Alper O Karacalioglu

Gulhane Military Medical Academy, Engüri, Ankara, Turkey

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Publications (24)43.59 Total impact

  • Semra Ince · Erdal Guzeldemir · Alper O Karacalioglu · Ozdes Emer · Engin Alagoz
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    ABSTRACT: Progressive speech and language disorders are commonly referred to as primary progressive aphasia (PPA), which is a clinical syndrome eroding both speech and language. Functional imaging may reveal the cause of this disorder even if structural imaging is absent. Fluorine-18- fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) allows the assessment of neuronal activity by semi-quantitatively measuring glucose metabolism in the brain. In medical literature, (18)F-FDG PET/CT studies show hypometabolic areas in different regions of the brain which are special clues for differentiating the subgroups of PPA. This case was reported to demonstrate the characteristic (18)F-FDG PET CT findings for a semantic variant of PPA.
    No preview · Article · Jul 2015 · Hellenic journal of nuclear medicine
  • Alper Karacalioglu · Mustafa Emer · Semra Ince · Engin Alagoz

    No preview · Article · Jan 2015 · Gulhane Medical Journal
  • Tarik Sengoz · Alper Karacalioglu · Semra Ince · Mustafa Emer · Mehmet Ozguven
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    ABSTRACT: 58-year-old female patient, who has been treated and followed-up for ovarian cancer and its colonic metastasis has also been on hemodialysis three times a week for 10 years due to chronic renal failure. Because of the right femoral pain, she underwent bone scintigraphy in order to evaluate the likelihood of developing metastatic disease. Diffuse Tc-99m MDP uptake in the heart was detected on her bone scan. This case was presented to highlight underlying reasons of this very rare and unexpected cardiac uptake in the patient without known heart disease.
    No preview · Article · Jan 2015 · Gulhane Medical Journal
  • Ozdes Emer · Alper O Karacalioglu · Erol Gursoy · Semra Ince
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    ABSTRACT: Objective: Since the effect of time on phase indices is still unclear, the aim of the study was to evaluate the variability of phase indices of the left ventricle which were derived from stress and rest single-photon emission computed tomography (SPECT) imaging acquired at early and late times. Methods: One hundred twenty-one patients (72 men, 49 women) were included into the study. All stress and rest gated myocardial perfusion imaging (gMPI) acquisitions were acquired at two different time points as early in 15 ± 5 min and late in 45 ± 5 min. The peak of the phase histogram (PP), the standard deviation of the phase distribution (SDPH), the width of the band (BPH), and the symmetry (histogram skewness, HS) and peakedness of the phase histogram (histogram kurtosis, HK) which are the parameters for assessing left ventricular systolic dyssynchrony were calculated in all stress and rest SPECT images acquired twice. Results: The phase indices derived from the late rest scans were smaller than those of the early rest scans but, the differences were not significant. When considering the comparisons of phase indices derived from two different time points after stress, PP showed a tendency to decrease (from 160.8 ± 18.3 to 152.5 ± 17.3; p < 0.001) over time but SDPH (from 20.2 ± 10.6 to 22.4 ± 12.2; p = 0.018) and BPH (from 61.5 ± 36.0 to 66.3 ± 37.3; p = 0.045) tended to increase over time. When the post-stress and the resting dyssynchrony parameters derived at two different time points were compared to each other; PP decreased at early and late times approximately 12 and 9 %, respectively, SDPH increased at early and late times approximately 28.5 and 14 %, respectively, and BPH increased at early and late times approximately 23 and 12 %, respectively. Conclusions: In resting conditions, phase indices of the left ventricle, and therefore, the phase histogram tend to remain constant over time but, in conditions after exercise, the phase histogram tend to be long and narrow due to changes in phase indices and it shows tendency to return to resting conditions in time. Therefore, it appears that postexercise acquisition times should be standardized if we want to compare the phase indices results of the studies in the literature.
    No preview · Article · Jul 2014 · Annals of Nuclear Medicine
  • Bengul Gunalp · Semra Ince · Asli Ayan · Engin Alagoz · Ozdes Emer · Alper Ozgur Karacalioglu

    No preview · Conference Paper · May 2014
  • Mehmet A Ozguven · Alper O Karacalioglu · Semra Ince · Mustafa O Emer
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    ABSTRACT: Positron emission tomography-computed tomography (PET-CT) imaging of patients with diabetes can be problematic because elevated glucose levels may cause competitive inhibition of [F-18]-2-deoxy-2-fluoro-D-glucose (FDG) uptake in different tissues. Therefore, the aim of the study was to evaluate the biodistribution of FDG in patients with type-2 diabetes mellitus. Two hundred forty patients were retrospectively enrolled to the study. Study population was divided into three subgroups, named as the normal (group 1), the insulin (group 2) and the oral anti-diabetic (group 3). Unenhanced low-dose CT and PET emission data were acquired from the mid-thigh to the vertex of the skull. FDG uptakes in different organs were evaluated qualitatively or semi-quantitatively. In the diabetic groups, diffuse FDG uptake of the colon was increased (p > 0.001) but segmental FDG uptake was decreased (p > 0.001). Intestinal FDG uptake was detected in 20 % of the study population and only 3 % of these uptakes were in diffuse pattern. Segmental FDG uptake in the bowel was increased significantly in the groups of patients with diabetes (p = 0.002). Maximum standardized uptake values of the liver in the groups 1, 2, and 3 were 2.66 ± 0.6, 3.25 ± 0.9 and 3.16 ± 0.8, respectively, and the difference between the groups was not statistically significant (p = 0.083). Cardiac FDG uptake was decreased significantly in the groups of patients with diabetes (p < 0.001). According to our results, whole body biodistribution of FDG uptake seems to be changed in patients with type-2 diabetes who were using insulin or oral antidiabetic drugs. Although the use of oral antidiabetic drugs was known to change the biodistribution of FDG, insulin use also seems to change FDG uptake in different organs of diabetic patients.
    No preview · Article · Mar 2014 · Annals of Nuclear Medicine
  • Alper Karacalioglu · Semra Ince · Mustafa Emer · Engin Alagoz
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    ABSTRACT: The aim of the study was to compare the results calculated by automatic and semiautomatic methods in the multigated analysis (MUGA) scans and to research the correlation between the results calculated by both modalities. 30 patients including 18 (60%) men and 12 (40%) women (Age, mean±SD:15±8) were included into the study. Systolic parameters such as left ventricular ejection fraction (LVEF) and peak emptying rate (PER) together with diastolic parameters such as peak filling rate (PFR) and time-to-peak filling rate" (TTPFR) derived by automatic and semiautomatic analysis in MUGA scans were compared. These measurements were made by two nuclear medicine specialists and "interobserver" variability was also investigated. The results of EF, PER, PFR, and TTPFR were calculated by automatic and semiautomatic methods and levels of significance were 59,04±10,41 57,63±9,5 (p=0,134), 3,28±0,74, 3,42±0,79 (p=0,054), 3.48±1,03, 3,72±0,97 (p=0,030), 120,41±30,94, 116,73±35,37 (p=0,459), respectively, and statistically significant difference between the parameters except PER was not detected. When the automatic and semiautomatic analyses of both specialists were compared, statistically significant difference between the parameters except LVEF was not detected. The difference between the calculations of both methods was decreased in the semiautomatic analysis. Although there was not a statistically significant difference between the results of the systolic and diastolic functional parameters that were analyzed by automatic and semiautomatic analyses, the preference of semiautomatic analysis for LVEF calculations seems to give more precise results by decreasing the interobserver variability.
    No preview · Article · Jan 2014 · Gulhane Medical Journal
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    Alper O Karacalioglu · Sevket Balta · Ozdes Emer · Sait Demirkol · Turgay Celik · Mehmet Ozguven
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    ABSTRACT: Objective: A count-based new technique from gated myocardial perfusion single-photon emission tomography (gMPS) was developed to allow the phase analysis providing information about the left ventricular (LV) regional discordance in contractility which is a measure of LV dyssynchrony. Since the phase analysis provides data for evaluating the dyssynchronous LV contraction, it has an important role in diagnosis and management of patients with left ventricular dysfunction. The aim of the study was to assess the presence of left ventricular dyssynchrony in patients with reversible perfusion defects on gMPS scans and normal or near normal coronary arteries at angiography. Methods: 32 patients (19 men, 59 %) with reversible mild perfusion defects on gMPS and normal coronary angiogram were retrospectively enrolled in the study. The peak of the phase histogram, the standard deviation of the phase distribution (PSD), the width of the band (PHB), and the symmetry and peakedness of the phase histogram, which are the assessment parameters for the LV dyssynchrony, were calculated from gMPS scans of patients by means of the phase analysis. Results: Although, five quantitative variables are derived from the phase analysis of gMPS, PSD and PHB are two quantitative indices to assess LV global mechanical dyssynchrony and measurements of PSD (men 24.96 ± 7.31, women 24.26 ± 10.07) and PHB (men 70.1 ± 13.99, women 71.0 ± 30.4) were significantly higher than the those reported in the literature (p < 0.001). No significant differences in gMPS phase analysis indices were found between both sexes except kurtosis. Conclusion: As a conclusion, this study provides the phase analysis to detect LV mechanical dyssynchrony as new evidence supporting the concept that an abnormal scintigraphy finding, rather than being false-positive, may be an early marker of vasomotion changes associated with occult atherosclerosis in patients with normal coronary angiography findings.
    Full-text · Article · Feb 2013 · Annals of Nuclear Medicine
  • Alper Karacalioglu · Ayper Yildirim · Ozdes Emer · Mehmet Ozguven
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    ABSTRACT: A 21-year-old male with mild pain and swelling on his right cheek was referred to our department for the Tc-99m MDP bone scintigraphy. A focal, prominent activity uptake in the right maxillar region mimicking dental pathology at first sight was noticed on his bone scan. A mass originating from the right maxillary bone, invading surrounding soft tissue and showing calcifications that were characteristic radiological features of osteosarcoma was detected on his Computed Tomography scan. Osteosarcoma was diagnosed after histopathologic examination of the biopsy specimen. This case was presented to demonstrate unusual localization of a primary bone tumor mimicking dental pathology and causing diagnostic conflict on the bone scan.
    No preview · Article · Jan 2013 · Gulhane Medical Journal
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    Bengul Gunalp · Semra Ince · Alper Ozgur Karacalioglu · Asli Ayan · Ozdes Emer · Engin Alagoz
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    ABSTRACT: The purpose of this study was to determine the clinical significance of (18)F-FDG PET/CT on initial staging and therapy planning in patients with invasive breast cancer. One hundred and forty-one consecutive, biopsy proven preoperative and 195 postoperative high-risk breast cancer patients who were referred for PET/CT for initial staging were included in this retrospective study. The clinical stage had been determined by conventional imaging modalities prior to the PET/CT scan. Of the 141 examined preoperative patients, 19 had clinical stage I (T1N0), 51 had stage IIA (12 T2N0 and 39 T1N1), 49 had stage IIB (2 T3N0 and 47 T2N1), 12 had stage IIIA (11 T3N1, 1 T2N2), 2 had stage IIIB (2 T4N1) and 8 had stage IV. PET/CT modified the staging for 26% of stage I patients, 29% of stage IIA patients, 46% of stage IIB patients, 58% of stage IIIA patients and 100% of stage IIIB patients. PET/CT scans detected extra-axillary regional lymph nodes in 14 (9.9%) patients and distant metastasis in 41 (29%) patients. PET/CT scans detected multifocal lesions in 30 (21%) patients, multicentric lesions in 21 (14%) patients and malign foci in the contralateral breast (bilateral breast cancer) confirmed by biopsy in 5 (3.5%) patients. Of the examined 195 postoperative patients PET/CT detected axillary lymph nodes in 22 (11%) patients, extra-axillary regional lymph nodes in 21 (10%) patients and distant metastasis in 24 (12%) patients. PET/CT findings altered plans for radiotherapy in 22 (11%) patients and chemotherapy was adapted to the meta-static diseases in 24 (12%) patients. PET/CT was revealed to be superior to conventional imaging modalities for the detection of extra-axillary regional metastatic lymph nodes and distant metastases. These features make PET/CT an essential imaging modality for the primary staging of invasive breast cancer, particularly in patients with clinical stages II and III.
    Full-text · Article · Oct 2012 · Experimental and therapeutic medicine
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    ABSTRACT: Cerebral palsy is one of the most common reasons of osteopenia in childhood. Patients have a significantly decreased bone mineral density, and painful fractures with minor traumas are common. Biphosphonates in the treatment of childhood osteoporosis are increasingly being used. This study aimed to evaluate the efficacy of oral alendronate treatment in children with cerebral palsy. Twenty-six children (16 boys and 10 girls) aged 3 to 17 years who had quadriplegic cerebral palsy and osteopenia were included in the study. The patients received alendronate (1 mg/kg/week), calcium (600 mg/day), and vitamin D(3) (400 U/day) over a year. A complete blood count, kidney and liver functional tests, plasma calcium, phosphate and alkaline phosphatase levels, and lumbar vertebral bone mineral density were measured before and after treatment. Compared with pretreatment values, bone mineral density, serum calcium, and phosphate levels of the patients statistically increased and alkaline phosphatase levels decreased after treatment. No patient needed to interrupt treatment because of side effects. Oral alendronate at a dose of 1 mg/kg/week for the treatment of osteopenia in children with cerebral palsy was found to be safe and effective.
    No preview · Article · Sep 2011 · Child s Nervous System
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    Alper O Karacalioglu · Ersin Erdogan · Bulent Duz · Selim Kilic · Asli Ayan · Mehmet A Ozguven
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    ABSTRACT: Since, the effect of a large cranial defect on the cerebrospinal fluid (CSF) flow rate is still not clear, this study was designed to evaluate the effect of craniectomy in rabbits by using a radionuclide technique, under in vivo physiologic conditions. Eleven male New Zealand white rabbits were examined. After the injection of technetium-99m-diethylene-triaminepenta-acetic acid into the fourth ventricle of each rabbit, dynamic acquisition for 60 min (1 min per frame) was performed pre-op followed by about one third craniectomy to each animal. Injection of the radiopharmaceutical and the imaging steps were repeated at 24 h (post-op 24 h) and at 7 days (post-op 7 d) after craniectomy. The region of interest (ROI) was drawn around the injection site and a time activity curve was generated. Slopes of each curve were calculated to detect the flow rate of the radiopharmaceutical from the injection site during 60 min. Besides, the count decreased ratio (ROIcounts of the last frame ROI counts of the first frame X100) was calculated. Our results showed that the pre-op values of the slope of the time-activity curve and the count decreased ratio were decreased 24 h and 7 d post-op but statistically significant was only the difference between the above values pre-op and 7 d post-op (P=0.04, P=0.01 respectively). In conclusion, the data of the present study indicate that the CSF flow rate in rabbits decreased 7 d after one third craniectomy.
    Full-text · Article · Jan 2011 · Hellenic journal of nuclear medicine
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    Alper O Karacalioglu · Asli Ayan · Turgay Celik · Murat Kocaoglu · Mehmet Ozguven

    Full-text · Article · Sep 2010 · Hellenic journal of nuclear medicine
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    A Ozgur Karacalioglu · Kenan Soylu · Ozdeş Emer · Asli Ayan · Mehmet Ozguven
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    ABSTRACT: A 69 years old woman with chronic low back pain referred to our Department for bone scintigraphy. Patient did not have any other complaint and his physical examination of the patient was normal. Whole-body scan was acquired 3 h after the intravenous injection of 740 MBq of technetium-99m methylene diphosphonate ((99m)Tc-MDP). Distal sacrococcygeal region could not be observed during the visual analysis of the whole-body scan. Pelvic X-rays radiography and pelvic computed tomography of the patient, demonstrated hemiagenesis of the sacrum, which was consistent with type-2 sacral agenesis. Other structural abnormalities were not detected on the pelvic CT scan of the patient. This case is presented to demonstrate the rare congenital anomaly of sacral hemiagenesis causing empty pelvis appearance in the posterior projection of (99m)Tc-MDP whole body bone scan. This congenital anomaly could be associated with extensive abnormalities of the lower vertebrae, pelvis, and spine.
    Full-text · Article · Sep 2008 · Hellenic journal of nuclear medicine
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    ABSTRACT: Stress fractures could be classified as fatigue fractures and insufficiency fractures (IF). Fatigue fractures occur when abnormal mechanical stress is applied to a normal bone, on the other hand insufficiency fractures occur when normal to moderate pressure is applied to a bone that has decreased resistance (Daffner and Pavlov in Am J Radiol 159:242-245, 1992). IF have been observed mainly in patients with postmenopausal osteoporosis, and are becoming more common with the increase of elderly population (Daffner and Pavlov in Am J Radiol 159:242-245, 1992). Other systemic and metabolic conditions that can result in osteopenia and IF include osteomalacia, hyperparathyroidism, hyperthyroidism, rheumatoid arthritis, fluoride treatment, diabetes mellitus, fibrous dysplasia, Paget's disease, irradiation and mechanical factors (Daffner and Pavlov in Am J Radiol 159:242-245, 1992; Soubrier et al. in Joint Bone Spine 70:209-218, 2003; Epps et al. in Am J Orthop 33:457-460, 2004; Austin and Chrissos in Orthopedics 28:795-797, 2005). In this case report, the authors present an osteoporotic woman who developed bilateral insufficiency fracture of the femoral shaft after longstanding steroid, thyroxine replacement and alendronate therapy due to partial empty sella syndrome and osteoporosis, resulting in the treatment of the fracture by inflatable intramedullary nailing.
    No preview · Article · Oct 2007 · Archives of Orthopaedic and Trauma Surgery
  • Seyfettin Ilgan · Mehmet Ozguven · Mustafa O Emer · Alper O Karacalioglu
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    ABSTRACT: Inguinoscrotal herniation of the bladder is a rare clinical entity. The condition is often diagnosed incidentally or during the course of surgical repair of inguinal hernias. In a smaller number of cases, bladder hernia can be seen during nuclear medicine studies. We report a rare case of massive inguinoscrotal bladder herniation with ureter, causing urinary stasis on bone scintigraphy.
    No preview · Article · Sep 2007 · Annals of Nuclear Medicine
  • Elgin Ozkan · Nuri Arslan · Atilla Arslanoglu · Alper Ozgur Karacalioglu
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    ABSTRACT: Brown tumors are rare but serious complications of renal osteodystrophy, and can be treated by parathyroidectomy or by pharmacological treatment of hyperparathyroidism. In addition to parathyroid lesions such as adenoma, hyperplasia, and carcinoma, brown tumors have been detected effectively by using dual phase Tc-99m sestamibi and Tl-201 chloride. We describe an unusual case of brown tumor at the manibrium sterni which shows marked increased Tc-99m sestamibi uptake on the initial scan, with decreasing tracer activity on follow-up scan indicating a response to antimetabolic therapy.
    No preview · Article · Sep 2007 · Clinical Nuclear Medicine
  • Alper O Karacalioglu · Bekim Jata · Selim Kilic · Nuri Arslan · Seyfettin Ilgan · Mehmet A Ozguven
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    ABSTRACT: When body position changes from erect to supine, the effect of gravity on the organs also changes and is a possible underlying mechanism for upward creep of the heart during SPECT acquisitions. We hypothesized that if we provide enough time for the organs to settle after a positional change, the range of this vertical motion causing reconstruction artifacts can be decreased. Our aim was to evaluate the effect that a 5-min bed rest on the imaging table before both rest and stress SPECT acquisitions would have on upward creep of the heart. Before both stress and rest SPECT acquisitions, the first 101 consecutive patients (group A) had a 5-min bed rest and the remaining 99 patients (group B) did not have any bed rest after they were positioned on the imaging table. Upward creep was detected by comparing the distance between the lower edge of the image and the lowest part of the heart silhouette on the last projection image of detector 2 and the first projection image of detector 1. Upward creep was found in 53% (54/101) and 55% (56/101) of patients in group A and in 89% (88/99) and 86% (85/99) of patients in group B in stress and rest SPECT studies, respectively. Upward creep of the heart was decreased prominently in group A, and this decrease was statistically significant (p < 0.001). We conclude that before SPECT acquisition, at least a 5-min bed rest on the imaging table significantly decreases vertical motion of the heart.
    No preview · Article · Jan 2007 · Journal of Nuclear Medicine Technology
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    ABSTRACT: The diagnosis of endothelial dysfunction has been gaining clinical importance, but although endothelial function testing is available in the research setting, no technique yet exists that is simple, safe, reproducible and easily performed as a clinical screening method. The aim of this study was to design a new, scintigraphic method of imaging the flow-mediated dilation in the forearm, which represents the functional characteristic of endothelial dysfunction. The study group comprised 118 subjects in whom left forearm ischemia was induced by inflating a sphygmomanometer cuff to supra systolic pressure for 4.5 min. Later, dynamic acquisition (2 s frame/min) was initiated after the injection of technetium-99m methoxy-isobutyl isonitril into the dorsal pedal veins. Equivalent regions of interest were drawn on both arms to detect total activity counts during 1 min and the perfusion ratios (left arm/right arm) were calculated. The left arm counts (22,203.3+/-12,372.7) were significantly higher than the right arm counts (9,980.9+/-5,931.9) (p<0.001). A significant decrease in perfusion ratios was noted in the hypertension and hypercholesterolemia groups. An increase in the number of risk factors caused an insignificant decrease in perfusion ratio (p=0.346). Non-invasive evaluation of endothelium-dependent vasodilation by semiquantitative scintigraphic method using radioactive perfusion tracer provided promising results.
    No preview · Article · Apr 2006 · Circulation Journal
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    ABSTRACT: Background The diagnosis of endothelial dysfunction has been gaining, clinical importance, but although endothelial function testing is available in the research setting, no technique yet exists that is simple, safe, reproducible and easily performed as a clinical screening method. The aim of this study was to design a new, scintigraphic method of imaging the flow-mediated dilation in the forearm, which represents the functional characteristic of endothelial dysfunction. Methods and Results The study group comprised 118 subjects in whom left forearm ischemia was induced by inflating a sphygmomanometer cuff to supra systolic pressure for 4.5min. Later, dynamic acquisition (2s frame/min) was initiated after the injection of technetium-99m methoxy-isobutyl isonitril into the dorsal pedal veins. Equivalent regions of interest were drawn on both arms to detect total activity counts during 1 min and the perfusion ratios (left arm/right arm) were calculated. The left arm counts (22,203.3 +/- 12.372.7) were significantly higher than the right arm counts (9,980.9 +/- 5,931.9) (p < 0.001). A significant decrease in perfusion ratios was noted in the hypertension and hypercholesterolemia groups. An increase in the number of risk factors caused an insignificant decrease in perfusion ratio (p=0.346). Conclusion Non-invasive evaluation of endothelium-dependent vasodilation by semiquantitative scintigraphic method using radioactive perfusion tracer provided promising results.
    No preview · Article · Mar 2006 · Circulation Journal