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Another Pitfall in Brain Death Diagnosis: Return of Cerebral Function After Determination of Brain Death by Both Clinical and Radionuclide Cerebral Perfusion Imaging

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A Response to Letter To The Editor to this article was published on 20 April 2020

A Letters to the editor to this article was published on 20 April 2020

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References

  1. Wijdicks EF. Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology. 2002;58(1):20–5.

    Article  Google Scholar 

  2. Wijdicks EF, Varelas PN, Gronseth GS, et al. Evidence-based guideline update: determining brain death in adults: report of the quality standards subcommittee of the American academy of neurology. Neurology. 2010;74(23):1911–8.

    Article  Google Scholar 

  3. American College of Radiology Committee on Practice Parameters and Technical Standards. ACR-SPR practice parameter for the performance of single photon emission computed tomography (SPECT) brain perfusion imaging, including brain death examinations. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/BrainPerf-SPECT.pdf?la=en (2016). Accessed 7 Aug 2019.

  4. Joffe AR, Lequier L, Cave D. Specificity of radionuclide brain blood flow testing in brain death: case report and review. J Intensive Care Med. 2010;25(1):53–64.

    Article  Google Scholar 

  5. Brandau W, Schober O, Knapp WH. Determination of brain death with technetium-99m-HMPAO. J Nucl Med Off Publ Soc Nucl Med. 1990;31(12):2075–6.

    CAS  Google Scholar 

  6. Flowers WM Jr, Patel BR. Radionuclide angiography as a confirmatory test for brain death: a review of 229 studies in 219 patients. South Med J. 1997;90(11):1091–6.

    Article  Google Scholar 

  7. Case Reports in Critical C. Retracted: clinical brain death with false positive radionuclide cerebral perfusion scans. Case Rep Crit Care. 2016;2016:2057806.

    Google Scholar 

  8. Kramer AH. Ancillary testing in brain death. Semin Neurol. 2015;35(2):125–38.

    Article  Google Scholar 

  9. Adelstein W. Confirmation of brain death using 99m Tc HM-PAO. J Neurosci Nurs J Am Assoc Neurosci Nurses. 1994;26(2):118–20.

    Article  CAS  Google Scholar 

  10. Grunwald F, Menzel C, Pavics L, et al. Ictal and interictal brain SPECT imaging in epilepsy using technetium-99m-ECD. J Nucl Med Off Publ Soc Nucl Med. 1994;35(12):1896–901.

    CAS  Google Scholar 

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Funding

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Authors and Affiliations

  1. Department of Neurology and Neurosurgery (UH-7134), SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA

    Julius Gene S. Latorre & Elena B. Schmidt

  2. Department of Neurology, BU School of Medicine, Boston, MA, USA

    David M. Greer

Authors
  1. Julius Gene S. Latorre
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  2. Elena B. Schmidt
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  3. David M. Greer
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Contributions

JGSL, EBS, and DMG were involved in conception and design of the study. JGSL and EBS were involved in acquisition and analysis of data. JGSL, EBS, and DMG were involved in drafting a significant portion of the manuscript and figures. JGSL, EBS, and DMG were involved in revising the manuscript for important intellectual content.

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Correspondence to Julius Gene S. Latorre.

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This article does not contain any studies with human participants performed by any of the authors.

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Appendices

Appendix 1: SUNY Upstate Brain Death Checklist

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Appendix 2: SPECT Technical Detail

The data were acquired using a triple head gamma camera (Trionix, Triad XLT) equipped with low-energy high-resolution parallel beam collimators in a 128 × 128 detector element matrix over 360 degree orbits, with 120 views obtained at 3-degree intervals for 30 s per view following a circular orbit with a radius of 218 mm. The photopeak energy setting was at 140 keV with an 18% window. Transaxial images were reconstructed in a 128 × 128 matrix with attenuation correction and collimator modeling and 3.2-mm cubic voxels using the OSEM algorithm in ten iterations, OS = 30, a Butterworth post-filter (order = 5, cutoff = 1.0 cycle/cm). The reconstructed system resolution was approximately 12 mm full width at half maximum (FWHM). The images were viewed in the usual three orthogonal planes (coronal, sagittal, and transaxial) and as maximum intensity projection objects. Special care was taken to obtain good visualization of the posterior fossa and brainstem.

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Latorre, J.G.S., Schmidt, E.B. & Greer, D.M. Another Pitfall in Brain Death Diagnosis: Return of Cerebral Function After Determination of Brain Death by Both Clinical and Radionuclide Cerebral Perfusion Imaging. Neurocrit Care 32, 899–905 (2020). https://doi.org/10.1007/s12028-020-00934-2

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  • DOI: https://doi.org/10.1007/s12028-020-00934-2

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