Performance assessment of the single photon emission microscope: high spatial resolution SPECT imaging of small animal organs

The single photon emission microscope (SPEM) is an instrument developed to obtain high spatial resolution single photon emission computed tomography (SPECT) images of small structures inside the mouse brain. SPEM consists of two independent imaging devices, which combine a multipinhole collimator, a high-resolution, thallium-doped cesium iodide [CsI(Tl)] columnar scintillator, a demagnifying/intensifier tube, and an electron-multiplying charge-coupling device (CCD). Collimators have 300- and 450-µm diameter pinholes on tungsten slabs, in hexagonal arrays of 19 and 7 holes. Projection data are acquired in a photon-counting strategy, where CCD frames are stored at 50 frames per second, with a radius of rotation of 35 mm and magnification factor of one. The image reconstruction software tool is based on the maximum likelihood algorithm. Our aim was to evaluate the spatial resolution and sensitivity attainable with the seven-pinhole imaging device, together with the linearity for quantification on the tomographic images, and to test the instrument in obtaining tomographic images of different mouse organs. A spatial resolution better than 500 µm and a sensitivity of 21.6 counts·s-1·MBq-1 were reached, as well as a correlation coefficient between activity and intensity better than 0.99, when imaging 99mTc sources. Images of the thyroid, heart, lungs, and bones of mice were registered using 99mTc-labeled radiopharmaceuticals in times appropriate for routine preclinical experimentation of <1 h per projection data set. Detailed experimental protocols and images of the aforementioned organs are shown. We plan to extend the instrument's field of view to fix larger animals and to combine data from both detectors to reduce the acquisition time or applied activity.

Neurocirugia radioguiada en los tumores cerebrales de alto grado, experiencia INC

La cirugía radioguiada es una rama de la medicina nuclear con la cual se marca el tejido tumoral con un radiotrazador (MIBI) y mediante el uso de una gamasonda o gamacámara poder diferenciarlo del tejido cerebral sano in vivo en la sala de cirugía. Esta técnica se ha aplicado con éxito en tumores del SNC (Gliomas de alto grado, metástasis, meningiomas). Los tumores del SNC representan el 1% de todos los tumores pero son la tercera causa de mortalidad por cáncer en el mundo. Hay un mejor pronóstico de los pacientes con mayor extensión de la resección. Objetivos: Evaluar la factibilidad de la técnica y optimizar los procesos en el INC con la finalidad de desarrollar un protocolo de línea de investigación en esta materia. Materiales y métodos: se realiza un reporte de casos de pacientes con diagnóstico de tumor cerebral supratentorial. Se realizó SPECT cerebral con MIBI para confirmar captación del radiotrazador. En los pacientes que marcaron positivo se programó cirugía radioguiada con gamacámara portátil Sentinel Resultados: En 5 pacientes con tumores supratentoriales se realizó SPECT cerebral con MIBI: 3 de ellos fueron positivos los cuales fueron programados para cirugía radioguiada y los 2 restantes con cirugía convencional. Dos de los casos positivos correspondieron a Tumor de alto grado y un caso de tumor abscedado. En quienes se practicó la cirugía radioguiada se consiguió resección tumoral completa tumoral por imagen de gamacámara intraquirúrgica

Osteomielitis esternal: utilidad de las pruebas de diagnóstico por imágenes con enfoque en medicina nuclear

Introducción: El diagnóstico de osteomielitis esternal post-esternotomía resulta difícil empleando síntomas clínicos o de laboratorio y las imágenes morfológicas orientan a sospecha más que al diagnóstico. Un diagnóstico precoz ofrece calidad de vida y el mejor tratamiento para reducir una mortalidad que oscila entre 14% y 47%. La gammagrafía con leucocitos marcados ofrece el mejor rendimiento diagnóstico para infecciones y se destaca como el patrón de oro diagnóstico. Objetivo: Identificar el desempeño y utilidad de la gammagrafía con leucocitos autólogos marcados con 99mTc-HMPAO en los estudios realizados para la evaluación de osteomielitis esternal. Materiales y métodos: Se realizó un estudio descriptivo, retrospectivo de prueba diagnóstica en la Fundación Cardioinfantil de Bogotá entre enero/2010 y mayo/2015 evaluando gammagrafías con leucocitos marcados ante la sospecha de osteomielitis posterior a esternotomía. Resultados: Se evaluaron 52 pacientes, en los que la gammagrafía con leucocitos mostró 23 pacientes (44,2%) con osteomielitis esternal, logrando una sensibilidad y especificidad del 88,46% y 100% respectivamente. El valor predictivo positivo fue de 100%, y el valor predictivo negativo fue de 89,66%. El impacto de una prueba negativa no modificó el manejo médico inicial en el 93% de los casos mientras que una prueba positiva lo modificó en el 83%. Conclusiones: La gammagrafía con leucocitos autólogos radiomarcados con 99mTc-HMPAO continúa siendo el patrón de oro de referencia no invasiva para el diagnóstico de osteomielitis, y en el caso de osteomielitis esternal se convierte en la prueba de elección pertinente en la selección de pacientes que ameritan una re-intervención quirúrgica.

Enxertos ósseos liofilizados e impactados humano e bovino em revisão de artroplastia total de quadril

O presente estudo é uma coorte não concorrente em 63 pacientes (66 quadris) submetidos à revisão de artroplastia total de quadril (RATQ), com enxerto ósseo liofilizado moído e impactado. Foi realizado no Serviço de Ortopedia e Traumatologia do Hospital de Clínicas de Porto Alegre (HCPA), no período de maio de 1997 a setembro de 2003. O objetivo do estudo foi comparar clínica, radiográfica e cintilograficamente a capacidade de osteointegração dos enxertos ósseos liofilizados humano e bovino impactados em RATQs cimentadas e não-cimentadas. Os pacientes foram divididos em dois grupos: o Grupo 1 (n=35) foi composto pelos que receberam enxerto ósseo liofilizado de origem humana e o Grupo 2 (n=31) por aqueles que receberam enxerto de origem bovina. O tempo médio de seguimento foi de 33 meses. Os enxertos ósseos purificados e liofilizados foram produzidos pelo Banco de Tecidos do HCPA. A análise clínica baseou-se no escore de Merle, d’Aubigné e Postel; a radiográfica, nos critérios de radioluscência, densidade, formação de trabeculado ósseo, migração dos componentes e floculação, formulando-se um escore radiográfico de osteointegração (EROI). Foram escolhidos, aleatoriamente, como forma complementar de análise por imagem, 35 (53%) pacientes assintomáticos para realizarem cintilografia óssea com Tecnécio, sendo 17 (48,5%) do Grupo 1 e 18 (51,5%) do Grupo 2. Não foram encontradas diferenças clínicas, radiográficas ou cintilográficas relevantes entre os grupos, obtendo-se em torno de 85% de integração do enxerto, tanto no componente acetabular quanto femoral. Estes resultados são comparáveis aos relatados na literatura com o uso de enxerto alogênico congelado e confirmam a adequacidade do uso de enxertos liofilizados de origem bovina e humana em RATQ.

Quantificação de Shunt intrapulmonar por cintilografia e gasometria arterial com 02 a 100% em candidatos a transplante hepático com diferentes graus de dilatação vascular intrapulmonar

As dilatações vasculares intrapulmonares (DVIP) constituem a anormalidade vascular pulmonar mais freqüente e a principal causa de hipoxemia grave em hepatopatas. A associação de doença hepática, aumento do gradiente alvéoloarterial de oxigênio e DVIP é chamada de "síndrome hepatopulmonar". O objetivo principal deste estudo foi verificar se os níveis de DVIP aferidos por ecocardiografia com contraste estão relacionados à intensidade de shunt intrapulmonar, medida por dois diferentes métodos: cintilografia com 99mTc-MAA e gasometria com O2 a 100%. Foram estudados 28 candidatos a transplante hepático portadores com DVIP identificadas e graduadas por ecocardiografia conforme escala semi-quantitativa (graus I a IV). A idade média foi de 47,5 anos, e a doença hepática foi classificada como Child-Pugh B na maioria dos casos (60,7%). A intensidade das DVIP foi classificada como I, II, III e IV em 13 (46,4%), 9 (32,1%), 2 (7,1%) e 4 (14,3%) casos, respectivamente. Dos 28 pacientes, 21 (75%) tiveram quantificação de shunt pelo método cintigráfico e gasométrico, 6 (21,4%) apenas pelo método cintigráfico e 1 caso (3,6%) pelo método gasométrico apenas. A PaO2 média entre os pacientes com DVIP graus I e II por ecocardiografia foi 89,1 ± 11,0mmHg, enquanto naqueles com DVIP classificadas como graus III e IV foi 74,7 ± 13,2mmHg (p = 0,01). A média dos valores de shunt por cintilografia nos 27 pacientes submetidos ao exame foi 14,9 ± 9,0% do débito cardíaco (mínimo 6,9% e máximo 39%), sendo 11,7 ± 3,8% nos pacientes com DVIP graus I e II, e 26,3 ± 9,7% nos pacientes com DVIP graus III e IV (p = 0,01). A média dos valores de shunt pelo teste com O2a 100% foi 9,8 ± 3,9%, sendo 8,3 ± 2,3% nos pacientes com DVIP graus I e II, e 16,3 ± 2,6% nos pacientes com DVIP graus III e IV (p < 0,001). Observou-se uma relação estatisticamente significativa entre a graduação de DVIP por ecocardiografia e o valor de shunt aferido por gasometria com O2 a 100% (rs = 0,609, p < 0,01) e por cintilografia (rs = 0,567, p < 0,001). Observou-se relação estatisticamente significativa entre os valores de shunt medidos por cintilografia e aqueles medidos por gasometria com O2 a 100% nos 21 pacientes que se submeteram à quantificação de shunt pelos 2 métodos (rs = 0,666, p < 0,001). A avaliação semi-quantitativa do grau de DVIP por ecocardiografia apresentou correlação moderada a boa com os valores de shunt aferidos pelos dois outros métodos estudados, sendo que a melhor correlação foi observada com o teste com O2 a 100%.

Metabolic and hematologic consequences of colectomy associated to hepatectomy in rats

To investigate the influence of partial colectomy associated with hepatectomy on the biodistribution of the 99mTc-phytate, on metabolic parameters, as well as labeling and morphology of red blood cells. METHODS: Wistar rats were distributed into three groups (each with six), nominated as colectomy, colectomy+hepatectomy and sham. In the 30th postoperative day all rats were injected with 99mTc-phytate 0.1mL i.v. (radioactivity 0.66 MBq). After 15 minutes, liver sample was harvested and weighed. Percentage radioactivity per gram of tissue (%ATI/g) was determined using an automatic gammacounter. Serum AST, ALT, alkaline phosphatase and red blood cells labeling were determined. RESULTS: The liver %ATI/g and red blood cells labeling were lower in colectomy and colectomy+hepatectomy rats than in sham rats (p <0.05), and no difference was detected comparing the colectomy and colectomy+hepatectomy groups. Red blood cells morphology did not differ among groups. Serum levels of AST, ALT and alkaline fosfatase were significantly higher in colectomy+hepatectomy than in colectomy rats (p<0.001). CONCLUSION: Hepatectomy associated with colectomy lowered the uptake of radiopharmaceutical in liver and in red blood cells in rats, coinciding with changes in liver enzymatic activity.

Prevention of bacterial translocation using β-(1-3)-D-glucan in small bowel ischemia and reperfusion in rats

To investigate the role of β-(1-3)-D-glucan on 99mTc labelled Escherichia coli translocation and cytokines secretion in rats submitted to small bowel ischemia/reperfusion injury. Methods: Five groups (n=10 each) of Wistar rats were subjected to control(C), sham(S), group IR subjected to 45 min of bowel ischemia/60 min of reperfusion(I/R), and group I/R+glucan subjected to 45 min of bowel ischemia/60 min of reperfusion(I/R) and injected with 2mg/Kg intramuscular. Translocation of labelled bacteria to mesenteric lymph nodes, liver, spleen, lung and serum was determined using radioactivity/count and colony forming units/g(CFU/g). Serum TNFα, IL-1β, IL-6, IL-10 were measured by ELISA. Results: CFU/g and radioactivity/count were higher in I/R than in I/R+glucan rats. In C, S and S+glucan groups, bacteria and radioactivity/count were rarely detected. The I/R+glucan rats had enhancement of IL-10 and suppressed production of serum TNFα, IL-1β and, IL-6, compared to I/R untreated animals. Conclusion: The β-(1-3)-D-glucan modulated the production of pro-inflammatory and anti-inflammatory cytokines during bowel ischemia/reperfusion, and attenuated translocation of labelled bacteria

Prevention of bacterial translocation using β-(1-3)-D-glucan in small bowel ischemia and reperfusion in rats

To investigate the role of β-(1-3)-D-glucan on 99mTc labelled Escherichia coli translocation and cytokines secretion in rats submitted to small bowel ischemia/reperfusion injury. Methods: Five groups (n=10 each) of Wistar rats were subjected to control(C), sham(S), group IR subjected to 45 min of bowel ischemia/60 min of reperfusion(I/R), and group I/R+glucan subjected to 45 min of bowel ischemia/60 min of reperfusion(I/R) and injected with 2mg/Kg intramuscular. Translocation of labelled bacteria to mesenteric lymph nodes, liver, spleen, lung and serum was determined using radioactivity/count and colony forming units/g(CFU/g). Serum TNFα, IL-1β, IL-6, IL-10 were measured by ELISA. Results: CFU/g and radioactivity/count were higher in I/R than in I/R+glucan rats. In C, S and S+glucan groups, bacteria and radioactivity/count were rarely detected. The I/R+glucan rats had enhancement of IL-10 and suppressed production of serum TNFα, IL-1β and, IL-6, compared to I/R untreated animals. Conclusion: The β-(1-3)-D-glucan modulated the production of pro-inflammatory and anti-inflammatory cytokines during bowel ischemia/reperfusion, and attenuated translocation of labelled bacteria

Efeitos biológicos in vitro de agentes físicos utilizados em fisioterapia

The uses of radiobiocomplexes labeled with technetium-99m contributed to health science advances. Stannous chloride (SnCl2) has been used as a reducing agent for the labeling process. Cytotoxic and genotoxic effect of the SnCl2 have been described in several studies and with this experimental models alterations in molecular and cellular level can be evaluated. In the last years the physicals therapists acquired new devices which emits electromagnetic radiation such us Extremely Low Frequency Pulsated Electromagnetic Fields (E.L.F. P.E.M.F.), radiofrequency, Intense Pulsed Light (I.P.L.) and others which emits sonic waves such us Biorresonance. Scientific evidence of the effects and dosage is important to protect public health and to reach exposition levels that result in significant biological effects. The aim of this project is to verify the effects of these physical agents in plasmid DNA and E. coli AB1157 cultures in presence or absence of SnCl2 and the effects in blood constituents labeled with technetium-99m. Wistar rats blood was exposed to the cited sources and the labelling of blood constituents with 99mTc was carried through. Cultures of E. coli AB1157 and plasmidial samples DNA had been also exposed the physical agents. The results suggest that these agents are capable of altering neither the survival of E. coli cells or plasmid DNA electrophoresis mobility. The multidiscipline character was clearly in this study due the interaction between Nuclear Medicine department of the UERJ and the Laboratory of Physical Agents of the Maimonides University in Argentina until the union between the teacher (biomedical and physiotherapist) and student (physiotherapist), besides collaborators of the area of Physics and Biology, promoting new ideas and perspectives and also adding the knowledge of different areas and origins

Efeito de um extrato de chrysobalanus icaco na marcação de constituíntes sanguíneos com tecnécio-99m, na morfologia de hemácias, na topologia plasmidial e na ação do cloreto estanoso no dna plasmidial

The use of radionuclides has contributed for advances in Health Sciences, to research or to the diagnosis and/or treatment of diseases. These advances have been possible with the utilization of radiopharmaceuticals labeled with technetium-99m (99mTc). Stannous chloride (SnCl2) has the main reducing agent utilized to obtain radiopharmaceuticals labeled with technetium-99m. It has been reported that several natural or synthetic drugs are capable to alter the labeling of blood constituents with 99mTc, as well as the red blood cells morphology. The aim of this study was to evaluate possible alterations of Chrysobalanus icaco extract on the labeling of blood constituents with 99mTc, on the morphology of RBC of blood of Wistar rats, on the breakage of plasmid DNA and on the effects of stannous chloride on plasmid DNA. The results showed significant (P<0.05) alteration of the labeling of blood constituents with 99mTc, as well as, modification of the morphology and morphometry (perimeter/area ratio) of the RBC in presence of the extract. These data suggest that this abajeru extract could alter the labeling of blood constituents with 99mTc by its chelating/antioxidant action and/or effects on membrane structures. Moreover C. icaco extract altered the electrophoretic profile and decreased significantly (p<0.05) the effect of SnCl2 on plasmid DNA. The results obtained in this work could indicate a dose-dependent protective action against the SnCl2 and a genotoxic effect of C. icaco extract on plasmid DNA

Comparação de efeitos dos extratos de Hypericum perforatum (Hipérico) e de Mentha crispa (Hortelã) em diferentes modelos experiemtais

Several clinic evaluations have been possible with radiobiocomplexes labeled with technetium-99m (99mTc). Some natural and synthetic drugs are capable of to interfere on the labeling of blood constituents with 99mTc, as well as on the biodistribution of radiobiocomplexes. Authors have also reported about the toxicity of several natural products. The aim of this study was to compare the effects of the Mentha crispa (hortelã) and of the Hypericum perforatum (hipérico) in different experimental models. On the labeling of red blood cells (RBC) and plasma and cellular proteins with 99mTc, both extracts were capable of to decrease the radioactivity percentage on the cellular compartment and on the fixation on plasma and cellular proteins. On the morphometry of the RBC, only the hortelã was capable to alter the shape and the perimeter/area ratio of the RBC. On the biodistribution of the radiobiocomplex sodium pertechnetate (Na99mTcO4), the hortelã increased the Na99mTcO4 distribution in the kidney, spleen, liver and thyroid, meanwhile the hipérico decreased the Na99mTcO4 distribution in the bone, stomach, lungs and thyroid, and increased the Na99mTcO4 distribution in the pancreas. On the bacterial cultures survival, the hipérico was capable of to protect the bacteria against the stannous chloride (SnCl2) effect. The hipérico did not alter the topology of plasmidial DNA and did not protect the plasmidial DNA against the SnCl2 action. Probably, the effects presented by both extracts could be due to chemical compounds of the extracts that could alter the morphology of the RBC and the plasma membrane ions transport, and/or by phytocomplexes that could be formed with different effects dependent on the biological system considered

Efeito de preparações de produtos naturais (cravo da índia e tomate) e de um produto sintético na marcação de constituintes sangüineos com tecnécio-99m e na morfologia de hemácias isoladas de sangue de ratos wistar

There are strong interests in the evaluation of the biological effects of natural and synthetic products. Blood constituents labeled with technetium-99m (99mTc) are used in nuclear medicine. The aim of this work was to study the effects of Clove (Caryophyllus aromaticas L.) and OZE (preparation used in the Health Sciences) on the labeling blood constituents with 99mTc and on the morphologic red blood cells (RBC) and the action of an extract of tomato (TO) on the labeling of blood constituents Blood samples were incubated with clove or OZE or TO, stannous chloride and 99mTc. Plasma (P), blood cells (BC), insoluble fractions (IF) of plasma and blood cells were separated. The radioactivity was counted and percentage of radioactivity (%ATI) to each blood fraction was calculated. The shape and morphometric parameter (perimeter/area ratio) were evaluated in the studies with clove and OZE. Clove extract and OZE altered significantly (p<0.05) the %ATI of blood constituents and the shape of red blood cells. However, clove extract not altered the red blood cells perimeter/area ratio. The tomato extract used at the highest concentrations reduced significantly (p<0.05) the %ATI in IF-P, although this extract did not modify the radiolabeling on BC, neither the radioactivity fixation on IFBC. The results indicate that these chemical compounds would have oxidative/chelating actions

Efeitos de um extrato aquoso de buzhong yi qi wan (fórmula magistral chinesa) na marcação de constituintes sanguíneos com tecnécio-99m, na morfologia e na fragilidade osmótica de hemácias de ratos Wistar

Technetium-99m (99mTc) has been used to obtain several radiobiocomplexes utilized to aid in the diagnosis of diseases. Blood constituents, as red blood cells (RBC) and plasma proteins, have been labeled with 99mTc. Natural and synthetic drugs can alter the labeling of these constituents. The aim of this work was to investigate the possibility of a Buzhong YiQi Wan extract to alter (i) the labeling of blood constituents with 99mTc, (ii) the RBC morphology, and (iii) osmotic fragility of RBC withdrawn from Wistar rats. The data showed that the BYQW extract (i) could affect labeling of blood constituintes with 99mTc, (ii) could affect the membrane integrity decreasing the osmotic resistance and (iii) could not alter the shape of RBC. Probably, these findings would be associated with properties of the substances present in the aqueous extract of BYQW. This study has multiple disciplinary aspects in knowledge areas: Radiobiology, Botanic, Phytotherapy and Haematology

Avaliação de efeitos de um extrato aquoso de cinnamomum zeylanicum L. na marcação de constituintes sanguíneos com tecnécio-99m e na morfologia das hemácias de ratos wistar

Radiobiocomplexes are used to obtain images in nuclear medicine and employed in basic research. Blood constituents labeled with technetium-99m (99mTc) have also been employed as radiobiocomplexes and used also experimental model for evaluation of the biological effects of natural or synthetic drugs. The analysis of the morphology and the morphometrics parameters (perimeter/área ratio) can be used to evaluate the effects of drugs upon the structure of the membrane of red blood cells. Cinnamomum zeylanicum (cinnamon) is a spice used as herbal medicine to treat diseases. The aim of this study was to evaluate the effect of in vitro and in vivo treatment with an aqueous cinnamon extract on the labeling of blood constituents with 99mTc and on the morphology of red blood cells from Wistar rats. In the in vitro treatment, isolated blood sample from animals were incubated with cinnamon extract. In the in vivo treatment, blood samples were also withdrawn from animals treated with cinnamon extract. In both cases, the radiolabeling of blood constituents was done. The morphological analysis of red blood cells was also done. As control, blood or animals treated with NaCl 0.9%. The data obtained on the labeling of blood constituents with 99mTc experiments indicated that the in vitro treatment with cinnamon extract was capable to decrease signiicantly (p<0.05) the percentage of radioactivity in cellular compartments and on the fixation of cellular and plasma proteins. These effects were not observed on the in vivo treatment. The results obtained for the morphology of red blood cells suggest that the in vitro and in vivo treatments did not alter the morphology and the perimeter/area ratio. The in vitro treatment with aqueous cinnamon extract could affect the membrane structures related with the oxidation status of the stannous ion pertechnetate ion, altering the labeling of blood constituentes with 99mTc. This study was a multidisciplinary experimental research. It was developed with the contribution of the different Departments and Services of the Hospital Universitário Pedro Ernesto of the Universidade do Estado do Rio de Janeiro

Efeitos de um extrato aquoso de lantana camara (Cambará de espinho) na marcação de constituintes sanguíneos com técnecio-99m e na morfologia de hemácias de ratos-wistar

Medicinal plants have been studied and used in the world. Lantana camara has medicinal properties and it has been used in folk medicine. The aim was to verify the effect of a lantana extract on the labeling of blood constituents with 99mTc, and to evaluate the effect of an aqueous extract of Lantana camara on the morphology of RBC withdrawn from Wistar rats. The results showed that lantana extract has decreased the fixation of radioactivity on the IF-P. This effect was not observed in the BC compartment and in IF-BC. The BC-%ATI was decreased in all concentrations tested when the BC was washed. The osmotic fragility assay and morphological analysis were carried out. In presence of the extract, the data obtained indicated that (i) an increase of the hemolysis and (ii) modifications on the morphology of RBC. These effects of the Lantana camara could be associated with some pharmacological properties of the chemical compounds of this studied extract