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Superimposition of In-111 platelet SPECT and CT/MR imaging in intracardiac thrombus
K Suga1, K Nishigauchi, N Kume
1Department of Radiology, Yamaguchi University School of Medicine, Japan.
Insights
This study shows that combining Indium-111 (In-111) labeled platelet SPECT with CT/MRI accurately locates intracardiac thrombus. Fusion imaging improves visualization of thrombus activity compared to planar imaging alone.
Area of Science:
- Nuclear Medicine
- Cardiovascular Imaging
- Medical Physics
Background:
- Intracardiac thrombus diagnosis and localization are critical for patient management.
- Conventional imaging modalities may have limitations in precisely identifying thrombus location and extent.
- Indium-111 (In-111) labeled platelet scintigraphy offers functional information about thrombus activity.
Observation:
- Initial attempts to superimpose In-111 labeled platelet SPECT over CT/MRI were performed in two patients with intracardiac thrombus.
- One patient had a large right atrial thrombus, and the other had a smaller thrombus at the cardiac apex.
- SPECT/CT/MRI fusion imaging demonstrated increased In-111 activity on the surface of the thrombus in both cases.
Findings:
- Fusion imaging with CT confirmed increased In-111 activity on the surface of a large right atrial thrombus.
- SPECT/MR superimposition revealed that abnormal In-111 activity corresponded to a small cardiac apex thrombus and a previous biopsy site.
- The activity ratio of abnormal In-111 accumulation to the cardiac chamber was higher on SPECT images than on planar images.
Implications:
- Correlating In-111 platelet SPECT with CT/MRI is valuable for accurate intracardiac thrombus localization.
- This fusion imaging technique enhances the diagnostic capability for intracardiac thrombi.
- Improved localization may lead to more precise treatment strategies for patients with intracardiac thrombus.
Abstract:
An initial attempt to superimpose in-111-labeled platelet SPECT over CT/MRI in two patients with intracardiac thrombus is presented. One patient was a 65-year-old woman with a history of mitral and tricuspid valve replacement. This patient had a large thrombus measuring 74 x 43 x 34 mm in the right atrium. Fusion imaging with CT showed increased in-111 activity on the surface of the thrombus, which was visualized as circular activity on a planar image. The other patient was a 72-year-old woman who had a thrombus measuring 17 x 14 x 12 mm at the cardiac apex. Planar imaging showed two discrete areas of abnormal in-111 activity. Superimposition of the SPECT image over MR revealed that one of these areas corresponded to the small thrombus, whereas the other related to a previous subendomyocardial biopsy. In both patients, the activity ratio of the abnormal in-111 accumulation versus the cardiac chamber on SPECT was greater than that on planar images. The correlation of in-111 platelet SPECT and CT/MRI was useful in accurately localizing the intracardiac thrombus.