Multimodality imaging.
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Anatomy, Cross-Sectional↗
Biomedical subjects
Tracy L Faber
Publications and source records attributed to Tracy L Faber.
Initial human PET imaging studies with the dopamine transporter ligand 18F-FECNT.
UNLABELLED: The aim of this study was to do an initial assessment of the usefulness of 2beta-carbomethoxy-3beta-(4-chlorophenyl)-8-(2-(18)F-fluoroethyl)nortropane ((18)F-FECNT) PET scanning in determining in vivo brain dopamine transporter (DAT) density in healthy humans and subjects with Parkinson's disease (PD). METHODS: We investigated 6 neurologically healthy subjects and 5 PD patients: 2 with mild unilateral disease, 1 with mild-to-moderate bilateral disease, and 2 with moderately severe bilateral disease. The healthy subjects underwent a 3-h PET scan (26 frames) and the PD subjects underwent a 2-h PET scan (23 frames) while (18)F-FECNT was being injected over the first 5 min of the scan. Arterial blood samples were taken throughout scanning for well-counter and metabolite analysis to determine the presence of possible active metabolites. The scans were reconstructed; then we placed spheric regions of interest in the caudate nuclei, putamena, thalami, brain stem, cerebellum, and occipital cortex of each subject. The radioactivity level in each region was calculated for each frame of a subject's PET scan. Then we calculated target tissue-to-cerebellum ratios for each time frame. RESULTS: The analysis of arterial blood samples revealed that metabolism of the tracer was rapid. The ether-extractable component of the arterial input was >98% pure (18)F-FECNT. The caudate nucleus and putamen exhibited the highest uptake and prolonged retention of the radioligand. They both attained maximum uptake at approximately 90 min, with the healthy subjects' average caudate- and putamen-to-cerebellum ratios (+/-SD) at that time being 9.0 +/- 1.2 and 7.8 +/- 0.7, respectively. The maximal caudate-to-cerebellum ratios for the healthy subjects ranged from 7.6 to 10.5 and their maximal putamen-to-cerebellum ratios ranged from 7.1 to 9.3. The 2 early-stage, unilateral PD patients had, at 90 min, an average right caudate-to-cerebellum ratio of 5.3 +/- 1.1 and a left ratio of 5.9 +/- 0.7 and an average right putamen-to cerebellum ratio of 2.8 +/- 0.1 and a left ratio of 3.0 +/- 0.6. The late-stage PD patients had, at 90 min, an average right caudate-to-cerebellum ratio of 3.7 +/- 0.4 and a left ratio of 3.9 +/- 0 and an average right putamen-to cerebellum ratio of 1.8 +/- 0.1 and a left ratio of 1.8 +/- 0. CONCLUSION: These results indicate that (18)F-FECNT is an excellent candidate radioligand for in vivo imaging of the DAT system in humans. It has a much higher affinity for DAT than for the serotonin transporter and yields the highest peak striatum-to-cerebellum ratios and has among the most favorable kinetics of (18)F-radiolabeled DAT ligands. Having picked up presymptomatic changes in the hemisphere opposite the unaffected side of the body in our early-stage (unilateral) PD patients, it appears that, like other DAT radioligands, it may be able to identify presymptomatic PD.
Adult↗
[Unified three-dimensional images of myocardial perfusion and coronary angiography].
INTRODUCTION AND OBJECTIVES: In everyday clinical practice, the cardiologist needs to integrate anatomical and functional information from patients with coronary artery disease. The aim of this study is to present a way to unify, in three-dimensional images, anatomical information from coronary angiography with physiological information from myocardial perfusion scintigraphy. METHODS: Three patients with one vessel disease (left anterior descending, right coronary and left circumflex arteries, respectively) scheduled for percutaneous coronary revascularization were selected. Two-dimensional angiographic images were obtained before and after revascularization. 99mTc-tetrofosmin was administered during coronary occlusion and tomographic images corresponding to the occlusion were detected after coronary dilatation. Control rest scintigraphic images were obtained after two days. The three-dimensional coronary tree from coronary angiography was superposed on the epicardial contours of the myocardial perfusion images following a method of our own. RESULTS: A correct three-dimensional reconstruction of myocardial contour and coronary tree was achieved for each patient. The three-dimensional unified images showed excellent concordance between the extent of perfusion defects and the anatomic distribution of the occluded vessel. CONCLUSIONS: Three-dimensional unification of myocardial perfusion images and coronary angiography is technically possible. This technology integrates anatomical and functional information to facilitate the cardiologist's decision-making and so improve coronary patient management.
Aged↗
Cerebral blood flow during propofol induced sedation.
PURPOSE: This work determined if 2, 6-diisopropylphenol (propofol) selectively affects cerebral blood flow in regions associated with wakefulness. PROCEDURES: Cerebral blood flow (CBF) was measured with positron emission tomography (PET) using the 15O-water bolus technique in 10 subjects while awake and during light and deep sedation. Arterial blood was sampled for CBF estimation, blood gases and propofol plasma concentrations. RESULTS: Global CBF decreased under deep sedation. A regression analysis of CBF vs. propofol concentration showed significant decreases in CBF in the thalamus and posterior cingulate and increases in the hippocampus and cerebellum. An ANCOVA analysis on condition (controlling for pCO(2) levels) showed mean CBF decreased in the thalamus and posterior cingulate cortex and increased in the primary motor and hippocampal areas during the light and deep sedation compared to awake conditions. CONCLUSIONS: These data support the hypothesis that propofol preferentially alters CBF in specific brain regions necessary to maintain wakefulness.
Journal Article↗
Comparison between ECTb and QGS for assessment of left ventricular function from gated myocardial perfusion SPECT.
BACKGROUND: The most widely distributed software packages to compute left ventricular (LV) volume and ejection fraction (EF) from gated perfusion tomograms are QGS and the Emory Cardiac Toolbox (ECTb). Because LV modeling and time sampling differ between the algorithms, it is necessary to document relationships between values produced by them and to establish normal limits individually for each software package in order to interpret results obtained for individual patients. METHODS AND RESULTS: Gated single photon emission computed tomography technetium 99m sestamibi myocardial perfusion studies were collected and analyzed for 246 patients evaluated for coronary artery disease. QGS and ECTb values of ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume were found to correlate linearly (r = 0.90, 0.91, and 0.94, respectively), but EF and EDV were significantly lower for QGS than with ECTb (53% +/- 13% vs 61% +/- 13 and 102 +/- 45 mL vs 114 +/- 50 mL, respectively). To compare calculations for healthy subjects between the two software packages, data were also selected for 50 other patients at low likelihood for coronary artery disease, for whom EF and EDV were significantly lower for QGS compared with ECTb (62% +/- 9% vs 67% +/- 8% and 84 +/- 26 mL vs 105 +/- 33 mL, respectively). The ECTb lower limit was 51% for EF and the upper limits were 171 mL for EDV and 59 mL/m(2) for mass-indexed EDV, compared with limits of 44%, 137 mL, and 47 mL/m(2) for QGS. CONCLUSIONS: Although correlations were strong between the two methods of computing LV functional values, statistical scatter was substantial and significant biases and trends observed. Therefore, when both software packages are used at the same site, it will be important to take these differences into consideration and to apply normal limits specific to each set of algorithms.
Adult↗
Feasibility of detecting cardiac torsion in myocardial perfusion gated SPECT data.
BACKGROUND: The dynamic twisting component of cardiac motion is not accounted for by radionuclide techniques so that maps of perfusion and wall thickening are motion-blurred by torsion. This study examined whether torsion can be estimated from gated single photon emission computed tomography data and whether torsion corrections affect cardiac measurements. METHODS AND RESULTS: Technetium 99m sestamibi myocardial perfusion gated tomograms were selected retrospectively for 52 patients who had x-ray contrast arteriograms: 12 with normal perfusion (group 1), 12 with abnormal perfusion (group 2), and 28 studied after angioplasty (group 3). The 8 gated perfusion maps were transformed by contrast normalization, the count minimums of which were tracked to quantify torsion. Measured torsion was used to correct maps of perfusion and wall thickening. Torsion was found to be visually detectable equally well in groups 1 and 2. Apical torsion was significantly greater for group 1 than groups 2 and 3 (15 degrees +/- 9 degrees vs 9 degrees +/- 15 degrees and 2 degrees +/- 12 degrees ) and was opposite in sign for patients with apical aneurysms (-4 degrees +/- 13 degrees ) and for patients after coronary artery bypass grafting (CABG) (-4 degrees +/- 15 degrees ). Maximum percent count differences were 10% +/- 16% between torsion-corrected versus uncorrected perfusion maps. The greatest wall thickening differences were seen for patients with left ventricular apical aneurysms and for patients after CABG versus group 1 (10% +/- 6% and 8% +/- 6% vs 3% +/- 1%, respectively). CONCLUSIONS: It is feasible to detect cardiac torsion in the majority of Tc-99m sestamibi myocardial perfusion scans. Abnormal twisting patterns distinguished patients after CABG and those with left ventricular aneurysms from subjects with normal perfusion in a manner similar to magnetic resonance imaging observations.
Angioplasty↗