Imaging of mild traumatic brain injury using 57Co and 99mTc HMPAO SPECT as compared to other diagnostic procedures.
BACKGROUND
Traumatic brain injury (TBI) is usually assessed with the Glasgow Coma Scale (GCS), CT and EEG. TBI can result from either the primary mechanical impact or secondary (ischemic) brain damage, in which calcium (Ca) plays a pivotal role. This study was undertaken to compare the applicability of SPECT using 57Co as a Ca-tracer in patients with mild traumatic brain injury.


METHODS
8 patients with mild TBI (GCS 15) were clinically examined and studied with EEG, neuropsychological testing (NPT) and SPECT within 2 days post-TBI. After i.v.-administration of 37 MBq (1 mCi) 57Co (effective radiation dose 0.34 mSv x MBq(-1); 1.24 rem x mCi(-1); physical half-life 270 days, biological half-life 37.6 h), single-headed SPECT (12 h pi) was performed, consecutively followed by standard 925 MBq (25 mCi) Tc-99m HMPAO SPECT.


RESULTS
In 6 of the 8 patients, baseline NPT and SPECT showed focal abnormalities in the affected frontal and temporal brain regions, which were in good topographical accordance. CT and EEG did not detect (structural) lesions in any of these cases.


CONCLUSIONS
Single-headed 57Co-SPECT is able to show the site and extent of brain damage in patients with mild TBI, even in the absence of structural lesions. It may confirm and localize NPT findings. The predictive value of 57Co-SPECT should be assessed in larger patient series.
Audenaert
Kurt
K
Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium. kurt.audenaert@Ugent.be
Jansen
Hugo M L
HM
Otte
Andreas
A
Peremans
Kathelijne
K
Vervaet
Myriam
M
Crombez
Roger
R
de Ridder
Leo
L
van Heeringen
Cees
C
Thirot
Joel
J
Dierckx
Rudi
R
Korf
Jaap
J
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000175:diagnosis*; D003037:Cobalt Radioisotopes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed
D003037:Cobalt Radioisotopes; D015609:Organotechnetium Compounds; D013667:Technetium