Thesis (MScMed)--Stellenbosch University, 2004. / Copy not signed by author. / ENGLISH ABSTRACT: This study involved 33 patients, 19 men and 14 women. The age range was wide (20-90 years) and median age was 57 years. These patients had a single pulmonary nodule (SPN) defined radiologically as a well defined, round or oval intrapulmonary lung lesion not associated with atelectasis or adenopathy on chest radiography or computed tomography. Patients were investigated with Tc-99m MIBI and TI-201 (25 patients) and with Tc-99m MIBI alone (8 patients). Single photon emission computed tomography images were reconstructed using both iterative reconstruction (Ordered Subsets - Expectation Maximisation: aSEM) and filtered backprojection (FBP), on the Hermes system. Transverse, coronal and sagittal slices were displayed on the screen using a grey scale. The aSEM and FBP images for each study were co-registered semi-automatically using the multimodality programme on the Hermes. The best slice for the lesion was chosen according to the best view used to locate the SPN on chest radiograph. Regions of interest (Ral) were drawn manually outside the outer margin of the detected lesion, first on the aSEM image. This was automatically mirrored on the co-registered FBP image. For most patients, the background was automatically mirrored horizontally on the contralateral side, again, first on the OSEM then automatically on the FBP image. Automatic vertical mirroring or manual horizontal mirroring was used when background was found to be in a visually 'hot' area like the heart or vertebrae. The average counts and standard deviation of the Ral and background were generated automatically. Semi-quantitative image analysis was done by calculating the signal-to-noise ratio (SNR) and tumour-to-background (TIB) ratio using the following formulae: SNR = Mean counts ROI(lesion) - Mean counts background Standard deviation background TIB rati.o = -M---e-a-n-'--c-o--u-n-'t-s- ROI(lesion) Mean counts background Detection was found to be the same for the two reconstruction algorithms, that is, every lesion detected by using OSEM could also be detected by using FBP. However lesion detection did differ between Tl-201 and Tc-99m-MIBI. Sensitivity and specificity were calculated for different thresholds of SNR and TIB ratios. Receiver operating characteristics (ROC) curves were drawn to represent the different sensitivities and specificities at each threshold. Tuberculosis (TB) was not included in this analysis as uptake of Tl-20l was found to be significantly high and comparable to that of malignant nodules. However the effect of OSEM and FBP on the 'positive' TB nodules was assessed separately. By calculating the area under the ROC curves, TI-201 using OSEM was shown to be more accurate at differentiating malignant nodules from benign ones than FBP. Although this difference was not statistically significant (p=0.1 0), there was a clear tendency. The two reconstruction algorithms were found to be almost equally accurate, when using Tc-99m-MIBI, the difference between them being considerably insignificant. In conclusion, it was shown that there is a tendency that OSEM outperforms FBP for studies using Tl-201 but not for Tc-99m-MIBI. / AFRIKAANSE OPSOMMING: Hierdie studie sluit 33 pasiënte in, 19 mans en 14 vroue. Die ouderdomme wissel tussen 20 en 90 jaar met 'n gemiddelde ouderdom van 57 jaar. Elkeen van die pasiënte het 'n enkel longnodule (SPN) op borskas X-straal en/of rekenaar tomografie getoon, wat radiologies gedefinieer word as 'n goed omskrewe, ronde of ovaal intrapulmonale longletsel wat nie met atelektase of adenopatie geassosieer is nie. Pasiënte is met Tc-99m MIDI en TI-201 (25 pasiënte) of slegs met Tc-99m MIBI (8 pasiënte) ondersoek. Enkelfoton emissie rekenaar tomografiese (EFERT) beelde is met beide iteratiewe rekonstruksie (Ordered Subsets - Expectation Maximisation: OSEM) en gefilterde terugprojeksie (FBP) met die Hermes sisteem gerekonstrueer. Transvers, koronale en sagittale snitte is in grysskaal op die sisteem vertoon. Die OSEM en FBP beelde vir elke studie is semi-outomaties gekoregistreer met behulp van die multimodaliteitsprogram op die Hermes. Die optimale snit vir elke letsel is gekies volgens die beste aansig op die borskas X-straalom die SPN te lokaliseer. Gebiede van belang (ROl) is met die hand buite-om die buitenste rand van die letsel getrek op die OSEM beeld en daarna outomaties in die ooreenstemmende area op die gekoregistreerde FPB beeld geplaas. Vir die meeste pasiënte is die agtergrond outomaties as horisontale spieëlbeeld op die kontralaterale kant geplaas, eers op die OSEM en dan outomaties op die FBP beeld. 'n Outomatiese vertikale spieëlbeeld of manuele horisontale verskuiwing van die agtergrondsarea is gedoen indien die agtergrond oorvleuel het met 'n 'warm' area soos die hart of werwels. Die gemiddelde tellings en standaardafwyking van die ROl en agtergrond is outomaties gegenereer. Semi-kwantitatiewe beeldanalise is gedoen deur berekening van die sein-tot-agtergrond verhouding (signal-to-noise ratio - SNR) en tumor-tot-agtergrond (TIB) verhouding met behulp van die volgende formules: SNR = gemiddelde tellings ROI(letsel) - gemiddelde tellings agtergrond Standaard afwyking van agtergrond TIB rati.o = -g=em--id-d-e-l-d-e--te=ll-in-g-s__R:_O-I(-le-t-s'e-l) gemiddelde tellings agtergrond Opsporing is soortgelyk bevind vir die twee rekonstruksie algoritmes, dit wil sê elke letselopgespoor met behulp van OSEM kon ook met FBP opgespoor word. Letselwaameming het egter verskil tussen TI-201 en Tc-99m-MIBI. Sensitiwiteit en spesifisiteit is vir verskillende drempels van SNR en TIB verhoudings bereken. 'Receiver operating characteristics' (ROC) kurwes is getrek om die verskillende sensitiwiteite en spesifisiteite by elke drempel te verteenwoordig. Tuberkulose (TB) is nie in hierdie analise ingesluit nie aangesien opname van Tl-201 beduidend hoog en vergelykbaar met die van maligne nodules was. Die effek van OSEM en FBP op die 'positiewe' TB nodules is egter apart beoordeel. Deur berekening van die area onder die ROC kurwes, is getoon dat OSEM van Tl-201 tomografiese data meer akkuraat as FBP was om maligne van benigne nodules te onderskei. Alhoewel hierdie verskil nie statisties betekenisvol was nie (p=0.10), is daar wel 'n duidelike neiging gevind. Die twee rekonstruksie algoritmes was byna ewe akkuraat wanneer Tc-99m-MIBI gebruik is, met duidelik geen betekenisvolle verskil tussen die algoritmes nie. Gevo lgtrekking In hierdie studie is dit getoon dat daar 'n neiging is dat OSEM beter vaar as FBP vir studies met tallium-201 maar nie vir Tc-99m-MIBI nie.

Single photons - discrete wavepackets of light - are one of the most fundamental entities in physics. In recent years, the ability to consistently create and manipulate both single photons and pairs of photons has facilitated everything from tests of quantum theory to the implementation of quantum-enhanced precision measurements. These activities all fall within the scope of the rapidly-growing field of quantum information - the exploitation of the properties of quantum states (and specifically their capability to exist in superpositions) to accomplish tasks that would not be possible with classical objects. One stated goal of research in quantum information is to build a device consisting of a network of quantum logic gates that can evaluate quantum algorithms. The photonic implementation of individual logic gates has already been demonstrated. However, partly due to standard methods of preparing single photons, current schemes have severe limitations in terms of scaling up from a single logic gate to multiple concatenated operations. Until now it has not been proven that single photons can be generated in pure and indistinguishable quantum states, something upon which the successful operation of optical quantum logic gates relies. This thesis presents an experimental demonstration of simultaneous generation of almost identical single photons in highly pure states from two independent sources based on parametric downconversion. This is a process of photon pair generation during the passage of a light beam through a nonlinear crystal; one photon from the resulting pair is detected to herald the other. The work herein describes, refines, and implements a technique that minimises the strong quantum correlations usually present within each pair by spectral engineering of the source. This allows the heralded single photons to be in pure states, a property that is confirmed by observing a high-visibility two-photon interference effect without spectral filtering.

Fluorescence based analysis is a fundamental research technique used in the life sciences. However, conventional fluorescence intensity measurements are prone to misinterpretation due to illumination and fluorophore concentration non-uniformities. Thus, there is a growing interest in time-resolved fluorescence detection, whereby the characteristic fluorescence decay time-constant (or lifetime) in response to an impulse excitation source is measured. The sensitivity of a sample’s lifetime properties to the micro-environment provides an extremely powerful analysis tool. However, current fluorescence lifetime analysis equipment tends to be bulky, delicate and expensive, thereby restricting its use to research laboratories. Progress in miniaturisation of biological and chemical analysis instrumentation is creating low-cost, robust and portable diagnostic tools capable of high-throughput, with reduced reagent quantities and analysis times. Such devices will enable point-of-care or in-the-field diagnostics. It was the ultimate aim of this project to produce an integrated fluorescence lifetime analysis system capable of sub-nano second precision with an instrument measuring less than 1cm3, something hitherto impossible with existing approaches. To accomplish this, advances in the development of AlInGaN micro-LEDs and high sensitivity CMOS detectors have been exploited. CMOS allows electronic circuitry to be integrated alongside the photodetectors and LED drivers to produce a highly integrated system capable of processing detector data directly without the need for additional external hardware. In this work, a 16x4 array of single-photon avalanche diodes (SPADs) integrated in a 0.35μm high-voltage CMOS technology has been implemented which incorporates two 9-bit, in-pixel time-gated counter circuits, with a resolution of 400ps and on-chip timing generation, in order to directly process fluorescence decay data. The SPAD detector can accurately capture fluorescence lifetime data for samples with concentrations down to 10nM, demonstrated using colloidal quantum dot and conventional fluorophores. The lifetimes captured using the on-chip time gated counters are shown to be equivalent to those processed using commercially available external time-correlated single-photon counting (TCSPC) hardware. A compact excitation source, capable of producing sub-nano second optical pulses, was designed using AlInGaN micro-LEDs bump-bonded to a CMOS driver backplane. A series of driver array designs are presented which are electrically contacted to an equivalent array of micro-LEDs emitting at a wavelength of 370nm. The final micro-LED driver design is capable of producing optical pulses of 300ps in width (full width half maximum, FWHM) and a maximum DC optical output power of 550μW, this is, to the best of our knowledge, the shortest reported optical pulse from a CMOS driven micro-LED device. By integrating an array of CMOS SPAD detectors and an array of CMOS driven AlInGaN micro-LEDs, a complete micro-system for time-resolved fluorescence analysis has been realised. Two different system configurations are evaluated and the ability of both topologies to accurately capture lifetime data is demonstrated. By making use of standard CMOS foundry technologies, this work opens up the possibility of a low-cost, portable chemical/bio-diagnostic device. These first-generation prototypes described herein demonstrate the first time-resolved fluorescence lifetime analysis using an integrated micro-system approach. A number of possible design improvements have been identified which could significantly enhance future device performance resulting in increased detector and micro-LED array density, improved time-gate resolution, shorter excitation pulse widths with increased optical output power and improved excitation light filtering. The integration of sample handling elements has also been proposed, allowing the sample of interest to be accurately manipulated within the micro-environment during investigation.

No description available.

Diabetes is a rapidly growing disease with 415 million affected adults worldwide. The pancreatic endocrine cells, most importantly the insulin producing β-cells, play an important role in regulating blood glucose homeostasis. Type 1 diabetes (T1D) is characterized by the inability of the pancreas to secrete sufficient amounts of insulin due to autoimmune destruction of insulin producing β-cells. Type 2 diabetes (T2D) on the other hand is characterized by defects in insulin secretion and insulin sensitivity. Alterations in the β-cell mass (BCM) and/or function play a major role in the development and progression of the disease. Understanding BCM dynamics in disease models is therefore a key aspect for better interpretation of research results. In this thesis, we have used optical projection tomography (OPT) as a tool to evaluate a non-invasive imaging modality for β-cell scoring and to study disease dynamics in frequently used animal models for T1D and T2D. The possibility to monitor BCM in vivo would radically improve our competence in studying the pathogenesis of diabetes and in therapeutic interventions. Single photon emission computed tomography (SPECT) is a widely used technique that has become a promising approach to monitor changes in BCM in vivo. A key issue for using this approach is to evaluate the β-cell specificity and read out of the utilized radiotracers. This is most commonly performed by conventional stereological approaches, which rely on the extrapolation of 2D data. We developed a protocol for SPECT-OPT multimodal imaging that enables rapid and accurate cross evaluation of SPECT based assessments of BCM. While histological determination of islet spatial distribution was challenging, SPECT and OPT revealed similar distribution patterns of the radiotracer 111In-exendin-3 and insulin positive β-cell volumes respectively between different pancreatic lobes, both visually and quantitatively. We propose SPECT-OPT multimodal imaging as an accurate and better approach for validating the performance of β-cell radiotracers. The leptin deficient ob/ob mouse is a widely used model for studies of metabolic disturbances leading to T2D, including obesity and insulin resistance. By OPT imaging we created the first 3D-spatial and quantitative account of BCM distribution in this model. We observed a previously unreported degree of cystic lesions in hypertrophic islets, that were occupied by red blood cells (RBCs) and/or fibrin mesh. We propose that these lesions are formed by a mechanism involving the extravasation of RBCs/plasma due to increased blood flow and islet vessel instability. Further, our data indicate that the primary lobular compartments of the ob/ob pancreas have different potentials for expanding their β-cell population. Unawareness of these characteristics of β-cell expansion in ob/ob mice presented in this study may significantly influence ex vivo and in vivo assessments of this model in studies of β-cell adaptation and function. The tomographic data, on which this study was based, will be made publically available as a resource to the research community for the planning and interpretation of research involving this model. There are limited studies on early metabolic and functional changes of BCM in the settings of T1D. In order to assess initial metabolic alterations in BCM before the onset of diabetes, we characterized congenic diabetes prone Bio-breeding (BB) DR.lyp/lyp rats, a widely used model for T1D diabetes. We observed lower acute insulin response, reduced islet blood flow and a significant reduction in the BCM of small and medium sized islets at a very early stage (40 days), i.e. before insulitis and development of diabetes. Underlying changes in islet function may be a previously unrecognized factor of importance in the development of T1D.

This thesis reports the study of single photon sources that emit one infrared wavelength photon at a time, creating cavity quantum electrodynamical effects for applications such as quantum information processing. This work considers two major single photon sources: a) InAs single quantum dots and b) single carbon nanotubes, which both emit in the infrared range. Photonic crystal slabs and photonic crystal waveguides are served as distinctive passive devices with manipulated photonic band-gaps to control the propagating light. A simulation of leaky modes of two-dimensional photonic crystal slabs is introduced to constrain model parameters in the device design. Fullerenes are used as fluorescent material to achieve resonance of a leaky mode with excitation 1492 nm and emission at 1519 nm and to see enhancement of the PL. We include novel characterization techniques and PL measurements to show sharp emission peaks from single quantum dots and successfully couple them to micro-cavities. The strong coupling effect is observed and is amongst the best examples of cavity-dot structures achieved to date. Single-walled carbon nanotubes have shown anti-bunched light emission, thus we systematically study them as another possible candidate of single photon sources. PLE spectra show clear evidence of the existence of excited states, and time evolution measurements reveal the disorder induced diffusion, which separate the tubes into a series of quantum dots. These strongly confined states are concluded as the origin of the possibility that single-walled carbon nanotubes are single photon sources.

Nucleic acids, such as DNA, play an essential role in all known forms of life; however, despite their fundamental importance, there is still a significant lack of understanding surrounding their functional behaviour. This thesis explores the structure and dynamics of DNA by employing methods based on fluorescence and through the use of computational calculations. Time-resolved fluorescence experiments have been performed on dinucleotides containing 2-aminopurine (2AP) in various alcohol-water mixtures. 2AP, a fluorescent analogue of the nucleobase adenine, has been used extensively to investigate nucleic acids because of its ability to be incorporated into their structures with minimal perturbation and its high sensitivity to its local environment. Direct solvent effects on 2AP were established through measurements on the free fluorophore. Analysis of the complex fluorescence decays associated with the dinucleotides was challenging but has provided insight into their conformational dynamics. Solvent polarity was found to play a significant role in determining both photophysical and conformational properties in these systems. The complicated fluorescence decay of 2AP in nucleic acids highlights the need for accurate and unbiased analysis methods. Various time-resolved fluorescence analysis methods, including iterative reconvolution and the exponential series method, have been investigated with real and simulated data to obtain an overview of their benefits and limitations. The main outcome of the evaluation is that no single method is preferred in all situations and there is likely to be value in using a combination when there is ambiguity in the interpretation of the results. Regardless of the analysis technique used, the parameterised description of the observed fluorescence decay is meaningless if the underlying physical model is unrealistic. The advance of computational methods has provided a new means to rigorously test the viability of proposed models. Calculations have been performed at the M06-2X/6-31+G(d) level of theory to investigate the stability of 2AP-containing dinucleotides in conformations similar to those observed in the double-helical structure of DNA. The results help to explain the similarity of the time-resolved fluorescence behaviour of 2AP in dinucleotide and DNA systems but also bring to light subtle differences that could perhaps account for experimental discrepancies. The recent emergence of advanced optical microscopy techniques has offered the prospect of being able to directly visualise nucleic acid structure at the nanoscale but, unfortunately, limitations of existing labelling methods have hindered delivery of this potential. To address this issue, a novel strategy has been used to introduce reversible fluorescence photoswitching into DNA at high label density. Photophysical studies have implicated aggregation and energy-transfer as possible quenching mechanisms in this system, which could be detrimental to its future application. The reliability of fluorescence photoswitching was investigated at ensemble and single-molecule level and by performing optical lock-in detection imaging. These developments lay the foundations for improved and sequence-specific super-resolution microscopy of DNA, which could offer new insights into the 3D nanoscale structure of this remarkable biopolymer. In summary, the work presented in this thesis outlines important observations and developments that have been made in the study of the structure and dynamics of nucleic acids.

Este trabalho apresenta o desenvolvimento de dispositivos semicondutores utilizando óxidos de zinco e estanho. O primeiro dispositivo semicondutor estudado está relacionado ao desenvolvimento de sensores de pH a partir do efeito de campo, enquanto que o segundo consiste na utilização de ondas acústicas de superfície para o transporte de portadores voltados para o desenvolvimento de detectores de um único fóton. Primeiramente, esses materiais foram utilizados como membranas sensíveis a íons de hidrogênio. Para isso foram fabricados os dispositivos denominados EGFETs cujo princípio de funcionamento é semelhante ao ISFET. Foram desenvolvidos filmes de SnO2 obtidos a partir da rota Pechini e pela técncia Sol-gel com o objetivo de investigar a resposta elétrica do EGFET em função da concentração de íons de H+ . Os sensores fabricados pela técnica sol-gel não apresentaram respostas satisfatórias devido à presença de poros. Por outro lado, obtivemos uma sensibilidade de 33mV/pH para o EGFET desenvolvido a partir da rota Pechini com uma membrana calcinada à 400o C. Propusemos também a utilização do ZnO como um possível candidato a sensor de pH a partir do EGFET. A melhor resposta do EGFET (uma sensibilidade de 38mV/pH) foi alcançada com a utilização de filmes de ZnO aquecidos à temperatura de 150o C. Além dos dispositivos para a detecção de íons de H+ apresentamos uma nova abordagem para a detecção de um único fóton a partir da combinação de dispositivos utilizando ondas acústicas de superfície e os transistores de um único elétron. Basicamente os protótipos consistem em uma estrutura de várias camadas otimizadas para uma eficiente absorção de fótons, uma junção p-i-n utilizada para coleta de portadores, IDT para geração da SAW e guias metálicos para controle de portadores durante o transporte acústico. Os portadores são eficientemente transportados por uma distância de 100 mm com uma perda de 12 % para a melhor configuração. Nessas condições, a eficiência do dispositivo é de 75%. / This work presents the study and development of semiconductor devices base on tin and zinc oxides. The first device is related to the development of pH sensors based on field effect, while the second device uses surface acoustic waves for the transport of carriers related to a single photon detector device. Initially, the semiconductors were used as hydrogen ions sensing membranes. For that aim extended gate field effect transistors (EGFET) were developed. Their working principle is similar to the ion sensitive field effect transistor (ISFET). Through Pechini and sol-gel SnO2 thin films were obtained. The EGFET response to H+ ions was not optimal due to the presence of pores. Using Pechini, a response of 33mV/pH was obtained for the EGFET membrane calcinated at 400o C. The use of ZnO as sensing membrane was also investigated, and the best response was a sensibility of 38mV/pH) for a film heated up to 150o C. In addition to the EGFET structure, a new approach to a single photon detection is presented. This uses the combination of surface acoustic waves with a single electron transistor. Two prototypes were developed using a multi-layered structure optimized for photon absorption. Carriers are collected using a p-i-n structure. Inter-digital-transducers are used for surface acoustinc wave generation. Metallic guides are used to control the carriers during acoustic tranport. Carriers were efficiently transported over a length of 100 mm with a loss of 12 % for the best configuration. Under this optimized conditions, the efficiency of the device is 75%.

INTRODUÇÃO: O zumbido é um sintoma muito freqüente e de difícil tratamento. Atualmente, algumas evidências mostraram que o zumbido está associado a alterações funcionais do sistema nervoso central. Nos últimos anos, a modulação da atividade cortical relacionada ao zumbido por meio da estimulação magnética transcraniana repetitiva (EMT) tem sido proposta como um tratamento promissor. Entretanto, nenhum estudo avaliou sua eficácia no controle do zumbido em pacientes sem perda auditiva concomitante, nem seu efeito de longa duração. O objetivo do trabalho foi investigar os efeitos imediatos e a longo prazo da estimulação magnética transcraniana repetitiva de baixa freqüência (1 Hz) em pacientes com zumbido e audiometria normal. MÉTODOS: Utilizando um ensaio clínico aleatorizado, duplo cego e paralelo, foram randomizados 20 pacientes para receber a EMT ativa ou placebo. A estimulação foi aplicada no córtex têmporo-parietal esquerdo por cinco dias consecutivos. A avaliação clínica foi feita por meio do Tinnitus Handicap Inventory e da escala análogo-visual. A avaliação por neuroimagem foi feita por meio do SPECT, o qual foi realizado antes e 14 dias após o período de estimulação. RESULTADOS: Clinicamente, o grupo submetido à estimulação magnética transcraniana ativa apresentou uma melhora significativa do zumbido, mantida por até seis meses, quando comparado ao grupo que recebeu a estimulação placebo. A avaliação por SPECT demonstrou redução do fluxo sanguíneo no lobo temporal esquerdo após o período de estimulação ativa. CONCLUSÃO: Os resultados revelam o potencial terapêutico da estimulação magnética transcraniana como nova ferramenta no tratamento do zumbido, proporcionando redução significativa do incômodo provocado pelo zumbido por até seis meses e reduzindo a atividade neuronal no córtex temporal. / INTRODUCTION: Tinnitus is a frequent disorder which is very difficult to treat. There is compelling evidence that tinnitus is associated with functional alterations in the central nervous system. Recently, the targeted modulation of tinnitus-related cortical activity through repetitive transcranial magnetic stimulation (rTMS) has been proposed as a promising new treatment approach. However, its efficacy in patients without hearing loss has never been studied, as well as the long-term duration of its effect. The objective of this study was to investigate both immediate and long-term effect of low frequency (1 Hz) rTMS in patients with tinnitus and normal hearing. METHODS: Using a randomized double-blind and parallel clinical trial, 20 patients were divided to receive either active or placebo transcranial magnetic stimulation over the left temporoparietal cortex for 5 consecutive days. The clinical evaluation was performed by using the Tinnitus Handicap Inventory and the visual analogue scale. The neuroimage evaluation included and ECD-SPECT imaging, which was performed before and 14 days after rTMS. RESULTS: From the clinical point of view, the group submitted to active rTMS presented significant improvement of the tinnitus score, which was sustained up to six months, when compared to the group that received the sham rTMS. SPECT measurements demonstrated a reduction of metabolic activity in the left temporal lobe after active rTMS. CONCLUSION: These results support the potential of rTMS as a new therapeutic tool for the treatment of chronic tinnitus, by demonstrating a significant reduction of tinnitus complaints over a period of at least six months and a significant reduction of neural activity in the temporal cortex.

Bakgrund: Kranskärlssjukdom (CAD) är en hjärtsjukdom som kan diagnostiseras med icke-invasiva metoder, såsom myocardial perfusion imaging med single-photon emission computed tomography (SPECT), och genom invasiva metoder, såsom invasiv koronarangiografi (ICA). ICA är den golden standardmetod för att diagnostisera CAD. Men å andra sidan är ICA mer kostsam än SPECT och kan orsaka många komplikationer. Metoder och resultat: det är en retrospektiv kohortstudie. Studien analyserade 62 patienter som har genomgått både SPECT och ICA under 2018 vid Universitetssjukhuset Örebro (USÖ). Av dessa 62 utförde 56 patienter SPECT först. Analyseringen gjordes för att undersöka hur väl resultatet av ICA-sjukdomsdetektering och lokalisering kunde bestämmas av SPECT. Aktiv CAD definierades som närvaron av en behandling-krävande signifikant stenos vid ICA. SPECT-resultaten visade att 91% av fallen var patologiska och 9% var icke-patologiska. Sensitivitet, specificitet och noggrannhet för SPECT för detektering av aktiv CAD var 89%, 7% respektive 47% vid referens till ICA. Medan positiva prediktiva värden (PV +) och negativa prediktiva värden (PV-) var 48% respektive 40%. SPECT sensitivitet för lokalisering av defekter i referens till ICA var 35% för LAD-defekter, 68% för LCX-defekter och 92% för RCA-defekter. Slutsats: Resultatet skilde sig från den ursprungliga hypotesen. SPECT anses fortfarande vara effektiv för att identifiera patienter med aktiv CAD. Därför kan SPECT användas som initial undersökningsmetod för utvärdering av CAD hos patienter med låg till måttlig risk. SPECT var inte optimalt för att lokalisera defekterna.