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Farahi N, Loutsios C, Tregay N, Wright AKA, Berair R, Lok LSC, Gillett D, Cullum I, Simmonds RP, Summers C, Wong A, Solanki CK, Buscombe J, Pang PH, Thavakumar A, Peters AM, Brightling CE, Condliffe AM, Chilvers ER. Reply. J Allergy Clin Immunol 2019; 143:1265-1266. [PMID: 30639067 DOI: 10.1016/j.jaci.2018.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/16/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Neda Farahi
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
| | - Chrystalla Loutsios
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Nicola Tregay
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Adam K A Wright
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Leicester, United Kingdom
| | - Rachid Berair
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Leicester, United Kingdom
| | - Laurence S C Lok
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Daniel Gillett
- Department of Nuclear Medicine, Addenbrooke's Hospital, CUHNHSFT, Cambridge, United Kingdom
| | - Ian Cullum
- Department of Nuclear Medicine, Addenbrooke's Hospital, CUHNHSFT, Cambridge, United Kingdom
| | - Rosalind P Simmonds
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Charlotte Summers
- Division of Anaesthesia, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Anna Wong
- Department of Nuclear Medicine, Addenbrooke's Hospital, CUHNHSFT, Cambridge, United Kingdom
| | - Chandra K Solanki
- Department of Nuclear Medicine, Addenbrooke's Hospital, CUHNHSFT, Cambridge, United Kingdom
| | - John Buscombe
- Department of Nuclear Medicine, Addenbrooke's Hospital, CUHNHSFT, Cambridge, United Kingdom
| | - Pee Hwee Pang
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Leicester, United Kingdom
| | - Arthikkaa Thavakumar
- Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Leicester, United Kingdom
| | - A Michael Peters
- Division of Clinical and Laboratory Investigation, Brighton and Sussex Medical School, Brighton, United Kingdom
| | | | - Alison M Condliffe
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Edwin R Chilvers
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Loutsios C, Farahi N, Simmonds R, Cullum I, Gillett D, Solanki C, Solanki K, Buscombe J, Condliffe AM, Peters AM, Chilvers ER. Clinical application of autologous technetium-99m-labelled eosinophils to detect focal eosinophilic inflammation in the lung. Thorax 2015; 70:1085-6. [PMID: 26108571 PMCID: PMC4680123 DOI: 10.1136/thoraxjnl-2015-207156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 04/16/2015] [Indexed: 01/21/2023]
Abstract
The detection of focal eosinophilic inflammation by non-invasive means may aid the diagnosis and follow-up of a variety of pulmonary pathologies. All current methods of detection involve invasive sampling, which may be contraindicated or too high-risk to be performed safely. The use of injected autologous technetium-99m (Tc-99m)-labelled eosinophils coupled to single-photon emission computed tomography (SPECT) has been demonstrated to localise eosinophilic inflammation in the lungs of a patient with antineutrophil cytoplasmic antibody-positive vasculitis. Here, we report on the utility of this technique to detect active eosinophilic inflammation in a patient with focal lung inflammation where a biopsy was contraindicated.
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Affiliation(s)
- Chrystalla Loutsios
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Neda Farahi
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Rosalind Simmonds
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Ian Cullum
- Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Daniel Gillett
- Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Chandra Solanki
- Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Kishor Solanki
- Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - John Buscombe
- Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Alison M Condliffe
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - A Mike Peters
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK
| | - Edwin R Chilvers
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
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Mahmood S, Erlandsson K, Cullum I, Hutton B. Experimental results from a prototype slit-slat collimator with mixed multiplexed and non-multiplexed data. Phys Med Biol 2011; 56:4311-31. [DOI: 10.1088/0031-9155/56/14/007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Alnaaimi MA, Royle GJ, Ghoggali W, Banoqitah E, Cullum I, Speller RD. Performance evaluation of a pixellated Ge Compton camera. Phys Med Biol 2011; 56:3473-86. [DOI: 10.1088/0031-9155/56/12/002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mahmood ST, Erlandsson K, Cullum I, Hutton BF. The potential for mixed multiplexed and non-multiplexed data to improve the reconstruction quality of a multi-slit-slat collimator SPECT system. Phys Med Biol 2010. [PMID: 20354282 DOI: 10.1088/0031‐9155/55/8/009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Multiplexing is a way of increasing the sensitivity in a multi-slit-slat SPECT system by allowing the overlap of projections from neighboring apertures. The fundamental objective of multiplexing is to increase the signal-to-noise ratio for a given system resolution. Multiplexing may therefore lead to an improved tradeoff between resolution and sensitivity. Overlapped projections, however, introduce ambiguities in the data which can lead to non-uniqueness of solution for the inverse problem, deterioration in the quality of reconstruction and ultimately loss of resolution. Therefore, it is not straightforward to evaluate the advantage of the extra sensitivity gained by multiplexing, without first devising a method to overcome the image artifacts caused due to this overlapping of projection data. In this paper we investigate the effect of multiplexing on the reconstructed image quality and we determine whether reconstruction of multiplexed data could be improved by the addition of non-multiplexed data. For this purpose we have done simulations based on three digital phantoms. We compared the reconstructed images both qualitatively and quantitatively for different degrees of multiplexing and different fractions of non-multiplexed data. Our results indicate that the recovery coefficient (and therefore spatial resolution) can be maintained with a high degree of multiplexing leading to a significant increase in the SNR (up to 25%) due to a reduced noise level. This gain in the SNR corresponds to a 75% increase in counts or sensitivity which can be utilized to reduce acquisition time, patient dose or/and improve image quality.
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Affiliation(s)
- Shelan T Mahmood
- Institute of Nuclear Medicine, UCL and UCLH NHS Foundation Trust, London, UK.
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Mahmood ST, Erlandsson K, Cullum I, Hutton BF. The potential for mixed multiplexed and non-multiplexed data to improve the reconstruction quality of a multi-slit–slat collimator SPECT system. Phys Med Biol 2010; 55:2247-68. [DOI: 10.1088/0031-9155/55/8/009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Menezes LJ, Kotze CW, Hutton BF, Endozo R, Dickson JC, Cullum I, Yusuf SW, Ell PJ, Groves AM. Vascular Inflammation Imaging with 18F-FDG PET/CT: When to Image? J Nucl Med 2009; 50:854-7. [DOI: 10.2967/jnumed.108.061432] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Abstract
We present three novel multi-slit-slat (MSS) system designs which allow for the acquisition of data with variable multiplexing in order to optimize the use of a high intrinsic resolution detector for clinical brain SPECT. In this paper we first study the relationship between the geometric parameters of a MSS collimator system and the resulting resolution and sensitivity for an on-axis point at the centre of the field-of-view (FOV), assuming a continuous cylindrical detector model. The model predicts that for optimal system sensitivity and resolution, the ratio of the detector radius to slit collimator radius should be 1.3-1.5, as any further increase in this ratio results in significant deterioration in both system resolution and sensitivity. The analytical results were used to fix the geometric parameters for the three novel MSS system designs. Comparison of the three designs, asymmetric rotating collimator (ARC), asymmetric rotating detector (ARD) and symmetric rotating collimator (SRC) with variable slit spacing, suggests that the SRC system performs better in terms of the system sensitivity (5.1 x 10(-4)) for the same average resolution (6.0 mm) in comparison to designs based on an ARC (3.7 x 10(-4)) and ARD (4.2 x 10(-4)).
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Affiliation(s)
- S T Mahmood
- Institute of Nuclear Medicine, UCL and UCLH NHS Foundation Trust, London, UK.
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Du Y, Cullum I, Illidge TM, Ell PJ. Fusion of metabolic function and morphology: sequential [18F]fluorodeoxyglucose positron-emission tomography/computed tomography studies yield new insights into the natural history of bone metastases in breast cancer. J Clin Oncol 2007; 25:3440-7. [PMID: 17592153 DOI: 10.1200/jco.2007.11.2854] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE By monitoring bone metastases with sequential [(18)F]fluorodeoxyglucose positron-emission tomography/computed tomography ([(18)F]FDG-PET/CT) imaging, this study investigates the clinical relevance of [(18)F]FDG uptake features of bone metastases with various radiographic appearances. PATIENTS AND METHODS Bone metastases were found in 67 of 408 consecutive patients with known/suspected recurrent breast cancer on [(18)F]FDG-PET/CT, characterized by CT morphology changes and/or bony [(18)F]FDG uptake. Twenty-five of the patients had sequential [(18)F]FDG-PET/CT examinations (86 studies) over an average follow-up period of 23 months. The temporal changes in [(18)F]FDG uptake and corresponding CT morphology features of 146 bone lesions identified in these 25 patients were followed up and correlated with therapeutic outcome retrospectively. RESULTS The 146 lesions were classified as osteolytic (77), osteoblastic (41), mixed-pattern (11), or no change/negative (17) on CT. The majority of the osteolytic (72; 93.5%) and mixed-pattern lesions (nine; 81.8%), but fewer of the osteoblastic lesions (25; 61%), showed increased [(18)F]FDG uptake. After treatment, 58 osteolytic lesions (80.5%) became [(18)F]FDG negative and osteoblastic on CT and only 14 relatively large lesions (19.5%) remained [(18)F]FDG avid. Of the 25 [(18)F]FDG-avid osteoblastic lesions, 13 (52%) became [(18)F]FDG negative, but 12 (48%) remained [(18)F]FDG avid and increased in size on CT. Five of the mixed-pattern lesions remained [(18)F]FDG avid after treatment. All 17 CT-negative lesions became [(18)F]FDG negative; however, nine of them became osteoblastic. None of the initially [(18)F]FDG-negative lesions showed [(18)F]FDG avidity during follow-up. CONCLUSION [(18)F]FDG uptake reflects the immediate tumor activity of bone metastases, whereas the radiographic morphology changes vary greatly with time among patients.
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Affiliation(s)
- Yong Du
- Institute of Nuclear Medicine, 5th Floor, University College Hospital, London, United Kingdom.
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Groves AM, Cullum I, Syed R, Nagabushan N, Kayani I, Pakzad F, Ell PJ. How often do patients undergo repeat PET or PET/CT examinations? Experience from a UK institution. Nucl Med Commun 2005; 26:137-9. [PMID: 15657507 DOI: 10.1097/00006231-200502000-00010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM According to the report of the Intercollegiate Standing Committee on Nuclear Medicine, the UK requires 40-60 positron emission tomography (PET) machines in the next decade (Intercollegiate Standing Committee on Nuclear Medicine). Positron Emission Tomography: a Strategy for Provision in the UK. London: Royal College of Physicians of London; 2003, pp. 1-9). This figure is based mainly on patients receiving only one examination and restricting the clinical indication to three primary diagnoses. The aim of this study was to assess the appropriateness of this figure and the assumptions made in the Intercollegiate report on UK PET provision. METHODS We examined retrospectively our institution's entire PET and PET/computed tomography (CT) database, which spans 4 years and 9 months. We recorded the number of patients who received repeat examinations. RESULTS Reports were available for 3354 PET/CT or PET-only studies; 418 of 2268 patients (18.4%) received at least one repeat PET/CT examination. The three main indications for PET examination in the Intercollegiate report only accounted for approximately 60% of the examinations undertaken. CONCLUSION Our records suggest that basing the UK's future PET provision on a single examination and on three clinical indications only is no longer realistic.
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Affiliation(s)
- Ashley M Groves
- Institute of Nuclear Medicine, University College London, Middlesex Hospital, London W1T 3AA, UK.
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Clunie G, Lui D, Cullum I, Ell PJ, Edwards JC. Clinical outcome after one year following samarium-153 particulate hydroxyapatite radiation synovectomy. Scand J Rheumatol 1996; 25:360-6. [PMID: 8996470 DOI: 10.3109/03009749609065647] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The clinical outcome and tolerability following treatment with samarium-153 particulate hydroxyapatite was evaluated in patients with persistent rheumatoid knee synovitis. The clinical review of 18 patients treated with intra-articular samarium-153 particulate hydroxyapatite combined with triamcinolone hexacetonide who had failed to obtain more than 4 weeks symptom relief from a prior intra-articular glucocorticoid injection was undertaken. No unwanted effects from the treatment were observed. Symptom relief was maintained in 56% patients at 6 months and in 44% of patients at 12 months following treatment. Median duration of symptom relief was 9 months. There was a significantly higher mean baseline Ritchie Articular Index in patients relapsing within 3 months and a trend towards earlier relapse in patients with higher indices of disease activity at the time of treatment. There was a trend towards earlier relapse in patients with a poor range of knee flexion at baseline and with worse indices of intra-articular radiopharmaceutical distribution. Samarium-153 particulate hydroxyapatite knee synovectomy is well tolerated and may be an effective treatment for carefully selected patients with persistent rheumatoid knee synovitis.
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Affiliation(s)
- G Clunie
- Department of Medicine, University College London, UK
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Clunie G, Lui D, Cullum I, Edwards JC, Ell PJ. Samarium-153-particulate hydroxyapatite radiation synovectomy: biodistribution data for chronic knee synovitis. J Nucl Med 1995; 36:51-7. [PMID: 7799082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
UNLABELLED Biodistribution data for the radiation synovectomy agent samarium-153-particulate hydroxyapatite (153Sm-PHYP) are reported. METHODS Mean extra-articular activity accumulation calculated from serial whole-body scans in 13 patients treated for chronic knee synovitis was 0.74% of injected activity (range 0%-3%). RESULTS In four patients (31%), activity was noted in the lung (mean 0.68% of injected activity). In six patients (46%), 0.29% of injected activity accumulated in the regional lymph nodes and in three patients (23%), 0.62% of injected dose accumulated in the liver. Absorbed dose estimates were lung: 14 mGy, regional lymph nodes; 50 mGy, liver; 4 mGy. SPECT demonstrated good distribution of 153Sm-PHYP throughout the anterior knee compartments, although distribution to the posterior compartment was variable. CONCLUSION Distribution is dependent on adequate knee flexion immediately following injection and may be influenced by the size range of labeled particles. Favorable biodistribution data suggest that 153Sm-PHYP is a potentially useful radiation synovectomy agent.
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Affiliation(s)
- G Clunie
- Department of Medicine, University College London, U.K
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Abstract
We discuss recent trends in collimator design and technology, with emphasis on theoretical and practical issues of importance for single photon emission tomography (SPET). The well-known imaging performance parameters of parallel-hole collimators are compared with those of fan-beam collimators, which have enjoyed considerable success in recent years, particularly for brain SPET. We review a simplistic approach to the collimator optimization problem, as well as more sophisticated "task-dependent" treatments and important considerations for SPET collimator design. Practical guidance is offered for understanding trade-offs that must be considered for clinical imaging. Finally, selective comparisons among different SPET systems and collimators are presented for illustrative purposes.
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Affiliation(s)
- S C Moore
- Department of Biomedical Engineering, Worcester Polytechnic Institute, MA 01609
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Ell PJ, Hocknell JM, Jarritt PH, Cullum I, Lui D, Campos-Costa D, Nowotnik DP, Pickett RD, Canning LR, Neirinckx RD. A 99Tcm-labelled radiotracer for the investigation of cerebral vascular disease. Nucl Med Commun 1985; 6:437-41. [PMID: 3877889 DOI: 10.1097/00006231-198508000-00002] [Citation(s) in RCA: 92] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The first clinical data is given on 99Tcm-hexamethylpropyleneamine oxime (HM-PAO) in normal subjects and patients with established stroke. Regional cerebral blood flow maps (rCBF) have been recorded and displayed in tomographic mode with this new radiopharmaceutical. Good images were obtained, comparable to those achieved with 123I-isopropylamphetamine (IMP).
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Ell PJ, Jarritt PH, Cullum I, Hocknell JM, Costa DC, Lui D, Jewkes RF, Steiner TJ, Nowotnik DP, Pickett RD. Regular cerebral blood flow mapping with 99mTc-labelled compound. Lancet 1985; 2:50-1. [PMID: 2861506 DOI: 10.1016/s0140-6736(85)90110-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
The cerebral distribution of a new class of 123I radiopharmaceuticals was determined by emission tomography after the isotope had been injected intravenously into 20 patients with a variety of neurological disorders. Regional cerebral blood flow images of diagnostic quality were obtained in all cases. Early and late ischaemic stroke showed up as areas of impaired perfusion, and gliomas and secondary deposits as areas of increased or reduced blood flow. A hyperaemic focus was clearly seen in an epileptic patient in whom other imaging techniques, including CT scanning and electroencephalography, had been uninformative. This new technique promises to be an extremely useful addition to the range of radioisotope brain scanning methods.
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Abstract
A new approach to the radionuclide imaging of the lungs is illustrated in this paper, describing four patients who were subjected to section scanning of the chest in addition to conventional planar imaging. The significance of this new method in the investigation of patients suspected of having pulmonary embolism is discussed. The main advantages of the new approach include increased information with depth, clearer definition of the mediastinal space, and the detection in some instances of new lesions not seen by conventional means.
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