tellurium and Heart-Diseases

Topics: Arsenic; Cadmium; Central Nervous System Diseases; Chemical and Drug Induced Liver Injury; Cobalt; Copper; Gastrointestinal Diseases; Heart Diseases; Humans; Liver; Lung Diseases; Manganese Poisoning; Molybdenum; Nickel; Occupational Medicine; Selenium; Tellurium; Tin; Trace Elements; Vanadium; Zinc

Topics: Cadmium; Databases, Factual; Female; Gamma Cameras; Heart Diseases; Humans; Male; Myocardial Perfusion Imaging; Sensitivity and Specificity; Sex Factors; Tellurium; Zinc

Topics: Cadmium; Gamma Cameras; Heart Diseases; Humans; Myocardial Perfusion Imaging; Sensitivity and Specificity; Stroke Volume; Tellurium; Tomography, Emission-Computed, Single-Photon; Ventricular Function, Left; Zinc

To compare the outputs of a novel all-purpose SPECT camera equipped with CZT detectors (Discovery NM/CT 670) with the state-of-the-art represented by a dedicated CZT (Alcyone, Discovery 530c) cardiac camera in patients submitted to myocardial perfusion imaging (MPI).. We included 19 patients that underwent sequential low-dose. The two cameras showed excellent correlation for segmental myocardial % uptake at stress (R = 0.90; P < 0.001) and at rest (R = 0.88; P < 0.001) with narrow Bland-Altman limits of agreement. The level of diagnostic agreement of Discovery 670 and Alcyone cameras regarding perfusion analysis was excellent (Cohen's κ 0.85). Similarly, the two cameras showed excellent correlation in the evaluation of LV ejection fraction (R = 0.95), peak filling rate (R = 0.97), and mass (R = 0.98).. Our preliminary results suggest that MPI with an all-purpose Discovery 670 CZT-SPECT camera is feasible, comparing well with the current state-of-the-art technology.

Topics: Aged; Cadmium; Female; Gamma Cameras; Heart Diseases; Humans; Male; Middle Aged; Myocardial Perfusion Imaging; Observer Variation; Reproducibility of Results; Stroke Volume; Tellurium; Tomography, Emission-Computed, Single-Photon; Ventricular Function, Left; Zinc

Transthyretin cardiac amyloidosis (ATTR) is a rare, but underdiagnosed, cardiomyopathy. Traditionally diagnosed invasively, ATTR can be diagnosed with non-invasive. Forty-three subjects (24 ATTR, 19 non-ATTR) were imaged with Philips Dual-Head Anger (planar) and General Electric CZT cameras. Myocardial uptake was quantified by heart-to-contralateral (H/CL) ratios. CZT scans were quantified by two readers blinded to planar H/CL, with one repeating blinded quantification. Using the previously validated diagnostic threshold (H/CL ≥ 1.5), sensitivity and specificity of CZT scintigraphy was measured. McNemar's test and Pearson's correlation coefficient were calculated.. Among subjects (76.7% male, age 77 ± 9), there was no significant difference in proportion of ATTR-positive identification between modalities. There was high correlation between CZT and planar H/CL ratios (r = 0.92, P < 0.0001), with low intra- [ICC = 0.89 (0.80-0.94)] and inter-observer [ICC = 0.80 (0.65-0.89)] variability. CZT scintigraphy had 100% sensitivity and specificity for diagnosing ATTR.. ANTECEDENTES: la amiloidosis cardíaca asociada a transtiretina (ATTR) es una cardiomiopatía poco frecuente y poco diagnosticada. Tradicionalmente el diagnóstico se realiza de forma invasiva, aunque se puede diagnosticar con gammagrafía planar con tecnecio 99m pirofosfato (99mTc-PYP). En el presente trabajo se desarrolla y se valida un protocolo diagnóstico de ATTR. MéTODO: Se estudiaron 43 sujetos (24 con diagnóstico de ATTR y 19 sin ATTR) las imágenes fueron adquiridas con las cámaras Philips Dual-Head Anger (planar) y General Electric CZT. La captación miocárdica se cuantificó con proporción corazón-contralateral (H/CL). La adquisición con las cámaras CZT se cuantificaron mediante 2 lectores cegados a la proporción H/CL planar, con una cuantificación ciega repetida. Utilizando el umbral de diagnóstico previamente validado (H/CL ≥ 1.5), se midió la sensibilidad y la especificidad de la gammagrafía con CZT. Para el análisis estadístico se utilizó la prueba De McNemar y el coeficiente de correlación de Pearson. RESULTADOS: entre la población de estudio (76.7% varones, edad 77 ± 9), no hubo diferencias estadísticamente significativas en la proporción de identificación de ATTR positiva. Se identificó una alta correlación entre la cámara CZT y la proporción planar H/CL (r = 0.92, p < 0.0001), así como una baja variabilidad intraobservador (ICC = 0.89 (0.80-0.94)) e interobservador (ICC = 0.80 (0.65-0.89)). La gammagrafía con CZT tuvo una sensibilidad y especificidad del 100% para el diagnóstico de ATTR. CONCLUSIóN: La imagen con 99mTc-PYP en cámaras CZT es altamente sensible y específica para el diagnóstico de ATTR. Estos hallazgos son de relevancia debido a la aparición de terapias modificadoras de la enfermedad.. 背景: 甲状腺素转运蛋白相关型心脏淀粉样变 (ATTR) 是一种罕并且难以诊断的心肌病。 传统的诊断方法是有创的, ATTR 可以通过无创99m锝标记的焦磷酸钙 (99mTc-PYP) 平面闪烁扫描进行诊断。而其它非平面成像方法尚未得到验证。本研究中我们探讨了一种镉锌碲化物(CZT)成像方案用于ATTR的可行性。 方法: 43 名受试者 (24名ATTR, 19名非ATTR) 分别使用飞利浦公司双探头显像仪平面扫描,以及通用公司CZT探头显像仪进行扫描。 心肌摄取采用心/对侧肺 (H/CL) 放射性计数比值作为定量方法。CZT 图像由2位研究者在不知道(双探头)平面扫描 H/CL 值的情况下进行定量测量。 以既往验证的 H/CL ≥ 1.5 作为 ATTR 诊断阈值,评价 CZT 扫描的诊断敏感性和特异性。 (统计学上) 计算了配对卡方检验和皮尔逊相关系数。 结果: 在受试者中 (男性占76.7%,年龄77 ± 9岁), ATTR 阳性诊断率无显著差异。 CZT 与平面扫描 H/CL 值相关性高 (r = 0.92, p  < 0.0001), 观察者内部 (ICC = 0.89(0.80-0.94)) 和观察者之间 (ICC = 0.80(0.65-0.89)) 的变异系数低。 CZT 扫描诊断 ATTR 的敏感性和特异性均为 100%。 结论: 99mTc-PYP CZT 扫描对 ATTR 的诊断具有与双探头扫描类似的高灵敏度和特异性。 鉴于 ATTR 疾病调节疗法的出现,这种新的扫描方法由于提高了诊断能力将具有重要的临床价值。.. L’amyloïdose cardiaque à transthyrétine (ATTR) est une cardiomypathie rare, mais sous-diagnostiquée. Traditionnellement diagnostiquée de façon invasive, l’ ATTR peut être évaluée par scintigraphie planaire au 99mTechnetium (99mTc-PYP). Dans cette étude, nous avons développé et validé un protocole avec detectors Cadmium Zinc Telluride (CZT) pour le diagnostic de l’ATTR. MéTHODES: 43 sujets (24 ATTR, 19 non-ATTR), ont été évaluées avec la camera Anger double tête de Philips et avec la camera CZT de General Electric. L’uptake myocardique du tracer a été quantifié en utilisant le rapport cœur- hemithorax contro-latéral (H/CL). Les scintigraphies obtenues sur camera CZT ont été analysées à deux reprises par deux experts qui n’avaient pas connaissance des résultats des images planaires obtenus au moyen de la caméra Philips. Utilisant le seuil diagnostique précédemment validé (H/CL) de 1.5, la sensibilité et la spécificité de la scintigraphie CZT ont été mesurées. Le test de McNemar et le coefficient de corrélation de Pearson ont été calculés. RéSULTATS: Nous n’avons pas observé de difference significative dans l’identification de l’amyloïdose cardiaque à transthyrétine (ATTR) chez les sujets étudies (76,7% d’ hommes, 77 à 9 ans) entre les deux modalitées scintigraphiques. De plus, nous avons noté une étroite correlation entre les résultats H/CL obtenus par imagerie CZT et Anger planaire (r-0,92, p-0,0001), avec une faible variabilité intra- (ICC-0,89(0,80-0,94)) et inter-observateurs (ICC 0,80 (0,65-0,89)). Le diagnostique de l’ATTR par scintigraphie à CZT a montré une sensibilité et une spécificité de 100%.. l’imagerie scintigraphique au 99mTc-PYP obtenue sur camera CZT est aussi sensible et spécifique que celle obtenue sur camera Anger planaire pour le diagnostiqe de l’amyloidose cardiaque ATTR. L’utilisation des caméras CZT devraient faciliter le diagnostic et par conséquent l’implémentation des nouvelles thérapies de l’amyloidose cardiaque ATTR.

Topics: Aged; Aged, 80 and over; Amyloidosis; Cadmium; Cardiology; Electrocardiography; Female; Follow-Up Studies; Heart Diseases; Heart Failure; Humans; Male; Natriuretic Peptide, Brain; Peptide Fragments; Prealbumin; Radionuclide Imaging; Reproducibility of Results; Sensitivity and Specificity; Technetium Tc 99m Pyrophosphate; Tellurium; Zinc

The applicability of ultra-low-dose computed tomography (CT) for attenuation correction (AC) of single-photon-emission computed tomography myocardial perfusion imaging (SPECT-MPI) remains elusive.. One-hundred patients underwent one-day. Attenuation maps for MPI obtained from ultra-low radiation dose CT scans are interchangeable with attenuation maps from standard-dose CT while offering a substantial reduction in radiation dose exposure.

Topics: Aged; Cadmium; Female; Heart Diseases; Humans; Male; Middle Aged; Myocardial Perfusion Imaging; Organophosphorus Compounds; Organotechnetium Compounds; Prospective Studies; Radiation Dosage; Reproducibility of Results; Sensitivity and Specificity; Tellurium; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Zinc

The aim of this study was to clarify the differences in thallium-201-chloride (thallium-201) myocardial perfusion imaging (MPI) scans evaluated by conventional anger-type single-photon emission computed tomography (conventional SPECT) versus cadmium-zinc-telluride SPECT (CZT SPECT) imaging in normal databases for different ethnic groups. MPI scans from 81 consecutive Japanese patients were examined using conventional SPECT and CZT SPECT and analyzed with the pre-installed quantitative perfusion SPECT (QPS) software. We compared the summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) for the two SPECT devices. For a normal MPI reference, we usually use Japanese databases for MPI created by the Japanese Society of Nuclear Medicine, which can be used with conventional SPECT but not with CZT SPECT. In this study, we used new Japanese normal databases constructed in our institution to compare conventional and CZT SPECT. Compared with conventional SPECT, CZT SPECT showed lower SSS (p < 0.001), SRS (p = 0.001), and SDS (p = 0.189) using the pre-installed SPECT database. In contrast, CZT SPECT showed no significant difference from conventional SPECT in QPS analysis using the normal databases from our institution. Myocardial perfusion analyses by CZT SPECT should be evaluated using normal databases based on the ethnic group being evaluated.

Topics: Aged; Aged, 80 and over; Asian People; Cadmium; Coronary Angiography; Coronary Circulation; Databases, Factual; Equipment Design; Female; Gamma Cameras; Heart Diseases; Humans; Japan; Male; Middle Aged; Myocardial Perfusion Imaging; Predictive Value of Tests; Prospective Studies; Radiopharmaceuticals; Tellurium; Thallium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Zinc

High efficiency cadmium-zinc-telluride (CZT) cameras provide an opportunity to lower the injected activities of radiopharmaceuticals for single photon emission tomography (SPECT) myocardial perfusion imaging (MPI). The limits for reducing activities of thallium have not been determined, particularly in obese patients. After an injection of 0.7 megabecquerel (MBq) of thallium/kg, we collected an average 1.5 million counts for the 10-min acquisition in a pilot cohort of ten patients. After extrapolation, we reduced the administered activity to 0.5 MBq/kg to obtain the expected 1 million counts. We studied the image quality in 124 patients (86 men, 43 obese with body mass index over 30 kg/m

Topics: Aged; Body Mass Index; Cadmium; Czech Republic; Feasibility Studies; Female; Gamma Cameras; Heart Diseases; Humans; Male; Middle Aged; Myocardial Perfusion Imaging; Obesity; Patient Positioning; Pilot Projects; Predictive Value of Tests; Prone Position; Radiation Dosage; Radiopharmaceuticals; Reproducibility of Results; Tellurium; Tomography, Emission-Computed, Single-Photon; Zinc

A miniature CdTe probe interfaced to a microcomputer was used to measure left ventricular ejection fraction (LVEF) in 25 patients. LVEF obtained with the CdTe module, in the beat-to-beat mode, or the integrated gated mode agreed well with LVEF obtained with a gamma camera (r = 0.80; r = 0.82 respectively). Similarly, LVEF by CdTe probe agreed with LVEF obtained by gated equilibrium studies performed with a computerized NaI probe. The CdTe probe can provide comparable measurement of LVEF at a fraction of the cost of a camera-computer system and, being small and lightweight, the CdTe probe is adaptable for monitoring patients in intensive care facilities.

Topics: Adult; Aged; Cadmium; Cadmium Compounds; Cardiac Output; Heart; Heart Diseases; Humans; Male; Microcomputers; Middle Aged; Miniaturization; Radionuclide Imaging; Stroke Volume; Technetium; Tellurium

The authors describe a miniature cadmium telluride (CdTe) detector module for continuous monitoring of ventricular function using an equilibrium radionuclide blood-pool label. The detector and collimator are small, light, and suitable for direct attachment to the chest wall. Clinical studies in 18 patients using a prototype system demonstrated reasonably good correlation with left-ventricular ejection fractions (LVEF) determined by first-pass studies performed with a multicrystal scintillation camera (r = 0.74) and gated equilibrium studies performed with a computerized sodium iodide (Nal) probe (r = 0.76). The CdTe device may prove to be useful in patients in intensive and coronary care units as well as in ambulatory patients.

Topics: Adult; Aged; Cadmium; Cadmium Compounds; Female; Heart; Heart Diseases; Heart Function Tests; Humans; Male; Middle Aged; Miniaturization; Monitoring, Physiologic; Radionuclide Imaging; Stroke Volume; Tellurium