Pituitary adenoma and cerebral infarction demonstrated by Tc-99m HMPAO using a high-resolution SPECT system.
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Biomedical subjects
Publications and source records attributed to N Yui.
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SPECT of the skull was performed on twelve patients with histologically proven nasopharyngeal carcinoma using newly developed three detectors SPECT system (Toshiba GCA 9300A) mounted with fan-beam collimators, for the purpose of early detection of skull base involvement of the disease. This SPECT system has extremely improved resolution with FWHM of 8 mm in the center, and it provides clear tomographic images of the skull which has anatomically complex structure. SPECT image was taken 3 hours after injection of 740 MBq (20 mCi) of 99mTc-MDP following whole body skeletal survey. In twelve patients with confirmed nasopharyngeal carcinoma, 8 patients showed positive findings on SPECT. Three of SPECT positive patients also showed destructive findings on CT. Other five positive patients did not show destructive findings on CT at their initial examinations, but in three of them CT findings turned to positive later. SPECT was superior to CT in early detection of skull base involvement. We believe that SPECT of the skull is a diagnostic tool for early detection of skull base involvement of nasopharyngeal carcinoma.
A multislice fan beam collimator was designed for a SPECT system with a rotating scintillation camera, and it was constructed by the lead casting method which was devised in recent years. The focal length from the surface of the detector side of the collimator is 75 cm. In order to reconstruct the SPECT images we modified the interpolation method which was developed for reconstruction of the X-ray CT and applied it. Primary photopeak data were obtained with a 20% energy window centered at 140 keV for 99mTc and 159 keV for 123I. The fan beam collimator reduces the field of view, and it would therefore be limited to use only for the head and neck region at present; however, both resolution and sensitivity were approximately 20% better than those of the parallel hole collimator. A fan beam collimator is a useful implement for the SPECT study.
201Tl SPECT was performed on 17 patients with pancreatic cancer or chronic pancreatitis using a three-head rotating gamma camera SPECT system. In 7 of 10 patients with pancreatic cancer, the lesions were clearly delineated by 201Tl SPECT. Whereas the lesion of 30 mm in diameter was visualized, a large tumor of 80 mm in diameter could not be visualized. Namely, it was thought that 201Tl uptake by pancreatic cancer might be well correlated with tumor blood flow and/or its histological subtype rather than with tumor size. In 5 of 7 patients with chronic pancreatitis, no uptake by the pancreas was shown. The sensitivity, specificity, and accuracy in diagnosing pancreatic cancer by 201Tl SPECT were 70%, 71%, and 71%, respectively. The present results obtained by 201Tl SPECT were thought satisfactory enough to evaluate pancreatic cancer under the present conditions where there was no useful imaging agent for visualizing pancreatic cancer by SPECT. 201Tl SPECT is expected to be a new diagnostic tool for investigation of pancreatic tumorous lesion.
Using 3-heads rotating gamma camera SPECT system, regional blood flow was measured from the super-early image obtained 4 to 6 minutes after the intravenous injection of 123I-IMP on 11 patients with various brain tumors. Two cases of olfactory groove meningioma and malignant astrocytoma showed significantly high 123I-IMP uptake by the lesion visualized by MRI compared to the uptake by normal brain cortex on super-early image but 123I-IMP uptake by the tumor decreased on early image. In both cases, blood flow of the tumor measured from super-early image showed values much higher than those of normal brain cortex. It was thought that usual correction method based on early image did not correctly represent the blood flow of the lesion but that the present method based on super-early image could show the increase of blood flow of the tumor.
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Single photon radioisotope computed tomography (RCT) images were obtained using the following devices such as conventional gamma camera, data processer for exclusive use of nuclear medicine (C.D.S.-4096), magnetic tape and medium size electronic computer FACOM 230-28S (48K) for multipurposes, which are routinely used for clinical purpose. To reconstruct the RCT image we made absorption correction by geometric mean of opposing counts considering the thickness of source and used the convolution integral method. The reconstructed images of phantom study resolved one centimeter clearly and were very similar to original. The RCT image of patient was acquired by the rotation of patients using the revolving chair and the handmade implement which settles the center of patient's head. Three dimensional informations were obtained by one examination with a gamma camera which collects two dimensional images. When using a gamma camera, therefore, not only a transaxial but an arbitraly RCT image will be important to contribute for diagnosis.
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