Leg arteritis exploration by quantitative muscle scintigraphy with 201Tl

Area of Science:

• Nuclear Medicine
• Vascular Imaging
• Diagnostic Radiology

Background:

• Peripheral arterial disease (PAD) affects lower limb circulation.
• Accurate detection and localization of PAD are crucial for effective treatment.
• Current diagnostic methods have limitations in quantifying localized perfusion deficits.

Purpose of the Study:

• To evaluate the efficacy of quantitative scintigraphy with thallium-201 (201Tl) in detecting and localizing peripheral arterial disease.
• To correlate scintigraphic findings with established functional tests for PAD.

Main Methods:

• Intravenous injection of 201Tl at peak exercise and rest.
• Scintigraphic imaging of lower limb segments (thighs, knees, calves, feet) and skull.
• Calculation of intralimb and interlimb count ratios (e.g., T/S, C/S).
• Comparison with functional tests: walk perimeter, arterial blood pressure, Strandness test, plethysmography.

Main Results:

• Exercise-induced 201Tl scintigraphy showed medium to good correlations between limb segment ratios (T/C, C/K, CL/CR) and hyperemic calf blood flow.
• Ratios of limb segments to skull counts (T/S, C/S) correlated well with the systolic pressure index and hyperemic flux.
• Thigh-to-skull (T/S) and calf-to-skull (C/S) ratios showed a strong correlation with the distance walked, indicating their utility in assessing PAD severity.

Conclusions:

• Quantitative scintigraphy using 201Tl is an accurate method for measuring local muscular perfusion deficits in lower limb arterial disease.
• This technique provides valuable quantitative data for PAD detection, localization, and severity assessment.
• 201Tl scintigraphy offers a promising non-invasive approach to complement existing PAD diagnostic tools.