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Perfusion scintigraphy

Søren Hess, Evan C Frary, Oke Gerke, Poul Henning Madsen
Pulmonary embolism (PE) is a common, ubiquitous, and potentially lethal disease. As symptoms and clinical findings are notoriously nonspecific, diagnostic imaging is essential to avoid undertreatment as well as overtreatment. Controversies remain regarding first-line imaging in suspected PE. The two main contemporary contenders are ventilation/perfusion scintigraphy with single-photon emission computed tomography (V/Q SPECT) with or without additional low-dose CT (SPECT/CT) and CT angiography (CTA). We present our results from a systematic review and meta-analysis of the diagnostic performances of these modalities: V/Q SPECT, V/Q SPECT/CT, and CTA are all viable options, but we consider V/Q SPECT/CT to be superior in most clinical settings with better overall diagnostic performance, that is, pooled sensitivities (97...
October 20, 2016: Seminars in Thrombosis and Hemostasis
Jose F Condado, Vasilis Babaliaros, Travis S Henry, Brian Kaebnick, Dennis Kim, Gerald W Staton
BACKGROUND: The best treatment of patients with external pulmonary vascular compression due to advanced sarcoidosis is unknown. OBJECTIVES: To report a single-center experience of percutaneous treatment for pulmonary vascular stenosis caused by external compression due to advanced sarcoidosis. METHODS: We report a case series of 5 patients with biopsy confirmed advanced sarcoidosis, seen at our academic institution with worsening dyspnea despite increase of immunosuppressive therapy...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Yusuf Ziya Tan, Semra Özdemir, Burak Altun, Fatmanur Çelik
OBJECTIVE: This study aimed to investigate the effects of assessment with myocardial perfusion scintigraphy (MPS) and heart rate recovery (HRrec) measurements in combination to evaluate the current status of patients with a diagnosis or suspicion of coronary artery disease (CAD). METHODS: A total of 350 patients were included in the study. CAD group consisted of 200 patients with stable angina pectoris and a known history of CAD, while the control group consisted of 150 patients with suspicious stress test who had no history of known CAD...
October 5, 2016: Molecular Imaging and Radionuclide Therapy
Emmelie Stock, Katrien Vanderperren, Tim Bosmans, André Dobbeleir, Luc Duchateau, Myriam Hesta, Lien Lybaert, Kathelijne Peremans, Eva Vandermeulen, Jimmy Saunders
Contrast-enhanced ultrasound (CEUS) is an emerging technique to evaluate tissue perfusion. Promising results have been obtained in the evaluation of renal perfusion in health and disease, both in human and veterinary medicine. Renal scintigraphy using 99mTc-Mercaptoacetyltriglycine (MAG3) is another non-invasive technique that can be used to evaluate renal perfusion. However, no data are available on the ability of CEUS or 99mTc- MAG3 scintigraphy to detect small changes in renal perfusion in cats. Therefore, both techniques were applied in a normal feline population to evaluate detection possibilities of perfusion changes by angiotensin II (AT II)...
2016: PloS One
Saeed Elojeimy, Irene Cruite, Stephen Bowen, Jing Zeng, Hubert Vesselle
OBJECTIVE: In this article, we describe the concepts of ventilation-perfusion planar, SPECT, and SPECT/CT and outline the advantages of integrated ventilation-perfusion SPECT/CT over planar imaging. We present an overview of the traditional and new applications of ventilation-perfusion scintigraphy. CONCLUSION: SPECT/CT has improved the diagnostic accuracy of ventilation-perfusion imaging and opened the door for a new spectrum of applications.
October 11, 2016: AJR. American Journal of Roentgenology
Christopher J François, Mark L Schiebler
Multimodality, noninvasive imaging is increasingly used in the identification and management of pulmonary hypertension (PH). Chest radiography, ventilation-perfusion scintigraphy, and Doppler echocardiography are frequently the initial studies used to evaluate patients suspected of having PH. However, their ability to evaluate the right ventricle (RV) and pulmonary vasculature is limited. Computed tomography (CT) and magnetic resonance (MR) imaging are increasingly used to identify causes of PH and assess the effect of PH on RV function...
November 2016: Radiologic Clinics of North America
Asim Rizvi, Bríain Ó Hartaigh, Paul Knaapen, Jonathon Leipsic, Leslee J Shaw, Daniele Andreini, Gianluca Pontone, Subha Raman, Muhammad Akram Khan, Michael Ridner, Faisal Nabi, Alessia Gimelli, James Jang, Jason Cole, Ryo Nakazato, Christopher Zarins, Donghee Han, Ji Hyun Lee, Jackie Szymonifika, Millie J Gomez, Quynh A Truong, Hyuk-Jae Chang, Fay Y Lin, James K Min
BACKGROUND: Coronary computed tomography angiography (CCTA) allows for non-invasive assessment of obstructive coronary artery disease (CAD) beyond measures of stenosis severity alone. This assessment includes atherosclerotic plaque characteristics (APCs) and calculation of fractional flow reserve (FFR) from CCTA (FFRCT). Similarly, stress imaging by myocardial perfusion scintigraphy (MPS) provides vital information. To date, the diagnostic performance of integrated CCTA assessment versus integrated MPS assessment for diagnosis of vessel-specific ischemia remains underexplored...
October 6, 2016: BMC Cardiovascular Disorders
Biao Si, Zhao-Sheng Luan, Tong-Jian Wang, Yan-Song Ning, Na Li, Meng Zhu, Zhong-Min Liu, Guang-Hong Ding, Bin Qiao
The aim of the present study was to determine the distribution of lung blood in a modified bilateral Glenn procedure designed in our institute with lung perfusion scintigraphy. Sixteen consecutive patients who underwent modified bilateral Glenn operation from 2011 to 2014 were enrolled in the study. The control group consisted of 7 patients who underwent bidirectional Glenn shunt. Radionuclide lung perfusion scintigraphy was performed using Tc-99m-macro aggregated albumin (MAA) in all patients. For the patients in modified bilateral Glenn group, the time at which the radioactivity accumulation peaked did not differ significantly between the right and left lung field (t = 0...
September 2016: Medicine (Baltimore)
Semra Ozdemir, Yusuf Ziya Tan, Emine Gazi
In this study, we have compared scintigraphic and echocardiographic data in order to investigate whether increased septal perfusion represents asymmetrical septal hypertrophy (ASH), which is a symptom followed in the scintigraphy of myocardial perfusion. The study consists of a total of 186 patients (120 females and 66 males with an average age of 59.45 ± 11.54 years) who had normal myocardial perfusion scintigraphy and echocardiography examinations. Statistical comparison of septal wall thickness measurements obtained from echocardiography and septal-to-lateral wall ratios (S/L ratio) was performed scintigraphically...
September 2016: World Journal of Nuclear Medicine
Carmine Siniscalchi, Claudio Reverberi, Nicola Gaibazzi
BACKGROUND AND AIM: Individuals with ischemia during cardiac stress-test (cST) have a high risk of developing myocardial infarction (MI), but the pathophysiologic mechanism has never been clarified. It is thought that non flow-limiting coronary plaques (FLP) cause more often MI than FLP, but this is in contradiction with the predictive value of cST. We investigated the correspondence between reversible ischemia and location of subsequent MI, since functional assessment shortly before MI could clarify whether the culprit plaque is a FLP or not...
2016: Acta Bio-medica: Atenei Parmensis
Milan Simanek, Pavel Koranda
Hybrid pulmonary imaging in the present day has seen a fusion of various uses of CT scans, including angiography (CTAG), diagnostic CT, low dose CT (LDCT), and perfusion or ventilation scintigraphy in tomographic or planar imaging. Determining the most effective individualized test for the complete diagnostics of patients with pulmonary symptoms for various groups of patients is a major issue. The aim of the present study was to assess the effectiveness of the implementation of hybrid imaging in current methods of nuclear medicine in differential diagnostics of pulmonary embolism (PE)...
2016: American Journal of Nuclear Medicine and Molecular Imaging
Søren Hess, Poul Henning Madsen
Diagnostic imaging plays an integral role in the diagnostic workup of suspected pulmonary embolism, and several modalities have been employed over the years. In recent years, the choice has been narrowed to either computer tomographic or radionuclide based methods, i.e. computer tomographic angiography (CTA) and ventilation-perfusion scintigraphy (V/Q-scan). Both methods display advantages and shortcomings, and while we provide some insights into CTA and alternative methods, the paper's main focus is a review of the V/Q-scan...
September 13, 2016: Advances in Experimental Medicine and Biology
John P Greenwood, David P Ripley, Colin Berry, Gerry P McCann, Sven Plein, Chiara Bucciarelli-Ducci, Erica Dall'Armellina, Abhiram Prasad, Petra Bijsterveld, James R Foley, Kenneth Mangion, Mark Sculpher, Simon Walker, Colin C Everett, David A Cairns, Linda D Sharples, Julia M Brown
IMPORTANCE: Among patients with suspected coronary heart disease (CHD), rates of invasive angiography are considered too high. OBJECTIVE: To test the hypothesis that among patients with suspected CHD, cardiovascular magnetic resonance (CMR)-guided care is superior to National Institute for Health and Care Excellence (NICE) guidelines-directed care and myocardial perfusion scintigraphy (MPS)-guided care in reducing unnecessary angiography. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, 3-parallel group, randomized clinical trial using a pragmatic comparative effectiveness design...
September 13, 2016: JAMA: the Journal of the American Medical Association
Svetlana I Sazonova, Julia N Ilyushenkova, Yuri B Lishmanov, Roman E Batalov, Alexey E Sazonov, Ludmila A Larionova, Evgeniy A Nesterov, Natalia V Varlamova, Julia V Rogovskaya, Tatyana A Shelkovnikova, Sergey V Popov
OBJECTIVE: Aim was to study the performance of single-photon emission computed tomography (SPECT) with (99m)Tc-pyrophosphate ((99m)Tc-PYP) in diagnostics of chronic latent inflammation in myocardium of patients with atrial fibrillation (AF). METHODS: The research included 70 patients (the average age of 49.3 ± 10.2 years) with persistent form of idiopathic AF. All patients underwent myocardium SPECT with (99m)Tc-PYP and cardiac magnetic resonance imaging (CMR) before the ablation...
August 24, 2016: Annals of Nuclear Medicine
Malak Itani, Joanna Fair, Zachary Hillman, Fatemeh Behnia, Saeed Elojeimy
A 52-year-old woman presenting with dyspnea was referred for a ventilation and perfusion scan (VQ). VQ images (with Tc-DTPA [diethylene triamine pentaacetic acid aerosol] and Tc-MAA [macroaggregated albumin]) initially appeared normal; however, count rates on perfusion images were similar to ventilation images, implying little Tc-MAA had reached the lungs. Spot images of the injected extremity demonstrated focal Tc-MAA accumulation worrisome for a venous thrombus, subsequently confirmed by Doppler ultrasound...
October 2016: Clinical Nuclear Medicine
Hisashi Sugiyama, Tetsuko Ishii, Toshio Nakanishi, In-Sam Park
BACKGROUND: Multiple plexus-like coronary to pulmonary fistulas (CAPFs) originating from bilateral coronary arteries are a rare type of coronary artery fistula (CAF). Their etiology and therapeutic strategy are discussed. METHODS AND RESULTS: Three patients were diagnosed with dual origin plexus-like CAFs drained to the pulmonary artery trunk. Their ages ranged from 40 to 78 years. Enhanced computed tomography could clearly demonstrate three-dimensional anatomy of CAPFs...
August 20, 2016: Journal of Cardiology
Pierre-Yves Le Roux, Tracy L Leong, Stephen A Barnett, Rodney J Hicks, Jason Callahan, Peter Eu, Renee Manser, Michael S Hofman
BACKGROUND: Pre-operative evaluation of lung cancer patients relies on calculation of predicted post-operative (PPO) lung function based on split lung function testing. Pulmonary perfusion (Q) PET/CT can now be performed by substituting Technetium-99 m labeling of macroaggregated albumin (MAA) with Gallium-68. This study compares Q PET/CT with current recommended methods of pre-operative lung function assessment. METHODS: Twenty-two patients planned for curative surgical resection (mean FEV1 77 %, SD 21 %; mean DLCO 66 %, SD 17 % predicted) underwent pre-operative Q PET/CT...
2016: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Shawn Karls, Hani Hassoun, Vilma Derbekyan
A 67-year-old male presented with dyspnea for which lung scintigraphy was ordered to rule out pulmonary embolus. Planar images demonstrated abnormal midline uptake of Tc-99m macroaggregated albumin, which SPECT/CT localized to several thoracic vertebrae. Thoracic vertebral uptake on perfusion lung scintigraphy was previously described on planar imaging. Radionuclide venography and contrast-enhanced CT subsequently demonstrated superior vena cava (SVC) obstruction with collateralization through the azygous/hemiazygous system and vertebral venous plexus...
September 2016: Nuclear Medicine and Molecular Imaging
Yoshiharu Ohno, Hisanobu Koyama, Ho Yun Lee, Sachiko Miura, Takeshi Yoshikawa, Kazuro Sugimura
Assessment of regional pulmonary perfusion as well as nodule and tumor perfusions in various pulmonary diseases are currently performed by means of nuclear medicine studies requiring radioactive macroaggregates, dual-energy computed tomography (CT), and dynamic first-pass contrast-enhanced perfusion CT techniques and unenhanced and dynamic first-pass contrast enhanced perfusion magnetic resonance imaging (MRI), as well as time-resolved three-dimensional or four-dimensional contrast-enhanced magnetic resonance angiography (MRA)...
September 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
S P Mironov, A A Ansheles, D N Shulgin, V B Sergienko
OBJECTIVE: to specify frequency, patterns and diagnostic significance of extraosseous soft tissue findings in 99mTc-pyrophosphate skeletal scintigraphy. MATERIAL AND METHODS: Results of skeletal scintigraphy from 1060 patients (447 men, 613 women) were analyzed. Scanning in "whole body" mode started in 3-4 hours after 740 MBq of radiotracer activity intravenous administration, and performed in anterior and posterior projections in continuous table motion mode at rate of 6-8 cm per minute...
March 2016: Vestnik Rentgenologii i Radiologii
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