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.)

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

International Nuclear Information System (INIS)

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

1984-01-01

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

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

International Nuclear Information System (INIS)

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

1994-01-01

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

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

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.).

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

International Nuclear Information System (INIS)

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

1998-01-01

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

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)

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

International Nuclear Information System (INIS)

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

1992-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1994-01-01

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

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

International Nuclear Information System (INIS)

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

1990-01-01

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

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2003-04-01

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

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

International Nuclear Information System (INIS)

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

2003-01-01

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

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

Science.gov (United States)

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

2004-04-01

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

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.)

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

Energy Technology Data Exchange (ETDEWEB)

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

1992-03-01

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

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

International Nuclear Information System (INIS)

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

1990-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1992-07-01

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

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)

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

Science.gov (United States)

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

1996-02-01

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

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1992-03-01

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

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

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

International Nuclear Information System (INIS)

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

2011-01-01

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

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

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

International Nuclear Information System (INIS)

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

2006-01-01

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

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

International Nuclear Information System (INIS)

Hisatake, Shinji; Yamashina, Shohei; Yamazaki, Junichi

2004-01-01

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

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

International Nuclear Information System (INIS)

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

1995-01-01

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

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

International Nuclear Information System (INIS)

Suzuki, Kazuo

2002-01-01

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

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

International Nuclear Information System (INIS)

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

1988-01-01

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

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

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.)

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

International Nuclear Information System (INIS)

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

1992-01-01

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

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

International Nuclear Information System (INIS)

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

1990-01-01

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

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

International Nuclear Information System (INIS)

Nishikubo, Naotsugu; Tamai, Hiroyuki

2013-01-01

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

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

International Nuclear Information System (INIS)

Shimazaki, Hiroshi; Oono, Ryuichi

2001-01-01

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

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)

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 �

Effects of ischemic-like insult on myocardial 201Tl accumulation

International Nuclear Information System (INIS)

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

1983-01-01

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

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

International Nuclear Information System (INIS)

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

1992-01-01

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

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

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

International Nuclear Information System (INIS)

Wang Qian; Fumiko Nakanishi; Shusuke Sone

1994-01-01

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

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

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

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

2000-02-01

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

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

International Nuclear Information System (INIS)

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

2007-01-01

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

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

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

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)

Methods, qualitative and quantitative evaluations of 201Tl myocardial scintiscans

International Nuclear Information System (INIS)

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

1981-01-01

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

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

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

1997-01-01

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

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)

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)

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.)

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)

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

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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

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

International Nuclear Information System (INIS)

Ouyang Wei; He Guorong; Liu Jinhua

2004-01-01

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

Evaluation of Tl-201 SPECT imaging findings in prostate cancer

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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.

Enhanced Diagnosis of Coronary Artery Disease in Women by Dobutamine Thallium-201 ST-Segment/Heart Rate Slope and Thallium-201 Myocardial SPECT

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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.

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.)

Scintigraphic detection of ischemic and other myocardial lesions using 201Tl

International Nuclear Information System (INIS)

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

1981-01-01

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

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)

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.)

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

Science.gov (United States)

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

2002-03-01

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

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

International Nuclear Information System (INIS)

Seiderer, M.

1979-01-01

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

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

International Nuclear Information System (INIS)

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

1999-01-01

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

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).

Myocardial SPECT in children with sickle cell disease

International Nuclear Information System (INIS)

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

2002-01-01

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

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

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

1986-01-01

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

Assessment of congenital heart disease by a thallium-201 SPECT study in children

International Nuclear Information System (INIS)

Ishii, Iwao; Nakajima, Kenichi; Taki, Junichi; Taniguchi, Mitsuru; Bunko, Hisashi; Tonami, Norihisa; Hisada, Kinichi; Ohno, Takashi

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 ( 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 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 201 Tl R/L count ratio was in accordance with improvement of right ventricular overload. We conclude that 201 Tl SPECT study can be a good indicator for estimation of right ventricular pressure. (author)

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)

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

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)

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

International Nuclear Information System (INIS)

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

2013-01-01

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

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1985-04-01

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

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

International Nuclear Information System (INIS)

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

1987-01-01

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

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

International Nuclear Information System (INIS)

Setsuta, Koichi

1991-01-01

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

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.)

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

International Nuclear Information System (INIS)

Lin Jinghui; Chai Xiaofeng; Zhu Mei

1997-01-01

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

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

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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.

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)

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

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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.)

Comparative study of 201Tl reinjection tomography and combined use of 13N-ammonia and 18F-fluorodeoxyglucose positron emission tomography for detection of viable myocardium

International Nuclear Information System (INIS)

Wang Lijuan; Qi Guoxian; Hu Jian

2001-01-01

Objective: To compare the clinical value of 201 Tl reinjection tomography and combined use of 13 N-ammonia (NH 3 ) regional myocardial perfusion and 18 F-fluorodeoxyglucose (FDG) positron emission tomography transfer function and for the myocardium. Methods: The authors performed exercise 201 Tl SPECT (Tl SPECT) on 20 patients with myocardial infarction and obtained standard 201 Tl exercise-redistribution images. 201 Tl was reinjected immediately after redistribution study, and the images were then acquired as also. The 20 patients also underwent PET imaging with 13 N-NH 3 and 18 F-FDG (NH 3 -FDG PET) within one week of the above study. Vertical and horizontal long axis cuts were divided into nine segments, and uptakes of radioisotope were evaluated into four classes visually (Defect score, DS) (0:normal uptake, 3:severely reduced). Quantitative evaluation was performed on the vertical and horizontal long axis cuts of 201 Tl redistribution, reinjection and FDG PET images using regions of interest. The relative myocardial 201 Tl uptake and 18 F-FDG uptake (% ID) were expressed as the percentage of this reference region accounted for of the maximal counts. Results: In 48 segments identified as viable by the NH 3 -FDG PET images, 45 (93.8%) segments were also identified as viable by the 201 Tl redistribution imaging. Of 24 segments with severe irreversible defects on the 201 Tl redistribution imaging, 87.5% of the segments were concordantly confirmed by 201 Tl reinjection and NH 3 -FDG PET images with 37.5% identified as viable and 50% identified as scar. There was no significant difference in the average % ID, furthermore, regression analysis revealed a high positive correlation in the segmental % ID between 201 Tl reinjection and FDG PET images in the 61 segments with myocardial infarction (r = 0.722). Conclusions: The results show that 201 Tl reinjection tomography is of similar accuracy with NH 3 -FDG PET for detection of viable myocardium and possess important

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)

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)

Quantification of the right ventricular wall using stress myocardial emission computed tomography with thallium-201 in normal subjects

International Nuclear Information System (INIS)

Akanabe, Hiroshi; Oshima, Motoo; Sakuma, Sadayuki; Yamamoto, Shuhei; Kawai, Naoki; Sotobata, Iwao

1985-01-01

Although many studies of quantitative analysis of left ventricular myocardial wall (LVMW) have been reported using stress thallium-201 (Tl-201), few reports of right ventricular myocardial wall (RVMW) have been estimated. In this study we determined whether single photon emission computed tomography (SPECT) with Tl-201 could accurately define normal range of RVMW in normal subjects. Twelve persons who have no valvular disease, nor coronary artery disease were included in this study. Stress SPECT study was reconstructed to make a short axial images of ventricles. RVMW and LVMW were flagged by mamual. Each ventricle was divided into 36 parts at every 10 degree. Relative activity counts in each ventricle were calculated as a percent counts of maximum counts in left ventricle. The normal range of RVMW with stress SPECT was as follows: anterior wall (33.2 +- 11.4 %, mean +- 2 standard deviation, -62.7 +- 18.4 %), free wall (30.1 +- 12.4 % - 38.5 +- 8.8 %), inferior wall (40.4 +- 7.8 % - 60.0 +- 21.4 %), septal wall (65.2 +- 17.2 % - 71.1 +- 14.2 %). Above the results, SPECT with Tl-201 can accurately define the normal range of RVMW, and this method is usefull to quantify the degree of ischemia and hypertrophy in RVMW. (author)

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

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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.)

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

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

2005-01-01

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

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

International Nuclear Information System (INIS)

Wang Lijuan; Kaname Akioka; Hiroyuki Yamagishi

1999-01-01

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

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

Clinical use of /sup 201/Tl myocardial scintigraphy

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

1977-04-01

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

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

International Nuclear Information System (INIS)

Takeishi, Yasuchika; Chiba, Junya; Abe, Shinya

1992-01-01

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

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

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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).

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)

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

Energy Technology Data Exchange (ETDEWEB)

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

1976-12-01

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

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

International Nuclear Information System (INIS)

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

1984-01-01

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

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

Intravenous dipyridamole thallium-201 SPECT imaging in patients with left bundle branch block

International Nuclear Information System (INIS)

Rockett, J.F.; Wood, W.C.; Moinuddin, M.; Loveless, V.; Parrish, B.

1990-01-01

Tl-201 exercise imaging in patients with left bundle branch block (LBBB) has proven to be indeterminate for significant left anterior descending (LAD) coronary artery stenosis because of the presence of immediate septal perfusion defects with redistribution on delayed images in almost all cases. Tl-201 redistribution occurs regardless of the presence or absence of LAD stenosis. Nineteen patients having LBBB were evaluated with dipyridamole Tl-201 SPECT. Fourteen of these subjects had normal dipyridamole Tl-201 SPECT imaging. Three patients had normal coronary angiograms. None of the remaining 11 patients with normal dipyridamole Tl-201 SPECT images was found to have clinical coronary artery disease in a 5-11 month follow-up period. Five patients had abnormal septal perfusion. Four underwent coronary angiography. One had a significant LAD stenosis. The single patient with septal redistribution who refused to undergo coronary angiography died shortly thereafter of clinical coronary artery disease. This preliminary work suggests that dipyridamole Tl-201 SPECT may be more useful for excluding LAD stenosis in patients with LBBB than Tl-201 exercise imaging

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)

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

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

1990-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2003-07-01

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

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)

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

International Nuclear Information System (INIS)

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

1991-01-01

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

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

International Nuclear Information System (INIS)

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

2000-01-01

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

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.

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

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.)

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).

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)

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

International Nuclear Information System (INIS)

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

2006-01-01

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

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)

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

International Nuclear Information System (INIS)

Indo, Shunju

1992-01-01

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

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)

Clinical efficacy of 99mTc-tetrofosmin myocardial scintigraphy

International Nuclear Information System (INIS)

Adachi, Itaru; Sugioka, Yasushi; Tanaka, Yasunori

1993-01-01

99m Tc-tetrofosmin is a lipophilic, cationic diphosphine which has been developed for myocardial imaging. We examined 9 patients with ischemic heart disease including 3 angina pectoris (AP), 4 old myocardial infarction (OMI), 1 AP with OMI and 1 syndrome X. One patient was examined before and after operation. Three hundred seventy MBq of 99m Tc-tetrofosmin was injected during exercise and 740 MBq at rest. And 74 MBq of 201 Tl myocardial exercise and redistribution scintigraphy was also performed to compare with 99m Tc-tetrofosmin myocardial scintigraphy. SPECT, multiple gated SPECT and anterior planar images were obtained in all cases. We calculated percent wall thickening (%WT) using multiple gated SPECT images. There was a decreased lung uptake in 99m Tc-tetrofosmin planar images compared to 201 Tl myocardial scintigraphy. Liver and Biliary system uptake in 99m Tc-tetrofosmin images was decreased with intake of milk. Segmental comparison of SPECT images showed an agreement in 9/10 of the segment between 201 Tl and 99m Tc-tetrofosmin. We could obtain excellent quality of multiple gated SPECT images in all patients. We could calculate percent wall thickening (%WT) in all patients. We conclude that 99m Tc-tetrofosmin myocardial scintigraphy should provide usefulness for detection of ischemic myocardium as same as 201 Tl myocardial scintigraphy, although the biologic characteristics of two agents were different. These data and excellent quality of multiple gated SPECT images suggest that 99m Tc-tetrofosmin is a new 99m Tc agent for evaluation of patients with ischemic heart disease. (author)

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)

Quality control 201TlCl solution obtained at IPEN-CNEN/SP through the direct method of 201Tl preparation

International Nuclear Information System (INIS)

Fernandes, L.; Silva, C.P.G. da.

1991-09-01

The radiopharmaceutical 201 TlCl is used in Nuclear medicine for myocardial visualization. The solution of 201 TlCl was prepared using 201 Tl obtained by irradiating a natural mercury target with protons. This radionuclide was subjected to different quality control processes to verify the purity required for its use in Medicine. Some of these controls concerned the determination of 200 Tl, 201 Tl and 202 Tl; the chemical identification of 201 Tl +1 ; the hydrazine concentration, mercury contamination and the presence of phosphate. Furthermore, the biologic distribution in Wistar rats and tests for sterility, pyrogens and for toxicity were carried out. It was verified that the solution obtained was in the form of thallous chloride. This radiopharmaceutical can give a good heart image in animals but due to the contamination of 201 Tl with 200 Tl and 202 Tl its use in human beings is not possible unless enriched 202 Hg is used as target of irradiation. (author)

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

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

International Nuclear Information System (INIS)

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

1987-01-01

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

Radiation exposure around patients after 201Tl-myocardial scintigraphy

International Nuclear Information System (INIS)

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

1997-01-01

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

Thallium-201 myocardial imaging

International Nuclear Information System (INIS)

Wackers, F.J.Th.

1980-01-01

Three views are routinely obtained for 201 Tl scintigraphy: 0 0 anterior, 45 0 left-anterior-oblique, both views with the patient supine and a left-lateral view, with the patient lying on his right side. Following intravenous injection of 201 Tl, the scintiscans of a normal subject only demonstrate the left ventricle. In patients with normal myocardial perfusion, the left ventricle appears horseshoe or ovoid in shape. The central area of decreased activity represents the left ventricular cavity and is normal. The accumulation of 201 Tl in the normal left ventricle is usually homogeneous. However, some areas with apparent diminished uptake may occur in the normal subject. These variations of the normal image are discussed. The right ventricle, because of its smaller myocardial mass and relatively less 201 Tl accumulation per gram of tissue, is usually on a resting study not, or only faintly, visualized. However, following exercise, the right ventricle is clearly visualized. (Auth.)

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

International Nuclear Information System (INIS)

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

1995-01-01

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

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

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.

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)

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

International Nuclear Information System (INIS)

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

1985-01-01

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

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.)

Coronary spasm: 201Tl scintiscanning following pharmacological provocation

International Nuclear Information System (INIS)

Montz, R.; Mathey, D.; Bleifeld, W.; Hamburg Univ.

1981-01-01

According to the authors' experience so far, 201 Tl myocardial scintiscanning is a sufficiently sensitive non-invasive method for detection of coronary vasospasm provoked by ergotamine administration. Mild incomplete and asymptotic forms of coronary vasospasm were detected by scintiscanning. Indications for myocardial scintiscanning of ergotamine-provoked vasospasm are: Cases of angina pectoris at rest in which electrocardiograms during spasm are not available; elleviated symptoms after nitroglycerine administration; exercise electrocardiograms without any sign of ischaemia; negative results of exercise 201 Tl myocardial scintiscanning. (orig.) [de

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

International Nuclear Information System (INIS)

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

2004-01-01

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

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

International Nuclear Information System (INIS)

Tang Anwu; Qiao Shuixian; Luo Yaowu; Liang Xiaolin

2002-01-01

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

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

International Nuclear Information System (INIS)

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

1985-01-01

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

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

International Nuclear Information System (INIS)

Suzuki, Aya

2003-01-01

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

Diagnostic accuracy of 201thallium-SPECT and 18F-FDG-PET in the clinical assessment of glioma recurrence

International Nuclear Information System (INIS)

Gomez-Rio, Manuel; Rodriguez-Fernandez, Antonio; Ramos-Font, Carlos; Lopez-Ramirez, Escarlata; Llamas-Elvira, Jose M.

2008-01-01

Reliable differential diagnosis between tumour recurrence and treatment-induced lesions is required to take advantage of new therapeutic approaches to recurrent gliomas. Structural imaging methods offer a high sensitivity but a low specificity, which might be improved by neurofunctional imaging. This study aimed to test the hypothesis that incorporation of 18-fluoro-deoxy-glucose positron emission tomography (FDG-PET) increases the accuracy of this differential diagnosis obtained with 201 Tl chloride-single-photon emission computed tomography ( 201 Tl-SPECT). Seventy-six patients (mean age 47.72 ± 16.19 years) under suspicion of glioma recurrence, 42% with low-grade and 58% with high-grade lesions, were studied by 201 Tl-SPECT and FDG-PET, reporting results under blinded conditions using visual analysis. Tumour was confirmed by histological confirmation (23 patients) or clinical and structural neuroimaging follow-up (mean of 2.6 years). This population had a high disease prevalence (72%). Globally, highest sensitivity was obtained using 201 Tl-SPECT assessed with MRI (96%) and highest specificity using FDG-PET + MRI (95%). FDG-PET appeared slightly better for confirming tumour recurrence, whereas 201 Tl-SPECT was superior for ruling out possible recurrence (disease present in 38% of FDG-PET negative explorations). In the high-grade subgroup, there were no false-positive examinations (specificity: 100%), but sensitivity differed among techniques ( 201 Tl-SPECT: 94%; 201 Tl-SPECT + MRI: 97%; FDG-PET + MRI: 83%). In the low-grade subgroup, 201 Tl-SPECT+ MRI showed highest sensitivity (95%) and lowest posttest negative probability (9%); FDG-PET + MRI offered highest specificity (92%) with a posttest negative probability of 35%. FDG-PET does not clearly improve the diagnostic accuracy of 201 Tl-SPECT, which appears to be a more appropriate examination for the diagnosis of possible brain tumour recurrence, especially for ruling it out. (orig.)

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)

Quality control of the solution sup(201)TlCl obtained at IPEN-CNEN/SP by sup(201)Tl direct preparation

International Nuclear Information System (INIS)

Fernandes, L.; Silva, C.P.G. da

1991-01-01

The radiopharmaceutical sup(201) TlCl is used in Nuclear Medicine for myocardial visualization. The solution of sup(201)TlCl was prepared using sup(201)Tl obtained by irradiating a natural mercury target with protons. This radionuclide was subjected to different quality control processes to verify the purity required for its use in Medicine. Some of these controls concerned the determination of sup(200)Tl, sup(201)Tl and sup(202)Tl; the chemical identification of sup(201)Tl sup(+1); the hydrazine concentration, mercury contamination and the presence of phosphate. Furthermore, the biologic distribution in Wistar rats and tests for sterility pyrogens and for toxicity were carried out. It was verified that the solution obtained was in the form of tallous chloride. This radiopharmaceutical can give a good heart image in animals but due to the contamination of sup(201)Tl with sup(200)Tl and sup(202)Tl its use in human beings is not possible unless enriched sup(202)Hg is used as target of irradiation. (author)

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

International Nuclear Information System (INIS)

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

2001-01-01

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

The usefulness of [sup 201]TlCl scintigraphy for the diagnosis of breast tumor

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Tamami; Moriya, Etsuo; Miyamoto, Yukio; Kawakami, Kenji; Kubo, Hirotaka; Uchida, Takeshi [Jikei Univ., Tokyo (Japan). School of Medicine

1994-06-01

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

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)

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)

The quantitative evaluation of 201Tl myocardial scintigraphy using reinjection method

International Nuclear Information System (INIS)

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

1993-01-01

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

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

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)

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

International Nuclear Information System (INIS)

Matsutomo, Norikazu; Nagaki, Akio; Sasaki, Masayuki

2014-01-01

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

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

International Nuclear Information System (INIS)

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

2001-01-01

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

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

Science.gov (United States)

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

1994-01-01

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

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

International Nuclear Information System (INIS)

Watanabe, Shigeyuki; Ajisaka, Ryuichi; Masuoka, Takeshi

1990-01-01

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

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

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.

Brain scintigraphy (SPECT) using 201thallium in patients with primary tumors of the brain

International Nuclear Information System (INIS)

Barzen, G.; Schubert, C.; Richter, W.; Calder, D.; Eichstaedt, H.; Felix, R.; Baerwald, M.

1992-01-01

We evaluated the role of thallium 201 Single-Photon-Emission-Computed-Tomography (SPECT) in diagnosis, differential diagnosis and follow-up of 33 patients with primary brain tumors. 27 of 33 lesions were detectable by Tl-201-SPECT because only two of eight low-grade (grade 1 and 2) astrocytomas showed Tl-201 accumulation up to a tumor to nontumor ratio of 2.6. High grade (grade 3 and 4) astrocytomas showed Tl-201 accumulation in the range of 2.2 up to 13.0 and were different from low-grade astrocytomas. Noninvasive grading of astrocytomas is therefore possible, whereas differential diagnosis of oligodendrogliomas and astrocytomas or meningeomas was not possible with Tl-201. In the follow-up of six patients, we could demonstrate, that tumor progression is correlated with increasing and tumor regression with decreasing Tl-201 accumulations. This functional changings proceed morphological findings in CT. But vanishing of Tl-201 accumulation during therapy does not mean vanishing of tumor as could be demonstrated by follow-up. (orig.) [de

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-02-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2001-09-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1982-06-01

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

Evaluation of 201Tl stress-redistribution imaging for the detection of myocardial ischemia and assessment of its therapeutic effect (40 cases attached)

International Nuclear Information System (INIS)

Lin Jinghui

1989-01-01

The characteristics of 201 Tl stress-redistribution imagings of 21 normal controls and 19 myocardial ischemia were reported. Normal variability of myocardial images and its influencing factors were discussed as well. All of 40 cases were also undergoing coronary arteriography (CAG), and exercise ECG. Taken the stenosis of coronary artery > 50% by CAG as the criterion of diagnosis of CHD, the sensitivity and specificity of 201 Tl image were 94.7% and 100%, while as exercise ECG were 66.6% and 80.9% respectively. 2 patients with bypass surgery and 6 patients with PTCA were examined pre- and postoperatively by 201 Tl images. The results indicated that this technique was noninvasive and reliable also for the assessment of their therapeutic effect and follow up studies

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

Differential diagnosis in patients with ring-like thallium-201 uptake in brain SPECT

International Nuclear Information System (INIS)

Kinuya, Keiko; Ohashi, Masahiro; Itoh, Syotaro

2002-01-01

This study was performed to investigate lesions with ring-like thallium-201 ( 201 Tl) uptake and to determine whether SPECT provides any information in differential diagnosis. A total of 244 201 Tl SPECT images were reviewed. In each study, early (15 min postinjection) and late (3 hr) brain SPECT images were obtained with 111 MBq of 201 Tl. The early uptake ratio (ER; lesion to normal brain average count ratio) and the late uptake ratio (LR) and the L/E ratio (ratio of LR to ER) were calculated. Ring-like uptake was observed in pre-therapeutic 26 SPECT images, including ten glioblastoma multiformes (ER, 3.45±0.64; LR, 2.74±0.54; L/E ratio 0.80±0.13), five meningiomas (6.48±2.34; 4.41±1.41; 0.72±0.19), four metastatic lung cancers (3.47±1.23; 2.40±0.98; 0.70±0.14), four brain abscesses (2.48±1.06; 1.59±0.30; 0.78±0.15), one invasive lesion of squamous cell carcinoma from the ethmoid sinus (1.54; 1.52; 0.99), one medulloblastoma (3.53; 3.52; 1.00) and one hematoma (3.32; 2.36; 0.71). The ER of meningioma was significantly higher than those of glioblastoma multiforme (p 201 Tl SPECT has still difficulty in differentiating abscess from brain tumor. (author)

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

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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).

Effect of maintenance oral theophylline on dipyridamole-thallium-201 myocardial imaging using SPECT and dipyridamole-induced hemodynamic changes

International Nuclear Information System (INIS)

Daley, P.J.; Mahn, T.H.; Zielonka, J.S.; Krubsack, A.J.; Akhtar, R.; Bamrah, V.S.

1988-01-01

To evaluate the effect of maintenance oral theophylline therapy on the diagnostic efficacy of dipyridamole-thallium-201 single photon emission computed tomography (SPECT) imaging for coronary artery disease, dipyridamole-thallium-201 SPECT imaging was performed in eight men with documented coronary artery disease before initiation of theophylline treatment and repeated while these patients were receiving therapeutic doses of oral theophylline. Before theophylline treatment, intravenous dipyridamole caused a significant increase in heart rate, decrease in blood pressure, angina in seven of eight patients, and ST segment depression in four of eight patients. While they were being treated with theophylline, none of the patients had angina or ST segment depression, and there were no hemodynamic changes with intravenous dipyridamole. Before theophylline treatment, dipyridamole-thallium-201 SPECT imaging showed reversible perfusion defects in myocardial segments supplied by stenotic coronary arteries. With theophylline treatment, dipyridamole-thallium-201 SPECT showed total absence of reversible perfusion defects. Treatment with theophylline markedly reduced the diagnostic accuracy of dipyridamole-thallium-201 imaging for coronary artery disease

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

International Nuclear Information System (INIS)

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

1998-01-01

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

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

Myocardial imaging by direct injection of thallium-201 into coronary artery

International Nuclear Information System (INIS)

Sugihara, Hiroki; Inagaki, Suetsugu; Kubota, Yasushi

1988-01-01

Myocardial perfusion images were evaluated by direct injection of Thallium (Tl)-201 into coronary artery. Approximately 0.5 - 1 mCi of Tl-201 were instilled into the right coronary artery and/or the left coronary artery after coronary arteriography. Three images were obtained in the anterior, left anterior oblique and left lateral projections. Myocardial perfusion images of single photon emission computed tomography were also acquired in some patients. An image of supreme quality could be obtained in spite of small dose of Tl-201 since there was a lack of interference from background activity. Myocardial perfusion images corresponded to areas which were supplied by left or right coronary artery respectively. And the regional myocardial blood flow distribution of a coronary artery bypass graft could be revealed by instilling Tl-201 into the graft. Further, contribution of collateral channels to myocardial perfusion was showed. Not only left ventricle but also right ventricle was clearly visualized by injection of Tl-201 into right coronary artery. But in a case with arrhythmogenic right ventricular dysplasia, there was an area of decreased tracer uptake in the apex of the right ventricle which was identified as the site of dysplasia by electrophysiologic study. We conclude that direct injection of Tl-201 into coronary artery is an useful method to clarify the correlation between coronary anatomical findings and coronary perfusion and contribution of collaterals to myocardial perfusion, and also to detect the right ventricular myopathic site. (author)

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

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.)

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

International Nuclear Information System (INIS)

Nagai, Teruo; Murata, Kazuhiko; Torizuka, Kanji

1982-01-01

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

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

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

International Nuclear Information System (INIS)

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

1982-01-01

To determine the prevalence and clinical significance of increased lung 201 Tl uptake during submaximal exercise myocardial scintigraphy performed 2 weeks after acute myocardial infarction, 61 patients underwent submaximal exercise testing (target heart rate, 120 beats/min), multigated blood pool imaging at rest and coronary angiography before hospital discharge. Thallium lung uptake on the initial anterior projection image was graded qualitatively by comparing the intensity of 201 Tl activity in the lungs with that in the mediastinum. In 39 patients (64 percent), it was normal (equal to mediastinal activity) and in 22 (36 percent), it was increased (greater than mediastinal activity). Compared with patients with normal lung uptake, those with increased uptake had a greater prevalence of prior infarction (13 versus 36 percent, probability [p] less than 0.05), less global cardiac reserve as assessed by the four level New York Heart Association classification (p less than 0.05), more advanced Killip class in the coronary care unit (p less than 0.05), a higher Norris coronary prognostic index (2.6 +/- 1.9 versus 4.6 +/- 2.3 [mean +/- standard deviation], p less than 0.01), failure to achieve the target heart rate because of dyspnea, fatigue or angina (36 versus 86 percent, p less than 0.01), a greater prevalence of exercise-induced S-T segment depression (18 versus 45 percent, p less than 0.05), a greater number of anterior 201 Tl myocardial defects (p less than 0.05); a lower radionuclide ejection fraction at rest (50.4 +/- 6.1 versus 39.6 +/- 9.3 percent, p less than 0.01) and a greater number of asynergic left ventricular segments (p less than 0.05). Thus, the occurrence of increased lung 201 Tl uptake during submaximal exercise scintigraphy in the early postinfarction period is frequent and appears to be a marker of severe and functionally more important coronary artery disease associated with left ventricular dysfunction

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

Quantitative analysis of thallium-201 myocardial scintigraphy

International Nuclear Information System (INIS)

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

1981-01-01

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

Preclinical pharmacological study of 99mTcN(NOET)2 and comparison with 201Tl in redistribution of ischemia myocardium

International Nuclear Information System (INIS)

Wang, J.C.; Zhang, J.B.; Wang, Q.; Mi, H.Z.; Wang, X.B.

2002-01-01

Aim: To study the biological properties of the myocardial imaging agent 99m TcN(NOET) 2 and compare with 201 Tl in redistribution of ischemia myocardium. Materials and Methods: To prepared the 99m TcN(NOET) 2 complex, the intermediate [ 99m TcN] 2+ and ligand NOET were synthesized. In the presence of reducer and the doner of N, the [ 99m Tc=N] 2+ could be synthesized at 100, then NOET was added, 99m TcN(NOET) 2 was formed at room temperature. 201 Tl was provided by the Department of Isotope, China Institute of Atomic Energy. Five dogs were from the Fu Wai experimental animal feeding center, two of them were made into ischemia myocardium models by ligating some coronary artery branches were demonstrated by X-ray coronary angiography, the extent of stenosis of those blood vessels was over 90%. Dynamic imaging of rest was performed respectively in three normal dogs after injecting a dose of 555MBq (15mCi) of 99m TcN(NOET) 2 complex up to two hours. The whole body imaging planar and tomography imaging was carried out respectively at fixed time intervals during two hours in order to obtain the time-activity curves of heart, lung and liver, in vivo biodistribution and quality analysis of myocardial images. Moreover, intravenous blood samples were collected at different times to gain the kinetics of blood clearance. Stress and redistribution imaging underwent in two dogs with ischemia myocardium. Dipyridamol was given intravenously at a dose of 0.6mg/Kg in 4 mins. Stress :9 9m TcN(NOET) 2 myocardial SPECT imaging was performed at 30, 70 and 110 min after injection of 99m TcN(NOET) 2 complex, stress 201 Tl myocardial SPECT imaging was carried out 10 min and redistribution imaging 4 hr after injection of 55.5MBq (1.5mCi) 201 Tl chloride. The tests of 99m TcN(NOET) 2 and 201 Tl were performed respectively in the same dog within 10 days, in order to obtain a comparison between two myocardial redistribution imaging. Results: Radiochemical purity of 99m TcN(NOET) 2 was 98.41%�

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

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

Sex-specific criteria for interpretation of thallium-201 myocardial uptake and washout studies

International Nuclear Information System (INIS)

Rabinovitch, M.; Suissa, S.; Elstein, J.

1986-01-01

A study was undertaken to determine the effect of gender on criteria for the quantitative analysis of exercise-redistribution 201 Tl myocardial scintigraphy. The studies of 26 normal females and 23 normal males were subjected to bilinear interpolative background subtraction and horizontal profile analysis. Significant sexual differences were found in both regional uptake ratios and washout rates. These differences primarily reflected a proportionately decreased anterior and upper septal uptake in females, and faster washout in females. Faster myocardial 201 Tl washout rates in females could not be clearly ascribed to either a physiological or artifactual explanation. It is concluded that since important differences exist between males and females in the detected pattern of 201 Tl myocardial uptake and washout, sex-specific criteria may enhance the predictive accuracy of exercise-redistribution 201 Tl myocardial scintigraphy

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

Science.gov (United States)

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

1992-01-01

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

Myocardial uptake of thallium-201 augmented with bicarbonate: concise communication

International Nuclear Information System (INIS)

Hetzel, K.R.; Westerman, B.R.; Quinn, J.L. III; Meyers, S.; Barresi, V.

1977-01-01

Sodium bicarbonate was used to enhance the myocardial concentration of Tl-201 in rabbits and dogs. Organ distribution studies in rabbits and in vivo imaging in dogs showed a 1.5 to 2-fold increase in myocardial Tl-201 concentration in bicarbonate-treated animals as compared with matched controls. Image improvement was noted, with threefold enhancement of myocardium-to-liver ratios. The results suggest that a similar improvement may be possible for clinical myocardial imaging

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

Mechanisms of thallium-201 myocardial accumulation

International Nuclear Information System (INIS)

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

1980-01-01

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

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

International Nuclear Information System (INIS)

Nagai, Teruo; Murata, Kazuhiko; Torizuka, Kanji

1982-01-01

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

A clinical study of thallium-201 SPECT in the diagnostic imaging of oral squamous cell carcinomas

International Nuclear Information System (INIS)

Satoh, Hitoshi

2003-01-01

Recently the usefulness of thallium 201 chloride (201Tl) as a tumor imaging agent for various tumors has been reported. However, the application of 201Tl SPECT to oral squamous cell carcinomas has not been established. The purpose of this study is to investigate the usefulness of 201Tl SPECT in the assessment of malignancy or in the differential diagnosis of oral squamous cell carcinomas from inflammatory diseases. Thirty-two patients with 33 primary oral squamous cell carcinomas and 4 patients with inflammatory disease were studied. SPECT images were acquired 15 minutes (early image) and 3 hours (delayed image) after the intravenous injection with 74 MBq 201Tl, and then early uptake ratio (ER), delayed uptake ratio (DR), and retention index (RI) were measured. The relations between these parameters and the size, the site, the degree of differentiation and the mode of invasion of the primary tumor were analyzed statistically. 201Tl SPECT correctly identified 32 of the 33 tumors, with 32 patients having oral squamous cell carcinoma, making the positive rate 97%. Significant negative correlation was observed between RI and major or minor axis of tumors; therefore, this study revealed that RI was influenced by the size of a tumor. In comparison with the average value of RI according to histopathological diagnosis, there was statistically significant difference (p=0.011) between carcinomas (0.80±0.16, n=30) and inflammatory diseases (0.58±0.04, n=4); thus, it was supposed that differential diagnosis between them could be possible. About the tumors with the range of minor-axis 20 mm-40 mm for little influence of tumor size to the RI, the tendency to decrease for the RI of well-differentiated group or low-invasive group was seen. For oral squamous cell carcinomas, 201Tl SPECT had a high positive rate. The application was suggested for use in the differential diagnosis between inflammatory disease and carcinomas, where clinical usefulness could be expected. (author)

Combined thallium-201 and dynamic iodine-123 iodophenylpentadecanoic acid single-photon emission computed tomography in patients after acute myocardial infarction with effective reperfusion.

Science.gov (United States)

Richter, W S; Beckmann, S; Cordes, M; Schuppenhauer, T; Schartl, M; Munz, D L

2000-12-01

Considerable derangements of energy metabolism are to be expected during ischemia and reperfusion. In ischemic myocardium, the oxidative degradation of carbohydrates is shifted toward the anaerobic production of lactate and the oxidation of fatty acids is suppressed. The aim of this study was to examine the uptake and metabolism of iodine-123 (123I) iodophenylpentadecanoic acid (IPPA) in stunned myocardium. In 15 patients, SPECT with 201Tl and 123I IPPA as well as echocardiography with low-dose dobutamine stimulation were performed 12 +/- 5 days after myocardial infarction with reperfusion. Follow-up echocardiography was carried out 24 +/- 8 days later for documentation of functional improvement. Uptake of 201Tl and 123I IPPA were obtained in five left ventricular segments, and dynamic SPECT imaging was used for calculation of the fast and the slow components of the biexponential myocardial 123I IPPA clearance. Wall motion improved in 14 of 26 dysfunctional segments (54%). Stunned segments were characterized by a reduced 123I IPPA extraction, a shorter half-life of the fast, and a longer half-life of the slow clearance component. All parameters of the combined 201Tl/123I IPPA study predicted functional recovery with similar accuracies (area under the receiver operator characteristic curves between 0.68 and 0.76; p = NS). Analysis of 201Tl uptake alone could not predict functional recovery in this study. Stunned myocardium is characterized by a disturbance of fatty acid metabolism. For prediction of functional improvement, 123I IPPA imaging added significant diagnostic information.

Present assessment of myocardial viability by nuclear imaging.

Science.gov (United States)

Saha, G B; MacIntyre, W J; Brunken, R C; Go, R T; Raja, S; Wong, C O; Chen, E Q

1996-10-01

Prospective delineation of viable from nonviable myocardium in patients with coronary artery disease in an important factor in deciding whether a patient should be revascularized or treated medically. Two common techniques--single-photon emission computed tomography (SPECT) and positron-emission computed tomography (PET)--are used in nuclear medicine using various radiopharmaceuticals for the detection of myocardial viability in patients. Thallium-201 (201Tl) and technetium-99m (99mTc)-sestamibi are the common radiopharmaceuticals used in different protocols using SPECT, whereas fluoride-18 (18F)-fluorodeoxyglucose (FDG) and rubidium-82 (82Rb) are most widely used in PET. The SPECT protocols involve stress/redistribution, stress/redistribution/reinjection, and rest/redistribution imaging techniques. Many studies have compared the results of 201Tl and (99mTc)-sestamibi SPECT with those of FDG PET; in some studies, concordant results have been found between delayed thallium and FDG results, indicating that 201Tl, although considered a perfusion agent, shows myocardial viability. Discordant results in a number of studies have been found between sestamibi and FDG, suggesting that the efficacy of sestamibi as a viability marker has yet to be established. Radiolabeled fatty acids such as iodine-123 (123I)-para-iodophenylpentadecanoic acid and carbon-11 (11C)-palmitic acid have been used for the assessment of myocardial viability with limited success. 11C-labeled acetate is a good marker of oxidative metabolism in the heart and has been used to predict the reversibility of wall motion abnormalities. (18F)-FDG is considered the marker of choice for myocardial viability, although variable results are obtained under different physiological conditions. Detection of myocardial viability can be greatly improved by developing new equipment and radiopharmaceuticals of better quality.

When is 201Tl myocardial scintigraphy indicated?

International Nuclear Information System (INIS)

Klepzig, H. Jr.; Kaltenbach, M.

1987-01-01

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

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.

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

International Nuclear Information System (INIS)

Nakajima, Kenichi; Kumita, Shinichiro; Ishida, Yoshio

2007-01-01

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

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

International Nuclear Information System (INIS)

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

1978-01-01

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

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)

Quantitative Analysis of Thallium-201 Myocardial Tomograms

International Nuclear Information System (INIS)

Kim, Sang Eun; Nam, Gi Byung; Choi, Chang Woon

1991-01-01

The purpose of this study was to assess the ability of quantitative Tl-201 tomography to identify and localize coronary artery disease (CAD). The study population consisted of 41 patients (31 males, 10 females; mean age 55 ± 7 yr) including 14 with prior myocardial infarction who underwent both exercise Tl-201 myocardium SPECT and coronary angiography for the evaluation of chest pain. From the short axis and vertical long axis tomograms, stress extent polar maps were generated by Cedars-Sinai Medical Center program, and the 9 stress defect extent (SDE) was quantified for each coronary artery territory. For the purpose of this study, the coronary circulation was divided into 6 arterial segments, and the myocardial ischemic score (MIS) was calculated from the coronary angiogram. Sensitivity for the detection of CAD (>50% coronary stenosis by angiography) by stress extent polar map was 95% in single vessel disease, and 100% in double and triple vessel diseases. Overall sensitivity was 97%<. Sensitivity and specificity for the detection of individual diseased vessels were, respectively, 87% and 90% for the left anterior descending artery (LAD), 36% and 93% for the left circumflex artery (LCX), and 71% and 70%, for the right coronary artery (RCA). Concordance for the detection of individual diseased vessels between the coronary angiography and stress polar map was fair for the LAD (kappa=0.70), and RCA (kappa=0.41) lesions, whereas it was poor for the LCK lesions (kappa =0.32) There were significant correlations between the MIS and SDE in LAD (rs=0. 56, p=0.0027), and RCA territory (rs=0.60, p=0.0094). No significant correlation was found in LCX territory. When total vascular territories were combined, there was a significant correlation between the MIS and SDE (rs=0.42, p=0,0116). In conclusion, the quantitative analysis of Tl-201 tomograms appears to be accurate for determining the presence and location of CAD.

Evaluation of myocardial function with the 201 Thallium scintimetry in various diseases of the heart. A correlative study based on 100 patients

Energy Technology Data Exchange (ETDEWEB)

Buell, U; Niendorf, H P; Strauer, B E; Hast, B

1976-08-12

To assess the validity of the quantitative /sup 201/Tl scintimetry in various diseases of the heart (coronary heart disease with and without myocardial infarction, non-coronary cardiomyopathy, scleroderma heart disease and asymmetric septal hypertrophy with IHSS), the /sup 201/Tl myocardial uptake values for five standardized projections (a) were correlated with the grade of LAD stenosis, (b) the pattern of myocardial wall motion and (c) were compared with the /sup 201/Tl uptake values derived from normal patients. Significant reduction (c) of /sup 201/Tl myocardial uptake could in individual cases be evaluated in acute myocardial infarction (95%), in dys- and akinesia (90%), in hypokinesia (71%), in scleroderma heart disease (50%), in non-coronary cardiomyopathy (50%) as well as in normokinesia (28%) when associated with LAD stenosis. The mean values (b) of /sup 201/Tl uptake in normo- and hypokinesia significantly differed between these two groups and from those evaluated in dys- and akinesia. The latter group showed the lowest /sup 201/Tl uptake values computed which in some cases were very close to the mean mediastinal /sup 201/Tl uptake. The correlation (a) of individual /sup 201/Tl values demonstrated that /sup 201/Tl distribution in the myocardium is not only equivalent to myocardial ''perfusion'' but is corresponding with the myocardial function. In non-coronary cardiomyopathy reduced /sup 201/Tl values sometimes could not be separated from values in coronary heart disease (and myocardial infarction). A regional increase of myocardial mass as in septal hypertrophy correlated well with an augmented /sup 201/Tl uptake when referred to the /sup 201/Tl storage in the mediastinum.

Evaluation of myocardial function with the 201 Thallium scintimetry in various diseases of the heart. A correlative study based on 100 patients

Energy Technology Data Exchange (ETDEWEB)

Buell, U.; Niendorf, H.P.; Strauer, B.E.; Hast, B.

1976-08-12

To assess the validity of the quantitative /sup 201/Tl scintimetry in various diseases of the heart (coronary heart disease with and without myocardial infarction, non-coronary cardiomyopathy, scleroderma heart disease and asymmetric septal hypertrophy with IHSS), the /sup 201/Tl myocardial uptake values for five standardized projections (a) were correlated with the grade of LAD stenosis, (b) the pattern of myocardial wall motion and (c) were compared with the /sup 201/Tl uptake values derived from normal patients. Significant reduction (c) of /sup 201/Tl myocardial uptake could in individual cases be evaluated in acute myocardial infarction (95%), in dys- and akinesia (90%), in hypokinesia (71%), in scleroderma heart disease (50%), in non-coronary cardiomyopathy (50%) as well as in normokinesia (28%) when associated with LAD stenosis. The mean values (b) of /sup 201/Tl uptake in normo- and hypokinesia significantly differed between these two groups and from those evaluated in dys- and akinesia. The latter group showed the lowest /sup 201/Tl uptake values computed which in some cases were very close to the mean mediastinal /sup 201/Tl uptake. The correlation (a) of individual /sup 201/Tl values demonstrated that /sup 201/Tl distribution in the myocardium is not only equivalent to myocardial ''perfusion'' but is corresponding with the myocardial function. In non-coronary cardiomyopathy reduced /sup 201/Tl values sometimes could not be separated from values in coronary heart disease (and myocardial infarction). A regional increase of myocardial mass as in septal hypertrophy correlated well with an augmented /sup 201/Tl uptake when referred to the /sup 201/Tl storage in the mediastinum.

Fatty acid metabolism in symptomatic patients with mitral valve prolapse but without coronary artery disease - comparison with 201Tl myocardial perfusion scintigraphy

International Nuclear Information System (INIS)

Voth, E.; Schicha, H.; Neumann, P.; Emrich, D.; Tebbe, U.

1987-01-01

Using 123 I-ω-heptadecanoic acid (HDA) and 201 Tl, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination half-life was 26.1±3.6 min, whereas the patients with MVP had a mean value of 25.0±6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31% and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using 201 Tl showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by 201 Tl, presumably due to ischemia based on small-vessel disease or abnormalities of cellular metabolism. (orig.) [de

Evaluation of suspected malignant pulmonary lesions with 201Tl single photon emission computed tomography

International Nuclear Information System (INIS)

Tonami, N.; Yokoyama, K.; Shuke, N.

1993-01-01

201 Tl single photo emission computed tomography (SPECT) was evaluated in 170 patients suspected of having a malignant pulmonary lesion greater than 20 mm in diameter on the surgical specimen. Delayed SPECT visualized all of the 147 malignant pulmonary lesions and 16 of the 23 benign pulmonary lesions, and generally exhibited the lesion more clearly than the early SPECT images. There was no significant difference in delayed ratio (uptake ratio of the lesion to the normal lung on delayed scan) among the various histological groups except between the adenocarcinoma and large cell carcinoma groups, and no difference was noted between the malignant and benign lesions. However, in retention index (degree of retention in the lesion) a significant difference was noted between the malignant and benign lesions, although there was no significant difference in this index among malignant different histology groups. These results indicate that this method is useful for visualizing malignant pulmonary lesions greater than 20 mm in diameter to exclude the possibility of malignancy in the lesions when no abnormal 201 Tl accumulation is observed. When the lesion shows abnormal 201 Tl accumulation, the retention index seems to help differentiate malignant from benign lesions. (author)

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

Two dimensional polar display of cardiac blood pool SPECT

International Nuclear Information System (INIS)

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

1989-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1996-03-01

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

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

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

1992-01-01

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

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

International Nuclear Information System (INIS)

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

1989-01-01

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

ECG-gated myocardial imaging with 201Tl

International Nuclear Information System (INIS)

Baehre, M.

1980-01-01

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

Differential diagnosis in patients with ring-like thallium-201 uptake in brain SPECT

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Kinuya, Keiko; Ohashi, Masahiro; Itoh, Syotaro [Tonami General Hospital, Toyama (Japan)] (and others)

2002-09-01

This study was performed to investigate lesions with ring-like thallium-201 ({sup 201}Tl) uptake and to determine whether SPECT provides any information in differential diagnosis. A total of 244 {sup 201}Tl SPECT images were reviewed. In each study, early (15 min postinjection) and late (3 hr) brain SPECT images were obtained with 111 MBq of {sup 201}Tl. The early uptake ratio (ER; lesion to normal brain average count ratio) and the late uptake ratio (LR) and the L/E ratio (ratio of LR to ER) were calculated. Ring-like uptake was observed in pre-therapeutic 26 SPECT images, including ten glioblastoma multiformes (ER, 3.45{+-}0.64; LR, 2.74{+-}0.54; L/E ratio 0.80{+-}0.13), five meningiomas (6.48{+-}2.34; 4.41{+-}1.41; 0.72{+-}0.19), four metastatic lung cancers (3.47{+-}1.23; 2.40{+-}0.98; 0.70{+-}0.14), four brain abscesses (2.48{+-}1.06; 1.59{+-}0.30; 0.78{+-}0.15), one invasive lesion of squamous cell carcinoma from the ethmoid sinus (1.54; 1.52; 0.99), one medulloblastoma (3.53; 3.52; 1.00) and one hematoma (3.32; 2.36; 0.71). The ER of meningioma was significantly higher than those of glioblastoma multiforme (p<0.0005), metastatic lung cancer (p<0.005) and brain abscess (p<0.0005). There were no significant differences among these three entities. The LR of meningioma was significantly higher than those of glioblastoma multiforme (p<0.005), metastatic lung cancer (p<0.005) and brain abscess (p<0.0001). The LR of brain abscess was significantly lower than that of glioblastoma multiforme (p<0.05). The L/E ratio could not differentiate these four entities. High ER and high LR in a lesion with ring-like uptake is likely an indicator of meningioma. The LR of brain abscess was significantly lower than that of glioblastoma multiforme, but {sup 201}Tl SPECT has still difficulty in differentiating abscess from brain tumor. (author)

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)

Behaviors of cost functions in image registration between 201Tl brain tumor single-photon emission computed tomography and magnetic resonance images

International Nuclear Information System (INIS)

Soma, Tsutomu; Takaki, Akihiro; Teraoka, Satomi; Ishikawa, Yasushi; Murase, Kenya; Koizumi, Kiyoshi

2008-01-01

We studied the behaviors of cost functions in the registration of thallium-201 ( 201 Tl) brain tumor single-photon emission computed tomography (SPECT) and magnetic resonance (MR) images, as the similarity index of image positioning. A marker for image registration [technetium-99m ( 99m Tc) point source] was attached at three sites on the heads of 13 patients with brain tumor, from whom 42 sets of 99m Tc- 201 Tl SPECT (the dual-isotope acquisition) and MR images were obtained. The 201 Tl SPECT and MR images were manually registered according to the markers. From the positions where the two images were registered, the position of the 201 Tl SPECT was moved to examine the behaviors of the three cost functions, i.e., ratio image uniformity (RIU), mutual information (MI), and normalized MI (NMI). The cost functions MI and NMI reached the maximum at positions adjacent to those where the SPECT and MR images were manually registered. As for the accuracy of image registration in terms of the cost functions MI and NMI, on average, the images were accurately registered within 3 deg of rotation around the X-, Y-, and Z-axes, and within 1.5 mm (within 2 pixels), 3 mm (within 3 pixels), and 4 mm (within 1 slice) of translation to the X-, Y-, and Z-axes, respectively. In terms of rotation around the Z-axis, the cost function RIU reached the minimum at positions where the manual registration of the two images was substantially inadequate. The MI and NMI were suitable cost functions in the registration of 201 Tl SPECT and MR images. The behavior of the RIU, in contrast, was unstable, being unsuitable as an index of image registration. (author)

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

International Nuclear Information System (INIS)

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

1986-01-01

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

Simultaneous /sup 201/Tl//sup 99m/Tc seven-pinhole tomography in acute myocardial infarction

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Krause, T; Schuemichen, C; Fischer, R; Strauss, E; Hoffmann, G

1986-06-01

Combined infarction scintigraphy with /sup 201/Tl-chloride and /sup 99m/Tc-pyrophosphate (PPi) by simultaneous seven-pinhole tomography was investigated with a phantom as well as in patients. No artificial defects occurred when the collimator was centered correctly in axial position, but a very high standard of image uniformity and linearity of the gamma camera was required. Artefacts by overlying activity from the skeleton or cardiac blood pool were not observed. All 11 controls showed normal results. Despite a poor depth resolution due to limitations of the system even small areas of partially damaged myocardium could be recognized and correlated three-dimensionally. Of 24 patients with proven myocardial infarction, in 16 both a positive (/sup 99m/Tc-PPi) and a negative (/sup 201/Tl) image was obtained in congruence with the necrosis. 8 patients (33%) showed discordant results providing however additional information on the nature and extent of the necrosis. 4 out of 6 non-transmural infarctions seen by tomography had been suspected clinically.

Effects of dipyridamole-induced vasodilation on myocardial uptake and clearance kinetics of thallium-201

International Nuclear Information System (INIS)

Beller, G.A.; Holzgrefe, H.H.; Watson, D.D.

1983-01-01

Myocardial thallium-201 (201Tl) uptake and clearance after intravenous administration of dipyridamole (150 micrograms/kg) were determined in 12 open-chest anesthetized dogs with a partial coronary artery stenosis. 201Tl (1.5 mCi) was injected intravenously and myocardial biopsy specimens were obtained 10 min, 60 min, and 2 hr after injection. Serial changes in 201Tl activity in the normal zone and in the zone of partial stenosis were correlated with microsphere-determined regional blood flow and distal coronary pressure. Another nine dogs with equivalent stenosis not given dipyridamole before 201Tl served as controls. Data indicate that dipyridamole-induced vasodilation in the presence of a partial stenosis results in diminished uptake and delayed clearance compared with increased uptake and more rapid clearance in normally perfused myocardium producing an initial 201Tl defect with delayed redistribution

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

International Nuclear Information System (INIS)

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

2007-01-01

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

201Tl-redistribution analysis in early and delayed myocordial scintigrams of patients with coronary heart disease (CHD)

International Nuclear Information System (INIS)

Hoer, G.; Sebening, H.; Sauer, E.; Dressler, J.; Lutilsky, L.; Wagner-Manslau, C.; Bofilias, I.; Technische Univ. Muenchen

1979-01-01

Scans were performed on 8 healthy subjects and 25 with coronary heart disease proven by angiography and ventriculography including 6 with previous myocardial infarction at rest, exercise, and 1 and 2 h after exercise. Data were collected by a gamma camera interfaced to a data collection system. In healthy subjects 201 Tl distribution was homogeneous at rest and after exercise, the count rate ranging between 100% - as set in the region of maximum - and 80% over other regions of myocardium. In 19 patients with coronary heart disease it was uniform only at rest; 6 patients with previous myocardial infarction had locally diminished 201 Tl uptake even at rest. In patients with coronary heart disease without previous myocardial infarction, scans made immediately after exercise showed significant 201 Tl hypofixation in region of minimum, the count rate of which was less than 80% of the count rate as determined over region of maximum, 201 Tl uptake. Scans made 1 and 2 h after exercise had filling-in of 201 Tl within the region of minimum the count rate of which returned to the normal range of at least 80% of the count rate measured over region of maximum uptake. This return to resting distribution was called 201 Tl redistribution. Six patients with coronary heart disease and previous myocardial infarction had 201 Tl defects larger after exercise than at rest, without redistribution being observed. Redistribution in late postexercise scans is a sign of reversible ischemia in coronary heart disease. Scans at rest may be omitted in coronary heart disease, because transient ischemia is undetectable, unless spontaneous angina occurs during scan procedure. (orig.) [de

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

International Nuclear Information System (INIS)

Machida, Kikuo; Honda, Norinari; Matsumoto, Toru

1996-01-01

Fifteen-four studies of 201 Tl brain tumor SPECT were independently interpreted by 9 nuclear medicine physicians with and without reference magnetic resonance images in 2 separate sessions to define an effect of referring images, and inter-observer variations. The physicians were requested to detect foci of abnormal deposits, and to discriminate whether they were malignant or not according to 5-grade scaling of subjective diagnostic confidence. Receiver-operating characteristics (ROC) analysis was performed. Mean sensitivity for presence of lesions (SFP), and sensitivity and specificity for malignancy of 2 01 Tl SPECT were 84, and 53 and 55%, which were changed to 94 and 74 and 55% after referring to the MR images. The SFP was significantly improved (p 201 Tl brain tumor SPECT has moderate sensitivity and specificity for malignancy, which is not improved by addition of anatomical reference images, that additional MR images reduce inter-observer variation of confidence on lesion presence, and that SPECT localization of lesions has great inter-observer variations. (author)

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

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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).

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)

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

International Nuclear Information System (INIS)

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

2005-01-01

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

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

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

2005-02-15

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

Comparison of 18F-FDG PET and 201 thallium chloride SPECT in the evaluation of cerebral glioma prior to surgery

International Nuclear Information System (INIS)

Poon, A.M.T.; Cher, L.; Berlangieri, S.U.; Fabinyi, G.; Tochon-Danguy, H.; Chan, J.G.; Scott, A.M.

2000-01-01

Full text: The purpose of the study was to compare the accuracy of 18 F-FDG PET and 201 Tl SPECT in detecting and grading primary cerebral glioma through comparison to surgical pathology. A total of 33 patients with primary cerebral glioma had 35 18 F-FDG PET/ 201 Tl SPECT scans prior to surgery. Pre-operative 18 F -FDG PET and 201 Tl SPECT studies were reviewed and compared with histologic tumour grade. Radiological comparisons were also performed when pre-operative studies were available. 17/18 patients with glioblastoma multiforme demonstrated hypermetabolic lesions on 18 F-FDG PET scan and increased thallium uptake on SPECT scan. Increased 18 F -FDG and thallium uptake were also demonstrated in patients with anaplastic astrocytoma, gemistocytic astrocytoma, and one biopsy which was difficult to grade because of small biopsy sample and co-existing radiation necrosis. In general, low grade gliomas had reduced 18 F -FDG uptake and normal thallium uptake (6/7, where two patients had tumour with hypermetabolic and hypometabolic regions). MRI correctly identified 4/7 patients with low to intermediate grade glioma. Pilocytic astrocytoma, protoplastic astrocytoma and oligoastrocytoma all demonstrated hypometabolic PET activity and normal thallium uptake. In conclusion, 18 F-FDG PET and 201 Tl SPECT are very sensitive in pre-operative prediction of high grade glioma. In low grade tumour, 201 Tl SPECT appeared to be less useful in the absence of breakdown of the blood brain barrier. MR imaging accurately identified the presence of tumour but was less accurate in determining the grade of tumour. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

Effect of thallium-201 blood levels on reversible myocardial defects

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

1989-01-01

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

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)

Impaired coronary flow reserve is the most important marker of viable myocardium in the myocardial segment-based analysis of dual-isotope gated myocardial perfusion single-photon emission computed tomography

International Nuclear Information System (INIS)

Lee, Won Woo; So, Young; Kim, Ki Bong; Lee, Dong Soo

2014-01-01

The aim of this study was to investigate the most robust predictor of myocardial viability among stress/rest reversibility (coronary flow reserve [CFR] impairment), 201 Tl perfusion status at rest, 201 Tl 24 hours redistribution and systolic wall thickening of 99m Tc-methoxyisobutylisonitrile using a dual isotope gated myocardial perfusion single-photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) who were re-vascularized with a coronary artery bypass graft (CABG) surgery. A total of 39 patients with CAD was enrolled (34 men and 5 women), aged between 36 and 72 years (mean 58 ± 8 standard in years) who underwent both pre- and 3 months post-CABG myocardial SPECT. We analyzed 17 myocardial segments per patient. Perfusion status and wall motion were semi-quantitatively evaluated using a 4-point grading system. Viable myocardium was defined as dysfunctional myocardium which showed wall motion improvement after CABG. The left ventricular ejection fraction (LVEF) significantly increased from 37.8 ± 9.0% to 45.5 ± 12.3% (p 201 Tl rest perfusion status (p = 0.024) were significant predictors of wall motion improvement. However, in multiple logistic regression analysis, stress/rest reversibility alone was a significant predictor for post-CABG wall motion improvement (p < 0.001). Stress/rest reversibility (impaired CFR) during dual-isotope gated myocardial perfusion SPECT was the single most important predictor of wall motion improvement after CABG.

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)

Safety and feasibility of thallium-201 myocardial SPECT with intravenous infusion of disodium adenosine triphosphate (ATP) in the diagnosis of coronary artery disease

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Pai, Moon Sun; Park, Chan H.; Yoon, Seok Nam; Kim, Won; Kim, Han Soo [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

1998-08-01

ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet bee sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-102 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Although 76.5% of he patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease.

Safety and feasibility of thallium-201 myocardial SPECT with intravenous infusion of disodium adenosine triphosphate (ATP) in the diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Pai, Moon Sun; Park, Chan H.; Yoon, Seok Nam; Kim, Won; Kim, Han Soo

1998-01-01

ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet bee sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-102 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Although 76.5% of he patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease

Clinical evaluation of 123I-BMIPP myocardial scintigraphy in patients with hypertrophic cardiomyopathy

International Nuclear Information System (INIS)

Ohtsuki, Katsuichi; Sugihara, Hiroki; Umamoto, Ikuo

1992-01-01

123 I-β-methyl-p-iodophenylpentadecanoic acid ( 123 I-BMIPP) myocardial scintigraphy was performed in 13 patients with hypertrophic cardiomyopathy and compared with 201 Tl myocardial scintigraphy performed within 3 months for evaluating the clinical significance of 123 I-BMIPP myocardial scintigraphy. SPECT images were divided into 13 segments and segmental images were visually scored on a 4 (increased tracer uptake) to 0 (severely decreased tracer uptake) scale according to the tracer uptake. In comparison of 123 I-BMIPP early images and 201 Tl perfusion images, mismatches were seen in about 70% of all segments. The number of segments demonstrating lower myocardial uptake of 123 I-BMIPP was larger than that of 201 Tl. In hypertrophic regions, the tracer uptake of 123 I-BMIPP early images was significantly lower than that of 201 Tl images and the lower uptake of 123 I-BMIPP delayed images was more marked. In non-hypertrophic regions, no significant difference was seen between the tracer uptakes of 123 I-BMIPP early images and 201 Tl images but the tracer uptake of 123 I-BMIPP delayed images was significantly lower than that of 201 Tl images. The mismatch between the tracer uptakes of 123 I-BMIPP images and 201 Tl images was thought to be a reflection of disordered myocardial fatty acid metabolism. 'Washout', the difference between the tracer uptakes of 123 I-BMIPP early images and delayed images was also thought to be a reflection of disordered myocardial fatty acid metabolism. These results suggest that 123 I-BMIPP is a promising radiopharmaceutical for evaluating disordered myocardial fatty acid metabolism in patients with HCM. (author)

Evaluating microvascular obstruction after acute myocardial infarction using cardiac magnetic resonance imaging and 201-thallium and 99m-technetium pyrophosphate scintigraphy

International Nuclear Information System (INIS)

Onishi, Takayuki; Kobayashi, Isshi; Onishi, Yuko; Kawashima, Tomoyuki; Muramoto, Hirotaka; Nakamura, Hiroaki; Nagata, Yasutoshi; Umezawa, Shigeo; Niwa, Akihiro

2010-01-01

Few studies have compared the ability of cardiac magnetic resonance (CMR) with that of scintigraphy using 201-thallium (201-Tl) and 99m-technetium pyrophosphate (99m-Tc PYP) to evaluate microvascular obstructions (MOs). In the present study the relationship between the scintigraphic and CMR characteristics of MOs after acute myocardial infarction (MI) was examined. The 14 patients (age 69±8 years, 11 males) underwent 201-Tl/99m-Tc PYP single photon emission computed tomography (SPECT) 7±3 days, initial CMR 16±12 days, and follow-up CMR 193±20 days after a reperfused first acute MI. Each image was analyzed using a 17-segment model. Segmental extent of delayed enhancement (DE), wall motion (WM) and degree of 201-Tl uptake were scored in 238 segments. Of 91 MI segments, MO was recognized in 22 (25%) segments on CMR. WM was significantly better in proportion to 201-Tl uptake (P=0.01) in MO segments. All 8 MO segments with WM improvement at follow-up had 99m-Tc PYP uptake, although only 3 (21%) of 14 MO segments that did not show WM improvement at follow-up had 99m-Tc PYP uptake (P=0.001). 99m-Tc PYP and 201-Tl scintigraphy have the potential to predict WM status and improvement of the MO region after reperfused acute MI. (author)

Effects of heart rate on myocardial thallium-201 uptake and clearance

International Nuclear Information System (INIS)

Nordrehaug, J.E.; Danielsen, R.; Vik-Mo, H.

1989-01-01

The effects of heart rate on the myocardial uptake and clearance of 201 Tl were studied prospectively in seven healthy men, mean age 43 +/- 7 (s.d.) yr. Initial and delayed (3 hr) thallium images were obtained in three views after three bicycle exercise tests: to maximal, 80% and 60% of predicted maximal heart rate. The mean of three views initial myocardial 201 Tl uptake was higher at maximal than at both 80% and 60% of predicted maximal heart rate, being 81% (p less than 0.01) and 60% (p less than 0.01) of maximal activity, respectively. The myocardial activity in the delayed images was identical. There was a linear relationship between heart rate and the initial myocardial activity, r = 0.86 (p less than 0.001). The mean (range) 201 Tl clearance was 58% (51-65), 47% (34-56), and 34% (22-49) (all differences p less than 0.01), respectively. Concordance among the three individual views in estimating clearance was best for the highest exercise level. There was a linear relationship between heart rate and clearance, r = 0.80 (p less than 0.001). Clearance was altered by only 1.67 x 10%/heart bpm (0.024 hr/heart beat). Clearance in the liver, spleen and lungs increased at submaximal exercise levels. Thus, a linear relationship between heart rate and clearance is the result of changes in the initial exercise myocardial 201 Tl activity. Submaximal exercise may reduce reproducibility of clearance estimation, and the change of myocardial clearance with heart rate seems less than previously suggested

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)

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

International Nuclear Information System (INIS)

Yarman, S.; Mudun, A.

2002-01-01

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

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.

Simultaneous dual-radionuclide myocardial perfusion imaging with a solid-state dedicated cardiac camera

International Nuclear Information System (INIS)

Ben-Haim, Simona; Kacperski, Krzysztof; Hain, Sharon; Van Gramberg, Dean; Hutton, Brian F.; Erlandsson, Kjell; Waddington, Wendy A.; Ell, Peter J.; Sharir, Tali; Roth, Nathaniel; Berman, Daniel S.

2010-01-01

We compared simultaneous dual-radionuclide (DR) stress and rest myocardial perfusion imaging (MPI) with a novel solid-state cardiac camera and a conventional SPECT camera with separate stress and rest acquisitions. Of 27 consecutive patients recruited, 24 (64.5±11.8 years of age, 16 men) were injected with 74 MBq of 201 Tl (rest) and 250 MBq 99m Tc-MIBI (stress). Conventional MPI acquisition times for stress and rest are 21 min and 16 min, respectively. Rest 201 Tl for 6 min and simultaneous DR 15-min list mode gated scans were performed on a D-SPECT cardiac scanner. In 11 patients DR D-SPECT was performed first and in 13 patients conventional stress 99m Tc-MIBI SPECT imaging was performed followed by DR D-SPECT. The DR D-SPECT data were processed using a spill-over and scatter correction method. DR D-SPECT images were compared with rest 201 Tl D-SPECT and with conventional SPECT images by visual analysis employing the 17-segment model and a five-point scale (0 normal, 4 absent) to calculate the summed stress and rest scores. Image quality was assessed on a four-point scale (1 poor, 4 very good) and gut activity was assessed on a four-point scale (0 none, 3 high). Conventional MPI studies were abnormal at stress in 17 patients and at rest in 9 patients. In the 17 abnormal stress studies DR D-SPECT MPI showed 113 abnormal segments and conventional MPI showed 93 abnormal segments. In the nine abnormal rest studies DR D-SPECT showed 45 abnormal segments and conventional MPI showed 48 abnormal segments. The summed stress and rest scores on conventional SPECT and DR D-SPECT were highly correlated (r=0.9790 and 0.9694, respectively). The summed scores of rest 201 Tl D-SPECT and DR-DSPECT were also highly correlated (r=0.9968, p 201 Tl D-SPECT acquisition. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2008-09-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1977-05-01

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

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...

Relationships between the lung-heart ratio assessed from post-exercise thallium-201 myocardial tomograms, myocardial ischemia and the extent of coronary artery disease

International Nuclear Information System (INIS)

Ilmer, B.; Reijs, A.E.; Reiber, J.H.; Bakker, W.; Fioretti, P.

1990-01-01

Uptake of thallium (Tl)-201 in the lungs has been proposed as a measure of left ventricular dysfunction. In this study we were interested in pursuing two goals: (1) to assess possible relationships between the post-exercise Tl-201 lung-heart (LH)-ratio determined from the anterior view during SPECT-acquisition, myocardial ischemia and the extent of coronary artery disease; and (2) to explore the effects of coronary revascularisation procedures on the LH-ratio. The study group consisted of 145 patients with early and late postexercise Tl-201 tomograms, including 32 PTCA-patients with pre- and post-PTCA studies and 20 patients who underwent coronary artery bypass surgery (CABG) with corresponding pre- and post-CABG studies. Ischemia was defined as evoked angina during the exercise test in combination with greater than or equal to 1 mm horizontal or downsloping ST-depression on the ECG. The severity of coronary obstructions was assessed from coronary angiograms with a PC-based digital caliper technique; a stenosis was defined to be significant when its severity exceeded 50% diameter stenosis. The LH-ratio was defined by the ratio of the mean pulmonary counts and the mean myocardial counts assessed from corresponding regions of interest (ROI's) positioned over the left lung and the heart, respectively in the anterior view of a tomographic data acquisition procedure. Our results made clear that the LH-ratio was not significantly different between patients with and without ischemia during exercise, and between patients with single vs. multiple vessel disease

Thallium-201 myocardial imaging in acute-myocardial infarction

International Nuclear Information System (INIS)

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

1980-01-01

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

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)

Analysis of the relationship between myocardial viability and regional left ventricular wall motion

International Nuclear Information System (INIS)

Furutani, Yuhji; Ozaki, Masaharu; Yamamoto, Takeshi; Sato, Shinichi; Saiki, Atsushi; Kusukawa, Reizo

1993-01-01

Myocardial viability was determined by using postsystolic shortening (PSS) as an index, as obtained by cardiac blood pool scintigraphy with Tc-99m HSA. The findings were compared with those of thallium-201 myocardial SPECT. The study population was comparised of 41 patients with single blood vessel disease in the left anterior descending artery (34 with old myocardial infarction and 7 with effort angina pectoris). Left ventricular area was divided into 6 segments, and global and regional left ventricular blood volume curves were obtained. Delayed end-systole was the most common in the apex (41%), followed by the upper septum (37%) and lower septum (10%). PSS resulting from delayed end-systole was seen in 36 areas. PSS/end-diastolic volume (EDV) and PSS/systolic volume (SV) were obtained by adjusting end-diastolic and stroke counts, respectively. Thallium-201 myocardial SPECT images were divided into 5 segments to obtain defect score (DS) for visual Tl uptake. Both PSS/EDV and PSS/SV were greater in association with more delayed end-systole, greater DS, and lower reginal ejection fraction. Areas showing greater PSS were associated with less myocardial viability, as observed on Tl myocardial SPECT images. Thus, PSS seemed to reflect the degree of myocardial necrosis within the region of interest. (N.K.)

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)

Sensitivity and accuracy of thallium-201 myocardial scintigraphy in the detection of coronary artery and myocardial disease

International Nuclear Information System (INIS)

Loesse, B.; Kroenert, H.; Rafflenbeul, D.; Feinendegen, L.E.; Loogen, F.; Duesseldorf Univ.

1979-01-01

169 patients (154 men, 15 women, mean age 49.5 years, range 27 to 64 years) were studied by means of 201-Thallium myocardial scintigraphy (201-Tl) and coronary angiography. According to the coronarangiogram, 130 patients had coronary artery disease (CAD): 53 a 1-vessel CAD, 29 a 2-vessel CAD, 48 a 3-vessel CAD. 39 patients had normal or less than 50% stenosed coronary arteries, but only 13 of these patients had also a normal ventriculogram, whereas 26 had an abnormal ventriculogram with local hypo-, a- or dyskinesia, diffuse hypokinesia, dilatation, or marked hypertrophy. The ramus interventicularis anterior (RIVA) was involved (stenosis of more than 50%) in 117 cases, the ramus circumflexus (R. circ.) in 70 cases, and the right coronary artery (RCA) in 67 cases. 201-Tl was abnormal in 98% of all 130 patients with CAD, in 100% of 93 patients with prior infarction, and in 95% of 37 patients without prior infarction. The sensitivity of the rest and/or exercise ECG in the same patients was only 79%, 88% and 57%, respectively. 201-Tl was abnormal in all 26 patients with a pathologic ventriculogram in spite of normal coronary arteries. 201-Tl and ECG were normal in only 9 of the 13 patients (=69%) with normal coronary arteries and normal ventriculogram. Myocardial biopsy, however, performed in 2 of the other 4 patients disclosed in part severe degenerative changes which can possibly explain the abnormal findings of 201-Tl and ECG. Significantly, i.e. more than 50% stenosed RIVA was correctly detected by 201-Tl in 98%, R. circ. in 71%, and RCA in 91% of the cases. The specificity of 201-Tl was limited by the great number of patients with a pathologic ventriculogram combined with normal coronary arteries. (orig.) [de

Clinical evaluation of sup 123 I-BMIPP myocardial scintigraphy in patients with hypertrophic cardiomyopathy

Energy Technology Data Exchange (ETDEWEB)

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

1992-02-01

{sup 123}I-{beta}-methyl-p-iodophenylpentadecanoic acid ({sup 123}I-BMIPP) myocardial scintigraphy was performed in 13 patients with hypertrophic cardiomyopathy and compared with {sup 201}Tl myocardial scintigraphy performed within 3 months for evaluating the clinical significance of {sup 123}I-BMIPP myocardial scintigraphy. SPECT images were divided into 13 segments and segmental images were visually scored on a 4 (increased tracer uptake) to 0 (severely decreased tracer uptake) scale according to the tracer uptake. In comparison of {sup 123}I-BMIPP early images and {sup 201}Tl perfusion images, mismatches were seen in about 70% of all segments. The number of segments demonstrating lower myocardial uptake of {sup 123}I-BMIPP was larger than that of {sup 201}Tl. In hypertrophic regions, the tracer uptake of {sup 123}I-BMIPP early images was significantly lower than that of {sup 201}Tl images and the lower uptake of {sup 123}I-BMIPP delayed images was more marked. In non-hypertrophic regions, no significant difference was seen between the tracer uptakes of {sup 123}I-BMIPP early images and {sup 201}Tl images but the tracer uptake of {sup 123}I-BMIPP delayed images was significantly lower than that of {sup 201}Tl images. The mismatch between the tracer uptakes of {sup 123}I-BMIPP images and {sup 201}Tl images was thought to be a reflection of disordered myocardial fatty acid metabolism. 'Washout', the difference between the tracer uptakes of {sup 123}I-BMIPP early images and delayed images was also thought to be a reflection of disordered myocardial fatty acid metabolism. These results suggest that {sup 123}I-BMIPP is a promising radiopharmaceutical for evaluating disordered myocardial fatty acid metabolism in patients with HCM. (author).

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

NARCIS (Netherlands)

Hijnen, N.M.; Vries, de A.; Blange, R.; Burdinski, D.; Grüll, H.

2010-01-01

Introduction The aim of this study was to assess the use of 201thallium3+ (201Tl3+) as a radiolabel for nuclear imaging tracers. Methods for labeling of 1,4,7,10-tetraazacyclododecane-N,N',N¿,N'¿ tetraacetic acid (DOTA) and diethylenetriaminepentaacetic acid (DTPA) chelators with 201Tl3+ were

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

Scintigraphic anatomy of coronary artery disease in digital thallium-201 myocardial images

International Nuclear Information System (INIS)

Wainwright, R.J.

1981-01-01

One hundred and eight patients with single and multiple vessel coronary artery disease confirmed by arteriography were evaluated by exercise thallium-201 ( 201 Tl) myocardial scintigraphy to determine the scintigraphic appearances of specific coronary stenoses. In general proximal stenoses caused more widespread, but not necessarily more severe, myocardial tracer deficit, than distal stenoses. In particular, proximal dominant right coronary artery disease was specifically associated with extensive inferior wall tracer deficit in the anterior scintigram, whereas proximal left circumflex disease caused similar tracer depletion best visualised in the left lateral scintigram. A triad of uptake defects was caused by left anterior descending coronary artery disease; one of these defects called 'diagonal window tracer deficit' was the most useful scintigraphic sign distinguishing proximal from distal disease in the left anterior descending coronary artery. Certain scintigraphic patterns of 201 Tl myocardial accumulation appear invaluable in the noninvasive localisation of stenoses within specific coronary arteries and thus may be useful in predicting life-threatening coronary artery disease which should be confirmed by definitive coronary arteriography. The digital 201 Tl myocardial scintigram also provides an independent functional guide to the interpretation of coronary arteriograms and may be helpful in the planning of aortocoronary bypass graft surgery. (author)

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.)

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

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)

Clinical usefulness of hyperventilation-loaded SPECT in coronary artery disease

International Nuclear Information System (INIS)

Taya, Makoto

1994-01-01

The purpose of this study was twofold: (1) to assess the clinical usefulness of hyperventilation-loaded Tl-201 myocardial single photon emission computed tomography (HV-SPECT) in detecting coronary spasm; and (2) to correlate coronary spasm with ischemic heart diseases. A total of 138 patients were examined. They were divided into Group 1 of a total of 69 patients with chest pain at rest, consisting of 25 with vasospastic angina and 44 with atypical chest pain; Group 2 of 37 patients with angina pectoris; and Group 3 of 32 patients with myocardial infarction. In Group I, HV-SPECT was positive in 96% (24/25) for vasospastic angina and 50% (22/44) for atypical angina pectoris. When thallium defect scores 2 or more were interpreted as a decreased thallium uptake, Tl-201 HV-SPECT had a sensitivity of 72%, a specificity of 93%, and an accuracy of 85.6% in diagnosing vasospastic angina. In Group 2, HV-SPECT showed a significantly higher positive rate in patients with resting angina pectoris than those with effort angina pectoris (69% vs 22%). In Group 3, HV-SPECT was a positive rate of 53%. When Nifedipine was administered, the positive cases turned to be negative in 47%. HV-SPECT proved to be useful as a noninvasive method for diagnosing coronary spasm. Coronary spasm was suggested to be present in ischemic heart disease other than vasospastic angina and atypical chest pain. (N.K.)

Thallium 201 Exercise Scintigraphy for Detection of Multivessel Coronary Artery Disease After Transmural Myocardial Infarction

Science.gov (United States)

Ahmadpour, Hedayatolah; Siegel, Michael E.; Colletti, Patrick; Haywood, L. Julian

1984-01-01

Fifty patients with prior transmural myocardial infarction were studied with cardiac catheterization, coronary angiography, and thallium 201 exercise perfusion scintigraphy. Obstructive coronary disease involved two or three vessels in 37 patients. The sensitivity of a positive electrocardiographic test during exercise for detecting multivessel coronary disease was only 40 percent (15/37), and the sensitivity of a reversible defect on 201Tl perfusion scintigraphy was 48 percent (18/37). The combination of exercise testing and 201Tl scintigraphy detected multivessel coronary disease in 75 percent (28/37) (P < .05). New perfusion defects occurred in 61 percent (13/21) of patients with inferior myocardial infarction and multivessel coronary disease whereas it occurred in only 35 percent (5/14) of patients with prior anterior infarction and multivessel coronary disease (P < .05). 201Tl exercise perfusion scintigraphy appears to be more sensitive for detecting significant multivessel coronary disease in the presence of previous inferior infarction compared with previous anterior infarction. Combined graded exercise testing and 201Tl perfusion scintigraphy can reliably detect the presence of significant multivessel coronary disease after transmural myocardial infarction. ImagesFigure 3 PMID:6512876

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

International Nuclear Information System (INIS)

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

2007-01-01

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

The significance of resting thallium-201 delayed SPECT for assessing viability of infarcted regions

International Nuclear Information System (INIS)

Mori, Takao; Yamabe, Hiroshi; Yoshida, Hiroyuki; Maeda, Kazumi; Fukuzaki, Hisashi

1991-01-01

Thirty-eight patients with old myocardial infarction (OMI) and 35 patients with effort angina pectoris (EAP) underwent resting thallium-201 (Tl) SPECT one week after exercise (Ex) Tl SPECT. On the basis of both resting and Ex Tl SPECT scans, OMI patients were divided into 3 groups: those who had Tl redistribution (RD) on Ex images and the same perfusion defect (PD) on both resting and Ex delayed images (n=12, Group 1); those who had a lower PD on resting delayed images than Ex delayed images (n=15, Group 2); and those who had no Tl RD on Ex images in spite of the same PD on both resting and EX delayed images (n=11, Group 3). EAP patients were divided into Group 1 (n=18) in whom no PD was seen on Ex delayed image and Group 2 (n=17) in whom PD was not seen on Ex delayed images either, but seen on resting delayed images. EX images showed higher pulmonary artery wedge pressure in Group 2 than Group 1 of both OMI and EAP patients (27±7 mmHg vs 15±6 mmHg for OMI patients; 22±6 mmHg vs 12±7 mmHg for EAP patients). For PD, Tl uptake rate on Ex initial images was higher in Group 1 than Gorup 2 of both OMI and EAP patients (63±7% vs 55±9% for OMI patients; 72±7% vs 65±9% for EAP patients). Resting delayed images for OMI patients showed the highest Tl uptake rate in Group 1 (78±7%), followed by Group 2 (74±8%) and then Group 3 (41±10%). In the group of OMI patients, the incidence of akinetic or dyskinetic wall motion on left ventriculography was the highest in Group 3 (85.7%), followed by Group 2 (52.2%) and Group 1 (24.3%). OMI patients, as well as EAP patients, had lower PD on resting delayed images than EX delayed images. Thus, severer ischemia may be associated with stress and infarcted areas may not involve viable muscle when Tl PD is decreased on resting delayed images. (N.K.)

Upward creep of the heart: A frequent source of false-positive reversible defects during thallium-201 stress-redistribution SPECT

International Nuclear Information System (INIS)

Friedman, J.; Van Train, K.; Maddahi, J.; Rozanski, A.; Prigent, F.; Bietendorf, J.; Waxman, A.; Berman, D.S.

1989-01-01

A new cause of artifactual 201 Tl defects on single photon emission computed tomography (SPECT) termed upward creep of the heart is described. In 102 consecutive patients undergoing 201 Tl SPECT, 30 (29%) demonstrated upward creep defined by an upward movement of the heart of greater than or equal to 2 pixels during acquisition. In 45 consecutive patients with a less than 5% likelihood of coronary artery disease, 17 (38%) had upward creep. Of these nine had reversible 201 Tl defects localized to the inferior and basal inferoseptal walls, while none of the 28 without upward creep had defects. The 17 low likelihood patients with upward creep had longer exercise duration and higher peak heart rate than those without upward creep. In five additional low likelihood patients with upward creep in whom imaging was immediately repeated, the upward creep pattern disappeared on the repeated images. After we changed our test protocol to begin imaging 15 min postexercise, only five (14%) of 36 low likelihood patients tested demonstrated upward creep. Upward creep is probably related to a transient increase in mean total lung volume early following exhaustive exercise, resulting in a mean lower position of the diaphragm (and thus the heart) at the beginning of imaging. The frequency of this source of false-positive 201 Tl studies can be reduced by delaying SPECT acquisition until 15 min postexercise

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

International Nuclear Information System (INIS)

Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa; Minamino, Takazoh; Katoh, Osamu; Higashino, Yorihiko.

1989-01-01

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

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

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Hideaki Shiga

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

201Thallium SPECT, accuracy in astrocytoma diagnosis and treatment evaluation

International Nuclear Information System (INIS)

Kaellen, K.

1999-10-01

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

Thallium-201 myocardial imaging for evaluation of right-ventricular overloading

International Nuclear Information System (INIS)

Kondo, M.; Kubo, A.; Yamazaki, H.; Ohsuzu, F.; Handa, S.; Tsugu, T.; Masaki, H.; Kinoshita, F.; Hashimoto, S.

1978-01-01

This study evaluated the specificity and sensitivity of Tl-201 myocardial imaging in the detection of right-ventricular (RV) overloading. Right-ventricular visualization (RVV) after administration of Tl-201 chloride was studied on 99 patients with various heart diseases. Tracer uptake in the free wall of the RV was graded in four degrees. The degree of RVV was compared with the findings of cardiac catheterization. The comparisons indicated that the uptake increased in step with the inreases in RV systolic pressure, RV end-diastolic pressure, mean pulmonary arterial pressure, total pulmonary vascular resistance, and stroke-work index of the right ventricle (P < 0.05--P < 0.001). Of the patients with visible RV, all but three had RV overloading, and all but three of those without RVV had normal RV systolic pressure. Myocardial images also reflect the type of RV overloading. In patients with RV pressure overloading, the septum showed a tendency to appear straight. In patients with atrial septal defect leading to RV volume overloading, the RV cavity was dilated, the LV image small, and the septum convex toward the RV cavity. These results indicate that Tl-201 myocardial imaging is a sensitive and specific method for the study of RV overloading

Simultaneous dual-radionuclide myocardial perfusion imaging with a solid-state dedicated cardiac camera.

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Ben-Haim, Simona; Kacperski, Krzysztof; Hain, Sharon; Van Gramberg, Dean; Hutton, Brian F; Erlandsson, Kjell; Sharir, Tali; Roth, Nathaniel; Waddington, Wendy A; Berman, Daniel S; Ell, Peter J

2010-08-01

We compared simultaneous dual-radionuclide (DR) stress and rest myocardial perfusion imaging (MPI) with a novel solid-state cardiac camera and a conventional SPECT camera with separate stress and rest acquisitions. Of 27 consecutive patients recruited, 24 (64.5+/-11.8 years of age, 16 men) were injected with 74 MBq of (201)Tl (rest) and 250 MBq (99m)Tc-MIBI (stress). Conventional MPI acquisition times for stress and rest are 21 min and 16 min, respectively. Rest (201)Tl for 6 min and simultaneous DR 15-min list mode gated scans were performed on a D-SPECT cardiac scanner. In 11 patients DR D-SPECT was performed first and in 13 patients conventional stress (99m)Tc-MIBI SPECT imaging was performed followed by DR D-SPECT. The DR D-SPECT data were processed using a spill-over and scatter correction method. DR D-SPECT images were compared with rest (201)Tl D-SPECT and with conventional SPECT images by visual analysis employing the 17-segment model and a five-point scale (0 normal, 4 absent) to calculate the summed stress and rest scores. Image quality was assessed on a four-point scale (1 poor, 4 very good) and gut activity was assessed on a four-point scale (0 none, 3 high). Conventional MPI studies were abnormal at stress in 17 patients and at rest in 9 patients. In the 17 abnormal stress studies DR D-SPECT MPI showed 113 abnormal segments and conventional MPI showed 93 abnormal segments. In the nine abnormal rest studies DR D-SPECT showed 45 abnormal segments and conventional MPI showed 48 abnormal segments. The summed stress and rest scores on conventional SPECT and DR D-SPECT were highly correlated (r=0.9790 and 0.9694, respectively). The summed scores of rest (201)Tl D-SPECT and DR-DSPECT were also highly correlated (r=0.9968, pstress perfusion defects were significantly larger on stress DR D-SPECT images, and five of these patients were imaged earlier by D-SPECT than by conventional SPECT. Fast and high-quality simultaneous DR MPI is feasible with D-SPECT in a

Thallium-201 myocardial imaging in unstable angina and variant angina

International Nuclear Information System (INIS)

Wackers, F.J.Th.; Lie, K.I.; Liem, K.L.; Sokole, E.B.; Schoot, J.B. van der

1980-01-01

It is of clinical relevance in the coronary care unit to evaluate the potential role of 201 Tl scintigraphy in patients with unstable angina. In the present chapter the authors discuss 1) the pattern of 201 Tl scintigraphy in patients with unstable angina; and 2) the potential predictive value of 201 Tl scintigraphy in identifying patients with unstable angina who have a poorer prognosis or greater tendency to subsequently develop acute myocardial infarction. All patients with unstable angina pectoris were purposely studied during the pain free period. It seemed conceivable that injecting 201 Tl during an anginal attack would result in a high percentage of scintigraphic defects and probably diminish a potential discriminative value of the method. Moreover in clinical practice the majority of patients arrive at the coronary care unit some time after the last anginal attack. If a diagnostic test performed at this time could distinguish high and low risk patients, important therapeutic decisions might be made at the earliest possible times. (Auth.)

Diagnosis of coronary stenosis using thallium-201 myocardial emission computed tomography

International Nuclear Information System (INIS)

Ito, Tsunaaki; Takeda, Hiroshi; Maeda, Hisato; Nakagawa, Tsuyoshi; Yamaguchi, Nobuo; Makino, Katsutoshi; Futagami, Yasuo; Konishi, Tokuji

1985-01-01

Thallium-201 myocardial emission computed tomography (ECT) was described with respect to methods of correcting ECT data and reconstructing the images, qualitative and quantitative diagnosis in the detection of coronary stenosis. Although 201 Tl myocardial ECT (using circumferential profile method combined with washout method) has relatively high diagnostic sensitivity, the correction of absorption is not satisfactory yet. Inside absorption coefficient is considered uniform by regarding the human body as oval shape. However, the chest, including the heart, lungs, vertebrae and thoracic wall, has four different absorption coefficients. If absorption can be corrected accurately, it will be possible to completely assess the myocardial blood flow by measuring the regional myocardial uptake of thallium-201. (Namekawa, K.)

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

International Nuclear Information System (INIS)

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

2007-01-01

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

Assessment of myocardial viability in patients with myocardial infarction using twenty-four hour thallium-201 late redistribution imaging

International Nuclear Information System (INIS)

Yang Xiangjun; He Yongming; Zhang Bin; Wu Yiwei; Hui Jie; Jiang Tingbo; Song Jianping; Liu Zhihua; Jiang Wenping

2006-01-01

Rest thallium-201 ( 201 Tl) myocardial perfusion imaging has been widely used for evaluation of myocardial ischemia/viability after myocardial infarction, but the ideal timing for imaging after injection to maximally estimate viability is not well established. Thirty-six patients with myocardial infarction underwent the initial, 3 h, and 24 h redistribution imaging after intravenous injection of 148-185 MBq 201 Tl. The initial and 3 h images, the initial and 24 h images, and the 3 and 24 h images were compared double-blinded. Out of the 184 abnormal segments based on the initial imaging, 56 (30%) segments improved by at least 1 grade on the 3 h imaging while 78 (42%) segments improved by at least 1 grade on the 24 h imaging. The 24 h late imaging detected more viable myocardium than the 3 h imaging did, with a significant difference (χ 2 =5.680, p=0.017). There were 158 abnormal segments on the 3 h imaging, with average 28% (44) segments improved by at least 1 grade on the 24 h imaging. There were 128 initial abnormal segments with no improvement on the 3 h imaging. Out of these segments, the 24 h late redistribution imaging detected additional redistribution in 26 segments, taking up 20%. Twenty-four hour late 201 Tl imaging will demonstrated additional redistribution in patients who have incompletely reversible defects on early redistribution imaging at 3 h. (author)

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

Tl-201 per rectum scintigraphy in chronic liver disease: assessment of Tl-201 uptake indices

International Nuclear Information System (INIS)

Moon, Won Jin; Choi, Yun Young; Cho, Suk Shin; Lee, Min Ho

1999-01-01

Heart to liver ratio on Tl-201 per rectal scintigraphy (shunt index) is known to be useful in the assessment of portal systemic shunt. We assessed Tl-201 uptake pattern and early liver/heart uptake rate of Tl-201 and correlated with shunt index in patients with chronic active hepatitis (CAH) and liver cirrhosis (LC). Fifty eight patients with biopsy-proven chronic liver disease (35 with CAH, 23 with LC) underwent Tl-201 per rectum scintigraphy after instillation of 18.5 MBq of Tl-201 into the upper rectum. We evaluated hepatic uptake (type 1: homogeneous, 2: inhomogeneous segmental, 3: inhomogeneous nonsegmental) and extrahepatic uptake of spleen, heart and kidney (grade 0: no uptake, 1: less than liver, 2: equal to liver, 3: greater than liver). We measured the early liver/heart uptake rate (the slope of the liver to heart uptake ratio for 10 mim) and shunt index (heart to liver uptake ratio). Tl-201 uptake pattern and early liver/heart uptake rate of Tl-201 was correlated with the pathologic diagnosis and shunt index. Hepatic uptake patterns of type 1 and 2 were dominant in CAH (CAH: 27/35, LC: 8/23), and type 3 in LC (CAH: 8/35, LC: 15/23)(p<0.005). The grades of extrahepatic uptake were higher in LC than in CAH (spleen: p<0.001, other soft tissue: p<0.005). The early liver/heart uptake rate of CAH (0.110±0.111) was significantly higher than that of LC (0.014±0.090)(p<0.001). The sensitivity and specificity of the early liver/heart uptake rate were 77.7% and 67.7% in differentiating LC from CAH. There was negative correlation between early liver/heart uptake rate and shunt index (r=-0.3347, p<0.01). Hepatic and extrahepatic uptake pattern and early liver/heart uptake rate on Tl-201 per rectum scintigraphy are useful in the assessment of portal systemic shunt in patients with chronic liver disease

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)

Difference in 201TlCl accumulation mechanism in brain tumors. A comparison of their Na+-K+ ATPase activities

International Nuclear Information System (INIS)

Sugo, Nobuo; Kuroki, Takao; Nemoto, Masaaki; Mito, Toshiaki; Seiki, Yoshikatsu; Shibata, Iekado

2000-01-01

The accumulation levels of 201 TlCl and Na + -K + ATPase activity in tumor tissue were compared among glioblastoma, benign glioma and meningioma to study the difference in the mechanism of 201 TlCl accumulation. The subjects were 19 cases comprised of 6 glioblastoma, 2 oligodendroglioma, 1 fibrillary astrocytoma, 1 pilocytic astrocytoma and 9 meningioma. Preoperative 201 TlCl SPECT was performed in all the cases, and Thallium Index (TL index) was calculated by a ratio of 201 TlCl in the tumor area and the contralateral area. In addition, cell membrane was extracted from the tumor tissue collected intraoperatively to determine Na + -K + ATPase activity. No statistically significant difference in TL index was noted between the glioblastoma group (6.97±2.67) and the meningioma group (5.87±1.99). This fact showed that there was no difference in the accumulation level of 201 TlCl between the two groups. On the other hand, the glioblastoma group indicated a higher value of Na + -K + ATPase activity (49.13±43.76 μmole/hour/mg protein) than the meningioma group (7.73±13.84 μmol/hour/mg protein) (p + -K + ATPase activity in 201 TlCl accumulation in glioblastoma and the influences of other accumulation mechanism than Na + -K + ATPase activity such as the volume of intratumoral vascular bed in meningioma. (author)

Myocardial Perfusion SPECT 2015 in Germany

Science.gov (United States)

Burchert, Wolfgang; Schäfer, Wolfgang; Hacker, Marcus

2016-01-01

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

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)

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

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Kaellen, K

1999-10-01

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

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

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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)

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

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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.

Thallium-201 myocardial imaging for evaluation of pulmonary hypertension

International Nuclear Information System (INIS)

Ikuno, Yoshiyasu

1979-01-01

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

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

International Nuclear Information System (INIS)

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

1981-01-01

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

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

Characterization of cartilaginous tumors with 201Tl scintigraphy

International Nuclear Information System (INIS)

Higuchi, Takahiro; Taki, Junichi; Sumiya, Hisashi; Kinuya, Seigo; Nakajima, Kenichi; Tonami, Norihisa

2005-01-01

Histological diagnosis and grading of cartilaginous tumors are closely correlated with patient prognosis; consequently, they are essential elements. We attempted to clarify the characteristics of 201 Tl uptake in various histological types of cartilaginous tumors and to assess its clinical value. Twenty-two cases with histologically proven cartilaginous tumors (3 enchondromas, 15 conventional chondrosarcomas (grade I=9, II=5, III=1), 3 mesenchymal chondrosarcomas, and 1 de-differentiated chondrosarcoma) were examined retrospectively. Planar 201 Tl images were recorded 15 mm following intravenous injection of 201 Tl (111 MBq). 201 Tl uptake in the tumor was evaluated visually employing a five-grade scoring system: 0=no appreciable uptake, 1=faint uptake above the background level, 2=moderate uptake, 3=intense uptake but lower than heart uptake and 4=uptake higher than heart uptake. 201 Tl uptake scores were 0 in 3 of 3 enchondromas, 9 of 9 grade I, and 4 of 5 grade II conventional chondrosarcomas. 201 Tl uptake scores were 1 among 1 of 5 grades II and a grade III conventional chondrosarcoma. Mesenchymal chondrosarcoma and de-differentiated chondrosarcoma displayed 201 Tl uptake scores of 2 or 3. Absence of elevated 201 Tl uptake in cartilaginous tumors was indicative of enchondroma or low-grade conventional chondrosarcoma. However, in instances in which 201 Tl uptake is obvious, high-grade chondrosarcoma or variant types should be considered. (author)

The clinical usefulness of myocardial thallium-201 washout rate after exercise stress

International Nuclear Information System (INIS)

Iwasaki, Tsutomu; Takino, Yutaka; Sakurai, Fumio

1989-01-01

Myocardial Tl-201 Washout rates (WORs) after exercise stress were measured in 15 normal subjects and 67 patients with coronary artery disease (CAD) or chest pain syndrome and the usefulness of WOR for the detection of CAD was studied. Myocardial tomograms were obtained both immediately after exercise and 3 hours later using a rotating gamma camera in 15 normal subjects and 67 patients. After low-pass filtering, images were reconstructed into short-axis, horizontal long-axis and vertical long-axis tomograms and visually interpreted. By using short-axis tomograms, left ventricle WORs were expressed as circumferential profile curves at the apex, center and base of the ventricle. Lower normal limits of the WOR were set at 2 SDs from the mean of the normal subjects. The combination of visual interpretation of SPECT with WOR increased the sensitivity of detection of CAD from 8.3% to 66.7% in patients with three-vessel CAD without losing specificity. WOR after exercise stress is believed to be a useful method of detecting multivessel CAD. (author)

123I-BMIPP fatty acid analogue imaging is a novel diagnostic and prognostic approach following acute myocardial infarction.

Science.gov (United States)

Biswas, S K; Sarai, M; Hishida, H; Ozaki, Y

2009-10-01

Fatty acid oxidation is the most efficient mode of myocardial energy production which requires a large amount of oxygen. Thus, alteration of fatty acid oxidation is considered to be a sensitive marker of ischaemia and myocardial damage. (123)I-BMIPP ([123]I-beta-methyl-p-iodophenylpentadecanoic acid) is a newly-investigated single-photon branching free fatty acid radiopharmaceutical with slow metabolism; thus, it is well-suited for single-photon emission computed tomography (SPECT). Assessment of fatty acid metabolism by radionuclide techniques has a potential role for the early detection of myocardial ischaemia and the assessment of the severity of ischaemic heart disease. Although stable patients with a healed myocardial infarction may have a relatively good prognosis, risk stratification in the predischarge period should be valuable for deciding upon appropriate management. In this respect, the presence of discordant BMIPP uptake relative to (201)Tl perfusion appears to be the best predictor of future cardiac events among all other cardiovascular imaging modalities. Since discordant BMIPP uptake correlates well with redistribution on stress (201)Tl imaging and perfusion-metabolism mismatch on positron emission tomography, it is considered that such BMIPP and (201)Tl discordance may identify a high-risk subgroup among patients with acute myocardial infarction. A BMIPP scan may reflect prior severe ischaemia after recovery of perfusion, the so-called "ischaemic memory". Gated BMIPP SPECT has been recently introduced for simultaneous assessment of myocardial metabolism and ventricular function. Such a new technique seems to be valuable for a better understanding of the pathophysiological state of heart failure and cardiomyopathy.

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

Science.gov (United States)

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

2016-01-01

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

Myocardial perfusion SPECT imaging in patients with myocardial bridging

International Nuclear Information System (INIS)

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

2008-01-01

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

Myocardial perfusion imaging with Technetium-99m Sestamibi and Thallium-201. Results of the phase III clinical trial

International Nuclear Information System (INIS)

Giering, L.; Haber, S.; Joseph, J.L.; Neacy, W.

1998-01-01

Full text: Technetium-99m-Sestamibi (MIBI) has been compared to 201 TI and coronary angiography in a large Phase III clinical trial to assess diagnostic accuracy. Exercise and rest planar (P) and SPECT (S) MIBI, and exercise and redistribution thallium-201 studies were performed in 150 healthy volunteers and 396 patients (379 males; mean age 51.3 years). Prior myocardial infarction was present in 50% of the patients. Sensitivity and specificity for angiographically defined cardiovascular diseases - CAD (>70% stenosis) for planar imaging was 90.3% and 81.3% for MIBI and 91.6% and 50.0% for 201 TI. Agreement was 88.7% MIBI and 84.0% for 201 TI. For SPECT imaging, sensitivity and specificity were 95.1% and 46.0% for MIBI and 92.3% and 39.7% for 201 TI. Agreement was 80.0% for MIBI and 76.1% for 201 TI. Tomographic normality rates were 91.4% and 92.9% for MIBI and 201 TI. Agreement for characterisation of defect type by MIBI and 201 TI SPECT was 82.5%. In females, sensitivity was comparable for both agents. Specificity of MIBI planar and SPECT imaging was higher then for 201 TI (P: 90.9% v. 66.7%; S: 76.2% v. 61.9%). The improved imaging characteristics of MIBI results in better diagnostic confidence when interpreting myocardial perfusion studies especially in women and obese patients

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

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

1997-09-01

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

Spectrophotometric determination of Tl carrier in 201Tl-TlCl injection

International Nuclear Information System (INIS)

Gong Quansheng; Jing Lie

1997-01-01

A simple and sensitive method for the spectrophotometric determination of carrier content (Thallium) in 201 Tl-TlCl injection is described. Thallium (I) is oxidised to Thallium (III) by aqueous bromine, then excess bromine is removed by adding sulfosalicylic acid. In buffer solution (NH 4 Cl-NH 4 OH) at pH 11.7 with the presence of emulsifier OP, thallium (III) and cadion form a complex having an absorption maximum at 469 nm with a molar absorptivity of 1.37 x 10 4 m 2 /mol. Beer's law is obeyed in the concentration range of 0-7 μg/5 mL. The effect of impurity elements in 201 Tl-TlCl injection is examined. It is an ideal method for the analysis of radioactive solution

Myocardial uptake of thallium-201 in rat with cardiac hypertrophy

International Nuclear Information System (INIS)

Torii, Yukio; Adachi, Haruhiko; Kizu, Akira; Nakagawa, Masao; Ijichi, Hamao

1985-01-01

The thallium-201 (TL) has been used in order to diagnose myocardial infarction and ischemia. Although it is well known that TL distributes in the myocardium in proportion to the distribution of coronary blood flow, the biological property of TL in the loaded myocardium remains unclear. We studied the myocardial uptake of TL in rat with cardiac hypertrophy. Experiments were performed in 30 anesthetized rats devided into 3 groups; control group (C,N=14), hypertrophy group (H,N=6) and diltiazem group (D, 0.3 mg/kg/min. IV. N=10). Cardiac hypertrophy was produced with the banding of the ascending aorta. Myocardial blood flow (MBF) was measured by microspheres labeled with Strontium-85. Cardiac weight was increased in H, and both MBF and TL uptake were proportionally increased. MBF was negatively correlated with the extraction fraction in C (r=-0.71), in H (r=-0.66) and in D (r=-0.85), and this relationship in H was significantly different from it in C (p<0.05), but not in D. From these results, we concluded that TL uptake in H is not always dependant on MBF and affected by the altered metabolism of hypertrophied myocardium. (author)

False-negative dipyridamole-thallium-201 myocardial imaging after caffeine infusion

International Nuclear Information System (INIS)

Smits, P.; Corstens, F.H.; Aengevaeren, W.R.; Wackers, F.J.; Thien, T.

1991-01-01

The vasodilator effect of intravenously administered dipyridamole may be caused by an increase in endogenous plasma adenosine levels. The authors evaluated the effect of caffeine, an adenosine receptor antagonist, on the diagnostic results of dipyridamole-201Tl myocardial imaging in eight patients with coronary artery disease. Caffeine infusion significantly attenuated the dipyridamole-induced fall in blood pressure and the accompanied increase in heart rate. The infusion of dipyridamole alone resulted in chest pain and ST-segment depressions on the electrocardiogram in four patients, whereas none of these problems occurred when the tests were repeated after caffeine. In six of eight patients, caffeine was responsible for false-negative dipyridamole-201Tl tests. Semiquantitive scores of the dipyridamole-induced 201Tl perfusion defects were decreased by caffeine from 9.0 ± 0.9 to 2.0 ± 1.1 points (p less than 0.05). Computerized analysis revealed a caffeine-mediated reduction in the percent reversibility of the images from 46% ± 16% to 6% ± 10% (p less than 0.05). They conclude that the use of caffeinated products prior to dipyridamole-201Tl testing may be responsible for false-negative findings

False-negative dipyridamole-thallium-201 myocardial imaging after caffeine infusion

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Smits, P.; Corstens, F.H.; Aengevaeren, W.R.; Wackers, F.J.; Thien, T. (University Hospital Nijmegen (Netherlands))

1991-08-01

The vasodilator effect of intravenously administered dipyridamole may be caused by an increase in endogenous plasma adenosine levels. The authors evaluated the effect of caffeine, an adenosine receptor antagonist, on the diagnostic results of dipyridamole-201Tl myocardial imaging in eight patients with coronary artery disease. Caffeine infusion significantly attenuated the dipyridamole-induced fall in blood pressure and the accompanied increase in heart rate. The infusion of dipyridamole alone resulted in chest pain and ST-segment depressions on the electrocardiogram in four patients, whereas none of these problems occurred when the tests were repeated after caffeine. In six of eight patients, caffeine was responsible for false-negative dipyridamole-201Tl tests. Semiquantitive scores of the dipyridamole-induced 201Tl perfusion defects were decreased by caffeine from 9.0 {plus minus} 0.9 to 2.0 {plus minus} 1.1 points (p less than 0.05). Computerized analysis revealed a caffeine-mediated reduction in the percent reversibility of the images from 46% {plus minus} 16% to 6% {plus minus} 10% (p less than 0.05). They conclude that the use of caffeinated products prior to dipyridamole-201Tl testing may be responsible for false-negative findings.

Use of thallium-201 myocardial scintigraphy for the prediction of the response to {beta}-blocker therapy in patients with dilated cardiomyopathy

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Hara, Yuji; Hamada, Mareomi; Ohtsuka, Tomoaki; Ogimoto, Akiyoshi; Saeki, Hideyuki; Suzuki, Jun; Matsunaka, Tsuyoshi; Nakata, Shigeru; Shigematsu, Yuji [Ehime Univ., Shigenobu (Japan). School of Medicine

2002-12-01

This study was performed to evaluate whether thallium-201 myocardial scintigraphy (Tl-201) and iodine-123-metaiodobenzylguanidine (MIBG) myocardial scintigraphy could predit the usefulness of {beta}-blocker therapy in patients with dilated cardiomyopathy (DCM). Tl-201 and MIBG were performed in 47 patients before {beta}-blocker therapy. Patients were classified into group A, if their cardiac function improved, and group B, whose function remained unchanged Two types of extent score (ES) by Tl-201 were proposed to quantitate myocardial damage, mean-2SD (ES-2) and mean -3SD (ES-3). The ES difference between ES-2 and ES-3 was calculated, and according to ES and ES difference, DCM cases were classified into 3 groups: mild-defect type (mild-type), moderate-defect type (moderate-type) and severe-defect type (severe-type). The heart-to-mediastinum (H/M) MIBG uptake ratio was evaluated, and the percent washout ratio of myocardial MIBG was obtained from these data. Group A comprised 18 mild-type, 14 moderate-type and 1 severe-type cases, and group B comprised 5 mild-type, 4 moderate-type and 5 severe-type cases. A significant relation was observed between the defect type on Tl-201 and the response to {beta}-blocker therapy (p=0.0090). Both H/M MIBG uptake ratios and washout ratio were not significantly different in the 2 groups. Tl-201 may be useful for predicting the response to {beta}-blocker therapy in patients with DCM. (author)