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ABSTRACT: Demonstrate brain perfusion changes due to neuronal activation after functional electrical stimulation (FES).
It was studied 14 patients with hemiplegia who were submitted to a program with FES during fourteen weeks. Brain perfusion SPECT was performed before and after FES therapy. These patients were further separated into 2 groups according to the hemiplegia cause: cranial trauma and major vascular insults. All SPECT images were analyzed using SPM.
There was a significant statistical difference between the two groups related to patient's ages and extent of hypoperfusion in the SPECT. Patients with cranial trauma had a reduction in the hypoperfused area and patients with major vascular insult had an increase in the hypoperfused area after FES therapy.
FES therapy can result in brain perfusion improvement in patients with brain lesions due to cranial trauma but probably not in patients with major vascular insults with large infarct area.
Arquivos de neuro-psiquiatria 08/2011; 69(4):682-6. · 0.55 Impact Factor
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ABSTRACT: To compare the accuracy of SPM and visual analysis of brain SPECT in patients with mesial temporal lobe epilepsy (MTLE).
Interictal and ictal SPECTs of 22 patients with MTLE were performed. Visual analysis were performed in interictal (VISUAL(inter)) and ictal (VISUAL(ictal/inter)) studies. SPM analysis consisted of comparing interictal (SPM(inter)) and ictal SPECTs (SPM(ictal)) of each patient to control group and by comparing perfusion of temporal lobes in ictal and interictal studies among themselves (SPM(ictal/inter)).
For detection of the epileptogenic focus, the sensitivities were as follows: VISUAL(inter)=68%; VISUAL(ictal/inter)=100%; SPM(inter)=45%; SPM(ictal)=64% and SPM(ictal/inter)=77%. SPM was able to detect more areas of hyperperfusion and hypoperfusion.
SPM did not improve the sensitivity to detect epileptogenic focus. However, SPM detected different regions of hypoperfusion and hyperperfusion and is therefore a helpful tool for better understand pathophysiology of seizures in MTLE.
Arquivos de neuro-psiquiatria 04/2010; 68(2):153-60. · 0.55 Impact Factor
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ABSTRACT: Studies using radionuclides are the most appropriate method for estimating renal function. Dimercaptosuccinic acid chelate labeled with technetium-99m (99mTc-DMSA) is the radiopharmaceutical of choice for high-resolution imaging of the renal cortex and estimation of the functional renal mass. The aim of this study was to evaluate a simplified method for determining the absolute renal uptake (ARU) of 99mTc-DMSA prior to nephrectomy, using the radioactivity counts of nephrectomy specimens as the gold standard.
Prospective study at the Division of Nuclear Medicine, Department of Radiology, Universidade Estadual de Campinas.
Seventeen patients (12 females; range 22-82 years old; mean age 50.8 years old) underwent nephrectomy for various reasons. Renal scintigraphy was performed three to four hours after intravenous administration of a mean dose of 188.7 MBq (5.1 mCi) of 99mTc-DMSA, which was done six to 24 hours before surgery. The in vivo renal uptake of 99mTc-DMSA was determined using the radioactivity of the syringe before the injection (measured using a dose calibrator) and the images of the syringe and kidneys, obtained from a scintillation camera. After surgery, the reference value for renal uptake of 99mTc-DMSA was determined by measuring the radioactivity of the nephrectomy specimen using the same dose calibrator.
The ARU measurements were very similar to those obtained using the reference method, as determined by linear regression (r-squared = 0.96).
ARU estimation using the proposed method before nephrectomy seems to be accurate and feasible for routine use.
Sao Paulo Medical Journal 06/2008; 126(3):150-5. · 0.71 Impact Factor
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Giuliano Mendes Duarte,
César Cabello,
Renato Zocchio Torresan,
Marcelo Alvarenga,
Gilliat H Q Telles,
Susana Trigo Bianchessi,
Nelson Caserta,
Silmara R Segala, Mariana da Cunha Lopes de Lima,
Elba Cristina Sá de Camargo Etchebehere,
Edwaldo E Camargo,
Eduardo Tinois
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ABSTRACT: To achieve a more specific method to estimate the real size of breast cancer, we have developed a method to fuse magnetic resonance imaging (MRI) and scintimammography (SM) images. The aim of this study was to assess the feasibility of this method and to evaluate its accuracy to measure the size of breast cancer compared with MRI alone, mammography, and clinical examination, employing pathologic size as the gold standard.
Twenty consecutive breast cancer women at stages IIA-IIIA, scheduled for mastectomies, underwent SM with (99m)Tc-sestamibi and MRI with gadolinium 2-10 days before surgery. All patients had had recent mammographies and were examined clinically. Software was developed in visual language to perform the fusion between MRI and SM images and tumor measurements (MRI/SM). The tumor size, in 3 diameters (anteroposterior, longitudinal, and transverse), for each examination was correlated with pathological measurements using linear regression.
The MRI/SM technique was successfully performed in all patients, and the principal tumor was measured by this method. The MRI/SM cancer measurements correlated better with pathology than MRI, mammography, and clinical exam in all diameters analyzed (r = 0.88, 0.81, 0.81; SE = 0.11, 0.14, 0.11 in anteroposterior, longitudinal, and transverse diameters, respectively).
The MRI/SM is a feasible technique and appears to be more accurate than other examinations (MRI alone, mammography, and clinical exam) to measure breast cancer size.
Annals of Surgical Oncology 11/2007; 14(10):2903-10. · 4.17 Impact Factor
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ABSTRACT: The diagnosis of repetitive strain injury (RSI) is subjective and solely based on clinical signs and physical examination. The aim of this paper was to assess the usefulness of three-phase bone scintigraphy (TPBS) in diagnosing RSI.
Prospective study at the Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP).
Seventy-three patients (mean age 31.2 years; 47 males) with clinical suspicion of RSI in the upper limbs were studied. A total of 127 joints with suspicion of RSI were studied. The shoulders, elbows and wrists were analyzed semi-quantitatively, using the shafts of the humeri and ulnae as references. The results were compared with a control group of 40 normal individuals. The patients signs and symptoms were used as the "gold standard" for calculating the probabilities.
From visual analysis, abnormalities were observed in the flow phase for four joints, in the blood pool phase for 11 joints and in the delayed images for 26 joints. Visual analysis of the joints of the control group did not show any abnormalities. Semi-quantitative analysis showed that most of the patients joint ratios were normal. The exceptions were the wrists of patients with left-sided RSI (p = 0.0216). However, the sensitivity (9%) and accuracy (41%) were very low.
TPBS with semi-quantitative analysis has very low sensitivity and accuracy in the detection of RSI abnormalities in the upper limbs.
Sao Paulo Medical Journal 06/2006; 124(3):145-9. · 0.71 Impact Factor
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Giuliano Mendes Duarte,
César Cabello dos Santos,
Renato Zocchio Torresan,
Marcelo Alvarenga,
Gilliat H Q Telles,
Susana Trigo Bianchessi,
Nelson Caserta,
Silmara R Segala, Mariana da Cunha Lopes de Lima,
Elba Cristina Sá de Camargo Etchebehere,
Edwaldo E Camargo
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ABSTRACT: The purpose of this study was to evaluate the feasibility of surgery radioguided with intravenous (99m)Tc sestamibi associated with magnetic resonance imaging (MRI) of the breast to detect tumor extent and guide complete tumor resection. A descriptive experimental study was developed with 10 breast cancer patients (stage IIA-IIB) who underwent mastectomy. From 2 to 10 days before surgery, the patients underwent breast MRI with 0.1 mmol/kg of gadolinium and scintimammography with a 740 MBq of (99m)Tc sestamibi. A region of interest was drawn around the tumor image and an uptake curve as a function of time was plotted to calculate the optimal time to perform radioguided surgery. In the perioperative period, the same dose of (99m)Tc sestamibi was intravenously injected into the patients. Tumor resection was performed under the guidance of a gamma probe. MRI was used to evaluate the skin and deep fascia involvement and to detect occult tumor foci which were also excised. Subsequently a modified radical mastectomy was performed. Tumor and residual breast were histopathologically examined. In a series of 10 women, all demonstrated (99m)Tc sestamibi uptake in tumor cells. Eight patients showed no disease in the residual breast, one presented with one foci of invasive ductal carcinoma measuring 0.5 cm in diameter located 5 cm from the tumor bed, and one presented with one foci of ductal carcinoma in situ measuring 0.8 cm at the resection margin. The mean tumor size in the histopathologic assessment was 3.3 cm and in MRI was 5.0 cm. Radioguided surgery using (99m)Tc sestamibi associated with MRI is a feasible technique that can be employed in tumor resection.
The Breast Journal 12(3):202-7. · 1.64 Impact Factor
