We have noted that the presence of left ventricular anterior/apical aneurysm on contrast ventriculography or echocardiography correlates well with the finding of failure of convergence of the left ventricular walls toward the apex on single photon emission computed tomography (SPECT) thallium-201 images. To assess this observation, we analyzed the SPECT thallium scans of 74 sequential patients who had SPECT thallium scintigraphy and contrast ventriculography and/or echocardiography for evaluation of coronary artery disease. Immediate post-stress and 4-hr redistribution thallium-201 SPECT images, obtained following i.v. administration of 2 mCi of thallium-201, were reconstructed with no attenuation correction using three-dimensional linear and nonlinear filters and displayed in short, vertical-long, and horizontal-long axes. Of the 74 patients, contrast ventriculography and/or echocardiography showed anterior/apical aneurysms in 15 and a posterolateral aneurysm in one. SPECT thallium scans detected 14 of the 16 aneurysms, based on the criterion of failure of convergence of the ventricular walls toward the apex. There were two false-positives. Thus SPECT thallium-201 scintigraphy for the detection of left-ventricular aneurysm in this series had a sensitivity of 94%, a specificity of 97%, and an accuracy of 96%.

To define the range of inter- and intra-subject variability on gastric emptying measurements, eight healthy male subjects (ages 19-40) received meals on four separate occasions. The meal consisted of 150 g of beef stew labeled with Tc-99m SC labeled liver (600 ..mu..Ci) and 150 g of orange juice containing In-111 DTPA (100 ..mu..Ci) as the solid- and liquid-phase markers respectively. Images of the solid and liquid phases were obtained at 20 min intervals immediately after meal ingestion. The stomach region was selected from digital images and data were corrected for radionuclide interference, radioactive decay and the geometric mean of anterior and posterior counts. More absolute variability was seen with the solid than the liquid marker emptying for the group. The mean solid half-emptying time was 58 +- 17 min (range 29-92) while the mean liquid half-emptying time was 24 +- 8 min (range 12-37). A nested random effects analysis of variance showed moderate intra-subject variability for solid half-emptying times (rho = 0.4594), and high intra-subject variability was implied by a low correlation (rho = 0.2084) for liquid half-emptying. The average inter-subject differences were 58.3% of the total variance for solids (rho = 0.0017). For liquids, the inter-subject variability was 69.1%more » of the total variance, but was only suggestive of statistical significance (rho = 0.0666). The normal half emptying time for gastric emptying of liquids and solids is a variable phenomenon in healthy subjects and has great inter- and intra-individual day-to-day differences.« less

This study was designed to assess the relative influence of meal weight and caloric content on gastric emptying of liquid and solid meals in man. A dual radioisotopic method which permits noninvasive and simultaneous measurement of liquid- and solid-phase emptying by external gamma camera techniques was employed. Nine healthy volunteer subjects ingested 50-, 300-, and 900-g lettuce and water meals adjusted to either 68, 208, or 633 kcal with added salad oil. The following observations were made: (1) absolute emptying rates (grams of solid food emptied from the stomach per minute) increased directly and significantly with meal weight; (2) increasing meal total caloric content significantly slowed solid food gastric emptying but did not overcome the enhancing effect of meal weight; and (3) liquid emptying rates were uninfluenced by meal total kcal amount.

A retrospective review was undertaken to evaluate the frequency and significance of pulmonary activity noted on 306 indium-111 leukocyte studies involving 232 patients with suspected occult infections. Forty-eight studies showed pulmonary activity in one of two patterns of uptake, focal or diffuse. Fourteen of 27 studies (52%) with focal uptake and two of 21 studies (10%) with diffuse uptake were associated with infectious processes. Lung uptake of indium-111-labeled leukocytes was a poor predictor of pulmonary infection in patients studied for occult infection, although the focal pattern was more likely than the diffuse pattern to be associated with infection.