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Wednesday, August 18, 1999 Published at 18:07 GMT 19:07 UK


Brain scans diagnose vCJD

Examining brain tissue is the only way to be sure it is vCJD

The human form of 'mad cow disease' could be diagnosed using a brain scan, according to a British radiologist.

At the moment it is extremely difficult to diagnose variant Creutzfeldt-Jakob disease (vCJD) as it does not bear all the characteristics of the classic form of CJD.

While that produces a distinct pattern of brain wave activity in sufferers, the new variant version does not and can only be identified after death when the brain is examined.

However, a radiologist from Newcastle says that if doctors can develop an experienced eye, they may be able to identify the condition using a standard brain scan.

Scarring in the brain

Dr Alan Coulthard, a consultant radiologist at the Royal Victoria Infirmary in Newcastle upon Tyne, says vCJD could be identified by scarring deep inside the brain that shows up during magnetic resonance imaging (MRI) scans.

[ image: A scan does not require tissue to be removed]
A scan does not require tissue to be removed
This is not seen in cases of classic CJD.

Dr Coulthard compared the brain scans of three patients diagnosed with vCJD with 14 from patients without the disease.

He found a higher intensity of certain signals in the vCJD patients than among the others.

However, the difference is very subtle and it is not yet certain whether it is a reliable indicator that the disease is present, Dr Coulthard said.

And doctors would have difficulty identifying the scarring because they see so few cases of vCJD compared to other brain conditions - there have only been 43 confirmed or probable cases between the discovery of the disease in 1994-95 and July 1999.

Non-invasive test

However, using the new study as an example of what to look for to identify vCJD - or to rule it out - radiologists could be able to provide a non-invasive method of diagnosis, Dr Coulthard told BBC News Online.

"It will be helpful in terms of making an early diagnosis, because the other ways of detecting the disease are very invasive, so it will be very helpful to have a non-invasive test," he said.

At the moment, examining a piece of the patient's brain is the best way to be certain they have the disease, and the only other tests to have shown real potential so far involve removing tissue.

Meanwhile a blood test to diagnose the disease is still under development in Leeds.

Less anxiety

Dr Coulthard said the existence of a brain scan test could help calm the fears of patients and their families.

"It might prevent angst in patients who may have similar findings but don't have vCJD," he said.

"So instead of going through invasive tests you'll be able to say if you've got a normal MRI scan - if these findings are verified - that you don't need to go through those tests," he said.

Dr Coulthard's work was published in the British Journal of Radiology and reported in New Scientist magazine.

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