• Title/Summary/Keyword: Perfusion

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Quantification of Myocardial Perfusion and Function Using SPECT and PET (SPECT와 PET을 이용한 심장관류 및 기능의 정량화)

  • Lee, Jae-Sung
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.75-81
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    • 2005
  • Myocardial perfusion and function can be quantified using SPECT and PET. There was controversy over the usefulness of the correction techniques for physical artifacts, such as photon attenuation and scatter, in the quantification of myocardial perfusion using SPECT. However, the cumulated results of many investigations have leaded the consensus on the usefulness of the correction procedures to improve the accuracy and specificity of the myocardial SPECT in the assessment of coronary artery diseases. Although the clinical value of the myocardial perfusion PET has not been preyed yet, the absolute myocardial blood flow and perfusion reserve values quantified using myocardial PET are employed in many basic investigations. In this paper, the methods for the quantitative myocardial SPECT and PET will be reviewed.

Perfusion Computed Tomography in Predicting Treatment Response of Advanced Esophageal Squamous Cell Carcinomas

  • Li, Ming-Huan;Shang, Dong-Ping;Chen, Chen;Xu, Liang;Huang, Yong;Kong, Li;Yu, Jin-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.797-802
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    • 2015
  • Background: The purpose of this study was to prospectively evaluate the predictive value of perfusion computed tomography (CT) for response of local advanced esophageal carcinoma to radiotherapy and chemotherapy. Materials and Methods: Before any treatment, forty-three local advanced esophageal squamous cell carcinomas were prospectively evaluated by perfusion scan with 16-row CT from June 2009 to January 2012. Perfusion parameters, including perfusion (BF), peak enhanced density (PED), blood volume (BV), and time to peak (TTP) were measured using Philips perfusion software. Seventeen cases received definitive radiotherapy and 26 received concurrent chemo-radiotherapy. The response was evaluated by CT scan and esophagography. Differences in perfusion parameters between responders and non-responders were analyzed, and ROCs were used to assess predictive value of the baseline parameters for treatment response. Results: There were 25 responders (R) and 18 non-responders (NR). Responders showed significantly higher BF (R:34.1 ml/100g/min vs NR: 25.0 ml/100g/min, p=0.001), BV (23.2 ml/100g vs 18.3 ml/100g, p=0.009) and PED (32.5 HU vs 28.32HU, P=0.003) than non-responders. But the baseline TTP (R: 38.2s vs NR: 44.10s, p=0.172) had no difference in the two groups. For baseline BF, a threshold of 36.1 ml/100g/min achieved a sensitivity of 56%, and a specificity of 94.4% for detection of clinical responders from non-responders. Conclusions: The results suggest that the perfusion CT can provide some helpful information for identifying tumors that may respond to radio-chemotherapy.

Complete Recovery of Perfusion Abnormalities in a Cardiac Arrest Patient Treated with Hypothermia: Results of Cerebral Perfusion MR Imaging

  • Kim, Min Jeong;Park, Yae Won;Lim, Soo Mee
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.56-60
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    • 2018
  • Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.

Preoperative evaluation of quantitative perfusion lung scintigraphy in the patient with lung cancer (정량적 폐관류스캔에 의한 악성폐종양 환자에서의 수술전 평가에 관한 고찰)

  • 김원곤;서경필
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.94-100
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    • 1984
  • The purpose of present study is to investigate the significance of preoperative evaluation with perfusion lung scintigraphy in patients with lung cancer. Lung scans with the use of macroaggregated human serum albumin labeled with technetlum-99m were carried out in 35 patients with lung cancer before thoracotomy at Seoul National University Hospital during the period from November 1981 to September 1983. The relationship between size of the perfusion defect as seen by perfusion lung scan and size of the mass lesion as seen radiologically was correlated with the presence of regional adenopathy and resectability. Among patients with a larger perfusion defect than mass lesion on chest X-ray film.86% were found to have regional lymph node involvement with 29% resectability, whereas among patients in whom a larger defect was not present only 14% had such extension of the disease with 93% resectability. The relative pulmonary arterial perfusion of affected lung was calculated from the counts of radioactivity recorded from affected lung on both anterior and posterior scans expressed as a percentage of the total counts in the scan. The mean relative pulmonary arterial perfusion of the inoperable group [34\ulcorner%] is significantly different from both that of the pneumonectomy group [39\ulcorner%] and that of the lobectomy group [48\ulcorner%].(p<0.01)

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Prediction of Prognosis by Acetazolamide Brain Perfusion SPECT in Patients with Arteriovenous Malformation (뇌 동정맥기형 환자 수술시 휴식/아세타졸아마이드 뇌혈류 SPECT의 예후 예측력)

  • Bae, Sang-Kyun;Moon, Jae-Gon;Lee, Seok-Mo;Kim, Han-Kyu;Yum, Ha-Yong;Hwang, Do-Yun
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.426-432
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    • 2000
  • After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.

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Effect of Intermittent Versus Continuous Infusion of Progesterone on LHRH Release In Viuo from the Rat Mediobasal Hypothalamus

  • 김경진
    • The Korean Journal of Zoology
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    • v.32 no.4
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    • pp.329-338
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    • 1989
  • Present study examined the effect of intermittent versus continuous infusion of progesterone(P) on LHRH release in uiuo from the mediobasal hvpothalamus of ovariectomiEed, estradiol-primed adult rats bearing push-pull cannulae. Three experimental groups were studied: 1) control (perfusion medium only),2) intermittent perfusion of P (10-min on,20-min off, and 3) continuous perfusion of p. p (10 ng/mll was directly infused into the MBH following a 3 hr basal collection. Perfusates were collected at 10 min intents린s on ice and LHRH release was measured by LHRH radioimmunoassav. Cycle detector analysis revealed that the spontaneous HRH output in the control group was pulsatile over a 7 hr push-pull perfusion period. The mean basal LHRH release, pulse amplitude and pl서se period were 0.68 $\pm$ 0.03 ps110 min, 1.15 $\pm$0.08 pg and 60 $\pm$ 9 min, respectivelv. Intermi구eat perfusion of P clearly stimulated the mean LHRH release (pre-P vs post-P: 1.14 $\pm$ 0.18 vs 1.99 $\pm$ 0.53 pg) without changes in LHRH pulse frequency. In contrast to intermittent infusion of p, continuous administration of P faithed to modify LHRH release, since the mean LHRH release and pulse amplitude between pre-P and post-P perfusion urere similar. The in vitro study clearly showed that intermittent, but not continuous administration of P is effective in stimulating LHRH release. Therefore, it appears that rhythmic secretion of P mal be the erective signal for activating the neural LHRH apparatus.

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Quantitative gated myocardial perfusion SPECT (정량적 게이트 심근관류 SPECT)

  • Ahn, Byeong-Cheol
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.207-218
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    • 2003
  • Myocardial perfusion imaging has been increasingly used to provide prognostic data and guidance on the choice of appropriate management of patients with known or suspected coronary artery disease. The electrocardiogram gated myocardial SPECT program is corning into wide use with an advent of $^{99m}Tc-labeled$ tracers and an improvement of SPECT machines. The gated technique permits measurement of important cardiac prognostic indicators without any further discomforts or radiation burden in patients underwent standard myocardial perfusion SPECT. In addition, gated study significantly improves diagnostic yield by reducing the number of borderline interpretations and could find myocardial stunning and viable myocardium. Gated single photon emission computed tomography (SPECT) imaging allows the automated calculation of end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and the assessment of regional wall motion and thickening, and it have dramatically improved assessment of coronary artery disease in routine nuclear practice. This allows the simultaneous assessment of both perfusion and function within the same acquisition, and serves as a cost-effective technique for providing more diagnostic data with fewer diagnostic tests. Because the diagnostic and prognostic power derived from knowledge of left ventricular function can be added to that provided by assessing myocardial perfusion, gated SPECT imaging has rapidly gained widespread acceptance and is now used on a routine clinical basis in a growing number of laboratories, including South Korea. The gated SPECT technique for measurement of left ventricular parameters has been validated against a variety of well established techniques. In this work, overview of gated myocardial perfusion SPECT focus on functional parameters is presented.

Development of the Three-Dimensional Perfusion Culture Technology for the Salivary Ductal Cells (타액선 도관세포의 관류 배양 기술 개발)

  • Kim, Ji Won;Kim, Jeong Mi;Choi, Jeong-Seok
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.160-166
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    • 2018
  • Background and objectives: Salivary hypofunction is one of the common side effects after radioiodine therapy, and its pathophysiology is salivary ductal stenosis resulting from ductal cell injury. This study aimed to develop the functional culture environment of human parotid gland ductal cells in in vitro three-dimensional perfusion culture system. Materials and Methods: We compared plastic dish culture method and three-dimensional culture system containing Matrigel and nanofiber. Morphogenesis of reconstituted salivary structures was assessed by histomorphometry. Functional characteristics were assessed by immunohistochemistry and reverse transcription polymerase chain reaction (aquaporin 5, CK7, CK18, connexin 43, and p21). In addition, we designed the media perfusion culture system and identified higher rate of cell proliferation and expression of connexin 43 in perfusion system comparing to dish. Results: Human parotid ductal cells were well proliferated with the ductal cell characters under environment with Matrigel. In the presence of Matrigel, aquaporin 5, CK18 and connexin 43 were more expressed than 2D dish and 3D nanofiber setting. In the media perfusion culture system, ductal cells in 3D culture media showed higher cells count and connexin 43 expression compared to 2D dish. Conclusion: This in vitro ductal cell perfusion culture system using Matrigel could be used to study for radioiodine induced sialadenitis model in vivo.

Diagnosis of Coronary Artery Disease Using Myocardial Perfusion SPECT (심근 SPECT를 이용한 관상동맥질환의 진단)

  • Won, Kyoung-Sook;Kim, Hae-Won
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.196-202
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    • 2009
  • Myocardial perfusion scintigraphy is currently by far the most commonly performed cardiac nuclear study, constituting approximately one third of all nuclear medicine procedure. It plays an important role in the diagnosis, prognosis, risk assessment and management of heart disease. Aim of this review is to describe recent evolution of myocardial perfusion imaging on the focus of diagnosis of coronary artery disease. In addition, current status of other imaging modalities will be reviewed.

Evaluation and Comparison of Myocardial Perfusion Defects in Patients with Early Breast Cancer Subjected to Different Radiation Simulation Techniques (조기유방암 환자에서 방사선 모의치료 방법의 차이에 따른 심근관류결손의 비교 평가)

  • Nam, Ji-Ho;Ki, Yong-Kan;Kim, Dong-Won;Kim, Won-Taek
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.26-33
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    • 2007
  • [ $\underline{Purpose}$ ]: The aim of this study is to evaluate and compare the incidence and aspects of myocardial perfusion defects in patients who were subjected to either two-dimensional or three-dimensional simulation techniques for early left-sided breast cancer. The myocardial perfusion defects were determined from using single photon emitted computerized tomography (SPECT) myocardial perfusion images. $\underline{Materials\;and\;Methods}$: Between January 2002 and August 2003, 32 patients were enrolled in this study. The patients were diagnosed as having early (AJCC stage T1-T2N0M0) left-sided breast cancer and were treated with tangential irradiation after breast-conserving surgery and systemic chemotherapy. The patients were divided into two groups according to the type of simulation received: two-dimensional simulation using an X-ray fluoroscope simulator or three-dimensional simulation with a CT simulator. All patients underwent technetium-99m-sestamibi gated perfusion SPECT at least 3 years after radiotherapy. The incidence and area of myocardial perfusion defects were evaluated and were compared in the two groups, and at the same time left ventricular ejection fraction and cardiac wall motion were also analyzed. The cardiac volume included in the radiation fields was calculated and evaluated to check for a correlation between the amount of irradiated cardiac volume and aspects of myocardial perfusion defects. $\underline{Results}$: A myocardial perfusion defect was detected in 11 of 32 patients (34.4%). There were 7 (46.7%) perfusion defect cases in 15 patients who underwent the two-dimensional simulation technique and 4 (23.5%) patients with perfusion defects in the three-dimensional simulation group (p=0.0312). In 10 of 11 patients who had myocardial perfusion changes, the perfusion defects were observed in the cardiac apex. The left ventricular ejection fraction was within the normal range and cardiac wall motion was normal in all patients. The irradiated cardiac volume of patients in the three-dimensional simulation group was less than that of patients who received the two-dimensional simulation technique, but there was no statistical significance as compared to the incidence of perfusion defects. $\underline{Conclusion}$: Radiotherapy with a CT simulator (three-dimensional simulation technique) for early left-sided breast cancer may reduce the size of the irradiated cardiac volume and the incidence of myocardial perfusion defects. Further investigation and a longer follow-up duration are needed to analyze the relationship between myocardial perfusion defects and clinical ischemic heart disease.