Iofetamine I 123 single photon emission computed tomography is accurate in the diagnosis of Alzheimer's disease.

To determine the diagnostic accuracy of iofetamine hydrochloride I 123 (IMP) with single photon emission computed tomography in Alzheimer's disease, we studied 58 patients with AD and 15 age-matched healthy control subjects. We used a qualitative method to assess regional IMP uptake in the entire brain and to rate image data sets as normal or abnormal without knowledge of subjects'clinical classification. The sensitivity and specificity of IMP with single photon emission computed tomography in AD were 88% and 87%, respectively. In 15 patients with mild cognitive deficits (Blessed Dementia Scale score, less than or equal to 10), sensitivity was 80%. With the use of a semiquantitative measure of regional cortical IMP uptake, the parietal lobes were the most functionally impaired in AD and the most strongly associated with the patients' Blessed Dementia Scale scores. These results indicated that IMP with single photon emission computed tomography may be a useful adjunct in the clinical diagnosis of AD in early, mild disease.

Second virial coefficient of rod-shaped molecules and molecular dynamics simulations of the isotropic phase.

The second virial coefficient, B(2) is computed of linear rigid rods composed of m equally spaced sites interacting with sites on other rods via the hard-sphere or Weeks-Chandler-Andersen (WCA) pair potentials. The dependence of B(2) on a wide range of separation distance between the sites L and m for both types of potential is computed. Molecular dynamics simulations were carried out of the thermodynamic, static, and percolation properties of the WCA rigid rods in the isotropic phase as a function of rod number density ρ. Simple scaling relationships are discovered between thermodynamic and other static properties as a function of ρ and m, which extend well into the semidilute density range. The percolation threshold distance (PTD) between the centers of mass of the rods complies well with a mean-field random orientation approximation from low density well into the semidilute regime. The corresponding site-site PTD proved more problematic to represent by simple functions, but at high rod density, scales better with the number of sites density rather than the rod number density.

Cerebral perfusion imaging in Alzheimer's disease. Use of single photon emission computed tomography and iofetamine hydrochloride I 123.

We used single photon emission computed tomography (SPECT) to study 15 patients with Alzheimer's disease and nine controls. Iofetamine hydrochloride I 123 uptake data were recorded from the entire brain using a rotating gamma camera. Activity ratios were measured for the frontal, posterior parietal, posterior, medial, and lateral cortical temporal regions and striate cortex and were normalized by the activity in the cerebellum. Abnormalities in iofetamine hydrochloride I 123 activity were similar to the abnormalities in glucose metabolism observed with positron emission tomography. Cortical tracer activity was globally depressed in patients with Alzheimer's disease, with the greatest reduction in the posterior parietal cortex.

Increased iofetamine I 123 brain uptake in metastatic melanoma.

Four of five patients with brain metastases from melanoma had increased lofetamine I 123 uptake in the region of the tumor deposits. A comparison group of five patients with melanoma with no clinical or radiologic evidence of brain involvement and 46 of 47 patients without malignant melanoma but with known brain tumors of other histologic types had normal or decreased iofetamine I 123 brain uptake in the region of the tumor. An exception was one patient whose metastatic small cell lung cancer to the brain showed focally increased uptake. These findings suggest that certain brain tumors such as melanoma are capable of selectively binding iofetamine I 123 because of specific chemical properties of the radiopharmaceutical. Increased uptake of iofetamine I 123 in brain lesions in a patient at risk for metastatic melanoma may be a useful aid to differential diagnosis.

Performance of collimators used for tomographic imaging of I-123 contaminated with I-124.

Iodine-123 prepared from the 124Te(p,2n)123I reaction is contaminated with between 3% to 5% I-124 when imaging is performed. The effects of such a mixture were evaluated for medium-energy and low energy general-purpose collimators on a commercially available rotating gamma camera equipped to perform tomography. The planar sensitivity for I-123 was less for the general-purpose collimator, varying between 0.84 and 0.85 in water relative to that measured for the medium energy-collimator. Counts due to scattering or septal penetration of I-124 photons were greater for the general-purpose collimator (36%) than for the medium-energy collimator (15%). Evaluation of the higher-frequency components of the modulation transfer functions confirmed that the low-energy general-purpose collimator is expected to offer significantly more contrast information at frequencies above 0.21 cycles/cm. This is expected to contribute to image quality when studies are performed with collimators of similar design.

Characteristics of a scanning, multidetector, single-photon ECT body imager.

We evaluated a single-photon emission computed tomographic system using ten scanning detectors in a circular array. The system uses focusing collimators that scan radially as well as tangentially. The spatial resolution in the tomographic plane is 2.6 cm FWHM and the axial resolution is 3.3 cm FWHM. The resolution is independent of position within the field of view, and nearly independent of energy through 511 keV. Sensitivity was found to be 4600 cps/muCi-ml for an extended phantom, 20-cm in diameter, filled with Tc-99m; 7200 cps/muCi-ml with TI-201; and 8000 cps/muCi-ml with Ga-67. Investigations of positional uniformity indicated some quantitative distortion of data due to inadequate attenuation correction. Improvement in the attenuation correction is necessary before truly quantitative tracer distribution studies are undertaken.

I-123 HIPDM brain imaging with a rotating gamma camera and slant-hole collimator.

The performance of a slant-hole collimator was compared with that of a standard straight-bore, low-energy collimator for tomographic imaging of I-123-iodinated amine brain agents. Improved in-slice resolution was due to the greater proximity between collimator and the subjects' heads. We conclude that high quality tomographic images of the brain can be obtained from rotating cameras equipped with slant-hole collimators.

A new Tc-99m-labeled myocardial imaging agent, hexakis(t-butylisonitrile)-technetium(I) [Tc-99m TBI]: initial experience in the human.

The cationic complex Tc-99m hexakis(t-butylisonitrile)technetium(I) (TBI) has been shown to concentrate in the myocardial tissue of several animal species. In the present preliminary study, the biodistribution of this material was examined in four normal subjects and in two patients with coronary artery disease. In three normal humans injected at rest, planar, tomographic, and gated myocardial images of high technical quality were obtained between 1 and 4 hr after injection. In one subject studied both at rest and during maximal exercise, the lung and heart activities were similar, whereas the liver-to-heart activity ratio was 3:1 at 60 min at rest compared with 1.8:1 with maximal exercise. In two patients with coronary artery disease, transient ischemia appeared as a perfusion defect up to 4 hr after injection at maximal exercise, and the image appeared normal when Tc-99m TBI was administered at rest. The images of areas of infarction appeared abnormal after injection at rest and after injection during exercise. Technetium-99m TBI is a promising myocardial imaging agent that may permit high-quality planar, gated, and tomographic imaging of myocardial ischemia and infarction.

Measurement of infarct size using single photon emission computed tomography and technetium-99m pyrophosphate: a description of the method and comparison with patient prognosis.

The application of dual tracer transaxial emission computed tomography of the heart was studied with use of technetium-99m pyrophosphate and technetium-99m-labeled red blood cells for measuring infarct size in 20 patients with acute myocardial infarction and 10 without infarction. Imaging was performed with a standard gamma camera and with a multidetector transaxial emission computed tomographic body scanner 3 hours after injection of technetium-99m pyrophosphate. Immediately after the scanning procedure, technetium-99m pertechnetate was injected to label red blood cells, and the scanning protocol was repeated. Technetium-99m pyrophosphate was detected in the anterior wall with involvement of the interventricular septum or lateral wall in patients with electrocardiographic criteria for anterior infarction, whereas uptake was detected in the diaphragmatic left ventricular wall with involvement of the posterior, posteroseptal or posterolateral left ventricle or of the right ventricle in patients with electrocardiographic criteria for inferior or posterior infarction. Infarct size measured from transaxial images ranged from 14.0 to 117.0 g in weight. There was a direct relation between infarct size and patient prognosis in that, of the 13 patients with infarct greater than 40 g, 11 (85 percent) had complications, whereas only 2 (29 percent) of 7 patients with an infarct less than 40 g had complications during a follow-up period averaging 17.8 months (p less than 0.05).

The complementary role of SPECT in the diagnosis of cavernous hemangioma of the liver.

Cavernous hemangiomas are the most common benign tumors of the liver. Although their clinical course is usually uncomplicated, an accurate diagnosis may be important to exclude conditions that need treatment, (or to avoid an unnecessarily risky percutaneous biopsy). Although blood pool scintigraphy using planar gamma camera imaging is a reliable examination for the diagnosis of liver hemangiomas, it may fail to depict small, deeply seated lesions, and hence miss the diagnosis. Two cases are reported in which SPECT demonstrated delayed pooling in small, deep, space-occupying lesions, which were poorly seen on planar images, and therefore made a cavernous hemangioma the most likely diagnosis.

The utilization of technetium-99m CPI as a myocardial perfusion imaging agent in exercise studies.

Myocardial perfusion imaging with Tc-99m carbomethoxyisopropylisonitrile (CPI) was compared with Tl-201 imaging in 22 patients who were assessed for coronary artery disease. There was agreement between Tc-99m CPI and Tl-201 imaging for detecting segmental myocardial ischemia and fixed defects in 185/198 (93%) of left ventricular segments. There was also an excellent correlation between the two tracers for the detection of coronary artery disease (18/22 patients). Myocardial clearance of the isonitrile complex was slow, and there was no redistribution into ischemic regions; the normal to ischemic myocardial ratio remained relatively constant over time. Reinjection at rest was used to distinguish transient ischemia from infarction. The isonitrile complex was excreted rapidly via the hepatobiliary system. After 3 hours, background activity was reduced to about 20% of the initial activity. Tc-99m CPI appears comparable to Tl-201 thallous chloride for detecting coronary artery disease. Tc-99m CPI may be useful as a myocardial imaging agent because there is no myocardial redistribution, myocardial clearance is slow, and clearance from background tissues is rapid.

Decreased iodine-123 IMP caudate nucleus uptake in patients with Huntington's disease.

To determine whether I-123 isopropyl iodoamphetamine (IMP) uptake is reduced in the basal ganglia of patients with Huntington's disease compared with that in aged-matched normal and abnormal control subjects, a caudate ratio was defined that compared the average separation (in pixel units) between the midline and the left and right caudate heads to the width of the brain as measured on transaxial cross-sections of I-123 IMP SPECT brain images. For six patients with Huntington's disease, the average caudate ratio was 29.0% (SD +/- 2.7%), significantly higher than that for 12 normal volunteer subjects (average caudate ratio, 19.1% +/- 3.5%; p less than 0.001) and 13 patients with a variety of other neurologic disorders (average caudate ratio, 19.3 +/- 2.2%; p less than 0.001).

Myocardial clearance of Tc-99m hexakis-2-methoxy-2-methylpropyl isonitrile (MIBI) in patients with coronary artery disease.

Myocardial clearance of the new cationic, lypophilic myocardial perfusion agent, Tc-99m-hexakis-2-methoxy-2-methylpropyl isonitrile (MIBI) was studied in nine patients with coronary artery disease. Regional time-activity curves were determined from serial postexercise myocardial SPECT images after a single dose of Tc-99m MIBI. There were significant differences between the clearance rates from normal and ischemic myocardium. Tc-99m MIBI washout from normal myocardium was 27 +/- 8% by 6 hours after injection. Clearance from mild myocardial defects (initial activity greater than 60% of the activity in normal myocardium) was 16% by 6 hours in six patients. No washout was detected by 6 hours in the three patients with severe myocardial defects. The ratio between the activity in ischemic and normal myocardium increased from 0.70 +/- 0.08 to 0.80 +/- 0.13 and 0.84 +/- 0.13 at 4 and 6 hours after injection in the patients with mild defects. In the patients with large defects, the ratio increased from 0.42 +/- 0.09 to 0.54 +/- 0.07 at 6 hours. It is concluded that, while redistribution is substantially slower than with Tl-201, image interpretation and data evaluation should be approached cautiously when imaging is delayed 4 hours or more after injection of Tc-99m MIBI. Quantitative techniques aimed at evaluating the extent and intensity of myocardial ischemia will be particularly affected.

Computed tomography in nuclear medicine.

Utilizing mathematical techniques and computer processing similar to those employed in x-ray transmission computed tomography and magnetic resonance imaging, cross-sectional images of radiopharmaceutical distribution are demonstrating encouraging maps of organ physiology and pathophysiology. The basic concepts of single photon emission computed tomography (SPECT), and some of its clinical implications, are presented to demonstrate the potential applications of this new modality.

Brownian dynamics simulations of associating diblock copolymers.

A novel coarse-grained computational model for associating polymers is proposed that is based on a Gaussian "blob" representation of the polymer chains. The model allows a large number of model polymers to be simulated at moderate computational cost over a wide packing fraction range using the Brownian dynamics, BD, technique. The attraction of the hydrophobic part of the polymer to those on other molecules can lead to strong aggregation of the polymer molecules in real systems, and this is included in the model by an attractive potential felt by the Gaussian blobs to a common "nodal" point that represents the center of the micelle. Attention here is confined to model AB diblock copolymers in which the hydrophilic block, A, has a much higher mass than the hydrophobic moiety, B, which leads to relatively small aggregation numbers, Nagg, of approximately 8. The aggregation number at low packing fractions is found to increase with packing fraction, as observed in experiments, with a functional form that closely follows a simple theory derived here that is based on entropy-derived mean-field terms for the free-energy change associated with the incorporation of the polymer molecule into the micelle. The computational model exhibits an extremely low critical micelle concentration (cmc), and micelles with Nagg approximately 5 are observed at the lowest packing fractions, phi, simulated ( approximately 10-4), which is consistent with experiment. The long-time self-diffusion coefficient of the polymers (and hence micelles) decreases logarithmically with packing fraction, and the viscosity increased with concentration according to the Huggins equation. The spherical blob coarse graining results in the simulable time scales being longer than the Rouse time of the chain, and hence for the nonassociating polymers the intrinsic viscosity is an input parameter in the model. The introduction of association leads to the partial inclusion of the intrinsic viscosity in the simulation and has an effect on the computed Huggins coefficient, kH, which is found to be approximately 6 in those cases.

Interaction of sodium dodecyl sulfate with methacrylate-PEG comb copolymers.

A series of sodium methacrylate and poly(ethylene glycol) (PEG) comb copolymers (MAA/PEG) with approximate PEG chain lengths of 7, 11, and 22 ethylene oxide units were synthesized by free radical polymerization. Their weight-average molecular mass was found to be approximately 66 000. A commercial sample of a PEG comb polymer with an acrylic backbone was also used in the studies (Sokalan HP 80). The interaction of the MAA/PEG comb polymers and pure sodium methacrylate (SPMA) with sodium dodecyl sulfate (SDS) was studied by ESR spectroscopy using 5-doxyl stearic acid (5-DSA) spin probe and by conductivity measurements. Surfactant aggregation in water occurred at SDS concentrations lower than the surfactant critical micelle concentration (cmc) and depended on the polymer concentration. The observations have been attributed to changes in the effective ionic strength of the systems due to the polymer itself, and it has been concluded that there is no interaction between the MAA/PEG comb copolymers or SPMA and SDS. This has been confirmed by the fact that the decrease in surfactant aggregation concentration is similar in magnitude to the decrease observed on adding NaCl when counterion ion condensation effects are taken into account. It is apparent that the electrostatic repulsions between the surfactant molecules and the methacrylate backbone of the MAA/PEG comb copolymers inhibit association of SDS with the PEG side chains.

Cavernous hemangioma of the liver: detection with single-photon emission computed tomography.

The roles of single-photon emission computed tomography (SPECT) and planar imaging with technetium-99m-labeled red blood cells in the diagnosis of cavernous hemangioma of the liver were evaluated. The study group consisted of 26 consecutive patients referred for evaluation of liver lesions. A total of 23 cavernous hemangiomas were found, all of which showed decreased or normal flow and delayed uptake of the radiotracer. SPECT demonstrated 13 hemangiomas that were not detected with planar imaging; both modalities demonstrated the other ten lesions. Lesions that were not cavernous hemangiomas showed either normal (n = 6) or increased (n = 4) flow; none had delayed increased uptake on either planar or SPECT images. SPECT with labeled red blood cells is an accurate method for the detection of cavernous hemangiomas of the liver and is more sensitive than planar imaging in depicting small lesions.

Cerebral abnormalities in cocaine abusers: demonstration by SPECT perfusion brain scintigraphy. Work in progress.

Single photon emission computed tomography (SPECT) perfusion brain scans with iodine-123 isopropyl iodoamphetamine (IMP) were obtained in 12 subjects who acknowledged using cocaine on a sporadic to a daily basis. The route of cocaine administration varied from nasal to intravenous. Concurrent abuse of other drugs was also reported. None of the patients were positive for human immunodeficiency virus. Brain scans demonstrated focal defects in 11 subjects, including seven who were asymptomatic, and no abnormality in one. Among the findings were scattered focal cortical deficits, which were seen in several patients and which ranged in severity from small and few to multiple and large, with a special predilection for the frontal and temporal lobes. No perfusion deficits were seen on I-123 SPECT images in five healthy volunteers. Focal alterations in cerebral perfusion are seen commonly in asymptomatic drug users, and these focal deficits are readily depicted by I-123 IMP SPECT.