Single Photon Emission Computed Tomography

Theaimof this studywasto assesswhethernitrateadministra tion improvesthe imagingcapabilitiesof @°‘Tc-MlBl tomogra phy in detectingviablemyocardiumin coronaryarterydisease (CAD). Methods: Thirty-one patients withangiographically proven CADand chronicLV dysfunction(ejectionfraction39% ±9%) underwenttwo @°‘Tc-MlBl studieson separatedays:oneunder rest conditionsand the other after nitroglycerine(0.005mg/kg per Os)administration.Within1 wk, all patientsalso underwent rest-redistribution 2o1@fl imaging. Eightpatients werealsostud ied by echocardiography before and 5 ±3 mo after coronary revascularization. Results: On resting 99mTc.MlBl im ages, 302 segmentshad normal uptake, 183 segmentshad moderatelyreduceduptakeand 197 had severelyreducedup take. Of the segmentswith severelyreduceduptake,54 (27%) had increased uptake after nitroglycerineand were viable on 201fl images. Of the 143 (73%) segmentswith severely reduced @°Tc-MlBl uptakeand no changeafternitroglycerine, 81% werenonvi...

Tissue hypoxia results from an inadequate supply of oxygen (O2) that compromises biological functions. Structural and functional abnormalities of the tumour vasculature together with altered diffusion conditions inside the tumour seem to be the main causes of tumour hypoxia. Evidence from experimental and clinical studies points to a role for tumour hypoxia in tumour propagation, resistance to therapy and malignant

Summary: Rasmussen encephalitis is a chronic, progres- sive inflammation of the brain of unknown origin. Early diagnosis and treatment with immunoactive agents and/or hemispherectomy are sought to prevent the progressive cognitive decline that accompanies this disease. Combined anatomic and functional neuroimaging may serve to focus the diagnostic workup and to hasten brain biopsy for de- finitive diagnosis. Two biopsy proved

Prospective evaluation by magnetic resonance imaging (MRI) and both single photon emission computed tomography (SPECT) and planar bone scintigraphy was undertaken in 31 temporomandibular joints (TMJs) of 21 symptomatic patients. When compared with the results of subsequent arthrography, MRI (0.88) was more sensitive than SPECT (0.76) or planar (0.56) scintigraphy for detection of internal derangement of the TMJ. A diagnostic sensitivity of 0.96 was achieved when the results of either MRI or SPECT was considered evidence of internal joint derangement. Five symptomatic TMJs, clinically thought to be abnormal, were positive on SPECT but showed no evidence of anterior disk displacement at the time of arthrography. In such instances, SPECT may be detecting functionally significant altered joint mechanics that are not evident on anatomic imaging of the TMJ.

Purpose The aim of this study was to improve the uniformity of the axial spatial resolution and sensitivity in pinhole single-photon emission computed tomography (SPECT) and to extend the axial field of view, by using a dedicated three-pinhole collimator. Methods A rectangular tungsten plate with three pinhole apertures of 1.5 mm diameter was designed to image a cylindrical field of view of 55 mm diameter and 160 mm axial length using a clinical gamma camera. To evaluate the non-uniformity of spatial resolution and noise, a multiple-disk phantom was built. The phantom was filled with Tc-99m, and data were acquired using a circular orbit and reconstructed with a dedicated iterative reconstruction algorithm. The axial spatial resolution together with the noise was measured in each disk. These measurements were compared to a single-pinhole system using an identical acquisition geometry and reconstruction. Results At the central slice, a spatial resolution of 2.7 mm was observed for both the three-pinhole and single-pinhole geometries. At 17.5 mm from the central slice, the axial spatial resolution deteriorated to 10.3 mm when using a single pinhole, while the spatial resolution remained 2.7 mm for the three-pinhole system. In the central slice, 19% noise was observed for both geometries. At 31.5 mm from this central slice, the noise remained 19% for the three-pinhole geometry, while it increased to 32% using a single pinhole. Conclusion The presented three-pinhole collimator improves the uniformity of the axial spatial resolution and sensitivity in pinhole SPECT and consequently extends the axial field of view, a requirement for whole-body small-animal imaging.

Myocardial perfusion and regional wall motion during adenosine-induced coronary vasodilation were assessed in 40 patients with angina pectoris by technetium-99m sestamibi single-photon emission computed tomography (SPECT) and simultaneous 2-dimensional echocardiography. Adenosine was infused intravenously at a dose of 140 micrograms/kg body weight per minute for 6 minutes, and technetium-99m sestamibi was injected at 3 minutes. Adenosine caused a significant decrease in systolic and diastolic blood pressure and a significant increase in heart rate and the heart rate-blood pressure product. Adverse effects were mild and transient and no patient required aminophylline. Completely or partially reversible defects on SPECT were present in 28 patients, a fixed defect was seen in 4 patients, and no defect was seen in 8 patients. Two-dimensional echocardiography revealed a new or worsening wall motion abnormality in 21 patients, a fixed abnormality in 4 patients and no abnormality in 15. Transient perfusion defects were associated with transient wall motion abnormalities in 71% of cases. The overall sensitivity, specificity and predictive accuracy of adenosine echocardiography in detecting significant coronary artery disease (> 50% diameter stenosis) were 74, 100 and 78%, respectively, whereas those of adenosine SPECT were 94, 100 and 95%, respectively (p < 0.05, NS, and < 0.05, respectively). Thus adenosine technetium-99m sestamibi SPECT has a higher sensitivity and predictive accuracy than adenosine echocardiography, suggesting that adenosine-induced perfusion defects are not always associated with wall motion abnormality.(ABSTRACT TRUNCATED AT 250 WORDS)

Neuroimaging plays a major role in the evaluation of patients with neurologic disorders. The utility of various neuroimaging studies is rapidly increasing in both clinical and research settings. Neurologists should learn about the technical aspects, indications, and ...

Preparations of d,l- and meso-hexamethylpropyleneamine oxime (HM-PAO) labeled with technetium-99m were added to rat brain homogenates diluted with phosphate buffer (l: 10). The conversion of d,l-HM-PAO to hydrophilic forms took place with an initial rate constant of 0.12 min−1. Incubation of the brain homogenate with 2% diethyl maleate for 5 h decreased the homogenate's measured glutathione (GSH) concentration from 160 to 16 μ M and decreased the conversion rate to 0.012 min−1. Buffered aqueous solutions of glutathione rapidly converted the HM-PAO tracers to hydrophilic forms having the same chromatographic characteristics as found in the brain homogenates. The rate constant for the conversion reaction of d,l-HM-PAO in GSH aqueous solution was 208 and 317 L/mol/min in two different assay systems and for meso-HM-PAO the values were 14.7 and 23.2 L/mol/min, respectively. Rat brain has a GSH concentration of about 2.3 m M and the conversion of the d,l-HM-PAO due to GSH alone should...

PET is a technique with a strong potential for use in drug evaluation and development. In particular, the distribution and pharmacokinetics of locally administered drugs may be advantageously explored noninvasively using labeled compounds. This pilot study was performed to demonstrate the effectiveness of PET for drug development and to determine the human biodistribution and kinetics of triamcinolone acetonide, labeled with 11C, formulated and nasally administered as Nasacort AQ nasal inhalant. Carbon-11-labeled triamcinolone acetonide was formulated as the commercial product, and PET scans of the heads of four volunteers were performed in a vertical orientation. Region-of-interest analysis with MRI coregistration was used to analyze the distribution and kinetics in nasal tissues. Deposition of the majority of the dose on target tissues was immediate. Penetration into sinuses was observed. There was moderate redistribution and slow migration of the drug through nasal passages to th...

Hippocampal volume is a core biomarker of Alzheimer's disease (AD). However, its contribution over the standard diagnostic workup is unclear. Three hundred fifty-six patients, under clinical evaluation for cognitive impairment, with suspected AD and Mini-Mental State Examination ≥20, were recruited across 17 European memory clinics. After the traditional diagnostic workup, diagnostic confidence of AD pathology (DCAD) was estimated by the physicians in charge. The latter were provided with the results of automated hippocampal volumetry in standardized format and DCAD was reassessed. An increment of one interquartile range in hippocampal volume was associated with a mean change of DCAD of -8.0% (95% credible interval: [-11.5, -5.0]). Automated hippocampal volumetry showed a statistically significant impact on DCAD beyond the contributions of neuropsychology, (18)F-fluorodeoxyglucose positron emission tomography/single-photon emission computed tomography, and cerebrospinal fluid ma...