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1.
Z Gastroenterol ; 57(11): 1304-1308, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31739376

RESUMO

Selective internal radiation therapy (SIRT) is a therapeutic option for primary and metastatic liver tumors. Microspheres containing Yttrium 90, a beta-emitting radionuclide, are administered into the hepatic artery allowing selective internal radiation of a liver tumor. SIRT-related complications may appear due to migration of the radiation microspheres to organs distant from the tumor site. In order to prevent these complications, unintended non target embolization of Yttrium microspheres has to be avoided. However, data from external-beam radiation therapy (EBRT) suggests that the stomach/small bowel may actually be less radiosensitive than the liver. Gastric ulcers, a well-known SIRT-related complication, may therefore not only be caused by local radiation but also by unusual accumulation of microspheres in the submucosa and small vessel damage. We herein report a more than two- year-long persisting, highly symptomatic, non-neoplastic ulceration of the gastric antrum leading to pyloric stenosis caused by SIRT therapy with Yttrium 90 microspheres for the treatment of intrahepatic cholangiocellular carcinoma. The chronic courses of the ulcer disease together with the specific histological features highlight the pivotal role of radiation-induced small vessel damage in SIRT-induced adverse events.


Assuntos
Neoplasias dos Ductos Biliares/patologia , Neoplasias dos Ductos Biliares/radioterapia , Colangiocarcinoma/patologia , Colangiocarcinoma/radioterapia , Lesões por Radiação/diagnóstico , Úlcera Gástrica/etiologia , Radioisótopos de Ítrio/efeitos adversos , Ductos Biliares Intra-Hepáticos , Feminino , Artéria Hepática , Humanos , Microesferas , Pessoa de Meia-Idade , Úlcera Gástrica/diagnóstico , Tomografia Computadorizada de Emissão de Fóton Único , Resultado do Tratamento , Radioisótopos de Ítrio/uso terapêutico
2.
Nihon Hoshasen Gijutsu Gakkai Zasshi ; 75(10): 1158-1164, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31631109

RESUMO

PURPOSE: To calculate the quantitative values in bone single-photon emission computed tomography, it is necessary to measure the amount of syringe radiation before and after the administration of a radiopharmaceutical. We proposed a method to omit the measurement of radioactivity. In this study, we clarified the effects of adopting this method and calculated its influence on quantitative values in a clinical setting. METHODS: We derived a relational expression of the administration time and dose of radioactivity from the measured value and the administration time of the syringe dose before and after the administration in each patient. Next, we determined the differences for radioactivity calculated from this relational expression (estimated dose) and actual administered radioactivity (actual dose). Furthermore, we calculated the differences in the quantitative values of a normal region (the fourth lumbar vertebra) on adopting these data. RESULTS: No significant differences between the estimated dose and actual dose were noted. Additionally, no significant differences in the quantitative values were observed. CONCLUSION: Our findings suggest that adoption of the estimated dose does not affect the quantitative value. When the estimated dose is adopted, it can be administered with an accuracy of 0.80%. Thus, it is possible to omit the actual measurement of radioactivity by using our proposed method.


Assuntos
Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton Único , Humanos , Compostos Radiofarmacêuticos/administração & dosagem
3.
Artigo em Japonês | MEDLINE | ID: mdl-31548466

RESUMO

PURPOSE: Computed tomography (CT) attenuation correction of myocardial perfusion in single-photon emission computed tomography (SPECT) /CT systems is possibility of misregistration between emission and transmission scans. This study aimed to evaluate the influence of misregistration using a polar map of 17 segments model. METHODS: Using the fusion software, we assessed the magnitude and direction of misregistration in 200 consecutive myocardial perfusion SPECT images with 99mTechnetium (99mTc) tetrofosmin. After registration, CT data was shifted by ±1, ±2, and ±3 pixels along the cephalad/caudal, dorsal/ventral, and left/right axes, respectively. The registered image was compared with the shifted image. RESULTS: Misregistration between the SPECT and CT images occurred by 1-2 pixels in 127 cases (63.5%) and by 2 or more pixels in four cases (2%); the maximum misregistration was 1.2±0.4 pixels on average. The polar map scoring was most significantly affected by 3 pixel ventral shift. A ventral shift of 1 pixel affected the scores for the anterolateral and inferolateral segments, whereas a caudal shift of 1 pixel affected the scores for the anterior segment. CONCLUSION: Since the 17 segments model can evaluate the position more precisely than the five segments model, it is possible to evaluate up to 1 pixel misregistration.


Assuntos
Artefatos , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Sensibilidade e Especificidade , Tecnécio , Tomografia Computadorizada de Emissão de Fóton Único/normas , Tomografia Computadorizada por Raios X/normas
4.
Br J Radiol ; 92(1104): 20190506, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31365277

RESUMO

99mTc-MDP-single photon emission computed tomography (SPECT)/CT has established itself as a useful modality in the assessment of the painful foot and ankle, owing to its ability to depict anatomical and functional information simultaneously. Despite its growing popularity, much of the literature describing the utility of 99mTc-MDP-SPECT/CT of the foot and ankle is limited to osseous and articular pathology, with descriptions of ligamentous pathology limited to just a handful of cases. Though assessment of soft tissues using a combination of bone tracer and CT is limited, with a sound understanding of the regional anatomy, it is certainly within the scope of 99mTc-MDP-SPECT/CT to accurately identify ligamentous injuries based on focal tracer uptake patterns and suspected ligamentous injuries should be reported as such. This article provides a case-based pictorial review of the 99mTc-MDP-SPECT/CT appearances of the various ligamentous injuries of the foot and ankle with case examples and MRI correlation where available, most of which have yet to be described. The typical patterns of bone tracer uptake and associated CT abnormalities that may be observed are discussed.


Assuntos
Articulação do Tornozelo/diagnóstico por imagem , Articulações do Pé/diagnóstico por imagem , Ligamentos Articulares/lesões , Compostos Radiofarmacêuticos , Entorses e Distensões/diagnóstico por imagem , Medronato de Tecnécio Tc 99m , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adulto , Feminino , Humanos , Ligamentos Articulares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
Neurol Neurochir Pol ; 53(4): 311-314, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31441498

RESUMO

AIM: Drug-induced parkinsonism (DIP) is the most common form of parkinsonism after Parkinson's disease (PD) itself. It has been widely believed that DIP is characterised by symmetry of symptoms. Studies of patients with DIP in whom PD had been ruled out by SPECT-DaTSCAN have shown that symptom asymmetry is a common element of DIP clinical presentation. The aim of our study was to determine whether the asymmetry of symptoms in DIP is related to any abnormality within the presynaptic part of the nigrostriatal dopaminergic system. MATERIALS AND METHODS: Eleven patients with the diagnosis of DIP and asymmetric symptoms were studied. Their individual SPECT-DaTSCANs were normal. Indices calculated for the whole group of radiotracer uptake in the whole striatum, putamen and caudate contralateral to more severe DIP symptoms were compared to values obtained in the opposite hemisphere. RESULTS: We did not find significant differences in radiotracer uptake in structures contralateral to more severe clinical symptoms when compared to the homolateral hemisphere. CONCLUSIONS: Our results have not confirmed the presence of a presynaptic nigrostriatal deficit which could be related to asymmetry of DIP. The factors responsible for the asymmetry of DIP symptoms should be sought in the postsynaptic part of the nigrostriatal dopaminergic system.


Assuntos
Transtornos Parkinsonianos , Proteínas da Membrana Plasmática de Transporte de Dopamina , Humanos , Transtornos Parkinsonianos/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Tropanos
6.
N Engl J Med ; 381(8): 739-748, 2019 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-31433921

RESUMO

BACKGROUND: The role of assessment of myocardial viability in identifying patients with ischemic cardiomyopathy who might benefit from surgical revascularization remains controversial. Furthermore, although improvement in left ventricular function is one of the goals of revascularization, its relationship to subsequent outcomes is unclear. METHODS: Among 601 patients who had coronary artery disease that was amenable to coronary-artery bypass grafting (CABG) and who had a left ventricular ejection fraction of 35% or lower, we prospectively assessed myocardial viability using single-photon-emission computed tomography, dobutamine echocardiography, or both. Patients were randomly assigned to undergo CABG and receive medical therapy or to receive medical therapy alone. Left ventricular ejection fraction was measured at baseline and after 4 months of follow-up in 318 patients. The primary end point was death from any cause. The median duration of follow-up was 10.4 years. RESULTS: CABG plus medical therapy was associated with a lower incidence of death from any cause than medical therapy alone (182 deaths among 298 patients in the CABG group vs. 209 deaths among 303 patients in the medical-therapy group; adjusted hazard ratio, 0.73; 95% confidence interval, 0.60 to 0.90). However, no significant interaction was observed between the presence or absence of myocardial viability and the beneficial effect of CABG plus medical therapy over medical therapy alone (P = 0.34 for interaction). An increase in left ventricular ejection fraction was observed only among patients with myocardial viability, irrespective of treatment assignment. There was no association between changes in left ventricular ejection fraction and subsequent death. CONCLUSIONS: The findings of this study do not support the concept that myocardial viability is associated with a long-term benefit of CABG in patients with ischemic cardiomyopathy. The presence of viable myocardium was associated with improvement in left ventricular systolic function, irrespective of treatment, but such improvement was not related to long-term survival. (Funded by the National Institutes of Health; STICH ClinicalTrials.gov number, NCT00023595.).


Assuntos
Ponte de Artéria Coronária , Coração/fisiologia , Isquemia Miocárdica/cirurgia , Volume Sistólico , Idoso , Ecocardiografia sob Estresse , Feminino , Seguimentos , Coração/diagnóstico por imagem , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/mortalidade , Isquemia Miocárdica/fisiopatologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Tomografia Computadorizada de Emissão de Fóton Único , Resultado do Tratamento , Função Ventricular Esquerda
7.
Br J Radiol ; 92(1103): 20190174, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31364397

RESUMO

OBJECTIVE: The effect of functional lung avoidance planning on radiation dose-dependent changes in regional lung perfusion is unknown. We characterized dose-perfusion response on longitudinal perfusion single photon emission computed tomography (SPECT)/CT in two cohorts of lung cancer patients treated with and without functional lung avoidance techniques. METHODS: The study included 28 primary lung cancer patients: 20 from interventional (NCT02773238) (FLARE-RT) and eight from observational (NCT01982123) (LUNG-RT) clinical trials. FLARE-RT treatment plans included perfused lung dose constraints while LUNG-RT plans adhered to clinical standards. Pre- and 3 month post-treatment macro-aggregated albumin (MAA) SPECT/CT scans were rigidly co-registered to planning four-dimensional CT scans. Tumour-subtracted lung dose was converted to EQD2 and sorted into 5 Gy bins. Mean dose and percent change between pre/post-RT MAA-SPECT uptake (%ΔPERF), normalized to total tumour-subtracted lung uptake, were calculated in each binned dose region. Perfusion frequency histograms of pre/post-RT MAA-SPECT were analyzed. Dose-response data were parameterized by sigmoid logistic functions to estimate maximum perfusion increase (%ΔPERFmaxincrease), maximum perfusion decrease (%ΔPERFmaxdecrease), dose midpoint (Dmid), and dose-response slope (k). RESULTS: Differences in MAA perfusion frequency distribution shape between time points were observed in 11/20 (55%) FLARE-RT and 2/8 (25%) LUNG-RT patients (p < 0.05). FLARE-RT dose response was characterized by >10% perfusion increase in the 0-5 Gy dose bin for 8/20 patients (%ΔPERFmaxincrease = 10-40%), which was not observed in any LUNG-RT patients (p = 0.03). The dose midpoint Dmid at which relative perfusion declined by 50% trended higher in FLARE-RT compared to LUNG-RT cohorts (35 GyEQD2 vs 21 GyEQD2, p = 0.09), while the dose-response slope k was similar between FLARE-RT and LUNG-RT cohorts (3.1-3.2, p = 0.86). CONCLUSION: Functional lung avoidance planning may promote increased post-treatment perfusion in low dose regions for select patients, though inter-patient variability remains high in unbalanced cohorts. These preliminary findings form testable hypotheses that warrant subsequent validation in larger cohorts within randomized or case-matched control investigations. ADVANCES IN KNOWLEDGE: This novel preliminary study reports differences in dose-response relationships between patients receiving functional lung avoidance radiation therapy (FLARE-RT) and those receiving conventionally planned radiation therapy (LUNG-RT). Following further validation and testing of these effects in larger patient populations, individualized estimation of regional lung perfusion dose-response may help refine future risk-adaptive strategies to minimize lung function deficits and toxicity incidence.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Relação Dose-Resposta à Radiação , Feminino , Humanos , Neoplasias Pulmonares/radioterapia , Masculino , Pessoa de Meia-Idade , Imagem de Perfusão/métodos , Estudos Prospectivos , Planejamento da Radioterapia Assistida por Computador , Tomografia Computadorizada de Emissão de Fóton Único/métodos
8.
J Surg Oncol ; 120(6): 911-918, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31376162

RESUMO

BACKGROUND: A new technique named "Selected Lymph Node" ("SeLyN") was evaluated, aiming to identify the most functional groin lymph nodes (LNs) for an effective LN transplantation. METHODS: Bilateral lower-limb SPECT-CT was performed in the upper-limb lymphedema patients, to select the most radioactive inguinal LN. Recorded data included demographics, stage, etiology of lymphedema, flap consistency in accordance to preoperative findings, flap size, number of LN, and harvesting time. Infection episodes per year and volume changes of the upper limbs were documented. Donor-site complications were recorded and lower-limb evaluation was performed through clinical examination, volume analysis, and lymphoscintigraphy. RESULTS: A total of 41 patients underwent a "SeLyN" transfer technique. The mean flap size was 28.34 cm2 containing a mean of 3.4 LNs. The mean time spent on flap harvest was 39 minutes. A mean 56.5% volume reduction (P < .001) and a mean 1.41 to 0.29 infection episodes per patient per year (P < .001) were recorded. Clinical evaluation and lymphography of the donor site advocated no major complications for a mean follow-up period of 42.5 months. CONCLUSIONS: "SeLyN" is a safe and effective technique in selecting the most suitable LNs, minimizing the donor-site morbidity, and decreasing the overall operating time.


Assuntos
Neoplasias da Mama/cirurgia , Virilha/cirurgia , Linfonodos/transplante , Vasos Linfáticos/cirurgia , Linfedema/cirurgia , Linfocintigrafia/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adulto , Idoso , Neoplasias da Mama/patologia , Feminino , Seguimentos , Humanos , Linfonodos/diagnóstico por imagem , Linfedema/diagnóstico por imagem , Linfedema/etiologia , Masculino , Mastectomia/efeitos adversos , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos
9.
Medicine (Baltimore) ; 98(30): e16603, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348305

RESUMO

Neuroimaging in the context of examining atypical parkinsonian tauopathies is an evolving matter. Positron emission tomography and single photon emission computed tomography (SPECT) bring tools, which may be reasonable in supplementary examination, however, cannot be interpreted as a criterion standard for correct diagnosis. The aim of this observational study was to assess the differentiating potential of perfusion SPECT in 3 types of atypical parkinsonisms: multiple system atrophy parkinsonian type (MSA-P), corticobasal syndrome (CBS), and progressive supranuclear palsy (PSP). The study was carried out using the comparison of standard deviations of perfusion in patients from these 3 groups. Data obtained from 10 patients with clinical diagnosis MSA-P, 14 patients with CBS and 21 patients with PSP, which were analyzed using Tukey honest significant difference post-hoc test, revealed significant differences of perfusion P < .05 between MSA-P and PSP within the cerebellum and thalamus. No significant differences between CBS and PSP were observed.


Assuntos
Atrofia de Múltiplos Sistemas/diagnóstico , Paralisia Supranuclear Progressiva/diagnóstico , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Idoso , Cerebelo/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Atrofia de Múltiplos Sistemas/diagnóstico por imagem , Transtornos Parkinsonianos/diagnóstico por imagem , Paralisia Supranuclear Progressiva/diagnóstico por imagem , Tálamo/diagnóstico por imagem
10.
Medicine (Baltimore) ; 98(27): e16183, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277123

RESUMO

RATIONALE: Apical hypertrophic cardiomyopathy (AHCM) is a rare form of hypertrophic cardiomyopathy which affects predominantly the apex of the left ventricle. Generally, left ventricular enlargement is not present in AHCM; additionally, endomyocardial fibrosis, and calcification are also rare. PATIENT CONCERNS: A 61-year-old female (Case 1) and a 60-year-old female (Case 2) both presented with the symptoms of atypical chest pain, dyspnoea, exercise intolerance, palpitations. DIAGNOSIS: Magnetic resonance and single-photon emission computed tomography (SPECT) revealed apical hypertrophic cardiomyopathy. Furthermore, 2D-transthoracic echocardiogram showed left atrium and ventricular enlargement, as well as endomyocardial fibrosis and calcification. Based on these findings, the patients were diagnosed with AHCM. INTERVENTIONS: Both the patients were treated with ACEI, metoprolol, and aspirin. Additionally, both these patient underwent genetic test. OUTCOMES: The results of the genetic test of the 2 cases for hypertrophic cardiomyopathy (HCM) were negative. However, the gene mutation for dilated cardiomyopathy (TMPO) was detected in one of the cases. No change in condition during follow-up. LESSONS: In past reports, Apical hypertrophic cardiomyopathy has been shown to have a benign prognosis. But in this case report, the imaging studies of the 2 patients suggest a poor prognosis. Furthermore, diagnosing cardiomyopathy should require multimodality imaging examinations to rule out differential diagnoses.


Assuntos
Calcinose/complicações , Cardiomiopatia Hipertrófica/complicações , Fibrose Endomiocárdica/complicações , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Aspirina/uso terapêutico , Calcinose/diagnóstico por imagem , Calcinose/tratamento farmacológico , Calcinose/patologia , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Cardiomiopatia Hipertrófica/tratamento farmacológico , Cardiomiopatia Hipertrófica/patologia , Ecocardiografia , Eletrocardiografia , Fibrose Endomiocárdica/diagnóstico por imagem , Fibrose Endomiocárdica/tratamento farmacológico , Feminino , Humanos , Imagem por Ressonância Magnética , Metoprolol/uso terapêutico , Pessoa de Meia-Idade , Tomografia Computadorizada de Emissão de Fóton Único
11.
Neurol Neurochir Pol ; 53(4): 265-270, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31343070

RESUMO

AIM: The purpose of this study was to analyse the diagnostic value of gated myocardial perfusion imaging (G-MPI) in the evaluation of myocardial injury in sarcoglycanopathy. MATERIALS AND METHODS: Twenty-eight patients diagnosed with sarcoglycanopathy were evaluated using 99m- -methoxyisobutylisonitrile(99Tcm-MIBI) G-MPI. The data was processed into tomographic images, and the left ventricular function was analysed using quantitative gated SPECT (QGS) to assess the degree of impairment in myocardial and cardiac function. RESULTS: The images of 23 of the patients (82.1%) were positive. Two hundred and twenty-nine sub-segments with abnormal lesions were detected out of 391 cardiac sub-segments of these 23 positive cases. According to the segmental abnormalities, the cases were divided into two cases (8.7%) with single abnormal wall segment, six cases (26.1%) with two abnormal wall segments, and 15 cases (65.2%) with three or more abnormal wall segments or scattered lesions. CONCLUSIONS: 99Tcm-MIBI G-MPI can objectively show impaired myocardium in patients with sarcoglycanopathy. Therefore, this method is helpful for early diagnosis and follow-up of myocardial damage.


Assuntos
Imagem de Perfusão do Miocárdio , Sarcoglicanopatias , Humanos , Compostos Radiofarmacêuticos , Sarcoglicanopatias/diagnóstico , Tecnécio Tc 99m Sestamibi , Tomografia Computadorizada de Emissão de Fóton Único
12.
J Cardiothorac Surg ; 14(1): 141, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337418

RESUMO

BACKGROUND: Severe carotid and intracranial artery stenosis disease (CIAD) is major risk for perioperative stroke in coronary artery bypass grafting. Then, preoperative risk assessment is quite important. CASE PRESENTATION: A 58-years old Japanese woman with bilateral carotid stenosis and bilateral middle cerebral artery occlusion was suffered from worsening effort angina due to severe three coronary vessel disease. Magnetic resonance imaging angiography demonstrated severe carotid and intracranial vessel stenosis. Selective carotid/cerebral angiography also showed severe stenosis and delayed filling of the right internal carotid artery and moderate stenosis of the left internal carotid artery, with occlusion of the bilateral middle cerebral arteries. However, quantitative evaluation with brain perfusion, single-photon emission computed tomography (SPECT) with acetazolamide showed depleted cerebral perfusion volume and vascular responses, particularly in the left middle cerebral artery area. However, both sides of MCA reserve cerebral blood flow was maintained at > 34 ml/100 g/min. So, we finally considered that her cerebral perfusion reserve was maintained a certain level and could tolerate open heart surgery. Then, she underwent off-pump coronary artery grafting. Before sternotomy, prophylactic intra-aortic balloon pump support was used to minimize possible perioperative stroke. As a result, hemodynamic status and brain regional oxygen saturation were stable throughout the operation, and recovered uneventfully. CONCLUSIONS: Preoperative quantitative evaluation using brain perfusion SPECT with acetazolamide is useful in assessing hemodynamic cerebrovascular risk in patients with severe obstructive CIAD. Off pump coronary artery bypass grafting with intra aortic balloon pump assist is a good option for prevention of cerebrovascular morbidity in ischemic heart disease with severe CIAD.


Assuntos
Estenose das Carótidas/diagnóstico por imagem , Artérias Cerebrais/diagnóstico por imagem , Acetazolamida/administração & dosagem , Estenose das Carótidas/fisiopatologia , Estenose das Carótidas/cirurgia , Artérias Cerebrais/fisiopatologia , Artérias Cerebrais/cirurgia , Circulação Cerebrovascular , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/fisiopatologia , Constrição Patológica/cirurgia , Ponte de Artéria Coronária , Feminino , Humanos , Angiografia por Ressonância Magnética , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Medição de Risco , Acidente Vascular Cerebral/prevenção & controle , Tomografia Computadorizada de Emissão de Fóton Único
13.
Artigo em Japonês | MEDLINE | ID: mdl-31327774

RESUMO

This study was to reveal the characteristics for each correction effect of specific binding ratio (SBR) and standardized uptake value (SUV) in the dopamine transporter (DAT) single photon emission computed tomography (SPECT). We created the 123I solution of five radioactive concentrations, which was filled with two types of striatum phantom such as separated or integrated caudate and putamen. We created 10 striatum accumulation models by combining the 123I solution. Images were reconstructed using ordered subset expectation maximization (OSEM) incorporating attenuation correction (AC), scatter correction (SC) or resolution recovery (RR) for the collected data of 10 striatum accumulation models and 66 patients. Correction combinations were AC, ACSC, ACRR and ACSCRR. The SBR, SUVmean and SUVmax were evaluated correlation and relative error between SBR, SUVmean and SUVmax by each correction method. The SBR and SUV had a significant positive correlation with all correction methods. The minimum values of relative error for SBR, SUVmean and SUVmax were 39.7% with ACSCRR, 18.4% with AC and 16.5% with ACSC, respectively. In addition, the ACSC of SBR and SUVmean was almost same value. The SBR showed significantly higher values by incorporating SC, while the SUV was significantly higher values by incorporating RR. It was suggested that SUV could be used for the quantitative index of DAT SPECT. Furthermore, we demonstrated the characteristic among each correction for SBR and SUV.


Assuntos
Tomografia Computadorizada de Emissão de Fóton Único , Proteínas da Membrana Plasmática de Transporte de Dopamina , Humanos , Imagens de Fantasmas
14.
Expert Rev Med Devices ; 16(8): 711-734, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31287715

RESUMO

Introduction: Radioguided surgery is an ever-evolving part of nuclear medicine. In fact, this nuclear medicine sub-discipline actively bridges non-invasive molecular imaging with surgical care. Next to relying on the availability of radio- and bimodal-tracers, the success of radioguided surgery is for a large part dependent on the imaging modalities and imaging concepts available for the surgical setting. With this review, we have aimed to provide a comprehensive update of the most recent advances in the field. Areas covered: We have made an attempt to cover all aspects of radioguided surgery: 1) the use of radioisotopes that emit γ, ß+, and/or ß- radiation, 2) hardware developments ranging from probes to 2D cameras and even the use of advanced 3D interventional imaging solutions, and 3) multiplexing solutions such as dual-isotope detection or combined radionuclear and optical detection. Expert opinion: Technical refinements in the field of radioguided surgery should continue to focus on supporting its implementation in the increasingly complex minimally invasive surgical setting, e.g. by accommodating robot-assisted laparoscopic surgery. In addition, hybrid concepts that integrate the use of radioisotopes with other image-guided surgery modalities such as fluorescence or ultrasound are likely to expand in the future.


Assuntos
Medicina Nuclear , Cirurgia Assistida por Computador/métodos , Humanos , Tomografia por Emissão de Pósitrons , Radioisótopos/química , Tomografia Computadorizada de Emissão de Fóton Único
15.
Int J Nanomedicine ; 14: 4367-4381, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354266

RESUMO

Purpose: Polyethylenimine (PEI) has been widely used as a versatile template to develop multifunctional nanosystems for disease diagnosis and treatment. In this study, we manufactured iodine-131 (131I)-labeled PEI-entrapped gold nanoparticles (Au PENPs) as a novel nanoprobe for single-photon emission computed tomography/computed tomography (SPECT/CT) imaging and radionuclide therapy. Materials and methods: PEI was PEGylated and sequentially conjugated with Buthus martensii Karsch chlorotoxin (BmK CT, a tumor-specific ligand which can selectively bind to MMP2), 3-(4'-hydroxyphenyl)propionic acid-OSu (HPAO), and fluorescein isothiocyanate to form the multifunctional PEI template for entrapment of Au NPs. Then, the PEI surface was radiolabeled with 131I via HPAO to produce the novel nanoprobe (BmK CT-Au PENPs-131I). Results: The synthesized multifunctional Au PENPs before and after 131I radiolabeling were well-characterized as follows: structure, X-ray attenuation coefficient, colloid stability, cytocompatibility, and radiochemical stability in vitro. Furthermore, BmK CT-Au PENPs-131I were suitable for targeted SPECT/CT imaging and radionuclide therapy of tumor cells in vitro and in a xenograft tumor model in vivo. Conclusion: The developed multifunctional Au PENPs are a promising theranostic platform for targeted imaging and treatment of different MMP2-overexpressing tumors.


Assuntos
Ouro/química , Radioisótopos do Iodo/química , Nanopartículas Metálicas/química , Polietilenoimina/química , Compostos Radiofarmacêuticos/uso terapêutico , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Animais , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Coloides/química , Glioma/patologia , Glioma/radioterapia , Humanos , Nanopartículas Metálicas/ultraestrutura , Camundongos Endogâmicos BALB C , Camundongos Nus , Especificidade de Órgãos , Tamanho da Partícula , Propionatos/química , Venenos de Escorpião/toxicidade
16.
Br J Radiol ; 92(1101): 20190184, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31287737

RESUMO

OBJECTIVES: In non-small cell lung cancer (NSCLC) patients, to establish whether the fractional volumes of irradiated anatomic or perfused lung differed between those with and without deteriorating lung function or radiation associated lung injury (RALI). METHODS: 48 patients undergoing radical radiotherapy for NSCLC had a radiotherapy-planning CT scan and single photon emission CT lung perfusion imaging (99mTc-labelled macroaggregate albumin). CT defined the anatomic and the single photon emission CT scan (co-registered with CT) identified the perfused (threshold 20 % of maximum) lung volumes. Fractional volumes of anatomic and perfused lung receiving more than 5, 10, 13, 20, 30, 40, 50 Gy were compared between patients with deteriorating (>median decline) vs stable (30, 40, 50 Gy). Fractional volumes of anatomic and perfused lung receiving > 10 Gy best predicted decline in FEV1 (Area under receiver operating characteristic curve (Az = 0.77 and 0.76 respectively); sensitivity/specificity 75%/81 and 80%/71%) for a 32.7% anatomic and 33.5% perfused volume cut-off. Irradiating an anatomic fractional volume of 4.7% to > 50 Gy had a sensitivity/specificity of 83%/89 % for indicating RALI (Az = 0.83). CONCLUSION: A 10-20 Gy radiation dose to anatomic or perfused lung results in decline in FEV1. A fractional anatomic volume of >5% receiving >50 Gy influences development of RALI. ADVANCES IN KNOWLEDGE: Extent of low-dose radiation to normal lung influences functional respiratory decline.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Lesões por Radiação/diagnóstico por imagem , Planejamento da Radioterapia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/efeitos da radiação , Neoplasias Pulmonares/radioterapia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Dosagem Radioterapêutica , Tomografia Computadorizada de Emissão de Fóton Único/métodos
17.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 36(3): 511-514, 2019 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-31232557

RESUMO

Chronic kidney disease (CKD) is now recognized as a worldwide public health challenge, and the incidence rate and hospitalization rate have significantly increased in recent years. Without prompt diagnoses and effective treatment in the early renal function damage of CKD, the symptoms will continue to worsen and eventually develop into end-stage renal disease. Functional imaging techniques such as single photon emission computed tomography (SPECT), contrast-enhanced ultrasound (CEUS), computerized tomography perfusion (CTP), and magnetic resonance perfusion weighted imaging (MR-PWI) could be used to quantitatively analyze renal perfusion and renal filtration function. Their diagnostic values are increasingly evident and have become the research hotspot in evaluating renal function. The aim of this review is to briefly evaluate the research and application advances in the early renal function damage assessment of CKD, so as to raise the efficiency of clinical applications.


Assuntos
Insuficiência Renal Crônica/diagnóstico por imagem , Humanos , Rim/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Ultrassonografia
18.
Artigo em Russo | MEDLINE | ID: mdl-31166314

RESUMO

OBJECTIVE: To study the effect of metabolic characteristics of the tumor determined by 99mTc-MIBI single-photon emission computed tomography (SPECT) and various molecular genetic features on the outcomes of combination treatment of hemispheric glioblastomas. MATERIAL AND METHODS: This single-center prospective cohort study involved 68 patients aged 25-78 years (38 males and 30 females) with primary glioblastomas. Hypermetylation of the promotor region of the MGMT gene was observed in 24 (42%) out of 57 patients. The IDH1 mutation was revealed in two (3.5%) patients. The catamnestic data were available for 66 out of 68 patients. The first SPECT/CT study was carried out before chemoradiation therapy; the second SPECT/CT study was performed after the chemoradiation therapy. In each study, quantitative measures were calculated for the early (15-30 min after the patient had received a radiopharmaceutical) and late (after 45-60 min) phases. RESULTS: The actuarial survival rates after 12 and 24 months were 69.6 and 29.1%, respectively. The median overall survival rate was 17.5 months (95% CI 12.9-20.3). Favorable prognostic factors for overall survival included the higher uptake index (UI) in the late phase compared to UI in the early phase of the first SPECT/CT study (p=0.0444), dynamics of changes in UI during the second SPECT/CT compared to baseline over 10% (p=0.0436), MGMT hypermethylation (p=0.0003), and duration of the period between surgery and initiation of chemoradiotherapy being <1 month (p=0.0008). No statistically significant correlations were revealed between the absolute UI values in the tumor and its molecular genetic features. CONCLUSION: The 99mTc-MIBI SPECT/CT can be used to predict overall survival and to plan radiation therapy of glioblastoma as it is more readily available at primary healthcare facilities than amino acid PET.


Assuntos
Neoplasias Encefálicas , Glioblastoma , Tecnécio Tc 99m Sestamibi , Adulto , Idoso , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/metabolismo , Feminino , Glioblastoma/diagnóstico por imagem , Glioblastoma/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X
19.
Nuklearmedizin ; 58(3): 258-264, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31075799

RESUMO

INTRODUCTION: Thyroid scintigraphy with 99mTc-methoxyisobutylisonitrile (MIBI) is a helpful tool for the risk stratification of thyroid nodules (TN). Whereas a nodule with low or hypointense MIBI uptake has a low risk for malignancy, a hyperintense uptake may indicate a malignant nodule, which requires surgical resection. The appropriate diagnostic or therapeutic regimen of an isointense nodule with an uptake similar to the paranodular tissue is discussed controversially. Aim of this study was to assess the interobserver agreement (IA) for the assignment of TN to the three categories: hypo-, iso-or hyperintense. METHODS: Retrospective analysis of planar and SPECT images of MIBI scintigraphy was performed in 36 randomly selected patients with hypofunctioning TN and histological diagnosis. Four observers with different levels of experience in MIBI-scintigraphy analyzed MIBI uptake and assigned the nodules to the appropriate category. To assess the IA, Fleiss' Kappa was calculated. RESULTS: The study cohort included 11 patients with papillary thyroid carcinoma (diameter 20.3 mm) and 25 patients with benign nodules (diameter 24.8 mm). The IA for all nodules using planar images was 0.76 compared to 0.80 for SPECT images. The IA was better in the subgroup of malignant nodules for planar images as well as SPECT images (Kappa 0.91 and 0.90, respectively) compared to benign nodules (0.65 and 0.76, respectively). Using SPECT images, only one thyroid carcinoma presented with hypointense uptake, the remainder with hyper- or isointense uptake. In contrast, benign nodules were found in all categories. CONCLUSION: MIBI scintigraphy shows a good IA for the interpretation of thyroid carcinoma. The IA is further improved if MIBI scintigraphy is performed in SPECT technique.


Assuntos
Carcinoma Papilar/patologia , Cintilografia/métodos , Tecnécio Tc 99m Sestamibi/metabolismo , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Carcinoma Papilar/diagnóstico por imagem , Seguimentos , Humanos , Variações Dependentes do Observador , Prognóstico , Compostos Radiofarmacêuticos/metabolismo , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem
20.
Methods Mol Biol ; 1974: 355-369, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31099014

RESUMO

The use of cationic polymers to interact with negatively charged siRNA via charge complexation to form polyelectrolyte complexes has been widely studied ever since the 1998 report on RNA interference. These polyelectrolyte complex formulations aim to overcome the many pitfalls associated with the use of RNA interference as a potential cancer therapy. The triblock copolymer polyethylenimine-polycaprolactone-polyethylene glycol (PEI-PCL-PEG) contains the cation PEI and has been shown to be an efficient carrier capable of complexing with nucleic acids for gene delivery. This copolymer system also allows for targeting moieties to be linked to the micelleplex, thereby exploiting overexpressed receptors (such as the folate receptor) located within tumors. Additionally, we demonstrated recently that microfluidic mixing of PEI-PCL-PEG nanoparticles allows for the rapid, scaled-up production of micelleplexes while maintaining small and uniform particle distributions. The preparation of small and reproducible particles is imperative for clinical translation of nanomedicine and for tumor targeting via systemic administration. Furthermore, to enable tracing of its deposition in vivo after its administration, micelleplexes can be radiolabeled. To assess tumor targeting over time, the noninvasive imaging technique single-photon emission computed tomography (SPECT) offers the ability to examine the same subject at multiple time points and generate biodistribution profiles. Since the biodistribution and tumor targeting of the therapeutic load of micelleplexes is of foremost interest, we recently described an approach to modify siRNA with a DTPA (diethylenetriaminepentaacetic acid) chelator. Herein, we explain the details of encapsulating indium-labeled siRNA via microfluidic mixing in PEI-PCL-PEG nanoparticles with a folic acid targeting ligand for assessment of their in vivo tumor targeting in an orthotopic ovarian cancer model.


Assuntos
Microfluídica/métodos , Nanopartículas/química , Neoplasias Ovarianas/terapia , RNA Interferente Pequeno/genética , Animais , Linhagem Celular Tumoral , Feminino , Xenoenxertos/diagnóstico por imagem , Humanos , Camundongos , Nanopartículas/uso terapêutico , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , Ácido Pentético/química , Ácido Pentético/farmacologia , Poliésteres/química , Polietilenoglicóis/química , Polietilenoimina/química , RNA Interferente Pequeno/química , RNA Interferente Pequeno/farmacologia , Tomografia Computadorizada de Emissão de Fóton Único
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