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Cobalt-55 positron emission tomography in recurrent ischaemic stroke
J De Reuck1, P Santens, J Keppens
1PET Centre UZ/RUG, University Hospital, Gent, Belgium. jdereuck@allserv.rug.ac.be
Clinical Neurology and Neurosurgery
|June 1, 1999
Summary
Cobalt-55 (55Co) positron emission tomography (PET) effectively detects recent recurrent strokes by showing high tracer uptake in new infarcts. Older strokes show lower uptake, aiding in differentiating stroke recurrence over time.
Area of Science:
- Neurology
- Nuclear Medicine
- Radiochemistry
Background:
- Stroke recurrence poses a significant clinical challenge, particularly in identifying recent events in patients with prior infarcts.
- Distinguishing recent from older infarcts is crucial for appropriate management and therapeutic decisions.
Purpose of the Study:
- To evaluate the utility of Cobalt-55 (55Co) positron emission tomography (PET) in detecting and differentiating recent, recurrent strokes in patients with a history of stroke in the same vascular territory.
- To assess the changes in 55Co uptake ratios in infarcts of varying ages.
Main Methods:
- Fourteen patients with recurrent strokes underwent brain 55Co PET imaging.
- Quantification of 55Co uptake ratios in recently infarcted areas (less than 2 months old), older infarcts (6 months to 1 year, and older than 2 years), and compared to normal brain tissue.
Main Results:
- Recently infarcted areas (<2 months) exhibited a high 55Co uptake ratio.
- Infarcts aged 6 months to 1 year showed uptake ratios similar to normal brain tissue.
- Infarcts older than 2 years demonstrated decreased 55Co uptake ratios compared to controls.
- The temporal changes in 55Co uptake correlate with the inflammatory response within the infarct core.
Conclusions:
- 55Co PET is a viable method for demonstrating stroke recurrence.
- The dynamic changes in 55Co uptake over time can help differentiate infarct age.
- Single photon emission tomography (SPECT) using 57Co may offer a more accessible alternative for routine clinical use in assessing stroke recurrence.