scholarly journals Efficient 1-Hour Technetium-99 m Pyrophosphate Imaging Protocol for the Diagnosis of Transthyretin Cardiac Amyloidosis

2020 ◽  
Vol 13 (2) ◽  
Author(s):  
Ahmad Masri ◽  
Syed Bukhari ◽  
Shahzad Ahmad ◽  
Ricardo Nieves ◽  
Yvonne S. Eisele ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Single Photon ◽  
Photon Emission ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Myocardial Uptake ◽  
Planar Imaging ◽  
Imaging Protocol ◽  
Tertiary Center ◽  
Grade 3

Background: Technetium-99 m pyrophosphate protocols for transthyretin cardiac amyloidosis diagnosis have variably used 1- and 3-hour imaging time points. We investigated whether imaging at 1 hour with superior efficiency had comparable diagnostic accuracy as 3-hour imaging. Methods: This is a registry analysis of patients with suspected transthyretin cardiac amyloidosis referred for technetium-99 m pyrophosphate at a single tertiary center from June 2015 through January 2019. Patients underwent planar and single-photon emission computed tomography (SPECT) imaging at 1 and 3 hours. A positive Tc-99m pyrophosphate study was defined by the presence of diffuse myocardial tracer uptake on SPECT. For planar imaging, visual semiquantitative (grades 0-3, ≥2 considered positive) and quantitative heart to contralateral ratios (≥1.5 considered positive) were used. Results: Two hundred thirty-three patients (69% men; median age, 77 [69–83] years) underwent the study protocol. There were 60 (25.8%) patients with diffuse myocardial uptake, 1 (0.4%) with regional uptake, and 172 (73.8%) with no myocardial uptake. Results of SPECT were identical at 1 and 3 hours. Planar imaging at 1 hour had 98% sensitivity and 96% specificity. Planar grade 0 uptake or heart to contralateral ratio ≤1.2 and planar grade 3 uptake or heart to contralateral ratio ≥2.0 were always associated with negative and positive SPECT, respectively. For planar grades 1 and 2 uptake and heart to contralateral ratio 1.3 to 1.9, SPECT was needed to make a diagnosis. No patient with light-chain cardiac amyloidosis had positive SPECT. Conclusions: An efficient 1-hour technetium-99 m pyrophosphate protocol had comparable diagnostic performance to a 3-hour protocol.

Computerized Tomography (CT) Updates and Challenges in Diagnosis of Bone Metastases During Prostate Cancer

2020 ◽  
Vol 16 (5) ◽  
pp. 565-571
Author(s):  
Jinguo Zhang ◽  
Guanzhong Zhai ◽  
Bin Yang ◽  
Zhenhe Liu
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Computerized Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Major Complication ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Pet Ct

Prostate cancer is one of the most common cancers in men. This cancer is often associated with indolent tumors with little or no lethal potential. Some of the patients with aggressive prostate cancer have increased morbidity and early deaths. A major complication in advanced prostate cancer is bone metastasis that mainly results in pain, pathological fractures, and compression of spinal nerves. These complications in turn cause severe pain radiating to the extremities and possibly sensory as well as motor disturbances. Further, in patients with a high risk of metastases, treatment is limited to palliative therapies. Therefore, accurate methods for the detection of bone metastases are essential. Technical advances such as single-photon emission computed tomography/ computed tomography (SPECT/CT) have emerged after the introduction of bone scans. These advanced methods allow tomographic image acquisition and help in attenuation correction with anatomical co-localization. The use of positron emission tomography/CT (PET/CT) scanners is also on the rise. These PET scanners are mainly utilized with 18F-sodium-fluoride (NaF), in order to visualize the skeleton and possible changes. Moreover, NaF PET/CT is associated with higher tracer uptake, increased target-to-background ratio and has a higher spatial resolution. However, these newer technologies have not been adopted in clinical guidelines due to lack of definite evidence in support of their use in bone metastases cases. The present review article is focused on current perspectives and challenges of computerized tomography (CT) applications in cases of bone metastases during prostate cancer.

scholarly journals NOGA-Guided Analysis of Regional Myocardial Perfusion Abnormalities Treated With Intramyocardial Injections of Plasmid Encoding Vascular Endothelial Growth Factor A-165 in Patients With Chronic Myocardial Ischemia

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Mariann Gyöngyösi ◽  
Aliasghar Khorsand ◽  
Sholeh Zamini ◽  
Wolfgang Sperker ◽  
Christoph Strehblow ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Perfusion Defect ◽  
Single Photon ◽  
Photon Emission ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Background— The aim of this substudy of the EUROINJECT-ONE double-blind randomized trial was to analyze changes in myocardial perfusion in NOGA-defined regions with intramyocardial injections of plasmid encoding plasmid human (ph)VEGF-A 165 using an elaborated transformation algorithm. Methods and Results— After randomization, 80 no-option patients received either active, phVEGF-A 165 (n=40), or placebo plasmid (n=40) percutaneously via NOGA-Myostar injections. The injected area (region of interest, ROI) was delineated as a best polygon by connecting of the injection points marked on NOGA polar maps. The ROI was projected onto the baseline and follow-up rest and stress polar maps of the 99m-Tc-sestamibi/tetrofosmin single-photon emission computed tomography scintigraphy calculating the extent and severity (expressed as the mean normalized tracer uptake) of the ROI automatically. The extents of the ROI were similar in the VEGF and placebo groups (19.4±4.2% versus 21.5±5.4% of entire myocardium). No differences were found between VEGF and placebo groups at baseline with regard to the perfusion defect severity (rest: 69±11.7% versus 68.7±13.3%; stress: 63±13.3% versus 62.6±13.6%; and reversibility: 6.0±7.7% versus 6.7±9.0%). At follow-up, a trend toward improvement in perfusion defect severity at stress was observed in VEGF group as compared with placebo (68.5±11.9% versus 62.5±13.5%, P =0.072) without reaching normal values. The reversibility of the ROI decreased significantly at follow-up in VEGF group as compared with the placebo group (1.2±9.0% versus 7.1±9.0%, P =0.016). Twenty-one patients in VEGF and 8 patients in placebo group ( P <0.01) exhibited an improvement in tracer uptake during stress, defined as a ≥5% increase in the normalized tracer uptake of the ROI. Conclusions— Projection of the NOGA-guided injection area onto the single-photon emission computed tomography polar maps permits quantitative evaluation of myocardial perfusion in regions treated with angiogenic substances. Injections of phVEGF A 165 plasmid improve, but do not normalize, the stress-induced perfusion abnormalities.

scholarly journals Gamma Radiation Imaging System via Variable and Time-Multiplexed Pinhole Arrays

Sensors ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. 3013 ◽  
Author(s):  
Ariel Schwarz ◽  
Amir Shemer ◽  
Yossef Danan ◽  
Rachel Bar-Shalom ◽  
Hemy Avraham ◽  
...  
Keyword(s):  
Gamma Radiation ◽  
Imaging System ◽  
Single Photon ◽  
Photon Emission ◽  
Three Dimensional ◽  
Medical Diagnostics ◽  
Emission Computed Tomography ◽  
Planar Imaging ◽  
Gamma Imaging ◽  
Image Capturing

Biomedical planar imaging using gamma radiation is a very important screening tool for medical diagnostics. Since lens imaging is not available in gamma imaging, the current methods use lead collimator or pinhole techniques to perform imaging. However, due to ineffective utilization of the gamma radiation emitted from the patient’s body and the radioactive dose limit in patients, poor image signal to noise ratio (SNR) and long image capturing time are evident. Furthermore, the resolution is related to the pinhole diameter, thus there is a tradeoff between SNR and resolution. Our objectives are to reduce the radioactive dose given to the patient and to preserve or improve SNR, resolution and capturing time while incorporating three-dimensional capabilities in existing gamma imaging systems. The proposed imaging system is based on super-resolved time-multiplexing methods using both variable and moving pinhole arrays. Simulations were performed both in MATLAB and GEANT4, and gamma single photon emission computed tomography (SPECT) experiments were conducted to support theory and simulations. The proposed method is able to reduce the radioactive dose and image capturing time and to improve SNR and resolution. The results and method enhance the gamma imaging capabilities that exist in current systems, while providing three-dimensional data on the object.

scholarly journals Beyond the bones and joints: a review of ligamentous injuries of the foot and ankle on 99mTc-MDP-SPECT/CT

2019 ◽  
Vol 92 (1104) ◽  
pp. 20190506
Author(s):  
Ramin Mandegaran ◽  
Sukhvinder Dhillon ◽  
Ho Jen
Keyword(s):  
Soft Tissues ◽  
Single Photon ◽  
Photon Emission ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Foot And Ankle ◽  
Case Examples ◽  
Pictorial Review ◽  
Articular Pathology ◽  
Photon Emission Computed Tomography

99mTc-MDP-single photon emission computed tomography (SPECT)/CT has established itself as a useful modality in the assessment of the painful foot and ankle, owing to its ability to depict anatomical and functional information simultaneously. Despite its growing popularity, much of the literature describing the utility of 99mTc-MDP-SPECT/CT of the foot and ankle is limited to osseous and articular pathology, with descriptions of ligamentous pathology limited to just a handful of cases. Though assessment of soft tissues using a combination of bone tracer and CT is limited, with a sound understanding of the regional anatomy, it is certainly within the scope of 99mTc-MDP-SPECT/CT to accurately identify ligamentous injuries based on focal tracer uptake patterns and suspected ligamentous injuries should be reported as such. This article provides a case-based pictorial review of the 99mTc-MDP-SPECT/CT appearances of the various ligamentous injuries of the foot and ankle with case examples and MRI correlation where available, most of which have yet to be described. The typical patterns of bone tracer uptake and associated CT abnormalities that may be observed are discussed.

Relationship of gastric emptying and volume changes after a solid meal in humans

2005 ◽  
Vol 289 (2) ◽  
pp. G261-G266 ◽  
Author(s):  
Duane D. Burton ◽  
H. Jae Kim ◽  
Michael Camilleri ◽  
Debra A. Stephens ◽  
Brian P. Mullan ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Volume Change ◽  
Single Photon ◽  
Photon Emission ◽  
Gastric Volume ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Planar Imaging ◽  
Solid Meal ◽  
3 Dimensional

Noninvasive imaging has been developed to measure gastric volumes. The relationship between gastric emptying and volume postprandially is unclear. The aims were to 1) develop a 3-dimensional (3D) single photon emission-computed tomography (SPECT) method to simultaneously measure gastric volume and emptying postprandially, 2) describe the course of gastric volume change during emptying of the meal, and 3) assess a 3D method measuring gastric emptying. In 30 healthy volunteers, we used 111In-planar and 99mTc-SPECT imaging to estimate gastric emptying and volume after a radiolabeled meal. A customized analysis program of SPECT imaging assessed gastric emptying. A Bland-Altman plot assessed the performance of the new SPECT analysis compared with planar analysis. Gastric volume postprandially exceeds the fasting volume plus meal volume. The course of volume change and gastric emptying differ over time. Higher differences in volumes exist relative to fasting plus residual meal volumes at 15 min (median 763 vs. 568 ml, respectively, P < 0.001), 1 h (median 632 vs. 524 ml, P < 0.001), and 2 h (median 518 vs. 428 ml, P < 0.02), in contrast to similar volumes at 3 h (median 320 vs. 314 ml, P = 0.85). Analysis of SPECT imaging accurately measures gastric emptying compared with planar imaging with median differences of 1% (IQR −2.25 to 2.0) at 1 h, 1% (−3.25 to 2.25) at 2 h, and −2.5% (−4 to 0) at 3 h. Gastric volume exceeds meal volume during the first 2 postprandial hours, and simultaneous measurements of gastric volume and emptying can be achieved with a novel 3D SPECT method.

scholarly journals The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastoma

2021 ◽  
Vol 20 (4) ◽  
pp. 22-32
Author(s):  
E. D. Kireeva ◽  
. Kailash ◽  
T. V. Shamanskaya ◽  
M. Ya. Yadgarov ◽  
D. Yu. Kachanov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Whole Body ◽  
Emission Computed Tomography ◽  
Planar Imaging ◽  
Single Photon Emission ◽  
Emission Computed ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastomaWhole body scintigraphy with ¹²³I-Metaiodobenzylguanidine (¹²³I-MIBG) is an important imaging modality for evaluation of patients with neuroblastoma (NB). As the intrinsic nuclear scintigraphic characteristics, the assessment of conventional planar ¹²³I-MIBG images presents some difficulties. The limited resolution of planar images can induce false-negative results for small lesions, whereas the presence of physiologic MIBG uptake is not always easily differentiable from pathologic uptake and can induce false-positive results. Single-photon emission computed tomography combined with computed tomography (SPECT/ CT) hybrid imaging technique, allowing the direct fusion of morphologic and functional information, has been suggested to be more accurate. However, SPECT/CT imaging renders slightly more radiation to patients from CT portion of the study and is time consuming. The aim of our study was to investigate how much SPECT/CT can have additional diagnostic value over planar imaging in NB patients at initial staging. The study was approved by the Independent Ethics Committee and the Scientific Council of the D. Rogachev NMRCPHOI. A total of 251 SPECT/CT scans following by planar ¹²³I-MIBG imaging scans performed in 251 patients with NB were retrospectively analyzed. In 72.1% of the studies, the whole-body planar images and SPECT/CT images showed the same result. In 27.9% of studies, however, SPECT/CT images provided additional very important information. In our study, the diagnosis reached by planar imaging was revised or specified by SPECT/CT in 70 of the 251 patients and was clinically significant. 

Abstract 170: Inflammation Imaging in the Primate Heart Using 111 In-Labeled Anti-Tenascin-C Antibody

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Michiaki Hiroe ◽  
Naohide Ageyama ◽  
Yasuhiro Yasutomi ◽  
Hiroyuki Kurosawa ◽  
Ousuke Fujimoto ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Single Photon ◽  
Photon Emission ◽  
Border Zone ◽  
Myocardial Inflammation ◽  
Emission Computed Tomography ◽  
Myocardial Uptake ◽  
Dual Isotope ◽  
Tenascin C ◽  
Active Inflammation

Myocardial inflammation after myocardial infarction and myocarditis may cause cardiac remodeling, leading to congestive heart failure and arrhythmias. Tenascin-C (TNC), an extracellular matrix glycoprotein, is not normally expressed but specifically expressed associated with active inflammation. The aim of this study was to explore the myocardial expression of TNC after myocardial infarction in Macaca fascicularis (crab-eating monkey) using 111 In-labeled anti-TNC antibody ( 111 In-TNC-Fab’). The left coronary artery was permanently ligated in two monkies and 4 days later, we performed dual-isotope single-photon emission computed tomography imaging (SPECT) of 111 In-TNC-Fab’ and 99m Tc methoxy- isobutyl isonitrile (MIBI), and compared with those of an age-matched control. Then, dual autoradiography was compared with histology and immunostaining for TNC of the heart. Dual-isotope SPECT demonstrated the regional myocardial uptake of 111 In-TNC-Fab’ in the areas of decreased uptake of MIBI. On autoradiography, the radioactivities were observed in the border zone between the infarcted and the noninfarcted area of MI hearts. The hot spots corresponded with the positively immunostained areas. In contrast, no radioactivites of 111 In-TNC-Fab’ were detected in the control. These data clearly indicated that, using 111 In-TNC-Fab’, we can visualize the inflammatory lesions followed by myocardial infarction of the primate.

Targeted imaging of hypoxia-induced integrin activation in myocardium early after infarction

2008 ◽  
Vol 104 (5) ◽  
pp. 1504-1512 ◽  
Author(s):  
Leszek Kalinowski ◽  
Lawrence W. Dobrucki ◽  
David F. Meoli ◽  
Donald P. Dione ◽  
Mehran M. Sadeghi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ex Vivo ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Αvβ3 Integrin ◽  
Myocardial Uptake ◽  
Planar Imaging ◽  
Integrin Activation ◽  
Infarct Region

The αvβ3-integrin is expressed in angiogenic vessels in response to hypoxia and represents a potential novel target for imaging myocardial angiogenesis. This study evaluated the feasibility of noninvasively tracking hypoxia-induced αvβ3-integrin activation within the myocardium as a marker of angiogenesis early after myocardial infarction. Acute myocardial infarction was produced by coronary artery occlusion in rodent and canine studies. A novel 111In-labeled radiotracer targeted at the αvβ3-integrin (111In-RP748) was used to localize regions of hypoxia-induced angiogenesis early after infarction. In rodent studies, the specificity of 111In-RP748 for αvβ3-integrin was confirmed with a negative control compound (111In-RP790), and regional uptake of these compounds correlated with 201Tl perfusion and a 99mTc-labeled nitroimidazole (BRU59-21), which was used as a quantitative marker of myocardial hypoxia. The ex vivo analysis demonstrated that only 111In-RP748 was selectively retained in infarcted regions with reduced 201Tl perfusion and correlated with uptake of BRU59-21. In canine studies, myocardial uptake of 111In-RP748 was assessed using in vivo single-photon-emission computed tomography (SPECT), ex vivo planar imaging, and gamma well counting of myocardial tissue and correlated with 99mTc-labeled 2-methoxy-2-methyl-propyl-isonitrile (99mTc-sestamibi) perfusion. Dual-radiotracer in vivo SPECT imaging of 111In-RP748 and 99mTc-sestamibi provided visualization of 111In-RP748 uptake within the infarct region, which was confirmed by ex vivo planar imaging of excised myocardial slices. Myocardial 111In-RP748 retention was associated with histological evidence of αvβ3-integrin expression/activation in the infarct region. 111In-RP748 imaging provides a novel noninvasive approach for evaluation of hypoxia-induced αvβ3-integrin activation in myocardium early after infarction and may prove useful for directing and evaluating angiogenic therapies in patients with ischemic heart disease.

Ventilation/perfusion SPECT/CT in patients with pulmonary emphysema

2015 ◽  
Vol 54 (01) ◽  
pp. 31-35
Author(s):  
V. Schreiter ◽  
I. Steffen ◽  
H. Huebner ◽  
J. Bredow ◽  
U. Heimann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Emphysema ◽  
Interobserver Agreement ◽  
Single Photon ◽  
Photon Emission ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Visual Interpretation ◽  
Lung Lobe ◽  
Count Density

SummaryThe purpose of this study was to evaluate the reproducibility of a new software based analysing system for ventilation/perfusion single-photon emission computed tomography/ computed tomography (V/P SPECT/CT) in patients with pulmonary emphysema and to compare it to the visual interpretation. Patients, material and methods: 19 patients (mean age: 68.1 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. Data were analysed by two independent observers in visual interpretation (VI) and by software based analysis system (SBAS). SBAS PMOD version 3.4 (Technologies Ltd, Zurich, Switzerland) was used to assess counts and volume per lung lobe/per lung and to calculate the count density per lung, lobe ratio of counts and ratio of count density. VI was performed using a visual scale to assess the mean counts per lung lobe. Interobserver variability and association for SBAS and VI were analysed using Spearman's rho correlation coefficient. Results: Interobserver agreement correlated highly in perfusion (rho: 0.982, 0.957, 0.90, 0.979) and ventilation (rho: 0.972, 0.924, 0.941, 0.936) for count/count density per lobe and ratio of counts/count density in SBAS. Interobserver agreement correlated clearly for perfusion (rho: 0.655) and weakly for ventilation (rho: 0.458) in VI. Conclusions: SBAS provides more reproducible measures than VI for the relative tracer uptake in V/P SPECT/CTs in patients with pulmonary emphysema. However, SBAS has to be improved for routine clinical use.

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