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PubMed1984

[Quantitation of left-sided valvular regurgitation by gated cardiac blood pool scan: evaluation of a new approach using the Fourier amplitude ratio].

Utilizing the Fourier amplitude ratio (FA ratio), we evaluated a new approach for quantitating valvular regurgitation by the gated cardiac blood pool scan. The subjects consisted of 36 patients with documented left ventricular regurgitation of grade I-IV (group 1), 24 patients with myocardial infarction including severe cardiac dysfunction (group 2), and 15 normal persons (group 3). From each pixel of the gated cardiac blood pool scan, a time-activity curve was obtained and the first-harmonic Fourier analysis was performed. Two functional images; namely, the phase and amplitude images, were generated. To generate the FA ratio, the region of interest was drawn around each ventricle in the amplitude image. The FA ratio was calculated using the following formula; FA ratio = left ventricular amplitude value/right ventricular amplitude value. The FA ratio was 2.66 +/- 1.75 (mean +/- S.D.) in group 1; 1.29 +/- 0.27 in group 2; and 1.11 +/- 0.19 in group 3. The FA ratio for group 1 was significantly higher than those of groups 2 and 3 (p less than 0.001). There was no significant difference between the FA ratios of groups 2 and 3. In patients with regurgitation, the FA ratio was 1.50 +/- 0.37 in patients with grade I, 1.97 +/- 0.34 in grade II, 2.73 +/- 0.95 in grade III; and 6.65 +/- 2.14 in grade IV. There was a good agreement between the FA ratios and quantitative angiographic estimates of regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[The role of computerized tomography in primary malignant tumors of the nasopharynx. Observations on 20 cases].

20 patients, with primary tumors of the nasopharynx have been studied over 3 years by CT with a second generation equipment. All cases were bioptically confirmed and 13 undifferentiated carcinomas, 4 differentiated epidermoid carcinomas, 1 adenoid-cystic carcinoma, 2 lymphomas were found. In every case, the CT provided a direct visualization of the lesion and correctly evaluated the extranasopharyngeal spread. This allowed a better T staging by classifying as T3 4 patients previously evaluated, on a clinical and radiological basis, as T2. Moreover, CT showed a circumscribed lesion on the right wall of the nasopharynx in a patient who resulted negative at clinical and radiological examination, and guided the biopsy which resulted positive for tumor. HCT, with a 100% positivity, is a better diagnostic tool with respect to posterior rhinoscopy and conventional radiology, respectively 95% and 88% positivity in the series of the authors. Finally CT was very helpful in therapy planning and post-irradiation follow-up.

Adenocarcinoma↗
PubMed1996

Localization of small-cell lung cancer xenografts with iodine-125-, indium-111-, and rhenium-188-somatostatin analogs.

We examined the potential of radiolabeled somatostatin analogs, 125I-Tyr-3-octreotide (125I-octreotide), (111)In-DTPA(diethylenetriaminepentaacetatic acid)-D-Phe-1-octreotide (111In-octreotide), and 188Re-octreotide for targeting small-cell lung cancer (SCLC) in a mouse model. Tyr-3-octreotide was labeled with 125I by the chloramine T method, and (111)In-octreotide was obtained as a kit, while 188Re was eluted from a 188W/188Re generator, and octreotide was directly labeled with 188Re by reducing disulfide bonds. The 125I-, 111In-, and 188Re-octreotides were injected i.v. into athymic mice bearing NCI-H69 tumors, and the biodistributions were determined at 15 min, and 2, 4, 8, and 24 h. Tumor uptakes were 0.5+/-0.2, 0.3+/-0.1, 0.3+/-0.1 %ID/g, and tumor-to-blood ratios were 1.8, 11.9, 1.2 at 8 h for 125I-, 111In-, and 188Re-octreotides, respectively. Accumulations of 111In-octreotide in normal tissues were lower than those of 125I- and 188Re-octreotides. 188Re-octreotide can be used to localize SCLC lesions as efficiently as radioiodinated octreotide. However, 111In-octreotide was the most suitable agent to obtain high tumor-to-normal tissue contrast for localizing SCLC.

Animals↗
PubMed2006

Validation of a semi-automated scintigraphic technique for detecting episodic, real-time colonic flow.

The relationships between the movement of colonic content and regional pressures have only been partially defined. During the analysis of a combined colonic scintigraphic and manometric study, a quantitative technique for determining discrete, episodic, real-time colonic flow was developed. Our aim was to validate this technique through the construction of a computer-generated phantom model of known antegrade and retrograde motility. The anthropoid phantom was rasterized into a 6-mm voxel model to create a 3D voxel phantom of the colon with four distinct colonic segments. Associating a time/activity curve with each segment simulated dynamic behaviour. Activity in the model was based on data obtained from human colonic scintigraphic recordings using 30 MBq of (99m)Tc sulphur colloid. The flow was simulated by modifying the input time/activity functions to represent episodes of net flow of 2%, 5% or 10% of segmental content. Our quantitative technique was applied to the phantom model to measure the accuracy with which simulated flows were detected. Our quantitative technique proved to be a sensitive and specific means of detecting the presence and the magnitude of discrete episodes of colonic flow and therefore, should improve our ability to correlate colonic flow and motor patterns.

Adult↗
PubMed2006

[Application study of JPEG2000 image compression in nuclear medicine].

To study the usefulness of JPEG2000 compression for nuclear medicine (NM) image, normal and abnormal static images were compressed using a JPEG2000 plug-in. For lossless algorithm, the compressing ratio (CR) was calculated. For lossy algorithm, images were visually analyzed by NM physicians and ROC curves were generated. The area under ROC curve (AUC) was used as the index of image diagnostic quality. Paired sample t tests were performed to compare the AUCs. It was found that the lossless CR was (1.34+/-0.05) : 1. For lossy algorithm, the AUC decreased with the increase of CR. Comparison between the original and the compressed images revealed no significant difference for 10:1 CR but significant difference for bigger CRs. It was concluded that lossless compression has little usefulness for NM image because of very low CR. While lossy compression isused, the diagnostic quality of static NM images is preserved at CRs 50 : 1,40 : 1, 30 : 1,20 : 1 up to 10 : 1. For other types of NM image, CR should be increased or decreased according to their characteristics, especially the level of intrinsic statistical noise of NM image.

Algorithms↗
PubMed1981

Relative value of computed tomography and hypocycloidal tomography in the diagnosis of pituitary microadenoma. A radio-surgical correlative study.

The relative value of a second generation CT scanner and complex motion polytomography are compared in 36 patients undergoing transsphenoidal surgery due to clinical and biological evidence of pituitary hypersecretion. CT findings of focal glandular hypodensity in 17 patients and upward convexity of the sellar contents in 15 patients suggested the presence of a pituitary microadenoma. Complex motion tomographic findings suggesting a microadenoma were found in 21 of 32 cases and included bulging of the sellar floor or localized thinning of the lamina dura. Selective transsphenoidal adenomectomy was performed on 34 of the 36 patients and the preoperative location based on CT scanning data was positively correlated with surgical results in 75% of the cases. When there is a strong clinical suspicion of pituitary hypersecretion both CT and polytomography may suggest the existence and location of a microadenoma. CT should be the radiographic technique of choice since it produces accurate information as to the size and density of the pituitary gland.

Adenoma↗
PubMed2005

[Research on time-course differential imaging by bone scintigraphy].

The temporal image subtraction technique was applied to bone scintigraphy, using Photoshop (commercially available image processing software) and Morpher (public domain warping software). For the temporal subtraction images, 81 subtraction images (19 cases) were prepared by a method used to subtract the previous images from the current ones. Registration of the current and previous images was performed by manual operation using Photoshop, and warping was done using the warping function of Morpher. In addition, difference images prepared after correcting the distributions of radioactive isotopes of the current and previous images using the count of the pelvic region were also examined. Compared with manual operation, alignment of images by warping improved registration and reduced the generation of pseudo-images of subtraction images. The rate of identification of abnormal accumulation-enhanced regions and subjective evaluation by doctors was improved for warping more than for manual operation. Furthermore, abnormal hot regions, which are difficult to find in film images, could be found in three subtraction images. In addition, it was confirmed that abnormal hot regions become more visible in many cases by preparing subtraction images after correcting the count between images using the count of the pelvic region. Thus, it is suggested that the temporal image subtraction technique in bone scintigraphy enables more accurate observation of enhancement of or changes in abnormal hot regions, which will support diagnostic reading. It is considered that enhancement of or changes in abnormal hot regions will be more accurately understood through further detailed discussion in the future.

Bone and Bones↗
PubMed1998

Myocardial fatty acid metabolism during acute cardiac allograft rejection.

Fatty acids are promptly taken up, metabolised and eliminated by healthy cardiomyocytes. Cardiomyopathy, coronary heart disease and chronic rejection are known to be associated with an impaired fatty acid metabolism. It was the aim of this study to investigate fatty acid metabolism in a rat heart transplant model and to correlate scintigraphic findings with histological changes. After right-side nephrectomy of Lewis recipients Brown Norway cardiac allografts were anastomosed to the renal vessels. Animals were given no immunosuppression. The metabolism of carrier-free 17-123 jodo-heptadecanoic acid (123J-HDA) with a specific activity of > 2 x 10(17) Bq/ml was scintigraphically measured between days 1 and 11. An increase in the grade of rejection was observed over time. Fifty-six frames of 30 s duration each were recorded. For the region of interest (native heart, transplanted heart, left kidney) frames 10-56 were superimposed, time-activity curves generated and monoexponentially fitted. Furthermore, elimination half-life and intercepts were calculated. Following scintigraphic evaluation the animals were killed and graft as well as native hearts excised for histological examination. The uptake of the tracer identified severe grades of rejection. Elimination half-life of the tracer was twice as long from hearts with mild rejection and more than 14 times as long in severe rejection compared with no rejection. Elimination half-life and amplitude did not permit discrimination between grades 1, 2 and 3 a, but significantly decreased in groups 3 b and 4. This method therefore seems to be a valuable tool for the noninvasive detection of severe acute cardiac allograft rejection. Since fatty acid metabolism is clearly stress-dependent it remains to be seen whether this method allows detection of earlier rejection in loaded hearts.

Animals↗
PubMed1998

Seven-hour stabilization of 99Tcm-exametazime (HMPAO) for cerebral perfusion.

The objective of this study was to increase the stability of 99Tcm-exametazime and to investigate the effects of relaxing the eluate restrictions imposed by the manufacturer. We added 1800 MBq freshly eluted pertechnetate to 0.5 ml aliquots of stannous-enhanced exametazime followed by the addition of 0.7 mg gentisic acid and 0.5 ml sterile absolute alcohol BP. The radiochemical purity as measured by thin-layer chromatography was maintained at over 80% (range 88-99%, n = 40) for up to 7 h after preparation. High-performance liquid chromatography confirmed that the primary complex was maintained at over 80% (ranges 89-92%) for up to 7 h. In a second series of studies using the first eluate from a newly delivered generator to prepare 99Tcm-exametazime, a radiochemical purity of more than 80% was achieved for up to 7 h (range 88-95%, n = 24). In a third series using a 3-hour-old generator eluate, a radiochemical purity of more than 80% (range 88-93%, n = 18) was achieved for up to 5 h (for logistic reasons, we were unable to continue readings beyond 5 h). These results suggest that the manufacturer's restrictions on the eluate may be relaxed. Clinical validation was performed in a blinded study of 21 patients using single photon emission tomography. Image quality was assessed on the basis of salivary activity, nasal activity and the overall (global) image quality. There was no significant difference between the images obtained using the stabilized exametazime and exametazime prepared without gentisic acid and ethanol (chi 2 = 2.85, P = 0.05). We conclude that stabilization of 99Tcm-exametazime can be achieved for up to 7 h by using gentisic acid and alcohol and that the eluate restrictions may be disregarded.

Butanones↗
PubMed1992

Radioaerosol assessment of lung improvement in cystic fibrosis patients treated for acute pulmonary exacerbations.

We compared bronchopulmonary distribution homogeneity of a radioaerosol before and after hospitalization in 20 patients with cystic fibrosis (CF) with pulmonary exacerbations in order to assess lung improvement. Deposition homogeneity was quantified in terms of skew (an index of distribution symmetry), derived from frequency distribution histograms generated from gamma camera images of the lungs following radioaerosol inhalation. Lower skew values indicate enhanced distribution homogeneity. Right lung skew (RLS) was significantly reduced following therapy (1.00 +/- 0.49 to 0.84 +/- 0.47), whereas skew in the left lung was unchanged (0.95 +/- 0.38 to 0.87 +/- 0.40). The reduction in RLS was significant in patients with Shwachman-Kulczycki (SK) clinical scores less than 50 (1.27 +/- 0.53 to 0.90 +/- 0.42), but not in patients with scores greater than 50 (0.81 +/- 0.38 to 0.80 +/- 0.52). These results indicate that treatment affected the right lung more than the left lung, particularly in patients with SK scores less than 50, and suggests that radioaerosol lung imaging may be valuable in identifying sites of impairment to be targeted during treatment. Statistically, skew was less sensitive an indicator of acute change than several other clinical indices that improved following hospital treatment.

Acute Disease↗
PubMed1989

[Bone metabolism in thalassemic children with multiple transfusions. Compartmental analysis of 99mTc-Sn-MDP kinetics].

The kinetics of 99mTc(Sn) methylene diphosphonate [99mTc(Sn)MDP] were evaluated by means of compartmental analysis in 5 normal children and 17 thalassemic subjects. Blood and urine activity were analyzed with a computer program which generates intercompartmental rate constants by an iterative least-square method providing a best-fit to the input data. The amount of tracer in each compartment (corrected for decay) was determined as a function of time. The transfer rate of 99mTc(Sn)MDP from blood to extracellular fluid and lamellar bone (K1-3) was about 20% higher in thalassemic subjects than in normal children. The transfer rate of 99mTc(Sn)MDP from blood to woven bone (K1-4) was about 57% higher in thalassemic subjects. A faster rate of spread into woven bone appears to be the major cause of higher bone uptake of 99mTc(Sn)MDP in thalassemic subjects, which suggests that in these patients bone tissue reoccupies the space previously replaced by hyperplastic marrow. Moreover, the increased bone extraction rate revealed a correlation between anemia and bone metabolic activity.

Adolescent↗
PubMed2000

Efficient lung scintigraphy.

Lung scintigraphy is a first-choice method to diagnose lung embolism. The clinical routine in most centres is a perfusion study complemented with a ventilation study when judged necessary. We describe a routine with ventilation scintigraphy preceding perfusion scintigraphy, which is completed within one hour. Furthermore, the data acquired allow the determination of lung clearance of the tracer 99mTc-DTPA (diethylene triamine penta-acetate) used for the ventilation scintigraphy. An aerosol generator charged once a day with 99mTc-DTPA solution is used for all inhalations during the day. Inhalation is monitored with a counter and interrupted when the count rate corresponds to about 20 MBq. The ventilation imaging starts and ends with posterior projections. This allows calculation of lung clearance of 99mTc-DTPA. Perfusion scintigraphy is performed in a standard fashion with 100 MBq of 99mTc-MAA (macro-aggregated albumin). The ventilation study was considered to give some diagnostic information in the majority of the patients. The clearance determination allows detection of inflammatory lung disease. The background activity caused by the ventilation study comprised only 13% of the activity in the perfusion scintigraphy and did not significantly interfere with interpretation of the perfusion scan. The cost for the investigation is low because of the rational system for aerosol administration and the short time for a complete study.

Humans↗
PubMed1999

Ultraviolet A radiation induces immediate release of iron in human primary skin fibroblasts: the role of ferritin.

In mammalian cells, the level of the iron-storage protein ferritin (Ft) is tightly controlled by the iron-regulatory protein-1 (IRP-1) at the posttranscriptional level. This regulation prevents iron acting as a catalyst in reactions between reactive oxygen species and biomolecules. The ultraviolet A (UVA) radiation component of sunlight (320-400 nm) has been shown to be a source of oxidative stress to skin via generation of reactive oxygen species. We report here that the exposure of human primary skin fibroblasts, FEK4, to UVA radiation causes an immediate release of "free" iron in the cells via proteolysis of Ft. Within minutes of exposure to a range of doses of UVA at natural exposure levels, the binding activity of IRP-1, as well as Ft levels, decreases in a dose-dependent manner. This decrease coincides with a significant leakage of the lysosomal components into the cytosol. Stabilization of Ft molecules occurs only when cells are pretreated with lysosomal protease inhibitors after UVA treatment. We propose that the oxidative damage to lysosomes that leads to Ft degradation and the consequent rapid release of potentially harmful "free" iron to the cytosol might be a major factor in UVA-induced damage to the skin.

Cells, Cultured↗
PubMed2004

Brain incorporation of 11C-arachidonic acid, blood volume, and blood flow in healthy aging: a study with partial-volume correction.

UNLABELLED: PET with 11C-arachidonic acid (AA) can be used to quantify neural signaling related to phospholipase A2 (PLA2). Animal studies suggest reduction in the activity of this signaling system with age. The aim of this study was to evaluate the effect of healthy aging on brain incorporation of 11C-AA, before and after partial-volume correction (PVC). METHODS: Absolute measurements of cerebral blood flow (CBF) were obtained in 8 young and 7 old healthy subjects (mean age +/- SD, 27 +/- 5 y and 65 +/- 9 y) with bolus injection of 15O-water. About 15 min later, dynamic 60-min 3-dimensional scans were acquired after the injection of 11C-AA. Radioactivity frames of 11C-AA were corrected for head motion and registered to magnetic resonance (MR) images. A 3-segment (3S) and a 2-segment (2S) PVC was applied pixel-by-pixel to the activity frames. For the 3S method, the white matter value was estimated using a new automatic method by extrapolating the activity values of pixels with white matter membership > 0.99. Parametric images of the brain incorporation rate of 11C-AA (K*) and cerebral blood volume (Vb), as well as CBF, were generated and regional gray matter values were obtained. RESULTS: Among cortical areas, there were no significant differences (uncorrected P < 0.05) in K* or Vb absolute values between young and old subjects before or after PVC. A significant reduction of CBF was detected in the frontal cortex of the elderly group. After normalization to the global gray average, K*, Vb, and CBF values revealed significant reductions in the frontal lobe of old subjects; none of these differences were significant after PVC. CONCLUSION: These results confirm previous PET findings that brain function at rest is minimally affected by healthy aging. Proper PVC methodology is of critical importance in accurate quantitative assessment of PET physiologic measures.

Adult↗
PubMed2005

[Bisphosphonates-related jaw osteonecrosis].

INTRODUCTION: The latest generations of bisphosphonates constitute a major advance in the management of disorders including Paget's disease, osteoporosis, and osteolytic bone tumors. Recent reports describe numerous cases of osteonecrosis of the jaw in patients treated with bisphosphonates. Some of these reports mention predisposing factors, including surgical procedures, chemotherapy, and radiotherapy. CASES: In the past 12 months, we have observed and treated 9 cases of maxillary osteonecrosis, which we present summarily. DISCUSSION: Some of our cases (3 of 9), like many of those described in literature, do not present predisposing factors. The osteonecrosis may thus be due mainly to the effect of bisphosphonates that, by blocking bone remodeling, may cause excessive bone mineralization. If this hypothesis is confirmed, these cases of osteonecrosis may be due to excess doses. Better dose adjustment should thus help prevent this complication.

Adolescent↗
PubMed1991

Imaging pattern of radiolabelled lymphokine-activated killer cells in patients with metastatic malignant melanoma.

In patients with metastatic malignant melanoma the distribution patterns of radiolabelled lymphokine-activated killer (LAK) cells were investigated. Peripheral mononuclear cells (PMC) were isolated from six patients. LAK cells were generated by culturing PMC in complete medium containing 1000 U interleukin (IL)-2/ml and labelled with indium 111 before retransfer. We obtained scans at 2.5, 24, 48 or 96 h after injection with a high resolution gamma-camera. Intravenously injected LAK cells distributed to the lungs, liver, spleen and bone marrow. External tumour detection of known lymph node and bone metastases was successful in four. It failed in one patient with a solitary lung metastasis and in another patient with subcutaneous metastases. Our results suggest that LAK cells show tumour homing, providing a direct interaction between tumour and cytotoxic cells. We conclude that PMC seem to retain their ability to migrate after IL-2 stimulation and 111In-labeling. This technique may be helpful for kinetics studies or external detection of metastases in patients with malignant melanoma.

Adult↗
PubMed1990

The derivation and verification of a non-stationary, optimal smoothing filter for nuclear medicine image data.

A non-stationary optimal smoothing filter for digital nuclear medicine image data, degraded by Poisson noise, has been derived and applied to temporal simulated and clinical gated blood pool study (GBPS) data. The derived filter is automatically calculated from a large group (library) of similar GBPS which are representative of all studies acquired according to the same protocol in a defined patient population (the ensemble). The filter is designed to minimize the mean-square difference between the filtered data and the true image values; it provides an optimal trade-off between noise reduction and signal degradation for members of the ensemble. The filter is evaluated using a computer simulated ensemble of GBPS. Libraries of Poisson-degraded and non-degraded studies were generated. Libraries of up to 400 Poisson-degraded simulated studies were used to estimate optimal temporal filters that, when applied to Poisson-degraded members of the ensemble not included in the libraries, reduced the mean-square error in the raw data by 65%. When the non-degraded studies were used instead to compute the optimal filter values, the corresponding reduction in the error was 83%. Libraries of previously acquired clinical GBPS were then used to estimate optimal temporal filters for an ensemble of similarly acquired studies. These filters were subsequently applied to studies of 13 patients (not in the original libraries) who received multiple sequential repeat studies. Comparisons of both the filtered and raw data to averages of the repeat studies demonstrated that optimal filters calculated from 400 and 800 clinical studies reduced the mean-square error in the clinical data by 56% and 63% respectively.

Filtration↗
PubMed2006

Quantitative evaluation of salivary gland dysfunction after radioiodine therapy using salivary gland scintigraphy.

AIM: The most frequent non-thyroidal complication of high-dose (131)I therapy for thyroid carcinoma is salivary gland dysfunction, which may be transient or permanent. In this study, we assessed radioiodine-induced permanent salivary gland dysfunction using quantitative salivary gland scintigraphy. METHODS: Salivary scintigraphy was performed with (99m)Tc-pertechnetate on 50 thyroid carcinoma patients who had been given radioiodine for thyroid ablation; 20 normal subjects were imaged as the control population. Dynamic scintigraphy was performed and time-activity curves for four major salivary glands were generated. The glandular functional parameters maximum secretion, time at maximum count and uptake ratio of the parotid and submandibular glands were calculated. Correlation of the administered dose and subjective symptoms with findings of salivary gland scintigraphy was evaluated. RESULTS: The maximum secretion and uptake ratio were decreased in 46% and 42% of patients who received radioiodine therapy, respectively. Salivary gland dysfunction correlated well with the administered dose. The parotid glands were more affected than the submandibular glands. Fifty-two per cent of patients were symptomatic, 69.23% of whom showed salivary gland dysfunction. CONCLUSION: Parenchymal damage to the salivary glands induced by radioactive iodine treatment can be evaluated by salivary gland scintigraphy. The impairment was worse in parotid glands and increased with the total dose. The maximum secretion and uptake ratio were found to be sufficiently sensitive to distinguish the severity of the damage.

Adult↗