Diagnosis of Regional Cerebral Blood Flow Abnormalities Using Spect: Agreement between Individualized Statistical Parametric Maps and Visual Inspection by Nuclear Medicine Physicians with Different Levels of Expertise in Nuclear Neurology

INTRODUCTION: Visual analysis is widely used to interpret regional cerebral blood flow (rCBF) SPECT images in clinical practice despite its limitations. Automated methods are employed to investigate between-group rCBF differences in research studies but have rarely been explored in individual analyses. OBJECTIVES: To compare visual inspection by nuclear physicians with the automated statistical parametric mapping program using a SPECT dataset of patients with neurological disorders and normal control images. METHODS: Using statistical parametric mapping, 14 SPECT images from patients with various neurological disorders were compared individually with a databank of 32 normal images using a statistical threshold of p<0.05 (corrected for multiple comparisons at the level of individual voxels or clusters). Statistical parametric mapping results were compared with visual analyses by a nuclear physician highly experienced in neurology (A) as well as a nuclear physician with a general background of experience (B) who independently classified images as normal or altered, and determined the location of changes and the severity. RESULTS: Of the 32 images of the normal databank, 4 generated maps showing rCBF abnormalities (p<0.05, corrected). Among the 14 images from patients with neurological disorders, 13 showed rCBF alterations. Statistical parametric mapping and physician A completely agreed on 84.37% and 64.28% of cases from the normal databank and neurological disorders, respectively. The agreement between statistical parametric mapping and ratings of physician B were lower (71.18% and 35.71%, respectively). CONCLUSION: Statistical parametric mapping replicated the findings described by the more experienced nuclear physician. This finding suggests that automated methods for individually analyzing rCBF SPECT images may be a valuable resource to complement visual inspection in clinical practice

Diagnosis of regional cerebral blood flow abnormalities using SPECT: agreement between individualized statistical parametric maps and visual inspection by nuclear medicine physicians with different levels of expertise in nuclear neurology

INTRODUCTION: Visual analysis is widely used to interpret regional cerebral blood flow (rCBF) SPECT images in clinical practice despite its limitations. Automated methods are employed to investigate between-group rCBF differences in research studies but have rarely been explored in individual analyses. OBJECTIVES: To compare visual inspection by nuclear physicians with the automated statistical parametric mapping program using a SPECT dataset of patients with neurological disorders and normal control images. METHODS: Using statistical parametric mapping, 14 SPECT images from patients with various neurological disorders were compared individually with a databank of 32 normal images using a statistical threshold of

Hyperventilation revisited: Physiological effects and efficacy on focal seizure activation in the era of video-EEG monitoring

Purpose: Hyperventilation is an activation method that provokes physiological slowing of brain rhythms, interictal discharges, and seizures, especially in generalized idiopathic epilepsies. in this study we assessed its effectiveness in inducing focal seizures during video-EEG monitoring.Methods: We analyzed the effects of hyperventilation (HV) during video-EEG monitoring (video-EEG) of patients with medically intractable focal epilepsies. We excluded children younger than 10 years, mentally retarded patients, and individuals with frequent seizures.Results: We analyzed 97 patients; 24 had positive seizure activation (PSA), and 73 had negative seizure activation (NSA). No differences were found between groups regarding sex, age, age at epilepsy onset, duration of epilepsy, frequency of seizures, and etiology. Temporal lobe epilepsies were significantly more activated than frontal lobe epilepsies. Spontaneous and activated seizures did not differ in terms of their clinical characteristics, and the activation did not affect the performance of ictal single-photon emission computed tomography (SPECT).Conclusions: HV is a safe and effective method of seizure activation during monitoring. It does not modify any of the characteristics of the seizures and allows the obtaining of valuable ictal SPECTs. This observation is clinically relevant and suggests the effectiveness and the potential of HV in shortening the presurgical evaluation, especially of temporal lobe epilepsy patients, consequently reducing its costs and increasing the number of candidates for epilepsy surgery.Universidade Federal de São Paulo, Dept Neurol, Escola Paulista Med, São Paulo, BrazilUniv São Paulo, Sch Med, Nucl Med Lab, São Paulo, BrazilUniv São Paulo, Ribeirao Preto Sch Med, Dept Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, Escola Paulista Med, São Paulo, BrazilWeb of Scienc

Rooting of herbaceous cuttings of guava selection 8501-1 submitted to basal lesion and IBA concentrations

Este trabalho objetivou avaliar o efeito de diferentes concentrações de ácido indolbutírico (AIB), na capacidade de enraizamento de estacas herbáceas de goiabeira, preparadas com e sem lesão na base. Foram utilizadas estacas com aproximadamente 0- cm de comprimento, submetidas a dois tipos de preparo (com lesão e sem lesão na base) e quatro concentrações do AIB (0 mg L L- , .000 mg L L- , .000 mg L L- e 3.000 mg L L- ). As estacas foram colocadas para enraizar em caixas plásticas contendo casca de arroz carbonizada. O delineamento experimental foi o inteiramente casualizado com cinco repetições, em arranjo fatorial x 4, sendo cada parcela composta por 0 estacas. Após 85 dias, foram avaliadas as seguintes variáveis: retenção foliar (%), estacas enraizadas (%),sobrevivência das estacas (%), estacas com calo não enraizadas (%), número de raízes por estaca, comprimento de raízes por estaca e massa fresca e seca de raízes por estaca. Pelos resultados obtidos, conclui-se que não houve diferenças significativas entre as concentrações de AIB testadas quanto à variável porcentagem de estacas enraizadas, entretanto foram observadas diferenças significativas para as variáveis número de raízes por estaca e massa fresca e seca de raízes por estaca onde as doses de .000 e 3.000 mg L- resultaram nas maiores médias. O emprego de lesão na base da estaca não resultou em melhorias nos parâmetros de enraizamento de estacas. A utilização do AIB na concentração de 3.000 mg L L- propiciou o maior número de raízes por estaca.This work aimed to evaluate the influence of different concentrations of indolebutiric acid (IBA) on the rooting potential of 0- cm long herbaceous cuttings of guava selection 850 - , submitted or not to basal lesions. The cuttings were prepared in two ways (with or without basal lesions) and submitted to four concentrations of IBA (0 mg L- , ,000 mg L- , ,000 mg L- and 3,000 mg L- ). After the lesions were made, the cuttings were placed to root in plastic boxes containing carbonized rice husk. The experiment was randomized with five replicates in 2 x 4 factorial arrangement, where each plot was composed by 0 cuttings. After 85 days, the following variables were evaluated: foliar retention (%); rooted cuttings (%); cutting survival rate (%); cuttings with callus but without roots (%); root number per cutting; root length per cutting and wet and dry root matter per cutting (g). There is no significant contrast amongst the IBA different concentrations related to the percentage of rooted cuttings, but there is a significant difference related to the root number per cutting and wet and dry root matter per cutting where the doses of ,000 and 3,000 mg L- showed the highest averages; the basal lesions do not bring improvements on the cutting rooting potential; the 3,000 mg L- IBA concentrations resulted in the largest number of roots per cutting