Localization of cerebral hypoperfusion in dogs with refractory and non-refractory epilepsy using [99mTc] ethyl cysteinate dimer and single photon emission computed tomography.

To evaluate the localization of functional deficit area in epileptogenic zones of the brain in seven refractory and seven non-refractory epilepsy dogs using technetium 99m labeled with ethyl cysteinate dimer and interictal single photon emission computed tomography [99mTc-ECD SPECT] co-registration with Magnetic Resonance Imaging (MRI). Regions showing perfusion deficits in the SPECT images were analyzed by using the standard semiquantitative evaluation method to compare the level of cortical perfusion to the maximum number of counts within the cerebellum (max C), considered the area of reference. This study showed that SPECT imaging revealed abnormalities in several regions of the brain in both epilepsy groups. The refractory epilepsy dogs showed more frequency area of hypoperfusion in temporal lobe than non-refractory group with not statistically significance (P=0.28). The result suggests the lesion in temporal might be relevance with refractory epilepsy in canine patients.

Relationships between amyloid levels, glucose metabolism, morphologic changes in the brain and clinical status of patients with Alzheimer's disease.

OBJECTIVE: The current study was conducted to improve the understanding of relationships between regional cortical amyloid load, glucose metabolism, cortical morphology (volume), and severity of clinical symptoms in patients with AD, MCI, and age-matched controls. METHODS: To objectivize the radiological evaluation of patients with suspected AD, head-to-head multi-modality imaging studies were conducted using MRI and PET/CT with [18F]FDG and [18F]AV45 for visualization and quantitation of brain morphology, glucose metabolism, and amyloid levels, respectively. A total of 84 subjects was studied, including 33 patients with AD, 31 patients with MCI, and 20 age-matched healthy controls (HC). A new quantitative index was calculated as a ratio of regional SUV of [18F]AV45 (normalized to cerebellar cortex) over the corresponding regional SUV of [18F]FDG, divided by the corresponding regional volume, measured from the co-registered MRI and normalized to the normal age-matched control group (AV45/FDG/NVol index). Relationships between clinical scores (TMSE, ADAS) and AV45/FDG/NVol indices for different structures of the brain in study groups were determined using linear regression analyses. RESULTS: A significant direct linear correlation was observed between the AV45/FDG/NVol index and ADAS-Cog test score and an inverse correlation with TMSE score at baseline and with the degree of changes in ADAS and TMSE scores assessed one year later (disease progression). The observed correlations between AV45/FDG/NVol index and clinical scores were higher than those with MRI-based cortical volumes, FDG SUV, or cerebellum-normalized AV45 SUV alone. CONCLUSIONS: Current study demonstrated that AV45/FDG/NVol index mapping of the brain is a novel quantitative molecular imaging biomarker that correlates with clinical neurocognitive status and may facilitate more accurate diagnosis, staging, and prognosis of AD. Additional larger scale clinical studies are required to further evaluate the efficacy of this new quantitative index as a diagnostic and prognostic biomarker of AD as well as for the evaluation of safety and efficacy of novel agents undergoing clinical trials for therapy of AD.

Circulating thyrotropin receptor messenger ribonucleic acid is not an effective marker in the follow-up of differentiated thyroid carcinoma.

BACKGROUND: Circulating thyrotropin receptor messenger ribonucleic acid (TSHR mRNA) assay has been validated in the follow-up of differentiated thyroid carcinoma (DTC) because of its high sensitivity during thyroid hormone therapy and no interference with endogenous anti-thyroglobulin antibodies (TgAb) compared to serum thyroglobulin (Tg). We investigated the efficacy of TSHR mRNA assay in 160 DTC patients using quantitative PCR (qPCR). FINDINGS: Only TSHR mRNA level of structural persistent disease with TgAb-positive (3.47 (2.97-9.53) pg equivalents/µg total RNA; p = 0.013) and its subgroup of distant metastasis patients with TgAb-positive (5.55 (3.28-12.52) pg equivalents/µg total RNA; p = 0.009) were significantly different from patients with no evidence of disease (2.32 (1.44-3.94) pg equivalents/µg total RNA). Applying cutoff at 2.00 pg equivalents/µg total RNA enabled us to predict structural persistent disease patients with a sensitivity of 62.3 % and a specificity of 42.9 %. Although, the sensitivity of TSHR mRNA assay in TgAb-postive patients (88.2 %) was superior than serum Tg (47.1 %) (p = 0.00002), the accuracy of the test is only 54.5 %. CONCLUSIONS: This study demonstrated that TSHR mRNA assay has good sensitivity in TgAb-positive patients but it is neither specific enough as a first-line of testing nor a surrogate marker in the follow-up of our DTC patients.