Specificity of radionuclide brain blood flow testing in brain death: Case report and review

Journal of Intensive Care Medicine

Volumn 25, Issue 1, 2010, Pages 53-64

  Joffe, Ari R ^a   Lequier, Laurance ^a   Cave, Dominic ^a  

^a STOLLERY CHILDREN S HOSPITAL   (Canada)

Author keywords

Brain death; Organotechnetium compounds; Radiopharmaceuticals; Single photon emission computed tomography (SPECT); Technetium Tc 99m exametazime

Indexed keywords

AMMONIA; GLUCOSE; HEXAMETHYLPROPYLENE AMINE OXIME TECHNETIUM TC 99M; TECHNETIUM COMPLEX; VASOPRESSIN;

ANGIOGRAPHY; BLOOD PRESSURE; BRAIN BLOOD FLOW; BRAIN DEATH; CASE REPORT; DIABETES INSIPIDUS; ELECTROLYTE BLOOD LEVEL; FEMALE; GLASGOW COMA SCALE; HUMAN; INFANT; PRIORITY JOURNAL; RESUSCITATION; REVIEW; SENSITIVITY AND SPECIFICITY; SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY;

BRAIN; BRAIN DEATH; CEREBROVASCULAR CIRCULATION; FEMALE; HUMANS; INFANT; SENSITIVITY AND SPECIFICITY; TOMOGRAPHY, EMISSION-COMPUTED, SINGLE-PHOTON; TOMOGRAPHY, X-RAY COMPUTED;

EID: 76149141274     PISSN: 08850666     EISSN: 15251489     Source Type: Journal    
DOI: 10.1177/0885066609355388     Document Type: Review

References (67)

1. Shemie SD, Doig C., Dickens B., et al, for the Pediatric Reference Group; Neonatal Reference Group. Severe brain injury to neurological determination of death: Canadian forum recommendations. CMAJ. 2006 ; 174 (6). S1 - S12.
2. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Practice parameters for determining brain death in adults (summary statement). Neurology. 1995 ; 45 (5). 1012-1014.
3. Heran MKS, Heran HS, Shemie SD A review of ancillary tests in evaluating brain death. Can J Neurol Sci. 2008 ; 35 (4). 409-419.
4. Shemie SD, Lee D., Sharpe M., Tampieri D., Young B., Canadian Critical Care Society, for the participants in the expert consensus meeting on brain blood flow in the neurological determination of death. Brain blood flow in the neurological determination of death: Canadian expert report. Can J Neurol Sci. 2008 ; 35 (2). 140-145.
5. Schober O., Galaske R., Heyer R. Determination of brain death with 123I-IMP and 99mTc-HM-PAO. Neurosurg Rev. 1987 ; 10 (1). 19-22.
6. Galaske RG, Schober O., Heyer R. 99mTc-HM-PAO and 123I-amphetamine cerebral scintigraphy: a new, non invasive method in determination of brain death in children. Eur J Nucl Med. 1988 ; 14 (9-10). 446-452. (Pubitemid 18240609)
7. Laurin NR, Driedger AA, Hurwitz GA, et al. Cerebral perfusion imaging with technetium-99m HM-PAO in brain death and severe central nervous system injury. J Nucl Med. 1989 ; 30 (10). 1627-1635.
8. Reid RH, Gulenchyn KY, Ballinger JR Clinical use of technetium-99m HM-PAO for determination of brain death. J Nucl Med. 1989 ; 30 (10). 1621-1626.
9. Reid RH, Gulenchyn KY, Ballinger JR, Ventureyra ECG. Cerebral perfusion imaging with technetium-99m HMPAO following cerebral trauma: initial experience. Clin Nucl Med. 1990 ; 15 (6). 383-388.
10. de la Riva A., Gonzalez FM, Llamas-Elvira JM, et al. Diagnosis of brain death: superiority of perfusion studies with 99Tcm-HMPAO over conventional radionuclide cerebral angiography. Br J Radiol. 1992 ; 65 (772). 289-294.
11. Schlake HP, Bottger IG, Grotemeyer KH, Husstedt IW, Brandau W., Schober O. Determination of cerebral perfusion by means of planar brain scintigraphy and 99mTc-HMPAO in brain death, persistent vegetative state and severe coma. Intensive Care Med. 1992 ; 18 (2). 76-81.
12. Wilson K., Gordon L., Selby JB Sr. The diagnosis of brain death with Tc-99m HMPAO. Clin Nucl Med. 1993 ; 18 (5). 428-434.
13. Muttini P., Dagnino N. 99mTc-HMPAO and mobile gamma-camera in the diagnosis of brain death. J Nucl Biol Med. 1994 ; 38 (1). 14-17.
14. Singh NC, Reid RH, Loft JA, Frewen TC, Parker BL, Dhillon JS Usefulness of Tc99m HM-PAO scan in supporting clinical brain death in children: uncoupling flow and function. Clin Intensive Care. 1994 ; 5 (2). 71-74.
15. Spieth ME, Ansari AN, Kawada TK, Kimura RL, Siegel ME Direct comparison of Tc-99m DTPA and Tc-99m HMPAO for evaluating brain death. Clin Nucl Med. 1994 ; 19 (10). 867-872.
16. Mrhac L., Zakko S., Parikh Y. Brain death: the evaluation of semiquantitative parameters and other signs in HMPAO scintigraphy. Nucl Med Commun. 1995 ; 16 (12). 1016-1020.
17. Kurtek RW, Lai KKY, Tauxe WN, Eidelman BH, Fung JJ Tc-99m Hexamethylpropylene Amine Oxime scintigraphy in the diagnosis of brain death and its implications for harvesting of organs used for transplantation. Clin Nucl Med. 2000 ; 25 (1). 7-10.
18. Lopez-Navidad A., Caballeero F., Domingo P., et al. Early diagnosis of brain death in patients treated with central nervous system depressant drugs. Transplantation. 2000 ; 70 (1). 131-135.
19. Harding JW, Chatterton BE Outcomes of patients referred for confirmation of brain death by 99mTc-exametazime scintigraphy. Intensive Care Med. 2003 ; 29 (4). 539-543.
20. Appelt EA, Song WS, Phillips WT, Metter DF, Salman UA, Blumhardt R. The ĝĝhot noseĝ™ĝ™ sign on brain death nuclear scintigraphy: where does the flow really go ? Clin Nucl Med. 2008 ; 33 (1). 55-57.
21. Erbengi A., Erbengi G., Cataltepe O., Topcu M., Erbas B., Aras T. Brain death: determination with brain stem evoked potentials and radionuclide isotope studies. Acta Neurochir. 1991 ; 112 (3-4). 118-125.
22. Wieler H., Marohl K., Kaiser KP, Klawki P., Frossler H. Tc-99m HMPAO cerebral scintigraphy: a reliable, noninvasive method for determination of brain death. Clin Nucl Med. 1993 ; 18 (2). 104-109.
23. Bonetti MG, Ciritella P., Vallc G., Perrone E. 99mTc HM-PAO brain perfusion SPECT in brain death. Neuroradiol. 1995 ; 37 (5). 365-369.
24. Yoshikai T., Tahara T., Kuroiwa T., et al. Plain CT findings of brain death confirmed by hollow skull sign in brain perfusion SPECT. Radiat Med. 1997 ; 15 (6). 419-424.
25. Facco E., Zucchetta P., Munari M., et al. 99mTc-HMPAO SPECT in the diagnosis of brain death. Intensive Care Med. 1998 ; 24 (9). 911-917.
26. Kahveci SF, Bekar A., Tamgac F., Korfali G., Alper E. Tc-99 HMPAO cerebral SPECT imaging to confirm brain death in patients with complex spinal automatism. Turkish J Trauma Emergency Surg. 2002 ; 8 (4). 198-201.
27. Al-Shammri S., Al- Feeli M. Confirmation of brain death using brain radionuclide perfusion imaging technique. Med Princ Pract. 2004 ; 13 (5). 267-272.
28. Okuyaz C., Gucuyener K., Karabacak NI, Aydin K., Serdaroglu A., Cingi E. Tc-99m-HMPAO SPECT in the diagnosis of brain death in children. Pediatr Int. 2004 ; 46 (6). 711-714.
29. Munari M., Zucchetta P., Carallo C., et al. Confirmatory tests in the diagnosis of brain death: comparison between SPECT and contrast angiography. Crit Care Med. 2005 ; 33 (9). 2068-2073.
30. Kraft O., Samlik J., Chmelova J. The diagnosis of brain death- own experience. Nucl Med Reviews. 2006 ; 9 (2). 132-137.
31. Larar G., Nagel JS Technetium-99m-HMPAO cerebral perfusion scintigraphy: considerations for timely brain death declaration. J Nucl Med. 1992 ; 33 (12). 2209-2213.
32. Schauwecker DS Tc-99m HMPAO brain survival study reveals flow to the cerebrum but none to the cerebellum. Clin Nucl Med. 1992 ; 17 (12). 984-985.
33. Costa DC, Motteux IMJ, McCready AC Diagnosis of brain death with technetium 99m hexamethylpropylene amine oxime. Eur J Nucl Med. 1991 ; 18 (7). 503-506.
34. Yatim A., Mercatello A., Coronel B., et al. 99mTc-HMPAO cerebral scintigraphy in the diagnosis of brain death. Transplant Proc. 1991 ; 23 (5). 2491.
35. Medlock MD, Hanigan WC, Cruse RP Dissociation of cerebral blood flow, glucose metabolism, electrical activity in pediatric brain death. Case report. Neurosurg. 1993 ; 79 (5). 752-755.
36. Adelstein W. Confirmation of brain death using 99m Tc HMPAO. J Neurosci Nurs. 1994 ; 26 (2). 118-120.
37. Idea RJ, Lewis DH Timely diagnosis of brain death in an emergency trauma center. AJR Am J Roentgenol. 1994 ; 163 (4). 927-928.
38. Spieth M., Abella E., Sutter C., Vasinrapee P., Wall L., Ortiz M. Importance of the lateral view in the evaluation of suspected brain death. Clin Nucl Med. 1995 ; 20 (11). 965-968.
39. Lu G., Wj S., Uy R. Findings on Tc-99m HMPAO brain imaging in brain death. Clin Nucl Med. 1996 ; 21 (11). 891-893.
40. Roine RO, Launes J., Lindroth L., Nikkinen P. 99mTchexamethylpropyleneamine oxime scans to confirm brain death. Lancet. 1986 ; 328 (8517). 1223-1224.
41. Abdel-Dayem HM, Bahar RH, Sigurdsson GH, Sadek S., Olivecrona H., Ali AM The hollow skull: a sign of brain death in Tc-99m HM-PAO brain scintigraphy. Clin Nucl Med. 1989 ; 14 (12). 912-916.
42. Takehara Y., Takahashi M., Isoda H., et al. Scintigraphic evaluation of brain death with 99mTc-d,l-Hexamethyl-propyleneamine oxime (HMPAO). Radioisotopes. 1989 ; 38 (8). 335-338.
43. Valle G., Ciritella P., Bonetti MG, Dicembrino F., Perrone E., Perna GP Considerations of brain death on a SPECT cerebral perfusion study. Clin Nucl Med. 1993 ; 18 (11). 953-954.
44. Ala TA, Kuhn MJ, Johnson AJ A case meeting clinical brain death criteria with residual cerebral perfusion. Am J Neuroradiol. 2006 ; 27 (9). 1804-1806.
45. George MS Establishing brain death: the potential role of nuclear medicine in the search for a reliable confirmatory test. Eur J Nucl Med. 1991 ; 18 (2). 75-77.
46. Wijdicks EFM. Determining brain death in adults. Neurology. 1995 ; 45 (5). 1003-1011.
47. Weckesser M., Schober O. Brain death revisitied: utility confirmed for nuclear medicine. Eur J Nucl Med. 1999 ; 26 (11). 1387-1391.
48. Borght TV, Laloux P., Maes A., Salmon E., Goethals I., Goldman S. Belgian Society for Nuclear Medicine: guideline for brain radionuclide imaging. Acta Neurol Belg. 2001 ; 101 (4). 196-209.
49. Donohoe KJ, Frey KA, Gerbaudo VH, Mariani G., Nagel JS, Shulkin B. Procedure guideline for brain death scintigraphy. J Nucl Med. 2003 ; 44 (5). 846-851.
50. Conrad GR, Sinha P. Scintigraphy as a confirmatory test of brain death. Semin Nucl Med. 2003 ; 33 (4). 312-323.
51. Young GB, Shemie SD, Doig CJ, Teitelbaum J. Brief review: the role of ancillary tests in the neurological determination of death. Can J Anesth. 2006 ; 53 (6). 533-539.
52. American College of Radiology. ACR Practice Guideline for the performance of single photon emission computed tomography (SPECT) brain perfusion and brain death studies. 2007 ; http://www.acr.org/SecondaryMainMenuCategories/quality- safety/guidelines/nuc-med/ct-spect-brain-perfusion.aspx. Accessed February 11, 2009.
53. Zuckier LS, Kolano J. Radionuclide studies in the determination of brain death: criteria, concepts, controversies. Semin Nucl Med. 2008 ; 38 (4). 262-273.
54. Flowers WM Jr, Patel BR Radionuclide angiography as a confirmatory test for brain death: a review of 229 studies in 219 patients. Southern Med J. 1997 ; 90 (11). 1091-1096.
55. Grigg MM, Kelly MA, Celesia GG, Ghobrial MW, Ross ER Electroencephalographic activity after brain death. Arch Neurol. 1987 ; 44 (9). 948-954.
56. Borch K., Greisen G. 99mTc-HMPAO as a tracer of cerebral blood flow in newborn infants. J Cerebral Blood Flow Metab. 1997 ; 17 (4). 448-454. (Pubitemid 27188541)
57. Altman DI, Powers WJ, Perlman JM, Herscovitch P., Volpe SL, Volpe JJ Cerebral blood flow requirement for brain viability in newborn infants is lower than in adults. Ann Neurol. 1988 ; 24 (2). 218-226.
58. Drake B., Ashwal S., Schneider S. Determination of cerebral death in the pediatric intensive care unit. Pediatrics. 1986 ; 78 (1). 107-112.
59. Mejia RE, Pollack MM Variability in brain death determination practices in children. JAMA. 1995 ; 274 (7). 550-553.
60. Mathur M., Petersen L., Stadtler M., et al. Variability in pediatric brain death determination and documentation in Southern California. Pediatrics. 2008 ; 121 (5). 988-993.
61. Joffe AR The neurological determination of death: what does it really mean ? Issues Law Med. 2007 ; 23 (2). 119-140.
62. Shewmon DA Mental disconnect: ĝ€physiological decapitationĝ€™ as a heuristic for understanding brain death. In: Msgr Marcelo Sanchez Sorondo HE, ed. Working Group on the Signs of Death 11-12 September 2006. Vatican City: Pontifica Academia Scientiarum ; 2007: 292-333.
63. Miller FG, Truog RD Rethinking the ethics of vital organ donations. Hastings Cent Rep. 2008 ; 38 (6). 38-46.
64. Shewmon DA Chronic ĝ€ĝ€brain deathĝ€ ™ĝ€™: meta-analysis and conceptual consequences. Neurology. 1998 ; 51 (6). 1538-1545.
65. Presidentĝ€™s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Defining Death: Medical, Legal and Ethical Issues in the Determination of Death. Washington, DC: U.S. Government Printing Office ; 1981.
66. Presidentĝ€™s Council of Bioethics. Controversies in the Determination of Death. Washington, DC: Presidentĝ€™s Council of Bioethics ; 2008.
67. Shewmon DA Brain death: can it be resuscitated? Hastings Cent Rep. 2009 ; 39 (2). 18-24.