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The Journal of Nuclear Medicine Vol. 39 No. 2 298-302
© 1998 by Society of Nuclear Medicine
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Cerebral Perfusion Scanning in Treating AIDS Dementia: A Pilot Study

Edwin R. Szeto, Judith Freund, Bruce J. Brew, Amanda Loder and Matthew R. Griffiths

Department of Nuclear Medicine and Department of Neurology and Center for Immunology, St. Vincent's Hospital, Sydney, Australia

Correspondence: For correspondence or reprints contact: Edwin Szeto, Department of Nuclear Medicine, St.Vincent's Hospital, Victoria St., Darlinghurst, Sydney 2010, Australia.

ABSTRACT

Acquired immunodeficiency syndrome (AIDS) dementia complex (ADC) is a common effect of the AIDS virus. We studied the regional cerebral blood flow of patients with early ADC and its response to atevirdine mesylate. Methods: Ten men with early ADC, who had failed or were intolerant to zidovudine or didanosine therapy, were treated with atevirdine mesylate for 12 wk. Cerebral perfusion SPECT using 99mTc-HMPAO was performed at Week 0 and Week 12. SPECT images were analyzed qualitatively and semiquantitatively. Results: The cerebral perfusion abnormalities in early ADC were usually mild and characteristically involved the cortices and periventricular regions bilaterally and symmetrically. Four patients were able to complete the protocol. Three of these patients responded to atevirdine clinically, two of whom showed improvement in their Week 12 SPECT images. The other responder had an essentially unchanged image. The patient who did not respond to atevirdine showed a definite deterioration in cerebral perfusion. Conclusion: Cerebral perfusion SPECT is useful in detecting and assessing therapeutic responses in ADC. The preliminary results of atevirdine in treating ADC are promising and need further investigation.

Key Words: AIDS • dementia • technetium-99m-HMPAO • atevirdine






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Copyright © 1998 by the Society of Nuclear Medicine.