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Sample records for ecd brain spect

  1. Evaluation of {sup 99m}Tc-ECD SPECT for the detection of brain tumor. Comparison with {sup 201}Tl SPECT

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    Oshima, Motoo; Sasaki, Yasushi; Kikuchi, Yoshirou; Kaminaga, Tatsuro; Furui, Shigeru [Teikyo Univ., Tokyo (Japan). Faculty of Medicine; Konoeda, Kouichi; Karigome, Masato; Yoshida, Katsuhiko

    1997-01-01

    For the evaluation of brain tumor (n=15), we performed both dynamic and static {sup 99m}Tc-ECD (ECD) SPECT studies. {sup 201}Tl SPECT was also used for comparison with the results of ECD SPECT. Dynamic ECD SPECT was obtained following the injection of 600 MBq of ECD. Five min after the injection of ECD, static ECD SPECT was performed. {sup 201}Tl SPECT was obtained 10 min after the injection of 74 MBq. Abnormal uptake was recognized in 7 of 15 tumors with dynamic ECD; 5 of 7 meningiomas, 1 of 1 glioblastoma and 1 of 1 astrocytoma. However, no abnormal uptake was seen in 3 of 3 benign tumors (1 low grade astrocytoma, 1 hemangioma, 1 craniopharyngioma) and in 2 of 2 brain metastases. In contrast abnormal uptake was seen in 11 of 15 tumors with {sup 201}Tl; 7 of 7 meningiomas, 2 of 2 brain metastases, 1 of 1 glioblastoma and 1 of 1 craniopharyngioma. No abnormal uptake was seen in 3 of 3 benign tumors (1 hemangioma and 2 low grade astrocytomas). Equivocal uptake was seen in 1 low grade astrocytoma with dynamic ECD and {sup 201}Tl. The mechanism of the accumulation of dynamic ECD to brain tumor is unclear. However, it may reflect not only blood flow, but also metabolism. (author)

  2. 99mTc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia

    International Nuclear Information System (INIS)

    Guedj, Eric; Taieb, David; Cammilleri, Serge; Lussato, David; Laforte, Catherine de; Mundler, Olivier; Niboyet, Jean

    2007-01-01

    Neuro-imaging studies with 99m Tc-HMPAO SPECT in fibromyalgia (FM) patients have reported only limited subcortical hypoperfusion. 99m Tc-ECD SPECT is known to provide better evaluation of areas of high cerebral blood flow and regional metabolic rate. We evaluated a homogeneous group of hyperalgesic patients with FM using 99m Tc-ECD SPECT. The aim of this study was to investigate brain processing associated with spontaneous pain in FM patients. Eighteen hyperalgesic FM women (mean age 49 years, range 25-63 years; American College of Rheumatology criteria) and ten healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). Visual Analogue Scale score for pain was 82±4 at the time of the SPECT study. Compared with control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis, with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. In the present study, performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in the sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective-attentional dimension. As current pharmacological and non-pharmacological therapies act differently on the two components of pain, we hypothesise that SPECT could be a valuable and readily available tool to guide individual therapeutic strategy and provide objective follow-up of pain processing recovery under treatment. (orig.)

  3. {sup 99m}Tc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia

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    Guedj, Eric; Taieb, David; Cammilleri, Serge; Lussato, David; Laforte, Catherine de; Mundler, Olivier [Assistance Publique des Hopitaux de Marseille, Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 05 (France); Niboyet, Jean [Clinique La Phoceanne, Unite d' Etude et de Traitement de la Douleur, Marseille (France)

    2007-01-15

    Neuro-imaging studies with {sup 99m}Tc-HMPAO SPECT in fibromyalgia (FM) patients have reported only limited subcortical hypoperfusion. {sup 99m}Tc-ECD SPECT is known to provide better evaluation of areas of high cerebral blood flow and regional metabolic rate. We evaluated a homogeneous group of hyperalgesic patients with FM using {sup 99m}Tc-ECD SPECT. The aim of this study was to investigate brain processing associated with spontaneous pain in FM patients. Eighteen hyperalgesic FM women (mean age 49 years, range 25-63 years; American College of Rheumatology criteria) and ten healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). Visual Analogue Scale score for pain was 82{+-}4 at the time of the SPECT study. Compared with control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis, with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. In the present study, performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in the sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective-attentional dimension. As current pharmacological and non-pharmacological therapies act differently on the two components of pain, we hypothesise that SPECT could be a valuable and readily available tool to guide individual therapeutic strategy and provide objective follow-up of pain processing recovery under treatment. (orig.)

  4. Evaluation of brain perfusion SPECT imaging using 99mTc-ECD

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi; Kinuya, Keiko; Higashi, Sotaro; Kawasaki, Yasuhiro; Sumiya, Hisashi; Shuke, Noriyuki; Hisada, Kinichi; Yamashita, Junkoh; Yamaguchi, Nariyoshi

    1991-01-01

    Fundamental and clinical evaluation was performed on 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD), that is a new agent for brain perfusion SPECT. Radiochemical purity reaches a plateau of approximately 98% at 30 min after reconstruction and remains stable up to 24 hours later. A biodistribution study showed approximately 5% injected dose in the brain, very slow brain washout of 5.6% per hour on the average, and rapid washout from the other organ mainly through the urinary system. Brain ECD distribution was determined within 2 min postinjection and remained stable for up to 1 hour. Three hours later, slight but significant changes in brain distribution were observed, that were relative reduction of cerebral cortical activity and gray to white matter activity ratio, and relative elevation of white matter and thalamic activities. Comparative studies of ECD images with 123 I-iodoamphetamine (IMP) and 99m Tc-d, l-hexa-methylpro-pyleneamine oxime (HMPAO) images revealed that radioactivity contrast between affected and unaffected areas was less prominent in ECD than in IMP in cerebral and cerebellar cortical lesions, more prominent in ECD than in IMP in striatal and thalamic lesions, and somewhat more prominent in ECD than in HMPAO in both lesions. Imaging around 1 hour postinjection seems to be more appropriate than immediate postinjection imaging because of the clearance of the extracranial radioactivity and somewhat better radioactivity contrast between affected and unaffected areas. (author)

  5. Usefulness of {sup 99m}Tc-ECD brain SPECT in acute onset pediatric CNS diseases. In comparison with CT and MRI

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    Hashimoto, Teisuke; Chikatsu, Hiroko; Nishiyama, Hiromune; Endo, Hiroko; Kono, Tatsuo; Iimura, Fumitoshi; Kuwashima, Shigeko; Saiki, Natoru; Fujioka, Mutsuhisa [Dokkyo Univ., Mibu, Tochigi (Japan). School of Medicine

    2001-07-01

    The purpose of this study was to assess the usefulness of regional cerebral blood flow (rCBF) measured by {sup 99m}Tc-L, L-ethyl cysteinate dimer (ECD) brain SPECT in the acute onset type of pediatric central nervous system (CNS) diseases. Thirteen children (7 girls, 6 boys, 4 month-12 years of age) who were diagnosed with 9 cases of viral encephalitis, two cases of febrile convulsion and one each of migraine and metabolic disorder underwent {sup 99m}Tc-ECD brain SPECT, CT and/or MRI within one week interval. The incidence of abnormal findings in the 13 patients was 96.4% (30/31) on {sup 99m}Tc-ECD brain SPECT, 17.6% (3/17) on CT and 63.6% (14/22) on MRI. The positive detection rate of {sup 99m}Tc-ECD brain SPECT was statistically (P<0.01 by a {chi}{sup 2} and/or Fisher's exact probability test) higher than those of CT and MRI. And the changes in rCBF were demonstrated. {sup 99m}Tc-ECD brain SPECT is a useful examination for the diagnosis and follow up management in patients with the acute onset type of pediatric CNS diseases. (author)

  6. SPM analysis of cerebrovascular reserve capacity after stimulation with acetazolamide measured by Tc-99m ECD SPECT in normal brain MRI patient

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    Lee, M. H.; Yoon, S. N.; Yoon, J. K.; Cho, C. W. [College of Medicine, Univ. of Ajou, Suwon (Korea, Republic of)

    2003-07-01

    This study was undertaken to evaluate normal response of acetazolamide in normal individuals, whose brain MRI is normal, using SPM99. In total, 10 Tc- 99m ECD brain SPECT were evaluated retrospectively. The half of the patients were male. Their mean age was 47.1 years old with a range of 33-61 years. They all visited our neurology department to evaluate stroke symptom. Their brain MRI was normal. Rest/acetazolamide brain SPECT was perfomed using Tc-99m ECD and the sequential injection and subtraction method. SPECT was acquired using fanbeam collimators and triple-head gamma camera (MultiSPECT III, Siemens medical systems, Inc. Hoffman Estates, III, USA). Chang's attenuation correction was applied their brain SPECT revealed normal rCBF pattern in visual analysis by two nuclear physician and they were diagnosed clinically normal. Using SPM method, we compared rest brain SPECT images with those of acetazolamide brain SPECT and measured the extent of the area with significant perfusion change (P<0.05) in predefined 34 cerebral regions. Acetazolamide brain SPECT showed no significant decreased region in comparison to rest brain SPECT. Only small portion of left mid temporal gyrus revealed increased rCBF on acetazolamide brain SPECT in comparison to rest brain SPECT. It apperas that there is no significant change in rCBF between rest and acetazolamide brain SPECT using Tc-99m ECD. The small number of this study is limitation of our study.

  7. Ictal 99mTc-ECD brain SPECT imaging: localization of seizure foci and correlation with semiology in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Kang, Do Young; Ryu, Jin Sook; Lee, Hee Kyung; Ma, Hyeo Il; Lee, Sang Ahm; Lee, Jung Kyo; Kang, Joong Koo

    1997-01-01

    The purpose of this study was to evaluate the usefulness of ictal 99m Tc-ECD brain SPECT in temporal lobe epilepsy (TLE) patients for presurgical localization of seizure foci, and to correlate ictal SPECT patterns with the semiology of seizure. ictal 99m Tc-ECD Brain SPECT was performed in 23 TLE patients whose MRI showed unilateral hippocampal atrophy (18 patients), other focal temporal lesions (4 patients) and normal finding (1 patient). Under CCTV monitoring, injection was done during ictal period in all patients with the mean delay of 38.5±17.3 sec (mean seizure duration : 90.5±35.9 sec). Ictal 99m Tc-ECD Brain SPECT was visually analysed by three blinded observers. All patients underwent temporal lobectomy with a minimum 3 months follow-up (range 3-29 months) ; all had good post-surgical seizure control (Engel's calssification class I). Ictal 99m Tc-ECD Brain SPECT showed unilateral temporal hyperperfusion concordant with epileptic foci in 22/23 (95.7%), whereas non-lateralization in 1/23 (4.3%). The hyperperfusion of the ipsilateral basal ganglia was present in 72.7% (16/22) of patients with dystonic/tonic posture of the contralateral hand. The contralateral cerebellar hyperperfusion was observed in the 7/22 (32%). The group with secondary generalized tonic clonic seizure (GTC) had brain stem and bilateral thalamic hyperperfusion in 4/7 (57.1%) while the group without secondary GTC had the same hyperperfusion in 1/16 (6.3%). There was statistically significant difference in brain stem and bilateral thalamic perfusion between two groups. Ictal 99m Tc-ECD Brain SPECT is a useful modality in pre-surgical localization of the epileptic foci and well correlated with the semiology of seizure

  8. Comparison of Tc-99m ECD brain SPECT between patients with delayed development and cerebral palsy

    International Nuclear Information System (INIS)

    Cho, I.; Chun, K.; Won, K.; Lee, H.; Jang, S.; Lee, J.

    2002-01-01

    Purpose: In previous study, thalamic or cerebellar hypoperfusion were reported in patients with cerebral palsy. This study was performed to evaluate cerebral perfusion abnormalities using Tc-99m ECD brain SPECT in patients with delayed motor development. Methods: Nineteen patients (9 boys, 10 girls, mean age 25.5 months) with delayed development underwent brain SPECT after injection of 185∼370 MBq of Tc-99m ECD. The imaging was obtained between 30 minutes and 1hr after injection. The patients were divided clinically as follows, patients with delayed development (n=5) and patients with cerebral palsy (n=14) who has delayed development and abnormal movement. The clinical subtypes of cerebral palsy were spastic quadriplegia (n=5), spastic diplegia (n=6) and spastic hemiplegia (n=3). In each group, decrease of cerebral perfusion was evaluated visually as mild, moderate and severe and quantitation of cerebral perfusion after Lassen's correction was also obtained. Results: SPECT findings showed normal or mildly decreased thalamic perfusion in patients with delayed development and severe decrease of thalamic or cerebellar perfusion in patients with spastic quadriplegia. In patients with spastic diplegia, mild decrease of perfusion was observed in thalamus. In quantified data, thalamic perfusion was lowest in patients with spastic quadriplegia and highest in patients with delayed development, but there were no statistically significant differences. Conclusion: Brain SPECT with Tc-99m ECD has a role in the detection of perfusion abnormalities in patients with delayed development and cerebral palsy

  9. Technetium-99m-ECD SPECT in antiphospholipid antibody syndrome: a drastic improvement in brain perfusion by antiplatelet therapy

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    Tokumaru, Sunao; Yoshikai, Tomonori; Uchino, Akira; Kudo, Sho [Dept. of Radiology, Saga Medical School (Japan); Matsui, Makoto; Kuroda, Yasuo [Dept. of Neurology, Saga Medical School (Japan)

    2001-12-01

    We present a case of antiphospholipid antibody syndrome (APS) with repeated transient ischemic attacks (TIAs). Magnetic resonance imaging showed multiple cerebral infarcts and ischemic changes in the cerebral white matter. Cerebral angiographies showed no abnormalities. Technetium-99m-ethyl cysteinate dimer (Tc-99m-ECD) brain SPECT showed multiple decreased perfusion areas, which were more extensive than the lesions demonstrated on MRI. After treatment with an antiplatelet agent, the patient subsequently recovered from the TIAs. Although no interval changes were observed by MRI after therapy, follow-up Tc-99m-ECD SPECT revealed a marked improvement in brain perfusion. This is the first imaging report of remarkable post-therapy improvement in brain perfusion in APS cases. (orig.)

  10. Technetium-99m-ECD SPECT in antiphospholipid antibody syndrome: a drastic improvement in brain perfusion by antiplatelet therapy

    International Nuclear Information System (INIS)

    Tokumaru, Sunao; Yoshikai, Tomonori; Uchino, Akira; Kudo, Sho; Matsui, Makoto; Kuroda, Yasuo

    2001-01-01

    We present a case of antiphospholipid antibody syndrome (APS) with repeated transient ischemic attacks (TIAs). Magnetic resonance imaging showed multiple cerebral infarcts and ischemic changes in the cerebral white matter. Cerebral angiographies showed no abnormalities. Technetium-99m-ethyl cysteinate dimer (Tc-99m-ECD) brain SPECT showed multiple decreased perfusion areas, which were more extensive than the lesions demonstrated on MRI. After treatment with an antiplatelet agent, the patient subsequently recovered from the TIAs. Although no interval changes were observed by MRI after therapy, follow-up Tc-99m-ECD SPECT revealed a marked improvement in brain perfusion. This is the first imaging report of remarkable post-therapy improvement in brain perfusion in APS cases. (orig.)

  11. The clinical usefulness of Tc-99m ECD brain SPECT in acute measles encephalitis

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    Lim, Seok Tae; Sohn, Myung Hee [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2003-08-01

    Since the prognosis of measles encephalitis is poor, early diagnosis and proper management are very important to improve clinical outcomes. We compared Tc-99m ECD brain SPECT (SPECT) with MR imaging (MRI) for the detection of acute measles encephalitis. Eleven patients (M : F=4 : 7, age range 18 months-14 yrs) with acute measles encephalitis were enrolled in this studies. All of them underwent both MRI and SPECT. The results of SPECT were scored from 0 (normal) to 3 (most severe defect) according to perfusion state. We compared two image modalities for the detection of brain abnormality in acute measles encephalitis. Seven of 11 patients (63.6%) revealed high signal intensity in the white matter on T2WI of MRI, on the other hand all patients (100%) showed hypoperfusion on SPECT. Severe perfusion deficits above score 2 were located with decreasing frequencies in the frontal lobe (81.8%), temporal lobe (72.7%), occipital lobe (27.3%), basal ganglia (27.3%), and parietal lobe (9.1%). We conclude that SPECT is more useful than MRI for the detection of brain involvement in patients with acute measles encephalitis.

  12. The clinical usefulness of Tc-99m ECD brain SPECT in acute measles encephalitis

    International Nuclear Information System (INIS)

    Lim, Seok Tae; Sohn, Myung Hee

    2003-01-01

    Since the prognosis of measles encephalitis is poor, early diagnosis and proper management are very important to improve clinical outcomes. We compared Tc-99m ECD brain SPECT (SPECT) with MR imaging (MRI) for the detection of acute measles encephalitis. Eleven patients (M : F=4 : 7, age range 18 months-14 yrs) with acute measles encephalitis were enrolled in this studies. All of them underwent both MRI and SPECT. The results of SPECT were scored from 0 (normal) to 3 (most severe defect) according to perfusion state. We compared two image modalities for the detection of brain abnormality in acute measles encephalitis. Seven of 11 patients (63.6%) revealed high signal intensity in the white matter on T2WI of MRI, on the other hand all patients (100%) showed hypoperfusion on SPECT. Severe perfusion deficits above score 2 were located with decreasing frequencies in the frontal lobe (81.8%), temporal lobe (72.7%), occipital lobe (27.3%), basal ganglia (27.3%), and parietal lobe (9.1%). We conclude that SPECT is more useful than MRI for the detection of brain involvement in patients with acute measles encephalitis

  13. Early and delayed Tc-99m ECD brain SPECT in SLE patients with CNS involvement

    International Nuclear Information System (INIS)

    Kikukawa, Kaoru; Toyama, Hiroshi; Katayama, Masao

    2000-01-01

    We compared early and delayed Tc-99m ECD SPECT scans in 32 SLE patients (Group 1, definite neuropsychiatric disorders; Group 2, minor neurologic symptoms or normal) with those of normal controls by visual inspection and semi-quantitative evaluation. With visual interpretation, 13 out of 14 patients in Group 1 (93%) and 7 out of 18 patients in Group 2 (39%) had diffuse uneven decrease in early scans. Seven patients in Group 2 (39%) who had normal early scans demonstrated focal decrease in the medial frontal lobe in delayed scans. With cerebral region to cerebellar ratios, in early scans, the medial frontal lobe in Group 1 and Group 2 was significantly lower than in normal controls, and lateral frontal lobe and occipital lobes in Group 1 were significantly lower than in normal controls. Nevertheless, in delayed scans, every cortical region except for the parietal lode in Groups 1 and 2 was significantly lower than in normal controls. The retention rates in all regions in SLE patients were significantly lower than in normal controls. No case showed SPECT improvement on follow-up studies in either group in spite of clinical improvement. Delayed Tc-99m ECD brain SPECT of high sensitivity might be useful in detecting CNS involvement. Although the SPECT findings did not correlate with the neuropsychiatric symptoms, early and delayed Tc-99m ECD SPECT seems to provide useful objective diagnostic information in SLE patients. (author)

  14. Tc-99m ECD brain SPECT in MELAS syndrome and mitochondrial myopathy: comparison with MR findings

    International Nuclear Information System (INIS)

    Park, Sang Joon; Ryu, Young Hoon; Jeon, Tae Joo; Kim, Jai Keun; Nam, Ji Eun; Yoon, Pyeong Ho; Yoon, Choon Sik; Lee, Jong Doo

    1998-01-01

    We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were performed and imaging features were analyzed. MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients

  15. Perfusion impairments in children with reactive attachment disorder (RAD) on 99mTc-ECD brain SPECT: comparison with MR findings

    International Nuclear Information System (INIS)

    Yoo, Y. H.; Sin, E. J.; Cheon, K. A.; Yoon, M. J.; Lee, J. D.; Jeon, T. J.

    2002-01-01

    This study aimed to reveal that severe disturbance of attachment relationship with primary care-giver can affect functional and anatomical brain development by measuring cerebral perfusion on 99m Tc-ECD brain SPECT and correlative MRI. We included 18 children aged 31 to 76 months who met the diagnostic criteria of RAD as defined in DSM-IV and ICD-10 and SSP and CARS. 99m Tc-ECD SPECT was performed using CERASPECT. MRI was performed in all patients. SPECT data were visually assessed. 15 of 18 children had abnormal perfusion on SPECT, revealing decreased perfusion of Lt.thalamus (7/15) and Rt.thalamus (3/15), and bilateral thalami (5/15). Perfusion of basal ganglia was decreased in 8 children. Decreased perfusion of Lt. parietal area was seen in 2. Whereas, all patients had normal MR findings. Perfusion abnormalities involving thalamus, BG in most children with RAD were found in this study. These results suggest that brain development of infant could be impeded by severe pathologic care and early nurturing environment would be important for normal development

  16. 99mTc-ECD SPECT study in dementia and aphasia

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo; Ichiya, Yuichi; Otsuka, Makoto; Sasaki, Masayuki; Akashi, Yuko; Fukumura, Toshimitsu; Yoshida, Tsuyoshi; Masuda, Kouji; Ichimiya, Atsushi

    1993-01-01

    We studied clinical significance of 99m Tc-L,L,-ethyl cysteine dimer ( 99m Tc-ECD) SPECT study in dementia and aphasia, and compared it with 99m Tc-HMPAO SPECT study. The subjects consisted of 13 patients, including 10 patients with dementia and 3 patients with aphasia. Hypoperfusion areas were detected in 5 out of 10 patients with dementia and 2 out of 3 patients with aphasia in 99m Tc-ECD SPECT, and in 4 out of 10 patients with dementia and all of 3 patients with aphasia in 99m Tc-HMPAO SPECT. The count rate ratios in 99m Tc-ECD and 99m Tc-HMPAO SPECT were correlated well with each other, and the contrast of the 99m Tc-ECD SPECT image was equivalent or slightly higher as compared with 99m Tc-HMPAO. Therefore, 99m Tc-ECD SPECT study was considered to be useful for the evaluation of cerebral perfusion in dementia and aphasia. (author)

  17. Voxel-by-voxel analysis of ECD-brain SPECT can separate penumbra from irreversibly damaged tissue at the acute phase of stroke

    International Nuclear Information System (INIS)

    Darcourt, J.; Migneco, O.; David, O.; Bussiere, F.; Mahagne, M.H.; Dunac, A.; Baron, J.C.

    2002-01-01

    Aim. At the acute phase of ischemic stroke, the target of treatment is still salvageable hypoperfused cerebral tissue; so called penumbra. We tested the possibility of separating on early ECD brain SPECT penumbral voxels (P) from irreversibly damaged damaged tissue (IDT). We used ECD which is not only a perfusion tracer but also a metabolic marker. Materials and methods. We prospectively studied 18 patients who underwent ECD-SPECT within the 12 hours following a first-ever acute middle cerebral artery stroke. Neurological evaluation was performed using the Orgogozo's scale at admission and 3 months later in order to calculate and evolution index (IE%) (Martinez-Vila et al.). SPECT data were obtained using a triple head camera equipped with fan beam collimators one hour after injection of 1000 MBq of 99mTc-ECD. On reconstructed images gray matter voxels were automatically segmented. Contralateral healthy hemisphere was used as reference leading to the identification of 3 cortical voxel types: normal (N-SPECT) above 80%; penumbra (P-SPECT) between 80% and 40% and IDT (IDT-SPECT) below 40%. 10 patients also underwent a T2 weighted 3D MRI study at 3 months. Cortical voxels with hypersignal served as reference for IDT (IDT-MRI) the others were considered normal (N-MRI). SPECT and MRI data were co-registered. Therefore each voxel belonged to one of 6 categories (3 SPECT x 2 MRI). Results. (1) The SPECT thresholds were validated on the MRI subgroup. 99% of the N-SPECT voxels were normal on late MRI. 84% of IDT-SPECT voxels corresponded to IDT-MRI. 89% of P-SPECT voxels were normal on late MRI and 11% corresponded to IDT on late MRI. Other categories of voxels (N-SPECT IDT-MRI and IDT-SPECT N-MRI) represented less than 5%. (2) Percentages of each voxel SPECT type was correlated with the EI% on the entire population (Spearman test). P-SPECT extent correlated with EI% improvement (p<0.001) and IDT-SPECT with EI% worsening (p<0.001). Conclusion. Analysis of ECD cortical

  18. Advance prediction of mild cognitive impairment (MCI) using 99mTc-ECD SPECT brain blood flow imaging

    International Nuclear Information System (INIS)

    Kawasaki, Yohsuke

    2008-01-01

    Mild Cognitive Impairment (MCI) is considered as a precursor state of Alzheimer disease (AD). Single photon emission computed tomography (SPECT) brain blood flow imaging was investigated in MCI and it's relevance to the prognosis of MCI was evaluated in an attempt define the characteristics of brain blood flow imaging of MCI (amnestic MCI; aMCI) converting to AD. Ninety-two patients over 60 years old with amnesia were studied. 99m Tc-ethyl cysteinate dimer (ECD) SPECT brain blood flow examinations of the subject under drug-free conditions were conducted and imaging was analyzed according to the first clinical diagnosis. Patients given a diagnosis of MCI on the first clinical diagnosis, were examined again after 2 years and the SPECT imaging before 2 years previously was classified and analyzed. Of them, there were 35 MCI patients, converting of 13 AD patients (37.1%; aMCI), 10 MCI patients (28.6%; non-converter), 4 depression patients (11.4%; Depression type MCI (dMCI)), 1 Geriatric psychosis patient, but 7 patients dropped out. In the aMCI group, relative hypoperfusion was recognized in the posterior cingulate and the precuneus. In the dMCI group, relative hypoperfusion was recognized in the dorsolateral prefrontal cortex (DLPFC) and the anterior cingulate. In the non-converter group, relative hypoperfusion was recognized in the basal forebrain. The hypoperfusion of the precuneus in aMCI, and the hypoperfusion of the right frontal lobe (DLPFC, dorsal-anterior cingulate) in dMCI were characteristic brain blood-flow abnormalities. We believe 99m Tc-ECD SPECT brain blood flow imaging to be useful in the diagnosis of aMCI and in the early detection of depression. (author)

  19. Tc-99m-bicisate (ECD)-brain-SPECT in rapidly progressive dementia; Hirn-SPECT mit Tc-99m-Bicisat (ECD) bei rasch progredientem dementiellen Syndrom

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    Marienhagen, J.; Eilles, C. [Regensburg Univ. (Germany). Abt. fuer Nuklearmedizin; Weingaertner, U.; Blaha, L. [Bezirkskrankenhaus Mainkofen (Germany). Psychiatrische Klinik; Zerr, I.; Poser, S. [Goettingen Univ. (Germany). Klinik und Poliklinik fuer Neurologie

    1999-07-01

    We present a 61-year-old male patient with progressive dementia. A brain SPECT with Tc-99m-bicisate was performed for confirmation of clinically suspected Alzheimer-dementia. At the time of the SPECT-investigation marked apraxia and aphasia besides severe dementia were present. Electrophysiological as well as anatomical neuroimaging findings showed non-diagnostic alterations. SPECT revealed distinct perfusion defects, which made Alzheimer Dementia unlikely. The further course of the patient was determined by rapidly progressive deterioration with development of akinetic mutism. Thereafter, increased levels of neuron-specific enolase as well as 14-3-3 proteins were found in the cerebro-spinal fluid (CSF). The patient finally died with signs of cerebral decortication. Due to the clinical course and the CSF-findings the patient's final diagnosis was Creutzfeld-Jakob-disease, nevertheless no autopsy was performed. The presented case report underscores the clinical utility of perfusion brain SPECT in the differential diagnosis of dementias. (orig.) [German] Wir berichten ueber einen 61jaehrigen Patienten mit progredientem dementiellen Syndrom, der unter der Verdachtsdiagnose einer Demenz vom Alzheimer-Typ (DAT) zur Hirn-SPECT-Untersuchung mit TC-99m-Bicisat (ECD) vorgestellt wurde. Zum Untersuchungszeitpunkt bestanden neben dem Vollbild einer Demenz eine ausgepraegte Apraxie und Aphasie bei unspezifischen Veraenderungen im EEG sowie der neuroradiologischen Bildgebung. In der Hirn-SPECT-Untersuchung fanden sich fuer eine DAT untypische ausgedehnte, vorwiegend rechtshemisphaerische Perfusionsstoerungen. Im weiteren Verlauf rasche Progredienz des Krankheitsbildes mit Entwicklung eines akinetischen Mutismus sowie Nachweis erhoehter Werte der neuronspezifischen Enolase und des 14-3-3-Proteins im Liquor. Der Patient verstarb schliesslich unter dem Bild einer Decortication. Aufgrund des klinischen Verlaufs sowie der Liquorbefunde wurde, da eine autoptische Befundsicherung

  20. [sup 99m]Tc-ECD SPECT study in dementia and aphasia

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo; Ichiya, Yuichi; Otsuka, Makoto; Sasaki, Masayuki; Akashi, Yuko; Fukumura, Toshimitsu; Yoshida, Tsuyoshi; Masuda, Kouji; Ichimiya, Atsushi (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine)

    1993-09-01

    We studied clinical significance of [sup 99m]Tc-L,L,-ethyl cysteine dimer ([sup 99m]Tc-ECD) SPECT study in dementia and aphasia, and compared it with [sup 99m]Tc-HMPAO SPECT study. The subjects consisted of 13 patients, including 10 patients with dementia and 3 patients with aphasia. Hypoperfusion areas were detected in 5 out of 10 patients with dementia and 2 out of 3 patients with aphasia in [sup 99m]Tc-ECD SPECT, and in 4 out of 10 patients with dementia and all of 3 patients with aphasia in [sup 99m]Tc-HMPAO SPECT. The count rate ratios in [sup 99m]Tc-ECD and [sup 99m]Tc-HMPAO SPECT were correlated well with each other, and the contrast of the [sup 99m]Tc-ECD SPECT image was equivalent or slightly higher as compared with [sup 99m]Tc-HMPAO. Therefore, [sup 99m]Tc-ECD SPECT study was considered to be useful for the evaluation of cerebral perfusion in dementia and aphasia. (author).

  1. 99mTc-ECD dynamic SPECT in 'luxury perfusion' of subacute stroke

    International Nuclear Information System (INIS)

    Ogasawara, Kuniaki; Fujiwara, Satoru; Yoshimoto, Takashi.

    1995-01-01

    To evaluate the cerebral pharmacokinetics of 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD) at blood flow levels beyond the normal range, we investigated 'luxury perfusion' in subacute stroke, ictal hyperperfusion in epilepsy and post-decompressive hyperemia in head trauma. All 7 patients showed a hyperactive area on SPECT studies using 99m Tc-HM-PAO. 99m Tc-ECD static image demonstrated a hyperactive area in both epilepsy and head trauma, and a hypoactive area in 'luxury perfusion.' On the dynamic SPECT of 99m Tc-ECD in both epilepsy and head trauma, brain distribution of the tracer was determined within 2 min postinjection and remained stable for up to 1 hour; however, 'luxury perfusion' area showed a change from initial hyperactivity to late hypoactivity with the passage of time. The time activity curve in 'luxury perfusion' area demonstrated a steep decrease of counts/pixel for up to 4-5 minutes postinjection, and a moderate decrease in the following phase. The early wash-out mechanism of 99m Tc-ECD from 'luxury perfusion' area can be described by a biexponential function including an initial steep decrease representing the rapid loss of the lipophilic complexes which were not metabolized in injured brain tissue. (author)

  2. A quantitative study of brain perfusion patterns of 99mTc-ECD SPECT in children with developmental disabilities

    International Nuclear Information System (INIS)

    Hirano, Keiko; Aiba, Hideo; Oguro, Katsuhiko

    2004-01-01

    The aim of this study was to investigate the relationship between developmental disabilities and brain perfusion patterns. We performed technetium-99m-ethylcysteinate dimer ( 99m Tc-ECD) single photon emission computed tomography (SPECT) in 30 children with neurological disorders using the Patlak plot method. In children without developmental disabilities, the distribution of regional cortical perfusion evolved in relation to brain maturation. At one month of age, there was a predominant uptake in the perirolandic cortex. Radionuclide uptake in both the parietal and occipital cortices became evident by three months. Uptake in the temporal and frontal cortex increased by 6 and 11 months, respectively. Brain perfusion showed a pattern similar to that of adults by two years of age at the latest. In children with developmental disabilities, developmental changes of brain perfusion were delayed compared to normally developing children. Brain SPECT is a useful tool to assess the brain maturation in children with developmental disabilities. (author)

  3. The need of appropriate brain SPECT templates for SPM comparisons

    International Nuclear Information System (INIS)

    Morbelli, S.; Altrinetti, V.; Piccardo, A.; Rodriguez, G.; Brugnolo, A.; Nobili, F.; Mignone, A.; Pupi, A.; Koulibaly, P.M.

    2008-01-01

    Statistical parametric mapping (SPM) is used worldwide to compare brain perfusion single photon emission computed tomography (SPECT) data. The default template within the SPM package used for SPECT image normalization includes images of a group of healthy subjects studied with 99m TcHMPAO. Since [ 99m Tc] HMPAO and [ 99m Tc] ECD have shown to distribute differently in SPECT studies, we formulated the hypothesis that comparing set of [ 99m Tc]ECD data normalized by means of a [ 99m Tc]HMPAO template may lead to incorrect results. A customized [ 99m Tc]ECD template was built with SPECT and magnetic resonance imaging (MRI) images of 22 neurologically healthy women. Then, two sets of subjects, i.e. a group of patients with very early Alzheimer's disease (eAD) and a matched control group, studied by means of [ 99m Tc]ECD SPECT, were chosen for comparisons. The same statistical approach (t-test between eAD patients and controls and correlation analysis between brain SPECT and a cognitive score) was applied twice, i.e. after normalization with either the default [ 99m Tc]HMPAO template or the customized [ 99m Tc]ECD template. In the comparison between eAD and controls, a cluster of difference in the posterior-cingulate gyrus of both hemispheres was only highlighted when using the customized [ 99m Tc]ECD template, but was missed when using the default [ 99m Tc]HMPAO template. In the correlation between brain perfusion and a cognitive score, the significant cluster was more significant and far more extended, also including the right superior temporal gyrus, using the customized [ 99m Tc]ECD template than using the default [ 99m Tc]HMPAO template. These data suggest the need of customized, radiopharmaceutical-matched SPECT templates to be used within the SPM package. The present customized [ 99m Tc]ECD template is now freely available on the web. (authors)

  4. Regional Cerebral Blood-Flow with 99mTc-ECD Brain Perfusion SPECT in Landau-Kleffner Syndrome: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Reza Nemati

    2014-01-01

    Full Text Available Landau-Kleffner syndrome (LKS is a rare childhood disorder characterized by acquired aphasia and epilepsy. 99mTc-ECD SPECT imaging was performed in two right-handed children with LKS. A relative decrease in perfusion was found in the left frontal-temporal cortices of both patients as well as in the left and right parietal cortices of one patient with aphasia, without clinical epilepsy. The degree of regional cerebral perfusion impairment did not correlate with the severity of the clinical and EEG abnormalities, but the area of hypoperfusion was compatible with the speech area of the brain. Overall, although asymmetrical temporoparietal perfusion appears as a common finding in LKS, SPECT findings in LKS alone cannot elucidate the pathogenic features of the disorder in the brain. Here, we present two cases of LKS in which we investigated SPECT perfusion scans.

  5. Brain MRI and SPECT in the diagnosis of early neurological involvement in Wilson's disease

    International Nuclear Information System (INIS)

    Piga, Mario; Satta, Loredana; Serra, Alessandra; Loi, Gianluigi; Murru, Alessandra; Demelia, Luigi; Sias, Alessandro; Marrosu, Francesco

    2008-01-01

    To evaluate the impact of brain MRI and single-photon emission computed tomography (SPECT) in early detection of central nervous system abnormalities in patients affected by Wilson's disease (WD) with or without neurological involvement. Out of 25 consecutive WD patients, 13 showed hepatic involvement, ten hepatic and neurological manifestations, and twp hepatic, neurological, and psychiatric symptoms, including mainly movement disorders, major depression, and psychosis. Twenty-four healthy, age-gender matched subjects served as controls. All patients underwent brain MRI and 99m Tc-ethyl-cysteinate dimer (ECD) SPECT before starting specific therapy. Voxel-by-voxel analyses were performed using statistical parametric mapping to compare differences in 99m Tc-ECD brain uptake between the two groups. Brain MRI showed T2-weighted hyperintensities in seven patients (28%), six of whom were affected by hepatic and neurological forms. Brain perfusion SPECT showed pathological data in 19 patients (76%), revealing diffuse or focal hypoperfusion in superior frontal (Brodmann area (BA) 6), prefrontal (BA 9), parietal (BA 40), and occipital (BA 18, BA 39) cortices in temporal gyri (BA 37, BA 21) and in caudatus and putamen. Moreover, hepatic involvement was detected in nine subjects; eight presented both hepatic and neurological signs, while two exhibited WD-correlated hepatic, neurological, and psychiatric alterations. All but one patient with abnormal MRI matched with abnormal ECD SPECT. Pathologic MRI findings were obtained in six out of ten patients with hepatic and neurological involvement while abnormal ECD SPECT was revealed in eight patients. Both patients with hepatic, neurological, and psychiatric involvement displayed abnormal ECD SPECT and one displayed an altered MRI. These findings suggest that ECD SPECT might be useful in detecting early brain damage in WD, not only in the perspective of assessing and treating motor impairment but also in evaluating better the

  6. 99mTc-ECD brain SPECT in patients with Moyamoya disease: a reflection of cerebral perfusion status at tissue level in the disease process

    International Nuclear Information System (INIS)

    Kashyap, Raghava; Mittal, Bhagwant Rai; Sunil, Hejjaji Venkataramarao; Bhattacharya, Anish; Singh, Baljinder; Mukherjee, Kanchan Kumar; Gupta, Sunil Kumar

    2011-01-01

    Moyamoya disease is a rare, progressive cerebrovascular disorder caused by intracranial stenosis of the circle of Willis, resulting in successive ischemic events. Computed tomography (CT) and magnetic resonance imaging (MRI) play a major role in diagnosis. The aim of the study was to describe the spectrum of findings on brain SPECT in patients with Moyamoya disease and to compare the findings with other investigations. 99m Tc-ECD SPECT scans of seventeen patients (7 children and 10 adults) were analysed to study the brain perfusion. Features of Moyamoya disease were detected on DSA in 11 patients, CTA in one, MR angiography in one patient. Brain perfusion SPECT analysis showed unilateral perfusion defects in 11 patients, normal perfusion in 2 and bilateral defects in 4 patients. No perfusion defects despite bilateral vascular changes were noted in one patient. Cerebral infarcts were detected on MRI unilaterally in three subjects while multiple infarcts were identified in one. 99m Tc-ECD Brain SPECT showed perfusion defects that were more extensive compared to those detected on MRI. Post acetazolamide studies for assessment of cerebrovascular reserve were done in three patients. Two of them showed good cerebrovascular reserve (>1). Follow-up studies post-surgical procedures (Myo-dura synangiosis) done in two patients showed partial resolution of perfusion defects in the involved areas. Brain perfusion scintigraphy is an important adjunct in evaluation of patients with Moyamoya disease yielding information about the direct end results of the pathology in the vessels and also prognostic information. (author)

  7. Development of a new statistical evaluation method for brain SPECT images

    International Nuclear Information System (INIS)

    Kawashima, Ryuta; Sato, Kazunori; Ito, Hiroshi; Koyama, Masamichi; Goto, Ryoui; Yoshioka, Seiro; Ono, Shuichi; Sato, Tachio; Fukuda, Hiroshi

    1996-01-01

    The purpose of this study was to develop a new statistical evaluation method for brain SPECT images. First, we made normal brain image databases using 99m Tc-ECD and SPECT in 10 normal subjects as described previously. Each SPECT images were globally normalized and anatomically standardized to the standard brain shape using Human Brain Atlas (HBA) of Roland et al. and each subject's X-CT. Then, mean and SD images were calculated voxel by voxel. For the next step, 99m Tc-ECD SPECT images of a patient were obtained, and global normalization and anatomical standardization were performed as the same way. Then, a statistical map was calculated as following voxel by voxel; (P-Mean)/SDx10+50, where P, mean and SD indicate voxel value of patient, mean and SD images of normal databases, respectively. We found this statistical map was helpful for clinical diagnosis of brain SPECT studies. (author)

  8. Follow-up of pain processing recovery after ketamine in hyperalgesic fibromyalgia patients using brain perfusion ECD-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric; Cammilleri, Serge; Colavolpe, Cecile; Laforte, Catherine de; Mundler, Olivier [Assistance Publique des Hopitaux de Marseille, Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille, Cedex 5 (France); Niboyet, Jean [Clinique La Phoceanne, Unite d' Etude et de Traitement de la Douleur, Marseille (France)

    2007-12-15

    The aim of this study was to determine whether the follow-up of pain processing recovery in hyperalgesic fibromyalgia (FM) could be objectively evaluated with brain perfusion ethyl cysteinate dimer single photon computerized tomography (ECD-SPECT) after administration of ketamine. We enrolled 17 hyperalgesic FM women patients (48.5 {+-} 11 years, range 25-63). After treatment with subcutaneous ketamine, 11 patients were considered as 'good responders', with a decrease in pain intensity, evaluated by visual analog scale (VAS), greater than 50%. On the other hand, six patients were considered as 'poor responders'. A voxel-based analysis of regional cerebral blood flow (rCBF) was conducted (p{sub voxel} < 0.001uc), in the two subgroups of patients, before and after treatment, in comparison to a group of ten healthy subjects, matched for age and gender. In comparison to baseline brain SPECT, midbrain rCBF showed a greater increase after ketamine in the responder group than in the nonresponder group (p{sub cluster} = 0.016c). In agreement with the clinical response, the change in midbrain rCBF after ketamine was highly correlated with the reduction of VAS pain score (r = 0.7182; p = 0.0041). This prospective study suggests that blockade of facilitatory descending modulation of pain with ketamine can be evaluated in the periaqueductal grey with brain perfusion SPECT. (orig.)

  9. Preliminary application of brain perfusion SPECT imaging in schizophrenia

    International Nuclear Information System (INIS)

    Wu Zhixing; Guo Chanliu; Li Xingbao; Liang Rongxiang; Zhao Jun; Yan Tingxiu

    1996-01-01

    The clinical value of 99m Tc-ECD brain perfusion SPECT imaging was evaluated in patients with schizophrenia. 32 patients with schizophrenia and 21 normal controls were analyzed with 99m Tc-ECD SPECT. 93.8% (30/32) of the patients showed decreased regional cerebral blood flow (rCBF). There was normal rCBF in controls. In the patient group rCBF decreased significantly in bilateral frontal lobes, left temporal lobe and right basal ganglion. The rCBF of left temporal lobe was significantly lower than that of right temporal lobe. The decreasing rCBF was not significantly related to previous treatment and duration of illness. 99m Tc-ECD SPECT is useful for the study and diagnosis of patients with schizophrenia

  10. Brain MRI and SPECT in the diagnosis of early neurological involvement in Wilson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Piga, Mario; Satta, Loredana; Serra, Alessandra; Loi, Gianluigi [Policlinico Universitario, University of Cagliari, Nuclear Medicine, Department of Medical Science, Monserrato, Cagliari (Italy); Murru, Alessandra; Demelia, Luigi [Policlinico Universitario, University of Cagliari, Gastroenterology, Department of Medical Science, Monserrato, Cagliari (Italy); Sias, Alessandro [Policlinico Universitario, University of Cagliari, Radiology, Department of Medical Science, Monserrato, Cagliari (Italy); Marrosu, Francesco [Policlinico Universitario, University of Cagliari, Neurology, Department of Medical Science, Monserrato, Cagliari (Italy)

    2008-04-15

    To evaluate the impact of brain MRI and single-photon emission computed tomography (SPECT) in early detection of central nervous system abnormalities in patients affected by Wilson's disease (WD) with or without neurological involvement. Out of 25 consecutive WD patients, 13 showed hepatic involvement, ten hepatic and neurological manifestations, and twp hepatic, neurological, and psychiatric symptoms, including mainly movement disorders, major depression, and psychosis. Twenty-four healthy, age-gender matched subjects served as controls. All patients underwent brain MRI and {sup 99m}Tc-ethyl-cysteinate dimer (ECD) SPECT before starting specific therapy. Voxel-by-voxel analyses were performed using statistical parametric mapping to compare differences in {sup 99m}Tc-ECD brain uptake between the two groups. Brain MRI showed T2-weighted hyperintensities in seven patients (28%), six of whom were affected by hepatic and neurological forms. Brain perfusion SPECT showed pathological data in 19 patients (76%), revealing diffuse or focal hypoperfusion in superior frontal (Brodmann area (BA) 6), prefrontal (BA 9), parietal (BA 40), and occipital (BA 18, BA 39) cortices in temporal gyri (BA 37, BA 21) and in caudatus and putamen. Moreover, hepatic involvement was detected in nine subjects; eight presented both hepatic and neurological signs, while two exhibited WD-correlated hepatic, neurological, and psychiatric alterations. All but one patient with abnormal MRI matched with abnormal ECD SPECT. Pathologic MRI findings were obtained in six out of ten patients with hepatic and neurological involvement while abnormal ECD SPECT was revealed in eight patients. Both patients with hepatic, neurological, and psychiatric involvement displayed abnormal ECD SPECT and one displayed an altered MRI. These findings suggest that ECD SPECT might be useful in detecting early brain damage in WD, not only in the perspective of assessing and treating motor impairment but also in evaluating

  11. Follow-up of pain processing recovery after ketamine in hyperalgesic fibromyalgia patients using brain perfusion ECD-SPECT

    International Nuclear Information System (INIS)

    Guedj, Eric; Cammilleri, Serge; Colavolpe, Cecile; Laforte, Catherine de; Mundler, Olivier; Niboyet, Jean

    2007-01-01

    The aim of this study was to determine whether the follow-up of pain processing recovery in hyperalgesic fibromyalgia (FM) could be objectively evaluated with brain perfusion ethyl cysteinate dimer single photon computerized tomography (ECD-SPECT) after administration of ketamine. We enrolled 17 hyperalgesic FM women patients (48.5 ± 11 years, range 25-63). After treatment with subcutaneous ketamine, 11 patients were considered as ''good responders'', with a decrease in pain intensity, evaluated by visual analog scale (VAS), greater than 50%. On the other hand, six patients were considered as ''poor responders''. A voxel-based analysis of regional cerebral blood flow (rCBF) was conducted (p voxel cluster = 0.016c). In agreement with the clinical response, the change in midbrain rCBF after ketamine was highly correlated with the reduction of VAS pain score (r = 0.7182; p = 0.0041). This prospective study suggests that blockade of facilitatory descending modulation of pain with ketamine can be evaluated in the periaqueductal grey with brain perfusion SPECT. (orig.)

  12. Comparison between CT perfusion and Tc-99m ECD SPECT in the assessment of cerebrovascular reserve: a case study

    International Nuclear Information System (INIS)

    Crouch, J.; Wood, C.; Campbell, A.; McCarthy, M.; Dunne, M.; Bynevelt, M.; Lenzo, N.

    2003-01-01

    Full text: Brain perfusion is sensitively assessed by cerebral SPECT imaging utilising perfusion agents such as Tc-99m HMPAO and Tc-99m ethyl cysteinate dimer (ECD). Positron emission tomography can accurately assess and quantify brain perfusion and MRI can also be used for perfusion assessment. Both MRI and PET however are currently limited by cost and availability. A new technique utilising CT with contrast has been developed to assess and quantitate cerebral perfusion. The technique utilises arterial input information and deconvolution analysis to develop quantifiable measures of perfusion and contrast transit. The technique has been validated for acute stroke assessment and is being assessed for other possible applications. We present a case study comparison of this technique with cerebral SPECT perfusion using Tc-99m ECD in the assessment of cerebrovasular reserve. In each case, the CT and SPECT studies were performed pre- and post-acetazolamide and the SPECT study was statistically compared with a normal database utilising an automated brain perfusion statistical analysis package (NeurostatT). We discuss the correlation found between techniques, their strengths, weaknesses and possible future roles. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  13. Brain 99Tcm-ECD SPECT imaging in patients with obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    Sun Da; Zhan Hongwei; Ye Xiaojuan; He Gangqiang

    2010-01-01

    Purpose Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder of unknown aetiology. The purpose of the study is to evaluate the changes of brain function in patients with OCD. Methods: Regional cerebral perfusion was investigated using SPECT in 25 patients with OCD. The mean ages of the patients were 29.04 (1 8-46) years old. The clinical symptom consists of repeating thinking (suspect, worry, nervous) and repeating action (checking, washing, counting, making telephone calls) principally. After administration of 740-925 MBq (20-25 mCi) 99mTc-ECD a single photon emission tomography study was performed and then transaxial, sagittal and coronal slices were obtained. For the semiquantitative analysis of the data Results: 92 per cent of patients (23125) had relative hypoperfusions in some cerebral regions. The patients had a significant decrease of rCBF in the frontal lobes, temporal lobes, basal ganglia, thalamus, and cingulate gyrus. There were no correlation between the change of rCBF and age of age or course of disease. But there were some correlation with clinical symptom. Conclusion: Obsessive-compulsive disorder (OCD) has been linked to a dysfunction of brain orbitofrontal-striatum-pallidum-thalamus networks that were confirmed by PET SPECT functional imaging studies. These study indicated hypoperfusion in frontal lobes, basal ganglion, thalamus in OCD patients, and suggests a reduced serotonergic input into the fronto-subcortical circuits in OCD, thereby diminishing the inhibitory regulation of serotonin on these circuits. According to our results, patients with OCD had profound dysfunction of the frontal and temporal cortices, and basal ganglia. These may reflect a fundamental feature of clinical neuropathophysiology in OCD, and support previous findings about dysfunction of frontal-subcortical circuits in this disorder. (authors)

  14. Role of 99mTc-ECD SPECT in the Management of Children with Craniosynostosis

    Science.gov (United States)

    Barik, Mayadhar; Bajpai, Minu; Das, Rashmi Ranajn; Malhotra, Arun; Panda, Shasanka Shekhar; Sahoo, Manas Kumar; Dwivedi, Sadanand

    2014-01-01

    Purpose of the Report. There is a paucity of data on correlation of various imaging modalities with clinical findings in craniosynostosis. Moreover, no study has specifically reported the role of 99mTc-ECD SPECT in a large number of subjects with craniosynostosis. Materials and Methods. We prospectively analyzed a cohort of 85 patients with craniosynostosis from year 2007 to 2012. All patients underwent evaluation with 99mTc-ECD SPECT and the results were correlated with radiological and surgical findings. Results. 99mTc-ECD SPECT revealed regional perfusion abnormalities in the cerebral hemisphere corresponding to the fused sutures preoperatively that disappeared postoperatively in all the cases. Corresponding to this, the mean mental performance quotient (MPQ) increased significantly (P < 0.05) postoperatively only in those children with absent perfusion defect postoperatively. Conclusions. Our study suggests that early surgery and release of craniosynostosis in patients with preoperative perfusion defects (absent on 99mTc-ECD SPECT study) are beneficial, as theylead to improved MPQ after surgery. PMID:24987670

  15. Role of 99mTc-ECD SPECT in the Management of Children with Craniosynostosis

    Directory of Open Access Journals (Sweden)

    Mayadhar Barik

    2014-01-01

    Full Text Available Purpose of the Report. There is a paucity of data on correlation of various imaging modalities with clinical findings in craniosynostosis. Moreover, no study has specifically reported the role of Tc99m-ECD SPECT in a large number of subjects with craniosynostosis. Materials and Methods. We prospectively analyzed a cohort of 85 patients with craniosynostosis from year 2007 to 2012. All patients underwent evaluation with Tc99m-ECD SPECT and the results were correlated with radiological and surgical findings. Results. Tc99m-ECD SPECT revealed regional perfusion abnormalities in the cerebral hemisphere corresponding to the fused sutures preoperatively that disappeared postoperatively in all the cases. Corresponding to this, the mean mental performance quotient (MPQ increased significantly P<0.05 postoperatively only in those children with absent perfusion defect postoperatively. Conclusions. Our study suggests that early surgery and release of craniosynostosis in patients with preoperative perfusion defects (absent on Tc99m-ECD SPECT study are beneficial, as theylead to improved MPQ after surgery.

  16. Presurgical evaluation of cerebral perfusion reserve in patients for cardiovascular surgery using {sup 99m}Tc-ECD SPECT with diamox enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kaname; Nakashima, Hiromichi; Tanaka, Kuniyoshi; Kitano, Tokio; Murashima, Shuichi; Takeda, Kan; Yuasa, Hiroshi; Yada, Isao; Nakagawa, Tsuyoshi [Mie Univ., Tsu (Japan). School of Medicine

    1996-03-01

    Cerebrovascular stroke is one of the major complications in cardiovascular surgery with cardiopulmonary bypass. The purpose of this study was to evaluate the usefulness of preoperative {sup 99m}Tc-ethyl cysteinate dimer (ECD) SPECT and acetazolamide (diamox) enhancement to predict neurological complications in cardiovascular surgery. Eighteen patients with coronary disease, valvular disease or aortic aneurysm were studied before the operations. Regional cerebral blood flow and perfusion reserve were evaluated using ECD SPECT before and after the intravenous administration of diamox (1 g). Three cases with moderate to severe baseline abnormalities and poor perfusion reserve had cerebral infarction postoperatively. Twelve cases with good to fair perfusion reserve had no neurological complication. Three cases having poor perfusion reserve had the operations with more intensive brain protection, in which higher perfusion pressure to the brain was maintained during cardiopulmonary bypass, and no neurological complication was observed. In conclusion, patients who have moderately or markedly abnormal baseline flow with poor perfusion reserve may have some risk of neurological complications in cardiovascular surgery. ECD SPECT with diamox enhancement may give information useful for selection of operation procedures. (author).

  17. Comparison of acetazolamide-enhanced brain SPECT using Tc-99m ECD with cerebral angiography in patients with cerebrovascular disease

    International Nuclear Information System (INIS)

    Choi, Y. Y.; Moon, D. H.; Ryu, J. S.; Yang, S. H.; Lee, H. K.; Lee, J. H.; Kim, J. S.; Kim, K. A.

    1997-01-01

    Cerebral vascular reserve can be assessed by development of collateral channels (DCC) on cerebral angiography(CA) or vasoreactivity (VR) on acetazolamide-enhanced brain SPECT (ACZ-SPECT). The purpose of this study was to compare Tc-99m ECD ACZ-SPECT with CA in the evaluation of vascular reserve in patients (pts) with cerebrovascular disease(CVD). Twenty seven patients with CVD, including TIA (n=13), infarction (n=11) and asymptomatic pts (AS, n=3), underwent CA and ACZ-SPECT. Basal and ACZ-SPECT was obtained consecutively, and image subtraction was performed. On CA, degree of DCC was scored 0-3 (0: normal, 3: poor) according to parenchymal staining on delayed film. In ACZ-SPECT, decrease of VR was graded 0-3 (0: normal, 3: more than 30% decrease). The correlation between degree of stenosis, DCC and VR were analyzed. 1) Variable degree of VR or DCC was observed in totally occluded or stenotic cerebral arterial territories. 2) In arterial territories with poor DCC, ACZ-SPECT showed poor VR. However, in 5 out of 11 TIA or AS with good DCC, poor VR was observed. These data suggests that 1) cerebral hemodynamic status cannot be assessed by the degree of stenosis on CA alone. 2) DCC may overestimate the cerebral vascular reserve in patients with TIA or AS. 3) ACZ-SPECT plays a complementary role to CA for evaluation of cerebral hemodynamic status in pts with CVD

  18. Brain perfusion abnormalities associated to drug abuse in recent abstinent patients using SPECT 99m Tc-ethylen-cysteinate-dimer (ECD)

    Energy Technology Data Exchange (ETDEWEB)

    Massardo, Teresa [University of Chile Clinical Hospital Nuclear Medicine Section, Department of Medicine, Santiago (Chile); Pallavicini, Julio [Addiction Unit, Psychiatric Clinic. University of Chile Clinical Hospital (Chile); Gonzalez, Patricio; Jaimovich, Rodrigo [University of Chile Clinical Hospital Nuclear Medicine Section, Department of Medicine, Santiago (Chile); Servat, Monica [Addiction Unit, Psychiatric Clinic. University of Chile Clinical Hospital (Chile); Lavados, Hugo [University of Chile Clinical Hospital Nuclear Medicine Section, Department of Medicine, Santiago (Chile); Arancibia, Pablo [Addiction Unit, Psychiatric Clinic. University of Chile Clinical Hospital (Chile); Padilla, Pamela [University of Chile Clinical Hospital Nuclear Medicine Section, Department of Medicine, Santiago (Chile)

    2009-04-15

    Several substances may produce brain perfusion abnormalities in drug-dependent patients. Their mechanism is unclear and several causes might be involved, especially vasospasm in cocaine consumption. Goal: To characterize residual brain perfusion abnormalities in substance-dependent population. We analyzed brain perfusion in 100 dependant patients (DSM-IV criteria) following a month of strict in-hospital abstinence (age:35{+-}12 y.o.; 86% men); 55% corresponded to poly-drug dependents, mainly to cocaine, alcohol and cannabis; 44% mono-drug users, mostly to alcohol. Results: Single Photon Emission Computed Tomography (SPECT) with 99mTc-ethylen-cysteinate-dimer (ECD) was abnormal in 54% of the cases, with bilateral cortical hypo-perfusion in 89%, focal in 54% and diffuse in 46% of them, with moderate or severe intensity in 61%. The abnormal perfusion group's age was 38{+-}12 versus 31{+-}10 years in the normal SPECT group (P=0.005) with a consumption period of 16{+-}11 versus 11{+-}8 years, respectively (P=0.043). Only 29% of women had abnormal perfusion versus 58% of men (P=0.047). Abnormal brain perfusion in 64% of mono and 45% in poly-drug dependents (P=0.07). Psychometric tests performed in 25 patients demonstrated association between perfusion defects and cognitive abnormalities. Relative risk for abnormal psychometric test was 2.5 [95%;CI=1.1-5.6] for abnormal SPECT. Conclusion: Dependent population after a month of abstinence persists with cortical brain perfusion abnormalities, associated to age, sex and type of drug consumption.

  19. Tc-99m ECD brain SPECT in MELAS syndrome: comparison with MR finding

    International Nuclear Information System (INIS)

    Park, Sang Joon; Ryu, Young Hoon; Yoon, Pyeong Ho; Jeon, Tae Joo; Kim, Jai Keun; Nam, Ji Eun; Lee, Jong Doo; Lee, Byung Hee; Shin, Hyung Cheol

    1998-01-01

    The purpose of this study was to evaluate SPECT findings of MELAS syndrome and mitochondrial myopathy and correlate them with MR findings in search of specific imaging features and to assess the role of SPECT in MELAS syndrome. Five patients (four females and one male; age range, 1 to 25 years) who presented with repeated stroke-like episodes or seizures or developmental delay or were asymptomatic but had elevated lactic acid in CSF and serum were evaluated with conventional noncontrast MR imaging and SPECT. MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly on the parietal (4/5) and occipital lobes (4/5) and in the basal ganglias (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased uptake of Tc-99m ECD on parietal (5/5) and occipital (4/5) and temporal (2/5) and frontal (1/5) lobe and basal ganglia (2/5) and thalami (2/5). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion is noted on left parietal area and bilateral thalami. Comparison of the numbers of abnormal findings revealed that decreased perfusion seen on SPECT were more numerous than anatomical abnormalities seen on MRI. SPECT may be a sensitive method for pathophysiological study of metabolic disturbances in MELAS. Moreover, in patients with mitochondrial myopathy without clinical encephalopathy, SPECT may play a role in evaluating subclinical encephalopathy even with normal conventional MR findings

  20. A limitation of the split-dose method for evaluating rCBF changes using 99mTc-ECD and SPECT

    International Nuclear Information System (INIS)

    Odano, Ikuo; Takahashi, Makoto; Noguchi, Eikichi; Ohtaki, Hiro; Shibaki, Mitsurou; Kasahara, Tosifumi; Hatano, Masayoshi; Ohkubo, Masaki.

    1997-01-01

    The purpose of the study is to validate the split-dose method corrected with dose ratio of 99m Tc-ECD for brain perfusion scan. A dose of 600 MBq of 99m Tc-ECD was divided into two with various dose ratios from 1 : 1 to 1 : 4, and injected to eleven patients with various cerebral diseases. A lesser dose of 99m Tc-ECD was injected under a control state for the first SPECT scan, and 15 min SPECT scan was performed 10 min after injection with a triple-head high resolution gamma camera. After the scan, the other dose of 99m Tc-ECD was injected under the same control state and the second SPECT scan was performed as same as above. A ratio of the activity of the first scan to the net activity of the second scan corrected by dose ratio, defined as K, was measured in brain regions of each subject. Expected value of K was 1, but the value was distributed with large variations in each subject. The mean % error of the K value was 10.4±4.9%. Hence it is considered that activity changes by more than 20% from the control values should be required to detect a significant rCBF change in an activation SPECT study. Then, we proposed a new method in which the activity of both two SPECT scans was normalized by cerebellar or occipital activity and compared. The ratio obtained by the proposed method came closer to 1 with less variations and with less mean % error in comparison with those of K value obtained by the dose-correction method. Although the proposed method has a limitation in the use of an activation study loaded with Diamox, it may be useful to evaluate an alteration of rCBF in the study such as postural testing or finger-moving test. (author)

  1. The study on regional brain blood flow in the patients with Parkinson's disease using 99Tcm-ECD SPECT

    International Nuclear Information System (INIS)

    Sun Da; Ye Xiaojuan; Zhan Hongwei; Xu Wei; Bao Chengkan

    2010-01-01

    Purpose The aim of this study is to evaluate the changes of brain blood floe in patients with Parkinson's disease (PD) and to investigate the clinical characteristics of the patients with PD correlate with rCBF. Methods: Regional cerebral perfusion was investigated using SPECT in 34 patients with PD . The mean ages of the patients were 56.61±11.04 Years old. The course of disease in most patients was from 1 to over 20 years. Results: 94.1 per cent of patients (32/3) had a significant decrease of rCBF in the basal ganglia, frontal lobes, temporal lobes and thalamus. Parietal and occipital cortex were involved in some patients. The decrease of rCBF in the basal ganglia is unilateral in most patients with PD. There were over 3 brain regions that Conclusion: According to our results, patients with PD had decreased rCBF in the basal ganglia, frontal and temporal cortices. These may reflect a fundamental feature of clinical neuropathophysiology in PD. 99 Tc m -ECD SPECT imaging is helpful to the diagnosis of PD and may help investigate the potential pathophysiology of PD. (authors)

  2. Concordance between (99m)Tc-ECD SPECT and 18F-FDG PET interpretations in patients with cognitive disorders diagnosed according to NIA-AA criteria.

    Science.gov (United States)

    Ito, Kimiteru; Shimano, Yasumasa; Imabayashi, Etsuko; Nakata, Yasuhiro; Omachi, Yoshie; Sato, Noriko; Arima, Kunimasa; Matsuda, Hiroshi

    2014-10-01

    The purpose of this study was to clarify the concordance of diagnostic abilities and interobserver agreement between 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and brain perfusion single photon-emission computed tomography (SPECT) in patients with Alzheimer's disease (AD) who were diagnosed according to the research criteria of the National Institute of Aging-Alzheimer's Association Workshop. Fifty-five patients with "AD and mild cognitive impairment (MCI)" (n = 40) and "non-AD" (n = 15) were evaluated with 18F-FDG PET and (99m)Tc-ethyl cysteinate dimer (ECD) SPECT during an 8-week period. Three radiologists independently graded the regional uptake in the frontal, temporal, parietal, and occipital lobes as well as the precuneus/posterior cingulate cortex in both images. Kappa values were used to determine the interobserver reliability regarding regional uptake. The regions with better interobserver reliability between 18F-FDG PET and (99m)Tc-ECD SPECT were the frontal, parietal, and temporal lobes. The (99m)Tc-ECD SPECT agreement in the occipital lobes was not significant. The frontal, temporal, and parietal lobes showed good correlations between 18F-FDG PET and (99m)Tc-ECD SPECT in the degree of uptake, but the occipital lobe and precuneus/posterior cingulate cortex did not show good correlations. The diagnostic accuracy rates of "AD and MCI" ranged from 60% to 70% in both of the techniques. The degree of uptake on 18F-FDG PET and (99m)Tc-ECD SPECT showed significant correlations in the frontal, temporal, and parietal lobes. The diagnostic abilities of 18F-FDG PET and (99m)Tc-ECD SPECT for "AD and MCI," when diagnosed according to the National Institute of Aging-Alzheimer's Association Workshop criteria, were nearly identical. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Usefulness of 99mTc-ECD SPECT in diseases of central nerve system

    International Nuclear Information System (INIS)

    Ono, Shimato; Yanagimoto, Shinichi; Mimura, Hiroaki

    1992-01-01

    The usefulness of a new cerebral perfusion imaging radiopharmaceutical, 99m Tc-ethyl cysteinate dimer (ECD), was clinically evaluated. The subjects of this study were 14 patients with neurological disorders including 10 patients with cerebral infarction and 4 patients with other diseases. A total of 15 examinations was performed. 99m Tc-hexamethylpropyleneamine oxime ( 99m Tc-HM-PAO) or 123 I-N-isopropyl-p-iodoamphetamine ( 123 I-IMP) SPECTs were performed simultaneously, and the findings from those examinations were compared with 99m Tc-ECD. As to the count ratio of lesions to normal area (L/N), the L/N ratio in severe ischemic patients was lower in 99m Tc-ECD than in 99m Tc-HM-PAO or 123 I-IMP. In mild ischemic patients, on the other hand, the L/N ratio was the lowest in 123 I-IMP. When the relationship between regional cerebral blood flows (rCBFs) obtained from 123 I-IMP and the values of L/N in 99m Tc-ECD or 99m Tc-HM-PAO was compared, the values of L/N in 99m Tc-ECD or 99m Tc-HM-PAO were found to have decreased linearity with increasing rCBF. In a patient showing luxury perfusion, the accumulation pattern of 99m Tc-ECD was different from that of the other two radiopharmaceuticals, and focal defect was revealed in 99m Tc-ECD SPECT. On the dynamic SPECT of 99m Tc-ECD in a patient with meningioma, the tumor showed a change from high to low perfusion with the passage of time. This finding indicated that care should be taken in the evaluation of accumulation of 99m Tc-ECD. Therefore, 99m Tc-ECD was found to be useful as a cerebral perfusion agent. In addition, as accumulation of 99m Tc-ECD might somehow reflect metabolism in some cases, further careful investigation of many cases should be carried out. (author)

  4. SPECT for smokers brain perfusion evaluation; SPECT para avaliacao da perfusao cerebral em fumantes

    Energy Technology Data Exchange (ETDEWEB)

    Maliska, C.M.; Martins, E.F.; Barros, D.S.; Lopes, M.M.S.; Lourenco, C.; Goncalves, S.; Goncalves, M.B.; Miranda, M.M.B.G.; Neto, L.M.; Penque, E.; Antonucci, J.B. [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil)

    2002-07-01

    Cigarette smoking increases brain stroke risk, however,five to fifteen years after ceasing this habit, brain perfusion recovers normal pattern. We propose to compare brain perfusion patterns performing brain SPECT scans of smokers and non-smokers. Thirteen volunteers age range 20-30 years old) composed of six non-smokers and seven smokers were studied by brain scans (SPECT).We used ECD- {sup 99m} Tc radiolabelled as recommended by the manufacturer. All patients received 740 MBq of the radiopharmaceutical through intravenous injection, with their eyes opened and their ears unplugged, in a quiet room. We used a one head SPECT camera ( General Electric/ StarCam 4000 and Siemens/ E.Cam) with low-energy ultrahigh resolution collimator. Imaging begin 40 minutes after tracer injection. For reconstruction we used a Butterworth filter.The preliminary results showed brain perfusion deficit areas on five of the smokers while all non- smokers had normal brain perfusion scans. We believe that smoking increases the possibility of brain perfusion deficits. (author)

  5. Contralateral thalamic hypoperfusion on brain perfusion SPECT

    International Nuclear Information System (INIS)

    Lee, Seok Mo; Bae, Sang Kyun; Yoo, Kyung Moo; Yum, Ha Yong

    2000-01-01

    Brain perfusion single photon emission computed tomography (SPECT) is useful for the localization of cerebrovascular lesion and sometimes reveals more definite lesion than radiologic imaging modality such as CT or MRI does. The purpose of this study was to evaluate the diagnostic usefulness of brain perfusion SPECT in patients with hemisensory impairment. Thirteen consecutive patients (M:F= 8:5, mean age = 48) who has hemisensory impairment were included. Brain perfusion SPECT was performed after intravenous injection of 1110 MBq of Tc-99m ECD. The images were obtained using a dual-head gamma camera with ultra-high resolution collimator. Semiquantitative analysis was performed after placing multiple ROIs on cerebral cortex, basal ganglia, thalamus and cerebellum. There were 10 patients with left hemisensory impairment and 3 patients with right-sided symptom. Only 2 patients revealed abnormal signal change in the thalamus on MRI. But brain perfusion SPECT showed decreased perfusion in the thalamus in 9 patients. Six patients among 10 patients with left hemisensory impairment revealed decreased perfusion in the contralateral thalamus on brain SPECT. The other 4 patients revealed no abnormality. Two patients among 3 patients with right hemisensory impairment also showed decreased perfusion in the contralateral thalamus on brain SPECT. One patients with right hemisensory impairment showed ipsilateral perfusion decrease. Two patients who had follow-up brain perfusion SEPCT after treatment revealed normalization of perfusion in the thalamus. Brain perfusion SPECT might be a useful tool in diagnosing patients with hemisensory impairment

  6. A limitation of the split-dose method for evaluating rCBF changes using {sup 99m}Tc-ECD and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo; Takahashi, Makoto; Noguchi, Eikichi; Ohtaki, Hiro; Shibaki, Mitsurou; Kasahara, Tosifumi; Hatano, Masayoshi [Niigata Univ. (Japan). School of Medicine; Ohkubo, Masaki

    1997-05-01

    The purpose of the study is to validate the split-dose method corrected with dose ratio of {sup 99m}Tc-ECD for brain perfusion scan. A dose of 600 MBq of {sup 99m}Tc-ECD was divided into two with various dose ratios from 1 : 1 to 1 : 4, and injected to eleven patients with various cerebral diseases. A lesser dose of {sup 99m}Tc-ECD was injected under a control state for the first SPECT scan, and 15 min SPECT scan was performed 10 min after injection with a triple-head high resolution gamma camera. After the scan, the other dose of {sup 99m}Tc-ECD was injected under the same control state and the second SPECT scan was performed as same as above. A ratio of the activity of the first scan to the net activity of the second scan corrected by dose ratio, defined as K, was measured in brain regions of each subject. Expected value of K was 1, but the value was distributed with large variations in each subject. The mean % error of the K value was 10.4{+-}4.9%. Hence it is considered that activity changes by more than 20% from the control values should be required to detect a significant rCBF change in an activation SPECT study. Then, we proposed a new method in which the activity of both two SPECT scans was normalized by cerebellar or occipital activity and compared. The ratio obtained by the proposed method came closer to 1 with less variations and with less mean % error in comparison with those of K value obtained by the dose-correction method. Although the proposed method has a limitation in the use of an activation study loaded with Diamox, it may be useful to evaluate an alteration of rCBF in the study such as postural testing or finger-moving test. (author)

  7. Tc-99m-bicisate (ECD)-brain-SPECT in rapidly progressive dementia

    International Nuclear Information System (INIS)

    Marienhagen, J.; Eilles, C.; Weingaertner, U.; Blaha, L.; Zerr, I.; Poser, S.

    1999-01-01

    We present a 61-year-old male patient with progressive dementia. A brain SPECT with Tc-99m-bicisate was performed for confirmation of clinically suspected Alzheimer-dementia. At the time of the SPECT-investigation marked apraxia and aphasia besides severe dementia were present. Electrophysiological as well as anatomical neuroimaging findings showed non-diagnostic alterations. SPECT revealed distinct perfusion defects, which made Alzheimer Dementia unlikely. The further course of the patient was determined by rapidly progressive deterioration with development of akinetic mutism. Thereafter, increased levels of neuron-specific enolase as well as 14-3-3 proteins were found in the cerebro-spinal fluid (CSF). The patient finally died with signs of cerebral decortication. Due to the clinical course and the CSF-findings the patient's final diagnosis was Creutzfeld-Jakob-disease, nevertheless no autopsy was performed. The presented case report underscores the clinical utility of perfusion brain SPECT in the differential diagnosis of dementias. (orig.) [de

  8. Diagnostic evaluation of brain SPECT imaging in diseases of nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Yongsheng, Jiang; Chengmo, Zhu; Jixian, Zhang; Weijia, Tian [Shanghai Second Medical Univ. (China). Ruijing Hospital

    1992-11-01

    The dynamic distributions of home made ECD and the Amersham brain SPECT imaging agent 'Ceretec' in normal person as well as their diagnostic use in diseases of nervous system were investigated. Semi-quantitative analysis combined with direct observation was more accurate for the diagnosis. Aside from cerebrovascular diseases, SPECT brain imaging has its unique value for the diagnosis of transient ischemic attack, Alzheimer disease, multiple ischemic dementia and epilepsy etc.

  9. Brain SPECT in severs traumatic head injury

    International Nuclear Information System (INIS)

    Beaulieu, F.; Eder, V.; Pottier, J.M.; Baulieu, J.L.; Fournier, P.; Legros, B.; Chiaroni, P.; Dalonneau, M.

    2000-01-01

    The aim of this work was to compare the results of the early brain scintigraphy in traumatic brain injury to the long term neuropsychological behavior. Twenty four patients had an ECD-Tc99m SPECT, within one month after the trauma; scintigraphic abnormalities were evaluated according to a semi-quantitative analysis. The neuropsychological clinical investigation was interpreted by a synthetic approach to evaluate abnormalities related to residual motor deficit, frontal behavior, memory and language disorders. Fourteen patients (58%) had sequela symptoms. SPECT revealed 80 abnormalities and CT scan only 31. Statistical analysis of uptake values showed significantly lower uptake in left basal ganglia and brain stem in patients with sequela memory disorders. We conclude that the brain perfusion scintigraphy is able to detect more lesions than CT and that it could really help to predict the neuropsychological behavior after severe head injury. Traumatology could become in the future a widely accepted indication of perfusion SPECT. (authors)

  10. Evaluation of role of brain SPECT in diagnosis of post stroke dementia

    International Nuclear Information System (INIS)

    Yousepour, G.; Alavi, M.

    2003-01-01

    Post stroke dementia is one of the most common complications of stroke that is preventable and relatively treatable too. The purpose of the study is comparison between the positive findings in the brain CT scan and brain perfusion SPECT. 15 patients who were complicated by dementia after cerebrovascular accident and also 5 patients as a control group enrolled in this study. Brain CT scan and brain SPECT were performed during at most one week after stroke. Abnormal findings in both brain CT scan and SPECT were seen in 46% of patients. Brain CT scan disclosed more abnormal findings compared to brain SPECT (33.3%). While brain SPECT findings were more information than brain CT scan (20%) this study is indicating that brain CT scan and the brain SPECT concomitantly for each other in better diagnosis of post stroke dementia. We did not find any specific diagnostic pattern in brain SPECT of patients suffering from post stroke dementia. The low quality of brain SPECT in spite of uniformity of gamma camera may be suggestive of low quality of Iran produced ECD kit that needs further evaluation

  11. Evaluation of both perfusion and atrophy in multiple system atrophy of the cerebellar type using brain SPECT alone

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi; Imabayashi, Etsuko; Kuji, Ichiei; Seto, Akira; Ito, Kimiteru; Kikuta, Daisuke; Yamada, Minoru; Shimano, Yasumasa; Sato, Noriko

    2010-01-01

    Partial volume effects in atrophied areas should be taken into account when interpreting brain perfusion single photon emission computed tomography (SPECT) images of neurodegenerative diseases. To evaluate both perfusion and atrophy using brain SPECT alone, we developed a new technique applying tensor-based morphometry (TBM) to SPECT. After linear spatial normalization of brain perfusion SPECT using 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD) to a Talairach space, high-dimension-warping was done using an original 99m Tc-ECD template. Contraction map images calculated from Jacobian determinants and spatially normalized SPECT images using this high-dimension-warping were compared using statistical parametric mapping (SPM2) between two groups of 16 multiple system atrophy of the cerebellar type (MSA-C) patients and 73 age-matched normal controls. This comparison was also performed in conventionally warped SPECT images. SPM2 demonstrated statistically significant contraction indicating local atrophy and decreased perfusion in the whole cerebellum and pons of MSA-C patients as compared to normal controls. Higher significance for decreased perfusion in these areas was obtained in high-dimension-warping than in conventional warping, possibly due to sufficient spatial normalization to a 99m Tc-ECD template in high-dimensional warping of severely atrophied cerebellum and pons. In the present high-dimension-warping, modification of tracer activity remained within 3% of the original tracer distribution. The present new technique applying TBM to brain SPECT provides information on both perfusion and atrophy at the same time thereby enhancing the role of brain perfusion SPECT

  12. Evaluation of both perfusion and atrophy in multiple system atrophy of the cerebellar type using brain SPECT alone

    Directory of Open Access Journals (Sweden)

    Matsuda Hiroshi

    2010-08-01

    Full Text Available Abstract Background Partial volume effects in atrophied areas should be taken into account when interpreting brain perfusion single photon emission computed tomography (SPECT images of neurodegenerative diseases. To evaluate both perfusion and atrophy using brain SPECT alone, we developed a new technique applying tensor-based morphometry (TBM to SPECT. Methods After linear spatial normalization of brain perfusion SPECT using 99mTc-ethyl cysteinate dimer (99mTc-ECD to a Talairach space, high-dimension-warping was done using an original 99mTc-ECD template. Contraction map images calculated from Jacobian determinants and spatially normalized SPECT images using this high-dimension-warping were compared using statistical parametric mapping (SPM2 between two groups of 16 multiple system atrophy of the cerebellar type (MSA-C patients and 73 age-matched normal controls. This comparison was also performed in conventionally warped SPECT images. Results SPM2 demonstrated statistically significant contraction indicating local atrophy and decreased perfusion in the whole cerebellum and pons of MSA-C patients as compared to normal controls. Higher significance for decreased perfusion in these areas was obtained in high-dimension-warping than in conventional warping, possibly due to sufficient spatial normalization to a 99mTc-ECD template in high-dimensional warping of severely atrophied cerebellum and pons. In the present high-dimension-warping, modification of tracer activity remained within 3% of the original tracer distribution. Conclusions The present new technique applying TBM to brain SPECT provides information on both perfusion and atrophy at the same time thereby enhancing the role of brain perfusion SPECT

  13. Mechanism study of recovery from aphasia with 99Tcm-ECD SPECT brain imaging after oral reading test

    International Nuclear Information System (INIS)

    Chen Jian; Xu Hao; Wang Hong; Chen Zhuoming; Wu Qiulian

    2007-01-01

    Objective: There may be two mechanisms for recovery from aphasia----repair of dam- aged left hemisphere language network and(or) activation of compensatory areas in right hemisphere. It is, however, still controversial on which mechanism plays a more important role. The goal of this study was to compare the regional cerebral blood flow (rCBF) between baseline and during oral reading in aphasic patients who had shown definite recovery from a focal lesion in left hemisphere. It also aimed at exploring the role of the two hemispheres in recovery from aphasia, thus providing theoretic basis for rehabilitation therapy. Methods: Baseline and oral reading 99 Tc m -ethylcysteinate dimer (ECD) brain SPECT imaging were performed in 7 patients with aphasia separately in one-day interval. Semi-quantitative analysis of rCBF was conducted on 26 symmetrical ROIs in bilateral hemispheres on the transverse slices. The rCBF was estimated by the ratio of the counts per pixel of each ROI to the average counts per pixel of the whole encephalon. The change in blood flow was represented by the difference in rCBF between oral reading and baseline. Results: The activated perfusion pattern of brain region was different in all 7 aphasic patients. In 5 of the 7 patients, whose reading capacity were relatively preserved, the brain perfusion pattern was mainly left lateralized, while the other two patients who had poor performance in reading showed bilateral activation foci with fight-sided dominance. Conclusion: Oral reading activated SPECT brain imaging may be a useful tool for monitoring the progress of speech recovery in the treatment of aphasic patients. (authors)

  14. A preliminary report of 99Tcm-ECD brain SPECT imaging in patients with acquired immunodeficiency syndrome

    International Nuclear Information System (INIS)

    Xu Hao; Tong Yuwei; Luo Jinxiang; Chen Jian; Wu Qiulian

    2001-01-01

    Objective: To investigate the changes of regional cerebral blood flow (rCBF) in patients with acquired immunodeficiency syndrome (AIDS). Methods: 99 Tc m -ECD brain SPECT imaging was performed on 5 patients with AIDS and 16 sex- and age-matched normal controls. The rCBF percentages compared to the cerebellum were calculated using a semi-quantitative processing software. Results: Hypo-perfusions in the right and left frontal, temporal, parietal lobe, basal ganglia and left thalamus were seen in 1 patient with dementia. Hypo-perfusions in the right and left frontal and temporal lobe were seen in 4 patients without dementia. The rCBF in the right and left frontal, temporal, parietal lobe, basal ganglia and thalamus, straight gyri and pons decreased significantly in patients with AIDS than those of the control subjects (P < 0.01). Conclusion: There is reduced cortico-subcortical rCBF in patients with AIDS

  15. Brain perfusion SPECT in the mouse: normal pattern according to gender and age.

    Science.gov (United States)

    Apostolova, Ivayla; Wunder, Andreas; Dirnagl, Ulrich; Michel, Roger; Stemmer, Nina; Lukas, Mathias; Derlin, Thorsten; Gregor-Mamoudou, Betina; Goldschmidt, Jürgen; Brenner, Winfried; Buchert, Ralph

    2012-12-01

    Regional cerebral blood flow (rCBF) is a useful surrogate marker of neuronal activity and a parameter of primary interest in the diagnosis of many diseases. The increasing use of mouse models spawns the demand for in vivo measurement of rCBF in the mouse. Small animal SPECT provides excellent spatial resolution at adequate sensitivity and is therefore a promising tool for imaging the mouse brain. This study evaluates the feasibility of mouse brain perfusion SPECT and assesses the regional pattern of normal Tc-99m-HMPAO uptake and the impact of age and gender. Whole-brain kinetics was compared between Tc-99m-HMPAO and Tc-99m-ECD using rapid dynamic planar scans in 10 mice. Assessment of the regional uptake pattern was restricted to the more suitable tracer, HMPAO. Two HMPAO SPECTs were performed in 18 juvenile mice aged 7.5 ± 1.5weeks, and in the same animals at young adulthood, 19.1 ± 4.0 weeks (nanoSPECT/CTplus, general purpose mouse apertures: 1.2kcps/MBq, 0.7mm FWHM). The 3-D MRI Digital Atlas Database of an adult C57BL/6J mouse brain was used for region-of-interest (ROI) analysis. SPECT images were stereotactically normalized using SPM8 and a custom made, left-right symmetric HMPAO template in atlas space. For testing lateral asymmetry, each SPECT was left-right flipped prior to stereotactical normalization. Flipped and unflipped SPECTs were compared by paired testing. Peak brain uptake was similar for ECD and HMPAO: 1.8 ± 0.2 and 2.1 ± 0.6 %ID (p=0.357). Washout after the peak was much faster for ECD than for HMPAO: 24 ± 7min vs. 4.6 ± 1.7h (p=0.001). The general linear model for repeated measures with gender as an intersubject factor revealed an increase in relative HMPAO uptake with age in the neocortex (p=0.018) and the hippocampus (p=0.012). A decrease was detected in the midbrain (p=0.025). Lateral asymmetry, with HMPAO uptake larger in the left hemisphere, was detected primarily in the neocortex, both at juvenile age (asymmetry index AI=2.7 ± 1

  16. Identification by [{sup 99m}Tc]ECD SPECT of anterior cingulate hypoperfusion in progressive supranuclear palsy, in comparison with Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Varrone, Andrea [University Federico II, Biostructure and Bioimaging Institute, National Research Council/Department of Biomorphological and Functional Sciences, Napoli (Italy); Karolinska Hospital, Department of Clinical Neuroscience, Psychiatry Section, Stockholm (Sweden); Pagani, Marco; Salmaso, Dario [National Research Council, Institute of Cognitive Sciences and Technologies, Rome and Padua (Italy); Salvatore, Elena; Amboni, Marianna; De Michele, Giuseppe; Filla, Alessandro; Barone, Paolo [University Federico II, Department of Neurological Sciences, Napoli (Italy); Sansone, Valeria; Pappata, Sabina; Salvatore, Marco [University Federico II, Biostructure and Bioimaging Institute, National Research Council/Department of Biomorphological and Functional Sciences, Napoli (Italy); Nobili, Flavio [University of Genoa, Clinical Neurophysiology, Department of Endocrinological and Metabolic Sciences, Genoa (Italy)

    2007-07-15

    Progressive supranuclear palsy (PSP) is an akinetic-rigid syndrome that can be difficult to differentiate from Parkinson's disease (PD), particularly at an early stage. [{sup 99m}Tc]ethyl cysteinate dimer (ECD) SPECT could represent a widely available tool to assist in the differential diagnosis. In this study we used voxel-based analysis and Computerised Brain Atlas (CBA)-based principal component analysis (PCA) of [{sup 99m}Tc]ECD SPECT data to test whether: (1) specific patterns of rCBF abnormalities can differentiate PSP from controls and PD; (2) networks of dysfunctional brain regions can be found in PSP vs controls and PD. Nine PD patients, 16 PSP patients and ten controls were studied with [{sup 99m}Tc]ECD SPECT using a brain-dedicated device (Ceraspect). Voxel-based analysis was performed with statistical parametric mapping. PCA was applied to volume of interest data after spatial normalisation to CBA. The voxel-based analysis showed hypoperfusion of the anterior cingulate and medial frontal cortex in PSP compared with controls and PD. In PSP patients the rCBF impairment extended to the pre-supplementary motor area and prefrontal cortex, areas involved in executive function and motor networks. Compared with PSP patients, PD patients showed a mild rCBF decrease in associative visual areas which could be related to the known impairment of visuospatial function. The PCA identified three principal components differentiating PSP patients from controls and/or PD patients that included groups of cortical and subcortical brain regions with relatively decreased (cingulate cortex, prefrontal cortex and caudate) or increased (parietal cortex) rCBF, representing distinct functional networks in PSP. Anterior cingulate hypoperfusion seems to be an early, distinct brain abnormality in PSP as compared with PD. (orig.)

  17. The effectiveness of acupuncture as a treatment for tinnitus: a randomized controlled trial using 99mTc-ECD SPECT

    International Nuclear Information System (INIS)

    Laureano, Maura Regina; Braga Neto, Pedro; Ligia Sanchez, Maura; Cogo Moreira, Hugo; Ribeiro de Almeida, Roberta; Parolin Jackowski, Andrea; Onishi, Ektor Tsuneo; Affonseca Bressan, Rodrigo; Batista, Ilza Rosa; Alves Reis, Marilia; Vieira Castiglioni, Mario Luiz; Vargas Garcia, Michele; Neves de Andrade, Adriana; Jara Garrido, Griselda

    2016-01-01

    Investigate the effect of acupuncture on brain perfusion using ethyl cysteinate dimer single-photon emission computed tomography ( 99m Tc-ECD SPECT) in patients with tinnitus. This randomized, single-blind, sham-control study examined patients (18-60 years old) with normal hearing and chronic, idiopathic, continuous tinnitus. Fifty-seven subjects were randomly assigned to true (n = 30) or sham (n = 27) acupuncture (ACP); 99m Tc-ECD SPECT examinations were performed before and after 12 twice-weekly ACP sessions. Secondary outcomes included changes in the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), Hamilton Anxiety Scale (HAS) and Beck Depression Inventory (BDI). Imaging data were analysed using Statistical Parametric Mapping (SPM8) software. Regression models were used to examine secondary outcomes via two paradigms: intention-to-treat (ITT; where multiple imputations were conducted because of study attrition) and complete cases. No between-group brain perfusion differences were observed. However, a significant improvement in THI scores was observed at the end of true ACP treatment for all domains (all p values < 0.01) except the catastrophic scale. ACP might reduce the effects of tinnitus on daily life; however, additional studies should be conducted to verify the effects of ACP on the neural architecture and brain function of tinnitus patients. (orig.)

  18. Voxel-based analysis of Tc-99 m ECD brain perfusion SPECT in patients with normal pressure hydrocephalus

    International Nuclear Information System (INIS)

    Yoon, Bora; Yang, Dong-Won; Shim, Yong-Soo; Chung, Sung-Woo; Ahn, Kook-Jin; O, Joo-Hyun; Kim, Sung-Hoon; Sohn, Hyung-Sun; Chung, Soo-Kyo; Chung, Yong-An

    2009-01-01

    Idiopathic normal pressure hydrocephalus (iNPH) is a reversible dementia characterized by gait disturbance, incontinence and dementia. This study investigates the neuropsychological characteristics and changes of regional cerebral blood flow (rCBF) in patients with iNPH. Ten patients who met the criteria of probable iNPH and 13 normal control subjects were evaluated. The general cognitive function and detailed neuropsychological functions were measured by K-MMSE and comprehensive neuropsychological battery. Tc-99m-ethyl cysteinate dimmer (Tc-99m-ECD) single photon emission computed tomography (SPECT) was performed to measure the rCBF and statistical parametric mapping (SPM) and statistical probabilistic brain anatomic map (SPAM) was applied to the objective analysis of SPECT data. On the neuropsychological examination, all the patients showed abnormality in memory, psychomotor speed and frontal executive function. SPM analysis of SPECT images revealed that rCBF in bilateral thalami, right prefrontal area, bilateral anterior and posterior cingulate gyri, right caudate nucleus, and left parahippocampal gyrus was significantly decreased in patients with iNPH compared to normal controls (uncorrected P<0.005). In SPAM analysis, rCBF reduction was observed in bilateral prefrontal area, anterior, posterior cingulate gyri and caudate nuclei. We have found that rCBF changes occurred predominantly in prefrontal and subcortical areas, the changes were associated with frontal subcortical circuit, and the affected frontal subcortical circuit may contribute to the cognitive decline seen in the iNPH patients. The reduction of rCBF and clinical cognitive impairment are closely connected in patients with iNPH.

  19. Voxel-based analysis of Tc-99 m ECD brain perfusion SPECT in patients with normal pressure hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Bora [Department of Neurology, College of Medicine, Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Yang, Dong-Won [Department of Neurology, College of Medicine, Catholic University of Korea, Seoul 137-701 (Korea, Republic of)], E-mail: neuroman@catholic.ac.kr; Shim, Yong-Soo; Chung, Sung-Woo [Department of Neurology, College of Medicine, Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Ahn, Kook-Jin; O, Joo-Hyun; Kim, Sung-Hoon; Sohn, Hyung-Sun; Chung, Soo-Kyo [Department of Radiology, College of Medicine, Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Chung, Yong-An [Department of Radiology, College of Medicine, Catholic University of Korea, Seoul 137-701 (Korea, Republic of); East-West Research Institute of Translational Medicine (EWTM), Incheon St. Mary' s Hospital, Incheon 403-720 (Korea, Republic of)], E-mail: nm@catholic.ac.kr

    2009-07-15

    Idiopathic normal pressure hydrocephalus (iNPH) is a reversible dementia characterized by gait disturbance, incontinence and dementia. This study investigates the neuropsychological characteristics and changes of regional cerebral blood flow (rCBF) in patients with iNPH. Ten patients who met the criteria of probable iNPH and 13 normal control subjects were evaluated. The general cognitive function and detailed neuropsychological functions were measured by K-MMSE and comprehensive neuropsychological battery. Tc-99m-ethyl cysteinate dimmer (Tc-99m-ECD) single photon emission computed tomography (SPECT) was performed to measure the rCBF and statistical parametric mapping (SPM) and statistical probabilistic brain anatomic map (SPAM) was applied to the objective analysis of SPECT data. On the neuropsychological examination, all the patients showed abnormality in memory, psychomotor speed and frontal executive function. SPM analysis of SPECT images revealed that rCBF in bilateral thalami, right prefrontal area, bilateral anterior and posterior cingulate gyri, right caudate nucleus, and left parahippocampal gyrus was significantly decreased in patients with iNPH compared to normal controls (uncorrected P<0.005). In SPAM analysis, rCBF reduction was observed in bilateral prefrontal area, anterior, posterior cingulate gyri and caudate nuclei. We have found that rCBF changes occurred predominantly in prefrontal and subcortical areas, the changes were associated with frontal subcortical circuit, and the affected frontal subcortical circuit may contribute to the cognitive decline seen in the iNPH patients. The reduction of rCBF and clinical cognitive impairment are closely connected in patients with iNPH.

  20. SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury.

    Science.gov (United States)

    Abdel-Dayem, H M; Abu-Judeh, H; Kumar, M; Atay, S; Naddaf, S; El-Zeftawy, H; Luo, J Q

    1998-05-01

    The purpose of this atlas is to present a review of the literature showing the advantages of SPECT brain perfusion imaging (BPI) in mild or moderate traumatic brain injury (TBI) over other morphologic imaging modalities such as x-ray CT or MRI. The authors also present the technical recommendations for SPECT brain perfusion currently practiced at their center. For the radiopharmaceutical of choice, a comparison between early and delayed images using Tc-99m HMPAO and Tc-99m ECD showed that Tc-99m HMPAO is more stable in the brain with no washout over time. Therefore, the authors feel that Tc-99m HMPAO is preferable to Tc-99m ECD. Recommendations regarding standardizing intravenous injection, the acquisition, processing parameters, and interpretation of scans using a ten grade color scale, and use of the cerebellum as the reference organ are presented. SPECT images of 228 patients (age range, 11 to 88; mean, 40.8 years) with mild or moderate TBI and no significant medical history that interfered with the results of the SPECT BP were reviewed. The etiology of the trauma was in the following order of frequency: motor vehicle accidents (45%) followed by blow to the head (36%) and a fall (19%). Frequency of the symptoms was headache (60.9%), memory problems (27.6%), dizziness (26.7%), and sleep disorders (8.7%). Comparison between patients imaged early (3 months) from the time of the accident, showed that early imaging detected more lesions (4.2 abnormal lesions per study compared to 2.7 in those imaged more than 3 months after the accident). Of 41 patients who had mild traumatic injury without loss of consciousness and had normal CT, 28 studies were abnormal. Focal areas of hypoperfusion were seen in 77% (176 patients, 612 lesions) of the group of 228 patients. The sites of abnormalities were in the following order: basal ganglia and thalami, 55.2%, frontal lobes, 23.8%, temporal lobes, 13%, parietal, 3.7%, insular and occipital lobes together, 4.6%.

  1. Technetium SPECT agents for imaging heart and brain

    International Nuclear Information System (INIS)

    Linder, K.E.

    1990-01-01

    One major goal of radiopharmaceutical research has been the development of technetium-based perfusion tracers for SPECT imaging of the heart and brain. The recent clinical introduction of the technetium complexes HM-PAO, ECD and DMG-2MP for brain imaging, and of CDO-MEB and MIBI for heart imaging promises to revolutionize the field of nuclear medicine. All of these agents appear to localize in the target tissue in proportion to blood flow, but their mechanisms of localization and/or retention may differ quite widely. In this talk, a survey of the new technetium SPECT agents will be presented. The inorganic and biological chemistry of these complexes, mechanisms of uptake and retention, QSAR studies, and potential clinical applications are discussed

  2. Role of 99mTc-ECD brain SPECT in the detection of cerebral perfusion abnormality in cases of Attention Deficit Hyperactivity Disorder

    International Nuclear Information System (INIS)

    Kumar, A.; Phom, H.; Thomas, E.J.; Tripathi, M.; Chandrashekar, N.; Bal, C.S.; Zamir, H.; Gulati, S.; Kalra, V.

    2002-01-01

    Aim: A randomized placebo controlled drug trial with Mentat, a herbal pharmacological agent, was initiated in January 2000 in the department of pediatrics at AIIMS, New Delhi, to compare the efficacy of Mentat with a placebo in school children with Attention Deficit Hyperactivity Disorder (ADHD). Materials and Methods: Contact was established with 12 Public schools in Delhi, to identify poor performers in classes I-V (age 6-12 yrs.). About 195 children with poor school performance were recruited in the study. They were screened for causes of poor performance, which included attention problems, hyperactivity, behavior problems, emotional problems, mental sub-normality and learning disability. ADHD suspected children were identified using the Malin's WISC, Connor's rating scale, Problem Behavior checklist, Bender Gestalt test and some sub tests of the Kaufman's Assessment Battery for Children (K-ABC). Sixty children diagnosed as ADHD (using DSM-IV criteria), with an IQ between 90-110, were enrolled into the study. Of the 60 children randomized in the study, 30 received Mentat and 30 received an identical looking placebo. The drug/Placebo was given for a six-month period. 99mTC-ECD brain SPECT was performed in a subset of 34 children with ADHD. Results: Abnormal cerebral perfusion was seen in 23/34; thalamic hypoperfusion in 11, basal ganglia hypoperfusion in 9, thalamus and basal ganglia hypoperfusion in 2 and basifrontal hypoperfusion in 1. So far, in ten children with abnormal pretreatment scans, post treatment scans have also been done. In mentat group, 2/5 children showed normalization of perfusion abnormality after treatment whereas in placebo group, 1/5. Conclusion: This study suggests that there is selective focal cerebral hypoperfusion in cases of ADHD and 99mTc-ECD brain SPECT can be used for evaluation and further monitoring of therapeutic outcome in such cases

  3. Relationship between 99mTc-ECD SPECT images and performance of the Wisconsin card sorting test in healthy humans

    International Nuclear Information System (INIS)

    Zhao Jinhua; Lin Xiangtong; Guan Yihui; Xu Lianqin; Zhang Guangming; Xue Fangpeng

    1998-01-01

    Purpose: To investigate the relationship between 99m Tc-ECD SPECT and performance of the Wisconsin Card Sorting Test (WCST) in normal young and aged volunteers through the semi-quantitative analysis of the baseline and cognition activated rCBF images. Methods: 18 young and 17 aged volunteers were enrolled. The education level of the two groups was matched. All subjects were healthy and CT results of all the aged volunteers were normal. Both baseline and cognition activated 99m Tc-ECD SPECT were performed on all the subjects. The cognition activated brain SPECT: The cognitive task was WCST. 1110 MBq 99m Tc-ECD was administered by intravenous bolus injection 5 minutes after the onset of the WCST. The images were reconstructed and semiquantitatively analyzed. WCST were scored through 9 items: 1) period, 2) categories, 3) total corrects, 4) conceptual level (%), 5) perseverative responses, 6) total errors, 7) perseverative errors, 8) perseverative error (%), 9) non-perseverative errors. Results: 1) Compared with the baseline, the activated rCBF values of frontal, left temporal and left parietal lobes were higher in young subjects. 2) The activated rCBF values of right frontal lobe is slightly higher than those of baseline in aged group. 3) WCST scores: the young had significantly better scores than the aged in 7 items. 4) The baseline and activated rCBF values of the frontal lobes and anterior cingule were closely related to the scores of categories, perseverative responses, total errors and non-perseverative errors. Conclusions: 1) The distribution patterns of 99m Tc-ECD are different between young and aged volunteers. 2) The performance of WCST mainly relates to frontal lobes. The mild hypoperfusion of the frontal lobe in aged group may be the cause of poor conceptual and thinking ability. 3) First found the significant correlation between anterior cingule and performance of WCST

  4. Interictal Spect with Tc-99m ECD studies in migraine patients. Role of Spect in the diagnosis of migraine with ura in headache-free periods

    International Nuclear Information System (INIS)

    Gonzalez, F.M.; Martinez, J.J.; Bermudez, M.C.; Fernandez, B.; Delgado, J.; Martin, A.; Padilla, O.; Nieto, R.

    2002-01-01

    Aim: The migraine is one of the neurological alterations more frequent provoking a discharge morbility and big inconveniences the one that endures it. The presence of brain perfusion abnormalities during the pain-free intervals of migraine even is fueling of controversies being so numerous the supporters of its existence as whom they deny it. This study was aimed at assessing the presence of cerebral perfusion abnormalities also during the interictal phase and the role of SPECT with Tc99 ECD on diagnosis of this migrainous patients. Materials And Methods: We studied 20 patients (16 woman and 4 man) with diagnose of migraine with aura during a periods without headache and 20 apareaded controls for age and sex of this patients.Was realized brain spect with 925 MBq Tc99m-ECD on a two heads rotating gamma camera (Piker Axis) equipped with a fan-beam collimator. The images were reconstructed using a filter Mezt and presented in courts in the three axes and reconstruction in three dimensions and later they were analyzed by two observers. Results: We found 14 of the patients (70%) with images of focal hypoperfusion with clear interhemispheric asymmetry while on control groups only two have this find (10%) being this difference statistically significant. The part of the brain more affected was the occipital one, though also they predominated over the more widespread hipocaptations. Conclusion: The brain Spect is a useful technology to identify the patients with migraine, being able to be used in the periods without pain. The boss of perfusion in the patients is the located hypoperfusion and is significantly different from that of the controls, It can be explained by an impaired regional cerebral vascular autoregulation may exist even during headache-free intervals in patients suffering from migraine. Future studies must be realized to determine if it exists relation between the zone of hypoperfusion and the type of present symptomatology in the aura

  5. Brain SPECT using dipyridamole for evaluation of vascular reserve

    International Nuclear Information System (INIS)

    Kim, Su Zy; Park, Chan Hee; Yoon, Soo Hwan; Pai, Moon Sun; Yoon, Suk Nam; Cho, Kyung Kee

    1997-01-01

    Baseline and stress brain SPECT studies using CO 2 inhalation, acetazolamide (Diamox R ) and adenosine administrations have been used in the evaluation of cerebral vascular reserve. Recently dipyridamole (Persantine R ) which is one of the pharmacologic myocardial perfusion SPECT agents as a potent vasodilator is suggested as another cerebral vasodilator. IV Diamox R is not available in Korea. Therefore, the purpose of our study was to evaluate dipyridamole in stress brain SPECT in patients with Moya Moya disease. Eight patients with angiographically proven Moya Moya disease were studied. Their ages ranged from 7 to 62 year old. There were 4 males and 4 females. Each patient had a baseline and persantine brain SPECT studies with 1 to 3 days' interval. Dipyridamole was given intravenously at a dose of 0.56 mg/kg over 4 minutes while watching vital signs such as blood pressure, heart rate, and electrocardiogram. Three minutes after the completion of the infusion, 99mTc-ECD (0.2 mCi/Ib body weight) was injected. Brain SPECT was performed 30 minutes later using a tripple head gamma camera equipped with LEHR collimators. A total of 128 projections with an acquisition time of 30 second per projection was obtained and reconstructed by filtered back projections without attenuation correction. The difference between the baseline and persantine studies was analysed by visual and semiquantitavely. During the infusion of persantine, heart rate, blood pressure and side effects such as headache, chest discomfort were similar to the persantine myocardial SPECT studies. Five of eight patients showed a significant decrease in rCBF on persantine brain SPECT in comparison to the baseline study. The remaining three revealed no significant change in rCBF. Our study suggests that the dipyridamole stress brain SPECT is feasible and useful in assessing cerebral blood flow reserve. However we need to evaluate more number of patients in the future

  6. Brain Perfusion SPECT Imaging in Sturge - Weber Syndrome : Comparison with MR Imaging

    International Nuclear Information System (INIS)

    Ryu, Jin Sook; Choi, Yun Young; Moon, Dae Hyuk; Yang, Seoung Oh; Ko, Tae Sung; Yoo, Shi Joon; Lee, Hee Kyung

    1996-01-01

    The purpose of this study was evaluate the characteristic perfusion changes in patients with Sturge-Weber syndrome by comparison of the findings of brain MR images and perfusion SPECT images. 99m Tc-HMPAO or 99m Tc-ECD interictal brain SPECTs were performed on 5 pediatric patients with Struge-Weber syndrome within 2 weeks after MR imaging. Brain SPECTs of three patients without calcification showed diminished perfusion in the affected area on MR image. A 3 month-old patient without brain atrophy or calcification demonstrated paradoxical hyperperfusion in the affected hemisphere, and follow-up perfusion SPECT revealed decreased perfusion in the same area. The other patient with advanced calcified lesion and atrophy on MR image showed diffusely decreased perfusion in the affected hemisphere, but a focal area of increased perfusion was also noted in the ipsilateral temporal lobe on SPECT. In conclusion, brain perfusion of the affected area of Sturge-Weber syndrome patients was usually diminished, but early or advanced patients may show paradoxical diffuse or focal hyperperfusion in the affected hemisphere. Further studies are needed for better understanding of these perfusion changes and pathophysiology of Struge-Weber syndrome.

  7. SPECT brain perfusion imaging in mild traumatic brain injury

    International Nuclear Information System (INIS)

    Li Juan; Liu Baojun; Zhao Feng; He Lirong; Xia Yucheng

    2003-01-01

    Objective: To study the clinical value of SPECT brain perfusion imaging after mild traumatic brain injury and to evaluate the mechanism of brain blood flow changes in the brain traumatic symptoms. Methods: SPECT 99 Tc m -ethylene cysteinate dimer (ECD) brain perfusion imaging was performed on 39 patients with normal consciousness and normal computed tomography. The study was performed on 23 patients within 3 months after the accidental injury and on 16 patients at more than 3 months post-injury. The cerebellum was used as the reference site (100% maximum value). Any decrease in cerebral perfusion in cortex or basal ganglia to below 70%, or even to below 50% in the medial temporal lobe, compared to the cerebellar reference was considered abnormal. Results: The results of 23 patients (59%) were abnormal. Among them, 20 patients showed 74 focal lesions with an average of 3.7 per patient (15 studies performed within 3 months and 8 studies performed more than 3 months after injury). The remaining 3 showed diffuse hypoperfusion (two at the early stage and one at more than 3 months after the injury). The 13 abnormal studies performed at the early stage showed 58 lesions (average, 4.5 per patient), whereas there was a reduction to an average of 2.3 per patient in the 7 patients (total 16 lesions) at more than 3 months post-injury. In the 20 patients with focal lesions, mainly the following regions were involved: frontal lobes 43.2% (32/74), basal ganglia 24.3% (18/74) and temporal lobes 17.6% (13/74). Conclusions: 1) SPECT brain perfusion imaging is more sensitive than computed tomography in detecting brain lesions of mild traumatic brain injury. 2) SPECT brain perfusion imaging is more sensitive at early stage than at late stage after injury. 3) The most common complaints were headache, dizziness, memory deficit. The patients without loss of consciousness may present brain hypoperfusion, too. 4) The changes may explain a neurological component of the patient symptoms in

  8. Functional brain imaging study in patients with anxiety disorders using SPECT

    International Nuclear Information System (INIS)

    Sun Da; Zhan Hongwei; Liu Hongbiao; Li Huichun

    2005-01-01

    Objective: To evaluate the changes of brain function in patients with anxiety disorders. Methods: Regional cerebral perfusion was investigated using SPECT in 65 patients with anxiety disorders dragnosed according to the fourth edition of the diagnostic and statistical manual of mental disorder (DSMTD) criteria and in a matched control group of 21 healthy volunteers. 65 cases of the patients were further divided into: drug treated group (31 patients) and non-drug treated group (34 patients). The mean ages of the patients and the controls were (39.2±26.1) and (34.4±9.7) years, respectively. The severity of the anxiety was assessed using the 17-item Hamilton Anxiety scale (mean: 24.8±5.5 and 24.7±7.5, respectively). After administration of 740-925 MBq 99 Tc m -ethylene cysteinate direct (ECD) brain SPECT image study was performed. For the semi- quantitative analysis of the data, the ratios of the mean counts/pixel in the different cerebral regions of interest (ROI) to that of cerebellum were calculated respectively as a regional perfusion index (RPI). Some patients had a repeated SPECT after three months of treatment. Results: 93.8% (61/65) patients had relative hypoperfusions in some cerebral regions. Compared with the control group, the patients had a significant decrease of regional cerebral blood flow (rCBF) in the bilateral frontal lobes, paralimbic system, temporal lobes and basal ganglia. The course of disease had negatively correlated with the changes of rCBF in both groups of patients. Follow-up SPECT study demonstrated increased rCBF related with the symptomatic improvement. Conclusions: Patients with anxiety disorders had profound dysfunction of the frontal and temporal cortices, and was closely related to the symptom and therapy. 99 Tc m -ECD brain SPECT may offer the most accurate assessment of response to therapy. . (authors)

  9. Importance of brain perfusion SPECT in the diagnosis and prognosis of migraine

    International Nuclear Information System (INIS)

    Colmenter, L.F.; Paz-Araviche, V.; Celedon-Arrieta, P.; Mora, E.; Tavares, A.

    2002-01-01

    Aim: The objective of this investigation was to establish the usefulness of ECD-99mTc brain perfusion SPECT in the evaluation of the diagnosis of functional alterations of Vascular Headaches of migrainous origin and to determine the changes in regional cerebral blood flow (FSCr) during the headache phase. Material and Methods: A population of 21 female patients, 5 controls, of the same age and sex, aged between 20 and 76 years, with clinical evidence of headache with or without aura, with a duration of 8 to 72 hours, pulsating pain, associated to nausea, photophobia, phonophobia, that does not resolve with common analgesics and characterized by increase of the pain with physical activity. Brain perfusion SPECT was practiced on them at the moment of crisis, independent of the presence of aura or pain, and without crisis. ECD-99mTc was administered at a dose of 925 to 1110 MBq. Images were analyzed by the semi quantification method. Results: SPECT detected 13 hypo-captures on the 16 patients studied. With an 81% sensitivity and 100% specificity, with a precision value of 86%. Analysis through X Binomial Aleatory Variable showed a precision of 90% (p= < 0,023) for the isotopic test, with a significance level of 5%. Conclusions: The results of this study confirm that brain SPECT is a neuroimaging technique capable of identifying migrainous patients, being able to reevaluate the type of hypo perfusion that each patient has, during crisis or out of crisis, and correlate the cortical perfusion deficits and the deterioration of neuropsychological functions

  10. 99mTc-ECD and 99mTc-HM-PAO SPECT in five patients with MELAS

    International Nuclear Information System (INIS)

    Katagiri, Shinako; Nishimaki, Hiroshi; Kitano, Masashi; Horiike, Shigeharu; Kan, Shinichi; Ishii, Katsumi; Matsubayashi, Takashi; Sakai, Fumihiko

    1998-01-01

    Cerebral perfusion was studied in five patients with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes syndrome (MELAS), using single photon emission computed tomography (SPECT) with 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD) or 99m Tc-hexamethyl propyleneamine oxime ( 99m Tc-HM-PAO). In four cases, regional cerebral blood flow (rCBF) was evaluated by the method reported by Mastuda et al. Immediately after the stroke-like episodes, accumulation of the tracer was relatively increased in the temporooccipital lobe, and also increased rCBF was shown in the same area. However, the region showed decreased radioactivity at the chronic stage, and rCBF decreased also. These findings are consistent with positron emission tomography (PET) at the acute stage and autopsy. 99m Tc-ECD SPECT and 99m Tc-HM-PAO SPECT may be useful in the diagnosis and assessment of the progress of the MELAS. (author)

  11. A comparative study of 99mTc-ECD and X-CT in the evaluation of patients with cerebropathy

    International Nuclear Information System (INIS)

    Sun Da

    1995-01-01

    The clinical value of functional brain imaging was evaluated preliminarily by comparing 99m Tc-ECD SPECT with X-CT in patients with cerebropathy. 219 patients underwent 99m Tc-ECD SPECT and X-CT. Both procedures were performed within two weeks in each patient. The data showed that while X-CT was an excellent technique in detecting structural lesions of brain, such as cerebral hemorrhage or infarct, cerebrum and cephalophyma, it is not capable of demonstrating a metabolic and functional lesions without structural abnormalities. The functional imaging had great advantage in this regard. Results indicated that 99m Tc-ECD SPECT can easily detect cerebral blood flow change of intracerebral foci not detectable by traditional morphological imaging. This advantage was obvious especially in patients with early stage of acute cerebral infarct, TIA, hemicrania, cerebral arteriosclerosis, dementia, extraphyramidal disorders, sequelae of head trauma and epilepsy. In some of the patients with sequelae of head trauma or epilepsy, satisfactory effect was obtained when conservative treatments were performed to improve rCBF. 99 Tc-ECD SPECT may play a useful role in the diagnosis and therapy of patients with cerebropathy

  12. The study of ictal brain SPECT during seizures induced by clonidine and sleep-deprivation in patients with epilepsy

    International Nuclear Information System (INIS)

    Wang Xiaohui; Chen Xuehong; Wang Zhengjiang; Liu Jiangyan; Feng Jianzhong; Ye Jiang; Zhao Li

    2010-01-01

    Objective: To evaluate the feasibility and clinical value of combined clonidine and sleep-deprivation induced seizures for ictal brain SPECT imaging in patients with epilepsy. Methods: Fifty-two epilepsy patients were given oral clonidine plus sleep-deprivation to induce seizures with video-electroencephalogram (VEEG) monitoring. Forty-seven patients were selected as control group, whose seizures were induced by sleep-deprivation only. 99 Tc m -ethylcysteinate dimer (ECD) was injected within 30 s since a clinical sign and/or a typical EEG discharge of epilepsy was recognized. Brain SPECT was performed 30 min after 99 Tc m -ECD injection. χ 2 -test was performed by using software SPSS 10.0. Results: One to two hr after oral intake of clonidine plus sleep-deprivation, 75% (39/52) patients were induced seizures, including 92.3% (36/39) with subclinical seizures and 7.7% (3/39) with clinical seizures. Ictal brain SPECT localized the lesions with high uptake of 99 Tc m -ECD in 37 (94.9%) patients. In control group, 38.3% (18/47) were induced epileptic seizures, including 77.8% (14/18) with subclinical seizures and 22.2% (4/18) with clinical seizures. The induction rate of epileptic seizures in clonidine plus sleep-deprivation group was significantly higher than that of control group (χ 2 = 13.614, P 2 = 1.253, P>0.05). Conclusions: The combination of oral intake of clonidine and sleep-deprivation could increase the induction rate of epileptic seizures and it is effective for epilepsy SPECT imaging. (authors)

  13. Hypoperfusion in baseline and cognitively activated brain SPECT imaging of adult and elderly patients with depression

    International Nuclear Information System (INIS)

    Zhao Jinhua; Lin Xiangtong; Jiang Kaida; Ang Qiuqing; Shi Shenxun; Xue Fangping

    2000-01-01

    Objective: To evaluate the rCBF abnormalities of the baseline and cognitively activated rCBF imaging in unmedicated adult and elderly patients with depression. Methods: The subjects were divided into four groups: depressed adults, normal adult controls, depressed elders and normal elderly controls. All depressed patients were unmedicated and the diagnoses (depression of moderate degree with accompanying somatization) were confirmed by the ICD-10 criteria. Age range of the 39 depressed adult patients was 17 - 55 years. 17 age-matched normal adult controls (age range 21 - 50 years) were studied under identical conditions. The age range of 18 depressed elderly patients was 62 - 76 years. 21 age-matched normal elderly controls (age range 60 - 72 years) were studied under identical conditions. Baseline and cognitively activated 99 Tc m -ECD SPECT were performed on 25 of the 39 adult patients with depression and 17 normal adult controls. Baseline 99 Tc m -ECD SPECT only was performed on the remaining 14 patients with depression. Baseline and cognitively activated 99 Tc m -ECD SPECT were performed on 12 of the 18 elderly patients with depression and 18 of the 21 normal elderly controls. Baseline 99 Tc m -ECD SPECT only was performed on the remaining elderly patients and 3 normal elderly controls. Results: 1) The characteristic abnormalities of baseline and cognitively activated brain SPECT imaging of depression in adults: the baseline rCBF values of frontal and temporal lobe decreased significantly and the activated rCBF values of frontal, temporal lobe decreased more evidently than that in the baseline imaging and additionally decreased activated rCBF values in parietal lobe were found. 2) The characteristic abnormalities of baseline and cognitively activated brain SPECT imaging of elderly patients with depression: the baseline rCBF values of frontal, temporal lobe and right basal ganglia decreased significantly and the activated rCBF values of frontal, temporal, right

  14. Investigation of olfactory function in normal volunteers by Tc-99m ECD Brain SPECT: Analysis using statistical parametric mapping

    International Nuclear Information System (INIS)

    Chung, Y.A.; Kim, S.H.; Park, Y.H.; Lee, S.Y.; Sohn, H.S.; Chung, S.K.

    2002-01-01

    The purpose of this study was to investigate olfactory function according to Tc-99m ECD uptake pattern in brain perfusion SPET of normal volunteer by means of statistical parametric mapping (SPM) analysis. The study population was 8 healthy volunteer subjects (M:F = 6:2, age range: 22-54 years, mean 34 years). We performed baseline brain perfusion SPET using 555 MBq of Tc-99m ECD in a silent dark room. Two hours later, we obtained brain perfusion SPET using 1110 MBq of Tc-99m ECD after 3% butanol solution under the same condition. All SPET images were spatially transformed to standard space smoothed and globally normalized. The differences between the baseline and odor-identification SPET images were statistically analyzed using SPM-99 software. The difference between two sets of brain perfusion SPET was considered significant at a threshold of uncorrected p values less than 0.01. SPM analysis revealed significant hyper-perfusion in both cingulated gyri, right middle temporal gyrus, right superior and inferior frontal gyri, right lingual gyrus and right fusiform gyrus on odor-identification SPET. This study shows that brain perfusion SPET can securely support other diagnostic techniques in the evaluation of olfactory function

  15. Motor cortex stimulation(MCS) for intractable complex regional pain syndrome (CRPS) type II: PSM analysis of Tc-99m ECD brain perfusion SPECT

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    Chung, Y. A.; Son, B. C.; Yoo, I. R.; Kim, S. H.; Kim, E. N.; Park, Y. H.; Lee, S. Y.; Sohn, H. S.; Chung, S. K. [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2001-07-01

    We had experienced a patient with intractable CRPS in whom statistical parametric mapping (SPM) analysis of cerebral perfusion explained the mechanism of pain control by MCS. A 43-year-old man presented spontaneous severe burning pain in his left hand and forearm and allodynia over the left arm and left hemibody. After the electrodes for neuromodulation therapy were inserted in the central sulcus, the baseline and stimulation brain perfusion SPECT using Tc-99m ECD were obtained within two days. The differences between the baseline and stimulation SPECT images, estimated at every voxel using t-statistics using SPM-99 software, were considered significant at a threshold of uncorrected P values less than 0.01. Among several areas significantly activated following pain relief with MCS, ipsilateral pyramidal tract in the cerebral peduncle might be related to the mechanism of pain control with MCS through efferent motor pathway. The result suggested that corticospinal neurons themselves or motor cortex efferent pathway maintained by the presence of intact corticospinal neurons could play an important role in producing pain control after MCS. This study would helpful in understanding of neurophysiology.

  16. Motor cortex stimulation(MCS) for intractable complex regional pain syndrome (CRPS) type II: PSM analysis of Tc-99m ECD brain perfusion SPECT

    International Nuclear Information System (INIS)

    Chung, Y. A.; Son, B. C.; Yoo, I. R.; Kim, S. H.; Kim, E. N.; Park, Y. H.; Lee, S. Y.; Sohn, H. S.; Chung, S. K.

    2001-01-01

    We had experienced a patient with intractable CRPS in whom statistical parametric mapping (SPM) analysis of cerebral perfusion explained the mechanism of pain control by MCS. A 43-year-old man presented spontaneous severe burning pain in his left hand and forearm and allodynia over the left arm and left hemibody. After the electrodes for neuromodulation therapy were inserted in the central sulcus, the baseline and stimulation brain perfusion SPECT using Tc-99m ECD were obtained within two days. The differences between the baseline and stimulation SPECT images, estimated at every voxel using t-statistics using SPM-99 software, were considered significant at a threshold of uncorrected P values less than 0.01. Among several areas significantly activated following pain relief with MCS, ipsilateral pyramidal tract in the cerebral peduncle might be related to the mechanism of pain control with MCS through efferent motor pathway. The result suggested that corticospinal neurons themselves or motor cortex efferent pathway maintained by the presence of intact corticospinal neurons could play an important role in producing pain control after MCS. This study would helpful in understanding of neurophysiology

  17. Neuropsychological Correlates of Brain Perfusion SPECT in Patients with Macrophagic Myofasciitis.

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    Axel Van Der Gucht

    Full Text Available Patients with aluminum hydroxide adjuvant-induced macrophagic myofasciitis (MMF complain of arthromyalgias, chronic fatigue and cognitive deficits. This study aimed to characterize brain perfusion in these patients.Brain perfusion SPECT was performed in 76 consecutive patients (aged 49±10 y followed in the Garches-Necker-Mondor-Hendaye reference center for rare neuromuscular diseases. Images were acquired 30 min after intravenous injection of 925 MBq 99mTc-ethylcysteinate dimer (ECD at rest. All patients also underwent a comprehensive battery of neuropsychological tests, within 1.3±5.5 mo from SPECT. Statistical parametric maps (SPM12 were obtained for each test using linear regressions between each performance score and brain perfusion, with adjustment for age, sex, socio-cultural level and time delay between brain SPECT and neuropsychological testing.SPM analysis revealed positive correlation between neuropsychological scores (mostly exploring executive functions and brain perfusion in the posterior associative cortex, including cuneus/precuneus/occipital lingual areas, the periventricular white matter/corpus callosum, and the cerebellum, while negative correlation was found with amygdalo-hippocampal/entorhinal complexes. A positive correlation was also observed between brain perfusion and the posterior associative cortex when the time elapsed since last vaccine injection was investigated.Brain perfusion SPECT showed a pattern of cortical and subcortical changes in accordance with the MMF-associated cognitive disorder previously described. These results provide a neurobiological substrate for brain dysfunction in aluminum hydroxide adjuvant-induced MMF patients.

  18. Statistical parametric mapping and statistical probabilistic anatomical mapping analyses of basal/acetazolamide Tc-99m ECD brain SPECT for efficacy assessment of endovascular stent placement for middle cerebral artery stenosis

    International Nuclear Information System (INIS)

    Lee, Tae-Hong; Kim, Seong-Jang; Kim, In-Ju; Kim, Yong-Ki; Kim, Dong-Soo; Park, Kyung-Pil

    2007-01-01

    Statistical parametric mapping (SPM) and statistical probabilistic anatomical mapping (SPAM) were applied to basal/acetazolamide Tc-99m ECD brain perfusion SPECT images in patients with middle cerebral artery (MCA) stenosis to assess the efficacy of endovascular stenting of the MCA. Enrolled in the study were 11 patients (8 men and 3 women, mean age 54.2 ± 6.2 years) who had undergone endovascular stent placement for MCA stenosis. Using SPM and SPAM analyses, we compared the number of significant voxels and cerebral counts in basal and acetazolamide SPECT images before and after stenting, and assessed the perfusion changes and cerebral vascular reserve index (CVRI). The numbers of hypoperfusion voxels in SPECT images were decreased from 10,083 ± 8,326 to 4,531 ± 5,091 in basal images (P 0.0317) and from 13,398 ± 14,222 to 7,699 ± 10,199 in acetazolamide images (P = 0.0142) after MCA stenting. On SPAM analysis, the increases in cerebral counts were significant in acetazolamide images (90.9 ± 2.2 to 93.5 ± 2.3, P = 0.0098) but not in basal images (91 ± 2.7 to 92 ± 2.6, P = 0.1602). The CVRI also showed a statistically significant increase from before stenting (median 0.32; 95% CI -2.19-2.37) to after stenting (median 1.59; 95% CI -0.85-4.16; P = 0.0068). This study revealed the usefulness of voxel-based analysis of basal/acetazolamide brain perfusion SPECT after MCA stent placement. This study showed that SPM and SPAM analyses of basal/acetazolamide Tc-99m brain SPECT could be used to evaluate the short-term hemodynamic efficacy of successful MCA stent placement. (orig.)

  19. Brain SPECT

    International Nuclear Information System (INIS)

    Feistel, H.

    1991-01-01

    Brain SPECT investigations have gained broad acceptance since the introduction of the lipophilic tracer Tc-99m-HMPAO. Depending on equipment and objectives in different departments, the examinations can be divided into three groups: 1. Under normal conditions and standardised patient preparation the 'rest' SPECT can be performed in every department with a tomographic camera. In cerebrovascular disease there is a demand for determination of either the perfusion reserve in reversible ischemia or prognostic values in completed stroke. In cases of dementia, SPECT may yield useful results according to differential diagnosis. Central cerebral system involvement in immunologic disease may be estimated with higher sensitivity than in conventional brain imaging procedures. In psychiatric diseases there is only a relative indication for brain SPECT, since results during recent years have been contradictory and may be derived only in interventional manner. In brain tumor diagnostics SPECT with Tl-201 possibly permits grading. In inflammatory disease, especially in viral encephalitis, SPECT may be used to obtain early diagnosis. Normal pressure hydrocephalus can be distinguished from other forms of dementia and, consequently, the necessity for shunting surgery can be recognised. 2. In departments equipped for emergency cases an 'acute' SPECT can be performed in illnesses with rapid changing symptoms such as different forms of migraine, transient global amnesia, epileptic seizures (so-called 'ictal SPECT') or urgent forms like trauma. 3. In cooperation with several departments brain SPECT can be practised as an interventional procedure in clinical and in scientific studies. (orig./MG) [de

  20. Discrepant 99mTc-ECD images of CBF in patients with subacute cerebral infarction. A comparison of CBF, CMRO2 and 99mTc-HMPAO imaging

    International Nuclear Information System (INIS)

    Shishido, Fumio; Uemura, Kazuo; Inugami, Atsushi; Ogawa, Toshihide; Fujita, Hideaki; Shimosegawa, Eku; Nagata, Ken.

    1995-01-01

    Three patients with subacute ischemic cerebral infarction examined by SPECT with 99m Tc-ECD and PET within the same day showed signs of luxury perfusion in the subacute phase, which is between 9 to 20 days after the onset. A 99m Tc-HMPAO SPECT study was also performed within 2 days of the ECD-SPECT study. ECD-SPECT images of three patients displayed a focal decreased uptake in the infarcted lesions, while in infarcted foci, there was almost equivalent or increased CBF compared to normal and unaffected areas, decreased CMRO 2 , and high HMPAO uptake. The ECD-SPECT results were similar to those of CMRO 2 rather than CBF, though the HMPAO-SPECT image was similar to that of CBF. In one patient, HMPAO images revealed hyperfixation of the tracer. In the chronic phase and in the acute phase before 5 days after the onset, there were no discrepancies among the ECD-SPECT, CBF, HMPAO-SPECT, and CMRO 2 images. These observations indicated that 99m Tc-ECD is a good indicator of damaged brain tissues in subacute ischemic infarction. They also suggested that 99m Tc-ECD is a potential agent with which to evaluate cerebral tissue viability in some pathological states of cerebrovascular disease. The characteristics may be suitable for confirming the effects of thrombolytic therapy in acute ischemia, because these conditions often show signs of luxury perfusion when the therapy is successful. (author)

  1. Brain SPECT. SPECT in der Gehirndiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Feistel, H. (Erlangen-Nuernberg Univ., Erlangen (Germany). Nuklearmedizinische Klinik mit Poliklinik)

    1991-12-01

    Brain SPECT investigations have gained broad acceptance since the introduction of the lipophilic tracer Tc-99m-HMPAO. Depending on equipment and objectives in different departments, the examinations can be divided into three groups: 1. Under normal conditions and standardised patient preparation the 'rest' SPECT can be performed in every department with a tomographic camera. In cerebrovascular disease there is a demand for determination of either the perfusion reserve in reversible ischemia or prognostic values in completed stroke. In cases of dementia, SPECT may yield useful results according to differential diagnosis. Central cerebral system involvement in immunologic disease may be estimated with higher sensitivity than in conventional brain imaging procedures. In psychiatric diseases there is only a relative indication for brain SPECT, since results during recent years have been contradictory and may be derived only in interventional manner. In brain tumor diagnostics SPECT with Tl-201 possibly permits grading. In inflammatory disease, especially in viral encephalitis, SPECT may be used to obtain early diagnosis. Normal pressure hydrocephalus can be distinguished from other forms of dementia and, consequently, the necessity for shunting surgery can be recognised. 2. In departments equipped for emergency cases an 'acute' SPECT can be performed in illnesses with rapid changing symptoms such as different forms of migraine, transient global amnesia, epileptic seizures (so-called 'ictal SPECT') or urgent forms like trauma. 3. In cooperation with several departments brain SPECT can be practised as an interventional procedure in clinical and in scientific studies. (orig./MG).

  2. Determination of hyperactive areas of Cortex Cerebri with using brain SPECT study

    International Nuclear Information System (INIS)

    Stepien, A.; Pawlus, J.; Wasilewska-Radwanska, M.

    2004-01-01

    The aim of this study was the assessment of the ability to apply of SPECT technique to determination of hyperactive areas of cortex cerebri. Analysis included 50 patients (mean aged 44 - 58). Brain SPECT scanning was performed after 1 hour after the intravenous injection of 740 MBq of ethylcisteinate dimmer labeled 99m Technetium (99mTc-ECD) with the use one-head gamma camera with a low-energy, ultra-high resolution collimator. Qualitative and quantitative analysis was performed using specialised software. In 20 cases normal biodistribution of the radiotracer was observed (hyperactive areas in cerebellum and occiput). In patients with psychiatric and neurological disturbances hyperactive areas were visualized in 25 cases in temporal lobes, in 4 cases in parietal lobes and in 1 patient in frontal area and basal ganglia. It is concluded that a number of factors limit the wide-scale use of SPECT, including the sophistication of imaging equipment (single-head cameras are inferior to the newer multihead units) and the experience of the physicians interpreting the scans and utilizing the data. In many diseases physicians do not know which areas of the patient's brain according disorders. Brain SPECT study can be a very useful tool to evaluation of hyperactive areas of cortex cerebri. This technique visualization of cortex cerebri completes standard analysis of disorders of brain activity

  3. Tc-99m ECD brain SPECT in patients with traumatic brain injury: evaluating distribution of hypoperfusion and assessment of cognitive and behavioral impairment in relation to thalamic hypoperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soon Ah; Lim, Seok Tae; Sohn, Myung Hee [College of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2000-12-01

    We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age 34.7{+-} 15.4 yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. The perfusion dificits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe (24{approx}26%) thalami (21{approx}22.4%), parietal and occipital lobe ({<=}10%). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former 4.7{+-}1.5 and the latter 3.2{+-}1.4 in G1, 5.0{+-}1.1 and 4.8{+-}1.2 in G2, 6.8{+-}1.8 and 6.3{+-}1.1 in G3, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities.

  4. Tc-99m ECD brain SPECT in patients with traumatic brain injury: evaluating distribution of hypoperfusion and assessment of cognitive and behavioral impairment in relation to thalamic hypoperfusion

    International Nuclear Information System (INIS)

    Park, Soon Ah; Lim, Seok Tae; Sohn, Myung Hee

    2000-01-01

    We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age 34.7± 15.4 yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. The perfusion dificits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe (24∼26%) thalami (21∼22.4%), parietal and occipital lobe (≤10%). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former 4.7±1.5 and the latter 3.2±1.4 in G1, 5.0±1.1 and 4.8±1.2 in G2, 6.8±1.8 and 6.3±1.1 in G3, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities

  5. Brain perfusion SPECT in dementia syndromes

    International Nuclear Information System (INIS)

    Libus, P.; Stupalova, J.; Kuzelka, I.; Konrad, J.

    2002-01-01

    Aim: Brain perfusion SPECT is used in differential diagnostics of dementia syndromes. First of all the aim is to distinguish vascular dementia from degenerative dementia and to differentiate dementia from delirium, psychiatric syndromes, depression and secondary dementia, which is important in relation to therapy. The purpose of our study was to detect significance of BP SPECT and include it into the diagnostic process in dementia syndromes. Materials and methods: 51 women and 63 men aged 55 - 88 were evaluated in the study. The patients correspond to the general criteria of dementia diagnosis. They were sent to the examination by neurological, internal and psychiatric departments and out-patient departments. All patients were examined by 99mTc ECD SPECT using a double head camera PRISM 200 VP with LEHR collimator. The scintigraphic data were evaluated by the visual and semiquantitative analysis. Results: It was established that most patients in our group had vascular dementia, while Alzheimer's disease was second. In other groups we found out dementia at strategic infarct location, e.g. in gyrus angularis in the dominant hemisphere, frontal temporal lobe dementia and alcoholic dementia. Twenty-four patients had a normal diagnosis. Fifteen of them had a somatic reason of the delirious state and were re-classified into pseudodementia. Nine patients were not diagnostically included and the examination will repeated in four months time. Conclusion: We have found out a good applicability of brain perfusion SPECT in dementia syndromes diagnosis in our work. The best diagnosticable and most specific were the findings in multi-infarct dementia, Alzheimer's disease and frontal temporal lobe dementia. When vascular dementia is concerned we can even distinguish dementia at strategic infarction location, e.g. in thalamus, basal frontal telencefalon, in gyrus angularis of the dominant hemisphere, etc

  6. Noninvasive quantitative assessment of cerebral blood flow (CBF) using Tc-99m ECD SPECT with adjunctive radionuclide angiography in ischemic stroke

    International Nuclear Information System (INIS)

    Yim, Jun Sung; Choi, Yun Young; Kim, Seung Hyun; Kim, Myung Ho; Cho, Suk Shin

    1999-01-01

    Quantitative CBF measurements are essential for diagnosing ischemic lesion, evaluating the therapeutic effects and predicting the prognosis of cerebral ischemia. Even though several methods have been introduced, these techniques are too cumbersome and invasive to be applied to routine studies. In this study, a non-invasive simple method for the quantitative angiography. Fifteen normal controls and 27 patients with unilateral carotid ischemic stoke were selected. Brain perfusion index (BPI) of each hemisphere was measured in each subject by acquisition of serial radionuclide angiography after injection of 20mCi of Tc-99m ECD. With Lassen's correction algorithm of curve-linear relationship between the brain activity and blood flow, rCBF on transaxial SPECT slice corresponding with MRI lesion sites (ischemic core, border zone and contralateral mirror locus) were calculated. BPI values for normal controls showed a significant negative correlation with advantage age (r=-0.64, p=0.021) and hemisphric BPI were 11.02±1.6 and 7.8±1.4 for normal controls and patient, respectively. Significant differences were observed between two groups (p=0.0012). rCBF obtained from core zone (12±2.5 ml/100/min), boneder zone (29.2±8.1) and contralateral mirror locus (52.1±15.1) were clearly defined in each subject of patient group. Measurement of BPI and rCBF using Tc-99m ECD SPECT with adjunctive radionuclide angiography could be an useful, simple and non-invasive method in evaluation of the cerebral flood in the ischemic stroke

  7. A correlation of clinical, MRI and brain SPECT in dementia

    International Nuclear Information System (INIS)

    Shelley, S.; Indirani, M.; Gokhale, S.; Anirudhan, N.; Sivakumar, M.R.; Jaganathan, K.

    2004-01-01

    Background: Dementia is a clinical syndrome characterised by acquired impairment in multiple neuropsycologic and behavior domains including memory, language, speech, visuospatial ability, cognition and mood/personality. Dementia produces deficits in perfusion reflecting decreased metabolic needs. Neuroimaging techniques help in determining whether the cognitive symptoms are organic and in which pattern of cognitive loss the patient may evolve. AIM: To differentiate various types of Dementia, based on the regional perfusion abnormalities seen in Brain SPECT and correlate this with Clinical and MRI findings. Material and methods: Patients suffering from memory impairment and memory loss were referred to our department for Brain SPECT as a part of work up for Dementia. They had undergone a detailed clinical examination, psychometry, mini mental status examination (MMSE), memory/cognitive testing and an MRI. Brain SPECT was done after injecting Tc 99m ECD (Ethylene Cysteinate Dimer ) and imaging after 45 minutes. The images obtained were reconstructed in a conventional way. The various patterns of perfusion abnormalities seen in the SPECT images was studied and correlated with MRI and clinical findings. The patients were thus classified as having Multi Infarct Dementia, Alzheimer's disease, Fronto-Temporal Dementia and Mixed variety. Results: Twenty One Patients were included in our study from February 2003 to February 2004. The mean age of the patients was 73 years ( 37 to 81). 15 were males and 6 were females. Out of 21 patients, 12 had Multi Infarct Dementia, 4 had Alzheimer's disease, 1 had Fronto- Temporal Dementia and 4 had Mixed variety. Conclusion: Brain SPECT aids in substantiating the clinical findings and in correlation with MRI helps in distinguishing various types of Dementia and thus has prognostic implications and helps in instituting early appropriate treatment to the patient. In our study, the majority of the patients have Multi Infarct Dementia

  8. Hyperfixation of Tc-99m ECD in subacute cortical infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Kweon, Sun Uck; Ryu, Jin Sook; Moon, Dae Hyuk; Lee, Hee Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2001-07-01

    It has been known that hyperfixation of Tc-99m ECD (HF) is not shown in subacute cerebral infarction because the brain distribution of Tc-99m ECD reflects not only perfusion but also the metabolic status of brain tissue. However, we observed several cases with HF in the subacute pure cortical infarction. To find out the cause of HF in subacute cortical infarction. We assessed the difference in associated cerebral hemodynamics and clinical findings between the subacute cortical infarctions with and without HF. We reviewed 16 patients (63.8{+-}8.6 yr, M/F: 15/1) with pure cortical infarction not involving adjacent subcortical white matter on MRI. All patients underwent acetazolamide stress brain perfusion SPECT using Tc-99m ECD and MRI at subacute period (7.3{+-}4.4 days from ictus). Uptake of Tc-99m ECD in infarcted cortex was assessed visually comparing the contralateral side. To assess the difference in associate clinical findings between the infarctions with and without HF, rCVR of the cerebral territory including infarcted cortex, extent of Gd-enhancement on MRI. Intervals between SPECT and ictus, and the presence of associated ICA stenosis were evaluated. Infarctions were focal (n=8) or multifocal (n=8) and located in frontoparietal cortices on MRI. Twelve patients were accompanied with ipsilateral ICA stenosis. Resting SPECT showed increased cortical uptake (=HF) in 7 patients and decreased in 9. rCVR of the MCA territory was preserved in all of the 7 patients with HF, compared with 4 of the 9 patients without HF (p=0.03). Gd-enhancement was minimal in all of the 7 patients with HF, compared with of the 0 patients without HF (p=0.03). Presence of ipsilateral ICA stenosis and intervals from ictus were not different (p>0.1) Subacute cerebral cortical infarction with HF was more frequently associated with preserved rCVR and minimal destruction of the blood-brain barrier than that without HF. Our findings suggest that HF may result from luxury perfusion of

  9. Brain SPECT in children

    International Nuclear Information System (INIS)

    Guyot, M.; Baulieu, J.L.

    1996-01-01

    Brain SPECT in child involves specific trends regarding the patient cooperation, irradiation, resolution and especially interpretation because of the rapid scintigraphic modifications related to the brain maturation. In a general nuclear medicine department, child brain SPECT represents about 2 % of the activity. The choice indications are the perfusion children: thallium and MIBI in brain tumours, pharmacological and neuropsychological interventions. In the future, brain dedicated detectors and new radiopharmaceuticals will promote the development of brain SPECT in children. (author)

  10. Investigation of olfactory function in normal volunteers and patients with anosmia : analysis of brain perfusion SPECTs using statistical parametric mapping

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y. A.; Kim, S. H.; Sohn, H. S.; Chung, S. K. [Catholic University College of Medicine, Seoul (Korea, Republic of)

    2002-07-01

    The purpose of this study was to investigate olfactory function with Tc-99m ECD brain perfusion SPECT using statistical parametric mapping (SPM) analysis in normal volunteers and patients with anosmia. The study populations were 8 subjects matched healthy volunteers and 16 subjects matched patients with anosmia. We obtaibed baseline and post-stimulation (3% butanol) brain perfusion SPECTs in the silent dark room. We analyzed the all SPECTs using SPM. The difference between two sets of brain perfusion SPECTs were compared with t-test. The voxels with p-value of less than 0.01 were considered to be significantly different. We demonstrated increased perfusion in the both cingulated gyri, right middle temporal gyrus, right superior and inferior frontal gyri, right lingual gyrus and right fusiform gyrus on post-stimulation brain SPECT in normal volunteers, and demonstrated decreased perfusion in the both cingulate gyri, right middle temporal gyrus, right rectal gyrus and both superior and inferior frontal gyri in the 10 patients with anosmia. No significant hypoperfusion area was observed in the other 6 patients with anosmia. The baseline and post-stimulation brain perfusion SPECTs can helpful in the evaluation of olfactory function and be useful in the diagnosis of anosmia.

  11. Investigation of olfactory function in normal volunteers and patients with anosmia : analysis of brain perfusion SPECTs using statistical parametric mapping

    International Nuclear Information System (INIS)

    Chung, Y. A.; Kim, S. H.; Sohn, H. S.; Chung, S. K.

    2002-01-01

    The purpose of this study was to investigate olfactory function with Tc-99m ECD brain perfusion SPECT using statistical parametric mapping (SPM) analysis in normal volunteers and patients with anosmia. The study populations were 8 subjects matched healthy volunteers and 16 subjects matched patients with anosmia. We obtaibed baseline and post-stimulation (3% butanol) brain perfusion SPECTs in the silent dark room. We analyzed the all SPECTs using SPM. The difference between two sets of brain perfusion SPECTs were compared with t-test. The voxels with p-value of less than 0.01 were considered to be significantly different. We demonstrated increased perfusion in the both cingulated gyri, right middle temporal gyrus, right superior and inferior frontal gyri, right lingual gyrus and right fusiform gyrus on post-stimulation brain SPECT in normal volunteers, and demonstrated decreased perfusion in the both cingulate gyri, right middle temporal gyrus, right rectal gyrus and both superior and inferior frontal gyri in the 10 patients with anosmia. No significant hypoperfusion area was observed in the other 6 patients with anosmia. The baseline and post-stimulation brain perfusion SPECTs can helpful in the evaluation of olfactory function and be useful in the diagnosis of anosmia

  12. Baseline and cognition activated brain SPECT imaging in depression

    International Nuclear Information System (INIS)

    Zhao Jinhua; Lin Xiangtong; Jiang Kaida; Liu Yongchang; Xu Lianqin

    1998-01-01

    Purpose: To evaluate the regional cerebral blood flow (rCBF) abnormalities through the semiquantitative analysis of the baseline and cognition activated rCBF imaging in unmedicated depressed patients. Methods: 27 depressed patients unmedicated by anti-depressants were enrolled. The diagnosis (depression of moderate degree with somatization) was confirmed by the ICD-10 criteria. 15 age matched normal controls were studied under identical conditions. Baseline and cognition activated 99m Tc-ECD SPECT were performed on 21 of the 27 patients with depression and 13 of the 15 normal controls. Baseline 99m Tc-ECD SPECT alone were performed on the rest 6 patients with depression and 2 normal controls. The cognitive activation is achieved by Wisconsin Card Sorting Test (WCST). 1110 MBq of 99m Tc-ECD was administered by intravenous bolus injection 5 minutes after the onset of the WCST. Semi-quantitative analysis was conducted with the 7th, 8th, 9th, 10th, 11th slices of the transaxial imaging. rCBF ratios of every ROI were calculated using the average tissue activity in the region divided by the maximum activity in the cerebellum. Results: 1) The baseline rCBF of left frontal (0.720) and left temporal lobe (0.720) were decreased significantly in depressed patients comparing with those of the control subjects. 2) The activated rCBF of left frontal lobe (0.719) and left temporal lobe (0.690), left parietal lobe (0.701) were decreased evidently than those of the controls. Conclusions: 1) Hypoperfusions of left frontal and left temporal cortexes were identified in patients with depression. 2) The hypoperfusion of left frontal and left temporal cortexes may be the cause of cognition disorder and depressed mood in patients with depression. 3) Cognition activated brain perfusion imaging is helpful for making a more accurate diagnosis of depression

  13. Ophthalmoplegic migraine with reversible thalamic ischemia by Tc-99m ethylcysteinate dimer brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Ho; Shin, Dong Jin; Kang, Sung Soo [Gachon Medical School, Gil Medical Center, Inchon (Korea, Republic of)

    1999-07-01

    Two patients presented with ophthalmoplegic migraine (OM) underwent EEG, Brain-MRI, cerebral angiography, and Tc-99m ECD SPECT during an attack. Follow-up SPECT was performed after neurologic symptoms resolved. In both cases, SPECT during an attack of ophthalmoplegia and headache demonstrated a significantly decreased regional cerebral blood flow in the thalamus to the side of ophthalmoplegia, which was normalized on the follow-up SPECT during a symptom free recovery phase (Lesion to Non-lesion thalamic ratio=1.19 to 0.96 and 1.16 to 0.98, respectively). The other roentgenographic and laboratory findings were normal. These findings are suggestive the ischemia in the perforators of PCA results in third nerve palsy because the portion of oculomotor nerve behind the cavernous sinus derives its blood supply from small perforating branches of the basilar and PCA. Matched ictal hypoperfusion of the thalamus to the site of ophthalmoplegic migraine is suggestive of the ischemic neuropathy as an etiology of OM.

  14. Brain perfusion SPECT correlates with CSF biomarkers in Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Habert, Marie-Odile [UMR-S 678, Universite Pierre et Marie Curie-Paris 6, INSERM, Paris (France); CHU Pitie-Salpetriere, AP-HP, Department of Nuclear Medicine, Paris (France); Hopital Pitie-Salpetriere, Department of Nuclear Medicine, Paris (France); Souza, Leonardo Cruz de; Dubois, Bruno; Sarazin, Marie [CHU Pitie-Salpetriere, AP-HP, Research and Resource Memory Centre and INSERM U610, Paris (France); Lamari, Foudil; Jardel, Claude [CHU Pitie-Salpetriere, AP-HP, Department of Metabolic Biochemistry, Paris (France); Daragon, Nelle; Desarnaud, Serge [CHU Pitie-Salpetriere, AP-HP, Department of Nuclear Medicine, Paris (France)

    2010-03-15

    Our aim was to study the correlations between cerebrospinal fluid (CSF) biomarker levels such as {beta}-amyloid 42 (A{beta}{sub 42}), total and phosphorylated tau protein (T-tau and P-tau) and brain perfusion SPECT in Alzheimer's disease (AD) using a voxel-based methodology. Patients (n = 31) with clinical features of AD (n = 25) or amnestic mild cognitive impairment (aMCI) (n = 6) were retrospectively included. All subjects underwent the same clinical, neuropsychological and neuroimaging tests. They had a lumbar puncture and a brain perfusion ({sup 99m}Tc-ECD) SPECT within a time interval of 10 ({+-}26) days. Correlations between CSF biomarker concentrations and perfusion were studied using SPM2 software. Individual normalised regional activity values were extracted from the eligible clusters for calculation of correlation coefficients. No significant correlation was found between A{beta}{sub 42} concentrations and brain perfusion. A significant correlation (p < 0.01, corrected) was found between T-tau or P-tau concentrations and perfusion in the left parietal cortex. Our results suggest a strong correlation between T-tau and P-tau levels and decreased brain perfusion in regions typically affected by neuropathological changes in AD. (orig.)

  15. Evaluation of the effects of rehabilitation exercise on cerebral infarction with 99Tcm-ECD SPECT brain imaging

    International Nuclear Information System (INIS)

    Jiang Ningyi; Lu Xianping; Liu Xingguang; Xiao Xiuhong; Xu Jianxing

    2003-01-01

    Objective: To investigate the therapeutic effects of motor therapy on hemiplegia with SPECT brain perfusion imaging. Methods: The study population consisted of 59 patients with cerebral infarction, and all patients were treated with motor therapy. Among them, 30 cases were assigned to undertake single bridging exercise and 29 cases passive exercise. SPECT brain perfusion imaging was performed before and after motor therapy under the same condition, and the regional cerebral blood flow (rCBF) changes were compared and analysed with visual and semi-quantitative methods; in addition, the relationship between rCBF changes and scores of Fugl-Meyer or Barthel index were also analysed. Results: After motor therapy, various degrees of radioactivity increase were compared with the pretreatment radioactivity hypoperfusion in patients with cerebral infarction, and showed that motor therapy could evidently improve rCBF of regional hypoperfusion. The posttreatment rCBF was higher than the pretreatment level (P<0.01), and the rCBF of group of single bridging was higher than that of passive exercise group. And the changes of rCBF were all significant after motor therapy. In addition, the variation of the rCBF after motor therapy was positively correlated with the variation of Fugl-Meyer and Barthel score. Conclusions: SPECT brain perfusion imaging can serve as a useful method for evaluating the effectiveness of motor therapy in cerebral infarction rehabilitation. The single bridging exercise and the passive exercise are both beneficial to brain rehabilitation, but the former improves the rCBF in lesions better than the later does

  16. Perfusion impairments on brain SPECT in patients with infantile autism and nonautistic pervasive developmental disorders: comparison with MR findings

    International Nuclear Information System (INIS)

    Ryu, Young Hoon; Lee, Jong Doo; Yoon, Pyeong Ho; Kim, Dong Ik; Jeon, Tae Joo; Shin, Yee Jin; Lee, Byung Hee; Shin, Hyung Cheol

    1998-01-01

    Neuroimaging findings of autism has been the subjects of continuing investigation. Because previous study had not demonstrated consistent and specific neuroimaging findings of autism and most studies comprised adults and school-aged children, we performed a retrospective review in search of common functional and structural abnormalities in pre-school aged autistic children using Tc-99m ECD brain SPECT and MRI and compared them with age-matched children with nonautistic pervasive developmental disorders (PDD). 58 children between 3 and 8 years of age infantile autism (n=37) and non-autistic PDD (n=21) were performed Tc-99m ECD brain SPECT and MRI. Diagnosis of autism and non-autistic PDD was based on the criteria of DSM-IV and Childhood Autism Rating Scale (CARS). Of the 37 autistic patients, 32 revealed decreased perfusion of cerebellar hemisphere, followed by hypoperfusion of thalami (n=30), parietal cortex (n=16), temporal cortex (n=12). Of those 21 PDD patients, 14 patients showed hypoperfusion of the thalami and 10 patients showed temporal hypoperfusion. However, cerebellar hemispheric (n=8) and parietal (n=1) hypoperfusion was infrequently seen. All autistic and nonautistic PDD patients had normal MRI scan. Cerebellar hemispheric and parietal hypoperfusion on brain SPECT showed statistically significant correlation with CARS. Cerebellar hemispheric and parietal hypoperfusion is significantly frequently noted in autistic patients although they had normal MRI and SPECT may be useful and more sensitive modality in reflecting pathophysiology of autism as evidenced by previous MRI and postmortem studies. Thalamic and temporal hypoperfusion can be seen in both autistic and nonautistic patients and further studies are necessary to determine the significance of the thalamic hypoperfusion

  17. Perfusion impairments on brain SPECT in patients with infantile autism and nonautistic pervasive developmental disorders: comparison with MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Young Hoon; Lee, Jong Doo; Yoon, Pyeong Ho; Kim, Dong Ik; Jeon, Tae Joo; Shin, Yee Jin; Lee, Byung Hee; Shin, Hyung Cheol [College of Medecine, Soonchunhyang Univ., Chonan (Korea, Republic of)

    1998-07-01

    Neuroimaging findings of autism has been the subjects of continuing investigation. Because previous study had not demonstrated consistent and specific neuroimaging findings of autism and most studies comprised adults and school-aged children, we performed a retrospective review in search of common functional and structural abnormalities in pre-school aged autistic children using Tc-99m ECD brain SPECT and MRI and compared them with age-matched children with nonautistic pervasive developmental disorders (PDD). 58 children between 3 and 8 years of age infantile autism (n=37) and non-autistic PDD (n=21) were performed Tc-99m ECD brain SPECT and MRI. Diagnosis of autism and non-autistic PDD was based on the criteria of DSM-IV and Childhood Autism Rating Scale (CARS). Of the 37 autistic patients, 32 revealed decreased perfusion of cerebellar hemisphere, followed by hypoperfusion of thalami (n=30), parietal cortex (n=16), temporal cortex (n=12). Of those 21 PDD patients, 14 patients showed hypoperfusion of the thalami and 10 patients showed temporal hypoperfusion. However, cerebellar hemispheric (n=8) and parietal (n=1) hypoperfusion was infrequently seen. All autistic and nonautistic PDD patients had normal MRI scan. Cerebellar hemispheric and parietal hypoperfusion on brain SPECT showed statistically significant correlation with CARS. Cerebellar hemispheric and parietal hypoperfusion is significantly frequently noted in autistic patients although they had normal MRI and SPECT may be useful and more sensitive modality in reflecting pathophysiology of autism as evidenced by previous MRI and postmortem studies. Thalamic and temporal hypoperfusion can be seen in both autistic and nonautistic patients and further studies are necessary to determine the significance of the thalamic hypoperfusion.

  18. Brain imaging during seizure: ictal brain SPECT

    International Nuclear Information System (INIS)

    Kottamasu, Sambasiva Rao

    1997-01-01

    The role of single photon computed tomography (SPECT) in presurgical localization of medically intractable complex partial epilepsy (CPE) in children is reviewed. 99m Technetium neurolite, a newer lipophylic agent with a high first pass brain extraction and little or no redistribution is injected during a seizure, while the child is monitored with a video recording and continuous EEG and SPECT imaging is performed in the next 1-3 hours with the images representing regional cerebral profusion at the time of injection. On SPECT studies performed with radiopharmaceutical injected during a seizure, ictal focus is generally hypervascular. Other findings on ictal brain SPECT include hypoperfusion of adjacent cerebral cortex and white matter, hyperperfusion of contralateral motor cortex, hyperperfusion of ipsilateral basal ganglia and thalamus, brain stem and contralateral cerebellum. Ictal brain SPECT is non-invasive, cost effective and highly sensitive for localization of epileptic focus in patients with intractable CPE. (author)

  19. Studies on asymptomatic cerebral ischemia in coronary heart disease with special reference to evaluation of postural changes in cerebral blood flow with {sup 99m}Tc-ECD brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sinozaki, Hideko [Teikyo Univ., Tokyo (Japan). Faculty of Medicine

    2001-03-01

    Postural changes in cerebral blood flow in patients with coronary heart disease (CHD) were evaluated with SPECT to detect asymptomaic cerebral ischemia (ACI). {sup 99m}Tc-ECD was used as a tracer. We developed a new analysis system for the processing of multiple images, making it possible to avoid the spatial shift in ROIs in different positions. The severity of ACI was classified into 3 groups based on SPECT findings in the supine position: group 1 without any abnormalities in cerebral perfusion, group 2 with a single perfusion defect, and group 3 with a number of perfusion defects. No cerebral siteobserved in any group showed a significant difference between the supine and upright positions in cerebral perfusion. Each group in each position, however, revealed a consistent perfusion pattern characterized by a significant decrease in perfusion in the occipital, temporal and frontal lobes. Moreover, the decrease in the latter two sites was significantly greater than in the former site. Concerning clinical profiles, hypertension and the thickness of the intima and media complex (TIMC) of the common carotid artery significantly correlated with the severity of ACI. Furthermore, in multiple regression analysis, only TIMC was identified as a significant determinant of ACI. In conclusion, cerebral blood flow determined with {sup 99m}Tc-ECD SPECT could accurately detect ACI in patients with CHD. (author)

  20. Noninvasive regional cerebral blood flow measurements at pre- and post-acetazolamide test using 99mTc-ECD

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi; Nakano, Seigo; Tanaka, Masaaki.

    1996-01-01

    A technique for serial noninvasive cerebral blood flow measurements at pre- and post-acetazolamide (Diamox) test was newly developed using 99m Tc-ECD without blood sampling. Baseline mean cerebral blood flow (mCBF) was measured from graphical analysis of time activity curves for brain and aortic arch obtained from radionuclide angiography by injection of 370-555 MBq 99m Tc-ECD. The first SPECT study was performed immediately after intravenous administration of 1 g of Diamox, then baseline regional cerebral blood flow (rCBF) was calculated using Lassen's correction algorithm. Immediately after the stop of the first SPECT study, additional 555-740 MBq of 99m Tc-ECD was administered, thereafter the second SPECT study was started. Post-Diamox SPECT images were obtained by subtraction of the first baseline images from the second images. Using Lassen's algorithm, post-Diamox mCBF was estimated from the baseline mCBF, the baseline mean SPECT counts, and post-Diamox mean SPECT counts corrected for administered dose and imaging time. Post-Diamox rCBF was obtained from the post-Diamox mCBF and the post-Diamox mean SPECT counts using Lassen's algorithm. Coefficient variation was shown 2.7% and 3.5%: mCBF and rCBF, respectively in test-retest results in six patients without Diamox administration. Nine demented patients without vascular disorders showed significant mCBF increase of 35.7% on the average by post-Diamox. In conclusion, this simplified method is practically useful for measuring CBF at pre- and post-Diamox test within short period of time without any blood sample. (author)

  1. 99mTc-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI / CT and EEG

    International Nuclear Information System (INIS)

    Yang, Hyung In; Im, Ju Hyuk; Choi, Chang Woon; Lee, Dong Soo; Chung, June Key; No, Jae Kyu; Lee, Myung Chul; Koh, Chang Soon

    1994-01-01

    We studied 115 patients with seizure who had been performed brain SPECT brain MRI of CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction ultiple sclerosis, AV-malformation. granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions. 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4. temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

  2. Brain spect imaging

    International Nuclear Information System (INIS)

    Lee, R.G.L.; Hill, T.C.; Holman, B.L.

    1989-01-01

    This paper discusses how the rapid development of single-photon radiopharmaceuticals has given new life to tomographic brain imaging in nuclear medicine. Further developments in radiopharmaceuticals and refinements in neuro-SPECT (single-photon emission computed tomography) instrumentation should help to reinstate brain scintigraphy as an important part of neurologic diagnosis. SPECT of the brain evolved from experimentation using prototype instrumentation during the early 1960s. Although tomographic studies provided superior diagnostic accuracy when compared to planar techniques, the arrival of X-ray CT of the head resulted in the rapid demise of technetium brain imaging

  3. Comparison of normal adult and children brain SPECT imaging using statistical parametric mapping(SPM)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myoung Hoon; Yoon, Seok Nam; Joh, Chul Woo; Lee, Dong Soo [Ajou University School of Medicine, Suwon (Korea, Republic of); Lee, Jae Sung [Seoul national University College of Medicine, Seoul (Korea, Republic of)

    2002-07-01

    This study compared rCBF pattern in normal adult and normal children using statistical parametric mapping (SPM). The purpose of this study was to determine distribution pattern not seen visual analysis in both groups. Tc-99m ECD brain SPECT was performed in 12 normal adults (M:F=11:1, average age 35 year old) and 6 normal control children (M:F=4:2, 10.5{+-}3.1y) who visited psychiatry clinic to evaluate ADHD. Their brain SPECT revealed normal rCBF pattern in visual analysis and they were diagnosed clinically normal. Using SPM method, we compared normal adult group's SPECT images with those of 6 normal children subjects and measured the extent of the area with significant hypoperfusion and hyperperfusion (p<0.001, extent threshold=16). The areas of both angnlar gyrus, both postcentral gyrus, both superior frontal gyrus, and both superior parietal lobe showed significant hyperperfusion in normal adult group compared with normal children group. The areas of left amygdala gyrus, brain stem, both cerebellum, left globus pallidus, both hippocampal formations, both parahippocampal gyrus, both thalamus, both uncus, both lateral and medial occipitotemporal gyrus revealed significantly hyperperfusion in the children. These results demonstrated that SPM can say more precise anatomical area difference not seen visual analysis.

  4. Comparison of normal adult and children brain SPECT imaging using statistical parametric mapping(SPM)

    International Nuclear Information System (INIS)

    Lee, Myoung Hoon; Yoon, Seok Nam; Joh, Chul Woo; Lee, Dong Soo; Lee, Jae Sung

    2002-01-01

    This study compared rCBF pattern in normal adult and normal children using statistical parametric mapping (SPM). The purpose of this study was to determine distribution pattern not seen visual analysis in both groups. Tc-99m ECD brain SPECT was performed in 12 normal adults (M:F=11:1, average age 35 year old) and 6 normal control children (M:F=4:2, 10.5±3.1y) who visited psychiatry clinic to evaluate ADHD. Their brain SPECT revealed normal rCBF pattern in visual analysis and they were diagnosed clinically normal. Using SPM method, we compared normal adult group's SPECT images with those of 6 normal children subjects and measured the extent of the area with significant hypoperfusion and hyperperfusion (p<0.001, extent threshold=16). The areas of both angnlar gyrus, both postcentral gyrus, both superior frontal gyrus, and both superior parietal lobe showed significant hyperperfusion in normal adult group compared with normal children group. The areas of left amygdala gyrus, brain stem, both cerebellum, left globus pallidus, both hippocampal formations, both parahippocampal gyrus, both thalamus, both uncus, both lateral and medial occipitotemporal gyrus revealed significantly hyperperfusion in the children. These results demonstrated that SPM can say more precise anatomical area difference not seen visual analysis

  5. A voxel-based analysis of cerebral perfusion with 99mTc-ECD brain SPECT in obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    Jeon, Tae Joo; Lee, Jong Doo; Kim, Hee Joung; Chang, Jin Woo; Kim, Chan Hyung; Lee, Hong Shick; Min, Sung Kil; Chung, Sang Sup

    2000-01-01

    Many neuroimaging studies, especially metabolic imaging with PET, showed a specific frontal-subcortical brain circuit connecting the orbitofrontal cortex (OFC), anterior cingulate gyrus, elements of basal ganglia and thalamus is involved in obsessive-compulsive disorder (OCD). Despite consistent metabolic alteration on PET, blood flow studies with SPECT were inconsistent and various cortical and subcortical structures showed abnormal perfusion patterns. In this study, brain SPECT images of seven patients with OCD were evaluated with a sophisticated method of statistical parametric mapping (SPM). Seven patients with severe, primary OCD (6 males and 1 female) with mean age of 25.4 4.7 yrs (20-32 yrs) were studied. The SPECT data of the patients were compared with those of healthy subjects and patients with drug nave schizophrenia using SPM. The SPM parameters were p value of 0.001 with Z value of 3.09 (higher threshold ) or p value of 0.005 with Z value 2.58 (lower threshold). On a higher threshold (p<0.01),five of the seven patients showed hyperperfusion within the anterior cingulate cortex, however, hyperperfusion within OFC or caudate nucleus was seen in only one patient. On a lower threshold (p<0.005), hyperperfusion within the anterior cingulate cortex was seen in all patients, and followed by thalamus (n=5), lentiform nucleus (n=4), caudate nucleus (n=3), and OFC (n=3). Perfusion within the anterior cingulate cortex was also increased in OCD compared with drug nave schizophrenia. Anterior cingulate cortex appears to be an important anatomical structure in the pathogenesis of OCD symptoms. Brain SPECT using a sophisticated analysis method of SPM is useful for the diagnosis of OCD and differentiation from schizophrenia

  6. {sup 99m}Tc-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI / CT and EEG

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hyung In [Kyunghee University Hospital, Seoul (Korea, Republic of); Im, Ju Hyuk; Choi, Chang Woon; Lee, Dong Soo; Chung, June Key; No, Jae Kyu; Lee, Myung Chul; Koh, Chang Soon [Seoul National University Hospital, Seoul (Korea, Republic of)

    1994-03-15

    We studied 115 patients with seizure who had been performed brain SPECT brain MRI of CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction ultiple sclerosis, AV-malformation. granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions. 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4. temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

  7. Three-dimensional stereotactic surface projection of brain perfusion SPECT improves diagnosis of Alzheimer's disease

    International Nuclear Information System (INIS)

    Honda, Norinari; Machida, Kikuo

    2003-01-01

    Alzheimer's disease (AD) is diagnosed by either inspection of the brain perfusion SPECT, or three-dimensional stereotactic surface display (3D-SSP). The purpose was to compare diagnostic performances of these methods. Sixteen nuclear medicine physicians independently interpreted 99m Tc-ECD SPECT in one session and SPECT with 3D-SSP in another session without clinical information for 50 studies of AD patients and 40 studies of healthy volunteers. Probabilities of AD were reported according to a subjective scale from 0% (normal) to 100% (definite AD). Receiver operating characteristics curves were generated to calculate areas under the receiver operating characteristic (ROC) curves (Az's) for the inspection as well as for an automated diagnosis based on a mean Z value in the bilateral posterior cingulate gyri in a 3D-SSP template. Mean Az for visual interpretation of SPECT alone (0.679±0.058) was significantly smaller than that for visual interpretation of both SPECT and 3D-SSP (0.778±0.060). Az for the automated diagnosis (0.883±0.037) was significantly greater than that for both modes of visual interpretation. 3D-SSP enhanced performance of the nuclear medicine physicians inspecting SPECT. Performance of the automated diagnosis exceeded that of the physicians inspecting SPECT with and without 3D-SSP. (author)

  8. A voxel-based analysis of cerebral perfusion with {sup 99m}Tc-ECD brain SPECT in obsessive-compulsive disorder

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Tae Joo; Lee, Jong Doo; Kim, Hee Joung; Chang, Jin Woo; Kim, Chan Hyung; Lee, Hong Shick; Min, Sung Kil; Chung, Sang Sup [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    2000-07-01

    Many neuroimaging studies, especially metabolic imaging with PET, showed a specific frontal-subcortical brain circuit connecting the orbitofrontal cortex (OFC), anterior cingulate gyrus, elements of basal ganglia and thalamus is involved in obsessive-compulsive disorder (OCD). Despite consistent metabolic alteration on PET, blood flow studies with SPECT were inconsistent and various cortical and subcortical structures showed abnormal perfusion patterns. In this study, brain SPECT images of seven patients with OCD were evaluated with a sophisticated method of statistical parametric mapping (SPM). Seven patients with severe, primary OCD (6 males and 1 female) with mean age of 25.4 4.7 yrs (20-32 yrs) were studied. The SPECT data of the patients were compared with those of healthy subjects and patients with drug nave schizophrenia using SPM. The SPM parameters were p value of 0.001 with Z value of 3.09 (higher threshold ) or p value of 0.005 with Z value 2.58 (lower threshold). On a higher threshold (p<0.01),five of the seven patients showed hyperperfusion within the anterior cingulate cortex, however, hyperperfusion within OFC or caudate nucleus was seen in only one patient. On a lower threshold (p<0.005), hyperperfusion within the anterior cingulate cortex was seen in all patients, and followed by thalamus (n=5), lentiform nucleus (n=4), caudate nucleus (n=3), and OFC (n=3). Perfusion within the anterior cingulate cortex was also increased in OCD compared with drug nave schizophrenia. Anterior cingulate cortex appears to be an important anatomical structure in the pathogenesis of OCD symptoms. Brain SPECT using a sophisticated analysis method of SPM is useful for the diagnosis of OCD and differentiation from schizophrenia.

  9. Tc-99m ECD brain SPET in the evaluation of dementia for institutionalized elderly patients

    International Nuclear Information System (INIS)

    Lee, Myoung Hoon; Park, Chan H.; Yoon, Seok Na.; Hwang, Kyung Hoon

    2001-01-01

    Dementia is one of the clinically recognized indications of regional cerebral blood flow (rCBF) measurement by Tc-99m ECD brain SPET (Single Photon Emission Tomography). There is only limited number of institutions for elderly demented patients who are institutionalized in Korea and SPET is nor available at these institutions. The aim of the study is to evaluate rCBF SPET findings of the patients from such an institution. Thirty-one patients were reffered for rCBF SPET from Yongin Hyoja Hospital, Yongin. They were screened using NINCDS-ADRDA criteria for probable Alzheimers disease (AD) and dementia severity was assumed by the Mini-Mental State examination. In a quite, dim light room, patients were injected with 740 mBq (20mCi) Tc-99m ethyl cysteinate dimmer (ECD), Neurolite R, Dupont Pharmaceuticals, Billerica, MA, USA). SPET was acquired using fanbeam collimators and triple-head gamma camera (MultiSPECT III, Siemens medical systems. Inc. Hoffman Estates, III.USA). SPET was done one hour after the tracer injection and most of the patients needed sedation 30 minutes before the scan. SPET was evaluated visually by 2 nuclear medicine physicians blinded to clinical information. The SPET scans of 31 patients revealed 3 typical AD, 9 atypical AD patterns. Other dementia patterns were 4 cases of frontotemporal lobe dementia, 5 cases of frontal lobe dementia and 2 multifocal infarctions. Only cerebral atrophy is depicted in 8 patients and normal SPECT findings was noted in one patient. Patients who are institutionalized for dementia have varying SPET patterns as expected and SPET findings are useful in the management of these patients with more clearer clinical insight

  10. SPM analysis of brain perfusion SPECT and F-18 FDG PET in the Korean autosomal dominant nocturnal frontal lobe epilepsy family

    International Nuclear Information System (INIS)

    Won, Kyoung Sook; Zeon, Seok Kil

    2004-01-01

    This study attempted to investigate the specific pattern of brain perfusion and glucose metabolism in the Korean autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) family. Using Tc-99m ECD brain perfusion SPECT. we assessed brain perfusion in 6 patients at interictal period and 5 patients at ictal period. Interictal F-18 FDG PET was performed on 6 affected family members. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The data of the affected family members were compared to those of the control subjects. Interictal F-18 FDG PET SPM group analysis showed decreased glucose metabolism over the left middle and superior frontal gyri and the left central regions including the anterior parietal lobe. There was a less pronounced decrease in glucose uptake in the right anterior superior frontal gyrus. Interictal brain perfusion SPECT SPM group analysis showed similar pattern of decreased perfusion compared to those of interictal F-18 FDG PET. Ictal brain perfusion SPECT SPM group analysis revealed increased perfusion over the left pre-and postcentral gyri and less pronounced increased perfusion in the right postcentral gyrus. lnterictal F -18 PET and brain perfusion SPECT SPM group analysis suggest that major abnormalities of ADNFLE family are in the left frontal lobe. These findings may be helpful to elucidate the pathophysiological mechanism of this rare disease entity

  11. SPM analysis of brain perfusion SPECT and F-18 FDG PET in the Korean autosomal dominant nocturnal frontal lobe epilepsy family

    Energy Technology Data Exchange (ETDEWEB)

    Won, Kyoung Sook; Zeon, Seok Kil [Keimyung University Dongsan Medical Center, Daegu (Korea, Republic of)

    2004-07-01

    This study attempted to investigate the specific pattern of brain perfusion and glucose metabolism in the Korean autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) family. Using Tc-99m ECD brain perfusion SPECT. we assessed brain perfusion in 6 patients at interictal period and 5 patients at ictal period. Interictal F-18 FDG PET was performed on 6 affected family members. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The data of the affected family members were compared to those of the control subjects. Interictal F-18 FDG PET SPM group analysis showed decreased glucose metabolism over the left middle and superior frontal gyri and the left central regions including the anterior parietal lobe. There was a less pronounced decrease in glucose uptake in the right anterior superior frontal gyrus. Interictal brain perfusion SPECT SPM group analysis showed similar pattern of decreased perfusion compared to those of interictal F-18 FDG PET. Ictal brain perfusion SPECT SPM group analysis revealed increased perfusion over the left pre-and postcentral gyri and less pronounced increased perfusion in the right postcentral gyrus. lnterictal F -18 PET and brain perfusion SPECT SPM group analysis suggest that major abnormalities of ADNFLE family are in the left frontal lobe. These findings may be helpful to elucidate the pathophysiological mechanism of this rare disease entity.

  12. Regional cerebral blood flow in children with autism spectrum disorders: a quantitative 99mTc-ECD brain SPECT study with statistical parametric mapping evaluation

    Institute of Scientific and Technical Information of China (English)

    YANG Wen-han; JING Jin; XIU Li-juan; CHENG Mu-hua; WANG Xin; BAO Peng; WANG Qing-xiong

    2011-01-01

    Background Autism spectrum disorders (ASD), which include autism, asperger syndrome (AS) and pervasive developmental disorder-not otherwise specified (PDD-NOS), are devastating neurodevelopmental disorders of childhood resulting in deficits in social interaction, repetitive patterns of behaviors, and restricted interests and activities. Single photon emission computed tomography (SPECT) is a common technique used to measure regional cerebral blood flow (rCBF). Several studies have measured rCBF in children with ASD using SPECT, however, findings are discordant. In addition, the majority of subjects used in these studies were autistic. In this study, we aimed to investigate changes in rCBF in children with ASD using SPECT.Methods A Technetium-99m-ethyl cysteinate dimmer (99mTc-ECD) brain SPECT study was performed on an ASD group consisting of 23 children (3 girls and 20 boys; mean age (7.2±3.0) years) who were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-Ⅳ) criteria and an age-matched control group with 8children (1 girl and 7 boys, mean age (5.5±2.4) years). Image data were evaluated with Statistical Parametric Mapping,5th version (SPM5). A Student's t test for unpaired data was used to compare rCBF and asymmetry in the autism and corresponding control group. The covariance analysis, taking age as covariance, was performed between the ASD and control group.Results There was a significant reduction in rCBF in the bilateral frontal lobe (frontal poles, arcula frontal gyrus) and the bilateral basal ganglia in the autism group, and a reduction in the bilateral frontal, temporal, parietal, legumina nucleus and cerebellum in the AS group compared to the control. In addition, asymmetry of hemispheric hypoperfusion in the ASD group was observed. Inner-group comparison analysis revealed that rCBF decreased significantly in the bilateral frontal lobe (42.7%), basal nucleus (24.9%) and temporal lobe (22.8%) in the autism

  13. 123I-iomazenil brain receptor SPECT in focal epilepsy. In comparison with 99mTc-HMPAO brain SPECT, MRI and Video/EEG monitoring

    International Nuclear Information System (INIS)

    Xu Hao; Wang Tongge; Huang Li; Michael Cordes

    1998-01-01

    Purpose: To evaluate the clinical value of 123 I-Iomazenil brain receptor SPECT in diagnosis of focal epilepsy in comparison with 99m Tc-HMPAO brain SPECT, MRI and Video/EEG monitoring. Methods 123 I-Iomazenil brain receptor SPECT was performed on 40 patients with focal epilepsy. The results were compared with those obtained by 99m Tc-HMPAO brain SPECT, MRI and Video/EEG monitoring. Results: In 40 patients, the sensitivity of Video/EEG monitoring for localization of epileptogenic area was 95% (38/40). The sensitivity of 123 I-iomazenil brain receptor SPECT, 99m Tc-HMPAO brain SPECT and MRI for localization of epileptogenic area compared with Video/EEG monitoring ('gold standard') was 65.8%(25/38), 55.3%(21/38) and 47.4%(18/38), respectively. The localization of epileptogenic area with 123 I-Iomazenil brain receptor SPECT was in concordance with Video/EEG monitoring in 20 patients, 99m Tc-HMPAO brain SPECT in 15 patients and MRI in 16 patients, respectively. The sensitivity of 123 I-Iomazenil brain receptor SPECT combined with MRI for localization of epileptogenic area was 84.2%(32/38). Conclusions: 123 I-Iomazenil brain receptor SPECT is a useful method in detecting and localizing epileptogenic area. The combination of 123 I-Iomazenil brain receptor SPECT and MRI has a high sensitivity for detecting epileptogenic area

  14. Brain SPECT in childhood

    International Nuclear Information System (INIS)

    Tranquart, F.; Saliba, E.; Prunier, C.; Baulieu, F.; Besnard, J.C.; Guilloteau, D.; Baulieu, J.L.

    2001-01-01

    The modalities and the indications of perfusion and neurotransmission SPECT in childhood are presented. The perfusion as well as neurotransmission tracers have not yet authorization for use in children; they have to be used by prescription of magistral preparation or in research protocols. The radioprotection rules have to be strictly respected. The most frequent indication of perfusion SPECT is pharmacologically resistant epilepsy; the ictal SPECT before surgery allows the localization of the epileptogenic focus. Other indications are relevant in the prognosis of neonatal anoxia and encephalitis. In psychiatric disorders, especially in autism, the interest is the physiopathological approach of the brain dysfunctions. The neurotransmission SPECT is emerging as a consequence of the development of new radiotracer, as the dopaminergic system ligands. The decrease of the dopamine D2 receptors in the striatum can be imaged and quantified in the neonate. The lesions of dopamine system seem to be a consequence of the neonatal hypoxia-ischemia and it is predictive of motor sequelae. Brain SPECT should become a routine examination in child neurologic and psychiatric disorders. (authors)

  15. Clinical significance of brain SPECT abnormalities of thalami and cerebellum in cerebral palsy with normal MRI

    International Nuclear Information System (INIS)

    Park, C. H.; Lim, S. Y.; Lee, I. Y.; Kim, O. H.; Bai, M. S.; Kim, S. J.; Yoon, S. N.; Cho, C. W.

    1997-01-01

    The cerebral palsy(CP) encephalopathies are often of uncertain etiology and various functional image findings comparing with anatomical image findings have been reported. However, only a few have mentioned its clinical implications. The purpose of our report is to compare clinical severity and functional SPECT abnormalities of thalami and cerebellum in CP patients with normal MRI. Thirty six CP patients with bilateral spastic palsy who had normal MRI and brain SPECT were studied from July 1996 to September 1997. The patients' age at the time of SPECT was 22.84±17.69 months. The patients were divided into two groups according to motor quotient(MQ); moderate defect (>50MQ : n=27 MQ=22.78±10.36), mild defect ( 2 test. Brain SPECT was performed following IV administration of 0.05-0.1 mCi/kg (minimum 2.0 mCi) of Tc-99m ECD and chloral hydrate sedation (50-80 mg/kg p.o) using a triple head system (MS 3, Siemens). Interpretation of brain SPECT was visual analysis: severe decrease is defined when the defect is moderate to marked and mild decrease in rCBF as mild. Seven of 36 (19.4%) showed unilateral or bilateral moderate decrease in rCBF in thalami, 20(55.6%) showed mild decrease, and 9(25.0%) showed no decreased rCBF. All 7 who had moderate thalamic defect reveled moderate motor defect clinically. Ten of 36(27.9%) revealed unilateral or bilateral moderate rCBF defect, 23 (63.9%) depicted mild defect, and 3(8.3%) showed no defect. Sixteen with moderate thalamic rCBF defect showed moderate motor defect in 15 patients. There was statistically significant (p=0.02605) relationship between rCBF defect and motor defect in our CP patients. In conclusion, brain SPECT appears sensitive, non-invasive tool in the evaluation as well as in the prognostication of bilateral spastic cerebral palsy patients and deserves further study using larger number of patients

  16. SPECT of the brain: Present and future

    International Nuclear Information System (INIS)

    Fazio, F.; Lenzi, G.L.

    1986-01-01

    In both PET and SPECT, most of the studies and the models have been addressed to two organs: brain and heart. So far, brain has certainly been investigated more. The several comparisons between planar scintigraphy and SPECT, between X-ray TCT and SPECT, and also between PET and SPECT, have tended to consider SPECT a cheap but scarcely useful tool for a nuclear medicine section. Again the authors feel that this is due to the fact that SPECT is really a ''physiological tomography'', with little known about its physiology or how it is measured. Thus the present state of the art of SPECT of the brain is characterized by a collection of data and reports on brain imaging and by a slowly growing basic understanding of the utilized modes. The introduction of a new brain-imaging radiopharmaceutical is immediately signaled by its ''first clinical application'' without parallel studies on the kinetics, the metabolic degradation, and the real suitability of the molecule as a tracer for measurement of regional CBF. Only a few attempts seek to narrow this discussion between clinic and biology, and the authors like to emphasize the need for nuclear medicine people to dedicate more time and effort

  17. 99mTc-HMPAO SPECT in brain death

    International Nuclear Information System (INIS)

    Tsuchida, Tatsuro; Sadato, Norihiro; Nishizawa, Sadahiko

    1993-01-01

    Brain single photon emission computed tomography (SPECT) with 99m Tc-d,l-hexamethyl-propyleneamine oxime (HMPAO) was performed twice in a 78-year-old man clinically diagnosed as brain death according to the standard criteria of the Japanese Ministry of Welfare. The first brain SPECT demonstrated the tracer accumulation in the brain, indicating preserved cerebral blood flow. The second brain SPECT performed 3 days later revealed cessation of the blood flow. In patients with preserved cerebral blood flow, the diagnosis of brain death cannot be made, even if they meet the existing criteria, because previous report noted the recovery in some of those patients. Brain perfusion SPECT plays an important role as a confirmatory test for the diagnosis of brain death. (author)

  18. The early diagnostic value of oral acetazolamide load combined with SPECT rCBF imaging in patients with transient ischemia attack in brain

    International Nuclear Information System (INIS)

    Liu Xintong; Zheng Zhiping; Qiao Suixian; Tang Anwu

    2001-01-01

    Objective: In order to assess the diagnostic value of acetazolamide (ACZ) combined with rCBF-SPECT imaging in patients with transient ischemia attack (TIA). Methods: SPECT imaging was performed before and after oral ACZ with visual and semiquantitative analysis of the images. Blood gas analysis was done before and after ACZ administration either. Results: After ACZ loading, in normal group, 99 Tc m -ECD was distributed symmetrically on correspondent parts of the brain and rCBF was generally increased. The blood pH was decreased and blood PCO 2 was increased, respectively in TIA group, the positive rate of hypoperfusion foci on SPECT images were increased from 5/6 to 6/6 in symptomatic patients and from 60% to 92% in asymptomatic patients. The total positive rate was 93%. Conclusion: Oral ACZ before SPECT imaging is a simple, reliable way for early diagnosis in patients with TIA

  19. In vivo tomographic study of cerebral blood perfusion with SPECT in hemiparkinsonian monkeys

    International Nuclear Information System (INIS)

    Chen Shengdi; Xu Delong

    1994-01-01

    The authors present data on the utility of functional brain imaging with 99m Tc-ECD and SPECT in the study of MPTP induced hemiparkinsonism in monkeys. Injection of MPTP into the right common carotid artery of 10 rhesus monkeys produced hemiparkinsonism in the contralateral limbs which responded to antiparkinsonian medication. The unilateral neurotoxicity of the MPTP treated side was confirmed biochemically by marked reduction of DA contents in the nigrostriatum and histologically by selective neuronal loss in the substantia nigra. These monkeys with hemiparkinsonism were studied with SPECT using 99m Tc-ECD as perfusion marker. The results of brain scanning showed that the cerebral blood perfusion of MPTP treated side was significantly depleted 20∼90 days after MPTP intoxication, and returned to normal 8 months after perfusion. The experiment indicates that abnormal cerebral blood perfusion is involved in the course of parkinsonian pathophysiology

  20. Mismatched uptake of Tc-99m-ECD and Tc-99m-HMPAO in subacute cerebral infarction: Tc-99m-ECD for viability and Tc-99m-HMPAO for flow restoration

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D. S.; Hyun, I. Y.; Kim, S. K. [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)] [and others

    1997-07-01

    Tc-99m-HMPAO reflects tissue perfusion but Tc-99m-ECD uptake is affected by tissue viability in addition to tissue perfusion which the varied state of cellular retention of Tc-99m-ECD reflects. Luxuriously perfused area on Tc-99m-HMPAO SPECT implies that this cortex was already reperfused either spontaneously or after thrombolysis and that accompanied paralysis of vascular reactivity in those zones warms progressive deterioration. We tried to find out if we can use sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT to reveal cortical perfusion and severity and range of risky areas of cerbral cortex despite reperfusion in sub-acute infarction. In 13 patients (M ; F =7 : 6, mean age 57 (range: 26-84)) with cortical (n=12) and basal ganglia infarction (1), we performed sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT at the same position. At first, 555 MBq of Tc-99m-ECD was injected and imaged and then 1110 MBq of Tc-99m-HMPAO was injected again and imaged with the patients in situ, and the first image (Tc-99m-ECD) and the subtracted image (2nd- 1st : Tc-99m-HMPAO) were compared slice by slice. Study was done from 3 days to 31 days (16{+-}9) after ictus. Tc-99m-ECD uptake was always less than or equal to Tc-99m-HMPAO uptake at the lesion in all cases. Luxury perfusion was prominent in four patients. Mismatched uptake was found in 10 patients. Severity of mismatch showed diverse spectrum and was ranged from total middle cerebral artery territory (1 case) to peripheral thin zones around infarction (2 cases). The other 7 showed intermediate amount of tissues with mismatch , i.e., Tc-99m-ECD defects where Tc-99m-HMPAO uptake is in part increased, normal or decreased. Upon discharge, patients having more uptake with Tc-99m-ECD predicted improvement. Patients having mismatched uptake went dichotomous way. In conclusion, Tc-99m-ECD/Tc-99m-HMPAO sequential SPECT is feasible and reveal both tissue perfusion (Tc-99m-HMPAO ) and discrepant Tc-99m-ECD uptake probably reflecting viability in acute

  1. Usefulness of brain SPECT

    International Nuclear Information System (INIS)

    Raynaud, C.; Rancurel, G.; Kieffer, E.; Ricard, S.; Askienazy, S.; Moretti, J.L.; Bourdoiseau, M.; Rapin, J.; Soussaline, F.

    1983-01-01

    Brain SPECT was not effectively exploited until I-123 isopropyl amphetamine (IAMP), indicator able to penetrate the blood brain barrier, became available. Although the experience of research teams working with IAMP is quite restricted due to the high cost of the indicator, some applications now appear to be worth the cost and in some cases provide data which cannot be obtained with routine techniques, especially in cerebrovascular patients, in epilepsy and some cases of tumor. Brain SPECT appears as an atraumatic test which is useful to establish a functional evaluation of the cerebral parenchyma, and which is a complement to arteriography, X-ray scan and regional cerebral blood flow measurement

  2. Brain SPECT in psychiatry: Delusion or reality?

    International Nuclear Information System (INIS)

    Pavel, D.G.; Davis, G.; Epstein, P.; Kohn, R.; Antonino, F.; Devore-Best, S.; Craita, I.; Liu, P.

    2002-01-01

    Aim: The need for functional information is becoming increasingly evident for proper therapeutic approaches to the treatment and follow up of psychiatric diseases. While data on this subject already exists, there is a general lack of consensus about the use of brain SPECT in this domain and also a considerable negative prejudice due to a number of factors including poor quality imaging and unrealistic expectations. Based on a large group of brain SPECT-s performed over the past 3 years we attempted to sort and refine the indications for SPECT in psychiatry. Materials and Methods: High resolution brain SPECT was performed with triple head gamma camera, super-high resolution fan beam collimator and Tc-HMPAO. A comprehensive semiquantitative color, 3D surface as well as multi-thresholded volume display was routinely used and supplemented by automatic realignment in case of longitudinal follow-up. Results: 470 brain SPECT-s done on 432 patients were all referred by psychiatrists or neuro-psychiatrists for a wide spectrum of psychiatric diseases and ranged in age from 7 to 88 years. The most common primary reasons for referral were : attention deficit hyperactive disorder (ADHD); anxiety; obsessive-compulsive disease, depression (refractory, chronic, bipolar ), impulse control problems; oppositional defiance, post traumatic brain injury; seizures, learning difficulties, pervasive development disorders, memory loss and differential of dementia. Among common denominators were long duration of the disease, unresponsiveness to treatment, worsening of clinical status, and presence of multiple conditions at the same time. The multiparametric display used enabled a comprehensive evaluation of the brain volume which included the hemispheric surfaces; the basal ganglia (striatum) and the thalamus, several components of the limbic and paralimbic systems: anterior and posterior cingulate and their respective subdivisions, insula-s and their subdivisions, apical and mesial

  3. Hemimegalencephaly: a rare cause of hemihypoperfusion on 99m technetium-ethyl cysteinate dimer brain perfusion single-photon emission computed tomography

    International Nuclear Information System (INIS)

    Damle, Nishikant A.; Singhal, Abhinav; Mukherjee, Anirban; Sahoo, Manas Kumar; Tripathi, Madhavi; Bal, Chandrasekhar

    2013-01-01

    Hemimegalencephaly is a rare congenital neuronal migration disorder that can presents with the equally rare finding of hemihypoperfusion on brain perfusion single-photon emission computed tomography (SPECT). It is an extremely rare cause of intractable epilepsy. Technetium-99m ethyl cysteinate dimer (ECD) brain perfusion SPECT is useful in excluding other foci of hypoperfusion in the contralateral since hemispherectomy has been suggested to be the treatment of choice. Furthermore, hemimegalencephaly may present with hyper as well as hypoperfusion on ECD SPECT. We present the case of an 11-year-old male child with intractable seizures who showed hemihypoperfusion in the hemimegalecephalic hemisphere. (author)

  4. Brain perfusion SPECT and FDG PET findings in a patient with ballism associated with hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Sang Kyun; Kim, Sang Jin [Pusan Paik Hospital, Pusan (Korea, Republic of)

    2007-07-01

    Ballism is a very rare presentation in association with hyperthyroidism. We describe a 22-year-old lady with episodes of recurrent ballism and hyperthyroidism. A 22-year-old lady was admitted to Neurology department because of sudden development of vigorous involuntary movement and dysarthria. She was diagnosed as hyperthyroidism at the age 12 and treated irregularly. She arrived at the emergency room because of sudden onset of involuntary movement. Computed tomography (CT) scan and Magnetic Resonance Imaging (MRI) of brain was normal. Serum levels of thyroid hormone were increased (Free T4 3.15 ng/dl; normal range 0.93-1.71 ng/dl), whereas thyroid-stimulating hormone (TSH) was undetectable. The thyroid gland was diffusely enlarged and exophthalmos was found. She had been given antithyroid medication from local clinic but medicated irregularly. Technetium thyroid scan reveals diffusely enlarged thyroid with increased radioactivity. Radioiodine uptake in 24 hours was 71 %. Brain perfusion SPECT using Tc-99m ECD reveals asymmetrical perfusion pattern in basal ganglia. Brain PET using F-18 FDG reveals increased metabolism at both caudate nucleus and putamen. She was treated with radioiodine and involuntary movement was improved. There is only few report on ballism associated with hyperthyroidism and no report on functional brain imaging. Brain perfusion SPECT and FDG PET may give useful information about functional status of brain in patients with ballism associated with hyperthyroidism in case of normal anatomical finding on CT/MRI.

  5. Brain perfusion SPECT and FDG PET findings in a patient with ballism associated with hyperthyroidism

    International Nuclear Information System (INIS)

    Bae, Sang Kyun; Kim, Sang Jin

    2007-01-01

    Ballism is a very rare presentation in association with hyperthyroidism. We describe a 22-year-old lady with episodes of recurrent ballism and hyperthyroidism. A 22-year-old lady was admitted to Neurology department because of sudden development of vigorous involuntary movement and dysarthria. She was diagnosed as hyperthyroidism at the age 12 and treated irregularly. She arrived at the emergency room because of sudden onset of involuntary movement. Computed tomography (CT) scan and Magnetic Resonance Imaging (MRI) of brain was normal. Serum levels of thyroid hormone were increased (Free T4 3.15 ng/dl; normal range 0.93-1.71 ng/dl), whereas thyroid-stimulating hormone (TSH) was undetectable. The thyroid gland was diffusely enlarged and exophthalmos was found. She had been given antithyroid medication from local clinic but medicated irregularly. Technetium thyroid scan reveals diffusely enlarged thyroid with increased radioactivity. Radioiodine uptake in 24 hours was 71 %. Brain perfusion SPECT using Tc-99m ECD reveals asymmetrical perfusion pattern in basal ganglia. Brain PET using F-18 FDG reveals increased metabolism at both caudate nucleus and putamen. She was treated with radioiodine and involuntary movement was improved. There is only few report on ballism associated with hyperthyroidism and no report on functional brain imaging. Brain perfusion SPECT and FDG PET may give useful information about functional status of brain in patients with ballism associated with hyperthyroidism in case of normal anatomical finding on CT/MRI

  6. Contribution of ictal- and interictal brain SPECT to the diagnostic work-up of epileptic patients

    International Nuclear Information System (INIS)

    Dondi, M.; Salgarello, M.; Zoboli, S.; Cidda, C.; Nanni, C.; Rubboli, G.; Meletti, S.; Volpi, L.; Tassinari, C.A.

    2002-01-01

    Aim of the study: We aimed at assessing the contribution of brain SPECT to the diagnostic work-up of patients admitted to the Intensive Epilepsy Monitoring Unit (IEMU) by evaluating concordance of SPECT results with clinical diagnosis (DX) at IEMU admittance (Adm-DX) and at hospital discharge (Disch-DX). Materials and methods: 48 consecutive patients were enrolled in this study and submitted to both ictal and inter-ictal brain SPECT, carried out by means of a three-head system. Before ictal studies, patients were video-EEG monitored in the IEMU. 740 MBq of Tc99m ECD were injected during seizures and imaging performed within 45-60 minutes. For interictal studies, injection was given after at least a 24-hours seizure-free interval. Slices were reconstructed along the orbito-meatal line as well as along the temporal cut. Possible epileptic foci were identified by visual comparison of ictal and interictal studies. Clinical data: Out of the 48 cases, 27 were diagnosed as temporal lobe epilepsies (TLE). Of these, 15 had an Adm-DX of lateralization, whereas 12 were not lateralized according to standardized clinical and EEG criteria. Frontal lobe epilepsy (FLE) was diagnosed in 11 patients, another group of 3 was classified as cryptogenetic (CRYP), while the remaining 7 cases did not fall into any of the previous groups (OTH). SPECT results: in TLE, ictal/interictal SPECT results were congruent with Adm-Dx in 13/27 cases (48%) whereas congruence was found with 25 out of 27 (92%) of Disch-DX. In FLE, concordance between SPECT and clinical diagnosis remained unchanged (9/11 in comparison to either Adm-DX or Disch-DX). CRYPT patients had no lateralization at Adm-DX, while Dis-DX was concordant with SPECT in 2/3 cases. The group labeled as OTH showed concordance SPECT with Adm-DX in 0/7 cases, as opposed to 5/7 of Disch-DX. On the whole, SPECT results were concordant with Adm-DX in 34/48 cases (71%) but concordance was much higher with Dis-DX (41/48; 85%). Conclusions: Brain

  7. Brain lesion analysis using three-dimensional SPECT imaging

    International Nuclear Information System (INIS)

    Shibata, Iekado; Onagi, Atsuo; Kuroki, Takao

    1995-01-01

    A three-headed gamma camera (PRISM 3000) is capable to scan the protocol of early dynamic SPECT and to analyze two radioisotopes at the same time. We have framed three-dimensional brain SPECT images for several brain diseases by using the Application Visualization System (AVS). We carried out volume measurements in brain tumors and/or AVMs by applying this methodology. Thallium-201 and/or 123I-IMP were used for brain SPECT imaging. The dynamic scan protocol was changed in accordance with the given disease. The protocol for brain tumors was derived from a preliminary comparative study with thallium-201 and 123I-IMP that had suggested a disparity in the detection of brain tumors and the differentiation between tumor tissue and normal brain. The three-dimension SPECT image represented the brain tumor or AVM in a striking fashion, and the changes with respect to tumor or AVM after radiosurgery or embolization were understood readily. (author)

  8. Voxel-based statistical analysis of cerebral blood flow using Tc-99m ECD brain SPECT in patients with traumatic brain injury: group and individual analyses.

    Science.gov (United States)

    Shin, Yong Beom; Kim, Seong-Jang; Kim, In-Ju; Kim, Yong-Ki; Kim, Dong-Soo; Park, Jae Heung; Yeom, Seok-Ran

    2006-06-01

    Statistical parametric mapping (SPM) was applied to brain perfusion single photon emission computed tomography (SPECT) images in patients with traumatic brain injury (TBI) to investigate regional cerebral abnormalities compared to age-matched normal controls. Thirteen patients with TBI underwent brain perfusion SPECT were included in this study (10 males, three females, mean age 39.8 +/- 18.2, range 21 - 74). SPM2 software implemented in MATLAB 5.3 was used for spatial pre-processing and analysis and to determine the quantitative differences between TBI patients and age-matched normal controls. Three large voxel clusters of significantly decreased cerebral blood perfusion were found in patients with TBI. The largest clusters were area including medial frontal gyrus (voxel number 3642, peak Z-value = 4.31, 4.27, p = 0.000) in both hemispheres. The second largest clusters were areas including cingulated gyrus and anterior cingulate gyrus of left hemisphere (voxel number 381, peak Z-value = 3.67, 3.62, p = 0.000). Other clusters were parahippocampal gyrus (voxel number 173, peak Z-value = 3.40, p = 0.000) and hippocampus (voxel number 173, peak Z-value = 3.23, p = 0.001) in the left hemisphere. The false discovery rate (FDR) was less than 0.04. From this study, group and individual analyses of SPM2 could clearly identify the perfusion abnormalities of brain SPECT in patients with TBI. Group analysis of SPM2 showed hypoperfusion pattern in the areas including medial frontal gyrus of both hemispheres, cingulate gyrus, anterior cingulate gyrus, parahippocampal gyrus and hippocampus in the left hemisphere compared to age-matched normal controls. Also, left parahippocampal gyrus and left hippocampus were additional hypoperfusion areas. However, these findings deserve further investigation on a larger number of patients to be performed to allow a better validation of objective SPM analysis in patients with TBI.

  9. Clinical significance of brain SPECT abnormalities of thalami and cerebellum in cerebral palsy with normal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Park, C. H.; Lim, S. Y.; Lee, I. Y.; Kim, O. H.; Bai, M. S.; Kim, S. J.; Yoon, S. N.; Cho, C. W. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    The cerebral palsy(CP) encephalopathies are often of uncertain etiology and various functional image findings comparing with anatomical image findings have been reported. However, only a few have mentioned its clinical implications. The purpose of our report is to compare clinical severity and functional SPECT abnormalities of thalami and cerebellum in CP patients with normal MRI. Thirty six CP patients with bilateral spastic palsy who had normal MRI and brain SPECT were studied from July 1996 to September 1997. The patients' age at the time of SPECT was 22.84{+-}17.69 months. The patients were divided into two groups according to motor quotient(MQ); moderate defect (>50MQ : n=27 MQ=22.78{+-}10.36), mild defect (<50MQ : n=9, MQ=66.11{+-}13.87). The degree of rCBF decrease between the two groups was evaluated by {chi}{sup 2} test. Brain SPECT was performed following IV administration of 0.05-0.1 mCi/kg (minimum 2.0 mCi) of Tc-99m ECD and chloral hydrate sedation (50-80 mg/kg p.o) using a triple head system (MS 3, Siemens). Interpretation of brain SPECT was visual analysis: severe decrease is defined when the defect is moderate to marked and mild decrease in rCBF as mild. Seven of 36 (19.4%) showed unilateral or bilateral moderate decrease in rCBF in thalami, 20(55.6%) showed mild decrease, and 9(25.0%) showed no decreased rCBF. All 7 who had moderate thalamic defect reveled moderate motor defect clinically. Ten of 36(27.9%) revealed unilateral or bilateral moderate rCBF defect, 23 (63.9%) depicted mild defect, and 3(8.3%) showed no defect. Sixteen with moderate thalamic rCBF defect showed moderate motor defect in 15 patients. There was statistically significant (p=0.02605) relationship between rCBF defect and motor defect in our CP patients. In conclusion, brain SPECT appears sensitive, non-invasive tool in the evaluation as well as in the prognostication of bilateral spastic cerebral palsy patients and deserves further study using larger number of patients.

  10. Single photon emission computed tomography (SPECT) in neurocysticercosis

    International Nuclear Information System (INIS)

    Braga, Francisco Jose H. N; Santos, Antonio C; Takanayagui, Oswaldo M; Agapejev, Svetlana; Maes, A

    2002-01-01

    Neurocysticercosis (NC) is a parasitic infectious disease caused by Taenia solium eggs that set in the brain. Its incidence is increasing both in the developing and the developed world, as a result of low economical and hygiene levels and immigration, respectively. Clinical manifestation of disease varies from no symptoms to epilepsy, increased intra-cranial pressure, arachnoiditis and dementia. In order to evaluate function (perfusion) of affected brains, we studied 40 patients (21 females and 19 males, 19-71 yo) by means of SPECT (ECD, ethyl cysteinate dimer, labelled with 99mTc) and with and without contrast CT. SPECT studies were all abnormal. No difference was noted between active and inactive disease. Two SPECT patterns were noted: a) several areas of focally reduced uptake, resulting from coalescent and big lesions and large destruction of brain tissue (small, isolated and symmetric cysts seen in CT were missed by SPECT); b) diffuse atrophy with reduction of the tracer uptake, associated with ventricle dilatation, corresponding to the cases where ventricular NC was important. Interestingly, we noted diffuse hypoperfusion, with the scintigraphic pattern of atrophy in 5 cases of massive parenchymal infection; in such cases, CT signs of atrophy were clearly less prominent. The first scintigraphic aspect can be explained by the destruction of large areas of brain, which produces focal absence of perfusion; generalised vasculitis and the destruction of large portions of brain tissue could explain the difference noted between the SPECT and the CT aspects in the 5 cases of massive parenchimal infection, and this may be interesting for prognosis. Dilatation of ventricles and Sylvian fissures were interestingly prominent in SPECT. SPECT may be of great value to evaluate brain perfusion in NC (Au)

  11. Radiopharmaceuticals for brain - SPECT

    International Nuclear Information System (INIS)

    Moretti, J.L.

    1992-01-01

    Perfusion tracers for brain SPECT imaging suitable for regional cerebral blood flow measurement and regional cerebral blood volume determination, with respect to their ability to pass the blood-brain-barrier, are described. Problems related t the use of specific radiotracers to map receptors distribution in the brain are also discussed in this lecture. 9 figs, 6 tabs

  12. Predictive value of brain perfusion SPECT for rTMS response in pharmacoresistant depression

    International Nuclear Information System (INIS)

    Richieri, Raphaelle; Lancon, Christophe; Boyer, Laurent; Farisse, Jean; Colavolpe, Cecile; Mundler, Olivier; Guedj, Eric

    2011-01-01

    The aim of this study was to determine the predictive value of whole-brain voxel-based regional cerebral blood flow (rCBF) for repetitive transcranial magnetic stimulation (rTMS) response in patients with pharmacoresistant depression. Thirty-three right-handed patients who met DSM-IV criteria for major depressive disorder (unipolar or bipolar depression) were included before rTMS. rTMS response was defined as at least 50% reduction in the baseline Beck Depression Inventory scores. The predictive value of 99m Tc-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) for rTMS response was studied before treatment by comparing rTMS responders to non-responders at voxel level using Statistical Parametric Mapping (SPM) (p 0.10). In comparison to responders, non-responders showed significant hypoperfusions (p < 0.001, uncorrected) in the left medial and bilateral superior frontal cortices (BA10), the left uncus/parahippocampal cortex (BA20/BA35) and the right thalamus. The area under the curve for the combination of SPECT clusters to predict rTMS response was 0.89 (p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the combination of clusters were: 94, 73, 81 and 92%, respectively. This study shows that, in pharmacoresistant depression, pretreatment rCBF of specific brain regions is a strong predictor for response to rTMS in patients with homogeneous demographic/clinical features. (orig.)

  13. Cerebral SPECT, a new diagnostic marker in depression

    International Nuclear Information System (INIS)

    Galli, Enrique

    2001-01-01

    Over the past twenty years the functional brain imagenology has improved greatly. Today the diagnostic, prognostic and therapeutic response are possible in psychiatry and neurology. The functional denomination in psychiatry has been known for more than a 100 years and it can be evident in the brain images. The relation between the blood brain flux and the brain can be seen as pictures in the Brain SPECT as hyper and hypo function areas. To carry out SPECT a venous injection of Tc-99m Technetium and (HMPAO) or (ECD) is applied in the arm. The images correspond to a period of two minutes after injection. The exam can be done until six hours after the brain fixation. The study is carried out in conditions, with the patient in repose, relaxed and without medication. The final result is an brain in colors. The yellow color gives us 95% of decrease and white color 95% of increase of the brain function. The red color gives a normal perfusion. The object of the study is to find that the Brain SPECT could be used as a new diagnostic marker of depression. The sample was 73 outpatients with major depression Our diagnostic marker is the prefrontal cortex ventral hypoperfusion (orbit frontal) in almost 100% of the patients and only 32% dorsal hypoperfusion (executive area), unlike most authors (Au)

  14. Brain areas involved in acupuncture needling sensation of de qi: a single-photon emission computed tomography (SPECT) study.

    Science.gov (United States)

    Chen, Jia-Rong; Li, Gan-Long; Zhang, Gui-Feng; Huang, Yong; Wang, Shu-Xia; Lu, Na

    2012-12-01

    De qi is a sensory response elicited by acupuncture stimulation. According to traditional Chinese medicine (TCM), de qi is essential for clinical efficacy. However, the understanding of the neurobiological basis of de qi is still limited. To investigate the relationship between brain activation and de qi by taking a single-photon emission computed tomography (SPECT) scan while applying acupuncture at TE5. A total of 24 volunteers were randomly divided into 4 groups, and received verum or sham acupuncture at true acupuncture point TE5 or a nearby sham point according to grouping. All subjects then received a (99m)Tc-ethylcysteinate dimer (ECD) SPECT scan. All six subjects in the verum acupuncture at true acupuncture point group experienced de qi sensation; in contrast, all six subjects in the sham acupuncture at the sham point group responded with nothing other than non-sensation. Compared to the scan results from subjects who experienced non-sensation, SPECT scans from subjects with de qi sensation demonstrated significant activated points mainly located in brodmann areas 6, 8, 19, 21, 28, 33, 35, 37, 47, the parahippocampal gyrus, lentiform nucleus, claustrum and red nucleus; deactivated points were seen in brodmann areas 9 and 25. Verum acupuncture at true acupuncture points is more likely to elicit de qi sensation. De qi sensations mainly resulted in brain area activations, but not deactivations. These brain areas are related to the curative effect of Te5. The acupuncture needle sensations of de qi and sharp pain are associated with different patterns of activations and deactivations in the brain.

  15. Visual and SPM analysis of regional cerebral perfusion with Tc-99m ECD brain SPECT in patients with developmental language disorder

    International Nuclear Information System (INIS)

    Yoon, Joon Kee; Lee, Myung Hoon; Joh, Chul Woo; Yoon, Seok Nam; Oh, Eun Young

    2003-01-01

    Developmental language disorder (DLD) refers to inadequate language acquisition at the expected age in children with otherwise normal development. However, language delay can be observed in patients with other developmental disoder (ODD). We, therefore, evaluated regional cerebral perfusion pattern in patients with DLD and ODD by means of visual and SPM analysis. Twelve patients, who underwent Tc-99m ECD brain SPECT within 3 weeks of their first visit, were included in the study. Psychological and language tests classified the patients into 2 groups ; 6 with DLD (3-7 yr, 5 male and I female) and 6 with ODD (2-6 yr, 6 male). Visual analysis for regional cerebral perfusion was done in each patient. SPM with 7 controls (age=7) was performed to evaluate difference between 2 groups using t-test. P value of less than 0.005 was considered to be significant. All patients had significant language delay for their age (9 month 3.5 yr). Among 6 patients with ODD, 4 had pervasive developmental disorder, 1 mental retardation and 1 attachment disorder. Visual analysis revealed significant perfusion decrease in only 1 patient with DLD and 2 with ODD ; the regions were left parieto-temporal cortex, both frontal and cerebellar cortices, and right temporal cortex respectively. Nine of 12 patients showed normal perfusion. SPM demonstrated perfusion decrease in left inferior frontal cortex and left superior parietal cortex (Wernicke's area) in patients with DLD, while, in patients with ODD, perfusion decrease was mostly located in the right hemisphere (lateral frontoorbital gyrus, occipitotemporal gyrus, cuneus and cerebellum). Corpus callosum showed no significant perfusion abnormality in both groups. Regional cerebral perfusion of patients with DLD, which was mainly located in the speech area, is quite different from that of ODD-patients with language delay. While SPM successfully revealed this difference in perfusion pattern, visual analysis had limited value

  16. Visual and SPM analysis of regional cerebral perfusion with Tc-99m ECD brain SPECT in patients with developmental language disorder

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Joon Kee; Lee, Myung Hoon; Joh, Chul Woo; Yoon, Seok Nam; Oh, Eun Young [College of Medicine, Univ. of Ajou, Suwon (Korea, Republic of)

    2003-07-01

    Developmental language disorder (DLD) refers to inadequate language acquisition at the expected age in children with otherwise normal development. However, language delay can be observed in patients with other developmental disoder (ODD). We, therefore, evaluated regional cerebral perfusion pattern in patients with DLD and ODD by means of visual and SPM analysis. Twelve patients, who underwent Tc-99m ECD brain SPECT within 3 weeks of their first visit, were included in the study. Psychological and language tests classified the patients into 2 groups ; 6 with DLD (3-7 yr, 5 male and I female) and 6 with ODD (2-6 yr, 6 male). Visual analysis for regional cerebral perfusion was done in each patient. SPM with 7 controls (age=7) was performed to evaluate difference between 2 groups using t-test. P value of less than 0.005 was considered to be significant. All patients had significant language delay for their age (9 month 3.5 yr). Among 6 patients with ODD, 4 had pervasive developmental disorder, 1 mental retardation and 1 attachment disorder. Visual analysis revealed significant perfusion decrease in only 1 patient with DLD and 2 with ODD ; the regions were left parieto-temporal cortex, both frontal and cerebellar cortices, and right temporal cortex respectively. Nine of 12 patients showed normal perfusion. SPM demonstrated perfusion decrease in left inferior frontal cortex and left superior parietal cortex (Wernicke's area) in patients with DLD, while, in patients with ODD, perfusion decrease was mostly located in the right hemisphere (lateral frontoorbital gyrus, occipitotemporal gyrus, cuneus and cerebellum). Corpus callosum showed no significant perfusion abnormality in both groups. Regional cerebral perfusion of patients with DLD, which was mainly located in the speech area, is quite different from that of ODD-patients with language delay. While SPM successfully revealed this difference in perfusion pattern, visual analysis had limited value.

  17. 99mTc HM-PAO brain perfusion SPECT in brain death

    International Nuclear Information System (INIS)

    Bonetti, M.G.; Ciritella, P.; Valle, G.; Perrone, E.

    1995-01-01

    We have easily carried out and interpreted 99m Tc HM-PAO SPECT in a consecutive series of 40 comatose patients with brain damage, without discontinuing therapy. Brain death was diagnosed in 7 patients, by recognising absence of brain perfusion, as shown by no intracranial radionuclide uptake. In patients in whom perfusion was seen on brain scans, HM-PAO SPECT improved assessment of the extent of injury, which in general was larger than suggested by CT. (orig.)

  18. The clinical use of brain SPECT imaging in neuropsychiatry

    International Nuclear Information System (INIS)

    Amen, Daniel G; Wu, Joseph C; Carmichael, Blake

    2003-01-01

    This article reviews the literature on brain SPECT imaging in brain trauma, dementia, and temporal lobe epilepsy. Brain SPECT allows clinicians the ability to view cerebral areas of healthy, low, and excessive perfusion. This information can be correlated with what is known about the function or dysfunction of each area. SPECT has a number of advantages over other imaging techniques, including wider availability, lower cost, and high quality resolution with multi-headed cameras. There are a number of issues that compromise the effective use of SPECT, including low quality of some imaging cameras, and variability of image rendering and readings (Au)

  19. Brain SPECT analysis using statistical parametric mapping in patients with transient global amnesia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, E. N.; Sohn, H. S.; Kim, S. H; Chung, S. K.; Yang, D. W. [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2001-07-01

    This study investigated alterations in regional cerebral blood flow (rCBF) in patients with transient global amnesia (TGA) using statistical parametric mapping 99 (SPM99). Noninvasive rCBF measurements using 99mTc-ethyl cysteinate dimer (ECD) SPECT were performed on 8 patients with TGA and 17 age matched controls. The relative rCBF maps in patients with TGA and controls were compared. In patients with TGA, significantly decreased rCBF was found along the left superior temporal extending to left parietal region of the brain and left thalamus. There were areas of increased rCBF in the right temporal, right frontal region and right thalamus. We could demonstrate decreased perfusion in left cerebral hemisphere and increased perfusion in right cerebral hemisphere in patients with TGA using SPM99. The reciprocal change of rCBF between right and left cerebral hemisphere in patients with TGA might suggest that imbalanced neuronal activity between the bilateral hemispheres may be important role in the pathogenesis of the TGA. For quantitative SPECT analysis in TGA patients, we recommend SPM99 rather than the ROI method because of its definitive advantages.

  20. Brain SPECT analysis using statistical parametric mapping in patients with transient global amnesia

    International Nuclear Information System (INIS)

    Kim, E. N.; Sohn, H. S.; Kim, S. H; Chung, S. K.; Yang, D. W.

    2001-01-01

    This study investigated alterations in regional cerebral blood flow (rCBF) in patients with transient global amnesia (TGA) using statistical parametric mapping 99 (SPM99). Noninvasive rCBF measurements using 99mTc-ethyl cysteinate dimer (ECD) SPECT were performed on 8 patients with TGA and 17 age matched controls. The relative rCBF maps in patients with TGA and controls were compared. In patients with TGA, significantly decreased rCBF was found along the left superior temporal extending to left parietal region of the brain and left thalamus. There were areas of increased rCBF in the right temporal, right frontal region and right thalamus. We could demonstrate decreased perfusion in left cerebral hemisphere and increased perfusion in right cerebral hemisphere in patients with TGA using SPM99. The reciprocal change of rCBF between right and left cerebral hemisphere in patients with TGA might suggest that imbalanced neuronal activity between the bilateral hemispheres may be important role in the pathogenesis of the TGA. For quantitative SPECT analysis in TGA patients, we recommend SPM99 rather than the ROI method because of its definitive advantages

  1. The change of cerebral blood flow after heart transplantation in congestive heart failure: a voxel-based and automatic VOl analysis of Tc-99m ECD SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hong, I. K.; Kim, J. J.; Lee, C. H.; Lim, K. C.; Moon, D. H.; Rhu, J. S.; Kim, J. S. [Asan Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    To investigate the change of global and regional cerebral blood flow after heart transplantation (HT) in congestive heart failure (CHF) patients. Twenty-one patients with CHF who underwent HT (45{+-}12 yrs, M/F=19/2) and 10 healthy volunteers (39{+-}13 yrs, M/F = 7/3) were prospectively included. All patients underwent echocardiography and radionuclide angiography including brain and aorta with brain SPECT which was performed after iv bolus injection of Tc-99m ECD (740MBq) before (175{+-}253 days) and after (129{+-}82 days) HT. Patients were divided into two groups according to the interval between HT and postoperative SPECT [early follow-up (f/u): <6 mo, n=14; late f/u: >6 mo, n=7]. Global CBF (gCBF) of bilateral hemispheres were calculated by Patlak graphical analysis. Absolute rCBF map was obtained from brain SPECT by Lassen's correction algorithm. Age-corrected voxel-based analysis using SPM2 and automatic VOl analysis were performed to assess the rCBF change. Cardiac ejection fraction of all patients improved after HT (20.8%{yields}64.0%). gCBF was reduced compared to normal before HT (35.7{+-}3.9 vs. 49.1{+-}3.0 ml/100g/min; p<0.001) and improved postoperatively (46.6{+-}5.4, p<0.001). The preoperative gCBFs of early and late f/u group were not different (34.6{+-}3.2 vs. 38.0{+-}4.4, p=0.149) but postoperative gCBF (43.9{+-}3.7) of late f/u group was higher than those (52.0{+-}4.0) of early f/u group (p<0.001). On voxel-based analysis, preoperative rCBF was reduced in entire brain but most severely in bilateral superior and inferior frontal cortex, supplementary motor area, precuneus and anterior cingulum, compared to normals (uncorrected p<0.001). After HT, rCBF of these areas improved more significantly in late f/u group than in early f/u group but still lower than normals. Global CBF was significantly reduced in CHF patients and improved after HT. rCBFs of the frontal cortex, precuneus and cingulum were most severely reduced and slowly improved after

  2. Old wine in new bottles: validating the clinical utility of SPECT in predicting cognitive performance in mild traumatic brain injury.

    Science.gov (United States)

    Romero, Kristoffer; Lobaugh, Nancy J; Black, Sandra E; Ehrlich, Lisa; Feinstein, Anthony

    2015-01-30

    The neural underpinnings of cognitive dysfunction in mild traumatic brain injury (TBI) are not fully understood. Consequently, patient prognosis using existing clinical imaging is somewhat imprecise. Single photon emission computed tomography (SPECT) is a frequently employed investigation in this population, notwithstanding uncertainty over the clinical utility of the data obtained. In this study, subjects with mild TBI underwent (99m)Tc-ECD SPECT scanning, and were administered a brief battery of cognitive tests and self-report symptom scales of concussion and emotional distress. Testing took place 2 weeks (n=84) and 1 year (n=49) post-injury. Multivariate analysis (i.e., partial least squares analysis) revealed that frontal perfusion in right superior frontal and middle frontal gyri predicted poorer performance on the Stroop test, an index of executive function, both at initial and follow-up testing. Conversely, SPECT scans categorized as normal or abnormal by radiologists did not differentiate cognitively impaired from intact subjects. These results demonstrate the clinical utility of SPECT in mild TBI, but only when data are subjected to blood flow quantification analysis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Application of SPECT to psychiatry

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi

    1999-01-01

    Brain perfusion SPECT using 99m Tc-ethyl-cysteinate dimer ( 99m Tc-ECD) was applied to psychiatric diseases with aid of statistical parametric mapping (SPM) for analysis of data. To evaluate influence of aging on brain perfusion, noninvasive measurements of cerebral blood flow using 99m Tc-ECD were performed in 53 normal volunteers, age 18 to 87 years old. Mean cerebral blood flow (mCBF) was 43.9±5.0 ml/100 g/min and showed weak negative correlation with aging (r=0.451). Perisylvian cerebral cortices and medial frontal areas including anterior cingulate gyri showed greater negative correlation than other areas. These findings suggest the necessity of age-matched control regional CBF (rCBF) data to investigate rCBF abnormality in patients. Four drug-naive schizophrenic patients showed flow decrease in bilateral frontal and superior temporal areas and a left infero-posterior temporal area. Haloperidol administration induced flow decrease in bilateral frontal and left parietal areas, while flow increase in bilateral striatal and right hippocampal areas. Ten aged depressive patients showed flow decrease in bilateral frontal and left temporo-parietal areas. Even after remission patients showed flow decrease in the left frontal area as compared with normal subjects. Remission induced flow increase in the right frontal, right parietal, and right orbitofrontal areas compared with depression. These results suggest that CBF measurements using 99m Tc-ECD were useful for objective evaluation of regional abnormality in brain function in psychiatric diseases. (author)

  4. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    Energy Technology Data Exchange (ETDEWEB)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui [Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr {approx} 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1{approx}9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI.

  5. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    International Nuclear Information System (INIS)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui

    2007-01-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr ∼ 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1∼9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI

  6. Clinical significance of I-123 IMP brain SPECT in children with brain diseases

    International Nuclear Information System (INIS)

    Takishima, Teruo; Machida, Kikuo; Honda, Norinari; Mamiya, Toshio; Takahashi, Taku; Kamano, Tsuyoshi; Hasegawa, Noriko

    1990-01-01

    Single photon emission computed tomography (SPECT) of the brain using N-isopropyl p-I-123-iodoamphetamine (I-123 IMP) was performed in 43 children with suspected brain diseases. Forty-three children (25 males and 18 females), with an age range of 24 days-15 years (mean: 6.6 years), were included in the study. Six patients were subsequently diagnosed as normal. Early SPECT of the brain was performed 30 minutes after intravenous administration of 74-111 MBq (2-3 mCi) I-123 IMP using a rotating gamma camera equipped with a 30-degree slant hole and medium energy collimator. Transverse images were reconstructed by Shepp-Logan filtered back projection method with attenuation correction after spatial filtering using an 8th order Butterworth-Wiener filter. Findings of I-123 IMP SPECT were compared with those of X-ray computed tomography (CT) and electroencephalography (EEG). The results showed that in I-123 IMP SPECT, abnormality was found in 30 out of 37 children with brain diseases. The incidence of abnormal findings in the 37 patients was 81% in I-123 IMP SPECT, 61% in X-ray CT, and 78% in EEG; in both cryptogenic and secondary epilepsy, the incidence of abnormality was higher in I-123 IMP SPECT than in X-ray CT. (70% and 94% vs 50% and 81% respectively), and epileptic foci detected by EEG did not correspond with defects found using I-123 IMP SPECT in 27% of the patients; and in asphyxiated infants, a high incidence of abnormality was observed on both I-123 IMP SPECT (86%) and X-ray CT (86%). In conclusion, I-123 IMP SPECT is a clinically useful examination in children with brain disease. (author)

  7. Effect of acupuncture on regional cerebral blood flow at acupoints GV 20, GV. 26, LI, 4. ST. 36, SP. 6 evaluated by Tc-99m ECD brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Chun; Bom, Hee Seung; Kang, Hwa Jeong; Kim, Seong Min; Jeong, Hwan Jeong; Kim, Ji Yeul [College of Medicine, Dongshin Univ., Naju (Korea, Republic of); Ahn, Soo Gi [College of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

    2000-12-01

    To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm posterior to the right fibular head. All images were spatially normalized, and the differences between rest and acupuncture stimulation were statistically analyzed using SPM for Windows. Acupuncture applied at acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV. 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. The results demonstrated a correlation between stimuation at each acupoint with increase in rCBF to the corresponding brain areas.

  8. Effect of acupuncture on regional cerebral blood flow at acupoints GV 20, GV. 26, LI, 4. ST. 36, SP. 6 evaluated by Tc-99m ECD brain SPECT

    International Nuclear Information System (INIS)

    Song, Ho Chun; Bom, Hee Seung; Kang, Hwa Jeong; Kim, Seong Min; Jeong, Hwan Jeong; Kim, Ji Yeul; Ahn, Soo Gi

    2000-01-01

    To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm posterior to the right fibular head. All images were spatially normalized, and the differences between rest and acupuncture stimulation were statistically analyzed using SPM for Windows. Acupuncture applied at acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV. 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. The results demonstrated a correlation between stimuation at each acupoint with increase in rCBF to the corresponding brain areas

  9. Regional cerebral blood flow of the patients with schizophrenia. A study using 99mTc-ECD SPECT at rest and activation

    International Nuclear Information System (INIS)

    Hu Ping; Wu Kening; Zeng Shiquan; Lin Zengtao; Yu Jinlong

    1996-01-01

    Regional cerebral blood flow (rCBF) changes of the patients with schizophrenia were observed. 99m Tc-ECD SPECT was performed on 22 patients with schizophrenia and 10 healthy volunteers at rest and activation with a cognitive task: a modified Wisconsin Card Sorting Test. At rest state, only 4 patients have abnormal rCBF pattern: left hemisphere over-perfusion relative to the right. A significant relative activation deficit in the left inferior prefrontal region was revealed in the patients during activation. The patients with schizophrenia may have frontal lobe dysfunction

  10. Brain SPECT analysis using statistical parametric mapping in patients with posttraumatic stress disorder

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Euy Neyng; Sohn, Hyung Sun; Kim, Sung Hoon; Chung, Soo Kyo; Yang, Dong Won [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2001-07-01

    This study investigated alterations in regional cerebral blood flow (rCBF) in patients with posttraumatic stress disorder (PTSD) using statistical parametric mapping (SPM99). Noninvasive rCBF measurements using {sup 99m}Tc-ethyl cysteinate dimer (ECD) SPECT were performed on 23 patients with PTSD and 21 age matched normal controls without re-exposure to accident-related stimuli. The relative rCBF maps in patients with PTSD and controls were compared. In patients with PTSD, significant increased rCBF was found along the limbic system in the brain. There were a few foci of decreased rCBF in the superior frontal gyrus, parietal and temporal region. PTSD is associated with increased rCBF in limbic areas compared with age-matched normal controls. These findings implicate regions of the limbic brain, which may mediate the response to aversive stimuli in healthy individuals, play on important role in patients suffering from PTSD and suggest that ongoing hyperfunction of 'overlearned survival response' or flashbacks response in these regions after painful, life threatening, or horrifying events without re-exposure to same traumatic stimulus.

  11. Brain SPECT analysis using statistical parametric mapping in patients with posttraumatic stress disorder

    International Nuclear Information System (INIS)

    Kim, Euy Neyng; Sohn, Hyung Sun; Kim, Sung Hoon; Chung, Soo Kyo; Yang, Dong Won

    2001-01-01

    This study investigated alterations in regional cerebral blood flow (rCBF) in patients with posttraumatic stress disorder (PTSD) using statistical parametric mapping (SPM99). Noninvasive rCBF measurements using 99m Tc-ethyl cysteinate dimer (ECD) SPECT were performed on 23 patients with PTSD and 21 age matched normal controls without re-exposure to accident-related stimuli. The relative rCBF maps in patients with PTSD and controls were compared. In patients with PTSD, significant increased rCBF was found along the limbic system in the brain. There were a few foci of decreased rCBF in the superior frontal gyrus, parietal and temporal region. PTSD is associated with increased rCBF in limbic areas compared with age-matched normal controls. These findings implicate regions of the limbic brain, which may mediate the response to aversive stimuli in healthy individuals, play on important role in patients suffering from PTSD and suggest that ongoing hyperfunction of 'overlearned survival response' or flashbacks response in these regions after painful, life threatening, or horrifying events without re-exposure to same traumatic stimulus

  12. Influences of reconstruction and attenuation correction in brain SPECT images obtained by the hybrid SPECT/CT device: evaluation with a 3-dimensional brain phantom

    International Nuclear Information System (INIS)

    Akamatsu, Mana; Yamashita, Yasuo; Akamatsu, Go; Tsutsui, Yuji; Ohya, Nobuyoshi; Nakamura, Yasuhiko; Sasaki, Masayuki

    2014-01-01

    The aim of this study was to evaluate the influences of reconstruction and attenuation correction on the differences in the radioactivity distributions in 123 I brain SPECT obtained by the hybrid SPECT/CT device. We used the 3-dimensional (3D) brain phantom, which imitates the precise structure of gray matter, white matter and bone regions. It was filled with 123 I solution (20.1 kBq/mL) in the gray matter region and with K 2 HPO 4 in the bone region. The SPECT/CT data were acquired by the hybrid SPECT/CT device. SPECT images were reconstructed by using filtered back projection with uniform attenuation correction (FBP-uAC), 3D ordered-subsets expectation-maximization with uniform AC (3D-OSEM-uAC) and 3D OSEM with CT-based non-uniform AC (3D-OSEM-CTAC). We evaluated the differences in the radioactivity distributions among these reconstruction methods using a 3D digital phantom, which was developed from CT images of the 3D brain phantom, as a reference. The normalized mean square error (NMSE) and regional radioactivity were calculated to evaluate the similarity of SPECT images to the 3D digital phantom. The NMSE values were 0.0811 in FBP-uAC, 0.0914 in 3D-OSEM-uAC and 0.0766 in 3D-OSEM-CTAC. The regional radioactivity of FBP-uAC was 11.5% lower in the middle cerebral artery territory, and that of 3D-OSEM-uAC was 5.8% higher in the anterior cerebral artery territory, compared with the digital phantom. On the other hand, that of 3D-OSEM-CTAC was 1.8% lower in all brain areas. By using the hybrid SPECT/CT device, the brain SPECT reconstructed by 3D-OSEM with CT attenuation correction can provide an accurate assessment of the distribution of brain radioactivity

  13. SPECT brain perfusion findings in mild or moderate traumatic brain injury

    International Nuclear Information System (INIS)

    Abu-Judeh, H.H.; Parker, R.; Aleksic, S.

    2000-01-01

    Background: The purpose of this manuscript is to present the findings in the largest series of SPECT brain perfusion imaging reported to date for mild or moderate traumatic brain injury. PATIENTS AND METHODS: This is a retrospective evaluation of 228 SPECT brain perfusion-imaging studies of patients who suffered mild or moderate traumatic brain injury with or without loss of consciousness (LOC). All patients had no past medical history of previous brain trauma, neurological, or psychiatric diseases, HIV, alcohol or drug abuse. The patient population included 135 males and 93 females. The ages ranged from 11-88 years (mean 40.8). The most common complaints were characteristic of the postconcussion syndrome: headaches 139/228 (61%); dizziness 61/228 (27%); and memory problems 63/228 (28%). LOC status was reported to be positive in 121/228 (53%), negative in 41/228 (18%), and unknown for 63/228 (28%). RESULTS: Normal studies accounted for 52/228 (23%). For abnormal studies (176/228 or 77%) the findings were as follows: basal ganglia hypoperfusion 338 lesions (55.2%); frontal lobe hypoperfusion 146 (23.8%); temporal lobes hypoperfusion 80 (13%); parietal lobes hypoperfusion 20 (3.7%); insular and or occipital lobes hypoperfusion 28 (4.6%). Patients' symptoms correlated with the SPECT brain perfusion findings. The SPECT BPI studies in 122/228 (54%) were done early within 3 months of the date of the accident, and for the remainder, 106/228 (46%) over 3 months and less than 3 years from the date of the injury. In early imaging, 382 lesions were detected; in 92 patients (average 4.2 lesions per study) imaging after 3 months detected 230 lesions: in 84 patients (average 2.7 lesions per study). CONCLUSIONS: Basal ganglia hypoperfusion is the most common abnormality following mild or moderate traumatic brain injury (p = 0.006), and is more common in patients complaining of memory problem (p = 0.0005) and dizziness (p = 0.003). Early imaging can detect more lesions than

  14. SPECT brain perfusion findings in mild or moderate traumatic brain injury.

    Science.gov (United States)

    Abu-Judeh, H H; Parker, R; Aleksic, S; Singh, M L; Naddaf, S; Atay, S; Kumar, M; Omar, W; El-Zeftawy, H; Luo, J Q; Abdel-Dayem, H M

    2000-01-01

    The purpose of this manuscript is to present the findings in the largest series of SPECT brain perfusion imaging reported to date for mild or moderate traumatic brain injury. This is a retrospective evaluation of 228 SPECT brain perfusion-imaging studies of patients who suffered mild or moderate traumatic brain injury with or without loss of consciousness (LOC). All patients had no past medical history of previous brain trauma, neurological, or psychiatric diseases, HIV, alcohol or drug abuse. The patient population included 135 males and 93 females. The ages ranged from 11-88 years (mean 40.8). The most common complaints were characteristic of the postconcussion syndrome: headaches 139/228 (61%); dizziness 61/228 (27%); and memory problems 63/228 (28%). LOC status was reported to be positive in 121/228 (53%), negative in 41/228 (18%), and unknown for 63/228 (28%). Normal studies accounted for 52/228 (23%). For abnormal studies (176/228 or 77%) the findings were as follows: basal ganglia hypoperfusion 338 lesions (55.2%); frontal lobe hypoperfusion 146 (23.8%); temporal lobes hypoperfusion 80 (13%); parietal lobes hypoperfusion 20 (3.7%); insular and or occipital lobes hypoperfusion 28 (4.6%). Patients' symptoms correlated with the SPECT brain perfusion findings. The SPECT BPI studies in 122/228 (54%) were done early within 3 months of the date of the accident, and for the remainder, 106/228 (46%) over 3 months and less than 3 years from the date of the injury. In early imaging, 382 lesions were detected; in 92 patients (average 4.2 lesions per study) imaging after 3 months detected 230 lesions: in 84 patients (average 2.7 lesions per study). Basal ganglia hypoperfusion is the most common abnormality following mild or moderate traumatic brain injury (p = 0.006), and is more common in patients complaining of memory problem (p = 0.0005) and dizziness (p = 0.003). Early imaging can detect more lesions than delayed imaging (p = 0.0011). SPECT brain perfusion

  15. Decreased regional cerebral blood flow in the bilateral thalami and medulla oblongata determined by an easy Z-score (eZIS) analysis of (99m)Tc-ECD-SPECT images in a case of MM2-thalamic-type sporadic Creutzfeldt-Jakob disease.

    Science.gov (United States)

    Hayashi, Yuichi; Iwasaki, Yasushi; Yoshikura, Nobuaki; Asano, Takahiko; Hatano, Taku; Tatsumi, Shinsui; Satoh, Katsuya; Kimura, Akio; Kitamoto, Tetsuyuki; Yoshida, Mari; Inuzuka, Takashi

    2015-11-15

    We report a case of autopsy-verified MM2-thalamic-type sporadic Creutzfeldt-Jakob disease (sCJD) in a 46-year-old patient with a 16-month history of abnormal behavior, progressive dementia, insomnia, and speech disturbances without family history. Neurological examination revealed progressive dementia, frontal signs, insomnia, speech disturbance, gait disturbance and bilaterally exaggerated tendon reflexes. Both brain MRI and cerebrospinal fluid examinations, including 14-3-3 protein, yielded normal results. An easy Z-score (eZIS) analysis for (99m)Tc-ethyl cysteinate dimer-single photon emission computed tomography ((99m)Tc-ECD-SPECT) revealed decreased regional cerebral blood flow in the bilateral thalami and medulla oblongata. PRNP gene analysis revealed methionine homozygosity at codon 129 without mutation. Neuropathological examinations revealed severe neuronal loss, gliosis, and hypertrophic astrocytosis in the medial thalamus and inferior olivary nucleus. A slight depletion of Purkinje cells was observed. PrP immunostaining showed no obvious PrP deposits in the basal ganglia, thalamus, cerebellum, or brainstem; however, mild synaptic-type PrP deposits with some smaller plaque-like structures were only partially observed in the localized region of the frontal lobe with the spongiform change. Western blot analyses of protease-resistant PrP showed a type 2 pattern. In conclusion, eZIS analysis of (99m)Tc-ECD-SPECT images is useful for detecting both thalamic and medullary lesions. This is the first case of medullary lesions detected in a live patient with MM2-thalamic-type sCJD using SPECT. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Anatomically standardized statistical mapping of 123I-IMP SPECT in brain tumors

    International Nuclear Information System (INIS)

    Shibata, Yasushi; Akimoto, Manabu; Matsushita, Akira; Yamamoto, Tetsuya; Takano, Shingo; Matsumura, Akira

    2010-01-01

    123 I-iodoamphetamine Single Photon Emission Computed Tomography (IMP SPECT) is used to evaluate cerebral blood flow. However, application of IMP SPECT to patients with brain tumors has been rarely reported. Primary central nervous system lymphoma (PCNSL) is a rare tumor that shows delayed IMP uptake. The relatively low spatial resolution of SPECT is a clinical problem in diagnosing brain tumors. We examined anatomically standardized statistical mapping of IMP SPECT in patients with brain lesions. This study included 49 IMP SPECT images for 49 patients with brain lesions: 20 PCNSL, 1 Burkitt's lymphoma, 14 glioma, 4 other tumor, 7 inflammatory disease and 3 without any pathological diagnosis but a clinical diagnosis of PCNSL. After intravenous injection of 222 MBq of 123 I-IMP, early (15 minutes) and delayed (4 hours) images were acquired using a multi-detector SPECT machine. All SPECT data were transferred to a newly developed software program iNeurostat+ (Nihon Medi-physics). SPECT data were anatomically standardized on normal brain images. Regions of increased uptake of IMP were statistically mapped on the tomographic images of normal brain. Eighteen patients showed high uptake in the delayed IMP SPECT images (16 PCNSL, 2 unknown). Other tumor or diseases did not show high uptake of delayed IMP SPECT, so there were no false positives. Four patients with pathologically proven PCNSL showed no uptake in original IMP SPECT. These tumors were too small to detect in IMP SPECT. However, statistical mapping revealed IMP uptake in 18 of 20 pathologically verified PCNSL patients. A heterogeneous IMP uptake was seen in homogenous tumors in MRI. For patients with a hot IMP uptake, statistical mapping showed clearer uptake. IMP SPECT is a sensitive test to diagnose of PCNSL, although it produced false negative results for small posterior fossa tumor. Anatomically standardized statistical mapping is therefore considered to be a useful method for improving the diagnostic

  17. Viewing the functional consequences of traumatic brain injury by using brain SPECT.

    Science.gov (United States)

    Pavel, D; Jobe, T; Devore-Best, S; Davis, G; Epstein, P; Sinha, S; Kohn, R; Craita, I; Liu, P; Chang, Y

    2006-03-01

    High-resolution brain SPECT is increasingly benefiting from improved image processing software and multiple complementary display capabilities. This enables detailed functional mapping of the disturbances in relative perfusion occurring after TBI. The patient population consisted of 26 cases (ages 8-61 years)between 3 months and 6 years after traumatic brain injury.A very strong case can be made for the routine use of Brain SPECT in TBI. Indeed it can provide a detailed evaluation of multiple functional consequences after TBI and is thus capable of supplementing the clinical evaluation and tailoring the therapeutic strategies needed. In so doing it also provides significant additional information beyond that available from MRI/CT. The critical factor for Brain SPECT's clinical relevance is a carefully designed technical protocol, including displays which should enable a comprehensive description of the patterns found, in a user friendly mode.

  18. Perfusion impairments on brian SPECT in patients with developmental language disorder: comparison with MR findings

    International Nuclear Information System (INIS)

    Ryu, Y. H.; Shin, E. J.; Kim, J. K.; Yoon, P. H.; Jeon, T. J.; Jeon, J. D.; Lee, J. D.

    1999-01-01

    Development language disorder (DLD) is diagnosed when there is a failure of normal language development in a child with normal nonverbal intelligence. Because previous study had not demonstrated consistent and specific neuroimaging findings of DLD, we performed a retrospective review in search of common functional and structural abnormalties in pre-school aged DLD children using Tc-99m ECD brain SPECT and MRI and compared them with age-matched children with infantile autism (AD). 50 children between 4 and 9 years of age with DLD (n=24) infantile autism (n=26) were performed Tc-99m ECD brain SPECT and MRI. Diagnosis of DLD and infantile autism was based on the criteria of DSM-IV and Childhood Autism Rating Scale (CARS). Of the 24 DLD patients, 10 revealed decreased perfusion of the thalami, followed by hypoperfusion of cerebellar hemisphere (n=9), frontal cortex (n=5), temporal cortex (n=5), parietal cortex (n=1). Of those 26 AD patients, 18 revealed hypoperfusion of the cerebellar hemisphere, followed by hypoperfusion of the thalami (n=16), parietal cortex (n=10), temporal cortex (n=4). Frontal hypoperfusion was significantly frequently seen in DLD, whereas, cerebellar hemispheric and parietal hypoperfusion was frequently seen in AD.All AD and DLD patients had normal MRI scan. Cerebellar hemispheric and parietal hypoperfusion on brain SPECT showed statistically significant correlation with CARS. SPECT may be useful and more sensitive modality in reflecting pathophysiology of DLD and AD as evidenced by previous MRI and postmortem studies although they had normal MRI. And further studies are necessary to determine the significant of the thalamic hypoperfusion

  19. Perfusion impairments on brian SPECT in patients with developmental language disorder: comparison with MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Y H [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of); Shin, E J; Kim, J K; Yoon, P H; Jeon, T J; Jeon, J D; Lee, J D [College of Medicine, Inje Univ., Pusan (Korea, Republic of)

    1999-07-01

    Development language disorder (DLD) is diagnosed when there is a failure of normal language development in a child with normal nonverbal intelligence. Because previous study had not demonstrated consistent and specific neuroimaging findings of DLD, we performed a retrospective review in search of common functional and structural abnormalties in pre-school aged DLD children using Tc-99m ECD brain SPECT and MRI and compared them with age-matched children with infantile autism (AD). 50 children between 4 and 9 years of age with DLD (n=24) infantile autism (n=26) were performed Tc-99m ECD brain SPECT and MRI. Diagnosis of DLD and infantile autism was based on the criteria of DSM-IV and Childhood Autism Rating Scale (CARS). Of the 24 DLD patients, 10 revealed decreased perfusion of the thalami, followed by hypoperfusion of cerebellar hemisphere (n=9), frontal cortex (n=5), temporal cortex (n=5), parietal cortex (n=1). Of those 26 AD patients, 18 revealed hypoperfusion of the cerebellar hemisphere, followed by hypoperfusion of the thalami (n=16), parietal cortex (n=10), temporal cortex (n=4). Frontal hypoperfusion was significantly frequently seen in DLD, whereas, cerebellar hemispheric and parietal hypoperfusion was frequently seen in AD.All AD and DLD patients had normal MRI scan. Cerebellar hemispheric and parietal hypoperfusion on brain SPECT showed statistically significant correlation with CARS. SPECT may be useful and more sensitive modality in reflecting pathophysiology of DLD and AD as evidenced by previous MRI and postmortem studies although they had normal MRI. And further studies are necessary to determine the significant of the thalamic hypoperfusion.

  20. Brain pertechnetate SPECT in perinatal asphyxia

    Energy Technology Data Exchange (ETDEWEB)

    Sfakianakis, G.; Curless, R.; Goldberg, R.; Clarke, L.; Saw, C.; Sfakianakis, E.; Bloom, F.; Bauer, C.; Serafini, A.

    1984-01-01

    Single photon emission computed tomography of the brain was performed in 6 patients with perinatal asphyxis aged 8-26 days. A single-head (LFOV) commercial SPECT system (Picker) was used and data were acquired 2-3 hr after an IV injection of 1-2 mCi Tc-99m-pertechnetate (360/sup 0/ rotation, 60 views, 64 x 64 matrix, 50K cts/view). Reconstruction in three planes was performed using MDS software (Hanning medium resolution filter, with or without attenuation correction using Sorenson's technique). For each clinical study, a ring type phantom source was used to identify the level of reconstruction noise in the tomographic planes. Abnormalities were found in all patients studied, 3 central (moderate intensity), 2 peripheral (1 severe, 1 moderate) and 1 diffuse (mild intensity). Despite use of oral perchlorate (50 mg) in one patient the choroid plexus was visible. Since attenuation correction tended to amplify noise, the clinical studies were interpreted both with and without this correction. All 3 patients with central lesions were found abnormal on early (1-4 mo) neurologic follow-up examination, whereas the others were normal. No correlation was found between SPECT and 24 hr blood levels of CPK, ammonia, base excess, or the Apgar scores. Ct scans were reported abnormal (3 diffuse, 1 peripheral, 1 central and 1 questionable). Planar scintigrams obtained immediately after SPECT were normal (2), questionable (2) and abnormal (2). Follow-up SPECT brain scintigrams in two of the patients showed partial resolution. SPECT of the brain appears promising in perinatal asphyxia but long-term correlation with patient development is necessary.

  1. Different uptake of 99mTc-ECD adn 99mTc-HMPAO in the same brains: analysis by statistical parametric mapping.

    Science.gov (United States)

    Hyun, Y; Lee, J S; Rha, J H; Lee, I K; Ha, C K; Lee, D S

    2001-02-01

    The purpose of this study was to investigate the differences between technetium-99m ethyl cysteinate dimer (99mTc-ECD) and technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) uptake in the same brains by means of statistical parametric mapping (SPM) analysis. We examined 20 patients (9 male, 11 female, mean age 62+/-12 years) using 99mTc-ECD and 99mTc-HMPAO single-photon emission tomography (SPET) and magnetic resonance imaging (MRI) of the brain less than 7 days after onset of stroke. MRI showed no cortical infarctions. Infarctions in the pons (6 patients) and medulla (1), ischaemic periventricular white matter lesions (13) and lacunar infarction (7) were found on MRI. Split-dose and sequential SPET techniques were used for 99mTc-ECD and 99mTc-HMPAO brain SPET, without repositioning of the patient. All of the SPET images were spatially transformed to standard space, smoothed and globally normalized. The differences between the 99mTc-ECD and 99mTc-HMPAO SPET images were statistically analysed using statistical parametric mapping (SPM) 96 software. The difference between two groups was considered significant at a threshold of uncorrected P values less than 0.01. Visual analysis showed no hypoperfused areas on either 99mTc-ECD or 99mTc-HMPAO SPET images. SPM analysis revealed significantly different uptake of 99mTc-ECD and 99mTc-HMPAO in the same brains. On the 99mTc-ECD SPET images, relatively higher uptake was observed in the frontal, parietal and occipital lobes, in the left superior temporal lobe and in the superior region of the cerebellum. On the 99mTc-HMPAO SPET images, relatively higher uptake was observed in the medial temporal lobes, thalami, periventricular white matter and brain stem. These differences in uptake of the two tracers in the same brains on SPM analysis suggest that interpretation of cerebral perfusion is possible using SPET with 99mTc-ECD and 99mTc-HMPAO.

  2. Brain SPECT imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Krausz, Y.; Yaffe, S.; Atlan, H.; Cohen, D.; Konstantini, S.; Meiner, Z.

    1991-01-01

    Temporal lobe epilepsy is diagnosed by clinical symptoms and signs and by localization of an epileptogenic focus. A brain SPECT study of two patients with temporal lobe epilepsy, using 99m Tc-HMPAO, was used to demonstrate a perfusion abnormality in the temporal lobe, while brain CT and MRI were non-contributory. The electroencephalogram, though abnormal, did not localize the diseased area. The potential role of the SPECT study in diagnosis and localization of temporal lobe epilepsy is discussed. (orig.)

  3. Global cerebral blood flow changes measured by brain perfusion SPECT immediately after whole brain irradiation

    International Nuclear Information System (INIS)

    Ohtawa, Nobuyuki; Machida, Kikuo; Honda, Norinari; Hosono, Makoto; Takahashi, Takeo

    2003-01-01

    Whole brain irradiation (WBI) is still a major treatment option for patients with metastatic brain tumor despite recent advances in chemotherapy and newer techniques of radiation therapy. Cerebral blood flow (CBF) of changes induced by whole brain radiation is not fully investigated, and the aim of the study was to measure CBF changes non-invasively with brain perfusion SPECT to correlate with treatment effect or prognosis. Total of 106 patients underwent WBI during April 1998 to March 2002. Both brain MRI and brain perfusion SPECT could be performed before (less than 1 week before or less than 10 Gy of WBI) and immediately after (between 1 week before and 2 weeks after the completion of WBI) the therapy in 17 of these patients. They, 10 men and 7 women, all had metastatic brain tumor with age range of 45 to 87 (mean of 61.4) years. Tc-99m brain perfusion agent (HMPAO in 4, ECD in 13) was rapidly administered in a 740-MBq dose to measure global and regional CBF according to Matsuda's method, which based on both Patlak plot and Lassens' linearity correction. Brain MRI was used to measure therapeutic response according to World Health Organization (WHO) classification as complete remission (CR), partial response (PR), no change (NC), and progressive disease (PD). Survival period was measured from the completion of WBI. Mean global CBF was 40.6 and 41.5 ml/100 g/min before and immediately after the WBI, respectively. Four patients increased (greater than 10%) their global mean CBF, 10 unchanged (less than 10% increase or decrease), and 3 decreased after the WBI. The WBI achieved CR in none, PR in 8, NC in 6, and PD in 3 on brain MRI. Change in global mean CBF (mean±SD) was significantly larger in PR (4.3±2.0 ml/100 g/min, p=0.002) and in NC (-0.1±4.5) than in PD (-3.9±6.4, P=0.002, P=0.016, respectively). Survival was not significantly (p>0.05) different among the patients with CR (20 weeks), NC (48 weeks), and PD (21 weeks). Change in global CBF and survival was

  4. Clinical Significance of Brain SPECT in Zipeprol Abusers

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Dai Ok; Kim, Jae Phil; Kim, Deog Yoon; Yang, Hyung In; Koh, Eun Mi; Kim, Kwang Won; Choi, Young Kil [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    1993-03-15

    Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of Tc-99m- HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction induced by zipeprol abuse.

  5. Clinical Significance of Brain SPECT in Zipeprol Abusers

    International Nuclear Information System (INIS)

    Cho, Dai Ok; Kim, Jae Phil; Kim, Deog Yoon; Yang, Hyung In; Koh, Eun Mi; Kim, Kwang Won; Choi, Young Kil

    1993-01-01

    Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of Tc-99m- HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction induced by zipeprol abuse.

  6. Equivalent brain SPECT perfusion changes underlying therapeutic efficiency in pharmacoresistant depression using either high-frequency left or low-frequency right prefrontal rTMS.

    Science.gov (United States)

    Richieri, Raphaëlle; Boyer, Laurent; Padovani, Romain; Adida, Marc; Colavolpe, Cécile; Mundler, Olivier; Lançon, Christophe; Guedj, Eric

    2012-12-03

    Functional neuroimaging studies have suggested similar mechanisms underlying antidepressant effects of distinct therapeutics. This study aimed to determine and compare functional brain patterns underlying the antidepressant response of 2 distinct protocols of repetitive transcranial magnetic stimulation (rTMS). 99mTc-ECD SPECT was performed before and after rTMS of dorsolateral prefrontal cortex in 61 drug-resistant right-handed patients with major depression, using high frequency (10Hz) left-side stimulation in 33 patients, and low frequency (1Hz) right-side stimulation in 28 patients. Efficiency of rTMS response was defined as at least 50% reduction of the baseline Beck Depression Inventory score. We compared the whole-brain voxel-based brain SPECT changes in perfusion after rTMS, between responders and non-responders in the whole sample (pleft- and right-stimulation. Before rTMS, the left- and right-prefrontal stimulation groups did not differ from clinical data and brain SPECT perfusion. rTMS efficiency (evaluated on % of responders) was statistically equivalent in the two groups of patients. In the whole-group of responder patients, a perfusion decrease was found after rTMS, in comparison to non-responders, within the left perirhinal cortex (BA35, BA36). This result was secondarily confirmed separately in the two subgroups, i.e. after either left stimulation (p=0.017) or right stimulation (pbrain functional changes associated to antidepressive efficiency, consisting to a remote brain limbic activity decrease within the left perirhinal cortex. However, these results will have to be confirmed in a double-blind randomized trial using a sham control group. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. A methodology for generating normal and pathological brain perfusion SPECT images for evaluation of MRI/SPECT fusion methods: application in epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Grova, C [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France); Jannin, P [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France); Biraben, A [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France); Buvat, I [INSERM U494, CHU Pitie Salpetriere, Paris (France); Benali, H [INSERM U494, CHU Pitie Salpetriere, Paris (France); Bernard, A M [Service de Medecine Nucleaire, Centre Eugene Marquis, Rennes (France); Scarabin, J M [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France); Gibaud, B [Laboratoire IDM, Faculte de Medecine, Universite de Rennes 1, Rennes (France)

    2003-12-21

    Quantitative evaluation of brain MRI/SPECT fusion methods for normal and in particular pathological datasets is difficult, due to the frequent lack of relevant ground truth. We propose a methodology to generate MRI and SPECT datasets dedicated to the evaluation of MRI/SPECT fusion methods and illustrate the method when dealing with ictal SPECT. The method consists in generating normal or pathological SPECT data perfectly aligned with a high-resolution 3D T1-weighted MRI using realistic Monte Carlo simulations that closely reproduce the response of a SPECT imaging system. Anatomical input data for the SPECT simulations are obtained from this 3D T1-weighted MRI, while functional input data result from an inter-individual analysis of anatomically standardized SPECT data. The method makes it possible to control the 'brain perfusion' function by proposing a theoretical model of brain perfusion from measurements performed on real SPECT images. Our method provides an absolute gold standard for assessing MRI/SPECT registration method accuracy since, by construction, the SPECT data are perfectly registered with the MRI data. The proposed methodology has been applied to create a theoretical model of normal brain perfusion and ictal brain perfusion characteristic of mesial temporal lobe epilepsy. To approach realistic and unbiased perfusion models, real SPECT data were corrected for uniform attenuation, scatter and partial volume effect. An anatomic standardization was used to account for anatomic variability between subjects. Realistic simulations of normal and ictal SPECT deduced from these perfusion models are presented. The comparison of real and simulated SPECT images showed relative differences in regional activity concentration of less than 20% in most anatomical structures, for both normal and ictal data, suggesting realistic models of perfusion distributions for evaluation purposes. Inter-hemispheric asymmetry coefficients measured on simulated data were

  8. The role of brain SPECT in children with epilepsy

    International Nuclear Information System (INIS)

    Liu Xingdang; Liu Yongchang; Lin Xiangtong

    1996-01-01

    The rCBF brain SPECT with 99m Tc-HMPAO was performed in 15 children with interictal epilepsy, and some cases were compared with EEG, X-ray CT and MRI. The results showed that the positive rate of SPECT was the highest (93.33%,), then the EEG (92.31%), and the CT and MRI were the lowest (66.67% and 75%). This study indicated that brain SPECT was an effective method for diagnosis and foci localization in epileptic children, and also was useful to the study of prognosis and relationship between changes of rCBF and progress in clinical pictures

  9. 99mTc-HMPAO Brain SPECT in Patients with Post-Traumatic Organic Mental Disorder

    International Nuclear Information System (INIS)

    Lee, Kang Wook; Lee, Dong Jin; Shong, Min Ho; Kang, Min Hee; Ghi, Ick Sung; Shin, Young Tai; Ro, Heung Kyu

    1994-01-01

    It is well known that 99m Tc-HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of 99m Tc-HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD). We included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of 99m Tc-HMPAO SPECT with those of MRI, EEG and MINI mental status examination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on 99m Tc-HMPAO SPECT. 2) Most frequent lesion on brain 99m Tc-HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain 99m Tc-HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain 99m Tc-HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain 99m Tc-HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that 99m Tc-HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.

  10. Brain SPECT in children; Explorations scintigraphiques en neurologie et psychiatrie de l`enfant

    Energy Technology Data Exchange (ETDEWEB)

    Guyot, M. [Hopital Pellegrin, 33 - Bordeaux (France); Baulieu, J.L. [Hopital Bretonneau, 37 - Tours (France)

    1996-12-31

    Brain SPECT in child involves specific trends regarding the patient cooperation, irradiation, resolution and especially interpretation because of the rapid scintigraphic modifications related to the brain maturation. In a general nuclear medicine department, child brain SPECT represents about 2 % of the activity. The choice indications are the perfusion children: thallium and MIBI in brain tumours, pharmacological and neuropsychological interventions. In the future, brain dedicated detectors and new radiopharmaceuticals will promote the development of brain SPECT in children. (author). 18 refs.

  11. Predictive value of brain perfusion SPECT for rTMS response in pharmacoresistant depression

    Energy Technology Data Exchange (ETDEWEB)

    Richieri, Raphaelle; Lancon, Christophe [Sainte-Marguerite University Hospital, Department of Psychiatry, Marseille (France); La Timone University, EA 3279 - Self-perceived Health Assessment Research Unit, School of Medicine, Marseille (France); Boyer, Laurent [La Timone University, EA 3279 - Self-perceived Health Assessment Research Unit, School of Medicine, Marseille (France); La Timone University Hospital, Assistance Publique - Hopitaux de Marseille, Department of Public Health, Marseille (France); Farisse, Jean [Sainte-Marguerite University Hospital, Department of Psychiatry, Marseille (France); Colavolpe, Cecile; Mundler, Olivier [La Timone University Hospital, Assistance Publique - Hopitaux de Marseille, Service Central de Biophysique et Medecine Nucleaire, Marseille (France); Universite de la Mediterranee, Centre Europeen de Recherche en Imagerie Medicale (CERIMED), Marseille (France); Guedj, Eric [La Timone University Hospital, Assistance Publique - Hopitaux de Marseille, Service Central de Biophysique et Medecine Nucleaire, Marseille (France); Universite de la Mediterranee, Centre Europeen de Recherche en Imagerie Medicale (CERIMED), Marseille (France); Hopital de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 5 (France)

    2011-09-15

    The aim of this study was to determine the predictive value of whole-brain voxel-based regional cerebral blood flow (rCBF) for repetitive transcranial magnetic stimulation (rTMS) response in patients with pharmacoresistant depression. Thirty-three right-handed patients who met DSM-IV criteria for major depressive disorder (unipolar or bipolar depression) were included before rTMS. rTMS response was defined as at least 50% reduction in the baseline Beck Depression Inventory scores. The predictive value of {sup 99m}Tc-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) for rTMS response was studied before treatment by comparing rTMS responders to non-responders at voxel level using Statistical Parametric Mapping (SPM) (p < 0.001, uncorrected). Of the patients, 18 (54.5%) were responders to rTMS and 15 were non-responders (45.5%). There were no statistically significant differences in demographic and clinical characteristics (p > 0.10). In comparison to responders, non-responders showed significant hypoperfusions (p < 0.001, uncorrected) in the left medial and bilateral superior frontal cortices (BA10), the left uncus/parahippocampal cortex (BA20/BA35) and the right thalamus. The area under the curve for the combination of SPECT clusters to predict rTMS response was 0.89 (p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the combination of clusters were: 94, 73, 81 and 92%, respectively. This study shows that, in pharmacoresistant depression, pretreatment rCBF of specific brain regions is a strong predictor for response to rTMS in patients with homogeneous demographic/clinical features. (orig.)

  12. The usefulness of CBF brain SPECT in forensic medicine: the civil law codes cases. A description of four cases

    International Nuclear Information System (INIS)

    Piskunowicz, M.; Lass, P.; Bandurski, T.; Krzyzanowski, M.

    2003-01-01

    The aim of this report was to assess the usefulness of cerebral blood flow (CBF) scanning utilising the SPECT technique in forensic medicine cases in the area of civil law cases. CBF SPECT scanning was performed in four patients utilising 99m Tc-ECD and a triple-head gammacamera. In the analysis both the asymmetry index and cerebellar normalisation were applied. Reference values were obtained by studying 30 healthy volunteers. In those cases CBF SPECT scanning played an important role in forensic argument. It influenced the sentence and the amount of financial compensation. CBF SPECT scanning may provide valuable information in forensic medicine argument in civil law cases, but only when taken together with psychometric tests and other neuroimaging methods (CT, MRI). The value of CBF SPECT scanning alone may be limited in judicial proceedings. (author)

  13. The cerebral SPECT in the psychiatric dysfunctions in severe atopic dermatitis; El SPECT cerebral en los trastornos psiquiatricos de la dermatitis atopica severa

    Energy Technology Data Exchange (ETDEWEB)

    Ferrando, Rodolfo; Lago, Graciela [Centro de Medicina Nuclear del Hospital de Clinicas, Montevideo (Uruguay); Vignale, Raul [Departamento de Dermatologia del Hospital de Clinicas, Montevideo (Uruguay); Fabius, Bettina; Lyford Pike, Alexander [Consultorio Psiquiatrico Dr. Lyford Pike, Facultad de Medicina. Universidad de la Republica, Montevideo (Uruguay)

    2007-01-15

    Introduction: Severe atopic dermatitis (AD) usually has a psychiatric component that may influence the course of the cutaneous symptoms. Functional neuroimaging could evidence brain dysfunctions in this kind of patients. Objective: Evaluate the presence and characteristics of cerebral perfusion changes in severe AD patients using SPECT. Materials and methods: 11 severe AD patients were subjected to clinical psychiatric evaluation and 99mTc-ECD SPECT. Results: 90.3% of the patients presented a generalized anxiety disorder, 63.6% an obsessive compulsive disorder and 63.6% a depression. The 11 patients presented perfusion changes that prevailed at the prefrontal cortex. The alterations were concordant with the patterns described in those patients in which anxiety disorders and depression coexist. Conclusions: We demonstrate the frequent presence of perfusion changes in severe AD patients with psychiatric symptoms (au)

  14. Study of a simple method and software for quantitative measurement of rCBF with 99Tcm-ECD SPECT brain imaging

    International Nuclear Information System (INIS)

    Shu Boxue; Lai Huaan; Li Zhigang; Shi An

    2000-01-01

    Objective: To create a simple, practical, stable and easy to popularize rCBF quantitative measurement method. Methods: 1) Creating attenuation correction factor (δ) of brain; 2) Proving a factor (ρ) between planar image and tomographic image; 3) Creating SPECT system to determine the dead time and to correct linear regression equation; 4) Measuring lung retardation rate (R 1 ); 5) Improving Nickel model and editing the software; 6) Clinical application; The modified method was performed in 24 subjects, including 15 healthy controls, 8 patients with epilepsy in intermission and 1 patient with brain infarction. Results: δ = 1.7, ρ = 2.23, R 1 -1 ·100 g -1 . The rCBFs of foci in 8 cases of epilepsy were obviously decreased, (22.5∼34.2) mL·min -1 ·100 g -1 , and in the case of brain infarction was only 7.2 mL·min -1 ·100 g -1 . Conclusions: The method is reliable, practical and easy to perform with good quality control. Overall, it is of high clinical value

  15. High-resolution brain SPECT imaging in attention deficit hyperactivity disorder children without comorbidity: quantitative analysis using statistical parametric mapping(SPM)

    International Nuclear Information System (INIS)

    Lee, Myoung Hoon; Yoon, Seok Nam; Oh, Eun Young; Chung, Young Ki; Hwang, Isaac; Lee, Jae Sung

    2002-01-01

    We examined the abnormalities of regional cerebral blood flow(rCBF) in children with attention deficit hyperactivity disorder(ADHD) without comorbidity using statistical parametric mapping(SPM) method. We used the patients with not compatible to DSM-IV diagnostic criteria of ADHD and normal rCBF pattern in visual analysis as normal control children. Tc-99m ECD brain SPECT was performed on 75 patients (M:F=64:11, 10.0±2.5y) with the DSM-IV diagnostic criteria of ADHD and 13 normal control children (M:F=9:4, 10.3±4.1y). Using SPM method, we compared patient group's SPECT images with those of 13 control subjects and measured the extent of the area with significant hypoperfusion(p<0.01) in predefined 34 cerebral regions. Only on area of left temporal lobe showed significant hypoperfusion in ADHD patients without comorbidity (n=75) compared with control subjects(n=13). (n=75, p<0.01, extent threshold=16). rCBF of left temporal area was decreased in ADHD group without comorbidity, such as tic, compared with control group

  16. High-resolution brain SPECT imaging in attention deficit hyperactivity disorder children without comorbidity: quantitative analysis using statistical parametric mapping(SPM)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myoung Hoon; Yoon, Seok Nam; Oh, Eun Young [Ajou University School of Medicine, Suwon (Korea, Republic of); Chung, Young Ki; Hwang, Isaac; Lee, Jae Sung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2002-07-01

    We examined the abnormalities of regional cerebral blood flow(rCBF) in children with attention deficit hyperactivity disorder(ADHD) without comorbidity using statistical parametric mapping(SPM) method. We used the patients with not compatible to DSM-IV diagnostic criteria of ADHD and normal rCBF pattern in visual analysis as normal control children. Tc-99m ECD brain SPECT was performed on 75 patients (M:F=64:11, 10.0{+-}2.5y) with the DSM-IV diagnostic criteria of ADHD and 13 normal control children (M:F=9:4, 10.3{+-}4.1y). Using SPM method, we compared patient group's SPECT images with those of 13 control subjects and measured the extent of the area with significant hypoperfusion(p<0.01) in predefined 34 cerebral regions. Only on area of left temporal lobe showed significant hypoperfusion in ADHD patients without comorbidity (n=75) compared with control subjects(n=13). (n=75, p<0.01, extent threshold=16). rCBF of left temporal area was decreased in ADHD group without comorbidity, such as tic, compared with control group.

  17. Brain SPECT in childhood; Temp cerebrale chez l'enfant

    Energy Technology Data Exchange (ETDEWEB)

    Tranquart, F; Saliba, E; Prunier, C; Baulieu, F; Besnard, J C; Guilloteau, D; Baulieu, J L [Hopital Bretonneau, Service de Medecine Nucleaire, Unite Inserm 316, 37 - Tours (France)

    2001-04-01

    The modalities and the indications of perfusion and neurotransmission SPECT in childhood are presented. The perfusion as well as neurotransmission tracers have not yet authorization for use in children; they have to be used by prescription of magistral preparation or in research protocols. The radioprotection rules have to be strictly respected. The most frequent indication of perfusion SPECT is pharmacologically resistant epilepsy; the ictal SPECT before surgery allows the localization of the epileptogenic focus. Other indications are relevant in the prognosis of neonatal anoxia and encephalitis. In psychiatric disorders, especially in autism, the interest is the physiopathological approach of the brain dysfunctions. The neurotransmission SPECT is emerging as a consequence of the development of new radiotracer, as the dopaminergic system ligands. The decrease of the dopamine D2 receptors in the striatum can be imaged and quantified in the neonate. The lesions of dopamine system seem to be a consequence of the neonatal hypoxia-ischemia and it is predictive of motor sequelae. Brain SPECT should become a routine examination in child neurologic and psychiatric disorders. (authors)

  18. Synthesis and formulation of {sup 99m} Tc-ECD radiopharmaceutical; Sintesis y formulacion del radiofarmaco {sup 99m} Tc-ECD

    Energy Technology Data Exchange (ETDEWEB)

    Ocampo G, B E

    1998-06-01

    Nuclear medicine is a medical specialty which uses radioactive compounds (radionuclides) for diagnostic and therapeutic purposes. {sup 99m} Tc is the more common radionuclide used in many studies in nuclear medicine because its advantages: it has a photopeak of 140 KeV and a half-life of 6 hours; it can be eluted from a Molybdenum 99 generator, so radiopharmaceuticals can be prepared on site. Ethyl cysteine dimer (ECD) labelled with reduced Technetium 99m has been purposed recently as a promising radiopharmaceutical for brain perfusion imaging {sup 99m} Tc-ECD is a lipophilic neutral complex which cross the brain blood barrier and show high brain uptake. The objective of this work was synthesize and to design a freeze dried formulation for the instant preparation of {sup 99m} Tc-ECD complex useful for brain perfusion imaging. We obtained a freeze dried stable formulation for the preparation of {sup 99m} Tc-ECD kit with a radiochemical purity higher than 90 %, which fulfills with the quality control of radiopharmaceuticals. Furthermore, we developed analytic techniques for the determination of the different chemical compounds into the lyophilized kit. (Author).

  19. Different uptake of {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO in the same brains: analysis by statistical parametric mapping

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, I.Y. [Dept. of Nuclear Medicine, Inha University College of Medicine, Incheon (Korea); Lee, J.S.; Lee, D.S. [Dept. of Nuclear Medicine, Seoul National University College of Medicine, Seoul (Korea); Rha, J.H.; Lee, I.K.; Ha, C.K. [Dept. of Neurology, Inha University College of Medicine, Incheon (Korea)

    2001-02-01

    The purpose of this study was to investigate the differences between technetium-99m ethyl cysteinate dimer ({sup 99m}Tc-ECD) and technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) uptake in the same brains by means of statistical parametric mapping (SPM) analysis. We examined 20 patients (9 male, 11 female, mean age 62{+-}12 years) using {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO single-photon emission tomography (SPET) and magnetic resonance imaging (MRI) of the brain less than 7 days after onset of stroke. MRI showed no cortical infarctions. Infarctions in the pons (6 patients) and medulla (1), ischaemic periventricular white matter lesions (13) and lacunar infarction (7) were found on MRI. Split-dose and sequential SPET techniques were used for {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO brain SPET, without repositioning of the patient. All of the SPET images were spatially transformed to standard space, smoothed and globally normalized. The differences between the {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO SPET images were statistically analysed using statistical parametric mapping (SPM) 96 software. The difference between two groups was considered significant at a threshold of uncorrected P values less than 0.01. Visual analysis showed no hypoperfused areas on either {sup 99m}Tc-ECD or {sup 99m}Tc-HMPAO SPET images. SPM analysis revealed significantly different uptake of {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO in the same brains. On the {sup 99m}Tc-ECD SPET images, relatively higher uptake was observed in the frontal, parietal and occipital lobes, in the left superior temporal lobe and in the superior region of the cerebellum. On the {sup 99m}Tc-HMPAO SPET images, relatively higher uptake was observed in the medial temporal lobes, thalami, periventricular white matter and brain stem. These differences in uptake of the two tracers in the same brains on SPM analysis suggest that interpretation of cerebral perfusion is possible using SPET with {sup 99m}Tc-ECD and

  20. Serial cerebral hemodynamic change after extracranial-intracranial (EC-IC) bypass surgery: evaluated by acetazolamide stress brain perfusion SPECT(acz-SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Im, Ki Chun; Kim, Euy Nyong; Mun, Dae Hyeog [Asan Medical Center, Seoul (Korea, Republic of)

    2005-07-01

    We evaluated serial cerebral hemodynamic changes after EC-IC bypass surgery in symptomatic pts with atherosclerotic occlusion of internal carotid (lCA) or mid-cerebral artery (MCA) using Acz-SPECT. 25 symptomatic pts (M/F 19/6, 53{+-}10 y) with ICA and MCA occlusion (16 uni - and 9 bilateral) prospectively underwent Acz-SPECT using Tc-99m ECD before and 1 week after EC-IC bypass surgery. Of these, 16 underwent additional f/u Acz-SPECT 5 mo later. Cerebral perfusion and perfusion reserve of MCA territory were evaluated visually and SPECT findings were classified into 4 groups: N/N; R/N; N/R; and R/R (perfusion/perfusion reserve: N = normal, R = reduced). For semiquantitative analysis, all SPECT images were normalized to MNI template and mean counts of MCA territory and cerebellum were obtained by AAL. Cerebral perfusion index (PI =C{sub region}/C{sub cere}) and perfusion reserve index (RI = (PI{sub Acz} - PI{sub basal}) /Pl{sub basal}) were calculated. Preop SPECT findings of ipsilateral MCA in 25 pts were R/N (4%), N/R (12%), and R/R (84% ). Early postop SPECT showed improvement of perfusion (26%) and/or reserve (68%) in ipsilateral MCA. Of 16 pts with 5mo f/u SPECT, 6 (38%) showed further improvement of perfusion or reserve. However, 4 (25%) showed aggravation of perfusion and one of these underwent revision surgery. Preop PI (1.1{+-}0.1) and RI (0.11{+-}0.07) of ipsilateral MCA were significantly lower than those of contralateral hemispheres (p<0.05). After surgery, PIs of bilateral MCA did not change at early postop period but improved in ipsilateral MCA at 5mo. Rls of ipsilateral MCA increased significantly (68%) at early postop period (P<0.001) and then did not changed. Cerebral perfusion and perfusion reserve changed with different manner during 5 mo after bypass surgery and perfusion reserve changed more dramatically than perfusion. Acz-SPECT is a feasible method for evaluating cerebral hemodynamic change after EC-IC bypass surgery.

  1. Detection of tumor recurrence using technetium99m-tetrofosmin brain SPECT in patients with previously irradiated brain tumors

    International Nuclear Information System (INIS)

    Llamas A; Reyes A; Uribe, L F; Martinez T

    2004-01-01

    Objective: to assess the clinical utility of brain SPECT with Tc-99m Tetrofosmin to differentiate between tumor recurrence and radionecrosis in patients with primary brain tumors previously treated with external beam radiotherapy. Materials and methods: thirteen patients with clinical or radiological suspicion of tumor recurrence were studied with brain SPECT using 20-mCi of Tc-99m Tetrofosmin. Obtained images were interpreted by consensus between two experienced observers and subsequently classified as positive or negative for tumor viability. Results were compared to those of conventional diagnostic imaging techniques. Diagnostic test values and 95% confidence intervals were quantified. Results: SPECT results included 7 true-positives, 5 true-negatives and 1 false negative result. Conclusions: Tc-99m Tetrofosmin brain SPECT night be a useful alternative to diagnose recurrent brain tumors, especially with non-conclusive clinical and radiological findings

  2. Perfusion MRI before and after acetazolamide administration for assessment of cerebrovascular reserve capacity in patients with symptomatic internal carotid artery (ICA) occlusion: comparison with {sup 99m}Tc-ECD SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Ma, J.; Holtmannspoetter, M.; Brueckmann, H. [University of Munich, Department of Neuroradiology, Klinikum Grosshadern, Munich (Germany); Mehrkens, J.H.; Schmid-Elsaesser, R. [University of Munich, Department of Neurosurgery, Klinikum Grosshadern, Munich (Germany); Linke, R. [University of Munich, Department of Nuclear Medicine, Klinikum Grosshadern, Munich (Germany); Steiger, H.J. [Heinrich-Heine University, Department of Neurosurgery, Duesseldorf (Germany); Bruening, R. [University of Munich, Department of Neuroradiology, Klinikum Grosshadern, Munich (Germany); Asklepios Klinik Barmbek, Department of Radiology, Hamburg (Germany)

    2007-04-15

    Impaired cerebral vascular reserve (CVR) in patients with symptomatic internal carotid artery (ICA) occlusion is regarded as a possible indication for performing extra-/intracranial (EC/IC) bypass surgery. As perfusion MR imaging (MRI) can demonstrate cerebral haemodynamics at capillary level, our hypothesis was that perfusion MRI could be used in these patients for the evaluation of CVR following acetazolamide challenge in a similar way to single photon emission CT (SPECT) and might provide additional information. Enrolled in the study were 12 patients (mean age 61.3 years; 11 male, 1 female) with symptomatic unilateral ICA occlusion proven by angiography. Both perfusion MRI and 99m-technetium-ethyl-cysteinate dimer ({sup 99m}Tc-ECD) SPECT were performed before and after injection of acetazolamide (Diamox,1000 mg i.v.). CVR parameters including regional cerebral blood flow (rCBF) and volume (rCBV), and mean transit times (MTT) were measured by perfusion MRI. The patients with impaired CVR proven by SPECT (n = 9) had a negative mean rCBF increment (-46.52%), negative rCBV increment (-13.5%) and delayed MTT (mean +2.98 s), respectively, on the occluded side (Student's t-test all P < 0.05). The patients with sufficient CVR (n = 3) had a mean rCBF increment of 1.2%, a decrement of rCBV of 10.46%, and a mean MTT shortening of 0.27 s following the acetazolamide injection. Perfusion MRI before and after acetazolamide administration compares favourably with {sup 99m}Tc-ECD SPECT for the detection of impaired CVR. The impact that perfusion MRI studies (before and after acetazolamide administration) might have on the treatment decision in patients with ICA occlusion has yet to be determined by a prospective study. (orig.)

  3. Increased thalamic perfusion as a characteristic finding with brain SPECT in patients with obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    Mut, F.; Beretta, M.; Nunez, M.; Zamora, R.

    2002-01-01

    Aim: Obsessive-compulsive disorder (OCD) is a relatively frequent psychiatric condition affecting most commonly young patients. Correct diagnosis and follow-up is essential in order to apply effective therapy. However, some common characteristics have been reported with brain SPECT for OCD and depression, with several brain structures belonging to the limbic system involved in both conditions: frontal cortex, cingulate gyrus, caudate nucleus, thalamus and hippocampus, among others. The aim of this study was to investigate quantitative findings of brain SPECT in OCD compared to other psychiatric conditions such as depression and dementia. Material and Methods: We studied 33 patients, 22 women, ages 39.3±10.9 years. Fifteen patients had clinical diagnosis of OCD (8 women, 21∫8 ys.), 13 of bipolar or unipolar depression (11 women, 28±15 ys.) and 5 of senile dementia (3 women, 69±10 ys). All were injected in the basal state with a standard dose of 925 MBq (25 mCi) of 99mTc-ECD. Brain SPECT was performed with a dual-head camera equipped with a high-resolution collimator using 360 0 rotation, 120 angular steps and 15 sec/step in a 64x64 matrix with 1.5 x magnification. Reconstruction of transaxial tomograms was performed using filtered backprojection with a Metz filter. Attenuation correction was applied according to Chang's method. In order to calculate uptake ratios, regions of interest (ROIs) were placed on the right and left frontal cortex (RFron, LFron), anterior or posterior cingulate gyrus (Cing) according to the site of highest uptake recorded, both caudate nucleus (RCau, LCau), thalamus (Thal) and cerebellum (cer). Results: The findings are presented. Conclusion: Cingulate gyrus hyperactivity has been reported in patients with OCD and confirmed in our series, however not significantly different from that observed in depressed patients. The only distinct finding was higher thalamic activity in OCD patients compared to the other groups, suggesting that this

  4. The findings of Tc-99m ECD brain perfusion SPECT in the patients with left anterior thalamic infarction

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Y. A.; Kim, S. H.; Sohn, H. S.; Jeong, S. G. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    The thalamus has multiple connections with areas of the cerebral cortex involved in arousal and cognition. Thalamic damage has been reported to be associated with variable neuropsychological dysfunctions and dementia. This study evaluates the changes of regional cerebral blood flow (rCBF) by using SPM analysis of brain perfusion SPECT and examining the neuropsychological abnormalities of 4 patients with anterior thalamic infarctions. Four patients with left anterior thalamic infarctions and eleven normal controls were evaluated. K-MMSE and the Seoul Neuropsychological Screening Battery were performed within 2 days after stroke. The normalized SPECT data of 4 patients were compared to those of 11 controls for the detection of areas with decreased rCBF by SPM analysis. All 4 patients showed anterograde amnesia in their verbal memory, which was not improved by recognition. Dysexecutive features were occasionally present, such as decreased word fluency and impaired Stroop test results. SPM analysis revealed decreased rCBF in the left supra marginal gyrus, the superior temporal gyrus, the middle and inferior frontal gyrus, the medial dorsal and anterior nucleus of the left thalamus. The changes of rCBF in patients with left anterior thalamic infarctions may be due to the remote suppression on metabolism by the interruption of the cortico-subcortical circuit, which connects the anterior thalamic nucleus and various cortical areas. The executive dysfunction and dysnomia may be caused by the left dorsolateral frontal dysfunction of the thalamo-cortical circuit. Anterograde amnesia with storage deficit may be caused by the disruption of mamillothalamic tract.

  5. The findings of Tc-99m ECD brain perfusion SPECT in the patients with left anterior thalamic infarction

    International Nuclear Information System (INIS)

    Jeong, Y. A.; Kim, S. H.; Sohn, H. S.; Jeong, S. G.

    2005-01-01

    The thalamus has multiple connections with areas of the cerebral cortex involved in arousal and cognition. Thalamic damage has been reported to be associated with variable neuropsychological dysfunctions and dementia. This study evaluates the changes of regional cerebral blood flow (rCBF) by using SPM analysis of brain perfusion SPECT and examining the neuropsychological abnormalities of 4 patients with anterior thalamic infarctions. Four patients with left anterior thalamic infarctions and eleven normal controls were evaluated. K-MMSE and the Seoul Neuropsychological Screening Battery were performed within 2 days after stroke. The normalized SPECT data of 4 patients were compared to those of 11 controls for the detection of areas with decreased rCBF by SPM analysis. All 4 patients showed anterograde amnesia in their verbal memory, which was not improved by recognition. Dysexecutive features were occasionally present, such as decreased word fluency and impaired Stroop test results. SPM analysis revealed decreased rCBF in the left supra marginal gyrus, the superior temporal gyrus, the middle and inferior frontal gyrus, the medial dorsal and anterior nucleus of the left thalamus. The changes of rCBF in patients with left anterior thalamic infarctions may be due to the remote suppression on metabolism by the interruption of the cortico-subcortical circuit, which connects the anterior thalamic nucleus and various cortical areas. The executive dysfunction and dysnomia may be caused by the left dorsolateral frontal dysfunction of the thalamo-cortical circuit. Anterograde amnesia with storage deficit may be caused by the disruption of mamillothalamic tract

  6. Cerebral perfusion changes in traumatic diffuse brain injury. IMP SPECT studies

    International Nuclear Information System (INIS)

    Ito, Hiroshi; Kawashima, Ryuta; Fukuda, Hiroshi; Ishii, Kiyoshi; Onuma, Takehide.

    1997-01-01

    Diffuse brain injury (DBI) is characterized by axonal degeneration and neuronal damage which cause diffuse brain atrophy. We have investigated the time course of abnormalities in cerebral perfusion distribution in cases of DBI by using Iodine-123-IMP SPECT, and the relationship to the appearance of diffuse brain atrophy. SPECT scans were performed on eight patients with diffuse brain injury due to closed cranial trauma in acute and chronic stages. All patients showed abnormalities in cerebral perfusion with decreases in perfusion, even in non-depicted regions on MRI, and the affected areas varied throughout the period of observation. Diffuse brain atrophy appeared in all patients. In some patients, diffuse brain atrophy was observed at or just after the time when the maximum number of lesions on SPECT were seen. The abnormalities in cerebral perfusion in cases of DBI might therefore be related to axonal degeneration and neuronal damage which causes diffuse brain atrophy. (author)

  7. Anything wrong with brain SPECT? Not really

    International Nuclear Information System (INIS)

    Pavel, D.G.; Davis, G.; Craita, I.; Liu, P.

    2002-01-01

    Aim: Despite increased evidence about the usefulness of Brain SPECT in Neuro-Psychiatry, it continues to represent only a low percentage of Nuclear Medicine procedures. The prevalent perception is that it is an inadequate diagnostic tool, and/or is not changing patient management. There are objective reasons for this, as the lack of awareness by Psychiatrists about the value of SPECT, but most important is the frequently poor quality of images provided. This can be due to inadequate gamma cameras but is mostly due to poor quality software. Materials and Methods: High resolution brain SPECT via triple head gamma camera, super-high resolution fan beam collimator and Tc-HMPAO. A combination of commercial software and local optimization was used for the final displays as well as for realignment of sequential brain SPECT studies. Results: We found out that 6 basic software improvements are needed to generate a final display where features can be clearly distinguished and which can be also easily assimilated by the referring physician. 1) Color scales: simple and efficient tools needed to generate user friendly and semiquantitative color shades as needed. Unfortunately various color scales may be needed depending on printer and paper used. 2): 3 D displays allowing, multiple standardized thresholdings, any number of groupings, differential coloring (with functional meaning) and adequate labeling. Should be completely or at least mostly automatic. 3) Automatic realignment of sequential studies: such programs exist in various forms (free WWW versions, proprietary Beta versions, etc.) but are still not supplied by the gamma camera vendors for general use. Should provide SPECT -SPECT and SPECT MRI options. 4) Localization of structures and slices a) Triangulation of structures and b) Identification of section location. 5) Graphics improvement for generating any number of optimized summary displays to accompany reports. 6) Availability of voxel based quantification software

  8. The cerebral SPECT in the psychiatric dysfunctions in severe atopic dermatitis

    International Nuclear Information System (INIS)

    Ferrando, Rodolfo; Lago, Graciela; Vignale, Raul; Fabius, Bettina; Lyford Pike, Alexander

    2007-01-01

    Introduction: Severe atopic dermatitis (AD) usually has a psychiatric component that may influence the course of the cutaneous symptoms. Functional neuroimaging could evidence brain dysfunctions in this kind of patients. Objective: Evaluate the presence and characteristics of cerebral perfusion changes in severe AD patients using SPECT. Materials and methods: 11 severe AD patients were subjected to clinical psychiatric evaluation and 99mTc-ECD SPECT. Results: 90.3% of the patients presented a generalized anxiety disorder, 63.6% an obsessive compulsive disorder and 63.6% a depression. The 11 patients presented perfusion changes that prevailed at the prefrontal cortex. The alterations were concordant with the patterns described in those patients in which anxiety disorders and depression coexist. Conclusions: We demonstrate the frequent presence of perfusion changes in severe AD patients with psychiatric symptoms (au)

  9. Utility of 99mTc-GHA Brain SPECT in the grading of brain tumors

    International Nuclear Information System (INIS)

    Bhattacharya, Anish; Mittal, B.R.; Kumar, Ashok

    2004-01-01

    Full text: Brain tumors are of diverse histological types, the most common being derived from glial tissue. The clinical management and prognosis of brain tumor patients is dependent on accurate neuro-pathologic diagnosis and grading. Radiological imaging is not always a good modality for assessing the exact nature and grade of a malignant tumor. Magnetic resonance imaging (MRI) has a very high soft tissue resolution and is helpful in classifying the grade of tumor. Radionuclide imaging techniques that can reveal metabolic activity within tumor cells are very helpful in predicting the degree of malignancy. Usefulness of Tl-201 SPECT and FDG PET studies have been widely reported to evaluate malignant lesions by measuring increased regional glucose metabolism and amino acid uptake. 99mTc-GHA (Glucoheptonate), more or less analogous to 18F-FDG, may show increased glucose metabolism and help in grading tumors. This study was carried out to determine the utility of 99mTc-GHA SPECT for grading cerebral gliomas. Nineteen patients (12M, 7F) aged 22 to 51 years (36.1 ± 8.3) diagnosed clinically and radiologically to have a brain tumor were evaluated with 99mTc-GHA brain SPECT. All the patients had undergone CT/ MRI examination prior to the brain SPECT study. No patient had undergone surgery, radiation therapy or chemotherapy before the imaging studies. Brain SPECT was performed twice, i.e 40 min and 3 hours after intravenous administration of 20 mCi of Tc99m-GHA under a dual head SPECT gamma camera (Ecam, Siemens), with a low energy high-resolution collimator. A total of 128 frames of 30 seconds each, 64 per detector, were acquired in 128 x 128 matrix, with 360-degree rotation in step and shoot mode. Reconstruction of the SPECT data was done using standard software. Abnormal concentration of tracer at the tumor site was compared to normal uptake on the contralateral side, and ratios obtained for early (40 min) and delayed (3 hours) uptake of tracer. Retention ratio (RR), a

  10. Brain SPECT with Tl-201 DDC

    International Nuclear Information System (INIS)

    Bruine, J.F. de.

    1988-01-01

    The development, animal and human experiments and the first clinical results of a new blood flow tracer thallium-201 diethyldithiocarbamate (Tl-201 DDC) are discussed for functional brain imaging with single-photon emission computed tomography (SPECT). 325 refs.; 43 figs.; 22 tabs

  11. The role of Tc-99m HMPAO brain perfusion SPECT in the psychiatric disability evaluation of patients with chronic traumatic brain injury

    Energy Technology Data Exchange (ETDEWEB)

    So, Young [Nuclear Medicne, Seoul National Univ., Seoul (Korea, Republic of); Lee, Kang Wook; Lee, Sun Woo; Ghi, Lek Sung; Song, Chang June [College of Medicine, Chungnam National Univ., Taejon (Korea, Republic of)

    2002-08-01

    We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Sixty-nine patients (M:F=58:11, age 39 {+-} 14 years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were performed 6 {approx} 61 months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SEPCT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

  12. The role of Tc-99m HMPAO brain perfusion SPECT in the psychiatric disability evaluation of patients with chronic traumatic brain injury

    International Nuclear Information System (INIS)

    So, Young; Lee, Kang Wook; Lee, Sun Woo; Ghi, Lek Sung; Song, Chang June

    2002-01-01

    We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Sixty-nine patients (M:F=58:11, age 39 ± 14 years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were performed 6 ∼ 61 months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SEPCT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI

  13. Brain SPECT in childhood; Temp cerebrale chez l'enfant

    Energy Technology Data Exchange (ETDEWEB)

    Tranquart, F.; Saliba, E.; Prunier, C.; Baulieu, F.; Besnard, J.C.; Guilloteau, D.; Baulieu, J.L. [Hopital Bretonneau, Service de Medecine Nucleaire, Unite Inserm 316, 37 - Tours (France)

    2001-04-01

    The modalities and the indications of perfusion and neurotransmission SPECT in childhood are presented. The perfusion as well as neurotransmission tracers have not yet authorization for use in children; they have to be used by prescription of magistral preparation or in research protocols. The radioprotection rules have to be strictly respected. The most frequent indication of perfusion SPECT is pharmacologically resistant epilepsy; the ictal SPECT before surgery allows the localization of the epileptogenic focus. Other indications are relevant in the prognosis of neonatal anoxia and encephalitis. In psychiatric disorders, especially in autism, the interest is the physiopathological approach of the brain dysfunctions. The neurotransmission SPECT is emerging as a consequence of the development of new radiotracer, as the dopaminergic system ligands. The decrease of the dopamine D2 receptors in the striatum can be imaged and quantified in the neonate. The lesions of dopamine system seem to be a consequence of the neonatal hypoxia-ischemia and it is predictive of motor sequelae. Brain SPECT should become a routine examination in child neurologic and psychiatric disorders. (authors)

  14. Assessment of Cerebrovascular Reserve before and after STA-MCA Bypass Surgery by SPECT and SPM Analysis

    International Nuclear Information System (INIS)

    O, Joo-Hyun; Jang, Kyung-Sool; Yoo, Ie-Ryung

    2007-01-01

    The purpose of this study was to objectively assess the efficacy of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using Technetium (Tc)-99m-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients who underwent STA-MCA bypass surgery. Brain perfusion SPECT images obtained at baseline and after the administration of acetazolamide were reconstructed using statistical parametric mapping in 23 patients, both before and after STA-MCA bypass surgery. The clinical outcomes of the surgery were also recorded and compared with the hemodynamic changes. A voxel with an uncorrected p-value of less than 0.001 was considered to be statistically significant. SPECT images of the territory supplied by the bypass graft showed an increase in both cerebrovascular flow and reserve at baseline, and the increase was significantly higher following the administration of acetazolamide. All patients showed improvement of clinical symptoms and increased blood flow to the left temporal, parietal, and frontal cortices as well as the thalamus. Brain SPECT effectively and objectively demonstrated the improved outcomes of STA-MCA bypass surgery, and thus may be used in postoperative analyses

  15. Diagnosis of functional loss using with PET or SPECT

    International Nuclear Information System (INIS)

    Maeda, Tetsuya; Nagata, Ken

    2009-01-01

    Described are outlines of positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging, and their application to diagnosis of brain diseases accompanying functional loss. PET imaging by annihilation photons is useful to see the brain metabolic activity with use of compounds labeled by positron emitters like 11 C, 15 O, 13 N and 18 F. Cerebral blood flow (CBF), CB volume and oxygen extraction fraction correlate well with the cerebral activity and can be measured by PET with C 15 O 2 , H 2 15 O or 15 O 2 . 18 F-glucose is usable to measure the cerebral metabolic rate of glucose. SPECT imaging by γ-rays of 133 Xe, 123 I-iofetamine (IMP), 99m Tc-hexamethyl propylene amine oxime (HMPAO) and 99m Tc-ethyl cysteinate dimer (ECD) is useful also to measure CBF in different mechanisms from agent to agent, which often reflect the pathophysiology of the lesion in problem. These imaging techniques are applied to the diagnosis of regional functional loss in ischemic brain diseases like infarction, dementia (Alzheimer and multiple vascular) and Parkinsonism, of which characters and details of actual images are presented herein. Authors say that although the imaging diagnosis for brain functional loss has progressed, the integration of neurological finding, clinical process and simple morphological brain image as well is still important in the routine examination. (K.T.)

  16. Synthesis and formulation of 99m Tc-ECD radiopharmaceutical

    International Nuclear Information System (INIS)

    Ocampo G, B.E.

    1998-01-01

    Nuclear medicine is a medical specialty which uses radioactive compounds (radionuclides) for diagnostic and therapeutic purposes. 99m Tc is the more common radionuclide used in many studies in nuclear medicine because its advantages: it has a photopeak of 140 KeV and a half-life of 6 hours; it can be eluted from a Molybdenum 99 generator, so radiopharmaceuticals can be prepared on site. Ethyl cysteine dimer (ECD) labelled with reduced Technetium 99m has been purposed recently as a promising radiopharmaceutical for brain perfusion imaging 99m Tc-ECD is a lipophilic neutral complex which cross the brain blood barrier and show high brain uptake. The objective of this work was synthesize and to design a freeze dried formulation for the instant preparation of 99m Tc-ECD complex useful for brain perfusion imaging. We obtained a freeze dried stable formulation for the preparation of 99m Tc-ECD kit with a radiochemical purity higher than 90 %, which fulfills with the quality control of radiopharmaceuticals. Furthermore, we developed analytic techniques for the determination of the different chemical compounds into the lyophilized kit. (Author)

  17. [Time consumption and quality of an automated fusion tool for SPECT and MRI images of the brain].

    Science.gov (United States)

    Fiedler, E; Platsch, G; Schwarz, A; Schmiedehausen, K; Tomandl, B; Huk, W; Rupprecht, Th; Rahn, N; Kuwert, T

    2003-10-01

    Although the fusion of images from different modalities may improve diagnostic accuracy, it is rarely used in clinical routine work due to logistic problems. Therefore we evaluated performance and time needed for fusing MRI and SPECT images using a semiautomated dedicated software. PATIENTS, MATERIAL AND METHOD: In 32 patients regional cerebral blood flow was measured using (99m)Tc ethylcystein dimer (ECD) and the three-headed SPECT camera MultiSPECT 3. MRI scans of the brain were performed using either a 0,2 T Open or a 1,5 T Sonata. Twelve of the MRI data sets were acquired using a 3D-T1w MPRAGE sequence, 20 with a 2D acquisition technique and different echo sequences. Image fusion was performed on a Syngo workstation using an entropy minimizing algorithm by an experienced user of the software. The fusion results were classified. We measured the time needed for the automated fusion procedure and in case of need that for manual realignment after automated, but insufficient fusion. The mean time of the automated fusion procedure was 123 s. It was for the 2D significantly shorter than for the 3D MRI datasets. For four of the 2D data sets and two of the 3D data sets an optimal fit was reached using the automated approach. The remaining 26 data sets required manual correction. The sum of the time required for automated fusion and that needed for manual correction averaged 320 s (50-886 s). The fusion of 3D MRI data sets lasted significantly longer than that of the 2D MRI data. The automated fusion tool delivered in 20% an optimal fit, in 80% manual correction was necessary. Nevertheless, each of the 32 SPECT data sets could be merged in less than 15 min with the corresponding MRI data, which seems acceptable for clinical routine use.

  18. Voxel-by-voxel analysis of brain SPECT perfusion in Fibromyalgia

    International Nuclear Information System (INIS)

    Guedj, Eric; Taieb, David; Cammilleri, Serge; Lussato, David; Laforte, Catherine de; Niboyet, Jean; Mundler, Olivier

    2007-01-01

    We evaluated brain perfusion SPECT at rest, without noxious stiumuli, in a homogeneous group of hyperalgesic FM patients. We performed a voxel-based analysis in comparison to a control group, matched for age and gender. Under such conditions, we made the assumption that significant cerebral perfusion abnormalities could be demonstrated, evidencing altered cerebral processing associated with spontaneous pain in FM patients. The secondary objective was to study the reversibility and the prognostic value of such possible perfusion abnormalities under specific treatment. Eighteen hyperalgesic FM women (mean age 48 yr; range 25-63 yr; ACR criteria) and 10 healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). All brain SPECT were performed before any change was made in therapy in the pain care unit. A second SPECT was performed a month later after specific treatment by Ketamine. Compared to control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. We also found that a medial frontal and anterior cingulate hypoperfusions were highly predictive (PPV=83%; NPV=91%) of non-response on Ketamine, and that only responders showed significant modification of brain perfusion, after treatment. In the present study performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective dimension. As current pharmacological and non-pharmacological therapies act differently on both components of pain, we hypothesize that SPECT could be a valuable and readily available tool to guide individual therapeutic

  19. Voxel-by-voxel analysis of brain SPECT perfusion in Fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France)]. E-mail: eric.guedj@ap-hm.fr; Taieb, David [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France); Cammilleri, Serge [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France); Lussato, David [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France); Laforte, Catherine de [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France); Niboyet, Jean [Unite d' Etude et de Traitement de la Douleur, Clinique La Phoceanne, Marseille (France); Mundler, Olivier [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France)

    2007-02-01

    We evaluated brain perfusion SPECT at rest, without noxious stiumuli, in a homogeneous group of hyperalgesic FM patients. We performed a voxel-based analysis in comparison to a control group, matched for age and gender. Under such conditions, we made the assumption that significant cerebral perfusion abnormalities could be demonstrated, evidencing altered cerebral processing associated with spontaneous pain in FM patients. The secondary objective was to study the reversibility and the prognostic value of such possible perfusion abnormalities under specific treatment. Eighteen hyperalgesic FM women (mean age 48 yr; range 25-63 yr; ACR criteria) and 10 healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). All brain SPECT were performed before any change was made in therapy in the pain care unit. A second SPECT was performed a month later after specific treatment by Ketamine. Compared to control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. We also found that a medial frontal and anterior cingulate hypoperfusions were highly predictive (PPV=83%; NPV=91%) of non-response on Ketamine, and that only responders showed significant modification of brain perfusion, after treatment. In the present study performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective dimension. As current pharmacological and non-pharmacological therapies act differently on both components of pain, we hypothesize that SPECT could be a valuable and readily available tool to guide individual therapeutic

  20. 99mTc-MIBI-SPECT-studies in the evaluation of brain tumors

    International Nuclear Information System (INIS)

    Ambrus, E.; Pavics, L.; Gruenwald, F.; Barath, B.; Tiszlavicz, L.; Bender, H.; Menzel, C.; Almasi, L.; Lang, J.; Bodosi, M.; Biersack, H.J.; Csernay, L.

    1994-01-01

    Brain SPECT studies were performed 5 and 60 minutes after 99m Tc-MIBI administration in 41 patients with brain tumors confirmed by CT and surgical removal (13 meningeomas, 8 astrocytomas grades I-III, 10 glioblastomas, 10 metastases). 99m Tc-MIBI uptake was found in 32 out of 41 brain tumors. According to the semiquantitative SPECT analysis, the tumor/non tumor radios revealed a statistically significant difference in the early tracer uptake between meningeomas and astrocytomas (+4.73±2.91 vs -1.75±0.75, p 99m Tc-MIBI uptake and its changes with time. We concluded that the combination of an early and late 99m Tc-MIBI brain SPECT may be helpful in the non invasive histological classification of brain tumors and the determination of the grade of theirs malignancy. (orig.) [de

  1. Pinhole SPECT: high resolution imaging of brain tumours in small laboratory animals

    International Nuclear Information System (INIS)

    Franceschim, M.; Bokulic, T.; Kusic, Z.; Strand, S.E.; Erlandsson, K.

    1994-01-01

    The performance properties of pinhole SPECT and the application of this technology to evaluate radionuclide uptake in brain in small laboratory animals were investigated. System sensitivity and spatial resolution measurements of a rotating scintillation camera system were made for a low energy pinhole collimator equipped with 2.0 mm aperture pinhole insert. Projection data were acquired at 4 degree increments over 360 degrees in the step and shoot mode using a 4.5 cm radius of rotation. Pinhole planar and SPECT imaging were obtained to evaluate regional uptake of Tl-201, Tc-99m-MIBI, Tc-99m-HMPAO and Tc-99m-DTPA in tumor and control regions of the brain in a primary brain tumor model in Fisher 344 rats. Pinhole SPECT images were reconstructed using a modified cone- beam algorithm developed from a two dimensional fan-beam filtered backprojection algorithm. The reconstructed transaxial resolution of 2.8 FWHM and system sensitivity of 0.086 c/s/kBq with the 2.0 mm pinhole collimator aperture were measured. Tumor to non-tumor uptake ratios at 19-28 days post tumor cell inoculation varied by a factor > 20:1 on SPECT images. Pinhole SPECT provides an important new approach for performing high resolution imaging: the resolution properties of pinhole SPECT are superior to those which have been achieved with conventional SPECT or PET imaging technologies. (author)

  2. High-resolution brain SPECT imaging by combination of parallel and tilted detector heads.

    Science.gov (United States)

    Suzuki, Atsuro; Takeuchi, Wataru; Ishitsu, Takafumi; Morimoto, Yuichi; Kobashi, Keiji; Ueno, Yuichiro

    2015-10-01

    To improve the spatial resolution of brain single-photon emission computed tomography (SPECT), we propose a new brain SPECT system in which the detector heads are tilted towards the rotation axis so that they are closer to the brain. In addition, parallel detector heads are used to obtain the complete projection data set. We evaluated this parallel and tilted detector head system (PT-SPECT) in simulations. In the simulation study, the tilt angle of the detector heads relative to the axis was 45°. The distance from the collimator surface of the parallel detector heads to the axis was 130 mm. The distance from the collimator surface of the tilted detector heads to the origin on the axis was 110 mm. A CdTe semiconductor panel with a 1.4 mm detector pitch and a parallel-hole collimator were employed in both types of detector head. A line source phantom, cold-rod brain-shaped phantom, and cerebral blood flow phantom were evaluated. The projection data were generated by forward-projection of the phantom images using physics models, and Poisson noise at clinical levels was applied to the projection data. The ordered-subsets expectation maximization algorithm with physics models was used. We also evaluated conventional SPECT using four parallel detector heads for the sake of comparison. The evaluation of the line source phantom showed that the transaxial FWHM in the central slice for conventional SPECT ranged from 6.1 to 8.5 mm, while that for PT-SPECT ranged from 5.3 to 6.9 mm. The cold-rod brain-shaped phantom image showed that conventional SPECT could visualize up to 8-mm-diameter rods. By contrast, PT-SPECT could visualize up to 6-mm-diameter rods in upper slices of a cerebrum. The cerebral blood flow phantom image showed that the PT-SPECT system provided higher resolution at the thalamus and caudate nucleus as well as at the longitudinal fissure of the cerebrum compared with conventional SPECT. PT-SPECT provides improved image resolution at not only upper but also at

  3. Neuroimaging of post-traumatic higher brain dysfunction using 123I-Iomazenil (IMZ) SPECT

    International Nuclear Information System (INIS)

    Nakagawara, Jyoji; Kamiyama, Kenji; Takahashi, Masaaki; Nakamura, Hirohiko

    2010-01-01

    In patients with mild traumatic brain injury (MTBI), higher brain dysfunctions which consist of cognitive impairments such as memory, attention, performance and social behavioral disturbances could be rarely apparent. However, higher brain dysfunctions should be identified by neuropsychological tests and supported by a social welfare for handicapped patients. Acknowledgement of higher brain dysfunctions after MTBI without obvious brain damages on morphological neuroimagings could be a social issue under controversy. An imaging of cortical neuron damages in patients with higher brain dysfunctions after MTBI was studied by functional neuroimaging using 123 I-Iomazenil (IMZ) single photon emission computed tomography (SPECT). Statistical imaging analyses using 3 dimensional stereotactic surface projections (3D-SSP) for 123 I-IMZ SPECT and 123 I-IMP SPECT as cerebral blood flow (CBF) studies were performed in 11 patients with higher brain dysfunctions after MTBI. In all patients with higher brain dysfunctions defined by neuropsychological tests, cortical neuron damages were observed in bilateral medial frontal lobes, but reduction of CBF in bilateral medial frontal lobes were less obviously showed in 8 patients (apparent in 3 and little in 5). Group comparison of 3D-SSP of 123 I-IMZ SPECT between 11 patients and 18 normal controls demonstrated significant selective loss of cortical neuron in bilateral medial frontal gyrus (MFG). Extent of abnormal pixels on each cortical gyrus using stereotactic extraction estimation (SEE) for 3D-SSP of 123 I-IMZ SPECT confirmed that 8 patients had abnormal pixel extent >10% in bilateral MFG and 5 patients had abnormal pixel extent >10% in bilateral anterior cingulate gyrus. In patients with MTBI, higher brain dysfunctions seems to correlate with selective loss of cortical neuron within bilateral MFG which could be caused by Wallerian degeneration as secondary phenomena after diffuse axonal injury within corpus callosum. Statistical

  4. Comparison of Tc-99m HM-PAO SPECT brain scan and x-ray CT in the detection of brain metastases

    International Nuclear Information System (INIS)

    Abdel-Dayem, H.M.; Sadek, S.; Sahwell, A.; Kubasek, H.; El-Sayed, M.; Ziada, G.; Mobarak, L.; Al-Huda, F.; Omar, Y.T.

    1986-01-01

    Tc-99m HM-PAO imaging was compared with x-ray CT in 14 patients with known or suspected brain metastases. Both studies were done within 3 days of each other. Static and single photon emission CT (SPECT) images were acquired after intravenous injection of 13 mCi of Tc-99m HM-PAO. All 14 patients underwent static and SPECT Tc-99m HM-PAO imaging and x-ray CT. Studies were positive in 7, 12, and 10 patients, respectively, by static, SPECT, and x-ray CT imaging, and negative in 7, 2, and 2. The number of lesions identified was 0 (static imaging), 32 (SPECT), and 26(x-ray CT). There were no ''suspicious'' studies by any modality. This study indicates that Tc-99m HM-PAO SPECT cerebral blood flow imaging is more sensitive than x-ray CT for detecting brain metastases, that biplane imaging is not sensitive and SPECT is essential, and that for Tc-99m HM-PAO SPECT brain imaging to regain its importance with respect to x-ray CT, acquisition time must be 10 minutes or less and determination of percentage brain uptake of the injected dose, and of regional distribution, is necessary

  5. Adjunct use of 3D-SSP analysis improves the ability to discriminate Alzheimer's disease from controls in visual inspection of brain SPECT. Examined by 16 inspectors belonging to 9 institutes

    International Nuclear Information System (INIS)

    Imabayashi, Etsuko; Matsuda, Hiroshi; Machida, Kikuo; Honda, Norinari; Matsumoto, Toru

    2004-01-01

    Sixteen physicians interpreted 99m Tc-ECD SPECT images in two sessions with or without 3D stereotactic surface projections (SSP) for 50 studies of Alzheimer's Disease (AD) patients and 40 studies of healthy volunteers. Mean areas under the receiver operating characteristic curves for visual interpretation of SPECT with 3D-SSP (0.778±0.060) was significantly greater than that for visual interpretation of SPECT alone (0.679±0.058). (author)

  6. Reduction in mean cerebral blood flow measurements using 99mTc-ECD-SPECT during normal aging

    International Nuclear Information System (INIS)

    Kawahata, Nobuya; Daitoh, Nobuyuki; Shirai, Fumie; Hara, Shigeru

    1997-01-01

    Mean cerebral blood flow (mCBF) was measured by SPECT using the 99m Tc-ECD-Patlak-Plot method in a selected group of 61 normal non-hospitalized subjects aged 51 to 91 years. The mCBF values showed 48.4±4.7 ml/100 g/min in aged 50-59 years group, 49.9±5.9 ml/100 g/min in aged 60-69 years group, 46.4 ±6.5 ml/100 g/min in aged 70-79 group, 38.0±3.7 ml/100 g/min in aged 80-89 years group, 38.9 ml/100 g/min in aged 90-99 years group. There was a statistically significant reduction of mCBF with advancing age (R=-0.41; p=0.001). Women have significantly higher mCBF values than men up to aged 70 years group. In this study, there was no significant laterality in the mCBF between right and left hemispheres in all decade groups. The history of hypertension, alcohol consumption, and cigarette smoking failed to show significant difference in the mCBF values. The present study shows that normal aging is associated with mCBF reduction. (author)

  7. 99mTc-HMPAO SPECT of the brain in mild to moderate traumatic brain injury patients: compared with CT--a prospective study.

    Science.gov (United States)

    Nedd, K; Sfakianakis, G; Ganz, W; Uricchio, B; Vernberg, D; Villanueva, P; Jabir, A M; Bartlett, J; Keena, J

    1993-01-01

    Single photon emission computed tomography (SPECT) with Technetium-99m hexamethyl propylenamine oxime (Tc-99m-HMPAO) was used in 20 patients with mild to moderate traumatic brain injury (TBI) to evaluate the effects of brain trauma on regional cerebral blood flow (rCBF). SPECT scan was compared with CT scan in 16 patients. SPECT showed intraparenchymal differences in rCBF more often than lesions diagnosed with CT scans (87.5% vs. 37.5%). In five of six patients with lesions in both modalities, the area of involvement was relatively larger on SPECT scans than on CT scans. Contrecoup changes were seen in five patients on SPECT alone, two patients with CT alone and one patient had contrecoup lesions on CT and SPECT. Of the eight patients (50%) with skull fractures, seven (43.7%) had rCBF findings on SPECT scan and five (31.3%) demonstrated decrease in rCBF in brain underlying the fracture. All these patients with fractures had normal brain on CT scans. Conversely, extra-axial lesions and fractures evident on CT did not visualize on SPECT, but SPECT demonstrated associated changes in rCBF. Although there is still lack of clinical and pathological correlation, SPECT appears to be a promising method for a more sensitive evaluation of axial lesions in patients with mild to moderate TBI.

  8. A preliminary study of neuroSPECT evaluation of patients with post-traumatic smell impairment

    International Nuclear Information System (INIS)

    Eftekhari, Mohammad; Assadi, Majid; Kazemi, Majid; Saghari, Mohsen; Esfahani, Armaghan Fard; Sichani, Babak Fallahi; Gholamrezanezhad, Ali; Beiki, Davood

    2005-01-01

    Most olfactory testings are subjective and since they depend upon the patients' response, they are prone to false positive results. The aim of this study was to use quantitative brain perfusion SPECT in order to detect possible areas of brain activation in response to odorant stimulation in patients with post-traumatic impaired smell in comparison to a group of normal subjects. Fourteen patients with post-traumatic impaired smell and ten healthy controls were entered in this prospective study. All subjects underwent brain SPECT after intravenous injection of 740-MBq 99m Tc-ECD and 48 hours later, the same procedure was repeated following olfactory stimulus (vanilla powder). In most of seven regions of interest (Orbital Frontal Cortex, Inferior Frontal Pole, Superior Frontal Pole, Posterior Superior Frontal Lobe, Parasagittal Area, Occipital Pole, and Cerebellar area) the post-stimulation quantitative values show increased cortical perfusion being more pronounced in normal volunteers than the anosmic patients (except cerebellar areas and the right occipital pole). Maximal activation was observed in orbitofrontal regions (right+ 25.45% and left +25.47%). Brain SPECT is a valuable imaging technique in the assessment of post-traumatic anosmia and could be competitive as an alternative to other imaging techniques, especially when functional MRI is unavailable or unsuitable. However, this procedure may benefit from complementary MRI or CT anatomical imaging

  9. Brain perfusion abnormalities in Rett syndrome: a qualitative and quantitative SPET study with 99Tc(m)-ECD.

    Science.gov (United States)

    Burroni, L; Aucone, A M; Volterrani, D; Hayek, Y; Bertelli, P; Vella, A; Zappella, M; Vattimo, A

    1997-06-01

    Rett syndrome is a progressive neurological paediatric disorder associated with severe mental deficiency, which affects only girls. The aim of this study was to determine if brain blood flow abnormalities detected with 99Tc(m)-ethyl-cysteinate-dimer (99Tc[m]-ECD) single photon emission tomography (SPET) can explain the clinical manifestation and progression of the disease. Qualitative and quantitative global and regional brain blood flow was evaluated in 12 girls with Rett syndrome and compared with an aged-matched reference group of children. In comparison with the reference group, SPET revealed a considerable global reduction in cerebral perfusion in the groups of girls with Rett syndrome. A large statistical difference was noted, which was more evident when comparing the control group with girls with stage IV Rett syndrome than girls with stage III Rett syndrome. The reduction in cerebral perfusion reflects functional disturbance in the brain of children with Rett syndrome. These data confirm that 99Tc(m)-ECD brain SPET is sensitive in detecting hypoperfused areas in girls with Rett syndrome that may be associated with brain atrophy, even when magnetic resonance imaging appears normal.

  10. Evaluation of epileptogenic focus in temporal lobe: correlation between ictal brain SPECT, magnetic resonance imaging and magnetic resonance spectroscopy; Avaliacao de foco epileptogenico do lobo temporal: correlacao entre SPECT ictal, ressonancia magnetica e ressonancia magnetica com espectroscopia de protons

    Energy Technology Data Exchange (ETDEWEB)

    Diegues, Maria Elena Martins [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear]. E-mail: emartyns@terra.com.br; Pellini, Marcos Pinto; Alves-Leon, Soniza Vieira [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Domingues, Romeu Cortes [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)

    2004-02-01

    The purpose of this study was to determine the degree of concordance between radiological and radioisotopic methods and, if positive, to evaluate the usefulness of ictal SPECT in the localization of the epileptogenic focus. Ictal brain SPECT, magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) were performed on six patients with refractory temporal lobe epilepsy. Ictal SPECT was performed after withdrawal of the anti-epileptogenic drugs during video-EEG monitoring, using {sup 99m}Tc-ECD, administered to patients at the time of the ictus. MRI was performed in T1, T2 and FLAIR sequences and MRS was obtained using the PRESS technique, with a single voxel positioned in both hippocampi. The statistical analysis included the determination of the values of Kappa (k), standard error (se) and significance level (p) for the lateralization of the ictal focus. The analysis of all findings was based on EEG localization of the ictal discharge, seizure duration (109-280 s; 152 s average) and time of radiotracer injection (30-262 s; 96 s average). We obtained correlated data in four patients (67 per cent) and values of k = 0.67, se = 0.38, and p 0.041. We concluded that there is a concordance between ictal SPECT, MRI and MRS data and the usefulness of the radioisotopic procedure is related to a non diagnostic EEG and when there is a discordant or misleading diagnosis after a comparative analysis of EEG and MRS. (author)

  11. Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT

    International Nuclear Information System (INIS)

    Kim, J. S.; Kim, G. E.; Yoo, J. Y.; Kim, D. G.; Moon, D. H.

    2005-01-01

    Scientific documentation of neurologic improvement following carotid endarterectomy (CEA) has not been established. The purpose of this prospective study is to investigate whether CEA performed for the internal carotid artery flow lesion improves gait and cerebrovascular hemodynamic status in patients with gait disturbance. We prospectively performed pre- and postCEA gait analysis and acetazolamide stress brain perfusion SPECT (Acz-SPECT) with Tc-99m ECD in 91 patients (M/F: 81/10, mean age: 64.1 y) who had gait disturbance before receiving CEA. Gait performance was assessed using a Vicon 370 motion analyzer. The gait improvement after CEA was correlated to cerebrovascular hemodynamic change as well as symptom duration. 12 hemiparetic stroke patients (M/F=9/3, mean age: 51 y) who did not receive CEA as a control underwent gait analysis twice in a week interval to evaluate whether repeat testing of gait performance shows learning effect. Of 91 patients, 73 (80%) patients showed gait improvement (change of gait speed > 10%) and 42 (46%) showed marked improvement (change of gait speed > 20%), but no improvement was observed in control group at repeat test. Post-operative cerebrovascular hemodynamic improvement was noted in 49 (54%) of 91 patients. There was marked gait improvement in patients group with cerebrovascular hemodynamic improvement compared to no change group (p<0.05). Marked gait improvement and cerebrovascular hemodynamic improvement were noted in 53% and 61% of the patient who had less than 3 month history of symptom compared to 31% and 24% of the patients who had longer than 3 months, respectively (p<0.05). Marked gait improvement was obtained in patients who had improvement of cerebrovascular hemodynamic status on Acz-SPECT after CEA. These results suggest functional improvement such as gait can result from the improved perfusion of misery perfusion area, which is viable for a longer period compared to literatures previously reported

  12. Evaluation of regional cerebral blood flow changes in normal aging using 99mTc-ECD SPECT and Patlak method

    International Nuclear Information System (INIS)

    Mizuno, Shinji; Nandate, Yuka; Enya, Mayumi; Manabe, Tomoko; Goto, Hiroo; Hoshi, Hiroaki; Takahashi, Yukitoshi; Kato, Zenichiro; Kondo, Naomi

    1998-01-01

    Changes in regional cerebral blood flow (rCBF) were studied using 99m Tc-ECD SPECT and Patlak method in 47 subjects, aged 1 to 79 years (mean 28.5 years). No abnormal finding was found on MR imaging in the subjects. We obtained mean cerebral blood flow (mCBF) by means of Patlak method. rCBF was measured by positioning regions of interest (ROIs) in frontal lobe, parietal lobe, temporal lobe, occipital lobe, cerebellum and thalamus. The correlation coefficient between ages and mCBF was r=-0.897 (p<0.0001). mCBF of children was significantly higher (p<0.05), compared with adults. By dispersion analysis according to the groups of ages, significantly higher rCBF values were available in the frontal, parietal, temporal and occipital lobes during childhood than adulthood (p<0.05), but there were almost no significant differences of rCBF during childhood than adulthood in cerebellum and thalamus. (author)

  13. Registration and display of brain SPECT and MRI using external markers

    International Nuclear Information System (INIS)

    Pohjonen, H.; Nikkinen, P.; Sipilae, O.; Launes, J.; Salli, E.; Salonen, O.; Karp, P.; Ylae-Jaeaeski, J.; Katila, T.; Liewendahl, K.

    1996-01-01

    Accurate anatomical localisation of abnormalities observed in brain perfusion single-photon emission computed tomography (SPECT) is difficult, but can be improved by correlating data from SPECT and other tomographic imaging modalities. For this purpose we have developed software to register, analyse and display 99m Tc-hexamethylpropyleneamine oxime SPECT and 1.0 T MRI of the brain. For registration of SPECT and MRI data external skin markers containing 99m Tc (220 kBq) in 50 μl of coconut butter were used. The software is coded in the C programming language, and the X Window system and the OSF/Motif standards are used for graphics and definition of the user interface. The registration algorithm follows a noniterative least-squares method using singular value decomposition of a 3 x 3 covariance matrix. After registration, the image slices of both data sets are shown at identical tomographic levels. The registration error in phantom studies was on average 4 mm. In the two-dimensional display mode the orthogonal cross-sections of the data sets are displayed side by side. In the three-dimensional mode MRI data are displayed as a surface-shaded 3 D reconstruction and SPECT data as cut planes. The usefulness of this method is demonstrated in patients with cerebral infarcts, brain tumour, herpes simplex encephalitis and epilepsy. (orig.). With 9 figs

  14. Preoperative evaluation of brain lesion with 201TI brain SPECT: is it useful to differentiate benign and malignant lesions?

    International Nuclear Information System (INIS)

    Sohn, Hyung Sun; Kim, Euy Neyng; Kim, Sung Hoon; Chung, Yong An; Chung, Soo Kyo; Hong, Yong Gil; Lee, Youn Soo

    2000-01-01

    Thallium-201 ( 201 TI) brain SPECT, which can represent cellular activity of brain lesions, may provide more useful information in differentiating between benign and malignant brain lesions more so than CT or MRI, that merely represents anatomic changes or breakdown of blood brain barrier. We used 201 TI brain SPECT prospectively to evaluate the utility of 201 TI-indices as an indicator of benign or malignant lesions. We studied 28 patients. There were 13 cases of benign lesions (3: nonspecific benign lesion, 3: meningioma, 2: low grade glioma, 1: tuberculoma, central neurocytoma, hemangioblastoma, radiation necrosis, and choroid plexus papilloma) and 15 cases of malignant lesions (6: glioblastoma multiforme, 5: anaplastic glioma, 2: medulloblastoma, 1: metastasis and lymphoma). In all patients, CT and/or MRI were obtained and then 201 TI brain SPECT was obtained with measuring mean 201 TI index and peak 201 TI index. An unpaired t-test was performed to compare the 201 TI-indices and pathologic diagnoses to evaluate the utility of 201 TI-indices as an indicator of benign or malignant lesions. There were no statistically significant difference in 201 TI-indices between benign and malignant brain lesions (P>0.05). These results demonstrated that we could not use 201 TI indices on brain SPECT alone as an indicator of benign or malignant brain lesions

  15. Presentation of regional cerebral blood flow in amphetamine abusers by 99Tcm-HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Kao, C.H.; Wang, S.J.; Yeh, S.H.

    1994-01-01

    The aim of this study was to describe the effectiveness of 99 Tc m -hexamethylpropyleneamine oxime ( 99 Tc m -HMPAO) brain single photon emission computed tomography (SPECT) in the assessment of the regional cerebral blood flow (rCBF) in amphetamine abusers. Twenty-one amphetamine abusers were included and 99 Tc m -HMPAO brain SPECT performed to evaluate rCBF. The drug-using periods ranged from 1 month to several years. The demonstrated neuropsychogenic symptoms and signs of the abusers were from normal presentation to various neurologic complications. The brain SPECT scans were interpreted visually as either normal or abnormal. The degree of abnormality was classified into mild or severe. The results revealed that (a) most SPECT studies in abusers show small defects (95%, 20/21 cases); 71% (15/21) of cases revealed multiple defects over both hemispheres (classified as severe); 24% (5/21) of the cases had focal defects (classified as mild); and only one case (5%, 1/21) demonstrated a normal SPECT finding; (b) the degree of abnormality on SPECT scans was not related to the dose and duration of drug use or the severity of the neuropsychiatric symptoms and signs. In conclusion, 99 Tc m -HMPAO brain SPECT is a sensitive but not specific test for neuropsychogenic abnormalities associated with amphetamine abuse. (Author)

  16. Examination of brain function using PET and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Yasuhito; Momose, Toshinitsu; Watanabe, Toshiaki; Oku, Shinya; Nishikawa, Junichi [Tokyo Univ. (Japan). Faculty of Medicine

    1996-12-31

    The purpose of the presentation is to elucidate the unique role of PET (positron emission computed tomography) and SPECT (single photon emission computed tomography) in assessing physiological and biochemical functions of the brain.

  17. The study of low level laser irradiation therapy on brain infarction with SPECT

    Institute of Scientific and Technical Information of China (English)

    Xiao Xuechang; Jia Shaowei; Zleng Xiyuan

    2000-01-01

    Objective: Effect of rCBF and brain function on ILIB treating brain infarction will be investigated by SPECT brain perfusion imaging. Method: 3 1 patients with brain infarction, 17 patients were treated by ILIB on standard pharmaceutial treatment. SPECT brain perfusion imaging was performed before and after ILIB therapy with comparison of oneself. They were quantified with BFCR% model effect during ILIB in 14 patients were observed. Result: ILIB 30 rnme SPECT showed the improvement of rCBF and cerebral function in 14 patients with brain infarction, and in 17 patients locus were prominence than mirror regions att er ILIB therapy, both are higher singnitficant difference ( t=4.4052, P<0.0001 ), but mirror regions were not singnificant difference before and after ILIB (t=1.6995, P>0.05). BFCR% quantitative results of locus were higher mirror regions, and higher singnificant difference (t=4.5278 p<0.0001 )。 Conclusion: ILIB can improve the rCBF and cerebral function of patients with brain infarction, and provoke function of brain cells. Some new evidence was provided for ILIB treatment of cerebral ischemia

  18. Automated voxel-based analysis of brain perfusion SPECT for vasospasm after subarachnoid haemorrhage

    International Nuclear Information System (INIS)

    Iwabuchi, S.; Yokouchi, T.; Hayashi, M.; Kimura, H.; Tomiyama, A.; Hirata, Y.; Saito, N.; Harashina, J.; Nakayama, H.; Sato, K.; Aoki, K.; Samejima, H.; Ueda, M.; Terada, H.; Hamazaki, K.

    2008-01-01

    We evaluated regional cerebral blood flow (rCBF) during vasospasm after subarachnoid haemorrhage ISAH) using automated voxel-based analysis of brain perfusion single-photon emission computed tomography (SPELT). Brain perfusion SPECT was performed 7 to 10 days after onset of SAH. Automated voxel-based analysis of SPECT used a Z-score map that was calculated by comparing the patients data with a control database. In cases where computed tomography (CT) scans detected an ischemic region due to vasospasm, automated voxel-based analysis of brain perfusion SPECT revealed dramatically reduced rCBF (Z-score ≤ -4). No patients with mildly or moderately diminished rCBF (Z-score > -3) progressed to cerebral infarction. Some patients with a Z-score < -4 did not progress to cerebral infarction after active treatment with a angioplasty. Three-dimensional images provided detailed anatomical information and helped us to distinguish surgical sequelae from vasospasm. In conclusion, automated voxel-based analysis of brain perfusion SPECT using a Z-score map is helpful in evaluating decreased rCBF due to vasospasm. (author)

  19. Importance of computerized tomography by single photon emission of brain perfusion in the diagnosis and prognostic of migraines

    International Nuclear Information System (INIS)

    Colmenter R, Luis Felipe

    2003-01-01

    The objective of this investigation was to establish the usefulness of ECD-99mTc brain perfusion SPECT in the evaluation of the diagnosis of functional alterations of Vascular Headaches of migrainous origin and to determine the changes in regional cerebral blood flow (FSCr) during the headache phase. A population of 21 female patients, 5 controls, of the same age and sex, aged between 20 and 76 years, with clinical evidence of headache with or without aura, with a duration of 8 to 72 hours, pulsating pain, associated to nausea, photophobia, phonophobia, that does not resolve with common analgesics and characterized by increase of the pain with physical activity. Brain perfusion SPECT was practiced on them at the moment of crisis, independent of the presence of aura or pain, and without crisis. ECD-99mTc was administered at a dose of 925 to 1110 MBq. Images were analyzed by the semi quantification method. SPECT detected 13 hypo-captures on the 16 patients studied. With a 81% sensitivity and 100% specificity, with a precision value of 86%. Analysis through X Binomial Aleatory Variable showed a precision of 90% (p= < 0,023) for the isotopic test, with a significance level of 5%. In conclusion, the results of this study confirm that brain SPECT is a neuroimaging technique capable of identifying migrainous patients, being able to reevaluate the type of hypo perfusion that each patient has, during crisis or out of crisis, and correlate the cortical perfusion deficits (Au)

  20. Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Piga, M.; Serra, A.; Loi, G.L.; Satta, L. [University of Cagliari, Nuclear Medicine - Department of Medical Sciences ' ' M. Aresu' ' , Cagliari (Italy); Deiana, L.; Liberto, M. Di; Mariotti, S. [University of Cagliari, Endocrinology - Department of Medical Sciences ' ' M. Aresu' ' , Cagliari (Italy)

    2004-12-01

    Brain perfusion abnormalities have recently been demonstrated by single-photon emission computed tomography (SPECT) in rare cases of severe Hashimoto's thyroiditis (HT) encephalopathy; moreover, some degree of subtle central nervous system (CNS) involvement has been hypothesised in HT, but no direct evidence has been provided so far. The aim of this study was to assess cortical brain perfusion in patients with euthyroid HT without any clinical evidence of CNS involvement by means of {sup 99m}Tc-ECD brain SPECT. Sixteen adult patients with HT entered this study following informed consent. The diagnosis was based on the coexistence of high titres of anti-thyroid auto-antibodies and diffuse hypoechogenicity of the thyroid on ultrasound in association with normal circulating thyroid hormone and TSH concentrations. Nine consecutive adult patients with non-toxic nodular goitre (NTNG) and ten healthy subjects matched for age and sex were included as control groups. All patients underwent {sup 99m}Tc-ECD brain SPECT. Image assessment was both qualitative and semiquantitative. Semiquantitative analysis was performed by generation of four regions of interest (ROI) for each cerebral hemisphere - frontal, temporal, parietal and occipital - and one for each cerebellar hemisphere in order to evaluate cortical perfusion asymmetry. The Asymmetry Index (AI) was calculated to provide a measurement of both magnitude and direction of perfusion asymmetry. As assessed by visual examination, {sup 99m}Tc-ECD cerebral distribution was irregular and patchy in HT patients, hypoperfusion being more frequently found in frontal lobes. AI revealed abnormalities in 12/16 HT patients, in three of the nine NTNG patients and in none of the normal controls. A significant difference in the mean AI was found between patients with HT and both patients with NTNG (p<0.003) and normal controls (p<0.001), when only frontal lobes were considered. These results show the high prevalence of brain perfusion

  1. Evaluation of time dependency of the acetazolamide effect on cerebral hemodynamics as measured by {sup 99m}Tc-ECD single-photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Takaki, Akihiro; Urata, Joji; Okada, Kazuhiro; Takaki, Rie [Saiseikai Kumamoto Hospital (Japan). Diagnostic Imaging Center; Mizuta, Yoshihiko; Murakami, Masaji; Yonehara, Toshiroh; Hirano, Teruyuki; Fujioka, Shodo

    2001-01-01

    Kuwabara et al. have examined the cerebral artery dilation with acetazolamide (ACZ) challenge test using PET. And, they reported that ACZ reaction came out time dependently. We have developed a unique SPECT's method using Technetium-99m ethyl cysteinate dimer ({sup 99m}Tc-ECD) to verify the results obtained by Kuwabara et al. One thousand MBq of {sup 99m}Tc-ECD was exactly divided into three syringes. Each of which was intravenous infused (IV) at rest, 7.5, and 20 minutes after ACZ administration. Data collection was started using dynamic SPECT immediately after {sup 99m}Tc-ECD IV at rest. Using necessary data only, SPECT images representing each of the three {sup 99m}Tc-ECD IV was reconstructed. SPECT counts were obtained by the ROI method from each images to calculate relative CBF from rest to 7.5 and 20 minutes after ACZ administration. The 18 hemispheres of nine patients in the negative control group in whom ACZ was not loaded, CBF was stable during the three evaluation. The measurement error our method was estimated as small. The 18 hemispheres of nine patients in the positive control group who has normal vasodilatory reserve, CBF was increased by 26.2{+-}8.1% at 7.5 minutes and 29.3{+-}13.1% at 20 minutes after ACZ administration. Seven patients with and chronic stage unilateral internal carotid artery severe stenosis and/or occlusion were evaluated as the test group. Case of unaffected side, CBF was increased by 17.6{+-}6.9% at 7.5 minutes and 24.8{+-}11.3% 20 minutes after ACZ administration. And, increase rate of CBF in the affected side was 2.8{+-}1.6% at 7.5 minutes and 17.3{+-}5.0% at 20 minutes after ACZ administration. In the affected side, timing of the maximum CBF increase caused by ACZ was remarkably delayed. Our method based on {sup 99m}Tc-ECD SPECT also revealed delayed cerebral artery dilation in the affected side. It was suggested that ACZ reaction came out time dependently, as reported by Kuwabara et al. (author)

  2. Reduction in mean cerebral blood flow measurements using {sup 99m}Tc-ECD-SPECT during normal aging

    Energy Technology Data Exchange (ETDEWEB)

    Kawahata, Nobuya; Daitoh, Nobuyuki; Shirai, Fumie; Hara, Shigeru [Narita Memorial Hospital, Toyohashi, Aichi (Japan)

    1997-10-01

    Mean cerebral blood flow (mCBF) was measured by SPECT using the {sup 99m}Tc-ECD-Patlak-Plot method in a selected group of 61 normal non-hospitalized subjects aged 51 to 91 years. The mCBF values showed 48.4{+-}4.7 ml/100 g/min in aged 50-59 years group, 49.9{+-}5.9 ml/100 g/min in aged 60-69 years group, 46.4 {+-}6.5 ml/100 g/min in aged 70-79 group, 38.0{+-}3.7 ml/100 g/min in aged 80-89 years group, 38.9 ml/100 g/min in aged 90-99 years group. There was a statistically significant reduction of mCBF with advancing age (R=-0.41; p=0.001). Women have significantly higher mCBF values than men up to aged 70 years group. In this study, there was no significant laterality in the mCBF between right and left hemispheres in all decade groups. The history of hypertension, alcohol consumption, and cigarette smoking failed to show significant difference in the mCBF values. The present study shows that normal aging is associated with mCBF reduction. (author)

  3. Longitudinal evaluation of early dementia of Alzheimer type using brain perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kogure, Daiji; Matsuda, Hiroshi; Ohnishi, Takashi; Kunihiro, Toshiyuki; Uno, Masataka; Asada, Takashi [National Center Hospital for Mental, Nervous, and Muscular Disorders, Kodaira, Tokyo (Japan); Takasaki, Masaru

    1999-02-01

    Regional cerebral blood flow (rCBF) measurements using a Patlak plot method of {sup 99m}Tc-ECD were performed in early dementia of Alzheimer type (DAT) with both HDS-R and MMSE of over 20 to investigate initial abnormality and longitudinal changes of rCBF. A fusion technique of MRI and SPECT images was developed for MRI-guided analysis of regions of interest in hippocampal areas and statistical parametric mapping (SPM) was used for automated and objective approach to analysis of SPECT image data. Seventeen patients with clinically diagnosed early DAT and age-matched 32 normal control subjects were studied. At the first SPECT studies, the mean cerebral blood flow (mCBF) of 38.6{+-}4.7 ml/100 g/min (mean{+-}SD) for early DAT did not show significant reduction as compared with the normal control value of 42.0{+-}3.8, whereas the rCBF values in the bilateral hippocampi (right; 26.8{+-}4.7, left; 26.7{+-}5.2) showed significant reduction (p<0.05) as compared with the normal control values (right; 38.3{+-}4.2, left; 38.4{+-}3.8). The SPM analysis (voxel height; p<0.001, Bonferroni correction; p<0.05) of the first SPECT images revealed significant selective decrease of relative rCBF in the bilateral posterior cingulate gyri. At the second SPECT studies after 1.4 year on the average from the first studies, mCBF for early DAT showed a slight decrease by 1.7{+-}3.8 ml/100 g/min/year. Bilateral hippocampi showed a greater decrease with slight left side dominance by 3.8{+-}3.3 on the right and 4.4{+-}3.2 on the left side. The SPM analysis demonstrated significant decrease of relative rCBF in the basal forebrain area, the left hippocampus, the left amygdala, and the left parahippocampal area. These results suggest that the MRI-guided ROI analysis of rCBF values in the hippocampus and the SPM analysis of SPECT images are quite useful for early diagnosis and follow-up of DAT. (author)

  4. Cortical region of interest definition on SPECT brain images using X-ray CT registration

    Energy Technology Data Exchange (ETDEWEB)

    Tzourio, N.; Sutton, D. (Commissariat a l' Energie Atomique, Orsay (France). Service Hospitalier Frederic Joliot); Joliot, M. (Commissariat a l' Energie Atomique, Orsay (France). Service Hospitalier Frederic Joliot INSERM, Orsay (France)); Mazoyer, B.M. (Commissariat a l' Energie Atomique, Orsay (France). Service Hospitalier Frederic Joliot Antenne d' Information Medicale, C.H.U. Bichat, Paris (France)); Charlot, V. (Hopital Louis Mourier, Colombes (France). Service de Psychiatrie); Salamon, G. (CHU La Timone, Marseille (France). Service de Neuroradiologie)

    1992-11-01

    We present a method for brain single photon emission computed tomography (SPECT) analysis based on individual registration of anatomical (CT) and functional ([sup 133]Xe regional cerebral blood flow) images and on the definition of three-dimensional functional regions of interest. Registration of CT and SPECT is performed through adjustment of CT-defined cortex limits to the SPECT image. Regions are defined by sectioning a cortical ribbon on the CT images, copied over the SPECT images and pooled through slices to give 3D cortical regions of interest. The proposed method shows good intra- and interobserver reproducibility (regional intraclass correlation coefficient [approx equal]0.98), and good accuracy in terms of repositioning ([approx equal]3.5 mm) as compared to the SPECT image resolution (14 mm). The method should be particularly useful for analysing SPECT studies when variations in brain anatomy (normal or abnormal) must be accounted for. (orig.).

  5. Herpes simplex encephalitis: increased retention of Tc-99m HMPAO on acetazolamide enhanced brain perfusion SPECT

    International Nuclear Information System (INIS)

    Choi, Yun Young; Kim, Kwon Hyung; Kim, Seung Hyun; Cho, Suk Shin

    1998-01-01

    We present an interesting case of herpes simplex encephalitis, which showed increased upta unilateral temporal cortex on brain perfusion SPECT using Tc-99m HMPAO, but in bilateral tem cortex after acetazolamide administration. A 42-year-old man was admitted via emergency room, due to rapidly progressing hea disorientation and mental changes. On neurologic examination, neck stiffness and Kernig sign noted. CSF examination showed pleocytosis with lymphcyte predominance. MRI showed swelling bilateral temporal lobe with left predominance, suggestive of herpes simplex encephalitis. Baseline/ Acetazolamide brain perfusion SPECT were acquired consecutively at the same position IV administration of 740MBq and additional 1480 MBq of Tc-99m HMPAO respectively. The temporal and inferior frontal cortex showed markedly increased perfusion on the baseline acetazolamide-enhanced SPECT images. The right temporal cortex showed normal uptake on the b SPECT images, and markedly increased uptake after acetazolamide administration, which seemed to the abundant vascularity at the acute inflammation site without marked brain damage. The fo brain perfusion SPECT after 6 months showed perfusion defect in left temporal cortex but norm perfusion in right temporal cortex. Therefore, we can conclude that baseline SPECT is helpful for the prediction of the prognosis acetazolamide SPECT for the evaluation of the extent of herpes simples encephalitis

  6. Time consumption and quality of an automated fusion tool for SPECT and MRI images of the brain

    International Nuclear Information System (INIS)

    Fiedler, E.; Platsch, G.; Schwarz, A.; Schmiedehausen, K.; Kuwert, T.; Tomandl, B.; Huk, W.; Rupprecht, Th.; Rahn, N.

    2003-01-01

    Aim: Although the fusion of images from different modalities may improve diagnostic accuracy, it is rarely used in clinical routine work due to logistic problems. Therefore we evaluated performance and time needed for fusing MRI and SPECT images using a semiautomated dedicated software. Patients, material and method: In 32 patients regional cerebral blood flow was measured using 99m Tc ethylcystein dimer (ECD) and the three-headed SPECT camera MultiSPECT 3. MRI scans of the brain were performed using either a 0,2 T Open or a 1,5 T Sonata. Twelve of the MRI data sets were acquired using a 3 D-T1 w MPRAGE sequence, 20 with a 2D acquisition technique and different echo sequences. Image fusion was performed on a Syngo workstation using an entropy minimizing algorithm by an experienced user of the software. The fusion results were classified. We measured the time needed for the automated fusion procedure and in case of need that for manual realignment after automated, but insufficient fusion. Results: The mean time of the automated fusion procedure was 123 s. It was for the 2D significantly shorter than for the 3D MRI datasets. For four of the 2D data sets and two of the 3D data sets an optimal fit was reached using the automated approach. The remaining 26 data sets required manual correction. The sum of the time required for automated fusion and that needed for manual correction averaged 320 s (50-886 s). Conclusion: The fusion of 3D MRI data sets lasted significantly longer than that of the 2D MRI data. The automated fusion tool delivered in 20% an optimal fit, in 80% manual correction was necessary. Nevertheless, each of the 32 SPECT data sets could be merged in less than 15 min with the corresponding MRI data, which seems acceptable for clinical routine use. (orig.) [de

  7. Measurement of mean cerebral blood flow using SPECT and dementia rating scales in the memory clinic

    International Nuclear Information System (INIS)

    Kawahata, Nobuya; Daitoh, Nobuyuki; Shirai, Fumie; Yoshikawa, Ayumi; Gotoh, Chiharu

    1997-01-01

    We investigated the association between mean cerebral blood flow (mCBF) values using single photon emission computed tomography (SPECT) and cognitive performance scores of three dementia rating scales (ADAS, MMSE, HDS-R). Mean CBF was measured by the 123 I-IMP-ARG method in a selected group of 51 out-patients aged 41 to 90 years and by the 99m Tc-ECD method in the other group of 57 out-patients aged 51 to 91 years. Simple regressions were calculated for each of the neuropsychological clusters and mCBF values. In 123 I-IMP-ARG-SPECT study, there was a significant correlation between the mCBF values and HDS-R scores (R=0.37, p=0.01). 99m Tc-ECD-SPECT study revealed statistically significant correlations between the mCBF values and ADAS scores (R=-0.48, p 123 I-IMP-ARG-SPECT study and 99m Tc-ECD-SPECT study showed the progressive declines of mCBF with advancing cognitive dysfunctions. Using the cut-off point study (23/24 scores in MMSE and 20/21 scores in HDS-R), we have found that the patients with cognitive dysfunctions had lower mCBF values than the patients with those in each group of aged 60-69 years, 70-79 years, and 80-89 years. However, the difference of mCBF values between the groups with cognitive dysfunctions and without those had decreased gradually with advancing age. The present study suggests that SPECT can provide important functional informations to assess the cognitive impairment in patients with the memory disturbance. (author)

  8. Are there any determinants of interictal brain SPECT perfusion change in unilateral hippocampal sclerosis?

    International Nuclear Information System (INIS)

    Tepmongkol, S.; Locharernkul, C.; Lerdlum, S.

    2005-01-01

    In localizing ictal onset during pre-surgical evaluation, interictal brain SPECT has been used to determine baseline brain abnormalities in order to compare with ictal SPECT. However, in some patients with hippocampal sclerosis (HS), no baseline perfusion abnormality is seen. In this subgroup of patients, performing interictal SPECT may be considered unnecessary. This study is aimed at determining the factors that may influence the interictal SPECT perfusion change in unilateral HS. Forty-one unilateral HS patients (21 males, 20 females; age 30.3±8.0 years) who had interictal brain perfusion SPECT (more than 24 hours after the seizure) were enrolled. Multiple factors i.e. age, sex, age of epilepsy onset, duration of epilepsy, presence of aura, clinical lateralization, interictal EEG lateralization, and ictal EEG lateralization were used as independent variables to predict hypoperfusion of the temporal lobe ipsilateral to hippocampal sclerosis detected on MRI. Ipsilateral temporal hypoperfusion were observed in 18/41 (43.9%) patients. None of these factors showed significant correlation to the perfusion changes. It was also concluded that age, sex, age of epilepsy onset, duration of epilepsy, presence of aura, clinical lateralization, interictal EEG lateralization, and ictal EEG lateralization cannot be used to predict interictal SPECT perfusion changes at the hippocampal sclerosis region. (author)

  9. Predictive value of brain perfusion SPECT for ketamine response in hyperalgesic fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric; Cammilleri, Serge; Colavolpe, Cecile; Taieb, David; Laforte, Catherine de; Mundler, Olivier [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Assistance Publique des Hopitaux de Marseille, Marseille Cedex 5 (France); Niboyet, Jean [Clinique La Phoceanne, Unite d' Etude et de Traitement de la Douleur, Marseille (France)

    2007-08-15

    Ketamine has been used successfully in various proportions of fibromyalgia (FM) patients. However, the response to this specific treatment remains largely unpredictable. We evaluated brain SPECT perfusion before treatment with ketamine, using voxel-based analysis. The objective was to determine the predictive value of brain SPECT for ketamine response. Seventeen women with FM (48 {+-} 11 years; ACR criteria) were enrolled in the study. Brain SPECT was performed before any change was made in therapy in the pain care unit. We considered that a patient was a good responder to ketamine if the VAS score for pain decreased by at least 50% after treatment. A voxel-by-voxel group analysis was performed using SPM2, in comparison to a group of ten healthy women matched for age. The VAS score for pain was 81.8 {+-} 4.2 before ketamine and 31.8 {+-} 27.1 after ketamine. Eleven patients were considered ''good responders'' to ketamine. Responder and non-responder subgroups were similar in terms of pain intensity before ketamine. In comparison to responding patients and healthy subjects, non-responding patients exhibited a significant reduction in bilateral perfusion of the medial frontal gyrus. This cluster of hypoperfusion was highly predictive of non-response to ketamine (positive predictive value 100%, negative predictive value 91%). Brain perfusion SPECT may predict response to ketamine in hyperalgesic FM patients. (orig.)

  10. Predictive value of brain perfusion SPECT for ketamine response in hyperalgesic fibromyalgia

    International Nuclear Information System (INIS)

    Guedj, Eric; Cammilleri, Serge; Colavolpe, Cecile; Taieb, David; Laforte, Catherine de; Mundler, Olivier; Niboyet, Jean

    2007-01-01

    Ketamine has been used successfully in various proportions of fibromyalgia (FM) patients. However, the response to this specific treatment remains largely unpredictable. We evaluated brain SPECT perfusion before treatment with ketamine, using voxel-based analysis. The objective was to determine the predictive value of brain SPECT for ketamine response. Seventeen women with FM (48 ± 11 years; ACR criteria) were enrolled in the study. Brain SPECT was performed before any change was made in therapy in the pain care unit. We considered that a patient was a good responder to ketamine if the VAS score for pain decreased by at least 50% after treatment. A voxel-by-voxel group analysis was performed using SPM2, in comparison to a group of ten healthy women matched for age. The VAS score for pain was 81.8 ± 4.2 before ketamine and 31.8 ± 27.1 after ketamine. Eleven patients were considered ''good responders'' to ketamine. Responder and non-responder subgroups were similar in terms of pain intensity before ketamine. In comparison to responding patients and healthy subjects, non-responding patients exhibited a significant reduction in bilateral perfusion of the medial frontal gyrus. This cluster of hypoperfusion was highly predictive of non-response to ketamine (positive predictive value 100%, negative predictive value 91%). Brain perfusion SPECT may predict response to ketamine in hyperalgesic FM patients. (orig.)

  11. HM-PAO-SPECT of the brain in a new-born child

    Energy Technology Data Exchange (ETDEWEB)

    Gruenwald, F.; Biersack, H.J.; Bindl, L.

    1988-08-01

    HM-PAO-SPECT of the brain was performed in a 14 days old new-born child. Diencephalon, brain stem and cerebellum showed a relative high tracer accumulation; there was nearly no accumulation in the neocortex.

  12. Functional brain imaging with SPECT in normal again and dementia. Methodological, pathophysiological, and diagnostic aspects

    International Nuclear Information System (INIS)

    Waldemar, G.

    1996-03-01

    New developments in instrumentation, radiochemistry, and data analysis, particularly the introduction of 99m Tc-labeled brain-retained tracers for perfusion studies, have opened up a new era of single photon emission computed tomography (SPECT). In this review critical methodological issues relating to the SPECT instrument, the radioactive tracers, the scanning procedure, the data analysis and interpretation of data, and subject selection are discussed together with the changes in regional cerebral blood flow (rCBF) observed in normal aging. An overview is given of the topography and the pathophysiological and diagnostic significance of focal rCBF deficits in Alzheimer's disease and in other dementia disorders, in which SPECT is capable of early or preclinical disease detection. In Alzheimer's disease, the diagnostic sensitivity and specificity of focal rCBF deficits measured with SPECT and brain-retained tracers are very high, in particular when combined with medial temporal lob atrophy on CT. Together with neuropsychological testing, SPECT serves to map the topography of brain dysfunction. Thus, in the clinical setting, SPECT provides information that is supplemental to that obtained in other studies. Future applications include neuroreceptor studies and treatment studies, in which SPECT may serve as a diagnostic aid in the selection of patients and as a potential mean for monitoring treatment effects. Although positron emission tomography is the best characterized tool for addressing some of these clinical and research issues in dementia, only the less expensive and technically simpler SPECT technique will have the potential of being available as a screening diagnostic instrument in the clinical setting. It is concluded that, properly approached, functional brain imaging with SPECT represents an important tool in the diagnosis, management, and research of dementia disorders. (au) 251 refs

  13. Differential diagnosis in patients with ring-like thallium-201 uptake in brain SPECT

    International Nuclear Information System (INIS)

    Kinuya, Keiko; Ohashi, Masahiro; Itoh, Syotaro

    2002-01-01

    This study was performed to investigate lesions with ring-like thallium-201 ( 201 Tl) uptake and to determine whether SPECT provides any information in differential diagnosis. A total of 244 201 Tl SPECT images were reviewed. In each study, early (15 min postinjection) and late (3 hr) brain SPECT images were obtained with 111 MBq of 201 Tl. The early uptake ratio (ER; lesion to normal brain average count ratio) and the late uptake ratio (LR) and the L/E ratio (ratio of LR to ER) were calculated. Ring-like uptake was observed in pre-therapeutic 26 SPECT images, including ten glioblastoma multiformes (ER, 3.45±0.64; LR, 2.74±0.54; L/E ratio 0.80±0.13), five meningiomas (6.48±2.34; 4.41±1.41; 0.72±0.19), four metastatic lung cancers (3.47±1.23; 2.40±0.98; 0.70±0.14), four brain abscesses (2.48±1.06; 1.59±0.30; 0.78±0.15), one invasive lesion of squamous cell carcinoma from the ethmoid sinus (1.54; 1.52; 0.99), one medulloblastoma (3.53; 3.52; 1.00) and one hematoma (3.32; 2.36; 0.71). The ER of meningioma was significantly higher than those of glioblastoma multiforme (p 201 Tl SPECT has still difficulty in differentiating abscess from brain tumor. (author)

  14. Differential diagnosis in patients with ring-like thallium-201 uptake in brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kinuya, Keiko; Ohashi, Masahiro; Itoh, Syotaro [Tonami General Hospital, Toyama (Japan)] (and others)

    2002-09-01

    This study was performed to investigate lesions with ring-like thallium-201 ({sup 201}Tl) uptake and to determine whether SPECT provides any information in differential diagnosis. A total of 244 {sup 201}Tl SPECT images were reviewed. In each study, early (15 min postinjection) and late (3 hr) brain SPECT images were obtained with 111 MBq of {sup 201}Tl. The early uptake ratio (ER; lesion to normal brain average count ratio) and the late uptake ratio (LR) and the L/E ratio (ratio of LR to ER) were calculated. Ring-like uptake was observed in pre-therapeutic 26 SPECT images, including ten glioblastoma multiformes (ER, 3.45{+-}0.64; LR, 2.74{+-}0.54; L/E ratio 0.80{+-}0.13), five meningiomas (6.48{+-}2.34; 4.41{+-}1.41; 0.72{+-}0.19), four metastatic lung cancers (3.47{+-}1.23; 2.40{+-}0.98; 0.70{+-}0.14), four brain abscesses (2.48{+-}1.06; 1.59{+-}0.30; 0.78{+-}0.15), one invasive lesion of squamous cell carcinoma from the ethmoid sinus (1.54; 1.52; 0.99), one medulloblastoma (3.53; 3.52; 1.00) and one hematoma (3.32; 2.36; 0.71). The ER of meningioma was significantly higher than those of glioblastoma multiforme (p<0.0005), metastatic lung cancer (p<0.005) and brain abscess (p<0.0005). There were no significant differences among these three entities. The LR of meningioma was significantly higher than those of glioblastoma multiforme (p<0.005), metastatic lung cancer (p<0.005) and brain abscess (p<0.0001). The LR of brain abscess was significantly lower than that of glioblastoma multiforme (p<0.05). The L/E ratio could not differentiate these four entities. High ER and high LR in a lesion with ring-like uptake is likely an indicator of meningioma. The LR of brain abscess was significantly lower than that of glioblastoma multiforme, but {sup 201}Tl SPECT has still difficulty in differentiating abscess from brain tumor. (author)

  15. Perfusion differences on SPECT and PWI in patients with acute ischemic stroke

    International Nuclear Information System (INIS)

    Nuutinen, Juho; Liu, Yawu; Laakso, Mikko P.; Karonen, Jari O.; Vanninen, Esko J.; Kuikka, Jyrki T.; Aronen, Hannu J.; Vanninen, Ritva L.

    2009-01-01

    The purposes of the present study were to compare the flow defect volumes on perfusion-weighted magnetic resonance imaging (PWI) and 99m Tc-labeled ethylcysteinate dimer ( 99m Tc-ECD) single photon emission computed tomography (SPECT) at acute and subacute stages of ischemic stroke and to analyze the relationship between the detected flow defects on the two methods and neurological status and clinical outcomes. Perfusion defects on PWI and SPECT were measured within 48 h and on day 8 of the onset of stroke from 22 patients with their first-ever acute supratentorial ischemic stroke. The primary neurological status was evaluated prior to the imaging. Clinical outcome was assessed at 3 months after the onset of the stroke. The volumes of cerebral blood flow (CBF) defects did not differ between SPECT and PWI within the 48-h examinations. However, the volume of CBF defect was significantly larger on SPECT than on PWI on day 8 (p = 0.03). Within the 48-h examinations, the CBF defect volumes on SPECT and PWI were comparably related to the neurological status. On day 8, the CBF defect volume on SPECT showed higher correlation to the neurological status and more precisely predicted the clinical outcomes at 3 months than PWI. 99m TC-ECD-SPECT and PWI both have ability to detect cerebral hypoperfusion in patients with ischemic stroke but with some differences. The value of SPECT is more accurate in terms of the delayed outcome, such as prognosis and rehabilitation planning. (orig.)

  16. Perfusion differences on SPECT and PWI in patients with acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Nuutinen, Juho [Kuopio University Hospital, University of Kuopio, Department of Neurology, Kuopio (Finland); Liu, Yawu; Laakso, Mikko P. [Kuopio University Hospital, University of Kuopio, Department of Neurology, Kuopio (Finland); Kuopio University Hospital, University of Kuopio, Department of Clinical Radiology, P. O. Box 1777, Kuopio (Finland); Karonen, Jari O. [Mikkeli Central Hospital, Department of Radiology, Mikkeli (Finland); Vanninen, Esko J. [Kuopio University Hospital, University of Kuopio, Department of Clinical Physiology and Nuclear Medicine, Kuopio (Finland); Kuikka, Jyrki T. [Kuopio University Hospital, University of Kuopio, Department of Clinical Physiology and Nuclear Medicine, Kuopio (Finland); Niuvanniemi Hospital, Kuopio (Finland); Aronen, Hannu J. [University of Turku, Department of Radiology, Turku (Finland); Vanninen, Ritva L. [Kuopio University Hospital, University of Kuopio, Department of Clinical Radiology, P. O. Box 1777, Kuopio (Finland)

    2009-10-15

    The purposes of the present study were to compare the flow defect volumes on perfusion-weighted magnetic resonance imaging (PWI) and {sup 99m}Tc-labeled ethylcysteinate dimer ({sup 99m}Tc-ECD) single photon emission computed tomography (SPECT) at acute and subacute stages of ischemic stroke and to analyze the relationship between the detected flow defects on the two methods and neurological status and clinical outcomes. Perfusion defects on PWI and SPECT were measured within 48 h and on day 8 of the onset of stroke from 22 patients with their first-ever acute supratentorial ischemic stroke. The primary neurological status was evaluated prior to the imaging. Clinical outcome was assessed at 3 months after the onset of the stroke. The volumes of cerebral blood flow (CBF) defects did not differ between SPECT and PWI within the 48-h examinations. However, the volume of CBF defect was significantly larger on SPECT than on PWI on day 8 (p = 0.03). Within the 48-h examinations, the CBF defect volumes on SPECT and PWI were comparably related to the neurological status. On day 8, the CBF defect volume on SPECT showed higher correlation to the neurological status and more precisely predicted the clinical outcomes at 3 months than PWI. {sup 99m}TC-ECD-SPECT and PWI both have ability to detect cerebral hypoperfusion in patients with ischemic stroke but with some differences. The value of SPECT is more accurate in terms of the delayed outcome, such as prognosis and rehabilitation planning. (orig.)

  17. Preoperative localization of epileptic foci with SPECT brain perfusion imaging, electrocorticography, surgery and pathology

    International Nuclear Information System (INIS)

    Jia Shaowei; Xu Wengui; Chen Hongyan; Weng Yongmei; Yang Pinghua

    2002-01-01

    Objective: The value of preoperative localization of epileptic foci with SPECT brain perfusion imaging was investigated. Methods: The study population consisted of 23 patients with intractable partial seizures which was difficult to control with anticonvulsant for long period. In order to preoperatively locate the epileptic foci, double SPECT brain perfusion imaging was performed during interictal and ictal stage. The foci were confirmed with electrocorticography (EcoG), surgery and pathology. Results: The author checked with EcoG the foci shown by SPECT, 23 patients had all typical spike discharge. The regions of radioactivity increase in ictal matched with the abnormal electrical activity areas that EcoG showed. The spike wave originated in the corresponding cerebrum cortex instead of hyperplastic and adherent arachnoid or tumor itself. Conclusions: SPECT brain perfusion imaging contributes to distinguishing location, size, perfusion and functioning of epileptogenic foci, and has some directive function on to making out a treatment programme at preoperation

  18. Quantification of cerebral blood flow and its clinical usefulness. Application of SPECT to psychiatry

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi; Uema, Takeshi; Kogure, Daisuke; Takano, Harumasa; Terada, Tomo [National Center Hospital for Mental, Nervous and Muscular Disorders, Kodaira, Tokyo (Japan)

    1998-10-01

    Brain perfusion SPECT using {sup 99m}Tc-ethyl-cysteinate dimer ({sup 99m}Tc-ECD) was applied to psychiatric diseases with aid of statistical parametric mapping (SPM) for analysis of data. To evaluate influence of aging on brain perfusion, noninvasive measurements of cerebral blood flow using {sup 99m}Tc-ECD were performed in 53 normal volunteers, aged 18 to 87 years old. Mean cerebral blood flow (mCBF) was 43.9{+-}5.0 ml/100 g/min and showed weak negative correlation with aging (r=-0.451). Perisylvian cerebral cortices and medial frontal areas including anterior cingulate gyri showed greater negative correlation than other areas. These findings suggest the necessity of age-matched control regional CBF (rCBF) data to investigate rCBF abnormality in patients. Four drug-naive schizophrenic patients showed flow decrease in bilateral frontal and superior temporal areas and a left infero-posterior temporal area. Haloperidol administration induced flow decrease in bilateral frontal and left parietal areas, while flow increase in bilateral striatal and right hippocampal areas. Ten aged depressive patients showed flow decrease in bilateral frontal and left temporo-parietal areas. Even after remission patients showed flow decrease in the left frontal area as compared with normal subjects. Remission induced flow increase in the right frontal, right parietal, and right orbitofrontal areas compared with depression. These results suggest that CBF measurements using {sup 99m}Tc-ECD are useful for objective evaluation of regional abnormality in brain function in psychiatric diseases. (author)

  19. SPECT and PET Serve as Molecular Imaging Techniques and in Vivo Biomarkers for Brain Metastases

    Science.gov (United States)

    Palumbo, Barbara; Buresta, Tommaso; Nuvoli, Susanna; Spanu, Angela; Schillaci, Orazio; Fravolini, Mario Luca; Palumbo, Isabella

    2014-01-01

    Nuclear medicine techniques (single photon emission computerized tomography, SPECT, and positron emission tomography, PET) represent molecular imaging tools, able to provide in vivo biomarkers of different diseases. To investigate brain tumours and metastases many different radiopharmaceuticals imaged by SPECT and PET can be used. In this review the main and most promising radiopharmaceuticals available to detect brain metastases are reported. Furthermore the diagnostic contribution of the combination of SPECT and PET data with radiological findings (magnetic resonance imaging, MRI) is discussed. PMID:24897023

  20. Technetium-99mTc-HMPAO brain SPECT in antiphospholipid syndrome - preliminary data

    International Nuclear Information System (INIS)

    Romanowicz, G.; Lass, P.; Koseda-Dragan, M.; Nowicki, R.; Krajka-Lauer, J.

    2000-01-01

    Background: Antiphospholipid syndrome (APS) is defined as the presence of repeated episodes of arterial or venous thrombosis, recurrent spontaneous abortions and throbocytopenia in patients with elevated antiphospholipid antibodies. An important feature of APS are cerebrovascular disorders of thrombotic origin. The aim of the study was to assess cerebral blood flow changes utilising brain SPECT HMPAO scanning. METHODS: Brain SPECT 99mTc-HMPAO scanning was performed in 20 patients with APS: 12 with systemic lupus erythematosus, 4 with Sneddon's syndrome, 2 with Sjoegren's syndrome, 2 with primary APS. 30 healthy volunteers served as a control group. RESULTS: 19 studies were abnormal, 1 normal. Abnormalities consisted of multifocal perfusion deficits and diffuse decrease of regional blood flow. The average number of focal perfusion deficits was 4.8±1.7. In 7 patients diffuse hypoperfusion of frontal lobes was seen, in 1 patient additionally hypoperfusion of temporal and occipital lobes. There was a correlation between the number of focal perfusion deficits and cognitive impairment in this group of patients. Correlation between SPECT images and clinical data was moderate in cerebellar syndrome and paresis, weak in persistent headache and vertigo. CONCLUSIONS: Those results indicate the high utility of CBF brain SPECT scanning in antiphospholipid syndrome. (author)

  1. Measurement of cerebral blood flow the blood sampling method using 99mTc-ECD. Simultaneous scintigram scanning of arterial blood samples and the brain with a gamma camera

    International Nuclear Information System (INIS)

    Hachiya, Takenori; Inugami, Atsushi; Iida, Hidehiro; Mizuta, Yoshihiko; Kawakami, Takeshi; Inoue, Minoru

    1999-01-01

    To measure regional cerebral blood flow (rCBF) by blood sampling using 99m Tc-ECD we devised a method of measuring the radioactive concentration in arterial blood sample with a gamma camera. In this method the head and a blood sample are placed within the same visual field to record the SPECT data of both specimens simultaneously. The results of an evaluation of the counting rate performance, applying the 30 hours decaying method using 99m Tc solution showed that this method is not comparable to the well-type scintillation counter and in clinical cases the active concentration in arterial blood sample remained well within the dynamic range. In addition, examination of the influence of scattered radiation from the brain by the dilution method showed that it was negligible at a distance of more than 7.5 cm between the brain and the arterial blood sample. In the present study we placed a head-shaped phantom next to the sample. The results of the examinations suggested that this method is suitable for clinical application, and because it does not require a well-type scintillation counter, it is expected to find wide application. (author)

  2. Brain SPECT in neurology: A critical review

    International Nuclear Information System (INIS)

    Bartenstein, P.; Essen Univ.; Weiller, C.; Essen Univ.

    1994-01-01

    SPECT of the brain with radiopharmaceuticals monitoring regional cerebral blood flow, receptor binding and metabolism offers a wide variety of potentially clinically useful applications. These can be found in neuro-oncology, epilepsy, cerebrovascular diseases, extrapyramidal disorders, dementia and the determination of brain death. The evaluation of the benefit of these methods in routine use requires a close cooperation between nuclear medicine physicians and neurologists, not only in the interpretation and analysis of the actual clinical studies, but also in the design and realization of clinically oriented research with large series of patients. (orig.) [de

  3. SPECT and PET Serve as Molecular Imaging Techniques and in Vivo Biomarkers for Brain Metastases

    Directory of Open Access Journals (Sweden)

    Barbara Palumbo

    2014-06-01

    Full Text Available Nuclear medicine techniques (single photon emission computerized tomography, SPECT, and positron emission tomography, PET represent molecular imaging tools, able to provide in vivo biomarkers of different diseases. To investigate brain tumours and metastases many different radiopharmaceuticals imaged by SPECT and PET can be used. In this review the main and most promising radiopharmaceuticals available to detect brain metastases are reported. Furthermore the diagnostic contribution of the combination of SPECT and PET data with radiological findings (magnetic resonance imaging, MRI is discussed.

  4. Brain SPECT with short focal-length cone-beam collimation

    International Nuclear Information System (INIS)

    Park, Mi-Ae; Moore, Stephen C.; Kijewski, Marie Foley

    2005-01-01

    Single-photon emission-computed tomography (SPECT) imaging of deep brain structures is compromised by loss of photons due to attenuation. We have previously shown that a centrally peaked collimator sensitivity function can compensate for this phenomenon, increasing sensitivity over most of the brain. For dual-head instruments, parallel-hole collimators cannot provide variable sensitivity without simultaneously degrading spatial resolution near the center of the brain; this suggests the use of converging collimators. We have designed collimator pairs for dual-head SPECT systems to increase sensitivity, particularly in the center of the brain, and compared the new collimation approach to existing approaches on the basis of performance in estimating activity concentration of small structures at various locations in the brain. The collimator pairs we evaluated included a cone-beam collimator, for increased sensitivity, and a fan-beam collimator, for data sufficiency. We calculated projections of an ellipsoidal uniform background, with 0.9-cm-radius spherical lesions at several locations in the background. From these, we determined ideal signal-to-noise ratios (SNR CRB ) for estimation of activity concentration within the spheres, based on the Cramer-Rao lower bound on variance. We also reconstructed, by an ordered-subset expectation-maximization (OS-EM) procedure, images of this phantom, as well as of the Zubal brain phantom, to allow visual assessment and to ensure that they were free of artifacts. The best of the collimator pairs evaluated comprised a cone-beam collimator with 20 cm focal length, for which the focal point is inside the brain, and a fan-beam collimator with 40 cm focal length. This pair yielded increased SNR CRB , compared to the parallel-parallel pair, throughout the imaging volume. The factor by which SNR CRB increased ranged from 1.1 at the most axially extreme location to 3.5 at the center. The gains in SNR CRB were relatively robust to mismatches

  5. Evaluation of the effects of methylprednisolone pulse therapy in patients with systemic lupus erythematosus with brain involvement by Tc-99m HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sun, S.S.; Kao, C.H. [Department of Nuclear Medicine, China Medical University Hospital, Taichung (Taiwan); Huang, W.S. [Department of Nuclear Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei (Taiwan); Chen, J.J.H. [Section of Rheumatology, Department of Internal Medicine, China Medicine University Hospital, Taichung (Taiwan); Chang, C.P. [Division of Allergy, Immunology and Rheumatology, Changhua Christian Hospital, Changhua (Taiwan); Wang, J.J. [Department of Medical Research, Chi-Mei Medical Center, Tainan (Taiwan)

    2004-07-01

    Methylprednisolone pulse therapy (MPT) was introduced to avoid life-threatening complications in patients with systemic lupus erythematosus (SLE) with brain manifestations; however, the efficacy of MPT in SLE patients with brain involvement is still uncertain and needs to be objectively evaluated. We enrolled 15 female SLE patients with neuropsychiatric manifestations in this study. All patients had normal brain MRI and abnormal brain HMPAO-SPECT findings. Follow-up HMPAO-SPECT studies were conducted 2 weeks after MPT. Serum levels of anticardiolipin antibodies (ACA) and anti-ribosomal P antibodies (anti-P) were measured before and after MPT. Before MPT, 7 patients were positive for ACA and 7 patients were positive for anti-P. After MPT, none of the 15 patients demonstrated positive serologic findings or neuropsychiatric manifestations. Based on the follow up brain HMPAO-SPECT images following MPT, 13 patients showed disappearance of the perfusion defects and 2 patients showed partial recovery of rCBF. Brain HMPAO-SPECT imaging is a logical and objective tool for measuring the effects of MPT in SLE patients with brain involvement by determining of changes in rCBF. (orig.)

  6. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  7. Longitudinal evaluation of early dementia of Alzheimer type using brain perfusion SPECT

    International Nuclear Information System (INIS)

    Kogure, Daiji; Matsuda, Hiroshi; Ohnishi, Takashi; Kunihiro, Toshiyuki; Uno, Masataka; Asada, Takashi; Takasaki, Masaru

    1999-01-01

    Regional cerebral blood flow (rCBF) measurements using a Patlak plot method of 99m Tc-ECD were performed in early dementia of Alzheimer type (DAT) with both HDS-R and MMSE of over 20 to investigate initial abnormality and longitudinal changes of rCBF. A fusion technique of MRI and SPECT images was developed for MRI-guided analysis of regions of interest in hippocampal areas and statistical parametric mapping (SPM) was used for automated and objective approach to analysis of SPECT image data. Seventeen patients with clinically diagnosed early DAT and age-matched 32 normal control subjects were studied. At the first SPECT studies, the mean cerebral blood flow (mCBF) of 38.6±4.7 ml/100 g/min (mean±SD) for early DAT did not show significant reduction as compared with the normal control value of 42.0±3.8, whereas the rCBF values in the bilateral hippocampi (right; 26.8±4.7, left; 26.7±5.2) showed significant reduction (p<0.05) as compared with the normal control values (right; 38.3±4.2, left; 38.4±3.8). The SPM analysis (voxel height; p<0.001, Bonferroni correction; p<0.05) of the first SPECT images revealed significant selective decrease of relative rCBF in the bilateral posterior cingulate gyri. At the second SPECT studies after 1.4 year on the average from the first studies, mCBF for early DAT showed a slight decrease by 1.7±3.8 ml/100 g/min/year. Bilateral hippocampi showed a greater decrease with slight left side dominance by 3.8±3.3 on the right and 4.4±3.2 on the left side. The SPM analysis demonstrated significant decrease of relative rCBF in the basal forebrain area, the left hippocampus, the left amygdala, and the left parahippocampal area. These results suggest that the MRI-guided ROI analysis of rCBF values in the hippocampus and the SPM analysis of SPECT images are quite useful for early diagnosis and follow-up of DAT. (author)

  8. Clinical applications of brain spect with N-isopropyl-123I-p-iodoamphetamine

    International Nuclear Information System (INIS)

    Moretti, J.L.; Sergent, A.; Raynaud, C.; Baron, J.C.; Samson, Y.; Lassen, N.; Bourdoiseau, M.

    1985-01-01

    Single-photon emission computed tomography (SPECT) with N-isopropyl- 123 I-p-iodoamphetamine (IAMP-I-123) was used for 250 patients suffering from brain disorders, comprising brain tumours (36), normal-pressure hydrocephalus (NPH) (23), cerebrovascular pathologies (127) and partial epilepsy (64). Brain tumours were found to be hypoactive, whatever the grade and nature. Frontal hypoactivity was found in NPH patients, and IAMP-I-123 perfusion was improved after cerebral spinal fluid (CSF) lumbar drainage, giving a good predictive criterion of clinical outcome after CSF diversion. For cerebrovascular disorders, it was possible to obtain with IAMP-I-123 SPECT larger pictures of hypoactive areas than the pictures of hypodense lesions obtained with X-ray CT scans; other hypoactive areas that could not be observed with CT were also delineated by IAMP-I-123 SPECT. The hypoactive areas found in constituted infarctions can present two types of kinetics - those which are 'persistent' (still present on delayed scans performed 5 h after IAMP-I-123 injection) and those which disappear with time, thereby suggesting hypofunctional parenchyma without tissue impairment. IAMP-I-123 SPECT was proved to be useful in assessing ischaemia, especially in reversible ischaemia patients, by defining the affected arterial territory and guiding complementary arteriographic exploration in view of surgical procedures. IAMP-I-123 SPECT was able to accurately delineate the affected parenchymal areas. It could also be of help in the follow-up of the efficiency of drug therapy and surgery, and it can be regarded as a good predictive criterion for stroke rehabilitation. The results obtained with IAMP-I-123 indicate that the lesional and epileptogenic areas in epileptic patients are hypoactive. The localization of these territories by IAMP-I-123 SPECT correlates well with other, more accurate, neuroradiological and stereotactic techniques. (author)

  9. In vivo quantification by SPECT of [123I] ADAM bound to serotonin transporters in the brains of rabbits

    International Nuclear Information System (INIS)

    Ye, X.-X.; Hwang, J.-J.; Hsieh, J.-F.; Chen, J.-C.; Chou, Y.-T.; Tu, K.-Y.; Wey, S.-P.; Ting Gann

    2004-01-01

    Background: A novel radioiodine ligand [ 123 I] ADAM (2-((2-((dimethylamino)methyl)phenyl)thio)-5-iodophenylamine) has been suggested as a promising serotonin transporter (SERT) imaging agent for the central nervous system. In this study, the biodistribution of SERTs in the rabbit brain was investigated using [ 123 I] ADAM and mapping images of the same animal produced by both single-photon emission computed tomography (SPECT) and microautoradiography. A semiquantification method was adopted to deduce the optimum time for SPECT imaging, whereas the input for a simple fully quantitative tracer kinetic model was provided from arterial blood sampling data. Methods: SPECT imaging was performed on female rabbits postinjection of 185 MBq [ 123 I] ADAM. The time-activity curve obtained from the SPECT images was used to quantify the SERTs, for which the binding potential was calculated from the kinetic modeling of [ 123 I] ADAM. The kinetic data were analyzed by the nonlinear least squares method. The effects of the selective serotonin reuptake inhibitors fluoxetine and p-chloroamphetamine (PCA) on rabbits were also evaluated. After scanning, the same animal was sacrificed and the brain was removed for microautoradiography. Regions-of-interest were analyzed using both SPECT and microautoradiography images. The SPECT images were coregistered manually with the corresponding microautoradiography images for comparative study. Results: During the time interval 90-100 min postinjection, the peak specific binding levels in different brain regions were compared and the brain stem was shown to have the highest activity. The target-to-background ratio was 1.89±0.02. Similar studies with fluoxetine and PCA showed a background level for SERT occupation. Microautoradiography demonstrated a higher level of anatomical details of the [ 123 I] ADAM distribution than that obtained by SPECT imaging of the rabbit brain. Conclusion: SPECT imaging of the rabbit brain with [ 123 I] ADAM showed

  10. Recovered neuronal viability revealed by Iodine-123-iomazenil SPECT following traumatic brain injury

    OpenAIRE

    Koizumi, Hiroyasu; Fujisawa, Hirosuke; Kurokawa, Tetsu; Suehiro, Eiichi; Iwanaga, Hideyuki; Nakagawara, Jyoji; Suzuki, Michiyasu

    2010-01-01

    We evaluated cortical damages following traumatic brain injury (TBI) in the acute phase with [123I] iomazenil (IMZ) single photon emission computed tomography (SPECT). In all, 12 patients with cerebral contusion following TBI were recruited. All patients underwent IMZ SPECT within 1 week after TBI. To investigate the changes in distribution of IMZ in the cortex in the chronic phase, after conventional treatment, patients underwent IMZ SPECT again. A decrease in the accumulation of radioligand...

  11. Evaluation of therapeutic effects of cognitive-behavioral therapy in patients with panic disorder using serial 99mTc-ECD brain perfusion

    International Nuclear Information System (INIS)

    Kim, Jung Hee; Song, Ho Chun; Yang, Jong Chul; Lee, Byeong Il; Heo, Young Jun; Bom, Hee Seung; Min, Jung Joon; Park, Tae Jin

    2006-01-01

    Although several neuroanatomical models of panic disorder have been proposed, little is known regarding the neurological mechanisms underlying cognitive-behavioral therapy (CBT) in patients with panic disorder. This study was performed to identify the brain structures that show changes of regional cerebral blood flow (rCBF) after CBT in patients with panic disorder. Seven patients who were diagnosed as panic disorder by DSM-IV were treated with CBT for 8 weeks and twelve healthy volunteers joined in this study. Serial 99m Tc-ECD brain perfusion SPECT images were aquisited and PDSS-SR (Self-Report version of Panic Disorder Severity Scale) and ACQ (Agoraphobic Cognitive Question) scores were measured just before and after CBT in all patients. Data were analyzed using SPM2. Subjective symptoms were improved, and PDSS-SR and ACQ scores were significantly reduced (14.9 ± 3.9 vs. 7.0 ± 1.8, ρ < 0.05; 30.3 ± 8.5 vs. 21.6 ± 3.4, ρ < 0.05, respectively) after CBT in panic patients. Before CBT, a significant increase of rCBF was found in the cingulate gylus, thalamus, midbrain, both medial frontal and temporal lobes of the panic patients compared to the normal volunteers. After CBT, we observed a significant rCBF decrease in the left parahippocamus, right insula and cingulate gyrus, both frontal and temporal lobes, and a significant rCBF increase in both the occipital lobes, left insula, both frontal and left parietal lobes. These data suggested that CBT is effective for panic disorder and diminish the activity of the brain areas associated with fear in panic disorder

  12. PET and SPECT in medically non-refractory complex partial seizures. Temporal asymmetries of glucose consumption, Benzodiazepine receptor density

    International Nuclear Information System (INIS)

    Matheja, P.; Kuwert, T.; Wolf, K.; Schober, O.; Stodieck, S.R.G.; Diehl, B.; Ringelstein, E.B.; Schuierer, G.

    1998-01-01

    Aim: In contrast to medically refractory complex partial seizures (CPS), only limited knowledge exists on cerebral perfusion and metabolism in medically non-refractory CPS. The aim of this study was to investigate the frequency of temporal asymmetries in regional cerebral glucose consumption (rCMRGlc), regional cerebral blood flow (rCBF), and regional cerebral benzodiazepine receptor density (BRD) in this group of patients. Methods: The study included 49 patients with medically non-refractory cryptogenic CPS (age: 36.0±16.1 years). rCMRGlc was studied with F-18-FDG-PET (FDG), rCBF with Tc-99m-ECD-SPECT (ECD), and BRD with I-123-iomazenil-SPECT (IMZ). All studies were performed interictally and within four weeks in each patient. Duration of epilepsy ranged from 0.1 to 42 years (median 4.0 years). SPECT was performed with the triple-headed SPECT camera Multispect 3, PET with the PET camera ECAT EXACT 47. Using linear profiles, glucose consumption, as well as uptake of ECD and IMZ, were measured in four temporal regions of interest (ROIs), and asymmetry indices were calculated (ASY). The results were compared to 95% confidence intervals determined in control subjects. Results: Thirty-five of the 49 (71%) patients had at least one significantly elevated ASY; temporal rCMRGlc was asymmetrical in 41% of the patients, temporal BRD in 29%, and temporal rCBF in 24%. One patient had an asymmetry of all three variables, two of temporal rCMRGlc and BRD, three of temporal rCMRGlc and rCBF, and another four of rCBF and BRD. Fourteen patients had an isolated temporal asymmetry in rCMRGlc, seven in BRD, and four in rCBF. A discrepancy in lateralization between the three modalities was not observed. Conclusion: The majority of patients with medically non-refractory CPS have focal abnormalities of blood flow and metabolism in their temporal lobe. In this group of patients, FDG-PET demonstrates abnormalities with the highest frequency of the three modalities studied, followed by IMZ-SPECT

  13. Analysis of brain SPECT with the statistical parametric mapping package SPM99

    International Nuclear Information System (INIS)

    Barnden, L.R.; Rowe, C.C.

    2000-01-01

    Full text: The Statistical Parametric Mapping (SPM) package of the Welcome Department of Cognitive Neurology permits detection in the brain of different regional uptake in an individual subject or a population of subjects compared to a normal population. SPM does not require a-priori specification of regions of interest. Recently SPM has been upgraded from SPM96 to SPM99. Our aim was to vary brain SPECT processing options in the application of SPM to optimise the final statistical map in three clinical trials. The sensitivity of SPM depends on the fidelity of the preliminary spatial normalisation of each scan to the standard anatomical space defined by a template scan provided with SPM. We generated our own SPECT template and compared spatial normalisation to it and to SPM's internal PET template. We also investigated the effects of scatter subtraction, stripping of scalp activity, reconstruction algorithm, non-linear deformation and derivation of spatial normalisation parameters using co-registered MR. Use of our SPECT template yielded better results than with SPM's PET template. Accuracy of SPECT to MR co-registration was 2.5mm with SPM96 and 1.2mm with SPM99. Stripping of scalp activity improved results with SPM96 but was unnecessary with SPM99. Scatter subtraction increased the sensitivity of SPM. Non-linear deformation additional to linear (affine) transformation only marginally improved the final result. Use of the SPECT template yielded more significant results than those obtained when co registered MR was used to derive the transformation parameters. SPM99 is more robust than SPM96 and optimum SPECT analysis requires a SPECT template. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  14. Brain perfusion SPECT imaging before and during the acetazolamide test using sup 99m Tc-HMPAO

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi; Higashi, Sotaro; Kinuya, Keiko; Tsuji, Shiro; Sumiya, Hisashi; Hisada, Kinichi; Yamashita, Junkoh (Kanazawa Univ. (Japan). School of Medicine)

    1990-05-01

    A new method using brain perfusion {sup 99m}Tc-HMPAO SPECT imaging was developed for evaluating cerebral perfusion reserve by the acetazolamide test with a short period. The first SPECT study was carried out for 13.5 min to obtain SPECT images at the resting state after 3 min postinjection of 555 MBq (15 mCi) of {sup 99m}Tc-HMPAO. At the same time as the start of the first SPECT study, 1 g of acetazolamide was intravenously injected. Immediately after the stop of the 1st SPECT study, 925 MBq (25 mCi) of {sup 99m}Tc-HMPAO from the same vial as in the first study was additionally injected. Three minutes later the second SPECT study was carried out for 10 min. After reconstruction the tomographic images in the first study were subtracted from the images in the second study to obtain those during the acetazolamide test after correction of the time differences in data acquisition between the two studies. This subtraction technique gives independent brain perfusion SPECT images before and during the acetazolamide test. Besides, the regional flow changes during the test were quantitatively analyzed. In conclusion this method seems to be practically useful for evaluating regional brain perfusion before and during drug treatments as a consecutive study with a short period of approximately 30 min. (author).

  15. Functional brain SPECT with 99mTc-HMPAO in the diagnosis of Alzheimer disease

    International Nuclear Information System (INIS)

    Urbanek, J.; Kupka, K.; Samal, M.; Jirak, R.; Obenberger, J.

    1998-01-01

    The explanatory power of perfusion diagrams obtained by the title technique was examined. In addition to the standard reconstruction procedure, a special reorientation procedure aimed at a differentiation of the hippocampus structure was applied. The study gave evidence of a high specificity and sensitivity of brain SPECT in the differential diagnosis of dementias. Multifactorial analysis of all available diagnostic techniques has borne out the dominant position of brain SPECT with 99m Tc-HMPAO, particularly when using special projection onto the hippocampus, and has led to the formulation of an examination algorithm where a combination of SPECT and MRI (and CT) enables DAT to be distinguished from dementias of other etiologies with a probability higher than 90%

  16. Extraosseous accumulation of bone scanning agents in malignant brain tumors. Comparison to semi-quantitative evaluation with 99mTc SPECT/201Tl SPECT and histological findings

    International Nuclear Information System (INIS)

    Suzuki, Aya

    2003-01-01

    Although 201 Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99m Tc-MDP or 99m Tc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation. (author)

  17. Evaluation of therapeutic effects of cognitive-behavioral therapy in patients with panic disorder using serial {sup 99m}Tc-ECD brain perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hee; Song, Ho Chun; Yang, Jong Chul; Lee, Byeong Il; Heo, Young Jun; Bom, Hee Seung; Min, Jung Joon [Chonnam National University Hospital, Gwangju (Korea, Republic of); Park, Tae Jin [Chonnam National University, Gwangju (Korea, Republic of)

    2006-12-15

    Although several neuroanatomical models of panic disorder have been proposed, little is known regarding the neurological mechanisms underlying cognitive-behavioral therapy (CBT) in patients with panic disorder. This study was performed to identify the brain structures that show changes of regional cerebral blood flow (rCBF) after CBT in patients with panic disorder. Seven patients who were diagnosed as panic disorder by DSM-IV were treated with CBT for 8 weeks and twelve healthy volunteers joined in this study. Serial {sup 99m}Tc-ECD brain perfusion SPECT images were aquisited and PDSS-SR (Self-Report version of Panic Disorder Severity Scale) and ACQ (Agoraphobic Cognitive Question) scores were measured just before and after CBT in all patients. Data were analyzed using SPM2. Subjective symptoms were improved, and PDSS-SR and ACQ scores were significantly reduced (14.9 {+-} 3.9 vs. 7.0 {+-} 1.8, {rho} < 0.05; 30.3 {+-} 8.5 vs. 21.6 {+-} 3.4, {rho} < 0.05, respectively) after CBT in panic patients. Before CBT, a significant increase of rCBF was found in the cingulate gylus, thalamus, midbrain, both medial frontal and temporal lobes of the panic patients compared to the normal volunteers. After CBT, we observed a significant rCBF decrease in the left parahippocamus, right insula and cingulate gyrus, both frontal and temporal lobes, and a significant rCBF increase in both the occipital lobes, left insula, both frontal and left parietal lobes. These data suggested that CBT is effective for panic disorder and diminish the activity of the brain areas associated with fear in panic disorder.

  18. Clinical Utility of '99mTc-HMPAO Brain SPECT Findings in Chronic Head Injury

    International Nuclear Information System (INIS)

    Chung, Jin ll; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Jong Doo; Park, Chang Yoon; Kim, Young Soo

    1992-01-01

    Minima deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using 99m Tc-HMPAO Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months following head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with 99m Tc-HMPAO Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using 99m Tc-HMPAO Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

  19. Marchiafava-Bignami disease: a case studied with brain magnetic resonance and SPECT

    International Nuclear Information System (INIS)

    Cardozo Oliver, J.; Casas Parera, Ignacio; Libere, G.; Malagold, S.

    2006-01-01

    Objective: To show the correlation between brain magnetic resonance images (MRI) and single-photon-emission computed tomography (SPECT) in a patient with Marchiafava-Bignami (MB) disease. Background: MB disease is a rare disorder associated with chronic alcoholism. It is characterized by symmetric demyelination of corpus callosum (CC) and adjacent white matter. These lesions can be demonstrated both by computed tomography or/and MRI. Scarce information is available about MRI and SPECT according to the research done. Design/methods: A 79-year-old white man with a history of excessive alcohol consumption (predominantly wine) was admitted to our Institute. A decrease in his physical activity was evidenced in the two years prior to admission and in the last twelve months progressive dementia with hallucinations and severe apathy developed. On admission neurologic examination showed papillae pale in both eyes, left hearing loss, action tremor of upper limbs and proximal hyporeflexia with distal arreflexia of all four limbs was observed. Affectation of higher cortical functions was evident. Cerebrospinal fluid was normal and serology for syphilis and HIV were negative. Both renal and hepatic functions were normal. Brain MRI and SPECT were performed. The patient died 70 days after diagnosis of MB disease. Results: MRI scans of the brain showed multiple hyperintense T2-weighted lesions in white matter and basal ganglia. Cortical atrophy, especially in the fronto-temporal areas, and a CC thickness reduction were also observed. Sagittal view showed an irregular cavitation in the genu of the CC, hypointense and hyperintense on T1 and T2-weighted images respectively. The SPECT showed an abnormal low perfusion on both frontal lobes, left temporo-parietal lobes and right basal ganglia. Conclusion: The clinical features and MRI were consistent with the diagnosis of MB disease. MRI and SPECT studies showed the connection between the lesion in the CC and bilateral cortical

  20. Clinical studies of brain functional images by motor activation using single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Masahiro [Gifu Univ. (Japan). School of Medicine

    1998-09-01

    Thirty participants (10 normal controls; group A, 5 patients with brain tumors located near central sulcus without hemiparesis; group B, 10 patients with brain tumors located near central sulcus with hemiparesis; group C, and 5 patients with brain tumors besides the central regions with hemiparesis; group D) were enrolled. The images were performed by means of split-dose method with {sup 99m}Tc-ECD at rest condition (SPECT 1) and during hand grasping (SPECT 2). The activation SPECT were obtained by subtracting SPECT 1 from SPECT 2, and the functional mapping was made by the strict registration of the activation SPECT with 3D MRI. To evaluate the changes of CBF (%{Delta}CBF) of the sensorimotor and supplementary motor areas on the functional mapping, ratio of the average counts of SPECT 1 and SPECT 2 was calculated and statistically compared. The functional activation paradigms caused a significant increase of CBF in the sensorimotor area contra-lateral to the stimulated hand, although the sensorimotor area and the central sulcus in groups B and C were dislocated, compared with hemisphere of non-tumor side. The sensorimotor area ipsi-lateral to the stimulated hand could be detected in almost of all subjects. The supplementary motor area could be detected in all subjects. In group A, the average %{Delta}CBF were up 24.1{+-}4.3% in the contra-lateral sensorimotor area, and 22.3{+-}3.6% in the supplementary motor area, respectively. The average %{Delta}CBF in the contra-lateral sensorimotor area of group D was significantly higher than that of group A. The brain functional mapping by motor activation using SPECT could localize the area of cortical motor function in normal volunteers and patients with brain tumors. The changes of regional CBF by activation SPECT precisely assess the cortical motor function even in patients with brain tumors located near central sulcus. (K.H.)

  1. Clinical studies of brain functional images by motor activation using single photon emission computed tomography

    International Nuclear Information System (INIS)

    Kawaguchi, Masahiro

    1998-01-01

    Thirty participants (10 normal controls; group A, 5 patients with brain tumors located near central sulcus without hemiparesis; group B, 10 patients with brain tumors located near central sulcus with hemiparesis; group C, and 5 patients with brain tumors besides the central regions with hemiparesis; group D) were enrolled. The images were performed by means of split-dose method with 99m Tc-ECD at rest condition (SPECT 1) and during hand grasping (SPECT 2). The activation SPECT were obtained by subtracting SPECT 1 from SPECT 2, and the functional mapping was made by the strict registration of the activation SPECT with 3D MRI. To evaluate the changes of CBF (%ΔCBF) of the sensorimotor and supplementary motor areas on the functional mapping, ratio of the average counts of SPECT 1 and SPECT 2 was calculated and statistically compared. The functional activation paradigms caused a significant increase of CBF in the sensorimotor area contra-lateral to the stimulated hand, although the sensorimotor area and the central sulcus in groups B and C were dislocated, compared with hemisphere of non-tumor side. The sensorimotor area ipsi-lateral to the stimulated hand could be detected in almost of all subjects. The supplementary motor area could be detected in all subjects. In group A, the average %ΔCBF were up 24.1±4.3% in the contra-lateral sensorimotor area, and 22.3±3.6% in the supplementary motor area, respectively. The average %ΔCBF in the contra-lateral sensorimotor area of group D was significantly higher than that of group A. The brain functional mapping by motor activation using SPECT could localize the area of cortical motor function in normal volunteers and patients with brain tumors. The changes of regional CBF by activation SPECT precisely assess the cortical motor function even in patients with brain tumors located near central sulcus. (K.H.)

  2. SPECT perfusion brain scintigraphy in dementia: early diagnostic and differential diagnostic

    International Nuclear Information System (INIS)

    Klisarova, A.

    2003-01-01

    The present review discusses the role of Single Photon Emission Computer Tomography (SPECT) and Positron Emission Tomography (PET) for the early detection and the differential diagnosis of the different types of dementia. The usefulness of the functional imaging is particularly emphasized in the detection of the early changes occurring in Alzheimer's diseases. The early diagnosis is a crucial factor for the treatment in the phase of reversible changes. The correlation between the severity of the diseases and the degree of hypoperfusion of the functional neuroimaging is also subject to review. SPECT and PET are of particular importance for the differential diagnosis of the various kinds of dementia. The imaging models are defined for the different stages of diseases. The functional imaging together with the clinical tests increase the diagnostic accuracy in Alzheimer's disease. The review presents the relation between the development of Alzheimer's disease and some risk factors. The review confirms the usefulness of SPECT and PET in the early diagnosis of Alzheimer's disease and the differential diagnosis of the different types of dementia which proves the SPECT appropriateness in the routine clinical practice. The brain structures are more advantageous than the other methods of visualisation (CT and MRI) for the detection of the functional disorders in the brain cortex in a number of diseases of the central nervous system. (author)

  3. Brain SPECT of chronic fatigue syndrome (CFS): a blinded visual analysis

    International Nuclear Information System (INIS)

    Casse, R.; Chew, G.; Barnden, L.; DelFante, P.; Burnet, R.; Kwiatek, R.; Chew, J.; Behin-Ain, S.; Unger, S.

    2002-01-01

    Full text: Chronic fatigue syndrome (CFS) is a debilitating and complex disorder characterised by profound fatigue and neuropsychiatric dysfunction. Previous studies with cerebral perfusion SPECT (rCBF) scans have yielded conflicting results. Most were performed with inhomogeneous patient populations and the findings were not based on a blinded visual analysis. To address this, HMPAO SPECT on a triple head gamma camera was performed on a group of 59 subjects. This group included 32 subjects (16-61 years, 24F and 8M) with moderate CFS based on the Fukuda criteria not on medication and not depressed and 27 normal volunteers (20-56 years, 16F and 11 M). Two blinded reviewers (RC and GC) separately assessed the SPECT studies. 28 brain structures were scored as either definitely abnormal(1), possibly abnormal(2) or normal(3-5). Abnormal results were only found in the temporal lobes and brainstem. The results (Sensitivity/Specificity) based on scores 1 or 2, show that that abnormal score yielded acceptable specificity but low sensitivity. Scores 1 or 2 improved sensitivity but reduced the specificity. This shows that visual analysis of brain SPECT is not a reliable discriminant test for CFS, although quantitative analysis with statistical parametric mapping (SPM) has demonstrated significant abnormalities. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  4. Evaluation of Gilles de la Tourette syndrome with [99mTc] HMPAO Brain SPECT

    International Nuclear Information System (INIS)

    Carreira, LCTF; Santos, A. O; Juarez, B. A; Leite, H. A; Lima, M. C. L; Ramos, C. D; Camargo, E. E

    2002-01-01

    Gilles de la Tourette syndrome (GLTS) is a disorder characterized by tics and several behavioral disturbances. Although GLTS is a relatively common disorder, little is known about its pathophysiology. Previous studies with SPECT and PET were performed in a small number of patients and have shown some discordant data. The aim of this study is to evaluate brain perfusion abnormalities in patients with GLTS and to correlate them with the clinical manifestations of the syndrome. Twenty-eight patients were submitted to brain [99mTc]-HMPAO SPECT. 82 percent of the patients had abnormal studies. The most frequent finding was perfusion abnormalities in the thalami in 16 patients (57 percent) and 85 percent of patients with hyperperfusion of one or both thalami had complex motor tics. This investigation has demonstrated that brain perfusion SPECT is able to identify cortical perfusion abnormalities, associated with clinical symptoms in patients with GLTS. These abnormalities involve the pre-frontal-striatal-thalamic-cortical pathways (Au)

  5. In vivo quantification by SPECT of [{sup 123}I] ADAM bound to serotonin transporters in the brains of rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Ye, X.-X. [Institute of Radiological Sciences, National Yang-Ming University, Taipei 112, Taiwan (China); Hwang, J.-J. [Institute of Radiological Sciences, National Yang-Ming University, Taipei 112, Taiwan (China); Hsieh, J.-F. [Department of Nuclear Medicine, Chi-Mei Foundation Medical Center, Yungkang City 710, Taiwan (China); Chen, J.-C. [Institute of Radiological Sciences, National Yang-Ming University, Taipei 112, Taiwan (China)]. E-mail: jcchen@ym.edu.tw; Chou, Y.-T. [Institute of Physiology, National Yang-Ming University, Taipei 112, Taiwan (China); Tu, K.-Y. [Department of Nuclear Medicine, Mackey Memorial Hospital, Taipei, Taiwan 104 (China); Wey, S.-P. [Department of Medical Imaging and Radiological Sciences, Chang-Gung University, Taoyuan, Taiwan 333 (China); Ting Gann [Institute of Nuclear Energy Research, Tao- Yuan 335, Taiwan (China)

    2004-11-01

    Background: A novel radioiodine ligand [{sup 123}I] ADAM (2-((2-((dimethylamino)methyl)phenyl)thio)-5-iodophenylamine) has been suggested as a promising serotonin transporter (SERT) imaging agent for the central nervous system. In this study, the biodistribution of SERTs in the rabbit brain was investigated using [{sup 123}I] ADAM and mapping images of the same animal produced by both single-photon emission computed tomography (SPECT) and microautoradiography. A semiquantification method was adopted to deduce the optimum time for SPECT imaging, whereas the input for a simple fully quantitative tracer kinetic model was provided from arterial blood sampling data. Methods: SPECT imaging was performed on female rabbits postinjection of 185 MBq [{sup 123}I] ADAM. The time-activity curve obtained from the SPECT images was used to quantify the SERTs, for which the binding potential was calculated from the kinetic modeling of [{sup 123}I] ADAM. The kinetic data were analyzed by the nonlinear least squares method. The effects of the selective serotonin reuptake inhibitors fluoxetine and p-chloroamphetamine (PCA) on rabbits were also evaluated. After scanning, the same animal was sacrificed and the brain was removed for microautoradiography. Regions-of-interest were analyzed using both SPECT and microautoradiography images. The SPECT images were coregistered manually with the corresponding microautoradiography images for comparative study. Results: During the time interval 90-100 min postinjection, the peak specific binding levels in different brain regions were compared and the brain stem was shown to have the highest activity. The target-to-background ratio was 1.89{+-}0.02. Similar studies with fluoxetine and PCA showed a background level for SERT occupation. Microautoradiography demonstrated a higher level of anatomical details of the [{sup 123}I] ADAM distribution than that obtained by SPECT imaging of the rabbit brain. Conclusion: SPECT imaging of the rabbit brain with

  6. Dynamic study on cerebral perfusion of the pentylenetetrazol kindling cats by SPECT

    International Nuclear Information System (INIS)

    Hou Min; Liu Xingdang; Wang Kaiyan

    2004-01-01

    Objective: To learn the change of cerebral perfusion in the pentylenetetrazol kindling cats during the development of epilepsy. Methods: firstly, we performed 12 basic 99m Tc- ethyl cysteinate dimmer (ECD) SPECT as auto-control before the cats were made into epileptic models. Then, according to seizure level of epileptic model, SPECT was performed when the cats began to seizure in the form of facial tic(level 1), nodding spasm (level 2), limb tonic seizures (level 3) and generalized tonic-clonic seizures(level 4). At the same time, we detected the EEG at each level of seizure in order to contrast with SPECT findings. Results:There is no abnormal SPECT finding of cats before using PTZ. The SPECT at each level of kindling: hyperperfusion in forehead and basal ganglia at level 1; more evident hyperperfusion in forehead at level 2; the hyperperfusion in forehead being weakened and another hyperperfusion appearing in deep parietal lobe at level 3; the hyperperfusion in forehead disappearing and the hyperfusion in deep parietal lobe becoming more obvious and a hypoperfusion beside it appearing at level 4. As the time going on, the hyperperfusion disappeared completely and the hypoperfusion became more and more clear. The SPECT findings are coincided with EEG findings. Conclusion: 1. During the kindling of cats, a regional hyperperfusion appeared in the cats' brain: at the stage of focal seizure, the cerebral perfusion increased in forehead and ganglia; at the stage of generalized seizure, the hyperperfusion region gradually moved from forehead to deep parietal lobe. 2. Once the model animal was completely kindled, there would be a fixed hypoperfusion region instead, which may be the epileptic focus. (authors)

  7. Maladaptation of cerebral perfusion in the spinal cord injured individuals

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Ihn Ho; Chun, Kyung A.; Lee, Hyoung Woo; Ahn, Sang Ho; Hayashida, Kohei [National Cardiovascular Center, Osaka (Korea, Republic of)

    2001-07-01

    The aim of this study was to evaluate the tilt-induced alteration of cerebral perfusion of spinal cord injured individuals. Supine and upright sitting brain SPECT was performed using a 1-day protocol with {sup 99m}Tc-ethylcysteinate dimer (ECD) in 11 SCI individuals (mean age, 32.6 y), with lesions between C3 and T4, ad 5 AB individuals (mean age, 31.4 y). The patients rested on a wheelchair in the supine position. Then, they sat up and, at the same time 555MBq of ECD was injected. The upright SPECT was done. Finally, 740MBq of ECD was injected and supine SPECT was performed again. The SPECT data were acquired with dual head gamma camera (E-cam, Siemens). For semiquantitative analysis, 14 ROIs were drawn on the brain. In the SCI individuals, the radiotracer uptake in the frontal, temporal and parietal areas were significantly decreased in the upright SPECT. No postural changes was evident in the occipital lobe, basal ganglia and thalamus in the SCI individuals. In the AB individuals, there were no such changes on the upright SPECT. Postural cerebral hypoperfusion in the frontal, temporal and parietal areas in the SCI individuals might relate to maladaptation of the vascular response during the upright position.

  8. Improvement of the 99mTc-ECD brain uptake ratio (BUR) method for measurement of cerebral blood flow

    International Nuclear Information System (INIS)

    Ito, Shigeki; Takaki, Akihiro; Inoue, Shinya

    2012-01-01

    The brain uptake ratio (BUR) method for the 99m Tc-ethylcysteinate dimer ( 99m Tc-ECD) single photon emission computed tomography (SPECT), a non-invasive measurement method of regional cerebral blood flow (rCBF), has been used in clinical practice in Japan, because it is simple to use. However, the accuracy of this method is limited, as it has problems in the determination of input function and the regression equation. The purpose of this study is to improve the BUR method by reconstructing the determination process of the input function and regression equation based on measurement of the rCBF by H 2 15 O positron emission tomography (PET). The input function was obtained by setting the region of interest on the ascending aorta instead of the aortic arch. The 3DSRT algorithm was used to obtain the anatomically standardized rCBF, and developed a semi-automatic analyzing software using C++ in order to stabilize the repeatability of the improved BUR (IBUR) method. The regression equation for the IBUR method was obtained by the H 2 15 O PET rCBFs in 15 patients with the arterial blood sampling method. All the measurements in this study were performed with the patient in the resting state. A good correlation was observed between the rCBF values measured by H 2 15 O PET and the regional BURs measured by the IBUR method (r=0.86, p 2 15 O PET. This finding indicates the potential clinical usefulness of this method. (author)

  9. Dynamic SPECT of the brain using a lipophilic technetium-99m complex, PnAO

    DEFF Research Database (Denmark)

    Holm, S; Andersen, A R; Vorstrup, S

    1985-01-01

    m PnAO was injected i.v. as a bolus of 15 to 25 mCi. The distribution was followed over 10-sec intervals using a highly sensitive, rapidly rotating SPECT (Tomomatic 64) and compared to 133Xe flow maps. Upon arrival of the PnAO bolus to the brain, a high uptake was found in brain tissue with high......The lipophilic 99mTc-labeled oxime propylene amine oxime (PnAO) should, according to recent reports behave like 133Xe in the human brain. This study compares SPECT images of the two tracers in six subjects: four stroke cases, one transitory ischemic attack case and one normal subject. Technetium-99......AO has a high yet incomplete brain extraction yielding a flow dominated initial distribution with limitations mentioned....

  10. A study of 99mTc-HM-PAO brain SPECT in the senile parkinson's disease

    International Nuclear Information System (INIS)

    Chen Wenxin; Lin Xiangtong; Song Wenzhong; Liu Yongchang

    1996-01-01

    Thirty-three cases of senile Parkinson's disease (PD) imaged by 99m Tc-HM-PAO brain SPECT were reported. 66.7% of the patients had cortical hypoperfusion and 18.2% showed asymmetrical hypoperfusion in the basal ganglia. Such a finding was not related with the Hoehn-Yahr stage and the laterality of motor symptoms. If complicated with dementia, the SPECT brain imaging showed similar pattern in Alzheimer's disease with diffuse hypoperfusion in cortical area reflecting widespread pathological changes in tremor paralysis

  11. Diamox-enhanced brain SPECT in cerebrovascular diseases

    International Nuclear Information System (INIS)

    Choi, Yun Young

    2007-01-01

    Acute event in cerebrovascular disease is the second most common cause of death in Korea following cancer, and it can also cause serious neurologic deficits. Understanding of perfusion status is important for clinical applications in management of patients with cerebrovascular diseases, and then the attacks of ischemic neurologic symptoms and the risk of acute events can be reduced. Therefore, the normal vascular anatomy of brain, various clinical applications of acetazolamide-enhanced brain perfusion SPECT, including meaning and role of assessment of vascular reserve in carotid stenosis before procedure, in pediatric Moyamoya disease before and after operation, in prediction of development of hyperperfusion syndrome before procedure, and in prediction of vasospasm and of prognosis in subarachnoid hemorrhage were reviewed in this paper

  12. 201Tl brain SPECT in differentiating central nervous system lymphoma from toxoplasmosis in AIDS patients

    International Nuclear Information System (INIS)

    Kamata, Noriko; Suzuki, Kenzo; Abe, Katsumi; Yokoyama, Yoshiaki; Ushimi, Hisashi; Terada, Kazushi

    1997-01-01

    In AIDS patients, toxoplasmosis and lymphoma are the leading causes of CNS mass lesions. It is important to make the correct diagnosis expeditiously, since the two diseases require markedly different treatments and have different prognoses. In general, CT and MR imaging have failed to provide specific distinguishing characteristics to differentiate CNS lymphoma from toxoplasmosis, and it is difficult to differentiate these entities clinically. We performed 201 Tl brain SPECT in order to differentiate two diseases. Counts ratio of a lesion to the normal brain (L/N ratio) was elevated in patients of lymphoma compared in patients of toxoplasmosis. 201 Tl brain SPECT is useful to differentiate CNS lymphoma from toxoplasmosis. (author)

  13. MRI and brain spect findings in patients with unilateral temporal lobe epilepsy and normal CT scan

    Directory of Open Access Journals (Sweden)

    P.G. Carrilho

    1994-06-01

    Full Text Available 26 patients with temporal lobe epilepsy clinically documented by several abnormal interictal surface EEGs with typical unitemporal epileptiform activity and a normal CT scan were studied. Interictal99mTC HMPAO brain SPECT and MRI were performed in all subjects. Abnormalities were shown in 61.5% of MRI (n=16 and 65.4% of SPECT (n=17. Hippocampal atrophy associated to a high signal on T2-weighted MRI slices suggesting mesial temporal sclerosis was the main finding (n=12; 75% of abnormal MRI. MRI correlated well to surface EEG in 50% (n=13. There was also a good correlation between MRI and SPECT in 30.7% (n=8. SPECT and EEG were in agreement in 57.7% (n=l5. MRI, SPECT and EEG were congruent in 26.9% (n=7. These results support the usefulness of interictal brain SPECT and MRI in detecting lateralized abnormalities in temporal lobe epilepsy. On the other hand, in two cases, interictal SPECT correlated poorly with surface EEG. This functional method should not be used isolately in the detection of temporal lobe foci. MRI is more useful than CT as a neuroimaging technique in temporal lobe epilepsy. It may detect small structural lesions and mesial temporal lobe sclerosis which are not easily seen with traditional CT scanning.

  14. Validation of brain tumour imaging with p-[123I]iodo-l-phenylalanine and SPECT

    International Nuclear Information System (INIS)

    Hellwig, Dirk; Sell, Nadja; Schaefer, Andrea; Kirsch, Carl-Martin; Samnick, Samuel; Ketter, Ralf; Moringlane, Jean R.; Romeike, Bernd F.M.

    2005-01-01

    The aims of this prospective study were to validate single-photon emission computed tomography (SPECT) with p-[ 123 I]iodo-l-phenylalanine (IPA) in brain tumours and to evaluate its potential for the characterisation of indeterminate brain lesions. In 45 patients with indeterminate brain lesions or suspected progression of glioma, amino acid uptake was studied using IPA-SPECT and compared with the final diagnosis established by biopsy or serial imaging. After image fusion of IPA-SPECT and magnetic resonance imaging, the presence of tumour was visually determined by two independent observers. IPA uptake was quantified as the ratio between maximum uptake in the suspicious lesion and mean uptake in unaffected brain. Primary brain tumours were present in 35 cases (12 low-grade and 23 high-grade gliomas). Non-neoplastic brain lesions were confirmed in seven cases (three dysplasias, three inflammatory lesions, one lesion after effective therapy). Visual analysis showed a high concordance between the two observers (kappa=0.90, p<0.001), with sensitivity and specificity of 86% and 100% for the discrimination of primary brain tumours and non-neoplastic lesions. At 30 min p.i., IPA uptake in primary brain tumours was higher than that in non-neoplastic lesions (1.70±0.36 vs 1.14±0.18, p<0.05). Brain metastases showed no increased uptake (1.13±0.22, n=3). The persistent retention of IPA in low-grade gliomas without disruption of the blood-brain barrier was visualised up to 24 h p.i. Low-grade and high-grade gliomas showed equivalent IPA uptake (1.72±0.37 vs 1.67±0.36 at 30 min, p=0.745). IPA shows long and specific retention in gliomas. IPA is a promising and safe radiopharmaceutical for the visualisation of gliomas and the characterisation of indeterminate brain lesions. (orig.)

  15. Optimization of Butterworth filter for brain SPECT imaging

    International Nuclear Information System (INIS)

    Minoshima, Satoshi; Maruno, Hirotaka; Yui, Nobuharu

    1993-01-01

    A method has been described to optimize the cutoff frequency of the Butterworth filter for brain SPECT imaging. Since a computer simulation study has demonstrated that separation between an object signal and the random noise in projection images in a spatial-frequency domain is influenced by the total number of counts, the cutoff frequency of the Butterworth filter should be optimized for individual subjects according to total counts in a study. To reveal the relationship between the optimal cutoff frequencies and total counts in brain SPECT study, we used a normal volunteer and 99m Tc hexamethyl-propyleneamine oxime (HMPAO) to obtain projection sets with different total counts. High quality images were created from a projection set with an acquisition time of 300-seconds per projection. The filter was optimized by calculating mean square errors from high quality images visually inspecting filtered reconstructed images. Dependence between total counts and optimal cutoff frequencies was clearly demonstrated in a nomogram. Using this nomogram, the optimal cutoff frequency for each study can be estimated from total counts, maximizing visual image quality. The results suggest that the cutoff frequency of Butterworth filter should be determined by referring to total counts in each study. (author)

  16. Comparison of benzodiazepine receptor SPECT and 18F-FDG PET using a coincidence detection camera in patients with temporal lobe epilepsy: preliminary results

    International Nuclear Information System (INIS)

    Wissmeyer, M.; Geiger, L.; Luescher, D.; Krause, T.; Loevblad, K.; Donati, F.; Wielepp, J.P.

    2002-01-01

    Full text: The aim of this preliminary study was to compare the results of benzodiazepine receptor (BDR) SPECT using 123 I-Iomazenil with those of 18 F-FDG (FDG) PET obtained on a double-headed gamma camera with a coincidence detection system in patients with temporal lobe epilepsy (TLE). We evaluated 6 patients (4 female, 2 male; age range 26-54 years, average 43.5 years) with therapy-refractory TLE due to mesiotemporal sclerosis or other focal brain anomalies. To delineate the epileptogenic zone, clinical evaluation, ictal and interictal surface EEG using the international 10-20 system, brain MRI, interictal CBF SPECT using 99m Tc-ECD, BDR SPECT and FDG coincidence PET were performed. The CBF SPECT, BDR SPECT and coincidence PET scans were viewed independently by 2 observers considering the regional cerebral blood flow, BDR density and FDG uptake asymmetry in the temporal lobe visually as none (0), low (1), moderate (2) and high (3). Ictal and interictal EEG recordings located the epileptogenic focus in all patients in the temporal region. Both the BDR SPECT and the FDG coincidence PET located the epileptogenic focus correctly in circumscribed areas of the temporal lobe in all patients, whereas brain MRI revealed focal anomalies only in 5 of 6 cases . The lateralization to the right (n=4) and left hemisphere (n=2) by interictal CBF SPECT, BDR SPECT and FDG coincidence PET corresponded to the EEG findings in all patients. The visual consideration of the asymmetry revealed a slightly but not statistically significant higher value for the FDG coincidence PET (observer 1: mean 2.333, SD 0.516; observer 2: mean 2.000, SD 0.632) than for the BDR SPECT (observer 1: mean 1.667, SD 1.033; observer 2: mean 1.833, SD 0.753). Visual consideration of the interictal CBF SPECT revealed mean values of 2.000 for both observers. The inter-observer variability was higher in the BDR SPECT than in the FDG coincidence PET and the interictal CBF SPECT, but the difference was not

  17. Imaging of mild traumatic brain injury using 57Co and 99mTc HMPAO SPECT as compared to other diagnostic procedures.

    Science.gov (United States)

    Audenaert, Kurt; Jansen, Hugo M L; Otte, Andreas; Peremans, Kathelijne; Vervaet, Myriam; Crombez, Roger; de Ridder, Leo; van Heeringen, Cees; Thirot, Joel; Dierckx, Rudi; Korf, Jaap

    2003-10-01

    Traumatic brain injury (TBI) is usually assessed with the Glasgow Coma Scale (GCS), CT and EEG. TBI can result from either the primary mechanical impact or secondary (ischemic) brain damage, in which calcium (Ca) plays a pivotal role. This study was undertaken to compare the applicability of SPECT using 57Co as a Ca-tracer in patients with mild traumatic brain injury. 8 patients with mild TBI (GCS 15) were clinically examined and studied with EEG, neuropsychological testing (NPT) and SPECT within 2 days post-TBI. After i.v.-administration of 37 MBq (1 mCi) 57Co (effective radiation dose 0.34 mSv x MBq(-1); 1.24 rem x mCi(-1); physical half-life 270 days, biological half-life 37.6 h), single-headed SPECT (12 h pi) was performed, consecutively followed by standard 925 MBq (25 mCi) Tc-99m HMPAO SPECT. In 6 of the 8 patients, baseline NPT and SPECT showed focal abnormalities in the affected frontal and temporal brain regions, which were in good topographical accordance. CT and EEG did not detect (structural) lesions in any of these cases. Single-headed 57Co-SPECT is able to show the site and extent of brain damage in patients with mild TBI, even in the absence of structural lesions. It may confirm and localize NPT findings. The predictive value of 57Co-SPECT should be assessed in larger patient series.

  18. Semi-automatic detection and correction of body organ motion, particularly cardiac motion in SPECT studies

    International Nuclear Information System (INIS)

    Quintana, J.C.; Caceres, F.; Vargas, P.

    2002-01-01

    Aim: Detect patient motion during SPECT imaging. Material and Method: SPECT study is carried out on a patient's body organ, such as the heart, and frame of image data are thereby acquired. The image data in these frames are subjected to a series of mappings and computations, from which frame containing a significant quantity of organ motion can be identified. Quantification of motion occurs by shifting some of the mapped data within a predetermined range, and selecting that data shift which minimizes the magnitude of a motion sensitive mathematical function. The sensitive mathematical function is constructed from all set of image frames using the pixel data within a region covering the body organ. Using cine display of planar image data, the operator defines the working region by marking two points, which define two horizontal lines covering the area of the body organ. This is the only operator intervention. The mathematical function integrates pixel data from all set of image frames and therefore does not use derivatives which may cause distortion in noisy data. Moreover, as a global function, this method is superior than that using frame-to-frame cross-correlation function to identify motion between adjacent frames. Using standard image processing software, the method was implemented computationally. Ten SPECT studies with movement (Sestamibi cardiac studies and 99m-ECD brain SPECT studies) were selected plus two others with no movement. The acquisition SPECT protocol for the cardiac study was as follow: Step and shoot mode, non-circular orbit, 64 stops 20s each, 64x64x16 matrix and LEHR colimator. For the brain SPECT, 128 stops over 360 0 were used. Artificial vertical displacements (±1-2 pixels) over several frames were introduced in those studies with no movement to simulate patient motion. Results: The method was successfully tested in all cases and was capable to recognize SPECT studies with no body motion as well as those with body motion (both from the

  19. 99Tcm brain imaging for the assessment of patients with intractable partial epilepsy - our experience

    International Nuclear Information System (INIS)

    Schlicht, S.; Bruns, M.; Booth, R.; Octigan, K.; Karamoskos, P.; Cook, M.; O'Brien, T.

    2000-01-01

    Full text: 99 Tc m - Ethyl Cysteinate Diethylester (ECD) or Bicisate is a new radiopharmaceutical used for the assessment of cerebral perfusion. Unlike 99 Tc m Hexamethylpropylene Amine Oxime ( 99 Tc m - HMPAO) which is unstable and needs to be reconstituted immediately prior to injection, 99 Tc m -ECD is stable for up to eight hours following reconstitution. Therefore, 99 Tc m -ECD does not require mixing just prior to injection and is readily available on a daily inpatient basis to the epilepsy unit, facilitating earlier and faster injections, and the acquisition of true ictal studies. This is particularly important with patients who have extra temporal seizures which are typically brief in duration. 45 patients have undergone 99 Tc m -ECD studies for epilepsy in our department over a period of one year. Image acquisition routinely commences within two hours of injection, and consists of a 360 degree elliptical SPECT using an ADAC Dual Headed Gamma Camera. Patients undergo both ictal and inter ictal SPECT studies, and an MRI. Visual comparison of the ictal, inter ictal and MRI images is performed, as well as subtraction and co-registration. The SISCOM analysis technique is used which allows subtraction of the SPECTs and co registration with MRI. This has the advantage of improved specificity, sensitivity, and accurate anatomical localisation. The results of our experience with 99Tcm-ECD will be presented. In conclusion, we have found that 99 Tc m -ECD is ideally suited for peri-ictal SPECT studies as part of the pre-operative assessment of patients with intractable partial epilepsy. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  20. Improvement of image quality using interpolated projection data estimation method in SPECT

    International Nuclear Information System (INIS)

    Takaki, Akihiro; Soma, Tsutomu; Murase, Kenya; Kojima, Akihiro; Asao, Kimie; Kamada, Shinya; Matsumoto, Masanori

    2009-01-01

    General data acquisition for single photon emission computed tomography (SPECT) is performed in 90 or 60 directions, with a coarse pitch of approximately 4-6 deg for a rotation of 360 deg or 180 deg, using a gamma camera. No data between adjacent projections will be sampled under these circumstances. The aim of the study was to develop a method to improve SPECT image quality by generating lacking projection data through interpolation of data obtained with a coarse pitch such as 6 deg. The projection data set at each individual degree in 360 directions was generated by a weighted average interpolation method from the projection data acquired with a coarse sampling angle (interpolated projection data estimation processing method, IPDE method). The IPDE method was applied to the numerical digital phantom data, actual phantom data and clinical brain data with Tc-99m ethyle cysteinate dimer (ECD). All SPECT images were reconstructed by the filtered back-projection method and compared with the original SPECT images. The results confirmed that streak artifacts decreased by apparently increasing a sampling number in SPECT after interpolation and also improved signal-to-noise (S/N) ratio of the root mean square uncertainty value. Furthermore, the normalized mean square error values, compared with standard images, had similar ones after interpolation. Moreover, the contrast and concentration ratios increased their effects after interpolation. These results indicate that effective improvement of image quality can be expected with interpolation. Thus, image quality and the ability to depict images can be improved while maintaining the present acquisition time and image quality. In addition, this can be achieved more effectively than at present even if the acquisition time is reduced. (author)

  1. Evolution of technetium-99m-HMPAO SPECT and brain mapping in a patient presenting with echolalia and palilalia.

    Science.gov (United States)

    Dierckx, R A; Saerens, J; De Deyn, P P; Verslegers, W; Marien, P; Vandevivere, J

    1991-08-01

    A 78-yr-old woman presented with transient echolalia and palilalia. She had suffered from Parkinson's disease for 2 yr. Routine laboratory examination showed hypotonic hyponatremia, but was otherwise unremarkable. Brain mapping revealed a bifrontal delta focus, more pronounced on the right. Single photon emission computed tomography (SPECT) of the brain with technetium-99m labeled d,l hexamethylpropylene-amine oxime (99mTc-HMPAO), performed during the acute episode showed relative frontoparietal hypoactivity. Brain mapping performed after disappearance of the echolalia and palilalia, which persisted only for 1 day, was normal. By contrast, SPECT findings persisted for more than 3 wk. Features of particular interest in the presented patient are the extensive defects seen on brain SPECT despite the absence of morphologic lesions, the congruent electrophysiologic changes and their temporal relationship with the clinical evolution.

  2. Cerebral blood flow of the non-affected brain in patients with malignant brain tumors as studied by SPECT

    International Nuclear Information System (INIS)

    Araki, Yuzo; Imao, Yukinori; Hirata, Toshifumi; Ando, Takashi; Sakai, Noboru; Yamada, Hiroshi

    1990-01-01

    In 40 patients (age range, 20-69 years) receiving radiation and chemotherapy for brain tumors, the mean cerebral blood flow (mCBF) in the non-affected area has been examined by single photon emission CT (SPECT) with Xe-133. Forty volunteers (age range, 25-82 years) served as controls. Although mCBF during external irradiation was transiently increased, it was significantly decreased at 3 months after beginning of external irradiation compared with that in the control group. Factors responsible for the decrease in mCBF were radiation doses, lesion volume, the degree of cerebral atrophy, and age; this was more pronounced when chemotherapy such as ACNU was combined with radiation. A decreased mCBF was independent of intraoperative radiation combined with external radiation and either local or whole brain irradiation. SPECT with Xe-133 was useful in determining minute changes in cerebral blood flow that precedes parenchymal brain damage. (N.K.)

  3. Clinical usefulness of scatter and attenuation correction for brain single photon emission computed tomography (SPECT) in pediatrics

    International Nuclear Information System (INIS)

    Adachi, Itaru; Doi, Kenji; Komori, Tsuyoshi; Hou, Nobuyoshi; Tabuchi, Koujirou; Matsui, Ritsuo; Sueyoshi, Kouzou; Utsunomiya, Keita; Narabayashi, Isamu

    1998-01-01

    This investigation was undertaken to study clinical usefulness of scatter and attenuation correction (SAC) of brain SPECT in infants to compare the standard reconstruction (STD). The brain SPECT was performed in 31 patients with 19 epilepsy, 5 cerebro-vascular disease, 2 brain tumor, 3 meningitis, 1 hydrocephalus and psychosis (mean age 5.0±4.9 years old). Many patients was necessary to be injected sedatives for restraining body motion after Technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO) was injected at the convulsion or rest. Brain SPECT data were acquired with triple detector gamma camera (GCA-9300 Toshiba Japan). These data were reconstructed by filtered backprojection after the raw data were corrected by triple energy windows method of scatter correction and Chang filtered method of attenuation correction. The same data was reconstructed by filtered backprojection without these corrections. Both SAC and STD SPECT images were analyzed by the visual interpretation. The uptake ratio of cerebral basal nuclei was calculated by the counts of the thalamus or lenticular nuclei divided by the cortex. All images of SAC method were excellent than that of STD method. The thalamic uptake ratio in SAC method was higher than that of STD method (1.22±0.09>0.87±0.22 p 1.02±0.16 p<0.01). Transmission scan is the most suitable method of absorption correction. But the transmission scan is not adequate for examination of children, because this scan needs a lot of time and the infants are exposed by the line source radioisotope. It was concluded that these scatter and absorption corrections were most suitable method for brain SPECT in pediatrics. (author)

  4. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy; SPECT cerebral interictal em pacientes com epilepsia do lobo temporal de dificil controle

    Energy Technology Data Exchange (ETDEWEB)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  5. Preparation and quality control of ECD kit

    International Nuclear Information System (INIS)

    Yassin, T.; Dadokh, M.; Almalki, R.

    2005-05-01

    ECD Kit for brain imaging after labeling with technetium 99m was prepared according to an optimum conditions, Each vial contains 1 mg of ECD and 0.155 mg of stannous chloride anhydrous SnCl 2 , 24 mg of Mannitol and 0.5 mg of Na 2 Ca EDTA, The prepared kit showed high quality satisfying the requirements of international pharmacopoeias from the points of physical, chemical, radiochemical and biological purities, and its validity for human injection. And the labeling yield exceeded 95 % with average value of about 97.63 ± 0.89% for 2mCi /2ml radioactivity , This study also showed that each vial content can be labeled with maximum activity of 99m Tc of about 50 mCi (Authors)

  6. Cerebral abnormalities in cocaine abusers: Demonstration by SPECT perfusion brain scintigraphy. Work in progress

    International Nuclear Information System (INIS)

    Tumeh, S.S.; Nagel, J.S.; English, R.J.; Moore, M.; Holman, B.L.

    1990-01-01

    Single photon emission computed tomography (SPECT) perfusion brain scans with iodine-123 isopropyl iodoamphetamine (IMP) were obtained in 12 subjects who acknowledged using cocaine on a sporadic to a daily basis. The route of cocaine administration varied from nasal to intravenous. Concurrent abuse of other drugs was also reported. None of the patients were positive for human immunodeficiency virus. Brain scans demonstrated focal defects in 11 subjects, including seven who were asymptomatic, and no abnormality in one. Among the findings were scattered focal cortical deficits, which were seen in several patients and which ranged in severity from small and few to multiple and large, with a special predilection for the frontal and temporal lobes. No perfusion deficits were seen on I-123 SPECT images in five healthy volunteers. Focal alterations in cerebral perfusion are seen commonly in asymptomatic drug users, and these focal deficits are readily depicted by I-123 IMP SPECT

  7. Study of cellular retention of HMPAO and ECD in a model simulating the blood-brain barrier

    International Nuclear Information System (INIS)

    Ponce, C.; Pittet, N.; Slosman, D.O.

    1997-01-01

    The HMPAO and ECD are two technetium-labelled lipophilic agents clinically used in the imagery of cerebral perfusion. These molecules cross the membranes and are retained inside the cell after being converted to a hydrophilic form. The aim of this study is to establish the distribution of this retention at the level of blood-brain barrier (BBB) and nerve cells. The incorporation of HMPAO or ECD was studied on a model of co-culture simulating the BBB by means of a T84 single-cell layer of tight junction separated from another layer of U373 astrocyte cells. The cell quality and tight junction permeability were evaluated by the cellular retention of 111-indium chloride and by para-cellular diffusion of 14 C mannitol,d-1. The values reported below were obtained at 180 minutes when the radiotracers were added near the 'T84 layer'. The cell quality is validated by the low cellular retention of the indium chloride(2.3±0.3 μg -1 for the T84 cells and 8.2±5.8 μg -1 for the U373 cells). The activity of 14 C mannitol,d-1 diminishes by 23 ± 5 % in the added compartment. The retention of ECD by the U373 cells is significantly higher (20.7 ±4.5 g -1 ) than that of T84 cells (2.9 ± 0.2 μg -1 ). For HMPAO a non-significant tendency could be observed (49 ± 34 μg -1 for the U373 cells and 38 ± 25 μg -1 for the T84 cells)> The results of cellular retention of indium by HMPAO or ECD when added near 'U373 layer' are not significantly different.In conclusion, independently of the side exposed to the radiotracers, one observes an enhanced incorporation of the U373 cells. The ensemble of these results represent additional arguments in favour of a specific cellular incorporation of the radiotracers, independent of the BBB permittivity

  8. The value of rCBF brain SPECT in assessing visual function of patients with honeymoons hemianopia

    International Nuclear Information System (INIS)

    Xie Ruiman; Yao Jingli; Qing Zheng

    1995-01-01

    Comparison of 99m Tc-HMPAO brain SPECT imaging of 8 cases with honeymoons hemianopia (HH) was taken before and after a course of oriented dynamic color photic stimulation (ODCPS). It was suggested that ODCPS in patients with HH was an effective method for increasing visual field and improving visual function. Cerebral metabolic patterns reflected the mechanism of ODCPS effecting the patients with HH. The retinal midbrain-occipital visual path-way may play an important role in mediating the increase of visual field and restoration of visual function. It was also concluded that brain SPECT imaging was an useful method for the studying of brain function

  9. Demonstration of cerebral abnormalities in cocaine abusers with SPECT perfusion brain scans

    International Nuclear Information System (INIS)

    Nagel, J.S.; Tumeh, S.S.; English, R.J.; Moore, M.; Lee, V.W.; Holman, L.B.

    1989-01-01

    This paper reports I-123 isopropyl iodoamphetamine (IMP) single-photon emission CT (SPECT) brain scans performed on cocaine users to investigate the effects of cocaine on the cerebral perfusion in a manner similar to previous CT, angiographic and positron-emission tomographic (PET) studies. Ten asymptomatic or mildly symptomatic cocaine users, two users with major neurovascular complications, and five normal subjects were studied with IMP SPECT. Rotating-brain images of the cerebral IMP uptake were displayed by using a distance-weighted surface-projection technique and were visually analyzed for focal cortical perfusion deficits. Eleven cocaine users had multiple scattered cortical IMP defects. Frontal lobe defects were most prominent. One user had confluent defects resembling swiss cheese. Concurrent CT scans available in nine patients were negative in seven and showed infarcts in two. No similar focal findings were visible in normals

  10. SPECT in psychiatry

    International Nuclear Information System (INIS)

    Kasper, S.; Gruenwald, F.; Walter, H.; Klemm, E.; Podreka, I.; Biersack, H.J.

    1994-01-01

    In the last fifteen years different attempts have been undertaken to understand the biological basis of major psychiatric disorders. One important tool to determine patterns of brain dysfunction is single emission computed tomography (SPECT). Whereas SPECT investigations are already a valuable diagnostic instrument for the diagnosis of dementia of the Alzheimer Type (DAT) there have not been consistent findings that can be referred to as specific for any other particular psychiatric diagnostic entity. Nevertheless, SPECT studies have been able to demonstrate evidence of brain dysfunction in patients with schizophrenia, depression, anxiety disorders, and substance abuse in which other methods showed no clear abnormality of brain function. Our manuscript reviews the data which are currently available in the literature and stresses the need for further studies, especially for prediction and monitoring psychiatric treatment modalities. (orig.) [de

  11. Clinical usefulness of scatter and attenuation correction for brain single photon emission computed tomography (SPECT) in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Itaru; Doi, Kenji; Komori, Tsuyoshi; Hou, Nobuyoshi; Tabuchi, Koujirou; Matsui, Ritsuo; Sueyoshi, Kouzou; Utsunomiya, Keita; Narabayashi, Isamu [Osaka Medical Coll., Takatsuki (Japan)

    1998-01-01

    This investigation was undertaken to study clinical usefulness of scatter and attenuation correction (SAC) of brain SPECT in infants to compare the standard reconstruction (STD). The brain SPECT was performed in 31 patients with 19 epilepsy, 5 cerebro-vascular disease, 2 brain tumor, 3 meningitis, 1 hydrocephalus and psychosis (mean age 5.0{+-}4.9 years old). Many patients was necessary to be injected sedatives for restraining body motion after Technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) was injected at the convulsion or rest. Brain SPECT data were acquired with triple detector gamma camera (GCA-9300 Toshiba Japan). These data were reconstructed by filtered backprojection after the raw data were corrected by triple energy windows method of scatter correction and Chang filtered method of attenuation correction. The same data was reconstructed by filtered backprojection without these corrections. Both SAC and STD SPECT images were analyzed by the visual interpretation. The uptake ratio of cerebral basal nuclei was calculated by the counts of the thalamus or lenticular nuclei divided by the cortex. All images of SAC method were excellent than that of STD method. The thalamic uptake ratio in SAC method was higher than that of STD method (1.22{+-}0.09>0.87{+-}0.22 p<0.01). The lenticular nuclear uptake ratio in SAC method was higher than that of STD method (1.26{+-}0.15>1.02{+-}0.16 p<0.01). Transmission scan is the most suitable method of absorption correction. But the transmission scan is not adequate for examination of children, because this scan needs a lot of time and the infants are exposed by the line source radioisotope. It was concluded that these scatter and absorption corrections were most suitable method for brain SPECT in pediatrics. (author)

  12. Clinical Utility of '9{sup 9m}Tc-HMPAO Brain SPECT Findings in Chronic Head Injury

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jin ll; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Jong Doo; Park, Chang Yoon; Kim, Young Soo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1992-03-15

    Minima deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using {sup 99m}Tc-HMPAO Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months following head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with {sup 99m}Tc-HMPAO Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using {sup 99m}Tc-HMPAO Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

  13. Types of traumatic brain injury and regional cerebral blood flow assessed by 99mTc-HMPAO SPECT.

    Science.gov (United States)

    Yamakami, I; Yamaura, A; Isobe, K

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with 99mtechnetium-hexamethyl propyleneamine oxime. Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated 1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, 2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and 3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient.

  14. Types of traumatic brain injury and regional cerebral blood flow assessed by 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Yamakami, Iwao; Yamaura, Akira; Isobe, Katsumi

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with 99m technetium-hexamethyl propyleneamine oxime (HMPAO). Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated: 1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, 2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and 3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient. (author)

  15. Novel radioiodinated sibutramine and fluoxetine as models for brain imaging

    International Nuclear Information System (INIS)

    Motaleb, M.A.; El-Kolaly, M.T.; Rashed, H.M.; Abd El-Bary, A.

    2011-01-01

    Brain imaging is a process which allows scientists and physicians to view and monitor the areas of the brain which allow diagnosis and following up different abnormalities in the brain. The aim of this study was to develop potential radiopharmaceuticals for the non-invasive brain imaging. Sibutramine and fluoxetine (two drugs that have the ability to cross blood-brain barrier) were successfully labeled with 125 I via direct electrophilic substitution reaction at ambient temperature. The reaction parameters studied were substrate concentration, oxidizing agent concentration, pH of the reaction mixture, reaction temperature, reaction time and in vitro stability of the iodocompounds. The iodocompounds gave maximum labeling yield of 92 ± 2.77 and 93 ± 2.1%, respectively, and maintained stability throughout working period (24 h). Biodistribution studies showed that maximum in vivo uptake of the iodocompounds in the brain was 5.7 ± 0.19 and 6.14 ± 0.26% injected activity/g tissue organ, respectively, at 15 and 5 min post-injection, whereas the clearance from the mice appeared to proceed via the hepatobiliary pathway. Brain uptake of 125 I-sibutramine and 125 I-fluoxetine is higher than that of 99m Tc-ECD and 99m Tc-HMPAO (currently used radiopharmaceuticals for brain imaging) and so radioiodinated sibutramine and fluoxetine could be used instead of 99m Tc-ECD and 99m Tc-HMPAO for brain SPECT. (author)

  16. Early effects of treatment in first episode schizophrenia on brain perfusion evaluated with 99mTc-ECD-SPECT

    International Nuclear Information System (INIS)

    Milcinski, M.; Grmek, M.; Novak, B.; Kocmur, M.

    2002-01-01

    Aim of our study was to evaluate regional cerebral blood flow (r-CBF) in acute first-episode schizophrenia and the early effects of antipsychotic drugs on r-CBF. Methods: Clinical criteria for schizophrenia were met according to International Classification of Diseases - 10th Edition (ICD-10). Psychic status and severity of disease of each patient were evaluated with a semi-structured psychiatric interview, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) on the same day as the scintigraphic study. R-CBF was evaluated using 99m-Tc-ECD. Until now 9 first-episode schizophrenic patients 2-7 (average 5.2) days after the beginning of antipsychotic treatment and 7 pts 8-15 (average 10.4) weeks later were investigated. R-CBF was evaluated in every patient in comparison to cerebellar blood flow in frontal and temporal regions in 4 slices. Both studies were compared. Homogeneity of brain perfusion was assessed visually as homogenous, moderately and severely non-homogenous. Results: In acute patients, perfusion was non-homogenous and decreased in left frontal lobe (90.1±4.4) in comparison to the right side (93.3±±4.6, p<0.05). Increase in perfusion was significant (p<0.05) between first and second scan in left (90.1±4.4 to 94.1±5.2, p<0.05) and right (93.4±4.6 to 96.9±5.8, p<0.05) frontal lobes. Significant difference in perfusion between right and left posterior region of temporal lobe found on the first scan was no longer present on the second scan. Perfusion was significantly more homogenous on the second scan. Significant decrease in PANSS (p<0.05) and CGI (p<0.001) scores was noted. Conclusions: Despite the low number of patients included so far, our findings implicate that patients with first-episode schizophrenia have significant bilateral frontal hypoperfusion, more pronounced on the left side. After average 10 weeks of medication, bilateral increase in blood flow was observed in frontal lobes and left-right difference was no

  17. Detection of a possible epilepsy focus in a preoperated patient by perfusion SPECT and computer-aided subtraction analysis

    International Nuclear Information System (INIS)

    Apostolova, I.; Wilke, F.; Clausen, M.; Buchert, R.; Lindenau, M.; Stodieck, S.; Fiehler, J.; Heese, O.

    2008-01-01

    Ictal perfusion SPECT with either 9 9mTc-hexamethylpropylene amine oxime (HMPAO) or 9 9mTc-ethylcysteinate dimer (ECD) has been reported to provide very good sensitivity for the determination of the SOA in fTLE. Sensitivity of interictal perfusion SPECT is much lower. However, interictal perfusion SPECT might enhance the specificity of ictal SPECT findings by improving the discrimination between seizure related local hyperperfusion and intersubject variability of perfusion (physiologic hyperperfusion). In addition, the combination of interictal and ictal perfusion SPECT might provide improved sensitivity compared to ictal SPECT alone, particularly when computer-aided subtraction of ictal and interictal SPECT is used instead of traditional side-by-side visual comparison. The combination of ictal and interictal perfusion SPECT eliminates not only physiological inter-subject variance, but it can also eliminate severe partial volume effects. Computer-aided subtraction analysis appears particularly useful in this case

  18. Detection of a possible epilepsy focus in a preoperated patient by perfusion SPECT and computer-aided subtraction analysis

    Energy Technology Data Exchange (ETDEWEB)

    Apostolova, I.; Wilke, F.; Clausen, M.; Buchert, R. [Univ. Medical Center Hamburg-Eppendorf (Germany). Dept. of Nuclear Medicine; Lindenau, M.; Stodieck, S. [Protestant Hospital Alsterdorf, Hamburg (Germany). Dept. of Neurology and Epileptology; Fiehler, J. [Univ. Medical Center Hamburg-Eppendorf (Germany). Dept. of Neuroradiology; Heese, O. [Univ. Medical Center Hamburg-Eppendorf (Germany). Neurological Surgery

    2008-07-01

    Ictal perfusion SPECT with either {sup 9}9mTc-hexamethylpropylene amine oxime (HMPAO) or {sup 9}9mTc-ethylcysteinate dimer (ECD) has been reported to provide very good sensitivity for the determination of the SOA in fTLE. Sensitivity of interictal perfusion SPECT is much lower. However, interictal perfusion SPECT might enhance the specificity of ictal SPECT findings by improving the discrimination between seizure related local hyperperfusion and intersubject variability of perfusion (physiologic hyperperfusion). In addition, the combination of interictal and ictal perfusion SPECT might provide improved sensitivity compared to ictal SPECT alone, particularly when computer-aided subtraction of ictal and interictal SPECT is used instead of traditional side-by-side visual comparison. The combination of ictal and interictal perfusion SPECT eliminates not only physiological inter-subject variance, but it can also eliminate severe partial volume effects. Computer-aided subtraction analysis appears particularly useful in this case.

  19. SPECT in psychiatry; Die Bedeutung der Hirn-SPECT in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Kasper, S [Universitaetsklinik fuer Psychiatrie, Wien (Austria); Gruenwald, F [Bonn Univ. (Germany). Klinik fuer Nuklearmedizin; Danos, P [Psychiatrische Universitaetsklinik, Bonn (Germany); Walter, H [Universitaetsklinik fuer Psychiatrie, Wien (Austria); Klemm, E [Bonn Univ. (Germany). Klinik fuer Nuklearmedizin; Bruecke, T [Universitaetsklinik fuer Neurologie, Wien (Austria); Podreka, I [Universitaetsklinik fuer Neurologie, Wien (Austria); Biersack, H J [Bonn Univ. (Germany). Klinik fuer Nuklearmedizin

    1994-10-01

    In the last fifteen years different attempts have been undertaken to understand the biological basis of major psychiatric disorders. One important tool to determine patterns of brain dysfunction is single emission computed tomography (SPECT). Whereas SPECT investigations are already a valuable diagnostic instrument for the diagnosis of dementia of the Alzheimer Type (DAT) there have not been consistent findings that can be referred to as specific for any other particular psychiatric diagnostic entity. Nevertheless, SPECT studies have been able to demonstrate evidence of brain dysfunction in patients with schizophrenia, depression, anxiety disorders, and substance abuse in which other methods showed no clear abnormality of brain function. Our manuscript reviews the data which are currently available in the literature and stresses the need for further studies, especially for prediction and monitoring psychiatric treatment modalities. (orig.) [Deutsch] In den vergangenen 15 Jahren wurde durch verschiedene methodologische Ansaetze versucht, die biologischen Ursachen psychiatrischer Erkrankungen naeher zu erforschen. Als eine bedeutende Methode hat sich dabei die Single-Photonen-Emissions-Computertomographie (SPECT) herausgestellt. Waehrend die SPECT-Untersuchungen bereits Eingang in die Routinediagnostik bei Demenzen vom Alzheimer-Typ gefunden haben, konnten fuer weitere psychiatrische Erkrankungen noch keine eindeutigen Befunde etabliert werden. Mit der SPECT-Methode ist es jedoch gelungen, funktionelle Veraenderungen des Gehirns von psychiatrischen Erkrankungen darzustellen, wie z.B. Schizophrenie, Depression, Angsterkrankungen bzw. Substanzmissbrauch. In Forschungsprotokollen wird durch die SPECT-Methode versucht, abzuklaeren, inwieweit es moeglich ist, innerhalb der Erkrankungsentitaeten psychiatrischer Erkrankungen oder auch diese uebergreifend eine Subklassifizierung zu finden und evtl. Gehirnsysteme ausfindig zu machen, die mit einer spezifischen

  20. Clinical utility of spatially normalized PET and SPECT to evaluate patients with memory and cognitive impairments

    International Nuclear Information System (INIS)

    Okumura, Ayumi; Nakayama, Noriyuki; Soeda, Akio; Miwa, Kazuhiro; Shinoda, Jun; Iwama, Toru

    2004-01-01

    We assessed cerebral metabolism and blood flow in patients with memory and other cognitive impairment using the easy Z score imaging system (eZIS) and statistical parametric mapping (SPM) of FDG-PET and SPECT scans. Twenty patients with dementia (12 Alzheimer's disease (AD), 3 diffuse Lewy body disease (DLB), and 2 frontotemporal dementia (FTD)) and twenty with diffuse axonal injury (DAI) and cognitive impairments were studied with FDG-PET and ECD-SPECT. All images were analyzed using eZIS with the same processing procedures, including smoothing, normalization, and z-transformation, and compared to a database of normals. Z score maps were super-imposed on 3D MRI brain images. Group analyses were performed using SPM. Age-related declines in cerebral metabolism and blood flow were observed in the anterior cingulate association area. In contrast, reductions in these cerebral functions correlated best with severity of AD in the posterior cingulate association areas. In DLB and FTD, eZIS analysis of PET and SPECT revealed reductions of cerebral functions in specific areas. DAI showed low metabolism and blood flow in mesiofrontal cortex including the anterior cingulate association area. Dysfunction of the anterior cingulate association area in DAI, which resembled age-related cognitive decline, may be responsible for cognitive impairments. Overall, PET and SPECT scans showed significant correlations according to the type of dementia. Spatially normalized maps contributed to PET and SPECT image interpretation for patients with memory and cognitive impairments because better 3D visualization allowed more objective and systematic investigations. (author)

  1. Multipinhole collimator with 20 apertures for a brain SPECT application

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tzu-Cheng; Ellin, Justin R.; Shrestha, Uttam; Seo, Youngho, E-mail: youngho.seo@ucsf.edu [Physics Research Laboratory, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California 94107 (United States); Huang, Qiu [School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030 (China); Gullberg, Grant T. [Department of Radiotracer Development and Imaging Technology, Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94702 (United States)

    2014-11-01

    Purpose: Several new technologies for single photon emission computed tomography (SPECT) instrumentation with parallel-hole collimation have been proposed to improve detector sensitivity and signal collection efficiency. Benefits from improved signal efficiency include shorter acquisition times and lower dose requirements. In this paper, the authors show a possibility of over an order of magnitude enhancement in photon detection efficiency (from 7.6 × 10{sup −5} to 1.6 × 10{sup −3}) for dopamine transporter (DaT) imaging of the striatum over the conventional SPECT parallel-hole collimators by use of custom-designed 20 multipinhole (20-MPH) collimators with apertures of 0.75 cm diameter. Methods: Quantifying specific binding ratio (SBR) of {sup 123}I-ioflupane or {sup 123}I-iometopane’s signal at the striatal region is a common brain imaging method to confirm the diagnosis of the Parkinson’s disease. The authors performed imaging of a striatal phantom filled with aqueous solution of I-123 and compared camera recovery ratios of SBR acquired between low-energy high-resolution (LEHR) parallel-hole collimators and 20-MPH collimators. Results: With only two-thirds of total acquisition time (20 min against 30 min), a comparable camera recovery ratio of SBR was achieved using 20-MPH collimators in comparison to that from the LEHR collimator study. Conclusions: Their systematic analyses showed that the 20-MPH collimator could be a promising alternative for the DaT SPECT imaging for brain over the traditional LEHR collimator, which could give both shorter scan time and improved diagnostic accuracy.

  2. Clinical correlative evaluation of an iterative method for reconstruction of brain SPECT images

    International Nuclear Information System (INIS)

    Nobili, Flavio; Vitali, Paolo; Calvini, Piero; Bollati, Francesca; Girtler, Nicola; Delmonte, Marta; Mariani, Giuliano; Rodriguez, Guido

    2001-01-01

    Background: Brain SPECT and PET investigations have showed discrepancies in Alzheimer's disease (AD) when considering data deriving from deeply located structures, such as the mesial temporal lobe. These discrepancies could be due to a variety of factors, including substantial differences in gamma-cameras and underlying technology. Mesial temporal structures are deeply located within the brain and the commonly used Filtered Back-Projection (FBP) technique does not fully take into account either the physical parameters of gamma-cameras or geometry of collimators. In order to overcome these limitations, alternative reconstruction methods have been proposed, such as the iterative method of the Conjugate Gradients with modified matrix (CG). However, the clinical applications of these methods have so far been only anecdotal. The present study was planned to compare perfusional SPECT data as derived from the conventional FBP method and from the iterative CG method, which takes into account the geometrical and physical characteristics of the gamma-camera, by a correlative approach with neuropsychology. Methods: Correlations were compared between perfusion of the hippocampal region, as achieved by both the FBP and the CG reconstruction methods, and a short-memory test (Selective Reminding Test, SRT), specifically addressing one of its function. A brain-dedicated camera (CERASPECT) was used for SPECT studies with 99m Tc-hexamethylpropylene-amine-oxime in 23 consecutive patients (mean age: 74.2±6.5) with mild (Mini-Mental Status Examination score ≥15, mean 20.3±3), probable AD. Counts from a hippocampal region in each hemisphere were referred to the average thalamic counts. Results: Hippocampal perfusion significantly correlated with the MMSE score with similar statistical significance (p<0.01) between the two reconstruction methods. Correlation between hippocampal perfusion and the SRT score was better with the CG method (r=0.50 for both hemispheres, p<0.01) than with

  3. Clinical correlative evaluation of an iterative method for reconstruction of brain SPECT images

    Energy Technology Data Exchange (ETDEWEB)

    Nobili, Flavio E-mail: fnobili@smartino.ge.it; Vitali, Paolo; Calvini, Piero; Bollati, Francesca; Girtler, Nicola; Delmonte, Marta; Mariani, Giuliano; Rodriguez, Guido

    2001-08-01

    Background: Brain SPECT and PET investigations have showed discrepancies in Alzheimer's disease (AD) when considering data deriving from deeply located structures, such as the mesial temporal lobe. These discrepancies could be due to a variety of factors, including substantial differences in gamma-cameras and underlying technology. Mesial temporal structures are deeply located within the brain and the commonly used Filtered Back-Projection (FBP) technique does not fully take into account either the physical parameters of gamma-cameras or geometry of collimators. In order to overcome these limitations, alternative reconstruction methods have been proposed, such as the iterative method of the Conjugate Gradients with modified matrix (CG). However, the clinical applications of these methods have so far been only anecdotal. The present study was planned to compare perfusional SPECT data as derived from the conventional FBP method and from the iterative CG method, which takes into account the geometrical and physical characteristics of the gamma-camera, by a correlative approach with neuropsychology. Methods: Correlations were compared between perfusion of the hippocampal region, as achieved by both the FBP and the CG reconstruction methods, and a short-memory test (Selective Reminding Test, SRT), specifically addressing one of its function. A brain-dedicated camera (CERASPECT) was used for SPECT studies with {sup 99m}Tc-hexamethylpropylene-amine-oxime in 23 consecutive patients (mean age: 74.2{+-}6.5) with mild (Mini-Mental Status Examination score {>=}15, mean 20.3{+-}3), probable AD. Counts from a hippocampal region in each hemisphere were referred to the average thalamic counts. Results: Hippocampal perfusion significantly correlated with the MMSE score with similar statistical significance (p<0.01) between the two reconstruction methods. Correlation between hippocampal perfusion and the SRT score was better with the CG method (r=0.50 for both hemispheres, p<0

  4. Brain abscess uptake at TI-201 brain SPECT

    International Nuclear Information System (INIS)

    Lee, Won Hyoung; Han, Eun Ji; Yoo, Ie Ryung; Chung, Yong An; Sohn, Hyung Sun; Kim, Sung Hoon; Chung, Soo Kyo; Choi, Yeong Jin

    2007-01-01

    A 22-year-old woman with a history of acute lymphoblastic leukemia was hospitalized for headache and vomiting CT scan showed a well-defined, ring like enhancing mass in the left frontal lobe with surrounding edema and midline shift. Magnetic resonance imaging demonstrated a round homogeneous mass with a ring of enhancement in the left frontal lobe. TI-201 brain SPECT showed increased focal uptake coinciding with the CT and MRI abnormality. Aspiration of the lesion performed through a burr hole yielded many neutrophils, a few lymphocytes and histiocytes with some strands of filamentous microorganism-like material. Modified AFB stained negative for norcardia. Gram stain showed a few white blood cells and no microorganism. Antibiotics were started and produced a good clinical response. After one month, CT scan showed markedly reduction in size and extent was observed

  5. Brain abscess uptake at TI-201 brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hyoung; Han, Eun Ji; Yoo, Ie Ryung; Chung, Yong An; Sohn, Hyung Sun; Kim, Sung Hoon; Chung, Soo Kyo; Choi, Yeong Jin [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-08-15

    A 22-year-old woman with a history of acute lymphoblastic leukemia was hospitalized for headache and vomiting CT scan showed a well-defined, ring like enhancing mass in the left frontal lobe with surrounding edema and midline shift. Magnetic resonance imaging demonstrated a round homogeneous mass with a ring of enhancement in the left frontal lobe. TI-201 brain SPECT showed increased focal uptake coinciding with the CT and MRI abnormality. Aspiration of the lesion performed through a burr hole yielded many neutrophils, a few lymphocytes and histiocytes with some strands of filamentous microorganism-like material. Modified AFB stained negative for norcardia. Gram stain showed a few white blood cells and no microorganism. Antibiotics were started and produced a good clinical response. After one month, CT scan showed markedly reduction in size and extent was observed.

  6. Analysis of Regional Cerebral Blood Flow Using 99mTc-HMPAO Brain SPECT in Senile Dementia of Alzheimer Type

    International Nuclear Information System (INIS)

    Lee, Myung Hae; Lee, Myung Chul; Koh, Chang Soon; Roh, Jae Kyu; Woo, Chong In

    1988-01-01

    99m Tc-HMPAO brain SPECT studies were performed in 11 patients with Alzheimer's disease, 7 patients with psychological depression and 12 normal controls. Changes of regional cerebral blood flow was semiquantitatively analyzed and the results were as follows. 1) In 11 patients with Alzheimer's disease, significant reduction of regional cerebral blood flow was found In both temporoparietal areas. 2) Relative perfusion between cerebral hemispheres was rather symmetrical in patient with Alzheimer's disease. 3) All patients with depression showed normal SPECT findings. As for conclusion, 99m Tc-HMPAO brain SPECT seemed to be a valuable method for clinical assessment and management of patients with Alzheimer's disease.

  7. Brain Single Photon Emission Computed Tomography in Anosmic Subjects Ater Closed Head Trauma

    Directory of Open Access Journals (Sweden)

    Roozbeh Banan

    2011-01-01

    Full Text Available Anosmia following head trauma is relatively common and in many cases is persistent and irreversible. The ability to objectively measure such a decline in smelling, for both clinical and medicolegal goals, is very important. The aim of this study was to find results of brain Single Photon Emission Computed Tomography (SPECT in anosmic subjects after closed head trauma. This case-control cross sectional study was conducted in a tertiary referral University Hospital. The brain perfusion state of nineteen anosmic patients and thirteen normal controls was evaluated by means of the SPECT with 99mtc- ECD infusion- before and after olfactory stimulation. The orbitofrontal lobe of the brain was assumed as the region of interest and changes in perfusion of this area before and after the stimulations were compared in two groups. The mean of brain perfusion in controls before and after the stimulation was 8.26% ± 0.19% and 9.89% ± 0.54%, respectively (P < 0.0001. Among patients group, these quantities were 7.97% ± 1.05% and 8.49% ± 1.5%, respectively (P < 0.004. The difference between all the measures in cases and controls were statistically significant (P < 0.0001. There were no differences in age and sex between two groups. The brain SPECT is an objective technique suitable for evaluating anosmia following the head trauma and it may be used with other diagnostic modalities

  8. Recovered neuronal viability revealed by Iodine-123-iomazenil SPECT following traumatic brain injury.

    Science.gov (United States)

    Koizumi, Hiroyasu; Fujisawa, Hirosuke; Kurokawa, Tetsu; Suehiro, Eiichi; Iwanaga, Hideyuki; Nakagawara, Jyoji; Suzuki, Michiyasu

    2010-10-01

    We evaluated cortical damages following traumatic brain injury (TBI) in the acute phase with [(123)I] iomazenil (IMZ) single photon emission computed tomography (SPECT). In all, 12 patients with cerebral contusion following TBI were recruited. All patients underwent IMZ SPECT within 1 week after TBI. To investigate the changes in distribution of IMZ in the cortex in the chronic phase, after conventional treatment, patients underwent IMZ SPECT again. A decrease in the accumulation of radioligand for the central benzodiazepine receptor in the cortex corresponding to the contusion revealed with computed tomography (CT) scans and magnetic resonance imaging (MRI) were shown on IMZ SPECT in the acute phase in all patients. In 9 of 12 patients (75%), images of IMZ SPECT obtained in the chronic phase of TBI showed that areas with a decreased distribution of IMZ were remarkably reduced in comparison with those obtained in the acute phase. Both CT scans and MRI showed a normal appearance of the cortex morphologically, where the binding potential of IMZ recovered in the chronic phase. Reduced binding potential of radioligand for the central benzodiazepine receptor is considered to be an irreversible reaction; however, in this study, IMZ accumulation in the cortex following TBI was recovered in the chronic phase in several patients. [(123)I] iomazenil SPECT may have a potential to disclose a reversible vulnerability of neurons following TBI.

  9. Types of traumatic brain injury and regional cerebral blood flow assessed by [sup 99m]Tc-HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamakami, Iwao; Yamaura, Akira; Isobe, Katsumi [Chiba Univ. (Japan). School of Medicine

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with [sup 99m]technetium-hexamethyl propyleneamine oxime (HMPAO). Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated: (1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, (2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and (3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient. (author).

  10. Dry Kit Development And Clinical Test Of 99mTc-L,L-ECD Radiopharmaceutical For Vrain Perfusion Imaging

    International Nuclear Information System (INIS)

    Kartini, Nani; Sofyan, Rohestri; Rukmini; Iswahyudi

    2000-01-01

    Technetium- 99m ethyl cysteinate dimer ( 99m Tc-L,L-ECD) has been synthesized and formulated based on ligand exchanged reaction with 99mTc-glucoheptonate. Considering the low stability of the dry kit produced, it was fairly necessary to develop the manufacture of L,L-ECD dry kit in order to obtain a more stable one that meet the requirements as brain perfusion imaging radiopharmaceutical. Experiment was done by modifying the packing of dry kit components of the previous formulation. Characteristics of 99m Tc-L,L-ECD produced from this formulation were studied by carrying out the sterility and toxicity test, then followed with clinical test to some volunteers. Evaluation of brain perfusion was done by tomography technique using gamma camera at Nuclear Medicine Installation, Hasan Sadikin Hospital. The modified formulation obtained consist of three components i.e. main ligand L,L-ECD; exchange ligand Ca-glucoheptonate and HaOH. Its stability could reach 8 months at-10 derajat C of storage. Effects of toxicity on mice did not appear. The result of clinical study shows that the radiopharmaceutical was distributed very rapidly in the blood brain circulations and retained in the brain for about one hour. The body scanning indicates that the substance was excreted in the brain for about one hour. The body scanning indicates that the substance was excreted though kidney, liver and spleen. Based on the results obtained the radiopharmaceutical could be promoted to be used for brain perfusion imaging

  11. Changes in regional cerebral blood flow correlate with symptoms of depression and severity of fatigue in 99mTc-ECD SPECT study in 45 workers

    International Nuclear Information System (INIS)

    Koyama, Fumihiko; Hojo, Kei; Otsuki, Kenro; Yamamoto, Haruyoshi

    2008-01-01

    We performed single photon emission computed tomography ( 99m Tc-ECD SPECT) of the brain in 25 workers suffering from major depression (22 males and 3 females at the average age of 47.5±7.7 standard deviation (S.D.) years and all patients were right handed) and identified frontal lobe hypoperfusion in 18 cases using the easy Z-score Imaging System (eZIS). During the remission period, which was within ten months of therapy, we observed normalization of the frontal cerebral perfusion in 75% of the patients. In further evaluation of the cerebral blood flow after the addition of 20 healthy volunteer workers (18 males and 2 females at the average age 47.1±9.8 S.D. years and all were right handed) as a control group, reduced cerebral blood flow in the dorsal area of the frontal lobe, which is supposed to be correlated to the severity of the feeling of fatigue estimated based on the self-rating depression scale (SDS), was demonstrated by statistical parametric mapping (SPM). The severity of the fatigue of all workers was estimated using a self-rating checklist disseminated by the Japan Ministry of Health, Labor, and Welfare, which pertains to the accumulation of fatigue due to labor. In the SPM analysis, limbic hypoperfusion, which is correlated to the total severity of fatigue in all worker cases, was estimated based on the reduction in the cerebral blood flow in the lower part of the temporal lobe. Accordingly, the accumulation of fatigue due to, for instance, over work may result in easy fatigue and a pre-depressive state, which are associated with a reduction in the cerebral blood flow. This research is a part of the research and development and the dissemination projects related to the 13 fields of occupational injuries and illnesses of the Japan Labor Health and Welfare Organization. (author)

  12. Diagnosis of ischemic cerebrovascular diseases with 99mTc-HMPAO brain SPECT using upright stress test

    International Nuclear Information System (INIS)

    Chen Shaoliang; Xiu Yan; Sun Xiaoguang

    1998-01-01

    Purpose: To evaluate the value of upright brain SPECT stress test, the authors performed 99m Tc-HMPAO brain SPECT in association with measurement of blood pressure in both upright and supine positions. Methods: The authors studied 5 patients with unilateral stenosis occlusion of the internal carotid (Group A), 8 patients with orthostatic hypotension (group B) and 7 normal controls. 370 MBq 99m Tc-HMPAO was injected immediately after uprighting from a supine position. then the first SPECT scan were performed. After the first SPECT, another 555 MBq of 99m Tc-HMPAO were administered while the patients remained on original supine position. Results: Semiquantitive analysis showed that the asymmetric ratios between upright and supine positions in group A changed significantly. In group B, showed postural cerebral hypoperfusion in the bilateral frontal areas, the mean count ratio of the frontal to cerebellar area between the upright and supine positions also significantly changed. In the normal group, there were no significantly changes during the upright test. Conclusions: The upright stress test is useful for detecting not only silent cerebral hypoperfusion, but also orthostatic hypoperfusion

  13. SPECT in psychiatry. SPECT in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Barocka, A. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Feistel, H. (Nuklearmedizinische Klinik, Erlangen (Germany)); Ebert, D. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Lungershausen, E. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany))

    1993-08-13

    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D[sub 2] and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.)

  14. Retention of 99mTc-bicisate in the human brain after intracarotid injection

    DEFF Research Database (Denmark)

    Friberg, L; Andersen, A R; Lassen, N A

    1994-01-01

    99mTc-bicisate (ECD) was injected as a bolus into the internal carotid artery, and cerebral uptake and retention were recorded with fast-rotating single photon emission computed tomography (SPECT) equipment in four patients suffering from temporal lobe epilepsy. Quantitative regional cerebral blood...... flow (rCBF) was measured tomographically with the 133Xe inhalation technique. We applied a three-compartment kinetic model and algorithms modified from a previous analysis of 99mTc d,l-hexamethylpropyleneamine oxide (HM-PAO) kinetics. The bicisate brain uptake and retention curve was very similar...

  15. Evaluation of seizure propagation on ictal brain SPECT using statistical parametric mapping in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Jeon, Tae Joo; Lee, Jong Doo; Kim, Hee Joung; Lee, Byung In; Kim, Ok Joon; Kim, Min Jung; Jeon, Jeong Dong

    1999-01-01

    Ictal brain SPECT has a high diagnostic sensitivity exceeding 90 % in the localization of seizure focus, however, it often shows increased uptake within the extratemporal areas due to early propagation of seizure discharge. This study aimed to evaluate seizure propagation on ictal brian SPECT in patients with temporal lobe epilepsy (TLE) by statistical parametric mapping (SPM). Twenty-one patients (age 27.14 5.79 y) with temporal lobe epilepsy (right in 8, left in 13) who had successful seizure outcome after surgery and nine normal control were included. The data of ictal and interictal brain SPECT of the patients and baseline SPECT of normal control group were analyzed using automatic image registration and SPM96 softwares. The statistical analysis was performed to compare the mean SPECT image of normal group with individual ictal SPECT, and each mean image of the interictal groups of the right or left TLE with individual ictal scans. The t statistic SPM [t] was transformed to SPM [Z] with a threshold of 1.64. The statistical results were displayed and rendered on the reference 3 dimensional MRI images with P value of 0.05 and uncorrected extent threshold p value of 0.5 for SPM [Z]. SPM data demonstrated increased uptake within the epileptic lesion in 19 patients (90.4 %), among them, localized increased uptake confined to the epileptogenic lesion was seen in only 4 (19%) but 15 patients (71.4%) showed hyperperfusion within propagation sites. Bi-temporal hyperperfusion was observed in 11 out of 19 patients (57.9%, 5 in the right and 6 in the left); higher uptake within the lesion than contralateral side in 9, similar activity in 1 and higher uptake within contralateral lobe in one. Extra-temporal hyperperfusion was observed in 8 (2 in the right, 3 in the left, 3 in bilateral); unilateral hyperperfusion within the epileptogenic temporal lobe and extra-temporal area in 4, bi-temporal with extra-temporal hyperperfusion in remaining 4. Ictal brain SPECT is highly

  16. Technetium-99m-HMPAO SPECT, CT and MRI in the evaluation of patients with chronic traumatic brain injury: a correlation with neuropsychological performance.

    Science.gov (United States)

    Ichise, M; Chung, D G; Wang, P; Wortzman, G; Gray, B G; Franks, W

    1994-02-01

    The purposes of this study were: (1) to compare 99mTc-hexamethylpropyleneamineoxime (HMPAO) SPECT with CT and MRI in chronic traumatic brain injury (TBI) patients and (2) to correlate both functional and structural neuroimaging measurements of brain damage with neuropsychological (NP) performance. Twenty-nine patients (minor TBI, n = 15 and major TBI, n = 14) and 17 normal controls (NC) underwent HMPAO SPECT, CT, MRI and NP testing. Imaging data were analyzed both visually and quantitatively. Nineteen (66%) patients showed 42 abnormalities on SPECT images, whereas 13 (45%) and 10 (34%) patients showed 29 abnormalities on MRI and 24 abnormalities on CT. SPECT detected relatively more abnormalities than CT or MRI in the minor TBI subgroup. The TBI group showed impairment on 11 tests for memory, attention and executive function. Of these, the anterior-posterior ratio (APR) correlated with six tests, whereas the ventricle-to-brain ratio (VBR), a known structural index of a poor NP outcome, correlated with only two tests. In evaluating chronic TBI patients, HMPAO SPECT, as a complement to CT or MRI, may play a useful role by demonstrating brain dysfunction in morphologically intact brain regions and providing objective evidence for some of the impaired NP performance.

  17. Tc99m-HMPAO Neuro--SPECT Assessment of Ischemic Penumbra in Acute Brain Infarct: Control of Intra-arterial Thrombolysis Treatment

    International Nuclear Information System (INIS)

    Mena, Francisco; Mena, Ismael; Ducci, Hector; Soto, Francisco; Pedraza, Luis; Contreras, Andrea; Miranda, Marcelo; Basaez, Esteban; Fruns, Manuel

    2004-01-01

    Acute brain infarct is a medical emergency potentially reversible if treated with thrombolysis, an approved therapy, if performed in the first 3 to 6 hours of evolution. Thrombolysis has many benefits, but it also has associated risks, mainly development of intracranial hemorrhage. The selection of which patient should receive this type of treatment had been an important research topic over the last decade. As a consequence neuroimaging of brain infarct has significantly improved during the last few years. A variety of diagnostic studies are now available in the evaluation of brain infarct and in particular of potentially reversible brain ischemia, including magnetic resonance imaging (MRI) diffusion-perfusion, perfusion computed tomography (CT) and functional neuroimaging techniques includes positron emission tomography (PET) and single-photon emission tomography (SPECT). The aim of this study is to present our experience with a group of patients that presented with acute brain ischemia and had a NeuroSPECT evaluation before and after intra-arterial thrombolysis and/or possible stent placement, in the treatment of acute brain infarct. Methods: 16 patients were treated acutely for a significant ischemic stroke with the following protocol. 1) Admission, and complete neurological evaluation. 2) Brain CT scan performed to rule out hemorrhage or established infarct. 3) IV injection of 1100MBq Tc 99m HMPAO (Ceretec tm ) 4) Conventional cerebral angiography and intra-arterial thrombolysis with tPA and /or angioplasty/stent if necessary. 5) NeuroSPECT assessment of ischemic penumbra (Pre-therapy results). 6) 14 of 16 patients received a NeuroSPECT (Post-therapy results) control at 24 hours. NeuroSPECT image acquisition was performed immediately following arterial thrombolysis with a dual Head Camera, Siemens ECAM, SHR collimators and conventional protocol. Image processing was performed using the Neurogam, Segami Corp. Software as previously reported in Alasbimn Journal 2

  18. Brain perfusion SPECT with Brodmann areas analysis in differentiating frontotemporal dementia subtypes.

    Science.gov (United States)

    Valotassiou, Varvara; Papatriantafyllou, John; Sifakis, Nikolaos; Tzavara, Chara; Tsougos, Ioannis; Psimadas, Dimitrios; Kapsalaki, Eftychia; Fezoulidis, Ioannis; Hadjigeorgiou, George; Georgoulias, Panagiotis

    2014-01-01

    Despite the known validity of clinical diagnostic criteria, significant overlap of clinical symptoms between Frontotemporal dementia (FTD) subtypes exists in several cases, resulting in great uncertainty of the diagnostic boundaries. We evaluated the perfusion between FTD subtypes using brain perfusion (99m)Tc-HMPAO SPECT with Brodmann areas (BA) mapping. NeuroGam software was applied on single photon emission computed tomographic (SPECT) studies for the semi-quantitative evaluation of perfusion in BA and the comparison with the software's normal database. We studied 91 consecutive FTD patients: 21 with behavioural variants (bvFTD), 39 with language variants (lvFTD) [12 with progressive non-fluent aphasia (PNFA), 27 with semantic dementia (SD)], and 31 patients with progressive supranuclear palsy (PSP)/corticobasal degeneration (CBD). Stepwise logistic regression analyses showed that the BA 28L and 32R could independently differentiate bvFTD from lvFTD, while the BA 8R and 25R could discriminate bvFTD from SD and PNFA, respectively. Additionally, BA 7R and 32R were found to discriminate bvFTD from CBD/PSP. The only BA that could differentiate SD from PNFA was 6L. BA 6R and 20L were found to independently differentiate CBD/PSP from lvFTD. Moreover, BA 20L and 22R could discriminate CBD/PSP from PNFA, while BA 6R, 20L and 45R were found to independently discriminate CBD/PSP from SD. Brain perfusion SPECT with BA mapping can be a useful additional tool in differentiating FTD variants by improving the definition of brain areas that are specifically implicated, resulting in a more accurate differential diagnosis in atypical or uncertain forms of FTD.

  19. Introduction of a novel ultrahigh sensitivity collimator for brain SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi-Ae, E-mail: miaepark@bwh.harvard.edu; Kijewski, Marie Foley; Lyon, Morgan C.; Horky, Laura; Moore, Stephen C. [Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts 02115 (United States); Keijzers, Ronnie; Keijzers, Mark [Nuclear Fields USA, Des Plaines, Illinois 60018 (United States)

    2016-08-15

    Purpose: Noise levels of brain SPECT images are highest in central regions, due to preferential attenuation of photons emitted from deep structures. To address this problem, the authors have designed a novel collimator for brain SPECT imaging that yields greatly increased sensitivity near the center of the brain without loss of resolution. This hybrid collimator consisted of ultrashort cone-beam holes in the central regions and slant-holes in the periphery (USCB). We evaluated this collimator for quantitative brain imaging tasks. Methods: Owing to the uniqueness of the USCB collimation, the hole pattern required substantial variations in collimator parameters. To utilize the lead-casting technique, the authors designed two supporting plates to position about 37 000 hexagonal, slightly tapered pins. The holes in the supporting plates were modeled to yield the desired focal length, hole length, and septal thickness. To determine the properties of the manufactured collimator and to compute the system matrix, the authors prepared an array of point sources that covered the entire detector area. Each point source contained 32 μCi of Tc-99m at the first scan time. The array was imaged for 5 min at each of the 64 shifted locations to yield a 2-mm sampling distance, and hole parameters were calculated. The sensitivity was also measured using a point source placed along the central ray at several distances from the collimator face. High-count projection data from a five-compartment brain phantom were acquired with the three collimators on a dual-head SPECT/CT system. The authors calculated Cramer-Rao bounds on the precision of estimates of striatal and background activity concentration. In order to assess the new collimation system to detect changes in striatal activity, the authors evaluated the precision of measuring a 5% decrease in right putamen activity. The authors also reconstructed images of projection data obtained by summing data from the individual phantom

  20. NeuroSPECT assessment of ischemic penumbra in acute brain infarct: control of intra-arterial thrombolysis

    International Nuclear Information System (INIS)

    Mena, F.J.; Mena, I.; Contreras, I.; Soto, F.; Ducci, H.; Fruns, M.

    2002-01-01

    Introduction: Brain infarct is the most common cause of incapacity in adults, the second cause of dementia and the 2nd or 3rd cause of death. Acute brain infarct is a medical emergency potentially reversible if treated with thrombolysis in the first hours of evolution. Thrombolysis is now an approved and efficacious method of treatment for acute ischemic stroke. During the first 3 hours of evolution, intravenous administration of plasminogen activator (tPA) can be performed. The window of time of treatment is expanded to 6 hours with the intra-arterial super selective route for thrombolysis. Aim: The aim of this study was to define levels of reversible ischemia (penumbra) demonstrated by statistically evaluated HMPAO Tc99m NeuroSPECT performed before and after intra-arterial thrombolysis in the treatment of acute infarct. Materials and Methods: 21 patients were treated during the first 6 hours of evolution of an acute ischemic stroke with the following protocol. 1) Admission, and complete neurological evaluation. 2) Brain CT scan to rule hemorrhage or established infarct. 3) I.V injection of 1100MBq Tc99m HMPAO (Ceretec tm) 4) Conventional cerebral angiography and intra-arterial thrombolysis and/or angioplasty/stenting if necessary. 5) NeuroSPECT assessment of ischemic penumbra. 6) Control at 24 hrs with NeuroSPECT. NeuroSPECT image acquisition is performed immediately following arterial thrombolysis with a dual Head Camera, SHR collimators and conventional protocol. Image processing was performed using the Segami Software, as previously reported in Alasbimn Journal2 (7): April 2000. http://www.alasbimnjournal.cl. The analysis consists of 1) Tallairach brain volume normalization. 2) Voxel by voxel comparison of the individual brain cortex uptake normalized to the maximum in the cortex with a normal database of 24 age-matched controls. Results: The results are expressed in standard deviations (S.D.) below the normal mean. Normal mean is 72% + 6. Only voxels between

  1. Diagnosis of Alzheimer's disease using brain perfusion SPECT and MR imaging: which modality achieves better diagnostic accuracy?

    International Nuclear Information System (INIS)

    Kubota, Takao; Ushijima, Yo; Yamada, Kei; Okuyama, Chio; Kizu, Osamu; Nishimura, Tsunehiko

    2005-01-01

    The purpose of this study was to compare the accuracy of MR imaging and brain perfusion single-photon emission tomography (SPECT) in diagnosing Alzheimer's disease (AD). The transaxial section display of brain perfusion SPECT, three-dimensional stereotactic surface projection (3D-SSP) SPECT image sets, thin-section MR imaging of the hippocampus and perfusion MR imaging were evaluated in 66 subjects comprising 35 AD patients and 31 subjects without AD. SPECT and MR imaging were visually interpreted by two experts and two novices, and the diagnostic ability of each modality was evaluated by receiver operating characteristic (ROC) analysis. In the experts' interpretations, there was no significant difference in the area under the ROC curve (A z ) between 3D-SSP and thin-section MR imaging, whereas the A z of transaxial SPECT display was significantly lower than that of 3D-SSP (3D-SSP: 0.97, thin-section MR imaging: 0.96, transaxial SPECT: 0.91), and the A z of perfusion MR imaging was lowest (0.63). The sensitivity and specificity of each modality were, respectively, 80.0% and 96.8% for 3D-SSP, 77.1% and 96.8% for thin-section MR imaging, 60.0% and 93.5% for transaxial SPECT display and 34.3% and 100% for perfusion MR imaging. In the novices' interpretations, the A z , sensitivity and specificity of 3D-SSP were superior to those of thin-section MR imaging. Thin-section hippocampal MR imaging and 3D-SSP image sets had potentially equivalent value for the diagnosis of AD, and they were superior to transaxial SPECT display and perfusion MR imaging. For avoidance of the effect of interpreters' experience on image evaluation, 3D-SSP appears to be optimal. (orig.)

  2. A Silicon SPECT System for Molecular Imaging of the Mouse Brain.

    Science.gov (United States)

    Shokouhi, Sepideh; Fritz, Mark A; McDonald, Benjamin S; Durko, Heather L; Furenlid, Lars R; Wilson, Donald W; Peterson, Todd E

    2007-01-01

    We previously demonstrated the feasibility of using silicon double-sided strip detectors (DSSDs) for SPECT imaging of the activity distribution of iodine-125 using a 300-micrometer thick detector. Based on this experience, we now have developed fully customized silicon DSSDs and associated readout electronics with the intent of developing a multi-pinhole SPECT system. Each DSSD has a 60.4 mm × 60.4 mm active area and is 1 mm thick. The strip pitch is 59 micrometers, and the readout of the 1024 strips on each side gives rise to a detector with over one million pixels. Combining four high-resolution DSSDs into a SPECT system offers an unprecedented space-bandwidth product for the imaging of single-photon emitters. The system consists of two camera heads with two silicon detectors stacked one behind the other in each head. The collimator has a focused pinhole system with cylindrical-shaped pinholes that are laser-drilled in a 250 μm tungsten plate. The unique ability to collect projection data at two magnifications simultaneously allows for multiplexed data at high resolution to be combined with lower magnification data with little or no multiplexing. With the current multi-pinhole collimator design, our SPECT system will be capable of offering high spatial resolution, sensitivity and angular sampling for small field-of-view applications, such as molecular imaging of the mouse brain.

  3. The Performance of Ictal Brain SPECT Localizing for Epileptogenic Zone in Neocortical Epilepsy

    International Nuclear Information System (INIS)

    Kim, Eun Sik; Lee, Dong Soo; Hyun, In Young; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Lee, Sang Kun; Chang, Kee Hyun

    1995-01-01

    The epileptogenic zones should be localized precisely before surgical resection of these zones in intractable epilepsy. The localization is more difficult in patients with neocortical epilepsy than in patients with temporal lobe epilepsy. This study aimed at evaluation of the usefulness of ictal brain perfusion SPECT for the localization of epileptogenic zones in neocortical epilepsy. We compared the performance of ictal SPECT with MRI referring to ictal scalp electroencephalography (sEEG). Ictal 99m Tc-HMPAO SPECT were done in twenty-one patients. Ictal EEG were also obtained during video monitoring. MRI were reviewed. According to the ictal sEEG and semiology, 8 patients were frontal lobe epilepsy, 7 patients were lateral temporal lobe epilepsy, 2 patients were parietal lobe epilepsy, and 4 patients were occipital lobe epilepsy. Ictal SPECT showed hyperperfusion in 14 patients(67%) in the zones which were suspected to be epileptogenic according to ictal EEG and semiology. MRI found morphologic abnormalities in 9 patients(43%). Among the 12 patients, in whom no epileptogenic zones were revealed by MR1, ictal SPECT found zones of hyperperfusion concordant with ictal sEEG in 9 patients(75%). However, no zones of hyperperfusion were found in 4 among 9 patients who were found to have cerebromalacia, abnormal calcification and migration anomaly in MRI. We thought that ictal SPECT was useful for localization of epileptogenic zones in neocortical epilepsy and especially in patients with negative findings in MRI.

  4. Analysis of Regional Cerebral Blood Flow Using {sup 99m}Tc-HMPAO Brain SPECT in Senile Dementia of Alzheimer Type

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Hae; Lee, Myung Chul; Koh, Chang Soon; Roh, Jae Kyu; Woo, Chong In [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1988-03-15

    {sup 99m}Tc-HMPAO brain SPECT studies were performed in 11 patients with Alzheimer's disease, 7 patients with psychological depression and 12 normal controls. Changes of regional cerebral blood flow was semiquantitatively analyzed and the results were as follows. 1) In 11 patients with Alzheimer's disease, significant reduction of regional cerebral blood flow was found In both temporoparietal areas. 2) Relative perfusion between cerebral hemispheres was rather symmetrical in patient with Alzheimer's disease. 3) All patients with depression showed normal SPECT findings. As for conclusion, {sup 99m}Tc-HMPAO brain SPECT seemed to be a valuable method for clinical assessment and management of patients with Alzheimer's disease.

  5. Mnemonic activation by SPECT

    International Nuclear Information System (INIS)

    Migneco, O.; Darcourt, J.; Benoit, M; Malandain, G.; Thirion, J.P.; Robert, Ph.; Vidal, R.; Desvignes, Ph.; Benoliel, J.; Ayache, N.; Bussiere, F.

    1997-01-01

    Data of literature show that SPECT is able to detect cerebral activations induced by sensory-motor stimuli. The facts are not clearly established in what concerns the cognitive activations the amplitude of which is lower. We have studied an activation paradigm such as the Grober and Bruschke test which implies the long term explicit memory. It comprises a visual presentation of words followed by their indexed recall. By using a two-day protocol, 2 SPECTs were achieved in 4 healthy right-handed voluntaries as follows: one of activation (A) and one of control (B). The fifth subject benefited by a SPECT B and of an MRI. The injection for the examination A has been done during the indexed recall stage and for the examination B at the moment when the patient repeated several times the same 3 words. The SPECT data were collected 1 hour after the injection of 370 MBq of ECD making use of a 3-head camera equipped with UHR fan collimators and ending by a LMH on the reconstructed images of 8 mm. The MRI has been achieved by means of a Signa 1.5 Tesla magnet. The SPECT A and B of the subjects 1 to 4 were matched elastically to that of the subject 5 and that of the subject 5 was rigidly matched on its MRI. In this way the individual activation cards of the 4 subjects could be averaged and superimposed on the MRI of the 5. subject. One observes an internal temporal activation (maximal activation of left tonsil, +25% and right uncus, +23%) and a right cingulum activation (maximal activation, +25%), in agreement with the neuro-physiological data. The elastic matching makes possible the inter-subject averaging, what increases the signal-to-noise ratio of activation. The inter-modality rigid matching facilitates the anatomical localisation of the activation site. With these adapted tools, the cognitive activation is thus possible by SPECT and opens perspectives for early diagnosis of neurological troubles, namely of Alzheimer's disease

  6. 99mTc-ECD brain perfusion SPET: variability, asymmetry and effects of age and gender in healthy adults

    International Nuclear Information System (INIS)

    Van Laere, K.; Versijpt, J.; Goethals, I.; Dierckx, R.; Audenaert, K.; Koole, M.; Achten, E.

    2001-01-01

    Reliable and high-resolution reference data for regional cerebral blood flow measured with single-photon emission tomography (SPET) are necessary for optimal clinical and research use. Therefore, a large dataset of normal technetium-99m labelled ethylene cysteine dimer (ECD) perfusion SPET in carefully screened healthy volunteers with an age range spanning six decades was created, with correction for non-uniform attenuation and scatter and based on an anatomically standardised analysis. Eighty-nine healthy volunteers, stratified for gender (46 females, 43 males; age 20-81 years), were included. Twelve volunteers underwent repeated 99m Tc-ECD SPET after 2.5±2.3 weeks. An automated whole-brain volume of interest analysis with MANOVA as well as voxelwise analysis using SPM99 was conducted. Average intersubject variability was 4.8% while intrasubject reproducibility was 3.0%. An age-related decline in tracer uptake was found in the anterior cingulate gyrus, bilateral basal ganglia, left prefrontal, left lateral frontal and left superior temporal and insular cortex (all P=0.001-0.02). There was an overall increase in right/left asymmetry with age, which was most pronounced in the frontal and temporal neocortex. The most significant correlations between AI and age decade were found in the prefrontal (R=0.35, P=0.001) and superior temporal neocortex (R=0.43, P 99m Tc-ECD perfusion SPET under a wide variety of clinical circumstances in relation to normal variations and highlights the importance of both age- and gender-specific normal datasets for optimal analysis sensitivity. (orig.)

  7. GATE simulation of a new design of pinhole SPECT system for small animal brain imaging

    International Nuclear Information System (INIS)

    Ozsahin, D. Uzun; Bläckberg, L.; Fakhri, G. El; Sabet, H.

    2017-01-01

    Small animal SPECT imaging has gained an increased interest over the past decade since it is an excellent tool for developing new drugs and tracers. Therefore, there is a huge effort on the development of cost-effective SPECT detectors with high capabilities. The aim of this study is to simulate the performance characteristics of new designs for a cost effective, stationary SPECT system dedicated to small animal imaging with a focus on mice brain. The conceptual design of this SPECT system platform, Stationary Small Animal SSA-SPECT, is to use many pixelated CsI:TI detector modules with 0.4 mm × 0.4 mm pixels in order to achieve excellent intrinsic detector resolution where each module is backed by a single pinhole collimator with 0.3 mm hole diameter. In this work, we present the simulation results of four variations of the SSA-SPECT platform where the number of detector modules and FOV size is varied while keeping the detector size and collimator hole size constant. Using the NEMA NU-4 protocol, we performed spatial resolution, sensitivity, image quality simulations followed by a Derenzo-like phantom evaluation. The results suggest that all four SSA-SPECT systems can provide better than 0.063% system sensitivity and < 1.5 mm FWHM spatial resolution without resolution recovery or other correction techniques. Specifically, SSA-SPECT-1 showed a system sensitivity of 0.09% in combination with 1.1 mm FWHM spatial resolution.

  8. Neuro-Spect and neuropsychological test in the differential diagnosis of dementia

    International Nuclear Information System (INIS)

    Marroni, B.M.; Louzada, A.G.; Andrea, S.A.; Raupp, A.A.; Sprinz, C.S.; Marroni, S.M.; Canani, L.C.; Zagoury, E.Z.; Borneman, C.B.

    2002-01-01

    Background/Aim: The role of the Neuro-Spect scintigraphy as a diagnostic tool in central nervous system diseases is well established. However, the simultaneous application of a neuro-psychological test (NPT) may be used to enhance the diagnostic accuracy of the test. The aim of this study was to test if the concomitant use of the NPT may be used to improve the differential diagnostic accuracy of the scintigraphy. Methods: A total of 144 cerebral perfusion studies (CPS) (Tc-ECD, 1110 MBq) were performed between March and October 2001. From this total 63 patients with non-specific complains of memory loss formed the study group. Patients with cancer, psychiatric disturbs or craniotomies were excluded. For analysis the patients were divided in 3 subgroups according to the major complain: a) memory deficit, b) depression and C) organic syndrome that included patients with cerebral stroke, occult hydrocephalus and head trauma. All patients submitted to the Neuro-Spect underwent a simultaneous NPT. The NPT included the following tests: Digit Span (WAIS-R), verbal fluency, clock drawing task, Minimental State Examination (MMSE) and Rey Auditory Verbal Learning Test (RAVLT). Well-established criteria, such as symmetry and concentration of the Tc-ECD were used for evaluation of the CPS. Concordance of the findings in the CPS and the anatomic lesion was used to reinforce the final conclusions. A scale for Alzheimer's Like Dementia (ALD) from 1 to 8 was developed (where 1=normal and 8 suggests ALD) using as reference the study of Holmann BL. Results: The NPT showed a positive correlation with the Neuro-Spect's probability scale. The tests with the best correlation were the verbal fluency (p<0.001), RAVLT and the memory recall (p<0.01). The MMSE did not show association with the Neuro-Spect probability scale. Conclusions: There is a positive association between the NPT and the Neuro-Spect. These results suggest that the NPT added to the Neuro-Spect may the be useful in the

  9. Effect of lamotrigine on cerebral blood flow in patients with idiopathic generalised epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Eun Yeon [Ewha Womans University, Department of Neurology, College of Medicine, Seoul (Korea); Hong, Seung Bong; Tae, Woo Suk; Han, Sun Jung; Seo, Dae Won [Sungkyunkwan University School of Medicine, Department of Neurology, Samsung Medical Center and Center for Clinical Medicine, SBRI, Gangnam-Gu, Seoul (Korea); Lee, Kyung-Han [Sungkyunkwan University School of Medicine, Department of Nuclear Medicine, Samsung Medical Center and Center for Clinical Medicine, SBRI, Gangnam-Gu, Seoul (Korea); Lee, Mann Hyung [Catholic University of Daegu, College of Pharmacy, Gyeongbuk (Korea)

    2006-06-15

    The purpose of this study was to investigate the effects of the new anti-epileptic drug, lamotrigine, on cerebral blood flow by performing {sup 99m}Tc-ethylcysteinate dimer (ECD) single-photon emission computed tomography (SPECT) before and after medication in patients with drug-naive idiopathic generalised epilepsy. Interictal {sup 99m}Tc-ECD brain SPECT was performed before drug treatment started and then repeated after lamotrigine medication for 4-5 months in 30 patients with generalised epilepsy (M/F=14/16, 19.3{+-}3.4 years). Seizure types were generalised tonic-clonic seizure in 23 patients and myoclonic seizures in seven. The mean lamotrigine dose used was 214.1{+-}29.1 mg/day. For SPM analysis, all SPECT images were spatially normalised to the standard SPECT template and then smoothed using a 12-mm full-width at half-maximum Gaussian kernel. The paired t test was used to compare pre- and post-lamotrigine SPECT images. SPM analysis of pre- and post-lamotrigine brain SPECT images showed decreased perfusion in bilateral dorsomedial nuclei of thalami, bilateral uncus, right amygdala, left subcallosal gyrus, right superior and inferior frontal gyri, right precentral gyrus, bilateral superior and inferior temporal gyri and brainstem (pons, medulla) after lamotrigine medication at a false discovery rate-corrected p<0.05. No brain region showed increased perfusion after lamotrigine administration. (orig.)

  10. Sequestration of latent TGF-β binding protein 1 into CADASIL-related Notch3-ECD deposits.

    Science.gov (United States)

    Kast, Jessica; Hanecker, Patrizia; Beaufort, Nathalie; Giese, Armin; Joutel, Anne; Dichgans, Martin; Opherk, Christian; Haffner, Christof

    2014-08-13

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) represents the most common hereditary form of cerebral small vessel disease characterized by early-onset stroke and premature dementia. It is caused by mutations in the transmembrane receptor Notch3, which promote the aggregation and accumulation of the Notch3 extracellular domain (Notch3-ECD) within blood vessel walls. This process is believed to mediate the abnormal recruitment and dysregulation of additional factors including extracellular matrix (ECM) proteins resulting in brain vessel dysfunction. Based on recent evidence indicating a role for the transforming growth factor-β (TGF-β) pathway in sporadic and familial small vessel disease we studied fibronectin, fibrillin-1 and latent TGF-β binding protein 1 (LTBP-1), three ECM constituents involved in the regulation of TGF-β bioavailability, in post-mortem brain tissue from CADASIL patients and control subjects. Fibronectin and fibrillin-1 were found to be enriched in CADASIL vessels without co-localizing with Notch3-ECD deposits, likely as a result of fibrotic processes secondary to aggregate formation. In contrast, LTBP-1 showed both an accumulation and a striking co-localization with Notch3-ECD deposits suggesting specific recruitment into aggregates. We also detected increased levels of the TGF-β prodomain (also known as latency-associated peptide, LAP) indicating dysregulation of the TGF-β pathway in CADASIL development. In vitro analyses revealed a direct interaction between LTBP-1 and Notch3-ECD and demonstrated a specific co-aggregation of LTBP-1 with mutant Notch3. We propose LTBP-1 as a novel component of Notch3-ECD deposits and suggest its involvement in pathological processes triggered by Notch3-ECD aggregation.

  11. Brain perfusion spect imaging with sup 99m Tc-HM-PAO in Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Wenzhong, Song; Xiangtong, Lin [Shanghai Medical Univ. (China). Huashan Hospital

    1991-02-01

    Forty patients with Parkinson's disease were studied using {sup 99m}Tc-HM-PAO brain perfusion SPECT. 62.5% (25 cases) showed abnormal blood perfusion. Among them 55% showed local decreased blood perfusion of cerebral cortex, 22% showed asymmetric decreased blood perfusion in basal gaglia, 10% showed decreased uptake of tracer in cerebellum. The pathophysiologic basis of the abnormality of brain blood perfusion were briefly discussed.

  12. Design and evaluation of two multi-pinhole collimators for brain SPECT.

    Science.gov (United States)

    Chen, Ling; Tsui, Benjamin M W; Mok, Greta S P

    2017-10-01

    SPECT is a powerful tool for diagnosing or staging brain diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD) but is limited by its inferior resolution and sensitivity. At the same time, pinhole SPECT provides superior resolution and detection efficiency trade-off as compared to the conventional parallel-hole collimator for imaging small field-of-view (FOV), which fits for the case of brain imaging. In this study, we propose to develop and evaluate two multi-pinhole (MPH) collimator designs to improve the imaging of cerebral blood flow and striatum. We set the target resolutions to be 12 and 8 mm, respectively, and the FOV at 200 mm which is large enough to cover the whole brain. The constraints for system optimization include maximum and minimum detector-to-center-of-FOV (CFOV) distances of 344 and 294 mm, respectively, and minimal radius-of-rotation (ROR) of 135 mm to accommodate patients' shoulder. According to the targeted FOV, resolutions, and constraints, we determined the pinhole number, ROR, focal length, aperture acceptance angle, and aperture diameter which maximized the system sensitivity. We then assessed the imaging performance of the proposed MPH and standard low-energy high-resolution (LEHR) collimators using analytical simulations of a digital NCAT brain phantom with 99m Tc-HMPAO/ 99m Tc-TRODAT-1 distributions; Monte Carlo simulations of a hot-rod phantom; and a Defrise phantom using GATE v6.1. Projections were generated over 360° and reconstructed using the 3D MPH/LEHR OS-EM methods with up to 720 updates. The normalized mean square error (NMSE) was calculated over the cerebral and striatal regions extracted from the reconstructed images for 99m Tc-HMPAO and 99m Tc-TRODAT-1 simulations, respectively, and average normalized standard deviation (NSD) based on 20 noise realizations was assessed on selected uniform 3D regions as the noise index. Visual assessment and image profiles were applied to the results of Monte Carlo

  13. Creation and evaluation of complementary composite three-dimensional image in various brain diseases. An application of three-dimensional brain SPECT image and three-dimensional CT image

    International Nuclear Information System (INIS)

    Seiki, Yoshikatsu; Shibata, Iekado; Mito, Toshiaki; Sugo, Nobuo

    2000-01-01

    The purpose of this study was to develop 3D composite images for use in functional and anatomical evaluation of various cerebral pathologies. Imaging studies were performed in normal volunteers, patients with hydrocephalus and patients with brain tumor (meningioma and metastatic tumor) using a three-detector SPECT system (Prism 3000) and helical CT scanner (Xvigor). 123 I-IMP was used in normal volunteers and patients with hydrocephalus, and 201 TLCL in patients with brain tumor. An Application Visualization System-Medical Viewer (AVS-MV) was used on a workstation (Titan 2) to generate 3D images. A new program was developed by synthesizing surface rendering and volume rendering techniques. The clinical effects of shunt operations were successfully evaluated in patients with hydrocephalus by means of translucent 3D images of the deep brain. Changes in the hypoperfusion area around the cerebral ventricle were compared with morphological changes in the cerebral ventricle on CT. In addition to the information concerning the characteristics of brain tumors and surrounding edemas, hemodynamic changes and changeable hypoperfusion areas around the tumors were visualized on 3D composite CT and SPECT images. A new method of generating 3D composite images of CT and SPECT was developed by combining graphic data from different systems on the same workstation. Complementary 3D composite images facilitated quantitative analysis of brain volume and functional analysis in various brain diseases. (author)

  14. N-isopropyl I-123 p-iodoamphetamine brain scintigraphy with SPECT in Creutzfeldt-Jakob disease

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Toshimitsu; Kosaka, Noboru; Nishikawa, Junichi; Ohtake, Tohru; Watanabe, Toshiaki; Yoshikawa, Kohki; Iio, Masahiro

    1988-10-01

    Two patients of clinically diagnosed Creutzfeldt-Jakob disease (CJD) were examined with N-Isopropyl I-123 p-Iodoamphetamine (IMP) SPECT, MRI and XCT. Both patient has myoclonus and severe conscious disturbance with periodic synchronized discharge (PSD) on EEG. SPECT images were obtained using GE400AC/T. Regional IMP uptake was determined by calculating the ratio of each cortical regional to cerebellar IMP uptake (cortico-cerebellar ratio: CCR) and compared with that of five normal controls. In both case, CCR was remarkably decreased in all cortical areas, although XCT or MRI shows no abnormality except slight cortical atrophy. It suggests that metabolic and functional changes proceed morphological abnormality seen on XCT or MRI. In one case of CJD, serial studies of SPECT and XCT were performed after three months of interval. CCR in second study was higher than in first study, while XCT revealed remarkable brain atrophy including cerebrum, pons and cerebellum. It can be interpreted as regional differences of disease process. In conclusion, I-123 IMP-SPECT is useful for the earlier detection of lesions in CJD.

  15. N-isopropyl I-123 p-iodoamphetamine brain scintigraphy with SPECT in Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Momose, Toshimitsu; Kosaka, Noboru; Nishikawa, Junichi; Ohtake, Tohru; Watanabe, Toshiaki; Yoshikawa, Kohki; Iio, Masahiro

    1988-01-01

    Two patients of clinically diagnosed Creutzfeldt-Jakob disease (CJD) were examined with N-Isopropyl I-123 p-Iodoamphetamine (IMP) SPECT, MRI and XCT. Both patient has myoclonus and severe conscious disturbance with periodic synchronized discharge (PSD) on EEG. SPECT images were obtained using GE400AC/T. Regional IMP uptake was determined by calculating the ratio of each cortical regional to cerebellar IMP uptake [cortico-cerebellar ratio: CCR] and compared with that of five normal controls. In both case, CCR was remarkably decreased in all cortical areas, although XCT or MRI shows no abnormality except slight cortical atrophy. It suggests that metabolic and functional changes proceed morphological abnormality seen on XCT or MRI. In one case of CJD, serial studies of SPECT and XCT were performed after three months of interval. CCR in second study was higher than in first study, while XCT revealed remarkable brain atrophy including cerebrum, pons and cerebellum. It can be interpreted as regional differences of disease process. In conclusion, I-123 IMP-SPECT is useful for the earlier detection of lesions in CJD. (author)

  16. Cortical damage following traumatic brain injury evaluated by iomazenil SPECT and in vivo microdialysis.

    Science.gov (United States)

    Koizumi, Hiroyasu; Fujisawa, Hirosuke; Suehiro, Eiichi; Iwanaga, Hideyuki; Nakagawara, Jyoji; Suzuki, Michiyasu

    2013-01-01

    [(123)I] iomazenil (IMZ) single photon emission computed tomography (SPECT) has been reported to be a useful marker of neuronal integrity. We evaluated cortical damage following traumatic brain injury (TBI) with IMZ SPECT at the acute stage. After conventional therapy for a cranial trauma, an IMZ SPECT re-evaluation was performed at the chronic stage. A reduction in IMZ uptake in the location of cerebral contusions was observed during the TBI acute phase; however, images of IMZ SPECT obtained during the chronic phase showed that areas with decreased IMZ distribution were remarkably reduced compared with those obtained during the acute phase. As a result of in vivo microdialysis study, the extracellular levels of glutamate in the cortex, where decreased IMZ distribution was shown during the acute phase, were increased during the 168-h monitoring period. During the chronic phase, IMZ uptake in the region with the microdialysis probes was recovered. The results suggest that this reduction in IMZ uptake might not be a sign of irreversible tissue damage in TBI.

  17. Quantitative SPECT reconstruction for brain distribution with a non-uniform attenuation using a regularizing method

    International Nuclear Information System (INIS)

    Soussaline, F.; Bidaut, L.; Raynaud, C.; Le Coq, G.

    1983-06-01

    An analytical solution to the SPECT reconstruction problem, where the actual attenuation effect can be included, was developped using a regularizing iterative method (RIM). The potential of this approach in quantitative brain studies when using a tracer for cerebrovascular disorders is now under evaluation. Mathematical simulations for a distributed activity in the brain surrounded by the skull and physical phantom studies were performed, using a rotating camera based SPECT system, allowing the calibration of the system and the evaluation of the adapted method to be used. On the simulation studies, the contrast obtained along a profile, was less than 5%, the standard deviation 8% and the quantitative accuracy 13%, for a uniform emission distribution of mean = 100 per pixel and a double attenuation coefficient of μ = 0.115 cm -1 and 0.5 cm -1 . Clinical data obtained after injection of 123 I (AMPI) were reconstructed using the RIM without and with cerebrovascular diseases or lesion defects. Contour finding techniques were used for the delineation of the brain and the skull, and measured attenuation coefficients were assumed within these two regions. Using volumes of interest, selected on homogeneous regions on an hemisphere and reported symetrically, the statistical uncertainty for 300 K events in the tomogram was found to be 12%, the index of symetry was of 4% for normal distribution. These results suggest that quantitative SPECT reconstruction for brain distribution is feasible, and that combined with an adapted tracer and an adequate model physiopathological parameters could be extracted

  18. SPECT I-123 iodoamphetamine brain imaging

    International Nuclear Information System (INIS)

    Tikofsky, R.S.; Liebman, A.; Hellman, R.S.; Collier, B.D.; Voslar, A.M.

    1988-01-01

    SPECT/IMP studies of 100 patients with a presumptive diagnosis of dementia were performed with a rotating gamma camera 15-20 minutes after intravenous injection of 3.5 mCi of IMP. Of these studies, 43 were interpreted as normal for age; 28 demonstrated decreased but not absent activity bilaterally in posterior parietal/occipital regions (consistent with Alzheimer-type dementia); 28 showed unilateral abnormalities in regional cerebral blood flow consistent with cerebrovascular disease; and one had mixed findings. Based on SPECT/IMP results, further diagnostic testing and/or management would be altered for 72% of patients, suggesting that SPECT/IMP provides valuable data, not available on clinical examination, to guide the evaluation and management of demented patients

  19. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  20. Clinical Utility of SPECT Neuroimaging in the Diagnosis and Treatment of Traumatic Brain Injury: A Systematic Review

    OpenAIRE

    Raji, Cyrus A.; Tarzwell, Robert; Pavel, Dan; Schneider, Howard; Uszler, Michael; Thornton, John; van Lierop, Muriel; Cohen, Phil; Amen, Daniel G.; Henderson, Theodore

    2014-01-01

    PURPOSE: This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI). METHODS: After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild,...

  1. Comparison of brain perfusion SPECT and MRI findings in children with neuronal ceroid-lipofuscinosis and in their families

    International Nuclear Information System (INIS)

    Sayit, E.; Yorulmaz, I; Gumuser, F.G.; Dirik, E.; Bekis, R.; Kaya, G.; Durak, H.

    2002-01-01

    Neuronal ceroid-lipofuscinoses (NCL) are among the progressive encephalopathies of childhood that are inherited in an autosomal recessive manner. In this study we specifically aimed to investigate any white-matter changes in the carriers (parents) and the healthy siblings of individuals with neuronal ceroid lipofuscinosis disease and whether we may be able to predict the occurrence of any neurological symptoms in healthy children in the future thus enabling early management. Since the NCLs are genetically determined diseases, we investigated fifteen individuals in three families that had diseased children of the juvenile type, with brain perfusion SPECT and MRI. Brain perfusion SPECT was performed after administering 222-555 MBq (6-15 mCi) Tc-99m hexamethyl-propylene amine oxime (HMPAO) intravenously in a dimmed and quiet room. Imaging was performed at least one hour after injection, with a three headed gamma camera equipped with high resolution collimators. A Metz filter (FWHM: 11 mm) was used for processing. Cranial MRI was performed with an imager operating at 1.5 Tesla. Spin-echo T1- and T2-weighted and FLAIR slices were obtained for each individual. In all of the five diseased children we observed pathologic findings both on MRI and Tc-99m HMPAO SPECT. The findings on MRI were mainly features of cerebral and cerebellar atrophy and the observations on Tc-99m HMPAO SPECT were regional perfusion abnormalities. We observed some structural abnormalities on MRI in four of the parents and two of the four healthy siblings. We also noted perfusion abnormalities on Tc-99m HMPAO SPECT in two of the parents and two of the healthy siblings. Because the disease is inherited in an autosomal recessive manner, the parents and the healthy siblings were not supposed to exhibit any demonstrable brain lesions, but the brain perfusion SPECT and MRI examinations clearly revealed multiple lesions in some of the parents and healthy siblings. Detailed neurological examinations of these

  2. CT-based attenuation correction and resolution compensation for I-123 IMP brain SPECT normal database: a multicenter phantom study.

    Science.gov (United States)

    Inui, Yoshitaka; Ichihara, Takashi; Uno, Masaki; Ishiguro, Masanobu; Ito, Kengo; Kato, Katsuhiko; Sakuma, Hajime; Okazawa, Hidehiko; Toyama, Hiroshi

    2018-03-19

    Statistical image analysis of brain SPECT images has improved diagnostic accuracy for brain disorders. However, the results of statistical analysis vary depending on the institution even when they use a common normal database (NDB), due to different intrinsic spatial resolutions or correction methods. The present study aimed to evaluate the correction of spatial resolution differences between equipment and examine the differences in skull bone attenuation to construct a common NDB for use in multicenter settings. The proposed acquisition and processing protocols were those routinely used at each participating center with additional triple energy window (TEW) scatter correction (SC) and computed tomography (CT) based attenuation correction (CTAC). A multicenter phantom study was conducted on six imaging systems in five centers, with either single photon emission computed tomography (SPECT) or SPECT/CT, and two brain phantoms. The gray/white matter I-123 activity ratio in the brain phantoms was 4, and they were enclosed in either an artificial adult male skull, 1300 Hounsfield units (HU), a female skull, 850 HU, or an acrylic cover. The cut-off frequency of the Butterworth filters was adjusted so that the spatial resolution was unified to a 17.9 mm full width at half maximum (FWHM), that of the lowest resolution system. The gray-to-white matter count ratios were measured from SPECT images and compared with the actual activity ratio. In addition, mean, standard deviation and coefficient of variation images were calculated after normalization and anatomical standardization to evaluate the variability of the NDB. The gray-to-white matter count ratio error without SC and attenuation correction (AC) was significantly larger for higher bone densities (p correction. The proposed protocol showed potential for constructing an appropriate common NDB from SPECT images with SC, AC and spatial resolution compensation.

  3. Age-dependence of local cerebral blood flow - investigations of 4 to 15 years old children and adults with Tc-99m-ECD

    International Nuclear Information System (INIS)

    Barthel, H.; Wiener, M.; Dannenberg, C.; Sattler, B.; Martin, W.G.; Knapp, W.H.

    1997-01-01

    Aim: This present study deals with the question whether normal distribution of local cerebral blood flow (ICBF) agents in adults can be transferred to the age group of 4 to 15 years old children. Methods: 23 children (age: 4-15 years, mean 11±3 y) (group I) and 10 adults (age: 27-56 years, mean 45±10 y) (group II) without evidence of cerebrovascular disease or other brain diseases underwent Tc-99m-ECD-SPECT imaging. Counts in the cortical ROIs were related to those of cerebellar ROIs (=100%). Results: In group I, relative cortical activity exceeded that of group II, particularly in parietal (107.6±9.8 vs. 84.1±12.4%), frontal (97.7±6.7 vs. 79.4±8.9%), left temporal areas (99.7±7.4 vs. 84.9±10.1%) and in the cingular cortex (112.1±9.1 vs. 95.9±10.1%, p [de

  4. Avaliação de foco epileptogênico do lobo temporal: correlação entre SPECT ictal, ressonância magnética e ressonância magnética com espectroscopia de prótons Evaluation of epileptogenic focus in temporal lobe: correlation between ictal brain SPECT, magnetic resonance imaging and magnetic resonance spectroscopy

    Directory of Open Access Journals (Sweden)

    Maria Elena Martins Diegues

    2004-02-01

    Full Text Available O objetivo deste trabalho foi determinar a existência de concordância entre os métodos radioisotópico e radiológico e, em caso positivo, avaliar a utilidade do SPECT ictal na determinação do foco epileptogênico. Foram realizados SPECT ictal, ressonância magnética (RM e ressonância magnética com espectroscopia de prótons (RME em seis pacientes com epilepsia de lobo temporal refratária. O SPECT ictal foi realizado após a retirada das drogas antiepilépticas durante monitoramento por vídeo-EEG, utilizando-se o 99mTc-ECD, administrado aos pacientes no início da crise. As imagens de RM foram obtidas em T1, T2 e FLAIR, com cortes de 3 e 5 mm de espessura, e a RME foi realizada com técnica PRESS, com voxel único posicionado no hipocampo, bilateralmente. A análise estatística incluiu os valores de Kappa (k, erro-padrão (ep e o nível de significância (p para a lateralização do foco. Os achados foram analisados com base na localização por EEG da descarga ictal, no tempo de duração da crise (109-280 s; média: 152 s e no tempo de administração do traçador (30-262 s; média: 96 s. Obtivemos dados correlatos em quatro pacientes (67%, com valores de k = 0,67, ep = 0,38 e p = 0,041. Concluímos que existe concordância entre SPECT ictal, RM e RME, e a utilidade do procedimento radioisotópico está relacionada aos casos em que o EEG não é diagnóstico e quando há discordância ou indefinição diagnóstica na análise comparativa entre EEG, RM e RME.The purpose of this study was to determine the degree of concordance between radiological and radioisotopic methods and, if positive, to evaluate the usefulness of ictal SPECT in the localization of the epileptogenic focus. Ictal brain SPECT, magnetic resonance imaging (MRI and magnetic resonance spectroscopy (MRS were performed on six patients with refractory temporal lobe epilepsy. Ictal SPECT was performed after withdrawal of the anti-epileptogenic drugs during video

  5. A SPECT study of language and brain reorganization three years after pediatric brain injury.

    Science.gov (United States)

    Chiu Wong, Stephanie B; Chapman, Sandra B; Cook, Lois G; Anand, Raksha; Gamino, Jacquelyn F; Devous, Michael D

    2006-01-01

    Using single photon emission computed tomography (SPECT), we investigated brain plasticity in children 3 years after sustaining a severe traumatic brain injury (TBI). First, we assessed brain perfusion patterns (i.e., the extent of brain blood flow to regions of the brain) at rest in eight children who suffered severe TBI as compared to perfusion patterns in eight normally developing children. Second, we examined differences in perfusion between children with severe TBI who showed good versus poor recovery in complex discourse skills. Specifically, the children were asked to produce and abstract core meaning for two stories in the form of a lesson. Inconsistent with our predictions, children with severe TBI showed areas of increased perfusion as compared to normally developing controls. Adult studies have shown the reverse pattern with TBI associated with reduced perfusion. With regard to the second aim and consistent with previously identified brain-discourse relations, we found a strong positive association between perfusion in right frontal regions and discourse abstraction abilities, with higher perfusion linked to better discourse outcomes and lower perfusion linked to poorer discourse outcomes. Furthermore, brain-discourse patterns of increased perfusion in left frontal regions were associated with lower discourse abstraction ability. The results are discussed in terms of how brain changes may represent adaptive and maladaptive plasticity. The findings offer direction for future studies of brain plasticity in response to neurocognitive treatments.

  6. Neuropsychological functions and rCBF SPECT in Parkinson's disease patients considered candidates for deep brain stimulation

    International Nuclear Information System (INIS)

    Paschali, Anna; Lakiotis, Velissarios; Vassilakos, Paulos; Messinis, Lambros; Lyros, Epameinondas; Papathanasopoulos, Panagiotis; Constantoyannis, Costas; Kefalopoulou, Zinovia

    2009-01-01

    In the present study, we examined relationships between neuropsychological functions and brain single photon emission computed tomography (SPECT) regional cerebral blood flow (rCBF) observed at presurgical evaluation for deep brain stimulation (DBS) of the subthalamic nucleus (STN) in advanced Parkinson's disease (PD) patients. Twenty advanced non-demented PD patients, candidates for DBS surgery, underwent perfusion brain SPECT study and neuropsychological assessment prior to surgery (range: 30-50 days). Patients were further assessed using the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr (H and Y) scale. During all assessments patients were ''on'' standard medication. NeuroGam software, which permits voxel by voxel analysis, was used to compare the brain perfusion of PD patients with a normal database adjusted for sex and age. Neuropsychological scores were compared to age, education and sex-adjusted normative databases. Our results indicated that the distribution of rCBF showed significant differences when compared to an age- and sex-adjusted normative database. We found impaired blood flow in 17 (85%) of our patients in the left prefrontal lobe, in 14 (70%) in the right prefrontal lobe and in 11 (55%) in the left frontal and right parietal lobes. Neuropsychological testing revealed that 18 (90%) of our patients had significant impairments in measures of executive functions (set-shifting) and 15 (75%) in response inhibition. Furthermore, we found significant correlations between measures of visual attention, executive functions and the right frontal lobe region. The presence of widespread blood flow reduction was observed mainly in the frontal lobes of dementia-free patients with advanced PD. Furthermore, performance on specific cognitive measures was highly related to perfusion brain SPECT findings. (orig.)

  7. Inter-observer variation of diagnosis of Alzheimer's disease by SPECT

    International Nuclear Information System (INIS)

    Oshima, Motoo; Machida, Kikuo; Koizumi, Kiyoshi

    2001-01-01

    SPECT shows characteristic distribution in Alzheimer's disease. The purpose of this study is to define inter-observer variations in the diagnosis of Alzheimer's disease. Fifty-seven patients, included 19 Alzheimer's disease were collected from four institutions. Five-graded score was used to interprete SPECT in 18 regions. Ten nuclear medicine physicians interpreted SPECT referred with MMSE and clinical information. Among 57 cases 19 Alzheimer's disease were selected in this study. Statistics were performed between SPECT score and MMSE score. In conclusion, inter-observer variation is present in SPECT interpretation. There was a good correlation SPECT and MMSE with proper brain SPECT physicians. They are superior to in the interpretation not only resident, but other specialists. Education in the interpretation of brain SPECT looks important. (author)

  8. Brain scintigraphy (SPECT) using 201thallium in patients with primary tumors of the brain

    International Nuclear Information System (INIS)

    Barzen, G.; Schubert, C.; Richter, W.; Calder, D.; Eichstaedt, H.; Felix, R.; Baerwald, M.

    1992-01-01

    We evaluated the role of thallium 201 Single-Photon-Emission-Computed-Tomography (SPECT) in diagnosis, differential diagnosis and follow-up of 33 patients with primary brain tumors. 27 of 33 lesions were detectable by Tl-201-SPECT because only two of eight low-grade (grade 1 and 2) astrocytomas showed Tl-201 accumulation up to a tumor to nontumor ratio of 2.6. High grade (grade 3 and 4) astrocytomas showed Tl-201 accumulation in the range of 2.2 up to 13.0 and were different from low-grade astrocytomas. Noninvasive grading of astrocytomas is therefore possible, whereas differential diagnosis of oligodendrogliomas and astrocytomas or meningeomas was not possible with Tl-201. In the follow-up of six patients, we could demonstrate, that tumor progression is correlated with increasing and tumor regression with decreasing Tl-201 accumulations. This functional changings proceed morphological findings in CT. But vanishing of Tl-201 accumulation during therapy does not mean vanishing of tumor as could be demonstrated by follow-up. (orig.) [de

  9. Relationship between cognitive function and regional cerebral blood flow in stroke patients using 99mTc-ECD SPECT 3DSRT

    International Nuclear Information System (INIS)

    Sasaki, Nobuyuki; Abo, Masahiro

    2006-01-01

    The purpose of this study was to investigate the associations between regional cerebral blood flow (rCBF) and cognitive function in patients having a local stroke within the thalamus or putamen. The Mini-Mental State Examination (MMSE) and the Kohs Block Design Test (KBDT) were used to evaluate cognitive function. Brain single-photon emission computed tomography (SPECT) was performed with 99m Tc-ethyl cysteinate dimer and analyzed with a 3-dimensional stereotactic region-of-interest template. Subjects were divided into subgroups according to the total MMSE score (D [Dementia: 23 points or less] and N [Normal: 24 points or more]) and according to KBDT scores (B [Bad: less than IQ 70] and G [Good: IQ 70 or more]). The rCBF was decreased in the MMSE D subgroup, especially in patients with a left putamen lesion, and in the KBDT B subgroup, especially in patients with a left thalamus lesion. When the lesion was in the right hemisphere, no significant difference in rCBF was found between the MMSE D and N subgroups or between the KBDT B and G subgroups. SPECT is useful for clinical evaluation of cerebral vascular disease, especially in patients with left hemispheric lesions. Additional data and further detailed evaluations are needed. (author)

  10. Deficits in Regional Cerebral Blood Flow on Brain SPECT Predict Treatment Resistant Depression.

    Science.gov (United States)

    Amen, Daniel G; Taylor, Derek V; Meysami, Somayeh; Raji, Cyrus A

    2018-03-22

    Depression remains an important risk factor for Alzheimer's disease, yet few neuroimaging biomarkers are available to identify treatment response in depression. To analyze and compare functional perfusion neuroimaging in persons with treatment resistant depression (TRD) compared to those experiencing full remission. A total of 951 subjects from a community psychiatry cohort were scanned with perfusion single photon emission computed tomography (SPECT) of the brain in both resting and task related settings. Of these, 78% experienced either full remission (n = 506) or partial remission (n = 237) and 11% were minimally responsive (n = 103) or non-responsive (11%. n = 106). Severity of depression symptoms were used to define these groups with changes in the Beck Depression Inventory prior to and following treatment. Voxel-based analyses of brain SPECT images from full remission compared to the worsening group was conducted with the statistical parametric mapping software, version 8 (SPM 8). Multiple comparisons were accounted for with a false discovery rate (p <  0.001). Persons with depression that worsened following treatment had reduced cerebral perfusion compared to full remission in the multiple regions including the bilateral frontal lobes, right hippocampus, left precuneus, and cerebellar vermis. Such differences were observed on both resting and concentration SPECT scans. Our findings identify imaging-based biomarkers in persons with depression related to treatment response. These findings have implications in understanding both depression to prognosis and its role as a risk factor for dementia.

  11. Changes in the peritumoral hypoperfusion area immediately after radiosurgery for metastatic brain tumor. Analysis using 3D-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nemoto, Masaaki [Toho Univ., Tokyo (Japan). School of Medicine

    2001-09-01

    Sixteen patients with single metastatic brain tumor underwent SPECT using N-isopropyl-p-({sup 123}I) iodoamphetamine ({sup 123}I-IMP) before and after radiosurgery. Influence of treatment was evaluated using three-dimensional SPECT images, threshold-voxel graphs and changes in the volume of the peritumoral hypoperfusion area. A three-detector type scanner, the PRISM3000, was also used. SPECT scanning was performed for 30 minutes after intravenous administration of {sup 123}I-IMP with sequential scans every 1 minutes. The data obtained 16-30 minutes after administration were processed using a low-pass ramp filter, and three-dimensional SPECT images were constructed from these data using the Application Visualization System (AVS). Furthermore, a threshold-voxel graph was plotted and the volume of the peritumoral hypoperfusion area was calculated. SPECT was performed before radiosurgery, and 1 day, 1 week, and 1 month after, and these data were compared. Three-dimensional SPECT presented the area of peritumoral hypoperfusion as a deficit image and changes were evaluated visually. Threshold-voxel graphs were evaluated as follows: changes in voxels with a threshold of 40-50% indicated a hypoperfusion area, and changes in voxels with a threshold of 70-95% indicated a hyperperfusion area in the tumor side hemisphere. The volume of the peritumoral hypoperfusion area was calculated using the voxel difference between the tumor side and normal hemispheres. Our results showed that the peritumoral hypoperfusion area gradually decreased after an initial first-day increase following radiosurgery. Visual three-dimensional SPECT allowed us to monitor both the volume of the peritumoral hypoperfusion area of metastatic brain tumors after radiosurgery by means of a threshold-voxel graph and changes in the peritumoral hypoperfusion area. (author)

  12. 123I-amphetamine-SPECT in the diagnosis of neurological disorders

    International Nuclear Information System (INIS)

    Biersack, H.J.; Kreiten, K.; Hartmann, A.; Friedrich, G.; Linck, H.A.; Winkler, C.; Bonn Univ.; Rheinische Landesklinik, Bonn

    1985-01-01

    In contrast to conventional brain scintigraphy with sup(99m)Tc-pertechnetate, SPECT with 123 I-IMP enables visualization of the brain tissue itself. The relevance of this imaging technique was evaluated in 54 patients with cerebral disorders. SPECT of the brain was performed with a rotating gamma camera. In 6 of 24 epileptic patients, SPECT revealed foci consistent with EEG-findings which were, however, not detected by CCT. In 4 of 25 patients with cerebrovascular disease, hypoperfused areas were detected by SPECT despite negative results obtained with CCT. In 50% (10/20) of the patients with cerebrovascular disease, SPECT showed a greater functional extent of the lesions than CCT. In 3 patients with migraine and normal CCT, regional perfusion disturbancers were found. SPECT with 123 I-labeled amphetamines, therefore, enables diagnosis of functional perfusion disorders and metabolic disturbances that are not revealed by CCT. In addition, SPECT can be used to exactly demonstrate the functional extent of lesions detected by CCT. (orig.) [de

  13. The current status of SPECT or SPECT/CT in South Korea

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Ik Dong; Choi, Eun Kyung; Chung, Yong An [Dept. of Radiology, Incheon Saint Mary' s HospitalThe Catholic University of Korea, Incheon (Korea, Republic of)

    2017-06-15

    The first step to nuclear medicine in Korea started with introduction of the gamma camera in 1969. Although planar images with the gamma camera give important functional information, they have the limitations that result from 2-dimensional images. Single-photon emission computed tomography (SPECT) due to its 3-dimensional image acquisition is superior to earlier planar gamma imaging in image resolution and diagnostic accuracy. As demand for a hybrid functional and anatomical imaging device has increased, integrated SPECT/CT systems have been used. In Korea, SPECT/CT was for the first time installed in 2003. SPECT/CT can eliminate many possible pitfalls on SPECT-alone images, making better attenuation correction and thereby improving image quality. Therefore, SPECT/CT is clinically preferred in many hospitals in various aspects. More recently, additional SPECT/CT images taken from the region with equivocal uptake on planar images have been helpful in making precise interpretation as part of their clinical workup in postoperative thyroid cancer patients. SPECT and SPECT/CT have various advantages, but its clinical application has gradually decreased in recent few years. While some researchers investigated the myocardial blood flow with cardiac PET using F-18 FDG or N-13 ammonia, myocardial perfusion SPECT is, at present, the radionuclide imaging study of choice for the risk stratification and guiding therapy in the coronary artery disease patients in Korea. New diagnostic radiopharmaceuticals for AD have received increasing attention; nevertheless, brain SPECT will remain the most reliable modality evaluating cerebral perfusion.

  14. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zhaosheng, Luan; Pengyong,; Xiqin, Sun; Wei, Wang; Huisheng, Liu; Wen, Zhou [88 Hospital PLA, Taian, SD (China). Dept. of Nuclear Medicine

    1992-11-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed.

  15. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    International Nuclear Information System (INIS)

    Luan Zhaosheng; Pengyong; Sun Xiqin; Wang Wei; Liu Huisheng; Zhou Wen

    1992-01-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed

  16. Increased cerebral blood flow in MELAS shown by Tc-99m HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Peng, N.J.; Tsay, D.G.; Liu, R.S.; Li, J.Y.; Kong, K.W.; Kwok, C.G.; Strauss, H.W.

    2000-01-01

    We report cerebral SPECT studies on two siblings with the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). Tc-99m HMPAO brain SPECT was performed 8, 19 and 30 days after a stroke-like episode in one case and 10 days after a stroke-like episode, 6 h after a partial seizure and as a follow-up study in the other. Increased blood flow was seen in both these patients with stroke-like episodes due to MELAS. The cause of the increased blood flow is uncertain, but it may be related to the decreased pH created by local increase in lactic acid. (orig.)

  17. Evaluation of brain tumors by simultaneous dual isotope SPECT with 201Tl-chloride and 99mTc-MIBI

    International Nuclear Information System (INIS)

    Nagai, Hidemasa; Yamasaki, Toshiki; Yamamoto, Yoshiaki; Takada, Daikei; Miyazaki, Takeshi; Sugimoto, Keiji; Matsumoto, Yoshifumi; Akiyama, Yasuhiko; Moritake, Kouzo

    2004-01-01

    Single photon emission computed tomography (SPECT) is useful for detecting brain tumors. In this study, we evaluated the utility of simultaneous dual SPECT with 201 Tl-Chloride (Tl) and 99m Tc-MIBI (MIBI) for diagnosis of brain tumors. We evaluated 20 cases, including 2 glioblastomas, 7 anaplastic astrocytomas, 2 oligodendrogliomas, 2 anaplastic ependymomas, 2 medulloblastomas, 2 meningiomas, 1 malignant meningioma, 1 pituitary adenoma, and 1 craniopharyngioma. We analyzed the uptake ratio (T/N ratio) of tracers in both Tl and MIBI at max counts/pixels ratio in the region of interest. The T/N ratios in early and delayed images were described as early ratios (ER) and delay ratios (DR), respectively. The retention index (RI) was calculated as the DR/ER ratio. Significant correlations were found between ER and DR for both Tl (DR=0.797 x ER+0.359, r=0.871), and MIBI (DR=0.961 x ER-0.191, r=0.784). Next, we analyzed the correlations between Tl and MIBI SPECT, for ER, DR, and RI. ER values for the two were strongly correlated (r=0.791), DR values were weakly correlated (r=0.556), and RI exhibited no correlation between them (r=0.328). There were no correlations between tumor volume and T/N ratio for the two (ER-Tl; r=0.0095, DR-Tl; r=0.0050, ER-MIBI; r=0.036, DR-MIBI; r=0.254). Lastly no correlation was found between RI-Tl and RI-MIBI (r=0.328). We discuss the difference in the mechanism of accumulation of two tracers and the significance of simultaneous dual SPECT using them for the differential diagnosis of pituitary tumors, regrowth of oligodendrogliomas, and multi-drug resistance of chemotherapy. Dual SPECT with Tl and MIBI appears to be useful for the diagnosis of brain tumor. (author)

  18. SISCOM imaging : an initial South African experience

    International Nuclear Information System (INIS)

    Warwick, J.; Rubow, S.; Van Heerden, B.; Ghoorun, S.; Butler, J.

    2004-01-01

    Full text: Subtraction ictal SPECT co-registered with MRI (SISCOM) is a new technique utilized for the detection and localization of epileptogenic foci in patients with refractory focal epilepsy who are candidates for surgical resection. The technique requires many challenges to be overcome, in particular in relation to the administration of the radiopharmaceutical, acquisition of brain SPECT and the conversion, co-registration and fusion of brain SPECT and MRI studies. Furthermore the interpretation of the studies is complex and is ideally performed in a multidisciplinary context in cooperation with disciplines such as neurology, radiology, psychiatry and neurosurgery. Materials and methods: Two brain SPECT studies are performed using 99m Tc-ethylene cystinate dimer (ECD). An ictal study is performed after the administration of the 99m Tc-ECD during a seizure. An interictal SPECT, performed between seizures is then subtracted from the ictal SPECT, and the difference image fused with an MRI study to optimise localization of the epileptogenic focus. Image conversion, co-registration and fusion was performed using MRlcro and SPM software. Results: To date the Departments of Neurology and Nuclear Medicine have completed over 10 SISCOM studies. Conclusion: During this presentation this initial work will be presented. The methodology as well as the challenges involved in performing and interpreting these studies will be discussed. Individual cases will be used to illustrate the impact of this powerful technique on future patient management. (author)

  19. Study of cellular retention of HMPAO and ECD in a model simulating the blood-brain barrier; Etude de la retention cellulaire de l`HMPAO et de l`ECD dans un modele simulant la barriere hematoencephalique

    Energy Technology Data Exchange (ETDEWEB)

    Ponce, C.; Pittet, N.; Slosman, D.O. [HUG, 1211 Geneve 14, (Switzerland)

    1997-12-31

    The HMPAO and ECD are two technetium-labelled lipophilic agents clinically used in the imagery of cerebral perfusion. These molecules cross the membranes and are retained inside the cell after being converted to a hydrophilic form. The aim of this study is to establish the distribution of this retention at the level of blood-brain barrier (BBB) and nerve cells. The incorporation of HMPAO or ECD was studied on a model of co-culture simulating the BBB by means of a T84 single-cell layer of tight junction separated from another layer of U373 astrocyte cells. The cell quality and tight junction permeability were evaluated by the cellular retention of 111-indium chloride and by para-cellular diffusion of {sup 14}C mannitol,d-1. The values reported below were obtained at 180 minutes when the radiotracers were added near the `T84 layer`. The cell quality is validated by the low cellular retention of the indium chloride(2.3{+-}0.3 {mu}g{sup -1} for the T84 cells and 8.2{+-}5.8 {mu}g{sup -1} for the U373 cells). The activity of {sup 14}C mannitol,d-1 diminishes by 23 {+-} 5 % in the added compartment. The retention of ECD by the U373 cells is significantly higher (20.7 {+-}4.5 g{sup -1}) than that of T84 cells (2.9 {+-} 0.2 {mu}g{sup -1}). For HMPAO a non-significant tendency could be observed (49 {+-} 34 {mu}g{sup -1} for the U373 cells and 38 {+-} 25 {mu}g{sup -1} for the T84 cells)> The results of cellular retention of indium by HMPAO or ECD when added near `U373 layer` are not significantly different.In conclusion, independently of the side exposed to the radiotracers, one observes an enhanced incorporation of the U373 cells. The ensemble of these results represent additional arguments in favour of a specific cellular incorporation of the radiotracers, independent of the BBB permittivity

  20. Does supplementation of contrast MR imaging with thallium-201 brain SPECT improve differentiation between benign and malignant ring-like contrast-enhanced cerebral lesions?

    International Nuclear Information System (INIS)

    Kita, Tamotsu; Hayashi, Katsumi; Yamamoto, Masayoshi; Kawauchi, Toshio; Sakata, Ikuko; Iwasaki, Yoshie; Kosuda, Shigeru

    2007-01-01

    The objective of this study was to determine whether thallium-201 ( 201 Tl) brain single photon emission computed tomography (SPECT) could supplement magnetic resonance (MR) imaging diagnostic information by visual comparison of two separate data sets from patients with ring-like contrast-enhanced cerebral lesions. A combination of MR imaging and 201 Tl brain SPECT sets obtained from 13 patients (10 men, 3 women) ranging in age from 26 years to 86 years (mean 61.0 years) were retrospectively reviewed. A total of 12 patients had a solitary lesion, and the others had multiple lesions. All but two intracranial foci were pathologically confirmed. The final diagnoses were six glioblastomas, two cerebral metastases from lung cancer, and one each of abscess, resolving hematoma, primary central nervous system lymphoma, toxoplasmosis, and radiation necrosis. The two separate image formats (MR images and SPECT) were shown to ten readers with practical experience. All of the MR images for each patient were shown to each reader first. After interpreting them, the readers were shown the SPECT images. Images were scored in terms of how benign or malignant the foci were on a 5-point scale from ''definitely benign'' to ''definitely malignant.'' The improvement in the performance of all ten readers was from 67.7% to 93.8% in mean accuracy (P=0.0028) and from 0.730 to 0.971 in mean Az value (P=0.0069) after they were shown the 201 Tl brain SPECT images. 201 Tl brain SPECT should substantially increase confidence in the diagnosis of intracranial lesions with ring-like contrast enhancement when MR imaging does not permit differentiation between benign and malignant disease. (author)

  1. Validation of a method for accurate and highly reproducible quantification of brain dopamine transporter SPECT studies

    DEFF Research Database (Denmark)

    Jensen, Peter S; Ziebell, Morten; Skouboe, Glenna

    2011-01-01

    In nuclear medicine brain imaging, it is important to delineate regions of interest (ROIs) so that the outcome is both accurate and reproducible. The purpose of this study was to validate a new time-saving algorithm (DATquan) for accurate and reproducible quantification of the striatal dopamine t...... transporter (DAT) with appropriate radioligands and SPECT and without the need for structural brain scanning....

  2. Predictive value of brain SPECT with 99 technetium - MIBI for differentiation of histologic grade brain gliomas

    International Nuclear Information System (INIS)

    León Castellón, Roberto; Martín Escuela, Juan Miguel; López Díaz, Ing. Adlin; Salva Camaño, Silvia; Gómez Viera, DrC. Nelson; San Pedro, Aley Palau; Castro Jiménez, Mayté

    2016-01-01

    Diagnosis and treatment of primary tumors of the nervous system remain difficult and are a challenge to be addressed in a multidisciplinary way. In order to determine the usefulness of brain SPECT 99 Tc MIBI to differentiate histologic grade brain gliomas - Frequently brain tumors - they were studied 68 patients with this technique. A dynamic study first step in AP and lateral view was performed, and a SPECT at 20 minutes post-administration and at 2 hours late views. the post-surgical histological study of injuries was used as control. several imaging parameters such as the absolute activity of 99m Tc-MIBI were calculated both early and late phase, cortex contralateral tumor rates; pituitary tumor; choroid plexus tumor and Reason Late / Early phase tumor index / contralateral cortex tumor volume functional phase, the volume concentration of MIBI activity in the tumor and the retention rate of the radiopharmaceutical. Of the 68 patients studied, 11 were high-grade tumors and 57 low grade. The cortex contralateral tumor in late stage index showed a negative satisfactory sensitivity of 98.6% and specificity 77.1%, positive predictive value (PPV) of 48.2% and (NPV) of 99.8%. The reason late stage / early in the index tumor / contralateral cortex showed values ​​in turn 96.3%, 98.7%, 98.8% and 98.8% sensitivity, specificity, PPV and NPV respectively. The retention rate showed a 99% sensitivity, 89% specificity and PPV, NPV of 95% and 99% respectively. Conclusion: The combination cortex contralateral tumor rate in late stage, the reason late stage / early stage tumor index / contralateral cortex and the retention rate of the radiopharmaceutical are the most useful parameters to predict histologic grade of brain gliomas. (author)

  3. Brain imaging with 123I-IMP-SPECT in migraine between attacks

    International Nuclear Information System (INIS)

    Schlake, H.P.; Boettger, I.G.G.; Grotemeyer, K.H.; Husstedt, I.W.

    1989-01-01

    123 I-IMP-SPECT brain imaging was performed in patients with classic migraine (n = 5) and migraine accompagnee (n = 18) during the headache-free interval. A regional reduction of tracer uptake into brain was observed in all patients with migraine accompagnee, while in patients with classic migraine only one case showed an area of decreased activity. The most marked alteration was found in a patient with persisting neurological symptoms (complicated migraine). In most cases the areas of decreased tracer uptake corresponded to headache localization as well as to topography of neurologic symptoms during migraine attacks. It may be concluded that migraine attacks occur in connection with exacerbations of preexisting changes of cerebral autoregulation due to endogenous or exogenous factors

  4. Towards adapting a normal patient database for SPECT brain perfusion imaging

    International Nuclear Information System (INIS)

    Smith, N D; Soleimani, M; Mitchell, C N; Holmes, R B; Evans, M J; Cade, S C

    2012-01-01

    Single-photon emission computerized tomography (SPECT) is a tool which can be used to image perfusion in the brain. Clinicians can use such images to help diagnose dementias such as Alzheimer's disease. Due to the intrinsic stochasticity in the photon imaging system, some form of statistical comparison of an individual image with a 'normal' patient database gives a clinician additional confidence in interpreting the image. Due to the variations between SPECT camera systems, ideally a normal patient database is required for each individual system. However, cost or ethical considerations often prohibit the collection of such a database for each new camera system. Some method of adapting existing normal patient databases to new camera systems would be beneficial. This paper introduces a method which may be regarded as a 'first-pass' attempt based on 2-norm regularization and a codebook of discrete spatially stationary convolutional kernels. Some preliminary illustrative results are presented, together with discussion on limitations and possible improvements

  5. SPECT in psychiatry

    International Nuclear Information System (INIS)

    Barocka, A.; Feistel, H.; Ebert, D.; Lungershausen, E.

    1993-01-01

    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D 2 and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.) [de

  6. /sup 123/I-amphetamine-SPECT in the diagnosis of neurological disorders

    Energy Technology Data Exchange (ETDEWEB)

    Biersack, H.J.; Kreiten, K.; Hartmann, A.; Friedrich, G.; Linck, H.A.; Winkler, C.

    1985-03-01

    In contrast to conventional brain scintigraphy with sup(99m)Tc-pertechnetate, SPECT with /sup 123/I-IMP enables visualization of the brain tissue itself. The relevance of this imaging technique was evaluated in 54 patients with cerebral disorders. SPECT of the brain was performed with a rotating gamma camera. In 6 of 24 epileptic patients, SPECT revealed foci consistent with EEG-findings which were, however, not detected by CCT. In 4 of 25 patients with cerebrovascular disease, hypoperfused areas were detected by SPECT despite negative results obtained with CCT. In 50% (10/20) of the patients with cerebrovascular disease, SPECT showed a greater functional extent of the lesions than CCT. In 3 patients with migraine and normal CCT, regional perfusion disturbancers were found. SPECT with /sup 123/I-labeled amphetamines, therefore, enables diagnosis of functional perfusion disorders and metabolic disturbances that are not revealed by CCT. In addition, SPECT can be used to exactly demonstrate the functional extent of lesions detected by CCT.

  7. Analysis of simulataneous I-123-IPT/Tc-99m-HMPAO dual isotope brain SPECT in Parkinson's disease and normal volunteers using SPM

    International Nuclear Information System (INIS)

    Chung, Y. A.; Juh, R. H.; Kim, S. H.; Park, Y. H.; Lee, S. Y.; Sohn, H. S.; Chung, S. K.

    2002-01-01

    The basal ganglia are usually poorly delineated in Parkinson's diseases on IPT images. We have studied simultaneous dual isotope brain SPECTs using I-123-IPT and Tc-99m-HMPAO, in order to overcome this limitation of IPT imaging. 17 patients (M: 7, F: 10) with Parkinson's disease (Idiopathic parkison's disease: 12, Multiple system atrophy: 5) and 4 normal volunteers (N) underwent the dual isotope brain SPECT following simultaneously injection of 370 MBq Tc-99m-HMPAO (energy window: 130-146 keV) and 111 MBq I-123-IPT (energy window: 152-168 keV). We first obtained parameters of spatial normalization during spatial normalization of Tc-99m-HMPAO brain SPECT using SPECT template. Using these parameters, we could spatially normalized I-123-IPT brain PSECT to standard space, because these images were obtained simultaneously. The difference between each groups(N vs IPD, N vs MSA, IPD vs MSA) were compared with t-test (p<0.01). We demonstrated decreased perfusion in the head and body caudate and globus pallidus on MSA compared with IPD. No significant hypo- and hyperperfusion area was observed in the other analysis. The method proposed in this study can effectively evaluate the dopamine function, and is easily applicable to conventional gamma camera system with any dual energy window acquisition modes

  8. Clinical results of neurotransmission SPECT in extra-pyramidal diseases; Resultats cliniques de la TEMP de la neurotransmission en pathologie extra-pyramidale

    Energy Technology Data Exchange (ETDEWEB)

    Baulieu, J.L.; Prunier, C.; Tranquart, F.; Guilloteau, D. [Centre Hospitalier Universitaire Bretonneau, Service de Medecine Nucleaire in vitro, INSERM U316, 37 - Tours (France)

    1999-12-01

    We present some methodological aspects and clinical applications of dopamine D2 receptor and transporter SPECT using new radiotracers radiolabeled with iodine 123. The gamma camera quality control and standardisation has to be adapted to the small volume and deep location of striata, where receptors and transporters are present. Phantom containing hollow spheres of different diameters which can be filled with different amounts of {sup 99m}Tc or {sup 123}I. The semi quantitation of receptor and transporter molecular concentration is based on an equilibrium binding model. According to this model, the binding potential (Bmax. Ka) is equal to the ratio between specific binding in the striatum and circulating activity in a reference region of interest in the occipital cortex. By comparing ECD and ILIS SPECT, it has been shown that striatal ILIS binding does not depend on the local perfusion. The clinical applications mainly concern the extra-pyramidal pathology: ILIS and IBZM SPECT are able to differentiate pre- and post-synaptic lesions. In Parkinson disease the nigrostriatal pathway is damaged and D2 receptors are normal or increased, as shown by normal or elevated IBZM or ILIS uptake. In other extra pyramidal degenerative diseases as progressive supra nuclear palsy or multiple system atrophy striatal D2 receptors are damaged as shown by decreased IBZM or ILIS uptake. In our experience, 88 per cent of patients are correctly classified by ILIS SPECT and 86 per cent with IBZM SPECT. Dopamine transporter SPECT with {beta}CIT and PE2I provides an evaluation of the presynaptic neuronal density in the striatum. One can expect an help for the early diagnosis and the evaluation of Parkinson disease. Another potential application of dopaminergic neurotransmission SPECT is the evaluation of neuronal loss after hypoxo-ischemia. We conclude that dopaminergic neurotransmission SPECT using specific ligands should become a useful diagnosis tool to study a large number of brain

  9. I-123 iodoamphetamine brain SPECT of leukoencephalopathy in dementia

    International Nuclear Information System (INIS)

    Kramer, E.L.; George, A.E.; Sanger, J.J.; De Leon, M.J.

    1987-01-01

    Six elderly patients with dementia underwent I-123 iodoamphetamine (IMP) SPECT and CT or MR imaging of the brain. In five of six, CT or MR imaging showed changes in the temporal lobes consistent with Alzheimer disease (AD). IMP scans in these five showed temporal and parietal defects. In five of six, CT or MR imaging showed white-matter lucencies and/or basal ganglia infarcts. In these, IMP defects corresponded to focal CT abnormalities but were more extensive and also involved structural normal adjacent cortex. IMP demonstrates the deficits of AD and leukoencephalopathy and may help clarify the contribution of small-vessel disease to dementia in the elderly

  10. Decision-making deficit of a patient with axonal damage after traumatic brain injury.

    Science.gov (United States)

    Yasuno, Fumihiko; Matsuoka, Kiwamu; Kitamura, Soichiro; Kiuchi, Kuniaki; Kosaka, Jun; Okada, Koji; Tanaka, Syohei; Shinkai, Takayuki; Taoka, Toshiaki; Kishimoto, Toshifumi

    2014-02-01

    Patients with traumatic brain injury (TBI) were reported to have difficulty making advantageous decisions, but the underlying deficits of the network of brain areas involved in this process were not directly examined. We report a patient with TBI who demonstrated problematic behavior in situations of risk and complexity after cerebral injury from a traffic accident. The Iowa gambling task (IGT) was used to reveal his deficits in the decision-making process. To examine underlying deficits of the network of brain areas, we examined T1-weighted structural MRI, diffusion tensor imaging (DTI) and Tc-ECD SPECT in this patient. The patient showed abnormality in IGT. DTI-MRI results showed a significant decrease in fractional anisotropy (FA) in the fasciculus between the brain stem and cortical regions via the thalamus. He showed significant decrease in gray matter volumes in the bilateral insular cortex, hypothalamus, and posterior cingulate cortex, possibly reflecting Wallerian degeneration secondary to the fasciculus abnormalities. SPECT showed significant blood flow decrease in the broad cortical areas including the ventromedial prefrontal cortex (VM). Our study showed that the patient had dysfunctional decision-making process. Microstructural abnormality in the fasciculus, likely from the traffic accident, caused reduced afferent feedback to the brain, resulting in less efficient decision-making. Our findings support the somatic-marker hypothesis (SMH), where somatic feedback to the brain influences the decision-making process. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Study on effects of an atypical antipsychotic agent, quetiapine, on regional cerebral blood flow with 99mTc-ECD SPECT in drug-naive or unmedicated schizophrenic patients

    International Nuclear Information System (INIS)

    Monkawa, Akikazu

    2007-01-01

    The objective of this study was to investigate the underlying mechanisms of intracerebral actions or clinical efficacies of quetiapine, an atypical antipsychotic agent and a multi-action receptor targeting agent (MARTA), and the influences of quetiapine on absolute regional cerebral blood flows (rCBFs) of schizophrenic patients. Correlations between rCBFs and psychotic symptoms were also examined. Subjects comprised 12 patients who met the ICD-10 criteria for schizophrenia. All patients were drug-naive or unmedicated. Using single photon emission computed tomography (SPECT) with 99m Tc-ethyl cysteinate dimer (ECD), rCBFs were measured. Psychotic symptoms were evaluated with positive and negative syndrome scale (PANSS). The evaluations of SPECT and PANSS were repeated before and after oral 2-week administration of quetiapine 300 mg/day in all patients and after subsequent 2-week administration of quetiapine 600 mg/day in 6 patients. Administration of quetiapine yielded no significant changes in rCBFs at any dose. And there were no significant correlations between the scores of PANSS and the values of rCBFs in any region, though the scores of PANSS decreased after qutiapine administration. It has been reported that, a typical antipsychotic agent, haloperidol, and an atypical antipsychotic agent, risperidone, decrease rCBFs in the cerebral cortex in dose-dependently in drug-naive or unmedicated schizophrenic patients. This phenomenon is considered to be attributable to a secondary inactivation of the cerebral cortex due to D2 receptor blockade of haloperidol or risperidone in the striatum through the cortico-striatal-thalamic pathway. In the frame of this hypothesis, results of this study may relate to the lower degree of D2 blockade induced by quetiapine than that produced by haloperidol and risperidone. (author)

  12. Effects of partial volume correction on discrimination between very early Alzheimer's dementia and controls using brain perfusion SPECT

    International Nuclear Information System (INIS)

    Kanetaka, Hidekazu; Matsuda, Hiroshi; Ohnishi, Takashi; Imabayashi, Etsuko; Tanaka, Fumiko; Asada, Takashi; Yamashita, Fumio; Nakano, Seigo; Takasaki, Masaru

    2004-01-01

    We assessed the accuracy of brain perfusion single-photon emission computed tomography (SPECT) in discriminating between patients with probable Alzheimer's disease (AD) at the very early stage and age-matched controls before and after partial volume correction (PVC). Three-dimensional MRI was used for PVC. We randomly divided the subjects into two groups. The first group, comprising 30 patients and 30 healthy volunteers, was used to identify the brain area with the most significant decrease in regional cerebral blood flow (rCBF) in patients compared with normal controls based on the voxel-based analysis of a group comparison. The second group, comprising 31 patients and 31 healthy volunteers, was used to study the improvement in diagnostic accuracy provided by PVC. A Z score map for a SPECT image of a subject was obtained by comparison with mean and standard deviation SPECT images of the healthy volunteers for each voxel after anatomical standardization and voxel normalization to global mean or cerebellar values using the following equation: Z score = ([control mean]-[individual value])/(control SD). Analysis of receiver operating characteristics curves for a Z score discriminating AD and controls in the posterior cingulate gyrus, where a significant decrease in rCBF was identified in the first group, showed that the PVC significantly enhanced the accuracy of the SPECT diagnosis of very early AD from 73.9% to 83.7% with global mean normalization. The PVC mildly enhanced the accuracy from 73.1% to 76.3% with cerebellar normalization. This result suggests that early diagnosis of AD requires PVC in a SPECT study. (orig.)

  13. {sup 99m}Tc-ECD brain perfusion SPET: variability, asymmetry and effects of age and gender in healthy adults

    Energy Technology Data Exchange (ETDEWEB)

    Van Laere, K.; Versijpt, J.; Goethals, I.; Dierckx, R. [Div. of Nuclear Medicine, Ghent University Hospital (Belgium); Audenaert, K. [Dept. of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent (Belgium); Koole, M. [Medical Signal and Image Processing Department (MEDISIP), Ghent University, Ghent (Belgium); Achten, E. [Division of Neuroradiology, Radiology Department, Ghent University Hospital, Ghent (Belgium)

    2001-07-01

    Reliable and high-resolution reference data for regional cerebral blood flow measured with single-photon emission tomography (SPET) are necessary for optimal clinical and research use. Therefore, a large dataset of normal technetium-99m labelled ethylene cysteine dimer (ECD) perfusion SPET in carefully screened healthy volunteers with an age range spanning six decades was created, with correction for non-uniform attenuation and scatter and based on an anatomically standardised analysis. Eighty-nine healthy volunteers, stratified for gender (46 females, 43 males; age 20-81 years), were included. Twelve volunteers underwent repeated {sup 99m}Tc-ECD SPET after 2.5{+-}2.3 weeks. An automated whole-brain volume of interest analysis with MANOVA as well as voxelwise analysis using SPM99 was conducted. Average intersubject variability was 4.8% while intrasubject reproducibility was 3.0%. An age-related decline in tracer uptake was found in the anterior cingulate gyrus, bilateral basal ganglia, left prefrontal, left lateral frontal and left superior temporal and insular cortex (all P=0.001-0.02). There was an overall increase in right/left asymmetry with age, which was most pronounced in the frontal and temporal neocortex. The most significant correlations between AI and age decade were found in the prefrontal (R=0.35, P=0.001) and superior temporal neocortex (R=0.43, P<0.001). Women had significantly higher uptake in the right parietal cortex (P<0.001), while men showed higher uptake in the cerebellum and the left anterior temporal and orbitofrontal cortex (all P<0.01). This normative dataset allows age- and gender-specific patient and group assessment of {sup 99m}Tc-ECD perfusion SPET under a wide variety of clinical circumstances in relation to normal variations and highlights the importance of both age- and gender-specific normal datasets for optimal analysis sensitivity. (orig.)

  14. Diagnosis of Alzheimer's disease using brain SPECT with three-dimensional stereotactic surface projections

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Asano, Tetsuichi; Kogure, Daiji; Abe, Shine; Iwamoto, Toshihiko; Takasaki, Masaru

    2001-01-01

    We compared the diagnostic usefulness of three-dimensional stereotactic surface projection (3D-SSP) with that of standard transaxial images in brain SPECT in patients with Alzheimer's disease (AD). The subjects consisted of 69 patients with AD and 60 patients with non-AD, including vascular dementia, Parkinson's disease with dementia, frontotemporal dementia, other dementing diseases and neuropsychiatric diseases. Standard transaxial section and 3D-SSP SPECT images with N-isopropyl-p-[ 123 I] iodoamphetamine were blindly interpreted by three examiners and were classified into the following three patterns: typical AD, atypical AD, and not indicative AD patterns. The 3D-SSP images demonstrated reductions of cerebral blood flow in the parieto-temporal association cortex and posterior cingulate gyrus more clearly and easily than the standard transaxial images. The diagnostic sensitivity and specificity were 93% and 85% with 3D-SSP and 83% and 82% with standard transaxial section respectively. 3D-SSP was especially useful for early or atypical AD which showed no characteristic perfusion abnormalities on standard transaxial images. These results suggest that SPECT with 3D-SSP provides an sensitive as well as accurate tool for the diagnosis of AD. (author)

  15. I-123 Iofetamine SPECT scan in children with neurological disorders

    International Nuclear Information System (INIS)

    Flamini, J.R.; Konkol, R.J.; Wells, R.G.; Sty, J.R.

    1990-01-01

    I-123 Iofetamine (IMP) single photon emission computed tomography (SPECT) imaging of the brain in 42 patients (ages 14 days to 23 years) was compared with other localizing studies in children with neurological diseases. All had an EEG and at least one imaging study of the brain (computed tomography (CT) or magnetic resonance imaging (MRI), or both). Seventy-eight percent of the patients had an EEG within 24-72 hours of the IMP-SPECT scan. Thirty-five (83%) had a history of seizures, and the remainder had other neurological conditions without a history of seizures. In most cases, a normal EEG reading with normal CT or MRI result predicted a normal SPECT study. When the EEG was abnormal the majority of the IMP-SPECT scans were abnormal and localized the abnormality to the same region. A comparison with CT and MRI showed that structural abnormalities involving the cortex were usually well demonstrated with IMP-SPECT imaging. Structural lesions confined to the white matter were generally not detectable with IMP-SPECT. In a few cases, SPECT scans revealed abnormalities in deep brain areas not identified by EEG. IMP-SPECT imaging is a valuable technique for the detection and localization of abnormal cerebral metabolic activity in children with seizure disorders. A correlation with CT or MRI is essential for proper interpretation of abnormalities detected with IMP SPECT imaging

  16. Cerebral perfusion abnormalities in therapy-resistant epilepsy in childhood: comparison between EEG, MRI and 99Tcm-ECD brain SPET.

    Science.gov (United States)

    Vattimo, A; Burroni, L; Bertelli, P; Volterrani, D; Vella, A

    1996-01-01

    We performed 99Tcm-ethyl cysteinate dimer (ECD) interictal single photon emission tomography (SPET) in 26 children with severe therapy-resistant epilepsy. All the children underwent a detailed clinical examination, an electroencephalogram (EEG) investigation and brain magnetic resonance imaging (MRI). In 21 of the 26 children, SPET demonstrated brain blood flow abnormalities, in 13 cases in the same territories that showed EEG alterations. MRI showed structural lesions in 6 of the 26 children, while SPET imaging confirmed these abnormalities in only 5 children. The lesion not detected on SPET was shown to be 3 mm thick on MRI. Five symptomatic patients had normal SPET. In one of these patients, the EEG findings were normal and MRI revealed a small calcific nodule (4 mm thick); in the others, the EEG showed non-focal but diffuse abnormalities. These data confirm that brain SPET is sensitive in detecting and localizing hypoperfused areas that could be associated with epileptic foci in this group of patients, even when the MRI image is normal.

  17. A Comparative Study of SPECT, q-EEG and CT in Patients with Mild, Acute Head Trauma

    International Nuclear Information System (INIS)

    Lee, Suk Ho; Kim, Jin Seok; Moon, Hee Seung

    1993-01-01

    Functional cerebral impairments have been verified objectively by brain SPECT and q-EEG (quantitative electroencephalography). Microcerebral circulatory defects without anatomical changes cannot be detected by the brain CT or MRI. Brain SPECT using 99m Tc-HMPAO (Hexamethyl propyleneamine oxime) as a key radioisotope may be accepted as the useful method for identifying functional cerebral impairments. We studied 25 patients with mild head trauma to define whether the SPECT was helpful in detecting cerebral impairment. The SPECT was positive in 23 patients out of 25, q-EEG positive in 16 patients and brain CT was positive in 3 cases. SPECT and q-EEG were more sensitive than CT. SPECT would be more useful method than brain CT to investigate cerebral function after head injury

  18. Contrasted study on the opening degree of blood-brain barriier after radiation therapy with SPECT and MRI

    International Nuclear Information System (INIS)

    Zhang Qing; Sun Aihua; Hu Yun; Zhang Li; Ye Hengguang

    2004-01-01

    The blood-brain barrier(BBB) is the largest barrier responsible for preventing direct contact between chemotherapeutic drugs in blood and tumors in brain, the permeability of BBB incease at different degree after brain irradiation in clinical brain tumors radiotherapy. Methods: In our study, 26 patients with metastatic brain tumors(21 cases in pr/mary lung carcinoma, 5 cases in breast carcinoma) were accepted the full brain irradiation. The detructive effects of radiation on the BBB were determined by the 99mTc-DTPA SPECT and the concentration ratio of methotrexate(MTX) in cerebrospinal fluid(CSF) and blood, the brain MRI before and after radiotherapy were retrospective contrasted study with SPECT. Results: the degree of destructive effect on the BBB was directly proportional to radiation doses. After a dose of 20Gy radiation to brain, the permeability of BBB inceased markedly(P<0.01). But in cases the dexamethasone(DXM) was administrated to decease the brain edema during radiotherapy, the permeability inceased less than that in patients without DXM(P<0.05). Conclutions: After 20Gy irradiation, the BBB would gradually open. At this time, chemotherapy is the best choice to improving the therapeutic effect. Dexamethasone was found to cause the decease in BBB permeability but no significant remission of brain edema. So, if the combination of radiotherapy and chemotherapy in treatment of metastatic brain tumors will be plan, the dexamethasone may be not used in expecting to deceasing the side effect and that no affecting the therapeutic effect. (authors)

  19. Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: a systematic review.

    Directory of Open Access Journals (Sweden)

    Cyrus A Raji

    Full Text Available PURPOSE: This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT in traumatic brain injury (TBI. METHODS: After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement, PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review. RESULTS: We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94% and temporal (77% lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value. CONCLUSIONS: This review demonstrates Level IIA evidence (at least one non-randomized controlled trial for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post

  20. Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: a systematic review.

    Science.gov (United States)

    Raji, Cyrus A; Tarzwell, Robert; Pavel, Dan; Schneider, Howard; Uszler, Michael; Thornton, John; van Lierop, Muriel; Cohen, Phil; Amen, Daniel G; Henderson, Theodore

    2014-01-01

    This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI). After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review. We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94%) and temporal (77%) lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value. This review demonstrates Level IIA evidence (at least one non-randomized controlled trial) for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post-injury neurological or psychiatric symptoms.

  1. Study of cerebrovascular diseases and SPECT with 99mTc HMPAO

    International Nuclear Information System (INIS)

    Collazo de la Maza, A.; Borron Molinos, M.; Barroso, E.

    1997-01-01

    Thirty eight patients with Cerebrovascular disease, that had suffered a Thrombotic brain infraction, demonstrated by Computed electroencephalogram or Brain Mapping (BM) and Computerized Tomography (CT) were investigated with '99' '9' 'm' Tc HM-PAO brain SPECT. Their ages ranged from 37 to 73 years old, 18 males and 20 female. Some of them were followed up with these diagnostic methods. The acquisition and processing of the SPECT studies were donw with a SOPHY DS7 Gamma Camera. The results showed that the global diagnostic sensibility of the SPECT was 79%. The sensibility of SPECT in the Acute stage was 75 %, CT 57% and BM 92%. In Steady stage we found a high positivity of SPECT with 83 %, Ct 66% and BM 66%. In the Recuperation Stage SPECT was 77%, CT 66% and 45%. Some phenomenon like the Luxury Perfusion and Diaschisis were studied and it is possible to found some prognostic relation

  2. High-resolution single photon planar and spect imaging of brain and neck employing a system of two co-registered opposed gamma imaging heads

    Science.gov (United States)

    Majewski, Stanislaw [Yorktown, VA; Proffitt, James [Newport News, VA

    2011-12-06

    A compact, mobile, dedicated SPECT brain imager that can be easily moved to the patient to provide in-situ imaging, especially when the patient cannot be moved to the Nuclear Medicine imaging center. As a result of the widespread availability of single photon labeled biomarkers, the SPECT brain imager can be used in many locations, including remote locations away from medical centers. The SPECT imager improves the detection of gamma emission from the patient's head and neck area with a large field of view. Two identical lightweight gamma imaging detector heads are mounted to a rotating gantry and precisely mechanically co-registered to each other at 180 degrees. A unique imaging algorithm combines the co-registered images from the detector heads and provides several SPECT tomographic reconstructions of the imaged object thereby improving the diagnostic quality especially in the case of imaging requiring higher spatial resolution and sensitivity at the same time.

  3. Role of brain SPECT in epilepsy exploration

    International Nuclear Information System (INIS)

    Biraben, A.; Bernard, AM.

    1996-01-01

    The management of epileptic patients is currently developing in relation with the introduction of video EEG and the opening of medical centers dedicated to epilepsy. The role of SPECT is now well established to assess the temporal and spatial dynamic phenomena during seizures. Ictal SPECT has technical and organisational requirements but is a very sensitive method, which appears to be superior to other available imaging techniques. (author)

  4. Brain SPECT by intraarterial infusion of 99mTc-HMPAO for assessing the cerebral distribution of carotid artery infusions in patient with brain tumor

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Kusano, Shoichi; Aoki, Shigeki

    1993-01-01

    In order to assess the cerebral distribution of intracarotid chemotherapy, 17 postoperative patients with brain tumor underwent brain SPECT obtrained by intraarterial infusion of 18.5 MBq of 99m Tc-d,l,-hexamethylpropyleneamine oxime ( 99m Tc-HMPAO). Injection methods were continuous (5.0 ml/min) or pulsatile infusion with supra- or infraophthalmic catheterization. The findings obtained by brain SPECT were frequently different from those of angiography and/or DSA. In supraophthalmic catheterization with continuous infusion, only 2 of 10 studies (20%) had homogeneous distribution and 5 of them (50%) had maldistribution of 99m Tc-HMPAO which appears in association with laminar flow effect. The remaining 3 studies showed localized distribution (two: tumor localization, one: healthy brain localization). On the other hand, all of 5 studies with pulsatile infusion had homogeneous distribution of 99m Tc-HMPAO. In infraophthalmic catheterization, all but one of 5 studies had homogeneous distribution with continuous infusion. These results suggest that pulsatile infusion may be effective in eliminating maldistribution of 99m Tc-HMPAO in supraophthalmic catheterization. In conclusion, we are convinced that 99m Tc-HMPAO is a useful intraarterial agent for assessing cerebral distribution of intracarotid chemotherpay. (author)

  5. PET and SPECT in neurology

    Energy Technology Data Exchange (ETDEWEB)

    Dierckx, Rudi A.J.O. [Groningen University Medical Center (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Ghent Univ. (Belgium). Dept. of Radiology and Nuclear Medicine; Vries, Erik F.J. de; Waarde, Aren van [Groningen University Medical Center (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Otte, Andreas (ed.) [Univ. of Applied Sciences Offenburg (Germany). Faculty of Electrical Engineering and Information Technology

    2014-07-01

    PET and SPECT in Neurology highlights the combined expertise of renowned authors whose dedication to the investigation of neurological disorders through nuclear medicine technology has achieved international recognition. Classical neurodegenerative disorders are discussed as well as cerebrovascular disorders, brain tumors, epilepsy, head trauma, coma, sleeping disorders, and inflammatory and infectious diseases of the CNS. The latest results in nuclear brain imaging are detailed. Most chapters are written jointly by a clinical neurologist and a nuclear medicine specialist to ensure a multidisciplinary approach. This state-of-the-art compendium will be valuable to anybody in the field of neuroscience, from the neurologist and the radiologist/nuclear medicine specialist to the interested general practitioner and geriatrician. It is the second volume of a trilogy on PET and SPECT imaging in the neurosciences, the other volumes covering PET and SPECT in psychiatry and in neurobiological systems.

  6. PET and SPECT in neurology

    International Nuclear Information System (INIS)

    Dierckx, Rudi A.J.O.; Ghent Univ.; Vries, Erik F.J. de; Waarde, Aren van; Otte, Andreas

    2014-01-01

    PET and SPECT in Neurology highlights the combined expertise of renowned authors whose dedication to the investigation of neurological disorders through nuclear medicine technology has achieved international recognition. Classical neurodegenerative disorders are discussed as well as cerebrovascular disorders, brain tumors, epilepsy, head trauma, coma, sleeping disorders, and inflammatory and infectious diseases of the CNS. The latest results in nuclear brain imaging are detailed. Most chapters are written jointly by a clinical neurologist and a nuclear medicine specialist to ensure a multidisciplinary approach. This state-of-the-art compendium will be valuable to anybody in the field of neuroscience, from the neurologist and the radiologist/nuclear medicine specialist to the interested general practitioner and geriatrician. It is the second volume of a trilogy on PET and SPECT imaging in the neurosciences, the other volumes covering PET and SPECT in psychiatry and in neurobiological systems.

  7. Reproducibility Between Brain Uptake Ratio Using Anatomic Standardization and Patlak-Plot Methods.

    Science.gov (United States)

    Shibutani, Takayuki; Onoguchi, Masahisa; Noguchi, Atsushi; Yamada, Tomoki; Tsuchihashi, Hiroko; Nakajima, Tadashi; Kinuya, Seigo

    2015-12-01

    The Patlak-plot and conventional methods of determining brain uptake ratio (BUR) have some problems with reproducibility. We formulated a method of determining BUR using anatomic standardization (BUR-AS) in a statistical parametric mapping algorithm to improve reproducibility. The objective of this study was to demonstrate the inter- and intraoperator reproducibility of mean cerebral blood flow as determined using BUR-AS in comparison to the conventional-BUR (BUR-C) and Patlak-plot methods. The images of 30 patients who underwent brain perfusion SPECT were retrospectively used in this study. The images were reconstructed using ordered-subset expectation maximization and processed using an automatic quantitative analysis for cerebral blood flow of ECD tool. The mean SPECT count was calculated from axial basal ganglia slices of the normal side (slices 31-40) drawn using a 3-dimensional stereotactic region-of-interest template after anatomic standardization. The mean cerebral blood flow was calculated from the mean SPECT count. Reproducibility was evaluated using coefficient of variation and Bland-Altman plotting. For both inter- and intraoperator reproducibility, the BUR-AS method had the lowest coefficient of variation and smallest error range about the Bland-Altman plot. Mean CBF obtained using the BUR-AS method had the highest reproducibility. Compared with the Patlak-plot and BUR-C methods, the BUR-AS method provides greater inter- and intraoperator reproducibility of cerebral blood flow measurement. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  8. Clinical value of scatter correction for interictal brain 99m Tc-HMPAO SPECT in mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Sanchez Catasus, C.; Morales, L.; Aguila, A.

    2002-01-01

    Aim: It is well known that some patients with temporal lobe epilepsy (TLE) show normal perfusion during interictal SPECT study. The aim of this research was to evaluate if the scatter radiation has some influence on this kind of result. Materials and Methods: We studied 15 patients with TLE by clinical diagnosis and by video-EEG monitoring with surface electrodes (11 left TLE, 4 right TLE), which showed normal perfusion during interictal brain 99m Tc-HMPAO SPECT. The SPECT data were reconstructed by filtered backprojection without scatter correction (A). The same SPECT data were reconstructed after the projections were corrected by dual energy window method of scatter correction (B). Attenuation was corrected in all cases using first order Chang Method. For A and B images groups, cerebellum perfusion ratios were calculated on irregular regions of interest (ROI) drawn on anterior (ATL), lateral (LTL), mesial (MTL) and whole temporal lobe (WTL). To evaluate the influence of scatter radiation, the cerebellum perfusion ratios of each subject were compared with a normal database of 10 normal subjects, with and without scatter correction, using z-score analysis. Results: In group A, the z-score was less than 2 in all cases. In group B, the z-score was more than 2 in 6 cases, 4 in MTL (3 left, 1 right) and 2 in left LTL, which were coincident with the EEG localization. All images of group B showed better contrast than images of group A. Conclusions: These results suggest that scatter correction could improve the sensitivity of interictal brain SPECT to identify epileptic focus in patients with TLE

  9. Clinical experience with Tc-99m HM-PAO high resolution SPECT of the brain in patients with cerebrovascular accidents

    International Nuclear Information System (INIS)

    Roo, M. de; Mortelmans, L.; Devos, P.; Verbruggen, A.; Wilms, G.; Carton, H.; Wils, V.; Bergh, R. van den

    1989-01-01

    In order to evaluate the diagnostic contribution of brain SPECT imaging with 99m Tc-HMPAO in cerebrovascular disease, we examined 92 stroke cases (144 lesions), 2 hematoma cases and 30 cases with transient neurologic symptoms. Abnormal tracer distribution is visible as zones of either hypoactivity or hyperactivity (border zone hyperemia or luxury perfusion). Remote vascularization changes could also be found (crossed cerebellar diaschisis or ipsilateral cortical perfusion reduction in thalamic or capsula interna lesions). Both X-ray CT and blood flow SPECT have comparable sensitivity in the exploaration of cerebral infarction, with detection in, respectively, 89,5% and 87,5% of the lesions. False negative scintitomographic images are frequently recorded in small lacunar infarcts within the basal ganglia and white matter (capsula interna). Some early infarcts and asymmetry of brain perfusion in patients with transient neurologic symptoms are frequently not detected by CT. An additional advantage of blood flow SPECT is its ability to visualize remote blood flow changes and the changing pattern of vascularization of ischemic lesions and their surrounding areas including hyperemia. (orig.)

  10. Clinical experience with Tc-99m HM-PAO high resolution SPECT of the brain in patients with cerebrovascular accidents

    Energy Technology Data Exchange (ETDEWEB)

    Roo, M. de; Mortelmans, L.; Devos, P.; Verbruggen, A.; Wilms, G.; Carton, H.; Wils, V.; Bergh, R. van den

    1989-01-01

    In order to evaluate the diagnostic contribution of brain SPECT imaging with /sup 99m/Tc-HMPAO in cerebrovascular disease, we examined 92 stroke cases (144 lesions), 2 hematoma cases and 30 cases with transient neurologic symptoms. Abnormal tracer distribution is visible as zones of either hypoactivity or hyperactivity (border zone hyperemia or luxury perfusion). Remote vascularization changes could also be found (crossed cerebellar diaschisis or ipsilateral cortical perfusion reduction in thalamic or capsula interna lesions). Both X-ray CT and blood flow SPECT have comparable sensitivity in the exploaration of cerebral infarction, with detection in, respectively, 89,5% and 87,5% of the lesions. False negative scintitomographic images are frequently recorded in small lacunar infarcts within the basal ganglia and white matter (capsula interna). Some early infarcts and asymmetry of brain perfusion in patients with transient neurologic symptoms are frequently not detected by CT. An additional advantage of blood flow SPECT is its ability to visualize remote blood flow changes and the changing pattern of vascularization of ischemic lesions and their surrounding areas including hyperemia.

  11. Compensation for nonuniform attenuation in SPECT brain imaging

    International Nuclear Information System (INIS)

    Glick, S.J.; King, M.A.; Pan, T.S.; Soares, E.J.

    1996-01-01

    Accurate compensation for photon attenuation is needed to perform quantitative brain single-photon-emission computed tomographic (SPECT) imaging. Bellini's attenuation-compensation method has been used with a nonuniform attenuation map to account for the nonuniform attenuation properties of the head. Simulation studies using a three-dimensional (3-D) digitized anthropomorphic brain phantom were conducted to compare quantitative accuracy of reconstructions obtained with the nonuniform Bellini method to that obtained with the Chang method and to iterative reconstruction using maximum-likelihood expectation maximization (ML-EM). Using the Chang method and assuming the head to be a uniform attenuator gave reconstructions with an average bias of approximately 6-8%, whereas using the Bellini or the iterative ML-EM method with a nonuniform attenuation map gave an average bias of approximately 1%. The computation time required to implement nonuniform attenuation compensation with the Bellini algorithm is approximately equivalent to the time required to perform one iteration of ML-EM. Thus, using the Bellini method with a nonuniform attenuation map provides accurate compensation for photon attenuation within the head, and the method can be implemented in computation times suitable for routine clinical use

  12. SPECT in patients with cortical visual loss.

    Science.gov (United States)

    Silverman, I E; Galetta, S L; Gray, L G; Moster, M; Atlas, S W; Maurer, A H; Alavi, A

    1993-09-01

    Single-photon emission computed tomography (SPECT) with 99mTc-hexamethylpropyleneamine oxime (HMPAO) was used to investigate changes in cerebral blood flow in seven patients with cortical visual impairment. Traumatic brain injury (TBI) was the cause of cortical damage in two patients, cerebral ischemia in two patients and carbon monoxide (CO) poisoning, status epilepticus and Alzheimer's Disease (AD) each in three separate patients. The SPECT scans of the seven patients were compared to T2-weighted magnetic resonance image (MRI) scans of the brain to determine the correlation between functional and anatomical findings. In six of the seven patients, the qualitative interpretation of the SPECT studies supported the clinical findings (i.e., the visual field defect) by revealing altered regional cerebral blood flow (rCBF) in the appropriate regions of the visual pathway. MR scans in all of the patients, on the other hand, were either normal or disclosed smaller lesions than those detected by SPECT. We conclude that SPECT may reveal altered rCBF in patients with cortical visual impairment of various etiologies, even when MRI studies are normal or nondiagnostic.

  13. A new method for brain functional study using Tc-99m HMPAO SPECT

    International Nuclear Information System (INIS)

    Momose, Toshimitsu; Kosaka, Noboru; Nishikawa, Junichi; Ohtake, Tohru; Watanabe, Toshiaki; Iio, Masahiro

    1989-01-01

    The distribution of 99m Tc-HMPAO in brain is in proportion to regional cerebral blood flow (rCBF) and can be interpreted as functional mapping. To evaluate local changes in CBF during neuropsychological testing, we developed a new subtraction method using HMPAO and SPECT. With patients resting, 15 mCi of HMPAO was injected and the first acquisition was performed, lasting a total of 10 minutes. Soon after the end of the first scan, patients were requested to undergo Buschke's memory test or to repeat words or numbers (repetition test). During the task, an additional 15 mCi of HMPAO was injected using the same position as in the first scan, and a second acquisition was started. A functional image was made by subtracting the image in the first scan from that in the second. In two patients with transient global amnesia and two normal controls, Buschke's memory test was performed in combination with SPECT. A relative increase in activity was seen in the thalamus, subthalamic area, hippocampus, and some cortial areas, apparently reflecting local functional change induced by the memory task. In two patients with moderate Alzheimer's disease with severe memory loss, no increase was detected in these areas. In one patient with aphasia, the repetition test with SPECT was correlated with the WADA test and dichotic listening test, and good agreement was obtained. In conclusion, our new SPECT technique is useful in detecting alterations in rCBF during mental activity and can be applied to neurophysiological studies. (author)

  14. A new method for brain functional study using Tc-99m HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Toshimitsu; Kosaka, Noboru; Nishikawa, Junichi; Ohtake, Tohru; Watanabe, Toshiaki; Iio, Masahiro (Tokyo Univ. (Japan). Faculty of Medicine)

    1989-04-01

    The distribution of {sup 99m}Tc-HMPAO in brain is in proportion to regional cerebral blood flow (rCBF) and can be interpreted as functional mapping. To evaluate local changes in CBF during neuropsychological testing, we developed a new subtraction method using HMPAO and SPECT. With patients resting, 15 mCi of HMPAO was injected and the first acquisition was performed, lasting a total of 10 minutes. Soon after the end of the first scan, patients were requested to undergo Buschke's memory test or to repeat words or numbers (repetition test). During the task, an additional 15 mCi of HMPAO was injected using the same position as in the first scan, and a second acquisition was started. A functional image was made by subtracting the image in the first scan from that in the second. In two patients with transient global amnesia and two normal controls, Buschke's memory test was performed in combination with SPECT. A relative increase in activity was seen in the thalamus, subthalamic area, hippocampus, and some cortial areas, apparently reflecting local functional change induced by the memory task. In two patients with moderate Alzheimer's disease with severe memory loss, no increase was detected in these areas. In one patient with aphasia, the repetition test with SPECT was correlated with the WADA test and dichotic listening test, and good agreement was obtained. In conclusion, our new SPECT technique is useful in detecting alterations in rCBF during mental activity and can be applied to neurophysiological studies. (author).

  15. A survey of head movement during clinical brain SPECT using an optical tracking system

    International Nuclear Information System (INIS)

    Pandos, G.; Barnden, L.; Lineage, H.; Smith, T.; Unger, S.

    2002-01-01

    Full text: The aim of this study was to survey patient motion during clinical brain SPECT using a commercial motion detection system called Polaris. Polaris is an optical tracker that remotely tracks head position and orientation via a small target attached to the patient. Its accuracy for position measurement is 1mm or 1 degree (deg), 33% moved > 2mm or 2deg and 10% moved > 4mm or 4deg. 65% of subjects moved 3 or more times. Motion in the D and P groups was equally likely to be small (<3mm or <3deg) or large and equally likely to occur early or late during acquisition. Motion in the N, F and C groups was less likely to be large and for N and F more likely to occur late in the acquisition suggesting fatigue was the main cause. The most common large movements were anterior-posterior translations and axial (Z) rotations. Significant head movement is common in brain SPECT, particularly in dementia and psychiatric subjects, and accurate motion correction is desirable to maintain image quality. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  16. Imaging cerebral activity in recovery from chronic traumatic brain injury: a preliminary report.

    Science.gov (United States)

    Lewis, David H; Bluestone, Judith P; Savina, Maryann; Zoller, William H; Meshberg, Emily B; Minoshima, Satoshi

    2006-07-01

    People in chronic phase of traumatic brain injury (TBI) are often told that there will be no further recovery in brain function, that they are in a "static phase." Holistic Approach to NeuroDevelopment and Learning Efficiency (HANDLE), an alternative therapy, aims to improve function by teaching a series of physical and mental activities that clients perform and encouraging changes in lifestyle. Five subjects (3 males) with chronic TBI (at least 3 years since ictus) completed the HANDLE Institute's program and were prospectively evaluated. Each had six regional cerebral blood flow (rCBF) single-photon emission computed tomography (SPECT) scans over 7 months (scans n= 30). Paired scans were performed with injection of Tc-99m ECD to image rCBF at rest and during the HANDLE "Crossed Arm Bounce" (CAB) exercise before the program, at 3-4 months into the program, and at 6-7 months, after the program had ended. SPECT images were analyzed statistically using Neurostat in which image sets were coregistered and warped into Talaraich atlas for pairwise subtraction between conditions. Group analysis of SPECT showed that CAB activated (increased rCBF) vermis and cerebellar hemispheres in first two paired scans and anterior cingulate and vermis on the final pair. Increased rCBF at rest occurred in cerebellar hemispheres, vermis, and right dorsomedial frontal cortex. These preliminary observations suggest that there may be a role of the hindbrain (vermis and cerebellum) with HANDLE treatment of chronic TBI.

  17. Neuropsychological functions and rCBF SPECT in Parkinson's disease patients considered candidates for deep brain stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Paschali, Anna; Lakiotis, Velissarios; Vassilakos, Paulos [University of Patras Medical School, Department of Nuclear Medicine, Patras (Greece); Messinis, Lambros; Lyros, Epameinondas; Papathanasopoulos, Panagiotis [University of Patras Medical School, Department of Neurology, Neuropsychology Section, Patras (Greece); Constantoyannis, Costas; Kefalopoulou, Zinovia [University of Patras Medical School, Department of Neurosurgery, Patras (Greece)

    2009-11-15

    In the present study, we examined relationships between neuropsychological functions and brain single photon emission computed tomography (SPECT) regional cerebral blood flow (rCBF) observed at presurgical evaluation for deep brain stimulation (DBS) of the subthalamic nucleus (STN) in advanced Parkinson's disease (PD) patients. Twenty advanced non-demented PD patients, candidates for DBS surgery, underwent perfusion brain SPECT study and neuropsychological assessment prior to surgery (range: 30-50 days). Patients were further assessed using the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr (H and Y) scale. During all assessments patients were ''on'' standard medication. NeuroGam software, which permits voxel by voxel analysis, was used to compare the brain perfusion of PD patients with a normal database adjusted for sex and age. Neuropsychological scores were compared to age, education and sex-adjusted normative databases. Our results indicated that the distribution of rCBF showed significant differences when compared to an age- and sex-adjusted normative database. We found impaired blood flow in 17 (85%) of our patients in the left prefrontal lobe, in 14 (70%) in the right prefrontal lobe and in 11 (55%) in the left frontal and right parietal lobes. Neuropsychological testing revealed that 18 (90%) of our patients had significant impairments in measures of executive functions (set-shifting) and 15 (75%) in response inhibition. Furthermore, we found significant correlations between measures of visual attention, executive functions and the right frontal lobe region. The presence of widespread blood flow reduction was observed mainly in the frontal lobes of dementia-free patients with advanced PD. Furthermore, performance on specific cognitive measures was highly related to perfusion brain SPECT findings. (orig.)

  18. Cerebrovascular disease in newborn infants: report of three cases with clinical follow-up and brain SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Moura-Ribeiro, Maria Valeriana L. de; Ciasca, Sylvia Maria; Vale-Cavalcanti, Mariza; Etchebehere, Elba C.S.C.; Camargo, Edwaldo E. [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas

    1999-07-01

    The clinical and neurological findings of three neonates with the diagnosis of cerebrovascular disease are reported. The neuropsychological evaluation disclosed impairment of fine motor function, coordination, language, perception and behavioral disturbances. Brain SPECT imaging revealed perfusional deficits in the three cases. (author)

  19. Cerebrovascular disease in newborn infants: report of three cases with clinical follow-up and brain SPECT imaging

    International Nuclear Information System (INIS)

    Moura-Ribeiro, Maria Valeriana L. de; Ciasca, Sylvia Maria; Vale-Cavalcanti, Mariza; Etchebehere, Elba C.S.C.; Camargo, Edwaldo E.

    1999-01-01

    The clinical and neurological findings of three neonates with the diagnosis of cerebrovascular disease are reported. The neuropsychological evaluation disclosed impairment of fine motor function, coordination, language, perception and behavioral disturbances. Brain SPECT imaging revealed perfusional deficits in the three cases. (author)

  20. Brain SPECT in mesial temporal lobe epilepsy: comparison between visual analysis and SPM (Statistical Parametric Mapping)

    Energy Technology Data Exchange (ETDEWEB)

    Amorim, Barbara Juarez; Ramos, Celso Dario; Santos, Allan Oliveira dos; Lima, Mariana da Cunha Lopes de; Camargo, Edwaldo Eduardo; Etchebehere, Elba Cristina Sa de Camargo, E-mail: juarezbarbara@hotmail.co [State University of Campinas (UNICAMP), SP (Brazil). School of Medical Sciences. Dept. of Radiology; Min, Li Li; Cendes, Fernando [State University of Campinas (UNICAMP), SP (Brazil). School of Medical Sciences. Dept. of Neurology

    2010-04-15

    Objective: to compare the accuracy of SPM and visual analysis of brain SPECT in patients with mesial temporal lobe epilepsy (MTLE). Method: interictal and ictal SPECTs of 22 patients with MTLE were performed. Visual analysis were performed in interictal (VISUAL(inter)) and ictal (VISUAL(ictal/inter)) studies. SPM analysis consisted of comparing interictal (SPM(inter)) and ictal SPECTs (SPM(ictal)) of each patient to control group and by comparing perfusion of temporal lobes in ictal and interictal studies among themselves (SPM(ictal/inter)). Results: for detection of the epileptogenic focus, the sensitivities were as follows: VISUAL(inter)=68%; VISUAL(ictal/inter)=100%; SPM(inter)=45%; SPM(ictal)=64% and SPM(ictal/inter)=77%. SPM was able to detect more areas of hyperperfusion and hypoperfusion. Conclusion: SPM did not improve the sensitivity to detect epileptogenic focus. However, SPM detected different regions of hypoperfusion and hyperperfusion and is therefore a helpful tool for better understand pathophysiology of seizures in MTLE. (author)

  1. Brain SPECT in mesial temporal lobe epilepsy: comparison between visual analysis and SPM (Statistical Parametric Mapping)

    International Nuclear Information System (INIS)

    Amorim, Barbara Juarez; Ramos, Celso Dario; Santos, Allan Oliveira dos; Lima, Mariana da Cunha Lopes de; Camargo, Edwaldo Eduardo; Etchebehere, Elba Cristina Sa de Camargo; Min, Li Li; Cendes, Fernando

    2010-01-01

    Objective: to compare the accuracy of SPM and visual analysis of brain SPECT in patients with mesial temporal lobe epilepsy (MTLE). Method: interictal and ictal SPECTs of 22 patients with MTLE were performed. Visual analysis were performed in interictal (VISUAL(inter)) and ictal (VISUAL(ictal/inter)) studies. SPM analysis consisted of comparing interictal (SPM(inter)) and ictal SPECTs (SPM(ictal)) of each patient to control group and by comparing perfusion of temporal lobes in ictal and interictal studies among themselves (SPM(ictal/inter)). Results: for detection of the epileptogenic focus, the sensitivities were as follows: VISUAL(inter)=68%; VISUAL(ictal/inter)=100%; SPM(inter)=45%; SPM(ictal)=64% and SPM(ictal/inter)=77%. SPM was able to detect more areas of hyperperfusion and hypoperfusion. Conclusion: SPM did not improve the sensitivity to detect epileptogenic focus. However, SPM detected different regions of hypoperfusion and hyperperfusion and is therefore a helpful tool for better understand pathophysiology of seizures in MTLE. (author)

  2. Brain SPECT analysis by 3D-SSP and clinical features of Parkinson's disease

    International Nuclear Information System (INIS)

    Mito, Yasunori; Yoshida, Kazuto; Makino, Kenichi; Yabe, Ichiro; Kikuchi, Seiji; Sasaki, Hidenao; Tashiro, Kunio

    2006-01-01

    The aim of the present study is to investigate the association of symptoms in Parkinson's disease (PD) with cerebral perfusion on single photon emission computed tomography (SPECT). The clinical features of PD were compared with SPECT images of the brain obtained by three-dimensional stereotactic surface projection (3D-SSP) analysis. Thirty-eight patients who had PD without dementia (17 men and 21 women with a mean age of 68.6±4.7 years) were enrolled in this study. Their symptoms were rated using the unified parkinson's disease rating scale (UPDRS). Within a week, all patients were examined by SPECT with I-123, and reconstructed images were analyzed with 3D-SSP using an image-analysis software, iSSP ver. 3.5. Data on brain surface perfusion extracted by 3D-SSP analysis were compared between the PD patients and the normal control group. The same comparisons were made for subgroups of PD patients with severe symptoms, such as tremor, gait disturbance, bradykinesia, and the UPDRS motor score. Cerebral perfusion was decreased at the anterior cingulate cortex and occipital lobe of the PD patients compared with the normal controls. In the subgroups with severe gait disturbance and severe bradykinesia, additional hypoperfusion was seen at the lateral frontal association and lateral temporal association and the medial frontal gyrus, and by the pixel-by-pixel comparison, perfusion was significantly decreased (p<0.05) at the medial frontal gyrus and anterior cingulate cortex compared with the normal control group. In PD patients, severe gait disturbance and bradykinesia may be correlated with hypoperfusion of the medial aspect of the frontal lobe. This suggests that functional disturbance of the supplementary motor area and other parts of the frontal lobe are involved in the development of gait disturbance and bradykinesia in PD. (author)

  3. 201Tl/99mTc-MIBI SPECT to evaluate therapy effect of BNCT with BSH and BPA for malignant brain tumor

    International Nuclear Information System (INIS)

    Shibata, Yasushi; Katayama, Wataru; Yamamoto, Tetsuya; Nakai, Kei; Endo, Kiyoshi; Matsuda, Masahide; Matsushita, Akira; Matsumura, Akira

    2006-01-01

    201 Tl/ 99m Tc-MIBI SPECT are imaging modalities to evaluate the malignancy and viability of brain tumor. We reviewed these SPECT findings before and after BNCT, and evaluated the usefulness of SPECT. The study includes total 11 patients admitted in our hospital between 1999 and 2005, 8 with glioblastoma, 2 with anaplastic astrocytoma and 2 with anaplastic oligodendroglioma. SPECT was taken with multidetector SPECT at 15 minutes and 3 hours after intravenous injection of Tl 74 MBq or MIBI 740 MBq. Region of interests were set on tumor and contralateral white matter and radioactivity ratios were calculated as Tl, MIBI indexes. For patients with no residual tumor in MRI, Tl/MIBI indexes were low. For patients with large residual tumor the indexes were high. For the patients with recurrent tumor the indexes were very high. Tl/MIBI indexes before BNCT correlated with survival and progression-free period after BNCT. SPECT indexes decreased after BNCT. For 8 patients with recurrent tumor, the indexes increased. Tl and MIBI SPECT are valuable to evaluate malignancy, viability, survival and recurrence of malignant glioma in BNCT. (author)

  4. Effect of cyclosporin A administration on the biodistribution and multipinhole {mu}SPECT imaging of [{sup 123}I]R91150 in rodent brain

    Energy Technology Data Exchange (ETDEWEB)

    Blanckaert, P.; Burvenich, I.; Bruyne, S. de; Moerman, L.; Wyffels, L.; Vos, F. de [Faculty of Pharmaceutical Sciences, Ghent University, Laboratory for Radiopharmacy, Gent (Belgium); Staelens, S. [Ghent University - IBBT, MEDISIP, Faculty of Engineering, Gent (Belgium)

    2009-03-15

    P-glycoprotein (Pgp) is an efflux protein found amongst other locations in the blood-brain barrier. It is important to investigate the effect of Pgp modulation on clinically used brain tracers, because brain uptake of the tracer can be altered by blocking of the Pgp efflux transporter. The function of Pgp can be blocked with cyclosporin A. We investigated the effect of cyclosporin A administration on the biodistribution of [{sup 123}I]R91150 in rodents, and the effect of Pgp blocking on the quality of multipinhole {mu}SPECT imaging with [{sup 123}I]R91150. The influence of increasing doses of cyclosporin A on the brain uptake of [{sup 123}I]R91150 was investigated in NMRI mice. A biodistribution study with [{sup 123}I]R91150 was performed in male Sprague-Dawley rats pretreated with cyclosporin A and not pretreated. Brain uptake of [{sup 123}I]R91150 after cyclosporin A injection was compared to the brain uptake in untreated animals, and a displacement study with ketanserin was performed in both groups. A multipinhole {mu}SPECT brain imaging study was also performed using a Milabs U-SPECT-II camera in male Sprague-Dawley rats. To exclude the effect of possible metabolites, a metabolite study was also performed. At the highest cyclosporin A dose (50 mg/kg), a sevenfold increase in brain radioactivity concentration was observed in NMRI mice. Also, a dose-response relationship was established between the dose of cyclosporin A and the brain uptake of [{sup 123}I]R91150 in mice. Compared to the control group, a five-fold increase in [{sup 123}I]R91150 radioactivity concentration was observed in the brain of Sprague-Dawley rats after cyclosporin A treatment (50 mg/kg). Radioactivity concentration in the frontal cortex increased from 0.24{+-}0.0092 to 1.58{+-}0.097% injected dose per gram of tissue after treatment with cyclosporin A (at the 1-h time-point). Blood radioactivity concentrations did not increase to the same extent. The cortical activity was displaced by

  5. A Novel Interaction of Ecdysoneless (ECD) Protein with R2TP Complex Component RUVBL1 Is Required for the Functional Role of ECD in Cell Cycle Progression.

    Science.gov (United States)

    Mir, Riyaz A; Bele, Aditya; Mirza, Sameer; Srivastava, Shashank; Olou, Appolinaire A; Ammons, Shalis A; Kim, Jun Hyun; Gurumurthy, Channabasavaiah B; Qiu, Fang; Band, Hamid; Band, Vimla

    2015-12-28

    Ecdysoneless (ECD) is an evolutionarily conserved protein whose germ line deletion is embryonic lethal. Deletion of Ecd in cells causes cell cycle arrest, which is rescued by exogenous ECD, demonstrating a requirement of ECD for normal mammalian cell cycle progression. However, the exact mechanism by which ECD regulates cell cycle is unknown. Here, we demonstrate that ECD protein levels and subcellular localization are invariant during cell cycle progression, suggesting a potential role of posttranslational modifications or protein-protein interactions. Since phosphorylated ECD was recently shown to interact with the PIH1D1 adaptor component of the R2TP cochaperone complex, we examined the requirement of ECD phosphorylation in cell cycle progression. Notably, phosphorylation-deficient ECD mutants that failed to bind to PIH1D1 in vitro fully retained the ability to interact with the R2TP complex and yet exhibited a reduced ability to rescue Ecd-deficient cells from cell cycle arrest. Biochemical analyses demonstrated an additional phosphorylation-independent interaction of ECD with the RUVBL1 component of the R2TP complex, and this interaction is essential for ECD's cell cycle progression function. These studies demonstrate that interaction of ECD with RUVBL1, and its CK2-mediated phosphorylation, independent of its interaction with PIH1D1, are important for its cell cycle regulatory function. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  6. Scintigraphic evaluation of brain death

    International Nuclear Information System (INIS)

    Park, C. H.; Bai, M. S.; Cho, K. K.; Kim, S. J.; Yoon, S. N.; Cho, C. W.

    1997-01-01

    A law recognizing brain death is a life saving legal measure in patients suffering from badly diseased organs such as kidney, liver, heart, and lung. Such law is being discussed for legalization at the Korean National Assembly. There are various criteria used for brain death in western world and brain scintiscan is one of them. However, the scintiscan is not considered in establishing brain death in the draft of the law. The purpose of this report is to spread this technique in nuclear medicine society as well as in other medical societies. We evaluated 7 patients with clinical suspicion of brain death by various causes. The patient's age ranged from 5 to 39 years. We used 5-20mCi 99m Tc-HMPAO (d.1-hexamethyl propylene amine oxime) or ECD (Ethyl Cysteinate Dimer), lipophilic agents that cross BBB (blood brain barrier). A dynamic study followed by static or SPECT (single photon emission tomography) was performed. Interpretive criteria used for brain death were 1) no intracranial circulation 2) no brain uptake. The second criteria is heavily used. Five of 7 patients were scintigraphically brain dead and the remaining 2 had some brain uptake excluding the diagnosis of scintigraphic brain death. In conclusion, cerebral perfusion study using a lipophilic brain tracer offers a noninvasive, rapid, easy, accurate and reliable mean in the diagnosis of brain death. We believe that this modality should be included in the criteria of brain death in the draft of the proposed Korean law

  7. Evaluation and investigation of regional cerebral blood flow by 1 point arterial blood collection method using 99mTc-ECD. Intravenous injection for 4 minutes with constant speed

    International Nuclear Information System (INIS)

    Itoh, Takeo; Shibata, Kazuhiro; Sudoh, Hideaki; Tanaka, Masato; Itoh, Kenjiro; Ueno, Yasushi

    1998-01-01

    Regional cerebral blood flow (rCBF) was measured using a 99m Tc-ECD through the 4-min constant intravenous infusion/one point arterial blood sampling method, proposed by Nakagawara et al. of Nakamura Memorial Hospital, and 133Xenon ( 133 Xe)-SPECT was performed on the same subjects to investigate the reproducibility of this method. We also determined whether cerebral blood flow (CBF) could be measured on the day of blood sampling through dilution of the obtained blood because it was difficult to measure the radioactivity in the blood on the day of blood sampling by this method. More, we investigated fixation of an octanol extraction rate and the substitution of venous blood for arterial blood in this method. The results revealed that CBF measured by this method with a 99m Tc-ECD were closely correlated to those measured by 133 Xe-SPECT, indicating the reliability as a method of measuring CBF. rCBF could be measured on the day of blood sampling through appropriate dilution of the obtained arterial blood. Octanol extraction rates were almost constant, indicating possible omission of cumbersome extraction procedure by fixation. However, the substitution of venous blood for arterial blood showed no correlation under the study system examined. (author)

  8. SP-ECT imaging and its physical study

    International Nuclear Information System (INIS)

    Kinoshita, Fujimi

    1983-01-01

    Recently, more than a hundred hospitals are provided with SPECT system for clinical examination in Japan. However, a standardization of measuring method and performance test of the systems is ont yet made. We have been studying some basic problems of SPECT system with special phantoms originaly designed by ourselves. We got a conclusion that a standardized phantom is necessary for comparing performances between SPECT systems. In clinical experiences with 3,332 cases, we think that SPECT image combined with conventional image presents much more informations for accurate diagnosis, especially in brain, bone and tumor imagings. Synthesized image of SPECT and XCT, double tracer image and transmission image are useful to visualize the body contour and the clinical diagnosis. (author)

  9. Clinical Comparison of 99mTc Exametazime and 123I Ioflupane SPECT in Patients with Chronic Mild Traumatic Brain Injury

    OpenAIRE

    Newberg, Andrew B.; Serruya, Mijail; Gepty, Andrew; Intenzo, Charles; Lewis, Todd; Amen, Daniel; Russell, David S.; Wintering, Nancy

    2014-01-01

    BACKGROUND: This study evaluated the clinical interpretations of single photon emission computed tomography (SPECT) using a cerebral blood flow and a dopamine transporter tracer in patients with chronic mild traumatic brain injury (TBI). The goal was to determine how these two different scan might be used and compared to each other in this patient population. METHODS AND FINDINGS: Twenty-five patients with persistent symptoms after a mild TBI underwent SPECT with both (99m)Tc exametazime to m...

  10. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping.

    Science.gov (United States)

    McGoron, Anthony J; Capille, Michael; Georgiou, Michael F; Sanchez, Pablo; Solano, Juan; Gonzalez-Brito, Manuel; Kuluz, John W

    2008-02-29

    Assessment of cerebral blood flow (CBF) by SPECT could be important in the management of patients with severe traumatic brain injury (TBI) because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia), or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. The focal effects of moderate traumatic brain injury (TBI) on cerebral blood flow (CBF) by SPECT cerebral blood perfusion (CBP) imaging in an animal model were investigated by parallelized statistical techniques. Regional CBF was measured by radioactive microspheres and by SPECT 2 hours after injury in sham-operated piglets versus those receiving severe TBI by fluid-percussion injury to the left parietal lobe. Qualitative SPECT CBP accuracy was assessed against reference radioactive microsphere regional CBF measurements by map reconstruction, registration and smoothing. Cerebral hypoperfusion in the test group was identified at the voxel level using statistical parametric mapping (SPM). A significant area of hypoperfusion (P TBI. Statistical mapping of the reference microsphere CBF data confirms a focal decrease found with SPECT and SPM. The suitability of SPM for application to the experimental model and ability to provide insight into CBF changes in response to traumatic injury was validated by the SPECT SPM result of a decrease in CBP at the left parietal region injury area of the test group. Further study and correlation of this characteristic lesion with long-term outcomes and auxiliary diagnostic modalities is critical to developing more effective critical care treatment guidelines and automated medical imaging processing techniques.

  11. Mnemonic activation by SPECT; Activation mnesique en TEMP

    Energy Technology Data Exchange (ETDEWEB)

    Migneco, O.; Darcourt, J.; Benoit, M; Malandain, G.; Thirion, J.P.; Robert, Ph.; Vidal, R.; Desvignes, Ph.; Benoliel, J.; Ayache, N.; Bussiere, F. [Universite de Nice Sophia-Antipolis, INRIA (France)

    1997-12-31

    Data of literature show that SPECT is able to detect cerebral activations induced by sensory-motor stimuli. The facts are not clearly established in what concerns the cognitive activations the amplitude of which is lower. We have studied an activation paradigm such as the Grober and Bruschke test which implies the long term explicit memory. It comprises a visual presentation of words followed by their indexed recall. By using a two-day protocol, 2 SPECTs were achieved in 4 healthy right-handed voluntaries as follows: one of activation (A) and one of control (B). The fifth subject benefited by a SPECT B and of an MRI. The injection for the examination A has been done during the indexed recall stage and for the examination B at the moment when the patient repeated several times the same 3 words. The SPECT data were collected 1 hour after the injection of 370 MBq of ECD making use of a 3-head camera equipped with UHR fan collimators and ending by a LMH on the reconstructed images of 8 mm. The MRI has been achieved by means of a Signa 1.5 Tesla magnet. The SPECT A and B of the subjects 1 to 4 were matched elastically to that of the subject 5 and that of the subject 5 was rigidly matched on its MRI. In this way the individual activation cards of the 4 subjects could be averaged and superimposed on the MRI of the 5. subject. One observes an internal temporal activation (maximal activation of left tonsil, +25% and right uncus, +23%) and a right cingulum activation (maximal activation, +25%), in agreement with the neuro-physiological data. The elastic matching makes possible the inter-subject averaging, what increases the signal-to-noise ratio of activation. The inter-modality rigid matching facilitates the anatomical localisation of the activation site. With these adapted tools, the cognitive activation is thus possible by SPECT and opens perspectives for early diagnosis of neurological troubles, namely of Alzheimer`s disease

  12. Design, Synthesis, and Preliminary Evaluation of SPECT Probes for Imaging β-Amyloid in Alzheimer's Disease Affected Brain.

    Science.gov (United States)

    Okumura, Yuki; Maya, Yoshifumi; Onishi, Takako; Shoyama, Yoshinari; Izawa, Akihiro; Nakamura, Daisaku; Tanifuji, Shigeyuki; Tanaka, Akihiro; Arano, Yasushi; Matsumoto, Hiroki

    2018-04-06

    In this study, we synthesized of a series of 2-phenyl- and 2-pyridyl-imidazo[1,2- a]pyridine derivatives and examine their suitability as novel probes for single-photon emission computed tomography (SPECT)-based imaging of β-amyloid (Aβ). Among the 11 evaluated compounds, 10 showed moderate affinity to Aβ(1-42) aggregates, exhibiting half-maximal inhibitory concentrations (IC 50 ) of 14.7 ± 6.07-87.6 ± 39.8 nM. In vitro autoradiography indicated that 123 I-labeled triaz