- Email: [email protected]
Dose Tc-99m-Tetrofosmin myocardial SPECT represent redistribution at rest and exercise?
$38
Abstracts
JOURNAL OF NUCLEAR CARDIOLOGY
Monday afternoon, April 24, 1995
M O N D A Y P M A P R I L
March/April 1995, Part 2
P06-149
P06-151
DOSE Tc-99m-TETROFOSMIN MYOCARDIAL SPECT REPRESENT REDISTRIBUTION AT REST AND EXERCISE ? H Kobayashi, T Oka, N Matsumoto, Y Ikkatai, K Kusakabe, S Hosoda, Tokyo Women's Medical College,Tokyo, Japan
EVALUATION OF HYPOPERFUSION AT LATERAL WALL IN HYPERTENSIVE PATIENTS WITH TL201 and Tc 99m SESTAMIBI STUDIES E. Ozalp, N.O. Ktiq~ik, EAltmyay, K.M. Ktr, G. Aras, G Erbay Ankara University Faculty of Medicine, Deptartment of Nuclear Medicine, 06100 ANKARA/TIORK|YE
To assess the existence of redistribution after the injection of 99mTc-Tetrofosmin at rest and exercise, 20 patients with old myocardial infarction (MI) at rest and 20 patients with angina pectoris (AP) at exercise were studied 99mTc-Tetrofosmin myocaridal scintigraphy. M e t h o d : SPECT images were obtained 30 minutes and 3 hours after the injection of 99mTc-Tetrofosmin. Results: Redistribution findings were not observed both in the rest and exercise delayed SPECT image. Although, mild reverse redistribution findings were observed in 4 of 20 MI patients and 7 of 20 AP patients. These reverse redistribution findings were frequently observed in the ischemic myocardial territories. Myocardial washout rate in the rest 99mTc-Tetrofosmin images were 5 to 35%, and patients variability were significant. Conclusion: Redistribution findings were not observed both in the rest and exercise 99mTcTetrofosmin images. Reverse redistribution were occasionally observed, and delayed image at rest is not suitable for evaluating myocardial viability.
The relative hypoperfusion at lateral wall due to septal hypertrophy on Tt201 myocardial pert~sion sca,~s (NIPS) have been previously reported in patients (pts) with hypertension The aim of the study was to investigate the frequency and degree of lateral hypoperfusion in pts with hypertensive (HT). While T1201 SPECT was pertbrmed in 33 HT pts and 27 normotensive (NT) pts, Tc99m Sestamibi SPECT was performed 18 HT pts and 10 NT pts. All of the pts have normal coronary angiograms. The images were evaluated quantitative method and lateral-to-septal (L/S) count density ratios were calculated from both stress and delay images. L/S ratios were found as in tbllowing table: Stress Rest TI201 HT (n:33) !.02+0.09 1.01+0.08(p<0.01) NT(n:27) I. I I_+0.09 1.09-+0.08(p<0.0 I) MIBI l-{T(n:lS) I 03_+009 I 05+007(p<0001) NT(n:10) 116_+006 I 18-+0.08(p<0001) The ratios of t,/S in HT pts were found significantly lower than NT pts in boti~ T1201 and Tc99m Sestamibi studies. Lateral fixed hypoperfusion which may mimic myocardial infarction may be seen , and physic,ans on TI20 l and also Tc 99m Sestamibi SPECT stud'es interpreting myocardial per'fusion scans should kept in mind this alteration.
P06-150
P06-152
SEMI-QUANTITATIVE RELATION B E T W E E N RESTING THALLIUM SPECT AND FDG SPECT IN NORMALS.
EVALUATIONOF THE LEFTVENTRICULARFUNCTION(LV} USING 3-DIMENS[ONAL(3-D) MYOCARDIALSPECT
Jeroen J. Bax, Frans C. Visser, A.B.Johan Groeneveld, Gerrit J.J. Teule, Arthur van Lingen, C.A. Visser. Free University Hospital Amsterdam, The Netherlands. Recently the feasibility of FDG and thallium-201 (2~ in combination with SPECT has been demonstrated. However, since differences in attenuation and photon energies exist for these tracers, this may cause a problem in the inferoseptal region, which is most susceptible to attenuation. Therefore, the relation between 20,T1 and FDG SPECT was studied in normal volunteers. Nine male subjects (43• yrs) underwent FDG SPECT during hvperinsulinemic glucose clamping and 201T1 SPECT. Three 20r~ Tl and FDG short-axis slices (apical, mid and basal) were analyzed using circumferential profiles (60 segments). Activities were normalized to the maximum counts in the slice. The segments were grouped into 4 regions: anterior (ANT), lateral (LAT), inferior (INF) and septal (SEPT). Pooled data showed a linear relation (p<.0001) between 2~ and FDG: FDG=0.762~ (r=0.70). Although individual tracer uptake varied significantly between the 4 regions, no difference was observed between 2~ and FDG within regions: SEPT ANT LAT INF 201TI 0,91• 1.04+0.07 1.08_+0.07 0.97_+0.09 FDG 0.90• 1.05_+0.09 1.08_+0.07 0.98_+0.08 In conclusion, no differences between ~~ and FDG uptake were found; these data can be used as a normal reference for patient studies.
Hisayo Yamashina, Jun-lchi yamazaki, Takeshi Merishita, Masaaki Takano, Katio Kosakai, l)Jun-ichi Sugita The Ist department of internal medicine, Toho univer sity school of medicine, l)Kubota co, jp, Tokyo, Japan We have developed the new program for quantitative analysis of the LV function from gated myocardial SPEC T by Application Visualization System {AVS), 3-D myocardial SPECT with ~9=Tc-MIBI was performed in myocardial phantom, We obtained the myocardial muscle volume from the number of voxels on the basis of the phantom we had already known, and determined the threshold of RI counts, After injection of ~=Tc-MIBI(740MBq}, myocardial gated SPECT was performed in 5 normal controls. The threshold in normal cases were determined(40--.45~} based on the phantom study(5S%) and visual findings, The myocardial volume and total counts of the endodiasto]ic(ED) and endosystolic(ES) phases were obtained by AVS, The contraction fraction(CF) was calculated accordingto the following formula, (ES(counts/volumelc/ v}-ED(c/v)}/EDIc/v ), The CF{0,57.--0,61) was correlated well to LVEF(0,54--~0,6) from R[ ventriculography with ~mTc-HSAD, The CF was considered to be a usuful index for evaluating LV function,
Abstracts
JOURNAL OF NUCLEAR CARDIOLOGY
Monday afternoon, April 24, 1995
M O N D A Y P M A P R I L
March/April 1995, Part 2
P06-149
P06-151
DOSE Tc-99m-TETROFOSMIN MYOCARDIAL SPECT REPRESENT REDISTRIBUTION AT REST AND EXERCISE ? H Kobayashi, T Oka, N Matsumoto, Y Ikkatai, K Kusakabe, S Hosoda, Tokyo Women's Medical College,Tokyo, Japan
EVALUATION OF HYPOPERFUSION AT LATERAL WALL IN HYPERTENSIVE PATIENTS WITH TL201 and Tc 99m SESTAMIBI STUDIES E. Ozalp, N.O. Ktiq~ik, EAltmyay, K.M. Ktr, G. Aras, G Erbay Ankara University Faculty of Medicine, Deptartment of Nuclear Medicine, 06100 ANKARA/TIORK|YE
To assess the existence of redistribution after the injection of 99mTc-Tetrofosmin at rest and exercise, 20 patients with old myocardial infarction (MI) at rest and 20 patients with angina pectoris (AP) at exercise were studied 99mTc-Tetrofosmin myocaridal scintigraphy. M e t h o d : SPECT images were obtained 30 minutes and 3 hours after the injection of 99mTc-Tetrofosmin. Results: Redistribution findings were not observed both in the rest and exercise delayed SPECT image. Although, mild reverse redistribution findings were observed in 4 of 20 MI patients and 7 of 20 AP patients. These reverse redistribution findings were frequently observed in the ischemic myocardial territories. Myocardial washout rate in the rest 99mTc-Tetrofosmin images were 5 to 35%, and patients variability were significant. Conclusion: Redistribution findings were not observed both in the rest and exercise 99mTcTetrofosmin images. Reverse redistribution were occasionally observed, and delayed image at rest is not suitable for evaluating myocardial viability.
The relative hypoperfusion at lateral wall due to septal hypertrophy on Tt201 myocardial pert~sion sca,~s (NIPS) have been previously reported in patients (pts) with hypertension The aim of the study was to investigate the frequency and degree of lateral hypoperfusion in pts with hypertensive (HT). While T1201 SPECT was pertbrmed in 33 HT pts and 27 normotensive (NT) pts, Tc99m Sestamibi SPECT was performed 18 HT pts and 10 NT pts. All of the pts have normal coronary angiograms. The images were evaluated quantitative method and lateral-to-septal (L/S) count density ratios were calculated from both stress and delay images. L/S ratios were found as in tbllowing table: Stress Rest TI201 HT (n:33) !.02+0.09 1.01+0.08(p<0.01) NT(n:27) I. I I_+0.09 1.09-+0.08(p<0.0 I) MIBI l-{T(n:lS) I 03_+009 I 05+007(p<0001) NT(n:10) 116_+006 I 18-+0.08(p<0001) The ratios of t,/S in HT pts were found significantly lower than NT pts in boti~ T1201 and Tc99m Sestamibi studies. Lateral fixed hypoperfusion which may mimic myocardial infarction may be seen , and physic,ans on TI20 l and also Tc 99m Sestamibi SPECT stud'es interpreting myocardial per'fusion scans should kept in mind this alteration.
P06-150
P06-152
SEMI-QUANTITATIVE RELATION B E T W E E N RESTING THALLIUM SPECT AND FDG SPECT IN NORMALS.
EVALUATIONOF THE LEFTVENTRICULARFUNCTION(LV} USING 3-DIMENS[ONAL(3-D) MYOCARDIALSPECT
Jeroen J. Bax, Frans C. Visser, A.B.Johan Groeneveld, Gerrit J.J. Teule, Arthur van Lingen, C.A. Visser. Free University Hospital Amsterdam, The Netherlands. Recently the feasibility of FDG and thallium-201 (2~ in combination with SPECT has been demonstrated. However, since differences in attenuation and photon energies exist for these tracers, this may cause a problem in the inferoseptal region, which is most susceptible to attenuation. Therefore, the relation between 20,T1 and FDG SPECT was studied in normal volunteers. Nine male subjects (43• yrs) underwent FDG SPECT during hvperinsulinemic glucose clamping and 201T1 SPECT. Three 20r~ Tl and FDG short-axis slices (apical, mid and basal) were analyzed using circumferential profiles (60 segments). Activities were normalized to the maximum counts in the slice. The segments were grouped into 4 regions: anterior (ANT), lateral (LAT), inferior (INF) and septal (SEPT). Pooled data showed a linear relation (p<.0001) between 2~ and FDG: FDG=0.762~ (r=0.70). Although individual tracer uptake varied significantly between the 4 regions, no difference was observed between 2~ and FDG within regions: SEPT ANT LAT INF 201TI 0,91• 1.04+0.07 1.08_+0.07 0.97_+0.09 FDG 0.90• 1.05_+0.09 1.08_+0.07 0.98_+0.08 In conclusion, no differences between ~~ and FDG uptake were found; these data can be used as a normal reference for patient studies.
Hisayo Yamashina, Jun-lchi yamazaki, Takeshi Merishita, Masaaki Takano, Katio Kosakai, l)Jun-ichi Sugita The Ist department of internal medicine, Toho univer sity school of medicine, l)Kubota co, jp, Tokyo, Japan We have developed the new program for quantitative analysis of the LV function from gated myocardial SPEC T by Application Visualization System {AVS), 3-D myocardial SPECT with ~9=Tc-MIBI was performed in myocardial phantom, We obtained the myocardial muscle volume from the number of voxels on the basis of the phantom we had already known, and determined the threshold of RI counts, After injection of ~=Tc-MIBI(740MBq}, myocardial gated SPECT was performed in 5 normal controls. The threshold in normal cases were determined(40--.45~} based on the phantom study(5S%) and visual findings, The myocardial volume and total counts of the endodiasto]ic(ED) and endosystolic(ES) phases were obtained by AVS, The contraction fraction(CF) was calculated accordingto the following formula, (ES(counts/volumelc/ v}-ED(c/v)}/EDIc/v ), The CF{0,57.--0,61) was correlated well to LVEF(0,54--~0,6) from R[ ventriculography with ~mTc-HSAD, The CF was considered to be a usuful index for evaluating LV function,