Many radiopharmaceuticals have been developed and wildy used in the imaging cardiac function. Myocardial perfusion imaging (MPI) is a well established noninvasive method of assessing coronary blood flow and has been widely used in patients diagnosed or suspected with coronary artery diseases. The innovation of radiopharmaceuticals used in the cardiac imaging is one of the most important contributors to the development of nuclear cardiology. Thallium-201 and various technetium-99m agents have been globally used for myocardial perfusion SPECT, and N-13 ammonia (13NH3), rubidium-82 (82Rb), O-15 water (H215O) for myocardial perfusion PET. As well as the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. Useful information can be obtained for diagnosing coronary artery disease, evaluating patients' condition, or assessing therapeutic effects. In this review, we describe the characteristics and clinical usefulness of radiopharmaceuticals used for cardiac SPECT and PET.
Ammonia ; Cardiology ; Coronary Artery Disease ; Humans ; Myocardial Perfusion Imaging ; Perfusion ; Radiopharmaceuticals ; Sympathetic Nervous System ; Tomography, Emission-Computed, Single-Photon ; Water

PURPOSE: We intended to evaluate myocardial oxygen consumption (MVO2) by applying recirculation correction and modified one-compartment model to have a reference range of MVO2 in normal young population and to reveal the effect of recirculation on time-activity curve (TAC). Materials and METHODS: In nine normal male volunteers with mean age of 26.3+/-4.0, MVO2 was estimated with 925 MBq (25mCi) of 11C-Acetate (Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, Korea) and PET/CT (Biograph 6, Siemens Medical Solution, Germany). Analysis software such as MATLAB(R) v7.1 (Mathworks, Inc., United States), Excel(R) 2007 (Microsoft, United States), and SPSS(R) v12.0 (Apache Software Foundation, United States) were used. Twenty three frames were of 12 x 10, 5 x 60, 3 x 120, 2 x 300's duration, respectively. The modified one-compartmental model and the recirculation correction method were applied. Statistical analysis was performed by using Test of Normality, ANOVA and Post-Hoc (Scheffe's) analysis, and p-value less than 0.05 was considered as significant. RESULTS: The normal reference ranges of MVO2 were presented as 3.18-4.64 x 10(-4) ml/g/sec, 1.91-3.94 x 10(-4) ml/g/sec, 4.31-6.40 x 10(-4) ml/g/sec, 2.84-4.53 x 10(-4) ml/g/sec and 3.42-5.00 x 10(-4) ml/g/sec in the septum, the inferior wall, the lateral wall, the anterior wall and the entire wall, respectively. In addition, it was noted that the dual exponentiality of the clearance curve is due to the recirculation effect and that the characteristic of the curve is essentially mono-exponential. CONCLUSION: 11C-Acetate is a radiotracer worthwhile to assess MVO2. Re-circulated 11C can influence TAC of 11C in myocadia and so the recirculation correction must be considered when measuring MVO2.
Academies and Institutes ; Acetates ; Carbon ; Humans ; Male ; Oxygen ; Oxygen Consumption ; Positron-Emission Tomography ; Reference Values

PURPOSE: We investigated whether the diagnostic performance of SPECT scintimammography (SMM) can be improved by adding computer-aided diagnosis (CAD) of ultrasonography (US). MATERIALS AND METHODS: We reviewed breast SPECT SMM images and corresponding US images from 40 patients with breast masses (21 malignant and 19 benign tumors). The quantitative data of SPECT SMM were obtained as the uptake ratio of lesion to contralateral normal breast. The morphologic features of the breast lesions on US were extracted and quantitated using the automated CAD software program. The diagnostic performance of SPECT SMM and CAD of US alone was determined using receiver operating characteristic (ROC) curve analysis. The best discriminating parameter (D-value) combining SPECT SMM and the CAD of US was created. The sensitivity, specificity and accuracy of combined two diagnostic modalities were compared to those of a single one. RESULTS: Both SPECT SMM and CAD of US showed a relatively good diagnostic performance (area under curve = 0.846 and 0.831, respectively). Combining the results of SPECT SMM and CAD of US resulted in improved diagnostic performance (area under curve =0.860), but there was no statistical differerence in sensitivity, specificity and accuracy between the combined method and a single modality. CONCLUSION: It seems that combining the results of SPECT SMM and CAD of breast US do not significantly improve the diagnostic performance for diagnosis of breast cancer, compared with that of SPECT SMM alone. However, SPECT SMM and CAD of US may complement each other in differential diagnosis of breast cancer.
Breast Neoplasms* ; Breast* ; Complement System Proteins ; Diagnosis* ; Diagnosis, Differential ; Humans ; ROC Curve ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography*

PURPOSE: The diagnosis of acute cholecystitis is usually made by performing ultrasonography or biliary scintigraphy. We have introduced the (99m)Tc-ciprofloxacin (infecton) scan for diagnosing of acute cholecystitis. The main aim of this study was to evaluate the efficacy of (99m)Tc-ciprofloxacin imaging in comparison with ultrasonographic findings for the diagnosis of acute cholecystitis. METHODS: Sixteen patients who were thought to have acute or chronic cholecystitis, based on the clinical and sonographic findings, were included in this study. We gave intravenous (99m)Tc-ciprofloxacin to sixteen patients and we obtained the SPECT images after one hour. The final diagnosis of acute cholecystitis was made according to the pathologic reports. RESULTS: According to pathologic reports, out of the sixteen patients, twelve patients had acute cholecystitis and four patients had chronic cholecystitis. On the (99m)Tc-ciprofloxacin scans, twelve patients had positive images showing acute cholecystitis on account of the hot uptake in the gallbladder and four patents had negative images showing chronic cholecystitis due to the negative uptake in the gallbladder. Among them, one false positive case and one false negative case were observed. With performing ultrasonography, twelve and four patients were diagnosed as having acute and chronic cholecystitis respectively. Out of them one false positive case and three false negative cases were observed. Based on the pathologic reports, (99m)Tc-ciprofloxacin imaging has a sensitivity of 91.7% and a specificity of 75%. The ultrasonography had a sensitivity of 91.7% and a specificity of 25%. CONCLUSION: As a result of comparing the sensitivity and specificity of the (99m)Tc-ciprofloxacin scan with those of the ultrasonography, the (99m)Tc-ciprofloxacin scan is considered to be useful test method to diagnose acute cholecystitis.
Cholecystitis ; Cholecystitis, Acute* ; Diagnosis* ; Gallbladder ; Humans ; Radionuclide Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography

PURPOSE: Aspiration scintigraphy is a procedure of nuclear imaging to evaluate aspiration and of quantifying the amount of aspirate. The ultimate goal of our study is to define the correlation between aspiration and aspiration pneumonia by aspiration scintigraphy, and this is a preliminary report of its trial. MATERIALS AND METHODS: Ten patients with positive findings by videofluoroscopy were selected. The patients ingested semi-solid food containing Tc-99m tin colloid 92.5 MBq (2.5 mCi) and images were acquired immediately after the ingestion and 3 hrs later. A fraction of aspiration to the ingested was calculated using an equation with a decay correction. RESULTS: Five patients were interpreted positive by aspiration scintigraphy. Four patients were positive at initial images and the fractions of aspiration were 0.11%, 0.11%, 0.81%, and 0.11%. The one patient who was shown aspirated at both images had initial 5.82% and delayed 2.26%. CONCLUSION: Aspiration scintigraphy enables us to localize the aspiration at any desired time of the test and to quantify its amount. Follow-up studies are warranted.
Colloids ; Eating ; Humans ; Pneumonia, Aspiration ; Radionuclide Imaging* ; Tin

A 44-year-old man with a past medical history of splenectomy came to hospital because of epigastric pain. Abdominopelvic computed tomography(CT) showed a soft tissue mass and multifocal variable-sized nodules as well as findings suggestive of cholecystitis. Subsequently, he underwent Tc-99m-labeled heat-denatured red blood cell(RBC) scintigraphy to evaluate the mass and nodules. The scintigraphy confirmed multifocal peritoneal splenosis in the abdominopelvic cavity.
Adult ; Cholecystitis ; Erythrocytes* ; Humans ; Radionuclide Imaging* ; Spleen ; Splenectomy ; Splenosis*

PURPOSE: Gastric emptying scan (GES) is usually acquired up to 2 hours. Our study investigated whether a fraction of meal-retention in the stomach at 120 minutes (FR120) was predicted from the data measured for 90 minutes by using non-linear curve fitting. We aimed at saving the delayed imaging by utilizing mathematical models. MATERIALS AND METHODS: Ninety-six patients underwent GES immediately after taking a boiled egg with 74 MBq (2 mCi) Tc-99m DTPA. The patients were divided into Group I (T1/2 < or=90 min) and Group II (90 min< T1/2< or=120 min). Group I (n=51) had 21 men and 30 women, and Group II (n=45) 15 men and 30 women. There was no significant difference in age and sex between the two groups. Simple exponential, power exponential, and modified power exponential curves were acquired from the measured fraction of meal-retention at each time (0, 15, 30, 45, 60, 75, and 90 min) by non-linear curve fitting (MATLAB (R) 5.3) and another simple exponential fitting was performed on the fractions at late times (60, 75, and 90 min). A predicted FR120 was calculated from the acquired functional formulas. A correlation coefficient between the measured FR120 and the predicted FR120 was computed (MedCalc (R) 6.0). RESULTS: Correlation coefficients (r) between the measured FR120 and the predicted FR120 of each mathematical functions were as follows: simple exponential function (Group I: 0.8858, Group II: 0.5982, p< 0.0001), power exponential function (Group I: 0.8755, Group II: 0.6008, p< 0.0001), modified power exponential function (Group I: 0.8892, Group II: 0.5882, p< 0.0001), and simple exponential function at the late times (Group I: 0.9085, Group II: 0.6832, p< 0.0001). In all the fitting models, the predicted FR120 were significantly correlated with the measured FR120 in Group I but not in Group II. There was no statistically significant difference in correlation among the 4 mathematical models. CONCLUSION: In the cases with T1/2 < or=90 min, the predicted FR120 is significantly correlated with the measured FR120. Therefore, FR120 can be predicted from the data measured for 90 minutes by using non-linear curve fitting, saving the delayed imaging after 90 minutes when T1/2 < or=90 min is ascertained.
Female ; Gastric Emptying* ; Humans ; Male ; Models, Theoretical* ; Ovum ; Pentetic Acid ; Radionuclide Imaging* ; Stomach

A tail-on-detector (TOD) view has been used to see the symphysis pubis or sacrococcyx in skeletal scintigraphy, but it is inconvenient to acquire because a patient must sit or lean on a detector. The TOD views are still frequently performed in training hospitals in Korea, although it is becoming almost impossible to sit on a camera in this age of dual-headed cameras. The authors show cases with lateral views obtained in supine position that were acquired for the same reason; they are easier and more useful than the TOD views.
Coccyx ; Humans ; Korea ; Radionuclide Imaging* ; Sacrococcygeal Region* ; Sacrum ; Supine Position ; Technetium Tc 99m Medronate

BACKGROUND: One of the theoretical advantages of skeletonized internal mammary artery harvesting in coronary artery bypass surgery is to minimize the interruption of the sternal blood flow inevitably accompanied by internal mammary harvesting. A study using bone scan is designed to determine the effects of internal mammary artery harvesting technique on the sternal blood flow. MATERIAL AND METHOD: From April 2002 to March 2003, 27 patients out of 48 patients who underwent the isolated coronary bypass surgery were enrolled into the study. The enrolled patients underwent bone scan in the preoperative period and postoperative period respectively. Bilateral internal mammary arteries were used in 8 patients (BIMA group) and single left internal mammary artery in 19 patients (LIMA group). The patients in LIMA group were divided into two groups: LIMA_skel group, in whom left internal mammary artery was harvested in skeletonized fashion (n=12), and LIMA_ped group, in whom left internal mammary artery was harvested in pedicled fashion (n=7). After the bone scan, the region of interest (ROI) was created on the left half of the sternum and the mirror image with the same pixel numbers was placed on the right half of the sternum. The mean counts per pixel on the left side of the sternum was compared with those on the right side and expressed as left to right ratio (L/R ratio). RESULT: In LIMA group, the L/R ratio decreased from 94.6+/-4.1% to 87.9+/-6.9% (p=0.003) after the operation as compared to BIMA group, in which no change of the L/R ratio was observed. The changes of the L/R ratio in LIMA_skel group and LIMA_ped group were from 95.3+/-4.2% to 88.3+/-7.7% and from 93.4+/-3.9% to 87.4+/-5.8% respectively. The % changes in L/R ratio were -7.44+/-7.08 in LIMA_skel group and -6.17+/-9.08 in LIMA_ped group, which did not reach the statistical difference. CONCLUSION: Ipsilateral sternal blood flow is interrupted by internal mammary artery harvesting as evidenced by the decrease in L/R ratio after left internal mammary artery harvesting irrespective of the harvesting techniques. Skeletonized harvesting did not show superiority in respect to sternal blood flow as compared to pedicled harvesting.
Coronary Artery Bypass ; Humans ; Mammary Arteries* ; Postoperative Period ; Preoperative Period ; Regional Blood Flow ; Skeleton* ; Sternum

AIMTo investigate the value of Tc-99m ciprofloxacin imaging in the differential diagnosis of chronic bacterial prostatitis.

METHODSThe study included 4 normal subjects as the negative controls, 2 patients with acute prostatitis or cystourethritis as the positive controls and 59 patients diagnosed as chronic bacterial prostatitis or chronic pelvic pain syndrome by traditional laboratory tests. In every subject, the single photon emission computerized tomography images were obtained 3 h after intravenous injection of Tc-99m Ciprofloxacin. The results of the imaging were compared with those of laboratory tests.

RESULTSOn the images, negative uptake was observed in all normal subjects, while strong hot uptake, in the whole prostate of acute prostatitis patients and in the whole urethra of acute cystourethritis patients. In 13 (68%) of 19 patients categorized as chronic bacterial prostatitis by standard laboratory tests, hot uptake with less intensity than that of acute prostatitis was observed in the prostate area around the prostatic urethra. Negative uptake in the prostate was observed in 6 of 19 patients (32%) categorized as chronic bacterial prostatitis. Interestingly, hot uptake in the prostate was exhibited in 28 (70%) of the 40 patients categorized as chronic pelvic pain syndrome.

CONCLUSIONTc-99m ciprofloxacin imaging is helpful in the differential diagnosis of prostatitis syndrome.

Adult ; Aged ; Bacterial Infections ; diagnostic imaging ; microbiology ; Chronic Disease ; Ciprofloxacin ; analogs & derivatives ; pharmacokinetics ; Humans ; Male ; Middle Aged ; Organotechnetium Compounds ; pharmacokinetics ; Pelvic Pain ; diagnostic imaging ; Prostatitis ; diagnostic imaging ; microbiology ; Radionuclide Imaging ; Radiopharmaceuticals ; pharmacokinetics ; Urethritis ; diagnostic imaging