SPECT Imaging of Epilepsy: An Overview and Comparison with F-18 FDG PET

Epilepsy surgery is highly effective in treating refractory epilepsy, but requires accurate presurgical localization of the epileptogenic focus. Briefly, localization of the region of seizure onset traditionally dependents on seizure semiology, scalp EEG recordings and correlation with anatomical imaging modalities such as MRI. The introduction of noninvasive functional neuroimaging methods, including single-photon emission computed tomography (SPECT) and positron emission tomography (PET) has dramatically changed the method for presurgical epilepsy evaluation. These imaging modalities have become powerful tools for the investigation of brain function and are an essential part of the evaluation of epileptic patients. Of these methods, SPECT has the practical capacity to image blood flow functional changes that occur during seizures in the routine clinical setting. In this review we present the basic principles of epilepsy SPECT and PET imaging. We discuss the properties of the SPECT tracers to be used for this purpose and imaging acquisition protocols as well as the diagnostic performance of SPECT in addition to SPECT image analysis methods. This is followed by a discussion and comparison to F-18 FDG PET acquisition and imaging analysis methods

Klaus Vieweg/Michael Winkler (Hrsg.): Bildung und Freiheit. Ein vergessener Zusammenhang. Paderborn: Schöningh, 2012[Rezension]

Rezension von: Klaus Vieweg/Michael Winkler (Hrsg.): Bildung und Freiheit. Ein vergessener Zusammenhang. Paderborn: Schöningh, 2012, 248 S., EUR 29,90

Obsessive and Compulsive Characteristics of Craving for Alcohol in Alcohol Abuse and Dependence

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65211/1/j.1530-0277.1992.tb01375.x.pd

Brain structure localization in positron emission tomography: Comparison of magnetic resonance imaging and a stereotactic method

A method commonly used for localization of brain regions on positron emission tomographic (PET) images is direct visualization and designation of structure on the image itself. This technique, however, is limited to portions of the brain having sufficient differential radionuclide uptake to permit the recognition of structure by observers familiar with brain anatomy. Two other methods commonly used instead of direct visualization are magnetic resonance imaging (MRI) and stereotactic methods of localization. This report compares the accuracy of a MRI method versus a stereotactic method of brain structure localization on PET. The three localization methods were analyzed for sixteen different brain regions in 5 different subjects by two independent observers. The results were converted to PET pixel size (1 PIXEL=.127 cm) for comparison. MRI localization differed from direct visualization by a mean and standard deviation of ~2+/-1 pixels in both the X and Y dimensions. Stereotactic localization differed from direct visualization by ~2+/-1 pixels in the X dimension and by ~6+/-2 pixels in the Y dimension. This larger variation seen with the stereotactic method may be, attributed to the questionable assumption of linearity of structure location with respect to size of the inner table of the calvarium.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29520/1/0000607.pd

Effect of Haloperidol on Measures of Craving and Impaired Control in Alcoholic * Subjects

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66324/1/j.1530-0277.1993.tb00755.x.pd

Echocardiographic Confirmation of Mitral Valve Prolapse: A New Finding on Radionuclide Ventriculography- A Case Report

A prominent filling defect was depicted on a radionuclide ventriculogram in a patient with mitral regurgitation. This defect was later shown, by cardiac ultrasound, to be due to mitral valve prolapse into the left ventricle during diastole. This case illustrates that mitral valve prolapse should be added to the list of clinical entities that can result in an intraventricular defect on a radionu clide ventriculogram.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67208/2/10.1177_000331978904000209.pd

Pre- and post-operative cerebral blood flow changes in subarachnoid haemorrhage

Assessment of cerebral perfusion on patients with subarachnoid haemorrhage (SAH) in the Neurologic Intensive Care Unit is difficult since nuclear medicine imaging modalities capable of measuring cerebral blood flow (CBF) are not generally available. We performed 101 quantitative (ml/100g-min) bedside CBF measurements on 40 individual patients to correlate SAH grade with CBF and to assess the effect of surgical intervention on CBF. Global CBF (G-CBF) and bihemispheric CBF (B-CBF) asymmetry were correlated with the grade of SAH pre- and post-operatively.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41645/1/701_2005_Article_BF01405693.pd

SPECT imaging of Moyamoya disease using 99mTc-HM-PAO comparison with computed tomography findings

99mTc-HM-PAO was used to evaluate regional cerebral blood flow in a 26-year-old woman with Moyamoya disease. This patient had an 18-month history of recurrent neurologic deficits and had angiographic evidence of Moyamoya disease. She had used oral contraceptives and cigarettes, but had no other risk factors for stroke. Single photon emission computed tomographic images showed bilateral and asymmetric reductions in blood flow to anterior and lateral brain regions. These findings correlated better with clinical symptomatology and suggested more extensive brain involvement than did computed tomography.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27118/1/0000110.pd

The impact of arterial input function determination variations on prostate dynamic contrast-enhanced magnetic resonance imaging pharmacokinetic modeling: a multicenter data analysis challenge, part II

This multicenter study evaluated the effect of variations in arterial input function (AIF) determination on pharmacokinetic (PK) analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data using the shutter-speed model (SSM). Data acquired from eleven prostate cancer patients were shared among nine centers. Each center used a site-specific method to measure the individual AIF from each data set and submitted the results to the managing center. These AIFs, their reference tissue-adjusted variants, and a literature population-averaged AIF, were used by the managing center to perform SSM PK analysis to estimate Ktrans (volume transfer rate constant), ve (extravascular, extracellular volume fraction), kep (efflux rate constant), and τi (mean intracellular water lifetime). All other variables, including the definition of the tumor region of interest and precontrast T1 values, were kept the same to evaluate parameter variations caused by variations in only the AIF. Considerable PK parameter variations were observed with within-subject coefficient of variation (wCV) values of 0.58, 0.27, 0.42, and 0.24 for Ktrans, ve, kep, and τi, respectively, using the unadjusted AIFs. Use of the reference tissue-adjusted AIFs reduced variations in Ktrans and ve (wCV = 0.50 and 0.10, respectively), but had smaller effects on kep and τi (wCV = 0.39 and 0.22, respectively). kep is less sensitive to AIF variation than Ktrans, suggesting it may be a more robust imaging biomarker of prostate microvasculature. With low sensitivity to AIF uncertainty, the SSM-unique τi parameter may have advantages over the conventional PK parameters in a longitudinal study