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Kashyap R, Neef P, Sivaratnam D, Better N. Correlation of current myocardial perfusion imaging and previous coronary angiography to avert the need for repeat intervention - A case report. J Med Imaging Radiat Sci 2023; 54:572-575. [PMID: 37453858 DOI: 10.1016/j.jmir.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/24/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Evaluation of chest pain in an individual with prior coronary artery bypass graft (CABG) procedures can be complex. Stress myocardial perfusion imaging (MPI) demonstrates reasonable sensitivity for detection of ischemia following bypass grafting [1] but often requires multi-modality imaging correlation for knowledge of graft anatomy. CASE AND OUTCOME We describe the findings of a reversible perfusion defect on myocardial perfusion scintigraphy in a person post-CABG. This was interpreted in combination with findings of coronary angiography, thereby identifying ischemia in a native un-grafted vessel territory and influencing management strategy. DISCUSSION Myocardial perfusion scintigraphy is a sensitive technique for evaluation of inducible ischemia. It provides information on the extent and severity of ischemia. Integrating the knowledge of changes on coronary angiography with MPI provides a comprehensive picture that can guide management decisions, as in our case. CONCLUSION Correlation of structural and functional imaging findings may be extremely helpful for management of patients with myocardial ischemia post-CABG.
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Affiliation(s)
- Raghava Kashyap
- Fellow Molecular Imaging and Therapy, Peter MacCallum Cancer Hospital, Melbourne, Australia
| | - Pieter Neef
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
| | - Dinesh Sivaratnam
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia; Department of Nuclear Medicine, Royal Melbourne Hospital, Melbourne, Australia; Cabrini Health, Melbourne, Australia
| | - Nathan Better
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia; Department of Nuclear Medicine, Royal Melbourne Hospital, Melbourne, Australia; Cabrini Health, Melbourne, Australia; Department of Medicine, University of Melbourne, Australia; Department of Medicine, Monash University, Australia.
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Gennari AG, Grünig H, Benz DC, Skawran S, Maurer A, Abukwaik AMA, Rossi A, Gebhard C, Buechel RR, Messerli M. Low-dose CT from myocardial perfusion SPECT/CT allows the detection of anemia in preoperative patients. J Nucl Cardiol 2022; 29:3236-3247. [PMID: 35175556 PMCID: PMC9834113 DOI: 10.1007/s12350-021-02899-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/14/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND To assess whether low-dose CT for attenuation correction of myocardial perfusion single-photon emission computed tomography (SPECT) allows for identification of anemic patients and grading anemia severity. METHODS AND RESULTS Patients who underwent a preoperative blood-test and low-dose CT scan, as a part of a cardiac SPECT exam, between 01 January 2015 and 31 December 2017 were enrolled in this retrospective study. Hemoglobin (Hb) levels and hematocrit were derived from clinical records. CT images were visually assessed (qualitative analysis) for the detection of inter-ventricular septum sign (IVSS) and aortic rim sign (ARS) and quantitative analysis were performed. The diagnostic accuracy for detecting anemia was compared using Hb values as the standard of reference. A total of 229 patients were included (110 with anemia; 57 mild; 46 moderate; 7 severe). The AUC of IVSS and ARS were 0.830 and 0.669, respectively (p<0.0001). The quantitative analysis outperformed ARS and IVSS; (AUC of 0.893, p=0.29). The optimal anemia cut-off using Youden index was 4.5 HU. CONCLUSION Quantitative analysis derived from low-dose CT images, as a part of cardiac SPECT exams, have a diagnostic accuracy similar to that of hematocrit for the detection of anemia and may allow discriminating different anemia severities.
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Affiliation(s)
- Antonio G Gennari
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Hannes Grünig
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Dominik C Benz
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Stephan Skawran
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Alexander Maurer
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Ahmad M A Abukwaik
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Alexia Rossi
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland.
- Maastricht UMC+, Heart and Vascular Center, Maastricht, The Netherlands.
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Chong A, Ha JM, Lee JY. Clinical Meaning of Hot Uptake on Bone Scan in Symptomatic Accessory Navicular Bones. Nucl Med Mol Imaging 2016; 50:322-328. [PMID: 27994687 DOI: 10.1007/s13139-016-0452-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/06/2016] [Accepted: 09/13/2016] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION We analyzed clinical factors related to uptake on a Tc-99 m HDP bone scan of the accessory navicular (AN). MATERIALS AND METHODS We retrospectively reviewed patients who had been examined by an orthopedic surgeon and underwent bone scan due to suspected symptomatic AN. A three-point grading system was used to evaluate uptake on bone scan. Relationships between grade, symptoms, age, gender, symptom duration, and bone size were analyzed. RESULTS In total, 73 ANs (30 asymptomatic, 43 symptomatic) were enrolled. The majority of asymptomatic ANs had no uptake but some had grade 1 (n = 8) or 2 (n = 2) uptake. All asymptomatic ANs with uptake remained asymptomatic during follow-up. For the asymptomatic ANs, larger bones showed a higher grade. With a cut-off value of size ≤6.8 mm, there is no chance of uptake. All symptomatic ANs showed uptake on bone scan. For symptomatic ANs, larger size and shorter pain duration were related to a higher grade. Age, gender, and left-/right-sideness were not related to grade. Multiple regressions revealed that only uptake grade, not size or symptom duration, was the significant risk factor for a symptomatic AN. With a cut-off value of grade <1, a symptomatic AN could be ruled out with a negative predictive value of 100 %. CONCLUSION Bone scanning is useful for symptomatic ANs with a high negative predictive value. Higher grade is related to larger size and shorter pain duration. For asymptomatic ANs, grade was related to size but did not predict symptom development.
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Affiliation(s)
- Ari Chong
- Department of Nuclear Medicine, Chosun University Hospital, 588 Seoseok-dong, Dong-gu Gwangju, Republic of Korea 501-757
| | - Jung-Min Ha
- Department of Nuclear Medicine, Chosun University Hospital, 588 Seoseok-dong, Dong-gu Gwangju, Republic of Korea 501-757
| | - Jun-Young Lee
- Department of Orthopaedic Surgery, Foot and Ankle Surgery, Chosun University Hospital, Gwangju, Republic of Korea
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Yuan J, Lv R, Robert Brašić J, Han M, Liu X, Wang Y, Zhang G, Liu C, Li Y, Deng Y. Dopamine transporter dysfunction in Han Chinese people with chronic methamphetamine dependence after a short-term abstinence. Psychiatry Res 2014; 221:92-6. [PMID: 24314908 DOI: 10.1016/j.pscychresns.2013.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Revised: 11/13/2012] [Accepted: 11/14/2013] [Indexed: 10/26/2022]
Abstract
Single-photon emission-computed tomography (SPECT) after the administration of (99m)Tc-TRODAT-1 was performed on healthy subjects and subjects with methamphetamine (METH)dependence at time 1 (T1) after 24-48 h of abstinence, time 2 (T2) after 2 weeks of abstinence, and time 3 (T3) after 4 weeks of abstinence. In contrast to values in controls, the values of the striatal DAT specific uptake ratios (SURs) in subjects with METH dependence were significantly lower at T1 (n=25), T2 (n=9), and T3 (n=8); a mild increase in SURs was observed at T2 and T3, but values were still significantly lower than those in controls. In subjects with METH dependence, there was a trend for a negative correlation of striatal DAT SURs and craving for METH at T1. METH craving, anxiety and depression scores significantly decreased from T1 to T2 to T3. We conclude that Han Chinese people with METH dependence experience significant striatal DAT dysfunction, and that these changes may be mildly reversible after 4 weeks of abstinence, but that DAT levels still remain significantly lower than those in healthy subjects. The mild recovery of striatal DAT may parallel improvements in craving, anxiety and depression.
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Affiliation(s)
- Jie Yuan
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Rongbin Lv
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - James Robert Brašić
- Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mei Han
- College of Chemistry, Beijing Normal University, Beijing, China
| | - Xingdang Liu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China.
| | - Yuankai Wang
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Guangming Zhang
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Congjin Liu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu Li
- Drug Rehabilitation Centre, Shanghai, China
| | - Yanping Deng
- Department of Clinical Pharmacology National Institute on Drug Dependence, Peking University, Beijing, China
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Holmes RB, Hoffman SMA, Kemp PM. Generation of realistic HMPAO SPECT images using a subresolution sandwich phantom. Neuroimage 2013; 81:8-14. [PMID: 23664942 DOI: 10.1016/j.neuroimage.2013.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 04/04/2013] [Accepted: 05/03/2013] [Indexed: 01/20/2023] Open
Abstract
UNLABELLED Traditional interpretation of rCBF SPECT data is of a qualitative nature and is dependent on the observer's understanding of the normal distribution of the tracer. The use of a normal database in quantitative regional analysis facilitates the detection of functional abnormality in individual and group studies by accounting for inter-subject variability. The ability to simulate realistic images would allow various important areas related to the use of normal databases to be studied. These include the optimisation of the detection of abnormal blood flow and the portability of normal databases between gamma camera systems. To investigate this further we have constructed a hardware phantom and scanned various configurations of radioactive brain patterns and simulated skull configurations. METHODS A subresolution sandwich phantom was constructed with a simulated skull which was assembled using a high-resolution segmented MR scan printed with a (99m)TcO₄ - mixture and scanned using a double-headed gamma camera with parallel-hole collimators. Various different grey-to-white matter (GM:WM) ratios and aluminium simulated skull configurations were used. A single difference measure between the phantom data and a control database mean image was used for optimisation. The realism of phantom data was assessed using statistical parametric mapping (SPM) and ROI analysis. RESULTS Optimisation was achieved with a range of WM:GM ratios from 1.9 to 2.4:1 with various simulated skull configurations. CONCLUSION The ability to simulate realistic HMPAO SPECT scans has been demonstrated using a subresolution sandwich phantom. Further work, involving scanning the optimised phantom on different gamma camera systems and comparison with camera-specific normal databases should further refine the phantom configuration.
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