Abstract:

Aim: was to make preclinical and imaging tests of the trans-1,2-diaminocyclohexane-N,N,N',N'-tetraacetic acid (DCTA) complex as a universal contrast agent for MRI and single-photon emission imaging, with Mn (Cyclomang) and ^99mTc- (Cyclotech), respectively.

Material and Methods: the complex of trans-1,2-diaminocyclohexane-N,N,N',N'-tetraacetic acid (DCTA) was synthesized at the department of organic chemistry of National Research Tomsk Polytechnic university, using the original technology in the nanopowder phase using manganese (II) carbonate, or generator eluate ^99mTc, and NaH₂DCTA, resulting in a 0.5 M solution of Мn-DCTA or ^99mTc-DCTA. LD50 values were determined in experiments on laboratory mice. A visualization study was performed in 4 cats and 3 dogs with malignant neoplasms of chest organs and in one dog with a tumor of the left pontocerebellar angle. All of them underwent consecutively MRI with contrast enhancement with Mn-DCTA and SPECT - with ^99mTc-DCTA.

Results: for Cyclotech LD50 >18/ml/kg, for 0.5 M Mn-DCTA (Cyclomang) solution, the LD50 index significantly exceeds 16.9 ml/kg BW. Changes in the content of manganese in the blood plasma of rats when they were administered Mn-DCTA, did not occur. LD50 values allow us to assign the drug in accordance with Russian regulation GOST 12.1.007-76. to group 4 (low-hazard substances). In both cases, in the range of physiological pH, the thermodynamic stability constant is >19.3. In studies in animals with MRI, the enhancement index of T1-weighted spin-echo image of the tumor in all cases exceeded 1.7 (mean 1.82±0.10). When calculating the «tumor/back-ground» index for ^99mTc-DCTA, it was 2.6-7.3 (mean 4.12±1.05).

Conclusion: DCTA complexes with manganese (II) - for enhancement in MRI and with ^99mTc- for SPECT- have very close pharmacokinetic properties, are non-toxic, do not dissociate in physiological environments and can be further used for contrast enhancement in multimodal MRI-SPECT studies. Chelate agents of the ^99mTc with thermodynamic stability constants over 16 may be employed in the nearest future as important source for the development of paramagnetic contrast agents binding Mn.

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Abstract:

The aim of the study was to assess the potential of nuclear imaging for long-term results assessment in myocardial infarction (MI) surgical treatment. 35 patients were included in the study: the main group (n = 15) of patients underwent bypass surgery in 3-4 weeks after MI, and the control group (n = 20) with conventional conservative MI treatment. Radionuclide angiopulmonography and radionuclide ECG-synchronized ventriculography was performed in all the patients in 1 month, 6 months, and 12 months after MI.

Scintigraphic markers of post-operative complications were the following: (1) prolongation of minimal pulmonary circulation time 1 month after operation followed by (2) right chamber passage prolongation and (3) ejection fraction decrease. Stability of the mentioned parameters can serve as a predictor of smooth postoperative course. Feebleness of pulmonary circulation occurs earlier that the ejection fraction decrease, so it can be mentioned among the earliest symptoms of heart failure in patients with MI.

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Abstract:

Background: according to the international registry ICOPER, right ventricular (RV) dysfunction is the most significant predictor of mortality in patients with pulmonary embolism (PE). Diagnosis of PE should include not only verification of thrombus in branches of pulmonary arteries, but also estimation of RV contractile function.

Aim: was to identify the most informative indicators of Gated Blood Pool SPECT (GBPS) for estimation of RV function in patients with PE.

Methods: 52 patients were included in the study Main group (n=37) included patients with PE; comparison group (n=15) included patients suffering from coronary heart disease (NYHA I-II). All patients received ventilation-perfusion lung scintigraphy, gated blood pool single photon emission computer tomography (GBPS), and estimation of plasma levels of endothelin-1, stable nitric oxide (NO) metabolites, and 6-keto-PG F1a.

Results: in patients with PE, RV end-systolic volume, stroke volume, ejection fraction, peak ejection rate, peak filling rate, and mean filling rate were significantly lower in comparison with patients without PE. In patients with PE volume from 3 to 7 bronchopulmonary segments, we have not found any correlations between PE volume and functional status of the right ventricle. In patients with PE, levels of endothelin-1, 6-keto-PG F1a, and stable NO metabolites were increased in comparison with patients without PE.

Conclusion: GBPS allows to verify RV dysfunction in patients without massive PE and severe pulmonary hypertension. Dissociation between volume of PE and the degree of RV dysfunction may be caused by humoral vasoactive factors disbalance. 

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