Pet investigation of radiation induced sequelae of the spinal cord

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dc.contributor.advisorTrón, Lajos
dc.contributor.authorLengyel, Zsolt
dc.contributor.departmentDE -- Orvos- és Egészségtudományi Centrum -- Általános Orvostudományi Kar -- PET Centrumhu
dc.contributor.departmentElméleti orvostudományok doktori iskolahu
dc.date.accessioned2007-05-15T17:35:53Z
dc.date.available2007-05-15T17:35:53Z
dc.date.created2003
dc.date.defended2004-04-21
dc.description.abstractRadiation myelopathy is a rare, but highly feared complication of radiotherapy. In vivo characterization of radiation induced pathological processes by functional imaging methods has only recently become possible, most promisingly by positron emission tomography (PET). Although data about the pathomorphology of radiation related damage abound, previous PET studies have provided only limited information on the radiation-induced reactions of the central nervous system (CNS). Data on spinal cord damage are practically not available, since the reported investigations focus exclusively on the pathological changes of the brain, most probably because of the low spatial resolution of PET cameras. We have carried out PET studies on a total of 5 patients suffering from different forms of radiation induced damage of the spinal cord in order to complete the information having been obtained by conventional imaging and non-imaging diagnostic methods. One patient represents a case with complete recovery of the spinal cord following a subthreshold dose of irradiation. Two nasopharyngeal cancer patients were investigated due to permanent Lhermitte’s sign after radiotherapy. We have reported on PET findings in a patient with partially reversible radiation myelopathy, which were later correlated with autopsy results after her demise. A patient with radiogenic lower motor neuron disease was also investigated by PET. All patients exhibited increased FDG accumulation indicating elevated levels of glucose metabolism in those spinal cord segments that had been included in the radiation fields. Regional tissue perfusion measurements with [15O]butanol showed parallel results, excluding severe deterioration of microcirculation. The increased tracer uptake observed can properly be attributed to a higher energy demand, since glucose is the primary fuel to nervous tissue. The need of this extra energy could not be attributed to cell proliferation on the basis of either the anamnestic data or the pathologic findings, and was further supported by the results of [11C]methionine PET measurements. The restoration of axonal conduction, reflected by the improvement of the clinical symptoms, suggests that an alternative conduction mechanism (continuous impulse propagation) takes place in order to overcome the blockade caused by the loss of myelin sheath. This implies an elevated number of Na+-channels resulting in more effective Na+/K+-pump function, hence higher ATP demand.en
dc.description.degreePh.D. thesis ; Positron Emission Tomograph Centre, University of Debrecen, Medical and Health Science Centre, Faculty of Medicine, 2003hu
dc.description.degreePhDhu_HU
dc.format.extent104, [21] pen
dc.format.extent454801 bytes
dc.format.extent263835 bytes
dc.format.extent2801095 bytes
dc.format.mimetypeapplication/pdf
dc.format.mimetypeapplication/pdf
dc.format.mimetypeapplication/pdf
dc.identifier.urihttp://hdl.handle.net/2437/2285
dc.languageenghu
dc.language.isohuen
dc.language.isoenen
dc.rightsA kéziratos phd munkák csak a szerzői jogok maradéktalan tiszteletben tartásával használhatókhu
dc.subject.disciplineElméleti orvostudományokhu
dc.subject.sciencefieldOrvostudományokhu
dc.titlePet investigation of radiation induced sequelae of the spinal corden
dc.title.subtitlePh.D. thesisen
dc.title.translatedA gerincvelő sugársérülésének PET-vizsgálataen
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