Optimization of injected 68Ga-PSMA activity based on list-mode phantom data and clinical validation.

Optimization of injected gallium-68 (68Ga) activity for 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA PET/CT) studies is relevant for image quality, radiation protection, and from an economic point of view. However, no clear guidelines are available for 68Ga-PSMA studies. Therefore, a phantom study is performed to determine the highest coefficient of variation (COV) acceptable for reliable image interpretation and quantification.To evaluate image interpretation, the relationship of COV and contrast-to-noise ratio (CNR) was studied. The CNR should remain larger than five, according to the Rose criterion. To evaluate image quantification, the effect of COV on the percentage difference (PD) between quantification results of two studies was analyzed. Comparison was done by calculating the PD of the SUVmax. The maximum allowable PDSUVmax was set at 20%. The highest COV at which both criteria are still met is defined as COVmax. Of the NEMA Image Quality phantom, a 20 min/bed (2 bed positions) scan was acquired in list-mode PET (Philips Gemini TF PET/CT). The spheres to background activity ratio was approximately 9:1. To obtain images with different COV, lower activity was mimicked by reconstructions with acquisition times of 10 min/bed to 5 s/bed. Pairs of images were obtained by reconstruction of two non-overlapping parts of list-mode data.For the 10-mm diameter sphere, a COV of 25% still meets the criteria of CNRSUVmean ≥ 5 and PDSUVmax ≤ 20%. This phantom scan was acquired with an acquisition time of 116 s and a background activity concentration of 0.71 MBq/kg. Translation to a clinical protocol results in a clinical activity regimen of 3.5 MBq/kg min at injection. To verify this activity regimen, 15 patients (6 MBq/kg min) with a total of 22 lesions are included. Additional reconstructions were made to mimic the proposed activity regimen. Based on the CNRSUVmax, no lesions were missed with this proposed activity regimen.For our institution, a clinical activity regimen of 3.5 MBq/kg min at injection is acceptable, which indicates that activity can be reduced by almost 50% compared with the current code of practice. Our proposed method could be used to obtain an objective activity regimen for other PET/CT systems and tracers.

Dimorphism throughout the European eel's life cycle: are ontogenetic changes in head shape related to dietary differences?

A well-known link exists between an organism's ecology and morphology. In the European eel, a dimorphic head has been linked to differences in feeding ecology, with broad-headed eels consuming harder prey items than narrow-headed ones. Consequently, we hypothesized that broad-heads should exhibit a cranial musculoskeletal system that increases bite force and facilitates the consumption of harder prey. Using 3D-reconstructions and a bite model, we tested this hypothesis in two life stages: the sub-adult yellow eel stage and its predecessor, the elver eel stage. This allowed us to test whether broad- and narrow-headed phenotypes show similar trait differences in both life stages and whether the dimorphism becomes more pronounced during ontogeny. We show that broad-headed eels in both stages have larger jaw muscles and a taller coronoid, which are associated with higher bite forces. This increased bite force together with the elongated upper and lower jaws in broad-headed eels can also improve grip during spinning behavior, which is used to manipulate hard prey. Head shape variation in European eel is therefore associated with musculoskeletal variation that can be linked to feeding ecology. However, although differences in muscle volume become more pronounced during ontogeny, this was not the case for skeletal features.

Health-related quality of life and functional status in end-stage COPD: a longitudinal study.

Since there is still a dearth of information about the end stage of chronic obstructive pulmonary disease (COPD), the main aim of this study was to examine the development of health-related quality of life (HRQoL) and functional status over time in COPD patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage IV. 82 Dutch COPD patients completed the St George's Respiratory Questionnaire (SGRQ) for HRQoL and the Groningen Activities for Daily Living Restriction Scale (GARS) for functional status every 3 months during the year following enrolment. Survival was followed up to 5 yrs after enrolment. Data were analysed by stratifying the study population into severity subgroups according to the lowest, intermediate and highest tertile of SGRQ and GARS at baseline. Outcome measures were change in SGRQ and GARS scores over time and survival time. In the majority of patients, scores on the SGRQ and GARS declined gradually over time. In the subgroup of 32 patients that died within 2 yrs of enrolment, these scores also declined gradually, without steep deteriorations. In patients with end-stage COPD, HRQoL and functional status deteriorated gradually over time, indicating that clinicians did not gain much additional support for differentiating the end stage of COPD by considering HRQoL and functional status using the SGRQ and GARS.

What is the value of emission tomography studies in patients with a primary glioblastoma multiforme treated by 192Ir brachytherapy?

BACKGROUND: We studied the use of (201)Thallium SPECT and L-[1-(11)C]-tyrosine PET in patients with a primary glioblastoma multiforme treated with (192)Ir brachytherapy after surgery and external beam radiation therapy. We hypothesised that the patients most likely to benefit from further surgery after deterioration would be those with radiation necrosis and would be recognised by a negative emission tomography scan. METHODS: Twenty-one patients underwent (201)Thallium SPECT performed before brachytherapy, and this was repeated in 19 patients when recurrence was suspected. Nine patients also underwent a PET scan at the same time. Nine patients underwent a second operation. FINDINGS: SPECT and PET were highly concordant concerning the prediction of radionecrosis and/or tumour recurrence. Repeat surgery did not lead to a significant increase in survival. There was no significant association between the duration of survival and tumour-to-background ratio but the number studied was small. Both SPECT and PET showed highly active lesions, which were proved to be recurrent tumour by clinical and histological follow-up. CONCLUSION: Although PET and SPECT are both highly sensitive in detecting active tumour tissue, emission tomography was not clinically valuable in the investigation of patients with a primary glioblastoma treated with brachytherapy.

Effects of psychotherapy on regional cerebral blood flow during trauma imagery in patients with post-traumatic stress disorder: a randomized clinical trial.

BACKGROUND: Functional brain-imaging studies in post-traumatic stress disorder (PTSD) have suggested functional alterations in temporal and prefrontal cortical regions. Effects of psychotherapy on these brain regions have not yet been examined. METHOD: Twenty civilian PTSD out-patients and 15 traumatized control subjects were assessed at baseline using psychometric ratings. Cerebral blood flow was measured using trauma script-driven imagery during 99mtechnetium hexamethyl-propylene-amine-oxime single-photon emission computed tomography scanning. All 20 out-patients were randomly assigned to treatment or wait-list conditions. Treatment was brief eclectic psychotherapy (BEP) in 16 weekly individual sessions. RESULTS: At baseline, greater activation was found in the right insula and right superior/middle frontal gyrus in the PTSD group than in the control group. PTSD patients treated with BEP significantly improved on all PTSD symptom clusters compared to those on the waiting list. After effective psychotherapy, lower activation was measured in the right middle frontal gyrus, compared to the PTSD patients on the waiting list. Treatment effects on PTSD symptoms correlated positively with activation in the left superior temporal gyrus, and superior/middle frontal gyrus. CONCLUSIONS: BEP induced clinical recovery in PTSD patients, and appeared to modulate the functioning of specific PTSD-related sites in the prefrontal cortical regions.

Evaluation of high-resolution pinhole SPECT using a small rotating animal.

UNLABELLED: Ex vivo measurements in animals are used frequently in the field of nuclear medicine for the characterization of newly developed radioligands and for drug development. In vivo SPECT would replace these ex vivo measurements in a relatively large number of cases if one were able to adequately image small organs. The pinhole collimator has been used extensively to obtain greater detail in planar imaging. However, using a pinhole collimator for SPECT is difficult because it requires a heavy collimated detector to rotate around a small object with a constant radius of rotation. METHODS: We have developed a mechanism in which the gantry and collimator are fixed and the animal rotates. Hollow cylinders of different sizes were made to enable imaging of small animals of different sizes: mice, hamsters, and rats. The cylinder is mounted on a stepping motor-driven system and positioned exactly above the pinhole collimator of an ARC3000 camera with a 1-mm pinhole insert. The stepping motor is controlled by the Hermes acquisition/processing system. After imaging each projection, a signal is given to rotate the stepping motor with the desired number of angular degrees. Filtered backprojection, adapted to pinhole SPECT, was used for reconstruction. The system allows adjustments of the radius of rotation and along the axis of the cylinder to select the field of view. Calibration experiments were performed to ensure that the axis of rotation was exactly in the middle of the cylinder. Phantom experiments were performed to assess sensitivity, spatial resolution, and uniformity of the system and to test the system for distortion artifacts. In addition, a brain dopamine transporter rat study and a hamster myocardial study were performed to test the clinical feasibility of the entire system. RESULTS: In the line source experiment, the spatial resolution obtained in air was 1.3 mm full width at half maximum, with a radius of rotation of 33 mm. Furthermore, the system has good uniformity and is capable of detecting cold spots of 2-mm diameter. The animal studies showed that it was feasible to image receptors or transporters and organs with sufficient detail in a practical setup. CONCLUSION: A rotating cylinder mechanism for pinhole SPECT is feasible and shows the same characteristics as conventional pinhole SPECT with a rotating camera head, without distortion artifacts. This mechanism permits pinhole SPECT to replace many ex vivo animal experiments.

Effects of ecstasy (MDMA) on the brain in abstinent users: initial observations with diffusion and perfusion MR imaging.

PURPOSE: To evaluate the effects of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) on the human brain by using diffusion and perfusion magnetic resonance (MR) imaging. MATERIALS AND METHODS: Eight abstinent ecstasy users and six ecstasy nonusers underwent diffusion and perfusion MR imaging. Apparent diffusion coefficient and relative cerebral volume maps were reconstructed. Differences in apparent diffusion coefficient values and relative cerebral volume ratios between the groups were analyzed with the Mann-Whitney-Wilcoxon test. The relationship between apparent diffusion coefficient and relative cerebral volume and the extent of previous ecstasy use was investigated with Spearman rank correlation. RESULTS: Apparent diffusion coefficient values (0.84 vs 0.65 x 10(-5) cm(2)/sec, P <.025) and relative cerebral volume ratios (1.22 vs 1.01, P <.025) were significantly higher in the globus pallidus of ecstasy users compared with nonusers, respectively. Increases in pallidal relative cerebral volume were positively correlated with the extent of previous use of ecstasy (rho = 0.73, P <.04). CONCLUSION: Ecstasy use is associated with tissue changes in the globus pallidus. These findings are in agreement with findings in case reports, suggesting that the globus pallidus is particularly sensitive to the effects of ecstasy.

Quantitative analysis of 99Tcm-sestamibi myocardial perfusion SPECT using a three-dimensional reference heart: a comparison with experienced observers.

BACKGROUND: Quantification of myocardial perfusion single photon emission computed tomography (SPECT) may improve scintigraphic analysis. Recently, a fully operator independent technique for the quantification of myocardial perfusion SPECT was described, based on a normal three-dimensional averaged reference heart. The purpose of this study was to compare the automated SPECT quantification technique with experienced observers. METHODS: A total of 43 patients, 36 with one-vessel coronary artery disease (CAD) and seven with a low likelihood of CAD, underwent 99Tcm-sestamibi SPECT (99Tcm-MIBI SPECT). Three experienced observers and a panel (composed of the three observers), blinded to the clinical and angiographic data, analysed the size and severity of perfusion defects and the relation to the distribution areas of the coronary arteries. Inter-observer agreement was calculated by using kappa (kappa) statistics. RESULTS: The inter-observer agreement between the human observers and the automated quantitative analysis, for severity and size of perfusion abnormality, was moderate (kappa range 0.38-0.68), while this was fair between three individual observers (kappa range 0.36-0.87) and good between the individual observers and the panel (kappa range 0.63-0.89). There were no differences between the quantitative analysis and the panel in the allocation of perfusion abnormalities to the affected coronary artery. CONCLUSIONS: The operator independent quantification method showed a moderate agreement with individual observers and a panel analysis for size and severity of perfusion abnormalities. The automatic quantification has a similar ability to assign perfusion abnormalities to the diseased coronary artery as compared to an expert panel.

Dopamine transporter density in young patients with schizophrenia assessed with [123]FP-CIT SPECT.

Disturbances in the dopamine (DA) system are thought to play a major role in schizophrenia. Amphetamine-induced release of endogenous DA is shown to be enhanced in schizophrenia, as is striatal [18F]FDOPA uptake in the striatum. It is not clear if the density of DA neurons is altered in schizophrenia. By studying the DA transporter with [123I]FP-CIT single photon emission computed tomography (SPECT), the density of nigrostriatal dopaminergic cells can be studied. Using [123I]FP-CIT SPECT, DA transporter density in the striatum was studied in 36 young patients with schizophrenia. Ten patients were antipsychotic (AP)-naive, 15 were treated with olanzapine, eight with risperidone and three were AP-free. A control group of 10 age-matched volunteers was included. Striatal [123I]FP-CIT binding was not significantly different between AP-naive patients (2.87), patients treated with olanzapine (2.76), patients treated with risperidone (2.76), AP-free patients (2.68) and controls (2.82) (F=0.07,p=0.98). Unexpectedly, striatal [123I]FP-CIT binding in females was significantly higher than in males (3.29 and 2.70, respectively; t=-2.56, p=0.014).Concluding, functional changes in the dopaminergic system in schizophrenia are not likely to be reflected in a change in DA transporter density. Moreover, DA transporter density does not seem to be altered by AP medication.

Effect of age and gender on dopamine transporter imaging with [123I]FP-CIT SPET in healthy volunteers.

Dopamine transporter imaging is a valuable tool to investigate the integrity of the dopaminergic neurons. To date, several reports have shown an age-associated decline in dopamine transporters in healthy volunteers. Although animal studies suggest an effect of gender on dopamine transporter density, this gender effect has not yet been confirmed in human studies. To study the influence of age and gender on dopamine transporter imaging in healthy volunteers, we performed single-photon emission tomography imaging with [123I]FP-CIT to quantify dopamine transporters. Forty-five healthy volunteers (23 males and 22 females) were included, ranging in age from 18 to 83 years. SPET imaging was performed 3 h after injection of +/-110 MBq [123I]FP-CIT. An operator-independent volume of interest analysis was used for quantification of [123I]FP-CIT binding in the striatum. The ratio of specific striatal to non-specific [123I]FP-CIT binding was found to decrease significantly with age. Moreover, we found a high variance in [123I]FP-CIT binding in young adults. Finally, females were found to have significantly higher [123I]FP-CIT binding ratios than males. This effect of gender on [123I]FP-CIT binding ratios was not related to age. The results of this study are consistent with findings from previous studies, which showed that dopamine transporter density declines with age. The intriguing finding of a higher dopamine transporter density in females than in males is in line with findings from animal studies.

MDMA ("Ecstasy") and its association with cerebrovascular accidents: preliminary findings.

BACKGROUND AND PURPOSE: Abuse of the popular recreational drug "Ecstasy" (MDMA) has been linked to the occurrence of cerebrovascular accidents. It is known that MDMA alters brain serotonin (5-HT) concentrations and that brain postsynaptic 5-HT(2) receptors play a role in the regulation of brain microvasculature. Therefore, we used brain imaging to find out whether MDMA use predisposes one to cerebrovascular accidents by altering brain 5-HT neurotransmission. METHODS: The effects of MDMA use on brain cortical 5-HT(2A) receptor densities were studied using [(123)I]R91150 single-photon emission CT in 10 abstinent recent MDMA users, five former MDMA users, and 10 healthy control subjects. Furthermore, to examine whether changes in brain 5-HT(2A) receptor densities are associated with alterations in blood vessel volumes, we calculated relative cerebral blood volume maps from dynamic MR imaging sets in five MDMA users and six healthy control subjects. RESULTS: An analysis of variance revealed that mean cortical [(123)I]R91150 binding ratios were significantly lower in recent MDMA users than in former MDMA users and control subjects. This finding suggests down-regulation of 5-HT(2) receptors caused by MDMA-induced 5-HT release. Furthermore, in MDMA users, low cortical 5-HT(2) receptor densities were significantly associated with low cerebral blood vessel volumes (implicating vasoconstriction) and high cortical 5-HT(2) receptor densities with high cerebral blood vessel volumes (implicating vasodilatation) in specific brain regions. CONCLUSION: These findings suggest a relationship between the serotonergic system and an altered regulation of 5-HT(2) receptors in human MDMA users. MDMA users may therefore be at risk for cerebrovascular accidents resulting from alterations in the 5-HT neurotransmission system.

Quantification and visualization of defects of the functional dopaminergic system using an automatic algorithm.

UNLABELLED: In SPECT, the binding of radiotracers in brain areas is usually assessed by manual positioning of regions of interest (ROIs). The disadvantages of this method are that it is an observer-dependent procedure and that it may not be sensitive for assessing defects significantly smaller than the ROI. To circumvent these limitations, we developed a fully automatic three-dimensional technique that quantifies neuronal radiotracer binding on a voxel-by-voxel basis. METHODS: To build a model of normal 123I-labeled N-omega-fluoropropyl-2beta-carbomethoxy-3beta-(4-iodophenyl) nortropane (FPCIT) binding, 17 studies of healthy volunteers were registered to the same orientation. After registration, the specific-to-nonspecific binding ratio was calculated for each voxel of the striatal volumes of interest (VOIs). The mean and SD of that binding ratio were then calculated on a voxel-by-voxel basis. For the analysis of 10 healthy volunteer studies (control group) and 21 studies of drug-naive patients with Parkinson's disease, the registration and calculation of the specific-to-nonspecific [123I]FPCIT binding ratio were performed by the same method. Subsequently, a voxel of the striata was classified as a diminished [123I]FPCIT binding ratio if its value was lower than the mean -2 x SD. For each subject, the defect size, the relative number of voxels with a diminished binding ratio and the binding ratio of the whole striatal VOIs were calculated and compared with the binding ratio as assessed by the traditional ROI method. RESULTS: The results of the automatic method correlated significantly with the results of the traditional ROI method. Furthermore, for the ipsilateral side, the automatically calculated defect size had less overlap between the patient and the control group than the traditionally calculated binding ratio. CONCLUSION: The method presented quantifies [123I]FPCIT binding ratio automatically on a voxel-by-voxel basis, by comparison with a model of healthy volunteers. We have shown that it is appropriate to use the automatic method as a replacement for the traditional manual method, which enables us to study the localized dopaminergic degeneration process in Parkinson's disease more precisely and without any inter- or intraobserver variability.

Imaging of dopamine transporters with iodine-123-FP-CIT SPECT in healthy controls and patients with Parkinson's disease.

UNLABELLED: Several SPECT studies reported decreased striatal 123I-N-omega-fluoropropyl-2beta-carbomethoxy-3beta-(4-iodoph enyl)nortropane ([123I]FP-CIT) binding in patients with Parkinson's disease. For application in routine clinical studies, information on the reliability and reproducibility of the [123I]FP-CIT SPECT technique is critical. This study reports on the reliability and reproducibility of [I23I]FP-CIT SPECT in healthy control subjects and patients with Parkinson's disease using two different analysis protocols: the conventional region of interest (ROI) protocol and a newly developed, fully automatic, operator-independent volume of interest (VOI) protocol. METHODS: We performed repeated [123I]FP-CIT SPECT scans in 6 healthy control subjects and 10 patients with Parkinson's disease to measure scan-to-scan variations. Scintigraphic data were analyzed 3 hr after injection of the radiotracer. RESULTS: In controls, the mean test/retest for the ratio of the striatal-to-nonspecific [123I]FP-CIT uptake were (3.79 +/- 0.67/3.82 +/- 0.74) and (4.16 +/- 0.70/4.08 +/- 0.97) for the ROI and VOI technique, respectively. No significant differences were measured between test/retest studies. The mean test/retest variability for the ROI technique was low (7.25%) with excellent reliability (rho = 0.99). In addition, the mean test/retest variability for the VOI technique was also low (7.47%) with very high reliability (rho = 0.95). In Parkinson's disease patients, we found mean test/retest for the striatal-to-nonspecific [123I]FP-CIT ratio of (1.78 +/- 0.23/1.79 +/- 0.25) and (1.83 +/- 0.31/1.85 +/- 0.35) using the ROI and VOI technique, respectively. Also in patients, these results did not differ significantly between test/retest studies. The mean test/retest variability for the ROI technique was low (7.90%) with excellent reliability (rho = 1.00). In addition, the mean test/retest variability for the VOI technique was also low (7.36%) with high reliability (rho = 0.96). CONCLUSION: Reliable and reproducible results were obtained with the ROI, as well as the VOI technique, for the analysis of striatal dopamine transporters with [123I]FP-CIT SPECT in healthy controls and Parkinson's disease patients. The use of an operator-independent method will be a great advantage in routine clinical studies.

Registration of MR and SPECT without using external fiducial markers.

The aim of our work is to present, test and validate an automated registration method used for matching brain SPECT scans with corresponding MR scans. The method was applied on a data set consisting of ten brain IDEX SPECT scans and ten T1- and T2-weighted MR scans of the same subjects. Of two subjects a CT scan was also made. (Semi-) automated algorithms were used to extract the brain from the MR, CT and SPECT images. Next, a surface registration technique called chamfer matching was used to match the segmented brains. A perturbation study was performed to determine the sensitivity of the matching results to the choice of the starting values. Furthermore, the SPECT segmentation threshold was varied to study its effect on the resulting parameters and a comparison between the use of MR T1- and T2-weighted images was made. Finally, the two sets of CT scans were used to estimate the accuracy by matching MR to CT and comparing the MR-SPECT match to the SPECT-CT match. The perturbation study showed that for initial perturbations up to 6 cm the algorithm fails in less than 4% of the cases. A variation of the SPECT segmentation threshold over a realistic range (25%) caused an average variation in the optimal match of 0.28 cm vector length. When T2 is used instead of T1 the stability of the algorithm is comparable but the results are less realistic due the large deformations. Finally, a comparison of the direct SPECT-MR match and the indirect match with CT as intermediate yields a discrepancy of 0.4 cm vector length. We conclude that the accuracy of our automatic matching algorithm for SPECT and MR, in which no external markers were used, is comparable to the accuracies reported in the literature for non-automatic methods or methods based on external markers. The proposed method is efficient and insensitive to small variations in SPECT segmentation.

Demonstration of a reduction in muscarinic receptor binding in early Alzheimer's disease using iodine-123 dexetimide single-photon emission tomography.

Decreased muscarinic receptor binding has been suggested in single-photon emission tomography (SPET) studies of Alzheimer's disease. However, it remains unclear whether these changes are present in mildly demented patients, and the role of cortical atrophy in receptor binding assessment has not been investigated. We studied muscarinic receptor binding normalized to neostriatum with SPET using [123I]4-iododexetimide in five mildly affected patients with probable Alzheimer's disease and in five age-matched control subjects. Region of interest (ROI) analysis was performed in a consensus procedure blind to clinical diagnosis using matched magnetic resonance (MRI) images. Cortical atrophy was assessed by calculating percentages of cerebrospinal fluid in each ROI. An observer study with three observers was conducted to validate this method. Alzheimer patients showed statistically significantly less [123I]4-iododexetimide binding in left temporal and right temporo-parietal cortex compared with controls, independent of age, sex and cortical atrophy. Mean intra-observer variability was 3.6% and inter-observer results showed consistent differences in [123I]4-iododexetimide binding between observers. However, differences between patients and controls were comparable among observers and statistically significant in the same regions as in the consensus procedure. Using an MRI-SPET matching technique, we conclude that [123I]4-iododexetimide binding is reduced in patients with mild probable Alzheimer's disease in areas of temporal and temporo-parietal cortex.

The size of the horizontal cell receptive fields adapts to the stimulus in the light adapted goldfish retina.

In this study the dynamic properties of goldfish horizontal cell (HC) receptive fields were evaluated. The size of HC receptive fields increases up to about 60 msec after stimulus onset, and then reduces to a smaller end value. They can therefore not adequately be described by the cable equation. Estimates of the length constant of the HC network based on the sustained responses are about 43% smaller than those based on the initial part of the response. This difference can be accounted for by feedback connections from HCs to cones because negative feedback reduces the receptive field size. The implication is that HCs are strongly coupled when the retina is stimulated more or less homogeneously but that they partly uncouple from the rest of the HC network when they are stimulated differently than the rest of the retina. The HCs thus generate a feedback signal based on the "local" stimulus properties. The size of the HC receptive fields depends on the spatial detail of the stimulus.

Evaluation of [123I] beta-CIT binding with SPECT in controls, early and late Parkinson's disease.

The main neuropathological feature in Parkinson's disease (PD) is a severe degeneration of the dopaminergic neurons in the substantia nigra resulting in a loss of dopamine in the striatum. Recently, a new radioligand (beta-CIT) for single photon emission computed tomography (SPECT) became available for in vivo imaging of the dopamine transporter on nerve endings of dopaminergic neurons in the striatum. The present results demonstrate that [123I]-beta-CIT SPECT allows a discrimination between early and late PD patients. In our opinion, these preliminary data suggest that [123I]-beta-CIT SPECT should be used from now on in longitudinal studies (such as the DATATOP study) in which the effects of (putative) neuroprotective interventions in PD are monitored.

Identification of peak V in brainstem auditory evoked potentials with neural networks.

A feature extractor for determining the latency of peak V in brainstem auditory evoked potentials (BAEPs) is presented in this paper. A feature extractor that combines artificial neural networks with an algorithmic approach is presented. It consists of a series of small neural networks that have to make simple decisions. Each neural network decides what part of the input pattern contains the peak, and the algorithm passes that part of the pattern to the next neural network; in this way the size of the input patterns decreases during the process, and the last neural network determines the exact location of the peak. An optimal configuration of neural networks could determine the latencies of peak V in all synthetic evoked potentials correctly. With real evoked potentials, the networks yield results that comply with the opinion of a human expert in 80 +/- 6% of the cases.

Resistance of platelet proteins to effects of ionizing radiation.

Gamma irradiation of blood components prevents lymphocyte-induced graft-versus-host disease after transfusion in immunocompromised individuals. In this report we demonstrate the resistance of blood platelet proteins to gamma radiation-induced protein cleavage and aggregate formation when platelet concentrates were treated with a dose of 5000 rad. Results of one- and two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis of total platelet protein and cytoskeletal protein preparations indicate that platelet proteins are neither cleaved nor cross-linked under these conditions of irradiation. These results support those of a previous study that documented the lack of any adverse effect of 5000 rad gamma radiation on in vitro platelet properties.