scholarly journals Influence of 99m-Tc-Nanocolloid Activity Concentration on Sentinel Lymph Node Detection in Endometrial Cancer: A Quantitative SPECT/CT Study

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 700
Author(s):  
Samine Sahbai ◽  
Francesco Fiz ◽  
Florin Taran ◽  
Sara Brucker ◽  
Diethelm Wallwiener ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Injection Site ◽  
Activity Concentration ◽  
Single Photon ◽  
Gamma Probe ◽  
Photon Emission ◽  
Injection Technique ◽  
Quantitative Spect ◽  
Absolute Activity ◽  
Detection Failure

This study evaluates quantitative combined single photon emission tomography/computed x-ray tomography (SPECT/CT) to assess the influence of radiotracer concentration on detection of sentinel lymph nodes (SLN) in endometrial cancer (EC). Eighty EC patients underwent pericervical 99m-Tc-nanocolloid injection followed by SPECT/CT. The subgroup of patients with failed SLN detection in SPECT/CT (n = 20) was compared to match-paired patients showing at least two SLNs. Results of intraoperative gamma probe measurements and quantitative SPECT/CT were used for comparison. In patients with detection failure, the percentage of injected dose, absolute activity, and volume of the injection site were significantly lower (30 ± 24% vs. 55 ± 19%; p = 0.01, 43 ± 36 MBq vs. 73 ± 33 MBq; p = 0.04, and 183 ± 164 mL vs. 266 ± 164 mL; p = 0.03) while mean activity concentration in liver, spleen, and bone marrow was significantly higher (p = 0.02). Activity concentration (>33 KBq/mL) and absolute activity (>73 MBq) of injection areas correlated with successful intraoperative SLN detection. In a subgroup of 19 SLNs, a correlation between SPECT/CT-derived uptake and intraoperative count rate was found (R2 = 0.8; p < 0.001). SLN detection in EC patients depended on high radiotracer activity at the cervical injection site. Quantitative SPECT/CT could predict successful intraoperative SLN detection and may help to optimize injection technique.

Comparison of lymphoscintigraphy and single photon emission computed tomography with computed tomography (SPECT/CT) for sentinel lymph node detection in endometrial cancer

2020 ◽  
Vol 30 (5) ◽  
pp. 626-630
Author(s):  
Shinichi Togami ◽  
Toshihiko Kawamura ◽  
Shintaro Yanazume ◽  
Masaki Kamio ◽  
Hiroaki Kobayashi
Keyword(s):  
Computed Tomography ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Metastasis ◽  
Detection Rate ◽  
Single Photon ◽  
Photon Emission ◽  
Single Photon Emission ◽  
Node Metastasis

BackgroundEndometrial cancer is the most common gynecologic cancer, and lymph node metastasis is one of the most important prognostic factors. Increasing evidence shows that sentinel lymph node (SLN) mapping is an effective alternative to comprehensive lymphadenectomy. Single photon emission CT with computed tomography (SPECT/CT) is associated with a high SLN detection rate.ObjectiveTo compare the clinical efficacy of SPECT/CT with that of lymphoscintigraphy in detecting SLNs in patients with endometrial cancer.MethodsBetween May 2014 and October 2018, 151 patients with endometrial cancer were enrolled in this study at the Department of Obstetrics and Gynecology of the Kagoshima University Hospital. Inclusion criteria were patients with endometrial cancer, older than 18 years, and with pre-operative International Federation of Gynecology and Obstetrics (FIGO) staging of I and II. All patients underwent pre-operative CT, and patients with suspected peritoneal dissemination and lymph node metastasis were excluded from this study. Pelvic SLNs were detected by injection of tecnetium-99m-labeled phytate into the uterine cervix. The number and locations of SLNs detected using lymphoscintigraphy and SPECT/CT were evaluated. JMP software (version 14, SAS Institute Inc., Cary, North Carolina, USA) was used for statistical analysis.ResultsA total of 151 patients who underwent pre-operative lymphoscintigraphy and SPECT/CT were included in the study. The median age was 57 years (range 24–79), and the median body mass index was 24.3 kg/m2 (range 16–40). The final pathology was as follows: 135 (89%) endometrioid carcinoma, 11 (7%) serous carcinoma, one (1%) clear cell carcinoma, and four (3%) other histotypes. Based on SPECT/CT, 204 pelvic SLNs were detected. The bilateral pelvic SLN detection rate was better for SPECT/CT (43% (65/151)) than for lymphoscintigraphy (32% (48/151)) (p<0.0001). The overall pelvic SLN detection rate (at least one pelvic SLN detected) was also better with SPECT/CT (77% (16/151)) vs lymphoscintigraphy (68% (102/151)) (p<0.0001). The distribution of SLN locations detected using SPECT/CT was as follows: external iliac, 91 (45%); obturator, 61 (30%); common iliac, 28 (14%); internal iliac, 19 (9%); para-aortic, 2 (1%); parametrium, 2 (1%), and presacral, 1 (1%). The SLN detection rate using SPECT/CT was significantly worse in patients of advanced age (p<0.0001).DiscussionOverall and bilateral SLN detection rate was better with SPECT/CT than with lymphoscintigraphy in patients with stage I/II endometrial cancer.

scholarly journals Reproducibility of Cerebral Blood Flow Assessment using a Quantitative SPECT Reconstruction Program and Split-Dose 123I-Iodoamphetamine in Institutions with Different γ-Cameras and Collimators

2012 ◽  
Vol 32 (9) ◽  
pp. 1757-1764 ◽  
Author(s):  
Hiroshi Yoneda ◽  
Satoshi Shirao ◽  
Hiroyasu Koizumi ◽  
Fumiaki Oka ◽  
Hideyuki Ishihara ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Vascular Reactivity ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Multicenter Studies ◽  
Quantitative Spect ◽  
Split Dose ◽  
Acetazolamide Challenge

Single photon emission computed tomography (SPECT) is used widely in clinical studies. However, the technique requires image reconstruction and the methods for correcting scattered radiation and absorption are not standardized among SPECT procedures. Therefore, quantitation of cerebral blood flow (CBF) may not be constant across SPECT models. The quantitative SPECT (QSPECT) software package has been developed for standardization of CBF. Using the QSPECT/dual-table autoradiographic (DTARG) method, CBF and cerebral vascular reactivity (CVR) at rest and after acetazolamide challenge can be evaluated using 123I-iodoamphetamine in a single SPECT session. In this study, we examined the reproducibility of quantitative regional CBF and CVR in QSPECT/DTARG using different SPECT models at two facilities. The subjects were nine patients with chronic cerebral ischemic disease who underwent QSPECT/DTARG at both facilities with use of different γ-cameras and collimators. There were significant correlations for CBF at rest and after acetazolamide challenge measured at the two facilities. The consistency of the CBFs of the patients measured at the two facilities were good in all cases. Our results show that CBF measured by QSPECT/DTARG in the same patients is reproducible in different SPECT models. This indicates that standardized evaluation of CBF can be performed in large multicenter studies.

Physiological evaluation of a new quantitative SPECT method measuring regional ventilation and perfusion

2004 ◽  
Vol 96 (3) ◽  
pp. 1127-1136 ◽  
Author(s):  
Johan Petersson ◽  
Alejandro Sánchez-Crespo ◽  
Malin Rohdin ◽  
Stéphanie Montmerle ◽  
Sven Nyrén ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Single Photon ◽  
Photon Emission ◽  
Inert Gas ◽  
Emission Computed Tomography ◽  
Regional Ventilation ◽  
Quantitative Spect ◽  
Respiratory Gases ◽  
Photon Emission Computed Tomography ◽  
Ventilation And Perfusion

We have developed a new quantitative single-photon-emission computed tomography (SPECT) method that uses 113mIn-labeled albumin macroaggregates and Technegas (99mTc) to estimate the distributions of regional ventilation and perfusion for the whole lung. The multiple inert-gas elimination technique (MIGET) and whole lung respiratory gas exchange were used as physiological evaluations of the SPECT method. Regional ventilation and perfusion were estimated by SPECT in nine healthy volunteers during awake, spontaneous breathing. Radiotracers were administered with subjects sitting upright, and SPECT images were acquired with subjects supine. Whole lung gas exchange of MIGET gases and arterial Po2 and Pco2 gases was predicted from estimates of regional ventilation and perfusion. We found a good agreement between measured and SPECT-predicted exchange of MIGET and respiratory gases. Correlations ( r2) between SPECT-predicted and measured inert-gas excretions and retentions were 0.99. The method offers a new tool for measuring regional ventilation and perfusion in humans.

scholarly journals Quantitative bone single-photon emission computed tomography imaging for uninfected nonunion: comparison of hypertrophic nonunion and non-hypertrophic nonunion

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Keisuke Oe ◽  
Feibi Zeng ◽  
Tomoaki Fukui ◽  
Munenobu Nogami ◽  
Takamichi Murakami ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Quantitative Spect ◽  
Quantitative Parameters ◽  
Emission Computed ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Abstract Background Recently, a standardized uptake value (SUV) has been used to evaluate bone single-photon emission computed tomography (SPECT). The aim of this study was to investigate quantitative SPECT imaging of uninfected nonunion to compare hypertrophic nonunion and non-hypertrophic nonunion using volume-based parameters. Methods We evaluated 23 patients with uninfected nonunion who underwent SPECT acquisition 3 h after an injection of 99mTc-hydroxymethylene diphosphonate or 99mTc-methylene diphosphonate from April 2014 to November 2019. We reconstructed the acquired data and performed voxel-based quantitative analysis using the GI-BONE software. Quantitative parameters, maximum SUV (SUVmax), peak SUV (SUVpeak), and mean SUV (SUVmean) in the high and low uptake areas of nonunion were compared between hypertrophic nonunion and non-hypertrophic nonunion. The contralateral limb was used as a control, and the ratios of the quantitative parameters were calculated. Results The values for the quantitative parameters (high uptake area/low uptake area, respectively), SUVmax control ratio (12.13 ± 4.95/6.44 ± 4.71), SUVpeak control ratio (11.65 ± 4.58/6.45 ± 4.64), and SUVmean control ratio (11.94 ± 5.03/6.28 ± 4.95) for hypertrophic nonunion were higher than those for non-hypertrophic nonunion (7.82 ± 4.76/3.41 ± 2.09 (p = 0.065/0.12), 7.56 ± 4.51/3.61 ± 2.23 (p = 0.065/0.22), and 7.59 ± 5.18/3.05 ± 1.91 (p = 0.076/0.23)). Conclusions SUVmax, SUVpeak, and SUVmean control ratios obtained from bone SPECT images can quantitatively evaluate the biological activity of nonunions and may be an effective evaluation method for treatment decisions, especially the necessity of autologous bone grafting.

scholarly journals Quantitative Bone Single Photon Emission Computed Tomography Imaging for Uninfected Nonunion: Comparison of Hypertrophic Nonunion and Non-Hypertrophic Nonunion

2020 ◽  
Author(s):  
Keisuke Oe ◽  
Feibi Zeng ◽  
Tomoaki Fukui ◽  
Munenobu Nogami ◽  
Takamichi Murakami ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Quantitative Spect ◽  
Quantitative Parameters ◽  
Emission Computed ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Abstract BackgroundRecently, a standardized uptake value (SUV) has been used to evaluate bone single photon emission computed tomography (SPECT). The aim of this study was to investigate quantitative SPECT imaging of uninfected nonunion to compare hypertrophic nonunion and non-hypertrophic nonunion using volume-based parameters.MethodsWe evaluated 23 patients with uninfected nonunion who underwent SPECT acquisition 3 h after an injection of 99mTc-hydroxymethylene diphosphonate or 99mTc-methylene diphosphonate from April 2014 to November 2019. We reconstructed the acquired data and performed voxel-based quantitative analysis using GI-BONE software. Quantitative parameters, maximum SUV (SUVmax), peak SUV (SUVpeak), and mean SUV (SUVmean) in the high and low uptake areas of nonunion were compared between hypertrophic nonunion and non-hypertrophic nonunion. The contralateral limb was used as a control, and the ratios of the quantitative parameters were calculated. ResultsThe values for the quantitative parameters (high uptake area/low uptake area, respectively), SUVmax control ratio (12.13 ± 4.95/6.44 ± 4.71), SUVpeak control ratio (11.65 ± 4.58/6.45 ± 4.64), and SUVmean control ratio (11.94 ± 5.03/6.28 ± 4.95) for hypertrophic nonunion were higher than those for non-hypertrophic nonunion (7.82 ± 4.76/3.41 ± 2.09 (p = 0.065/0.12), 7.56 ± 4.51/3.61 ± 2.23 (p = 0.065/0.22), and 7.59 ± 5.18/3.05 ± 1.91 (p = 0.076/0.23). ConclusionsSUVmax, peak, mean control ratios obtained from bone SPECT images can quantitatively evaluate the biological activity of nonunions and may be an effective evaluation method for treatment decisions, especially the necessity of autologous bone grafting.

Results of a standardized protocol for sentinel node imaging in breast cancer with Tc-99m labeled nanocolloidal albumin

2001 ◽  
Vol 40 (03) ◽  
pp. 80-85 ◽  
Author(s):  
T. Heuser ◽  
H. Fitz ◽  
H.-J. Schroth ◽  
E. Weller ◽  
H. H. Zippel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Sentinel Node ◽  
Gamma Probe ◽  
Axillary Lymph Nodes ◽  
Injection Technique ◽  
Axillary Lymph ◽  
Standardized Protocol ◽  
Detection Failure ◽  
Significant Difference

Summary Aim of this study was to evaluate the results of o standardized protocol for sentinel node (SN) detection in breast cancer using Tc-99m labeled nanocolloidal albumin and a combined intra- and subdermal injection technique. Methods: One hundred and fifty-five women with proven breast cancer (disease stages Tis-T2) were included. Four injections of 10 to 15 MBq of Tc-99m nanocolloid in 0.1 ml physiologic saline were administered intra- and subdermally at the 3,6,9 and 12 o’clock positions in the skin overlying the tumor. Planar scintigraphic images in lateral and anterior projections were obtained once between 2.5 and 18 hours after tracer administration. Guided by a gamma probe, all radioactive lymph nodes in the axilla were resected, then complete dissection followed. Results: In 151 of the 155 women (97.4%), nodal tracer uptake (range 1-7 foci, average 2.2) was scinligraphically revealed. In one of these cases, drainage was only to the internal mammary lymphatic chain. Three of the 4 women with detection failure presented with histologically proven tumor infiltration of the lymphatics and axillary involvement. In 49 of the patients with visualized axillary lymph nodes (32.7%), at least one SN was metastatic. In 21 cases, this SN was the only positive node. The remaining 101 patients with negative SN included 4 cases with axillary involvement. The sensitivity of the SN with respect to the histological status of the entire axilla was thus 92.5%, the negative predictive value was 96.0%. The overall accuracy of the method was 97.3%. There was a significant difference between the number of totally detected radioactive nodes in the groups with and without nodal metastases (3.49 vs. 2.57, p <0.01). Conclusion: The described protocol represents an easy reproducible and reliable method for SN detection in breast cancer that additionally allows flexible timing of surgery. Further, we found evidence that the number of scinligraphically visualized nodes also reflects the histological status of the axilla.

scholarly journals The influence of gravity on regional lung blood flow in humans: SPECT in the upright and head-down posture

2017 ◽  
Vol 122 (6) ◽  
pp. 1445-1451 ◽  
Author(s):  
M. Ax ◽  
A. Sanchez-Crespo ◽  
S. G. E. Lindahl ◽  
M. Mure ◽  
J. Petersson
Keyword(s):  
Blood Flow ◽  
Single Photon ◽  
Regional Blood Flow ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Tidal Breathing ◽  
Quantitative Spect ◽  
Lung Structure ◽  
Regional Lung ◽  
Lung Blood Flow

Previous studies in humans have shown that gravity has little influence on the distribution of lung blood flow while changing posture from supine to prone. This study aimed to evaluate the maximal influence of posture by comparison of regional lung blood flow in the upright and head-down posture in 8 healthy volunteers, using a tilt table. Regional lung blood flow was marked by intravenous injection of macroaggregates of human albumin labeled with 99mTc or 113mIn, in the upright and head-down posture, respectively, during tidal breathing. Both radiotracers remain fixed in the lung after administration. The distribution of radioactivity was mapped using quantitative single photon emission computed tomography (SPECT) corrected for attenuation and scatter. All images were obtained supine during tidal breathing. A shift from upright to the head-down posture caused a clear redistribution of blood flow from basal to apical regions. We conclude that posture plays a role for the distribution of lung blood flow in upright humans, and that the influence of posture, and thereby gravity, is much greater in the upright and head-down posture than in horizontal postures. However, the results of the study demonstrate that lung structure is the main determinant of regional blood flow and gravity is a secondary contributor to the distribution of lung blood flow in the upright and head-down positions. NEW & NOTEWORTHY Using a dual-isotope quantitative SPECT method, we demonstrated that although a shift in posture redistributes blood flow in the direction of gravity, the results are also consistent with lung structure being a greater determinant of regional blood flow than gravity. To our knowledge, this is the first study to use modern imaging methods to quantify the shift in regional lung blood flow in humans at a change between the upright and head-down postures.

Location of Sentinel Lymph Node in Cervical Carcinoma and Factors Associated With Unilateral Detection

2015 ◽  
Vol 25 (9) ◽  
pp. 1663-1668 ◽  
Author(s):  
Rekha Wuntakal ◽  
Andreas John Papadopoulos ◽  
Stephen Attard Montalto ◽  
Milica Perovic ◽  
Michael Coutts ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Gamma Probe ◽  
Photon Emission ◽  
Pelvic Lymphadenectomy ◽  
Older Age ◽  
Emission Computed Tomography ◽  
Internal Iliac ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

ObjectiveThe aims of this study were to assess locality of the sentinel lymph node (SLN) in cervical carcinoma and examine factors affecting bilateral SLN detection.MethodsThis was a retrospective review of SLN data (anatomical location, count and laterality) in patients with early-stage cervical cancer (International Federation of Gynecology and Obstetrics stage IA1 with lymphovascular space invasion to stage IIA) using intraoperative gamma probe and blue dye. The preoperative single-photon emission computed tomography with computed tomography was used to detect laterality, number of the SLNs, and rare locations. Patients were treated between January 2005 to January 2015 at the West Kent Gynaecological Oncology Centre, Maidstone Hospital, Maidstone, United Kingdom.ResultsA total of 132 women were investigated. The most common SLN location was the external iliac (38.6%) followed by obturator (25.3%) and internal iliac (23.6%) regions. A small percentage was identified in presacral (1.4%) and para-aortic regions (0.7%). Older age (P= 0.01) and an elevated body mass index (P= 0.03) were associated with decreased SLN count by preoperative single-photon emission computed tomography with computed tomography, and only age affected SLN count by gamma probe (P= 0.01). Initial surgery, large loop excision of the transformation zone, or cone biopsy of the cervix had no effect on SLN count. There was no difference observed in bilateral detection with respect to surgical approach (open: n = 48/laparoscopic: n = 84). However, older age was independently associated with a decrease in bilateral SLN detection (P= 0.003). In these patients who underwent unilateral full pelvic lymphadenectomy, all the nonsentinel nodes were negative.ConclusionsThe majority of SLNs were located in the external iliac, obturator, and internal iliac regions. Both older age and an elevated body mass index were associated with a reduced SLN count. Unilateral detection of SLN was independently associated with older age, which may be due to sclerosis in the lymphatic vessels or reduced perfusion in the pelvis in these women. If no SLN is detected on one side, the consensus is to perform a full pelvic lymphadenectomy on that side of the pelvis.

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