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(99m)Tc-hexamethyl propyleneamine oxime brain perfusion single photon emission computed tomography in characterization of dementia: an initial experience in Indian clinical practice.

Santra A, Sinha GK, Neogi R, Thukral RK - World J Nucl Med (2014)

Bottom Line: To reduce the healthcare cost and effective management of dementia illness, early diagnosis, accurate differentiation and their progression assessment is becoming crucially important.Final diagnosis was done with clinical correlation.All imaging findings are well-correlated with clinical background.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Medical College, Kolkata, West Bengal, India.

ABSTRACT
There is a growing health burden in developing countries due to recent trends of increasing incidence of neurodegenerative diseases. To reduce the healthcare cost and effective management of dementia illness, early diagnosis, accurate differentiation and their progression assessment is becoming crucially important. We are utilizing (99m)Tc-d, l-hexamethyl propyleneamine oxime (HMPAO) brain perfusion single photon emission computed tomography (SPECT) to characterize dementia on the basis of perfusion patterns and observed significant improvement in their management. Eleven patients (median age of 60 years range of 53-83 years) with clinical suspicion of dementia underwent (99m)Tc-HMPAO brain perfusion SPECT. SPECT-computed tomography acquisition done, data are reconstructed, reviewed in three view and further processed in "neurogam" to get voxel based analysis and the comparison with age based normal database and surface mapping. Final diagnosis was done with clinical correlation. Four patients are diagnosed as Alzheimer's disease, two as frontotemporal dementia, one as dementia of Lewy bodies, two as vascular dementia and two as pseudodementia. All imaging findings are well-correlated with clinical background. Brain perfusion SPECT with HMPAO was very helpful to us in characterizing the patients of dementia by its perfusion pattern.

No MeSH data available.


Related in: MedlinePlus

A 62-year-old male patient with history of right sided cerebral stroke and loss of memory problem is showing the brain perfusion pattern of a vascular dementia in 99mTc-hexamethyl propyleneamine oxime brain perfusion single photon emission computed tomography (SPECT) study. (a) Transaxial,b) coronal,c) sagittal view of SPECT images and (d) right lateral,e) left lateral surface projection views of “Neurogam” processed images, are showing bilateral diffuse cortical hypoperfusion including the area of stroke
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Figure 4: A 62-year-old male patient with history of right sided cerebral stroke and loss of memory problem is showing the brain perfusion pattern of a vascular dementia in 99mTc-hexamethyl propyleneamine oxime brain perfusion single photon emission computed tomography (SPECT) study. (a) Transaxial,b) coronal,c) sagittal view of SPECT images and (d) right lateral,e) left lateral surface projection views of “Neurogam” processed images, are showing bilateral diffuse cortical hypoperfusion including the area of stroke

Mentions: All of 11 patients studied were presented with some form of memory loss and evaluated for dementia. Eight patients had some form of psychological disturbances, two had history of cerebrovascular accident (CVA) with neurologic correlation, one had presented with muscle rigidity and akathesia. A master chart of the patients, their clinical history, perfusion pattern and differential diagnosis are tabulated [Table 2]. Five patients revealed perfusion pattern consistent with posterior dementia. One of them had typical posterior parietal and temporal hypoperfusion, which is sign of early AD. Three patients had also frontal hypoperfusion in addition to parietotemporal hypoperfusion, consistent with advanced AD pattern [Figure 1]. One of posterior dementia pattern had finding of occipital lobe hypoperfusion in addition to parietotemporal hypoperfusion, which is typical of Lewy body dementia [Figure 2]. Two patients had frontotemporal hypoperfusion, which is a typical pattern found in frontotemporal dementia (FTD) or Pick's disease [Figure 3]. Both of the patients with history of CVA displayed diffuse cerebral hypoperfusion, including the area of stroke, not consistent with any of typical pattern and diagnosed as vascular dementia [Figure 4]. Two patients with severe depression revealed on bilateral prefrontal hypoperfusion and are diagnosed as pseudodementia [Figure 5].


(99m)Tc-hexamethyl propyleneamine oxime brain perfusion single photon emission computed tomography in characterization of dementia: an initial experience in Indian clinical practice.

Santra A, Sinha GK, Neogi R, Thukral RK - World J Nucl Med (2014)

A 62-year-old male patient with history of right sided cerebral stroke and loss of memory problem is showing the brain perfusion pattern of a vascular dementia in 99mTc-hexamethyl propyleneamine oxime brain perfusion single photon emission computed tomography (SPECT) study. (a) Transaxial,b) coronal,c) sagittal view of SPECT images and (d) right lateral,e) left lateral surface projection views of “Neurogam” processed images, are showing bilateral diffuse cortical hypoperfusion including the area of stroke
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150154&req=5

Figure 4: A 62-year-old male patient with history of right sided cerebral stroke and loss of memory problem is showing the brain perfusion pattern of a vascular dementia in 99mTc-hexamethyl propyleneamine oxime brain perfusion single photon emission computed tomography (SPECT) study. (a) Transaxial,b) coronal,c) sagittal view of SPECT images and (d) right lateral,e) left lateral surface projection views of “Neurogam” processed images, are showing bilateral diffuse cortical hypoperfusion including the area of stroke
Mentions: All of 11 patients studied were presented with some form of memory loss and evaluated for dementia. Eight patients had some form of psychological disturbances, two had history of cerebrovascular accident (CVA) with neurologic correlation, one had presented with muscle rigidity and akathesia. A master chart of the patients, their clinical history, perfusion pattern and differential diagnosis are tabulated [Table 2]. Five patients revealed perfusion pattern consistent with posterior dementia. One of them had typical posterior parietal and temporal hypoperfusion, which is sign of early AD. Three patients had also frontal hypoperfusion in addition to parietotemporal hypoperfusion, consistent with advanced AD pattern [Figure 1]. One of posterior dementia pattern had finding of occipital lobe hypoperfusion in addition to parietotemporal hypoperfusion, which is typical of Lewy body dementia [Figure 2]. Two patients had frontotemporal hypoperfusion, which is a typical pattern found in frontotemporal dementia (FTD) or Pick's disease [Figure 3]. Both of the patients with history of CVA displayed diffuse cerebral hypoperfusion, including the area of stroke, not consistent with any of typical pattern and diagnosed as vascular dementia [Figure 4]. Two patients with severe depression revealed on bilateral prefrontal hypoperfusion and are diagnosed as pseudodementia [Figure 5].

Bottom Line: To reduce the healthcare cost and effective management of dementia illness, early diagnosis, accurate differentiation and their progression assessment is becoming crucially important.Final diagnosis was done with clinical correlation.All imaging findings are well-correlated with clinical background.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Medical College, Kolkata, West Bengal, India.

ABSTRACT
There is a growing health burden in developing countries due to recent trends of increasing incidence of neurodegenerative diseases. To reduce the healthcare cost and effective management of dementia illness, early diagnosis, accurate differentiation and their progression assessment is becoming crucially important. We are utilizing (99m)Tc-d, l-hexamethyl propyleneamine oxime (HMPAO) brain perfusion single photon emission computed tomography (SPECT) to characterize dementia on the basis of perfusion patterns and observed significant improvement in their management. Eleven patients (median age of 60 years range of 53-83 years) with clinical suspicion of dementia underwent (99m)Tc-HMPAO brain perfusion SPECT. SPECT-computed tomography acquisition done, data are reconstructed, reviewed in three view and further processed in "neurogam" to get voxel based analysis and the comparison with age based normal database and surface mapping. Final diagnosis was done with clinical correlation. Four patients are diagnosed as Alzheimer's disease, two as frontotemporal dementia, one as dementia of Lewy bodies, two as vascular dementia and two as pseudodementia. All imaging findings are well-correlated with clinical background. Brain perfusion SPECT with HMPAO was very helpful to us in characterizing the patients of dementia by its perfusion pattern.

No MeSH data available.


Related in: MedlinePlus