The 54th Nuclear Medicine Imaging Conference update: Nov 22, 2002

• Age/Sex: 82M
• Chief Complaint: なんとなく体がだるい
• Clinical Course
  • 15年前 complete AV blockでpacemaker植え込み
  • 昨年6月 COPDに対して在宅酸素療法
  • 昨年7月 倦怠感出現
  • 昨年8月 内科へ入院
  • 甲状腺精査のためI-123甲状腺シンチグラフィを予定していたが患者の事情により退院することとなった。
  • 退院前に^99mTcO₄に変更して甲状腺シンチグラフィを施行した。
• Lab. data
  • TP:7.8g/dl, T-Bil:1.00mg/dl, ALP:329 IU/L, LAP:66 IU/L, γ-GTP:114 IU/L, CHE:94IU/L, AST:77.4 IU/L, ALT:40 IU/L, LDH:140.8 IU/L
  • CPK:911IU/L, CPKMB:25.8IU/L
  • WBC:3200/μL, RBC:369万/μL, Hb:12.0g/dl, Hct 37.4%, Plt 14.9万/μL, CRP 0.1mg/dl
  • TSH: 179.76μU/ml, FT3 0.77pg/ml, FT4 0.66ng/dl, microsome test 409,600, Anti-TPO Ab >50, Anti-Tg Ab >100
• Images
  • Tc-99m scan: uptake 6.8%

  

  • neck CT

    

    2001.5(倦怠感出現前)	2001.8 (入院時)
    magnify	magnify

あなたの診断はWhat is your first impression?

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• Age/Sex: 76F
• Chief Complaint: 胸部異常陰影
• Images: (click each image to magnify)
  • X-CT

  • magnify

    magnify

  • Nuclear

    Tl-201 Early

    Tl-201 Delayed

    F-18 FDG

    　

あなたの診断はWhat is your first impression?

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• Age/Sex:51M
• Chief Complaint:
• Clinical course: 2000年4月、早期胃癌の診断で胃部分切除術（T1N0M0、stage�蘗、 根治度A）を受けた。術中脾損傷により脾摘を受けた。その後外来で経過観察を受けていた。
• Images:

  • 手術前

    術後2ヶ月

    術後１年

  • 鑑別診断は？
  • 次に行なうべき核医学検査は？

あなたの診断はWhat is your first impression?

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• Age/Sex: 66M
• Chief Complaint:両下肢痛および紅潮
  • ある病院に入院中の患者に起こったできごとです(この所見が原因で入院になったわけではありません）。
  • なぜこんな所見になったのか？考えて欲しいとの出題者からのコメントです。
• Images:
  • Bone scan

    Whole-body magnify

    Left lateral view

あなたの診断はWhat is your first impression?

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• Age/Sex: 67M
• Chief Complaint: 骨転移の検索
• Images:
  • Bone scan（図1）
  　
  • X-ray film (図2)
  

あなたの診断はWhat is your first impression?

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• Age/Sex:　31M
• Chief Complaint: no symptom
• Images:
  • 糖負荷(+), FDG7mCi静注後60minでガンマカメラにてcoincidence imaging（20min収集）
  • 再構成はFBP法, BW filter10_54, attenuation correctionなし)　
  • FDG image上の異常は？
  • 
  • 

あなたの診断はWhat is your first impression?

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Presentation from a Recent Paper: MY05

A new method for measuring dynamic change of tracer distribution using dynamic single photon emission tomography with a slip-ring rotational gamma camera

Y. MIYAZAKI ¹; M. HASHIMOTO ²; S. KINUYA ³; Y. MURATA ⁴; H. INOUE ¹; J. SHIOZAKI ¹; M. TAKIMOTO ¹; K. YOSHIOKA ⁵; K. NAKAJIMA ³; J. TAKI ³

Departments of ¹Radiology, ²Neurosurgery, and ⁴Cardiology, Noto General Hospital, Nanao, Japan; ³Department of Biotracer Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan; and ⁵Group of Clinical Application Technology, Daiichi Radioisotope Laboratories, Ltd, Tokyo, Japan

Nuclear Medicine Communications 2002; 23(11):1115-1121

• Background and Purpose
  • The clinical applicability of dynamic single photon emission tomograpy (SPET) using a dual-head gamma camera equipped with a slip-ring rotational mechanism, referred to as serial SPET, was examined in the present investigation. Serial SPET enables the production of tomographic images for any arbitrary time frame from an arbitrary range of data to 360°.
• Methods
  • In a pre-clinical evaluation, a correlation between radioactivity concentration and serial SPET counts was evaluated in a phantom with continuous changes in ^99mTc concentration.
  • A differential value was obtained from each pair of SPET images; moreover, moving average approximation processing was investigated with respect to the elimination of noise in the data.
  • In 11 and one patient presenting with cerebrovascular disease and meningioma, respectively, changes in SPET counts were evaluated when ^99mTc-ECD was continuously administered at a constant rate in the resting state.
  • Furthermore, in 6 of 11 subjects with cerebrovascular disease, changes occurring in SPET counts were examined by using acetazolamide loading while continuously administering ^99mTc-ECD at a constant rate.
• Results
  • Serial SPET enabled the evaluation of changes in radioactivity concentration over time in both the phantom and preliminary clinical studies.
  • Data analysis by differential processing utilizing moving average approximation processing enabled the detection of minor changes in radioactivity concentration.
  • An increase of 15.1±5.4% was observed in SPET counts of the unaffected cerebral hemisphere with acetazolamide loading.
  • The response of the affected hemisphere was less prominent.
• Conclusion
  • These findings suggest that serial SPET would be an effective technique for the pharmacokinetic analysis of radiopharmaceuticals in vivo.
• Key words
  • slip-ring gamma camera
  • dynamic serial photon emission tomography
  • ^99mTc ethyl cysteinate dimer
  • continuous infusion
  • acetazolamide

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ご意見，質問のメールはnakajima@med.kanazawa-u.ac.jp