We determined the effect of retention on the changes in regional biodistribution of Tc-99m ECD in the brain. A total of 14 cases, 7 normal volunteers and 7 patients with various diagnoses but with very minimal radiologic findings or none were included in the study. SPECT images were taken at 30 min, 1, 2, 3, 4 and 6 hrs after an intravenous injection. Retention rates were calculated in various regions and were corrected according to the time decay of technetium. There was a tendency for the retention rate to increase up to three hours of imaging and then a decrease was noted in most regions of the brain. In the thalamus, increasing retention was noted. In conclusion, Tc-99m ECD retention in the different regions of the brain varies with time. These differences should always be considered when planning and interpreting SPECT quantitative studies.

Triple Energy Window (TEW) 処理機能を持たない3検出器型SPECT装置において散乱補正を行う方法 (Modified-TEW法, 以下M-TEW法) を考案し, その有効性をファントム実験により検討した。また, 本法を99mTcと201T1の2核種同時収集法に応用する可能性を基礎的に検討し, 負荷心筋シンチに使用した。201Tl, 99mTcにおけるサブウインドウのデータの固有均一性を測定した結果, エネルギーウインドウ幅は5keV近傍が最適であった。2核種同時収集法では201Tlから99mTcウインドウに2.8-19.7%, 99mTcから201Tlウインドウに4.7-31.8%のクロストークがみられたが, M-TEW法を用いて散乱補正を行うことで99mTcウインドウでは20.9-32.4%が, 201Tlウインドウでは43.9-62.4%が散乱成分として除去された。臨床例で201Tlと99mTcテトロフォスミンによる2核種同時収集法による心筋シンチを施行する際, M-TEW法を用いて散乱補正を行うことにより, 散乱補正を行わない場合と比較して診断能が向上した。M-TEW法は, TEW処理機能のない3検出器型SPECT装置においてもTEW法が応用可能であり, 2核種同時収集心筋SPECTを行う際にクロストーク, 散乱線除去法として有用な方法と考えられた。

PURPOSE: To evaluate the CAD system for screening mammograms. MATERIALS AND METHODS: Mammograms of patients with asymptomatic breast cancerwere examined retrospectively. A total of 260 screening mammograms from 65 patients (bilateral cranio-caudal and medio-lateral-oblique views from each) were tested by using the CAD system (ImageChecker M1000 system, R2 Technology, Los Altos, CA, USA). Results: With 0.58 microcalcifications marks/film and 0.20 mass marks/film set as the false positive rate, 100% of microcalcifications cases and 79% of mass cases were detected correctly. Conclusion: The CAD system has the potential to become a second reader. Further developments are expected to improve the accuracy of detection of mass lesions

The case of a 77-year-old male patient who complained of left upper quadrant pain and progressive vomiting. Laboratory examination showed extremely high lactic acid dehydrogenase (LDH) and adult T-cell leukemia antibody (ATLA). The anatomical studies CT, MRI, US and upper GI series substantiated an omental lymphadenopathy which was causing a circumferential compression of portions of the duodenum and jejunum. Gallium-67 citrate (Ga-67) scintigraphy showed high uptake at LUQ. Ultrasound guided biopsy failed to confirm the diagnosis. Irradiation was performed. Ga-67 scintigraphy had a contributory role in clinical subtyping of the disease, planning of treatment, posttreatment assessment and prognostication of adult T-cell lymphoma.

肝胆道腫瘍患者32症例 (男性24人, 女性8人) を対象に99mTc-GSAを用いて肝予備能の評価を行った。HH15, LHL15, T1/2の各指標と肝予備能の指標であるプロトロンビン時間, ヘパプラスチンテスト, 血清アルブミン, コリンエステラーゼとの相関を調べた。さらに三つの各指標と血漿ICG15分停滞率 (ICG15) との相関を閉塞性黄疸例を含めた場合と閉塞性黄疸例を除外した場合に分けて検討した。HH15, LHL15, T1/2は閉塞性黄疸例でもICG15分停滞率とは異なり高ビリルビン血症の影響を受けず, 肝予備能の評価に有用であった。特に今回考案したTl/2は正常例と異常例の分離が良好で, かつ従来からの肝予備能の指標とも最も良好な相関を示し有用な指標と思われた。

To investigate the influence of diabetic myocardial damage (suspected myocardial damage; SMD) diagnosed by201T1-SPECT and diabetic cardiac autonomic neuropathy (AN) on myocardial MIBG uptake in patients with non-insulin-dependent diabetes mellitus (NIDDM).

PURPOSE:We review our initial experience with direct percutaneous transluminal angioplasty (PTA) as a reperfusion treatment for acute occlusion of the middle cerebral artery.METHODS:Ten patients in whom successful thrombolysis might not be expected because of the risk of hemorrhagic complications or reocclusion were treated with direct PTA. When early ischemic findings were present on the initial CT scans and/or when lenticulostriate arteries were involved, we performed direct PTA rather than thrombolytic therapy. Direct PTA was also performed when superselective local angiography via a Tracker catheter advanced just distal to the occlusion site showed the presence of a large embolus or high-grade stenosis suggestive of thrombosis. Angioplasty was performed with a Stealth balloon catheter with a maximum diameter of 2.0 to 2.5 mm. The balloon catheter was advanced into the site of occlusion and inflated to 2 atm initially, and subsequently up to 3 atm. Two to six inflations, each of 30 seconds' duration, were performed.RESULTS:Although the rate of initial recanalization was 100% (10 of 10), reocclusion occurred in two patients with atherothrombotic M2 occlusion. The final angiographic success rate of direct PTA was 80% (8 of 10). There were no hemorrhagic or technical complications, and five of 10 patients showed marked clinical improvement. In two of seven patients with cardioembolic M1 trunk occlusion, crushed fragments of the embolus obstructed M2 portions after direct PTA, necessitating local thrombolysis.CONCLUSION:Direct PTA may be performed safely as an alternative to thrombolytic therapy in patients with acute occlusion of the middle cerebral artery when early CT findings and/or lenticulostriate artery involvement are present or when superselective local angiography shows the presence of a large embolus or high-grade stenosis.

We assessed the relationship between 99Tcm-HMDP extraosseous accumulation (EOA), the histopathology of primary lesions and various laboratory findings. In 155 of 4824 patients, 163 EOA were noted. Of these, 33.7% were in the abdomen, 27.6% in the chest, 22.7% in the extremities, 9.8% in the pelvic area and 6.1% in the head and neck area. We found that 72.4% of EOA were due to malignant processes and 27.6% to benign processes. In the abdomen, 36.6% of the EOA were due to hepatocellular carcinoma and intestinal carcinoma. In the chest, 46.7% of EOA were a result of breast carcinoma. In the extremities, 28.7% of the EOA were due to sarcoma. The mean white blood cell count was elevated (8.0 +/- 6.3 x 10(3)) in patients with malignant processes. The mean serum haemoglobin and haematocrit in benign and malignant processes, for both males and females, were below normal values. All other laboratory findings were within normal limits. Significant differences in serum haemoglobin and haematocrit were noted between male and female patients with benign processes (P = 0.04 and P = 0.04, respectively). No other significant differences between benign and malignant processes were noted. Therefore, EOA is more frequently associated with malignant processes of primary lesions and is often accompanied by leukocytosis and anaemia.

A 33-year-old, female presenting with dementia was admitted to our institution. Except for slight muscle atrophy noted on both lower extremities there were no other significant physical signs or laboratory findings. Since initial Tc-99m-HMPAO SPECT showed hypoperfusion on both temporal, parietal and occipital lobes, follow up study with the same radiotracer was done. Increase in uptake was noted in the left side of the face. There was no abnormality noted on ENT examination. CT scan and MRI showed slight nasal mucosal wall thickening. Tl-201 SPECT showed increased uptake in the nasal area. The increase in uptake could be due to nasal mucosal thickening. This could simulate nasal tumor and interfere in determining ROI for brain perfusion studies.

Background: Thallium-201 (201Tl) has come to be widely used in the diagnosis of several kinds of malignant tumor, but its usefulness in diagnosing head and neck cancer has not been established. Purpose: This study investigated the usefulness of201Tl SPECT imaging in patients with head and neck cancer histologically confirmed. Methods: Eighteen patients with histologically proven head and neck cancer were studied.201Tl SPECT images were obtained both 15 min and 4 hours after intravenous injection of 148 MBq of201Tl-chloride.201Tl-indices were calculated semiquantitatively to assess the tracer uptake in relation to tumor size and histological type. Results: High201Tl uptake was noted in all primary tumors and metastatic lymph nodes on the both early and delayed images, but201Tl-indices did not show any correlation with tumor size or histological type. Conclusion: Primary head and neck cancer and lymph node metastasis can be effectively visualized with201Tl SPECT. It may provide information in addition to morphological changes and may be a supplemental method to use in the evaluation of head and neck cancer.

We examined the chemotactic response of eosinophils to five eosinophil chemotactic factors (ECF; ECF-PI5, −PI6, −PI7, −PI8 and -PI9) from an established T cell line (ST02) in 31 patients with bronchial asthma (BA). The asthmatic patients were divided into three groups according to the ratio of the chemotactic response to ECF-PI5 and -PI9 (PI5/PI9). A type 1 response occurred when eosinophils responded to both ECF-PI5 and to ECF-PI9, a type 2 response occurred when eosinophils responded to ECF-PI5 only and a type 3 response occurred when eosinophils responded to ECF-PI9 only. Of 31 asthmatic patients, 21 exhibited a type 2 response, six exhibited a type 1 response and the remainder exhibited a type 3 response. In contrast, 23 of 25 healthy donors exhibited a type 1 response and none of them exhibited a type 2 response. This typing of asthmatic patients was apparently correlated with the clinical symptoms of the patients. All patients exhibiting a type 1 response were diagnosed with mild and episodic asthma and none of them had taken oral prednisolone. In contrast, many patients exhibiting a type 2 response were diagnosed with moderate, persistent and perennial asthma. Indeed, eight of these 21 patients had taken oral prednisolone. The patients exhibiting a type 3 response were diagnosed with mild to moderate and episodic asthma, but none of them had taken oral prednisolone. Furthermore, according to the total percentage migration to five ST02-derived ECF, asthmatic patients were further divided into two groups: high- and low-responding groups. Sixteen of 21 patients exhibiting a type 2 response belonged to the high-responding group, whereas all patients exhibiting a type 1 or type 3 response belonged to low-responding group. The present results indicate that such chemotactic heterogeneity of eosinophils to ST02-derived ECF is closely associated with the severity of BA, particularly with regard to the necessity of steroid therapy.

Tl-201 SPECT and Tc-99m-Human serum albumin (HSA) multigated radionuclide ventriculography were performed on 11 patients with progressive muscular dystrophy (Becker type 2, Fukuyama type 2, Limb-girdle type 7) to evaluate myocardial involvement. Hypoperfusion was detected in 8 patients on Tl-201 SPECT. Decreases in both systolic function (left ventricular ejection fraction; LVEF) and diastolic function (peak filling rate; PFR) were also seen in these patients. A high incidence of myocardial involvement of these kinds of progressive muscular dystrophy was suggested.

妊娠状態では種々の脳血管障害の頻度が増加することが知られており, 脳循環動態異常の関与が推測されるが, 現在のところその原因は明らかにされていない。今回, われわれは重要な指標の一つである脳血流量を評価する量的で妊娠中絶予定の妊婦10例を対象に中絶前後で133Xeガス吸入法を用いて局所脳血流量の変化を測定した。中絶前では, 大脳半球61.6±9.1, 前頭葉60.6±8.7, 側頭葉75.0±12.3, 頭頂葉64.5±9.2, 後頭葉62.6±11.7, 大脳基底核69.2±10.7, 小脳72.3±13.0, 中絶後では大脳半球56.6±9.7, 前頭葉56.6±9.9, 側頭葉68.2±13.4, 頭頂葉51.2±9.1, 後頭葉59.1±11.1, 大脳基底核62.4±11.1, 小脳60.2±10.1 (単位はいずれもml/100g/min) と後頭葉を除く各部位で妊娠時の方が有意に高値を示した。妊娠状態では非妊娠時に比べ局所脳血流量が増加していることが確認された。