Analysis and interpretation of dynamic FDG PET oncological studies using data reduction techniques

<p>Abstract</p> <p>Background</p> <p>Dynamic positron emission tomography studies produce a large amount of image data, from which clinically useful parametric information can be extracted using tracer kinetic methods. Data reduction methods can facilitate the initial interpretation and visual analysis of these large image sequences and at the same time can preserve important information and allow for basic feature characterization.</p> <p>Methods</p> <p>We have applied principal component analysis to provide high-contrast parametric image sets of lower dimensions than the original data set separating structures based on their kinetic characteristics. Our method has the potential to constitute an alternative quantification method, independent of any kinetic model, and is particularly useful when the retrieval of the arterial input function is complicated. In independent component analysis images, structures that have different kinetic characteristics are assigned opposite values, and are readily discriminated. Furthermore, novel similarity mapping techniques are proposed, which can summarize in a single image the temporal properties of the entire image sequence according to a reference region.</p> <p>Results</p> <p>Using our new cubed sum coefficient similarity measure, we have shown that structures with similar time activity curves can be identified, thus facilitating the detection of lesions that are not easily discriminated using the conventional method employing standardized uptake values.</p

Isotretinoin and psychopathology: a review

Isotretinoin, a synthetic oral retinoid that is used against severe nodulocystic acne, has been associated with various psychiatric side effects such as depression, suicidality and psychotic symptoms. A great number of reports on its effects have been published since its introduction into the market. However, a causal relationship has not been established and the link between isotretinoin use and psychiatric events remains controversial. The present paper reviews the available evidence regarding the association of isotretinoin and psychiatric side effects. All published material reporting psychiatric side effects following isotretinoin treatment, including case reports, case series, reports from adverse drug event reporting systems, prospective surveys and retrospective case-control studies, are presented. In addition, the neurobiology of the retinoids and possible biological mechanisms that may lead to psychopathology are described

Efficient methodology for 3D statistical reconstruction of high resolution coplanar PET/CT scanner

Proceeding of: 2008 IEEE Nuclear Science Symposium Conference Record (NSS '08), Dresden, Germany, 19-25 Oct. 2008A fully 3D statistical image reconstruction algorithm has been developed for a high-resolution coplanar PETtCT scanner based on rotating planar PET detectors. The system matrix has been modeled with custom Monte Carlo techniques optimized for the specific scanner architecture. The system model includes positron range, non-colinearity of gamma rays and crystal interaction modelling with attenuation and Compton scattering effects. Only 0.21 % of the system matrix columns are modeled in detail, obtaining the rest of the values with axial and transaxial voxel-driven symmetries. The iterative algorithm is a fully 3D approach, regularized with the anatomical registered image using a novel version of the minimum cross entropy (MXE) scheme, and accelerated employing ordered subsets. The proposed method has been shown to produce images with superior quality than 3D hybrid (FORE+2D-OSEM) algorithms applied on synthetic GATE data, as well as on real small animal acquisitionsThis work has been partly funded by the CDTEAM project and CENIT programme (Spanish Ministry of Industry), EMIL (ED Network of Excellence), CIBER CB07/09/0031 and RETIC-RECAVA (Spanish Ministry of Health) and TEC2007-64731/TCM(Spanish Ministry of Education and Science

Modeling the acquisition front-end in high resolution gamma-ray imaging

Proceeding of: 2004 IEEE Nuclear Science Symposium Conference Record, Rome, Italy, 16-22 October 2004The availability of synthetic realistic data enables design optimization, algorithm evaluation and verification of any digital system where a significant amount of digital signal processing is performed. The evolution of positron emission tomography cameras towards continuous sampling of individual position-sensitive photomultiplier anodes with processing algorithms implemented on digital programmable logic devices creates a new framework where new approaches to the γ-event detection are possible. We have developed a system model of the acquisition chain, including multi-layer phoswich, photomultiplier, front-end analog electronics, data acquisition and data processing. This processing includes estimation algorithms for the most relevant event parameters: energy, layerof- interaction, time picking-off and event location. The selected simulation platform couples gently to digital hardware simulation tools, in such a way that implemented models may generate reallike stimuli for the digital system under development. The modeling of the whole front-end electronics enables deeper understanding and tuning of different system trade-offs and provides a rapid and soft transition between specification and hardware development

Olanzapine-associated neuroleptic malignant syndrome: Is there an overlap with the serotonin syndrome?

BACKGROUND: The neuroleptic malignant syndrome is a rare but serious condition mainly associated with antipsychotic medication. There are controversies as to whether "classical" forms of neuroleptic malignant syndrome can occur in patients given atypical antipsychotics. The serotonin syndrome is caused by drug-induced excess of intrasynaptic 5-hydroxytryptamine. The possible relationship between neuroleptic malignant syndrome and serotonin syndrome is at present in the focus of scientific interest. METHODS: This retrospective phenomenological study aims to examine the seventeen reported olanzapine – induced neuroleptic malignant syndrome cases under the light of possible overlap between neuroleptic malignant syndrome and serotonin syndrome clinical features. RESULTS: The serotonin syndrome clinical features most often reported in cases initially diagnosed as neuroleptic malignant syndrome are: fever (82%), mental status changes (82%) and diaphoresis (47%). Three out of the ten classical serotonin syndrome clinical features were concurrently observed in eleven (65%) patients and four clinical features were observed in seven (41%) patients. CONCLUSION: The results of this study show that the clinical symptoms of olanzapine-induced neuroleptic malignant syndrome and serotonin syndrome are overlapping suggesting similarities in underlying pathophysiological mechanisms

Treatment of severe neuroleptic-induced tardive torticollis

BACKGROUND: The aim of this paper is to describe a case of severe neuroleptic-induced tardive torticollis successfully treated with a combination of clozapine, clonazepam and botulinum toxin-A. CASE REPORT: The patient, a 30-year old man with a seven-year history of delusional disorder experienced severe right torticollis with painful tightness of the neck and elevation of the shoulder. At this time he was receiving haloperidol 20 mg, trifluoperazine 5 mg, zuclopenthixol 20 mg and biperidine 4 mg daily. The combination therapy with clozapine and clonazepam and the long-term use of botulinum toxin-A resulted in a complete remission of dystonic movements. CONCLUSIONS: The present observations provide evidence indicating that this combination therapy may be of benefit in patients with severe neuroleptic-induced tardive torticollis

Digital timing in positron emission tomography

Proceeding of: 2006 IEEE Nuclear Science Symposium Conference Record, San Diego, CA, Oct. 29 - Nov. 1, 2006Positron emission tomography (PET) requires accurate timing of events in order to properly discriminate between coincident and non-coincident events. The traditional solution to timing is based on custom ASIC designs, whose cost may not be justified in the design of an experimental small animal PET scanner. The new generation of PET scanners introduces the idea of continuous sampling of the detected scintillation pulse, in substitution of the event triggered acquisition systems. This approach enables new options to timing based on digital processing of the sampled pulse signal. This work proposes a time stamping algorithm based on the optically matched filter and compares the potential performance benefits of this approach versus other FIR filter designs, some of which have been already implemented by different authors. Results show that time resolution of the timestamp may be as 1 ns without the need of expensive high-speed converters when the proper processing is applied.This work has been partially funded by the Spanish Ministry of Culture and Science through the FPU grant program as well as projects TEC2004-07052-C02-02 and PI052204.

Physical anhedonia in the acute phase of schizophrenia

BACKGROUND: The aim of the current study is to investigate the relationship between physical anhedonia and psychopathological parameters, pharmacological parameters or motor side-effects in a sample of inpatients with schizophrenia in an acute episode of their illness. METHOD: Eighty one patients with schizophrenia, consecutively admitted, with an acute episode of their illness, at the Eginition Hospital, Department of Psychiatry, University of Athens, during a one-year period were investigated regarding possible relationships between physical anhedonia, social-demographic data and clinical parameters as well as motor side-effects, induced by antipsychotic agents. All patients were assessed using the Chapman Revised Physical Anhedonia Scale (RPAS), the Positive and Negative Syndrome Scale (PANSS), the Rating Scale for Extrapyramidal Side-Effects (EPSE), the Barnes Akathisia Rating Scale (BARS) and the Abnormal Involuntary Movement Scale (AIMS). Simple cross tabulations were initially employed. Subsequently, multiple regression analysis was performed. RESULTS: Both positive and negative symptoms were associated with physical anhedonia. A positive association between physical anhedonia and the non-paranoid sub-category of schizophrenia was also proved. CONCLUSION: According to these results, it seems that in the acute phase of schizophrenia, physical anhedonia may be a contributing factor to patient's psychopathology

Preliminary studies on the design and simulation of high resolution small animal PET scanners with octagonal geometry

Proceding of: 2003 IEEE Nuclear Science Symposium Conference Record, Portland, Oregon, USA, 19-25 October, 2003We present a preliminary study on the design of a small animal positron emission tomograph with octagonal geometry. The main goal is to evaluate the impact of critical design parameters on the quality of the reconstructed images. Monte Carlo simulations take into account the depth of interaction in individual crystals. The activity sources are simulated as parametric distributions within the field of view and images are reconstructed with iterative algorithms based on the estimation of maximum likelihood and Bayesian regularization. The probability system matrix used by these algorithms is also calculated based on statistical models and Monte Carlo simulation. 2D and 3D techniques have been employed.This work has been partly founded by the Spanish Ministry of Science & Technology, (TIC 2001-0175-C03) and by Red Temática IM3 from Spanish Health Ministry (G03/185).Publicad

Combination therapy as a potential risk factor for the development of type 2 diabetes in patients with schizophrenia: the GOMAP study.

BACKGROUND: Schizophrenia (SCZ) is associated with increased risk of type 2 diabetes (T2D). The potential diabetogenic effect of concomitant application of psychotropic treatment classes in patients with SCZ has not yet been evaluated. The overarching goal of the Genetic Overlap between Metabolic and Psychiatric disease (GOMAP) study is to assess the effect of pharmacological, anthropometric, lifestyle and clinical measurements, helping elucidate the mechanisms underlying the aetiology of T2D. METHODS: The GOMAP case-control study (Genetic Overlap between Metabolic and Psychiatric disease) includes hospitalized patients with SCZ, some of whom have T2D. We enrolled 1653 patients with SCZ; 611 with T2D and 1042 patients without T2D. This is the first study of SCZ and T2D comorbidity at this scale in the Greek population. We retrieved detailed information on first- and second-generation antipsychotics (FGA, SGA), antidepressants and mood stabilizers, applied as monotherapy, 2-drug combination, or as 3- or more drug combination. We assessed the effects of psychotropic medication, body mass index, duration of schizophrenia, number of hospitalizations and physical activity on risk of T2D. Using logistic regression, we calculated crude and adjusted odds ratios (OR) to identify associations between demographic factors and the psychiatric medications. RESULTS: Patients with SCZ on a combination of at least three different classes of psychiatric drugs had a higher risk of T2D [OR 1.81 (95% CI 1.22-2.69); p = 0.003] compared to FGA alone therapy, after adjustment for age, BMI, sex, duration of SCZ and number of hospitalizations. We did not find evidence for an association of SGA use or the combination of drugs belonging to two different classes of psychiatric medications with increased risk of T2D [1.27 (0.84-1.93), p = 0.259 and 0.98 (0.71-1.35), p = 0.885, respectively] compared to FGA use. CONCLUSIONS: We find an increased risk of T2D in patients with SCZ who take a combination of at least three different psychotropic medication classes compared to patients whose medication consists only of one or two classes of drugs