Lau, Y.H. [Westmead Hospital, Westmead, Sydney, NSW (Australia). Departments of Nuclear Medicine and Ultrasound and Medical Physics

    1998-06-01

    Full text: The introduction of transmission based attenuation correction (AC) has increased the diagnostic accuracy of Tc-99m MIBI myocardial perfusion SPECT. The aim of this study is to evaluate recent developments, including scatter correction (SC) and resolution recovery (RR). We reviewed 13 patients who underwent Tc-99m MIBI SPECT (two day protocol) and coronary angiography and 4 manufacturer supplied studies assigned a low pretest likelihood of coronary artery disease (CAD). Patients had a mean age of 59 years (range: 41-78). Data were reconstructed using filtered backprojection (FBP; method 1), maximum likelihood (ML) incorporating AC (method 2), ADAC software using sinogram based SC+RR followed by ML with AC (method 3) and ordered subset ML incorporating AC,SC and RR (method 4). Images were reported by two of three blinded experienced physicians using a standard semiquantitative scoring scheme. Fixed or reversible perfusion defects were considered abnormal; CAD was considered present with stenoses > 50%. Patients had normal coronary anatomy (n=9), single (n=4) or two vessel CAD (n=4) (four in each of LAD, RCA and LCX). There were no statistically significant differences for any combination. Normalcy rate = 100% for all methods. Physicians graded 3/17 (methods 2,4) and 1/17 (method 3) images as fair or poor in quality. Thus, AC or AC+SC+RR produce good quality images in most patients; there is potential for improvement in sensitivity over standard FBP with no significant change in normalcy or specificity

  6. SPECT myocardial perfusion versus fractional flow reserve for evaluation of functional ischemia: A meta analysis

    International Nuclear Information System (INIS)

    Zhou, Tao; Yang, Lin-feng; Zhai, Ji-liang; Li, Jiang; Wang, Qi-meng; Zhang, Rui-jie; Wang, Sen; Peng, Zhao-hui; Li, Min; Sun, Gang

    2014-01-01

    Purpose: The present meta-analysis illustrates the accuracy of myocardial perfusion SPECT (MPS) to diagnose functional stenotic coronary artery disease (CAD) with fractional flow reserve (FFR) as standard reference. Methods: All investigators screened and selected studies that compared MPS with FFR in symptomatic patients with suspected CAD. Patients and study characteristics were independently extracted by two investigators; differences were resolved by consensus. Results: 13 articles, including 1,017 patients, 699 vessels were included in the study. No significant publication bias was detected (P = 0.65). At the patient level, the summary sensitivity and specificity were 77% (95% confidence interval [CI], 70–83%) and 77% (95%CI, 67–84%) for MPS. Vessel-level pooled sensitivity was 66% (95%CI, 57–74%) and specificity was 81% (95%CI, 70–89%). The overall diagnostic performance of MPS was moderate. [The area under the summary receiver operating characteristic (sROC) curve was 0.83]. No study influenced the pooled results larger than 0.03. Conclusions: The accuracy between FFR and MPS SPECT was moderate

  7. SPECT myocardial perfusion versus fractional flow reserve for evaluation of functional ischemia: A meta analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Tao; Yang, Lin-feng [Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031 (China); Zhai, Ji-liang [Department of Medical Imaging, The Branch of TaiAn Central Hospital, Middle of Changcheng Road, Shandong Province, China. 271000 (China); Li, Jiang [Department of Medical Imaging, Affiliated Hospital of Taishan Medical University, No, 706, Taishan Road, Shandong Province, China. 271000 (China); Wang, Qi-meng [Department of Medical Imaging, Taishan Hospital of Traditional Chinese Medicine, No, 216, Yingxuan Street, Shandong Province, China. 271000. (China); Zhang, Rui-jie; Wang, Sen; Peng, Zhao-hui [Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031 (China); Li, Min, E-mail: liminyingxiang@163.com [Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031 (China); Sun, Gang, E-mail: cjr.sungang@vip.163.com [Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031 (China)

    2014-06-15

    Purpose: The present meta-analysis illustrates the accuracy of myocardial perfusion SPECT (MPS) to diagnose functional stenotic coronary artery disease (CAD) with fractional flow reserve (FFR) as standard reference. Methods: All investigators screened and selected studies that compared MPS with FFR in symptomatic patients with suspected CAD. Patients and study characteristics were independently extracted by two investigators; differences were resolved by consensus. Results: 13 articles, including 1,017 patients, 699 vessels were included in the study. No significant publication bias was detected (P = 0.65). At the patient level, the summary sensitivity and specificity were 77% (95% confidence interval [CI], 70–83%) and 77% (95%CI, 67–84%) for MPS. Vessel-level pooled sensitivity was 66% (95%CI, 57–74%) and specificity was 81% (95%CI, 70–89%). The overall diagnostic performance of MPS was moderate. [The area under the summary receiver operating characteristic (sROC) curve was 0.83]. No study influenced the pooled results larger than 0.03. Conclusions: The accuracy between FFR and MPS SPECT was moderate.

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

    Science.gov (United States)

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

    2011-09-01

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

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

    International Nuclear Information System (INIS)

    Massie, B.M.; Wisneski, J.; Kramer, B.; Hollenberg, M.; Gertz, E.; Stern, D.

    1982-01-01

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

  10. Added Value of 3D Cardiac SPECT/CTA Fusion Imaging in Patients with Reversible Perfusion Defect on Myocardial Perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eun Jung; Cho, Ihn Ho [Yeungnam University Hospital, Daegu (Korea, Republic of); Kang, Won Jun [Yonsei University Hospital, Seoul (Korea, Republic of); Kim, Seong Min [Chungnam National University Medical School and Hospital, Daejeon (Korea, Republic of); Won, Kyoung Sook [Keomyung University Dongsan Hospital, Daegu (Korea, Republic of); Lim, Seok Tae [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of); Hwang, Kyung Hoon [Gachon University Gil Hospital, Incheon (Korea, Republic of); Lee, Byeong Il; Bom, Hee Seung [Chonnam National University Medical School and Hospital, Gwangju (Korea, Republic of)

    2009-12-15

    Integration of the functional information of myocardial perfusion SPECT (MPS) and the morphoanatomical information of coronary CT angiography (CTA) may provide useful additional diagnostic information of the spatial relationship between perfusion defects and coronary stenosis. We studied to know the added value of three dimensional cardiac SPECT/CTA fusion imaging (fusion image) by comparing between fusion image and MPS. Forty-eight patients (M:F=26:22, Age: 63.3{+-}10.4 years) with a reversible perfusion defect on MPS (adenosine stress/rest SPECT with Tc-99m sestamibi or tetrofosmin) and CTA were included. Fusion images were molded and compared with the findings from the MPS. Invasive coronary angiography served as a reference standard for fusion image and MPS. Total 144 coronary arteries in 48 patients were analyzed; Fusion image yielded the sensitivity, specificity, negative and positive predictive value for the detection of hemodynamically significant stenosis per coronary artery 82.5%, 79.3%, 76.7% and 84.6%, respectively. Respective values for the MPS were 68.8%, 70.7%, 62.1% and 76.4%. And fusion image also could detect more multi-vessel disease. Fused three dimensional volume-rendered SPECT/CTA imaging provides intuitive convincing information about hemodynamic relevant lesion and could improved diagnostic accuracy.

  11. Myocardial perfusion and left ventricular function during exercise evaluated by 201Tl myocardial scintigraphy and 99mTc radionuclide ventriculography in patients treated with PTCA

    International Nuclear Information System (INIS)

    Honda, Toshio; Jo, Tadafumi; Doiuchi, Junji

    1992-01-01

    To evaluate the effects of percutaneous transluminal coronary angioplasty (PTCA), we investigated myocardial ischemia and left ventricular function during exercise before and after successful PTCA in 30 patients. We used extent and severity scores of 201 thallium ( 201 Tl) exercise myocardial scintigraphy to assess myocardial ischemia and determined global and regional left ventricular ejection fraction (EF and REF) of 99m Tc-RBC exercise radionuclide ventriculography to assess left ventricular function. The extent and severity scores of stress images were significantly less after PTCA than before PTCA. The scores of the redistribution images were unchanged before and after PTCA. Global EF during exercise was significantly higher after PTCA than before PTCA. There was no difference in resting global EF between before and after PTCA. Myocardial ischemia induced by exercise was semi-quantitatively analyzed as transient perfusion defect with severity score. Severity score was significantly less after PTCA than before PTCA. ΔEF, which was obtained by subtraction of resting global EF from exercise one, was significantly higher after PTCA than before PTCA. However, the degree of improvement in myocardial ischemia and left ventricular function varied from patient to patient. In 17 patients with one-vessel left anterior descending artery disease, ΔREF, which was determined by subtracting resting regional EF from exercise one, was significantly higher in septal and apical segments after PTCA than before PTCA. Myocardial ischemia and left ventricular function under exercise were alleviated by PTCA. However, the degree of improvement varied from patient to patient and it might have been affected by various factors including coronary dissection, edema, thrombus, restenosis, spasm, side branch stenosis or occlusion, distal thrombus, and myocardial hibernation. (author)

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2018-04-15

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

  14. Utility of the combination of DAT SPECT and MIBG myocardial scintigraphy in differentiating dementia with Lewy bodies from Alzheimer's disease

    International Nuclear Information System (INIS)

    Shimizu, Soichiro; Hirao, Kentaro; Kanetaka, Hidekazu; Namioka, Nayuta; Hatanaka, Hirokuni; Hirose, Daisuke; Fukasawa, Raita; Umahara, Takahiko; Sakurai, Hirohumi; Hanyu, Haruo

    2016-01-01

    123 I-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane ( 123 I-FP-CIT) dopamine transporter single photon emission computed tomography (DAT SPECT) and 123 I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy can be used to assist in the diagnosis of patients with dementia with Lewy bodies (DLB). We compared the diagnostic value of these two methods in differentiating DLB from Alzheimer's disease (AD). Furthermore, we evaluated whether a combination of DAT SPECT and MIBG myocardial scintigraphy would provide a more useful means of differentiating between DLB and AD. Patients with AD (n = 57) and patients with DLB (n = 76) who underwent both DAT SPECT and MIBG myocardial scintigraphy were enrolled. The sensitivity, specificity, and accuracy of both methods as well as their combination for differentiating DLB from AD were calculated. Moreover, we examined whether symptoms of the patients with DLB were associated with the patterns of the abnormalities displayed on DAT SPECT and MIBG myocardial scintigraphy. The sensitivity and specificity of differentiating DLB from AD were 72.4 and 94.4 % by the heart to mediastinum ratio of MIBG uptake, 88.2 and 88.9 % by the specific binding ratio on DAT SPECT, and 96.1 and 90.7 % by their combination, respectively. The combined use of DAT SPECT and MIBG myocardial scintigraphy enabled more accurate differentiation between DLB and AD compared with either DAT SPECT or MIBG myocardial scintigraphy alone. There was a significantly higher frequency of parkinsonism in the abnormal DAT SPECT group than the normal DAT SPECT group. On the other hand, there was a higher frequency of the appearance of rapid eye movement (REM) sleep behavior disorder in the abnormal MIBG uptake group than the normal MIBG uptake group. These results suggested that using a combination of these scintigraphic methods is a useful and practical approach to differentiate DLB from AD. (orig.)

  15. Utility of the combination of DAT SPECT and MIBG myocardial scintigraphy in differentiating dementia with Lewy bodies from Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, Soichiro; Hirao, Kentaro; Kanetaka, Hidekazu; Namioka, Nayuta; Hatanaka, Hirokuni; Hirose, Daisuke; Fukasawa, Raita; Umahara, Takahiko; Sakurai, Hirohumi; Hanyu, Haruo [Tokyo Medical University, Department of Geriatric Medicine, Shinjuku-ku, Tokyo (Japan)

    2016-01-15

    {sup 123}I-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane ({sup 123}I-FP-CIT) dopamine transporter single photon emission computed tomography (DAT SPECT) and {sup 123}I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy can be used to assist in the diagnosis of patients with dementia with Lewy bodies (DLB). We compared the diagnostic value of these two methods in differentiating DLB from Alzheimer's disease (AD). Furthermore, we evaluated whether a combination of DAT SPECT and MIBG myocardial scintigraphy would provide a more useful means of differentiating between DLB and AD. Patients with AD (n = 57) and patients with DLB (n = 76) who underwent both DAT SPECT and MIBG myocardial scintigraphy were enrolled. The sensitivity, specificity, and accuracy of both methods as well as their combination for differentiating DLB from AD were calculated. Moreover, we examined whether symptoms of the patients with DLB were associated with the patterns of the abnormalities displayed on DAT SPECT and MIBG myocardial scintigraphy. The sensitivity and specificity of differentiating DLB from AD were 72.4 and 94.4 % by the heart to mediastinum ratio of MIBG uptake, 88.2 and 88.9 % by the specific binding ratio on DAT SPECT, and 96.1 and 90.7 % by their combination, respectively. The combined use of DAT SPECT and MIBG myocardial scintigraphy enabled more accurate differentiation between DLB and AD compared with either DAT SPECT or MIBG myocardial scintigraphy alone. There was a significantly higher frequency of parkinsonism in the abnormal DAT SPECT group than the normal DAT SPECT group. On the other hand, there was a higher frequency of the appearance of rapid eye movement (REM) sleep behavior disorder in the abnormal MIBG uptake group than the normal MIBG uptake group. These results suggested that using a combination of these scintigraphic methods is a useful and practical approach to differentiate DLB from AD. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-11-01

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

  17. 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

  18. Comparison of multi-slice CT (MSCT) and TI-201 myocardial SPECT in detection of coronary artery disease: relation to coronary arteriography

    Energy Technology Data Exchange (ETDEWEB)

    Pai, M. S.; Kim, Y. K.; Shim, S. S. [College of Medicine, Univ. of Ewha Womens, Seoul (Korea, Republic of)

    2003-07-01

    To evaluate the diagnostic potentials of MSCT and TI-201 SPECT in the assessment of coronary artery disease. Twenty-four patients (15 men, 9 women, 42-79 years) with clinically suspected coronary artery disease were studied by TI-201 myocardial SPECT and MSCT. MSCT data were obtained with 12 x 0.75 mm, 420ms rotation, multi-slice CT scanner (SOMATOM Sensation, Siemens) using non-ionic contrast, 80ml, 4ml/sec. Multiplanar reconstruction techniques were used for evaluation of coronary arteries. TI-201 myocardial SPECT were performed at stress with adenosine and at rest. Data from MSCT and TI-201 SPECT were compared territory by territory (divided into two segments; LAD and RCA/LCx) and related to coronary arteriography, in which more than 60% stenoses are regarded as significant. MSCT and TI-201 SPECT showed agreement in 37 out of 48 segments (77.1%). Out of 11 disagreed segments (22.9), TI-201 SPECT was superior in 6 segments and MSCT was superior in 5 segments. Sensitivities and specificities of MSCT and TI-201 SPECT by coronary arteriography are 81.8%, 69.2% and 86.3%, 76.9%, respectively. Agreed 4 segments between MSCT and TI-201 SPECT exhibited results that differ from the results of coronary arteriography. Myocardial bridge in two cases were detected as significant stenoses by MSCT but showed normal perfusion in TI-201 SPECT. Agreement between MSCT and TI-201 SPECT in the assessment of coronary artery disease was good but TI-201 SPECT has higher sensitivity and specificity for the detection of jeopardized myocardium than MSCT. MSCT and TI-201 SPECT provide complementary information in the assessment of coronary artery disease and could help reduce probable mistake in the interpretation of hemo dynamically insignificant lesion in coronary arteriography.

  19. Vestibularis-schwannomers diagnostik og vaekst bedømt ved SPECT kombineret med TL-201 Thallium

    DEFF Research Database (Denmark)

    Charabi, S; Lassen, N A; Jacobsen, G K

    1999-01-01

    The value of SPECT scanning in diagnosis and growth potential of vestibular schwannoma (VS) was investigated in a series of 29 patients. SPECT demonstrated all tumours > 0.8 cm3, but had limitations as a diagnostic modality of small intracanalicular tumours, when compared to gadolinium DTPA...

  20. Two dimensional polar display of cardiac blood pool SPECT

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  1. SPECT myocardial perfusion imaging. Long-term prognostic value in diabetic patients with and without coronary artery disease

    International Nuclear Information System (INIS)

    Koehli, M.; Monbaron, D.; Gaillard, R.C.; Ruiz, J.; Prior, J.O.; Bischof Delaloye, A.; Calcagni, M.L.; Fivaz-Arbane, M.; Stauffer, J.C.

    2006-01-01

    Aim: To determine the long-term prognostic value of SPECT myocardial perfusion imaging (MPI) for the occurrence of cardiovascular events in diabetic patients. Patients, methods: SPECT MPI of 210 consecutive Caucasian diabetic patients were analysed using Kaplan-Meier event-free survival curve and independent predictors were determined by Cox multivariate analyses. Results: Follow-up was complete in 200 (95%) patients with a median period of 3.0 years (0.8-5.0). The population was composed of 114 (57%) men, age 65 ± 10 years, 181 (90.5%) type 2 diabetes mellitus, 50 (25%) with a history of coronary artery disease (CAD) and 98 (49%) presenting chest pain prior to MPI. The prevalence of abnormal MPI was 58%. Patients with a normal MPI had neither cardiac death, nor myocardial infarction, independently of a history of coronary artery disease or chest pain. Among the independent predictors of cardiac death and myocardial infarction, the strongest was abnormal MPI (p 5-fold increase in cardiovascular events. This emphasizes the value of SPECT MPI in predicting and risk-stratifying cardiovascular events in diabetic patients. (orig.)

  2. Clinical implications of increased lung uptake of 201Tl during exercise scintigraphy 2 weeks after myocardial infarction

    International Nuclear Information System (INIS)

    Gibson, R.S.; Watson, D.D.; Carabello, B.A.; Holt, N.D.; Beller, G.A.

    1982-01-01

    To determine the prevalence and clinical significance of increased lung 201 Tl uptake during submaximal exercise myocardial scintigraphy performed 2 weeks after acute myocardial infarction, 61 patients underwent submaximal exercise testing (target heart rate, 120 beats/min), multigated blood pool imaging at rest and coronary angiography before hospital discharge. Thallium lung uptake on the initial anterior projection image was graded qualitatively by comparing the intensity of 201 Tl activity in the lungs with that in the mediastinum. In 39 patients (64 percent), it was normal (equal to mediastinal activity) and in 22 (36 percent), it was increased (greater than mediastinal activity). Compared with patients with normal lung uptake, those with increased uptake had a greater prevalence of prior infarction (13 versus 36 percent, probability [p] less than 0.05), less global cardiac reserve as assessed by the four level New York Heart Association classification (p less than 0.05), more advanced Killip class in the coronary care unit (p less than 0.05), a higher Norris coronary prognostic index (2.6 +/- 1.9 versus 4.6 +/- 2.3 [mean +/- standard deviation], p less than 0.01), failure to achieve the target heart rate because of dyspnea, fatigue or angina (36 versus 86 percent, p less than 0.01), a greater prevalence of exercise-induced S-T segment depression (18 versus 45 percent, p less than 0.05), a greater number of anterior 201 Tl myocardial defects (p less than 0.05); a lower radionuclide ejection fraction at rest (50.4 +/- 6.1 versus 39.6 +/- 9.3 percent, p less than 0.01) and a greater number of asynergic left ventricular segments (p less than 0.05). Thus, the occurrence of increased lung 201 Tl uptake during submaximal exercise scintigraphy in the early postinfarction period is frequent and appears to be a marker of severe and functionally more important coronary artery disease associated with left ventricular dysfunction

  3. Utility of the premature cocked in SPECT of myocardial perfusion with technetium and artery-dilators. Inherent problems and analysis of local preliminary experience

    International Nuclear Information System (INIS)

    Gutierrez, Daniela; Massardo, Teresa; Jaimovich, Rodrigo; Anzoategui, Wilfredo; Guzman, Alfonso; Lavados, Hugo; Alliende, Isabel

    2007-01-01

    Using myocardial perfusion studies, severe coronary artery disease (CAD) with left ventricular dysfunction could be observed through transient cavity dilation and radiopharmaceutical lung uptake increase, described initially with stress 201 Tl. Dipyridamole (DIP) induced ischemia also can diminish systolic function. Delayed post stress left ventricular ejection fraction (FEVI) may not be able to detect this phenomena, depending on the acquisition timing. There are diverse reports and results in this issue. Goal: Evaluate the correlation between left ventricular parameters and ischemia presence in early gated DIP tomography in patients referred for CAD evaluation along to review the new protocol difficulties.Methods: From 158 patients evaluated initially, 31% presenting extra-cardiac activity were excluded due to interference with automatic edge detection. The analyzed group included 109 subjects between 33 and 91 years, mean age 64.3 ± 11.7; 52% women. Thirty of them were known CAD patients; 18 with myocardial infarction and 31 with ischemia in perfusion images. 99m Tc-Sestamibi SPECT was carried out during the 60 min post DIP infusion, using 1 day protocol. Cedars QGS QPS Programs were used to measure LVEF and left ventricular volumes. Diastolic transient ischemic dilation (TID) calculation was performed as well as lung/heart index (LHR). Results: The mean time lapse between DIP injection and acquisition was 27 min (range: 18-43 min). There was not significant difference between DIP and rest LVEF (66.55±17.33% vs 67.58±18.41%) LVEF delta was 1.03±6.72%. There was not correlation observed between measured functional parameters and presence of ischemia, infarction or known CAD. There was clear difference in left ventricular volumes in patients with and without CAD and known myocardial infarction. Conclusion: Nor association between LHR, LVEF delta or TID and ischemia was demonstrated in early post DIP SPECT acquisition using Sestamibi. In addition, significant

  4. Clinical efficacy of 99mTc-tetrofosmin myocardial scintigraphy

    International Nuclear Information System (INIS)

    Adachi, Itaru; Sugioka, Yasushi; Tanaka, Yasunori

    1993-01-01

    99m Tc-tetrofosmin is a lipophilic, cationic diphosphine which has been developed for myocardial imaging. We examined 9 patients with ischemic heart disease including 3 angina pectoris (AP), 4 old myocardial infarction (OMI), 1 AP with OMI and 1 syndrome X. One patient was examined before and after operation. Three hundred seventy MBq of 99m Tc-tetrofosmin was injected during exercise and 740 MBq at rest. And 74 MBq of 201 Tl myocardial exercise and redistribution scintigraphy was also performed to compare with 99m Tc-tetrofosmin myocardial scintigraphy. SPECT, multiple gated SPECT and anterior planar images were obtained in all cases. We calculated percent wall thickening (%WT) using multiple gated SPECT images. There was a decreased lung uptake in 99m Tc-tetrofosmin planar images compared to 201 Tl myocardial scintigraphy. Liver and Biliary system uptake in 99m Tc-tetrofosmin images was decreased with intake of milk. Segmental comparison of SPECT images showed an agreement in 9/10 of the segment between 201 Tl and 99m Tc-tetrofosmin. We could obtain excellent quality of multiple gated SPECT images in all patients. We could calculate percent wall thickening (%WT) in all patients. We conclude that 99m Tc-tetrofosmin myocardial scintigraphy should provide usefulness for detection of ischemic myocardium as same as 201 Tl myocardial scintigraphy, although the biologic characteristics of two agents were different. These data and excellent quality of multiple gated SPECT images suggest that 99m Tc-tetrofosmin is a new 99m Tc agent for evaluation of patients with ischemic heart disease. (author)

  5. Reduction of the influence of the liver uptake to the myocardial uptake on technetium-99m myocardial SPECT. Usefulness and problems of a mask processing method

    Energy Technology Data Exchange (ETDEWEB)

    Takaki, Akihiro; Okada, Kazuhiro; Urata, Johji; Matsuda, Hirofumi; Takao, Yuji [Saiseikai Kumamoto Hospital (Japan)

    1999-07-01

    The aim of this study is to evaluate the usefulness of a mask processing method for obtaining the true myocardial tracer distribution by eliminating the influence of the liver uptake to the myocardial uptake on myocardial SPECT images by using technetium-99m ({sup 99m}Tc) blood flow agents. A SPECT imaging was performed with a two-head SPECT system (GCA-7200A/DI) in both phantom and clinical studies. The mask processing method was applied to the reconstructed and projection images. The phantom consisted of heart, lung, liver and spine. A defect was located in the inferior wall of the left ventricle and other parts of the heart and liver were filled with {sup 99m}Tc solution. For clinical study 10 patients with difficulty in the interpretation of the inferior wall were selected for the evaluation of usefulness of the mask method. In the phantom study, the mask processing method applied to the reconstructed images was able to remove the overlapped liver from the heart, but was not able to remove the influence of the liver uptake to the myocardial uptake. Nevertheless, the mask processing method applied to the projection images successfully eliminated not only the overlapped liver but also the influence of the liver uptake to the myocardial uptake. In the clinical study, the liver uptake could be removed from the uptake in the inferior wall in 8 of 10 patients with the mask processing methods. In 2 patients, the overlapped liver uptake could not be eliminated from the uptake in the inferior wall because the distance between the liver and heart was too short. The mask processing method applied to the projection images was thought to be superior to that applied to the reconstruction images in both phantom and clinical studies. The mask processing method, especially applied to the projection images, seems to be useful for the elimination of the liver uptake from the inferior wall of the myocardium on myocardial SPECT images using {sup 99m}Tc blood flow agents. (author)

  6. Reduction of the influence of the liver uptake to the myocardial uptake on technetium-99m myocardial SPECT. Usefulness and problems of a mask processing method

    International Nuclear Information System (INIS)

    Takaki, Akihiro; Okada, Kazuhiro; Urata, Johji; Matsuda, Hirofumi; Takao, Yuji

    1999-01-01

    The aim of this study is to evaluate the usefulness of a mask processing method for obtaining the true myocardial tracer distribution by eliminating the influence of the liver uptake to the myocardial uptake on myocardial SPECT images by using technetium-99m ( 99m Tc) blood flow agents. A SPECT imaging was performed with a two-head SPECT system (GCA-7200A/DI) in both phantom and clinical studies. The mask processing method was applied to the reconstructed and projection images. The phantom consisted of heart, lung, liver and spine. A defect was located in the inferior wall of the left ventricle and other parts of the heart and liver were filled with 99m Tc solution. For clinical study 10 patients with difficulty in the interpretation of the inferior wall were selected for the evaluation of usefulness of the mask method. In the phantom study, the mask processing method applied to the reconstructed images was able to remove the overlapped liver from the heart, but was not able to remove the influence of the liver uptake to the myocardial uptake. Nevertheless, the mask processing method applied to the projection images successfully eliminated not only the overlapped liver but also the influence of the liver uptake to the myocardial uptake. In the clinical study, the liver uptake could be removed from the uptake in the inferior wall in 8 of 10 patients with the mask processing methods. In 2 patients, the overlapped liver uptake could not be eliminated from the uptake in the inferior wall because the distance between the liver and heart was too short. The mask processing method applied to the projection images was thought to be superior to that applied to the reconstruction images in both phantom and clinical studies. The mask processing method, especially applied to the projection images, seems to be useful for the elimination of the liver uptake from the inferior wall of the myocardium on myocardial SPECT images using 99m Tc blood flow agents. (author)

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

    NARCIS (Netherlands)

    Hijnen, N.M.; Vries, de A.; Blange, R.; Burdinski, D.; Grüll, H.

    2010-01-01

    Introduction The aim of this study was to assess the use of 201thallium3+ (201Tl3+) as a radiolabel for nuclear imaging tracers. Methods for labeling of 1,4,7,10-tetraazacyclododecane-N,N',N¿,N'¿ tetraacetic acid (DOTA) and diethylenetriaminepentaacetic acid (DTPA) chelators with 201Tl3+ were

  8. 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

  9. Characteristic findings of exercise ECG test, perfusion SPECT and coronary angiography in patients with exercise induced myocardial stunning

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Byeong Cheol; Seo, Ji Hyoung; Bae, Jin Ho; Jeong, Shin Young; Park, Hun Sik; Lee, Jae Tae; Chae, Shung Chull; Lee, Kyu Bo [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2004-06-01

    Transient wall motion abnormality and contractile dysfunction of the left ventricle (LV) can be observed in patients with coronary artery disease due to post-stress myocardial stunning. To understand clinical characteristics of stress induced LV dysfunction, we have compared the findings of exercise stress test, myocardial perfusion SPECT and coronary angiography between subjects with and without post-stress LV dysfunction. Among subjects who underwent exercise stress test, myocardial perfusion SPECT and coronary angiography within a month of interval, we enrolled 36 patients with post-stress LV ejection fraction (LVEF) was {>=}5% lower than rest (stunning group) and 16 patients with difference of post-stress and rest LVEF was lesser than 1% (non-stunning group) for this study. Treadmill exercise stress gated myocardial perfusion SPECT was performed with dual head SPECT camera using 740 MBq Tc-99m MIBI and coronary angiography was also performed by conventional Judkins method. Stunning group had a significantly higher incidence of hypercholesterolemia than non-stunning group(45.5 vs 7.1%, p=0.01). Stunning group also had higher incidence of diabetes mellitus and lower incidence of hypertension, but these were not statistically significant. Stunning group had larger and more severe perfusion defect in stress perfusion myocardial SPECT than non-stunning group(extent 18.2 vs 9.2%, p=0.029; severity 13.5 vs 6.9, p=0.040). Stunning group also had higher degree of reversibility of perfusion defect, higher incidence of positive exercise stress test and higher incidence of having severe stenosis(80{approx}99%) in coronary angiography than non-stunning group, but these were not statistically significant. In stunning group, all of 4 patients without perfusion defect had significant coronary artery stenosis and had received revascularization treatment. Patients with post-stress LV dysfunction had larger and more severe perfusion defect and severe coronary artery stenosis than

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  11. The value of Tc-99m MIBI SPECT during isosorbide dinitrate infusion in assessment of viable myocardium in patients with myocardial infarction

    International Nuclear Information System (INIS)

    Li Shengting; Liu Xiujie; Lu Zongliang

    1996-01-01

    Tc-99m MIBI myocardial SPECT has shown promise for evaluation of coronary artery disease. But its role in predicting myocardial viability is still under investigation. The purpose of this study was to evaluate the value of Tc-99m MIBI myocardial SPECT during isosorbide dinitrate (ISDN) infusion in the assessment of myocardial viability. Thirty-seven patients with previous myocardial infarction (the infarct age ranged from ≤ 30 days to 900 days) were studied, of them 13 patients had Tc-99m MIBI studies before and after coronary artery bypass grafting (CABG). The results showed that out of 134 segments with hypoperfusion at resting SPECT, 56 segments (41.8%) had an increase in Tc-99m MIBI uptake during ISDN infusion. Among them, 17 segments (30.4%) were normalized, 6 segments (10.7%) were significantly improved and 33 segments (58.9%) were improved. The degree of improvement in perfusion was related to the age of the myocardial infarction. In 13 patients with CABG, of 31 segments with improvement in perfusion post CABG, 25 segments (80.6%) showed perfusion improvement during ISDN infusion, and of 28 segments with improved wall motion post CABG, 23 segments (82.1%) showed improvement in perfusion during ISDN infusion. Tc-99m MIBI SPECT during ISDN infusion may therefore be a useful approach for assessing myocardial viability. (author)

  12. Predictors of abnormal heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    De Souza Leao Lima, R.; Machado, L.; Azevedo, A.B.; De Lorenzo, A.

    2011-01-01

    The objective of this study was to identify predictors of abnormal HR response to dipyridamole (DIP) in patients undergoing myocardial perfusion SPECT (MPS). Patients with a reduced heart rate (HR) response to DIP have higher cardiac mortality, but the mechanism is unknown. We studied 432 patients who underwent dual-isotope gated MPS. DIP (0.56 mg/kg) was infused over 4 min, and Tc-99m tetrofosmin was injected 3 min after the end of the infusion. MPS was semiquantitatively interpreted. Left ventricular ejection fraction (LVEF) and volumes were automatically calculated. The population was categorized into quartiles according to HR ratio, and characteristics in each quartile were compared. Logistic regression analysis was performed to identify predictors of abnormal HR response, using the lowest quartile as the independent variable. Patients with abnormal HR response were more frequently without chest pain, with a history of chronic renal failure and taking digoxin. Baseline HR was higher and had fewer symptoms during stress. The stress and rest perfusion defects were greater, but reversibility was not; in addition, LVEF was lower. Multivariable logistic regression analysis demonstrated that the independent predictors of abnormal HR response were baseline HR and low LVEF. LV dysfunction is an independent predictor of abnormal HR response to DIP, and the association between low LVEF and low HR ratio may explain the link between abnormal HR ratio and increased mortality. (author)

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

    Science.gov (United States)

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

    2017-12-01

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

  14. Diagnosis of coronary artery disease using myocardial perfusion SPECT in patients with diabetes mellitus: analysis of risk factors

    International Nuclear Information System (INIS)

    Seo, Ji Hyoung; Kang, Seong Min; Bae, Jin Ho; Jeong, Shin Young; Lee, Sang Woo; Yoo, Jeong Soo; Ahn, Byeong Cheol; Lee, Jae Tae

    2006-01-01

    Diabetes mellitus is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is growing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. 203 diabetic patients (64 male, mean age 64.1 ± 9.0 years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was 36 ± 18 months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the occurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events

  15. Diagnosis of coronary artery disease using myocardial perfusion SPECT in patients with diabetes mellitus: analysis of risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Ji Hyoung; Kang, Seong Min; Bae, Jin Ho; Jeong, Shin Young; Lee, Sang Woo; Yoo, Jeong Soo; Ahn, Byeong Cheol; Lee, Jae Tae [Kyungpook National University, Daegu, (Korea, Republic of)

    2006-06-15

    Diabetes mellitus is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is growing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. 203 diabetic patients (64 male, mean age 64.1 {+-} 9.0 years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was 36 {+-} 18 months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the occurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  17. Transient ischemic dilation ratio (TID) correlates with HbA1c in patients with diabetes type 2 with proven myocardial ischemia according to exercise myocardial SPECT

    International Nuclear Information System (INIS)

    Adamikova, A.; Rybka, J.; Bakala, J.; Bernatek, J.; Svacina, S.

    2006-01-01

    Abnormal values of the transient ischemic dilation ratio (TID) according to an exercise myocardial single photon emission computed tomography (SPECT) are linked to severe coronary artery disease. The authors investigated the relationship between TID and the levels of vascular cell adhesion molecule (VCAM), intercellular adhesion molecule (ICAM), E-selectin, microalbuminuria, intimamedia thickness and HbA 1c of diabetic subjects. We observed 38 subjects with diabetes type 2 (10 women, 28 men), of average age 56.08±8.24 years, with no past history of cardiovascular disease. All subjects were examined using an exercise myocardial SPECT. Transient ischemic dilation, summed stress score (SSS), summed rest score (SRS) and stress total severity score (STSS) were determined to quantify myocardial ischemia. The average IMT value was 1.05±0.31 mm. The TID value was 1.02±0.154, VCAM 795.24±163.25 mg/l, ICAM 516.55±164.07, E-selectin 63.82±38.89, HbA 1c 7.09±1.68%, microalbuminuria 68.01±55.21 mg/l. When ascertaining the relation of TID to the other factors we used Pearson's correlation at the level of significance p 1c (p=0.035); the other factors did not show any significant correlation. Diabetes and its long term unsatisfactory compensation can be one of the factors which affect left ventricular transient ischemic dilation. (author)

  18. Evaluation of 201Tl stress-redistribution imaging for the detection of myocardial ischemia and assessment of its therapeutic effect (40 cases attached)

    International Nuclear Information System (INIS)

    Lin Jinghui

    1989-01-01

    The characteristics of 201 Tl stress-redistribution imagings of 21 normal controls and 19 myocardial ischemia were reported. Normal variability of myocardial images and its influencing factors were discussed as well. All of 40 cases were also undergoing coronary arteriography (CAG), and exercise ECG. Taken the stenosis of coronary artery > 50% by CAG as the criterion of diagnosis of CHD, the sensitivity and specificity of 201 Tl image were 94.7% and 100%, while as exercise ECG were 66.6% and 80.9% respectively. 2 patients with bypass surgery and 6 patients with PTCA were examined pre- and postoperatively by 201 Tl images. The results indicated that this technique was noninvasive and reliable also for the assessment of their therapeutic effect and follow up studies

  19. Effect of maintenance oral theophylline on dipyridamole-thallium-201 myocardial imaging using SPECT and dipyridamole-induced hemodynamic changes

    International Nuclear Information System (INIS)

    Daley, P.J.; Mahn, T.H.; Zielonka, J.S.; Krubsack, A.J.; Akhtar, R.; Bamrah, V.S.

    1988-01-01

    To evaluate the effect of maintenance oral theophylline therapy on the diagnostic efficacy of dipyridamole-thallium-201 single photon emission computed tomography (SPECT) imaging for coronary artery disease, dipyridamole-thallium-201 SPECT imaging was performed in eight men with documented coronary artery disease before initiation of theophylline treatment and repeated while these patients were receiving therapeutic doses of oral theophylline. Before theophylline treatment, intravenous dipyridamole caused a significant increase in heart rate, decrease in blood pressure, angina in seven of eight patients, and ST segment depression in four of eight patients. While they were being treated with theophylline, none of the patients had angina or ST segment depression, and there were no hemodynamic changes with intravenous dipyridamole. Before theophylline treatment, dipyridamole-thallium-201 SPECT imaging showed reversible perfusion defects in myocardial segments supplied by stenotic coronary arteries. With theophylline treatment, dipyridamole-thallium-201 SPECT showed total absence of reversible perfusion defects. Treatment with theophylline markedly reduced the diagnostic accuracy of dipyridamole-thallium-201 imaging for coronary artery disease

  20. Results of RNV studies and /sup 201/Tl myocardial scintigraphy in patients with progressive systemic scleroderma (PSS)

    Energy Technology Data Exchange (ETDEWEB)

    Ammari, B.; Hotze, A.; Gruenwald, F.; Biersack, H.J.; Biltz, H.; Kuester, W.

    1988-12-01

    Prognosis of progressive systemic scleroderma (PSS) depends directly on the extent of visceral organ involvement, and in particular, on the cardiac, renal and pulmonary appearance. Therapeutic approaches therefore require periodic followup with non-invasive methods to evaluate the actual course of disease and the success of therapy. Tl-201 scintigraphy showed pathologic heart abnormalities in 47% and RNV in 23% of the PSS patients. Our results and published data reveal the sensitivity of both myocardial scans and RNV in the evaluation of patients with PSS. Other current methods for the diagnosis of heart diseases, however, such as echocardiography should also be performed. In patients with PSS coronary angiography, however, usually shows normal coronary vessels.

  1. The value of 201Tl myocardial scintigraphy and of computed tomography for predicting the effectiveness of coronary artery bypass surgery

    International Nuclear Information System (INIS)

    Krosse, B.; Duck, H.J.; Neumann, G.; Huppert, P.; Schulz, H.G.; Lindenau, K.F.

    1986-01-01

    50 male patients with stenosing coronary artery sclerosis and an indication for coronary artery bypass surgery were subjected to pre- and postsurgical 201 Tl scintigraphy and postsurgical computed tomography. Control by angiography was carried out in six cases. Scintigraphy revealed an improved myocardial perfusion in 30 patients, whereas it was unchanged in 15 and deteriorated in 5 patients. Angiography exhibited two cases of graft occlusion, one case of bad run off, and two cases of progressing arteriosclerosis under intact graft. Computed tomography showed that 83 bypasses of the 50 patients were occluded in 6 cases, which was confirmed by angiography in 3 cases. The investigation demonstrates the high value of the two non-invasive methods for the control of bypass patency. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

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

  3. Comparison of adenosine and exercise stress 201Tl myocardial perfusion imaging for diagnosing coronary heart disease in women

    International Nuclear Information System (INIS)

    Li Jiangjin; Ma Shuren; Meng Tao; Bao Zhi; Cui Jianhe

    2011-01-01

    Objective: To compare the diagnostic value of adenosine and exercise stress myocardial perfusion imaging (MPI) for detecting coronary heart disease (CHD) in women. Methods: One hundred and thirty-eight patients with CHD were randomly divided into two groups: adenosine stress group (n=69)and exercise stress group (n=69). All patients underwent myocardial SPECT evaluation. Coronary angiography (CAG), referred as 'gold standard' , was performed in each patient within 1 week before or after MPI. The diagnostic value of the two stress MPI was compared with χ 2 test or Fisher's exact test. Results: In adenosine stress group, the sensitivity, negative predictive value and accuracy were 88.2% (45/51), 72.7% (16/22), 88.4% (61/69), respectively, which were not significantly different from those of the exercise stress group (91.7% (44/48), 66.7% (8/12), 81.2% (52/64); χ 2 =0.571, 0.714, 0.249, P>0.05). However, the false positive rate of adenosine stress (11.1%, 2/18) was significantly lower than that of exercise stress (50.0%, 8/16), P=0.023. Conclusions: Adenosine and exercise stress MPI have similar value for CHD diagnosis in women, however, adenosine stress MPI may have an advantage of low false positive rate. (authors)

  4. Simultaneous /sup 201/Tl//sup 99m/Tc seven-pinhole tomography in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Krause, T; Schuemichen, C; Fischer, R; Strauss, E; Hoffmann, G

    1986-06-01

    Combined infarction scintigraphy with /sup 201/Tl-chloride and /sup 99m/Tc-pyrophosphate (PPi) by simultaneous seven-pinhole tomography was investigated with a phantom as well as in patients. No artificial defects occurred when the collimator was centered correctly in axial position, but a very high standard of image uniformity and linearity of the gamma camera was required. Artefacts by overlying activity from the skeleton or cardiac blood pool were not observed. All 11 controls showed normal results. Despite a poor depth resolution due to limitations of the system even small areas of partially damaged myocardium could be recognized and correlated three-dimensionally. Of 24 patients with proven myocardial infarction, in 16 both a positive (/sup 99m/Tc-PPi) and a negative (/sup 201/Tl) image was obtained in congruence with the necrosis. 8 patients (33%) showed discordant results providing however additional information on the nature and extent of the necrosis. 4 out of 6 non-transmural infarctions seen by tomography had been suspected clinically.

  5. Cold pressor test myocardial perfusion SPECT as a predictor of the development of ischemia at exercise in the follow up of asymptomatic patients with moderate cardiovascular risk

    International Nuclear Information System (INIS)

    Traverso, Sonia S.; Redruello, Marcela F.; Grynberg, Laura E.; Cragnolino, Daniel E.; Maciel, Neiva R.; Masoli, Osvaldo H.; Perez Balino, Nestor A.; Meretta, Alejandro

    2007-01-01

    Introduction: Previous studies have published the correlation between myocardial perfusion SPECT (MP) during cold pressor test (CPT) and intracoronary acetylcholine and its usefulness as independent marker of endothelial dysfunction (ED). Objective: To analyze the incidence of positivization of MP exercise studies in the follow up of asymptomatic patients with moderate cardiovascular risk (CV) and ED detected by PF. Material and Methods: Of 301 patients of the PARADIGMA Registry (normal exercise MP SPECT and clinical probability [es

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  7. Cost-effectiveness of substituting dual-energy CT for SPECT in the assessment of myocardial perfusion for the workup of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Mathias [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim–Heidelberg University, Mannheim (Germany); Nance, John W. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC (United States); Moscariello, Antonio [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, “A. Gemelli” Hospital, Rome (Italy); Weininger, Markus; Rowe, Garrett W.; Ruzsics, Balazs [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Kang, Doo Kyoung [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Chiaramida, Salvatore A. [Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC (United States); Schoenberg, Stefan O.; Fink, Christian [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim–Heidelberg University, Mannheim (Germany); and others

    2012-12-15

    Purpose: We compared cost-effectiveness and potential lifetime benefits of using dual-energy computed tomography (DECT) for myocardial perfusion assessment instead of single photon emission computed tomography (SPECT) for the workup of coronary artery disease (CAD). Materials and methods: A decision and simulation model was developed to estimate cost and health effects of using DECT myocardial perfusion imaging instead of SPECT for identifying patients in need of invasive imaging and possible revascularization. The model was based on the performance indices of stress/rest DECT compared with stress/rest SPECT for detecting myocardial perfusion deficits in 50 patients (mean age 61 ± 10 years) with CAD. Stress/rest perfusion and delayed enhancement cardiac MRI served as reference standard. For DECT a reimbursement of US$1700 was assumed but costs of cardiac MRI were not included in the model. All other actual healthcare costs in these patients were derived from MUSC's hospital billing system. Results: Compared with cardiac MRI, DECT (versus SPECT) had 90% (85%) sensitivity and 71% (58%) specificity for identifying patients with obstructive CAD. Compared with the no imaging and no treatment strategy, routine SPECT gained 13.49 quality-adjusted life-years (QALYs) with an incremental cost-effectiveness ratio (ICER) of US$3557 (in 2010) per QALY. In comparison, DECT ICER was lower (US$3.191 per QALY, p = 0.0002) and an additional 0.64 QALYs was obtained (total of 14.13 QALYs) if compared with the SPECT strategy as well as the no imaging and no treatment strategy. Conclusion: Using DECT as the first-line imaging test for myocardial perfusion for the workup of patients with CAD has the potential to provide gains in QALYs, while lowering costs if compared to routine myocardial perfusion SPECT.

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

    Science.gov (United States)

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

    2015-11-01

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

  9. Cost-effectiveness of substituting dual-energy CT for SPECT in the assessment of myocardial perfusion for the workup of coronary artery disease

    International Nuclear Information System (INIS)

    Meyer, Mathias; Nance, John W.; Schoepf, U. Joseph; Moscariello, Antonio; Weininger, Markus; Rowe, Garrett W.; Ruzsics, Balazs; Kang, Doo Kyoung; Chiaramida, Salvatore A.; Schoenberg, Stefan O.; Fink, Christian

    2012-01-01

    Purpose: We compared cost-effectiveness and potential lifetime benefits of using dual-energy computed tomography (DECT) for myocardial perfusion assessment instead of single photon emission computed tomography (SPECT) for the workup of coronary artery disease (CAD). Materials and methods: A decision and simulation model was developed to estimate cost and health effects of using DECT myocardial perfusion imaging instead of SPECT for identifying patients in need of invasive imaging and possible revascularization. The model was based on the performance indices of stress/rest DECT compared with stress/rest SPECT for detecting myocardial perfusion deficits in 50 patients (mean age 61 ± 10 years) with CAD. Stress/rest perfusion and delayed enhancement cardiac MRI served as reference standard. For DECT a reimbursement of US$1700 was assumed but costs of cardiac MRI were not included in the model. All other actual healthcare costs in these patients were derived from MUSC's hospital billing system. Results: Compared with cardiac MRI, DECT (versus SPECT) had 90% (85%) sensitivity and 71% (58%) specificity for identifying patients with obstructive CAD. Compared with the no imaging and no treatment strategy, routine SPECT gained 13.49 quality-adjusted life-years (QALYs) with an incremental cost-effectiveness ratio (ICER) of US$3557 (in 2010) per QALY. In comparison, DECT ICER was lower (US$3.191 per QALY, p = 0.0002) and an additional 0.64 QALYs was obtained (total of 14.13 QALYs) if compared with the SPECT strategy as well as the no imaging and no treatment strategy. Conclusion: Using DECT as the first-line imaging test for myocardial perfusion for the workup of patients with CAD has the potential to provide gains in QALYs, while lowering costs if compared to routine myocardial perfusion SPECT.

  10. Decreased perfusion in myocardial region of normal donor artery secondary to collateral development

    International Nuclear Information System (INIS)

    Koga, Y.; Takahashi, M.; Kojima, A.; Takaki, Y.; Tomiguchi, S.; Hirota, Y.; Kugiyama, K.; Yasue, H.; Hayasaki, K.; Kumamoto Saiseikai Hospital

    1992-01-01

    Thirty-one patients suffering from single vessel exertional angina with collaterals (Group A) were evaluated by stress 201 Tl myocardial emission CT (Tl-SPECT) with 16 controls of severely stenotic single vessel exertional angina without collaterals (Group B). Group A included 21 patients (68%) who showed an extensive perfusion defect in double artery myocardial regions, including the normal donor artery myocardial region (DMR). However, there were no such cases in Group B, giving a significant difference between these 2 groups (p < 0.001). Four patients in Group A, having a perfusion defect both in DMR and in the collateral dependent myocardial region (CMR) underwent a successful percutaneous transluminal coronary angioplasty (PTCA) with disappearance of collaterals. Tl-SPECT findings after PTCA showed no perfusion defect either in CMR or in DMR. This has been explained on the basis that the coronary collaterals stole blood and produced perfusion defect in DMR. (orig.)

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  12. Non invasive evaluation of the coronary atherosclerosis illness in patients with silent ischemia: utility of the SPECT of myocardial perfusion. Electric, angiographic and image correlation; Valoracion no invasiva de la enfermedad ateroesclerosa coronaria en pacientes con isquemia silente: utilidad del SPECT de perfusion miocardica. Correlacion electrica, angiografica y de imagen

    Energy Technology Data Exchange (ETDEWEB)

    Puente B, A.; Roffe G, F.; Aceves C, J.; Gomez A, E. [Hospital Centro Medico Nacional 20 de Noviembre, ISSSTE, Mexico D.F. (Mexico)

    2005-07-01

    The objective of the work was to determine the utility of the SPECT (Single Photon Emission Computerized Tomography) of myocardial perfusion for the ischemia detection in asymptomatic patients with Coronary Atherosclerosis Illness. It was concluded that the SPECT of myocardial perfusion has a high sensitivity (97%) for the silent ischemia diagnosis.

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  14. 201Tl uptake in variant angina: probable demonstration of myocardial reactive hyperemia in man

    International Nuclear Information System (INIS)

    Kronenberg, M.W.; Robertson, R.M.; Born, M.L.; Steckley, R.A.; Robertson, D.; Friesinger, G.C.

    1982-01-01

    Myocardial thallium scintigraphy was performed in four subjects with variant angina and in one subject with isolated, fixed coronary obstruction. Three subjects with variant angina had short episodes of ischemic ST-segment elevation that lasted 20--100 seconds. Thallium scintigrams demonstrated excess uptake in regions judged to be ischemic by angiographic and electrocardiographic criteria. Two subjects, one with variant angina and the other with a fixed coronary lesion, had prolonged episodes of ischemia that lasted 390--900 seconds. Both had reduced thallium uptake in the ischemic regions. We conclude that myocardial reactive hyperemia is the cause of excess thallium uptake in patients with variant angina who have short episodes of myocardial ischemia

  15. Clinical investigation of large perfusion defect cases with 201Tl exercise myocardial scintigraphy

    International Nuclear Information System (INIS)

    Morota, Motoi; Kobayashi, Yasuhiko

    1999-01-01

    We investigated retrospectively the clinical significance of large perfusion defect on 201 Thallium myocardial scintigraphy from the records of 833 patients during the past 3 years from 1991 to 1994. The patients were divided into 3 groups according to the extent of perfusion defect; cases with normal perfusion (n=561), with small perfusion defect (n=211) and with large perfusion defect (n=61). We found that the proportions of cases with large perfusion defect was significantly larger than that of cases with small perfusion defect in myocardial disease (MD; hypertrophic cardiomyopathy, dilated cardiomyopathy, and post myocarditis combined) (P 201 Thallium myocardial scintigraphy and that complication of diabetes mellitus and clinical symptoms may be useful in differentiating IHD from MD. (author)

  16. SPECT myocardial perfusion imaging. Long-term prognostic value in diabetic patients with and without coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Koehli, M. [Dept. of Endocrinology, Diabetology and Metabolism, Univ. Hospital Lausanne (Switzerland); Dept. of Nuclear Medicine, Univ. Hospital Lausanne (Switzerland); Monbaron, D.; Gaillard, R.C.; Ruiz, J. [Dept. of Endocrinology, Diabetology and Metabolism, Univ. Hospital Lausanne (Switzerland); Prior, J.O.; Bischof Delaloye, A. [Dept. of Nuclear Medicine, Univ. Hospital Lausanne (Switzerland); Calcagni, M.L. [Dept. of Nuclear Medicine, Univ. Hospital Lausanne (Switzerland); Dept. of Cardiology, Univ. Hospital Lausanne (Switzerland); Fivaz-Arbane, M.; Stauffer, J.C. [Inst. of Nuclear Medicine, Univ. Cattolica del Sacro Cuore, Roma (Italy)

    2006-07-01

    Aim: To determine the long-term prognostic value of SPECT myocardial perfusion imaging (MPI) for the occurrence of cardiovascular events in diabetic patients. Patients, methods: SPECT MPI of 210 consecutive Caucasian diabetic patients were analysed using Kaplan-Meier event-free survival curve and independent predictors were determined by Cox multivariate analyses. Results: Follow-up was complete in 200 (95%) patients with a median period of 3.0 years (0.8-5.0). The population was composed of 114 (57%) men, age 65 {+-} 10 years, 181 (90.5%) type 2 diabetes mellitus, 50 (25%) with a history of coronary artery disease (CAD) and 98 (49%) presenting chest pain prior to MPI. The prevalence of abnormal MPI was 58%. Patients with a normal MPI had neither cardiac death, nor myocardial infarction, independently of a history of coronary artery disease or chest pain. Among the independent predictors of cardiac death and myocardial infarction, the strongest was abnormal MPI (p < 0.0001), followed by history of CAD (Hazard Ratio (HR) = 15.9; p = 0.0001), diabetic retinopathy (HR = 10.0; p = 0.001) and inability to exercise (HR = 7.7; p = 0.02). Patients with normal MPI had a low revascularisation rate of 2.4% during the follow-up period. Compared to normal MPI, cardiovascular events increased 5.2 fold for reversible defects, 8.5 fold for fixed defects and 20.1 fold for the association of both defects. Conclusion: Diabetic patients with normal MPI had on excellent prognosis independently of history of CAD. On the opposite, an abnormal MPI led to a > 5-fold increase in cardiovascular events. This emphasizes the value of SPECT MPI in predicting and risk-stratifying cardiovascular events in diabetic patients. (orig.)

  17. Using adaptive neuro-fuzzy inference system technique for crosstalk correction in simultaneous {sup 99m}Tc/{sup 201}Tl SPECT imaging: A Monte Carlo simulation study

    Energy Technology Data Exchange (ETDEWEB)

    Heidary, Saeed, E-mail: saeedheidary@aut.ac.ir; Setayeshi, Saeed, E-mail: setayesh@aut.ac.ir

    2015-01-11

    This work presents a simulation based study by Monte Carlo which uses two adaptive neuro-fuzzy inference systems (ANFIS) for cross talk compensation of simultaneous {sup 99m}Tc/{sup 201}Tl dual-radioisotope SPECT imaging. We have compared two neuro-fuzzy systems based on fuzzy c-means (FCM) and subtractive (SUB) clustering. Our approach incorporates eight energy-windows image acquisition from 28 keV to 156 keV and two main photo peaks of {sup 201}Tl (77±10% keV) and {sup 99m}Tc (140±10% keV). The Geant4 application in emission tomography (GATE) is used as a Monte Carlo simulator for three cylindrical and a NURBS Based Cardiac Torso (NCAT) phantom study. Three separate acquisitions including two single-isotopes and one dual isotope were performed in this study. Cross talk and scatter corrected projections are reconstructed by an iterative ordered subsets expectation maximization (OSEM) algorithm which models the non-uniform attenuation in the projection/back-projection. ANFIS-FCM/SUB structures are tuned to create three to sixteen fuzzy rules for modeling the photon cross-talk of the two radioisotopes. Applying seven to nine fuzzy rules leads to a total improvement of the contrast and the bias comparatively. It is found that there is an out performance for the ANFIS-FCM due to its acceleration and accurate results.

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

    International Nuclear Information System (INIS)

    Okada, Mitsuhiro; Kawai, Naoki; Yamamoto, Shuhei

    1984-01-01

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

  19. Effects of angular sampling in tomographic myocardial perfusion imaging with Tl-201

    International Nuclear Information System (INIS)

    Rebelo, M.S.; Robilotta, C.C.

    1989-01-01

    The present work presents results of computational and experimental simulations, in order to show the influence of angular sampling in the quality of SPECT images reconstructed with the Convolution Backprojection algorithm. Geometric deformations and contrast artifacts had been produced in the incomplete sampled images. The experimental images were sampled at 32 projections over 180 0 and 64 projections over 360 0 . Attenuation correction was performed for images sampled over 360 0 . The coomputationally simulated images were sampled at both 64 and 128 projections over 360 0 . (author) [pt

  20. Prognosis of patients with positive exercise test and normal myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Seo, J. H.; Jeong, S. Y.; Bae, J. H.; Ahn, B. C.; Lee, J.; Lee, K. B [College of Medicine, Kyungpook National University, Daegu (Korea, Republic of)

    2004-07-01

    Exercise SPECT myocardial perfusion imaging(Ex-MPI) is regarded as a predictive technique particularly in patients with coronary artery disease(CAD) capable of performing exercise testing. In clinical practice, we encounter equivocal situations of discordant findings between exercise ECG and MPI. We evaluated the prognosis of subjects with positive ECG and normal MPI findings, and predictive factors for cardiac events. 2571 Ex-MPI studies were reviewed over a period of 3 years. Subjects were followed for more than 2 years(24-56 months, mean 35{+-}10months) for cardiac events after study. The cardiac events were defined as hard events(cardiac death and nonfatal myocardial infarction(MI)) and soft events(aggravation of CAD necessitating revascularization, congestive heart failure necessitating hospital admission). We evaluated age, sex, typical angina pain, rest ECG, hypertension, diabetes mellitus(DM), serum levels of cholesterol and LDL, smoking history, history of cerebrovascular disease(CVD) and peripheral artery disease(PAD), and rest left ventricular ejection fraction(LVEF) as clinical variables. Of 83 subjects with positive ECG and normal MPS findings, 6 were considered as false negative results confirmed with coronary angiography. There were 77 patients (mean age 52{+-}10 years, 39 males) with positive ECG and normal MPI results. During the follow-up period, of 77 there were 3 cardiac events (annual rate 1.9%), no cardiac death, 2 nonfatal MIs (annual rate 1.3%) and 1 soft event (annual rate 0.6%). 2/39 males(5.1%), and 1/38 females(2.6%) had cardiac events. All cardiac events were observed within 2 years. 1-year cardiac event rate was 0.6% and 2-year cardiac event rate was 1.9%. Among clinical factors, male sex, typical chest pain and smoking history at the time of MPI were predictive of cardiac events. Patients with positive ECG and negative EX-MPI results have low risk for cardiac events. Nevertheless, the cardiac events cannot be excluded totally in some

  1. Prognosis of patients with positive exercise test and normal myocardial perfusion SPECT

    International Nuclear Information System (INIS)

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

    2004-01-01

    Exercise SPECT myocardial perfusion imaging(Ex-MPI) is regarded as a predictive technique particularly in patients with coronary artery disease(CAD) capable of performing exercise testing. In clinical practice, we encounter equivocal situations of discordant findings between exercise ECG and MPI. We evaluated the prognosis of subjects with positive ECG and normal MPI findings, and predictive factors for cardiac events. 2571 Ex-MPI studies were reviewed over a period of 3 years. Subjects were followed for more than 2 years(24-56 months, mean 35±10months) for cardiac events after study. The cardiac events were defined as hard events(cardiac death and nonfatal myocardial infarction(MI)) and soft events(aggravation of CAD necessitating revascularization, congestive heart failure necessitating hospital admission). We evaluated age, sex, typical angina pain, rest ECG, hypertension, diabetes mellitus(DM), serum levels of cholesterol and LDL, smoking history, history of cerebrovascular disease(CVD) and peripheral artery disease(PAD), and rest left ventricular ejection fraction(LVEF) as clinical variables. Of 83 subjects with positive ECG and normal MPS findings, 6 were considered as false negative results confirmed with coronary angiography. There were 77 patients (mean age 52±10 years, 39 males) with positive ECG and normal MPI results. During the follow-up period, of 77 there were 3 cardiac events (annual rate 1.9%), no cardiac death, 2 nonfatal MIs (annual rate 1.3%) and 1 soft event (annual rate 0.6%). 2/39 males(5.1%), and 1/38 females(2.6%) had cardiac events. All cardiac events were observed within 2 years. 1-year cardiac event rate was 0.6% and 2-year cardiac event rate was 1.9%. Among clinical factors, male sex, typical chest pain and smoking history at the time of MPI were predictive of cardiac events. Patients with positive ECG and negative EX-MPI results have low risk for cardiac events. Nevertheless, the cardiac events cannot be excluded totally in some

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  3. 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).

  4. Semi-quantitative approach of tracer uptake abnormalities in myocardial SPECT: application to inferior defects

    International Nuclear Information System (INIS)

    Damien, J.; Bontemps, L.; Gabain, M.; Felecan, R.; Itti, R.

    1997-01-01

    This study was designed in order to evaluate in a more objective manner than visual inspection, the detection of myocardial inferior wall hypo-fixations in perfusion SPECT. We have studied 90 patients, divided into four groups: GO (7 M, 13 F, 55 ± 21 years) and G1 (9 M, 12 F, 49 ± 26 years) are groups of patients considered as normal; G2 (20 M, 3 F, 60 ± 12 years) corresponds to patients with reversible ischaemia, where the stress examination is abnormal but the resting one is close to normality; G3 (21 H, 5 F, 63 ± 8 years) includes infarcts where both examinations are definitely abnormal. Intra and inter-group statistical comparisons were first done using polar maps (Bull's eye) and an iterative method has then been developed for comparing each image of groups 1, 2 and to the mean normal data (GO). Finally, we have built a ROC (receiver operating characteristic) curves network for determining the best confidence interval and the optimal normality / abnormality criterion (number of pixels located without the confidence interval). The results are expressed in terms of sensitivity and specificity using the most favourable situation derived from the ROC curves. For 2.5 standard deviations, we obtain, for G2 (reversible injury) compared to G1, 78.3 % sensibility and 76.2 % for specificity at rest with at maximum 20 abnormal pixels as normality criterion, and at stress 81 % and 82.6 % for pixels. For G3 (permanent injury) compared to G1, the values are respectively : sensitivity = 88.5 % and specificity = 85.2 % at rest for 40 pixels; sensitivity = 92.3 % and specificity = 85.2 % at stress for 80 pixels. The method developed seems to be applicable on a wider scale, not only limited to inferior area abnormalities. It is able to optimise, for each situation, the confidence interval for an abnormal image definition and the most significant criterion, in terms of number of abnormal pixels, to detect a diseased myocardial area. (authors)

  5. Applying the J-optimal channelized quadratic observer to SPECT myocardial perfusion defect detection

    Science.gov (United States)

    Kupinski, Meredith K.; Clarkson, Eric; Ghaly, Michael; Frey, Eric C.

    2016-03-01

    To evaluate performance on a perfusion defect detection task from 540 image pairs of myocardial perfusion SPECT image data we apply the J-optimal channelized quadratic observer (J-CQO). We compare AUC values of the linear Hotelling observer and J-CQO when the defect location is fixed and when it occurs in one of two locations. As expected, when the location is fixed a single channels maximizes AUC; location variability requires multiple channels to maximize the AUC. The AUC is estimated from both the projection data and reconstructed images. J-CQO is quadratic since it uses the first- and second- order statistics of the image data from both classes. The linear data reduction by the channels is described by an L x M channel matrix and in prior work we introduced an iterative gradient-based method for calculating the channel matrix. The dimensionality reduction from M measurements to L channels yields better estimates of these sample statistics from smaller sample sizes, and since the channelized covariance matrix is L x L instead of M x M, the matrix inverse is easier to compute. The novelty of our approach is the use of Jeffrey's divergence (J) as the figure of merit (FOM) for optimizing the channel matrix. We previously showed that the J-optimal channels are also the optimum channels for the AUC and the Bhattacharyya distance when the channel outputs are Gaussian distributed with equal means. This work evaluates the use of J as a surrogate FOM (SFOM) for AUC when these statistical conditions are not satisfied.

  6. The effect of patient anxiety and depression on motion during myocardial perfusion SPECT imaging

    International Nuclear Information System (INIS)

    Lyra, Vassiliki; Kallergi, Maria; Rizos, Emmanouil; Lamprakopoulos, Georgios; Chatziioannou, Sofia N.

    2016-01-01

    Patient motion during myocardial perfusion SPECT imaging (MPI) may be triggered by a patient’s physical and/or psychological discomfort. The aim of this study was to investigate the impact of state anxiety (patient’s reaction to exam-related stress), trait anxiety (patient’s personality characteristic) and depression on patient motion during MPI. All patients that underwent MPI in our department in a six-month period were prospectively enrolled. One hundred eighty-three patients (45 females; 138 males) filled in the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI), along with a short questionnaire regarding their age, height and weight, level of education in years, occupation, and marital status. Cardiovascular and other co-morbidity factors were also evaluated. Through inspection of raw data on cinematic display, the presence or absence of patient motion was registered and classified into mild, moderate and severe, for both phases involved in image acquisition. The correlation of patient motion in the stress and delay phases of MPI and each of the other variables was investigated and the corresponding Pearson’s coefficients of association were calculated. The anxiety-motion (r = 0.43, P < 0.0001) and depression-motion (r = 0.32, P < 0.0001) correlation results were moderately strong and statistically significant for the female but not the male patients. All the other variables did not demonstrate any association with motion in MPI, except a weak correlation between age and motion in females (r = 0.23, P < 0.001). The relationship between anxiety-motion and depression-motion identified in female patients represents the first supporting evidence of psychological discomfort as predisposing factor for patient motion during MPI

  7. The effect of patient anxiety and depression on motion during myocardial perfusion SPECT imaging.

    Science.gov (United States)

    Lyra, Vassiliki; Kallergi, Maria; Rizos, Emmanouil; Lamprakopoulos, Georgios; Chatziioannou, Sofia N

    2016-08-22

    Patient motion during myocardial perfusion SPECT imaging (MPI) may be triggered by a patient's physical and/or psychological discomfort. The aim of this study was to investigate the impact of state anxiety (patient's reaction to exam-related stress), trait anxiety (patient's personality characteristic) and depression on patient motion during MPI. All patients that underwent MPI in our department in a six-month period were prospectively enrolled. One hundred eighty-three patients (45 females; 138 males) filled in the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI), along with a short questionnaire regarding their age, height and weight, level of education in years, occupation, and marital status. Cardiovascular and other co-morbidity factors were also evaluated. Through inspection of raw data on cinematic display, the presence or absence of patient motion was registered and classified into mild, moderate and severe, for both phases involved in image acquisition. The correlation of patient motion in the stress and delay phases of MPI and each of the other variables was investigated and the corresponding Pearson's coefficients of association were calculated. The anxiety-motion (r = 0.43, P depression-motion (r = 0.32, P patients. All the other variables did not demonstrate any association with motion in MPI, except a weak correlation between age and motion in females (r = 0.23, P anxiety-motion and depression-motion identified in female patients represents the first supporting evidence of psychological discomfort as predisposing factor for patient motion during MPI.

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  9. A quantitative analysis of Tl-201 myocardial perfusion image with special reference to circumferential profile method

    International Nuclear Information System (INIS)

    Miyanaga, Hajime

    1982-01-01

    A quantitative analysis of thallium-201 myocardial perfusion image (MPI) was attempted by using circumferential profile method (CPM) and the first purpose of this study is to assess the clinical utility of this method for the detection of myocardial ischemia. In patients with coronary artery disease, CPM analysis to exercise T1-MPI showed high sensitivity (9/12, 75%) and specificity (9/9, 100%), whereas exercise ECG showed high sensitivity (9/12, 75%), but relatively low specificity (7/9, 78%). In patients with myocardial infarction, CPM also showed high sensitivity (34/38, 89%) for the detection of myocardial necrosis, compared with visual interpretation (31/38, 81%) and with ECG (31/38, 81%). Defect score was correlated well with the number of abnormal Q waves. In exercise study, CPM was also sensitive to the change of perfusion defect in T1-MPI produced by exercise. So the results indicate that CPM is a good method not only quantitatively but also objectively to analyze T1-MPI. Although ECG is the most commonly used diagnostic tool for ischemic heart disease, several exercise induced ischemic changes in ECG have been still on discussion as criteria. So the second purpose of this study is to evaluate these ischemic ECG changes by exercise T1-MPI analized quantitatively. ST depression (ischemic 1 mm and junctional 2 mm or more), ST elevation (1 mm or more), and coronary T wave reversion in exercise ECG were though to be ischemic changes. (J.P.N.)

  10. Quantitative analysis of Tl-201 myocardial perfusion image with special reference to circumferential profile method

    Energy Technology Data Exchange (ETDEWEB)

    Miyanaga, Hajime [Kyoto Prefectural Univ. of Medicine (Japan)

    1982-08-01

    A quantitative analysis of thallium-201 myocardial perfusion image (MPI) was attempted by using circumferential profile method (CPM) and the first purpose of this study is to assess the clinical utility of this method for the detection of myocardial ischemia. In patients with coronary artery disease, CPM analysis to exercise T1-MPI showed high sensitivity (9/12, 75%) and specificity (9/9, 100%), whereas exercise ECG showed high sensitivity (9/12, 75%), but relatively low specificity (7/9, 78%). In patients with myocardial infarction, CPM also showed high sensitivity (34/38, 89%) for the detection of myocardial necrosis, compared with visual interpretation (31/38, 81%) and with ECG (31/38, 81%). Defect score was correlated well with the number of abnormal Q waves. In exercise study, CPM was also sensitive to the change of perfusion defect in T1-MPI produced by exercise. So the results indicate that CPM is a good method not only quantitatively but also objectively to analyze T1-MPI. Although ECG is the most commonly used diagnostic tool for ischemic heart disease, several exercise induced ischemic changes in ECG have been still on discussion as criteria. So the second purpose of this study is to evaluate these ischemic ECG changes by exercise T1-MPI analized quantitatively. ST depression (ischemic 1 mm and junctional 2 mm or more), ST elevation (1 mm or more), and coronary T wave reversion in exercise ECG were though to be ischemic changes.

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  12. Simultaneous dual-radionuclide myocardial perfusion imaging with a solid-state dedicated cardiac camera.

    Science.gov (United States)

    Ben-Haim, Simona; Kacperski, Krzysztof; Hain, Sharon; Van Gramberg, Dean; Hutton, Brian F; Erlandsson, Kjell; Sharir, Tali; Roth, Nathaniel; Waddington, Wendy A; Berman, Daniel S; Ell, Peter J

    2010-08-01

    We compared simultaneous dual-radionuclide (DR) stress and rest myocardial perfusion imaging (MPI) with a novel solid-state cardiac camera and a conventional SPECT camera with separate stress and rest acquisitions. Of 27 consecutive patients recruited, 24 (64.5+/-11.8 years of age, 16 men) were injected with 74 MBq of (201)Tl (rest) and 250 MBq (99m)Tc-MIBI (stress). Conventional MPI acquisition times for stress and rest are 21 min and 16 min, respectively. Rest (201)Tl for 6 min and simultaneous DR 15-min list mode gated scans were performed on a D-SPECT cardiac scanner. In 11 patients DR D-SPECT was performed first and in 13 patients conventional stress (99m)Tc-MIBI SPECT imaging was performed followed by DR D-SPECT. The DR D-SPECT data were processed using a spill-over and scatter correction method. DR D-SPECT images were compared with rest (201)Tl D-SPECT and with conventional SPECT images by visual analysis employing the 17-segment model and a five-point scale (0 normal, 4 absent) to calculate the summed stress and rest scores. Image quality was assessed on a four-point scale (1 poor, 4 very good) and gut activity was assessed on a four-point scale (0 none, 3 high). Conventional MPI studies were abnormal at stress in 17 patients and at rest in 9 patients. In the 17 abnormal stress studies DR D-SPECT MPI showed 113 abnormal segments and conventional MPI showed 93 abnormal segments. In the nine abnormal rest studies DR D-SPECT showed 45 abnormal segments and conventional MPI showed 48 abnormal segments. The summed stress and rest scores on conventional SPECT and DR D-SPECT were highly correlated (r=0.9790 and 0.9694, respectively). The summed scores of rest (201)Tl D-SPECT and DR-DSPECT were also highly correlated (r=0.9968, pstress perfusion defects were significantly larger on stress DR D-SPECT images, and five of these patients were imaged earlier by D-SPECT than by conventional SPECT. Fast and high-quality simultaneous DR MPI is feasible with D-SPECT in a

  13. Clinical Characteristics and Findings of 99mTc-MIBI Heart SPECT in Patients with Acute Myocardial Infarction with Normal Coronary Arteriography

    International Nuclear Information System (INIS)

    Park, Myung Jae; Choi, Tae Youl; Kim, Deong Yoon; Kang, Heung Sun; Choue, Chung Whee; Kim, Kwon Sam; Kim, Kwang Won; Kim, Myung Shick; Song, Jung Sang; Bae, Jong Hoa

    1993-01-01

    Among 64 patients with acute myocardial infarction who underwent coronary angiography, 7 patients (10.9%)showed normal coronary artery. Six patients were men and 1 patient was female. The mean age of patients were 31.1 ± 3.9 years. Among the risk factors of coronary heart disease, smoking was most probable factor in patients with acute myocardial infarction with normal coronary angiography. 99m Tc-MIBI heart SPECT performed 5 of 7 patients and showed that it could be used in diagnosis, localization, extent of infarct area in patients with acute myocardial infarction with normal coronary angiography. But follow up 99m Tc-MIBI heart SPECT study will be needed to define the ability of myocardial viability in this patients.

  14. ROC evaluation of SPECT myocardial lesion detectability with and without single iteration non-uniform Chang attenuation compensation using an anthropomorphic female phantom

    International Nuclear Information System (INIS)

    Jang, S.; Jaszczak, R.J.; Duke Univ. Medical Center, Durham, NC; Gilland, D.R.; Turkington, T.G.; Coleman, R.E.; Tsui, B.M.W.; Metz, C.E.

    1998-01-01

    The purpose of this work was to evaluate lesion detectability with and without nonuniform attenuation compensation (AC) in myocardial perfusion SPECT imaging in women using an anthropomorphic phantom and receiver operating characteristics (ROC) methodology. Breast attenuation causes artifacts in reconstructed images and may increase the difficulty of diagnosis of myocardial perfusion imaging in women. The null hypothesis tested using the ROC study was that nonuniform AC does not change the lesion detectability in myocardial perfusion SPECT imaging in women. The authors used a filtered backprojection (FBP) reconstruction algorithm and Chang's single iteration method for AC. In conclusion, with the proposed myocardial defect model nuclear medicine physicians demonstrated no significant difference for the detection of the anterior wall defect; however, a greater accuracy for the detection of the inferior wall defect was observed without nonuniform AC than with it. Medical physicists did not demonstrate any statistically significant difference in defect detection accuracy with or without nonuniform AC in the female phantom

  15. Value of Tl-201 in evaluating myocardial damage and ischemia in transplant patients

    International Nuclear Information System (INIS)

    Jazmati, B.; Tumeh, S.S.; Holman, L.B.

    1989-01-01

    Orthotopic heart transplant recipients suffer from graft rejection and accelerated coronary artery disease. The authors have evaluated 29 recipients of orthotopic heart transplants who had multiple biopsy-proved episodes of rejection and underwent annual T1-201 exercise myocardial scintigraphy and coronary angiography. Of 43 pairs of nuclear scans and coronary angiograms, 39 showed normal radiotracer uptake and coronary arteries. In four scans, there were ischemic changes, and in only one case was there significant two-vessel coronary artery disease. The nuclear scans correlated with the coronary angiograms in 93% of the cases. The authors conclude that T1-201 myocardial scintigraphy is insensitive in the early detection of graft rejection and can reliably rule out significant coronary artery disease in transplant recipients

  16. Brain SPECT

    International Nuclear Information System (INIS)

    Feistel, H.

    1991-01-01

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

  17. Disappearance of myocardial perfusion defects on prone SPECT imaging: Comparison with cardiac magnetic resonance imaging in patients without established coronary artery disease

    Directory of Open Access Journals (Sweden)

    Hedén Bo

    2009-08-01

    Full Text Available Abstract Background It is of great clinical importance to exclude myocardial infarction in patients with suspected coronary artery disease who do not have stress-induced ischemia. The diagnostic use of myocardial perfusion single-photon emission computed tomography (SPECT in this situation is sometimes complicated by attenuation artifacts that mimic myocardial infarction. Imaging in the prone position has been suggested as a method to overcome this problem. Methods In this study, 52 patients without known prior infarction and no stress-induced ischemia on SPECT imaging were examined in both supine and prone position. The results were compared with cardiac magnetic resonance imaging (CMR with delayed-enhancement technique to confirm or exclude myocardial infarction. Results There were 63 defects in supine-position images, 37 of which disappeared in the prone position. None of the 37 defects were associated with myocardial infarction by CMR, indicating that all of them represented attenuation artifacts. Of the remaining 26 defects that did not disappear on prone imaging, myocardial infarction was confirmed by CMR in 2; the remaining 24 had no sign of ischemic infarction but 2 had other kinds of myocardial injuries. In 3 patients, SPECT failed to detect small scars identified by CMR. Conclusion Perfusion defects in the supine position that disappeared in the prone position were caused by attenuation, not myocardial infarction. Hence, imaging in the prone position can help to rule out ischemic heart disease for some patients admitted for SPECT with suspected but not documented ischemic heart disease. This would indicate a better prognosis and prevent unnecessary further investigations and treatment.

  18. Comparison of diagnostic value of coronary artery disease between ATP-stress and exercise-stress thallium myocardial SPECT images

    International Nuclear Information System (INIS)

    Suzuki, Shigeo

    1994-01-01

    A study was made between adenosine triphosphate disodium (ATP)-stress thallium myocardial scintigrams and exercise-stress scintigrams to compare their respective extents and degree of defects. The subjects of the study were 33 ischemic heart disease patients, who received ATP stress and treadmill exercise stress with a mean interval of 25 days. ATP was infused for 5 minutes with an infusion rate of 0.16 or 0.18 mg per kg of body weight per minute. Thallium was injected three minutes after infusion. The percent-defect index (percentage of the extent and degree of the defects for all 33 patients), was calculated with visual scoring using a five-zone myocardial division method and semi-quantitative four-grade representation method for both the ATP and exercise SPECT images. The extent of the defects in ATP- and exercise-stress images was 51.5% and 44.2%, and that in redistribution images was 36.4% and 33.9%, respectively. The degree of defects in ATP- and exercise-stress images was 35.8% and 32.3%, while that in redistribution images was 20.8% and 17.2%, respectively (p=NS in all cases). In conclusion, the image quality of thallium SPECT with ATP stress was equivalent that of exercise stress, indicating identical diagnostic values for coronary lesions. (author)

  19. Semiquantitative SPECT myocardial perfusion with dipyridamole in patients unable to exercise. Event rate during 4 years of follow up

    International Nuclear Information System (INIS)

    Balestrini, V.R.; Arja, V.J.; Sandrin, A.L.; Calvo, G.R.; Gomez Bosh, Z.; Quiroga, W.; Balestrini, C.E.; Joekes, S.

    2002-01-01

    The increasingly numbers of patients (P) that can't reach an adequate level of exercise in order to evaluate CAD, lead us to use pharmacological and technical tools available for this subgroup of P. Aim: evaluate the prognostic significance of myocardial perfusion SPECT imaging with pharmacological stress in P without LBBB, unable to exercise. Material and Methods: 209 P were included. Mean age: 65 years old (39-88), male 66%. Clinical: Pre test likelihood 8: 28%; SDS 0 and SRS 0: 31.7%; SDS 0 + SRS >=1: 21%; SDS >=1: 47.3%. III) Follow up: 13 patients were early re-vascularized induced by SPECT study results, 10 patients get lost and 186 were follow up by a mean 1086 days. Cumulative events rate: 1st year SCE 9.7%, HCE 1.6%; 2nd year SCE 14%, HCE 4.3%; 3rd year SCE 17.7%, HCE 5.4%; 4th year SCE 21%, HCE 5,4%. Scintigraphic indices and events rate relationship are presented. Conclusion: There was a relationship between scintigraphic indices and hard cardiac events. The semiquantitative myocardial perfusion with dipyridamole stress was a safe test and useful to discriminate groups of P with different risk of events

  20. Comparison of CsI(Tl) and CsI(Na) partially slotted crystals for high-resolution SPECT imaging

    International Nuclear Information System (INIS)

    Giokaris, N.; Loudos, G.; Maintas, D.; Karabarbounis, A.; Lembesi, M.; Spanoudaki, V.; Stiliaris, E.; Boukis, S.; Sakellios, N.; Karakatsanis, N.; Gektin, A.; Boyarintsev, A.; Pedash, V.; Gayshan, V.

    2006-01-01

    Dedicated systems based on Position Sensitive Photomultiplier Tubes (PSPMTs) coupled to scintillators, have been used over the past years for the construction of compact systems, suitable for applications such as small animal imaging and small organs imaging. Most of the proposed systems are based on fully pixelized scintillators. Previous studies have shown that partially slotted scintillators offer a good compromise between cost, energy resolution and spatial resolution. In this work, the performance of two sets of CsI(Tl) and CsI(Na) partially slotted crystals is compared. Initial results show that CsI(Tl) scintillators are more suitable for gamma-ray detection, since their performance in terms of sensitivity, spatial and energy resolution is superior than that of CsI(Na)

  1. Comparative value of brain perfusion SPECT and [{sup 123}I]MIBG myocardial scintigraphy in distinguishing between dementia with Lewy bodies and Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Hanyu, Haruo; Shimizu, Soichiro; Hirao, Kentaro; Kanetaka, Hidekazu; Iwamoto, Toshihiko [Tokyo Medical University, Department of Geriatric Medicine, Tokyo (Japan); Chikamori, Taishiro; Usui, Yasuhiro; Yamashina, Akira [Tokyo Medical University, 2. Department of Internal Medicine, Tokyo (Japan); Koizumi, Kiyoshi; Abe, Kimihiko [Tokyo Medical University, Department of Radiology, Tokyo (Japan)

    2006-03-15

    Both decreased occipital perfusion on brain single-photon emission computed tomography (SPECT) and reduction in cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) uptake are characteristic features of dementia with Lewy bodies (DLB), and potentially support the clinical diagnosis of DLB. The aim of this study was to compare the diagnostic value of these two methods for differentiation of DLB from Alzheimer's disease (AD). The study population comprised 19 patients with probable DLB and 39 patients with probable AD who underwent both SPECT with N-isopropyl-p-[{sup 123}I]iodoamphetamine and MIBG myocardial scintigraphy. Objective and quantitative measurement of perfusion in the medial occipital lobe, including the cuneus and lingual gyrus, was performed by the use of three-dimensional stereotactic surface projections. Medial occipital perfusion was significantly decreased in the DLB group compared with the AD group. The mean heart/mediastinum ratios of MIBG uptake were significantly lower in the DLB group than in the AD group. Although SPECT failed to demonstrate significant hypoperfusion in the medial occipital lobe in five patients with DLB, marked reduction of MIBG uptake was found in all patients with DLB. Receiver operating characteristic analysis revealed that MIBG myocardial scintigraphy enabled more accurate discrimination between DLB and AD than was possible with perfusion SPECT. MIBG myocardial scintigraphy may improve the sensitivity in the detection of DLB. In particular, this method may provide a powerful differential diagnostic tool when it is difficult to distinguish cases of DLB from AD using brain perfusion SPECT. (orig.)

  2. Comparative value of brain perfusion SPECT and [123I]MIBG myocardial scintigraphy in distinguishing between dementia with Lewy bodies and Alzheimer's disease

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Shimizu, Soichiro; Hirao, Kentaro; Kanetaka, Hidekazu; Iwamoto, Toshihiko; Chikamori, Taishiro; Usui, Yasuhiro; Yamashina, Akira; Koizumi, Kiyoshi; Abe, Kimihiko

    2006-01-01

    Both decreased occipital perfusion on brain single-photon emission computed tomography (SPECT) and reduction in cardiac 123 I-metaiodobenzylguanidine (MIBG) uptake are characteristic features of dementia with Lewy bodies (DLB), and potentially support the clinical diagnosis of DLB. The aim of this study was to compare the diagnostic value of these two methods for differentiation of DLB from Alzheimer's disease (AD). The study population comprised 19 patients with probable DLB and 39 patients with probable AD who underwent both SPECT with N-isopropyl-p-[ 123 I]iodoamphetamine and MIBG myocardial scintigraphy. Objective and quantitative measurement of perfusion in the medial occipital lobe, including the cuneus and lingual gyrus, was performed by the use of three-dimensional stereotactic surface projections. Medial occipital perfusion was significantly decreased in the DLB group compared with the AD group. The mean heart/mediastinum ratios of MIBG uptake were significantly lower in the DLB group than in the AD group. Although SPECT failed to demonstrate significant hypoperfusion in the medial occipital lobe in five patients with DLB, marked reduction of MIBG uptake was found in all patients with DLB. Receiver operating characteristic analysis revealed that MIBG myocardial scintigraphy enabled more accurate discrimination between DLB and AD than was possible with perfusion SPECT. MIBG myocardial scintigraphy may improve the sensitivity in the detection of DLB. In particular, this method may provide a powerful differential diagnostic tool when it is difficult to distinguish cases of DLB from AD using brain perfusion SPECT. (orig.)

  3. Impact of right-ventricular apical pacing on the optimal left-ventricular lead positions measured by phase analysis of SPECT myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Hung, Guang-Uei; Huang, Jin-Long; Lin, Wan-Yu; Tsai, Shih-Chung; Wang, Kuo-Yang; Chen, Shih-Ann; Lloyd, Michael S.; Chen, Ji

    2014-01-01

    The use of SPECT phase analysis to optimize left-ventricular (LV) lead positions for cardiac resynchronization therapy (CRT) was performed at baseline, but CRT works as simultaneous right ventricular (RV) and LV pacing. The aim of this study was to assess the impact of RV apical (RVA) pacing on optimal LV lead positions measured by SPECT phase analysis. This study prospectively enrolled 46 patients. Two SPECT myocardial perfusion scans were acquired under sinus rhythm with complete left bundle branch block and RVA pacing, respectively, following a single injection of 99m Tc-sestamibi. LV dyssynchrony parameters and optimal LV lead positions were measured by the phase analysis technique and then compared between the two scans. The LV dyssynchrony parameters were significantly larger with RVA pacing than with sinus rhythm (p ∝0.01). In 39 of the 46 patients, the optimal LV lead positions were the same between RVA pacing and sinus rhythm (kappa = 0.861). In 6 of the remaining 7 patients, the optimal LV lead positions were along the same radial direction, but RVA pacing shifted the optimal LV lead positions toward the base. The optimal LV lead positions measured by SPECT phase analysis were consistent, no matter whether the SPECT images were acquired under sinus rhythm or RVA pacing. In some patients, RVA pacing shifted the optimal LV lead positions toward the base. This study supports the use of baseline SPECT myocardial perfusion imaging to optimize LV lead positions to increase CRT efficacy. (orig.)

  4. Application of three-class ROC analysis to task-based image quality assessment of simultaneous dual-isotope myocardial perfusion SPECT (MPS).

    Science.gov (United States)

    He, Xin; Song, Xiyun; Frey, Eric C

    2008-11-01

    The diagnosis of cardiac disease using dual-isotope myocardial perfusion SPECT (MPS) is based on the defect status in both stress and rest images, and can be modeled as a three-class task of classifying patients as having no, reversible, or fixed perfusion defects. Simultaneous acquisition protocols for dual-isotope MPS imaging have gained much interest due to their advantages including perfect registration of the (201)Tl and (99m)Tc images in space and time, increased patient comfort, and higher clinical throughput. As a result of simultaneous acquisition, however, crosstalk contamination, where photons emitted by one isotope contribute to the image of the other isotope, degrades image quality. Minimizing the crosstalk is important in obtaining the best possible image quality. One way to minimize the crosstalk is to optimize the injected activity of the two isotopes by considering the three-class nature of the diagnostic problem. To effectively do so, we have previously developed a three-class receiver operating characteristic (ROC) analysis methodology that extends and unifies the decision theoretic, linear discriminant analysis, and psychophysical foundations of binary ROC analysis in a three-class paradigm. In this work, we applied the proposed three-class ROC methodology to the assessment of the image quality of simultaneous dual-isotope MPS imaging techniques and the determination of the optimal injected activity combination. In addition to this application, the rapid development of diagnostic imaging techniques has produced an increasing number of clinical diagnostic tasks that involve not only disease detection, but also disease characterization and are thus multiclass tasks. This paper provides a practical example of the application of the proposed three-class ROC analysis methodology to medical problems.

  5. Myocardial ischemia detection by artificial intelligence interpretation of Tl-201 tomograms

    International Nuclear Information System (INIS)

    Herbst, M.D.; Garcia, E.V.; Cooke, C.D.; Folks, R.D.; Ezquerra, N.F.

    1989-01-01

    This paper reports on an expert system environment which automatically assigned certainty factors to abnormal regions in stress and delayed myocardial thallium-201 polar bulls-eye plots. MYCIN-type algorithms propagated certainty factors for the presence, location, and character of each coronary lesion. Ninety-four previously validated rules that considered only stress perfusion defects spawned 91 new rules considering tracer redistribution. Fifteen new rules assessed vascular territories for the presence and location of fixed or reversible defects. This artificial intelligence tool can provide novice readers of cardiac T1-201 studies automatic, consistent, objective, and justified interpretations that consider artifacts, coronary territory overlap, and multiple defects

  6. The Association between Left Verticle Diastolic Dysfunction and Endothelial Dysfunction and the Result of Stress Myocardial SPECT in Asymptomatic Patients with Type 2 Diabetes

    Czech Academy of Sciences Publication Activity Database

    Charvát, J.; Michalová, K.; Chlumský, J.; Valenta, Zdeněk; Kvapil, M.

    2005-01-01

    Roč. 33, - (2005), s. 473-482 ISSN 0300-0605 Institutional research plan: CEZ:AV0Z10300504 Keywords : coronary heart disease * type 2 diabetes mellitus * left ventricular diastolic dysfunction * left ventricular hyperthropy * stress myocardial SPECT Subject RIV: FA - Cardiovascular Disease s incl. Cardiotharic Surgery Impact factor: 0.653, year: 2005

  7. Frequency and severity of myocardial perfusion abnormalities using Tc-99m MIBI SPECT in cardiac syndrome X

    International Nuclear Information System (INIS)

    Saghari, Mohsen; Assadi, Majid; Eftekhari, Mohammad; Yaghoubi, Mohammad; Fard-Esfahani, Armaghan; Malekzadeh, Jan-Mohammad; Sichani, Babak Fallhi; Beiki, Davood; Takavar, Abbas

    2006-01-01

    Cardiac syndrome X is defined by a typical angina pectoris with normal or near normal (stenosis <40%) coronary angiogram with or without electrocardiogram (ECG) change or atypical angina pectoris with normal or near normal coronary angiogram plus a positive none-invasive test (exercise tolerance test or myocardial perfusion scan) with or without ECG change. Studies with myocardial perfusion imaging on this syndrome have indicated some abnormal perfusion scan. We evaluated the role of myocardial perfusion imaging (MPI) and also the severity and extent of perfusion abnormality using Tc-99m MIBI Single Photon Emission Computed Tomography (SPECT) in these patients. The study group consisted of 36 patients with cardiac syndrome X. The semiquantitative perfusion analysis was performed using exercise Tc-99m MIBI SPECT. The MPI results were analyzed by the number, location and severity of perfusion defects. Abnormal perfusion defects were detected in 13 (36.10%) cases, while the remaining 23 (63.90%) had normal cardiac imaging. Five of 13 (38.4%) abnormal studies showed multiple perfusion defects. The defects were localized in the apex in 3, apical segments in 4, midventricular segments in 12 and basal segments in 6 cases. Fourteen (56%) of all abnormal segments revealed mild, 7(28%) moderate and 4 (16%) severe reduction of tracer uptake. No fixed defects were identified. The vessel territories were approximately the same in all subjects. The Exercise treadmill test (ETT) was positive in 25(69%) and negative in 11(30%) patients. There was no consistent pattern as related to the extent of MPI defects or exercise test results. Our study suggests that multiple perfusion abnormalities with different levels of severity are common in cardiac syndrome X, with more than 30 % of these patients having at least one abnormal perfusion segment. Our findings suggest that in these patients microvascular angina is probably more common than is generally believed

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

    International Nuclear Information System (INIS)

    Yasugi, Naoko; Hiroki, Tadayuki

    2002-01-01

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

  9. Tl scintiscanning hemodynamics and left ventricular kinetics in patients to be suspected of myocardial sarcoidosis

    International Nuclear Information System (INIS)

    Schaedel, H.; Kirsten, D.; Strauss, H.J.; Haenselt, V.; Schmidt, H.; Gottschild, D.; Zinner, G.

    1985-01-01

    The cardiological examination of 22 patients to be suspected of heart sarcoidosis (histologically established sarcoidosis, heart rhythm disturbances, cardiomegaly) has revealed thallium scan defects in 20 patients at rest and during exercise. In 19 patients pathologic left heart wall motions established by levocardiography applying the half axis method were found. The number of pathologic half axis shortenings correlated with ejection fraction, but not with left ventricular enddiastolic pressure and volume index, resp. Coronary heart disease could not be found by coronarography in any case. Myocardial biopsy did not show myocarditis. Cardiomyopathies, other specific heart muscle diseases or rheumatic myocarditis could not be excluded as causes of the results mentioned above. The follow-up examinations of the patients will give more detailed information on the etiology of the pathologic cardiac findings. (author)

  10. Tl-201 myocardial perfusion scanning in patients with right bundle branch block coronary artery disease

    International Nuclear Information System (INIS)

    Shirani, J.; Malpani, A.R.; Blend, M.J.; Bekerman, C.

    1990-01-01

    This paper evaluates the specificity of stress T1-201 myocardial perfusion studies (T1-201 MPS) for coronary artery disease (CAD) in patients with right bundle branch block (RBBB). Twenty-four patients with RBBB and atypical chest pain with ECG findings limited to RBBB, adequate stress test (ie, >85% of maximal heart rate for age), and no clinical, hemodynamic, or ECG evidence of ischemia during exercise underwent T1-201 MPS. These perfusion patterns were compared with an equal number of age- and gender-matched controls with a normal ECG who met all other criteria mentioned above. Patients with RBBB showed a significantly higher frequency of reversible inferoposterior T1-201 defects (62.5% vs 20.8%)

  11. Prognostic value of myocardial perfusion SPECT imaging in elderly patients without history of coronary artery disease and low prevalence of them

    International Nuclear Information System (INIS)

    Arja, V.J.; Balestrini, V.R.; Sandrin, A.L.; Conci, E.C.; Serra, C.M.; Joekes, S.

    2002-01-01

    Elderly patients without history of coronary artery disease are difficult to characterized because the clinical symptoms are often atypical, occult or absent. On the other hand, these patients frequently cannot achieve adequate level of exercise during stress testing and this limitation can compromise the diagnostic and prognostic ability of the test. Generally the prognostic value of myocardial perfusion SPECT is well established for a general population but not for elderly patients. Aim: This study assessed the prognostic value of Tc99m-sestamibi SPECT in a group of patients older than 65 years with low prevalence of coronary artery disease. Material and Methods: Population: 161 consecutive patients older than 65 years without history of coronary artery disease and low prevalence of them were studied with Tc99m-sestamibi SPECT perfusion imaging. Mean age 71 years old (65-87), male 55%, mean pretest likelihood 11%. Risk factors: diabetes 17%, high blood pressure 74%, high cholesterol 45%, smokers 88%. Stress test: bicycle exercise 39% and dipyridamole 61%. Myocardial perfusion SPECT: semiquantitative analysis to evaluate perfusion defects with a 14-segments model and 4-point scoring system for uptake reduction. Scintigraphic indices: SSS (sum of the stress scores), SRS (sum of the rest scores) and SDS (SSS-SRS). Follow up: cardiac events: hard (acute myocardial infarction and cardiac death) and soft (need for PTCA/CABG and angina). Results: Mean follow up: 508 days. Events rate: hard 0.6% (1 acute myocardial infarction), soft 5.6%. Univariate analysis identified sex (p=0.017) and SDS (p=0.009) as cardiac events predictors. Complete or reduced (independent variables which predicted events) logistic regression analysis correctly predicted the absence of events but did not predict the presence of events. Conclusion: In this elderly population with a low clinical risk where the stress test is a suboptimal method of study for coronary artery disease, semiquantitative

  12. Role of stress myocardial perfusion SPECT scan in detection and management of coronary artery disease: Nairobi experience

    International Nuclear Information System (INIS)

    Makhdomi, K.B.; Warshow, M.M.; Patel, P.K.J.; Shah, D.; Githegi, D.R.M.

    2002-01-01

    Aim: Stress myocardial perfusion scans have acquired a significant role in the detection and management of Coronary Artery Disease. However, this mode of investigation has only recently been available in Nairobi, and this is the first such study from East Africa. We undertook a comparison of our results with that in the literature, to see whether they conformed to it. Materials and Methods: We performed a review of our initial 82 evaluable studies. The scans were performed with 99mTc-Tetrofosmin, using the single day stress-rest protocol with SPECT acquisitions. We carried out a correlation of our scan findings with angiographic data (where available), and clinical follow-up. The clinical end points where furnished by the referring physicians. We focused on myocardial infarction, need for re-vascularisation, and death. The mean clinical follow-up was 21.8 months (range of 12 months to 39 months). Results: Eighty (98%) of the studies revealed concordance with angiographic findings and/or were predictive of clinical outcome. Two studies were discordant, and will be discussed. The results are comparable with those in the literature. Conclusion: It is concluded that stress myocardial perfusion studies, done at our Centre, had a good predictive value, with regards to the presence and severity of disease, and correlated with the clinical outcome data

  13. Assessment of Takotsubo (ampulla) cardiomyopathy using 99mTc-tetrofosmin myocardial SPECT. Comparison with acute coronary syndrome

    International Nuclear Information System (INIS)

    Ito, Kazuki; Katoh, Shuji

    2003-01-01

    We assessed Takotsubo (ampulla) cardiomyopathy compared with acute coronary syndrome (ACS) using two-dimensional echocardiography and 99m Tc-tetrofosmin myocardial SPECT. We examined 10 patients with Takotsubo cardiomyopathy and 16 with ACS at the time of emergency admission (acute phase), at three to nine days after the attack (subacute phase) and at one month after the attack (chronic phase). The left ventricle was divided into nine regions on echocardiograms and SPECT images, and the degree of abnormalities in each region was scored in five grades from normal (0) to severely abnormal (4). Coronary angiography revealed total or subtotal occlusion in patients with ACS but no stenotic legions in those with Takotsubo cardiomyopathy. The amount of ST segment elevation (mm) was 7.9±3.4 in patients with Takotsubo cardiomyopathy and 7.3±3.7 in those with ACS (N.S.). Abnormal wall motion scores on echocardiograms were 13.8±4.4, 4.4±3.8 and 1.8±2.3 during the acute, subacute and chronic phases in patients with Takotsubo cardiomyopathy, and 13.9±4.0, 11.7±3.7, 7.6±4.2, respectively in patients with ACS. The value of MB fraction of creatine phosphokinase (IU/l) was 34±23 in patients with Takotsubo cardiomyopathy and 326±98 in those with ACS (p 99m Tc-tetrofosmin myocardial SPECT were 11.4±3.2, 3.2±3.3 and 0.7±1.1 during the acute, subacute and chronic phases respectively, in patients with Takotsubo cardiomyopathy, and 15.8±4.1, 13.5±4.4, 8.2±4.4, respectively, in those with ACS. The numbers of myocardial segments that did not uptake 99m Tc-tetrofosmin during the acute phase were 0.5±0.8 and 3.6±2.8 in patients with Takotsubo cardiomyopathy and ACS, respectively. Impaired coronary microcirculation might be a causative mechanism of Takotsubo cardiomyopathy. (author)

  14. 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.

  15. Clinical application of cardiac SPECT

    International Nuclear Information System (INIS)

    Nishimura, Shigeyuki

    1999-01-01

    Single-photon emission computed tomography (SPECT) has replaced planar imaging techniques for myocardial scintigraphy. Thallium-201 was the dominant agent employed for myocardial perfusion imaging. Today new technetium-99m labelled radionuclides have been used as excellent alternatives to 201 Tl for detection of coronary artery disease, prognostification, and even assessment of myocardial viability. Pharmacologic stress imaging using either dipyridamole, adenosine or dobutamine is a substitute for exercise stress. Accurate determination of myocardial viability is vitally important for clinical decision making for patients with LV dysfunction who will most benefit from revascularization. Stunned and hibernated myocardium may result in profound regional LTV dysfunction in absence of necrosis. The various approach such as stress-redistribution-reinjection imaging, rest-redistribution imaging and stress-redistribution-24 hours delayed imaging has been utilized to assess myocardial viability with 201 Tl. Quantitative assessment of 99m Tc MIBI uptake reflect the degree of viability. 123 I-Metaiodobenzylguanidine (MIBG), an analog of norepinephrine, has been used for scintigraphic assessment of regional cardiac adrenergic innervation. Cardiac sympathetic denervation, assessed by 123 I-MIBG, due to ischemia in non-Q myocardial infarction and unstable angina has been shown. Quantitative cardiac MIBG scintigram was shown to have prognostic value in patients with severe congestive heart failure. 23 I-BMIPP (ρ-methyl-iodophenyl pentadecanoic acid) has been used to assess myocardial fatty acid utilization. BMIPP has the memory function of ischemia in unstable angina, since decreased BMIPP uptake persists several days after ischemic episode. Nuclear cardiology in Japan has experienced an expansion in the techniques including use of new radionuclides, 99m Tc perfusion agents, 123 I-MIBG and 23 I-BMIPP and in associated clinical application to the various cardiac diseases

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

    International Nuclear Information System (INIS)

    Kasalicky, J.; Kidery, J.; Svacinka, J.; Vanko, J.; Brunova, J.; Bartos, V.

    1990-01-01

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

  17. 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)

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-11-30

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

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

    International Nuclear Information System (INIS)

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

    1988-01-01

    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 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. (author)

  1. Early and delayed Tc-99m-tetrofosmin myocardial SPECT in patients with left bundle branch block

    International Nuclear Information System (INIS)

    Sugihara, Hiroki; Kinoshita, Noriyuki; Adachi, Yoshihiko

    1998-01-01

    To determine the utility of the myocardial tracer Tc-99m-tetrofosmin in the examination of patients with left bundle branch block (LBBB) and to investigate Tc-99m-tetrofosmin uptake and retention in the myocardium, early and delayed Tc-99m-tetrofosmin SPECT was performed in 10 patients having LBBB without coronary stenosis. After 740 MBq of Tc-99m-tetrofosmin injection in the resting state, the early and delayed SPECT imaging was done at 30 min and 180 min, respectively. Decreased Tc-99m-tetrofosmin uptake in the septal segments was observed in 4 patients (40%) at 30 min and in 9 (90%) at 180 min. Reverse redistribution was seen in 9 of 10 patients. In patients with LBBB, the septal-to-lateral uptake ratio was lower in the delayed images than in the early images (0.80±0.09 vs. 0.89±0.09, p<0.001). In patients with LBBB, the washout rate of Tc-99m-tetrofosmin was higher in the septal segments than in the lateral segments (28.3±4.3% vs. 22.8±3.3%, p<0.001). The SPECT data indicate that in LBBB without coronary stenosis, the uptake of Tc-99m-tetrofosmin is decreased in the septal wall, and that reverse redistribution occurs frequently. Our results contribute to the elucidation of both the cellular biokinetics of Tc-99m-tetrofosmin in the myocardium and the hemodynamics of the septum in LBBB, and indicate the possible clinical utility of Tc-99m-tetrofosmin. (author)

  2. Clinical usefulness of 123I-labeled 15-iodophenyl 3-methyl pentadecanoic acid (BMIPP) myocardial SPECT in coronary artery disease

    International Nuclear Information System (INIS)

    Ito, Kazuki

    1998-01-01

    123 I-BMIPP (BMIPP) myocardial SPECT was carried out in 22 patients with acute myocardial infarction, in 20 patients with unstable angina pectoris, in 80 patients with effort angina pectoris and in 25 patients with vasospastic angina pectoris. In a study of patients with acute myocardial infarction, BMIPP uptake was less than thallium perfusion in areas of myocardial infarction. Such discordant BMIPP/thallium uptake was often observed in areas with recanalized arteries, and in those with abnormal wall motion. In the areas showing discordant BMIPP/thallium uptake, the wall motion abnormalities improved in the chronic phase after recanalization therapy. Therefore, the discordant BMIPP/thallium uptake might represent asynergic but viable regions, and might be valuable in predicting the improvement of wall motion abnormalities. In a study of patients with unstable angina pectoris, the severity of regional wall motion abnormality was significantly correlated with severity of BMIPP uptake. BMIPP imaging well visualized the culprit regions in patients with unstable angina pectoris. In a study of patients with effort angina pectoris, the abnormal BMIPP images were associated with severe coronary artery stenosis of more than 90% and with multivessel stenosis. BMIPP imaging could detect patients with functionally severe coronary artery disease and help to guide coronary angioplasty in patients with effort angina. In a study of patients with vasospastic angina pectoris, metabolic abnormality assessed by BMIPP was associated with left ventricular asynergy and spastic regions. Those abnormalities also correlated inversely with the period from the last attack, and improved after medical treatment. (K.H.)

  3. Usefulness of 99mTc-MIBI stress myocardial SPECT Bull's-eye quantification incoronary artery disease

    International Nuclear Information System (INIS)

    Rubello, D.; Zanco, P.; Borsato, N.; Chierichetti, F.; Saitta, B.; Ferlin, G.; Candelpergher, G.; Minello, S.

    1995-01-01

    99m Tc-methoxy-isobutyl isonitrile (MIBI) myocardial SPECT quantification performed using a Bull's-eye polar map, was evaluated and compared with visual analysis in 120 patients with proven or suspected CAD. The study series comprised 106 men and 14 women, age 37-75 years, 68 of whom had had a prior myocardial infarction. Coronary angiography was taken as the gold standard. Forty age-matched subjecs, with less than a 5% chance of having CAD, were enrolled to establish the normal database for males and females. ROC analysis was used to calculate the optimal thresholds for the definition of the disease extension in each vascular territory of the Bull's-eye polar map. Bull's-eye analysis agreed with visual analysis in 296/360 vessels. Two and three-vessel disease were most frequently observed using the Bull's-eye approach. However, a greater number of false positive (FP) cases were found with Bull's-eye than with visual analysis (28 versus 3 cases): FP cases were detected principally (21/28) in patients with previous myocardial infarction. It is interesting to note that this phenomenon, commonly observed in the LCX or RCA territory, was almost always correctly interpreted as a FP case by visual analysis. In conclusion, it is found the sensitivity and specificity for CAD diagnosis with the Bull's-eye approach to be similar to that of visual analysis, but the former method seems to be somewhat more sensitive for the localization of LAD and LCX disease. However, particular attention should be paid to patients with previous myocardial infarction, as FP cases are not infrequently observed with quantitative analysis, especially in the LCX and RCA territories

  4. Improved stage of infarction wall motion in AMI. Association between the presence or absence of mismatch in myocardial scintigrams of Tl and BMIPP and CK release pattern

    International Nuclear Information System (INIS)

    Kurihara, Masato; Abe, Masahiro; Abe, Toshihiro; Nagai, Yoshikazu; Ibukiyama, Chiharu

    1998-01-01

    Binuclear myocardial scintigraphy with BMIPP and 201 TlCl was conducted on 40 patients with myocardial infarction. In all of 40 patients, reperfusion therapy in the acute stage succeeded. The relationship between serum CK release pattern and timing of improvement of wall motion at infarct-related area in the chronic stage was investigated. The patients were divided into 3 groups according to the early or late appearance of peak CK, and the presence or absence of B type mismatch in dual myocardial scintigraphy with BMIPP and 201 TlCl obtained one month after acute onset of myocardial infarction. Infarct size obtained from 201 TlCl scintigraphy and wall motion related to infarction were also investigated immediately after reperfusion and one month thereafter, respectively. No differences were recognized between Group I, in which the infarct area had B type mismatch with early appearance of CK peak, and Group II, in which the infarct area also had B type mismatch with the late appearance of CK peak. Although the wall motion did not change at all in Group I, it improved in Group II one month after reperfusion. Group III did not demonstrate B type mismatch with late appearance of CK peak and smaller infarct size compared to those in Group I and Group II. The wall motion in Group III had a tendency to improve immediately after reperfusion and maintain that level one month later. The timing of improvement of wall motion after successful reperfusion in the area with B type mismatch was not uniform. This suggests that the nonuniformity of the timing of improvement of wall motion in the area with B type mismatch is partly attributable to some kinds of injury to myocardium caused by reperfusion. (author)

  5. Studies on Tl-201 single photon emission computed tomography (SPECT) of myocardium in patients with ischemic heart disease

    International Nuclear Information System (INIS)

    Igarashi, Takeki; Yokoi, Toshio; Ueda, Mitsuru; Horimoto, Masashi; Funayama, Naoki; Takenaka, Takashi; Tasho, Teruo; Tsutsuji, Yuko; Oi, Tsuyoshi

    1985-01-01

    Seventy-six patients with IHD were divided into 2 groups, A) angina pectoris (n=50) and B) previous myocardial infarction(n=26). Each group was classified into three subgroups, without considering hypertension, that is 1) without complication, 2) with hypercholesterolemia, and 3) with diabetes mellitus. We studied and compared the findings of ECG, Echocardiogram (ECHO) and Emission CT (ECT) in these patients at rest. In the previous myocardial infarction group (Group B), we could find 100% ischemic patterns on ECG, 100% asynergy of either IVS or the posterior wall on ECHO and higher percentages of various grade of perfusion defects on ECT compared with group A. In group A, the percentages of perfusion defects were similar in three subgroups. But interestingly, in the hypercholesterolemic group, we could find diffuse moth-eaten like low perfusion areas on ECT. Further study is required whether this finding is peculiar for angina pectoris with hypercholesterolemia or an artifact on ECT. The percentage of ischemic patterns on ECG was lower than in the other groups. In angina pectoris with diabetes mellitus, asynergy in ECHO finding was a significantly higher percentage, compared with other groups. We believe, that ECG, ECHO and ECT are of compensatory importance in the diagnosis of patients with IHD. (author)

  6. 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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

  9. Comparison of Diagnostic Accuracy for Detecting coronary Artery Disease of Dipyridamole 99mTc-MIBI Myocardial SPECT and It's Defect Map between Men and Women

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Oh, Byung Hee; Chung, June Key; Lee, Myoung Mook; Park, Young Bae; Lee, Myung Chul; Seo, Jung Don; Lee, Young Woo; Koh, Chang Soon

    1993-01-01

    To evaluate the usefulness and differences in diagnosing coronary artery disease (CAD) between men and women of intravenous dipyridamole 99m Tc-MIBI myocardial SPECT, we obtained 99m Tc-MIBI myocardial SPECT and compared with the findings of coronary angiographies. Ninety eight male and 37 female patients who underwent dipyridamole 99m Tc- MIBI myocardial imaging within one month of cardiac catheterization were studied. Scans were considered abnormal if perfusion defect was detected and the defect size was more than 12% for left anterior descending artery (LAD) and circumflex(LCX) and 8% for right coronary artery (RCA) territories. Lesions ≥ 50% luminal diameter narrowing were considered significant CAD. Overall sensitivity for detection of CAD was 94.3% in men and 96.4% in women; specificity was 70% in men and 52.6% in women (P=not significant, ns). Vessel-matched sensitivity was 75.3% in men and 72.7% in women (P=ns); specificity was 84.6% in men and 67.9% in women (P 99m Tc-MIBI myocardial SPECT is a safe, noninvasive test for evaluation of CAD. There was no gender difference to detect CAD, but more false-positive rate in women especially in the territory of LAD.

  10. Safety and feasibility of thallium-201 myocardial SPECT with intravenous infusion of disodium adenosine triphosphate (ATP) in the diagnosis of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Moon Sun; Park, Chan H.; Yoon, Seok Nam; Kim, Won; Kim, Han Soo [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1998-08-01

    ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet bee sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-102 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Although 76.5% of he patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease.

  11. Safety and feasibility of thallium-201 myocardial SPECT with intravenous infusion of disodium adenosine triphosphate (ATP) in the diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Pai, Moon Sun; Park, Chan H.; Yoon, Seok Nam; Kim, Won; Kim, Han Soo

    1998-01-01

    ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet bee sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-102 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Although 76.5% of he patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease

  12. Aid in the detection of myocardial perfusion abnormality utilizing SPECT atlas and images registration: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Padua, Rodrigo Donizete Santana de [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia]. E-mail: rodrigo_dsp@hcrp.fmrp.usp.br; Oliveira, Lucas Ferrari de [Universidade Federal de Pelotas (UFPel), RS (Brazil). Inst. de Fisica e Matematica. Dept. de Tecnologia da Informacao; Marques, Paulo Mazzoncini de Azevedo [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Centro de Ciencias das Imagens e Fisica Medica; Groote, Jean-Jacques Georges Soares de [Instituto de Ensino Superior COC, Ribeirao Preto, SP (Brazil). Lab. of Artifical Intelligence and Applications; Castro, Adelson Antonio de [Universidade de Sao Paulo (USP), Ribeirao Preto, SP, (Brazil). Faculdade de Medicina; Ana, Lauro Wichert [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Centro de Ciencias das Imagens e Fisica Medica; Simoes, Marcus Vinicius [Universidade de Sao Paulo (USP), Ribeirao Preto, SP, (Brazil). Faculdade de Medicina. Divisao de Cardiologia

    2008-11-15

    To develop an atlas of myocardial perfusion scintigraphy and evaluating its applicability in computer-aided detection of myocardial perfusion defects in patients with ischemic heart disease. The atlas was created with rest-stress myocardial perfusion scintigraphic images of 20 patients of both genders with low probability of coronary artery disease and considered as normal by two experienced observers. Techniques of image registration and mathematical operations on images were utilized for obtaining template images depicting mean myocardial uptake and standard deviation for each gender and physiological condition. Myocardial perfusion scintigraphy images of one male and one female patient were aligned with the corresponding atlas template image, and voxels with myocardial uptake rates two standard deviations below the mean voxel value of the respective region in the atlas template image were highlighted on the tomographic sections and confirmed as perfusion defects by both observe. The present study demonstrated the creation of an atlas of myocardial perfusion scintigraphy with promising results of this tool as an aid in the detection of myocardial perfusion defects. However, further prospective validation with a more representative sample is recommended. (author)

  13. Aid in the detection of myocardial perfusion abnormality utilizing SPECT atlas and images registration: preliminary results

    International Nuclear Information System (INIS)

    Padua, Rodrigo Donizete Santana de; Oliveira, Lucas Ferrari de; Marques, Paulo Mazzoncini de Azevedo; Groote, Jean-Jacques Georges Soares de; Castro, Adelson Antonio de; Ana, Lauro Wichert; Simoes, Marcus Vinicius

    2008-01-01

    To develop an atlas of myocardial perfusion scintigraphy and evaluating its applicability in computer-aided detection of myocardial perfusion defects in patients with ischemic heart disease. The atlas was created with rest-stress myocardial perfusion scintigraphic images of 20 patients of both genders with low probability of coronary artery disease and considered as normal by two experienced observers. Techniques of image registration and mathematical operations on images were utilized for obtaining template images depicting mean myocardial uptake and standard deviation for each gender and physiological condition. Myocardial perfusion scintigraphy images of one male and one female patient were aligned with the corresponding atlas template image, and voxels with myocardial uptake rates two standard deviations below the mean voxel value of the respective region in the atlas template image were highlighted on the tomographic sections and confirmed as perfusion defects by both observe. The present study demonstrated the creation of an atlas of myocardial perfusion scintigraphy with promising results of this tool as an aid in the detection of myocardial perfusion defects. However, further prospective validation with a more representative sample is recommended. (author)

  14. Fatty acid metabolism in symptomatic patients with mitral valve prolapse but without coronary artery disease - comparison with 201Tl myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Voth, E.; Schicha, H.; Neumann, P.; Emrich, D.; Tebbe, U.

    1987-01-01

    Using 123 I-ω-heptadecanoic acid (HDA) and 201 Tl, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination half-life was 26.1±3.6 min, whereas the patients with MVP had a mean value of 25.0±6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31% and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using 201 Tl showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by 201 Tl, presumably due to ischemia based on small-vessel disease or abnormalities of cellular metabolism. (orig.) [de

  15. Both semiquantitative degree of rest Tl-201 uptake and reversibility at 24 hour-delay were needed to predict wall motion improvement after bypass surgery

    International Nuclear Information System (INIS)

    Lee, D. S.; Yoon, S. N.; Kim, K. B.; Jeong, Z. K.; Lee, M. C.; Ko, C. S.

    1997-01-01

    Controversy still exists about how to use the uptake at rest and 24 hour delay in rest redistribution Tl-201 SPECT to predict improvement of wall motion abnormality after bypass surgery. To find the best way to combine diagnostic efficacy of Tl-201 SPECT to predict myocardial viability, we studied the predictive values (positive: PPV, negative: NPV) of rest and 24 hour-delay Tl-201 SPECT in 21 patients. Wall motion was assessed comparing preoperative post-stress gated Tc-99m-MIBI SPECT with that of 3 months after surgery. Four point scoring system was used for 17 myocardial segments to asses uptakes ( 0 to 3 for normal to defect) at rest and 24 hour-delay and wall motion ( 0 to 3 for normal to dyskinesia). Ejection fraction improved after surgery (5011% vs 4313%). Intra-observer and inter-observer reproducibility of EF was 7 and 9% respectively when we used 3D Perfusion-Motion Map. Sixty seven segments showed wall motion abnormality before surgery. Predictive values of rest Tl-201 uptake decrease were as follows: 0: 15/15(100%), 1: 30/34(88%), 2: 6/11 (55%), 3: 3/7(43%). So PPV of mild decrease was 88%, and NPV of severe decrease was 50%. Delayed reversibility was evaluated in 37 segments (15 patients). Twenty seven segment had persistence or aggravation, but the other 10 segments improved at 24 hour delay. PPV of reversible 10 segments was 80%, and NPV of reversibility was only 46%. PPV of combination of rest Tl-201 uptake of mild degree and 24 hour reversibility was 86% (38/44) and NPV of neither one was 88%. We concluded that both semi-quantitative degree of Tl-201 uptake at rest and reversibility at 24 hour delay was the best to warrant or abandon postoperative improvement of abnormal wall motion found at preoperative post-stress gated myocardial SPECT

  16. The Role of Routine Whole Volume SPECT Reconstruction in Comparison to Cine Raw Data in the Detection of Extracardiac Uptake on Myocardial Perfusion Scans

    International Nuclear Information System (INIS)

    Maharaj, M.; Korowlay, N.A.

    2011-01-01

    The objective of this study was to determine the role of routine whole volume reconstructed single-photon emission tomography (rSPECT) compared to cine raw data to detect extracardiac uptake of Sestamibi (MIBI). In a retrospective study, the myocardial perfusion studies of 426 patients were inspected separately for extracardiac uptake on cine raw data and rSPECT. The acquisition parameters for all the images were done according to departmental protocol. The whole volume SPECT data was selected and processed by HOSEM iterative reconstruction using the HERMES computer software system. The images were assessed by two observers, a student in training and a senior consultant nuclear medicine physician. The overall mean age and standard deviation of the 426 patients at the time of the study was 60 ± 12 years. Statistical analysis was performed using the Kappa and McNemars tests. The clinical significance of the extracardiac uptake was evaluated using hospital folders and /or laboratory results after viewing images. rSPECT detected 25 patients (5.9%) and cine raw data identified 18 patients (4.2%) with extracardiac uptake. All the areas of extracardiac uptake noted on cine raw data were seen on the rSPECT images. Only 21 of the 25 patients had complete 5-year clinical follow-up. The value of the clinical significance of the extracardiac uptake was limited due to the study being retrospective. The proportion of positives identified by rSPECT was significantly larger than those identified by cine raw data (P = 0.0082). Although our study demonstrates that rSPECT is more sensitive than cine raw data in detecting extracardiac uptake, it also shows that there is no benefit in routine whole volume rSPECT in daily clinical practice

  17. Clinical usefulness of hyperventilation-loaded SPECT in coronary artery disease

    International Nuclear Information System (INIS)

    Taya, Makoto

    1994-01-01

    The purpose of this study was twofold: (1) to assess the clinical usefulness of hyperventilation-loaded Tl-201 myocardial single photon emission computed tomography (HV-SPECT) in detecting coronary spasm; and (2) to correlate coronary spasm with ischemic heart diseases. A total of 138 patients were examined. They were divided into Group 1 of a total of 69 patients with chest pain at rest, consisting of 25 with vasospastic angina and 44 with atypical chest pain; Group 2 of 37 patients with angina pectoris; and Group 3 of 32 patients with myocardial infarction. In Group I, HV-SPECT was positive in 96% (24/25) for vasospastic angina and 50% (22/44) for atypical angina pectoris. When thallium defect scores 2 or more were interpreted as a decreased thallium uptake, Tl-201 HV-SPECT had a sensitivity of 72%, a specificity of 93%, and an accuracy of 85.6% in diagnosing vasospastic angina. In Group 2, HV-SPECT showed a significantly higher positive rate in patients with resting angina pectoris than those with effort angina pectoris (69% vs 22%). In Group 3, HV-SPECT was a positive rate of 53%. When Nifedipine was administered, the positive cases turned to be negative in 47%. HV-SPECT proved to be useful as a noninvasive method for diagnosing coronary spasm. Coronary spasm was suggested to be present in ischemic heart disease other than vasospastic angina and atypical chest pain. (N.K.)

  18. Rest delayed images on 99mTc-MIBI myocardial SPECT as a noninvasive screen for the diagnosis of vasospastic angina pectoris

    International Nuclear Information System (INIS)

    Ono, Soichi; Yamaguchi, Hiroyuki; Takayama, Shin; Kurabe, Atsushi; Heito, Takayuki

    2002-01-01

    Diagnostic usefulness of 99m Tc-hexakis-2-methoxy isobutyl isonitrile (MIBI) myocardial SPECT at rest was examined in 39 cases of coronary vasospastic angina pectoris who were diagnosed by a positive reaction to ergonovine provocation. SPECT was performed 45 minutes (early image) and 3 hours (delayed image) after the intravenous injection of approximately 600 MBq of MIBI. Decrease in accumulation was ranked by four defect scores (0: normal; 1: slight decrease; 2: moderate decrease; 3: severe decrease) and the total defect score was evaluated semiquantitatively. The washout rate between the normal area and the spasm area was also evaluated quantitatively using bull's eye. As a result, 15 cases (15/39; 38.4%) showed decreased accumulation in the early image and 27 cases (27/39; 69.2%) showed decreased accumulation in the delayed image. All of the cases which showed decreased accumulation in the early image had decreased accumulation in the delayed image as well. In 6 cases (6/34; 17.6%) showed ST wave changes during exercise ECG and 16 cases (16/34: 47%) showed decreased accumulation in the exercise myocardial SPECT. The washout rate of MIBI in the decreased accumulation area was significantly higher than that of the normal area. Of 32 ergonovine induced vasospastic area, 23 areas (72%) exhibited decreased accumulation in the delayed image for the same area. Decreased accumulation in the delayed image in MIBI was due to the enhanced washout, which, in turn, indicated declined retention of MIBI by mitochondrial membrane. In coronary vasospastic angina pectoris, spasm induced ischemia was thought to have an effect on the mitochondria. This study suggested that even with a normal exercise ECG and exercise myocardial SPECT, there's a strong possibility of coronary vasospastic angina pectoris if a decreased accumulation was found in the delayed image in the MIBI myocardial SPECT at rest. Hence, in diagnosing coronary vasospastic angina pectoris, the delayed image in the

  19. New software for raw data mask processing increases diagnostic ability of myocardial SPECT imaging.

    Science.gov (United States)

    Tanaka, Ryo; Yoshioka, Katsunori; Seino, Kazue; Ohba, Muneo; Nakamura, Tomoharu; Shimada, Katsuhiko

    2011-05-01

    Increased activity of myocardial perfusion tracer technetium-99m in liver and hepatobiliary system causes streak artifacts, which may affect clinical diagnosis. We developed a mask-processing tool for raw data generated using technetium-99m as a myocardial perfusion tracer. Here, we describe improvements in image quality under the influence of artifacts caused by high accumulation in other organs. A heart phantom (RH-2) containing 15 MBq of pertechnetate was defined as model A. Model B was designed in the same phantom containing ten times of cardiac radioactivity overlapping with other organs. Variance in the vertical profile count in the lower part of the myocardial inferior wall and in the myocardial circumferential profile curve were investigated in a phantom and clinical cases using our raw data masking (RDM) software. The profile variances at lower parts of myocardial inferior walls were 965.43 in model A, 1390.11 in model B and 815.85 in B-RDM. The mean ± SD of myocardial circumferential profile curves were 83.91 ± 7.39 in model A, 69.61 ± 11.45 in model B and 82.68 ± 9.71 in model B-RDM. For 11 clinical images with streak artifacts, the average of the variance significantly differed between with and without RDM (3.95 vs. 21.05; P software. The waiting time between infusion and image acquisition should be decreased, thus reducing patient burden and improving the diagnostic ability of the procedure.

  20. The usefulness of the nuclear cardiology in the cellular implant in patients with severe myocardial damage

    International Nuclear Information System (INIS)

    Omelas A, M.; Arguero S, R.; Garrido G, M.H.; Rodriguez C, A.; Careaga, G.; Castano G, R.; Nambo, M.J.; Pascual P, J.; Ortega R, A.; Gaxiola A, A.; Magana S, J.A.; Estrada A, H.; Equipo de Tecnicos en Medicina Nuclear

    2005-01-01

    The recent therapeutic advances as the cellular implant as well as those different protocols of image acquisition in the field of the Nuclear Cardiology its have allowed that the patient with severe myocardial damage and without some possibility of revascularization is benefited with these advances. Doubtless the Tl-201 par excellence has an important paper for standardize the more appropriate therapeutic behavior for the heart attack patient; reason by this investigation protocol was developed. The objective of the study was to identify the heart attack regions without viable tissue with SPECT in patient with important myocardial damage without some possibility of traditional revascularization; for the 'Stem cell' cellular implantation therapy. The methodology it was carried out by a study of myocardial perfusion in 10 patients with important myocardial damage previous cellular implants, with PICANUC/ SPECT methodology and using a software (Emory Tool Box) for the image processing validated by the University of Emory Atlanta GA; and using as tracer the Tl - 201 to identify the heart attack regions without presence of viable tissue with an analysis model of 17 segments standardized for the left ventricle; qualifying this way the myocardial perfusion in: 0 (normal), 1 (light), 2 (moderate), 3 (severe), 4 (absent) and x (bad technique). The conclusions were that the SPECT study with PICANUC methodology with Tl-201 is safe and effective for the precise localization for the cellular implantation via direct intra myocardial. (Author)

  1. Quantitative interpretation of myocardial Tl-201 single-photon emission computerized tomograms: A probabilistic approach to the assessment of coronary artery disease

    International Nuclear Information System (INIS)

    Maddahi, J.; Prigent, F.; Staniloff, H.; Garcia, E.; Becerra, A.; Van Train, K.; Swan, H.J.C.; Waxman, A.; Berman, D.

    1985-01-01

    Probabilistic criteria for abnormality would enhance application of stress-redistribution Tl-201 rotational tomography (tomo) for evaluation of coronary artery disease (CAD). Thus, 91 pts were studied, of whom 45 had angiographic CAD (≥ 50% coronary narrowing) and 46 were normal (nl). The validity of this model was prospectively tested in the remaining 51 pts (26 nls and 25 with CAD) by comparing the predicted and observed likelihood of CAD in four subgroups (I-IV). In this paper a logistic model is developed and validated that assigns a CAD likelihood to the quantified size of tomograhic myocardial perfusion defects

  2. Interpretative intra- and interobserver reproducibility of Stress/Rest 99m Tc-steamboat's myocardial perfusion SPECT using semi quantitative 20-segment model

    International Nuclear Information System (INIS)

    Fazeli, M.; Firoozi, F.

    2002-01-01

    It well established that myocardial perfusion SPECT with 201 T L or 99 mTc-se sta mi bi play an important role diagnosis and risk assessment in patients with known or suspected coronary artery disease. Both quantitative and qualitative methods are available for interpretation of images. The use of a semi quantitative scoring system in which each of 20 segments is scored according to a five-point scheme provides an approach to interpretation that is more systematic and reproducible than simple qualitative evaluation. Only a limited number of studies have dealt with the interpretive observer reproducibility of 99 mTc-steamboat's myocardial perfusion imaging. The aim of this study was to assess the intra-and inter observer variability of semi quantitative SPECT performed with this technique. Among 789 patients that underwent myocardial perfusion SPECT during last year 80 patients finally need to coronary angiography as gold standard. In this group of patients a semi quantitative visual interpretation was carried out using short axis and vertical long-axis myocardial tomograms and a 20-segments model. These segments we reassigned on six evenly spaced regions in the apical, mid-ventricular, and basal short-axis view and two apical segments on the mid-ventricular long-axis slice. Uptake in each segment was graded on a 5-point scale (0=normal, 1=equivocal, 2=moderate, 3=severe, 4=absence of uptake). The steamboat's images was interpreted separately w ice by two observers without knowledge of each other's findings or results of angiography. A SPECT study was judged abnormal if there were two or more segments with a stress score equal or more than 2. We con eluded that semi-quantitative visual analysis is a simple and reproducible method of interpretation

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

    Science.gov (United States)

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

    2012-07-01

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

  4. 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)

  5. Simultaneous Tc-99m/I-123 dual-radionuclide myocardial perfusion/innervation imaging using Siemens IQ-SPECT with SMARTZOOM collimator

    International Nuclear Information System (INIS)

    Du, Yong; Frey, Eric C; Bhattacharya, Manojeet

    2014-01-01

    Simultaneous dual-radionuclide myocardial perfusion/innervation SPECT imaging can provide important information about the mismatch between scar tissue and denervated regions. The Siemens IQ-SPECT system developed for cardiac imaging uses a multifocal SMARTZOOM collimator to achieve a four-fold sensitivity for the cardiac region, compared to a typical parallel-hole low-energy high-resolution collimator, but without the data truncation that can result with conventional converging-beam collimators. The increased sensitivity allows shorter image acquisition times or reduced patient dose, making IQ-SPECT ideal for simultaneous dual-radionuclide SPECT, where reduced administrated activity is desirable in order to reduce patient radiation exposure. However, crosstalk is a major factor affecting the image quality in dual-radionuclide imaging. In this work we developed a model-based method that can estimate and compensate for the crosstalk in IQ-SPECT data. The crosstalk model takes into account interactions in the object and collimator-detector system. Scatter in the object was modeled using the effective source scatter estimation technique (ESSE), previously developed to model scatter with parallel-hole collimators. The geometric collimator-detector response was analytically modeled in the IQ-SPECT projector. The estimated crosstalk was then compensated for in an iterative reconstructio