Soft tissue uptake of Tc-99m labeled bone seeking agents, such as Tc-99m 3,3-diphosphono-1,2-propanedicarboxylic acid (DPD), is commonly seen in clinical practice, even though bone scintigraphy is mainly used to detect bone disease. However, gastric uptake of bone agents in patients with gastric cancer is very rare. And it has been reported that calcified gastric adenocarcinoma appears in only about 5% of all gastric cancer. We report a rare case of bone scintigraphy, single photon emission computed tomography and computed tomography fusion images that demonstrated diffuse gastric uptake of Tc-99m DPD in a patient with advanced gastric cancer.
Stomach Neoplasms/*metabolism ; Stomach/*metabolism ; Radiopharmaceuticals/*pharmacokinetics ; Organotechnetium Compounds/diagnostic use/*pharmacokinetics ; Male ; Humans ; Diphosphonates/diagnostic use/*pharmacokinetics ; Bone and Bones/*radionuclide imaging ; Aged

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

Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis.
Administration, Oral ; Adult ; Anti-Arrhythmia Agents/therapeutic use ; Humans ; Hypokalemic Periodic Paralysis/*diagnosis/drug therapy/etiology ; Male ; Organotechnetium Compounds/chemistry/diagnostic use ; Potassium Chloride/therapeutic use ; Propranolol/therapeutic use ; Radiopharmaceuticals/diagnostic use ; Thyroiditis/*complications/radiography/ultrasonography ; Thyrotoxicosis/*diagnosis/etiology

This study examined the suitability of a nuclear imagingtechnique using 99mTc-tetrofosmin as an agent to assess theheart functions of healthy micropigs. The mean age of thepigs was 360 days (male), and the mean body weight was35.3kg ranging from 34.5-36kg. There were no significantperfusion defects in any of the reconstructed images.Gated single-photon emission computed tomographyimaging can be used to calculate the ventricular volumeand ejection fraction (EF). In this case, an EF of 79% wascalculated from the ventricular volume of the end-systolicimage (10 ml) subtracted from that of the end-diastolicvolume (49 ml). A perfusion defect (particularly the apex,lateral wall) is unlikely because of the presence of apreserved wall motion in a segment with a defect. It isconcluded that quantitative cardiac scintigraphy, using99mTc-tetrofosmin is an adequate technique for estimatingthe heart functions of healthy micropigs.
Animals ; Heart/*radionuclide imaging ; Heart Function Tests/methods/*veterinary ; Male ; Organophosphorus Compounds/*diagnostic use ; Organotechnetium Compounds/*diagnostic use ; Swine ; Swine, Miniature/*physiology ; Tomography, Emission-Computed, Single-Photon/methods/*veterinary

We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging.
Abdominal Pain/etiology/*radionuclide imaging ; Edetic Acid/*analogs & derivatives/diagnostic use ; Female ; Humans ; *Incidental Findings ; Leiomyoma/complications/*radionuclide imaging ; Middle Aged ; Organotechnetium Compounds/*diagnostic use ; Radiopharmaceuticals/diagnostic use ; Tomography, Emission-Computed, Single-Photon/*methods ; Uterine Neoplasms/complications/*radionuclide imaging

We used single photon emission computed tomography (SPECT) with technetium-99m hexamethylpropylene amine oxime (99mTc-HM-PAO) in 14 studies on 6 patients with delayed neurologic sequelae from carbon monoxide (CO) poisoning to determine whether any changes in cerebral blood flow could be correlated with clinical or computed tomographic evidence of delayed deficits. Among the six initial CT brain scans, two showed low density of both basal ganglia and two showed decreased density of the cerebral white matter. There was no correlation between the clinical outcome and the findings of the follow-up CT brain scans. Of the two SPECTS with 99mTc-HM-PAO performed during acute anoxic insult, one showed focal hypoperfusion which appeared 20 days prior to the onset of delayed neurologic sequelae after CO poisoning. Seven SPECTs in the six patients performing the delayed phase showed diffuse patched patterns of hypoperfusion which improved on follow-up images. There was good correlation between the clinical outcome and the findings of the 99mTc-HM-PAO SPECT. In preliminary conclusion, 9Tc-HM-PAO brain SPECT can be used for predicting or evaluating the outcome of delayed neurologic sequelae after CO poisoning. Cerebral vascular changes may be the possible cause of hypoperfusion in patients with CO poisoning.
Adult ; Aged ; Brain Diseases/etiology/*radionuclide imaging ; Carbon Monoxide Poisoning/*complications ; Female ; Humans ; Middle Aged ; Organotechnetium Compounds/*diagnostic use ; Oximes/*diagnostic use ; Predictive Value of Tests ; Technetium Tc 99m Exametazime ; Time Factors ; *Tomography, Emission-Computed, Single-Photon

We undertook this study to assess the patterns of regional cerebral perfusion (RCP) with SPECT using Technetium-99m-ethyl cysteinate dimer (Tc-99m-ECD) in children with Tourette's Syndrome (TS), and to compare these with the patterns in a group of normal controls. The study sample consisted of 38 children (7 to 14 years) who met the ICD-10 and DSM/IV criteria for Tourette's Syndrome, and a control group of 18 children (9 to 14 years). The Children's Depression Inventory and Maudsley Obsessional-Compulsive Questionnaire were used for assessment, and the severity of motor and vocal tics were assessed using the Goetz Rating Scale. The RCP values were significantly lower in the TS group in left caudate, cingulum, right cerebellum, left dorsolateral prefrontal, and the left orbital frontal region. A positive correlation was found between the severity of vocal tics and blood flow of mid-cerebellum, right dorsolateral prefrontal and left dorsolateral prefrontal regions. Although no depressive or obsessive patients were included in the study, the depression and obsession scores were found to be negatively correlated with all RCP values, especially in the temporal regions. Further studies are needed to explore the relationship between the hypoperfusion of certain brain areas and the underlying neurophysiology and neurobiology of patients with TS. Additional disturbances such as obsessive- compulsive symptoms and depressive symptoms should also be assessed.
Adolescent ; Brain/*radionuclide imaging ; Cerebrovascular Circulation ; Child ; Cysteine/*analogs & derivatives/*diagnostic use ; Female ; Human ; Male ; Organotechnetium Compounds/*diagnostic use ; *Tomography, Emission-Computed, Single-Photon ; Tourette Syndrome/physiopathology/*radionuclide imaging

OBJECTIVE: Na18F bone positron emission tomography (bone PET) is a new imaging modality which is useful for the evaluation of bone diseases. Here, we compared the diagnostic accuracies between bone PET and bone scan for the detection of bone metastasis (BM). MATERIALS AND METHODS: Sixteen cancer patients (M:F = 10:6, mean age = 60 +/- 12 years) who underwent both bone PET and bone scan were analyzed. Bone PET was conducted 30 minutes after the injection of 370 MBq Na18F, and a bone scan was performed 3 hours after the injection of 1295 MBq 99mTc-hydroxymethylene diphosphonate. RESULTS: In the patient-based analysis (8 patients with BM and 8 without BM), the sensitivities of bone PET (100% = 8/8) and bone scan (87.5% = 7/8) were not significantly different (p > 0.05), whereas the specificity of bone PET (87.5% = 7/8) was significantly greater than that of the bone scan (25% = 2/8) (p < 0.05). In the lesion-based analysis (43 lesions in 14 patients; 31 malignant and 12 benign), the sensitivity of bone PET (100% = 31/31) was significantly greater than that of bone scan (38.7% = 12/31) (p < 0.01), and the specificity of bone PET (75.0% = 9/12) was also significantly higher than that of bone scan (8.3% = 1/12) (p < 0.05). The receiver operating characteristic curve analysis showed that bone PET was significantly more accurate than the bone scan in the patient (p = 0.0306) and lesion (p = 0.0001) based analyses. CONCLUSION: Na18F bone PET is more accurate than bone scan for BM evaluation.
Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Bone Neoplasms/*radionuclide imaging/*secondary ; Diphosphonates/diagnostic use ; Female ; Fluorine Radioisotopes/diagnostic use ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Male ; Middle Aged ; Multimodal Imaging/methods ; Organotechnetium Compounds/diagnostic use ; Positron-Emission Tomography/*methods ; Retrospective Studies ; Sensitivity and Specificity ; Sodium/diagnostic use ; Tomography, X-Ray Computed/methods

The six patients included in this study had painful dysesthesia, resulting from vascular lesions in or near the thalamus, confirmed by computerized tomography(CT) brain scan. Using hexamethyl propyleneamine oxime(HM-PAO) single photon emission computed tomography(SPECT) brain scanning, regional cerebral perfusion(rCP) was demonstrated. In contrast to three patients with lesions near the thalamus who showed symmetrical cortical radioactivity, the other three patients with thalamic lesions revealed decreased rCP in the ipsilateral cerebral cortex on HM-PAO brain SPECT. We thought that the loss of afferent activating stimuli from the thalamus led to decreased cortical neuronal activity and the following hypoperfusion. In patients with thalamic syndrome resulting from thalamic lesions, the role of the remote effect of the thalamic damage and consequent cortical deregulation in the development of thalamic pain and/or neuropsychological symptoms cannot be excluded completely.
Brain/*radionuclide imaging ; Female ; Human ; Male ; Middle Age ; Organotechnetium Compounds ; Oximes ; Pain/etiology ; Syndrome ; Technetium/diagnostic use ; Technetium Tc 99m Exametazime ; Thalamic Diseases/*radionuclide imaging ; Tomography, Emission-Computed, Single-Photon

99mTc-ECD SPECT is valuable for the evaluation of cell viability and function. The purpose of the present study was to evaluate the significance of 99mTc-ECD brain SPECT in ischemic stroke. We compared 99mTc-ECD brain SPECT with perfusion and diffusion weighted images (PWI, DWI). Ten patients with acute and early subacute ischemic stroke were included in this prospective study. T2-weighted images (T2WI), DWI, PWI and 99mTc-ECD SPECT were obtained during both the acute/early subacute and late subacute stages. In the case of PWI, time to peak (TTP) and regional cerebral blood volume (rCBV) maps were obtained. The rCBV map and 99mTc-ECD SPECT images were compared in 8 lesions using delta AI. The asymmetry index (AI) was calculated as (Ci - Cc) X 200 / (Ci + Cc); where Ci is the mean number of pixel counts of an ipsilateral lesion and Cc is the mean number of pixel counts of the normal contralateral hemisphere. delta AI was defined as AIacute - AIsubacute in the ischemic core and periphery. PWI and 99mTc-ECD SPECT detected new lesions of the hyperacute stage or of evolving stroke more accurately than T2WI and DWI. 99mTc-ECD SPECT was able to localize the infarct core and peri-infarct ischemia in all lesions in both the acute and the subacute stages. delta AI was higher in the rCBV map than in the 99mTc-ECD SPECT images in the ischemic core (p = 0.063) and in the periphery (p = 0.091). In the 99mTc-ECD SPECT images, delta AI was higher in the ischemic core than in the periphery (p = 0.028). During the subacute stage, 99mTc-ECD SPECT detected all the lesions without the pseudonormalization seen in the MR images of 5/11 lesions. Based on this study, 99mTc-ECD SPECT is comparable to PWI in terms of its ability to detect acute stroke and is more useful than PWI in the case of subacute infarction.
Acute Disease ; Adult ; Aged ; Brain Ischemia/*complications ; Cerebrovascular Accident/*diagnosis/*etiology ; Comparative Study ; Cysteine/*analogs & derivatives/*diagnostic use ; Diffusion ; Female ; Human ; Magnetic Resonance Imaging/methods ; Male ; Middle Age ; Organotechnetium Compounds/*diagnostic use ; Perfusion ; Radiopharmaceuticals/*diagnostic use ; *Tomography, Emission-Computed, Single-Photon