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"Either-or" two-slit interference: stable coherent propagation of individual photons through separate slits.

In quantum theory, nothing that is observable, be it physical, chemical, or biological, is separable from the observer. Furthermore, ". all possible knowledge concerning that object is given by its wave function" (Wigner, E. 1967. Symmetries and Reflections. Indiana University Press, Bloomington, IN), which can only describe probabilities of future events. In physical systems, quantum mechanical probabilistic events that are microscopic must, in turn, account for macroscopic events that are associated with a greater degree of certainty. In biological systems, probabilistic statistical mechanical events, such as secretion of microscopic synaptic vesicles, must account for macroscopic postsynaptic potentials; probabilistic single-channel events sum to produce a macroscopic ionic current across a cell membrane; and bleaching of rhodopsin molecules (responsible for quantal potential "bumps") produces a photoreceptor generator potential. Among physical systems, a paradigmatic example of how quantum theory applies to the observation of events concerns the interactions of particles (e.g., photons, electrons) with the two-slit apparatus to generate an interference pattern from a single common light source. For two-slit systems that use two independent laser sources with brief (<1 ms) intervals of mutual coherence (Paul, H. 1986. Rev. Modern Phys. 58:209-231), each photon has been considered to arise from both beams and has a probability amplitude to pass through each of the two slits. Here, a single laser source two-slit interference system was constructed so that each photon has a probability amplitude to pass through only one or the other, but not both slits. Furthermore, all photons passing through one slit could be distinguished from all photons passing through the other slit before their passage. This "either-or" system produced a stable interference pattern indistinguishable from the interference produced when both slits were accessible to each photon. Because this system excludes the interaction of one photon with both slits, phase correlation of photon movements derives from the "entanglement" of all photon wave functions due to their dependence on a common laser source. Because a laser source (as well as Young's original point source) will have stable time-averaged spatial coherence even at low intensities, the "either-or" two-slit interference can result from distinct individual photons passing one at a time through one or the other slit-rather than wave-like behavior of individual photons. In this manner, single, successive photons passing through separate slits will assemble over time in phase-correlated wave distributions that converge in regions of low and high probability.

Biophysical Phenomena↗

Tilted angle CZT detector for photon counting/energy weighting x-ray and CT imaging.

X-ray imaging with a photon counting/energy weighting detector can provide the highest signal to noise ratio (SNR). Scanning slit/multi-slit x-ray image acquisition can provide a dose-efficient scatter rejection, which increases SNR. Use of a photon counting/energy weighting detector in a scanning slit/multi-slit acquisition geometry could provide highest possible dose efficiency in x-ray and CT imaging. Currently, the most advanced photon counting detector is the cadmium zinc telluride (CZT) detector, which, however, is suboptimal for energy resolved x-ray imaging. A tilted angle CZT detector is proposed in this work for applications in photon counting/energy weighting x-ray and CT imaging. In tilted angle configuration, the x-ray beam hits the surface of the linear array of CZT crystals at a small angle. This allows the use of CZT crystals of a small thickness while maintaining the high photon absorption. Small thickness CZT detectors allow for a significant decrease in the polarization effect in the CZT volume and an increase in count rate. The tilted angle CZT with a small thickness also provides higher spatial and energy resolution, and shorter charge collection time, which potentially enables fast energy resolving x-ray image acquisition. In this work, the major performance parameters of the tilted angle CZT detector, including its count rate, spatial resolution and energy resolution, were evaluated. It was shown that for a CZT detector with a 0.7 mm thickness and 13 degrees tilting angle, the maximum count rate can be increased by 10.7 times, while photon absorption remains >90% at photon energies up to 120 keV. Photon counting/energy weighting x-ray imaging using a tilted angle CZT detector was simulated. SNR improvement due to optimal photon energy weighting was 23% and 14% when adipose contrast element, inserted in soft tissue with 10 cm and 20 cm thickness, respectively, was imaged using 5 energy bins and weighting factors optimized for the adipose. SNR improvement was 42% and 31% when CaCO(3) contrast element, inserted in soft tissue with 10 cm and 20 cm thickness, respectively, was imaged using 5 energy bins and weighting factors optimized for CaCO(3). The SNRs of the photon counting single-kVp dual-energy subtracted images of CaCO(3) and adipose were higher by 2.04 and 2.74 times, respectively, as compared to currently used dual-kVp dual-energy subtracted images. Experiments with a CZT crystal with 2 mm thickness have shown significant decrease in the tailing effect of the CZT pulse spectrum at 59 keV and 122 keV photon energies, when the tilting angle configuration was used. Finally, feasibility of the tilted angle CZT detector for photon counting cone beam breast CT imaging was demonstrated.

Artifacts↗

Effects of a color filter used in auriculomedicine on ultraweak photon emission of the human body.

CONTEXT: The human body emits ultraweak photons. It has been demonstrated that feedback regulation of ultraweak photon emission from the hand is detectable utilizing gelatin color filters in complete darkness. Color filters are commonly utilized in auriculomedicine diagnostic procedures based on the radial artery vascular autonomic signal. OBJECTIVE: To evaluate the possibility of an effect by a dark-adapted red filter on (1) local ultraweak human photon emission using different anatomic locations, and (2) on systemic photon emission using one location for red filter exposure and another for photon emission recording. DESIGN: Photon emission of abdomen, forehead, palm, and dorsum of the hand was recorded before and after the presence of a red filter. In addition, photon emission of forehead and dorsum of the hand was recorded before, during, and after the presence of the red filter close to the palm. In both instances, the filter was dark-adapted and placed in close proximity to, but not touching the skin of the dark-adapted subject. A low-noise, end window photomultiplier for recording ultraviolet and visible (200-650 nm) photon emission (with a very low background count rate) and designed for manipulation in three directions was situated in a dark room. The technology was utilized to record spontaneous photon emission of the abdomen, forehead, palm, and dorsum of the hand of one human male subject. RESULTS: Data demonstrate that a dark-adapted subject responds in the total absence of light with a temporary increase in photon emission from the anatomic locations that had been exposed for 200 s at a distance of 3 cm to a dark-adapted red filter. Data from sequential time series suggest red filter initiation of a refractory emission reaction. Exposure of the palm to the red filter also evokes photon emission from the dorsum of the same hand and from the forehead. This response could be registered immediately after the beginning of the exposure. The stimulated emission is followed by a slow decrease of emission in the period after exposure to the filter. CONCLUSION: Data suggest that red filter-stimulated photon emission response is systemic and rapid. Data imply an exchange of information vis-à-vis light from both hand and red filter. The mechanism of such interaction is currently speculation only.

Abdomen↗

Photon track evolution.

Given the time scale of biological, biochemical, biophysical and physical effects in a radiation exposure of living tissue, the first physical stage can be considered to be independent of time. All the physical interactions caused by the incident photons happen at the same starting time. From this point of view it would seem that the evolution of photon tracks is not a relevant topic for analysis; however, if the photon track is considered as a sequence of several interactions, there are several steps until the total degradation of the energy of the primary photon. We can characterise the photon track structure by the probability p(E,j), that is, the probability that a photon with energy E suffers j secondary interactions. The aim of this work is to analyse the photon track structure by considering j as a step of the photon track evolution towards the total degradation of the photon energy. Low energy photons (<150 keV) are considered, with water phantoms and half-extended geometry. The photon track evolution concept is presented and compared with the energy deposition along the track and also with the spatial distribution of the several steps in the photon track.

Algorithms↗

Large-scale synthesis of a silicon photonic crystal with a complete three-dimensional bandgap near 1.5 micrometres

Photonic technology, using light instead of electrons as the information carrier, is increasingly replacing electronics in communication and information management systems. Microscopic light manipulation, for this purpose, is achievable through photonic bandgap materials, a special class of photonic crystals in which three-dimensional, periodic dielectric constant variations controllably prohibit electromagnetic propagation throughout a specified frequency band. This can result in the localization of photons, thus providing a mechanism for controlling and inhibiting spontaneous light emission that can be exploited for photonic device fabrication. In fact, carefully engineered line defects could act as waveguides connecting photonic devices in all-optical microchips, and infiltration of the photonic material with suitable liquid crystals might produce photonic bandgap structures (and hence light-flow patterns) fully tunable by an externally applied voltage. However, the realization of this technology requires a strategy for the efficient synthesis of high-quality, large-scale photonic crystals with photonic bandgaps at micrometre and sub-micrometre wavelengths, and with rationally designed line and point defects for optical circuitry. Here we describe single crystals of silicon inverse opal with a complete three-dimensional photonic bandgap centred on 1.46 microm, produced by growing silicon inside the voids of an opal template of dose-packed silica spheres that are connected by small 'necks' formed during sintering, followed by removal of the silica template. The synthesis method is simple and inexpensive, yielding photonic crystals of pure silicon that are easily integrated with existing silicon-based microelectronics.

Journal Article↗

Minimizing urine autofluorescence under multi-photon excitation conditions.

We report on the effects of excitation wavelength, laser power, and phase resolution on the multi-photon-excited autofluorescence (background) from human urine. When compared to the autofluorescence under one-photon excitation conditions (lambda(ex) = 260-480 nm), the urine multi-photon-excited autofluorescence (lambda(ex) = 725-950 nm) can be less complicated. However, at higher laser powers, the multi-photon-excited autofluorescence spectra that are produced by excitation above ~775 nm are more complex in comparison to the corresponding one-photon-excited autofluorescence. The origin of these more complex spectra arises from simultaneous two- and three-photon-driven excitation of intrinsic luminescent species within the urine. At lower laser powers, three-photon-driven processes are minimized and the autofluorescence spectrum is simplified. Phase resolution is used to further minimize the urine autofluorescence, but it cannot fully eliminate autofluorescence even when excitation is performed under multi-photon conditions at 950 nm. For detecting 250 nM Rhodamine 6G (a mock analyte) dissolved in urine, we find that the two-photon excitation is superior in comparison to one-photon excitation by 5- to 70-fold, depending on the excitation wavelength. Phase resolution combined with two-photon excitation leads to an additional 5- to 7-fold improvement in signal-to-background ratios in comparison to steady-state two-photon excitation.

Algorithms↗

Dose profiles in the region of abutting photon and electron fields in the irradiation of head and neck tumors.

In the treatment of head and neck tumors, after excluding the spinal cord from the primary photon beam, en face electron fields are employed to boost the dose to the tissues overlying the spinal cord. The electron fields are "hot-matched" on skin with the posterior edges of the photon fields irradiating the primary tumor. The purpose of this study is to measure the dose distribution in the "hot" matched region between the photon and the en face electron fields. Using film dosimetry, we measured the dose distributions at depths of 1 cm and 3 cm in the junction of the abutting photon (4 MV) and electron (9 MeV) fields for a hot-match setup. Two photon field setups were studied: (1) laterally opposed and, (2) shallow (5 degrees) right and left anterior oblique fields, a configuration sometimes used to avoid treating through the shoulders. To investigate the changes in dose distributions due to setup uncertainties, we also measured dose profiles at the same two depths using a 2 mm overlap and a 2 mm gap between the electron and photon fields. For a perfect hot-match, the dose profile across the junction at 1 cm depth consists of "hot-spots" on both sides of the junction. The minimum and maximum doses across the junction are 15% and 58%, respectively, above the prescribed dose for a parallel opposed setup and 35% and 54%, respectively, for the angled setup. At 3 cm depth, a 10% "cold spot" is observed in the electron field proximal to the junction while a 50% 'hot spot' is observed in the photon field for the opposed lateral setup. With the lateral fields angled 5 degrees anteriorly, hot spots are observed on both sides of the junction. The minimum and maximum doses are 23% and 54%, respectively, above the prescribed dose. With the right and left anterior oblique fields, a 2 mm overlap of the en face electron field with the ipsilateral photon field resulted in a 72% and 65% hot spot at 1 cm and 3 cm depths, respectively, in the photon field adjacent to the junction. A 2 mm gap still resulted in about a 45% hot spot in the same region at both depths. Clinically, if dose to the overlying tissue of the spinal cord is of primary concern, our measurements suggest that 80% normalization in the electron boost, together with a slight angulation of the photon fields would ensure adequate dose to the overlying tissues. If dose inhomogeneity to the superficial tissues is critical in the electron irradiation, 90% dose normalization in the electron boost, together with laterally opposed photon fields would be preferred. The clinical decision can only be made on a patient-by-patient basis.

Electrons↗

Two-photon excitation studies of hypocrellins for photodynamic therapy.

The photophysical and photochemical properties of hypocrellins (HA and HB) are examined with two-photon excitations at 800 nm using femtosecond pulses from a Ti:sapphire laser. The two-photon excited fluorescence spectra of HA and HB are very similar to those obtained by one-photon excitation, which may indicate that the two-photon induced photodynamic processes of hypocrellins are similar to one-photon induced photodynamic processes. The two-photon excitation cross sections of HA and HB are measured at 800 nm as about 34.8 x 10(-50) cm(4) s/photon and 21.3 x 10(-50) cm(4) s/photon, respectively. The large two-photon cross sections of both HA and HB, suggest that the hypocrellins can be potential two-photon phototherapeutic agents. As an example for two-photon photodynamic therapy of hypocrellins, we also further examine the cell-damaging effects of HA upon two-photon illumination. Our preliminary results of cell viability test indicate hypocrellins can effectively damage the Hela cells under two-photon illumination.

Models, Molecular↗

Entangled photon absorption in an organic porphyrin dendrimer.

Two-photon absorption spectroscopy is an intensity dependent nonlinear effect related to the excitation of virtual intermediate states. The classical two-photon absorption has an extremely low efficiency which is quantified by its cross-section (delta approximately 10(-48) cm4 s at 800 nm). To overcome this limitation, we demonstrate a novel effect of the two-photon absorption method utilizing the high degree of quantum optical correlation between photon pairs created by the process of spontaneous parametric downconversion. A large entangled two-photon absorption cross-section (delta(e) approximately 10(-17) cm2 at 800 nm) was measured in an organic porphyrin dendrimer. We also discuss the nonmonotonic behavior of variation of the entangled two-photon absorption cross-section by controlling the entanglement time. This novel effect may open new avenues for ultrasensitive detection in chemical and biological systems. TPA spectroscopy has been considered as a powerful tool in physics, chemistry, and biology. The inherent nonlinear process of the classical TPA is distinguishable from the single photon absorption (SPA) linear process. Although the benefits of greater penetration depth and better control and reduction of scattering, the TPA spectroscopy has been restricted by the necessity of a high power optical source due to the low efficiency of the TPA effect. The use of entangled photons from a correlated source for the purpose of the two-photon effect is promising in this regard as one may obtain two-photon effects with very small numbers of photons.

Journal Article↗

Generation of ultraviolet entangled photons in a semiconductor.

Entanglement is one of the key features of quantum information and communications technology. The method that has been used most frequently to generate highly entangled pairs of photons is parametric down-conversion. Short-wavelength entangled photons are desirable for generating further entanglement between three or four photons, but it is difficult to use parametric down-conversion to generate suitably energetic entangled photon pairs. One method that is expected to be applicable for the generation of such photons is resonant hyper-parametric scattering (RHPS): a pair of entangled photons is generated in a semiconductor via an electronically resonant third-order nonlinear optical process. Semiconductor-based sources of entangled photons would also be advantageous for practical quantum technologies, but attempts to generate entangled photons in semiconductors have not yet been successful. Here we report experimental evidence for the generation of ultraviolet entangled photon pairs by means of biexciton resonant RHPS in a single crystal of the semiconductor CuCl. We anticipate that our results will open the way to the generation of entangled photons by current injection, analogous to current-driven single photon sources.

Journal Article↗

Why arguments based on photon energy may be highly misleading for power line frequency electromagnetic fields.

When evaluating possible mechanisms by which low frequency electromagnetic fields may have a biological effect, arguments based on photon energy have often been used in a misleading way. For visible light the concept of photons has proved to be very useful in explaining experimental findings. However, the concept of photons cannot be used without major modifications in describing phenomena related to near field problems at power frequency (50 or 60 Hz) electric and magnetic fields. For this regime, the photon description is very complex. A very high number of highly coherent photons must be used in a quantum electrodynamic description of low frequency electromagnetic field phenomena. Thus, one-photon interaction descriptions must be replaced by multiple-photon interaction formalism. However, at low frequencies, a classical electromagnetic field description is far more useful than quantum electrodynamics. There is in principle no difference in how much energy an electron can pick up from a low frequency electric field as compared to from a high frequency photon. Thus, the total gain in energy is not limited to the energy carried by a single photon, which is E = hv, where h is Planck's constant and (v) is the frequency of the radiation. However, the time scale of the primary event in a mechanism of action is very different for ionizing radiation compared to power line frequency fields. The advice is to consider the time scale given by the inverse of the frequency of the fields, rather than photon energy, when one use physics as a guidance in evaluating possible mechanisms for biological effects from low frequency electromagnetic fields.

Electricity↗

Photobleaching in two-photon excitation microscopy.

The intensity-squared dependence of two-photon excitation in laser scanning microscopy restricts excitation to the focal plane and leads to decreased photobleaching in thick samples. However, the high photon flux used in these experiments can potentially lead to higher-order photon interactions within the focal volume. The excitation power dependence of the fluorescence intensity and the photobleaching rate of thin fluorescence samples ( approximately 1 microm) were examined under one- and two-photon excitation. As expected, log-log plots of excitation power versus the fluorescence intensity and photobleaching rate for one-photon excitation of fluorescein increased with a slope of approximately 1. A similar plot of the fluorescence intensity versus two-photon excitation power increased with a slope of approximately 2. However, the two-photon photobleaching rate increased with a slope > or =3, indicating the presence of higher-order photon interactions. Similar experiments on Indo-1, NADH, and aminocoumarin produced similar results and suggest that this higher-order photobleaching is common in two-photon excitation microscopy. As a consequence, the use of multi-photon excitation microscopy to study thin samples may be limited by increased photobleaching.

Biophysical Phenomena↗

A treatment planning inter-comparison of proton and intensity modulated photon radiotherapy.

PURPOSE: A comparative treatment planning study has been undertaken between standard photon delivery techniques,b intensity modulated photon methods and spot scanned protons in order to investigate the merits and limitations of each of these treatment approaches. METHODS: Plans for each modality were performed using CT scans and planning information for nine patients with varying indications and lesion sites and the results have been analysed using a variety of dose and volume based parameters. RESULTS: Over all cases, it is predicted that the use of protons could lead to a reduction of the total integral dose by a factor three compared to standard photon techniques and a factor two compared to IM photon plans. In addition, in all but one Organ at Risk (OAR) for one case, protons are predicted to reduce both mean OAR dose and the irradiated volume at the 50% mean target dose level compared to both photon methods. However, when considering the volume of an OAR irradiated to 70% or more of the target dose, little difference could be shown between proton and intensity modulated photon plans. On comparing the magnitude of dose hot spots in OARs resulting from the proton and IM photon plans, more variation was observed, and the ranking of the plans was then found to be case and OAR dependent. CONCLUSIONS: The use of protons has been found to reduce the medium to low dose load (below about 70% of the target dose) to OARs and all non-target tissues compared to both standard and inversely planned photons, but that the use of intensity modulated photons can result in similar levels of high dose conformation to that afforded by protons. However, the introduction of inverse planning methods for protons is necessary before general conclusions on the relative efficacy of photons and protons can be drawn.

Algorithms↗

[Influence of photon scattering on the quantification of relative changes in longitudinal brain PET studies with 18F-FDG].

AIM: To study the effect of photon scattering on the quantification of relative changes of 18F-FDG uptake in longitudinal brain PET studies. MATERIALS AND METHODS: Two studies from a numerical Zubal phantom were simulated. One of these was a basal reference study and the other was an activated study showing an increase or decrease in the uptake in a region of the anterior cingulated cortex. SimSET Monte Carlo code was used to simulate PET sinograms. Primary photons, which did not undergo interactions, and scattered photons, which underwent one or more interactions, were stored in separate files to assess the effect of scattering. Reconstruction was carried out using an iterative algorithm based on ordered subsets of projections (OSEM-2D). The relative changes in uptake were calculated from images reconstructed with all the photons (primary and scattered) and from images reconstructed with only primary photons. RESULTS: A linear relationship between the calculated and theoretical values was obtained both for the images reconstructed with all the photons and for those reconstructed with primary photons. Our findings show a relative change recovery of 79% +/- 0.4% for all photons and 91% +/- 0.5% for primary photons only. CONCLUSIONS: Our results highlight subestimation of relative changes of 12% +/- 0.7% when scattered photons are used. Thus the importance of correcting this degradation in order to improve quantification is shown.

Algorithms↗

Fluorescence of reduced nicotinamides using one- and two-photon excitation.

We examined the steady-state and time-resolved emission of NADH and NAMH resulting from one-photon and two-photon excitation. Similar emission spectra were observed for both modes of excitation. The fundamental anisotropy of NADH is near 0.54 for two-photon excitation from 690 to 740 nm, which is 46% higher than the value of 0.37 observed for one-photon excitation. This observation of a higher anisotropy with two-photon excitation was consistent with INDO/SDCI calculations of the one- and two-photon transitions. Minor differences in the multi-exponential decays of NADH were observed for one- and two-photon excitation, but presently available resolution does not allow us to conclude the decays are distinct. NADH-LADH-IBA complex formation led to an order of magnitude larger of the average lifetimes of NADH fluorescence resulting from one- and two-photon excitation. Fluorescence intensity and fluorescence anisotropy decays of NADH was double-exponential for both modes of excitation and show that the observed heterogeneity of the fluorescence decay kinetics of reduced nicotinamides arises from the inherent photoprocess of the dihydronicotinamide chromophore and not due to any intramolecular interactions with adenine part of NADH. Such interactions are responsible for the depolarization of NADH fluorescence observed for excitation wavelength below 300 nm for OPE and 600 nm for TPE, respectively. NADH displays a low cross-section for two-photon excitation which suggests that fluorescence from NADH will be moderately difficult to observe with two-photon fluorescence microscopy, and may not interfere with observations of TPIF of other extrinsic probes used to label cells.

Absorptiometry, Photon↗

Three-photon excitation of N-acetyl-L-tyrosinamide.

We observed emission from the tyrosine derivative N-acetyl-L-tyrosinamide (NATyrA) when excited with the fundamental output of a femtosecond Ti:Sapphire laser from 780 to 855 nm. The dependence on incident laser power indicates a three-photon process. The emission spectra and intensity decay in glycerol-water (30:70) at 5 degrees C were found to be identical for one- and three-photon excitation. Also the excitation spectrum of three-photon-induced fluorescence of NATyrA corresponds to the one-photon excitation spectrum. The time-zero or fundamental anisotropy spectrum was reconstructed from the frequency-domain anisotropy decays. The three-photon anisotropies are similar or larger than the one-photon anisotropies. These three-photon anisotropies are surprising given the near zero values known for tyrosine with two-photon excitation. The observations indicate that one- and three-photon excitation directly populates the same singlet excited states(s). However, the origin of the anisotropies with multi-photon excitation of tyrosine remain unclear and unpredictable.

Fluorescence Polarization↗

Two-photon photodynamic therapy.

OBJECTIVE: We demonstrate the use of infrared excitation in conjunction with an efficient two-photon absorbing dye and a photosensitizer in photodynamic therapy. SUMMARY BACKGROUND DATA: An efficient two-photon absorbing dye is excited by short infrared (800 nm) laser pulses, which transfer its energy to the photosensitizer and the photosensitizer, in turn, generates the singlet oxygen. METHODS: A new approach to photodynamic cancer therapy based on the strong two-photon absorption of certain newly developed organic molecules. Near infrared pulsed laser light efficiently excites these molecules which, in turn, transfer the energy to the photosensitizer used in photodynamic therapy. RESULTS: A newly synthesized two-photon absorbing dye 4-[N-(2-hydroxyethyl)-N-(methyl) amino phenyl]-4'-(6-hydroxyhexyl sulfonyl)stilbene (APSS), which exhibits a strong two-photon absorption at 800 nm, and upconverted fluorescence at 520 nm, in solution in the presence of a photosensitizer was found to generate singlet oxygen under infrared excitation (800 nm). The generation of singlet oxygen in a reaction system containing two-photon absorbing dye and photosensitizer under infrared excitation has been chemically detected by using ADPA (9,10-anthracenedipropionic acid) as singlet oxygen detector. CONCLUSIONS: The efficient two-photon absorption of certain chromophores can be used to extend photodynamic therapy to the near infrared spectral region. Whereas the photosensitizer itself may not exhibit two-photon absorption, it could be used in conjunction with one of these new chromophores. The chromophores can act as "photon harvesters" whereby they absorb two photons of near infrared light and transfer the energy to the photosensitizer, which can generate singlet oxygen in the presence of atmospheric oxygen.

Absorption↗

Prognostic role of single-photon emission computed tomography (SPECT) imaging in myocardial viability.

PURPOSE OF REVIEW: Cardiac imaging is evolving rapidly. Appropriate use of this technology could reduce morbidity and mortality, but inappropriate use could have a significant financial burden. Single-photon emission computed tomography imaging is widely available. This review summarizes the clinical utility and limitations of the prognostic role of single-photon emission computed tomography imaging for myocardial viability in patients with coronary artery disease and left-ventricular dysfunction. RECENT FINDINGS: 201Tl single-photon emission computed tomography, 99mTc single-photon emission computed tomography with sestamibi or tetrofosmin, and 18F-fluorodeoxyglucose single-photon emission computed tomography are validated tools for assessing myocardial viability. These techniques have a very similar predictive value in determining regional and global response to revascularization. 201Tl single-photon emission computed tomography viability studies are predictive of reverse left-ventricular remodeling, symptom improvement, and patient outcome after revascularization. Combination imaging with dual-isotope simultaneous acquisition single-photon emission computed tomography or positron-emission tomography/single-photon emission computed tomography may improve the positive and negative predictive values of single-photon emission computed tomography-based viability studies. SUMMARY: Single-photon emission computed tomography-based myocardial viability testing is an important diagnostic modality due to widespread availability and reasonably good sensitivity and specificity for detecting viable myocardium and predicting clinical and functional responses to revascularization. In the future single-photon emission computed tomography viability techniques may have a prognostic role in predicting responses to cardiac resynchronization therapy and evaluating myocardial stem-cell transplantation.

Coronary Artery Disease↗