This study showed( 18)F-FDG PET to be more sensitive than ( 99m)Tc-depreotide SPECT in the diagnosis of malignancy of SPNs. However, the combination of both techniques may provide additional accuracy.

BackgroundThe purpose of this study is to evaluate the feasibility, the image quality, and the clinical relevance of an early gated post-stress (GPS) single-photon emission computed tomography (SPECT) tetrofosmin (Myoview™—GE Healthcare) acquisition protocol. Time delay between myocardial technetium-labeled tracer administration and SPECT acquisition is usually about 30 minutes after stress, and 45 to 60 minutes at rest: because of the absence of significant redistribution, perfusion images are related to stress even 30 minutes after stress injection, while function and thickening data obtained with gated acquisition 30 minutes after stress are mainly related to rest conditions.Methods194 patients were prospectively included and analyzed, in a multicenter registry. Three gated-SPECT 99mTc-Tetrofosmin studies were performed per patient: GPS-SPECT, 30 minutes post-stress (GS30), and at rest (GR30).ResultsGPS image quality was excellent/good (93.9%), and similar to GS30 images (96.6%). The presence of adjacent myocardial sub-diaphragmatic activity on GPS images was similar to GS30 images (24% vs 22%), and less frequent than on GR30 images (31%). For perfusion, thickening, and motion scores, there was no significant difference between early and 30 minute post-stress in the global patient population, but significant differences were observed between GPS and GS30 for LVEF (65% ± 15% vs 63% ± 14%). In the ischemic patients, with the stress-rest protocol, the perfusion score was 14.2 on GPS images and 12.4 on GS30 images (P = .002).ConclusionsTetrofosmin early GPS-SPECT is feasible without impairment of image quality (better count rate). Ischemic defect size on early post-stress images is slightly more pronounced than at 30 minutes: this could modify therapeutic decision. This technique produces reliable function information during early post-stress period, and might be useful for disclosing transient motion abnormalities.

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Plusieurs phénomènes expliquent le développement des modes de transport dont la déréglementation de l'industrie, les innovations technologiques et la globalisation des marchés.Actuellement, le juste-à-temps devient, pour plusieurs, l'emblème de la suprématie concurrentielle.Mais il augmente le niveau de complexité des exigences en approvisionnement et en livraison. Nous examinerons donc les implications du JàT sur le transport, considérant que les entreprise nord américaines évolueront dans un environnement plus ouvert et plus concurrentiel suite à l'Accord de Libre-ÉchangeNord-Américain (ALENA).