Nuclear medicine communications
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The value of gated single-photon emission computed tomography technetium-99m methoxyisobutylisonitrile (gated SPECT (99m)Tc-MIBI) in children is not yet established probably because gated SPECT (99m)Tc-MIBI has rarely been used in pediatric clinical and research studies. The purpose of this study was to evaluate perfusion abnormalities and left ventricular (LV) function by gated SPECT (99m)Tc-MIBI in children and adolescents with severe congenital heart disease (CHD). ⋯ Poststress and rest-gated SPECT (99m)Tc-MIBI results indicate that children and adolescents with severe CHD show a range of abnormalities in myocardial perfusion and LV function, which is useful for determining functional importance of morphological malformations. Thus, gated SPECT (99m)Tc-MIBI provides complementary information that may guide clinical decision making in children and adolescents with severe CHD.
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Cerebral vasospasm is a major cause of morbidity and mortality among patients after subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms. Patients are often monitored using transcranial Doppler (TCD) ultrasound and single photon emission computed tomography (SPECT) techniques. Historically SPECT has been evaluated qualitatively, though quantitative analysis software is now used to evaluate other cerebral pathologies. ⋯ BRASS SPECT is a useful method for evaluating cerebral perfusion and needs further optimization, particularly as it pertains to establishing semiquantitative cerebral perfusion parameters. It can serve as an adjunct to traditional SPECT evaluation of SAH particularly in determining subtle changes in the perfusion of the anterior and posterior arterial distributions.
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Comparative Study Clinical Trial
Comparison of V/Q SPECT and planar V/Q lung scintigraphy in diagnosing acute pulmonary embolism.
Planar ventilation/perfusion (V/Q) scintigraphy is currently the standard method for the diagnosis of pulmonary embolism (PE) in most nuclear medicine centers. However, recent studies have shown a superior sensitivity and specificity when applying V/Q single photon emission computed tomography (SPECT) in diagnosing PE. This study evaluated the diagnostic performance of three-dimensional V/Q SPECT in comparison with planar V/Q scintigraphy. ⋯ We conclude that V/Q SPECT has a superior diagnostic performance compared with planar V/Q scintigraphy and should be preferred when diagnosing PE.
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The management of the patients with carcinoma of an unknown primary represents a difficult challenge in oncology. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) has provided new insights in the diagnosis, staging, and follow-up of oncological patients. ⋯ Whole-body FDG PET/CT has to be considered a useful method, especially in an early phase of the diagnostic workup of patients with carcinoma of an unknown primary syndrome, to optimize the management.
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Attenuation correction of PET data requires accurate determination of the attenuation map (mumap), which represents the spatial distribution of linear attenuation coefficients of different tissues at 511 keV. The presence of high-density metallic dental filling material in head and neck X-ray computed tomography (CT) scanning is known to generate streak artefacts in the resulting CT images and thus in the corresponding mumaps generated using CT-based attenuation correction. Consequently, an under/overestimation of activity concentration occurs in corresponding regions of the corrected PET images. The purpose of this study is to develop a simple yet practical approach for reduction of metallic dental implant artefacts in the generated mumaps. ⋯ The proposed MAR method provides a simple and convenient approach allowing correction for the presence of metal artefacts caused by dental implants without the need to manipulate the complex raw CT data. Further evaluation using a larger clinical PET/CT database is under way to evaluate the potential of the technique in a clinical setting.