فهرست مطالب

Nuclear Medicine - Volume:24 Issue: 2, Summer-Autumn 2016

Iranian Journal of Nuclear Medicine
Volume:24 Issue: 2, Summer-Autumn 2016

  • تاریخ انتشار: 1395/04/21
  • تعداد عناوین: 12
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  • Mahidul Haque Prodhan*, Hasan Talukder, Fazlul Huq, Zahid Hasan Mahmood Pages 76-84
    Introduction
    The different factors that affect the camera uniformity of Single Photon Emission Computed Tomography (SPECT) technique have been analyzed including peak shift (%) and window width of energy. The effect of peak shift and window width on SPECT image uniformity has been investigated using a point source to perform intrinsic flood images.
    Methods
    The relation between calculated integral & differential Center Field of View (CFOV) and Useful Field of View (UFOV) uniformity values were plotted with peak shift and window width change. The effects of window width of energy 5%, 10%, 15%, 20% and 25% on SPECT images were investigated using the 99mTc radioisotope with energy of 140 keV.
    Results
    Although 0% shift is the optimum peak shift, but in the current research we have found that the data in the range of 0% to 2% peak shift provides result with satisfactory image quality. Integral Uniformity (IU %) and Differential Uniformity (DU %) values of CFOV and UFOV were noticeably changed with the change of energy window width. In this research, the optimum energy window width of the images of different flood phantom has been found to be in the range from 15% to 20%.
    Conclusion
    Finally, 0% to 2% peak shift at 15% energy window width applied on heart phantom provides suitable images leading to proper diagnosis which conform our findings.
    Keywords: SPECT, Center field of view (CFOV), Useful field of view (UFOV), Integral uniformity (IU), Differential uniformity (DU)
  • Hassan Yousefnia*, Masoumeh, Sadat Mousavi, Daramoroudi, Samaneh Zolghadri, Fereydoun Abbasi, Davani Pages 85-91
    Introduction
    Somatostatin receptors expressed on a wide range of human tumors, are potential targets for the peptide receptor radionuclide therapy (PRRT). In this study, 177Lu-[DOTA-DPhe1, Tyr3]octreotide (177Lu-DOTATOC) as an agent for PRRT was prepared and its biodistribution was studied in rats.
    Methods
    The best condition for the preparation of the 177Lu-DOTATOC radiolabeled complex was determined by various experiments. Radiochemical purity of the radiolabeled complex was checked using ITLC method. The stability of the complex in room temperature and in human serum was studied up to 48 h. The biodistribution of 177Lu-DOTATOC solution was investigated in male rats at each selected interval time (2, 4, 24, 48, 72 and 168 h) after injection and compared with the biodistribution of 177LuCl3 solution in the same-type rats.
    Results
    177Lu-DOTATOC was prepared successfully with radiochemical purity of higher than 99% in 30 min at the optimized conditions. The stability of the radiolabeled complex at room temperature and in human serum at 37 °C showed no decrease in the radiochemical purity even after for 48 h. The biological behavior of the complex showed a major difference uptake with 177LuCl3 solution especially in the liver and spleen and also in somatostatin receptor-positive tissues such as pancreas and adrenal.
    Conclusion
    The results showed that 177Lu-DOTATOC has the comparable pharmacokinetic with the other DOTATOC complexes, while has completely different pattern compared with 177Lu cation.
    Keywords: DOTATOC, 177Lu, Biodistribution
  • Sied Kazem Razavi Ratki, Babak Fallahi*, Nassim Namiranian, Alireza Emami, Ardekani, Mohsen Saghari, Arash Mirabzadeh, Armaghan Fard, Esfahani, Davood Beiki, Mohammad Eftekhari, Farzaneh Pooyafard Pages 92-97
    Introduction
    Differentiated thyroid carcinoma (DTC) is associated with excellent prognosis and high survival rates. This study was conducted to evaluate the influence of baseline and treatment-related factors on the health related quality of life (QoL) in cured DTC.
    Methods
    This study was an analytic cross-sectional study on radio-iodine (RAI) treated DTC patients during 2011-2012. The data on patients’ QoL were recorded using a validated EORTC QLQ-C30 version 3.0. Also a checklist was used to record demographic data as well as information about the educational, marital and economic status. Duration of follow up, frequency of RAI therapies and number of surgeries were also recorded. General linear model multivariate analysis of variances (GLM-MANOVA) was used to analyze the data.
    Results
    Totally 435 DTC patients, 41.11±11.25 years, 77% female were assessed. Most of them were married (79%) and unemployed (57%). Global health and Qol as well as functional domains were better in women, single and higher educated patients. The QoL score in female cases was better in four functional subdomains, i.e physical, emotional, role and cognitive, but not for social functioning. QoL was adversely affected by increased number of radio-iodine therapies, radio-iodine cumulative doses and number of surgeries.
    Conclusion
    We found that quality-of-life scores are affected by the majority of socio-economic, treatment and follow-up variables. Attention to the quality of life and well-being of the patient as well as availability of professional support may be important aspects of the DTC patients’ treatment and follow-up.
    Keywords: Quality of life, Differentiated thyroid carcinoma, Follow, up
  • Sagili Chandrasekhara Reddy*, Ahmad Zakaria, Venkata Muralikrishna Bhavaraju Pages 98-105
    Introduction
    This study was done to determine the site of obstruction in lacrimal drainage system in Asian patients suffering from epiphora and to determine the transit time taken for the tracer material to reach the lacrimal sac and the nasal cavity.
    Methods
    Dacryoscintigraphy was performed using radionuclide technetium-99m pertechnetate (99mTc) in 34 patients suffering from unilateral or bilateral epiphora and in 3 cases of post-operative dacryocystorhinostomy. The site of obstruction was noted during the dynamic scintigraphy procedure. The time taken for the tracer material to reach the lacrimal sac in all the eyes and the nasal cavity in the eyes with patency of nasolacrimal duct was determined.
    Results
    Complete obstruction of nasolacrimal duct (NLD) was noted in all 22 unilateral cases. However, in 4 of the contralateral asymptomatic eyes in these patients complete obstruction of NLD was detected. Out of 12 bilateral cases, complete obstruction of NLD was noted in both eyes in 4 cases, and in one eye only in 8 cases. There was partial obstruction of NLD in the other eye in these 8 patients. The mean transit time taken for the tracer material to reach the lacrimal sac was 8 seconds (range 5 – 14 seconds) and to the nasal cavity was 6 minutes 20 seconds (range 2 minutes 16 seconds – 12 minutes).
    Conclusion
    This non-invasive procedure helps in the diagnosis of partial obstruction of NLD which can be missed by syringing procedure. The time taken for the tears to drain into the nasal cavity can also be measured in eyes with patent nasolacrimal duct by this procedure.
    Keywords: Technetium, 99m, Epiphora, Dacryoscintigraphy, Nasolacrimal duct obstruction, Dacryocystorhinostomy
  • Behnaz Piroozfar, Behrouz Alirezapoor, Farahnaz Motamedi Sedeh, Amir Reza Jalilian*, Mohammad Mirzaei, Gholamreza Raisali Pages 106-113
    Introduction
    Auger electron based radioimmunotherapy (RIT) using 111In-DOTA-trastuzumab (111In-DOTA-antiHer2) feasibility was studied in vitro on a HER2/neu positive cell line, SkBr3.
    Methods
    111In-DOTA-antiHer2 was prepared according to the optimized conditions followed by quality control tests including radiochemical purity; immunoreactivity). SkBr3 as a HER2/neu positive cell line was used to determine the degree of internalization and cell viability of 111In-DOTA-antiHer2. For comet assay freshly cultivated SkBr3 cells incubated with 111In-DOTA-antiHer2 in 3.7 and 7.4 MBq doses at 37ºC for 24h.
    Results
    111In-DOTA-antiHer2 (>95% radiochemical purity; >79% immunoreactivity) demonstrated significant internalization in SKBr3 cells in 24 h. no significant cell viability difference observed for 111In-DOTA-antiHer2 and 111In cation treatments. Comet assay at 3.7 MBq demonstrated no significant DNA damage, while at 7.4 MBq dose DNA damage observed at least 16% more than control In-111 chloride after 24 h.
    Conclusion
    Although the internalization of 111In-DOTA-antiHer2 was approved in this study, however, lack of cell death and slight DNA breakage for 111In-DOTA-antiHer2 treatment suggests absence of nucleus entry which is essential for demonstration of DNA damage according to Auger electron range at cellular level.
    Keywords: Auger therapy, 111In, DOTA, antiHer2, SkBr3, Immunoreactivity, Internalization, Cell viability, Comet assay
  • Mpumelelo Nyathi*, Enoch Sithole, Ouma Ramafi Pages 114-119
    Introduction
    The limited resolution of the imaging system causes partial volume effects (PVEs). These results in spreading of image counts to the neighboring pixels. This phenomenon is called spill-out effect. This study aimed at quantifying PVEs using ImageJ.
    Methods
    Technetium-99m solution of concentration of 74 kBq/ml was filled into spheres A, B and C of diameters: 26 mm, 20 mm and 16 mm respectively. The spheres were imaged mounted inside a Jaszczak phantom filled with activity free water using a Siemens E-Cam dual head gamma camera. Images were quantified using ImageJ following a two-step method. Step 1: Drawing of region of interest 1 (ROI 1) closely on the boundary of the planar image to extract images counts before PVEs correction. Step 2: Drawing region of interest 2 (ROI 2) to extract true sphere image counts. ROI 2 extends from the boundary of ROI 1 by the FWHM of the imaging system.
    Results
    The studyrevealed that PVEs are aggravated by decrease in sphere size. Underestimation of image counts on the 64 × 64 pixels matrix was found to be: 9.7%; 15% and 26% in the order of decreasing sphere size. However, an improvement in the spatial resolution decreased PVEs (128 × 128 pixels: 6.7%; 12.0% and 22.5%; 256 × 256 pixels: 6.5% ; 9% and 19.3%; 256 × 256 pixels: 6.1%; 8.0% and 18.7% in the order of decreasing sphere size).
    Conclusion
    ImageJ successfully quantified PVEs attributed to the spill-out effect in planar imaging.
    Keywords: Planar imaging, Partial volume effects, Quantification
  • Sanaz Katal, Arman Hassanzadeh, Rad*, Mohammad Eftekhari, Armaghan Fard, Esfahani, Davood Beiki, Babak Fallahi, Alireza Emami, Ardekani, Mehrshad Abbasi Pages 120-128
    Introduction
    Peripheral Vascular Disease (PVD) is a major cause of morbidity and is associated with Coronary Artery Disease (CAD). We aimed to perform Lower Limb Perfusion Scan (LLPS) in patients referred for Myocardial Perfusion Imaging (MPI) and estimate prevalence of PVD in subgroups with normal and abnormal MPI results. We also compared quantitative indices of LLPS in patients with and without abnormal MPI results with semi-quantitative QPS indices.
    Methods
    120 patients referred for MPI entered the study. Exercise or dipyridamole infusion was used as stress modality. After 99mTc-MIBI injection at peak stress, whole body posterior views and planar images from thighs and calves were obtained. Gated MPI was done subsequently. Rest phase was performed the following day. LLPS was analyzed visually and quantitatively.
    Results
    In patients with abnormal and normal MPI results, LLPS revealed 22.58% and 1.92% prevalence of PVD in exercise subgroup (P-Value=0.004) and 50.00% and 10.52% in dipyridamole subgroup (P-Value= 0.013), respectively. Both of these different prevalence were statistically significant. In exercise subgroup, mean ranks of Stress Index (Is) for all lower limb regions were statistically significantly greater in patients with normal MPI result. Also, among patients who had ischemia in exercise-rest MPI, negative correlations were seen between Is and Rest Index (Ir) of all regions and QPS quantitative indices.
    Conclusion
    LLPS with 99mTc-MIBI, combined with MPI is a feasible method to detect lower limbs ischemia, especially in patients with abnormal MPI results. Correlating quantitative indices of LLPS with MPI-QPS also reflect coexistence of CAD and PVD.
    Keywords: Lower extremity, Myocardial perfusion imaging, 99mTc, MIBI
  • Leili Zarifmahmoudi, Hossein Shabahang, Farzaneh Shariati, Vahid Reza Dabbagh Kakhki, Mostafa Mehrabibahar, Roya Sadat Alavifard, Ali Jangjoo, Ramin Sadeghi* Pages 129-134
    Introduction
    Lymphoscintigraphy is imaging of the lymphatic system and has been integrated into the sentinel node mapping procedures. Lymphoscintigraphy usually encompasses early or delayed static images. However, immediate dynamic imaging of the lymphatic basins and tumors has also been used as an adjunct lymphoscintigraphy imaging. The aim of this study was to assess the role of early dynamic acquisition versus static lymphoscintigraphy images for sentinel node detection in breast cancer.
    Methods
    Seventy five women with proved breast cancer and clinically node negative axilla entered the study. For each patient 0.5 mCi Tc-99m-antimony sulfide colloid in the 0.2 cc volume was injected in periareolar region in an intradermal fashion. Immediately after injection dynamic imaging was started as 1 minute per frame for 15 minutes. Static anterior and lateral images (5min/image) was also taken 30 minutes post injection. Imaging data for each patient were evaluated blindly by two experienced nuclear physicians and early dynamic imaging data were assessed for its value in detection of sentinel nodes.
    Results
    Overall 75 patients entered the current study. Sentinel node(s) could be identified on the dynamic lymphoscintigraphy images in 65 patients (86.6%). In 4 patients, dynamic lymphoscintigraphy could differentiate the second visible sentinel nodes as second echelon or true sentinel nodes.
    Conclusion
    Dynamic lymphoscintigraphy immediately after radiotracer injection is feasible in breast cancer patients with a high detection rate. The added value of dynamic over delayed static imaging is the ability to differentiate between second echelon and secondary sentinel nodes.
    Keywords: Breast cancer, Lymphoscintigraphy, Dynamic, Second echelon nodes, Second tier nodes
  • Alireza Sadremomtaz*, Zeinab Telikani Pages 135-142
    Introduction
    Image quality and accuracy of in vivo activity quantification in SPECT are affected by collimator penetration and scatter components, especially in high energy imaging. These phenomena highly depend on the collimator characteristic and photon energy. The presence of penetrated and scattered photons from collimator in SPECT images degrades spatial resolution, contrast and image quality. Knowledge of penetration and scatter distribution is essential for optimization of collimator design and development of reconstruction algorithms.The aim of this study to survey the collimator performance of the newly developed HiReSPECT dual head gamma camera with pixelated array CsI(Na).
    Methods
    We modeled the HiReSPECT, by using SIMIND Monte Carlo simulation code. The contribution of geometric, scatter and penetration components were quantitatively calculated for the different energy sources. Then we compared these results with simulation results of another small animal SPECT with compact pixelated array CsI(Tl) detector.
    Results
    The simulated System spatial resolution and energy resolution of the HiReSPECT at 140keV respectively are 1.9mm and 29.72 keV (21.23%) FWHM at 2.5cm distance from detector surface also Geometric, penetration, and scatter at 140keV for the HiReSPECT collimator are 96.42%, 2.22%, 1.30%, respectively. Similarly, geometric, penetration, and scatter at 159keV and 245keV for this system collimator are (95.24%, 3.08%, 1.68%) and (87.21%, 8.10%, 4.69%), respectively.
    Conclusion
    The results verified that the magnitude of these components depend on collimator geometric structure and photons energy. The measured performances indicated that the HiReSPECT scanner is well suited for preclinical molecular imaging research and provide high resolution for small animal imaging.
    Keywords: SPECT, Compact pixelated gamma camera, Septal penetration, Scatter, Monte Carlo simulation
  • Lebriz Uslu, Be, Li, Mustafa Demir *, Nami Yeyini., Ffet, Ccedil, Avdar Pages 143-145
    Undesired radiation exposure to caregivers is an important problem in radioiodine therapy in thyroid carcinoma patients, especially when patient is non-ambulatory. Special precautions are needed to keep the exposure to caregivers low when higher dose of radioiodine is necessary.
    Here we present a case-report of a 74-year old male patient with papillary thyroid carcinoma with local invasion and distant metastases, who received 9250 MBq I-131. The patient was confined to bed and needed special assistance for nasogastric tube and urinary catheter. Two family members helped the patient for daily care under the supervision of nursing staff. Caregivers were instructed for radiation protection and lead aprons, lead collars, two pair of gloves and lead screen were used during close contact with the patient. The patient was given daily amount of 4 liter water to increase the urinary excretion of radioiodine. The patient stayed at the hospital for 2 days and discharged when dose rate fell below 30 mSv/h at 1 m. Caregivers at home used lead aprons and lead collars for 3 more days. Cumulative radiation dose measured at the 5th day for two caregivers was 1320 μSv (264 μSv/day), which is under the safety limit of 5 mSv given by ICRP.
    Keywords: Thyroid neoplasms, Thyroid cancer, Radioiodine, Caregiver, Radiation protection
  • Armaghan Fard *, Esfahani, Mehraneh Marzban, Alireza Emami, Ardekani, Arman Hassanzadeh, Rad, Babak Fallahi, Davood Beiki, Parham Geramifar, Mohammad Eftekhari Pages 146-148
    A 60-year-old patient with testicular seminoma was referred for F-18 FDG PET/CT Study to evaluate recurrence. In addition to hypermetabolic cervical, mediastinal and hilar lymph node tumoral metastases, segmental intense FDG uptake along the lumbar spinal cord suggestive of tumoral metastasis was noted which quite an unusual presentation is. At the time of PET study the patient was symptomless, and neurological symptoms and signs associated with spinal cord metastasis developed only several days afterwards, emphasizing the role of FDG PET study in early detection of spinal cord metastasis. The patient underwent radiotherapy of the spinal cord with consequent clinical improvement.
    Keywords: Spinal cord metastasis, Seminoma, Testicular cancer, F, 18 FDG PET scan
  • Somayeh Ghahremani, Susan Shafiee, Mahsa Sabour, Ahmad Bazrafshan, Ramin Sadeghi* Pages 149-152
    We reported a 14 months old boy referred for evaluation of chylous ascites to our nuclear medicine department. Tc-99m Phytate was injected subcutaneously in his calves and whole body images as well as abdominal SPECT were performed. The SPECT images could localize an area of several intestinal lymphangiomata in the abdominal region. The abnormal region was surgically resected and the patient ascites symptoms subsided consequently.
    Keywords: Lymphoscintigraphy, Chylous ascites, SPECT