scholarly journals Differential diagnosis of parkinsonism: a head-to-head comparison of FDG PET and MIBG scintigraphy

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Joachim Brumberg ◽  
Nils Schröter ◽  
Ganna Blazhenets ◽  
Lars Frings ◽  
Jens Volkmann ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Fdg Pet ◽  
Statistical Significance ◽  
Lewy Bodies ◽  
Area Under The Curve ◽  
Mibg Scintigraphy ◽  
Imaging Results ◽  
Case Vignettes ◽  
Heart To Mediastinum Ratio

Abstract[18F]fluorodeoxyglucose (FDG) PET and [123I]metaiodobenzylguanidine (MIBG) scintigraphy may contribute to the differential diagnosis of neurodegenerative parkinsonism. To identify the superior method, we retrospectively evaluated 54 patients with suspected neurodegenerative parkinsonism, who were referred for FDG PET and MIBG scintigraphy. Two investigators visually assessed FDG PET scans using an ordinal 6-step score for disease-specific patterns of Lewy body diseases (LBD) or atypical parkinsonism (APS) and assigned the latter to the subgroups multiple system atrophy (MSA), progressive supranuclear palsy (PSP), or corticobasal syndrome. Regions-of-interest analysis on anterior planar MIBG images served to calculate the heart-to-mediastinum ratio. Movement disorder specialists blinded to imaging results established clinical follow-up diagnosis by means of guideline-derived case vignettes. Clinical follow-up (1.7 ± 2.3 years) revealed the following diagnoses: n = 19 LBD (n = 17 Parkinson’s disease [PD], n = 1 PD dementia, and n = 1 dementia with Lewy bodies), n = 31 APS (n = 28 MSA, n = 3 PSP), n = 3 non-neurodegenerative parkinsonism; n = 1 patient could not be diagnosed and was excluded. Receiver operating characteristic analyses for discriminating LBD vs. non-LBD revealed a larger area under the curve for FDG PET than for MIBG scintigraphy at statistical trend level for consensus rating (0.82 vs. 0.69, p = 0.06; significant for investigator #1: 0.83 vs. 0.69, p = 0.04). The analysis of PD vs. MSA showed a similar difference (0.82 vs. 0.69, p = 0.11; rater #1: 0.83 vs. 0.69, p = 0.07). Albeit the notable differences in diagnostic performance did not attain statistical significance, the authors consider this finding clinically relevant and suggest that FDG PET, which also allows for subgrouping of APS, should be preferred.

Single-subject SPM FDG-PET patterns predict risk of dementia progression in Parkinson disease

Neurology ◽  
2018 ◽  
Vol 90 (12) ◽  
pp. e1029-e1037 ◽  
Author(s):  
Andrea Pilotto ◽  
Enrico Premi ◽  
Silvia Paola Caminiti ◽  
Luca Presotto ◽  
Rosanna Turrone ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Fdg Pet ◽  
Cognitive Assessment ◽  
Disease Duration ◽  
Age At Onset ◽  
Statistical Parametric Mapping ◽  
Lewy Bodies ◽  
Single Subject ◽  
Incident Dementia

ObjectiveTo evaluate the statistical parametric mapping (SPM) procedure for fluorodeoxyglucose (FDG)-PET imaging as a possible single-subject marker of progression to dementia in Parkinson disease (PD).MethodsFifty-four consecutive patients with PD without dementia (age at onset of 59.9 ± 10.1 years, disease duration of 5.3 ± 3.4 years) entered the study. The patients underwent an extensive motor and cognitive assessment and a single-subject FDG-PET SPM evaluation at baseline. A 4-year follow-up provided disease progression and dementia diagnosis.ResultsThe FDG-PET SPM was evaluated by 2 expert raters allowing the identification of a “typical PD pattern” in 29 patients, whereas 25 patients presented with “atypical patterns,” namely, dementia with Lewy bodies (DLB)-like (n = 12), Alzheimer disease (AD)-like (n = 6), corticobasal syndrome (CBS)-like (n = 5), and frontotemporal dementia (FTD)-like (n = 2). At 4-year follow-up, 13 patients, all showing atypical brain metabolic patterns at baseline, progressed to dementia (PD dementia). The DLB- and AD-like SPM patterns were the best predictor for incident dementia (p < 0.005, sensitivity 85%, specificity 88%), independently from demographics or cognitive baseline classification.ConclusionsThis study suggests that FDG-PET SPM at the single-subject level might help in identifying patients with PD at risk of developing dementia.

scholarly journals Role of serial cardiac 18F-FDG PET-MRI in Anderson–Fabry disease: a pilot study

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Carmela Nappi ◽  
Andrea Ponsiglione ◽  
Antonio Pisani ◽  
Eleonora Riccio ◽  
Teodolinda Di Risi ◽  
...  
Keyword(s):  
Fabry Disease ◽  
Fdg Pet ◽  
Cardiac Involvement ◽  
Cardiac Injury ◽  
Gadolinium Enhancement ◽  
Enzyme Replacement ◽  
Imaging Results ◽  
Relationship Of

Abstract Aim We investigated the value of serial cardiac 18F-FDG PET-MRI in Anderson–Fabry disease (AFD) and the potential relationship of imaging results with FASTEX score. Methods and results Thirteen AFD patients underwent cardiac 18F-FDG PET-MRI at baseline and follow-up. Coefficient of variation (COV) of FDG uptake and FASTEX score were assessed. At baseline, 9 patients were enzyme replacement therapy (ERT) naïve and 4 patients were under treatment. Two patients presented a FASTEX score of 0 indicating stable disease and did not show any imaging abnormality at baseline and follow-up PET-MRI. Eleven patients had a FASTEX score > 20% indicating disease worsening. Four of these patients without late gadolinium enhancement (LGE) and with normal COV at baseline and follow-up had a FASTEX score of 35%. Three patients without LGE and with abnormal COV at baseline and follow-up had a FASTEX score ranging from 30 to 70%. Three patients with LGE and abnormal COV at baseline and follow-up had a FASTEX score between 35 and 75%. Finally, one patient with LGE and normal COV had a FASTEX score of 100%. Of the 12 patients on ERT at follow-up, FASTEX score was significantly higher in those 4 showing irreversible cardiac injury at baseline compared to 8 with negative LGE (66 ± 24 vs. 32 ± 21, p = 0.03). Conclusion 18F-FDG PET-MRI may be effective to monitor cardiac involvement in AFD.

scholarly journals Spatial covariance analysis of FDG-PET and HMPAO-SPECT for the differential diagnosis of dementia with Lewy bodies and Alzheimer's disease.

2021 ◽  
Author(s):  
Matthew Ingram ◽  
Sean J Colloby ◽  
Michael J Firbank ◽  
Jim J Lloyd ◽  
John T O'Brien ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Fdg Pet ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Spatial Covariance ◽  
Visual Rating ◽  
Hmpao Spect ◽  
Diagnosis Of Dementia ◽  
Pet Scans ◽  
Differential Diagnosis Of Dementia

We investigated diagnostic characteristics of spatial covariance analysis (SCA) of FDG-PET and HMPAO-SPECT scans in the differential diagnosis of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), in comparison with visual ratings and region of interest (ROI) analysis. Sixty-seven patients (DLB 29, AD 38) had both HMPAO-SPECT and FDG-PET scans. Spatial covariance patterns were used to separate AD and DLB in an initial derivation group (DLB n=15, AD n=19), before being forward applied to an independent group (DLB n=14, AD n=19). Visual ratings were by consensus, with ROI analysis utilising medial occipital/medial temporal uptake ratios. SCA of HMPAO-SPECT performed poorly (AUC 0.59 +/- 0.10), whilst SCA of FDG-PET (AUC 0.83 +/- 0.07) was significantly better. For FDG-PET, SCA showed similar diagnostic performance to ROI analysis (AUC 0.84 +/- 0.08) and visual rating (AUC 0.82 +/- 0.08). In contrast to ROI analysis, there was little concordance between SCA and visual ratings of FDG-PET scans. We conclude that SCA of FDG-PET outperforms that of HMPAO-SPECT and performed similarly to other analytical approaches, with the potential to improve with larger derivation groups. Compared to visual rating, SCA of FDG-PET relies on different sources of group variance to separate DLB from AD.

scholarly journals Multimodal PET/MRI Imaging Results Enable Monitoring the Side Effects of Radiation Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Noémi Kovács ◽  
Krisztián Szigeti ◽  
Nikolett Hegedűs ◽  
Ildikó Horváth ◽  
Dániel S Veres ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Side Effects ◽  
Radiation Exposure ◽  
Fdg Pet ◽  
Tumor Therapy ◽  
Imaging Biomarkers ◽  
Imaging Protocol ◽  
Imaging Results ◽  
The Brain

Radiotherapy is one of the most frequently applied treatments in oncology. Tissue-absorbed ionizing radiation damages not only targeted cells but the surrounding cells too. The consequent long-term induced oxidative stress, irreversible tissue damage, or second malignancies draw attention to the urgent need of a follow-up medical method by which personalized treatment could be attained and the actually dose-limiting organ could be monitored in the clinical practice. We worked out a special hemisphere irradiation technique for mice which mimics the radiation exposure during radiotherapy. We followed up the changes of possible brain imaging biomarkers of side effects, such as cerebral blood flow, vascular endothelial function, and cellular metabolic processes for 60 days. BALB/c mice were divided into two groups (n=6 per group) based on the irradiation doses (5 and 20 Gy). After the irradiation procedure arterial spin labeling (ASL), diffusion-weighted imaging (DWI) in magnetic resonance modality and [18F]fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) scans of the brain were obtained at several time points (3, 7, 30, and 60 days after the irradiation). Significant physiological changes were registered in the brain of animals following the irradiation by both applied doses. Elevated standard uptake values were detected all over the brain by FDG-PET studies 2 months after the irradiation. The apparent diffusion coefficients from DWI scans significantly decreased one month after the irradiation procedure, while ASL studies did not show any significant perfusion changes in the brain. Altogether, our sensitive multimodal imaging protocol seems to be an appropriate method for follow-up of the health status after radiation therapy. The presented approach makes possible parallel screening of healthy tissues and the effectiveness of tumor therapy without any additional radiation exposure.

FV12 Molecular imaging in the differential diagnosis of parkinsonism: A head-to-head comparison of FDG PET and MIBG scintigraphy

2020 ◽  
Vol 131 (4) ◽  
pp. e229-e230
Author(s):  
J. Brumberg ◽  
N. Schröter ◽  
G. Blazhenets ◽  
L. Frings ◽  
J. Volkmann ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Molecular Imaging ◽  
Fdg Pet ◽  
Mibg Scintigraphy

scholarly journals A 5-Minute Cognitive Assessment For Remote Safety Use In COVID-19 Patients (Preprint)

2020 ◽  
Author(s):  
Thomas Beresford ◽  
Patrick Ronan
Keyword(s):  
Differential Diagnosis ◽  
High Risk ◽  
Brain Region ◽  
Brain Function ◽  
Cognitive Assessment ◽  
Early Experience ◽  
Brain Regions ◽  
Diagnosis And Treatment ◽  
Case Vignettes

BACKGROUND Early experience with the COVID-19 Pandemic has begun to elucidate brain function changes resulting in compromised cognition. This occurs both acutely and during variable recovery periods. OBJECTIVE Aimed at characterizing different courses of injury and recovery, we present here a brief, reproducible cognitive examination that can be given safely by telephone. METHODS First developed for use in delirious cases, including subtle forms of encephalopathy, it gathers information by brain region for differential diagnosis, contrasted to simple orientation or simplistic screen exam scores. RESULTS We present a series of brief COVID-19 case vignettes to illustrate its use in diagnosis and treatment of brain effects. CONCLUSIONS This is a safe, brief cognitive exam that can be given remotely in high risk situations such as active COVID-19 cases that is useful 1) in the evaluation of specific brain regions, 2) in serial follow-up testing, 3) and in situations requiring safe, least impact assessments. CLINICALTRIAL n/a

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