Adjustable syringe helps doctors see inside brain

Device marks breakthrough in epilepsy research

The new adjustable syringe allows staff to accurately inject a radioactive dye into a patient’s body at the end of an epileptic fit

Doctors could be able pinpoint the exact area in the brain where epileptic fits begin, thanks to a new device.

The test could help reduce the need for highly-invasive investigations when used in tandem with other tests, according to scientists and technologists from Sheffield Teaching Hospitals NHS Foundation Trust.

Spilt-seconds make all the difference when a patient is having an epileptic fit, and giving patients who are often shaking and moving the precise amounts of a radioactive dye within the required 20 seconds is virtually impossible with a normal syringe

Nuclear medicine scientists and technologists the trust have developed an adjustable syringe guard for injecting radioactive tracers, which are used in imaging tests to find problems inside the body. The tracers give off particles that can be detected and turned into a picture.

The adjustable syringe allows staff to accurately inject a radioactive dye into a patient’s body at the end of a fit. This dye traces the blood flow in the patient’s brain, and helps to locate areas of abnormal blood flow in parts of the brain. Ideally the radioactive material must be given within about 20 seconds for doctors to clearly see which areas of the brain experience these changes in blood flow.

This is often challenging as epileptic patients suffer from severe convulsions, jerks and twitches. Radioactive material also decays over a certain timescale, and because it is impossible to know when a patient is going to have a fit, the setting on the syringe holder must be reset every half an hour to ensure that the correct amount is given.

About half an hour after injection, a large gamma camera, capable of detecting high-energy gamma rays rather than normal light, is used to scan the patient’s brain to see where the radioactive dye has gone. The resulting images show up as abnormal areas of blood flow, and can be critical in pinpointing where heightened nerve cell activity takes place during a seizure. /

Thanks to this adjustable device, we have improved the accuracy of the test and ensured the patient does not get given more radiation doses than necessary

Philip Hillel, a consultant healthcare scientist from the medical physics department at the Royal Hallamshire Hospital, said: “Spilt-seconds make all the difference when a patient is having an epileptic fit, and giving patients who are often shaking and moving the precise amounts of a radioactive dye within the required 20 seconds is virtually impossible with a normal syringe. Thanks to this adjustable device, we have improved the accuracy of the test and ensured the patient does not get given more radiation doses than necessary.

“When looked at alongside other diagnostic tests, the 3D images produced from this scan can confirm the exact area in the brain where abnormal activity begins, sometimes without the need for other highly-invasive investigations which could involve potential damage to parts of the brain.”

Another advantage is that the syringe better protects staff from the radioactive gamma rays as it is made of lead and stainless steel.

The adjustable syringe was designed and built by John Wilson and his team in the clinical engineering workshops at Sheffield Teaching Hospitals NHS Foundation Trust. It is now routinely used at the Royal Hallamshire Hospital, the Northern General and the Children’s Hospital. One device costs £400 to manufacture, but can be made at a cheaper cost if ordered in bulk.

The device marks a breakthrough in the care of epileptic patients

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