Evaluation of six scatter correction methods based on spectral analysis in 99m Tc SPECT imaging using SIMIND Monte Carlo simulation

Compton-scattered photons included within the photopeak pulse-height window result in the degradation of SPECT images both qualitatively and quantitatively. The purpose of this study is to evaluate and compare six scatter correction methods based on setting the energy windows in 99m Tc spectrum. SIMIND Monte Carlo simulation is used to generate the projection images from a cold-sphere hot-background phantom. For evaluation of different scatter correction methods, three assessment criteria including image contrast, signal-to-noise ratio (SNR) and relative noise of the background (RNB) are considered. Except for the dual-photopeak window (DPW) method, the image contrast of the five cold spheres is improved in the range of 2.7-26. Among methods considered, two methods show a nonuniform correction performance. The RNB for all of the scatter correction methods is ranged from minimum 0.03 for DPW method to maximum 0.0727 for the three energy window (TEW) method using trapezoidal approximation. The TEW method using triangular approximation because of ease of implementation, good improvement of the image contrast and the SNR for the five cold spheres, and the low noise level is proposed as most appropriate correction method

AS1411 Aptamer-Anionic Linear Globular Dendrimer G2-Iohexol Selective Nano-Theranostics

Molecular theranostics is of the utmost interest for diagnosis as well as treatment of different malignancies. In the present study, anionic linear globular dendrimer G2 is employed as a suitable carrier for delivery and AS1411 aptamer is exploited as the targeting agent to carry Iohexol specifically to the human breast cancer cells (MCF-7). Dendrimer G2 was prepared and conjugation of dendrimer and aptamer was carried out thereafter. Based on the data yielded by AFM, morphology of smooth and spherical non-targeted dendrimer changed to the rough aspherical shape when it conjugated. Then, conjugation was confirmed using DLS, ELS and SLS methods. Toxicity on nucleolin positive MCF-7 cells and nucleolin negative HEK-293 cells was assessed by XTT and apoptosis/necrosis assays. In vitro uptake was determined using DAPI-FITC staining and ICP-MS methods. In vivo studies including in vivo CT imaging, pathology and blood tests were done to confirm the imaging ability, bio-safety and targeted nature of the Nano-Theranostics in vivo. In a nutshell, the prepared construction showed promising effects upon decreasing the toxicity of Iohexol on normal cells and accumulation of it in the cancer tumors as well as reducing the number of cancer cells. © 2017 The Author(s)

Is correction for metallic artefacts mandatory in cardiac SPECT/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

Introduction: Metallic artifacts due to pacemaker/ implantable cardioverter defibrillator (ICD) leads in CT images can produce artifactual uptake in cardiac SPECT/CT images. The aim of this study was to determine the influence of the metallic artifacts due to pacemaker and ICD leads on myocardial SPECT/CT imaging. Methods: The study included 9 patients who underwent myocardial perfusion imaging (MPI). A cardiac phantom with an inserted solid defect was used. The SPECT images were corrected for attenuation using both artifactual CT and CT corrected using metal artifact reduction (MAR). VOI-based analysis was performed in artifactual regions. Results: In phantom studies, mean-of-relative-difference in white-region, between artifact-free attenuation-map without/with MAR were changed from 9.2 and 2.1 to 3.7 and 1.2 for ICD and pacemaker lead, respectively. However, these values for typical patient were 9.7±7.0 and 3.8±2.4 for ICD and pacemaker leads respectively, in white-region. MAR effectively reduces the artifacts in white-regions while this reduction is not significant in black-regions. Conclusion: Following application of MAR, visual and quantification analyses revealed that while quality of CT images were significantly improved, the improvements in the SPECT/CT images were not as pronounced or significant. Therefore cardiac SPECT images corrected for attenuation using CT in the presence of metallic-leads can be interpreted without correction for metal artefacts. © 2018 Tehran University of Medical Sciences. All rights reserved

Preoperative assessment of meningioma aggressiveness by Thallium-201 brain SPECT

Introduction: Meningioma is usually a benign brain tumor, but sometimes with aggressive course. The aim of this study was to assess the ability of 201Tl Brain SPECT to differentiate the pathologic grade of meningioma preoperatively. Methods: Thirty lesions in 28 patients were evaluated in this study. Early (20 minutes) and late (3 hours) brain SPECT images were performed and early uptake ratio (EUR), late uptake ratio (LUR) and retention index (RI) were calculated. All patients were operated and pathologic grade of tumors were defined according to World Health Organization grading system. Results: SPECT results were compared in different pathologic groups. Data analysis clarified no significant difference of EUR in benign and aggressive meningioma (P=0.2). However LUR and RI were significantly higher in aggressive tumors (P=0.001 and P=0.02, respectively). Conclusion: According to our data Tl-201 Brain SPECT with early and late imaging has 80 sensitivity and specificity to differentiate malignant from benign meningioma

Preclinical studies of166Ho-chitosan for treatment of hepatocellular carcinoma

Introduction: Recently, due to the special characteristics of166Ho and chitosan,166Ho-chitosan complex was developed for treatment of tumors such as hepatocellular carcinoma. This complex has been lately prepared with high radiochemical purity in our lab. The preclinical studies of the complex however should be performed to evaluate the tracer concentration in target and normal tissues before human use. Methods: In this study,166Ho-chitosan was prepared and its preclinical studies for treatment of hepatocellular carcinoma was carried out by injection of the radiopharmaceutical into the rabbit's liver via two different methods, surgery and venography. Leakage of the injected activity from the injection site in the rabbit organs was investigated using SPECT and SPECT-CT imaging up to 24 hours. Results: Both SPECT and SPECT-CT imaging of the rabbits showed that there was no significant leakage of the injected activity. Almost all the activity would remain in the injection site at least 24 h post injection. Conclusion: Considering all of the excellent features of the complex, this radiopharmaceutical is suggestive for treatment of hepatocellular carcinoma by radioembolization method

Author Correction: Prediction of Response to Neoadjuvant Chemoradiotherapy by MRI-Based Machine Learning Texture Analysis in Rectal Cancer Patients (Journal of Gastrointestinal Cancer, (2020), 51, 2, (601-609), 10.1007/s12029-019-00291-0)

The original version of this article unfortunately contained a mistake. In the author group section, the correct name of the fourth author is �Reza Ghalehtaki.� The authors apologize for this oversight and for any confusion it may have caused. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Determination of normal ranges of regional and global phase parameters using gated myocardial perfusion imaging with Cedars-Sinai's QGS software

Introduction: Myocardial perfusion imaging using gated SPECT and phase analysis is an effective tool in evaluation of mechanical dyssynchrony. The purpose of this study was to determine the normal ranges of global and regional phase parameters. Methods: A total of 100 patients with normal resting and stress electrocardiograms, low pretest likelihood for coronary artery disease and a normal gated MPI study were recruited in the study. All of the patients underwent a standard 2-day stress/rest gated MPI study according to standard protocols. The reconstructed images were further analyzed by Cedar-Sinai's quantitative gated SPECT. Left ventricular phase indices were provided both globally and regionally for both genders and the normal interquartile range of these parameters were defined. Results: Normal ranges of global and wall-based regional phase parameters are presented both in unisex and in gender-specific formats. Both global (P<0.001) and major LV regional phase parameters (P<0.05) are found to be significantly different between the two genders with a significant positive association between end-diastolic volume with phase global indices (P<0.01). There is also more synchronized phase distribution in phase analysis results of post-exercise gated MPI as compared to the phase analysis of the same patients at resting state. Conclusion: Normal ranges of phase indices are defined in this article by using Cedar-Sinai's QGS software. As normal ranges of phase dyssynchrony parameters are gender-specific and are related to LV volume, stress or resting state and stress type, the need for careful incorporation of these data is indicated in interpretation of phase studies. © 2018 Tehran University of Medical Sciences. All rights reserved

Diagnostic ability of 384-slice computed tomographic angiography in prediction of myocardial ischemia in patients with myocardial bridging (MB) as compared to SPECT-MPI examination

Background: During the past decade, coronary computed tomographic angiography (CCTA) has become the primary non-invasive imaging technique for the assessment of myocardial bridging (MB). Objectivs: The aim of this study was to evaluate the ability of CCTA to predict myocardial ischemia in patients with MB. Patients and Methods: A total of 32 MB patients (21 males and 11 females) participated in this study. Eleven MB parameters were measured to assess the ability of CCTA to predict MB patients with ischemia. In order to evaluate ischemia, all the patients underwent single positron emission computed tomography-myocardial perfusion imaging (SPECT-MPI) examination. Results: Ischemia was observed in 17 patients (53.1), while 15 patients (46.9) did not show signs of ischemia. Out of the 32 patients, superficial MB was observed in 15 patients while deep MB was identified in 12, and borderline was observed in five patients. All MB examined parameters were found to be significantly different between ischemic and non-ischemic patients, except for the location and tunnel artery diameter in diastole. Moreover, a cut-off value of 0.65 mm was able to discriminate ischemia with a sensitivity of 100, specificity of 93, and yield area under the receiver operating characteristic (ROC) curve (AUC) of 0.996. Also, by considering the depth cut-off value of 1.75 mm, ischemia can be distinguished with sensitivity and specificity of 100. MB length had a lower discrimination power, with a cut off value of 22.5 mm yield, 76 sensitivity, 67 specificity, and AUC = 0.810 in the diagnosis of ischemia. Conclusion: CCTA was a reliable modality with high accuracy to depict MB, identify high risk MB, and prevent unnecessary SPECT-MPI examination. © 2018, Iranian Journal of Radiology

Assessment of left ventricular mechanical dyssynchrony by phase analysis of gated-SPECT myocardial perfusion imaging and tissue Doppler imaging: Comparison between QGS and ECTb software packages

Background: Recently, the phase analysis of gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has become feasible via several software packages for the evaluation of left ventricular mechanical dyssynchrony. We compared two quantitative software packages, quantitative gated SPECT (QGS) and Emory cardiac toolbox (ECTb), with tissue Doppler imaging (TDI) as the conventional method for the evaluation of left ventricular mechanical dyssynchrony. Methods and Results: Thirty-one patients with severe heart failure (ejection fraction ≤35%) and regular heart rhythm, who referred for gated-SPECT MPI, were enrolled. TDI was performed within 3 days after MPI. Dyssynchrony parameters derived from gated-SPECT MPI were analyzed by QGS and ECTb and were compared with the Yu index and septal-lateral wall delay measured by TDI. QGS and ECTb showed a good correlation for assessment of phase histogram bandwidth (PHB) and phase standard deviation (PSD) (r = 0.664 and r = 0.731, P < .001, respectively). However, the mean value of PHB and PSD by ECTb was significantly higher than that of QGS. No significant correlation was found between ECTb and QGS and the Yu index. Nevertheless, PHB, PSD, and entropy derived from QGS revealed a significant (r = 0.424, r = 0.478, r = 0.543, respectively; P < .02) correlation with septal-lateral wall delay. Conclusion: Despite a good correlation between QGS and ECTb software packages, different normal cut-off values of PSD and PHB should be defined for each software package. There was only a modest correlation between phase analysis of gated-SPECT MPI and TDI data, especially in the population of heart failure patients with both narrow and wide QRS complex. © 2014, American Society of Nuclear Cardiology

Knowledge, attitude and practice of nuclear medicine staff towards radiation protection

Introduction: Ionizing radiation in medical imaging is one of the dominant sources of exposure, and correct knowledge of radiation protection, affects staff safety behaviors during procedures. This study aimed to assess the radiation protection Knowledge, Attitude and Practice (KAP) amongst nuclear medicine centers' staff in Iran. Methods: To evaluate the level of radiation protection KAP, a validated questionnaire was distributed between 243 participants considering demographic characteristics in different geographical regions in Iran from 2014 to 2015. Results: There were statistically significant differences in the level of nuclear medicine staff KAP radiation protection with gender (p0.05). Conclusion: Our findings have shown that radiation protection KAP level of nuclear medicine staff was inadequate in some regions. This might be due to the lack of continuous training and absence of adequate safety knowledge about ionizing radiation. It seems that awareness about radiation protection rules and regulations, along with continuous training and preparations has a direct effect on radiation practice leading to enhanced KAP of staff in nuclear medicine centers. © 2019 Tehran University of Medical Sciences. All rights reserved