Gallium-67 Imaging In A Patient With Paracoccidioidomycosis: A Case Report

A 26 year-old female was admitted with abdominal pain, fever and weight loss. The clinical and laboratory investigations led to the diagnosis of paracoccidioidomycosis. Gallium-67 whole body images correlated well with the clinical course of the disease and with the patient's prognosis.423167170Barbosa, W., Paracoccidioidomicose (Blastomicose sul-americana) (1989), pp. 653-662. , AMATO NETO, V. & BALDY, J.L.S., ed. Doenças transmissíveis. 3. ed. São Paulo, SarvierBarbosa, W., Daher, R.R., Blastomicose sul-americana (Paracoccidioidomicose) (1995), pp. 634-646. , VERONESI, R.FOCACCIA, R. & DIETZE, R., ed. Doenças infecciosas e parasitárias. 8. ed. São Paulo, Guanabara-KooganBecker, W., The contribution of nuclear medicine to the patient with infection (1995) Europ. J. Nucl. Med., 22, pp. 1195-1211Bethlem, N.M., Lemle, A., Bethlem, E., Wanke, B., Paracoccidioidomycosis (1991) Semin. Resp. Med., 12, pp. 81-97Braga, F.J.H.N., Abreu, P.R., Rivitti, M.C.M., La paracoccidioidomycose chéloide étudiée avec le gallium (1992) Bull. Soc. Path. Exot., 85, pp. 118-119Braga, F.J.H.N., Camargo, E.E., Segurado, A.A.C., La paracoccidioidomycose évaluée par quatre études isotopiques (1992) Bull. Soc. Path. Exot., 85, pp. 115-117Dayaniki, B.F., Weissman, A.F., Wahl, R.L., Successful gallium-67 imaging of North American pulmonary blastomycosis (1993) J. Nucl. Med., 34, pp. 958-960Del Negro, G.M.B., Garcia, N.M., Rodrigues, E.G., The sensitivity, specificity and efficiency values of some serological tests used in the diagnosis of paracoccidioidomycosis (1991) Rev. Inst. Med. Trop. S. Paulo, 33, pp. 277-280Giorgi, M.C.P., Camargo, E.E., Pinto, W.P., Del Negro, G., Gallium-67 imaging in the diagnosis of blastomycosis (1987) Europ. J. Nucl. Med., 13, pp. 300-304Negroni, R., Paracoccidioidomycosis (1993) Int. J. Derm., 32, pp. 847-859Palestro, C.J., The current role of gallium imaging in infection (1994) Semin. Nucl. Med., 24, pp. 128-141Peters, A.M., The use of nuclear medicine in infections (1998) Brit. J. Radiol., 71, pp. 252-26

Surgical Planning With18f-fdg Spect In Refractory Neocortical Temporal Lobe Epilepsy: Case Report [avaliação Pré-cirúrgica De Epilepsia Neocortical De Lobo Temporal Com Utilização De Fdg-18f Spect: Relato De Caso]

Introduction: Several patients with partial epilepsies do not present an easily identified epileptogenic focus on scalp EEG or visible lesion on MRI. There are some useful functional neuroimaging techniques that could be considered in these cases, such as interictal positron emission tomography (PET) scan and ictal single-photon emission computed tomography (SPECT). These techniques can guide the placement of deep electrodes or even prevent their use in some situations. Unfortunately, PET scanners are not easily available in a great number of epilepsy centers because of its cost. Objective: To demonstrate that 18F-FDG SPECT could be a good alternative replacing PET scan on localization of epileptic focus and surgical planning in places where this technology is not available. Materials and Methods: Case report of a patient with refractory neocortical temporal lobe epilepsy, with normal MRI and nuclear EEG localization. Results: The patient was submitted to interictal 18F-FDG SPECT scan, that showed hypometabolism in the anterior, mesial and lateral parts of the right temporal lobe. These areas were surgically resected and the patient outcome after 24 moths has been very good (Engel IB). Conclusion: We suggest that in some situations an interictal 18F-FDG SPECT scan could replace 18F-FDG PET scan where this technique is not available.123169173Cendes, F., Partial epilepsies: An Overview (2003) Arq. Neuropsiquiatr, 61 (SUPPL. 1), pp. 1-7Elchebehere, E.C.S.C., Yacubian, E.M.T., Camargo, E.E., SPECT Cerebral em epilepsia (2000) Epilepsia, pp. 155-165. , Guerreiro CAM, editor, 3rd ed. Lemos;Palmini, A., Calcagnotto, M.E., Cendes, F., Epilepsias refratárias: Diagnóstico sindrômico, topográfico e etiológico (2000) Epilepsia, pp. 369-378. , Guerreiro CAM, editor, 3rd ed. Lemos;Henry, T.R., Van Heertum, R.L., Positron emission tomography in epilepsy care (2003) Semin Ncl Med, 33 (2), pp. 88-104Palmini, A., Najm, I., Avanzini, G., Babb, T., Guerrini, R., Foldvary-Schaefer, N., Jackson, G., Vinters, H.V., Terminology and classification of the cortical dysplasias (2004) Neurology, 62 (6 SUPPL. 3), pp. S2-S8Lee, S.K., Yun, C.H., Oh, J.B., Intracranial ictal onset zone in nonlesional lateral temporal lobe epilepsy on scalp ictal EEG (2003) Neurology, 61, pp. 757-764Salanova, V., Andermann, F., Rasmussen, T., Parietal lobe epilepsy: Clinical manifestations and outcome in 82 patients treated surgically between 1929 and 1988 (1995) Brain, 118, pp. 607-627Duncan, J.S., Imaging and epilepsy (1997) Brain, 102, pp. 339-377Bronen, R.A., Epilepsy: The role of MR imaging (1992) Am J Radiol, 159, pp. 1165-1174Semah, F., Picot, M.-C., Adam, C., Is the underlying cause of epilepsy a major prognostic factor for recurrence? (1998) Neurology, 51, pp. 1256-1262Santos, S.L.M., Ghizoni, E., Li, L.M., Dynamic assessment of high-resolution MRI with multi-planar reconstruction increases the yield of lesion detection in patients with partial epilepsy (2005) J Epilepsy Clin Neurophysiol, 11 (3), pp. 111-116Barkovich, A.J., Rowley, H.A., Andermann, F., MR in partial epilepsy: Value of high-resolution techniques (1995) AJNR, 16, pp. 339-343Knowlton, R.C., The role of FDG-PET, ictal SPECT and MEG in the epilepsy surgery evaluation (2006) Epilepsy and Behavior, 8, pp. 91-101Spencer, S.S., The relative contributions of MRI, SPECT and PET imaging in epilepsy (1994) Epilepsia, 35 (SUPPL. 6), pp. S72-S89Duarte, P.S., Zhuang, H., King, D., Hipometabolismo cerebral em pacientes com esclerose mesial temporal demons trado pelo FDG-PET (2000) Arq. Neuropsiquiatr, 58 (3 -B), pp. 869-876Diehl, B., LaPresto, E., Najm, I., Neocortical temporal FDG-PET hypometabolism correlates with temporal lobe atrophy in hippocampal sclerosis associated with microscopic cortical dysplasia (2003) Epilepsia, 44 (4), pp. 559-564Schwartz, W.J., Smith, C.B., Davidsen, L., Metabolic mapping of functional activity in the hypotalomo - neurohypophysial system of the rat (1979) Science, 205, pp. 723-72