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Dana F, Maurer A, Muehlematter UJ, Husmann L, Schaab J, Mader CE, Beintner-Skawran S, Messerli M, Sah BR, Dana M, Dana M, Duhnsen SH, Mueller SA, Stadler T, Morand GB, Meerwein C, Orita E, Kaufmann PA, Huellner MW. The Monocle Sign on 18F-FDG PET Indicates Contralateral Peripheral Facial Nerve Palsy. Clin Nucl Med 2024:00003072-990000000-01082. [PMID: 38651767 DOI: 10.1097/rlu.0000000000005238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND The aim of our study was to retrospectively analyze FDG PET/CT data in patients with facial nerve palsy (FNP) for the presence of the monocle sign. PATIENTS AND METHODS A total of 85 patients with unilateral FNP were included into our study, thereof 73 with peripheral FNP and 12 with central FNP. FDG uptake (SUVmax, SUVmean, total lesion glycolysis) was measured in both orbicularis oculi muscles (OOMs). FDG uptake of paretic and nonparetic muscles was compared in patients with FNP (Wilcoxon test and Mann-Whitney U test) and was also compared with FDG uptake in 33 patients without FNP (Mann-Whitney U test). SUVmax ratios of OOM were compared. A receiver operating characteristic curve and Youden Index were used to determine the optimal cutoff SUVmax ratio for the prevalence of contralateral peripheral FNP. RESULTS The SUVmax ratio of OOM was significantly higher in patients with peripheral FNP compared with patients with central FNP and those without FNP (1.70 ± 0.94 vs 1.16 ± 0.09 vs 1.18 ± 0.21, respectively; P < 0.001). The SUVmax ratio of OOM yielded an area under the curve (AUC) of 0.719 (95% confidence interval, 0.630-0.809), with an optimal cutoff of 1.41, yielding a specificity of 94.4% and a sensitivity of 44.1% for identifying contralateral peripheral FNP. One hundred percent specificity is achieved using a cutoff of 1.91 (sensitivity, 29.4%). CONCLUSIONS Asymmetrically increased FDG uptake of the OOM (the "monocle sign") indicates contralateral peripheral FNP. A nearly 2-fold higher SUVmax represents a practically useful cutoff.
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Affiliation(s)
- Fatemeh Dana
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexander Maurer
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Urs J Muehlematter
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lars Husmann
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Schaab
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Cäcilia E Mader
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stephan Beintner-Skawran
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Messerli
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bert-Ram Sah
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Masih Dana
- Institute of Information Technology Hamfekr Gostar-Mehr-Espadan, Isfahan, Iran
| | - Mohsen Dana
- Department of Application Development and Distribution, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Simon A Mueller
- Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Thomas Stadler
- Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Christian Meerwein
- Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Philipp A Kaufmann
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Frischknecht L, Schaab J, Schmauch E, Yalamanoglu A, Arnold DD, Schwaiger J, Gruner C, Buechel RR, Franzen DP, Kolios AG, Nilsson J. Assessment of treatment response in cardiac sarcoidosis based on myocardial 18F-FDG uptake. Front Immunol 2023; 14:1286684. [PMID: 38077350 PMCID: PMC10704456 DOI: 10.3389/fimmu.2023.1286684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
Objective Immunosuppressive therapy for cardiac sarcoidosis (CS) still largely consists of corticosteroid monotherapy. However, high relapse rates after tapering and insufficient efficacy are significant problems. The objective of this study was to investigate the efficacy and safety of non-biological and biological disease-modifying anti-rheumatic drugs (nb/bDMARDs) considering control of myocardial inflammation assessed by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of the heart. Methods We conducted a retrospective analysis of treatment response to nb/bDMARDs of all CS patients seen in the sarcoidosis center of the University Hospital Zurich between January 2016 and December 2020. Results We identified 50 patients with CS. Forty-five patients with at least one follow-up PET/CT scan were followed up for a mean of 20.5 ± 12.8 months. Most of the patients were treated with prednisone and concomitant nb/bDMARDs. At the first follow-up PET/CT scan after approximately 6.7 ± 3 months, only adalimumab showed a significant reduction in cardiac metabolic activity. Furthermore, comparing all serial follow-up PET/CT scans (143), tumor necrosis factor inhibitor (TNFi)-based therapies showed statistically significant better suppression of myocardial 18F-FDG uptake compared to other treatment regimens. On the last follow-up, most adalimumab-treated patients were inactive (n = 15, 48%) or remitting (n = 11, 35%), and only five patients (16%) were progressive. TNFi was safe even in patients with severely reduced left ventricular ejection fraction (LVEF), and a significant improvement in LVEF under TNFi treatment was observed. Conclusion TNFi shows better control of myocardial inflammation compared to nbDMARDs and corticosteroid monotherapies in patients with CS. TNFi was efficient and safe even in patients with severely reduced LVEF.
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Affiliation(s)
- Lukas Frischknecht
- Department of Immunology, University Hospital Zurich (USZ), Zurich, Switzerland
| | - Jan Schaab
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Eloi Schmauch
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Artturi Ilmari (A.I) Virtanen Institute, University of Eastern Finland, Kuopio, Finland
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Ayla Yalamanoglu
- Department of Immunology, University Hospital Zurich (USZ), Zurich, Switzerland
| | - Dennis D. Arnold
- Department of Immunology, University Hospital Zurich (USZ), Zurich, Switzerland
| | - Judith Schwaiger
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Christiane Gruner
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Ronny R. Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Daniel P. Franzen
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Antonios G.A. Kolios
- Department of Immunology, University Hospital Zurich (USZ), Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Jakob Nilsson
- Department of Immunology, University Hospital Zurich (USZ), Zurich, Switzerland
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Lohaus N, Schaab J, Schaer D, Balabanov S, Huellner MW. VEXAS Syndrome With Tracheal Involvement but Absence of Vasculitis in FDG PET/CT. Clin Nucl Med 2023:00003072-990000000-00630. [PMID: 37418279 DOI: 10.1097/rlu.0000000000004770] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
ABSTRACT In early 2022, a 77-year-old man presented with weight loss and recurrent subfebrile temperatures since 6 months. Workup with CT revealed a lung infiltrate. Despite antibiotic treatment, serum inflammation markers remained high. The patient further developed eczematous skin changes, uveitis (sequentially on both eyes), and macrocytic anemia. Finally, an autoinflammatory disease was suspected, and FDG PET/CT was performed. The examination revealed metabolically active foci in several tissues (tracheal cartilage, bone marrow, muscles). Bone marrow aspiration revealed an UBA1 mutation, which is pathognomonic for VEXAS syndrome.
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Strkalj N, De Luca G, Campanini M, Pal S, Schaab J, Gattinoni C, Spaldin NA, Rossell MD, Fiebig M, Trassin M. Depolarizing-Field Effects in Epitaxial Capacitor Heterostructures. Phys Rev Lett 2019; 123:147601. [PMID: 31702200 DOI: 10.1103/physrevlett.123.147601] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/08/2019] [Indexed: 06/10/2023]
Abstract
We identify a transient enhancement of the depolarizing field, leading to an unexpected quench of net polarization, during the growth of a prototypical metal-ferroelectric-metal epitaxial system made of BaTiO_{3} and SrRuO_{3}. Reduced conductivity and, hence, charge screening efficiency in the early growth stage of the SrRuO_{3} top electrode promotes a breakdown of ferroelectric BaTiO_{3} into domains. We demonstrate how a thermal annealing procedure can recover the single-domain state. By tracking the polarization state in situ, using optical second harmonic generation, we bring new understanding to interface-related electrostatic effects in ferroelectric capacitors.
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Affiliation(s)
- N Strkalj
- Department of Materials, ETH Zurich, CH-8093 Zürich, Switzerland
| | - G De Luca
- Department of Materials, ETH Zurich, CH-8093 Zürich, Switzerland
| | - M Campanini
- Electron Microscopy Center, Empa, Swiss Federal Laboratories for Materials Science and Technology, CH-8600 Dübendorf, Switzerland
| | - S Pal
- Department of Materials, ETH Zurich, CH-8093 Zürich, Switzerland
| | - J Schaab
- Department of Materials, ETH Zurich, CH-8093 Zürich, Switzerland
| | - C Gattinoni
- Department of Materials, ETH Zurich, CH-8093 Zürich, Switzerland
| | - N A Spaldin
- Department of Materials, ETH Zurich, CH-8093 Zürich, Switzerland
| | - M D Rossell
- Electron Microscopy Center, Empa, Swiss Federal Laboratories for Materials Science and Technology, CH-8600 Dübendorf, Switzerland
| | - M Fiebig
- Department of Materials, ETH Zurich, CH-8093 Zürich, Switzerland
| | - M Trassin
- Department of Materials, ETH Zurich, CH-8093 Zürich, Switzerland
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Mundy JA, Schaab J, Kumagai Y, Cano A, Stengel M, Krug IP, Gottlob DM, Dog Anay H, Holtz ME, Held R, Yan Z, Bourret E, Schneider CM, Schlom DG, Muller DA, Ramesh R, Spaldin NA, Meier D. Functional electronic inversion layers at ferroelectric domain walls. Nat Mater 2017; 16:622-627. [PMID: 28319611 DOI: 10.1038/nmat4878] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 02/06/2017] [Indexed: 06/06/2023]
Abstract
Ferroelectric domain walls hold great promise as functional two-dimensional materials because of their unusual electronic properties. Particularly intriguing are the so-called charged walls where a polarity mismatch causes local, diverging electrostatic potentials requiring charge compensation and hence a change in the electronic structure. These walls can exhibit significantly enhanced conductivity and serve as a circuit path. The development of all-domain-wall devices, however, also requires walls with controllable output to emulate electronic nano-components such as diodes and transistors. Here we demonstrate electric-field control of the electronic transport at ferroelectric domain walls. We reversibly switch from resistive to conductive behaviour at charged walls in semiconducting ErMnO3. We relate the transition to the formation-and eventual activation-of an inversion layer that acts as the channel for the charge transport. The findings provide new insight into the domain-wall physics in ferroelectrics and foreshadow the possibility to design elementary digital devices for all-domain-wall circuitry.
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Affiliation(s)
- J A Mundy
- School of Applied and Engineering Physics, Cornell University, Ithaca, New York 14853, USA
| | - J Schaab
- Department of Materials, ETH Zurich, 8093 Zürich, Switzerland
| | - Y Kumagai
- Department of Materials, ETH Zurich, 8093 Zürich, Switzerland
| | - A Cano
- CNRS, Université de Bordeaux, ICMCB, UPR 9048, 33600 Pessac, France
| | - M Stengel
- ICREA-Institució Catalana de Recerca i Estudis Avançats, 08010 Barcelona, Spain
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC), Campus UAB, 08193 Bellaterra, Spain
| | - I P Krug
- Institut für Optik und Atomare Physik, TU Berlin, 10623 Berlin, Germany
| | - D M Gottlob
- Peter Grünberg Institute (PGI-6), Forschungszentrum Jülich, 52425 Jülich, Germany
| | - H Dog Anay
- Peter Grünberg Institute (PGI-6), Forschungszentrum Jülich, 52425 Jülich, Germany
| | - M E Holtz
- School of Applied and Engineering Physics, Cornell University, Ithaca, New York 14853, USA
| | - R Held
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York 14853, USA
| | - Z Yan
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, ETH Zurich, Otto-Stern-Weg 1, 8093 Zürich, Switzerland
| | - E Bourret
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C M Schneider
- Peter Grünberg Institute (PGI-6), Forschungszentrum Jülich, 52425 Jülich, Germany
| | - D G Schlom
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York 14853, USA
- Kavli Institute at Cornell for Nanoscale Science, Ithaca, New York 14853, USA
| | - D A Muller
- School of Applied and Engineering Physics, Cornell University, Ithaca, New York 14853, USA
- Kavli Institute at Cornell for Nanoscale Science, Ithaca, New York 14853, USA
| | - R Ramesh
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Materials Science and Engineering and Department of Physics, UC Berkeley, Berkeley, California 94720, USA
| | - N A Spaldin
- Department of Materials, ETH Zurich, 8093 Zürich, Switzerland
| | - D Meier
- Department of Materials, ETH Zurich, 8093 Zürich, Switzerland
- Department of Materials Science and Engineering, Norwegian University of Science and Technology, 7491 Trondheim, Norway
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