Holmium-166 Transarterial Radioembolization for the Treatment of Intrahepatic Cholangiocarcinoma: A Case Series.

Background: Transarterial radioembolization (TARE) is used to treat primary and secondary malignancies in the liver that are not amenable to curative resection. Accumulating evidence demonstrates the efficacy and safety of TARE with yttrium-90 (Y), which is the most widely used radionuclide for TARE, and later with holmium-166 (Ho) for various indications. However, the safety and efficacy of Ho TARE in patients with intrahepatic cholangiocarcinoma (ICC) remains to be studied.

Fractional flow reserve and myocardial perfusion imaging in patients with angiographic multivessel coronary artery disease.

Objectives: The aim of this study was to investigate the correlation between myocardial ischemia detected by myocardial perfusion imaging (MPI) with single-photon emission computed tomography with intracoronary pressure-derived fractional flow reserve (FFR) in patients with multivessel coronary disease at angiography.

Background: Myocardial perfusion imaging can underestimate the number of ischemic territories in patients with multivessel disease. However, there are limited data comparing MPI and FFR, a highly accurate functional index of myocardial ischemia, in multivessel coronary disease.

Comparison of the prognostic value of dipyridamole and dobutamine myocardial perfusion scintigraphy in hemodialysis patients.

Screening for coronary artery disease (CAD) in hemodialysis patients is hampered by contraindications and/or limitations of the available techniques in this population. Myocardial perfusion scintigraphy (MPS) using dipyridamole has been considered inaccurate due to abnormally high basal levels of adenosine in uremia that could blunt the vasodilatory response. Since dobutamine may be more reliable, we directly compared the two in patients on hemodialysis.

VE/VCO2 slope and oxygen uptake efficiency slope in patients with coronary artery disease and intermediate peakVO2.

Background: Peak exercise oxygen uptake (peakVO2) is a widely used prognosticator. Novel spirometric parameters, less affected by submaximal performance, such as the rate of increase of minute ventilation per unit decrease of carbon dioxide production (VE/VCO2 slope) and the oxygen uptake efficiency slope (OUES) have recently been introduced.

Aim: To evaluate the discriminative value of OUES, as compared to VE/VCO2 slope in patients with coronary artery disease (CAD) and intermediate peakVO2 values.

Comparison among tomographic radionuclide ventriculography algorithms for computing left and right ventricular normal limits.

Background: Various algorithms have been developed to compute right ventricular (RV) and left ventricular (LV) end-diastolic volumes, end-systolic volumes, and ejection fractions (EF) from tomographic radionuclide ventriculography (TRV). The aims of this investigation were to establish sex-specific normal limits, to determine whether different algorithms produce the same normal values, and to compare TRV normal limits vs for magnetic resonance imaging values in the literature.

Methods: Fifty-one healthy volunteers (29 men, 22 women) were studied prospectively.

Fasting blood glucose levels are related to exercise capacity in patients with coronary artery disease.

Background And Aim: Previous studies have demonstrated reduced exercise capacity in patients with diabetes mellitus. This study evaluated the relationship between fasting blood glucose (FBG) levels and exercise capacity in patients with coronary artery disease (CAD).

Methods: We evaluated 986 consecutive patients with CAD referred for bicycle spiroergometry combined with gated myocardial perfusion imaging.

Maximum oxygen uptake at peak exercise in elderly patients with coronary artery disease and preserved left ventricular function: the role of inflammation on top of tissue Doppler-derived systolic and diastolic function.

Background: Several studies have shown that longitudinal systolic function and left ventricular filling pressures, as assessed with tissue Doppler imaging, predict exercise capacity.

Aim: The aim of this study was to evaluate whether natriuretic peptides and inflammatory parameters can independently predict maximum oxygen uptake at peak exercise (VO2max) on top of tissue Doppler imaging-derived markers.

Methods: We evaluated 142 patients (age 70 +/- 6 years, 77% men) with known or suspected coronary artery disease and a preserved left ventricular ejection fraction (> or = 50%).

Diabetes and impaired fasting glucose as predictors of morbidity and mortality in male coronary artery disease patients with reduced left ventricular function.

Objectives: To evaluate the prognostic value of impaired fasting glucose and diabetes mellitus in male patients with coronary artery disease and poor left ventricular function.

Methods And Results: From a prospective database on patients referred for gated myocardial perfusion imaging between 1998 and 2002 all male patients with a history of coronary artery disease and poor left ventricular function were selected. Poor function was defined as left ventricular ejection fraction < or = 40%.

Myocardial perfusion imaging in the elderly: a review.

Coronary artery disease is a major cause of morbidity and mortality in the elderly population. As a result of ageing of the population and better medical, interventional and surgical treatment of patients with coronary artery disease, more and more elderly patients are referred to the cardiology department for diagnostic work-up. Stress testing, in combination with myocardial perfusion imaging, is routinely used in elderly patients, a population in which the diagnosis of significant coronary artery disease is often challenging because of atypical symptomatology.

Incremental prognostic value of combined perfusion and function assessment during myocardial gated SPECT in patients aged 75 years or older.

Background: Perfusion and functional data obtained during gated single photon emission computed tomography (SPECT) have proven prognostic value in the middle-aged patient population. The aim of this study was to investigate whether perfusion and functional cardiac gated SPECT data have prognostic value in patients aged 75 years or older.

Methods And Results: We studied clinical and gated SPECT predictors of cardiac and all-cause death in 294 patients aged 75 years or older with known or suspected coronary artery disease who were referred for tetrofosmin cardiac gated SPECT imaging.

Relationship between QRS duration, left ventricular volumes and prevalence of nonviability in patients with coronary artery disease and severe left ventricular dysfunction.

Background: Patients with coronary artery disease (CAD), a QRS duration >or=120 ms and left ventricular ejection fraction (LVEF)
Methods: We studied 132 patients (118 men, age 68+/-5 years) with CAD and LVEF View Article and Find Full Text PDF

Agreement between four available algorithms to evaluate global systolic left and right ventricular function from tomographic radionuclide ventriculography and comparison with planar imaging.

Background And Aim: Left and right ventricular ejection fractions (LVEF and RVEF) and end-diastolic and end-systolic volumes (LVEDV, RVEDV, LVESV and RVESV) can be calculated from tomographic radionuclide ventriculography (TRV). The aim of this study was to validate and compare these parameters obtained using four different TRV software programs (QBS, QUBE, 4D-MSPECT and BP-SPECT).

Methods: LVEF obtained from planar radionuclide ventriculography (PRV) was compared with LVEF obtained from TRV using the four different software programs in 166 patients.

Accuracy of commercially available processing algorithms for planar radionuclide ventriculography using data for a dynamic left ventricular phantom.

Background: Automatic and semi-automatic algorithms to calculate ejection fraction (EF) from planar radionuclide ventriculography (PRV) have been used for many years in nuclear medicine. Validation of these algorithms is scarce and often performed on outdated versions of the software. Nevertheless, clinical trials where PRV is being used as the 'gold standard' for EF are numerous.

Accuracy of 4 different algorithms for the analysis of tomographic radionuclide ventriculography using a physical, dynamic 4-chamber cardiac phantom.

Unlabelled: Various automatic algorithms are now being developed to calculate left ventricular (LV) and right ventricular (RV) ejection fraction from tomographic radionuclide ventriculography. We tested the performance of 4 of these algorithms in estimating LV and RV volume and ejection fraction using a dynamic 4-chamber cardiac phantom.

Methods: We developed a realistic physical, dynamic 4-chamber cardiac phantom and acquired 25 tomographic radionuclide ventriculography images within a wide range of end-diastolic volumes, end-systolic volumes, and stroke volumes.

99mTc-ciprofloxacin planar and tomographic imaging for the diagnosis of infection in the postoperative spine: experience in 48 patients.

The non-invasive assessment of postoperative spinal infections can pose a substantial diagnostic challenge, especially in the presence of orthopaedic devices. Whereas white blood cell scanning is of limited use in the spine, the low normal bone marrow uptake of technetium-99m ciprofloxacin combined with its claimed bacterial specificity makes it theoretically an ideal candidate for the evaluation of postoperative spinal infections. This study aimed to evaluate 99mTc-ciprofloxacin planar and single-photon emission tomography (SPET) imaging in relation to microbiological and clinical diagnosis in the postoperative spine.

Day-to-day variability of global left ventricular functional and perfusional measurements by quantitative gated SPECT using Tc-99m tetrofosmin in patients with heart failure due to coronary artery disease.

Background: Although myocardial gated single photon emission computed tomography (SPECT) is routinely used for functional measurements in patients with coronary artery disease (CAD) and heart failure, day-to-day variability of left ventricular ejection fraction (LVEF), left ventricular (LV) volumes, and global perfusion scoring has not yet been investigated.

Methods And Results: In 20 consecutive patients with CAD and an LVEF lower than 40% who routinely underwent a resting tetrofosmin gated SPECT study, we performed an additional gated SPECT study at rest 1 to 5 days later under the same circumstances. LV volumes and LVEF were calculated from the gated SPECT data by commercially available software (QGS).

The role of nuclear medicine in the prediction and detection of radiation-associated normal pulmonary and cardiac damage.

Dose-effect calculations used in the planning of modern radiotherapy (RT) involving normal lung or cardiac tissue rely on structural imaging techniques, such as CT, as the basis for measuring and predicting dose-response. However, more accurate methods for predicting dose-response may result if information on the locoregional functional status of the irradiated organ(s) is included in the computational model. For RT cases that involve delivering dose to the lung and heart, this may be achieved by the assessment of tomographic scintigraphies of lung perfusion (Q) and ventilation (V) and scintigraphic imaging of myocardial perfusion and function, respectively.

Validation of gated blood-pool SPECT cardiac measurements tested using a biventricular dynamic physical phantom.

Unlabelled: We have developed a biventricular dynamic physical cardiac phantom to test gated blood-pool (GBP) SPECT image-processing algorithms. Such phantoms provide absolute values against which to assess accuracy of both right and left computed ventricular volume and ejection fraction (EF) measurements.

Methods: Two silicon-rubber chambers driven by 2 piston pumps simulated crescent-shaped right ventricles wrapped partway around ellopsoid left ventricles.

Clinical relevance of left ventricular volume assessment by gated myocardial SPET in patients with coronary artery disease.

Coronary artery disease (CAD) is the leading cause of mortality in the Western world. Multiple parameters have been investigated to predict prognosis in CAD patients. The prognostic value of the left ventricular ejection fraction (LVEF) in patients with CAD is well established.

Tumour angiogenesis pathways: related clinical issues and implications for nuclear medicine imaging.

Tumour angiogenesis is essential for growth, invasion and metastasis. Retrospective studies suggest that it is an independent prognostic factor that merits prospective validation. Furthermore, as tumour blood vessels show many differences from normal vessels and are not genetically unstable, they form a key area for therapy development.