The open medical imaging journal最新文献

{"title":"How Useful is an Integrated SPECT/CT in Clinical Setting and Research?: Evaluation of a Low Radiation Dose 4 Slice System §","authors":"T. Belhocine, I. Rachinsky, C. Akincioglu, S. Gambhir, B. Wilcox, W. Vezina, L. Stitt, A. Driedger, J. Urbain","doi":"10.2174/1874347100802010080","DOIUrl":"https://doi.org/10.2174/1874347100802010080","url":null,"abstract":"Hybrid imaging is becoming a popular technology in nuclear medicine. We have evaluated the added value of an integrated SPECT/low-dose multislice CT over conventional planar/SPECT nuclear imaging. Phantom and clinical studies were performed on the Infinia™ Hawkeye™ 4 slice (HWK-4) with an upgraded software package (Xeleris 2.05v) from GE Heatlthcare to assess 1) the benefit of CT for contrast-resolution, attenuation correction, and anatomic localisation; 2) the impact of hybrid imaging in 456 consecutive patients in a clinical setting. SPECT/CT data were compared to conventional planar/SPECT data and correlated to clinical, biochemical, morphological imaging, angiography, and pathology findings. SPECT/CT was well tolerated by the patients with minimal CT irradiation dose (< 2mSv). HWK-4 provided useful attenuation correction for its routine use in MPI and accurate anatomic localisation of physiological and pathological foci in 99m Tc-RBC, 99m Tc-HMPAO-WBC, 131/123 I-MIBG, Octreoscan ® , and 67 Ga studies. Low-dose multislice CT also helped detect gross morphological abnormalities. Hybrid imaging had a significant impact in ProstaScint ® and parathyroid imaging for image-guided intervention. In bone imaging and differentiated thyroid cancers, SPECT/CT was able to clarify equivocal findings from planar whole-body scan. SPECT/CT was also found useful to precisely localize sentinel lymph nodes. Research protocols are being evaluated for half-time acquisition with resolution recovery and quantification of tracer distribution. SPECT/low-dose multislice CT has been successfully implemented in routine clinical practice. CT provided added value for effective attenuation correction and accurate anatomic localisation of disease with an impact on patient management.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"52 1","pages":"80-108"},"PeriodicalIF":0.0,"publicationDate":"2008-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88355013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Scan with Confusing Appearance: Superscan or Metabolic Disorder","authors":"S. Gratz, W. Kaiser, T. Behr","doi":"10.2174/1874347100802010109","DOIUrl":"https://doi.org/10.2174/1874347100802010109","url":null,"abstract":"We present a patient with metastatic prostate cancer with known bone involvement and unknown osteomyelofibrosis. It has the general appearance of a superscan, with homogeneously increased tracer uptake and no visualization of the kidneys. However, while a superscan should have greater uptake in the axial skeleton compared to the appendicular skeleton, this scan is reverse, raising the suspicion of an overlying metabolic bone disorder. Subsequent laboratory-, bioptical findings confirmed a myeloproliferative syndrome with osteomyelofibrosis. As such, this scan demonstrates that in a patient with both affiliations, metabolic bone disease can override even severe osseous metastases on a bone scan.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"188 1","pages":"109-110"},"PeriodicalIF":0.0,"publicationDate":"2008-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78059281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advantages of Hybrid SPECT/CT vs SPECT Alone","authors":"H. Jacene, S. Goetze, H. Patel, R. Wahl, H. Ziessman","doi":"10.2174/1874347100802010067","DOIUrl":"https://doi.org/10.2174/1874347100802010067","url":null,"abstract":"We present our initial two year clinical experience with SPECT/CT, compare the interpretation to SPECT alone, provide illustrative cases, and review the published literature. Hybrid SPECT/CT has added clinical value over SPECT imaging alone primarily due to more precise anatomical lesion localization. After reading this report, the reader will appreciate the advantages of SPECT/CT imaging for clinical practice. We have reviewed SPECT/CT studies of 144 adult patients referred for various clinical indications in a busy nuclear medicine practice. The SPECT and fused SPECT/CT images were reviewed and interpreted separately to determine if addition of the fused CT images added incremental information, e.g., more definitive anatomic localization, more definitive diagnostic certainty, or changed final image interpretation compared to the SPECT images alone. Our analysis showed that SPECT/CT provided additional information for image interpretation in 54% (78/144) of cases. In most of these (68/78), the CT data improved localization of abnormal and physiologic findings. Diagnostic certainty was improved in 34/144 cases (24%) and image interpretation was beneficially altered in 18/144 cases (13%). The fusion of anatomical and functional information by hybrid SPECT/CT positively impacts image interpretation and adds diagnostic value over SPECT alone.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"12 1","pages":"67-79"},"PeriodicalIF":0.0,"publicationDate":"2008-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86207342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Assurance in Ultrasonographic Measurements of the MyomatousUterus","authors":"Päivi H. Rovio, T. Luukkaala, M. Vuento, S. Oksa, P. Heinonen","doi":"10.2174/1874347100802010062","DOIUrl":"https://doi.org/10.2174/1874347100802010062","url":null,"abstract":"It is important to evaluate quality control in health care. The aim of the current study was to evaluate different sources of variation in estimating the preoperative weight of the myomatous uterus by using repeatability and reproducibility (R&R) method. Material and Methods: Estimation of the total weight of the uterus by a formula combining the formulas for the prolate ellipsoid and cylinder was preoperatively determined using a transvaginal ultrasound probe. Three physicians repeated each round of measurements three times, producing in total 108 findings (12 subjects x 3 investigators x 3 rounds) in 12 women with symptomatic leiomyomas scheduled to undergo hysterectomy. Variation was divided into different components: physicians, patients, and repeated measurements. Variation due to differences across repeated measurements (repeatability), across physicians (reproducibility), and across patients (variability) was then estimated. The estimates of uterine weights were compared to the true weight of the hysterectomy specimen. Results: The more experienced the physician was in taking the ultrasound measurements the less deviation was observed between her own three measurements. Repeatability was 28 %, reproducibility 0% and patient-to-patient variation 72%. There was no significant difference between the accuracy of the measurements of the three physicians. Conclusions: The experience of the physician had an effect on repeatability but not on reproducibility in estimating uterine weight by ultrasound. Our results indicate the importance of conscientiousness in taking measurements of the uterus and cervix.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"20 1","pages":"62-66"},"PeriodicalIF":0.0,"publicationDate":"2008-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79060857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colour Doppler Flow Measurements using Surface Integration of Velocity Vectors (SIVV): effect of colour flow gain, pulse repetition frequency and number of imaging planes","authors":"M. Chew, J. Brandberg, B. J. Sjöberg, E. Sloth","doi":"10.2174/1874347100802010056","DOIUrl":"https://doi.org/10.2174/1874347100802010056","url":null,"abstract":"Colour Doppler flow measurements using surface integration of velocity vectors (SIVV) : Effect of colour flow gain, pulse repetition frequency and number of imaging planes","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"42 1","pages":"56-61"},"PeriodicalIF":0.0,"publicationDate":"2008-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74309736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of Tomographic Versus Planar Lung Scintigraphy in Suspected Pulmonary Embolism in a Daily PracticeT","authors":"P. Weinmann, J. Moretti, M. Brauner","doi":"10.2174/1874347100802010049","DOIUrl":"https://doi.org/10.2174/1874347100802010049","url":null,"abstract":"Objectives: Lung scintigraphy is non-diagnostic in most patients suspected of pulmonary embolism when performed in planar mode. Tomographic mode could improve lung scan performance but has not been rigorously assessed. In this study we assessed the usefulness of tomographic mode in patients with a non-diagnostic lung scan scintigraphy. Methods: pulmonary embolism was diagnosed or ruled out in consecutive patients with a non-diagnostic lung scan by the combination of a 4-slices computerized tomography and a lower-limb ultrasonography. Results given by reading the tomographic mode in ventilation/perfusion lung scan were compared to final diagnosis. Results: 142 out of 392 consecutive patients with a non-diagnostic planar lung scintigraphy were included while 47 were excluded, 45 because of contra-indication to contrast medium and 2 because of non-optimal opacification of pulmonary arteries. Ninety-five patients were evaluated. Pulmonary embolism was diagnosed in 20 (21%) patients and ruled out in 75 (79%). Concordance with final diagnosis was found in 77/94 (82%) patients. Tomographic mode was non-diagnostic in 1 (1%) patient. Tomographic mode sensitivity/specificity/accuracy were 0.79/0.83/0.80 respectively. Negative predictive value was 0.94. Discordances were related to single sub segmental or non-occluding segmental thrombus. Conclusion: Tomographic mode is diagnostic in nearly all patients and agreement with final diagnosis is found in the majority. Its excellent negative predictive value enables to rule out pulmonary embolism. Discordances were related to single sub segmental or non-occluding segmental thrombus which prognosis value remains to be established.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"30 1","pages":"49-55"},"PeriodicalIF":0.0,"publicationDate":"2008-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73295957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exogenous Cell Stimulation for Imaging Infection","authors":"S. Gratz, M. Gotthardt, A. Pfestroff, T. Behr, H. Höffken","doi":"10.2174/1874347100802010042","DOIUrl":"https://doi.org/10.2174/1874347100802010042","url":null,"abstract":"Leukocyte activation is a property of systemic infection. In a previous animal experiment we could demon- strate, that granulocytes, which were already activated by the immune system, were more useful in the evaluation of scin- tigraphic imaging infection than non activated donor granulocytes. The purpose of the present study was to investigate the in vitro activation of isolated polymorphonuclear (PMN) donor leukocytes in the presence of various biological active modulators in rabbits with E. coli infection. Methods: In vitro, incubation of isolated leukocytes of non infected donors was performed with different immune stimu- lating modulators such as granulocyte-colony stimulating factor (G-CSF), proinflammatory cytokines (IL-8, IL-1 ) and bacterial products (fMLP) at 37 degrees C for 2 hrs. Afterwards, the different radiolabeled granulocyte preparations were studied in rabbits with an E. coli infection in the left calf muscle. The soft tissue infections were scintigraphically visual- ized following injection of 18 MBq 99m Tc-HMPAO-purified-heterologous in vitro stimulated granulocytes of non infected donor rabbits. Non-stimulated 99m Tc-HMPAO-purified-heterologous granulocytes served as a control. Gamma camera im- ages were acquired at 2 min, 1, 2 and 4 hrs p.i. After the last image the rabbits were sacrificed and the uptake of the radio- label in the dissected tissues was determined. Results: The 99m Tc-HMPAO-heterologous granulocytes incubated with G-CSF faintly visualized the infectious focus in the calf muscle at 2 hr p.i. and a slightly better delineation of the infection was noticed at 4 hr p.i. With heterologous granulocytes incubated with proinflammatory cytokines and fMLP a delineation of the infected calf muscle was not pos- sible. The absolute uptake in the infected calf muscle was not significantly different between G-CSF (0.26 ± 0.06% ID), proinflammatory cytokines (0.23 ± 0.06% ID), fMLP (0.22 ± 0.02% ID) and the controls (0.17 ± 0.02% ID). The ratio of the infection to the non infected contralateral muscle was slightly higher for 99m Tc-HMPAO-heterologous granulocytes incubated with G-CSF (2.63 ± 0.03) as compared with the proinflammatory cytokines (1.3 ± 0.01), fMLP (1.4 ± 0.08) and the control (1.4 ± 0.04), respectively (all statistical differences were not significant with p=0.1-0.32). Conclusions: Our results confirm a direct, but probably weak stimulating effect of only G-CSF on the PMN for imaging infection. In addition, in-vivo heterologous granulocytes harvested from infected animals in a previous study showed bet- ter results as compared to the present data, suggesting the need of intrinsic cell activation for specific granulocyte migra- tion, which cannot be mimicked by other stimuli.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"96 1","pages":"42-48"},"PeriodicalIF":0.0,"publicationDate":"2008-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76731175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vivo Mapping of Fiber Pathways in the Rhesus Monkey Brain","authors":"S. Hofer, J. Frahm","doi":"10.2174/1874347100802010032","DOIUrl":"https://doi.org/10.2174/1874347100802010032","url":null,"abstract":"The study of complex fiber systems in relation to the cognitive abilities of humans is a long-standing challenge for neuroscientists. With the development of diffusion tensor imaging (DTI) it is now possible to visualize large fiber bundles non-invasively. The existing knowledge of the white matter architecture largely stems from either lesion studies of human patients or, in more detail, tracer injection studies of non-human primates. Hence, it seems mandatory to com- pare DTI results with histochemical findings obtained for the same species. Using a geometrically undistorted DTI tech- nique and fiber tractography, we examined the fiber anatomy of the macaque brain in vivo and related the results to fiber pathways previously identified in monkeys with conventional tract tracing. The approach identified multiple fiber tracts including the main association and projection pathways as well as fibers of the limbic system, commissural system, optic system, and cerebellar system. In conclusion, in vivo fiber tractography based on current-state DTI allows for a compre- hensive analysis of major fiber pathways in the intact macaque brain.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"1 1","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2008-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89026535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuclear Medicine Imaging in the Detection of Complications After Total Knee Arthroplasty (TKA)","authors":"S. Gratz, M. Gotthardt, T. Behr, H. Strosche, P. Reize","doi":"10.2174/1874347100802010024","DOIUrl":"https://doi.org/10.2174/1874347100802010024","url":null,"abstract":"The differentiation of septic and aseptic total knee arthroplasty (TKA) loosening often generates major difficulties. Nuclear medicine imaging of infection has proven to have a high potential. Therefore, we evaluated the diagnostic accuracy of 99m Tc-DPD triple-phase bone scintigraphy (TPBS) in combination with 99m Tc-labelled antigranulocyte antibody (BW 250/183) for the differentiation of septic and aseptic TKA loosening. Eighty seven patients with 94 TKA were investigated between 2003 and 2007. TPBS was classified as abnormal when an increased blood supply and increased bone uptake around the TKA was visible. BW 250/183 was considered positive for infection, when the activity around the TKA increased from 4 hr to 24 hr by more than 10% as compared with normal bone marrow images after injection of the radioabelled monoclonal antigranulocyte antibody. TPBS was true positive for septic and aseptic loosening in all patients, whereas false positive results for septic loosening were found in 9/20 cases (n=45%). False positive results with TPBS were correctly diagnosed by a negative BW 250/183 scan. These results suggest that TPBS is highly sensitive for the diagnosis of TKA loosening, whereas BW 250/183 allows for a specific diagnosis of periprosthetic infection. The combination of both is complementary and increases in diagnostic accuracy significantly (p<0.001). Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"2 1","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"2008-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88470201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Stunning Demonstrated by Adenosine Myocardial Perfusion Scintigraphy as a Predictor of Significant Coronary Artery Disease","authors":"M. Salahuddin, A. Vasudeva, S. Underwood","doi":"10.2174/1874347100802010014","DOIUrl":"https://doi.org/10.2174/1874347100802010014","url":null,"abstract":"Myocardial stunning may occur after a brief but profound episode of ischaemia that is insufficient to lead to myocyte necrosis but following which there is depression of myocyte function that persists for hours or days. It is thought to be caused by disordered intra-cellular calcium handling and, when seen after stress-induced myocardial ischemia, it indicates profound ischaemia and potentially an adverse prognosis.","PeriodicalId":90366,"journal":{"name":"The open medical imaging journal","volume":"87 1","pages":"14-16"},"PeriodicalIF":0.0,"publicationDate":"2008-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74948487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}