Single Photo Emission Computed Tomography Research Articles

Myocardial salvage after ST-segment-elevation myocardial infarction: comparison between prasugrel and clopidogrel in the presence or absence of high-residual platelet reactivity

BackgroundThe effect of prasugrel over clopidogrel on myocardial salvage in ST-segment-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (p-PCI) is not fully elucidated. MethodsAmong 854 consecutive STEMI patients who underwent p-PCI, 446 patients were evaluated by two-phase (7 days and 3 months) single-photo emission computed tomography (SPECT). Patients were divided into two groups based on the loading P2Y12 inhibitor. The clopidogrel group was further divided based on the result of platelet function testing. Thus, the prasugrel group included 227 patients; the clopidogrel without high-residual platelet reactivity (HRPR) group, 109 patients; and the clopidogrel with HRPR group, 107 patients. The primary endpoint was the Myocardial Salvage Index (MSI), determined by SPECT. ResultsThe incidence of final TIMI 0/1 and TIMI myocardial perfusion grade 0/1 was higher in the clopidogrel with HRPR group (0.9%, 1.8%, and 7.5%, P = .002; 19.8%, 29.4%, and 41.1%, P = .0002, in the prasugrel, clopidogrel without HRPR, and clopidogrel with HRPR groups, respectively). The MSI was significantly lower in the clopidogrel with HRPR group (48% [27-66], 44% [30-72], and 36% [15-55], P = .006, respectively). ConclusionsPrasugrel in STEMI patients was associated with an increased MSI compared with clopidogrel in the presence of HRPR.

A-032 The Relative Contribution of Neuropsychological Assessment and Radiological Scans to Diagnostic Accuracy in Young Onset Dementia

Abstract Objective Younger-onset dementias (YOD) are relatively rare neurodegenerative disorders that often present unique diagnostic challenges to health professionals. These difficulties often result in significant delays to diagnosis and uncertainty in clarifying the aetiology of a client’s presenting problems. In this audit of routine clinical practice, we evaluate the utility of radiological scan reports (Magnetic Resonance Imaging (MRI), Single Photo Emission Computed Tomography (SPECT) and Computerised Tomography (CT) with neuropsychological assessment, and retrospectively evaluate the relative contribution of each approach to diagnostic accuracy. Method 83 clinical records were reviewed from a regional specialist centre for assessment and diagnosis of YOD in the United Kingdom. Patients were assessed using clinical interview, neuropsychological assessment and neuroradiological diagnosis (MRI, SPECT or CT scan). The correlations between radiologist report, neuropsychological status and neuropsychiatric evaluation were compared to established diagnoses retrospectively. Results The diagnostic labels identified and highlighted in radiology reports were found to be congruent with the final agreed diagnosis, arrived as a consensus by a multidisciplinary team of clinicians, in 70% of cases. In contrast, neuropsychological opinion was congruent with the final agreed clinical diagnosis in 93% of cases. Substantial differences in congruency between scan report and clinical diagnosis were observed for the different neuroradiological techniques with SPECT showing high rates of false positive abnormality. Conclusion Overall, neuropsychological opinion concurred with final diagnostic outcomes significantly more frequently than diagnosis indicated by radiology scan report. Results are discussed in terms of both cost–benefit analysis and the clinical utility of both assessments in the diagnosis of YOD.

Sentinel lymph node biopsies in early stage oral and oropharyngeal carcinoma: a retrospective single-centre experience.

The aim of this retrospective study was to analyse a consecutive series of patients with oral and oropharyngeal carcinoma who had had sentinel lymph node biopsy (SLNB) at our hospital during 2008-2017. A total of 70 patients with clinically and radiologically confirmed primary oral (n=67) or oropharyngeal (n=3) carcinoma, with no signs of metastatic lymph nodes preoperatively (clinically N0) were included. Patients' clinical and personal data, characteristics of the tumours, sentinel lymph node (SLN) status and outcomes were recorded. Eight patients had invaded SLN. Two patients with clear sentinel lymph node biopsies had recurrences in the cervical lymph nodes with no new primary tumour as origin. The negative predictive value (NPV) and sensitivity for SLNB were 97% and 80%, respectively. The depth of invasion was an individual predictor for cervical lymph node metastasis (p=0.043). Single photo emission computed tomography (SPECT) detected fewer SLN in patients with invaded lymph nodes than in patients with clear lymph nodes (p=0.018). Our data support the use of SLNB as a minimally invasive method for staging the cervical lymph nodes among patients with cN0 oral and oropharyngeal carcinoma. Our results further confirm that greater depth of invasion is associated with cervical lymph node metastases.

Value of 68Ga-DOTA-TATE Positron Emission Tomography/Computed Tomography in the Localization of Culprit Tumors Causing Osteomalacia with Negative 99mTc-HYNIC-TOC Single Photo Emission Computed Tomography

Objective To analyze 68Ga-DOTA-TATE positron emission tomography/computed tomography (PET/CT) imaging features of tumor-indud osteomalacia (TIO) patients with negative 99mTc-HYNIC-TOC single photo emission computed tomography (SPECT) findings and to investigate the value of 68Ga-DOTA-TATE PET/CT in accurate localization of culprit tumors.Methods We retrospectively analyzed 68Ga-DOTA-TATE PET/CT imaging features including location,size,density,the maximum and mean standardized uptake value in 37 TIO patients with negative 99mTc-HYNIC-TOC SPECT findings.Results Totally 37 solitary TIO tumors,including 35 phosphaturic mesenchymal tumors and 2 spindle cell tumors confirmed by pathological examinations,were detected via 68Ga-DOTA-TATE PET/CT scans in the included 37 cases. These 37 TIO tumors showed obviously increased activities,with an maximum standardized uptake value of 7.2±4.3 and mean standardized uptake value of 4.3±2.4. The average maximum diameter was (1.9±0.7) cm. The majority of the tumors occurred in the lower extremities (19/37),followed by the trunk (11/37),maxillary/mandibular bone (5/37),and upper extremities (2/37). In addition,24 bone lesions were located in long bones of lower extremities (13/24),most of which demonstrated eccentric growth (8/13). Osteolytic changes (14/24) were observed mainly in the lesions via the corresponding CT imaging;meanwhile,sclerotic changes presented in nine cases. Of the 13 soft-tissue lesions,the majority (10/13) showed well-circumscribed isodense or hypodense nodules on the CT images,with spot calcification in one lesion located in the pleura.Conclusions 68Ga-DOTA-TATE PET/CT scans can detect the TIO culprit tumors miss-diagnosed by 99mTc-HYNIC-TOC SPECT. Somatostatin-receptors highly expressed lesions with focal osteolytic or osteosclerotic change in bone and isodense or hypodense nodules in soft tissue will favor the diagnosis of TIO tumors.

Clinical Brain SPECT Changes in Accordance to Physical Activity of Seniors Woman

The purpose of this study is to investigate about the change which can delay the aging of mind. When senior woman perform aerobic exercise consistently for an extended amount of time, improvements of regional blood flow in brain could be noticed. This could lead to advance research about positive effects of increased brain blood flow to investigate the relation of neurotransmitter, hormone, and relation with cerebrovascular disease. The effects of SPECT(Single Photo Emission Computed Tomography) scan results to brain blood flow. Improvement of blood stream in prefrontal and temporal lobe will help to prevent the dementia. But, to get positive results, it is important to have the seniors exercise. Exercise prescription guideline to the seniors is difficult and demands long period of time to reach the expected goal. One of the important issues is to overcome metabolic syndrome which is often found in seniors. It decreases metabolism of the senior gradually reducing brain activity, eventually failing all physical functions. As a result, it is essential to increase the neurotransmitter and brain blood flow to in order to provide healthy life quality to the seniors. Of all exercises, aerobic exercise increases the oxygen being supplied to brain. It brings positive influence and effect to nervous system and cardiopulmonary monitor, resulting active brain activity. Therefore, in this current society where the senior population is increasing, it is important that we invest in this research within the field of physical education and provide a healthy solution for the '100 year life' generation.

Evaluation of Imaging Modules Based on SensL Array SB-8 for Nuclear Medicine Applications

Recent advances in the development of silicon photomultipliers (SiPM) offer new opportunities for medical imaging applications. Specifically, novel imaging devices for positron emission (PET) and single photo-emission computed tomography (SPECT) are becoming feasible. In this investigation, we tested a monolithic array of new generation SiPMs, an SB-8 array from SensL. 8×8 array of 6-mm square SiPMs was studied with two different multiplexing readouts, 4- and 16-channels. SB-8 detector was coupled to various scintillation arrays and resulting prototypes were evaluated. Testing demonstrated that the new device is capable of resolving 1 mm LYSO and 1.5 mm NaI crystals with 16-channel readout and 1.57 mm LYSO and 3 mm NaI crystals with 4-channel readout. Energy resolution of approximately 15% at 511 keV and 19% at 122 keV were obtained with LYSO and NaI crystals, respectively. A timing resolution of 1.52 ns was measured with 1.57 mm LYSO array and the 16-channel readout. It is concluded that new B-series SiPMs from SensL are suitable for use in high spatial resolution nuclear medicine particle detectors.

Management of patients with condylar hyperplasia: A diverse experience with 18 patients

Purpose:The purpose was to report the clinical experience with patients diagnosed with Condylar Hyperplasia (CH).Materials and Methods:Eighteen patients with CH underwent condylar growth assessment using clinical and radiographic examinations. Seven patients with suspected active condyles underwent single photo emission computed tomography (SPECT) examination. A total of patients with asymmetry and malocclusion were treated with orthognathic surgery. Three patients with intact occlusion; underwent inferior border osteotomy with nerve repositioning. All patients were followed up for 3 years without any complications.Conclusion:There is great diversity in the clinical and radiographic presentation in cases with CH. Assessment of condylar growth activity is the cornerstone in managing these cases. After that each case has its own diverse treatment plan to achieve a satisfactory facial symmetry.

Imagerie scintigraphique de la démence : technique d’acquisition

Scintigraphic imaging of dementia relies today essentially on the study of brain Single Photo Emission Computed Tomography (SPECT) perfusion, after intravenous injection of 99mTc radiopharmaceutic. This paper is based on the guidelines published in October 2001 by the European Association of Nuclear Medicine ( http://eanm.org/).

Incorporation of system resolution compensation (RC) in the ordered-subset transmission (OSTR) algorithm for transmission imaging in SPECT

In order to reconstruct attenuation maps with improved spatial resolution and quantitative accuracy, we developed an approximate method of incorporating system resolution compensation (RC) in the ordered-subset transmission (OSTR) algorithm for transmission reconstruction. Our method approximately models the blur caused by the finite intrinsic detector resolution, the nonideal source collimation and detector collimation. We derived the formulation using the optimization transfer principle as in the derivation of the OSTR algorithm. The formulation includes one forward-blur step and one back-blur step, which do not severely slow down reconstruction. The formulation could be applicable to various transmission geometries, such as point-source, line-source, and sheet-source systems. Through computer simulations of the MCAT phantom and transmission measurements of the air-filled Data Spectrum Deluxe single photo emission computed tomography (SPECT) Phantom on a system which employed a cone-beam geometry and a system which employed a scanning-line-source geometry, we showed that incorporation of RC increased spatial resolution and improved the quantitative accuracy of reconstruction. In simulation studies, attenuation maps reconstructed with RC correction improved the quantitative accuracy of emission reconstruction.

Identification and Detection of Transmissible Spongiform Encephalopathies

Scrapie is a slowly developing transmissible spongiform encephalopathy (TSE) occurring naturally in sheep and goats. At present, there is no efficient antemortem diagnostic test for TSEs. Electroencephalograms (EEGs), electrocardiograms (ECGs), magnetic-resonance imaging (MRI), positron emission tomography (PET), single photo emission computed tomography (SPECT), as well as conformation-dependent immunoassay (CDI), which show patterns characteristic of prion diseases, can obtain diagnostic information for TSEs. Other methods include testing cerebrospinal fluid for the presence of 14-3-3 proteins, Fourier transformation infrared spectroscopy (FTIR), brain biopsy, nasal biopsy and tonsil biopsy. For better TSE diagnosis, most TSEs need to be confirmed by the presentation of abnormal prion protein by Western blot, ELISA immunochemical methods, or immunocytochemistry methods, or by bioassays, a more sensitive but time-consuming method, which involves inoculating suspended homogenates into susceptible hosts and waiting for a long incubation period to conclude. An antemortem diagnostic test for TSEs can be done from spleen or lymph node biopsy by evaluating PrPSc presence. Since it has been suggested that the buffy coat of TSE animals may carry infectivity, a method for presymptomatic diagnosis of TSE from blood is clearly possible and desirable. At present, antibodies against prion protein cannot distinguish normal prion protein (PrP C) and abnormal prion protein (PrPSc); there is no reliable antibody to detect PrPSc only. In this review, we propose that the development of gene chips and / or protein chips for assays of TSE diseases might prove very useful. A great deal of basic research on TSE diagnosis, prevention, and treatment remains to be conducted. Keywords: transmissible spongiform encephalopathies, prion diseases, tse, prion protein, abnormal prion protein

Biodistribution of fullerene derivative C60(OH)x(O)y

The biological behavior of fullerene derivatives shows their considerable potential application in medicine field. To understand the biodistribution of C60 derivatives as drugs or drug carriers, a simple water-soluble derivative C60(OH)x(O)y was labeled with99mTc. A γ-counter and a single photo emission computed tomography (SPECT) were used to assess the biodistribution and metabolism of the labeled compound in mice and rabbits, respectively. The results showed that the compound could be absorbed rapidly by tissues, especially by coronal bone, breastbone, backbone, extremity honeycomb, liver and spleen. The clearance was slow from all tissues except for brain. The compound might be excreted through urine and enteron. The biodistribution shows some difference from that of Yamago et al. In this note, we discuss the possible reason leading to the difference. Further study is needed to find out to what extent the C60 itself determines the biodistribution of derivatives.

Development of Tc-99m labeled tropanes: TRODAT-1, as a dopamine transporter imaging agent

Advances in the technetium chemistry have significantly enhanced the development of Tc-99m radiopharmaceuticals for clinical use. Efforts in designing novel Tc-99m labeled receptor or site-specific imaging agents using [Tc vO] +3N 2S 2 core have produced useful imaging agents for single photo emission computed tomography (SPECT). The success in developing Tc-99m TRODAT-1 for CNS dopamine transporters (DAT) serves as the first example of Tc-99m site-specific imaging of human brain. New innovative Tc-99m labeled site-specific agents are particularly suitable to develop simple and useful routine diagnostic procedures.