Italian multicenter reinjection trial (SIRT): preliminary results of thallium-201 segmental analysis.
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Biomedical subjects
M Brambilla
Publications and source records attributed to M Brambilla.
Thallium-201: what do we gain from new clinical protocols and acquisition procedures? The Italian Study on Thallium Reinjection/SIRT).
Nine medical centers, equipped with the same gamma camera and computer software, participated in this multicenter study on thallium-201 reinjection imaging. Preliminary findings for the first 143 patients with ischemic heart disease and perfusion defects at stress imaging are reported. Eighty-eight patients were reinjected at rest after conventional stress-redistribution imaging. Another 55 patients were reinjected at rest on a separate day. After segmental comparison of conventional redistribution versus stress imaging, differences > 1 in the segmental scores on a reduced 3 point scale identified 58 patients with irreversible or mainly irreversible defects (dominant scar pattern) and 85 patients with reversible or mainly reversible defects (dominant ischemic pattern). When reinjection was compared to stress images, 24 patients out of 58 with a dominant scar pattern at the conventional analysis were then assigned to the group with a dominant ischemic pattern. No clinical variables or exercise stress data were found to be significantly different in this patient subgroup. Only 4 out of 85 patients with a dominant ischemic pattern were reassigned to a dominant scar pattern after reinjection scoring. These preliminary results of the SIRT study confirm the consistent problem of scar overestimation by conventional stress-redistribution imaging and the clinical value of the thallium-201 reinjection procedure for differentiating viable from necrotic myocardium.
Cell Survival↗
A laboratory and thrombokinetic study of HCV-associated thrombocytopenia: a direct role of HCV in bone marrow exhaustion?
OBJECTIVE: In order to investigate HCV associated thrombocytopenia, 6 patients suffering from this disease, in the absence of splenomegaly and other common causes of peripheral platelet destruction, underwent laboratory and scintigraphic tests. RESULTS: Thrombokinetic studies revealed a significant, nearly linear, delayed splenic accumulation with normal or low-normal values for the average platelet life span, low-normal recovery, and depressed platelet production. Megakariopoiesis was normal or slightly increased. HCV infection of the megakariocytes was found in two patients. Autoantibodies and liver disease were also investigated. CONCLUSIONS: A role of immunological mechanisms in HCV associated thrombocytopenia appears to be ruled out. The authors conclude that tests for HCV infection should be included in the evaluation of thrombocytopenia in adults and a possible direct involvement of HCV cannot be excluded.
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Comparison of inter-observer reproducibility between conventional chest radiography and AMBER in the evaluation of silicosis.
The aims of this study were to test inter-observer and intraobserver agreement in the diagnosis of silicosis using conventional chest radiography and AMBER. One hundred and fifteen patients underwent chest x-rays and AMBER for the diagnosis of silicosis. Five readers blindly and independently evaluated the radiograms with standard ILO/UC classification scales. Reproducibility was assessed using ANOVA repeated measurements methods. AMBER showed a better technical quality of radiograms than conventional chest x-rays; interobserver reproducibility was high and similar (R = 0.75); intraobserver agreement between chest x-rays and AMBER was high ranging from 0.62 to 0.86 for the 5 readers. Notwithstanding the absence of standards for profusion classification, the interobserver reproducibility with AMBER was similar to that obtained with chest x-rays. Moreover, the intraobserver agreement in profusion scoring between AMBER and chest radiography was high, suggesting that AMBER and chest radiography provided similar information in the evaluation of silicosis.
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