Analysis of myocardial perfusion and metabolism in patients with hypertrophic obstructive cardiomyopathy undergoing percutaneous transluminal septal myocardial ablation by99 Tcm-MIBI and 18F-FDG images / 中华核医学杂志

Objective To evaluate the use of gated SPECT in patients with hypertrophic obstructive cardiomyopathy (HOCM) and the effects of percutaneous transluminal septal myocardial ablation (PTSMA) on myocardial perfusion.Methods 99 Tcm-methoxyisobutylisonitrile (MIBI) and 18F-fluorodeoxyglucose (FDG) images were performed in 31 HOCM patients before PFSMA and in 15 patients 3-7 d after PTSMA.The images in different left ventricular segments were analysed by using scores.Results In 99Tcm-MIBI images, uptake decreased at the septal regions in 12 HOCM patients (80.0%, 12/15) after PTSMA, 18F-FDG images also showed decreased uptake at the septal regions in 5 HOCM patients (33.3%, 5/15) after PTSMA.Conclusion 99Tcm-MIBI images might be an important method to evaluate PTSMA results, and 18 F-FDG images showed important value as reference.

Significance of sentinel lymph node detection for cN0 laryngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study was to investigate the clinical value of radiolabeled tracer method, methylene blue method and combination of these two methods in detection of sentinel lymph node (SLN), and to evaluate the accuracy of SLN in predicting the cervical lymph nodes status in laryngeal carcinoma patients with clinically negative neck lymph nodes (cN0 ).</p><p><b>METHODS</b>Forty-one patients with cN0 laryngeal neoplasms underwent SLN detection using both of radiolabeled tracer and methylene blue. SLN imaging was performed with laryngoscope-guided injection of radioactive isotope 99Tc(m)-sulfur colloid (SC) into the laryngeal carcinoma before surgery, then all these patients underwent intraoperative lymphatic mapping with a handheld gamma-detecting probe. After mapping of SLN, methylene blue was subsequently injected at the same spots around the tumor in order to identify SLN during surgery. The results of SLN detection by isotope tracer, dye and combination of both methods were compared.</p><p><b>RESULTS</b>The SLN detection rates by radiolabeled tracer, methylene blue and combined method were 87.8%, 70.7% and 92.7%, respectively (P < 0.01). The number of detected SLN was significantly different between radiolabeled tracer method and combined method (P < 0.05), and also between blue dye method and combined method (P < 0.01). However, no statistically significant difference was found between methylene blue method and radiolabeled tracer method (P > 0.05). Nine patients were found to have lymph node metastasis by final pathological examination. The sensitivity, accuracy and negative predictive values of SLN detection by the combined method using radiolabeled tracer and methylene blue were 88.9%, 97.4% and 96.7%, respectively.</p><p><b>CONCLUSION</b>The combined method using radiolabeled tracer and methylene blue can improve the accuracy of sentinel lymph node detection. Furthermore, sentinel lymph node detection can accurately predict the cervical lymph node status in cN0 laryngeal carcinoma.</p>

Diagnostic value of 99mTc-N-NOET myocardial perfusion imaging during exercise for coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the value of (99m)Tc-N-NOET ((99m)Tc-N-ethoxy-N-ethyl dithiocarbamato-nitrito) myocardial perfusion SPECT for the diagnosis of coronary artery disease.</p><p><b>METHODS</b>A total of 42 patients [mean age (54 +/- 9) years, 35 men] with suspected chest pain were included in this study. 740 MBq of (99m)Tc-N-NOET was injected intravenously during bicycle exercise when the heart rate attained reached more than 85% of the expected maximum, or in cases of angina pectoris, severe arrhythmias and ischemic ST segment changes. (99m)Tc-N-NOET 740 MBq, SPECT myocardial imaging acquisitions were obtained at 15 minutes and 2 hours after (99m)Tc-N-NOET injection. Coronary angiography was performed in all patients.</p><p><b>RESULTS</b>Coronary artery stenosis was detected in 26 patients and normal coronary angiography was shown in 16 patients. (99m)Tc-N-NOET myocardial perfusion imaging was abnormal in twenty-one patients out of the 26 patients with significant coronary artery stenosis (sensitivity, 81%); 14 out of 16 patients with normal angiography had a normal myocardial perfusion imaging (specificity, 88%). The positive predictive value, negative predictive value and predictive accuracy of (99m)Tc-N-NOET myocardial perfusion imaging for detection of CAD was 91%, 74% and 83%, respectively. The sensitivity of the imaging for detecting single vessel, double vessels and triple vessels disease were 60% (6/10), 86% (6/7) and 100% (9/9), respectively. There was mild (99m)Tc-N-NOET lung uptake in patients with coronary artery stenosis 15 minutes post (99m)Tc-N-NOET injection.</p><p><b>CONCLUSION</b>SPECT myocardial perfusion imaging with (99m)Tc-N-NOET supplied an important diagnostic tool for detecting coronary artery disease. Lung uptake with stress (99m)Tc-N-NOET might be related to coronary artery disease.</p>

Myocardial perfusion imaging with (99m)Tc (N) (PNP5) (DBODC)(+) in canine model of acute myocardial ischemia / 中华心血管病杂志

<p><b>OBJECTIVE</b>(99m)Tc-[bis (dimethoxypropylphosphinoethyl)-ethoxyethylamine (PNP5)]-[bis (N-ethoxyethyl)-dithiocarbamate (DBODC)] nitride ([(99m)Tc (N) (PNP5) (DBODC)](+)) is a new myocardial perfusion tracer with high heart uptake and rapid liver clearance. The objectives of this study were to compare the myocardial imaging of [(99m)Tc (N) (PNP5) (DBODC)](+) with (99m)Tc-MIBI in a canine model of acute myocardial ischemia.</p><p><b>METHODS</b>The left anterior descending artery (LAD) was occluded in 12 adult beagle dogs, adenosine was then infused intravenously at a rate of 0.14 mg.kg(-1).min(-1) for 6 min. At the end of 3 min of adenosine infusion, 185 MBq of [(99m)Tc (N) (PNP5) (DBODC)](+) or (99m)Tc-MIBI was injected intravenously. The occluder was released after 6 min adenosine infusion. Serial myocardial SPECT imaging acquisitions were obtained at 0.5, 1, 1.5 and 2 h after tracer injection, respectively. Rest myocardial SPECT imaging was acquired in the next day.</p><p><b>RESULTS</b>Similar as (99m)Tc-MIBI, [(99m)Tc (N) (PNP5) (DBODC)](+) exhibited high heart uptake, minimal lung uptake and minimal redistribution. No significant myocardial washout was observed with both tracers over a period of 2 hours. [(99m)Tc (N) (PNP5) (DBODC)](+) clearance from the liver was more rapid than that with (99m)Tc-MIBI (heart-liver radio at 60 min, 1.36 +/- 0.43 vs. 0.58 +/- 0.21, P = 0.005). [(99m)Tc (N) (PNP5) (DBODC)](+) the ability to detect myocardial ischemia was also comparable between the two tracers ([(99m)Tc (N) (PNP5) (DBODC)](+) detected 3.60 +/- 1.52 defect segments, (99m)Tc-MIBI detected 4.25 +/- 0.96 defect segments, P = 0.48). The image quality of [(99m)Tc (N) (PNP5) (DBODC)](+) was better than (99m)Tc-MIBI.</p><p><b>CONCLUSION</b>[(99m)Tc (N) (PNP5) (DBODC)](+) is comparable to (99m)Tc-MIBI on detecting myocardial ischemia in this model and liver clearance is more rapid and the image quality is better than (99m)Tc-MIBI.</p>