RESUMEN
Technetium-99m tetrofosmin (Myoview) has unique properties for myocardial perfusion imaging very early after injection of the tracer. We used a very short same-day rest/stress protocol, to be performed within 2 h and evaluated its diagnostic accuracy. The study included 144 patients from seven Spanish and four Portuguese centres with a diagnosis of uncomplicated coronary artery disease (CAD); 78 patients (54%) had no history of prior myocardial infarction. Patients were injected with /=50%) was achieved with a sensitivity of 64% for the left anterior descending artery, 49% for the left circumflex artery and 86% for the right coronary artery, and an accuracy of 71%, 72% and 73% respectively. Concordance of SPET and CA was 62% for single-vessel disease and 68% for multivessel disease. In conclusion, this Spanish-Portuguese multicentre clinical trial confirmed, in a considerable number of patients who underwent coronary angiography, the feasibility of 99mTc tetrofosmin (Myoview) rest/stress myocardial SPET using a very short protocol (2 h).
Asunto(s)
Angiografía Coronaria , Enfermedad Coronaria/diagnóstico por imagen , Corazón/diagnóstico por imagen , Compuestos Organofosforados , Compuestos de Organotecnecio , Tomografía Computarizada de Emisión de Fotón Único , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Factores de TiempoRESUMEN
Scintigraphy using Tc-99m MDP and Tl-201 was performed in a patient with polyostotic Paget's disease and sarcomatous degeneration in the right iliac bone. Tc-99m MDP imaging showed abnormal uptake in both types of lesions. Tl-201 imaging showed increased uptake in the sarcomatous lesion and absent uptake in pagetic lesions. This result supports the idea that Tl-201 scintigraphy may have a potential role to play in the differentiation of Paget's disease from malignancy. To the authors' knowledge, Tl-201 has never been reported for the detection of sarcomatous change of pagetic bone.
Asunto(s)
Neoplasias Óseas/diagnóstico por imagen , Ilion/diagnóstico por imagen , Osteítis Deformante/diagnóstico por imagen , Osteosarcoma/diagnóstico por imagen , Radioisótopos de Talio , Huesos/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Cintigrafía , Medronato de Tecnecio Tc 99mRESUMEN
For successful surgery for drug-resistant epilepsy the site of the seizure focus needs to be known exactly. The purpose of this study was to compare the evaluation of the regional cerebral blood flow (rCBF) (localization and degree of disturbances) by 99mTc-hexamethylpropyleneamineoxime (HMPAO) single photon emission computed tomography (SPECT) with computerized electroencephalographic topography (CET) and transmission computed X-ray tomography (CT) in partial epilepsy. The study included 20 patients with medically refractory complex partial seizures. Of the 20 patients included, 15 were studied interictally, four ictally and one in both states, interictally and ictally. 99mTc-HMPAO SPECT detected rCBF changes in 95% of the patients. Interictal studies demonstrated focal areas of hypoperfusion in 93% of the patients. Ictal studies demonstrated an area of hyperperfusion in all patients. Blood flow disturbances in deeper structures of the brain, such as basal ganglia, could be detected. The areas of abnormal 99mTc-HMPAO uptake were concordant, in localization, with CET in 85% of the patients. Abnormal data with CT scans were found in only 45% of the patients. Focal lesions were found in 20% of the patients by CT scans. 99mTc-HMPAO SPECT combined with CET may be a useful screening procedure prior to referral for invasive diagnostic procedures in future management with medically refractory complex partial seizures.
Asunto(s)
Mapeo Encefálico/métodos , Electroencefalografía/métodos , Epilepsia Parcial Compleja/diagnóstico por imagen , Epilepsia Parcial Compleja/diagnóstico , Compuestos de Organotecnecio , Oximas , Tomografía Computarizada de Emisión de Fotón Único/métodos , Adolescente , Adulto , Circulación Cerebrovascular , Niño , Computadores , Epilepsia Parcial Compleja/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Exametazima de Tecnecio Tc 99m , Tomografía Computarizada por Rayos XRESUMEN
High-grade astrocytoma represents the most common primary malignant brain tumour in the adult, and is associated with high morbidity and mortality rates. The aim of this study was to investigate the prognostic value of 99Tcm-hexamethylpropyleneamine oxime (HMPAO) brain single photon emission computed tomography (SPECT) in predicting neurological function and tumour therapy response after surgical resection of astrocytoma. The correlation between 99Tcm-HMPAO studies and other noninvasive methods [computed tomography (CT), magnetic resonance imaging (MRI) and 201Tl (SPECT)] was evaluated. The clinical population included 21 patients with previous surgical debulking of astrocytoma. All patients were evaluated with 99Tcm-HMPAO brain SPECT. Seven patients, who suffered progressive clinical deterioration after radiotherapy, underwent dual-isotope SPECT imaging with 201Tl and 99Tcm-HMPAO. Neurological examinations and CT were performed in all patients. Magnetic resonance imaging was performed in seven patients. Prior to radiotherapy and/or chemotherapy, the patients with neurological improvement during the follow-up evaluation commonly showed less intense abnormal 99Tcm-HMPAO uptake than the patients without neurological improvement. In addition, after therapy none of the former patients had increased 99Tcm-HMPAO uptake. Most patients without neurological improvement had evidence of high focal uptake. Computed tomography and MRI usually demonstrated pathological contrast enhancement regardless of the presence or absence of improvement of neurological function. Foci of high 201Tl accumulation were observed on SPECT images in five patients. In four of these patients, the 99Tcm-HMPAO was greater than in normal brain, and in two patients the 99Tcm-HMPAO uptake was lower than in normal brain. One patient with decreased 99Tcm-HMPAO uptake in a medium-sized lesion had a normal 201Tl study. Our hypothesis that 99Tcm-HMPAO SPECT may be useful for providing prognostic information after surgical debulking of astrocytoma seems to be promising. Further studies are needed to document this new important role of 99Tcm-HMPAO SPECT.