WorldWideScience

Sample records for repeated ictal spect

  1. Ictal SPECT in Sturge-Weber syndrome

    OpenAIRE

    O. Bilgin; Vollmar, C.; Peraud, A.; la Fougere, C.; Beleza, P; Noachtar, S.

    2008-01-01

    We report on a patient with right-sided Sturge-Weber syndrome (SWS), in whom earlier functional hemispherectomy failed. Subtraction of ictal and interictal single-photon-emission-computed-tomography (SPECT) superimposed on individual MRI showed a right fronto-orbital hyperperfusion, with a left-sided EEG seizure pattern. Ictal SPECT supported our assumption that right frontal originated seizure pattern propagated to left hemisphere via the remaining right frontal bridge. Right orbito-frontal ...

  2. Ictal SPECT Using an Attachable Automated Injector: Clinical Usefulness in the Prediction of Ictal Onset Zone

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung-Ju (Dept. of Neurology, Eulji General Hospital, Eulji Univ. College of Medicine, Seoul (Korea)). e-mail. sangunlee@dreamwiz.com; Lee, Sang Kun (Dept. of Neurology, Seoul National Univ. College of Medicine, Seoul (Korea)); Choi, Jang Wuk (Dept. of Neurology, Seoul National Univ. Hospital, Seoul (Korea)) (and others)

    2009-12-15

    Background: Ictal single-photon emission computed tomography (SPECT) is a valuable method for localizing the ictal onset zone in the presurgical evaluation of patients with intractable epilepsy. Conventional methods used to localize the ictal onset zone have problems with time lag from seizure onset to injection. Purpose: To evaluate the clinical usefulness of a method that we developed, which involves an attachable automated injector (AAI), in reducing time lag and improving the ability to localize the zone of seizure onset. Material and Methods: Patients admitted to the epilepsy monitoring unit (EMU) between January 1, 2003, and June 30, 2008, were included. The definition of ictal onset zone was made by comprehensive review of medical records, magnetic resonance imaging (MRI), data from video electroencephalography (EEG) monitoring, and invasive EEG monitoring if available. We comprehensively evaluated the time lag to injection and the image patterns of ictal SPECT using traditional visual analysis, statistical parametric mapping-assisted, and subtraction ictal SPECT coregistered to an MRI-assisted means of analysis. Image patterns were classified as localizing, lateralizing, and nonlateralizing. The whole number of patients was 99: 48 in the conventional group and 51 in the AAI group. Results: The mean (SD) delay time to injection from seizure onset was 12.4+-12.0 s in the group injected by our AAI method and 40.4+-26.3 s in the group injected by the conventional method (P=0.000). The mean delay time to injection from seizure detection was 3.2+-2.5 s in the group injected by the AAI method and 21.4+-9.7 s in the group injected by the conventional method (P=0.000). The AAI method was superior to the conventional method in localizing the area of seizure onset (36 out of 51 with AAI method vs. 21 out of 48 with conventional method, P=0.009), especially in non-temporal lobe epilepsy (non-TLE) patients (17 out of 27 with AAI method vs. 3 out of 13 with conventional

  3. The Performance of Ictal Brain SPECT Localizing for Epileptogenic Zone in Neocortical Epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Sik; Lee, Dong Soo; Hyun, In Young; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Lee, Sang Kun; Chang, Kee Hyun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1995-09-15

    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 {sup 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. The usefulness of subtraction ictal SPECT and ictal near-infrared spectroscopic topography in patients with West syndrome.

    Science.gov (United States)

    Haginoya, Kazuhiro; Uematsu, Mitsugu; Munakata, Mitsutoshi; Kakisaka, Yosuke; Kikuchi, Atsuo; Nakayama, Tojo; Hino-Fukuyo, Naomi; Tsuburaya, Rie; Kitamura, Taro; Sato-Shirai, Ikuko; Abe, Yu; Matsumoto, Yoko; Wakusawa, Keisuke; Kobayashi, Tomoko; Ishitobi, Mamiko; Togashi, Noriko; Iwasaki, Masaki; Nakasato, Nobukazu; Iinuma, Kazuie

    2013-11-01

    The recent findings on subtraction ictal SPECT and ictal near-infrared spectroscopic topography in patients with West syndrome were summarized and its availability for presurgical evaluation was discussed. The subtraction ictal SPECT study in patients with West syndrome demonstrated the cortical epileptic region and subcortical involvement, which may consist of epilepsy networks related to the spasms. Moreover, subtraction ictal SPECT may have predictive power for short-term seizure outcome. Patients with a symmetric hyperperfusion pattern are predicted to have a better seizure outcome, whereas patients with asymmetric hyperperfusion pattern may develop poor seizure control. Importantly, asymmetric MRI findings had no predictive power for seizure outcome. Multichannel near-infrared spectroscopic topography applied to the patients with West syndrome detected an increase in regional cerebral blood volume in multiple areas which were activated either simultaneously or sequentially during spasms. Topographic changes in cerebral blood volume were closely correlated with spasm phenotype, suggesting that the cortex is involved in the generation of spasms. In conclusion, subtraction ictal SPECT may be considered as a useful tool for presurgical evaluation of patients with West syndrome and investigation of the pathophysiology of spasms. The ictal near-infrared spectroscopic topography should be more investigated to see if this is useful tool for presurgical evaluation.

  5. The Performance of Ictal Brain SPECT for Localizing Epileptogenic Foci in Temporal Lobe epilepsies

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Sil; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Chang, Kee Hyun; Lee, Sang Kun; Chung, Chun Kee [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1995-06-15

    Anterior temporal lobectomy has become a widely used respective surgery in patients with medically intractable temporal lobe epilepsies. Prerequisites of this resection include the accurate localization of the epileptogenic focus and the determination that the proposed resection would not result in unacceptable postoperative memory or language deficits. The purpose of this study was to evaluate the performance of ictal SPECT compared to MRI findings for localization of epileptogenic foci in this group of patients. 11 patients who had been anterior temporal oral lobectomy were evaluated with ictal {sup 99m}Tc-HMPAO SPECT and MRI. MRI showed 8/11(73%) concordant lesion to the side of surgery and ictal SPECT also showed 8/11(73%) concordant hyperperfusion. In 3 cases with incorrect or nonlocalizing findings of MRI, ictal SPECT showed concordant hyperperfusion. In 2 cases confirmed by pre-resectional invasive EEG, MRI showed bilateral and contralateral lesion but ictal SPECT showed concordant hyperperfusion. 3 delayed injection of ictal SPECT showed discordant hyperperfusion. Thus, ictal SPECT was a useful method for localizing epileptogenic foci in temporal lobe epilepsies and appeared complementay to MRI.

  6. Voxel significance mapping in epilepsy studies using subtraction ictal SPECT

    Science.gov (United States)

    Brinkmann, Benjamin H.; O'Brien, Terence J.; Webster, Desmond B.; Robins, Peter D.; Mullan, Brian P.; Robb, Richard A.

    1999-05-01

    Subtraction ictal SPECT coregistered to MRI (SISCOM) has been shown to aid epileptogenic localization and improve surgical outcomes in partial epilepsy patients. This paper reports a new method of identifying significant areas of epileptogenic activation in the SISCOM subtraction image taking into account normal variation between sequential Tc-99m Ethyl Cysteinate Diethylester SPECT scans of single individuals. The method uses the AIR 3.0 nonlinear registration software to combine a group of subtraction images into a common anatomical framework. A map of the pixel intensity standard deviation values in the subtraction images is created, and this map is nonlinearly registered to a patient's SISCOM subtraction image. Pixels in the patient subtraction image may then be evaluated based upon the statistical characteristics of corresponding pixels in the atlas. Validation experiments were performed to verify that local image variances are not constant across the image and that nonlinear registration preserves local image variances. SISCOM images created with the voxel variance method were rated higher in quality than the conventional image variance method in images from fifteen patients. No difference in localization rate was observed between the voxel variance mapping and image variance methods. The voxel significance mapping method was shown to improve the quality of clinical SISCOM images without removing localizing information.

  7. Ictal SPECT in neocortical epilepsies: clinical usefulness and factors affecting the pattern of hyperperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Kun [Seoul National University Hospital, Department of Neurology, Seoul (Korea); Lee, Seo-Young [Kangwon National University Hospital, Department of Neurology, Chuncheon (Korea); Yun, Chang-Ho [Inha University Hospital, Department of Neurology, Incheon (Korea); Lee, Ho-Young; Lee, Jae-Sung; Lee, Dong-Soo [Seoul National University Hospital, Department of Nuclear Medicine, Seoul (Korea)

    2006-09-15

    The aims of this analysis were to: (1) determine the value of ictal SPECT in the localization of neocortical epileptogenic foci, (2) evaluate the relationships between the results of ictal SPECT and other potential affecting factors, and (3) compare traditional visual analysis and the subtraction method. We retrospectively analyzed 81 consecutive patients with neocortical epilepsy who underwent epilepsy surgery and achieved a favourable surgical outcome, including 36 patients with normal MRI. Side-by-side visual analysis and subtraction images were classified as correctly localizing,correctly lateralizing, or non-localizing/non-lateralizing images according to the resected lobe. Side-by-side visual analysis and subtraction SPECT correctly localized the epileptogenic lobe in 58.9% and 63.0% of patients, respectively. The two methods were complementary and the diagnostic sensitivity of ictal SPECT using the two methods was 79.0%. Ictal SPECT using the visual method correctly localized the epileptogenic lobe more frequently in patients with a localizing pattern of ictal scalp EEG at the time of radioligand injection. When using subtraction images, an injection delay of less than 20 s after seizure onset was significantly correlated with correct localization. The subtraction method was superior to the visual method for localizing frontal lobe epilepsy (FLE) and parietal lobe epilepsy (PLE), and in patients with non-localizing/non-lateralizing EEG at onset. Ictal SPECT analyses using visual and subtraction methods are useful and complementary for the localization of the epileptogenic foci of neocortical epilepsy. Early radioligand injection and ictal EEG patterns are related to ictal SPECT localization. The subtraction method may be more useful in some epileptic syndromes. (orig.)

  8. 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)

  9. Ictal SPECT in paroxysmal non-kinesigenic dyskinesia. Case report and review of the literature.

    Science.gov (United States)

    del Carmen García M; Intruvini; Vazquez; Beserra; Rabinowicz

    2000-04-01

    Purpose: Paroxysmal non-kinesigenic dyskinesia (PNKD) should be included in the list of differential diagnosis in patients with refractory epilepsy. Although the pathophysiological mechanisms that underlie this disorder remain controversial, it is now accepted that the basal ganglia are the anatomical substrate responsible for it.Material and methods: We report a 16-year-old mentally retarded male with PNKD admitted for video-EEG monitoring and ictal SPECT, which showed hyperperfusion on the right caudate and thalamus.Conclusion: This case supports more evidence for the involvement of the caudate nucleus and thalamus in the mechanisms responsible for the production of PNKD.

  10. Comparison of diagnostic performance between interictal F-18-FDG PET and ictal Tc-99m-HMPAO SPECT in occipital lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seok Ki; Lee, Dong Soo; Yeo, Jeong Seok; Lee, Sang Kun; Kim, Joo Yong; Jeong, Jae Min; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-02-01

    Interictal F-18-fluorodeoxyglucose (FDG) PET and ictal Tc-99m-HMPAO SPECT are found to be useful in localizing epileptogenic zones in neocortical lateral temporal or frontal lobe epilepsy. We investigated whether interictal F-18-FDG PET or ictal Tc-99m-HMPAO SPECT was useful to find epileptogenic zones in occipital lobe epilepsy (OLE). We reviewed patterns of hypometabolism in interictal F-18 FDG PET and of hyperfusion in ictal Tc-99m-HMPAO SPECT in 17 OLE patients (mean age=27{+-}6.8 year, M : F=10:7, injection time =30{+-}17 sec). OLE was diagnosed based on invasive electroencephalography (EEG) study, surgery and post-surgical outcome (Engel class I in all for average 14 months). Epileptogenic zones were correctly localized in 9 (60%) out of 15 patients by interictal F-18-FDG PET. Epiletogenic hemispheres were correctly lateralized in 14 patients (93%) . By ictal Tc-99m-HMPAO SPECT, epileptogenic hemispheres were correctly lateralized in 13 patients (76%), but localization was possible only in 3 patients (18%). Among patients who showed no abnormality with MR imaging and no correct localization with ictal Tc-99m-HMPAO SPECT, interictal F-18-FDG PET was helpful in 2 patients. Ictal Tc-99m-HMPAO SPECT was helpful in lateralization but not in localization in OLE. Interictal F-18-FDG PET was helpful for localization of epileptogenic zones even in patients with ambiguous MR of ictal SPECT findings.

  11. Ictal and interictal 99mTc-HMPAO brain SPECT of a MELAS case presented with epilepsy-like visual hallucination.

    Science.gov (United States)

    Wei, Cheng-Yu; Hsiao, Heng-Long; Chen, Shang-Chi; Hung, Guang-Uei; Kao, Chia-Hung

    2012-09-01

    A 55-year-old woman was diagnosed with the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). She was referred for Tc-HMPAO brain SPECT because of visual hallucinations, which were suspected to be related to epileptic seizures. Ictal SPECT images showed remarkable hyperperfusion in the left occipital cortex, which returned to near-normal status on the interictal SPECT images after treatment with anticonvulsants. It is very rare to see such an ictal SPECT image of epileptic or epilepsy-like disorders, especially in the setting of MELAS syndrome with visual hallucination.

  12. The usefulness of repeated ictal SPET for the localization of epileptogenic zones in intractable epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Soo; Chung, June-Key; Lee, Myung Chul [Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea); Department of Nuclear Medicine, Seoul National University College of Medicine (Korea); Lee, Sang Kun [Department of Neurology, Seoul National University College of Medicine (Korea); Kim, Yu Kyeong [Department of Nuclear Medicine, Seoul National University College of Medicine (Korea); Kang, Eunjoo; Lee, Jae Sung [Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea)

    2002-05-01

    This study investigated whether repeated ictal single-photon emission tomography (SPET) is helpful in the localization of epileptogenic zones and whether it can provide information confirming that an area of increased perfusion is really the culprit epileptogenic lesion. Fifty-four repeated ictal SPET studies were performed in 24 patients with ambiguous or unexpected findings on the first ictal SPET study. These patients were enrolled from among 502 patients with intractable epilepsy in whom pre-operative localization of epileptogenic zones was attempted with a view to possible surgical resection. Video monitoring of ictal behaviour and EEGs was performed in all patients. Repeated ictal SPET was performed using technetium-99m hexamethylpropylene amine oxime (HMPAO) when there was no prominently hyperperfused area or when unexpected findings were obtained during the first study. Two ictal SPET studies were performed in 19 patients, three studies in four patients and four studies in one patient. The average delay between ictal onset and injection was 28 s for the first study and 22 s for the second, third and fourth studies. Using interictal SPET, ictal-interictal subtraction images were acquired and co-registered with the population magnetic resonance imaging (MRI) template. Invasive study and surgery were performed in 18 patients, and in these cases the surgical outcome was known. In the other six patients, epileptogenic foci were determined using MRI, positron emission tomography (PET) and ictal EEG findings. Two patients were found to have mesial temporal lobe epilepsy, two lateral temporal lobe epilepsy, eight frontal lobe epilepsy, three parietal lobe epilepsy and one occipital lobe epilepsy. The other eight had multifocal epilepsy. The first study was normal in 12 patients (group I) and indicated certain zones to be epileptogenic in the other 12 (group II). Among group I, the correct epileptogenic zone or lateralization was revealed at the repeated study in

  13. Ictal {sup 99m}Tc-ECD brain SPECT imaging: localization of seizure foci and correlation with semiology in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Ryu, Jin Sook; Lee, Hee Kyung; Ma, Hyeo Il; Lee, Sang Ahm; Lee, Jung Kyo; Kang, Joong Koo [Asan Medical Center, Seoul (Korea, Republic of)

    1997-07-01

    The purpose of this study was to evaluate the usefulness of ictal {sup 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 {sup 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 {sup 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 {sup 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 {sup 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.

  14. Ictal technetium-99 m ethyl cysteinate dimer single-photon emission tomographic findings in epileptic patients with polymicrogyria syndromes: A subtraction of ictal-interictal SPECT coregistered to MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Wichert-Ana, Lauro [University of Sao Paulo, Center for Epilepsy Surgery, Department of Neurology, Psychiatry and Clinical Psychology, Ribeirao Preto (Brazil); Hospital das Clinicas, USP, Centro de Cirurgia de Epilepsia, CIREP, Ribeirao Preto, SP (Brazil); Mazzoncini de Azevedo-Marques, Paulo; Santos, Antonio C.; Araujo, David [University of Sao Paulo, Center for Imaging Science and Medical Physics, Department of Internal Medicine, Ribeirao Preto (Brazil); Ferrari Oliveira, Lucas [Federal University of Pelotas, Informatics Department, Pelotas, RS (Brazil); Fernandes, Regina M.F.; Velasco, Tonicarlo R.; Sakamoto, Americo C. [University of Sao Paulo, Center for Epilepsy Surgery, Department of Neurology, Psychiatry and Clinical Psychology, Ribeirao Preto (Brazil); Kato, Mery [University of Sao Paulo, Division of Nuclear Medicine, Department of Internal Medicine from the Ribeirao Preto Medical School, Ribeirao Preto (Brazil); Muxfeldt Bianchin, Marino [Rio Grande do Sul Federal University, Neurology Division, HCPA, Porto Alegre, RS (Brazil)

    2008-06-15

    To describe the ictal technetium-99 m-ECD SPECT findings in polymicrogyria syndromes (PMG) during epileptic seizures. We investigated 17 patients with PMG syndromes during presurgical workup, which included long-term video-electroencephalographic (EEG) monitoring, neurological and psychiatry assessments, invasive EEG, and the subtraction of ictal-interictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM). The analysis of the PMG cortex, using SISCOM, revealed intense hyperperfusion in the polymicrogyric lesion during epileptic seizures in all patients. Interestingly, other localizing investigations showed heterogeneous findings. Twelve patients underwent epilepsy surgery, three achieved seizure-freedom, five have worthwhile improvement, and four patients remained unchanged. Our study strongly suggests the involvement of PMG in seizure generation or early propagation. Both conventional ictal single-photon emission computed tomography (SPECT) and SISCOM appeared as the single contributive exam to suggest the localization of the epileptogenic zone. Despite the limited number of resective epilepsy surgery in our study (n = 9), we found a strong prognostic role of SISCOM in predicting surgical outcome. This result may be of great value on surgical decision-making of whether or not the whole or part of the PMG lesion should be surgically resected. (orig.)

  15. Temporal lobe epilepsy subtypes, differential patterns of cerebral perfusion on ictal SPECT

    NARCIS (Netherlands)

    Ho, SS; Berkovic, SF; McKay, WJ; Kalnins, RM; Bladin, PF

    1996-01-01

    Purpose: We studied cerebral perfusion patterns in the various subtypes of TLE, as determined by pathology and good outcome after temporal lobectomy (as confirmation of temporal origin). Methods: We studied clinical features and ictal technetium 99m hexamethyl-propyleneamineoxime (Tc-99m-HMPAO) sing

  16. Correlação entre semiologia clínica e achados do SPECT ictal nas crises epilépticas hipercinéticas

    OpenAIRE

    Ursula Thomé Costa

    2016-01-01

    INTRODUÇÃO: A classificação recente das Crises Hipercinéticas (CH) proposta por Rheims et al. (2008) sugere dois padrões de CH, baseado na semiologia ictal (Tipos I e II): no Tipo I, a zona epileptogênica foi identificada na região ventral pré-frontal, enquanto que no Tipo II, na região mesial pré-motora. Estudos com SPECT ictal em pacientes com CH evidenciaram hiperperfusão nas regiões frontais e extrafrontais, incluindo ínsula e lobo temporal, além de áreas subcorticais, tais como cerebelo,...

  17. 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

  18. 'What is it?' A functional MRI and SPECT study of ictal speech in a second language

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, V.; Chauvire, V.; Baulac, M.; Cohen, L. [Department of Neurology, AP-HP, Hopital de la Pitie-Salpetriere, IFR 70, Paris (France); Delmaire, Ch.; Lehericy, St. [Department of Neuroradiology, AP-HP, Hopital de la Pitie-Salpetriere, IFR 70, Paris (France); Habert, M.O. [Department of Nuclear Medicine, AP-HP, Hopital de la Pitie-Salpetriere, IFR 70, Paris (France); Footnick, R.; Pallier, Ch. [INSERM, U562, CEA/DSV, IFR 49, Orsay (France); Baulac, M.; Cohen, L. [Universite Paris VI, Faculte Pitie-Salpetriere, Paris (France)

    2009-07-01

    Neuronal networks involved in second language (L2) processing vary between normal subjects. Patients with epilepsy may have ictal speech automatisms in their second language. To delineate the brain systems involved in L2 ictal speech, we combined functional MRI during bilingual tasks and ictal - inter-ictal single-photon emission computed tomography in a patient who presented L2 ictal speech productions. These analyses showed that the networks activated by the seizure and those activated by L2 processing intersected in the right hippocampus. These results may provide some insights both into the pathophysiology of ictal speech and into the brain organization for L2. (authors)

  19. Statistical voxel-wise analysis of ictal SPECT reveals pattern of abnormal perfusion in patients with temporal lobe epilepsy Análise estatística baseada em voxel do SPECT ictal revela um padrão de alteração perfusional em pacientes com epilepsia de lobo temporal

    Directory of Open Access Journals (Sweden)

    Bárbara Juarez Amorim

    2005-12-01

    Full Text Available OBJECTIVE: To investigate the pattern of perfusion abnormalities in ictal and interictal brain perfusion SPECT images (BSI from patients with temporal lobe epilepsy (TLE. METHOD: It was acquired interictal and ictal BSI from 24 patients with refractory TLE. BSIs were analyzed by visual inspection and statistical parametric mapping (SPM2. Statistical analysis compared the patients group to a control group of 50 volunteers. The images from patients with left-TLE were left-right flipped. RESULTS: It was not observed significant perfusional differences in interictal scans with SPM. Ictal BSI in SPM analysis revealed hyperperfusion within ipsilateral temporal lobe (epileptogenic focus and also contralateral parieto-occipital region, ipsilateral posterior cingulate gyrus, occipital lobes and ipsilateral basal ganglia. Ictal BSI also showed areas of hypoperfusion. CONCLUSION: In a group analysis of ictal BSI of patients with TLE, voxel-wise analysis detects a network of distant regions of perfusional alteration which may play active role in seizure genesis and propagation.OBJETIVO: Investigar o padrão de anormalidades perfusionais no SPECT de perfusão cerebral (SPC ictal e interictal na epilepsia de lobo temporal (ELT. MÉTODO: Foram realizados SPCs ictal e interictal de 24 pacientes com ELT que foram analisados visualmente e com o statistical parametric mapping (SPM2. A análise estatística comparou o grupo de pacientes versus um grupo controle de 50 voluntários. RESULTADOS: Na análise do SPM não foram observadas diferenças significativas no grupo de SPC interictal. No grupo de SPC ictal o SPM revelou hiperperfusão no lobo temporal ipsilateral (foco epileptogênico e também na região parieto-occipital contralateral, porção posterior do cíngulo ipsilateral, lobos occipitais e núcleos da base ipsilateral. O SPC ictal também mostrou áreas de hipoperfusão. CONCLUSÃO: Em uma análise de grupo do SPC ictal de pacientes com ELT, a an

  20. Ictal SPECT in patients with rapid eye movement sleep behaviour disorder.

    Science.gov (United States)

    Mayer, Geert; Bitterlich, Marion; Kuwert, Torsten; Ritt, Philipp; Stefan, Hermann

    2015-05-01

    Rapid eye movement sleep behaviour disorder is a rapid eye movement parasomnia clinically characterized by acting out dreams due to disinhibition of muscle tone in rapid eye movement sleep. Up to 80-90% of the patients with rapid eye movement sleep behaviour disorder develop neurodegenerative disorders within 10-15 years after symptom onset. The disorder is reported in 45-60% of all narcoleptic patients. Whether rapid eye movement sleep behaviour disorder is also a predictor for neurodegeneration in narcolepsy is not known. Although the pathophysiology causing the disinhibition of muscle tone in rapid eye movement sleep behaviour disorder has been studied extensively in animals, little is known about the mechanisms in humans. Most of the human data are from imaging or post-mortem studies. Recent studies show altered functional connectivity between substantia nigra and striatum in patients with rapid eye movement sleep behaviour disorder. We were interested to study which regions are activated in rapid eye movement sleep behaviour disorder during actual episodes by performing ictal single photon emission tomography. We studied one patient with idiopathic rapid eye movement sleep behaviour disorder, one with Parkinson's disease and rapid eye movement sleep behaviour disorder, and two patients with narcolepsy and rapid eye movement sleep behaviour disorder. All patients underwent extended video polysomnography. The tracer was injected after at least 10 s of consecutive rapid eye movement sleep and 10 s of disinhibited muscle tone accompanied by movements registered by an experienced sleep technician. Ictal single photon emission tomography displayed the same activation in the bilateral premotor areas, the interhemispheric cleft, the periaqueductal area, the dorsal and ventral pons and the anterior lobe of the cerebellum in all patients. Our study shows that in patients with Parkinson's disease and rapid eye movement sleep behaviour disorder-in contrast to wakefulness

  1. 视频脑电图与发作期SPECT对痫灶定位的对比研究%Comparative study of ictal SPECT and video EEG on localization of epileptogenic foci for intractable epilepsy

    Institute of Scientific and Technical Information of China (English)

    杨梅华; 蔡方成; 张琴; 黄轶; 杨华安; 刘仕勇; 杨辉; 安宁; 黄婷; 刘立红; 石先俊

    2010-01-01

    Objective To investigate the value of ictal single photon emission computed tomography and VEEG in localization of epileptogenic foci for intractable epilepsy. Method The data of ictal SPECT and VEEG were reviewed from 48 patients with intractable epilepsy, all the results were analyzed and compared with each other. Surgical treatment were performed on 48 cases. Results The positive rate of ictal SPECT and VEEG localization was 94% and 96% respectively. The rate of complete coincidence of the two methods was 46% (22/48), partial coincidence was 29% (14/48). Comparing ictal SPECT with video EEG in the ratio of lateral and focal epileptic foci localization, twenty - seven of 48 patients had an Engel Class Ⅰ outcome after surgery and an additional ten patients had rare seizure (Engel Class Ⅱ), and eight patient had a decrease in seizure frequency (Engel Class Ⅲ) , no marked chang (Engel Class Ⅳ) in three patients. In Engel Class Ⅰ and Class Ⅱ outcome cases, there were 33 (out of 37) cases came from its coincidence of ictal SPECT and VEEG localization. Conclusions VEEG combined with ictal SPECT can increase the accuracy on localization of epileptogenic foci for intractable epilepsy.%目的 探讨视频脑电图(VEEG)、发作期SPECT在术前痫灶定位中的作用.方法 回顾性对比分析48例难治性癫痫患者术前所行长程VEEG与发作期SPECT定位的情况,比较两者定位的一致性.结果 发作期SPECT定位阳性率为94%,VEEG为96%.两者完全一致占46%,部分一致占29%,完全不一致占25%.阳性率及定侧率差异无统计学意义(P>0.05),局灶定位差异有统计学意义(P<0.01).随访结果显示48例患者中Engel Ⅰ级27例,Ⅱ级10例,Ⅲ级8例,Ⅳ级3例;其中EngelⅠ~Ⅱ级的37例中33例来自两者定位一致的患者.结论 发作期SPECT与VEEG检查有较高的一致性,两者联合应用优势互补,可提高定位准确性,获得良好的手术疗效.

  2. The consistency of ictal SPECT and VEEG studies in localizing the epileptic focus%发作期SPECT脑血流灌注显像和VEEG在癫痫灶定位诊断中的一致性

    Institute of Scientific and Technical Information of China (English)

    王晓慧; 陈雪红; 柳江燕; 冯建中; 鲁秀娟; 王为民; 庞小溪

    2014-01-01

    Objective To localize the epileptic focus by means of ictal SPECT and video-electroencephalography(VEEG) patterns to decide whether the combination of them are capable of localizing epileptic focus correctly.Methods The present study was performed in 45 epileptic patients,who showed spike waves during VEEG monitoring when deprived of sleep to provoke seizures,even oral application of clonidine was given when deprivation of sleep was failed in limited time.Technetium-99m ethyl cysteinate dimer(99Tcm-ECD)was injected within 30 s when a clinical sign and/or an typical VEEG discharge was recognized,then brain SPECT was performed after 30 min.In the end,compared the results of ictal SPECT and VEEG in localization.x2 test was performed by using software SPSS l 9.0.Results Ictal brain SPECT localized in 93.3% (42/45)patients,of whom 95.2% (40/42)patients had single hyperperfusion,and 4.8%(2/42)had multiple hyperperfusion.VEEG showed partial seizures in 68.9% (31/45) patients,and 31.1%(14/45)patients showed generalized spike waves.The relationship of ictal SPECT and VEEG in localizing epileptic focus was turned out as following:Firstly,the consistency of ictal SPECT and VEEG is 83.9%(26/31)in partial seizure,as for generalized tonic-clonic seizure,VEEG showed generalized spike waves,and ictal brain SPECT declared single hyperperfusion,therefore,the localization of them was different.The consistency of partial seizure was significantly higher than that of generalized tonic-clonic seizure (x2=24.478,P<0.05).Conclusions The consistency of ictal SPECT and VEEG in localization has something to do with epilepsy categories.The study indicates that it is possible to obtain localization in patients with partial seizures using a combination of ictal SPECT and VEEG patterns,as for generalized tonic-clonic seizure,the combination of them is not enough and it' s imperative to use other techniques.%目的 探讨癫痫发作期SPECT脑血流灌注显像和视频脑电

  3. Ictal singing due to right mesial temporal lobe epilepsy involving a bihemispheric network.

    Science.gov (United States)

    Lee, Eun Mi; Kang, Joong Koo; Park, Ga Young; Oh, Jung Su; Kim, Jae Seung

    2013-01-01

    Singing is a rare ictal symptom of focal epilepsy. Here, we report a case of a right-handed patient who demonstrated ictal singing due to right mesial temporal lobe epilepsy. Subtraction ictal SPECT coregistered to MRI (SISCOM) performed during ictal singing demonstrated areas of hyperperfusion in the bilateral frontal regions (more prominent in the left frontal lobe), bilateral subcortical regions, insular cortices, and bilateral cerebellum in addition to the right temporal area. An intracranial EEG revealed that an ictal singing episode commenced after an ictal rhythm from the right temporal area was propagated to the contralateral side of the left hemisphere. These findings suggest that the symptomatogenic zone for ictal singing includes neural networks from the frontal and temporal regions of both hemispheres rather than specific cortical areas even when the epileptogenic zone is located in the right mesial temporal area, as evidenced in this patient.

  4. Value of interictal/ictal single photon emission computed tomography regional cerebral blood flow imaging in localization of epileptic foci%发作间期/发作期SPECT rCBF显像在癫痫灶定位诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    杨雅娜; 罗焱; 胡云; 苏红媛; 杨辉; 张青

    2012-01-01

    Objective To study the value of interictal/ictal single photon emission computed tomography (SPECT) regional cerebral blood flow (rCBF) imaging in localization of epileptic foci. Methods Interictal/ictal SPECT, EEG, VEEG, CT or MRI, and ECoG of 115 epilepsy patients, who underwent operation in Department of Neurosurgery, Xinqiao Hospital, Third Military Medical University, were retrospectively analyzed and compared. Results The positive detection rate of interictal/ictal SPECT for epilepsy was higher than that of EEG, VEEG, CT and MRI (90.4% va 37.4% , 82.6% , 48. 8% and 54.2% , P <0.05). The localization rate of interictal/ictal SPECT for epileptic foci was higher than that of ECoG (91. 3% vs 71. 2% , P<0.05). Conclusion The interictal/ictal SPECT is highly consistent with ECoG in localization of epileptic foci, thus playing an important role in preoperative localization of epilepsy.%目的 探讨发作间期/发作期SPECT局部脑血流灌注显像(regional cerebral blood flow,rCBF)在癫痫术前定位诊断中的价值.方法 回顾性分析第三军医大学新桥医院神经外科行外科手术治疗的115例癫痫患者,术前分别行发作间期/发作期SPECT显像、常规脑电图(electroencephalogram,EEG)、视频脑电图(vedio-EEC,VEEG)、CT或MRI检查,术中行皮层脑电图(electrocorticogram,ECoG)监测,与发作间期/发作期SPECT、EEG、VEEG、CT和MRI检查结果进行比较分析.结果 发作间期/发作期SPECT检出癫痫的阳性率为90.4%,高于EEG的37.4% (P <0.05)、VEEG的82.6%(P>0.05)、CT的48.8% (P <0.05)和MRI的54.2% (P <0.05).与术中ECoG结果比较,发作间期/发作期SPECT对癫痫灶定侧率为91.3%,定位率为71.2%.结论 术前发作间期/发作期SPECT显像与ECoG在癫痫灶定位诊断上具有较高的一致性,在术前综合定位诊断中具有重要意义.

  5. Application of subtraction ictal SPECT co-registered to MRI in locating the epileptogenic focus of intractable epilepsy%应用发作期单光子发射计算机断层显像减影和MRI图像配准在难治性癫痫中定位癫痫源

    Institute of Scientific and Technical Information of China (English)

    金超岭; 郑玉民; 焦劲松; 刘晓建; 李小璇; 田宏; 颜珏; 任连坤; 吴冬燕

    2016-01-01

    目的 探讨发作期单光子发射计算机断层显像减影和MRI图像配准(subtraction ictal SPECT co-registered to MRI,SISCOM)在癫痫源定位中的价值.方法 我们收集了2例代表性病例,其中1例具有脑软化灶:左顶叶弥散性囊性变;而另一例虽头颅MRI阴性,但需要鉴别颞叶内侧及颞叶外起源.2例患者均因术前无创性评估不能确定癫痫源,在充分知情同意的前提下,分别在发作间歇期和发作期注射示踪剂99mTc-双半胱乙酯进行SPECT检查.通过运用SISCOM技术处理,包括经过线性配准、体素标准化以及减影后,以灌注变化增高3个标准差作为差异有统计学意义,显示灌注增高的结果.结果 2例患者均观察到发作期与发作间歇期相比存在局灶的灌注增高.其中1例与弥散性软化灶相比,周围出现局限性高灌注;而另一例为内侧颞叶起源发作的典型高灌注模式.2例患者均准确定位了癫痫源区,在此基础上进行了手术治疗,术后均无发作.结论 SISOCM技术对难治性癫痫复杂病例可能具有积极的临床应用价值.%Objective To investigate the value of subtraction ictal SPECT co-registered to MRI (SISCOM) on localizing epileptogenic focus.Methods Two representative patients were enrolled.One suffered from refractory seizure due to diffuse encephalomalacia on left parietal lobe,while another showed MRI negative with frequency uncontrolled seizure,of which the origin from the medial temporal lobe or the temporal lobe needed to be identified.As the conventional approaches including semiological analysis,MRI and scalp electroencephalogram failed to describe the epileptogenic zone exactly,interictal and ictal 99mTcethyl cysteinate dimer (ECD) SPECT was further performed,followed by SISCOM processing,including linear coregister,voxel normalization and subtraction with ictal and interictal 99mTc-ECD SPECT.Three standard deviation of focal area hyperperfusion above the interictal period

  6. Ictal headache: headache as first ictal symptom in focal epilepsy.

    Science.gov (United States)

    Dainese, Filippo; Mai, Roberto; Francione, Stefano; Mainardi, Federico; Zanchin, Giorgio; Paladin, Francesco

    2011-12-01

    Headache may be associated with seizures as a preictal, ictal, or postictal phenomenon, but it is often neglected because of the dramatic neurological manifestations of the seizure. Headache can also be the sole or predominant clinical manifestation of epileptic seizures, although this is a relatively rare condition. We describe two cases of focal symptomatic drug-resistant epilepsy with headache as the first ictal symptom. In both cases, the headache, which lasted a few seconds, was contralateral to the ictal discharge and did not have the clinical features of migraine. Ictal headache is a rare epilepsy symptom that can help to localize ictal EEG discharges. Recently, the term ictal epileptic headache has been proposed in cases in which headache is the sole ictal epileptic manifestation Diagnosis requires the simultaneous onset of headache with EEG-demonstrated ictal discharges.

  7. 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).

  8. SPECT in epilepsies; SPECT bei Epilepsien

    Energy Technology Data Exchange (ETDEWEB)

    Stefan, H. [Neurologische Klinik, Univ. Erlangen-Nuernberg, Zentrum Epilepsie Erlangen (Germany)

    1997-06-01

    Registration of regional cerebral blood flow provides important new data for the investigation of pathophysiological processes in epilepsies. Further to the registration of perfusions, receptor studies are employed for the differentiation of localisation in focal epilepsies. For ultimative issues interictal registrations are supplemented by ictal recordings during the epileptic seizure. The combination of SPECT and electrophysiological registration can contribute to analysis of propagation of focal epileptic activity. (orig.) [Deutsch] Die Messung der regionalen Hirndurchblutung liefert wichtige neue Erkenntnis zur Untersuchung pathophysiologischer Ablaeufe bei Epilepsien. Ergaenzend zur Registrierung der Perfusion koennen Rezeptor-Studien zur Differenzierung der Lokalisation fokaler Epilepsien beitragen. Interiktale Registrierungen werden fuer letztere Fragestellung durch iktuale Messungen waehrend des epileptischen Anfalls ergaenzt. Die Kombination von SPECT und elektrophysiologischen Registrierungen kann zur Analyse der Propagation fokaler epileptischer Aktivitaet beitragen. (orig.)

  9. 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)

  10. SPECT and PET imaging in epilepsia; SPECT und PET in der Diagnostik von Epilepsien

    Energy Technology Data Exchange (ETDEWEB)

    Landvogt, C. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-09-15

    In preoperative localisation of epileptogenic foci, nuclear medicine diagnostics plays a crucial role. FDG-PET is used as first line diagnostics. In case of inconsistent MRI, EEG and FDG-PET findings, {sup 11}C-Flumazenil-PET or ictal and interictal perfusion-SPECT should be performed. Other than FDG, Flumazenil can help to identify the extend of the region, which should be resected. To enhance sensitivity and specificity, further data analysis using voxelbased statistical analyses or SISCOM (substraction ictal SPECT coregistered MRI) should be performed.

  11. Ictal kissing: occurrence and etiology.

    Science.gov (United States)

    Asadi-Pooya, Ali A; Fletman, Elizabeth W

    2017-02-01

    Ictal kissing is a rare semiological manifestation in patients with epilepsy. We tried to estimate its occurrence and characterize the underlying etiology. We retrospectively reviewed all video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term "kiss". We then searched the electronic database PubMed on September 21, 2016 using the following search terms in the English language: "ictal" OR "seizure" OR "epilepsy" AND "kiss" OR "kissing". Relevant original studies were included. During the study period, 5133 patients were investigated in our epilepsy monitoring unit. One patient (0.02%) had one episode of documented ictal kissing. He had drug-resistant right mesial temporal lobe epilepsy. In total, five studies met the criteria for inclusion in the review. These studies described nine patients with drug-resistant focal epilepsy and ictal kissing behavior. Six out of ten patients with ictal kissing had hippocampal sclerosis. We add to the literature on ictal kissing by providing additional information on its frequency and etiology. The most common underlying etiology for ictal kissing is hippocampal sclerosis. However, this semiological ictal phenomenon is not pathognomonic for any etiology or localization.

  12. Brain SPECT in mesial temporal lobe epilepsy: comparison between visual analysis and SPM SPECT cerebral na epilepsia de lobo temporal mesial: comparação entre análise visual e SPM

    Directory of Open Access Journals (Sweden)

    Bárbara Juarez Amorim

    2010-04-01

    Full Text Available 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.OBJETIVO: Comparar a acurácia do SPM com a análise visual na detecção do foco epileptogênico e alterações perfusionais à distância no SPECT cerebral. MÉTODO: Foram realizados os SPECTs ictal e interictal de 22 pacientes com epilepsia de lobo temporal mesial (ELTM. A análise visual foi realizada nos estudos interictal (VISUAL(inter e ictal (VISUAL(ictal/inter. Na análise com SPM foi comparado o estudo interictal (SPM(inter e ictal (SPM(ictal de cada paciente com o grupo controle e comparou-se a perfusão dos lobos temporais entre os estudos ictal e interictal (SPM(ictal/inter. RESULTADOS: Para a detecção do foco epileptogênico, as sensibilidades foram as seguintes: VISUAL(inter=68%; VISUAL(ictal/inter=100%; SPM(inter=45%; SPM(ictal=64% and SPM(ictal/inter=77%. O SPM foi capaz de detectar mais áreas de hiperperfusão e hipoperfusão. CONCLUSÃO: O SPM não aumentou a sensibilidade na detecção do foco epileptog

  13. Ictal Generalized EEG Attenuation (IGEA) and hypopnea in a child with occipital type 1 cortical dysplasia - Is it a biomarker for SUDEP?

    Science.gov (United States)

    Chaitanya, Ganne; Santosh, N Subbareddy; Velmurugan, Jayabal; Arivazhagan, Arima; Bharath, Rose D; Mahadevan, Anita; Nagappa, Madhu; Bindu, Parayil S; Rao, Malla Bhaskara; Taly, Arun B; Satishchandra, Parthasarathy; Sinha, Sanjib

    2015-01-01

    An interesting association of ictal hypopnea and ictal generalized EEG attenuation (IGEA) as possible marker of sudden unexpected death in epilepsy (SUDEP) is reported. We describe a 5-years-old girl with left focal seizures with secondary generalization due to right occipital cortical dysplasia presenting with ictal hypopnea and IGEA. She had repeated episodes of the ictal apnoea in the past requiring ventilator support and intensive care unit (ICU) admission during episodes of status epilepticus. The IGEA lasted for 0.26-4.68 seconds coinciding with the ictal hypopnea during which both clinical seizure and electrical epileptic activity stopped. Review of literature showed correlation between post-ictal apnoea and post ictal generalized EEG suppression and increased risk for SUDEP. The report adds to the growing body of literature on peri-ictal apnea, about its association with IGEA might be considered as a marker for SUDEP. She is seizure free for 4 months following surgery.

  14. Ictal Generalized EEG Attenuation (IGEA and hypopnea in a child with occipital type 1 cortical dysplasia - Is it a biomarker for SUDEP?

    Directory of Open Access Journals (Sweden)

    Ganne Chaitanya

    2015-01-01

    Full Text Available An interesting association of ictal hypopnea and ictal generalized EEG attenuation (IGEA as possible marker of sudden unexpected death in epilepsy (SUDEP is reported. We describe a 5-years-old girl with left focal seizures with secondary generalization due to right occipital cortical dysplasia presenting with ictal hypopnea and IGEA. She had repeated episodes of the ictal apnoea in the past requiring ventilator support and intensive care unit (ICU admission during episodes of status epilepticus. The IGEA lasted for 0.26-4.68 seconds coinciding with the ictal hypopnea during which both clinical seizure and electrical epileptic activity stopped. Review of literature showed correlation between post-ictal apnoea and post ictal generalized EEG suppression and increased risk for SUDEP. The report adds to the growing body of literature on peri-ictal apnea, about its association with IGEA might be considered as a marker for SUDEP. She is seizure free for 4 months following surgery.

  15. Perfusion SPECT, SISCOM and PET (18)F-FDG in the assessment of drug- refractory epilepsy patients candidates for epilepsy surgery.

    Science.gov (United States)

    Suárez-Piñera, M; Mestre-Fusco, A; Ley, M; González, S; Medrano, S; Principe, A; Mojal, S; Conesa, G; Rocamora, R

    2015-01-01

    Brain perfusion SPECT (ictal-interictal), SPECT images and subtraction ictal SPECT coregistered to MRI (SISCOM) and (18)F-FDG-PET (interictal), play an important role in the pre-surgical diagnosis of patients with medically refractory epilepsy. This study aimed to establish: the reproducibility of visual ictal-interictal SPECT and SISCOM analysis altogether with the capacity of SPECT, SISCOM and PET to determine the epileptogenic zone. (99m)Tc-HMPAO SPECT ictal-interictal and SISCOM (Analyze 7.0) were performed on 47 refractory epilepsy patients (24 F, 19-60 yrs). In 13 patients, SISCOM was also performed using a new program (Focus DET). Ictal-interictal SPECT and SISCOM images were analysed independently by two nuclear medicine physicians (observer 1 and 2). Kappa concordance coefficient was used to evaluate the reproducibility. In sixteen patients, SPECT, SISCOM and PET findings were compared with the resected area during the surgery, and surgical outcome using Engel scale or with the stereo EEG-(SEEG). The ictal-interictal SPECT interobserver agreement was 91%, Kappa index 0.86, SISCOM (Analyze 7.0) interobserver agreement percentage was 82%, Kappa index 0.80, Analyze 7.0 showed a higher inconclusive results than visual SPECT analysis. SISCOM FocusDET interobserver agreement was 92%, Kappa index 0.87, with lower inconclusive results than Analyze 7.0. SPECT, SISCOM and PET combined findings identified 87% seizure onset zone: 79% temporal, 26% parieto-temporal and 7% frontal. Ictal-interictal SPECT and SISCOM showed a high reproducibility in this sample of patients with drug-refractory epilepsy. SPECT,SISCOM and PET combined findings improved detection of epileptogenic zone in comparison with the individual assessment. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  16. Ictal kissing: Electroclinical features of an unusual ictal phenomenon.

    Science.gov (United States)

    Özkara, Çiğdem; Taşkıran, Emine; Çarpraz, İrem Yıldırım; Bilir, Erhan; Demir, Aylin Bican; Bora, İbrahim; Aydoğdu, İbrahim; Delil, Şakir; Chassoux, Francine

    2016-11-01

    The study aimed to describe the electroclinical features of ictal kissing, an unusual behavior that may occur during focal seizures. Twenty-five patients collected from four epilepsy centers and previously published reports were reviewed for their demographic, clinical, and electrophysiological features. Sixteen of 25 patients were female. The mean age was 32.9 years (9.9-51 years) and the average age at seizure onset was 14.5 years. All seizures were localized to the temporal lobe (TL) and lateralized to right side in 17 patients, left side in 2 patients, and unclear in 6 patients. A total of 55 ictal video electroencephalograms (EEGs) were analyzed. There were other symptoms such as speaking, spitting, hugging, and oral and upper-extremity automatisms along with different types of ictal kissing behavior during the seizures. The median duration of all seizures was 106.7±73.73s. Kissing occurred at a median time of 71s (1-95s) after the onset of seizure, and ictal epileptiform discharges usually involved TL during kissing episode. Ictal kissing is mainly associated with right TL and female gender, although association with left TL may also occurs, possibly related to the circuits involving temporo-insular structures. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  17. 可乐定联合剥夺睡眠诱发癫(癎)发作的SPECT脑血流灌注显像研究%The study of ictal brain SPECT during seizures induced by clonidine and sleep-deprivation in patients with epilepsy

    Institute of Scientific and Technical Information of China (English)

    王晓慧; 陈雪红; 王正江; 柳江燕; 冯建中; 叶江; 赵莉

    2010-01-01

    目的 探讨可乐定加剥夺睡眠诱发癫(癎)发作,获取发作期SPECT显像结果的可行性及临床价值.方法 选择临床确诊的癫(癎)患者52例,口服可乐定并剥夺睡眠以诱发癫(癎)(简称可乐定组),在视频脑电图(VEEG)监测下,当患者出现临床发作和(或)VEEG出现典型癫(癎)波时,30 s内静脉注射99Tcm-双半胱乙酯(ECD),30 min后行脑血流灌注断层显像.同时,选择同等条件下癫(癎)患者47例作为对照,通过单纯剥夺睡眠以诱发癫(癎)(简称剥夺睡眠组).应用SPSS 10.0统计软件对2组患者癫(癎)诱发率进行x2检验.结果 可乐定组的52例癫(癎)患者中,39例(75.0%)口服可乐定后1~2 h出现了VEEG异常,其中亚临床发作(仅出现典型癫(癎)波)92.3%(36/39),临床发作7.7%(3/39).发作期SPECT定位阳性率为94.9%(37/39),均表现为高血流灌注灶.剥夺睡眠组的47例患者中,诱发率为38.3%(18/47),其中亚临床发作77.8%(14/18),临床发作22.2%(4/18).2组诱发率差异有统计学意义(x2=13.614,P<0.01);2组临床发作率差异无统计学意义(x2=1.253,P>0.05).结论 可乐定联合剥夺睡眠对癫(癎)的诱发率明显高于单纯剥夺睡眠,前者可在有限的时间内诱发癫(癎),以亚临床发作为主,故可作为进行发作期SPECT脑显像安全、有效的诱发方法.%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 Fiftytwo 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. 99Tcm-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 99TcmECD injection. X2-test was

  18. Spect in epilepsy; SPECT bei Anfallsleiden

    Energy Technology Data Exchange (ETDEWEB)

    Feistel, H. [Nuklearmedizinische Klinik mit Poliklinik und Neurologische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Weis, M. [Nuklearmedizinische Klinik mit Poliklinik und Neurologische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Michalik, K. [Nuklearmedizinische Klinik mit Poliklinik und Neurologische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Schueler, P. [Nuklearmedizinische Klinik mit Poliklinik und Neurologische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Platsch, G. [Nuklearmedizinische Klinik mit Poliklinik und Neurologische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Stefan, H. [Nuklearmedizinische Klinik mit Poliklinik und Neurologische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Wolf, F. [Nuklearmedizinische Klinik mit Poliklinik und Neurologische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany)

    1997-06-01

    In the Federal Republic of Germany it is assumed that about 80 000 patients suffer from a focal form of epilepsy which can not be sufficiently controlled with medication. As potential candidates for surgery, these patients undergo stepwise monitoring procedure in which the epileptic focus is located by means of increasingly invasive methods. In Erlangen the periictal SPECT is performed, whereby the perfusion tracer is injected after onset (ictal SPECT), immediately after cessation of the seizure (postictal scan) or between the seizures (interictal scan). To administer the tracer strongly in ictal or postictal state a close functional cooperation between the neurology and nuclear medicine department must be arranged. Injection inside the monitoring unit must be attuned to federal antiradiation precaution law. In temporal lobe epilepsy, different injection-times demonstrate a large area of hyperperfusion after ictal onset, which refines in the first two postictal minutes to the generating focus together with a decreased parietal blood flow pattern. Later, the entire temporal lobe epilepsy an early tracer injection within 40 seconds has to be achieved, otherwise an ictal propagation into distant brain areas, possibly contralateral, may occur. Extratemporal epilepsy is often linked to trauma or congenital malformations, and is difficult to categorize. In difficult cases with equivocal results, efforts can be undertaken by means of receptor scintigraphy with, for example, iomazenil, to localize the focus as a cold lesion caused by neuronal loss. (orig.) [Deutsch] In der Bundesrepublik Deutschland leiden nach vorsichtigen Schaetzungen ca. 80 000 Patienten an einer fokalen Epilepsieform, die mit Medikamenten nur unzureichend kontrolliert werden kann. Als potentielle Kandidaten fuer einen epilepsiechirurgischen Eingriff werden sie einem intensiven Monitoringverfahren unterzogen, in dem stufenweise nach dem Grad der Invasivitaet gesteigert, verschiedene Moeglichkeiten zu

  19. 发作间期PET显像与发作期SPECT显像在癫痫灶定位中的应用%Associated application studies of epileptic interictal PET and ictal SPECT brain imaging

    Institute of Scientific and Technical Information of China (English)

    吴金陵; 李家敏; 李树生; 孙爱君; 刘健; 苏富勇

    2001-01-01

    目的探讨发作间期PET显像与发作期SPECT显像在癫痫灶定位中的的特点和相关性.方法对54例癫痫患者行发作间期PET和发作期SPECT 2次检查,对结果进行对比分析.结果54例发作间期PET显像示低代谢者中33例(61.1%)表现为单叶局限性低代谢,21例(38.9%)表现为多个病灶或弥漫性改变.发作期SPECT显像50例可见高灌注灶,高灌注中37例(74%)为单叶局限性高灌注,13例(26%)为多个病灶,未见弥漫性高灌注.2项检查比较,46例(85.2%)2项检查结果相符合,其中32例(69.6%)显示为颞叶病灶.发作间期PET示多病灶及弥漫性改变者于发作期SPECT显像时有9例 (42.9%)转化为单叶局限性病灶,7例(33.3%)排除了部分低代谢病灶.结论癫痫灶灌注与代谢改变具有明显的相关性.发作间期PET显像定位癫痫灶解剖结构显示较为清晰,发作期SPECT显像替代发作期PET检查可提高定位特异性.2项检查联合应用可排除非致痫性病变和发作过程中痫性电活动的泛化,具有较好的互补性.

  20. Interictal SPECT in the pre surgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Lucia H.N. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Neurologia. Centro Cirurgico de Epilepsia; Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil); Ferraz-Filho, Jose R.L. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil); Lins-Filho, Mario L.M. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Radiologia; Maciel, Marina G.; Yoshitake, Rafael; Filetti, Sarah V. [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil)

    2009-07-01

    The aim of this study was to evaluate the sensitivity of interictal compared to ictal SPECT in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (TLE) patients that present with normal magnetic resonance imaging (MRI) or bilateral mesial temporal sclerosis (MTS). Thirty patients with TLE, for whom MRI examinations were normal or who presented with bilateral MTS, were retrospectively studied. Using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal SPECTs. In conclusion the interictal SPECT is only useful when associated with the ictal SPECT and does not substitute it in the localization of epileptogenic areas in patients with normal MRI or bilateral MTS. (author)

  1. SPECT and PET imaging in epilepsy; La TEP et la TEMP pour l'etude des epilepsies

    Energy Technology Data Exchange (ETDEWEB)

    Semah, F. [Service Hospitalier Frederic-Joliot, Institut d' Imagerie Biomedicale, Dir. des Sciences du Vivant, Commissariat a l' Energie Atomique, 91 - Orsay (France)

    2007-06-15

    Positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging are very useful for the management of patients with medically refractory partial epilepsy. Presurgical evaluation of patients with medically refractory partial epilepsy often included PET imaging using FDG. The use of SPECT in these patients adds some more information and gives the clinicians the possibility of having ictal imaging. Furthermore, PET and SPECT imaging are performed to better understand the pathophysiology of epilepsy. (authors)

  2. Source localization of rhythmic ictal EEG activity

    DEFF Research Database (Denmark)

    Beniczky, Sándor; Lantz, Göran; Rosenzweig, Ivana

    2013-01-01

    Although precise identification of the seizure-onset zone is an essential element of presurgical evaluation, source localization of ictal electroencephalography (EEG) signals has received little attention. The aim of our study was to estimate the accuracy of source localization of rhythmic ictal ...

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

    Science.gov (United States)

    Grova, C.; Jannin, P.; Biraben, A.; Buvat, I.; Benali, H.; Bernard, A. M.; Scarabin, J. M.; Gibaud, B.

    2003-12-01

    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 found within

  4. SPECT in Focal Epilepsies

    Directory of Open Access Journals (Sweden)

    Roderick Duncan

    2000-01-01

    Full Text Available Brain perfusion changes during seizures were first observed in the 1930s. Single Photon Emission Computed Tomography (SPECT was developed in the 1970s, and tracers suitable for the imaging of regional cerebral perfusion (rCP became available in the 1980s. The method was first used to study rCP in the interictal phase, and this showed areas of low perfusion in a proportion of cases, mainly in patients with temporal lobe epilepsies. However, the trapping paradigm of tracers such as hexamethyl propyleneamine oxime (HMPAO provided a practicable method of studying changes in rCP during seizures, and a literature was established in the late 1980s and early 1990s showing a typical sequence of changes during and after seizures of mesial temporal lobe origin; the ictal phase was associated with large increases in perfusion throughout the temporal lobe, with first the lateral, then the mesial temporal lobe becoming hypoperfused in the postictal phase. Activation and inhibition of other structures, such as the basal ganglia and frontal cortex, were also seen. Studies of seizures originating elsewhere in the brain have shown a variety of patterns of change, according to the structures involved. These changes have been used practically to aid the process of localisation of the epileptogenic zone so that epilepsy surgery can be planned.

  5. Ictal Magnetic Source Imaging in Presurgical Assessment.

    Science.gov (United States)

    Badier, Jean-Michel; Bénar, Christian-George; Woodman, Michael; Cruto, Catarina; Chauvel, Patrick; Bartolomei, Fabrice; Gavaret, Martine

    2016-01-01

    Ictal MEG recordings constitute rare data. The objective of this study was to evaluate ictal magnetic source localization (MSI), using two algorithms: linearly constrained minimum variance (LCMV), a beamforming technique and equivalent current dipole (ECD). Ictal MSI was studied in six patients. Three of them were undergoing post-operative re-evaluation. For all patients, results were validated by the stereoelectroencephalographic (SEEG) definition of the epileptogenic zone (EZ). EZ was quantified using the epileptogenicity index (EI) method, which accounts for both the propensity of a brain area to generate rapid discharges and the time for this area to become involved in the seizure. EI values range from 0 (no epileptogenicity) to 1 (maximal epileptogenicity). Levels of concordance between ictal MSI and EZ were determined as follows: A: ictal MSI localized the site whose value EI = 1, B: MSI localized a part of the EZ (not corresponding to the maximal value of EI = 1), C: a region could be identified on ictal MSI but not on SEEG, D: a region could be identified on SEEG but not on MSI, E: different regions were localized on MSI and SEEG. Ictal MEG pattern consisted of rhythmic activities between 10 and 20 Hz for all patients. For LCMV (first maxima), levels of concordance were A (two cases), B (two cases) and E (two cases). For ECD fitted on each time point separately (location characterized by the best goodness-of-fit value), levels of concordance were A (one case), B (one case), D (three cases) and E (one case). For ECD calculated for the whole time window, levels of concordance were A (two cases) and D (four cases). Source localization methods performed on rhythmic patterns can localize the EZ as validated by SEEG. In terms of concordance, LCMV was superior to ECD. In some cases, LCMV allows extraction of several maxima that could reflect ictal dynamics. In a medial temporal lobe epilepsy case, ictal MSI indicated an area of delayed propagation and was non

  6. Ictal EEG modifications in temporal lobe epilepsy.

    Science.gov (United States)

    Pelliccia, Veronica; Mai, Roberto; Francione, Stefano; Gozzo, Francesca; Sartori, Ivana; Nobili, Lino; Lo Russo, Giorgio; Pizzanelli, Chiara; Tassi, Laura

    2013-12-01

    Temporal lobe epilepsy is the most common type of epilepsy in adults with medically intractable, localisation-related epilepsy, amenable to surgery. Together with clinical and neuroimaging data, presurgical ictal scalp-EEG findings are often sufficient to define the epileptogenic zone. It is widely believed that ictal scalp-EEG findings in temporal lobe epilepsy are represented by 5-9-Hz lateralised rhythmic theta activity or 2-5-Hz lateralised rhythmic delta activity. On the basis of experimental models and experience with intra-cerebral EEG recordings, the pattern of low-voltage fast activity is considered to be the electrophysiological hallmark of the epileptogenic zone. We reviewed the ictal scalp-EEG data relating to 111 seizures in 47 patients with temporal lobe epilepsy who underwent video-EEG recordings during presurgical work-up. We found that 35 patients (74.4%) showed flattening, low-voltage fast activity or fast activity as the initial EEG pattern. When visible, the rhythmic delta or theta activity followed the fast activity. Low-voltage fast activity, flattening or fast activity occurs in the majority of patients with temporal lobe epilepsy and represents the main ictal EEG pattern. Low-voltage fast activity (or similar) is also identifiable as the initial ictal EEG pattern in scalp-EEG recordings.

  7. Ictal kissing with subdural EEG recording.

    Science.gov (United States)

    Alsemari, Abdulaziz; Alotaibi, Faisal; Baz, Salah

    2013-01-01

    Ictal kissing has been described in the literature. Five cases were reported and associated with temporal lobe epilepsy lateralizing to the nondominant hemisphere. A case of ictal kissing was identified. The aim was to demonstrate the clinical, clinical and electrophysiological features (as recorded by subdural electrodes). The surgical procedure, histopathology, and imaging data were reviewed and correlated with the literature. A 29-year-old right-handed female, who presented with ictal right hand left arm dystonic posturing, and lip smacking, was studied. The automatism was usually followed by prolonged emotional gestures and by hugging and kissing her relative and/or attendant nurse. Magnetic resonance imaging of the brain showed right small cortical and subcortical lesions of the right inferior frontal lobe with gliosis but without mass effect and normal-sized hippocampi. The PET scan showed hypometabolism of the right temporal lobe. Neuropsychological evaluation showed deficit in her nonverbal memory. The subdural electrodes showed high amplitude spikes over right mesial temporal lobe strips. The offsite of the ictal discharges was usually at the right frontal strips. Right standard temporal lobectomy with amygdalohippocampectomy and right inferior frontal lesionectomy were performed. The patient continued to be seizure-free for one year postoperatively. Our case report supports with subdural EEG recording the findings of the few reported cases of ictal kissing behavior lateralized to the nondominant hemisphere. However, the affectionate kissing behavior was associated with spread of the epileptic discharges to the right frontal lobe.

  8. Ictal PET in presurgical workup of refractory extratemporal epilepsy

    Directory of Open Access Journals (Sweden)

    Javeria Nooraine

    2013-01-01

    Full Text Available Ictal Pet in presurgical workup of refractory epilepsy is seldom performed and limited due to technical difficulties. In carefully selected patient subset with frequent extratemporal seizures, ictal PET depicts ′seizure onset zone′ with high spatial resolution even within a widespread pathology. We here depict a four year old with posterior quadrant dysplasia evaluated with ictal PET.

  9. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A.R.; Hansen, B.A.; Hogenhaven, H;

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the 'Engel score', was at least 3 years. The data were analyzed in a blind...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation...

  10. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A R; Hansen, B A; Høgenhaven, H;

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the "Engel score", was at least 3 years. The data were analyzed in a blind...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation....

  11. Simple autonomic seizures and ictal enuresis

    DEFF Research Database (Denmark)

    Rosenzweig, Ivana; Varga, Edina T; Akeson, Per

    2011-01-01

    manifestation of the de novo post-traumatic simple autonomic seizures. Source analysis of the ictal epileptiform discharges showed activation of the cortical areas surrounding the right inferior frontal sulcus, adjacent to the lesional zone. The case depicted here further endorses recent neuroimaging studies...

  12. Ictal PET in Ohtahara Syndrome With Hemimegalencephaly.

    Science.gov (United States)

    Roy, Shambo Guha; Tripathi, Madhavi; Tripathi, Manjari; Ramanujam, Bhargavi; Singhal, Abhinav; Bal, Chandrasekhar

    2017-05-01

    Ohtahara syndrome is one of the causes of infantile epilepsies, which presents with refractory seizures and characteristic EEG changes. It is often associated with structural anomalies in the brain. We report a case of 5-month-old girl with Ohtahara syndrome with hemimegalencephaly who presented with refractory seizures and ictal FDG PET/CT helped in localizing the seizure focus.

  13. Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL vs DSC-MRI.

    Science.gov (United States)

    Pizzini, Francesca B; Farace, Paolo; Manganotti, Paolo; Zoccatelli, Giada; Bongiovanni, Luigi G; Golay, Xavier; Beltramello, Alberto; Osculati, Antonio; Bertini, Giuseppe; Fabene, Paolo F

    2013-07-01

    Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment.

  14. Ictal Ceretec studies - the Austin experience

    Energy Technology Data Exchange (ETDEWEB)

    Nerouppos, L.; Scott, A.M.; Parsons, K.; Mihalinac, D.S.; Munoz, P.; McKay, W.J. [Austin Hospital , Heidelberg, VIC (Australia). Departments of Nuclear Medicine and Neurology

    1998-06-01

    Full text: Ictal Ceretec studies play a major role in the patient work-up for surgery of focal epilepsy in the Comprehensive Epilepsy Program at the Austin Hospital. The validity of ictal Ceretec and the superior sensitivity of this technique for the detection of epileptic foci over post-ictal and inter-ictal studies are well documented. Over the past eight years our experience and close collaboration with the Comprehensive Epilepsy Program has led to the implementation of a streamlined program enabling ictal Ceretec to be performed on numerous patients. The patients on this program since October 1991 will be reviewed and quality assurance (QA) results will be addressed. Ceretec is stored in a special lead-lined container in the video monitoring rooms, together with a shielded syringe of freshly eluted pre-calibrated technetium. Once a seizure is detected, the medical staff prepare the Ceretec and inject the required volume, obtained from the pre-calibration sheet, through a previously inserted in-dwelling line. The ward staff record the time of injection, the estimated duration of the seizure, the clinical impression of the seizure and the suspected focus. The injection tray is brought to the department within thirty minutes, where the patient injected dose is determined and quality control is performed. The scan is performed on a triple-headed Trionix gamma camera and reported once EEG and video recordings obtained during the ictus confirm the nature of the seizure. The advantages of this program are numerous. Many modifications have been made to the program over the past three years, due to close inspection of the QA forms. Ward and nuclear medicine staff deal with problems promptly, ensuring an effective and efficient program

  15. Ictal kissing behavior: neurological and psychodynamic overview.

    Science.gov (United States)

    Taşkıran, Emine; Özmen, Mine; Kılıc, Özge; Sentürk, Aslı; Özkara, Cigdem

    2013-11-01

    This study is based on the psychodynamic and neurological analysis of three Turkish patients who displayed ictal kissing automatism during their seizures. To unveil the probable underlying causes of their kissing behaviors, all patients underwent psychiatric interviews after being evaluated by ictal video-EEG recordings. The group consisted of two females (ages 35 and 29) and one male (age 26). In addition to prominent oral automatisms, each patient also displayed behaviors of kissing or blowing kisses to individuals at close proximity. Seizures were related to the right temporal lobe in two patients and the left temporal lobe in one patient. Magnetic resonance imaging showed mesial temporal sclerosis in two of the patients (one left, one right) and was normal in one. According to the DSM-IV-TR criteria, each of the three patients also suffered from major depression, while the psychodynamic interviews revealed traumatic childhood histories and intense unfulfilled affective needs. © 2013.

  16. Focal epilepsy with ictal abdominal pain: a case report.

    Science.gov (United States)

    Cerminara, Caterina; El Malhany, Nadia; Roberto, Denis; Curatolo, Paolo

    2013-12-09

    Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed us to make a diagnosis of focal epilepsy with ictal abdominal pain. This is a rare epileptic phenomenon that should be suspected in patients with unexplained paroxysmal abdominal pain and migraine-like symptoms. We suggest that, after the exclusion of more common etiologies, focal epilepsy with ictal abdominal pain should be considered in patients with paroxysmal abdominal pain and ictal EEG abnormalities.

  17. Unusual ictal foreign language automatisms in temporal lobe epilepsy.

    Science.gov (United States)

    Soe, Naing Ko; Lee, Sang Kun

    2014-12-01

    The distinct brain regions could be specifically involved in different languages and the differences in brain activation depending on the language proficiency and on the age of language acquisition. Speech disturbances are observed in the majority of temporal lobe complex motor seizures. Ictal verbalization had significant lateralization value: 90% of patients with this manifestation had seizure focus in the non-dominant temporal lobe. Although, ictal speech automatisms are usually uttered in the patient's native language, ictal speech foreign language automatisms are unusual presentations of non-dominent temporal lobe epilepsy. The release of isolated foreign language area could be possible depending on the pattern of ictal spreading of non-dominant hemisphere. Most of the case reports in ictal speech foreign language automatisms were men. In this case report, we observed ictal foreign language automatisms in middle age Korean woman.

  18. Ictal autoscopic phenomena and near death experiences: a study of five patients with ictal autoscopies.

    Science.gov (United States)

    Hoepner, Robert; Labudda, Kirsten; May, Theodor W; Schoendienst, Martin; Woermann, Friedrich G; Bien, Christian G; Brandt, Christian

    2013-03-01

    Autoscopic phenomena in general may-among other conditions-occur during epileptic seizures and near death experiences. We set the hypothesis that ictal autoscopic phenomena and near death experiences have a similar semiology as measured by the Near Death Experience Questionnaire. We also investigated whether patients with aura before temporal lobe seizures with or without autoscopic phenomena could be distinguished by this questionnaire. For these purposes, we examined five patients with ictal autoscopy and 12 patients with aura before temporal lobe seizures without ictal autoscopy as controls. We used a cut-off of 7 points or higher on the Near Death Experience Questionnaire for indicating the semiology of a near death experience and for distinguishing patients with ictal autoscopy from controls. This cut-off separated patients with ictal autoscopic phenomena from aura before temporal lobe seizures without autoscopy (p = 0.0002, two-sided, exact Fisher's Test; specificity: 100 % [CI95 % 77.9 and 100 %], sensitivity: 100 % [CI95 % 54.9 and 100 %]). Furthermore, all autoscopic patients (range 7-10) and none of the controls (range 0-5) had scores of 7 points or higher. Thus, the individual experiences during simple partial autoscopic seizures and near death experiences are similar, at least in some prominent aspects. These findings might be of particular interest for the pathophysiology of near death experiences, as all patients with ictal autoscopic phenomena had an epileptic dysfunction at the temporo-parietal junction or its neighboring regions. Therefore, a malfunction of this brain region might also be involved in near death experiences of other origins especially during states which could cause a near death experience and a cerebral excitability.

  19. Peri-ictal QTc changes are not associated with hypoxemia.

    Science.gov (United States)

    Moseley, Brian D; Britton, Jeffrey W

    2014-07-01

    It has previously been suggested that abnormalities in cardiac repolarization (QTc lengthening and shortening) are more likely to accompany seizures with hypoxemia and may be involved in sudden unexpected death in epilepsy (SUDEP). Accordingly, we evaluated for associations between peri-ictal QTc changes and hypoxemia. We performed a reanalysis of cardiac and respiratory data gathered prospectively in our epilepsy monitoring units. The Bazett, Fridericia, Framingham, and Hodges heart rate correction formulas were utilized to calculate QTc in the pre-ictal, ictal, and post-ictal periods. Hypoxemia (defined as a drop in oxygen saturation below 90% for at least four contiguous seconds) was also examined during identical periods. Fifty-eight seizures from 29 patients were analyzed. Peri-ictal hypoxemia was not rare, occurring in 18/58 (31%) seizures. QTc lengthening was more commonly observed than shortening, with 11/58 (19%) seizures demonstrating peri-ictal QTc values≥500 using the Bazett formula. There was no significant difference between the minimum and maximum QTc values in seizures with and without peri-ictal hypoxemia, regardless of the correction formula utilized. All examined parameters of QTc lengthening and shortening were not associated with peri-ictal hypoxemia. This suggests that factors other than hypoxia result in peri-ictal cardiac repolarization abnormalities.

  20. The effective connectivity of the seizure onset zone and ictal perfusion changes in amygdala kindled rhesus monkeys.

    Science.gov (United States)

    Cleeren, Evy; Premereur, Elsie; Casteels, Cindy; Goffin, Karolien; Janssen, Peter; Van Paesschen, Wim

    2016-01-01

    Epileptic seizures are network-level phenomena. Hence, epilepsy may be regarded as a circuit-level disorder that cannot be understood outside this context. Better insight into the effective connectivity of the seizure onset zone and the manner in which seizure activity spreads could lead to specifically-tailored therapies for epilepsy. We applied the electrical amygdala kindling model in two rhesus monkeys until these animals displayed consistent stage IV seizures. At this stage, we investigated the effective connectivity of the amygdala by means of electrical microstimulation during fMRI (EM-fMRI). In addition, we imaged changes in perfusion during a seizure using ictal SPECT perfusion imaging. The spatial overlap between the connectivity network and the ictal perfusion network was assessed both at the regional level, by calculating Dice coefficients using anatomically defined regions of interest, and at the voxel level. The kindled amygdala was extensively connected to bilateral cortical and subcortical structures, which in many cases were connected multisynaptically to the amygdala. At the regional level, the spatial extents of many of these fMRI activations and deactivations corresponded to the respective increases and decreases in perfusion imaged during a stage IV seizure. At the voxel level, however, some regions showed residual seizure-specific activity (not overlapping with the EM-fMRI activations) or fMRI-specific activation (not overlapping with the ictal SPECT activations), indicating that frequently, only a part of a region anatomically connected to the seizure onset zone participated in seizure propagation. Thus, EM-fMRI in the amygdala of electrically-kindled monkeys reveals widespread areas that are often connected multisynaptically to the seizure focus. Seizure activity appears to spread, to a large extent, via these connected areas.

  1. Comparison of ictal and interictal EEG signals using fractal features.

    Science.gov (United States)

    Wang, Yu; Zhou, Weidong; Yuan, Qi; Li, Xueli; Meng, Qingfang; Zhao, Xiuhe; Wang, Jiwen

    2013-12-01

    The feature analysis of epileptic EEG is very significant in diagnosis of epilepsy. This paper introduces two nonlinear features derived from fractal geometry for epileptic EEG analysis. The features of blanket dimension and fractal intercept are extracted to characterize behavior of EEG activities, and then their discriminatory power for ictal and interictal EEGs are compared by means of statistical methods. It is found that there is significant difference of the blanket dimension and fractal intercept between interictal and ictal EEGs, and the difference of the fractal intercept feature between interictal and ictal EEGs is more noticeable than the blanket dimension feature. Furthermore, these two fractal features at multi-scales are combined with support vector machine (SVM) to achieve accuracies of 97.58% for ictal and interictal EEG classification and 97.13% for normal, ictal and interictal EEG classification.

  2. Peri-ictal signal changes in seven patients with status epilepticus: interesting MRI observations

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, Manoj K.; Sinha, Sanjib [National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurology, Bangalore, Karnataka (India); Ravishankar, Shivshankar; Shivshankar, Jai Jai [National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neuroimaging and Interventional Radiology, Bangalore (India)

    2009-03-15

    Transient peri-ictal changes on imaging had been described following status epilepticus (SE), but its cause is not very well understood. We analyzed the magnetic resonance imaging (MRI) findings in SE patients in order to elucidate such changes including peri-ictal signal. This prospective study involved 34 patients (M/F 23:11, mean age 25.8 {+-} 17.2 years) who experienced SE. MRI was performed during or within 96 h of cessation of seizures. Twenty-five patients had generalized convulsive status epilectus (GCSE; ten secondary GCSE and 15 primary GCSE). Seven patients had epilepsia partialis continua and two patients non-convulsive SE. Eight patients had a history of seizures and three patients previous SE. The mean duration of SE prior to MRI was 89.2 {+-} 105.3 h (range 2-360 h). MRI provided diagnosis in 17 patients, and in 13 patients, no structural cause was identified. Peri-ictal focal signal changes with restricted diffusion on apparent diffusion coefficient maps were present in seven (20.6%) patients with SE (generalized convulsive, three; partial, three; non-convulsive, one). The changes were observed when MRI was performed during SE in 3/10 (30%) patients, or within 24 h in 1/7 (14.3%), 48 h in 1/5 (20%), 72 h in 1/6 (16.7%), or 96 h in 1/6 (16.7%) patients after cessation of seizures. Repeat MRI revealed disappearance of signal changes in two patients. Peri-ictal MR changes with restricted diffusion appear to be an effect rather than the cause of SE. (orig.)

  3. Field effects and ictal synchronization: insights from in homine observations.

    Science.gov (United States)

    Weiss, Shennan A; McKhann, Guy; Goodman, Robert; Emerson, Ronald G; Trevelyan, Andrew; Bikson, Marom; Schevon, Catherine A

    2013-12-05

    It has been well established in animal models that electrical fields generated during inter-ictal and ictal discharges are strong enough in intensity to influence action potential firing threshold and synchronization. We discuss recently published data from microelectrode array recordings of human neocortical seizures and speculate about the possible role of field effects in neuronal synchronization. We have identified two distinct seizure territories that cannot be easily distinguished by traditional EEG analysis. The ictal core exhibits synchronized neuronal burst firing, while the surrounding ictal penumbra exhibits asynchronous and relatively sparse neuronal activity. In the ictal core large amplitude rhythmic ictal discharges produce large electric fields that correspond with highly synchronous neuronal firing. In the penumbra rhythmic ictal discharges are smaller in amplitude, but large enough to influence spike timing, yet neuronal synchrony is not observed. These in homine observations are in accord with decades of animal studies supporting a role of field effects in neuronal synchronization during seizures, yet also highlight how field effects may be negated in the presence of strong synaptic inhibition in the penumbra.

  4. Field effects and ictal synchronization: insights from in homine observations.

    Directory of Open Access Journals (Sweden)

    Shennan Aibel Weiss

    2013-12-01

    Full Text Available It has been well established in animal models that electrical fields generated during inter-ictal and ictal discharges are strong enough in intensity to influence action potential firing threshold and synchronization. We discuss recently published data from microelectrode array recordings of human neocortical seizures and what they imply about the possible role of field effects in neuronal synchronization. We have identified two distinct seizure territories that cannot be easily distinguished by traditional EEG analysis. The ictal core exhibits synchronized neuronal burst firing, while the surrounding ictal penumbra exhibits asynchronous and relatively sparse neuronal activity. In the ictal core large amplitude rhythmic ictal discharges produce large electric fields that correspond with relatively synchronous neuronal firing. In the penumbra rhythmic ictal discharges are smaller in amplitude, but large enough to influence spike timing, yet neuronal synchrony is not observed. These in homine observations are in accord with decades of animal studies supporting a role of field effects in neuronal synchronization during seizures, yet also highlight how field effects may be negated in the presence of strong synaptic inhibition in the penumbra.

  5. 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.)

  6. A child with ictal vocalizations and generalized epilepsy.

    Science.gov (United States)

    Kurian, Mary; Heritier Barras, Anne-Chantal; Korff, Christian M

    2015-03-01

    Ictal vocalizations in the form of both articulate speech and non-speech vocalizations have been described in focal epilepsies, with seizures originating mainly from the frontal and temporal lobe, however, this phenomenon has not been described in generalized epilepsies. We report the case of an adolescent boy with juvenile-onset generalized epilepsy who presented with ictal "ovine vocalizations" (resembling the bleating of sheep). The ictal EEG revealed a clear correlate of vocalizations with time-locked generalized spikes and polyspike discharges. The 3T cerebral MRI ruled out any focal lesion. The boy is currently seizure-free under valproic acid, after twelve months of follow-up. We conclude that ictal non-speech vocalizations may be observed not only in focal or structural epilepsies, but also in generalized epilepsies; the exact underlying mechanism of this phenomenon needs to be further delineated. [Published with video sequence].

  7. Ictal EEG/fMRI study of vertiginous seizures.

    Science.gov (United States)

    Morano, Alessandra; Carnì, Marco; Casciato, Sara; Vaudano, Anna Elisabetta; Fattouch, Jinane; Fanella, Martina; Albini, Mariarita; Basili, Luca Manfredi; Lucignani, Giulia; Scapeccia, Marco; Tomassi, Regina; Di Castro, Elisabetta; Colonnese, Claudio; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2017-03-01

    Vertigo and dizziness are extremely common complaints, related to either peripheral or central nervous system disorders. Among the latter, epilepsy has to be taken into consideration: indeed, vertigo may be part of the initial aura of a focal epileptic seizure in association with other signs/symptoms, or represent the only ictal manifestation, a rare phenomenon known as "vertiginous" or "vestibular" seizure. These ictal symptoms are usually related to a discharge arising from/involving temporal or parietal areas, which are supposed to be a crucial component of the so-called "vestibular cortex". In this paper, we describe three patients suffering from drug-resistant focal epilepsy, symptomatic of malformations of cortical development or perinatal hypoxic/ischemic lesions located in the posterior regions, who presented clusters of vertiginous seizures. The high recurrence rate of such events, recorded during video-EEG monitoring sessions, offered the opportunity to perform an ictal EEG/fMRI study to identify seizure-related hemodynamic changes. The ictal EEG/fMRI revealed the main activation clusters in the temporo-parieto-occipital regions, which are widely recognized to be involved in the processing of vestibular information. Interestingly, ictal deactivation was also detected in the ipsilateral cerebellar hemisphere, suggesting the ictal involvement of cortical-subcortical structures known to be part of the vestibular integration network. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Peri-ictal and inter-ictal headache in children and adolescents with idiopathic epilepsy: a multicenter cross-sectional study.

    Science.gov (United States)

    Verrotti, Alberto; Coppola, Giangennaro; Spalice, Alberto; Di Fonzo, Alessia; Bruschi, Raffaella; Tozzi, Elisabetta; Iannetti, Paola; Villa, Maria Pia; Parisi, Pasquale

    2011-09-01

    Headache in epileptic population ranges from 8% to 15%. The aim of this paper was to study the clinical and temporal characteristics of primary headache comorbidity in idiopathic epileptic children. From June 2006 to June 2009, a cross-sectional multi-center study involving five Italian Child Neurology University Centers (two in Rome, one in Chieti, one in Naples, and one in L'Aquila) was conducted. Among 1,264 consecutively newly diagnosed, idiopathic, partial, or generalized, epileptic children, according to ILAE diagnostic criteria (aged between 5 and 15 years of age), we selected 142 children (11.2%) (130 of whom completed the study) who showed an associated peri-ictal and/or inter-ictal headache diagnosed according to the International Headache Society Criteria. Rare cases of "ictal epileptic headache", in which headache represents the sole ictal epileptic manifestation, were excluded from this study. Post-ictal headaches were most frequent (62%). Pre-ictal headaches were less common (30%). Inter-ictal headaches were described in 57.6%. Clear migrainous features were present in 93% of pre-ictal and 81.4% of post-ictal headaches. Inter-ictal headaches meet criteria for migraines in 87%. The association between partial epilepsy and migraine without aura is most common and reported in 82% of our patients with peri-ictal headache and in 76.5% of patients with post-ictal headache.

  9. Ictal alterations of consciousness during ecstatic seizures.

    Science.gov (United States)

    Picard, Fabienne; Kurth, Florian

    2014-01-01

    Patients with ecstatic epileptic seizures report an altered consciousness, which they describe as a sense of heightened perception of themselves – they “feel very present” – and an increased vividness of sensory perceptions. Recently, the anterior insula has been proposed as the region where these seizures originate, based on the results of ictal nuclear imaging in three patients, the first induction of ecstatic auras by electrical stimulation, and the functional characteristics of the anterior insula in neuroimaging literature. Specifically, the anterior insula is thought to play a key role in integrating information from within the body, the external world, as well as the emotional states. In addition, the anterior insula is thought to convert this integrated information into successive global emotional moments, thus enabling both the construct of a sentient self as well as a mechanism for predictive coding. As part of the salience network, this region is also involved in switching from mind wandering toward attentional and executive processing. In this review, we will summarize previous patient reports and recap how insular functioning may be involved in the phenomenon of ecstatic seizures. Furthermore, we will relate these hypotheses to the results from research on meditation and effects of drug abuse.

  10. Ictal movements mimicking Islamic praying rituals: localizing value in a series of 12 patients.

    Science.gov (United States)

    Vural, Gonul; Irsel Tezer, F; Saygi, Serap

    2015-12-01

    The aim of this study was to determine the lateralizing value of the ictal praying gesture and of ictal religious speech in patients who are candidates for epilepsy surgery. We retrospectively searched video/EEG data of 1430 patients who were evaluated at an epilepsy center from 1999 to 2014. Twelve patients were found to have demonstrated ictal praying during their complex partial seizures. Among all patients, the ictal focus was in the right temporal region. Ictal behavior simulating prayer, which includes both hands as in the Islamic ritual tradition is a rare automatism that lateralizes the ictal focus.

  11. EEG, MRI, and SPECT in epilepsy. Relative contributions to preoperative evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Gaku [Luoyang Medical Coll. Associated Hospital (China); Hoshida, Tohru; Goda, Kazuo; Hashimoto, Hiroshi; Nakase, Hiroyuki; Hirabayashi, Hidehiro; Kawaguchi, Shoichiro; Morimoto, Tetsuya; Sakaki, Toshisuke

    1998-07-01

    We comparatively assessed detection of epileptogenic areas on preoperative evaluation in 33 patients with intractable partial epilepsy using scalp interictal and ictal electroencephalography (EEG), magnetic resonance imaging (MRI), and interictal single photon emission computed tomography (SPECT). There are 22 temporal and 11 extratemporal lobe epilepsies. All or almost of their seizures have stopped after resective surgery for more than 12 months follow-up period, averaged 43 months. MRI studies demonstrated 21 organic lesions, 11 mesial temporal sclerosis and one patient showed normal brain tissue. Scalp EEG could correctly identify the focus in 14 of 33 cases (42%), interictal SPECT in 18 of 26 (69%), MRI in 29 of 33 (88%), interictal scalp EEG-video monitoring in 17 of 24 (71%), and ictal scalp EEG-video monitoring in 15 of 22 (68%). Although neuroimaging studies, especially MRI, are useful to detect not only localization of epileptic lesions but also epileptogenic focus, for example, mesial temporal sclerosis, the exact localization of epileptogenic areas could be done by comprehensive evaluation including ictal scalp EEG-video monitoring. (author)

  12. Recurrence risk of ictal asystole in epilepsy.

    Science.gov (United States)

    Hampel, Kevin G; Thijs, Roland D; Elger, Christian E; Surges, Rainer

    2017-08-22

    To determine the recurrence risk of ictal asystole (IA) and its determining factors in people with epilepsy. We performed a systematic review of published cases with IA in 3 databases and additionally searched our local database for patients with multiple seizures simultaneously recorded with ECG and EEG and at least one IA. IA recurrence risk was estimated by including all seizures without knowledge of the chronological order. Various clinical features were assessed by an individual patient data meta-analysis. A random mixed effect logistic regression model was applied to estimate the average recurrence risk of IA. Plausibility of the calculated IA recurrence risk was checked by analyzing the local dataset with available information in chronological order. Eighty patients with 182 IA in 537 seizures were included. Recurrence risk of IA amounted to 40% (95% confidence interval [CI] 32%-50%). None of the clinical factors (age, sex, type and duration of epilepsy, hemispheric lateralization, duration of IA per patient) appeared to have a significant effect on the short-term recurrence risk of IA. When considering the local dataset only, IA recurrence risk was estimated to 30% (95% CI 14%-53%). Information whether IA coincided with symptoms (i.e., syncope) or not was given in 60 patients: 100 out of 142 IAs were symptomatic. Our data suggest that in case of clinically suspected IA, the recording of 1 or 2 seizures is not sufficient to rule out IA. Furthermore, the high short-term recurrence risk favors aggressive treatment, including pacemaker implantation if seizure freedom cannot be achieved. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  13. {sup 1}H MR spectroscopic imaging in patients with MRI-negative extratemporal epilepsy: correlation with ictal onset zone and histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Krsek, Pavel; Komarek, Vladimir [Charles University, Department of Pediatric Neurology, Second Medical School, Motol Hospital, Prague (Czech Republic); Hajek, Milan [Institute for Clinical and Experimental Medicine, MR Unit, Department of Diagnostic and Interventional Radiology, Prague (Czech Republic); Institute for Clinical and Experimental Medicine, MR Spectroscopy, Prague 4 (Czech Republic); Dezortova, Monika; Jiru, Filip; Skoch, Antonin [Institute for Clinical and Experimental Medicine, MR Unit, Department of Diagnostic and Interventional Radiology, Prague (Czech Republic); Marusic, Petr [Charles University, Department of Neurology, Second Medical School, Motol Hospital, Prague (Czech Republic); Zamecnik, Josef [Charles University, Department of Pathology and Molecular Medicine, Second Medical School, Motol Hospital, Prague (Czech Republic); Kyncl, Martin [Charles University, Department of Radiology, Second Medical School, Motol Hospital, Prague (Czech Republic); Tichy, Michal [Charles University, Department of Pediatric Neurosurgery, Second Medical School, Motol Hospital, Prague (Czech Republic)

    2007-08-15

    Proton magnetic resonance spectroscopy ({sup 1}H MRS) is beneficial in the lateralization of the epileptogenic zone in temporal lobe epilepsy; however, its role in extratemporal and, especially, MRI-negative epilepsy has not been established. This study seeks to verify how {sup 1}H MRS could help in localizing the epileptogenic zone in patients with MRI-negative extratemporal epilepsy. Seven patients (8-23 years) with MRI-negative refractory focal epilepsy were studied using {sup 1}H MRS on a 1.5T MR system. Chemical shift imaging sequence in the transversal plane was directed towards the suspected epileptogenic zone localized by seizure semiology, scalp video/EEG, ictal SPECT and {sup 18}FDG-PET. Spectra were evaluated using the program CULICH, and the coefficient of asymmetry was used for quantitative lateralization. MRS detected lateralization in all patients and was able to localize pathology in five. The most frequent findings were decreased ratios of N-acetylaspartate to choline compounds characterized by increasing choline concentration. The localization of the {sup 1}H MRS abnormality correlated well with ictal SPECT and subdural mapping. In all cases, histopathological analysis revealed MRI-undetected focal cortical dysplasias. {sup 1}H MRS could be more sensitive for the detection of discrete malformations of cortical development than conventional MRI. It is valuable in the presurgical evaluation of patients without MRI-apparent lesions. (orig.)

  14. Pitfalls in ictal EEG interpretation: critical care and intracranial recordings.

    Science.gov (United States)

    Gaspard, Nicolas; Hirsch, Lawrence J

    2013-01-01

    EEG is the cornerstone examination for seizure diagnosis, especially nonconvulsive seizures in the critically ill, but is still subject to many errors that can lead to a wrong diagnosis and unnecessary or inadequate treatment. Many of these pitfalls to EEG interpretation are avoidable. This article reviews common errors in EEG interpretation, focusing on ictal or potentially ictal recordings obtained in critically ill patients. Issues discussed include artifacts, nonepileptic events, equivocal EEG patterns seen in comatose patients, and quantitative EEG artifacts. This review also covers some difficulties encountered with intracranial EEG recordings in patients undergoing epilepsy surgery, including issues related to display resolution.

  15. MRI in temporal lobe epilepsy. Correlation between EEG, SPECT and clinical features

    Energy Technology Data Exchange (ETDEWEB)

    Uesugi, Hideji; Onuma, Teiichi; Matsuda, Hiroshi; Ishida, Shiro [National Center Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo (Japan)

    1996-02-01

    The relationship between MRI, SPECT, EEG and clinical features in temporal lobe epilepsy was investigated. Subjects were 162 patients (84 males, 78 females) whose average age was 38.1{+-}12.1 years. SPECT was carried out in 45 patients. The results were as follows: abnormal MR images were obtained in 36% of the group without epileptic discharge, and in 42% of the group with temporal spikes. There was no correlation between epileptic discharge in EEG and MRI abnormality. The lateralities of epileptic discharge and MRI were in disagreement in 9 of 39 patients (23%), indicating that determining the epileptic focus from scalp EEG was difficult. There was no correlation between the basic activity in EEG and abnormality in MRI. The rate of abnormal SPECT (89%) was higher than that of abnormal MRI (40%). The rate of the group with ictal automatism (52%) was higher than that of the group without ictal automatism (35%). The rate of abnormal MR images was high in the group with encephalitis (73%). The rate was higher in the group with febrile convulsion (62%) than in the group without it (28%). The rate of the abnormal MR images was higher in the group with a seizure frequency of at least several mal/month (48%) than in the group with a seizure frequency of less than several mal/year (29%). (author).

  16. Comparison and spacial correlation of interictal HMPAO-SPECT and FDG-PET in intractable temporal lobe epilepsy.

    Science.gov (United States)

    Coubes, P; Awad, I A; Antar, M; Magdinec, M; Sufka, B

    1993-06-01

    The respective contribution of interictal HMPAO-SPECT and FDG-PET to the imaging of the epileptogenic zone in intractable temporal lobe epilepsy is not known. Ten consecutive patients with drug resistant focal epilepsy of temporal lobe origin were studied with prolonged noninvasive video-EEG monitoring, magnetic resonance imaging, interictal FDG-PET and HMPAO-SPECT. Five patients demonstrated unitemporal and 5 patients bitemporal interictal and/or ictal EEG epileptiform abnormalities. We developed a 3-dimensional semiquantitative method for interpretation and comparison of FDG-PET and HMPAO-SPECT using a 15-compartment model of the temporal lobe. In all 5 patients with unilateral epileptogenicity, interictal hypometabolism and hypoperfusion were recorded on the side of the EEG abnormalities without discrepancy between PET and SPECT. The severity and the extent of focal abnormalities were consistently greater on PET than on SPECT, in agreement with previously well documented better 'sensitivity' of PET. Among the 5 patients with bitemporal epileptogenicity, results of SPECT and PET were convergent in only 2 cases. In this group, SPECT abnormalities appeared more profound but either SPECT or PET were not constantly correlated with the side of predominant EEG epileptogenicity. Abnormalities on PET and SPECT were more frequently limited to mesiobasal structures among cases with unilateral epileptogenicity and tended to involve neocortical structures in bitemporal cases. We conclude that interictal FDG-PET and HMPAO-SPECT provide the same type of information on the side of the epileptogenic zone in cases with clearly unilateral epileptogenicity, with abnormalities more intense and more extensive on PET.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Dynamics of epileptic phenomena determined from statistics of ictal transitions

    NARCIS (Netherlands)

    Suffczynski, P.; Silva, F.H.L. da; Parra, J.; Velis, D.N.; Bouwman, B.M.; Rijn, C.M. van; Hese, P. van; Boon, P.; Khosravani, H.; Derchansky, M.; Carlen, P.; Kalitzin, S.

    2006-01-01

    In this paper, we investigate the dynamical scenarios of transitions between normal and paroxysmal state in epilepsy. We assume that some epileptic neural network are bistable i.e., they feature two operational states, ictal and interictal that co-exist. The transitions between these two states may

  18. [Complex partial status epilepticus with recurrent episodes of complex visual hallucinations: study by using 123I-IMP-SPECT, brain MRI and EEG].

    Science.gov (United States)

    Sakai, Toshiyuki; Kondo, Masahide; Tomimoto, Hidekazu

    2015-01-01

    We report a 72-year-old woman with complex partial status epilepticus who showed recurrent episodes of complex visual hallucinations (CVH). Brain diffusion-weighted magnetic resonance images revealed gyriform cortical hyperintensity in the right parietal, occipital and temporal lobes, and brain magnetic resonance angiograhy revealed a hyperintensity in the right dilated middle cerebral artery during ictal period. Ictal N-isopropyl-p-(iodine-123)-iodoamphetamine single photon emission computed tomography (123I-IMP-SPECT) with three-dimensional stereotactic surface projection (3D-SSP) 14 days after the onset of the first CVH revealed hyperperfusion in the right latero-inferior occipito-temporal region with relation to motion. CVH spontaneously subsided 17 days after the onset of the first CVH. CVH recurred one year after the first CVH. Ictal 123I-IMP-SPECT with 3D-SSP revealed marked hyperperfusion in the right lateral parietal region probably with relation to face and figure hallucinations. Ictal scalp EEGs revealed rhythmic polyspikes at 12 Hz with high amplitude (100-200 μV) in bilateral posterior occipital and temporal region with the right side dominance for 20 seconds and more in several occasions. Interictal 123I-IMP-SPECT with 3D-SSP 28 days after recurrence of CVH revealed marked hypoperfusion in the right lateral parietal region, and recovery of hypoperfusion in the right latero-inferior occipito-temporal region. These findings suggest that ictal CVH might be induced by the spread of epileptic discharges from the right parieto-occipito-temporal region with the old brain contusion (epileptogenic region) to the right latero-inferior occipito-temporal region and the right lateral parietal region (symptomatogenic regions).

  19. 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)

  20. Unilateral Eye Blinking Arising From the Ictal Ipsilateral Occipital Area.

    Science.gov (United States)

    Falsaperla, Raffaele; Perciavalle, Valentina; Pavone, Piero; Praticò, Andrea Domenico; Elia, Maurizio; Ruggieri, Martino; Caraballo, Roberto; Striano, Pasquale

    2016-07-01

    We report on an 18-month-old boy with unilateral left eye blinking as a single ictal manifestation without facial twitching. The clinical onset of this phenomenon was first recorded (as an occasional event) at age 3 months, and it was overlooked. By age 6 months, the child's blinking increased to almost daily occurrence in clusters: during blinking the infant showed intact awareness and occasional jerks in the upper limbs and right leg. A video-electroencephalography (video-EEG) documented clinical correlation with a focal pattern arising from the left occipital region, and brain magnetic resonance imaging (MRI) revealed severe brain damage, consisting in poroencephalic hollows and increased spaces in the convexities involving a large area of the left cerebral hemisphere. The boy was prescribed sodium valproate (30 mg/kg/d), resulting in drastic reduction of his clinical seizures. Follow-up to his current age documented good general status, with persistent partial right hemilateral seizures. The blinking progressively disappeared, and is no longer recorded. The pathogenic hypotheses of the unilateral ictal blinking include involvement of the ipsilateral cerebral hemisphere and/or the cerebellar pathways. Review of previous reports of unilateral eye blinking, arising from the ictal ipsilateral brain, revealed that different damaged regions may give rise to blinking ictal phenomena, likely via the trigeminal fibres innervating the subdural intracranial structures and the pial vessels in the ipsilateral affected brain. The eye blinking in the present child represents a further example of an ictal phenomenon, which is predictive of the damaged brain region.

  1. Semi-automatic Epileptic Hot Spot Detection in ECD brain SPECT images

    Science.gov (United States)

    Papp, Laszlo; Zuhayra, Maaz; Henze, Eberhard

    A method is proposed to process ECD brain SPECT images representing epileptic hot spots inside the brain. For validation 35 ictal —interictal patient image data were processed. The images were registered by a normalized mutual information method, then the separation of the suspicious and normal brain areas were performed by two threshold-based segmentations. Normalization between the images was performed by local normal brain mean values. Based on the validation made by two medical physicians, minimal human intervention in the segmentation parameters was necessary to detect all epileptic spots and minimize the number of false spots inside the brain.

  2. 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.

  3. Ictal Asystole in Focal Epilepsy: To Pace or Not to Pace?

    Science.gov (United States)

    Newey, Christopher R; Sarwal, Aarti

    2015-10-01

    Ictal bradyarrhythmias are rare episodes occurring in patients with or without a past cardiac history. These episodes go unnoticed unless the patient is monitored on simultaneous video-electroencephalogram and 1-lead electrocardiogram. Recognizing ictal bradyarrhythmias is important, since episodes may predispose patients to sudden, unexplained death in epilepsy. We present 2 cases of ictal asystole in patients with right temporal lobe epilepsy. The first patient had seizures refractory to medical therapy and received a pacemaker. The seizures in the second patient responded well to antiepileptic medication, and a pacemaker was deferred. These cases highlight the differing cardiovascular treatment options for ictal asystole.

  4. 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.

  5. 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.

  6. Preictal and ictal neurovascular and metabolic coupling surrounding a seizure focus.

    Science.gov (United States)

    Zhao, Mingrui; Nguyen, John; Ma, Hongtao; Nishimura, Nozomi; Schaffer, Chris B; Schwartz, Theodore H

    2011-09-14

    Epileptic events initiate a large focal increase in metabolism and cerebral blood flow (CBF) to the ictal focus. In contrast, decreases in CBF have been demonstrated surrounding the focus, the etiology of which is unknown (i.e., arising either from active shunting of blood or passive steal). The relationship between these events and neuronal activity and metabolism are also unknown. We investigated neurovascular and neurometabolic coupling in the ictal surround using optical imaging of light scattering and cerebral blood volume, autofluorescence flavoprotein imaging (AFI), direct measurements of the cortical metabolic rate of oxygen and two-photon imaging of blood vessel diameter in a rat model of ictal events elicited with focal injection of 4-aminopyridine. We discovered a novel phenomenon, in which ictal events are preceded by preictal vasoconstriction of blood vessels in the surround, occurring 1-5 s before seizure onset, which may serve to actively shunt oxygenated blood to the imminently hypermetabolic focus or may be due to small local decreases in metabolism in the surround. Early ictal hypometabolism, transient decreases in cell swelling and cerebral blood volume in the surround are consistent with early ictal surround inhibition as a precipitating event in seizure onset as well as shaping the evolving propagating ictal wavefront, although the exact mechanism of these cerebrovascular and metabolic changes is currently unknown. AFI was extremely sensitive to the ictal onset zone and may be a useful mapping technique with clinical applications.

  7. Description of Ictal HFO Mapping in Patients with Both Temporal and Extratemporal Seizure Focus

    Directory of Open Access Journals (Sweden)

    Juan G. Ochoa

    2016-01-01

    Full Text Available Objective. Review presurgical use of ictal HFO mapping to detect ictal activation areas with dual seizure focus in both the temporal and extratemporal cortex. Methods. Review of consecutive patients admitted to the University of South Alabama Epilepsy Monitoring Unit (SouthCEP between January 2014 and October 2015, with suspected temporal lobe epilepsy and intracranial electrode recording. Ictal HFO localization was displayed in 3D reconstructed brain images using the patient’s own coregistered magnetic resonance imaging (MRI and computed tomography (CT with the implanted electrodes. Results. Four of fifteen patients showed evidence of extratemporal involvement at the onset of the clinical seizures. Ictal HFO mapping involving both frontal and temporal lobe changed the surgical resection areas in three patients where the initial surgical plan included only the temporal lobe. Resection of the ictal HFO at the onset of the seizure and the initial propagation region was associated with seizure freedom in all patients; follow-up period ranged from 12 to 25 months. Significance. Extratemporal ictal involvement may not have clinical manifestations and may account for surgical failure in temporal lobe epilepsy. Ictal HFO mapping is useful to define the ictal cortical network and may help detect an extratemporal focus.

  8. Ictal kissing: a release phenomenon in non-dominant temporal lobe epilepsy.

    Science.gov (United States)

    Rashid, Razi M; Eder, Katherine; Rosenow, Joshua; Macken, Michael P; Schuele, Stephan U

    2010-12-01

    A variety of ictal automatisms with strong emotional elements have been described. Ictal kissing has not been well characterized and may provide useful clinical information and insight into the mechanisms of stereotyped ictal behaviour. Three of 220 patients (1.4%) admitted for video EEG monitoring between 7/2006 and 6/2009 with ictal kissing were identified. Clinical, neurophysiological and imaging data were reviewed and correlated. All patients were right-handed women with a longstanding history and findings consistent with right temporal lobe epilepsy (TLE). Multiple habitual events were recorded for each patient, characterized by staring, oral automatisms and amnesia. In addition, partial preservation of responsiveness and speech were seen during seizures in all three patients. The first two patients showed kissing behaviour triggered by interactions during seizure testing. The last patient had six seizures overnight and developed spontaneous kissing behaviour in the ictal and post-ictal period of her later events, associated with hyperorality and sexual disinhibition. Our series supports the findings of two prior cases, of one male and one female, which reported IK behaviour associated with TLE and lateralizing to the non-dominant hemisphere. This behaviour has not been described in simple partial seizures or seen with electrical cortical stimulation suggesting that it represents a release phenomenon rather than activation of distinct symptomatogenic cortex. This is also supported by the fact that ictal kissing can occur within the spectrum of seizure-induced Kluver-Bucy syndrome and may extend into the post-ictal period.

  9. Ictal unilateral hyperkinetic proximal lower limb movements: an independent lateralising sign suggesting ipsilateral seizure onset.

    Science.gov (United States)

    Teotónio, Rute; Rodionov, Roman; McEvoy, Andrew W; Duncan, John; Diehl, Beate; Wehner, Tim

    2013-06-01

    Our aim was to determine the lateralising value of ictal repetitive unilateral hyperkinetic proximal lower limb movements. Among 16 patients with ictal hyperkinetic features who underwent intracranial EEG between 2008 and 2011 in our centre, three had repetitive unilateral hyperkinetic proximal lower limb movements, sometimes associated with "hemiballic-like" movements of the ipsilateral upper limb. There were no other consistent lateralising signs. In all patients, these movements were ipsilateral to the ictal onset zone and started a few seconds after electroencephalographic seizure onset. In two patients, intracranial EEG showed seizure onset within the parietal lobe and mesial temporal ictal onset was recorded in a third. Two patients underwent resection and became seizure-free. Our results suggest that unilateral ictal repetitive hyperkinetic proximal lower limb movements may be an independent lateralising sign to the ipsilateral hemisphere.

  10. Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

    Directory of Open Access Journals (Sweden)

    Paulo Breno Noronha Liberalesso

    2012-07-01

    Full Text Available OBJECTIVE: Nonconvulsive status epilepticus (NCSE is currently considered as one of the most frequent types of status epilepticus (SE. The objective of the present study was to identify the natural history of the electrographical evolution of refractory NCSE and to establish the relationship between ictal patterns and prognosis. METHODS: We analyzed, retrospectively, 14 patients with loss of consciousness and NCSE. The ictal patterns were classified as discrete seizures (DS, merging seizures (MS, continuous ictal discharges (CID, continuous ictal discharges with flat periods (CID-F, and periodic lateralized epileptiform discharges (PLEDs. RESULTS: The ictal patterns were DS (n=7; 50.0%, PLEDs (n=3; 1.4%, CID (n=2; 14.3%, MS (n=1; 7.1%, and CID-F (n=1; 7.1%. CONCLUSIONS: NCSE electrographic findings are heterogeneous and do not follow a stereotyped sequence. PLEDs were related to a higher probability of neurological morbidity and mortality.

  11. Improved diagnostic accuracy of lung perfusion imaging using Tc-99m MAA SPECT

    Energy Technology Data Exchange (ETDEWEB)

    O' Donnell, J.K.; Golish, J.A.; Go, R.T.; Risius, B.; Graor, R.A.; MacIntyre, W.J.; Feiglin, D.H.

    1984-01-01

    The addition of emission tomography (SPECT) to pulmonary perfusion imaging should improve diagnostic accuracy by detecting perfusion defects otherwise masked by superimposition of normal lung activity and by reducing problems with interpretation of defects that result from overlying soft tissue or pleural effusions. In order to examine the contribution of SPECT in the scintigraphic evaluation for pulmonary embolus (PE), the authors have obtained both planar and SPECT studies in 94 cases of suspected PE. All studies employed 3-4 mCi of Tc-99m MAA and standard six-view planar image acquisition. SPECT raw data of 64 images were then acquired over a 360 degree transaxial rotation with subsequent computer reconstruction. Xe-133 ventilation studies were performed when clinically indicated and tolerated by the patient. For 19 studies angiographic (AN) correlation was obtained within 24 hours. In 16/19 planar and SPECT both gave a high probability of PE but SPECT gave better segmental localization and showed better agreement with the number of defects seen at AN. In 3 indeterminate planar scans, 2 were low probability with SPECT and had negative AN. The third, a patient with Wegener's vasculitis, remained indeterminate with SPECT and had negative AN. Five patients with PE had repeat planar/SPECT/AN studies to evaluate response to treatment. SPECT correlated better with AN findings in each case. The authors conclude that SPECT perfusion imaging provides better anatomic accuracy for defects representing PE and is the non-invasive technique of choice for documenting response to therapy.

  12. Ictal epileptic headache as "subtle" symptom in generalized idiopathic epilepsy.

    Science.gov (United States)

    Fanella, Martina; Fattouch, Jinane; Casciato, Sara; Lapenta, Leonardo; Morano, Alessandra; Egeo, Gabriella; Manfredi, Mario; Prencipe, Massimiliano; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2012-04-01

    Epilepsy and migraine are common neurologic chronic disorders with episodic manifestations characterized by recurrent attacks and a return to baseline conditions between attacks. Epilepsy and migraine are frequently observed in comorbidity, with the occurrence of one disorder increasing the probability of the other: Migraine occurs in about one-fourth of patients with epilepsy, whereas epilepsy is present in 8-15% of patients with migraine. The link between headache and seizures is controversial and multifactorial. In epilepsy, headache can be seen as a preictal, ictal, or postictal phenomenon. In this report, we describe a case of a 37-year-old patient, affected by both drug-resistant generalized idiopathic epilepsy and headache, who displayed the sudden onset of a headache attack referred during a 24-h electroencephalography (EEG). The EEG tracing during this event revealed the activation of subcontinuous epileptic activity consisting of generalized spike-wave discharges (GSWDs) and generalized polyspike and wave discharges (GPSWDs) that persisted for 60 min, that is, until the disappearance of the headache. The case we describe appears to be original in that it represents one of the few EEG-documented ictal epileptic headaches in generalized idiopathic epilepsy. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

  13. Ictal epileptic headache: a review of current literature and differentiation from migralepsy and other epilepsies.

    Science.gov (United States)

    Saitowitz, Zacharry; Flamini, Robert; Berenson, Frank

    2014-10-01

    Ictal headaches are increasingly becoming the focus of research as more data demonstrate headaches existing as a sole manifestation of an epileptic event. Due to the difficulty in diagnosing the event as an epileptic phenomenon as opposed to a migraine, the condition is often misdiagnosed. This paper seeks to review the current published literature on ictal epileptic headaches as well as provide differentiation between ictal headaches and similarly presenting conditions. In doing so, we hope to improve the diagnosis of ictal headaches and thus improve patient care. We review two case studies that exemplify the potential of multiple conditions with comparable symptoms to ictal headaches, and discuss how to differentiate the variable diagnoses. As of the writing of this paper, there is no universally agreed upon set of features of ictal headaches; however, reviewing the current literature, there do seem to be several features that should be noted when treating patients. More research on the pathophysiology of ictal epileptic headaches needs to be done before the condition can be fully understood.

  14. Ictal epileptic headache revealing non convulsive status epilepticus in a case of eyelid myoclonia with absences.

    Science.gov (United States)

    Fanella, Martina; Morano, Alessandra; Fattouch, Jinane; Albini, Mariarita; Casciato, Sara; Manfredi, Mario; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2015-01-01

    Epileptic seizures and headache attacks are two common neurologic phenomena characterized by paroxysmal alteration of brain functions followed by complete restauration of the baseline condition. Headache and epilepsy are related in numerous ways, and they often co-occur. Although the link between these two diseases is not completely clear, several clinical, physiopathological and therapeutic features overlap. Headache is reported in association with epileptic seizures as a pre-ictal, ictal or post-ictal phenomenon. We present the case of a 40 year-old woman affected by eyelid myoclonia with absences (EMA) with a history of prolonged headache attacks. A video-EEG recording performed during one of these episodes showed subcontinuous epileptic activity consisting of generalized spike-and-wave discharges (GSWDs), clinically associated with tensive headache. Our work represents one of the few well EEG-documented cases of ictal epileptic headache in idiopathic generalized epilepsy (IGE).

  15. Measuring the level and content of consciousness during epileptic seizures: the Ictal Consciousness Inventory.

    Science.gov (United States)

    Cavanna, A E; Mula, M; Servo, S; Strigaro, G; Tota, G; Barbagli, D; Collimedaglia, L; Viana, M; Cantello, R; Monaco, F

    2008-07-01

    Ictal alterations of the level of general awareness and subjective content of consciousness play a pivotal role in the clinical phenomenology of epilepsy, and reflect the pathological involvement of different neurobiological substrates. However, no self-reported measures have been proposed for patients experiencing altered conscious states during seizures. This study describes the development and validation of a new scale for the quantitative assessment of the level and content of ictal consciousness, the Ictal Consciousness Inventory (ICI). The ICI is a 20-item questionnaire generated on the basis of interviews with patients, literature review, and consultation with experts. It was tested on a sample of 110 patients attending three different epilepsy clinics in Northern Italy, who also completed standardized clinical scales. Standard psychometric methods were used to demonstrate that this scale satisfies criteria for acceptability, reliability, and validity. The ICI is proposed as a user-friendly and clinically sound instrument for the measurement of ictal alterations of consciousness in patients with epilepsy.

  16. Radiopharmaceuticals for SPECT cancer detection

    Science.gov (United States)

    Chernov, V. I.; Medvedeva, A. A.; Zelchan, R. V.; Sinilkin, I. G.; Stasyuk, E. S.; Larionova, L. A.; Slonimskaya, E. M.; Choynzonov, E. L.

    2016-08-01

    The purpose of the study was to assess the efficacy of single photon emission computed tomography (SPECT) with 199Tl and 99mTc-MIBI in the detection of breast, laryngeal and hypopharyngeal cancers. A total of 220 patients were included into the study: 120 patients with breast lesions (100 patients with breast cancer and 20 patients with benign breast tumors) and 100 patients with laryngeal/hypopharyngeal diseases (80 patients with laryngeal/hypopharyngeal cancer and 20 patients with benign laryngeal/hypopharyngeal lesions). No abnormal 199Tl uptake was seen in all patients with benign breast and laryngeal lesions, indicating a 100% specificity of 199Tl SPECT. In the breast cancer patients, the increased 199Tl uptake in the breast was visualized in 94.8% patients, 99mTc-MIBI—in 93.4% patients. The increased 199Tl uptake in axillary lymph nodes was detected in 60% patients, and 99mTc-MIBI—in 93.1% patients. In patients with laryngeal/hypopharyngeal cancer, the sensitivity of SPECT with 199Tl and 99mTc-MIBI was 95%. The 199Tl SPECT sensitivity in identification of regional lymph node metastases in the patients with laryngeal/hypopharyngeal cancer was 75% and the 99mTc-MIBI SPECT sensitivity was 17%. The data obtained showed that SPECT with 199Tl and 99mTc-MIBI can be used as one of the additional imaging methods in detection of tumors.

  17. Tc-{sup 99m} ECD brain SPECT in MELAS syndrome: comparison with MR finding

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Joon; Ryu, Young Hoon; Yoon, Pyeong Ho; Jeon, Tae Joo; Kim, Jai Keun; Nam, Ji Eun; Lee, Jong Doo [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of); Lee, Byung Hee [Poondang Cha Hospital, Sungnam (Korea, Republic of); Shin, Hyung Cheol [College of Medicine, Soonchunhyang Univ., Chonnon (Korea, Republic of)

    1998-07-01

    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.

  18. Resection of ictal high-frequency oscillations leads to favorable surgical outcome in pediatric epilepsy

    Science.gov (United States)

    Fujiwara, Hisako; Greiner, Hansel M.; Lee, Ki Hyeong; Holland-Bouley, Katherine D.; Seo, Joo Hee; Arthur, Todd; Mangano, Francesco T.; Leach, James L.; Rose, Douglas F.

    2012-01-01

    Summary Purpose Intracranial electroencephalography (EEG) is performed as part of an epilepsy surgery evaluation when noninvasive tests are incongruent or the putative seizure-onset zone is near eloquent cortex. Determining the seizure-onset zone using intracranial EEG has been conventionally based on identification of specific ictal patterns with visual inspection. High-frequency oscillations (HFOs, >80 Hz) have been recognized recently as highly correlated with the epileptogenic zone. However, HFOs can be difficult to detect because of their low amplitude. Therefore, the prevalence of ictal HFOs and their role in localization of epileptogenic zone on intracranial EEG are unknown. Methods We identified 48 patients who underwent surgical treatment after the surgical evaluation with intracranial EEG, and 44 patients met criteria for this retrospective study. Results were not used in surgical decision making. Intracranial EEG recordings were collected with a sampling rate of 2,000 Hz. Recordings were first inspected visually to determine ictal onset and then analyzed further with time-frequency analysis. Forty-one (93%) of 44 patients had ictal HFOs determined with time-frequency analysis of intracranial EEG. Key Findings Twenty-two (54%) of the 41 patients with ictal HFOs had complete resection of HFO regions, regardless of frequency bands. Complete resection of HFOs (n = 22) resulted in a seizure-free outcome in 18 (82%) of 22 patients, significantly higher than the seizure-free outcome with incomplete HFO resection (4/19, 21%). Significance Our study shows that ictal HFOs are commonly found with intracranial EEG in our population largely of children with cortical dysplasia, and have localizing value. The use of ictal HFOs may add more promising information compared to interictal HFOs because of the evidence of ictal propagation and followed by clinical aspect of seizures. Complete resection of HFOs is a favorable prognostic indicator for surgical outcome. PMID

  19. Molecular imaging agents for SPECT (and SPECT/CT)

    Energy Technology Data Exchange (ETDEWEB)

    Gnanasegaran, Gopinath [Guy' s and St Thomas' NHS Foundation Trust, Department of Nuclear Medicine, London (United Kingdom); Ballinger, James R. [Guy' s and St Thomas' NHS Foundation Trust, Department of Nuclear Medicine, London (United Kingdom); King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom)

    2014-05-15

    The development of hybrid single photon emission computed tomography/computed tomography (SPECT/CT) cameras has increased the diagnostic value of many existing single photon radiopharmaceuticals. Precise anatomical localization of lesions greatly increases diagnostic confidence in bone imaging of the extremities, infection imaging, sentinel lymph node localization, and imaging in other areas. Accurate anatomical localization is particularly important prior to surgery, especially involving the parathyroid glands and sentinel lymph node procedures. SPECT/CT plays a role in characterization of lesions, particularly in bone scintigraphy and radioiodine imaging of metastatic thyroid cancer. In the development of novel tracers, SPECT/CT is particularly important in monitoring response to therapies that do not result in an early change in lesion size. Preclinical SPECT/CT devices, which actually have spatial resolution superior to PET/CT devices, have become essential in characterization of the biodistribution and tissue kinetics of novel tracers, allowing coregistration of serial studies within the same animals, which serves both to reduce biological variability and reduce the number of animals required. In conclusion, SPECT/CT increases the utility of existing radiopharmaceuticals and plays a pivotal role in the evaluation of novel tracers. (orig.)

  20. The correlation between ictal semiology and magnetoencephalographic localization in frontal lobe epilepsy.

    Science.gov (United States)

    Wu, Xintong; Rampp, Stefan; Weigel, Daniel; Kasper, Burkhard; Zhou, Dong; Stefan, Hermann

    2011-11-01

    The aim of this study was to investigate the correlation of ictal semiology with localization and/or lateralization by magnetoencephalography (MEG). Seven patients from the Neurology Department of the University Hospital Erlangen who underwent resective surgery for frontal lobe epilepsy (FLE) with an Engel 1a outcome were investigated retrospectively. MEG localizations were classified according to five compartments (separate or combined) of the frontal lobe: frontal basal (FB), frontal lateral (FL), frontal polar (FP), frontal mesial (FM), and frontal precentral (FPr). On the basis of previous studies that investigated the value of ictal semiology in localization and lateralization, we compared the experiential localization and/or lateralization of the epileptogenic region deduced from ictal semiology, that is, both seizure history and ictal video/EEG monitoring, with MEG localization. It is easier to determine lateralization than localization from ictal semiology because of the variety of signs and fast propagation in FLE. All of the patients had specific MEG localizations according to favorable postoperative outcome. Three patients had MEG foci associated with ictal semiology; in another four, the MEG localization was adjacent to the estimated area suggested by ictal semiology. Head version signs could be observed in all compartments of the frontal lobe: clonic in FB and FP areas; postural in FPr, FL, and FM areas; hypermotor in FB, FP, FPr, and FM areas; sensation aura in FB, FL, and FM areas; and automatisms in FP, FPr, and FL areas. All patients had concordant lateralizing and limited valuable locating information from ictal semiology, but no complete correlation with MEG foci. Ictal semiology may indicate the involvement of a symptomatogenic brain region during a seizure, but extent of seizure onset in central motor or sensorimotor area is not reliable enough to indicate the seizure onset zone and favorable postoperative outcome in FLE. MEG provided specific

  1. Topographic movie of intracranial ictal high-frequency oscillations with seizure semiology: epileptic network in Jacksonian seizures.

    Science.gov (United States)

    Akiyama, Tomoyuki; Chan, Derrick W; Go, Cristina Y; Ochi, Ayako; Elliott, Irene M; Donner, Elizabeth J; Weiss, Shelly K; Snead, O Carter; Rutka, James T; Drake, James M; Otsubo, Hiroshi

    2011-01-01

    We developed a technique to produce images of dynamic changes in ictal high-frequency oscillations (HFOs) >40 Hz recorded on subdural electroencephalography (EEG) that are time-locked to the ictal EEG and ictal semiology video. We applied this technique to Jacksonian seizures to demonstrate ictal HFO propagation along the homunculus in the primary sensory-motor cortex to visualize the underlying epileptic network. We analyzed intracranial ictal EEGs from two patients with intractable Jacksonian seizures who underwent epilepsy surgery. We calculated the degrees of increase in amplitude within 40-80, 80-200, and 200-300 Hz frequency bands compared to the interictal period and converted them into topographic movies projected onto the brain surface picture. We combined these data with the ictal EEGs and video of the patient demonstrating ictal semiology. The ictal HFOs began in the sensory cortex and appeared concomitantly with the sensory aura. They then propagated to the motor cortex at the same time that focal motor symptoms evolved. As the seizure progressed, the ictal HFOs spread or reverberated in the rolandic region. However, even when the seizure became secondarily generalized, the ictal HFOs were confined to the rolandic region. In both cases, there was increased amplitude of higher frequency bands during seizure initiation compared to seizure progression. This combined movie showed the ictal HFO propagation corresponding to the ictal semiology in Jacksonian seizures and revealed the epileptic network involved in seizure initiation and progression. This method may advance understanding of neural network activities relating to clinical seizure generation and propagation. Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.

  2. Molecular imaging of angiogenesis with SPECT.

    NARCIS (Netherlands)

    Dijkgraaf, I.; Boerman, O.C.

    2010-01-01

    Single-photon emission computed tomography (SPECT) and position emission tomography (PET) are the two main imaging modalities in nuclear medicine. SPECT imaging is more widely available than PET imaging and the radionuclides used for SPECT are easier to prepare and usually have a longer half-life th

  3. Progress in BazookaSPECT.

    Science.gov (United States)

    Miller, Brian W; Barber, H Bradford; Furenlid, Lars R; Moore, Stephen K; Barrett, Harrison H

    2009-01-01

    Recent progress on a high-resolution, photon-counting gamma-ray and x-ray imager called BazookaSPECT is presented. BazookaSPECT is an example of a new class of scintillation detectors based on integrating detectors such as CCD(charge-coupled device) or CMOS(complementary metal-oxide semiconductor) sensors. BazookaSPECT is unique in that it makes use of a scintillator in close proximity to a microchannel plate-based image intensifier for up-front optical amplification of scintillation light. We discuss progress made in bringing about compact BazookaSPECT modules and in real-time processing of event data using graphics processing units (GPUs). These advances are being implemented in the design of a high-resolution rodent brain imager called FastSPECT III. A key benefit of up-front optical gain is that any CCD/CMOS sensor can now be utilized for photon counting. We discuss the benefits and feasibility of using CMOS sensors as photon-counting detectors for digital radiography, with application in mammography and computed tomography (CT). We present as an appendix a formal method for comparing various photon-counting integrating detectors using objective statistical criteria.

  4. Ictal consciousness in epilepsy and nonepileptic attack disorder.

    Science.gov (United States)

    Ali, Fizzah; Rickards, Hugh; Bagary, Manny; Greenhill, Lyn; McCorry, Doug; Cavanna, Andrea Eugenio

    2010-11-01

    Exploration of subjective experiences during seizures may enhance knowledge of the differing natures of epilepsy and nonepileptic attack disorder (NEAD). We performed a quantitative evaluation of both the general level of awareness and the specific contents of consciousness during seizures using the Ictal Consciousness Inventory (ICI). Ninety-five adult outpatients attending general neuropsychiatry and epilepsy clinics with established diagnoses of either epilepsy (n = 66) or NEAD (n = 29) completed one ICI for each witnessed seizure recalled. Patients with a dubious/dual diagnosis were excluded. ICI Level (ICI-L) and ICI Content (ICI-L) scores were calculated for the 167 questionnaires generated by patients with epilepsy (n = 119, of which 58 from patients with temporal lobe epilepsy, 14 frontal lobe epilepsy, and 47 idiopathic 30 generalized epilepsy) and patients with NEAD (n = 48). Mann-Whitney U tests revealed statistically significant higher ICI-L and ICI-C scores for patients with NEAD (both P = 0.01). Subjective reports of consciousness experiences varied between epilepsy and NEAD, with patients with NEAD reporting significantly greater levels of general awareness/responsiveness and more vivid subjective experiences during attacks. The ICI is proposed as a potentially useful self-report instrument to supplement clinical and instrumental tests for the differential diagnosis of epilepsy and NEAD. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Mapping preictal and ictal haemodynamic networks using video-electroencephalography and functional imaging.

    Science.gov (United States)

    Chaudhary, Umair J; Carmichael, David W; Rodionov, Roman; Thornton, Rachel C; Bartlett, Phillipa; Vulliemoz, Serge; Micallef, Caroline; McEvoy, Andrew W; Diehl, Beate; Walker, Matthew C; Duncan, John S; Lemieux, Louis

    2012-12-01

    Ictal patterns on scalp-electroencephalography are often visible only after propagation, therefore rendering localization of the seizure onset zone challenging. We hypothesized that mapping haemodynamic changes before and during seizures using simultaneous video-electroencephalography and functional imaging will improve the localization of the seizure onset zone. Fifty-five patients with ≥2 refractory focal seizures/day, and who had undergone long-term video-electroencephalography monitoring were included in the study. 'Preictal' (30 s immediately preceding the electrographic seizure onset) and ictal phases, 'ictal-onset'; 'ictalestablished' and 'late ictal', were defined based on the evolution of the electrographic pattern and clinical semiology. The functional imaging data were analysed using statistical parametric mapping to map ictal phase-related haemodynamic changes consistent across seizures. The resulting haemodynamic maps were overlaid on co-registered anatomical scans, and the spatial concordance with the presumed and invasively defined seizure onset zone was determined. Twenty patients had typical seizures during functional imaging. Seizures were identified on video-electroencephalography in 15 of 20, on electroencephalography alone in two and on video alone in three patients. All patients showed significant ictal-related haemodynamic changes. In the six cases that underwent invasive evaluation, the ictal-onset phase-related maps had a degree of concordance with the presumed seizure onset zone for all patients. The most statistically significant haemodynamic cluster within the presumed seizure onset zone was between 1.1 and 3.5 cm from the invasively defined seizure onset zone, which was resected in two of three patients undergoing surgery (Class I post-surgical outcome) and was not resected in one patient (Class III post-surgical outcome). In the remaining 14 cases, the ictal-onset phase-related maps had a degree of concordance with the presumed

  6. Ictal high-frequency oscillations at 80-200 Hz coupled with delta phase in epileptic spasms.

    Science.gov (United States)

    Nariai, Hiroki; Matsuzaki, Naoyuki; Juhász, Csaba; Nagasawa, Tetsuro; Sood, Sandeep; Chugani, Harry T; Asano, Eishi

    2011-10-01

    Previous studies of epileptic spasms reported that ictal events were associated with high-frequency oscillations (HFOs) or delta waves involving widespread regions. We determined whether ictal HFOs at 80-200 Hz were coupled with a phase of slow-wave, whether ictal slow-waves were diffusely or locally synchronous signals, and whether the mode of coupling between HFOs and slow-wave phases differed between ictal and interictal states. We studied 11 children who underwent extraoperative electrocorticography (ECoG) recording. The phases and amplitudes of slow-waves were measured at the peak of ictal and interictal HFOs in the seizure-onset sites. Ictal HFOs were locked tightly to the phase of slow-wave at ≤1 Hz. Ictal slow-waves propagated from the seizure-onset site to other regions. In contrast, interictal HFOs in the seizure-onset site were loosely locked to the phase of slow-wave at ≤1 Hz but tightly to that of ≥3-Hz. Ictal slow-waves coupled with HFOs can be explained as near-field and locally synchronized potentials generated by the neocortex rather than far-field potentials generated by subcortical structures. Ictal slow-waves in epileptic spasms may be generated by a mechanism different from what generates interictal HFOs-slow-wave complexes.

  7. Ictal propagation of high frequency activity is recapitulated in interictal recordings: effective connectivity of epileptogenic networks recorded with intracranial EEG.

    Science.gov (United States)

    Korzeniewska, A; Cervenka, M C; Jouny, C C; Perilla, J R; Harezlak, J; Bergey, G K; Franaszczuk, P J; Crone, N E

    2014-11-01

    Seizures are increasingly understood to arise from epileptogenic networks across which ictal activity is propagated and sustained. In patients undergoing invasive monitoring for epilepsy surgery, high frequency oscillations have been observed within the seizure onset zone during both ictal and interictal intervals. We hypothesized that the patterns by which high frequency activity is propagated would help elucidate epileptogenic networks and thereby identify network nodes relevant for surgical planning. Intracranial EEG recordings were analyzed with a multivariate autoregressive modeling technique (short-time direct directed transfer function--SdDTF), based on the concept of Granger causality, to estimate the directionality and intensity of propagation of high frequency activity (70-175 Hz) during ictal and interictal recordings. These analyses revealed prominent divergence and convergence of high frequency activity propagation at sites identified by epileptologists as part of the ictal onset zone. In contrast, relatively little propagation of this activity was observed among the other analyzed sites. This pattern was observed in both subdural and depth electrode recordings of patients with focal ictal onset, but not in patients with a widely distributed ictal onset. In patients with focal ictal onsets, the patterns of propagation recorded during pre-ictal (up to 5 min immediately preceding ictal onset) and interictal (more than 24h before and after seizures) intervals were very similar to those recorded during seizures. The ability to characterize epileptogenic networks from interictal recordings could have important clinical implications for epilepsy surgery planning by reducing the need for prolonged invasive monitoring to record spontaneous seizures.

  8. Peri-ictal water drinking and other ictal vegetative symptoms: Localizing and lateralizing the epileptogenic zone in temporal lobe epilepsy? Two case reports and review of the literature.

    Science.gov (United States)

    Errguig, L; Lahjouji, F; Belaidi, H; Jiddane, M; Elkhamlichi, A; Dakka, T; Ouazzani, R

    2013-11-01

    Peri-ictal behavior disorders can be helpful in localizing and lateralizing seizure onset in partial epilepsies, especially those originating in the temporal lobe. In this paper, we present the case of two right-handed women aged 36 and 42 years who presented with partial seizures of mesial temporal type. Both of the patients had drug resistant epilepsy and undergone presurgical evaluation tests including brain magnetic resonance imaging, video-EEG monitoring and neuropsychological testing. The two patients had hippocampal sclerosis in the right temporal lobe and exhibited PIWD behavior concomitant with right temporal lobe discharges documented during video-EEG recordings. Anterior temporal lobectomy was performed in one case with an excellent outcome after surgery. The patient was free of seizures at 3 years follow-up. We reviewed other publications of peri-ictal autonomic symptoms considered to have a lateralizing significance, such as peri-ictal vomiting, urinary urge, ictal pilo-erection. Clinicians should search for these symptoms, even if not spontaneously reported by the patient, because they are often under-estimated, both by the patients themselves and by physicians. Additionally, patients with lateralizing auras during seizures have a significantly better outcome after epilepsy surgery than those without lateralizing features.

  9. Neuronal autoantibodies in epilepsy patients with peri-ictal autonomic findings.

    Science.gov (United States)

    Baysal-Kirac, Leyla; Tuzun, Erdem; Erdag, Ece; Ulusoy, Canan; Vanli-Yavuz, Ebru Nur; Ekizoglu, Esme; Peach, Sian; Sezgin, Mine; Bebek, Nerses; Gurses, Candan; Gokyigit, Aysen; Vincent, Angela; Baykan, Betul

    2016-03-01

    Autonomic dysfunction has frequently been reported in autoimmune encephalitis associated with seizures and there is growing evidence that epilepsy patients may display neuronal autoantibodies (NAAb). The aim of this study was to investigate the frequency of NAAb in epilepsy patients with peri-ictal autonomic findings. Fifty-eight patients (37 women/21 men; average age of 34.2 ± 9.9 years and epilepsy duration of 19.1 ± 9.6 years) who had at least one video-EEG recorded focal or secondary generalized seizure with clear-cut documented peri-ictal autonomic findings, or consistently reported seizures with autonomic semiology, were included. NAAb were tested by RIA or cell based assays. NAAb were present in 17 of 58 (29.3%) patients. Among seropositive patients, antibodies were directed against N-methyl-D-aspartate receptor (NMDAR) in 5 (29%), contactin-associated protein-like 2 (CASPR2) in 5 (29%), uncharacterized voltage gated potassium channel (VGKC)-complex antigens in 3 (18%), glutamic acid decarboxylase (GAD) in 2 (12%), glycine receptor (GLYR) in one (6%) and type A gamma aminobutyric acid receptor (GABAAR) in one patient (6%). Peri-ictal gastrointestinal manifestations, piloerection, ictal fever, urinary urge, and cough occurred more commonly in the seropositive group. The prevalences of psychotic attacks and status epilepticus were significantly increased in the seropositive group. Seropositivity prevalence in our patient group with peri-ictal autonomic findings is higher than other previously reported epilepsy cohorts. In our study, ictal fever-VGKC-complex antibody and pilomotor seizure-GABAAR antibody associations were documented for the first time. Chronic epilepsy patients with peri-ictal autonomic semiology, history of status epilepticus and psychotic disorder may benefit from autoantibody screening.

  10. Organ volume estimation using SPECT

    CERN Document Server

    Zaidi, H

    1996-01-01

    Knowledge of in vivo thyroid volume has both diagnostic and therapeutic importance and could lead to a more precise quantification of absolute activity contained in the thyroid gland. In order to improve single-photon emission computed tomography (SPECT) quantitation, attenuation correction was performed according to Chang's algorithm. The dual-window method was used for scatter subtraction. We used a Monte Carlo simulation of the SPECT system to accurately determine the scatter multiplier factor k. Volume estimation using SPECT was performed by summing up the volume elements (voxels) lying within the contour of the object, determined by a fixed threshold and the gray level histogram (GLH) method. Thyroid phantom and patient studies were performed and the influence of 1) fixed thresholding, 2) automatic thresholding, 3) attenuation, 4) scatter, and 5) reconstruction filter were investigated. This study shows that accurate volume estimation of the thyroid gland is feasible when accurate corrections are perform...

  11. 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.

  12. Hypersynchronous ictal onset in the perirhinal cortex results from dynamic weakening in inhibition.

    Science.gov (United States)

    Köhling, Rüdiger; D'Antuono, Margherita; Benini, Ruba; de Guzman, Philip; Avoli, Massimo

    2016-03-01

    We obtained field, K(+) selective and "sharp" intracellular recordings from the rat entorhinal (EC) and perirhinal (PC) cortices in an in vitro brain slice preparation to identify the events occurring at interictal-to-ictal transition during 4-aminopyridine application. Field recordings revealed interictal- (duration: 1.1 to 2.2s) and ictal-like (duration: 31 to 103s) activity occurring synchronously in EC and PC; in addition, interictal spiking in PC increased in frequency shortly before the onset of ictal oscillatory activity thus resembling the hypersynchronous seizure onset seen in epileptic patients and in in vivo animal models. Intracellular recordings with K-acetate+QX314-filled pipettes in PC principal cells showed that spikes at ictal onset had post-burst hyperpolarizations (presumably mediated by postsynaptic GABAA receptors), which gradually decreased in amplitude. This trend was associated with a progressive positive shift of the post-burst hyperpolarization reversal potential. Finally, the transient elevations in [K(+)]o (up to 4.4mM from a base line of 3.2mM) - which occurred with the interictal events in PC - progressively increased (up to 7.3mM) with the spike immediately preceding ictal onset. Our findings indicate that hypersynchronous seizure onset in rat PC is caused by dynamic weakening of GABAA receptor signaling presumably resulting from [K(+)]o accumulation.

  13. The importance of cardiac monitoring in the epilepsy monitoring unit: a case presentation of ictal asystole.

    Science.gov (United States)

    Agostini, Susan D; Aniles, Ejerzain; Sirven, Joseph; Drazkowski, Joseph F

    2012-09-01

    Ictal asystole may be a potent marker for epilepsy patients at high risk for sudden unexpected death in epilepsy (SUDEP). The use of inpatient long-term video-electroencephalographic (VEEG) monitoring coupled with simultaneous continuous cardiac telemetry is an important tool to detect ictal asystole as well as other significant ictal cardiac arrhythmias. In this paper a case of ictal asystole detected during VEEG is presented. Routine 12-lead EKG was normal upon admission. After antiepileptic medication was tapered, the patient had a typical complex partial seizure with oral automatisms at onset followed by secondary generalization. Ictal onset was noted in left temporal lobe with subsequent spread to the right temporal region. A 20 second period of asystole began just prior to the secondary generalization. During this admission the patient underwent a potentially life-saving pacemaker implantation. The use of cardiac telemetry and baseline EKG are suggested for patients admitted into epilepsy monitoring units as part of the standard epilepsy monitoring protocol.

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

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Joon; Ryu, Young Hoon; Jeon, Tae Joo; Kim, Jai Keun; Nam, Ji Eun; Yoon, Pyeong Ho; Yoon, Choon Sik; Lee, Jong Doo [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    1998-08-01

    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. PET and SPECT in psychiatry

    Energy Technology Data Exchange (ETDEWEB)

    Dierckx, Rudi A.J.O. [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Ghent Univ. (Belgium); Otte, Andreas [Univ. of Applied Sciences Offenburg (Germany). Faculty of Electrical Engineering and Information Technology; Vries, Erik F.J. de; Waarde, Aren van (eds.) [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging

    2014-09-01

    Covers classical psychiatric disorders as well as other subjects such as suicide, sleep, eating disorders, and autism. Emphasis on a multidisciplinary approach. Written by internationally acclaimed experts. PET and SPECT in Psychiatry showcases the combined expertise of renowned authors whose dedication to the investigation of psychiatric disease through nuclear medicine technology has achieved international recognition. The classical psychiatric disorders as well as other subjects - such as suicide, sleep, eating disorders, and autism - are discussed and the latest results in functional neuroimaging are detailed. Most chapters are written jointly by a clinical psychiatrist and a nuclear medicine expert to ensure a multidisciplinary approach. This state of the art compendium will be valuable to all who have an interest in the field of neuroscience, from the psychiatrist and the radiologist/nuclear medicine specialist to the interested general practitioner and cognitive psychologist. It is the first volume of a trilogy on PET and SPECT imaging in the neurosciences; other volumes will focus on PET and SPECT in neurology and PET and SPECT of neurobiological systems.

  16. SPECT og PET i neurobiologien

    DEFF Research Database (Denmark)

    Paulson, O.B.; Lassen, N.A.

    1997-01-01

    PET (positron emission tomography) and SPECT (single photon emission computed tomography) are isotopic methods in which the distribution is registered of radiolabelled tracers given in such small amounts that they are without effect on the organism or the organism's disposal of them. Thus, a series...

  17. Targeted multi-pinhole SPECT

    NARCIS (Netherlands)

    Branderhorst, W.; Vastenhouw, B.; Van der Have, F.; Blezer, E.L.A.; Bleeker, W.K.; Beekman, F.J.

    2010-01-01

    Purpose: Small-animal single photon emission computed tomography (SPECT) with focused multi-pinhole collimation geometries allows scanning modes in which large amounts of photons can be collected from specific volumes of interest. Here we present new tools that improve targeted imaging of specific

  18. SPECT og PET i neurobiologien

    DEFF Research Database (Denmark)

    Paulson, O B; Lassen, N A

    1997-01-01

    PET (positron emission tomography) and SPECT (single photon emission computed tomography) are isotopic methods in which the distribution is registered of radiolabelled tracers given in such small amounts that they are without effect on the organism or the organism's disposal of them. Thus, a series...

  19. A new technique for fractal analysis applied to human, intracerebrally recorded, ictal electroencephalographic signals.

    Science.gov (United States)

    Bullmore, E; Brammer, M; Alarcon, G; Binnie, C

    1992-11-09

    Application of a new method of fractal analysis to human, intracerebrally recorded, ictal electroencephalographic (EEG) signals is reported. 'Frameshift-Richardson' (FR) analysis involves estimation of fractal dimension (1 EEG data; it is suggested that this technique offers significant operational advantages over use of algorithms for FD estimation requiring preliminary reconstruction of EEG data in phase space. FR analysis was found to reduce substantially the volume of EEG data, without loss of diagnostically important information concerning onset, propagation and evolution of ictal EEG discharges. Arrhythmic EEG events were correlated with relatively increased FD; rhythmic EEG events with relatively decreased FD. It is proposed that development of this method may lead to: (i) enhanced definition and localisation of initial ictal changes in the EEG presumed due to multi-unit activity; and (ii) synoptic visualisation of long periods of EEG data.

  20. Denoising of Ictal EEG Data Using Semi-Blind Source Separation Methods Based on Time-Frequency Priors.

    Science.gov (United States)

    Hajipour Sardouie, Sepideh; Bagher Shamsollahi, Mohammad; Albera, Laurent; Merlet, Isabelle

    2015-05-01

    Removing muscle activity from ictal ElectroEncephaloGram (EEG) data is an essential preprocessing step in diagnosis and study of epileptic disorders. Indeed, at the very beginning of seizures, ictal EEG has a low amplitude and its morphology in the time domain is quite similar to muscular activity. Contrary to the time domain, ictal signals have specific characteristics in the time-frequency domain. In this paper, we use the time-frequency signature of ictal discharges as a priori information on the sources of interest. To extract the time-frequency signature of ictal sources, we use the Canonical Correlation Analysis (CCA) method. Then, we propose two time-frequency based semi-blind source separation approaches, namely the Time-Frequency-Generalized EigenValue Decomposition (TF-GEVD) and the Time-Frequency-Denoising Source Separation (TF-DSS), for the denoising of ictal signals based on these time-frequency signatures. The performance of the proposed methods is compared with that of CCA and Independent Component Analysis (ICA) approaches for the denoising of simulated ictal EEGs and of real ictal data. The results show the superiority of the proposed methods in comparison with CCA and ICA.

  1. A novel spatiotemporal analysis of peri-ictal spiking to probe the relation of spikes and seizures in epilepsy.

    Science.gov (United States)

    Krishnan, Balu; Vlachos, Ioannis; Faith, Aaron; Mullane, Steven; Williams, Korwyn; Alexopoulos, Andreas; Iasemidis, Leonidas

    2014-08-01

    The relation between epileptic spikes and seizures is an important but still unresolved question in epilepsy research. Preclinical and clinical studies have produced inconclusive results on the causality or even on the existence of such a relation. We set to investigate this relation taking in consideration seizure severity and spatial extent of spike rate. We developed a novel automated spike detection algorithm based on morphological filtering techniques and then tested the hypothesis that there is a pre-ictal increase and post-ictal decrease of the spatial extent of spike rate. Peri-ictal (around seizures) spikes were detected from intracranial EEG recordings in 5 patients with temporal lobe epilepsy. The 94 recorded seizures were classified into two classes, based on the percentage of brain sites having higher or lower rate of spikes in the pre-ictal compared to post-ictal periods, with a classification accuracy of 87.4%. This seizure classification showed that seizures with increased pre-ictal spike rate and spatial extent compared to the post-ictal period were mostly (83%) clinical seizures, whereas no such statistically significant (α = 0.05) increase was observed peri-ictally in 93% of sub-clinical seizures. These consistent across patients results show the existence of a causal relation between spikes and clinical seizures, and imply resetting of the preceding spiking process by clinical seizures.

  2. Ictal epileptic headache in adult life: Electroclinical patterns and spectrum of related syndromes.

    Science.gov (United States)

    Fanella, Martina; Morano, Alessandra; Fattouch, Jinane; Albini, Mariarita; Manfredi, Mario; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2015-12-01

    Both headache and epilepsy are frequent paroxysmal disorders that often co-occur or are related in numerous ways. Although ictal epileptic headache has become the focus of several studies, this remains a very rare and not well-known phenomenon. Electroclinical features, pathophysiology, and syndromic context are heterogeneous. We investigated the electroclinical and neuroimaging findings in a population of adult patients with ictal epileptic headache. We retrospectively examined 8800 EEG recordings of almost 4800 patients admitted to our video-EEG laboratory from 2010 to 2013 with a history of well-documented epilepsy. We selected patients who reported headache closely related to a seizure documented by video-EEG or 24-hour ambulatory EEG. We analyzed ictal electroclinical features of headache, and we defined the related epileptic syndromes. We identified five patients with ictal epileptic headache. Two patients described tension headache during an epileptic seizure. In three patients, the headache was accompanied by other "minor" neurological symptoms mimicking a migrainous aura. In all cases, the headache stopped with the end of the epileptic activity. Three patients had a history of partial symptomatic epilepsy with cerebral lesions (low grade glioma, astrocytoma, porencephalic cyst) in the left posterior regions, whereas two patients were affected by idiopathic generalized epilepsy. This study confirms the rarity of ictal epileptic headache. To date, well-documented video-EEG cases remain as exceptional reports, especially in cases of idiopathic generalized epilepsies. Moreover, we confirm the main involvement of posterior regions in patients with ictal epileptic headache affected by partial symptomatic epilepsies. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Targeted multi-pinhole SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Branderhorst, Woutjan; Blezer, Erwin L.A. [University Medical Centre Utrecht, Image Sciences Institute and Rudolf Magnus Institute of Neuroscience, Utrecht (Netherlands); Vastenhouw, Brendan; Have, Frans van der; Beekman, Freek J. [University Medical Centre Utrecht, Image Sciences Institute and Rudolf Magnus Institute of Neuroscience, Utrecht (Netherlands); Molecular Imaging Laboratories BV, Utrecht (Netherlands); Delft University of Technology, Section of Radiation Detection and Medical Imaging, Applied Sciences, Delft (Netherlands); Bleeker, Wim K. [Genmab BV, Utrecht (Netherlands)

    2011-03-15

    Small-animal single photon emission computed tomography (SPECT) with focused multi-pinhole collimation geometries allows scanning modes in which large amounts of photons can be collected from specific volumes of interest. Here we present new tools that improve targeted imaging of specific organs and tumours, and validate the effects of improved targeting of the pinhole focus. A SPECT system with 75 pinholes and stationary detectors was used (U-SPECT-II). An XYZ stage automatically translates the animal bed with a specific sequence in order to scan a selected volume of interest. Prior to stepping the animal through the collimator, integrated webcams acquire images of the animal. Using sliders, the user designates the desired volume to be scanned (e.g. a xenograft or specific organ) on these optical images. Optionally projections of an atlas are overlaid semiautomatically to locate specific organs. In order to assess the effects of more targeted imaging, scans of a resolution phantom and a mouse myocardial phantom, as well as in vivo mouse cardiac and tumour scans, were acquired with increased levels of targeting. Differences were evaluated in terms of count yield, hot rod visibility and contrast-to-noise ratio. By restricting focused SPECT scans to a 1.13-ml resolution phantom, count yield was increased by a factor 3.6, and visibility of small structures was significantly enhanced. At equal noise levels, the small-lesion contrast measured in the myocardial phantom was increased by 42%. Noise in in vivo images of a tumour and the mouse heart was significantly reduced. Targeted pinhole SPECT improves images and can be used to shorten scan times. Scan planning with optical cameras provides an effective tool to exploit this principle without the necessity for additional X-ray CT imaging. (orig.)

  4. Steal phenomenon in Sturge-Weber syndrome imitating an ictal electroencephalography change in the contralateral hemisphere: report of 2 cases.

    Science.gov (United States)

    Limotai, Chusak; Go, Cristina Y; Baba, Shiro; Okanari, Kazuo; Ochi, Ayako; Rutka, James T; Snead, O Carter; Otsubo, Hiroshi

    2015-08-01

    Infants with Sturge-Weber syndrome (SWS) are considered for surgery if they develop seizures and the seizures prove medically refractory. The authors report on 2 infants (15 and 19 months old) with SWS who underwent scalp video electroencephalography (EEG) and subsequent functional hemispherotomy for intractable partial motor seizures due to extensive left hemispheric angiomatosis. They presented with similar interictal and ictal EEG findings. Ictal EEG showed abrupt high-amplitude delta slow waves, without evolution on the contralateral hemisphere before the build-up of ictal EEG changes on the lesional hemisphere. The patients became seizure free after hemispherotomy. The ictal contralateral slow waves were not a sign of an ictal hemisphere and may indicate prominent ischemic changes resulting from a steal phenomenon of hemispheric angiomatosis during seizure.

  5. Ictal high frequency oscillations distinguish two types of seizure territories in humans.

    Science.gov (United States)

    Weiss, Shennan A; Banks, Garrett P; McKhann, Guy M; Goodman, Robert R; Emerson, Ronald G; Trevelyan, Andrew J; Schevon, Catherine A

    2013-12-01

    High frequency oscillations have been proposed as a clinically useful biomarker of seizure generating sites. We used a unique set of human microelectrode array recordings (four patients, 10 seizures), in which propagating seizure wavefronts could be readily identified, to investigate the basis of ictal high frequency activity at the cortical (subdural) surface. Sustained, repetitive transient increases in high gamma (80-150 Hz) amplitude, phase-locked to the low-frequency (1-25 Hz) ictal rhythm, correlated with strong multi-unit firing bursts synchronized across the core territory of the seizure. These repetitive high frequency oscillations were seen in recordings from subdural electrodes adjacent to the microelectrode array several seconds after seizure onset, following ictal wavefront passage. Conversely, microelectrode recordings demonstrating only low-level, heterogeneous neural firing correlated with a lack of high frequency oscillations in adjacent subdural recording sites, despite the presence of a strong low-frequency signature. Previously, we reported that this pattern indicates a failure of the seizure to invade the area, because of a feedforward inhibitory veto mechanism. Because multi-unit firing rate and high gamma amplitude are closely related, high frequency oscillations can be used as a surrogate marker to distinguish the core seizure territory from the surrounding penumbra. We developed an efficient measure to detect delayed-onset, sustained ictal high frequency oscillations based on cross-frequency coupling between high gamma amplitude and the low-frequency (1-25 Hz) ictal rhythm. When applied to the broader subdural recording, this measure consistently predicted the timing or failure of ictal invasion, and revealed a surprisingly small and slowly spreading seizure core surrounded by a far larger penumbral territory. Our findings thus establish an underlying neural mechanism for delayed-onset, sustained ictal high frequency oscillations, and

  6. Mapping human preictal and ictal haemodynamic networks using simultaneous intracranial EEG-fMRI.

    Science.gov (United States)

    Chaudhary, Umair J; Centeno, Maria; Thornton, Rachel C; Rodionov, Roman; Vulliemoz, Serge; McEvoy, Andrew W; Diehl, Beate; Walker, Matthew C; Duncan, John S; Carmichael, David W; Lemieux, Louis

    2016-01-01

    Accurately characterising the brain networks involved in seizure activity may have important implications for our understanding of epilepsy. Intracranial EEG-fMRI can be used to capture focal epileptic events in humans with exquisite electrophysiological sensitivity and allows for identification of brain structures involved in this phenomenon over the entire brain. We investigated ictal BOLD networks using the simultaneous intracranial EEG-fMRI (icEEG-fMRI) in a 30 year-old male undergoing invasive presurgical evaluation with bilateral depth electrode implantations in amygdalae and hippocampi for refractory temporal lobe epilepsy. One spontaneous focal electrographic seizure was recorded. The aims of the data analysis were firstly to map BOLD changes related to the ictal activity identified on icEEG and secondly to compare different fMRI modelling approaches. Visual inspection of the icEEG showed an onset dominated by beta activity involving the right amygdala and hippocampus lasting 6.4 s (ictal onset phase), followed by gamma activity bilaterally lasting 14.8 s (late ictal phase). The fMRI data was analysed using SPM8 using two modelling approaches: firstly, purely based on the visually identified phases of the seizure and secondly, based on EEG spectral dynamics quantification. For the visual approach the two ictal phases were modelled as 'ON' blocks convolved with the haemodynamic response function; in addition the BOLD changes during the 30 s preceding the onset were modelled using a flexible basis set. For the quantitative fMRI modelling approach two models were evaluated: one consisting of the variations in beta and gamma bands power, thereby adding a quantitative element to the visually-derived models, and another based on principal components analysis of the entire spectrogram in attempt to reduce the bias associated with the visual appreciation of the icEEG. BOLD changes related to the visually defined ictal onset phase were revealed in the medial and

  7. Mapping human preictal and ictal haemodynamic networks using simultaneous intracranial EEG-fMRI

    Science.gov (United States)

    Chaudhary, Umair J.; Centeno, Maria; Thornton, Rachel C.; Rodionov, Roman; Vulliemoz, Serge; McEvoy, Andrew W.; Diehl, Beate; Walker, Matthew C.; Duncan, John S.; Carmichael, David W.; Lemieux, Louis

    2016-01-01

    Accurately characterising the brain networks involved in seizure activity may have important implications for our understanding of epilepsy. Intracranial EEG-fMRI can be used to capture focal epileptic events in humans with exquisite electrophysiological sensitivity and allows for identification of brain structures involved in this phenomenon over the entire brain. We investigated ictal BOLD networks using the simultaneous intracranial EEG-fMRI (icEEG-fMRI) in a 30 year-old male undergoing invasive presurgical evaluation with bilateral depth electrode implantations in amygdalae and hippocampi for refractory temporal lobe epilepsy. One spontaneous focal electrographic seizure was recorded. The aims of the data analysis were firstly to map BOLD changes related to the ictal activity identified on icEEG and secondly to compare different fMRI modelling approaches. Visual inspection of the icEEG showed an onset dominated by beta activity involving the right amygdala and hippocampus lasting 6.4 s (ictal onset phase), followed by gamma activity bilaterally lasting 14.8 s (late ictal phase). The fMRI data was analysed using SPM8 using two modelling approaches: firstly, purely based on the visually identified phases of the seizure and secondly, based on EEG spectral dynamics quantification. For the visual approach the two ictal phases were modelled as ‘ON’ blocks convolved with the haemodynamic response function; in addition the BOLD changes during the 30 s preceding the onset were modelled using a flexible basis set. For the quantitative fMRI modelling approach two models were evaluated: one consisting of the variations in beta and gamma bands power, thereby adding a quantitative element to the visually-derived models, and another based on principal components analysis of the entire spectrogram in attempt to reduce the bias associated with the visual appreciation of the icEEG. BOLD changes related to the visually defined ictal onset phase were revealed in the medial

  8. [Ictal Gerstmann's syndrome in a patient with symptomatic parietal lobe epilepsy].

    Science.gov (United States)

    Shimotake, Akihiro; Fujita, Youshi; Ikeda, Akio; Tomimoto, Hidekazu; Takahashi, Jun; Takahashi, Ryosuke

    2008-03-01

    A 34-year-old man with astrocytoma in the left parietal lobe had symptomatic partial epilepsy, and he presented transient episodes of acalculia, agraphia and finger agnosia. Occasionally he had difficulty in finding appropriate letters when making an e-mail, and difficulty in writing and calculation. Neurological examinations revealed ictal symptoms of Gerstmann's syndrome without right to left disorientation. No other higher cortical dysfunction or neurological deficits were noted. Scalp EEGs showed frequent, regional ictal discharges in the left parietal area lasting for 60-240 seconds. These clinico-electrographical observations strongly support that epileptic seizures produced a loss of cortical higher function manifesting Gerstmann's syndrome.

  9. Improvement of tomographic reconstruction in bone SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Schuenemann, M.; Sahlmann, C.O.; Siefker, U.; Luig, H.; Meller, J. [Abteilungen fuer Nuklearmedizin, Georg-August-Univ. Goettingen (Germany); Heidrich, G. [Abteilungen fuer Diagnostische Radiologie, Georg-August-Univ., Goettingen (Germany); Werner, C.; Brunner, E. [Abteilungen fuer Medizinische Statistik, Georg-August-Univ., Goettingen (Germany)

    2006-07-01

    Aim: the comparison between iterative reconstruction and filtered backprojection in the reconstruction of bone SPECT in the diagnosis of skeletal metastases. Patients, methods: 47 consecutive patients (vertebral segments: n = 435), with suspected malignancy of the vertebral column, were examined by bone scintigraphy and MRI (maximal interval between the two procedures {+-} 5 weeks). The SPECT-data were reconstructed with an iterative algorithm (ISA) and with filtered backprojection. We defined semiquantitative criteria in order to assess the quality of the tomograms. Conventional reconstruction was performed both by a Wiener-filter and a low-pass-filter. Iterative reconstruction was performed by the ISA algorithm. The clinical evaluation of the different reconstruction algorithms was performed by MRI as the gold-standard. Results: sensitivity (%): 87.3 (ISA), 86.4 (low-pass), 79.7 (Wiener); specificity (%): 95.3 (ISA), 95 (low-pass), 85.4 (Wiener). The sensitivity of iterative reconstructed SPECT and low-pass reconstructed SPECT was significantly higher (p < 0.05) compared with the sensitivity of SPECT reconstructed by the Wiener-filter. The specificity of iterative reconstruction ISA and low-pass-filter reconstructed SPECT were significantly higher compared with the SPECT data reconstructed by the Wiener-filter. ISA was significantly superior to the Wiener-SPECT relating to all criteria of quality. Iterative reconstruction was significantly superior to the low-pass-SPECT relating to 2 of 3 criteria. In addition the Wiener-SPECT was significantly inferior to the low-pass-SPECT regarding to 2 of 3 criteria. Conclusion: in our series the iterative algorithm ISA was the method of choice in the reconstruction of bone SPECT data. In comparison with conventional algorithms ISA offers a significantly higher quality of the tomograms and yields a high diagnostic accuracy. (orig.)

  10. Mapping human preictal and ictal haemodynamic networks using simultaneous intracranial EEG-fMRI

    Directory of Open Access Journals (Sweden)

    Umair J. Chaudhary

    2016-01-01

    In conclusion, icEEG-fMRI allowed us to reveal BOLD changes within and beyond the SOZ linked to very localised ictal fluctuations in beta and gamma activity measured in the amygdala and hippocampus. Furthermore, the BOLD changes within the SOZ structures were better captured by the quantitative models, highlighting the interest in considering seizure-related EEG fluctuations across the entire spectrum.

  11. Inter-ictal spike detection using a database of smart templates

    NARCIS (Netherlands)

    Lodder, S.S.; Askamp, J.; Putten, van M.J.A.M.

    2013-01-01

    Objective: Visual analysis of EEG is time consuming and suffers from inter-observer variability. Assisted automated analysis helps by summarizing key aspects for the reviewer and providing consistent feedback. Our objective is to design an accurate and robust system for the detection of inter-ictal

  12. A self-adapting system for the automated detection of inter-ictal epileptiform discharges

    NARCIS (Netherlands)

    Lodder, S.S.; Putten, van M.J.A.M.

    2014-01-01

    Purpose Scalp EEG remains the standard clinical procedure for the diagnosis of epilepsy. Manual detection of inter-ictal epileptiform discharges (IEDs) is slow and cumbersome, and few automated methods are used to assist in practice. This is mostly due to low sensitivities, high false positive rates

  13. Clinical, electrophysiological and brain imaging features during recurrent ictal cortical blindness associated with chronic liver failure.

    Science.gov (United States)

    van Pesch, V; Hernalsteen, D; van Rijckevorsel, K; Duprez, Th; Boschi, A; Ivanoiu, A; Sindic, C J M

    2006-12-01

    Transient neuroimaging features indicating primary cortical and secondary subcortical white matter cytotoxic oedema have been described in association with prolonged or intense seizures. We describe the unusual condition of recurrent ictal cortical blindness due to focal occipital status epilepticus, in the context of chronic hepatic failure. There was a close association between the onset and disappearance of clinical, electrophysiological and magnetic resonance imaging abnormalities.

  14. SPECT of aged backache patients

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki [Prefectural Tajimi Hospital, Gifu (Japan)

    1995-12-01

    Single photon emission computed tomography (SPECT) using {sup 99m}Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. {sup 99m}Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.).

  15. Dorsal raphe nucleus acetylcholine-mediated neurotransmission modulates post-ictal antinociception: The role of muscarinic and nicotinic cholinergic receptors.

    Science.gov (United States)

    de Oliveira, Rithiele Cristina; de Oliveira, Ricardo; Biagioni, Audrey Francisco; Falconi-Sobrinho, Luiz Luciano; Coimbra, Norberto Cysne

    2016-01-15

    The dorsal raphe nucleus (DRN) is a key structure of the endogenous pain inhibitory system. Although the DRN is rich in serotoninergic neurons, cholinergic neurons are also found in that nucleus. Both ictal and inter-ictal states are followed by post-ictal analgesia. The present study investigated the role of cholinergic mechanisms in postictal antinociceptive processes using microinjections of atropine and mecamylamine, muscarinic and nicotinic cholinergic receptor antagonists, respectively, in the DRN of rats. Intraperitoneal injection of pentylenetetrazole (PTZ) (at 64mg/kg) caused tonic and tonic-clonic seizures. The convulsive motor reactions were followed by an increase in pain thresholds, a phenomenon known as post-ictal analgesia. Pre-treatment of the DRN with atropine or mecamylamine at 1µg, 3µg and 5µg/0.2µL decreased the post-ictal antinociceptive phenomenon. The present results showed that the post-ictal analgesia was mediated by muscarinic and nicotinic cholinergic receptors in the DRN, a structure crucially involved in the neural network that organises post-ictal hypoalgesia.

  16. Ictal propagation of high frequency activity is recapitulated in interictal recordings: effective connectivity of epileptogenic networks recorded with intracranial EEG

    Science.gov (United States)

    Korzeniewska, A.; Cervenka, M.C.; Jouny, C.C.; Perilla, J.R.; Harezlak, J.; Bergey, G.K.; Franaszczuk, P.J.; Crone, N.E.

    2014-01-01

    Seizures are increasingly understood to arise from epileptogenic networks across which ictal activity is propagated and sustained. In patients undergoing invasive monitoring for epilepsy surgery, high frequency oscillations have been observed within the seizure onset zone during both ictal and interictal intervals. We hypothesized that the patterns by which high frequency activity is propagated would help elucidate epileptogenic networks and thereby identify network nodes relevant for surgical planning. Intracranial EEG recordings were analyzed with a multivariate autoregressive modeling technique (short-time direct directed transfer function - SdDTF), based on the concept of Granger causality, to estimate the directionality and intensity of propagation of high frequency activity (70–175 Hz) during ictal and interictal recordings. These analyses revealed prominent divergence and convergence of high frequency activity propagation at sites identified by epileptologists as part of the ictal onset zone. In contrast, relatively little propagation of this activity was observed among the other analyzed sites. This pattern was observed in both subdural and depth electrode recordings of patients with focal ictal onset, but not in patients with a widely distributed ictal onset. In patients with focal ictal onsets, the patterns of propagation recorded during pre-ictal (up to 5 minutes immediately preceding ictal onset) and interictal (more than 24 hours before and after seizures) intervals were very similar to those recorded during seizures. The ability to characterize epileptogenic networks from interictal recordings could have important clinical implications for epilepsy surgery planning by reducing the need for prolonged invasive monitoring to record spontaneous seizures. PMID:25003814

  17. 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.

  18. SPECT/CT in neuroendocrine cancers; SPECT/CT bei neuroendokrinen Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Miederer, M. [Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik; Mainz Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Castrop, C.; Scheidhauer, K. [Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik; Buck, A.K. [Universitaetsklinikum Wuerzburg (Germany). Nuklearmedizinische Klinik und Poliklinik

    2011-03-15

    The accuracy of functional SPECT imaging has been significantly improved by addition of CT. This is especially relevant for functional imaging of neuroendocrine tumors using highly specific radiopharmaceuticals. Parathyroid adenomas can be detected by {sup 99m}Tc-MIBI SPECT/CT with very high sensitivity and specificity, playing an important role especially when minimally invasive techniques are used for surgical resection. With SPECT/CT, extra-adrenal manifestations of pheochromocytomas and tumors of the adrenal cortex can be detected with high accuracy. Because of the availability of PET radiopharmaceuticals such as {sup 68}Ga-DOTATOC, the clinical relevance of {sup 111}In-Octreotide SPECT for detection of neuroendocrine cancers has been recently reduced. Because of the better availability, SPECT and SPECT/CT still represent standard tools for imaging neuroendocrine cancers. SPECT/CT represents the superior imaging modality for monitoring radiopeptide based therapies, which are now increasingly used for treatment of neuroendocrine cancers. (orig.)

  19. Multi-centre evaluation of accuracy and reproducibility of planar and SPECT image quantification. An IAEA phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, Brian E. [National Institute of Standards and Technology, Gaithersburg, MD (United States); Grosev, Darko [Univ. Hospital Centre Zagreb (Croatia); Buvat, Irene [Service Hospitalier Frederic Joliot, Paris (France); and others

    2017-08-01

    Accurate quantitation of activity provides the basis for internal dosimetry of targeted radionuclide therapies. This study investigated quantitative imaging capabilities at sites with a variety of experience and equipment and assessed levels of errors in activity quantitation in Single-Photon Emission Computed Tomography (SPECT) and planar imaging. Participants from 9 countries took part in a comparison in which planar, SPECT and SPECT with X ray computed tomography (SPECT-CT) imaging were used to quantify activities of four epoxy-filled cylinders containing {sup 133}Ba, which was chosen as a surrogate for {sup 131}I. The sources, with nominal volumes of 2, 4, 6 and 23 mL, were calibrated for {sup 133}Ba activity by the National Institute of Standards and Technology, but the activity was initially unknown to the participants. Imaging was performed in a cylindrical phantom filled with water. Two trials were carried out in which the participants first estimated the activities using their local standard protocols, and then repeated the measurements using a standardized acquisition and analysis protocol. Finally, processing of the imaging data from the second trial was repeated by a single centre using a fixed protocol. In the first trial, the activities were underestimated by about 15% with planar imaging. SPECT with Chang's first order attenuation correction (Chang-AC) and SPECT-CT overestimated the activity by about 10%. The second trial showed moderate improvements in accuracy and variability. Planar imaging was subject to methodological errors, e.g., in the use of a transmission scan for attenuation correction. The use of Chang-AC was subject to variability from the definition of phantom contours. The project demonstrated the need for training and standardized protocols to achieve good levels of quantitative accuracy and precision in a multicentre setting. Absolute quantification of simple objects with no background was possible with the strictest protocol to

  20. Diagnostic value of SPECT in bone scintigraphy; Bedeutung der SPECT bei der Knochenszintigraphie

    Energy Technology Data Exchange (ETDEWEB)

    Gratz, S.; Becker, W. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

    2000-05-01

    Single Photon Emission Computed Tomography (SPECT) reflects the realization of its ability to remove unwanted activity from bone structures with greater contrast. Especially in the spine SPECT improves the diagnostic accuracy compared with planar bone scintigraphy, because smaller structures of single vertebral bodies can be diagnosed with better anatomic resolution due to SPECT with consequently higher sensitivities and specificities. With SPECT, alterations of the lateral part of the vertebral body, pars interacticularis and smaller facet joints can be correctly diagnosed as spondylarthrotic degenerative alterations. In patients with suspected spine malignancies SPECT did not demonstrate to be a reliable instrument for diagnosing malignancy. We recommend to perform SPECT in case of patients with back pain and suspected spine pathologies seen on planar bone scans, since a correct diagnosis of especially benign spondylarthrotic spine lesions is possible with SPECT. With SPECT, a reduction of radiological examinations of 23% should be possible. (orig.) [German] Die Single-Photonenemissionscomputertomographie (SPECT) erlaubt bei der Knochenszintigraphie eine ueberlagerungsfreie Darstellung von Knochenstrukturen mit hoher Kontrastgenauigkeit. Insbesondere bei Wirbelsaeulenerkrankungen ermoeglicht SPECT einen deutlichen diagnostischen Zugewinn gegenueber planaren Aufnahmen, da kleinere Strukturen einzelner Wirbelkoerper aufgrund des hohen anatomischen Aufloesungsvermoegens mit SPECT sehr sensitiv und spezifisch dargestellt werden. Veraenderungen, die sich auf den lateralen Anteil des Wirbelkoerpers, die Pars interarticularis und die kleinen Facettengelenke projizieren, koennen mit SPECT als spondylarthrotisch degenerative Laesionen eingestuft werden. Zwingende SPECT-szintigraphische Kriterien, die eine Laesion als eindeutig maligne nachweisen, gibt es dagegen nicht. Wir denken, dass SPECT bei allen Patienten mit Rueckenschmerzen und planarszintigraphisch suspekten

  1. Clinical applications of SPECT-CT

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadzadehfar, Hojjat; Biersack, Hans-Juergen (eds.) [University Hospital Bonn (Germany). Dept. of Nuclear Medicine

    2014-06-01

    Covers the full spectrum of clinical applications of SPECT/CT in diagnosis of benign and malignant diseases. Includes chapters on the use of SPECT/CT for dosimetry and for therapy planning. Completely up to date. Many helpful illustrations. SPECT/CT cameras have considerably improved diagnostic accuracy in recent years. Such cameras allow direct correlation of anatomic and functional information, resulting in better localization and definition of scintigraphic findings. In addition to this anatomic referencing, CT coregistration provides superior quantification of radiotracer uptake based on the attenuation correction capabilities of CT. Useful applications of SPECT/CT have been identified not only in oncology but also in other specialties such as orthopedics and cardiology. This book covers the full spectrum of clinical applications of SPECT/CT in diagnosis and therapy planning of benign and malignant diseases. Opening chapters discuss the technology and physics of SPECT/CT and its use for dosimetry. The role of SPECT/CT in the imaging of a range of pathologic conditions is then addressed in detail. Applications covered include, among others, imaging of the thyroid, bone, and lungs, imaging of neuroendocrine tumors, cardiac scintigraphy, and sentinel node scintigraphy. Individual chapters are also devoted to therapy planning in selective internal radiation therapy of liver tumors and bremsstrahlung SPECT/CT. Readers will find this book to be an essential and up-to-date source of information on this invaluable hybrid imaging technique.

  2. SPECT/CT and pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, Jann [Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); The Faroese National Hospital, Department of Medicine, Torshavn (Faroe Islands); Gutte, Henrik [Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Herlev Hospital, Copenhagen University Hospital, Department of Radiology, Copenhagen (Denmark); University of Copenhagen, Cluster for Molecular Imaging, Faculty of Health Sciences, Copenhagen (Denmark)

    2014-05-15

    Acute pulmonary embolism (PE) is diagnosed either by ventilation/perfusion (V/P) scintigraphy or pulmonary CT angiography (CTPA). In recent years both techniques have improved. Many nuclear medicine centres have adopted the single photon emission CT (SPECT) technique as opposed to the planar technique for diagnosing PE. SPECT has been shown to have fewer indeterminate results and a higher diagnostic value. The latest improvement is the combination of a low-dose CT scan with a V/P SPECT scan in a hybrid tomograph. In a study comparing CTPA, planar scintigraphy and SPECT alone, SPECT/CT had the best diagnostic accuracy for PE. In addition, recent developments in the CTPA technique have made it possible to image the pulmonary arteries of the lungs in one breath-hold. This development is based on the change from a single-detector to multidetector CT technology with an increase in volume coverage per rotation and faster rotation. Furthermore, the dual energy CT technique is a promising modality that can provide functional imaging in combination with anatomical information. Newer high-end CT scanners and SPECT systems are able to visualize smaller subsegmental emboli. However, consensus is lacking regarding the clinical impact and treatment. In the present review, SPECT and SPECT in combination with low-dose CT, CTPA and dual energy CT are discussed in the context of diagnosing PE. (orig.)

  3. First use of mini gamma cameras for intra-operative robotic SPECT reconstruction.

    Science.gov (United States)

    Matthies, Philipp; Sharma, Kanishka; Okur, Ash; Gardiazabal, José; Vogel, Jakob; Lasserl, Tobias; Navab, Nassir

    2013-01-01

    Different types of nuclear imaging systems have been used in the past, starting with pre-operative gantry-based SPECT systems and gamma cameras for 2D imaging of radioactive distributions. The main applications are concentrated on diagnostic imaging, since traditional SPECT systems and gamma cameras are bulky and heavy. With the development of compact gamma cameras with good resolution and high sensitivity, it is now possible to use them without a fixed imaging gantry. Mounting the camera onto a robot arm solves the weight issue, while also providing a highly repeatable and reliable acquisition platform. In this work we introduce a novel robotic setup performing scans with a mini gamma camera, along with the required calibration steps, and show the first SPECT reconstructions. The results are extremely promising, both in terms of image quality as well as reproducibility. In our experiments, the novel setup outperformed a commercial fhSPECT system, reaching accuracies comparable to state-of-the-art SPECT systems.

  4. SPECT/CT and pulmonary embolism

    DEFF Research Database (Denmark)

    Mortensen, Jann; Borgwardt, Henrik Gutte

    2014-01-01

    Acute pulmonary embolism (PE) is diagnosed either by ventilation/perfusion (V/P) scintigraphy or pulmonary CT angiography (CTPA). In recent years both techniques have improved. Many nuclear medicine centres have adopted the single photon emission CT (SPECT) technique as opposed to the planar...... technique for diagnosing PE. SPECT has been shown to have fewer indeterminate results and a higher diagnostic value. The latest improvement is the combination of a low-dose CT scan with a V/P SPECT scan in a hybrid tomograph. In a study comparing CTPA, planar scintigraphy and SPECT alone, SPECT/CT had...... the best diagnostic accuracy for PE. In addition, recent developments in the CTPA technique have made it possible to image the pulmonary arteries of the lungs in one breath-hold. This development is based on the change from a single-detector to multidetector CT technology with an increase in volume...

  5. Palilalia, echolalia, and echopraxia-palipraxia as ictal manifestations in a patient with left frontal lobe epilepsy.

    Science.gov (United States)

    Cho, Yang-Je; Han, Sang-Don; Song, Sook Keun; Lee, Byung In; Heo, Kyoung

    2009-06-01

    Palilalia is a relatively rare pathologic speech behavior and has been reported in various neurologic and psychiatric disorders. We encountered a case of palilalia, echolalia, and echopraxia-palipraxia as ictal phenomena of left frontal lobe epilepsy. A 55-year-old, right-handed man was admitted because of frequent episodes of rapid reiteration of syllables. Video-electroencephalography monitoring revealed stereotypical episodes of palilalia accompanied by rhythmic head nodding and right-arm posturing with ictal discharges over the left frontocentral area. He also displayed echolalia or echopraxia-palipraxia, partially responding to an examiner's stimulus. Magnetic resonance imaging revealed encephalomalacia on the left superior frontal gyrus and ictal single photon emission computed tomography showed hyperperfusion just above the lesion, corresponding to the left supplementary motor area (SMA), and subcortical nuclei. This result suggests that the neuroanatomic substrate involved in the generation of these behaviors as ictal phenomena might exist in the SMA of the left frontal lobe.

  6. Extracellular potassium dynamics in the hyperexcitable state of the neuronal ictal activity

    Science.gov (United States)

    Florence, Gerson; Pereira, Tiago; Kurths, Jürgen

    2012-12-01

    An enduring question in epilepsy research concerns with the mechanisms responsible for the neuronal hyperexcitability. This theme is under debate and different hypotheses have been put forward. One hypothesis relates to extracellular ionic variations, especially the increase of the extracellular potassium concentration ([K+]o). During the epileptiform bursting, an increase of [K+]o is observed which raises the cellular excitability. It remains unclear, however, how the extracellular potassium variation could affect the generation and persistence of epileptiform bursting within the ictal phase, that is, during the epileptic seizure. The neuronal mechanisms responsible for this cellular hyperexcitability are not yet fully understood, hindering the development of more efficient therapies to control epilepsy. Mathematical models with biological plausibility have provided considerable insights into the mechanisms underlying epileptiform pattern. This paper reviews experimental evidences and computational studies concerning effects of the extracellular potassium dynamics on the cellular excitability within the neuronal ictal activity.

  7. Molecular imaging of angiogenesis with SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Dijkgraaf, Ingrid; Boerman, Otto C. [Radboud University Nijmegen Medical Center, Department of Nuclear Medicine, P.O. Box 9101, HB Nijmegen (Netherlands)

    2010-08-15

    Single-photon emission computed tomography (SPECT) and position emission tomography (PET) are the two main imaging modalities in nuclear medicine. SPECT imaging is more widely available than PET imaging and the radionuclides used for SPECT are easier to prepare and usually have a longer half-life than those used for PET. In addition, SPECT is a less expensive technique than PET. Commonly used gamma emitters are: {sup 99m}Tc (E{sub max} 141 keV, T{sub 1/2} 6.02 h), {sup 123}I (E{sub max} 529 keV, T{sub 1/2} 13.0 h) and {sup 111}In (E{sub max} 245 keV, T{sub 1/2} 67.2 h). Compared to clinical SPECT, PET has a higher spatial resolution and the possibility to more accurately estimate the in vivo concentration of a tracer. In preclinical imaging, the situation is quite different. The resolution of microSPECT cameras (<0.5 mm) is higher than that of microPET cameras (>1.5 mm). In this report, studies on new radiolabelled tracers for SPECT imaging of angiogenesis in tumours are reviewed. (orig.)

  8. Seizure onset zone localization from ictal high-density EEG in five patients

    OpenAIRE

    Staljanssens, Willeke; Strobbe, Gregor; Van Holen, Roel; Birot, Gwénaël; Michel, Christophe M; Seeck, Margitta; Vandenberghe, Stefaan; Vulliémoz, Serge; van Mierlo, Pieter

    2015-01-01

    Rationale Because epilepsy is a network disease, localization of the exact seizure onset zone (SOZ) is difficult because the epileptic activity can spread to other regions within milliseconds. Functional connectivity metrics quantify how the activity in different brain regions is interrelated. In the past, it has been shown that functional connectivity analysis of ictal intracranial EEG (icEEG) recordings can help with SOZ localization in patients with focal epilepsy (van Mierlo et al., 20...

  9. Ictal central apnea and bradycardia in temporal lobe epilepsy complicated by obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Yoko Nishimura

    2015-01-01

    Full Text Available We describe the case of a 12-year-old boy who developed temporal lobe epilepsy (TLE with daily complex partial seizures (CPS and monthly generalized seizures. Moreover, he frequently snored while asleep since early childhood. Polysomnography (PSG revealed severe obstructive sleep apnea with apnea–hypopnea index (AHI of 37.8/h. Video-PSG with simultaneous electroencephalography (EEG recording captured two ictal apneic episodes during sleep, without any motor manifestations. The onset of rhythmic theta activity in the midtemporal area on EEG was preceded by the onset of apnea by several seconds and disappeared soon after cessation of central apnea. One episode was accompanied by ictal bradycardia of <48 beats/min which persisted for 50 s beyond the end of epileptic activity. After treatment with carbamazepine and tonsillectomy/adenoidectomy, the seizures were well controlled and AHI decreased to 2.5/h. Paroxysmal discharges also disappeared during this time. Uncontrolled TLE complicated by sleep apnea should be evaluated for the presence of ictal central apnea/bradycardia.

  10. Do ictal EEG characteristics predict treatment outcomes in schizophrenic patients undergoing electroconvulsive therapy?

    Science.gov (United States)

    Simsek, Gulnihal Gokce; Zincir, Selma; Gulec, Huseyin; Eksioglu, Sevgin; Semiz, Umit Basar; Kurtulmus, Yasemin Sipka

    2015-08-01

    The aim of this study is to investigate the relationship between features of electroencephalography (EEG), including seizure time, energy threshold level and post-ictal suppression time, and clinical variables, including treatment outcomes and side-effects, among schizophrenia inpatients undergoing electroconvulsive therapy (ECT). This is a naturalistic follow-up study on schizophrenia patients, diagnosed using DSM-IV-TR criteria, treated by a psychosis inpatient service. All participants completed the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning (GAF) scale, the Frontal Assessment Battery (FAB) and a Data Collection Form. Assessments were made before treatment, during ECT and after treatment. Statistically significant improvements in both clinical and cognitive outcome were noted after ECT in all patients. Predictors of improvement were sought by evaluating electrophysiological variables measured at three time points (after the third, fifth and seventh ECT sessions). Logistic regression analysis showed that clinical outcome/improvement did not differ by seizure duration, threshold energy level or post-ictal suppression time. We found that ictal EEG parameters measured at several ECT sessions did not predict clinical recovery/outcomes. This may be because our centre defensively engages in "very specific patient selection" when ECT is contemplated. ECT does not cause short-term cognitive functional impairment and indeed improves cognition, because symptoms of the schizophrenic episode are alleviated.

  11. Differentiating Interictal and Ictal States in Childhood Absence Epilepsy through Permutation Rényi Entropy

    Directory of Open Access Journals (Sweden)

    Nadia Mammone

    2015-07-01

    Full Text Available Permutation entropy (PE has been widely exploited to measure the complexity of the electroencephalogram (EEG, especially when complexity is linked to diagnostic information embedded in the EEG. Recently, the authors proposed a spatial-temporal analysis of the EEG recordings of absence epilepsy patients based on PE. The goal here is to improve the ability of PE in discriminating interictal states from ictal states in absence seizure EEG. For this purpose, a parametrical definition of permutation entropy is introduced here in the field of epileptic EEG analysis: the permutation Rényi entropy (PEr. PEr has been extensively tested against PE by tuning the involved parameters (order, delay time and alpha. The achieved results demonstrate that PEr outperforms PE, as there is a statistically-significant, wider gap between the PEr levels during the interictal states and PEr levels observed in the ictal states compared to PE. PEr also outperformed PE as the input to a classifier aimed at discriminating interictal from ictal states.

  12. Crossed cerebellar hyperperfusion in brain perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Jinnouchi, Seishi; Nagamachi, Shigeki; Nishii, Ryuuichi; Futami, Shigemi; Tamura, Shozo [Miyazaki Medical Coll., Kiyotake (Japan); Kawai, Keiichi

    2000-10-01

    Crossed cerebellar diaschisis is a well-known brain SPECT finding in stroke patients. Few reports, however, have described supratentorial and contralateral cerebellar hyperperfusion (crossed cerebellar hyperperfusion, CCH). We assessed the incidence of CCH in 33 patients with cerebral hyperperfusion. Brain SPECT showed CCH in five patients out of 20 epilepsy and three of 13 patients with acute encephalitis. These eight patients with CCH had recent epileptic attack. CCH was found in ECD SPECT as well as HM-PAO. The contralateral cerebellar activity correlated with the cerebral activity in patients with CCH. CCH would have a relation with supratentrial hyperfunction in epilepsy and acute encephalitis. (author)

  13. SPECT Myocardial Blood Flow Quantitation Concludes Equivocal Myocardial Perfusion SPECT Studies to Increase Diagnostic Benefits.

    Science.gov (United States)

    Chen, Lung-Ching; Lin, Chih-Yuan; Chen, Ing-Jou; Ku, Chi-Tai; Chen, Yen-Kung; Hsu, Bailing

    2016-01-01

    Recently, myocardial blood flow quantitation with dynamic SPECT/CT has been reported to enhance the detection of coronary artery disease in human. This advance has created important clinical applications to coronary artery disease diagnosis and management for areas where myocardial perfusion PET tracers are not available. We present 2 clinical cases that undergone a combined test of 1-day rest/dipyridamole-stress dynamic SPECT and ECG-gated myocardial perfusion SPECT scans using an integrated imaging protocol and demonstrate that flow parameters are capable to conclude equivocal myocardial perfusion SPECT studies, therefore increasing diagnostic benefits to add value in making clinical decisions.

  14. Repeated administration of D-amphetamine induces loss of [I-123]FP-CIT binding to striatal dopamine transporters in rat brain: a validation study

    NARCIS (Netherlands)

    J. Booij; K. de Bruin; W.B. Gunning

    2006-01-01

    In recent years, several PET and SPECT studies have shown loss of striatal dopamine transporter (DAT) binding in arnphetamine (AMPH) users. However, the use of DAT SPECT tracers to detect AMPH-induced changes in DAT binding has not been validated. We therefore examined if repeated administration of

  15. Automatic composition of MRI and SPECT images

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Hiromi [Research Inst. of Brain and Blood Vessels, Akita (Japan)

    1999-12-01

    The new method to automatically compose MRI image and SPECT image was devised to support the SPECT image which was inferior in the morphological information. This method is a kind of the coordinate transformation to obtain maximal agreement between images using cross correlation of MRI image and SPECT image as the evaluation function to show the degree of the agreement. For the calculation of the cross correlation, MRI T1 weighted image and the morphological information of SPECT image treated by the spatial quadratic differentiation (Laplacian) were used. This method does not require to fix the control point in the tomographic imaging, and can be also applied to PET other than SPECT. This is also useful to follow up the chronological change of a patient by composition among SPECT images and among PET images. Since this method is focused on the internal structure of brain, it is also useful for cases such as cerebral infarction which brain structure has little change. But this method is still under the trial and the examination of the accuracy remained. (K.H.)

  16. SPECT/CT diagnostics for skeletal infections; SPECT/CT-Infektdiagnostik am Skelett

    Energy Technology Data Exchange (ETDEWEB)

    Klaeser, B.; Spanjol, M.; Krause, T. [Inselspital Bern, Universitaetsklinik fuer Nuklearmedizin, Bern (Switzerland)

    2012-07-15

    Skeletal infections are often a diagnostic and clinical challenge. Nuclear imaging modalities used in the diagnostic workup of acute and chronic skeletal infections include three-phase bone scintigraphy and scintigraphy with labelled leucocytes. The introduction of hybrid technologies, such as single photon emission computed tomography/computed tomography (SPECT/CT) has dramatically changed nuclear medical imaging of infections. In general SPECT/CT leads to a considerably more accurate diagnosis than planar or SPECT imaging. Given the integrated acquisition of metabolic, functional and morphological information, SPECT/CT has increased in particular the specificity of three-phase skeletal scanning and scintigraphy with labeled leucocytes. (orig.) [German] Knoecherne Infekte stellen nicht selten eine diagnostische und klinische Herausforderung dar. Nuklearmedizinische Standardverfahren fuer die Diagnostik akuter und chronischer Knocheninfekte sind die Mehrphasenskelettszintigraphie und die Infektszintigraphie mit markierten Leukozyten. Die Einfuehrung von Hybridtechnologien wie der SPECT/CT hat die nuklearmedizinische Infektbildgebung tiefgreifend veraendert. Die SPECT/CT erlaubt bei der Frage nach Knocheninfekten insgesamt eine wesentlich genauere Beurteilung als planare Aufnahmen und SPECT. Die integrierte Akquisition von metabolischer, funktioneller und topographisch-morphologischer Information mit SPECT/CT steigerte insbesondere die Spezifitaet der Mehrphasenskelettszintigraphie und der Infektszintigraphie mit markierten Leukozyten. (orig.)

  17. Contribution of SPECT/CT for sentinel node localization in patients with ipsilateral breast cancer relapse

    Energy Technology Data Exchange (ETDEWEB)

    Borrelli, Pablo [Antoni Van Leeuwenhoek Hospital, Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam (Netherlands); Hospital La Fe, Nuclear Medicine, Medical Imaging Clinical Area, Valencia (Spain); Donswijk, Maarten L.; Stokkel, Marcel P.; Teixeira, Suzana C. [Antoni Van Leeuwenhoek Hospital, Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam (Netherlands); Tinteren, Harm van [Antoni Van Leeuwenhoek Hospital, Department of Biometrics, The Netherlands Cancer Institute, Amsterdam (Netherlands); Rutgers, Emiel J.T. [Antoni Van Leeuwenhoek Hospital, Department of Surgery, The Netherlands Cancer Institute, Amsterdam (Netherlands); Valdes Olmos, Renato A. [Antoni Van Leeuwenhoek Hospital, Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam (Netherlands); Leiden University Medical Centre, Nuclear Medicine Section and Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden (Netherlands)

    2017-04-15

    In recent years repeat sentinel node (SN) biopsy has been proven to be feasible in local breast cancer recurrence (LBCR). However, in these patients SNs outside the ipsilateral axilla are frequently observed. This study evaluates the contribution of SPECT/CT for SN localization and surgical adjustment in LBCR patients. SN biopsy was performed in 122 LBCR patients (median age 60.5 years, range 24-87), enrolled from August 2006 to July 2015. Median disease-free time lapse was 109.5 months (range 9-365). Axillary lymph node dissection (ALND) had previously been performed in 55 patients, SN biopsy in 44, both techniques in 13 and fine-needle aspiration in 10. Primary breast cancer treatment included radiotherapy in 104 patients (85.3 %) and chemotherapy in 40 (32.8 %). Preoperative lymphatic mapping, using planar scintigraphy (PS) and SPECT/CT included report of SN location according to lymph node territory. In case of a territorial PS-SPECT/CT mismatch, surgery was adjusted according to SPECT/CT findings. SPECT/CT SN visualization rate was higher than PS (53.3 % vs. 43.4 %, p n.s.) with, in total, 19 additional SN (118 vs. 99, p n.s.). PS-SPECT/CT territory mismatch, found in 60 % (39/65) of patients with SN visualization, led to surgical adjustment in 21.3 % (26/122) of patients. The SN procedure was finally performed in 104 patients resulting in a 65.7 % surgical retrieval rate with a total of 132 removed SNs (1.86/patient). SN metastases were found in 17/71 patients (23.9 %), in 16 of them (94 %) in ipsilateral basins outside the axilla or in the contralateral axilla. Using SPECT/CT there is a trend to visualize more SNs in LBCR, providing at the same time important anatomical information to adjust intraoperative SN procedures. The addition of SPECT/CT to the standard imaging protocol may lead to better staging mainly in patients presenting drainage outside the ipsilateral axilla. (orig.)

  18. Clinical evaluation of stress thallium spect in ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Sui, Osamu; Kimura, Nazuna; Soeki; Takeshi; Takeichi, Naoki; Shinohara, Hisanori; Tamura, Yoshiyuki; Fukuda, Nobuo [Zentsuji National Hospital, Kagawa (Japan)

    1997-05-01

    Thallium SPECT was performed in patients with significant coronary artery stenosis, 67 cases were after maximal exercise and 74 cases were during coronary vasodilation induced by ATP (adenosine triphosphate) infusion. In patients suspected of angina pectoris, the sensitivity, specificity and predictive accuracy for detection of coronary artery disease (CAD) were 88%, 78% and 82% for exercise SPECT, and 100%, 72% and 84% for ATP SPECT studies, respectively. In patients with old myocardial infarction, these were 73%, 100% and 88% for exercise SPECT and 71%, 100% and 81% for ATP SPECT. These were 75%, 49% and 60% for treadmill exercise test in the patient group including both angina and myocardial infarction. For detection of diseased vessels, the diagnostic accuracy for left anterior descending artery and right coronary artery lesions was almost equal for ATP and exercise SPECT study, but ATP SPECT study was more sensitive than exercise SPECT study in detection of left circumflex artery lesions. ATP as well as exercise SPECT studies occasionally gave false positive results in patients with single-vessel disease. ATP as well as exercise SPECT studies underestimated the severity of multi-vessel disease. In general, the results of ATP SPECT imaging were highly concordant with the results of exercise SPECT imaging. ATP stress thallium SPECT imaging provided a safe and highly accurate diagnostic tool for detection of CAD. (author)

  19. SPECT/CT - Technical aspects and optimization possibilities; SPECT/CT - Technische Aspekte und Optimierungsmoeglichkeiten

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, W. [Klinikum Passau, Klinik fuer Nuklearmedizin, Passau (Germany)

    2012-07-15

    In contrast to positron emission tomography/computed tomography (PET/CT), the currently available single photon emission computed tomography/computed tomography (SPECT/CT) systems are very heterogeneous. On the side of the gamma cameras, dual-head systems are established, which are not very different from one manufacturer to the other. For the CT component, there are low dose tubes on the one side and flat detector-based cone beam CT and multislice-CT on the other. The CT image data can be used for anatomic correlation of suspicious findings as well as for attenuation correction of SPECT data. Attenuation correction enables on the one hand enhancement of SPECT image quality and on the other hand quantification of the radioactivity concentration becomes possible. Modern iterative reconstruction algorithms allow scatter correction and attenuation correction of SPECT data using the density values from CT. It still has to be shown to what extent attenuation-corrected whole body SPECT/CT studies will be able to improve the sensitivity of scintigraphy studies. As SPECT/CT primarily aims at morphologic correlation and not detection of additional lesions, an attempt should be made to balance the necessary anatomic information and the additional radiation exposure. Besides SPECT-guided CT all technical possibilities for dose reduction should be exhausted. (orig.) [German] Im Gegensatz zur Positronenemissionstomographie/Computertomographie (PET/CT) sind die auf dem Markt angebotenen Single-photon-emission-computed-tomography/CT(SPECT/CT)-Systeme sehr heterogen. Auf der Seite der Gammakameras sind Zweikopfsysteme etabliert, die sich bei den verschiedenen Wettbewerbern nur unwesentlich unterscheiden. Hingegen reicht bei der CT-Komponente die Palette von der einfachen Niedrigdosisroentgenroehre ueber die flachdetektorbasierte Cone-beam-CT-Technologie bis hin zum Mehrzeilenspiral-CT. Die CT-Bilddaten werden dabei zum einen zur anatomischen Korrelation funktionell auffaelliger

  20. Improved Benefit of SPECT/CT Compared to SPECT Alone for the Accurate Localization of Endocrine and Neuroendocrine Tumors

    Directory of Open Access Journals (Sweden)

    Gonca G. Bural

    2012-12-01

    Full Text Available Objective: To assess the clinical utility of SPECT/ CT in subjects with endocrine and neuroendocrine tumors compared to SPECT alone. Material and Methods: 48 subjects (31 women;17 men; mean age 54±11 with clinical suspicion or diagnosis of endocrine and neuroendocrine tumor had 50 SPECT/CT scans (32 Tc-99m MIBI, 5 post treatment I-131, 8 In-111 Pentetreotide, and 5 I-123 MIBG. SPECT alone findings were compared to SPECT/CT and to pathology or radiological follow up. Results: From the 32 Tc-99m MIBI scans, SPECT accurately localized the lesion in 22 positive subjects while SPECT/CT did in 31 subjects. Parathyroid lesions not seen on SPECT alone were smaller than 10 mm. In five post treatment I-131 scans, SPECT alone neither characterized, nor localized any lesions accurately. SPECT/CT revealed 3 benign etiologies, a metastatic lymph node, and one equivocal lesion. In 8 In-111 Pentetreotide scans, SPECT alone could not localize primary or metastatic lesions in 6 subjects all of which were localized with SPECT/CT. In five I-123 MIBG scans, SPECT alone could not detect a 1.1 cm adrenal lesion or correctly characterize normal physiologic adrenal uptake in consecutive scans of the same patient with prior history of adrenelectomy, all of which were correctly localized and characterized with SPECT/CT. Conclusion: SPECT/CT is superior to SPECT alone in the assessment of endocrine and neuroendocrine tumors. It is better in lesion localization and lesion characterization leading to a decrease in the number of equivocal findings. SPECT/CT should be included in the clinical work up of all patients with diagnosis or suspicion of endocrine and neuroendocrine tumors. (MIRT 2012;21:91-96

  1. SPECT/CT workflow and imaging protocols

    Energy Technology Data Exchange (ETDEWEB)

    Beckers, Catherine [University Hospital of Liege, Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, Liege (Belgium); Hustinx, Roland [University Hospital of Liege, Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, Liege (Belgium); Domaine Universitaire du Sart Tilman, Service de Medecine Nucleaire et Imagerie Oncologique, CHU de Liege, Liege (Belgium)

    2014-05-15

    Introducing a hybrid imaging method such as single photon emission computed tomography (SPECT)/CT greatly alters the routine in the nuclear medicine department. It requires designing new workflow processes and the revision of original scheduling process and imaging protocols. In addition, the imaging protocol should be adapted for each individual patient, so that performing CT is fully justified and the CT procedure is fully tailored to address the clinical issue. Such refinements often occur before the procedure is started but may be required at some intermediate stage of the procedure. Furthermore, SPECT/CT leads in many instances to a new partnership with the radiology department. This article presents practical advice and highlights the key clinical elements which need to be considered to help understand the workflow process of SPECT/CT and optimise imaging protocols. The workflow process using SPECT/CT is complex in particular because of its bimodal character, the large spectrum of stakeholders, the multiplicity of their activities at various time points and the need for real-time decision-making. With help from analytical tools developed for quality assessment, the workflow process using SPECT/CT may be separated into related, but independent steps, each with its specific human and material resources to use as inputs or outputs. This helps identify factors that could contribute to failure in routine clinical practice. At each step of the process, practical aspects to optimise imaging procedure and protocols are developed. A decision-making algorithm for justifying each CT indication as well as the appropriateness of each CT protocol is the cornerstone of routine clinical practice using SPECT/CT. In conclusion, implementing hybrid SPECT/CT imaging requires new ways of working. It is highly rewarding from a clinical perspective, but it also proves to be a daily challenge in terms of management. (orig.)

  2. A self-adapting system for the automated detection of inter-ictal epileptiform discharges.

    Directory of Open Access Journals (Sweden)

    Shaun S Lodder

    Full Text Available PURPOSE: Scalp EEG remains the standard clinical procedure for the diagnosis of epilepsy. Manual detection of inter-ictal epileptiform discharges (IEDs is slow and cumbersome, and few automated methods are used to assist in practice. This is mostly due to low sensitivities, high false positive rates, or a lack of trust in the automated method. In this study we aim to find a solution that will make computer assisted detection more efficient than conventional methods, while preserving the detection certainty of a manual search. METHODS: Our solution consists of two phases. First, a detection phase finds all events similar to epileptiform activity by using a large database of template waveforms. Individual template detections are combined to form "IED nominations", each with a corresponding certainty value based on the reliability of their contributing templates. The second phase uses the ten nominations with highest certainty and presents them to the reviewer one by one for confirmation. Confirmations are used to update certainty values of the remaining nominations, and another iteration is performed where ten nominations with the highest certainty are presented. This continues until the reviewer is satisfied with what has been seen. Reviewer feedback is also used to update template accuracies globally and improve future detections. KEY FINDINGS: Using the described method and fifteen evaluation EEGs (241 IEDs, one third of all inter-ictal events were shown after one iteration, half after two iterations, and 74%, 90%, and 95% after 5, 10 and 15 iterations respectively. Reviewing fifteen iterations for the 20-30 min recordings 1 took approximately 5 min. SIGNIFICANCE: The proposed method shows a practical approach for combining automated detection with visual searching for inter-ictal epileptiform activity. Further evaluation is needed to verify its clinical feasibility and measure the added value it presents.

  3. Ictal and postictal semiology in patients with bilateral temporal lobe epilepsy.

    Science.gov (United States)

    Řehulka, Pavel; Doležalová, Irena; Janoušová, Eva; Tomášek, Martin; Marusič, Petr; Brázdil, Milan; Kuba, Robert

    2014-12-01

    Bilateral temporal lobe epilepsy is characterized by evidence of seizure onset independently in both temporal lobes. The main aim of the present study was to determine whether patients with evidence of independent bilateral temporal lobe epilepsy (biTLE) can be identified noninvasively on the basis of seizure semiology analysis. Thirteen patients with biTLE, as defined by invasive EEG, were matched with 13 patients with unilateral temporal lobe epilepsy (uniTLE). In all 26 patients, the frequency of predefined clusters of ictal and periictal signs were evaluated: ictal motor signs (IMSs), periictal motor signs (PIMSs), periictal vegetative signs (PIVSs), the frequency of early oroalimentary automatisms (EOAs), and the duration of postictal unresponsiveness (PU). Some other noninvasive and clinical data were also evaluated. A lower frequency of IMSs was noted in the group with biTLE (patients = 46.2%, seizures = 20.7%) than in the group with uniTLE (patients = 92.3%, seizures = 61.0%) (p = 0.030; p < 0.001, respectively). The individual IMS average per seizure was significantly lower in the group with biTLE (0.14; range = 0-1.0) than in the group with uniTLE (0.80; range = 0-2.6) (p = 0.003). Postictal unresponsiveness was longer than 5 min in more patients (75.0%) and seizures (42.9%) in the group with biTLE than in the group with uniTLE (patients = 30.8%, seizures = 18.6%) (p = 0.047; p = 0.002). The frequency of EOAs, PIMSs, PIVSs, and other clinical data did not differ significantly. There is a lower frequency of ictal motor signs and longer duration of postictal unresponsiveness in patients with biTLE. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Follow-up findings in regional cerebral blood flow (r-CBF)-SPECT in a case of idiopathic childhood hemidystonia. Functional neuroimaging and pathophysiological implications

    Energy Technology Data Exchange (ETDEWEB)

    Fiedler, A.; Aderbauer, J.; Segerer, H. [St. Hedwig Hospital, Regensburg (Germany). Dept. of Pediatrics; Marienhagen, J.; Bock, E.; Eilles, C. [Univ. Hospital, Regensburg (Germany). Dept. of Nuclear Medicine

    1999-05-01

    A 9 1/2-year-old girl suffered from intermitting tremor and jitteriness of her left hand and oral muscles every 4 to 6 weeks with long lasting episodes. Clinically myoclonias and dystonic positioning of the left arm, hand and facial muscles were seen. No evidence of trauma, infection or inborn errors of metabolism was found. Successful therapy with carbamazepine was initiated while L-DOPA failed. An ictal 99m-Tc-HMPAO-SPECT showed severe asymmetry with focal hyperperfusion of the contralateral right thalamus and basal ganglia as well as of the bifrontal cortex, whereas no anatomical lesions were found by MRI. In contrast, an interictally performed 99m-Tc-HMPAO SPECT showed hypoperfusion or the right thalamus and normalisation of the frontal perfusion under medical treatment. These 99m-Tc-HMPAO-SPECT findings may provide new insights into the localisation and pathophysiological pathways of idiopathic childhood dystonia. (orig.) [Deutsch] Ein 9 1/2jaehriges Maedchen litt an rezidivierenden, langdauernden Schueben von Tremor und Zittern der linken Hand und der perioralen Muskulatur links. Klinisch fanden sich eine dystone Haltung des linken Armes und unerschoepfliche Myoklonien des Armes, der Hand und der Gesichtsmuskulatur links. Trauma, Infektion oder ein Stoffwechseldefekt als Ursache lagen nicht vor. Ein Therapieversuch mit L-DOPA war erfolglos. Unter Gabe von Carbamazepin wurde Beschwerdefreiheit bleibend erreicht. Ein iktuales 99m-Tc-HMPAO-SPECT zeigte eine fokale Hyperperfusion des rechtsseitigen Thalamus und der Basalganglien, sowie des bifrontalen Kortex. Ein interiktuales 99m-Tc-HMPAOSPECT ergab dann eine deutliche Hypoperfusion des rechtseitigen Thalamus bei normalisierter Perfusion des bifrontalen Kortex. Eine kranielle Magnetresonanztomographie (MRI) ergab einen unauffaelligen Befund. Der Vergleich der iktualen und interiktualen Perfusionsverhaeltnisse weist auf neue pathophysiologische Zusammenhaenge bei idiopathischer kindlicher Dystonie hin. (orig.)

  5. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Punit; Kumar, Rakesh; Singh, Harmandeep; Bal, Chandrasekhar; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Julka, Pramod Kumar [All India Institute of Medical Sciences, Department of Radiation Oncology, New Delhi (India); Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India)

    2012-07-15

    The objective of the present study was to compare the role of single photon emission computed tomography (SPECT), computed tomography (CT) and SPECT-CT of selected volume in lung cancer patients with indeterminate lesions on planar bone scintigraphy (BS). The data of 50 lung cancer patients (53 {+-} 10.3 years; range 30-75; male/female 38/12) with 65 indeterminate lesions on planar BS (January 2010 to November 2010) were retrospectively evaluated. All of them underwent SPECT-CT of a selected volume. SPECT, CT and SPECT-CT images were independently evaluated by two experienced readers (experience in musculoskeletal imaging, including CT: 5 and 7 years) in separate sessions. A scoring scale of 1 to 5 was used, in which 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each modality, taking a score {<=}2 as metastatic. With receiver operating characteristic (ROC) curve analysis, areas under the curve (AUC) were calculated for each modality and compared. Clinical and imaging follow-up and/or histopathology were taken as reference standard. For both readers SPECT was inferior to CT (P = 0.004, P = 0.022) and SPECT-CT (P = 0.003, P = 0.037). However, no significant difference was found between CT and SPECT-CT for reader 1 (P = 0.847) and reader 2 (P = 0.592). The findings were similar for lytic as well as sclerotic lesions. Moderate inter-observer agreement was seen for SPECT images ({kappa} = 0.426), while almost perfect agreement was seen for CT ({kappa} = 0.834) and SPECT-CT ({kappa} = 0.971). CT alone and SPECT-CT are better than SPECT for accurate characterisation of indeterminate lesions on planar BS in lung cancer patients. CT alone is not inferior to SPECT-CT for this purpose and might be preferred because of shorter acquisition time and wider availability. (orig.)

  6. ICTAL AND INTERICTAL EEG ABNORMALITIES IN 100 MIGRAINEURS WITH AND WITHOUT AURA

    OpenAIRE

    2007-01-01

    There are several conflicting reports about the EEG of the migraineurs. In this study we report the ictal and interictal EEGs of 100 migraineurs, in comparison with control group. The range age for patient and control groups were 9-48 (mean: 26 ± 1.8) and 10-46 (mean: 23 ± 2.1) years respectively. 32% of the patients were less than 14 years old and the remaining 68% were more than 14 years. In the patient group, 68% of cases had migraine without aura and 32% suffered fro...

  7. Brain SPECT imaging in Sydenham's chorea

    Directory of Open Access Journals (Sweden)

    Barsottini O.G.P.

    2002-01-01

    Full Text Available The objective of the present study was to determine whether brain single-photon emission computed tomography (SPECT imaging is capable of detecting perfusional abnormalities. Ten Sydenham's chorea (SC patients, eight females and two males, 8 to 25 years of age (mean 13.4, with a clinical diagnosis of SC were submitted to brain SPECT imaging. We used HMPAO labeled with technetium-99m at a dose of 740 MBq. Six examinations revealed hyperperfusion of the basal ganglia, while the remaining four were normal. The six patients with abnormal results were females and their data were not correlated with severity of symptoms. Patients with abnormal brain SPECT had a more recent onset of symptoms (mean of 49 days compared to those with normal SPECT (mean of 85 days but this difference did not reach statistical significance. Brain SPECT can be a helpful method to determine abnormalities of the basal ganglia in SC patients but further studies on a larger number of patients are needed in order to detect the phase of the disease during which the examination is more sensitive.

  8. SPECT/CT and tumour imaging

    Energy Technology Data Exchange (ETDEWEB)

    Abikhzer, Gad [Rambam Health Care Campus, Department of Nuclear Medicine, Haifa (Israel); Keidar, Zohar [Rambam Health Care Campus, Department of Nuclear Medicine, Haifa (Israel); Technion - Israel Institute of Technology, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa (Israel)

    2014-05-15

    Scintigraphic techniques are sensitive imaging modalities in the diagnosis and follow-up of cancer patients providing the functional and metabolic activity characteristics of the tumour. Hybrid SPECT/CT improves the diagnostic accuracy of these well-established imaging techniques by precise anatomical localization and characterization of morphological findings, differentiation between foci of physiological and pathological tracer uptake, resulting in a significant impact on patient management and more definitive interpretations. The use of SPECT/CT has been studied in a variety of applications in tumour imaging which are reviewed in this article. By combining functional and anatomical information in a single imaging session, SPECT/CT has become a one-stop cancer imaging modality. (orig.)

  9. [{sup 123}I]-IMP SPECT findings in spinocerebellar ataxia type 6

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Yasuhiko; Nakabayashi, Haruo; Iguchi, Yasuyuki; Suzuki, Masahiko; Kobayashi, Masayuki [Jikei Univ., Chiba (Japan). Kashiwa Hospital; Nakajima, Takashi

    2000-01-01

    To study the dynamics of metabolic function in the cerebellar hemispheres, vermis and brain stem of patients with spinocerebellar ataxia type 6 (SCA6), we used single photon emission computed tomography (SPECT) with N-isopropyl-p-[{sup 123}I] iodoamphetamine (IMP) to measure regional cerebral blood flow (rCBF) in six Japanese patients with SCA6 and nine normal control subjects. All patients with SCA6 were found to have expanded CAG repeats (from 22 to 24 repeats). The SPECT data were also analyzed semiquantitatively. The rCBF in the cerebellar hemisphere, vermis and brain stem was not significantly lower in patients with SCA6 than in normal controls. However, the ratio of the cerebellar hemisphere to occipital lobe (C/O ratio) was significantly lower in patients. The ratio of the vermis and brain stem to occipital lobe (V/O, P/O ratio) were not significantly lower in patients. The C/O, V/O and P/O ratio were especially sensitive indexes for regional cerebral function in patients with SCA6. Results of this study suggest that the functional decrease in SCA6 may begin in the cerebellar hemispheres. IMP SPECT was useful for evaluating rCBF in patients with SCA6. (author)

  10. Motor activation SPECT for the neurosurgical diseases. Clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Hiroshi; Kawaguchi, Shoichiro; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

    1999-08-01

    We evaluated and analyzed the motor activation single photon emission computed tomography (M-SPECT) findings on patients with ischemic cerebrovascular diseases (CVD). The M-SPECT studies were carried out on 91 patients with ischemic cerebrovascular diseases. The M-SPECT study was performed using the finger opposition task in each case. The SPECT images were superimposed on the magnetic resonance images (MRIs) for each case using Image Fusion Software. The result of the M-SPECT was expressed as positive or negative. The cases with a marked increase of blood flow in the sensorio-motor cortex after the finger opposition task were categorized as positive, and those cases showing no marked increase of blood flow were categorized as negative. Among the 91 cases examined, 53 (58%) were categorized as positive in the M-SPECT study. Among the negative M-SPECT cases treated with revascularization surgery, there were some cases showing positive M-SPECT results postoperatively. The cases without any revascularization surgery did not change the M-SPECT findings in each during the follow-up period. The M-SPECT procedure for examining intracranial lesions could provide the cortical localization of the motor function. The M-SPECT procedure in the ischemic CVDs contributes to knowledge about the choices of treatment and the evaluation of the treatment result. (author)

  11. Application of SPECT to psychiatry

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi [National Center Hospital for Mental, Nervous, and Muscular Disorders, Kodaira, Tokyo (Japan)

    1999-07-01

    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, 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 {sup 99m}Tc-ECD were useful for objective evaluation of regional abnormality in brain function in psychiatric diseases. (author)

  12. Radioembolization with Y-90 Glass Microspheres: Do We Really Need SPECT-CT to Identify Extrahepatic Shunts?

    Directory of Open Access Journals (Sweden)

    Jens M Theysohn

    Full Text Available Selective Internal Radiation Therapy (SIRT with 90yttrium (Y-90 is an increasingly used therapeutic option for unresectable liver malignancies. Nontarget embolization of extrahepatic tissue secondary to vascular shunting can lead to SIRT associated complications. Our aim was to assess whether extrahepatic shunts can reliably be diagnosed based on hepatic digital subtraction angiography (DSA or whether subsequent SPECT/CT data can provide additional information.825 patients with hepatocellular carcinoma (n = 636, hepatic metastases (n = 158 or cholangiocellular carcinoma (n = 31 were retrospectively analyzed. During hepatic DSA 128 arteries causing shunt flow to gastrointestinal tissue were coilembolized (right gastric artery n = 63, gastroduodenal artery n = 29; branches to duodenum / pancreas n = 36. Technectium-99m-labeled human serum albumin (HSA was injected in all 825 patients. SPECT/CT data was used to identify additional or remaining shunts to extrahepatic tissue.An unexpected uptake of HSA in extrahepatic tissue was found by SPECT/CT in 54/825 (6.5% patients (located in stomach n = 13, duodenum n = 26, distal bowel segments n = 12, kidney n = 1, diaphragm n = 2. These patients underwent repeated DSA and newly identified shunt vessels were coilembolized in 22/54 patients, while in 12/54 patients a more distal catheter position for repeat injection of HSA was chosen. In 20/54 patients the repeated SPECT/CT data still revealed an extrahepatic HSA uptake. These patients did not receive SIRT.Most extrahepatic shunts can be identified on DSA prior to Y-90 therapy. However, SPECT-CT data helps to identify additional shunts that were initially not seen on DSA.

  13. 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

  14. Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology.

    Science.gov (United States)

    Erlandsson, Kjell; Kacperski, Krzysztof; van Gramberg, Dean; Hutton, Brian F

    2009-05-07

    D-SPECT (Spectrum Dynamics, Israel) is a novel SPECT system for cardiac perfusion studies. Based on CZT detectors, region-centric scanning, high-sensitivity collimators and resolution recovery, it offers potential advantages over conventional systems. A series of measurements were made on a beta-version D-SPECT system in order to evaluate its performance in terms of energy resolution, scatter fraction, sensitivity, count rate capability and resolution. Corresponding measurements were also done on a conventional SPECT system (CS) for comparison. The energy resolution of the D-SPECT system at 140 keV was 5.5% (CS: 9.25%), the scatter fraction 30% (CS: 34%), the planar sensitivity 398 s(-1) MBq(-1) per head ((99m)Tc, 10 cm) (CS: 72 s(-1) MBq(-1)), and the tomographic sensitivity in the heart region was in the range 647-1107 s(-1) MBq(-1) (CS: 141 s(-1) MBq(-1)). The count rate increased linearly with increasing activity up to 1.44 M s(-1). The intrinsic resolution was equal to the pixel size, 2.46 mm (CS: 3.8 mm). The average reconstructed resolution using the standard clinical filter was 12.5 mm (CS: 13.7 mm). The D-SPECT has superior sensitivity to that of a conventional system with similar spatial resolution. It also has excellent energy resolution and count rate characteristics, which should prove useful in dynamic and dual radionuclide studies.

  15. Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology

    Science.gov (United States)

    Erlandsson, Kjell; Kacperski, Krzysztof; van Gramberg, Dean; Hutton, Brian F.

    2009-05-01

    D-SPECT (Spectrum Dynamics, Israel) is a novel SPECT system for cardiac perfusion studies. Based on CZT detectors, region-centric scanning, high-sensitivity collimators and resolution recovery, it offers potential advantages over conventional systems. A series of measurements were made on a β-version D-SPECT system in order to evaluate its performance in terms of energy resolution, scatter fraction, sensitivity, count rate capability and resolution. Corresponding measurements were also done on a conventional SPECT system (CS) for comparison. The energy resolution of the D-SPECT system at 140 keV was 5.5% (CS: 9.25%), the scatter fraction 30% (CS: 34%), the planar sensitivity 398 s-1 MBq-1 per head (99mTc, 10 cm) (CS: 72 s-1 MBq-1), and the tomographic sensitivity in the heart region was in the range 647-1107 s-1 MBq-1 (CS: 141 s-1 MBq-1). The count rate increased linearly with increasing activity up to 1.44 M s-1. The intrinsic resolution was equal to the pixel size, 2.46 mm (CS: 3.8 mm). The average reconstructed resolution using the standard clinical filter was 12.5 mm (CS: 13.7 mm). The D-SPECT has superior sensitivity to that of a conventional system with similar spatial resolution. It also has excellent energy resolution and count rate characteristics, which should prove useful in dynamic and dual radionuclide studies.

  16. PET and SPECT of neurobiological systems

    Energy Technology Data Exchange (ETDEWEB)

    Dierckx, Rudi A.J.O. [Groningen Univ. (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Gent Univ. (Belgium). Dept. of Nuclear Medicine; Otte, Andreas [Univ. of Applied Sciences, Offenburg (Germany). Faculty of Electrical Engineering and Information Technology; Vries, Erik F.J. de; Waarde, Aren van (eds.) [Groningen Univ. (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging

    2014-04-01

    Addresses a variety of aspects of neurotransmission in the brain. Details the latest results in probe development. Emphasis on a multidisciplinary approach. Written by internationally acclaimed experts. PET and SPECT of Neurobiological Systems combines the expertise of renowned authors whose dedication to the development of novel probes and techniques for the investigation of neurobiological systems has achieved international recognition. Various aspects of neurotransmission in the brain are discussed, such as visualization and quantification of (more than 20 different) neuroreceptors, neuroinflammatory markers, transporters, and enzymes as well as neurotransmitter synthesis, ?-amyloid deposition, cerebral blood flow, and the metabolic rate of glucose. The latest results in probe development are also detailed. Most chapters are written jointly by radiochemists and nuclear medicine specialists to ensure a multidisciplinary approach. This state of the art compendium will be valuable to anyone in the field of clinical or preclinical neuroscience, from the radiochemist and radiologist/nuclear medicine specialist to the interested neurobiologist and general practitioner. It is the second volume of a trilogy on PET and SPECT imaging in the neurosciences. Other volumes focus on PET and SPECT in psychiatry and PET and SPECT in neurology''.

  17. Methodology for ventilation/perfusion SPECT

    DEFF Research Database (Denmark)

    Bajc, Marika; Neilly, Brian; Miniati, Massimo

    2010-01-01

    Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas ov...

  18. Singular Value Decomposition of Pinhole SPECT Systems.

    Science.gov (United States)

    Palit, Robin; Kupinski, Matthew A; Barrett, Harrison H; Clarkson, Eric W; Aarsvold, John N; Volokh, Lana; Grobshtein, Yariv

    2009-03-12

    A single photon emission computed tomography (SPECT) imaging system can be modeled by a linear operator H that maps from object space to detector pixels in image space. The singular vectors and singular-value spectra of H provide useful tools for assessing system performance. The number of voxels used to discretize object space and the number of collection angles and pixels used to measure image space make the matrix dimensions H large. As a result, H must be stored sparsely which renders several conventional singular value decomposition (SVD) methods impractical. We used an iterative power methods SVD algorithm (Lanczos) designed to operate on very large sparsely stored matrices to calculate the singular vectors and singular-value spectra for two small animal pinhole SPECT imaging systems: FastSPECT II and M(3)R. The FastSPECT II system consisted of two rings of eight scintillation cameras each. The resulting dimensions of H were 68921 voxels by 97344 detector pixels. The M(3)R system is a four camera system that was reconfigured to measure image space using a single scintillation camera. The resulting dimensions of H were 50864 voxels by 6241 detector pixels. In this paper we present results of the SVD of each system and discuss calculation of the measurement and null space for each system.

  19. SPECT and PET in Eating Disorders

    NARCIS (Netherlands)

    van Waarde, Aren; Audenaert, Kurt; Busatto, Geraldo F.; Buchpiguel, Carlos; Dierckx, Rudi; Dierckx, Rudi AJO; Otte, Andreas; de Vries, Erik FJ; van Waarde, Aren; den Boer, Johan A

    2014-01-01

    Medical imaging techniques like PET and SPECT have been applied for investigation of brain function in anorexia and bulimia nervosa. Regional abnormalities have been detected in cerebral blood flow, glucose metabolism, the availability of several neurotransmitter receptors (serotonin 1A and 2A, dopa

  20. PET and SPECT imaging in veterinary medicine.

    Science.gov (United States)

    LeBlanc, Amy K; Peremans, Kathelijne

    2014-01-01

    Veterinarians have gained increasing access to positron emission tomography (PET and PET/CT) imaging facilities, allowing them to use this powerful molecular imaging technique for clinical and research applications. SPECT is currently being used more in Europe than in the United States and has been shown to be useful in veterinary oncology and in the evaluation of orthopedic diseases. SPECT brain perfusion and receptor imaging is used to investigate behavioral disorders in animals that have interesting similarities to human psychiatric disorders. This article provides an overview of the potential applications of PET and SPECT. The use of commercially available and investigational PET radiopharmaceuticals in the management of veterinary disease has been discussed. To date, most of the work in this field has utilized the commercially available PET tracer, (18)F-fluorodeoxyglucose for oncologic imaging. Normal biodistribution studies in several companion animal species (cats, dogs, and birds) have been published to assist in lesion detection and interpretation for veterinary radiologists and clinicians. Studies evaluating other (18)F-labeled tracers for research applications are underway at several institutions and companion animal models of human diseases are being increasingly recognized for their value in biomarker and therapy development. Although PET and SPECT technologies are in their infancy for clinical veterinary medicine, increasing access to and interest in these applications and other molecular imaging techniques has led to a greater knowledge and collective body of expertise for veterinarians worldwide. Initiation and fostering of physician-veterinarian collaborations are key components to the forward movement of this field.

  1. SPECT and PET in Eating Disorders

    NARCIS (Netherlands)

    van Waarde, Aren; Audenaert, Kurt; Busatto, Geraldo F.; Buchpiguel, Carlos; Dierckx, Rudi; Dierckx, Rudi AJO; Otte, Andreas; de Vries, Erik FJ; van Waarde, Aren; den Boer, Johan A

    2014-01-01

    Medical imaging techniques like PET and SPECT have been applied for investigation of brain function in anorexia and bulimia nervosa. Regional abnormalities have been detected in cerebral blood flow, glucose metabolism, the availability of several neurotransmitter receptors (serotonin 1A and 2A,

  2. SPECT using asymmetric pinholes with truncated projections

    Energy Technology Data Exchange (ETDEWEB)

    Lin Jianyu; Meikle, Steven R, E-mail: jianyu.lin@curtin.edu.au [Ramaciotti Imaging Centre, Brain and Mind Research Institute, University of Sydney (Australia)

    2011-07-07

    Tomographic systems employing truncated projections have been developed for parallel and fan beam collimation and for cone beam CT but the idea has not been extensively explored in pinhole single photon emission computed tomography (SPECT). In this paper, we explore the sampling requirements and system performance of SPECT systems with asymmetric pinhole collimators and truncated projections. We demonstrate that complete 3D sampling can be achieved by using multiple detectors with truncated asymmetric pinholes, offset axially from each other, and a spiral orbit. The use of truncated projections can be exploited in the design of pinhole SPECT systems by moving the pinholes closer to the subject, resulting in increased sensitivity and improved spatial resolution. Truncated and untruncated pinhole systems were evaluated using the contrast-to-noise ratio (CNR) calculated from the linearized local impulse response as a figure of merit. The CNR for the truncated pinhole system was up to 60% greater than that for the untruncated system at matched resolution for a source voxel near the centre of a uniform phantom and 30% greater at the edge. We conclude that an object can be reconstructed from asymmetric pinholes with truncated projections, which leads to potentially important design considerations and applications in single- and multi-pinhole SPECT.

  3. [{sup 123}]FP-CIT SPECT scans initially rated as normal became abnormal over time in patients with probable dementia with Lewy bodies

    Energy Technology Data Exchange (ETDEWEB)

    Zande, J.J. van der; Scheltens, P.; Lemstra, A.W. [VU Medical Center Alzheimer Center, Amsterdam (Netherlands); Booij, J. [Academic Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands); Raijmakers, P.G.H.M. [VU Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands)

    2016-06-15

    Decreased striatal dopamine transporter (DAT) binding on SPECT imaging is a strong biomarker for the diagnosis of dementia with Lewy bodies (DLB). There is still a lot of uncertainty about patients meeting the clinical criteria for probable DLB who have a normal DAT SPECT scan (DLB/S-). The aim of this study was to describe the clinical and imaging follow-up in these patients, and compare them to DLB patients with abnormal baseline scans (DLB/S+). DLB patients who underwent DAT imaging ([{sup 123}I]FP-CIT SPECT) were selected from the Amsterdam Dementia Cohort. All [{sup 123}I]FP-CIT SPECT scans were evaluated independently by two nuclear medicine physicians and in patients with normal scans follow-up imaging was obtained. We matched DLB/S- patients for age and disease duration to DLB/S+ patients and compared their clinical characteristics. Of 67 [{sup 123}I]FP-CIT SPECT scans, 7 (10.4 %) were rated as normal. In five DLB/S- patients, a second [{sup 123}I]FP-CIT SPECT was performed (after on average 1.5 years) and these scans were all abnormal. No significant differences in clinical characteristics were found at baseline. DLB/S- patients could be expected to have a better MMSE score after 1 year. This study was the first to investigate DLB patients with the initial [{sup 123}I]FP-CIT SPECT scan rated as normal and subsequent scans during disease progression rated as abnormal. We hypothesize that DLB/S- scans could represent a relatively rare DLB subtype with possibly a different severity or spread of alpha-synuclein pathology (''neocortical predominant subtype''). In clinical practice, if an alternative diagnosis is not imminent in a DLB/S- patient, repeating [{sup 123}I]FP-CIT SPECT should be considered. (orig.)

  4. Familial hemiplegic migraine with prolonged global aura: follow-up findings of subtraction ictal SPECT co-registered to MRI (SISCOM).

    Science.gov (United States)

    Arias-Rivas, Susana; Rodríguez-Yañez, Manuel; Cortés, Julia; Pardo-Parrado, María; Aguiar, Pablo; Leira, Rogelio; Castillo, José; Blanco, Miguel

    2012-10-01

    All authors contributed equally to this work. Susana Arias-Rivas wrote the main paper. Manuel Rodriguez-Yáñez investigated the supplementary data. Julia Cortés and Pablo Aguiar performed the nuclear image studies and analysed and described the neuroimaging results. María Pardo, Rogelio Leira and Jose Castillo jointly conceived the study, followed the patient and prepared the manuscript. Miguel Blanco discussed the results. All authors discussed the results and implications and commented on the manuscript at all stages.

  5. Cerebral perfusion SPECT in transient ischemic attack

    Energy Technology Data Exchange (ETDEWEB)

    You, D.-L. E-mail: dlyou@mail.kfcc.org.tw; Shieh, F.-Y.; Tzen, K.-Y.; Tsai, M.-F.; Kao, P.-F

    2000-04-01

    Purpose: The purpose of our study is to evaluate the efficacy of cerebral perfusion single photon emission computerized tomography (SPECT) in patients with transient ischemic attack (TIA). Methods: Thirty-seven patients with TIA were collected for study. All patients had transient focal neurological symptoms or signs with complete recovery within 24 h after onset. The patients underwent cerebral perfusion SPECT between 6 h and 11 days after onset, with 10 cases performed within 24 h (group A), nine cases performed between 1 and 3 days (group B), 11 cases performed between 3 and 5 days (group C), and seven cases performed after more than 5 days (group D). A semi-quantitative method was used for analyzing the SPECT data, and the difference ratios between lesion side and contralateral normal side were calculated on each pair of regions of interest. Results: In total, 78.4% (29/37) of patients had reduced perfusion in the cerebral cortical regions or deep nuclei, and the regions with reduced perfusion corresponded with clinical presentations of the patients. The abnormal rate with reduced perfusion was 90.0% in group A, 77.8% in group B, 72.7% in group C and 71.4% in group D. Cross cerebellar diaschisis (CCD) was present in seven patients, and all of the primary cerebral perfusion defects of these patients were located at the territory of left or right middle cerebral artery. Conclusion: Cerebral perfusion SPECT is a potential tool to detect cerebral perfusion defects and CCD in patients with TIA. Although the perfusion defect may persist more than 5 days after onset, we suggest cerebral perfusion SPECT should be performed as soon as possible.

  6. 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.

  7. Monte Carlo scatter correction for SPECT

    Science.gov (United States)

    Liu, Zemei

    The goal of this dissertation is to present a quantitatively accurate and computationally fast scatter correction method that is robust and easily accessible for routine applications in SPECT imaging. A Monte Carlo based scatter estimation method is investigated and developed further. The Monte Carlo simulation program SIMIND (Simulating Medical Imaging Nuclear Detectors), was specifically developed to simulate clinical SPECT systems. The SIMIND scatter estimation (SSE) method was developed further using a multithreading technique to distribute the scatter estimation task across multiple threads running concurrently on multi-core CPU's to accelerate the scatter estimation process. An analytical collimator that ensures less noise was used during SSE. The research includes the addition to SIMIND of charge transport modeling in cadmium zinc telluride (CZT) detectors. Phenomena associated with radiation-induced charge transport including charge trapping, charge diffusion, charge sharing between neighboring detector pixels, as well as uncertainties in the detection process are addressed. Experimental measurements and simulation studies were designed for scintillation crystal based SPECT and CZT based SPECT systems to verify and evaluate the expanded SSE method. Jaszczak Deluxe and Anthropomorphic Torso Phantoms (Data Spectrum Corporation, Hillsborough, NC, USA) were used for experimental measurements and digital versions of the same phantoms employed during simulations to mimic experimental acquisitions. This study design enabled easy comparison of experimental and simulated data. The results have consistently shown that the SSE method performed similarly or better than the triple energy window (TEW) and effective scatter source estimation (ESSE) methods for experiments on all the clinical SPECT systems. The SSE method is proven to be a viable method for scatter estimation for routine clinical use.

  8. Comparison and planar and SPECT ventilation/perfusion lung scanning

    Energy Technology Data Exchange (ETDEWEB)

    Eberl, S.; Uren, R.; Bautovich, G.; Dugal, T.; Forster, J. [Royal Prince Alfred Hospital, Camperdown, NSW (Australia). Department of PET and Nuclear Medicine

    1998-06-01

    Full text: Ventilation/perfusion (V/Q) lung scanning, using multiple planar views, is an accepted technique for diagnosing pulmonary embolism (PE). Under PIOPED criteria, there are a substantial number of indeterminate results due to confounding factors such as CAL, unusual anatomy or superimposed activity in the planar image. Our aim was to investigate if SPECT could improve the diagnostic accuracy of V/Q scanning in the diagnosis of PE. Both planar and SPECT images were acquired on a dual or a triple head gamma camera following inhalation of {sup 99m}Tc-Technegas and after injection of {sup 99m}Tc-MAA. Total acquisition time for SPECT studies was 7.5 min for ventilation and 5 min for perfusion. SPECT studies were reconstructed with an accelerated iterative reconstruction (OSEM) and ventilation slices and perfusion slices were registered with an automated image registration package. Total processing time was 5 min. We have now performed more than 600 planar and SPECT studies. A subset of 50 sequential patients and 10 cases with pulmonary angiography were scored blinded by experienced nuclear medicine physicians. Scores ranged from 0 (no PE) to 5 (definite PE). A score of 3 indicated indeterminate for PE. In the 60 patients analysed, planar and SPECT scores were equal in 27 patients, SPECT was more definite in 16 and less definite in 7 patients. In 8 patients, SPECT indicated PE and planar imaging low probability of PE. In 1 patient planar imaging was scored as PE and SPECT as low probability. Indeterminate rate was reduced from 8 to 1 with SPECT. In the 10 patients with angiography, SPECT studies agreed with angiography findings in 8 patients, while planar studies agreed with angiography findings in 5 patients. Our preliminary data suggest that SPECT V/Q lung scanning can: i) provide a significant improvement over planar imaging for the diagnosis of PE, and ii) our short acquisition time for V/Q SPECT is clinically practicable

  9. SPECT/CT imaging in children with papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hwa-Young; Gelfand, Michael J.; Sharp, Susan E. [Cincinnati Children' s Hospital, Department of Radiology, Cincinnati, OH (United States)

    2011-08-15

    SPECT/CT improves localization of single photon-emitting radiopharmaceuticals. To determine the utility of SPECT/CT in children with papillary thyroid carcinoma. 20 SPECT/CT and planar studies were reviewed in 13 children with papillary thyroid carcinoma after total thyroidectomy. Seven studies used I-123 and 13 used I-131, after elevating TSH by T4 deprivation or intramuscular thyrotropin alfa. Eight children had one study and five children had two to four studies. Studies were performed at initial post-total thyroidectomy evaluation, follow-up and after I-131 treatment doses. SPECT/CT was performed with a diagnostic-quality CT unit in 13 studies and a localization-only CT unit in 7. Stimulated thyroglobulin was measured (except in 2 cases with anti-thyroglobulin antibodies). In 13 studies, neck activity was present but poorly localized on planar imaging; all foci of uptake were precisely localized by SPECT/CT. Two additional foci of neck uptake were found on SPECT/CT. SPECT/CT differentiated high neck uptake from facial activity. In six studies (four children), neck uptake was identified as benign by SPECT/CT (three thyroglossal duct remnants, one skin contamination, two by precise anatomical CT localization). In two children, SPECT/CT supported a decision not to treat with I-131. When SPECT/CT was unable to identify focal uptake as benign, stimulated thyroglobulin measurements were valuable. In three of 13 studies with neck uptake, SPECT/CT provided no useful additional information. SPECT/CT precisely localizes neck iodine uptake. In small numbers of patients, treatment is affected. SPECT/CT should be used when available in thyroid carcinoma patients. (orig.)

  10. Electrical source imaging and connectivity analysis to localize the seizure-onset zone based on high-density ictal scalp EEG recordings

    OpenAIRE

    Staljanssens, Willeke; Strobbe, Gregor; Van Holen, Roel; Birot, Gwenael; Michel, Christophe; Seeck, Margitta; Vulliémoz, Serge; van Mierlo, Pieter

    2015-01-01

    Functional connectivity analysis of ictal intracranial EEG (icEEG) recordings can help with seizure-onset zone (SOZ) localization in patients with focal epilepsy1. However, it would be of high clinical value to be able to localize the SOZ based on non-invasive ictal EEG recordings to better target or avoid icEEG and improve surgical outcome. In this work, we propose an approach to localize the SOZ based on non-invasive ictal high- density EEG (hd-EEG) recordings. We considered retrospectiv...

  11. Time-course changes of regional cerebral blood flow by SPECT with N-isopropyl-p-( sup 123 I)-iodoamphetamine in childhood partial seizures

    Energy Technology Data Exchange (ETDEWEB)

    Michihiro, Narumi; Ariizumi, Motomizu; Shiihara, Hiroaki; Egami, Yuriko; Saga, Takeshi (Dokkyo Univ. School of Medicine, Koshigaya, Saitama (Japan). Koshigaya Hospital)

    1992-07-01

    Single photon emission computed tomography (SPECT) with N-isopropyl-p-({sup 123}I)-iodoamphetamine was performed twice at different times in 18 children suffering from partial seizures to evaluate the time-course changes of the hemodynamics in the focal region. Comparison of the 2 SPECT images revealed that a decreased regional cerebral blood flow (CBF) in the first was normalized in 4 cases (22.2%) and contracted in 7 cases (38.9%). The region of decreased blood flow in the second was contralateral to that in the first in 1 case (5.6%) and unchanged in 6 cases (33.3%). Most of the normalized and contracted cases were those in which clinical seizures disappeared and the EEG findings were normalized. In these cases which responded to treatment, the decreased regional CBF was also found to be improved. Repeated SPECT appears to be useful for evaluating the therapeutic efficacy. On the other hand, most of the underchanged cases were those in which clinical seizures were frequent or uncontrolled, or which persistently showed the abnormalities in their EG. SPECT was considered to reflect well the conditions of the epileptic foci. These results indicate that repeated SPECT for observing the time-course changes of the regional CBF represents a useful technique which can be applied in evaluating the therapeutic efficacy or deciding the time to discontinue treatment and for pathogenetic elucidation of the epileptic foci. (author).

  12. Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs: an intriguing EEG phenomenon

    Directory of Open Access Journals (Sweden)

    Mariana Ribeiro Marcondes da Silveira

    2013-12-01

    Full Text Available SIRPIDs, an acronym for stimulus-induced rhythmic, periodic, or ictal discharges, were first named in 2004. This is a pattern observed in continuous electroencephalogram (CEEG consistently elicited by stimulation in comatose patients. The pathophysiology of SIRPIDs probably involves dysregulation of subcortico–cortical projections, particularly thalamocortical circuit, in a markedly abnormal brain with hyperexci­table cortex. This may explain some studies found an association of prolonged periodic epileptiform discharges (PEDs activity and a higher incidence of concurrent electrographic seizures and SIRPIDs. An association of SIRPIDs and poor prognosis has already been described. However, it is not yet possible to assert whether these discharges can cause neuronal injury or if they are simply a marker of severe brain injury. Objective of this paper is to review clinical relevance and pathophysiology of SIRPIDs, as well as its role as a brain response in the critically ill patient.

  13. Gap Junctions Contribute to Ictal/Interictal Genesis in Human Hypothalamic Hamartomas.

    Science.gov (United States)

    Wu, Jie; Gao, Ming; Rice, Stephen G; Tsang, Candy; Beggs, John; Turner, Dharshaun; Li, Guohui; Yang, Bo; Xia, Kunkun; Gao, Fenfei; Qiu, Shenfeng; Liu, Qiang; Kerrigan, John F

    2016-06-01

    Human hypothalamic hamartoma (HH) is a rare subcortical lesion associated with treatment-resistant epilepsy. Cellular mechanisms responsible for epileptogenesis are unknown. We hypothesized that neuronal gap junctions contribute to epileptogenesis through synchronous activity within the neuron networks in HH tissue. We studied surgically resected HH tissue with Western-blot analysis, immunohistochemistry, electron microscopy, biocytin microinjection of recorded HH neurons, and microelectrode patch clamp recordings with and without pharmacological blockade of gap junctions. Normal human hypothalamus tissue was used as a control. Western blots showed increased expression of both connexin-36 (Cx36) and connexin-43 (Cx43) in HH tissue compared with normal human mammillary body tissue. Immunohistochemistry demonstrated that Cx36 and Cx43 are expressed in HH tissue, but Cx36 was mainly expressed within neuron clusters while Cx43 was mainly expressed outside of neuron clusters. Gap-junction profiles were observed between small HH neurons with electron microscopy. Biocytin injection into single recorded small HH neurons showed labeling of adjacent neurons, which was not observed in the presence of a neuronal gap-junction blocker, mefloquine. Microelectrode field recordings from freshly resected HH slices demonstrated spontaneous ictal/interictal-like discharges in most slices. Bath-application of gap-junction blockers significantly reduced ictal/interictal-like discharges in a concentration-dependent manner, while not affecting the action-potential firing of small gamma-aminobutyric acid (GABA) neurons observed with whole-cell patch-clamp recordings from the same patient's HH tissue. These results suggest that neuronal gap junctions between small GABAergic HH neurons participate in the genesis of epileptic-like discharges. Blockade of gap junctions may be a new therapeutic strategy for controlling seizure activity in HH patients.

  14. Multivariate regression methods for estimating velocity of ictal discharges from human microelectrode recordings

    Science.gov (United States)

    Liou, Jyun-you; Smith, Elliot H.; Bateman, Lisa M.; McKhann, Guy M., II; Goodman, Robert R.; Greger, Bradley; Davis, Tyler S.; Kellis, Spencer S.; House, Paul A.; Schevon, Catherine A.

    2017-08-01

    Objective. Epileptiform discharges, an electrophysiological hallmark of seizures, can propagate across cortical tissue in a manner similar to traveling waves. Recent work has focused attention on the origination and propagation patterns of these discharges, yielding important clues to their source location and mechanism of travel. However, systematic studies of methods for measuring propagation are lacking. Approach. We analyzed epileptiform discharges in microelectrode array recordings of human seizures. The array records multiunit activity and local field potentials at 400 micron spatial resolution, from a small cortical site free of obstructions. We evaluated several computationally efficient statistical methods for calculating traveling wave velocity, benchmarking them to analyses of associated neuronal burst firing. Main results. Over 90% of discharges met statistical criteria for propagation across the sampled cortical territory. Detection rate, direction and speed estimates derived from a multiunit estimator were compared to four field potential-based estimators: negative peak, maximum descent, high gamma power, and cross-correlation. Interestingly, the methods that were computationally simplest and most efficient (negative peak and maximal descent) offer non-inferior results in predicting neuronal traveling wave velocities compared to the other two, more complex methods. Moreover, the negative peak and maximal descent methods proved to be more robust against reduced spatial sampling challenges. Using least absolute deviation in place of least squares error minimized the impact of outliers, and reduced the discrepancies between local field potential-based and multiunit estimators. Significance. Our findings suggest that ictal epileptiform discharges typically take the form of exceptionally strong, rapidly traveling waves, with propagation detectable across millimeter distances. The sequential activation of neurons in space can be inferred from clinically

  15. Gap Junctions Contribute to Ictal/Interictal Genesis in Human Hypothalamic Hamartomas

    Directory of Open Access Journals (Sweden)

    Jie Wu

    2016-06-01

    Full Text Available Human hypothalamic hamartoma (HH is a rare subcortical lesion associated with treatment-resistant epilepsy. Cellular mechanisms responsible for epileptogenesis are unknown. We hypothesized that neuronal gap junctions contribute to epileptogenesis through synchronous activity within the neuron networks in HH tissue. We studied surgically resected HH tissue with Western-blot analysis, immunohistochemistry, electron microscopy, biocytin microinjection of recorded HH neurons, and microelectrode patch clamp recordings with and without pharmacological blockade of gap junctions. Normal human hypothalamus tissue was used as a control. Western blots showed increased expression of both connexin-36 (Cx36 and connexin-43 (Cx43 in HH tissue compared with normal human mammillary body tissue. Immunohistochemistry demonstrated that Cx36 and Cx43 are expressed in HH tissue, but Cx36 was mainly expressed within neuron clusters while Cx43 was mainly expressed outside of neuron clusters. Gap-junction profiles were observed between small HH neurons with electron microscopy. Biocytin injection into single recorded small HH neurons showed labeling of adjacent neurons, which was not observed in the presence of a neuronal gap-junction blocker, mefloquine. Microelectrode field recordings from freshly resected HH slices demonstrated spontaneous ictal/interictal-like discharges in most slices. Bath-application of gap-junction blockers significantly reduced ictal/interictal-like discharges in a concentration-dependent manner, while not affecting the action-potential firing of small gamma-aminobutyric acid (GABA neurons observed with whole-cell patch-clamp recordings from the same patient's HH tissue. These results suggest that neuronal gap junctions between small GABAergic HH neurons participate in the genesis of epileptic-like discharges. Blockade of gap junctions may be a new therapeutic strategy for controlling seizure activity in HH patients.

  16. [Abnormal cerebral blood flow distributions during the post-ictal phase of febrile status epilepticus in three pediatric patients measured by arterial spin labeling perfusion MRI].

    Science.gov (United States)

    Hirano, Keiko; Fukuda, Tokiko

    2016-05-01

    The ability to visualize brain perfusion is important for identifying epileptic foci. We present three pediatric cases showing asymmetrical cerebral blood flow (CBF) distributions during the post-ictal phase of febrile status epilepticus measured by arterial spin labeling (ASL) perfusion MRI. During the acute phase, regional CBF measurements in the areas considered including epileptic foci were higher than in the corresponding area of the contralateral hemisphere, though the exact quantitative value varied between cases. We could not identify the correct epileptogenic foci, because those ASL images were taken after the prolonged and extraordinary activation of neurons in the affected area. During the recovery phase, the differences reduced and the average regional CBF measurement was 54.6 ± 6.1 ml/100 g per minute, which was a little less than the number of previous ASL studies. ASL perfusion MRI imaging provides a method for evaluating regional CBF by using magnetically labeled arterial blood water as an endogenous tracer. With this technique, we can repeatedly evaluate both the brain structure and the level of perfusion at the same time. ASL is noninvasive and easily accessible, and therefore it could become a routine tool for assessment of perfusion in daily practice of pediatric neurology.

  17. Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome.

    Science.gov (United States)

    Lalonde, Michel; Wells, R Glenn; Birnie, David; Ruddy, Terrence D; Wassenaar, Richard

    2014-07-01

    Phase analysis of single photon emission computed tomography (SPECT) radionuclide angiography (RNA) has been investigated for its potential to predict the outcome of cardiac resynchronization therapy (CRT). However, phase analysis may be limited in its potential at predicting CRT outcome as valuable information may be lost by assuming that time-activity curves (TAC) follow a simple sinusoidal shape. A new method, cluster analysis, is proposed which directly evaluates the TACs and may lead to a better understanding of dyssynchrony patterns and CRT outcome. Cluster analysis algorithms were developed and optimized to maximize their ability to predict CRT response. About 49 patients (N = 27 ischemic etiology) received a SPECT RNA scan as well as positron emission tomography (PET) perfusion and viability scans prior to undergoing CRT. A semiautomated algorithm sampled the left ventricle wall to produce 568 TACs from SPECT RNA data. The TACs were then subjected to two different cluster analysis techniques, K-means, and normal average, where several input metrics were also varied to determine the optimal settings for the prediction of CRT outcome. Each TAC was assigned to a cluster group based on the comparison criteria and global and segmental cluster size and scores were used as measures of dyssynchrony and used to predict response to CRT. A repeated random twofold cross-validation technique was used to train and validate the cluster algorithm. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and compare results to those obtained for SPECT RNA phase analysis and PET scar size analysis methods. Using the normal average cluster analysis approach, the septal wall produced statistically significant results for predicting CRT results in the ischemic population (ROC AUC = 0.73;p Cluster analysis results were similar to SPECT RNA phase analysis (ROC AUC = 0.78, p = 0.73 vs cluster AUC; sensitivity/specificity = 59%/89%) and

  18. Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome

    Energy Technology Data Exchange (ETDEWEB)

    Lalonde, Michel, E-mail: mlalonde15@rogers.com; Wassenaar, Richard [Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada); Wells, R. Glenn; Birnie, David; Ruddy, Terrence D. [Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7 (Canada)

    2014-07-15

    Purpose: Phase analysis of single photon emission computed tomography (SPECT) radionuclide angiography (RNA) has been investigated for its potential to predict the outcome of cardiac resynchronization therapy (CRT). However, phase analysis may be limited in its potential at predicting CRT outcome as valuable information may be lost by assuming that time-activity curves (TAC) follow a simple sinusoidal shape. A new method, cluster analysis, is proposed which directly evaluates the TACs and may lead to a better understanding of dyssynchrony patterns and CRT outcome. Cluster analysis algorithms were developed and optimized to maximize their ability to predict CRT response. Methods: About 49 patients (N = 27 ischemic etiology) received a SPECT RNA scan as well as positron emission tomography (PET) perfusion and viability scans prior to undergoing CRT. A semiautomated algorithm sampled the left ventricle wall to produce 568 TACs from SPECT RNA data. The TACs were then subjected to two different cluster analysis techniques, K-means, and normal average, where several input metrics were also varied to determine the optimal settings for the prediction of CRT outcome. Each TAC was assigned to a cluster group based on the comparison criteria and global and segmental cluster size and scores were used as measures of dyssynchrony and used to predict response to CRT. A repeated random twofold cross-validation technique was used to train and validate the cluster algorithm. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and compare results to those obtained for SPECT RNA phase analysis and PET scar size analysis methods. Results: Using the normal average cluster analysis approach, the septal wall produced statistically significant results for predicting CRT results in the ischemic population (ROC AUC = 0.73;p < 0.05 vs. equal chance ROC AUC = 0.50) with an optimal operating point of 71% sensitivity and 60% specificity. Cluster

  19. Regional cerebral blood flow in various pediatric neurological patients using /sup 123/I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, Tohru; Naganuma, Yoshihiro; Hongou, Kazuhisa; Murakami, Miyako; Yamatani, Miwa; Okada, Toshio

    1988-03-01

    The recent development of a new radiopharmaceutical /sup 123/I-isopropyl-iodoamphetamine (IMP), which is taken up by the brain from the blood flow, has offered a possibility of constructing scintigraphy maps of regional cerebral blood flow (rCBF) using single photon emission CT. We used this mehtod in various pediatric neurological diseases. Six patients with cerebro-vascular disorders (moya-moya disease 2, infarction 3 and HHE syndrome 1), 6 patients with infectious diseases of CNS (acute encephalitis 4, septic meningitis 1 and SSPE 1) and a miscellaneous group of six patients were studied. The rCBF abnormalities in cerebro-vascular diseases were more extensive and frequent than x-ray CT abnormalities. Repeated studies of IMP-SPECT revealed usefulness for the understanding of changeable hemodynamic pathophysiology and for the judgment of theraptic effectiveness and prognosis. The rCBF decrease in infectious diseases tended to be more diffuse and slight than that in cerebro-vascular diseases. In almost all patients, the area of rCBF decrease coincided with the area of EEG slowing evaluated by EEG topographic analysis. Brain imaging using /sup 123/I-IMP SPECT may reveal functional abnormalities as well as organic lesions. /sup 123/I-IMP SPECT has introduced a new era for the useful application of nuclear medicine to the investigation of pediatric neurological diseases.

  20. Rhythmic ictal nonclonic hand (RINCH) motions in temporal lobe epilepsy: invasive EEG findings, incidence, and lateralizing value.

    Science.gov (United States)

    Kuba, Robert; Musilová, Klára; Vojvodič, Nikola; Tyrlíková, Ivana; Rektor, Ivan; Brázdil, Milan

    2013-10-01

    The main purpose of this retrospective analysis was to evaluate the incidence and lateralization value of rhythmic ictal nonclonic hand (RINCH) motions in patients with temporal lobe epilepsy (TLE), who were classified as Engel I at least 2 years after epilepsy surgery. We analyzed the distribution of ictal activity at the time of RINCH appearance in patients in whom RINCH motions were present during invasive EEG monitoring. A group of 120 patients was included in this study. In total, we reviewed 491 seizures: 277 seizures in patients with temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (TLE-HS group) and 214 in TLE caused by other lesions (TLE-OTH group). We analyzed 29 patients (79 of the seizures) during invasive EEG monitoring. Fisher's exact test and binomial test were used for the statistical analysis. RINCH motions were observed in 24 out of 120 patients (20%) and in 48 out of 491 seizures (9.8%). There was no significant difference between the occurrence of RINCH motions in patients with TLE-HS and in patients with TLE-OTH, or between gender, right/left-sided TLE, and language dominant/nondominant TLE. RINCH motions were contralateral to the seizure onset in 83.3% of patients and 91.7% of seizures (p=0.0015; pictal activity. In 3 seizures, we observed time-locked epileptic activation associated with the appearance of RINCH motions, i.e., in the orbitofrontal cortex in 2 seizures and in both the orbitofrontal cortex and anterior cingulate gyrus in 1 seizure. RINCH motions are a relatively frequent ictal sign in patients with TLE. They have a high lateralizing value in these patients, occurring contralateral to the ictal onset. RINCH motions usually occur after the spread of ictal activity beyond the temporal lobe, and their appearance is usually associated with the presence of ictal activity in various regions of the contralateral frontal lobe, mainly the orbitofrontal cortex and anterior cingulate gyrus. This is the first study analysing

  1. 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

  2. Geometric calibration for a SPECT system dedicated to breast imaging

    Institute of Scientific and Technical Information of China (English)

    WU Li-Wei; WEI Long; CAO Xue-Xiang; WANG Lu; HUANG Xian-Chao; CHAI Pei; YUN Ming-Kai; ZHANG Yu-Bao; ZHANG Long; SHAN Bao-Ci

    2012-01-01

    Geometric calibration is critical to the accurate SPECT reconstruction.In this paper,a geometric calibration method was developed for a dedicated breast SPECT system with a tilted parallel beam (TPB)orbit.The acquisition geometry of the breast SPECT was firstly characterized.And then its projection model was established based on the acquisition geometry.Finally,the calibration results were obtained using a nonlinear optimization method that fitted the measured projections to the model.Monte Carlo data of the breast SPECT were used to verify the calibration method.Simulation results showed that the geometric parameters with reasonable accuracy could be obtained by the proposed method.

  3. Deployment Repeatability

    Science.gov (United States)

    2016-04-01

    controlled to great precision, but in a Cubesat , there may be no attitude determination at all. Such a Cubesat might treat sun angle and tumbling rates as...could be sensitive to small differences in motor controller timing. In these cases, the analyst might choose to model the entire deployment path, with...knowledge of the material damage model or motor controller timing precision. On the other hand, if many repeated and environmentally representative

  4. SPECT Molecular Imaging in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Ling Wang

    2012-01-01

    Full Text Available Parkinson's disease (PD is a common disorder, and the diagnosis of Parkinson's disease is clinical and relies on the presence of characteristic motor symptoms. The accuracy of the clinical diagnosis of PD is still limited. Functional neuroimaging using SPECT technique is helpful in patients with first signs of parkinsonism. The changes detected may reflect the disease process itself and/or compensatory responses to the disease, or they may arise in association with disease- and/or treatment-related complications. This paper addresses the value of SPECT in early differential diagnosis of PD and its potential as a sensitive tool to assess the pathophysiology and progression, as well as the therapeutic efficacy of PD.

  5. Methodology for ventilation/perfusion SPECT

    DEFF Research Database (Denmark)

    Bajc, Marika; Neilly, Brian; Miniati, Massimo;

    2010-01-01

    radiolabeled liquid aerosols are not restricted to the presence of obstructive lung disease. Radiolabeled macroaggregated human albumin is the imaging agent of choice for perfusion scintigraphy. An optimal combination of nuclide activities and acquisition times for ventilation and perfusion, collimators......Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas over......, and imaging matrix yields an adequate V/Q SPECT study in approximately 20 minutes of imaging time. The recommended protocol based on the patient remaining in an unchanged position during the initial ventilation study and the perfusion study allows presentation of matching ventilation and perfusion slices...

  6. Silicon Detectors for PET and SPECT

    Science.gov (United States)

    Cochran, Eric R.

    Silicon detectors use state-of-the-art electronics to take advantage of the semiconductor properties of silicon to produce very high resolution radiation detectors. These detectors have been a fundamental part of high energy, nuclear, and astroparticle physics experiments for decades, and they hold great potential for significant gains in both PET and SPECT applications. Two separate prototype nuclear medicine imaging systems have been developed to explore this potential. Both devices take advantage of the unique properties of high resolution pixelated silicon detectors, designed and developed as part of the CIMA collaboration and built at The Ohio State University. The first prototype is a Compton SPECT imaging system. Compton SPECT, also referred to as electronic collimation, is a fundamentally different approach to single photon imaging from standard gamma cameras. It removes the inherent coupling of spatial resolution and sensitivity in mechanically collimated systems and provides improved performance at higher energies. As a result, Compton SPECT creates opportunities for the development of new radiopharmaceuticals based on higher energy isotopes as well as opportunities to expand the use of current isotopes such as 131I due to the increased resolution and sensitivity. The Compton SPECT prototype consists of a single high resolution silicon detector, configured in a 2D geometry, in coincidence with a standard NaI scintillator detector. Images of point sources have been taken for 99mTc (140 keV), 131I (364keV), and 22Na (511 keV), demonstrating the performance of high resolution silicon detectors in a Compton SPECT system. Filtered back projection image resolutions of 10 mm, 7.5 mm, and 6.7 mm were achieved for the three different sources respectively. The results compare well with typical SPECT resolutions of 5-15 mm and validate the claims of improved performance in Compton SPECT imaging devices at higher source energies. They also support the potential of

  7. SPECT/CT in pediatric patient management

    Energy Technology Data Exchange (ETDEWEB)

    Nadel, Helen R. [British Columbia Children' s Hospital, University of British Columbia, Pediatric Radiologist and Nuclear Medicine Physician, Division of Nuclear Medicine Department of Radiology, Vancouver, British Columbia (Canada)

    2014-05-15

    Hybrid SPECT/CT imaging is becoming the standard of care in pediatric imaging. Indications are mainly for oncologic imaging including mIBG scintigraphy for neuroblastoma and I-123 post surgical imaging of children with thyroid carcinoma, bone scintigraphy for back pain, children referred from sports medicine and neurodevelopmentally delayed children presenting with pain symptoms. The studies provide improved diagnostic accuracy, and oncologic imaging that includes optimized CT as part of the SPECT/CT study may decrease the number of studies and sedation procedures an individual child may need. The studies, however, must be tailored on an individual basis as the addition of the CT study can increase exposure to the child and should only be performed after appropriate justification and with adherence to optimized low dose pediatric protocols. (orig.)

  8. {sup 99m}Tc-MIBI pinhole SPECT in primary hyperparathyroidism: comparison with conventional SPECT, planar scintigraphy and ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Carlier, Thomas; Bodet-Milin, Caroline; Kraeber-Bodere, Francoise; Ansquer, Catherine [Hotel Dieu University Hospital, Nuclear Medicine Department, Nantes (France); INSERM CRCNA, Nantes (France); Oudoux, Aurore [Hotel Dieu University Hospital, Nuclear Medicine Department, Nantes (France); Mirallie, Eric [Hotel Dieu University Hospital, Surgery Department, Nantes (France); Seret, Alain [University of Liege, Institute of Physics, Experimental Medical Imaging, Liege (Belgium); Daumy, Isabelle [Ultrasonography Center, Nantes (France); Leux, Christophe [Saint Jacques University Hospital, PIMESP, Nantes (France)

    2008-03-15

    A pinhole collimator is routinely used to increase the resolution of scintigraphy. This prospective study was conducted to determine the interest of {sup 99m}Tc-MIBI pinhole single-photon emission computed tomography (SPECT) for the preoperative localisation of parathyroid lesions in primary hyperparathyroidism. All patients underwent a neck ultrasonography (US), {sup 99m}TcO{sub 4}{sup -} and {sup 99m}Tc-MIBI planar images and two consecutive SPECT with a parallel (C-SPECT) and a pinhole collimator (P-SPECT). P-SPECT was performed with a tilted detector equipped with a pinhole collimator and reconstructed with a dedicated OSEM algorithm. A diagnostic confidence score (CS) was assigned to each procedure considering intensity and extra-thyroidal location of suspected lesions: 0 = negative, 1 = doubtful, 2 = moderately positive, 3 = positive. The results of these preoperative localisation studies were compared with surgical, pathological and 6-month biological findings. Fifty-one patients cured after surgery were included. Surgery revealed 55 lesions (median weight 0.5 g, 11 in ectopy). Sensitivities of US, planar imaging, C-SPECT and P-SPECT were, respectively, 51, 76, 82 and 87%. Nine glands were only detected by tomography and five glands only by P-SPECT. {sup 99m}Tc-MIBI/{sup 99m}TcO{sub 4}{sup -} planar scans and P-SPECT were complementary and, when combined together, showed the highest sensitivity (93%). Compared with planar imaging and C-SPECT, P-SPECT increased CS for 42 and 53% of lesions, respectively, and contributed to markedly reduce the number of uncertain results. A combination of planar {sup 99m}Tc-MIBI/{sup 99m}TcO{sub 4}{sup -} scintigraphy and P-SPECT appears to be a highly accurate preoperative imaging procedure in primary hyperparathyroidism. (orig.)

  9. Clinical utility and reliability of sup(81m)Kr SPECT images applied to posterior circulation

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizawa, Takashi; Kikuchi, Haruhiko; Karasawa, Jun (National Cardiovascular Center, Suita, Osaka (Japan))

    1984-08-01

    The instrument used in this study has a sensitivity of 28,000 counts/mCi/cm/sup 3/ for sup(99m)Tc and a spatial resolution of approximately 20mm full width at a half-maximum. The tomographic images were obtained by the continuous infusion of sup(81m)Kr at the base of the ascending aorta. Material was subsequently studied in 49 cases that met the conditions of: 1) obstructive vertebrobasilar system lesions (8 cases), 2) no ischemic cerebrovascular diseases (10), or 3) ischemic cerebrovascular disorders in anterior circulation (31). The reproducibility, as studied in 20 cases, was satisfactory. 6 cases were compared with a stable Xe CT CBF map that had regional depressions similar to those of the sup(81m)Kr SPECT images. In the 2nd group, 8 of the 10 cases showed a mild laterality on cerebellar perfusion images obtained by SPECT, as did 29 of the 31 in the 3rd group; among them, 2 cases with a recently completed stroke revealed a marked depression in the ipsilateral cerebellar hemisphere to the side of the hemiplegia. Cases of the lst group showed generally depressed perfusion images of the brain stem or cerebellum, and the low-density areas of X-ray CT were comparable to the lower perfusional regions on SPECT. The authors concluded that posterior perfusion images obtained by sup(81m)Kr SPECT were affected by occlusive vertebrobasilar-system lesions as well as by carotid-system lesions and cerebellar functions, and that this method for evaluating hemodynamics will be of much more clinical use in repeated studies to demonstrate the changes in posterior ciculation in course or by some loadings with subclinical characteristics, for this paper includes the first report on cerebellar functional images, though it is restricted by the low-spatial resolution from defining the architecture of the posterior fossa in detail.

  10. 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).

  11. Accelerated GPU based SPECT Monte Carlo simulations

    Science.gov (United States)

    Garcia, Marie-Paule; Bert, Julien; Benoit, Didier; Bardiès, Manuel; Visvikis, Dimitris

    2016-06-01

    Monte Carlo (MC) modelling is widely used in the field of single photon emission computed tomography (SPECT) as it is a reliable technique to simulate very high quality scans. This technique provides very accurate modelling of the radiation transport and particle interactions in a heterogeneous medium. Various MC codes exist for nuclear medicine imaging simulations. Recently, new strategies exploiting the computing capabilities of graphical processing units (GPU) have been proposed. This work aims at evaluating the accuracy of such GPU implementation strategies in comparison to standard MC codes in the context of SPECT imaging. GATE was considered the reference MC toolkit and used to evaluate the performance of newly developed GPU Geant4-based Monte Carlo simulation (GGEMS) modules for SPECT imaging. Radioisotopes with different photon energies were used with these various CPU and GPU Geant4-based MC codes in order to assess the best strategy for each configuration. Three different isotopes were considered: 99m Tc, 111In and 131I, using a low energy high resolution (LEHR) collimator, a medium energy general purpose (MEGP) collimator and a high energy general purpose (HEGP) collimator respectively. Point source, uniform source, cylindrical phantom and anthropomorphic phantom acquisitions were simulated using a model of the GE infinia II 3/8" gamma camera. Both simulation platforms yielded a similar system sensitivity and image statistical quality for the various combinations. The overall acceleration factor between GATE and GGEMS platform derived from the same cylindrical phantom acquisition was between 18 and 27 for the different radioisotopes. Besides, a full MC simulation using an anthropomorphic phantom showed the full potential of the GGEMS platform, with a resulting acceleration factor up to 71. The good agreement with reference codes and the acceleration factors obtained support the use of GPU implementation strategies for improving computational efficiency

  12. Accelerated GPU based SPECT Monte Carlo simulations.

    Science.gov (United States)

    Garcia, Marie-Paule; Bert, Julien; Benoit, Didier; Bardiès, Manuel; Visvikis, Dimitris

    2016-06-07

    Monte Carlo (MC) modelling is widely used in the field of single photon emission computed tomography (SPECT) as it is a reliable technique to simulate very high quality scans. This technique provides very accurate modelling of the radiation transport and particle interactions in a heterogeneous medium. Various MC codes exist for nuclear medicine imaging simulations. Recently, new strategies exploiting the computing capabilities of graphical processing units (GPU) have been proposed. This work aims at evaluating the accuracy of such GPU implementation strategies in comparison to standard MC codes in the context of SPECT imaging. GATE was considered the reference MC toolkit and used to evaluate the performance of newly developed GPU Geant4-based Monte Carlo simulation (GGEMS) modules for SPECT imaging. Radioisotopes with different photon energies were used with these various CPU and GPU Geant4-based MC codes in order to assess the best strategy for each configuration. Three different isotopes were considered: (99m) Tc, (111)In and (131)I, using a low energy high resolution (LEHR) collimator, a medium energy general purpose (MEGP) collimator and a high energy general purpose (HEGP) collimator respectively. Point source, uniform source, cylindrical phantom and anthropomorphic phantom acquisitions were simulated using a model of the GE infinia II 3/8" gamma camera. Both simulation platforms yielded a similar system sensitivity and image statistical quality for the various combinations. The overall acceleration factor between GATE and GGEMS platform derived from the same cylindrical phantom acquisition was between 18 and 27 for the different radioisotopes. Besides, a full MC simulation using an anthropomorphic phantom showed the full potential of the GGEMS platform, with a resulting acceleration factor up to 71. The good agreement with reference codes and the acceleration factors obtained support the use of GPU implementation strategies for improving computational

  13. Staging of moyamoya disease by perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo [Kyushu Univ., Fukuoka (Japan). Hospital; Matsushima, Toshio; Fukui, Masashi

    2001-04-01

    Staging of moyamoya disease, based on angiography and PET have already been established. The authors have established staging of moyamoya disease based on perfusion SPECT, that can be summarized as follows: Stage I, no abnormality is seen at rest or after acetazolamide loading; Stage II, no abnormality is seen at rest, however, a decreased response (blood flow increase rate: <15%) is seen to acetazolamide loading (a, a decreased response is seen only in the frontal lobe; b, a decreased response is seen in regions other than the frontal lobe; and c, a decreased response is seen throughout the cerebrum); Stage III, localized decrease in blood flow (blood flow decrease compared with peripheral tissue: {>=}15%) and marked decrease in response to acetazolamide (blood flow increase rate: <5%) are seen at rest. In Stage III, CT and MRI show no abnormal findings or only mild lesions of the white matter; and Stage IV, multiple decreases in blood flow are seen at rest, and CT and MRI reveal infarctions and severe atrophy at the same sites. The above staging does not require determination of cerebral blood flow, and thus it can be used in children, in whom cerebral blood flow determination is difficult. The authors performed 99m-Tc ECD perfusion SPECT in 25 patients with moyamoya disease for the staging, and compared staging based on angiography with staging based on perfusion SPECT. The results did not show a correlation between the 2 staging methods. A problem inherent in the staging of moyamoya disease based on perfusion SPECT is that the relationship between cerebral blood flow and cerebral radioactivity concentrations may differ depending on the drug used to determine cerebral blood flow. Thus, although the present staging system does not depend on any specific radioactive drug to determine cerebral blood flow, further investigation is necessary to identify a more appropriate drug than those in current use. (K.H.)

  14. ENVISION, developing SPECT imaging for particle therapy

    CERN Multimedia

    2013-01-01

    Particle therapy is an advanced technique of cancer radiation therapy, using protons or other ions to target the cancerous mass. ENVISION aims at developing medical imaging tools to improve the dose delivery to the patient, to ensure a safer and more effective treatment. The animation illustrates the use of Single Photon Emission Computed Tomography (SPECT) for monitoring the dose during treatment. Produced by: CERN KT/Life Sciences and ENVISION Project Management: Manuela Cirilli 3D animation: Jeroen Huijben, Nymus3d

  15. SPECT and PET Imaging of Meningiomas

    Directory of Open Access Journals (Sweden)

    Varvara Valotassiou

    2012-01-01

    Full Text Available Meningiomas arise from the meningothelial cells of the arachnoid membranes. They are the most common primary intracranial neoplasms and represent about 20% of all intracranial tumors. They are usually diagnosed after the third decade of life and they are more frequent in women than in men. According to the World Health Organization (WHO criteria, meningiomas can be classified into grade I meningiomas, which are benign, grade II (atypical and grade III (anaplastic meningiomas, which have a much more aggressive clinical behaviour. Computed Tomography (CT and Magnetic Resonance Imaging (MRI are routinely used in the diagnostic workup of patients with meningiomas. Molecular Nuclear Medicine Imaging with Single Photon Emission Computed Tomography (SPECT and Positron Emission Tomography (PET could provide complementary information to CT and MRI. Various SPECT and PET tracers may provide information about cellular processes and biological characteristics of meningiomas. Therefore, SPECT and PET imaging could be used for the preoperative noninvasive diagnosis and differential diagnosis of meningiomas, prediction of tumor grade and tumor recurrence, response to treatment, target volume delineation for radiation therapy planning, and distinction between residual or recurrent tumour from scar tissue.

  16. SPECT detectors: the Anger Camera and beyond

    Science.gov (United States)

    Peterson, Todd E.; Furenlid, Lars R.

    2011-09-01

    The development of radiation detectors capable of delivering spatial information about gamma-ray interactions was one of the key enabling technologies for nuclear medicine imaging and, eventually, single-photon emission computed tomography (SPECT). The continuous sodium iodide scintillator crystal coupled to an array of photomultiplier tubes, almost universally referred to as the Anger Camera after its inventor, has long been the dominant SPECT detector system. Nevertheless, many alternative materials and configurations have been investigated over the years. Technological advances as well as the emerging importance of specialized applications, such as cardiac and preclinical imaging, have spurred innovation such that alternatives to the Anger Camera are now part of commercial imaging systems. Increased computing power has made it practical to apply advanced signal processing and estimation schemes to make better use of the information contained in the detector signals. In this review we discuss the key performance properties of SPECT detectors and survey developments in both scintillator and semiconductor detectors and their readouts with an eye toward some of the practical issues at least in part responsible for the continuing prevalence of the Anger Camera in the clinic.

  17. SPECT detectors: the Anger Camera and beyond.

    Science.gov (United States)

    Peterson, Todd E; Furenlid, Lars R

    2011-09-07

    The development of radiation detectors capable of delivering spatial information about gamma-ray interactions was one of the key enabling technologies for nuclear medicine imaging and, eventually, single-photon emission computed tomography (SPECT). The continuous sodium iodide scintillator crystal coupled to an array of photomultiplier tubes, almost universally referred to as the Anger Camera after its inventor, has long been the dominant SPECT detector system. Nevertheless, many alternative materials and configurations have been investigated over the years. Technological advances as well as the emerging importance of specialized applications, such as cardiac and preclinical imaging, have spurred innovation such that alternatives to the Anger Camera are now part of commercial imaging systems. Increased computing power has made it practical to apply advanced signal processing and estimation schemes to make better use of the information contained in the detector signals. In this review we discuss the key performance properties of SPECT detectors and survey developments in both scintillator and semiconductor detectors and their readouts with an eye toward some of the practical issues at least in part responsible for the continuing prevalence of the Anger Camera in the clinic.

  18. Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology

    Energy Technology Data Exchange (ETDEWEB)

    Erlandsson, Kjell; Kacperski, Krzysztof; Van Gramberg, Dean; Hutton, Brian F [Institute of Nuclear Medicine, University College London and UCLH NHS Foundation Trust, London NW1 2BU (United Kingdom)], E-mail: kjell.erlandsson@uclh.nhs.uk

    2009-05-07

    D-SPECT (Spectrum Dynamics, Israel) is a novel SPECT system for cardiac perfusion studies. Based on CZT detectors, region-centric scanning, high-sensitivity collimators and resolution recovery, it offers potential advantages over conventional systems. A series of measurements were made on a {beta}-version D-SPECT system in order to evaluate its performance in terms of energy resolution, scatter fraction, sensitivity, count rate capability and resolution. Corresponding measurements were also done on a conventional SPECT system (CS) for comparison. The energy resolution of the D-SPECT system at 140 keV was 5.5% (CS: 9.25%), the scatter fraction 30% (CS: 34%), the planar sensitivity 398 s{sup -1} MBq{sup -1} per head ({sup 99m}Tc, 10 cm) (CS: 72 s{sup -1} MBq{sup -1}), and the tomographic sensitivity in the heart region was in the range 647-1107 s{sup -1} MBq{sup -1} (CS: 141 s{sup -1} MBq{sup -1}). The count rate increased linearly with increasing activity up to 1.44 M s{sup -1}. The intrinsic resolution was equal to the pixel size, 2.46 mm (CS: 3.8 mm). The average reconstructed resolution using the standard clinical filter was 12.5 mm (CS: 13.7 mm). The D-SPECT has superior sensitivity to that of a conventional system with similar spatial resolution. It also has excellent energy resolution and count rate characteristics, which should prove useful in dynamic and dual radionuclide studies.

  19. Status epilepticus in a patient with fragile X syndrome: electro-clinical features and peri-ictal neuroimaging.

    Science.gov (United States)

    Di Bonaventura, Carlo; Mari, Francesco; Pierallini, Alberto; Mecarelli, Oriano; Randi, Franco; Manfredi, Mario; Prencipe, Massimiliano; Giallonardo, Anna Teresa

    2006-09-01

    Fragile X syndrome (Fra-X) is a common cause of mental retardation that can be associated with partial epilepsy characterized by a variety of electro-clinical features. A wide spectrum of interictal activities are reported, although no data regarding ictal EEG activity have as yet been published. Drug-resistant seizures are uncommon, and the occurrence of clustering seizures or status epilepticus has only been reported anecdotally. We describe a Fra-X patient with refractory partial epilepsy related to a malformation of cortical development who experienced a partial status epilepticus that was well documented by video-EEG and MRI. We report the electro-clinical features and peri-ictal neuroimaging data.

  20. Transition to seizure: ictal discharge is preceded by exhausted presynaptic GABA release in the hippocampal CA3 region.

    Science.gov (United States)

    Zhang, Zhang J; Koifman, Julius; Shin, Damian S; Ye, Hui; Florez, Carlos M; Zhang, Liang; Valiante, Taufik A; Carlen, Peter L

    2012-02-15

    How the brain transitions into a seizure is poorly understood. Recurrent seizure-like events (SLEs) in low-Mg2+/ high-K+ perfusate were measured in the CA3 region of the intact mouse hippocampus. The SLE was divided into a "preictal phase," which abruptly turns into a higher frequency "ictal" phase. Blockade of GABA(A) receptors shortened the preictal phase, abolished interictal bursts, and attenuated the slow preictal depolarization, with no effect on the ictal duration, whereas SLEs were blocked by glutamate receptor blockade. In CA3 pyramidal cells and stratum oriens non-fast-spiking and fast-spiking interneurons, recurrent GABAergic IPSCs predominated interictally and during the early preictal phase, synchronous with extracellularly measured recurrent field potentials (FPs). These IPSCs then decreased to zero or reversed polarity by the onset of the higher-frequency ictus. However, postsynaptic muscimol-evoked GABA(A) responses remained intact. Simultaneously, EPSCs synchronous with the FPs markedly increased to a maximum at the ictal onset. The reversal potential of the compound postsynaptic currents (combined simultaneous EPSCs and IPSCs) became markedly depolarized during the preictal phase, whereas the muscimol-evoked GABA(A) reversal potential remained unchanged. During the late preictal phase, interneuronal excitability was high, but IPSCs, evoked by local stimulation, or osmotically by hypertonic sucrose application, were diminished, disappearing at the ictal onset. We conclude that the interictal and early preictal states are dominated by GABAergic activity, with the onset of the ictus heralded by exhaustion of presynaptic release of GABA, and unopposed increased glutamatergic responses.

  1. A multiresolution restoration method for cardiac SPECT

    Science.gov (United States)

    Franquiz, Juan Manuel

    Single-photon emission computed tomography (SPECT) is affected by photon attenuation and image blurring due to Compton scatter and geometric detector response. Attenuation correction is important to increase diagnostic accuracy of cardiac SPECT. However, in attenuation-corrected scans, scattered photons from radioactivity in the liver could produce a spillover of counts into the inferior myocardial wall. In the clinical setting, blurring effects could be compensated by restoration with Wiener and Metz filters. Inconveniences of these procedures are that the Wiener filter depends upon the power spectra of the object image and noise, which are unknown, while Metz parameters have to be optimized by trial and error. This research develops an alternative restoration procedure based on a multiresolution denoising and regularization algorithm. It was hypothesized that this representation leads to a more straightforward and automatic restoration than conventional filters. The main objective of the research was the development and assessment of the multiresolution algorithm for compensating the liver spillover artifact. The multiresolution algorithm decomposes original SPECT projections into a set of sub-band frequency images. This allows a simple denoising and regularization procedure by discarding high frequency channels and performing inversion only in low and intermediate frequencies. The method was assessed in bull's eye polar maps and short- axis attenuation-corrected reconstructions of a realistic cardiac-chest phantom with a custom-made liver insert and different 99mTc liver-to-heart activity ratios. Inferior myocardial defects were simulated in some experiments. The cardiac phantom in free air was considered as the gold standard reference. Quantitative analysis was performed by calculating contrast of short- axis slices and the normalized chi-square measure, defect size and mean and standard deviation of polar map counts. The performance of the multiresolution

  2. Quantitative Monte Carlo-based holmium-166 SPECT reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Elschot, Mattijs; Smits, Maarten L. J.; Nijsen, Johannes F. W.; Lam, Marnix G. E. H.; Zonnenberg, Bernard A.; Bosch, Maurice A. A. J. van den; Jong, Hugo W. A. M. de [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Viergever, Max A. [Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2013-11-15

    Purpose: Quantitative imaging of the radionuclide distribution is of increasing interest for microsphere radioembolization (RE) of liver malignancies, to aid treatment planning and dosimetry. For this purpose, holmium-166 ({sup 166}Ho) microspheres have been developed, which can be visualized with a gamma camera. The objective of this work is to develop and evaluate a new reconstruction method for quantitative {sup 166}Ho SPECT, including Monte Carlo-based modeling of photon contributions from the full energy spectrum.Methods: A fast Monte Carlo (MC) simulator was developed for simulation of {sup 166}Ho projection images and incorporated in a statistical reconstruction algorithm (SPECT-fMC). Photon scatter and attenuation for all photons sampled from the full {sup 166}Ho energy spectrum were modeled during reconstruction by Monte Carlo simulations. The energy- and distance-dependent collimator-detector response was modeled using precalculated convolution kernels. Phantom experiments were performed to quantitatively evaluate image contrast, image noise, count errors, and activity recovery coefficients (ARCs) of SPECT-fMC in comparison with those of an energy window-based method for correction of down-scattered high-energy photons (SPECT-DSW) and a previously presented hybrid method that combines MC simulation of photopeak scatter with energy window-based estimation of down-scattered high-energy contributions (SPECT-ppMC+DSW). Additionally, the impact of SPECT-fMC on whole-body recovered activities (A{sup est}) and estimated radiation absorbed doses was evaluated using clinical SPECT data of six {sup 166}Ho RE patients.Results: At the same noise level, SPECT-fMC images showed substantially higher contrast than SPECT-DSW and SPECT-ppMC+DSW in spheres ≥17 mm in diameter. The count error was reduced from 29% (SPECT-DSW) and 25% (SPECT-ppMC+DSW) to 12% (SPECT-fMC). ARCs in five spherical volumes of 1.96–106.21 ml were improved from 32%–63% (SPECT-DSW) and 50%–80

  3. Nephrotoxicity in mice after repeated imaging using 111In- labeled peptides

    NARCIS (Netherlands)

    M.L. Melis (Marleen); E. Vegt (Erik); M.W. Konijnenberg (Mark); M. de Visser (Monique); M. Bijster (Magda); M. Vermeij (Marcel); E.P. Krenning (Eric); O.C. Boerman (Otto); M. de Jong (Marion)

    2010-01-01

    textabstractWe determined the renal radiation dose of a series of111Inlabeled peptides using animal SPECT. Because the animals' health deteriorated, renal toxicity was assessed. Methods: Wild-type and megalin-deficient mice were imaged repeatedly at 3- to 6-wk intervals to quantify renal retention a

  4. Nephrotoxicity in mice after repeated imaging using 111In-labeled peptides.

    NARCIS (Netherlands)

    Melis, M.; Vegt, E.; Konijnenberg, M.W.; Visser, M. de; Bijster, M.; Vermeij, M.; Krenning, E.P.; Boerman, O.C.; Jong, M. de

    2010-01-01

    We determined the renal radiation dose of a series of (111)In-labeled peptides using animal SPECT. Because the animals' health deteriorated, renal toxicity was assessed. METHODS: Wild-type and megalin-deficient mice were imaged repeatedly at 3- to 6-wk intervals to quantify renal retention after inj

  5. Development and evaluation of Monte Carlo-based SPECT reconstruction

    NARCIS (Netherlands)

    Xiao, J.

    2009-01-01

    Single Photon Emission Computed Tomography (SPECT) is one of the most applied molecular imaging techniques to diagnose human diseases, e.g., of the heart, the brain or in oncology. For example, cardiac SPECT imaging plays a central role in diagnosing coronary heart diseases by providing clinicians w

  6. Ultra-high-resolution small-animal SPECT imaging

    NARCIS (Netherlands)

    Have, F. van der

    2007-01-01

    The main subject of this thesis is the development of the first two in a series of dedicated ultra-high resolution Single Photon Emission Computed Tomography (SPECT) systems (U-SPECT-I and II) for the imaging of distributions of radio-isotope labeled tracers in small laboratory animals such as mice

  7. Simulation, construction and application of focused pinhole small animal SPECT

    NARCIS (Netherlands)

    Vastenhouw, B.

    2008-01-01

    New developments in molecular imaging techniques like small animal SPECT systems are important tools to analyze mouse models of human diseases. The main subjects of this thesis are simulation, construction and image reconstruction algorithms needed for the development of a small-animal SPECT system

  8. Single photon emission computed tomography (SPECT) in epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Leroy, R.F. [Univ. of Texas Southwestern Medical School, Dallas (United States)

    1991-12-31

    Epilepsy is a common neurologic disorder which has just begun to be studied with single photon emission computerized tomography (SPECT). Epilepsy usually is studied with electroencephalographic (EEG) techniques that demonstrate the physiologic changes that occur during seizures, and with neuroimaging techniques that show the brain structures where seizures originate. Neither method alone has been adequate to describe the pathophysiology of the patient with epilepsy. EEG techniques lack anatomic sensitivity, and there are no structural abnormalities shown by neuroimaging which are specific for epilepsy. Functional imaging (FI) has developed as a physiologic tool with anatomic sensitivity, and SPECT has been promoted as a FI technique because of its potentially wide availability. However, SPECT is early in its development and its clinical utility for epilepsy still has to be demonstrated. To understand this role of SPECT, consideration must be given to the pathophysiology of epilepsy, brain physiology, types of seizure, epileptic syndromes, and the SPECT technique itself. 44 refs., 2 tabs.

  9. [When does post-ictal period start in temporal lobe epilepsy? A quantitative EEG perspective].

    Science.gov (United States)

    Sanz-Garcia, A; Vega-Zelaya, L; Pastor, J; Sola, R G; Ortega, G J

    2017-04-16

    Introduccion. En las crisis parciales, el periodo postictal presenta grandes dificultades de caracterizacion, tanto desde el punto de vista clinico como en electroencefalografia. Un analisis espectral y de redes complejas permitiria una definicion mas precisa de sus limites y una comprension mas completa de las crisis. Pacientes y metodos. Se analizaron registros digitales de electroencefalografia de electrodos de scalp y foramen oval, 32 crisis, de 15 pacientes con epilepsia farmacorresistente del lobulo temporal (Engel I). Numericamente se estudio la entropia espectral, las distintas bandas de frecuencia y medidas de caracterizacion de la red cortical, la densidad de enlaces, la modularidad, el coeficiente de agrupamiento y la longitud de camino medio, y se cuantifico la variacion del periodo postictal respecto al preictal. Resultados. Durante el periodo postictal de las crisis complejas existe un marcado aumento de la densidad de enlaces en la red cortical coincidente con un descenso en la entropia espectral, principalmente debido al aumento de la actividad en la banda delta. Los valores extremos de estas medidas se alcanzan aproximadamente un minuto despues del fin de las crisis, definidas electroencefalograficamente usando metodos tradicionales. Conclusiones. Nuestros resultados pueden explicarse por la aparicion de un mecanismo de 'finalizacion' de las crisis que comienza dentro del periodo ictal definido clasicamente y que alcanzan su efecto maximo durante el periodo postictal. Estos resultados podrian emplearse para definir el inicio del periodo postictal como aquel donde la sincronizacion es maxima, esto es, donde la densidad de enlaces resulta mayor y la entropia espectral es minima.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. S.; Kim, G. E.; Yoo, J. Y.; Kim, D. G.; Moon, D. H. [Asan Medical Center, Seoul (Korea, Republic of)

    2005-07-01

    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.

  11. Bayesian learning for cardiac SPECT image interpretation.

    Science.gov (United States)

    Sacha, Jarosław P; Goodenday, Lucy S; Cios, Krzysztof J

    2002-01-01

    In this paper, we describe a system for automating the diagnosis of myocardial perfusion from single-photon emission computerized tomography (SPECT) images of male and female hearts. Initially we had several thousand of SPECT images, other clinical data and physician-interpreter's descriptions of the images. The images were divided into segments based on the Yale system. Each segment was described by the physician as showing one of the following conditions: normal perfusion, reversible perfusion defect, partially reversible perfusion defect, fixed perfusion defect, defect showing reverse redistribution, equivocal defect or artifact. The physician's diagnosis of overall left ventricular (LV) perfusion, based on the above descriptions, categorizes a study as showing one or more of eight possible conditions: normal, ischemia, infarct and ischemia, infarct, reverse redistribution, equivocal, artifact or LV dysfunction. Because of the complexity of the task, we decided to use the knowledge discovery approach, consisting of these steps: problem understanding, data understanding, data preparation, data mining, evaluating the discovered knowledge and its implementation. After going through the data preparation step, in which we constructed normal gender-specific models of the LV and image registration, we ended up with 728 patients for whom we had both SPECT images and corresponding diagnoses. Another major contribution of the paper is the data mining step, in which we used several new Bayesian learning classification methods. The approach we have taken, namely the six-step knowledge discovery process has proven to be very successful in this complex data mining task and as such the process can be extended to other medical data mining projects.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  13. Evaluation of Tl-201 SPECT imaging findings in prostate cancer

    Directory of Open Access Journals (Sweden)

    Sinem Ozyurt

    2015-07-01

    Full Text Available Objectives: To compare with histopathological findings the findings of prostate cancer imaging by SPECT method using Tl-201 as a tumor seeking agent. Methods: The study comprised 59 patients (age range 51-79 years, mean age 65.3 ± 6.8 years who were planned to have transrectal ultrasonography (TRUS-guided biopsies due to suspicion of prostate cancer between April 2011 and September 2011. Early planar, late planar and SPECT images were obtained for all patients. Scintigraphic evaluation was made in relation to uptake presence and patterns in the visual assessment and to Tumor/Background (T/Bg ratios for both planar and SPECT images in the quantitative assessment. Histopathological findings were compatible with benign etiology in 36 (61% patients and malign etiology in 23 (39% patients. Additionally, comparisons were made to evaluate the relationships between uptake patterns,total PSA values and Gleason scores. Results: A statistically significant difference was found between the benign and malignant groups in terms of uptake in planar and SPECT images and T/Bg ratios and PSA values. No statistically significant difference was found between uptake patterns of planar and SPECT images and Gleason scores in the malignant group. Conclusions: SPECT images were superior to planar images in the comparative assessment. Tl-201 SPECT imaging can provide an additional contribution to clinical practice in the diagnosis of prostate cancer and it can be used in selected patients.

  14. Presurgical evaluation for partial epilepsy: Relative contributions of chronic depth-electrode recordings versus FDG-PET and scalp-sphenoidal ictal EEG

    Energy Technology Data Exchange (ETDEWEB)

    Engel, J. Jr.; Henry, T.R.; Risinger, M.W.; Mazziotta, J.C.; Sutherling, W.W.; Levesque, M.F.; Phelps, M.E.

    1990-11-01

    One hundred fifty-three patients with medically refractory partial epilepsy underwent chronic stereotactic depth-electrode EEG (SEEG) evaluations after being studied by positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) and scalp-sphenoidal EEG telemetry. We carried out retrospective standardized reviews of local cerebral metabolism and scalp-sphenoidal ictal onsets to determine when SEEG recordings revealed additional useful information. FDG-PET localization was misleading in only 3 patients with temporal lobe SEEG ictal onsets for whom extratemporal or contralateral hypometabolism could be attributed to obvious nonepileptic structural defects. Two patients with predominantly temporal hypometabolism may have had frontal epileptogenic regions, but ultimate localization remains uncertain. Scalp-sphenoidal ictal onsets were misleading in 5 patients. For 37 patients with congruent focal scalp-sphenoidal ictal onsets and temporal hypometabolic zones, SEEG recordings never demonstrated extratemporal or contralateral epileptogenic regions; however, 3 of these patients had nondiagnostic SEEG evaluations. The results of subsequent subdural grid recordings indicated that at least 1 of these patients may have been denied beneficial surgery as a result of an equivocal SEEG evaluation. Weighing risks and benefits, it is concluded that anterior temporal lobectomy is justified without chronic intracranial recording when specific criteria for focal scalp-sphenoidal ictal EEG onsets are met, localized hypometabolism predominantly involves the same temporal lobe, and no other conflicting information has been obtained from additional tests of focal functional deficit, structural imaging, or seizure semiology.

  15. SPECT Imaging of patients with parkinsonian syndromes; SPECT-Untersuchungen bei Patienten mit Parkinson-Syndromen

    Energy Technology Data Exchange (ETDEWEB)

    Tatsch, K. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Univ. Muenchen-Grosshardern (Germany)

    2002-09-01

    Stimulated by the commercial availability of specific radioligands in vivo characterization of the dopaminergic system with single-photon emission tomography (SPECT) has gained clinical importance in the diagnostic work-up of patiens with parkinsonism. Currently interest is focused on two aspects of the dopaminergic neurotransmission: Cocaine analogues bind to the presynaptically located striatal dopamine transporter and herewith allow to assess the structural integrity of the presynaptic terminals which are the striatal projections of neurons originating in the substantia nigra. For functional assessment of the postsynaptic aspect of the dopaminergic synapse binding of specific receptor antagonists to postsynaptically located D2 receptors is analyzed. Depending on the clinical question and the pathology expected both methods - either each one alone or a combination of both - provide valuable diagnostic information. Currently those SPECT methods are applied to confirm or exclude a Parkinsonian syndrome, in the early and differential diagnosis of Parkinsonian syndromes, to assess disease severity and measure disease progression, and to monitor the effects of therapy e.g. with potentially neuroprotective drugs. This paper offers a comprehensive summary of the SPECT results reported in the literature dealing with the mentioned clinical applications. (orig.) [German] Stimuliert durch die kommerzielle Verfuegbarkeit spezifischer Radioliganden gewinnt die In-vivo-Charakterisierung des dopaminergen Systems mit der single-photon-emissions-computertomographie (SPECT) bei der diagnostischen Abklaerung von Parkinson-Syndromen zunehmend an Bedeutung. Hierbei stehen zwei Aspekte der dopaminergen Neurotransmission im Blickpunkt des Interesses: Die Bindung von Kokainanaloga an den praesynaptischen Dopamintransporter laesst Rueckschluesse auf die Integritaet von Neuronen der Substantia nigra mit ihren zum Corpus striatum projizierenden Axonen (praesynaptische Nervenfasern) zu. Die

  16. Advances in SPECT and PET Hardware.

    Science.gov (United States)

    Slomka, Piotr J; Pan, Tinsu; Berman, Daniel S; Germano, Guido

    2015-01-01

    There have been significant recent advances in single photon emission computed tomography (SPECT) and positron emission tomography (PET) hardware. Novel collimator designs, such as multi-pinhole and locally focusing collimators arranged in geometries that are optimized for cardiac imaging have been implemented to reduce imaging time and radiation dose. These new collimators have been coupled with solid state photon detectors to further improve image quality and reduce scanner size. The new SPECT scanners demonstrate up to a 7-fold increase in photon sensitivity and up to 2 times improvement in image resolution. Although PET scanners are used primarily for oncological imaging, cardiac imaging can benefit from the improved PET sensitivity of 3D systems without inter-plane septa and implementation of the time-of-flight reconstruction. Additionally, resolution recovery techniques are now implemented by all major PET vendors. These new methods improve image contrast, image resolution, and reduce image noise. Simultaneous PET/magnetic resonance (MR) hybrid systems have been developed. Solid state detectors with avalanche photodiodes or digital silicon photomultipliers have also been utilized in PET. These new detectors allow improved image resolution, higher count rate, as well as a reduced sensitivity to electromagnetic MR fields. Copyright © 2015. Published by Elsevier Inc.

  17. Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults.

    Science.gov (United States)

    Yoo, Ji Yeoun; Marcuse, Lara V; Fields, Madeline C; Rosengard, Jillian L; Traversa, Maria Vittoria; Gaspard, Nicolas; Hirsch, Lawrence J

    2017-05-01

    Brief potentially ictal rhythmic discharges (B(I)RDs) have been described in neonates and critically ill adults, and their association with seizures has been demonstrated. Their significance in noncritically ill adults remains unclear. We aimed to investigate their prevalence, electrographic characteristics, and clinical significance. We identified adult patients with B(I)RDs who received long-term EEG recordings either in the epilepsy monitoring unit or in the ambulatory setting. Patients with acute findings on imaging or status epilepticus were excluded. B(I)RDs were defined as very brief (<10 seconds) runs of focal or generalized sharply contoured rhythmic activity greater than 4 Hz, with or without evolution, that were not consistent with any known normal or benign pattern. The clinical history, EEG, and imaging results were retrieved. Each patient with B(I)RDs was matched by age and etiology to a control group with epileptiform discharges but without B(I)RDs in a 1:2 ratio. We identified B(I)RDs in 15 patients of 1,230 EEGs (1.2%). The pattern typically consisted of 0.5 to 4 second runs of sharply contoured alpha activity without evolution. All patients with B(I)RDs had epilepsy, and, when compared with controls with epilepsy but without BIRDs, were more likely to be medically refractory (10 of 15 [67%] vs. 5 of 30 [17%]; P < 0.01). All seizure onsets colocalized to the B(I)RDs, and most were morphologically similar. In noncritically ill patients, B(I)RDs are associated with refractory epilepsy and their location is correlated with the seizure onset area.

  18. Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Non-critically Ill Adults.

    Science.gov (United States)

    Yoo, Ji Yeoun; Marcuse, Lara V; Fields, Madeline C; Rosengard, Jillian; Traversa, Maria Vittoria; Gaspard, Nicolas; Hirsch, Lawrence J

    2016-10-19

    Brief potentially ictal rhythmic discharges (B(I)RDs) have been described in neonates and critically ill adults, and their association with seizures has been demonstrated. Their significance in non-critically ill adults remains unclear. We aimed to investigate their prevalence, electrographic characteristics and clinical significance. We identified adult patients with B(I)RDs who received long term EEG recordings either in the epilepsy monitoring unit or in the ambulatory setting. Patients with acute findings on imaging or status epilepticus were excluded. B(I)RDs were defined as very brief (<10 seconds) runs of focal or generalized sharply contoured rhythmic activity greater than 4 Hz, with or without evolution, that were not consistent with any known normal or benign pattern. The clinical history, EEG and imaging results were retrieved. Each patient with B(I)RDs was matched by age and etiology to a control group with epileptiform discharges but without B(I)RDs in a 1:2 ratio. We identified B(I)RDs in 15 patients out of 1230 EEGs (1.2%). The pattern typically consisted of 0.5-4 second runs of sharply contoured alpha activity without evolution. All patients with B(I)RDs had epilepsy, and, when compared to controls with epilepsy but without BIRDs, were more likely to be medically refractory (10 of 15 [67%] vs. 5 of 30 [17%]; p<0.01). All seizure onsets co-localized to the B(I)RDs, and most were morphologically similar. In non-critically ill patients, B(I)RDs are associated with refractory epilepsy and their location is correlated with the seizure onset area.

  19. ICTAL AND INTERICTAL EEG ABNORMALITIES IN 100 MIGRAINEURS WITH AND WITHOUT AURA

    Directory of Open Access Journals (Sweden)

    H. Pourmahmoodian

    2007-07-01

    Full Text Available There are several conflicting reports about the EEG of the migraineurs. In this study we report the ictal and interictal EEGs of 100 migraineurs, in comparison with control group. The range age for patient and control groups were 9-48 (mean: 26 ± 1.8 and 10-46 (mean: 23 ± 2.1 years respectively. 32% of the patients were less than 14 years old and the remaining 68% were more than 14 years. In the patient group, 68% of cases had migraine without aura and 32% suffered from migraine with aura. Hemiplegic and basilar migraines were observed in one and two of our patients respectively. Gender and age had no effect on the type of migraine. Family history for first degree relatives was found in 64% of patients, without being influenced by gender or type of migraine. Male to female ratio was 1/1.6 (38/62. Abnormal EEG was found to be much more frequent in migraineurs than the control group (47% vs. 7%. Children had an overall somewhat more abnormal EEGs, compared with adult group (53% vs. 44% or 17/32 vs. 30/68, though slow discharges were detected more in adult group. The most common abnormality was slow high voltage waves, which was observed in 33/47 (70% of abnormal recordings. The less common findings, in decreasing order of frequency were: focal (slow, sharps or mixed discharges in 14/47 (29%, epileptiform (alone or associated with slow waves in 4/47 (8.5%, diffuse beta and frontal intermittent delta, activity each being in 1/47 (2.1% of abnormal recordings.

  20. Electrical Stimulations of the Human Insula: Their Contribution to the Ictal Semiology of Insular Seizures.

    Science.gov (United States)

    Mazzola, Laure; Mauguière, François; Isnard, Jean

    2017-07-01

    Stereotactic stimulations of the insular cortex through intracranial electrodes aim at characterizing the semiology of insular seizures. These stimulations, carried out in the context of Stereo-Electro-Encephalography (SEEG) during presurgical monitoring of epilepsy, reproduce the ictal symptoms observed during the development of insular seizures. The authors reviewed the results of insular stimulations performed in 222 patients admitted between 1997 and 2015 for presurgical SEEG exploration of atypical temporal or perisylvian epilepsy. Stimulations (50 Hz, trains of 5 seconds, pulses of 0.5 ms, intensity 0.2-3.5 mA) were carried out using transopercular electrodes implanted orthogonal to midsagittal plane. Out of a total of 669 stimulations, 550 were clinically eloquent in the absence of any postdischarge (237 and 313, respectively, in the right and left insulae). Somatosensory responses (61% of evoked sensations) including pain and visceral sensations (14.9%) were the most frequent, followed by auditory sensations (8%), vestibular illusions (7.5%), speech impairment (5%), gustatory, (2.7%), and olfactory (1%) sensations. Although these responses showed some functional segregation (in particular a privileged pain representation in the postero-superior quadrant), there was a clear spatial overlap between representations of the different modalities. Symptoms evoked by insular stimulations are multiple. None of them can be considered as absolutely specific to the insular cortex, but the occurrence in given seizure of a somatosensory symptom such as pain or of a laryngeal spasm associated with vestibular, auditory, aphasic, or olfacto-gustatory symptoms points to a discharge development in the insular cortex, which is the only cortical region where stimulations demonstrate such a multimodal representation.

  1. Sensitivity and specificity of interictal EEG-fMRI for detecting the ictal onset zone at different statistical thresholds.

    Directory of Open Access Journals (Sweden)

    Simon eTousseyn

    2014-07-01

    Full Text Available There is currently a lack of knowledge about EEG-fMRI specificity. Our aim was to define sensitivity and specificity of Blood Oxygen Level Dependent (BOLD responses to interictal epileptic spikes during EEG-fMRI for detecting the ictal onset zone (IOZ. We studied 21 refractory focal epilepsy patients who had a well-defined IOZ after a full presurgical evaluation and interictal spikes during EEG-fMRI. Areas of spike-related BOLD changes overlapping the IOZ in patients were considered as true positives; if no overlap was found, they were treated as false negatives. Matched healthy case-controls underwent similar EEG-fMRI in order to determine true negative and false positive fractions. The spike-related regressor of the patient was used in the design matrix of the healthy case-control. Suprathreshold BOLD changes in the brain of controls were considered as false positives, absence of these changes as true negatives. Sensitivity and specificity were calculated for different statistical thresholds at the voxel level combined with different cluster size thresholds and represented in receiver operating characteristic (ROC-curves. Additionally, we calculated the ROC-curves based upon the cluster containing the maximal significant activation. We achieved a combination of 100% specificity and 62% sensitivity, using a Z-threshold in the interval 3.4-3.5 and cluster size threshold of 350 voxels. We could obtain higher sensitivity at the expense of specificity. Similar performance was found when using the cluster containing the maximal significant activation. Our data provide a guideline for different EEG-fMRI settings with their respective sensitivity and specificity for detecting the ictal onset zone. The unique cluster containing the maximal significant BOLD activation was a sensitive and specific marker of the ictal onset zone.

  2. EEG/fMRI study of ictal and interictal epileptic activity: methodological issues and future perspectives in clinical practice.

    Science.gov (United States)

    Di Bonaventura, Carlo; Vaudano, Anna E; Carnì, Marco; Pantano, Patrizia; Nucciarelli, Valter; Garreffa, Girolamo; Maraviglia, Bruno; Prencipe, Massimiliano; Bozzao, Luigi; Manfredi, Mario; Giallonardo, Anna T

    2006-01-01

    Electroencephalography/functional magnetic resonance imaging (EEG/fMRI) has been proposed recently as a tool to study electrophysiological activity and, consequently, detect brain regions activated during epileptiform EEG abnormalities. The purpose of the study was to review our two-year experience with studying ictal and interictal activities in patients with epilepsy. Using EEG/fMRI, we studied hemodynamic changes associated with ictal and interictal EEG abnormalities in 43 patients with partial (31 cases) or generalized (12 cases) epilepsy. Using two different paradigms (block design and event-related design), we studied several forms of EEG activity consisting of (i) interictal abnormalities constantly elicitable by specific stimulation (8 cases); (ii) focal and generalized interictal activity, such as focal spikes or typical and atypical generalized spike-and-wave discharges (18 cases); and (iii) focal and generalized ictal electro-clinical activity, such as tonic seizures or pseudo-absences in frontal lobe epilepsy, typical absences in idiopathic generalized epilepsy, complex partial seizures in temporal lobe epilepsy, and perisylvian seizures in special syndromes (17 patients). EEG/fMRI revealed clear hemodynamic changes related to EEG abnormalities in 21 patients. In 18 of these patients, the changes were highly concordant with electro-clinical findings. In the remaining 22 patients, fMRI analysis data failed to show activation or deactivation clusters, probably owing either to lack or inadequate amount of temporal distribution of abnormal EEG activity, or to intrinsic methodological problems. By defining the electro-clinical and hemodynamic correlates of EEG activity, fMRI may shed light on the neurophysiological mechanisms underlying epileptic phenomena. However, as several methodological issues have yet to be addressed, further studies are warranted to assess the reliability and usefulness of EEG/fMRI in clinical practice.

  3. Ictal vomiting as a sign of temporal lobe epilepsy confirmed by stereo-EEG and surgical outcome.

    Science.gov (United States)

    Pietrafusa, Nicola; de Palma, Luca; De Benedictis, Alessandro; Trivisano, Marina; Marras, Carlo Efisio; Vigevano, Federico; Specchio, Nicola

    2015-12-01

    Vomiting is uncommon in patients with epilepsy and has been reported in both idiopathic and symptomatic epilepsies. It is presumed to originate in the anterior part of the temporal lobe or insula. To date, 44 cases of nonidiopathic focal epilepsy and seizures associated with ictal vomiting have been reported. Of the 44 cases, eight were studied using invasive exploration (3 stereo-EEG/5 subdural grids). Here, we report a 4-year-and-7-month-old patient with a history of febrile convulsion in the second year of life and who developed episodes of vomiting and complex partial seizures at 3 years of age. Scalp EEG showed no electrical modification during vomiting while the complex partial seizure displayed a clear right temporal origin. Brain MR showed hippocampal volume reduction with mild diffuse blurring of the temporal lobe. Stereoelectroencephalography study confirmed the mesiotemporal origin of the seizures and showed that the episodes of vomiting were strictly related to an ictal discharge originating in the mesial temporal structures without insular diffusion. The patient is now seizure-free (18 months) after removal of the right anterior and mesial temporal structures. In all the reported patients, seizures seemed to start in mesial temporal structures. The grid subgroup is more homogeneous, and the most prominent characteristic (4/5) is the involvement of both mesial and lateral temporal structures at the time of vomiting. In the S-EEG group, there is evidence of involvement of either the anterior temporal structures alone (2/3) or both insular cortices (1/3). Our case confirms that vomiting could occur when the ictal discharge is limited to the anterior temporal structure without insular involvement. Regarding the pathophysiology of vomiting, the role of subcortical structures such as the dorsal vagal complex and the central pattern generators (CPG) located in the reticular area is well established. Vomiting as an epileptic phenomenon seems to be related to

  4. Quantification of perfusion and risk stratification by myocardial perfusion SPECT; Quantifizierung der Perfusion und Risikostratifizierung durch die Myokardperfusions-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nowak, Bernd [Ueberoertliche Gemeinschaft (GbR) fuer diagnostische und interventionelle Radiologie und Nuklearmedizin (DIRANUK), Bielefeld (Germany); Klinikum Bielefeld-Mitte (Germany). Klinik fuer Nuklearmedizin; Schaefer, W.M. [Kliniken Maria Hilf GmbH, Krankenhaus St. Franziskus, Moenchengladbach (Germany). Klinik fuer Nuklearmedizin

    2010-06-15

    Myocardial perfusion SPECT detects flow-limiting coronary artery disease with high sensitivity and specificity, enables semiquantification of severity and extensiveness of myocardial ischemia, and furthermore enables reliable assessment of future cardiac events independently of other clinical and diagnostic parameters. A normal myocardial perfusion SPECT is associated with a favorable prognosis and warrants restrictive patient management. Cardiac risk increases in relation to the severity of perfusion abnormalities. Differentiated analysis of quantitative parameters derived from myocardial perfusion SPECT provides effective risk stratification of patients with a large variety of risk factors. (orig.)

  5. SPECT/CT in the Diagnosis of Skull Base Osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Damle, Nishikant Avinash; Kumar, Rakesh; Kumar, Praveen; Jaganthan, Sriram; Patnecha, Manish; Bal, Chandrasekhar; Bandopadhyaya, Gurupad; Malhotra, Arun [All India Institute of Medical Sciences, New Delhi (India)

    2011-09-15

    Skull base osteomyelitis is a potentially fatal disease. We demonstrate here the utility of SPECT/CT in diagnosing this entity, which was not obvious on a planar bone scan. A {sup 99mT}c MDP bone scan with SPECT/CT was carried out on a patient with clinically suspected skull base osteomyelitis. Findings were correlated with contrast enhanced CT (CECT) and MRI. Planar images were equivocal, but SPECT/CT showed intense uptake in the body of sphenoid and petrous temporal bone as well as the atlas corresponding to irregular bone destruction on CT and MRI. These findings indicate that SPECT/CT may have an additional role beyond planar imaging in the detection of skull base osteomyelitis.

  6. High-resolution SPECT for small-animal imaging

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    This article presents a brief overview of the development of high-resolution SPECT for small-animal imaging. A pinhole collimator has been used for high-resolution animal SPECT to provide better spatial resolution and detection efficiency in comparison with a parallel-hole collimator. The theory of imaging characteristics of the pinhole collimator is presented and the designs of the pinhole aperture are discussed. The detector technologies used for the development of small-animal SPECT and the recent advances are presented. The evolving trend of small-animal SPECT is toward a multi-pinhole and a multi-detector system to obtain a high resolution and also a high detection efficiency.

  7. Impact of reconstruction parameters on quantitative I-131 SPECT

    NARCIS (Netherlands)

    van Gils, C A J; Beijst, C; van Rooij, R; de Jong, H W A M

    2016-01-01

    Radioiodine therapy using I-131 is widely used for treatment of thyroid disease or neuroendocrine tumors. Monitoring treatment by accurate dosimetry requires quantitative imaging. The high energy photons however render quantitative SPECT reconstruction challenging, potentially requiring accurate cor

  8. Application of PET/SPECT imaging in vascular disease

    NARCIS (Netherlands)

    van der Vaart, M. G.; Meerwaidt, R.; Slart, R. H. J. A.; van Dam, G. M.; Tio, R. A.; Zeebregts, C. J.

    2008-01-01

    Background. Nuclear medicine imaging differs from other imaging modalities by showing physiological processes instead of anatomical details. Objective. To describe the current applications of positron emission tomography (PET) and single photon emission computed tomography (SPECT) as a diagnostic to

  9. Performance evaluation of advanced industrial SPECT system with diverging collimator.

    Science.gov (United States)

    Park, Jang Guen; Jung, Sung-Hee; Kim, Jong Bum; Moon, Jinho; Yeom, Yeon Soo; Kim, Chan Hyeong

    2014-12-01

    An advanced industrial SPECT system with 12-fold-array diverging collimator was developed for flow visualization in industrial reactors and was discussed in the previous study. The present paper describes performance evaluation of the SPECT system under both static- and dynamic- flow conditions. Under static conditions, the movement of radiotracer inside the test reactor was compared with that of color tracer (blue ink) captured with a high-speed camera. The comparison of the reconstructed images obtained with the radiotracer and the SPECT system showed fairly good agreement with video-frames of the color tracer obtained with the camera. Based on the results of the performance evaluation, it is concluded that the SPECT system is suitable for investigation and visualization of flows in industrial flow reactors.

  10. Impact of reconstruction parameters on quantitative I-131 SPECT

    NARCIS (Netherlands)

    van Gils, C A J; Beijst, C; van Rooij, R; de Jong, H W A M

    2016-01-01

    Radioiodine therapy using I-131 is widely used for treatment of thyroid disease or neuroendocrine tumors. Monitoring treatment by accurate dosimetry requires quantitative imaging. The high energy photons however render quantitative SPECT reconstruction challenging, potentially requiring accurate

  11. The value of SPECT/CT in carpal boss

    Energy Technology Data Exchange (ETDEWEB)

    Bhure, Ujwal; Huellner, Martin W.; Gruenig, Hannes; Zander, Andrea; Sol Perez Lago, Maria del; Strobel, Klaus [Cantonal Hospital Lucerne, Nuclear Medicine and Radiology, Lucerne (Switzerland); Hug, Urs [Cantonal Hospital Lucerne, Department of Hand and Plastic Surgery, Lucerne (Switzerland)

    2015-11-15

    To assess the value of SPECT/CT in patients with carpal boss (CB). In 24 wrists with CB (18 right-sided, 6 left-sided) in 21 patients, planar images and SPECT/CT images were obtained. Three patients had bilateral CB. The grade of uptake (0 absent, 1 low, 2 moderate, 3 high) on planar imaging and SPECT/CT was assessed and compared with CT findings, clinical symptoms and follow-up findings. CB affected carpometacarpal joint II in 4 wrists, carpometacarpal joint III in 17 wrists and both carpometacarpal joints II and III in 3 wrists. Of the 24 CB, 12 (50 %) were active (i.e. increased radionuclide uptake) on planar images and 18 (75 %) on SPECT/CT images. Of the 17 symptomatic CB, 10 (59 %) were active on planar images and 14 (82 %) were active (mean grade 1.9, range 1 - 3) on SPECT/CT images. Of the 7 asymptomatic CB, 2 were active on planar images and 4 were active (mean grade 1.25, range 1 - 2) on SPECT/CT images. CT alone showed CB in all patients and an accessory ossicle (os styloideum) in 8 wrists. MR imaging was available in 7 patients and positive for CB in 5 (sensitivity 71 %). Plain radiographs were available in 17 patients and positive in 10 (59 %). Therapeutic infiltration of the CB was performed in 9 patients, and resection of the CB in 7 patients. SPECT/CT provides important morphological and metabolic information for the clinical assessment of CB, but because SPECT/CT tends to overestimate the clinical importance of CB, we recommend that planar images should still be obtained. (orig.)

  12. A review on the clinical uses of SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Mariani, Giuliano; Bruselli, Laura [University of Pisa Medical School, Regional Center of Nuclear Medicine, Pisa (Italy); Kuwert, Torsten [Friedrich-Alexander-University, Clinic of Nuclear Medicine, Erlangen-Nuremberg (Germany); Kim, Edmund E. [MD Anderson Cancer Center, Nuclear Medicine Service, Houston, TX (United States); Flotats, Albert [Universitat Autonoma de Barcelona, Hospital de Sant Pau, Nuclear Medicine Department, Barcelona (Spain); Israel, Ora [Rambam Health Care Campus, Department of Nuclear Medicine, Haifa (Israel); Dondi, Maurizio [International Atomic Energy Agency, Nuclear Medicine Section, Division of Human Health, Vienna (Austria); Watanabe, Naoyuki [International Atomic Energy Agency, Nuclear Medicine Section, Division of Human Health, Vienna (Austria); Gunma Prefectural College of Health Sciences, Department of Radiological Technology, Gunma (Japan)

    2010-10-15

    In the era when positron emission tomography (PET) seems to constitute the most advanced application of nuclear medicine imaging, still the conventional procedure of single photon emission computed tomography (SPECT) is far from being obsolete, especially if combined with computed tomography (CT). In fact, this dual modality imaging technique (SPECT/CT) lends itself to a wide variety of useful diagnostic applications whose clinical impact is in most instances already well established, while the evidence is growing for newer applications. The increasing availability of new hybrid SPECT/CT devices with advanced technology offers the opportunity to shorten acquisition time and to provide accurate attenuation correction and fusion imaging. In this review we analyse and discuss the capabilities of SPECT/CT for improving sensitivity and specificity in the imaging of both oncological and non-oncological diseases. The main advantages of SPECT/CT are represented by better attenuation correction, increased specificity, and accurate depiction of the localization of disease and of possible involvement of adjacent tissues. Endocrine and neuroendocrine tumours are accurately localized and characterized by SPECT/CT, as also are solitary pulmonary nodules and lung cancers, brain tumours, lymphoma, prostate cancer, malignant and benign bone lesions, and infection. Furthermore, hybrid SPECT/CT imaging is especially suited to support the increasing applications of minimally invasive surgery, as well as to precisely define the diagnostic and prognostic profile of cardiovascular patients. Finally, the applications of SPECT/CT to other clinical disorders or malignant tumours is currently under extensive investigation, with encouraging results in terms of diagnostic accuracy. (orig.)

  13. Comparison of heterogeneity quantification algorithms for brain SPECT perfusion images

    OpenAIRE

    Modzelewski, Romain; Janvresse, Elise; De La Rue, Thierry; Vera, Pierre

    2012-01-01

    Background Several algorithms from the literature were compared with the original random walk (RW) algorithm for brain perfusion heterogeneity quantification purposes. Algorithms are compared on a set of 210 brain single photon emission computed tomography (SPECT) simulations and 40 patient exams. Methods Five algorithms were tested on numerical phantoms. The numerical anthropomorphic Zubal head phantom was used to generate 42 (6 × 7) different brain SPECT simulations. Seven diffuse cortical ...

  14. Cervical SPECT Camera for Parathyroid Imaging

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2012-08-31

    Primary hyperparathyroidism characterized by one or more enlarged parathyroid glands has become one of the most common endocrine diseases in the world affecting about 1 per 1000 in the United States. Standard treatment is highly invasive exploratory neck surgery called Parathyroidectomy. The surgery has a notable mortality rate because of the close proximity to vital structures. The move to minimally invasive parathyroidectomy is hampered by the lack of high resolution pre-surgical imaging techniques that can accurately localize the parathyroid with respect to surrounding structures. We propose to develop a dedicated ultra-high resolution (~ 1 mm) and high sensitivity (10x conventional camera) cervical scintigraphic imaging device. It will be based on a multiple pinhole-camera SPECT system comprising a novel solid state CZT detector that offers the required performance. The overall system will be configured to fit around the neck and comfortably image a patient.

  15. ACR testing of a dedicated head SPECT unit.

    Science.gov (United States)

    Sensakovic, William F; Hough, Matthew C; Kimbley, Elizabeth A

    2014-07-08

    Physics testing necessary for program accreditation is rigorously defined by the ACR. This testing is easily applied to most conventional SPECT systems based on gamma camera technology. The inSPira HD is a dedicated head SPECT system based on a rotating dual clamshell design that acquires data in a dual-spiral geometry. The unique geometry and configuration force alterations of the standard ACR physics testing protocol. Various tests, such as intrinsic planar uniformity and/or resolution, do not apply. The Data Spectrum Deluxe Phantom used for conventional SPECT testing cannot fit in the inSPira HD scanner bore, making (currently) unapproved use of the Small Deluxe SPECT Phantom necessary. Matrix size, collimator type, scanning time, reconstruction method, and attenuation correction were all varied from the typically prescribed ACR instructions. Visible spheres, sphere contrast, visible rod groups, uniformity, and root mean square (RMS) noise were measured. The acquired SPECT images surpassed the minimum ACR requirements for both spatial resolution (9.5 mm spheres resolved) and contrast (6.4 mm rod groups resolved). Sphere contrast was generally high. Integral uniformity was 4% and RMS noise was 1.7%. Noise appeared more correlated than in images from a conventional SPECT scanner. Attenuation-corrected images produced from direct CT scanning of the phantom and a manufacturer supplied model of the phantom demonstrated negligible differences.

  16. Tc-99m Ciprofloxacin SPECT of Pulmonary Tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Kyung; Hwang, Kyung Hoon [Gachon University Gil Hospital, Incheon (Korea, Republic of); Yoon, Min Ki [Good Samaritan Hospital, Pohang (Korea, Republic of); Choe, Won Sick [Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    2010-06-15

    Tc-99m ciprofloxacin is available for imaging infection. However, there has been no study on employing single photon emission computed tomography (SPECT) with using Tc-99m ciprofloxacin to image active pulmonary tuberculosis. Therefore, we conducted this study to assess the efficacy of Tc-99m ciprofloxacin SPECT for imaging active pulmonary tuberculosis. Twenty-one participants were enrolled in this prospective study. They were divided into two groups according to the clinical and radiological assessment. Group one (Gr. 1) consisted of five normal volunteers and six patients with inactive pulmonary tuberculosis. Group two (Gr. 2) consisted of ten patients with active pulmonary tuberculosis. SPECT was performed 3 h after injecting 555 MBq (15 mCi) of Tc-99m ciprofloxacin. The findings of Tc-99m ciprofloxacin SPECT were interpreted by a nuclear medicine specialist and then the results were analyzed according to the patients' clinical and radiological classifications. The results of Tc-99m ciprofloxacin SPECT were as follows: eight true-positive cases, ten true-negative cases, one false-positive case and two false-negative cases. The sensitivity and specificity was 80.0% and 90.0%, respectively. The positive predictive value was 88.9% and the negative predictive value was 83.3%. Conclusions Tc-99m ciprofloxacin SPECT is feasible for imaging active pulmonary tuberculosis. It is a useful nuclear-imaging method for discriminating between the active and inactive tuberculosis states in patients with a past medical history of pulmonary tuberculosis.

  17. Evaluation of SPECT imaging using myocardial phantoms in Akita prefecture

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Kiyohiko [Akita Univ. (Japan). Hospital; Watarai, Jiro; Miura, Mamoru

    1998-09-01

    Evaluation of SPECT imaging using myocardial phantom in Akita Prefecture. The Society of Nuclear Medicine for Circulation disease in Akita was established in July, 1997. To improve myocardial spect imaging in Akita Prefecture, we first visually evaluated two acrlic defect (2 cm{phi} x 1 cm thickness aqcliel and 1 cm{phi} x 1 cm thickness) images of long axis and short axis of myocardial phantoms, using 14 SPECT Cameras. These defect images of myocardial phantom were evaluated by four cardiologists and twelve radiologists between August and December, 1996. Secondly, we measured the FWHM of four line sources (anterior, lateral, inferior, and septum positions in the short axis of myocardial phantom) using quantitative analysis by myocardial phantom between April and July, 1997. The results were reported at the 4th and 5th meeting of the Society of Nuclear Medicine for Circulation Disease in Akita. In conclusion, about 70% of myocardial spect images were of good or normal quality, whereas about 30% of the images were evaluated as of bad quality. To improve the myocardial spect images, we recognized that the basic performance of the SPECT cameras need be investigated. (author)

  18. PET/SPECT imaging: From carotid vulnerability to brain viability

    Energy Technology Data Exchange (ETDEWEB)

    Meerwaldt, Robbert [Department of Surgery, Isala Clinics, Zwolle (Netherlands); Slart, Riemer H.J.A. [Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen (Netherlands); Dam, Gooitzen M. van [Department of Surgery, University Medical Center Groningen, Groningen (Netherlands); Luijckx, Gert-Jan [Department of Neurology, University Medical Center Groningen, Groningen (Netherlands); Tio, Rene A. [Department of Cardiology, University Medical Center Groningen, Groningen (Netherlands); Zeebregts, Clark J. [Department of Surgery, University Medical Center Groningen, Groningen (Netherlands)], E-mail: czeebregts@hotmail.com

    2010-04-15

    Background: Current key issues in ischemic stroke are related to carotid plaque vulnerability, brain viability, and timing of intervention. The treatment of ischemic stroke has evolved into urgent active interventions, as 'time is brain'. Functional imaging such as positron emission tomography (PET)/single photon emission computed tomography (SPECT) could improve selection of patients with a vulnerable plaque and evaluation of brain viability in ischemic stroke. Objective: To describe the current applications of PET and SPECT as a diagnostic tool in relation to ischemic stroke. Methods: A literature search using PubMed identified articles. Manual cross-referencing was also performed. Results: Several papers, all observational studies, identified PET/SPECT to be used as a tool to monitor systemic atheroma modifying treatment and to select high-risk patients for surgery regardless of the degree of luminal stenosis in carotid lesions. Furthermore, PET/SPECT is able to quantify the penumbra region during ischemic stroke and in this way may identify those patients who may benefit from timely intervention. Discussion: Functional imaging modalities such as PET/SPECT may become important tools for risk-assessment and evaluation of treatment strategies in carotid plaque vulnerability and brain viability. Prospective clinical studies are needed to evaluate the diagnostic accuracy of PET/SPECT.

  19. A testbed to explore the optimal electrical stimulation parameters for suppressing inter-ictal spikes in human hippocampal slices.

    Science.gov (United States)

    Min-Chi Hsiao; Pen-Ning Yu; Dong Song; Liu, Charles Y; Heck, Christi N; Millett, David; Berger, Theodore W

    2014-01-01

    New interventions using neuromodulatory devices such as vagus nerve stimulation, deep brain stimulation and responsive neurostimulation are available or under study for the treatment of refractory epilepsy. Since the actual mechanisms of the onset and termination of the seizure are still unclear, most researchers or clinicians determine the optimal stimulation parameters through trial-and-error procedures. It is necessary to further explore what types of electrical stimulation parameters (these may include stimulation frequency, amplitude, duration, interval pattern, and location) constitute a set of optimal stimulation paradigms to suppress seizures. In a previous study, we developed an in vitro epilepsy model using hippocampal slices from patients suffering from mesial temporal lobe epilepsy. Using a planar multi-electrode array system, inter-ictal activity from human hippocampal slices was consistently recorded. In this study, we have further transferred this in vitro seizure model to a testbed for exploring the possible neurostimulation paradigms to inhibit inter-ictal spikes. The methodology used to collect the electrophysiological data, the approach to apply different electrical stimulation parameters to the slices are provided in this paper. The results show that this experimental testbed will provide a platform for testing the optimal stimulation parameters of seizure cessation. We expect this testbed will expedite the process for identifying the most effective parameters, and may ultimately be used to guide programming of new stimulating paradigms for neuromodulatory devices.

  20. Evaluation of Ictal Consciousness in Temporal and Extra Temporal Epilepsy: Observations from a Tertiary Care Hospital in India

    Science.gov (United States)

    Chaudhari, Rima M; Dash, Deepa; Ramanujam, Bhargavi; Rana, Manit K; Appukuttan, Renjith; Sharma, Anubha; Kunwar, Yuvraj; Tejaniya, Gaurav; Padma, Vasantha; Chandra, Sarat P; Tripathi, Manjari

    2016-01-01

    Background and Purpose Differences in consciousness during seizures depend on the location of the seizure onset. Methods The present study evaluates ictal consciousness using the ictal consciousness inventory (ICI) in drug refractory mesial temporal (MTLE), neocortical temporal (NTLE) and extra temporal epilepsy (ETLE). This was a cross sectional cohort study with 45 patients with mesial temporal epilepsy, 47 with extra temporal and 11 patients with neocortical temporal epilepsy. The ICI a 20 item questionnaire was used to calculate the scores for level (L, question 1–10) and content (C, question 11–20) of consciousness. Results The patients in mesial temporal group had higher ICI-L scores, p = 0.0129 as compared to the extra temporal group, but no difference was observed in the content of consciousness. The ICI-L and C scores were not different in the mesial temporal and the neocortical temporal group (p = 0.53 and 0.65) respectively. Conclusions Patients with mesial temporal epilepsy had a higher level of consciousness than the extra temporal group but there was no difference in the content. Also there was no difference in the level and content of consciousness between mesial and the neocortical temporal group. PMID:28101481

  1. Induction of psychogenic nonepileptic events: success rate influenced by prior induction exposure, ictal semiology, and psychological profiles.

    Science.gov (United States)

    Chen, David K; Izadyar, Shahram; Collins, Robert L; Benge, Jared F; Lemaire, Ashley W; Hrachovy, Richard A

    2011-06-01

    To evaluate whether certain preinduction clinical characteristics may influence the success rate of induction. We prospectively enrolled and attempted inductions on 51 patients who were suspected to have psychogenic nonepileptic events based on clinical grounds. In addition to careful examination of the reported ictal semiology, we administered a battery of four psychological instruments to our enrolled patients. We found that among 42 cases of successful induction, 92.9% (n=39) of these cases were successfully induced on the first attempt (i.e., without prior induction exposure). We observed that induction showed significantly higher rate of success in cases that demonstrate: (1) hypermotor ictal semiology (p=0.029); (2) more prevalent self-reporting of uncommon cognitive and affective symptoms (p=0.035); or (3) higher tendency to rely on coping strategies of "instrumental support" (p=0.013) and "active coping" (p=0.027), when compared to noninducible cases. Singular administration of placebo induction on preselected patients with these clinical characteristics may reduce costs by shortening video electroencephalography-(EEG) monitoring sessions and improve the diagnostic yield of video-EEG even for patients with very infrequent events. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  2. Importance of SPECT/CT for resolving diseases of the jaw; Stellenwert der SPECT/CT zur Abklaerung von Kiefererkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, K.; Huellner, M.W.; Bolouri, C.; Veit-Haibach, P.; Sol Perez-Lago, M. del [Luzerner Kantonsspital, Institut fuer Nuklearmedizin und Roentgendiagnostik, Luzern (Switzerland); Merwald, M.; Kuttenberger, J. [Luzerner Kantonsspital, Klinik fuer Mund-, Kiefer- und Gesichtschirurgie, Luzern (Switzerland)

    2012-07-15

    Diseases of the jaw, such as osteomyelitis, condylar hyperactivity and tumors need adequate imaging to evaluate the extension and activity for therapy planning. Conventional planar scintigraphy, orthopantomography, computed tomography (CT) and magnetic resonance imaging (MRI) can be used for the evaluation of jaw diseases. Single photon emission computed tomography/computed tomography (SPECT/CT) provides metabolic and morphologic information in one imaging step and is becoming increasingly more available in larger hospitals. The SPECT/CT is superior to planar scintigraphy alone, CT and orthopantomography in the evaluation of the extension and activity of osteomyelitis and jaw tumors. In our hospital SPECT/CT has replaced the other imaging modalities in the evaluation of osteomyelitis and condylar hyperactivity. If available SPECT/CT should be performed for the evaluation of osteomyelitis of the jaw. (orig.) [German] Kiefererkrankungen wie Osteomyelitis, kondylaere Hyperaktivitaet und Kiefertumoren benoetigen eine exakte bildgebende Abklaerung, um die Therapie adaequat planen zu koennen. Die klassische planare Skelettszintigraphie, Orthopantomographie, CT und MRT koennen zur Abklaerung von Kiefererkrankungen eingesetzt werden. Die ''single photon emission computed tomography''/CT (SPECT/CT) bietet metabolische und morphologische Informationen in einem Untersuchungsgang und ist zunehmend in groesseren Kliniken verfuegbar. Die SPECT/CT ist zur Beurteilung der Ausbreitung und Aktivitaet einer Osteomyelitis und von Kiefertumoren der planaren Szintigraphie alleine, der CT und der Orthopantomographie ueberlegen. In unserer Klinik hat die SPECT/CT die bisherigen Verfahren zur Beurteilung der Kieferosteomyelitis und kondylaeren Hyperaktivitaet abgeloest. Sofern verfuegbar, sollte zur Abklaerung einer Kieferosteomyelitis die SPECT/CT eingesetzt werden. (orig.)

  3. Importance of SPECT/CT for knee and hip joint prostheses; Stellenwert der SPECT/CT bei Knie- und Hueftgelenkprothesen

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, K.; Steurer-Dober, I.; Huellner, M.W.; Veit-Haibach, P.; Allgayer, B. [Luzerner Kantonsspital (Switzerland). Institut fuer Nuklearmedizin und Roentgendiagnostik

    2012-07-15

    Complications, such as loosening or infections are common problems after hip or knee arthroplasty. If conventional X-rays are equivocal bone scintigraphy is the classical second-line imaging modality. Single photon emission computed tomography/computed tomography (SPECT/CT) offers metabolic and morphologic information in one imaging step and is becoming increasingly more available in larger hospitals. The SPECT/CT procedure is a promising method and is increasingly being used in daily routine to evaluate joint arthroplasty. The additional benefit compared with classical conventional bone scintigraphy has to be evaluated in further prospective studies. In our hospital SPECT/CT regularly gives important additional information regarding prosthetic joint complications. SPECT/CT is increasingly being used as the second step imaging standard modality if conventional X-rays are equivocal. (orig.) [German] Komplikationen wie Lockerung und Infekt stellen ein haeufiges Problem nach Hueft- und Kniegelenkprothesen dar. Wenn die konventionelle Roentgenaufnahme nicht zum Ziel fuehrt, ist die klassische konventionelle Skelettszintigraphie die am haeufigsten verwendete ''Second-line''-Bildgebung. Die ''single photon emission computed tomography''/CT (SPECT/CT) bietet metabolische und morphologische Informationen bzgl. Prothesenkomplikationen in einem Untersuchungsgang und ist zunehmend in groesseren Kliniken verfuegbar. Die SPECT/CT ist eine viel versprechende Methode und wird im klinischen Alltag bei der Evaluation von Gelenkprothesen zunehmend eingesetzt. Es sind noch mehr prospektive Studien noetig, um die Leistungsfaehigkeit und den Zusatznutzen gegenueber der klassischen Szintigraphie zu evaluieren. In unserer Klinik wird die Knochenszintigraphie bei der Abklaerung von Prothesenkomplikationen zumeist mit einer SPECT/CT kombiniert und liefert regelmaessig wichtige Zusatzinformationen. Die SPECT/CT entwickelt sich zunehmend zum Standard

  4. Sequential SPECT/CT imaging starting with stress SPECT in patients with left bundle branch block suspected for coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Engbers, Elsemiek M.; Mouden, Mohamed [Isala, Department of Cardiology, Zwolle (Netherlands); Isala, Department of Nuclear Medicine, Zwolle (Netherlands); Timmer, Jorik R.; Ottervanger, Jan Paul [Isala, Department of Cardiology, Zwolle (Netherlands); Knollema, Siert; Jager, Pieter L. [Isala, Department of Nuclear Medicine, Zwolle (Netherlands)

    2017-01-15

    To investigate the impact of left bundle branch block (LBBB) on sequential single photon emission computed tomography (SPECT)/ CT imaging starting with stress-first SPECT. Consecutive symptomatic low- to intermediate-risk patients without a history of coronary artery disease (CAD) referred for SPECT/CT were included from an observational registry. If stress SPECT was abnormal, additional rest SPECT and, if feasible, coronary CT angiography (CCTA) were acquired. Of the 5,018 patients, 218 (4.3 %) demonstrated LBBB. Patients with LBBB were slightly older than patients without LBBB (65±12 vs. 61±11 years, p<0.001). Stress SPECT was more frequently abnormal in patients with LBBB (82 % vs. 46 %, p<0.001). After reviewing stress and rest images, SPECT was normal in 43 % of the patients with LBBB, compared to 77 % of the patients without LBBB (p<0.001). Sixty-four of the 124 patients with LBBB and abnormal stress-rest SPECT underwent CCTA (52 %), which could exclude obstructive CAD in 46 of the patients (72 %). Sequential SPECT/CT imaging starting with stress SPECT is not the optimal imaging protocol in patients with LBBB, as the majority of these patients have potentially false-positive stress SPECT. First-line testing using CCTA may be more appropriate in low- to intermediate-risk patients with LBBB. (orig.)

  5. Efficacy of (99m)Tc-EDDA/HYNIC-TOC SPECT/CT scintigraphy in Graves' ophthalmopathy.

    Science.gov (United States)

    Zhao, Rong; Wang, Jiang; Deng, Jinglan; Yang, Weidong; Wang, Jing

    2012-01-01

    The aim of this study was to investigate the predictive role of the orbital somatostatin receptor scintigraphy with (99m)Tc-EDDA/HYNIC-TOC ((99m)Tc-TOC) to detect clinical stage of Graves' ophthalmopathy and the response to corticosteroid therapy. The subjects of the experiment were 46 patients with Graves' ophthalmopathy (GO) and four volunteers without eye disease or GO as the normal group (NG). Single photon emission computed tomography (SPECT), computed tomography (CT) and the left and right lateral position planar imaging of the heads of the all subjects were obtained 4 h after the intravenous injection of 555 MBq of (99m)Tc-TOC. The (99m)Tc-TOC SPECT/CT was repeated 3 months later. 35 (35/46) patients were received corticosteroid therapy (prednisolone, 10 mg po tid ) for 3 months, however, the other 11 patients as control groups did not receive any treatment. The treatment effect was evaluated both by the orbital (99m)Tc-TOC uptake and NOSPECS. A significant decrease in the O/OC ratio was observed in 22 GO patients between pre- and post-treatment (1.64 ± 0.13 vs. 1.21 ± 0.09, P TOC scintigraphy is a feasible technique to estimate the Graves' ophthalmopathy activity and predict the response to subsequent corticosteroid therapy in GO patients. The technique could be a useful tool for physicians not familiar with CAS determination.

  6. Diagnostic role of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for early and atypical bone metastases.

    Science.gov (United States)

    Chen, Xiao-Liang; Li, Qian; Cao, Lin; Jiang, Shi-Xi

    2014-01-01

    The bone metastasis appeared early before the bone imaging for most of the above patients. (99)Tc(m)-MDP ((99)Tc(m) marked methylene diphosphonate) bone imaging could diagnosis the bone metastasis with highly sensitivity, but with lower specificity. The aim of this study is to explore the diagnostic value of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for the early period atypical bone metastases. 15 to 30 mCi (99)Tc(m)-MDP was intravenously injected to the 34 malignant patients diagnosed as doubtful early bone metastases. SPECT, CT and SPECT/CT images were captured and analyzed consequently. For the patients diagnosed as early period atypical bone metastases by SPECT/CT, combining the SPECT/CT and MRI together as the SPECT/MRI integrated image. The obtained SPECT/MRI image was analyzed and compared with the pathogenic results of patients. The results indicated that 34 early period doubtful metastatic focus, including 34 SPECT positive focus, 17 focus without special changes by using CT method, 11 bone metastases focus by using SPECT/CT method, 23 doubtful bone metastases focus, 8 doubtful bone metastases focus, 14 doubtful bone metastases focus and 2 focus without clear image. Totally, SPECT/CT combined with SPECT/MRI method diagnosed 30 bone metastatic focus and 4 doubtfully metastatic focus. In conclusion, (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging shows a higher diagnostic value for the early period bone metastases, which also enhances the diagnostic accuracy rate.

  7. Fractal analysis of electroencephalographic signals intracerebrally recorded during 35 epileptic seizures: evaluation of a new method for synoptic visualisation of ictal events.

    Science.gov (United States)

    Bullmore, E T; Brammer, M J; Bourlon, P; Alarcon, G; Polkey, C E; Elwes, R; Binnie, C D

    1994-11-01

    Traditional electroencephalography (EEG) produces a large volume display of brain electrical activity, which creates problems particularly in assessment of long periods of intracranial, stereoelectroencephalographic (SEEG) recording. A method for fractal analysis that describes 100 SEEG data points in terms of a single estimate of fractal dimension (1 signal (using a Sun SPARCstation LX). The diagnostic sensitivity of this method, applied to quantification and synoptic visualisation of SEEG signals recorded during 35 epileptic seizures in 7 patients, is evaluated. It is found that the method consistently defines ictal onset in terms of rapid relative increase in FD across several channels. Clinically severe seizures are characterised by more intense and generalised ictal changes in FD than clinically less severe events. For all 7 patients, and for 75% of individual seizures, "fractal diagnoses" of anatomically defined ictal onset zone coincided closely with ictal onset zone independently determined by inspection of traditional EEG displays of the same data. We conclude that the method is a computationally feasible way to achieve substantial reduction in the volume of SEEG data without undue loss of diagnostically important information in the primary signal.

  8. Nicotinic and muscarinic cholinergic receptors are recruited by acetylcholine-mediated neurotransmission within the locus coeruleus during the organisation of post-ictal antinociception.

    Science.gov (United States)

    de Oliveira, Rithiele Cristina; de Oliveira, Ricardo; Biagioni, Audrey Franceschi; Falconi-Sobrinho, Luiz Luciano; Dos Anjos-Garcia, Tayllon; Coimbra, Norberto Cysne

    2016-10-01

    Post-ictal antinociception is characterised by an increase in the nociceptive threshold that accompanies tonic and tonic-clonic seizures (TCS). The locus coeruleus (LC) receives profuse cholinergic inputs from the pedunculopontine tegmental nucleus. Different concentrations (1μg, 3μg and 5μg/0.2μL) of the muscarinic cholinergic receptor antagonist atropine and the nicotinic cholinergic receptor antagonist mecamylamine were microinjected into the LC of Wistar rats to investigate the role of cholinergic mechanisms in the severity of TCS and the post-ictal antinociceptive response. Five minutes later, TCS were induced by systemic administration of pentylenetetrazole (PTZ) (64mg/kg). Seizures were recorded inside the open field apparatus for an average of 10min. Immediately after seizures, the nociceptive threshold was recorded for 130min using the tail-flick test. Pre-treatment of the LC with 1μg, 3μg and 5μg/0.2μL concentrations of both atropine and mecamylamine did not cause a significant effect on seizure severity. However, the same treatments decreased the post-ictal antinociceptive phenomenon. In addition, mecamylamine caused an earlier decrease in the post-ictal antinociception compared to atropine. These results suggest that muscarinic and mainly nicotinic cholinergic receptors of the LC are recruited to organise tonic-clonic seizure-induced antinociception.

  9. Proceedings of clinical SPECT (single photon emission computed tomography) symposium

    Energy Technology Data Exchange (ETDEWEB)

    1986-09-01

    It has been five years since the last in-depth American College of Nuclear Physicians/Society of Nuclear Medicine Symposium on the subject of single photon emission computed tomography (SPECT) was held. Because this subject was nominated as the single most desired topic we have selected SPECT imaging as the basis for this year's program. The objectives of this symposium are to survey the progress of SPECT clinical applications that have taken place over the last five years and to provide practical and timely guidelines to users of SPECT so that this exciting imaging modality can be fully integrated into the evaluation of pathologic processes. The first half was devoted to a consideration of technical factors important in SPECT acquisition and the second half was devoted to those organ systems about which sufficient clinical SPECT imaging data are available. With respect to the technical aspect of the program we have selected the key areas which demand awareness and attention in order to make SPECT operational in clinical practice. These include selection of equipment, details of uniformity correction, utilization of phantoms for equipment acceptance and quality assurance, the major aspect of algorithms, an understanding of filtered back projection and appropriate choice of filters and an awareness of the most commonly generated artifacts and how to recognize them. With respect to the acquisition and interpretation of organ images, the faculty will present information on the major aspects of hepatic, brain, cardiac, skeletal, and immunologic imaging techniques. Individual papers are processed separately for the data base. (TEM)

  10. Radiotracers for SPECT imaging. Current scenario and future prospects

    Energy Technology Data Exchange (ETDEWEB)

    Adak, S.; Vijaya Raj, K.K.; Mandal, S. [GE Healthcare Medical Diagnostics, John F. Welch Technology Center, Bangalore (India).; Bhalla, R.; Pickett, R.; Luthra, S.K. [GE Healthcare Medical Diagnostics, The Grove Centre, Amersham (United Kingdom)

    2012-07-01

    Single photon emission computed tomography (SPECT) has been the cornerstone of nuclear medicine and today it is widely used to detect molecular changes in cardiovascular, neurological and oncological diseases. While SPECT has been available since the 1980s, advances in instrumentation hardware, software and the availability of new radiotracers that are creating a revival in SPECT imaging are reviewed in this paper. The biggest change in the last decade has been the fusion of CT with SPECT, which has improved attenuation correction and image quality. Advances in collimator design, replacement of sodium iodide crystals in the detectors with cadmium zinc telluride (CZT) detectors as well as advances in software and reconstruction algorithms have all helped to retain SPECT as a much needed and used technology. Today, a wide spectrum of radiotracers is available for use in cardiovascular, neurology and oncology applications. The development of several radiotracers for neurological disorders is briefly described in this review, including [{sup 123}I]FP-CIT (DaTSCAN trademark) available for Parkinson's disease. In cardiology, while technetium-99m labeled tetrofosmin and technetium-99m labeled sestamibi have been well known for myocardial perfusion imaging, we describe a recently completed multicenter clinical study on the use of [{sup 123}I]mIBG (AdreView trademark) for imaging in chronic heart failure patients. For oncology, while bone scanning has been prevalent, newer radiotracers that target cancer mechanisms are being developed. Technetium-99m labeled RGD peptides have been reported in the literature that can be used for imaging angiogenesis, while technetium-99m labeled duramycin has been used to image apoptosis. While PET/CT is considered to be the more advanced technology particularly for oncology applications, SPECT continues to be the modality of choice and the workhorse in many hospitals and nuclear medicine centers. The cost of SPECT instruments also

  11. Dual Isotope SPECT Study With Epilepsy Patients Using Semiconductor SPECT System.

    Science.gov (United States)

    Shiga, Tohru; Suzuki, Atsuro; Sakurai, Kotarou; Kurita, Tsugiko; Takeuchi, Wataru; Toyonaga, Takuya; Hirata, Kenji; Kobashi, Keiji; Katoh, Chietsugu; Kubo, Naoki; Tamaki, Nagara

    2017-09-01

    We developed a prototype CdTe SPECT system with 4-pixel matched collimator for brain study. This system provides high-energy-resolution (6.6%), high-sensitivity (220 cps/MBq/head), and high-spatial-resolution images. The aim of this study was to evaluate dual-isotope study of CBF and central benzodiazepine receptor (BZR) images using Tc-ECD and I-IMZ with the new SPECT system in patients with epilepsy comparing with single-isotope study using the conventional scintillation gamma camera. This study included 13 patients with partial epilepsy. The BZR images were acquired at 3 hours after I-IMZ injection for 20 minutes. The images of IMZ were acquired with a conventional 3-head scintillation gamma camera. After BZR image acquisition with the conventional camera, Tc-ECD was injected, and CBF and BZR images were acquired simultaneously 5 minutes after ECD injection with the new SPECT system. The CBF images were also acquired with the conventional camera on separate days. The findings were visually analyzed, and 3D-SSP maximum Z scores of lesions were compared between the 2 studies. There were 47 abnormal lesions on BZR images and 60 abnormal lesions on CBF images in the single-isotope study with the conventional camera. Dual-isotope study with the new system showed concordant abnormal findings of 46 of 47 lesions on BZR and 54 of 60 lesions on CBF images with the single-isotope study with the conventional camera. There was high agreement between the 2 studies in both BZR and CBF findings (Cohen κ values = 0.96 for BZR and 0.78 for CBF). In semiquantitative analysis, maximum Z scores of dual-isotope study with the new system strongly correlated with those of single-isotope study with the conventional camera (BZR: r = 0.82, P < 0.05, CBF: r = 0.87, P < 0.05). Our new SPECT system permits dual-isotope study for pixel-by-pixel analysis of CBF and BZR information with the same pathophysiological condition in patients with epilepsy.

  12. Precise Localization of Occult Gastrointestinal Hemorrhage Using Dynamic SPECT/CT.

    Science.gov (United States)

    Murrey, Douglas A; Hall, Nathan C; Wright, Chadwick L; Mankoff, David A

    2016-01-01

    Active but intermittent gastrointestinal (GI) bleeding can be readily detected with dynamic planar scintigraphic imaging. This is a case of a 48-year-old woman who presented from an outside institution with active GI bleeding on 99mTc-labeled RBC (99mTc-RBC) scintigraphy, but the upper and lower GI evaluations failed to subsequently localize the site of persistent bleeding. Repeat 99mTc-RBC planar scintigraphy identified a focus of active extravasation in the right lower quadrant of the abdomen. Dynamic SPECT/CT imaging was immediately performed and further identified the ileocecal valve region as the precise site of active extravasation, which was confirmed at surgery.

  13. U-SPECT-II: An Ultra-High-Resolution Device for Molecular Small-Animal Imaging

    NARCIS (Netherlands)

    Van der Have, F.; Vastenhouw, B.; Ramakers, R.M.; Branderhorst, W.; Krah, J.O.; Ji, C.; Staelens, S.G.; Beekman, F.J.

    2009-01-01

    We present a new rodent SPECT system (U-SPECT-II) that enables molecular imaging of murine organs down to resolutions of less than half a millimeter and high-resolution total-body imaging. Methods: The U-SPECT-II is based on a triangular stationary detector set-up, an XYZ stage that moves the animal

  14. SPECT imaging of cardiac reporter gene expression in living rabbits

    Institute of Scientific and Technical Information of China (English)

    LIU Ying; LAN Xiaoli; ZHANG Liang; WU Tao; JIANG Rifeng; ZHANG Yongxue

    2009-01-01

    This work is to demonstrate feasibility of imaging the expression of herpes simplex virus 1-thymidine ki-nase (HSV1-tk) reporter gene in rabbits myocardium by using the reporter probe 131I-2'-fluoro-2'-deoxy-1-β-D- arabi-nofuranosyl-5-iodouracil (131I-FIAU) and SPECT. Rabbits of the study group received intramyocardial injection of Ad5-tk and control group received aseptic saline injection. Two sets of experiments were performed on the study group. Rabbits of the 1st set were injected with 131I-FIAU 600 μCi at Day 2 after intramyocardial transfection of Ad5-tk in 1×109, 5×108, 1×108, 5×107 and 1×107 pfu, and heart SPECT imaging was done at different hours. Rabbits of the 2nd were transferred various titers of Ad5-tk (1×109, 5×108, 1×108, 5×107, 1×107 pfu) to determine the threshold and optimal viral titer needed for detection of gene expression. Two days later, 131I-FIAU was injected and heart SPECT imaging was performed at 6, 24 and 48 h, before killing them for gamma counting of the hearts. Reverse tran-scription-polymerase chain reaction (RT-PCR) was used to verify the transferred HSV1-tk gene expression. Semi-quantitative analysis derived of region of interest (ROI) of SPECT images and RT-PCR images was performed and the relationship of SPECT images with ex vivo gamma counting and mRNA level were evaluated. SPECT images conformed 131I-FIAU accumulation in rabbits injected with Ad5-tk in the anterolateral wall. The optimal images qual-ity was obtained at 24~48 h for different viral titers. The highest radioactivity in the focal myocardium was seen at 6 h, and then declined with time. The threshold was 5×107 pfu of virus titer. The result could be set better in 1~5×108 pfu by SPECT analysis and gamma counting. ROI-derived semi-quantitative study on SPECT images correlated well with ex vivo gamma counting and mRNA levels from RT-PCR analysis. The HSV1-tk/131I-FIAU reporter gene/reporter probe system is feasible for cardiac SPECT reporter gene imaging

  15. Repeat-until-success quantum repeaters

    Science.gov (United States)

    Bruschi, David Edward; Barlow, Thomas M.; Razavi, Mohsen; Beige, Almut

    2014-09-01

    We propose a repeat-until-success protocol to improve the performance of probabilistic quantum repeaters. Conventionally, these rely on passive static linear-optics elements and photodetectors to perform Bell-state measurements (BSMs) with a maximum success rate of 50%. This is a strong impediment for entanglement swapping between distant quantum memories. Every time a BSM fails, entanglement needs to be redistributed between the corresponding memories in the repeater link. The key ingredients of our scheme are repeatable BSMs. Under ideal conditions, these turn probabilistic quantum repeaters into deterministic ones. Under realistic conditions, our protocol too might fail. However, using additional threshold detectors now allows us to improve the entanglement generation rate by almost orders of magnitude, at a nominal distance of 1000 km, compared to schemes that rely on conventional BSMs. This improvement is sufficient to make the performance of our scheme comparable to the expected performance of some deterministic quantum repeaters.

  16. Parallel-hole collimator concept for stationary SPECT imaging.

    Science.gov (United States)

    Pato, Lara R V; Vandenberghe, Stefaan; Zedda, Tiziana; Van Holen, Roel

    2015-11-21

    Parallel-hole SPECT collimators have traditionally been manufactured by stacking sheets of lead foil or by casting. These techniques significantly restrict our options in terms of collimator geometry. However, recent developments in metal additive manufacturing are making novel collimator designs possible, giving rise to new opportunities in SPECT imaging. In this paper we propose an innovative type of collimator for stationary SPECT, using parallel-holes whose collimation direction depends on their axial position. Its main advantage compared to current stationary SPECT systems (which are based on pinholes) is that, using only axial bed translations, we can achieve complete angular sampling of an increased portion of the transaxial area of the collimator bore. This allows the system to be much more compact than current stationary SPECT systems that image objects of the same size. We describe three possible designs, for full-body, brain and small-animal imaging, respectively, and test their feasibility using simulations. The system modeling method is validated against realistic Monte Carlo simulations, and then used in the evaluation of the systems' performances and reconstructions. The simulations show that the system is able to reconstruct objects occupying the predicted field of view ([Formula: see text] of the transaxial area of the bore) without sampling artifacts. In particular, we perform reconstructions from noisy projection data obtained for an activity and scanning time similar to standard protocols for the three applications, and the resulting images indicate the possibility of using the proposed systems in practice.

  17. Affordable CZT SPECT with dose-time minimization (Conference Presentation)

    Science.gov (United States)

    Hugg, James W.; Harris, Brian W.; Radley, Ian

    2017-03-01

    PURPOSE Pixelated CdZnTe (CZT) detector arrays are used in molecular imaging applications that can enable precision medicine, including small-animal SPECT, cardiac SPECT, molecular breast imaging (MBI), and general purpose SPECT. The interplay of gamma camera, collimator, gantry motion, and image reconstruction determines image quality and dose-time-FOV tradeoffs. Both dose and exam time can be minimized without compromising diagnostic content. METHODS Integration of pixelated CZT detectors with advanced ASICs and readout electronics improves system performance. Because historically CZT was expensive, the first clinical applications were limited to small FOV. Radiation doses were initially high and exam times long. Advances have significantly improved efficiency of CZT-based molecular imaging systems and the cost has steadily declined. We have built a general purpose SPECT system using our 40 cm x 53 cm CZT gamma camera with 2 mm pixel pitch and characterized system performance. RESULTS Compared to NaI scintillator gamma cameras: intrinsic spatial resolution improved from 3.8 mm to 2.0 mm; energy resolution improved from 9.8% to molecular imaging, coupled with optimal collimator and image reconstruction, result in minimized dose and exam time. With CZT cost improving, affordable whole-body CZT general purpose SPECT is expected to enable precision medicine applications.

  18. Enhancing the utility of prostascint SPECT scans for patient management.

    Science.gov (United States)

    Noz, Marilyn E; Chung, Grace; Lee, Benjamin Y; Maguire, Gerald Q; DeWyngaert, J Keith; Doshi, Jay V; Kramer, Elissa L; Murphy-Walcott, Antoinette D; Zeleznik, Michael P; Kwak, Noeun G

    2006-04-01

    This project investigated reducing the artifact content of In-ill ProstaScint SPECT scans for use in treatment planning and management. Forty-one patients who had undergone CT or MRI scans and simultaneous Tc-99m RBC/In-111 ProstaScint SPECT scans were included. SPECT volume sets, reconstructed using Ordered Set-Expectation Maximum (OS-EM) were compared against those reconstructed with standard Filtered Back projection (FBP). Bladder activity in Tc-99m scans was suppressed within an ellipsoidal volume. Tc-99m voxel values were subtracted from the corresponding In-111 after scaling based on peak activity within the descending aorta. The SPECT volume data sets were merged with the CT or MRI scans before and after processing. Volume merging, based both on visual assessment and statistical evaluation, was not affected. Thus iterative reconstruction together with bladder suppression and blood pool subtraction may improve the interpretation and utility of ProstaScint SPECT scans for patient management.

  19. A SPECT imager with synthetic collimation

    Science.gov (United States)

    Havelin, Ronan J.; Miller, Brian W.; Barrett, Harrison H.; Furenlid, Lars R.; Murphy, J. M.; Foley, Mark J.

    2013-09-01

    This work outlines the development of a multi-pinhole SPECT system designed to produce a synthetic-collimator image of a small field of view. The focused multi-pinhole collimator was constructed using rapid-prototyping and casting techniques. The collimator projects the field of view through forty-six pinholes when the detector is adjacent to the collimator. The detector is then moved further from the collimator to increase the magnification of the system. The amount of pinhole-projection overlap increases with the system magnification. There is no rotation in the system; a single tomographic angle is used in each system configuration. The maximum-likelihood expectation-maximization (MLEM) algorithm is implemented on graphics processing units to reconstruct the object in the field of view. Iterative reconstruction algorithms, such as MLEM, require an accurate model of the system response. For each system magnification, a sparsely-sampled system response is measured by translating a point source through a grid encompassing the field of view. The pinhole projections are individually identified and associated with their respective apertures. A 2D elliptical Gaussian model is applied to the pinhole projections on the detector. These coefficients are associated with the object-space location of the point source, and a finely-sampled system matrix is interpolated. Simulations with a hot-rod phantom demonstrate the efficacy of combining low-resolution non-multiplexed data with high-resolution multiplexed data to produce high-resolution reconstructions.

  20. Brain SPECT in neurology: A critical review; Hirn-SPECT in der Neurologie: Eine kritische Uebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Bartenstein, P. [Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik]|[Essen Univ. (Gesamthochschule) (Germany). Klinik und Poliklinik fuer Neurologie; Weiller, C. [Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik]|[Essen Univ. (Gesamthochschule) (Germany). Klinik und Poliklinik fuer Neurologie

    1994-10-01

    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.) [Deutsch] Die SPECT-Untersuchung des Gehirnes bietet mit Radiopharmaka des regionalen zerebralen Blutflusses, Rezeptorliganden und Stoffwechselmarkern ein breites Spektrum diagnostischer Moeglichkeiten in der Neuro-Onkologie, die Epilepsiediagnostik, bei zerebrovaskulaeren Erkrankungen, extrapyramidalen Bewegungsstoerungen, dementiellen Syndromen und der Hirntodbestimmung. Zur Evaluierung klinisch sinnvoller Indikationen in der Routinediagnostik bedarf es einer engen Zusammenarbeit zwischen Nuklearmedizinern und Neurologen bei der Auswertung und Interpretation der Befunde, aber auch beim Design und der Durchfuehrung klinischer Studien mit ausreichend grossen Patientenzahlen. (orig.)

  1. Classification of Normal and Pre-Ictal EEG Signals Using Permutation Entropies and a Generalized Linear Model as a Classifier

    Directory of Open Access Journals (Sweden)

    Francisco O. Redelico

    2017-02-01

    Full Text Available In this contribution, a comparison between different permutation entropies as classifiers of electroencephalogram (EEG records corresponding to normal and pre-ictal states is made. A discrete probability distribution function derived from symbolization techniques applied to the EEG signal is used to calculate the Tsallis entropy, Shannon Entropy, Renyi Entropy, and Min Entropy, and they are used separately as the only independent variable in a logistic regression model in order to evaluate its capacity as a classification variable in a inferential manner. The area under the Receiver Operating Characteristic (ROC curve, along with the accuracy, sensitivity, and specificity are used to compare the models. All the permutation entropies are excellent classifiers, with an accuracy greater than 94.5% in every case, and a sensitivity greater than 97%. Accounting for the amplitude in the symbolization technique retains more information of the signal than its counterparts, and it could be a good candidate for automatic classification of EEG signals.

  2. Mesio-temporal ictal semiology as an indicator for surgical treatment of epilepsies with large multilobar cerebral lesions.

    Science.gov (United States)

    Catenoix, Hélène; Montavont, Alexandra; Isnard, Jean; Guénot, Marc; Chatillon, Claude-Edouard; Streichenberger, Nathalie; Ryvlin, Philippe; Mauguière, François

    2013-06-01

    Mesio-temporal ictal semiology is sometimes observed in patients with large multilobar lesion. In this situation, surgery is often discarded because of the lesion size and/or suspicion of extended or multifocal epileptogenic areas. In this retrospective study we evaluated the surgical outcome of such patients in order to assess whether the electro-clinical presentation of seizures could be a prognostic marker of surgical outcome. Among the temporal lobe epilepsy population explored in our department between 2000 and 2011 (240 patients), we identified 7 patients who presented an extensive lesion on brain Magnetic Resonance Imaging (MRI) (multilobar in four, hemispheric in two, and bilateral in one). All patients underwent (18)Fluorodeoxyglucose Positron Emission Tomography, which showed large, hemispheric or multilobar, areas of glucose hypometabolism. Because of the large lesion size, all patients were explored by stereoelectroencephalography (SEEG) before taking a decision regarding surgical indication. SEEG confirmed the temporal origin of the seizures and discarded the possibility of multiple epileptogenic zones. A temporal lobectomy, tailored on the basis of SEEG data, was proposed to the seven patients. The seven patients are classified Engel class I after the surgery (mean follow-up: 37.4±22.1 months). Our data thus suggest that, even in the absence of hippocampal MRI abnormality, ictal symptoms compatible with a temporal origin of seizures should be considered as a reliable indicator for surgery eligibility regardless of MRI lesion size. On the basis of our findings, the mesio-temporal semiology of seizures appears as one of the most reliable markers of operability in patients with large MRI lesions. These patients should not be excluded a priori from invasive exploration and surgical treatment, even if a large portion of their lesion is likely to be left in place after surgery. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All

  3. Corrections in clinical Magnetic Resonance Spectroscopy and SPECT

    DEFF Research Database (Denmark)

    de Nijs, Robin

    to the known mean and median filtering. The data comes from non-anesthetized preterm infants, where motion during scanning is a common problem. Both the novel outlier identification and the independent component analysis (ICA) perform satisfactory and better than the common mean and median filtering. ICA...... a detrimental effect of the extra-uterine environment on brain development. Paper II describes a method to correct for downscatter in low count Iodine-123 SPECT with a broad energy window above the normal imaging window. Both spatial dependency and weight factors were measured. As expected, the implicitly...... of the striatum due to downscatter correction. This makes the difference between healthy subjects and patients more profound. Downscatter in Iodine-123 SPECT is not the only deteriorating mechanism. Normal scatter compromises the images quality as well. Since scatter correction of SPECT-images also can...

  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. SPECT-CT and PET-CT progress in the research of computer analysis method

    Directory of Open Access Journals (Sweden)

    Jingang Guo

    2015-04-01

    Full Text Available The development of multimodal imaging equipment is milestone in the development of imaging, after the PET-CT, American GE company launched a Discovery 670 NM/CT, CT and SPECT, the organic integration of the formation of SPECT-CT new molecular medical imaging equipment, with SPECT, CT and PET-CT is getting more and more widely attention and application, many of SPECT-CT and PET-CT image analysis computer method arises at the historic moment, getting increasing attention of the clinical and imaging science. The paper carried on the detailed description of the SPECT-CT and PET-CT computer analysis method.

  6. Determination of left ventricular mass through SPECT imaging

    Science.gov (United States)

    Zárate-Morales, A.; Rodríguez-Villafuerte, M.; Martínez-Rodríguez, F.; Arévila-Ceballos, N.

    1998-08-01

    An edge detection algorithm has been applied to estimate left ventricular (LV) mass from single photon emission computed tomography (SPECT) thallium-201 images. The algorithm was validated using SPECT images of a phantom. The algorithm was applied to 20 patient studies from the Hospital de Cardiologia, Centro Médico Nacional Siglo XXI. Left ventricular masses derived from the stress and redistribution studies were highly correlated (r=0.96). The average LV masses obtained were 162±37 g and 169±34 g in the redistribution and stress studies, respectively.

  7. Feasibility of one-eighth time gated myocardial perfusion SPECT functional imaging using IQ-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Caobelli, Federico; Thackeray, James T.; Bengel, Frank M. [Medizinische Hochschule Hannover, Klinik fuer Nuklearmedizin, Hannover (Germany); Soffientini, Alberto; Pizzocaro, Claudio; Guerra, Ugo Paolo [Fondazione Poliambulanza, Department of Nuclear Medicine, Brescia (Italy)

    2015-11-15

    IQ-SPECT, an add-on to general purpose cameras based on multifocal collimation, can reduce myocardial perfusion imaging (MPI) acquisition times to one-fourth that of standard procedures (to 12 s/view). In a phantom study, a reduction of the acquisition time to one-eighth of the standard time (to 6 s/view) was demonstrated as feasible. It remains unclear whether such a reduction could be extended to clinical practice. Fifty patients with suspected or diagnosed CAD underwent a 2-day stress-rest {sup 99m}Tc-sestamibi MPI protocol. Two consecutive SPECT acquisitions (6 and 12 s/view) were performed. Electrocardiogram-gated images were reconstructed with and without attenuation correction (AC). Polar maps were generated and visually scored by two blinded observers for image quality and perfusion in 17 segments. Global and regional summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) were determined. Left ventricular volumes and ejection fraction were calculated based on automated contour detection. Image quality was scored higher with the 12 s/view acquisition, both with and without AC. Summed scores were statistically comparable between the 6 s/view and the 12 s/view acquisition, both globally and in individual coronary territories (e.g. in images with AC, SSS were 6.6 ± 8.3 and 6.2 ± 8.2 with 6 s and 12 s/view, respectively, p = 0.10; SRS were 3.9 ± 5.6 and 3.5 ± 5.3, respectively, p = 0.19; and SDS were 2.8 ± 5.7 and 2.6 ± 5.7, respectively, p = 0.59). Both acquisitions allowed MPI-based diagnosis of CAD in 25 of the 50 patients (with AC). Calculated end-diastolic volume (EDV) and end-systolic volume (ESV) were modestly higher with the 6 s/view acquisition than with the 12 s/view acquisition (EDV +4.8 ml at rest and +3.7 ml after stress, p = 0.003; ESV +4.1 ml at rest and +2.6 ml after stress, p = 0.01), whereas the ejection fraction did not differ (-1.2 % at rest, p = 0.20, and -0.9 % after stress, p = 0.27). Image quality and

  8. SPECT and PET in Late-Life Depression

    NARCIS (Netherlands)

    Vieira, Tiago S; Oude Voshaar, Richard; De Deyn, Peter; Dierckx, Rudi; van Waarde, Aren; Dierckx, Rudi AJO; Otte, Andreas; de Vries, Erik FJ; van Waarde, Aren; den Boer, Johan A

    2014-01-01

    Late-life late onset depression (i.e., depression with an age of onset above 60 yrs) appears to differ from depression with early onset in its association with cerebral small vessel disease, beta-amyloid and tau deposition, and neurodegenerative processes. Multimodality imaging (SPECT, PET, MRI) sup

  9. CALOR87: HETC87, MICAP, EGS4, and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Gabriel, T.A.; Alsmiller, F.S.; Alsmiller, R.G. Jr.; Bishop, B.L.; Hermann, O.W.; Johnson, J.O.

    1987-01-01

    A brief history of CALOR (HETC, EGS, MICAP, SPECT) is presented to indicate the evolution of this code system. Details concerning the current modifications and additions to the high-energy transport code, HETC, are also presented and new comparisons with experimental data are included to verify the new physics improvements. 27 refs., 5 figs.

  10. Small hepatocellular carcinomas in chronic liver disease: Detection with SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kudo, M.; Hirasa, M.; Takakuwa, H.; Ibuki, Y.; Fujimi, K.; Miyamura, M.; Tomita, S.; Komori, H.; Todo, A.; Kitaura, Y.

    1986-06-01

    Single-photon emission computed tomography (SPECT) performed using a rotating gamma camera was compared with ..cap alpha../sub 1/-fetoprotein (AFP) assay, conventional liver scintigraphy, ultrasound (US) imaging, computed tomography (CT), and selective celiac angiography in 40 patients with a total of 50 small hepatocellular carcinomas (HCCs;<5 cm). The detection rates of US and CT were determined on an initial screening study and on a second, more precisely focused study. The detection rate of small HCCs by the various modalities was as follows: AFP, 13%; liver scintigraphy, 36%; SPECT, 72%; initial screening US, 80%; second, more precise US studies, 94%; initial screening CT, 64%; second, more precise CT study, 82%; angiography, 88%. Although SPECT was inferior to the initial screening US examination in detecting HCCs less than 2 cm in size, its sensitivity was identical to that of the initial screening US study for detecting HCCs of 2-5 cm. The combination of SPECT and US was an excellent method for the early detection of HCCs, yielding a detection rate of 94%.

  11. Role of SPECT/CT in diagnosis of hepatic hemangiomas

    Institute of Scientific and Technical Information of China (English)

    Jian-Guo Zheng; Zhi-Ming Yao; Chong-Ye Shu; Ying Zhang; Xia Zhang

    2005-01-01

    AIM: To investigate the role of SPECT/CT in the diagnosis of hepatic hemangiomas whose anatomical positions are not ideal, situated adjacent to the heart, the inferior cava,hepatic vessels or abdominal aorta, etc.METHODS: The hepatic perfusion, blood pool, and fusion imaging were carried out using SPECT/CT in 54 patients,who were suspected for hepatic hemangiomas. When the anatomical positions were not ideal, the diagnosis was difficult by SPECT only. So the information of computed tomography (CT) was applied to help in diagnosing. The results were recorded as hemangiomas or not.RESULTS: Of the 54 patients, 31 patients were diagnosed as suffering from hepatic hemangiomas. The anatomical positions of eight patients' hepatic hemangiomas (25.81%)were not ideal. Among these lesions of the eight patients,three patients' hepatic lesions were located near to the abdominal aorta, one to the heart, and four to the inferior cava. In addition, six abnormal radioactivity accumulation regions, adjacent to the heart and inferior cava, with the help of CT, were confirmed to be the imaging of inferior cava other than hepatic hemangiomas.CONCLUSION: When the anatomical positions of hepatic hemangiomas are not good enough for diagnosis, the fusion imaging of SPECT/CT is a simple and efficient method for differential diagnosis.

  12. Cerebral fat embolism studied with MRI and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, E. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Namer, I.J. (Inst. of Biophysics, Faculty of Medicine, Louis Pasteur Univ., Strasbourg (France)); Saribas, O. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Aras, T. (Dept. of Nuclear Medicine, Hacettepe Univ. School of Medicine Ankara (Turkey)); Tan, E. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Bekdik, C. (Dept. of Nuclear Medicine, Hacettepe Univ. School of Medicine Ankara (Turkey)); Zileli, T. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey))

    1993-03-01

    In a patient with fat embolism to the brain CT showed no abnormality. MRI performed after recovery from coma, when the patient had aphasia and quadriparesis, demonstrated multiple high signal abnormalities in the white matter on both T1- and T2-weighted images. HMPAO-SPECT showed left-sided hypoperfusion which resolved in parallel with clinical improvement 1 month later. (orig.)

  13. Molecular Imaging of Conscious, Unrestrained Mice with AwakeSPECT

    Energy Technology Data Exchange (ETDEWEB)

    Baba, Justin S. [Oak Ridge National Laboratory; Endres, Christopher J. [Johns Hopkins, Baltimore; Foss, Catherine A. [Johns Hopkins, Baltimore; Nimmagadda, Sridhar [Johns Hopkins, Baltimore; Jung, Hyeyun [Johns Hopkins, Baltimore; Goddard, James S. [Oak Ridge National Laboratory; Lee, Seung Joon [JLAB; McKisson, John [JLAB; Smith, Mark F. [University of Maryland; Stolin, Alexander V. [West Virginia University; Weisenberger, Andrew G. [JLAB; Pomper, Martin G. [Johns Hopkins, Baltimore

    2013-06-01

    We have developed a SPECT imaging system, AwakeSPECT, to enable molecular brain imaging of untrained mice that are conscious, unanesthetized, and unrestrained. We accomplished this with head tracking and motion correction techniques. Methods: The capability of the system for motion-corrected imaging was demonstrated with a ^99mTc-pertechnetate phantom, ^99mTc-methylene diphosphonate bone imaging, and measurement of the binding potential of the dopamine transporter radioligand ^123I-ioflupane in mouse brain in the awake and anesthetized (isoflurane) states. Stress induced by imaging in the awake state was assessed through measurement of plasma corticosterone levels. Results: AwakeSPECT provided high-resolution bone images reminiscent of those obtained from CT. The binding potential of ^123I-ioflupane in the awake state was on the order of 50% of that obtained with the animal under anesthesia, consistent with previous studies in nonhuman primates. Levels of stress induced were on the order of those seen in other behavioral tasks and imaging studies of awake animals. Conclusion: These results demonstrate the feasibility of SPECT molecular brain imaging of mice in the conscious, unrestrained state and demonstrate the effects of isoflurane anesthesia on radiotracer uptake.

  14. Molecular Imaging of Conscious, Unrestrained Mice with AwakeSPECT

    Energy Technology Data Exchange (ETDEWEB)

    Baba, Justin S [ORNL; Endres, Christopher [Johns Hopkins University; Foss, Catherine [Johns Hopkins University; Nimmagadda, Sridhar [Johns Hopkins University; Jung, Hyeyun [Johns Hopkins University; Goddard Jr, James Samuel [ORNL; Lee, Seung Joon [Jefferson Lab; McKisson, John [Jefferson Lab; Smith, Mark F. [University of Maryland School of Medicine, The, Baltimore, MD; Stolin, Alexander [West Virginia University, Morgantown; Weisenberger, Andrew G. [Jefferson Lab; Pomper, Martin [Johns Hopkins University

    2013-01-01

    We have developed a SPECT imaging system, AwakeSPECT, to enable molecular brain imaging of untrained mice that are conscious, unanesthetized, and unrestrained. We accomplished this with head tracking and motion correction techniques. Methods: The capability of the system for motion-corrected imaging was demonstrated with a 99mTc-pertechnetate phantom, 99mTcmethylene diphosphonate bone imaging, and measurement of the binding potential of the dopamine transporter radioligand 123I-ioflupane in mouse brain in the awake and anesthetized (isoflurane) states. Stress induced by imaging in the awake state was assessed through measurement of plasma corticosterone levels. Results: AwakeSPECT provided high-resolution bone images reminiscent of those obtained from CT. The binding potential of 123I-ioflupane in the awake state was on the order of 50% of that obtained with the animal under anesthesia, consistent with previous studies in nonhuman primates. Levels of stress induced were on the order of those seen in other behavioral tasks and imaging studies of awake animals. Conclusion: These results demonstrate the feasibility of SPECT molecular brain imaging of mice in the conscious, unrestrained state and demonstrate the effects of isoflurane anesthesia on radiotracer uptake.

  15. Diagnosis of lung embolism by V / Q scintigraphy. Pt. 2. SPECT and SPECT-CT for pulmonary diagnostic in nuclear medicine; V / Q-Szintigrafie zur Diagnostik der Lungenembolie. T. 2. SPECT und SPECT-CT in der nuklearmedizinischen Lungendiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Krause, T. [Universitaetsklinik fuer Nuklearmedizin, Bern (Switzerland). Inselspital

    2008-12-15

    Imaging of the pulmonary ventilation and perfusion by using SPECT proved to be a useful development of this examination. At first this article gives a brief overview of the technical aspects followed by a discussion of clinical questions regarding pulmonary embolism, preoperative assessment of postoperative lung function as well as radioaerosol deposition and clearance. (orig.)

  16. Thallium-201 accumulation in cerebral candidiasis: Unexpected finding on SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tonami, N.; Matsuda, H.; Ooba, H.; Yokoyama, K.; Hisada, K.; Ikeda, K.; Yamashita, J. (Kanazawa Univ. (Japan))

    1990-06-01

    The authors present an unexpected finding of Tl-201 uptake in the intracerebral lesions due to candidiasis. SPECT demonstrated the extent of the lesions and a high target-to-background ratio. The regions where abnormal Tl-201 accumulation was seen were nearly consistent with CT scans of those enhanced by a contrast agent. After treatment, most of the abnormal Tl-201 accumulation disappeared.

  17. Hemimegalencephaly: Clinical, EEG, neuroimaging, and IMP-SPECT correlation

    Energy Technology Data Exchange (ETDEWEB)

    Konkol, R.J.; Maister, B.H.; Wells, R.G.; Sty, J.R. (Medical College of Wisconsin, Milwaukee (USA))

    1990-11-01

    Iofetamine-single photon emission computed tomography (IMP-SPECT) was performed on 2 girls (5 1/2 and 6 years of age) with histories of intractable seizures, developmental delay, and unilateral hemiparesis secondary to hemimegalencephaly. Electroencephalography (EEG) revealed frequent focal discharges in 1 patient, while a nearly continuous burst suppression pattern over the malformed hemisphere was recorded in the other. IMP-SPECT demonstrated a good correlation with neuroimaging studies. In spite of the different EEG patterns, which had been proposed to predict contrasting clinical outcomes, both IMP-SPECT scans disclosed a similar decrease in tracer uptake in the malformed hemisphere. These results are consistent with the pattern of decreased tracer uptake found in other interictal studies of focal seizures without cerebral malformations. In view of recent recommendations for hemispherectomy in these patients, we suggest that the IMP-SPECT scan be used to compliment EEG as a method to define the extent of abnormality which may be more relevant to long-term prognosis than EEG alone.

  18. Accelerated Monte Carlo simulation for scatter correction in SPECT

    NARCIS (Netherlands)

    Jong, Hugo Wilhelmus Antonius Maria de

    2002-01-01

    Single Photon Emission Tomography (SPECT) is often used in the clinical practice to image the distribution of photon-emitting pharmaceuticals in the patient. From this distribution, functional information can be obtained (e.g. perfusion and metabolic processes). To assess the viability of myocardia

  19. Reduced contralateral hemispheric flow measured by SPECT in cerebellar lesions

    DEFF Research Database (Denmark)

    Sönmezoğlu, K; Sperling, B; Henriksen, T

    1993-01-01

    to the cerebellar lesion CBF showed variable alterations. A relative CBF decrease was seen in upper part of basal ganglia in all four cases, but it was not a constant phenomenon. A relative CBF increase in both early and late SPECT scans was seen at low levels of neostriatum in two cases. The remote CBF changes...

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

    Energy Technology Data Exchange (ETDEWEB)

    Morbelli, S.; Altrinetti, V.; Piccardo, A. [S Martino Univ Hosp, Nucl MedUnit DIMI, I-16132 Genoa (Italy); Rodriguez, G.; Brugnolo, A.; Nobili, F. [S Martino Univ Hosp, Clin Neurophysiol Unit DiSEM, DiTeC, I-16132 Genoa (Italy); Mignone, A. [Osped Riuniti Bergamo, Nucl Med Unit, I-24100 Bergamo (Italy); Pupi, A. [Univ Florence, Nucl Med Unit DFP, Florence (Italy); Koulibaly, P.M. [CEA-Univ Nice Sophia Antipolis, TIRO, Dept Nucl Med, Ctr Antoine Lacassagne, Nice (France)

    2008-07-01

    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 {sup 99m}TcHMPAO. Since [{sup 99m}Tc] HMPAO and [{sup 99m}Tc] ECD have shown to distribute differently in SPECT studies, we formulated the hypothesis that comparing set of [{sup 99m}Tc]ECD data normalized by means of a [{sup 99m}Tc]HMPAO template may lead to incorrect results. A customized [{sup 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 [{sup 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 [{sup 99m}Tc]HMPAO template or the customized [{sup 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 [{sup 99m}Tc]ECD template, but was missed when using the default [{sup 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 [{sup 99m}Tc]ECD template than using the default [{sup 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 [{sup 99m}Tc]ECD template is now freely available on the web. (authors)

  1. [Variables that influence the indication of a second myocardial perfusion gated-SPECT after a normal stress-rest gated SPECT].

    Science.gov (United States)

    Romero-Farina, G; Candell-Riera, J; Aguadé-Bruix, S; Cuberas-Borrós, G; Pizzi, M N; Santos, A; de León, G; García-Dorado, D

    2014-01-01

    The objective of this study was to investigate predictor variables at the moment of normal stress-rest myocardial perfusion gated SPECT for indication of a second gated SPECT. A prospective, single center cohort study was conducted. We evaluated 2326 consecutive patients (age 63.6 ± 13 years, 57.3% females) without perfusion defects and with normal left ventricular ejection fraction on a myocardial perfusion gated SPECT. Clinical and stress test variables were studied to predict indication of a second gated SPECT and presence of reversible perfusion defects in the second gated SPECT. During a mean follow-up of 3.6 ± 2 years a second gated SPECT was performed in 286 patients (12.3%). Independent predictor variables of a second gated SPECT were presence of three or more cardiovascular risk factors (χ(2): 5.510; HR: 1.4; p=0.019), previous acute myocardial infarction (χ(2): 3.867; HR: 1.4; p=0.049), previous coronary revascularization (χ(2): 41.081; HR: 2.5; p<0.001), and a positive stress test (χ(2): 8.713; HR: 1.5; p=0.003). Observation of perfusion defects in the 280 patients in whom a second stress-rest gated SPECT was performed was more likely in male patients (χ(2): 4.322; HR: 1.9; p=0.038) who had a first pure pharmacological gated-SPECT (χ(2): 7.182; HR: 2.6; p=0.007). In patients with a first normal myocardial perfusion gated SPECT, various clinical factors and variables derived from the stress test affect the indication of a second gated SPECT and the presence of ischemia in the latter. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  2. Collimator design for a multipinhole brain SPECT insert for MRI

    Energy Technology Data Exchange (ETDEWEB)

    Van Audenhaege, Karen; Van Holen, Roel; Vanhove, Christian; Vandenberghe, Stefaan [Department of Electronics and Information Systems, Ghent University-iMinds Medical IT, MEDISIP-IBiTech, De Pintelaan 185 block B/5, Ghent B-9000 (Belgium)

    2015-11-15

    Purpose: Brain single photon emission computed tomography (SPECT) imaging is an important clinical tool, with unique tracers for studying neurological diseases. Nowadays, most commercial SPECT systems are combined with x-ray computed tomography (CT) in so-called SPECT/CT systems to obtain an anatomical background for the functional information. However, while CT images have a high spatial resolution, they have a low soft-tissue contrast, which is an important disadvantage for brain imaging. Magnetic resonance imaging (MRI), on the other hand, has a very high soft-tissue contrast and does not involve extra ionizing radiation. Therefore, the authors designed a brain SPECT insert that can operate inside a clinical MRI. Methods: The authors designed and simulated a compact stationary multipinhole SPECT insert based on digital silicon photomultiplier detector modules, which have shown to be MR-compatible and have an excellent intrinsic resolution (0.5 mm) when combined with a monolithic 2 mm thick LYSO crystal. First, the authors optimized the different parameters of the SPECT system to maximize sensitivity for a given target resolution of 7.2 mm in the center of the field-of-view, given the spatial constraints of the MR system. Second, the authors performed noiseless simulations of two multipinhole configurations to evaluate sampling and reconstructed resolution. Finally, the authors performed Monte Carlo simulations and compared the SPECT insert with a clinical system with ultrahigh-resolution (UHR) fan beam collimators, based on contrast-to-noise ratio and a visual comparison of a Hoffman phantom with a 9 mm cold lesion. Results: The optimization resulted in a stationary multipinhole system with a collimator radius of 150.2 mm and a detector radius of 172.67 mm, which corresponds to four rings of 34 diSPM detector modules. This allows the authors to include eight rings of 24 pinholes, which results in a system volume sensitivity of 395 cps/MBq. Noiseless simulations

  3. Collimator design for a multipinhole brain SPECT insert for MRI.

    Science.gov (United States)

    Van Audenhaege, Karen; Van Holen, Roel; Vanhove, Christian; Vandenberghe, Stefaan

    2015-11-01

    Brain single photon emission computed tomography (SPECT) imaging is an important clinical tool, with unique tracers for studying neurological diseases. Nowadays, most commercial SPECT systems are combined with x-ray computed tomography (CT) in so-called SPECT/CT systems to obtain an anatomical background for the functional information. However, while CT images have a high spatial resolution, they have a low soft-tissue contrast, which is an important disadvantage for brain imaging. Magnetic resonance imaging (MRI), on the other hand, has a very high soft-tissue contrast and does not involve extra ionizing radiation. Therefore, the authors designed a brain SPECT insert that can operate inside a clinical MRI. The authors designed and simulated a compact stationary multipinhole SPECT insert based on digital silicon photomultiplier detector modules, which have shown to be MR-compatible and have an excellent intrinsic resolution (0.5 mm) when combined with a monolithic 2 mm thick LYSO crystal. First, the authors optimized the different parameters of the SPECT system to maximize sensitivity for a given target resolution of 7.2 mm in the center of the field-of-view, given the spatial constraints of the MR system. Second, the authors performed noiseless simulations of two multipinhole configurations to evaluate sampling and reconstructed resolution. Finally, the authors performed Monte Carlo simulations and compared the SPECT insert with a clinical system with ultrahigh-resolution (UHR) fan beam collimators, based on contrast-to-noise ratio and a visual comparison of a Hoffman phantom with a 9 mm cold lesion. The optimization resulted in a stationary multipinhole system with a collimator radius of 150.2 mm and a detector radius of 172.67 mm, which corresponds to four rings of 34 diSPM detector modules. This allows the authors to include eight rings of 24 pinholes, which results in a system volume sensitivity of 395 cps/MBq. Noiseless simulations show sufficient axial

  4. Ictal technetium-99m ethyl cysteinate dimer single-photon emission tomographic findings and propagation of epileptic seizure activity in patients with extratemporal epilepsies

    Energy Technology Data Exchange (ETDEWEB)

    Noachtar, S.; Arnold, S.; Werhahn, K.J. [Department Neurologie, Ludwig-Maximilians Universitaet, Muenchen (Germany); Yousry, T.A. [Muenchen Univ. (Germany). Abt. fuer Neuroradiologie; Bartenstein, P. [Department of Nuclear Medicine, Technical University of Munich, Munich (Germany); Tatsch, K. [Department of Nuclear Medicine, Ludwig-Maximilians University of Munich, Munich (Germany)

    1998-02-01

    We investigated the influence of the propagation of extratemporal epileptic seizure activity on the regional increase in cerebral blood flow, which is usually associated with epileptic seizure activity. Forty-two consecutive patients with extratemporal epilepsies were prospectively evaluated. All patients underwent ictal SPET studies with simultaneous electroencephalography (EEG) and video recordings of habitual seizures and imaging studies including cranial magnetic resonance imaging and positron emission tomography with 2-[{sup 18}F]-fluoro-2 deoxy-d-glucose. Propagation of epilptic seizure activity (PESA) was defined as the absence of hyperperfusion on ictal ECD SPET in the lobe of seizure onset, but its presence in another ipsilateral or contralateral lobe. Observers analysing the SPET images were not informed of the other results. PESA was observed in 8 of the 42 patients (19%) and was ipsilateral to the seizure onset in five (63%) of these eight patients. The time between clinical seizure onset and injection of the ECD tracer ranged from 14 to 61 s (mean 34 s). Seven patients (88%) with PESA had parieto-occipital epilepsy and one patient had a frontal epilepsy. PESA was statistically more frequent in patients with parieto-occipital lobe epilepsies (58%) than in the remaining extratemporal epilepsy syndromes (3%) (P<0.0002). These findings indicate that ictal SPET studies require simultaneous EEG-video recordings in patients with extratemporal epilepsies. PESA should be considered when interpreting ictal SPET studies in these patients. Patients with PESA are more likely to have parieto-occipital lobe epilepsy than seizure onset in other extratemporal regions. (orig./MG) (orig.) With 1 fig., 2 tabs., 23 refs.

  5. In-111-labeled leukocyte brain SPECT imaging. Clinical significance in evaluating acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Fujinuma, Kunihiko [Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine

    2002-02-01

    Many experimental studies have demonstrated that leukocyte infiltration plays an important role in the progression of ischemic cellular damage or post perfusion brain injury. However, only a few clinical studies have been reported. The purpose of this study is to evaluate the clinical significance of leukocyte accumulation in the ischemic brain tissue. Seventy six patients (49 men, 27 women; mean age: 65.5{+-}13.9 years) with acute ischemic stroke were studied by leukocyte brain SPECT imaging. A diagnosis included cardioembolism (n=46), atherothrombotic infarction (n=24), TIA (n=3) and lacuna (n=3). Immediately after the CBF study using Tc-99m-ECD (600 MBq), indium-111-labeled autologous leukocytes were injected. A brain scan for leukocytes was performed 48 hours later. The leukocyte-SPECT study was made 11.1{+-}7.7 days after the onset of stroke. Regional accumulation of leukocytes in the ischemic tissue was evaluated both by visual assessment and by measuring the hemispheric asymmetry index for leukocyte (AI-leuko), and was evaluated by comparison with variable factors including age, gender, infarction size, hemorrhagic transformation, timing of study after the onset, type of stroke and functional outcome. Of the 61 patients with acute ischemic stroke within 2 weeks of onset, 28 patients showed the accumulation of leukocytes in the central zone of ischemia. Six of 7 patients with repeated studies showed a reduction in leukocyte accumulation with time after the onset. Factors significantly associated with the higher accumulation of leukocyte included cardioembolic stroke, larger size of infarct, presence of hemorrhagic transformation and significant reduction in flow. In the 61 patients within 2 weeks of onset, the functional outcome was significantly correlated with the accumulation of leukocyte (p<0.001). The accumulation of leukocytes was seen more in patients with embolic stroke, larger infarction, and hemorrhagic transformation. The higher accumulation

  6. Scatter and attenuation correction in Technetium-99m brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Jun [Keio Univ., Tokyo (Japan). School of Medicine

    1997-11-01

    The imaging in the nuclear medicine is inferior to other modalities in the spatial resolution, but it can quantitatively evaluate the biological function. The attempt to measure the absolute or the relative values of local functions quantitatively based on the SPECT of the brain or the heart, has become popular recently. It is not only necessary to introduce an appropriate analytical model for each radioisotope tracer for the correct quantification, but also to be equipped with the photographing system to measure correctly the accumulation of the tracer. The main cause to decrease the precision of the photographing system is the scatter and the absorption (attenuation) of photon. In the present study we attempted to enhance the quantification of the brain SPECT by the usable and practical correction method for the scatter and the attenuation in the daily clinical business. We used the triple-energy-window (TEW) method as the scatter correction and the attenuation calculation map obtained from the transmission scanning (TCT) by the external source as the attenuation correction. We examined the brain SPECT in combination with these two correction methods. We could not measure correctly the amount of the tracer accumulation by only one correction method, and obtain the excellent quantitative SPECT images in combination with both correction methods. We could get excellently stable data by collecting the emission and the transmission data simultaneously as well as separately, and the excellent images by the arithmetical treatment of data between the scatter beam and the detector correction when we used {sup 99m}Tc as the source which is economically cheap, and adopted the combination of the tracers labeled by the same kind of radioisotopes. Altogether we expect that our method is very practical and will contribute to enhance the accuracy in quantitative analysis of clinical brain SPECT imaging. (K.H.)

  7. SPECT in der Diagnostik von Parkinson-Syndromen

    Directory of Open Access Journals (Sweden)

    Pirker W

    2004-01-01

    Full Text Available Nur die Hälfte der Patienten mit einem in der Allgemeinpraxis diagnostizierten Morbus Parkinson erfüllt in der neurologischen Untersuchung tatsächlich die klinisch-diagnostischen Kriterien der Erkrankung. Post-mortem-Untersuchungen haben gezeigt, daß die Treffsicherheit für die klinische Diagnose eines M. Parkinson selbst in spezialisierten Zentren und unter Einhaltung strikter Kriterien bei maximal 90 % liegen dürfte. Der Essentielle Tremor und andere Tremorsyndrome, medikamenteninduzierte Parkinson-Syndrome, vaskuläre Parkinson-Syndrome, Parkinson-Syndrome im Rahmen von Demenzerkrankungen und atypische Parkinson-Erkrankungen degenerativer Ätiologie wie die Multisystematrophie führen am häufigsten zu Fehldiagnosen. SPECT-Untersuchungen mit Dopamintransporter-Liganden wie [123 I] beta-CIT erlauben bereits im Frühstadium eine zuverlässige Dokumentation der dopaminergen Degeneration beim M. Parkinson und atypischen Parkinson-Erkrankungen. Damit ist eine zuverlässige Abgrenzung dieser Erkrankungen von nichtdegenerativen Parkinson- und Tremorsyndromen möglich. Die Dopamintransporter-SPECT erlaubt darüber hinaus eine Differenzierung der Demenz mit Lewy-Körperchen von der Alzheimer-Demenz. SPECT-Untersuchungen postsynaptischer Dopamin-D2-Rezeptoren mit [123 I]IBZM können zur Differentialdiagnose zwischen M. Parkinson und Multisystematrophie bzw. der Progressiven Supranukleären Paralyse beitragen. In der folgenden Übersicht werden typische SPECT-Befunde bei Parkinson-Syndromen und klinische Indikationen für SPECT-Untersuchungen bei diesen Störungen dargestellt.

  8. CT-Based Attenuation Correction in I-123-Ioflupane SPECT

    Science.gov (United States)

    Lange, Catharina; Seese, Anita; Schwarzenböck, Sarah; Steinhoff, Karen; Umland-Seidler, Bert; Krause, Bernd J.; Brenner, Winfried; Sabri, Osama

    2014-01-01

    Purpose Attenuation correction (AC) based on low-dose computed tomography (CT) could be more accurate in brain single-photon emission computed tomography (SPECT) than the widely used Chang method, and, therefore, has the potential to improve both semi-quantitative analysis and visual image interpretation. The present study evaluated CT-based AC for dopamine transporter SPECT with I-123-ioflupane. Materials and methods Sixty-two consecutive patients in whom I-123-ioflupane SPECT including low-dose CT had been performed were recruited retrospectively at 3 centres. For each patient, 3 different SPECT images were reconstructed: without AC, with Chang AC and with CT-based AC. Distribution volume ratio (DVR) images were obtained by scaling voxel intensities using the whole brain without striata as reference. For assessing the impact of AC on semi-quantitative analysis, specific-to-background ratios (SBR) in caudate and putamen were obtained by fully automated SPM8-based region of interest (ROI) analysis and tested for their diagnostic power using receiver-operator-characteristic (ROC) analysis. For assessing the impact of AC on visual image reading, screenshots of stereotactically normalized DVR images presented in randomized order were interpreted independently by two raters at each centre. Results CT-based AC resulted in intermediate SBRs about half way between no AC and Chang. Maximum area under the ROC curve was achieved by the putamen SBR, with negligible impact of AC (0.924, 0.935 and 0.938 for no, CT-based and Chang AC). Diagnostic accuracy of visual interpretation also did not depend on AC. Conclusions The impact of CT-based versus Chang AC on the interpretation of I-123-ioflupane SPECT is negligible. Therefore, CT-based AC cannot be recommended for routine use in clinical patient care, not least because of the additional radiation exposure. PMID:25268228

  9. CT-based attenuation correction in I-123-ioflupane SPECT.

    Directory of Open Access Journals (Sweden)

    Catharina Lange

    Full Text Available PURPOSE: Attenuation correction (AC based on low-dose computed tomography (CT could be more accurate in brain single-photon emission computed tomography (SPECT than the widely used Chang method, and, therefore, has the potential to improve both semi-quantitative analysis and visual image interpretation. The present study evaluated CT-based AC for dopamine transporter SPECT with I-123-ioflupane. MATERIALS AND METHODS: Sixty-two consecutive patients in whom I-123-ioflupane SPECT including low-dose CT had been performed were recruited retrospectively at 3 centres. For each patient, 3 different SPECT images were reconstructed: without AC, with Chang AC and with CT-based AC. Distribution volume ratio (DVR images were obtained by scaling voxel intensities using the whole brain without striata as reference. For assessing the impact of AC on semi-quantitative analysis, specific-to-background ratios (SBR in caudate and putamen were obtained by fully automated SPM8-based region of interest (ROI analysis and tested for their diagnostic power using receiver-operator-characteristic (ROC analysis. For assessing the impact of AC on visual image reading, screenshots of stereotactically normalized DVR images presented in randomized order were interpreted independently by two raters at each centre. RESULTS: CT-based AC resulted in intermediate SBRs about half way between no AC and Chang. Maximum area under the ROC curve was achieved by the putamen SBR, with negligible impact of AC (0.924, 0.935 and 0.938 for no, CT-based and Chang AC. Diagnostic accuracy of visual interpretation also did not depend on AC. CONCLUSIONS: The impact of CT-based versus Chang AC on the interpretation of I-123-ioflupane SPECT is negligible. Therefore, CT-based AC cannot be recommended for routine use in clinical patient care, not least because of the additional radiation exposure.

  10. Advanced reconstruction of attenuation maps using SPECT emission data only

    Science.gov (United States)

    Salomon, André; Goedicke, Andreas; Aach, Til

    2009-02-01

    Today, attenuation corrected SPECT, typically performed using CT or Gadolinium line source based transmission scans, is more and more becoming standard in many medical applications. Moreover, the information about the material density distribution provided by these scans is key for other artifact compensation approaches in advanced SPECT reconstruction. Major drawbacks of these approaches are the additional patient radiation and hardware/maintenance costs as well as the additional workflow effort, e.g. if the CT scans are not performed on a hybrid scanner. It has been investigated in the past, whether it is possible to recover this structural information solely from the SPECT scan data. However, the investigated methods often result in noticeable image artifacts due to cross-dependences between attenuation and activity distribution estimation. With the simultaneous reconstruction method presented in this paper, we aim to effectively prevent these typical cross-talk artifacts using a-priori known atlas information of a human body. At first, an initial 3D shape model is coarsely registered to the SPECT data using anatomical landmarks and each organ structure within the model is identified with its typical attenuation coefficient. During the iterative reconstruction based on a modified ML-EM scheme, the algorithm simultaneously adapts both, the local activity estimation and the 3D shape model in order to improve the overall consistency between measured and estimated sinogram data. By explicitly avoiding topology modifications resulting in a non-anatomical state, we ensure that the estimated attenuation map remains realistic. Several tests with simulated as well as real patient SPECT data were performed to test the proposed algorithm, which demonstrated reliable convergence behaviour in both cases. Comparing the achieved results with available reference data, an overall good agreement for both cold as well as hot activity regions could be observed (mean deviation: -5.98%).

  11. Update: SPECT in der Diagnostik von Parkinson-Syndromen

    Directory of Open Access Journals (Sweden)

    Pirker W

    2015-01-01

    Full Text Available Die Diagnose des Morbus Parkinson fußt primär auf Anamnese und klinischer Untersuchung. Die Abgrenzung von milden Bewegungsstörungen bei ansonsten gesunden älteren Personen, von medikamenteninduzierten und vaskulären Parkinson-Syndromen sowie von Tremor-Syndromen kann jedoch schwierig sein. Die Differenzierung zwischen M. Parkinson und atypischen Parkinson-Erkrankungen wie der Multisystematrophie (MSA und der progressiven supranukleären Paralyse (PSP ist im Frühstadium häufig unmöglich und kann auch in fortgeschrittenen Stadien Probleme bereiten. Die SPECT-Untersuchung mit Dopamin-Transporter- (DAT- Liganden wie 123I-FP-CIT erlaubt mit wenigen Ausnahmen bereits im Frühstadium eine Dokumentation der dopaminergen Degeneration beim M. Parkinson und atypischen Parkinson- Erkrankungen und damit meist eine Abgrenzung von nichtdegenerativen Parkinson- und Tremor-Syndromen. Sie kann die einzelnen degenerativen Parkinson-Syndrome jedoch nicht voneinander unterscheiden. Die Untersuchung postsynaptischer Dopamin- D2-Rezeptoren mit der 123I-IBZM-SPECT kann zur Differenzierung von M. Parkinson und MSA bzw. PSP beitragen. Neueren Untersuchungen zufolge dürften die Untersuchung des zerebralen Glukosemetabolismus mittels 18F-FDG-PET sowie moderne MRT-basierte Methoden in dieser Fragestellung jedoch eine höhere Sensitivität und Spezifität haben. Während Medikamente die diagnostische Aussagekraft von DAT-SPECT-Untersuchungen selten beeinflussen, kann das Ergebnis der IBZM-SPECT sowohl durch dopaminerge Substanzen als auch durch Dopaminantagonisten stark verfälscht werden. Die richtige Interpretation von SPECT-Daten setzt darüber hinaus die Kenntnis der individuellen strukturellen bildgebenden Befunde voraus. Eine MRT- oder CCTUntersuchung sollte zum Ausschluss von läsionellen Parkinson-Syndromen und zur Dokumentation von Kopathologien immer Bestandteil der Parkinson-Abklärung sein.

  12. Altered SPECT 123I iomazenil Binding in the Cingulate Cortex of Children with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Shinichiro eNagamitsu

    2016-02-01

    Full Text Available Several lines of evidence suggest that anxiety plays a key role in the development and maintenance of anorexia nervosa (AN in children. The purpose of this study was to examine cortical GABA(A-benzodiazepine receptor binding before and after treatment in children beginning intensive AN treatment. Brain single photon emission computed tomography (SPECT measurements using 123I iomazenil, which binds to GABA(A-benzodiazepine receptors, was performed in 26 participants with AN who were enrolled in a multimodal treatment program. Sixteen of the 26 participants underwent a repeat SPECT scan immediately before discharge at conclusion of the intensive treatment program. Eating behavior and mood disturbances were assessed using Eating Attitudes Test with 26 items (EAT-26 and the short form of the Profile of Mood States (POMS. Clinical outcome scores were evaluated after a 1-year period. We examined association between relative iomazenil binding activity in cortical regions of interest (ROIs and psychometric profiles, and determined which psychometric profiles show interaction effects with brain regions. Further, we determined if binding activity could predict clinical outcome and treatment changes. Higher EAT-26 scores were significantly associated with lower iomazenil binding activity in the anterior posterior cingulate cortex (ACC. Higher POMS subscale scores were significantly associated with lower iomazenil binding activity in the left frontal, parietal cortex, and posterior cingulate cortex (PCC. Depression-Dejection, and Confusion POMS subscale scores, and total POMS score, showed interaction effects with brain regions in iomazenil binding activity. Decreased binding in the ACC and left parietal cortex was associated with poor clinical outcomes. Relative binding increases throughout the PCC and occipital gyrus were observed after weight gain in children with AN. These findings suggest that cortical GABAergic receptor binding is altered in children

  13. Skeletal scintigraphy and SPECT/CT in orthopedic imaging; Knochenszintigrafie und SPECT/CT bei orthopaedischen Fragestellungen

    Energy Technology Data Exchange (ETDEWEB)

    Klaeser, B.; Walter, M.; Krause, T. [Inselspital Bern (Switzerland). Universitaetsklinik fuer Nuklearmedizin

    2011-03-15

    Multi-modality imaging with SPECT-CT in orthopaedics combines the excellent sensitivity of scintigraphy with the morphological information of CT as a key for specific interpretation of findings in bone scans. The result is an imaging modality with the clear potential to prove of value even in a competitive setting dominated by MRI, and to significantly add to diagnostic imaging in orthopaedics. SPECT-CT is of great value in the diagnostic evaluation after fractures, and - in contrast to MRI - it is well suited for imaging in patients with osteosyntheses and metallic implants. In sports medicine, SPECT-CT allows for a sensitive and specific detection of osseous stress reactions before morphological changes become detectable by CT or MRI. In patients with osseous pain syndromes, actively evolving degenerative changes as a cause of pain can be identified and accurately localized. Further, particularly prospective diagnostic studies providing comparative data are needed to strengthen the position of nuclear imaging in orthopaedics and sports medicine and to help implementing SPECT/CT in diagnostic algorithms. (orig.)

  14. A combined static-dynamic single-dose imaging protocol to compare quantitative dynamic SPECT with static conventional SPECT.

    Science.gov (United States)

    Sciammarella, Maria; Shrestha, Uttam M; Seo, Youngho; Gullberg, Grant T; Botvinick, Elias H

    2017-08-03

    SPECT myocardial perfusion imaging (MPI) is a clinical mainstay that is typically performed with static imaging protocols and visually or semi-quantitatively assessed for perfusion defects based upon the relative intensity of myocardial regions. Dynamic cardiac SPECT presents a new imaging technique based on time-varying information of radiotracer distribution, which permits the evaluation of regional myocardial blood flow (MBF) and coronary flow reserve (CFR). In this work, a preliminary feasibility study was conducted in a small patient sample designed to implement a unique combined static-dynamic single-dose one-day visit imaging protocol to compare quantitative dynamic SPECT with static conventional SPECT for improving the diagnosis of coronary artery disease (CAD). Fifteen patients (11 males, four females, mean age 71 ± 9 years) were enrolled for a combined dynamic and static SPECT (Infinia Hawkeye 4, GE Healthcare) imaging protocol with a single dose of (99m)Tc-tetrofosmin administered at rest and a single dose administered at stress in a one-day visit. Out of 15 patients, eleven had selective coronary angiography (SCA), 8 within 6 months and the rest within 24 months of SPECT imaging, without intervening symptoms or interventions. The extent and severity of perfusion defects in each myocardial region was graded visually. Dynamically acquired data were also used to estimate the MBF and CFR. Both visually graded images and estimated CFR were tested against SCA as a reference to evaluate the validity of the methods. Overall, conventional static SPECT was normal in ten patients and abnormal in five patients, dynamic SPECT was normal in 12 patients and abnormal in three patients, and CFR from dynamic SPECT was normal in nine patients and abnormal in six patients. Among those 11 patients with SCA, conventional SPECT was normal in 5, 3 with documented CAD on SCA with an overall accuracy of 64%, sensitivity of 40% and specificity of 83%. Dynamic SPECT image

  15. Is it necessary to define the ictal onset zone with EEG prior to performing resective epilepsy surgery?

    Science.gov (United States)

    Miller, John W; Cole, Andrew J

    2011-02-01

    When evaluating candidates for neurosurgical treatment for medically intractable epilepsy, is it always necessary to define the region of seizure onset with EEG? A simple answer to this question is not possible. There are specific situations where surgery is commonly performed without clear EEG ictal localization, and other situations where electrical localization is mandatory. However, opinions differ in many other situations. What are the core issues for determining when EEG localization is necessary? Neuroimaging is imperfect. It does not always accurately identify the site of seizure origination, because seizures do not always arise from visible structural lesions. EEG localization is also imperfect, as well as expensive and time consuming. Sometimes the site of origin is not identified, or a region of spread is misidentified as site of origin. False localization and lateralization can occur. Finally, epilepsy surgery is imperfect. It can produce life-changing results, but it carries risk, and surgical failure is not rare. The limitations of these methods, and the high stakes of epilepsy surgery imply that we should be very cautious to omit EEG studies. The desire to improve access to epilepsy surgery, and to minimize the expense and risk from inpatient EEG studies, must be weighed against the possibility of an ineffective resection. To improve outcomes, improvements in both neuroimaging and EEG techniques are needed.

  16. Increased sensitivity of the neuronal nicotinic receptor alpha 2 subunit causes familial epilepsy with nocturnal wandering and ictal fear.

    Science.gov (United States)

    Aridon, Paolo; Marini, Carla; Di Resta, Chiara; Brilli, Elisa; De Fusco, Maurizio; Politi, Fausta; Parrini, Elena; Manfredi, Irene; Pisano, Tiziana; Pruna, Dario; Curia, Giulia; Cianchetti, Carlo; Pasqualetti, Massimo; Becchetti, Andrea; Guerrini, Renzo; Casari, Giorgio

    2006-08-01

    Sleep has traditionally been recognized as a precipitating factor for some forms of epilepsy, although differential diagnosis between some seizure types and parasomnias may be difficult. Autosomal dominant frontal lobe epilepsy is characterized by nocturnal seizures with hyperkinetic automatisms and poorly organized stereotyped movements and has been associated with mutations of the alpha 4 and beta 2 subunits of the neuronal nicotinic acetylcholine receptor. We performed a clinical and molecular genetic study of a large pedigree segregating sleep-related epilepsy in which seizures are associated with fear sensation, tongue movements, and nocturnal wandering, closely resembling nightmares and sleep walking. We identified a new genetic locus for familial sleep-related focal epilepsy on chromosome 8p12.3-8q12.3. By sequencing the positional candidate neuronal cholinergic receptor alpha 2 subunit gene (CHRNA2), we detected a heterozygous missense mutation, I279N, in the first transmembrane domain that is crucial for receptor function. Whole-cell recordings of transiently transfected HEK293 cells expressing either the mutant or the wild-type receptor showed that the new CHRNA2 mutation markedly increases the receptor sensitivity to acetylcholine, therefore indicating that the nicotinic alpha 2 subunit alteration is the underlying cause. CHRNA2 is the third neuronal cholinergic receptor gene to be associated with familial sleep-related epilepsies. Compared with the CHRNA4 and CHRNB2 mutations reported elsewhere, CHRNA2 mutations cause a more complex and finalized ictal behavior.

  17. Receptor mapping in psychiatric patients with SPECT; Rezeptor-SPECT-Untersuchungen bei psychiatrischen Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Schlegel, S. [Mainz Univ. (Germany). Psychiatrische Klinik

    1997-06-01

    This paper summarizes some data of our studies with the single-photon-emission-computerized tomography (SPECT), focussing on the dopamine-D2- and the benzodiazepine receptor mapping. Benzodiazepine receptors: Central benzodiazepine receptors (BZr) can be visualized with iomazenil which is an analogue of the benzodiazepine antagonist flumazenil, labeled with 123-iodine. Since the involvement of the BZr system is discussed in the pathogenesis of anxiety and depression, patients with these disorders were investigated. A third study investigated the BZr-occupancy during benzodiazepine treatment (lorazepam). Results: (a) Patients with panic disorders had lower iomazenil uptake values compared to epileptic patients. (b) Depressed patients showed a positive correlation between severity of illness and frontal uptake. (c) BZr occupancy during lorazepam treatment was measurable, but not associated with lorazepam plasma levels. Dopamine-D2-receptors: With 123-I-iodobenzamide (IBZM), and iodine-labeled dopamine receptor ligand, the D2 receptor density can be measured by a semiquantitative approach (striatum/frontal cortex=ST/FC). Therefore, we investigated the D2-receptor occupancy during treatment with typical and atypical neuroleptics in relationship to dosages (normalized with different formulas of chlorpromazine equivalents), side effects, and prolactin plasma levels. Results: Dependent on the selected formula for chlorpromazine equivalents, the ST/FC ratio was correlated with dosages. Side effects and prolactin plasma levels showed a negative association with lower ST/FC ratios. (orig.) [Deutsch] Der Beitrag soll einen Ueberblick ueber verschiedene eigene Studien geben, die die Darstellung von Dopamin-D2- und Benzodiazepinrezeptoren mit der Single-Photon-Emissions-Computertomographie (SPECT) untersuchten. Benzodiazepinrezeptoren: Jomazenil, der mit 123-Jod markierte Benzodiazepinantagonist Flumazenil, ermoeglicht die Darstellung der zentralen Benzodiazepinrezeptoren (BZr

  18. 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.).

  19. Attenuation correction of myocardial SPECT images with X-ray CT. Effects of registration errors between X-ray CT and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Yasuyuki; Murase, Kenya [Osaka Univ., Suita (Japan). Graduate School of Medicine; Higashino, Hiroshi [Ehime Prefectural Imabari Hospital (Japan); Mochizuki, Teruhito [Ehime Univ., Matsuyama (Japan). School of Medicine; Motomura, Nobutoku [Toshiba Corp., Otawara, Tochigi (Japan). Medical Engineering Lab.

    2002-09-01

    Attenuation correction with an X-ray CT image is a new method to correct attenuation on SPECT imaging, but the effect of the registration errors between CT and SPECT images is unclear. In this study, we investigated the effects of the registration errors on myocardial SPECT, analyzing data from a phantom and a human volunteer. Registerion (fusion) of the X-ray CT and SPECT images was done with standard packaged software in three dimensional fashion, by using linked transaxial, coronal and sagittal images. In the phantom study, and X-ray CT image was shifted 1 to 3 pixels on the x, y and z axes, and rotated 6 degrees clockwise. Attenuation correction maps generated from each misaligned X-ray CT image were used to reconstruct misaligned SPECT images of the phantom filled with {sup 201}Tl. In a human volunteer, X-ray CT was acquired in different conditions (during inspiration vs. expiration). CT values were transferred to an attenuation constant by using straight lines; an attenuation constant of 0/cm in the air (CT value=-1,000 HU) and that of 0.150/cm in water (CT value=0 HU). For comparison, attenuation correction with transmission CT (TCT) data and an external {gamma}-ray source ({sup 99m}Tc) was also applied to reconstruct SPECT images. Simulated breast attenuation with a breast attachment, and inferior wall attenuation were properly corrected by means of the attenuation correction map generated from X-ray CT. As pixel shift increased, deviation of the SPECT images increased in misaligned images in the phantom study. In the human study, SPECT images were affected by the scan conditions of the X-ray CT. Attenuation correction of myocardial SPECT with an X-ray CT image is a simple and potentially beneficial method for clinical use, but accurate registration of the X-ray CT to SPECT image is essential for satisfactory attenuation correction. (author)

  20. Quantum repeated games revisited

    CERN Document Server

    Frackiewicz, Piotr

    2011-01-01

    We present a scheme for playing quantum repeated 2x2 games based on the Marinatto and Weber's approach to quantum games. As a potential application, we study twice repeated Prisoner's Dilemma game. We show that results not available in classical game can be obtained when the game is played in the quantum way. Before we present our idea, we comment on the previous scheme of playing quantum repeated games.

  1. {sup 67}Ga-SPECT/CT with a hybrid system in the clinical management of lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Palumbo, Barbara; Sivolella, Silvio; Palumbo, Renato [University of Perugia, Nuclear Medicine Section, Department of Radiological Sciences, Perugia (Italy); Palumbo, Isabella; Liberati, Anna Marina [University of Perugia, Internal Medicine and Oncology, Department of Clinical and Experimental Medicine, Perugia (Italy)

    2005-09-01

    The purpose of this study was to investigate the added value of co-registered fusion imaging using a hybrid system in patients with lymphoma. Twenty-four lymphoma patients underwent {sup 67}Ga-SPECT/CT using a hybrid tomograph consisting of a dual-head, variable-angle gamma camera and a low-dose X-ray tube. Results were compared with those of SPECT alone. Forty-five lesions were identified by SPECT alone, while 49 were detected by SPECT/CT. Forty out of the 45 lesions observed on SPECT were confirmed as lymphoma, but five were due to other causes (thoracic aorta blood pool activity, sialoadenitis in the submandibular gland, bowel activity, rib fracture and bone marrow activation due to radiotherapy). SPECT/CT identified nine more neoplastic lesions compared with SPECT alone: four areas of radiopharmaceutical accumulation were observed in para-aortic lymph nodes, three in the spleen, one in the liver and one in para-iliac lymph nodes. In five cases, SPECT/CT provided additional anatomical information over SPECT alone. In four patients, four large areas of {sup 67}Ga uptake (one mediastinal, two supraclavicular and one para-aortic) were better characterised; in one subject uptake was localised in the seventh thoracic vertebra only by SPECT/CT. Hybrid imaging provided additional data in 13 patients (54.2%), thus inducing oncologists to reconsider the therapeutic approach in eight subjects (33.2%): unnecessary treatment was avoided in four (16.6%) while therapy was altered in another four (16.6%). SPECT/CT hybrid system is able to provide information not obtained by SPECT alone. It allows the anatomical localisation of lymphoma and physiological radiopharmaceutical uptake, facilitates the diagnosis of tumours located in the abdomen (subdiaphragmatic lesions) and provides information that may cause a change in therapeutic strategy. (orig.)

  2. 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.

  3. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision

    Energy Technology Data Exchange (ETDEWEB)

    Verberne, Hein J.; Eck-Smit, Berthe L.F. van; Wit, Tim C. de [University of Amsterdam, Department of Nuclear Medicine, F2-238, Academic Medical Center, Amsterdam (Netherlands); Acampa, Wanda [National Council of Research, Institute of Biostructures and Bioimaging, Naples (Italy); Anagnostopoulos, Constantinos [Academy of Athens, Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Athens (Greece); Ballinger, Jim [Guy' s Hospital - Guy' s and St Thomas' Trust Foundation, Department of Nuclear Medicine, London (United Kingdom); Bengel, Frank [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Bondt, Pieter De [OLV Hospital, Department of Nuclear Medicine, Aalst (Belgium); Buechel, Ronny R.; Kaufmann, Philip A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Flotats, Albert [Universitat Autonoma de Barcelona, Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain); Hacker, Marcus [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Vienna (Austria); Hindorf, Cecilia [Skaane University Hospital, Department of Radiation Physics, Lund (Sweden); Lindner, Oliver [University Hospital of the Ruhr-University Bochum, Heart and Diabetes Center North Rhine-Westphalia, Institute for Radiology, Nuclear Medicine and Molecular Imaging, Bad Oeynhausen (Germany); Ljungberg, Michael [Lund University, Department of Medical Radiation Physics, Lund (Sweden); Lonsdale, Markus [Bispebjerg Hospital, Department of Clinical Physiology and Nuclear Medicine, Copenhagen (Denmark); Manrique, Alain [Caen University Hospital, Department of Nuclear Medicine, Service Commun Investigations chez l' Homme, GIP Cyceron, Caen (France); Minarik, David [Skaane University Hospital, Radiation Physics, Malmoe (Sweden); Scholte, Arthur J.H.A. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Slart, Riemer H.J.A. [University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Traegaardh, Elin [Skaane University Hospital and Lund University, Clinical Physiology and Nuclear Medicine, Malmoe (Sweden); Hesse, Birger [University Hospital of Copenhagen, Department of Clinical Physiology and Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark)

    2015-11-15

    Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/ publications/guidelines/2015{sub 0}7{sub E}ANM{sub F}INAL myocardial{sub p}erfusion{sub g}uideline.pdf. (orig.)

  4. Evaluation of the use of freehand SPECT for sentinel node biopsy in early stage oral carcinoma.

    Science.gov (United States)

    Heuveling, Derrek A; van Weert, Stijn; Karagozoglu, K Hakki; de Bree, Remco

    2015-03-01

    Inadequate intraoperative visualization of the sentinel node can hamper its harvest. Freehand SPECT is a 3D tomographic imaging modality based on the concepts of SPECT, which can be used for intraoperative visualization and navigation towards the sentinel node in order to improve its localization and removal during surgery. The use of freehand SPECT was evaluated during 66 sentinel node biopsy procedures in early stage oral cancer patients. Intraoperative detection of sentinel nodes was compared with preoperative identified sentinel nodes on lymphoscinitigraphic examination. Additional value of freehand SPECT was subjectively scored by the surgeon directly following the biopsy procedure. Freehand SPECT was able to detect 94% of sentinel nodes intraoperatively. Most sentinel nodes not detected (7 out of 9) were located in level I of the neck. Freehand SPECT appeared to be of additional value for facilitating the intraoperative detection of the sentinel node in 24% of procedures. The use of the freehand SPECT system is feasible in the intraoperative detection of sentinel nodes in early stage oral cancer. Freehand SPECT provides helpful information facilitating the SN biopsy procedure in a quarter of cases. However, freehand SPECT cannot detect all SNs which are located in the vicinity of the injection site. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. DMSA SPECT imaging using oblique reconstruction in a paediatric population - benefits and technical considerations

    Energy Technology Data Exchange (ETDEWEB)

    Parsons, G.; Ford, M.; Crisp, J.; Bernard, E.; Howman-Giles, R. [The New Childrens Hospital, Westmead, NSW, (Australia). Department of Nuclear Medicine

    1997-09-01

    Full text: DMSA renal scans are frequently requested for the diagnosis and follow-up of acute pyelonephritis and cortical scarring. This study was designed to:- 1. evaluate oblique reconstruction of DMSA SPECT over standard plane reconstruction and planar imaging; and 2. report on the technical aspects important in obtaining high quality DMSA SPECT, particularly in neonates. Over seven months, 210/231 (91 %) of DMSA scans were performed with SPECT on children from age nine days to 16 years, the median age being 2.5 years. 65 patients (31 %) were under one year and 39 (18%) were under six months. Planar and SPECT imaging with standard plane reconstruction and oblique reorientation was performed on the Siemens triple-headed gamma camera. High quality SPECT images were obtained on the smallest babies using a paediatric palette, and were of comparable quality to those of older children. At the time of reporting, the nuclear medicine physician assessed the diagnostic value of the three types of date presented: (1) planar images; (2) standard plane SPECT reconstruction; and (3) oblique SPECT reconstruction. Cortical defects were identified separately for upper, middle and lower poles. Three physicians concluded that high quality SPECT is superior to planar images when assessing the renal cortex. In addition, oblique reorientation is superior to standard reconstruction, particularly at the upper and lower poles. SPECT is now performed routinely on patients of all ages, and the oblique sagittal and coronal reorientation is now used in place of the standard reconstruction.

  6. Processamento auditivo e SPECT em crianças com dislexia Dichotic listening and spect in dyslexic children

    Directory of Open Access Journals (Sweden)

    Luciane Sauer

    2006-03-01

    Full Text Available Aplicamos em um grupo de 36 crianças os testes dicótico de dígitos, dicótico de dissílabos alternados e dicótico não-verbal, os quais fazem parte do conjunto de avaliação do processamento auditivo. As crianças foram divididas em dois grupos que foram correlacionados: grupo experimental (GE formado por 18 crianças com diagnóstico de dislexia e 18 crianças normais compondo o grupo comparação (GC, sem queixa de aprendizagem e pareadas em relação a sexo, lateralidade e nível sócio-econômico ao GE. Realizamos o exame de imagem (SPECT no GE. Encontramos em nosso estudo diferença estatisticamente significante entre os grupos (GE e GC em todos os testes avaliados. Em relação ao SPECT, apesar de não encontrarmos diferença estatisticamente significante entre os resultados, pudemos observar que 50% dos sujeitos avaliados apresentaram alteração, sendo a maior parte em áreas do lobo temporal esquerdo. Concluímos que crianças com dislexia apresentam alterações do processamento neurológico central que podem ser detectadas tanto em testes específicos de processamento auditivo, quanto em exames funcionais de imagem como SPECT.Dichotic listening (DL was evaluated in 36 children with: verbal dichotic listening test, alternating dissilable dichotic test and non-verbal dichotic listening test. Children were separated into two groups: experimental group with 18 dyslexic children and control group with 18 normal children. Both groups were comparable in gender, laterality and social-economic level. All dyslexic children underwent neuroimaging exam (SPECT. Our data showed that there was a statistical difference between both groups in all DL tests. Abnormal SPECT findings were seen in 50% of the dyslexic children, hypoperfusion of the left temporal lobe being the most frequent abnormality. We conclude that dyslexic children present an impairment of central neurologic processing that may be detected by DL tests, and by functional imaging

  7. Cerebral SPECT under VEEG monitoring combined with semi-quantitative analysis in localization of epileptogenic zone%视频脑电结合半定量分析的脑血流灌注显像定位致痫灶

    Institute of Scientific and Technical Information of China (English)

    郝科技; 王茜; 刘献增; 邱李恒; 高旭光; 李原

    2014-01-01

    目的 评价一种在视频脑电监测(VEEG)下结合半定量分析的脑血流灌注SPECT显像法用于癫痫致痫灶定位诊断的价值.方法 对81例难治性癫痫患者的临床资料进行回顾性分析.脑血流灌注SPECT在VEEG监测下进行,显像前以睡眠剥夺、逐步减少或停服抗癫痫药的方式争取诱发癫痫发作.影像判读采用视觉判断与半定量分析结合的方法.结果 19例同时获得发作期和发作间期显像,62例仅获得发作间期显像.SPECT、VEEG和MRI对病灶的检出率分别为95%、98%和42%,SPECT与VEEG检出率之间差异无统计学意义(P>0.05),但二者均显著高于MRI(x 2=52.913,P<0.001;x2 =59.247,P<0.001).SPECT与VEEG、SPECT与MRI和MRI与VEEG对病灶的定位符合率分别为69%、25%和27%,SPECT与VEEG之间的符合率显著高于SPECT与MRI(x2=26.905,P<0.001)及MRI与VEEG之间的符合率(x2=26.905,P<0.001).SPECT、VEEG和MRI的定位准确性分别为83%、74%和52%;术后随访结果示,疗效达Ⅰ~Ⅱ级患者中,有11例(n=14)其术前SPECT与VEEG定位结果一致.结论 脑SPECT显像法对致痫灶定位具有较高的价值,提倡作为常规检查法用于难治性癫痫的定位诊断.%Objective To investigate the value of the cerebral blood flow SPECT used for localization of epileptogenic zone in patients with intractable epilepsy,which was performed under the videoelectroencephalogram (VEEG) monitoring combined with the semi-quantitative analysis.Methods Ccrcbral blood flow SPECT was performed under VEEG monitoring and seizures were captured either by sleep-deprived or by reducing dose or by withholding of antiepileptic drugs (AEDs).Neurogam analysis was used in the procedure of image interpretation.Results 19 inter-ictal combined with ictal images and 62 only inter-ictal images were obtained in this study.The detection rates of the pathological focus for SPECT,VEEG and MRI were 95%、98% and 42%,respectively.There was no

  8. Recent advances in cardiac SPECT instrumentation and system design.

    Science.gov (United States)

    Smith, Mark F

    2013-08-01

    Recent advances in clinical cardiac SPECT instrumentation are reviewed from a systems perspective. New hardware technologies include pixelated scintillator and semiconductor detector elements; photodetectors such as position-sensitive photomultiplier tubes (PSPMT), avalanche photodiodes (APD) and silicon photomultipliers (SiPM); and novel cardiac collimation methods. There are new approaches for positioning detectors and controlling their motion during cardiac imaging. Software technology advances include iterative image reconstruction with modeling of Poisson statistics and depth-dependent collimator response. These new technologies enable faster acquisitions, the lowering of administered activity and radiation dose, and improved image resolution. Higher sensitivity collimators are a significant factor enabling faster acquisitions. Several clinical systems incorporating new technologies are discussed and different system designs can achieve similar performance. With detector elements such as APDs, SiPMs and semiconductors that are insensitive to magnetic fields, the potential for cardiac SPECT imagers that are MRI compatible opens up new frontiers in clinical cardiac research and patient care.

  9. Status report of the neutron lifetime experiment tau-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Karch, Jan Peter; Beck, Marcus; Dragisic, Simo; Haak, Jan; Heil, Werner; Kories, Fabian; Kunz, Simon; Stepanow, Dietmar [Institut fuer Physik, University of Mainz (Germany); Geppert, Christopher; Karpuk, Sergei [Institut fuer Kernchemie, University of Mainz (Germany); Sobolev, Yury [Institut fuer Physik, University of Mainz (Germany); Institut fuer Kernchemie, University of Mainz (Germany)

    2015-07-01

    The decay of the free neutron into a proton, electron and antineutrino is the prototype of the semi-leptonic weak decay and plays a key role in particle physics and astrophysics. Nowadays, the accuracy achieved is limited by systematic errors, mainly caused by anomalous losses during storage of neutrons (ultracold neutrons) in material vessels. The magnetic storage of neutrons aims to avoid these systematic limitations and is expected to reach an accuracy of 0.1-0.3 s in the lifetime of the neutron. In this talk, the magnetic spectrometer tau-SPECT is presented, which uses a combination of magnetic multipole fields for radial storage and the field configuration of the superconducting aSPECT magnet for longitudinal storage of ultracold neutrons. This storage experiment benefits greatly from the new ultracold neutron source at the pulsable TRIGA reactor Mainz. The talk gives an overview of the experimental status: Proton detection system and adiabatic fast passages device.

  10. Results and present status of the spectrometer aSPECT

    Energy Technology Data Exchange (ETDEWEB)

    Ayala Guardia, Fidel; Borg, Michael; Glueck, Ferenc; Heil, Werner; Konrad, Gertrud; Munoz Horta, Raquel; Sobolev, Yury [Institut fuer Physik, Universitaet Mainz (Germany); Angerer, Heinz; Konorov, Igor; Petzoldt, Gerd; Simson, Martin; Wirth, Hans-Friedrich; Zimmer, Oliver [Physik Department, Technische Universitaet Muenchen (Germany); Baessler, Stefan [Department of Physics, University of Virginia, Charlottesville (United States); Eberhardt, Klaus [Institut fuer Kernchemie, Universitaet Mainz (Germany)

    2008-07-01

    The aim of the aSPECT spectrometer is a precise measurement of the proton recoil spectrum in free neutron decay. For kinematic reasons, the shape of the proton spectrum depends on the angular correlation coefficient between the momenta of the electron antineutrino and the electron, a. An accurate measurement of the angular correlation coefficient a is of great interest in order to test the unitarity of the Cabibbo Kobayashi Maskawa Matrix (CKM-Matrix). A first test beam time was performed during 2005/06 at the beam line MEPHISTO at the neutron research reactor FRM-II in Garching. Results of the data analysis as well as the present status of the aSPECT spectrometer are presented in this talk.

  11. aSPECT - Measuring the proton spectrum in neutron decay

    Energy Technology Data Exchange (ETDEWEB)

    Simson, Martin; Soldner, Torsten; Zimmer, Oliver [Institut Laue-Langevin, Grenoble (France); Physik-Department E18, TU Muenchen (Germany); Ayala Guardia, Fidel; Borg, Michael; Heil, Werner; Konrad, Gertrud; Munoz Horta, Raquel; Ostrick, Beatrix [Institut fuer Physik, Universitaet Mainz (Germany); Baessler, Stefan [University of Virginia, Charlottesville, VA (United States); Glueck, Ferenc [IEKP, Universitaet Karlsruhe (Germany); Konorov, Igor [Physik-Department E18, TU Muenchen (Germany); Wirth, Hans-Friedrich [Fakultaet fuer Physik, LMU Muenchen (Germany)

    2010-07-01

    With the aSPECT spectrometer we measure the proton recoil spectrum in the decay of the free neutron. Its shape depends on the angular correlation between the momenta of the antineutrino and electron for kinematic reasons. A precision measurement of this correlation coefficient a allows to test the unitarity of the CKM matrix and provides limits on the existence of scalar and tensor currents. aSPECT is a retardation spectrometer, this means protons from neutron decay are guided by a strong magnetic field and the proton recoil spectrum is measured by counting all protons that overcome a electrostatic barrier. By varying the height of the barrier the shape of the proton spectrum can be reconstructed. After the barrier the protons are accelerated to {proportional_to}15 keV and detected by a silicon drift detector. This talk covers details of the spectrometer and detector, as well as techniques used in the data analysis.

  12. HM-PAO-SPECT in complicated migraine. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Gruenwald, F.; Ruhlmann, J.; Biersack, H.J.; Durwen, H.; Penin, H.

    1988-10-01

    Three HM-PAO-SPECT investigations have been performed in a female patient with a complicated migraine. 2.5 hours after an attack with right-sided numbness and atonic hemiparesis, at the left side a reduced blood flow was seen parietotemporally and in the subcortical structures. The cerebellum showed crossed diaschisis. During a symptom-free interval the SPECT showed a slightly increased parietotemporal blood blow and a reduced right temporooccipital blood flow. During a seizure with left-sided facial spasm, unsystematic clonic movements in all extremities and a following left-sided hemiparesis, the uptake in the visual cortex was increased by 60%. In the right frontotemporal and left temporal region a slightly increased accumulation was found.

  13. Accuracy of quantitative reconstructions in SPECT/CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shcherbinin, S; Celler, A [Department of Radiology, University of British Columbia, 366-828 West 10th Avenue, Vancouver BC, V5Z 1L8 (Canada); Belhocine, T; Vanderwerf, R; Driedger, A [Department of Nuclear Medicine, London Health Sciences Centre, 375 South Street, PO Box 5375, London ON, N6A 4G5 (Canada)], E-mail: shcher2@interchange.ubc.ca

    2008-09-07

    The goal of this study was to determine the quantitative accuracy of our OSEM-APDI reconstruction method based on SPECT/CT imaging for Tc-99m, In-111, I-123, and I-131 isotopes. Phantom studies were performed on a SPECT/low-dose multislice CT system (Infinia-Hawkeye-4 slice, GE Healthcare) using clinical acquisition protocols. Two radioactive sources were centrally and peripherally placed inside an anthropometric Thorax phantom filled with non-radioactive water. Corrections for attenuation, scatter, collimator blurring and collimator septal penetration were applied and their contribution to the overall accuracy of the reconstruction was evaluated. Reconstruction with the most comprehensive set of corrections resulted in activity estimation with error levels of 3-5% for all the isotopes.

  14. Infective endocarditis detection through SPECT/CT images digital processing

    Science.gov (United States)

    Moreno, Albino; Valdés, Raquel; Jiménez, Luis; Vallejo, Enrique; Hernández, Salvador; Soto, Gabriel

    2014-03-01

    Infective endocarditis (IE) is a difficult-to-diagnose pathology, since its manifestation in patients is highly variable. In this work, it was proposed a semiautomatic algorithm based on SPECT images digital processing for the detection of IE using a CT images volume as a spatial reference. The heart/lung rate was calculated using the SPECT images information. There were no statistically significant differences between the heart/lung rates values of a group of patients diagnosed with IE (2.62+/-0.47) and a group of healthy or control subjects (2.84+/-0.68). However, it is necessary to increase the study sample of both the individuals diagnosed with IE and the control group subjects, as well as to improve the images quality.

  15. Role of brain perfusion SPECT with 99mTc HMPAO in the assessment of response to drug therapy in patients with autoimmune vasculitis: A prospective study

    Directory of Open Access Journals (Sweden)

    Liberatore Mauro

    2015-01-01

    Full Text Available Background: The diagnosis of vasculitis in the brain remains a quite difficult achievement. To the best of our knowledge, there is no imaging method reported in literature which is capable of reaching to a diagnosis of vasculitis with very high sensitivity. Aim: The aim of this study was to determine whether perfusion brain single photon emission computed tomography (SPECT can be usefully employed in monitoring the treatment of vasculitis, allowing treating only potentially responder patients and avoiding the side effects on patients who do not respond. Materials and Methods: Twenty patients (two males and 18 females suffering from systemic lupus erythematosus (SLE; n = 5, Behcet′s disease (BD; n = 5, undifferentiated vasculitis (UV; n = 5, and Sjogren′s syndrome (SS; n = 5 were included in the study. All patients underwent a wide neurological anamnestic investigation, a complete objective neurological examination and SPECT of the brain with 99mTc-hexamethyl-propylene-aminoxime (HMPAO. The brain SPECT was then repeated after appropriate medical treatment. The neurological and neuropsychiatric follow-up was performed at 6 months after the start of the treatment. Results: Overall, the differences between the scintigraphic results obtained after and before the medical treatment indicated a statistically significant increase of the cerebral perfusion (CP. In 19 out of 200 regions of interest (ROI studied, the difference between pre- and post treatment percentages had negative sign, indicating a worsening of CP. This latter event has occurred six times (five in the same patients in the UV, 10 times (eight in the same patients in the SLE, never in BD, and three times (two in the same patient in the SS. Conclusion: The reported results seem to indicate the possibility of identifying, by the means of a brain SPECT, responder and nonresponder (unchanged or worsened CP patients, affected by autoimmune vasculitis, to the therapy.

  16. Transient Crossed Aphasia: A Case Study with SPECT

    Directory of Open Access Journals (Sweden)

    José M. Ferro

    1991-01-01

    Full Text Available A 45-year-old right-handed man developed “crossed” anomie aphasia, neglect and inaccurate reaching of his left arm in both hemispaces due to a right parietal haemorrhage. Aphasia cleared in a few days. SPECT failed to demonstrate crossed left hemispheric diaschisis. This report emphasizes the importance of evaluating patients in the acute stage and of coupling “static” and “functional” imaging methods when studying brain-behavior relationships.

  17. Evaluation of pelvic ring injuries using SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Scheyerer, Max J. [University Hospital Zurich, Division of Trauma Surgery, Department of Surgery, Zurich (Switzerland); University Medical Center, Centre for Orthopaedic and Trauma Surgery, Cologne (Germany); Huellner, Martin; Pietsch, Carsten [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Werner, Clement M.L. [University Hospital Zurich, Division of Trauma Surgery, Department of Surgery, Zurich (Switzerland); Veit-Haibach, Patrick [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); University Hospital Zurich, Diagnostic and Interventional Radiology, Department of Medical Radiology, Zurich (Switzerland)

    2014-08-12

    The incidence of pelvic fractures is relatively low compared with other fracture locations. The low incidence is in great contrast to the high morbidity and mortality. Particularly in the elderly, with apparently isolated fractures of the pubic rami, these observations are believed to be due to additional occult lesions of the posterior pelvic ring. In these cases diagnosis cannot be established by conventional imaging alone and SPECT/CT is considered as a diagnostic adjunct. The aim of this study was to assess concomitant bony or soft tissue lesions within the pelvic ring in a population of patients with fractures of the anterior elements. In all patients with no obvious lesions of the posterior pelvic ring on X-rays and CT or with suspicious but inconclusive findings on CT an additional SPECT/CT was carried out in a non-acute setting within 3 days of the trauma. In all cases additional lesions within the pelvic ring were found. Most lesions were vertical sacral fractures, followed by transverse fractures, one non-dislocated fracture of the acetabulum on the side of the pubic rami fracture, and one post-traumatic dilatation of the sacroiliac joint with increased tracer uptake. According to our results after SPECT/CT all patients with pubic rami fracture suffered additional lesions, none detectable previously by X-ray or CT, within the pelvic ring. In this context SPECT/CT has proved to be very helpful in the clinical routine to visualize occult fractures and instability within the sacroiliac joint. (orig.)

  18. In vivo SPECT reporter gene imaging of regulatory T cells.

    Directory of Open Access Journals (Sweden)

    Ehsan Sharif-Paghaleh

    Full Text Available Regulatory T cells (Tregs were identified several years ago and are key in controlling autoimmune diseases and limiting immune responses to foreign antigens, including alloantigens. In vivo imaging techniques including intravital microscopy as well as whole body imaging using bioluminescence probes have contributed to the understanding of in vivo Treg function, their mechanisms of action and target cells. Imaging of the human sodium/iodide symporter via Single Photon Emission Computed Tomography (SPECT has been used to image various cell types in vivo. It has several advantages over the aforementioned imaging techniques including high sensitivity, it allows non-invasive whole body studies of viable cell migration and localisation of cells over time and lastly it may offer the possibility to be translated to the clinic. This study addresses whether SPECT/CT imaging can be used to visualise the migratory pattern of Tregs in vivo. Treg lines derived from CD4(+CD25(+FoxP3(+ cells were retrovirally transduced with a construct encoding for the human Sodium Iodide Symporter (NIS and the fluorescent protein mCherry and stimulated with autologous DCs. NIS expressing self-specific Tregs were specifically radiolabelled in vitro with Technetium-99m pertechnetate ((99mTcO(4(- and exposure of these cells to radioactivity did not affect cell viability, phenotype or function. In addition adoptively transferred Treg-NIS cells were imaged in vivo in C57BL/6 (BL/6 mice by SPECT/CT using (99mTcO(4(-. After 24 hours NIS expressing Tregs were observed in the spleen and their localisation was further confirmed by organ biodistribution studies and flow cytometry analysis. The data presented here suggests that SPECT/CT imaging can be utilised in preclinical imaging studies of adoptively transferred Tregs without affecting Treg function and viability thereby allowing longitudinal studies within disease models.

  19. Physiological imaging with PET and SPECT in Dementia

    Energy Technology Data Exchange (ETDEWEB)

    Jagust, W.J. (California Univ., San Francisco, CA (United States). Dept. of Neurology Lawrence Berkeley Lab., CA (United States))

    1989-10-01

    Dementia is a medical problem of increasingly obvious importance. The most common cause of dementia, Alzheimer's disease (AD) accounts for at least 50% of all cases of dementia, with multi-infarct dementia the next most common cause of the syndrome. While the accuracy of diagnosis of AD may range from 80 to 90%, there is currently no laboratory test to confirm the diagnosis. Functional imaging techniques such as positron emission tomography (PET) and single photon emission computed tomography (SPECT) offer diagnostic advantages since brain function is unequivocally disturbed in all dementing illnesses. Both PET and SPECT have been utilized in the study of dementia. While both techniques rely on principles of emission tomography to produce three dimensional maps of injected radiotracers, the differences between positron and single photon emission have important consequences for the practical applications of the two procedures. This briefly reviews the technical differences between PET and SPECT, and discusses how both techniques have been used in our laboratory to elucidate the pathophysiology of dementia. 32 refs., 2 figs.

  20. SVD-Based Evaluation of Multiplexing in Multipinhole SPECT Systems

    Directory of Open Access Journals (Sweden)

    Aaron K. Jorgensen

    2008-01-01

    Full Text Available Multipinhole SPECT system design is largely a trial-and-error process. General principles can give system designers a general idea of how a system with certain characteristics will perform. However, the specific performance of any particular system is unknown before the system is tested. The development of an objective evaluation method that is not based on experimentation would facilitate the optimization of multipinhole systems. We derive a figure of merit for prediction of SPECT system performance based on the entire singular value spectrum of the system. This figure of merit contains significantly more information than the condition number of the system, and is therefore more revealing of system performance. This figure is then compared with simulated results of several SPECT systems and is shown to correlate well to the results of the simulations. The proposed figure of merit is useful for predicting system performance, but additional steps could be taken to improve its accuracy and applicability. The limits of the proposed method are discussed, and possible improvements to it are proposed.

  1. Advances in SPECT imaging with respect to radionuclide therapy.

    Science.gov (United States)

    D'Asseler, Y

    2009-06-01

    Radionuclide therapy is gradually becoming more important as a therapy option in various diseases. Nuclear medicine imaging plays an important role in this, before, during and after the therapy. Single photon emission computed tomography (SPECT) imaging can be used to predict therapy response, calculate doses delivered to the tumour and the surrounding organ, check radiopharmaceutical distribution and follow-up this distribution in time. On a technological level, radionuclide imaging in a therapy setting shows some particularities and issues to be resolved. Accurate quantification is important but is hampered by attenuation, scatter from different energy peaks and from bremsstrahlung photons, septal penetration, partial volume effects etc. Some of these issues are discussed in this paper. A technique specific for therapy imaging is bremsstrahlung imaging, which can be used if the therapeutical agent is a pure beta emitter. Quantitative bremsstrahlung imaging is particularly challenging due to the complicated nature of the energy spectrum of these photons. Some work towards quantitative bremsstrahlung imaging is discussed here. Finally, some recent technical advances relevant to this field are pointed out. On the software side, Monte Carlo simulations seem to have a great potential for accurate quantitative SPECT reconstruction and subsequent patient specific image based dose calculations. Concerning hardware, the availability of SPECT-CT technology may have a large impact in imaging in radionuclide therapy. Novel detector technologies such as solid-state detectors may also prove to have significant advantages in this field.

  2. Grafted bone used in acetabular reconstruction: assessment by SPECT scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujikawa, Yosuke [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Torisu, Takehiko [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Takasita, Mitsuhiro [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Masumi, Shogo [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan)

    1995-08-01

    Single photon emission computed tomography (SPECT) was carried out at the 1st, 6th, and 12th month after the operation and the uptakes on serial SPECT scintigrams were normalized. The horizontal histogram of scintigraphic activity at the level of the central grafted bone in the coronal image was designated the profile curve. Seven patients who had undergone bipolar hip arthroplasty for osteoarthritis of the hip were randomly selected. Five of seven profile curves obtained at the 1st month demonstrated a single peak at the host-graft junction. The profile curve obtained at the 6th month showed two peaks at the host-graft junction and the priphery of the grafted bone in all patients. The profile curve of the 12th month showed slightly increased activity in the center of the grafted bone. This preliminary study demonstrates that comparison of the serial profile curves on SPECT is valuable in evaluating the progress of incorporation of the grafted bone in hip arthroplasty. (orig.)

  3. [Usefulness of attenuation correction with transmission source in myocardial SPECT].

    Science.gov (United States)

    Murakawa, Keizo; Katafuchi, Tetsuro; Nishimura, Yoshihiro; Enomoto, Naoyuki; Sago, Masayoshi; Oka, Hisashi

    2006-01-20

    Attenuation correction in SPECT has been used for uniformly absorptive objects like the head. On the other hand, it has seldom been applied to nonuniform absorptive objects like the heart and surrounding lungs because of the difficulty and inaccuracy of data processing. However, since attenuation correction using a transmission source recently became practical, we were able to apply this method to a nonuniform absorptive object. Therefore, we evaluated the usefulness of this attenuation correction system with a transmission source in myocardial SPECT. The dose linearity, defect/normal ratio using a myocardial phantom, and myocardial count distribution in clinical cases was examined with and without the attenuation correction system. We found that all data processed with attenuation correction were better than those without attenuation correction. For example, in myocardial count distribution, while there was a difference between men and women without attenuation correction, which was considered to be caused by differences in body shape, after processing with attenuation correction, myocardial count distribution was almost the same in all cases. In conclusion, these results suggested that attenuation correction with a transmission source was useful in myocardial SPECT.

  4. Novel SPECT Technologies and Approaches in Cardiac Imaging

    Directory of Open Access Journals (Sweden)

    Piotr Slomka

    2016-12-01

    Full Text Available Recent novel approaches in myocardial perfusion single photon emission CT (SPECT have been facilitated by new dedicated high-efficiency hardware with solid-state detectors and optimized collimators. New protocols include very low-dose (1 mSv stress-only, two-position imaging to mitigate attenuation artifacts, and simultaneous dual-isotope imaging. Attenuation correction can be performed by specialized low-dose systems or by previously obtained CT coronary calcium scans. Hybrid protocols using CT angiography have been proposed. Image quality improvements have been demonstrated by novel reconstructions and motion correction. Fast SPECT acquisition facilitates dynamic flow and early function measurements. Image processing algorithms have become automated with virtually unsupervised extraction of quantitative imaging variables. This automation facilitates integration with clinical variables derived by machine learning to predict patient outcome or diagnosis. In this review, we describe new imaging protocols made possible by the new hardware developments. We also discuss several novel software approaches for the quantification and interpretation of myocardial perfusion SPECT scans.

  5. SVD-based evaluation of multiplexing in multipinhole SPECT systems.

    Science.gov (United States)

    Jorgensen, Aaron K; Zeng, Gengsheng L

    2008-01-01

    Multipinhole SPECT system design is largely a trial-and-error process. General principles can give system designers a general idea of how a system with certain characteristics will perform. However, the specific performance of any particular system is unknown before the system is tested. The development of an objective evaluation method that is not based on experimentation would facilitate the optimization of multipinhole systems. We derive a figure of merit for prediction of SPECT system performance based on the entire singular value spectrum of the system. This figure of merit contains significantly more information than the condition number of the system, and is therefore more revealing of system performance. This figure is then compared with simulated results of several SPECT systems and is shown to correlate well to the results of the simulations. The proposed figure of merit is useful for predicting system performance, but additional steps could be taken to improve its accuracy and applicability. The limits of the proposed method are discussed, and possible improvements to it are proposed.

  6. Concordance between myocardial perfusion scan assessed by SPECT and fractional flow reserve findings for detection of significant ischemia

    Directory of Open Access Journals (Sweden)

    Morteza Safi

    2016-09-01

    Conclusion: FFR and MPI with SPECT techniques showed significant concordance for detection of myocardial ischemia, regardless of the type of diseased coronary arteries. In this context, SPECT has high sensitivity and NPV for detection of ischemia compared with FFR.

  7. A new method to evaluate ischemic heart disease. Combined use of rest thallium-201 myocardial SPECT and Tc-99m exercise tetrofosmin first pass and myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong-ih; Goto, Hideki; Kobayashi, Katsuhiro; Sawada, Yoshihiro; Miyake, Yoshitaka; Fujiwara, Go [Nishiyodo Hospital, Osaka (Japan); Okada, Tomoya; Nishimura, Tsunehiko

    1999-06-01

    We developed a new diagnostic method for simultaneously evaluating myocardial ischemia, myocardial viability and ventricular function in less than 90 minutes by combined use of rest thallium-201 (Tl) SPECT and exercise Tc-99m tetrofosmin (TF) first pass and SPECT. The subjects were 9 healthy controls, 19 angina pectoris patients, and 19 old myocardial infarction patients, in all of whom coronary angiography had been performed. Rest Tl myocardial SPECT was performed first, and was followed by exercise TF myocardial SPECT. We also performed first pass radionuclide angiography by TF during maximum exercise on a bicycle ergometer to assess the left ventricular ejection fraction (LVEF). The total examination time was less than 90 minutes. SPECT diagnosis was performed by semi-quantitative analysis. LVEF below 55% was regarded as abnormal. In the patients with angina pectoris, analysis according to the coronary artery showed that the diagnostic accuracy of SPECT was 85.0% for ischemia in the region of the left anterior descending branch (LAD), 87.5% for the left circumflex branch (LCX) and 77.8% for the right coronary artery (RCA). The accuracy of diagnosis for angina pectoris was 82.1%, as determined by SPECT alone, and rose to 89,3% when the LVEF levels were also taken into consideration. In the patients with old myocardial infarction, the diagnostic accuracy of SPECT was 84.2% for the LAD, 92.3% for the LCX and 85.0% for the RCA. Analysis by patients showed that the accuracy of diagnosis for myocardial infarction was 85.7%, as determined by SPECT alone. The diagnostic accuracy, however, rose to 89.3% when the LVEF levels also were taken into consideration. In conclusion, it was demonstrated that this combined diagnostic method was highly reliable for evaluating ischemic heart disease within a short time. (author)

  8. 3D SPECT/CT fusion using image data projection of bone SPECT onto 3D volume-rendered CT images: feasibility and clinical impact in the diagnosis of bone metastasis.

    Science.gov (United States)

    Ogata, Yuji; Nakahara, Tadaki; Ode, Kenichi; Matsusaka, Yohji; Katagiri, Mari; Iwabuchi, Yu; Itoh, Kazunari; Ichimura, Akira; Jinzaki, Masahiro

    2017-05-01

    We developed a method of image data projection of bone SPECT into 3D volume-rendered CT images for 3D SPECT/CT fusion. The aims of our study were to evaluate its feasibility and clinical usefulness. Whole-body bone scintigraphy (WB) and SPECT/CT scans were performed in 318 cancer patients using a dedicated SPECT/CT systems. Volume data of bone SPECT and CT were fused to obtain 2D SPECT/CT images. To generate our 3D SPECT/CT images, colored voxel data of bone SPECT were projected onto the corresponding location of the volume-rendered CT data after a semi-automatic bone extraction. Then, the resultant 3D images were blended with conventional volume-rendered CT images, allowing to grasp the three-dimensional relationship between bone metabolism and anatomy. WB and SPECT (WB + SPECT), 2D SPECT/CT fusion, and 3D SPECT/CT fusion were evaluated by two independent reviewers in the diagnosis of bone metastasis. The inter-observer variability and diagnostic accuracy in these three image sets were investigated using a four-point diagnostic scale. Increased bone metabolism was found in 744 metastatic sites and 1002 benign changes. On a per-lesion basis, inter-observer agreements in the diagnosis of bone metastasis were 0.72 for WB + SPECT, 0.90 for 2D SPECT/CT, and 0.89 for 3D SPECT/CT. Receiver operating characteristic analyses for the diagnostic accuracy of bone metastasis showed that WB + SPECT, 2D SPECT/CT, and 3D SPECT/CT had an area under the curve of 0.800, 0.983, and 0.983 for reader 1, 0.865, 0.992, and 0.993 for reader 2, respectively (WB + SPECT vs. 2D or 3D SPECT/CT, p < 0.001; 2D vs. 3D SPECT/CT, n.s.). The durations of interpretation of WB + SPECT, 2D SPECT/CT, and 3D SPECT/CT images were 241 ± 75, 225 ± 73, and 182 ± 71 s for reader 1 and 207 ± 72, 190 ± 73, and 179 ± 73 s for reader 2, respectively. As a result, it took shorter time to read 3D SPECT/CT images than 2D SPECT/CT (p < 0.0001) or WB + SPECT

  9. Quantifying the Increase in Radiation Exposure Associated with SPECT/CT Compared to SPECT Alone for Routine Nuclear Medicine Examinations

    Directory of Open Access Journals (Sweden)

    Ann M. Larkin

    2011-01-01

    Full Text Available Purpose. We quantify the additional radiation exposure in terms of effective dose incurred by patients in the CT portion of SPECT/CT examinations. Methods. The effective dose from a variety of common nuclear medicine procedures is calculated and summarized. The extra exposure from the CT portion of the examination is summarized by examination and body part. Two hundred forty-eight scans from 221 patients are included in this study. The effective dose from the CT examination is also compared to average background radiation. Results. We found that the extra effective dose is not sufficient to cause deterministic effects. However, the stochastic effects may be significant, especially in patients undergoing numerous follow-up studies. The cumulative effect might increase the radiation exposure compared to patient management with SPECT alone. Conclusions. While the relative increase in radiation exposure associated with SPECT/CT is generally considered acceptable when compared with the benefits to the patient, physicians should make every effort to minimize this effect by using proper technical procedures and educating patients about the exposure they will receive.

  10. Reconfigurable multiport EPON repeater

    Science.gov (United States)

    Oishi, Masayuki; Inohara, Ryo; Agata, Akira; Horiuchi, Yukio

    2009-11-01

    An extended reach EPON repeater is one of the solutions to effectively expand FTTH service areas. In this paper, we propose a reconfigurable multi-port EPON repeater for effective accommodation of multiple ODNs with a single OLT line card. The proposed repeater, which has multi-ports in both OLT and ODN sides, consists of TRs, BTRs with the CDR function and a reconfigurable electrical matrix switch, can accommodate multiple ODNs to a single OLT line card by controlling the connection of the matrix switch. Although conventional EPON repeaters require full OLT line cards to accommodate subscribers from the initial installation stage, the proposed repeater can dramatically reduce the number of required line cards especially when the number of subscribers is less than a half of the maximum registerable users per OLT. Numerical calculation results show that the extended reach EPON system with the proposed EPON repeater can save 17.5% of the initial installation cost compared with a conventional repeater, and can be less expensive than conventional systems up to the maximum subscribers especially when the percentage of ODNs in lightly-populated areas is higher.

  11. Revisiting the TALE repeat.

    Science.gov (United States)

    Deng, Dong; Yan, Chuangye; Wu, Jianping; Pan, Xiaojing; Yan, Nieng

    2014-04-01

    Transcription activator-like (TAL) effectors specifically bind to double stranded (ds) DNA through a central domain of tandem repeats. Each TAL effector (TALE) repeat comprises 33-35 amino acids and recognizes one specific DNA base through a highly variable residue at a fixed position in the repeat. Structural studies have revealed the molecular basis of DNA recognition by TALE repeats. Examination of the overall structure reveals that the basic building block of TALE protein, namely a helical hairpin, is one-helix shifted from the previously defined TALE motif. Here we wish to suggest a structure-based re-demarcation of the TALE repeat which starts with the residues that bind to the DNA backbone phosphate and concludes with the base-recognition hyper-variable residue. This new numbering system is consistent with the α-solenoid superfamily to which TALE belongs, and reflects the structural integrity of TAL effectors. In addition, it confers integral number of TALE repeats that matches the number of bound DNA bases. We then present fifteen crystal structures of engineered dHax3 variants in complex with target DNA molecules, which elucidate the structural basis for the recognition of bases adenine (A) and guanine (G) by reported or uncharacterized TALE codes. Finally, we analyzed the sequence-structure correlation of the amino acid residues within a TALE repeat. The structural analyses reported here may advance the mechanistic understanding of TALE proteins and facilitate the design of TALEN with improved affinity and specificity.

  12. Optimized brain SPECT for ictal epilepsy patients%癫痫患者发作期脑血流灌注显像规范化采集的初步探讨

    Institute of Scientific and Technical Information of China (English)

    郭勇; 杨自更; 周颖; 彭静

    2008-01-01

    目的:研究癫痫患者发作期脑血流灌注显像规范化采集的程序及方法.方法:通过对41例癫痫患者发作期显像,并与脑电图及MR的结果进行比较,结合手术后病理,探讨癫痫发作期提高致癫灶检出率的方法.结果:规范发作期脑血流灌注采集方法后,可检出92%的致癫灶.结论:发作期脑血流灌注显像的规范化采集可明显提高致癫灶的检出率.

  13. The additive prognostic value of perfusion and functional data assessed by quantitative gated SPECT in women

    NARCIS (Netherlands)

    Y.G.C.J. America (Yves); J.J. Bax (Jeroen); H. Boersma (Eric); M. Stokkel (Marcel); E.E. van der Wall (Ernst)

    2009-01-01

    textabstractBackground: The aim of this study was to assess the prognostic value of technetium-99m tetrofosmin gated SPECT imaging in women using quantitative gated single photon emission computed tomography (SPECT) imaging. Methods: We followed 453 consecutive female patients. Average follow-up was

  14. Evaluation of the use of freehand SPECT for sentinel node biopsy in early stage oral carcinoma

    NARCIS (Netherlands)

    Heuveling, D.A.; van Weert, S.; Karagozoglu, K.H.; de Bree, R.

    2015-01-01

    Rationale Inadequate intraoperative visualization of the sentinel node can hamper its harvest. Freehand SPECT is a 3D tomographic imaging modality based on the concepts of SPECT, which can be used for intraoperative visualization and navigation towards the sentinel node in order to improve its

  15. SPECT-OPT multimodal imaging enables accurate evaluation of radiotracers for beta-cell mass assessments

    NARCIS (Netherlands)

    Eter, W.A.; Parween, S.; Joosten, L.; Frielink, C.; Eriksson, M.; Brom, M.; Ahlgren, U.; Gotthardt, M.

    2016-01-01

    Single Photon Emission Computed Tomography (SPECT) has become a promising experimental approach to monitor changes in beta-cell mass (BCM) during diabetes progression. SPECT imaging of pancreatic islets is most commonly cross-validated by stereological analysis of histological pancreatic sections

  16. GATE simulation of a new design of pinhole SPECT system for small animal brain imaging

    Science.gov (United States)

    Uzun Ozsahin, D.; Bläckberg, L.; El Fakhri, G.; 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.

  17. Quantitative multi-pinhole small-animal SPECT : uniform versus non-uniform Chang attenuation correction

    NARCIS (Netherlands)

    Wu, C.; de Jong, J. R.; van Andel, H. A. Gratama; van der Have, F.; Vastenhouw, B.; Laverman, P.; Boerman, O. C.; Dierckx, R. A. J. O.; Beekman, F. J.

    2011-01-01

    Attenuation of photon flux on trajectories between the source and pinhole apertures affects the quantitative accuracy of reconstructed single-photon emission computed tomography (SPECT) images. We propose a Chang-based non-uniform attenuation correction (NUA-CT) for small-animal SPECT/CT with focusi

  18. Quantitative multi-pinhole small-animal SPECT: uniform versus non-uniform Chang attenuation correction

    NARCIS (Netherlands)

    Wu, C.; Jong, J.R. de; Gratama van Andel, H.A.; Have, F. van der; Vastenhouw, B.; Laverman, P.; Boerman, O.C.; Dierckx, R.A.; Beekman, F.J.

    2011-01-01

    Attenuation of photon flux on trajectories between the source and pinhole apertures affects the quantitative accuracy of reconstructed single-photon emission computed tomography (SPECT) images. We propose a Chang-based non-uniform attenuation correction (NUA-CT) for small-animal SPECT/CT with focusi

  19. Implementation of angular response function modeling in SPECT simulations with GATE

    Energy Technology Data Exchange (ETDEWEB)

    Descourt, P; Visvikis, D [INSERM, U650, LaTIM, IFR SclnBioS, Universite de Brest, CHU Brest, Brest, F-29200 (France); Carlier, T; Bardies, M [CRCNA INSERM U892, Nantes (France); Du, Y; Song, X; Frey, E C; Tsui, B M W [Department of Radiology, J Hopkins University, Baltimore, MD (United States); Buvat, I, E-mail: dimitris@univ-brest.f [IMNC-UMR 8165 CNRS Universites Paris 7 et Paris 11, Orsay (France)

    2010-05-07

    Among Monte Carlo simulation codes in medical imaging, the GATE simulation platform is widely used today given its flexibility and accuracy, despite long run times, which in SPECT simulations are mostly spent in tracking photons through the collimators. In this work, a tabulated model of the collimator/detector response was implemented within the GATE framework to significantly reduce the simulation times in SPECT. This implementation uses the angular response function (ARF) model. The performance of the implemented ARF approach has been compared to standard SPECT GATE simulations in terms of the ARF tables' accuracy, overall SPECT system performance and run times. Considering the simulation of the Siemens Symbia T SPECT system using high-energy collimators, differences of less than 1% were measured between the ARF-based and the standard GATE-based simulations, while considering the same noise level in the projections, acceleration factors of up to 180 were obtained when simulating a planar 364 keV source seen with the same SPECT system. The ARF-based and the standard GATE simulation results also agreed very well when considering a four-head SPECT simulation of a realistic Jaszczak phantom filled with iodine-131, with a resulting acceleration factor of 100. In conclusion, the implementation of an ARF-based model of collimator/detector response for SPECT simulations within GATE significantly reduces the simulation run times without compromising accuracy. (note)

  20. SPECT assay of radiolabeled monoclonal antibodies. Final performance report, March 1992--November 1995

    Energy Technology Data Exchange (ETDEWEB)

    Jaszczak, R.J.

    1995-12-01

    Research is described in the following areas: development and evaluation quantitatively of reconstruction algorithms with improved compensations for attenuation, scatter, and geometric collimator response; evaluation of single photon emission computed tomography (SPECT) quantification of iodine 123 and astatine 211; and the development and evaluation of SPECT pinhole imaging for low and medium energy photons.

  1. NOTE: Implementation of angular response function modeling in SPECT simulations with GATE

    Science.gov (United States)

    Descourt, P.; Carlier, T.; Du, Y.; Song, X.; Buvat, I.; Frey, E. C.; Bardies, M.; Tsui, B. M. W.; Visvikis, D.

    2010-05-01

    Among Monte Carlo simulation codes in medical imaging, the GATE simulation platform is widely used today given its flexibility and accuracy, despite long run times, which in SPECT simulations are mostly spent in tracking photons through the collimators. In this work, a tabulated model of the collimator/detector response was implemented within the GATE framework to significantly reduce the simulation times in SPECT. This implementation uses the angular response function (ARF) model. The performance of the implemented ARF approach has been compared to standard SPECT GATE simulations in terms of the ARF tables' accuracy, overall SPECT system performance and run times. Considering the simulation of the Siemens Symbia T SPECT system using high-energy collimators, differences of less than 1% were measured between the ARF-based and the standard GATE-based simulations, while considering the same noise level in the projections, acceleration factors of up to 180 were obtained when simulating a planar 364 keV source seen with the same SPECT system. The ARF-based and the standard GATE simulation results also agreed very well when considering a four-head SPECT simulation of a realistic Jaszczak phantom filled with iodine-131, with a resulting acceleration factor of 100. In conclusion, the implementation of an ARF-based model of collimator/detector response for SPECT simulations within GATE significantly reduces the simulation run times without compromising accuracy.

  2. High-resolution tomography of positron emitters with clustered pinhole SPECT

    NARCIS (Netherlands)

    Goorden, M.C.; Beekman, F.J.

    2010-01-01

    State-of-the-art small-animal single photon emission computed tomography (SPECT) enables sub-half-mm resolution imaging of radio-labelled molecules. Due to severe photon penetration through pinhole edges, current multi-pinhole SPECT is not suitable for high-resolution imaging of photons with high

  3. Recursive quantum repeater networks

    CERN Document Server

    Van Meter, Rodney; Horsman, Clare

    2011-01-01

    Internet-scale quantum repeater networks will be heterogeneous in physical technology, repeater functionality, and management. The classical control necessary to use the network will therefore face similar issues as Internet data transmission. Many scalability and management problems that arose during the development of the Internet might have been solved in a more uniform fashion, improving flexibility and reducing redundant engineering effort. Quantum repeater network development is currently at the stage where we risk similar duplication when separate systems are combined. We propose a unifying framework that can be used with all existing repeater designs. We introduce the notion of a Quantum Recursive Network Architecture, developed from the emerging classical concept of 'recursive networks', extending recursive mechanisms from a focus on data forwarding to a more general distributed computing request framework. Recursion abstracts independent transit networks as single relay nodes, unifies software layer...

  4. Evaluation of quantitative accuracy in CZT-based pre-clinical SPECT for various isotopes

    Science.gov (United States)

    Park, S.-J.; Yu, A. R.; Kim, Y.-s.; Kang, W.-S.; Jin, S. S.; Kim, J.-S.; Son, T. J.; Kim, H.-J.

    2015-05-01

    In vivo pre-clinical single-photon emission computed tomography (SPECT) is a valuable tool for functional small animal imaging, but several physical factors, such as scatter radiation, limit the quantitative accuracy of conventional scintillation crystal-based SPECT. Semiconductor detectors such as CZT overcome these deficiencies through superior energy resolution. To our knowledge, little scientific information exists regarding the accuracy of quantitative analysis in CZT-based pre-clinical SPECT systems for different isotopes. The aim of this study was to assess the quantitative accuracy of CZT-based pre-clinical SPECT for four isotopes: 201Tl, 99mTc, 123I, and 111In. The quantitative accuracy of the CZT-based Triumph X-SPECT (Gamma-Medica Ideas, Northridge, CA, U.S.A.) was compared with that of a conventional SPECT using GATE simulation. Quantitative errors due to the attenuation and scatter effects were evaluated for all four isotopes with energy windows of 5%, 10%, and 20%. A spherical source containing the isotope was placed at the center of the air-or-water-filled mouse-sized cylinder phantom. The CZT-based pre-clinical SPECT was more accurate than the conventional SPECT. For example, in the conventional SPECT with an energy window of 10%, scatter effects degraded quantitative accuracy by up to 11.52%, 5.10%, 2.88%, and 1.84% for 201Tl, 99mTc, 123I, and 111In, respectively. However, with the CZT-based pre-clinical SPECT, the degradations were only 9.67%, 5.45%, 2.36%, and 1.24% for 201Tl, 99mTc, 123I, and 111In, respectively. As the energy window was increased, the quantitative errors increased in both SPECT systems. Additionally, the isotopes with lower energy of photon emissions had greater quantitative error. Our results demonstrated that the CZT-based pre-clinical SPECT had lower overall quantitative errors due to reduced scatter and high detection efficiency. Furthermore, the results of this systematic assessment quantifying the accuracy of these SPECT

  5. 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)

  6. Investigating the role of SPECT/CT in dynamic sentinel lymph node biopsy for penile cancers

    Energy Technology Data Exchange (ETDEWEB)

    Saad, Ziauddin Zia; Bomanji, Jamshed [University College Hospitals London, Department of Nuclear Medicine, London (United Kingdom); UCLH NHS Foundation Trust, Institute of Nuclear Medicine, 5th Floor, London (United Kingdom); Omorphos, Savvas; Malone, Peter; Nigam, Raj; Muneer, Asif [University College Hospitals London, Department of Urology, London (United Kingdom); Michopoulou, Sofia; Gacinovic, Svetislav [University College Hospitals London, Department of Nuclear Medicine, London (United Kingdom)

    2017-07-15

    Currently, most centres use 2-D planar lymphoscintigraphy when performing dynamic sentinel lymph node biopsy in penile cancer patients with clinically impalpable inguinal nodes. This study aimed to investigate the role of SPECT/CT following 2-D planar lymphoscintigraphy (dynamic and static) in the detection and localization of sentinel lymph nodes in the groin. A qualitative (visual) review was performed on planar followed by SPECT/CT lymphoscintigraphy in 115 consecutive patients (age 28-86 years) who underwent injection of {sup 99m}Tc-nanocolloid followed by immediate acquisition of dynamic (20 min) and early static scans (5 min) initially and further delayed static (5 min) images at 120 min followed by SPECT/CT imaging. The lymph nodes detected in each groin on planar lymphoscintigraphy and SPECT/CT were compared. A total of 440 and 467 nodes were identified on planar scintigraphy and SPECT/CT, respectively. Overall, SPECT/CT confirmed the findings of planar imaging in 28/115 cases (24%). In the remaining 87 cases (76%), gross discrepancies were observed between planar and SPECT/CT images. SPECT/CT identified 17 instances of skin contamination (16 patients, 13%) and 36 instances of in-transit lymphatic tract activity (24 patients, 20%) that had been interpreted as tracer-avid lymph nodes on planar imaging. In addition, SPECT/CT identified 53 tracer-avid nodes in 48 patients (42%) that were not visualized on planar imaging and led to reclassification of the drainage basins (pelvic/inguinal) of 27 tracer-avid nodes. The addition of SPECT/CT improved the rate of detection of true tracer-avid lymph nodes and delineated their precise (3-D) anatomic localization in drainage basins. (orig.)

  7. The role of Sesta-Mibi-SPECT in angiographically documented coronary heart disease. Zur Bedeutung der Sesta-Mibi-SPECT bei angiographisch dokumentierter koronarer Herzerkrankung

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, H. (Inst. fuer Nuklearmedizin, 1. Medizinische Klinik, Zentralklinikum Augsburg (Germany)); Graf, G. (Inst. fuer Nuklearmedizin, 1. Medizinische Klinik, Zentralklinikum Augsburg (Germany)); Krawietz, W. (Inst. fuer Nuklearmedizin, 1. Medizinische Klinik, Zentralklinikum Augsburg (Germany)); Bolte, H.D. (Inst. fuer Nuklearmedizin, 1. Medizinische Klinik, Zentralklinikum Augsburg (Germany)); Heidenreich, P. (Inst. fuer Nuklearmedizin, 1. Medizinische Klinik, Zentralklinikum Augsburg (Germany))

    1994-04-01

    131 patients were studied to compare the results of 99mTc-Mibi-SPECT with coronary angiography (CAG). 127 patients remained for final evaluation. A scar was falsely diagnosed in 17. 13 patients had a normal CAG and pathologic Sesta-Mibi-SPECT. 5 of them suffered from cardiomyopathy. 2 patients have had a myocarditis, at 2 others a PTCA was perfomred. 1 patient had a 20% LCA-stenosis and another one a left ventricular hypertrophy. Two times the reason for the pathologic Sesta-Mibi-SPECT could not be found. 1 patient had a normal Sesta-Mibi-SPECT despite of a pathologic CAG, angina pectoris and pathologic ECG. We got congruent results in 113 patients. 7 patients showed a left bundle branch block (LBBB), in 5 of them the Mibi-SPECT corresponded well with the CAG. 2 patients with dilated cardiomyopathy and no CHD showed an exercise induced ischemia in the anteroseptal wall. In patiens with angiographically documented CHD Sesta-Mibi-SPECT gives reliable diagnostic information concerning the myocardial perfusion. (orig./MG)

  8. [An approach for comparative quantification of myocardial blood flow (O-15-H2O-PET), perfusion (Tc-99m-tetrofosmin-SPECT) and metabolism (F-18-FDG-PET)].

    Science.gov (United States)

    Schäfer, W M; Nowak, B; Kaiser, H J; Block, S; Koch, K C; vom Dahl, J; Büll, U

    2001-10-01

    In the present study a new approach has been developed for comparative quantification of absolute myocardial blood flow (MBF), myocardial perfusion, and myocardial metabolism in short-axis slices. 42 patients with severe CAD, referred for myocardial viability diagnostics, were studied consecutively with 0-15-H2O PET (H2O-PET) (twice), Tc-99m-Tetrofosmin SPECT (TT-SPECT) and F-18-FDG PET (FDG-PET). All data sets were reconstructed using attenuation correction and reoriented into short axis slices. Each heart was divided into three representative slices (base, midventricular, apex) and 18 ROIs were defined on the FDG PET images and transferred to the corresponding H2O-PET and TT-SPECT slices. TT-SPECT and FDG-PET data were normalized to the ROI showing maximum perfusion. MBF was calculated for all left-ventricular ROIs using a single-compartment-model fitting the dynamic H2O-PET studies. Microsphere equivalent MBF (MBF_micr) was calculated by multiplying MBF and tissue-fraction, a parameter which was obtained by fitting the dynamic H2O-PET studies. To reduce influence of viability only well perfused areas (> 70% TT-SPECT) were used for comparative quantification. First and second mean global MBF values were 0.85 ml x min-1 x g-1 and 0.84 ml x min-1 x g-1, respectively, with a repeatability coefficient of 0.30 ml x min-1 x g-1. After sectorization mean MBF_micr was between 0.58 ml x min-1 x ml-1 and 0.68 ml x min-1 x ml-1 in well perfused areas. Corresponding TT-SPECT values ranged from 83% to 91%, and FDG-PET values from 91% to 103%. All procedures yielded higher values for the lateral than the septal regions. Comparative quantification of MBF, MBF_micr, TT-SPECT perfusion and FDG-PET metabolism can be done with the introduced method in short axis slices. The obtained values agree well with experimentally validated values of MBF and MBF_micr.

  9. 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.

  10. Impact of reconstruction parameters on quantitative I-131 SPECT

    Science.gov (United States)

    van Gils, C. A. J.; Beijst, C.; van Rooij, R.; de Jong, H. W. A. M.

    2016-07-01

    Radioiodine therapy using I-131 is widely used for treatment of thyroid disease or neuroendocrine tumors. Monitoring treatment by accurate dosimetry requires quantitative imaging. The high energy photons however render quantitative SPECT reconstruction challenging, potentially requiring accurate correction for scatter and collimator effects. The goal of this work is to assess the effectiveness of various correction methods on these effects using phantom studies. A SPECT/CT acquisition of the NEMA IEC body phantom was performed. Images were reconstructed using the following parameters: (1) without scatter correction, (2) with triple energy window (TEW) scatter correction and (3) with Monte Carlo-based scatter correction. For modelling the collimator-detector response (CDR), both (a) geometric Gaussian CDRs as well as (b) Monte Carlo simulated CDRs were compared. Quantitative accuracy, contrast to noise ratios and recovery coefficients were calculated, as well as the background variability and the residual count error in the lung insert. The Monte Carlo scatter corrected reconstruction method was shown to be intrinsically quantitative, requiring no experimentally acquired calibration factor. It resulted in a more accurate quantification of the background compartment activity density compared with TEW or no scatter correction. The quantification error relative to a dose calibrator derived measurement was found to be  Gaussian or no CDR modelling. Scatter correction showed a small effect on quantification of small volumes. When using a weighting factor, TEW correction was comparable to Monte Carlo reconstruction in all measured parameters, although this approach is clinically impractical since this factor may be patient dependent. Monte Carlo based scatter correction including accurately simulated CDR modelling is the most robust and reliable method to reconstruct accurate quantitative iodine-131 SPECT images.

  11. Impact of subcortical white matter lesions on dopamine transporter SPECT.

    Science.gov (United States)

    Funke, Elisabeth; Kupsch, Andreas; Buchert, Ralph; Brenner, Winfried; Plotkin, Michail

    2013-07-01

    Subcortical arteriosclerotic encephalopathy (SAE) can affect the nigrostriatal system and presumably cause vascular parkinsonism (VP). However, in patients with SAE, the differentiation of VP from idiopathic Parkinson's disease (IPS) is challenging. The aim of the present study was to examine the striatal dopamine transporter (DAT) density in patients with parkinsonism and SAE. Fifteen consecutive patients with parkinsonian symptoms displayed SAE, as detected by magnetic resonance imaging (MRI). Fifteen retrospectively chosen, matched patients with diagnosis of IPS without any abnormalities in MRI served as a reference group. DAT SPECT was performed using the tracer ¹²³I-FP-CIT. Scans were acquired on a triple-head SPECT system (Multispect 3, Siemens) and analysed using the investigator-independent BRASS™ software (HERMES). In the SAE group, a DAT deficit was observed in 9/15 patients. In contrast, all patients from the IPS group showed a reduced DAT binding (p = 0.008). The specific binding ratios (BR) of putamen contralateral to the side of the more affected limb versus occipital lobe were in trend higher in patients with SAE versus patients in the IPS-group (p = 0.053). Indices for putaminal asymmetry (p = 0.036) and asymmetry caudate-to-putamen (p = 0.026) as well as the ratio caudate-to-putamen (p = 0.048) were significantly higher in IPS patients having no SAE. DAT deficit was less pronounced in patients with SAE and parkinsonism than in patients with IPS without any abnormalities in the MRI. A potential role of DAT SPECT in the differential diagnosis of VP and IPS requires more assessments within prospective studies.

  12. Molecular imaging of cancer using PET and SPECT

    DEFF Research Database (Denmark)

    Kjaer, Andreas

    2006-01-01

    for molecular imaging of cancer. Especially the possibility of a quick transfer of methods developed in animals to patients (translational research) is an important strength. This article will briefly discuss the newest applications and their importance and perspective in relation to the shift in paradigm......Molecular imaging allows for the study of molecular and cellular events in the living intact organism. The nuclear medicine methodologies of positron emission tomography (PET) and single photon emission computer tomography (SPECT) posses several advantages, which make them particularly suited...

  13. Myocardial Perfusion Spect Imaging in Dextrocardia: A Case Report

    Directory of Open Access Journals (Sweden)

    Semra Özdemir

    2013-08-01

    Full Text Available The myocardial perfusion scintigraphy acquisition and analysis present some technical differences in the rare dextrocardia cases. Here we report a case of a 38 year-old woman with dextrocardia who had been applied myocardial perfusion scintigraphy. Presented case showed that the thoracic and abdominal organs had a mirror image with situs inversus totalis type dextrocardia. The incidence of coronary heart disease and life span of people with situs inversus totalis are the same as the normal population. So we may apply myocardial perfusion scintigraphy to this patient group. The current case is presented in order to remind the special applications of myocardial perfusion SPECT imaging in patients with dextrocardia.

  14. The neutron decay spectrometer aSPECT: Latest results

    Energy Technology Data Exchange (ETDEWEB)

    Wirth, Hans-Friedrich; Angerer, Heinz; Konorov, Igor; Petzoldt, Gerd; Simson, Martin; Zimmer, Oliver [Physik-Department, Technische Universtitaet Muenchen (Germany); Ayala Guardia, Fidel; Borg, Michael; Glueck, Ferenc; Heil, Werner; Konrad, Gertrud; Munoz Horta, Raquel; Sobolev, Yury [Institut fuer Physik, Universitaet Mainz (Germany); Baessler, Stefan [Department of Physics, University of Virginia, Charlottesville (United States); Eberhardt, Klaus [Institut fuer Kernchemie, Universitaet Mainz (Germany)

    2008-07-01

    The neutron decay spectrometer aSPECT was designed to measure accurately the proton spectrum of the free neutron decay. The knowledge of the proton spectrum allows to extract the neutrino electron angular correlation coefficient a, from which we will determine with highest accuracy the ratio {lambda}= g{sub A}/g{sub V} of the weak coupling constants of the nucleon. After successful beamtimes in 2005/06 at the FRM-II near Munich we continue the measurements at the ILL in Grenoble. Latest results and experiences with a new proton detector, which is a silicon drift detector, are presented.

  15. High Sensitivity SPECT for Small Animals and Plants

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Gregory S. [UC Davis

    2015-02-28

    Imaging systems using single gamma-ray emitting radioisotopes typically implement collimators in order to form the images. However, a tradeoff in sensitivity is inherent in the use of collimators, and modern preclinical single-photon emission computed tomography (SPECT) systems detect a very small fraction of emitted gamma-rays (<0.3%). We have built a collimator-less system, which can reach sensitivity of 40% for 99mTc imaging, while still producing images of sufficient spatial resolution for certain applications in thin objects such as mice, small plants, and well plates used for in vitro experiments.

  16. Robin Hood caught in Wonderland: brain SPECT findings.

    Science.gov (United States)

    Morland, David; Wolff, Valérie; Dietemann, Jean-Louis; Marescaux, Christian; Namer, Izzie Jacques

    2013-12-01

    We present the case of a 53-year-old woman presenting several episodes of body image distortions, ground deformation illusions, and problems assessing distance in the orthostatic position corresponding to the Alice in Wonderland syndrome. No symptoms were reported when sitting or lying down. She had uncontrolled hypertension, hyperglycemia, hypercholesterolemia, and a history of head trauma. Her condition had been diagnosed with left internal carotid artery dissection 2 years earlier. Brain SPECT with 99mTc-ECD performed after i.v. injection of the radiotracer in supine and in standing positions showed hypoperfusion in the healthy contralateral frontoparietal operculum (Robin Hood syndrome), deteriorating when standing up.

  17. The Pentapeptide Repeat Proteins

    Energy Technology Data Exchange (ETDEWEB)

    Vetting,M.; Hegde, S.; Fajardo, J.; Fiser, A.; Roderick, S.; Takiff, H.; Blanchard, J.

    2006-01-01

    The Pentapeptide Repeat Protein (PRP) family has over 500 members in the prokaryotic and eukaryotic kingdoms. These proteins are composed of, or contain domains composed of, tandemly repeated amino acid sequences with a consensus sequence of [S, T,A, V][D, N][L, F]-[S, T,R][G]. The biochemical function of the vast majority of PRP family members is unknown. The three-dimensional structure of the first member of the PRP family was determined for the fluoroquinolone resistance protein (MfpA) from Mycobacterium tuberculosis. The structure revealed that the pentapeptide repeats encode the folding of a novel right-handed quadrilateral {beta}-helix. MfpA binds to DNA gyrase and inhibits its activity. The rod-shaped, dimeric protein exhibits remarkable size, shape and electrostatic similarity to DNA.

  18. Repeating the Past

    Science.gov (United States)

    Moore, John W.

    1998-05-01

    As part of the celebration of the Journal 's 75th year, we are scanning each Journal issue from 25, 50, and 74 years ago. Many of the ideas and practices described are so similar to present-day "innovations" that George Santayana's adage (1) "Those who cannot remember the past are condemned to repeat it" comes to mind. But perhaps "condemned" is too strong - sometimes it may be valuable to repeat something that was done long ago. One example comes from the earliest days of the Division of Chemical Education and of the Journal.

  19. Impact of SPECT/CT in imaging inflammation and infection; Wertigkeit der SPECT/CT fuer die nuklearmedizinische Entzuendungsdiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Linke, R. [Klinikum Bremen-Mitte, Bremen (Germany). Klinik fuer Nuklearmedizin; Kuwert, T. [Erlangen-Nuernberg Univ., Erlangen (Germany). Nuklearmedizinische Klinik mit Poliklinik

    2011-03-15

    Even today infection remains a significant concern, and the diagnosis and localization of infectious foci is an important health issue. As an established infection-imaging modality, nuclear medicine plays a vital health-care role in the diagnosis and subsequent effective treatment of this condition. Several techniques in nuclear medicine significantly aid infection diagnosis, including triple-phase bone scanning, {sup 18}F-FDG-PET and imaging with {sup 111}In-oxine-, {sup 99m}Tc-HMPAO-labeled leukocytes. Each radiopharmaceutical has specific advantages and disadvantages that makes it suitable to diagnose different infectious processes (e.g., soft-tissue sepsis, inflammatory bowel disease, osteomyelitis, occult fever, fever of unknown origin, and infections commonly found in immuno-compromised patients). However, their clinical applications may be limited by the relatively low spatial resolution and the lack of anatomic landmarks of a highly specific tracer with only scarce background uptake to use as a framework for orientation. Anatomic imaging modalities such as CT provide a high-quality assessment of structural abnormalities related to infection, but these structural abnormalities may be unspecific. Furthermore, to detect infection before anatomical changes are present, functional imaging could have some advantages over anatomical imaging. Scintigraphic studies have demonstrated high sensitivity and specificity to an infectious process. Diagnosis and precise delineation of infection may be challenging in certain clinical scenarios, rendering decisions concerning further patient management difficult. The SPECT/CT-technology combines the acquisition of SPECT and CT data with the same imaging device enabling perfect overlay of anatomical and functional images. SPECT/CT imaging data has been shown to be beneficial for many clinical settings such as indeterminate findings in bone scintigraphy, orthopaedic disorders, endocrine, and neuroendocrine tumors. Therefore

  20. 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.

  1. /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.

  2. The usefulness of myocardial SPECT for the preoperative cardiac risk evaluation in noncardiac surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Lee, Dong Soo; Kang, Won Jon; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-02-01

    We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. 118 patients ( M: F=66: 52, 62.7{+-}10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest Tl-201/ stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heat failure and unstable angina) were surveyed through perioperative periods (14.6{+-}5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.

  3. [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).

  4. SPECT with N-isopropyl-p iodoamphetamine in occlusive cerebrovascular diseases.

    Science.gov (United States)

    Higa, T; Tanaka, T; Ikekubo, K; Komatsu, T; Torizuka, K

    1986-12-01

    The role of SPECT imaging with N-isopropyl-p iodoamphetamine (I-123 IMP) in the detection of angiographically documented occlusive cerebrovascular diseases was evaluated in 24 patients, and the results of regional cerebral blood flow (rCBF) were compared with x-ray CT. Twelve patients had internal carotid occlusion, ten had intracranial occlusion beyond the circle of Willis, one had common carotid occlusion, and one had basilar artery occlusion. SPECT images were obtained with a gamma camera, which was rotated 360 degrees around the patient's head 30 minutes after an intravenous injection of 3 mCi of I-123 IMP. CT images in the transverse plane were obtained, and the regions of reduced attenuation were identified for comparison of topographic extension of the lesion with the regions of decreased rCBF seen on SPECT. In six cases, the lesions seen on the SPECT images were distinctly more extensive than those seen on CT. In the remaining 18 cases, the extent of the lesion was identical on both CT and SPECT images. Radiochemical and radionuclide impurities, the distance of the detector from the head, and the nature of the collimator affected the SPECT results. I-123 IMP SPECT imaging complements CT findings in detecting the ischemic zones beyond the regions identified on CT images, and may have a major rule in the management of patients with occlusive cerebrovascular diseases.

  5. A single CdZnTe detector for simultaneous CT/SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Barber, W.C. E-mail: bill@barber.uscf.edu; Iwata, Koji; Hasegawa, B.H.; Bennett, P.R.; Cirignano, L.J.; Shah, K.S

    2003-06-01

    Clinical CT/SPECT systems acquire CT and SPECT data sequentially using different detectors in close proximity to minimise patient movement and interscan delay. We have developed a prototype simultaneous CT/SPECT imager, using a single CdZnTe detector, with the goal of improving image coregistration and decreasing scan time. A 16-pixel CdZnTe detector was operated in pulse-counting mode with 50 ns shaping time. Energy discrimination is used to separate the CT and SPECT data. Simultaneous SPECT and CT images were obtained for a phantom with the X-ray flux limited to reduce pulse pile-up in the radionuclide energy window. At 140 keV, the efficiency and energy resolution are 70% and 10%, respectively, and were constant for fluence rates up to 10{sup 3} cps per detector element for 140 keV gamma rays, but degrade rapidly at higher fluence rates. In pulse-counting mode, the maximum count rate of 10{sup 3} cps per element from the CdZnTe detector is sufficient for SPECT imaging, but is considerably lower than the fluence rates encountered in CT. The smallest lesion visually detectable in SPECT is 9 mm and the CT spatial resolution is smaller than 4.5 mm. Image registration is intrinsic because the data can be acquired simultaneously with a single detector with the same reconstruction geometry.

  6. All-optical repeater.

    Science.gov (United States)

    Silberberg, Y

    1986-06-01

    An all-optical device containing saturable gain, saturable loss, and unsaturable loss is shown to transform weak, distorted optical pulses into uniform standard-shape pulses. The proposed device performs thresholding, amplification, and pulse shaping as required from an optical repeater. It is shown that such a device could be realized by existing semiconductor technology.

  7. Bidirectional Manchester repeater

    Science.gov (United States)

    Ferguson, J.

    1980-01-01

    Bidirectional Manchester repeater is inserted at periodic intervals along single bidirectional twisted pair transmission line to detect, amplify, and transmit bidirectional Manchester 11 code signals. Requiring only 18 TTL 7400 series IC's, some line receivers and drivers, and handful of passive components, circuit is simple and relatively inexpensive to build.

  8. Radiotracers for PET and SPECT studies of neurotransmitter systems

    Energy Technology Data Exchange (ETDEWEB)

    Fowler, J.S.

    1991-01-01

    The study of neurotransmitter systems is one of the major thrusts in emission tomography today. The current generation of Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) radiotracers examines neurotransmitter properties from a number of different perspectives including their pre and post synaptic sites and the activity of the enzymes which regulate their concentration. Although the dopamine system has been the most extensively investigated, other neurotransmitter systems including the acetylcholine muscarine, serotonin, benzodiazepine, opiate, NMDA and others are also under intensive development. Enzymes involved in the synthesis and regulation of neurotransmitter concentration, for example monoamine oxidase and amino acid decarboxylase has also been probed in vivo. Medical applications range from the study of normal function and the characterization of neurotransmitter activity in neurological and psychiatric diseases and in heart disease and cancer to the study of the binding of therapeutic drugs and substances of abuse. This chapter will provide an overview of the current generation of radiotracers for PET and SPECT studies of neurotransmitter systems including radiotracer design, synthesis localization mechanisms and applications in emission tomography. 60 refs., 1 tab.

  9. Applications of SPECT imaging of dopaminergic neurotransmission in neuropsychiatric disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kugaya, Akira; Fujita, Masahiro; Innis, R.B. [Yale Univ., New Haven, CT (United States). School of Medicine

    2000-02-01

    Single photon emission computed tomography (SPECT) tracers selective for pre- and post-synaptic targets have allowed measurements of several aspects of dopaminergic (DA) neurotransmission. In this article, we will first review our DA transporter imaging in Parkinson's disease. We have developed the in vivo dopamine transporter (DAT) imaging with [{sup 123}I]{beta}-CIT ((1R)-2{beta}-Carbomethoxy-3{beta}-(4-iodophenyl)tropane). This method showed that patients with Parkinson's disease have markedly reduced DAT levels in striatum, which correlated with disease severity and disease progression. Second, we applied DA imaging techniques in patients with schizophrenia. Using amphetamine as a releaser of DA, we observed the enhanced DA release, which was measured by imaging D2 receptors with [{sup 123}I]IBZM (iodobenzamide), in schizophrenics. Further we developed the measurement of basal synaptic DA levels by AMPT (alpha-methyl-paratyrosine)-induced unmasking of D2 receptors. Finally, we expanded our techniques to the measurement of extrastriatal DA receptors using [{sup 123}I]epidepride. The findings suggest that SPECT is a useful technique to measure DA transmission in human brain and may further our understanding of the pathophysiology of neuropsychiatric disorders. (author)

  10. First measurements with the neutron decay spectrometer aSPECT

    Energy Technology Data Exchange (ETDEWEB)

    Baessler, S.; Ayala Guardia, F.; Borg, M.; Heil, W.; Konrad, G.; Munoz Horta, R.; Sobolev, Yu. [Universitaet Mainz, Institut fuer Physik, Mainz (Germany); Glueck, F. [IEKP, Universitaet Karlsruhe, Karlsruhe (Germany); Theory Department, Research Institute for Nuclear and Particle Physics, Budapest 114 (Hungary); Konorov, I.; Petzoldt, G.; Simson, M.; Wirth, H.F.; Zimmer, O. [Physik-Department, Technische Universitaet Muenchen, Garching (Germany); Rich, D. [Forschungsneutronenquelle Heinz Maier-Leibnitz, Garching (Germany)

    2008-10-15

    The neutron decay spectrometer aSPECT has been built to perform a precise measurement of the proton spectrum shape in the decay of free neutrons. Such a measurement allows a determination of the neutrino electron angular-correlation coefficient a. The present best experiments have an uncertainty of {delta}a/a=5% and since the seventies there is no substantial improvement. With aSPECT, we aim for an uncertainty which is lower by more than an order of magnitude, thus enabling us to perform several precise tests of the Standard Model. In our first beam time at the particle physics beam MEPHISTO at the Forschungsneutronenquelle Heinz Maier-Leibnitz, we studied the properties of the spectrometer. The most serious problem turned out to be the situation- and time-dependent behavior of the background. From the data sets from this beam time in which a background problem was not obvious, we could extract a value of a=-0.1151{+-}0.0040{sup stat}, but we could not quantify the background uncertainty. We show ways to deal with the background and other problems for future beam times. (orig.)

  11. First measurements with the neutron decay spectrometer a SPECT

    Science.gov (United States)

    Baeßler, S.; Ayala Guardia, F.; Borg, M.; Glück, F.; Heil, W.; Konrad, G.; Konorov, I.; Muñoz Horta, R.; Petzoldt, G.; Rich, D.; Simson, M.; Sobolev, Yu.; Wirth, H.-F.; Zimmer, O.

    2008-10-01

    The neutron decay spectrometer a SPECT has been built to perform a precise measurement of the proton spectrum shape in the decay of free neutrons. Such a measurement allows a determination of the neutrino electron angular-correlation coefficient a . The present best experiments have an uncertainty of Δ a/ a = 5% and since the seventies there is no substantial improvement. With a SPECT, we aim for an uncertainty which is lower by more than an order of magnitude, thus enabling us to perform several precise tests of the Standard Model. In our first beam time at the particle physics beam MEPHISTO at the Forschungsneutronenquelle Heinz Maier-Leibnitz, we studied the properties of the spectrometer. The most serious problem turned out to be the situation- and time-dependent behavior of the background. From the data sets from this beam time in which a background problem was not obvious, we could extract a value of a = - 0.1151±0.0040stat , but we could not quantify the background uncertainty. We show ways to deal with the background and other problems for future beam times.

  12. Myocardial Perfusion SPECT Imaging in Patients after Percutaneous Coronary Intervention.

    Science.gov (United States)

    Georgoulias, Panagiotis; Valotassiou, Varvara; Tsougos, Ioannis; Demakopoulos, Nikolaos

    2010-05-01

    Coronary artery disease (CAD) is the most prevalent form of cardiovascular disease affecting about 13 million Americans, while more than one million percutaneous transluminal intervention (PCI) procedures are performed annually in the USA. The relative high occurrence of restenosis, despite stent implementation, seems to be the primary limitation of PCI. Over the last decades, single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), has proven an invaluable tool for the diagnosis of CAD and patients' risk stratification, providing useful information regarding the decision about revascularization and is well suited to assess patients after intervention. Information gained from post-intervention MPI is crucial to differentiate patients with angina from those with exo-cardiac chest pain syndromes, to assess peri-intervention myocardial damage, to predict-detect restenosis after PCI, to detect CAD progression in non-revascularized vessels, to evaluate the effects of intervention if required for occupational reasons and to evaluate patients' long-term prognosis. On the other hand, chest pain and exercise electrocardiography are largely unhelpful in identifying patients at risk after PCI.Although there are enough published data demonstrating the value of myocardial perfusion SPECT imaging in patients after PCI, there is still debate on whether or not these tests should be performed routinely.

  13. Sequential MRI, SPECT and PET in respiratory syncytial virus encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Hirayama, K.; Sakazaki, Hiromi; Murakami, Seiko; Yonezawa, Sumiko [Department of Paediatrics, Izumi Municipal Hospital, Osaka (Japan); Fujimoto, Keiji [Dept. of Radiology, Izumi Municipal Hospital, Osaka (Japan); Seto, Toshiyuki; Tanaka, Katsuji; Hattori, Hideji; Matsuoka, Osamu [Dept. of Paediatrics, Osaka City University Medical School, Osaka (Japan); Murata, Ryosuke [Children`s Medical Centre, Osaka City General Hospital, Osaka (Japan)

    1999-04-01

    We report on a 3-year-old girl with respiratory syncytial virus (RSV) encephalitis manifested by disturbance of consciousness, conjugate eye deviation, anuria, truncal ataxia and intention tremor. T2-weighted magnetic resonance imaging (MRI) showed hyperintense areas in the cerebellar cortex. No lesion was detected in the cerebral cortex, pons or spinal cord. The hyperintense areas in the cerebellar cortex diminished with recovery from the clinical manifestations and had resolved 2 months after onset. The MRI lesions in the cerebellum were considered to be due to oedema. SPECT and positron emission tomography (PET), performed 3 months after onset, disclosed areas of hypoperfusion and hypometabolism at the same sites. One year after onset, MRI showed mild atrophy of the cerebellum. Hypoperfusion on SPECT and hypometabolism on PET remained. Neuroimaging showed that ataxia and tremor in this case were the result of cerebellitis. The patient has no neurological deficit except for mild truncal ataxia. This patient is a rare example of RSV encephalitis. (orig.) With 4 figs., 16 refs.

  14. aSPECT - Measuring the proton spectrum in neutron decay

    Energy Technology Data Exchange (ETDEWEB)

    Simson, Martin; Leung, Kent; Zimmer, Oliver [Institut Laue-Langevin, Grenoble (France); Physik-Department E18, TU, Muenchen (Germany); Ayala Guardia, Fidel; Borg, Michael; Heil, Werner; Konrad, Gertrud; Munoz Horta, Raquel; Sobolev, Yury [Institut fuer Physik, Universitaet Mainz (Germany); Baessler, Stefan [University of Virginia, Charlottesville, VA (United States); Glueck, Ferenc [IEKP, Universitaet Karlsruhe (Germany); Konorov, Igor [Physik-Department E18, TU, Muenchen (Germany); Soldner, Torsten [Institut Laue-Langevin, Grenoble (France); Wirth, Hans-Friedrich [Fakultaet fuer Physik, LMU, Muenchen (Germany)

    2009-07-01

    With the aSPECT spectrometer we measure the proton recoil spectrum in the decay of the free neutron. Its shape depends on the angular correlation between the momenta of the antineutrino and electron for kinematic reasons. A precision measurement of this correlation coefficient a allows to test the unitarity of the CKM matrix and provides limits on the existence of scalar and tensor currents. aSPECT is a retardation spectrometer, i.e. the proton recoil spectrum is measured by counting all decay protons that overcome a potential barrier. By varying the height of the barrier the shape of the proton spectrum can be reconstructed. After the barrier the protons are accelerated to {proportional_to}15 keV and detected by a silicon drift detector. Unpolarized cold neutrons are guided through the decay volume of the spectrometer where a fraction of them decays. The recoil protons produced in these decays are guided to the detector by magnetic field lines. In the last beam time a statistical accuracy of about 2 % per 24 hours measurement time was reached, the total error is expected to be well below 5 %. Details of the spectrometer setup as well as the status of the ongoing data analysis are presented in the talk.

  15. Simultaneous reconstruction and segmentation for dynamic SPECT imaging

    Science.gov (United States)

    Burger, Martin; Rossmanith, Carolin; Zhang, Xiaoqun

    2016-10-01

    This work deals with the reconstruction of dynamic images that incorporate characteristic dynamics in certain subregions, as arising for the kinetics of many tracers in emission tomography (SPECT, PET). We make use of a basis function approach for the unknown tracer concentration by assuming that the region of interest can be divided into subregions with spatially constant concentration curves. Applying a regularised variational framework reminiscent of the Chan-Vese model for image segmentation we simultaneously reconstruct both the labelling functions of the subregions as well as the subconcentrations within each region. Our particular focus is on applications in SPECT with the Poisson noise model, resulting in a Kullback-Leibler data fidelity in the variational approach. We present a detailed analysis of the proposed variational model and prove existence of minimisers as well as error estimates. The latter apply to a more general class of problems and generalise existing results in literature since we deal with a nonlinear forward operator and a nonquadratic data fidelity. A computational algorithm based on alternating minimisation and splitting techniques is developed for the solution of the problem and tested on appropriately designed synthetic data sets. For those we compare the results to those of standard EM reconstructions and investigate the effects of Poisson noise in the data.

  16. New SPECT and PET Radiopharmaceuticals for Imaging Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Oyebola O. Sogbein

    2014-01-01

    Full Text Available Nuclear cardiology has experienced exponential growth within the past four decades with converging capacity to diagnose and influence management of a variety of cardiovascular diseases. Single photon emission computed tomography (SPECT myocardial perfusion imaging (MPI with technetium-99m radiotracers or thallium-201 has dominated the field; however new hardware and software designs that optimize image quality with reduced radiation exposure are fuelling a resurgence of interest at the preclinical and clinical levels to expand beyond MPI. Other imaging modalities including positron emission tomography (PET and magnetic resonance imaging (MRI continue to emerge as powerful players with an expanded capacity to diagnose a variety of cardiac conditions. At the forefront of this resurgence is the development of novel target vectors based on an enhanced understanding of the underlying pathophysiological process in the subcellular domain. Molecular imaging with novel radiopharmaceuticals engineered to target a specific subcellular process has the capacity to improve diagnostic accuracy and deliver enhanced prognostic information to alter management. This paper, while not comprehensive, will review the recent advancements in radiotracer development for SPECT and PET MPI, autonomic dysfunction, apoptosis, atherosclerotic plaques, metabolism, and viability. The relevant radiochemistry and preclinical and clinical development in addition to molecular imaging with emerging modalities such as cardiac MRI and PET-MR will be discussed.

  17. SPECT reconstruction using DCT-induced tight framelet regularization

    Science.gov (United States)

    Zhang, Jiahan; Li, Si; Xu, Yuesheng; Schmidtlein, C. R.; Lipson, Edward D.; Feiglin, David H.; Krol, Andrzej

    2015-03-01

    Wavelet transforms have been successfully applied in many fields of image processing. Yet, to our knowledge, they have never been directly incorporated to the objective function in Emission Computed Tomography (ECT) image reconstruction. Our aim has been to investigate if the ℓ1-norm of non-decimated discrete cosine transform (DCT) coefficients of the estimated radiotracer distribution could be effectively used as the regularization term for the penalized-likelihood (PL) reconstruction, where a regularizer is used to enforce the image smoothness in the reconstruction. In this study, the ℓ1-norm of 2D DCT wavelet decomposition was used as a regularization term. The Preconditioned Alternating Projection Algorithm (PAPA), which we proposed in earlier work to solve penalized likelihood (PL) reconstruction with non-differentiable regularizers, was used to solve this optimization problem. The DCT wavelet decompositions were performed on the transaxial reconstructed images. We reconstructed Monte Carlo simulated SPECT data obtained for a numerical phantom with Gaussian blobs as hot lesions and with a warm random lumpy background. Reconstructed images using the proposed method exhibited better noise suppression and improved lesion conspicuity, compared with images reconstructed using expectation maximization (EM) algorithm with Gaussian post filter (GPF). Also, the mean square error (MSE) was smaller, compared with EM-GPF. A critical and challenging aspect of this method was selection of optimal parameters. In summary, our numerical experiments demonstrated that the ℓ1-norm of discrete cosine transform (DCT) wavelet frame transform DCT regularizer shows promise for SPECT image reconstruction using PAPA method.

  18. Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT/CT

    Directory of Open Access Journals (Sweden)

    Otakar Kraft

    2012-08-01

    Full Text Available Objective: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN detection in patients with gynecologic tumours. Material and Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 64 consecutive women with gynecologic tumours (mean age 53.6 with range 30-77 years: 36 pts with cervical cancer (Group A, 21 pts with endometrial cancer (Group B, 7 pts with vulvar carcinoma (Group C. Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Efficacy of these two techniques to image SLN were compared. Results: Planar scintigraphy did not image SLN in 7 patients (10.9%, SPECT/CT was negative in 4 patients (6.3%. In 35 (54.7% patients the number of SLNs captured on SPECT/CT was higher than on planar imaging. Differences in detection of SLN between planar and SPECT/CT imaging in the group of all 64 patients are statistically significant (p<0.05. Three foci of uptake (1.7% from totally visible 177 foci on planar images in 2 patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT. SPECT/CT showed the exact anatomical location of all visualised sentinel nodes. Conclusion: In some patients with gynecologic cancers SPECT/CT improves detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localise pelvic and paraaortal SLNs. It improves anatomic localization of SLNs. (MIRT 2012;21:47-55

  19. V/P SPECT as a diagnostic tool for pregnant women with suspected pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Bajc, Marika; Olsson, Berit; Joegi, Jonas [Skaane University Hospital and Lund University, Clinical Physiology and Nuclear Medicine, Lund (Sweden); Gottsaeter, Anders [Skaane University Hospital, Vascular Diseases, Malmoe (Sweden); Hindorf, Cecilia [Skaane University Hospital, Radiation Physics, Lund (Sweden)

    2015-07-15

    The purpose of the study was to assess the prevalence of pulmonary embolism (PE) and other lung diseases among pregnant women with suspected PE and to calculate the radiation exposure to patient and fetus in this population. As a secondary aim, we evaluated the negative predictive value of a normal ventilation/perfusion single photon emission computed tomography (V/P SPECT) examination in pregnancy. We studied all 127 pregnant women who had suspected PE and had undergone V/P SPECT at our institution in the course of a 5-year period. Radiation exposure to patient and fetus and the negative predictive value of a normal V/P SPECT examination were also measured. V/P SPECT identified PE in 11 women (9 %). Moreover, in 15 women (12 %) the examination revealed pneumonia (in 2 cases in addition to PE) and in 1 woman signs of airway obstruction were revealed. Among the 116/127 women (91 %) where PE was ruled out by V/P SPECT, none was diagnosed subsequently with PE or deep venous thrombosis (DVT) during the same pregnancy or puerperal period. For P SPECT, the calculated fetal absorbed dose was < 0.6 mGy,and the calculated breast absorbed dose 0.6 mGy. For V SPECT, the calculated fetal absorbed dose was < 0.014 mGy and the breast absorbed dose 0.25 mGy. The prevalence of PE was low (9 %) among pregnant women with suspected disease. Pneumonia was diagnosed in 12 % of patients. The negative predictive value of V/P SPECT was high, and the radiation exposure from V/P SPECT was low both for fetus and patient. (orig.)

  20. Onboard functional and molecular imaging: A design investigation for robotic multipinhole SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Bowsher, James, E-mail: james.bowsher@duke.edu; Giles, William; Yin, Fang-Fang [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 and Medical Physics Graduate Program, Duke University, Durham, North Carolina 27710 (United States); Yan, Susu [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27710 (United States); Roper, Justin [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 (United States)

    2014-01-15

    Purpose: Onboard imaging—currently performed primarily by x-ray transmission modalities—is essential in modern radiation therapy. As radiation therapy moves toward personalized medicine, molecular imaging, which views individual gene expression, may also be important onboard. Nuclear medicine methods, such as single photon emission computed tomography (SPECT), are premier modalities for molecular imaging. The purpose of this study is to investigate a robotic multipinhole approach to onboard SPECT. Methods: Computer-aided design (CAD) studies were performed to assess the feasibility of maneuvering a robotic SPECT system about a patient in position for radiation therapy. In order to obtain fast, high-quality SPECT images, a 49-pinhole SPECT camera was designed which provides high sensitivity to photons emitted from an imaging region of interest. This multipinhole system was investigated by computer-simulation studies. Seventeen hot spots 10 and 7 mm in diameter were placed in the breast region of a supine female phantom. Hot spot activity concentration was six times that of background. For the 49-pinhole camera and a reference, more conventional, broad field-of-view (FOV) SPECT system, projection data were computer simulated for 4-min scans and SPECT images were reconstructed. Hot-spot localization was evaluated using a nonprewhitening forced-choice numerical observer. Results: The CAD simulation studies found that robots could maneuver SPECT cameras about patients in position for radiation therapy. In the imaging studies, most hot spots were apparent in the 49-pinhole images. Average localization errors for 10-mm- and 7-mm-diameter hot spots were 0.4 and 1.7 mm, respectively, for the 49-pinhole system, and 3.1 and 5.7 mm, respectively, for the reference broad-FOV system. Conclusions: A robot could maneuver a multipinhole SPECT system about a patient in position for radiation therapy. The system could provide onboard functional and molecular imaging with 4-min

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  2. Noninvasive Nuclear SPECT Myocardial Blood Flow Quantitation to Guide Management for Coronary Artery Disease.

    Science.gov (United States)

    Chen, Lung-Ching; Jong, Bor-Hsin; Lin, Sheng-Che; Ku, Chi-Tai; Chen, Ing-Jou; Chen, Yen-Kung; Hsu, Bailing

    2017-09-01

    Recently, myocardial blood flow quantitation with dynamic SPECT has been validated to enhance the detection of multivessel coronary artery disease (CAD) and conclude equivocal SPECT myocardial perfusion study. This advance opened an important clinical application to utilize the tool in guiding CAD management for area where myocardial perfusion tracers for PET are unavailable or unaffordable. We present a clinical patient with ongoing recursive angina who underwent multiple nuclear stress tests for a sequence of CAD evaluation in 26 months and demonstrated that SPECT myocardial blood flow quantitation properly guided CAD management to warrant patient outcome.

  3. Brain PET and technetium-99m-ECD SPECT imaging in Lhermitte-Duclos disease

    Energy Technology Data Exchange (ETDEWEB)

    Ogasawara, K.; Yasuda, S.; Beppu, T.; Kobayashi, M.; Doi, M.; Kuroda, K.; Ogawa, A. [Dept. of Neurosurgery, Iwate Medical Univ., Morioka (Japan)

    2001-11-01

    Two patients with Lhermitte-Duclos disease were evaluated by brain positron emission tomography (PET) and technetium-99m-ethyl cysteinate dimer ({sup 99m}Tc-ECD) single-photon emission computed tomography (SPECT). In the lesions in both patients, hyperperfusion was detected on cerebral blood flow images obtained by PET, and hyperactivity by standard {sup 99m}Tc-ECD SPECT. Dynamic {sup 99m}Tc-ECD SPECT images demonstrated a plateau of activity in each lesion. These findings suggest that lesions in Lhermitte-Duclos disease have a retention mechanism for {sup 99m}Tc-ECD equivalent to that of normal neural tissue. (orig.)

  4. Lung function assessment using Xe-133 dynamic SPECT in dual-camera system

    Energy Technology Data Exchange (ETDEWEB)

    Sakaji, Katsuyuki; Akiyama, Masayuki; Nakazawa, Yasuo [Showa Univ., Tokyo (Japan). Hospital; Umeda, Hirotaka; Takenaka, Haruki; Shinozuka, Akira

    2001-09-01

    The purpose of this study was to estimate lung regional function using Xe-133 dynamic SPECT. SPECT equipment with a dual camera was used. Fourteen rotation acquisitions were obtained beginning immediately after Xe-133 gas inhalation. The time activity curve of each pixel was obtained, and T{sub 1/2} of the washout phase was calculated and mapped. Residual radioactivity was evaluated. Adequate images could be obtained at 30 seconds per rotation even with the dual-camera system. Mapping of T{sub 1/2} allowed temporal changes on one image. Three-dimensional evaluation could be made on a SPECT system using our method. (author)

  5. Sequential sup 123 I-IMP-SPECT in acute infantile hemiplegia

    Energy Technology Data Exchange (ETDEWEB)

    Shirasaka, Y.; Ito, M.; Okuno, T.; Fujii, T.; Mikawa, H. (Kyoto Univ. (Japan))

    1989-09-01

    Sequential {sup 123}I-N-isopropyl-p-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) was performed in 2 patients with acute infantile hemiplegia. In both patients, low uptake of IMP was detected in the targeted abnormal hemisphere. The {sup 123}I-IMP-SPECT findings indicative of a pathologic condition persisted even when the clinical findings and electroencephalographic abnormalities improved. Because of its sensitivity, noninvasiveness, and accurate reflection of the cerebral blood flow distribution, {sup 123}I-IMP-SPECT is useful in the examination of acute infantile hemiplegia and in the evaluation of prognosis.

  6. Contribution of V/Q SPECT to planar scintigraphy in the diagnosis of pulmonary embolism.

    Science.gov (United States)

    Quirce, R; Ibáñez-Bravo, S; Jiménez-Bonilla, J; Martínez-Rodríguez, I; Martínez-Amador, N; Ortega-Nava, F; Lavado-Pérez, C; Bravo-Ferrer, Z; Carril, J M

    2014-01-01

    To evaluate the feasibility of V/Q SPECT and analyze its contribution to planar V/Q lung scintigraphy in the diagnosis of pulmonary embolism (PE). A total of 109 patients with suspected PE showing Wells score>2 and elevated D-dimer were studied. The V/Q could not be completed in 7 patients, so they were excluded. Ventilation and perfusion scans were done using Technegas and (99m)Tc-MAA. Planar study included 8 projections on a 256×256 matrix and 128 projections on a 128×128 matrix were acquired for the SPECT study, applying an iterative method. Planar images were interpreted according to modified PIOPED criteria, and SPECT by the guidelines of the EANMMI. The results with both techniques were compared. V/Q planar scintigraphy and SPECT could be performed in 102 patients. V/Q planar scintigraphy was considered "diagnostic" in 39 of the 102 patients, and "non-diagnostic" in 63. Of the 39 "diagnostic" studies, 31 were reported as high probability of PE and 8 as normal. Of the 63 "non-diagnostic", 26 corresponded to intermediate, 29 to low, and 8 to very low probability. The SPECT study was "diagnostic" in 97 and indeterminate in only 5. All patients with a high probability planar scintigraphy had a positive SPECT. In the 8 patients with a normal planar scintigraphy SPECT was negative in 5 and positive in 3. In the 63 patients with a "non-diagnostic" planar scintigraphy SPECT was "diagnostic" in 58 of them, positive in 17 and negative in 41. V/Q SPECT is a feasible technique as it was performed in 102 of the 109 patients who were enrolled in the study (94%). The addition of V/Q SPECT to planar V/Q decreases the number of "non-diagnostic" reports from 62% in planar scintigraphy to 4.9% in SPECT. Therefore, V/Q SPECT should be included in the diagnosis approach of PE due to its high diagnostic yield. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  7. Development of a high-resolution detection module for the INSERT SPECT/MRI system

    Energy Technology Data Exchange (ETDEWEB)

    Busca, Paolo; Fiorini, Carlo; Butt, Arslan D; Occhipinti, Michele; Quaglia, Riccardo; Trigilio, Paolo [Politecnico di Milano, Dipartimento di Elettronica, Informazione e Bioingegneria, Via Golgi 40, 20133 Milano (Italy); Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Via Celoria 16, 20133 Milano (Italy); Nemeth, Gabor; Major, Peter; Bukki, Tamas; Nagy, Kalman [Mediso Medical Imaging Systems, Alsotorokvesz 14, H-1022 Budapest (Hungary); Piemonte, Claudio; Ferri, Alessandro; Gola, Alberto [Fondazione Bruno Kessler (FBK), Via Sommarive, 18, 38123 Trento (Italy); Rieger, Jan [MRI.TOOLS GmbH, Robert-Roessle-Str. 10, 13125 Berlin (Germany); Niendorf, Thoralf [MRI.TOOLS GmbH, Robert-Roessle-Str. 10, 13125 Berlin (Germany); Berlin Ultrahigh Field Facility (B.UniversityF.F.), Max-Delbrueck-Center for Molecular Medicine, Berlin (Germany)

    2014-07-29

    A new multi-modality imaging tool is under development in the framework of the INSERT (Integrated SPECT/MRI for Enhanced Stratification in Radio-chemo Therapy) project, supported by the European Community. The final goal is to develop a custom SPECT apparatus that can be used as an insert for commercially available MRI systems. INSERT is expected to offer more effective and earlier diagnosis with potentially better outcome in survival for the treatment of brain tumors, primarily glioma. Two SPECT prototypes are being developed, one dedicated to preclinical imaging (7 and 9.4 T), the second one dedicated to clinical imaging (3 T).

  8. Performance analysis of a low-cost small animal PET/SPECT scanner

    Energy Technology Data Exchange (ETDEWEB)

    Guerra, Pedro [B104 ETS de Telecomuniacion, Universidad Politecnica de Madrid, 28040 Madrid (Spain)]. E-mail: pguerra@die.upm.es; Rubio, Jose L. [B104 ETS de Telecomuniacion, Universidad Politecnica de Madrid, 28040 Madrid (Spain); Ortuno, Juan E. [B104 ETS de Telecomuniacion, Universidad Politecnica de Madrid, 28040 Madrid (Spain); Kontaxakis, Georgios [B104 ETS de Telecomuniacion, Universidad Politecnica de Madrid, 28040 Madrid (Spain); Ledesma, Maria J. [B104 ETS de Telecomuniacion, Universidad Politecnica de Madrid, 28040 Madrid (Spain); Santos, Andres [B104 ETS de Telecomuniacion, Universidad Politecnica de Madrid, 28040 Madrid (Spain)

    2007-02-01

    In this work the performance of novel small animal positron/single-photon emission (PET/SPECT) scanner is estimated via Monte Carlo simulation, considering a YAP/LSO phoswich detector. To overcome the differences between PET and SPECT and in order to simplify the design, the system implements most signal processing digitally with programmable devices. The estimated performance of the described setup, expressed in terms of spatial image resolution and sensitivity, is 1.4 mm/0.6% for PET and 2.5 mm/0.025% for SPECT, figures that are comparable with state of the art dedicated scanners.

  9. Increased parasellar activity on gallium SPECT is not specific for active cluster headache

    Energy Technology Data Exchange (ETDEWEB)

    Sianard-Gainko, J.; Milet, J.; Ghuysen, V.; Schoenen, J. (Univ. Departments of Neurology and Nuclear Medicine, Liege (Belgium))

    1994-04-01

    The authors have performed gallium SPECT head scans in 30 successive cluster headache (CH) patients and in 7 migraineurs without aura. Parasellar hyperactivity was judged as present in 81% of chronic CH patients. 54% of episodic CH patients in an active period, 56% of episodic CH patients in remission and 71% of migraineurs. No significant correlations were found between the SPECT images and the duration of the disease, of cluster periods or of remissions. Increased parasellar activity on gallium SPECT is thus not specific for CH, nor for the active period of episodic CH. The method lacks reliability for investigation of putative cavernous sinus inflammation. 4 refs., 1 tab.

  10. SPECT/CT imaging in bone scintigraphy of a case of clavicular osteoma

    Directory of Open Access Journals (Sweden)

    Yuka Yamamoto

    2014-05-01

    diphosphonate (HMDP. Whole-body image showed a focus of intensely increased uptake in the clavicle. Single photon emission computed tomography/ computed tomography (SPECT/CT images were also acquired and clearly showed intense uptake at the tumor site. Integrated SPECT/CT imaging supplies both functional and anatomic information about bone: the SPECT imaging improves sensitivity compared with planar imaging, the CT imaging provides precise localization of the abnormal uptake, and information on the shape and structure of the abnormalities improves the specificity of the diagnosis.

  11. Development of 4D mathematical observer models for the task-based evaluation of gated myocardial perfusion SPECT.

    Science.gov (United States)

    Lee, Taek-Soo; Frey, Eric C; Tsui, Benjamin M W

    2015-04-07

    This paper presents two 4D mathematical observer models for the detection of motion defects in 4D gated medical images. Their performance was compared with results from human observers in detecting a regional motion abnormality in simulated 4D gated myocardial perfusion (MP) SPECT images. The first 4D mathematical observer model extends the conventional channelized Hotelling observer (CHO) based on a set of 2D spatial channels and the second is a proposed model that uses a set of 4D space-time channels. Simulated projection data were generated using the 4D NURBS-based cardiac-torso (NCAT) phantom with 16 gates/cardiac cycle. The activity distribution modelled uptake of (99m)Tc MIBI with normal perfusion and a regional wall motion defect. An analytical projector was used in the simulation and the filtered backprojection (FBP) algorithm was used in image reconstruction followed by spatial and temporal low-pass filtering with various cut-off frequencies. Then, we extracted 2D image slices from each time frame and reorganized them into a set of cine images. For the first model, we applied 2D spatial channels to the cine images and generated a set of feature vectors that were stacked for the images from different slices of the heart. The process was repeated for each of the 1,024 noise realizations, and CHO and receiver operating characteristics (ROC) analysis methodologies were applied to the ensemble of the feature vectors to compute areas under the ROC curves (AUCs). For the second model, a set of 4D space-time channels was developed and applied to the sets of cine images to produce space-time feature vectors to which the CHO methodology was applied. The AUC values of the second model showed better agreement (Spearman's rank correlation (SRC) coefficient = 0.8) to human observer results than those from the first model (SRC coefficient = 0.4). The agreement with human observers indicates the proposed 4D mathematical observer model provides a good predictor of the

  12. Development of 4D mathematical observer models for the task-based evaluation of gated myocardial perfusion SPECT

    Science.gov (United States)

    Lee, Taek-Soo; Frey, Eric C.; Tsui, Benjamin M. W.

    2015-04-01

    This paper presents two 4D mathematical observer models for the detection of motion defects in 4D gated medical images. Their performance was compared with results from human observers in detecting a regional motion abnormality in simulated 4D gated myocardial perfusion (MP) SPECT images. The first 4D mathematical observer model extends the conventional channelized Hotelling observer (CHO) based on a set of 2D spatial channels and the second is a proposed model that uses a set of 4D space-time channels. Simulated projection data were generated using the 4D NURBS-based cardiac-torso (NCAT) phantom with 16 gates/cardiac cycle. The activity distribution modelled uptake of 99mTc MIBI with normal perfusion and a regional wall motion defect. An analytical projector was used in the simulation and the filtered backprojection (FBP) algorithm was used in image reconstruction followed by spatial and temporal low-pass filtering with various cut-off frequencies. Then, we extracted 2D image slices from each time frame and reorganized them into a set of cine images. For the first model, we applied 2D spatial channels to the cine images and generated a set of feature vectors that were stacked for the images from different slices of the heart. The process was repeated for each of the 1,024 noise realizations, and CHO and receiver operating characteristics (ROC) analysis methodologies were applied to the ensemble of the feature vectors to compute areas under the ROC curves (AUCs). For the second model, a set of 4D space-time channels was developed and applied to the sets of cine images to produce space-time feature vectors to which the CHO methodology was applied. The AUC values of the second model showed better agreement (Spearman’s rank correlation (SRC) coefficient = 0.8) to human observer results than those from the first model (SRC coefficient = 0.4). The agreement with human observers indicates the proposed 4D mathematical observer model provides a good predictor of the

  13. The role of preclinical SPECT in oncological and neurological research in combination with either CT or MRI

    Energy Technology Data Exchange (ETDEWEB)

    Bernsen, Monique R.; Jong, Marion de [Erasmus MC, Department of Nuclear Medicine, Rotterdam (Netherlands); Erasmus MC, Department of Radiology, Rotterdam (Netherlands); Vaissier, Pieter E.B. [Delft University of Technology, Section Radiation Detection and Medical Imaging, Delft (Netherlands); Holen, Roel van [Ghent University, iMinds, ELIS Department, MEDISIP, Ghent (Belgium); Booij, Jan [University of Amsterdam, Department of Nuclear Medicine, Academic Medical Center, Amsterdam (Netherlands); Beekman, Freek J. [Delft University of Technology, Section Radiation Detection and Medical Imaging, Delft (Netherlands); MILabs B.V., Utrecht (Netherlands)

    2014-05-15

    Preclinical imaging with SPECT combined with CT or MRI is used more and more frequently and has proven to be very useful in translational research. In this article, an overview of current preclinical research applications and trends of SPECT combined with CT or MRI, mainly in tumour imaging and neuroscience imaging, is given and the advantages and disadvantages of the different approaches are described. Today SPECT and CT systems are often integrated into a single device (commonly called a SPECT/CT system), whereas at present combined SPECT and MRI is almost always carried out with separate systems and fiducial markers to combine the separately acquired images. While preclinical SPECT/CT is most widely applied in oncology research, SPECT combined with MRI (SPECT/MRI when integrated in one system) offers the potential for both neuroscience applications and oncological applications. Today CT and MRI are still mainly used to localize radiotracer binding and to improve SPECT quantification, although both CT and MRI have additional potential. Future technology developments may include fast sequential or simultaneous acquisition of (dynamic) multimodality data, spectroscopy, fMRI along with high-resolution anatomic MRI, advanced CT procedures, and combinations of more than two modalities such as combinations of SPECT, PET, MRI and CT all together. This will all strongly depend on new technologies. With further advances in biology and chemistry for imaging molecular targets and (patho)physiological processes in vivo, the introduction of new imaging procedures and promising new radiopharmaceuticals in clinical practice may be accelerated. (orig.)

  14. Implementation and assessment of an animal management system for small-animal micro-CT / micro-SPECT imaging

    Science.gov (United States)

    Holdsworth, David W.; Detombe, Sarah A.; Chiodo, Chris; Fricke, Stanley T.; Drangova, Maria

    2011-03-01

    Advances in laboratory imaging systems for CT, SPECT, MRI, and PET facilitate routine micro-imaging during pre-clinical investigations. Challenges still arise when dealing with immune-compromised animals, biohazardous agents, and multi-modality imaging. These challenges can be overcome with an appropriate animal management system (AMS), with the capability for supporting and monitoring a rat or mouse during micro-imaging. We report the implementation and assessment of a new AMS system for mice (PRA-3000 / AHS-2750, ASI Instruments, Warren MI), designed to be compatible with a commercial micro-CT / micro-SPECT imaging system (eXplore speCZT, GE Healthcare, London ON). The AMS was assessed under the following criteria: 1) compatibility with the imaging system (i.e. artifact generation, geometric dimensions); 2) compatibility with live animals (i.e. positioning, temperature regulation, anesthetic supply); 3) monitoring capabilities (i.e. rectal temperature, respiratory and cardiac monitoring); 4) stability of co-registration; and 5) containment. Micro-CT scans performed using a standardized live-animal protocol (90 kVp, 40 mA, 900 views, 16 ms per view) exhibited low noise (+/-19 HU) and acceptable artifact from high-density components within the AMS (e.g. ECG pad contacts). Live mice were imaged repeatedly (with removal and replacement of the AMS) and spatial registration was found to be stable to within +/-0.07 mm. All animals tolerated enclosure within the AMS for extended periods (i.e. > one hour) without distress, based on continuous recordings of rectal temperature, ECG waveform and respiratory rate. A sealed AMS system extends the capability of a conventional micro-imaging system to include immune-compromised and biosafety level 2 mouse-imaging protocols.

  15. Usefulness of BMIPP SPECT to evaluate myocardial viability, contractile reserve and coronary stenotic progression after reperfusion in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Katsunuma, Eita; Kurokawa, Shingo; Takahashi, Motoi; Fukuda, Naoto; Kurosawa, Toshiro; Izumi, Tohru [Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine

    2001-07-01

    Using combined {sup 123}I-BMIPP (BMIPP), {sup 201}Tl (Tl) and {sup 99m}Tc-PYP (PYP) myocardial SPECT imaging, risk areas of acute myocardial infarction were documented in the acute stage, and then these images were evaluated for how well they reflected muscle viability, contractile reserve and coronary stenotic progression subsequent to reperfusion therapy. Patients who only experienced a first attack of myocardial infarction were enrolled. In total, 36 cases who had had the occluded artery successfully reperfused were examined during the past year. They had no significant vessel disease except for the culprit single artery. The patients were comprised of 32 men and 4 women. The mean age was 59.5 years. All patients underwent coronary angiography and left ventricular (LV) angiography in the emergency room. BMIPP/Tl and PYP myocardial SPECT were conducted in the acute stage and chronic stage. In the chronic stage LV angiography was repeated to assess the improvement of LV wall motion. The response to postextrasystolic potentiation (PESP) testing was performed to estimate myocardial contractile reserve. The risk area of acute myocardial infarction (AMI) was documented by reduced BMIPP accumulation. The size of reduced BMIPP accumulation was larger than that of PYP accumulation. A BMIPP/Tl discrepancy and PYP accumulation were documented to assess myocardial viability. Both improvement in LV wall motion and augmentation of PESP response were more closely related to a BMIPP/Tl discrepancy in the presence or absence of PYP accumulation. Therefore, it would be possible to evaluate myocardial viability and contractile reserve by the BMIPP/Tl discrepancy. In patients with good viability, it is important to predict whether there is coronary stenotic progression or not. In this study, we demonstrated that most patients with improved BMIPP images had no significant progression at the site of intervention. Serial observation of BMIPP images from the acute stage to the chronic

  16. Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various study protocols

    Energy Technology Data Exchange (ETDEWEB)

    Verger, Antoine; Karcher, Gilles [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Djaballah, Wassila [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947, Nancy (France); Fourquet, Nicolas [Clinique Pasteur, Toulouse (France); Rouzet, Francois; Le Guludec, Dominique [AP-HP, Hopital Bichat, Department of Nuclear Medicine, Paris (France); INSERM U 773 Inserm and Denis Diderot University, Paris (France); Koehl, Gregoire; Roch, Veronique [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Imbert, Laetitia [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Centre Alexis Vautrin, Department of Radiotherapy, Vandoeuvre (France); Poussier, Sylvain [INSERM U947, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Fay, Renaud [INSERM, Centre d' Investigation Clinique CIC-P 9501, Nancy (France); Marie, Pierre-Yves [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); INSERM U961, Nancy (France); Hopital de Brabois, CHU-Nancy, Medecine Nucleaire, Vandoeuvre-les-Nancy (France)

    2013-03-15

    The results of stress myocardial perfusion SPECT could be enhanced by new cadmium-zinc-telluride (CZT) cameras, although differences compared to the results with conventional Anger cameras remain poorly known for most study protocols. This study was aimed at comparing the results of CZT and Anger SPECT according to various study protocols while taking into account the influence of obesity. The study population, which was from three different institutions equipped with identical CZT cameras, comprised 276 patients referred for study using protocols involving {sup 201}Tl (n = 120) or {sup 99m}Tc-sestamibi injected at low dose at stress ({sup 99m}Tc-Low; stress/rest 1-day protocol; n = 110) or at high dose at stress ({sup 99m}Tc-High; rest/stress 1-day or 2-day protocol; n = 46). Each Anger SPECT scan was followed by a high-speed CZT SPECT scan (2 to 4 min). Agreement rates between CZT and Anger SPECT were good irrespective of the study protocol (for abnormal SPECT, {sup 201}Tl 92 %, {sup 99m}Tc-Low 86 %, {sup 99m}Tc-High 98 %), although quality scores were much higher for CZT SPECT with all study protocols. Overall correlations were high for the extent of myocardial infarction (r = 0.80) and a little lower for ischaemic areas (r = 0.72), the latter being larger on Anger SPECT (p < 0.001). This larger extent was mainly observed in 50 obese patients who were in the {sup 201}Tl or {sup 99m}Tc-Low group and in whom stress myocardial counts were particularly low with Anger SPECT (228 {+-} 101 kcounts) and dramatically enhanced with CZT SPECT (+279 {+-} 251 %). Concordance between the results of CZT and Anger SPECT is good regardless of study protocol and especially when excluding obese patients who have low-count Anger SPECT and for whom myocardial counts are dramatically enhanced on CZT SPECT. (orig.)

  17. Reference Range of Functional Data of Gated Myocardial Perfusion SPECT by Quantitative Gated SPECT of Cedars-Sinai and 4D-MSPECT of Michigan University

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Kim, Moo Hyun; Kim, Young Dae [College of Medicine, Univ. of Donga, Pusan (Korea, Republic of)

    2003-07-01

    Various programs have been developed for gating of myocardial perfusion SPECT. Among the those program, the most popular program is the Quantitative Gated SPECT (QGS)? developed by Cedars-Sinai hospital and most recently released program is 4D-MSPECT? developed by university of Michigan. It is important to know the reference range of the functional data of gated myocardial perfusion SPECT because it is necessary to determine abnormality of individual patient and echocardiographic data is different from those of gated SPECT. Tc-99m MIBI gated myocardial perfusion SPECT image was reconstructed by dual head gamma camera (Siemens, BCAM, esoft) as routine procedure and analyzed using QGS? and 4D-MSPECT? program. All patients (M: F=9: 18, Age 69{+-}9 yrs) showed normal myocardial perfusion. The patients with following characteristics were excluded: previous angina or MI history, ECG change with Q wave or ST-T change, diabetes melitius, hypercholesterolemia, typical chest pain, hypertension and cardiomyopathy. Pre-test likelihood of all patients was low. (1) In stress gated SPECT by QGS?, EDV was 73{+-}25 ml, ESV 25{+-}14 ml, EF 67{+-}11 % and area of first frame of gating 106.4{+-}21cm{sup 2}. In rest gated SPECT, EDV was 76{+-}26 ml, ESV 27{+-}15 ml, EF 66{+-}12 and area of first frame of gating 108{+-}20cm{sup 2}. (2) In stress gated SPECT by 4D-MSPECT?, EDV was 76{+-}28 ml, ESV 23{+-}16 ml, EF 72{+-}11 %, mass 115{+-}24 g and ungated volume 42{+-}15 ml. In rest gated SPECT, EDV was 75{+-}27 ml, ESV 23{+-}12 ml, EF 71{+-}9%, mass 113{+-}25g and ungate dvolume 42{+-}15 ml, (3) s-EDV, s-EF, r-ESV and r-EF were significantly different between QGS? and 4D-MSPECT? (each p=0.016, p<0.001. p=0.003 and p=0.001). We determined the normal reference range of functional parameters by QGS? and 4D-MSPECT? program to diagnose individually the abnormality of patients. And the reference ranges have to adopted to be patients by each specific gating program.

  18. 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.

  19. Navigation of a robot-integrated fluorescence laparoscope in preoperative SPECT/CT and intraoperative freehand SPECT imaging data: a phantom study

    Science.gov (United States)

    van Oosterom, Matthias Nathanaël; Engelen, Myrthe Adriana; van den Berg, Nynke Sjoerdtje; KleinJan, Gijs Hendrik; van der Poel, Henk Gerrit; Wendler, Thomas; van de Velde, Cornelis Jan Hadde; Navab, Nassir; van Leeuwen, Fijs Willem Bernhard

    2016-08-01

    Robot-assisted laparoscopic surgery is becoming an established technique for prostatectomy and is increasingly being explored for other types of cancer. Linking intraoperative imaging techniques, such as fluorescence guidance, with the three-dimensional insights provided by preoperative imaging remains a challenge. Navigation technologies may provide a solution, especially when directly linked to both the robotic setup and the fluorescence laparoscope. We evaluated the feasibility of such a setup. Preoperative single-photon emission computed tomography/X-ray computed tomography (SPECT/CT) or intraoperative freehand SPECT (fhSPECT) scans were used to navigate an optically tracked robot-integrated fluorescence laparoscope via an augmented reality overlay in the laparoscopic video feed. The navigation accuracy was evaluated in soft tissue phantoms, followed by studies in a human-like torso phantom. Navigation accuracies found for SPECT/CT-based navigation were 2.25 mm (coronal) and 2.08 mm (sagittal). For fhSPECT-based navigation, these were 1.92 mm (coronal) and 2.83 mm (sagittal). All errors remained below the robot-integrated fluorescence laparoscope is feasible and may aid fluorescence-guided surgery procedures.

  20. Duct Leakage Repeatability Testing

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-01-01

    Duct leakage often needs to be measured to demonstrate compliance with requirements or to determine energy or Indoor Air Quality (IAQ) impacts. Testing is often done using standards such as ASTM E1554 (ASTM 2013) or California Title 24 (California Energy Commission 2013 & 2013b), but there are several choices of methods available within the accepted standards. Determining which method to use or not use requires an evaluation of those methods in the context of the particular needs. Three factors that are important considerations are the cost of the measurement, the accuracy of the measurement and the repeatability of the measurement. The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards.

  1. Discriminating among degenerative parkinsonisms using advanced 123I-ioflupane SPECT analyses

    Directory of Open Access Journals (Sweden)

    Simon Badoud

    2016-01-01

    PD, MSA, PSP and CBD have distinct patterns of dopaminergic depletion on 123I-ioflupane SPECT. The high specificity of 84–90% for PD versus APS indicates that the classifier is particularly useful for confirming APS cases.

  2. Absolute quantitative total-body small-animal SPECT with focusing pinholes

    NARCIS (Netherlands)

    Wu, Chao; van der Have, Frans; Vastenhouw, Brendan; Dierckx, Rudi A. J. O.; Paans, Anne M. J.; Beekman, Freek J.

    2010-01-01

    In pinhole SPECT, attenuation of the photon flux on trajectories between source and pinholes affects quantitative accuracy of reconstructed images. Previously we introduced iterative methods that compensate for image degrading effects of detector and pinhole blurring, pinhole sensitivity and scatter

  3. Absolute quantitative total-body small-animal SPECT with focusing pinholes

    NARCIS (Netherlands)

    Wu, C.; Van der Have, F.; Vastenhouw, B.; Dierckx, R.A.J.O.; Paans, A.M.J.; Beekman, F.J.

    2010-01-01

    Purpose: In pinhole SPECT, attenuation of the photon flux on trajectories between source and pinholes affects quantitative accuracy of reconstructed images. Previously we introduced iterative methods that compensate for image degrading effects of detector and pinhole blurring, pinhole sensitivity an

  4. Hyperpolarized 3He MRI and 81mKr SPECT in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Stavngaard, Trine; Søgaard, Lise; Mortensen, J

    2005-01-01

    was to compare ventilation imaging methods in 26 patients with chronic obstructive pulmonary disease (COPD) and nine lung healthy volunteers. METHODS: HP 3He MRI, 81mKr single-photon emission computed tomography (SPECT), high-resolution computed tomography (HRCT) and pulmonary function tests were performed...... visual defect score (r=0.80, ptest and HRCT). The defect scores were largest on 81mKr SPECT (the score on HP 3He MRI...... was one-third less than that on 81mKr SPECT), but the difference was reduced after normalisation for different breathing depths (HP 3He MRI at total lung capacity; 81mKr SPECT at tidal breathing at functional residual capacity). CONCLUSION: HP 3He MRI provides detailed ventilation distribution images...

  5. Development of new peripheral benzodiazepine receptor ligands for SPECT and PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Katsifis, A.; Fookes, C.; Pham, T.; Holmes, T.; Mattner, F.; Berghoffer, P.; Gregoire, M.C.; Loc' h, C.; Greguric, I. [Radiopharmaceuticas Research Institute, ANSTO, Menai, N.S.W. Sydney (Australia); Thominiaux, C.; Boutin, H.; Chauveau, F.; Gregoire, M.C.; Hantraye, Ph.; Tavitain, B.; Dolle, F. [Service Hospitalier Frederic Joliot, CEA/DSV, 91 - Orsay (France); Arlicot, N.; Chalon, S.; Guilloteau, D. [Universite Francois Rabelais, Inserm U619, 37 - Tours (France)

    2008-02-15

    This study aims to demonstrate that a number of radiolabelled ({sup 123}I,{sup 11}C, {sup 18}F) imidazo pyridines, imidazo pyridazines and indolglyoxylamides can be developed as potential tracers for SPECT and PET imaging. (N.C.)

  6. Combined SPECT/CT and PET/CT for breast imaging

    Energy Technology Data Exchange (ETDEWEB)

    Russo, Paolo [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy); Larobina, Michele [Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Via Tommaso De Amicis, 95, Naples I-80145 (Italy); Di Lillo, Francesca [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy); Del Vecchio, Silvana [Università di Napoli Federico II, Dipartimento di Scienze Biomediche Avanzate, Via Pansini, 5, Naples I-80131 (Italy); Mettivier, Giovanni, E-mail: mettivier@na.infn.it [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy)

    2016-02-11

    In the field of nuclear medicine imaging, breast imaging for cancer diagnosis is still mainly based on 2D imaging techniques. Three-dimensional tomographic imaging with whole-body PET or SPECT scanners, when used for imaging the breast, has performance limits in terms of spatial resolution and sensitivity, which can be overcome only with a dedicated instrumentation. However, only few hybrid imaging systems for PET/CT or SPECT/CT dedicated to the breast have been developed in the last decade, providing complementary functional and anatomical information on normal breast tissue and lesions. These systems are still under development and clinical trials on just few patients have been reported; no commercial dedicated breast PET/CT or SPECT/CT is available. This paper reviews combined dedicated breast PET/CT and SPECT/CT scanners described in the recent literature, with focus on their technological aspects.

  7. [Effect of wall thickness of left ventricle on 201Tl myocardial SPECT images: myocardial phantom study].

    Science.gov (United States)

    Koto, M; Namura, H; Kawase, O; Yamasaki, K; Kono, M

    1996-07-01

    201Tl myocardial SPECT is known for better sensitivity, specificity, and accuracy than planar images in detecting coronary artery disease and diagnosing myocardial viability. SPECT images are also superior to planar images in diagnostic sensitivity and anatomical orientation. However, as limitation of the spatial resolution of the machine, we often encounter poor SPECT plower image quality in patients with decreased wall thickness. To test the accuracy of SPECT images in patients with marked thinning of the left ventricular wall, as occurs in dilated cardiomyopathy, we performed a experimental study using myocardial phantom with 7 mm wall thickness. Tomographic image of the phantom images were rather heterogeneous, though no artificial defect was located. Dilated cardiomyopathy is thought to be characterized by patchy defects in the left ventricle. Careful attention should be given to elucidating myocardial perfusion in patients with a thin left ventricle wall, as there are technical limitations in addition to clinical features.

  8. Perfusion Imaging with SPECT in the Era of Pathophysiology-Based Biomarkers for Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Markus Weih

    2010-01-01

    Full Text Available SPECT allows registration of regional cerebral blood flow (rCBF which is altered in a characteristic temporoparietal pattern in Alzheimer's Dementia. Numerous studies have shown the diagnostic value of reduced cerebral blood flow and metabolic changes using perfusion SPECT and FDG-PEPT in AD diagnosis as well as in differential diagnosis against frontotemporal dementia, dementia with Lewy bodies and vascular disease. Recently more pathophysiology-based biomarkers in CSF and Amyloid-PET tracers have been developed that probably have a higher diagnostic accuracy than the more indirect rCBF changes seen in perfusion SPECT. In the paper review, we describe recent advances in AD biomarkers as well as improvements in the SPECT technique.

  9. 99mTc-HMPAO perfusion SPECT/CT in the diagnosis of brain death.

    Science.gov (United States)

    Derlin, Thorsten; Weiberg, Desiree

    2016-01-01

    This report describes a case of brain death (BD) evaluated by 99mTc-hexamethylpropylene amine oxime (HMPAO) single photon emission tomography/computed tomography (SPECT/CT). A 16-year-old boy with a history of rapid unexpected brain herniation due to pilocytic astrocytoma underwent 99mTc-HMPAO SPECT/CT for evaluation of brain death in the context of organ donation. Flow images demonstrated lack of blood flow to the brain, and delayed images showed absence of demonstrable radionuclide activity within the brain. SPECT/CT confirmed absence of tracer accumulation, and was deemed helpful for evaluation of the brain stem. 99mTc-HMPAO SPECT/CT is a valuable tool enabling imaging-based confirmation of BD.

  10. U-SPECT-BioFluo: an integrated radionuclide, bioluminescence, and fluorescence imaging platform

    NARCIS (Netherlands)

    Van Oosterom, M.N.; Kreuger, R.; Buckle, T.; Mahn, W.A.; Bunschoten, A.; Josephson, L.; Van Leeuwen, F.W.B.; Beekman, F.J.

    2014-01-01

    Background: In vivo bioluminescence, fluorescence, and single-photon emission computed tomography (SPECT) imaging provide complementary information about biological processes. However, to date these signatures are evaluated separately on individual preclinical systems. In this paper, we introduce a

  11. Meta-analysis of the literature on diagnostic accuracy of SPECT in parkinsonian syndromes

    Directory of Open Access Journals (Sweden)

    Kessels Alfons GH

    2007-09-01

    Full Text Available Abstract Background Parkinson's disease (PD is the second most common neurodegenerative disorder. One of the most widely used techniques to diagnose PD is a Single Photon Emission Computer Tomography (SPECT scan to visualise the integrity of the dopaminergic pathways in the brain. Despite this there remains some discussion on the value of SPECT in the differential diagnosis of PD. We did a meta-analysis of all the existing literature on the diagnostic accuracy of both pre- and post-synaptic SPECT imaging in the differential diagnosis of PD. Methods Relevant studies were searched in Medline, EMBASE and Cochrane databases with back-searching of their reference lists. We limited our analysis to studies with a clinically relevant methodology: i.e. when they assessed the ability of the SPECT to provide 1. diagnosis of PD in an early phase vs. normalcy; 2 diagnostic differentiation between PD and essential tremor (ET; 3. distinguishing between PD and vascular parkinsonism (VP; 4. delineation of PD from atypical parkinsonian syndromes (APS. Gold standard was, dependent on the study type, clinical examination at initial visit or follow-up, and/or response to dopaminergic agents. Results The search gave 185 hits, of which we deemed 32 suitable for our analysis. From these we recalculated the diagnostic odds ratio of SPECT for the clinical questions above. The pooled odds ratio (with 95%CI for presynaptic SPECT scan's ability to distinguish between early PD and normalcy was 60 (13 – 277. For the ability to differentiate between PD and ET this ratio was 210 (79–562. The ratio for presynaptic SPECT's ability to delineate PD from VP was 105 (32 – 348. The mean odds ratio for the presynaptic SPECT scans to differentiate between PD and the two APS was 2 (1 – 4, and for the postsynaptic SPECT imaging this was 19 (9–36. Conclusion SPECT with presynaptic radiotracers is relatively accurate to differentiate patients with PD in an early phase from

  12. [Neurological diseases and SPECT--analysis using easy Z-score imaging system (eZIS)].

    Science.gov (United States)

    Matsuda, Hiroshi

    2007-05-01

    We developed a method for automated diagnosis of brain perfusion SPECT and designated this method as an easy Z-score imaging system (eZIS). In this software program, voxel-by-voxel Z-score analysis after voxel normalization to global mean or cerebellar values; Z-score = ( [control mean] - [individual value] )/ (control SD) is performed. These Z-score maps are displayed by overlay on tomographic sections and by projection with averaged Z-score of 14mm thickness to surface rendering of the anatomically standardized MRI template. Anatomical standardization of SPECT images into a stereotactic space is performed using statistical parametric mapping (SPM) 2. This program has an advantage of capability of incorporation of SPM results into automated analysis of Z-score values as a volume of interest (VOI). A specific VOI can be determined by group comparison of SPECT images for patients with a neuropsychiatric disease with those for healthy volunteers using SPM. Even if a center can construct a normal database with good quality comprising a large number of healthy volunteers, other centers have not been able to use this normal database because of differences between the used gamma cameras, collimators and physical correction algorithms. Since SPECT exhibits greater variations in image quality among different centers than PET, conversion of SPECT images may be necessary for sharing a normal database. In this eZIS software, we incorporated a newly developed program for making it possible to share a normal database in SPECT studies. A Hoffman 3-dimensional brain phantom experiment was conducted to determine systematic differences between SPECT scanners. SPECT images for the brain phantom were obtained using two different scanners. Dividing these two phantom images after anatomical standardization by SPM created a 3-dimensional conversion map. The use of a conversion map obtained from SPECT images of the same phantom provided very similar SPECT data despite extreme differences

  13. Combining SPECT and Quantitative EEG Analysis for the Automated Differential Diagnosis of Disorders with Amnestic Symptoms

    Directory of Open Access Journals (Sweden)

    Yvonne Höller

    2017-09-01

    Full Text Available Single photon emission computed tomography (SPECT and Electroencephalography (EEG have become established tools in routine diagnostics of dementia. We aimed to increase the diagnostic power by combining quantitative markers from SPECT and EEG for differential diagnosis of disorders with amnestic symptoms. We hypothesize that the combination of SPECT with measures of interaction (connectivity in the EEG yields higher diagnostic accuracy than the single modalities. We examined 39 patients with Alzheimer's dementia (AD, 69 patients with depressive cognitive impairment (DCI, 71 patients with amnestic mild cognitive impairment (aMCI, and 41 patients with amnestic subjective cognitive complaints (aSCC. We calculated 14 measures of interaction from a standard clinical EEG-recording and derived graph-theoretic network measures. From regional brain perfusion measured by 99mTc-hexamethyl-propylene-aminoxime (HMPAO-SPECT in 46 regions, we calculated relative cerebral perfusion in these patients. Patient groups were classified pairwise with a linear support vector machine. Classification was conducted separately for each biomarker, and then again for each EEG- biomarker combined with SPECT. Combination of SPECT with EEG-biomarkers outperformed single use of SPECT or EEG when classifying aSCC vs. AD (90%, aMCI vs. AD (70%, and AD vs. DCI (100%, while a selection of EEG measures performed best when classifying aSCC vs. aMCI (82% and aMCI vs. DCI (90%. Only the contrast between aSCC and DCI did not result in above-chance classification accuracy (60%. In general, accuracies were higher when measures of interaction (i.e., connectivity measures were applied directly than when graph-theoretical measures were derived. We suggest that quantitative analysis of EEG and machine-learning techniques can support differentiating AD, aMCI, aSCC, and DCC, especially when being combined with imaging methods such as SPECT. Quantitative analysis of EEG connectivity could become

  14. Absolute quantitative total-body small-animal SPECT with focusing pinholes

    OpenAIRE

    Wu, C.; Have, F. van der; Vastenhouw, B.; Dierckx, R. A. J. O.; Paans, A.M.J.; Beekman, F.J.

    2010-01-01

    Purpose: In pinhole SPECT, attenuation of the photon flux on trajectories between source and pinholes affects quantitative accuracy of reconstructed images. Previously we introduced iterative methods that compensate for image degrading effects of detector and pinhole blurring, pinhole sensitivity and scatter for multi-pinhole SPECT. The aim of this paper is (1) to investigate the accuracy of the Chang algorithm in rodents and (2) to present a practical Changbased method using body outline con...

  15. Hotspot quantification of myocardial focal tracer uptake from molecular targeted SPECT/CT images: experimental validation

    Science.gov (United States)

    Liu, Yi-Hwa; Sahul, Zakir; Weyman, Christopher A.; Ryder, William J.; Dione, Donald P.; Dobrucki, Lawrence W.; Mekkaoui, Choukri; Brennan, Matthew P.; Hu, Xiaoyue; Hawley, Christi; Sinusas, Albert J.

    2008-03-01

    We have developed a new single photon emission computerized tomography (SPECT) hotspot quantification method incorporating extra cardiac activity correction and hotspot normal limit estimation. The method was validated for estimation accuracy of myocardial tracer focal uptake in a chronic canine model of myocardial infarction (MI). Dogs (n = 4) at 2 weeks post MI were injected with Tl-201 and a Tc-99m-labeled hotspot tracer targeted at matrix metalloproteinases (MMPs). An external point source filled with Tc-99m was used for a reference of absolute radioactivity. Dual-isotope (Tc-99m/Tl-201) SPECT images were acquired simultaneously followed by an X-ray CT acquisition. Dogs were sacrificed after imaging for myocardial gamma well counting. Images were reconstructed with CT-based attenuation correction (AC) and without AC (NAC) and were quantified using our quantification method. Normal limits for myocardial hotspot uptake were estimated based on 3 different schemes: maximum entropy, meansquared-error minimization (MSEM) and global minimization. Absolute myocardial hotspot uptake was quantified from SPECT images using the normal limits and compared with well-counted radioactivity on a segment-by-segment basis (n = 12 segments/dog). Radioactivity was expressed as % injected dose (%ID). There was an excellent correlation (r = 0.78-0.92) between the estimated activity (%ID) derived using the SPECT quantitative approach and well-counting, independent of AC. However, SPECT quantification without AC resulted in the significant underestimation of radioactivity. Quantification using SPECT with AC and the MSEM normal limit yielded the best results compared with well-counting. In conclusion, focal myocardial "hotspot" uptake of a targeted radiotracer can be accurately quantified in vivo using a method that incorporates SPECT imaging with AC, an external reference, background scatter compensation, and a suitable normal limit. This hybrid SPECT/CT approach allows for the serial

  16. Evaluation of MR perfusion abnormalities in organophosphorus poisoning and its correlation with SPECT

    OpenAIRE

    K Uday Bhanu; Niranjan Khandelwal; Sameer Vyas; Paramjeet Singh; Anuj Prabhakar; B R Mittal; Ashish Bhalla

    2017-01-01

    Aim: Acute organophosphate (OP) pesticide poisoning causes substantial morbidity and mortality worldwide. Many imaging modalities, such as computerized tomography (CT), magnetic resonance imaging (MRI), and single photon emission computed tomography (SPECT) of the brain, have been used for quantitative assessment of the acute brain insult caused by acute OP poisoning. Perfusion defects on SPECT in acutely poisoned patients with OPs have been described, however, MR perfusion abnormalities have...

  17. Radiation risk and protection of patients in clinical SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Brix, Gunnar; Nekolla, Elke A.; Nosske, Dietmar [Federal Office for Radiation Protection, Department of Medical and Occupational Radiation Protection, Oberschleissheim (Germany); Borowski, Markus [Klinikum Braunschweig, Institute of Radiation Diagnostics and Nuclear Medicine, Braunschweig (Germany)

    2014-05-15

    Clinical studies have demonstrated that hybrid single photon emission computed tomography (SPECT)/CT for various diagnostic issues has an added value as compared to SPECT alone. However, the combined acquisition of functional and anatomical images can substantially increase radiation exposure to patients, in particular when using a hybrid system with diagnostic CT capabilities. It is, therefore, essential to carefully balance the diagnostic needs and radiation protection requirements. To this end, the evidence on health effects induced by ionizing radiation is outlined. In addition, the essential concepts for estimating radiation doses and lifetime attributable cancer risks associated with SPECT/CT examinations are presented taking into account both the new recommendations of the International Commission on Radiological Protection (ICRP) as well as the most recent radiation risk models. Representative values of effective dose and lifetime attributable risk are reported for ten frequently used SPECT radiopharmaceuticals and five fully diagnostic partial-body CT examinations. A diagnostic CT scan acquired as part of a combined SPECT/CT examination contributes considerably to, and for some applications even dominates, the total patient exposure. For the common SPECT and CT examinations considered in this study, the lifetime attributable risk of developing a radiation-related cancer is less than 0.27 %/0.37 % for men/women older than 16 years, respectively, and decreases markedly with increasing age at exposure. Since there is no clinical indication for a SPECT/CT examination unless an emission scan has been indicated, the issue on justification comes down to the question of whether it is necessary to additionally acquire a low-dose CT for attenuation correction and anatomical localization of tracer uptake or even a fully diagnostic CT. In any case, SPECT/CT studies have to be optimized, e.g. by adapting dose reduction measures from state-of-the-art CT practice, and

  18. Combining SPECT and Quantitative EEG Analysis for the Automated Differential Diagnosis of Disorders with Amnestic Symptoms

    Science.gov (United States)

    Höller, Yvonne; Bathke, Arne C.; Uhl, Andreas; Strobl, Nicolas; Lang, Adelheid; Bergmann, Jürgen; Nardone, Raffaele; Rossini, Fabio; Zauner, Harald; Kirschner, Margarita; Jahanbekam, Amirhossein; Trinka, Eugen; Staffen, Wolfgang

    2017-01-01

    Single photon emission computed tomography (SPECT) and Electroencephalography (EEG) have become established tools in routine diagnostics of dementia. We aimed to increase the diagnostic power by combining quantitative markers from SPECT and EEG for differential diagnosis of disorders with amnestic symptoms. We hypothesize that the combination of SPECT with measures of interaction (connectivity) in the EEG yields higher diagnostic accuracy than the single modalities. We examined 39 patients with Alzheimer's dementia (AD), 69 patients with depressive cognitive impairment (DCI), 71 patients with amnestic mild cognitive impairment (aMCI), and 41 patients with amnestic subjective cognitive complaints (aSCC). We calculated 14 measures of interaction from a standard clinical EEG-recording and derived graph-theoretic network measures. From regional brain perfusion measured by 99mTc-hexamethyl-propylene-aminoxime (HMPAO)-SPECT in 46 regions, we calculated relative cerebral perfusion in these patients. Patient groups were classified pairwise with a linear support vector machine. Classification was conducted separately for each biomarker, and then again for each EEG- biomarker combined with SPECT. Combination of SPECT with EEG-biomarkers outperformed single use of SPECT or EEG when classifying aSCC vs. AD (90%), aMCI vs. AD (70%), and AD vs. DCI (100%), while a selection of EEG measures performed best when classifying aSCC vs. aMCI (82%) and aMCI vs. DCI (90%). Only the contrast between aSCC and DCI did not result in above-chance classification accuracy (60%). In general, accuracies were higher when measures of interaction (i.e., connectivity measures) were applied directly than when graph-theoretical measures were derived. We suggest that quantitative analysis of EEG and machine-learning techniques can support differentiating AD, aMCI, aSCC, and DCC, especially when being combined with imaging methods such as SPECT. Quantitative analysis of EEG connectivity could become an

  19. Absolute quantification in multi-pinhole micro-SPECT for different isotopes

    OpenAIRE

    Vandeghinste, B.; Vanhove, C.; Beenhouwer, De, Jan; Van Holen, R.; Vandenberghe, S; Staelens, S.

    2011-01-01

    Abstract: In preclinical Single Photon Emission Tomography (SPECT), absolute quantification is interesting, expressed in percentage of injected radioactive dose per gram of tissue. This allows for accurate evaluation of disease progression and precise follow-up studies without the need for sacrificing animals. Accurate modeling of image degrading effects is currently under development for isotopes different from Tc-99m. The aim of this work is to develop absolute micro-SPECT quantification fo...

  20. 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.)

  1. A Modified Post Processing Correction Matrix For SPECT

    Science.gov (United States)

    Macey, D. J.; DeNardo, G. L.; DeNardo, S. J.; Seibert, J. A.

    1986-01-01

    A post reconstruction method of attenuation compensation for Single Photon Emission Computed Tomography (SPECT) has been investigated that offers a new approach to the problem of quantitation. A modified correction matrix is generated for attenuation compensation in which the Linear Attenuation Coefficient (LAC) for each pixel is assigned a value depending on the radial distance of the pixel from the true section boundary. Attenuation compensation of transverse section images of small and large volume sources of Tc-99m in phantoms using this modified matrix indicated that a known quantity of radionuclide could be determined to better than 10%. The scatter fraction was estimated as the difference in the corrected section images using a multiplicative matrix generated with a constant LAC for each pixel and the modified matrix proposed in this report.

  2. Crossed cerebellar diaschisis demonstrated by SPECT in hemiplegic children

    Energy Technology Data Exchange (ETDEWEB)

    Hamano, Shin-ichiro; Nara, Takahiro; Nozaki, Hidetsugu; Fukushima, Kiyomi (Saitama Children' s Medical Center, Iwatsuki (Japan)); Imai, Masayuki; Kumagai, Koumei; Maekawa, Kihei

    1991-01-01

    Crossed cerebellar diaschisis (CCD) in twenty five children with hemiplegia were studied using single photon emission computed tomography (SPECT) with N-isopropyl-p-I-123-iodoamphetamine. Seven of twenty-five patients had cerebral palsy, and the others were impaired by acquired brain injury between ten months and fourteen years of age. CCD was demonstrated in five patients (20%), who were impaired by acquired brain injury after seven years of age. CCD could never be detected in patients with cerebral palsy. Ipsilateral cerebellar diaschisis was also demonstrated in two patients with cerebral palsy and three with early acquired brain injury before three years of age. It is suggested that diaschisis presents itself as a different form in a contralateral and ipsilateral cerebellum before three years of age from a form which presents after seven years of age. (author).

  3. The neutron decay spectrometer aSPECT: latest results

    Energy Technology Data Exchange (ETDEWEB)

    Borg, M.; Guardia, F.A.; Baessler, S.; Brito, L.C.; Glueck, F.; Heil, W.; Konrad, G.; Brito, L.C.; Horta, R.M.; Palmer, C.A.; Sobolev, Y. [Inst. fuer Physik, Univ. Mainz (Germany); Angerer, H.; Konorov, I.; Petzoldt, G.; Simson, M.; Wirth, H.F.; Zimmer, O. [Physik Dept. E18, TU Muenchen (Germany); Eberhardt, K. [Inst. fuer Kernchemie, Univ. Mainz (Germany); Rich, D. [FRM-II, TU Muenchen (Germany)

    2007-07-01

    The intention of the neutron decay spectrometer aSPECT is the measurement of the proton spectrum in the decay of free neutrons. The proton spectrum is used to deduce the value of the neutrino electron correlation coefficient a, an important experimental quantity which is useful to resolve the problem with the unitarity of the Cabbibo-Kobayashi-Maskawa Matrix. In a beam time in 2005/ 2006 at the neutron beam MEPHISTO of the research reactor ''Forschungsneutronenquelle Heinz Maier-Leibnitz'' (FRM-II), first proton spectra have been measured and several systematic tests were performed. In my talk, I will present the physical motivation and the design of our spectrometer, but mainly I will discuss our latest results and the on-going optimizations for the next beam time. (orig.)

  4. Latest results with the neutron decay spectrometer a SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Konrad, Gertrud; Ayala Guardia, Fidel; Borg, Michael; Heil, Werner; Munoz Horta, Raquel; Sobolev, Yury [Institut fuer Physik, Universitaet Mainz (Germany); Baessler, Stefan [University of Virginia, Charlottesville, VA (United States); Glueck, Ferenc [IEKP, Universitaet Karlsruhe (Germany); Konorov, Igor [Physik-Department E18, TU Muenchen (Germany); Leung, Kent; Soldner, Torsten [Institut Laue-Langevin, Grenoble (France); Simson, Martin; Zimmer, Oliver [Physik-Department E18, TU Muenchen (Germany); Institut Laue-Langevin, Grenoble (France); Wirth, Hans-Friedrich [Fakultaet fuer Physik, LMU Muenchen (Germany)

    2009-07-01

    The purpose of the retardation spectrometer a SPECT is to determine the antineutrino electron angular correlation coefficient a with high precision, by measuring the integral proton spectrum in free neutron decay. With a precise measurement of the correlation coefficient a tests of the validity of the Standard Model become possible. Of great interest are here the search for scalar and tensor interactions, and to test the unitarity of the CKM matrix. In a beam time performed during April/May 2008 at the neutron research reactor ILL in Grenoble/ France we reached a statistical accuracy of about 2 % per 24 hours measurement time. From the investigated systematic effects and the collected statistics, we expect a total relative error well below the present literature value of 5 %. The physical motivation and the design and optimization of the spectrometer as well as the status and first results of the data analysis are presented in this talk.

  5. Brain perfusion SPECT and EEG findings in Rett syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lappalainen, R. [Children`s Castle Hospital, Dept. of Child Neurology, Helsinki (Finland); Liewendahl, K.; Nikkinen, P. [Univ. Central Hospital, Division of Nuclear Medicine, Laboratory Dept., Helsinki (Finland); Sainio, K.; Riikonen, R.S. [Univ. Central Hospital, Child Neurology, Helsinki (Finland)

    1997-01-01

    Thirteen patients (mean age 8.4 + 5.3 years) with Rett syndrome (RS) were studied with EEG and {sup 99m}Tc-HMPAO SPECT. Eleven patients had background abnormalities and 10 patients paroxysmal activity in EEG. Hypoperfusion of varying severity was detected in 11 patients, 7 patients having multiple lesions. Bifrontal hypoperfusion, observed in 6 patients, was the most distinctive finding. Hypoperfusion was observed also in other cortical regions, except for the occipital lobes. There was no correlation between severity of the background abnormality or presence of paroxysmal activity in EEG and grade of hypoperfusion. There was, however, an association between the severity of hypoperfusion and early manifestation of symptoms in patients with RS. Whether this early-onset group of patients represents a different disease entity or only reflects disease variability the basic pathology being the same, is a possibility that deserves further clarification. (au) 37 refs.

  6. Diamox-enhanced brain SPECT in cerebrovascular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Young [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2007-04-15

    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.

  7. 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.

  8. Usefulness of {sup 99m}Tc-HMPAO SPECT in Patients with Subarachnoid Hemorrhage due to Ruptured Intracranial Aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Choi, C. W.; Lee, K. H.; Kim, J. H.; Kwark, C. E.; Lee, D. S.; Chung, J. K.; Lee, M. C.; Han, D. H.; Koh, C. S. [Seoul National University Hospital, Seoul (Korea, Republic of)

    1993-07-15

    We evaluated the usefulness of {sup 99m}Tc-HMPAO SPECT in 21 Patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm and in 3 patients with unruptured intracranial aneurysm. SPECT study could detect the bilaterally hypoperfused cases in 10 patients(48%), but CT/MRI showed the bilateral abnormalities in only 3 patients(14%). The number of abnormal lesions were 56 in SPECT and 25 in CT/MRI. The lesions found in SPECT were well correlated with the neurological signs of the patients such as aphasia or hemiplegia. SPECT study during Matas test was helpful in evaluating the risk for carotid artery occlusion therapy. We thought that {sup 99m}Tc-HMPAO brain SPECT is helpful in evaluating the functional changes in patients with subarachnoid hemorrhage.

  9. Attenuation correction effects on SPECT/CT procedures: phantoms studies.

    Science.gov (United States)

    Oliveira, M L; Seren, M E G; Rocha, F C; Brunetto, S Q; Ramos, C D; Button, V L S N

    2013-01-01

    Attenuation correction is widely used in SPECT/CT (Single Photon Emission Computed Tomography) procedures, especially for imaging of the thorax region. Different compensation methods have been developed and introduced into clinical practice. Most of them use attenuation maps obtained using transmission scanning systems. However, this gives extra dose of radiation to the patient. The purpose of this study was to identify when attenuation correction is really important during SPECT/CT procedures.For this purpose, we used Jaszczak phantom and phantom with three line sources, filled with technetium ((99m)-Tc), with scattering materials, like air, water and acrylic, in different detectors configurations. In all images acquired were applied analytic and iterative reconstruction algorithms; the last one with or without attenuation correction. We analyzed parameters such as eccentricity, contrast and spatial resolution in the images.The best reconstruction algorithm on average was iterative, for images with 128 × 128 and 64 × 64 matrixes. The analytical algorithm was effective only to improve eccentricity in 64 × 64 matrix and matrix in contrast 128 × 128 with low statistics. Turning to the clinical routine examinations, on average, for 128 × 128 matrix and low statistics counting, the best algorithm was the iterative, without attenuation correction,improving in 150% the three parameters analyzed and, for the same matrix size, but with high statistical counting, iterative algorithm with attenuation correction was 25% better than that without correction. We can conclude that using the iterative algorithm with attenuation correction in the water, and its extra dose given, is not justified for the procedures of low statistic counting, being relevant only if the intention is to prioritize contrast in acquisitions with high statistic counting.

  10. Multipinhole SPECT helical scan parameters and imaging volume

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Rutao, E-mail: rutaoyao@buffalo.edu; Deng, Xiao [Department of Nuclear Medicine, State University of New York at Buffalo, Buffalo, New York 14214 (United States); Wei, Qingyang; Dai, Tiantian; Ma, Tianyu [Department of Engineering Physics, Tsinghua University, Beijing 100084 (China); Lecomte, Roger [Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Center, Université de Sherbrooke, Sherbrooke, Quebec J1H 5N4 (Canada)

    2015-11-15

    Purpose: The authors developed SPECT imaging capability on an animal PET scanner using a multiple-pinhole collimator and step-and-shoot helical data acquisition protocols. The objective of this work was to determine the preferred helical scan parameters, i.e., the angular and axial step sizes, and the imaging volume, that provide optimal imaging performance. Methods: The authors studied nine helical scan protocols formed by permuting three rotational and three axial step sizes. These step sizes were chosen around the reference values analytically calculated from the estimated spatial resolution of the SPECT system and the Nyquist sampling theorem. The nine helical protocols were evaluated by two figures-of-merit: the sampling completeness percentage (SCP) and the root-mean-square (RMS) resolution. SCP was an analytically calculated numerical index based on projection sampling. RMS resolution was derived from the reconstructed images of a sphere-grid phantom. Results: The RMS resolution results show that (1) the start and end pinhole planes of the helical scheme determine the axial extent of the effective field of view (EFOV), and (2) the diameter of the transverse EFOV is adequately calculated from the geometry of the pinhole opening, since the peripheral region beyond EFOV would introduce projection multiplexing and consequent effects. The RMS resolution results of the nine helical scan schemes show optimal resolution is achieved when the axial step size is the half, and the angular step size is about twice the corresponding values derived from the Nyquist theorem. The SCP results agree in general with that of RMS resolution but are less critical in assessing the effects of helical parameters and EFOV. Conclusions: The authors quantitatively validated the effective FOV of multiple pinhole helical scan protocols and proposed a simple method to calculate optimal helical scan parameters.

  11. Pharmacokinetics of SPECT radiopharmaceuticals for imaging hypoxic tissues.

    Science.gov (United States)

    Wiebe, L I; Stypinski, D

    1996-09-01

    Although hypoxia has been known for decades to play an important role in the outcome of radiotherapy in oncology, and inspite of the contribution of hypoxia to a myriad of pathologies that involve vascular disease, the selective imaging of hypoxic tissue has attained prominence only within the past decade. Contemporary research in the hypoxia imaging field is based largely on radiosensitizer research of the 1960's and 1970's. Early sensitizer research identified a family of nitro-organic compounds, the N-1 substituted 2-nitroimidazoles as candidate drugs. The early champion, and still the reference standard for therapeutic radiosensitization of hypoxic tumor cells is misonidazole (MISO). Its peripheral neurotoxicity led to failure in clinical studies, but its biological, biophysical and biochemical properties have been investigated in detail and serve as a basis for further design, not only of sensitizers, but of diagnostic radiopharmaceuticals for imaging tissue hypoxia. Pharmacokinetic characterization of radiopharmaceuticals, specifically radiopharmaceuticals for imaging tissue hypoxia, has not been a central theme in their development. The advent of PET, through which quantitative determinations first became possible, opened the field for both descriptive and analytical radiopharmacokinetic studies. In SPECT, however, this approach is still undergoing refinement. This paper addresses some of the underlying issues in radiopharmaceutical pharmacokinetics. There is a paucity of published radiopharmacokinetic data for SPECT hypoxia imaging agents. Consequently, the pharmacokinetic issues for MISO are presented as a basis for development of pharmacokinetics for the chemically-related imaging agents. Properties of an hypoxia marker are described from a pharmacokinetic viewpoint, a theoretical model for descriptive pharmacokinetics is introduced and finally, recent pharmacokinetic studies from our laboratory are described.

  12. Final Report: A CdZnTe detector for MRI-compatible SPECT Systems

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Ling-Jian

    2012-12-27

    The key objective of this project is to develop the enabling technology for future MRI-compatible nuclear (e.g. SPECT) imaging system, and to demonstrate the feasibility of performing simultaneous MR and SPECT imaging studies of the same object. During the past three years, we have developed (a) a MRI-compatible ultrahigh resolution gamma ray detector and associated readout electronics, (b) a theoretical approach for modeling the effect of strong magnetic field on SPECT image quality, and (c) a maximum-likelihood (ML) based reconstruction routine with correction for the MR-induced distortion. With this support, we have also constructed a four-head MR-compatible SPECT system and tested the system inside a 3-T clinical MR-scanner located on UI campus. The experimental results obtained with this system have clearly demonstrated that sub-500um spatial resolution can be achieved with a SPECT system operated inside a 3-T MRI scanner. During the past three years, we have accomplished most of the major objectives outlined in the original proposal. These research efforts have laid out a solid foundation the development of future MR-compatible SPECT systems for both pre-clinical and clinical imaging applications.

  13. De-Noising SPECT Images from a Typical Collimator Using Wavelet Transform

    Directory of Open Access Journals (Sweden)

    Farshid Babapour Mofrad

    2009-12-01

    Full Text Available Introduction: SPECT is a diagnostic imaging technique the main disadvantage of which is the existence of Poisson noise. So far, different methods have been used by scientists to improve SPECT images. The Wavelet Transform is a new method for de-noising which is widely used for noise reduction and quality enhancement of images. The purpose of this paper is evaluation of noise reduction in SPECT images by wavelet. Material and Methods: To calculate and simulate noise in images, it is common in nuclear medicine to use Monte Carlo techniques. The SIMIND software was used to simulate SPECT images in this research. The simulated and real images formed using the current typical (hexagonal collimator were de-noised by different types of wavelets. Results: The best type of wavelet was selected for SPECT images. The results demonstrated that the best type of wavelet in the simulated and real images increased Signal to Noise Ratio (SNR by 33% and 45% respectively. Also, Coefficient of Variation (CV decreased by 77% and 71% respectively, while Contrast of Recovery (CR was reduced by only 4% and 9% respectively. Conclusion: Comparing the results for real SPECT images in this paper with previously acquired results in real PET images, it can be concluded that the images of both nuclear medicine systems using Wavelet Transform differ in SNR and CR by only 5% and 7% respectively, and in CV by about 20%. Therefore, wavelet transform is applicable for nuclear medicine image de-noising.

  14. SPECT Imaging of Epilepsy: An Overview and Comparison with F-18 FDG PET

    Directory of Open Access Journals (Sweden)

    Sunhee Kim

    2011-01-01

    Full Text Available Epilepsy surgery is highly effective in treating refractory epilepsy, but requires accurate presurgical localization of the epileptogenic focus. Briefly, localization of the region of seizure onset traditionally dependents on seizure semiology, scalp EEG recordings and correlation with anatomical imaging modalities such as MRI. The introduction of noninvasive functional neuroimaging methods, including single-photon emission computed tomography (SPECT and positron emission tomography (PET has dramatically changed the method for presurgical epilepsy evaluation. These imaging modalities have become powerful tools for the investigation of brain function and are an essential part of the evaluation of epileptic patients. Of these methods, SPECT has the practical capacity to image blood flow functional changes that occur during seizures in the routine clinical setting. In this review we present the basic principles of epilepsy SPECT and PET imaging. We discuss the properties of the SPECT tracers to be used for this purpose and imaging acquisition protocols as well as the diagnostic performance of SPECT in addition to SPECT image analysis methods. This is followed by a discussion and comparison to F-18 FDG PET acquisition and imaging analysis methods.

  15. Usefulness of {sup 99m}Tc-HMPAO-SPECT in evaluation of bacterial meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Kentaro; Ando, Hiroshi; Sueyoshi, Keiko; Matsuyuki, Makado; Hashimoto, Nobuo; Ono, Eiichiro; Katsuragi, Makoto [St. Maria Hospital, Kurume, Fukuoka (Japan)

    1997-03-01

    {sup 99m}Tc-HMPAO SPECT was performed to detect the periodical changes of blood flow distribution in 6 infants (average age 5.5 months) with bacterial meningitis and was compared with findings by CT and MRI i