scholarly journals Bottom-of-sulcus dysplasia: the role of 18F-FDG PET in identifying a focal surgically remedial epileptic lesion

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
S. U. Berlangieri ◽  
R. Mito ◽  
M. Semmelroch ◽  
M. Pedersen ◽  
G. Jackson
Keyword(s):  
Fdg Pet ◽  
Focal Cortical Dysplasia ◽  
Intractable Epilepsy ◽  
Structural Mri ◽  
Structural Abnormality ◽  
Clinical Value ◽  
Mri Features ◽  
Before And After ◽  
Mri Scans

Abstract Purpose Bottom-of-sulcus dysplasia (BOSD) is a type of focal cortical dysplasia and an important cause of intractable epilepsy. While the MRI features of BOSD have been well documented, the contribution of PET to the identification of these small lesions has not been widely explored. The aim of this study was to investigate the role of F-18 fluorodeoxyglucose (18F-FDG) PET in the identification of BOSD. Methods Twenty patients with BOSD underwent both 18F-FDG PET and structural MRI scans as part of preoperative planning for surgery. Visual PET analysis was performed, and patients were classified as positive if they exhibited a focal or regional hypometabolic abnormality, or negative in the absence of a hypometabolic abnormality. MRI data were reviewed to determine if any structural abnormality characteristic of BOSD were observed before and after co-registration with PET findings. Results PET detected hypometabolic abnormalities consistent with the seizure focus location in 95% (19/20) of cases. Focal abnormalities were detected on 18F-FDG PET in 12/20 (60%) patients, while regional hypometabolism was evident in 7/20 (35%). BOSD lesions were missed in 20% (4/20) of cases upon initial review of MRI scans. Co-registration of 18F-FDG PET with MRI enabled detection of the BOSD in all four cases where the lesion was initially missed. Conclusion Our findings show that 18F-FDG PET provides additional clinical value in the localisation and detection of BOSD lesions, when used in conjunction with MRI.

scholarly journals Cortical Dyplasia: Complete Resection Correlates with Outcome…But, Complete Resection of What?

2009 ◽  
Vol 9 (4) ◽  
pp. 100-102 ◽  
Author(s):  
Theodore H. Schwartz
Keyword(s):  
Fdg Pet ◽  
Pediatric Patients ◽  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome ◽  
Type I ◽  
Type Ii ◽  
Presurgical Evaluation ◽  
Mri Scans

Incomplete Resection of Focal Cortical Dysplasia Is the Main Predictor of Poor Postsurgical Outcome. Krsek P, Maton B, Jayakar P, Dean P, Korman B, Rey G, Dunoyer C, Pacheco-Jacome E, Morrison G, Ragheb J, Vinters HV, Resnick T, Duchowny M. Neurology 2009;72(3):217–223. BACKGROUND: Focal cortical dysplasia (FCD) is recognized as the major cause of focal intractable epilepsy in childhood. Various factors influencing postsurgical seizure outcome in pediatric patients with FCD have been reported. OBJECTIVE: To analyze different variables in relation to seizure outcome in order to identify prognostic factors for selection of pediatric patients with FCD for epilepsy surgery. METHODS: A cohort of 149 patients with histologically confirmed mild malformations of cortical development or FCD with at least 2 years of postoperative follow-up was retrospectively studied; 113 subjects had at least 5 years of postoperative follow-up. Twenty-eight clinical, EEG, MRI, neuropsychological, surgical, and histopathologic parameters were evaluated. RESULTS: The only significant predictor of surgical success was completeness of surgical resection, defined as complete removal of the structural MRI lesion (if present) and the cortical region exhibiting prominent ictal and interictal abnormalities on intracranial EEG. Unfavorable surgical outcomes are mostly caused by overlap of dysplastic and eloquent cortical regions. There were nonsignificant trends toward better outcomes in patients with normal intelligence, after hemispherectomy and with FCD type II. Other factors such as age at seizure onset, duration of epilepsy, seizure frequency, associated pathologies including hippocampal sclerosis, extent of EEG and MRI abnormalities, as well as extent and localization of resections did not influence outcome. Twenty-five percent of patients changed Engel's class of seizure outcome after the second postoperative year. CONCLUSIONS: The ability to define and fully excise the entire region of dysplastic cortex is the most powerful variable influencing outcome in pediatric patients with focal cortical dysplasia. FDG-PET/MRI Coregistration Improves Detection of Cortical Dysplasia in Patients with Epilepsy. Salamon N, Kung J, Shaw SJ, Koo J, Koh S, Wu JY, Lerner JT, Sankar R, Shields WD, Engel J Jr, Fried I, Miyata H, Yong WH, Vinters HV, Mathern GW. Neurology 2008;71(20):1594–1601. OBJECTIVE: Patients with cortical dysplasia (CD) are difficult to treat because the MRI abnormality may be undetectable. This study determined whether fluorodeoxyglucose (FDG)-PET/MRI coregistration enhanced the recognition of CD in epilepsy surgery patients. METHODS: Patients from 2004–2007 in whom FDG-PET/MRI coregistration was a component of the presurgical evaluation were compared with patients from 2000–2003 without this technique. For the 2004–2007 cohort, neuroimaging and clinical variables were compared between patients with mild Palmini type I and severe Palmini type II CD. RESULTS: Compared with the 2000–2003 cohort, from 2004–2007 more CD patients were detected, most had type I CD, and fewer cases required intracranial electrodes. From 2004–2007, 85% of type I CD cases had normal non–University of California, Los Angeles (UCLA) MRI scans. UCLA MRI identified CD in 78% of patients, and 37% of type I CD cases had normal UCLA scans. EEG and neuroimaging findings were concordant in 52% of type I CD patients, compared with 89% of type II CD patients. FDG-PET scans were positive in 71% of CD cases, and type I CD patients had less hypometabolism compared with type II CD patients. Postoperative seizure freedom occurred in 82% of patients, without differences between type I and type II CD cases. CONCLUSIONS: Incorporating fluorodeoxyglucose-PET/MRI coregistration into the multimodality presurgical evaluation enhanced the noninvasive identification and successful surgical treatment of patients with cortical dysplasia (CD), especially for the 33% of patients with nonconcordant findings and those with normal MRI scans from mild type I CD.

scholarly journals Pubertal hormones and brain structure: Exploring the value of hair assays

2019 ◽  
Author(s):  
Nandita Vijayakumar ◽  
Elizabeth Shirtcliff ◽  
Michelle L Byrne ◽  
Kathryn L. Mills ◽  
Theresa W Cheng ◽  
...  
Keyword(s):  
Brain Development ◽  
Cortical Thickness ◽  
Brain Structure ◽  
Structural Mri ◽  
Pubertal Stage ◽  
Prefrontal Cortical ◽  
Hair Samples ◽  
Mri Scans ◽  
Hormonal Exposure

Neuroimaging research has highlighted the role of puberty in structural brain development in humans, but studies investigating the mechanistic role of hormones in this association have produced inconsistent findings. Limitations of current approaches to hormonal assessments have long been recognized, as basal hormone levels are susceptible to momentary influences (in particular, circadian rhythmicity and menstrual cyclicity). However, emerging research suggests that a novel method of assaying pubertal hormone concentrations in hair may overcome some of these issues by capturing hormonal exposure across a longer period of time. This study is the first to compare associations between hormone concentrations measured via hair and saliva with brain structure in a sample of early adolescent females (N = 112, 10-13 years of age). Estradiol, testosterone, and DHEA concentrations were assayed from i) 5cm hair samples collected proximal to the scalp, reflecting approximately 5 months of hormonal exposure, and ii) repeated weekly saliva samples collected over the course of one month. Participants also underwent structural MRI scans, and estimates of cortical thickness and subcortical volume were obtained. Findings revealed that pubertal hormones in saliva samples exhibited strongest associations with parieto-occipital cortices. Comparatively, hair hormone concentrations exhibited stronger negative associations with cingulate and lateral prefrontal cortical thickness, which may reflect unique developmental processes that occur across longer periods of hormonal exposure. However, controlling for pubertal stage removed much of the cortical associations with hormones in saliva, and resulted in minimal change in cortical associations with hormones in hair. Thus hormone concentrations in hair may reflect biological processes not captured by self-reported pubertal stage that influence brain development. Further research is needed to improve our understanding of these potentially unique neurodevelopmental processes captured by saliva and hair hormone concentrations.

scholarly journals Multimodal Prediction of Alzheimer's Disease Severity Level Based on Resting-State EEG and Structural MRI

2021 ◽  
Vol 15 ◽  
Author(s):  
Belmir Jesus ◽  
Raymundo Cassani ◽  
William J. McGeown ◽  
Marco Cecchi ◽  
K. C. Fadem ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Disease Severity ◽  
Resting State ◽  
Structural Mri ◽  
Rate Of Change ◽  
Machine Learning Algorithms ◽  
Mri Features ◽  
Mri Scans ◽  
Eeg Features

While several biomarkers have been developed for the detection of Alzheimer's disease (AD), not many are available for the prediction of disease severity, particularly for patients in the mild stages of AD. In this paper, we explore the multimodal prediction of Mini-Mental State Examination (MMSE) scores using resting-state electroencephalography (EEG) and structural magnetic resonance imaging (MRI) scans. Analyses were carried out on a dataset comprised of EEG and MRI data collected from 89 patients diagnosed with minimal-mild AD. Three feature selection algorithms were assessed alongside four machine learning algorithms. Results showed that while MRI features alone outperformed EEG features, when both modalities were combined, improved results were achieved. The top-selected EEG features conveyed information about amplitude modulation rate-of-change, whereas top-MRI features comprised information about cortical area and white matter volume. Overall, a root mean square error between predicted MMSE values and true MMSE scores of 1.682 was achieved with a multimodal system and a random forest regression model.

scholarly journals Common features of F-18 FDG PET/CT findings in Scrub Typhus: prospective study before and after antibiotics therapy

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Joo-Hee Hwang ◽  
Yeon-Hee Han ◽  
Seung Hee Choi ◽  
Mir Jeon ◽  
Suhyun Kim ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Clinical Value ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Before And After ◽  
Generalized Lymphadenopathy ◽  
Fdg Pet Ct

Abstract Scrub typhus is an acute febrile illness caused by obligate intracellular organism Orientia tsutsugamushi. While there have been many reports on the evaluation of disease activity and infectious diseases using F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), the clinical value of FDG PET/CT in scrub typhus has not been fully investigated. We enrolled 17 patients who were 18 years of age or older and clinically suspected of having scrub typhus with eschar. Clinical assessments, blood samples, and FDG PET/CT images were obtained at enrolment and again after 3 weeks. The median age of the patients was 65 years; 9 (52.9%) patients were male. On initial FDG PET/CT, the eschars showed markedly increased FDG uptake on PET imaging that improved after treatment. Generalized lymphadenopathy and splenomegaly with high FDG uptake were observed in all patients. On follow-up FDG PET/CT after appropriate therapy, FDG uptake and sizes of eschar, lymph nodes, and spleen were markedly decreased. As far as we are aware, this is the first investigation with multiple patients of FDG PET/CT in scrub typhus and the demonstration of clinical utility. FDG PET/CT imaging of scrub typhus could provide useful information about the clinical features before and after antibiotic treatment.

scholarly journals The role of 18F-FDG PET/CT before and after the treatment of multiple myeloma: Our clinical experience

2017 ◽  
Vol 3 (1) ◽  
pp. 20 ◽  
Author(s):  
Kornelia Kajary ◽  
Zsuzsa Molnár
Keyword(s):  
Multiple Myeloma ◽  
Fdg Pet ◽  
Progression Free Survival ◽  
Focal Lesions ◽  
Free Survival ◽  
Pet Ct ◽  
Before And After ◽  
Fdg Pet Ct

<p>To evaluate the role of FDG PET/CT before and after the treatment of multiple myeloma (MM) in our clinical practice, data from 32 patients (before therapy: 10 patients; after therapy: 22 patients) and from 46 examinations (before therapy: 10; after: 36) with a median time of follow-up of 24 months (before the therapy) and 26 months (after the therapy) were evaluated. FDG PET/CT positivity was characterized by SUVmax &gt;2.5, SUVmax &gt;4.2, focal lesions (FLs) &gt;3, and presence of extramedullary disease (EMD). The median progression-free survival (PFS) and the median overall survival (OS) for FDG PET/CT positive patients were shorter than for negative patients, according to all parameters. Before the therapy, significant correlation was found only between PFS and the number of FLs (<em>p</em> = 0.033). After the treatment, significant correlation was found between PFS and SUVmax (cut-off value 2.5: p &lt; 0.001; cut off value 4.2: p &lt; 0.001), between PFS and the number of FLs (<em>p</em> = 0.009), and between PFS and the presence of EMD (p &lt; 0.001). Significant correlation was found between OS and SUVmax (cut-off value = 2.5, <em>p</em> &lt; 0.001 and 4.2, <em>p</em> = 0.009), between OS and the number of FLs (<em>p</em> = 0.007), and between OS and the presence of EMD (<em>p</em> = 0.022). Our results confirmed the reliability and good prognostic value of FDG PET/CT in MM.</p>

Clinical Value of PET/CT in Staging Melanoma and Potential New Radiotracers

2020 ◽  
Vol 13 (1) ◽  
pp. 6-13 ◽  
Author(s):  
Salvatore Annunziata ◽  
Riccardo Laudicella ◽  
Federico Caobelli ◽  
Daniele A. Pizzuto ◽  
Young Aimn Working Group
Keyword(s):  
Malignant Melanoma ◽  
Fdg Pet ◽  
Literature Search ◽  
Clinical Value ◽  
Future Developments ◽  
Pet Ct ◽  
Pet Radiotracers ◽  
18F Fdg ◽  
Fdg Pet Ct

Background: 18F-FDG PET/CT has been suggested as an effective tool to stage patients affected by melanoma. In the latest years, new radiopharmaceuticals have been proposed and the use of hybrid PET/ceCT has emerged. Objective: To review recent evidence on the role of PET/CT in melanoma staging as well as its potential for future developments. Methods: A comprehensive computer literature search of PubMed/MEDLINE was carried out to find relevant published articles concerning the feasibility of PET/CT in patients with malignant melanoma. Results: Some recent studies about potentials and limitations of 18F-FDG PET/CT in staging melanoma, new PET radiotracers beyond 18F-FDG and application of hybrid PET/ceCT have been reviewed and discussed. Conclusion: PET/CT plays an important role in the staging workup of patients affected by melanoma. New radiopharmaceuticals and hybrid PET/ceCT could improve the potential of this diagnostic tool in this field.

Child and Adolescent Suicides in Bosnia and Herzegovina Before and After the War (1992–1995)

Crisis ◽  
2010 ◽  
Vol 31 (3) ◽  
pp. 160-164 ◽  
Author(s):  
Almir Fajkic ◽  
Orhan Lepara ◽  
Martin Voracek ◽  
Nestor D. Kapusta ◽  
Thomas Niederkrotenthaler ◽  
...  
Keyword(s):  
Bosnia And Herzegovina ◽  
Age Differences ◽  
Suicide Risk ◽  
Child And Adolescent ◽  
Youth Suicide ◽  
Southeastern Europe ◽  
Suicide Rates ◽  
Before And After ◽  
Sex And Age Differences

Background: Evidence on youth suicides from Southeastern Europe is scarce. We are not aware of previous reports from Bosnia and Herzegovina, which experienced war from 1992 to 1995. Durkheim’s theory of suicide predicts decreased suicide rates in wartime and increased rates afterward. Aims: To compare child and adolescent suicides in Bosnia and Herzegovina before and after the war. Methods: Data on youth suicide for prewar (1986–90) and postwar (2002–06) periods were analyzed with respect to prevalence, sex and age differences, and suicide methods. Suicide data from 1991 through 2001 were not available. Results: Overall youth suicide rates were one-third lower in the postwar than in the prewar period. This effect was most pronounced for girls, whose postwar suicide rates almost halved, and for 15–19-year-old boys, whose rates decreased by about a one-fourth. Suicides increased among boys aged 14 or younger. Firearm suicides almost doubled proportionally and were the predominant postwar method, while the most common prewar method had been hanging. Conclusions: The findings from this study indicate the need for public education in Bosnia and Herzegovina on the role of firearm accessibility in youth suicide and for instructions on safe storage in households. Moreover, raising societal awareness about suicide risk factors and suicide prevention is needed.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

SUBLINGUAL VITAMIN D3 DRUG THERAPY IN VITAMIN D DEFICIENCY PATIENTS AT PRAVARA RURAL HOSPITAL

2019 ◽  
pp. 18-20
Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Before And After

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route

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