Combined DaT imaging and olfactory testing for differentiating parkinsonian disorders.

OBJECTIVE: Dopamine transporter (DaT) imaging with single photon emission computed tomography (SPECT) detects loss of striatal dopaminergic innervation with very high sensitivity. It cannot readily distinguish idiopathic Parkinson's disease (iPD) and dementia with Lewy bodies (DLB) from atypical disorders (aPD). However, most iPD/DLB patients are hyposmic, whereas the majority of aPD patients were reported to have intact olfaction. For this reason, we conducted a longitudinal follow-up study to investigate the power of combined DaT imaging and olfactory testing to predict the final diagnosis of the patients. MATERIALS AND METHODS: A total of 129 patients received [123I]FP-CIT SPECT and olfactory testing at baseline assessment. Clinical follow-up 30 ± 12 months later was the diagnostic standard of truth. A normative dataset of 24 healthy controls was used for comparison. RESULTS: Baseline DaT imaging predicted a dopamine-deficient diagnosis with 98% sensitivity and 98% specificity. The combined DaT/olfactory testing correctly classified 91% of patients as iPD/DLB (PPV 91%). The PPV rose to 97% or greater in anosmic patients. In contrast, only 45% of aPD patients were categorised correctly by combined DaT/olfactory testing - mainly because of the presence of normosmic iPD patients. CONCLUSIONS: In patients with an abnormal DaT SPECT, hyposmia yields an a posteriori likelihood of iPD/DLB of > 90%. In contrast, a finding of normosmia only increases the a posteriori likelihood of aPD to approximately the 50%.

Contrast-Enhanced Stereotactic Biopsy (CESB): Patient selection and practical considerations.

Since its introduction in 2012, contrast-enhanced mammography (CEM) has shown increased clinical relevance as a diagnostic tool in breast imaging. Its diagnostic accuracy is on par with breast MRI, rendering it a viable and potentially cost-effective alternative for breast MRI indications, especially in areas with lower accessibility to MRI. Like MRI, CEM occasionally shows 'CEM-only' lesions, i.e., areas of contrast enhancement without corresponding findings on low-energy images, ultrasound, or digital tomosynthesis. The current workaround usually consists of performing MRI-guided biopsy. However, contrast-enhanced stereotactic biopsy (CESB) offers a new alternative and has become commercially available since 2020. This narrative review will outline patient selection, the procedure, important considerations when performing CESB, and an overview of current literature.

Ketanserin accelerates wound epithelialization and neovascularization.

We investigated the acute effects of topical ketanserin, a 5-HT(2) (serotonin) receptor blocker, on wound epithelialization and vascularization with the use of the hairless mouse ear model. Varying concentrations of Ketanserin (0%, 0.2%, 2.0%, 20% weight/volume) were administered to standardized full-thickness skin wounds on the dorsum of the hairless mouse ear immediately after surgery and daily thereafter. With the use of video microscopy and computer-assisted planimetry, vascularization and epithelialization were traced every third day until the wounds were fully healed. Arteriole diameters at selected sites near the skin wound were measured before wound creation and after wounding. It was concluded that topically administered ketanserin significantly accelerates both the vascular (p < 0.001 at 2% and 20% concentrations) and epithelial (p < 0.001 at 20% concentration) rates of wound healing in full-thickness nonpathologic skin wounds. Vasodilation of terminal arterioles was not a major response to Ketanserin. Faster epithelialization was possibly due to direct effect of ketanserin on epithelial cells.

Direct visualization and measurements of wound neovascularization: application in microsurgery research.

Neovascularization or angiogenesis is an essential yet poorly understood component of the healing process. In wound healing research, there is a lack of models enabling quantitative and continuous measurements of wound neovascularization. The hairless mouse ear wound model permits quantitative measurements of wound epithelialization and neovascularization continuously throughout the healing process. On the ears of male homozygous (hr/hr) hairless mice, standardized circular full thickness dermal wounds are produced; then, using vital microscopy, these two processes are directly viewed and measured at day 0 and every third day thereafter until these are complete. This model system and its application to clinically relevant situations are reviewed.