Efficiency of 123I-ioflupane SPECT as the marker of basal ganglia damage in acute methanol poisoning: 6-year prospective study
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Observational Study
- Keywords
- 123I-ioflupane SPECT, MRI-volumetry, Methanol poisoning, basal ganglia lesion, putamen necrosis, toxic brain damage,
- MeSH
- Basal Ganglia diagnostic imaging drug effects MeSH
- Adult MeSH
- Tomography, Emission-Computed, Single-Photon methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Magnetic Resonance Imaging MeSH
- Methanol poisoning MeSH
- Basal Ganglia Diseases chemically induced diagnostic imaging MeSH
- Neuroimaging MeSH
- Nortropanes MeSH
- Prospective Studies MeSH
- Putamen diagnostic imaging drug effects MeSH
- Radiopharmaceuticals MeSH
- Iodine Radioisotopes MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Names of Substances
- ioflupane MeSH Browser
- Methanol MeSH
- Nortropanes MeSH
- Radiopharmaceuticals MeSH
- Iodine Radioisotopes MeSH
CONTEXT: Investigate whether 123I-ioflupane SPECT (DaT SPECT) has the potential as a marker of basal ganglia damage in acute methanol poisoning. METHODS: Prospective, single-centre, cohort study of patients with confirmed methanol poisoning was conducted. DaT SPECT was performed twice with semi-quantification using DaTQUANTTM and MRI-based volumetry was calculated. Specific binding ratios (SBR) of striatum, caudate nucleus, and putamen were correlated with laboratory parameters of outcome, volumetric data, and retinal nerve fibres layer (RNFL) thickness measurements. RESULTS: Forty-two patients (mean age 46.3 ± 4.2 years; 8 females), including 15 with MRI-detected putamen lesions (group I) and 27 patients with intact putamen (group II), underwent DaT SPECT. Volumetry was calculated in 35 of the patients assessed. SBR values for the left putamen correlated with putamen volume (r = 0.665; p < 0.001). Decreased bilateral SBR values were determined for the striatum and the putamen, but not for the nucleus caudate, in group I (p < 0.05). Significant correlation was observed between the SBR of the posterior putamen and arterial blood pH (r = 0.574; p < 0.001) and other toxicological parameters of severity of poisoning/outcome including serum lactate, glucose, and creatinine concentrations (p < 0.05). The SBR of the posterior putamen positively correlated with the global RNFL thickness (p < 0.05). ROC analysis demonstrated a significant discriminatory ability of SBR of the posterior putamen with AUC = 0.753 (95%CI 0.604-0.902; p = 0.007). The multivariate regression model demonstrated that arterial blood pH, age, and gender were the most significant factors associated with SBR of the posterior putamen. CONCLUSION: DaT SPECT demonstrates significant potential for the diagnosis of methanol-induced basal ganglia damage.
Department of Neurology 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Occupational Medicine 1st Faculty of Medicine Charles University Prague Czech Republic
Toxicological Information Centre General University Hospital Prague Czech Republic
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