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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. 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)

  3. 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.)

  4. Assessment of hibernating myocardium following coronary artery bypass grafting using resting 201Tl myocardial SPECT

    International Nuclear Information System (INIS)

    Oshima, Motoo; Higashi, Shizuka; Yasukochi, Hiroshi; Hayase, Shuhei.

    1995-01-01

    In this study, the effect of coronary artery bypass grafting (CABG) in 35 patients (pts) (male 29, female 6) with fixed defects were evaluated before and one month after surgery using resting 201 Tl SPECT. Nine pts (7 old myocardial infarction; OMI) had 2 vessel disease (VD) and 26 pts (19 OMI) had 3 VD. Pts ages ranged from 41 to 75 (mean 61.4±8.4) years. All 35 pts were divided into 4 groups according to the results of 201 Tl SPECT and left ventriculogram pre- and post-CABG. Thirteen pts who improved of both 201 Tl SPECT and wall motion scores post-CABG were considered as hibernating myocardium (group I). Nine patients who improved of 201 Tl SPECT score but no change of wall motion were group II. Seven pts who improved of wall motion but no change of 201 Tl SPECT score were group III. Six pts who had no improvement of both 201 Tl SPECT and wall motion scores were group IV and considered as myocardial infarction. (author)

  5. 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)

  6. ATP-loaded diagnosis. A comparison of Tl myocardial SPECT and echocardiography

    International Nuclear Information System (INIS)

    Okura, Katsuya; Harada, Masahiko; Ri, Tetsuo; Sugiyama, Sukekimi; Suzuki, Shinji; Hirai, Hironori; Hase, Hiroki; Yabuki, So; Yamaguchi, Toru

    1996-01-01

    Tl myocardial SPECT and echocardiography under ATP loading were compared for diagnosis of ischemic heart (coronary artery) diseases. ATP (0.14 mg/kg/min) was dripped intravenously to 35 patients with ischemic heart disease of 64 +/- 11 y for 5 min. Before and during dripping, echocardiograms were continuously taken. At 4 min after dripping, 111 MBq of Tl was injected intravenously and conventional SPECT was performed at the early and delayed stages. The sensitivity for detection of stenosis was 79% in SPECT and 50% in echocardiography (p<0.01) and the specificity, 84% and 100% (p<0.05), respectively. The sensitivity for the stenotic grade was higher in SPECT than in echocardiography (p<0.05). In 11 false negatives in SPECT, echocardiography gave 4 true positives. The combination of the two methods was thus useful. (K.H.)

  7. Assessment of reverse redistribution on exercise [sup 201]Tl myocardial SPECT in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-06-01

    Reverse redistribution is revealed on exercise [sup 201]Tl myocardial SPECT in some cases of hypertrophic cardiomyopathy. Ten patients with hypertrophic cardiomyopathy without coronary artery disease who showed reverse redistribution visually were studied. Reverse redistribution was evaluated by the early and delayed images of exercise [sup 201]Tl myocardial SPECT. Relation between reverse redistribution and distribution of left ventricular hypertrophy estimated by echocardiography and magnetic resonance imaging was investigated, and the mechanism of reverse redistribution was analyzed by referring to Bull's eye display of washout rate. Reverse redistribution was displayed in non-hypertrophic region and washout rate was normal in that region and low in hypertrophic region. In conclusion, in order to interpret reverse redistribution it is necessary to recognize hypertrophic region and to refer to washout rate. (author).

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-01-01

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

  9. 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)

  10. 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

  11. Evaluation of no-reflow phenomenon using 201TlCl/123I-BMIPP dual-isotope myocardial SPECT.

    Science.gov (United States)

    Shimizu, Yasuhiro; Kumita, Shin-ichiro; Cho, Keiichi; Toba, Masahiro; Mizumura, Sunao; Tanaka, Keiji; Takano, Teruo; Kumazaki, Tatsuo

    2006-10-01

    We assessed the usefulness of (201)thallous chloride (TlCl)/(123)I-beta-methyl iodophenyl pentadecanoic acid (BMIPP) dual-isotope single-photon emission computed tomography (SPECT) to identify the "no-reflow phenomenon," defined as inadequate myocardial perfusion through a given segment of the coronary circulation without angiographic evidence of mechanical vessel obstruction. (201)TlCl/(123)I-BMIPP SPECT was performed in 73 patients within approximately 1 week of initial acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). We divided the left ventricular myocardium into 17 segments on each SPECT image and scored tracer accumulation in each segment with a five-point scoring system according to the American Heart Association criteria. Total severity scores were calculated by summing the scores for all 17 segments. The mismatch ratio between myocardial perfusion and metabolism was derived from the (201)TlCl and (123)I-BMIPP total severity scores: mismatch ratio=((123)I-BMIPP total severity score -(201)TlCl total severity score)/(123)I-BMIPP total severity score. Patients were classified according to Thrombolysis in Myocardial Infarction (TIMI) flow grade as having TIMI reflow grade 0-I (TIMI 0-I reflow group; n=11), II (TIMI II reflow group; n=17) and III (TIMI III reflow group; n=45). The TIMI III reflow group was subdivided into two groups with (201)TlCl total severity scores of or =14 (TIMI III (B) reflow group; n=9), respectively. The mismatch ratios in the TIMI II (0.4 +/- 0.3) and TIMI III (0.4 +/- 0.2) reflow groups were significantly higher than that in the TIMI 0-1 reflow group (0.1 +/- 0.1, pisotope myocardial SPECT reveals the biochemical degree of the no-reflow phenomenon, whereas coronary angiography shows recanalized vascular flow only. Dual-isotope myocardial SPECT might be useful for evaluating reperfusion therapy.

  12. 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)

  13. 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

  14. 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.)

  15. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-01-01

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

  17. 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)

  18. 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

  19. 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.)

  20. [sup 123]I-labelled BMIPP fatty acid myocardial scintigraphy in patients with hypertrophic cardiomyopathy: SPECT comparison with stress [sup 201]Tl

    Energy Technology Data Exchange (ETDEWEB)

    Taki, J.; Nakajima, K.; Bunko, H.; Shimizu, M.; Taniguchi, M.; Hisada, K. (Kanazawa Univ. (Japan). School of Medicine)

    1993-03-01

    [sup 123]I-labelled 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) myocardial single photon emission computed tomography (SPECT) was performed in 17 patients with hypertrophic cardiomyopathy, and was compared with [sup 201]Tl exercise stress myocardial perfusion (SPECT) images. Fourteen patients showed asymmetrical hypertrophy, and three demonstrated apical hypertrophy. SPECT was performed 20 min and 3 h after injection of 111 MBq [sup 123]I-BMIPP at rest. Exercise stress [sup 201]Tl SPECT was performed at 10 min and 3 h after injection and was compared with BMIPP imaging. In 13 patients BMIPP accumulation in the hypertrophied area in the 20 min image was lower that that of 3 h [sup 201]Tl uptake. Interestingly, six patients demonstrated [sup 201]Tl redistribution in the region where the uncoupling of BMIPP uptake at 20 min and [sup 201]Tl accumulation at 3 h after exercise was observed. These findings suggest that impaired fatty acid metabolism or utilization in hypertrophic myocardium and ischaemia or impaired coronary flow reserve may be one of the causes of the abnormality of fatty acid accumulation. (Author).

  1. Serial change of TL/BMIPP dual SPECT myocardial scintigram in patients with acute myocardial infarction. Meaning of chronic mismatch phenomenon

    International Nuclear Information System (INIS)

    Iwasawa, Hirohito; Abe, Masahiro; Abe, Toshihiro; Nagai, Yoshikazu; Ibukiyama, Chiharu

    1999-01-01

    This study was aimed to elucidate the serial changes and clinical significance of accumulation mismatch with TL and BMIPP dual SPECT myocardial scintigraphy during 6 months in patients with acute myocardial infarction (AMI). The dual SPECT scintigraphy was performed at one, three and six months after onset of AMI in 46 patients who underwent reperfusion therapy. Long axis fractional shortening in infarct-related area and left ventricular end-diastolic volume index (LVEDVI) were measured by left ventriculography performed immediately after reperfusion and at one, six months after onset of AMI. The patients were divided into two groups: those with mismatch (Group (+)) and those without (Group (-)) at one month after reperfusion. Group (+) was subdivided into three groups according to duration of persistence of mismatch; one month persistence (1M), three months (3M) and six months (6M). Improvement of wall motion abnormality (WMA) in infarct-related area was seen at one month after reperfusion in group 1M and group 3M, while group 6M showed no apparent change in WMA throughout the study period. LVEDVI did not change at six months after reperfusion in group 1M and 3M, while significant increase was seen in group 6M. It is concluded that the case with disappearance of mismatch between TL and BMIPP until three months after reperfusion indicates myocardial stunning while in the case with long-standing mismatch left ventricular remodeling is suggested. (author)

  2. Comparison of Exercise Tc-99m Tetrofosmin Myocardial Perfusion SPECT with Exercise Tl-201 Myocardial Perfusion SPECT in the diagnosis of coronary artery disease in patients with left bundle branch block (LBBB)

    International Nuclear Information System (INIS)

    Kumar, R.; Barai, S.; Malhotra, A.; Karthikeyan, G.; Mishra, S.; Sood, A.K.

    2004-01-01

    Exercise Tl-201 Myocardial Perfusion SPECT (MPS) has poor specificity for the diagnosis of coronary artery disease (CAD) in patients with left bundle branch block (LBBB). Tc-99m-Tetrofosmin is an agent with kinetics similar to Sestamibi. There has not been any study reported in literature comparing exercise Tc-99m Tetrofosmin MPS with that of exercise Tl-201 MPS in patients with LBBB. We compared exercise Tc-99m-Tetrofosmin MPS with exercise Tl-201 MPS in the diagnosis of coronary artery disease (CAD) in patients with LBBB. Exercise Tc-99m Tetrofosmin and Tl-201 myocardial SPECT studies were conducted in 15 patients with LBBB suspected to have CAD. All patients underwent coronary angiography. Both tests were assessed for their ability to differentiate normally perfused coronary artery territories from those supplied by a diseased coronary artery, with special reference to the septum. Tc-99m Tetrofosmin MPS identified 13 out of 15 segments perfused by a stenosed coronary artery as compared to 14 by Tl-201 SPECT. Tc99m-Tetrofosmin and Tl-201 MPS studies revealed perfusion abnormalities in 15 and 16 of 40 normal segments respectively. False positive perfusion defects over the septum identified on the stress thallium scans did not show reversibility in the rest images. There was no difference in the reversibility of the true and false positive segments identified on the Tetrofosmin scans. The results of this study showed comparable efficacy of exercise Tc-99m Tetrofosmin MPS and Tl-201 MPS in the diagnosis of CAD in patients with LBBB. (author)

  3. Tl-201 Gated-SPECT: Post-exercise regional myocardial dysfunction in normoperfused territories as an indicator of TVD

    International Nuclear Information System (INIS)

    Bharathi Dasan, J.; Choudhury, S.; Hadi, M.; Kumar, R.; Malhotra, A.; Karthikeyan, G.

    2002-01-01

    Introduction: The identification of multivessel coronary artery disease has implications in management of patients with coronary artery disease (CAD). Non-gated Thallium-201 SPECT has a suboptimal sensitivity in the detection of individual coronary stenoses in patients with multi-vessel disease. The present study assesses the incremental value of regional post-stress myocardial dysfunction obtained with Thallium-201 gated SPECT studies (Tl-201gSPECT), in the detection of individual coronary stenoses in patients with triple-vessel coronary artery disease (TVD). Materials and Methods: Patients in group I, n= 25 (24 males, 1 female), aged 36 to 75 years (avg-56 + 9.3 yrs), with previously diagnosed or subsequently proven angiographic evidence of TVD, underwent same day exercise stress and redistribution myocardial Tl-201 gSPECT studies. An additional 15 patients (13 males, 2 females), aged 41 to 75 (avg. 58 + 9), who were angiographically normal (n=3) or had SVD (n=7) or DVD (n=5) were also recruited under the same protocol (group II). All patients underwent symptom limited treadmill exercise with the same protocol. The mean double product in group I was 22,985 + 4280 and the reasons for termination of exercise were THR in 14, dyspnoea in 7, fatigue in 2, ischemic ST segment changes in 1 and angina in 1. In group II, the mean double product was 24000 + 4326 and the reasons for termination of exercise were THR in 11, fatigue in 2, and chest pain in 1. The anterior and inferior myocardial walls were each divided into 3 segments, the septum and lateral wall into 6 and apex into 2. Segmental perfusion (SP), walls thickening (WT) and wall motion (WM) were then assessed. SP was scored from 0=normal to 4= absent. Emory Cardiac Toolbox software generated polar maps were used to score WT. WM was assessed qualitatively using scores of 0=normal to 4= dyskinesia. Where the endocardial border was not visualized, computer generated endocardial outlines were used to assess the wall

  4. 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

  5. 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

  6. Evaluation of simultaneous 99mTc-MIBI and 201Tl dual-isotopic myocardial perfusion SPECT imaging for the detection of the hibernating myocardium

    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 rest technetium-99m sestamibi ( 99m Tc-MIBI) and stress-reinjection thallium-201 (201Tl) simultaneous dual-isotopic myocardial perfusion SPECT imaging in the detection of the 'hibernating myocardium'. Methods: 77 patients with suspected coronary artery disease underwent simultaneous dual-isotopic myocardial perfusion SPECT imaging with 99m Tc-MIBI and 201Tl. 18mCi (666 MBq) 99m Tc-MIBI was injected at rest, 15 min later dobutamine was instilled into vein begin with 5 mg·kg-1 min-1, before and after instilling the base ECG, blood pressure, heart rate was recorded, when the end point were reached, 3mCi (111 MBq) thallium-201 was injected, the early dual-isotopic simultaneously SPECT imagine was performed. After tomographic reconstruction, the defect were found on the stress 201Tl and rest 99m Tc-MIBI image, 3 hr later 1mCi (37 MBq) thallium-201 was reinjected. 30 min later after that the delay dual-isotopic simultaneously SPECT imagine was performed. The images were interpreted by two experienced observers without previous knowledge of results of other studies. In two weeks, coronary angiography was performed. Results: (1) All of 77 patient were found abnormal by angiography, 39 of those with one coronary artery abnormality, 27 with two coronary artery abnormality, 11 with three coronary artery abnormality. (2) 23 with the radioactivity defect on the stress 201Tl and rest 99m Tc-MIBI image showed radiofilling on the reinjection images, therefore 'hibernating myocardium' was suggested. (3) 54 with the radioactivity defect on the stress 201Tl and rest 99m Tc-MIBI image didn't show radiofilling on the reinjection images, thus infarct myocardium or scar issue was suggested. Conclusion: Simultaneous rest 99m Tc-MIBI and stress-reinjection 201Tl Dual-isotopic myocardial perfusion SPECT imaging is an effective method in the detection of the hibernating myocardium. (authors)

  7. 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)

  8. 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.)

  9. 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

  10. 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

  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. 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

  13. 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

  14. Clinical evaluation of Tl-201 SPECT in nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Togawa, Takashi; Yui, Nobuharu; Shimada, Fumiyuki; Omura, Ken; Katahashi, Tatsuaki; Hatano, Kazuo [Chiba Cancer Center (Japan). Hospital

    1995-03-01

    Tl-201 SPECT was performed on 19 patients, 13 males and 6 females aged 28 to 73 yrs (mean 51), with nasopharyngeal carcinoma (NPC) histologically proven to evaluate whether or not Tl-201 SPECT was useful and reliable for assessing the tumor viability of NPC. Thirty eight Tl-201 SPECT studies were performed for the follow-up study after radiation therapy in 9 of 19 patients and for the assessment of tumor extent before treatment in the other 10 patients. Data acquisition was started 5 min after the intravenous injection of 111 MBq of Tl-201 chloride using a three-head rotating gamma camera (Toshiba GCA 9300A) equipped with fan-beam collimators. Tl-201 clearly accumulated to the tumor in 10 patients before radiation treatment and increased Tl-201 uptake by the lesion disappeared after the treatment. Three of 9 patients who were followed up after radiotherapy developed apparent local recurrence and Tl-201 SPECT could definitely visualize these recurrent lesions. Tl-201 SPECT was very useful for detecting local recurrent tumor. High resolution SPECT system with the use of Tl-201 chloride is a new reliable and accurate diagnostic tool for assessing the tumor viability of NPC. (author).

  15. Detection of extracardiac disease during Tl-201 myocardial perfusion study

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-07-01

    It is important to observe extracardiac disease processes (ECD) during cardiac perfusion imaging for valuable information can be obtained at no extracost to patients. The aim of the study is to find out the frequency of ECD during Tl-201 stress myocardial perfusion imaging (TSMPI). Retrospective evaluation of 552 TSMPI was done. There were 229 males and 223 females reffered for evaluation of possible ischemic heart disease. Their ages range from 20 to 80 with mean age of 58.8 years. Three mCi (111 MBq) of 201 TlCl is used for adenosine or treadmil exercise testing and myocardial SPECT is performed utilizing low energy high resolution collimators and a triple-head camera ( MultiSPECT, Siemens medical systems, Inc., Hoffman Estate, III., USA). In addition to routine cardiac Tl-201 SPECT acquisition, included in the protocol is 1 min, anterior planar views in 128 128 matrix after stress and rest SPECT studies for evaluation of lung uptake and chamber size. Utilizing these views ECD is assessed. Five patients had focal increased activity suggesting tumor and 3 of 5 cases were confirmed as malignancy. The malignancies were thyroid cancer (Hurthle cell), lung cancer, and breast cancer. Benign lesions were autonomous thyroid nodule and pheochromocytoma. Other ECDs include pericardial effusion, pleural effusion, and paralyzed hemidiapharm.. Extracardiac disease processes such as benign or malignancy are easily detected during Tl-201 myocardial perfusion imaging using our acquisition protocol at no cost to the patients. This information could be life saving in some patients for early detection of clinically unsuspected malignancy.

  16. Tl-201 SPECT in nasopharyngeal carcinoma for monitoring treatment response

    Energy Technology Data Exchange (ETDEWEB)

    Togawa, Takashi; Yui, Nobuharu; Hatano, Kazuo; Sekiya, Yuichi; Shimada, Fumiyuki; Omura, Ken; Takeuchi, Yosuke [Chiba Cancer Center Hospital (Japan); Katahashi, Tatsuaki

    1996-03-01

    A total of 43 Tl-201 SPECT studies were performed on 11 patients with nasopharyngeal carcinoma (NPC) histologically proven before and after treatment to evaluate whether or not Tl-201 SPECT was a useful diagnostic tool for assessing tumor viability. Data acquisition was started 5 min after the intravenous injection of 111 MBq of Tl-201 chloride using 3-head rotating gamma camera SPECT systems (GCA-9300A). Three patients received radiotherapy alone and the other 8 received radiotherapy and chemotherapy. Treatment response was classified as complete response (CR), partial response (PR), and no change (NC) based on the findings of MRI. Intense Tl-201 uptake by the tumor was seen in all patients before treatment. After treatment, MRI showed 1 CR and 10 PR patients, whereas Tl-201 uptake was decreased in 4 and disappeared in 7 patients. Follow-up MRI and Tl-201 SPECT studies of 4 PR patients revealed that tumor gradually decreased after the desappearance of Tl-201 uptake. Tl-201 SPECT was a very useful tool for monitoring radiotherapeutic effects. (author).

  17. 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)

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

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  19. 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

  20. 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.

  1. Relationship between thallium-201 myocardial SPECT and findings of endomyocardial biopsy specimens in dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Motohiro; Gotoh, Kohshi; Nagashima, Kenshi [Gifu Univ. (Japan). School of Medicine] (and others)

    2001-02-01

    The purpose of this study was to clarify which myocardial histological findings associated with dilated cardiomyopathy (DCM) are reflected in quantitative {sup 201}Tl myocardial SPECT. We obtained studied SPECT images from 21 patients with DCM 10 minutes and 2 hours after they received an injection of 111 MBq {sup 201}Tl at rest. We calculated the percent coefficient of variation of myocardial {sup 201}Tl counts [%CV(Tl)], the washout rate (WR), standard deviation of WR [SD(WR)], extent score (ES) and severity score (SS). We used image analysis to measure % fibrosis, % myocytes, the ratio of fibrous tissue to myocyte tissue (F/My), myocyte size and standard deviation of myocyte size [SD(My)] in left ventricular endomyocardial biopsy specimens. The %CV(Tl) was correlated with % fibrosis and F/My. The ES and SS also correlated with F/My. The correlation between SD(WR) and SD(My) was significant. The present findings suggest that %CV(Tl), ES and SS of rest {sup 201}Tl SPECT reflect myocardial fibrosis and that the standard deviation of washout reflects the distribution of myocyte size. (author)

  2. Usefulness of rest-redistribution on thallium myocardial scintigraphy in patients with acute myocardial infarction by SPECT

    International Nuclear Information System (INIS)

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

    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 201 Tl. Bull's eye images and unfolded map images were prepared. A 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 (ΔEF>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)

  3. 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

  4. 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)

  5. 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.)

  6. Creation and characterization of normal myocardial perfusion imaging databases using the IQ·SPECT system.

    Science.gov (United States)

    Okuda, Koichi; Nakajima, Kenichi; Matsuo, Shinro; Kondo, Chisato; Sarai, Masayoshi; Horiguchi, Yoriko; Konishi, Takahiro; Onoguchi, Masahisa; Shimizu, Takeshi; Kinuya, Seigo

    2017-01-03

    Image acquisition by short-time single-photon emission-computed tomography (SPECT) has been made feasible by IQ·SPECT. The aim of this study was to generate normal databases (NDBs) of thallium-201 ( 201 Tl) myocardial perfusion imaging for IQ·SPECT, and characterize myocardial perfusion distribution. We retrospectively enrolled 159 patients with a low likelihood of cardiac diseases from four hospitals in Japan. All patients underwent short-time 201 Tl myocardial perfusion IQ·SPECT with or without attenuation and scatter correction (ACSC) in either supine or prone position. The mean myocardial counts were calculated using 17-segment polar maps. Three NDBs were derived from supine and prone images as well as supine images with ACSC. Differences between the supine and prone positions were observed in the uncorrected sex-segregated NDBs in the mid-inferolateral counts (p ≤ 0.016 for males and p ≤ 0.002 for females). Differences between IQ·SPECT and conventional SPECT were also observed in the mid-anterior, inferolateral, and apical lateral counts (p ≤ 0.009 for males and p ≤ 0.003 for females). Apical low counts attributed to myocardial thinning were observed in the apical anterior and apex segments in the supine IQ·SPECT NDB with ACSC. There were significant differences between uncorrected supine and prone NDBs, between uncorrected supine NDB and supine NDB with ACSC, and between uncorrected supine NDB and conventional SPECT NDB. Understanding the pattern of normal distribution in IQ-SPECT short-time acquisitions with and without ACSC will be helpful for interpretation of imaging findings in patients with coronary artery disease (CAD) or low likelihood of CAD and the NDBs will aid in quantitative analysis.

  7. 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.)

  8. 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

  9. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Lee, Dong Soo; Kang, Won Jon; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-02-01

    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.

  11. Estimation of infarct size by three-dimensional surface display method of myocardial single photon emission CT with 201Tl

    International Nuclear Information System (INIS)

    Kubota, Masahiro; Tsuda, Takatoshi; Akiba, Hidenari; Morita, Kazuo; Hosoba, Minoru; Ban, Ryuichi; Hirano, Takako.

    1987-01-01

    To estimate infarct size, we devised three-dimensional (3D) surface display method of 201 Tl myocardial single photon emission CT (SPECT). The method was performed with maximum-count circumferential profiles (CPs) of short axis views of 201 Tl myocardial SPECT. The counts of maximum-count CP were put into a pixel line with the calculated left ventricular circumferential length on each short axis slice. A 3D-surface display map was created by arrangement of these pixel lines from apex to base of left ventricle in order. The sizes of defects in myocardial phantom were calculated by this method. There was a high correlation between the real defect sizes and the calculated defect sizes. In 6 patients with anterior myocardial infarction, the infarct sizes were calculated by this method. The extent of abnormality was identified by automatic computer comparison of each patient's profiles with corresponding lower limits of normal profiles. The infarct sizes calculated by 3D-surface display method were closely correlated not only with the infarct sizes calculated by summation of defect sizes in short axis views, but also with left ventricular ejection fractions. We concluded that the 3D-surface display method of 201 Tl myocardial SPECT is effective for noninvasive assessment of the extent of myocardial infarction. (author)

  12. 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

  13. 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

  14. Clinical usefulness of {sup 201}Tl SPECT in diagnosing nasopharyngeal tumor

    Energy Technology Data Exchange (ETDEWEB)

    Togawa, Takashi; Yui, Nobuharu; Hatano, Kazuo; Takeuchi, Yousuke; Hayasaki, Katsutake [Chiba Cancer Center (Japan); Omura, Ken [Tokyo Medical and Dental Univ. (Japan). Graduate School

    2003-03-01

    {sup 201}Tl SPECT was performed on 54 patients suspected of nasopharyngeal tumor using a three-head rotating gamma camera and its clinical usefulness was evaluated. {sup 201}Tl accumulations were shown in 53 of the 54 patients (50 nasopharyngeal carcinoma, 1 malignant melanoma and 2 lymphoid hyperplasia) before treatment. In 48 of 50 patients with nasopharyngeal carcinoma, the effectiveness for treatment response could be assessed after treatment. {sup 201}Tl SPECT was concordant with MRI and CT in 26 patients (15 complete response (CR), 11 partial response (PR)), whereas it was discordant in 22 patients who showed CR in {sup 201}Tl SPECT but PR in MRI and CT. Follow-up MRI and {sup 201}Tl SPECT studies of 16 of these 22 patients from 6 to 33 months (mean 13 months) after treatment revealed that the tumor gradually decreased and finally vanished. Recurrent and metastatic lesions occurred in 8 patients from 9 to 69 months (mean 24 months) after treatment, and {sup 201}Tl SPECT could detect all 10 lesions in 8 patients. From the results obtained, it was concluded that {sup 201}Tl SPECT is very useful in the initial evaluation, in the assessment of treatment response and in detecting recurrent and metastatic lesions of nasopharyngeal tumor. (author)

  15. 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.)

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

    Directory of Open Access Journals (Sweden)

    Seul Ki Lee

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

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  18. Clinical significance of {sup 123}I-BMIPP myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Junichi [Toho Univ., Tokyo (Japan). School of Medicine

    1998-07-01

    {sup 123}I-BMIPP is a radioiodinated branched chain fatty acid analog, showing high accumulation as well as prolonged retention in the myocardium. Therefore, it is used as a metabolic imaging agent suitable for myocardial SPECT. After {sup 123}I-BMIPP is taken in the myocardium, it remains there mainly as a storage type fatty acid of triglyceride, and it shows different behavior by the stage of cardiac disease. Usually, we evaluate metabolic findings by early imaging (20 minutes) after intravenous injection of {sup 123}I-BMIPP, however, sometimes washout or fill in are seen in the case of myocardial infarction or hypertrophic cardiomyopathy by delayed imaging (after 4 hours). The mismatch of {sup 201}TlCl and {sup 123}I-BMIPP are useful for the diagnosis of stunned myocardium or evaluation of prognosis. However, behavior of {sup 123}I-BMIPP in myocardium is known still not completely. Therefore clinical significance of this examination is thought to be clarified by the stock of cases of various heart diseases. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-11-01

    On SPECT thallium images, myocardial left ventricular (LV) anterior wall attenuation due to breast tissue is common in women. In contrast, in men, inferior wall counts are normally decreased compared to anterior counts. The purpose of this report is to describe cases of inferior wall attenuation of counts in women caused by peritoneal fluid, not myocardial disease. Twelve consecutive SPECT thallium myocardial studies performed in women on peritoneal dialysis, being evaluated for kidney transplant, were included in this study. For all studies, 3.5 mCi 201Tl were injected intravenously. Thirty-two images were acquired over 180 degrees (45 degrees RAO progressing to 45 degrees LPO) at 40 sec per stop. SPECT images were reviewed in short axis, horizontal long and vertical long axes. Data were also displayed in bullseye format with quantitative comparison to gender-matched normal files. Ten of 12 female patients studied had inferior wall defects on images, confirmed by bullseye display. All patients had approximately 2 liters of peritoneal fluid. Review of planar rotational views showed diaphragm elevation and fluid margin attenuations affecting left ventricular inferior wall. Thus, peritoneal fluid is a cause of inferior attenuation on 201Tl cardiac imaging.

  20. Visualization of nasopharyngeal carcinoma with Tl-201 chloride and a three-head rotating gamma camera SPECT system

    Energy Technology Data Exchange (ETDEWEB)

    Togawa, Takashi; Yui, Nobuharu; Kinoshita, Fujimi; Shimada, Fumiyuki; Omura, Ken; Takemiya, Sanzou (Chiba Cancer Center Hospital (Japan))

    1993-05-01

    Tl-201 SPECT was performed on 12 patients with nasopharyngeal carcinoma (NPC) by means of a three-head rotating gamma camera to evaluate whether or not Tl-201 SEPCT was useful and reliable for assessing the tumor viability of NPC. Tl-201 clearly accumulated in the tumor in 3 patients before radiation treatment and increased Tl-201 uptake by the lesion ceased after the treatment. Three of 9 patients who were followed up after radiotherapy developed apparent local recurrence and Tl-201 SPECT clearly visualized these recurrent lesions. Tl-201 SPECT was very useful for assessing the tumor response to irradiation and for detecting local recurrent tumor. A high resolution SPECT system employing Tl-201 chloride is a new reliable and accurate diagnostic tool for the assessment of NPC. (author).

  1. 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.

  2. 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)

  3. Abnormal perfusion on myocardial perfusion SPECT in patients with WPW syndrome: clinical implications

    International Nuclear Information System (INIS)

    Kang, Do Young; Cha, Kwang Soo; Kim, Moo Hyun; Kim, Young Dae; Kim, Duk Kyu

    2001-01-01

    Myocardial perfusion is altered significantly in patients with rhythm disturbances such as CLBBB and right ventricular pacing rhythm. 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 SPECT in patients with WPW syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial SPECT with or without coronary angiography were performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG or electrophysiologic study. Small to large extent (11.0 8.5%, range: 0 35%) and mild to moderate severity (-71.8 42.7%, range: -217 0%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patient with right free wall AP showed normal. Other defect locations were as follows. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. It was not specifically correlated with location of accessory pathway, but most of all patients were abnormal perfusion pattern. Therefore myocardial perfusion SPECT was interpreted carefully in patients with WPW syndrome

  4. 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)

  5. 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

  6. 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)

  7. 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)

  8. The significance of {sup 123}I-BMIPP myocardial SPECT on the evaluation of angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Kurosawa, Kazuhiko; Ohtani, Hiroshi; Saitou, Tomiyoshi; Maruyama, Yukio [Fukushima Medical Coll. (Japan); Katohno, Eiichi; Ohwada, Kenji

    1998-06-01

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

  9. 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

  10. Effect of verapamil on myocardial ischemia in patients with hypertrophic cardiomyopathy; Evaluation by exercise thallium-201 SPECT

    Energy Technology Data Exchange (ETDEWEB)

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

    The effect of verapamil myocardial ischemia in patients with hypertrophic cardiomyopathy (HCM) was evaluated exercise myocardial [sup 201]TlSPECT (EX-Tl). EX-Tl was performed before and after 8.1[+-]6.1 weeks of oral administration of verapamil (240 mg/day) on 20 patients with HCM who showed transient [sup 201]Tl perfusion defects under control conditions. SPECT images were divided into nine segments. The [sup 201]Tl perfusion defect was visually scored and evaluated for four grades in each segment and the sum total grade was calculated as the defect score. Transient dilation index was calculated as a reflection of subendocardial ischemia. Improvements in defect score were demonstrated in 18 of 20 patients after administration of verapamil. The mean defect score decreased significantly from 5.1[+-]2.3 to 2.5[+-]2.4 (p<0.001). Although 18 of 20 patients showed abnormal transient dilation index under control conditions, 16 showed improvement and 12 were normalized after verapamil therapy. Mean transient dilation index decreased from 1.24[+-]0.19 to 1.08[+-]0.10 (p<0.01). Verapamil improves myocardial ischemia on patients with HCM. (author).

  11. Assessment of myocardial perfusion abnormalities in patients with apical hypertrophic cardiomyopathy using exercise [sup 201]Tl scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-11-01

    Regional myocardial perfusion abnormalities commonly occur during exercise in patients with hypertrophic cardiomyopathy (HCM). Exercise [sup 201]Tl myocardial scintigraphy has provided a noninvasive means of identifying myocardial perfusion abnormalities in patients with HCM. On the other hand, apical hypertrophic cardiomyopathy (APH) is reported as a subtype of HCM. Whether APH is essentially equal to HCM or not is controversial. To assess myocardial ischemia in patients with APH, we studied 28 patients with APH, with exercise [sup 201]Tl SPECT. Myocardial perfusion images were obtained immediately after submaximal exercise and again after a 3-hour delay. Regional perfusion defects during exercise were identified in 19 of the 28 patients (68%) with APH. Complete reversible defects were observed in 15 (79%) patients with APH. Although perfusion defects were present in all regions of the left ventricle in patients with HCM, they were present only in the apical region in patients with APH. Thus, reversible [sup 201]Tl perfusion abnormalities commonly occur during exercise in patients with APH as well as in patients with HCM. (author).

  12. 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.

  13. 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).

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

    International Nuclear Information System (INIS)

    Maeno, Masakazu; Ishida, Yoshio; Shimonagata, Tsuyoshi

    1993-01-01

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

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

    International Nuclear Information System (INIS)

    Togawa, Takashi; Yui, Nobuharu; Kinoshita, Fujimi; Koakutsu, Masaki; Ryu, Munemasa; Yamazaki, Masato.

    1991-01-01

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

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

    International Nuclear Information System (INIS)

    Karasawa, Kensuke; Ayusawa, Mamoru; Noto, Nobutaka; Yamaguchi, Hideo; Okada, Tomoo; Harada, Kensuke

    1994-01-01

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

  17. 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)

  18. 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.)

  19. Evaluation of myocardial perfusion and ventricular shape in hypertrophic cardiomyopathy using [sup 99m]Tc-tetrofosmin scintigraphy; Comparison with [sup 201]Tl myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-04-01

    Hypertrophic cardiomyopathy (HCM) is known to have the impairment of myocardial perfusion as well as irregularly hypertrophic myocardium. To evaluate myocardial perfusion and ventricular shape in HCM, [sup 99m]Tc-Tetrofosmin scintigraphy was performed after exercise (Ex) and at resting state (Re) in 10 patients with HCM and was compared with early image (Ea) and delayed image (De) of [sup 201]Tl scintigraphy performed after exercise. SPECT images of both [sup 99m]Tc-Tetrofosmin and [sup 201]Tl scintigraphy were analyzed with five scaled visual scores set in 18 segments. The complete concordance ratio between [sup 99m]Tc-Tetrofosmin (Ex and Re) and [sup 201]Tl(Ea and De) images in segmental analysis was 75%. Image quality of [sup 99m]Tc-Tetrofosmin was seemed to be superior to that of [sup 201]Tl scintigraphy. In 9 patients with HCM, [sup 99m]Tc-Tetrofosmin scintigraphy was performed under the ECG gating and the thickness of septal and free wall was measured. Good correlation was observed with the data by ultrasound cardiography (r=0.79, p<0.002 in wall thickness, r=0.84, p<0.01 in the ratio of septal wall thickness to free wall thickness). Left ventricular shape (ventricular long axis) was closely resemble to that of left ventriculography by contrast medium. In conclusion, [sup 99m]Tc-Tetrofosmin scintigraphy is useful for the evaluation of myocardial morphology as well as perfusion abnormality. (author).

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-11-01

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

  1. 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

  2. Comparison of 1- and 2-day protocols for myocardial SPECT

    DEFF Research Database (Denmark)

    El-Ali, H H; Palmer, John; Carlsson, Marcus

    2005-01-01

    Myocardial perfusion single-photon emission computed tomography (SPECT) is carried out by combining a rest and a stress study that are performed either on one day or two separate days. A problem when performing the two studies on 1 day is that the residual activity from the first study contribute...

  3. 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

  4. 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.

  5. Thallium chloride 201Tl combined with single photon emission computed tomography (SPECT) in the evaluation of vestibular schwannoma growth

    DEFF Research Database (Denmark)

    Charabi, Samih Ahmed; Lassen, N A; Thomsen, J

    1997-01-01

    Thallium chloride 201Tl combined with SPECT was performed in a series of 29 patients with neuroradiological evidence of vestibular schwannoma (VS). The relative tumor uptake (U) and relative tumor concentration (C) of the radiotracer 201Tl was determined, and the cerebellum served as a reference....

  6. 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)

  7. Study of washout rate in patients with chronic renal failure by dipyridamole 201Tl myocardial scintigraphy

    International Nuclear Information System (INIS)

    Matsumura, Kaname; Nakagawa, Tsuyoshi; Senda, Yutaka; Ito, Tsunao; Mizutani, Yasuhide; Yoshida, Nobutaka; Yasuda, Ryuichi; Takagi, Isao.

    1993-01-01

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

  8. 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)

  9. 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)

  10. 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)

  11. Evaluation of the effect of reconstructed image pixel size on defect detectability in Tl-201 fan-beam SPECT by an observer performance study

    Science.gov (United States)

    Gregoriou, G. K.; Gsui, B. M. W.; Gullberg, G. T.

    1995-08-01

    The effect of reconstructed image pixel size in the fan-beam filtered backprojection method in myocardial defect detection was investigated using an observer performance study and receiver operating characteristics (ROC) analysis. A mathematical phantom of the human torso was used to model the anatomy and Thallium-201 (Tl-201) uptake in humans. Realistic projections from the phantom were simulated using a low-energy high resolution fan-beam collimator that incorporated the effects of photon attenuation, spatially varying detector response, scatter, and Poison noise. For a fan-beam collimator with a focal length of 55 cm and with a radius of rotation of 25 cm, the magnification at the center of rotation was two and the maximum magnification in the reconstructed region of interest was three. Myocardial defects were simulated as Gaussian-shaped decreases in Tl-201 uptake distribution. By changing the reconstructed image pixel size, five different classes of reconstructed images resulted, with projection bin width to reconstructed image pixel size (PBIP) ratios of 1, 2, 3, 4, and 5. The results from the observer study indicate that the reconstructed image pixel size has a significant effect on myocardial defect detection in reconstructed Tl-201 SPECT images. Moreover, the study indicated that in order to ensure maximum defect detectability the PBIP ratio should be at least as large as the maximum possible magnification within the reconstructed image array.

  12. Detecting viable hibernating myocardium in chronic coronary artery disease. A comparison of resting 201Tl single photon emission computed tomography (SPECT), 99mTc-methoxy-isobutyl isonitrile SPECT after nitrate administration, and 201Tl SPECT after 201Tl-glucose-insulin infusion

    International Nuclear Information System (INIS)

    Toyama, Takuji; Hoshizaki, Hiroshi; Isobe, Naoki; Adachi, Hitoshi; Naito, Shigeto; Oshima, Shigeru; Taniguchi, Koichi

    2000-01-01

    To identify and quantify the amount of viable hibernating myocardium in patients with chronic coronary artery disease, resting 201 Tl single photon emission computed tomography (SPECT) was compared with 99m Tc-methoxy-isobutyl isonitrile (MIBI) SPECT after nitrate infusion (nitrate- 99m Tc-MIBI) and 201 Tl SPECT after 201 Tl with glucose-insulin-potassium infusion ( 201 Tl-GIK) in 25 patients. Twenty-one patients also underwent completely left ventriculography beforehand and 5±4 months afterwards. SPECT images were divided into 9 segments and scored visually from 0 (normal uptake) to 3 (absent). The defect score was calculated as the summation of the total scores (TDS) in each patient. The TDS of nitrate- 99m Tc-MIBI images (6.3±4.3) and 201 Tl-GIK images (5.8±4.2) were significantly lower than the 7.4±4.3 of resting 201 Tl images (p 201 Tl-GIK imaging (85%) was significantly higher (p 99m Tc-MIBI imaging (79%) also tended to be higher (p=0.08), than that of 201 Tl imaging (62%) in detecting viable myocardium. The specificity of the 3 methods was almost the same. The nitrate- 99m Tc-MIBI and 201 Tl-GIK methods were more useful than the resting 201 Tl method for evaluating viable hibernating myocardium. Furthermore, the 201 Tl-GIK method may provide a more accurate estimate of the amount of viable myocardium than the nitrate- 99m Tc-MIBI method. (author)

  13. 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

  14. 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)

  15. 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.)

  16. 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)

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

    International Nuclear Information System (INIS)

    Koga, Yutaka; Ishizuka, Takehiro; Otabe, Hiroyuki; Kori, Takeo; Ota, Toshiko; Suzuki, Kazushige

    1999-01-01

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

  18. 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)

  19. 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

  20. 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

  1. 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.)

  2. 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.

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

    Science.gov (United States)

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

    2017-07-01

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

  4. 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.)

  5. 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)

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

    International Nuclear Information System (INIS)

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

    1985-01-01

    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 (ΣCPK) 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 ΣCPK (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 ΣCPK (r=-0.74). No statically significant correlation was shown between TcIA and ΣCPK, 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)

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

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Takuhisa; Shibuya, Noritoshi (Kawatana National Hospital, Nagasaki (Japan)); Hashiba, Kunitake; Oku, Yasuhiko; Mori, Hideki; Yano, Katsusuke

    1993-01-01

    Myocardial damage and cardiopulmonary functions in patients with Duchenne's muscular dystrophy (DMD) were assessed using thallium-201 myocardial single-photon emission computed tomography (SPECT) and technetium-99m multigated radionuclide angiography. Twenty-five patients with DMD were divided into 4 groups according to percent of perfusion defect (%PD) calculated by the bull's-eye method and age. PD was detected in 24 (96.0%) of 25 patients with DMD, and it spread from the left ventricular lateral wall to the anterior wall and/or interventricular septum. PD was detected even in a 6-year-old DMD boy. Patients in Group I (%PD[>=]10% and age<15 years old) were shown to have a higher risk of left-sided heart failure without respiratory failure. Patients in Group II (%PD[>=]10 and age[>=]15) showed decreased pulmonary function and worsened arterial blood gas values as compared with Group IV (%PD<10 and age[>=]15). There was no significant difference in cardiac function among the 4 groups. It is postulated that myocardial damage in Group II patients is dependent primarily on a deficiency of dystrophin and on chronic respiratory failure, and that some of them are at risk of cardiopulmonary failure. It is concluded that myocardial SPECT is useful for the early diagnosis of myocardial damage and evaluation of cardiopulmonary function in DMD patients. (author).

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

    International Nuclear Information System (INIS)

    Tamura, Takuhisa; Shibuya, Noritoshi; Hashiba, Kunitake; Oku, Yasuhiko; Mori, Hideki; Yano, Katsusuke.

    1993-01-01

    Myocardial damage and cardiopulmonary functions in patients with Duchenne's muscular dystrophy (DMD) were assessed using thallium-201 myocardial single-photon emission computed tomography (SPECT) and technetium-99m multigated radionuclide angiography. Twenty-five patients with DMD were divided into 4 groups according to percent of perfusion defect (%PD) calculated by the bull's-eye method and age. PD was detected in 24 (96.0%) of 25 patients with DMD, and it spread from the left ventricular lateral wall to the anterior wall and/or interventricular septum. PD was detected even in a 6-year-old DMD boy. Patients in Group I (%PD≥10% and age<15 years old) were shown to have a higher risk of left-sided heart failure without respiratory failure. Patients in Group II (%PD≥10 and age≥15) showed decreased pulmonary function and worsened arterial blood gas values as compared with Group IV (%PD<10 and age≥15). There was no significant difference in cardiac function among the 4 groups. It is postulated that myocardial damage in Group II patients is dependent primarily on a deficiency of dystrophin and on chronic respiratory failure, and that some of them are at risk of cardiopulmonary failure. It is concluded that myocardial SPECT is useful for the early diagnosis of myocardial damage and evaluation of cardiopulmonary function in DMD patients. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-06-01

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

  10. 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

  11. 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

  12. 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.)

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. Study on the un-conformable results between myocardial perfusion SPECT and coronary angiography

    International Nuclear Information System (INIS)

    Yao Zhiming; Liu Xiujie; Yu Quanjun

    1997-01-01

    PURPOSE: To analyze the un-conformable results between myocardial perfusion SPECT and coronary angiography (CAG). METHODS: The data of 408 in-patients who underwent myocardial perfusion SPECT and CAG were analyzed. RESULTS: Among them, twenty five patients, 22 males and 3 females (average age 51.7 +- 10.5 years old) had un-conformable results of SPECT and CAG. Group A included 15 cases with myocardial defect on SPECT and normal coronary artery or coronary stenosis<50% on CAG, which were 3 old myocardial infarction, 7 X syndrome, 1 30%∼40% coronary stenosis, 1 essential hypertension, 1 dilated cardiomyopathy, 1 cardiac tumor and 1 sleep dyspnea syndrome. Group B included 10 cases with normal SPECT and coronary stenosis≥50% on CAG. There were 5 coronary artery stenosis between 50%∼60%, 5 right coronary artery stenosis, 5 terminal branches stenosis, 2 collateral circulation, and 1 insufficient exercise involved in 10 patients. CONCLUSION: It can not be considered that all abnormal SPECT without significant coronary stenosis is false positive; while all normal SPECT with significant coronary stenosis is truly negative, probably due to terminal branch stenosis, coronary stenosis between 50%∼60% on right coronary artery stenosis

  18. 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.)

  19. Quantitative detection of myocardial ischaemia by stress echocardiography; a comparison with SPECT

    Science.gov (United States)

    Gudmundsson, Petri; Shahgaldi, Kambiz; Winter, Reidar; Dencker, Magnus; Kitlinski, Mariusz; Thorsson, Ola; Willenheimer, Ronnie B; Ljunggren, Lennart

    2009-01-01

    Aims Real-time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique angio-mode (AM), provides images for off-line perfusion quantification using Qontrast® software, generating values of peak signal intensity (A), myocardial blood flow velocity (β) and myocardial blood flow (Axβ). By comparing rest and stress values, their respective reserve values (A-r, β-r, Axβ-r) are generated. We evaluated myocardial ischaemia by RTP-ASE Qontrast® quantification, compared to visual perfusion evaluation with 99mTc-tetrofosmin single-photon emission computed tomography (SPECT). Methods and Results Patients admitted to SPECT underwent RTP-ASE (SONOS 5500) using AM during Sonovue® infusion, before and throughout adenosine stress, also used for SPECT. Visual myocardial perfusion and wall motion analysis, and Qontrast® quantification, were blindly compared to one another and to SPECT, at different time points off-line. We analyzed 201 coronary territories (left anterior descendent [LAD], left circumflex [LCx] and right coronary [RCA] artery territories) in 67 patients. SPECT showed ischaemia in 18 patients and 19 territories. Receiver operator characteristics and kappa values showed significant agreement with SPECT only for β-r and Axβ-r in all segments: area under the curve 0.678 and 0.665; P < 0.001 and < 0.01, respectively. The closest agreements were seen in the LAD territory: kappa 0.442 for both β-r and Axβ-r; P < 0.01. Visual evaluation of ischaemia showed good agreement with SPECT: accuracy 93%; kappa 0.67; P < 0.001; without non-interpretable territories. Conclusion In this agreement study with SPECT, RTP-ASE Qontrast® quantification of myocardial ischaemia was less accurate and less feasible than visual evaluation and needs further development to be clinically useful. PMID:19534829

  20. Washout ratio of thallium-201 myocardial SPECT at rest in patients with hypertrophic cardiomyopathy or essential hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Deguchi, Fumiko; Gotoh, Kohshi; Yagi, Yasuo (Gifu Univ. (Japan). Faculty of Medicine) (and others)

    1991-01-01

    Tl-201 myocardial SPECT at rest was performed in 32 patients with hypertrophic cardiomyopathy (HCM), 17 patients with essential hypertension (HTN), and 11 control subjects (C). Washout ratio was determined on both early and delayed SPECT images to compare myocardial thickness in the three groups. In addition, it was correlated with the rate of fibrosis. Early images showed no visual evidence of perfusion defects in either Group HTN or Group C, in contrast to 22% in Group HCM. Redistribution at rest showed 38% in Group HCM and 18% in Group HTN. Mean washout ratio was significantly lower in Group HCM (12.3+-10.3%) than Group HTN (17.9+-7.3%) and Group C (22.7+-7.4%). Washout ratio between the hypertrophic and non-hypertrophic sites did not differ in either Group HCM or Group HTN. Group HCM had a significantly higher rate of fibrosis than Group C (9.6+-8.8% vs. 3.3+-2.8%). It was also higher than Group HTN with no significant difference (9.6+-8.8% vs. 6.6+-4.9%). There was negative correlation between washout ratio at rest and the rate of fibrosis. (N.K.).

  1. 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.)

  2. 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)

  3. 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)

  4. 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

  5. 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

  6. 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

  7. 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).

  8. 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.

  9. Quantitative detection of myocardial ischaemia by stress echocardiography; a comparison with SPECT

    Directory of Open Access Journals (Sweden)

    Thorsson Ola

    2009-06-01

    Full Text Available Abstract Aims Real-time perfusion (RTP adenosine stress echocardiography (ASE can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique angio-mode (AM, provides images for off-line perfusion quantification using Qontrast® software, generating values of peak signal intensity (A, myocardial blood flow velocity (β and myocardial blood flow (Axβ. By comparing rest and stress values, their respective reserve values (A-r, β-r, Axβ-r are generated. We evaluated myocardial ischaemia by RTP-ASE Qontrast® quantification, compared to visual perfusion evaluation with 99mTc-tetrofosmin single-photon emission computed tomography (SPECT. Methods and Results Patients admitted to SPECT underwent RTP-ASE (SONOS 5500 using AM during Sonovue® infusion, before and throughout adenosine stress, also used for SPECT. Visual myocardial perfusion and wall motion analysis, and Qontrast® quantification, were blindly compared to one another and to SPECT, at different time points off-line. We analyzed 201 coronary territories (left anterior descendent [LAD], left circumflex [LCx] and right coronary [RCA] artery territories in 67 patients. SPECT showed ischaemia in 18 patients and 19 territories. Receiver operator characteristics and kappa values showed significant agreement with SPECT only for β-r and Axβ-r in all segments: area under the curve 0.678 and 0.665; P Conclusion In this agreement study with SPECT, RTP-ASE Qontrast® quantification of myocardial ischaemia was less accurate and less feasible than visual evaluation and needs further development to be clinically useful.

  10. 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.)

  11. 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...

  12. Functional imaging in the assessment of myocardial infarction: MR imaging vs. MDCT vs. SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H. [Department of Diagnostic Radiology, RWTH Aachen University (Germany); Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University (Germany)], E-mail: mahnken@rad.rwth-aachen.de; Bruners, Philipp [Department of Diagnostic Radiology, RWTH Aachen University (Germany); Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University (Germany); Stanzel, Sven [Institute of Medical Statistics, RWTH Aachen University (Germany); Koos, Ralf [Medical Clinic I, RWTH Aachen University (Germany); Muehlenbruch, Georg; Guenther, Rolf W. [Department of Diagnostic Radiology, RWTH Aachen University (Germany); Reinartz, Patrick [Department of Nuclear Medicine, RWTH Aachen University (Germany); Radios Center of Diagnostic Radiology and Nuclear Medicine, Duesseldorf (Germany)

    2009-09-15

    Purpose: To intraindividually compare magnetic resonance (MR) imaging, ECG-gated multi-detector spiral computed tomography (MDCT) and gated single photon emission computed tomography (SPECT) for the evaluation of global and regional myocardial function and the identification of myocardial perfusion abnormalities. Materials and methods: Nine patients (8 men; 55.1 {+-} 8.9 years) with a history of myocardial infarction (MI) were included in this retrospective study. All patients had undergone segmented k-space steady state free precession MR imaging, {sup 99m}Tc-MIBI gated myocardial perfusion SPECT and contrast enhanced ECG-gated 16-MDCT. Ventricular volumes and ejection fraction (EF) were calculated. Left ventricular (LV) wall motion at rest was analyzed. For SPECT and arterial phase MDCT perfusion abnormalities were assessed. Data was compared with Lin's concordance-correlation coefficient ({rho}{sub c}), Bland-Altman plots and kappa statistics. Results: For EF, there was an excellent concordance and correlation ({rho}{sub c} = 0.99) between SPECT (EF = 41.7 {+-} 10.4%), MDCT (EF = 42.2 {+-} 11.1%), and MR imaging (EF = 41.9 {+-} 11.4%). Considering MR imaging as standard of reference, MDCT ({kappa} = 0.86) is superior to SPECT ({kappa} = 0.51) for the assessment of the regional wall motion at rest. There was a good agreement between SPECT and MDCT regarding the detection of perfusion abnormalities ({kappa} = 0.62). Conclusion: MDCT, MR imaging, and SPECT allow for the reliable assessment of global and regional left ventricular function in patients with a history of MI. MDCT also allows to some extent for the detection of perfusion abnormalities. With its potential to assess both, the coronary arteries as well as the myocardium, MDCT a promising modality for the comprehensive diagnostic work-up in patients with suspected myocardial ischemia.

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

    International Nuclear Information System (INIS)

    Akhter, Nasima; Nakajima, Kenichi; Okuda, Koichi; Matsuo, Shinro; Yoneyama, Tatsuya; Taki, Junichi; Kinuya, Seigo

    2008-01-01

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

  14. Scatter correction in myocardial thallium SPECT. Needs for optimization of energy window settings in the energy window-based scatter correction techniques

    International Nuclear Information System (INIS)

    Narita, Yuichiro; Iida, Hidehiro

    1999-01-01

    Accuracy and limitation of energy-window based scatter correction techniques have been evaluated for myocardial 201 Tl SPECT by means of Monte Carlo simulation. In particular, projection view-dependency of energy distribution of the scattered photons was evaluated. Two geometrical configurations were simulated; namely a homogeneous cylindrical radioactivity located asymmetrically in a homogeneous cylindrical phantom, and a homogeneous ring radioactivity positioned at the myocardial region of a human thorax phantom. Energy spectra were recorded for each projection, and accuracy of the triple-energy window (TEW) method was then evaluation for both phantoms. The energy distribution of the scattered photons was apparently dependent on the projection view. TEW also demonstrated systematic overcorrection for the scatter because of multiple photo peaks around 80 keV, and more importantly, the error was highly dependent on the projection view. The error reached to 35-38% for the view that is the closest to the 201 Tl radioactivity (anterior view in case of the myocardial ring phantom), and was approximately 20% in the opposite view. This view-dependency of the error remained for other energy window settings, and was found to cause significant artifact in the reconstructed myocardial images, typically causing a defect in the anterior myocardial wall. Thus, this study demonstrated the need for optimizing the window settings for each projection view in all energy window-based scatter correction methods. (author)

  15. Usefulness of 123I-MIBG and 123I-BMIPP myocardial scintigraphy for detecting coronary artery disease and for evaluating left ventricular function

    International Nuclear Information System (INIS)

    Toyama, Takuji; Suzuki, Yasushi; Tsukagoshi, Joichi

    1995-01-01

    We evaluated the diagnostic value of 123 I-metaiodobenzylguanidine (MIBG) and 123 I-labeled beta-methyliodophenyl pentadecanoic acid (BMIPP) myocardial SPECTs for evaluating coronary artery disease and left ventricular function, in comparison with the diagnostic value of 201 Tl (Tl) SPECT. For forty-nine patients with coronary artery disease, resting MIBG and BMIPP SPECTs were performed to detect coronary artery stenosis, compared with the diagnostic value of exercise Tl. Left ventricular ejection fraction and regional wall motion were compared with the total US (TUS) and regional US (RUS) of resting MIBG and BMIPP SPECTs, and in turn, compared with resting Tl SPECT. The sensitivity of resting BMIPP SPECT for detecting coronary artery stenosis was lower, and the specificity of resting MIBG SPECT was lower than the other two methods. The accuracy of resting MIBG SPECT for evaluating coronary lesions was nearly the same as the accuracy of exercise Tl, but higher than that of BMIPP SPECT. Left ventricular ejection fraction was well correlated with TUS of resting MIBG SPECT (r=0.80), resting BMIPP SPECT (r=0.77), and resting Tl SPECT (r=0.68). Regional wall motion was most correlated with RUS of resting BMIPP SPECT, compared with that of resting Tl and MIBG SPECTs. These data suggest that resting MIBG SPECT is useful for detecting coronary artery disease and that resting BMIPP SPECT is valuable in evaluating regional left ventricular function. (author)

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

    International Nuclear Information System (INIS)

    Sekiai, Yasuhiro; Mikuniya, Atsushi; Sawai, Michihiko

    1988-01-01

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

  17. 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

  18. 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.

  19. 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)

  20. Performance of degree of accumulation with {sup 201}Tl-SPECT in 13 cases of lung cancer smaller than 2 cm

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuhiro; Sone, Shusuke; Maruyama, Yuichiro; Oguchi, Kazuhiro; Itoh, Atsuko [Shinshu Univ., Matsumoto, Nagano (Japan). School of Medicine

    2000-10-01

    The aim of this study was to determine the sensitivity of {sup 201}Tl-chloride for small lung cancers. The study subjects consisted of 13 cases of surgically verified lung cancer smaller than 2 cm who had undergone {sup 201}Tl-SPECT prior to surgery, owing to the difficulty of establishing a diagnosis of lung cancer based on diagnostic CT. Among 13 cases, four showed positive accumulation in early and delayed SPECT, and nine negative, with a degree of accumulation of 31% (4/13). (author)

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

    International Nuclear Information System (INIS)

    Ahmad, M.; Dubiel, J.P.; Haibach, H.

    1982-01-01

    201 Tl myocardial scintigraphy was performed during cold pressor stimulation in 36 patients aged 36 to 69 years. Thirty-one patients had coronary artery disease and 5 patients did not, as confirmed by coronary cineangiography. 201 Tl (1.5 to 2 mCi) was injected at 30 seconds of the cold pressor stimulation. The product of systolic pressure X heart rate increased from a baseline of 77.4 +/- 16 (standard deviation [SD]) to 103.6 +/- 17 at 30 seconds of the cold pressor test (p less than 0.0005). Transient perfusion deficits developed in 24 of 31 patients with coronary artery disease (sensitivity 77%), and all 5 patients without coronary artery disease had normal scintigrams. The sensitivity in detecting coronary artery disease was 40% in patients with 1 vessel disease, 91% in patients with 2 vessel disease, and 100% in patients with 3 vessel disease. Exercise electrocardiograms (available in 29 of 36 patients) were positive for ischemia in 18 of 24 patients with coronary artery disease and in 1 of 5 patients without coronary artery disease (sensitivity 75% and specificity less than 80%). Exercise 201 Tl scintigrams, obtained in 16 patients, were positive in 11 patients with coronary artery disease and positive cold pressor 201 Tl scintigrams. Five patients without coronary artery disease and with normal cold pressor 201 Tl scintigrams had normal exercise 201 Tl scintigrams. Coronary cineangiography performed during cold pressor stimulation in 6 patients who had positive cold pressor and exercise 201 Tl scintigrams did not show coronary spasm. Our data indicate that cold pressor thallium-201 scintigraphy offers promise as a noninvasive test in the diagnosis of coronary artery disease and may be used in patients in whom exercise testing is not feasible

  2. Detection of culprit lesion in patients with unstable angina pectoris by using ATP thallium-201 myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, Tokuo; Mori, Yutaka [Jikei Univ., Tokyo (Japan). School of Medicine; Yamashina, Akira; Kubo, Toru; Usui, Yasuhiro

    1999-10-01

    The purpose of this study is to determine the diagnostic accuracy for detection of culprit lesions in patients with unstable angina. Both ATP {sup 201}Tl SPECT and coronary angiography were performed in 51 patients with unstable angina pectoris within a week since the last attack. SPECT images were divided into 17 segments and the regional uptakes were scored semiquantitatively (0=normal to 3=no activity) and compared with the coronary angiographic findings. ATP {sup 201}Tl SPECT revealed decreased uptakes in 54 of 56 culprit lesions. The sensitivity, specificity and accuracy for detection of culprit lesions were 96.4%, 89.5% and 92.4%, respectively. Although adverse effects during ATP administration were complicated in 28 (54.9%) patients, all the complications were mild and resolved within two minutes. ATP {sup 201}Tl SPECT is sensitive and reliable method for detecting culprit lesions and can be performed safely even at acute phase in patients with unstable angina pectoris. (author)

  3. Acute myocardial infarction: estimation of at-risk and salvaged myocardium at myocardial perfusion SPECT 1 month after infarction.

    Science.gov (United States)

    Romero-Farina, Guillermo; Aguadé-Bruix, Santiago; Candell-Riera, Jaume; Pizzi, M Nazarena; Pineda, Victor; Figueras, Jaume; Cuberas, Gemma; de León, Gustavo; Castell-Conesa, Joan; García-Dorado, David

    2013-11-01

    To estimate at-risk and salvaged myocardium by using gated single photon emission computed tomography (SPECT) myocardial perfusion imaging after acute myocardial infarction (AMI). The study was approved by the hospital's Ethical Committee on Clinical Trials (trial register number, PR(HG)36/2000), and all patients gave informed consent. Forty patients (mean age, 61.78 years; eight women) with a first AMI underwent two gated SPECT examinations--one before percutaneous coronary intervention (PCI) and one 4-5 weeks after PCI. Myocardium at risk was estimated by assessing the perfusion defect at the first gated SPECT examination, and salvaged myocardium was estimated by assessing the risk area minus necrosis at the second examination. Myocardium at risk was estimated by determining the discordance between the areas of left ventricular (LV) wall motion and perfusion at the second examination. Concordance between tests was analyzed by means of linear regression analysis, the Pearson correlation, the intraclass correlation coefficient, and Bland-Altman analysis. An improvement in perfusion, wall motion, wall thickening, and LV ejection fraction (P Myocardial perfusion gated SPECT performed 1 month after early PCI in a first AMI provides potentially useful information on at-risk and salvaged myocardium. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13122324/-/DC1. RSNA, 2013

  4. 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)

  5. 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).

  6. 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)

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

    Science.gov (United States)

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

    2014-06-21

    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 crosstalk

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-02-15

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

  9. 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)

  10. 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...

  11. 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.

  12. 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

  13. Myocardial perfusion imaging using SPECT/CT and PET/CT; Myokardperfusionsszintigrafie mit SPECT/CT und PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, Marcus; Uebleis, C. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Univ. Muenchen (Germany)

    2010-06-15

    With technical progress coronary CT angiography is increasingly accepted as a noninvasive alternative in morphological imaging. However, image quality and interpretation are still influenced by various factors like blooming artifacts, misregistration and the experience of the interpreter. The combination with stress-rest myocardial perfusion SPECT or PET as a hybrid scanner or two standalone scanners enables comprehensive noninvasive anatomical and functional imaging of the heart as well as three dimensional image fusion. Hybrid-imaging is feasible with today's commercially available software packages but still requires time demanding manual intervention and experienced interpretation. PET investigations, either in replacement of SPECT for perfusion measurements, or in addition with new biomarkers will provide even more impact to hybrid imaging in future. (orig.)

  14. Exercise Tl-201 myocardial scintigraphy and coronary blood flow velocity in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Umamoto, Ikuo; Harada, Yoshiaki (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1992-03-01

    In 22 patients with hypertrophic cardiomyopathy not associated with coronary stenosis, findings of exercise Tl-201 myocardial scintigraphy were reviewed in relation to coronary blood flow velocity. Blood flow velocity of the left antero-inferior segment was recorded by using a Doppler catheter. From time velocity integration in systolic and diastolic phases, both % systolic fraction (%SF) and %diastolic 1st third fraction (%d1F) were obtained. A decreased perfusion was visually assessed on exercise Tl-201 myocardial images. In addition, transient dilation of the left ventricular cavity was quantitatively assessed by expressing it as a transient dilation index (TDI) for subendocardial ischemia. Coronary blood flow velocity was characterized by a decrease in both %SF and %d1F and negative systolic flow. Both %SF and %d1F were inversely correlated with TDI. Coronary negative systolic flow was frequently associated with a decreased perfusion. These results suggest factors such as left ventricular relaxation impairment, other than coronary small vessel lesions, may also be involved in the occurrence of myocardial ischemia in hypertrophic cardiomyopathy. (N.K.).

  15. 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

  16. Comparison of prone and supine positions in myocardial perfusion SPECT on diaphragmatic attenuation

    International Nuclear Information System (INIS)

    Modarres Mosalla, M.M.

    2002-01-01

    Tissue attenuation effect, especially breast and diaphragm can produce artifactual defects in the myocardial perfusion SPECT. Several ways are suggested to minimize such an effect. The aim of this study is evaluation of the effect of supine and prone position on the anterior and inferior left ventricular walls during myocardial perfusion SPECT. 48 patients, 30 men and 18 women, with age of 42-73 years without typical chest pain, <15% probability of coronary artery disease, significant abdominal fat pad, and hypo activity of the inferior wall in supine position were selected. SPECT was repeated in the prone position. 22(73%) male patients and 8(44%) of female patients showed more activity of the anterior wall in the prone position (p<0.01). The anterior wall became hypoactive in 7(23%) of male patients (p<0.01) in the prone position. The anterior wall showed lesser activity in the supine position in 6(33%) of female patients (p<0.01). Although breast attenuation is more common in female, diaphragmatic attenuation can also be troublesome. In these selected women prone position minimized both effects. Prone position in the male patients decreases the attenuation effect of diaphragm significantly but may cause false defect in the anterior wall. Myocardial perfusion SPECT is preferred to be performed in prone position in both sexes, however possibility of anterior wall false defect should be considered

  17. 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.)

  18. 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)

  19. 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)

  20. 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)

  1. 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

  2. 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

    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...... or pharmacologic stress SPECT before and within 60 days of coronary angiography. Images from CT perfusion imaging, SPECT, and coronary angiography were interpreted at blinded, independent core laboratories. The primary diagnostic parameter was the area under the receiver operating characteristic curve (Az...

  3. Effects of CT-based attenuation correction of rat microSPECT images on relative myocardial perfusion and quantitative tracer uptake

    Energy Technology Data Exchange (ETDEWEB)

    Strydhorst, Jared H., E-mail: jared.strydhorst@gmail.com; Ruddy, Terrence D.; Wells, R. Glenn [Cardiac Imaging, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 (Canada)

    2015-04-15

    Purpose: Our goal in this work was to investigate the impact of CT-based attenuation correction on measurements of rat myocardial perfusion with {sup 99m}Tc and {sup 201}Tl single photon emission computed tomography (SPECT). Methods: Eight male Sprague-Dawley rats were injected with {sup 99m}Tc-tetrofosmin and scanned in a small animal pinhole SPECT/CT scanner. Scans were repeated weekly over a period of 5 weeks. Eight additional rats were injected with {sup 201}Tl and also scanned following a similar protocol. The images were reconstructed with and without attenuation correction, and the relative perfusion was analyzed with the commercial cardiac analysis software. The absolute uptake of {sup 99m}Tc in the heart was also quantified with and without attenuation correction. Results: For {sup 99m}Tc imaging, relative segmental perfusion changed by up to +2.1%/−1.8% as a result of attenuation correction. Relative changes of +3.6%/−1.0% were observed for the {sup 201}Tl images. Interscan and inter-rat reproducibilities of relative segmental perfusion were 2.7% and 3.9%, respectively, for the uncorrected {sup 99m}Tc scans, and 3.6% and 4.3%, respectively, for the {sup 201}Tl scans, and were not significantly affected by attenuation correction for either tracer. Attenuation correction also significantly increased the measured absolute uptake of tetrofosmin and significantly altered the relationship between the rat weight and tracer uptake. Conclusions: Our results show that attenuation correction has a small but statistically significant impact on the relative perfusion measurements in some segments of the heart and does not adversely affect reproducibility. Attenuation correction had a small but statistically significant impact on measured absolute tracer uptake.

  4. 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

  5. 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.

  6. 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)

  7. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-11-01

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

  9. Assesment of repeatability of myocardial perfusion 99mTc-MIBI SPECT images

    International Nuclear Information System (INIS)

    Dabrowski, A.; Wnuk, J.; Konieczna, S.; Teresinska, A.

    2004-01-01

    To our knowledge, the repeatability of the myocardial perfusion 99m Tc-MIBI SPECT studies has not been measured. The main aim of this study was to assess the repeatability of rest myocardial perfusion 99m Tc-MIBI SPECT imaging after two MIBI injections on separate days and two different time intervals between radiotracer injection and acquisition. The additional aim was to evaluate the influence of rest variability on the global stress-rest myocardial perfusion study diagnosis. One hundred and seventeen patients with rest perfusion worsening (in first rest investigation-SP1) in routine stress-rest 99m Tc-MIBI SPECT perfusion imaging were studied. The rest study was repeated on another day, 1 hour (second rest investigation-SP2) and 3 hours (third rest investigation-SP3) following the injection of the radiotracer. Regional myocardial perfusion was evaluated quantitatively, in 17 segments of the LV, compered among all the three rest studies (SP1, SP2, SP3) and additionally combined with stress study. Altogether 1939 segments were studied. In 1260 segments (65%) perfusion in all three rest images was equal. In 232 segments (12%) perfusion in both studies performed after the same radiotracer injection (SP2 and SP3) was equal (but different than in SP1 examination). In 99 segments (5%) with the same time interval between injection and acquisition, perfusion was equal (but different than in the third evaluation). Repeated rest studies (SP2 and SP3) were compared to segments with stress defect. In 58% of those defects perfusion in SP2 and SP3 was equal; in 66% of the patients with at least one moderate stress defect, the stress-rest SPECT study result was the same after SP2 and SP3. In the special population of patients with perfusion worse at rest than at stress, our results showed: 1) the repeatability of the segmental myocardial perfusion at rest was 65%; 2) 66% patients had the same results of perfusion examination independently of the rest study used for comparison

  10. 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

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

    Science.gov (United States)

    Kamínek, M; Myslivecek, M; Husák, V; Koranda, P; Skvarilová, M; Ostransky, J; Lang, O

    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 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).

  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. 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

  14. 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)

  15. 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)

  16. 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.

  17. Myocardial Perfusion Tomoscintigraphy With 99mTc MIBI (SPECT MPS 99mTc MIBI) In The Assessment Of Myocardial Viability

    International Nuclear Information System (INIS)

    Pop Gjorcheva, Daniela

    2002-03-01

    Prognosis of the patients with severe coronary artery disease is highly dependent on the degree of left ventricular dysfunction. Impaired contractile performance at rest is not necessarily due to Irreversible tissue damage but may relate to the 'hibernating' myocardium which has been defined as potentially reversible, chronic contractile dysfunction during prolonged, painless ischemia. Recovery of function may occur after successful revascularization only in the presence of substantial amount of viable myocardium. The development of highly precise and predictable diagnostic methods for the identification of viable myocardium and postoperative functional improvement is crucial for reasonable preoperative selection of the patients. Detection of hibernated myocardium Is a real diagnostic challenge when FDG-Fl8 PET, as the most accurate method for myocardial viability assessment is not available and Tl 201, as already established myocardial viability marker is not routinely used. Interest for the 99mTc labeled complexes, most often 99mTc MIBI, as proved myocardial perfusion but not yet viability tracer is constantly increasing, supported by the widespread availability of this radioisotope, its better imaging and radio dosimetric properties when compared to Ti 201. The aim of this study was to evaluate the diagnostic value of different SPECT MIBI Tc99m myocardial perfusion scintigraphy (MPS) modalities performed at rest and after nitrate administration, in the detection of myocardial viability (MV) arid to compare it with rest-redistribution TI 201 MPS (R-Red) and with the control SPECT MPS Tc99m MIBI study after revascularization. In a prospective study, 176 patients (34-77yrs, 25 female, 151 male), with angiographically proved coronary artery disease, most of them with previous myocardial infarction (143/176p (81%),>6 months) and LV dysfunction (110/176p (62%), EF G-MPS 41+/-16%) underwent ECG Gated SPECT MPS Tc 99m MIBI at rest and after s.l. administration of 0,5 mg

  18. 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

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

    NARCIS (Netherlands)

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

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

    NARCIS (Netherlands)

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

  1. 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...

  2. 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.

  3. 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

  4. Analysis of Myocardial Function Using Gated Myocardial SPECT : Comparison of QGS, 4D-MSPECT Software and Echocardiography

    International Nuclear Information System (INIS)

    Lee, Seok Mo; Bae, Sang Kyun

    2008-01-01

    Gated myocardial perfusion SPECT provides not only myocardial perfusion status but also various functional parameters of left ventricle. We compared left ventricular ejection fraction, end-diastolic volume, LV mass by cardiac SPECT using Quantitative Gated SPECT (QGS), 4D-MSPECT software and standard 2D-echocardiography. One hundred fourteen patients (male 51, female 63; 29-85 years old, mean 61.3 ± 13.3 years old) with normal perfusion status on Tc-99m tetrofosmin gated myocardial perfusion SPECT were analyzed retrospectively. Ejection fraction (LVEF), End-diastolic volume (LVED), LV mass (LVM) were calculated using QGS, 4D-MSPECT, and LVEF, LVM using 2D-echocardiography. Statistical analysis including Bland-Altman plot was performed using MedCalc (MedCalc software, Mariakerke, Belgium). The correlation of LVEF between methods was good: 0.95/0.96 (stress/rest) between QGS and 4D-MSPECT, 0.79 between QGS and echocardiography, 0.79 between 4D-MSPECT and echocardiography (p<0.001). Using Bland-Altman plot, the 95% confidence interval of agreement between QGS and 4D-MSPECT ranged from -12.7% to 7.3% / from -12.2% to 6.5% (stress/rest). The agreement between QGS and echocardiography, 4D-MSPECT and echocardiography ranged from -17.4% to 24.0%, and -14.8% to 27.0% respectively. The correlation of LVM between methods was also good: 0.95 between QGS and 4D-MSPECT, 0.76 between QGS and echocardiography, 0.73 between 4D-MSPECT and echocardiography (p<0.001). The 95% confidence interval of agreement between QGS and 4D-MSPECT ranged from -33.8 g to 14.1 g (stress/rest). The 95% confidence interval of agreement between QGS and echocardiography, 4D-MSPECT and echocardiography ranged from -148.7 g to 21.8. g, and -142.8 g to 35.5 g, respectively. There was a good correlation for LVEF, LVED, LVM among methods (QGS, 4D-MSPECT, echocardiography), but the variance between methods was big. Therefore, the functional parameters by each method cannot be used interchangeably

  5. 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)

  6. 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.)

  7. Morfologic characterization of hypertrophic myocardiopathy by perfusion myocardial SPECT: quantitative analysis

    International Nuclear Information System (INIS)

    Pereztol Valdes, Osvaldo; Romero Farina, Guillermo; Candell Riera, Jaume; Galve, Enrique; Palet Balart, Jordi; Castell Conesa, Joan; Aguade Bruix, Santiago; Simo, Marc; Ortega, Domingo; Soler Soler, Jordi

    2000-01-01

    Objective. To study the usefulness of myocardial perfusion single photon emission computed tomography (SPECT) so as to evaluate quantitatively left ventricular thickness in patients with hypertrophic cardiomyopathy (HC) in order to establish its morphological characterization. Methods. Two groups of patients were studied. HC group consisted of 70 patients (53± 13 years, 30 f) in whom HC was diagnosed by echocardiogram (36 with dynamic obstruction). The control group consisted of 20 normal subjects (46± 11 years, 7 f). Exercise-rest 99m Tc-tetrofosmin SPECT (one-day-protocol) was performed in all patients. An intravenous dose of 99m Tc-tetrofosmin (8-10 mCi) was administered 30 to 60 seconds before the end of exercise. A 20-25 mCi dose of 99m Tc-tetrofosmin was administered immediately after stress images were obtained. Wall thickness was measured in the middle of septal, anterior, lateral and inferior regions at rest 99m Tc-tetrofosmin SPECT in the short-axis plane at the apical and medial level. In order to establish normal limits for each region, standard deviation values in the control group were determined and compared with the corresponding region in HC group. Results. Septal and anterior regions were the most involved in patients with HC. Thirteen morphological models of HC could be observed according to the different associations of hypertrophic segments. Conclusions. These results show that quantitative myocardial SPECT permits a morphological characterization of HC in 13 different models depending of the localization of hypertrophy. Septal and anterior regions are the most frequently involved (Au)

  8. Diagnostic accuracy of technetium-99m-MIBI myocardial SPECT in women and men.

    Science.gov (United States)

    Santana-Boado, C; Candell-Riera, J; Castell-Conesa, J; Aguadé-Bruix, S; García-Burillo, A; Canela, T; González, J M; Cortadellas, J; Ortega, D; Soler-Soler, J

    1998-05-01

    Noninvasive diagnosis of coronary artery disease in women has some limitations due to a higher percentage of false-positive results. In addition, a lower prevalence of disease can be observed in this population. In this study, we evaluated the diagnostic accuracy of 99mTc-methoxy-isobutyl-isonitrile (MIBI) SPECT in women and men, in a group of patients with proven coronary artery disease by coronary angiography (select minority) and in all patients where a noninvasive test (silent majority) was performed. Seven hundred and two consecutive patients without previous myocardial infarction were studied with 99mTc-MIBI myocardial SPECT. One hundred sixty-three patients had coronary angiography (select minority) and 539 did not (silent majority). All patients underwent exercise stress testing, and simultaneous dipyridamole was administered in 32% of patients who did not achieve maximum predicted heart rates. Diagnostic accuracy of the test was calculated for the select minority. Then, sensitivity and specificity of the silent majority were recalculated according to the Diamond criteria. Prevalence of coronary artery disease (32% versus 80%, p = 0.0001) and peak O2 consumption achieved in exercise tests (watts, exercise duration) were lower in women. The probability of positive results of 99mTc-MIBI SPECT also was lower in women (34% versus 65%). The sensitivity of 99mTc-MIBI SPECT in women of the select minority was lower (85% versus 93%, p = 0.01), whereas there was no significant difference for specificity (91% versus 89%). After correcting the results for the silent majority, there were no significant differences in sensitivity (87% versus 88%) and specificity (91% versus 96%) between women and men. These results were not different for patients who achieved maximum predicted heart rates during stress testing (without dipyridamole administration). The sensitivity of 99mTc-MIBI myocardial SPECT in women was lower than in men when only the select minority was considered

  9. 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)

  10. Development of a New Cardiac and Torso Phantom for Verifying the Accuracy of Myocardial Perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto; Tomoaki [Dept. of Radiological Science, School of Health Science, International University of Health and Welfare, Otawara(Japan); Kim, Jung Min; Lee, Ki Sung [Dept. of Radiological Science, College of Health Science, Korea University, Seoul (Korea, Republic of); Takayama, Teruhiko [Dept. of Clinical Laboratory Science, Graduate School of Medicine, Kanazawa University, Kanazawa (Japan); Kitashi, Kitahara [Dept. of Radiology, Fujigaoka Hospital, Showa University, Tokyo (Korea, Republic of)

    2008-12-15

    Corrections of attenuation, scatter and resolution are important in order to improve the accuracy of single photon emission computed tomography (SPECT) image reconstruction. Especially, the heart movement by respiration and beating cause the errors in the corrections. Myocardial phantom is used to verify the correction methods, but there are many different parts in the current phantoms in actual human body. Therefore the results using a phantom are often considered apart from the clinical data. We developed a new phantom that implements the human body structure around the thorax more faithfully. The new phantom has the small mediastinum which can simulate the structure in which the lung adjoins anterior, lateral and apex of myocardium. The container was made of acrylic and water-equivalent material was used for mediastinum. In addition, solidified polyurethane foam in epoxy resin was used for lung. Five different sizes of myocardium were developed for the quantitative gated SPECT (QGS). The septa of all different cardiac phantoms were designed so that they can be located at the same position. The proposed phantom was attached with liver and gallbladder, the adjustment was respectively possible for the height of them. The volumes of five cardiac ventricles were 150.0, 137.3, 83.1, 42.7 and 38.6 ml respectively. The SPECT were performed for the new phantom, and the differences between the images were examined after the correction methods were applied. The three-dimensional tomography of myocardium was well reconstructed, and the subjective evaluations were done to show the difference among the various corrections. We developed the new cardiac and torso phantom, and the difference of various corrections was shown on SPECT images and QGS results.

  11. 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

  12. 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

  13. 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

  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 13N-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 99m Tc-Sestamibi (MIBI) single photon emission computed tomography (SPECT) compared with 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 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 accuracy and functional parameters of myocardial perfusion scintigraphy using accelerated cardiac acquisition with IQ SPECT technique in comparison to conventional imaging.

    Science.gov (United States)

    Pirich, Christian; Keinrath, Peter; Barth, Gabriele; Rendl, Gundula; Rettenbacher, Lukas; Rodrigues, Margarida

    2017-03-01

    IQ SPECT consists of a new pinhole-like collimator, cardio-centric acquisition, and advanced 3D iterative SPECT reconstruction. The aim of this paper was to compare diagnostic accuracy and functional parameters obtained with IQ SPECT versus conventional SPECT in patients undergoing myocardial perfusion scintigraphy with adenosine stress and at rest. Eight patients with known or suspected coronary artery disease underwent [99mTc] tetrofosmin gated SPECT. Acquisition was performed on a Symbia T6 equipped with IQ SPECT and on a conventional gamma camera system. Gated SPECT data were used to calculate functional parameters. Scores analysis was performed on a 17-segment model. Coronary angiography and clinical follow-up were considered as diagnostic reference standard. Mean acquisition time was 4 minutes with IQ SPECT and 21 minutes with conventional SPECT. Agreement degree on the diagnostic accuracy between both systems was 0.97 for stress studies, 0.91 for rest studies and 0.96 for both studies. Perfusion abnormalities scores obtained by using IQ SPECT and conventional SPECT were not significant different: SSS, 9.7±8.8 and 10.1±6.4; SRS, 7.1±6.1 and 7.5±7.3; SDS, 4.0±6.1 and 3.9±4.3, respectively. However, a significant difference was found in functional parameters derived from IQ SPECT and conventional SPECT both after stress and at rest. Mean LVEF was 8% lower using IQ SPECT. Differences in LVEF were found in patients with normal LVEF and patients with reduced LVEF. Functional parameters using accelerated cardiac acquisition with IQ SPECT are significantly different to those obtained with conventional SPECT, while agreement for clinical interpretation of myocardial perfusion scintigraphy with both techniques is high.

  17. Assessment of myocardial perfusion and function in victims of scorpion envenomation using gated-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Figueiredo, Alexandre Baldini de; Cupo, Palmira; Pintya, Antonio O.; Caligaris, Fabio; Marin-Neto, Jose A; Hering, Sylvia E.; Simoes, Marcus Vinicius, E-mail: simoesmv@yahoo.co [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2010-04-15

    Background: cardiogenic shock and acute pulmonary edema are the major causes of death of patients with scorpion envenomation, whose pathophysiological mechanism remains controversial. Objective: to investigate the correlation between myocardial perfusion abnormalities and left ventricular contractile function in victims of scorpion envenomation. Methods: fifteen patients underwent ECG-gated myocardial perfusion scintigraphy (gated SPECT) within 72 hours of, and 15 days after scorpion envenomation. Images were analyzed by means of a semi-quantitative visual perfusion score (0 = normal, 4 = absent) and motion score (0 = normal, 4 akinesia), using the 17-segment model. Summed perfusion (SPS) and summed motion (SMS) scores were calculated for each patient. Ejection fraction (LVEF) was calculated by a commercially available software. Results: at baseline, 12 out of the 15 patients presented abnormal myocardial perfusion and contractility. Mean values of SPS, SMS and LVEF were 12.5 +- 7.3, 17.0 +- 12.8, and 44.6 +- 16.0%, respectively. A positive correlation between SPS and SMS (r = 0.68; p = 0.005) and negative correlation between SPS and LVEF (r -0.75; p = 0.0021) were found. The follow-up studies showed recovery of global contractility (LVEF of 68.9 +- 9.5, p = 0.0002), segmental contractility (SMS of 2.6 +- 3.1, p = 0.0009) and perfusion (SPS of 3.7 +- 3.3, p = 0.0003). Improvement of LVEF correlated positively with improvement of SPS (r = 0.72; p = 0.0035). Conclusions: myocardial perfusion abnormalities are common in scorpion envenomation and correlate topographically with the contractile dysfunction. Recovery of contractility correlates with reversibility of perfusion defects. These findings suggest the participation of myocardial perfusion abnormalities in the pathophysiology of this form of acute ventricular failure. (author)

  18. 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 enhan...

  19. Measurement of left ventricular chamber and myocardial volume in hypertrophic cardiomyopathy patients by ECG-gated myocardial perfusion SPECT. Application of a newly developed edge-detection algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Yoshihiro; Katafuchi, Tetsuro; Hirase, Yoshinori; Sagoh, Masayoshi; Oka, Hisashi [National Cardiovascular Center, Suita, Osaka (Japan); Mori, Hideaki [Siemens-Asahi Medical Technologies, Ltd., Tokyo (Japan); Murase, Kenya [Osaka Univ., Suita (Japan). Medical School

    2002-12-01

    Quantitative gated SPECT (QGS) software has been reported to demonstrate inaccurate edge detection in the left ventricular chamber in hypertrophic cardiomyopathy patients. In this study we developed a method to calculate left ventricular volume (LVV) and left myocardial volume (LMV) from gated SPECT data using a newly developed edge-detection algorithm, and we compared it with the QGS method of calculating LVV and LMV in a phantom study. Our method gave more accurate measurements LVV and LMV whereas the QGS method underestimated LMV. Compared with QGS LVV and LMV, our method yielded better results in the phantom study. (author)

  20. 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

  1. 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

  2. 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

  3. 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

  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. 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

  6. 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.

  7. Optimization of the filter parameters in (99m)Tc myocardial perfusion SPECT studies: the formulation of flowchart.

    Science.gov (United States)

    Shibutani, Takayuki; Onoguchi, Masahisa; Yamada, Tomoki; Kamida, Hiroki; Kunishita, Kohei; Hayashi, Yuuki; Nakajima, Tadashi; Kinuya, Seigo

    2016-06-01

    Myocardial perfusion single photon emission computed tomography (SPECT) is typically subject to a variation in image quality due to the use of different acquisition protocols, image reconstruction parameters and image display settings by each institution. One of the principal image reconstruction parameters is the Butterworth filter cut-off frequency, a parameter strongly affecting the quality of myocardial images. The objective of this study was to formulate a flowchart for the determination of the optimal parameters of the Butterworth filter for filtered back projection (FBP), ordered subset expectation maximization (OSEM) and collimator-detector response compensation OSEM (CDR-OSEM) methods using the evaluation system of the myocardial image based on technical grounds phantom. SPECT studies were acquired for seven simulated defects where the average counts of the normal myocardial components of 45° left anterior oblique projections were approximately 10-120 counts/pixel. These SPECT images were then reconstructed by FBP, OSEM and CDR-OSEM methods. Visual and quantitative assessment of short axis images were performed for the defect and normal parts. Finally, we formulated a flowchart indicating the optimal image processing procedure for SPECT images. Correlation between normal myocardial counts and the optimal cut-off frequency could be represented as a regression expression, which had high or medium coefficient of determination. We formulated the flowchart in order to optimize the image reconstruction parameters based on a comprehensive assessment, which enabled us to perform objectively processing. Furthermore, the usefulness of image reconstruction using the flowchart was demonstrated by a clinical case.

  8. 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.)

  9. 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.)

  10. 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.)

  11. Recent advances of {sup 123}I-BMIPP myocardial SPECT for evaluating ischemic heart disease and cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, T. [Tracer Kinetics and Nuclear Medicine, Osaka Univ., Medical School (Japan)

    1998-12-31

    Recent advances of {sup 123}I-BMIPP myocardial SPECT for evaluating ischemic heart disease and cardiomyopathy were reviewed. The dissociation between BMIPP and thallium defects was frequently observed in patients with acute myocardial infarction with successful reperfusion. The degree and improvement of perfusion/metabolism mismatch may reflect subsequent recovery from postischemic wall motion abnormality. BMIPP myocardial SPECT is also sensitive for detecting myocardial ischemia in acute coronary syndrome. BMIPP defects were observed at sites that corresponded to hypertrophic cardiomyopathy. On the other hand, the dissociation between BMIPP and thallium defects was not observed frequently in dilated cardiomyopathy. However, the heart to the mediastinum ratio and defect score were significantly decreased after coenzyme Q10 treatment. It was confirmed to be sensitive in evaluating the therapeutic effect. Furthermore, the basic mechanisms of BMIPP uptake were also reviewed in relation to BMIPP metabolism and longchain fatty acid transporter (CD36). (orig.) [Deutsch] Es wird eine Uebersicht ueber neueste Entwicklungen der {sup 123}I-BMIPP-Myokard-SPECT fuer die Diagnostik ischaemischer Herzerkrankungen und der Kardiomyopathie praesentiert. Regelmaessig wurde eine Dissoziation zwischen BMIPP- und Thallium-Defekten bei Patienten mit akutem Myokardinfarkt und erfolgreicher Reperfusion beobachtet. Die BMIPP-Aufnahme ist also im erfolgreich therapierten Myokard unmittelbar nach der Reperfusion gestoert, obwohl die Durchblutung wiederhergestellt wurde. Der Grad und die Entwicklung der Perfusions-Stoffwechsel-Mismatche repraesentieren eine spaetere Erholung von der postischaemischen Wandbewegungsstoerung. Die Ruhe-BMIPP-SPECT ist ein sehr sensitives Verfahren, um die Myokardischaemie beim akuten Koronarsyndrom zu erfassen. Diese Methoden sind unter dem Aspekt der Myokardvitalitaet beim Notfallpatienten fuer das Patientenmanagement wertvoll. In 80% der Patienten mit

  12. 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)

  13. Evaluation of myocardial viability-a comparative study using dobutamine Doppler tissue imaging and nitroglycerin intervened 99Tcm -sestamibi myocardial SPECT

    International Nuclear Information System (INIS)

    Wu, H.; Yang, J.

    2002-01-01

    Aim: Doppler tissue imaging (DTI) is a newly developed ultrasonic technique and has rarely be used to study the myocardial viability. In the present study low dose dobutamine stressed DTI and nitroglycerin intervened 99 Tc m -sestamibi (MIBI) myocardial perfusion single photon emission computer tomography (SPECT) were compared in detecting viable hibernating myocardium. Material and Methods: Twenty patients with coronary artery disease and chronic left ventricular dysfunction underwent low dose dobutamine stressed DTI. Nine of them underwent 99 Tc m -MIBI SPECT under baseline condition and during nitroglycerin infusion. Low dose dobutamine stressed echocardiography was used as standard evaluation of myocardial viability in the present study. In echocardiography demonstrated 100/240 asynergic segments, 35 segments improved after dobutamine infusion, which were defined to be viable myocardium and classified as group A, the other 65 segments did not show improvement, which were defined to be non-viable and classified as group B. Results: In DTI evaluation, peak systolic velocity of S wave (Vs) was used as quantitative index. The change rate of Vs was calculated as: VR= (Vs post-dobutamine - Vs pre-dobutamine)/Vs pre-dobutamine. VR in group A was significantly higher than in group B (0.6∫0.4 vs 0.25±0.32, p 0.8 were in group A. When using 0.4 for VR as cut-off of viable myocardium, the sensitivity and specificity of detecting myocardial viability with DTI were 73.3% and 75.8%, respectively. In the nine patients who underwent SPECT there were 48/108 dysfunctional segments demonstrated by echocardiography. There were 15/48 segments in group A and 33/48 in group B. Nitroglycerin induced significant decrease of the defect area of black-out polar map in group A while no significant changes in group B. When using a cut-off of 20% for decrement of black-out size in a special segment after nitroglycerin intervention, the sensitivity and specificity were 75.8% and 81

  14. The effect of image translation table on diagnostic efficacy of myocardial perfusion SPECT studies

    International Nuclear Information System (INIS)

    Siennicki, J.; Kovacevic-Kusmierek, K.; Bienkiewicz, M.; Plachcinska, A.; Kusmierek, J.; Chizynski, K.

    2010-01-01

    Background: The aim of this study was to determine which of the most popular colour scales used in the Xeleris processing system (GE) should preferably be used during a clinical interpretation of myocardial perfusion images, and to find out whether a colour scale saturation level affects the diagnostic efficacy of the study. Material And Methods: From among 100 patients in whom a myocardial perfusion scintigraphy had been performed, a subgroup of people referred for coronary angiography, with neither prior history nor ECG signs of a myocardial infarction has been selected retrospectively. This group consisted of 41 patients (14 females) in the age group 46 to 76 years. All patients underwent two-day myocardial perfusion SPECT imaging using 99mT c-MIBI as a radiopharmaceutical. Reconstructed slices were interpreted in 3 colour scales: white-red-yellow-green-blue-black with computer-assigned thresholds (French 100%), the same French scale but without a white colour (image maximum set manually to a border value between red and white - French w.w.), and a white-yellow-violet-pink-blue-black scale (GEcolor), by consensus of two experienced nuclear medicine specialists. A semiquantitative method for evaluation of perfusion images was applied, based on myocardium segmentation. Perfusion in each segment was scored using a five-point system. Study interpretation (normal/abnormal perfusion) was based on summed stress scores (SSS), being equal/above or below a given threshold value. The choice of optimal SSS threshold value was based on sensitivity and specificity of the study in detection of perfusion defects resulting from critical stenoses of main coronary arteries. Results: SSS values differed among colour scales (p < 0.00001). The lowest values were obtained for a French 100% scale (mean value = 5.0, SD = 8.0), the highest for French w.w. (mean values = 8.1, SD = 8.7), and for GE colour scale - mean value - 5.6, SD - 7.9. A French 100% scale gave high sensitivity (88

  15. Regularized Image Reconstruction Algorithms for Dual-Isotope Myocardial Perfusion SPECT (MPS) Imaging Using a Cross-Tracer Prior

    OpenAIRE

    He, Xin; Cheng, Lishui; Fessler, Jeffrey A.; Frey, Eric C.

    2010-01-01

    In simultaneous dual-isotope myocardial perfusion SPECT (MPS) imaging, data are simultaneously acquired to determine the distributions of two radioactive isotopes. The goal of this work was to develop penalized maximum likelihood (PML) algorithms for a novel cross-tracer prior that exploits the fact that the two images reconstructed from simultaneous dual-isotope MPS projection data are perfectly registered in space. We first formulated the simultaneous dual-isotope MPS reconstruction problem...

  16. Estimation of myocardial viability and clinical significance of reverse redistribution in resting technetium-99m sestamibi myocardial single photon emission computed tomography in patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Itagane, Hiroshi; Otsuka, Masato; Suto, Yayoi; Kajiwara, Kenji; Naruko, Takahiko; Tojo, Osamu; Okumachi, Fukumaru; Haze, Kazuo; Yamagishi, Hiroyuki.

    1997-01-01

    The clinical significance of reverse redistribution of Tc-99m sestamibi (MIBI) was investigated in 36 patients with acute myocardial infarction and angiographically confirmed single-vessel disease, but without previous infarction using resting MIBI myocardial SPECT and exercise-reinjection Tl-201 (Tl) myocardial SPECT. MIBI myocardial SPECT was performed 90 min and 300 min after injection of MIBI 370 MBq at rest. Four hours after exercise Tl imaging was completed, reinjection imaging was obtained. Wall motion abnormalities on left ventriculograms were analyzed at the onset of infarction and 1 month later. The severity scores on the MIBI early image, MIBI delayed image and Tl reinjection image were 98±18, 170±22 and 90±18, respectively. The reverse redistribution of MIBI was marked in acute infarction. A significant correlation of severity score was found between the MIBI early image and Tl reinjection image. In 18 patients with significant stenosis of an infarct-related artery, there was a significant correlation between the degree of reverse redistribution and that of Tl redistribution. A good correlation was found between the severity score on the MIBI early image and wall motion abnormality at 1 month after infarction. There was a significant correlation between the degree of reverse redistribution and wall motion improvement. Despite stenosis of the infarct-related artery, the wall motion abnormality was less in 22 patients with marked reverse redistribution than the other 14 patients. (K.H.)

  17. 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.)

  18. 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.

  19. A new protocol of dual energy acquisition on stress {sup 201}Tl and rest {sup 99m}Tc-tetrofosmin myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Maeno, Masakazu; Matsuo, Takeshi; Imamura, Takurou; Koiwaya, Yasushi; Eto, Tanenao; Nagamachi, Shigeki; Jinnouchi, Seishi [Miyazaki Medical Coll., Kiyotake (Japan)

    2001-03-01

    We carried out stress {sup 201}Tl (Tl) and rest {sup 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)

  20. Comparative study of diagnostic methods for myocardial infarction in Kawasaki disease

    International Nuclear Information System (INIS)

    Kondoh, Chisato; Nakanishi, Toshio; Satomi, Gengi; Matsumoto, Yasutoshi; Takao, Atsuyoshi; Hiroe, Michiaki

    1986-01-01

    The diagnostic value of electrocardiography (ECG), left ventriculography (LVG), thallium-201 (Tl-201) myocardial imaging (SPECT and planar imaging), and two-dimensional echocardiography (2DE) for myocardial infarction (MI) secondary to Kawasaki disease was compared in 10 children with ≥ 90 % coronary stenosis. The sensitivity of these modalities for detecting MI was assessed by the incidence of abnormal findings corresponding to the region which was supplied by 15 branches with a ≥ 90 % stenosis on coronary arteriography (CAG). The sensitivity was 60 % for ECG, 73 % for LVG, 87 % for Tl-SPECT, 60 % for Tl-planar imaging, 60 % for quantitative 2DE, and 33 % for visual 2DE. It is concluded that LVG or Tl SPECT, in combination with CAG, has higher ability to detect MI for Kawasaki disease than ECG or 2DE. (Namekawa, K.)

  1. 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

  2. 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

  3. 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)

  4. 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.

  5. Quantitative analysis of SPECT imaging parameters in patients with resting perfusion defects on myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Pruthi, Ankur; Asopa, Ramesh; Rajan, M.G.R.; Basu, Sandip

    2010-01-01

    Functional status/contractile behaviour of hibernating myocardium was analyzed objectively by analyzing the available quantitative parameters obtained on gated SPECT myocardial perfusion imaging (MPI) using Emory cardiac toolbox (ECTB) software. Materials and Methods: In this retrospective study, 70 patients with perfusion defects on 99 Tc-Sestamibi MPI (12 females, 58 males) who also underwent 18 F-FDG Cardiac PET study for assessment of hibernating myocardium were included for analysis. Patients were divided in three categories based on summed rest score (SRS) obtained from ECTB software, depicting the extent of perfusion defects. In a study population matched for extent of perfusion defects, quantitative parameters obtained from ECTB software such as left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (EDV), left ventricular end systolic volume (ESV) and left ventricular stroke volume (SV) were compared between patients showing evidence of hibernating myocardium and patients showing no evidence of hibernating myocardium. Student 't' test was applied on the given observations and a P-value <0.05 was considered as a significant difference between the means in two categories. Results: There was no significant difference in LVEF, EDV, ESV and SV measurements between those who demonstrate hibernating myocardium and those who show no evidence of hibernating myocardium across all the categories of patients. Few trends were evident in the present study in LVEF, EDV and ESV measurements i.e., fall in mean LVEF with increasing SRS and rise in mean EDV and ESV with increasing SRS. Conclusions: The findings were consistent with the nature of hibernating myocardium i.e., non-contractile and dysfunctional. The fall in the LVEF was suggestive of deteriorating myocardial function with increasing extent of perfusion defects. The increasing left ventricular EDV and ESV with increasing extent of perfusion defects was suggestive of rising incidence of

  6. 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

  7. Usefulness of thallium-201 myocardial SPECT using dipyridamole infusion combined with submaximum exercise of the detection of the ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, Akinori; Baba, Shinsuke; Iwagaki, Naofumi; Toyonaga, Shinji; Sunayama, Masayuki; Suzuki, Seiyuu; Takasugi, Kenta; Shibata, Tsuneo [Sumitomo Besshi Hospital, Niihama, Ehime (Japan)

    1995-05-01

    The present study assessed the usefulness and safety of myocardial single photon emission computed tomography with combined iv dipyridamole infusion and submaximum exercise (DE-SPECT). The subjects were 89 patients with arteriographically significant coronary artery disease (CAD+) and 21 patients with arteriographically non-proven CAD (CAD-). There was no change in cardiovascular dynamics after iv dipyridamole infusion in the group of CAD-. In the group of CAD+, on the other hand, dipyridamole infusion significantly induced ischemia even when combined exercise was minor. DE-SPECT has a sensitivity of 99% and specificity of 91%. Furthermore, 25 selected CAD + patients underwent myocardial SPECT after iv dipyridamole infusion and 3-minute stepping exercise (DS-SPECT). Although DE-SPECT was positive in all 25 patients, DS-SPECT was false negative in 12% (3/25) with a sensitivity of 88%. These 3 false-negative patients had a single vessel disease and could tolerate exercise. Although angina pectoris like symptoms occurred by DE-SPECT in approximately 80% of the CAD+ group, there was no serious complication. In conclusion, DE-SPECT increased diagnostic sensitivity for ischemic heart disease. (N.K.).

  8. 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.

  9. 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)

  10. SPECT myocardial perfusion imaging with prone-only acquisitions: correlation with coronary angiography.

    Science.gov (United States)

    Shin, John H; Pokharna, Hemlata K; Williams, Kim A; Mehta, Rupa; Ward, R Parker

    2009-01-01

    Recent evidence suggests that combining supine and prone acquisitions during stress-gated SPECT myocardial perfusion imaging (MPS) improves detection of obstructive coronary artery disease (CAD), though the additional imaging time required may not be feasible in routine clinical practice. MPS with prone-only acquisitions is occasionally performed in many laboratories, though little is known about the ability of modern MPS with prone-only acquisitions to detect obstructive CAD. Our goal was to assess the ability of MPS with prone-only acquisitions to detect obstructive CAD as determined by coronary angiography. We studied 386 patients referred for MPS with either recent coronary angiography or a low pretest likelihood of coronary artery disease. All rest and stress images were obtained exclusively in the prone position. The sensitivity of prone-only MPS was 88% for detecting > or =50% coronary artery stenosis and 92% for detecting > or =70% coronary artery stenosis as determined by coronary angiography. Normalcy rate for prone-only MPS in patients with low probability for CAD was 95%, and normalcy rates did not significantly differ among coronary artery distributions. The findings of this study suggest that MPS using prone-only acquisitions is a reasonable diagnostic option for the detection of ischemia due to obstructive coronary artery disease.

  11. 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

  12. 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.

  13. 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)

  14. Brain SPECT

    International Nuclear Information System (INIS)

    Feistel, H.

    1991-01-01

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

  15. 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)

  16. 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

  17. 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.

  18. Myocardial scintigraphy in the diagnosis of myocardial contusion

    Energy Technology Data Exchange (ETDEWEB)

    Terashima, Masayoshi; Shinoda, Mitsutaka; Iwama, Hiroshi; Hirama, Hisao; Hoshino, Toshiaki; Urabe, Shinpei [Central Aizu General Hospital, Fukushima (Japan); Meguro, Taiichiroh

    1996-04-01

    To assess the clinical value of a new fatty acid imaging tracer, {sup 123}I-{beta}-methyl iodophenyl pentadecanoic acid (BMIPP), I-BMIPP and thallium-201 (Tl) dual imaging was performed at rest in fifteen patients with mild blunt chest trauma (mean AIS thoracic 1.4{+-}0.51, mean ISS 6.47{+-}3.50, mean RTS 7.69{+-}0.43). All patients were prospectively evaluated on the basis of serial electrocardiograms (ECG) and cardiac enzyme studies (total CPK). Tl and BMIPP dual scintigrams were performed within 10 days following admission. SPECT images were divided into seven segments, and the segmental images were visually scored according to tracer uptake on a 3 (severely decreased tracer uptake) to 0 (normal) scale. Nine patients had scintigraphic defects and were considered to have a myocardial contusion. ECG findings, AIS, ISS, and CPK levels failed to distinguish between scintigraphically positive patients and scintigraphically negative patients. Five of the 14 hypoperfused segments on BMIPP imaging, showed normal Tl uptake, one showed lower BMIPP uptake than Tl, and the remaining eight showed similar distribution of both tracers. The mismatch between tracer uptake on BMIPP images and Tl images was thought to reflect impaired myocardial fatty acid metabolism. Thus, mild blunt chest trauma results in a higher frequency of traumatic myocardial injury than previously recognized, and BMIPP is a promising radio-pharmaceutical for evaluating impaired myocardial fatty acid metabolism in patients with myocardial contusion. (author).

  19. 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)

  20. Thallium chloride 201Tl combined with single photon emission computed tomography (SPECT) in the evaluation of vestibular schwannoma growth

    DEFF Research Database (Denmark)

    Charabi, Samih Ahmed; Lassen, N A; Thomsen, J

    1997-01-01

    in the tumors expressed by positive staining with the monoclonal antibody MIB-1 for Ki-67. A positive 201TI enhancement was detected in 17 tumors (n = 17). Tumors U and C were statistically unrelated to tumor volume (p = 0.236 and p = 0.439). SPECT demonstrated all tumors > 0.8 cm3, but it had its limitation...... modality capable of providing data on VS vascularity and determination of growth potential in the individual tumor. A high radioactive tracer uptake in the tumor corresponded to high tumor vascularity, indicating a high growth rate and vice versa....

  1. 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)

  2. 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

  3. 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.)

  4. Reverse redistribution of Tc-99m-tetrofosmin in exercise myocardial SPECT in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Taniguchi, Yoko; Kinoshita, Noriyuki [Kyoto Prefectural Univ. of Medicine (Japan)] [and others

    1998-10-01

    We examined the usefulness of Tc-99m-tetrofosmin in detecting exercise induced perfusion abnormalities in patients with hypertrophic cardiomyopathy (HCM) and to clarify time-related changes in myocardial distribution of Tc-99m-tetrofosmin after a single injection. We studied 44 consecutive patients with HCM by means of exercise/rest Tc-99m-tetrofosmin single photon emission computed tomography (SPECT). After injecting 370 MBq of Tc-99m-tetrofosmin at the peak exercise, the early SPECT imaging was performed at 30 min (EX-30) and the delayed imaging at 180 min (EX-180). Immediately after the delayed imaging, 740 MBq of Tc-99m-tetrofosmin was injected in the resting state, and the rest SPECT imaging was performed 30 min later. Exercise-induced regional perfusion defects and/or apparent reversible left ventricular cavity dilation were identified in 26 (68.2%) of the 44 patients. When EX-30 images and EX-180 images were compared, reverse redistribution was confirmed in 36 patients (81.8%). Reverse redistribution was detected most frequently in the septal portion of the anterior wall, followed by the septal portion of the posterior wall and the septum. Exercise/rest Tc-99m-tetrofosmin myocardial imaging was a useful method for assessing myocardial perfusion abnormalities in patients with HCM. Reverse redistribution was detected very frequently on early and delayed images of exercise. We assumed that reverse redistribution may reflect a retention disorder of Tc-99m-tetrofosmin caused by some metabolic dysfunction of myocytes. (author)

  5. 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.)

  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. 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).

  8. 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)

  9. 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

  10. 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

  11. Efficacy of the direct myocardial revascularization performed on the beating heart or performed with the use of extra corporal circulation - comparison by means of myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Kwinecki, P.; Jemielity, M.; Dyszkiewicz, W.; Czepczynski, R.; Sowinski, J.

    2002-01-01

    Introduction. In the recent years, new techniques of direct myocardial revascularization: OPCAB - off pump coronary artery bypass and MIDCAB - minimal invasive coronary artery bypass were developed. Aim of this study was to compare the efficacy of these methods with that of CABG performed with the use of extracorporal circulation. Material and methods. 20 patients operated on the beating heart (group 1; 16 men and 4 women; aged 40 to 65 years; mean 53,0 ±8,6 years) and 36 patients operated in the extracorporal circulation (group 2; 33 men and 3 women; aged 34 to 69 years, mean 52,5 ±8,6 years). In all the patients myocardial SPECT using 99mTc-MIBI at rest and after stimulation with dipyridamole (0,56 mg/kg) was performed twice: before and 4-7 months after revascularization. Myocardial perfusion was evaluated in 9 segments using following scale: from 1 (normal) to 5 points (no uptake). The average score in all nine segments constituted a perfusion index (PI). The differences of PI before and after operation, both at rest and after dipyridamole were compared. Results. In none of the patients of group 1 a perioperational ischemia was found by ECG or enzymatic (CK-MB) measurements. In a part of group 2 signs of transient ischemia were found. Global evaluation of perfusion in SPECT is presented. PI were similar in both groups, both at rest and after dipyridamole. Conclusion: Efficacy of the direct myocardial revascularization performed on the beating heart is similar to that of the CABG operations performed with the use of extracorporal circulation. The OPCAB and MIDCAM operations are less traumatizing

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-02-01

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

  13. 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

  14. Nitrate-enhanced gated SPECT in patients with primary angioplasty for acute myocardial infarction: evidence of a reversible and nitrate-sensitive impairment of myocardial perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Djaballah, Wassila [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); UHP-INSERM ERI13, Nancy (France); Hopital de Brabois, Service de Medecine Nucleaire, CHU-Nancy, Vandoeuvre Cedex (France); Muller, Marc A.; Karcher, Gilles [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Angioi, Michael [CHU-Nancy, Department of Cardiology, Nancy (France); UHP-INSERM U684, Nancy (France); Moulin, Frederic; Ethevenot, Gerard; Aliot, Etienne [CHU-Nancy, Department of Cardiology, Nancy (France); Codreanu, Andrei [UHP-INSERM ERI13, Nancy (France); CHU-Nancy, Department of Cardiology, Nancy (France); Mandry, Damien [UHP-INSERM ERI13, Nancy (France); CHU-Nancy, Department of Radiology, Nancy (France); Marie, Pierre Y. [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); UHP-INSERM U684, Nancy (France)

    2007-12-15

    Reperfusion of myocardial infarction (MI) leads to a reversible dysfunction of coronary vessels. We hypothesised that vasodilating drugs such as nitrates might improve sestamibi uptake within viable areas of recently reperfused MI, thereby enhancing prediction of subsequent improvements in perfusion and contractility. This study was aimed at assessing nitrate-enhanced sestamibi gated SPECT after MI reperfusion. Twenty-nine patients underwent rest followed by nitrate sestamibi gated SPECT at 9 {+-} 3 days after primary angioplasty for acute MI and at follow-up, 4-10 months later. Four MBq/kg of {sup 99m}Tc-sestamibi was injected at rest, and 12 MBq/kg after nitroglycerin spray. Follow-up improvements were documented for both perfusion (P+) and contractility (C+) in 18% of the 180 initially abnormal segments, in neither perfusion (P-) nor contractility (C-) in 44%, in contractility only (C+P-) in 16% and in perfusion only (C-P+) in 22%. Perfusion improvement was related to lower sestamibi uptake on baseline rest SPECT (P+: 42 {+-} 15% vs P-: 50 {+-} 15%, p = 0.001) and, moreover, to a higher increase between rest and nitrate uptake (P+: +9.5 {+-} 6.5% vs P-: +2.0 {+-} 5.9%, p < 0.001). Contractility improvement was related to sestamibi uptake on baseline nitrate SPECT (C+: 58 {+-} 15% vs C-: 38 {+-} 16%, p < 0.001), a variable enhancing the prediction provided by sestamibi uptake at rest (p < 0.05). The improvement in perfusion which is documented in the months following MI reperfusion is predicted by initial nitrate enhancement of sestamibi uptake, suggesting a mechanism of reversible vascular injury. In this particular setting, sestamibi uptake is a better predictor of contractility recovery when determined after nitrate administration rather than under conventional resting conditions. (orig.)

  15. 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.

  16. 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

  17. 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.)

  18. Hybrid CCTA/SPECT myocardial perfusion imaging findings in patients with anomalous origin of coronary arteries from the opposite sinus and suspected concomitant coronary artery disease.

    Science.gov (United States)

    Gräni, Christoph; Benz, Dominik C; Schmied, Christian; Vontobel, Jan; Mikulicic, Fran; Possner, Mathias; Clerc, Olivier F; Stehli, Julia; Fuchs, Tobias A; Pazhenkottil, Aju P; Gaemperli, Oliver; Buechel, Ronny R; Kaufmann, Philipp A

    2017-02-01

    Anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS) are associated with adverse cardiac events. Discrimination between ACAOS and coronary artery disease (CAD)-related perfusion defects may be difficult. The aim of the present study was to investigate the value of hybrid coronary computed tomography angiography (CCTA)/SPECT-MPI in patients with ACAOS and possible concomitant CAD. We retrospectively identified 46 patients (mean age 56 ± 12 years) with ACAOS revealed by CCTA who underwent additional SPECT-MPI. ACAOS with an interarterial course were classified as malignant, whereas all other variants were considered benign. CCTA/SPECT-MPI hybrid imaging findings (ischemia or scar) were analyzed according to the territory subtended by an anomalous vessel or a stenotic coronary artery. Twenty-six (57%) patients presented with malignant ACAOS. Myocardial ischemia or scar was found only in patients who had concomitant obstructive CAD in the vessel matching the perfusion defect as evidenced by hybrid CCTA/SPECT imaging. Hybrid CCTA/SPECT-MPI represents a valuable non-invasive tool to discriminate the impact of ACAOS from concomitant CAD on myocardial ischemia. Our results suggest that in a middle-aged population myocardial ischemia due to ACAOS per se may be exceedingly rare and is more likely attributable to concomitant CAD.

  19. Calculation of variability in myocardial uptake of {sup 99m}Tc-tetrofosmin at exercise and rest SPECT images. Application to hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Nii, Takeshi; Nishida, Takuji; Kakizaki, Junko; Sugahara, Syuji [Kyoto Prefectural Univ. of Medicine (Japan)

    1998-11-01

    We examined whether or not it is better to use delayed myocardial SPECT images in determining the variability in myocardial uptake ({Delta}TF) of {sup 99m}Tc-tetrofosmin under the one-day protocol. We injected 370 MBq of {sup 99m}Tc-tetrofosmin at peak exercise, and initial (TF1) and delayed (TF2) exercise SPECT images were acquired 30 min and 3 hr, respectively, after the injection. Then, 740 MBq of {sup 99m}Tc-tetrofosmin was reinjected soon after TF2 acquisition, and rest SPECT images (TF3) were obtained 30 min later. Myocardial counts of TF1, TF2, and TF3 were defined as C1, C2, and C3, respectively, and {Delta}TF was determined by the following formula: {Delta}TF(A) = ({l_brace}C1 x R-(C3-C2`){r_brace}/(C3-C2`)) x 100(%). {Delta}TF(B) = ({l_brace}C1 x R-(C3-C1`){r_brace}/(C3-C1`)) x 100(%), where R is dose ratio, A is the procedure of imaging with delayed exercise SPECT, and B is the procedure of imaging without delayed exercise SPECT. The combination in which the delayed image was used better clarified the decreased uptake of {sup 99m}Tc-tetrofosmin at the hypertrophied myocardium, and thus proved to be useful. (author)

  20. 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

  1. Automatic Valve Plane Localization in Myocardial Perfusion SPECT/CT by Machine Learning: Anatomic and Clinical Validation.

    Science.gov (United States)

    Betancur, Julian; Rubeaux, Mathieu; Fuchs, Tobias A; Otaki, Yuka; Arnson, Yoav; Slipczuk, Leandro; Benz, Dominik C; Germano, Guido; Dey, Damini; Lin, Chih-Jen; Berman, Daniel S; Kaufmann, Philipp A; Slomka, Piotr J

    2017-06-01

    Precise definition of the mitral valve plane (VP) during segmentation of the left ventricle for SPECT myocardial perfusion imaging (MPI) quantification often requires manual adjustment, which affects the quantification of perfusion. We developed a machine learning approach using support vector machines (SVM) for automatic VP placement. Methods: A total of 392 consecutive patients undergoing 99m Tc-tetrofosmin stress (5 min; mean ± SD, 350 ± 54 MBq) and rest (5 min; 1,024 ± 153 MBq) fast SPECT MPI attenuation corrected (AC) by CT and same-day coronary CT angiography were studied; included in the 392 patients were 48 patients who underwent invasive coronary angiography and had no known coronary artery disease. The left ventricle was segmented with standard clinical software (quantitative perfusion SPECT) by 2 experts, adjusting the VP if needed. Two-class SVM models were computed from the expert placements with 10-fold cross validation to separate the patients used for training and those used for validation. SVM probability estimates were used to compute the best VP position. Automatic VP localizations on AC and non-AC images were compared with expert placement on coronary CT angiography. Stress and rest total perfusion deficits and detection of per-vessel obstructive stenosis by invasive coronary angiography were also compared. Results: Bland-Altman 95% confidence intervals (CIs) for VP localization by SVM and experts for AC stress images (bias, 1; 95% CI, -5 to 7 mm) and AC rest images (bias, 1; 95% CI, -7 to 10 mm) were narrower than interexpert 95% CIs for AC stress images (bias, 0; 95% CI, -8 to 8 mm) and AC rest images (bias, 0; 95% CI, -10 to 10 mm) ( P learning with SVM allows automatic and accurate VP localization, decreasing user dependence in SPECT MPI quantification. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  2. 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.

  3. Establishment of normal limits for left ventricular ejection fraction and volume measurements from 99Tcm-sestamibi myocardial perfusion gated SPECT

    International Nuclear Information System (INIS)

    Zhang Wanchun; Li Sijin; Kang Chunsong; Hu Guang; Liu Jianzhong; Wang Jin; Kong Fanzhen

    2004-01-01

    Objective: Gated SPECT is a reproducible method for assessing left ventricular volume (LVV) and left ventricular ejection fraction (LVEF) from 99 Tcm-sestamibi ( 99 Tcm-MIBI) myocardial perfusion imaging studies. LVV and LVEF measurements by this approach correlate well with those obtained from other cardiovascular imaging techniques. Nevertheless, the lack of criteria for abnormal test findings has limited the potential clinical application of this new imaging technique. Methods: Gated myocardial perfusion SPECT with 99 Tcm-MIBI (QGSPECT) was performed on 96 individuals with a low Bayesian likelihood ( 99 Tcm-MIBI, 2-dimensional echocardiography was performed on 30 cases within 72 h. Results: The correlation between rest QGSPECT and 2-dimensional echocardiography was r=0.714 for LVEF (p 2 in men and ≤60 ml/m 2 in women, and ESV index ≤41 ml/m 2 in men and ≤25 ml/m 2 in women. Conclusion: (1) Quantification of LV function can be accurately evaluated using gated myocardial perfusion SPECT with 99 Tcm-MIBI, (2) Using a cohort of low-likelihood subjects, we generated sex-specific normal limits for LVV and LVEF for myocardial perfusion gated SPECT. These normal limits can now be evaluated prospectively for their potential clinical value. (authors)

  4. 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 Diseases incl. Cardiotharic Surgery Impact factor: 0.653, year: 2005

  5. 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)

  6. 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)

  7. Comparison of intravenous myocardial contrast echocardiography, low dose dobutamine echocardiography, and Tc-99m sestamibi myocardial SPECT for detection of viable myocardium in chronic coronary artery disease

    International Nuclear Information System (INIS)

    Fujino, Susumu

    2003-01-01

    Low-dose dobutamine echocardiography (LDDE) is an established technique to detect dysfunctional but viable myocardium. Microvascular integrity assessed by intravenous myocardial contrast echocardiography (MCE) may also reflect tissue viability. The aim of this study was to compare MCE and LDDE in comparison with myocardial Tc-99m MIBI uptake, which reportedly correlates with the amount of viable tissue. Forty patients with coronary artery disease underwent intravenous MCE, LDDE and MIBI-SPECT. MCE was achieved with intravenous bolus injection of Levovist at baseline and during low dose dobutamine stress. Using a 12 segments model, functional response to dobutamine on LDDE or contrast enhancement on MCE was considered a marker of viable myocardium. Of 40 patients, 37 achieved good MCE images. Of a total of 444 segments, 187 (42%) had abnormal wall motion at baseline. Of these, 88 showed a response to dobutamine, while 99 did not. The majority of the LDDE viable segments (84/88, 95%) were enhanced by MCE, whereas 51% (50/99) of LDDE nonviable segments were still enhanced by MCE, suggesting overestimation of viability by MCE. However, MIBI uptake in the LDDE nonviable but MCE viable segments was significantly higher than that in the nonviable segments with both techniques (56.1±13.4 vs. 40.2±12.6% P<0.05). The sensitivity, specificity and predictive accuracy for reversible dysfunction were, respectively, 94%, 59% and 75% for MCE, 87%, 82% and 85% for LDDE and 94%, 76% and 85% for MIBI-SPECT. The diagnostic performance of MCE was similar to LDDE and MIBI-SPECT for sensitivity but poorly specific and accurate compared with LDDE and MIBI-SPECT (P<0.05). However, the majority of both LDDE and MCE viable segments (25/30 segments, 83%) improved wall motion after revascularization, whereas all of segments evaluated nonviable by both technique (14/14 segments, 100%) did not improve. Intravenous MCE may provide unique information on viability, which cannot be obtained from

  8. TI-201 redistribution SPECT and N-13 ammonia PET images in patients with old myocardial infarction and left ventricular dysfunction: segmental comparison and discordance analysis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Lee, Kyung Han; Kim, Young Hwan; Lee, Eun Jeong; Chung, Hyun Woo; Lee, Su Jin; Lee, Sang Hoon; Kim, Byung Tae [School of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2004-06-01

    We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between PET and SPECT images and analyze the discordant pattern. Rest N-13 ammonia and F-18 FDG PET were performed on 18 patients with old myocardial infarction and left ventricular dysfunction whose dipyridamole - 4hr redistribution TI-201 SPECT showed one or more severe fixed defects. Regional perfusion and metabolism were evaluated visually and quantitatively with 5-segment myocardial model. There were high concordant rate in uptake pattern (80/90 segments, 88.9%) and high correlation coefficient on quantitative analysis (R=0.81, p<0.001) between redistribution TI-201 SPECT and N-13 ammonia PET images. Nine of 18 patients had SPECT-PET concordant pattern (Group I). Ten segments (9 in inferior wall, 1 in apex) from the remaining 9 patients showed SPECT-PET discordant pattern with abnormal TI-201 defect and near normal N-13 ammonia uptake (Group II). The diastolic and systolic left ventricular dimensions were significantly increased in Group II compared to those of Group I. When attenuation uncorrected N-13 ammonia PET images were reconstructed in Group II, it resulted in PET images with severe inferior wall defects nearly identical to those seen in redistribution TI-201 SPECT images. Redistribution TI-201 SPECT images showed high concordant rate and correlation with rest N-13 ammonia PET images. Most of discordant segments had fixed thallium defects in inferior wall with nearly normal N-13 ammonia uptake, which may result from severe left ventricular dilatation and attenuation by the left hemidiaphragm and cardiac blood pool.

  9. 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)

  10. Noninvasive quantification of myocardial perfusion heterogeneity by Markovian analysis in SPECT nuclear imaging; Quantification non invasive de l'heterogeneite de la perfusion du myocarde par analyse markovienne en imageries nucleaire SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Pons, G.

    2011-04-28

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-06-01

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

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

    International Nuclear Information System (INIS)

    Kurata, Chinori; Uehara, Akihiko; Sugi, Toshihiko; Yamazaki, Keisuke; Tawarahara, Kei; Mikami, Tadashi; Matoh, Fumitaka; Odagiri, Keiichi

    2000-01-01

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

  14. Serial assessment of left ventricular performance at rest and during bicycle exercise by ECG-gated myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kumita, Shin-ichiro; Cho, Keiichi; Nakajo, Hidenobu [Nippon Medical School, Tokyo (Japan)] [and others

    2002-07-01

    The present study evaluates left ventricular performance during exercise by ECG-gated myocardial perfusion SPECT with short-time data collection. The study population consisted of 10 healthy volunteers (Group N) and 9 patients with ischemic heart disease (Group I). Seven patients in Group I had a history of prior myocardial infarction. Rest ECG-gated SPECT was performed 40 min after an injection of Tc-99m-tetrofosmin (555-740 MBq). After resting data acquisition, Group N underwent up to two 5-min stages of exercise (75 and 125 watts) on a detachable bicycle ergometer. The Group I patients all underwent symptom-limited, maximal testing on the ergometer. ECG-gated SPECT data were acquired from both groups for 3 min at rest and during the last 3 min of each exercise stage. Significant increases occurred in LVEF from rest to peak stress in both groups (from 55.4{+-}5.8 to 66.6{+-}4.1% in group N, p<0.0001; from 49.0{+-}12.8 to 56.7{+-}13.8% in Group I, p<0.001). The LVESV values significantly decreased to peak stress in Group N (from 49.9{+-}13.1 to 37.8{+-}10.0 ml, p<0.0001), whereas LVEDV did not change (from 110.6{+-}18.9 to 112.0{+-}19.0 ml). In contrast, the LVESV values at rest and under peak stress were similar in Group I (from 52.6{+-}23.9 to 51.7{+-}31.4 ml) and LVEDV in Group I at peak exercise tended to increase (from 102.8{+-}36.7 to 111.3{+-}39.0 ml). The changes in LVESV from rest to peak stress were significantly different between Group N and I (-12.1{+-}6.3 vs. -0.9{+-}11.6 ml, p<0.02). ECG-gated SPECT with short-time data collection can assess left ventricular function during exercise and may offer useful information for evaluating patients with ischemic heart disease. (author)

  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. Clinical application of cardiac SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Shigeyuki [Yokohama Rosai Hospital (Japan)

    1999-07-01

    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 {sup 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 {sup 201}Tl. Quantitative assessment of {sup 99m}Tc MIBI uptake reflect the degree of viability. {sup 123}I-Metaiodobenzylguanidine (MIBG), an analog of norepinephrine, has been used for scintigraphic assessment of regional cardiac adrenergic innervation. Cardiac sympathetic denervation, assessed by {sup 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. {sup 23}I-BMIPP ({rho}-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, {sup 99m}Tc perfusion agents, {sup 123}I-MIBG and {sup 23}I-BMIPP and in associated clinical

  17. Prognostic value of normal exercise {sup 99m}Tc-MIBI myocardial perfusion SPECT: comparison with exercise electrocardiography and coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Woo; Lee, Jae Tae; Chun, Kyung Ah; Kang, Do Young; Kim, Dong Hwan; Cho, Yong Keun; Chae, Shung Chull; Lee, Kyu Bo [Kyungpook National Univ. College of Medicine, Taegu (Korea, Republic of)

    2000-06-01

    Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise {sup 99m}Tc-MIBI myocardial perfusion single photon emission computed tomography (SPECT) and to analyze results with regard to those of exercise electrocardiography or coronary angiography. We evaluated 301 patients (mean age 52{+-}10 years, 166 males and 135 females) with normal exercise {sup 99m}Tc-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subjects were evaluated for cardiac events and followed for 8-55 months (mean 19{+-}10 months) after imaging. During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0.21% per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patinets with positive (n=3D27) and negative (n=3D235) exercise electrocardiography (p:NS). There was no cardiac event in 17 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Patients with normal exercise {sup 99m}Tc-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.

  18. 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

  19. 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

  20. 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

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

    Science.gov (United States)

    Okudan, Berna; Smitherman, Thomas C

    2004-06-01

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

  2. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-06-01

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

  4. Evaluation of the therapeutic effect of hyperbaric oxygenation and erythropoietin in the treatment of chronic heart failure using myocardial perfusion scintigraphy G-SPECT

    Directory of Open Access Journals (Sweden)

    Baškot Branislav

    2009-01-01

    Full Text Available Background. The most important predictors of longterm survival in patients with cardiac ischemic disease are left ventricular ejection fraction, left ventricular volumes, infarction size, presence and extent of residual myocardial ischemia. One of the most important recent developments in single photon emission computed tomography (SPECT myocardial perfusion imaging is the ability to acquire these studies in conjunction with electrocardiogram (ECG gating (G-SPECT. The ability to asses radionuclide myocardial perfusion and function with ECG G-SPECT imaging has revolutionized this field of nuclear cardiology. Study with G-SPECT development algorithms permits to quantify measures of left ventricular (LV volume, ejection fraction (LVEF and even regional myocardial wall motion and thickening. The American Society of Nuclear Cardiology (ASNC in its position paper from March 1999 recommends the routine incorporation of G-SPECT during cardiac perfusion scintigraphy. Case report. We presented a 70-year-old male with ischemic heart disease (dilatative, cardiomyopathy and absolute arrhythmia. He was few times hospitally treated by medicamentous therapy with no evidence of improvement. After hospital treatment, we included hyperbaric oxygenation (HBO and erythropoietin injections. Hyperbaric oxygenation was carried out in a monoplace hyperbaric chamber, BLK S-303, by a graduated protocol for patients with severe heart insufficiency, totally 15 treatments. Recombinant erythropoietin beta (RecormonR F. Hoffmann-La Roche was applied deeply subcutaneously, every second day from 2 000 IU to totally 16 000 IU. Before the therapy G-SPECT study was performed with 99m technetium-MIBI, and we obtained the functional parameters and perfusion of the left ventricle to follow-up the therapy effects. The study was performed by an ADAC-VERTEX PLUS-EPIC two-head gamma camera with dedicated quantitatively algorithm Auto-QUANT. The results of LVEF were 15%, with severity

  5. 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)

  6. 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.)

  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. 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.)

  9. Effects of diltiazem on myocardial perfusion abnormalities during exercise in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Taniguchi, Yoko; Ito, Kazuki [Kyoto Prefectural Univ. of Medicine (Japan)] [and others

    1998-12-01

    The effect of diltiazem on myocardial ischemia in patients with hypertrophic cardiomyopathy (HCM) was evaluated by exercise myocardial {sup 201}Tl single photon emission computed tomography (SPECT). Exercise myocardial SPECT was performed before and 8 weeks after oral administration of diltiazem (180 mg/day) in 20 patients with HCM who showed transient perfusion defects on exercise myocardial {sup 201}Tl SPECT under control conditions. SPECT images were divided into 17 segments. The {sup 201}Tl perfusion defects were visually scored and evaluated as the defect score. The transient dilation index was calculated as an index of subendocardial ischemia. Improvement of the defect score was demonstrated in 15 patients after the administration of diltiazem. The mean defect score decreased significantly from 9.90{+-}5.17 to 5.50{+-}4.89 (p<0.0001). Although 16 of 20 patients showed an abnormal transient dilation index before diltiazem treatment, 16 showed improvement and 13 of these normalized after diltiazem therapy. The mean transient dilation index decreased from 1.16{+-}0.10 to 1.02{+-}0.09 (p<0.0001). In conclusion, diltiazem prevents or diminishes myocardial ischemia in patients with HCM. (author)

  10. Long-term prognostic value of Tc-99m tetrofosmin myocardial gated-SPECT imaging in asymptomatic patients after percutaneous coronary intervention.

    Science.gov (United States)

    Georgoulias, Panagiotis; Demakopoulos, Nikolaos; Tzavara, Chara; Giannakou, Stavroula; Valotassiou, Varvara; Tsougos, Ioannis; Xaplanteris, Petros; Fezoulidis, Ioannis

    2008-11-01

    To evaluate the long-term prognostic value of Tc-99m tetrofosmin myocardial gated-SPECT in asymptomatic patients after coronary artery stenting. We included 246 consecutive patients in the study. All patients underwent exercise gated-single photon emission computed tomography (SPECT) myocardial imaging 5 to 7 months after percutaneous coronary intervention (PCI) and were followed for a mean period of 8.3 years (SD = 2.9). Myocardial scintigrams were evaluated calculating the summed stress score (SSS), summed rest score, and summed difference score (SDS) indexes. Cardiovascular death and nonfatal myocardial infarction were considered hard cardiac events, whereas late revascularization (>3 months after myocardial SPECT) procedures were considered to be soft events. Cox proportional hazard models were applied to evaluate the association between several variables and the investigated outcome. During the follow-up period, hard cardiac events occurred in 32 (13%) patients (cardiac death occurred in 12 patients and nonfatal myocardial infarction in 20 patients). In addition, 60 (24.4%) patients underwent a late revascularization procedure. When multiple Cox regression analysis was implied, the factors that remained significant in the final model for soft events were SSS, SDS, and angina during exercise testing. In addition, SSS, SDS, and left ventricular dilatation were independently associated with hard cardiac events as defined from the results of multiple analysis. However, SSS and SDS were the only independent predictors for both hard and soft events. Tc-99m tetrofosmin myocardial perfusion imaging (MPI), performed 6 months post-percutaneous coronary intervention, has an independent and powerful clinical value to predict hard and soft cardiac events in asymptomatic patients after PCI.

  11. 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

  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. The value of attenuation correction by hybrid SPECT/CT imaging on infarct size quantification in male patients with previous inferior myocardial infarct.

    Science.gov (United States)

    Giubbini, Raffaele Mario Tarquinio; Gabanelli, Sara; Lucchini, Silvia; Merli, Giuseppe; Puta, Erinda; Rodella, Carlo; Motta, Federica; Paghera, Barbara; Rossini, Pierluigi; Terzi, Arturo; Bertagna, Francesco

    2011-11-01

    Attenuation correction (AC) has been shown to improve the accuracy of myocardial perfusion single photon emission computed tomography (SPECT) for the detection and evaluation of patients with coronary artery disease. Attenuation artifacts, because of diaphragmatic attenuation, frequently affect the evaluation of the inferior wall, especially in male patients. The aim of this study was to evaluate the value of AC for the assessment of infarct size in coronary artery disease patients after inferior myocardial infarction. Gated-SPECT with Tc-labeled compounds with AC by hybrid SPECT/computed tomography (CT) was performed in 56 male patients with documented previous inferior myocardial infarction. Both corrected and uncorrected SPECT images were processed after motion and scatter correction by ordered-subset expectation maximization iterative reconstruction. When needed, a manual realignment between SPECT and computed tomography (CT) sections was performed. Uncorrected and corrected SPECT images were analyzed for perfusion using a 5-point segmental scoring scale from 0 (normal) to 4 (absent). Summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) of the inferior left ventricle wall (inferoseptal, inferior, infero-apical and infero-lateral segments) were determined and compared with the regional wall motion score as determined by uncorrected gated-SPECT. The SSS, SRS, SDS for attenuation-uncorrected and attenuation-corrected studies were 14.02 ± 7.9, 9.51 ± 7, 4.5 ± 3.2 and 9.39 ± 7.1, 5.6 ± 6.1, 3.8 ± 2.8, respectively. Differences were statistically significant (P<0.0001) for SSS and SRS but not for SDS. The regional summed rest score of the inferior wall (SRS of inferior segments) showed a better correlation with the regional summed wall motion score of the same segments: R²=0.50 in comparison to uncorrected SRS, R²=0.46. The combination of diaphragmatic attenuation and inferior myocardial infarction determines an artifactual

  14. 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)

  15. 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

  16. Gender differences in detecting coronary artery disease with dipyridamole stress myocardial perfusion imaging using 99m-Tc sestamibi gated SPECT.

    OpenAIRE

    Majstorov, Venjamin; Pop Gjorceva, Daniela; Vaskova, Olivija; Vavlukis, Marija; Peovska, Irena; Maksimović, Jelena

    2005-01-01

    There are some specifics in the presentation of coronary artery disease (CAD) in women compared with men that may cause diagnostic pitfalls. The accuracy of noninvasive diagnostic testing in women tends to be lower than that in men. Stress myocardial perfusion imaging with 99m-Tc sestamibi gated SPECT is an accurate technique for detecting CAD. Only a few studies have compared dipyridamole stress imaging according to gender. The aim of the study was to compare the diagnostic value of dipyrida...

  17. Influence of proton-pump inhibitors on stomach wall uptake of 99mTc-tetrofosmin in cadmium-zinc-telluride SPECT myocardial perfusion imaging.

    Science.gov (United States)

    Mouden, Mohamed; Rijkee, Karlijn S; Schreuder, Nanno; Timmer, Jorik R; Jager, Pieter L

    2015-02-01

    Proton-pump inhibitors (PPIs) induce potentially interfering stomach wall activity in single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) with technetium-99m ((99m)Tc)-sestamibi. However, no data are available for (99m)Tc-tetrofosmin. We assessed the influence of prolonged (>2 weeks) PPI use on the stomach wall uptake of (99m)Tc-tetrofosmin in patients referred for stress MPI with a cadmium-zinc-telluride-based SPECT camera and its relation with dyspepsia symptoms. Consecutive patients (n=127) underwent a 1-day adenosine stress-first SPECT-MPI with (99m)Tc-tetrofosmin, of whom 54 (43%) patients had been on PPIs for more than 2 weeks. Stomach wall activity was identified on stress SPECT using computed tomographic attenuation maps and was scored using a four-point grading scale into clinically relevant (scores 2 or 3) or nonrelevant (scores 0 or 1).Patients on PPIs had stomach wall uptake more frequently as compared with patients not using PPIs (22 vs. 7%, P=0.017). Dyspepsia was similar in both groups. Prolonged use of PPIs is associated with stomach wall uptake of (99m)Tc-tetrofosmin in stress cadmium-zinc-telluride-SPECT images. Gastric symptoms were not associated with stomach wall uptake.

  18. 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)

  19. Comparison of Channelized Hotelling and Human Observers inDetermining Optimum OS-EM Reconstruction Parameters for MyocardialSPECT

    Energy Technology Data Exchange (ETDEWEB)

    Gilland, Karen L.; Tsui, Benjamin M.W.; Qi, Yujin; Gullberg,Grant T.

    2005-07-01

    The performance of the Channelized Hotelling Observer (CHO)was compared to that of human observers for determining optimumparameters for the iterative OS-EM image reconstruction method for thetask of defect detection in myocardial SPECT images. The optimumparameters were those that maximized defect detectability in the SPECTimages. Low noise, parallel SPECT projection data, with and without ananterior, inferior or lateral LV wall defect, were simulated using theMonte Carlo method. Poisson noise was added to generate noisyrealizations. Data were reconstructed using OS-EM at 1&4subsets/iteration and at 1, 3, 5, 7&9 iterations. Images wereconverted to 2D short-axis slices with integer pixel values. The CHO used3 radially-symmetric, 2D channels, with varying levels of internalobserver noise. For each parameter setting, 600 defect-present and 600defect-absent image vectors were used to calculate the detectabilityindex (dA). The human observers rated the likelihood that a defect waspresent in a specified location. For each parameter setting, the AUC wasestimated from 48 defect-present and 48 defect-absent images. Thecombined human observer results showed the optimum parameter settingcould be in the range 5-36 updates ([number of subsets]/iteration enumber of iterations). The CHO results showed the optimum parametersetting to be 4-5 updates. The performance of the CHO was much moresensitive to the reconstruction parameter setting than was that of thehuman observers. The rankings of the CHO detectability values did notchange with varying levels of internal noise.

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

    Science.gov (United States)

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

    2015-04-01

    This paper presents two 4D mathematical observer models for the detection of motion defects in 4D gated medical images. Their performance was compared with results from human observers in detecting a regional motion abnormality in simulated 4D gated myocardial perfusion (MP) SPECT images. The first 4D mathematical observer model extends the conventional channelized Hotelling observer (CHO) based on a set of 2D spatial channels and the second is a proposed model that uses a set of 4D space-time channels. Simulated projection data were generated using the 4D NURBS-based cardiac-torso (NCAT) phantom with 16 gates/cardiac cycle. The activity distribution modelled uptake of 99mTc MIBI with normal perfusion and a regional wall motion defect. An analytical projector was used in the simulation and the filtered backprojection (FBP) algorithm was used in image reconstruction followed by spatial and temporal low-pass filtering with various cut-off frequencies. Then, we extracted 2D image slices from each time frame and reorganized them into a set of cine images. For the first model, we applied 2D spatial channels to the cine images and generated a set of feature vectors that were stacked for the images from different slices of the heart. The process was repeated for each of the 1,024 noise realizations, and CHO and receiver operating characteristics (ROC) analysis methodologies were applied to the ensemble of the feature vectors to compute areas under the ROC curves (AUCs). For the second model, a set of 4D space-time channels was developed and applied to the sets of cine images to produce space-time feature vectors to which the CHO methodology was applied. The AUC values of the second model showed better agreement (Spearman’s rank correlation (SRC) coefficient = 0.8) to human observer results than those from the first model (SRC coefficient = 0.4). The agreement with human observers indicates the proposed 4D mathematical observer model provides a good predictor of the

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

    International Nuclear Information System (INIS)

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

    2015-01-01

    This paper presents two 4D mathematical observer models for the detection of motion defects in 4D gated medical images. Their performance was compared with results from human observers in detecting a regional motion abnormality in simulated 4D gated myocardial perfusion (MP) SPECT images. The first 4D mathematical observer model extends the conventional channelized Hotelling observer (CHO) based on a set of 2D spatial channels and the second is a proposed model that uses a set of 4D space-time channels. Simulated projection data were generated using the 4D NURBS-based cardiac-torso (NCAT) phantom with 16 gates/cardiac cycle. The activity distribution modelled uptake of 99m Tc MIBI with normal perfusion and a regional wall motion defect. An analytical projector was used in the simulation and the filtered backprojection (FBP) algorithm was used in image reconstruction followed by spatial and temporal low-pass filtering with various cut-off frequencies. Then, we extracted 2D image slices from each time frame and reorganized them into a set of cine images. For the first model, we applied 2D spatial channels to the cine images and generated a set of feature vectors that were stacked for the images from different slices of the heart. The process was repeated for each of the 1,024 noise realizations, and CHO and receiver operating characteristics (ROC) analysis methodologies were applied to the ensemble of the feature vectors to compute areas under the ROC curves (AUCs). For the second model, a set of 4D space-time channels was developed and applied to the sets of cine images to produce space-time feature vectors to which the CHO methodology was applied. The AUC values of the second model showed better agreement (Spearman’s rank correlation (SRC) coefficient = 0.8) to human observer results than those from the first model (SRC coefficient = 0.4). The agreement with human observers indicates the proposed 4D mathematical observer model provides a good predictor of the

  2. Evaluation of a decision support system for interpretation of myocardial perfusion gated SPECT.

    Science.gov (United States)

    Lomsky, Milan; Gjertsson, Peter; Johansson, Lena; Richter, Jens; Ohlsson, Mattias; Tout, Deborah; van Aswegen, Andries; Underwood, S Richard; Edenbrandt, Lars

    2008-08-01

    We have recently presented a decision support system for interpreting myocardial perfusion scintigraphy (MPS). In this study, we wanted to evaluate the system in a separate hospital from where it was trained and to compare it with a quantification software package. A completely automated method based on neural networks was trained for the interpretation of MPS regarding myocardial ischaemia and infarction using 418 MPS from one hospital. Features from each examination describing rest and stress perfusion, regional and global function were used as inputs to different neural networks. After the training session, the system was evaluated using 532 MPS from another hospital. The test images were also processed with the quantification software package Emory Cardiac Toolbox (ECTb). The images were interpreted by experienced clinicians at both the training and the test hospital, regarding the presence or absence of myocardial ischaemia and/or infarction and these interpretations were used as gold standard. The neural network showed a sensitivity of 90% and a specificity of 85% for myocardial ischaemia. The specificity for the ECTb was 46% (p neural network sensitivity for myocardial infarction was 89% and the specificity 96%. The corresponding specificity for the ECTb was 54% (p neural networks presents interpretations more similar to experienced clinicians compared to a conventional automated quantification software package. This study shows the feasibility of disseminating the expertise of experienced clinicians to less experienced physicians by the use of neural networks.

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

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan); Nakajima, Kenichi [Kanazawa University Graduate School of Medical Science, Department of Biotracer Medicine, Kanazawa (Japan); Kusuoka, Hideo [Osaka National Hospital, Osaka (Japan); Yamashina, Akira [Tokyo Medical University Hospital, Second Department of Internal Medicine, Tokyo (Japan); Nishimura, Shigeyuki [Saitama Medical School Hospital, Division of Cardiology, Saitama (Japan)

    2008-02-15

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

  4. [Rest gated-SPECT myocardial perfusion post (99m)Tc-MIBI injection in a patient with acute chest pain and with no medical history of ischemic heart disease].

    Science.gov (United States)

    Negre-Busó, M; Muntaner-Muñoz, L; Rubió-Rodríguez, A; Marin-Buriticá, A; Ferran-Sureda, N; Bassaganyas-Vilarrasa, J

    2015-01-01

    Gated-SPECT myocardial perfusion imaging is a widely used technique indicated for assessment of patients with no clear diagnosis of ischemic heart disease. Early rest gated-SPECT myocardial perfusion study in patients with acute chest pain has high sensitivity and high negative predictive value for ruling out coronary disease. We report a case of a patient admitted for the study of her chest pain. She underwent a myocardial perfusion stress-rest whose interpretation could have been equivocal due to the clinical status of the patient during the injection of the radiotracer. Copyright © 2014 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  5. An attempt of thallium-201 myocardial perfusion imaging during transient coronary arterial occlusion by PTCA

    International Nuclear Information System (INIS)

    Nakagawa, Tatsuya; Sugihara, Hiroki; Katahira, Toshio

    1989-01-01

    To evaluate the myocardial perfusion during transient coronary occlusion, we attempted to obtain the myocardial scintigraphy during percutaneous transluminal coronary angioplasty (PTCA). Tl-201 was injected at the last inflation of angioplastic balloon and occlusion was kept on for 60 sec. Planar images or SPECT were obtained immediately after PTCA. With this protocol, myocardial perfusion defects were observed during PTCA and fully redistributed 3 hours after Tl injection. Extent of ischemic lesions were almost same as that observed during exercise in two cases without collateral vessels. In a case with well visualized collateral vessels, perfusion defect was smaller in PTCA images than that in exercise stressed images. We conclude that intravenous injection of Tl-201 during PTCA is useful to assess the alteration of myocardial perfusion due to transient coronary occlusion without increasing the risk of angioplastic procedure. (author)

  6. Usefulness of the novel risk estimation software, Heart Risk View, for the prediction of cardiac events in patients with normal myocardial perfusion SPECT.

    Science.gov (United States)

    Sakatani, Tomohiko; Shimoo, Satoshi; Takamatsu, Kazuaki; Kyodo, Atsushi; Tsuji, Yumika; Mera, Kayoko; Koide, Masahiro; Isodono, Koji; Tsubakimoto, Yoshinori; Matsuo, Akiko; Inoue, Keiji; Fujita, Hiroshi

    2016-12-01

    Myocardial perfusion single-photon emission-computed tomography (SPECT) can predict cardiac events in patients with coronary artery disease with high accuracy; however, pseudo-negative cases sometimes occur. Heart Risk View, which is based on the prospective cohort study (J-ACCESS), is a software for evaluating cardiac event probability. We examined whether Heart Risk View was useful to evaluate the cardiac risk in patients with normal myocardial perfusion SPECT (MPS). We studied 3461 consecutive patients who underwent MPS to detect myocardial ischemia and those who had normal MPS were enrolled in this study (n = 698). We calculated cardiac event probability by Heart Risk View and followed-up for 3.8 ± 2.4 years. The cardiac events were defined as cardiac death, non-fatal myocardial infarction, and heart failure requiring hospitalization. During the follow-up period, 21 patients (3.0 %) had cardiac events. The event probability calculated by Heart Risk View was higher in the event group (5.5 ± 2.6 vs. 2.9 ± 2.6 %, p risk estimation by Heart Risk View adds more prognostic information, especially in patients with normal MPS.

  7. Is chronic ST segment elevation a marker of myocardial non viability in patients with Q wave anteroseptal MI? Correlation with myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Padma, S.; Zachariah, M.; Haridas, K.K.

    2004-01-01

    Persistence of ST segment elevation for more than 2-4 weeks in patients with acute antero septal transmural myocardial infarction (ASMI) is considered to be a specific marker of left ventricular aneurysm. Objective: We attempted to assess the face value of this statement by correlating the findings of 99m Tc Sestamibi Myocardial perfusion SPECT (MPSPECT), one of the most specific modalities of myocardial viability assessment with resting 12 lead ECG. METHOD: 240 ASMI patients (192:48 Male: Female pts, age range 36-71 yrs Mean 51±8 yrs) referred for risk stratification to our department between Jan 02 -Jan 04 were retrospectively analysed. The baseline demographic details and LV systolic function parameters were more or less the same for all these patients. The mean LV EF at rest was 40±6 %. All these patients fulfilled the following inclusion criteri 1) Patients with Q Wave ASMt more than 1 month old, 2) ECG at rest showing sinus rhythm, QRS 1.5 mm. Patients with atrial arrhythmias and bundle branch block were excluded. All these patients underwent same day rest stress gated 99m Tc MIBI/ tetrofosmin MPSPECT on a dual head variable angle gamma camera. Patients performed either conventional treadmill stress or taken up for pharmacological stress. LAD territory myocardial segments (i.e. apex, anterior, septal) were evaluated for the presence of reversible ischaemia / viable myocardium. Images were visually interpreted and using a 16 segment myocardial model quantification was also performed. Presence of reversible perfusion defects, uptake of MIBI at rest more than 40 % and myocardial systolic wall thickening (count increase by at least 10% during systole) were considered as markers of viability. Results' Patients were categorized into two groups. ST elevation positive i.e. patients with rest ST elevation > 1.5 mm (137 pts 57%) and ST elevation negative (103 pts 37%) by the rest ECG criteria. In ST positive group, 47/137 pts (34%) showed viability (mean viable

  8. Reduced coronary flow reserve in patients with primary hyperparathyroidism: a study by G-SPECT myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Marini, Cecilia [CNR Institute of Bioimages and Molecular Physiology Milan, Genoa (Italy); Giusti, Massimo; Vera, Lara; Minuto, Francesco [University of Genoa, Department of Endocrinological and Metabolic Sciences, Genoa (Italy); Armonino, Riccardo; Ghigliotti, Giorgio; Bezante, Gian Paolo; Morbelli, Silvia; Pomposelli, Elena; Massollo, Michela; Gandolfo, Patrizia; Sambuceti, Gianmario [University of Genoa, Department of Internal Medicine, Genoa (Italy)

    2010-12-15

    The mechanisms underlying increased cardiovascular risk in primary hyperparathyroidism (pHPT) have not been fully defined. Recently, this issue has become the subject of renewed interest due to the increasing evidence that the endothelium and vascular wall are targets for parathyroid hormone (PTH). The aim of this study was to measure regional coronary flow reserve (CFR) to determine whether the vascular damage induced by pHPT extends to affect the coronary microvascular function. A total of 22 pHPT patients without a history of coronary artery disease and 7 age-matched control subjects were recruited. Dipyridamole myocardial blood flow (MBF) was assessed using {sup 99m}Tc-sestamibi by measuring first-transit counts in the pulmonary artery and myocardial count rate from G-SPECT images. Baseline MBF was estimated 2 h later according to the same procedure. Regional CFR was defined as the ratio between dipyridamole and baseline MBF using a 17-segment left ventricular model. Three pHPT patients showed reversible perfusion defects and were excluded from the analysis. In the remaining 19, CFR was significantly lower with respect to the control subjects (1.88 {+-} 0.64 vs. 3.36 {+-} 0.66, respectively; p < 0.01). Moreover, patients studied for more than 28 months from pHPT diagnosis showed lower CFR values than the others (1.42 {+-} 0.18 vs. 2.25 {+-} 0.64, respectively; p < 0.01). Consequently, the time from diagnosis to the nuclear study showed a reasonable correlation with the degree of CFR impairment (Spearman's rho -0.667, p < 0.02). pHPT is associated with a significant dysfunction of the coronary microcirculation. This disorder might contribute to the high cardiovascular risk of conditions characterized by chronic elevations in serum PTH levels. (orig.)

  9. Detection of myocardial viability could be improved by rest GIK (glucose-insulin-potassium solution)-Tc 99m sestamibi compared with TL-201 reinjection, in post myocardial infarction patients.

    Science.gov (United States)

    Orea, Arturo; Castillo, Lilia; Ochoa, Víctor; Rull, Juan Antonio; Gómez-Pérez, Francisco; Rebollar, Verónica; Sepulveda, Jesus; Dorantes, Joel; Asensio, Enrique; Oseguera, Jorge; González, Ofelia

    2004-01-01

    GIK solutions improve detection of myocardium viability after acute infarction because they could change the metabolic conditions, improving myocardial perfusion defects. Seventy four patients (52 men, 22 women, mean age 53.3.08 +/- 12.14 years) with previous myocardial infarction (evolution time, 4.2 +/- 3.1 months) underwent pharmacological stress (dipyridamole), rest redistribution and reinjection Tl-201 image as well rest/stress Tc-99m Sestamibi, after the intravenous administration of GIK (200 g glucose +/- 30 UI regular insuline +/- 40 mEq potassiumchloride/500 mL in continuous infusion during 3 hours), Group A (N = 22) or oral administration of 70 g of glucose+/- 40 mEq of potassium chloride taking in advantage the endogenous insulin secretion, to non-diabetic patients (group B = GB, N = 26) and group C (GC, diabetic patients N = 26). All of the 74 patients received 10 mg of sublingual Isorbide previous to 25 mCi of Tc99m Sestamibi administration in a different 2 days protocol. A total of 1,480 myocardial segments were assessed and numbered, and the severity of perfusion defects in the segments involved, were compared between Thallium 201 rest reinjection and GIK-MIBI as the main objective of the study. Involved territories number: 4.02 +/- 2.50 vs. 6.88 +/- 2.12, p = 0.005 for AD; 5.2 +/- 1.44 vs. 6.35 +/- 1.11, p = 0.05 for RC and 1.58 +/- 1.01 vs. 2.05 +/- 1.05, p = 0.05 Cx. For GIK-MIBI vs. Tl-201 reinjection respectively, and defect severity: 8.2 +/- 6.04 vs. 13.22 +/- 5.38, p = 0.01 for LAD; 11.72 +/- 5.08 vs. 15.13 +/- 4.42, p = 0.005 for RC and 2.66 +/- 2.09 vs. 4.69 +/- 3.58, p = 0.003 Cx . For GIK-MIBI vs. Tl-201 reinjection respectively, were found. Our data suggest that GIK-MIBI protocol is a safe and easy procedure which improves the detection of perfusion reversible defects compared with Tl-201 reinjection, obtaining better information regarding myocardial viability, with lower acquisition time and less cost.

  10. An open-source framework of neural networks for diagnosis of coronary artery disease from myocardial perfusion SPECT.

    Science.gov (United States)

    Guner, Levent A; Karabacak, Nese Ilgin; Akdemir, Ozgur U; Karagoz, Pinar Senkul; Kocaman, Sinan A; Cengel, Atiye; Unlu, Mustafa

    2010-06-01

    The purpose of this study is to develop and analyze an open-source artificial intelligence program built on artificial neural networks that can participate in and support the decision making of nuclear medicine physicians in detecting coronary artery disease from myocardial perfusion SPECT (MPS). Two hundred and forty-three patients, who had MPS and coronary angiography within three months, were selected to train neural networks. Six nuclear medicine residents, one experienced nuclear medicine physician, and neural networks evaluated images of 65 patients for presence of coronary artery stenosis. Area under the curve (AUC) of receiver operating characteristics analysis for networks and expert was .74 and .84, respectively. The AUC of the other physicians ranged from .67 to .80. There were no significant differences between expert, neural networks, and standard quantitative values, summed stress score and total stress defect extent. The open-source neural networks developed in this study may provide a framework for further testing, development, and integration of artificial intelligence into nuclear cardiology environment.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

  12. Myocardial CT Perfusion Imaging and SPECT for the Diagnosis of Coronary Artery Disease: A Head-to-Head Comparison from the CORE320 Multicenter Diagnostic Performance Study

    Science.gov (United States)

    Mehra, Vishal C.; Chen, Marcus Y.; Kitagawa, Kakuya; Arbab-Zadeh, Armin; Miller, Julie M.; Matheson, Matthew B.; Vavere, Andrea L.; Kofoed, Klaus F.; Rochitte, Carlos E.; Dewey, Marc; Yaw, Tan S.; Niinuma, Hiroyuki; Brenner, Winfried; Cox, Christopher; Clouse, Melvin E.; Lima, João A. C.; Di Carli, Marcelo

    2014-01-01

    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 or pharmacologic stress SPECT before and within 60 days of coronary angiography. Images from CT perfusion imaging, SPECT, and coronary angiography were interpreted at blinded, independent core laboratories. The primary diagnostic parameter was the area under the receiver operating characteristic curve (Az). Sensitivity and specificity were calculated with use of prespecified cutoffs. The reference standard was a stenosis of at least 50% at coronary angiography as determined with quantitative methods. Results CAD was diagnosed in 229 of the 381 patients (60%). The per-patient sensitivity and specificity for the diagnosis of CAD (stenosis ≥50%) were 88% (202 of 229 patients) and 55% (83 of 152 patients), respectively, for CT perfusion imaging and 62% (143 of 229 patients) and 67% (102 of 152 patients) for SPECT, with Az values of 0.78 (95% confidence interval: 0.74, 0.82) and 0.69 (95% confidence interval: 0.64, 0.74) (P = .001). The sensitivity of CT perfusion imaging for single- and multivessel CAD was higher than that of SPECT, with sensitivities for left main, three-vessel, two-vessel, and one-vessel disease of 92%, 92%, 89%, and 83%, respectively, for CT perfusion imaging and 75%, 79%, 68%, and 41%, respectively, for SPECT. Conclusion The overall performance of myocardial CT perfusion imaging in the diagnosis of anatomic CAD (stenosis ≥50%), as demonstrated with the

  13. Diagnostic Value of Myocardial Perfusion SPECT with Dipyridamole in a Female Population

    International Nuclear Information System (INIS)

    Perez-Iruela, Juan; Pastor, Purificacion; Lumbreras, Luis; Martin, Ana M.; Ruiz, Francisco J.; Posadas, A.; Puentes, Carmen

    2009-01-01

    Background: Exercise stress scintigraphy is a safe procedure widely used for the diagnosis of ischemic heart disease. Pharmacologic stress testing is an important alternative. The delayed presentation of ischemic heart disease in women, together with a lower diagnostic accuracy of exercise stress testing in this population, has generated interest in the potential benefits provided by myocardial perfusion imaging tests. Objective: To determine the diagnostic value of myocardial perfusion images with 99m Tc-tetrofosmin in a one day protocol after a pharmacologic stress with dipyridamole in a female population, and the relation with the coronary territories using coronary angiography as a reference technique. Material and Methods: In total, 149 clinical charts of women with suspected ischemic heart disease undergoing myocardial perfusion imaging tests and coronary angiography were retrospectively analyzed. Results: Sensitivity and specificity were 94% (93.47%-94.53%) and 82% (80.94%-83.06%), respectively. Values of sensitivity and specificity according to coronary territories were 71.62% (70.88%-72.36%) and 76% (75.27%-76.73%) for the left anterior descending (LAD) artery, 69.09% (68.11%-70.07%) and 76.84% (76.26%-77.42%) for the left circumflex (LCx) coronary artery, and 87.23% (86.11%-88.36%) and 74.51% (73.97%-75.05%) for the right coronary artery (RCA), respectively. Conclusion: Myocardial perfusion scintigraphy with 99m Tc-tetrofosmin and dipyridamole using a one day stress-rest protocol has high sensitivity and specificity for the diagnosis of ischemic heart disease in women. (authors) [es

  14. Prognostic risk stratification of myocardial ischaemia evaluated by gated myocardial perfusion SPECT in patients with chronic kidney disease

    Energy Technology Data Exchange (ETDEWEB)

    Hatta, Tsuguru [Ohmihachiman Community Medical Center, Division of Nephrology, Department of Medicine, Shiga (Japan); Nishimura, Shigeyuki [Saitama Medical School Hospital, Division of Cardiology, Saitama (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2009-11-15

    The aim of this study was to identify useful predictors of cardiac events in patients with chronic kidney disease (CKD). Among 4,031 patients identified from the Japanese Assessment of Cardiac Events and Survival Study (J-ACCESS) database with suspected or known ischaemic heart disease, we selected 820 with an estimated glomerular filtration rate (eGFR) of < 60 ml/min per 1.73 m{sup 2}. A total of 75 cardiac events developed among these 820 patients. The incidence of cardiac events was higher in the group with a lower eGFR. Multivariate Cox analysis indicated that age, diabetes mellitus, end-systolic volume, summed stress score (SSS) and eGFR were predictors of cardiac events. Event rates of patients with SSS {>=} 9 were significantly higher in groups with lower eGFR values (< 40 and 40-49 ml/min). The SSS value ({>=} 9) is a reliable predictor of cardiac events and myocardial single photon emission computed tomography has incremental value for predicting cardiac events and survival in CKD. (orig.)

  15. Prognostic risk stratification of myocardial ischaemia evaluated by gated myocardial perfusion SPECT in patients with chronic kidney disease

    International Nuclear Information System (INIS)

    Hatta, Tsuguru; Nishimura, Shigeyuki; Nishimura, Tsunehiko

    2009-01-01

    The aim of this study was to identify useful predictors of cardiac events in patients with chronic kidney disease (CKD). Among 4,031 patients identified from the Japanese Assessment of Cardiac Events and Survival Study (J-ACCESS) database with suspected or known ischaemic heart disease, we selected 820 with an estimated glomerular filtration rate (eGFR) of 2 . A total of 75 cardiac events developed among these 820 patients. The incidence of cardiac events was higher in the group with a lower eGFR. Multivariate Cox analysis indicated that age, diabetes mellitus, end-systolic volume, summed stress score (SSS) and eGFR were predictors of cardiac events. Event rates of patients with SSS ≥ 9 were significantly higher in groups with lower eGFR values (< 40 and 40-49 ml/min). The SSS value (≥ 9) is a reliable predictor of cardiac events and myocardial single photon emission computed tomography has incremental value for predicting cardiac events and survival in CKD. (orig.)

  16. Quantification of myocardial perfusion SPECT for the assessment of coronary artery disease: should we apply scatter correction?

    International Nuclear Information System (INIS)

    Hambye, A.S.; Vervaet, A.; Dobbeleir, A.

    2002-01-01

    Compared to other non invasive testings for CAD diagnosis, myocardial perfusion imaging (MPI) is considered as a very sensitive method which accuracy is however often dimmed by a certain lack of specificity, especially in patients with a small heart. With gated SPECT MPI, use of end-diastolic instead of summed images has been presented as an interesting approach for increasing specificity. Since scatter correction is reported to improve image contrast, it might potentially constitute another way to ameliorate MPI accuracy. We aimed at comparing the value of both approaches, either separate or combined, for CAD diagnosis. Methods. Hundred patients addressed for gated 99m-Tc sestamibi SPECT MPI were prospectively included (Group A). Thirty-five had an end-systolic volume <30ml by QGS-analysis (Group B). All had a coronary angiogram within 3 months of the MPI. Four polar maps (non-corrected and scatter-corrected summed, and non-corrected and scatter-corrected end-diastolic) were created to quantify the extent (EXT) and severity (TDS) of the perfusion defects if any. ROC-curve analysis was applied to define the optimal thresholds of EXT and TDS separating non-CAD from CAD-patients, using a 50%-stenosis on coronary angiogram as cutoff for disease positivity. Results. Significant CAD was present in 86 patients (25 in Group B). In Group A, assessment of EXT and TDS of perfusion defects on scatter-corrected summed images demonstrated the highest accuracy (76% for EXT; sens: 77%; spec: 71%, and 74% for TDS, sens: 73%, spec: 79%). Accuracy of EXT and TDS calculated from the other data sets was slightly but not significantly lower, especially because of a lower sensitivity. As a comparison, visual analysis was 90% accurate for the diagnosis of CAD (sens: 94%, spec: 64%). In group B, overall results were worse mainly due to a decreased sensitivity, with accuracies ranging between 51 and 63%. Again scatter-corrected summed data were the most accurate (EXT: 60%, TDS: 63%, visual

  17. Potential diagnostic value of regional myocardial adrenergic imaging using {sup 123}I-MIBG SPECT to identify patients with Lewy body diseases

    Energy Technology Data Exchange (ETDEWEB)

    Lebasnier, Adrien; Peyronnet, Damien; Bouvard, Gerard [University Hospital Center of Caen, Department of Nuclear Medicine, Caen (France); Lamotte, Guillaume; Defer, Gilles [University Hospital Center of Caen, Department of Neurology, Caen (France); Manrique, Alain [University Hospital Center of Caen, Department of Nuclear Medicine, Caen (France); Cyceron PET Centre, Caen (France); Normandie Universite, Caen (France); Agostini, Denis [University Hospital Center of Caen, Department of Nuclear Medicine, Caen (France); Normandie Universite, Caen (France)

    2015-01-28

    The aim of this study was to determine the potential diagnostic value of regional myocardial adrenergic {sup 123}I-metaiodobenzylguanidine (MIBG) single photon emission computed tomography (SPECT) imaging to identify patients with Lewy body diseases (LBD+). Sixty-four consecutive patients who underwent cardiac {sup 123}I-MIBG SPECT to differentiate LBD+, including Parkinson's disease (PD) and dementia with Lewy bodies (DLB), from patients without LBD (LBD-) were retrospectively reviewed. A neurologist expert in memory disorders determined the final clinical diagnosis by using international clinical diagnostic criteria. Planar [heart to mediastinum ratio (HMR)] and {sup 123}I-MIBG SPECT[innervation defect score (IDS)] using the 17-segment left ventricular model (five-point scale) were obtained 4 h after the injection of {sup 123}I-MIBG on a low-energy high-resolution (LEHR) collimator. Receiver-operating characteristic (ROC) analysis was performed to determine the optimal HMR and IDS cut-off values to discriminate LBD+ from LBD-. Of the 64 patients, 45 (70 %) were diagnosed LBD+ (DLB, n = 27; PD, n = 18) and 19 were diagnosed LBD- (5 other dementias, 14 other parkinsonisms). The HMR and IDS of LBD+ were significantly different from those of LBD- (1.30 ± 0.21 vs 1.65 ± 0.26, p < 0.001; 39 ± 28 vs 8 ± 16, p = 0.001). The optimal HMR and IDS cut-off values to discriminate LBD+ (n = 45) from LBD- (n = 19) were 1.47 and 6/68, providing a sensitivity and specificity of 82.2 and 84.2 % and 86.7 and 73.7 %, respectively. Regional myocardial adrenergic {sup 123}I-MIBG imaging SPECT has a potential diagnostic value to identify LBD+. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-01-15

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

  19. Detection and assessment of unstable angina using myocardial perfusion imaging: Comparison between technetium-99m sestamibi SPECT and 12-lead electrocardiogram

    International Nuclear Information System (INIS)

    Gregoire, J.; Theroux, P.

    1990-01-01

    Forty-five studies using technetium-99m (Tc-99m) sestamibi single photon emission computed tomography (SPECT) were performed on patients hospitalized for spontaneous chest pain suggestive of myocardial ischemia. The studies were done after an injection during an episode of chest pain and a repeated injection when the patients were free of pain. All patients were hospitalized with a presumed diagnosis of unstable angina, and none had evidence of a previous myocardial infarction. The presence of a perfusion defect observed with Tc-99m sestamibi injected during chest pain had a 96% sensitivity and a 79% specificity for the detection of significant coronary artery disease (stenosis greater than or equal to 50%) on subsequent angiography. When the criterion of a larger perfusion defect during pain compared to absence of pain was used, the sensitivity was 81% and the specificity was 84%. In contrast, transient electrocardiographic ischemic changes during pain had a sensitivity of 35% and a specificity of 68%; electrocardiographic changes during or outside episodes of chest pain had a sensitivity of 65% and a specificity of 63% for the diagnosis. Tc-99m sestamibi SPECT represents a reliable noninvasive diagnostic tool that could aid in the diagnosis of myocardial ischemia in patients with spontaneous chest pain and provide additional information to that provided by the electrocardiogram

  20. Therapeutic effects of coenzyme Q10 on dilated cardiomyopathy. Assessment by {sup 123}I-BMIPP myocardial single photon emission computed tomography (SPECT). A multicenter trial in Osaka University Medical School Group

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Tsunehiko; Hori, Masatsugu [Osaka Univ. (Japan). Faculty of Medicine

    1996-01-01

    To evaluate therapeutic effects of Coenzyme Q10 (CoQ10), 15 patients with dilated cardiomyopathy were investigated by {sup 123}I-BMIPP myocardial single photon emission computed tomography (SPECT). The BMIPP defect score was determined semiquantitatively by using representative short and long axial SPECT images. Mean BMIPP defect score with CoQ10 treatment was significantly low, 7.7{+-}6.1 compared to 12.7{+-}7.4 without CoQ10 treatment. On the other hand, in 8 patients of dilated cardiomyopathy, % fractional shortening using echocardiography was not different before and after CoQ10 treatment. In conclusion, {sup 123}I-BMIPP myocardial SPECT was proved to be sensitive to evaluate the therapeutic effects of CoQ10, which improve myocardial mitochondrial function, in the cases of dilated cardiomyopathy. (author).

  1. The development of iodine-123-labeled-methyl-branched fatty acids for myocardial SPECT imaging

    International Nuclear Information System (INIS)

    Knapp, F.F. Jr.; Kropp, J.

    1994-01-01

    Iodine-123-labeled fatty acids represent unique metabolic probes for correlation of energy substrate metabolism with regional myocardial viability. Interest in the use of these agents results from differences which are often observed in various types of heart disease between regional myocardial fatty acid uptake patterns and flow tracer distribution. Although the physiological basis is not completely understood, differences between regional fatty acid and flow tracer distribution may reflect alterations in important parameters of metabolism which can be useful for patient management or therapeutic strategy decision making. The iodine-123-labeled 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) fatty acid analogue was developed at the Oak Ridge National Laboratory and was recently introduced as ''Cardiodine trademark'' in 1993 by Nihon Medi-Physics for commercial distribution in Japan. Iodine-123-BMPP is also being used in clinical studies on an institutional approval basis at several institutions in Europe and the US. This paper describes the development of the concept of fatty acid ''metabolic trapping'' of methyl-branched fatty acids and their use for single photon emission computerized tomographic cardiac imaging

  2. Expected utility value of Tc-99m sestamibi rest gated myocardial perfusion SPECT imaging at the emergency room compared to troponins and non-guided hospitalization

    International Nuclear Information System (INIS)

    Merlano, S.; Rodriguez, E.; Murgueitio, R.

    2006-01-01

    The evaluation of acute chest pain at the emergency room remains a challenge. The expected utility value of the Tc- 99m sestamibi rest gated myocardial perfusion SPECT imaging (rest gated SPECT) in patients with typical or atypical chest pain and normal or non diagnostic electrocardiogram was evaluated. Three decision models were developed. In the first model; Decision Tree-A, non guided hospitalization and rest gated SPECT were analyzed. The second model; Decision Tree -B, analysed Troponins within 0-12 hrs and hospitalization, and the third model, i.e., Decision Tree -C, analyzed Troponins and rest gated SPECT. Patients and outcomes were categorised as follows: 1. High risk patients, those with positive scans who experienced adverse cardiac events (True positive); 2. Patients with positive results who did not have an acute event (False positive); 3. Negative results without an event (True negative); 4. High risk patients hospitalized who did not have acute event (False positive) and 5. Low risk patients with proven acute coronary event (False negative). We incorporated probabilities for measuring the favorable and unfavorable outcomes, using a scale of 0 to 1. Expected utilities were calculated using the software Tree Age through the roll-back method. The overall expected utility of rest gated SPECT to decide hospitalization was 0.79, while the non-guided hospitalization was 0 .45. The highest expected utility encountered was 0.91 for the decision of no hospitalization based on a negative rest perfusion scan result with a favorable outcome. When troponins and hospitalization were compared, the expected utility value observed for troponin was 0.59, greater than that of 0.47 for the symptom based hospitalization. Finally, when the two alternatives troponins and myocardial perfusion imaging were compared, the greatest expected utility value observed was with the nuclear cardiology procedure with an expected utility value of 0.81, as compared to that of 0.60 for the

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

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Byeong Cheol; Bae, Sun Keun; Lee, Sang Woo; Jeong, Sin Young; Lee, Jae Tae; Lee, Kyu Bo [Kyungpook National University Medical School, Daegu (Korea, Republic of)

    2002-12-01

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

  4. Prediction of wall motion improvement after coronary revascularization in patients with postmyocardial infarction. Diagnostic value of dobutamine stress echocardiography and myocardial contrast echocardiography

    International Nuclear Information System (INIS)

    Waku, Sachiko; Ohkubo, Tomoyuki; Takada, Kiyoshi; Ishihara, Tadashi; Ohsawa, Nakaaki; Adachi, Itaru; Narabayashi, Isamu

    1997-01-01

    The diagnostic value of dobutamine stress echocardiography, myocardial contrast echocardiography and dipyridamole stress thallium-201 single photon emission computed tomography (SPECT) for predicting recovery of wall motion abnormality after revascularization was evaluated in 13 patients with postmyocardial infarction. Seventeen segments showed severe wall motion abnormalities before revascularization. Nine segments which had relatively good Tl uptake on delayed SPECT images despite severely abnormal wall motion were opacified during myocardial contrast echocardiography, and showed improved wall motion after revascularization. In contrast, three segments which had poor Tl uptake and severely abnormal wall motion were not opacified during myocardial contrast echocardiography, and showed no improvement in wall motion during dobutamine stress echocardiography and after revascularization. The following three findings were assumed to be signs of myocardial viability: good Tl uptake on delayed SPECT images, improved wall motion by dobutamine stress echocardiography, and positive opacification of the myocardium by myocardiai contrast echocardiography. Myocardial contrast echocardiography had the highest sensitivity (100%) and negative predictive value (100%). Delayed SPECT images had the highest specificity (100%) and positive predictive value (100%). Dobutamine stress echocardiography had a sensitivity of 83.0%, specificity of 80.0%, positive predictive value of 90.9%, and negative predictive value of 66.7%, respectively. Myocardial contrast echocardiography showed the lowest specificity (60.0%). The techniques of dobutamine stress echocardiography and SPECT, though noninvasive, may underestimate wall motion improvement after revascularization. Further examination by myocardial contrast echocardiography is recommended to assess myocardial viability for determining the indications for coronary revascularization in spite of its invasiveness. (author)

  5. The consequences of a new software package for the quantification of gated-SPECT myocardial perfusion studies

    International Nuclear Information System (INIS)

    Veen, Berlinda J. van der; Dibbets-Schneider, Petra; Stokkel, Marcel P.M.; Scholte, Arthur J.

    2010-01-01

    Semiquantitative analysis of myocardial perfusion scintigraphy (MPS) has reduced inter- and intraobserver variability, and enables researchers to compare parameters in the same patient over time, or between groups of patients. There are several software packages available that are designed to process MPS data and quantify parameters. In this study the performances of two systems, quantitative gated SPECT (QGS) and 4D-MSPECT, in the processing of clinical patient data and phantom data were compared. The clinical MPS data of 148 consecutive patients were analysed using QGS and 4D-MSPECT to determine the end-diastolic volume, end-systolic volume and left ventricular ejection fraction. Patients were divided into groups based on gender, body mass index, heart size, stressor type and defect type. The AGATE dynamic heart phantom was used to provide reference values for the left ventricular ejection fraction. Although the correlations were excellent (correlation coefficients 0.886 to 0.980) for all parameters, significant differences (p < 0.001) were found between the systems. Bland-Altman plots indicated that 4D-MSPECT provided overall higher values of all parameters than QGS. These differences between the systems were not significant in patients with a small heart (end-diastolic volume <70 ml). Other clinical factors had no direct influence on the relationship. Additionally, the phantom data indicated good linear responses of both systems. The discrepancies between these software packages were clinically relevant, and influenced by heart size. The possibility of such discrepancies should be taken into account when a new quantitative software system is introduced, or when multiple software systems are used in the same institution. (orig.)

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  7. Regularized image reconstruction algorithms for dual-isotope myocardial perfusion SPECT (MPS) imaging using a cross-tracer prior.

    Science.gov (United States)

    He, Xin; Cheng, Lishui; Fessler, Jeffrey A; Frey, Eric C

    2011-06-01

    In simultaneous dual-isotope myocardial perfusion SPECT (MPS) imaging, data are simultaneously acquired to determine the distributions of two radioactive isotopes. The goal of this work was to develop penalized maximum likelihood (PML) algorithms for a novel cross-tracer prior that exploits the fact that the two images reconstructed from simultaneous dual-isotope MPS projection data are perfectly registered in space. We first formulated the simultaneous dual-isotope MPS reconstruction problem as a joint estimation problem. A cross-tracer prior that couples voxel values on both images was then proposed. We developed an iterative algorithm to reconstruct the MPS images that converges to the maximum a posteriori solution for this prior based on separable surrogate functions. To accelerate the convergence, we developed a fast algorithm for the cross-tracer prior based on the complete data OS-EM (COSEM) framework. The proposed algorithm was compared qualitatively and quantitatively to a single-tracer version of the prior that did not include the cross-tracer term. Quantitative evaluations included comparisons of mean and standard deviation images as well as assessment of image fidelity using the mean square error. We also evaluated the cross tracer prior using a three-class observer study with respect to the three-class MPS diagnostic task, i.e., classifying patients as having either no defect, reversible defect, or fixed defects. For this study, a comparison with conventional ordered subsets-expectation maximization (OS-EM) reconstruction with postfiltering was performed. The comparisons to the single-tracer prior demonstrated similar resolution for areas of the image with large intensity changes and reduced noise in uniform regions. The cross-tracer prior was also superior to the single-tracer version in terms of restoring image fidelity. Results of the three-class observer study showed that the proposed cross-tracer prior and the convergent algorithms improved the

  8. Quantitative myocardial-perfusion SPECT: comparison of three state-of-the-art software packages.

    Science.gov (United States)

    Wolak, Arik; Slomka, Piotr J; Fish, Mathews B; Lorenzo, Santiago; Acampa, Wanda; Berman, Daniel S; Germano, Guido

    2008-01-01

    We aimed to compare the automation and diagnostic performance in the detection of coronary artery disease (CAD) of the 4DMSPECT (4DM), Emory Cardiac Toolbox (EMO), and QPS systems for automated quantification of myocardial perfusion. We studied 328 patients referred for rest/stress Tc-99m sestamibi imaging, 140 low-likelihood patients and 188 with angiography. Contours were corrected when necessary. All other processing was fully automated. A 17-segment analysis was performed, and a summed stress score (SSS) > or =4 was considered abnormal. The average SSSs (+/-SD) for 4DM, EMO, and QPS were 10.5 +/- 9.4, 11.1 +/- 8.3, and 10.1 +/- 8.9, respectively (P = .02 for QPS versus EMO). The receiver operator characteristics areas-under-the-curve for the detection of CAD (+/-SEM) were 0.84 +/- 0.03, 0.76 +/- 0.04, and 0.88 +/- 0.03 for 4DM, EMO, and QPS, respectively (P = .001 for QPS versus EMO, and P = .03 for 4DM versus EMO). Normalcy rate was higher for QPS and 4DM versus EMO, at 91% and 94% versus 77%, respectively (P = .02). Sensitivity was higher for QPS (87%) versus 4DM (80%) (P = .045). Specificity was higher for QPS (71%) versus EMO (49%) (P = .01). The accuracy rate was higher for QPS versus 4DM and EMO, at 83% versus 77% and 76%, respectively (P = .05). There are differences in myocardial-perfusion quantification, diagnostic performance, and degree of automation of software packages.

  9. Prediction of revascularization after myocardial perfusion SPECT by machine learning in a large population.

    Science.gov (United States)

    Arsanjani, Reza; Dey, Damini; Khachatryan, Tigran; Shalev, Aryeh; Hayes, Sean W; Fish, Mathews; Nakanishi, Rine; Germano, Guido; Berman, Daniel S; Slomka, Piotr

    2015-10-01

    We aimed to investigate if early revascularization in patients with suspected coronary artery disease can be effectively predicted by integrating clinical data and quantitative image features derived from perfusion SPECT (MPS) by machine learning (ML) approach. 713 rest (201)Thallium/stress (99m)Technetium MPS studies with correlating invasive angiography with 372 revascularization events (275 PCI/97 CABG) within 90 days after MPS (91% within 30 days) were considered. Transient ischemic dilation, stress combined supine/prone total perfusion deficit (TPD), supine rest and stress TPD, exercise ejection fraction, and end-systolic volume, along with clinical parameters including patient gender, history of hypertension and diabetes mellitus, ST-depression on baseline ECG, ECG and clinical response during stress, and post-ECG probability by boosted ensemble ML algorithm (LogitBoost) to predict revascularization events. These features were selected using an automated feature selection algorithm from all available clinical and quantitative data (33 parameters). Tenfold cross-validation was utilized to train and test the prediction model. The prediction of revascularization by ML algorithm was compared to standalone measures of perfusion and visual analysis by two experienced readers utilizing all imaging, quantitative, and clinical data. The sensitivity of machine learning (ML) (73.6% ± 4.3%) for prediction of revascularization was similar to one reader (73.9% ± 4.6%) and standalone measures of perfusion (75.5% ± 4.5%). The specificity of ML (74.7% ± 4.2%) was also better than both expert readers (67.2% ± 4.9% and 66.0% ± 5.0%, P < .05), but was similar to ischemic TPD (68.3% ± 4.9%, P < .05). The receiver operator characteristics areas under curve for ML (0.81 ± 0.02) was similar to reader 1 (0.81 ± 0.02) but superior to reader 2 (0.72 ± 0.02, P < .01) and standalone measure of perfusion (0.77 ± 0.02, P < .01). ML approach is comparable or better than

  10. Incremental prognostic value of myocardial SPET with dual-isotope rest (201)Tl/stress (99m)Tc-tetrofosmin

    NARCIS (Netherlands)

    Groutars, Reginald G. E. J.; Verzijlbergen, J. Fred; Zwinderman, Aeilco H.; Tiel-van Buul, Monique M. C.; Ascoop, Carl A. P. L.; van Hemel, Norbert M.; van der Wall, Ernst E.

    2002-01-01

    The incremental prognostic value of dual-isotope myocardial perfusion scintigraphy using technetium-99m tetrofosmin for the stress images was evaluated in 597 consecutive patients with known or suspected coronary artery disease. We used semi-quantitative visual analysis with a five-point scoring

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  12. Importance of correct patient positioning in myocardial perfusion SPECT when using a CZT camera.

    Science.gov (United States)

    Hindorf, Cecilia; Oddstig, Jenny; Hedeer, Fredrik; Hansson, Magnus J; Jögi, Jonas; Engblom, Henrik

    2014-08-01

    Myocardial perfusion single photon emission computed tomography (MPS) is one of the most widely used diagnostic methods in patients with suspected ischemic heart disease (IHD). Recently, a novel technique based on cadmium-zinc-telluride (CZT) detectors, pinhole collimators, and a stationary gantry was introduced for MPS. The aim of this work was to investigate how patient positioning affects the reconstructed MPS images using this novel technique. Eighteen patients referred for a clinical MPS due to suspected IHD were included in the study. All patients underwent MPS imaging on a GE Discovery NM 530c CZT camera. After image acquisition with the heart positioned in the center of the quality field of view (QFOV), the patients were re-imaged in different positions 5-20 mm off-center. The heart was still positioned within the limits of the QFOV during the off-center scans. The summed stress score and/or the summed rest score (SSS and/or SRS) for the acquisition performed in the center was compared to the same parameter for the acquisitions performed off-center. There was a statistically significant increase in SSS and/or SRS when imaging was performed with the heart 5-20 mm outside the center of the QFOV compared to optimal positioning (7.7 ± 1.3 vs 6.6 ± 1.3, P = .006). The SSS and/or SRS increased with ≥2 U in 35% (14/40) of the off-center examinations. It is important to carefully position the patient's heart within the center of the QFOV when performing MPS with the Discovery NM 530c CZT camera to avoid positioning-related image artifacts that could affect the diagnostic accuracy.

  13. Deep Learning for Prediction of Obstructive Disease From Fast Myocardial Perfusion SPECT: A Multicenter Study.

    Science.gov (United States)

    Betancur, Julian; Commandeur, Frederic; Motlagh, Mahsaw; Sharir, Tali; Einstein, Andrew J; Bokhari, Sabahat; Fish, Mathews B; Ruddy, Terrence D; Kaufmann, Philipp; Sinusas, Albert J; Miller, Edward J; Bateman, Timothy M; Dorbala, Sharmila; Di Carli, Marcelo; Germano, Guido; Otaki, Yuka; Tamarappoo, Balaji K; Dey, Damini; Berman, Daniel S; Slomka, Piotr J

    2018-03-12

    The study evaluated the automatic prediction of obstructive disease from myocardial perfusion imaging (MPI) by deep learning as compared with total perfusion deficit (TPD). Deep convolutional neural networks trained with a large multicenter population may provide improved prediction of per-patient and per-vessel coronary artery disease from single-photon emission computed tomography MPI. A total of 1,638 patients (67% men) without known coronary artery disease, undergoing stress 99m Tc-sestamibi or tetrofosmin MPI with new generation solid-state scanners in 9 different sites, with invasive coronary angiography performed within 6 months of MPI, were studied. Obstructive disease was defined as ≥70% narrowing of coronary arteries (≥50% for left main artery). Left ventricular myocardium was segmented using clinical nuclear cardiology software and verified by an expert reader. Stress TPD was computed using sex- and camera-specific normal limits. Deep learning was trained using raw and quantitative polar maps and evaluated for prediction of obstructive stenosis in a stratified 10-fold cross-validation procedure. A total of 1,018 (62%) patients and 1,797 of 4,914 (37%) arteries had obstructive disease. Area under the receiver-operating characteristic curve for disease prediction by deep learning was higher than for TPD (per patient: 0.80 vs. 0.78; per vessel: 0.76 vs. 0.73: p < 0.01). With deep learning threshold set to the same specificity as TPD, per-patient sensitivity improved from 79.8% (TPD) to 82.3% (deep learning) (p < 0.05), and per-vessel sensitivity improved from 64.4% (TPD) to 69.8% (deep learning) (p < 0.01). Deep learning has the potential to improve automatic interpretation of MPI as compared with current clinical methods. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Zhao, Chunlei; Shuke, Noriyuki; Okizaki, Atsutaka

    2003-01-01

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

  15. Retrospective analysis of quantitative parameters obtained on myocardial perfusion SPECT imaging (ECTB software) in heart failure patients and their comparison with 2D-echocardiography results

    International Nuclear Information System (INIS)

    Pruthi, A.; Asopa, R.; Rajan, M.G.R.; Basu, S.

    2010-01-01

    The objectives of the study are to study the quantitative parameters obtained on Gated MPI SPECT on ECTB software in patients of fixed defects on myocardial perfusion imaging and their comparison between individuals showing evidence of hibernating myocardium and patients without any evidence of hibernating myocardium and to do the comparative analysis of quantitative parameters such as LVEF, EDV, ESV and SV obtained in the aforementioned patients on Gated MPI SPECT (ECTB) and 2D ECHOCARDIOGRAPHY. It is concluded that the present findings are consistent with the nature of hibernating myocardium i.e. non-contractile and dysfunctional myocardium. The noticeable difference in the EDV and ESV in category 'SRS 0-10' is indicative of evidence of early diastolic dysfunction in this group of patients. The trends in the LVEF, EDV and ESV are suggestive of deteriorating myocardial function with increasing extent of ischemia. The increase in left ventricular EDV and ESV with increasing ischemia is suggestive of increasing incidence of gross morphological LV cavity dilatation or 'Dilated ischemic cardiomyopathy (DCMP)' in these patients. The quantitative parameters obtained on ECTB software on MPI study shows good correlation with 2D Echocardiography results

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  17. Radiopharmaceuticals for SPECT cancer detection

    Energy Technology Data Exchange (ETDEWEB)

    Chernov, V. I., E-mail: chernov@oncology.tomsk.ru; Medvedeva, A. A., E-mail: tickayaAA@oncology.tomsk.ru; Zelchan, R. V., E-mail: r.zelchan@yandex.ru; Sinilkin, I. G., E-mail: sinilkinig@oncology.tomsk.ru [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation); Stasyuk, E. S.; Larionova, L. A. [Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation); Slonimskaya, E. M.; Choynzonov, E. L. [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation)

    2016-08-02

    The purpose of the study was to assess the efficacy of single photon emission computed tomography (SPECT) with {sup 199}Tl and {sup 99}mTc-MIBI in the detection of breast, laryngeal and hypopharyngeal cancers. A total of 220 patients were included into the study: 120 patients with breast lesions (100 patients with breast cancer and 20 patients with benign breast tumors) and 100 patients with laryngeal/hypopharyngeal diseases (80 patients with laryngeal/hypopharyngeal cancer and 20 patients with benign laryngeal/hypopharyngeal lesions). No abnormal {sup 199}Tl uptake was seen in all patients with benign breast and laryngeal lesions, indicating a 100% specificity of {sup 199}Tl SPECT. In the breast cancer patients, the increased {sup 199}Tl uptake in the breast was visualized in 94.8% patients, {sup 99m}Tc-MIBI—in 93.4% patients. The increased {sup 199}Tl uptake in axillary lymph nodes was detected in 60% patients, and {sup 99m}Tc-MIBI—in 93.1% patients. In patients with laryngeal/hypopharyngeal cancer, the sensitivity of SPECT with {sup 199}Tl and {sup 99m}Tc-MIBI was 95%. The {sup 199}Tl SPECT sensitivity in identification of regional lymph node metastases in the patients with laryngeal/hypopharyngeal cancer was 75% and the {sup 99m}Tc-MIBI SPECT sensitivity was 17%. The data obtained showed that SPECT with {sup 199}Tl and {sup 99m}Tc-MIBI can be used as one of the additional imaging methods in detection of tumors.

  18. Evaluation of thallium-201 myocardial emission computed tomography based on a comparison with postmortem findings

    International Nuclear Information System (INIS)

    Nagashima, Jun-ichi; Yamada, Hideo; Ohkawa, Shin-ichiro; Yonamine, Shigemichi; Nishino, Hideo; Yamagata, Atsushi; Suzuki, Yasuko; Tanno, Munehiko; Chiba, Kazuo

    1986-01-01

    The correlative study of myocardial perfusion assessed by 201 Tl myocardial ECT with the pathological finding of the heart was performed in 10 autopsied cases with mean age of 77 years old (range: 60 - 90 y). In 6 cases with myocardial infarction (MI) 7 perfusion defects were observed, that was, 3 in anteroseptal wall, 1 in anterolateral wall and 3 in posterior wall on the images of SPECT. Seven MIs were also found in postmortem examination. Six MIs were observed at autopsy corresponding to perfusion defect on SPECT images. In one myocardial perfusion defect at inferoposterior portion on SPECT, a non-transmural MI was found at anteroseptum. In one case with valvular disease a false positive result was obtained at posterior wall where neither myocardial necrosis nor fibrosis was observed at autopsy. This case had aortic stenosis due to bicuspid aortic valve by autopsy. The ventricle was devided into 16 segments in each of 4 short axial images to evaluate extent of MI. SPECT for extent of MI showed sensitivity of 81.9 %, specificity of 96.0 % and diagnostic accuracy of 92.5 %. False negative segment was apt to be observed at the surrounding of non-transmural MI or basal half of left ventricle (LV) with transmural MI, while false positive segment was at posterior portion of basal half of LV. It was concluded that myocardial ECT was useful for evaluation of the site and extent of MI. (author)

  19. Impact of injection dose, post-reconstruction filtering, and collimator choice on image quality of myocardial perfusion SPECT using cadmium-zinc telluride detectors in the rat.

    Science.gov (United States)

    Mizutani, Asuka; Matsunari, Ichiro; Kobayashi, Masato; Nishi, Kodai; Fujita, Wataru; Miyazaki, Yoshiharu; Nekolla, Stephan G; Kawai, Keiichi

    2015-12-01

    The aims of this study were (1) to evaluate the impact of injection dose, post-reconstruction filtering, and collimator choice on image quality of myocardial perfusion single-photon emission computed tomography (SPECT) using cadmium-zinc telluride (CZT) detectors and (2) to determine how these factors affect measured infarct size in the in vivo rat. Twenty-four healthy and eight myocardial infarct (MI) rats underwent myocardial perfusion SPECT imaging after injection of various doses (25 to 200 MBq) of (99m)Tc-tetrofosmin using a standard (STD) five-pinhole collimator and high-sensitivity (HS) five-pinhole collimator. Image quality score, contrast-to-noise ratio, sharpness index, coefficient of variation (CV), and measured defect size were assessed as measures of image quality. The image quality score increased and CV decreased as a function of injection dose. The contrast-to-noise ratio increased and sharpness index decreased as a function of Gaussian kernel size. When STD and HS were compared, HS tended to show higher image quality score and lower CV than STD. The use of post-reconstruction filter significantly improved image quality score and lessened CV. The reproducibility of defect size measurements, as assessed by intraclass correlation coefficients (ICC), between the collimators was poor-to-moderate (ICC = -0.31~0.57) with low (25 MBq) injection dose and with no or light (1.5-mm kernel size) filtering, whereas it was good-to-excellent (ICC = 0.75~0.97) with high (200 MBq) dose or low dose with heavy (2.5-mm kernel size) filtering. The filtering-related reproducibility was poor (ICC = -0.18~0.17) for STD with low injection dose, whereas it was good-to-excellent (ICC = 0.79~0.89) for HS. Furthermore, there was a filtering-related underestimation of defect size particularly with the use of heavy smoothing. Appropriate imaging setting is important to obtain high quality images and thereby reliable measurements using a preclinical myocardial

  20. Improved Accuracy of Myocardial Perfusion SPECT for the Detection of Coronary Artery Disease by Utilizing a Support Vector Machines Algorithm

    Science.gov (United States)

    Arsanjani, Reza; Xu, Yuan; Dey, Damini; Fish, Matthews; Dorbala, Sharmila; Hayes, Sean; Berman, Daniel; Germano, Guido; Slomka, Piotr

    2012-01-01

    We aimed to improve the diagnostic accuracy of automatic myocardial perfusion SPECT (MPS) interpretation analysis for prediction of coronary artery disease (CAD) by integrating several quantitative perfusion and functional variables for non-corrected (NC) data by support vector machines (SVM), a computer method for machine learning. Methods 957 rest/stress 99mtechnetium gated MPS NC studies from 623 consecutive patients with correlating invasive coronary angiography and 334 with low likelihood of CAD (LLK < 5% ) were assessed. Patients with stenosis ≥ 50% in left main or ≥ 70% in all other vessels were considered abnormal. Total perfusion deficit (TPD) was computed automatically. In addition, ischemic changes (ISCH) and ejection fraction changes (EFC) between stress and rest were derived by quantitative software. The SVM was trained using a group of 125 pts (25 LLK, 25 0-, 25 1-, 25 2- and 25 3-vessel CAD) using above quantitative variables and second order polynomial fitting. The remaining patients (N = 832) were categorized based on probability estimates, with CAD defined as (probability estimate ≥ 0.50). The diagnostic accuracy of SVM was also compared to visual segmental scoring by two experienced readers. Results Sensitivity of SVM (84%) was significantly better than ISCH (75%, p < 0.05) and EFC (31%, p < 0.05). Specificity of SVM (88%) was significantly better than that of TPD (78%, p < 0.05) and EFC (77%, p < 0.05). Diagnostic accuracy of SVM (86%) was significantly better than TPD (81%), ISCH (81%), or EFC (46%) (p < 0.05 for all). The Receiver-operator-characteristic area-under-the-curve (ROC-AUC) for SVM (0.92) was significantly better than TPD (0.90), ISCH (0.87), and EFC (0.60) (p < 0.001 for all). Diagnostic accuracy of SVM was comparable to the overall accuracy of both visual readers (85% vs. 84%, p < 0.05). ROC-AUC for SVM (0.92) was significantly better than that of both visual readers (0.87 and 0.88, p < 0.03). Conclusion Computational

  1. High Concordance Between Mental Stress-Induced and Adenosine-Induced Myocardial Ischemia Assessed Using SPECT in Heart Failure Patients: Hemodynamic and Biomarker Correlates.

    Science.gov (United States)

    Wawrzyniak, Andrew J; Dilsizian, Vasken; Krantz, David S; Harris, Kristie M; Smith, Mark F; Shankovich, Anthony; Whittaker, Kerry S; Rodriguez, Gabriel A; Gottdiener, John; Li, Shuying; Kop, Willem; Gottlieb, Stephen S

    2015-10-01

    Mental stress can trigger myocardial ischemia, but the prevalence of mental stress-induced ischemia in congestive heart failure (CHF) patients is unknown. We characterized mental stress-induced and adenosine-induced changes in myocardial perfusion and neurohormonal activation in CHF patients with reduced left-ventricular function using SPECT to precisely quantify segment-level myocardial perfusion. Thirty-four coronary artery disease patients (mean age±SD, 62±10 y) with CHF longer than 3 mo and ejection fraction less than 40% underwent both adenosine and mental stress myocardial perfusion SPECT on consecutive days. Mental stress consisted of anger recall (anger-provoking speech) followed by subtraction of serial sevens. The presence and extent of myocardial ischemia was quantified using the conventional 17-segment model. Sixty-eight percent of patients had 1 ischemic segment or more during mental stress and 81% during adenosine. On segment-by-segment analysis, perfusion with mental stress and adenosine were highly correlated. No significant differences were found between any 2 time points for B-type natriuretic peptide, tumor necrosis factor-α, IL-1b, troponin, vascular endothelin growth factor, IL-17a, matrix metallopeptidase-9, or C-reactive protein. However, endothelin-1 and IL-6 increased, and IL-10 decreased, between the stressor and 30 min after stress. Left-ventricular end diastolic dimension was 179±65 mL at rest and increased to 217±71 after mental stress and 229±86 after adenosine (Pmental stress (Pmental stress. Ejection fraction was 30±12 at baseline, 29±11 with mental stress, and 28±10 with adenosine (P=not significant). There was high concordance between ischemic perfusion defects induced by adenosine and mental stress, suggesting that mental stress is equivalent to pharmacologic stress in eliciting clinically significant myocardial perfusion defects in CHF patients. Cardiac dilatation suggests clinically important changes with both

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

    International Nuclear Information System (INIS)

    Momose, Mitsuru; Nakajima, Kenichi; Nishimura, Tsunehiko

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Guang-Uei Hung

    2005-05-01

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

  4. Brain SPECT. SPECT in der Gehirndiagnostik

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-04-01

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

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

    International Nuclear Information System (INIS)

    Koitabashi, Norimichi; Toyama, Takuji; Hoshizaki, Hiroshi

    2000-01-01

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

  8. The usefulness of the nuclear cardiology in the cellular implant in patients with severe myocardial damage; La utilidad de la cardiologia nuclear en el implante celular en pacientes con dano miocardico severo

    Energy Technology Data Exchange (ETDEWEB)

    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 [Centro Medico Nacional Siglo XXI IMSS Hospital de Cardiologia-Servicio de Medicina Nuclear Mexico DF (Mexico)

    2005-07-01

    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)

  9. Quantification of the extent of myocardial infarction by thallium-201 single photon emission computed tomography; Comparisons with postmortem findings

    Energy Technology Data Exchange (ETDEWEB)

    Ide, Hiroshi; Yamada, Hideo; Ohkawa, Shin-ichiro (Tokyo Metropolitan Geriatric Medical Center (Japan)); Sugiura, Masaya; Harumi, Ken-ichi

    1991-01-01

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

  10. Optimization of energy window and evaluation of scatter compensation methods in myocardial perfusion SPECT using the ideal observer with and without model mismatch and an anthropomorphic model observer

    Science.gov (United States)

    Ghaly, Michael; Links, Jonathan M.; Frey, Eric

    2015-01-01

    Abstract. We used the ideal observer (IO) and IO with model mismatch (IO-MM) applied in the projection domain and an anthropomorphic channelized Hotelling observer (CHO) applied to reconstructed images to optimize the acquisition energy window width and to evaluate various scatter compensation methods in the context of a myocardial perfusion single-photon emission computed tomography (SPECT) defect detection task. The IO has perfect knowledge of the image formation process and thus reflects the performance with perfect compensation for image-degrading factors. Thus, using the IO to optimize imaging systems could lead to suboptimal parameters compared with those optimized for humans interpreting SPECT images reconstructed with imperfect or no compensation. The IO-MM allows incorporating imperfect system models into the IO optimization process. We found that with near-perfect scatter compensation, the optimal energy window for the IO and CHO was similar; in its absence, the IO-MM gave a better prediction of the optimal energy window for the CHO using different scatter compensation methods. These data suggest that the IO-MM may be useful for projection-domain optimization when MM is significant and that the IO is useful when followed by reconstruction with good models of the image formation process. PMID:26029730

  11. Impairment of myocardial perfusion in children with sickle cell disease

    International Nuclear Information System (INIS)

    Maunoury, C.; Acar, P.; Montalembert, M. de

    2003-01-01

    While brain, bone and spleen strokes are well documented in children with sickle cell disease (SCD), impairment of myocardial perfusion is an unknown complication. Non invasive techniques such as exercise testing and echocardiography have a low sensitivity to detect myocardial ischemia in patients with SCD. We have prospectively assessed myocardial perfusion with Tl-201 SPECT in 23 patients with SCD (10 female, 13 male, mean age 12 ± 5 years). Myocardial SPECT was performed after stress and 3 hours later after reinjection on a single head gamma camera equipped with a LEAP collimator (64 x 64 matrix size format, 30 projections over 180 deg C, 30 seconds per step). Left ventricular ejection fraction (LVEF) was assessed by equilibrium radionuclide angiography at rest on the same day. Myocardial perfusion was impaired in 14/23 patients: 9 reversible defects and 5 fixed defects. The left ventricular cavity was dilated in 14/23 patients. The mean LVEF was 63 ± 9%. There was no relationship between myocardial perfusion and left ventricular dilation or function. The frequent impairment of myocardial perfusion in children with SCD could lead to suggest a treatment with hydroxyurea, an improvement of perfusion can be noted with hydroxyurea. (author)

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  13. Clinical usefulness of {sup 123}I-labeled 15-iodophenyl 3-methyl pentadecanoic acid (BMIPP) myocardial SPECT in coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kazuki [Kyoto Prefectural Univ. of Medicine (Japan)

    1998-01-01

    {sup 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.)

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

    International Nuclear Information System (INIS)

    Cho, Keiichi; Kumita, Shinichiro; Mizumura, Sunao

    1997-01-01

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

  15. Simultaneous Tc-99m/Tl-201 imaging using energy-based estimation of the spatial distributions of contaminant photons

    International Nuclear Information System (INIS)

    Moore, S.C.; Tow, D.E.; English, R.J.; Syravanh, C.; Zimmerman, R.E.; Chan, K.H.; Kijewski, M.F.; Brigham and Women's Hospital, Boston, MA

    1995-01-01

    The advantages of simultaneous acquisition of TC-99m and Tl-201 myocardial perfusion SPECT images can be fully realized only if the effects of the Tc-99m agent can be accurately removed from the Tl-201 image. The authors and others have previously reported simultaneous dual-isotope techniques for cardiac studies which make use of a third energy-window to estimate the Tc-99m scatter to be subtracted from the Tl-201 window. The authors have recently demonstrated, however, using a Monte Carlo program which simulates all details of the photon transport, that lead x-rays produced in the collimator may also contribute significantly to contamination in the Tl-201 window. The spatial distribution of the Tc-99m scattered photons differs from that of the lead x-rays. Therefore, the authors modified their correction technique so that, at each projection angle, the contaminant image to be subtracted from the image in the Tl-201 window was estimated as a linear combination of a scatter-window (90--110 keV) image, blurred by a 2D Gaussian filter, and the Tc-99m photopeak image, blurred by a different Gaussian filter. For simulated data which included 'liver' activity and non-uniform 'lung' attenuation, the improved dual-window subtraction technique provided a more accurate estimate of the true Tl-201 image, with less image noise, than did the single-window correction

  16. Comparison of cone beam SPECT with conventional SPECT by means of cardiac-thorax phantom

    International Nuclear Information System (INIS)

    McGrath, M.A.; Manglos, S.H.

    1989-01-01

    Because of poor energy characteristics of Tl-201 used for myocardial perfusion imaging, the high sensitivity of cone-beam collimation is highly desirable. Using a cardiac-thorax phantom, the authors have compared single photon emission computed tomographic (SPECT) images obtained with a cone-beam collimator to those from a parallel hole collimator commonly used for thallium studies. A water-filled circular phantom with a cardiac insert was imaged. The myocardial shell was filled with Tl-201 (220 μCi). Two solid inserts within the myocardium simulated perfusion defects. The phantom ignores truncation effects in this preliminary experiment. For the authors' collimator, the resolution was designed to be similar to the authors' all-purpose, parallel-hole collimator at 10 cm. The focal length was 50 cm. The experimental protocol was chosen to be similar to their clinical protocol. A filtered back projection algorithm was used for cone-beam data. The same algorithm was used for the parallel-hole data, but with focal length set to infinity

  17. Prognostic value of myocardial perfusion single photon emission computed tomography for major adverse cardiac cerebrovascular and renal events in patients with chronic kidney disease: results from first year of follow-up of the Gunma-CKD SPECT multicenter study

    International Nuclear Information System (INIS)

    Kasama, Shu; Toyama, Takuji; Sato, Makito; Sano, Hirokazu; Ueda, Tetsuya; Sasaki, Toyoshi; Nakahara, Takehiro; Kurabayashi, Masahiko; Higuchi, Tetsuya; Tsushima, Yoshito

    2016-01-01

    Patients with chronic kidney disease (CKD) have an increased risk of adverse cardio-cerebrovascular events. We examined whether stress myocardial perfusion single photon emission computed tomography (SPECT) provides reliable prognostic markers for these patients. In this multicenter, prospective cohort trial from the Gunma-CKD SPECT study protocol, patients with CKD [estimated glomerular filtration rate (eGFR) < 60 min/ml per 1.73 m 2 ] undergoing stress 99m Tc-tetrofosmin SPECT for suspected or possible ischemic heart disease were initially followed for 1 year, with the following study endpoints: primary, the occurrence of cardiac deaths (CDs), and secondary, major adverse cardiac, cerebrovascular, and renal events (MACCREs). The summed stress score (SSS), summed rest score, and summed difference score (SDS) were estimated with the standard 17-segment, 5-point scoring model. Left ventricular end-diastolic volume, end-systolic volume (ESV), and ejection fraction were measured using electrocardiogram-gated SPECT. During the first year of follow-up, 69 of 299 patients experienced MACCREs (CD, n = 7; non-fatal myocardial infarction, n = 3; hospitalization for heart failure, n = 13; cerebrovascular accident, n = 1; need for revascularization, n = 38; and renal failure, i.e., hemodialysis initiation, n = 7). ESV and SSS were associated with CDs (p < 0.05), and eGFR and SDS were associated with MACCREs (p < 0.05), in multivariate logistic analysis. Patients with high ESV and high SSS had a significantly higher CD rate during the first year than the other CKD patient subgroups (p < 0.05). Patients with low eGFR and high SDS had a significantly higher MACCRE rate than the other subgroups (p < 0.05). Myocardial perfusion SPECT can provide reliable prognostic markers for patients with CKD. (orig.)

  18. Prognostic value of myocardial perfusion single photon emission computed tomography for major adverse cardiac cerebrovascular and renal events in patients with chronic kidney disease: results from first year of follow-up of the Gunma-CKD SPECT multicenter study

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Toyama, Takuji [Department of Cardiovascular Medicine, Gunma Prefectural Cardiovascular Center, Maebashi (Japan); Sato, Makito [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Tatebayashi Kosei Hospital, Department of Internal Medicine, Gunma (Japan); Sano, Hirokazu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Isesaki Municipal Hospital, Department of Cardiovascular Medicine, Isesaki (Japan); Ueda, Tetsuya [Fujioka General Hospital, Division of Cardiology, Fujioka (Japan); Sasaki, Toyoshi [Takasaki General Medical Center, Division of Cardiology, Takasaki (Japan); Nakahara, Takehiro; Kurabayashi, Masahiko [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Higuchi, Tetsuya; Tsushima, Yoshito [Gunma University Graduate School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Maebashi (Japan)

    2016-02-15

    Patients with chronic kidney disease (CKD) have an increased risk of adverse cardio-cerebrovascular events. We examined whether stress myocardial perfusion single photon emission computed tomography (SPECT) provides reliable prognostic markers for these patients. In this multicenter, prospective cohort trial from the Gunma-CKD SPECT study protocol, patients with CKD [estimated glomerular filtration rate (eGFR) < 60 min/ml per 1.73 m{sup 2}] undergoing stress {sup 99m}Tc-tetrofosmin SPECT for suspected or possible ischemic heart disease were initially followed for 1 year, with the following study endpoints: primary, the occurrence of cardiac deaths (CDs), and secondary, major adverse cardiac, cerebrovascular, and renal events (MACCREs). The summed stress score (SSS), summed rest score, and summed difference score (SDS) were estimated with the standard 17-segment, 5-point scoring model. Left ventricular end-diastolic volume, end-systolic volume (ESV), and ejection fraction were measured using electrocardiogram-gated SPECT. During the first year of follow-up, 69 of 299 patients experienced MACCREs (CD, n = 7; non-fatal myocardial infarction, n = 3; hospitalization for heart failure, n = 13; cerebrovascular accident, n = 1; need for revascularization, n = 38; and renal failure, i.e., hemodialysis initiation, n = 7). ESV and SSS were associated with CDs (p < 0.05), and eGFR and SDS were associated with MACCREs (p < 0.05), in multivariate logistic analysis. Patients with high ESV and high SSS had a significantly higher CD rate during the first year than the other CKD patient subgroups (p < 0.05). Patients with low eGFR and high SDS had a significantly higher MACCRE rate than the other subgroups (p < 0.05). Myocardial perfusion SPECT can provide reliable prognostic markers for patients with CKD. (orig.)

  19. Myocardial ischaemia in children with sickle cell disease.

    Science.gov (United States)

    de Montalembert, M; Maunoury, C; Acar, P; Brousse, V; Sidi, D; Lenoir, G

    2004-04-01

    The heart may be involved in children affected with sickle cell disease (SCD) via several mechanisms. Principally, chronic anaemia increases cardiac output and may cause left ventricular enlargement and cardiac insufficiency. To investigate whether the heart also suffers from ischaemia in SCD, as has already been shown for other organs (bone, brain, etc), and to look for risk factors predisposing to this complication. Twenty two children with SCD, and chest pain or ECG or echocardiographic signs (left ventricle dilation or hypokinesis) suggesting myocardial ischaemia were subjected to thallium-201 (201Tl) single photon emission computed tomography (SPECT). Eight children had a normal SPECT, 14 an abnormal one. Myocardial perfusion defects were reversible in nine, fixed in five. Patients with perfusion defects tended to be older and have more severe disease. Five had had cardiac symptoms (episodes of cardiac failure in three, ventricular fibrillation in one, angina in one). Myocardial perfusion was reassessed after six months of hydroxyurea treatment in three patients, and was found to be improved. Myocardial perfusion defects are present in children with SCD and may be demonstrated using SPECT. Hydroxyurea improved perfusion in three patients.

  20. Thallium-201 accumulation in cerebral candidiasis: Unexpected finding on SPECT

    International Nuclear Information System (INIS)

    Tonami, N.; Matsuda, H.; Ooba, H.; Yokoyama, K.; Hisada, K.; Ikeda, K.; Yamashita, J.

    1990-01-01

    The authors present an unexpected finding of Tl-201 uptake in the intracerebral lesions due to candidiasis. SPECT demonstrated the extent of the lesions and a high target-to-background ratio. The regions where abnormal Tl-201 accumulation was seen were nearly consistent with CT scans of those enhanced by a contrast agent. After treatment, most of the abnormal Tl-201 accumulation disappeared

  1. Thallium-201 accumulation in cerebral candidiasis: Unexpected finding on SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tonami, N.; Matsuda, H.; Ooba, H.; Yokoyama, K.; Hisada, K.; Ikeda, K.; Yamashita, J. (Kanazawa Univ. (Japan))

    1990-06-01

    The authors present an unexpected finding of Tl-201 uptake in the intracerebral lesions due to candidiasis. SPECT demonstrated the extent of the lesions and a high target-to-background ratio. The regions where abnormal Tl-201 accumulation was seen were nearly consistent with CT scans of those enhanced by a contrast agent. After treatment, most of the abnormal Tl-201 accumulation disappeared.

  2. Study on depiction in myocardial SPECT images. Difference images acquired between opposite 180-degree collection (full scan) and L-style 76-degree collection (half scan) when using collimators for the heart

    International Nuclear Information System (INIS)

    Aikawa, Shuji; Hoshino, Hirobumi; Ban, Shinji

    2003-01-01

    A cardio high-sensitivity (CaHS) collimator has been developed for myocardial SPECT. In our preliminary experiment, it was found that the sensitivity of our CaHS collimator was 2.3-times greater than the sensitivity of our low-energy high-resolution (LEHR) collimator and that its resolution was 11.6 mm in full width at half maximum (FWHM), while the FWHM of our LEHR was 7.15 mm. The purpose of this study was to assess the clinical usefulness of myocardial SPECT images acquired at two different angles using the CaHS collimator: opposite 180-degree collection (full scan) and the L-style 76-degree collection (half scan). It was found that the images acquired by the full scan had fewer deficits in specific regions of the heart than the images acquired by the half scan. We concluded that the size of the small amount of unusual uptake in the anterior wall of the heart might be overestimated on myocardial SPECT images obtained by L-style 76 degrees. When evaluating at the clinical, therefore, it should be careful. (author)

  3. Myocardial ischemia in Kawasaki disease

    International Nuclear Information System (INIS)

    Fukuda, Tsuyoshi

    1993-01-01

    The detection of myocardial ischemia is essential for evaluation of patients with Kawasaki disease, especially who have had coronary artery lesions. To evaluate the clinical efficacy of Tl-201 single photon emission computed tomography (SPECT) after dipyridamole infusion (maximum dose 0.70 mg/kg) for detecting myocardial ischemia, 44 patients with Kawasaki disease aged 7.7±4.8 years at the study and 10 age matched controls were observed. In the Kawasaki disease group, significant coronary artery stenosis was observed in 14, coronary aneurysm without stenosis in 18, the regression of the coronary aneurysms in 2 and without coronary lesions in 10 patients. In 24 of 44 patients, treadmill exercise stress test was also performed at the same period. Myocardial ischemic changes were observed in 11 patients, all combined with significant coronary artery stenosis. The sensitivity of SPECT for detection of overall coronary stenosis was 79%, coronary that of treadmill exercise test was only 33% (p<0.001). Furthermore, among the patients having significant coronary stenosis, the severity score was significantly elevated in patients who had electrocardiographic abnormal Q wave compared to those without abnormal Q wave (51.0±38.8 versus 20.0±12.1, p<0.05). These data suggest that the pharmacological stress scintigraphy using dipyridamole injection provides not only the accurate detection but quantitative evaluation of myocardial ischemia in these patients. This noninvasive technique may become one of the most useful index for detection and follow-up of myocardial ischemia in Kawasaki disease. (author)

  4. SPECT myocardial perfusion imaging as an adjunct to coronary calcium score for the detection of hemodynamically significant coronary artery stenosis

    Directory of Open Access Journals (Sweden)

    von Ziegler Franz

    2012-12-01

    Full Text Available Abstract Background Coronary artery calcifications (CAC are markers of coronary atherosclerosis, but do not correlate well with stenosis severity. This study intended to evaluate clinical situations where a combined approach of coronary calcium scoring (CS and nuclear stress test (SPECT-MPI is useful for the detection of relevant CAD. Methods Patients with clinical indication for invasive coronary angiography (ICA were included into our study during 08/2005-09/2008. At first all patients underwent CS procedure as part of the study protocol performed by either using a multidetector computed tomography (CT scanner or a dual-source CT imager. CAC were automatically defined by dedicated software and the Agatston score was semi-automatically calculated. A stress-rest SPECT-MPI study was performed afterwards and scintigraphic images were evaluated quantitatively. Then all patients underwent ICA. Thereby significant CAD was defined as luminal stenosis ≥75% in quantitative coronary analysis (QCA in ≥1 epicardial vessel. To compare data lacking Gaussian distribution an unpaired Wilcoxon-Test (Mann–Whitney was used. Otherwise a Students t-test for unpaired samples was applied. Calculations were considered to be significant at a p-value of Results We consecutively included 351 symptomatic patients (mean age: 61.2±12.3 years; range: 18–94 years; male: n=240 with a mean Agatston score of 258.5±512.2 (range: 0–4214. ICA verified exclusion of significant CAD in 66/67 (98.5% patients without CAC. CAC was detected in remaining 284 patients. In 132/284 patients (46.5% with CS>0 significant CAD was confirmed by ICA, and excluded in 152/284 (53.5% patients. Sensitivity for CAD detection by CS alone was calculated as 99.2%, specificity was 30.3%, and negative predictive value was 98.5%. An additional SPECT in patients with CS>0 increased specificity to 80.9% while reducing sensitivity to 87.9%. Diagnostic accuracy was 84.2%. Conclusions In patients

  5. Comparative value of thallium and glucose SPECT imaging in childhood brain tumors.

    Science.gov (United States)

    Maria, B L; Drane, W E; Mastin, S T; Jimenez, L A

    1998-11-01

    Thallium-201 chloride (201Tl) single-photon emission computed tomography (SPECT) detects a high percentage of histologically and anatomically diverse pediatric brain tumors. Thallium-201 chloride SPECT and F-18 fluoro-deoxy-glucose (18F-FDG) positron emission tomography (PET) are the most commonly used radionuclide techniques in neuro-oncology. Having developed a methodology to image 18F-FDG with SPECT, the authors performed SPECT scans coupled with magnetic resonance imaging to assess the comparative sensitivity of 201Tl and 18F-FDG in 19 children with brain tumors. Tumors were detected using 201Tl SPECT in 14 of 19 patients. Five of five postoperative residual tumors were detected by 201Tl SPECT, and six of seven after irradiation recurrences were detected. F-18 fluoro-deoxy-glucose SPECT detected tumors in only three of 19 patients, all of whom had abnormal 201Tl studies (all three after therapy recurrences). Thallium-201 chloride SPECT could be interpreted in 18 of 19 patients without magnetic resonance imaging confirmation, but none of the 19 18F-FDG SPECT studies could be interpreted without magnetic resonance imaging. Thallium-201 chloride SPECT is more sensitive than 18F-FDG SPECT in the detection of primary or recurrent childhood brain tumors. The failure of 18F-FDG SPECT in follow-up after therapy is primarily a problem of limited fluoro-deoxy-glucose uptake, not spatial resolution. Thallium-201 chloride SPECT is a promising imaging modality in neuro-oncology.

  6. Diagnosis of myocardial involvement in patients with systemic myopathies with 15-(p-[I-123]iodophenyl) pentadecanoic acid (IPPA) SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kropp, J.; Briele, B.; Smekal, A.V.; Hotze, A.L.; Biersack, H.J.; Koehler, U.; Zierz, St. [Bonn Univ. (Germany); Knapp, F.F. [Oak Ridge National Lab., TN (United States)

    1992-03-01

    Involvement of the myocardium in non-infectious myopathies presents in most cases as systolic dysfunction or a disturbed cardiac rhythm. We are interested in exploring how often cardiac involvement can be evaluated with various diagnostic techniques in patients with proven myopathy. We investigated 41 patients with myopathies of various etiology, including mitochondrial and congenital myopathies, Curshmann-Steinert disease, muscular dystrophy, and others. Myopathy was proven by muscular biopsy usually from the bicep. Fatty acid imaging was performed with 15-(p-[I-123]iodophenyl)pentadecanoic acid (IP-PA) and sequential SPECT-scintigraphy with a 180 deg. rotation starting at the 45 deg. RAO position. 190 MBq were injected at the maximal stage of a submaximal exercise. Filtered backprojection and reorientation of the slices were achieved by standard techniques. The quantitative comparison of the oblique slices (bulls-eye technique) of the SPECT-studies revealed turnover-rates as a qualitative measure of {beta}-oxidation. Serum levels of lactate (L), pyruvate (P), glucose (G) and triglycerides (TG) were measured at rest and stress. Ventricular function was investigated by radionuclide ventriculography (MUGA) at rest and under stress with Tc-99m labeled red blood cells. In addition, ECG, 24 hour-ECG, and echocardiography were also performed with standard techniques.

  7. Diagnosis of myocardial involvement in patients with systemic myopathies with 15-(p-[I-123]iodophenyl) pentadecanoic acid (IPPA) SPECT

    International Nuclear Information System (INIS)

    Kropp, J.; Briele, B.; Smekal, A.V.; Hotze, A.L.; Biersack, H.J.; Koehler, U.; Zierz, St.; Knapp, F.F.

    1992-01-01

    Involvement of the myocardium in non-infectious myopathies presents in most cases as systolic dysfunction or a disturbed cardiac rhythm. We are interested in exploring how often cardiac involvement can be evaluated with various diagnostic techniques in patients with proven myopathy. We investigated 41 patients with myopathies of various etiology, including mitochondrial and congenital myopathies, Curshmann-Steinert disease, muscular dystrophy, and others. Myopathy was proven by muscular biopsy usually from the bicep. Fatty acid imaging was performed with 15-(p-[I-123]iodophenyl)pentadecanoic acid (IP-PA) and sequential SPECT-scintigraphy with a 180 deg. rotation starting at the 45 deg. RAO position. 190 MBq were injected at the maximal stage of a submaximal exercise. Filtered backprojection and reorientation of the slices were achieved by standard techniques. The quantitative comparison of the oblique slices (bulls-eye technique) of the SPECT-studies revealed turnover-rates as a qualitative measure of β-oxidation. Serum levels of lactate (L), pyruvate (P), glucose (G) and triglycerides (TG) were measured at rest and stress. Ventricular function was investigated by radionuclide ventriculography (MUGA) at rest and under stress with Tc-99m labeled red blood cells. In addition, ECG, 24 hour-ECG, and echocardiography were also performed with standard techniques

  8. Diagnosis of myocardial involvement in patients with systemic myopathies with 15-(p-(I-123)iodophenyl) pentadecanoic acid (IPPA) SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kropp, J.; Briele, B.; Smekal, A.V.; Hotze, A.L.; Biersack, H.J.; Koehler, U.; Zierz, St. (Bonn Univ. (Germany)); Knapp, F.F. (Oak Ridge National Lab., TN (United States))

    1992-01-01

    Involvement of the myocardium in non-infectious myopathies presents in most cases as systolic dysfunction or a disturbed cardiac rhythm. We are interested in exploring how often cardiac involvement can be evaluated with various diagnostic techniques in patients with proven myopathy. We investigated 41 patients with myopathies of various etiology, including mitochondrial and congenital myopathies, Curshmann-Steinert disease, muscular dystrophy, and others. Myopathy was proven by muscular biopsy usually from the bicep. Fatty acid imaging was performed with 15-(p-(I-123)iodophenyl)pentadecanoic acid (IP-PA) and sequential SPECT-scintigraphy with a 180 deg. rotation starting at the 45 deg. RAO position. 190 MBq were injected at the maximal stage of a submaximal exercise. Filtered backprojection and reorientation of the slices were achieved by standard techniques. The quantitative comparison of the oblique slices (bulls-eye technique) of the SPECT-studies revealed turnover-rates as a qualitative measure of {beta}-oxidation. Serum levels of lactate (L), pyruvate (P), glucose (G) and triglycerides (TG) were measured at rest and stress. Ventricular function was investigated by radionuclide ventriculography (MUGA) at rest and under stress with Tc-99m labeled red blood cells. In addition, ECG, 24 hour-ECG, and echocardiography were also performed with standard techniques.

  9. Prognostic value of myocardial perfusion single photon emission computed tomography for major adverse cardiac cerebrovascular and renal events in patients with chronic kidney disease: results from first year of follow-up of the Gunma-CKD SPECT multicenter study.

    Science.gov (United States)

    Kasama, Shu; Toyama, Takuji; Sato, Makito; Sano, Hirokazu; Ueda, Tetsuya; Sasaki, Toyoshi; Nakahara, Takehiro; Higuchi, Tetsuya; Tsushima, Yoshito; Kurabayashi, Masahiko

    2016-02-01

    Patients with chronic kidney disease (CKD) have an increased risk of adverse cardio-cerebrovascular events. We examined whether stress myocardial perfusion single photon emission computed tomography (SPECT) provides reliable prognostic markers for these patients. In this multicenter, prospective cohort trial from the Gunma-CKD SPECT study protocol, patients with CKD [estimated glomerular filtration rate (eGFR) disease were initially followed for 1 year, with the following study endpoints: primary, the occurrence of cardiac deaths (CDs), and secondary, major adverse cardiac, cerebrovascular, and renal events (MACCREs). The summed stress score (SSS), summed rest score, and summed difference score (SDS) were estimated with the standard 17-segment, 5-point scoring model. Left ventricular end-diastolic volume, end-systolic volume (ESV), and ejection fraction were measured using electrocardiogram-gated SPECT. During the first year of follow-up, 69 of 299 patients experienced MACCREs (CD, n = 7; non-fatal myocardial infarction, n = 3; hospitalization for heart failure, n = 13; cerebrovascular accident, n = 1; need for revascularization, n = 38; and renal failure, i.e., hemodialysis initiation, n = 7). ESV and SSS were associated with CDs (p < 0.05), and eGFR and SDS were associated with MACCREs (p < 0.05), in multivariate logistic analysis. Patients with high ESV and high SSS had a significantly higher CD rate during the first year than the other CKD patient subgroups (p < 0.05). Patients with low eGFR and high SDS had a significantly higher MACCRE rate than the other subgroups (p < 0.05). Myocardial perfusion SPECT can provide reliable prognostic markers for patients with CKD.

  10. Usefulness of myocardial scintigraphy using cigarette smoking and isosorbide dinitrate in patients with angina pectoris

    International Nuclear Information System (INIS)

    Igarashi, Takeki; Horimoto, Masashi; Funayama, Naoki

    1989-01-01

    Cigarette smoking is not only one of the most important risk factors for coronary artery disease, but also anginal attacks often occur during smoking. Coronary vasoconstriction is considered to be one of the mechanisms which cause anginal episodes. Thirty patients with angina pectoris, 27 men and 3 women, were investigated. Group I comprised 22 patients with rest angina and group II consisted of 8 patients with effort angina. Five minutes after smoking one cigarette, a first study of 20l Tl myocardial SPECT was performed. Consequently, after sublingual administration of isosorbide denitrate, a second SPECT was done. Most cases improved and it was recognized as positive when changes of localized perfusion defects were observed between both SPECTs. In the group I, 19 out of 22 patients (86%) were positive, but in the group II, 2 out of 8 (25%) were positive. The differences were statistically significant (p<0.05). By the examination of coronarty angiography in 20 patients, the result of myocardial scintigraphy using cigarette smoking and isosorbide dinitrate seemed inversely proportional to the severity of narrowing of the coronary artery. In addition, background factors including risk factors were also compared for both groups. Because the result of this myocardial scintigraphy was positive in the rest angina group and in the group with minimal coronary arteriogrpahic abnormalities, it seggests that myocardial scintigraphy using cigarette smoking and isosorbide dinitrate is useful as a non-invasive auxiliary diagnostic method to detect coronary spasm or coronary vasoconstriction-prone angina pectoris including silent myocardial ischemia. (author)

  11. Physiological assessment of myocardial perfusion using nuclear cardiology would enhance coronary artery disease patient care. Which imaging modality is best for evaluation of myocardial ischemia? (SPECT-side)

    International Nuclear Information System (INIS)

    Yoshinaga, Keiichiro; Manabe, Osamu; Tamaki, Nagara

    2011-01-01

    Nuclear cardiology has played an important role in both diagnosis and risk assessments of coronary artery disease since early 1970. Among the non-invasive diagnostic tests, the great advantage of nuclear imaging is that this technique can obtain physiological information, such as myocardial perfusion, which is difficult to obtain by other techniques. When patients have inducible myocardial ischemia and sufficient viable myocardium, coronary revascularization treatment should be performed. Both stress myocardial perfusion imaging (MPI) and viability imaging provide important information. Another important aspect of stress perfusion imaging is that normal stress perfusion is associated with low risk for future cardiac events. Therefore, stress MPI plays an important role in the selection of an invasive therapeutic regime and also in avoiding unnecessary invasive procedures. As is the case for other imaging techniques, there have been many technical and instrumental developments in recent years in nuclear cardiology imaging, including new single-photon-emission computed tomography tracers, new pharmacological stress agents, a new generation of γ camera, and positron emission tomography. This review will address the advantages of nuclear cardiology in the clinical setting and recent developments in nuclear cardiology. (author)

  12. Measurement of myocardial perfusion and metabolic viability with 18 F-FDG, 201 TL and 99m Tc MIBI using a normal gamma camera: results of routine examination of 60 patients

    International Nuclear Information System (INIS)

    Hoeflin, F.; Roesler, H.; Ledermann, H.; Hopf, M.; Weinreich, R.

    1990-01-01

    18F-Fluoro-Deoxy-Glucose (18F-FDG) is known to be taken up in ischemic myocardium (MC), even in persistent perfusion defects with 201 Thallium (201 Tl), as in hibernating or stunned MC. It is shown how experiences with Positron Emission Tomography (PET) imaging can be reproduced with a modified Anger-type Camera, the most common Nuclear Medicine tool shielded with a lead reinforced table and fitted with special lead protected Seven PinHole (SPH) Collimator. Routinely static SPH images with 99m Tc-Cardiolite were compared with 18F-FDG images which have been obtained during the same session and in identical position in pts up to 12 weeks after acute Myocardial Infarction (MI). 201 Tl stress/redistribution studies had shown scars in all, confirmed by X-ray coronaro/angiography, and 99mTc-first-pass-angiography. More than half of these scars showed FDG uptake in the lesions. It is concluded that SPH-Tomoscintigraphy with 201 Tl, 99m Tc-Cardiolite and 18F-FDG is a widely available method for the detection of ischemic but viable myocardium after MI. This technique can be used much easier than PET in daily practice. 18F-FDG exams could be made available within 1 hour transportation distance from a cyclotron. 7 refs., 2 figs

  13. SPECT imaging of myocardial infarction using {sup 99m}Tc-labeled C2A domain of synaptotagmin I in a porcine ischemia-reperfusion model

    Energy Technology Data Exchange (ETDEWEB)

    Fang Wei [Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing 100037 (China); Wang Feng [Nuclear Medicine Department, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006 (China); Ji Shundong [Jiangsu Institute of Hematology, 1st Hospital of Suzhou University, Suzhou 215006 (China); Zhu Xiaoguang [Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States); Meier, Heidi T. [Clinical Veterinarian and Radiology Research, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, WI 53295 (United States); Hellman, Robert S. [Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States); Brindle, Kevin M. [MRC Laboratory of Molecular Biology, Cambridge CB2 2QH (United Kingdom); Davletov, Bazbek [Department of Biochemistry, University of Cambridge, Cambridge CB2 1GA (United Kingdom); Zhao Ming [Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States)], E-mail: mzhao@mcw.edu

    2007-11-15

    Introduction: The C2A domain of synaptotagmin I recognizes necrotic and apoptotic cells by binding to exposed anionic phospholipids. The goal is to explore the potential imaging utility of {sup 99m}Tc-labeled C2A in the detection of acute cardiac cell death in a porcine model that resembles human cardiovascular physiology. Methods: Ischemia (20-25 min) was induced in pigs (M/F, 20-25 kg) using balloon angioplasty. {sup 99m}Tc-C2A-GST (n=7) or {sup 99m}Tc-BSA (n=2) was injected intravenously 1-2 h after reperfusion. Noninfarct animals were injected with {sup 99m}Tc-C2A-GST (n=4). SPECT images were acquired at 3 and 6 h postinjection. Cardiac tissues were analyzed to confirm the presence of cell death. Results: Focal uptake was detected in five out of seven subjects at 3 h and in all infarct subjects at 6 h postinjection but not in infarct animals injected with {sup 99m}Tc-BSA or in noninfarct animals with {sup 99m}Tc-C2A-GST. Gamma counting of infarct versus normal myocardium yielded a 10.2{+-}5.7-fold elevation in absolute radioactivity, with histologically confirmed infarction. Conclusions: We present data on imaging myocardial cell death in the acute phase of infarction in pigs. C2A holds promise and warrants further development as an infarct-avid molecular probe.

  14. Tc-99m tetrofosmin myocardial perfusion SPECT after dipyridamole combined with low-level exercise in the diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Fukuzawa, Shigeru; Ozawa, Shun; Inagaki, Masayuki; Inoue, Toshihiro; Morooka, Shigeru; Sugioka, Juji

    1996-01-01

    Tc-99m tetrofosmin is a lipophilic, cationic perfusion imaging agent that changes to Tl-201 in detecting coronary artery disease during exercise testing. The purpose of this study is to evaluate the usefulness of Tc-99m tetrofosmin dipyridamole stress imaging combined with low level exercise for the detection of coronary artery disease. We examined 42 patients and 10 normal volunteers who also underwent coronary angiography. A one-day protocol was used: in the stress study, 296 MBq of tetrofosmin was injected and in the rest study 888 MBq was injected. After intravenous administration of dipyridamole (0.142 mg/kg/min for 4 minutes), the patient was exercised on a bicycle ergometer for 3 min (25 Watts). Tetrofosmin was injected 2 minutes after dipyridamole infusion during the exercise. Single photon emission computed tomographic images were obtained 30 minutes after the tracer injection. Images were interpreted as abnormal in 36 of 42 patients with coronary artery disease, and normal in all of 10 normal volunteers. The Overall sensitivity of detection of coronary artery disease was 83.3% and the normalcy rate was 100%. The diagnostic values for the detection of significant stenosis in the three major arteries were: LAD sensitivity 83%, specificity 92%; LCX sensitivity 47%, specificity 91%; RCA sensitivity 75%, specificity 83%. Of the 66 arteries with more than 50% stenosis, 48 arteries were correctly identified. Of the 36 with more than 70% stenosis, 31 were identified. Scintigraphic evidence of multivessel disease was found in only 9 patients (50%). A protocol of Tc-99m tetrofosmin SPECT combined with low level exercise after dipyridamole is therefore useful for the detection of the coronary artery disease. (author)

  15. Characteristics of single- and dual-photopeak energy window acquisitions with thallium-201 IQ-SPECT/CT system.

    Science.gov (United States)

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

    2017-08-01

    Although dual-energy (DE) acquisition with conventional 201 Tl myocardial perfusion SPECT has several advantages such as improved attenuation of the inferior wall and increased acquisition counts, the characteristics of IQ-SPECT have not been fully evaluated. We evaluate the difference of characteristics between single-energy (SE) and dual-energy (DE) imaging using 201 Tl myocardial IQ-SPECT. Two myocardial phantoms were created simulating normal myocardium and infarction of the inferior wall. Energy windows were set at 70 keV ± 10% for SE, and an additional 167 keV ± 7.5% for DE. SPECT images were reconstructed using the ordered subset conjugates gradient minimizer (OSCGM) method. We visually and quantitatively compared short-axis images of correction for no (NC), for attenuation (AC) or for both AC and scatter (ACSC) images. The average counts of SE and DE projection data were 17.5 and 20.3 counts/pixel, respectively. The DE data increased acquisition counts by approximately 16% compared with the SE data. The average visual score of normal myocardium did not differ significantly between the SE and DE images. However, the DE image of defective myocardium showed a significantly lower score in AC than SE images. The % uptake values of DE image with both NC and AC were significantly higher than those of SE images. The DE images of the inferior defective areas (segments 4 and 10) showed approximately 5-10% higher uptake compared with the SE images. The DE image with NC improved attenuation of the inferior wall. However, DE image with AC showed low defect detectability. Thus, AC should be used with SE rather than DE. Furthermore, while the SE image with ACSC can be used to detect perfusion defects, it must be interpreted carefully including the possibility of artificial inhomogeneity even in the normal myocardium.

  16. Late gadolinium uptake demonstrated with magnetic resonance in patients where automated PERFIT analysis of myocardial SPECT suggests irreversible perfusion defect

    International Nuclear Information System (INIS)

    Rosendahl, Lene; Blomstrand, Peter; Ohlsson, Jan L; Björklund, Per-Gunnar; Ahlander, Britt-Marie; Starck, Sven-Åke; Engvall, Jan E

    2008-01-01

    Myocardial perfusion single photon emission computed tomography (MPS) is frequently used as the reference method for the determination of myocardial infarct size. PERFIT ® is a software utilizing a three-dimensional gender specific, averaged heart model for the automatic evaluation of myocardial perfusion. The purpose of this study was to compare the perfusion defect size on MPS, assessed with PERFIT, with the hyperenhanced volume assessed by late gadolinium enhancement magnetic resonance imaging (LGE) and to relate their effect on the wall motion score index (WMSI) assessed with cine magnetic resonance imaging (cine-MRI) and echocardiography (echo). LGE was performed in 40 patients where clinical MPS showed an irreversible uptake reduction suggesting a myocardial scar. Infarct volume, extent and major coronary supply were compared between MPS and LGE as well as the relationship between infarct size from both methods and WMSI. MPS showed a slightly larger infarct volume than LGE (MPS 29.6 ± 23.2 ml, LGE 22.1 ± 16.9 ml, p = 0.01), while no significant difference was found in infarct extent (MPS 11.7 ± 9.4%, LGE 13.0 ± 9.6%). The correlation coefficients between methods in respect to infarct size and infarct extent were 0.71 and 0.63 respectively. WMSI determined with cine-MRI correlated moderately with infarct volume and infarct extent (cine-MRI vs MPS volume r = 0.71, extent r = 0.71, cine-MRI vs LGE volume r = 0.62, extent r = 0.60). Similar results were achieved when wall motion was determined with echo. Both MPS and LGE showed the same major coronary supply to the infarct area in a majority of patients, Kappa = 0.84. MPS and LGE agree moderately in the determination of infarct size in both absolute and relative terms, although infarct volume is slightly larger with MPS. The correlation between WMSI and infarct size is moderate

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  18. Assessment of cardiac function using myocardial perfusion imaging technique on SPECT with 99mTc sestamibi

    Science.gov (United States)

    Gani, M. R. A.; Nazir, F.; Pawiro, S. A.; Soejoko, D. S.

    2016-03-01

    Suspicion on coronary heart disease can be confirmed by observing the function of left ventricle cardiac muscle with Myocardial Perfusion Imaging techniques. The function perfusion itself is indicated by the uptake of radiopharmaceutical tracer. The 31 patients were studied undergoing the MPI examination on Gatot Soebroto Hospital using 99mTc-sestamibi radiopharmaceutical with stress and rest conditions. Stress was stimulated by physical exercise or pharmacological agent. After two hours, the patient did rest condition on the same day. The difference of uptake percentage between stress and rest conditions will be used to determine the malfunction of perfusion due to ischemic or infarct. Degradation of cardiac function was determined based on the image-based assessment of five segments of left ventricle cardiac. As a result, 8 (25.8%) patients had normal myocardial perfusion and 11 (35.5%) patients suspected for having partial ischemia. Total ischemia occurred to 8 (25.8%) patients with reversible and irreversible ischemia and the remaining 4 (12.9%) patients for partial infarct with characteristic the percentage of perfusion ≤50%. It is concluded that MPI technique of image-based assessment on uptake percentage difference between stress and rest conditions can be employed to predict abnormal perfusion as complementary information to diagnose the cardiac function.

  19. Prognostic estimation of coronary artery disease risk with resting perfusion abnormalities and stress ischemia on myocardial perfusion SPECT.

    Science.gov (United States)

    Shaw, Leslee J; Hendel, Robert C; Heller, Gary V; Borges-Neto, Salvador; Cerqueira, Manuel; Berman, Daniel S

    2008-01-01

    The extent and severity of stress ischemia are strong predictors of coronary artery disease (CAD) events. Prognosis associated with myocardial perfusion single photon emission computed tomography (MPS) abnormalities on the resting scan as it relates to stress ischemia has been incompletely described. The Myoview Prognosis Registry was a prospective consecutive series of 7849 outpatients enrolled from 5 geographically diverse centers. Patients were followed up for the occurrence of CAD events (nonfatal myocardial infarction [MI] or death related to MI, heart failure, or sudden cardiac death). Time to CAD event (n = 545) was estimated by use of univariable and multivariable Cox proportional hazards models (risk adjusted by symptoms, risk factors, and comorbid conditions). For patients with no resting defects, overall CAD event rates were 1.2%, 8%, and 10% for patients with 0% ischemic myocardium, 1% to 4.9% ischemic myocardium, and 5% ischemic myocardium or greater, respectively (P ischemic myocardium, there was a 7% increased risk of CAD events (P disease, and MPS with provocative ischemia.

  20. Phase 2 study of. beta. -methyl-p-( sup 123 I)-iodophenyl-pentadecanoic acid, a myocardial imaging agent for evaluating myocardial fatty acid metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Kanji (Fukui Medical School, Matsuoka (Japan)); Yonekura, Yoshiharu; Nishimura, Tsunehiko; Tamaki, Nagara; Uehara, Toshiisa

    1992-03-01

    A phase 2 study of {beta}-methyl-p-({sup 123}I)-iodophenyl-pentadecanoic acid ({sup 123}I-BMIPP), a myocardial imaging agent developed for evaluating myocardial fatty acid metabolism, was performed in 197 patients with various heart diseases. The myocardial distribution of {sup 123}I-BMIPP did not change from early to late images in 88% of 91 patients with ischemic heart disease (IHD), while washout and/or fill-in were observed in 45% of 55 patients with hypertrophic cardiomyopathy (HCM). In comparison with {sup 201}Tl in 165 patients with various heart diseases, the decrease in uptake was more profound with BMIPP in 56% and with {sup 201}Tl in only 4%. {sup 123}I-BMIPP showed more severely decreased uptake in 83% of the patients with subacute myocardial infarction (15 to 30 days after the onset) and in 73% of the patients with HCM. High-quality SPECT images were obtained with {sup 123}I-BMIPP in 93% of 194 patients analyzed. However, the image quality in cardiomyopathy was inferior to that in IHD. The optimal injection dose range and standard dose of {sup 123}I-BMIPP were considered to be 74-148 MBq and 111 MBq, respectively. These findings suggest that {sup 123}I-BMIPP myocardial imaging is safe and useful for evaluating myocardial fatty acid metabolism in various heart diseases. (author).

  1. Myocardial metabolism of 123I-BMIPP under low-dose dobutamine infusion: implications for clinical SPECT imaging of ischemic heart disease

    International Nuclear Information System (INIS)

    Hosokawa, Ryohei; Fujita, Masatoshi; Kambara, Naoshige; Ohba, Muneo; Tadamura, Eiji; Kimura, Takeshi; Kita, Toru; Nohara, Ryuji; Hirai, Taku; Fujibayashi, Yasuhisa

    2005-01-01

    123 I-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid ( 123 I-BMIPP) is a fatty acid analog for single-photon emission computed tomography (SPECT) imaging that is mainly stored in the triglyceride pool. Low-dose dobutamine infusion has been reported to improve BMIPP uptake in the stunned myocardium, but the mechanism underlying this effect remains unclear. The purpose of this study was therefore to investigate the myocardial metabolism of 123 I-BMIPP in the stunned myocardium under low-dose dobutamine infusion, and to elucidate the mechanism by which dobutamine improves BMIPP uptake. Using open-chest dogs, stunned myocardium was induced by occlusion of the left anterior descending artery (LAD) for 30 min, with subsequent reperfusion (ischemia group, n=6). After direct injection of BMIPP into the LAD, myocardial extraction and retention were examined and metabolites evaluated (using high-performance liquid chromatography) during dobutamine infusion. The results in the ischemia group were compared with findings obtained in a control group under dobutamine infusion (n=6). Dobutamine infusion significantly increased both the rapid extraction (within 30 s) of BMIPP into the myocardium (control vs ischemia group: 48±19% vs 66±14%, p<0.05) and its subsequent retention (73±13% vs 85±8%, p<0.05). The metabolites from the myocardium consisted of back diffusion of nonmetabolized BMIPP, the alpha-oxidation metabolite, intermediate metabolites, and the full-oxidation metabolite. Among these metabolites, the full-oxidation metabolite decreased significantly (from 34.0±20.0% to 15.8±9.3%, p<0.05) in the stunned regions, though back diffusion of nonmetabolized BMIPP increased (from 51.3±21.9% to 71.3±10.1%, p<0.05). These results indicate that increased uptake of BMIPP in stunned myocardium is mainly due to decreased beta-oxidation in tissue and increased shunt retention of BMIPP in the triglyceride pool, and thereby provide further insight into the pathophysiology of

  2. Myocardial metabolism of {sup 123}I-BMIPP under low-dose dobutamine infusion: implications for clinical SPECT imaging of ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Hosokawa, Ryohei; Fujita, Masatoshi; Kambara, Naoshige; Ohba, Muneo; Tadamura, Eiji; Kimura, Takeshi; Kita, Toru [Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, and Nuclear Medicine, Kyoto (Japan); Nohara, Ryuji [The Tazuke Kofukai Medical Research Institute, Department of Cardiology, Kitano Hospital, Osaka (Japan); Hirai, Taku [Kinki University School of Medicine, Department of Cardiology, Nara Hospital, Nara (Japan); Fujibayashi, Yasuhisa [Fukui Medical University, Molecular Imaging, Biomedical Imaging Research Center, Fukui (Japan)

    2005-01-01

    {sup 123}I-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid ({sup 123}I-BMIPP) is a fatty acid analog for single-photon emission computed tomography (SPECT) imaging that is mainly stored in the triglyceride pool. Low-dose dobutamine infusion has been reported to improve BMIPP uptake in the stunned myocardium, but the mechanism underlying this effect remains unclear. The purpose of this study was therefore to investigate the myocardial metabolism of {sup 123}I-BMIPP in the stunned myocardium under low-dose dobutamine infusion, and to elucidate the mechanism by which dobutamine improves BMIPP uptake. Using open-chest dogs, stunned myocardium was induced by occlusion of the left anterior descending artery (LAD) for 30 min, with subsequent reperfusion (ischemia group, n=6). After direct injection of BMIPP into the LAD, myocardial extraction and retention were examined and metabolites evaluated (using high-performance liquid chromatography) during dobutamine infusion. The results in the ischemia group were compared with findings obtained in a control group under dobutamine infusion (n=6). Dobutamine infusion significantly increased both the rapid extraction (within 30 s) of BMIPP into the myocardium (control vs ischemia group: 48{+-}19% vs 66{+-}14%, p<0.05) and its subsequent retention (73{+-}13% vs 85{+-}8%, p<0.05). The metabolites from the myocardium consisted of back diffusion of nonmetabolized BMIPP, the alpha-oxidation metabolite, intermediate metabolites, and the full-oxidation metabolite. Among these metabolites, the full-oxidation metabolite decreased significantly (from 34.0{+-}20.0% to 15.8{+-}9.3%, p<0.05) in the stunned regions, though back diffusion of nonmetabolized BMIPP increased (from 51.3{+-}21.9% to 71.3{+-}10.1%, p<0.05). These results indicate that increased uptake of BMIPP in stunned myocardium is mainly due to decreased beta-oxidation in tissue and increased shunt retention of BMIPP in the triglyceride pool, and thereby provide further insight

  3. Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang-Geon; Park, Ki Seong; Kim, Jahae; Kim, Jong Sang; Song, Ho-Chun [Chonnam National University Hospital, Department of Nuclear Medicine, Gwang-ju (Korea, Republic of); Jabin, Zeenat; Kang, Sae-Ryung; Kwon, Seong Young; Jeong, Geum-Cheol; Song, Minchul; Min, Jung-Joon; Bom, Hee-Seung [Chonnam National University Hwasun Hospital, Department of Nuclear Medicine, Hwasun-gun, Jeonnam (Korea, Republic of); Cho, Jae Yeong; Kim, Hyun Kuk [Chonnam National University Hospital, Department of Cardiology, Gwang-ju (Korea, Republic of)

    2017-02-15

    The aim of this study was to evaluate the prognostic value of additional evaluation of left ventricular mechanical dyssynchrony (LVMD) by gated myocardial perfusion single-photon emission computed tomography (GMPS) in patients with acute myocardial infarction (MI) and multivessel disease. One hundred and nine acute MI patients with >50 % stenosis in at least one non-culprit artery who underwent GMPS within 2 weeks were enrolled. All patients underwent successful revascularization of the culprit arteries. Those with previous MI, atrial fibrillation, or frequent ventricular premature complexes, cardiac devices, significant patient motion, or procedure-related events were excluded. Phase standard deviation (PSD) and phase histogram bandwidth (PBW) were measured for assessment of LVMD. Patients were followed up for a median of 26 months after index MI, for composite major adverse cardiac events (MACE), which consisted with all-cause death, unplanned hospitalization due to heart failure and severe ventricular arrhythmias (sustained ventricular tachycardia or ventricular fibrillation). Independent predictors of MACE were evaluated. MACE occurred in 22 patients (20 %). Stress PSD (53.3 ± 17.3 vs. 35.3 ± 18.9 ; p <0.001), stress PBW (147.6 ± 54.6 vs. 96.8 ± 59.2 ; p = 0.001) and resting PBW (126.8 ± 37.5 vs. 96.6 ± 48.9 ; p = 0.001) were significantly higher in patients with MACE compared to those without. Multivariate analysis revealed that stress PSD ≥45.5 and stress PBW ≥126.0 were predictive of MACE, as well as suboptimal non-culprit artery revascularization (SNR) and renin-angiotensin system (RAS) blockade medication. Higher stress PSD and stress PBW were associated with poorer prognosis both in patients with and without SNR, and those with RAS blockade medication, but not in those without RAS blockade medication. LVMD measured by GMPS showed added prognostic value in acute MI with multivessel disease. GMPS could serve as a comprehensive evaluation imaging

  4. Myocardial scintigraphy

    International Nuclear Information System (INIS)

    Bunko, Hisashi; Hisada, Kinichi

    1982-01-01

    Among the various methods of image diagnosis of the cardiovascular disorder, nuclear cardiology provides noninvasive means for evaluation of myocardial perfusion as well as morphological and functional informations. In this article, clinical application and image diagnosis of myocardial scintigraphy including Tl-201 myocardial perfusion scintigraphy, single photon emission computed tomography with Tl-201, acute myocardial infarction scintigraphy with Tc-99m-pyrophosphate and Ga-67 imaging of the heart, were discussed. Multiplanar imaging of the heart with Tl-201 after stress and at redistribution was the accepted method for detection and evaluation of the ischemic heart disease. Although it achieved high sensitivity and specificity for ischemic heart disease, detection of the small ischemia and quantation of the regional Tl-201 accumulation were difficult with conventional multiplanar imaging. Application of emission computed tomography improved detectability and quantitativity of the ischemia. However, 7-pinhole tomography did not increase the diagnostic accuracy significantly. It had limited clinical applicability due to poor quantitativity in spite of improved image contrast and its tomographic nature. Advantage and limitation of these tomographic imaging and multiplanar imaging were discussed. Problems and prognostic significance of pyrophosphate imaging of the acute myocardial infarction were also discussed. Visualization of the heart with Ga-67 was helpful for identification of the tumor or inflammation of the heart as well as evaluation of the effect of the therapy. (author)

  5. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other factors; KIHD perspective

    International Nuclear Information System (INIS)

    Maseeh-uz-Zaman; Fatima, N.; Samad, A.; Rasheed, S.Z.; Ishaq, M.; Rehman, K.; Wali, A.

    2009-01-01

    The objective of the present study was to assess the prevalence of coronary artery disease (CAD) among diabetic (DM) and nondiabetic (NDM) women using Gated SPECT (GSPECT) and to study the impact of other. risk factors like hypertension (HTN), dyslipidemia, family history and menopause. This is a prospective cross-sectional study on a consecutive sample of 287 women referred to Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD) for GSPECT for evaluation of known or suspected CAD (from January 2009 till June 2009). Women with a history of DM diagnosed less than 5 years were excluded. Same day (reststress) GSPECT study was conducted and fixed or reversible perfusion defects were considered positive GSPECT for CAD. GSPECT was positive for CAD in 41/115 (36%, P 0.002) diabetic women and 37/172 (21 %, P 0.005) non-diabetic cohort. In diabetic cohort, GSPECT was positive in 5/9 (56%, P 0.013) women with diabetes only, 17/35 (48%, P 0.02) DM with HTN, 12/15 (80%, P value 0.02) DM with dyslipidemia and 11/43 (26%, P 0.001) DM with >2 risk factors. GSPECT was normal in all 3 diabetic women with positive family history for CAD. In nondiabetic cohort, GSPECT was positive in 9/32 (28%, P value 0.739) women with no risk factor, 5/58 (26%, P 0.866) HTN only, 2/5 (40%, P value 0.655) only dyslipidemic women, 1/12. (8%, P 0.004) with family history only and 4/23 (17%, P value 0.166) non-diabetic with >2 risk factors. Interestingly, 35/93 post-menopausal diabetic (38%, p value 0.017) had positive GSPECT while 33/123 non-diabetic postmenopausal women (27%, p 0.03) had positive perfusion scans. GSPECT was positive in 6/26 (23%, P 0.006) and 4/49 (8%, P 0.05) in diabetic and non-diabetic pre-menopausal women. The prevalence of CAD in our diabetic women is as high as internationally reported and diabetes is a strong risk factor for CAD. Dyslipidemia with diabetes is a major contributor to CAD than HTN and F/H. Diabetes erases the protective effect of estrogen

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-06-15

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

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

    International Nuclear Information System (INIS)

    Calvo Montero, Karla; Coto Rodriguez, Maria Fernanda

    2011-01-01

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

  8. Specificity and sensitivity of SPECT myocardial perfusion studies at the Nuclear Medicine Department of the Limassol General Hospital in Cyprus

    Energy Technology Data Exchange (ETDEWEB)

    Koumna, S [Athens Anticancer - Oncology Hospital ' AgiosSavvas' , Athens (Greece); Yiannakkaras, Ch [Medical Physics Department, Nicosia General Hospital, Nicosia (Cyprus); Avraamides, P [Cardiology Clinic, Limassol General Hospital, Limassol (Cyprus); Demetriadou, O, E-mail: stelkoum@gmail.com [Nuclear Medicine Department, Limassol General Hospital, Limassol (Cyprus)

    2011-09-23

    The aim is to determine the sensitivity and specificity of Myocardial Perfusion Imaging (MPI) performed at the Nuclear Medicine Department of the Limassol General Hospital in Cyprus. Through a retrospective analysis, patient results obtained by MPI were compared to results obtained by Invasive Angiography. We analyzed data from 96 patients that underwent both MPI and Angiography during the years 2009-2010, with a maximum time interval of {+-} 9 months between the two types of medical exams. For 51 patients, the indication was the detection of CAD. For 45 patients, the indication was to assess viability and/or ischemia after MI, PCI or CABG. Out of 84 patients with CAD confirmed by angiography, 80 patients resulted in abnormal MPI (sensitivity of 95% and positive predictive value of 98%). Out of 12 patients with normal coronaries, 10 patients resulted in normal MPI (specificity of 83% and negative predictive value of 71%).In conclusion, for the patients with abnormal MPI and confirmed CAD, MPI was a useful aid for further therapy management.

  9. The Benefits of Prone SPECT Myocardial Perfusion Imaging in Reducing Both Artifact Defects and Patient Radiation Exposure.

    Science.gov (United States)

    Stathaki, Maria; Koukouraki, Sophia; Papadaki, Emmanouela; Tsaroucha, Angeliki; Karkavitsas, Nikolaos

    2015-10-01

    Prone imaging has been demonstrated to minimize diaphragmatic and breast tissue attenuation. To determine the role of prone imaging on the reduction of unnecessary rest perfusion studies and coronary angiographies performed, thus decreasing investigation time and radiation exposure. We examined 139 patients, 120 with an inferior wall and 19 with an anterior wall perfusion defect that might represented attenuation artifact. Post-stress images were acquired in both the supine and prone position. Coronary angiography was used as the "gold standard" for evaluating coronary artery patency. The study was terminated and rest imaging was obviated in the presence of complete improvement of the defect in the prone position. Quantitative interpretation was performed. Results were compared with clinical data and coronary angiographic findings. Prone acquisition correctly revealed defect improvement in 89 patients (89/120) with inferior wall and 12 patients (12/19) with anterior wall attenuation artifact. Quantitative analysis demonstrated statistically significant difference in the mean summed stress scores (SSS) of supine and mean SSS of prone studies in patients with disappearing inferior wall defect in the prone position and patent right coronary artery (true negative results). The mean difference between SSS in supine and in prone position was higher with disappearing than with remaining defects. Technetium-99m (Tc-99m) tetrofosmin myocardial perfusion imaging with the patient in the prone position overcomes soft tissue attenuation; moreover it provides an inexpensive, accurate approach to limit the number of unnecessary rest perfusion studies and coronary angiographies performed.

  10. Increased accuracy of single photon emission computed tomography (SPECT myocardial perfusion scintigraphy using iterative reconstruction of images

    Directory of Open Access Journals (Sweden)

    Stević Miloš

    2016-01-01

    Full Text Available Background/Aim. Filtered back projection (FBP is a common way of processing myocardial perfusion imaging (MPI studies. There are artifacts in FBP which can cause falsepositive results. Iterative reconstruction (IR is developed to reduce false positive findings in MPI studies. The aim of this study was to evaluate the difference in the number of false positive findings in MPI studies, between FBP and IR processing. Methods. We examined 107 patients with angina pectoris with MPI and coronary angiography (CAG, 77 man and 30 woman, aged 32−82. MPI studies were processed with FBP and with IR. Positive finding at MPI was visualization of the perfusion defect. Positive finding at CAG was stenosis of coronary artery. Perfusion defect at MPI without coronary artery stenosis at CAG was considered like false positive. The results were statistically analyzed with bivariate correlation, and with one sample t-test. Results. There were 20.6% normal, and 79.4% pathologic findings at FBP, 30.8% normal and 69.2% pathologic with IR and 37.4% normal and 62.6% pathologic at CAG. FBP produced 19 false-positive findings, at IR 11 false positive findings. The correlation between FBP and CAG was 0.658 (p < 0.01 and between IR and CAG 0.784 (p < 0.01. The number of false positive findings at MPI with IR was significantly lower than at FBP (p < 0.01. Conclusion. Our study shows that IR processing MPI scintigraphy has less number of false positive findings, therefore it is our choice for processing MPI studies.

  11. The regional wall motion and the myocardial fatty acid metabolism at hibernating myocardium

    International Nuclear Information System (INIS)

    Toyama, Takuji; Hoshizaki, Hiroshi; Isobe, Naoki; Ohshima, Shigeru; Taniguchi, Koichi; Suzuki, Yasushi; Suzuki, Tadashi; Nagai, Ryozo; Endo, Keigo.

    1996-01-01

    To evaluate the regional wall motion and the myocardial fatty acid metabolism at hibernating myocardium after revascularization (PTCA or CABG), we performed dual SPECT with 201 Tl and 123 I-β-methyl-iodophenyl-pentadecanoic acid (BMIPP), and left ventriculography (LVG) in 34 patients with coronary artery disease before and 3 to 4 months after revascularization. In the SPECT, regional tracer uptake was estimated qualitatively (visual) and quantitatively (% uptake). Regional wall motion was estimated qualitatively (visual) and quantitatively (shortening fraction). At the 78 hibernating areas, the improvement of regional wall motion was more significantly (p 123 I-BMIPP (r=0.63) than 201 Tl (r=0.39), and also correlated with the improvement of the difference between 201 Tl and 123 I-BMIPP regional uptake (r=0.36). These results suggest that the improvement of wall motion at hibernating myocardium is more significantly correlated with the improvement of 123 I-BMIPP than 201 Tl uptake after revascularization. (author)

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

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

    International Nuclear Information System (INIS)

    Kanamori, Norio; Kondo, Makoto; Fukuoka, Yoshitomo; Higuchi, Hirokazu; Kubota, Tomoyuki; Matsuoka, Ryota; Araki, Makoto; Tanio, Hitoshi; Doyama, Kiyoshi

    2007-01-01

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

  14. Stress-first protocol for myocardial perfusion SPECT imaging with semiconductor cameras: high diagnostic performances with significant reduction in patient radiation doses

    International Nuclear Information System (INIS)

    Perrin, Mathieu; Claudin, Marine; Veran, Nicolas; Morel, Olivier; Besseau, Cyril; Boutley, Henri; Djaballah, Wassila; Poussier, Sylvain; Verger, Antoine; Moulin, Frederic; Imbert, Laetitia; Karcher, Gilles; Marie, Pierre-Yves

    2015-01-01

    Effective doses of 14 mSv or higher are currently being attained in patients having stress and rest myocardial perfusion imaging (MPI) single photon emission computed tomography (SPECT) performed on the same day with conventional protocols. This study aimed to assess the actual reduction in effective doses as well as diagnostic performances for MPI routinely planned with: (1) high-sensitivity cadmium zinc telluride (CZT) cameras, (2) very low injected activities and (3) a stress-first protocol where the normality of stress images may lead to avoiding rest imaging. During a 1-year period, 2,845 patients had MPI on a CZT camera, a single-day stress-first protocol and low injected activities (120 MBq of 99m Tc-sestamibi at stress for 75 kg body weight and threefold higher at rest). The ability to detect > 50 % coronary stenosis was assessed in a subgroup of 149 patients who also had coronary angiography, while the normalcy rate was assessed in a subgroup of 128 patients with a low pretest likelihood of coronary artery disease (<10 %). Overall, 33 % of patients had abnormal MPI of which 34 % were women and 34 % were obese. The mean effective doses and the percentage of exams involving only stress images were: (1) 3.53 ± 2.10 mSv and 37 % in the overall population, (2) 4.83 ± 1.56 mSv and 5 % in the subgroup with angiography and (3) 1.96 ± 1.52 mSv and 71 % in the low-probability subgroup. Sensitivity and global accuracy for identifying the 106 patients with coronary stenosis were 88 and 80 %, respectively, while the normalcy rate was 97 %. When planned with a low-dose stress-first protocol on a CZT camera, MPI provides high diagnostic performances and a dramatic reduction in patient radiation doses. This reduction is even greater in low-risk subgroups with high rates of normal stress images, thus allowing the mean radiation dose to be balanced against cardiac risk in targeted populations. (orig.)

  15. Stress-first protocol for myocardial perfusion SPECT imaging with semiconductor cameras: high diagnostic performances with significant reduction in patient radiation doses

    Energy Technology Data Exchange (ETDEWEB)

    Perrin, Mathieu; Claudin, Marine; Veran, Nicolas; Morel, Olivier; Besseau, Cyril; Boutley, Henri [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Djaballah, Wassila; Poussier, Sylvain; Verger, Antoine [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); INSERM U947 et Universite de Lorraine, Nancy (France); Moulin, Frederic [CHU-Nancy, Department of Cardiology, Nancy (France); Imbert, Laetitia; Karcher, Gilles [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); UMR 7039 CRAN et Universite de Lorraine, Nancy (France); Marie, Pierre-Yves [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); INSERM U1116 et Universite de Lorraine, Nancy (France)

    2015-02-25

    Effective doses of 14 mSv or higher are currently being attained in patients having stress and rest myocardial perfusion imaging (MPI) single photon emission computed tomography (SPECT) performed on the same day with conventional protocols. This study aimed to assess the actual reduction in effective doses as well as diagnostic performances for MPI routinely planned with: (1) high-sensitivity cadmium zinc telluride (CZT) cameras, (2) very low injected activities and (3) a stress-first protocol where the normality of stress images may lead to avoiding rest imaging. During a 1-year period, 2,845 patients had MPI on a CZT camera, a single-day stress-first protocol and low injected activities (120 MBq of {sup 99m}Tc-sestamibi at stress for 75 kg body weight and threefold higher at rest). The ability to detect > 50 % coronary stenosis was assessed in a subgroup of 149 patients who also had coronary angiography, while the normalcy rate