[Establishing a protein signature from prostate tissue biopsies]. / Erstellung eines Proteinprofils aus Gewebeproben der Prostata.

The prostate-specific antigen test (PSA) has been a major factor contributing to a better management of prostate cancer. The low specificity limits its use in diagnosis especially in early detection of prostate cancer. Multiply expressed proteins need to be identified to establish a disease-specific protein signature that distinguishes between cancerous and noncancerous tissue. The first aim of our study is to identify differentially expressed proteins in both tissues using two-dimensional gel electrophoresis and subsequent mass spectrometry. We elucidated whether prostate biopsies are useful. First results have shown a different protein expression pattern in cancerous and noncancerous tissue. PCR revealed an increasing amount of mRNA for some upregulated proteins. We conclude that biopsies are useful material to establish protein expression patterns.

[Percutaneous vertebroplasty -- the role of osseous phlebography]. / Die perkutane Vertebroplastie -- Rolle der ossären Phlebographie.

PURPOSE: To evaluate the usefulness of osseous phlebography preceding percutaneous vertebroplasty. MATERIALS AND METHODS: Seventy-five patients with painful osteoporotic (57) or malignant (18) vertebral fractures were treated by percutaneous vertebroplasty under fluoroscopic control. Prior to cement injection, osseous phlebography was performed, with 247 phlebographic studies included in the retrospective correlation with radiographic and CT images. Clinical results were assessed by standardized questionnaire. RESULTS: In 69/75 (92 %) patients, pain and mobility improved and medication needed for pain control decreased significantly after vertebroplasty. Two clinically apparent complications occurred. The results of osseous phlebography prompted correction of the needle position in 34/247 (14 %) of the procedures and cancellation of the cement injection in 19/247 (8 %). No complications occurred related to osseous phlebography. CT was superior to conventional radiography in detecting extra-osseous cement leakage (106/247 by CT vs. 63/247 by conventional radiography). The cement leakage was asymptomatic in 104/106 (98 %) cases for the duration of follow-up. DISCUSSION: Osseous phlebography prior to percutaneous vertebroplasty had a significant impact on the procedure in our retrospective study and was able to predict the cement distribution in the majority of cases. However, phlebography was unable to foresee and therefore prevent 2 clinically relevant complications. Complications related to phlebography did not occur.

Dopamine D2 receptor imaging with iodine-123-iodobenzamide SPECT in idiopathic rotational torticollis.

UNLABELLED: The cause of idiopathic rotational torticollis (IRT) is not completely understood to date. However, basal ganglia are believed to be involved in the pathophysiology of IRT. To elucidate this disorder further, the value of iodobenzamide (IBZM) SPECT was studied for the evaluation of striatal dopamine D2 receptors in these patients. METHODS: Striatal dopamine D2 receptor density was assessed in 10 patients with IRT using 123I-IBZM SPECT. The images were interpreted by a nuclear medicine physician initially to determine IBZM binding within the striatum and the cerebellum and, secondly, interstriatal IBZM binding. The results were correlated with the clinical parameters of the patients and compared with the results obtained from normal controls. RESULTS: No difference was found in average, specific striatal IBZM binding (basal ganglia/cerebellum ratio) between patients and controls. However, interstriatal analysis of IBZM binding revealed a significantly higher binding in the striatum contralateral to the direction of the torticollis (p = 0.026, by chi-square test). CONCLUSION: It was concluded that the striatal dopamine D2 receptor status is altered in patients with IRT.

Loss of dopamine-D2 receptor binding sites in Parkinsonian plus syndromes.

UNLABELLED: This study analyzed temporal changes of striatal dopamine-D2 receptor binding during the course of different extrapyramidal movement disorders using 123I-iodobenzamide (IBZM) SPECT. METHODS: Eighteen patients (9 with Parkinson's disease, 9 with parkinsonian plus syndrome) were followed for 11-53 mo. Dopamine-D2 receptor binding was assessed using 123I-IBZM SPECT at the beginning and at the end of the follow-up period. SPECT data were acquired 120 min postinjection of 3-5 mCi 123I-IBZM. A semiautomated algorithm was applied to the raw data for semiquantitative evaluation of regional cerebral receptor binding. RESULTS: Intraobserver (r = 0.992) and interobserver (r = 0.930) variance was low for the semiautomated interpretation of the SPECT examination of the dopaminergic D2 receptor binding, reflecting a highly reproducible SPECT algorithm. Mean specific dopamine-D2 receptor binding was lower in patients with parkinsonian plus syndrome compared to patients with Parkinson's disease on the initial (p < 0.001) as well as the follow-up study (p < 0.001). In patients with Parkinson's disease, we observed an unaffected receptor binding compared to a reduced binding of radiotracer in patients with parkinsonian plus syndrome during the course of the disease (p < 0.001). CONCLUSION: During the follow-up, patients with Parkinson's disease showed a constant dopamine-D2 receptor binding. In contrast, patients with parkinsonian plus syndrome revealed a decline of the binding of dopamine-D2 receptor. These findings are in agreement with histopathological data that demonstrated a preserved dopamine-D2 receptor status in patients with Parkinson's disease and a decline of the dopamine-D2 receptors in patients with parkinsonian plus syndrome. SPECT examinations using 123I-IBZM are useful for assessing dynamic changes of dopamine-D2 receptors in extrapyramidal movement disorders. Semiquantitative SPECT evaluations may provide valuable information for clinical management and prognosis of the patient with extrapyramidal movement disorders.

D-galactose-based signal-enhanced color Doppler sonography of breast tumors and tumorlike lesions.

RATIONALE AND OBJECTIVES: This study sought to evaluate prospectively the diagnostic potential of unenhanced and enhanced color Doppler and power Doppler for the differentiation of tumors and tumorlike lesions of the breast. METHODS: Ninety-two patients with 110 tumors or tumorlike lesions of the breast were investigated by unenhanced and enhanced color and power Doppler ultrasound. The sonomorphologic aspects of vascularization were analyzed. In addition, maximal systolic frequency shift, resistance, and pulsatility indices were determined. RESULTS: In 15 (24%) of 63 primary carcinomas, 15 (68%) of 22 fibroadenomas, and all (100%) of 14 postoperative lesions, the sonomorphologic analysis for the differential diagnosis of breast tumors was improved after contrast enhancement in color Doppler mode. In comparing unenhanced color Doppler to power Doppler, the latter was found to be slightly superior (sensitivity, 60% vs. 67%; specificity, 39% vs. 45%, respectively); after enhancement, both modes were equivalent (sensitivity, 100% vs. 100%; specificity, 95% vs. 95%, respectively). Signal enhancement resulted in a significant improvement in sensitivity and specificity (P < 0.01). Typical signs of malignancy were irregular vessel calibers, serpiginous courses, penetration of the tumor's margin, and irregular reticular vascularization. The quantitative parameters proved not to be helpful for the differential diagnosis of breast tumors. CONCLUSIONS: By improved analysis of the vascularization pattern, d-galactose-enhanced color Doppler sonography was found to provide more reliable differential diagnostic information than unenhanced Doppler ultrasound in tumors and tumorlike lesions of the breast.

Modified surface-active monomers for adhesive bonding to dentin.

PMGDM, a PMDM-type adhesive monomer, was synthesized from pyromellitic dianhydride and glycerol dimethacrylate. Only the para isomer of PMDM, a solid, is used in dental adhesives. The adhesive monomer PMGDM is a liquid and consists of a mixture of para- and meta isomers. This study shows that PMGDM has several advantages over PMDM. For example, the adhesive can be applied at a greater thickness, and additives and/or additional initiators for improved curing can be incorporated. Use of the liquid monomer PMGDM also provided a convenient means of varying the thickness of the adhesive layer between dentin and composite. The adhesive bonds were tested in both shear and tensile modes. PMDM was used as the control. The reliability of the bonds, as judged from the Weibull modulus and Weibull characteristic strength, was improved by (1) use of more concentrated solutions of PMGDM adhesive, (2) use of an adhesive thickness of about 25 microns, and (3) modification of PMGDM with a diluent monomer which is expected to enhance the degree of cure and/or the dentin-wetting properties of the adhesive resin.

[Blood flow quantification in hemodialysis shunts by phase contrast magnetic resonance angiography (PC-MRA) compared with duplex sonography]. / Flussquantifizierung in Hämodialyseshunts mittels Phasenkontrast-Magnetresonanzangiographie (PC-MRA) im Vergleich zur Duplex-sonographie.

PURPOSE: Aim of this study was to evaluate whether phase contrast MR angiography (PC-MRA) could provide additional functional information besides morphology in the assessment of haemodialysis fistulae. MATERIAL AND METHOD: Twenty-two patients (11 male, 11 female), aged 22-77 years, were examined. MR images were obtained with a 1.5 T Gyroscan ACS-NT (Philips, Best, Netherlands) using a high-resolution wrap-around coil. In addition to MRA blood-flow measurements were performed with a gradient-echo sequence (TR 14 ms, TE 5-5.5 ms, flip-angle 15 degrees, 6 mm slice thickness, retrospective gating, matrix 96:128) in the venous and arterial section of the fistulae. Doppler flow measurements were performed at the same position with a Sonoline Elegra (Siemens AG, Erlangen) using a 7.5 MHz transducer. RESULTS: Both methods of flow-volume measurements showed a good correlation (r = 0.94 in the arterial section, r = 0.90 in the venous section, p < 0.001). The average calculated blood flow was measured 11% (arterial section) and 12.8% (venous section) higher with Pulsed Waved Doppler as compared to PC-MRA. CONCLUSION: PC-MRA with a high-resolution wrap-around coil is a reliable method for measuring functional parameters like flow-volume and flow velocity in haemodialysis fistulae and a useful complement to the visualisation capabilities of MRA.

[Percutaneous vertebroplasty]. / Perkutane Vertebroplastie.

PURPOSE: To describe the procedure of percutaneous vertebroplasty and to present our first clinical results of patients treated for benign or malignant painful vertebral body disease. MATERIAL AND METHODS: We performed percutaneous vertebroplasty in 31 painful lesions of the spine. Liquid bone cement was injected into the affected vertebral body using fluoroscopic guidance through a bilateral transpedicular approach. Etiology of the bone disease was assessed by biopsy. Pain intensity was assessed before and 1 week after the procedure by standardized catalogue. RESULTS: Percutaneous vertebroplasty was performed in 17 thoracic and in 14 lumbar spine bodies of benign (n = 23) or malignant (n = 8) disease; no clinically relevant complications occurred. All patients reported significant pain relief 1 week after the intervention. One week after treatment, patients were pain-free in 15/31 vertebral bodies, and reported mild residual pain not necessitating narcotic medication in 16/31 cases. CONCLUSION: In accordance with the literature, percutaneous vertebroplasty proved to be a highly effective, minimal invasive interventional procedure to treat severely painful bone lesions of benign and malignant origin.

[Osteoplastic bone metastases in prostatic carcinoma: magnetic resonance tomography and bone marrow scintigraphy]. / Osteoplastische Knochenmetastasen beim Prostatakarzinom: Magnetresonanztomographie und Knochenmarkszintigraphie.

MRI of the vertebral column was performed in 28 patients with histologically confirmed prostate carcinoma. Besides routine spin-echo sequences all patients were examined with gradient-echo sequences using the chemical shift mode. In addition, in all patients bone marrow scintigraphy (BMS) was performed, and all results were compared with routine bone scan (BS). In our study BMS was not superior to bone scan. In contrast, MRI scan revealed solitary metastases in two patients with negative BS and BMS. Osteoplastic metastases showed a contrast enhancement in the MRI and could be distinguished from benign alterations.

[Preoperative staging of bladder carcinomas with Gd-DTPA-supported dynamic magnetic resonance tomography. Comparison with plain and Gd-DTPA-supported spin-echo sequences]. / Präoperatives Staging von Blasenkarzinomen mit der Gd-DTPA-unterstützten dynamischen Magnetresonanztomographie. Vergleich mit nativen und Gd-DTPA-unterstützten Spin-Echo-Sequenzen.

PURPOSE: Evaluation of dynamic Gd-DTPA enhanced MR imaging in the staging of bladder cancer. METHODS: We studied 40 patients with histologically proven bladder cancer. All patients were examined with routine T1- and T2-weighted MRI and late Gd-DTPA enhanced T1-weighted MRI. Additionally, a dynamic study was performed with 10 subsequent short FLASH-2-D gradient echo sequences without delay immediately after bolus injection of Gd-DTPA. Signal intensities of the tumour and of the surrounding tissue as well as image contrast parameters were quantified. RESULTS: The dynamic study showed a higher accuracy in the evaluation of stage pTa to pT2 cancer compared to spin echo MRI (63% and 46%, respectively) and no difference regarding the sensitivity (87.5%). However, overstaging was a problem with both modalities. The contrast-to-noise ratio of bladder tumour and muscle was equal or significant higher with the dynamic study compared to spin echo MRI. A higher signal-to-contrast ratio of bladder tumour and bladder muscle was calculated for the dynamic study compared with the spin-echo MRI (p < 0.01; Mann-Whitney U test). CONCLUSION: Dynamic Gd-DTPA enhanced MRI is recommended to be used additionally in the preoperative staging of bladder neoplasms.

[Color-coded signal-enhanced duplex ultrasonography of space-occupying intramammary processes]. / Farbkodierte signalverstärkte Duplexsonographie raumfordernder intramammärer Prozesse.

PURPOSE: Prospective comparison of plain and signal-enhanced frequency and amplitude-modulated colour Doppler ultrasound of intramammary tumours to evaluate new criteria for diagnostic analysis. METHODS: Frequency and amplitude-modulated colour Doppler examination with qualitative and quantitative analysis of 80 potentially malignant intramammary lesions were performed before and after application of d-galactose. RESULTS: Signal-enhanced sonography revealed a typical vessel morphology of primary and recurrent breast cancer facilitating differential diagnosis. In 18 (frequency modulated US) or 16 (amplitude modulated US) of 51 carcinomas, the typical malignant vascularisation structure was sufficiently visible only after application of the signal enhancing agent. In 50% of the fibroadenomas, Doppler analysis of the vessels was possible only after application of d-galactose. CONCLUSION: The application of d-galactose provides additional criteria for the differential diagnosis of breast lesions due to improved visualisation of the vascularisation structure.

[[111In]-DTPA-D-phenylalanine octreotide SPECT for the scintigraphic imaging of enhanced somatostatin-receptor density in endocrine ophthalmopathy]. / [111In]-DTPA-D-Phenylalanin-Octreotide-SPECT zur szintigraphischen Darstellung einer erhöhten Somatostatin-Rezeptordichte bei der endokrinen Ophthalmopathie.

Recently, [111In]-DTPA-D-phenylalanine-octreotide was introduced for clinical use. This radioligand binds specifically to somatostatin receptors and is suitable for SPECT examinations. The aim of this study was to clarify whether an increased somatostatin receptor density can be imaged and quantified in patients with endocrine ophthalmopathy (e.o.). 7 patients between 34 and 55 years with e.o. at stages III to VI and 4 controls between 38 and 63 years were examined. All patients and controls received approximately 200 MBq [111In]-DTPA-D-phenylalanine-octreotide by IV injection. A SPECT examination was performed 4 hours after injection and a normalised tracer uptake (A(n)) was calculated for both orbitae. In patients with e.o. the values of A(n) were significantly higher compared with controls (P = 0.002). There was a correlation between A(n) and exophthalmus stages according to Hertel with r = 0.844 (P = 0.001). These results indicate that [111In]-DTPA-D-phenylalanine-octreotide SPECT might be useful for the in vivo assessment of an increased somatostatin receptor density in e.o. These findings could have an impact on the treatment with somatostatin analogous in e.o.

[Vascularization patterns in focal liver lesions: comparison of plain and signal-enhanced amplitude-modulated color duplex ultrasonography]. / Vaskularisationsmuster in fokalen Leberläsionen: Vergleich der nativen und signalverstärkten amplitudenmodulierten Farbduplexsonographie.

PURPOSE: Morphology of focal liver lesions was studied by power Doppler. Plain images and images after i.v. application of galactose-based microbubbles (Levovist, Schering AG) were compared. METHODS: 21 patients with focal liver lesions were studied by power Doppler before and after application of the signal enhancer. RESULTS: In lesions that showed short pulsations in plain studies, vascular structures were visible after application of the signal enhancer. In hepatocellular carcinomas, multiple arteries with small diameter became visible. Peripheral veins were detected in metastases. A large feeding artery was detected in 1/2 haemangiomas with flow and in a focal nodular hyperplasia. CONCLUSION: In comparison to plain amplitude-modulated colour-coded duplex ultrasound, vascular patterns of focal liver lesions were more clearly visible after injection of a signal-enhancer.

[Use of high resolution color Doppler sonography in diagnosis of temporal arteritis]. / Einsatz der hochauflösenden Farb-Doppler-Sonographie in der Diagnostik einer Arteriitis temporalis.

PURPOSE: To define sonographic signs of arteritis temporalis using color coded duplex sonography. METHODS: 20 patients with clinically suspected temporal arteritis were examined with color coded Doppler ultrasound prior to temporalis biopsy. The investigation included the temporal artery on both sides and documentation was performed with color prints of the longitudinal orientation of both temporal arteries. All patients had an unilateral biopsy of the temporal artery. RESULTS: 6/20 patients had histologically confirmed temporal arteritis. All patients showed a paravasal zone of lower echogenicity (halo-sign) along the temporal artery. 12/14 patients without temporal arteritis showed no halo-sign. However, a halo-sign was found in 2/14 patients without temporal arteritis which could not be distinguished from the halo-sign observed in patients with temporal arteritis. CONCLUSIONS: A halo-sign could be detected in the majority of patients with arteritis temporalis in concordance with the recent published findings of Schmidt et al. However, a definite specificity of this halo-sign must be rejected.

[Contrast agent enhanced duplex ultrasonography: visualization of the hepatic artery after orthotopic liver transplantation]. / Kontrastmittelgestützte Duplexsonographie: Darstellung der Arteria hepatica nach orthotoper Lebertransplantation.

PURPOSE: A prospective study was carried out to determine whether an improved assessment of the anatomy and flow velocity in the hepatic artery could be achieved by the administration of a capillary transversing contrast agent (Levovist) in patients after orthotopic liver transplantation. METHODS: In 21 (62%) of 34 patients after liver transplantation, only an insufficient visualisation of the hepatic artery was achieved. Therefore, a capillary transversing contrast agent was administered intravenously. Pre- and post-contrast peak velocity and Doppler frequency shift in the proper hepatic artery were measured and image quality of colour and spectral Doppler was assessed by a qualitative scale. RESULTS: Image quality, with complete visualisation of hepatic artery in 79% (precontrast 38%) of all cases, was significantly improved (p < 0.01 (Wilcoxon test)) by the administration of a contrast agent. CONCLUSIONS: Visualisation of the hepatic artery after orthotopic liver transplantation can be improved by the administration of Levovist. It allows a reliable measurement of peak velocity and Doppler frequency shift and helps to avoid further imaging.

[Magnetic resonance tomography in patients with Parkinson's disease and Parkinson-plus syndromes]. / Magnetresonanztomographie bei Patienten mit Morbus Parkinson und Parkinson-Plus-Syndromen.

PURPOSE: To define characteristic MR-findings in patients with clinically typical extrapyramidal movement disorders. METHODS: 15 patients with Parkinson's disease (PD), 9 with multisystem atrophy (MSA), and 6 with progressive supranuclear palsy (PSP) underwent MRI using a 1.5 T. Magnetom unit. Two investigators analysed the images with special regard to global and/or focal atrophy and to changes in signal intensity of the CNS in the consensus mode. Normal images of 10 subjects served as controls to patient's images. RESULTS: In all patients with PSP and MSA characteristic pathological findings on MRI were observed including regional changes within the extrapyramidal nuclei. In contrast all patients with PD had an unremarkable MRI study of the CNS. CONCLUSION: MRI enables us to define characteristic morphological changes of the brain in patients with extrapyramidal movement disorders. Early recognition of these findings avoids misdiagnoses in patients who are difficult to diagnose.

[The diagnosis and imaging of the a. hepatica after orthoptic liver transplantation--a comparison of frequency-modulated and amplitude-modulated color Doppler sonography]. / Diagnostik und Darstellung der A. hepatica nach orthotoper Lebertransplantation--Vergleich von frequenzmodulierter und amplitudenmodulierter Farb-Doppler-Sonographie.

PURPOSE: We examined whether amplitude-modulated color Doppler (power Doppler) sonography provides a better anatomic imaging of the vascular course of the hepatic artery after liver transplantation. PATIENTS AND METHODS: 82 patients were examined with Doppler sonography after liver transplantation. The distal section of the hepatic artery was imaged both with frequency-modulated color Doppler (color Doppler) and power Doppler and a Doppler spectrum derived from each mode for determination of the flow velocity. RESULTS: Native imaging of the hepatic artery was possible in 78/82 patients, in 2/82 patients only after administration of Levovist, and in 2/82 patients it could not be seen. In these two patients the diagnosis of hepatic artery occlusion was confirmed by angiography. The anatomic course was demonstrated more longitudinally by power Doppler than by color Doppler (p < 0.001; chi 2 test) which made the angle correction easier. A disadvantage of power Doppler was the lack of image contrast to the portal veins; thus evaluation of the vascular course in this section was better possible with color Doppler by means of a specifically generated aliasing in the flow of the hepatic artery (p < 0.001; chi 2 test). Determination of the flow velocity showed no significant differences between color and power Doppler supported duplex sonography. CONCLUSIONS: The combined use of color Doppler and power Doppler improves visualization of the hepatic artery after liver transplantation. The lack of visualization of the vessel after administration of Levovist is diagnostic for occlusion of the vessel.

[123I-iomazenil- and 99mTc-HMPAO in the diagnosis of focal epilepsies: a comparison of untreated and treated patients]. / 123J-Iomazenil- und 99mTc-HMPAO in der Diagnostik fokaler Epilepsien: Vergleich von unbehandelten und behandelten Patienten.

The purpose of this study was to compare HMPAO- and IMZ-SPECT findings in treated and untreated patients with focal epilepsies. We examined 20 patients (untreated 13; treated 7). All patients had a normal CT and/or MRI scan. In all patients both whole-brain activity and regional count density (rcd) were evaluated by SPECT. Furthermore, the specific and non-specific binding of IMZ were calculated for each ROI and the results of both, treated and untreated patients were compared. Our data indicate that the normalized cerebral total binding of IMZ was significantly increased in all regions in the group of treated patients (p < 0.001). In contrast, no difference in the tracer binding was found with HMPAO-SPECT. We conclude that the difference in the IMZ-binding might be due either to exogenous or endogenous factors. In our study IMZ-SPECT had a higher sensitivity and a lower specificity in the detection of decreased rcd in areas with EEG findings that indicate an epileptogenic focus compared with HMPAO-SPECT.

Quantitative estimation of I-123-Iomazenil receptor binding in temporal lobe epilepsies using two SPECT acquisitions--comparison with the regional cerebral blood flow and a compartment model.

AIM: To compare published fractional rate constants of I-123-Iomazenil (IMZ) and C-11-Flumazenil (three-compartment/four-parameter model) with a I-123-Iomazenil receptor index calculated from two SPECT acquisitions and to compare the receptor index of the epileptogenic area with the contralateral side in patients with unilateral temporal lobe epilepsies. METHODS: 28 patients were studied. 13/28 patients had a drug-resistant unilateral temporal lobe epilepsy with a successful focus localisation performed by an extensive video/EEG monitoring. 15 other patients with clinically suspected focal epilepsy and a normal MRI and IMZ SPECT scanning were used as controls. SPECT scanning was performed in all patients 15 and 100 min after intravenous injection of 111 MBq IMZ and 10 min after application of 740 MBq Tc-99m-HMPAO. Quantification of the regional uptake was performed using ROI-technique and the specific and non-specific binding of IMZ was calculated. The receptor index was calculated by the difference of the specific binding from 15 to 100 min p.i. divided by the time interval. RESULTS: The receptor index showed a linear correlation with recently published fractional rate constants k3 (r = 0.69 and 0.67; p = 0.15) and a moderate correlation with the k4 constant (-0.53 and -0.43; p = 0.28) by the means of C-11-Flumazenil PET and I-123-Iomazenil SPECT studies, respectively. However, statistical significance was not reached due to the few data points available from the published reports. Furthermore, the IMZ receptor index was lower in the epileptogenic area of patients with unilateral temporal lobe epilepsies compared with their contralateral side (p = 0.02; Wilcoxon-test). The IMZ receptor index showed a weak correlation with the regional cerebral blood flow independent of the evaluated region (r < 0.4; p < 0.05). CONCLUSION: The IMZ receptor index indicated to be a simple routine approach to estimate the fractional rate constant k3 (r = 0.67). The lower value of the receptor index within the epileptogenic area might be due to a lower receptor density. However in further studies, IMZ might be a helpful tool to find out subtle changes of the receptor affinity due to its approximately 30-fold higher ligand-receptor affinity compared to C-11-Flumazenil.

[Preoperative evaluation of drug resistant focal epilepsies with 123I-iomazenil SPECT. Comparison with vidio/EEG monitoring and postoperative results]. / Präoperative Bewertung pharmakoresistenter fokaler Epilepsien mit der 123J-Iomazenil-SPECT. Vergleich mit dem Video/EEG-Monitoring und postoperativen Ergebnissen.

SPECT with the benzodiazepine receptor antagonist 123I-Iomazenil was performed in 33 patients with intractable partial seizures for pre-operative evaluation. The results combined with MRI and 99mTc-HMPAO-SPECT findings were compared with the video-assisted EEG monitoring ("gold standard") which localised the focus in 25 patients. 11 patients underwent surgical resection of the epileptogenic area and became seizure-free for a period up to 13 months. The Iomazenil SPECT had a significantly higher sensitivity compared to 99mTc-HMPAO in the visualization of an epileptogenic area and should be regularly used in the diagnostic of medically intractable partial seizures.