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1.
Hidaka F Amano Y Takahama K Takagi R Murakami R Onozawa S Kumita S 《Japanese journal of radiology》2011,29(6):378-385
Purpose
The aim of this study was to determine whether non-contrast-enhanced magnetic resonance imaging (MRI) can detect three levels of renal impairment by evaluating the differences and agreement with 99mTc-diethylenetriamine pentaacetic acid (DTPA) renography. 相似文献2.
Krystyna M. Jones Lilja B. Solnes Steven P. Rowe Michael A. Gorin Sara Sheikhbahaei George Fung Eric C. Frey Mohamad E. Allaf Yong Du Mehrbod S. Javadi 《Annals of nuclear medicine》2018,32(2):87-93
Objective
Technetium-99m (99mTc)-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has previously been shown to allow for the accurate differentiation of benign renal oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) apart from other malignant renal tumor histologies, with oncocytomas/HOCTs showing high uptake and renal cell carcinoma (RCC) showing low uptake based on uptake ratios from non-quantitative single-photon emission computed tomography (SPECT) reconstructions. However, in this study, several tumors fell close to the uptake ratio cutoff, likely due to limitations in conventional SPECT/CT reconstruction methods. We hypothesized that application of quantitative SPECT/CT (QSPECT) reconstruction methods developed by our group would provide more robust separation of hot and cold lesions, serving as an imaging framework on which quantitative biomarkers can be validated for evaluation of renal masses with 99mTc-sestamibi.Methods
Single-photon emission computed tomography data were reconstructed using the clinical Flash 3D reconstruction and QSPECT methods. Two blinded readers then characterized each tumor as hot or cold. Semi-quantitative uptake ratios were calculated by dividing lesion activity by background renal activity for both Flash 3D and QSPECT reconstructions.Results
The difference between median (mean) hot and cold tumor uptake ratios measured 0.655 (0.73) with the QSPECT method and 0.624 (0.67) with the conventional method, resulting in increased separation between hot and cold tumors. Sub-analysis of 7 lesions near the separation point showed a higher absolute difference (0.16) between QPSECT and Flash 3D mean uptake ratios compared to the remaining lesions.Conclusions
Our finding of improved separation between uptake ratios of hot and cold lesions using QSPECT reconstruction lays the foundation for additional quantitative SPECT techniques such as SPECT-UV in the setting of renal 99mTc-sestamibi and other SPECT/CT exams. With robust quantitative image reconstruction and biomarker analysis, there may be an expanded role for SPECT/CT imaging in renal masses and other pathologic conditions.3.
Tatsuaki Sumiyoshi Yasuo Shima Takehiro Okabayashi Yasuhiro Hata Yoshihiro Noda Michihiko Kouno Yuichi Saisaka Kenta Sui Sojiro Morita Yuji Negoro Taijiro Sueda 《Japanese journal of radiology》2017,35(12):748-754
Purpose
Our aim was to determine the utility of Tc-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin single-photon-emission computed tomography (99mTc-GSA SPECT/CT) fusion imaging for detecting incomplete portal vein embolization (PVE).Materials and methods
Fifty-five candidates underwent PVE. Among them, five underwent second PVE. Detectability of first inadequate PVE using CT and 99mTc-GSA SPECT/CT fusion imaging was analyzed.Results
Cases of inadequate PVE were detected in three patients using CT and in five using 99mTc-GSA SPECT/CT fusion imaging. Fusion imaging detected two cases of insufficient PVE in which portal branches were apparently well embolized on CT. Median value for volumetric rate in the embolized liver was 63.3% after the first PVE and 54.7% after the second (P < 0.01). Median functional rate value in embolized liver was 60.1% after the first PVE and 49.4% after the second (P < 0.01). Median value for change of volumetric and functional rates in embolized liver after the second PVE was 7.1 and 10.3%, respectively, and change of functional rate was greater than that of volumetric rate (P < 0.01).Conclusions
99mTc-GSA SPECT/CT fusion imaging was useful for detecting inadequate PVE, and second PVE was effective for increasing volumetric and functional rates.4.
Background
Detection of pulmonary contusion in patients with blunt chest trauma is very important so as to commence therapy immediately to avoid irreversible damage. The purpose of our study was to evaluate the efficacy of technetium-99m diethylene triamine pentaacetic acid (99mTc-DTPA) aerosol inhalation lung scintigraphy in comparison with chest computed tomography (CT) in the diagnosis of pulmonary contusion at acute blunt chest trauma.Methods
Twenty-nine patients with isolated blunt chest trauma were referred to the emergency department of our hospital, and nine healthy people participated in this study. Sixteen patients who had pulmonary contusion on CT scans were referred to as group 1, and 13 patients who had normal CT scans as group 2. Nine healthy people comprised a control group. 99mTc-DTPA aerosol inhalation lung scintigraphy was performed on the first day in all patients.Results
The mean half time (T½) and penetration index values of 99mTc-DTPA clearance were significantly lower in groups 1 and 2 compared with the control group. Among the three groups, there were no significant differences in arterial blood gas analysis except for PO2. The mean T½ value of 99mTc-DTPA clearance did correlate with PO2 values but not with pH, PCO2, or HCO3 values.Conclusions
99mTc-DTPA radioaerosol inhalation lung imaging may serve as a useful adjunct and supportive method to chest CT scanning for detecting mild pulmonary contusion.5.
Mike Sathekge Osvaldo Garcia-Perez Diana Paez Noura El-Haj Taylor Kain-Godoy Ismaheel Lawal Enrique Estrada-Lobato 《Annals of nuclear medicine》2018,32(1):54-59
Objective
To determine the added value of CT over planar and SPECT-only imaging in the diagnosis of musculoskeletal infection using 99mTc-UBI 29-4.Materials and methods
184 patients with suspected musculoskeletal infection who underwent planar and SPECT/CT imaging with 99mTc-UBI 29-41 were included. Planar, SPECT-only and SPECT/CT images were reviewed by two independent analysts for presence of bone or soft tissue infection. Final diagnosis was confirmed with tissue cultures, surgery/histology or clinical follow-up.Results
99mTc-UBI 29-41 was true positive in 105/184 patients and true negative in 65/184 patients. When differentiating between soft tissue and bone infection, planar?+?SPECT-only imaging had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 95.0, 74.3, 84.8, 91.3 and 86.9%, respectively, versus 99.0, 94.5, 92.5, 98.5 and 94.5% for SPECT/CT. SPECT/CT resulted in a change in reviewers’ confidence in the final diagnosis in 91/184 patients. Inter-observer agreement was better with SPECT/CT compared with planar?+?SPECT imaging (kappa 0.87, 95% CI 0.71–0.85 versus kappa 0.81, 95% CI 0.58–0.75).Conclusion
Addition of CT to planar and SPECT-only imaging led to an increase in diagnostic performance and an improvement in reviewers’ confidence and inter-observer agreement in differentiating bone from soft tissue infection.6.
Mohsen?Beheshti Lukas?Hehenwarter Zeinab?Paymani Gundula?Rendl Larisa?Imamovic Rupert?Rettenbacher Oleksiy?Tsybrovskyy Werner?Langsteger Christian?Pirich
Purpose
In this prospective study we compared the accuracy of 18F-fluorocholine PET/CT with that of 99mTc-MIBI or99mTc-tetrofosmin SPECT/CT in the preoperative detection of parathyroid adenoma in patients with primary hyperparathyroidism. We also assessed the value of semiquantitative parameters in differentiating between parathyroid hyperplasia and adenoma.Methods
Both 18F-fluorocholine PET/CT and 99mTc-MIBI/tetrofosmin SPECT/CT were performed in 100 consecutive patients with biochemical evidence of primary hyperparathyroidism. At least one abnormal focus on either 18F-fluorocholine or 99mTc-MIBI/tetrofosmin corresponding to a parathyroid gland or ectopic parathyroid tissue was considered as a positive finding. In 76 patients with positive findings on at least one imaging modality, surgical exploration was performed within 6 months, and the results were related to histopathological findings and clinical and laboratory findings at 3–6 months as the standard of truth. In 24 patients, no surgery was performed: in 18 patients with positive imaging findings surgery was refused or considered risky, and in 6 patients imaging was negative. Therefore, data from 82 patients (76 undergoing surgery, 6 without surgery) in whom the standard of truth criteria were met, were used in the final analysis.Results
All patients showed biochemical evidence of primary hyperparathyroidism with a mean serum calcium level of 2.78?±?0.34 mmol/l and parathormone (PTH) level of 196.5?±?236.4 pg/ml. The study results in 76 patients with verified histopathology and 3 patients with negative imaging findings were analysed. Three of six patients with negative imaging showed normalized serum PTH and calcium levels on laboratory follow-up at 3 and 6 months, and the results were considered true negative. In a patient-based analysis, the detection rate with 18F-fluorocholine PET/CT was 93% (76/82), but was only 61% (50/82) with 99mTc-MIBI/tetrofosmin SPECT/CT. In a lesion-based analysis, the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of 18F-fluorocholine PET/CT in the detection of parathyroid adenoma were 93.7%, 96.0%, 90.2%, 97.4% and 95.3%, respectively, and of 99mTc-MIBI/tetrofosmin SPECT/CT were 60.8%, 98.5%, 94.1%, 86.3% and 87.7%, respectively. Although 18F-fluorocholine PET-positive adenomatous lesions showed higher SUVmax values than the hyperplastic glands (6.80?±?3.78 vs. 4.53?±?0.40) in the semiquantitative analysis, the difference was not significant (p?=?0.236). The mean size (measured as the length of the greatest dimension) and weight of adenomas were 15.9?±?7.6 mm (median 15 mm, range 1–40 mm) and 1.71?±?1.86 g (median 1 g, range: 0.25–9 g), respectively. Among the analysed parameters including serum calcium and PTH and the size and weight of parathyroid adenomas, size was significantly different between patients with negative 99mTc-MIBI/tetrofosmin SPECT/CT and those with positive 99mTc-MIBI/tetrofosmin SPECT/CT (mean size 13.4?±?7.6 mm vs. 16.9?±?7.4 mm, respectively; p?=?0.042).Conclusion
In this prospective study, 18F-fluorocholine PET/CT showed promise as a functional imaging modality, being clearly superior to 99mTc-MIBI/tetrofosmin SPECT/CT, especially in the detection and localization of small parathyroid adenomas in patients with primary hyperparathyroidism. SUVmax was higher in parathyroid adenomas than in hyperplasia. However, further evaluation of this modality is needed.7.
Objective
Our aim of this research was to determine the value of SPECT/CT with 99mTc-HYNIC-TOC for evaluation of the pancreatic masses which were suspected as neuroendocrine neoplasms and follow-up of patients with pancreatic neuroendocrine neoplasms.Methods
We retrospectively analyzed 184 patients who performed 99mTc-HYNIC-TOC SPECT/CT. All the patients were divided into two groups: one for assessment of diagnostic efficiency for pancreatic suspected masses (n?=?140) and another for monitoring recurrence after surgery (n?=?44). The image findings acquired at 2 h postinjection were compared to final diagnoses from pathological results and clinical follow-up. Then, the correlation between ratios of tumor-to-background (TBR) and tumor grade was analyzed.Results
In group 1, 95/140 (67.9%) patients were confirmed as neuroendocrine neoplasms including 85 neuroendocrine tumors and 10 neuroendocrine carcinomas. Patient-based analysis showed that the sensitivity, specificity and accuracy of diagnosing neuroendocrine neoplasms with SPECT/CT were 81.1, 84.4 and 82.1%. There was significant difference of TBRs among G1, G2 and G3 (F?=?3.175, P?=?0.048). In group 2, 22/44 (50.0%) patients occurred metastasis mainly in liver. The sensitivity, specificity and accuracy of monitoring recurrence were 87.0, 100 and 93.2%.Conclusions
99mTc-HYNIC-TOC SPECT/CT is a reliable method of diagnosing and monitoring of pancreatic neuroendocrine neoplasms, especially neuroendocrine tumors.8.
Cachin F Boisgard S Vidal A Filaire M Auzeloux P Culot D Askienazy S Madelmont JC Chezal JM Miot-Noirault E 《European journal of nuclear medicine and molecular imaging》2011,38(11):2077-2082
Purpose
Preclinical data pointed to 99mTc-NTP 15-5 as a good candidate for single photon emission computed tomography (SPECT) imaging of cartilaginous disease. We set out to investigate and quantify 99mTc-NTP 15-5 ex vivo uptake by human articular cartilage relative to bone 99mTc-hydroxymethylene diphosphonate (HMDP) radiotracer. 相似文献9.
Haug AR Heinemann V Bruns CJ Hoffmann R Jakobs T Bartenstein P Hacker M 《European journal of nuclear medicine and molecular imaging》2011,38(6):1037-1045
Purpose
90Y radioembolization has emerged as a valuable therapy for intrahepatic cholangiocellular carcinomas (ICC). We aimed to evaluate the prognostic power of FDG PET/CT and that of pretherapeutic scintigraphy with 99mTc-labelled macroagglutinated albumin (MAA), an index of tumour vascularization. 相似文献10.
Purpose
This study compared 68Gallium-prostate-specific-membrane-antigen based Positron-emission-tomography (68Ga-PSMA-PET) and 99metastabletechnetium-3,3-diphospho-1,2-propanedicarbonacid (99mTc-DPD-SPECT) in performing skeletal staging in prostate cancer (PC) patients and evaluated the additional value of the information from low-dose-computed tomography (CT).Materials and Methods
In this retrospective study, 54 patients who received 68Ga-PSMA-PET/CT and 99mTc-DPD-SPECT/CT within 80 days were extracted from our database. Osseous lesions were classified as benign, malignant or equivocal. Lesion, region and patient based analysis was performed with and without CT fusion. The reference standard was generated by defining a best valuable comparator (BVC) containing information from all available data.Results
In the patient based analysis, accuracies measured as “area-under-the-curve” (AUC) for 68Ga-PSMA-PET, 99mTc-SPECT, 68Ga-PSMA-PET/CT and 99mTc-SPECT/CT were 0.97-0.96, 0.86-0.83, 1.00 and 0.83, respectively (p<0.05) (ranges = optimistic vs. pessimistic view). Region based analysis resulted in the following sensitivities and specificities: 91.8-97.7%, 100-99.5% (PET); 61.2-70.6%, 99.8-98.3% (SPECT); 97.7%, 100% (PET/CT), 69.4% and 98.3% (SPECT/CT) (p<0.05). The amount of correct classifications of equivocal lesions by CT was significantly higher in PET (100%) compared to SPECT (52.4%) (p<0.05).Conclusion
68Ga-PSMA-PET outperforms 99mTc-DPD-SPECT in detecting bone metastases in PC patients. Additional information from low-dose-CT resulted in a significant reduction in equivocal lesions in both modalities, however 68Ga-PSMA-PET benefited most.Key Points
? Ga-PSMA-PET outperforms 99m Tc-DPD-SPECT in skeletal staging in prostate cancer patients ? Proportion of equivocal decisions was significantly reduced by CT-fusion in both modalities ? Ga-PSMA-PET benefits more from CT information, compared to 99m Tc-DPD-SPECT11.
Purpose
We evaluated the efficacy of 99mTc-sestamibi SPECT/CT for planning minimally invasive parathyroidectomy (MIP), comparing with dual phase 99mTc-sestamibi scintigraphy, 99mTc-sestamibi SPECT and conventional imaging (US and CT).Methods
Thirty-one patients (M:F?=?10:21, range 35?C78?years old) who showed high serum parathyroid hormone (intact PTH) level were included. 99mTc-sestamibi scintigraphy was performed 15 and 150?min after injection of 99mTc-sestamibi (555?MBq), and 99mTc-sestamibi SPECT/CT was obtained just after the delayed scan. Comparison study between imaging modalities was done by patient-based and lesion location-based analysis. The location of the lesion was confirmed by the operative finding. An operation was performed in 24 patients. Seven patients had normal 99mTc-sestamibi SPECT/CT, and followed for more than 6?months after SPECT/CT.Results
Among 24 patients, parathyroid adenoma was detected in 19 patients and the other 5 had parathyroid hyperplasia (total 35 lesions). 99mTc-sestamibi scintigraphy detected abnormal uptake in 15 patients with 24 lesions. Conventional imaging identified abnormal findings in 17 patients with 27 lesions. SPECT detected abnormal findings in 18 patients with 27 lesions. SPECT/CT identified abnormal findings in 24 patients with 35 lesions. SPECT/CT demonstrated 100?% sensitivity in a patient-based analysis. SPECT/CT exhibited significantly better sensitivity than 99mTc-sestamibi scintigraphy, SPECT and conventional imaging (p?<?0.05). All lesion location was correctly identified to perform MIP. The final clinical diagnosis of 7 normal SPECT/CT patients was secondary hyperparathyroidism on 6?months follow-up.Conclusions
We correctly identified the precise location of parathyroid adenomas or hyperplasia by 99mTc-sestamibi SPECT/CT which was helpful to perform MIP. 相似文献12.
Tatsuaki Sumiyoshi Takehiro Okabayashi Yuji Negoro Yasuhiro Hata Yoshihiro Noda Kenta Sui Jun Iwata Manabu Matsumoto 《Japanese journal of radiology》2018,36(9):537-543
Purpose
The value of indocyanine green (ICG) test is negatively affected in patients with intrahepatic shunt, ICG excretory defect, or jaundice. This study evaluated 99mTc-GSA SPECT/CT fusion imaging for assessing liver function in patients with severely deteriorated ICG values.Materials and methods
Thirteen hepatectomy candidates with ICG retention rates over 40% were retrospectively analyzed. The ICG clearance rate (KICG) and estimated KICG obtained by 99mTc-GSA scintigraphy (KGSA) were used to evaluate preoperative whole liver function. Remnant liver function was assessed using the remnant (rem) KICG (=?KICG?×?volumetric rate) and remKGSA (=?KGSA?×?functional rate) indices; hepatectomy was considered unsafe for values <?0.05. The correlations of remKICG and remKGSA with postoperative mortality and morbidity were also investigated.Results
KGSA values were significantly greater than KICG values (median: 0.12 vs. 0.059; p?<?0.01); remKGSA values were greater than remKICG values in all patients (median: 0.107 vs. 0.0413; p?<?0.01). Hepatectomy was considered unsafe in 70% patients using remKICG, and in none of those using remKGSA; liver failure or postoperative mortality did not occur.Conclusions
99mTc-GSA SPECT/CT fusion imaging enables more accurate liver function assessment than the ICG test in patients with severely deteriorated ICG values.13.
Guoxu Zhang Zhiguo Wang Shanhu Hao Tong Zhang Wenwen Zhang Jia Guo Zongpeng Zhang 《Clinical imaging》2013,37(5):847-851
ObjectiveThe objective was to evaluate the clinical value of the single photon emission computerized tomography/computed tomography (SPECT/CT) fusion imaging for the diagnosis and determination of localisation of cerebrospinal rhinorrhea.MethodsA total of 33 patients with cerebrospinal rhinorrhea were preoperatively injected with 99mTc-diethylenetriamine pentaacetic acid (DTPA) through lumbar puncture and then subjected to planar imaging of the cistern 120 min and 180 min after operation. CT and ECT were then performed. Finally, the rhinorrhea ventage and leaking path were confirmed by fusion image analysis.ResultsThirty-one patients who underwent fusion imaging and 30 patients who underwent planar imaging showed abnormal nuclide activity in the cavity between the basis cranii and the nose. After operation, 30 patients who underwent fusion imaging and 18 patients who underwent planar imaging showed complete correction of the leakage. The diagnosis sensitivity and positional accuracy of fusion imaging were 93.9% (31/33) and 90.9% (30/33) at P> .05. The values of planar imaging were 93.5% (29/31) and 79.3% (23/29) at P< .05.Conclusion99mTc-DTPA SPECT/CT fusion imaging of the cistern is an efficient, simple, and accurate method that may be used for diagnosing and determining the localisation of cerebrospinal rhinorrhea ventage and leakage path. 相似文献
14.
Objective:
A retrospective analysis of the clinical utility of 99mTc-dimercaptosuccinic acid (DMSA) single photon emission CT (SPECT) for characterization of suspected renal masses.Methods:
15 patients who had undergone 99mTc-DMSA SPECT were identified, and 13 patients also had SPECT/CT. 99mTc-DMSA uptake in the renal lesion was characterized semiquantitatively. Other imaging tests, histology and clinical data were available for correlation.Results:
99mTc-DMSA was not taken up in all five renal masses with histological confirmation of malignancy (uptake 7–19% of normal renal tissue); in two further masses, which were clinically likely to be malignant; and in one indeterminate mass (lack of sufficiently long follow-up). No renal malignancy was identified in any of the seven patients whose renal masses had normal 99mTc-DMSA uptake (41–130%).Conclusion:
Although caution with regard to applying those results in clinical practice must be advised, owing to the retrospective nature of this report and the small number of patients included, it seems that 99mTc-DMSA SPECT shows a clinically useful diagnostic accuracy for distinguishing true renal masses (which in many cases require surgery) from pseudomasses.Advances in knowledge:
99mTc-DMSA SPECT is a clinically useful adjunct test for characterization of suspected renal masses.99mTc-labelled 2,3-dimercaptosuccinic acid (DMSA) has been the standard radiopharmaceutical for static renal scintigraphy for many years.1 It has a high degree of plasma protein binding (76%). Its main metabolic pathway first involves glomerular filtration, followed by tubular reabsorption, with minimal urinary excretion (5%).2 In adults, its foremost clinical use is to determine differential renal function, but also to image ectopic renal tissue.3We have occasionally used 99mTc-DMSA scans to establish whether a suspected renal mass or pseudomass contains functioning renal tissue or not. Such use is acknowledged in a respected textbook,4 stating that “for many years 99mTc-DMSA with or without single-photon emission CT (SPECT) was used as a problem-solving technique to differentiate a space-occupying solid mass from a column of Bertin…”. However, we were surprised to be able to identify only a small number of publications reporting the use of 99mTc-DMSA SPECT for this purpose in a series of patients.5,6This article reports the results of 99mTc-DMSA SPECT in 15 patients referred for evaluation of a suspected renal mass from our case archive. 相似文献15.
Ossi Lindell Arto Kivisaari Timo Lehtonen 《European journal of nuclear medicine and molecular imaging》1986,12(2):80-85
We studied renal anatomy and function using 99mTc-2-3 dimercaptosuccinic acid (DMSA) and 99mTc-diethylenetriaminepentaacetic acid (DTPA) in 27 patients with conduit urinary diversion. In this condition, free ureteral reflux is often associated with bacteriuria, and these factors are thought to precipitate progressive renal deterioration. Gamma-camera images provided valuable information concerning the structure of the renal parenchyma, the function of individual kidneys and possible ureteral obstruction, thus helping us to decide whether or not to instigate further treatment. The information gained using renal gamma imaging with 99mTc-DTPA and 99mTc-DMSA was complementary and partly overlapping. We preferred the use of 99mTc-DTPA because of its ability to visualise the ureters and the region of ureteroconduit anastomosis. Using diuretic medication, we were able to differentiate true ureteral obstruction from atony in 9 patients using 99mTc-DTPA. 相似文献
16.
Shigeyuki Ogi Eisuke Gotoh Mayuki Uchiyama Kunihiko Fukuda Mitsuyoshi Urashima Nobuyoshi Fukumitsu 《Japanese journal of radiology》2009,27(1):20-24
Purpose
We investigated whether hilar radioaerosol deposition affects the clearance rate of technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) from peripheral alveolar regions.Materials and methods
A total of 38 patients underwent 99mTc-DTPA inhalation lung scintigraphy. Six region of interest (ROI) patterns were adopted: ROI 1 was outlined around the entire hemithorax, and ROIs 2–6 were outlined around the hemithorax but excluded square ROIs of different size in the hilar region. Half-times (T½) were calculated with time-activity curves using onecompartment and two-compartment analyses. The T½ of ROIs 1–5 were plotted against the T½ of ROI 6, and regression lines were obtained with the least-squares method. The absolute values of the differences between surveyed values and regression line were calculated. The Wilcoxon test for trend and a single linear regression model were used to determine statistical significance.Results
There were significant reductions in the absolute values of the differences between surveyed values and regression line from ROIs 1–5 by one-component analysis and the fast component of two-compartment analysis (P < 0.001).Conclusion
Our results suggest that the deposition of radioaerosol in the hilar region affects the clearance rate of 99mTc-DTPA from the alveoli in damaged lungs. The hilar region should be excluded from ROIs when alveolar epithelial permeability is evaluated.17.
R. D. Gunasekera D. J. Allison A. M. Peters 《European journal of nuclear medicine and molecular imaging》1996,23(1):49-54
The rate constant (
2) of the terminal exponential of the technetium-99m diethylene triamine pentaacetic acid (DTPA) plasma clearance curve is close to the ratio of glomerular filtration rate (GFR) to extracellular fluid volume (ECV) and is therefore a convenient, already normalised, measure of filtration function. Since
2 depends on the distribution volume of the tracer, our aim was to compare
2 from inulin and99mTc-DTPA and also to compare the equilibration kinetics of the two filtration markers. Fifty millititres of99mTc-DTPA (250 MBq) and inulin (10%), mixed in the same syringe, were given by intravenous injection in 15 patients undergoing routine99mTc-DTPA renography for a variety of clinical indications. Frequent antecubital venous blood samples were taken up to about 4 h after injection to construct plasma clearance curves from which GFR, ECV and GFR/ECV (i.e. the reciprocal of mean transit time through the distribution volume) were calculated.99mTc-DTPA/inulin concentration ratio curves were also constructed after normalisation to the ratio in the syringe. GFR given by the two markers correlated closely (DTPA=0.98·inulin—0.4ml/min;r=0.98).99mTc-DTPA had the same distribution volume as inulin, had a similar transit time through it and gave the same value of
2 (r=0.98). GFR/ECV from99mTc-DTPA accordingly correlated closely with GFR/ECV from inulin (DTPA=0.75·inulin+0.99 ml/min;r=0.95). Even though the distribution volumes and the times to equilibration (i.e. to reach the terminal exponential) were similar, the distribution volume of99mTc-DTPA at about 10 min after injection was, after subtraction of the plasma volume, about twice that of inulin.We confirm the validity of99mTc-DTPA for measuring GFR.
2 is a convenient measure of GFR, can be based on the terminal exponential of inulin of99mTc-DTPA curves and can be converted to GFR/ECV with an appropriate scaling factor. The kinetics or the two clearance curves with respect to anatomical correlates of the exponentials and the rates of diffusion throughout the respective distribution volumes requires further study. 相似文献
18.
Sang Hyun Hwang Yumie Rhee Mijin Yun Jung Hyun Yoon Jeong Won Lee Arthur Cho 《Nuclear Medicine and Molecular Imaging》2017,51(1):32-39
Purpose
Parathyroid adenoma detection with dual-phase 99mTc-sestamibi (MIBI) scintigraphy depends on differential MIBI washout from thyroid. However, autoimmune thyroid disease (AITD) may cause MIBI to be retained in the thyroid gland and reduce parathyroid detection. We evaluated the impact of AITD on MIBI thyroid retention and additional benefit of SPECT/CT in these patients.Methods
Dual phase planar MIBI and SPECT/CT was performed on 82 patients. SPECT/CT was performed immediately after delayed planar scan. Thyroid density (Hounsfield unit, CT-HU) and size were measured on CT component of SPECT/CT. MIBI uptake in early scans and retention in delayed scans were visually graded and correlated with clinical factors and CT findings. Finally, planar and SPECT/CT findings were compared for parathyroid lesion visualization according to thyroid MIBI retention.Results
In early scan, multivariate analysis showed only thyroid size predicted early uptake. In delayed scan, multivariate analysis showed higher visual grade in early scan, lower CT-HU or AITD were significant predictors for delayed thyroid parenchymal retention. Overall, ten more parathyroid lesions were visualized on SPECT/CT compared to planar scans (57 vs. 47, p?=?0.002). SPECT/CT was especially more useful in patients with thyroidal MIBI retention, as eight out of the ten additional lesions detected were found in patients with thyroid MIBI retention.Conclusion
AITD is an important factor for MIBI thyroid parenchymal retention on delayed scans, and may impede parathyroid lesion detection. Patients with MIBI retention in the thyroid parenchyma on delayed scans are likely to benefit from an additional SPECT/CT.19.
Background
We have previously reported normal values for LV mechanical synchrony from post-stress exercise 99mTc SPECT studies; the goal of this study was to develop normal values for mechanical synchrony from pharmacologic stress and rest 82Rb PET studies and compare these values to a population of LBBB patients. 相似文献20.
Amir Sabet Khaled Ezziddin Ulrich-Frank Pape Karl Reichman Torjan Haslerud Hojjat Ahmadzadehfar Hans-Jürgen Biersack James Nagarajah Samer Ezziddin 《European journal of nuclear medicine and molecular imaging》2014,41(3):505-510