Differences of Various Region-of-Interest Methods for Measuring Dopamine Transporter Availability Using T

This study was to investigate whether various region-of-interest (ROI) methods for measuring dopamine transporter (DAT) availabilities by single photon emission computed tomography (SPECT) are statistically different, whether results of medical research are thereby influenced, and causes of these differences. Eighty-four healthy adults with Tc99m-TRODAT-1 SPECT and magnetic resonance imaging (MRI) scans were included. Six major analysis approaches were compared: (1) ROI drawn on the coregistered MRI; (2) ROIs drawn on the SPECT images; (3) standard ROI templates; (4) threshold-ROIs; (5) atlas-based mappings with coregistered MRI; and (6) atlas-based mappings with SPECT images. Using the atlas-based approaches we assessed the influence of striatum ROIs by slice-wise and voxel-wise comparisons. In (5) and (6), three partial-volume correction (PVC) methods were also explored. The results showed that DAT availabilities obtained from different methods were closely related but quite different and leaded to significant differences in determining the declines of DAT availability per decade (range: 5.95–11.99%). Use of 3D whole-striatum or more transverse slices could avoid biases in measuring the striatal DAT declines per decade. Atlas-based methods with PVC may be the preferable methods for medical research

The Relationship between Brown Adipose Tissue Activity and Neoplastic Status: an 18F-FDG PET/CT Study in the Tropics

<p>Abstract</p> <p>Background</p> <p>Brown adipose tissue (BAT) has thermogenic potential. For its activation, cold exposure is considered a critical factor though other determinants have also been reported. The purpose of this study was to assess the relationship between neoplastic status and BAT activity by 2-deoxy-2-[18F]fluoro-D-glucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) in people living in the tropics, where the influence of outdoor temperature was low.</p> <p>Methods</p> <p>¹⁸F-FDG PET/CT scans were reviewed and the total metabolic activity (TMA) of identified activated BAT quantified. The distribution and TMA of activated BAT were compared between patients with and without a cancer history. The neoplastic status of patients was scored according to their cancer history and ¹⁸F-FDG PET/CT findings. We evaluated the relationships between the TMA of BAT and neoplastic status along with other factors: age, body mass index, fasting blood sugar, gender, and outdoor temperature.</p> <p>Results</p> <p>Thirty of 1740 patients had activated BAT. Those with a cancer history had wider BAT distribution (<it>p </it>= 0.043) and a higher TMA (<it>p </it>= 0.028) than those without. A higher neoplastic status score was associated with a higher average TMA. Multivariate analyses showed that neoplastic status was the only factor significantly associated with the TMA of activated BAT (<it>p </it>= 0.016).</p> <p>Conclusions</p> <p>Neoplastic status is a critical determinant of BAT activity in patients living in the tropics. More active neoplastic status was associated with more vigorous TMA of BAT.</p

Discriminating Glucose Tolerance Status by Regions of Interest of Dual-Energy X-Ray Absorptiometry: Clinical Implications of Body Fat Distribution

WSTĘP. Zbadanie, czy ocena rozmieszczenia tkanki tłuszczowej w organizmie metodą absorpcjometrii promieniowania rentgenowskiego o podwójnej energii (DEXA, dual energy X-ray absorptiometry) może być pomocny w ocenie stanu tolerancji glukozy. MATERIAŁ I METODY. U 1015 badanych mieszkańców Chin (559 mężczyzn i 456 kobiet) zastosowano doustny test obciążenia glukozą (75,0 g). Na podstawie jego wyników wyodrębniono osoby o prawidłowej (NGT, normal glucose tolerance) i upośledzonej (IGT, impaired glucose tolerance) tolerancji glukozy oraz osoby, u których rozpoznano cukrzycę (DM, diabetes mellitus). Mierzono wysokość ciśnienia tętniczego i oceniano profil lipidowy. Na podstawie stosunku obwodu talii do bioder (WHR, waist-to-hip ratio) i wyników DEXA oceniano rozmieszczenie tkanki tłuszczowej u osób w poszczególnych grupach. WYNIKI. Rozmieszczenie tkanki tłuszczowej, wyrażone poprzez WHR oraz wskaźnik centralizacji, wykazało znamienną częściową korelację ze stężeniem hemoglobiny glikowanej, wysokością ciśnienia tętniczego i profilem lipidowym u wszystkich badanych. Po skorygowaniu wyników wobec wieku i wskaźnika masy ciała (BMI, body mass index), stwierdzono znamienne różnice częstości wszystkich sercowo-naczyniowych czynników ryzyka w poszczególnych grupach, z wyjątkiem stężenia cholesterolu całkowitego. W grupie DM odnotowano znamiennie wyż-sze wartości WHR i wskaźnika centralizacji przy niższej procentowo zawartości tkanki tłuszczowej w udach. Ponadto, pacjentów z grupy IGT charakteryzował wyższy wskaźnik centralizacji niż osoby z grupy NGT. Nie stwierdzono jednakże znamiennych różnic masy tkanek beztłuszczowych w porównywanych grupach. Po dokonaniu wieloczynnikowej analizy logistycznej regresji wskaźnik centralizacji pozostał istotnym czynnikiem umożliwiającym ocenę tolerancji glukozy, niezależnie od procentowej zawartości tkanki tłuszczowej w organizmie. WNIOSKI. Otyłość centralna wykazuje znamienną korelację z sercowo-naczyniowymi czynnikami ryzyka w grupach osób o różnej tolerancji glukozy. Indeks centralizacji, oceniany metodą DEXA, wydaje się lepszym wskaźnikiem upośledzenia tolerancji glukozy niż WHR, otyłość brzuszna czy uogólniona otyłość (wyrażone odpowiednio jako odsetek zawartości tłuszczu całkowitego lub BMI) w dużej grupie badanych Chińczyków.OBJECTIVE. To determine whether measuring body fat distribution by dual-energy X-ray a bsor ptio metry (DEXA) can be used to discriminate glucose tolerance status. RESEARCH DESIGN AND METHODS. Using a 75-g oral glucose tolerance test, a total of 1,015 Chinese subjects (559 men and 456 women) were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), or diabetes. Blood pre ssure and lipid profiles of these subjects were measured. Waist-to-hip ratio (WHR) and DEXA were used to evaluate the varying patterns of body fat distribution among the gro ups. RESULTS. Body fat distribution, as reflected by WHR and the centrality index, showed significant partial correlation coefficients with glycosylated hemoglobin, blood pressure, and lipid profiles in all subjects. After adjusting for age and BMI, there were significant differences among the three glycemic groups for all the cardiovascular risk factors except for total cholesterol level. The diabetic group had a significantly higher WHR and centrality index, but lower femoral fat percentage than the NGT and IGT groups. The diabetic group also showed higher abdominal fat percentage than the NGT group. More over, the IGT group had a higher centrality index than the NGT group. However, no significant differences were found in the percentage of lean tissue mass among the three groups. Using multiple stepwise logistic regression models, the centrality index remained a significant factor for discriminating different glucose tolerance status independent of the percentage total body fat. CONCLUSIONS. Central obesity has shown significant correlation with cardio vascular risk factors among the three different glycemic groups. Centrality index measured by DEXA appears to be the better predictor of glucose intolerance, compared with WHR, abdominal fat, and general obesity (reflected by percentage total body fat or BMI) in a large cohort of the Chinese population

A False Positive 18F-FDG PET/CT Scan Caused by Breast Silicone Injection

We present here the case of a 40-year-old woman with a greater than 10 year prior history of bilateral breast silicone injection and saline bag implantation. Bilateral palpable breast nodules were observed, but the ultrasound scan was suboptimal and the magnetic resonance imaging showed no gadolinium-enhanced tumor. The 18F-FDG PET/CT scan showed a hypermetabolic nodule in the left breast with a 30% increase of 18F-FDG uptake on the delayed imaging, and this mimicked breast cancer. She underwent a left partial mastectomy and the pathology demonstrated a siliconoma

Effects of Metformin on the Cerebral Metabolic Changes in Type 2 Diabetic Patients

Metformin, a widely used antidiabetic drug, has numerous effects on human metabolism. Based on emerging cellular, animal, and epidemiological studies, we hypothesized that metformin leads to cerebral metabolic changes in diabetic patients. To explore metabolism-influenced foci of brain, we used 2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography for type 2 diabetic patients taking metformin (MET, n=18), withdrawing from metformin (wdMET, n=13), and not taking metformin (noMET, n=9). Compared with the noMET group, statistical parametric mapping showed that the MET group had clusters with significantly higher metabolism in right temporal, right frontal, and left occipital lobe white matter and lower metabolism in the left parahippocampal gyrus, left fusiform gyrus, and ventromedial prefrontal cortex. In volume of interest (VOI-) based group comparisons, the normalized FDG uptake values of both hypermetabolic and hypometabolic clusters were significantly different between groups. The VOI-based correlation analysis across the MET and wdMET groups showed a significant negative correlation between normalized FDG uptake values of hypermetabolic clusters and metformin withdrawal durations and a positive but nonsignificant correlation in the turn of hypometabolic clusters. Conclusively, metformin affects cerebral metabolism in some white matter and semantic memory related sites in patients with type 2 diabetes

Accumulation of Tc-99m HL91 in Tumor Hypoxia: In Vitro Cell Culture and In Vivo Tumor Model

Hypoxic cells within a tumor can account, in part, for resistance to radiotherapy and chemotherapy. Indeed, the oxygenation status has been shown to be a prognostic marker for the outcome of therapy. The purpose of this study was to determine whether Tc-99m HL91 (HL91), a noninvasive imaging tracer, detects tumor hypoxia in vitro in cell culture and in vivo in a tumor model. Uptake of HL91 in vitro into human lung cancer cells (A549) and murine Lewis lung cancer cells (LL2) was investigated at oxygen concentrations of 20% O2 (normoxia), and 1% O2 (hypoxia). HL91 biodistribution was studied in four groups: severe combined immune deficiency (SCID) mice bearing A549 tumors, C57BL/6NCrj (B6) mice bearing LL2 tumors, SCID controls, and B6 controls. Accumulation of the tracer was compared between tumors treated with hydralazine or phosphate-buffered saline (PBS). Scintigraphic images were obtained for hydralazine-treated mice and PBS-treated mice in each of the four study groups. Autoradiography of tumor slices was also acquired. In vitro studies identified hypoxia-selective uptake of HL91, with significantly increased uptake in the hypoxic state than in the normoxic state. Biodistribution and scintigraphy showed increased HL91 uptake during tumor hypoxia at 0.5 hours, and there was progressively increased activity for up to 4 hours after tracer administration. HL91 accumulation in tumor hypoxia was markedly increased in mice treated with hydralazine compared with those treated with PBS. Autoradiography revealed high HL91 uptake in the peripheral areas around the necrotic regions of the tumor, which were identified by histologic examination. HL91 exhibits selectivity for tumor hypoxia both in vitro and in vivo and provides a successful imaging modality for the detection of tumor hypoxia in vivo

Diffuse Abdominal Uptake Mimicking Peritonitis in Gallium Inflammatory Scan: An Unusual Feature of Acute Q Fever

The clinical features in patients with acute Q fever are variable. We present a patient with fever, abdominal distension, pericardial effusion, and diffuse gallium uptake in the abdominal cavity, mimicking peritonitis or peritoneum carcinomatosis. Serologic surveys revealed acute infection by Coxiella burnetii. The patient responded poorly to doxycycline and improved with oral levofloxacin. During the afebrile period, gallium inflammatory scan showed resolution of previous diffuse uptake in the abdomen, and cardiac echo resolution of pericardial effusion, which was suggestive of peritoneal inflammation related to acute C. burnetii infection. Therefore, clinicians in Taiwan should be alert to the possibility of acute Q fever in patients with fever of unknown cause, especially with clinical evidence of peritoneal and/or pericardial inflammation