How to apply the evidence-based medicine concept to nuclear medicine diagnostic studies -- a review.

Evidence-based medicine (EBM) is defined as using the best available evidence for managing patients in daily healthcare practice. Although this approach has been applied successfully in many medical fields, it has not been addressed fully in the radiological discipline in general and nuclear medicine in particular. In this review, the concept of EBM has been introduced briefly and four steps of EBM practice have been explained.

Application of technetium-99m-sestamibi in differentiation of active from inactive pulmonary tuberculosis using a single photon emission computed tomography method.

Objective: We studied the usefulness of 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy for differentiation between active and inactive pulmonary tuberculosis.

Methods: Thirty-six patients (aged 27-82 years, 16 males and 20 females) were included in our study. Each patient was injected with 740 MBq (20 mCi) 99mTc-MIBI and both planar and single photon emission computed tomography (SPECT) imaging were performed 15 and 60 min after injection.

Age-related changes in skull uptake on bone scintigraphy: a quantitative study.

Background: "Hot skull", or diffuse increased activity of bone seeking radiotracers, is frequently seen in the bone scans of some patients, especially elderly women. This finding has been attributed to enhanced bone metabolism in old age.

Material And Methods: We semi-quantitatively studied 342 normal bone scans (161 male and 181 female within the age range 12 to 82 years).

Assessment of transient left ventricular dilation ratio via 2-day dipyridamole Tc-99m sestamibi nongated myocardial perfusion imaging.

Background: The definition of an abnormal transient ischemic dilation (TID) ratio may be different according to stress type, type of isotope, and imaging protocols. The aim of this study was to derive the normal threshold and assessment of the TID ratio via 2-day dipyridamole stress/rest technetium 99m sestamibi myocardial perfusion single photon emission computed tomography (MPS).

Methods And Results: We performed 2-day dipyridamole stress/rest Tc-99m sestamibi MPS in 665 patients.

Comparison of two software in gated myocardial perfusion single photon emission tomography, for the measurement of left ventricular volumes and ejection fraction, in patients with and without perfusion defects.

Emory cardiac toolbox (ECTb) and quantitative gated single photon emission tomography - SPET (QGS) software are the two most often used techniques for automatic calculation of left ventricular volumes (LVV) and ejection fraction (LVEF). Few studies have shown that these software are not interchangeable, however the effect of perfusion defects on performance of these software has not been widely studied. The aim of this study was to compare the performance of QGS and ECTb for the calculation of LVEF, end-systolic volume (ESV) and end-diastolic volume (EDV) in patients with normal and abnormal myocardial perfusion.

Importance of gated imaging in both phases of myocardial perfusion SPECT: myocardial stunning after dipyridamole infusion.

We present the case report of a 72-y-old woman who underwent (99m)Tc-sestamibi gated myocardial perfusion SPECT with a 2-d protocol. SPECT images revealed ischemia of the apical, anteroapical, apicoseptal, and septal walls. Postdipyridamole gated SPECT revealed significant deterioration in the left ventricular ejection fraction (LVEF), wall motion, and systolic wall thickening relative to the findings obtained with rest gated SPECT.

The value of 99mTc-MIBI whole body scintigraphy in active and in remission multiple myeloma.

Technetium-99m methoxy-isobutyl-isonitrile (99mTc-MIBI) has been proposed as an in-vivo marker of various active malignant diseases. The goal of this study was to evaluate the 99mTc-MIBI whole body scintiscan for the early detection of multiple myeloma (MM), active or in remission. We have studied 43 patients with MM, 32 men and 11 women aged 52+/-10 years.