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BACKGROUND: In patients with multi-vessel disease presenting with ST elevation myocardial infarction (STEMI), the efficacy and safety of ischemia-guided, vs routine non-culprit vessel angioplasty has not been adequately studied. METHODS: We conducted an international, randomized, non-inferiority trial comparing ischemia-guided non-culprit vessel angioplasty to routine non-culprit vessel angioplasty, following primary PCI for STEMI. The primary outcome was the between-group difference in percent ischemic myocardium at follow-up stress MPI. All MPI images were processed and analyzed at a central core lab, blinded to treatment allocation. RESULTS: In all, 109 patients were enrolled from nine countries. In the ischemia-guided arm, 25/48 (47%) patients underwent non-culprit vessel PCI following stress MPI. In the routine non-culprit PCI arm, 43/56 (77%) patients underwent angioplasty (86% within 6 weeks of randomization). The median percentage of ischemic myocardium on follow-up imaging (mean 16.5 months) was low, and identical (2.9%) in both arms (difference 0.13%, 95%CI - 1.3%-1.6%, P < .0001; non-inferiority margin 5%). CONCLUSION: A strategy of ischemia-guided non-culprit PCI resulted in low ischemia burden, and was non-inferior to a strategy of routine non-culprit vessel PCI in reducing ischemia burden. Selective non-culprit PCI following STEMI offers the potential for cost-savings, and may be particularly relevant to low-resource settings. (CTRI/2018/08/015384).
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Intervención Coronaria Percutánea , Infarto del Miocardio con Elevación del ST , Humanos , Angioplastia , Infarto del Miocardio con Elevación del ST/terapia , Tomografía Computarizada de Emisión de Fotón Único , Resultado del TratamientoRESUMEN
PURPOSE: We sought to evaluate the behavior of cardiac mechanical synchrony as measured by phase SD (PSD) derived from gated MPI SPECT (gSPECT) in patients with super-response after CRT and to evaluate the clinical and imaging characteristics associated with super-response. METHODS: 158 subjects were evaluated with gSPECT before and 6 months after CRT. Patients with an improvement of LVEF > 15% and NYHA class I/II or reduction in LV end-systolic volume > 30% and NYHA class I/II were labeled as super-responders (SR). RESULTS: 34 patients were classified as super-responders (22%) and had lower PSD (32° ± 17°) at 6 months after CRT compared to responders (45° ± 24°) and non-responders 46° ± 28° (P = .02 for both comparisons). Regression analysis identified predictors independently associated with super-response to CRT: absence of previous history of CAD (odds ratio 18.7; P = .002), absence of diabetes mellitus (odds ratio 13; P = .03), and history of hypertension (odds ratio .2; P = .01). CONCLUSION: LV dyssynchrony after CRT implantation, but not at baseline, was significantly better among super-responders compared to non-super-responders. The absence of diabetes, absence of CAD, and history of hypertension were independently associated with super-response after CRT.
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Terapia de Resincronización Cardíaca , Insuficiencia Cardíaca , Hipertensión , Terapia de Resincronización Cardíaca/métodos , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/terapia , Humanos , Hipertensión/complicaciones , Oportunidad Relativa , Tomografía Computarizada de Emisión de Fotón Único/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: Gated myocardial perfusion scintigraphy (GMPS) phase analysis is an important tool to investigate the physiology of left ventricular (LV) dyssynchrony. We aimed to test the performance of GMPS LV function and phase analysis in different clinical settings and on a diverse population. METHODS: This is a post hoc analysis of a prospective, non-randomized, multinational, multicenter cohort study. Clinical evaluation and GMPS prior to cardiac resynchronization therapy (CRT)(baseline) and 6-month post CRT (follow-up) were done. LV end-systolic volume (LVESV), LV end-diastolic volume (LVEDV), LV ejection fraction (LVEF), LV phase standard deviation (LVPSD), and percentage of left ventricle non-viable (PLVNV) were obtained by 10 centers and compared to the core lab. RESULTS: 276 GMPS studies had all data available from individual sites and from core lab. There were no statistically significant differences between all variables except for LVPSD. When subjects with no mechanical dyssynchrony were excluded, LVPSD difference became non-significant. LVESV, LVEF, LVPSD and PLVNV had strong correlation in site against core lab comparison. Bland-Altman plots demonstrated good agreement. CONCLUSIONS: The presented correlation and agreement of LV function and dyssynchrony analysis over different sites with a diverse sample corroborate the strength of GMPS in the management of heart failure in clinical practice.
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Disfunción Ventricular Izquierda , Estudios de Cohortes , Humanos , Perfusión , Estudios Prospectivos , Reproducibilidad de los Resultados , Tomografía Computarizada de Emisión de Fotón Único , Tomografía Computarizada por Rayos X , Disfunción Ventricular Izquierda/diagnóstico por imagenRESUMEN
BACKGROUND: Placing the left ventricular (LV) lead in a viable segment with the latest mechanical activation (vSOLA) may be associated with optimal cardiac resynchronization therapy (CRT) response. We assessed the role of gated SPECT myocardial perfusion imaging (gSPECT MPI) in predicting clinical outcomes at 6 months in patients submitted to CRT. METHODS: Ten centers from 8 countries enrolled 195 consecutive patients. All underwent gSPECT MPI before and 6 months after CRT. The procedure was performed as per current guidelines, the operators being unaware of gSPECT MPI results. Regional LV dyssynchrony (Phase SD) and vSOLA were automatically determined using a 17 segment model. The lead was considered on-target if placed in vSOLA. The primary outcome was improvement in ≥1 of the following: ≥1 NYHA class, left ventricular ejection fraction (LVEF) by ≥5%, reduction in end-systolic volume by ≥15%, and ≥5 points in Minnesota Living With Heart Failure Questionnaire (MLHFQ). RESULTS: Sixteen patients died before the follow-up gSPECT MPI. The primary outcome occurred in 152 out of 179 (84.9%) cases. Mean change in LV phase standard deviation (PSD) at 6 months was 10.5°. Baseline dyssynchrony was not associated with the primary outcome. However, change in LV PSD from baseline was associated with the primary outcome (OR 1.04, 95% CI 1.01-1.07, P = .007). Change in LV PSD had an AUC of 0.78 (0.66-0.90) for the primary outcome. Improvement in LV PSD of 4° resulted in the highest positive likelihood ratio of 7.4 for a favorable outcome. In 23% of the patients, the CRT lead was placed in the vSOLA, and in 42% in either this segment or in a segment within 10° of it. On-target lead placement was not significantly associated with the primary outcome (OR 1.53, 95% CI 0.71-3.28). CONCLUSION: LV dyssynchrony improvement by gSPECT MPI, but not on-target lead placement, predicts clinical outcomes in patients undergoing CRT.
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Terapia de Resincronización Cardíaca , Tomografía Computarizada por Emisión de Fotón Único Sincronizada Cardíaca , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/terapia , Imagen de Perfusión Miocárdica , Anciano , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Resultado del TratamientoRESUMEN
BACKGROUND: Left ventricular diastolic dyssynchrony (LVDD) can be assessed by gated myocardial perfusion single-photon emission computed tomography (GMP-SPECT). LVDD is an area of interest in subjects who underwent cardiac resynchronization therapy (CRT). The aim of this post hoc analysis was to assess the role of LVDD in subjects with CRT who were followed up at 6-month period. MATERIAL & METHODS: Left ventricular diastolic dyssynchrony was assessed by GMP-SPECT at baseline and after CRT procedure in 160 subjects from 10 different cardiological centers. CRT procedure was performed as per current guidelines. Outcomes were defined as improvement in ≥1 New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF) by 5%, and reduction in end-systolic volume (ESV) by 15% and 5% points in Minnesota Living with Heart Failure Questionnaire. LVDD was defined as diastolic phase standard deviation ≥40 ± 14°. RESULTS: Improvement in NYHA functional class occurred in 105 (65.6%), LVEF in 74 (46.3%), decrease in ESV in 86 (53.8%), and Minnesota score in 85 (53.1%) cases. Baseline LV diastolic standard deviation was 53.53° ± 20.85 and at follow-up 40.44° ± 26.1283; (P < 0.001). LVDD was not associated with improvement in clinical outcomes at follow-up. CONCLUSION: CRT improves both systolic and diastolic dyssynchrony values at 6-month follow-up. LVDD at baseline is correlated with cardiac functionality at follow-up, but not with overall favorable clinical outcomes.
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Terapia de Resincronización Cardíaca , Tomografía Computarizada por Emisión de Fotón Único Sincronizada Cardíaca , Imagen de Perfusión Miocárdica , Disfunción Ventricular Izquierda/diagnóstico por imagen , Anciano , Diástole , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Volumen Sistólico , Disfunción Ventricular Izquierda/terapiaRESUMEN
PURPOSE: Regadenoson, an A2A adenosine receptor pharmacologic stress agent for radionuclide myocardial perfusion imaging (MPI), is administered as a single, fixed dose. We studied the side effect profile of regadenoson combined with two types of low-level exercise, according to body mass index (BMI). METHODS: Three hundred and fifty-six patients (46.1% men, mean age 67.7±10.7 years, range 31-90 years) underwent regadenoson stress testing combined with low-level exercise. Subjects were classified according to BMI as normal, overweight, or obese, and the type of low-level exercise performed as walking on the treadmill (TE group, n=190) or forcefully swinging legs while sitting (SS group, n=166). Patients' demographics, medical history, clinical symptoms during stress, changes in ECG, oxygen saturation (SatO2), systolic blood pressure (SBP), and heart rate (HR) were evaluated. RESULTS: Groups were comparable (p=ns) with regard to cardiovascular risks factors. The incidence of side effects was similar across BMI (p=ns), although the TE patients showed improved profiles over those with SS exercise, with a significantly lower incidence of flushing, dizziness and nausea/gastrointestinal discomfort (12.9% vs. 28.4%; 19.9% vs. 33.4%; 11.4% vs. 19.2%, respectively; all p<0.05). Regarding the hemodynamic response, we did not observe significant changes in SBP and HR after regadenoson administration across BMI categories. Comparing the TE and SS groups, no significant changes were observed in SBP, but there was a higher increase in HR in the TE group (p<0.05). CONCLUSIONS: Regadenoson in combination with low-level exercise is safe and well tolerated over a wide range of BMI, with TE exercise showing a better side effect profile than SS.
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Agonistas del Receptor de Adenosina A2/efectos adversos , Índice de Masa Corporal , Prueba de Esfuerzo/métodos , Ejercicio Físico , Imagen de Perfusión Miocárdica/métodos , Purinas/efectos adversos , Pirazoles/efectos adversos , Agonistas del Receptor de Adenosina A2/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Prueba de Esfuerzo/efectos adversos , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Imagen de Perfusión Miocárdica/efectos adversos , Purinas/administración & dosificación , Pirazoles/administración & dosificaciónRESUMEN
BACKGROUND: In Spain, nuclear cardiology (NC) procedures represent the second most frequently performed studies in nuclear medicine (NM) centers. METHODS: The NC Working Group of the Spanish Society of Nuclear Medicine and Molecular Imaging invited NM departments across the country to answer an online questionnaire regarding 2014 activity. RESULTS: Data on 40,161 patients from 42 centers were collected. The responding public centers served 39% of Spain´s population. The estimated NC activity for public hospitals was 2 studies/1,000 population/year. Of all the NC procedures, 69% were SPECT myocardial perfusion imaging (MPI), 17% equilibrium ventriculography, 12% 18F-FDG PET, 1.3% first pass ventriculography, and <1% innervation and amyloidosis imaging, respectively. The most frequent NC study was a 99mTc tracer, exercise, 2-day MPI ECG-gated SPECT ordered by a cardiologist for diagnosis in an outpatient with 21 days of mean waiting time, the stress phase being supervised by both a cardiologist and a NM physician, with a NM physician writing a complete report. CONCLUSIONS: A major challenge for NC in Spain is the gradual adoption of high-sensitivity, low-dose-dedicated cardiac SPECT cameras and the broadening of cardiac PET utilization with more cameras, and the availability of MPI tracers alongside the viability/inflammation setup.
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Cardiología , Medicina Nuclear , Fluorodesoxiglucosa F18 , Humanos , Imagen de Perfusión Miocárdica , Tomografía de Emisión de Positrones , España , Tomografía Computarizada de Emisión de Fotón ÚnicoAsunto(s)
Tomografía Computarizada por Emisión de Fotón Único Sincronizada Cardíaca , Insuficiencia Cardíaca/diagnóstico por imagen , Imagen de Perfusión Miocárdica , Disfunción Ventricular Izquierda/diagnóstico por imagen , Algoritmos , Terapia de Resincronización Cardíaca , Insuficiencia Cardíaca/terapia , Humanos , Selección de Paciente , Volumen Sistólico , Disfunción Ventricular Izquierda/terapiaRESUMEN
PURPOSE: To compare the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise, between subjects with mild/moderate chronic obstructive pulmonary disease (COPD) and asthma referred for myocardial perfusion imaging (MPI). METHODS: We studied 116 patients, of whom 67 had COPD and 49 asthma (62 % men, mean age 68.3 ± 11.3 years, range 31 - 87 years). Patient demographics, past medical history, medications, clinical symptoms during stress and changes in blood pressure (BP) and heart rate (HR) were evaluated. RESULTS: Both groups were comparable with regard to hypertension, dyslipidaemia, diabetes and medications with the exception of a higher rate of use of anticholinergics in patients with COPD and of antileukotrienes in asthmatics (58.2 % vs. 28.6 % and 1.5 % vs. 14.3 %, respectively; all p < 0.01). There was a higher incidence of dyspnoea in COPD patients and of headache and feeling hot in asthmatic patients (40.3 % vs. 22.4 %, 6 % vs. 18.4 % and 10.4 % vs. 26.5 %, respectively; all p < 0.05). Although there was no difference in the incidence of other adverse events, we observed a higher frequency in asthmatics of flushing, dry mouth, sweating and fatigue (1.5 % vs. 6.1 %, 14.9 % vs. 24.5 %, 0 % vs. 4.1 % and 37.3 % vs. 49 %, respectively). Adverse events were self-limiting, except in three patients who suffered persistent dyspnoea (2 of 67 COPD patients; 1 of 49 asthma patients) requiring theophylline administration. We observed no significant changes in BP among either group, but there was a tendency towards a higher increase in systolic BP in COPD patients following regadenoson administration (148.3 ± 27.6 vs. 154.6 ± 31.0 mmHg, p = 0.056). CONCLUSION: This study showed a good safety profile in our series of COPD and asthma patients undergoing MPI. Regadenoson was well tolerated by all patients, with dyspnoea, headache and feeling hot showing differences between groups.
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Asma/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Purinas/efectos adversos , Pirazoles/efectos adversos , Seguridad , Adulto , Anciano , Anciano de 80 o más Años , Asma/fisiopatología , Presión Sanguínea/efectos de los fármacos , Prueba de Esfuerzo , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Purinas/uso terapéutico , Pirazoles/uso terapéutico , Estrés Fisiológico/efectos de los fármacosRESUMEN
PURPOSE: To assess the value of FDG-PET/CT in the evaluation of gallbladder carcinomas (GBC). METHODS: A prospective cohort of patients with suspicion of or confirmed GBC was studied with FDG-PET/CT. Diagnostic accuracy parameters were calculated in comparison with pathology and/or the clinical course of patients. Clinical impact of PET/CT imaging was estimated. RESULTS: Forty-nine patients were enrolled (34 malignant tumors, 15 benign lesions; 37 staging, 12 restaging). Overall diagnostic accuracy was 95.9% for the diagnosis of the primary lesion, 85.7% for lymph node involvement and 95.9% for metastatic disease. Mean SUVmax in malignant gallbladder lesions was 7.92 ± 6.25 Analysis of ROC curves showed a SUVmax cut-off value of 3.62 for malignancy (S: 78.1%; Sp: 88.2%). Diagnostic accuracy in the restaging group reached 100%. FDG-PET/CT changed the management of 22.4% of the population. COMMENTS: Diagnosis of malignancy or benignity of suspicious gallbladder lesions is accurately made with FDG PET/CT, allowing a precise staging of GBC due to its ability to identify unsuspected metastatic disease. SUVmax has a complementary role in addition to visual analysis.
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Fluorodesoxiglucosa F18 , Neoplasias de la Vesícula Biliar/diagnóstico , Imagen Multimodal/métodos , Tomografía de Emisión de Positrones , Radiofármacos , Tomografía Computarizada por Rayos X , Adenocarcinoma/diagnóstico , Adenocarcinoma Mucinoso/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Tumor Carcinoide/diagnóstico , Carcinoma Adenoescamoso/diagnóstico , Femenino , Neoplasias de la Vesícula Biliar/diagnóstico por imagen , Neoplasias de la Vesícula Biliar/patología , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Tomografía de Emisión de Positrones/métodos , Valor Predictivo de las Pruebas , Estudios Prospectivos , Sensibilidad y EspecificidadAsunto(s)
Cardiología/tendencias , Medicina Nuclear/tendencias , Cardiología/organización & administración , Prueba de Esfuerzo , Humanos , Estudios Multicéntricos como Asunto , Medicina Nuclear/organización & administración , Médicos , Sociedades Médicas , España/epidemiología , Encuestas y CuestionariosAsunto(s)
Agonistas del Receptor de Adenosina A2/efectos adversos , Purinas/efectos adversos , Pirazoles/efectos adversos , Taquicardia Supraventricular/inducido químicamente , Taquicardia Supraventricular/diagnóstico , Agonistas del Receptor de Adenosina A2/administración & dosificación , Anciano , Esquema de Medicación , Femenino , Humanos , Purinas/administración & dosificación , Pirazoles/administración & dosificación , Taquicardia Supraventricular/terapiaRESUMEN
BACKGROUND: In this substudy of the Value of Gated-SPECT MPI for Ischemia- Guided PCI of non-culprit vessels in STEMI Patients with Multi vessel Disease after primary PCI trial after primary PCI we aim to assess if infarct size affects conventional measures of dyssynchrony at rest. Additionally, we explore if there is an independent correlation of stress-inducible ischemia with dyssynchrony at rest. METHODS: The 48 patients with imaging at randomization were analyzed. Gated-single-photon emission computed tomography (SPECT) MPI with vasodilator stress and technetium-99m-labeled tracers was performed. The phase histogram bandwidth (HBW), phase SD, and entropy were obtained with the QGS software. Correlation between dyssynchrony at rest and infarct size and inducible ischemia was performed using the Spearman test. RESULTS: According to normal database limits dyssynchrony parameters at rest were abnormal for men. In women only HBW was abnormal. Correlation between the summed rest score with dyssynchrony was significant only for entropy ( P â =â 0.035). No correlation was observed for dyssynchrony and stress-induced ischemia. CONCLUSION: Entropy, as a measure of dyssynchrony, has potential in the assessment of patients with STEMI and multivessel disease after primary PCI. Smaller residual myocardial scars in PCI-reperfused patients with STEMI may contribute to the lack of correlation between dyssynchrony at rest and infarct size and stress-induced ischemia, respectively.
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Infarto del Miocardio con Elevación del ST , Humanos , Masculino , Femenino , Infarto del Miocardio con Elevación del ST/diagnóstico por imagen , Infarto del Miocardio con Elevación del ST/terapia , Infarto del Miocardio con Elevación del ST/fisiopatología , Persona de Mediana Edad , Anciano , Tomografía Computarizada por Emisión de Fotón Único Sincronizada Cardíaca , Imagen de Perfusión Miocárdica , Tomografía Computarizada de Emisión de Fotón Único , Intervención Coronaria PercutáneaRESUMEN
SARS-CoV-2 infection has a very important relationship with cardiovascular disease. Since the beginning of the pandemic, a close relationship has been observed between cardiovascular comorbidity and a worse prognosis in COVID-19 patients. The study of the pathophysiology of SARS-CoV-2 infection and cardiovascular disease suggests several concomitant hypotheses: direct myocardial damage by the virus, hypoxemia secondary to respiratory failure, inflammatory response to infection and/or thromboembolic phenomena. Cardiovascular damage can manifest in the acute phase of infection with acute myocardial infarction, myocarditis, arrhythmias , during this phase Nuclear Cardiology procedures have not played a determining role in the diagnosis and management of these patients. On the other hand, in the subacute phase of the infection and in the post-acute COVID syndrome, Nuclear Cardiology seems to shed light on what happens in the cardiovascular system in this phase of the disease. The COVID-19 pandemic has represented a great challenge for health systems, with a significant reduction in non-urgent diagnostic procedures with the aim of reducing the risk of transmission to patients and health personnel. Nuclear Cardiology has not been an exception. In addition to the prioritization of urgent/non-deferrable procedures and general screening, hygiene and distance measures, the main organizations and scientific societies of Nuclear Medicine and Nuclear Cardiology released recommendations and guidelines for safe practice, introducing significant changes in myocardial perfusion SPECT protocols.
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COVID-19 , Cardiología , Sistema Cardiovascular , Infarto del Miocardio , Humanos , Pandemias , SARS-CoV-2 , Síndrome Post Agudo de COVID-19 , Infarto del Miocardio/epidemiologíaRESUMEN
AIM: To analyze the sample of pregnant patients who underwent pulmonary perfusion scintigraphy to rule out the pulmonary embolism (PE) suspicion during the acute COVID-19 infection hospitalization period in our hospital. MATERIAL AND METHODS: SPECT scintigraphy with a reduced dose (111 MBq) of 99mTc-macroaggregated albumin was performed in all of the patients (n=5). The obtained images were interpreted by comparing the findings with the radiological images according to the PISAPED criteria. RESULTS: Only one of the 5 patients was diagnosed with PE. Two patients obtained pathological findings of the scintigraphy attributable to radiological alterations due to COVID-19 pneumonia, and the other two had normal pulmonary perfussion. CONCLUSION: Given the non-specific features of the clinical manifestations and D-dimer values in COVID-19, as well as their similarity to those of PE, the pulmonary perfusion scintigraphy plays a crucial role in the screening of PE in these patients due to its high sensitivity and lower irradiation compared to CT. Despite the limited number of patients, the results obtained have special relevance related to the absence of scientific publications on this group of patients within the context of COVID-19 pandemic exceptional situation.
RESUMEN
OBJECTIVES: We aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe. METHODS: The online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries. RESULTS: Centres in Northern and Southern Europe were more likely to cancel all outpatient activities compared with Western and Eastern Europe. There was a greater reduction in total procedure volumes in Europe compared with the rest of the world in March 2020 (45% vs 41%, p=0.003), with a more marked reduction in Southern Europe (58%), but by April 2020 this was similar in Europe and the rest of the world (69% vs 63%, p=0.261). Regional variations were apparent between imaging modalities, but the largest reductions were in Southern Europe for nearly all modalities. In March 2020, location in Southern Europe was the only independent predictor of the reduction in procedure volume. However, in April 2020, lower gross domestic product and higher COVID-19 deaths were the only independent predictors. CONCLUSION: The first wave of the COVID-19 pandemic had a significant impact on care of patients with cardiac disease, with substantial regional variations in Europe. This has potential long-term implications for patients and plans are required to enable the diagnosis of non-COVID-19 conditions during the ongoing pandemic.
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COVID-19 , Técnicas de Imagen Cardíaca/tendencias , Cardiólogos/tendencias , Disparidades en Atención de Salud/tendencias , Cardiopatías/diagnóstico por imagen , Pautas de la Práctica en Medicina/tendencias , Europa (Continente) , Encuestas de Atención de la Salud , Humanos , Valor Predictivo de las PruebasRESUMEN
One of the alternative methods for the measurement of radiochemical purity (RCP) of Technetium-sestamibi uses Whatman 3MM paper as the stationary phase and ethyl acetate as the mobile phase. However, alternative method shows peak splitting and shouldering of the radiopharmaceutical. This could be because of higher levels of analyte. We aimed to assess the effect of sample dilution (1 : 1) on this method and to compare these RCP values with the reference method. The diluted samples showed a unique peak in the radiopharmaceutical zone, but the RCP values were significantly different (P<0.05) and correlated poorly with the reference method.
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Radioquímica/métodos , Tecnecio Tc 99m Sestamibi/química , Control de Calidad , Radioquímica/normas , Estándares de Referencia , Tecnecio Tc 99m Sestamibi/aislamiento & purificaciónRESUMEN
La osificación heterotópica es una condición limitante, que afecta predominantemente a la cadera. Dada su relación con patología postraumática/posquirúrgica, la gammagrafía ósea SPECT/TC resulta de especial utilidad en el diagnóstico diferencial con movilización protésica, aun cuando no hay alteraciones radiológicas. Además, resulta ser una herramienta eficaz para planificación quirúrgica atendiendo al grado de maduración ósea y la posibilidad de fabricar biomodelos mediante impresión 3D.(AU)
Heterotopic ossification is a limiting condition that predominantly affects the hip. Because of its association with post-trau-matic/postoperative pathology, bone SPECT/CT scintigraphy has proven to be especially useful regarding differential diag-nosis involving prosthetic mobilization, even in the absence of radiological abnormalities. Additionally, it is an effective toolfor surgical planning, considering the degree of bone maturation and the possibility of creating biomodels using 3Dprinting.(AU)