Rayjanah Allie - Academia.edu (original) (raw)

Papers by Rayjanah Allie

The Journal of Nuclear Medicine, May 1, 2012

Nuclear Medicine Communications, Apr 1, 2020

In late 2019, a novel coronavirus was isolated from a cluster of patients presenting with viral p... more In late 2019, a novel coronavirus was isolated from a cluster of patients presenting with viral pneumonia in Wuhan, China 1. With increasing global population movement, there has been a great deal of concern regarding the possibility that this new virus may spread and reach pandemic levels 2. While the initial cluster of patients were believed to have caught the virus from the wet "seafood market" in Wuhan. There have since been multiple reports of person-to-person transmission 3 and it has reached multiple countries in virtually all continents, with new countries affected reported almost daily 4. Primarily COVID-19 spreads in a similar way to flu.

Journal of Nuclear Cardiology, Jan 30, 2014

We have assessed whether additional upright imaging increases the confidence of interpretation of... more We have assessed whether additional upright imaging increases the confidence of interpretation of stress only supine myocardial perfusion imaging (MPI) in obese patients. Tc-MIBI stress MPI of 101 consecutive patients (M = 49, 62 ± 12 years) with BMI ≥30 scanned on the D-SPECT cardiac camera were assessed. Images were interpreted as diagnostic or equivocal and the need for a rest study was recorded. Stress supine MPI was interpreted first, then gated and finally upright data were added. Defects on supine but not on upright were defined as artefacts and defects seen on both as abnormal. The total perfusion deficit (TPD) was also quantified. There were 27 normal, 22 abnormal, and 52 equivocal supine scans. The median EF was 52%, unaffecting the need for rest imaging. Upright imaging reclassified 32/52 (62%) equivocal studies as normal and 6/52 (11%) as abnormal (P < 0.001). Rest scan was deemed needed in 74/101 patients on supine vs 42/101 on supine/upright (P < 0.001). Supine TPD was normal in 53 and supine/upright TPD was normal in 70 patients (P < 0.001). Supine stress MPI is inadequate in obese patients. The addition of upright imaging significantly increases the ability to interpret scans as diagnostic and may reduce considerably the need for rest imaging.

The Journal of Nuclear Medicine, May 1, 2013

The Journal of Nuclear Medicine, May 1, 2012

The Journal of Nuclear Medicine, May 1, 2011

Nuclear Medicine Communications, Feb 1, 2014

The aim of the study was to evaluate the value of single-photon emission computerized tomography/... more The aim of the study was to evaluate the value of single-photon emission computerized tomography/computed tomography (SPECT/CT) in the clinical assessment of painful knee prostheses. Between 2009 and 2011 we identified 105 patients who had undergone Tc-hydroxydiphosphonate SPECT/CT for painful knee prosthesis. Complete follow-up data were available for 69 patients (50 women and 19 men; mean age, 71 years) with painful knee prostheses (59 total, nine unicompartmental, one patellofemoral) and clinical suspicion of infection or loosening. The imaging test report in conjunction with the clinical data from the patient's notes was used to gauge how useful the test had been in terms of patient management. SPECT/CT confirmed the suspected clinical diagnosis of loosening in nine patients (13%) and of infection in two (2.9%) and identified other causes in 43 patients (62.3%). In 85.5% of patients, SPECT/CT was clinically useful (both positive and negative results), whereas in 14.5% it had no clinical impact on patient management. Revision surgery was performed in 24/69 (34.8%) patients and confirmed the SPECT/CT diagnosis in 21 patients (seven loosening, one infection, two subchondral fractures, two postoperative inflammation and nine patellofemoral osteoarthritis). SPECT/CT is a useful tool for the evaluation of painful knee prosthesis in 85.5% of cases and helps in confirming mechanical loosening and in excluding other causes such as infection and patellofemoral osteoarthritis.

Journal of Nuclear Cardiology, Sep 24, 2015

Myocardial perfusion imaging (MPI) is a well-established and widely used imaging technique for th... more Myocardial perfusion imaging (MPI) is a well-established and widely used imaging technique for the assessment of patients with known or suspected coronary artery disease. Pitfalls and artifacts associated with conventional gamma cameras are well known and the ways to avoid and correct them have been described. In recent years solid-state detector dedicated cardiac cameras were introduced and have been shown to offer improved accuracy in addition to new imaging protocols and novel applications. The purpose of this manuscript is to familiarize the readers with the causes and effects of technical, patient related and operator-related pitfalls and artifacts associated with the D-SPECT dedicated cardiac camera with solid-state detectors. The manuscript offers guidance on how to avoid these factors, how to detect them and how to correct better for them, providing high-quality diagnostic images. 3 Abbreviations list MPI-myocardial perfusion imaging CAD-coronary artery disease CZT-Cadmium Zinc telluride LEHR-Low energy high resolution QC-quality control ROI-region of interest LV-left ventricle RFID-radiofrequency identification

Nuclear Medicine Communications, Dec 16, 2022

Nuclear Medicine Communications, Aug 1, 2014

European Journal of Nuclear Medicine and Molecular Imaging

Strategy planning in nuclear medicine imaging in uncertain times can be a challenging task. In th... more Strategy planning in nuclear medicine imaging in uncertain times can be a challenging task. In the traditional strategicplanning model, managers attempt to forecast how the imaging landscape will evolve and how competitors will respond. They then define a multi-year plan to position their departments in this envisaged future state. That model worked well when the health landscape and economies were more stable, and the primary factors influencing future growth and expansion were easier to forecast. However, the world and the health landscape are changing so quickly that no service can plan for every eventuality. A critical aspect of strategic imaging planning is identifying and assessing the potential risks and uncertainties that departments may face. These include economic downturns; technological changes; patient needs, preferences, and expectations; and regulatory changes. By identifying and analyzing these risks and remaining flexible and adaptable, managers can develop contingency plans to mitigate their potential impact on departments. This article offers a different approach and mindset for making strategic decisions and a model for managing strategy development and performance monitoring. In summary, strategy planning in imaging in uncertain times requires careful consideration; the use of tools and techniques such as risk assessment and scenario planning and a focus on flexibility, adaptability, clear vision, effective communication, and ongoing monitoring and evaluation. By following these principles, leaders can create a plan that helps their imaging department navigate uncertain times and emerge stronger.

Nuclear Medicine Communications

The International Journal of Cardiovascular Imaging, 2012

Background. We measured myocardial blood flow (MBF) and perfusion reserve (MPR) by dynamic CZT-SP... more Background. We measured myocardial blood flow (MBF) and perfusion reserve (MPR) by dynamic CZT-SPECT and 82 Rb-PET in patients with suspected or known coronary artery disease (CAD) and compared the accuracy of the two methods in predicting obstructive CAD. Methods. Twenty-five patients with available coronary angiography data underwent 99m Tcsestamibi CZT-SPECT and 82 Rb-PET cardiac imaging. Stress and rest MBF and MPR were calculated by both methods and compared. Diagnostic accuracies of CZT-SPECT and PET were also assessed using a receiver-operator-characteristic curve. Results. CZT-SPECT yielded similar baseline MBF, but higher hyperemic MBF and MPR values compared to PET. There was a modest correlation between the two methods for MPR (r = 0.56, P < .01). MPR by CZT-SPECT showed a good ability in identify a reduced MPR by PET, with an area under the curve of 0.85. A MPR cutoff of 2.5 was identified by CZT-SPECT for detection of abnormal MPR by PET, with a sensitivity, specificity and accuracy of 86%, 73% and 80%. The area under the curve for the identification of obstructive CAD by regional MPR were 0.83 for CZT-SPECT and 0.84 for PET (P = .90). At CZT-SPECT, a regional MPR of 2.1 provided the best trade-off between sensitivity and specificity for identifying obstructive CAD. Diagnostic accuracy of CZT-SPECT and PET using respective cutoff values was comparable (P = .62). Conclusion. Hyperemic MBF and MPR values obtained by CZT-SPECT are higher than those measured by 82 Rb-PET imaging, with a moderate correlation between the two methods. CZT-SPECT shows good diagnostic accuracy for the identification of obstructive CAD. These findings may encourage the use of this new technique to a better risk stratification and patient management. (J Nucl Cardiol 2020) Electronic supplementary material The online version of this article (

Nuclear Medicine Communications, 2014

The aim of the study was to evaluate the value of single-photon emission computerized tomography/... more The aim of the study was to evaluate the value of single-photon emission computerized tomography/computed tomography (SPECT/CT) in the clinical assessment of painful knee prostheses. Between 2009 and 2011 we identified 105 patients who had undergone Tc-hydroxydiphosphonate SPECT/CT for painful knee prosthesis. Complete follow-up data were available for 69 patients (50 women and 19 men; mean age, 71 years) with painful knee prostheses (59 total, nine unicompartmental, one patellofemoral) and clinical suspicion of infection or loosening. The imaging test report in conjunction with the clinical data from the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s notes was used to gauge how useful the test had been in terms of patient management. SPECT/CT confirmed the suspected clinical diagnosis of loosening in nine patients (13%) and of infection in two (2.9%) and identified other causes in 43 patients (62.3%). In 85.5% of patients, SPECT/CT was clinically useful (both positive and negative results), whereas in 14.5% it had no clinical impact on patient management. Revision surgery was performed in 24/69 (34.8%) patients and confirmed the SPECT/CT diagnosis in 21 patients (seven loosening, one infection, two subchondral fractures, two postoperative inflammation and nine patellofemoral osteoarthritis). SPECT/CT is a useful tool for the evaluation of painful knee prosthesis in 85.5% of cases and helps in confirming mechanical loosening and in excluding other causes such as infection and patellofemoral osteoarthritis.

Journal of the American College of Cardiology, 2014

Journal of Nuclear Cardiology, 2014

We have assessed whether additional upright imaging increases the confidence of interpretation of... more We have assessed whether additional upright imaging increases the confidence of interpretation of stress only supine myocardial perfusion imaging (MPI) in obese patients. Tc-MIBI stress MPI of 101 consecutive patients (M = 49, 62 ± 12 years) with BMI ≥30 scanned on the D-SPECT cardiac camera were assessed. Images were interpreted as diagnostic or equivocal and the need for a rest study was recorded. Stress supine MPI was interpreted first, then gated and finally upright data were added. Defects on supine but not on upright were defined as artefacts and defects seen on both as abnormal. The total perfusion deficit (TPD) was also quantified. There were 27 normal, 22 abnormal, and 52 equivocal supine scans. The median EF was 52%, unaffecting the need for rest imaging. Upright imaging reclassified 32/52 (62%) equivocal studies as normal and 6/52 (11%) as abnormal (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Rest scan was deemed needed in 74/101 patients on supine vs 42/101 on supine/upright (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Supine TPD was normal in 53 and supine/upright TPD was normal in 70 patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Supine stress MPI is inadequate in obese patients. The addition of upright imaging significantly increases the ability to interpret scans as diagnostic and may reduce considerably the need for rest imaging.

Journal of Nuclear Cardiology, 2015

Myocardial perfusion imaging (MPI) is a well-established and widely used imaging technique for th... more Myocardial perfusion imaging (MPI) is a well-established and widely used imaging technique for the assessment of patients with known or suspected coronary artery disease. Pitfalls and artifacts associated with conventional gamma cameras are well known and the ways to avoid and correct them have been described. In recent years solid-state detector dedicated cardiac cameras were introduced and have been shown to offer improved accuracy in addition to new imaging protocols and novel applications. The purpose of this manuscript is to familiarize the readers with the causes and effects of technical, patient related and operator-related pitfalls and artifacts associated with the D-SPECT dedicated cardiac camera with solid-state detectors. The manuscript offers guidance on how to avoid these factors, how to detect them and how to correct better for them, providing high-quality diagnostic images. 3 Abbreviations list MPI-myocardial perfusion imaging CAD-coronary artery disease CZT-Cadmium Zinc telluride LEHR-Low energy high resolution QC-quality control ROI-region of interest LV-left ventricle RFID-radiofrequency identification

The Journal of Nuclear Medicine, 2012

The Journal of Nuclear Medicine, 2012

The Journal of Nuclear Medicine, May 1, 2012

Nuclear Medicine Communications, Apr 1, 2020

In late 2019, a novel coronavirus was isolated from a cluster of patients presenting with viral p... more In late 2019, a novel coronavirus was isolated from a cluster of patients presenting with viral pneumonia in Wuhan, China 1. With increasing global population movement, there has been a great deal of concern regarding the possibility that this new virus may spread and reach pandemic levels 2. While the initial cluster of patients were believed to have caught the virus from the wet "seafood market" in Wuhan. There have since been multiple reports of person-to-person transmission 3 and it has reached multiple countries in virtually all continents, with new countries affected reported almost daily 4. Primarily COVID-19 spreads in a similar way to flu.

Journal of Nuclear Cardiology, Jan 30, 2014

We have assessed whether additional upright imaging increases the confidence of interpretation of... more We have assessed whether additional upright imaging increases the confidence of interpretation of stress only supine myocardial perfusion imaging (MPI) in obese patients. Tc-MIBI stress MPI of 101 consecutive patients (M = 49, 62 ± 12 years) with BMI ≥30 scanned on the D-SPECT cardiac camera were assessed. Images were interpreted as diagnostic or equivocal and the need for a rest study was recorded. Stress supine MPI was interpreted first, then gated and finally upright data were added. Defects on supine but not on upright were defined as artefacts and defects seen on both as abnormal. The total perfusion deficit (TPD) was also quantified. There were 27 normal, 22 abnormal, and 52 equivocal supine scans. The median EF was 52%, unaffecting the need for rest imaging. Upright imaging reclassified 32/52 (62%) equivocal studies as normal and 6/52 (11%) as abnormal (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Rest scan was deemed needed in 74/101 patients on supine vs 42/101 on supine/upright (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Supine TPD was normal in 53 and supine/upright TPD was normal in 70 patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Supine stress MPI is inadequate in obese patients. The addition of upright imaging significantly increases the ability to interpret scans as diagnostic and may reduce considerably the need for rest imaging.

The Journal of Nuclear Medicine, May 1, 2013

The Journal of Nuclear Medicine, May 1, 2012

The Journal of Nuclear Medicine, May 1, 2011

Nuclear Medicine Communications, Feb 1, 2014

The aim of the study was to evaluate the value of single-photon emission computerized tomography/... more The aim of the study was to evaluate the value of single-photon emission computerized tomography/computed tomography (SPECT/CT) in the clinical assessment of painful knee prostheses. Between 2009 and 2011 we identified 105 patients who had undergone Tc-hydroxydiphosphonate SPECT/CT for painful knee prosthesis. Complete follow-up data were available for 69 patients (50 women and 19 men; mean age, 71 years) with painful knee prostheses (59 total, nine unicompartmental, one patellofemoral) and clinical suspicion of infection or loosening. The imaging test report in conjunction with the clinical data from the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s notes was used to gauge how useful the test had been in terms of patient management. SPECT/CT confirmed the suspected clinical diagnosis of loosening in nine patients (13%) and of infection in two (2.9%) and identified other causes in 43 patients (62.3%). In 85.5% of patients, SPECT/CT was clinically useful (both positive and negative results), whereas in 14.5% it had no clinical impact on patient management. Revision surgery was performed in 24/69 (34.8%) patients and confirmed the SPECT/CT diagnosis in 21 patients (seven loosening, one infection, two subchondral fractures, two postoperative inflammation and nine patellofemoral osteoarthritis). SPECT/CT is a useful tool for the evaluation of painful knee prosthesis in 85.5% of cases and helps in confirming mechanical loosening and in excluding other causes such as infection and patellofemoral osteoarthritis.

Journal of Nuclear Cardiology, Sep 24, 2015

Myocardial perfusion imaging (MPI) is a well-established and widely used imaging technique for th... more Myocardial perfusion imaging (MPI) is a well-established and widely used imaging technique for the assessment of patients with known or suspected coronary artery disease. Pitfalls and artifacts associated with conventional gamma cameras are well known and the ways to avoid and correct them have been described. In recent years solid-state detector dedicated cardiac cameras were introduced and have been shown to offer improved accuracy in addition to new imaging protocols and novel applications. The purpose of this manuscript is to familiarize the readers with the causes and effects of technical, patient related and operator-related pitfalls and artifacts associated with the D-SPECT dedicated cardiac camera with solid-state detectors. The manuscript offers guidance on how to avoid these factors, how to detect them and how to correct better for them, providing high-quality diagnostic images. 3 Abbreviations list MPI-myocardial perfusion imaging CAD-coronary artery disease CZT-Cadmium Zinc telluride LEHR-Low energy high resolution QC-quality control ROI-region of interest LV-left ventricle RFID-radiofrequency identification

Nuclear Medicine Communications, Dec 16, 2022

Nuclear Medicine Communications, Aug 1, 2014

European Journal of Nuclear Medicine and Molecular Imaging

Strategy planning in nuclear medicine imaging in uncertain times can be a challenging task. In th... more Strategy planning in nuclear medicine imaging in uncertain times can be a challenging task. In the traditional strategicplanning model, managers attempt to forecast how the imaging landscape will evolve and how competitors will respond. They then define a multi-year plan to position their departments in this envisaged future state. That model worked well when the health landscape and economies were more stable, and the primary factors influencing future growth and expansion were easier to forecast. However, the world and the health landscape are changing so quickly that no service can plan for every eventuality. A critical aspect of strategic imaging planning is identifying and assessing the potential risks and uncertainties that departments may face. These include economic downturns; technological changes; patient needs, preferences, and expectations; and regulatory changes. By identifying and analyzing these risks and remaining flexible and adaptable, managers can develop contingency plans to mitigate their potential impact on departments. This article offers a different approach and mindset for making strategic decisions and a model for managing strategy development and performance monitoring. In summary, strategy planning in imaging in uncertain times requires careful consideration; the use of tools and techniques such as risk assessment and scenario planning and a focus on flexibility, adaptability, clear vision, effective communication, and ongoing monitoring and evaluation. By following these principles, leaders can create a plan that helps their imaging department navigate uncertain times and emerge stronger.

Nuclear Medicine Communications

The International Journal of Cardiovascular Imaging, 2012

Background. We measured myocardial blood flow (MBF) and perfusion reserve (MPR) by dynamic CZT-SP... more Background. We measured myocardial blood flow (MBF) and perfusion reserve (MPR) by dynamic CZT-SPECT and 82 Rb-PET in patients with suspected or known coronary artery disease (CAD) and compared the accuracy of the two methods in predicting obstructive CAD. Methods. Twenty-five patients with available coronary angiography data underwent 99m Tcsestamibi CZT-SPECT and 82 Rb-PET cardiac imaging. Stress and rest MBF and MPR were calculated by both methods and compared. Diagnostic accuracies of CZT-SPECT and PET were also assessed using a receiver-operator-characteristic curve. Results. CZT-SPECT yielded similar baseline MBF, but higher hyperemic MBF and MPR values compared to PET. There was a modest correlation between the two methods for MPR (r = 0.56, P < .01). MPR by CZT-SPECT showed a good ability in identify a reduced MPR by PET, with an area under the curve of 0.85. A MPR cutoff of 2.5 was identified by CZT-SPECT for detection of abnormal MPR by PET, with a sensitivity, specificity and accuracy of 86%, 73% and 80%. The area under the curve for the identification of obstructive CAD by regional MPR were 0.83 for CZT-SPECT and 0.84 for PET (P = .90). At CZT-SPECT, a regional MPR of 2.1 provided the best trade-off between sensitivity and specificity for identifying obstructive CAD. Diagnostic accuracy of CZT-SPECT and PET using respective cutoff values was comparable (P = .62). Conclusion. Hyperemic MBF and MPR values obtained by CZT-SPECT are higher than those measured by 82 Rb-PET imaging, with a moderate correlation between the two methods. CZT-SPECT shows good diagnostic accuracy for the identification of obstructive CAD. These findings may encourage the use of this new technique to a better risk stratification and patient management. (J Nucl Cardiol 2020) Electronic supplementary material The online version of this article (

Nuclear Medicine Communications, 2014

The aim of the study was to evaluate the value of single-photon emission computerized tomography/... more The aim of the study was to evaluate the value of single-photon emission computerized tomography/computed tomography (SPECT/CT) in the clinical assessment of painful knee prostheses. Between 2009 and 2011 we identified 105 patients who had undergone Tc-hydroxydiphosphonate SPECT/CT for painful knee prosthesis. Complete follow-up data were available for 69 patients (50 women and 19 men; mean age, 71 years) with painful knee prostheses (59 total, nine unicompartmental, one patellofemoral) and clinical suspicion of infection or loosening. The imaging test report in conjunction with the clinical data from the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s notes was used to gauge how useful the test had been in terms of patient management. SPECT/CT confirmed the suspected clinical diagnosis of loosening in nine patients (13%) and of infection in two (2.9%) and identified other causes in 43 patients (62.3%). In 85.5% of patients, SPECT/CT was clinically useful (both positive and negative results), whereas in 14.5% it had no clinical impact on patient management. Revision surgery was performed in 24/69 (34.8%) patients and confirmed the SPECT/CT diagnosis in 21 patients (seven loosening, one infection, two subchondral fractures, two postoperative inflammation and nine patellofemoral osteoarthritis). SPECT/CT is a useful tool for the evaluation of painful knee prosthesis in 85.5% of cases and helps in confirming mechanical loosening and in excluding other causes such as infection and patellofemoral osteoarthritis.

Journal of the American College of Cardiology, 2014

Journal of Nuclear Cardiology, 2014

We have assessed whether additional upright imaging increases the confidence of interpretation of... more We have assessed whether additional upright imaging increases the confidence of interpretation of stress only supine myocardial perfusion imaging (MPI) in obese patients. Tc-MIBI stress MPI of 101 consecutive patients (M = 49, 62 ± 12 years) with BMI ≥30 scanned on the D-SPECT cardiac camera were assessed. Images were interpreted as diagnostic or equivocal and the need for a rest study was recorded. Stress supine MPI was interpreted first, then gated and finally upright data were added. Defects on supine but not on upright were defined as artefacts and defects seen on both as abnormal. The total perfusion deficit (TPD) was also quantified. There were 27 normal, 22 abnormal, and 52 equivocal supine scans. The median EF was 52%, unaffecting the need for rest imaging. Upright imaging reclassified 32/52 (62%) equivocal studies as normal and 6/52 (11%) as abnormal (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Rest scan was deemed needed in 74/101 patients on supine vs 42/101 on supine/upright (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Supine TPD was normal in 53 and supine/upright TPD was normal in 70 patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Supine stress MPI is inadequate in obese patients. The addition of upright imaging significantly increases the ability to interpret scans as diagnostic and may reduce considerably the need for rest imaging.

Journal of Nuclear Cardiology, 2015

Myocardial perfusion imaging (MPI) is a well-established and widely used imaging technique for th... more Myocardial perfusion imaging (MPI) is a well-established and widely used imaging technique for the assessment of patients with known or suspected coronary artery disease. Pitfalls and artifacts associated with conventional gamma cameras are well known and the ways to avoid and correct them have been described. In recent years solid-state detector dedicated cardiac cameras were introduced and have been shown to offer improved accuracy in addition to new imaging protocols and novel applications. The purpose of this manuscript is to familiarize the readers with the causes and effects of technical, patient related and operator-related pitfalls and artifacts associated with the D-SPECT dedicated cardiac camera with solid-state detectors. The manuscript offers guidance on how to avoid these factors, how to detect them and how to correct better for them, providing high-quality diagnostic images. 3 Abbreviations list MPI-myocardial perfusion imaging CAD-coronary artery disease CZT-Cadmium Zinc telluride LEHR-Low energy high resolution QC-quality control ROI-region of interest LV-left ventricle RFID-radiofrequency identification

The Journal of Nuclear Medicine, 2012

The Journal of Nuclear Medicine, 2012