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G L Tarolo

Publications and source records attributed to G L Tarolo.

88 records · Page 5Linked to original sources
PubMedDate not supplied

[Improvement of the diagnostic value of synchronous myocardial tomoscintigraphy in the assessment of regional myocardial perfusion].

INTRODUCTION: Gated SPECT using 99mTc-labeled flow tracers provides simultaneous assessment of global and regional myocardial function. PURPOSE: To investigate whether studying regional wall thickening after stress and at rest provides additional diagnostic information in coronary artery disease patients. METHODS: We examined 61 consecutive patients (40 men) who underwent conventional diagnostic dual day stress/rest Gated SPECT using a dual head SPECT camera, following injection of 925 MBq of 99mTc-Tetrofosmin. The mean age of these patients was 61 years (range: 23-73); 28 patients had a history of myocardial infarction. Perfusion was analyzed on both ungated and end-diastolic images using 20 segments scored on a 5-point scale (0 = normal, 4 = no uptake), while wall thickening and motion were assessed visually on stress/rest end-systolic images using a 4-point score (0 = normal, 3 = no wall thickening/motion). Twenty eight patients underwent coronary angiography. RESULTS AND DISCUSSION: 14/61 (23%) patients showed no segmental defects, while fixed equivocal defects, with preserved wall thickening, in 10/61 (16%) patients were considered artifactual. 11/61 (18%) showed true fixed defects. The remaining 26 patients showed al least one reversible defect. 14/61 (23%) patients with post-stress wall thinning and normal rest wall thickness, were considered stunned. The stunned subgroup showed a significant post-stress reduction in left ventricular ejection fraction. Finally, analyzing 1220 segments, we found an excellent agreement (k = .697) between the segmental score obtained by end-diastolic and ungated post-stress images: in fact, comparing the two sets of images, diagnostic accuracy was not significantly different. However the number of segments with fixed defects and normal wall thickening was lower with end-diastolic perfusion images than with ungated images, probably due to attenuation artifacts. This suggests a better accuracy of the former in the evaluation of regional myocardial perfusion. CONCLUSIONS: Although stress end-diastolic images do not seem to significantly improve diagnostic perfusion accuracy compared to ungated acquisitions, the simultaneous assessment of stress-rest wall thickening permits better characterization of a coronary artery disease population.

Coronary Circulation↗
PubMedDate not supplied

Labelled leukocytes for diagnosis of infectious diseases. Our experience in labelling and clinical usefulness.

BACKGROUND: To review our experience in infectious diseases diagnosis, using a simple labelling technique. METHODS: We made 101 scans in 91 patients with suspected infectious diseases confirmed by clinical, histologic or cultural specimens; a clinical or instrumental follow-up was available for every patient. Patients were divided into four subgroups: A: Inflammatory Bowel Diseases; B: Septic Syndromes; C: Bone diseases; D: Others. We used 99mTc-HMPAO in 80 scans and 111In in 21. In 20/80 frozen and stored HMPAO was used. RESULTS: 99mTc-HMPAO frozen and stored labelling yield was: 60%(SD15%), 99mTcHMPAO: 62(12)(p n.s.), 111In 75%(10%), (p < 0.05). Frozen-stored HMPAO was sterile and apyrogen. 27 had positive scan without leukocytosis or neutrophilia. No correlation between leukocytosis or neutrophilia and yield was observed. Transit lung times ranged between 14-16 min without differences among three radiopharmaceuticals. In each Group and in the sample as a whole True Positive, False Positive, True Negative, False Negative, Sensitivity, Specificity and Accuracy, were calculated. In Group B and in the sample as a whole Predictive Positive Value and Negative Predictive Value were also evaluated. CONCLUSIONS: Labelling yields and "viability" were good using the three radiopharmaceuticals; labelling procedure was simple and safe. Accuracy PPV, NPV, cost-effectiveness were good; 111In is the choice for diagnosis of bone and joint infections. Frozen-stored HMPAO should be introduced as a cost-saving labelling procedure in practice.

Adolescent↗
PubMedDate not supplied

[Proposal for a quality control procedure for rotating gamma camera tomographic systems].

Single photon emission computerized tomography using a rotating gamma camera needs accurate calibration of electromechanical components, detection system and reconstruction software. A complete group of quality control procedures, developed on the basis of experience and experimental data acquired using a series of widely used gamma camera SPECT systems is presented. The procedures are divided into controls related to the rotational movement. of the detector and controls on the principal physical parameters characterizing a tomographic image. All quality controls here presented were performed with commercial phantoms.

Quality Control↗
PubMedDate not supplied

[Clinical significance of the role of left ventricular cavitation ratio in the assessment of coronary artery disease with 99mTc-tetrofosmin].

UNLABELLED: This study was aimed at assessing the increase in left ventricular cavity volume in patients with induced stress ischemia, by the quantitative analysis of myocardial SPECT perfusion images obtained 30-45 min after 99mTc-Tetrofosmin injection. PATIENTS AND METHODS: 31 consecutive patients with suspected CAD (group A) and 16 low risk CAD subjects (group B) underwent the study. Global (GMPR) and regional myocardial perfusion reserve indices were assessed superimposing a 17 ROI mask on stress and rest bull's eye images. Ventricular cavitation index (VCI) was calculated manually, outlining the left ventricular cavity on stress and rest midventricular SPECT slices. L/H ratio was determined on anterior SPECT images. RESULTS: On the basis of perfusion patterns, group A was divided into two subgroups: subgroup 1 included the patients with reversible perfusion defects (n = 20) and subgroup B those with irreversible perfusion defects (n = 11). Average stress CI was significantly higher in group A than in group B (p < 0.01) and in subgroup 1 than in group B (p < 0.005). Rest CVI, GMPR and L/H ratio showed no significant intergroup differences. The stress VCI to rest VCI ratio (VCI ratio) was higher in subgroup 1 than group B (p < 0.0001) and in subgroup 1 than in subgroup 2 (p < 0.01). Moreover, VCI ratio was higher in group A than in group B. CONCLUSION: These preliminary data show that, in ischemic patients, left ventricular cavity volume increases after stress also in 99mTc-Tetrofosmin images. Since our images were acquired 30-45 min after stress, when the dilatation due to ventricular dysfunction is usually resolved, the volume increase may be caused by a cavitation effect due to reduced intracardiac blood flow.

Aged↗