123I-Iomazenil: A Quantitative Study of the Central Benzodiazepine Receptor Distribution

Regina C. Haldemann; Ivette Bicik; A. Pfeiffer; H. G. Wieser; P. H. Hasler; P. Schubiger; G. K. von Schulthess

doi:10.1055/s-0038-1629608

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1992; 31(03): 91-97
DOI: 10.1055/s-0038-1629608

Originalarbeiten

Schattauer GmbH

¹²³I-Iomazenil: A Quantitative Study of the Central Benzodiazepine Receptor Distribution

Regina C. Haldemann

¹From the Division of Nuclear Medicine, Department of Medical Radiology, Villigen, Switzerland

,

Ivette Bicik

¹From the Division of Nuclear Medicine, Department of Medical Radiology, Villigen, Switzerland

,

A. Pfeiffer

¹From the Division of Nuclear Medicine, Department of Medical Radiology, Villigen, Switzerland

,

H. G. Wieser

²The Clinic and Policlinic of Neurology, University Hospital, Zurich, Switzerland

,

P. H. Hasler

³The Paul Scherrer Institute, Villigen, Switzerland

,

P. Schubiger

³The Paul Scherrer Institute, Villigen, Switzerland

,

G. K. von Schulthess

¹From the Division of Nuclear Medicine, Department of Medical Radiology, Villigen, Switzerland

› Author Affiliations

Abstract

Zusammenfassung

Mit dem neuen Benzodiazepinrezeptor-Marker ¹²³I-Iomazenil und SPECT wurden 14 Patienten mit Temporallappen-Epilepsie (TE), 9 Patienten mit Amygdalo-Hippokampektomie (AHE) und drei gesunde Versuchspersonen untersucht. Die Patienten mit TE wurden ausschließlich interiktal untersucht. Vergleichend wurden Hirnperfusions-Studien mit ^99mTc-HMPAO und SPECT durchgeführt und eine quantitative ROI-Analyse berechnet. Diese quantitative Analyse bestand aus Rechts/Links-Verhältnissen für ¹²³I-lomazenil SPECT wobei Werte von 1 mit geringgradigen Standardabweichungen beobachtet wurden. Die ROI-Auswertungen des medialen okzipitalen, frontalen, parietalen Kortex, des Zerebellums und der weißen Substanz zeigten eine Benzodiazepin-rezeptor-Verteilung, die in Übereinstimmung mit den bereits mit PET und in der Autoradiographie gemachten Beobachtungen stand, wenn die Schichten in ¹²³I-lomazenil und ^99mTc-HMPAO zueinander ins Verhältnis gebracht wurden. Die Pathologie der Temporallappen soll in dieser Arbeit nicht diskutiert werden.

Summary

Fourteen patients with temporal lobe epilepsy, 9 patients after amygdalohippocampectomy and 3 healthy volunteers were examined with the new benzodiazepine receptor marker ¹²³I-lomazenil and SPECT. For comparison perfusion SPECT studies with ^99mTc-H M PAO were done and a quantitative ROI analysis of the data performed. This quantitative analysis consisted of calculation of right-to-left ratios for ¹²³I-lomazenil SPECTs, whereby values of 1 were obtained with narrow standard deviations. ROI measurements of the medial occipital, frontal and parietal cortex, the cerebellum and white matter showed a pattern of benzodiazepine receptor concentration in concordance with that previously found in PET and autoradiographic studies, if ¹²³I-lomazenil ROIs were normalized to the corresponding ^99mTc-HMPAO ROIs. The abnormal distribution in the temporal lobes will not be discussed in this paper.

Schlüsselwörter

Temporallappen-Epilepsie - Benzodiazepin-Rezeptor - quantitative SPECT

Key words

Temporal lobe epilepsy - benzodiazepine receptor - quantitative SPECT

Full Text

References

REFERENCES
1 Bartenstein B, Ludolph A, Schober O. et al. Benzodiazepine-receptors and cerebral blood flow in partial epilepsy. Eur J Nucl Med 1991; 18: 111-8.
2 Beer HF, Bläuenstein PA, Hasler PH. et al. In vitro and in vivo evaluation of [¹²³I]-Ro 16-0154: A new imaging agent for SPECT investigations of benzodiazepine receptors. J Nucl Med 1990; 31: 1007-14.
3 Bonte FJ. et al. Single-photon tomographic study of regional cerebral blood flow in epilepsy, a preliminary report. Arch Neurol 1983; 40: 267-70.
4 Chavoix C, Hantraye PH, Brouillet E. et al. Status epilepticus induced by pentylenetetrazole modulates in vivo [ⁿC]Ro 15-1788 binding to benzodiazepine receptors. Effects of ligands acting at the supramolecular receptor complex. Eur J Pharmacol 1988; 146: 207-14.
5 Leonard JP, Nowotnik DP, Neirinckx RD. Technetium-99m-d, I-HM-PAO: A new radiopharmaceutical for imaging regional brain perfusion using SPECT. A comparison with Iodine-123 HIPDM. J Nucl Med 1986; 27: 1819-23.
6 Mindus P, Ehrin E, Ericsson L. et al. Central benzodiazepine receptor binding studied with 11-C labelled Ro 15-1788 and positron emission tomography. Pharmacopsychiat 1986; 19: 2-3.
7 Pappata S, Samson Y. Chavoix et al. Regional specific binding of [¹¹C]RO 15-1788 to central type benzodiazepine receptors in human brain: Quantitative evaluation by PET. J Cerebr Blood Flow Metab 1988; 08: 304-13.
8 Persson A, Ehring E, Eriksson L. et al. Imaging of [¹¹C]-labelled Ro 15-1788 binding to benzodiazepine receptors in the human brain by positron emission tomography. J Psychiat Res 1985; 19: 609-22.
9 Podreka I, Lang W, Suess E. et al. HMPAO SPECT in epilepsy. Human Science Press Brain Topography 1988; 01: 55-60.
10 Podreka I, Suess E, Goldenberg G. et al. Initial experience with technetium-99m HM-PAO brain SPECT. J Nucl Med 1987; 28: 1657-66.
11 Ribak CE. Axon terminals of GABAergic chandelier cells are lost at epileptic foci. Brain Res 1985; 326: 251-60.
12 Rowe ChC, Berkovic SF, Sia STB. et al. Localisation of epileptic foci with postictal single photon emission computed tomography. Ann Neurol 1989; 26: 660-8.
13 Samson Y. et al. Kinetics and displacement of [C11]R015-1788, a benzodiazepine antagonist, studies in human brain in vivo by positron tomography. Eur J Pharmacol 1985; 110: 247-51.
14 Savic I, Persson A, Roland P. et al. In vivo demonstration of reduced benzodiazepine receptor binding in human epileptic foci. The Lancet 1988; ii: 863-6.
15 Schulthess GKvon, Ketz E, Schubiger PA, Bekier A. Regional quantitative noninvasive assessment of cerebral perfusion and function with N Isopropyl [¹²³I]-p-Iodoamphetamine. J Nucl Med 1985; 26: 9-16.
16 Shepp LA, Logan BE. The Fourier reconstruction of a head section. IEEE Trans Nucl Sei 1974; NS-21 21-43.
17 Sherwin A, Robitaille Y, Quesney F. et al. Exitatory amino acids are elevated in human epileptic cerebral cortex. Neurol 1988; 38: 920-3.
18 Shinoto H, Yamasaki T, Inoue O. et al. Visualization of specific binding sites of benzodiazepine in human brain. J Nucl Med 1986; 27: 1593-9.
19 Stefan H, Pawlik G, Biicher-Schwarz HG. et al. Functional and morphological abnormalities in temporal lobe epilepsy: a comparison of interictal EEG, CT, MRI, SPECT and PET. J Neurol 1987; 234: 377-84.
20 Stefan H, Bauer J, Feistei H. et al. Regional cerebral blood flow during focal seizures of temporal and frontocentral onset. Ann Neurol 1990; 27: 162-6.
21 Wieser HG. Selective amygdalohippocampectomy for temporal lobe epilepsy. Epilepsia 1988; 29 (Suppl. 02) 100-13.
22 Wieser HG, Moser S. Improved multipolar foramen ovale electrode monitoring. J Epilepsy 1988; 01: 13-22.
23 Yasargil MG, Wieser HG. Selective amygdalohippocampectomy at the university hospital Zurich. In Surgical treatment of the epilepsies. Engel J. ed. New York: Raven Press; 1987: 653-8.