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J Taki

Publications and source records attributed to J Taki.

At least 55 records · Page 3Linked to original sources

Myocardial fatty acid imaging with 123I-labelled 9-methyl-branched pentadecanoic acid (9MPA) using SPET.

123I-labelled 15-(p-iodophenyl)-9-(R,S)-methylpentadecanoic acid (9MPA) is a modified long-chain fatty acid that shows some beta-oxidation. Some basic aspects of this fatty acid, including myocardial uptake, distribution, clearance and differences from 201Tl myocardial perfusion, have yet to be evaluated. An average of 150 MBq of 123I-9MPA was injected intravenously into 16 patients with coronary artery disease. Planar images were obtained 45, 120 and 240 min post-injection, and single photon emission tomography (SPET) was performed at the initial (5 min), middle (45 min) and late (120 min) phases after injection. Myocardial uptake and clearance were evaluated by planar imaging, and a segmental comparison between 123I-9MPA and reinjection or resting 201Tl was performed on the SPET images. 123I-9MPA showed good uptake between 5 and 60 min, but a severe decrease was seen after 120 min in three (19%) patients. The heart-to-mediastinum ratio was 1.68 +/- 0.19, 1.55 +/- 0.19 and 1.40 +/- 1.40 at 45, 120 and 240 min, respectively. The washout rate after background subtraction was 28% for 45 min to 2 h and 47% for 45 min to 4 h. The segmental comparison (n = 182) between 123I-9MPA and 201Tl showed complete agreement of 72, 75 and 65% at 10, 45 and 120 min, respectively. The grading of the uptake of 123I-9MPA was less than that of 201Tl in 20-30% of the segments indicating myocardial fatty acid metabolic impairment relative to perfusion. The regional clearance from 5 to 120 min in the reduced-count region was lower than that in the normal region (28 +/- 7% vs 36 +/- 8%, P < 0.01). All 123I-9MPA SPET images showed good contrast if the data were acquired within 60 min. Based on the clearance of 123I-9MPA from the myocardium, imaging within 120 min is desirable. A mismatch of fatty acids and perfusion was seen in one-quarter of patients, and differential regional clearance may be clinically significant and should be investigated.

Adult↗

Decreased myocardial 123I-MIBG uptake in Parkinson's disease.

We studied myocardial 123I-metaiodobenzylguanidine (MIBG) accumulation in 12 patients with Parkinson's disease (PD). MIBG is an analog of norepinephrine (NE) and a tracer for sympathetic neuron integrity and function. MIBG uptake of the myocardium was significantly lower in PD than in controls. The heart to mediastinum ratio (H/M) was calculated by using the average count per pixel for the heart and mediastinum. In PD, H/M was lower than in controls (P<0.0001), while the washout ratio of the heart was higher (P<0.001). A decrease in myocardial accumulation of MIBG was observed in the early stage of PD. This suggests that the measurement of MIBG may help the diagnosis of early PD, and the causative factor underlying in PD may be operating the NE neuron as well as dopamine neuron.

3-Iodobenzylguanidine↗

Blood flow measurement during distraction osteogenesis.

The regional blood flow of 30 distraction segments in 27 patients was measured during distraction osteogenesis. There were three groups of patients. Group A consisted of seven patients with high grade malignant tumors who received chemotherapy preoperatively and postoperatively. Group B consisted of eight patients with low grade malignant and aggressive benign tumors, who all were treated without chemotherapy. Group C (the control group) consisted of 12 patients with nontumoral conditions. Using quantitative technetium scintigraphy, the regional blood flow within the distracted segment and surrounding soft tissues was measured. The measured radioisotope count was expressed as the ratio of the distracted site to the control site (blood flow ratio). The blood flow ratio for all the cases averaged 1.70 +/- 0.70. Group A had a lower blood flow ratio, which was statistically significant in comparison with the other two groups. The external fixation index showed no significant difference in callus formation among these three groups. No correlation was found between the blood flow ratio and external fixation index. Chemotherapy decreases regional blood flow, but with distraction osteogenesis the regional blood flow can be kept within the normal range or higher. Distraction osteogenesis may overcome the effects of chemotherapy by increasing blood flow.

Adolescent↗

Prediction of prognosis in peripheral facial nerve paralysis using submandibular gland scintigraphy.

UNLABELLED: In this study, we evaluated the ability of submandibular gland scintigraphy to predict the prognosis of peripheral facial nerve paralysis. METHODS: Submandibular gland scintigraphy was performed in 78 patients with acute peripheral facial nerve paralysis. After injection of 180-370 MBq [99mTc]pertechnetate, serial 1-min images were acquired for 25 min. At 15 min after injection of radionuclide, ascorbic acid was administered intraorally to stimulate salivary secretion. Regions of interest were set manually on both submandibular glands, and time-activity curves were generated. The ratios of peak count density (PCR) and washout (WR) of the affected side to the normal side were calculated. Parameters of > or = 0.8 suggested normal affected submandibular function and indicated a good prognosis. RESULTS: Complete recovery of facial nerve paralysis was observed in 52 of 78 patients. The sensitivity, specificity and accuracy of PCR for a good prognosis were 79%, 50% and 69%, and those of WR were 85%, 77% and 82%, respectively. Positive and negative predictive values for a good prognosis were 76% and 54% in PCR and 88% and 71% in WR, respectively. When WR obtained within 14 days of the onset was used, positive and negative predictive values for a good prognosis were 94% and 73%, respectively. None of the eight patients who had values of <0.8 for both parameters within 14 days of the onset recovered completely. CONCLUSION: Submandibular gland scintigraphy can serve as a reliable indicator to predict the prognosis of acute peripheral facial nerve paralysis in its early symptomatic period.

Acute Disease↗

Assessment of P-glycoprotein in patients with malignant bone and soft-tissue tumors using technetium-99m-MIBI scintigraphy.

UNLABELLED: Overexpression of P-glycoprotein (Pgp) has been detected in many malignant tumors including bone and soft-tissue tumors. Technetium-99m-MIBI has proved to be a transport substrate for Pgp. The purpose of our study was to explore 99mTc-MIBI as a functional imaging agent reflecting Pgp expression in malignant bone and soft-tissue tumors. METHODS: Technetium-99m-MIBI scintigraphy was performed in 30 patients with malignant bone and soft-tissue tumors. Radionuclide angiography with 99mTc-MIBI was done and, at 15 min and 3 hr postinjection of the radiopharmaceutical, imaging was performed. The 99mTc-MIBI uptake ratio was calculated by dividing the lesion count by the background count. The washout rate (WR) for 99mTc-MIBI was calculated by the following formula: WR = 100 x [(Te-Be)-(Td-Bd)]/(Te-Be) (%), where Te and Td = decay-corrected count density of the tumor in the 15-min and 3-hr images, respectively. Be and Bd = decay-corrected count density of the background in the 15-min and 3-hr images, respectively. The lesions were resected by open biopsy to obtain a histopathological diagnosis, and immunohistochemical staining was performed to detect Pgp. RESULTS: Twenty-four of 30 patients showed significant uptake at the 15-min image. In these 24 patients, the lesions with a high Pgp expression showed a similar 99mTc-MIBI perfusion index (3.00 +/- 1.04) and uptake ratio (2.05 +/- 0.58) at the 15-min image to those of lesions without a high Pgp expression (2.65 +/- 0.85 and 2.28 +/- 0.64, respectively). On delayed images, the 99mTc-MIBI uptake ratio was lower in patients with a high Pgp expression than in patients without a high Pgp expression (1.37 +/- 0.41 versus 1.87 +/- 0.39, p < 0.01). The washout ratio of 99mTc-MIBI was higher in patients with a high Pgp expression than in patients without a high Pgp expression (66% +/- 25% versus 29% +/- 18%, p < 0.001). None of the 6 patients without 99mTc-MIBI uptake at the 15-min imaging showed 201TI uptake, and only 2 had a high Pgp expression. CONCLUSION: In malignant bone and soft-tissue tumors, perfusion and initial 99mTc-MIBI uptake were not related to the Pgp expression; however, washout of 99mTc-MIBI from the tumor was related to Pgp expression. Technetium-99m-MIBI scintigraphy with washout analysis may be a useful method for the evaluation of Pgp overexpression and its function.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

[Estimation of cardiac output by first-pass data with technetium-99m-labeled myocardial perfusion imaging agent].

Technetium-99m-tetrofosmin, a myocardial perfusion imaging agent was used for estimation of cardiac output by means of first-pass radionuclide angiography performed in the anterior projection. Region of interests (ROIs) were assigned over right ventricle, left ventricle and whole chest, and time activity curves (TACs) were obtained. Cardiac output indices (COIs) were calculated by the following equation; COI = p3/2. Qc/[symbol: see text] A(s)ds, where p = number of pixels of the ventricular ROI, Qc = the peak count rate of the TAC obtained from the whole chest's ROI and [symbol: see text] A(s)ds = the area under ventricular TAC. The COI (y) determined by ROI over the left ventricle yield the best correlation with the cardiac output by conventional radionuclide method (x) (y = 0.0381x + 6.22, r = 0.828, n = 48, p < 0.001). In conclusion, cardiac output can be easily measured with first pass data using myocardial perfusion imaging agent.

Adult↗

Midcourse thallium-201 scintigraphy to predict tumor response in bone and soft-tissue tumors.

UNLABELLED: The purpose of this study was to assess the predictive power of 201TI scintigraphy in the midcourse of chemotherapy for the final tumor response to chemotherapy in malignant bone and soft-tissue tumors. METHODS: The 21 patients studied with 201TI scintigraphy were 14 males and 7 females (average age 39.8+/-22.1 yr; age range 8-74 yr). Planar scintigraphy was performed 15 min after injection of 111 MBq 201TI before chemotherapy, after the third chemotherapy cycle (midcourse) in all 21 patients and after the final chemotherapy cycle but before surgery in 11 patients. The 201TI uptake ratio was calculated by dividing the count density of the lesion by that of the contralateral normal area. The percent reduction of the 201TI uptake ratio calculated by 100 x [(prechemotherapy ratio - postchemotherapy ratio)/prechemotherapy ratio] in the midcourse was compared with that after the final course of chemotherapy, and it also was compared with the histologic response. RESULTS: In patients with histologically complete response [(CR), n=6] and with partial response [(PR), n=5], the percent reduction in 201TI uptake ratio after three cycles of chemotherapy was 64.1%+/-14.4% and 50.9% +/-10.5%, respectively. In patients with histologically no change [(NC), n=10], the percent reduction was 0.40%+/-18.2% after the third cycle; -5.3%+/-20.9% in four patients with full courses of chemotherapy (p < 0.0001 and p < 0.005 compared with the CR and PR groups, respectively). After the final cycle of chemotherapy, the percent reduction in 201TI uptake ratio was 68.6%+/-14.7%, 56.2%+/-6.1% and -0.3%+/-17.2% in the CR, PR and NC groups, respectively (NC versus CR, p < 0.0005; NC versus PR, p < 0.005). CONCLUSION: Thallium-201 scintigraphy performed in the midcourse of chemotherapy is predictive of the final response to chemotherapy that can be demonstrated histologically. Serial 201TI scintigraphy in the midcourse of chemotherapy is useful in assessing final chemotherapeutic response in the early stage of chemotherapy, and it helps clinicians when choosing the most appropriate treatment strategies in patients with bone and soft-tissue tumors.

Adolescent↗

Absent myocardial iodine-123-BMIPP uptake and platelet/monocyte CD36 deficiency.

UNLABELLED: Global absence of myocardial 123I-15-(p-iodophenyl)-3-(R,S)-methyl pentadecanoic acid (BMIPP) uptake is occasionally noted, and it reflects myocardial long-chain fatty acid uptake abnormality. CD36, a membrane glycoprotein expressed on platelet, monocyte and endothelial cells, may contribute to myocardial fatty acid transport, and its deficiency has been reported in a small subset of the population. We hypothesized that CD36 deficiency may be related to absent myocardial BMIPP uptake. Thus, we investigated CD36 expression of platelet/monocyte in patients with absent myocardial BMIPP uptake. METHODS: Peripheral blood of 7 patients with global absence of myocardial BMIPP uptake (3 of 7 patients in one family) and 3 control subjects were examined in flow cytometric analysis. Platelet/monocyte surface CD36 was detected by using OKM5, an anti-CD36 mouse monoclonal antibody. RESULTS: There were no apparent relationships between specific clinical symptoms and absent myocardial BMIPP uptake. None of the blood samples of the 7 patients were stained with OKM5 on the platelet/monocyte cell surface, indicating that all of these patients were Type I CD36-deficient subjects. In contrast, all the control subjects showed normal staining. CONCLUSION: The fact that rare Type I CD36 deficiency was observed in all patients with absent myocardial BMIPP uptake suggests that CD36 plays a role in the myocardial long-chain fatty acid uptake process in humans.

Adult↗

Discrepancy between blood flow and muscarinic receptor distribution in rat brain after middle cerebral artery occlusion.

To clarify whether muscarinic acetylcholine receptor (mAChR) binding can be a viable muscarinic neuronal marker which provides therapeutic information different from perfusional information in global brain, we evaluated the discrepancy between the distribution of cerebral blood flow (CBF), mAChR and its five subtypes of messenger ribonucleic acid (mRNA) in the acute (n=9) and chronic (n=8) phases of a middle cerebral artery (MCA) occlusion model and in sham-operated controls (n=6). In the acute phase, regional CBF was markedly reduced in the MCA territory, whereas mAChR was not reduced and the mRNA was reduced only slightly. In the chronic phase, mAChR was reduced markedly in the infarcted lesion and the mRNA was also reduced. The mAChR was slightly reduced in the ipsilateral substantia nigra and pontine nucleus because of remote effects; however, regional CBF in the substantia nigra was slightly increased and did not change in the pontine nucleus. The discrepancy between CBF and mAChR was clarified, and the tendency toward a reduction in mRNA in the acute ischaemic region without a reduction in mAChR suggested the presence of cholinergic neurons which were viable but hypometabolic. It is concluded that mAChR imaging may be of value for the assessment of the viable cholinergic neuron density in vivo.

Animals↗

Intense Ga-67 uptake in adenosquamous carcinoma of the pancreas.

Gallium-67 citrate (Ga-67) scintigraphy was performed in a patient with adenosquamous carcinoma of the pancreas. Intense and homogeneous uptake was observed in the tumor. Few reports have dealt with Ga-67 findings in pancreatic cancers. Ga-67 uptake in the tumor was assumed to be due to accumulation in the component of squamous cell carcinoma. This case suggested that Ga-67 citrate scintigraphy may be useful in detecting adenosquamous carcinoma of the pancreas. To our knowledge, no report has described findings of Ga-67 citrate scintigraphy of adenosquamous carcinoma of the pancreas. Radiologists should remember adenosquamous carcinoma of the pancreas when encountering such scintigraphic findings.

Aged↗

Functional imaging of gated Tc-99m tetrofosmin study as a simple method to quantify ventricular wall motion.

Myocardial perfusion scintigraphy with wall motion analysis is known to enhance accuracy in diagnosing ischemic heart disease. The purpose of this study is to determine the best method to evaluate regional wall motion in a gated planar perfusion study. Planar gated 99mTc tetrofosmin (GTF) study in two projections was performed after rest-exercise sequence SPECT studies (n = 29). To evaluate wall motion, cine-mode display, wall thickening, and inverted tetrofosmin studies including ventricular inner border tracing, segmental wall shortening and functional images were used. The results were compared with gated blood-pool (GBP) study in the same projections. In the GTF study, functional image identified asynergy significantly better than cinematic display. The best correlation between GTF and GBP studies was observed with functional images of phase and amplitude, with complete visual agreement seen in 145 of 168 (86%) segments. With quantitative analysis by means of regions of interest (n = 280), a good correlation was observed between GTF and GBP regarding regional amplitude (r = 0.78), regional phase (r = 0.84), average left ventricular phase (r = 0.91) and standard deviation of phase values (r = 0.90). The value for the count-based "ejection fraction" derived from inverted GTF showed insufficient correlation to that of the GBP study (r = 0.69). Functional imaging with myocardial perfusion imaging is a simple and effective means to evaluate ventricular asynergy. Similar diagnostic criteria to gated blood-pool imaging and comparable diagnostic accuracy are advantages of this approach.

Aged↗

Comparison of flow capacities of arterial and venous grafts for coronary artery bypass grafting: evaluation with exercise thallium-201 single-photon emission tomography.

Stress thallium-201 tomography was performed to compare the flow capacities of arterial and saphenous vein grafts in patients with coronary artery bypass grafting (CABG). One hundred and seven consecutive patients (95 male and 12 female; mean age 58+/-9.1 years) underwent exercise-redistribution 201Tl myocardial single-photon emission tomography 4-5 weeks after CABG. When a reversible perfusion defect was present in the area covered by a patent bypass graft, the flow capacity of the graft was defined as insufficient. Of all 285 grafts, 211 were considered as complete bypass. Reversible perfusion defects were present in 29 (27%) of 108 myocardial areas supplied by patent arterial grafts but in only 5 (5%) of 103 myocardial areas supplied by patent saphenous vein grafts (P<0.0001). In the LAD area reversible defects were observed in 22 of 82 areas covered by arterial grafts, in contrast to only 1 of 29 areas covered by venous grafts (P<0.01); in the RCA area reversible defects were observed in 7 of 17 and 4 of 41 areas respectively (P<0.01). There was no difference between the native coronary artery stenosis bypassed by patent arterial and venous grafts (88%+/-12% vs 86%+/-14% respectively, P=0.27). In conclusion, flow capacities during peak myocardial demand were more frequently insufficient in arterial bypass grafts than in saphenous vein grafts.

Coronary Artery Bypass↗

Transthoracic transdiaphragmatic approach for hepatectomy of Couinaud's segments VII and VIII.

For hepatectomy of Couinaud's segment VII or VIII, severe compression and mobilization of the liver is required to establish the operative field via the usual transabdominal approach. Compression of the cirrhotic liver impairs hepatic and systemic blood circulation, which may cause liver dysfunction. We adopted a transthoracic transdiaphragmatic approach for hepatectomy of segment VII or VIII in cirrhotic patients to establish a good operative field without compressing the liver. The aim of this study was to evaluate the benefits of this approach. Forty-four patients with hepatocellular carcinoma (HCC) complicating liver cirrhosis who underwent limited hepatectomy of Couinaud's segment VII or VIII were studied. The patients were randomized to two groups preoperatively: group I (n = 22), transabdominal approach; group II (n = 22), transthoracic transdiaphragmatic approach. There were no differences in preoperative liver function tests, hepatic functional reserve, or extent of tumor between the two groups. The operative time in group II was significantly shorter than that in group I (243 +/- 50 versus 313 +/- 80 minutes;p < 0.01). Operative blood loss in group II was also significantly smaller than that in group I (1190 +/- 1098 versus 2679 +/- 2267 g;p < 0.01). Serum lactate dehydrogenase levels on postoperative day 1 in group II were significantly lower than those in group I (587 +/- 154 versus 791 +/- 383 IU/L;p < 0.05). Major postoperative complications were significantly fewer in group II. It was concluded that the transthoracic transdiaphragmatic approach is a useful method for hepatectomy of segments VII and VIII in cirrhotic patients.

Chi-Square Distribution↗

Quantitative rest technetium-99m tetrofosmin imaging in predicting functional recovery after revascularization: comparison with rest-redistribution thallium-201.

OBJECTIVES: This study was undertaken to 1) compare the regional myocardial tracer distributions between rest technetium (Tc)-99m tetrofosmin and rest-redistribution thallium (Tl)-201 images in patients with coronary artery disease and left ventricular dysfunction; and 2) assess the comparative values of these agents for predicting functional recovery after revascularization. BACKGROUND: Tc-99m tetrofosmin is a new myocardial perfusion imaging agent, but its role for detecting viable myocardium is still unclear. METHODS: Thirty-six patients with coronary artery disease and left ventricular dysfunction underwent rest Tc-99m tetrofosmin, rest-redistribution Tl-201 and gated blood pool scintigraphy. In 21 patients with successful revascularization confirmed by follow-up angiography, gated blood pool scintigraphy was repeated after revascularization. Optimal threshold cutoffs to separate reversible from irreversible dysfunction were determined by receive operating characteristic analysis. RESULTS: Regional Tc-99m tetrofosimin activity highly correlated with redistribution Tl-201 activity (r = 0.93). The diagnostic performance for predicting functional recovery, as measured by the area under the receiver operating characteristic curves, measured 0.66 +/- 0.07 (mean +/- SD) for Tc-99m tetrofosmin and 0.67 +/- 0.07 for Tl-201 (p = 0.60, 96.7% power to detect difference in area of 0.10). The optimal threshold cutoffs for viability were considered to be 50% of peak activity for Tc-99m tetrofosmin and 55% of peak activity for Tl-201. The positive and negative predictive values for reversible dysfunction were, respectively, 69% and 82% for Tc-99m tetrofosmin and 69% (p = 0.99 vs. Tc-99m tetrofosmin) and 71% (p = 0.66 vs. Tc-99m tetrofosmin) by Tl-201. CONCLUSIONS: The diagnostic performance of quantitative rest Tc-99m tetrofosmin imaging in predicting functional recovery after revascularization is comparable to that of rest-redistribution Tl-201.

Aged↗

Thallium-201 SPECT in differentiating bone infarction from metastatic lesions in osteosarcoma.

The authors present a case of bone infarction in the proximal epiphysis of the right tibia, which was caused by preoperative intraarterial chemotherapy for osteosarcoma. MR imaging revealed that suspected metastases had inhomogeneous signal intensity similar to that of the primary tumor, which made a metastatic lesion difficult to exclude. On TI-201 SPECT, no accumulation was found in the lesions, confirming that they were not osseous metastases. Consequently, this enabled limb salvage surgery to be performed with joint preservation. Intraoperative biopsy revealed no viable tumor cells in the lesion, and bone infarction was suspected. TI-201 SPECT was very useful, not only in differentiating bone infarction from tumor progression, including metastatic lesions, but also in the determination of the operative technique.

Adolescent↗

[Evaluation of the graft flow reserve after coronary artery bypass grafting by stress 201T1 myocardial SPECT: comparison between arterial grafts and venous grafts].

We performed stress 201T1 myocardial SPECT to evaluate ischemia and perfusion reserve after coronary artery bypass grafting (CABG). A total of 103 patients was performed stress 201T1 myocardial SPECT one month after CABG. Each patient's myocardium was divided into 9 segments and visually evaluated using five grade scoring system (0 = defect, 1 = severe decrease, 2 = moderate decrease, 3 = mild decrease, 4 = normal uptake). Eleven of 133 (8.27%) segments covered by patent venous grafts showed reversible 201T1 defect, however, 36 of 117 (30.8%) segments which covered by patent arterial grafts showed reversible 201T1 defect. This finding was observed more significantly in arterial grafts than in venous grafts (p < 0.001). These finding suggests that arterial grafts have lower flow capacity than venous grafts at peak exercise.

Aged↗