34 results on '"Suga K"'
Search Results
2. Evaluation of abnormal regional ventilation in patients with lung cancer using three-dimensional display of dynamic 133Xe SPET
- Author
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SUGA, K., KUME, N., SHIMIZU, K., NISHIGAUCHI, K., MATSUMOTO, T., and MATSUNAGA, N.
- Published
- 1998
3. Three-dimensional surface displays of perfusion SPET in the evaluation of patients with pulmonary emphysema for thoracoscopic lung volume reduction surgery
- Author
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SUGA, K., NISHIGAUCHI, K., MATSUNAGA, N., KAWAKAMI, Y., KUME, N., SUGI, K., and ESATO, K.
- Published
- 1997
4. Altered regional clearance of 99Tcm-DTPA in radiation pneumonitis
- Author
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SUGA, K., ARIYOSHI, I., NISHIGAUCHI, K., YOSHIMIZU, T., NAKANISHI, T., UTSUMI, H., and YAMADA, N.
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- 1992
5. Clinical and experimental studies on the mechanism of abnormal accumulation in lung scanning with 123I-IMP
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SUGA, K., ARIYOSHI, I., NAKANISHI, T., UTSUMI, H., and YAMADA, N.
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- 1992
6. Lymphoscintigraphic assessment of leg oedema following arterial reconstruction using a load produced by standing
- Author
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SUGA, K., UCHISAKO, H., NAKANISHI, T., UTSUMI, H., YAMADA, N., OOHARA, M., and ESATO, K.
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- 1991
7. Assessment of 99Tcm-HMPAO tumour scintigraphy using VX-2 tumours implanted in a lower limb muscle of rabbits
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SUGA, K., HONMA, Y., UCHISAKO, H., KURAMITSU, T., TANAKA, N., ITOU, K., ARIYOSHI, I., and NAKANISHI, T.
- Published
- 1991
8. Experimental evaluation of the usefulness of 201Tl-chloride scintigraphy for monitoring radiotherapeutic effects
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SUGA, K., NISHIGAUCHI, K., FUJITA, T., and NAKANISHI, T.
- Published
- 1994
9. Difference in 201Tl accumulation on single photon emission computed tomography in benign and malignant thoracic lesions
- Author
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SUGA, K., KUME, N., ORIHASHI, N., NISHIGAUCHI, K., UCHISAKO, H., MATSUMOTO, T., YAMADA, N., and NAKANISHI, T.
- Published
- 1993
10. Altered kinetics of 123I-IMP in irradiated rabbit lungs
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SUGA, K., primary, ARIYOSHI, I., additional, NAKANISHI, T., additional, UTSUMI, H., additional, and YAMADA, N., additional
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- 1992
- Full Text
- View/download PDF
11. Visualization of functional improvement by 123I-IMP lung SPET after thromboendarterectomy for chronic pulmonary embolism.
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KUME, N., HAYASHIDA, K., NAKANISHI, N., CHO, I., SUGA, K., and MATSUNAGA, N.
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- 1999
- Full Text
- View/download PDF
12. Evaluation of abnormal regional ventilation in patients with lung cancer using three-dimensional display of dynamic 133Xe SPET.
- Author
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SUGA, K., KUME, N., SHIMIZU, K., NISHIGAUCHI, K., MATSUMOTO, T., and MATSUNAGA, N.
- Published
- 1998
- Full Text
- View/download PDF
13. Experimental evaluation of the usefulness of 201Tl-chloride scintigraphy for monitoring radiotherapeutic effects.
- Author
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SUGA, K., NISHIGAUCHI, K., FUJITA, T., and NAKANISHI, T.
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- 1994
- Full Text
- View/download PDF
14. Difference in 201Tl accumulation on single photon emission computed tomography in benign and malignant thoracic lesions.
- Author
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SUGA, K., KUME, N., ORIHASHI, N., NISHIGAUCHI, K., UCHISAKO, H., MATSUMOTO, T., YAMADA, N., and NAKANISHI, T.
- Published
- 1993
- Full Text
- View/download PDF
15. Altered kinetics of 123I-IMP in irradiated rabbit lungs.
- Author
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SUGA, K., ARIYOSHI, I., NAKANISHI, T., UTSUMI, H., and YAMADA, N.
- Published
- 1992
- Full Text
- View/download PDF
16. Altered regional clearance of 99Tcm-DTPA in radiation pneumonitis.
- Author
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SUGA, K., ARIYOSHI, I., NISHIGAUCHI, K., YOSHIMIZU, T., NAKANISHI, T., UTSUMI, H., and YAMADA, N.
- Published
- 1992
- Full Text
- View/download PDF
17. Clinical and experimental studies on the mechanism of abnormal accumulation in lung scanning with 123I-IMP.
- Author
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SUGA, K., ARIYOSHI, I., NAKANISHI, T., UTSUMI, H., and YAMADA, N.
- Published
- 1992
- Full Text
- View/download PDF
18. Assessment of 99Tcm-HMPAO tumour scintigraphy using VX-2 tumours implanted in a lower limb muscle of rabbits.
- Author
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SUGA, K., HONMA, Y., UCHISAKO, H., KURAMITSU, T., TANAKA, N., ITOU, K., ARIYOSHI, I., and NAKANISHI, T.
- Published
- 1991
- Full Text
- View/download PDF
19. Visualization of functional improvement by 123IIMP lung SPET after thromboendarterectomy for chronic pulmonary embolism
- Author
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KUME, N., HAYASHIDA, K., NAKANISHI, N., CHO, I., SUGA, K., and MATSUNAGA, N.
- Abstract
We report on six patients with chronic pulmonary embolism who underwent 123I-IMP and 99Tcm-MAA lung SPET before and after thromboendarterectomy. 123I-IMP lung SPET can assess the viability of lung parenchyma, because it is a non-particulate agent that accumulates in the endothelial membranes of pulmonary capillaries. Chronic pulmonary thromboembolism accompanied by pulmonary hypertension has a poor prognosis that may be improved only by thromboendarterectomy. We compared 123I-IMP and 99Tcm-MAA lung SPET in terms of functional improvement after such surgery. After thromboendarterectomy, all six patients were functionally improved, according to the criteria of the New York Heart Association. The pre- and post-surgery percentage of vascular obstruction did not differ significantly with 99Tcm-MAA lung SPET (44.8 ± 11.2 and 32.5 ± 15.6 pre- and post-surgery, respectively). In contrast, 123I-IMP lung SPET revealed a significant pre- versus post-surgery difference (15.5 ± 9.5 and 3.3 ± 5.9 pre- and post-surgery, respectively). 123I-IMP lung SPET could be useful for evaluating thromboendarterectomy because pulmonary parenchymal viability owing to arterial microvasculature can be estimated.
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- 1999
20. Assessment of 99Tcm-HMPAO tumour scintigraphy using VX2 tumours implanted in a lower limb muscle of rabbits
- Author
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SUGA, K., HONMA, Y., UCHISAKO, H., KURAMITSU, T., TANAKA, N., ITOU, K., ARIYOSHI, I., and NAKANISHI, T.
- Abstract
Tumour scintigraphy using 99Tcm-hexamethylpropyleneamine oxime (99Tcm-HMPAO) was investigated in VX-2 tumours implanted in the muscles of the lower legs of rabbits to assess the feasibility of using this agent clinically for this procedure. On the time-activity curves for 99Tcm-HMPAO in the tumour, an initial peak and a subsequent decrease of radioactivity immediately after the initial peak were observed, while there was a slow, gradual decrease of activity over the next hour. The tumour/normal muscle ratio of HMPAO activity during this period was high and constant, and was independent of time. Comparison of the static images of 99Tcm-HMPAO with angiography and histological findings suggests that the tumour image of 99Tcm-HMPAO reflects tumour blood perfusion. These findings indicate that the distribution of 99Tcm-HMPAO on static images can provide a qualitative assessment of the perfusion of the tumour, despite the limitations of this tracer for quantifying tumour blood flow due to its early efflux from the tumour.
- Published
- 1991
21. Evaluation of abnormal regional ventilation in patients with lung cancer using threedimensional display of dynamic 133Xe SPET
- Author
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SUGA, K., KUME, N., SHIMIZU, K., NISHIGAUCHI, K., MATSUMOTO, T., and MATSUNAGA, N.
- Abstract
Preliminary studies were carried out of regional ventilation in lung cancer using three-dimensional (3D) display of dynamic pulmonary 133Xe single photon emission tomography (SPET). Transaxial equilibrium and washout images were obtained from SPET data acquired with an acquisition time of 30 s using a triple-detector SPET system in 39 patients with lung cancer. After reconstructing colour-illuminated, surface-rendered 3D images of equilibrium and 3-min washout (WO3), a single 3D fusion display was created from these two different time-course image sets, in which the 3D WO3image indicating 133Xe retention was visible through the 3D equilibrium image delineating lung contours. The extent of retention was assessed using the 133Xe retention index, defined as the ratio of summed pixels of the segmented WO3data to those of the segmented equilibrium data. 133Xe SPET was highly sensitive and specific for the presence of regional ventilation abnormalities associated with endobronchial tumour or bronchial compression due to enlarged lymph nodes. These abnormalities were demonstrated irrespective of the presence or absence of secondary changes distal to the tumour on the chest computed tomography scan. The geometrically realistic 3D fusion display enhanced anatomic localization of the regional ventilation abnormalities compared to the information from multislice tomograms, and the 133Xe retention index correlated well with FEV1(r= 0.828). This topographic 3D display for 133Xe SPET allows better perception of anatomic localization and extent of 133Xe retention. It will be useful for assessing regional ventilatory function in patients with lung cancer.
- Published
- 1998
22. Altered kinetics of 123IIMP in irradiated rabbit lungs
- Author
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SUGA, K., ARIYOSHI, I., NAKANISHI, T., UTSUMI, H., and YAMADA, N.
- Abstract
Radiation-induced alteration of intrapulmonary kinetics of 123I-IMP was investigated in 11 rabbits receiving a 50 Gy dose of radiation to one lung. In all 13 examinations of these rabbits, 3–17 weeks following radiation, the delayed images of 123I-IMP lung scintigrams showed abnormal accumulation in the irradiated lungs. The time-activity curves of the irradiated lung following injection of 123I-IMP had shallower downslopes of both the initial fast phase and the following slow phase than those of the non-irradiated lung. Finally the radioactivity of the irradiated lung exceeded that of the normal lung. The altered intrapulmonary kinetics of 123I-IMP in the irradiated lung was clearly confirmed. 99Tcm-MAA lung perfusion scintigrams showed reduced uptake in the irradiated lungs; the uptake decreased with time following radiation. Pulmonary arterial perfusion was considered to influence the distribution and kinetics of 123I-IMP, however, those of 123-IMP did not reflect only the pulmonary arterial perfusion observed by 99Tcm-MAA scintigrams. Chest radiography and histological studies revealed a relatively slight change or injury of the irradiated lung in these rabbits. These results indicate that this agent could be useful in detecting and assessing early lung injury induced by radiation, and will give us pathological information in addition to lung perfusion in the peripheral area where the large 99Tcm-MAA molecule cannot reach.
- Published
- 1992
23. Threedimensional surface displays of perfusion SPET in the evaluation of patients with pulmonary emphysema for thoracoscopic lung volume reduction surgery
- Author
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SUGA, K., NISHIGAUCHI, K., MATSUNAGA, N., KAWAKAMI, Y., KUME, N., SUGI, K., and ESATO, K.
- Abstract
A modified, three-dimensional display was applied to 99Tcm-macroaggregated albumin (99Tcm-MAA) SPET to help assess the effect of thoracoscopic lung volume reduction surgery (LVRS) on regional lung perfusion. Surface-rendered three-dimensional images for 99Tcm-MAA and xenon-133 (133Xe) equilibrium (EQ) SPET were obtained in 11 patients with pulmonary emphysema before and after LVRS. A single three-dimensional fusion display of both images was then reconstructed, and the perfused lungs were transparently visible through the lung contours delineated by the three-dimensional 133Xe EQ image. The extent of preserved perfusion in the lung (the perfusion index) was estimated using the ratio () of the total pixel numbers of the segmented perfusion data to those of the 133Xe lung volume data. The three-dimensional fusion display provided an overview of the distribution of hypoperfusion in the lungs with geometric realism and enhanced the perception of anatomic size and configuration compared with multiple tomograms and three-dimensional perfusion images without superimposition of the three-dimensional 133Xe image. Post-operatively, it displayed restored perfusion in the remaining lungs, and changes in the perfusion index correlated with FEV1(r= 0.731, P= 0.0001) more closely than the perfusion data alone (r= 0.593, P< 0.01). This method is useful for directing LVRS and assessing its effectiveness, as it provides precise tomographic information on regional perfusion.
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- 1997
24. Experimental evaluation of the usefulness of 201Tlchloride scintigraphy for monitoring radiotherapeutic effects
- Author
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SUGA, K., NISHIGAUCHI, K., FUJITA, T., and NAKANISHI, T.
- Abstract
The level of Na+-K+adenosine triphosphatase (ATPase) has been demonstrated to be correlated with tumour growth potential, and accelerated active transport of K+carried out by Na+-K+ATPase is said to be a trigger of 201Tl affinity for malignant tumour cells. Therefore, 201Tl scintigraphy appears to be a good indicator for evaluation of changes of tumour proliferative potential after treatment. In the present study, the usefulness of 201Tl scintigraphy for monitoring radiotherapeutic effects was evaluated in VX-2 tumours irradiated with variable doses (10–40 Gy of radiation). Changes in 201Tl uptake were compared with tumour growth, and 201Tl uptake on day 7 after irradiation was compared with tumour bromodeoxyuridine (BrdU) uptake, which reflects DNA synthesis. All the treated tumours showed dose-dependent diminished 201Tl uptake, accompanied by either dose-dependent tumour growth delay or tumour regression/resolution. The diminished 201Tl uptake had already appeared on day 7 after irradiation, accompanied by diminished BrdU uptake, although, at this time, the tumour volumes were increased, or were not significantly decreased compared to pre-irradiation. Moreover, the 20 Gy tumours demonstrated two different rumour growth patterns, each accompanied by a different degree of reduction of 201Tl uptake. These findings suggest that the degree of reduction of tumour 201Tl uptake following irradiation can reflect the degree of suppressed proliferative activity in the treated tumours, and that assessment of altered 201Tl uptake at a relatively early time following irradiation allows prediction of subsequent tumour growth, regardless of the tumour volume.
- Published
- 1994
25. Intrabullous ventilation in pulmonary emphysema: assessment with dynamic xenon-133 gas SPECT.
- Author
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Suga K, Iwanaga H, Tokuda O, Okada M, and Matsunaga N
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pulmonary Ventilation, Tomography, X-Ray Computed, Xenon Radioisotopes pharmacokinetics, Pulmonary Emphysema diagnostic imaging, Tomography, Emission-Computed, Single-Photon methods
- Abstract
Purpose: Intrabullous ventilation in patients with pulmonary emphysema (PE) was cross-sectionally evaluated using dynamic xenon-133 gas single photon emission computed tomography (SPECT)., Methods: Fifty-two patients with PE with a total of 109 bullae of more than 4 cm in maximum diameter underwent xenon-133 gas SPECT. The real xenon-133 gas half-clearance time (T1/2) at each bulla was compared with that at the surrounding lung in the same lobe. The emphysema subtype of the surrounding lung was classified into centrilobular, panlobular, and paraseptal on computed tomography (CT)., Results: All bullae except for one in all patients showed xenon-133 gas wash-in. Of the 108 bullae with wash-in, 95 (87.9%) bullae in 46 (88%) patients showed marked xenon-133 gas retention with a T1/2 beyond 110 s (mean: 184 s ± 91). The surrounding lungs of these bullae also showed marked retention with a T1/2 of greater than 100 s (mean: 174 s ± 82), and the majority (N=92, 96.8%) were centrilobular or panlobular on CT. The remaining 13 (12.0%) bullae in six (11%) patients showed minimal retention with a T1/2 of less than 80 s (mean: 62 s ± 11), regardless of no significant difference in size compared with the bullae with marked retention. All the surrounding lungs of these bullae except for one also showed minimal retention with a T1/2 of less than 70 s (mean: 60 s ± 18), which was significantly less compared with that of the bullae with marked retention (P<0.0001), and the majority (N=11, 84.6%) were paraseptal with or without an interstitially fibrotic change and predominantly located at the lower lung lobe on CT. The T1/2 of the 108 bullae with xenon-133 gas wash-in was significantly correlated with that of the surrounding lungs (r=0.884, P<0.0001)., Conclusion: Intrabullous ventilation in patients with PE appears to depend on the ventilation status of the surrounding lung, and bullae with the surrounding lungs of paraseptal-type emphysema tend to show minimal air trapping. Xenon-133 gas SPECT is useful for assessment of the interaction between intrabullous and surrounding lung's ventilation, which is difficult on CT.
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- 2012
- Full Text
- View/download PDF
26. Steal phenomenon-induced lung perfusion defects in pulmonary arteriovenous fistulas: assessment with automated perfusion SPECT-CT fusion images.
- Author
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Suga K, Iwanaga H, Tokuda O, Okada M, Tanaka N, and Matsunaga N
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- Adolescent, Arteriovenous Fistula physiopathology, Automation, Child, Female, Humans, Lung diagnostic imaging, Male, Middle Aged, Respiration, Arteriovenous Fistula diagnostic imaging, Lung blood supply, Pulmonary Circulation, Tomography, Emission-Computed, Single-Photon methods, Tomography, X-Ray Computed methods
- Abstract
Purpose: Lung perfusion impairment in patients with pulmonary arteriovenous fistula (AVF) was evaluated by automated deep inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images., Methods: Participants were 14 patients with a single (N=6) or multiple nodular AVFs (N=8) diagnosed by contrast-enhanced CT scan and/or pulmonary angiography. After the injection of 185MBq Tc-99m-macroaggregated albumin, a whole-body scan was obtained to quantify an intrapulmonary right-to-left shunt. Subsequently, DIBrH SPECT was obtained using the continuous rotating acquisition mode of a dual-headed SPECT system, which was automatically coregistered with DIBrH CT. The anatomic relationship between AVF and perfusion defects was assessed on the fusion images., Results: The whole-body scan depicted systemic organs indicating the presence of an intrapulmonary right-to-left shunt in all the patients. DIBrH SPECT showed 34 perfusion defects in these patients, which were located at the AVF and in the surrounding lungs of the AVF on the fusion images, regardless of the absence of morphologic abnormality on CT in all the patients. These defects were considered to be caused by the 'steal phenomenon' associated with the high and fast pulmonary arterial flow to each AVF, which were more extensive and severe in the multiple AVFs compared with a single AVF (P=0.0012), occasionally extending to the entire lobe with AVF or even to the adjacent lobe. In five patients, the fusion images detected a total of six tiny AVFs with unexpectedly extensive 'steal phenomenon'-induced defects, which had been missed by other radiological imaging techniques. The summed value of the shunt index estimated by the whole-body scan and the lung perfusion defect extent estimated by DIBrH SPECT was significantly correlated with PaO2 in all the patients (P < 0.0001), with a better correlation compared with the shunt index alone., Conclusion: In addition to the right-to-left shunt, 'steal phenomenon'-induced perfusion defects are common in the surrounding lung of pulmonary nodular AVF and cause hypoxemia. DIBrH SPECT-CT fusion images contribute to the objective evaluation of 'steal phenomenon'-induced lung perfusion impairment in AVF and the detection of tiny, subtle AVFs that may be missed by other radiological imaging techniques.
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- 2010
- Full Text
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27. Assessment of cross-sectional lung ventilation-perfusion imbalance in primary and passive pulmonary hypertension with automated V/Q SPECT.
- Author
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Suga K, Tokuda O, Okada M, Koike M, Iwanaga H, and Matsunaga N
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- Adult, Aged, Albumins, Automation, Case-Control Studies, Female, Humans, Lung blood supply, Male, Middle Aged, Sodium Pertechnetate Tc 99m, Tomography, X-Ray Computed, Young Adult, Hypertension, Pulmonary diagnostic imaging, Hypertension, Pulmonary physiopathology, Lung diagnostic imaging, Lung physiopathology, Tomography, Emission-Computed, Single-Photon, Ventilation-Perfusion Ratio
- Abstract
Purpose: Cross-sectional lung ventilation (V)-perfusion (Q) imbalance in primary pulmonary arterial hypertension (PAH) and passive pulmonary hypertension (PH) was characterized by automated V/Q single-photon emission computed tomography (SPECT)., Materials and Methods: Technegas/macro-aggregated albumin SPECT-derived V/Q SPECT and V/Q profile were automatically built to characterize cross-sectional lung V-Q imbalance in 12 patients with primary (idiopathic or familial) PAH and 15 patients with passive PH associated with left ventricular dysfunction or failure. The abnormality of V/Q distribution in these patients was correlated with PaO2 and pulmonary arterial pressure and with lung morphologic changes on computed tomography (CT)., Results: Markedly low V/Q ratios (reverse V-Q mismatch) in the background lungs with heterogeneous V/Q distribution was seen in 12 of the 12 (100%) patients with primary PAH and in 10 of the 15 (66%) patients with passive PH, which were predominantly seen in the upper lung zone. Including these regions with reverse V-Q mismatch, the V/Q profile frequently showed flattened peaks with asymmetric and broadened V/Q distribution in all patients, with significant correlation between the standard deviation of V/Q ratios in the entire lungs and PaO2 and mean pulmonary arterial pressure (both; P<0.01). At the regions of the lungs with reverse V-Q mismatch, bronchial lumens compressed by dilated pulmonary arteries and heterogeneous lung attenuations were frequently seen on CT., Conclusion: Patients with primary PAH and passive PH seem to characteristically have a high prevalence of reverse V-Q mismatch indicative of an inadequate hypoxic vasoconstriction reflex on V/Q SPECT, frequently accompanied with heterogeneous lung attenuations and compressed airways on CT., (2010 Wolters Kluwer Health / Lippincott Williams & Wilkins.)
- Published
- 2010
- Full Text
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28. Characteristic crescentic subpleural lung zones with high ventilation (V)/perfusion (Q) ratios in interstitial pneumonia on V/Q quotient SPECT.
- Author
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Suga K, Kawakami Y, Koike M, Iwanaga H, and Matsunaga N
- Subjects
- Adult, Aged, Albumins chemistry, Case-Control Studies, Female, Humans, Male, Middle Aged, Organotechnetium Compounds, Protein Multimerization, Protein Structure, Quaternary, Retrospective Studies, Tomography, X-Ray Computed, Lung diagnostic imaging, Lung physiopathology, Lung Diseases, Interstitial diagnostic imaging, Lung Diseases, Interstitial physiopathology, Tomography, Emission-Computed, Single-Photon, Ventilation-Perfusion Ratio
- Abstract
Objective: Nonspecific interstitial pneumonia (NSIP) and usual IP (UIP) preferentially involve subpleural lung zones (SPLZ), and may result in characteristic regional lung function impairment. The aim of this study was to characterize cross-sectional lung ventilation (V)-perfusion (Q) imbalance in these disorders on automated V/Q quotient single photon emission computed tomography (SPECT)., Methods: 99mTc-technegas/macroaggregated albumin SPECT-derived V/Q quotient SPECT and V/Q profile were automatically built for assessment of cross-sectional lung V-Q imbalance in 38 patients with NSIP or UIP. The findings of V/Q quotient SPECT were correlated with lung CT morphology. The results were compared with 12 healthy nonsmoker controls and 48 patients with chronic obstructive pulmonary disease., Results: V/Q quotient SPECT showed 81 crescentic SPLZ with high V/Q ratios in 32 patients (84%) with NSIP or UIP, which were not observed in controls and patients with chronic obstructive pulmonary disease. Sixty-three (77.7%) of them were located at high-attenuation areas (reticular and/or ground-glass opacities) with or without small cystic air spaces (honeycombing and/or traction bronchiectasis) on CT, and 12 (14.8%) at normal lung areas. V/Q profile at the lung sections with crescentic SPLZ with high V/Q ratios showed flattened peaks with broadened V/Q ratio distribution compared with controls, and standard deviation of V/Q ratios in the entire lungs was significantly correlated with partial oxygen arterial blood pressure (P = 0.0009) and predicted diffusing capacity of the lungs for carbon monoxide (P = 0.0139). Five of eight patients with NSIP or UIP and with worsening of hypoxemia showed an extension of SPCZ with high V/Q ratios on follow-up V/Q quotient SPECT, without significant changes on CT., Conclusion: A high prevalence of crescentic SPLZ with high V/Q ratios is a characteristic feature of lung V-Q imbalance causing alveolar gas exchange impairment in NSIP and UIP.
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- 2009
- Full Text
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29. A stripe sign on 99mTc-Technegas SPECT in pulmonary emphysema.
- Author
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Suga K, Kawakami Y, Iwanaga H, Tokuda O, and Matsunaga N
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- Adult, Aged, Female, Humans, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive complications, Pulmonary Emphysema complications, Radiopharmaceuticals, Image Interpretation, Computer-Assisted methods, Pulmonary Disease, Chronic Obstructive diagnostic imaging, Pulmonary Emphysema diagnostic imaging, Sodium Pertechnetate Tc 99m, Tomography, Emission-Computed, Single-Photon methods
- Abstract
Objective: By focusing on a stripe sign (interposed preserved radioactivity between central defects and pleural surface of the lung), the cross-sectional ventilation difference between the central and peripheral lung in pulmonary emphysema was evaluated on Tc-Technegas SPECT, and compared with other forms of chronic obstructive pulmonary disease (COPD)., Methods: Technegas and perfusion SPECT were performed in 47 patients with relatively advanced emphysema, 15 patients with other forms of COPD without alveolar destruction and six controls. The presence or absence of a stripe sign was evaluated at upper, middle and lower lung zones on both SPECT. At stripe sign-positive lung zones on Technegas SPECT in pulmonary emphysema, the pattern of low attenuation areas (LAAs) distribution on X-ray CT was also evaluated., Results: Of the total of 282 lung zones in patients with emphysema, a stripe sign was positive on Technegas SPECT at 153 (54.2%) zones in 27 (57.4%) patients, although less frequently positive on perfusion SPECT at 166 (58.8%) zones in 30 (63.8%) patients. This sign was negative on Technegas SPECT throughout the stripe sign-negative zones on perfusion SPECT. Throughout the lung zones in controls and patients with other forms of COPD, this sign was negative both on Technegas and perfusion SPECT. On X-ray CT, 124 (81%) of 153 stripe-positive lung zones on Technegas SPECT in pulmonary emphysema showed central lung-dominant LAA., Conclusion: In contrast to other forms of COPD, a stripe sign was frequently positive on Technegas SPECT in relatively advanced emphysema, with central-lung dominant LAA on X-ray CT. Relative preservation of peripheral lung ventilation seems to be a characteristic feature of this disease, indicating a lower susceptibility of the peripheral lung for alveolar destruction.
- Published
- 2008
- Full Text
- View/download PDF
30. Characterization of 133Xe gas washout in pulmonary emphysema with dynamic 133Xe SPECT functional images.
- Author
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Suga K, Kawakami Y, Yamashita T, Zaki M, and Matsunaga N
- Subjects
- Administration, Inhalation, Adult, Aged, Aged, 80 and over, Female, Gases administration & dosage, Gases pharmacokinetics, Humans, Male, Metabolic Clearance Rate, Middle Aged, Pulmonary Disease, Chronic Obstructive diagnostic imaging, Pulmonary Disease, Chronic Obstructive metabolism, Reproducibility of Results, Respiratory Function Tests methods, Sensitivity and Specificity, Tissue Distribution, Xenon Radioisotopes administration & dosage, Image Interpretation, Computer-Assisted methods, Pulmonary Emphysema diagnostic imaging, Pulmonary Emphysema metabolism, Tomography, Emission-Computed, Single-Photon methods, Xenon Radioisotopes pharmacokinetics
- Abstract
Purpose: To characterize regional ventilation impairment of pulmonary emphysema using dynamic 133Xe single photon emission computed tomography (SPECT) functional images, compared with other forms of chronic obstructive pulmonary disease (COPD)., Methods: Dynamic 133Xe SPECT was performed in 34 patients with emphysema and 15 patients with other forms of COPD. Three-dimensional voxel-based functional images of the half-clearance time (T1/2) mainly reflecting the initial rapid washout of 133Xe gas from the large airways, and of the mean transit time (MTT) reflecting 133Xe gas washout from the entire lungs, including the small airways and alveoli, were created based on an area-over-height method. T1/2 and MTT values were compared with the regional extent of low attenuation areas (%LAA) on density-mask computed tomography images and the diffusing capacity of the lungs for carbon monoxide (DLCO)., Results: The MTT/T1/2 ratio in each lung in emphysema was significantly higher than that in other forms of COPD (1.60+/-0.74 vs. 1.21+/-0.26; P<0.01). In the selected unilateral lungs with similar T1/2 values, MTT values were also significantly higher in emphysema. MTT values in each lung showed a significantly closer correlation with the corresponding %LAA values compared with T1/2 values in emphysema (R=0.698, P<0.0001 vs. R=0.338, P<0.01; P<0.05); while only the T1/2 values showed a significant correlation in other forms of COPD (P<0.0001). In correlation with DLCO, MTT values showed a significantly closer correlation compared with T1/2 values in emphysema (R=0.909, P<0.0001 vs. R=0.555, P<0.001; P<0.05); while either value did not show a significant correlation in other forms of COPD., Conclusion: MTT values are more critically affected in emphysema compared with other forms of COPD without significant alveolar destruction, and MTT and T1/2 values appear to be differently correlated with the regional extent of LAA between these two disorders. Direct comparison of regional T1/2 and MTT values on functional images may contribute to the demarcation of lung pathology of these two disorders.
- Published
- 2006
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31. Enhanced perfusion defect clarity and inhomogeneity in smokers' lungs with deep-inspiratory breath-hold perfusion SPECT images.
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Suga K, Yasuhiko K, Iwanaga H, Hayashi N, Yamashita T, and Matsunaga N
- Subjects
- Artifacts, Humans, Lung Diseases etiology, Male, Movement, Pulmonary Circulation, Radionuclide Imaging, Reproducibility of Results, Respiration, Sensitivity and Specificity, Vascular Diseases etiology, Image Enhancement methods, Image Interpretation, Computer-Assisted methods, Inhalation, Lasers, Lung diagnostic imaging, Lung Diseases diagnostic imaging, Smoking adverse effects, Vascular Diseases diagnostic imaging
- Abstract
Purpose: Deep-inspiratory breath-hold (DIBrH) Tc-99m-macroaggregated albumin (MAA) SPECT images were developed to accurately evaluate perfusion impairment in smokers' lungs., Methods: DIBrH SPECT was performed in 28 smokers with or without low attenuation areas (LAA) on CT images, using a triple-headed SPECT system and a laser light respiratory tracking device. DIBrH SPECT images were reconstructed from every 4 degrees projection of five adequate 360 degrees projection data sets with almost the same respiratory dimension at 20 sec DIBrH. Perfusion defect clarity was assessed by the lesion (defect)-to-contralateral normal lung count ratios (L/N ratios). Perfusion inhomogeneity was assessed by the coefficient of variation (CV) values of pixel counts and correlated with the diffusing capacity of the lungs for carbon monoxide/alveolar volume (DLCO/VA) ratios. The results were compared with those on conventional images., Results: Five DIBrH projection data sets with minimal dimension differences of 2.9+/-0.6 mm were obtained in all subjects. DIBrH images enhanced perfusion defects compared with conventional images, with significantly higher L/N ratios (P<0.0001), and detected a total of 109 (26.9%) additional detects (513 vs. 404), with excellent inter-observer agreement (kappa value of 0.816). CV values in the smokers' lungs on DIBrH images were also significantly higher compared with those on conventional images (0.31+/-0.10 vs. 0.19+/-0.06, P<0.0001). CV values in smokers on DIBrH images showed a significantly closer correlation with DLCO/VA ratios compared with conventional images (R = 0.872, P<0.0001 vs. R=0.499, P<0.01)., Conclusion: By reducing adverse effect of respiratory motion, DIBrH SPECT images enhance perfusion defect clarity and inhomogeneity, and provide more accurate assessment of impaired perfusion in smokers' lungs compared with conventional images.
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- 2005
- Full Text
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32. Preferential location of acute pulmonary thromboembolism induced consolidative opacities: assessment with respiratory gated perfusion SPECT-CT fusion images.
- Author
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Zaki M, Suga K, Kawakami Y, Yamashita T, Shimizu K, Seto A, and Matsunaga N
- Subjects
- Acute Disease, Adult, Diagnosis, Differential, Female, Humans, Image Processing, Computer-Assisted, Inflammation, Male, Middle Aged, Perfusion, Pulmonary Embolism pathology, ROC Curve, Radiopharmaceuticals, Sensitivity and Specificity, Pulmonary Embolism diagnosis, Tomography, Emission-Computed, Single-Photon methods, Tomography, X-Ray Computed methods
- Abstract
Purpose: Preferential location of acute pulmonary thromboembolism (PTE) induced consolidative opacities (infarction/atelectasis) was determined on respiratory gated perfusion SPECT-CT fusion images., Method: Gated end-inspiratory perfusion SPECT images were obtained in 21 patients with acute PTE and 17 patients with inflammatory diseases, using a triple-headed SPECT system and a respiratory tracking device. Anatomical relationships of consolidative opacities and perfusion defects were assessed on gated SPECT-rest inspiratory CT fusion images. The size and radioactivity of perfusion defects with acute PTE consolidative opacities were compared with those of defects without these opacities. The contribution of fusion images for differential diagnosis of acute PTE induced and inflammatory disease induced lesions was evaluated by receiver operating characteristic (ROC) curve analysis., Results: Of the total 56 acute PTE induced consolidative opacities, 42 (75%) were located at the peripheral interface between the severely decreased and adjacent relatively preserved perfusion areas within wedge shaped perfusion defects on fusion images. These defects with consolidative opacities were significantly larger and had taken up less radioactivity compared with those in the 86 defects without these lesions (P<0.0001). In contrast, of the 29 inflammatory disease induced opacities, 14 (48.2%) had the matched defects and 13 (44.8%) were located at the proximal portion of defects. These preferential locations of acute PTE induced and inflammation induced lesions were significantly different (P<0.01). In ROC curves, the combined reading of fusion images showed a significantly higher differential diagnostic accuracy compared with the reading of CT and SPECT images alone (P<0.01)., Conclusions: Acute PTE induced consolidative opacities preferentially occur at the peripheral lung interface between severely decreased and adjacent relatively preserved perfusion areas within relatively large and severely decreased perfusion defects. The fusion images, which provide an accurate assessment of the morphological-perfusion defect relationship could, potentially, provide a differential diagnosis between acute PTE induced and inflammatory disease induced lesions.
- Published
- 2005
- Full Text
- View/download PDF
33. Initial application of respiratory-gated 201Tl SPECT in pulmonary malignant tumours.
- Author
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Kawakami Y, Suga K, Yamashita T, Iwanaga H, Zaki M, and Matsunaga N
- Subjects
- Adult, Aged, Female, Humans, Lung Neoplasms physiopathology, Male, Middle Aged, Movement, Radiography, Radionuclide Imaging, Radiopharmaceuticals, Reproducibility of Results, Sensitivity and Specificity, Artifacts, Image Enhancement methods, Image Interpretation, Computer-Assisted methods, Lung Neoplasms diagnostic imaging, Respiratory Mechanics, Subtraction Technique, Thallium
- Abstract
Aim: Respiratory-gated thallium-201 chloride (201Tl) single photon emission computed tomography (SPECT) was used in preliminary investigations to reduce the adverse respiratory motion effects observed on standard ungated SPECT images and to obtain reliable fusion images with computed tomography (CT) in patients with malignant lung tumours., Methods: Fifteen patients with primary lung cancer (n=10) or metastatic lung tumours (n=5) underwent gated SPECT 20 min after intravenous injection of 148 MBq 201Tl, using triple-headed SPECT and laser light respiratory tracking units. Projection data were acquired by a step and shoot mode, with 20 stops over 120 degrees for each detector and a preset time of 30 s for each 6 degrees stop. Gated end-inspiratory and ungated images were obtained from 1/8 data centred at peak inspiration for each regular respiratory cycle and for the full respiratory cycle data, respectively. The degree and size of tumour 201Tl uptake were compared between these images by regions of interest (ROI) analysis. Gated SPECT images were registered with rest inspiratory CT images using an automated three-dimensional (3D) image registration tool. Registration mismatch was assessed by measuring the 3D distance of the centroid of 14 201Tl-avid peripheral tumours. Attenuation correction of gated SPECT images was performed using CT attenuation values of these fusion images., Results: Gated SPECT images improved image clarity and contrast of tumour 201Tl uptakes compared with ungated images, regardless of the decreased count density due to the use of gated images. The lesion-to-normal (L/N) lung count ratios and ROI size in 18 well-circumscribed 201Tl-avid tumours were significantly higher and smaller on gated images (both P<0.0001). Gated images showed positive 201Tl uptakes in two small peripheral tumours, although negative on ungated images, and demarcated 201Tl-avid tumours from adjacent 201Tl-avid lymph node or surrounding focal 201Tl uptakes caused by other pathology, although these were not clearly demarcated on ungated images. On fusion images, gated images yielded a significantly better SPECT-CT matching compared with ungated images (P<0.0001). Fusion images accurately localized 201Tl uptakes of tumour/lymph node and other focal pathological/physiological conditions. Attenuation-corrected gated SPECT images further facilitated the detection of 201Tl uptake in small or deeply located lesions, with significantly increased L/N ratios., Conclusion: Gated SPECT images facilitate the detection of tumour 201Tl uptake and provide reliable SPECT-CT fusion images, which contribute to accurate interpretation and attenuation correction of Tl SPECT images.
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- 2005
- Full Text
- View/download PDF
34. Pulmonary perfusion assessment with respiratory gated 99mTc macroaggregated albumin SPECT: preliminary results.
- Author
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Suga K, Kawakami Y, Zaki M, Yamashita T, Matsumoto T, and Matsunaga N
- Subjects
- Adult, Aged, Aged, 80 and over, Airway Obstruction diagnostic imaging, Female, Humans, Lung Diseases physiopathology, Male, Middle Aged, Tomography, Emission-Computed, Single-Photon, Pulmonary Circulation physiology, Radiopharmaceuticals, Respiratory Mechanics physiology, Technetium Tc 99m Aggregated Albumin
- Abstract
Purpose: Respiratory gated perfusion single photon emission computed tomography (SPECT) was applied to reduce respiratory lung motion effects and to reliably assess perfusion impairment in various lung diseases., Methods: After injection of 259 MBq of 99mTc macroaggretated albumin (99mTc-MAA), gating was performed using a triple-headed SPECT unit connected to a physiological synchronizer in a total of 35 patients with either obstructive lung diseases (n = 14), pulmonary embolism (n = 8), small lung nodules (n = 7) or acute interstitial pneumonia (n = 6). Projection data were acquired in a 64 x 64 matrix, with 20 stops over 120 degrees for each detector with a preset time of 15 s for each stop. Inadequate data for the respiratory cycle were automatically eliminated. In addition to end inspiration images and end expiration images derived from 12.5% threshold data centred at peak inspiration and expiration for each respiratory cycle, respectively, an ungated image was obtained from full respiratory cycle data., Results: Gated images were completed for 13.7 +/- 1.8 min in all subjects. Although the total lung radioactivity of the gated images were reduced to approximately 13% of that of the ungated images, these gated images showed uniform perfusion in the unaffected lungs and visualized a total of 94 (21.9%) additional perfusion defects against 429 defects visualized on ungated images in 31 patients with focal perfusion defects. Among the perfusion defects visualized on both gated images, the defect size was occasionally larger on the end inspiration images. The end expiration images showed significantly higher lesion-to-normal lung radioactivity ratios compared with those on the end expiration and ungated images in the affected lower lungs throughout the lung diseases. Radioactivity changes per pixel between end inspiration and end expiration images in the affected lower lungs of the obstructive lung diseases were significantly lower compared with those of pulmonary embolism and acute interstitial pneumonia (P<0.0001 and P<0.01, respectively)., Conclusion: This technique appears to enhance the clarity of perfusion defects, and lung radioactivity changes between end inspiration and end expiration may characterize regionally impaired ventilation status.
- Published
- 2004
- Full Text
- View/download PDF
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