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Gender-based medicine is medical research and care conducted with conscious consideration of the sex and gender differences of subjects and patients. This issue of Seminars is focused on diseases for which nuclear medicine is part of routine management and for which the diseases have sex- or gender-based differences that affect incidence or pathophysiology and that thus have differences that can potentially affect the results of the relevant nuclear medicine studies. In this first article, we discuss neurologic diseases, certain gastrointestinal conditions, and thyroid conditions. The discussion is in the context of those sex- or gender-based aspects of these diseases that should be considered in the performance, interpretation, and reporting of the relevant nuclear medicine studies. Cardiovascular diseases, gynecologic diseases, bone conditions such as osteoporosis, pediatric occurrences of some diseases, human immunodeficiency virus-related conditions, and the radiation dose considerations of nuclear medicine studies are discussed in the other articles in this issue.

The quality of a Teboroxime single-photon emission computed tomography (SPECT) study ran be degraded by Teboroxime's rapid myocardial washout and high liver uptake. Described is the use of fast-fanning acquisition and nonlinear regression with distance penalty (NLRDP) to compensate for the two effects. Tl-201/conventional single-rotation Sestamibi (MIBI) and Tl-201/dynamic fast-fanning Teboroxime (TEBO) rest/stress acquisitions were conducted on 18 subjects. TEBO reconstructions were processed by NLRDP using group-averaged kinetics to separate images into liver, myocardium, and background. Reprojections of these compartments were registered with the measured projections. This made possible the extraction of patient-specific kinetics. NLRDP identified defects (abnormal myocardium with different kinetics from normal tissue) by differences in the kinetics of the defect pixels. Enhanced-TEBO (E-TEBO) images were produced by using the kinetic curves to calculate the Teboroxime concentration in each pixel at the time of expected peak myocardial uptake and by omitting the liver compartment. Stress and reversibility total severity scores and total impaired and reversible myocardial mass were computed for the MIBI, TEBO, and E-TEBO images using the Emory Cardiac Toolbox. Regression and correlation analyses of these quantitative indices indicate that Teboroxime SPECT can produce results similar to those of Sestamibi SPECT if E-TEBO images are generated. Index Terms--Dynamic single-photon emission computed tomography, fast-fanning acquisition, nonlinear regression with distance penalty, technetium-99m Teboroxime.

The quality of a Teboroxime single-photon emission computed tomography (SPECT) study can be degraded by Teboroxime's rapid myocardial washout and high liver uptake. Described is the use of fast-fanning acquisition and nonlinear regression with distance penalty (NLRDP) to compensate for the two effects. Tl-201/conventional single-rotation Sestamibi (MIBI) and Tl-201/dynamic fast-fanning Teboroxime (TEBO) rest/stress acquisitions were conducted on 18 subjects. TEBO reconstructions were processed by NLRDP using group-averaged kinetics to separate images into liver, myocardium, and background. Reprojections of these compartments were registered with the measured projections. This made possible the extraction of patient-specific kinetics. NLRDP identified defects (abnormal myocardium with different kinetics from normal tissue) by differences in the kinetics of the defect pixels. Enhanced-TEBO (E-TEBO) images were produced by using the kinetic curves to calculate the Teboroxime concentration in each pixel at the time of expected peak myocardial uptake and by omitting the liver compartment. Stress and reversibility total severity scores and total impaired and reversible myocardial mass were computed for the MIBI, TEBO, and E-TEBO images using the Emory Cardiac Toolbox. Regression and correlation analyses of these quantitative indices indicate that Teboroxime SPECT can produce results similar to those of Sestamibi SPECT if E-TEBO images are generated. [ABSTRACT FROM AUTHOR]

Reports on developments in nuclear medicine. Combined SPECT perfusion and PET fludeoxyglucose F 18 metabolic imaging for determining the appropriateness of revascularization; Fusion of SPECT images with other images and PET for accurate localization of tumor foci; Refinements in renal functional analysis; Continued clinical documentation of the value of PET imaging.