1
|
TCT-473 Contrast-induced nephropathy (CIN) in patients with renal impairment: Pooled data from three prospective, randomized studies comparing iodixanol 320 mg and iopamidol 370mg. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
2
|
P3‐160: Implications of better signal: Noise properties of 18F NAV4694 PET amyloid imaging for visual interpretation and scan quantitation. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
3
|
OC-041: Pivotal trial results and EU comparison of 99mTc-Tilmanocept in sentinel node biopsy in head and neck cancer patients. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34801-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
4
|
Age dependence of brain β-amyloid deposition in Down syndrome: An [18F]florbetaben PET study. Neurology 2015; 84:500-7. [PMID: 25568295 DOI: 10.1212/wnl.0000000000001212] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate brain β-amyloid binding in subjects with Down syndrome (DS) using [(18)F]florbetaben PET imaging. METHODS Thirty-nine subjects with DS (46.3 ± 4.7 years) were assessed with [(18)F]florbetaben PET imaging. Three blinded independent readers assessed the scans to provide a visual analysis. The primary quantitative imaging outcome was a standardized uptake value ratio (SUVR) obtained for 6 brain regions. Cognitive status was evaluated using the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID). RESULTS [(18)F]Florbetaben uptake was correlated with age (p < 0.0001, R(2) = 0.39); 90% of scans in subjects with DS aged 50 years or older (SUVR = 1.62 ± 0.26), 53% in those aged 45 to 49 years (SUVR = 1.43 ± 0.16), and 7% in those aged 40 to 45 years (SUVR = 1.27 ± 0.11) were visually assessed as positive. Visual and quantitative assessments were highly related (χ(2) = 11.3823, p = 0.0007; Cohen κ = 0.58). Only 2 of 34 participants were considered to have dementia by the DSQIID. CONCLUSIONS Brain β-amyloid binding, as measured by [(18)F]florbetaben, increases with age in DS. Subjects with DS who have no evidence of dementia demonstrate brain β-amyloid binding in vivo, suggesting that [(18)F]florbetaben PET imaging may detect β-amyloid in this at-risk population.
Collapse
|
5
|
101. 99mTc-Tilmanocept (TcTm) provides stably localised detection of lymph nodes (LN) in melanoma across all anatomic locations regardless of body mass index (BMI), or day of surgery. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
6
|
104. The false negative rate (FNR) for 99mTc-tilmanocept is crucially low across breast cancer (BC), melanoma (ME), and head/neck squamous cell carcinoma (HNSCC), portending good patient outcome. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
7
|
IC‐P‐048: LONGITUDINAL FOLLOW‐UP OF AMYLOIDOSIS AND GLUCOSE HYPOMETABOLISM IN A TRANSGENIC RAT MODEL OF ALZHEIMER'S DISEASE. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
IN VITRO
PROPERTIES OF [18F]NAV4694: DYNAMIC RANGE, DISPLACEMENT, AND WHITE‐MATTER BINDING. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
9
|
IN VITRO
PROPERTIES OF [18F]NAV4694: DYNAMIC RANGE, DISPLACEMENT, AND WHITE‐MATTER BINDING. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
10
|
O3‐03‐01: DETECTION OF PRODROMAL ALZHEIMER'S DISEASE WITH 18F‐FLORBETABEN AB IMAGING: A PROSPECTIVE OUTCOME STUDY. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.04.280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
PET quantification of 18F-florbetaben binding to β-amyloid deposits in human brains. J Nucl Med 2013; 54:723-31. [PMID: 23471310 DOI: 10.2967/jnumed.112.107185] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED (18)F-florbetaben is a novel (18)F-labeled tracer for PET imaging of β-amyloid deposits in the human brain. We evaluated the kinetic model-based approaches to the quantification of β-amyloid binding in the brain from dynamic PET data. The validity of the practically useful tissue ratio was also evaluated against the model-based parameters. METHODS (18)F-florbetaben PET imaging was performed with concurrent multiple arterial sampling after tracer injection (300 MBq) in 10 Alzheimer disease (AD) patients and 10 age-matched healthy controls. Regional brain-tissue time-activity curves for 90 min were analyzed by a 1-tissue-compartment model and a 2-tissue-compartment model (2TCM) with metabolite-corrected plasma data estimating the specific distribution volume (VS) and distribution volume ratio (DVR [2TCM]) and a multilinear reference tissue model estimating DVR (DVR [MRTM]) using the cerebellar cortex as the reference tissue. Target-to-reference tissue standardized uptake value ratios (SUVRs) at 70-90 min were also calculated. RESULTS All brain regions required 2TCM to describe the time-activity curves. All β-amyloid binding parameters in the cerebral cortex (VS, DVR [2TCM], DVR [MRTM], and SUVR) were significantly increased in AD patients (P < 0.05), and there were significant linear correlations among these parameters (r(2) > 0.83). Effect sizes in group discrimination between 8 β-amyloid-positive AD scans and 9 β-amyloid-negative healthy control scans for all binding parameters were excellent, being largest for DVR (2TCM) (4.22) and smallest for VS (3.25) and intermediate and the same for DVR (MRTM) and SUVR (4.03). CONCLUSION These results suggest that compartment kinetic model-based quantification of β-amyloid binding from (18)F-florbetaben PET data is feasible and that all β-amyloid binding parameters including SUVR are excellent in discriminating between β-amyloid-positive and -negative scans.
Collapse
|
12
|
Impact of beta-amyloid-specific florbetaben PET imaging on confidence in early diagnosis of Alzheimer's disease. Dement Geriatr Cogn Disord 2013; 33:416-22. [PMID: 22814208 DOI: 10.1159/000339367] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early diagnosis of Alzheimer's disease (AD) may be corroborated by imaging of beta-amyloid plaques using positron emission tomography (PET). Here, we performed an add-on questionnaire study to evaluate the relevance of florbetaben imaging (BAY 949172) in diagnosis and consecutive management of probable AD patients. METHODS AD patients with a clinical diagnosis in accordance with the NINCDS-ADRDA criteria or controls were imaged using florbetaben. Referring physicians were asked on a voluntary basis about their confidence in initial diagnosis, significance of PET imaging results, and their anticipated consequences for future patient care. RESULTS 121 questionnaires for probable AD patients and 80 questionnaires for controls were evaluated. In 18% of patients who had initially received the diagnosis of probable AD, PET scans were rated negative, whereas in controls 18% of scans were positive. An increase in confidence in the initial diagnosis was frequently reported (80%). Imaging results had a significant impact on the intended patient care, as judged by the referring physicians; this was most prominent in those patients with a contradicting scan and/or a low confidence in the initial diagnosis. CONCLUSION Florbetaben amyloid imaging increases the overall confidence in diagnosis of AD and may frequently influence clinical decisions and patient management.
Collapse
|
13
|
P4‐167: Techniques for histopathological verification of florbetaben PET in a global phase III clinical trial. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
IC‐P‐031: Cognitive change and Aβ deposition in MCI subjects studied with serial 18F‐florbetaben PET over 2 years. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
15
|
O4‐10‐01: Prediction of Aß and clinical outcome in patients with MCI with neuropsychological tests. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
16
|
O2‐11‐04: Cognitive change and beta‐amyloid deposition in MCI subjects studied with serial 18F‐Florbetaben PET over 2 years. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
17
|
O1‐04‐01: Multicentre phase 3 trial on florbetaben for beta‐amyloid brain PET in Alzheimer's disease. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
18
|
IC‐P‐113: Automated regional and voxel‐wise quantification of florbetaben beta‐amyloid brain PET. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
19
|
IC‐P‐100: Evaluation of the efficacy and safety of florbetaben PET in adults with down syndrome. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
20
|
P2‐109: An automated, operator‐independent method for evaluating various brain areas of florbetaben PET scans to compare regional normal versus diseased beta‐amyloid burdens. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
21
|
P4‐457: Accuracy of ß‐amyloid PET with florbetaben in Alzheimer's disease (AD) patients and healthy volunteers (HVs): influence of scan duration. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.09.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
22
|
P1‐331: Conversion from mild cognitive impairment to Alzheimer's disease over 12 months: Predictive value of Aβ imaging with 18F‐Florbetaben. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
23
|
Individualized quantification of brain β-amyloid burden: results of a proof of mechanism phase 0 florbetaben PET trial in patients with Alzheimer’s disease and healthy controls. Eur J Nucl Med Mol Imaging 2011; 38:1702-14. [DOI: 10.1007/s00259-011-1821-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 04/06/2011] [Indexed: 10/18/2022]
|
24
|
Cerebral amyloid-β PET with florbetaben (18F) in patients with Alzheimer's disease and healthy controls: a multicentre phase 2 diagnostic study. Lancet Neurol 2011; 10:424-35. [PMID: 21481640 DOI: 10.1016/s1474-4422(11)70077-1] [Citation(s) in RCA: 409] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Imaging with amyloid-β PET can potentially aid the early and accurate diagnosis of Alzheimer's disease. Florbetaben (¹⁸F) is a promising ¹⁸F-labelled amyloid-β-targeted PET tracer in clinical development. We aimed to assess the sensitivity and specificity of florbetaben (¹⁸F) PET in discriminating between patients with probable Alzheimer's disease and elderly healthy controls. METHODS We did a multicentre, open-label, non-randomised phase 2 study in 18 centres in Australia, Germany, Switzerland, and the USA. Imaging with florbetaben (¹⁸F) PET was done on patients with probable Alzheimer's disease (age 55 years or older, mini-mental state examination [MMSE] score=18-26, clinical dementia rating [CDR]=0·5-2·0) and age-matched healthy controls (MMSE ≥ 28, CDR=0). Our primary objective was to establish the diagnostic efficacy of the scans in differentiating between patients with probable disease and age-matched healthy controls on the basis of neocortical tracer uptake pattern 90-110 min post-injection. PET images were assessed visually by three readers masked to the clinical diagnosis and all other clinical findings, and quantitatively by use of pre-established brain volumes of interest to obtain standard uptake value ratios (SUVRs), taking the cerebellar cortex as the reference region. This study is registered with ClinicalTrials.gov, number NCT00750282. FINDINGS 81 participants with probable Alzheimer's disease and 69 healthy controls were assessed. Independent visual assessment of the PET scans showed a sensitivity of 80% (95% CI 71-89) and a specificity of 91% (84-98) for discriminating participants with Alzheimer's disease from healthy controls. The SUVRs in all neocortical grey-matter regions in participants with Alzheimer's disease were significantly higher (p < 0·0001) compared with the healthy controls, with the posterior cingulate being the best discriminator. Linear discriminant analysis of regional SUVRs yielded a sensitivity of 85% and a specificity of 91%. Regional SUVRs also correlated well with scores of cognitive impairment such as the MMSE and the word-list memory and word-list recall scores (r -0·27 to -0·33, p ≤ 0·021). APOE ɛ4 was more common in participants with positive PET images compared with those with negative scans (65%vs 22% [p=0·027] in patients with Alzheimer's disease; 50%vs 16% [p = 0·074] in healthy controls). No safety concerns were noted. INTERPRETATION We provide verification of the efficacy, safety, and biological relevance of florbetaben (¹⁸F) amyloid-β PET and suggest its potential as a visual adjunct in the diagnostic algorithm of dementia. FUNDING Bayer Schering Pharma AG.
Collapse
|
25
|
Compartment-model based quantification of beta-amyloid binding with Florbetaben PET in Alzheimer's disease and control subjects. Neuroimage 2010. [DOI: 10.1016/j.neuroimage.2010.04.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
26
|
Kinetic modeling of florbetaben binding to beta-amyloid in human brains using one and two input functions. Neuroimage 2010. [DOI: 10.1016/j.neuroimage.2010.04.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
27
|
IC‐P‐059: Assessment of Aβ Deposition in Mild Cognitive Impairment with 18F‐Florbetaben. Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.05.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
28
|
IC‐P‐119: A Model‐Based Approach to Improve Intra‐Individual Comparison of Clustered Beta‐Amyloid Brain PET Imaging Data: Accounting for Overlapping Imaging Time Windows. Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.05.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
29
|
P2‐402: Influence of ethnic group, age, gender, and tracer mass dose on florbetaben β‐amyloid brain PET results in elderly normal controls. Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.05.1455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
30
|
|
31
|
IC‐P‐126: Objective SUVr Determination using MRI Segmentation Maps in Florbetaben Beta‐amyloid Brain PET Improves Discrimination of Alzheimer's and Controls. Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.05.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
32
|
FP43-TH-03 [18 F]BAY 94–9172 positron emission tomography in the detection/exclusion of cerebral amyloid beta: an open-label, multicentre study in patients with probable Alzheimer's disease compared with healthy volunteers. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
33
|
P2‐009: Test‐retest variability studies in Alzheimer's disease and normal ageing of the new amyloid imaging agent [18F]BAY 94‐9172. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.04.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
34
|
P2‐002: [
18
F]BAY 94‐9172 PET ‐ Towards in vivo quantification of brain β‐amyloid plaque load in Alzheimer disease. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.04.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
35
|
O1‐05‐06: Efficacy of [
18
F]BAY94‐9172 Positron Emission Tomography in the Detection/Exclusion of Cerebral Amyloid Beta in Patients with Probable Alzheimer's Disease Compared with Healthy Volunteers: An Open‐label, Global, Multicentre Study. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
36
|
Abstract
BACKGROUND (123)I-FP-CIT SPECT (single photon emission computed tomography) can help in the differential diagnosis of probable dementia with Lewy bodies (Lewy body dementia) and Alzheimer's disease. AIMS Our aim was to determine the accuracy of (123)I-FP-CIT SPECT in diagnosing people with possible dementia with Lewy bodies. METHOD We undertook a 12-month follow-up of 325 individuals with probable or possible Lewy body or non-Lewy body dementia who had previously undergone (123)I-FP-CIT SPECT. A consensus panel, masked to SPECT findings, established diagnosis at 12 months in 264 people. RESULTS Of 44 people with possible dementia with Lewy bodies at baseline, at follow-up the diagnosis for 19 people was probable dementia with Lewy bodies (43%), in 7 people non-Lewy body dementia (16%) and for 18 individuals it remained possible dementia with Lewy bodies (41%). Of the 19 who at follow-up were diagnosed with probable dementia with Lewy bodies, 12 had abnormal scans at baseline (sensitivity 63%); all 7 individuals with a possible diagnosis who were diagnosed as having Alzheimer's disease at follow-up had normal scans (specificity 100%). CONCLUSIONS Our findings confirm the diagnostic accuracy of (123)I-FP-CIT SPECT in distinguishing Lewy body from non-Lewy body dementia and also suggest a clinically useful role in diagnostically uncertain cases, as an abnormal scan in a person with possible dementia with Lewy bodies is strongly suggestive of dementia with Lewy bodies.
Collapse
|
37
|
P1‐285: First results toward
in vivo
quantification of cerebral β‐amyloid plaque load in Alzheimer's disease by means of BAY 94–9172‐PET. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
38
|
Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 2007; 6:305-13. [PMID: 17362834 DOI: 10.1016/s1474-4422(07)70057-1] [Citation(s) in RCA: 378] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) needs to be distinguished from other types of dementia because of important differences in patient management and outcome. Current clinically based diagnostic criteria for DLB have limited accuracy. Severe nigrostriatal dopaminergic degeneration occurs in DLB, but not in Alzheimer's disease or most other dementia subtypes, offering a potential system for a biological diagnostic marker. The primary aim of this study was to investigate the sensitivity and specificity, in the ante-mortem differentiation of probable DLB from other causes of dementia, of single photon emission computed tomography (SPECT) brain imaging with the ligand (123)I-2beta-carbometoxy-3beta-(4-iodophenyl)-N-(3-fluoropropyl) nortropane ((123)I-FP-CIT), which binds to the dopamine transporter (DAT) reuptake site. Diagnostic accuracy, positive and negative predictive values, and inter-reader agreement were the secondary endpoints and a subgroup of possible DLB patients was also included. METHODS We did a phase III study in which we used a (123)I-FP-CIT SPECT scan to assess 326 patients with clinical diagnoses of probable (n=94) or possible (n=57) DLB or non-DLB dementia (n=147) established by a consensus panel (in 28 patients no diagnosis could be made). Three readers, unaware of the clinical diagnosis, classified the images as normal or abnormal by visual inspection. The study had 90% power to detect the differences between our anticipated sensitivity (0.80) and specificity (0.85) targets and prespecified lower thresholds (sensitivity 0.65, specificity 0.73) using one-sided binomial tests with a significance level of alpha=0.025. FINDINGS Abnormal scans had a mean sensitivity of 77.7% for detecting clinical probable DLB, with specificity of 90.4% for excluding non-DLB dementia, which was predominantly due to Alzheimer's disease. A mean value of 85.7% was achieved for overall diagnostic accuracy, 82.4% for positive predictive value, and 87.5% for negative predictive value. Inter-reader agreement for rating scans as normal or abnormal was high (Cohen's kappa=0.87). The procedure was well tolerated with few adverse events. INTERPRETATION A revision of the International Consensus Criteria for DLB has recommended that low DAT uptake in the basal ganglia, as shown by SPECT or PET imaging, be a suggestive feature for diagnosis. Our findings confirm the high correlation between abnormal (low binding) DAT activity measured with (123)I-FP-CIT SPECT and a clinical diagnosis of probable DLB. The diagnostic accuracy is sufficiently high for this technique to be clinically useful in distinguishing DLB from Alzheimer's disease.
Collapse
|
39
|
IC–102–01: The use of DaTSCAN spect to facilitate the differential diagnosis of dementia with lewy bodies. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.2190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
40
|
Renal Artery Stenosis: Functional Assessment with Dynamic MR Perfusion Measurements—Feasibility Study. Radiology 2006; 238:586-96. [PMID: 16436819 DOI: 10.1148/radiol.2382041553] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively assess feasibility of renal magnetic resonance (MR) perfusion measurement method based on turbo fast low-angle shot sequences for grading effect of renal artery stenosis (RAS) on parenchymal perfusion. MATERIALS AND METHODS Institutional review board approved this study, and patients gave written consent. Seventy-three patients (34 male, 39 female; age range, 17-84 years) who were clinically suspected of having RAS underwent contrast material-enhanced (gadodiamide) saturation-recovery turbo fast low-angle shot imaging for measurement of renal perfusion and high-spatial-resolution MR angiography for RAS detection and grading. Degree of stenosis was evaluated as high grade (>/=75% stenosis), low to intermediate grade (>0% to <75% stenosis), or absent. High temporal resolution of the turbo fast low-angle shot sequence allowed acquisition of an exact first-pass tracing of the contrast agent bolus from which a signal intensity (SI)-time curve was derived. On the basis of this curve, mean transit time (MTT) of the contrast agent bolus, maximal upslope (MUS) of the curve, maximum SI, and time to SI peak (TTP) were calculated with a gamma variate fit. Wilcoxon rank sum test, Pearson product moment correlation, and paired t test were used for statistical analysis. RESULTS Twenty-four renal arteries had high-grade RAS, 12 renal arteries had low- to intermediate-grade RAS, and 104 renal arteries had no RAS. Significant differences between patients without stenoses or with low- to intermediate-grade stenoses and patients with high-grade stenoses were found for MTT, MUS, and TTP (P < .001). Perfusion parameters were correlated with patients' serum creatinine levels, and significant correlations were found for MTT (r = 0.41), MUS (r = 0.48), and TTP (r = 0.4), with P < .001. CONCLUSION MR perfusion parameters can be used to assess effect of RAS on parenchymal perfusion. Perfusion measurements reflect renal function as measured with serum creatinine levels.
Collapse
|
41
|
Evidence of luminal phosphatidylcholine secretion in rat ileum. Biochim Biophys Acta Mol Cell Biol Lipids 2004; 1682:63-71. [PMID: 15158757 DOI: 10.1016/j.bbalip.2004.01.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2002] [Revised: 01/05/2004] [Accepted: 01/29/2004] [Indexed: 11/28/2022]
Abstract
BACKGROUND Intestinal mucus not only facilitates substrate absorption, but also forms a hydrophobic, phosphatidylcholine (PC) enriched, barrier against luminal gut contents. METHODS For evaluation of the origin of PC in intestinal mucus, we first analyzed the mucus PC in mice with absent biliary phospholipid secretion (mdr2 (-/-) mice) using electrospray ionization (ESI) tandem mass spectroscopy (MS/MS). Second, in situ perfused rat jejunum, ileum and colon were analyzed after i.v. bolus injections of 155 pmol [(3)H]-PC. Additional in vitro experiments were performed with isolated mucosal cells after incubation with the PC precursor [(3)H]-choline. RESULTS In mdr2 (-/-) mice and control animals no significant quantitative difference in mucus PC was found, indicating that mucus PC is of intestinal and not biliary origin. In situ perfusion studies detected intestinal secretion of [(3)H]-PC, which was stimulated in presence of 2 mM taurocholate (TC). Secretion rates of [(3)H]-PC were highest in ileum (9.0+/-0.8 fmol h(-1)xcm(-1)), lower in jejunum (4.3+/-0.5) and minimal in colon (0.8+/-0.2). It compares to an intestinal secretion of native PC originating to 64% from bile, 9% from jejunum, 28% from ileum, and 1% from colon. Complementary in vitro studies showed 30-min secretion rates for [(3)H]-PC to be highest in enterocytes from ileum (26.5+/-5.3% of intracellular [(3)H]-PC) and jejunum (19.8+/-2.9%), and significantly lower in colonocytes (8.4+/-1.3%). CONCLUSION PC in the intestinal mucus originates from secretion by ileal and jejunal enterocytes.
Collapse
|
42
|
[Simultaneous vascular and endovascular surgery of complex vascular diseases]. LANGENBECKS ARCHIV FUR CHIRURGIE. SUPPLEMENT. KONGRESSBAND. DEUTSCHE GESELLSCHAFT FUR CHIRURGIE. KONGRESS 1999; 115:532-7. [PMID: 9931673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Complex vascular disease requires combined, intraoperative endovascular and reconstructive therapy. Hereby, transprosthetic, transluminal angioplasty is particularly well suited for this purpose. The 5-year patency rate after combined inguinal patch plasty and femoral balloon dilation (n = 58) was 70%. The 5-year patency rates following transgraft angioplasty, with subsequent stent implantation and cross-over bypass (n = 46) and after transprosthetic, popliteal-crural dilation was 83% and 63%, respectively. Three patients with a type IIb (after Allenberg) aneurysm were treated with an aortoiliac stent prosthesis, combined with a cross-over bypass. The follow-up examinations at 2, 16 and 36 months were uneventful.
Collapse
|
43
|
[Treatment of venous thrombosis]. DER ORTHOPADE 1993; 22:128-35. [PMID: 8497397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In the treatment of deep vein thrombosis (DVT), a rapid clinical diagnosis supported by the appropriate equipment, the age of the patient, and the extent of the thrombosis are the major determinants of successful therapy. Active and conservative treatment should be aimed at the prevention of pulmonary embolisms, rethrombosis and elimination of the thrombus, while preserving venous valvular function, which in turn is essential to avoid the development of post-thrombotic syndrome. The treatment of acute DVT remains controversial. For this reason the indication, treatment, and recently published results of thrombectomy, thrombolysis, and the possibilities for preventing DVT are discussed.
Collapse
|
44
|
Abstract
Adhesivity and aggregability of blood platelets may reflect normal and diseased states. A quantitative assessment of such reactivity should thus provide further insight into disease mechanism. The well defined conditions of stagnation point flow using platelet-rich-plasma (PRP) as fluid permit quantitative treatment of the formation of platelet microthrombi on the stagnation plate. By measuring the growth kinetics (photometry) and corresponding morphology (light- and electron microscopy) of the microthrombus, platelet adhesion as well as aggregation could be analyzed separately by means of a quantitative procedure. Parameters are evaluated for PRP samples obtained from patients exhibiting deep venous thrombosis, arterial angiopathy or myocardial infarction, respectively. The results obtained demonstrate the usefulness of the proposed method for quantifying platelet reactivity as reflected by type and degree of flow induced platelet deposition. This, in turn, provides a basis for correlating the in vitro findings with the disease state.
Collapse
|