Abstract

IJNM

Indian Journal of Nuclear Medicine

0972-3919

Society of Nuclear Medicine, India

ijnm-19-4-session-004

Session IV

122004

194139141

Effects of Pranayama in Patients of CAD with Post Intervention

Muthu

G S

Mitra

Bharat

Das

N K

Kapoor

Department of Nuclear Medicine, Cardiology and Radiology, Tata Main Hospital, Jamshedpur-831001

Ref. No: 28 GS NC B2

AbstractObjective

This study has been undertaken to analyse the effects of Pranayama in ten patients with diagnosed Coronary Artery Diease (CAD) who have undergone interventional procedures (CABG and PTCA)

Method

Six-minute walk test, lipid profile test and myocardial perfusion SPECT studies were carried out on these patients in pre and post Pranayama stages.These patients were taught Pranayama daily for one week for two hours a day, initially. Patient were advised to practice Pranayama every day for four months without any break even for single day, as recommended by experts. To ensure compliance and correct technique, patient were followed up at the following time intervals : once in a week for the first two months and once in a fortnight later.

Result

All these patients showed imporvements in existing symptoms within the first two weeks of commencing pranayama. One of the patients who had undergone PTCA procedure twice showed disappearance of pedal edema within the first two weeks and lost two kilograms body weight.

Conclusion

Post Pranayama studies shows improvements in sixwalk test, lipid profile test and myocardial perfusion status observed in theses patients are discussed in this paper.

Bio Kinetics of Sesta MIBI and Tetrophosmin: A Comparison

Benjamin

R Sukumar

Padmavathi

Rao

L Babu

Kumar

V Naveen

Mahadev

D Shan kar

Ameerpet

Department of Nuclear Medicine Image Hospitals, Hyderabad.

Ref. No: 29 SB NC B3

AbstractAim

To compare and evaluate the bio kinetics and organ uptake of the two cardiac radio pharmaceuticals.

Materials & Methods

A total of 8 patients (3 Sesta MIBI and 5 Tetrophosmin), referred for stress cardiac study were evaluated using one day protocol (Rest followed by Stress). 8-10 mCi of one of the mentioned radiopharmaceuticals was injected to the patients. Imaging was started with in 5minutes of injection including in the view lungs, heart, liver, kidneys and part of intestine. A frame rate of 2minutes per view 128* 128 matrix for 30 minutes, and delayed images at 60minutes, 90minutes and 120 minutes were acquired. Regions of interest (ROI) were drawn over LV of the heart, liver, gallbladder, kidneys and intestine and curves were generated. Average count of each organ was also calculated and curve was generated. An exponential trend curve was also generated and from the regression formula counts at 40minutes, 60 minutes and 90 minutes were estimated.

Results

The cardiac uptake in Sesta MIBI patients showed 15% more counts then those of Tetrophosmin. In liver an increased uptake of 19% was observed in the case of Sesta MIBI than Tetrophosmin whereas Gall Bladder (G.B) uptake of Tetrophosmin was 29% higher .The liver retention of Tetrophosmin at the end of 29 minutes was 81%, at 40 minutes 88%, at 60 minutes 82% and at 90 minutes; 76%. whereas in the case of Sesta MIBI the liver retention at 29 minutes was 89%, at 40 minutes 75%, at 60 minutes 69%, at 90 minutes 61%. In the case of Tetrophosmin G.B were exponentially rising even at the end of 90 minutes. In the case of Sesta MIBI the counts reduced by 55% peaking at 60minutes.The peak counts of kidneys and intestine were at end of the study. At end of 90 minutes showed reduction of 54% in the case of Tetrophosmin and 59% in the case of Sesta MIBI. As claimed by Tetrophosmin manufactures imaging cannot be started at 5 minutes because of significant liver retention even at the end of 30 minutes we found that significant liver retention(81%) were observed. The best time for imaging either of the agents was found to be at 40 minutes and higher. It was observed there was no change in cardiac uptake counts by either agents i.e. there is no washout.

Conclusions

Our findings suggest that percentage uptake of Sesta MIBI by LV is more than Tetrophosmin. Though the liver uptake of Tetrophosmin was less in comparison with Sesta MIBI there is no significant difference in excretion of either agent. Good images can be obtained even at the end of 90 minutes to 2hrs.

Key wordsSesta MIBITetrophosminBio-kineticsOrgan uptake

Clinical Utility of Positron Coincidence Dual Head Gamma Camera with High Resolution CT Fusion and Attenuation Correction

Salgia

Ritu

Galge

A G

Kulkarni

D S

Mehta

Priya

Lele

V R

Dept of Nuclear Medicine, Jaslok Hospital & Research Centre, 15, Dr G. Deshmukh Marg, Mumbai-400 026

Ref. No: 30RSPETF2

AbstractObjective

To study the clinical utility of dual head coincidence gamma camera PET in private hospital practice and to determine the feasibility of registering coincidence images with high-resolution CT images for lesion localization and attenuation correction.

Methods

185 patients were studied on a dual head coincidence gamma camera with 1" NaI crystal 1 hour after i.v injection of 18F-FDG. Among these, 170 were referred for oncological indications (Hodgkin's disease - 27, Non Hodgkin's Lymphoma-11, Ca. Breast-19 others - 84, Suspected malignancy 12 and occult primary 10), 7 for recurrence, 11 were for neurological (neuro degenerative disease) and 2 were for cardiac (Myocardial viability) indications.

All patients underwent high resolution CT (whole body for oncology patients, chest for cardiac patients and brain for neurological patients), on a different CT scanner one hour before ¹⁸F -FDG injection. 10 mCi of ¹⁸F - FDG was injected to the patients after overnight fast (1 hour post oral glucose loading for cardiac patients) and after estimating blood sugar. Acquired data were rebinned with Fourier rebinning and reconstructed with an iterative reconstruction algorithm based on coincidence ordered subsets expectation maximization (COSEM). These reconstructed images were fused with the CT images imported through hospital network. CT based attenuation map was determined and applied to get attenuation corrected images. Both non-corrected and corrected images were interpreted by fusing them with CT images. Findings are compared with those of physical examination, computed tomography and histopathology.

Results

Among 170 oncology patients, positive scans for active disease were found in 96 patients. 80 patients were referred to evaluate response to therapy and failure of response was demonstrated in 70 of them. 16 patients were for staging of disease. 7 patients were for recurrence, of these 5 patients were demonstrated to have recurrence. 12 patients were referred for suspected malignant pathology, 7 patients were detected to have malignancy. Non - attenuation corrected images demonstrated all the lesions and attenuation corrected images did not add to lesion detectability. CT image fusion greatly increased the confidence in exact anatomical lesion localization.

Conclusions

Coincidence PET with dual head gamma camera was found very useful in following up the response to therapy in oncology patients.

Non - attenuation corrected images were as good as attenuation corrected images in lesion detection. Fusion with CT - images increased confidence of anatomical localization.

Attenuation correction using CT - images from different scanner is difficult as exact image fusion is difficult to obtain.

Dual head coincidence PET is an acceptable, cost effective alternative till dedicated PET becomes affordable.

Key wordsCoincidence PETAttenuation CorrectionCT Image Fusion

Use of Co-Registration of SPECT-CT in Scintigraphic Evaluation

Kashyap

Ravi

Savita

Mondal

Sharma

Swaroop

Rawat

H.S.

Division of Nuclear Medicine & Medical Informatics, Institute of Nuclear Medicine and Allied Sciences, Brig. S. K. Mazumdar Road, Delhi - 110054

Ref. No: 31NSCTF3

AbstractObjective

This retrospective analysis of cases of SPECT-CT done for coregistration purpose in our institution aims to present the utility of the same as encountered by us between 2003-2004.

Methods

The study included 80 patients who were referred to us by various hospitals for scintigraphic evaluation of particular region.SPECT-CT coregistration was carried out in these patients for precise anatomical localization as region of clinical interest could not be precisely studied through planar and SPECT acquisition. Among the 80 patients, 25 were of brain imaging, 35 patients included skeletal scintigraphy, 10 cases were of abdominal imaging and 10 patients included imaging of thorax. Images were acquired on Hawkeye GE Medical Systems which combines a dual head sodium iodide crystal gamma camera and a CT mounted on a common gantry.SPECT was performed with a 360 degrees rotation consisting of 60 projections of 6 degrees apart in a matrix of 128X128.

Results

In patients of brain imaging we were able to carry out functional-anatomical mapping and multiple sites of lesion could be localized in a single study. In patients of abdominal imaging we were able to localize accurately region of GI Bleed and were able to make a diagnosis of hemangioma and liver metastases in a single study. In thoracic imaging we could look for rib erosion in lung carcinoma. Among skeletal scintigraphy diagnosis of avascular necrosis of head of femur could be easily made. Differentiation between cortical and medullary component of bone could be done.

Conclusions

Coregistration of sequential studies of two imaging modalities on a hybrid gamma camera/CT scanner may lead to improved interpretation and accuracy of both tests. The improved contrast of SPECT scanning improves lesion detection and anatomical localization as compared with planar or simple tomographic imaging.SPECT-CT coregistraton may be done in types of situations that demand more precise anatomical localization of abnormal tracer uptake.