OBJECTIVE: Gated myocardial perfusion single-photon emission computed tomography (GSPECT) has been established as an accurate and reproducible diagnostic and prognostic technique for the assessment of myocardial perfusion and function. Respiratory motion is among the major factors that may affect the quality of myocardial perfusion imaging (MPI) and consequently the accuracy of the examination. In this study, we have proposed a new approach for the tracking of respiratory motion and the correction of unwanted respiratory motion by the use of respiratory-cardiac gated-SPECT (RC-GSPECT). In addition, we have evaluated the use of RC-GSPECT for quantitative and visual assessment of myocardial perfusion and function. MATERIALS AND METHODS: Twenty-six patients with known or suspected coronary artery disease (CAD)-underwent two-day stress and rest (99m)Tc-Tetrofosmin myocardial scintigraphy using both conventional GSPECT and RC-GSPECT methods. The respiratory signals were induced by use of a CT real-time position management (RPM) respiratory gating interface. A PIO-D144 card, which is transistor-transistor logic (TTL) compatible, was used as the input interface for simultaneous detection of both ECG and respiration signals. RESULTS: A total of 26 patients with known or suspected CAD were examined in this study. Stress and rest myocardial respiratory motion in the vertical direction was 8.8-16.6 mm (mean, 12.4 +/- 2.9 mm) and 7.8-11.8 mm (mean, 9.5 +/- 1.6 mm), respectively. The percentages of tracer intensity in the inferior, inferoseptal and septal walls as well as the inferior to lateral (I/L) uptake ratio was significantly higher with the use of RC-GSPECT as compared to the use of GSPECT (p < 0.01). In a left ventricular ejection fraction (LVEF) correlation analysis between the use of rest GSPECT and RC-GSPECT with echocardiography, better correlation was noted between RC-GSPECT and echocardiography as compared with the use of GSPECT (y = 0.9654x + 1.6514; r = 0.93, p < 0.001 versus y = 0.8046x + 5.1704; r = 0.89, p < 0.001). Nineteen (19/26) patients (73.1%) showed abnormal myocardial perfusion scans with reversible regional myocardial defects; of the 19 patients, 14 (14/26) patients underwent coronary angiography. CONCLUSION: Respiratory induced motion can be successfully corrected simultaneously with the use of ECG-gated SPECT in MPI studies using this proposed technique. Moreover, the use of ECG-gated SPECT improved image quality, especially in the inferior and septal regions that are mostly affected by diaphragmatic attenuation. However, the effect of respiratory correction depends mainly on the patient respiratory pattern and may be clinically relevant in certain cases.
Aged ; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography/*methods ; Coronary Artery Disease/radionuclide imaging ; *Coronary Circulation ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Organophosphorus Compounds/diagnostic use ; Organotechnetium Compounds/diagnostic use ; Radiopharmaceuticals/diagnostic use ; *Respiration

Objective: To identify serodiagnosis and quantification of Toxoplasma gondii (T. gondii) infection among pregnant women in Salmas, northwest of Iran. Methods: In this cross-sectional study, 276 blood samples were collected from pregnant women referred to the health care centers in Salmas city. The demographic variables were also recorded. Titers of anti-Toxoplasma IgM and IgG antibodies (Ab) were determined using the chemiluminescence immunoassay. Quantitative real-time PCR targeting the T. gondii repeated element gene was also performed on the blood sample. Results: Out of all, 19.92% (55/276) and 2.17% (6/276) patients were seropositive for anti-Toxoplasma IgG and IgM Ab, respectively. Moreover, the presence of T. gondii DNA was observed in 12.31% (34/276) blood samples. A significant relationship was observed between the IgG Ab seropositivity and contact with the cat as a risk factor (P=0.022). Conclusions: The seroprevalence rate of T. gondii infection in pregnant women is relatively low. Consequently, the seronegative pregnant women are at risk, and a considerable rate of positive blood samples for the presence of parasite's DNA should not be ignored. Besides, quantitative real-time PCR could be considered as an accurate method for diagnosis of acute toxoplasmosis especially when the precise results are of the most importance in pregnancy. Limiting contact with cats is also suggested for pregnant women.