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Co-55-PET in stroke: relation to bloodflow, oxygen metabolism and gadolinium-MRI

(1997) ACTA NEUROLOGICA BELGICA. 97(3). p.172-177
Author
Organization
Abstract
BACKGROUND: Several studies have shown the feasibility of Co-isotopes (Co-55 and Co-57) in imaging of neuronal damage in stroke, multiple sclerosis, cerebral tumors and trauma. These studies indicate that Co-isotopes allow visualization of brain pathology related to inflammatory processes, reactive gliosis and cell death. Until now, it is not clear if Co-55 accumulation occurs in the core of infarction or in the penumbra. Therefore, in the present study, we compared Co-55-PET with functional parameter such as cerebral bloodflow (rCBF) using (CO2)-O-15, oxygen metabolism (rCMRO(2)) using O-15(2) and cerebral bloodvolume (CBV) using (CO)-O-15 in PET and with the anatomical parameter Gd-MRI. PATIENTS AND METHODS: Seventeen patients (11 male; 6 female) age 43 to 84 (mean 69) with middle cerebral artery (mca) stroke, as proven by CT or MRI, were examined with Co-55-PET (0.5-1.0 mCi (CoCl2)-Co-55), (CO2)-O-15-, O-15(2)- and (CO)-O-15-PET in one session 0-30 days after stroke-onset. Regions of infarction were defined by rCMRO(2) being smaller than 65% or rCBF below 45% of the contralateral value and were subsequently superimposed on the cobalt scan. To compare the Cobalt uptake with the Gd-MRI, a realignment program was used that matches the MRI with the blood-flow images. Clinical status was established using the Orgogozo stroke scale at admission and at discharge (at least 6 weeks after admission) and the Barthel index. RESULTS: Eight patients showed a positive Co-PET scan and were used for further analysis. It appeared that Co accumulates in areas with a diminished oxygen metabolism and with a preserved bloodflow. We found Co-uptake in only a part of the Gd enhanced brain tissue with a tendency to be located peripherally or outside the Gd demarcated brain tissue. CONCLUSION: The results of the present study suggest that Co accumulates into infarcted brain tissue with a rather preserved flow independently of blood-brain barrier breakdown.
Keywords
POSITRON EMISSION TOMOGRAPHY, PROGRESSIVE MULTIPLE-SCLEROSIS, TRAUMATIC BRAIN INJURY, ACUTE ISCHEMIC STROKE, CALCIUM, NEURONS, TISSUE

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MLA
Stevens, H, HML Jansen, Jacques De Reuck, et al. “Co-55-PET in Stroke: Relation to Bloodflow, Oxygen Metabolism and gadolinium-MRI.” ACTA NEUROLOGICA BELGICA 97.3 (1997): 172–177. Print.
APA
Stevens, H, Jansen, H., De Reuck, J., Lemmerling, M., Strijckmans, K., Goethals, P., Lemahieu, I., et al. (1997). Co-55-PET in stroke: relation to bloodflow, oxygen metabolism and gadolinium-MRI. ACTA NEUROLOGICA BELGICA, 97(3), 172–177. Presented at the International Symposium on Nuclear Medicine and Clinical Neurology.
Chicago author-date
Stevens, H, HML Jansen, Jacques De Reuck, Marc Lemmerling, Karel Strijckmans, P Goethals, Ignace Lemahieu, BM De Jong, ATM Willemsen, and J Korf. 1997. “Co-55-PET in Stroke: Relation to Bloodflow, Oxygen Metabolism and gadolinium-MRI.” Acta Neurologica Belgica 97 (3): 172–177.
Chicago author-date (all authors)
Stevens, H, HML Jansen, Jacques De Reuck, Marc Lemmerling, Karel Strijckmans, P Goethals, Ignace Lemahieu, BM De Jong, ATM Willemsen, and J Korf. 1997. “Co-55-PET in Stroke: Relation to Bloodflow, Oxygen Metabolism and gadolinium-MRI.” Acta Neurologica Belgica 97 (3): 172–177.
Vancouver
1.
Stevens H, Jansen H, De Reuck J, Lemmerling M, Strijckmans K, Goethals P, et al. Co-55-PET in stroke: relation to bloodflow, oxygen metabolism and gadolinium-MRI. ACTA NEUROLOGICA BELGICA. 1997;97(3):172–7.
IEEE
[1]
H. Stevens et al., “Co-55-PET in stroke: relation to bloodflow, oxygen metabolism and gadolinium-MRI,” ACTA NEUROLOGICA BELGICA, vol. 97, no. 3, pp. 172–177, 1997.
@article{273275,
  abstract     = {BACKGROUND: Several studies have shown the feasibility of Co-isotopes (Co-55 and Co-57) in imaging of neuronal damage in stroke, multiple sclerosis, cerebral tumors and trauma. These studies indicate that Co-isotopes allow visualization of brain pathology related to inflammatory processes, reactive gliosis and cell death. Until now, it is not clear if Co-55 accumulation occurs in the core of infarction or in the penumbra. Therefore, in the present study, we compared Co-55-PET with functional parameter such as cerebral bloodflow (rCBF) using (CO2)-O-15, oxygen metabolism (rCMRO(2)) using O-15(2) and cerebral bloodvolume (CBV) using (CO)-O-15 in PET and with the anatomical parameter Gd-MRI. PATIENTS AND METHODS: Seventeen patients (11 male; 6 female) age 43 to 84 (mean 69) with middle cerebral artery (mca) stroke, as proven by CT or MRI, were examined with Co-55-PET (0.5-1.0 mCi (CoCl2)-Co-55), (CO2)-O-15-, O-15(2)- and (CO)-O-15-PET in one session 0-30 days after stroke-onset. Regions of infarction were defined by rCMRO(2) being smaller than 65% or rCBF below 45% of the contralateral value and were subsequently superimposed on the cobalt scan. To compare the Cobalt uptake with the Gd-MRI, a realignment program was used that matches the MRI with the blood-flow images. Clinical status was established using the Orgogozo stroke scale at admission and at discharge (at least 6 weeks after admission) and the Barthel index. RESULTS: Eight patients showed a positive Co-PET scan and were used for further analysis. It appeared that Co accumulates in areas with a diminished oxygen metabolism and with a preserved bloodflow. We found Co-uptake in only a part of the Gd enhanced brain tissue with a tendency to be located peripherally or outside the Gd demarcated brain tissue. CONCLUSION: The results of the present study suggest that Co accumulates into infarcted brain tissue with a rather preserved flow independently of blood-brain barrier breakdown.},
  author       = {Stevens, H and Jansen, HML and De Reuck, Jacques and Lemmerling, Marc and Strijckmans, Karel and Goethals, P and Lemahieu, Ignace and De Jong, BM and Willemsen, ATM and Korf, J},
  issn         = {0300-9009},
  journal      = {ACTA NEUROLOGICA BELGICA},
  keywords     = {POSITRON EMISSION TOMOGRAPHY,PROGRESSIVE MULTIPLE-SCLEROSIS,TRAUMATIC BRAIN INJURY,ACUTE ISCHEMIC STROKE,CALCIUM,NEURONS,TISSUE},
  language     = {eng},
  location     = {Ghent, Belgium},
  number       = {3},
  pages        = {172--177},
  title        = {Co-55-PET in stroke: relation to bloodflow, oxygen metabolism and gadolinium-MRI},
  volume       = {97},
  year         = {1997},
}