Impact of metoclopramide on image quality in myocardial perfusion imaging

Background: The effectiveness of metoclopramide in reducing gastrointestinal-induced artifacts in myocardial perfusion imaging (MPI) is a subject of debate. We examined the significance of this pharmacological intervention in the quality of images obtained from MPI studies. Patients and Methods: A total of 211 suspected or known cases with coronary artery disease routinely referred to our nuclear medicine department for MPI were randomly assigned to group A and group B. Group A (N=125) comprised patients who received 10 mg of metoclopramide orally after the injection of the radiotracer technetium-99m-labeled methoxyisobutyl isonitril (Tc-MIBI) 1 h before image acquisition, and group B (N=86) comprised patients who did not receive any pharmacological intervention and were considered the control group. All the scans in each group were assessed in the rest phase of a routine 2-day protocol. The single-photon emission computerized tomography (SPECT) images were visually evaluated in terms of extracardiac activities and their effects on image quality by three nuclear medicine physicians, who were blinded to the details of the protocol. Results: Of the 125 patients who had received metoclopramide, 16 (13%) had nonacceptable, 72 (57.6%) had acceptable (interpretable), and 37 (29.6%) had good image quality. The image quality in group B was nonacceptable in 10 (11.23%), acceptable in 48 (50.23%), and good in 28 (33.56%) patients. The overall interobserver agreement was good (κ: 0.6-0.9, P<0.05) among the three readers. Conclusion: There was no statistically significant difference in terms of MPI-SPECT image quality between patients who received metoclopramide and those in the control group. Metoclopramide, therefore, did not exert a remarkable effect on the quality of our MPI scans. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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

Study on macrobenthic communities in the range of fish cage-culture area (before breeding) in the southern Caspian Sea (Mazandaran coast-Kelarabad)

The abundance and biomass of benthic macroinvertebrates were studied in the place of fish cage culture in southern coasts of Caspian sea (Mazandaran waters- kelarabad). The goal of this study was to consider of fish cage culture effects on the abundance and biomass of benthic macroinvertebrates. The sampling was carried out in 3 stations in depth of 20 meter of Kelarabad waters monthly. In this study 7 species were identified belonged to 5 genus of 4 family. Totally 23442 sample of benthic invertebrates were counted that the lowest and highest abundance were in station 1(23.4%) and station 2(46.8%) respectively. The results of stations study showed that the highest abundance and biomass were in stations 2 and 3 with the average of 646 ± 1230.4 n/m^2 and 0.526 ± 1.001 gr/m^2 respectively. This coulld be respectively dependant to not settling of cage (witness station) and appearance of Cerastoderma glaucum because of its large body in station 1. The difference of abundance and biomass between different stations was not significant (p ›0.05). The study on abundance and biomass in different seasons showed that the highest abundance in autumn with the avarage of 888.13 ± 1371.58 n/m^2 belonged to Strblospio gynobranchiata and the highest biomass belonged to C. glaucum which was because of appearance of not native species of polychaeta and also the species with shell covering from bivalvia. The results showed that the specie of S. gynobranchiata from polychaeta including 93.3% of abundance was the dominant specie that could be related to appropriate ecological conditions for living and high adaptability. It was concluded that the abundance and biomass of benthic macroinvertebrates in station 1 was lower than other stations which was related to fish cage culture activity and its effects on benthic macroinvertebrates. So it is suggested that each mariculture activity in southern coasts of Caspian Sea should be carried out with regarding to environmental considerations and performance of comparative evaluation project of environmental effects

Evaluation of sternal wound infection after median sternotomy using 99mTc-labeled Ubiquicidin 29-41

Aims- Previous studies have demonstrated that 99mTc-labeled Ubiquicidin 29-41 (99mTc-UBI) can be used for the detection of bacterial infections as an accurate method.1 This study was conducted to evaluate the clinical use of 99mTc-UBI for the evaluation of sternal wound infection (SWI) after cardiac surgery. Materials and Methods - Twenty-one patients with suspected SWI after median sternotomy were included. Qualitative and quantitative voxel-based analyses of 99mTc-UBI images were performed by two experienced nuclear physicians and the images were reported as negative, positive for superficial, or positive for deep SWI on the basis of the uptake patterns. SWI was defined according to the Centres for Disease Control and Classifications' guideline. Results- Among the cases, only one subject with a final diagnosis of non-infectious inflammation was reported as superficial SWI in 99mTc-UBI scintigraphy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for distinguishing SWI from sterile inflammation were equal to 100, 83.3, 93.8, and 100. After implicating a threshold of 3.08 for the target-to-background ratio, the specificity and PPV reached 100. The sensitivity, specificity, positive, and negative predictive values for the detection of superficial and deep SWI were 100, 92.9, 87.5, and 100 and 100, 100, 100, and 100, respectively. There was also a high interobserver agreement with all the kappa values exceeding 0.8. Conclusions- The results of the present study suggest that 99mTc-UBI could be of great use as an accurate method for the evaluation of suspected postoperative SWI and could help in the selection of appropriate treatment strategies for these patients

Assessment of bone mineral density in patients undergoing hemodialysis; An Iranian population-based study

Background: End-stage renal disease (ESRD) is a condition in which bone turnover and metabolism is impaired; thus, osteoporosis and low bone density are subsequently inevitable. We aimed to determine bone mineral density (BMD) and biochemical markers, and associated factors in hemodialysis (HD) patients. Methods: Patients aged 30-70 years undergoing HD between 2015 to 2019 were enrolled in this cross-sectional study. BMD measured by dual energy x-ray absorptiometry (DEXA) and biochemical laboratory tests were assessed in 200 patients undergoing HD. Statistical analysis was based on t test, Pearson, regression and Mann-Whitney tests using SPSS 16. Results: Two hundred patients were investigated. Sixty percent of the patients were female. Mean ± SD of participants' age was 58.6 (±11.63) years and mean ± SD for duration of HD was 45.69 (± 43.76) months. Osteoporosis was found in 48 (n = 96) and low bone density in 36 (n = 76) of our patients. General osteoporosis was more frequent in those undergoing HD for more than 3 years, although not significantly (P = 0.093, odds ratio OR = 0.37). However, regional osteoporosis in hip and femoral neck, but not spine vertebrae, were significantly higher after three years of HD (P = 0.036, OR = 0.27; P = 0.042, OR = 0.27; and P = 0.344, OR = 0.56, respectively). Increased body mass index (BMI) correlated negatively with osteoporosis (P = 0.050). Conclusion: With increasing age and duration of HD, BMD decreases. Higher BMI was associated with higher bone mass density. Bone density assessment seems to be necessary in patients undergoing HD. © 2021 Academy of Medical Sciences of I.R. Iran. All rights reserved