tellurium and Myocardial-Infarction

The solid-state cadmium-zinc-telluride (CZT) gamma camera for myocardial perfusion single-photon emission computed tomography (MPS) has theoretical advantages compared to the conventional gamma camera technique. This includes more sensitive detectors and better energy resolution. We aimed to explore the diagnostic performance of gated MPS with a CZT gamma camera compared to a conventional gamma camera for detection of myocardial infarct (MI) and assessment of left ventricular (LV) volumes and ejection fraction (LVEF), using cardiac magnetic resonance (CMR) as the reference method.. Seventy-three patients (26% female) with known or suspected chronic coronary syndrome were examined with gated MPS using both a CZT gamma camera and a conventional gamma camera as well as with CMR. Presence and extent of MI on MPS and late gadolinium enhancement (LGE) CMR was evaluated. For LV volumes, LVEF and LV mass, gated MPS images and cine CMR images were evaluated.. MI was found in 42 patients on CMR. The overall sensitivity, specificity, positive and negative predictive values for the CZT and the conventional gamma camera were the same (67%, 100%, 100% and 69%). For infarct size > 3% on CMR, the sensitivity was 82% for the CZT and 73% for the conventional gamma camera, respectively. LV volumes were significantly underestimated by MPS compared to CMR (P ≤ .002 for all measures). The underestimation was slightly less pronounced for the CZT compared to the conventional gamma camera (2-10 mL, P ≤ .03 for all measures). For LVEF, however, accuracy was high for both gamma cameras.. Differences between a CZT and a conventional gamma camera for detection of MI and assessment of LV volumes and LVEF are small and do not appear to be clinically significant.

Topics: Cadmium; Contrast Media; Female; Gadolinium; Gamma Cameras; Humans; Male; Myocardial Infarction; Myocardial Perfusion Imaging; Perfusion; Tellurium; Tomography, Emission-Computed, Single-Photon

Topics: Cadmium; Fatty Acids; Feasibility Studies; Humans; Iodine Radioisotopes; Iodobenzenes; Myocardial Infarction; Organophosphorus Compounds; Organotechnetium Compounds; Tellurium; Zinc

The use of cadmium-zinc-telluride-based scanners may increase the clinical feasibility of simultaneous dual-isotope imaging. In the current study, we sought to investigate a potential acquisition time in simultaneous Tc-tetrofosmin/I-β-methyl-p-iodophenyl pentadecanoic acid dual-isotope imaging using a Discovery NM/CT 670 cadmium-zinc-telluride.. Simultaneous Tc-tetrofosmin/I-β-methyl-p-iodophenyl pentadecanoic acid dual-isotope imaging was performed in 29 patients who had undergone primary percutaneous coronary intervention for acute myocardial infarction. Referenced images with an acquisition time of 65 s/view (16.25 min) were reframed to produce images with acquisition times of 33, 16, and 8 s/view. The values for the quantitative-gated single-photon emission computed tomography (SPECT) and the quantitative perfusion SPECT were compared.. The quantitative-gated SPECT values for images with 33, 16, and 8 s/views showed good consistency with those for 65 s/view (the lower 95% confidence intervals for the intraclass correlation were ≥0.80). The quantitative perfusion SPECT values for Tc-tetrofosmin images with 33, 16, and 8 s/views also showed good consistency with those for 65 s/view; however, the quantitative perfusion SPECT values for I-β-methyl-p-iodophenyl pentadecanoic acid images with an acquisition time of 8 s/view were not consistent with the reference acquisition time of 65 s/view.. The quantitative-gated SPECT and quantitative perfusion SPECT values obtained from images with shorter acquisition times correlated with the values obtained from images with a reference acquisition time of 65 s/view; however, tracer-specific predisposition should be considered. These findings suggest that it is possible to reduce acquisition time when performing simultaneous Tc-tetrofosmin/I-β-methyl-p-iodophenyl pentadecanoic acid dual-tracer imaging with the novel cadmium-zinc-telluride scanner.

Topics: Acute Disease; Cadmium; Fatty Acids; Female; Humans; Image Processing, Computer-Assisted; Iodobenzenes; Male; Middle Aged; Myocardial Infarction; Organophosphorus Compounds; Organotechnetium Compounds; Percutaneous Coronary Intervention; Tellurium; Time Factors; Tomography, Emission-Computed, Single-Photon; Zinc

A highly sensitive fluorescence detection probe was developed by tailoring plastic antibodies on the external surface of aqueous soluble quantum dots (QDs). The target was Myoglobin (Myo), a cardiac biomarker that quenched the intrinsic fluorescent emission of cadmium telluride (CdTe) QDs capped with mercaptopropionic acid (CdTe-MPA-QDs). The QDs were incubated with the target protein and further modified with a molecularly-imprinted polymer (MIP) produced by radical polymerization of acrylamide and bisacrylamide. The main physical features of the materials were assessed by electron microscopy, dynamic light scattering (DLS), UV/Vis spectrophotometry and spectrofluorimetry. The plastic antibodies enabled Myo rebinding into the QDs with subsequent fluorescence quenching. This QD-probe could detect Myo concentrations from 0.304 to 571 pg/ml (50.6 fM to 95 pM), with a limit of detection of 0.045 pg/ml (7.6 fM). The proposed method was applied to the determination of Myo concentrations in synthetic human serum. The results obtained demonstrated the ability of the modified-QDs to determine Myo below the cut-off values of myocardial infarction. Overall, the nanostructured MIP-QDs reported herein displayed quick responses, good stability and sensitivity, and high selectivity for Myo, offering the potential to be explored as new emerging sensors for protein detection in human samples.

Topics: Acrylic Resins; Biomarkers; Cadmium Compounds; Humans; Molecular Imprinting; Myocardial Infarction; Myoglobin; Quantum Dots; Sensitivity and Specificity; Tellurium

Cadmium-zinc-telluride (CZT) cameras allow to decrease significantly the acquisition time of myocardial perfusion imaging (MPI), but the duration of the examination is still long. Therefore, this study was performed to test the feasibility of early imaging following injection of Tc-99 m sestamibi using a CZT camera.. Seventy patients underwent both an early and a delayed image acquisition after exercise stress test (n = 30), dipyridamole stress test (n = 20), and at rest (n = 20). After injection of Tc-99 m sestamibi, the early image acquisition started on average within 5 minutes for the exercise and rest groups, and 3 minutes 30 seconds for the dipyridamole group. Two independent observers evaluated image quality and extracardiac uptake on four-point scales. The difference between early and later images for each patient was scored on a five-point scale.. The image quality and extracardiac uptake of early and delayed image acquisitions were not different for the three groups (P > .05). There was no significant difference between early and delayed image acquisitions in the exercise, dipyridamole, and rest groups, respectively, in 63%, 40%, and 80% of cases. In the exercise group and rest group, a defect was only present in early MPI, respectively, in 13% and 20% of cases. A defect was only present in delayed images in 10% of cases in the exercise group and in 45% of cases in the dipyridamole group.. There was no difference between early and later image acquisitions in terms of quality. This protocol reduces the length of the procedure for the patient. Beginning with early image acquisitions may help to overcome the artifacts that are observed at the delayed time.

Topics: Aged; Aged, 80 and over; Cadmium; Exercise Test; Female; Gamma Cameras; Humans; Injections; Male; Middle Aged; Myocardial Infarction; Myocardial Perfusion Imaging; Technetium Tc 99m Sestamibi; Tellurium; Zinc

New multipinhole cadmium-zinc-telluride (CZT) cameras allow for faster imaging and lower radiation doses for single photon emission computed tomography (SPECT) studies, but assessment of prognostic ability is necessary.. We collected data from all myocardial SPECT perfusion studies performed over 15 months at our institution, using either a CZT or conventional Anger camera. A Cox proportional hazards model was used to assess the relationship between camera type, imaging results, and either death or myocardial infarction (MI). Clinical variables including age, sex, body mass index (BMI), and historical risk factors were used for population description and model adjustments. We had 2,088 patients with a total of 69 deaths and 65 MIs (122 events altogether). A 3% increase in DDB (difference defect burden) represented a 12% increase in the risk of death or MI, whereas a 3% increase in rest defect burden or stress defect burden represented an 8% increase; these risks were the same for both cameras (P > .24, interaction tests).. The CZT camera has similar prognostic values for death and MI to conventional Anger cameras. This suggests that it may successfully be used to decrease patient dose.

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Cadmium; Equipment Design; Equipment Failure Analysis; Female; Gamma Cameras; Humans; Male; Middle Aged; Myocardial Infarction; Myocardial Perfusion Imaging; North Carolina; Prevalence; Prognosis; Reproducibility of Results; Risk Assessment; Sensitivity and Specificity; Sex Distribution; Survival Analysis; Tellurium; Tomography, Emission-Computed, Single-Photon; Young Adult; Zinc

Recent advances in nuclear myocardial perfusion imaging (MPI) have made it possible to develop a dual-isotope protocol for high-speed acquisition with image quality and radiation delivery comparable to that obtained with conventional single isotope protocols. So far, no study has compared dual-isotope high-speed MPI to invasive coronary angiography (ICA) in a large cohort using a Cadmium-zinc-telluride SPECT system.. Over a 1-year period (May 2011 to April 2012), 1366 patients underwent dual-isotope high-speed MPI. Patients with ICA within 3 months after dual-isotope high-speed MPI were included together with patients with a low likelihood of coronary artery disease (CAD) in order to assess normalcy rate. Global summed stress score (SSS) and summed rest score (SRS) were calculated, and ICA results were analyzed independently. The main end point was a patient-based assessment of the diagnostic performance of dual-isotope high-speed MPI in detecting or ruling out significant CAD (>70% reduction in lumen diameter).. Inclusion criteria were fulfilled for 214 patients (143 men; age 60 ± 14 years; ICA, n = 104; low likelihood for CAD, n = 110). An exercise stress test was performed in 62% of patients and a pharmacological stress test was performed with either dipyridamole (32%) or dobutamine (6%). Average examination duration was 22.4 ± 4.5 minutes. Mean SSS, SRS, and SDS were 8.0 ± 4.9, 3.1 ± 4.3, and 5.0 ± 3.2, respectively. Prevalence of angiographic CAD was 75%. ICA detected stenosis in the left main trunk, left anterior descending artery, left circumflex artery, and right coronary artery in 4, 33, 31, and 42 patients, respectively. Sensitivity of dual-isotope high-speed MPI was 94%, normalcy rate was 92%, and accuracy was 83% for detecting CAD.. Dual-isotope high-speed MPI is reliable at detecting or ruling out CAD. NCT01785589.

Topics: Adult; Aged; Aged, 80 and over; Angina, Unstable; Cadmium; Cardiomyopathies; Cohort Studies; Coronary Angiography; Coronary Artery Bypass; Coronary Artery Disease; Exercise Test; Female; Humans; Male; Middle Aged; Myocardial Infarction; Myocardial Perfusion Imaging; Nuclear Medicine; Radiopharmaceuticals; Rest; Sensitivity and Specificity; Technetium Tc 99m Sestamibi; Tellurium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Ventricular Dysfunction, Left; Zinc

To assess the relationships between myocardial structure and function on cardiac magnetic resonance (CMR) imaging and sympathetic tone on (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy early after myocardial infarction (MI).. Ten patients underwent (123)I-MIBG and (99m)Tc-tetrofosmin rest cadmium zinc telluride scintigraphy 4 ± 1 days after MI. The segmental left ventricular (LV) relative radiotracer uptake of both (99m)Tc-tetrofosmin and early (123)I-MIBG was calculated. The day after scintigraphy, on CMR imaging, the extent of ischaemia-related oedema and of myocardial fibrosis (late gadolinium enhancement, LGE) was assessed. Accordingly, the extent of oedema and LGE was evaluated for each segment and segmental wall thickening determined. Based on LGE distribution, LV segments were categorized as "infarcted" (56 segments), "adjacent" (66 segments) or "remote" (48 segments).. Infarcted segments showed a more depressed systolic wall thickening and greater extent of oedema than adjacent segments (p < 0.001) and remote segments (p < 0.001). Interestingly, while uptake of (99m)Tc-tetrofosmin was significantly depressed only in infarcted segments (p < 0.001 vs. both adjacent and remote segments), uptake of (123)I-MIBG was impaired not only in infarcted segments (p < 0.001 vs. remote) but also in adjacent segments (p = 0.024 vs. remote segments). At the regional level, after correction for (99m)Tc-tetrofosmin and LGE distribution, segmental (123)I-MIBG uptake (p < 0.001) remained an independent predictor of ischaemia-related oedema.. After acute MI the regional impairment of sympathetic tone extends beyond the area of altered myocardial perfusion and is associated with myocardial oedema.

Topics: 3-Iodobenzylguanidine; Acute Disease; Aged; Cadmium; Edema; Female; Heart; Humans; Magnetic Resonance Imaging; Male; Myocardial Infarction; Radionuclide Imaging; Sympathetic Nervous System; Tellurium; Zinc

Since myocardial perfusion imaging (MPI) with conventional sodium iodine (NaI) device has low spatial resolution, there have been some cases in which small structures such as non-transmural myocardial infarction could not be properly detected. The purpose of this study was to evaluate potential usefulness of cadmium-telluride (CdTe) semiconductor detector-based high spatial resolution gamma cameras in detecting myocardial infarction sites, especially non-transmural infarction.. A total of 38 patients (mean age ± SD: 64 ± 21 year) who were clinically diagnosed with acute myocardial infarction were included. Twenty-eight cases of them were with ST segment elevation myocardial infarction (STEMI) and 10 cases with non-ST segment elevation myocardial infarction (NSTEMI). In all patients, myocardial perfusion single photon emission computed tomography images were acquired with Infinia (NaI device) and R1-M (CdTe device), and the images were compared concerning the detectability of acute myocardial infarction sites.. The detection rates of the myocardial infarction site in cases with STEMI were 100% both by NaI and CdTe images. In cases with NSTEMI, detection rate by NaI images was 50%, while that of CdTe images was 100% (p = 0.033). The summed rest score (SRS) value derived from CdTe images was significantly higher than that from NaI images in cases with STEMI [NaI images: 12 (7-18) versus CdTe images: 14 (9-20)] (p < 0.001). SRS derived from CdTe images was significantly higher than that derived from NaI images in cases with NSTEMI [NaI images: 2 (0-5) versus CdTe images: 6 (6-8)] (p = 0.006).. These results indicate that MPI using CdTe-semiconductor device will provide a much more accurate assessment of acute myocardial infarction in comparison to current methods.

Topics: Acute Disease; Aged; Cadmium Compounds; Female; Gamma Cameras; Humans; Male; Middle Aged; Myocardial Infarction; Myocardial Perfusion Imaging; Phantoms, Imaging; Semiconductors; Tellurium; Tomography, Emission-Computed, Single-Photon

Topics: Cadmium; Cadmium Compounds; Gamma Rays; Humans; Myocardial Infarction; Neoplasms; Nuclear Medicine; Radiation Monitoring; Radiation, Ionizing; Radiography, Dental; Radioisotopes; Radiometry; Radionuclide Imaging; Scintillation Counting; Telemetry; Tellurium; Thrombosis