Direct Comparison of Tc-99m DTP A and Tc-99m HMPAO for Evaluating Brain Death

Spieth, Michael E.; Ansari, Azizullah N.; Kawada, Tom K.; Kimura, Robyn L.; Siegel, Michael E.

doi:10.1097/00003072-199410000-00005

Cited by 34 publications

(11 citation statements)

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“…18 The use of these techniques fell into disfavor in most centers after 99m Tc-HMPAO became available. All radionuclide techniques demand special equipment and logistics and are therefore also not available in all hospitals.…”

Section: Discussionmentioning

confidence: 99%

Computed tomographic angiography as a useful adjunct in the diagnosis of brain death

Welschehold

Kerz²,

Boor³

et al. 2013

Journal of Trauma and Acute Care Surgery

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Section: Discussionmentioning

confidence: 99%

Computed tomographic angiography as a useful adjunct in the diagnosis of brain death

Welschehold

Kerz²,

Boor³

et al. 2013

Journal of Trauma and Acute Care Surgery

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“…Many believe that studies using lipophilic radiopharmaceuticals (incorporating both parenchymal and angiographic phases) are superior to studies using nonlipophilic radiopharmaceuticals (which include only an angiographic phase). On direct comparison of 99m Tc-DTPA and 99m Tc-HMPAO imaging, there was complete agreement between the two methods in 14 patients with brain death and 12 patients with persistent flow (91). 99m Tc-HMPAO was considered more technically forgiving, though expensive.…”

Section: Confirmatory and Ancillary Examinationsmentioning

confidence: 84%

Radionuclide Evaluation of Brain Death in the Post-McMath Era

Zuckier

2016

J Nucl Med

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Learning Objectives: On successful completion of this activity, participants should be able to (1) relate the diagnostic protocols and recommendations regarding the clinical diagnosis of brain death; (2) list the relative advantages and disadvantages of lipophilic and nonlipophilic blood flow radiopharmaceuticals for brain blood flow studies; and (3) consider how the nuclear medicine blood flow study could assist the clinician in making the difficult diagnosis of brain death.Financial Disclosure: The author of this article has indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through October 2019.The pronouncement of death is a determination of paramount social, legal, and ethical import. The novel construct of "brain death" was introduced 50 years ago, yet there persist gaps in understanding regarding this diagnosis on the part of medical caregivers and families. The tragic, much-publicized case of Jahi McMath typifies potential problems that can be encountered with this diagnosis and serves as an effective point of departure for discussion. This article recapitulates the historical development of brain death and the evolution of scintigraphic examinations as ancillary or confirmatory studies, emphasizing updated clinical and imaging practice guidelines and the current role of scintigraphy. The limitations of clinical and radionuclide studies are then reviewed. Finally, the article examines whether radionuclide examinations might be able to play an expanded role in the determination of brain death by improving accuracy and facilitating effective communication with family members.

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“…5G) liegen noch keine ausreichend evaluierten Studien vor. Single photon emission computer tomography (SPECT)-Untersuchungen mit radioaktiv markierten Tracern, wie 99 m Technetium markiertes HMPAO oder ECD, stellen eine weitere Option der zerebralen Perfusionsuntersuchung im Rahmen der Hirntodfeststellung dar [41,42]. Hierbei fehlt im Falle des Hirntodes jegliches Signal des intrakraniellen Kompartimentes bei normaler TracerAufnahme in extrazerebralen Strukturen.…”

Section: Nachweis Der Irreversibilitätunclassified

Sonografische Methoden in der Hirntoddiagnostik

et al. 2014

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Zusammenfassung Die Hirntoddiagnostik ist eines der wichtigsten diagnostischen Verfahren in der Intensivmedizin. Nach Pr?fung der Voraussetzungen und klinischer Feststellung von Koma und Hirnstammareflexie sind sonografische Methoden zum Nachweis der Irreversibilit?t von gro?er Bedeutung. Bei entsprechender Expertise ist die sonografische Diagnose des zerebralen Zirkulationsstillstandes mit hoher Sensitivit?t und Spezifit?t m?glich, wenn intrakraniell in den Gef??en des Circulus Willisii ein Pendelfluss oder systolische Spitzen in einem Abstand von 30 Minuten detektiert werden. Allerdings sollten limitierende Faktoren beachtet werden, die die Anwendung sonografischer Methoden in der Hirntoddiagnostik einschr?nken k?nnen.

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Direct Comparison of Tc-99m DTP A and Tc-99m HMPAO for Evaluating Brain Death

Cited by 34 publications

References 0 publications

Computed tomographic angiography as a useful adjunct in the diagnosis of brain death

Computed tomographic angiography as a useful adjunct in the diagnosis of brain death

Radionuclide Evaluation of Brain Death in the Post-McMath Era

Sonografische Methoden in der Hirntoddiagnostik

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