• Title/Summary/Keyword: Thallium-201

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운동부하 201-thallium-SPECT를 이용한 nicorandil의 심근허혈 감소효과 평가에 관한 연구

  • 이명묵;오병희;박영배;최윤식;서정돈;이영우
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.164-164
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    • 1993
  • Nicorandil의 심근허혈 감소효과를 평가하고운동부하 201-Thallium 심근허혈 감소효과의 임상적 판정에 적용 가능성 여부를 알아보고자 하였다. 대상 및 방법: 위약투여 후 시행한운동부하 201-thallium-SPECT 상에서 가역적 thallium 결손을 보였던 49명의 노작성 협심증 환자들을 대상으로 하여 7일후 nicorandil을 10mg (group 1:n=19)혹은 20mg (group 2: n=20) 1회 경구투여한후 다시 운동부하201- thallium-SPECT를 시행하여 비교 분석하였다. 다답차운동 부하의 최대 운동량에 도달시 201-thallium을 정주하여 1분간 운동을 지속시킨후 부하영상을 얻고 안정 4시간후 재촬영하여 thallium결손 범위를 비교하여 심근허혈 범위를 정하였다.

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Accumulation of Thallium-201 in Hemorrhagic Cerebral Infarction (Thallium-201 brain SPECT에서 양성 소견을 보인 출혈성 뇌경색)

  • Lee, Ki-Yeol;Kim, Kyung-Min;Choe, Jae-Gol;Chung, Yong-Gu
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.3
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    • pp.337-340
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    • 1999
  • Thallium-201 brain SPECT is utilized in the diagnosis of brain tumor especially in cases where CT or MRI findings alone cannot differentiate malignant lesion from benign. Recently we came across two cases of positive T1-201 brain SPECT in clinically suspected brain tumor patients that turned out to be hemorrhagic cerebral infarction instead on biopsy. The findings in these cases demonstrate that thallium-201 accumulation may occur by the breakdown of the blood-brain barrier and phagocytic cell infiltration in the liquefaction stage of infarction.

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The Role of Thallium-201 Scintigraphy in Bone and Soft Tissue Tumor (근골격계 종양에서 탈륨 스캔의 역할)

  • Shin, Duk-Seop
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.117-128
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    • 2003
  • Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

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Extracardiac Uptake of Thallium-201 during Myocardial Perfusion Imaging with Pharmaeologic Vasodilation (심근관류 스캔중에 나타난 Thallium-201의 심장외 국소적 섭취)

  • Choi, Chung-Il;Kwak, Dong-Suk;Chung, Byung-Cheon;Park, Moo-Keun;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.65-71
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    • 1992
  • Myocardial perfusion imaging with $^{201}Tl-chloride$ following exercise or vasodilator-induced hyperemia has been effective in detecting the presence of coronary artery disease. An increased lung uptake of thallium has been reported as a sensitive marker of severe and extensive coronary artery disease and associated with poor prognosis. Thallium has also been noted to concentrate in a variety of malignant lesions. We report 5 cases of extracardiac uptake of thallium during myocardial perfusion scan with pharmacologic vasodilation. Accumulation of thallium was found in the lesions of a breast cancer, a lung cancer, a Castleman's disease and 2 cases of thymoma. We believe that the presence of focal extracardiac uptake of thallium during myocardial perfusion scan should suggest the need for further clinical evaluation to detect the tumor and must differentiate the increased lung uptake of thallium due to left ventricular dysfunction in coronary artery disease.

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Myocardial Uptake and Clearance of Thallium-201 in Normal Subjects: A Comparison Between Pharmacologic Stress with Intravenous Adenosine, Dipyridamole and Dobutamine, and Exercise Stress Testing (정상인 심근의 Thallium-201 섭취 및 제거 : Adenosine, Dipyridamole Dobutamine 정맥주사와 운동부하시의 비교)

  • Lee, Jae-Tae;Chung, Byung-Chun;Choi, Jung-Il;Kwak, Dong-Suk;Lee, Kyu-Bo;Chae, Shung-Chull;Chung, Chin-Hong
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.35-50
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    • 1993
  • 심근관류 스캔에서 약제부하 검사에 많이 이용되는 것으로는 adenosine, dipyridamole, dobutamine등이 있다. 이 약제들이 혈역학 및 thallium의 약동학에 미치는 효과를 검사하기 위하여 저자들은 15명의 건강인을 대상으로 이들 약제를 정맥주사한 후에와 그리고 운동부하를 시행한 후에 thallium-201 신근관류 스캔을 시행하여 thallium의 약동학에 미치는 영향에 대하여 서로 비교하였다. 부작용은 adenosine (87%), dipyridamole(80%), dobutamine (73%)을 정맥주사할 시에 흔히 나타났으나 경미하였다. 1예에서는 dobutamine을 주사할때의 부작용으로 인하여 최대용량을 투여하지는 못한바 있었다. 대상들은 dipyridamole (13%)이나 dobutamine (27%)보다 adenosine (60%)을 선호하였다 (P<0.05). Thallium의 절대 적인 심근섭취는 운동부하 검사보다 adenosine (1.3배), dipyridamole(1.2배), dobutamine(1.4배) 부하시에 더 많았고, 이들 약제 사이에는 유의한 차이는 없었다. Thallium의 심근제거율(%/hr)는 운동부하 검사보다 약제부하한 후에가 더 늦었다. 폐, 간, 비장, 및 내장지역에서 thallium의 섭취 및 제거는 운동부하 검사보다 약제부하시에 더 많았으나, 이들 약제 사이에는 유의한 차이가 없었다. Dobutamine 투여시의 thallium의 섭취 및 제거는 adenosine 또는 dipyridamole을 투여시의 결과와 상응하였다. 저자들은 adenosine, dipyridamole 및 dobutamine을 이용한 약제부하 thallium-201 심근관류 검사를 시행하는데 코든 대상들에서 어려움 없이 쉽게 시행할 수 있었다. Thallium의 심근내 섭취 및 제거는 각 약제부하에 따라서 다를 수가 있으므로 심근관류 스캔의 정량적인 분석을 시행할 때는 각각 약제에 대한 특별한 진단기준이 마련되어야 할 것으로 생각된다.

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Quantitative Analysis of Thallium-201 Scintigraphy in Bone Tumor (골종양에서 탈륨 스캔의 정량적 분석)

  • Shin, Duk-Seop;Cho, Ihn-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.45-51
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    • 2003
  • Purpose: This study was designed to know the ability of thallium-201 scintigraphy to discriminate malignant bone tumor from benign by analysing the quantitative thallium uptake ratio. Materials and Methods: We took thallium-201 scintigraphy prospectively with other imaging studies in 82 bone tumor suspecting patients. The results of scintigraphy were read qualitatively and calculated quantitatively, and retention indexes were estimated. For the statistical analysis the patients were divided as four group; high grade malignant bone tumor, benign bone tumor, giant cell tumor and low grade malignant bone tumor. Results: The mean thallium uptake ratio was 4.14 in early phase and 2.26 in delayed phase in high grade malignant bone tumor group, 1.16 and 1.09 in benign bone tumor, 3.15 and 1.94 in giant cell tumor, and 1.41 and 1.31 in low grade malignant bone tumor. Retention indexes were 0.62, 0.97, 0.66, 0.93 in same order. The thallium uptake ratio and retention indexes were statistically correlated in high grade malignant bone tumor and benign bone tumor group(p<0.001). Conclusion: Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors.

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A Case of Ectopic Parathyroid Adenoma Detected by 201 Thallium Scintiscan (201 Thallium Scintiscan으로 확인된 이소성 부갑상선 선종의 1예)

  • Shong, Young-Kee;Lee, Myung-Chul;Cho, Bo-Youn;Koh, Chang-Soon;Min, Hun-Ki;Oh, Seung-Keun
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.1
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    • pp.75-78
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    • 1987
  • A 57 year old female patient was diagnosed as primary hyperparathyroidism after incidental finding of hypercalcemia. She was treated with radioiodine for Graves disease twenty years ago. Preoperative localization procedures with sonography and CT were unrevealing but 201 thallium scintiscan clearly demonstrated ectopic parathyroid adenoma which was confirmed by surgery. Brief review of the preoperative parathyroid localization procedure was done and the relationship between radioiodine therapy and hyperparathyroidism was discussed.

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Thallium-201 Uptake and Washout in T1-201 Brain SPECT of Various Brain Tumors (각종 뇌 종양의 Thallium-201 뇌 SPECT에서 Thallium-201의 동태)

  • Lim, Sang-Moo;Hong, Sung-Woon;Rhee, Chang-Hun;Lee, Seung-Hoon;Kim, Jong-Hyun
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.360-364
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    • 1992
  • Treatment for the brain tumors consist of surgery, chemotherapy, and a variety of methods of irradiation. Therapy is aimed to destroy the tumor, but necrosis and edema occur concurrently. Conventional structural imaging techniques such as CT or MRI are unable to reliably distinguish persistent and recurrent tumor from necrosis or edema. T1-201 has been shown to be useful in the evaluation of the myocardial viability by comparing the early uptake and redistribution image. The aim of this study is to evaluate the clinical usefulness of the early uptake and delayed washout images of the T1-201 brain SPECT in the brain tumors. In the pathologically diagnosed various brain tumor patients, brain SPECT was done with rotating gamma camera 15 minutes and 3 hours after T1-201 injection, and the T1-201 uptake in the tumor was compared with the skull and scalp activity. In the glioblastoma multiforme, meningioma and metastatic tumor, the T1-201 uptake was higher than low grade glioma in both 15 minute and 3 hour images (p<0.02). In the low grade glioma,3 hour T1-201 uptake was significantly lower than 15 minute uptake (p<0.05) but in the glioblastoma, meningioma and metastatic tumor there was no significant difference. There was no significant difference in the T1-201 uptake among the glioblastoma, meningioma and metastatic tumors. In one matastatic tumor, T1-201 uptake was decreased after radiation therapy. T1-201 brain SPECT could distinguish the benign and malignancy, and seems to be useful in the follow-up after treatment. But one of the early or delayed SPECT seems not to be necessary for these purposes.

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Safety and Feasibility of Thallium-201 Myocardial SPECT with Intravenous Infusion of Disodium Adenosine Triphosphate (ATP) in the Diagnosis of Coronary Artery disease (관상동맥 질환 진단에서 ATP부하 T1-201 심근 관류 SPECT의 안전성과 유용성)

  • Pai, Moon-Sun;Park, Chan-H.;Yoon, Seok-Nam;Kim, Won;Kim, Han-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.250-258
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    • 1998
  • Purpose: ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet been sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-201 myocardial SPECT using an intra-venous ATP infusion in patients with suspected coronary artery disease. Materials and Methods: Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/kg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Results: Although 76.5% of the patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Conclusion: Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease.

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