PET scans critical for early, accurate diagnosis and treatment of dementia, say researchers at SNM’s 56th Annual Meeting  

TORONTO—A new study shows that the use of positron emission tomography (PET) scans may improve the accuracy of dementia diagnoses early in disease onset for more than one out of four patients. The results were presented at SNM’s 56th Annual Meeting.  

Early, accurate diagnosis of dementia is critical for providing the best available courses of treatment and therapies in the beginning stages of disease, when treatments can be most effective. PET scans enable physicians to identify the neurological conditions underlying each patient’s mental decline and choose appropriate courses of treatment.

 “Routine clinical assessments do not accurately identify the root causes of dementia in the early stages,” said Kirk A. Frey, a physician with the University of Michigan Hospitals’ Division of Nuclear Medicine and lead author of the study. “Our preliminary results clearly indicate that molecular imaging technologies, such as PET scans, can help diagnose a patient’s specific type of dementia. This is critical for providing the best possible care. Additionally, PET’s ability to pinpoint neurological underpinnings of different forms of dementia could lead to new, more targeted drugs and therapies.”

More than 5 million people each year are newly diagnosed with dementia, a disease that takes many forms and includes memory loss or other mental impairments that interfere with daily life. The most common type of dementia is Alzheimer’s disease. Other types include frontotemporal dementia, which affects the frontal and temporal lobes of the brain, and Lewy body dementia, which involves degeneration of dopamine nerves in addition to the temporal and parietal lobes. Although these types of dementia have different causes, patients can express similar symptoms in the early stages, making accurate diagnosis difficult. Providing appropriate treatments and therapies as early as possible can avoid unnecessary, and sometimes severe, side-effects and complications.  

The new study identified 66 patients with mild dementia or mild cognitive impairment who were evaluated through standard neurological testing and anatomic brain imaging. Three clinical experts reviewed the results of these data to make diagnoses of either Alzheimer’s disease, frontotemporal dementia or dementia with Lewy bodies. Patients then underwent PET scans for amyloid deposits and for dopamine nerve integrity. Patients’ initial diagnoses changed more than 25 percent of the time after PET imaging. PET scans provided images of important signals for disease that other examinations missed, such as deposits of amyloid plaque, which are a common indicator of Alzheimer’s disease, and damage to dopamine nerves in Lewy body dementia.  

The study will track patients for two years to confirm the accuracy of their diagnoses. 

Reference:

Scientific Paper 251: K. Frey, J. Burke, B. Giodani, R. Koeppe, R. Albin, The University of Michigan, Ann Arbor, MI; “PET neurochemical vs. clinical phenotypes in mild-early dementia,” SNM’s 56th Annual Meeting, June 13-17, 2009.

SNM – Society of Nuclear Medicine, PET Scans May Improve Accuracy of Dementia Diagnosis, June 10, 2009

About SNM – Advancing Molecular Imaging and Therapy

SNM is an international scientific and medical organization dedicated to raising public awareness about what molecular imaging is and how it can help provide patients with the best health care possible. SNM members specialize in molecular imaging, a vital element of today’s medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated.  

SNM’s more than 17,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit www.snm.org.

‘No Family History’ author makes compelling case for environmental link to breast cancer and urges women, advocates, and policymakers to focus on prevention.   

PHILADELPHIA – Has the key to reducing breast cancer gotten lost in the race for a cure? A new book, No Family History, presents compelling evidence that exposure to everyday products such as cosmetics and toiletries, hormones in food, household cleaners and pesticides is behind the dramatic increase in breast cancer and argues that the solution is simple: prevention.  

“Every three minutes, one woman in the United States is diagnosed with breast cancer. Yet, most women with breast cancer defy most or all of the risk factors, including weight, diet, whether they gave birth and breast fed, and family history,” says No Family History author Sabrina McCormick, Ph.D., a Robert Wood Johnson Foundation Health & Society Scholar at the University of Pennsylvania. 

The incidence of breast cancer has increased at an alarming rate over the past 60 years. In 1940, around one in 24 women who lived to be 80 was afflicted. By 2006, that number rose to one in eight.  

In her book, McCormick cites compelling evidence showing that the reason for this dramatic increase is the rise in the production and use of cancer-causing chemicals women are exposed to on a daily basis.  

Breast cancer “hot spots” from Long Island, N.Y., to Northern California have two common threads—industrial pollution and agricultural pesticides. These “hot spots” are pockets of the United States where breast cancer has risen six times faster than the national rate. In Long Island, the incidence of breast cancer is 200 percent higher than the national average. 

“In our race for a cure for breast cancer, we have ignored the overwhelming body of evidence that demonstrates a link between products from cosmetics to pesticides and breast cancer,” McCormick says. “We must focus on prevention by demanding safer products, reducing our exposure to chemicals and urging our policymakers to ban cancer-causing chemicals in everyday products.” 

European governments responded to this scientific evidence by banning cosmetic products with certain chemicals from being sold in their countries. According to No Family History, one American cosmetics company known as much for its “pink ribbon” marketing campaigns as for its pink lipstick removed these chemicals from products sold in Europe, but these same chemicals remain in the products the company sells in the United States. 

“Women and girls should not have to check the ingredients in every stick of lipstick and each bottle of moisturizer. Better regulation to ensure that these products are safe would go a long way to reducing the incidence of breast cancer,” McCormick says. 

Many companies that profit from “pink” marketing campaigns or breast cancer treatments, McCormick argues, are the same ones fighting against tougher regulations of cancer-causing chemicals in everyday products. McCormick dubs this the “political economy” of breast cancer.

“In the case of breast cancer, many activists have unwittingly bought into campaigns leading down the road away from a cause, and instead into more and more breast cancer,” McCormick writes in her book. 

No Family History: The Environmental Links to Breast Cancer (Rowman & Littlefield) is a provocative glimpse into environmental links to breast cancer, profiling research as well as women’s stories. McCormick recommends that women reduce their exposure to many cosmetics and toiletries and urges policymakers to strengthen regulations to ban cancer-causing chemicals from being used in everyday products. 

Reference: Robert Wood Johnson Foundation Health & Society Scholars, Are everyday products from cosmetics to household cleaners causing the high rates of breast cancer? June, 15, 2009 

For more information on the book (in stores in June) and a documentary McCormick produced on the subject, visit www.nofamilyhistory.org

Recent epidemiological studies have revealed an increase in the frequency of genital malformations in male newborns (e.g., un-descended testes) and a decrease in male fertility.  

The role played by the growing presence in our environment of contaminants that reduce male hormone action could explain this phenomenon. 

It is known that the birth weight of males is higher than that of females due to the action of male hormones on the male fetus.If the exposure of pregnant women to environmental contaminants that diminish the action of male hormones has increased over the years, one would expect to see a decrease in the sex difference in birth weight.

This is exactly what a new study published in the July 2009 issue of Epidemiology shows. Investigators analyzed the Public Health Agency of Canada’s database on the birth weights of more than five million children born in Canada between 1981 and 2003.  

Using statistical methods that control for changes over time of mother’s age and parity, the investigators effectively show a sustained decrease in birth weight differences between boys and girls, which supports the hypothesis of growing endocrine disruption related to environmental contaminants. Contaminants found in plastic materials represent plausible candidates, since they are known to diminish the action of male hormones. 

“Our study underlines the importance of probing the impact of environmental contaminants on the health of mothers and fetuses and on the reproductive potential of future generations,” says lead researcher Dr. Guy Van Vliet, a pediatric endocrinologist and investigator at the Sainte-Justine University Hospital Research Center and a professor at the Department of Pediatrics of the Université de Montréal.

Reference: Sainte-Justine University Hospital Research Center, Newborn weights affected by environmental contaminants, University of Montreal, McGill University and Public Health Agency of Canada, June 15, 2009  

Sixty-five farmers reported on pesticide use and the signs and symptoms of acute pesticide poisoning when using two different plant protection strategies: in 2003 using chemical controls and in 2004 using an approach to Integrated Pest Management (IPM) based on an ecological analysis of the field conditions.

Exposure to organophosphates was confirmed as a serious risk factor for occupational poisoning. The adoption of IPM reduced the use of pesticides and halved the incidence of acute pesticide poisoning. Overall, the pesticide use spectrum shifted towards lower WHO Hazard Classes. A reduction of adverse health effects was attained through a reduction in exposure to toxic pesticides and behavioural changes. Given that other strategies to reduce the rate of acute poisoning have proven ineffective, interventions aiming to minimize pesticide poisoning in India and in other developing countries with similar rural conditions should focus on restricting the use of highly toxic compounds and educating farmers on IPM.

Reference: Mancini F, Jiggins JL, O’Malley M., Reducing the incidence of acute pesticide poisoning by educating farmers on integrated pest management in South India, Wageningen University, Int J Occup Environ Health. 2009 Apr-Jun;15(2):143-51

A local study completed in Singapore, which was part of an international multi-country study that aims to develop a global assessment of exposure to second-hand smoke in indoor workplaces, gathered data regarding the indoor air quality of public areas. It was hypothesised that air would be less polluted in non-smoking venues compared to places where smoking occurred.  

A TSI SidePak AM510 Personal Aerosol Monitor was used to sample and record the levels of respirable suspended particles (RSP) in the air. A broad range of venues were sampled in Singapore. The primary goal of data analysis was to assess the difference in the average levels of RSP in smoke-free and non smoke-free venues. Data was assessed at 3 levels: (a) the mean RSP across all venues sampled compared with the mean levels of smoke-free and non smoke-free venues, (b) levels in venues where smoking occurred compared with similar venues in Ireland, and (c) comparison between smoke-free and non smoke-free areas according to the type of venue. Statistical significance was assessed using the Mann-Whitney U-test.

The level of indoor air pollution was 96% lower in smoke-free venues compared to non smoke-free venues. Averaged across each type of venue, the lowest levels of indoor air pollution were found in restaurants (17 microg/m3) and the highest in bars (622 microg/m3); both well above the US EPA Air Quality Index hazardous level of >or=251 ug/m3.  

This study demonstrates that workers and patrons are exposed to harmful levels of a known carcinogen and toxin. Policies that prohibit smoking in public areas dramatically reduce exposure and improve worker and patron health. 

Reference: Koong HN, Khoo D, Higbee C, Travers M, Hyland A, Cummings KM, Dresler C., Global air monitoring study: a multi-country comparison of levels of indoor air pollution in different workplaces, Department of Surgical Oncology, National Cancer Centre, Singapore. Ann Acad. Med Singapore. 2009 Mar;38(3):202-6. 

Free Fulltext: Global Air Monitoring Study: A Multi-country Comparison of Levels of Indoor Air Pollution in Different Workplaces