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Biomedical subjects

K Hisada

Publications and source records attributed to K Hisada.

At least 145 records · Page 8Linked to original sources

[Evaluation of brain perfusion SPECT imaging using 99mTc-ECD].

Fundamental and clinical evaluation was performed on 99mTc-ECD, a new agent for brain perfusion SPECT. Radiochemical purity reaches a plateau of approximately 98% at 30 min after reconstitution and remains stable up to 24 hours later. A biodistribution study showed approximately 5% injected dose in the brain, very slow brain washout of 5.6% per hour on the average, and rapid washout from the other organ mainly through the urinary system. Brain ECD distribution was determined within 2 min postinjection and remained stable for up to 1 hour. Three hours later, slight but significant changes in brain distribution were observed, that were relative reduction of cerebral cortical activity and gray to white matter activity ratio, and relative elevation of white matter and thalamic activities. Comparative studies of ECD images with IMP and HMPAO images revealed that radioactivity contrast between affected and unaffected areas was less prominent in ECD than in IMP in cerebral and cerebellar cortical lesions, more prominent in ECD than in IMP in striatal and thalamic lesions, and somewhat more prominent in ECD than in HMPAO in both lesions. Imaging around 1 hour postinjection seems to be more appropriate than immediate postinjection imaging because of the clearance of the extracranial radioactivity and somewhat better radioactivity contrast between affected and unaffected areas.

Adult↗

[The diagnostic value of In-111 transferrin imaging in protein-losing gastroenteropathy].

The diagnostic value of In-111 transferrin abdominal imaging was studied in 17 patients with clinical suspicion of protein-losing gastroenteropathy, compared to that of alpha-1-antitrypsin fecal clearance test. The presence or absence of gastrointestinal protein-loss was finally decided based on the result of alpha-1-antitrypsin fecal clearance test (normal range, less than 13 ml/day) or of protein content measurement on the gastric juice (normal range, less than 71 mg/dl). In-111 transferrin was labeled in vitro. After intravenous administration, serial anterior abdominal images were obtained. All seven patients with a value equal to or more than 20 ml/day on the alpha-1-antitrypsin clearance test and two out of ten patients with a value less than 20 ml/day showed definite intestinal activity demonstrating protein-loss, and the loss-site was estimated by observing the movement of radiotracer within the bowel lumen. The patients with severe protein-loss showed the intestinal activity on the early image. In the patients with milder protein-loss, on the other hand, the activity was noted on the later image. All two patients with positive In-111 transferrin imaging and negative alpha-1-antitrypsin test were associated with protein-losing gastropathy, where a value of alpha-1-antitrypsin clearance was not increased because of denatured alpha-1-antitrypsin by acidic gastric juice and pepsin. These results suggest that In-111 transferrin abdominal imaging can be more useful for the diagnosis of protein-losing gastroenteropathy, because of its capabilities to evaluate the patients with gastropathy as well as to estimate the loss-site.

Adult↗

Dynamic acquisition with a three-headed SPECT system: application to technetium 99m-SQ30217 myocardial imaging.

A method for SPECT data acquisition, "continuous repetitive rotation acquisition," was developed with a high-sensitivity three-headed SPECT system. The method was applied to the dynamic imaging of 99mTc-SQ30217, a new myocardial imaging agent. After acquisition and reconstruction of SPECT data every minute, projection images at arbitrary intervals were used for tomographic reconstruction to determine the best timing of SPECT imaging in 99mTc-SQ30217. Based on a comparison of several possible acquisition intervals, SPECT data acquisition within 9 min after injection is recommended because of high myocardial uptake (myocardium-to-lung ratio, 2.83 +/- 0.42 (mean +/- s.e.m.) at 3-6 min) and relatively low hepatic uptake (myocardium-to-liver ratio, 0.85 +/- 0.13 at 3-6 min). The rate constant of the clearance of 99mTc-SQ30217 from the myocardium obtained by SPECT was: k1 = 0.249 +/- 0.050 per min (average half-life = 2.8 min) and k2 = 0.012 +/- 0.004/min (average half-life = 58 min). The continuous repetitive rotation acquisition SPECT study appears useful for imaging SQ30217 with its rapidly changing myocardial distribution.

Adult↗

[Lung ventilation imaging with TECHNEGAS: clinical study of lung deposition and ventilation/perfusion].

In order to optimize inhalation method for lung ventilation imaging with Tc-99m-gas (TECHNEGAS), relation between lung deposition of TECHNEGAS and inhalation method was evaluated. Submaximal inhalation with breath-holding (BH), continuous submaximal inhalation (C) and tidal inhalation (TV) were compared in 35 patients (36 studies) with various lung diseases. Mean lung deposition of TECHNEGAS was 6.6-7.4%/LD in BH group and was significantly higher than other groups of inhalation method (p less than 0.05-0.001). Lung deposition increased according to the times of inhalation in C group. TV group resulted in the lowest lung deposition which was same as 5 times of inhalation in C group. Lung/filter ratio (L/F) was highest in BH group. Image quality of TECHNEGAS was significantly better in BH group. Hot spot in central airway was seen in 15% of patients. All of them was in TV or C groups. In order to improve lung deposition and image quality of the TECHNEGAS, sufficient breath-holding was important. L/F seemed to be the index of effective inhalation of the TECHNEGAS. TV was suitable for poorly cooperative or dyspneic patients. TECHNEGAS was useful for evaluation of lung ventilation to provide good quality image with safety and simplicity.

Administration, Inhalation↗

[Myocardial perfusion imaging with 99mTc-SQ30217: application of three-headed SPECT system].

The early dynamic change of a new myocardial imaging agent, 99mTc-SQ30217, was investigated in SPECT study. A three-headed high sensitivity SPECT system was employed to evaluate the serial changes of accumulation pattern in the heart, lung and liver using a "continuous repetitive acquisition" mode. The myocardial activity reached a peak rapidly and decreased with rapid clearance rate. The analysis of myocardial clearance curve showed a T1/2 of 2.8 minutes (k1 = 0.25 +/- 0.12/min) in the rapid phase, and a T1/2 of 57 minutes (k2 = 0.012 +/- 0.011/min) in the slow phase. The tracer clearance in the lung was more rapid, while the hepatic uptake reached a peak approximately 10 to 15 minutes after injection. When the serial SPECT images were reviewed, the early 3-minute acquisition within 10 minutes after injection showed better image quality than the images obtained after 10 minutes. The hepatic activity did not obscure the infero-septal wall in the earlier images, but did in the images 10 minutes after injection. Thus, quick SPECT data acquisition seemed to be desirable for this agent. We concluded that 99mTc-SQ30217 was a promising radiopharmaceutical for myocardial perfusion imaging.

Aged↗

Fluctuations of interictal brain imaging in repeated 123I-IMP SPECT scans in an epileptic patient.

Single photon emission computed tomography (SPECT) brain scans with N-isopropyl-(iodine 123) p-iodoamphetamine (123I-IMP) were performed three times in interictal periods in a 35-year-old man with intractable frontal lobe epilepsy and normal X-ray CT findings. The first scan showed decreased 123I-IMP uptake in the right frontal lobe. This abnormal image was regarded as the primary focus of his epilepsy on the basis of its regional agreement with focal epileptic discharges on EEGs. In the second scan, he showed normal imaging, while the third scan showed the same abnormal image as before, in the right frontal lobe. The frequency of his clinical seizures was almost unchanged during the intervals between scans and further EEGs recorded soon after each scan showed almost no changes in the basic activities and frequency of the epileptic discharges. Such fluctuations in SPECT brain imaging suggest that the severity of functional inactivation underlying the focal hypoperfusion image as an epileptic focus may fluctuate considerably in the interictal state with no relation to the clinical features of epilepsy.

Adult↗

Whole-body distribution of iodine 123 metaiodobenzylguanidine in hypertrophic cardiomyopathy: significance of its washout from the heart.

Whole-body distribution of iodine 123 metaiodobenzylguanidine (123I-mIBG) was evaluated in 27 patients with hypertrophic cardiomyopathy (HCM). At 1 and 4 h after injection, anterior and posterior whole-body images were obtained with a dual-headed, camera-computer system. Patients were classified into three groups based on the septal wall thickness as determined by echocardiography: group 1 consisted of 7 patients with less than or equal to 15 mm septal thickness, group 2 included 12 patients with 16-19 mm septal thickness, and group 3 included 6 patients with greater than or equal to 20 mm septal thickness. Although the myocardial mIBG uptakes at 1 h were similar among these groups (1.84% +/- 0.19%, 1.95% +/- 0.38%, 1.98% +/- 0.57%, respectively; NS), mIBG washout from the heart in group 3 was faster than in groups 1 and 2 (31.5% +/- 13.0% vs. 15.8% +/- 11.0% (group 1, P less than 0.05), 17.6% +/- 7.3% (group 2, P less than 0.01)). There was a significant positive correlation between mIBG washout from the heart and septal thickness, with correlation coefficient r = 0.52 (P less than 0.01). The liver, lung, parotid gland, spleen and skeletal muscle showed similar mIBG uptake and washout among the three groups. We conclude from these data that mIBG washout from the heart in HCM was faster in patients with severe hypertrophy than in patients with mild to moderate hypertrophy, and hence it may be a useful parameter for evaluating the severity of altered adrenergic innervation and activities.

3-Iodobenzylguanidine↗

Mechanism of gallium 67 accumulation in inflammatory tissue.

The present study was undertaken to elucidate the accumulation mechanism of gallium 67 in inflammatory tissue. 67Ga accumulation in inflammatory tissue was observed by macro- and microautoradiogram. Permeability indices were calculated for serum albumin from blood vessels into inflammatory and normal tissue. Neutrophils and macrophages did not play a major role in 67Ga accumulation in the inflammatory tissue because 67Ga could hardly be detected in the sites in which neutrophils were crowded; the accumulation was concentrated in the intercellular space around these cells in the tissue. Permeability indices for inflammatory tissue were much greater than those for normal tissues. It is thought from the present study and previously reported results that 67Ga, together with plasma from permeable blood vessels, readily penetrates the inflammatory tissue and stays there by binding to the acid mucopolysaccharide present in the tissue.

Animals↗

Error of uptake in dual energy acquisition with 201Tl and 123I labeled radiopharmaceuticals.

In myocardial scintigraphy, simultaneous injection of two radionuclides and dual energy acquisition are potentially useful in the assessment of regional perfusion and metabolism. The feasibility of dual radionuclide study with 201Tl and 123I labeled radiopharmaceuticals (meta-iodobenzylguanidine I 123, in this study) was investigated in phantoms and patients. The crosstalk of one radionuclide to the other pulse height window was defined as the ratio of the 201Tl count in the 123I and 201Tl windows, R[I/Tl], and the ratio of the 123I count in the 201Tl and 123I windows, R[Tl/I]. The ratios were determined in planar images and SPECT studies. In clinical studies with whole body scintigraphy (n = 8), the value of R differed significantly in various organs. In the SPECT study (n = 13), R was not uniform and varied with time and location, resulting in significant errors in uptake and regional count ratio. Thus, dual energy acquisition with 201Tl and 123I labeled radiopharmaceuticals is generally not recommended because of varying amounts of crosstalk interference. Possible solutions to this problem are discussed. The feasibility of dual radionuclide study must be confirmed in human as well as in phantom studies.

3-Iodobenzylguanidine↗

Diagnostic values of gallbladder hyperperfusion and the rim sign in radionuclide angiography and hepatobiliary imaging.

The diagnostic values of hyperperfusion to the gallbladder fossa and the rim sign were retrospectively evaluated in 24 histopathologically proven cases of gallbladder disease. Although 12 of 13 patients (92%) with acute cholecystitis had nonvisualization of the gallbladder, the positive predictive value with this finding was 71%. However, when the finding was associated with hyperperfusion to the gallbladder fossa or the rim sign, the positive predictive value with both (90%) was markedly increased, compared to the prevalence ratio of 54%. Such a combination could be useful for preserving a high positive predictive value in the diagnosis of acute cholecystitis.

Acute Disease↗

High reproducibility of regional abnormalities on interictal 123I-IMP SPECT brain scans in adults with partial epilepsy.

The reproducibility of two N-isopropyl-(iodine 123) p-iodoamphetamine (123I-IMP single photon emission computed tomography (SPECT) scans both taken during interictal periods was studied in 13 adult patients with partial epilepsy who had normal CT scans. The frequency of the seizures and the nature of the ictal symptoms were virtually unchanged during the interval between the two SPECT scans performed in each case. In 8 (72.7%) of 11 patients who had abnormal images consisting of focal hypofixation images of 123I-IMP, i.e. zones of decreased regional cerebral blood flow on the first scans, complete or partial regional reproduction of the SPECT abnormalities was observed. This high reproducibility supports the usefulness of SPECT scans in the regional diagnosis of epileptic foci.

Amphetamines↗

Distant metastases in differentiated thyroid carcinomas: a clinical and pathologic study.

Of 514 patients with differentiated thyroid carcinoma treated between 1970 and 1987, 34 (6.6%) had distant metastases. Twelve patients died of their distant metastases; eight of these patients died within 5 years from the time of initial diagnosis. Death from cancer was most frequent in the seventh decade. The metastases were most often found in the lungs and bones. In the fatal group, pleural, brain, and pericardial metastases were noted. Local recurrences were found only in 24% of these 34 patients. Histologic types of primary thyroid tumors and metastatic tumors were reexamined and classified using our criteria, which were mainly based on the World Health Organization nomenclature and currently obtained pathologic observations of thyroid tumors. In 31 thyroid tumors, the surgical specimens were available for review. Twenty-four tumors were papillary and seven were follicular. Of the 24 papillary carcinomas, nine were follicular, eight were well-differentiated, and seven were trabecular. On the other hand, the seven follicular carcinomas consisted of four well-differentiated, two solid, and one oxyphilic. The majority of the thyroid tumors showed an extrathyroidal extension; however, two were intrathyroidal carcinomas and two were encapsulated carcinomas, larger than 5 cm in diameter. Distant metastases were confirmed morphologically in 18 patients (11 by surgical or biopsy material, five by autopsy, and two by cytology). The histologic types of metastatic tumors were consistent with those of primary thyroid tumors. Diagnostic 131I uptake was examined in 32 patients and absorption of diagnostic 131I in metastatic tumors was demonstrated in 21 patients. The 10-year survival rate of patients with 131I accumulating metastases (70%) was significantly better than that of patients with metastases lacking such uptake (40%). Immunoreactivity for thyroglobulin in metastatic tumors was correlated with the 131I absorption. This finding indicated that immunostaining of thyroglobulin in metastatic tumors might be useful in the prediction of the effectiveness of 131I therapy.

Adenocarcinoma↗

Quantitative analysis of 123I-meta-iodobenzylguanidine (MIBG) uptake in hypertrophic cardiomyopathy.

Myocardial scintigraphy with 123I-meta-iodobenzylguanidine (MIBG) and thallium-201 (201Tl) was performed in 29 patients with hypertrophic cardiomyopathy (HCM) using whole-body scintigraphy and single-photon emission computed tomography (SPECT). Nonhypertensive patients were classified into three groups according to the septal thickness determined by ultrasonography; group 1 (wall thickness less than 16 mm, n = 5), group 2 (from 16 to 20 mm, n = 12) and group 3 (greater than 20 mm, n = 4). The regional myocardial uptakes of both 201Tl and 123I-MIBG (percent of injected dose/cm3 myocardium) were higher in the more hypertrophic septa. However, when regional MIBG uptake at 3 hours was divided by the 201Tl uptake to calculate the MIBG uptake per unit of blood flow, the hypertrophic septa showed lower mean values--0.39 +/- 0.23 and 0.50 +/- 0.10 in groups 3 and 2, respectively (p less than 0.1 compared with 0.69 +/- 0.20 in group 1). The regional MIBG clearance rate in the septum was significantly higher in group 3 compared with group 1 (13.4 +/- 8.0%/hr versus 1.5 +/- 6.2%/hr, p less than 0.05). The uptake and 123I-MIBG clearance rate in the lateral wall showed a similar tendency. Myocardial uptake determined by whole-body scintigraphy was slightly increased in group 2 (3.5 +/- 0.6%, p less than 0.05) compared with group 1 (2.7 +/- 0.8%); however, it was lower in group 3 (2.7 +/- 0.4%). Myocardial 123I-MIBG distribution demonstrated various patterns in comparison with 201Tl distribution, suggesting that flow-independent changes in sympathetic innervation or activity may exist in patients with HCM.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Iodobenzylguanidine↗

Tc-99m MDP bone imaging in inflammatory enthesopathy.

A case is presented in which uptake of Tc-99m MDP was noted at the sites of tendon and ligament attachments to the calcaneus in inflammatory enthesopathy. Following successful treatment with corticosteroids, the uptake was markedly decreased in accordance with subsidence of clinical manifestations and normalization of laboratory data. Radionuclide bone imaging may be useful in evaluating the response to treatment with corticosteroids as well as revealing the active disease sites in inflammatory enthesopathy.

Bone and Bones↗

Shunt between right subclavian vein and the left heart in superior vena cava obstruction due to lung cancer.

A case in which there was a shunt between systemic veins and the left heart in superior vena cava syndrome due to lung cancer is reported. Superior vena cava syndrome developed one and a half years after right upper lobectomy with combined resection of thoracic wall. Radionuclide venography from the right antecubital vein showed immediate visualization of the left ventricle and aorta, before the right atrium and right ventricle were seen. In the superior vena cava syndrome due to a malignant tumor, this rare pathway as well as usual collaterals should be considered.

Carcinoma, Squamous Cell↗

Thallium-201 accumulation in cerebral candidiasis: unexpected finding on SPECT.

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.

Adult↗

Tc-99m HMPAO brain perfusion tomography atlas using a high resolution SPECT system.

Excellent SPECT images of brain perfusion with Tc-99m HMPAO were obtained by the use of a three-head rotating gamma camera SPECT system with high resolution (FWHM 7mm) in a normal volunteer. These images should be clinically effective for evaluating various neurologic disorders. Transverse, coronal, and sagittal sectional HMPAO-SPECT images are correlated with corresponding brain MRI images of the same normal volunteer in this atlas.

Adult↗