Optimization of OSEM parameters in myocardial perfusion imaging reconstruction as a function of body mass index: a clinical approach.

OBJECTIVE: The present study is aimed at contributing to identify the most appropriate OSEM parameters to generate myocardial perfusion imaging reconstructions with the best diagnostic quality, correlating them with patients' body mass index. MATERIALS AND METHODS: The present study included 28 adult patients submitted to myocardial perfusion imaging in a public hospital. The OSEM method was utilized in the images reconstruction with six different combinations of iterations and subsets numbers. The images were analyzed by nuclear cardiology specialists taking their diagnostic value into consideration and indicating the most appropriate images in terms of diagnostic quality. RESULTS: An overall scoring analysis demonstrated that the combination of four iterations and four subsets has generated the most appropriate images in terms of diagnostic quality for all the classes of body mass index; however, the role played by the combination of six iterations and four subsets is highlighted in relation to the higher body mass index classes. CONCLUSION: The use of optimized parameters seems to play a relevant role in the generation of images with better diagnostic quality, ensuring the diagnosis and consequential appropriate and effective treatment for the patient.

OBJETIVO: O presente trabalho visa contribuir para identificar quais os parâmetros OSEM que geram as reconstruções na cintilografia de perfusão do miocárdio com o maior valor clínico de diagnóstico, relacionando-os com as classificações de índice de massa corporal. MATERIAIS E MÉTODOS: Foram selecionados 28 pacientes adultos que realizaram cintilografia de perfusão do miocárdio em um hospital público. Cada paciente teve seu exame processado com o método OSEM em seis combinações diferentes de número de iterações e subsets. As imagens foram analisadas por especialistas em cardiologia nuclear, que consideraram o valor clínico de diagnóstico delas e indicaram quais as imagens que mais se adequavam à qualidade diagnóstica. RESULTADOS: Em análise global da pontuação conforme as avaliações médicas, o arranjo de quatro iterações e quatro subsets gerou as imagens com melhor qualidade diagnóstica em todas as classes de índice de massa corporal, porém o arranjo com seis iterações e quatro subsets se destacou nas classes de maiores índices de massa corporal. CONCLUSÃO: A utilização de parâmetros otimizados parece ter papel importante em proporcionar reconstruções de melhor qualidade diagnóstica, garantindo-se assim que o paciente tenha o seu diagnóstico e consequente terapêutica encaminhados de forma mais adequada e eficaz.

Optimization of OSEM parameters in myocardial perfusion imaging reconstruction as a function of body mass index: a clinical approach / Otimização de parâmetros OSEM na reconstrução de cintilografias de perfusão do miocárdio em função do índice de massa corporal: uma escolha clínica

AbstractObjective:The present study is aimed at contributing to identify the most appropriate OSEM parameters to generate myocardial perfusion imaging reconstructions with the best diagnostic quality, correlating them with patients' body mass index.Materials and Methods:The present study included 28 adult patients submitted to myocardial perfusion imaging in a public hospital. The OSEM method was utilized in the images reconstruction with six different combinations of iterations and subsets numbers. The images were analyzed by nuclear cardiology specialists taking their diagnostic value into consideration and indicating the most appropriate images in terms of diagnostic quality.Results:An overall scoring analysis demonstrated that the combination of four iterations and four subsets has generated the most appropriate images in terms of diagnostic quality for all the classes of body mass index; however, the role played by the combination of six iterations and four subsets is highlighted in relation to the higher body mass index classes.Conclusion:The use of optimized parameters seems to play a relevant role in the generation of images with better diagnostic quality, ensuring the diagnosis and consequential appropriate and effective treatment for the patient.

ResumoObjetivo:O presente trabalho visa contribuir para identificar quais os parâmetros OSEM que geram as reconstruções na cintilografia de perfusão do miocárdio com o maior valor clínico de diagnóstico, relacionando-os com as classificações de índice de massa corporal.Materiais e Métodos:Foram selecionados 28 pacientes adultos que realizaram cintilografia de perfusão do miocárdio em um hospital público. Cada paciente teve seu exame processado com o método OSEM em seis combinações diferentes de número de iterações e subsets. As imagens foram analisadas por especialistas em cardiologia nuclear, que consideraram o valor clínico de diagnóstico delas e indicaram quais as imagens que mais se adequavam à qualidade diagnóstica.Resultados:Em análise global da pontuação conforme as avaliações médicas, o arranjo de quatro iterações e quatro subsets gerou as imagens com melhor qualidade diagnóstica em todas as classes de índice de massa corporal, porém o arranjo com seis iterações e quatro subsets se destacou nas classes de maiores índices de massa corporal.Conclusão:A utilização de parâmetros otimizados parece ter papel importante em proporcionar reconstruções de melhor qualidade diagnóstica, garantindo-se assim que o paciente tenha o seu diagnóstico e consequente terapêutica encaminhados de forma mais adequada e eficaz.

The role of molecular imaging in modern drug development.

Drug development represents a highly complex, inefficient and costly process. Over the past decade, the widespread use of nuclear imaging, owing to its functional and molecular nature, has proven to be a determinant in improving the efficiency in selecting the candidate drugs that should either be abandoned or moved forward into clinical trials. This helps not only with the development of safer and effective drugs but also with the shortening of time-to-market. The modern concept and future trends concerning molecular imaging will assumedly be hybrid or multimodality imaging, including combinations between high sensitivity and functional (molecular) modalities with high spatial resolution and morphological techniques.

Preclinical imaging: an essential ally in modern biosciences.

Translational research is changing the practice of modern medicine and the way in which health problems are approached and solved. The use of small-animal models in basic and preclinical sciences is a major keystone for these kinds of research and development strategies, representing a bridge between discoveries at the molecular level and clinical implementation in diagnostics and/or therapeutics. The development of high-resolution in vivo imaging technologies provides a unique opportunity for studying disease in real time, in a quantitative way, at the molecular level, along with the ability to repeatedly and non-invasively monitor disease progression or response to treatment. The greatest advantages of preclinical imaging techniques include the reduction of biological variability and the opportunity to acquire, in continuity, an impressive amount of unique information (without interfering with the biological process under study) in distinct forms, repeated or modulated as needed, along with the substantial reduction in the number of animals required for a particular study, fully complying with 3R (Replacement, Reduction and Refinement) policies. The most suitable modalities for small-animal in vivo imaging applications are based on nuclear medicine techniques (essentially, positron emission tomography [PET] and single photon emission computed tomography [SPECT]), optical imaging (OI), computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy imaging (MRSI), and ultrasound. Each modality has intrinsic advantages and limitations. More recently, aiming to overcome the inherent limitations of each imaging modality, multimodality devices designed to provide complementary information upon the pathophysiological process under study have gained popularity. The combination of high-resolution modalities, like micro-CT or micro-MRI, with highly sensitive techniques providing functional information, such as micro-PET or micro-SPECT, will continue to broaden the horizons of research in such key areas as infection, oncology, cardiology, and neurology, contributing not only to the understanding of the underlying mechanisms of disease, but also providing efficient and unique tools for evaluating new chemical entities and candidate drugs. The added value of small-animal imaging techniques has driven their increasing use by pharmaceutical companies, contract research organizations, and research institutions.