13N-NH3 PET: The assessment of myocardial perfusion in patients with AMI and stem cell therapy
Massimo CastellaniCristina CanziVirgilio LongariRosaria GiordanoDavide SoligoAlessandro ColomboSimone PalatresiMarco CarlettoPaolo RebullaPaolo Gerundini
1
Citation
0
Reference
20
Related Paper
Citation Trend
Abstract:
7 Objectives: To assess the changes of myocardial perfusion after intracoronary bone marrow stem cells injection following a recent AMI. Methods: Fifteen patients (14M; mean age: 52 yrs; range: 30-64) were enrolled within 7 days after ST segment elevation AMI. The patients were randomly submitted to intracoronary injection of cells derived from autologous bone marrow (BM;5) or mobilized from peripheral blood (PB;5); the remaining 5 patients were treated with standard medical therapy alone and considered as controls (C). 13N-NH3 PET study was performed within 7 days after AMI and after 12 months from therapy. The 13N-NH3 uptake in infarct related segments was assessed on a 9-region model polar map of the heart with 5-level uptake score (summed rest score;SRS). The infarct size (IS) was expressed as the percentage of the polar map with a tracer uptake lower than 50% of the maximum. The myocardial blood flow (MBF) was calculated by means of Munich Heart software and expressed in mL/mg/min. Results: At present, 12/15 patients completed the study and a decrease of the SRS was observed in all groups, although a more pronounced reduction was seen in BM group (table). Accordingly, a major decrease in infarct size was seen in these patients. The improvement of MBF was observed in the infarct-related areas of BM group whereas a moderate or mild decrease was respectively seen in PB and C patiens. A re-infarction occurred in 1 PB patient, whereas one C patient underwent heart transplantation. Stable clinical conditions were noted in the remaining 10 patients. Conclusions: 13N-NH3 PET is able to detect the changes of myocardial perfusion in patients with and without intracoronary bone marrow stem cells injection. The reduction of perfusion in PB patients should be considered in the treatment of AMI with bone marrow stem cells therapy.Keywords:
Stem Cell Therapy
Cite
Objective To discuss the value of leukocyte-targeted myocardial contrast echocardiography (MCE) as a tool in observing the degree of acute rejection after heart transplantation. Methods Abdominal heterotopic cardiac transplantation was performed on 32 rats successfully, among which 8 isografts served as group A, and groups B, C and D involved 8 allografts respectively. The rats in groups B and C were treated with cyclosporine A (CsA) at a high dose (10mg· kg-1 · day-1 ), a low dose (3 mg · kg-1 · day-1 ) from 3rd day before transplantation respectively.The rats in groups A and D were untreated with CsA. MCE was performed during continuous intravenous SonoVue injection postoperatively on the third day after operation. We performed 2 types of MCE: perfusion imaging and leukocyte-targeted imaging. The images were obtained at 20 s and 5 min after injection of contrast agent. The value of the contrast image grayscale (GS) was measured by image analyzer (GS20s, GS5 min). GStarget was calculated as the GS5min minus the GS20s in the same rat.Postmortem histology was performed after observation. The degree of myocardial rejection was determined by HE-stained graft myocardium. Immunohistochemistry was performed to quantify the CD3-positive cells, and correlation analysis was performed between CD3-positive cell count and GS20s,GS5min, GStarget. Results Perfusion imaging showed no significant difference in myocardial GS20s of each group. Leukocyte-Targeted imaging exhibited a clear gradient in these groups (P＜0. 05). There was significant difference in GStarget of each group (P＜0. 001). Postmortem histology showed 0- Ⅰ grade rejection in group A, Ⅰ -Ⅱ grade rejection in group B, Ⅱ-Ⅲ grade rejection in group C, Ⅲ-Ⅳ grade rejection in group D. Immunohistochemistry revealed the CD3-positive cell infiltration was increased in turn from the group A to the group D. There was a significantly positive correlation between the CD3-positive cell count and GStarget ( r = 0. 86, P ＜ 0. 001 ). Conclusion Leukocyte-targeted contrast echocardiography may thus offer a noninvasive and effective ultrasound imaging technique for detecting the degree of acute cardiac transplant rejection.
Key words:
Heart transplantation; Graft rejection; Myocardium; Ultrasonography
Histology
Cite
Citations (0)
Objective: To investigate the clinical study of hepatic arterial infusion of stem cells in treatment of patients with decompensated cirrhosis. Methods: The cord blood 100- 120 m L of the healthy pregnant women giving birth in our hospital was collected. In strict accordance with the kit instructions,umbilical cord blood stem cell suspension 10 m L was isolated. Modified Seldinger technique using percutaneous femoral artery catheterization was used to place the tube in the common hepatic artery for angiography,space- occupied lesions were excluded and intrahepatic vascular conditions were observed. Further in- depth catheter in the hepatic artery,the prepared stem cell suspension 10 m L was slowly injected into within 20- 30 min. After the treatment,all patients were monitored with persistent ECG 12 h,and given conventional drugs to hepatoprotection,anti- virus,albumin infusion and other symptomatic treatment. Results: After the treatment,the patient's liver function was improved significantly,ALT,AST,TBIL,G levels were decreased significantly compared with those before the treatment,A and PT levels were increased compared with those before the treatment,and the differences were statistically significant. The immune parameters showed that CD3,CD8,CD25,Ig G,and Ig A were increased compared with those before the treatment,and the differences were statistically significant. The liver imaging displayed that maximum cross- sectional area of the liver and liver unenhanced CT values were improved compared with those before the treatment,and the differences were statistically significant( P 0. 05). All patients had no serious adverse reactions. Conclusions: Hepatic arterial infusion of stem cells in the treatment of decompensated cirrhosis can improve liver function in the patients,restore immune damages,and improve the patient's liver morphology,and has small adverse reactions.
Liver function
Cord blood
Cite
Citations (0)
Liver Cancer
Arterial perfusion
Liver tumor
Cite
Citations (5)
Objective Using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to evaluate the hemodynamic perfusion characteristics of bone marrow infiltration in patients with acute leukemia (AL). Methods Forty-seven patients with AL received coronal pelvic T1WI DCE-MRI with fast low angle shot (FLASH) sequence. Among them, 25 were initial onset untreated (IOU) patients, 22 were treated AL patients, including 14 with complete remission (CR) and 8 with non-remission ( NR). The hemodynamic perfusion parameters including maximum percentage of enhancement ( Emax ) and slope were determined based on enhancement-time curves ( ETCs ) of iliac and lumbar vertebra. The proportion of marrow myeloblasts was recorded. For all patients, quantitative perfusion parameters of bone marrow infiltration in ilium were compared with those in lumbar. The values of Emax and ES were compared among IOU,CR and NR patients. Correlations between perfusion parameters and histopathological results were assessed. Results In all the 47 patients, the Emax values of bilateral iliac bone marrow ( 15.70 ± 7.06)were slightly higher than that of lumbar bone marrow ( 11. 28 ± 5.52 ), and the difference was statistically significant (P ＜0. 01 ). There was no significant difference in the slop value between bilateral iliac bone marrow (0. 82 ± 0. 12 ) and lumbar bone marrow (0. 80 ± 0. 09 ) ( P ＞ 0. 05 ). In the 25 untreated patients,the Emax and slop values were 17. 15 ± 5.75 and 0. 98 ± 0. 13, respectively; in the 14 CR patients, they were 8. 76 ±3.93 and 0. 26 ± 0. 04, respectively, and in the 8 NR patients, they were 21.62 ± 6. 50 and 1. 38 ± 0. 02, respectively. There was significant difference in the Emax and slop values among the three groups (P＜0. 05). Compared with IOU and NR patients, both the Emax and slop values decreased significantly in iliac bone marrow of AL patients with CR (P ＜ 0. 05 ). There was no significant difference between IOU and NR patients ( P ＞ 0. 05 ). A significant positive correlation was found between Emax value of iliac bone marrow and the proportion of marrow myeloblasts ( r ＝0. 501 ,P ＜0. 05 ). There was a negative correlation between slop value of iliac bone marrow and the proportion of marrow myeloblasts ( r ＝0. 235 ,P ＞0.05). ConclusionsDCE-MRI can be used for evaluating the hemedynamic characteristics of microcirculation of bone marrow infiltration in patients with AL, which can provide useful information in evaluating prognosis and monitoring therapeutic effect.
Key words:
Acute leukemia; Bone marrow; Infiltration; Dynamic contrast enhancement; Magnetic resonance imaging
Infiltration (HVAC)
Cite
Citations (0)
Thallium
Ventricular Function
Myocardial imaging
Cite
Citations (1)
Purpose Physiological myocardial accumulation of FDG impairs the diagnosis of inflammatory/infectious or tumoral myocardial detection by FDG PET/CT. We prospectively evaluated the addition, 3 hours before imaging, of an intravenous 100-mL lipid emulsion infusion (Intralipid) to a high-fat, low-carbohydrate diet (HFLCD) for at least 2 meals followed by a fast of at least 6 to 12 hours in patients referred for the diagnosis of myocardial inflammation, endocarditis, cardiac or paracardiac masses, intracardiac device, or prosthetic valve infections. Methods Data of 58 patients consecutively included (28 Intralipid patients, 30 controls with HFLCD alone) were compared. FDG uptake in normal myocardium was scored from 0 (complete myocardial suppression) to 3 (high diffuse uptake). Myocardial maximal, peak, and mean SUV and the rate of interpretable images according to the clinical indication were measured. Results Compared with controls, Intralipid infusion significantly improved the rate of score 0 (89% vs 63%, P = 0.021), of interpretable images according to the clinical indication (100% vs 72%, P = 0.0047) and decreased all myocardial SUV values (eg, SUVmax median, 1.9 [interquartile range, 1.7–2.5] vs 3.1 [interquartile range, 2.3–4.1]; P < 0.001). Conclusions A lipid emulsion infusion in addition to HFLCD better suppresses cardiac glucose metabolism than HFLCD alone.
Interquartile range
Cardiac PET
Lipid emulsion
Carbohydrate Metabolism
Cite
Citations (10)
Objective To analyze the clinical value of perfusion CT parameters in the assessment of the effect of the treatment and prediction of prognosis of lung cancer.Methods A total of 106 lung cancer patients in Baoding Second Hospital from Jan.2009 to Sep.2012 were selected for this study.The patients were divided into chemotherapy group and radiotherapy group according to random number table mehtod,53patients in each groups.Chemotherapy:Oxaliplatin 130mg/m2,injected every 21 days,combined with vinorelbine 25 mg/m2,which were given on the 1st day and the 8th day,the circulation was 21 days.Radiotherapy:on 5 consecutive days every week,2 Gy per time,6 weeks in total.The application of CT perfusion parameters in patients who received chemotherapy and radiotherapy,and the influence of blood volume of the tumor tissue,blood flow of the tumor tissue,surface permeability of the vessels on the prognosis were observed.Results In patients of valid and invalid chemotherapy treatment,the blood flow of the tumor tissue,the blood volume of the tumor tissue,the surface permeability of the vessels were[(64.19 ± 32.95)mL/(min·100 g)vs(66.54 ± 33.26) mL/(min·100 g)],[(5.22 ± 2.13) min/100 g vs(5.36 ±1.92) mL/100 g],[(14.34 ± 8.72)min/100 g vs(14.67 ± 5.43) min/100 g](P 0.05) respectively;in patients of valid and invalid radiotherapy treatment,the blood flow of the tumor tissue,the blood volume of the tumor tissue,the surface permeability of the vessels were[(51.09 ± 29.64)mL/(min·100 g)vs(65.83± 32.78) mL/(min·100 g)],[(3.83 ± 2.15) min/100 g vs(5.26 ± 1.17) mL/100 g],[(8.16 ±5.37)min/100 g vs(15.14 ± 5.65)min/100 g](P 0.05) respectively;;among 68 lung cancer patients,47 had decreased surface permeability,21 had increased surface permeability,the overall survival of the former was higher than the latter[(16.27 ± 5.42)months vs(8.95 ± 3.86)]months(P 0.05).Conclusion The change of CT perfusion parameters can assess the effect of the radiotherapy treatment and predict the prognosis of lung cancer,while it has no such value for chemotherapy.
Vinorelbine
Cite
Citations (0)
To observe the effect of Modified Yiqi Chutan Recipe (MYCR) on blood flow perfusion in treating mid-late stage non-small cell lung cancer (NSCLC) patients by using multislice CT perfusion (CTP) , and to assess the relationship between each CTP parameter and the prognosis as well.Totally 87 mid-late stage NSCLC patients were randomly assigned to the treatment group (44 cases, Shenyi Capsule + MYCR +chemotherapy) and the control group (43 cases, chemotherapy alone) in the ratio of 1:1. And 21 days consisted of 1 therapeutic course, 4 courses in total. All of them underwent CTP of primary tumor and routine thoracic CT examination (plain CT and enhancement CT) 3 times (before therapy, after 2 and 4 cycles). CT findings were analyzed for tumor size and perfusion parameters [blood flow (BF), blood volume (BV), permeability surface (PS), mean transit time (MTT), and time to peak (TP) before and after treatment, and relationship between perfusion parameters and prognosis was also assessed.In 87 cases, 7 dropped out and 80 cases were available, 40 in the treatment group and 40 in the control group. (1) The relief rate was 47.5% (19/40) and the total stable rate was 77.5% (31/40) in the treatment group, and they were 40.0% (16/40) and 65.0% (26/40) in the control group, with no statistical difference between the two groups (χ² = 0.672, 1.227; P > 0.05). (2) Compared with before treatment group in the same group, BF and PS decreased, and MTT increased in the two groups after 2 and 4 courses (P < 0.05); BE and PS decreased, and MTT increased in the control group after 2 courses (P < 0.05). Compared with the control group after 4 courses, BE decreased more significantly in the treatment group (P < 0.05). (3) After 4 courses, all patients were assigned to the remission group (35 cases) and the non-remission group (45 cases) according to the RECIST standard. Compared with before treatment in the same group, BF, BF, and PS all decreased, and MTT increased in the remission group after treatment (all P < 0.05); BF increased in the non-remission group after treatment (P < 0.05). (4) All patients were assigned to the BE increase group (34 cases) and the BE decrease group (46 cases) according to changed BE values after treatment. Results showed the mean survival rate was 246 days in the BF increase group (the 1-year accumulative survival rate being 13.0%) and 387 days in the BE decrease group (the 1-year accumulative survival rate being 53.1%). The life span was prolonged and the 1-year accumulative survival rate was elevated in the BE increase group, with statistical difference as compared with the BE decrease group (χ² = 19.057, P < 0.01).Shenyi Capsule plus MYCR could reduce BE in mid-late stage NSCLC patients , improve vascular permeability, showing better synergistic effect with chemotherapy. CTP could not only reflect the change of tumor size, but also reflect vascular function of the tumor. Meanwhile, changes of CTP parameters were closely associated with prognosis. Patients with post-treatment decreased BE value had better prognosis and longer life span.
Cite
Citations (4)
1666 Objectives Myocardial perfusion imaging has previously been used to evaluate the radiation induced heart diseases. However, clinical follow-up about radiation induced heart disease is affected by many factors, such as, individual differences, therapeutic protocols, and follow-up time, et al. In this study, we used gated myocardial perfusion imaging to observe the variation of perfusion of beagles irradiated anterior myocardium. Methods Eight adult male beagle weighting 13-14kg as the research object, a single 20 Gy radiation guided by imaging was used of which left anterior myocardial to induced heart injury, 13N-NH3 PET/CT scintigraphy were performed 1 week before and 3, 6 months after irradiation respectively. The ratio of the RAig / RAni(irradiated region /Nor-irradiated region) are quantitative analyzed, LVEF was calculated by software. Myocardial perfusion and functional were observed dynamically before radiotherapy and different periods of post-radiotherapy. Results Myocardial perfusion imaging was normal before irradiation. Myocardial perfusion imaging showed perfusion increased in the heart irradiated areas compared to non-irradiated areas 3 months after irradiation. With the follow-up time, perfusion reduced gradually in irradiation area 6 months after irradiation. The ratios of the RAig / RAni were 0.98±0.09, 1.21±0.15, 0.96±0.25 respectively at baseline, 3 months and 6 months after irradiation (P Conclusions 13N-NH3 PET/CT scintigraphy provide an method to monitor the early injury of radiation induced heart disease. 3 months after irradiation, myocardial perfusion increased is found for the first time in experimental study, the subsequent change of myocardial perfusion requiring further observation, and its clinical significance needs further study.
Myocardial perfusion scintigraphy
Beagle
Cite
Citations (0)
The feasibility of imaging the inflammatory response to acute transmural myocardial infarction in man using biologically active indium-111 (111In)-labeled autologous leukocytes was assessed in 36 patients. Indium-111 leukocytes (approximately 500 microCi) were injected i.v. 18-112 hours after the onset of chest pain. Cardiac imaging was performed 24 hours later with a mobile gamma camera. Twenty-one patients had positive images and 15 had negative images. The percent of positive images increased as the interval between infarction and 111In-leukocyte injection shortened; all patients injected within 24 hours of infarction had positive images. Patients with positive images were injected with 111In leukocytes earlier after infarction (mean +/- SEM, 43 +/- 4 vs 63 +/- 7 hours; p less than 0.05) and were younger (53 +/- 2 vs 65 +/- 3 years; p less than 0.05) than those with negative images. Several other parameters that could possibly have affected the imaging results were examined and were not significantly d...
Myocardial imaging
Inflammatory response
Cite
Citations (0)