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  • 1
    Electronic Resource
    Electronic Resource
    A comparison of adenosine and arbutamine for myocardial perfusion imaging (1998)
    Springer
    European journal of nuclear medicine 25 (1998), S. 394-400 
    Details
    ISSN: 1619-7089
    Keywords: Key words: Adenosine ; Arbutamine ; Thallium-201 ; Myocardial perfusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We have compared our standard stress protocol (adenosine combined with exercise) with the new stress agent arbutamine, for thallium-201 myocardial perfusion imaging (MPI) in order to assess the comparative value of arbutamine. We studied 23 patients referred for MPI, and each patient had two studies (18 males, median age 66 years, five with previous myocardial infarction). Uptake scores were assigned to each of nine segments, and the extent and severity of defects were measured using a polar plot. Haemodynamic changes were greater with arbutamine (rate-pressure product increase 78% vs 51%, P = 0.003). Symptoms were experienced by 21 patients with arbutamine and 16 with adenosine (P = 0.07). Agreement between the techniques for classification of patients as normal or as having reversible, fixed or mixed defects was good (19 of 23 studies, 83%, κ = 0.76). Agreement for similar classification of segments was also good (82%, κ = 0.71). Segmental agreement for stress scores was good (86%, κ = 0.77). However, mean size of stress defect was larger with adenosine (83±52 pixels vs 65±48 pixels, P〈0.05), though severity and reversibility were similar (P = NS). We conclude that arbutamine provides comparable results to those obtained with adenosine and exercise and that the observed differences are not clinically significant.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002590050237
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  • 2
    Electronic Resource
    Electronic Resource
    Clinical significance of technetium-99m methylene diphosphonate myocardial uptake: association with carcinoma of the prostate (1995)
    Springer
    European journal of nuclear medicine 22 (1995), S. 148-153 
    Details
    ISSN: 1619-7089
    Keywords: Myocardial uptake ; Technetium-99m methylene diphosphonate ; Technetium-99m hydroxydiphosphonate ; Bone scintigraphy ; Prostatic carcinom
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Benign myocardial uptake of technetium-99m labelled phosphates, not related to cardiac or metabolic disorders, has been documented except in the case of99mTc-methylene diphosphonate (MDP). The aim of this study was to assess the frequency of myocardial uptake and its possible association with malignant tumours in general and prostatic carcinoma in particular. We reviewed bone scintigrams performed with either99mTc-hydroxydiphosphonate (HDP) or99mTc-MDP over a period of more than 2 years for all patients with prostatic carcinoma and a matching group of patients suffering from other malignant and non-malignant disorders. A total of 965 scintigrams of 812 patients (males=559, females=253; age range 50–91 years, average age 69.2 years) were reviewed. Increased myocardial uptake was detected in 19 scintigrams (MDP=13, HDP=6) of 18 patients (17 males, one female). Most of the male patients with increased myocardial uptake had prostatic carcinoma (13/17) and were over 80 years of age (12/17). All patients were free of any cardiac or noncardiac disorder that might account for such uptake. When scintigraphy was repeated in the same patient, the uptake of99mTc-HDP was more diffuse and of higher grade than that of99mTc-MDP “Benign” myocardial uptake of99mTc-MDP is more common than previously thought. Although uptake of radiophosphates is attributed to asymptomatic atherosclerotic changes associated with old age, a strong association with prostatic carcinoma exists which may indicate variations in the bone: soft tissue affinity of different MDP complexes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00838945
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  • 3
    Electronic Resource
    Electronic Resource
    Regional myocardial motion and thickening assessed at rest by ECG-gated99mTc-MIBI emission tomography and by magnetic resonance imaging (1996)
    Springer
    European journal of nuclear medicine 23 (1996), S. 909-916 
    Details
    ISSN: 1619-7089
    Keywords: Myocardial perfusion imaging ; Gated single-photon emission tomography ; Technetium-99m methoxyisobutylisonitrile ; Magnetic resonance imaging ; Left ventricular function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have validated ECG-gated emission tomography using technetium-99m methoxyisobutylisonitrile for the assessment of regional ventricular function by comparing it with cine magnetic resonance imaging (MRI). Gated tomography was performed at rest in 24 patients referred for myocardial perfusion imaging [17 males and seven females with a mean age of 58 years, nine of whom had had a previous myocardial infarction (MI)]. Scores were assigned to each of nine myocardial segments for wall motion and for thickening. Cine MRI was analysed in an identical fashion. Four out of 216 (2%) segments were uninterpretable by gated tomography because of inadequate tracer uptake. In eight patients without coronary artery disease (CAD), wall motion and thickening were normal by both methods. Gated tomography showed abnormal wall motion or thickening in all patients with previous MI and in five of seven patients with CAD but no prior MI. Association between wall motion and thickening was good (r s=0.86). Overall, there was good agreement between gated tomography and MRI for both wall motion (178/212 segments, κ=0.66) and wall thickening (184/212 segments, κ=0.69). In segments with severely reduced perfusion, however, there was poorer agreement (κ=0.31). Interobserver and intraobserver agreement was high (κ from 0.61 to 0.78). Thus, in patients investigated for CAD, there is good overall agreement between gated tomography and MRI but the agreement is lower in segments with severe perfusion defects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01084364
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  • 4
    Electronic Resource
    Electronic Resource
    A comparison of resting images from two myocardial perfusion tracers (1995)
    Springer
    European journal of nuclear medicine 22 (1995), S. 1029-1034 
    Details
    ISSN: 1619-7089
    Keywords: Myocardial perfusion ; Thallium-201 ; Technetium-99m methoxyisobutylisonitrile ; Viable myocardium ; Single-photon emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have compared stress-redistribution and delayed rest thallium-201 with rest technetium-99m methoxyisobutylisonitrile (MIBI) tomograms in order to compare the tracers for the assessment of myocardial viability and to validate a rapid protocol combining the two tracers. We studied 30 consecutive patients with known or suspected coronary artery disease [group 1: 16 with normal left ventricular function, mean left ventricular ejection fraction (LVEF) 55%, SD 6%; group 2: 14 with abnormal function, mean LVEF 28%, SD 8%].201Tl was injected during infusion of adenosine followed by acquisition of conventional stress and redistribution tomograms. On a separate day,201Tl was injected at rest with imaging 4 h later.99mTc-MIBI was then given at rest and imaging was performed. Three images were compared: redistribution201Tl, rest201Tl, and rest99mTc-MIBI. Tracer activity was classified visually and quantitatively in nine segments and segments with〉50% activity were defined as containing clinically significant viable myocardium. Mean (±SD) global tracer uptake as a percentage of maximum was similar in group 1 (rest201Tl 69%±12%, redistribution201Tl 69%±15%, rest99mTc-MIBI 70%±13%, ANOVAP〉0.05), but in group 2 mean tracer uptake was significantly greater in the rest201Tl images (59%±16%) than in redistribution201Tl images (53%±17%) or rest99mTc-MIBI images (53%±19%) (ANOVAP=0.02). Overall agreement for regional uptake score was excellent (κ from 0.79 to 0.84), although there were a significant number of segments with less uptake shown by redistribution201Tl and by rest99mTc-MIBI than by rest201Tl in group 2 (P〈0.001). The number of segments with significant viable myocardium in group 1 was very similar between the three images (P〉0.05) but in group 2 rest201Tl identified significantly more segments as viable than the other images (McNemarP〈0.001). Thus201Tl and99mTc-MIBI provide similar information in patients without prior infarction and with normal left ventricular function (group 1), and a rapid protocol with stress201Tl injection and imaging followed immediately by rest99mTc-MIBI injection and imaging is feasible. In patients with abnormal left ventricular function and prior infarction (group 2),99mTc-MIBI may underestimate the extent of clinically significant viable myocardium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00808415
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