scholarly journals Brain SPECT as an Imaging Biomarker for Evaluating Effects of Novel Treatments in Psychiatry–A Case Series

2022 ◽  
Vol 12 ◽  
Author(s):  
Steven R. D. Best ◽  
Natalie Haustrup ◽  
Dan G. Pavel
Keyword(s):  
Photon Emission ◽  
Case Series ◽  
Functional Brain Imaging ◽  
Brain Spect ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Novel Treatments ◽  
Potential Biomarker ◽  
Neuropsychiatric Conditions ◽  
Spect Images

The difficulties of evaluating patients with complex neuropsychiatric conditions and prescribing appropriate treatments are well known. Imaging complements clinical assessments and allows a clinician to narrow the differential diagnosis by facilitating accurate and efficient evaluation. This is particularly relevant to neuropsychiatric conditions that are often diagnosed using a trial-and error process of exclusion. Single Photon Emission Computed Tomography (SPECT) is a functional brain imaging procedure that allows practitioners to measure the functional changes of gray matter structures based on regional cerebral blood flow (rCBF). The accurate diagnosis and treatment selection in psychiatry is challenging due to complex cases and frequent comorbidities. However, such complex neuropsychiatric conditions are increasingly benefitting from new treatment approaches, in addition to established medications. Among these are combination transcranial magnetic stimulation with ketamine infusions (CTK), hyperbaric oxygen therapy (HBOT) and perispinal administration of etanercept (PSE). This article provides readers with six case study examples that demonstrate how brain SPECT imaging can be used, both as a diagnostic tool, and as a potential biomarker for monitoring and evaluating novel treatments for patients with complex neuropsychiatric conditions. Six patients were assessed in our clinic and baseline brain SPECT imagesTourettes and a long history of alcohol were visually compared with SPECT images collected after periods of treatment with CTK or HBOT followed by PSE. This retrospective review demonstrates the clinical utility of these novel treatments and describes how SPECT imaging can complement standard diagnostic assessments. A novel display technique for SPECT images is described and we argue that SPECT imaging can be used for monitoring biomarker for clinical change.

scholarly journals [123I]-IMP single-photon emission computed tomography imaging in visual snow syndrome: A case series

Cephalalgia ◽  
2020 ◽  
Vol 40 (14) ◽  
pp. 1671-1675
Author(s):  
Mamoru Shibata ◽  
Kei Tsutsumi ◽  
Yu Iwabuchi ◽  
Masashi Kameyama ◽  
Tsubasa Takizawa ◽  
...  
Keyword(s):  
Single Photon ◽  
Photon Emission ◽  
Case Series ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Visual Stream ◽  
Ventral Visual Stream ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Background Visual snow syndrome (VSS) is a neurological condition characterized by persistent flickering dots in the visual fields, palinopsia, enhanced entoptic phenomenon, photophobia, and nyctalopia. Neuroimaging evidence supports the role of the visual association cortex in visual snow syndrome. Case series: We provided clinical care to three patients with visual snow syndrome, in whom [123I]-IMP single-photon emission computed tomography (SPECT) imaging was performed. Case 1 was a 21-year-old male with a past history of migraine with aura who exhibited visual snow and entoptic phenomenon. In this patient, [123I]-IMP SPECT imaging revealed right occipital and temporal hypoperfusion with a distribution matching the ventral visual stream. [123I]-IMP SPECT imaging detected only mild bilateral frontal hypoperfusion in Case 2 and no overt abnormalities in Case 3. Conclusion Although visual snow syndrome seems to be a heterogenous condition, our observations indicate that abnormal visual processing within the ventral visual stream may play a role in the pathogenesis of this condition.

scholarly journals Convolutional neural network-based automatic heart segmentation and quantitation in 123I-metaiodobenzylguanidine SPECT imaging

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shintaro Saito ◽  
Kenichi Nakajima ◽  
Lars Edenbrandt ◽  
Olof Enqvist ◽  
Johannes Ulén ◽  
...  
Keyword(s):  
Neural Network ◽  
Convolutional Neural Network ◽  
Single Photon ◽  
Photon Emission ◽  
Spect Imaging ◽  
Background Correction ◽  
Emission Computed Tomography ◽  
Planar Imaging ◽  
Cardiac Region ◽  
Spect Images

Abstract Background Since three-dimensional segmentation of cardiac region in 123I-metaiodobenzylguanidine (MIBG) study has not been established, this study aimed to achieve organ segmentation using a convolutional neural network (CNN) with 123I-MIBG single photon emission computed tomography (SPECT) imaging, to calculate heart counts and washout rates (WR) automatically and to compare with conventional quantitation based on planar imaging. Methods We assessed 48 patients (aged 68.4 ± 11.7 years) with heart and neurological diseases, including chronic heart failure, dementia with Lewy bodies, and Parkinson's disease. All patients were assessed by early and late 123I-MIBG planar and SPECT imaging. The CNN was initially trained to individually segment the lungs and liver on early and late SPECT images. The segmentation masks were aligned, and then, the CNN was trained to directly segment the heart, and all models were evaluated using fourfold cross-validation. The CNN-based average heart counts and WR were calculated and compared with those determined using planar parameters. The CNN-based SPECT and conventional planar heart counts were corrected by physical time decay, injected dose of 123I-MIBG, and body weight. We also divided WR into normal and abnormal groups from linear regression lines determined by the relationship between planar WR and CNN-based WR and then analyzed agreement between them. Results The CNN segmented the cardiac region in patients with normal and reduced uptake. The CNN-based SPECT heart counts significantly correlated with conventional planar heart counts with and without background correction and a planar heart-to-mediastinum ratio (R2 = 0.862, 0.827, and 0.729, p < 0.0001, respectively). The CNN-based and planar WRs also correlated with and without background correction and WR based on heart-to-mediastinum ratios of R2 = 0.584, 0.568 and 0.507, respectively (p < 0.0001). Contingency table findings of high and low WR (cutoffs: 34% and 30% for planar and SPECT studies, respectively) showed 87.2% agreement between CNN-based and planar methods. Conclusions The CNN could create segmentation from SPECT images, and average heart counts and WR were reliably calculated three-dimensionally, which might be a novel approach to quantifying SPECT images of innervation.

The Diagnostic Utility of 99mTc-HMPAO SPECT Imaging: A Retrospective Case Series from a Tertiary Referral Early-Onset Cognitive Disorders Clinic

2015 ◽  
Vol 39 (3-4) ◽  
pp. 186-193 ◽  
Author(s):  
Amanda Swan ◽  
Briony Waddell ◽  
Guy Holloway ◽  
Thomas Bak ◽  
Shuna Colville ◽  
...  
Keyword(s):  
Early Onset ◽  
Single Photon ◽  
Photon Emission ◽  
Case Series ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Tertiary Referral ◽  
Indirect Measure ◽  
Hmpao Spect ◽  
Clinical Diagnoses

Background/Aims: Patients with early-onset dementia (EOD) often present atypically, making an accurate diagnosis difficult. Single-photon emission-computed tomography (SPECT) provides an indirect measure of cerebral metabolic activity and can help to differentiate between dementia subtypes. This study aims to investigate the clinical utility of SPECT imaging in the diagnosis of early-onset Alzheimer's disease. Methods: All patients attending a tertiary referral clinic specialising in EOD between April 2012 and October 2013 were included in the study. Statistical analysis of SPECT patterns with clinical diagnoses, Addenbrooke's Cognitive Examination version 3 scores, and magnetic resonance imaging (MRI) atrophy was undertaken. Results: The results demonstrated a highly significant association between SPECT hypoperfusion patterns and clinical diagnoses. SPECT changes were demonstrated more frequently than MRI atrophy. Conclusions: The results suggest that SPECT imaging may be a useful adjunct to clinical evaluation and a more sensitive biomarker than standard structural imaging.

scholarly journals Impact of DaTscan Imaging on Clinical Decision Making in Clinically Uncertain Parkinson’s Disease

2021 ◽  
pp. 1-5
Author(s):  
Jonathan R. Isaacson ◽  
Salima Brillman ◽  
Nisha Chhabria ◽  
Stuart H. Isaacson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Diagnosis ◽  
Clinical Decision Making ◽  
Photon Emission ◽  
Case Series ◽  
Emission Computed Tomography ◽  
Medication Therapy ◽  
Clinical Scenarios ◽  
The Impact

Background: The diagnosis of Parkinson’s disease (PD) is primarily clinical, but in cases of diagnostic uncertainty, evaluation of nigrostriatal dopaminergic degeneration (NSDD) by imaging of the dopamine transporter using DaTscan with single-photon emission computed tomography (SPECT) brain imaging may be helpful. Objective/Methods: In the current paper, we describe clinical scenarios for which DaTscan imaging was used in a prospective case series of 201 consecutive patients in whom a movement disorder specialist ordered DaTscan imaging to clarify NSDD. We describe the impact of DaTscan results on changing or confirming pre-DaTscan clinical diagnosis and on post-DaTscan treatment changes. Results/Conclusion: DaTscan imaging can be useful in several clinical scenarios to determine if NSDD is present. These include in patients with early subtle symptoms, suboptimal response to levodopa, prominent action tremor, drug-induced parkinsonism, and in patients with lower extremity or other less common parkinsonism clinical presentations. We also found DaTscan imaging to be useful to determine underlying NSDD in patients with PD diagnosis for 3-5 years but without apparent clinical progression or development of motor fluctuations. Overall, in 201 consecutive patients with clinically questionable NSDD, DaTscan was abnormal in 58.7% of patients, normal in 37.8%, and inconclusive in 3.5%. DaTscan imaging changed clinical diagnosis in 39.8% of patients and led to medication therapy changes in 70.1% of patients.

SPECT Scan in Somatization Disorder Patients: An Exploratory Study of Eleven Cases

2001 ◽  
Vol 35 (3) ◽  
pp. 359-363 ◽  
Author(s):  
Javier Garcia-Campayo ◽  
Concepcion Sanz-Carrillo ◽  
Teresa Baringo ◽  
Concepción Ceballos
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Spect Imaging ◽  
The Other ◽  
University Hospital ◽  
Somatization Disorder ◽  
Emission Computed Tomography ◽  
Axis I ◽  
Pain Symptoms

Objective: There are no previous studies using single photon emission computed tomography (SPECT) scans in somatization disorder (SD) patients. The aim of this paper is to assess SPECT imaging abnormalities in SD patients and study any relation to laterality. Method: Eleven SD patients from the Somatization Disorder Unit of Miguel Servet University Hospital, Zaragoza, Spain, not fulfilling criteria for any other psychiatric disorder and showing normal computed tomography (CT) and magnetic resonance imaging (MRI) images were studied with SPECT. Patients with DSM-IV axis I comorbidity were ruled out because it has been demonstrated that SPECT scans can show abnormalities in patients with depression and anxiety disorders. The technique used for SPECT was 99mTc-D,1,hexamethylpropyleneamide- oxime (99mTc-HMPAO) in four patients and 99mTc-bicisate in the other seven. The SPECT scans were evaluated without knowledge of clinical data and entirely by visual inspection. Results: Seven out of 11 (63.6%) SD patients showed hypoperfusion in SPECT imaging. In four cases there was hypoperfusion in the non-dominant hemisphere and the predominance of pain symptoms took place in the contralateral hemibody. In the other three patients hypoperfusion was bilateral. The anatomical regions affected were cerebellum (four cases), frontal and prefrontal areas (three cases), temporoparietal areas (two cases) and the complete hemisphere (one case). Conclusions: A proportion of SD patients may present hypoperfusion in SPECT images, uni- or bilaterally, in different brain areas. Possible aetiological explanations for this finding are discussed. Controlled studies are necessary to confirm or refute this hypothesis.

Functional Neuroimaging: A Transformative Tool for Integrative Psychiatry

2018 ◽  
Author(s):  
Abass Alavi ◽  
Andrew B. Newberg
Keyword(s):  
Psychiatric Disorders ◽  
Functional Neuroimaging ◽  
Single Photon ◽  
Cerebral Metabolism ◽  
Photon Emission ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Positron Emission ◽  
Integrative Psychiatry ◽  
Integrative Therapies

Functional neuroimaging with positron emission tomography (PET), single photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI) can be highly useful in the evaluation and management of patients with psychiatric disorders. PET and SPECT imaging typically evaluate cerebral metabolism and blood flow, respectively, and can determine patterns associated with different disorders such as depression or schizophrenia. PET and SPECT imaging can also evaluate neurotransmitter changes such as dopamine or serotonin associated with different psychiatric disorders. fMRI is an excellent tool for studying the effects of psychiatric disorders on specific brain processes related to cognition and mood. fMRI activations studies allow researchers to present various stimuli to a subject in order to determine how the brain reacts and whether psychiatric disorders are associated with different brain reactivity patterns. Functional neuroimaging with PET, SPECT, and fMRI can be highly useful in the investigation of the mechanism of action of integrative therapies for psychiatric disorders.

scholarly journals 99mTc-3PRGD2 SPECT Predicts the Outcome of Endostar and Cisplatin Therapy in Xenograft Animals

Dose-Response ◽  
2019 ◽  
Vol 17 (4) ◽  
pp. 155932581988254
Author(s):  
Wei Sun ◽  
Guifu He ◽  
Mingming Zhang ◽  
Yi Zhao ◽  
Hongmei Yu ◽  
...  
Keyword(s):  
Single Photon ◽  
Antiangiogenic Therapy ◽  
Photon Emission ◽  
Xenograft Model ◽  
Treated Group ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Histopathological Analysis ◽  
Photon Emission Computed Tomography ◽  
Cisplatin Therapy

Aims: Our study was designed to investigate the usefulness of 99mTc-3PRGD2 single-photon emission computed tomography (SPECT) for noninvasively monitoring the response of integrin αvβ3 expression to antiangiogenic treatment with endostar and cisplatin in xenograft animals. Methods: 99mTc-3PRGD2 SPECT imaging was performed at days 0, 7, 14, and 21. Tumors were harvested at all imaging time points for Western blotting and histopathological analysis. Result: In 99mTc-3PRGD2 SPECT imaging, the radioactivity accumulation of NaCl group rised gradually in the first half and dispersed on day 21 due to the necrosis of the tumor. While the radioactivity accumulation of treated groups gradually decreased throughout the course. The downtrend of tumor to nontumor ratio in endostar-treated group was more remarkable than cisplatin-treated group. The expression of intergrin αvβ3 of treated groups was lower than NaCl group from day 14. The expression of intergrin αvβ3 of endostar-treated group was significantly lower than cisplatin-treated group from baseline onward. Conclusion: It’s demonstrated that the 99mTc-3PRGD2 could noninvasively visualize and semiquantify tumor angiogenesis in the xenograft model and monitor the response to the antiangiogenic therapy of endostar and cisplatin effectively. It also can predict the outcome of endostar and cisplatin therapy in xenograft animals.

scholarly journals Single photon emission-computed tomography (SPECT) for functional investigation of the proximal tubule in conscious mice

2010 ◽  
Vol 298 (2) ◽  
pp. F454-F460 ◽  
Author(s):  
François Jouret ◽  
Stéphan Walrand ◽  
Kleber S. Parreira ◽  
Pierre J. Courtoy ◽  
Stanislas Pauwels ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Proximal Tubule ◽  
Knockout Mice ◽  
Single Photon ◽  
Photon Emission ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Noninvasive analysis of renal function in conscious mice is necessary to optimize the use of mouse models. In this study, we evaluated whether single photon emission-computed tomography (SPECT) using specific radionuclear tracers can be used to analyze changes in renal proximal tubule functions. The tracers included 99mTC- dimercaptosuccinic acid (99mTc-DMSA), which is used for cortex imaging; 99mTc-mercaptoacetyltriglycine (99mTc-MAG3), used for dynamic renography; and 123I-β2-microglobulin, which monitors receptor-mediated endocytosis. 99mTc-DMSA SPECT imaging was shown to delineate the functional renal cortex with a ∼1-mm spatial resolution and accumulated in the cortex reaching a plateau 5 h after injection. The cortical uptake of 99mTc-DMSA was abolished in Clcn5 knockout mice, a model of proximal tubule dysfunction. Dynamic renography with 99mTc-MAG3 in conscious mice demonstrated rapid extraction from blood, renal accumulation, and subsequent tubular secretion. Anesthesia induced a significant delay in the 99mTc-MAG3 clearance. The tubular reabsorption of 123I-β2-microglobulin was strongly impaired in the Clcn5 knockout mice, with defective tubular processing and loss of the native tracer in urine, reflecting proximal tubule dysfunction. Longitudinal studies in a model of cisplatin-induced acute tubular injury revealed a correlation between tubular recovery and 123I-β2-microglobulin uptake. These data show that SPECT imaging with well-validated radiotracers allows in vivo investigations of specific proximal tubule functions in conscious mice.

scholarly journals Filtering in SPECT Image Reconstruction

2011 ◽  
Vol 2011 ◽  
pp. 1-14 ◽  
Author(s):  
Maria Lyra ◽  
Agapi Ploussi
Keyword(s):  
Image Processing ◽  
Image Quality ◽  
Single Photon ◽  
Photon Emission ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Clinical Role ◽  
Tomographic Images ◽  
Reconstruction Software ◽  
The Times

Single photon emission computed tomography (SPECT) imaging is widely implemented in nuclear medicine as its clinical role in the diagnosis and management of several diseases is, many times, very helpful (e.g., myocardium perfusion imaging). The quality of SPECT images are degraded by several factors such as noise because of the limited number of counts, attenuation, or scatter of photons. Image filtering is necessary to compensate these effects and, therefore, to improve image quality. The goal of filtering in tomographic images is to suppress statistical noise and simultaneously to preserve spatial resolution and contrast. The aim of this work is to describe the most widely used filters in SPECT applications and how these affect the image quality. The choice of the filter type, the cut-off frequency and the order is a major problem in clinical routine. In many clinical cases, information for specific parameters is not provided, and findings cannot be extrapolated to other similar SPECT imaging applications. A literature review for the determination of the mostly used filters in cardiac, brain, bone, liver, kidneys, and thyroid applications is also presented. As resulting from the overview, no filter is perfect, and the selection of the proper filters, most of the times, is done empirically. The standardization of image-processing results may limit the filter types for each SPECT examination to certain few filters and some of their parameters. Standardization, also, helps in reducing image processing time, as the filters and their parameters must be standardised before being put to clinical use. Commercial reconstruction software selections lead to comparable results interdepartmentally. The manufacturers normally supply default filters/parameters, but these may not be relevant in various clinical situations. After proper standardisation, it is possible to use many suitable filters or one optimal filter.

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