Meta-123Iiodobenzylguanidine (123IMIBG) scintigraphy with SPECT/CT is the standard of care for diagnosing and monitoring neuroblastoma. Replacing 123IMIBG with the new PET tracer ...meta-18Ffluorobenzylguanidine (18FMFBG) and further improving sensitivity and reducing noise in a new long-axial-field-of-view (LAFOV) PET/CT scanner enable increased image quality and a faster acquisition time, allowing examinations to be performed without sedation or general anesthesia (GA). Focusing on feasibility, we present our first experience with 18FMFBG LAFOV PET/CT and compare it with 123IMIBG scintigraphy plus SPECT/CT for imaging in neuroblastoma in children. Methods: A pilot of our prospective, single-center study recruited children with neuroblastoma who were referred for 123IMIBG scintigraphy with SPECT/CT. Within 1 wk of 123IMIBG scintigraphy and SPECT/low-dose CT, 18FMFBG LAFOV PET/ultra-low-dose CT was performed 1 h after injection (1.5-3 MBq/kg) without sedation or GA, in contrast to the 24-h postinjection interval needed for scanning with 123IMIBG, the 2- to 2.5-h acquisition time, and the GA often needed in children less than 6 y old. Based on the spirocyclic iodonium-ylide precursor, 18FMFBG was produced in a fully automated good manufacturing practice-compliant procedure. We present the feasibility of the study. Results: In the first paired scans of the first 10 children included (5 at diagnosis, 2 during treatment, 2 during surveillance, and 1 at relapse), 18FMFBG PET/CT scan showed a higher number of radiotracer-avid lesions in 80% of the cases and an equal number of lesions in 20% of the cases. The SIOPEN score was higher in 50% of the cases, and the Curie score was higher in 70% of the cases. In particular, intraspinal, retroperitoneal lymph node, and bone marrow involvement was diagnosed with much higher precision. None of the children (median age, 1.6 y; range, 0.1-7.9 y) had sedation or GA during the PET procedure, whereas 80% had GA during 123IMIBG scintigraphy with SPECT/CT. A PET acquisition time of only 2 min without motion artifacts was the data requirement of the 10-min acquisition time for reconstruction to provide a clinically useful image. Conclusion: This pilot study demonstrates the feasibility of performing 18FMFBG LAFOV PET/CT for imaging of neuroblastoma. Further, an increased number of radiotracer-avid lesions, an increased SIOPEN score, and an increased Curie score were seen on 18FMFBG LAFOV PET/CT compared with 123IMIBG scintigraphy with SPECT/CT, and GA and sedation was avoided in all patients. Thus, with a 1-d protocol, a significantly shorter scan time, a higher sensitivity, and the avoidance of GA and sedation, 18FMFBG LAFOV PET/CT shows promise for future staging and response assessment and may also have a clinical impact on therapeutic decision-making for children with neuroblastoma.Meta-123Iiodobenzylguanidine (123IMIBG) scintigraphy with SPECT/CT is the standard of care for diagnosing and monitoring neuroblastoma. Replacing 123IMIBG with the new PET tracer meta-18Ffluorobenzylguanidine (18FMFBG) and further improving sensitivity and reducing noise in a new long-axial-field-of-view (LAFOV) PET/CT scanner enable increased image quality and a faster acquisition time, allowing examinations to be performed without sedation or general anesthesia (GA). Focusing on feasibility, we present our first experience with 18FMFBG LAFOV PET/CT and compare it with 123IMIBG scintigraphy plus SPECT/CT for imaging in neuroblastoma in children. Methods: A pilot of our prospective, single-center study recruited children with neuroblastoma who were referred for 123IMIBG scintigraphy with SPECT/CT. Within 1 wk of 123IMIBG scintigraphy and SPECT/low-dose CT, 18FMFBG LAFOV PET/ultra-low-dose CT was performed 1 h after injection (1.5-3 MBq/kg) without sedation or GA, in contrast to the 24-h postinjection interval needed for scanning with 123IMIBG, the 2- to 2.5-h acquisition time, and the GA often needed in children less than 6 y old. Based on the spirocyclic iodonium-ylide precursor, 18FMFBG was produced in a fully automated good manufacturing practice-compliant procedure. We present the feasibility of the study. Results: In the first paired scans of the first 10 children included (5 at diagnosis, 2 during treatment, 2 during surveillance, and 1 at relapse), 18FMFBG PET/CT scan showed a higher number of radiotracer-avid lesions in 80% of the cases and an equal number of lesions in 20% of the cases. The SIOPEN score was higher in 50% of the cases, and the Curie score was higher in 70% of the cases. In particular, intraspinal, retroperitoneal lymph node, and bone marrow involvement was diagnosed with much higher precision. None of the children (median age, 1.6 y; range, 0.1-7.9 y) had sedation or GA during the PET procedure, whereas 80% had GA during 123IMIBG scintigraphy with SPECT/CT. A PET acquisition time of only 2 min without motion artifacts was the data requirement of the 10-min acquisition time for reconstruction to provide a clinically useful image. Conclusion: This pilot study demonstrates the feasibility of performing 18FMFBG LAFOV PET/CT for imaging of neuroblastoma. Further, an increased number of radiotracer-avid lesions, an increased SIOPEN score, and an increased Curie score were seen on 18FMFBG LAFOV PET/CT compared with 123IMIBG scintigraphy with SPECT/CT, and GA and sedation was avoided in all patients. Thus, with a 1-d protocol, a significantly shorter scan time, a higher sensitivity, and the avoidance of GA and sedation, 18FMFBG LAFOV PET/CT shows promise for future staging and response assessment and may also have a clinical impact on therapeutic decision-making for children with neuroblastoma.
Bruns' syndrome and racemose neurocysticercosis: a case report Diehl Rodriquez, Roberta; Crestani, Denise Neme da Silva; Dworzecki Soares, José Otávio ...
Revista da Sociedade Brasileira de Medicina Tropical,
03/2012, Volume:
45, Issue:
2
Journal Article
Peer reviewed
Open access
Cysticercosis is an infection caused by the larval stage of the tapeworm Taenia solium. The parasite may infect the central nervous system, causing neurocysticercosis (NCC). The clinical ...manifestations depend on load, type, size, location, stage of development of the cysticerci, and the host's immune response against the parasite. The racemose variety occurs in the ventricles or basal cisterns and is a malignant form. Mobile ventricular mass can produce episodic hydrocephalus on changing head posture with attacks of headache, vomiting, and vertigo, triggered by abrupt movement of the head, a phenomenon called Bruns' syndrome (BS). We report a patient with racemose NCC and BS.
A newborn female was hospitalized due to metabolic acidosis and conjugated hyperbilirubinaemia. Extrahepatic biliary atresia (EHBA) was suspected why a (99m)Tc-mebrofenin cholescintigraphy was ...performed. It showed poor hepatocyte tracer uptake and no drainage to the gut. The hepatocyte dysfunction was caused by an obstructing adrenal gland neuroblastoma later visualised by ultrasound and MRI. The cholescintigraphy is a non-invasive modality to exclude or confirm the suspicion of EHBA. Furthermore neonatal conjugated hyperbilirubinaemia demands the use of a multimodality imaging strategy for differential diagnosis to EHBA.
A Rainbow Trout Lectin with Multimeric Structure Jensen, Liselotte E; Thiel, Steffen; Petersen, Torben E ...
Comparative Biochemistry and Physiology Part B: Biochemistry and Molecular Biology,
04/1997, Volume:
116, Issue:
4
Journal Article
Peer reviewed
A novel lectin has been identified in rainbow trout serum and plasma. The lectin binds to Sepharose (an agarose polymer) in a calcium-dependent manner. Glucose,
N-acetyl-glucosamine, mannose,
...N-acetyl-mannosamine,
l-fucose, maltose and
α-methyl-mannoside are good inhibitors of this binding, whereas glucosamine and
d-fucose inhibits to a lesser degree and mannosamine and galactose do not inhibit the binding to Sepharose. When analysed by SDS-PAGE under non-reducing conditions, the lectin appears as a characteristic ladder of bands with approximately 16 kDa between consecutive bands. Upon reduction, the lectin appears as a 16-kDa band. On size-exclusion chromatography of trout serum and plasma, the protein emerges over a broad range corresponding to sizes from about 2000 kDa to less than 200 kDa. The NH
2-terminal sequence (AAENRNQXPPG) shows no significant homology with known proteins. Because of the characteristic appearance in non-reducing SDS-PAGE and the lectin activity, we propose to name the protein “ladderlectin.”
Background
ESPRIT is a randomized trial comparing the clinical impact of interleukin (IL)‐2 plus antiretrovirals vs antiretrovirals alone. Identification of factors that influence the relationship ...between IL‐2 and CD4 count recovery will enable better personalization of treatment with IL‐2 in HIV‐1‐positive individuals. The IL‐2 induction phase consists of three dosing cycles over 6–8 months (7.5 MIU twice a day, for 5 days every 8 weeks).
Methods
We included patients initiating IL‐2 at the 7.5 MIU dose with an 8‐month CD4 count, measured at least 30 days after their last cycle. We identified baseline predictors of CD4 count changes over 8 months using linear regression.
Results
Of 2090 patients assigned IL‐2, 1673 (80%) were included in the analysis. The median (interquartile range) baseline CD4 count was 461 (370, 587) cells/μL with a median increase of 233 (90, 411) cells/μL at month 8. After adjustments, significant predictors of CD4 count change included CD4 nadir (29.8 cells/μL greater increase per 100 cells/μL higher; P<0.0001), last CD4 count before baseline (mean 36.0 cells/μL greater increase per 100 cells/μL higher; P<0.0001), time from antiretroviral start to baseline (8.3 cells/μL smaller increase per year longer; P=0.001), age (11.7 cells/μL smaller increase per 5 years older; P=0.005) and race (79.7 cells/μL greater increase for black patients vs white patients; P=0.003). A linear relationship existed between total IL‐2 dose in the first cycle and CD4 count change (73.1 cells/μL greater increase per 15 MIU higher; P<0.0001).
Conclusions
Prior nadir and current CD4 counts, age and IL‐2 dose are major determinants of CD4 increases induced by with intermittent administration of IL‐2 in HIV‐1‐positive individuals on antiretrovirals. The clinical function of these induced CD4 cells is under study.
Serum amyloid P-component (SAP) is a glycoprotein consisting of five or ten noncovalently associated identical subunits of molecular weight 19,000–30,000. Herein we report the isolation and partial ...characterization of a SAP-like protein from rainbow trout serum. The protein was isolated by calcium-dependent binding to Sepharose followed by ion-exchange and size-exclusion chromatography. Rabbit antibody against human SAP reacted with the trout protein and the NH
2-terminal sequence of 16 amino acids showed 60% identity with the first 15 residues of human SAP. SDS-PAGE and endoglycosidase treatment indicated that the trout protein is a glycoprotein in which five or six subunits are linked by disulphide bonds. The subunits have a molecular weight of 37,000 of which approximately 13% is due to carbohydrate. We propose to name the trout protein sulphide linked SAP (SL-SAP).
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