scholarly journals Is there a preference for PET or SPECT brain imaging in diagnosing dementia? The views of people with dementia, carers, and healthy controls

2015 ◽  
Vol 28 (1) ◽  
pp. 123-131 ◽  
Author(s):  
Claire Bamford ◽  
Kirsty Olsen ◽  
Chris Davison ◽  
Nicky Barnett ◽  
Jim Lloyd ◽  
...  
Keyword(s):  
Heart Rate ◽  
Diagnostic Accuracy ◽  
Brain Imaging ◽  
Pulse Rate ◽  
Photon Emission ◽  
Diagnostic Tools ◽  
Emission Computed Tomography ◽  
Routine Practice ◽  
Baseline Heart Rate ◽  
Rate Data

ABSTRACTBackground:Positron emission tomography (PET) and single photon emission computed tomography (SPECT) brain imaging are widely used as diagnostic tools for suspected dementia but no studies have directly compared participant views of the two procedures. We used a range of methods to explore preferences for PET and SPECT.Methods:Patients and controls (and accompanying carers) completed questionnaires immediately after undergoing PET and SPECT brain scans. Pulse rate data were collected during each scan. Scan attributes were prioritized using a card sorting exercise; carers and controls additionally answered willingness to pay (WTP) questions.Results:Few differences were found either between the scans or groups of participants, although carers marginally preferred SPECT. Diagnostic accuracy was prioritized over other scan characteristics. Mean heart rate during both scans was lower than baseline heart rate measured at home (p < 0.001).Conclusion:Most participants viewed PET and SPECT scans as roughly equivalent and did not have a preference for either scan. Carer preference for SPECT is likely to reflect their desire to be with the patient (routine practice for SPECT but not for PET), suggesting that they should be able to accompany vulnerable patients throughout imaging procedures wherever possible. Pulse rate data indicated that brain imaging was no more stressful than a home visit (HV) from a researcher. The data do not support the anecdotal view that PET is a more burdensome procedure and the use of PET or SPECT scans in dementia should be based on diagnostic accuracy of the technique.

Clinical value of amino acid imaging in paediatric brain tumours

2005 ◽  
Vol 44 (04) ◽  
pp. 131-136 ◽  
Author(s):  
K. Lang ◽  
S. Kloska ◽  
R. Straeter ◽  
C. H. Rickert ◽  
G. Goder ◽  
...  
Keyword(s):  
Amino Acid ◽  
Brain Tumours ◽  
Photon Emission ◽  
Diagnostic Tools ◽  
Emission Computed Tomography ◽  
Gadolinium Enhancement ◽  
Tumour Grading ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Paediatric Brain Tumours

Summary Purpose: To evaluate single photon emission computed tomography (SPECT) using the amino acid l-3-[123I]-α-methyl tyrosine (IMT) and contrast enhanced magnetic resonance imaging (MRI) as diagnostic tools in primary paediatric brain tumours in respect of non-invasive tumour grading. Patients, materials, methods: 45 children with primary brain tumours were retrospectively evaluated. IMT uptake was quantified as tumour/nontumour- ratio, a 4-value-scale was used to measure gadolinium enhancement on contrast enhanced MRI. Statistical analyses were performed to evaluate IMT uptake and gadolinium enhancement in low (WHO I/II) and high (WHO III/ IV) grade tumours and to disclose a potential relationship of IMT uptake to disruption of blood brain barrier as measured in corresponding MRI scans. Results: IMT uptake above background level was observed in 35 of 45 patients. IMT uptake was slightly higher in high grade tumours but the difference failed to attain statistical significance. Grading of individual tumours was neither possible by IMT SPECT nor by gadolinium enhanced MRI. Conclusion: IMT is accumulated in most brain tumours in children. Tumour grading was not possible using IMT or contrast enhancement as determined by MRI. Neither morphological nor functional imaging can replace histology in paediatric brain tumours.

Diagnostic Value of the Updated Diamond and Forrester Score to Predict Coronary Artery Disease in Patients with Acute-Onset Chest Pain

Cardiology ◽  
2015 ◽  
Vol 133 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Mathias Sørgaard ◽  
Jesper James Linde ◽  
Klaus Fuglsang Kofoed ◽  
Jørgen Tobias Kühl ◽  
Henning Kelbæk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Stress Test ◽  
Photon Emission ◽  
Acute Onset ◽  
Emission Computed Tomography ◽  
Artery Disease

Objectives: In the recently updated clinical guidelines from the European Society of Cardiology on the management of stable coronary artery disease (CAD), the updated Diamond Forrester score has been included as a pretest probability (PTP) score to select patients for further diagnostic testing. We investigated the validity of the new guidelines in a population of patients with acute-onset chest pain. Methods: We examined 527 consecutive patients with either an exercise-ECG stress test or single-photon emission computed tomography, and subsequently coronary computed tomography angiography (CCTA). We compared the diagnostic accuracy of PTP and stress testing assessed by the area under the receiver operating characteristic curve (AUC) to identify significant CAD, defined as at least 1 coronary artery branch with >70% diameter stenosis identified by CCTA. Results: The diagnostic accuracy of PTP was significantly higher than the stress test (AUC 0.80 vs. 0.69; p = 0.009), but the diagnostic accuracy of the combination of PTP and a stress test did not significantly increase when compared to PTP alone (AUC 0.86 vs. 0.80; p = 0.06). Conclusions: PTP using the updated Diamond and Forrester Score is a very useful tool in risk-stratifying patients with acute-onset chest pain at a low-to-intermediate risk of having CAD. Adding a stress test to PTP does not appear to offer significant diagnostic benefit.

Discrepancy Between the Degree of Cognitive Impairment and Brain Imaging Abnormalities in Alzheimer’s Disease Patients Is Associated with Cognitive Reserve

2021 ◽  
pp. 1-9
Author(s):  
Tomohiko Sato ◽  
Haruo Hanyu ◽  
Yumi Koyama ◽  
Haruka Horita ◽  
Toshinori Aoki ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Brain Imaging ◽  
Cognitive Reserve ◽  
Photon Emission ◽  
Clinical Manifestations ◽  
Leisure Activity ◽  
Emission Computed Tomography ◽  
Imaging Findings

Background: In Alzheimer’s disease (AD) patients, the severity of cognitive impairment is thought to correlate with the degree of brain imaging abnormalities. However, some patients show only mild cognitive deficit, despite severe brain atrophy on magnetic resonance imaging (MRI) or marked hypoperfusion in the cerebral cortices on single-photon emission computed tomography (SPECT). This suggests that cognitive reserve (CR) can compensate for the clinical manifestations of AD in patients with extensive brain pathology. Objective: We aimed to determine whether this discrepancy between cognitive and imaging findings is associated with CR. Methods: Factors associated with the discrepancy between the degree of cognitive impairment and MRI (medial temporal lobe atrophy) and SPECT (posterior cerebral hypoperfusion) findings were analyzed in 135 patients with probable AD. Factors as proxies for CR included education, occupation, leisure activity, comorbidities, frailty, and other demographics. The discrepancy index (DI) was calculated as the difference between the degree of imaging abnormalities and the degree of cognitive dysfunction. Results: Multiple regression analysis showed that leisure activity and education were significantly associated with the discrepancy between cognitive and imaging findings. When the level of CR was determined based on leisure activity and education, the high-CR group showed a significantly larger DI than the moderate- and low-CR groups. Conclusion: The discrepancy between cognitive and imaging findings in patients with AD is associated with CR, measured using a combination of two indicators, i.e., leisure activity and education. Therefore, lifestyle interventions may delay the appearance of clinical symptoms resulting from underlying AD pathology, by increasing CR.

Cardiac autonomic activity and Type II diabetes mellitus

2005 ◽  
Vol 108 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Daniela MANZELLA ◽  
Giuseppe PAOLISSO
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Function ◽  
Single Photon ◽  
Low Cost ◽  
Photon Emission ◽  
Cardiac Autonomic Neuropathy ◽  
Emission Computed Tomography ◽  
Published Data ◽  
Increased Risk

CAN (cardiac autonomic neuropathy) is a common complication of diabetes. Meta-analyses of published data demonstrate that reduced cardiovascular autonomic function, as measured by heart rate variability, is strongly associated with an increased risk of silent myocardial ischaemia and mortality. A major problem in ischaemia-induced impairment of vascular performance in the diabetic heart is unrecognized cardiac sympathetic dysfunction. Determining the presence of CAN is based on a battery of autonomic function tests and techniques such as SPECT (single-photon emission computed tomography) and PET (positron emission tomography). Nevertheless, spectral analysis of heart rate variability seems to remain the primary technique in evaluating CAN, due to its low cost, easy use and good intra-individual reproducibility.

Skeletal SPECT/CT of the peripheral extremities -interdisciplinary approach in orthopaedic disorders-first clinical results

Open Medicine ◽  
2007 ◽  
Vol 2 (4) ◽  
pp. 499-510 ◽  
Author(s):  
Wolfgang Wuest ◽  
Torsten Kuwert ◽  
Markus Grunewald ◽  
Werner Bautz ◽  
Raimund Forst ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Hybrid Imaging ◽  
Single Photon ◽  
Photon Emission ◽  
Interdisciplinary Approach ◽  
Spiral Ct ◽  
Emission Computed Tomography ◽  
Main Diagnosis ◽  
Ct Scanner ◽  
Lesion Localization

AbstractBone scintigraphy, although quite sensitive to detect skeletal lesions, has a comparatively low specificity. Hybrid-cameras combining single-photon emission computed tomography (SPECT) and spiral-CT offer the opportunity to correlate scintigraphic information with high-quality visualization of morphology in one session. This may lead to an improvement in diagnostic accuracy and anatomic lesion localization. We present 11 patients, who underwent SPECT/CT of the feet (n=10) and hands (n = 1). The examinations were performed due to pain in foot or hand with the following suspected clinical diagnoses: arthrosis (n=1); fracture (n=3); osteomyelitis (n=4); reflex dystrophia (n=1); and, pain of unclear origin (n=2). All patients underwent SPECT/CT hybrid imaging using a dual-headed SPECT camera integrated with a 2-slice spiral CT scanner in one gantry. SPECT, CT, and SPECT/CT were evaluated independently from each other with respect to main diagnosis, anatomic lesion localization, and detection of a possible additional diagnosis. SPECT/CT improved lesion localization in 8 of 11 patients (73%) in comparison to SPECT alone, and in 4 of 11 patients (36%) in comparison to CT alone. Diagnostic accuracy was improved in 4 of 11 patients (36%) in comparison to either SPECT or CT alone. In conclusion, skeletal SPECT/CT improves diagnostic accuracy and lesion localization of orthopedic disorders in the feet and hands. The obtained results encouraged extensive studies to further investigate the potential gain in diagnostic accuracy brought about by SPECT/spiral-CT hybrid imaging in orthopedic disorders of the peripheral extremities.

scholarly journals Relative Function: Nuclear Brain Imaging in United States Courts

2011 ◽  
Vol 39 (4) ◽  
pp. 567-593 ◽  
Author(s):  
Susan E. Rushing ◽  
Daniel D. Langleben
Keyword(s):  
Brain Imaging ◽  
Functional Imaging ◽  
Brain Structure ◽  
Neuropsychological Testing ◽  
Photon Emission ◽  
Structure And Function ◽  
Emission Computed Tomography ◽  
Brain Structure And Function ◽  
And Function ◽  
The Brain

Neuropsychological testing—medical imaging of the brain structure and function—allows the expert to inform the court on the brain structure and function of the forensic examinee. Supported by extensive clinical use, neuropsychological testing and structural imaging in the form of computerized tomography and structural magnetic resonance imaging have achieved general acceptance in court. However, functional imaging such as functional MRI and nuclear medicine techniques, such as positron emission tomography (PET), have faced more admissibility challenges. While functional imaging is becoming an increasingly important tool in assessing neuropsychiatric illness, we surmise that evidentiary challenges are largely related to the phase of trial in which the nuclear study is offered as evidence. This article will review the basic science of functional nuclear imaging including PET and single photon emission computed tomography. We will then review cases where admissibility of these techniques has been challenged and consider whether and how nuclear brain imaging can influence the outcome of the trial.

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