• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.101-107
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• 1999

We evaluated the results of sequential SPECT dual-isotope imaging with Tl-201 and Tc-99m MIBI in 24 patients. all of whom also had coronary angiography within the past one month. Coronary angiography showed that 12 patients had no CAD, 4 patients had one-vessel CAD, 7 patients had two-vessel CAD and 1 patient had three-vessel CAD. Serial studies of resting Tl-201 and dipyridamole stress Tc-99m MIBI were completed within 2 hours. When more than 50% of coronary artery narrowing was considered significant, the overall sensitivity and specificity of CAD detection were 91.7%. The sensitivity of CAD detection in patients with one-vessel and multi-vessel diseases was 75% and 100%. respectively. Therefore, sequential dual-isotope SPECT demonstrated high sensitivity and specificity for CAD detection. In conclusion, sequential dual-isotope imaging is feasible and can be completed in a short time and may therefore enhance laboratory throughput and patient convenience.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.88-91
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• 2018

Purpose The purpose of this study is to investigate the simultaneous dual isotope (SDI) myocardial perfusion scan that can be performed in a short time using a semiconductor gamma camera. Materials and Methods Of the 86 patients who underwent Rest/Stress $^{99m}TC$-sestaMIBI 1-day myocardial perfusion scan and Rest $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope myocardial perfusion scan using a heart-only gamma camera, the test results were the same, 36 patients who did not show any change in the clinical outcome. Quantitative values were statistically analyzed using a QPS program to confirm the correlation between the images of the two examinations. Results Rest/Stress $^{99m}TC$-sestaMIBI simultaneous dual myocardial perfusion scans and $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ double-isotope myocardial perfusion scans were analyzed for Summed score. The $R^2$ value of the Rest summed score (RSS) was 0.91 and the $R^2$ value of the stress summed score (SSS) was 0.71. Conclusion The $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope scan confirmed its correlation with the previous day's test. The $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope scan can be completed in approximately 30minutes. It maybe clinically useful for patients who need short examination time such as emergency patients or elderly patients.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.112-117
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• 1996

Objective: Standard stress/rest Tc-99m MIBI and T1-201 myocardial perfusion study have some limitations such as stress/rest image overlap for Tc-99m-MIBI, low energy for T1-201 and long period of study time for two separate studies. Separate acquisition rest T1-201/stress Tc-99m MIBI dual isotope study is a potentially efficient myocardial perfusion imaging protocol that combines the high resolution of Tc-99m for stress perfusion assessment and T1-201 for viability assessment. This study assessed the usefulness and diagnostic accuracy for this new approach. Methods: We tried to evaluate sensitivity and specificity of dual isotope separate acquisition protocol in 67 patients. Immediately after resting T1-201 SPECT data was acquired, dipyridamole stress Tc-99m MIBI myocardial perfusion study was performed. Visual analysis was carried out qualitatively with 0 to 3 scoring system for 17 segments of left ventricle in the reconstructed horizontal long axis and short axis slices. Results: Total study was completed within 3 hours. In angiographic correlation, dual isotope SPECT demonstrated high sensitivity(85%) and in a small group of patients, high specificity was also observed (100%). Conclusion: Combined thallium-201/stress Tc-99m MIBI SPECT displayed similiar diagnostic accuracy to protocol using stress/rest Tc-99m MIBI SPECT. This protocol was completed in shorter period than the previous protocols and therefore enhance laboratory throughput and patients convenience.

• Progress in Medical Physics
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• v.20 no.4
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• pp.216-224
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• 2009

$^{131}I$ is a radiological isotope being used widely for treatment of cancer as emitting gamma-ray and it is also applied to estimate the function of thyroid for its accumulation in thyroid. However, $^{131}I$ is more difficult to quantitate comapred to $^{99m}Tc$, because $^{131}I$ has multiple energy gamma-ray emissions compared to $^{99m}Tc$ which is a mono energetic gamma-ray source. Especially, scattered ray and septal penetration resulted by high energy gamma ray have a bad influence upon nuclear medicine image. The purpose of this study was to estimate scatter components depending on the different source locations within a phantom using Monte Carlo simulation (GATE). The simulation results were validated by comparing with the results of real experiments. Dual-head gamma camera (ECAM, Chicago, Illinois Siemens) with high energy, general-purpose, and parallel hole collimators (hole radius: 0.17 cm, septal thickness: 0.2 cm, length: 5.08 cm) was used in this experiment. The NaI crystal is $44.5{\times}59.1\;cm$ in height and width and 0.95 cm in thickness. The diameter and height of PMMA phantom were 16 cm and 15 cm, respectively. The images were acquired at 5 different locations of $^{131}I$ point source within the phantom and the images of $^{99m}Tc$ were also acquired for comparison purpose with low energy source. The simulation results indicated that the scattering was influenced by the location of source within a phantom. The scattering effects showed the same tendency in both simulation and actual experiment, and the results showed that the simulation was very adequate for further studies. The results supported that the simulation techniques may be used to generalize the scattering effects as a function of a point source location within a phantom.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.484-492
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• 1996

To detect ischemic tissue in experimental model of cerebral ischemia made by middle cerebral artery(MCA)-occlusion, we acquired triple image of $^{99m}Tc$-glucarate, [$^{18}F$]fluoro-deoxyglucose (FDG), and 2,3,5- triphenyltetrazolium (TTC) staining. We made cerebral infarction either with reperfusion (after occlusion of 2 hours) or without reperfusion in 10 Sprague-Dawley rats by inserting thread to MCA through internal carotid artery. After 22 hours, we injected 740 MBq of $^{99m}Tc$-glucarate and 55.5 MBq of [$^{18}F$]FDG through tail vein. Each 1 mm slice of rat brains was frozen and exposed to imaging plate for 20 minutes in freezer to get an [$^{18}F$]FDG image. After 20 hours enough to fade radioactivity of [$^{18}F$]FDG, the slices were again imaged by BAS1500 for $^{99m}Tc$-glucarate uptake. Finally, these brain tissues were stained with TTC. Semi-quantitative visual analysis was done by grading 0 to 3 points according to the degree of uptakes($^{99m}Tc$-glucarate) and decreased uptakes([$^{18}F$]FDG and TTC). Ten rats survived with neurologic symptoms. TTC staining confirmed the development of infarction. The size of the infarction was relatively larger in the group without reperfusion. [$^{18}F$]FDG images were similar to TTC-stained images. However, we found regions with intermediate uptake which were not stained with TTC. We found regions with intermediate [$^{18}F$]FDG uptake where TTC staining was normal. $^{99m}Tc$-glucarate uptake was round only in TTC non-stained region. In the TTC stained regions, there were no uptake of $^{99m}Tc$-glucarate. We could not find clear relation between $^{99m}Tc$-glucarate uptake with [$^{18}F$]FDG uptake. This was partly because percent uptake of $^{99m}Tc$-glucarate was so small (less than 1 percent of injected dose) and because there were quite heterogeneity of patterns of [$^{18}F$]FDG uptake and TTC. With these findings, we could conclude that $^{99m}Tc$-glucarate were taken up only in part of ischemic tissues which were proven to be nonviable. The establishment of MCA-occluded rat model with or without reperfusion and triple imaging for $^{99m}Tc,\;^{18}F$ and TTC helped the characterization of $^{99m}Tc$-glucarate uptakes. Further work is needed to clarify the meaning or diversities or [$^{18}F$]FDG and TTC and their relation with $^{99m}Tc$-glucarate.