Kevin C. Allman

Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia

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Publications (87)479.62 Total impact

  • Seung Wook Ryu · Adrian Waugh · Kevin C Allman
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    ABSTRACT: Extrapulmonary deposition of macroaggregated albumin particles on lung perfusion scintigraphy occurs in the presence of right-to-left shunting, as demonstrated in this case of portosystemic shunting related to superior vena cava obstruction by germ cell tumor of the mediastinum. The case demonstrates the importance of examining tracer deposition within the entire field of view on 99mTc-macroaggregated albumin perfusion lung scintigraphy for extrapulmonary findings. © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
    No preview · Article · Feb 2014 · Journal of Nuclear Medicine Technology
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    Seung Wook Ryu · Kevin C Allman
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    ABSTRACT: The value of (99m)Tc-labeled white blood cell scintigraphy for endovascular prosthetic infections is well known. In the unique case reported here, infection of the native aorta was detected in addition to an infected vascular prosthesis. The case demonstrates that (99m)Tc-labeled white blood cell scintigraphy can identify not only the more usual prosthetic stent/graft infection but also infection of the native aorta. When scrutinizing studies for infection of prosthetic material, readers should also carefully examine the native aorta.
    Preview · Article · Feb 2014 · Journal of Nuclear Medicine Technology
  • Kevin C Allman
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    ABSTRACT: Observations of reversibility of cardiac contractile dysfunction in patients with coronary artery disease and ischemia were first made more than 40 years ago. Since that time a wealth of basic science and clinical data has been gathered exploring the mechanisms of this phenomenon of myocardial viability and relevance to clinical care of patients. Advances in cardiac imaging techniques have contributed greatly to knowledge in the area, first with thallium-201 imaging, then later with Tc-99m-based tracers for SPECT imaging and metabolic tracers used in conjunction with positron emission tomography (PET), most commonly F-18 FDG in conjunction with blood flow imaging with N-13 ammonia or Rb-82 Cl. In parallel, stress echocardiography has made great progress also. Over time observational studies in patients using these techniques accumulated and were later summarized in several meta-analyses. More recently, cardiac magnetic resonance imaging (CMR) has contributed further information in combination with either late gadolinium enhancement imaging or dobutamine stress. This review discusses the tracer and CMR imaging techniques, the pooled observational data, the results of clinical trials, and ongoing investigation in the field. It also examines some of the current challenges and issues for researchers and explores the emerging potential of combined PET/CMR imaging for myocardial viability.
    No preview · Article · Jun 2013 · Journal of Nuclear Cardiology
  • William J van Gaal · Kevin Allman

    No preview · Article · Jun 2011 · The Medical journal of Australia
  • Bjoern Kitzing · Paul J Torzillo · Kevin C Allman
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    ABSTRACT: We present the right to left shunt study findings of a 50-year-old male patient with hepatitis C cirrhosis, who complained of worsening dyspnea on exertion. Follow-up images showed resolution of hepatopulmonary syndrome following methadone withdrawal although there had been no improvement in his liver disease. This was unusual and may have been due to the effect of opiate receptors on nitric oxide signaling in the pulmonary vasculature.
    No preview · Article · Feb 2011 · Clinical nuclear medicine
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    Bjoern Kitzing · Kevin C Allman
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    ABSTRACT: To the best of our knowledge, we present for the first time the bone scintigraphy findings of a patient with Morquio's syndrome. A 46-year-old Caucasian man with Morquio's syndrome presented with lower back pain six weeks after a left total hip replacement. A whole body bone scan demonstrated an anthropomorphic skeletal pattern consistent with a mucopolysaccharide storage disease, thereby showing the cause of the patient's pain. To the best of our knowledge, the bone scintigraphy findings of a case of Morquio's syndrome have never before been published. We present our case report to add to the knowledge we have of this rare disease.
    Preview · Article · Jan 2011 · Journal of Medical Case Reports
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    ABSTRACT: Figure 1 illustrates the patient flow resulting from the above discussion. It is consistent with the concept of lowering the radiation dose while maintaining or improving image quality which should be considered an improvement in quality of care. The lower the radiation and the higher the image quality the greater the improvement in the quality of patient care. This approach combines the radiation reduction factors, which if implemented correctly, will provide the highest quality MPI studies at the lowest possible radiation dose. It must be recognized that such an approach requires moving away from the comfortable, familiar, time-tested, and efficient protocols adapted in most nuclear cardiology laboratories. It requires patient assessment at the time of scheduling, flexibility in patient flow as each patient will potentially go through a different protocol, and ultimately modifying existing imaging systems or purchasing new equipment. Based on these recommendations, we expect that for the population of patients referred for SPECT or PET MPI, on average a total radiation exposure of ≤9 mSv can be achieved in 50% of studies by 2014.
    Preview · Article · Aug 2010 · Journal of Nuclear Cardiology
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    Kevin C Allman

    Preview · Article · Mar 2010 · Journal of Nuclear Medicine
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    ABSTRACT: Polyarteritis nodosa can on rare occasions manifest itself as vasculitis of the gallbladder. Patients typically present with right upper quadrant pain and are initially worked up for cholecystitis. The definitive diagnosis is then usually based on surgical and histopathological findings. In this case a 23-year-old Caucasian female presented with a 3 week history of right upper quadrant pain and fevers. The clinical pathway and imaging findings of a rare case of gallbladder vasculitis as a manifestation of polyarteritis nodosa are demonstrated.
    Full-text · Article · Dec 2009 · Cases Journal
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    ABSTRACT: In 2005, 80% of cardiovascular disease (CVD) deaths occurred in low- to middle-income countries (i.e., developing nations). Cardiovascular imaging, such as myocardial perfusion SPECT, is one method that may be applied to detect and foster improved detection of at-risk patients. This document will review the availability and utilization for nuclear cardiology procedures worldwide and propose strategies to devise regional centers of excellence to achieve quality imaging around the world. As a means to establish the current state of nuclear cardiology, International Atomic Energy Agency member and non-member states were queried as to annual utilization of nuclear cardiology procedures. Other sources for imaging statistics included data from medical societies (American Society of Nuclear Cardiology, European Society of Cardiology, and the European Association of Nuclear Medicine) and nuclear cardiology working groups within several nations. Utilization was calculated by dividing annual procedural volume by 2007 population statistics (/100,000) and categorized as high (>1,000/100,000), moderate-high (250-999/100,000), moderate (100-249/100,000), low-moderate (50-99/100,000) and low (<50/100,000). High nuclear cardiology utilization was reported in the United States, Canada, and Israel. Most Western European countries, Australia, and Japan reported moderate-high utilization. With the exception of Argentina, Brazil, Colombia and Uruguay, South America had low usage. This was also noted across Eastern Europe, Russia, and Asia. Utilization patterns generally mirrored each country's gross domestic product. However, nuclear cardiology utilization was higher for developing countries neighboring moderate-high "user" countries (e.g., Algeria and Egypt); perhaps the result of accessible high-quality training programs. Worldwide utilization patterns for nuclear cardiology vary substantially and may be influenced by physician access to training and education programs. Development of regional training centers of excellence can guide utilization of nuclear cardiology through the application of guideline- and appropriateness-driven testing, training, continuing education, and quality assurance programs aiding developing nations to confront the epidemics of CVD.
    No preview · Article · Aug 2009 · Journal of Nuclear Cardiology
  • William J van Gaal · B Couthino · M Chan · K.C. Allman
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    ABSTRACT: Controversy exists regarding the safety of intravenous dipyridamole in patients with severe chronic obstructive pulmonary disease (COPD), and it is contraindicated in patients with asthma. There is currently little published literature on the safety of adenosine in patients with airways disease, despite potential advantages over dipyridamole with respect to side effects. We studied 46 consecutive patients with a history of COPD or asthma undergoing adenosine stress myocardial perfusion scintigraphy. Spirometry with measurement of forced expiratory volume in 1 s (FEV(1)), forced vital capacity, peak expiratory flow rate and a repeat FEV(1) postinhaled bronchodilator in all those with a history of asthma was performed prior to receiving intravenous adenosine 140 mg/kg/min for 4 min. The cohort exhibited significant airflow limitation on spirometry (see Table 1), however the majority of patients (24/46) did not experience any dyspnoea or chest pain during adenosine infusion. Fourteen patients experienced chest discomfort during adenosine, and 9 complained of dyspnoea. No patient required aminophylline or resuscitative measures. In our cohort of patients with a history of COPD, asthma or both who demonstrated impaired lung function on spirometry, adenosine was safe and well tolerated.
    No preview · Article · Aug 2007 · International journal of cardiology
  • W.J. van Gaal · B. Couthino · M. Chan · K.C. Allman

    No preview · Article · Jul 2006 · Journal of Nuclear Cardiology
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    ABSTRACT: Acute pulmonary thromboembolism (PTE) can be associated with right ventricular (RV) dysfunction. The relative importance of individual echocardiographic parameters, including those suggesting interdependence between right and left heart chambers, in predicting thromboembolic burden in elderly patients with acute PTE is unknown. We retrospectively studied the transthoracic echocardiograms of 63 elderly patients (age 71 +/- 16 years) with acute PTE, and assessed which individual echocardiographic parameters identified more than 30% pulmonary artery obstruction on the basis of quantitative ventilation/perfusion pulmonary scintigraphy. RV hypokinesis (visual grade 0-3, P = .02), and the quantitative parameters RV end-systolic area (P = .005) and RV ejection area (P = .01) were associated with more extensive pulmonary artery obstruction. Although right atrial end-systolic area and RV end-diastolic area did not correlate with extent of PTE, the ratio of RV:left ventricular end-diastolic area (P = .003), and ratio of right:left atrial end-systolic area (P = .004), were strongly associated with the extent of pulmonary artery obstruction. These transthoracic echocardiographic parameters were independent of clinical variables such as prior chronic lung disease, congestive cardiac failure, or prior PTE. RV systolic dysfunction, RV end-systolic dilatation, right:left atrial end-systolic area ratio, and RV:left ventricular end-diastolic area ratio correlate with extent of PTE in the elderly.
    No preview · Article · Apr 2006 · Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography
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    ABSTRACT: Transient ischemic dilation of the left ventricle found on SPECT myocardial perfusion imaging (MPI) is an accepted marker of severe and extensive coronary artery disease (CAD) and poor prognosis. The influence of other clinical variables on the incidence of transient ischemic dilation is less certain. The aim of this study was to investigate clinical factors that may influence the incidence of transient ischemic dilation. In particular, we looked at factors that may independently affect subendocardial perfusion, such as left ventricular hypertrophy (LVH) and diabetes. MPI studies of 103 consecutive patients who had undergone recent coronary angiography (< or =6 mo) and transthoracic echocardiography within a year of stress electrocardiography-gated MPI were retrospectively analyzed. Transient ischemic dilation was assessed quantitatively using a software program. A ratio cutoff of > or =1.22 was considered to represent transient ischemic dilation. Summed stress score and summed difference score (ischemia score) were determined using the standard 17-segment 5-point scoring system to quantify myocardial ischemia. LVH was defined as a left ventricular wall thickness of >11 mm on M-mode echocardiography. Severe CAD was defined as severe stenosis (> or =90%) of either the left anterior descending artery or both the right coronary and lateral circumflex arteries. Nineteen (18%) of the 103 patients had transient ischemic dilation, 19 (18%) had LVH, and 23 (22%) were diabetic. A high percentage had severe CAD (46/103 [45%]), whereas 57 of 103 (55%) had less severe CAD (30/103 [29%]) or nonsignificant CAD (26/103 [25%]). Severe CAD (P < 0.001), diabetes (P < 0.0001), LVH (P < 0.003), and the ischemia score (P < 0.023) were independent predictors of transient ischemic dilation by multivariate logistic regression. In patients with severe CAD, the effect of LVH on the incidence of transient ischemic dilation was additive, increasing the incidence from 21% (8/38) without LVH to 75% (6/8) with LVH (P < 0.006). Likewise, with severe CAD, the incidence of transient ischemic dilation rose from 21% (7/33) in patients without diabetes to 54% (7/13) in those with diabetes (P < 0.04). The presence of transient ischemic dilation on myocardial perfusion SPECT is associated with the presence of severe CAD, but this association is modified by the presence of LVH and diabetes.
    Full-text · Article · Oct 2005 · Journal of Nuclear Medicine
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    ABSTRACT: A 26-year-old man presented with left lower leg pain after a skiing injury. Plain radiography was initially reported as normal at the site of the suspected fracture but revised after the bone scan. An additional area of calcification was described adjacent to the proximal fibula without a conclusive diagnosis. A fibula fracture was easily apparent on Tc-99m bone scintigraphy, and the more proximal focus of uptake in the soft tissues was thought to be an area of myositis ossificans, subsequently confirmed on ultrasound. The patient provided a history of trauma to the area 1 year previously. The typical correlative imaging features of confounding myositis ossificans and a stress fracture are outlined.
    No preview · Article · Jan 2005 · Clinical Nuclear Medicine
  • L Emmett · K. C Allman · M Magee · B Freedman · W Van Gaal · L Kritharides
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    ABSTRACT: Transient ischaemic dilatation (TID) on myocardial perfusion imaging (MPI) is an indicator of severe coronary artery disease (CAD), but its dependence on other clinical variables is less well defined. The aim of this study was to explore the relationship between clinical variables, particularly left ventricular hypertrophy (LVH), diabetes, and TID.Methods: MPI studies of 103 consecutive patients who underwent coronary angiography within 6 months and transthoracic echocardiography within a year of stress ECG-gated MPI were retrospectively analysed. TID was assessed visually with the consensus agreement of 2 readers. Summed stress scores (SSS) were determined using the standard 17 segment module. Severe CAD was defined as >90% LAD stenosis, or > 2 vessels >90% stenosis. LVH was defined as LV wall thickness >1.1mm on echo.Results:*VariableTID positiveTID negativeP valueSevere CAD15/28 (62%)28/75 (35%)
    No preview · Article · Aug 2004 · Journal of Nuclear Cardiology
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    Full-text · Article · Jul 2004 · Journal of Nuclear Cardiology
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    Preview · Article · Jun 2004 · Circulation
  • Kevin C Allman · S Ben Freedman

    No preview · Article · Feb 2004 · Journal of Nuclear Cardiology
  • Kevin C. Allman · Florence Prigent

    No preview · Article · Nov 2003 · Journal of Nuclear Cardiology

Publication Stats

2k Citations
479.62 Total Impact Points


  • 1990-2013
    • Royal Prince Alfred Hospital
      • Department of Pet & Nuclear Medicine
      Camperdown, New South Wales, Australia
  • 2004-2010
    • University of Sydney
      Sydney, New South Wales, Australia
  • 1996-2006
    • Concord Repatriation General Hospital
      Sydney, New South Wales, Australia
  • 1997-2004
    • Concord Hospital
      Concord, New Hampshire, United States
  • 1993-1999
    • University of Michigan
      • Department of Internal Medicine
      Ann Arbor, Michigan, United States
    • Concordia University–Ann Arbor
      Ann Arbor, Michigan, United States