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  • Single-photon emission tomography  (6)
  • 1
    ISSN: 1619-7089
    Keywords: Single-photon emission tomography ; Iodine-123 iomazenil ; GABAA receptor ; Epilepsy ; Arachnoid cyst
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Imaging cerebral GABAA receptor density (GRD) with single-photon emission tomography (SPET) and iodine-123 iomazenil is highly accurate in lateralizing epileptogenic foci in patients with complex partial seizures of temporal origin. Limited knowledge exists on how iomazenil SPET compares with magnetic resonance imaging (MRI) in this regard. We present a patient with complex partial seizures in whom MRI had identified an arachnoid cyst anterior to the tip of the left temporal lobe. Contralaterally to this structural abnormality, interictal electroencephalography (EEG) performed after sleep deprivation disclosed an intermittent frontotemporal dysrhythmic focus with slow and sharp waves. On iomazenil SPET images GRD was significantly reduced in the right temporal lobe and thus contralaterally to the MRI abnormality, but ipsilaterally to the pathological EEG findings. These data suggest that iomazenil SPET may significantly contribute to the presurgical evaluation of epileptic patients even when MRI identifies potentially epileptogenic structural lesions.
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  • 2
    ISSN: 1619-7089
    Keywords: Brain neoplasms ; Amino acids ; Iodine-123-α-methyl tyrosine ; Radionuclide imaging ; Single-photon emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Using single-photon emission tomography (SPET), the radiopharmaceuticall,-3-iodine-123-α-methyl tyrosine (IMT) has been applied to the imaging of amino acid transport into brain tumours. It was the aim of this study to investigate whether IMT SPET is capable of differentiating between high-grade gliomas, low-grade gliomas and non-neoplastic brain lesions. To this end, IMT uptake was determined in 53 patients using the triple-headed SPET camera MULTISPECT 3. Twenty-eight of these subjects suffered from high-grade gliomas (WHO grade III or IV), 12 from low-grade gliomas (WHO grade II), and 13 from non-neoplastic brain lesions, including lesions after effective therapy of a glioma (five cases), infarctions (four cases), inflammatory lesions (three cases) and traumatic haematoma (one case). IMT uptake was significantly higher in high-grade gliomas than in low-grade gliomas and non-neoplastic lesions. IMT uptake by low-grade gliomas was not significantly different from that by non-neoplastic lesions. Diagnostic sensitivity and specificity were 71% and 83% for differentiating high-grade from low-grade gliomas, 82% and 100% for distinguishing high-grade gliomas from non-neoplastic lesions, and 50% and 100% for discriminating low-grade gliomas from non-neoplastic lesions. Analogously to positron emission tomography with radioactively labelled amino acids and fluorine-18 deoxyglucose, IMT SPET may aid in differentiating high-grade gliomas from histologically benign brain tumours and non-neoplastic brain lesions; it is of only limited value in differentiating between non-neoplastic lesions and histologically benign brain tumours.
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  • 3
    ISSN: 1619-7089
    Keywords: Brain neoplasms ; Positron emission tomography ; Single-photon emission tomography ; Fluorine-18 fluorodeoxyglucose ; Iodine-123-α-methyl tyrosine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Use of iodine-123-α-methyl tyrosine (123I-IMT) allows investigation of the amino acid transport rate in gliomas. It was the aim of this study to compare the value of measurement of glucose metabolism with that of measurement of123I-IMT uptake for the non-invasive grading of brain tumours. The study population comprised 23 patients with histopathologically proven primary brain tumours; 14 had high-grade gliomas, and nine low-grade brain neoplasms. Glucose metabolism was studied using an ECAT EXACT 47 positron emission tomography (PET) camera and fluorine-18 fluorodeoxyglucose (18F-FDG);123I-IMT uptake was measured with the triple-headed single-photon emission tomography (SPET) camera, MULTISPECT 3.18F-FDG and123I-IMT uptake was quantified as ratios between the uptake by the tumour and contralateral regions of reference. Glucose metabolism and amino acid uptake of the brain tumours correlated significantly (r=0.71,P 〈0.001). Assuming discrimination thresholds between high-grade and low-grade tumours of 0.8 for18F-FDG uptake and 1.8 for123I-IMT uptake, the accuracy values of18F-FDG PET and123I-IMT SPET for differentiating between high-grade and low-grade tumours were 21/23 (91%) and 19/23 (83%), respectively. The difference in diagnostic performance was not significant on receiver operating characteristic analysis (P 〉0.4). It is concluded that there is no major difference between the PET investigation of glucose metabolism and the less expensive SPET measurement of amino acid uptake in terms of their accuracy in evaluating the malignancy grade of primary brain tumours. This encourages the performance of further studies to analyse the potential impact of123I-IMT SPET on the therapeutic management of patients with brain tumours.
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  • 4
    ISSN: 1619-7089
    Keywords: Key words: Myocardium ; Contour detection ; Elastic surfaces ; Positron emission tomography ; Single-photon emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Since the human heart has a complex anatomy, the two-dimensional analysis of myocardial scintigrams obviously is not satisfactory. Three-dimensional display can be more easily read by clinicians and depicts more accurately tracer accumulation defects. In this study we propose a three-dimensional myocardial contour detection approach using elastic surfaces. After manual reorientation into short-axis slices and transformation into heart coordinates, the myocardial mid-wall surface passing through the radial activity mass points is calculated using a second-order partial differential equation as a mathematical model. Special considerations are implemented to demarcate organs close to the heart. In a total of 1102 myocardial scintigrams the three-dimensional contour detection calculated a reasonable shape of the left ventricular myocardium in all cases. Even in areas with severe myocardial infarction, this approach was able to bridge tracer accumulation defects. Inter- and intra-observer variability tests confirmed a high reproducibility and user independence. In conclusion, in this study the proposed three-dimensional contour detection of left ventricular myocardium using elastic surfaces was found to be fast, user-independent and reliable, leading to realistic three-dimensional parametric images of myocardial scintigrams that even clinicians not experienced in nuclear cardiology can easily read.
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  • 5
    ISSN: 1619-7089
    Keywords: Hibernating myocardium ; Wall motion ; Revascularization ; Thallium-201 reinjection ; Single-photon emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thallium-201 reinjection improves detection of hibernating myocardium in about 30%–50% of persisting defects. The main goal of cardiac revascularization techniques is amelioration of clinical symptoms such as angina and dyspnoea; however, improvement in regional and global pump function is an additional and important target. The aim of this study was to investigate whether fill-in in the reinjection study is correlated with improved contractile function after treatment (percutaneous transluminal coronary angioplasty/aortocoronary bypass surgery). We studied 32 patients with coronary heart disease and impaired regional wall motion (RWM). RWM and ejection fraction (EF) were assessed by analysing ventriculographic images using the centreline method (values in standard deviations from mean values found in a healthy control group). Three201T1 single-photon emission tomographic studies (stress, redistribution and reinjection) were performed prior to revascularization and analysed using a bull's-eye scheme. Patients were divided into two groups (group FI-=no fill-in,n=16; group FI+=fill-in,n=16). Fifty-six percent of all patients showed persisting defects, and 56% of these defects showed fill-in after reinjection. Fill-in in our patient group was independent of the size of the persisting defects. After revascularization RWM increased significantly in group FI+ (from −1.9 to 0.0 SD,P〈0.001) whereas group FI- showed no significant change (from −1.6 to −1.8 SD). EF increased from −4.3 preoperatively to −2.1 SD postoperatively in group FI+ and did not change significantly in group Fl- (−2.5 to −3.2 SD). The predictive value of reinjection for improvement of RWM was 88%. It is concluded that fill-in in the201Tl reinjection image can predict recovery of RWM and EF after revascularization and should be used in all patients with impaired RWM and persisting defects independent of their extent.
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  • 6
    ISSN: 1619-7089
    Keywords: Key words: Brain neoplasms ; Positron emission tomography ; Single-photon emission tomography ; Fluorine-18 fluorodeoxyglucose ; Iodine-123-α-methyl tyrosine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Use of iodine-123-α-methyl tyrosine (123I-IMT) allows investigation of the amino acid transport rate in gliomas. It was the aim of this study to compare the value of measurement of glucose metabolism with that of measurement of 123I-IMT uptake for the non-invasive grading of brain tumours. The study population comprised 23 patients with histopathologically proven primary brain tumours; 14 had high-grade gliomas, and nine low-grade brain neoplasms. Glucose metabolism was studied using an ECAT EXACT 47 positron emission tomography (PET) camera and fluorine-18 fluorodeoxyglucose (18F-FDG); 123I-IMT uptake was measured with the triple-headed single-photon emission tomography (SPET) camera, MULTISPECT 3. 18F-FDG and 123I-IMT uptake was quantified as ratios between the uptake by the tumour and contralateral regions of reference. Glucose metabolism and amino acid uptake of the brain tumours correlated significantly (r=0.71, P 〈0.001). Assuming discrimination thresholds between high-grade and low-grade tumours of 0.8 for 18F-FDG uptake and 1.8 for 123I-IMT uptake, the accuracy values of 18F-FDG PET and 123I-IMT SPET for differentiating between high-grade and low-grade tumours were 21/23 (91%) and 19/23 (83%), respectively. The difference in diagnostic performance was not significant on receiver operating characteristic analysis (P 〉0.4). It is concluded that there is no major difference between the PET investigation of glucose metabolism and the less expensive SPET measurement of amino acid uptake in terms of their accuracy in evaluating the malignancy grade of primary brain tumours. This encourages the performance of further studies to analyse the potential impact of 123I-IMT SPET on the therapeutic management of patients with brain tumours.
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