Association between body mass index (BMI) and [123I]Ioflupane (DaTSCAN) availabilities in patients with parkinsonism using single-photon emission computed tomography–computed tomography (SPECT-CT)
Puja K. ParekhPatrick BegleyMaryam JessopMark AplinElena MissirHelena McMeekinGosia RaczekNitasha SinghSabina Dizdarevic
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[123I]Ioflupane (DaTSCAN) has a high binding affinity to the dopamine (DA) transporter (DaT) and tenfold less affinity to serotonin (5-HT) transporter (SERT). Both neurotransmitters are considered to contribute to body weight regulation. This study assesses the association between body mass index (BMI) and DaTSCAN availability in brain.Scans from 74 consecutive patients who had undergone DaTSCAN single-photon emission computed tomography-computed tomography (SPECT-CT) were used to obtain semi- and absolute quantitative data in several volumes of interest (VOIs). Relative semi-quantitative specific binding ratios (SBRs) from Chang attenuated SPECT were obtained from GE DaTQUANT. Absolute normalised concentration (NC) was calculated from attenuation/scatter corrected SPECT-CT images, using an adapted version of the EARL Ltd (European Association of Nuclear Medicine (EANM) Research 4 Life) template. Scans were subdivided into either degenerative parkinsonism (abnormal = 49), borderline (n = 14) or scan without evidence of dopaminergic deficit (SWEDD = 11) using visual assessment and SBR values by two nuclear medicine consultants.SBRs did not correlate with BMI. However, NC values correlated negatively in the entire cohort, with the strongest correlation in the frontal (r = - 0.649. p = 0.000), occipital (r = - 0.555, p = 0.000) regions and pons (r = - 0.555, p = 0.000). In the abnormal (n = 49) and SWEDD group (n = 11), NC of the frontal region was the most correlated with BMI (r = - 0.570, p = 0.000; r = - 0.813, p = 0.002, respectively). In the borderline group (n = 14), the left posterior putamen displayed the strongest correlation (r = - 0.765, p = 0.001).Absolute NC values demonstrate a strong inverse correlation with BMI, strongest in the extrastriatal regions. Due to the predominately non-overlapping distribution of DaT and SERT, this study suggests greater involvement of SERT in obesity with possible interplay with DA transmission.Keywords:
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This review discusses the current use of single photon emission computerised tomography (SPECT) for central benzodiazepine receptor imaging and quantitation. The general principles underlying SPECT imaging and receptor quantitation methods such as the kinetic, pseudo-equilibrium and steady-state (tracer infusion and bolus) approaches are described. The advantages and practical drawbacks of these techniques are highlighted.
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Single photon emission computed tomography(SPECT)can be used in Parkinson desease due to the high affinity of the specific isotope with dopamine transporter(DAT).Nowadays,SPECT imaging in human brain is widely applied in clinical practice of Parkinson disease,such as early diagnosis,differential diagnosis,monitoring,outcome evaluation and prognosis.In this article,a survey is conducted on DAT SPECT imaging and its clinical application in patients with Parkinson disease.
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Single-photon emission computed tomography (SPECT) cameras acquire multiple planar views of the radioactivity in an organ. SPECT utilizes the single photons emitted by gamma-emitting radionuclides such as 99m Tc, 111 In, and 123 I. The simplest camera design for SPECT imaging is similar to that of a planar camera but with two additional features. First, the SPECT camera is constructed so that the head can rotate about the patient to acquire multiple views. Second, it is equipped with a computer that integrates the multiple images to produce the cross-sectional views of the organ. Cardiac imaging is performed on a general purpose two-headed SPECT camera with the heads oriented at 90 degrees; the gantry rotates approximately 90 degrees to acquire the 180 degrees of cardiac SPECT data. An estimate of the amount of radionuclide activity in a lesion can be helpful in differentiating benign from malignant lesions and for tracking disease progression or response to treatment.
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No AccessJournal of UrologyImaging1 Aug 1990Renal Cortical Scintigraphy and Single Proton Emission Computerized Tomography (SPECT) in the Assessment of Renal Defects in Children David B. Joseph, Daniel W. Young, and Sharon P. Jordon David B. JosephDavid B. Joseph More articles by this author , Daniel W. YoungDaniel W. Young More articles by this author , and Sharon P. JordonSharon P. Jordon More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)39531-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Single photon emission computerized tomography (SPECT) is finding greater clinical applicability in pediatric imaging. We applied the principles of SPECT imaging to renal cortical scintigraphy in the assessment of renal defects. We evaluated retrospectively 35 children who were undergoing 99mtechnetium-glucoheptonate renal cortical scintigraphy. Each child underwent planar, SPECT and pinhole imaging. Of the 35 children 9 had normal systems bilaterally and the remaining 26 had at least 1 defect in 1 or both kidneys. Over-all, we identified 29 abnormal renal units. Planar imaging identified 59% of the defects, while pinhole and SPECT imaging identified 83% of the defects. When combining any 2 studies (that is planar and pinhole, planar and SPECT or pinhole and SPECT) we were able to identify 97% of the defects, which approached but was not statistically significant at p = 0.09. When data from all 3 studies were combined 100% of the defects were identified, which was a statistically significant increase in defects noted when compared to only planar images (p = 0.016). SPECT imaging was found to be a technically feasible undertaking with conventional equipment, although its clinical applicability at this time is limited. © 1990 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByAllen T, Arant B and Roberts J (2018) Commentary: Vesicoureteral Reflux—1992Journal of Urology, VOL. 148, NO. 5 Part 2, (1758-1760), Online publication date: 1-Nov-1992. Volume 144Issue 2 Part 2August 1990Page: 595-597 Advertisement Copyright & Permissions© 1990 by The American Urological Association Education and Research, Inc.MetricsAuthor Information David B. Joseph More articles by this author Daniel W. Young More articles by this author Sharon P. Jordon More articles by this author Expand All Advertisement Loading ...
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Multiple system atrophy (MSA) is subdivided into two types: MSA-P (parkinsonian) and MSA-C (cerebellar). Brain SPECT allows for the detection of nigrostriatal involvement, even in the early stages. To date, the scientific literature does not show a consensus on how to follow-up MSA, especially MSA-C. Our aim was to analyze the diagnostic effectiveness of repeat [123I]Ioflupane SPECT for the follow-up of MSA.A longitudinal observational study on 22 MSA patients (11 males and 11 females).Significant changes were obtained in the quantitative SPECT assessments in the three Striatum/Occipital indices. The qualitative SPECT diagnosis did not show differences between the initial and evolving SPECT, but the neurologist's clinical suspicion did. Our results showed a brain deterioration of around 31% at 12 months, this being the optimal cut-off for differentiating a diseased subject (capable of solving diagnostic error rate). Previous imaging tests were inconclusive, as they showed less deterioration in the SPECT and quantitative assessments with respect to the group of confirmed patients. Repeated SPECT increased the diagnostic sensitivity (50% vs. 75%) and positive predictive value (72.73% vs. 77%). In addition, repeated SPECT proved decisive in the diagnosis of initial inconclusive cases.Repeat SPECT at 12 months proves useful in the diagnosis and follow-up of MSA.
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In order to confirm the diagnosis and clarify the pathophysiology in the ischemic lesions in brain, 99mTc-PAO SPECT was performed in 42 patients with ischemic cerebral diseases, and the findings on 99mTc-PAO SPECT were compared with those on 123I-IMP or 99mTc-DTPA SPECT, and on X-CT. Furthermore, count ratio of ischemic lesion to normal contralateral region (I/N) was used for the evaluation of the detectability in the lesions on 99mTc-PAO or 123I-IMP SPECT, and less than 0.95 of I/N ratio was defined as the decreased accumulation. The detectability of ischemic lesion in brain with 99mTc-PAO SPECT was 80%, which was superior to that (60%) of LDA on X-CT. Especially, 99mTc-PAO SPECT was useful in cases which were examined early after the onset of the attack. On the other hand, 123I-IMP SPECT showed the best result (88%) in the detectability, and furthermore I/N ratio on 123I-IMP SPECT was lower than that on 99mTc-PAO SPECT. In the delayed phase on 123I-IMP SPECT the redistribution was observed in 30%, while on 99mTc-PAO SPECT it was done in none of them. The accumulation of 99mTc-DTPA in brain was found in 6 of 14 cases (43%), and 2 cases among them also showed the accumulation of 99mTc-PAO in the ischemic lesion. In such cases the destruction of BBB might be considered as the cause of the accumulation of 99mTc-PAO. Thus, 99mTc-PAO SPECT was thought to be useful method in clinical studies of the ischemic cerebral diseases.
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Single photon emission computed tomography (SPECT) myocardial perfusion imaging is widely used for diagnosing coronary artery disease (CAD). However, SPECT costs, imaging time, and radiation exposure, limit SPECT indications.Determine whether a stress-only SPECT imaging would be enough to obtain a diagnosis of CAD improving nuclear laboratory efficiency.122 patients with unknown CAD were evaluated with stress-only SPECT imaging. In order to evaluate diagnostic accuracy and the prognostic value of the stress-only protocol, patients with abnormal SPECT underwent invasive angiography and patients with normal SPECT were followed-up during 3 years.Diagnosis time, SPECT cost, and radiopharmaceutical dosage were significantly lower as compared with the conventional SPECT imaging protocol (30, 40 and 55%, respectively). Diagnostic accuracy and cardiac prognosis information were comparable to those obtained with the conventional imaging protocol (positive predictive value for CAD of 85% and negative predictive value for cardiac events of 97%).In patients with intermediate risk for CAD, stress-only SPECT imaging will significantly improve nuclear laboratory efficiency, and with similar accuracy than that the one obtained with the conventional protocol.
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SUMMARY The regional cerebral blood flow (rCBF) pattern is a reflection of neural activity in different brain regions due to the tight coupling between regional cerebral blood flow and neuronal activity. With Single Photon Emission Computed Tomography (SPECT) using the flow tracer Tc-99m-HMPAO, high resolution rCBF images can be obtained. SPECT images of five patients with various degree of cognitive impairment and features of dementia are reported. Different rCBF patterns are noticed in Alzheimer's disease and multi-infarct dementia. The clinical applications of SPECT in the management of dementia are discussed. INTRODUCTION Single Photon Emission Computed Tomography (SPECT) is an imaging technique of brain function and is a measurement of regional cerebral blood flow (rCBF). It is based on the observation that there is a tight coupling between CBF and metabolic activity. It involves injection of radiopharmaceuticals into a subject and the detection of its distribution by a rotating gamma camera. The gamma camera consists of a collimator (a focusing device),a crystal (sodium iodide) which will emit photons on impact by gamma rays from radioisotopes and a circuitry that detects and analyses the photon emission pattern. Radiopharmaceuticals commonly used are Tc-99m-HMPAO and I-123-IMP. These lipophilic isotopes once taken up by the neurons will be transformed to a lipophobic ligand and will stay in the cells. In other words, the pattern of the distribution or radioactivity will be determined by the pattern of regional cerebral blood flow at the time of the injection of radiopharmaceuticals. The patient can be at a resting position during injection or he or she can be asked to perform a variety of tasks like verbal fluency activation as well as pharmacological activation and sensory stimulation (Devous, 1989; Friberg, 1989). The evolution of various techniques of cerebral blood flow measurement like Positron Emission Tomography (PET) and SPECT and their application in the studies of dementia was discussed by Bonte et al (1990). Brain SPECT is generally regarded as the culmination of a series of investigations of CBF pioneered by Kety and Schmidt (1948). The relative inexpensiveness and simplicity in operation as compared with PET has made SPECT widely applied in clinical practice. A number of SPECT studies have now been performed using Tc-99m-HMPAO to investigate dementia and has been reviewed by Geaney and Abou-Saleh (1990). These studies have shown that SPECT can reveal cerebral abnormalities when CT and MRI do not because the latter are measures of cerebral structure while the former are measures of cerebral function. Various rCBF patterns have been reported in different demented conditions like Alzheimer's disease (AD), multi-infarct dementia (MID), Pick's disease and Huntington's disease with different degree of specificity. The aim of this study is to summarize our experience at Queen Mary Hospital in the SPECT brain imaging of patients with various demented conditions and to discuss the relevant clinical applications in psychiatry. PATIENTS & METHOD Two patients with Alzheimer's disease, one patient with multi-infarct dementia, one patient with delirium and one patient with depression were studied. The diagnosis in these patients satisfied the DSM-111-R criteria. Mini-Mental State examination (Folstein et al, 1975) was also performed. SPECT were performed in the first hour following the intravenous injection of 550MBq of Tc-99m-HMPAO. Injection was given within 30 minutes of preparation of the compound. The patient was imaged on a tomographic table using a rotating gamma camera (Elscint Apex). A head support was used that enables the camera to rotate with the minimum possible radius around the patient's head. Images were acquired for 25 seconds each at 60 angles over 360 degrees and the total study time was approximately 30 minutes. A low energy high resolution collimator was used and images structured in a 64 x 64 matrix. …
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