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Biomedical subjects

J Mantil

Publications and source records attributed to J Mantil.

14 recordsLinked to original sources

Altered mesolimbocortical and thalamic dopamine in Tourette syndrome.

We used [F-18]fallypride PET in six adults with Tourette syndrome and age-matched controls to assess extrastriatal dopamine 2 (D2) receptors. D2 receptor availability was significantly lower in the orbitofrontal cortex, primary motor cortex, anterior cingulate gyrus, mediodorsal nucleus of thalamus, and hippocampus, areas important for motivation and reward, sensory gating, movement, and attention. Altered dopaminergic function in mesolimbocortical systems and thalamus may contribute to increased motivational salience of tics.

Adolescent↗

Functional imaging of a large demyelinating lesion.

PURPOSE: To determine the metabolic characterization of a large solitary demyelinating lesion. METHODS: Magnetic Resonance Spectroscopy (MRS) and Positron Emission Tomography (PET) studies with 2-deoxy-2-[F-18]fluoro-d-glucose (FDG), carbon-11-methionine (methionine) and carbon-11-choline (choline) were done on the demyelinating lesion. RESULTS: The demyelinating lesion exhibited a low glucose uptake, prominent methionine uptake and a minimal choline uptake on the PET studies. MRS data revealed an increased choline to creatine (cho/cr) ratio and a decreased N-acetyl-aspartate to creatine (NAA/cr) ratio, which demonstrated a return to near normal ratios on follow-up study. CONCLUSION: The report summarizes the metabolic characteristics of a demyelinating plaque.

Adult↗

Radiation-induced medulloblastoma in an adult: a functional imaging study.

We describe functional imaging findings using MRI, 1H-Magnetic resonance spectroscopy and positron emission tomography in a case of radiation-induced medulloblastoma following radiotherapy for pineal gland tumor. MRS showed a prominent choline peak; FDG, 11C-Met and 11C-Choline PET showed a minimal glucose, increased methionine and choline uptake.

Adult↗

Evaluation of dopamine D-2 receptor occupancy by clozapine, risperidone, and haloperidol in vivo in the rodent and nonhuman primate brain using 18F-fallypride.

We have used the high-affinity dopamine D-2 receptor radioligand, 18F-fallypride for evaluating receptor occupancy by the antipsychotic drugs, clozapine, risperidone, and haloperidol in rodents and nonhuman primates. In rodents, clozapine (0.1 mg/kg to 100 mg/kg) competed with 18F-fallypride at all the doses administered. At doses over 40 mg/kg, clozapine was able to displace all the administered 18F-fallypride. A pseudobiphasic profile of receptor occupancy by clozapine was observed. This behavior was compared with such other neuroleptics as risperidone and haloperidol that exhibited over 90% receptor occupancy at doses over 0.1 mg/kg and did not exhibit a biphasic nature. Dopamine D-2 receptor occupancy in the monkeys was studied using positron emission tomography (PET) after acute subcutaneous doses of the various drugs. At therapeutically relevant doses, clozapine, risperidone, and haloperidol were able to compete significantly with the binding of 18F-fallypride in all brain regions in rhesus monkeys, and our analyses indicate that these drugs (clozapine, risperidone, and haloperidol) do not discriminate between the striatal (caudate and putamen) and the extrastriatal (thalamus and cortical regions) dopamine receptors. The following extent of D-2 receptor occupancies were measured in the monkey brain using PET: clozapine approximately 70% (dose of 9.7 mg/kg), risperidone approximately 75% (0.05 mg/kg), and haloperidol approximately 90% (0.05 mg/kg).

Animals↗

11C-methionine PET imaging of leptomeningeal metastases from primary breast cancer--a case report.

Leptomeningeal metastases (LM) is often an elusive disease frequently diagnosed at an advanced clinical stage. Early diagnosis may allow for prompt initiation of treatment with minimal tumor burden and maximal chance of survival, especially in solid tumors such as breast cancer. Although the method of choice for imaging LM currently is by gadolinium enhanced magnetic resonance imaging (MRI), the technique has a high sensitivity but low specificity. We report the first case of Carbon 11-labelled methionine (Cmet) positron emission tomography (PET) imaging of leptomeningeal metastases in a patient with primary breast cancer. This patient presented with clinical features suggestive of LM, but had inconclusive cerebrospinal fluid (CSF) findings. Although, the contrast enhanced MRI revealed calvarial and meningeal lesions, it is known that meningeal enhancement on MRI does not always indicate metastases. In this clinical dilemma the strong methionine uptake on PET helped steer the diagnosis in favor of cancerous infiltration even before the CSF cytology became positive for malignancy.

Breast Neoplasms↗

In vitro and in vivo evaluation of the binding of the dopamine D2 receptor agonist (11)C-(R,S)-5-hydroxy-2-(di-n-propylamino)tetralin in rodents and nonhuman primate.

The in vitro autoradiographic binding characteristics as well as in vivo imaging characteristics of a dopamine D2 receptor agonist, (R, S)-2-(N-propyl-N-1'-(11)C-propyl)amino-5-hydroxytetralin ((11)C-5-OH-DPAT), were studied. In (3)H-spiperone assays using rat striata, 5-OH-DPAT exhibited an affinity of IC(50) = 2.5 nM. In vitro autoradiographs in rat brain slices with (11)C-5-OH-DPAT revealed selective binding to the dopaminergic regions in the striata which was displaceable by sulpiride. Varying concentrations of dopamine displaced this selective binding of (11)C-5-OH-DPAT to the striata in rat brain slices. This selective binding to the striata was also removed in the presence of the GTP analog, 5'-guanylylimidodiphosphate, indicative of the binding of (11)C-5-OH-DPAT to the high-affinity state of the D2 receptor. Ex vivo autoradiographic study in rats exhibited selective binding of (11)C-5-OH-DPAT to the striata. A PET study in a rhesus monkey showed selective localization of (11)C-5-OH-DPAT in the striata and the ratio between striata and cerebellum approached approximately 2 at 40 min postinjection.

8-Hydroxy-2-(di-n-propylamino)tetralin↗

Correlative Whole-Body FDG-PET and Intraoperative Gamma Detection of FDG Distribution in Colorectal Cancer.

Purpose: 18F-Fluorodeoxyglucose-positron emission tomography (FDG-PET) is the superior imaging modality for detection of primary and recurrent colorectal cancer compared to magnetic resonance imaging (MRI) or computerized tomography (CT). We investigated the feasibility of developing intraoperative procedures for detection of FDG in tumor deposits in order to assist the surgeon in achieving an optimal reduction of tumor burden.Procedures: Fourteen patients (45-83 years of age) were scanned using FDG-PET followed by Gamma Detection Probe evaluation at laparotomy. One patient did not have a pre-operative FDG-PET scan. The collimated detector probe contained a CdZnTe crystal (7mm diameter x 2mm thick). We used a lower window setting of 200 KeV and an open upper window setting. Fasted patients were given an IV bolus of FDG (4.0-5.7 mCi) 15-20 minutes prior to preparation for surgery. Catheterization and the diuretic Lasix were used to remove FDG activity from the bladder. The time from FDG injection to intraoperative GDP data acquisition varied from 58-110 minutes.Results: In all patients, the GDP detected background activity in normal tissues (aorta, colon, liver, kidney, abdominal wall, mesentery, and urinary bladder). The GDP correctly identified single or multiple tumor foci in 13/14 patients as noted by an audible signal from the control unit (3 S.D. above counts obtained from normal tissues). These tumor foci corresponded to regions of high FDG uptake as seen on FDG-PET scans. The one case that the GDP did not localize was a recurrent mucin pseudomyxoma-producing tumor (acellular, mucinous deposits). Ex vivo GDP evaluations demonstrated significant tumor:normal adjacent tissue activity (audible signals in 6/6 tumor samples tested).Conclusions: These data demonstrate that tumors identified from pre-operative whole-body PET scans can be localized during surgery utilizing a gamma probe detector and FDG.

Journal Article↗

9:-9:15. 3D Data Acquisition for Whole Body Images on the ECAT HR+

Purpose: Evaluation of 3D clinical whole-body FDG PET imaging using recent improvements in data correction and reconstruction methods.Methods: Phantom studies following the NEMA NU 2-2000 draft were performed to evaluate count loss and accuracy of attenuation and scatter correction algorithms. Phantom results were used to estimate 3D vs. 2D efficiency. For patient studies, an established 2D imaging protocol (9 min emission, 3 min transmission acquisition per bed position, commencing 60 min after injection of 15 mCi FDG) was used. This was followed by a 3D acquisition of the same duration, commencing approximately 110 min later, so that 3D acquisition was performed with approximately 50% lower patient activity than 2D. Images were compared in terms of anatomic structural definition and visible artifacts.The count loss study showed that in a dose range of 10-15 mCi, 3D produced an approximately two-fold increase in effective NEC compared to 2D. The phantom imaging study showed slightly improved target to background ratios for both hot and the cold "lesions" when using 3D imaging. In 5 patients studied so far, comparison of 2D and 3D studies demonstrated no systematic differences in image quality between the two methods.Conclusion: 3D whole-body imaging with improved image reconstruction may permit a two-fold reduction in emission acquisition time or injected dose, without decrease in image quality compared to standard 2D imaging techniques.

Journal Article↗

A technique utilizing positron emission tomography and magnetic resonance/computed tomography image fusion to aid in surgical navigation and tumor volume determination.

Brain tumors are histologically heterogeneous. A technique for three-dimensional fusing of computed tomography (CT) or magnetic resonance images (MRI) with positron emission tomography (PET) images is described. This allows the anatomic detail provided by CT or MRI scans to be combined with the information about metabolic activity provided by PET scans. The fused images allowed selection of the most metabolically active portions of tumors. Fusion of CT and MRI images with PET scans has allowed first-pass diagnostic yield by providing the surgeon with a map of anatomical as well as functional (metabolic) detail. We describe a technique to allow routine fusion of MRI, CT, and PET information to help guide the neurosurgeon.

Adult↗

Iterative Principal Axes Registration method for analysis of MR-PET brain images.

Computerized automatic registration of MR-PET images of the brain is of significant interest for multimodality brain image analysis. In this paper, we discuss the Principal Axes Transformation for registration of three-dimensional MR and PET images. A new brain phantom designed to test MR-PET registration accuracy determines that the Principal Axes Registration method is accurate to within an average of 1.37 mm with a standard deviation of 0.78 mm. Often the PET scans are not complete in the sense that the PET volume does not match the respective MR volume. We have developed an Iterative Principal Axes Registration (IPAR) algorithm for such cases. Partial volumes of PET can be accurately registered to the complete MR volume using the new iterative algorithm. The quantitative and qualitative analyses of MR-PET image registration are presented and discussed. Results show that the new Principal Axes Registration algorithm is accurate and practical in MR-PET correlation studies.

Algorithms↗

Gallium-67 lung uptake: conjugate-view technique.

A conjugate-view technique is derived for calculation of absolute gallium-67 (Ga-67) uptake from scintillation-camera images. The technique combines counts of posterior and anterior images of the lung with an attenuation correction obtained from cobalt-57 (Co-57) transmission imaging. The formulation is such that the effects of Compton scatter build-up are accounted for. Studies utilizing a canine model indicated that, normally, more activity is located in the chest wall than in the lungs. The quantitative technique must therefore accurately account for a variety of Ga-67 distributions, including that in the chest wall. Calculations were performed using a three-component model comparing results obtained with the conjugate-view approach to the actual uptake. These calculations suggest that an assumption of uniform activity distribution allows an accuracy of approximately +/- 10% over a broad range of body-part thicknesses and uptake by the lungs. It was concluded that the conjugate-view technique is necessarily approximate but can provide clinically useful results.

Animals↗

Comparison of gallium-67 scanning, bronchoalveolar lavage, and serum angiotensin-converting enzyme levels in pulmonary sarcoidosis. Predicting response to therapy.

Patients with active pulmonary sarcoidosis underwent bronchoalveolar lavage, gallium scan, and serum angiotensin-converting enzyme (ACE) level determination prior to treatment with corticosteroids. Pulmonary function was tested before and after therapy. Increase in vital capacity after treatment ranged from 40 to 1,030 ml; 12 of the 16 patients studied had an increase of more than 200 ml. There was a close correlation between the percentage uptake of gallium scan and the increase of the vital capacity after therapy (r = 0.95, p less than 0.01). There was no relationship between the percentage of lymphocytes obtained on lavage and the changes in vital capacity with therapy (r = 0.05). There was a positive correlation between the changes in vital capacity and the ratio of T4(+):T8(+)lymphocytes (r = 0.62, p less than 0.05) and number of T4 (+) lymphocytes (r = 0.92, p less than 0.01) in the bronchoalveolar fluid. There was a low correlation between the pretreatment ACE level and the change in vital capacity (r = 0.368, p greater than 0.05).

Acetylcholinesterase↗

Medical high-technology assessment and implementation in a community hospital: nuclear magnetic resonance.

Health care administrators and physicians are under intense pressure from the government, industry, and the public at large to contain the escalating cost of health care. Operating margins of hospitals are averaging about 1%, and some hospitals are closing their doors. Health care providers are thus faced with the dilemma of how to bring costly high technology to a community hospital in a timely and effective manner without incurring serious financial setbacks. Despite all these pressures, we have presented several reasons why a community hospital should bring costly technology to its medical staff, and thus to its patients. We have described Kettering Medical Center's approach to this problem and our success in bringing it to the community early and cost-effectively, which has benefited the local community as well as the medical center. Our desire to be one of the "early adopters" may not work for everyone, since it requires extremely careful and perceptive evaluation of the technologic developments. It requires an intelligent, progressive, and committed board, administration, and medical staff, and it requires clever financing, such as large outside grants and help from a medical school. Such partnerships and research organizations, or liaisons with government agencies such as the Veterans Affairs system, are believed to be the keys in getting costly high technology into a community hospital. To achieve this, administration and key medical staff should constantly be on the lookout, evaluating high-technology developments. Once the hospital decides to get into a costly new high technology, it must seek alliances or partnerships with others. To identify, assess, and acquire new technology is an ongoing process.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost Control↗