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Biomedical subjects

Stephan Blinder

Publications and source records attributed to Stephan Blinder.

3 recordsLinked to original sources

Oral methylphenidate fails to elicit significant changes in extracellular putaminal dopamine levels in Parkinson's disease patients: positron emission tomographic studies.

In this study, we assessed the changes of endogenous dopamine (DA) levels in response to methylphenidate in 5 patients with idiopathic Parkinson's disease (PD) and 6 healthy controls. Three-dimensional positron emission tomography was performed with the D2 receptor antagonist [11C]raclopride (RAC) at baseline and 1 hour following the administration of oral methylphenidate (0.8 mg/kg) to assess changes in dopamine levels indirectly. Oral methylphenidate produced no significant change in extracellular DA levels in the putamen, as estimated by comparing changes in RAC binding at baseline and 1 hour following its administration in PD subjects and healthy controls. However, there were small changes in RAC binding of opposite direction in caudate and ventral striatal regions compared between the two groups. Although there was no consistent improvement in motor function in the PD group, some patients did experience a subjective high in response to methylphenidate (MP). Failure of oral MP to alter extracellular DA levels in putamen could result from degeneration of presynaptic dopaminergic terminals, with consequent severe reductions in the levels of endogenous DA and dopamine transporter in PD subjects. Our data provide in vivo neurochemical support for the lack of clinical efficacy following MP in PD patients and are also in keeping with reduced DA release following amphetamine in PD subjects.

Administration, Oral↗

Statistical dynamic image reconstruction in state-of-the-art high-resolution PET.

Modern high-resolution PET is now more than ever in need of scrutiny into the nature and limitations of the imaging modality itself as well as image reconstruction techniques. In this work, we have reviewed, analysed and addressed the following three considerations within the particular context of state-of-the-art dynamic PET imaging: (i) the typical average numbers of events per line-of-response (LOR) are now (much) less than unity, (ii) due to the physical and biological decay of the activity distribution, one requires robust and efficient reconstruction algorithms applicable to a wide range of statistics and (iii) the computational considerations in dynamic imaging are much enhanced (i.e., more frames to be stored and reconstructed). Within the framework of statistical image reconstruction, we have argued theoretically and shown experimentally that the sinogram non-negativity constraint (when using the delayed-coincidence and/or scatter-subtraction techniques) is especially expected to result in an overestimation bias. Subsequently, two schemes are considered: (a) subtraction techniques in which an image non-negativity constraint has been imposed and (b) implementation of random and scatter estimates inside the reconstruction algorithms, thus enabling direct processing of Poisson-distributed prompts. Both techniques are able to remove the aforementioned bias, while the latter, being better conditioned theoretically, is able to exhibit superior noise characteristics. We have also elaborated upon and verified the applicability of the accelerated list-mode image reconstruction method as a powerful solution for accurate, robust and efficient dynamic reconstructions of high-resolution data (as well as a number of additional benefits in the context of state-of-the-art PET).

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Problems created in attenuation-corrected SPECT images by artifacts in attenuation maps: a simulation study.

UNLABELLED: The importance of accurate attenuation correction, especially for imaging of the thorax region, is widely acknowledged. Appropriate compensation methods have been developed and introduced into clinical practice. Most of these methods use attenuation maps obtained using various transmission scanning systems. However, when maps are inaccurate, the correction procedure may introduce artifacts into the final images that can be difficult to identify and might inadvertently alter diagnosis and study outcome. As a result, attenuation correction is often avoided in clinical practice. Our objective was to examine issues related to the quality of attenuation maps and the effects that map artifacts may have on attenuation-corrected emission images. METHODS: The topics that are investigated include the problem of low transmission counts, cross-talk contributions from the emission isotope, truncation of the transmission data, and methods of map reconstruction and segmentation. Examples of patient studies displaying specific problems guided our investigations, but, because truth in these studies is seldom known, analytic and Monte Carlo-simulated data were used in the analysis. Attenuation maps and final emission images were visually checked for artifacts and for the presence of perfusion defects. In addition, quantitative evaluation of map uniformity, defect visibility, and size variation was performed. RESULTS: The statistical paired-sample t test showed significant (P < 0.05) improvement of relative SD for attenuation maps reconstructed with iterative methods as compared with filtered backprojection and for maps created with higher photon fluxes. When maps with artifacts were used to correct emission data, an increase in myocardial infarct size and creation of false heart defects were observed. CONCLUSION: Our study strongly recommends that at least a visual inspection of the quality of attenuation maps be performed before their use in compensation procedures. To improve image quality, remove artifacts, and increase diagnostic confidence, attenuation maps used in the correction procedure must be accurate and free of artifacts.

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