Journal of nuclear medicine : official publication, Society of Nuclear Medicine
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Paraaortic sentinel node biopsy may be a challenging procedure because the sentinel nodes are located retroperitoneally in close proximity to vital structures. The purpose of this study was to describe and evaluate the value of preoperative SPECT/CT for lymphatic mapping, and a portable gamma-camera for intraoperative radioguidance, in patients with paraaortic sentinel nodes. ⋯ If retroperitoneal drainage is expected, SPECT/CT provides good detection and clear localization of sentinel nodes in relation to anatomic structures. Detection and removal of paraaortic sentinel nodes by means of a laparoscopic gamma-probe and real-time imaging with a portable gamma-camera is a successful method with high intraoperative detection rates.
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Preoperative evaluation of future remnant liver (FRL) function is crucial in the determination of whether a patient can safely undergo liver resection. Although dynamic (99m)Tc-mebrofenin hepatobiliary scintigraphy (HBS) is used to measure FRL function, 2-dimensional planar images lack the ability to assess segmental liver function. Modern SPECT/CT cameras combine dynamic (99m)Tc-mebrofenin HBS with additional SPECT and the anatomic information of the CT scan. The aim of this study was to evaluate the additional value of (99m)Tc-mebrofenin SPECT for the measurement of segmental liver function and liver functional volume. ⋯ The Gmean dataset is recommended for the assessment of hepatic function by dynamic planar (99m)Tc-mebrofenin HBS. The combination of SPECT data with the dynamic uptake function measured by planar HBS provides valuable visible and quantitative information regarding segmental liver function and is an accurate measure for FRL function.
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PET image quality depends strongly on patient weight and habitus, decreasing for increasing weight and body mass index. Common adult injection rules prescribe either a dose proportional to weight or a fixed dose. In light patients, image quality may improve for decreasing weight more than by inverse proportion. If better quality than in average-adult studies does not justify the associated dose burden, attractive options are to reduce scan time, reduce dose, or any combination of the 2. The objective of this study was to determine quantitative injection rules for pediatric PET allowing clinical implementation of these trade-offs. ⋯ Results suggest that pediatric PET of constant image quality (in an NECRD sense) can be performed with time or dose savings, up to 50% for the lightest patients (10-20 kg).
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Although it is known that structural and functional changes in the pulmonary vasculature and parenchyma occur in the progress of chronic obstructive pulmonary disease (COPD), information is limited on early regional perfusion (Q(r)) alterations. ⋯ Q(r) is significantly redistributed in COPD. Q(r) heterogeneity in COPD patients is greater than in healthy subjects, mainly because of the contribution of large lung regions and not because of changes in tissue density or V(r). The assessment of spatial heterogeneity of lung perfusion with (13)NN-saline PET may serve as a vascular biomarker in COPD.