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9:05 - 9:20 am: SPECT and PECT perfusion changes after CCSVI restoration - Paolo Zamboni

Objectives:
•Define use of cerebral SPECT and PECT in relation to restricted venous outflow through the internal jugular vein
•Describe qualitative and quantitative criteria for assessment of cerebral venous outflow normalized to inflow in vein collaterals and in the major venous routes.
•Discuss modality of SPECT and PECT quantification respect to normal data base.
•Show and discuss results of a pilot study showing post op changes

Sharon wrote:Joan and Cece -

Dr. Zamboni's presentation on SPECT imaging is especially timely for me personally. In January, while I am in Miami for the ISET Conference, I will have the opportunity to be imaged with SPECT.

The team I will be working with in Florida is using SPECT imaging to measure traumatic brain injury. Diffuse brain injuries, which occur in the MS population, http://www.ncbi.nlm.nih.gov/pubmed/16230320 are hard to detect by MRI or CT but, they are noticeable in metabolic imaging i.e. SPECT. The brain SPECT imaging looks at blood flow and the activity of the brain. It can help to identify if trauma is present and which brain system or systems are affected. Once identified, therapies can be designed. It sounds as if Dr. Zamboni is using the SPECT image as a measurement for CCSVI treatment.

It will be interesting to have this new information.

Sharon

Sharon wrote:I believe the difference is between focal and diffuse brain damage. MRI is great for focal imaging, but the SPECT shows diffuse damage more distinctly. I will be imaged by a triple head SPECT which is more precise than the single. Diffuse damage is more prevalent in secondary progressive - focal in relapsing remitting.
Blood flow is imaged - I am unsure about blood volume. So much to learn...

differentiated cells do proliferate in vivo, generally via mitosis. Cancerous cells proliferate excessively, with no control from the cell cycle. Due to these facts stem cells aren't the only cell type to proliferate. With regards to the potency of the cells, zygotic cells are totipotent - meaning they can differentiate into any of the somatic cells of the organism. Adult stem cells however have lost some of their potency and are Pluripotent- They can only differentiate into the three germ layers, Ectoderm, mesoderm (if present) and Endoderm.

1eye wrote:

differentiated cells do proliferate in vivo, generally via mitosis. Cancerous cells proliferate excessively, with no control from the cell cycle. Due to these facts stem cells aren't the only cell type to proliferate. With regards to the potency of the cells, zygotic cells are totipotent - meaning they can differentiate into any of the somatic cells of the organism. Adult stem cells however have lost some of their potency and are Pluripotent- They can only differentiate into the three germ layers, Ectoderm, mesoderm (if present) and Endoderm.

- http://www.biology-online.org/biology-f ... rm#p152805

...which, if true, means that anyone trying to rely on adult stem cells to undo the ravages of "MS", may be barking up a dead tree, or flogging the wrong horse, or something....

Sharon wrote:I believe the difference is between focal and diffuse brain damage. MRI is great for focal imaging, but the SPECT shows diffuse damage more distinctly. I will be imaged by a triple head SPECT which is more precise than the single. Diffuse damage is more prevalent in secondary progressive - focal in relapsing remitting.
Blood flow is imaged - I am unsure about blood volume. So much to learn...

Personally I like having all information possible

SPECT and PECT Perfusion Changes after CCSVI Restoration
Paolo Zamboni, M.D.

Background: A number of MRI studies clearly show hypoperfusion of brain parenchyma in different neurodegenerative disorders, including MS. However, the contribution of cerebral venous return to brain reduced perfusion was not previously studied by the means of single-photon emission computed tomography (SPECT) and/or positron emission tomography (PET).

Methods: Pilot study 1. Five (5) patients affected by chronic cerebrospinal venous insufficiency (CCSVI) proven by combination of Doppler venous ultrasound and catheter venography, associated either with Huntington disease or multiple sclerosis (MS) underwent venous angioplasty of the extracranial and extravertebral veins. Cerebral metabolism and perfusion were preoperatively investigated by the means of PET, followed by Statistical Parametric Mapping (SPM) analysis. This is a software developed to analyze statistically brain activity recorded by several techniques including PET, fMRI and more. To perform SPM, a pre-processing step was performed for the subsequent actual processing analysis. PET and SPM analysis were performed respectively the day of the procedure and 24 h after the procedure. Pilot study 2. Fifteen (15) patients with complex extracranial primary venous obstruction were studied both by Doppler venous ultrasound with quantification of cerebral venous return and MRV. They underwent to open surgical reconstruction. Brain perfusion was performed the day preceding the operation and 30 days later.

Results: Pilot study 1. SPM analysis comparing pre and post procedural brain activity showed significant improvement especially in the cerebral cortex. Pilot study 2. All the selected patients showed significant hypoperfusion of brain parenchyma as compared to Neurogam-SPM data base of normality. Analysis of SPECT changes by comparing pre and post operative semiquantitative analysis are still in course.
Conclusions: both pilot evaluations confirm reduced perfusion in CCSVI condition of the brain with associated neurodegenerative disorders. Improvement of perfusion following venous outflow restoration seems to indicate impairment of venous outflow haemodynamics as a contributor to reduced parenchymal perfusion.

Conclusions: both pilot evaluations confirm reduced perfusion in CCSVI condition of the brain with associated neurodegenerative disorders. Improvement of perfusion following venous outflow restoration seems to indicate impairment of venous outflow haemodynamics as a contributor to reduced parenchymal perfusion.

Dr. Zamboni is getting ahold of some really high tech imaging equipment. No more ultrasound....and as he has found....

SPECT is sensitive in detecting impairment of regional cerebral function when CT or MRI shows only nonspecific findings such as cerebral atrophy.

Sharon wrote:Recently, I had a SPECT scan. I will post a summary of the experience and of my scan in the next few weeks.

Cece wrote:

Sharon wrote:Recently, I had a SPECT scan. I will post a summary of the experience and of my scan in the next few weeks.

Very interested in this. I don't understand SPECT well at all and, if Dr. Zamboni is presenting on it, it's undoubtedly worth understanding.