scholarly journals Diagnostic accuracy of imaging brain vesicular monoamine transporter type 2 (VMAT2) in clinically uncertain parkinsonian syndrome (CUPS): a 3-year follow-up study in community patients

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e025533 ◽  
Author(s):  
San San Xu ◽  
Paschal K Alexander ◽  
Yenni Lie ◽  
Vincent Dore ◽  
Svetlana Bozinovski ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Pet Scan ◽  
Vesicular Monoamine Transporter ◽  
Monoamine Transporter ◽  
Rubral Tremor ◽  
Diagnostic Changes ◽  
Community Patients

ObjectivesTo further validate the diagnostic utility of 18F-AV-133 vesicular monoamine transporter type 2 (VMAT2) positron emission tomography (PET) in patients with clinically uncertain parkinsonian syndromes (CUPS) by comparison to clinical diagnosis at 3 years follow-up.Design, setting and participantsIn a previous study, we reported that 18F-AV-133 PET in community patients with CUPS changed diagnosis and management and increased diagnostic confidence. The current diagnosis of this cohort was obtained from the patient and treating specialist and compared with the diagnosis suggested 3 years earlier by the 18F-AV-133 PET. A second 18F-AV-133 PET was available in those with a discordant or inconclusive final diagnosis.Study outcome measuresThe primary end point was the proportion of patients who had a follow-up clinical diagnosis, which was concordant with their initial 18F-AV-133 PET scan. Secondary end points were the proportion of patients who had the same diagnosis at follow-up as that reached after the initial scan and the stability of diagnostic changes made after the first scan.Results81 of the 85 patients previously recruited to the CUPS study had follow-up of which 79 had a clinical diagnosis and 2 remained CUPS. The diagnosis was in agreement with the initial 18F-AV-133 PET scan result in 74 cases. Five patients had a discordant diagnosis; one patient with rubral tremor had a severely abnormal scan that had worsened when rescanned; four cases with normal initial and repeat scans had a clinical diagnosis of Parkinson’s disease. Two patients with suspected genetic disorders remained classified as CUPS and both had normal scans. In the 24 CUPS cohort patients where 18F-AV-133 PET initially changed diagnosis, this change was supported by follow-up diagnosis in all but the one rubral tremor case.Conclusion18F-AV-133 PET is a useful tool in improving diagnostic accuracy in CUPS providing results and diagnostic changes that remain robust after 3 years follow-up.

scholarly journals Analysis and Follow up of Endoscopy Results in 1099 Patients with Terminal Ileum Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Qinglian Zhong ◽  
Anye Zhang ◽  
Jian Huang ◽  
Wen Yan ◽  
Jiayu Lin ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Terminal Ileum ◽  
Diagnostic Yield ◽  
Delayed Diagnosis ◽  
Clinical Treatment ◽  
Diagnosis And Management

Objective. We aim to analyze the diagnostic yield, diagnostic accuracy, and delayed diagnosis of patients with terminal ileum lesions, providing follow-up suggestions for suspected patients. Methods. We carried out an analysis of 1099 patients who had terminal ileum lesions in our hospital from 2009 to 2019. The endoscopy reports and histopathology reports of terminal ileal biopsies were recorded. Clinical diagnosis and management were reviewed to determine whether there was a need to correct after a follow-up endoscopy result. Results. A total of 1099 patients were found to have terminal ileum lesions, among which 959 in 1099 patients (87.26%) were diagnosed as benign, 17 in 1099 patients (1.55%) were diagnosed as malignant, and 123 in 1099 patients (11.19%) were diagnosed as suspected. The diagnostic accuracies of terminal ileal polyp, cyst, cancer, eosinophilic enteritis, parasite, lymphofollicular hyperplasia, and amyloidosis were 100%. The diagnosis was delayed in 9.93% of Crohn’s disease (CD) and 12.5% of lymphoma. Among the definite cases, the diagnosis was corrected during the follow-up in 12.5% of the patients, while the clinical treatment was corrected during the follow-up in 17.86% of the patients. Among the suspected cases, the diagnosis and treatment was corrected in 61.11% of the patients during the follow-up. Conclusion. Coincident diagnosis of ileitis and ileum ulcer is low. Delayed diagnosis of Crohn’s disease and lymphoma were observed in a certain proportion of patients with terminal ileum lesions. A follow-up endoscopy was strongly recommended for these suspected patients with terminal ileum lesions.

Duplexsonographie bei Riesenzellarteriitis – Abschätzung von Schweregrad und möglicher Erblindung

2020 ◽  
Vol 2 (4) ◽  
pp. 158-160
Author(s):  
Sabine Adler
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Ultrasound Examination ◽  
Vascular Inflammation ◽  
Temporal Artery ◽  
Clinical Factors ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
A Prospective Study

<b>Objectives:</b> Ultrasound of temporal and axillary arteries may reveal vessel wall inflammation in patients with giant cell arteritis (GCA). We developed a ultrasound scoring system to quantify the extent of vascular inflammation and investigated its diagnostic accuracy and association with clinical factors in GCA. <b>Methods:</b> This is a prospective study including 89 patients suspected of having GCA, of whom 58 had a confirmed clinical diagnosis of GCA after 6 months follow-up. All patients underwent bilateral ultrasound examination of the three temporal artery (TA) segments and axillary arteries, prior to TA biopsy. The extent of vascular inflammation was quantified by (1) counting the number of TA segments and axillary arteries with a halo and (2) calculating a composite Halo Score that also incorporated the thickness of each halo. <b>Results:</b> Halo counts and Halo Scores showed moderate diagnostic accuracy for a clinical diagnosis of GCA. They correlated positively with systemic inflammation. When compared with the halo count, the Halo Score correlated better with C-reactive protein (CRP) levels and allowed to firmly establish the diagnosis of GCA in more patients. Higher halo counts and Halo Scores were associated with a higher risk of ocular ischaemia. They allowed to identify subgroups of patients with low risk (≤5%) and high risk of ocular ischaemia (&#x3e;30%). <b>Conclusion:</b> Ultrasound halo scoring allows to quantify the extent of vascular inflammation in GCA. Extensive vascular inflammation on ultrasound may provide strong diagnostic confirmation and associates with ocular ischaemia in GCA.

scholarly journals In Vivo Measurement of Vesicular Monoamine Transporter Type 2 Density in Parkinson Disease with 18F-AV-133

2010 ◽  
Vol 51 (2) ◽  
pp. 223-228 ◽  
Author(s):  
N. Okamura ◽  
V. L. Villemagne ◽  
J. Drago ◽  
S. Pejoska ◽  
R. K. Dhamija ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Vesicular Monoamine Transporter ◽  
Monoamine Transporter ◽  
In Vivo Measurement

scholarly journals Novel ultrasonographic Halo Score for giant cell arteritis: assessment of diagnostic accuracy and association with ocular ischaemia

2020 ◽  
Vol 79 (3) ◽  
pp. 393-399 ◽  
Author(s):  
Kornelis S M van der Geest ◽  
Frances Borg ◽  
Abdul Kayani ◽  
Davy Paap ◽  
Prisca Gondo ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Clinical Diagnosis ◽  
Vascular Inflammation ◽  
Temporal Artery ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
A Prospective Study

ObjectivesUltrasound of temporal and axillary arteries may reveal vessel wall inflammation in patients with giant cell arteritis (GCA). We developed a ultrasound scoring system to quantify the extent of vascular inflammation and investigated its diagnostic accuracy and association with clinical factors in GCA.MethodsThis is a prospective study including 89 patients suspected of having GCA, of whom 58 had a confirmed clinical diagnosis of GCA after 6 months follow-up. All patients underwent bilateral ultrasound examination of the three temporal artery (TA) segments and axillary arteries, prior to TA biopsy. The extent of vascular inflammation was quantified by (1) counting the number of TA segments and axillary arteries with a halo and (2) calculating a composite Halo Score that also incorporated the thickness of each halo.ResultsHalo counts and Halo Scores showed moderate diagnostic accuracy for a clinical diagnosis of GCA. They correlated positively with systemic inflammation. When compared with the halo count, the Halo Score correlated better with C-reactive protein (CRP) levels and allowed to firmly establish the diagnosis of GCA in more patients. Higher halo counts and Halo Scores were associated with a higher risk of ocular ischaemia. They allowed to identify subgroups of patients with low risk (≤5%) and high risk of ocular ischaemia (>30%).ConclusionsUltrasound halo scoring allows to quantify the extent of vascular inflammation in GCA. Extensive vascular inflammation on ultrasound may provide strong diagnostic confirmation and associates with ocular ischaemia in GCA.

scholarly journals Decreased Vesicular Monoamine Transporter Type 2 Availability in the Striatum Following Chronic Cocaine Self-Administration in Nonhuman Primates

2015 ◽  
Vol 77 (5) ◽  
pp. 488-492 ◽  
Author(s):  
Rajesh Narendran ◽  
Hank P. Jedema ◽  
Brian J. Lopresti ◽  
Neale Scott Mason ◽  
Michael L. Himes ◽  
...  
Keyword(s):  
Nonhuman Primates ◽  
Vesicular Monoamine Transporter ◽  
Self Administration ◽  
Monoamine Transporter ◽  
Chronic Cocaine
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