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To investigate whether personality traits affect the rate of decline of gray matter volume, we analyzed the relationships between personality traits and the annual rate of changes of gray matter volume in 274 healthy community dwelling subjects with a large age range by applying a longitudinal design over 6 years, using brain magnetic resonance images (MRI) and the Revised NEO Personality Inventory (NEO-PI-R) at baseline. Brain MRI data were processed using voxel-based morphometry with a custom template by applying the DARTEL diffeomorphic registration tool. For each subject, we used NEO-PI-R to evaluate the five major personality traits, including neuroticism, extraversion, openness, agreeableness, and conscientiousness. The results show that the annual rate of change in regional gray matter volume in the right inferior parietal lobule was correlated significantly and negatively with a personality of openness, which is known to be related to intellect, intellectual curiosity, and creativity adjusting for age, gender, and intracranial volume. This result indicates that subjects with a personality trait of less openness have an accelerated loss of gray matter volume in the right inferior parietal lobule, compared with subjects with a personality trait of more openness. Because the right inferior parietal lobule is involved in higher cognitive function such as working memory and creativity, a personality trait of openness is thought to be important for preserving gray matter volume and cognitive function of the right inferior parietal lobule in healthy adults.
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Mapeo Encefálico , Encéfalo/anatomía & histología , Encéfalo/fisiología , Personalidad/fisiología , Adulto , Anciano , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Análisis de Regresión , Factores Sexuales , Factores de Tiempo , Adulto JovenRESUMEN
The aim of this study was to analyze correlations among the annual rate of gray matter volume change, age, gender, and cerebrovascular risk factors in 381 healthy community-dwelling subjects with a large age range by applying a longitudinal design over 6 years using brain magnetic resonance images (MRIs). Brain MRI data were processed with voxel-based morphometry using a custom template by applying diffeomorphic anatomical registration using the exponentiated lie algebra procedure. The annual rate of regional gray matter volume change showed significant positive correlations with age in several regions, including the bilateral temporal pole, caudate nucleus, ventral and dorsolateral prefrontal cortices, insula, hippocampus, and temporoparietal cortex, whereas significant negative correlations with age were observed in several regions including the bilateral cingulate gyri and anterior lobe of the cerebellum. Additionally, a significant age-by-gender interaction was found for the annual rate of regional gray matter volume change in the bilateral hippocampus. No significant correlations were observed between the annual rate of regional gray matter volume change and body mass index or systolic blood pressure. A significant positive correlation between the annual rate of gray matter volume change and age indicates that the region shows not linear but accelerated gray matter loss with age. Therefore, evaluating the annual rate of the gray matter volume change with age in healthy subjects is important in understanding how gray matter volume changes with aging in each brain region and in anticipating what cognitive functions are likely to show accelerated decline with aging.
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Envejecimiento/patología , Encéfalo/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Voluntarios Sanos , Humanos , Procesamiento de Imagen Asistido por Computador , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Although elevated serum high-sensitivity C-reactive protein (hsCRP) is related to atherosclerosis, brain infarction, and cognitive decline, it has not been clarified whether increased hsCRP is associated with the decline in brain gray matter volume. Therefore, the purpose of this study was to determine the relationship between hsCRP levels and brain regional gray matter volume using brain magnetic resonance imaging (MRI) data from 109 community-dwelling healthy elderly subjects. Brain MRIs were processed with voxel-based morphometry using a custom template by applying diffeomorphic anatomical registration using the exponentiated lie algebra (DARTEL) procedure. We found a significant negative correlation between regional gray matter volume of the posterior and lateral aspects of the left temporal cortex and hsCRP level after adjusting for age, gender, and intracranial volume. Our results suggest that subjects who have mild inflammation related to arteriosclerosis have decreased regional gray matter volume in the posterior and lateral aspects of the left temporal cortex. Thus, preventing the progression of arteriosclerosis may be important for preventing a decrease in gray matter volume in healthy elderly subjects.
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Encéfalo/anatomía & histología , Proteína C-Reactiva/análisis , Imagen por Resonancia Magnética , Neuroimagen , Anciano , Enfermedades Asintomáticas , Presión Sanguínea , Estudios Transversales , Progresión de la Enfermedad , Femenino , Humanos , Inflamación , Arteriosclerosis Intracraneal/patología , Japón , Lípidos/sangre , Masculino , Tamaño de los Órganos , Valores de Referencia , Lóbulo Temporal/patologíaRESUMEN
INTRODUCTION: Cigarette smoking decreases brain regional gray matter volume and is related to chronic obstructive lung disease (COPD). COPD leads to decreased pulmonary function, which is represented by forced expiratory volume in one second percentage (FEV1.0 %); however, it is unclear if decreased pulmonary function is directly related to brain gray matter volume decline. Because there is a link between COPD and cognitive decline, revealing a direct relationship between pulmonary function and brain structure is important to better understand how pulmonary function affects brain structure and cognitive function. Therefore, the purpose of this study was to analyze whether there were significant correlations between FEV1.0 % and brain regional gray and white matter volumes using brain magnetic resonance (MR) image data from 109 community-dwelling healthy elderly individuals. METHODS: Brain MR images were processed with voxel-based morphometry using a custom template by applying diffeomorphic anatomical registration using the exponentiated lie algebra procedure. RESULTS: We found a significant positive correlation between the regional white matter volume of the cerebellum and FEV1.0 % after adjusting for age, sex, and intracranial volume. CONCLUSION: Our results suggest that elderly individuals who have a lower FEV1.0 % have decreased regional white matter volume in the cerebellum. Therefore, preventing decreased pulmonary function is important for cerebellar white matter volume in the healthy elderly population.
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Cerebelo/anatomía & histología , Flujo Espiratorio Máximo/fisiología , Fibras Nerviosas Mielínicas/ultraestructura , Neuronas/citología , Anciano , Anciano de 80 o más Años , Cerebelo/fisiología , Femenino , Voluntarios Sanos , Humanos , Japón/epidemiología , Masculino , Tamaño de los Órganos/fisiología , Estadística como AsuntoRESUMEN
The aim of this study was to examine structural brain networks using regional gray matter volume, as well as to investigate changes in small-world and modular organization with normal aging. We constructed structural brain networks composed of 90 regions in young, middle, and old age groups. We randomly selected 350 healthy subjects for each group from a Japanese magnetic resonance image database. Structural brain networks in three age groups showed economical small-world properties, providing high global and local efficiency for parallel information processing at low connection cost. The small-world efficiency and node betweenness varied significantly and revealed a U- or inverted U-curve model tendency among three age groups. Results also demonstrated that structural brain networks exhibited a modular organization in which the connections between regions are much denser within modules than between them. The modular organization of structural brain networks was similar between the young and middle age groups, but quite different from the old group. In particular, the old group showed a notable decrease in the connector ratio and the intermodule connections. Combining the results of small-world efficiency, node betweenness and modular organization, we concluded that the brain network changed slightly, developing into a more distributed organization from young to middle age. The organization eventually altered greatly, shifting to a more localized organization in old age. Our findings provided quantitative insights into topological principles of structural brain networks and changes related to normal aging.
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Envejecimiento/patología , Encéfalo/patología , Vías Nerviosas/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Interpretación de Imagen Asistida por Computador , Imagen por Resonancia Magnética , Persona de Mediana Edad , Adulto JovenRESUMEN
Evaluating whole-brain or global gray matter volume decline rate is important in distinguishing neurodegenerative diseases from normal aging and in anticipating cognitive decline over a given period in non-demented subjects. Whether a significant negative correlation exists between baseline regional gray matter volume of several regions and global gray matter volume decline in the subsequent time period in healthy subjects has not yet been clarified. Therefore, we analyzed the correlation between baseline regional gray matter volumes and the rate of global gray matter volume decline in the period following baseline using magnetic resonance images of the brains of 381 healthy subjects by applying a longitudinal design over 6 years using voxel-based morphometry. As a result, the annual percentage change in gray matter ratio (GMR, APC(GMR)), in which GMR represents the percentage of gray matter volume in the intracranial volume, showed a significant negative correlation with the baseline regional gray matter volumes of the right posterior cingulate cortex/precuneus and the left hippocampus. Additionally, baseline regional gray matter volume of both the right PCC/precuneus and the left hippocampus significantly distinguished whether the APC(GMR) was above or below the mean of APC(GMR). Our results suggest that baseline regional gray matter volume predicts the rate of global gray matter volume decline in the subsequent period in healthy subjects. Our study may contribute to distinguishing neurodegenerative diseases from normal aging and to predicting cognitive decline.
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Envejecimiento , Encéfalo/citología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
This study applied volumetric analysis and voxel-based morphometry (VBM) of brain magnetic resonance (MR) images to assess whether correlations exist between global and regional gray/white matter volume and the cognitive functions of semantic memory and short-term memory, which are relatively well preserved with aging, using MR image data from 109 community-dwelling healthy elderly individuals. We used the Information and Digit Span subtests of the Wechsler Adult Intelligent Scale-Revised as measures of semantic memory and short-term memory, respectively. We found significant positive correlations between the gray matter ratio, the percentage of gray matter volume in the intracranial volume, and performance on the Digit Span subtest, and between the regional gray matter volumes of the bilateral anterior temporal lobes and performance on the Information subtest. No significant correlations between performance on the cognitive tests and white matter volume were found. Our results suggest that individual variability in specific cognitive functions that are relatively well preserved with aging is accounted for by the variability of gray matter volume in healthy elderly subjects.
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Envejecimiento/fisiología , Encéfalo/anatomía & histología , Encéfalo/fisiología , Cognición/fisiología , Memoria/fisiología , Anciano , Mapeo Encefálico , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Tamaño de los ÓrganosRESUMEN
INTRODUCTION: Whether the degree of white matter hyperintensities (WMHs) shows a significant correlation with the rate of global gray matter volume decline over a period following initial baseline measurement remains unclear. The purpose of the present study was to reveal the relationship between the degree of WMHs at baseline and the rate of global gray matter volume decline by applying a longitudinal design. METHODS: Using a 6-year longitudinal design and magnetic resonance images of the brains of 160 healthy individuals aged over 50 years and living in the community, we analyzed the correlation between degree of WMHs using Fazekas scaling at baseline and rate of global gray matter volume decline 6 years later. To obtain the rate of global gray matter volume decline, we calculated global gray matter volume and intracranial volume at baseline and at follow-up using a fully automated method. RESULTS: The annual percentage change in the gray matter ratio (GMR, APC(GMR)), in which GMR represents the percentage of gray matter volume in the intracranial volume, showed a significant positive correlation with the degree of deep WMHs and periventricular WMHs at baseline, after adjusting for age, gender, present history of hypertension, and diabetes mellitus. CONCLUSION: Our results suggest that degree of WMHs at baseline predicts the rate of gray matter volume decline 6 years later and that simple visual scaling of WMHs could contribute to predicting the rate of global gray matter volume decline.
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Envejecimiento/patología , Encéfalo/patología , Imagen por Resonancia Magnética , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Tamaño de los ÓrganosRESUMEN
A 59-year-old, right-handed woman made many mistakes in her job in a pharmacy, despite having considerable experience working in this setting. She had a can-do attitude, but also showed no sign of remorse when she failed. Other staff grew impatient with her and she was diagnosed with frontotemporal dementia based on clinical and brain imaging findings. After diagnosis, other staff understood that the disease was the cause of her difficulties, and her work tasks and hours were changed to fit with her stereotypical behavior. This support in the workplace made it possible for her to continue her job.
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BACKGROUND: The neurologic background of confabulations with reference to delusions or cognitive functions has not been clarified in Alzheimer disease (AD). METHODS: Confabulations of 41 AD patients and 12 healthy controls were studied using the Modified Confabulation Battery. The mini-mental state examination and Cognitive Abilities Screening Instrument were used for cognitive evaluations. Cerebral atrophy was assessed by voxel-based-morphometry of magnetic resonance imaging and the correlations with confabulations were analyzed by statistical parametric mapping 2. For the relations with delusion, the AD patients were divided into the delusion and nondelusion groups. The single photon emission computed tomography was performed to evaluate cerebral blood flow and the group difference was analyzed by statistical nonparametric mapping 3. RESULTS: The AD patients exhibited more confabulations on episodic memory questions compared with semantic questions. The semantic confabulation scores correlated with mini-mental state examination and most Cognitive Abilities Screening Instrument domains scores, and correlated with atrophy in the anterior cingulate, bilateral medial temporal, and right middle temporal gyrus. The delusion group exhibited more episodic confabulations and had lower prefrontal blood flow than the nondelusion group. CONCLUSIONS: Different mechanisms are involved in confabulations between semantic and episodic memories in AD. Episodic confabulation is affected by delusion related to frontal dysfunction, and semantic confabulation is associated with cognitive dysfunction.
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Enfermedad de Alzheimer/psicología , Memoria/fisiología , Represión Psicológica , Anciano , Enfermedad de Alzheimer/diagnóstico por imagen , Enfermedad de Alzheimer/patología , Mapeo Encefálico , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/psicología , Deluciones/etiología , Deluciones/psicología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Corteza Prefrontal/patología , Escalas de Valoración Psiquiátrica , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
OBJECTIVE: The dependent-density of computed tomography (CT) images of positron emission tomography (PET)/CT is sometimes difficult to distinguish from chronic interstitial lung disease (ILD) when it accompanies increased (18)F-fluorodeoxy-D: -glucose ((18)FDG) uptake. Though the possible utility of (18)FDG-PET for the diagnosis of active ILD has been reported, the clinical relevance of mild lung (18)FDG uptake in ILD cases without signs and symptoms suggesting acute progression has not been described. This study aimed to test relationships between (18)FDG uptake and lung density on CT using PET/CT in patients with normal lung as well as clinically stable chronic ILD. METHODS: Thirty-six patients with normal lungs (controls) and 28 patients with chronic ILD (ILD cases) without acute exacerbation were retrospectively selected from (18)FDG-PET/CT scans performed in examination of malignant neoplasms. Elliptical regions of interest (ROIs) were placed on the lung. The relationships between CT density and (18)FDG uptake between the control and ILD cases were tested. RESULTS: The CT density and (18)FDG uptake had a linear correlation in both the controls and the ILD cases without a difference in their regression slopes, and they were overlapped between the controls and the ILD cases with higher mean values in the ILD cases. CONCLUSIONS: Lung (18)FDG uptake was considered to reflect a gravity-dependent tissue density in the normal lung. Though the lung (18)FDG uptake as well as the CT density tended to be higher in chronic ILD patients, it may be difficult to distinguish them in normal dependent regions from those related to chronic ILD in some cases.
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Fluorodesoxiglucosa F18/metabolismo , Enfermedades Pulmonares Intersticiales/diagnóstico , Enfermedades Pulmonares Intersticiales/metabolismo , Pulmón/metabolismo , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Enfermedad Crónica , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pulmón/fisiopatología , Enfermedades Pulmonares Intersticiales/fisiopatología , Masculino , Persona de Mediana Edad , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: The Subcommittee on the Survey of Nuclear Medicine Practice in Japan has performed a nationwide survey of nuclear medicine practice every 5 years since 1982 to provide detailed information on its present status. METHODS: Questionnaires were sent to all institutions known to the Japan Radioisotope Association to conduct nuclear medicine examinations. The questionnaires addressed the number and kind of nuclear medicine examinations performed as well as the kind and dose of the radiopharmaceuticals used during the month of June 2007. The annual number of total or specific examinations was then estimated. RESULTS: Of the institutions sent questionnaires, 1219 were for in vivo study, 49 for in vitro study, and 212 for positron emission tomography (PET) study. Of these, 92.2% provided answers. A total of 1569 gamma cameras were installed in 1119 institutions, of which 70% were dual-head cameras. The estimated total annual number of in vivo examinations expressed by the number of administered radiopharmaceuticals was 1.41 million, representing a decrease of 11.5% when compared with that of the previous survey (2002). The frequency of study with respect to single-photon emission computed tomography (SPECT) slightly increased to 42.3% from 39.9% in the previous survey. The most frequently performed scintigraphy was bone (38.3%), followed by myocardium (26.2%) and brain perfusion (14.1%). Brain perfusion scintigraphy slightly increased, whereas tumor scintigraphy decreased by one-half when compared with the previous survey. The most commonly used radiopharmaceutical for each scintigraphy was (99m)Tc-HMDP for bone, thallium-201 ((201)Tl)-chloride for myocardium, gallium-67 ((67)Ga)-citrate for tumor, and technetium-99m-ethylcysteinate dimmer ((99m)Tc-ECD) for brain. The number of PET institutes increased from 36 to 212. (18)F-fluorodeoxyglucose ((18)F-FDG)-PET dramatically increased 14.8-fold during the past 5 years. Radionuclide therapy also increased. (131)I therapy for thyroid cancer and hyperthyroidism was conducted yearly in 2373 and 4146 patients, respectively. A total of 13.1 million in vitro radioassays were carried out yearly, the number of which has been decreasing continuously since 1992. CONCLUSIONS: It was proved that the content of nuclear medicine practice in Japan has changed considerably in the past 5 years. Namely, (18)F-FDG-PET and radionuclide therapy increased. This report might be useful for understanding the present trends of nuclear medicine practice in Japan.
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Encuestas de Atención de la Salud , Medicina Nuclear/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Radioterapia/estadística & datos numéricos , Tomografía Computarizada de Emisión/estadística & datos numéricos , JapónRESUMEN
BACKGROUND/AIMS: The serum tumor marker carbohydrate associated antigen 19-9 (CA19-9) has been used for screening for cancer, because its increase has been associated with many cancers. We aimed to evaluate the clinical value of positron emission tomography using F-18 fluorodeoxyglucose (18FDG-PET) that was prompted by increases of serum CA19-9 without findings on conventional imaging. METHODOLOGY: Twenty-two patients were retrospectively selected. Eleven were without a history of cancer and eleven had a history of cancer and were treated with curative intent. All 18FDG-PET findings were compared with the findings of histopathology by surgery or biopsy, or clinical follow-up for at least 1 year. RESULTS: We found only two true positive cases, and eleven cases without a cancer history included 10 true negatives and one false positive. CONCLUSIONS: Increases in serum CA19-9 are caused by many benign conditions. Increases of CA19-9 without findings on conventional imaging do not justify 18FDG-PET examination, particularly in patients without a cancer history.
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Antígeno CA-19-9/sangre , Neoplasias/diagnóstico , Tomografía de Emisión de Positrones/estadística & datos numéricos , Adulto , Anciano , Femenino , Fluorodesoxiglucosa F18 , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico por imagen , Valor Predictivo de las Pruebas , Radiofármacos , Estudios RetrospectivosRESUMEN
This report documents 2 cases of esophageal cancer complicated by sarcoidosis mimicking mediastinal lymph node metastases on F-18 fluorodeoxyglucose positron emission tomography (FDG PET) for staging of the cancer. In both cases, FDG PET demonstrated intense uptake in the swollen mediastinal and bilateral hilar lymph nodes. In 1 case, FDG PET showed intense uptake in the primary esophageal cancer. In another case, FDG PET showed no definite intense uptake in the primary esophageal cancer. The histopathology of the resected mediastinal and hilar lymph nodes demonstrated no malignant cells but sarcoid lesions such as noncaseating granuloma. Therefore, sarcoidosis should be considered when FDG PET shows intense FDG uptake in nonregional swollen lymph nodes, although the incidence of esophageal cancer complicated by sarcoidosis is rare.
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Neoplasias Esofágicas/diagnóstico por imagen , Neoplasias Esofágicas/secundario , Fluorodesoxiglucosa F18 , Ganglios Linfáticos/diagnóstico por imagen , Tomografía de Emisión de Positrones/métodos , Sarcoidosis/diagnóstico por imagen , Anciano , Diagnóstico Diferencial , Humanos , Metástasis Linfática , Masculino , Mediastino/diagnóstico por imagen , Persona de Mediana Edad , RadiofármacosRESUMEN
We previously examined cerebral blood flow (CBF) with single-photon emission computed tomography (SPECT) in Alzheimer's disease (AD) with reference to drug treatment (donepezil) and psychosocial intervention. OBJECTIVE: The aim is to provide "brain-based" evidence for psychosocial interventions using SPECT. METHODS: The participants were 27 consecutive outpatients with AD who received the drug and psychosocial intervention, and SPECT three times (baseline, pre-/post-intervention) at 6 month-intervals. The significance level of changes in CBF (Z score) and the extent of significantly changed areas, calculated with the eZIS system, were used as monitoring parameters. The participants were classified into three groups: improve (post-intervention CBF increased), worsening (progressive decline), and no change. RESULTS: Six, 8, and 13 patients were classified as improve, worsening, and no change, respectively. All subjects in the improve group showed improvement in cognitive test scores for the MMSE and/or the CGI scores associated with the brain area with a CBF increase (right parietal lobe), suggesting appropriate psychosocial intervention (visuospatial intervention). CONCLUSION: These results suggest that monitoring of CBF with the eZIS system may be clinically applicable for monitoring of drug treatment and psychosocial intervention in AD patients.
Nós examinamos previamente o fluxo sanguíneo cerebral (FSC) com tomografia computadorizada de emissão de fóton único (SPECT) na doença de Alzheimer (DA) com referência ao tratamento medicamentoso (donepezila) e intervenção psicossocial. OBJETIVO: Fornecer evidências "baseadas no cérebro" para intervenções psicossociais usando o SPECT. MÉTODOS: Os participantes foram 27 pacientes ambulatoriais consecutivos com DA que receberam a droga e intervenção psicossocial, e SPECT por três vezes (basal, pré/pós-intervenção) em intervalos de seis meses. O nível de significância das mudanças no FSC (escore Z) e a extensão das áreas significativamente alteradas calculadas com o sistema eZIS foram utilizados como parâmetros de monitoramento. Os participantes foram classificados em três grupos: melhora (FSC pós-intervenção aumentada), piora (declínio progressivo) e nenhuma mudança. RESULTADOS: Seis, oito e 13 pacientes foram classificados como melhora, piora e sem alteração, respectivamente. Todos no grupo melhora mostraram aumento dos escores no MEEM e/ou nos escores do CGI associados à área do cérebro com aumento do FSC (lobo parietal direito), sugerindo intervenção psicossocial apropriada (intervenção visoespacial). CONCLUSÃO: Estes resultados sugerem que o monitoramento do FSC com o sistema eZIS pode ser clinicamente aplicável para o monitoramento do tratamento medicamentoso e intervenção psicossocial em pacientes com DA.
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The vertebral spine is frequently affected by the SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. We report the collective imaging findings of hybrid F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT), as well as bone scans and magnetic resonance imaging, in a patient who had suspected metastatic vertebral bone tumors. 18FDG-PET/CT can be utilized to exclude metastatic vertebral tumors, as well as identifying stable lesions, by demonstrating active inflammatory lesions with accurate anatomic localization through the convergence of the functional information from 18FDG uptake with the anatomic information of CT.
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Síndrome de Hiperostosis Adquirido/diagnóstico , Fluorodesoxiglucosa F18 , Osteítis/diagnóstico , Tomografía de Emisión de Positrones/métodos , Neoplasias de la Columna Vertebral/diagnóstico , Neoplasias de la Columna Vertebral/secundario , Tomografía Computarizada por Rayos X/métodos , Anciano , Femenino , Humanos , RadiofármacosRESUMEN
We report a case demonstrating intense FDG uptake in the ovary, which was diagnosed to be a hemorrhage and congestion due to painless torsion. An asymptomatic retropelvic mass was detected in a 51-year-old female by echography. FDG-PET demonstrated intense uptake in the mass, thus suggesting an ovarian tumor. A resection of the tumor was performed, and histopathological examination revealed hemorrhage and congestion in the ovary due to ovarian torsion. An ovarian hemorrhage due to painless torsion should be considered in the differential diagnosis of intrapelvic masses demonstrating high FDG uptake, even in asymptomatic patients.
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Fluorodesoxiglucosa F18/farmacocinética , Enfermedades del Ovario/diagnóstico por imagen , Enfermedades del Ovario/metabolismo , Anomalía Torsional/diagnóstico por imagen , Anomalía Torsional/metabolismo , Femenino , Humanos , Persona de Mediana Edad , Enfermedades del Ovario/complicaciones , Dolor/diagnóstico por imagen , Dolor/etiología , Cintigrafía , Radiofármacos/farmacocinética , Anomalía Torsional/complicacionesRESUMEN
Metastatic tumors or secondary lymphoma of the kidney are rare and can often be missed on conventional computed tomography (CT) imaging. On the other hand, many types of metastatic tumor or lymphoma can be detected clearly as hotspots of elevated uptake on FDG PET. However, excreted FDG present in the urinary tract mimics these findings and interferes with image reading. Careful investigation of the renal cortex by FDG PET and review of anatomical images, such as the findings of CT and MRI, have important roles in the detection of renal tumor. Here, we present three cases of solitary metastatic/secondary tumor of the kidney, and discuss the features of the lesions on FDG PET in comparison with their appearance on CT.
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Fluorodesoxiglucosa F18 , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/secundario , Linfoma/diagnóstico por imagen , Adolescente , Adulto , Anciano , Humanos , Metástasis Linfática , Masculino , Tomografía de Emisión de Positrones/métodos , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina , Radiografía , RadiofármacosRESUMEN
OBJECTIVES: Three accumulative tracers, iodine-123-labeled N-isopropyl-p-iodoamphetamine (I-123-IMP), technetium-99m-labeled hexamethylpropyleneamineoxime (Tc-99m-HMPAO), and technetium-99m-labeled ethyl cysteinate dimer (Tc-99m-ECD) are widely used to measure cerebral blood flow (CBF) in single-photon emission computed tomography (SPECT). In the present study, normal regional distribution of CBF measured with three different SPECT tracers was entered into a database and compared with regional distribution of CBF measured by positron emission tomography (PET) with H2(15)O. The regional distribution of tissue fractions of gray matter determined by voxel-based morphometry was also compared with SPECT and PET CBF distributions. METHODS: SPECT studies with I-123-IMP, Tc-99m-HMPAO, and Tc-99m-ECD were performed on 11, 20, and 17 healthy subjects, respectively. PET studies were performed on 11 healthy subjects. Magnetic resonance (MR) imaging studies for voxel-based morphometry were performed on 43 of the 48 subjects who underwent SPECT study. All SPECT, PET, and MR images were transformed into the standard brain format with the SPM2 system. The voxel values of each SPECT and PET image were globally normalized to 50 ml/100 ml/min. Gray matter, white matter, and cerebrospinal fluid images were segmented and extracted from all transformed MR images by applying voxel-based morphometry methods with the SPM2 system. RESULTS: Regional distribution of all three SPECT tracers differed from that of H2150 in the pons, midbrain, thalamus, putamen, parahippocampal gyrus, posterior cingulate gyrus, temporal cortex, and occipital cortex. No significant correlations were observed between the tissue fraction of gray matter and CBF with any tracer. CONCLUSION: Differences in regional distribution of SPECT tracers were considered to be caused mainly by differences in the mechanism of retention of tracers in the brain. Regional distribution of CBF was independent of regional distribution of gray matter fractions, and consequently the blood flow per gray matter volume differed for each brain region.
Asunto(s)
Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Cisteína/análogos & derivados , Bases de Datos Factuales , Yofetamina , Compuestos de Organotecnecio , Exametazima de Tecnecio Tc 99m , Tomografía Computarizada de Emisión de Fotón Único/métodos , Encéfalo/metabolismo , Circulación Cerebrovascular , Cisteína/farmacocinética , Cisteína/normas , Femenino , Humanos , Imagenología Tridimensional/métodos , Imagenología Tridimensional/normas , Yofetamina/farmacocinética , Masculino , Persona de Mediana Edad , Compuestos de Organotecnecio/farmacocinética , Compuestos de Organotecnecio/normas , Radioisótopos de Oxígeno/farmacocinética , Tomografía de Emisión de Positrones/métodos , Tomografía de Emisión de Positrones/normas , Radiofármacos/farmacocinética , Valores de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Exametazima de Tecnecio Tc 99m/farmacocinética , Exametazima de Tecnecio Tc 99m/normas , Distribución Tisular , Tomografía Computarizada de Emisión de Fotón Único/normasRESUMEN
UNLABELLED: The limited spatial resolution of SPECT causes a partial volume effect (PVE) and can lead to the significant underestimation of regional tracer concentration in the small structures surrounded by a low tracer concentration, such as the cortical gray matter of an atrophied brain. The aim of the present study was to determine, using 123I-IMP and SPECT, normal CBF of elderly subjects with and without PVE correction (PVC), and to determine regional differences in the effect of PVC and their association with the regional tissue fraction of the brain. METHODS: Quantitative CBF SPECT using 123I-IMP was performed in 33 healthy elderly subjects (18 males, 15 females, 54-74 years old) using the autoradiographic method. We corrected CBF for PVE using segmented MR images, and analyzed quantitative CBF and regional differences in the effect of PVC using tissue fractions of gray matter (GM) and white matter (WM) in regions of interest (ROIs) placed on the cortical and subcortical GM regions and deep WM regions. RESULTS: The mean CBF in GM-ROIs were 31.7 +/- 6.6 and 41.0 +/- 8.1 ml/100 g/min for males and females, and in WM-ROIs, 18.2 +/- 0.7 and 22.9 +/- 0.8 ml/100 g/min for males and females, respectively. The mean CBF in GM-ROIs after PVC were 50.9 +/- 12.8 and 65.8 +/- 16.1 ml/100 g/min for males and females, respectively. There were statistically significant differences in the effect of PVC among ROIs, but not between genders. The effect of PVC was small in the cerebellum and parahippocampal gyrus, and it was large in the superior frontal gyrus, superior parietal lobule and precentral gyrus. CONCLUSION: Quantitative CBF in GM recovered significantly, but did not reach values as high as those obtained by invasive methods or in the H2(15)O PET study that used PVC. There were significant regional differences in the effect of PVC, which were considered to result from regional differences in GM tissue fraction, which is more reduced in the frontoparietal regions in the atrophied brain of the elderly.